Mrs. Klein, aged 35 years, has just been diagnosed as diabetic. She is being put on a 1200 calorie diabetic diet with 50% of the calories to be from carbohydrates, 20% from protein, and 30% from fat. In instructing her about her diet, which of the following would be the best breakfast to suggest?

Correct Answer: C

Rationale: The best breakfast option to suggest to Mrs. Klein, who has been diagnosed with diabetes and put on a 1200 calorie diabetic diet, is option C - a cheese omelet (4 oz cheddar, three eggs), one slice of toast, and one glass of milk. This option is the most suitable as it provides a balanced mix of carbohydrates, protein, and fat according to the prescribed diet plan. Option A is high in carbohydrates and lacks protein, which can lead to unstable blood sugar levels for a diabetic individual. Option B contains too many carbohydrates from corn flakes and orange juice, which can spike blood sugar levels. Option D is high in refined carbohydrates and lacks sufficient protein. Educationally, it is important to understand the impact of different nutrients on blood sugar levels in diabetic patients. Teaching patients like Mrs. Klein about making balanced meal choices that align with their dietary requirements is crucial in managing their condition effectively. Encouraging a diet rich in lean proteins, whole grains, and healthy fats can help stabilize blood sugar levels and improve overall health outcomes.

Correct Answer: B

Rationale: In the scenario of a patient who has just undergone a subtotal thyroidectomy, monitoring for signs of hemorrhage and shock (Option B) during the first 12 hours postoperatively is crucial. This is because post-thyroidectomy hemorrhage is a significant complication that can lead to airway compromise, hypovolemic shock, and potential death. Monitoring for early signs such as neck swelling, difficulty breathing, tachycardia, and hypotension allows for prompt intervention and prevention of serious consequences. In contrast, the other options are not priorities during the immediate postoperative period after a thyroidectomy. Instructing the patient to avoid moving the head (Option A) is not as critical as monitoring for hemorrhage and shock. Administering medications to reduce thyroid hormone levels (Option C) and preparing the patient for thyroid replacement therapy (Option D) are important aspects of long-term care but are not immediate concerns in the first 12 hours postoperatively. Educationally, understanding the priorities in post-thyroidectomy care is essential for nurses to provide safe and effective care to these patients. By emphasizing the importance of vigilant monitoring for complications like hemorrhage and shock, nurses can ensure early detection and intervention, ultimately improving patient outcomes and safety.

Correct Answer: D

Rationale: The correct answer is D) Hypertension, low HDL, and elevated triglycerides. In the context of metabolic syndrome, these signs and symptoms are commonly seen and are key components of the diagnostic criteria. Hypertension, or high blood pressure, is a hallmark feature of metabolic syndrome. It is a key risk factor for cardiovascular disease and is often present in individuals with this condition. Low HDL (high-density lipoprotein) levels and elevated triglycerides are also typical findings in metabolic syndrome. Low HDL levels are associated with an increased risk of heart disease, while elevated triglycerides indicate abnormal lipid metabolism, which is common in metabolic syndrome. Now, let's address why the other options are incorrect: A) Weight loss, malar rash, and pharyngitis: These symptoms are not typically associated with metabolic syndrome. Weight gain or obesity is actually a common feature of metabolic syndrome. B) Hypothyroidism, podagra, and elevated fasting glucose: While elevated fasting glucose is a symptom of metabolic syndrome, hypothyroidism and podagra are not typically part of this syndrome. C) Violaceous rash, pitting peripheral edema, and palpitation: These symptoms are not specific to metabolic syndrome. Pitting peripheral edema can be seen in conditions like heart failure, while palpitations can have various causes unrelated to metabolic syndrome. Educational Context: Understanding the signs and symptoms of metabolic syndrome is crucial for healthcare professionals, especially nurses, as they play a vital role in educating and supporting patients with this condition. By recognizing these key features, nurses can provide targeted interventions to help manage and prevent complications associated with metabolic syndrome, such as cardiovascular disease and type 2 diabetes. Education on lifestyle modifications, medication management, and regular monitoring is essential in empowering patients like Alexa to take control of their health and well-being.

Correct Answer: B

Rationale: The correct answer is B) Detect the presence of cerebrospinal fluid. In a client with acromegaly who has undergone nasal surgery, detecting the presence of cerebrospinal fluid is essential because damage to the nasal cavity during the surgery can lead to leakage of cerebrospinal fluid, which can increase the risk of infection and other complications. Option A, detecting signs of increased intracranial pressure and meningitis, is incorrect because while monitoring for these conditions is important post-operatively, detecting cerebrospinal fluid leakage takes precedence due to the immediate risk it poses. Option C, detecting signs of hypoglycemia, is unrelated to the situation described and is not a priority in this context. Option D, detecting the presence of striae, is also unrelated to the post-operative care of a client with acromegaly and nasal packing. In an educational context, understanding the priority nursing actions post-operatively for specific conditions like acromegaly and nasal surgery is crucial for providing safe and effective care to patients. Nurses must be able to prioritize assessments and interventions based on the individual needs of the patient to prevent complications and promote recovery.

Correct Answer: A

Rationale: In the scenario of a patient hospitalized with adrenocortical insufficiency, delegating the task of reminding the patient to change positions slowly to the nursing assistant is appropriate. This task falls within the scope of the nursing assistant's role as it involves a simple reminder that does not require specialized nursing knowledge or expertise. It is important for patients with adrenocortical insufficiency to change positions slowly to prevent orthostatic hypotension, a common complication in these patients. Checking the patient for muscle weakness (option B) requires a higher level of assessment skill and understanding of the condition, making it more suitable for a registered nurse to perform. Teaching the patient how to collect 24-hour urine (option C) involves patient education and requires a higher level of understanding of the endocrine system and its related conditions, making it beyond the scope of a nursing assistant's role. Planning nursing interventions to promote fluid balance (option D) involves critical thinking and decision-making skills that are typically within the realm of a registered nurse's responsibilities. Educationally, understanding delegation in nursing is crucial for effective teamwork and optimizing patient care. Delegating tasks appropriately based on the skill level and scope of practice of each team member ensures that patient needs are met efficiently and safely. It also allows nurses to focus on tasks that require their specialized knowledge and expertise, ultimately improving patient outcomes.