A diabetic patient is found unconscious at home and a family member calls the clinic. After determining that a glucometer is not available, what should the nurse advise the family member to do?

Correct Answer: D

Rationale: In this scenario, the correct answer is option D: Administer glucagon 1 mg intramuscularly (IM) or subcutaneously. This is the correct course of action because the patient is unconscious, indicating severe hypoglycemia, which requires immediate intervention to raise blood glucose levels. Option A (Have the patient drink some orange juice) is not appropriate in this case as the patient is unconscious and unable to swallow safely. Option B (Administer 10 U of regular insulin subcutaneously) would further lower blood glucose levels, exacerbating the hypoglycemia. Option C (Call for an ambulance to transport the patient to a medical facility) delays immediate intervention needed for a patient in this critical condition. Educationally, it is vital for healthcare professionals and family members of diabetic patients to understand the emergency management of hypoglycemia. Training on the administration of glucagon and recognizing the signs of severe hypoglycemia can be life-saving. Immediate intervention with glucagon can help restore the patient's blood glucose levels and prevent further complications.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D) Hyperparathyroidism. Hyperparathyroidism is a condition characterized by the overproduction of parathyroid hormone (PTH) by the parathyroid glands, leading to increased levels of calcium in the blood. This excess of PTH can result in the release of calcium from the bones, causing bone density loss and increasing the risk of conditions like osteoporosis. Option A) SIADH (Syndrome of Inappropriate Antidiuretic Hormone) is unlikely to cause bone density loss as it primarily affects water balance in the body, not calcium metabolism. Option B) Cushing syndrome is associated with excess cortisol production, which can lead to bone loss, but it typically presents with other symptoms such as weight gain, high blood pressure, and changes in body composition. Option C) Hypothyroidism can also impact bone health, but it usually results in decreased bone turnover rather than the rapid bone loss seen in this case. Educationally, understanding the relationship between endocrine disorders and bone health is crucial in clinical practice. Hyperparathyroidism's effect on bone density underscores the importance of early detection and management to prevent complications like fractures. This question also highlights the interconnectedness of different endocrine systems and the need for a comprehensive approach to patient care.

Correct Answer: A

Rationale: In this scenario, option A is the correct answer, and here's the detailed rationale: A) each ounce of alcohol contains approximately 50 calories Rationale: The correct answer is A because alcohol contains calories, and each gram of alcohol provides approximately 7 calories. Therefore, each ounce of alcohol contains around 50 calories. For a diabetic patient like Mr. Olson on a specific 1500-calorie diabetic diet, it is crucial to account for the calories from alcohol to maintain proper blood sugar levels and overall health. Now, let's discuss why the other options are incorrect: B) the bourbon should be mixed with 7-Up or ginger-ale rather than water This option is incorrect as mixing bourbon with sugary beverages like 7-Up or ginger-ale would increase the overall caloric intake and may negatively impact blood sugar levels, making it unsuitable for a diabetic following a specific diet plan. C) the caloric content of the alcohol must be subtracted from the total diet prescription While it is essential to consider the caloric content of alcohol in the overall diet, simply subtracting the calories from alcohol may not provide a comprehensive approach to managing diabetes and may overlook other important dietary considerations such as macronutrient balance and meal timing. D) Fermented spirits (beer, wine) would be better if he insists on a nightly drink This option is incorrect because different types of alcoholic beverages have varying effects on blood sugar levels. Beer and wine also contain calories and can impact diabetes management similarly to bourbon. It is essential to focus on moderation and understanding the caloric content rather than switching to other types of alcohol. Educational Context: This question highlights the importance of understanding the caloric content of alcohol and its implications for diabetic patients following specific dietary plans. Educating patients on making informed choices regarding alcohol consumption can empower them to manage their condition effectively and maintain overall health. It also emphasizes the need for healthcare providers to provide tailored guidance based on individual dietary requirements and health goals.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) increased exercise level. When someone with diabetes engages in physical activity like playing tennis, their body uses up glucose for energy. This increased demand for glucose, coupled with the effects of insulin that is already present in the body, can lead to hypoglycemia if the individual does not adjust their insulin dosage or food intake accordingly. Option B) insufficient insulin dosage is incorrect because in this case, the individual's insulin dosage would have been sufficient for their usual activity level but became excessive due to the additional glucose utilization during exercise. Option C) increased food intake is incorrect because consuming more food would actually help prevent hypoglycemia by providing more glucose for the body to use during exercise. Option D) increased glucagon production is incorrect because glucagon is released by the body to raise blood sugar levels when they are low, so increased glucagon production would actually help counteract hypoglycemia. Educationally, this question highlights the importance of monitoring blood sugar levels and adjusting insulin dosage and food intake based on physical activity levels for individuals with diabetes. It underscores the need for proactive management of blood sugar levels to prevent complications like hypoglycemia during exercise. This knowledge is crucial for healthcare professionals, caregivers, and individuals with diabetes to ensure safe and effective management of the condition.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Parathyroid hormone. After a thyroidectomy, there is a risk of inadvertently damaging or removing the parathyroid glands, which are responsible for regulating calcium levels in the body. Tetany, which is characterized by muscle spasms and twitching due to low calcium levels, is a common sign of hypoparathyroidism following thyroid surgery. Choice A) Insulin is not related to calcium regulation but to glucose metabolism, so it is not the correct answer in this context. Choice C) Thyroid hormone is also not directly involved in calcium regulation but rather in metabolism and growth. Choice D) Corticosteroids are not associated with tetany; they are involved in stress response and immune function. In an educational context, it is crucial for healthcare professionals to understand the interconnectedness of the endocrine system and the potential complications that can arise post-thyroidectomy. Recognizing the signs of hypoparathyroidism, such as tetany, is essential for prompt intervention and preventing further complications related to calcium imbalance. This knowledge can improve patient outcomes and safety in the postoperative period.