EAQ #4

A nurse is collecting information about a client with type 1 diabetes who is being admitted because of the diabetic ketoacidosis coma. Which factors can predispose a client to this condition? a. taking too much insulin b. getting too much exercise c. excessive emotional stress d. running a fever with the flu e. eating fewer calories than prescribed

C,D

Two clients with polydipsia and polyuria arrived at the hospital. Both are having similar symptoms but were diagnosed with different types of diabetes insipidus. Which assessment findings help to differentiate the diagnosis? a. urine output b. specific gravity c. urine osmolarity d. serum osmolarity

C. Urine osmolarity

A nurse is caring for a client after a thyroidectomy. Which symptoms indicating thyroid storm should the nurse monitor the client for? a. increased HR b. inc temp c. dec respirations d, inc pulse deficit e. dec BP

a, b

A nurse is caring for two clients newly diagnoses with diabetes. One client has type 1 diabetes and the other client has type 2 diabetes. When determining the main difference between type 1 and 2, the nurse recognizes what clinical presentation about type 1? a. onset of diabetes if slow b. excessive weight is a contributing factor c. complications are not present at the time of diagnosis d. treatment involves diet, exercise, and oral medications

c. complications are not present at the time of diagnosis

A nurse is caring for an older adult who has non-insulin dependent diabetes for 15 years that progressed to dependent diabetes 2 years ago. What common complications of diabetes should the nurse assess for when examining the patient? a. leg ulcers b. loss of visual acuity c. increased creatine clearance d. prolonged capillary refill in the toes e. decreased sensation in the lower extremities

a, b, d, e

A nurse is assessing a female client with cushing syndrome. Which clinical findings can the nurse expect to identify? a. hirsutism b. menorrhagia c. buffalo hump d. deficit edema e. migraine headaches

a, c

A client has undergone nasal hypophysectomy surgery. During the post-operative care, which finding indicated cerebrospinal leakage? a. dry mouth b. rigidity of neck muscles c. fall in BP and upon standing d. a yellow edge around nasal discharge

d. a yellow edge around nasal discharge

A client is admitted to the hospital with the diagnosis of cancer of the thyroid, and a thyroidectomy is scheduled. What is important for the nurse to consider when caring for this client during the postoperative period? a. hypercalcemia may result from parathyroid damage b. hypotension and bradycardia may result from thyroid storm c. tetany may result from under dosage of thyroid hormone replacement d. hoarseness and airway obstruction may result from laryngeal nerve damage

d. hoarseness and airway obstruction may result from laryngeal nerve damage

The nurse is teaching a client about safe insulin administeration. Which statement made by the client indicates the need for further education? a. i should see whether the insulin is expired b. i should keep a daily logbook of times of the insulin injection c. i should keep my medication in its original labeled container d. i should administer insulin only if there are symptoms

d. i should administer insulin only if there are symptoms

What interventions should the nurse implement when caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH) a. providing frequent oral care b. instituting fall risk precautions c. restricting fluids to 2 L per day d. placing the client in high-fowlers position e. monitoring for and reporting neurologic changes

a, b, e

What interventions should the nurse implement in caring for a client with diabetes insipidus following a head injury? a. providing adequate fluids within easy reach b. reporting an increasing urine specific gravity c. administering prescribed erythromycin d. assessing for and reporting changes in neurological status e. monitoring for constipation, weight loss, hypotension, and tachycardia

a, d, e

The nurse is providing care for a client with a small-cell carcinoma of the ling who develops the syndrome of inappropriate secretion of SIADH. Wha clinical findings correspond with the secretion of antidiuretic hormone? a. edema b. polyuria c. bradycardia d. hypotension e. hyponatremia

a,e

A client is diagnosed with acute kidney failure secondary to dehydration. An IV infusion of 50% glucose with regular insulin is prescribed. What does the nurse recognize as the primary purpose of the UV insulin for this client? a. correct hyperkalemia b. increase urine output c. prevent respiratory acidosis d. increase serum calcium levels

a. correct hyperkalemia

A nurse is providing postoperative care for a client one hour after an adrenaletomy. Maintenance steroid therapy has not begin yet. The nurse should monitor the client for which complication? a. hypotension b. hyperglycemia c. sodium retention d. potassium excretion

a. hypotension

A client with type 1 diabetes is transported via ambulance to the ED., The client is dry, hot, flushed skin, fruity breath, and kusslemans respirations. Which complication does the nurse suspect the client is experiencing? a. ketoacidosis b. somogyi phenomenon c. hypoglycemic reaction d. hyperosmolar nonketotic coma

a. ketoacidosis

The nurse is caring for a client who is experiencing an underproduction of thyroxine. Which client response is associated with an underproduction of thyroxine? a. myxedema b. acromegaly c. graves disease d. cushings disease

a. myxedema

Why does the nurse teach trhe parents of a young child with type 1 diabetes how to test the childs urine at home during period of stress or illness, even though the blood glucose testing is being done 4 times a day? a. urine should be tested for acetone during illness and when the blood glucose level is increased b. blood glucose testing before meals and at bedtime may be stopped once the child is stabilized on insulin c. urine testing remains the most accurate way to check for high blood glucose level is double-voided specimens are used d. the short term glucose level is more accurately reflected in a urine specimen than in a blood specimen, especially in children

a. urine should be tested for acetone during illness and when the blood glucose level is increased

A nurse is caring for a client with hypoglycemia. Which nursing intervention would be appropriate in managing the client's condition? a. administering insulin b. administering glucagon c. administering IV glucose d. administering oral hydrocortisone e. administering somatosatin

b,c,d

A 13 year old with type 1 diabetes is receiving 15 units of regular insulin and 20 units of NPH insulin at 7:00 AM each day. At what time does the nurse anticipate a hypoglycemia reaction from the NPH insulin to occur? a. Before noon b. in the afternoon c. within 30 mins d. during the evening

b. in the afternoon

The nurse is giving discharge teaching to a client with diabetes who has has a hypophysectomy. Which statement made by the client indicates that further teaching is necessary? a. there is a risk i could become permanently sterile b. my insulin dose will need to be increased from now on c. i must have cortisone therapy for the rest of my life d. life-long thyroxine replacement therapy will be required

b. my insulin dose will need to be increased from now on

A nurse plans to set up emergency equipment at the bedside of a client in the immediate post-op period after a thyroidectomy. What should the nurse include in the bedside setup? a. crash cart with bed bored b. trach set and O2 c. ampule of sodium bicarbonate d. airway and nonrebreather mask

b. trach set and O2

An older adult with a history of small cell lung carcinoma reports muscle cramping, thirst, and fatigue. The pcp diagnoses the client with a pituitary disorder and is treating the client accordingly. Which is an effective outcome of the treatment? a. urine output of 10 L/day b. urine specific gravity less than 1/025 c. urine osmolarity of 80 mOsm/kg (80 mmol/kg) d. serum osmolarity of 600 mOsm/kg (600 mmol/kg)

b. urine specific gravity less than 1/025

The nurse is teaching a diabetic client about the advantages of using an insulin pump. What information should the nurse include? a. it prevents ketoacidosis b. it helps cause weight loss c. it can improve A1C levels d. an insulin pump costs less than subq injections e. clients may be able to exercise without eating more carbs

c, e

Which insulin should the nurse prepare for the emergency treatment of ketoacidosis? a. glargine b. NPH c. aspart d. detemir

c. aspart

The nurse is caring for a client with diabetes who is scheduled to receive an IV administration of 25 units of insulin in 250 mL of normal saline. What does the nurse recognize as the only type of insulin comparable with IV solutions? a. NPH b. lispro c. regular d. glargine

c. regular

The nurse is caring for a client newly diagnosed with diabetes. When preparing the teaching plan about the importance of yearly eye exams, the nurse should instruct the client on which eye problem is most often associated with diabetes? a. cataracts b. glaucoma c. retinopathy d. astigmatism

c. retinopathy