Med surg quiz 2

The nurse notes that a patient who was admitted with diabetic ketoacidosis has rapid, deep respirations. Which action should the nurse take? Select one: a. Administer the prescribed normal saline bolus and insulin. b. Start the prescribed PRN oxygen at 2 to 4 L/min. c. Give the prescribed PRN lorazepam (Ativan). d. Encourage the patient to take deep, slow breaths with guided imagery.

a. Administer the prescribed normal saline bolus and insulin.

Which information will the nurse include when teaching a 50-year-old patient who has type 2 diabetes about glyburide (Micronase, DiaBeta, Glynase)? Select one: a. Glyburide stimulates insulin production and release from the pancreas. b. Glyburide should be taken even if the morning blood glucose level is low. c. Glyburide should not be used for 48 hours after receiving IV contrast media. d. Glyburide decreases glucagon secretion from the pancreas.

a. Glyburide stimulates insulin production and release from the pancreas.

The nurse assesses a patient who has been hospitalized for 2 days. The patient has been receiving normal saline IV at 100 mL/hr, has a nasogastric tube to low suction, and is NPO. Which assessment finding would be a priority for the nurse to report to the health care provider? Select one: a. Gradually decreasing level of consciousness (LOC) b. Weight gain of 2 pounds (1 kg) above the admission weight c. Serum sodium level of 138 mEq/L (138 mmol/L) d. Oral temperature of 100.1° F

a. Gradually decreasing level of consciousness (LOC)

A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about Select one: a. effects of oral hypoglycemic medications. b. lifestyle changes to lower blood glucose. c. self-monitoring of blood glucose. d. using low doses of regular insulin.

b. lifestyle changes to lower blood glucose.

An older patient receiving iso-osmolar continuous tube feedings develops restlessness, agitation, and weakness. Which laboratory result should the nurse report to the health care provider immediately? Select one: a. Ca+2 7.8 mg/dL (1.95 mmol/L) b. PO4-3 4.8 mg/dL (1.55 mmol/L) c. Na+ 154 mEq/L (154 mmol/L) d. K+ 3.4 mEq/L (3.4 mmol/L)

c. Na+ 154 mEq/L (154 mmol/L)

Which laboratory value reported to the nurse by the unlicensed assistive personnel (UAP) indicates the most urgent need for the nurse's assessment of the patient? Select one: a. Bedtime glucose of 140 mg/dL b. Fasting blood glucose of 130 mg/dL c. Noon blood glucose of 52 mg/dL d. 2-hr postprandial glucose of 220 mg/dL

c. Noon blood glucose of 52 mg/dL

After change-of-shift report, which patient should the nurse assess first? Select one: a. 19-year-old with type 1 diabetes who has a hemoglobin A1C of 12% b. 50-year-old who uses exenatide (Byetta) and is complaining of acute abdominal pain c. 40-year-old who is pregnant and whose oral glucose tolerance test is 202 mg/dL d. 23-year-old with type 1 diabetes who has a blood glucose of 40 mg/dL

d. 23-year-old with type 1 diabetes who has a blood glucose of 40 mg/dL

An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic. Which finding may indicate the need for a change in therapy? Select one: a. Heart rate at rest 58 beats/minute b. High density lipoprotein (HDL) level 65 mg/dL c. Hemoglobin A1C level 6.2% d. Blood pressure 146/88 mmHg

d. Blood pressure 146/88 mmHg

A patient who is lethargic and exhibits deep, rapid respirations has the following arterial blood gas (ABG) results: pH 7.32, PaO2 88 mm Hg, PaCO2 37 mm Hg, and HCO3 16 mEq/L. How should the nurse interpret these results? Select one: a. Respiratory alkalosis b. Respiratory acidosis c. Metabolic alkalosis d. Metabolic acidosis

d. Metabolic acidosis

Which action should the nurse take first when a patient complains of acute chest pain and dyspnea soon after insertion of a centrally inserted IV catheter? Select one: a. Offer reassurance to the patient. b. Auscultate the patient's breath sounds. c. Notify the health care provider. d. Give the prescribed PRN morphine sulfate IV.

b. Auscultate the patient's breath sounds.

A patient comes to the clinic complaining of frequent, watery stools for the last 2 days. Which action should the nurse take first? Select one: a. Draw blood for serum electrolyte levels. b. Check the patient's blood pressure. c. Obtain the baseline weight. d. Ask about any extremity numbness or tingling.

b. Check the patient's blood pressure.

IV potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient with severe hypokalemia. Which action should the nurse take? Select one: a. Administer the KCl as a rapid IV bolus. b. Infuse the KCl at a rate of 10 mEq/hour. c. Only give the KCl through a central venous line. d. Discontinue cardiac monitoring during the infusion.

b. Infuse the KCl at a rate of 10 mEq/hour.

A nurse is assessing a newly admitted patient with chronic heart failure who forgot to take prescribed medications and seems confused. The patient complains of "just blowing up" and has peripheral edema and shortness of breath. Which assessment should the nurse complete first? Select one: a. Heart sounds b. Mental status c. Capillary refill d. Skin turgor

b. Mental status

A 27-year-old patient admitted with diabetic ketoacidosis (DKA) has a serum glucose level of 732 mg/dL and serum potassium level of 3.1 mEq/L. Which action prescribed by the health care provider should the nurse take first? Select one: a. Administer IV potassium supplements. b. Place the patient on a cardiac monitor. c. Start an insulin infusion at 0.1 units/kg/hr. d. Obtain urine glucose and ketone levels.

b. Place the patient on a cardiac monitor.

A 26-year-old patient with diabetes rides a bicycle to and from work every day. Which site should the nurse teach the patient to administer the morning insulin? Select one: a. thigh. b. buttock. c. abdomen. d. upper arm.

c. abdomen.

The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes. Which question is most appropriate for the nurse to ask? Select one: a. "Have you lost weight lately?" b. "Are you anorexic?" c. "Is your urine dark colored?" d. "Do you crave sugary drinks?"

a. "Have you lost weight lately?"

A newly admitted patient is diagnosed with hyponatremia. When making room assignments, the charge nurse should take which action? Select one: a. Assign the patient to a semi-private room and place an order for a low-salt diet. b. Place the patient in a room nearest to the water fountain. c. Assign the patient to a room near the nurse's station. d. Place the patient on telemetry to monitor for peaked T waves.

c. Assign the patient to a room near the nurse's station.

Which information is most important for the nurse to report to the health care provider before a patient with type 2 diabetes is prepared for a coronary angiogram? Select one: a. The patient took the prescribed captopril (Capoten) this morning. b. The patient's most recent HbA1C was 6.5%. c. The patient's admission blood glucose is 128 mg/dL. d. The patient took the prescribed metformin (Glucophage) today.

d. The patient took the prescribed metformin (Glucophage) today.

A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient has been away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to Select one: a. ask that diagnostic testing area staff to start a 5% dextrose IV. b. save the lunch tray for the patient's later return to the unit. c. send a glass of milk or orange juice to the patient in the diagnostic testing area. d. request that if testing is further delayed, the patient be returned to the unit to eat.

d. request that if testing is further delayed, the patient be returned to the unit to eat.