Mrs. Jones, a 46-year-old diabetic, is 5'2\ and weighs 200 lb. Which area of health-care teaching should assume greatest priority for this patient?"

Correct Answer: C

Rationale: In the case of Mrs. Jones, a 46-year-old diabetic who is overweight, managing her diet should assume the greatest priority. This is because diet plays a crucial role in controlling blood sugar levels in diabetics. By educating Mrs. Jones on the importance of a balanced diet, low in sugar and carbohydrates, she can better manage her diabetes and potentially lose weight, which can further improve her condition. Exercise, while important, may not be the immediate priority as dietary changes can have a more significant impact on blood sugar levels. Foot care and eye care are also important aspects of diabetes management, but they are secondary to diet in terms of immediate importance. In an educational context, this question highlights the significance of dietary management in diabetes care. It emphasizes the need for healthcare providers to prioritize teaching patients about nutrition and its impact on their condition. By focusing on diet first, patients like Mrs. Jones can take proactive steps towards better managing their diabetes and overall health.

Correct Answer: B

Rationale: In the context of assessing a client's general status and ruling out disorders related to the endocrine system, option B, which is a complete blood count and chemistry profile, is the most appropriate choice. This is because a complete blood count (CBC) provides information about red blood cells, white blood cells, and platelets, which can indicate various health conditions like anemia or infections. The chemistry profile, on the other hand, evaluates organ function and can detect abnormalities in blood glucose levels, electrolytes, and kidney or liver function, which are crucial in diagnosing endocrine disorders such as diabetes or thyroid issues. Option A, which only includes a complete blood count, may provide some information about blood cell counts but lacks the comprehensive evaluation of organ function that the chemistry profile offers. Option C, which suggests only a chemistry profile, may not give a complete picture of the client's general health status as it does not include information on blood cell counts. Option D, radiographs of the chest or abdomen, are imaging studies that are not typically used as initial diagnostic tests for assessing general health status and ruling out endocrine disorders; they are more useful for visualizing anatomical structures. In an educational context, understanding the significance of different diagnostic tests in assessing endocrine disorders is crucial for healthcare professionals. By choosing the correct combination of tests like a complete blood count and chemistry profile, practitioners can gather comprehensive information to make accurate diagnoses and provide appropriate treatment plans for clients with endocrine-related concerns. This emphasizes the importance of selecting the most relevant and comprehensive diagnostic tools to ensure effective patient care.

Correct Answer: B

Rationale: The correct answer is B) Signs of hyperthyroidism. During initial therapy with a thyroid replacement, it is common for patients to experience signs of hyperthyroidism. This occurs because the body is adjusting to the introduction of thyroid hormone, which can initially lead to an excess of thyroid hormone levels in the blood. Symptoms of hyperthyroidism may include palpitations, tremors, weight loss, heat intolerance, and anxiety. Option A) Allergy is incorrect because while allergic reactions can occur with medications, they are not the most common adverse reaction during initial thyroid replacement therapy. Option C) Weight loss is incorrect because although weight changes can be a symptom of thyroid dysfunction, it is not the most common adverse reaction during initial thyroid replacement therapy. Option D) Bones becoming demineralized is incorrect because this would be a long-term effect of untreated or improperly managed thyroid disorders, not a common adverse reaction during initial thyroid replacement therapy. In an educational context, understanding the common adverse reactions during initial therapy with a thyroid replacement is crucial for healthcare professionals to monitor and manage patient care effectively. Recognizing signs of hyperthyroidism early on can help prevent complications and ensure proper adjustment of medication dosages to achieve optimal thyroid hormone levels in the body.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Rapid changes of position may cause hypotension. Rationale: Teaching the patient about the risk of hypotension with rapid position changes is crucial because glucocorticoids like prednisone can lead to fluid retention and sodium retention, increasing the risk of hypotension when changing positions quickly. Educating the patient about this potential side effect can help prevent falls and injuries. Option A (Report excessive weight gain or swelling to the physician) is not the most pertinent teaching point in this case as weight gain and swelling are more commonly associated with mineralocorticoid activity rather than glucocorticoid use. Option C (A diet with foods high in potassium may be beneficial) is incorrect because prednisone can actually cause potassium depletion, so a diet high in potassium may not be recommended without medical supervision. Option D (Signs of hypoglycemia may occur while taking this drug) is not directly related to prednisone use, as prednisone can actually increase blood glucose levels rather than cause hypoglycemia. Educational context: Patients with adrenal insufficiency require education on glucocorticoid replacement therapy, including potential side effects and how to manage them. Teaching about the risk of hypotension with rapid position changes is a crucial aspect of patient education to ensure their safety and well-being while on prednisone therapy.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Have another nurse check the amount and type of insulin drawn up against the order. This practice is known as the "double-check" system, which is a critical safety measure in healthcare to prevent medication errors. Insulin is a high-alert medication, and errors in dosage can have serious consequences for the client, such as hypoglycemia or hyperglycemia. Having another nurse independently verify the dosage and type of insulin drawn up adds an extra layer of safety by ensuring accuracy in medication administration. This process helps to catch any discrepancies or mistakes before the insulin is administered to the client, reducing the risk of harm. The other options are incorrect because: A) Checking the client's last glucose level and informing the physician is not directly related to preventing a medication error in administering insulin. While monitoring glucose levels is important in diabetes management, it does not address the immediate need for verifying the correct insulin dosage. B) Informing the diabetic educator that the client needs education is not relevant to the immediate task of preventing a medication error in insulin administration. While client education is essential for long-term diabetes management, it does not address the safety measure required before administering insulin. C) Assuming the client knows about the insulin and its purpose is risky and could lead to assumptions that may result in a medication error. It is crucial to verify and confirm all medication-related information to ensure patient safety. In an educational context, it is essential for healthcare professionals to understand and practice medication safety protocols diligently. Emphasizing the importance of double-checking high-risk medications like insulin can help prevent errors, promote patient safety, and instill a culture of accountability and thoroughness in healthcare practice.