Exam 3

A 29-year-old client has gestational diabetes. The nurse is teaching her about managing her glucose levels. Which therapy would be most appropriate for this client?

diet

The new nurse is discussing planned interventions to reduce the risk of the patient feeling isolated while on airborne precautions. Which statement by the new nurse requires follow-up by the charge RN?

"I will leave the door propped open to increase auditory and visual stimuli."

A diabetic educator is discussing "sick day rules" with a newly diagnosed type 1 diabetic. The educator is aware that the patient will require further teaching when the patient states what?

"I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours."

A 9-year-old was just diagnosed with type 1 diabetes. The parents state, "We hope our child won't have to take insulin injections." How should the nurse respond?

"The pancreas doesn't produce insulin in Type 1 diabetes, so it is likely that insulin injections will be necessary."

The nurse has told the 14-year-old adolescent with diabetes that the doctor would like to have a hemoglobin A1C test performed. Which comment by the client indicates that she understands what this test is for?

"This will tell my doctor what my average blood glucose level has been over the last 2 to 3 months."

Which of the following should be included in the teaching plan for a patient receiving glargine (Lantus),"peakless" basal insulin?

do not mix with other insulins

A 16-year-old adolescent is at the office for a checkup. The parent states, "My child keeps forgetting to take insulin. What can we do to make sure my child takes it?" Which is the best response by the nurse?

"you can set a medication time that allows your child to have a normal routine that does not interrupt school or sleep"

commonly used intravenous solutions is hypotonic?

0.45% NaCl

The nurse is teaching the client about home blood glucose monitoring. Which blood glucose measurement indicates hypoglycemia?

59 mg/dL

A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well controlled?

6.5%

in a patient with infection, which common interventions may reduce fever?

Antipyretic drug such as aspirin or acetaminophen External cooling, cooling blankets, cool compresses Fluid administration (including oral and IV) Antimicrobial therapy with antibiotic, antiviral or antifungal agents

The parents of a child on sulfamethoxazole for a UTI report the child has a red, blistery rash. The nurse should tell the parents to:

Discontinue the medication and come in for immediate further evaluation

A young child is diagnosed with acute otitis media. The child's mother states that the child has had a severe reaction to penicillin in the past. Which of the following statements by the nurse indicates a need for further education?

Here is your prescription for cephalexin from the physician

A female client with a UTI has been prescribed Bactrim. Which of the following should the nurse instruct the patient on?

Take with at least eight (8) oz. of water If you miss any doses, take the prescribed dose as soon as you remember and it if is very close to the next time of your dose, delay the next dose Finish the entire course of the prescribed medication to prevent reoccurrence, even if you start to feel better Take the medication on an empty stomach, but you may take the medication with food if you begin to experience gastric upset

In a child with diabetes insipidus, which characteristic would most likely be present in the child's health history?

abrupt onset of polyuria, nocturia, and polydipsia

During a mumps outbreak at a local school, a patient, who is a school teacher, is exposed. She has previously been immunized for mumps. What type of immunity does she possess?

acquired immunity

What food would the nurse provide for a patient who has hypokalemia?

bananas

Insulin is secreted by which of the following types of cells?

beta cells

A 17-year-old adolescent is found wandering around. The adolescent is confused, sweaty, and pale. Which test would the nurse expect to be performed first?

blood glucose level

The nurse is caring for a patient who had a parathyroidectomy. Upon evaluation of the patient's laboratory studies, the nurse would expect to see imbalances in which electrolytes related to the removal of the parathyroid gland?

calcium and phosphorus

The nurse is caring for a male client who has a diagnosis of heart failure. Today's laboratory results show a serum potassium of 3.2 mEq/L (3,2 mmol/L). For what complications should the nurse be aware, related to the potassium level?

cardiac dysrhythmias

The nurse is caring for Mr. Jones, who has a diagnosis of heart failure. Today's laboratory results show a serum potassium of 3.2 mEq/L. For what complications should the nurse be aware, related to the potassium level?

cardiac dysrythmias

Potassium is needed for neural, muscle, and

cardiac funtion

A patient's most recent blood work indicates a K+ level of 7.2 mEq/L, a finding that constitutes hyperkalemia. What signs and symptoms should the nurse vigilantly monitor for?

cardiac irregularities

A nurse is instructing a client on the antibiotic regimen for the treatment of pneumonia. Which statement is most important to share with client?

complete the entire prescription of medication

A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic nephropathy. Which of the following suggestions would be most important?

control blood glucose levels

Which type of testing should be completed prior to an anti-infective being prescribed?

culture

The nurse is caring for an older client admitted to the health-care facility with a new onset of confusion and a low-grade fever. Which age-related changes might contribute to decreased functioning of the immune system?

decreased kidney function

Which of the following is an age-related change that may affect diabetes and its management?

decreased renal function

The nurse is caring for a child with type 1 diabetes mellitus. The nurse notes that the child is drowsy, has flushed cheeks and red lips, a fruity smell to the breath, and there has been an increase in the rate and depth of the child's respirations. The nurse recognizes that these symptoms indicate the child has:

diabetic ketoacidosis

A client loses consciousness after strenuous exercise and needs to be admitted to a health care facility. The client is diagnosed with dehydration. The nurse caring for the client knows that the client needs restoration of which of the following?

electrolytes

Which of the following would be included in the teaching plan for a patient diagnosed with diabetes mellitus?

elevated blood glucose levels contribute to complications of diabetes, such as diminished vision

A client with chronic renal failure is admitted with a heart rate of 122 beats/minute, a respiratory rate of 32 breaths/minute, a blood pressure of 190/110 mm Hg, jugular vein distention, and bibasilar crackles. Which nursing diagnosis takes highest priority for this client?

excess fluid volume

A nurse is preparing to discharge a client with coronary artery disease and hypertension who is at risk for type 2 diabetes. Which information is important to include in the discharge teaching?

how to control blood glucose through lifestyle modifications with diet and exercise

The nurse is assigned to care for a client with a serum phosphorus concentration of 5.0 mg/dL (1.61 mmol/L). The nurse anticipates that the client will also experience which electrolyte imbalance?

hypocalcemia

When an 80-year-old client who takes diuretics for management of hypertension informs the nurse she take laxatives daily to promote bowel movements, the nurse assesses the client for possible symptoms of

hypokalemia

Endurance athletes who exercise for long periods of time and consume only water may experience a sodium deficit in their extracellular fluid. What is this electrolyte imbalance known as?

hyponatremia

During an assessment of an older adult client, the nurse notes an increase in pulse and respiration rates, and notes that the client has warm skin. The nurse also notes a decrease in the client's blood pressure. Which medical diagnosis may be responsible?

hypovlemia

Which of the following individuals with diarrhea for 3 days are more likely to suffer from fluid and electrolyte imbalance?

infant

A client admitted to the ICU with gunshot wounds in the chest and thigh is noted to have extensive edema present. Anticipating a generalized reaction to tissue damage, the nurse concludes that the client's edema is the result of what development?

inflammatory process

Which term refers to the progressive increase in blood glucose from bedtime to morning?

insulin waning

NPH is an example of which type of insulin?

intermediate-acting

The nurse, along with a nursing student, is caring for Mrs. Roper, who was admitted with dehydration. The student asks the nurse where most of the body fluid is located. The nurse should answer with which of the following fluid compartments?

intracellular

A woman develops gestational diabetes. Which assessment should she make daily?

measure serum for glucose level by a finger prick

A group of students are reviewing information about oral diabetic agents. The students demonstrate understanding of these agents when they identify which agent as reducing glucose production from the liver?

metformin

Mr. Jones is admitted to your unit from the emergency department with a diagnosis of hypocalcemia. His laboratory results show a serum calcium level of 8.2 mg/dL. For what assessment findings will you be looking?

muscle cramping and tetany

Mr. Jones is admitted to your unit from the emergency department with a diagnosis of hypokalemia. His laboratory results show a serum potassium of 3.2 mEq/L. For what manifestations will you be alert?

muscle weakness, fatigue, and dysrhythmias

which has more extracellular fluid?

newborn

a localized infection may include what symptoms?

pain redness swelling

The nurse is interviewing the caregivers of a child admitted with a diagnosis of type 1 diabetes mellitus. The caregiver states, "The teacher tells us that our child has to use the restroom many more times a day than other students do." The caregiver's statement indicates the child most likely has:

polyuria

A 50-year-old client with hypertension is being treated with a diuretic. The client complains of muscle weakness and falls easily. The nurse should assess which electrolyte?

potassium

A pregnant client has been diagnosed with gestational diabetes. Which are risk factors for developing gestational diabetes?

previous LGA infant obesity hypertension

what factor's increase a patient's susceptibility to infection?

recent hospitalization use of medical devices diabetes mellitus nicotine use advanced age

What is the only insulin that can be given intravenously?

regular

Which of the following would be a priority for the nurse monitor to prevent the client from experiencing any nephrotoxic effects from antibiotic therapy?

serum drug trough levels

a nurse is providing education to a woman at 28 weeks' gestation who has tested positive for gestational diabetes mellitus (GDM). What would be important for the nurse to include in the client teaching?

she is at increased risk for type 2 diabetes mellitus after her baby is born

A patient has sustained a severe right ankle sprain and the nurse is explaining the process of inflammation to the patient. Which information does the nurse include?

the presence of the inflammation does not always indicate infection is present it occurs in response to tissue injury it is a non-specific body defense to invasion or injury how widespread the symptoms are depends on the intensity and severity of the initiating injury

T/F antibiotic therapy should not begin until after a culture specimen is obtained

true

An elementary school child takes metformin three times each day. Which disorder would the school nurse expect the child to have?

type 2 diabetes mellitus

The nurse is speaking to the mother of an adolescent recently diagnosed with type 1 diabetes. The mother asks the nurse how her son's basketball training will affect his blood sugar. Which is the best response by the nurse?

"When exercising, your son should add an extra snack containing 15 to 30 g of carbohydrates for each 45 to 60 minutes of exercise."

When referred to a podiatrist, a client newly diagnosed with diabetes mellitus asks, "Why do you need to check my feet when I'm having a problem with my blood sugar?" The nurse's most helpful response to this statement is

"diabetes can affect sensation in your feet and you can hurt yourself without realizing it"

A nurse is teaching a client about type 2 diabetes mellitus. What information would reduce a client's risk of developing this disease?

"maintain weight within normal limits for your body size and muscle mass"

A client who has been newly diagnosed with type 1 diabetes asks the nurse, "Why do I have to take two shots of insulin? One shot isn't enough?" What should the nurse should tell the client?

"two shots will give you better control and decrease complications"

Which of the following individuals will take longer to sense thirst?

70 year old

The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer?

NPH

A client will be receiving high-dose IV antibiotics for a 3-4 week period. What should the home health care nurse plan to monitor for any adverse effects?

Serum BUN/Cr levels

Which of the following statements is true regarding gestational diabetes?

a glucose challenge test should be performed between 24 and 28 weeks

Which client will have more adipose tissue and less fluid?

a woman

Which of the following is the most common cause of symptomatic hypomagnesemia in the United States?

alcoholism

When completing a sexual health history for a patient at risk for STI's, which approach is the most therapeutic to elicit information from the patient?

ask open-ended questions

When teaching the diabetic client about foot care, what should the nurse instruct the client to do?

avoid going barefoot

The greatest percentage of people have which type of diabetes?

type 2

When an elderly client receiving a blood transfusion presents with an elevated blood pressure, distended neck veins, and shortness of breath, the client is most likely experiencing

fluid overload

Mr. Smith is admitted to your unit with a diagnosis of heart failure. His heart is not pumping effectively, which is resulting in edema and coarse crackles in his lungs. The term for this condition is which of the following?

fluid volume excess

The nurse's morning assessment of a patient who has a history of heart failure reveals the presence of 2+ pitting edema in the patient's ankles and feet bilaterally. What is this assessment finding suggestive of?

fluid volume excess

A medical nurse is careful to adhere to infection control protocols, including handwashing. Which statement about handwashing supports the nurse's practice?

frequent handwashing reduces transmission of pathogens from one client to another

A client with severe hypervolemia is prescribed a loop diuretic and the nurse is concerned with the client experiencing significant sodium and potassium losses. What drug was most likely prescribed?

furomeside

A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which information would the nurse expect to find?

gestational diabetes

which situation requires using soap and water for handwashing?

hands feeling sticky

A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are effective only if the client:

has type 2 diabetes

what is true about innate immunity?

it is genetically determined, nonspecific and cannot be transferred

Which of the following are byproducts of fat breakdown, which accumulate in the blood and urine?

ketones

When the nurse reviews the client's laboratory reports revealing sodium, 140 mEq/L; potassium, 4.1 mEq/L; calcium 7.9 mg/dL, and magnesium 1.9 mg/dL; the nurse should notify the physician of the client's

low calcium

A nurse monitoring a patient's IV infusion auscultates the patient's lung sounds and finds crackles in the bases in lungs that were previously clear. What would be the appropriate intervention in this situation?

notify PCP immediately for possible fluid overload

A client has a physician's order for NPO (nothing by mouth) following abdominal surgery to repair a bowel obstruction. The client has a nasogastric tube inserted to low intermittent suction. The client requires intravenous therapy to

replace fluid and electrolytes

A 58-year-old woman is suffering from food poisoning after eating at a local restaurant. She has had nausea, vomiting, and diarrhea for the past 12 hours. Her blood pressure is 88/50 and she is diaphoretic. She requires

replacement of fluids to be administered on an outpatient basis

A nurse is developing a teaching plan for a client with diabetes mellitus. A client with diabetes mellitus should:

wash and inspect feet daily

A nurse is providing an afternoon shift report and relates morning assessment findings to the oncoming nurse. Which daily assessment data is necessary to determine changes in the client's hypervolemia status?

weight