Take full exam for free

A client with type 2 diabetes mellitus (DM) who normally takes an oral antidiabetic agent asks the nurse why insulin is necessary during this hospitalization for chronic obstructive pulmonary disease (COPD) exacerbation and pneumonia. Review of the medication record indicates the client is taking methylprednisolone, clindamycin, and pioglitazone. How should the nurse respond?

"Antibiotics cause significant fluctuations in blood glucose, which are controlled with insulin."

"The infection and the steroid medications you are taking can increase your blood sugar."

"You may need to take insulin when you go home since your oral agent is no longer sufficient."

"The use of insulin is easier to control your blood sugars while you are hospitalized."

Answer and Explanation

The Correct Answer is B

Rationale:

A. While antibiotics can influence blood glucose, the primary reason for insulin in this context is the effect of steroids and infection on blood glucose levels.

B. Methylprednisolone, a steroid, can increase blood glucose levels, necessitating the use of insulin to manage elevated glucose levels during illness.

C. The need for insulin is related to the current hospitalization and medication effects, not necessarily a long-term change in diabetes management.

D. The ease of control is less relevant compared to the fact that steroids and infection can significantly impact blood glucose levels, necessitating insulin during hospitalization.

Free Nursing Test Bank

Take full exam free

View Related questions

A. Obtain a blood pressure every 15 minutes. B. Monitor the client's complete blood count (CBC) daily. C. Review creatinine and blood urea nitrogen results. D. Measure the client's urinary output daily.

Correct Answer is A

Explanation

Rationale:

A.Dopamine, a sympathomimetic agent, can cause significant changes in blood pressure. Monitoring blood pressure every 15 minutes is crucial to assess the client's response to the medication and to detect any adverse effects, such as hypertension or hypotension, promptly.

B.Monitoring CBC is important but not as immediately critical in this situation as monitoring blood pressure.

C.While reviewing creatinine and BUN results is important for overall kidney function, it is not the most immediate priority when administering dopamine for shock.

D. Measuring urinary output is important for assessing renal perfusion but should be done more frequently than daily in a client receiving dopamine for shock.

A. Remove the drainage bag and apply antibiotic ointment around the stoma. B. Apply a pulse oximeter to determine the client's oxygen saturation level. C. Replace the colostomy supplies with non-latex hypoallergenic supplies. D. Notify the healthcare provider of the appearance of the stoma immediately.

Correct Answer is D

Explanation

Rationale:

A. Applying antibiotic ointment is not appropriate for this situation as the issue is likely compromised blood flow, not infection.

B. Checking oxygen saturation is not related to the color change of the stoma.

C. Switching to non-latex supplies is important for clients with latex allergies but is not relevant to the immediate problem.

D. A dark red to bluish color of the stoma suggests compromised blood flow and possible ischemia, which requires immediate medical attention. The nurse should notify the healthcare provider immediately to address this potentially serious complication.

Free Nursing Test Bank

Correct Answer is A

Explanation

Correct Answer is D

Explanation

Quick Links

Resources

Free Nursing Test Bank

A client who is in shock is receiving a continuous IV infusion of a sympathomimetic dopamine. Which intervention should the nurse include in this client's plan of care?

Correct Answer is A

Explanation

In preparing to perform colostomy care, the nurse observes that a client's colostomy stoma has become a dark red to bluish color. Which action should the nurse implement?

Correct Answer is D

Explanation

An older adult client reports noticing increased difficulty hearing over the past year. The client explains that words often sound garbled and the end of sentences are often missed. Which follow-up question is best for the nurse to ask?

In assessing a client's neck, the nurse hears a blowing swish when auscultating the area over the left carotid artery, but hears no sound over the right carotid artery. How should the nurse document this finding?

An older client is admitted to the medical-surgical unit after falling and fracturing the left hip. The nurse is reviewing written preoperative instructions with the client and spouse. Which action should the nurse implement while providing these instructions?

A nurse is teaching an older adult client who has diabetes mellitus about preventing the long-term complications of retinopathy and nephropathy. Which of the following instructions should the nurse include?

When entering a client's room to assess vital signs, the nurse finds the client crying. After allowing the client to express feelings, which intervention should the nurse implement?

An older client who is experiencing urinary incontinence is brought to the clinic with increased confusion. The nurse observes serous drainage from a laceration on the client's left arm. Which assessment is most important for the nurse to obtain?

A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? Reference Range: White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 109/L)]

Quick Links

Resources