The home care nurse has identified the nursing problem, "risk for hopelessness" for a client who is terminally ill with a life expectancy of several days. Which instruction should the nurse provide to the client's spouse?

Maintain a cheerful and calm appearance while spending time with the client.

Listen for changes in what the client hopes for and try to help meet the goals.

Avoid the client having to make any decisions to help save the client's energy.

Offer meals prepared with the client's favorite foods at frequent, regular intervals.

Answer and Explanation

The Correct Answer is B

A. A cheerful and calm appearance may not always align with the client's emotional needs and could feel insincere.
B. As the client nears the end of life, their hopes may shift, and it is crucial for the spouse to listen and help fulfill these evolving goals to provide comfort and maintain dignity.
C. Encouraging the client to make decisions as they are able can empower them, rather than avoiding decision-making.
D. Offering favorite foods is thoughtful but does not directly address the emotional and psychological aspects of hopelessness.

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Correct Answer is B

Explanation

A. Insulin requirements generally increase as pregnancy progresses due to the growing placenta and hormones that cause insulin resistance, not fluctuate significantly.
B. Insulin requirements typically begin to increase around 18 weeks of gestation and continue to rise until approximately 36 weeks due to increased insulin resistance caused by placental hormones.
C. While insulin needs do increase, they do not typically double or quadruple during the second trimester. The increase is more gradual.
D. Insulin requirements increase during pregnancy and may decrease after delivery as the placenta is no longer present, removing the source of insulin resistance.

A. "Antibiotics cause significant fluctuations in blood glucose, which are controlled with insulin." B. "The infection and the steroid medications you are taking can increase your blood sugar." C. "You may need to take insulin when you go home since your oral agent is no longer sufficient." D. "The use of insulin is easier to control your blood sugars while you are hospitalized."

Correct Answer is B

Explanation

A. While antibiotics can influence blood glucose, the primary reason for insulin in this context is the effect of steroids and infection on blood glucose levels.
B. Methylprednisolone, a steroid, can increase blood glucose levels, necessitating the use of insulin to manage elevated glucose levels during illness.
C. The need for insulin is related to the current hospitalization and medication effects, not necessarily a long-term change in diabetes management.
D. The ease of control is less relevant compared to the fact that steroids and infection can significantly impact blood glucose levels, necessitating insulin during hospitalization.

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The home care nurse has identified the nursing problem, "risk for hopelessness" for a client who is terminally ill with a life expectancy of several days. Which instruction should the nurse provide to the client's spouse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who is 12 weeks pregnant has type 1 diabetes mellitus. Which instruction should the nurse provide related to insulin dosages?

Correct Answer is B

Explanation

Correct Answer is B

Explanation

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