Nursing Elites

1. A client with type 2 DM is prescribed metformin (Glucophage). The nurse should include which instruction when teaching the client about this medication?

• A. Take the medication with meals.
• B. Take the medication on an empty stomach.
• C. Avoid taking the medication if you miss a meal.
• D. Take the medication before bedtime.

Correct answer: A

Rationale: The correct instruction when taking metformin (Glucophage) is to take the medication with meals. Taking metformin with meals helps to reduce gastrointestinal side effects and improve absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of gastrointestinal side effects. Choice C is incorrect because missing a meal does not mean the medication should be avoided; the client should still take it with the next meal. Choice D is incorrect because there is no specific recommendation to take metformin before bedtime.

2. An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting:

• A. 2 to 5 g of a simple carbohydrate.
• B. 10 to 15 g of a simple carbohydrate.
• C. 18 to 20 g of a simple carbohydrate.
• D. 25 to 30 g of a simple carbohydrate.

Correct answer: B

Rationale: The correct answer is B: 10 to 15 g of a simple carbohydrate. In the treatment of hypoglycemia, it is important to administer a specific amount of simple carbohydrates to raise blood glucose levels effectively without causing hyperglycemia. 10 to 15 g of simple carbohydrates, such as glucose tablets, fruit juice, or regular soft drinks, is recommended to rapidly increase blood sugar levels in clients experiencing hypoglycemia. Choices A, C, and D are incorrect as they either provide too little or too much glucose, which may not effectively treat the hypoglycemic episode or may lead to rebound hyperglycemia.

3. The nurse is caring for a client with hypothyroidism. Which of the following clinical findings should the nurse expect?

• A. Tachycardia
• B. Weight loss
• C. Cold intolerance
• D. Diaphoresis

Correct answer: C

Rationale: Cold intolerance is a classic symptom of hypothyroidism. In hypothyroidism, the body's metabolic rate is decreased, leading to a decreased ability to regulate body temperature. This results in a feeling of being cold most of the time. Tachycardia (Choice A) is more commonly associated with hyperthyroidism, not hypothyroidism. Weight loss (Choice B) and diaphoresis (Choice D) are also more characteristic of hyperthyroidism, where there is an increased metabolic rate and excess heat production.

4. Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?

• A. Fluid intake is less than 2,500 ml/day
• B. Urine output measures more than 200 ml/hour
• C. Blood pressure is 90/50 mm Hg
• D. The heart rate is 126 beats/minute

Correct answer: A

Rationale: The correct outcome indicating effective treatment of diabetes insipidus in a male client is a fluid intake of less than 2,500 ml/day. In diabetes insipidus, excessive urination causes increased fluid intake to compensate for the fluid loss. By effectively managing the condition, the client's fluid intake should decrease. Choices B, C, and D do not directly reflect the effectiveness of treatment for diabetes insipidus. Increased urine output (choice B) may indicate inadequate control of the condition, while low blood pressure (choice C) and a high heart rate (choice D) are not specific indicators of effective treatment for diabetes insipidus.

5. During a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise?

• A. At least once a week
• B. At least three times a week
• C. At least five times a week
• D. Every day

Correct answer: C

Rationale: Exercising at least five times a week is recommended to meet the goals of planned exercise for diabetic clients. This frequency helps in managing blood sugar levels effectively and improving overall health. Exercising once a week (Choice A) may not provide sufficient benefits or consistency required for diabetic clients. Exercising three times a week (Choice B) is better but may still fall short of the recommended frequency for optimal outcomes. Exercising every day (Choice D) may lead to burnout or overtraining if not properly balanced with rest days, which could be counterproductive for diabetic clients.

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