A nurse is teaching a client with diabetes mellitus about chronic complications associated with the disease. Which information should be included in the teaching?

Ensure adequate fluid intake to prevent kidney damage

Schedule and keep appointments for annual eye exams

Podiatry exams are necessary every 3 months

Excessive exercise increases insulin resistances

Answer and Explanation

Correct Answer : B,C

A.   While maintaining adequate hydration is important for overall health and can help the kidneys function properly, this statement alone does not capture the full scope of kidney-related issues associated with diabetes, such as diabetic nephropathy. It’s important to emphasize regular monitoring of kidney function through lab tests (e.g., microalbuminuria) as part of diabetes management.
B.   People with diabetes are at increased risk for eye complications such as diabetic retinopathy, cataracts, and glaucoma. Regular eye exams are essential for early detection and management of these conditions, making this information critical for a client with diabetes.
C.   Many sources recommend at least annual foot exams, but those with neuropathy or previous foot problems may need more frequent evaluations (every 3 to 6 months). This statement is generally accurate but should be tailored to the individual's risk factors.
D.   Regular physical activity is generally recommended for individuals with diabetes as it improves insulin sensitivity, helping to manage blood glucose levels. While extreme exercise without proper management can lead to complications, stating that excessive exercise increases insulin resistance is misleading. The key is to balance exercise with proper nutrition and medication.

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Correct Answer is A

Explanation

A. Heparin acts quickly to provide immediate anticoagulation, while warfarin takes several days to reach therapeutic levels. Heparin ensures that the client is adequately anticoagulated during the initial phase while waiting for warfarin to take effect.
B. Neither heparin nor warfarin directly dissolves clots. They are both anticoagulants that prevent further clot formation and allow the body's natural processes (fibrinolysis) to break down the existing clot over time. The combination does not specifically facilitate the dissolution of clots.
C. This statement is misleading. The use of both medications is not primarily about reducing the doses. Instead, each medication has its own dosing based on the patient’s needs, and the combination is used for timing and efficacy rather than dose reduction.
D. While heparin does provide immediate anticoagulation, saying it provides "maximum protection" could be misleading. It does ensure effective anticoagulation in the short term, but the maximum effectis related to individual response and therapeutic levels, which vary. Additionally, once warfarin reaches therapeutic levels, it becomes the primary agent for long-term anticoagulation.

A. Prepare to administer prescribed epinephrine B. Assess the client's apical pulse and blood pressure C. Stop infusing the client's intravenous antibiotic D. Administer 4 liters of oxygen via nasal cannula

Correct Answer is C

Explanation

A. While epinephrine is crucial in cases of anaphylaxis, it should not be the first action taken. The immediate priority is to stop the offending medication.
B. While assessing vital signs is important, it is not the first action. The primary concern is to halt the exposure to the potential allergen.
C. The first action in this situation should be to immediately stop the infusion of the antibiotic. This prevents further exposure to the allergen and is critical to managing the potential anaphylactic reaction.

D. While providing oxygen may be necessary later if the client is hypoxic, the immediate priority is to stop the infusion of the antibiotic first. Administering oxygen is important but comes after halting the offending agent.

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A nurse is teaching a client with diabetes mellitus about chronic complications associated with the disease. Which information should be included in the teaching?

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Naxlex Comprehensive Predictor Exams

A client is receiving heparin sodium 5000 units IV and oral warfarin sodium 2.5 mg PO for thrombophlebitis in the left leg. The nurse educated the client that heparin and warfarin are both used because:

Correct Answer is A

Explanation

Ten minutes after initiating an intravenous antibiotic, the client complains of shortness of breath, itching, and difficulty swallowing. What is the nurse's initial action?

Correct Answer is C

Explanation

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