To prevent hyperglycemia or hypoglycemia related to exercise, what should the nurse teach the patient using glucose-lowering agents about the best time for exercise?

Correct Answer: B

Rationale: The correct answer is option B) About 1 hour after eating when blood glucose levels are rising. This option is the most appropriate because it takes into consideration the physiological response to food intake, which leads to a rise in blood glucose levels. Exercising at this time can help prevent hypoglycemia during the activity. Option A is incorrect because relying solely on a carbohydrate snack may not provide enough sustained energy for the duration of the exercise. Option C is incorrect as waiting for blood glucose to be in the normal range may not align with the optimal timing for exercise. Option D is incorrect because exercising when blood glucose levels are already high can increase the risk of hyperglycemia rather than preventing it. From an educational perspective, it is important for nurses to teach patients about the timing of exercise in relation to meals and glucose-lowering agents to help them manage their blood glucose levels effectively. Understanding the impact of different factors on blood glucose regulation can empower patients to make informed decisions about their exercise routines and medication management. It is crucial for patients using glucose-lowering agents to strike a balance between maintaining blood glucose within the target range and avoiding complications like hypo- or hyperglycemia during physical activity.

Correct Answer: A

Rationale: Rationale: The correct answer is A) How to support the head with the hands when turning in bed. This instruction is crucial for a patient undergoing a subtotal thyroidectomy as it helps prevent strain on the surgical site and minimizes the risk of complications such as excessive tension on the incision, which can lead to dehiscence or delayed healing. Proper head support also ensures the patient's comfort and safety during movements, promoting optimal recovery. Option B) Coughing should be avoided to prevent pressure on the incision is incorrect. While coughing should be minimized to reduce strain on the incision site, complete avoidance of coughing is not practical or advisable as it is a natural reflex that helps clear the airways. Patients are encouraged to use appropriate coughing techniques to minimize discomfort without compromising respiratory function. Option C) Head and neck will need to remain immobile until the incision heals is incorrect. While some degree of immobility may be necessary immediately post-op, complete immobilization of the head and neck can lead to stiffness, muscle atrophy, and other complications. Controlled and gentle movements, along with proper support as mentioned in option A, are typically recommended to prevent such issues. Option D) Any tingling around the lips or in the fingers after surgery is expected and temporary is incorrect. Tingling sensations around the lips or in the fingers can indicate potential nerve damage or compromise, which should be promptly reported to healthcare providers for further evaluation and intervention. Such symptoms should not be dismissed as expected or temporary without proper assessment to prevent long-term complications. In an educational context, it is essential for healthcare professionals to provide accurate and detailed preoperative instructions to patients undergoing surgical procedures to ensure their safety, promote optimal recovery, and empower them to actively participate in their care. Understanding the rationale behind each instruction enables patients to make informed decisions and adhere to the prescribed guidelines effectively, contributing to better outcomes and overall patient satisfaction.

Correct Answer: B

Rationale: The correct answer is B: "If my weight goes down, my dosage of steroid is probably too high." Rationale: A) Option A is correct as patients with Addison's disease are at risk of adrenal crisis with vomiting or diarrhea, which can lead to electrolyte imbalances and require medical attention. C) Option C is incorrect because increasing the steroid dose without medical supervision can lead to overmedication, putting the patient at risk of steroid toxicity and related complications. D) Option D is essential as patients with Addison's disease should have an emergency kit with injectable hydrocortisone to manage adrenal crisis situations where oral medication cannot be taken. Educational Context: This question assesses the patient's understanding of self-management in Addison's disease. It highlights the importance of patient education in managing this chronic condition. Patients need to be aware of when to seek medical help, how to adjust medication in certain situations, and the importance of having emergency supplies. The incorrect option emphasizes the need for clear and accurate patient education to prevent potential harm from mismanagement of medications.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) adjusting insulin requirements. The rationale behind this choice is that Mrs. Crane, being an insulin-dependent diabetic, is at risk of experiencing fluctuations in her blood sugar levels during and after surgery. Surgery and anesthesia can impact the body's stress response, leading to changes in glucose metabolism. Therefore, it is crucial for the nurse to educate Mrs. Crane on the importance of adjusting her insulin requirements to maintain optimal blood glucose levels. Option A) pain medications available postoperatively, while important for managing pain after surgery, is not the priority for an insulin-dependent diabetic like Mrs. Crane. Option B) coughing and deep breathing and Option C) early ambulation are essential aspects of postoperative care for general surgery patients, but they do not directly address the specific needs of a diabetic patient like Mrs. Crane. In an educational context, this question highlights the importance of individualized care for patients with chronic conditions like diabetes. It emphasizes the need for healthcare providers, including nurses, to have specialized knowledge and skills to address the unique needs of patients with comorbidities during perioperative care. By focusing on adjusting insulin requirements, the nurse can help Mrs. Crane have a smoother surgical experience and reduce the risk of complications related to her diabetes.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Osteoporosis and kyphosis have caused height loss. This is the best explanation for the discrepancy between Mrs. A.'s stated height and the height measured by the nurse. Osteoporosis can lead to bone density loss and compression fractures, resulting in a decrease in height. Kyphosis, a forward curvature of the spine, is commonly associated with osteoporosis in older adults and can further contribute to height loss. Option A) Mrs. A. is old and forgetful, is incorrect as it does not address the physical reasons for the height discrepancy. Option B) Mrs. A. has had previous back surgery, is incorrect as there is no indication in the scenario that back surgery would impact Mrs. A.'s height measurement. Option C) The nurse has measured Mrs. A. incorrectly, is incorrect as the discrepancy is more likely due to a physical condition affecting Mrs. A.'s height rather than a measurement error. From an educational standpoint, this question highlights the importance of considering underlying medical conditions when assessing patients. It emphasizes the impact of conditions like osteoporosis and kyphosis on physical measurements and the need for healthcare providers to be aware of these factors when evaluating patients. Understanding these connections is crucial for accurate diagnosis and treatment in clinical practice.