A patient diagnosed with Type 1 diabetes reports a blood glucose level of 210 mg/dL and symptoms of a sore throat, cough, and fever.
What advice should the nurse give to the patient?

Limit intake to non-caloric containing liquids until the glucose is within normal limits.

Decrease intake of carbohydrates until blood glucose level is less than 100 mg/dL.

Monitor blood glucose levels every 4 hours and notify the doctor if it continues to rise.

Only administer the morning prescribed dose of insulin.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Limiting intake to non-caloric containing liquids until the glucose is within normal limits is not the best advice for a patient with Type 1 diabetes reporting a blood glucose level of 210 mg/dL and symptoms of a sore throat, cough, and fever. While it’s important to stay hydrated, especially when sick, it’s also crucial to maintain a balanced diet to provide the body with necessary nutrients for recovery.

Choice B rationale

Decreasing intake of carbohydrates until blood glucose level is less than 100 mg/dL is not recommended. Carbohydrates are a primary source of energy, and reducing their intake could lead to low blood sugar or hypoglycemia, which can be dangerous.

Choice C rationale

Monitoring blood glucose levels every 4 hours and notifying the doctor if it continues to rise is the best advice. When a patient with diabetes is sick, their blood glucose levels can rise due to the stress the body is under. Regular monitoring allows for timely adjustments in insulin dosage and helps prevent diabetic ketoacidosis, a serious complication.

Choice D rationale

Administering only the morning prescribed dose of insulin is not advisable. Insulin requirements can increase when a person with diabetes is sick. Therefore, sticking to the regular insulin regimen without adjustments could lead to high blood sugar or hyperglycemia.

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Correct Answer is C

Explanation

A heart murmur due to mitral valve disease is typically heard loudest over the mitral area, which is located at the fifth intercostal space in the left midclavicular line.

A. Heparin makes the blood less thick and easier to flow. B. Heparin dissolves the clot and decreases the formation of platelets. C. Heparin does not thin the blood; it prevents new clots from forming. D. Heparin decreases the number of platelets so the blood flows more easily.

Correct Answer is C

Explanation

Choice A rationale

Heparin does not actually thin the blood or make it less thick. Instead, it works by increasing the activity of antithrombin, a protein that inhibits blood clotting. This prevents new clots from forming and existing clots from growing larger.

Choice B rationale

Heparin does not dissolve clots or decrease the formation of platelets. Its primary action is to increase the activity of antithrombin, which in turn inactivates thrombin and factor Xa, two key players in the blood clotting process.

Choice C rationale

This statement is accurate. Heparin does not thin the blood; instead, it prevents new clots from forming and existing clots from growing larger. It does this by increasing the activity of antithrombin, which in turn inactivates thrombin and factor Xa.

Choice D rationale

Heparin does not decrease the number of platelets or make the blood flow more easily. Its primary action is to increase the activity of antithrombin, which in turn inactivates thrombin and factor Xa.

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A patient diagnosed with Type 1 diabetes reports a blood glucose level of 210 mg/dL and symptoms of a sore throat, cough, and fever. What advice should the nurse give to the patient?

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with a heart murmur due to mitral valve disease. Where would the nurse hear the murmur the loudest?

Correct Answer is C

Explanation

A patient diagnosed with deep vein thrombosis asks the nurse, “How does this blood thinner heparin work?” Which response is most accurate?

Correct Answer is C

Explanation

Choice A rationale

Choice B rationale

Choice C rationale

Choice D rationale

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A patient diagnosed with Type 1 diabetes reports a blood glucose level of 210 mg/dL and symptoms of a sore throat, cough, and fever.
What advice should the nurse give to the patient?