Ch 57 - NCLEX Review Questions
b
A nurse assesses a patient who is taking parmlintide [Symlin] with mealtime insulin. Which finding requires immediate follow-up by the nurse? a) Skin rash b) Sweating c) Itching d) Pedal edema
b, d, e
A nurse caring for a patient who has diabetic ketoacidosis recognizes which characteristics in the patient? (Select all that apply.) a) Type 2 diabetes b) Altered fat metabolism leading to ketones c) Arteriole blood pH of 7.35 to 7.45 d) Sudden onset, triggered by acute illness e) Plasma osmolality of 300 to 320 mOsm/L
a
A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these outcomes related to the therapeutic effects of the medication? a) Blood glucose control for 24 hours. b) Mealtime coverage of blood glucose. c) Less frequent blood glucose monitoring. d) Peak effect achieved in 2 to 4 hours.
c
A patient ist King glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is teaching hypoglycemia awareness and should warn the patient about the presence of which symptom? a) Vomiting b) Muscle cramps c) Tachycardia d) Chills
d
A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse explains that normal insulin has which action in the body? a) It stimulates the pancreas to reabsorb glucose. b) It promotes the synthesis of amino acids into glucose. c) It stimulates the liver to convert glycogen to glucose. d) It promotes the passage of glucose into cells for energy.
a
A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which change to the nursing care plan? a) Refer the patient to a diabetes educator because the result reflects poor glycemic control. b) Glycemic control is adequate; no changes are needed. c) Hypoglycemia is a risk; teach the patient the symptoms. d) Instruct the patient to limit activity and weekly exercise.
b
A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect? a) Inhibition of carbohydrate digestion. b) Promotion of insulin secretion. c) Decreased insulin resistance. d) Inhibition of ketone formation.
c
A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse take? a) Take the patient's blood pressure. b) Give the patient's PRN dose of insulin. c) Check the patient's capillary blood sugar. d) Advise the patient to lie down with the legs elevated.
a
A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse? a) "Inject this insulin with your first bite of food, because it is very fast acting." b) "The duration of action for this insulin is about 8 to 10 hours, so you'll need a snack." c) "This insulin needs to be mixed with regular insulin to enhance the effects." d) "To achieve tight glycemic control, this is the only type of insulin you'll need."
a
Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value? a) Creatinine (Cr) level of 2.1 mg/dL b) Hemoglobin (Hgb) level of 9.5 mg/dL c) Sodium (Na) level of 131 mEq/dL d) Platelet count of 120,000/mm3
a
Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same syringe? a) "Draw up the clear regular insulin first, followed by the cloudy NPH insulin." b) "It is not necessary to rotate the NPH insulin vial when it is mixed with regular insulin." c) "The order of drawing up insulin does not matter as long as the insulin is refrigerated." d) "Rotate subcutaneous injection sites each day among the arm, thigh, and abdomen."