Archer Nclex Cardiovascular questions with correct answers

A client is scheduled for gastroscopy at 8:00 AM and has been placed on NPO since midnight. At 6:30 AM, the nurse checks the client's capillary blood glucose level and gets a result of 40 mg/dl on the glucometer. The client is alert, coherent, and reports, "I feel fine. I don't feel anything." The most appropriate action for the nurse is: A. Record the finding in the notes and withhold the client's morning insulin. B. Take a repeat sample of the capillary blood glucose. C. Give the client simple sugar by mouth. D. Administer intravenous dextrose 50 grams STAT. - Answer Choice B is correct. The nurse should repeat the test because the client does not display any symptoms of hypoglycemia. The glucometer readings are not always accurate. Many variables such as quality of blood sample, dirt on the meter, humidity, aged test strip, high hematocrit etc. may affect glucometer readings. In view of so many variables affecting the blood glucose reading in glucometer, the nurse must be alert while interpreting these values especially, in the absence of any symptoms. Definition of hypoglycemia differs in diabetic patients differs from that of non-diabetic patients. In diabetic patients, Hypoglycemia is defined as a blood glucose of less than 70mg/dl. Many diabetics may also have a condition called "Hypoglycemia unawareness" where there may not be sufficient autonomic warning symptoms before the onset of neuroglycopenia (impaired cognition, coma). In a diabetic patient, therefore, hypoglycemia needs to be treated as soon as possible based on the lab values even in the absence of overt symptoms. In non-diabetic adults with low glucose level, one should assess for symptoms. Symptoms may include cold, clammy skin, tachycardia, palpitations, impaired cognition, slurred speech, seizures, and confusion. A low blood glucose at the time of symptoms and improvement as soon as the blood glucose returns to normal confirm the diagnosis. In a non-diabetic client who has been fasting, a blood glucose less than 50 mg/dL can also be used to define hypoglycemia. In the absence of symptoms, however, the first step is to recheck t