The nurse is caring for a client with type 2 diabetes mellitus who reports frequent episodes of hypoglycemia. Which action should the nurse prioritize?

Increase carbohydrate intake at meals

Review the client’s medication regimen

Monitor blood glucose every hour

Encourage high-protein snacks

Answer and Explanation

The Correct Answer is B

Choice A reason: Increasing carbohydrate intake may prevent hypoglycemia but does not address the root cause, such as excessive insulin or oral hypoglycemic agents. Reviewing medications identifies dosing issues, ensuring safer management of type 2 diabetes, making it the priority over dietary changes.

Choice B reason: Reviewing the medication regimen is critical, as hypoglycemia in type 2 diabetes often results from excessive insulin or sulfonylureas. Adjusting doses or timing with a provider prevents recurrent episodes, addressing the primary cause and ensuring safe glycemic control, making it the priority action.

Choice C reason: Monitoring blood glucose hourly is reactive and impractical long-term. It confirms hypoglycemia but does not prevent it. Reviewing medications addresses the cause, such as inappropriate dosing, making it more effective for managing recurrent hypoglycemia in type 2 diabetes.

Choice D reason: High-protein snacks stabilize blood glucose but are secondary to addressing medication-related hypoglycemia. Excessive insulin or oral agents are likely causes, so reviewing the regimen is prioritized to correct dosing, preventing recurrent episodes more effectively than dietary adjustments alone.

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Correct Answer is B

Explanation

Choice A reason: Platelet count assesses bleeding risk but does not measure warfarin’s anticoagulant effect. Warfarin inhibits clotting factors, monitored by INR. Platelet counts are relevant for antiplatelet drugs, not anticoagulants, making INR the priority for evaluating warfarin efficacy in atrial fibrillation.

Choice B reason: INR measures warfarin’s anticoagulant effect by assessing prothrombin time, reflecting vitamin K-dependent clotting factor inhibition. In atrial fibrillation, therapeutic INR (2.0–3.0) prevents thromboembolism. Monitoring INR ensures effective anticoagulation, making it the critical lab value for warfarin therapy management.

Choice C reason: Hemoglobin level detects bleeding, a warfarin side effect, but does not assess its therapeutic effect. INR directly evaluates anticoagulation, ensuring stroke prevention in atrial fibrillation. Hemoglobin is secondary, monitored for complications, not efficacy, making INR the priority lab value.

Choice D reason: Serum potassium is unrelated to warfarin’s anticoagulant action. Electrolyte imbalances may affect cardiac rhythm in atrial fibrillation, but INR measures warfarin’s effect on clotting factors, ensuring therapeutic anticoagulation, making it the essential value to monitor for medication efficacy.

A. Imbalanced nutrition less than body requirements B. Risk for aspiration related to difficulty swallowing C. Anxiety and grieving related to progression of disease D. Chronic pain related to tissue destruction by tumor

Correct Answer is D

Explanation

Choice A reason: Imbalanced nutrition due to anorexia and dysphagia is significant in esophageal cancer, as it risks weight loss and weakness. However, pain at 8/10 is an acute, distressing symptom requiring immediate relief to improve quality of life, making it the priority over nutritional deficits.

Choice B reason: Risk for aspiration from dysphagia is a concern in esophageal cancer, as tumor obstruction can cause swallowing issues. While serious, aspiration is a potential risk, whereas severe pain is an immediate, actual problem, making pain management the priority to alleviate current suffering.

Choice C reason: Anxiety and grieving are valid in esophageal cancer due to its prognosis, but a pain level of 8/10 is an urgent physiological need. Addressing pain first improves the client’s ability to cope with psychological distress, prioritizing physical comfort over emotional concerns.

Choice D reason: Chronic pain from tumor-related tissue destruction, rated 8/10, is the priority, as severe pain causes significant distress and impairs function. Effective pain management enhances comfort, facilitates other interventions, and addresses the client’s immediate suffering, making it the most urgent nursing problem.

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The nurse is caring for a client with type 2 diabetes mellitus who reports frequent episodes of hypoglycemia. Which action should the nurse prioritize?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a history of atrial fibrillation is prescribed warfarin. Which laboratory value should the nurse monitor to assess the medication’s effectiveness?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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