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Question 1 of 5.

A friend brings the older adult homeless client to a free health screening clinic. The friend is unable to continue administering the client's morning and evening insulin dose for treating type 1 DM. When advocating for this client, which action by the nurse is most appropriate?

A. Notify Adult Protective Services about the client's condition and living situation.

B. Ask where the client lives and whether someone else could administer the insulin.

C. Arrange with a local homeless shelter to have someone give the insulin injections.

D. Have the client return to the screening clinic morning and evening to receive the injections.

Explanation: The nurse advocates by ensuring that the client has access to health care services. The nurse should contact a social worker whose role it is to make placement arrangements.

Question 2 of 5.

An 18-year-old female client, 5'4 tall, weighing 113 kg, comes to the clinic for a nonhealing wound on her lower leg, which she has had for two (2) weeks. Which disease process should the nurse suspect the client has developed?

A. Type 1 diabetes.

B. Type 2 diabetes.

C. Gestational diabetes.

D. Acanthosis nigricans.

Explanation: Obesity (BMI ~44) and a nonhealing wound suggest type 2 diabetes, associated with insulin resistance. Type 1 is less likely, gestational diabetes requires pregnancy, and acanthosis nigricans is a symptom, not a disease.

Question 3 of 5.

The nurse is assessing the feet of a client with long-term type 2 diabetes. Which assessment data warrant immediate intervention by the nurse?

A. The client has crumbling toenails.

B. The client has athlete's foot.

C. The client has a necrotic big toe.

D. The client has thickened toenails.

Explanation: A necrotic big toe indicates severe infection or gangrene, requiring immediate intervention to prevent amputation. Crumbling/thickened nails and athlete's foot are less urgent.

Question 4 of 5.

The nurse at a freestanding health-care clinic is caring for a 56-year-old male client who is homeless and is a type 2 diabetic controlled with insulin. Which action is an example of client advocacy?

A. Ask the client if he has somewhere he can go and live.

B. Arrange for someone to give him insulin at a local homeless shelter.

C. Notify Adult Protective Services about the client's situation.

D. Ask the HCP to take the client off insulin because he is homeless.

Explanation: Arranging insulin administration at a shelter ensures the client's medical needs are met, advocating for his health. Housing questions, APS notification, and stopping insulin are less supportive.

Question 5 of 5.

The client diagnosed with HHNS was admitted yesterday with a blood glucose level of 780 mg/dL. The client's blood glucose level is now 300 mg/dL. Which intervention should the nurse implement?

A. Increase the regular insulin IV drip.

B. Check the client's urine for ketones.

C. Provide the client with a therapeutic diabetic meal.

D. Notify the HCP to obtain an order to decrease insulin.

Explanation: A glucose drop from 780 to 300 mg/dL requires HCP notification to adjust insulin, preventing hypoglycemia. Increasing insulin, checking ketones, or meals are inappropriate.

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