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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","F","G"]
Explanation
A. Increase the fractional concentration of Inspired oxygen: As the partial pressure of oxygen (PaO) has decreased to 64 mm Hg from 99 mm Hg, and the oxygen saturation may drop, it's necessary to increase the fraction of inspired oxygen (FiO2) to maintain adequate oxygenation.
B. Change the ventilator settings to continuous positive airway pressure (CPAP): CPAP is not typically used in patients who are intubated. CPAP is a non-invasive ventilation mode used for patients with respiratory distress who are breathing spontaneously. In this case, the patient is intubated and requires mechanical ventilation, so CPAP is not appropriate.
C. Increase the respiratory rate: While the respiratory rate has decreased from 15 to 13 breaths/minute, it's important to maintain a careful balance when adjusting ventilator settings. Increasing the respiratory rate may not be necessary at this point, especially if the patient is still oxygenating adequately. Moreover, the primary concern appears to be hypoxemia rather than hypoventilation.
D. Continue weaning the ventilator as ordered: While weaning the patient off the ventilator is a goal, it may not be appropriate at this time, especially with the worsening blood gas values
indicating respiratory insufficiency. Continuing the weaning process could potentially exacerbate respiratory failure.
E. Decrease the tidal volume: Decreasing the tidal volume could worsen ventilation-perfusion matching and exacerbate hypoxemia. This approach might be considered in certain cases of acute respiratory distress syndrome (ARDS) or in patients with severe lung injury, but it's not typically indicated in this scenario without further assessment.
F. Alert the provider of the blood gas values: The nurse should inform the provider about the changes in blood gas values, especially the decrease in PaO2 and the increase in PaCO2, which indicate worsening respiratory status and potential respiratory acidosis.
G. Switch the ventilator to pressure control: Given the deterioration in respiratory status with an increase in PaCO2 and decrease in PaO2, switching to pressure control ventilation may provide better control over the patient's ventilation and oxygenation, especially in cases of acute
respiratory failure.
Correct Answer is ["A","B","C"]
Explanation
A. Swollen hands can indicate edema, which is a common sign of preeclampsia. Swelling, especially in the hands, face, or feet, can be due to elevated blood pressure and should be reported to the healthcare provider.
B. Headaches are a concerning symptom in preeclampsia, especially when they are persistent or severe. This is often due to high blood pressure and requires medical evaluation to prevent complications like eclampsia or stroke.
C. Blurred vision is a serious indicator of preeclampsia as it reflects possible neurological involvement or increased blood pressure, which can affect blood flow to the brain and eyes. This is an urgent symptom that needs prompt medical attention.
D. Lack of appetite is not a common or specific symptom of preeclampsia. It may be present in other conditions, but it is not a key indicator of preeclampsia.
E. Chills and fever are typically associated with infections, not preeclampsia. These symptoms do not indicate the presence of preeclampsia and are unrelated to hypertensive disorders of pregnancy.
F. Urinary frequency is more commonly related to pregnancy in general due to the growing uterus pressing on the bladder. It is not specifically associated with preeclampsia. In preeclampsia, a decrease in urine output may be more concerning as it can signal kidney involvement.
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