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 C
Explanation
Choice A reason: Asking for specifics about the night nurse's behavior could reinforce negative perceptions and does not address the client's current emotional state.
Choice B reason: Promising to talk to the night nurse may validate the client's split perception without verifying the facts.
Choice C reason: Expressing happiness for the client's improvement and discharge focuses on positive aspects and avoids engaging in potentially manipulative behavior.
Choice D reason: Acknowledging a preference for certain nurses can reinforce the client's splitting behavior, which is unhelpful in managing borderline personality disorder.
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"}}
Explanation
Choice A reason: No understanding.
While lifestyle changes can significantly reduce the risk of developing type 2 diabetes, they do not guarantee prevention. The client’s family history and current prediabetic fasting blood glucose level (122 mg/dL) indicate an increased risk. It’s important to understand that while risk can be minimized, it cannot be completely eliminated12.
Choice B reason:
People with diabetes or prediabetes can still consume sugar, but it should be in moderation and as part of a balanced diet. The DASH diet discussed with the client emphasizes portion control and a reduction in sugar intake, not complete elimination.
Choice C reason: No understanding
A single fasting blood glucose measurement below 100 mg/dL does not mean the client can revert to previous eating habits. Ongoing maintenance of a healthy diet and lifestyle is necessary to manage blood glucose levels and reduce the risk of diabetes.
Choice D reason: Understanding.
Lifestyle changes such as adopting the DASH diet and increasing physical activity can help manage weight, improve cholesterol levels, and lower the risk of chronic conditions like hypertension, cardiovascular disease, and type 2 diabetes.
Choice E reason: Understanding.
Increased thirst and urination are symptoms of high blood sugar levels. If the client experiences these symptoms, it would be prudent to check blood glucose levels to manage and monitor for diabetes.
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