HPA1 PrepU questions
A client who recently had a colostomy expresses concerns about the sexual relationship with the client's spouse. Which statement made by the nurse is appropriate?
"I can refer you to a support group so that you can speak with others with similar problems."
After teaching a client with type 1 diabetes who is scheduled to undergo an islet cell transplant, which client statement indicates successful teaching?
"I might need insulin later on but probably not as much or as often"
A client is taking glyburide (DiaBeta), 1.25 mg P.O. daily, to treat type 2 diabetes. Which statement indicates the need for further client teaching about managing this disease
"I skip lunch when I don't feel hungry."
A client is taking glyburide (DiaBeta), 1.25 mg P.O. daily, to treat type 2 diabetes. Which statement indicates the need for further client teaching about managing this disease?
"I skip lunch when I don't feel hungry."
Which statement by the client who is performing self-catheterization indicates a need for further teaching?
"I will need a sterile catheter kit each time I self-catheterize. Clients who self-catheterize use clean technique in the home setting.
The nurse is caring for a client who is scheduled for the creation of an ileal conduit. Which statement by the client provides evidence that client teaching was effective?
"My urine will be eliminated through a stoma."
A patient who is 6 months' pregnant was evaluated for gestational diabetes mellitus. The doctor considered prescribing insulin based on the serum glucose result of:
138 mg/dL, 2 hours postprandial.
A client with cancer of the bladder has just returned to the unit from the PACU after surgery to create an ileal conduit. The client weighs 60 kg. The nurse is monitoring the client's urine output hourly and notifies the health care provider when the hourly output is less than what
30 mL
A client with type 1 diabetes is to receive a short-acting insulin and an intermediate-acting insulin subcutaneously before breakfast. The nurse would administer the insulin at which site as the preferred site?
Abdomen
A patient's colorectal cancer has necessitated a hemicolectomy with the creation of a colostomy. In the 4 days since the surgery, the patient has been unwilling to look at the ostomy or participate in any aspects of ostomy care. What is the nurse's most appropriate response to this observation?
Acknowledge the patient's reluctance and initiate discussion of the factors underlying it.
A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl. His family reports that he has been skipping meals in an effort to lose weight. Which nursing intervention is most appropriate?
Administering 1 ampule of 50% dextrose solution, per physician's order
An ileal conduit is created for a client after a radical cystectomy. Which of the following would the nurse expect to include in the client's plan of care?
Application of an ostomy pouch
The nurse is educating a client with a new colostomy about gas-producing foods. Which gas-producing food should the client avoid to prevent gas buildup in the colostomy bag?
Baked beans
Insulin is secreted by which of the following types of cells?
Beta cells
Which clinical characteristic is associated with type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus)?
Blood glucose can be controlled through diet and exercise
Which of the following would a nurse expect to assess in a client with peritonitis?
Board-like abdomen The client with peritonitis would typically exhibit a rigid, board-like abdomen, with absent bowel sounds, elevated pulse rate, and rapid, shallow respirations.
The nurse working with a client after an ileal conduit notices that the pouching system is leaking small amounts of urine. What is the appropriate nursing intervention
Change the wafer and pouch
As the nurse comes from morning report, she is instructed to use a bladder scanner on a client following a client's attempt at urination. The client is able to void 300 mL. The client denies any pain on urination. The nurse scans 250 mL of remaining urine in the bladder. Which entry is most correct when documenting the intervention?
Client voided 300 mL with 250 mL residual volume
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 nursing diagnosis is appropriate for the client with a new ileal conduit? Select all that apply.
Deficient knowledge: management of urinary diversion Disturbed body image Risk for impaired skin integrity
Nursing management of the client with a urinary tract infection should include
Discouraging caffeine intake
Which information should be included in the teaching plan for a client receiving glargine, which is "peakless" basal insulin?
Do not mix with other insulins.
When assessing a client's nonverbal communication, the nurse should assess which aspect as being the most expressive?
Facial expressions
A client with type 1 diabetes mellitus is receiving short-acting insulin to maintain control of blood glucose levels. In providing glucometer instructions, the nurse would instruct the client to use which site for most accurate findings?
Finger
Which factor contributes to UTI in older adults?
Immunocompromise - high incidence of chronic illness, immobility, frequent use of antimicrobial agents, incomplete emptying of the bladder, and obstructed urine flow.
The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine?
Increases ability for glucose to get into the cell and lowers blood sugar
After undergoing retropubic prostatectomy, a client returns to his room. The client is on nothing-by-mouth status and has an IV infusing in his right forearm at a rate of 100 ml/hour. The client also has an indwelling urinary catheter that's draining light pink urine. While assessing the client, the nurse notes that his urine output is red and has dropped to 15 ml and 10 ml for the last 2 consecutive hours. How can the nurse best explain this drop in urine output?
It's an abnormal finding that requires further assessment.
A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?
Metformin
A client with diabetes is receiving an oral anti diabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?
Metformin Metformin is a biguanide and, along with the thiazolidinediones (rosiglitazone and pioglitazone), are categorized as insulin sensitizers; they help tissues use available insulin more efficiently. Glyburide and glipizide, which are sulfonylureas, and repaglinide, a meglitinide, are described as being insulin releasers because they stimulate the pancreas to secrete more insulin.
A client with type 1 diabetes is experiencing polyphagia. The nurse knows to assess for which additional clinical manifestation(s) associated with this classic symptom?
Muscle wasting and tissue loss
The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer?
NPH Intermediate-acting insulins are called NPH insulin (neutral protamine Hagedorn) or Lente insulin. Lispro (Humalog) is rapid acting, Iletin II is short acting, and glargine (Lantus) is very long acting.
The nurse is admitting a client with a diagnosis of diverticulitis and assesses that the client has a boardlike abdomen, no bowel sounds, and reports of severe abdominal pain. What is the nurse's first action
Notify the health care provider.
Which of the following is the most common symptom of a polyp?
Rectal bleeding
A patient has been newly diagnosed with type 2 diabetes, and the nurse is assisting with the development of a meal plan. What step should be taken into consideration prior to making the meal plan?
Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns
Which of the following will the nurse observe as symptoms of perforation in a patient with intestinal obstruction?
Sudden, sustained abdominal pain
A client who has undergone colostomy surgery is experiencing constipation. Which intervention should a nurse consider for such a client?
Suggest fluid intake of at least 2 L/day
The nurse is caring for a 16-year-old client with ulcerative colitis who has a new temporary colostomy. Which nursing intervention is priority?
Teach the client how to perform colostomy care
Which may be a potential cause of hypoglycemia in the client diagnosed with diabetes mellitus?
The client has not eaten but continues to take insulin or oral antidiabetic medications.
A client has a newly created colostomy. After participating in counseling with the nurse and receiving support from the spouse, the client decides to change the colostomy pouch unaided. Which behavior suggests that the client is beginning to accept the change in body image?
The client touches the altered body part
A nurse is caring for a client who has just undergone surgery to create an ileal conduit for urinary elimination via a stoma. Which fact about this procedure should the nurse mention to the client?
The client will have to wear an external appliance to collect urine
A client tells the nurse, "I am not having normal bowel movements." When differentiating between what are normal and abnormal bowel habits, what indicators are the most important?
The consistency of stool and comfort when passing stool
A client with bladder cancer had the bladder removed and an ileal conduit created for urine diversion. While changing this client's pouch, the nurse observes that the area around the stoma is red, weeping, and painful. What should the nurse conclude?
The pouch faceplate doesn't fit the stoma.
A client with a new ileal conduit asks what the disadvantages are to this type of stoma. The nurse explains that the client may experience which disadvantage?
Urine drains from it continuously
A client is having trouble adjusting to a colostomy surgically created 4 days ago. The nurse prioritizes which nursing diagnosis?
altered body image
A nurse is explaining the action of insulin to a client with diabetes mellitus. During client teaching, the nurse reviews the process of insulin secretion in the body. The nurse is correct when she states that insulin is secreted from the:
beta cells of the pancreas.
The nurse is educating a new colostomy client on gas-producing foods. Which food is a gas-producing food the client may choose to avoid?
brussels sprouts
Which finding best indicates that a nursing assistant has an understanding of blood glucose meter use?
demonstrating correct technique
A client reports severe pain and bleeding while having a bowel movement. Upon inspection, the health care provider notes a linear tear in the anal canal tissue. The client is diagnosed with a:
fissure
Diet therapy for clients diagnosed with irritable bowel syndrome (IBS) includes
high fiber diet
NPH is an example of which type of insulin?
intermediate acting
A client with a history of type 1 diabetes is demonstrating fast, deep, labored breathing and has fruity odored breath. What could be the cause of the client's current serious condition?
ketoacidosis
Which is a by-product of fat breakdown in the absence of insulin and accumulates in the blood and urine?
ketones
Diet modifications for patient diagnosed with chronic inflammatory bowel disease include which of the following?
lower residue
When caring for a psychiatric client, a nurse would make a formal contract with the client during which phase of the nurse-client relationship?
orientation phase
A nurse is performing focused assessment on her clients. She expects to hear hypoactive bowel sounds in a client with
paralytic ileus
A client has developed urinary incontinence and is beginning bladder training to regain control over urine elimination. The catheter would be clamped and unclamped to:
promote normal bladder function.
A nurse is caring for a client who had an ileal conduit 3 days earlier. Which assessment finding, if made by the nurse, would indicate a need for a further consultation with the enterostomal nurse?
red, sensitive skin around the stoma site
A nurse approaches a client with a recent colostomy for a routine assessment and finds the client tearful. The nurse's most appropriate response would be to
sit down and ask if the client would like to talk about any concerns.
gestational diabetes
think pregnancy
The nurse is assessing a client for constipation. To identify the cause of constipation, the nurse should begin by reviewing the client's:
usual pattern of elimination.