The nurse is teaching a client with type 1 diabetes mellitus how to treat adverse reactions to insulin. To reverse a hypoglycemic reaction, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always a possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand?

Correct Answer: C

Rationale: Glucagon is the hormone responsible for raising blood sugar levels in the body. In cases of severe hypoglycemic reactions where the client is unconscious or unable to ingest oral carbohydrates, glucagon can be administered via injection to help raise blood sugar levels rapidly. It is important for clients with type 1 diabetes mellitus to have glucagon on hand as a precautionary measure in case of severe hypoglycemic episodes. Epinephrine is typically used for severe allergic reactions, 50% dextrose is a form of oral carbohydrate, and hydrocortisone is a corticosteroid medication used for various conditions but not for treating hypoglycemia in clients with diabetes.

Correct Answer: A

Rationale: Among the given choices, the nursing diagnosis appropriate for a client with ulcerative colitis is "abdominal pain related to decreased peristalsis." Ulcerative colitis is a chronic inflammatory bowel disease that directly affects the lining of the colon and rectum, leading to symptoms such as abdominal pain, diarrhea, and bloody stool. Decreased peristalsis occurs in patients with ulcerative colitis, resulting in abdominal pain due to inflammation and irritation of the intestines. This pain is a common symptom experienced by individuals with ulcerative colitis and can significantly impact their quality of life. Therefore, addressing the client's abdominal pain is crucial in providing effective nursing care for someone diagnosed with ulcerative colitis.

Correct Answer: C

Rationale: The client is taking Isoniazid and Rifampicin, which are two common first-line medications prescribed for the treatment of tuberculosis. Both of these drugs can potentially cause liver toxicity as a side effect. Therefore, the diagnostic test that is most likely to have an abnormal result if the client is taking these medications is the liver function tests. These tests include parameters such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and bilirubin levels, which can indicate liver damage or dysfunction. Monitoring liver function is essential during treatment with these medications to detect any hepatic adverse effects early and make appropriate management decisions.

Correct Answer: C

Rationale: During the surgical procedure, the circulating nurse, scrub nurse, and nurse first assistant are responsible for keeping track of all instruments, needles, and sponges used. As the surgical incision is being closed, the circulating nurse and the scrub nurse/nurse first assistant conduct a final count of all needles, sponges, and instruments to ensure that nothing is accidentally left inside the patient's body. This is a critical step in preventing retained surgical items (RSI), which can lead to serious complications for the patient. It is part of the standard protocol in the operating room to have these specific personnel take charge of counting and verifying all items before the procedure is concluded.

Correct Answer: B

Rationale: Carbamazepine is a known enzyme inducer, and it can increase the metabolism of other drugs, such as phenytoin (Dilantin). This can lead to lower levels of phenytoin in the blood and potentially reduce its effectiveness. Therefore, patients taking carbamazepine should be monitored for elevated levels of phenytoin to ensure optimal seizure control. Diplopia (double vision), leukocytosis, and adult respiratory distress syndrome are not typically associated with carbamazepine use.