The nurse is caring for a client with a history of type 2 diabetes mellitus and hypertension who arrives at the clinic for a scheduled visit. Which finding requires further follow-up by the nurse?
Creatinine: Female: [0.5 to 1.1 mg/dL (44 to 97 µmol/L)], Male: [0.6 to 1.2 mg/dL (53 to 106 µmol/L)]
Blood pressure 130/80 mm Hg.
Serum creatinine 1.6 mg/dL (141.44 µmol/L).
Dark yellow urine.
Difficulty staying asleep.
The Correct Answer is B
Choice A reason: A blood pressure of 130/80 mm Hg is considered high normal and may not require immediate follow-up for a patient with a history of hypertension.
Choice B reason: A serum creatinine of 1.6 mg/dL is above the normal range for both males and females, indicating possible kidney dysfunction, which requires further follow-up.
Choice C reason: Dark yellow urine could be a sign of dehydration, which is common in diabetes, but it is not as concerning as an elevated serum creatinine level.
Choice D reason: Difficulty staying asleep could be related to various factors and may require follow-up, but it is not as urgent as abnormal laboratory values.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: While obtaining a 12-lead electrocardiogram is important for monitoring cardiac function, it is not as frequent or specific as potassium monitoring for hyperkalemia management.
Choice B reason: Evaluating glucose levels is necessary due to the risk of hypoglycemia from insulin administration, but the priority is monitoring potassium levels in hyperkalemia.
Choice C reason: Monitoring intake and output is part of fluid balance management but is secondary to the critical need to monitor serum potassium levels.
Choice D reason: Frequent assessment of serum potassium levels is essential to evaluate the effectiveness of the dextrose and insulin therapy in lowering potassium levels.
Correct Answer is ["A","E"]
Explanation
Choice A reason: Monitoring the WBC count can help determine if the antibiotic is effectively treating an infection, as a decreasing count may indicate recovery.
Choice B reason: The RBC count is not typically affected by respiratory infections and is not a direct indicator of antibiotic effectiveness.
Choice C reason: Serum potassium levels are not directly related to the effectiveness of antibiotics for respiratory infections.
Choice D reason: BUN levels are more indicative of kidney function and are not used to evaluate antibiotic effectiveness for respiratory infections.
Choice E reason: A sputum culture and sensitivity test can identify the causative bacteria and determine if the antibiotic is effective.
Choice F reason: Urinalysis is not directly related to respiratory infections but can be part of a broader assessment of health.
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