Exam 1 Study Q's

The nurse is educating a patient about the benefits of fruit vs fruit juice in the diabetic diet. The patient states, "What difference does it make if you drink the juice or eat the fruit? It is all the same." Which is the best response by the nurse?

"Eating the fruit instead of drinking juice decreases the glycemic index by slowing absorption"

Patients who experience a fracture of the humeral neck are advised that healing will take an average of ___ weeks with restricted activity for an additional __ weeks.

10, 4

A female patient with diabetes who weighs 130lbs has an ideal body weight of 116lbs. For weight reduction of 2lbs/wk, approximately what will her daily caloric intake be?

1000 calories (1 lb=500 calories)

The nurse is preparing to administer insulin to a patient with type 1 diabetes in the morning prior to surgical procedure. Which percentage of the usual morning dose of insulin will the nurse administer preoperatively?

50% to 60%

The nurse is caring for a patient after arthroscopic surgery for a rotator cuff tear. The nurse informs the patient that full activity can usually resume after what period of time?

6 to 12 months

A patient had an above the knee amputation of the left leg related to complications from peripheral vascular disease. The nurse enters the patient's room and observes the dressing and bed covers saturated with blood. Which is the first action by the nurse?

Apply a tourniquet.

A patient sustains a fracture of the arm. When will the nurse inform the patient that pendulum exercises will begin?

As soon as tolerated, after a reasonable period of immobilization

Which insulin agent is rapid acting?

Aspart

Common pulmonary complications for the older adult patient following a hip fracture are? (Select all that apply)

Atelectasis Pneumonia

A patient with joint dislocation is at risk for development of avascular necrosis. Which rationale should be provided to the patient?

Avascular tissue death is due to anoxia and diminished blood supply

A patient fell in a hole in the yard, causing an ankle injury. The ankle is edamatous and painful to palpation. How long will the nurse inform the patient that the acute inflammatory stage will last?

Between 24 and 48 hours

True or False: A patient's unrelieved pain should be reported to the provider 30 minutes after administered pain medication.

False

True or False: Diabetes leads to only microvascular complications

False

The nurse is educating a patient with diabetes about the importance of increasing dietary fiber. Which will the nurse explain is the reason for the increase? (Select all that apply)

May improve blood glucose levels Decrease the need for exogenous insulin Help reduce cholesterol levels

The femur fracture that commonly leads to avascular necrosis or nonunion due to an abundant supply of blood vessels in the area is a fracture of the?

Neck

True or False: Phantom limb pain is perceived in the amputated limb.

True

True or False: The nurse must never remove weights from skeletal traction unless a life-threatening situation occurs

True

True or False: The nurse never adjusts the clamps on the external fixator frame

True

What are the major classifications of diabetes? (Select all that apply)

Type 1, Type 2, Gestational

A patient falls while skiing and sustains a supracondylar fracture of the humerus. Which serious complication of this injury should the nurse monitor for?

Volkmann ischemic contracture

What is a contusion?

blunt force injury to soft tissue

Insulin resistance refers to?

decreased tissue sensitivity to insulin

What does insulin inhibit?

glycogenolysis and gluconeogenesis

What does uncontrolled type 2 diabetes lead to?

hyerglycemic hyperosmolar syndrome

What are the three P's?

polyuria, polydipsia, polyphagia

The nurse is preparing to administer IV fluids for a patient with ketoacidosis who has a history of hypertension and congestive heart failure. Which prescription for fluids will the nurse infuse for this patient?

0.45% normal saline

Which ROM exercises should be avoided in patients with lower extremity amputations?

Abduction External rotation Flexion

A nurse is caring for a patient with diabetes who has a diagnosis of nephropathy. What will the nurse expect the urinalysis report to indicate?

Albumin

The nurse is caring for a patient with a pelvic fracture. Which nursing assessments for a pelvic fracture will be included? (Select all that apply)

Checking the urine for hematuria Palpating peripheral pulses in both lower extremities Testing the stool for occult blood

What is the most common fracture of the distal radius?

Colles fracture

A patient was climbing a ladder, slipped on a rung, and fell on the right side of the chest. X-ray studies reveal three rib fractures, and the patient reports pain with inspiration. What is the anticipated treatment for this patient?

Coughing and deep breathing with pillow splinting

A patient sustains an open fracture of the left arm after an accident at the roller-skating rink. Which emergency management plans will be started for this patient? (Select all that apply)

Cover the area with a clean dressing if the fracture is open Immobilize the affected site Splint the injured limb

The most common complication of hip fractures in the older adult patient is:

Deep vein thrombosis

What are late complications of fractures? (Select all that apply)

Delayed union and malunion Avascular necrosis of bone Reaction to internal fixation devices Complex regional pain syndrome Heterotopic ossification

A nurse is caring for a patient who has had an amputation. Which interventions will the nurse provide to foster a positive self-image? (Select all that apply)

Encourage the patient to care for the residual limb Allowing expression of grief Introducing the patient to local amputee support groups

True or False: Avascular necrosis is prolongation of expected healing time for a fracture.

False

True or False: Urine testing for glucose is the most effective method to diagnose diabetes in older adults.

False

A patient sustained an open fracture of the femur 24 hours ago. While assessing the patient, the nurse observes the patient is having difficulty breathing, and oxygen saturation decreases to 88% from a previous 99%. Which complications of the fracture is the patient experiencing?

Fat emboli

The residual limb should never be placed on a pillow to avoid?

Flexion contracture of the hip

While riding a bicycle on a narrow road, a patient was hit from behind and thrown into a ditch, sustaining a pelvic fracture. Which complications does the nurse monitor for that are common with pelvic fractures?

Hemorrhage and shock

What are the three metabolic derangements that occur in diabetic ketoacidosis?

Hyperglycemia, ketosis, metabolic acidosis

An older adult patient is in the hospital with urosepsis. The patient begins to experience an altered level of consciousness, profound dehydration, and hypotension. Which condition does the nurse suspect the patient is experiencing?

Hyperglycemic hyperosmolar syndrome

When the nurse is caring for a patient with type 1 diabetes, which clinical manifestation would be a priority to closely monitor?

Hypoglycemia

A patient with diabetic ketoacidosis has had a large volume of fluid infused for rehydration. Which potential complication from rehydration will the nurse monitor for?

Hypokalemia

The nurse is monitoring a patient who sustained an open fracture of the left hip. Which type of shock will the nurse identify may occur with this type of injury?

Hypovolemic

Patients with open fractures risk three major complications:

Osteomyelitis Tetanus Gas gangrene

An older adult patient with diabetes type 2 comes to the ER with second-degree burns to the bottom of both feet and states, "I didn't feel too hot but my feet must have been too close to the heater." Which does the nurse understand is most likely the reason for the decrease in temperature sensations?

Peripheral neuropathy

The nurse is administering an insulin drop to a patient in ketoacidosis. Which insulin does the nurse administer that can be used intravenously?

Regular

A patient has been newly diagnosed with type 2 diabetes, and the nurse is assisting with the development of a meal plan. Which step will be taken into consideration prior to making the meal-plan?

Review the patient's diet history to identify eating habits, and lifestyle and cultural eating patterns

What are early complications of fractures? (Select all that apply)

Shock Fat embolism Compartment syndrome DVT Thromboembolism Infection

Which immediate nursing and medical management techniques are used for open fractures? (Select all that apply)

Stabilization and immobilization Restoring blood volume and circulation Relieving pain Protecting from further injury

What is a muscle tear that is microscopic and due to overuse?

Strain

Which fracture necessitates the longest immobilization time?

Tibial shaft fracture

A patient has suffered a femoral shaft fracture in an industrial injury. Which is an immediate nursing concern for this patient?

Hypovolemic shock

A patient sustains an open fracture with extensive soft tissue damage. The nurse identifies this fracture is classified as which grade?

III

The nurse is caring for a patient who sustained an open fracture of the right femur in an automobile crash. Which is the most serious complication this patient will need to be monitored for?

Infection

What are two main problems related to insulin in type 2 diabetes?

Insulin resistance and impaired insulin secretion

What is the most common risk of insulin pump therapy?

Ketoacidosis

A patient is diagnosed with type 1 diabetes. Which clinical characteristics does the nurse determine will likely be associated with this patient? (Select all that apply)

Ketosis prone Little endogenous insulin Younger than 30 years of age

The nurse is assessing a patient with nonproliferative retinopathy. When examining the retina, what will the nurse expect to assess? (Select all that apply)

Leakage of fluid or serum Microaneurysms Focal capillary single closure

The nurse is caring for a patient with abnormally low blood glucose concentration. Which glucose level will the nurse observe when assessing laboratory results?

Lower than 50 to 60 mg/dL

In the US, diabetes is the leading cause of

Nontraumatic amputation, blindness, end-stage kidney disease

The nurse identifies a grating sensation when moving a patient's extremity. What is the sensation caused by?

The rubbing of bone fragments against each other, also known as crepitus.

What is it called when excess glucose is excreted in the urine and accompanies by excessive loss of fluids and electrolytes?

osmotic diuresis