After teaching a client who is newly diagnosed with type 2 diabetes mellitus, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
a. "I should increase my intake of vegetables with higher amounts of dietary fiber."
b. "My intake of saturated fats should be no more than 10% of my total calorie intake."
c. "I should decrease my intake of protein and eliminate carbohydrates from my diet."
d. "My intake of water is not restricted by my treatment plan or medication regimen."
ANS: C
The client should not completely eliminate carbohydrates from the diet, and should reduce protein if microalbuminuria is present. The client should increase dietary intake of complex carbohydrates, including vegetables, and decrease intake of fat. Water does not need to be restricted unless kidney failure is present.
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The nurse working in the ICU knows that chronic elevation of left ventricular end-diastolic pressure will result in the patient displaying which of the following clinical manifestations?
A) Chest pain and intermittent ventricular tachycardia B) Dyspnea and crackles in bilateral lung bases C) Petechia and spontaneous bleeding D) Muscle cramping and cyanosis in the feet
The nurse suspects a patient has a pleural effusion. Which of the following respiratory findings would the nurse expect to find upon assessment of the patient?
A) Increased tactile fremitus, egophony, and a dull sound upon percussion of the chest wall B) Decreased tactile fremitus, wheezes, and a hyperresonant sound upon percussion of the chest wall C) Lung fields dull to percussion, tactile fremitus absent, and breath sounds absent D) Normal tactile fremitus, decreased breath sounds, and a resonant sound upon percussion of the chest wall
A client who was treated for a burn with an autograft is about to be discharged. The nurse should stress the importance of:
1. wearing pressure support garments. 2. maintaining IV therapy. 3. exercising the graft site. 4. monitoring the client for kidney failure.
A relatively healthy elderly client tells the nurse that he has been sleepy during the day and has fallen twice. Which of the following should the nurse suspect is occurring with this client?
a. The events could be medication related and should be investigated. b. The client is having a stroke. c. The client has sleep apnea. d. The client is aging and should move to an assisted living facility.