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The nurse assists an older man who has type 2 diabetes mellitus to improve his glucose control. ...
emeraldisle
emeraldisle
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5 years ago
5 years ago
The nurse assists an older man who has type 2 diabetes mellitus to improve his glucose control. ...
The nurse assists an older man who has type 2 diabetes mellitus to improve his glucose control. Which of the following instructions does the nurse give to this individual when he plans to walk more than usual in one day?
a. Omit antidiabetic medication. c. Supplement caloric intake.
b. Wear sturdy open-toed shoes. d. Prepare to adminis-ter insulin.
Question 2
The nurse teaches an older adult who has diabetes mellitus and takes metoprolol (Lopres-sor) to recognize clinical indicators of hypoglycemia.
Which clinical indicators of hypog-lycemia does the nurse include in patient teaching as the indicators this man is most likely to detect? a. Shaking
b. Dizziness
c. Weakness
d. Diaphoresis
e. Tachycardia
f. Impaired vision
Question 3
Which co-morbidity commonly associated with type 2 diabetes mellitus enhances the develop-ment of the microvascular complications of diabetes mellitus?
a. Hyperlipidemia c. Venous insuffi-ciency
b. Hypothyroidism d. Chronic constipa-tion
Question 4
A resident in a nursing home insists that a priest hear his confession. The resident is very anxious, and the nursing home does not have a Roman Catholic chaplain. Which intervention should the nurse implement?
a. An Episcopal priest is coming to visit the home this evening. Arrange an appoint-ment with her for the resident.
b. Report the resident's change in behavior in detail so that the attending physician can appropriately prescribe medication.
c. Refer the resident to the staff psychologist to address the underlying cause of the pa-tient's anxiety.
d. Look in the local telephone book for a Roman Catholic Church, and ask the priest to visit the resident.
Question 5
An older male adult who is a non-Hispanic Caucasian has a fasting blood sugar above 130 mg/dl. Which patient assessment does the nurse use to confirm a high risk for di-abetes mellitus in this man?
a. 68-years-old
b. 120/80 mm Hg
c. Peripheral pulses palpable
d. Total cholesterol 198 mg/dl
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thientrang2310
wrote...
#1
5 years ago
Answer to #1
C
Diabetes mellitus is controlled by balancing exercise, calories, and hypoglycemic medication; if one element of therapy is altered, then one or both of the remaining elements must be adjusted. When the patient's activity is going to metabolize more calories, the medication has to be re-duced or the calories have to increase. For a patient with type 2 diabetes mellitus, adjusting the medication can be difficult; therefore the nurse instructs this older adult to supplement his caloric intake, which can be accomplished by eating snacks during the walk or by increasing the gly-cemic load before walking. The patient ensures glucose control during these activities by testing his blood sugar levels. The nurse cannot tell the patient to omit medication because doing so is not within a nurse's scope of practice. The nurse instructs the older adult to wear closed, well-fitting leather shoes to protect the feet from trauma. Although many individuals with type 2 diabetes mellitus periodically take insulin, insulin is administered to induce hypoglycemia. Be-cause the individual plans to walk more than usual, more calories are needed to prevent hypog-lycemia.
Answer to #2
B, C, F
a. Incorrect. Shaking is an early clinical indicator of hypoglycemia and likely to be masked by the action of a beta-adrenergic blocker such as metoprolol, because beta-blockers oppose the surge of epinephrine in early hypoglycemia.
b. Correct. Dizziness is a clinical indicator of moderate hypoglycemia. It is unlikely to be masked by the affects of metoprolol, a beta-adrenergic blocker, because beta-blockers mask the early signs of hypoglycemia effectively.
c. Correct. Weakness is a clinical indicator of moderate hypoglycemia and is unlikely to be masked by the affects of metoprolol.
d. Incorrect. Diaphoresis is an early clinical indicator of hypoglycemia, and it is likely to be masked by the action of a beta-adrenergic blocker such as metoprolol.
e. Incorrect. Increased heart rate is an early clinical indicator of hypoglycemia and is likely to be masked by the action of a beta-adrenergic blocker such as metoprolol.
f. Correct. Impaired vision is a clinical indicator of moderate hypoglycemia and is unlikely to be masked by the effects of metoprolol.
Answer to #3
A
Hyperlipidemia, a condition commonly associated with type 2 diabetes mellitus, accelerates the development of microvascular complications of diabetes mellitus because high serum, low-density lipoproteins contribute to the formation of atherosclerotic plaque. The plaque first accumulates in the smallest arteries, causing complications of diabetes mellitus including peri-pheral arterial disease, retinopathy, and nephropathy. Hypothyroidism, venous insufficiency, and chronic constipation are not associated with type 2 diabetes mellitus.
Answer to #4
D
The nurse should respect the resident's beliefs and practices and accommodate them when they are not harmful. Receiving the Sacrament can potentially relieve much of the patient's anxiety. Arranging an appointment with an Episcopal priest for the resident is not an appropriate inter-vention; the two belief systems are not the same, and the resident is unlikely to experience the minister's efforts as satisfactory. Reporting the resident's change in behavior to the attending physician is also inappropriate; the resident's wish can be understood entirely within the resi-dent's belief system and need not reflect a medical problem, particularly if a visit by a priest re-lieves the resident's anxiety. Referring the resident to the staff psychologist to address the un-derlying cause of the patient's anxiety is an approach that attempts to change the resident's belief system.
Answer to #5
A
Feedback
A Correct. Diabetes is much more prevalent among older Americans.
B Incorrect. This man's blood pressure is normal.
C Incorrect. Palpable peripheral pulses are a normal finding.
D Incorrect. A total cholesterol level below 200 mg/dl is normal and highly desir-able for a man at risk for diabetes.
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emeraldisle
Author
wrote...
#2
5 years ago
I'm seriously surprised that you found the answers... What's your secret?!
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