The client injects his insulin as prescribed, but then gets busy and forgets to eat. What is the nurse's most likely assessment finding?
1. The client will be very thirsty.
2. The client will need to urinate.
3. The client will have moist skin.
4. The client will complain of nausea.
Correct Answer: 3
Rationale 1: Thirst is a sign of hyperglycemia; the client would experience hypoglycemia if he did not eat.
Rationale 2: Increased urination is a sign of hyperglycemia; the client would experience hypoglycemia if he did not eat.
Rationale 3: Moist skin is a sign of hypoglycemia, which the client would experience if he injected insulin and did not eat.
Rationale 4: Nausea is a sign of hyperglycemia; the client would experience hypoglycemia if he did not eat.
You might also like to view...
A nurse is caring for a postoperative client on the surgical unit. The client's blood pressure was 142/76 mm Hg 30 minutes ago, and now is 88/50 mm Hg. What action by the nurse is best?
a. Call the Rapid Response Team. b. Document and continue to monitor. c. Notify the primary care provider. d. Repeat blood pressure measurement in 15 minutes.
The nursing student is caring for a group of patients on the medical-surgical unit who need to be ambulated during the day. She tells the primary nurse, "Some of my patients feel so sick but want to get out of bed
Others say they feel well but don't want to get out of bed. What should I do?" What is the most appropriate response by the nurse? a. "All patients are supposed to be out of bed today so do the best you can with them." b. "This is not uncommon. Sometimes you have to push some patients more than others." c. "All patients may respond to illness differently. Explain to them that they must be out of bed today. d. "Get the patients out of bed who want to get up, and help the others to ambulate later in the day."
When the nurse manager or charge nurse assigns and directs all patient care responsibilities for the nursing staff, the system is called "functional nursing."
True False
A labor nurse is caring for a patient, 39 weeks gestation, who has been diagnosed with placenta previa. Which of the following physician orders should the nurse question?
A) Type and cross match her blood. B) Insert an internal fetal monitor electrode. C) Administer an oral stool softener. D) Assess her complete blood count.