1873 Exam 1

Which statement by the patient with type 2 diabetes is accurate? A. "I will limit my alcohol intake to one drink." B. "I am not allowed to eat any sweats because of my diabetes." C. "I cannot exercise because I take a blood glucose-lowering medication." D. "The amount of fat in my diet is not important. Only carbohydrates raise my blood sugar."

A. "I will limit my alcohol intake to one drink."

Which of the following is not a typical sign and symptom of Cushing's disease? A. A hyperpigmentation of the skin B. Hirsutism C. Purplish striae D. Moon face

A. A hyperpigmentation of the skin

A patient is admitted to the hospital with a diagnosis of primary hyperparathyroidism. A nurse checking the patient's lab results would expect which of the following changes in laboratory findings? A. Elevated serum calcium B. Low serum parathyroid hormone (PTH) C. Elevated serum vitamin D. D. Low urine calcium

A. Elevated serum calcium

You are developing a care plan for a patient with SIADH. Which of the following would be a potential nursing diagnosis for this patient? A. Fluid volume overload B. Fluid volume deficit C. Acute pain D. Impaired skin integrity

A. Fluid volume overload

You are caring for a patient with newly diagnosed type 1 diabetes what information is essential to include in your patient teaching before discharge from the hospital (select all that apply)? A. Insulin administration B. Elimination of sugar from diet C. Need to reduce physical activity D. Use of a portable blood glucose monitor E. Hypoglycemia prevention, symptoms, and treatments

A. Insulin administration D. Use of a portable blood glucose monitor E. Hypoglycemia prevention, symptoms, and treatment

Which of the following are treatment options for hyperthyroidism? Please select all that apply: A. Thyroidectomy B. Methimazole C. Liothyronin Sodium D. Radioactive Iodine

A. Thyroidectomy B. Methimazole D. Radioactive Iodine

1. Type 1 diabetics typically have the following clinical characteristics: A.) Thin, young with ketones present in the urine B.)Overweight, young with no ketones present in the urine C.)Thin, older adult with glycosuria D.)Overweight, adult-ages with ketones present in the urine

A.) Thin, young with ketones present in the urine

Which physician order do you perform FIRST for a patient withHHS A) Administer enoxaparin (Lovenox) 1mg/kg subcutaneously B) Begin IV of 1000 mL NSS with 40 mEq KCl to infuse at 150 mL/hr continuously. C) Begin IV of 1000 mL NSS with 500 U short-acting insulin to infuse at 20 U/hr D) Insert urinary catheter

B) Begin IV of 1000 mL NSS with 40 mEq KCl to infuse at 150 mL/hr continuously.

Which of the following would be priority assessments for a patient with HHS? Select all that apply. A) Pedal pulse B) Lung sounds C) Serum Electrolytes D) Intake & Output E) pupillary reaction F) Capillary glucose monitoring

B) Lung sounds C) Serum Electrolytes D) Intake & Output F) Capillary glucose monitoring

Possible Nursing interventions for HHS include all of the following except: A) Cardiac monitoring B) Subcutaneous administration regular insulin C) IV administration normal saline D) monitor serum electrolytes

B) Subcutaneous administration regular insulin

The health care provider prescribes levothyroxine for a patient with hypothyroidism. After teaching regarding this drug, the nurse determines the further instruction is needed when the patient says: A. "I can expect the medication dose may need to be adjusted." B. "I only need to take this drug until my symptoms are improved." C. "I can expect to return to normal function with the use of this drug." "I will report any chest pain or difficulty breathing to the doctor right away."

B. "I only need to take this drug until my symptoms are improved."

A patient hospitalized with hypoparathyroidism is about to order lunch. Which food selection is best for the patient based on their dietary needs at this time? A. Baked chicken, green beans, and boiled potatoes. B. Broccoli salad, cottage cheese, and peaches. C. Roast beef, carrots, and pinto beans. D. Hamburger, fries, and sorbet.

B. Broccoli salad, cottage cheese, and peaches.

A patient with diabetes has a morning glucose of 50. The patient is sweaty, cold, and clammy. Which of the following nursing interventions is most important? A. Recheck the glucose level B. Give the patient ½ cup (4 oz) of fruit juice C. Call the doctor Keep the patient nothing by mouth

B. Give the patient ½ cup (4 oz) of fruit juice

Vomiting, Diarrhea, and osmotic diuresis associated with HHS may be produce which EKG change? A) widening QRS B) Tall peaked T wave C) Present U wave D) Depressed ST segment

C) Present U wave

Which of the following nursing interventions is most appropriate for a client diagnosed with diabetes insipidus? A. limit oral fluid intake B. Hold all medications C. Encourage oral fluid intake D. Inset a indwelling urinary catheter

C. Encourage oral fluid intake

A nurse is caring for a client with acromegaly. Following a transsphenoidal hypophysectomy, the nurse should: A. Encourage the client to cough B. Suction the mouth and pharynx every hour C. Monitor the client's blood sugar D. Place the client in low Trendelenburg position.

C. Monitor the client's blood sugar

A patient with Addison's disease asks a nurse for nutrition and diet advice. Which of the following diet modifications is NOT recommended? A. A diet high in grains B. A diet with adequate caloric intake C. A high protein diet D. A restricted sodium diet

D. A restricted sodium diet

1. After thyroid surgery, the nurse suspect damage or removal of the parathyroid glands when the patient develops A. Muscles weakness and weight loss B. Hyperthermia and severe tachycardia C. Hypertension and difficulty breathing D. Irritability and tingling in the hands and feet

D. Irritability and tingling in the hands and feet

Which statement would be correct for a patient with type 2 diabetes who was admitted to the hospital with pneumonia? A. The patient must receive insulin therapy to prevent ketoacidosis. B. The patient has islet cell antibodies that have destroyed the pancreas's ability to produce insulin C. The patient has minimal or absent endogenous insulin secretion and requires daily insulin injections. D. The patient may have sufficient endogenous insulin to prevent ketosis bus is at risk for hyperosmolar hyperglycemic syndrome.

D. The patient may have sufficient endogenous insulin to prevent ketosis bus is at risk for hyperosmolar hyperglycemic syndrome.

Untreated diabetes may result in all the following except: A. Blindness B. Cardiovascular disease C. Kidney disease D. Tinnitus

D. Tinnitus

long acting onset, peak, duration

Onset: 0.8-4 hr Peak: no pronounced peak Duration: 16-24hr

intermediate acting onset, peak, duration

Onset: 1.5-4 hr Peak: 4-12 hr Duration: 12-18 hr

Rapid Acting Onset, peak, duration

Onset: 10-30 min Peak: 30 min-3 hr Duration: 3-5 hr

1. The nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is most likely at risk for a fluid volume deficit? a) A client with an ileostomy b) A client with heart failure c) A client on long-term corticosteroid therapy d) A client receiving frequent wound irrigations

a) A client with an ileostomy

A nurse is reviewing the assessment findings for a client who was admitted to the hospital with a diagnosis of diabetes insipidus. The nurse understands that which manifestations are associated with this disorder? Select all that apply. a) Polyuria b) Polydipsia c) Concentrated urine d) Complaints of excessive thirst e) Specific gravity lower than 1.005

a) Polyuria b) Polydipsia d) Complaints of excessive thirst e) Specific gravity lower than 1.005

1. The nurse is monitoring a client who was diagnosed with type 1 diabetes mellitus and is being treated with NPH and regular insulin. Which manifestations would alert the nurse to the presence of a possible hypoglycemic reaction? Select all that apply. a) Tremors b) Anorexia c) Irritability d) Nervousness e) Hot, dry skin f) Muscle cramps

a) Tremors c) Irritability d) Nervousness

1. The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which clinical manifestation would the nurse expect to note in the client? a) Twitching b) Hypoactive bowel sounds c) Negative Trousseau's sign d) Hypoactive deep tendon reflexes

a) Twitching

The nurse caring for a client who has been receiving intravenous (IV) diuretics suspects that the client is experiencing a fluid volume deficit. Which assessment finding would the nurse note in a client with this condition? a) Weight loss and poor skin turgor b) Lung congestion and increased heart rate c) Decreased hematocrit and increased urine output d) Increased respirations and increased blood pressure

a) Weight loss and poor skin turgor

Rapid acting insulin should be administered within 15 minutes of a meal. Which of the following is a rapid acting insulin? Select all that apply a) aspart b) glulisine c) lispro d) humulin r e) humulin n

a) aspart b) glulisine c) lispro

A client with diabetes mellitus has a blood glucose level of 50 mg/dL (2.85 mmol/L) and reports feeling hungry and shaky. Which should the nurse provide the client? The client needs immediate education before discharge. a) 3 oz of 2% milk b) 4 oz of apple juice c) 2 oz of orange juice d) A teaspoon of granulated sugar

b) 4 oz of apple juice

1. The nurse is preparing to care for a client with a potassium deficit. The nurse reviews the client's record and determines that the client is at risk for developing the potassium deficit because of which situation? a) Sustained tissue damage b) Requires nasogastric suction c) Has a history of Addison's disease d) Uric acid level of 9.4 mg/dL (559 mmol/L)

b) Requires nasogastric suction

1. A client received 20 units of Humulin N insulin subcutaneously at 08:00. At what time should the nurse plan to assess the client for a hypoglycemic reaction? a) 10:00 b) 11:00 c) 17:00 d) 24:00

c) 17:00 rationale: Humulin N is an intermediate-acting insulin. The onset of action is 60 to 120 minutes, it peaks in 6 to 14 hours, and the duration of action is 16 to 24 hours. Hypoglycemic reactions most likely occur during peak time.

1. The nurse should include which interventions in the plan of care for a client with hyperthyroidism? Select all that apply. a) Provide a warm environment for the client. b) Instruct the client to consume a low-fat diet. c) A thyroid-releasing inhibitor will be prescribed. d) Encourage the client to consume a well-balanced diet. e) Instruct the client that thyroid replacement therapy will be needed. f) Instruct the client that episodes of chest pain are expected to occur.

c) A thyroid-releasing inhibitor will be prescribed. d) Encourage the client to consume a well-balanced diet. Rationale: The nurse encourages the client to consume a well-balanced diet because clients with this condition experience increased appetite. Iodine preparations are used to treat hyperthyroidism. Iodine preparations decrease blood flow through the thyroid gland and reduce the production and release of thyroid hormone.

1. The nurse is preparing a client with a new diagnosis of hypothyroidism for discharge. The nurse determines that the client understands discharge instructions if the client states that which signs and symptoms are associated with this diagnosis? Select all that apply. a) Tremors b) Weight loss c) Feeling cold d) Loss of body hair e) Persistent lethargy f) Puffiness of the face

c) Feeling cold d) Loss of body hair e) Persistent lethargy f) Puffiness of the face

1. A nurse is reviewing the assessment findings and laboratory data for a client with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The nurse understands that which symptoms are associated characteristics of this disorder? Select all that apply. a) Hypernatremia b) Signs of water deficit c) High urine osmolality d) Low serum osmolality e) Hypotonicity of body fluids f) continued release of ADH

c) High urine osmolality d) Low serum osmolality e) Hypotonicity of body fluids f) continued release of ADH

Long acting insulin includes all of the following except: a) glargine b) degludec c) Humulin N d) detemir

c) Humulin N

5. The nurse is reading a health care provider's (HCP's) progress notes in the client's record and reads that the HCP has documented "insensible fluid loss of approximately 800 mL daily." The nurse makes a notation that insensible fluid loss occurs through which type of excretion? a) Urinary output b) Wound drainage c) Integumentary output d)The gastrointestinal tract

c) Integumentary output

6. The nurse reviews the electrolyte results of an assigned client and notes that the potassium level is 5.7 mEq/L (5.7 mmol/L). Which patterns would the nurse watch for on the cardiac monitor as a result of the laboratory value? Select all that apply. a) ST depression b) Prominent U wave c) Tall peaked T waves d) Prolonged ST segment e) Widened QRS complexes

c) Tall peaked T waves e) Widened QRS complexes

1. The nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose level of 120 mg/dL (6.8 mmol/L), temperature of 101°F (38.3°C), pulse of 102 beats/minute, respirations of 22 breaths/minute, and blood pressure of 142/72 mm Hg. Which finding would be the priority concern to the nurse? a) Pulse b) Respiration c) Temperature d) Blood pressure

c) Temperature

When should you inject Humulin R.? a) within 15 minutes of a meal b) at bedtime c) within 30-45 minutes of meal time d) 1 hour prior to eating

c) within 30-45 minutes of meal time

The nurse is performing an assessment on a client with a diagnosis of Cushing's syndrome. Which should the nurse expect to note on assessment of the client? a) Skin atrophy b) The presence of sunken eyes c) Drooping on 1 side of the face d) A rounded "moonlike" appearance to the face

d) A rounded "moonlike" appearance to the face Rationale: e nurse should be alert to signs and symptoms of adrenal insufficiency after adrenalectomy. These signs and symptoms include weakness, hypotension, fever, and mental status changes. The remaining options are incorrect.

The nurse is reviewing the health care provider's (HCP's) prescriptions for a client with a diagnosis of diabetes mellitus who has been hospitalized for treatment of an infected foot ulcer. The nurse expects to note which finding in the HCP's prescriptions? a) A decreased-calorie diet b) An increased-calorie diet c) A decreased amount of NPH insulin daily insulin d) An increased amount of NPH insulin daily insulin

d) An increased amount of NPH insulin daily insulin

A client with diabetes mellitus has a glycosylated hemoglobin A1C level of 9%. On the basis of this test result, the nurse plans to teach the client about the need for which measure? a) Avoiding infection b) Taking in adequate fluids c) Preventing and recognizing hypoglycemia d) Preventing and recognizing hyperglycemia

d) Preventing and recognizing hyperglycemia

Short acting onset, peak, duration

onset: 30 min-1 hr peak: 2-5 hr duration: 5-8 hr