Practice Questions

A patient with type 2 diabetes has DKA, which finding has the greatest effect on fluid loss? -hypotension -decreased serum K+ levels -rapid, deep respirations -warm, dry skin

-rapid, deep respirations

A pt with diabetes is taking insulin lispro injections. The nurse should advise the client to eat: -within 10-15 mins after injection -1 hour after injection -at any time b/c timing of meals with this insulin is unnecessary -2 hours before the injection

-within 10-15 mins after the injection

The HCP has prescribed insulin detemir for a pt with type 2 DM. The nurse should tell the pt: -you may increase carbs in your diet when using this insulin -you do not need to rotate injection sites -you do not mix insulin detemir, the solution is clear -you may refill the detemir insulin pen

-you do not mix insulin detemir, the solution is clear

A child recently diagnosed with epilepsy is being evaluated for anticonvulsant med therapy. The child will likely be placed on which type of regimen? -2/3 oral anticonvulsant meds so that dosing can be low and side effects minimal -1 oral anticonvulsant med to observe effectiveness and minimal side effects -one rectal gel to be admin in event of a seizure -combo of oral and IV anticonvulsant meds to ensure compliance

-1 oral anticonvulsant med to observe effectiveness and minimal side effects

The nurse is teaching the pt about home blood glucose monitoring. Which blood glucose measurement indicates hypoglycemia? -59mg/dl -75mg/dl -108mg/dl -119mg/dl

-59mg/dl

A child with a seizure disorder has been having episodes during which she drops her pencil and simply appears to be daydreaming. This is most likely an: -Myoclonic seizure -Absence seizure -Non-epileptic seizure -Partial seizure

-Absence seizure

Which finding should the nurse report to the healthcare provider for a client with unstable type 1 DM? Select all that apply -systolic BP of 145mmHg -diastolic BP of 87mmHg -high density lipoprotein (HDL) 30mg/dl -glycosolated hemoglobin 9HbA1c) of 10.2% -triglycerides 425mg/dl -urine ketones negative

a, b, c, d, e

The nurse is planning to institute seizure precautions for a pt who is being admitted from the ED. Which measures should the nurse include in planning safety? Select all that apply -padding the side rails of the bed -placing an airway at the bedside -placing bed in high position -putting padded tongue blade at HOB -placing O2 and suction at bedside -have IV equipment ready

a, b, e, f

Which information should the nurse include when developing a teaching plan for a pt newly diagnosed with type 2 DM? Select all that apply -major risk factor for complications is obesity and central abdominal obesity -supplemental insulin is mandatory for controlling DM -exercise increases insulin resistance -primary nutritional source requiring monitoring in the diet is carbs -annual eye & foot exams are recommended

a, e

The pt has been recently diagnosed with type 2 DM and is taking Metformin 2x a day, 1,000 mg before breakfast and dinner. The pt is experiencing diarrhea, n/v, abdominal bloating, and anorexia on admission to the hospital. The admission prescriptions includes metformin. What should the nurse do? Select all that apply -discontinue the metformin -admin glargine insulin rather than metformin -inform pt that the adverse side effects gradually subside over time -assess pt's renal function -monitor pt's glucose value prior to each meal

c, d, e

What is the priority nursing intervention in the postictal phase of a seizure? -reorient the pt to time, place, and person -determine pt's level of sleepiness -assess pt's breathing pattern -position pt comfortably

-assess pt's breathing pattern

The nurse is aware that cloudy cerebrospinal fluid (CSF) most likely indicates: -viral meningitis -bacterial meningitis -no infection, CSF is cloudy -sepsis

-bacterial meningitis

What nursing assessments should be documented at the beginning of the ictal phase of a seizure? -Heart rate, respirations, pulse oximeter, and blood pressure. -Last dose of anticonvulsant and circumstances at the time. -Type of visual, auditory, and olfactory aura the client experienced. -Movement of the head and eyes and muscle rigidity.

-Movement of the head and eyes and muscle rigidity

Select the best room assignment for a newly admitted child with bacterial meningitis. -Semiprivate room with a roommate who also has bacterial meningitis. -Semiprivate room with a roommate who has bacterial meningitis but has received IV antibiotics for more than 24 hours. -Private room that is dark and quiet with minimal stimulation. -Private room that is bright and colorful and has developmentally appropriate activities available.

-Private room that is dark and quiet with minimal stimulation.

Which medication should the nurse anticipate administering first to a child in status epilepticus? -establish an IV and admin lorazepam -admin rectal diazepam -admin oral glucose gel to side of pt's mouth -admin oral diazepam

-admin rectal diazepam

An adult with type 2 diabetes mellitus has been NPO since 10pm in preparation for having a nephrectomy the next day. At 6am on the day of the surgery, the nurse reviews the client's chart and laboratory results. Which finding should the nurse report to the HCP? -urine output of 350ml in8 hours -urine specific gravity of 1.015 -potassium of 4.0 meq -blood glucose of 140mg/dl

-blood glucose of 140mg/dl

Which intervention is most effective in minimizing the risk of seizure activity in a pt who is undergoing diagnostic studies after having experienced several episodes of seizures? -maintain the pt on bedrest -admin butabarbital sodium 30mg PO 3x day -close the door to minimize stimulation -admin carbamazepine 200mg PO 2x day

-close the door to minimize stimulation

Which clinical manifestation is a typical reaction to long-term phenytoin sodium therapy? -weight gain -insomnia -excessive growth of gum tissue -deteriorating eyesight

-excessive growth of gum tissue

Assessment of the diabetic pt for common complications should include exam of the: -abdomen -lymph glands -pharynx -eyes

-eyes

A preschooler has been having periods during which he suddenly falls and appears to be weak for short time after the event. The preschool teacher asks what she should do, select the nurses best response: -have the parents follow up with his HCP b/c this is likely an atonic seizure -find out if there has been any new stressors in his life b/c it could be attention-seeking behavior -have the parents follow up with his HCP b/c this is likely a absence seizure -the preschool years are a time of rapid growth, and many children appear clumsy

-have the parents follow up with his HCP b/c this is likely an atonic seizure

The diet that produces anticonvulsant effects from ketosis consist of: -high fat and low carbs -high fat and high carbs -low fat and low carb -low fact and high carbs

-high fat and low carbs

Which is the best action for the nurse to take during a child's seizure? -admin childs rescue dose of oral diazepam -loosen child's clothing and call for help -place tongue blade in child's mouth to prevent aspiration -carry child to infirmary to call 911 and start an IV

-loosen child's clothing and call for help

The nurse is providing discharge teaching to the parents of a toddler who experienced a febrile seizure. The nurse knows clarification is needed when the mother says: -my child will likely have another seizure -my childs 7 year old brother is also at high risk -ill give my child acetaminophen when ill to prevent the fever from rising too high too rapidly -most children with febrile seizure do not require medication

-my childs 7 year old brother is also at high risk