III MED

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? A) 6.5% B) 7.5% C) 8.0% D) 8.5%

A) 6.5%

Which of the following is a proton pump inhibitor used in the treatment of gastroesophageal reflux disease (GERD)? Select all that apply. A) Lansoprazole (Prevacid) B) Rabeprazole (AcipHex) C) Esomeprazole (Nexium) D) Famotidine (Pepcid) E) Nizatidine (Axid)

A) Lansoprazole (Prevacid) B) Rabeprazole (AcipHex) C) Esomeprazole (Nexium)

Lispro (Humalog) is an example of which type of insulin? A) Rapid-acting B) Intermediate-acting C) Short-acting D) Long-acting

A) Rapid-acting

A nurse who provides care in an ambulatory clinic integrates basic cancer screening into admission assessments. What client most likely faces the highest immediate risk of oral cancer? A. A 65-year-old man with alcoholism who smokes B. A 45-year-old woman who has type 1 diabetes and who wears dentures C. A 32-year-old man who is obese and uses smokeless tobacco D. A 57-year-old man with GERD and dental caries

A. A 65-year-old man with alcoholism who smokes

A nurse is working for the summer at a camp for adolescents with diabetes. When providing information on the prevention and management of hypoglycemia, what action should the nurse promote? A. Always carry a form of fast-acting sugar. B. Perform exercise prior to eating whenever possible. C. Eat a meal or snack every 8 hours. D. Check blood sugar at least every 24 hours.

A. Always carry a form of fast-acting sugar.

A client was treated in the emergency department and critical care unit after ingesting bleach. What possible complication of the resulting gastritis should the nurse recognize? A. Esophageal or pyloric obstruction related to scarring B. Uncontrolled proliferation of H. pylori C. Gastric hyperacidity related to excessive gastrin secretion D. Chronic referred pain in the lower abdomen

A. Esophageal or pyloric obstruction related to scarring

A client presents to the clinic reporting symptoms that suggest diabetes. What criteria would support checking blood levels for the diagnosis of diabetes? A. Fasting plasma glucose greater than or equal to 126 mg/dL (7.0 mmol/L) B. Random plasma glucose greater than 150 mg/dL (8.3 mmol/L) C. Fasting plasma glucose greater than 116 mg/dL (6.4 mmol/L) on two separate occasions D. Random plasma glucose greater than 126 mg/dL (7.0 mmol/L)

A. Fasting plasma glucose greater than or equal to 126 mg/dL (7.0 mmol/L)

A client has been brought to the emergency department by paramedics after being found unconscious. The client's MedicAlert bracelet indicates that the client has type 1 diabetes and the client's blood glucose is 22 mg/dL (1.2 mmol/L). The nurse should anticipate what intervention? A. IV administration of 50% dextrose in water B. Subcutaneous administration of 10 units of Humalog C. Subcutaneous administration of 12 to 15 units of regular insulin D. IV bolus of 5% dextrose in 0.45% NaCl

A. IV administration of 50% dextrose in water

A client presents to the clinic reporting vomiting and burning in the mid-epigastria. The nurse knows that in the process of confirming peptic ulcer disease, the health care provider is likely to order a diagnostic test to detect the presence of what? A. Infection with Helicobacter pylori B. Excessive stomach acid secretion C. An incompetent pyloric sphincter D. A metabolic acid-base imbalance

A. Infection with Helicobacter pylori

A client with GERD has undergone diagnostic testing and it has been determined that increasing the pace of gastric emptying may help alleviate symptoms. The nurse should anticipate that the client may be prescribed what drug? A. Metoclopramide B. Omeprazole C. Lansoprazole D. Calcium carbonate

A. Metoclopramide

A nurse is giving a client barium swallow test. What is the most important assessment a nurse would make to ensure that a client does not retain any barium after a barium swallow? A) Placing any stool passed in a specific preservative. B) Monitoring the stool passage and its color. C) Observing the color of urine. D) Monitoring the volume of urine.

B) Monitoring the stool passage and its color.

A client with diabetes is asking the nurse what causes diabetic ketoacidosis (DKA). Which of the following is a correct statement by the nurse? A. "DKA can be caused by taking too much insulin." B. "DKA can be caused by taking too little insulin." C. "DKA can happen without a cause." D. "DKA will not happen with type 1 diabetes."

B. "DKA can be caused by taking too little insulin."

An occupational health nurse is screening a group of workers for diabetes. What statement should the nurse interpret as being suggestive of diabetes? A. "I've always been a fan of sweet foods, but lately I'm turned off by them." B. "Lately, I drink and drink and can't seem to quench my thirst." C. "No matter how much sleep I get, it seems to take me hours to wake up." D. "When I went to the washroom the last few days, my urine smelled odd."

B. "Lately, I drink and drink and can't seem to quench my thirst."

A nurse is caring for a client with type 1 diabetes. The client's medication administration record includes the administration of regular insulin three times daily. Knowing that the client's lunch tray will arrive at 11:45 AM, when should the nurse administer the client's insulin? A. 10:45 AM B. 11:30 AM C. 11:45 AM D. 11:50 AM

B. 11:30 AM

A client is brought to the emergency department. The client is a type 2 diabetic and is experiencing hyperglycemic hyperosmolar syndrome (HHS). The nurse should identify what components of HHS? Select all that apply. A. Leukocytosis B. Glycosuria C. Dehydration D. Hypernatremia E. Hyperglycemia

B. Glycosuria C. Dehydration E. Hyperglycemia

A nurse is assessing a client who has peptic ulcer disease. The client requests more information about the typical causes of Helicobacter pylori infection. What would it be appropriate for the nurse to instruct the client? A. Most affected clients acquired the infection during international travel. B. Infection typically occurs due to ingestion of contaminated food and water. C. Many people possess genetic factors causing a predisposition to H. pylori infection. D. The H. pylori microorganism is endemic in warm, moist climates.

B. Infection typically occurs due to ingestion of contaminated food and water.

A client with a history of type 1 diabetes has just been admitted to the critical care unit (CCU) for diabetic ketoacidosis. The CCU nurse should prioritize what assessment during the client's initial phase of treatment? A. Monitoring the client for dysrhythmias B. Maintaining and monitoring the client's fluid balance C. Assessing the client's level of consciousness D. Assessing the client for signs and symptoms of venous thromboembolism

B. Maintaining and monitoring the client's fluid balance

A client has been scheduled for a urea breath test in one month's time. What nursing diagnosis most likely prompted this diagnostic test? A. Impaired dentition related to gingivitis B. Risk for impaired skin integrity related to peptic ulcers C. Imbalanced nutrition: Less than body requirements related to enzyme deficiency D. Diarrhea related to Clostridium difficile infection

B. Risk for impaired skin integrity related to peptic ulcers

The nurse is caring for a client receiving insulin isophane suspension (NPH) at breakfast. What is an important dietary consideration for the nurse to keep in mind? A) Make sure breakfast is not delayed. B) Provide fewest amount of carbohydrates at lunch meal. C) Encourage midday snack. D) Delay dinner meal.

C) Encourage midday snack.

The nurse is caring for a client in the emergency department who was admitted for a hypertensive emergency. The nurse knows the goal of intravenous vasodilator therapy for a hypertensive emergency would be which outcome? A. Lower the blood pressure to reduce the onset of neurological changes B. Decrease the blood pressure to a normal level based on the client's age C. Decrease the systolic blood pressure by no more than 25% within the first hour D. Decrease the blood pressure to less than or equal to 120/80 as quickly as possible

C. Decrease the systolic blood pressure by no more than 25% within the first hour

A nurse is addressing the prevention of esophageal cancer in response to a question posed by a participant in a health promotion workshop. What action should the nurse recommend as having the greatest potential to prevent esophageal cancer? A. Promotion of a nutrient-dense, low-fat diet B. Annual screening endoscopy for clients over 50 with a family history of esophageal cancer C. Early diagnosis and treatment of gastroesophageal reflux disease D. Adequate fluid intake and avoidance of spicy foods

C. Early diagnosis and treatment of gastroesophageal reflux disease

A student with diabetes reports feeling nervous and hungry. The school nurse assesses the student and finds the child has tachycardia and is diaphoretic with a blood glucose level of 50 mg/dL (2.8 mmol/L). What should the school nurse administer? A. A combination of protein and carbohydrates, such as a small cup of yogurt B. Two teaspoons of sugar dissolved in a cup of apple juice C. Half of a cup of juice, followed by cheese and crackers D. Half a sandwich with a protein-based filling

C. Half of a cup of juice, followed by cheese and crackers

5. The critical care nurse is caring for a client just admitted in a hypertensive emergency. The nurse should anticipate the administration of what medication? A. Warfarin B. Furosemide C. Sodium nitroprusside D. Ramipril

C. Sodium nitroprusside

A nurse expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which other laboratory finding should the nurse anticipate? A) Elevated serum acetone level B) Serum ketone bodies C) Serum alkalosis D) Below-normal serum potassium level

D) Below-normal serum potassium level

A client seeking care because of recurrent heartburn and regurgitation is subsequently diagnosed with a hiatal hernia. Which of the following should the nurse include in health education? A. "Drinking beverages after your meal, rather than with your meal, may bring some relief." B. "It's best to avoid dry foods, such as rice and chicken, because they're harder to swallow." C. "Many clients obtain relief by taking over-the-counter antacids 30 minutes before eating." D. "Instead of eating three meals a day, try eating smaller amounts more often."

D. "Instead of eating three meals a day, try eating smaller amounts more often."

A client with a hypertensive emergency is being treated in the intensive care unit. The nurse knows that which client is at risk for developing this type of emergency? A. A client who stops their antihypertensive medication abruptly B. A client with a diagnosis of primary hypertension C. A client with well-controlled hypertension D. A client with hypertension that was diagnosed 2 years ago

D. A client with hypertension that was diagnosed 2 years ago

33. A client will be undergoing a urea breath test for the detection of Helicobacter pylori. Which instruction should the nurse give to the client to prepare for this test? A. Ingest a capsule of carbon-labeled urea ingested three days before the test. B. Take prescribed antibiotics one month before the test. C. Fast for 12 hours before the test. D. Avoid taking cimetidine 24 hours before the test

D. Avoid taking cimetidine 24 hours before the test

An older adult client with type 2 diabetes is brought to the emergency department by the client's daughter. The client is found to have a blood glucose level of 600 mg/dL (33.3 mmol/L). The client's daughter reports that the client recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing action would be a priority? A. Administration of antihypertensive medications B. Administering sodium bicarbonate intravenously C. Reversing acidosis by administering insulin D. Fluid and electrolyte replacement

D. Fluid and electrolyte replacement

The staff educator is teaching emergency department nurses about hypertensive crisis. The nurse educator should explain that hypertensive urgency differs from hypertensive emergency in which way? A. The blood pressure (BP) is always higher in a hypertensive emergency. B. Vigilant hemodynamic monitoring is required during treatment of hypertensive emergencies. C. Hypertensive urgency is treated with rest and benzodiazepines to lower BP. D. Hypertensive emergencies are associated with evidence of target organ damage.

D. Hypertensive emergencies are associated with evidence of target organ damage.

A medical nurse is aware of the need to screen specific clients for their risk of hyperglycemic hyperosmolar syndrome (HHS). In what client population does this syndrome most often occur? A. Clients who are obese and who have no known history of diabetes B. Clients with type 1 diabetes and poor dietary control C. Adolescents with type 2 diabetes and sporadic use of antihyperglycemics D. Middle-aged or older people with either type 2 diabetes or no known history of diabetes

D. Middle-aged or older people with either type 2 diabetes or no known history of diabetes

The postanesthesia care unit nurse is caring for a client who had a hernia repair. The client's blood pressure is now 164/92 mm Hg; the client has no history of hypertension prior to surgery and preoperative blood pressure was 112/68 mm Hg. The nurse should assess for which potential causes of hypertension following surgery? A. Dysrhythmias, blood loss, and hyperthermia B. Electrolyte imbalances and neurologic changes C. A parasympathetic reaction and low blood volumes D. Pain, hypoxia, and bladder distention

D. Pain, hypoxia, and bladder distention

A client with type 2 diabetes has been managing his blood glucose levels using diet and metformin. Following an ordered increase in the client's daily dose of metformin, the nurse should prioritize which of the following assessments? A. Monitoring the client's neutrophil levels B. Assessing the client for signs of impaired liver function C. Monitoring the client's level of consciousness and behavior D. Reviewing the client's creatinine and BUN levels

D. Reviewing the client's creatinine and BUN levels