A patient with cystic fibrosis has blood glucose levels that are consistently between 180 to 250 mg/dL. Which action will the nurse expect to implement?
Teach the patient about administration of insulin.
Give oral hypoglycemic medications before meals.
Discuss the role of diet in blood glucose control.
Evaluate the patient’s use of pancreatic enzymes.
The Correct Answer is A
Choice A reason: CF-related diabetes (CFRD) from pancreatic damage requires insulin, as glucose of 180-250 mg/dL indicates insulin deficiency. Teaching administration addresses this directly, aligning with standard CFRD management for glycemic control.
Choice B reason: Oral hypoglycemics aren’t effective in CFRD, which stems from insulin lack, not resistance. Glucose levels of 180-250 mg/dL need insulin, making this inappropriate for CF’s unique endocrine pathology.
Choice C reason: Diet impacts glucose, but CFRD requires insulin first, not just dietary control. Levels of 180-250 mg/dL exceed dietary management alone, so this is secondary to initiating insulin therapy in CF.
Choice D reason: Pancreatic enzymes aid digestion in CF, not glucose control directly. Evaluating use is routine, but hyperglycemia of 180-250 mg/dL points to CFRD, necessitating insulin over enzyme adjustment.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: A cardiac diet (low sodium, low fat) supports blood pressure control long-term by reducing vascular strain. However, it’s less immediate than addressing adherence, as dietary change alone won’t correct current medication misuse driving the elevation.
Choice B reason: Cardiac assessment identifies complications like hypertrophy, useful for monitoring. It’s reactive, not proactive, and doesn’t address the root issue of inconsistent adherence, which directly impacts blood pressure control and outcomes now.
Choice C reason: Medication education tackles adherence, the primary cause of uncontrolled hypertension here. Teaching proper use ensures therapeutic levels, reducing pressure via vasodilation or fluid control, directly improving outcomes with evidence-based efficacy.
Correct Answer is C
Explanation
Choice A reason: Pleural effusion with chest discomfort suggests fluid buildup, causing pain but not immediate airway compromise. It’s stable compared to tracheal deviation, prioritizing respiratory distress over this less acute issue.
Choice B reason: Cor pulmonale with 4+ edema indicates chronic right heart failure, a serious but slower process. It’s less urgent than acute airway obstruction, as it’s manageable with diuretics, not an immediate threat.
Choice C reason: Tracheal deviation post-catheter insertion signals tension pneumothorax, a life-threatening emergency. It compresses airways and vessels, requiring immediate assessment and intervention to restore breathing and circulation.
Choice D reason: Fever of 101°F post-lung transplant suggests infection or rejection, critical but not airway-immediate. It’s urgent, yet tracheal deviation’s acute respiratory collapse takes precedence over this systemic concern.
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