Nursing Elites

1. The client with type 2 diabetes mellitus is being educated about lifestyle modifications. Which of the following recommendations is appropriate?

• A. Avoiding all forms of physical exercise
• B. Limiting carbohydrate intake to less than 30 grams per day
• C. Increasing physical activity to help control blood glucose levels
• D. Consuming a high-protein, low-fat diet

Correct answer: C

Rationale: The correct answer is to increase physical activity to help control blood glucose levels. Physical activity is essential in managing type 2 diabetes mellitus as it helps improve insulin sensitivity, control weight, and regulate blood sugar levels. Avoiding all forms of physical exercise (Choice A) is incorrect as exercise plays a crucial role in diabetes management. While limiting carbohydrate intake (Choice B) can be beneficial, setting a strict limit of less than 30 grams per day is too restrictive and may not be suitable for everyone. Consuming a high-protein, low-fat diet (Choice D) is generally a healthy choice, but it is not the primary lifestyle modification recommended for managing type 2 diabetes mellitus.

2. 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.

3. Which of the following symptoms would be most concerning in a client with diabetes insipidus?

• A. Polydipsia
• B. Polyuria
• C. Nocturia
• D. Hypertension

Correct answer: D

Rationale: In a client with diabetes insipidus, excessive thirst (polydipsia) and excessive urination (polyuria) are expected symptoms due to the inability to concentrate urine, leading to dilute urine production. Nocturia, waking up at night to urinate, is also common. However, hypertension is not a typical symptom of diabetes insipidus. The correct answer is D because hypertension may indicate a complication such as dehydration or electrolyte imbalances, which would require further assessment in a client with diabetes insipidus.

4. Knowing that gluconeogenesis helps to maintain blood glucose levels, a healthcare provider should:

• A. Document weight changes due to fatty acid mobilization.
• B. Evaluate the patient's sensitivity to low room temperatures due to decreased adipose tissue insulation.
• C. Protect the patient from sources of infection due to decreased cellular protein deposits.
• D. Do all of the above.

Correct answer: D

Rationale: Gluconeogenesis is a process where the body synthesizes glucose from non-carbohydrate sources to maintain blood glucose levels. Documenting weight changes due to fatty acid mobilization is important as it can impact the patient's metabolic status. Evaluating the patient's sensitivity to low room temperatures because of decreased adipose tissue insulation is crucial to prevent hypothermia. Protecting the patient from sources of infection due to decreased cellular protein deposits is essential to prevent complications. Therefore, all the options are relevant considerations in managing a patient undergoing gluconeogenesis, making option D the correct answer.

5. A client with diabetes insipidus is being treated with desmopressin. The nurse should monitor for which of the following side effects?

• A. Hyponatremia
• B. Hypernatremia
• C. Hypokalemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Hyponatremia. Desmopressin, a medication used in diabetes insipidus, can cause water retention by increasing water reabsorption in the kidneys. This excess water retention can lead to dilutional hyponatremia, where sodium levels in the body become too low. Monitoring for hyponatremia is crucial to prevent complications such as neurological symptoms. Choices B, C, and D are incorrect because desmopressin is not known to cause hypernatremia, hypokalemia, or hypercalcemia.

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