The nurse prepares to teach four clients about diabetes mellitus. Which client has the greatest need for instructions?

Reference Range:

Glycosylated hemoglobin A1C (HbA1C) [good glycemic control: less than 10%]

Random blood glucose [less than or equal to 200 mg/dL (less than 11.1 mmol/L]

Postprandial glucose (1-hour gestational diabetes) [less than 140 mg/dL (less than 7.8 mmol/L)]

Fasting blood glucose [70 to 110 mg/dL (less than 6.1 mmol/L)]

A child with asthma, who takes prednisone and has a fasting serum glucose of 180 mg/dL (10 mmol/L).

An adolescent male who has type 1 diabetes and a random glucose at 120 mg/dL (6.7 mmol/L).

A female who has gestational diabetes and has a 1-hour postprandial glucose at 140 mg/dL (7.8 mmol/L).

An adult who has type 2 diabetes and has a glycosylated hemoglobin (Hb A1C) at 10%.

Answer and Explanation

The Correct Answer is A

A. A child with asthma, who takes prednisone and has a fasting serum glucose of 180 mg/dL (10 mmol/L): This client’s fasting glucose is well above the normal range. Prednisone can increase blood glucose levels, placing the child at risk for hyperglycemia. This indicates a need for urgent education on blood glucose management while on steroids.

B. An adolescent male who has type 1 diabetes and a random glucose at 120 mg/dL (6.7 mmol/L): This blood glucose level is within normal limits for random testing. No immediate need for change in diabetic teaching is evident based on this value.

C. A female who has gestational diabetes and has a 1-hour postprandial glucose at 140 mg/dL (7.8 mmol/L): Her result meets the upper limit range for gestational diabetes. While she requires ongoing monitoring, her values do not indicate a need for urgent intervention.

D. An adult who has type 2 diabetes and has a glycosylated hemoglobin (Hb A1C) at 10%: Although this indicates poor long-term control, it reflects a chronic issue. The child with an acutely elevated fasting glucose and corticosteroid use is at greater immediate risk and thus has higher priority for education.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is D

Explanation

A. Estimating blood pressure based on the strength or quality of the radial pulse is not a reliable method. Pulse volume can provide only a very rough sense of perfusion but does not give a numeric measurement of systolic or diastolic pressure. Relying on this method could lead to inaccurate assessment, delayed recognition of hypotension or hypertension, and inappropriate clinical interventions, putting the client at risk.

B. While it is essential to document the limitations in obtaining vital signs, documentation alone does not resolve the issue. The client still needs accurate and timely blood pressure measurements for safe monitoring and care, especially if they have a condition that could compromise hemodynamic stability. Simply recording that measurement is not possible fails to meet the standard of care.

C. Using a previous blood pressure reading is unsafe because it does not reflect the client’s current condition. Vital signs can change rapidly due to fluid shifts, pain, medications, or other medical issues. Documenting an old reading can mislead the care team and result in inappropriate interventions or delayed response to changes in the client’s status.

D. This is the most appropriate and safe action. When the upper extremities are unavailable due to casts or injury, alternative validated sites, such as the popliteal artery, should be used. The nurse can teach the UAP how to position the client correctly, flexing the knee while supine, to allow proper cuff placement and accurate measurement. This ensures the client receives safe and reliable monitoring, and the staff is competent in using alternative techniques when standard sites are inaccessible.

A. Only 30% of clients did not attend self-management education sessions. B. Average client scores improved on specific risk factor knowledge tests. C. Clients who developed disease complications promptly received rehabilitation. D. More than 50% of at-risk clients were diagnosed early in their disease process.

Correct Answer is C

Explanation

A. Only 30% of clients did not attend self-management education sessions: This outcome does not directly indicate the effectiveness of a tertiary prevention program, which focuses on managing disease complications and improving quality of life after diagnosis.

B. Average client scores improved on specific risk factor knowledge tests: Improved knowledge is important, but tertiary prevention aims more at managing and reducing the impact of complications in individuals who already have the disease.

C. Clients who developed disease complications promptly received rehabilitation: Tertiary prevention focuses on minimizing the impact of established disease and preventing further disability. Effective rehabilitation for clients with complications demonstrates successful tertiary prevention.

D. More than 50% of at-risk clients were diagnosed early in their disease process: Early diagnosis falls under secondary prevention, not tertiary. Secondary prevention aims to identify and treat disease early to prevent complications, not managing existing complications.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The unlicensed assistive personnel (UAP) reports that a client's blood pressure cannot be measured in the arms because the client has casts on both arms and is unable to be measured in the legs because the client is in the supine position. Which action should the nurse implement?

Correct Answer is D

Explanation

The nurse implements a tertiary prevention program for type 2 diabetes mellitus in a rural health clinic. Which outcome indicates that the program was effective?

Correct Answer is C

Explanation

A client receives a prescription for itraconazole. Which statement made by the client requires additional instruction by the nurse?

The nurse is preparing to obtain a rapid coronavirus (COVID-19) test for a client who was exposed to the virus eight days ago. The client is experiencing fever, cough, and shortness of breath. Which action is most important for the nurse to take?

The nurse is assisting the healthcare provider with a thoracentesis for a client who has emphysema. Which equipment should the nurse have at the bedside in the event the procedure is ineffective?

The nurse is reviewing the plan of care for a newly admitted client who is intoxicated on admission. Which findings should the nurse include as indicators to begin implementing the detoxification medication protocol?

Exhibits The client has started to wake up more, opening her eyes without stimulation and looking around the room. Which should the nurse do as the client becomes more aware of her surroundings? Select all that apply.

A woman and her live-in significant other come in the emergency department following a motor vehicle collision. Which finding should alert the nurse to assess for the possibility of domestic violence?