The nurse is caring for several clients on a hospital unit. Which of the following clients is most at risk for hypoglycemia?
A client with type 1 diabetes mellitus who has taken a high dose of insulin
A client who has type 2 diabetes and has not taken any medication
An older adult client taking an antibiotic for an infection
A client who has metabolic syndrome and is taking a statin drug to lower cholesterol levels
The Correct Answer is A
Choice A reason: A client with type 1 diabetes mellitus who has taken a high dose of insulin is at significant risk for hypoglycemia. In type 1 diabetes, the body does not produce insulin, so insulin therapy is essential for controlling blood glucose levels. However, if the dose of insulin is too high relative to the patient's dietary intake or physical activity level, it can lead to a rapid decrease in blood glucose levels, resulting in hypoglycemia. Hypoglycemia is defined as a blood glucose level less than 70 mg/dL (3.9 mmol/L) and can cause symptoms such as confusion, sweating, weakness, and in severe cases, seizures or loss of consciousness.
Choice B reason: A client with type 2 diabetes who has not taken any medication may have elevated blood glucose levels but is not typically at immediate risk for hypoglycemia unless they are taking medications that lower blood glucose. Type 2 diabetes is characterized by insulin resistance, and while medication can help manage it, skipping medication does not usually result in hypoglycemia unless other factors are at play.
Choice C reason: An older adult client taking an antibiotic for an infection is not generally at risk for hypoglycemia unless the antibiotic interacts with other medications that the client is taking for diabetes management. Antibiotics themselves do not typically cause hypoglycemia.
Choice D reason: A client who has metabolic syndrome and is taking a statin drug to lower cholesterol levels is not at direct risk for hypoglycemia from the statin medication. Metabolic syndrome is a cluster of conditions that increase the risk for heart disease, stroke, and type 2 diabetes. While statins are used to lower cholesterol levels, they do not have a direct impact on blood glucose levels that would lead to hypoglycemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Asking if the client feels like they have food stuck at the base of their throat is a pertinent question for assessing swallowing in a client with oral achalasia. Achalasia is characterized by difficulty in swallowing due to the inability of the lower esophageal sphincter to relax, leading to a sensation of food being stuck.
Choice B reason: While burning sensations in the throat can be associated with gastroesophageal reflux disease (GERD), they are not specific to achalasia. However, some clients with achalasia may experience similar symptoms due to food stasis and fermentation in the esophagus.
Choice C reason: Feelings of fullness in the neck are not a typical symptom of achalasia. Achalasia primarily affects the esophagus and does not usually cause a sensation of fullness in the neck.
Choice D reason: Pain while swallowing, or odynophagia, can occur in achalasia but is more commonly associated with conditions that cause inflammation or irritation of the esophagus, such as infections or ingestion of irritants.
Correct Answer is B
Explanation
Choice A reason: The statement "You should limit discussing past events with the client" does not necessarily incorporate the client's and family's cultural beliefs. Discussing past events can be a part of reminiscence therapy, which can be beneficial for clients with terminal illnesses. It allows them to reflect on their life experiences and can provide a sense of fulfillment or closure.
Choice B reason: Saying "We will respect what is important to you" is a broad and inclusive statement that acknowledges the importance of the client's and family's cultural beliefs. It implies that the care team is willing to listen and adapt the care plan to align with the client's values, which is a fundamental aspect of culturally competent care. This approach can help ensure that the client's end-of-life care is respectful and responsive to their individual needs.
Choice C reason: Offering to "arrange all burial services" may not be appropriate as it assumes that the family requires assistance with this aspect of care without first understanding their specific cultural or religious practices. It is important to have a conversation with the client and family about their preferences and needs regarding end-of-life rituals before making any arrangements.
Choice D reason: The statement "Grieving should not be done in front of the client" may not align with the cultural beliefs of the client and family. Grieving practices vary widely among different cultures, and some may find it important to express grief openly in the presence of the dying person. It is essential to respect and accommodate the family's grieving process.
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