An adult client with type 2 diabetes mellitus (DM2) is to be admitted within the next hour to the medical unit from the emergency department. The client's laboratory findings indicate that

the serum glucose is 175 mg/dL (9.63 mmol/L) and the A1c is 9%.
When requesting a dinner tray for the client, which menu should the nurse select?

Reference Ranges:

Blood glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)] HbA1C [Good diabetic control: less than 7%]

Vegetarian lasagna with cheese and spinach, tossed green salad with ranch dressing, and fresh fruit.

Lean hamburger with cheese, tomato, and lettuce on a whole-wheat bun, and angel food cake.

Fried chicken breast, mashed potatoes, green beans, sliced tomatoes, and fresh apple pie.

Grilled fish with whole-grain brown rice, steamed broccoli, and pear poached in red wine.

Answer and Explanation

The Correct Answer is D

A. Vegetarian lasagna with cheese and spinach, tossed green salad with ranch dressing, and fresh fruit. This meal option contains carbohydrates from the lasagna, salad dressing, and fruit, which can raise blood glucose levels.
B. Lean hamburger with cheese, tomato, and lettuce on a whole-wheat bun, and angel food cake.

This meal option contains carbohydrates from the bun and angel food cake, which can raise blood glucose levels.
C. Fried chicken breast, mashed potatoes, green beans, sliced tomatoes, and fresh apple pie. This meal option contains significant amounts of carbohydrates from mashed potatoes and apple pie, which can raise blood glucose levels.
D. Grilled fish with whole-grain brown rice, steamed broccoli, and pear poached in red wine.

This meal option is lower in carbohydrates and contains healthier choices for a client with diabetes, helping to control blood glucose levels more effectively.

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Correct Answer is A

Explanation

A. Serum potassium. Insulin therapy causes potassium to move into cells, which can lead to hypokalemia. Monitoring serum potassium is critical because significant drops can lead to cardiac arrhythmias and other complications.
B. Urine ketones. While monitoring ketones is important for assessing the resolution of DKA, it is not as immediately critical as monitoring potassium levels.
C. Serum sodium. Sodium levels are important but typically do not change as rapidly as potassium levels during DKA treatment.
D. Blood urea nitrogen (BUN). BUN levels provide information about kidney function and hydration status but are less immediately critical than potassium levels in the context of insulin therapy for DKA.

A. Schedule a client and family conference to review the plan of care. B. Seek clarification of the type of advance directive the client has. C. Check the client's arm for a "Do Not Resuscitate" (DNR) bracelet. D. Explain that living wills cannot be followed by emergency personnel.

Correct Answer is B

Explanation

A. While scheduling a client and family conference may be necessary to discuss the plan of care, the immediate concern is to determine the type of advance directive the client has and whether it includes preferences regarding resuscitation.
B. This is the most appropriate action because it addresses the family member's concern and ensures that the client's wishes regarding resuscitation are understood and followed.
C. While checking for a DNR bracelet is important, it does not address the family member's question about why the code was called despite the client having a living will.
D. This statement is incorrect. Living wills can guide decision-making regarding end-of-life care, including resuscitation, depending on the legal requirements and documentation in place.

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

Correct Answer is B

Explanation

The nurse observes an unlicensed assistive personnel (UAP) who is preparing to provide personal care for a client who requires contact precautions. The UAP has applied a gown and gloves and secured the tops of the gloves over the gown sleeves. Which action should the nurse take?

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A client who weighs 176 pounds receives a prescription for enoxaparin sodium 1.5mg/kg/day subcutaneously. The medication is available in 120 mg/0.8 mL prefilled syringe. How many mL should the nurse administer? (Enter numerical value only.)

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