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NO.1 A violent client remains in restraints for several hours. Which of the following interventions is
most appropriate while he is in restraints?
A. Release restraints every 2 hours for client to exercise.
B. Give fluids if the client requests them.
C. Assess skin integrity and circulation of extremities before applying restraints and as they are
removed.
D. Measure vital signs at least every 4 hours.
Answer: A
Explanation:
(A) Fluids (nourishment) should be offered at regular intervals whether the client requests (or
refuses) them or not. (B) Skin integrity and circulation of the extremities should be checked regularly
while the client is restrained, not only before restraints are applied and
after they are removed. (C) Vital signs should be checked at least every 2 hours. If the client remains
agitated in restraints, vital signs should be monitored even more closely, perhaps every 1-2 hours. (D)
Restraints should be released every 2 hours for exercise, one extremity at a time, to maintain muscle
tone, skin and joint integrity, and circulation.

NO.2 A client is now pregnant for the second time. Her first child weighed 4536 g at delivery. The
client's glucose tolerance test shows elevated blood sugar levels. Because she only shows signs of
diabetes when she is pregnant, she is classified as having:
A. Gestational diabetes mellitus
B. Insulin-dependent diabetes
C. Type I diabetes mellitus
D. Type II diabetes mellitus
Answer: A

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Explanation:
(A) Insulin-dependent diabetes mellitus, also known as type I diabetes, usually appears before the
age of 30 years with an abrupt onset of symptoms requiring insulin for management. It is not related
to onset during pregnancy. (B) Non-insulin-dependent diabetes (type II diabetes) usually appears in
older adults. It has a slow onset and progression of symptoms. (C) This type of diabetes is the same as
insulin-dependent diabetes. (D) Gestational diabetes mellitus has its onset of symptoms during
pregnancy and usually disappears after delivery. These symptoms are usually mild and not life
threatening, although they are associated with increased fetal morbidity and other fetal
complications.