The nurse has just received a change of shift report on four patients. Which patient will the nurse assess first?

A post-operative patient after thyroid surgery preparing for discharge with a new medication

A patient diagnosed with Cushing's disease after insertion of a nasogastric tube

A patient scheduled for a chest radiograph who is anxious about their treatment

A patient with chronic obstructive pulmonary disease who requested a breathing treatment during the previous shift

Answer and Explanation

The Correct Answer is D

Choice A reason: While a post-operative patient preparing for discharge is important, they are stable enough to be considered for discharge and do not require immediate assessment.

Choice B reason: A patient with Cushing's disease after insertion of a nasogastric tube may need monitoring, but this is not as urgent as a patient with potential respiratory distress.

Choice C reason: A patient scheduled for a chest radiograph who is anxious about their treatment does not require immediate intervention compared to a patient experiencing respiratory issues.

Choice D reason: A patient with chronic obstructive pulmonary disease who requested a breathing treatment during the previous shift may be experiencing respiratory distress and requires immediate assessment and intervention to prevent further complications.

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Correct Answer is B

Explanation

Choice A reason: Advising the patient to consume protein and carbohydrates immediately is not appropriate in this context. The presence of ketones in the urine indicates that the body is using fat for energy due to a lack of insulin. Increasing carbohydrate intake without addressing the underlying insulin deficiency can worsen hyperglycemia and ketoacidosis.

Choice B reason: Notifying the provider of the result and recommending that the patient's insulin dose be increased is the appropriate intervention. The presence of ketones in the urine indicates inadequate insulin levels, and adjusting the insulin dose can help correct the metabolic imbalance and prevent further complications such as diabetic ketoacidosis.

Choice C reason: Instructing the patient to withhold the next scheduled dose of insulin is incorrect. Insulin is essential for managing blood glucose levels and preventing ketosis in patients with type 1 diabetes. Withholding insulin can lead to severe hyperglycemia and ketoacidosis.

Choice D reason: Suggesting that the patient ask their provider to start them on metformin therapy is not appropriate for type 1 diabetes. Metformin is used primarily for type 2 diabetes and is not effective in type 1 diabetes, where insulin is required for glucose management.

A. Foot ulcers and delayed wound healing B. Stroke prevention and cardiac health C. Retinopathy and nephropathy D. Hypertension management and cholesterol control

Correct Answer is C

Explanation

Choice A reason: Foot ulcers and delayed wound healing are related to diabetes but are considered macrovascular complications. Microvascular complications specifically refer to damage to small blood vessels.

Choice B reason: Stroke prevention and cardiac health are important but are related to macrovascular complications of diabetes. The focus here is on microvascular complications.

Choice C reason: Retinopathy and nephropathy are microvascular complications of diabetes. These conditions result from damage to small blood vessels in the eyes and kidneys, respectively. Diabetic retinopathy can lead to vision loss, while diabetic nephropathy can lead to kidney failure. It is important to monitor for these complications and manage blood glucose levels to prevent or slow their progression.

Choice D reason: Hypertension management and cholesterol control are important for overall cardiovascular health but are related to macrovascular complications. The discussion should focus on microvascular complications specific to diabetes.

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The nurse has just received a change of shift report on four patients. Which patient will the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is admitting a patient with type 1 diabetes. While reviewing the patient's laboratory results, the nurse notes the presence of ketones in the urine. What intervention will the nurse implement for this patient?

Correct Answer is B

Explanation

The nurse is discussing microvascular complications of diabetes with a patient. What topics will the nurse include in the discussion?

Correct Answer is C

Explanation

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