Adult Health Exam 5

Which would be included in the teaching plan for a client diagnosed with diabetes mellitus? The only diet change needed in the treatment of diabetes is to stop eating sugar. Once insulin injections are started in the treatment of type 2 diabetes, they can never be discontinued. An elevated blood glucose concentration contributes to complications of diabetes, such as diminished vision. Sugar is found only in dessert foods.

An elevated blood glucose concentration contributes to complications of diabetes, such as diminished vision.

A nurse is explaining the action of insulin to a client with diabetes mellitus. During client teaching, the nurse reviews the process of insulin secretion in the body. The nurse is correct when she states that insulin is secreted from the: beta cells of the pancreas. alpha cells of the pancreas. parafollicular cells of the thyroid. adenohypophysis.

beta cells of the pancreas.

When a client with an indwelling urinary catheter wants to walk to the hospital lobby to visit with family members, the nurse teaches him how to do this without compromising the catheter. Which client action indicates an accurate understanding of this information? The client loops the drainage tubing below its point of entry into the drainage bag. The client sets the drainage bag on the floor while sitting down. The client clamps the catheter drainage tubing while visiting with the family. The client keeps the drainage bag below the bladder at all times.

The client keeps the drainage bag below the bladder at all times.

A nurse is educating a client about the benefits of fruit versus fruit juice in the diabetic diet. The client states, "What difference does it make if you drink the juice or eat the fruit? It is all the same." What are the best responses by the nurse? Select all that apply. "Eating the fruit is more satisfying than drinking the juice. You will get full faster." "Eating the fruit instead of drinking juice decreases the glycemic index by slowing absorption." "The fruit has less sugar than the juice." "Eating the fruit will lead to hyperglycemia and the fruit juice will not lead to hyperglycemia." "Eating the fruit will give you more vitamins and minerals than the juice will."

"Eating the fruit instead of drinking juice decreases the glycemic index by slowing absorption." "The fruit has less sugar than the juice."

How long can insulin be out in room air?

30 Days.

How many carbs should a diabetic take in?

45% to 60%

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? 7.5% 8.0% 8.5% 6.5%

6.5%

The nurse is caring for a patient with dementia in the long-term care facility when the patient has a change in cognitive function. What should the nurse suspect this patient may be experiencing? A UTI A stroke An aneurysm Fecal impaction

A UTI

Which client is at highest risk for developing a hospital-acquired infection? A client with an i1619 A client who's taking prednisone (Deltasone) A client with a laceration to the left hand A client with Crohn's disease

A client with an i1619

Risk factors of type 2 diabetes?

Hypertension Obesity Diabetic ketoacidosis

Which of the following is a risk factor for the development of diabetes mellitus? Select all that apply. History of gestational diabetes Age greater of 45 years or older Obesity Hypertension Family history

Hypertension Obesity Family history Age greater of 45 years or older History of gestational diabetes

A client with type 1 diabetes is to receive a short-acting insulin and an intermediate-acting insulin subcutaneously before breakfast. The nurse would administer the insulin at which site as the preferred site? Abdomen Thighs Arms Upper buttock

Abdomen

A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl. His family reports that he has been skipping meals in an effort to lose weight. Which nursing intervention is most appropriate? Inserting a feeding tube and providing tube feedings Administering a 500-ml bolus of normal saline solution Administering 1 ampule of 50% dextrose solution, per physician's order Observing the client for 1 hour, then rechecking the fingerstick glucose level

Administering 1 ampule of 50% dextrose solution, per physician's order

A condition in men that causes frequent urinary tract infections?

BPH

Chronic kidney disease client needs more of what?

Calories

The nurse is educating a client who is required to restrict potassium intake. What foods would the nurse suggest the client eliminate that are rich in potassium? Cooked white rice Butter Citrus fruits Salad oils

Citrus fruits

What is high potassium food?

Citrus fruits

Signs of Hypoglycemia?

Cool clammy skin

A nurse is planning a group teaching session on the topic of urinary tract infection (UTI) prevention. Which point should the nurse include? Wear only nylon underwear to reduce the chance of irritation. Take medication ordered for a UTI until the symptoms subside. Limit fluid intake to reduce the need to urinate. Notify the physician if urinary urgency, burning, frequency, or difficulty occurs.

Notify the physician if urinary urgency, burning, frequency, or difficulty occurs.

The client with chronic renal failure is exhibiting signs of anemia. Which is the best nursing rationale for this symptom? Diminished erythropoietin production Electrolyte imbalances Azotemia Impaired immunologic response

Diminished erythropoietin production

Nursing management of the client with a urinary tract infection should include: Instructing the client to limit fluid intake Discouraging caffeine intake Teaching the client to douche daily Administering morphine sulfate

Discouraging caffeine intake

Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure? Increased red blood cell count Decreased serum potassium level Increased serum calcium level Increased serum creatinine level

Increased serum creatinine level

What does not work with a client with endometriosis?

NSAIDS

Which of the following describes awakening at night to urinate? Polyuria Oliguria Dysuria Nocturia

Nocturia

Recognition of hypoglycemai and hyperglycemis is what?

Priority teaching

Your client has blood sugar of 35 and is unconscious what do you give?

Subq/IM glucagon (1mg) or 25 to 50ml of 5% dextrose IV

An occupational health nurse is screening a group of workers for diabetes. What statement should the nurse interpret as being suggestive of diabetes? "I've always been a fan of sweet foods, but lately I'm turned off by them." "When I went to the washroom the last few days, my urine smelled odd." "Lately, I drink and drink and can't seem to quench my thirst." "No matter how much sleep I get, it seems to take me hours to wake up."

"Lately, I drink and drink and can't seem to quench my thirst."

A client with diabetes calls the clinic reporting a "flu bug." What should the nurse tell the client to do? Select all that apply. "For now, check your urine for ketones every 8 hours." "Take your usual dose of insulin." "Try to eat small amounts of carbs, if possible." "Make sure to stick to your normal diet." "Ensure that you check your blood glucose every hour."

"Take your usual dose of insulin." "Try to eat small amounts of carbs, if possible."

A nursing student asks the nurse why older adults are at risk for renal disease. The best response by the nurse is: "The glomerular filtration rate decreases as we age." "Contractility of the bladder wall increases with age." "Hypoplasia of the prostate occurs in older men." "Urethral hypertrophy occurs following menopause."

"The glomerular filtration rate decreases as we age."

A client with newly diagnosed type 2 diabetes is admitted to the metabolic unit. The primary goal for this admission is education. Which goal should the nurse incorporate into her teaching plan? Weight reduction through diet and exercise Maintenance of blood glucose levels between 180 and 200 mg/dl Smoking reduction but not complete cessation An eye examination every 2 years until age 50

Weight reduction through diet and exercise

A patient is having a problem with retention of urine in the bladder. Which of the following diagnostic tests measures the amount of residual urine in the bladder? Cystography Bladder ultrasonography Nuclear scan IV urography

Bladder ultrasonography

A client has been diagnosed with diabetes and discusses treatment strategies with the nurse. What consequences of untreated diabetes should the nurse include with client teaching? Select all that apply. Blindness Cardiovascular disease Kidney disease Liver failure Limb amputation

Blindness Limb amputation Cardiovascular disease Kidney disease

A patient comes to the clinic suspecting a possible UTI. What symptoms of a UTI would the nurse recognize from the assessment data gathered? Urine with a specific gravity of 1.005-1.022 Cloudy urine An output of 200mL with each voiding Rebound tenderness at McBurney's point

Cloudy urine

A client has presented with signs and symptoms that are characteristic of acute kidney injury, but preliminary assessment reveals no obvious risk factors for this health problem. The nurse should recognize the need to interview the client about what topic? Psychosocial stressors Allergy status Typical diet Current medication use

Current medication use

Which age-related change may affect diabetes and its management? Increased bowel motility Increased thirst Decreased renal function Hypotension

Decreased renal function

What does it mean if your fasting blood sugar is 160?

Diabetic

Which instruction would be included in a teaching plan for a client diagnosed with a urinary tract infection? Drink liberal amount of fluids. Use tub baths as opposed to showers. Drink coffee or tea to increase diuresis. Void every 4 to 6 hours.

Drink liberal amount of fluids.

Which term describes painful or difficult urination? Anuria Dysuria Oliguria Nocturia

Dysuria

What are ways a diabetic should manage illness?

Eat small carb meals throughout the day.

Most common bacteria that causes pyelonephritis?

Ecoli

What is a production in the kidneys to produce RCBs?

Erythropoietin

Which substance stimulates the bone marrow to produce red blood cells? Prostacyclin Prostaglandin E Erythropoietin Renin

Erythropoietin

Which is a risk factor for cervical cancer? Late childbearing Underweight status Exposure to the human papilloma virus (HPV) Sex with circumcised males

Exposure to the human papilloma virus (HPV)

A nurse is preparing to discharge a client with coronary artery disease and hypertension who is at risk for type 2 diabetes. Which information is important to include in the discharge teaching? How to monitor ketones daily How to recognize signs of diabetic ketoacidosis How to control blood glucose through lifestyle modification with diet and exercise How to self-inject insulin

How to control blood glucose through lifestyle modification with diet and exercise

The nurse is providing education regarding sexually transmitted infections. Which statement regarding herpes virus 2 (herpes genitalis) is accurate? In pregnant women with active herpes, babies delivered vaginally may become infected with the virus. Transmission of the virus requires sexual contact. Usually, the virus is killed at room temperature by drying. The virus is very difficult to kill.

In pregnant women with active herpes, babies delivered vaginally may become infected with the virus.

A client has been successfully treated for kidney stones and is preparing for discharge. The nurse recognizes the risk of recurrence and has planned the client's discharge education accordingly. What preventive measure should the nurse encourage the client to adopt? Adopting a high-calcium diet Increasing fluid intake Increasing intake of protein from plant sources Eating several small meals each day

Increasing fluid intake

Which is a by-product of fat breakdown in the absence of insulin and accumulates in the blood and urine? Hemoglobin Cholesterol Ketones Creatinine

Ketones

What education should be given to a diabetic?

Loss weight stop smoking diet/exercise

During a routine assessment, the client states; "I wake up all night long to go the bathroom." The nurse documents this finding as which condition? Polyuria Dysuria Oliguria Nocturia

Nocturia

What can cause increased abdominal girth?

Ovarian Cancer

The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order? Is less costly than performing daily blood sugar test Provides best information on the body's ability to maintain normal blood functioning Best indicator for the nutritional state of the client Reflects the amount of glucose stored in hemoglobin over past several months.

Reflects the amount of glucose stored in hemoglobin over past several months.

What is a upper urinary infection?

Renal abscess.

your client's blood sugar is 45 and alert and orientated what will you give? 3 oz orange juice 6 oz milk 2 graham crackers Saltines

Saltines

Usually happens in men between ages 15-35 and can be generic?

Testicular cancer

when the uterus and cervix is removed this is called?

Total hysterectomy

True/False Diabetes is the primary cause of kidney disease

True

True/False Readiness to learn must be assessed before starting education?

True

True/False A diabetic should rotate insulin injection sites.

True.

What type of diabetes are beta cells destroyed?

Type 1

The greatest percentage of people have which type of diabetes? Gestational Type 1 Impaired glucose tolerance Type 2

Type 2

The nurse is caring for a client who describes changes in his voiding patterns. The client states, "I feel the urge to empty my bladder several times an hour and when the urge hits me I have to get to the restroom quickly. But when I empty my bladder, there doesn't seem to be much urine flow." What would the nurse expect this client's physical assessment to reveal? Urine retention Hematuria Dehydration Kidney injury

Urine retention

The nurse who teaches a client about preventing recurrent urinary tract infections would include which statement? Void every 5 hours during the day. Increase intake of coffee, tea, and colas. Take tub baths instead of showers. Void immediately after sexual intercourse.

Void immediately after sexual intercourse.

The nurse is working on the renal transplant unit. To reduce the risk of infection in a client with a transplanted kidney, it is imperative for the nurse to do what? Wash hands carefully and frequently. Bar visitors from the client's room. Ensure immediate function of the donated kidney. Instruct the client to wear a face mask.

Wash hands carefully and frequently.

A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are effective only if the client: has type 2 diabetes. prefers to take insulin orally. is pregnant and has type 2 diabetes. has type 1 diabetes.

has type 2 diabetes.

A client with diabetes mellitus is receiving an oral antidiabetic agent. When caring for this client, the nurse should observe for signs of: polydipsia hypoglycemia blurred vision polyuria

hypoglycemia

A client diagnosed with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse anticipates administering: Sorbitol sodium polystyrene sulfonate (Kayexalate) Calcium supplements IV dextrose 50%

sodium polystyrene sulfonate (Kayexalate)

Why do we want a diabetic to maintain glucose control?

to prevent complications

A nurse is developing a teaching plan for a client with diabetes mellitus. A client with diabetes mellitus should: cut the toenails by rounding edges. wash and inspect the feet daily. walk barefoot at least once each day. use commercial preparations to remove corns.

wash and inspect the feet daily.