A 72-year-old woman is diagnosed with diabetes. What does the nurse recognize about the management of diabetes in the older adult?

Correct Answer: A

Rationale: The correct answer is A) It is more difficult to achieve strict glucose control than in younger patients. In older adults with diabetes, there are several factors that make strict glucose control more challenging. Firstly, aging is associated with a decline in organ function, including the pancreas, which affects insulin production and regulation of blood sugar levels. Additionally, older adults often have multiple comorbidities and take multiple medications, which can complicate diabetes management. Furthermore, older adults may have cognitive impairments or physical limitations that make it harder for them to adhere to complex treatment regimens. Social factors such as living alone or lack of support can also impact their ability to manage diabetes effectively. Option B is incorrect because waiting until a patient becomes severely hyperglycemic can lead to serious complications and is not the standard of care for diabetes management. Option C is incorrect as insulin therapy is a common treatment for diabetes in older adults and adjustments can be made to accommodate limitations in dexterity or vision. Option D is incorrect as it is not a general rule that younger family members must be responsible for the care of older adults with diabetes. It is important to empower older adults in self-management and support them in maintaining their independence while managing their condition effectively.

Correct Answer: A

Rationale: In Cushing syndrome, the body is exposed to high levels of cortisol over a prolonged period, leading to characteristic signs and symptoms. The correct answer is A) Hypertension, peripheral edema, and petechiae. Hypertension is common due to cortisol's role in fluid and electrolyte balance. Peripheral edema results from sodium retention and increased capillary permeability. Petechiae may occur due to fragile capillaries from cortisol-induced skin changes. Option B is incorrect as weight gain, not loss, is typical in Cushing syndrome. Buffalo hump and moon face are due to fat redistribution, not acne. Option C is incorrect as truncal obesity and striae are expected, not hypotension. Option D is incorrect as hyperpigmentation, anorexia, and dehydration are more indicative of Addison's disease, not Cushing syndrome. Educationally, understanding these specific manifestations of Cushing syndrome aids nurses in recognizing and managing patients with this condition effectively. It emphasizes the importance of differentiating between various endocrine disorders based on clinical presentations for accurate diagnosis and treatment.

Correct Answer: C

Rationale: In this question, the correct answer is option C) regular insulin. Regular insulin is the only type that can be safely administered intravenously. This is because regular insulin has a fast onset of action, making it suitable for intravenous use to quickly lower blood glucose levels in emergency situations such as diabetic ketoacidosis or hyperglycemic crises. Option A) Lente insulin and option B) Semi-Lente insulin are both long-acting insulins that are designed for subcutaneous administration and have a slower onset of action compared to regular insulin. Administering these types intravenously can lead to erratic absorption and potentially dangerous fluctuations in blood glucose levels. Option D) NPH insulin is an intermediate-acting insulin that is also meant for subcutaneous administration. Using NPH insulin intravenously can result in unpredictable absorption patterns and is not recommended due to the risk of hypoglycemia or hyperglycemia. From an educational standpoint, understanding the different types of insulin and their appropriate routes of administration is crucial for healthcare professionals, especially those working in settings where intravenous insulin administration may be necessary. Proper knowledge of insulin types and their characteristics helps ensure safe and effective management of diabetes and related conditions.

Correct Answer: B

Rationale: The correct answer is B) corns. Corns are areas of thickened skin that develop on the feet due to excessive pressure or friction, common in individuals with diabetes. By observing for the presence of corns on the patient's feet during the next visit, the nurse can assess whether the patient is following the foot care instructions provided. Corns indicate that there is still excessive pressure or friction on certain areas of the feet, suggesting that the patient may not be implementing the recommended foot care practices effectively. Option A) colored socks is incorrect as the color of the socks does not provide any direct indication of the patient's foot care practices or diabetic management. Option C) straight toenails is incorrect as well because while proper nail care is important for diabetic patients, it is not the most reliable indicator of the effectiveness of foot care teaching. Option D) dermatophytosis is a fungal infection that can affect the feet, but it is not directly related to the effectiveness of the foot care teaching provided by the nurse. In an educational context, understanding the significance of assessing foot health in diabetic patients is crucial. Poor foot care can lead to serious complications such as ulcers and infections, which can result in amputations. Nurses play a vital role in educating diabetic patients on proper foot care practices to prevent such complications. By evaluating the outcomes of their teaching, nurses can tailor their education to meet the specific needs of each patient and promote better health outcomes.

Correct Answer: B

Rationale: In the case of Mrs. J, a 40-year-old woman diagnosed with hypothyroidism, the most appropriate treatment plan would involve option B, which is thyroid hormone replacement therapy. This is the correct answer because hypothyroidism is a condition characterized by an underactive thyroid gland, leading to insufficient production of thyroid hormones. As a result, replacing these hormones through medication is essential to restore the body's normal functioning and alleviate symptoms associated with hypothyroidism. Option A, a high-protein diet, and option C, a high-fiber diet, are not directly related to the treatment of hypothyroidism. While a balanced diet is important for overall health, dietary modifications alone cannot address the underlying hormonal imbalance caused by hypothyroidism. Similarly, option D, low-sodium medications, is not a primary treatment for hypothyroidism and would not address the root cause of the condition. Educationally, understanding the appropriate treatment for hypothyroidism is crucial for healthcare professionals and patients alike. By knowing that thyroid hormone replacement therapy is the cornerstone of managing hypothyroidism, healthcare providers can ensure that patients like Mrs. J receive the necessary treatment to improve their quality of life and prevent complications associated with untreated hypothyroidism. This knowledge also empowers patients to advocate for themselves and actively participate in their treatment plans, leading to better health outcomes.