Y.L., a 34-year-old Southern Asian woman, comes to the clinic with complaints of chronic fatigue, increased
thirst, constant hunger, and frequent urination. She denies any pain, burning, or low-back pain on urination.
She tells you she has a vaginal yeast infection that she has treated numerous times with over-thecounter medication. She works full time as a clerk in a loan company and states she has difficulty reading
numbers and reports, resulting in her making frequent mistakes. She says, "By the time I get home and
make supper for my family, then put my child to bed, I am too tired to exercise." She reports her feet hurt;
they often "burn or feel like there are pins in them." She has a history of gestational diabetes and reports
that after her delivery she went back to her traditional eating pattern, which is high in carbohydrates.
In reviewing Y.L.'s chart, you note she last saw the provider 6 years ago after the delivery of her last
child. She has gained considerable weight; her current weight is 173 pounds. Today her blood pressure
(BP) is 152/97 mm Hg, and a random plasma glucose level is 291 mg/dL. The provider suspects that Y.L. has
developed type 2 diabetes mellitus (DM) and orders the laboratory studies shown in the chart.
Interpret Y.L.'s laboratory results.
The elevated fasting glucose level and HbA1c level confirm the presence of DM. Glucose should not
be present in the urine; its presence also suggests DM. The absence of ketones is consistent with
type 2 DM. In type 1 DM, the presence of ketones indicates that the body is using fat stores for
energy, a process which is rare in type 2 DM. Y.L.'s elevated total and LDL cholesterol levels, elevated
triglycerides, and low HDL cholesterol are consistent with values often seen in those with type 2 DM
because of insulin resistance. These also reflect an elevated risk for Y.L. developing atherosclerosis.
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A nurse is planning to care for a patient with a disease that is a major cause of death and disability in the United States. The nurse is caring for which patient?
a. One with an acute disease b. One with a chronic disease c. One with an infectious disease d. One with an exotic disease
The nurse is assessing a family dealing with the stress of unemployment and the stress of a child with chronic asthma. The assessment reveals that the family is attending to only those aspects of the situation that do not cause distress or pain
How should the nurse document this assessment finding? 1. Denial. 2. Selective inattention. 3. Isolation. 4. Rationalization.
To identify a patient or a resident:
a. Call the person by name b. Use the MSDS c. Use the ID bracelet d. Use the person's clothing
An experienced nurse says to a new graduate, "When you've practiced as long as I have, you'll instantly know how to take care of psychotic patients." What is the new graduate's best analysis of this comment? Select all that apply
a. The experienced nurse may have lost sight of patients' individuality, which may compromise the integrity of practice. b. New research findings must be continually integrated into a nurse's practice to provide the most effective care. c. Experience provides mental health nurses with the tools and skills needed for effective professional practice. d. Experienced psychiatric nurses have learned the best ways to care for psychotic patients through trial and error. e. Effective psychiatric nurses should be continually guided by an intuitive sense of patients' needs.