Nursing Elites

1. A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. Nurse Jack explains that these medications are only effective if the client:

• A. Prefers to take insulin orally.
• B. Has type 2 diabetes.
• C. Has type 1 diabetes.
• D. Is pregnant and has type 2 diabetes.

Correct answer: B

Rationale: Oral antidiabetic agents are specifically designed for type 2 diabetes mellitus. Type 1 diabetes requires insulin therapy as the primary treatment due to the absence of endogenous insulin production. Therefore, these medications are not effective for individuals with type 1 diabetes like the male client in this scenario. Choice A is incorrect as oral antidiabetic agents are not about preference but rather about treatment efficacy. Choice D is incorrect as being pregnant does not impact the effectiveness of oral antidiabetic agents; they are primarily indicated for type 2 diabetes.

2. The nurse is caring for a client with primary adrenal insufficiency (Addison's disease). Which of the following laboratory findings would the nurse expect?

• A. Hypernatremia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: B

Rationale: In primary adrenal insufficiency (Addison's disease), there is a decrease in aldosterone levels, leading to sodium loss and potassium retention. This imbalance results in hyperkalemia, making choice B the correct answer. Hypernatremia (choice A) is unlikely due to sodium loss. Hyperglycemia (choice C) and hypercalcemia (choice D) are not typically associated with primary adrenal insufficiency.

3. A client with type 2 DM is being treated with 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. Take the medication before bedtime.
• D. Avoid taking the medication if you miss a meal.

Correct answer: A

Rationale: The correct instruction for a client taking metformin (Glucophage) is to take the medication with meals. This helps reduce gastrointestinal side effects and improves absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of side effects. Choice C is incorrect as there is no specific recommendation to take metformin before bedtime. Choice D is incorrect as missing a meal should not lead to avoiding the medication, but the client should take it with the next meal as prescribed.

4. The client with DM who is taking insulin develops a fever and becomes confused. Which action should the nurse take first?

• A. Check the client's blood glucose level.
• B. Administer a fever-reducing medication.
• C. Give the client fluids to drink.
• D. Notify the health care provider.

Correct answer: A

Rationale: In a client with diabetes mellitus (DM) taking insulin, the development of fever and confusion may indicate hyperglycemia or diabetic ketoacidosis. Checking the blood glucose level is the priority action in this situation. This will help determine if the symptoms are related to high blood sugar levels, guiding further interventions. Administering a fever-reducing medication (choice B) addresses only the symptom of fever and does not address the underlying cause. Providing fluids to drink (choice C) is important but should come after addressing the potential hyperglycemia or diabetic ketoacidosis. Notifying the health care provider (choice D) can be important, but immediate action to evaluate and manage the client's condition should precede contacting the provider.

5. Why is it important to control blood glucose levels in type 2 DM?

• A. Hypertension and kidney disease.
• B. Weight gain and obesity.
• C. Improved wound healing.
• D. Decreased cholesterol levels.

Correct answer: A

Rationale: Controlling blood glucose levels in type 2 DM is crucial to prevent complications. High blood glucose levels can lead to hypertension and kidney disease, as seen in diabetic nephropathy and diabetic nephropathy. These are common complications of uncontrolled diabetes. Weight gain and obesity (choice B) are influenced by factors such as diet and physical activity rather than blood glucose levels. Improved wound healing (choice C) is not directly related to blood glucose control but can be affected by it indirectly. Decreased cholesterol levels (choice D) are not a direct consequence of high blood glucose levels and are more related to dietary and lifestyle factors.

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