A patient with type 1 diabetes has a high morning glucose measurement and the healthcare provider wants the patient evaluated for possible Somogyi effect. The nurse will plan to

obtain the patient's blood glucose level between 2a.m-4a.m

check the patient for a change in level of consciousness between 2a.m-4a.m

withhold the night time snack and check the glucose at 6:00a.m.

administer an increased dose of NPH insulin in the evening

Answer and Explanation

The Correct Answer is A

A. Obtain the patient's blood glucose level between 2a.m-4a.m – Correct Answer. The Somogyi effect occurs when nighttime hypoglycemia triggers a rebound hyperglycemia in the morning. Checking the blood glucose level during the early morning hours helps confirm this phenomenon.

B. Check the patient for a change in level of consciousness between 2a.m-4a.m – Incorrect. While severe hypoglycemia can affect consciousness, the best way to confirm the Somogyi effect is through blood glucose monitoring.

C. Withhold the nighttime snack and check the glucose at 6:00 a.m. – Incorrect. A nighttime snack can help prevent the hypoglycemia that leads to the Somogyi effect.

D. Administer an increased dose of NPH insulin in the evening. – Incorrect. Increasing insulin could worsen nighttime hypoglycemia, making the Somogyi effect worse.

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Correct Answer is D

Explanation

A. Stating "this is where you live now" may cause frustration.

B. Telling the patient it is safer does not acknowledge their emotions.

C. Mentioning family decisions may increase anxiety.

D. This approach validates the patient’s feelings and redirects the conversation without causing distress.

A. Check the patient's blood temperature. B. Administer an oral analgesic. C. Perform a complete blood count. D. Evaluate the patient's neurological status.

Correct Answer is A

Explanation

A. Check the patient’s blood temperature. – Correct Answer. A headache and stiff neck are classic signs of meningitis. Fever is another key symptom, so checking temperature helps confirm suspicion and guides urgent intervention.

B. Administer an oral analgesic. – Incorrect. Pain management is secondary. The priority is assessing for infection (meningitis).

C. Perform a complete blood count. – Incorrect. While a CBC may show elevated WBCs, immediate assessment is more urgent.

D. Evaluate the patient’s neurological status. – Incorrect. While neurological assessment is important, confirming fever as an infection indicator is the first step.

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A patient with type 1 diabetes has a high morning glucose measurement and the healthcare provider wants the patient evaluated for possible Somogyi effect. The nurse will plan to

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse at a community health clinic is caring for a patient who reports a headache and stiff neck. Which of the following actions should the nurse take first?

Correct Answer is A

Explanation

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