medsurg2 unit 1 pp questions
2. A patient is newly diagnosed with type 2 diabetes mellitus. The nurse correlates which medication classification's mechanism of action as decreasing glucose production in the liver? a. Biguanides b. Meglitinides c. Sulfonylureas
a
A diabetic patient who is experiencing a reaction to alternating periods of nocturnal hypoglycemia and hyperglycemia. The patient might be manifesting which of the following? a. Uncontrolled diabetes b. Somogyi phenomenon c. Brittle diabetes d. Diabetes insipidus
b
Glycosylated hemoglobin (HbA1C) test measures the average blood glucose control of an individual over the previous three months. Which of the following values is considered a diagnosis of pre-diabetes? a. 6.5-7% b. 5.7-6.4% c. 5-5.6% d. >5.6%
b
The nurse is caring for a patient admitted with severe dehydration secondary to gastroenteritis. Which item on the patient's meal tray does the nurse question? A. Apple juice B. Coffee C. Broth D. Caffeine-free soda
b
A nurse cares for a teenage girl with a new ileostomy. The patient states, "I cannot go to prom with an ostomy." How would the nurse respond? a. "Sure, you can. Purchase a prom dress one size larger to hide the ostomy appliance." b. "The pouch won't be as noticeable if you avoid broccoli and carbonated drinks prior to the prom." c. "Let's talk to the enterostomal therapist about options for ostomy supplies and dress styles." "You can remove the pouch from your ostomy appliance when you are at the prom so that it is less noticeable."
c
A patient has gastroesophageal reflux disease (GERD). The provider prescribes a proton pump inhibitor. About what medication would the nurse anticipate teaching the patient? a. Famotidine b. Magnesium hydroxide c. Omeprazole d. Ranitidine
c
A patient has returned to the nursing unit after an open Nissen fundoplication to repair a hiatal hernia. The patient has an indwelling urinary catheter, a nasogastric (NG) tube to low continuous suction, and two IVs. The nurse notes bright red blood in the NG tube. What action would the nurse take first? a. Document the findings in the chart. b. Notify the surgeon immediately. c. Reassess the drainage in 1 hour. d. Take a full set of vital signs.
d
Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the following, except: a. Integumentary inspection for the presence of brown spots on the lower extremities b. Observation for paleness of the lower extremities c. Observation for blanching of the feet after the legs are elevated for 60 seconds d. Palpation for increase pulse volume in the arteries of the lower extremities.
d
3. The nurse correlates which clinical manifestation in a patient with type 2 diabetes mellitus (DM) with macrovascular complications? a. Chest pain b. Sight impairment c. Gingival hyperplasia d. Chronic kidney failure
a
A 65-year-old patient has a glomerular filtration rate of 55 mL/min. The patient has a history of uncontrolled hypertension and coronary artery disease. You're assessing the new medication orders received for this patient. Which medication ordered by the physician will help treat the patient's hypertension along with providing a protective mechanism to the kidneys? a. Lisinopril b. Metoprolol c. Amlodipine d. Verapamil
a
In completing a history on a patient diagnosed with gastroenteritis caused by Salmonella, which recently ingested food does the nurse recognize as the most likely cause of this diagnosis? A. Undercooked eggs B . Undercooked pork C. Steamed shrimp D. Grilled beef
a
Which statement by the patient scheduled for proctocolectomy with permanent ileostomy for treatment of ulcerative colitis indicates the teaching was effective? A. "My colon and rectum will be removed, and my anus will be closed." B. "My colon will be removed, and my ileum is sutured to the anal canal." C. "My colon will be removed while the distal portion of my ileum is used to create a pouch." D. "My colon and rectal mucosa will be removed and a reservoir created using a portion of my ileum."
a
The nurse is aware that which factors are related to the development of gastroesophageal reflux disease (GERD)? (Select all that apply.) a. Delayed gastric emptying b. Eating large meals c. Hiatal hernia d. Obesity e. Viral infections
a b c d
The nurse is evaluating teaching provided to a patient with type 1 diabetes mellitus. Which patient observation indicates that medication teaching has been effective? A. Uses a 1 mL syringe to measure insulin dose B. Places a new injection an inch away from previous injection site C. Inserts the needle at a 25-degree angle before injecting the medication D. Provides an injection in the thigh after an abdominal injection in the morning
b
a 35-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of: a. 1130 and 1330 b. 1330 and 1930 c. 1530 and 2130 d. 1730 and 2330
b
The nurse provides discharge instructions to a patient who is postoperative for an appendectomy. Which patient statement indicates a need for additional teaching? A. "I can go home as soon as I am able to urinate." B. "I will get up and walk around as much as I can." C. "I will take the antibiotics until I no longer have a fever." D. "I will use the incentive spirometer 10 times an hour while awake."
c
4. The nurse provides education to a patient who is diagnosed with type 1 diabetes mellitus (DM). Which patient statements indicate the need for additional teaching regarding self-monitoring of blood glucose? Select all that apply. a. "I will check my blood glucose daily before meals and at bedtime." b. "I will monitor my blood glucose levels more frequently when I have the flu." c. "I don't need to document the results of my blood glucose if it is within the normal limits." d. "Because I am using an insulin pump, I don't need to check my blood glucose as often as before."
c d
The nurse monitors for which clinical manifestations of ulcerative colitis in the patient admitted for the treatment of irritable bowel disease (IBD)? Select all that apply. A. Fistulas B. Weight loss C. Hemorrhage D. Intermittent fever E. Frequent, liquid stools
c d e