NSG 4520 EXAM 1: Metabolism & Homeostasis ATI Quiz
A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client. What is the sequence of events the nurse should follow? (Place the steps of mixing insulin in the correct order) - Inject air into NPH insulin vial - Withdraw short-acting insulin into syringe - Roll NPH vial between palms of hands - Inspect vials for contaminants - Inject air into regular insulin vial - Add intermediate insulin to syringe
1. Inspect vials for contaminants 2. Roll NPH vial between palms of hands 3. Inject air into NPH insulin vial 4. Inject air into regular insulin vial 5. Withdraw short-acting insulin into syringe 6. Add intermediate insulin to syringe
A nurse observes mild hand tremors in a client who has diabetes mellitus. Which of the following actions should the nurse take after obtaining a glucose meter reading of 60 mg/dL? A) Administer 15 g of carbohydrates B) Retest the blood glucose level C) Administer 1 mg of glucagon IM D) Administer IV dextrose
A) Administer 15 g of carbohydrates
A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize that which of the following are manifestations of Cushing's syndrome? (SATA) A) Alopecia B) Tremors C) Moon face D) Purple striations E) Buffalo hump
A) Alopecia C) Moon face D) Purple striations E) Buffalo hump
A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (SATA) A) Assess blood glucose level B) Assess for neck vein distention C) Monitor for an irregular heart rate D) Monitor for postural hypotension E) Weigh the client daily
A) Assess blood glucose level B) Assess for neck vein distention E) Weigh the client daily
A nurse in a provider's office is reviewing the laboratory results of a client who takes furosemide for hypertension. The nurse notes that the client's potassium level is 3.3 mEq/L. The nurse should monitor the client for which of the following complications? A) Cardiac dysrhythmias B) Hypoglycemia C) Seizures D) Neurogenic shock
A) Cardiac dysrhythmias
A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client? A) Chvostek's sign B) Babinski's sign C) Brudzinski's sign D) Kernig's sign
A) Chvostek's sign
A nurse is assessing a client who has chronic kidney disease for fluid volume increase. Which of the following provides a reliable measure of fluid retention? A) Daily weight B) Sodium level C) Tissue turgor D) Intake and output
A) Daily weight
A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the client's blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following? A) Graham crackers B) 1 tsp sugar C) 4 oz diet soda D) 4 oz skim milk
A) Graham crackers
A nurse is reviewing the laboratory test results from a client who has prerenal kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect? A) Hyperkalemia B) Hypernatremia C) Hypercalcemia D) Hypophosphatemia
A) Hyperkalemia
A nurse is assessing a client who has type 1 diabetes mellitus and finds the client lying in bed, sweating, and reporting feeling anxious. Which of the following complications should the nurse expect? A) Hypoglycemia B) Nephropathy C) Hyperglycemia D) Ketoacidosis
A) Hypoglycemia
A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose? A) Insomnia B) Constipation C) Drowsiness D) Hypoactive deep-tendon reflexes
A) Insomnia
A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances? A) Iron B) Protein C) Potassium D) Sodium
A) Iron
A nurse is teaching a client who has a new prescription for regular insulin and NPH insulin. Which of the following instructions should the nurse include in the teaching? A) Keep the open vial of insulin at room temperature B) Inject the insulin into a large muscle C) Aspirate the medication prior to administration D) Administer the insulin in two separate injections
A) Keep the open vial of insulin at room temperature
A nurse is assessing a client who has hypothyroidism. Which of the following findings should the nurse expect? A) Lethargy B) Exophthalmos C) Weight loss D) Photophobia
A) Lethargy
A nurse is providing dietary teaching to a client who has chronic kidney disease (CKD). The nurse should instruct the client to limit which of the following nutrients? (SATA) A) Protein B) Calcium C) Calories D) Phosphorous E) Sodium
A) Protein D) Phosphorous E) Sodium
A nurse is preparing a teaching session about reducing the risk of complications of diabetes mellitus. Which of the following information should the nurse plan to include in the teaching? (SATA) A) Reduce cholesterol and saturated fat intake B) Increase physical activity and daily exercise C) Enroll in a smoking-cessation program D) Sustain hyperglycemia to reduce deterioration of nerve cells E) Maintain optimal blood pressure to prevent kidney damage
A) Reduce cholesterol and saturated fat intake B) Increase physical activity and daily exercise C) Enroll in a smoking-cessation program E) Maintain optimal blood pressure to prevent kidney damage
A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (SATA) A) Slurred speech B) Bone pain C) Bradypnea D) Pruritus E) Hypotension
A) Slurred speech B) Bone pain D) Pruritus
A nurse is caring for a client who has total thyroidectomy and a serum calcium level of 7.6 mg/dL. Which of the following findings should the nurse expect? A) Tingling of the extremities B) Hypoactive deep tendon reflexes C) Shortened QT intervals D) Constipation
A) Tingling of the extremities
A nurse is providing teaching for a client who is newly diagnosed with type 2 diabetes mellitus and has a prescription for glipizide. Which of the following statements by the nurse best describes the action of glipizide? A) "Glipizide absorbs the excess carbohydrates in your system." B) "Glipizide stimulates your pancreas to release insulin." C) "Glipizide replaces insulin that is not being produced by your pancreas." D) "Glipizide prevents your liver from destroying your insulin."
B) "Glipizide stimulates your pancreas to release insulin."
A nurse is providing teaching about foot care for a client who has type 2 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching? A) "I should soak my feet before trimming my nails." B) "I should buy new shoes late in the day." C) "I should wear a clean pair of nylon socks every day." D) "I should use a heating pad at night when my feet feel cold."
B) "I should buy new shoes late in the day."
A nurse is teaching a client who has diabetes about which dietary source should provide the greatest percentage of calories. Which of the following statements indicates the client understands the teaching? A) "Most of my calories each day should be from fats." B) "I should eat more calories from complex carbohydrates than anything else." C) "Simple sugars are needed more than other calorie sources." D) "Protein should be my main source of calories."
B) "I should eat more calories from complex carbohydrates than anything else."
A staff nurse is teaching a client who has Addison's disease about the disease process. The client asks the nurse what causes Addison's disease. Which of the following responses should the nurse make? A) "It is caused by the lack of production of insulin by the pancreas." B) "It is caused by the lack of production of aldosterone by the adrenal gland." C) "It is caused by the overproduction of growth hormone by the pituitary gland." D) "It is caused by the overproduction of parathormone by the parathyroid gland."
B) "It is caused by the lack of production of aldosterone by the adrenal gland."
A client who has Type 2 diabetes mellitus asks the nurse, "why did I develop diabetes?" Which of the following responses should the nurse make? A) "Your body is destroying the cells that secrete insulin." B) "Your body has insulin resistance and decreased insulin secretion." C) "An infection in your pancreas destroyed the cells that make insulin." D) "Your kidneys are not able to reabsorb water which leads to Type 2 diabetes mellitus."
B) "Your body has insulin resistance and decreased insulin secretion."
A nurse is caring for a client who has diabetic ketoacidosis. Which of the following manifestations should the nurse expect? A) Malignant hypertension B) Acetone odor to breath C) Cheyne-Stokes breathing D) Blood glucose level below 40 mg/dL
B) Acetone odor to breath
A nurse providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (SATA) A) Polyuria B) Blurred vision C) Polydipsia D) Tachycardia E) Moist, clammy skin
B) Blurred vision D) Tachycardia E) Moist, clammy skin
A nurse is assessing a client who has diabetes mellitus. Which of the following findings is a manifestation of hypoglycemia? A) Bradycardia B) Cool, clammy skin C) Vomiting D) Fruity odor on the client's breath
B) Cool, clammy skin
A home health nurse is making a home visit to a client who takes a daily diuretic for heart failure. Which of the following manifestations should the nurse identify as indicating the client is hypokalemic? A) Pitting edema B) Fatigue C) Dyspnea D) Oliguria
B) Fatigue
A nurse is providing teaching to a client who has a new diagnosis of hypothyroidism. On which of the following medications should the nurse prepare to instruct the client? A) Radioactive iodine B) Levothyroxine C) Sumatriptan D) Levofloxacin
B) Levothyroxine
A nurse is providing dietary teaching for a client who has Cushing's disease. Which of the following recommendations should the nurse include in the teaching? A) Limit intake of potassium-rich foods B) Restrict sodium intake C) Increase carbohydrate intake D) Decrease protein intake
B) Restrict sodium intake
A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of acute kidney injury? A) BUN 15 mg/dL B) Serum creatinine 6 mg/dL C) Hemoglobin 16 g/dL D) Serum potassium 4.5 mEq/L
B) Serum creatinine 6 mg/dL
A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following foods should the nurse instruct the client to avoid? (SATA) A) Green beans B) Tomatoes C) Bananas D) Asparagus E) Raisins
B) Tomatoes C) Bananas E) Raisins
A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take? A) Provide a low-carbohydrate diet B) Weigh the client daily C) Administer oral corticosteroids D) Restrict fluid intake
B) Weigh the client daily
A nurse is teaching a client who has type 1 diabetes mellitus about foot care. Which of the following statements by the client indicates an understanding of the teaching? A) "I'll wear sandals in warm weather." B) "I'll put lotion between my toes after drying my feet." C) "I'll check my feet every day for sores and bruises." D) "I'll soak my feet in cool water every night before I go to bed."
C) "I'll check my feet every day for sores and bruises."
A nurse is teaching a client who has pre-dialysis end-stage kidney disease about diet. Which of the following instructions should the nurse include? A) "Increase intake of dietary phosphorous." B) "Eliminate foods high in protein from your diet." C) "Reduce intake of foods high in potassium." D) "Increase intake of sodium-containing food."
C) "Reduce intake of foods high in potassium."
A nurse is reviewing a client's laboratory values and discovers the client has a serum potassium of 6.2 mEq/L. Which of the following interventions should the nurse anticipate? A) Initiating an IV potassium infusion B) Encouraging the client to eat bananas C) Administering sodium polystyrene sulfonate D) Administering a potassium-sparing diuretic
C) Administering sodium polystyrene sulfonate
A nurse is caring for a client who has a prescription for potassium chloride (KCL) 20 mEq PO daily. The nurse reviews the client's most recent laboratory results and finds the client's potassium level is 5.2 mEq/L. Which of the following actions should the nurse take? A) Give the ordered KCL as prescribed B) Omit the KCL dose and document it was not given C) Call the prescribing physician and inform her of the client's serum potassium level results D) Call the lab to verify the client's results
C) Call the prescribing physician and inform her of the client's serum potassium level results
A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include? A) Discard the NPH solution if it appears cloudy B) Shake the insulin vigorously before loading the syringe C) Expect the NPH insulin to peak in 6 to 14 hr D) Freeze unopened insulin vials
C) Expect the NPH insulin to peak in 6 to 14 hr
A nurse is reviewing the laboratory results of a client who is at risk for developing diabetes mellitus. The nurse should recognize that which of the following results indicates the client meets the criteria for diagnosis of diabetes mellitus? A) HbA1c 5.5% B) 2 hr blood glucose 170 mg/dL C) Fasting blood glucose 155 mg/dL D) Casual blood glucose 180 mg/dL
C) Fasting blood glucose 155 mg/dL
A nurse is assessing a client who has hyperthyroidism. The nurse should expect the client to report which of the following manifestations? A) Sensitivity to cold B) Constipation C) Frequent mood changes D) Weight gain of 4.5 kg (10 lb) in 3 weeks
C) Frequent mood changes
A nurse is caring for a client who has heart failure and a new prescription for furosemide. Which of the following laboratory values should the nurse review before administering furosemide? A) Bicarbonate B) Carbon dioxide C) Potassium D) Phosphate
C) Potassium
A nurse is teaching a client who has acute kidney injury about the oliguric phase. Which of the following information should the nurse include in the teaching? A) Renal function is reestablished B) BUN and creatinine levels decrease C) Urine output is less than 400 mL per 24 hr D) The glomerular filtration rate (GFR) recovers
C) Urine output is less than 400 mL per 24 hr
A nurse is assessing a client who has hypothyroidism. The nurse should expect which of the following findings? A) Exophthalos B) Palpitations C) Weight gain D) Diaphoresis
C) Weight gain
A nurse is teaching about disease management for a client who has type 1 diabetes mellitus. Which statement made by the client indicates an understanding of the teaching? A) "I am to take my blood sugar reading after meals." B) "Insulin allows me to eat ice cream at bedtime." C) "A weight reduction program will make me hypoglycemic." D) "I give the insulin injections in my abdominal area."
D) "I give the insulin injections in my abdominal area."
A nurse is teaching an older adult client who has diabetes mellitus about preventing the long-term complications of retinopathy and nephropathy. Which of the following instructions should the nurse include? A) "Have an eye examination once per year." B) "Examine your feet carefully every day." C) "Wear compression stockings daily." D) "Maintain stable blood glucose levels."
D) "Maintain stable blood glucose levels."
A nurse is reviewing the medical record of a client who has a potassium level of 3.0 mEq/L. Which of the following findings should the nurse recognize as a potential causative factor? A) Client is currently prescribed spironolactone B) Client has a history of alcohol abuse disorder C) Client reports drinking 3.5 to 4 L of water each day D) Client has an NG tube to gastric suction
D) Client has an NG tube to gastric suction
A nurse is reviewing the medical record of a client who has been on levothyroxine for several months. Which of the following findings indicates a therapeutic response to the medication? A) Decrease in level of thyroxine (T4) B) Increase in weight C) Increase in hr of sleep per night D) Decrease in level of thyroid stimulating hormone (TSH)
D) Decrease in level of thyroid stimulating hormone (TSH)
A nurse is teaching a client how to draw up regular insulin and NPH insulin into the same syringe. Which of the following instructions should the nurse include? A) Draw up the NPH insulin into the syringe first B) Inject air into the regular insulin first C) Shake the NPH insulin until it is well mixed D) Discard regular insulin that appears cloudy
D) Discard regular insulin that appears cloudy
A nurse is assessing a preschooler who has a calcium level of 8.0 mg/dL. Which of the following findings should the nurse expect? A) Dry, sticky mucous membranes B) Polyuria C) Negative Chvostek's sign D) Muscle tremors
D) Muscle tremors
A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client? A) NPH insulin B) Insulin glargine C) Insulin detemir D) Regular insulin
D) Regular insulin
A nurse is preparing to obtain a daily weight from a client who has chronic kidney disease. Which of the following actions should the nurse implement? A) Use any available scale to weigh the client B) Balance the scale at minus two before weighing the client C) Obtain the weight each day at a time most convenient for the client D) Weigh the client after he has voided
D) Weigh the client after he has voided