A nurse is discussing the care of a client who has type 1 diabetes mellitus with an assistive personnel (AP). Which of the following situations should the nurse instruct the AP to report immediately?
The client asks the AP to trim his broken toenail.
The client reports urine that is dark yellow in color.
The client reports dizziness when standing.
The client refuses breakfast and requests to sleep.
The Correct Answer is D
Rationale:
A. Toenail trimming should be performed by a professional to prevent injury, but it does not require immediate reporting.
B. Dark yellow urine can indicate dehydration, but it is not an urgent concern in this context.
C. Dizziness when standing is a concern, but it does not take priority over the refusal of breakfast, which may lead to hypoglycemia.
D. A refusal to eat can lead to hypoglycemia in clients with type 1 diabetes, and this situation should be reported immediately to prevent a dangerous drop in blood glucose levels.
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Correct Answer is B
Explanation
Rationale:
A. Weight gain is typically associated with hypothyroidism; clients with hyperthyroidism often experience weight loss due to increased metabolism.
B. Frequent mood changes, including anxiety and irritability, are common in hyperthyroidism as a result of increased thyroid hormone levels affecting mood regulation.
C. Sensitivity to cold is associated with hypothyroidism; hyperthyroid clients usually have an increased sensitivity to heat.
D. Constipation is more characteristic of hypothyroidism; hyperthyroidism often causes increased bowel movements or diarrhea.
Correct Answer is C
Explanation
Rationale:
A. In hyperparathyroidism, calcium levels are typically increased due to excessive parathyroid hormone activity, leading to calcium mobilization from bones.
B. Parathyroid hormone levels would generally be increased in hyperparathyroidism as the parathyroid glands produce more hormone in response to low calcium levels, but the condition itself is defined by elevated hormone levels.
C. Increased phosphate levels are expected due to the effects of elevated parathyroid hormone causing increased renal excretion of phosphate while allowing calcium to rise.
D. Magnesium levels can vary, but they are not typically significantly elevated in hyperparathyroidism; thus, increased magnesium is not a standard finding.