An older adult client with long-term type 2 diabetes mellitus (DM) is seen in the clinic for a routine health assessment. Which assessment(s) would the nurse complete to determine if a patient with type 2 diabetes mellitus (DM) is experiencing long-term complications? Select all that apply.

Skin condition of lower extremities.

Sensation in feet and legs.

Visual acuity.

Signs of respiratory tract infection.

Serum creatinine and blood urea nitrogen (BUN).

Answer and Explanation

Correct Answer : A,B,C,E

Choice A reason:

The correct answer is a) because checking the skin condition of the lower extremities helps identify complications like diabetic ulcers.

Choice B reason:

The correct answer is b) because assessing sensation in feet and legs helps detect neuropathy, a common complication of diabetes.

Choice C reason:

The correct answer is c) because visual acuity checks help identify diabetic retinopathy.

Choice D reason: Signs of respiratory tract infection are important but not specific to long-term complications of diabetes.

Choice E reason:

The correct answer is e) because serum creatinine and BUN levels help assess kidney function and identify nephropathy.

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Correct Answer is A

Explanation

Choice A reason:

The correct answer is a) because taking deep breaths followed by coughing helps produce a sputum sample from the lungs, which is necessary for accurate diagnostic testing.

Choice B reason: Restricting fluids before expectorating the sputum specimen is not necessary and may make it more difficult to produce a sample.

Choice C reason: Sputum specimens are best collected in the morning when secretions have accumulated overnight.

Choice D reason: Mouth care should be performed prior to sputum collection to reduce contamination from oral bacteria.

A. Bile-stained emesis. B. Clay-colored stool. C. Distended, hard, and rigid abdomen. D. Radiating, sharp pain in the right shoulder.

Correct Answer is C

Explanation

Choice A reason: Bile-stained emesis indicates an obstruction, but it is not as immediately critical as a distended, hard, and rigid abdomen.

Choice B reason: Clay-colored stool is a sign of bile duct obstruction but is not as urgent as the abdomen findings.

Choice C reason:

The correct answer is c) because a distended, hard, and rigid abdomen suggests peritonitis or a perforated organ, which requires immediate medical intervention.

Choice D reason: Radiating, sharp pain in the right shoulder is common in gallbladder issues but is not as immediately life-threatening as a distended, hard, and rigid abdomen.

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An older adult client with long-term type 2 diabetes mellitus (DM) is seen in the clinic for a routine health assessment. Which assessment(s) would the nurse complete to determine if a patient with type 2 diabetes mellitus (DM) is experiencing long-term complications? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is teaching a client how to collect a sputum specimen. Which steps should the nurse instruct the client to follow when collecting a sputum sample?

Correct Answer is A

Explanation

A client with cholelithiasis is admitted with jaundice due to obstruction of the common bile duct. Which finding is most important for the nurse to report to the healthcare provider?

Correct Answer is C

Explanation

One hour after major abdominal surgery, a client in the postanesthesia care unit (PACU) has a blood pressure (BP) of 136/80 mm Hg. Fifteen minutes later, it is 114/72 mm Hg. Which action should the nurse take first?

The nurse is caring for a client with a burn that is severely edematous with a wound bed that is brown and yellow in appearance. The client expresses feeling no pain. Which classification of burn depth should the nurse document?

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Which group of foods is best for the nurse to recommend for clients with a strong family history of colon and rectal cancers?

Which client has the highest risk for developing skin cancer?

The nurse is developing a plan of care for a client who reports blurred vision and who is newly diagnosed with type 2 diabetes mellitus (DM). Which outcome should the nurse include in the plan of care for this client?

An adult woman with Grave's disease is admitted with severe dehydration and malnutrition. She is currently restless and refusing to eat. Which action is most important for the nurse to implement?

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