Page 1432 - Saunders Comprehensive Review For NCLEX-RN

Test-Taking Strategy: Focus on the subject, chronic complications of diabetes
mellitus. Recall that poor glycemic control contributes to development of the chronic
complications of diabetes mellitus. Remember the 3 Ps associated with
hyperglycemia—polyuria, polydipsia, and polyphagia.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Analysis
Content Area: Adult Health: Endocrine
Health Problem: Adult Health: Endocrine: Diabetes Mellitus
Priority Concepts: Clinical Judgment; Glucose Regulation
Reference: Ignatavicius, Workman, Rebar (2018), pp. 1282-1283.

495. Answer: 2

Rationale: An increased blood glucose level will cause the kidneys to excrete the
glucose in the urine. This glucose is accompanied by fluids and electrolytes, causing
an osmotic diuresis leading to dehydration. This fluid loss must be replaced when it
becomes severe. Options 1, 3, and 4 are not related specifically to the information in
the question.
Test-Taking Strategy: Note the strategic word, priority, and focus on the
information in the question. Use Maslow’s Hierarchy of Needs theory. The correct
option indicates a physiological need and is the priority. Options 1, 3, and 4 are
problems that may need to be addressed after providing for the priority
physiological needs.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Planning
Content Area: Adult Health: Endocrine
Health Problem: Adult Health: Endocrine: Diabetes Mellitus
Priority Concepts: Clinical Judgment; Glucose Regulation
Reference: Lewis et al. (2017), p. 1143.

496. Answer: 1

Rationale: When a client with diabetes mellitus is unable to eat normally because
of illness, the client still should take the prescribed insulin or oral medication. The
client should consume additional fluids and should notify the PHCP. The client
should monitor the blood glucose level every 3 to 4 hours. The client should also
monitor the urine for ketones during illness.
Test-Taking Strategy: Note the strategic words, need for further teaching. These
words indicate a negative event query and the need to select the incorrect statement.
Remembering that the client needs to take insulin will direct you easily to the correct
option.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Adult Health: Endocrine

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