The nurse is caring for a client with type I diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:

Correct Answer: A

Rationale: In this scenario where the client with type I diabetes mellitus is exhibiting confusion, light-headedness, and aberrant behavior, indicating hypoglycemia, the first-line treatment would be administering I.M. or subcutaneous glucagon. Glucagon helps to rapidly increase blood sugar levels by stimulating the liver to release stored glucose. This is crucial in situations where the client is conscious but unable to take oral carbohydrates, such as in cases of severe hypoglycemia with altered mental status. Administration of glucagon helps to quickly raise blood sugar levels and prevent further deterioration in the client's condition. Options B, C, and D are not the initial interventions in this situation and may not be as effective in rapidly correcting hypoglycemia in a client who is exhibiting signs of confusion and aberrant behavior.

Correct Answer: D

Rationale: In a 28-year-old female client who is being successfully treated for Cushing syndrome, a decline in menstrual flow would be expected due to the normalization of the hormonal imbalances associated with Cushing syndrome. Cushing syndrome can lead to elevated levels of cortisol, which can disrupt the normal menstrual cycle by affecting the production of reproductive hormones. As treatment successfully addresses the underlying cause of the hormonal imbalance, such as surgery to remove the source of excessive cortisol production or medication to control cortisol levels, the menstrual cycle is likely to return to normal, resulting in a decline in menstrual flow. This improvement in menstrual regularity is a positive indicator of successful treatment for Cushing syndrome in female clients.

Correct Answer: A

Rationale: Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a progressive and fatal neurodegenerative disease that affects the nerve cells in the brain and spinal cord. The average life expectancy for individuals with ALS is around 2 to 5 years from the time of diagnosis. Therefore, the normal life expectancy for 50% of patients with ALS would be closer to the midpoint of this range, which is approximately 3 years. While some individuals may live longer than 3 years with ALS, for 50% of patients, this would be a reasonable estimate based on the typical progression of the disease.

Correct Answer: A

Rationale: When a patient is suspected to have a possible skull fracture, the nurse should observe him for signs of brain injury. Signs of brain injury can include changes in level of consciousness, altered pupil size or reaction to light, slurred speech, weakness or numbness in extremities, seizures, severe headache, vomiting, and vision changes. Monitoring for these signs would help in early detection of any worsening condition or complications related to the skull fracture. It is crucial to assess and monitor the patient's neurological status closely to provide timely interventions and prevent further damage.

Correct Answer: C

Rationale: Mr. Franco's conditions indicate a need for positioning aids and support to prevent pressure ulcers and maintain proper alignment. Sandbags can be used to provide support and stability for his lower extremities, while trochanter rolls can help maintain proper alignment of his hips and prevent external rotation of the legs. These aids are crucial in ensuring Mr. Franco's comfort, safety, and overall well-being during his stay in bed.