Med-Surge Exam#2 Prep-U Questions

A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is 6 mEq/L. For this client, the nurse's priority should be to assess her? A.) electrocardiogram (ECG) results. B.) bowel sounds. C.) respiratory rate. D.) neuromuscular function

A

Which is an insensible mechanism of fluid loss? A.) Breathing B.) Nausea C.) Bowel elimination D.) Urination

A

A client presents with anorexia, nausea and vomiting, deep bone pain, and constipation. The following are the client's laboratory values. Na + 130 mEq/L K + 4.6 mEq/L Cl - 94 mEq/L Mg ++ 2.8 mg/dL Ca ++ 13 mg/dL Which of the following alterations is consistent with the client's findings? A.) Hyperkalemia B.) Hypercalcemia C.) Hypermagnesemia D.) Hyponatremia

B

A client was admitted to the hospital unit after 2 days of vomiting and diarrhea. The client's spouse became alarmed when the client demonstrated confusion and elevated temperature, and reported "dry mouth." The nurse suspects the client is experiencing which condition? A.) hypercalcemia B.) hypervolemia C.) dehydration D.)hyperkalemia

C

After teaching a client with type 1 diabetes who is scheduled to undergo an islet cell transplant, which client statement indicates successful teaching? A.) "This transplant will provide me with a cure for my diabetes." B.) "I will receive a whole organ with extra cells to produce insulin." C.) "They'll need to create a connection from the pancreas to allow enzymes to drain." D.) "I might need insulin later on but probably not as much or as often."

D

An elderly patient has come to the clinic with his daughter. The patient is a diabetic and is concerned about foot care. The nurse goes over foot care with the patient and his daughter as the nurse realizes that foot care is extremely important. Why would the nurse believe that foot care is so important to this patient? A.) Drugs that patients are required to take for their diabetic condition often decrease circulation to the lower extremities. B.) Hypoglycemia is a dangerous situation, and it may lead to unsteadiness and falls. C.) An elderly patient with foot ulcers experiences severe foot pain due to diabetic polyneuropathy. D.)Avoiding the complications associated with foot ulcers may mean the difference between institutionalization and continued independent living.

D

The greatest percentage of people have which type of diabetes? A.) Impaired glucose tolerance B.) Gestational C.) Type 1 D.) Type 2

D

Which is considered an isotonic solution? A.) 0.45% normal saline B.) Dextran in normal saline C.) 3% NaCl D.) 0.9% normal saline

D

A client with a suspected overdose of an unknown drug is admitted to the emergency department. Arterial blood gas values indicate respiratory acidosis. What should the nurse do first?

Prepare to assist with ventilation

The nurse is caring for a client with a serum sodium concentration of 113 mEq/L (113 mmol/L). The nurse should monitor the client for the development of which condition? A.)Nausea B.) Headache C.) Confusion D.) Hallucinations

C

Treatment of FVE involves dietary restriction of sodium. Which of the following food choices would be part of a low-sodium diet, mild restriction (2 to 3 g/day)? A.) frozen, packaged low-fat dinner with a side salad B.) Three ounces of sliced ham, beets, and a salad C.) Three ounces of light or dark meat chicken, 1 cup of spaghetti and a garden salad D.) Tomato juice, low-fat cottage cheese, and three slices of bacon

C

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? A.) ketoacidosis B.) hepatic disorder C.) hyperosmolar hyperglycemic nonketotic syndrome D.) All options are correct.

A

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: A.) 138 mg/dL, 2 hours postprandial. B.) 90 mg/dL before meals. C.) 120 mg/dL, 1 hour postprandial. D.) 80 mg/dL, 1 hour postprandial.

A

In a nursing pathophysiology class the instructor is teaching about the regulation of fluid volume. How is fluid volume primarily regulated? A.) Urine excretion B.) Breathing C.) Bowel elimination D.) Perspiration

A

The pancreas continues to release a small amount of basal insulin overnight, while a person is sleeping. The nurse knows that if the body needs more sugar: A.) The pancreatic hormone glucagon will stimulate the liver to release stored glucose. B.) Insulin will be released to facilitate the transport of sugar. C.) The process of gluconeogenesis will be inhibited. D.) Glycogenesis will be decreased by the liver.

A

Which term refers to the progressive increase in blood glucose from bedtime to morning? A.) Insulin waning (progressive rise in blood glucose) B.) Dawn phenomenon (blood glucose is relatively normal until about 3 a.m) C.) Diabetic ketoacidosis (DKA) (absence or markedly inadequate amount of insulin) D.) Somogyi effect (blood glucose is normal or elevated at bedtime)

A

What is the only insulin that can be given intravenously? A.) NPH B.) Lantus C.) Regular D.) Ultralente

C

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.) 8.0% B.) 6.5% C.) 8.5% D.) 7.5%

B

A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. What are classic symptoms associated with diabetes? A.) Increased weight loss, dehydration, and fatigue B.) Increased thirst, hunger, and urination C.) Loss of appetite, increased urination, and dehydration D.) Increased weight gain, appetite, and thirst

B

The calcium concentration in the blood is regulated by which mechanism? A.) Androgens B.) Parathyroid hormone (PTH) C.) Thyroid hormone (TH) D.) Adrenal gland

B

The nurse is caring for a client in the intensive care unit (ICU) following a near-drowning event in saltwater. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen and dry tongue, flushed skin, and peripheral edema. The nurse anticipates that the client's serum sodium value would be A.) 145 mEq/L (145 mmol/L) B.) 155 mEq/L (155 mmol/L) C.) 135 mEq/L (135 mmol/L) D.) 125 mEq/L (125 mmol/L)

B

The nurse is teaching a client about self-administration of insulin and about mixing regular and neutral protamine Hagedorn (NPH) insulin. Which information is important to include in the teaching plan? A.) When mixing insulin, the NPH insulin is drawn up into the syringe first. B.)When mixing insulin, the regular insulin is drawn up into the syringe first. C.)There is no need to inject air into the bottle of insulin before withdrawing the insulin. D.) If two different types of insulin are ordered, they need to be given in separate injections.

B

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? A.) O saturation 95% B.) pH 7.48 C.) HCO 21 mEq/L D.) PaCO 36

B

A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which symptom when caring for this client? A.) Blurred vision B.) Polyuria C.) Hypoglycemia D.) Polydipsia

C

A nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare with absorption at other sites? A.) Insulin is absorbed rapidly regardless of the injection site. B.) Insulin is absorbed more slowly at abdominal injection sites than at other sites. C.) Insulin is absorbed more rapidly at abdominal injection sites than at other sites. D.) Insulin is absorbed unpredictably at all injection sites.

C

Fluid and electrolyte balance is maintained through the process of translocation. What specific process allows water to pass through a membrane from a dilute to a more concentrated area? A.)filtration B.) active transport C.) osmosis D.) evaporation

C

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: A.) "The circulation in your feet can help us determine how severe your diabetes is." B.) "The physician wants to be sure your shoes fit properly so you won't develop pressure sores." C.) "Diabetes can affect sensation in your feet and you can hurt yourself without realizing it." D.) "It's easier to get foot infections if you have diabetes."

C

Which clinical manifestation of type 2 diabetes occurs if glucose levels are very high? A.) Increased energy B.) Hyperactivity C.) Blurred vision D.) Oliguria

C

Which information should be included in the teaching plan for a client receiving glargine, a "peakless" basal insulin? A.) It is rapidly absorbed and has a fast onset of action. B.) Administer the total daily dosage in two doses. C.) Do not mix with other insulins. D.) Draw up the drug first, then add regular insulin.

C

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? A.) Glyburide B.) Glipizide C.) Metformin D.) Repaglinide

C (helps the tissues use available insulin more efficiently whereas A,B, & D help secrete insulin)

A client with type 1 diabetes is admitted to an acute care facility with diabetic ketoacidosis. To correct this acute diabetic emergency, which measure should the health care team take first? A.)Administer insulin. B.) Correct diabetic ketoacidosis. C.) Determine the cause of diabetic ketoacidosis. D.)Initiate fluid replacement therapy.

D

A male client, aged 42 years, is diagnosed with diabetes mellitus. He visits the gym regularly and is a vegetarian. Which of the following factors is important when assessing the client? A.) The client's exercise routine B.) The client's mental and emotional status C.) History of radiographic contrast studies that used iodine D.) The client's consumption of carbohydrates

D

The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration? A.) Crackles in the lung fields B.) Cool and pale skin C.) Distended jugular veins D.) Dark, concentrated urine

D

The nurse is caring for four clients on a medical unit. The nurse is most correct to review which client's laboratory reports first for an electrolyte imbalance? A.) A 7-year-old with a fracture tibia B.) A 65-year-old with a myocardial infarction C.) A 72-year-old with a total knee repair D.) A 52-year-old with diarrhea

D

Which instruction about insulin administration should a nurse give to a client? A.)"Shake the vials before withdrawing the insulin." B.)"Discard the intermediate-acting insulin if it appears cloudy." C.)"Store unopened vials of insulin in the freezer at temperatures well below freezing." D.) "Always follow the same order when drawing the different insulins into the syringe."

D

Which is the most common cause of symptomatic hypomagnesemia? A.) Sedentary lifestyle B.) Intravenous drug use C.) Burns D.) Alcoholism

D