N117 Exam 4

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A nurse is preparing a plan of care for a client with diabetes mellitus who has hyerglycemia. The priority nursing diagnosis would be: 1. Deficient knowledge 2. Deficient fluid volume 3. Compromised family coping 4. Imbalanced nutrition less than body requirements

2) deficient fluid volumeAn increased blood glucose level will cause the kidneys to excrete the glucose in the urine. This glucose is accompanied by fluids and electrolytes, causing an osmotic diuresis leading to dehydration. This fluid loss must be replaced when it becomes severe.

A patient has type 2 diabetes, obesity, hypertension, and hyperlipidemia. The patient tells the nurse, "I want to lose weight and exercise, but I can never find the time. Plus, I have so much weight to lose, what's the point?" How should the nurse respond to this patient? A. "Losing just 5% of your body weight is extremely beneficial." B. "If you don't exercise, you will die at a young age." C. "It's really a matter of putting your mind to it." D. "Diet is more important than exercise anyway when it comes to weight loss."

After not visiting their primary healthcare provider for over a decade, a 52-year-old man has a long list of health protection needs. The nurse can provide some of the teaching but thinks that the patient would benefit greatly from collaborative interventions. Which item on the patient's health protection plan involves an intervention that is collaborative? A. Scheduling a colonoscopy B. Handing the patient a "Choose My Plate" brochure C. Giving the family in-person counseling D. Providing individual telephone counseling

A certified nurse midwife works a 12-hour night shift and is able to go into the "on-call room" and get some sleep if there is no one in labor. A patient calls while the nurse is in stage N3 of the sleep cycle. What happens after the nurse is awakened and tries to go back to sleep? A. The nurse begins the sleep cycle where they left off. B. The nurse begins at the next cycle, stage N4 of the sleep cycle. C. The nurse begins at the REM stage of the sleep cycle. D. The nurse begins the sleep cycle anew at stage NI sleep.

18. The benefits of using an insulin pump include all of the following except: "a. By continuously providing insulin they eliminate the need for injections of insulin b. They simplify management of blood sugar and often improve A1C c. They enable exercise without compensatory carbohydrate consumption d. They help with weight loss

D: Using an insulin pump has many advantages, including fewer dramatic swings in blood glucose levels, increased flexibility about diet, and improved accuracy of insulin doses and delivery; however, the use of an insulin pump has been associated with weight gain.

A nurse teaches clients about the International Self-Care Foundation's seven pillars of self-care. Which of the following client statements indicates an understanding of the teaching? a. "I will perform moderate exercise several times each week." b. "I will wash my hands for 10 seconds before I eat." c. "I will increase my dietary intake of simple sugars." d. "I will limit my sun exposure to 1 hour in the middle of the day."

A nurse is caring for a client who has delivered a healthy newborn . The client is tense , refuses to hold the baby , and tells the nurse , " I have no idea how to handle having a baby . I wish this pregnancy had never happened . " Which of the following statements should the nurse make ? " Becoming a parent is a new experience for you . Let's talk about your concerns. " "You should be thrilled about having a healthy newborn. I would be. " " Why don't you hold the baby ? I'm sure it will make you feel better. " " How can you think that way? This is a joyous occasion and should be celebrated . "

" Becoming a parent is a new experience for you . Let's talk about your concerns . " Individuals perceptions of and responses to the stressor determine whether the stressor is positive (eustress) or negative (distress). by using therapeutic communication skills the nurse creates a safe environment for the client to express thoughts and feelings.

A nurse is caring for a client who has migraine headaches and reports that they are " getting worse . " Which of the following questions should the nurse ask the client to determine if the headaches are a stress - related disorder ? ( Select all that apply . ) " What is the intensity of your migraine headaches ? " " How often do the migraine headaches occur ? " " Are you eligible for workers ' compensation due to the migraine headaches ? " " What type of support is available to you when you have a migraine headache ? " " What coping strategies do you use when you experience a migraine headache "

" What is the intensity of your migraine headaches ? " " How often do the migraine headaches occur ? " " What type of support is available to you when you have a migraine headache ? " " What coping strategies do you use when you experience a migraine headache " The onset and severity of stress related disorders is affected by the type, frequency, and intensity of the stressor, perception of the stressor, access to support systems, and the individuals ability to effectively cope with the stressor

A nurse is interviewing a client who is in distress and tells the nurse , " My ex - partner is suing for full custody of my children . I am so worried and don't know what to do . " Which of the following questions should the nurse ask to evaluate the client's coping skills ? " Can you describe your relationship with your ex - partner ? " " What happens when you feel worried like this ? " " What do you believe was your contribution to the relationship breakup ? " What strategies have you used in the past to deal with stress ? "

" What strategies have you used in the past to deal with stress ? " This question is appropriate because it focuses on investigating the clients ability to cope with and manage stressful situation

"The client diagnosed with Type 1 diabetes has a glycosylated hemoglobin (A1c) of 8.1%. Which interpretation should the nurse make based on this result? 1.This result is below normal levels. 2.This result is within acceptable levels. 3.This result is above recommended levels 4.This result is dangerously high.

"1.The acceptable level for an A1c for a client with diabetes is between 6% and 7%, which corresponds to a 120-140 mg/dL average blood glucose level. 2.This result is not within acceptable levelsfor the client with diabetes, which is 6% to7%. 3.(CORRECT) This result parallels a serum blood glucoselevel of approximately 180 to 200 mg/dL. An A1 c is a blood test that reﬂects average blood glucose levels over a period of 2-3months; clients with elevated blood glucose levels are at risk for developing long-term complications. 4.An A1c of 13% is dangerously high; it reﬂects a 300-mg/dL average blood glucose level overthe past 3 months."

"An 18-year-old female client, 5'4'' tall, weighing 113 kg, comes to the clinic for a non-healing wound on her lower leg, which she has had for two weeks. Which disease process should the nurse suspect the client is developing? "A. Type 1 diabetes B. Type 2 diabetes C. Gestational diabetes D. Acanthosis nigricans"

"A: Type 1 diabetes usually occurs in young clients who are underweight. In this disease, there is no production of insulin from the beta cells in the pancreas. People with type 1 diabetes are insulin dependent with a rapid onset of symptoms, including polyuria, polydipsia, and polyphagia. CORRECT -->B. Type 2 diabetes is a disorder usually occurring around the age of 40, but it is now being detected in children and young adults as a result of obesity and sedentary lifestyles. Non-healing wounds are a hallmark sign of type 2 diabetes. This client weights 248.6 lbs and is short. C. Gestational diabetes occurs during pregnancy. There is no mention of this. D. Acanthosis nigricans (AN), dark pigmentation and skin creases in the neck, is a sign of hyperinsulinemia. The pancreas is secreting excess amounts of insulin as a result of excessive caloric intake. It is identified in young children and is a precursor to the development of type 2 diabetes."

The nurse is educating a pregnant client who has gestational diabetes. Which of the following statements should the nurse make to the client? Select all that apply. a. Cakes, candies, cookies, and regular soft drinks should be avoided. b. Gestational diabetes increases the risk that the mother will develop diabetes later in life. c. Gestational diabetes usually resolves after the baby is born. d. Insulin injections may be necessary. e. The baby will likely be born with diabetes f. The mother should strive to gain no more weight during the pregnancy.

"ANS: A, B, C, D Gestational diabetes can occur between the 16th and 28th week of pregnancy. If not responsive to diet and exercise, insulin injections may be necessary. Concentrated sugars should be avoided. Weight gain should continue, but not in excessive amounts. Usually, gestational diabetes disappears after the infant is born. However, diabetes can develop 5 to 10 years after the pregnancy"

"Prediabetes is associated with all of the following except: a. Increased risk of developing type 2 diabetes b. Impaired glucose tolerance c. Increased risk of heart disease and stroke d. Increased risk of developing type 1 diabetes"

"ANSWER: D Persons with elevated glucose levels that do not yet meet the criteria for diabetes are considered to have prediabetes and are at increased risk of developing type 2 diabetes. Weight loss and increasing physical activity can help people with prediabetes prevent or postpone the onset of type 2 diabetes."

During a diabetes screening program, a patient tells the nurse, "My mother died of complications of type 2 diabetes. Can I inherit diabetes?" The nurse explains that a.) as long as the patient maintains normal weight and exercises, type 2 diabetes can be prevented. b.) the patient is at a higher than normal risk for type 2 diabetes and should have periodic blood glucose level testing. c.) there is a greater risk for children developing type 2 diabetes when the father has type 2 diabetes. d.) although there is a tendency for children of people with type 2 diabetes to develop diabetes, the risk is higher for those with type 1 diabetes."

"B Rationale: Offspring of people with type 2 diabetes are at higher risk for developing type 2 diabetes. The risk can be decreased, but not prevented, by maintenance of normal weight and exercising. The risk for children of a person with type 1 diabetes to develop diabetes is higher when it is the father who has the disease. Offspring of people with type 2 diabetes are more likely to develop diabetes than offspring of those with type 1 diabetes."

Analyze the following diagnostic findings for your patient with type 2 diabetes. Which result will need further assessment? A) BP 126/80 B) A1C 9% C)FBG 130mg/dL D) LDL cholesterol 100mg/dL

"B) A1C 9% Rationale: Lowering hemoglobin A1C (to average of 7%) reduces microvascular and neuropathic complications. Tighter glycemic control(normal A1C < 6%) may further reduce complications but increases hypoglycemia risk."

"The nurse is caring for a patient whose blood glucose level is 55mg/dL. What is the likely nursing response? A. Administer a glucagon injection B. Give a small meal C. Administer 10-15 g of a carbohydrate D. Give a small snack of high protein food"

"C The client has low hypoglycemia. This is generally treated with a small snack."

Polydipsia and poly uria related to diabetes mellitus are primarily due to: a.The release of ketones from cells during fat metabolism b. Fluid shifts resulting from exposure to high levels of hyperglycemia c. Damage to the kidneys from exposure to high levels of glucose d. changes in RBCs resulting from attachemnt of excessibe glucose to hemoglobin"

"Coorect answer: d. Rationale: The osmotic effect of glucose produces the manifesatiaions of polydispsia and poly uria."

"The client, an 18-year-old female, 5'4'' tall, weighing 113 kg, comes to the clinic for a wound on her lower leg that has not healed for the last two (2) weeks. Which diseaseprocess would the nurse suspect that the client has developed? 1.Type 1 diabetes. 2.Type 2 diabetes. 3.Gestational diabetes. 4.Acanthosis nigricans"

"Correct Answer: 2 Type 2 diabetes is a disorder that usually occurs around the age of 40, but it is now being detected in children and young adultsas a result of obesity and sedentary life-styles. Wounds that do not heal are a hall-mark sign of Type 2 diabetes. This client weighs 248.6 pounds and is short"

Which statement by the patient with type 2 diabetes is accurate. a. ""I am supposed to have a meal or snak if I drink alcohol"" b. ""I am not allowed to eat any sweets because of my diabetes."" c. I do not need to watch what I eat because my diabetes is not the bad kind."" d. The amunt of fat in my diet is not important; it is just the carbohydrates that raise my blood sugar."""

"Correct Answer: A Alcohol should be consumed with food to reduce the risk of hypoglycemia."

"A patient with type 1 diabetes has received diet instruction as part of the treatment plan. The nurse determines a need for additional instruction when the patient says, "a. ""I may have an occasional alcoholic drink if I include it in my meal plan."" b. ""I will need a bedtime snack because I take an evening dose of NPH insulin."" c. ""I will eat meals as scheduled, even if I am not hungry, to prevent hypoglycemia."" d. ""I may eat whatever I want, as long as I use enough insulin to cover the calories.

"D. ""I may eat whatever I want, as long as I use enough insulin to cover the calories."" Rationale: Most patients with type 1 diabetes need to plan diet choices very carefully. Patients who are using intensified insulin therapy have considerable flexibility in diet choices but still should restrict dietary intake of items such as fat, protein, and alcohol. The other patient statements are correct and indicate good understanding of the diet instruction."

"The principal goals of therapy for older patients who have poor glycemic control are: A. Enhancing quality of life. B. Decreasing the chance of complications. C. Improving self-care through education. D. All of the above."

"D. All of the above. Rationale: The principal goals of therapy for older persons with diabetes mellitus and poor glycemic control are enhancing quality of life, decreasing the chance of complications, improving self-care through education, and maintaining or improving general health status."

"The client diagnosed with type 1 diabetse is receiving Humalog, a rapid-acting insulin, by sliding scale. The order reads blood glucose level: <150, zero (0) units; 151 to 200, three (3) units; 201 to 250, six (6 units); >251, contact health-care provider. The unlicensed assistive personnel (UAP) reports to thenurse the client's glucometer reading is 189. How much insulin should the nurse administer to the client?

3 unitsThe client's result is 189, which is between 151 and 200, so the nurse should administer 3 units of Humalog insulin subcutaneously.

A client asks the nurse. "Is drinking a protein drink sufficient as a meal?" Which is the nurses most appropriate response? A- Tell me more about the protein drink you are using B- no, you should never drink protein drinks C- add a piece of fruit to your Breakfast & Lunch routine D- yes, that is fine

The nurse is caring for a 10-month-old infant. Two of the infant's teeth recently erupted, and the parent asks the nurse several questions about oral care for the infant. Which instruction should the nurse provide to the parent regarding the infant's oral care? A. "Use a wet washcloth to wipe the inside of your baby's mouth." B. "Wet your finger with water and use it to wipe the inside of your baby's mouth." C. "Brushing is not important since they are baby teeth." D. "Start by using a soft bristle toothbrush and fluoride toothpaste."

The nurse is caring for a 29-year-old who is 32 weeks pregnant and experiencing a normal pregnancy thus far. The patient does not have any significant preexisting disease or condition. The patient mentions, "I've noticed that my gums have been bleeding every time I floss my teeth." Which response by the nurse is accurate? A. "This is caused by a hormonal response change to your gum tissue." B. "This is caused by a proliferation of bacteria that occurs during pregnancy." C. "This is caused by increased circulating blood volume in pregnancy." D. "This is caused by improper oral hygiene techniques."

Which should the nurse include in a health promotion program as the ideal amount of weekly exercise for a group of older adults aged 70 plus? A. 150 minutes of moderate-intensity aerobic or 75 minutes of vigorous-intensity activities B. 60 minutes of moderate-intensity aerobic activity 3 times per week with some vigorous-intensity activity C. 90 minutes of moderate-intensity aerobic or 75 minutes of vigorous-intensity activities D. 150 minutes of moderate-intensity aerobic activity; vigorous-intensity activity only if approved by healthcare provider

Which statement accurately reflects that the client understands how to use the MyPlate plan? A- I will eat foods from each of the five food groups at every meal. B- You will send me a plate to use for my meals. C- This seems too hard to remember. Can I just eat less? D- I will use the MyPlate handout to increase my portion sizes.

While teaching the client about niacin, the client asks the nurse: "what brand of niacin is best?" Which is the nurses correct response? A-Let me tell you about the side effects of various brands B- the brand is not important. Buy one that cost the least C- get the store brands D- I will ask the doctor which is the best brand

A nurse is assisting with teaching a class about sentinel events. The nurse should include that which of the following situations is a sentinel event? A) A nurse infused an incompatible blood product to a client. B) A client fell getting out of bed. C) A client who is confused walks out of the nursing unit. D) A nurse receives a needle stick injury from a contaminated needle

A) A nurse infused an incompatible blood product to a client. Rationale: A sentinel event is a serious reportable event that results in death, permanent harm, or severe injury to a CLIENT.

A nurse is using evidence-based practice (EBP) to address the incidence of catheter-associated infections on a surgical unit. According to EBP, which of the following actions should the nurse take first? A) Identify a clinical problem B) Collect best evidence relevant to the question C) Evaluate Studies to determine validity D) Share the findings with others

A) Identify a clinical problem.

A nurse is explaining National Patient Safety Goals (NPSGs) to a newly licensed nurse. The nurse should include that which of the following is a goal addressed in the NPSGs? A) Improving staff communication B) Improving staff retention C) Increasing client satisfaction D) Increasing client involvement in their plan of care

A) Improving staff communication

A nurse is reviewing a health care facility's policy that states to use a gauze dressing over IV insertion sites. After completing a literature review, the nurse discovers that evidence-based practice (EBP) indicates to use a transparent dressing over IV sites. Which of the following actions should the nurse take next? A) Recommend changing the procedure to the policy and procedure committee. B) Evaluate the results of the change in procedure C) Implement the change into clinical practice D) Communicate the outcomes of the procedure change with others

A) Recommend changing the procedure to the policy and procedure committee.

The client diagnosed with Type I diabetes is found lying unconscious on the floor of the bathroom. Which interventions should the nurse implement first? A. Administer 50% dextrose IVP. B. Notify the health-care provider. C. Move the client to ICD. D. Check the serum glucose level.

A) admin 50% dextrose IVPThe nurse should assume the client is hypoglycemic and administer IVP dextrose, which will rouse the client immediately. If the collapse is the result of hyperglycemia, this additional dextrose will not further injure the client.

"When assessing the patient experiencing the onset of symptoms of type 1 diabetes, which question should the nurse ask? a. ""Have you lost any weight lately?"" b. ""Do you crave fluids containing sugar?"" c. ""How long have you felt anorexic?"" d. ""Is your urine unusually dark-colored?""

A) lost any weight?"a. Weight loss occurs because the body is no longer able to absorb glucose and starts to break down protein and fat for energy. b. The patient is thirsty but does not necessarily crave sugar- containing fluids. c. Increased appetite is a classic symptom of type 1 diabetes. d. With the classic symptom of polyuria, urine will be very dilute."

A client is admitted with hyperosmolar hyperglycemic state (HHS) and a blood glucose level of 550 mg/dL. Which intervention should the nurse expect to include in the plan of care? (Select all that apply.) A. Give normal saline intravenously. B. Assess level of orientation. C. Obtain blood for hemoglobin A1C. D. Monitor serum potassium levels. E. Provide education about type 2 diabetes mellitus.

A,B,D Rationale: HHS can cause changes to a client's level of consciousness ranging from lethargy to coma; therefore, the nurse should assess the client's level of orientation. The hyperosmolarity of the blood causes severe dehydration and depletion of electrolytes. Therefore, the priority care for a client with HHS is to provide isotonic or colloid solutions intravenously. Potassium is depleted, so it must not only be monitored, but also replaced. This client is acutely ill, so the hemoglobin A1C should be reviewed, but it is not a priority. Education should wait until the client's blood glucose level is stabilized and the client is alert enough to be receptive to the teaching.

The nurse is taking a health history from a client who has type 1 diabetes mellitus. Which client symptom may indicate the development of complications? (Select all that apply.) A.Dizziness B.Numbness in the feet C.Quick wound healing D.Vision changes E. Frequent voiding of urine

A,B,D,E Rationale: Dizziness, vision changes, numbness in the feet, and frequent voiding of urine may indicate that the client has developed complications of type 1 diabetes mellitus. Clients with type 1 diabetes mellitus frequently experience prolonged wound healing; therefore, a report of quick wound healing would not indicate that the client has developed a complication of type 1 diabetes mellitus.

The nurse is teaching a group of young adults regarding nonmodifiable risk factors for the development of type 1 diabetes mellitus. Which attendee statement indicates a need for further instruction? (Select all that apply.) A."Type 1 diabetes mellitus can be passed on from one recessive gene from one parent." B."There are genes such as the HLA-DR3 and HLA-DR4 genes that can cause type 1 diabetes mellitus." C."Type 1 diabetes mellitus can be caused by exposure to excessive heat and temperatures." D."I can develop type 1 diabetes mellitus from bacterial infections." E."Type 1 diabetes mellitus is caused by exposure to processing of metals and proteins."

A,C,D,E The individual with type 1 diabetes mellitus usually inherits the risk factor for the disorder from each parent. Environmental factors such as cold weather and exposure to a virus also contribute to the development of type 1 diabetes mellitus. The genes HLA-DR3 and HLA-DR4 have been identified in people with type 1 diabetes mellitus. Exposure to processing of metals contributes to the development of cirrhosis.

The nurse is providing teaching to a client with a new diagnosis of type 1 diabetes mellitus. The nurse should instruct the client about incorporating which treatment to help manage the disease? (Select all that apply.) A.Exercise B. Fluid restriction C. Medication D. Daily weight checking E. Nutrition

A,C,E Clients with type 1 diabetes mellitus are treated with exercise, nutrition, and medication. Fluid restriction and daily weight checking are not part of the treatment plan for clients with type 1 diabetes mellitus.

The nurse is managing care for a client weighing 165 pounds who was admitted for the treatment of diabetic ketoacidosis (DKA). Which intervention would be most appropriate for the nurse to include in the plan of care? (Select all that apply.) A.Place the client on a telemetry monitor. B. Provide a high-protein diet. C.Give 100 mL of normal saline bolus. D. Measure intake and output every hour. E. Administer sliding-scale regular insulin.

A,D Rationale: The nurse would calculate intake and output on an hourly basis to determine fluid needs. The client would be placed on a telemetry monitor to monitor for dysrhythmias related to shifts in potassium levels. The client with DKA would be acutely ill and if able to eat, would be placed on a carbohydrate-controlled diet. The nurse would administer normal saline boluses at 10-20 mL/kg. A volume of 100 mL is not sufficient. Insulin would be administered intravenously, not sliding scale.

Which statement made by a client with type 1 diabetes mellitus indicates an understanding of instruction provided regarding disease management? (Select all that apply.) A."I should administer insulin during the day in multiple injections." B."I should maintain my hemoglobin A1C levels at or below 8%." C."I should count calories consumed to determine insulin needs for each day." D."I should trim my toenails at an angle to prevent cutting the skin." E. "I should obtain blood glucose levels prior to each insulin injection."

A,E Rationale: For better blood glucose control, the healthcare provider would instruct the client to administer insulin throughout the day in multiple injections and to obtain blood glucose levels prior to each injection. Hemoglobin A1C levels should be below 6.5%. The client should be instructed to count carbohydrates, not calories. Toenails should be cut straight across with a clipper and the edges and corners smoothed with an emery board. If the client is unable to see his feet or reach them easily, someone else can trim his nails. If the nails are very thick or ingrown, if toes overlap, or if circulation is poor, then a podiatrist should cut the client's toenails.

The nurse is demonstrating how to prepare a dinner menu using the MyPlate plan. Which food item should the nurse include. Select all that apply. A- Slices of roast beef B- one glass of milk C- sliced peaches D- steamed broccoli E- one cupcake

A- Slices of roast beef B- one glass of milk C- sliced peaches D- steamed broccoli

The nurse is preparing to present the benefits of evidence-based practice (EBP) as it relates to nursing to colleagues. Which benefit should the nurse include? (Select all that apply.) A. Receiving the best clientoutcomes B. Increasing the accuracy of charting C. Contributing to the knowledge of nursing D. Increasing teamwork in healthcare facilities E. Assisting in the delivery of high-quality nursing care

A. Receiving the best clientoutcomes C. Contributing to the knowledge of nursing E. Assisting in the delivery of high-quality nursing care Rationale: Some basic activities can provide a foundation for implementing EBP. These strategies can spark the necessary stimulus to engage in behaviors that encourage best practice. Participating in EBP contributes to the knowledge of nursing and client care in today's healthcare systems and delivery of high-quality nursing care for best outcomes. Utilizing EBP doesn't increase the accuracy ofcharting, as that is all dependent on the nurse and the knowledge of what they add to the record. EBP governs nursing practice, but teamwork is something that needs to be encouraged by management in each individual healthcare facility.

The nurse conducting a research study needs to determine if an individual qualifies to be a participant. Which criteria must be met for inclusion? (Select all that apply.) A.The individual meets all the inclusion criteria. B.The individual has been given informed consent. C.The individual receives payment for participation. D.The individual must waive the right to anonymity. E. The individual is informed of all aspects of the study.

A. The individual meets all the inclusion criteria. B. The individual has been given informed consent. E. The individual is informed of all aspects of the study. Rationale: Research participants are defined as volunteers for a specific study project who meet all the inclusion criteria, have been informed of all aspects of thestudy, and have given informed consent. Adherence to the ethical principle of justice requires protection of the research participant's anonymity. Payment is not a mandatory condition of participation in research.

A nurse is caring for a client diagnosed with hypertension. The client's healthcare provider suggests the client begin a regular exercise schedule. The client asks the nurse, "The healthcare provider said that exercise benefits the brain, but I don't see how it can." Which is the correct response by the nurse? A. "Exercise leads to increased oxygen to the brain, which improves the brain's thinking abilities." B. "Exercise increases oxygen flow to the brain, increasing the number of brain cells." C. "Exercise increases brain oxygen, resulting in an increase in the number of neurons in the brain." D. "Exercise opens the cerebral arteries, which improves short-term memory."

A."Exercise leads to increased oxygen to the brain, which improves the brain's thinking abilities." Rationale: Exercise increases ventilation and oxygen intake, improving gasexchange, eliminating more toxins, and increasing oxygen to the brain, thus enhancing the brain's cognitive (thinking) function. Short-term memory is not improved with exercise, and the number of brain cells and neurons does not increase with exercise and increased oxygen flow.

A community health nurse is providing education to a group of adults about the types of exercise that promote health. Which statement will the nurse include in the teaching? (Select all that apply.) A. "The talk test may be easier to use than the heart-rate calculation for determining effort in aerobicexercise." B. "Anaerobic exercises are exercises where the amount of oxygen taken into the body during exercise is greater than that used to perform the activity." C. "An example of an anaerobic exercise is weightlifting." D. "Isometric exercise, or isolated muscle contraction, creates an increase in blood flow to all parts of thebody." E. "Isotonic exercises like walking and swimming are also known as dynamic exercises."

A."The talk test may be easier to use than the heart-rate calculation for determining effort in aerobicexercise." C. "An example of an anaerobic exercise is weightlifting." E. "Isotonic exercises like walking and swimming are also known as dynamic exercises." Rationale: An example of anaerobic exercise is weightlifting. Isotonic exercises are also known as dynamic exercises. The talk test may be easier to use than the heart-rate calculation for determining effort in aerobic exercise. Aerobic exercises, not anaerobic, are exercises where the amount of oxygen taken into the body during exercise is greater than that used to perform the activity. Isometric exercise causes a slight increase in heart rate and cardiac output, but it causes no noticeable increase in blood flow to other parts of the body.

A nurse is caring for an older adult who is hospitalized due to a fractured hip secondary to a ground-level fall. The nurse is assisting the client with oral care when the client asks the nurse, "Why am I having more issues withcavities? I always brush and floss my teeth." Which is the correct response by the nurse? A. "This can happen as you age because your teeth lose enamel, making them more susceptible to damage and cavity formation." B. "This is not an abnormal finding with aging because you brush and floss regularly." C. "This can happen with aging because saliva production increases, making teeth more susceptible to cavity formation." D. "This is a normal finding with aging because gum disease causes tooth decay."

A."This can happen as you age because your teeth lose enamel, making them more susceptible to damage and cavity formation." Rationale: As a normal process of aging, the teeth become more susceptible to damage and decay due to the thinning of the tooth enamel. The other answer choices include responses that have incorrect information: saliva production does not increase (it decreases) with age; good oral hygiene (brushing and flossingregularly) would decrease the likelihood of cavity formation even with aging; and periodontal disease (gum disease) causes the loss of teeth, not dental caries.

Which information should the school nurse provide when teaching a group of adolescents the risk factors for type 2 diabetes mellitus? A. Get sufficient exercise and activity. B. Monitor blood glucose levels. C. Increase carbohydrate intake. D. Limit the amount of protein intake.

A.Get sufficient exercise and activity. Rationale: Frequently, children with type 2 diabetes mellitus develop the disease from a sedentary lifestyle and obesity. Therefore, the nurse would instruct the adolescents regarding the benefits of exercise and activity. Children should limit the amount of carbohydrates and include a normal amount of protein. They do not need to monitor blood glucose levels unless a diagnosis of type 2 diabetes mellitus is made.

Which evidence-based resource would be appropriate for the nurse to integrate into the care of a pregnant client? A. Information on breastfeeding from Healthy People 2020 B. Teaching pamphlets on circumcision C. Safety instructions from a car seat manufacturer D. Consequences of illegal drug use from the local police department

A.Information on breastfeeding from Healthy People 2020 Rationale: Evidence-based resources use current best evidence in making decisions about the care of individual patients. Healthy People 2020 providesscience-based benchmarks to track and monitor progress towards health to motivate individuals. While there are multiple opportunities for educational topics, only those based in the science can be considered evidence-based. Healthy People 2020 strives to identify nationwide health improvement priorities. As such, breastfeeding information from this source would be considered evidence-based, while other teaching pamphlets or information from local agencies or manufacturers may not.

The nurse is performing a physical assessment of a child. Which assessment finding should cause the nurse to suspect type 2 diabetes mellitus? A. Presence of acanthosis nigricans B. Body mass index 21 kg/m2 C. Blood pressure of 110/78 mmHg D.Pale mucous membranes

A.Presence of acanthosis nigricans Rationale: Acanthosis nigricans is a condition in which the skin is velvety in texture and brownish black in color with hyperkeratotic plaques; it is usually found in skin folds. This condition is often found in clients with type 2 diabetes mellitus and should be reported to the healthcare provider. A blood pressure reading of 110/78 mmHg is a normal finding as is a body mass index of 21 kg/m2. Pale mucous membranes could be a sign of anemia; darkened mucous membranes could indicate type 2 diabetes mellitus.

Which response is an example of a background question? (Select all that apply.) A.Why isn't long-acting insulin administered via the IV route? B. What is the pathophysiology of left ventricular heart failure? C. How does acupuncture compare with pain medication for treating chronic knee pain? D. How does incentive spirometry help prevent collapse of the small airways in the lungs? E. What is the link between healthcare providers' stethoscopes and healthcare-acquired infections?

A.Why isn't long-acting insulin administered via the IV route? B. What is the pathophysiology of left ventricular heart failure? D. How does incentive spirometry help prevent collapse of the small airways in the lungs? Rationale: Background questions are knowledgebased and seek more information about a topic, such as medications or diseases. Answers to background questions can be found in textbooks, drug guides, medical dictionaries, and other education resources. Foreground questions are practice based and, compared with background questions, they are narrower in scope. Foreground questions focus on a specific clinical issue and their answers identify useful information about direct client care that may guide the formulation of nursing interventions that improve client outcomes.

A nurse in a primary care clinic is caring for a client who has osteoporosis but no significant health history. Which statement made by the nurse is most appropriate when teaching this client about the benefits of exercise? A."Walking is an excellent choice of exercise for your condition." B. "Non-weight-bearing exercise is most beneficial in your condition." C. "Isometric exercise is an excellent choice for your condition." D. "Swimming is most beneficial for your condition."

A."Walking is an excellent choice of exercise for your condition." Rationale: Walking, or weight-bearing exercise, is most beneficial for the client with osteoporosis who can bear weight. Bone density and strength are maintained through weight-bearing activities. The stress of weight-bearing and high-impact movement maintains a balance between osteoblasts (bone-building cells) and osteoclasts (bone-resorption and bone-breakdown cells). Although swimming is a great choice for those who cannot bear weight, this client would best benefit from walking. Isometric exercises are beneficial for muscles but do not provideweight-bearing benefits for the client with osteoporosis.

A client is discussing recent difficulties with mild anxiety due to stress at work. They ask the nurse about ways that they can manage the anxiety, because they really do not want to take medication. Which intervention should the nurse include? SATA A. Teaching the client how to recognize stress triggers B. Teaching the client how to differentiate between different levels of stress. C. Speaking slowly and using a low pitched voice with the client. D. Encouraging the client to use the self management and diversion techniques to cope with stress. E. instructing the client to reduce environmental stimuli

ABD

The nurse is preparing teaching material for parents regarding symptoms of anxiety in children and adolescents. Which symptom, common to both age groups, should the nurse include? SATA A. headaches and body aches B. shyness C. stomachaches D. excessive worrying E. muscle tension F. frequent need to urinate.

ACDE

A nurse in a health clinic is interviewing a client who is upset and reports that their stress " is too much to handle . " The client is unemployed , a single guardian to young children , and has periodic asthma attacks . Which of the following stress - related conditions is the client experiencing ? Post - traumatic stress disorder ( PTSD ) Allostatic load Chronic illness Alarm stage

Allostatic load Chronic exposure to elevated or fluctuated endocrine or neural responses causes excessive wear and tear on the body organs, resulting in allostatic load. the nurse should identify that the clients constant stress may be manifesting itself and physical ailments such as periodic asthma attacks. The alarm stage is associated with the fight or flight response.

"The nurse caring for a 54-year-old patient hospitalized with diabetes mellitus would look for which of the following laboratory test results to obtain information on the patient's past glucose control? a. prealbumin level b. urine ketone level c. fasting glucose level d. glycosylated hemoglobin level

Answer d: A glycosylated hemoglobin level detects the amount of glucose that is bound to red blood cells (RBCs). When circulating glucose levels are high, glucose attaches to the RBCs and remains there for the life of the blood cell, which is approximately 120 days. Thus the test can give an indication of glycemic control over approximately 2 to 3 months.

A nurse is caring for a patient with asthma who is hospitalized due to an acute exacerbation of the disease. The nurse teaches the patient that exercise may be beneficial in the treatment of asthma. Which exercise should the nurse recommend? A. Swimming B. Yoga C. Cycling D. Running

A public health nurse is working with a community group to arrange a series of seminars about environmental control. Which response by the residents reveals a need for additional education? A. "We should look at the food chain, from farmers to the grocery store." B. "We should talk about ways to immunize kindergartners." C. "We must follow water conservation measures." D. "We should figure out how to reduce the use of cars for short trips."

A sedentary patient who is obese has been encouraged to begin to exercise. The patient asks the nurse if there are other ways in which weight might be lost without so much dependence on exercise. Which response by the nurse might encourage the patient to begin an exercise regimen? A. You could initially try changing your diet; that is an effective approach for some people." B. "Exercise has many benefits other than weight loss; it supports overall optimum mental and physical health." C. "I know it can be difficult, but it is vital to weight loss—you will likely be unsuccessful if you don't exercise." D. "While research on the effects and benefits of exercise can be mixed, it is important that you at least give it a try."

How many hours of sleep does an adolescent require as compared to an older adult? A. Adolescents require more hours than they did as a child but require less than older adults. B. Adolescents require on average 8-10 hours of sleep versus older adults who require on average 7-8 hours. C. Adolescents require on average 9-11 hours of sleep versus older adults who require on average 6-7 hours. D. Adolescents require on average less hours of sleep than older adults.

The nurse is completing a health history on a 2-year-old toddler. Which question by the nurse should elicit the most relevant information concerning oral health for the toddler? A. "Do you believe that your child generally consumes a balanced diet?" B. "Do you assist your toddler with brushing their teeth with a soft toothbrush after they eat?" C. "When did your toddler get their first tooth?" D. "Do you rinse your child's mouth with water after each meal?"

The nurse is working with a client who is having a panic attack. The client has been pacing back and forth in the back hallway for the past 45 minutes. How should the nurse immediately respond to this behavior? A. Contacting the unit counselor to meet with the client immediately to Discuss the cause of the panic. B. Allowing the client to pace to help diffuse energy C. Attempting to divert the client with another type of activity. D. Administering anxiolytics as prescribed

The school nurse is teaching a group of adolescents about oral health.Which nutrients should the nurse include in the presentation to prevent tooth decay? A. Vitamins B, E, and K and potassium B. Vitamins A, C, and D and calcium C. Iron, zinc, and chromium D. Folic acid and niacin

Which statement reflects a comparison of acute versus chronic illness? A. Chronic and acute illnesses can both generally be resolved, returning the patient to their normal level of wellness. B. Chronic illnesses generally have a slow onset and continue, whereas acute illnesses appear and subside abruptly. C. Acute illnesses are almost always followed by development of chronic illness requiring lifelong management. D. Most acute illnesses require medical intervention, whereas chronic illnesses can often be managed with only lifestyle changes.

A home health nurse is at the home of a client with diabetes and arthritis. The client has difficulty drawing up insulin. It would be most appropriate for the nurse to refer the client to: "A) A social worker from the local hospital B) An occupational therapist from the community center C) A physical therapist from the rehabilitation agency D) Another client with diabetes mellitus and takes insulin"

B) An occupational therapist can assist a client to improve the fine motor skills needed to prepare an insulin injection.

A group of students who are studying for final exams talking about ways to better deal with stressful events in life? One student suggest during finals week, we should avoid biogenic stressors. How should the students follow that advice SATA? a. Don't stay up all night study b. Don't drink fluids with caffeine in them c. Don't smoke cigarettes d. Don't go outside in freezing temperatures e. Don't worry about test results.

B, C, D

The nurse notices that a client recently lost 10 lb. Which question or statement should the nurse use to learn more about the weight loss? Select all that apply. A- Do you eat enough? B- Share with me what your daily eating habits look like. C- I noticed that you have lost weight. D- You need to eat more dessert. E- Tell me about how you do your food shopping.

B, C, E

A client reports a series of stressful events. They also report they are feeling very hopeless and empty. They are having difficulty solving even miner problems and are fantasizing what it would be like if all these things had not happened. Which of the indicators should be considered psychologic indicators? SATA a. difficulty solving minor problems b. hopelessness c. fantasizing d. feeling empty e. helplessness

B, D, E

The nurse learns that a client follows a vegan diet. Which suggestion should the nurse give the client to ensure an adequate intake of vitamins and minerals? Select all that apply. A- Include soft cheeses B- drink soy milk fortified with vitamin B12 C- put eggs into a salad every week D- add tofu and lentils into the diet E- increase the intake of citrus fruits

B, D, E

The nurse concludes that a client is demonstrating cardiovascular manifestations of undernutrition. Which assessment finding supports this conclusion? Select all that apply A- Lethargy B- low blood pressure C- amenorrhea D- slow respiratory rate E- irregular heartbeat

B, E

Which is the purpose of parenteral nutrition? Select all that apply. A- to Promote reducing the intake of fats and carbohydrates B- to provide nutrients when Foods cannot be consumed by mouth C- to facilitate adherence to reduced calorie eating plans D- to deliver calories during recovery from lap band or other bariatric surgical procedures E- to supply nutrients when needs cannot be met through oral intake

B, E

After performing a health history and physical assessment for a client, the nurse suspects type 2 diabetes mellitus. Which assessment finding is consistent with the nurse's suspicion? (Select all that apply.) A. Decreased urination B. Hyperglycemia C. Extreme thirst D. Acanthosis nigricans E. Hypertension

B,C,D,E Rationale: Symptoms that would lead the nurse to conclude the client has type 2 diabetes mellitus are extreme thirst, hyperglycemia, hypertension, and acanthosis nigricans (a condition in which the skin is velvety in texture and brownish black in color with hyperkeratotic plaques). A client with type 2 diabetes mellitus would have increased and not decreased urination.

Which suggestion should the nurse provide to a client with newly diagnosed type 2 diabetes mellitus regarding ways to increase activity? (Select all that apply.) A. Play card games at home. B. Take stairs at work. C. Limit computer time. D.Use a fitness tracker. E. Get a workout buddy.

B,C,D,E Rationale: Clients with newly diagnosed type 2 diabetes mellitus should incorporate a minimum of 150 minutes of exercise and activity per week into their lives. The nurse can instruct the client to take the stairs at work, use a fitness tracker to set goals and monitor activity, limit computer time because it is sedentary, and get a friend to go to the gym to exercise. Playing card games is a sedentary activity.

The nurse is planning to teach a class regarding factors that influence food choices. Which factor should the nurse include. Select all that apply A- level of hunger B- cost C- emotion D- convenience E- availability

B- cost C- emotion D- convenience E- availability

During a home visit, the nurse is concerned that the family is experiencing food insecurity. Which observation made by the nurse caused this concern? Select all that apply. A- the oldest daughter experiences abdominal cramps when ingesting milk products B- the mother prepares a meal for the children but she claims lack of appetite to avoid eating C- the children are visibly thin and argue over the food remaining on the serving plate D- the kitchen cabinets contain a limited amount of food for a family of 5 E- the mother is recovering from a second episode of pneumonia within 6 months

B- the mother prepares a meal for the children but she claims lack of appetite to avoid eating C- the children are visibly thin and argue over the food remaining on the serving plate D- the kitchen cabinets contain a limited amount of food for a family of 5 E- the mother is recovering from a second episode of pneumonia within 6 months

The nurse researcher is explaining evidence-based practice (EBP) to a group of nurses. Which statement is appropriate to include in the explanation? (Select all that apply.) A. "EBP promotes generalization of client care." B. "EBP incorporates the nurse's clinical expertise." C. "EBP considers the client's needs, values, and choices." D. "EBP tests hypotheses about health-related conditions." E."EBP is reflective of the best evidence from current research."

B. "EBP incorporates the nurse's clinical expertise." C."EBP considers the client's needs, values, and choices." D. "EBP is reflective of the best evidence from current research." Rationale: Evidence-based practice (EBP) combines the best evidence from the most current research available, the nurse's clinical expertise, and the client's preferences, including needs, values, and choices. EBP promotes individualization of client care. Nursing research tests hypotheses about health-related conditions and nursing care.

A nurse is caring for an older adult in the hospital and is providing the client with instruction on proper oral care. Which instructions will the nurse include in the teaching? A. "Use circular technique when brushing." B. "Use plain water to rinse the mouth after meals." C. "Use an alcohol-based mouth rinse after brushing." D. "Use mineral oil as a lip moisturizer if needed."

B. "Use plain water to rinse the mouth after meals." Rationale: When teaching the older adult about oral care, the nurse should instruct the client to rinse the mouth with plain water after meals to help remove residual food debris. Circular brushing techniques are not recommended. Use of mineral oil as a lip moisturizer is not recommended because aspiration of this may cause pneumonia. Alcohol-based mouth rinses are not recommended because these can irritate oral tissues.

Evidence-based practice (EBP) is very prescriptive across the lifespan. Which client would be the focus for decreasing the incidence of pressure ulcers as presented in Healthy People 2020? A. A 16-year-old who is hospitalized after knee surgery B. A 65-year-old client who is bedridden in a nursing home C. A 12-year-old whosleeps 10?12 hours a day D. A 35-year-old who is in a rehab facility following neck fusion surgery

B. A 65-year-old client who is bedridden in a nursing home Rationale: For older adults, Healthy People 2020 objectives address topics including increasing the number of individuals who are up to date on basic preventive care and decreasing the incidence of health alterations such as pressure ulcers and fall related injuries. The older adult who is bedridden would be the focus of pressure ulcer prevention due to thinner skin and no mobility. Lying in the bed put pressure on the bony prominences.

The nurse is working a health fair and teaching the public about risk factors for type 1 diabetes mellitus. Which ethnicity would the nurse include as having the highest risk in the United States? A.Hispanic B.Caucasian American C.African American D.Asian American

B. Caucasian American Rationale: Caucasian Americans have a higher risk of developing type 1 diabetes mellitus than Asian Americans, African Americans, or Hispanics.

A client asks the home care nurse about the difference between acute and chronic illness. Which information does the nurse give the client about the characteristics of chronic illness? (Select all that apply.) A. Chronic illness does not have exacerbations. B. Chronic illness can remain for life. C. Chronic illness can have remissions. D. Chronic illness usually lasts 6 months or more. E. Chronic illness has a slow onset.

B. Chronic illness can remain for life. C. Chronic illness can have remissions. D. Chronic illness usually lasts 6 months or more. E. Chronic illness has a slow onset. Rationale: Chronic illness can have both remissions and exacerbations. It usually lasts 6 months or more and can remain for life. It has a slow onset.

A client recently diagnosed with type 2 diabetes mellitus reports difficulty managing the disease. To which professional should the nurse refer the client for help with caloric intake? A. Primary healthcare provider B. Dietitian C. Social worker D. Personal trainer

B. Dietitian Rationale: The dietitian would best be able to help the client develop meal plans and incorporate foods that the client likes. The social worker would help the client find community resources to meet financial needs. A personal trainer would help the client increase activity. The primary healthcare provider manages the disease process as well as the multidisciplinary healthcare team.

A nurse working in a pulmonary rehabilitation clinic is conducting an exercise session for a group of clients with chronic obstructive pulmonary disease (COPD). Which exercise will the nurse include in the teaching session? (Select all that apply.) A. Stationary arm bicycle B. Lunges C. Squats D. Bicep curls E. Stair climbing

B. Lunges C. Squats E. Stair climbing Rationale: The client with COPD benefits most from lower-body exercises, including lunges, squats, and stair climbing. These exercises are performed as tolerated. Bicep curls and the use of stationary arm bicycles are beneficial; however, they are not as beneficial as lower-body exercises.

A nurse is caring for a newborn with a congenital malformation of the oral soft palate. Which problem will this client be at risk for if the malformation is not repaired? (Select all that apply.) A. Breathing problems because the soft palate stents the airway open B. Swallowing problems because the soft palate rises during swallowing to direct food into the esophagus C. Breathing problems because the soft palate includes cilia, which keep foreign bodies out of the trachea D. Swallowing problems because the soft palate includes the uvula, which aids in swallowing E. Breathing problems because the soft palate closes off the trachea when swallowing

B. Swallowing problems because the soft palate rises during swallowing to direct food into the esophagus D. Swallowing problems because the soft palate includes the uvula, which aids in swallowing Rationale: Alterations of the soft palate may lead to swallowing problems, increasing the risk of aspiration. This is because the soft palate rises during swallowing to direct food into the esophagus. The soft palate ends at the back of the mouth at a fold called the uvula. The pressure of the bolus against the uvula causes a reflex, and the soft palate rises in order to close off the nasopharynx to prevent food from entering into the nasal cavity. Congenital soft palate malformations do not cause problems with the act of external respiration. The soft palate does not contain cilia.

Which statement best reflects the nurse's correct understanding of principles related toevidence-based practice (EBP)? (Select all that apply.) A. "Client choices do not affect evidence-based practice." B. "Client-centered care is an outcome of evidence-based practice." C. "The nurse's level of expertise influences evidence-based practice." D. "Evidence-based practice promotes individualization of client care." E."Evidence-based practice requires application of all research evidence about a given topic."

B."Client-centered care is an outcome of evidence-based practice." C."The nurse's level of expertise influences evidence-based practice." D."Evidence-based practice promotes individualization of client care." Rationale: Evidence-based practice (EBP) combines the best evidence from the most current research available, the nurse's clinical expertise, and the client's preferences, including needs, values, and choices. EBP promotes individualization of client care and provides best practice for client-centered care.

The nurse is critically appraising a research study. Which statement is reflective of an appraisal of thestudy's reliability? A."Although the study was supposed to measure the client's wound healing, it really measured the client's satisfaction with care." B."The original study was repeated three times, but it did not produce consistent results." C."The study's results are not applicable to clinical practice." D. "The study's results are applicable to clinical practice."

B."The original study was repeated three times, but it did not produce consistent results." Rationale: Reliability is the study's ability to produce consistent results with each use. Validity is the degree to which the study measured what it intended to measure. Usefulness is reflective of the study's application to clinical practice.

A new mother who gained 55 pounds during her pregnancy is seen by the nurse-midwife for a 6-week follow-up after her delivery. The mother reports that she has 30 pounds of "baby weight" to lose. The mother tells the nurse that she is having trouble sleeping and asks why this is occurring because her infant is now sleeping through the night. Which response by the nurse is the most appropriate? A. "Hormonal shifts are causing your insomnia. I will prescribe you a sedative." B. "Your lack of weight loss may be the problem. Let's discuss a plan for this." C. "You must be worried about the baby's health. I will refer you to a counselor." D. "Once you become a parent, you have to get used to sleepless nights."

B."Your lack of weight loss may be the problem. Let's discuss a plan for this." Rationale: Weight gain has been associated with reduced total sleep time, interrupted sleep, and earlier awakening. It is appropriate for the nurse and the midwife to discuss a plan for this new mother to lose weight. Hormonal shifts can cause alterations in sleep patterns/insomnia in a new mother 6 weeks postpartum.Sedation, however, is not the appropriate treatment. There is no evidence to support that the client is worried about her baby's health. Becoming a parent does not automatically cause sleep disturbances.

A nurse is caring for a client who is postoperative from an open appendectomy. The client uses an overhead trapeze bar to transfer position in bed. Which type of exercise is demonstrated with this action? A. Isometric B. Isotonic C. Isodynamic D. Isokinetic

B.Isotonic Rationale: The client who uses an overhead trapeze bar to aid in transfer is demonstrating isotonic activity. Isometric activity is when the joint doesn't move but the muscle contracts (e.g., wall sits). Isokinetic exercise is when the muscle contracts against resistance.There are no exercises called isodynamic.

The nurse therapist is assessing an older adult. The client and the nurse are from different cultures. Which factor could complicate the nurses assessment of the client? SATA A. The clients work experience B. The clients normal. healthy cultural response C. The clients cognitive changes D. The clients age difference from the therapist E. The clients physical illness

BCE

A patient tells the nurse that they have been doing isotonic exercises to strengthen their abdominal muscles. How should the nurse respond to this comment? A. "It would be best to combine isotonic, isometric, and isokinetic exercises if you want to achieve optimal results." B. "The repetitive nature of aerobic exercise would probably be more effective for strengthening your abdominal muscles." C. "While isotonic exercises can increase muscle tone and mass, isometric exercises may be more useful for strengthening abdominal muscles." D. "It would be better to do isokinetic exercises such as weight lifting to strengthen your abdominal muscles."

A young adult reports difficulty sleeping. Which factor should the nurse state that negatively affects an individual's ability to sleep? A. Avoiding activities, such as homework, for the hour prior to bed B. Avoiding use of electronic devices for an hour before retiring C. Exercising late in the day D. Maintaining a regular nighttime schedule

The home care nurse is providing follow-up care for a patient who experienced a traumatic spinal cord injury and is now paralyzed from the waist down. Which intervention addresses the patient's vulnerability that impacts the patient and their role in the family secondary to this injury? A. Encourage involvement and awareness of other necessary healthcare professionals to support healthy aspects of patient lifestyle. B. Help the patient to express thoughts and feelings concerning the recent life change and to support effective coping. C. Provide information to the patient to allow patient participation in decision making and the ability to stay in control of life and family decisions. D. Reinforce desirable lifestyle changes to help the patient and family, and make them a permanent part of patient's daily routine.

The nurse is caring for a 15-month-old toddler at a well-child clinic. The toddler's caregiver tells the nurse that the child still drinks a bottle of milk before bed. Which statement by the nurse is appropriate regarding the child's oral health? A. "It is best if your child drinks the milk from a cup instead of a bottle." B. "It is best if you give your child cow's milk instead of breast milk." C. "It is best if your child does not go to bed with the bottle." D. "It is best if your child doesn't drink a bottle at night."

The nurse is completing a history and physical assessment on a patient being evaluated for sleep disturbances. Which question asked by the nurse would be most effective in determining the patient's sleep quality? A. "Are you able to achieve several periods of deep sleep each night?" B. "How many hours do you sleep at night?" C. "Do you feel rested and energized when you wake up?" D. "Do you sleep at least 7 to 8 hours each night?"

The nurse is providing a health promotion class to expectant parents. Which should the nurse include when teaching about the sleep needs of infants and toddlers? A. Infants and toddlers should both sleep according to a regular schedule. B. A security object, such as a blanket, may provide security for both infants and toddlers when they sleep. C. As the infant becomes a toddler, the need for midmorning naps generally decreases. D. Infants and toddlers should both be placed on their back to sleep even if they are able to roll over.

The nurse is providing health promotion teaching to a middle-aged woman at risk of osteoporosis. The patient asks, "What is the benefit of weight-bearing exercises for osteoporosis?" Which response by the nurse provides accurate information? A. "Joint flexibility, stability, and range of motion are all increased by weight-bearing exercises." B. "This type of exercise helps to enlarge muscles and increase the efficiency of muscular contraction." THE CORRECT ANSWER C. "Weight-bearing exercises help maintain a balance between bone building and bone resorption and breakdown of cells." D. "These exercises help to maintain the size, shape, tone, and strength of your muscles."

The nurse is supervising a new unlicensed assistive personnel (UAP) who is providing oral care to an unconscious patient who cannot tolerate a soft-bristled brush. Which action by the nursing assistant would reflect appropriate care for this patient? A. Provides oral care daily in the morning. B. Uses an alcohol-based mouthwash on a swab to clean the mouth. C. Uses an oral swab soaked in saline to clean the mouth. D. Uses a syringe to gently

To a parent of a young child shares with the nurse that the child refuses play outside, go to parks, or participate in family gatherings where a dog might be present for fear of getting bitten. Which question should the nurse ask to determine if this behavior meets the DSM-5 criteria for phobias? A. does your child worry constantly about possibly encountering a dog? B. is your child frightened of all dogs? C. how long has your child been exhibiting this phobia? D. does your child have a panic attack if a dog is nearby ?

A nurse is assisting with teaching a newly licensed nurse about the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) tool. Which of the following information should the nurse include? A) The HCAHPS tool is provided to clients upon admission to a facility. B) The HCAHPS tool is completed during an in-person interview. C) The HCAHPS tool is issued to measure client satisfaction about health care service. D) The HCAHPS tool results are not shared with the public

C) The HCAHPS tool is issued to measure client satisfaction about health care service.

In educating a client with diabetes, what response would reveal need for further education? A. I should avoid tights B. I should take good care of my toe nails C. I should not go more than 3 days without washing my feet D. I should avoid going barefoot and should wear clean socks

C)I should not go more than 3 days w/o washing my feet"The recommended self-care routine is to wash feet on a daily basis without soaking and carefully cleaning."

The nurse is conducting a health fair to screen for type 2 diabetes mellitus. Which participant should the nurse consider to be at highest risk? A. 30-year-old nurse who works in an intensive care unit B. 60-year-old retired architect who works at job site C. 50-year-old office worker who sits at the computer D. 40-year-old kindergarten teacher who works in a classroom

C. 50-year-old office worker who sits at the computer Rationale: A sedentary lifestyle is a risk factor for type 2 diabetes mellitus. The 50-year-old office worker who sits at the computer would be at highest risk for type 2 diabetes mellitus. All the other participants are physically active and are at lower risk.

A 2-year-old child with cerebral palsy may benefit from the model known as a medical home. Which goal from Healthy People 2020 does the nurse identify for the client? A. Limiting who lives in the home B. Paying for their medication C. Coordinating their healthcare services D. Paying the mortgage for the home

C. Coordinating their healthcare services Rationale: Healthy People 2020 objectives include reducing child mortality rates as well as decreasing the incidence of transmission of preventable diseases among children. Increasing access to a medical homelong dash—which is a model of care that promotes physician-led, client-centered, coordinated health serviceslong dash—for children with special needs is also an objective. The services do not provide financial backing nor do they limit who lives in the home.

Which type of exercise is also known as dynamic exercise? A. Isometric B. Isokinetic C. Isotonic D. Isodynamic

C. Isotonic Rationale: Isotonic exercises are also known as dynamic exercises. These exercises are said to be practiced when active movement occurs and muscles shorten and contract. There are no exercises called isodynamic. Isometric exercises are also known as static exercises because the muscle contracts but the joint does not move. Isokinetic exercises are known as resistive, where the muscle contracts against resistance.

Which statement best describes validity of research evidence? A.It is reflective of the study's application to clinical practice. B. It is the study's ability to produce consistent results with each use. C.It is the degree to which the study measured what it intended to measure. D.It is used to determine the strengths and weaknesses of a study and its resulting evidence.

C.It is the degree to which the study measured what it intended to measure. Rationale: Validity is the degree to which the study measured what it intended to measure. Reliability is the study's ability to produce consistent results with each use. Usefulness is reflective of the study's application to clinical practice. Critical appraisal is used to identify strengths and weaknesses of a study and its resulting evidence.

"Which of the following factors are risks for the development of diabetes mellitus? (Select all that apply.) "a) Age over 45 years b) Overweight with a waist/hip ratio >1 c) Having a consistent HDL level above 40 mg/dl d) Maintaining a sedentary lifestyle

Correct: a,b,d"Rationale: Aging results in reduced ability of beta cells to respond with insulin effectively. Overweight with waist/hip ratio increase is part of the metabolic syndrome of DM II. There is an increase in atherosclerosis with DM due to the metabolic syndrome and sedentary lifestyle.

A mother has brought her 12 yr old daughter for therapy. The daughter witnessed a horrific motor vehicle crash in which several people, including children, were killed. The mother, who was with the child at the time, says "I don't understand why she still seems affected by the crash. I'm not. Which statement by the nurse is most appropriate to help the mother better understand the daughters situation? A. A young persons negative experience can be erased by piling on positive events. B. A young persons coping responses are part of the skills that they are born with. C. A young persons memory bank is much more detailed than an adults. D. A young persons response can vary significantly from that of an adult

The nurse has completed an individual and home assessment for an older adult patient with diabetes and hypertension who is at risk for falling. After the assessments are completed, which activity by the nurse would be considered primary prevention related to the patient's risk for falling? A. Assessment for presence of orthostatic hypotension B. Review of the results of the Mini- Mental State Exam (MMSE) C. Education concerning the need to monitor blood sugar and blood pressure routinely D. Discussion with the patient concerning removal of throw rugs and clutter

The nurse is teaching a group of adults about the effects of exercise on various body systems. Which statement provides the rationale for how beneficial exercise is? A. "Adequate exercise promotes more efficient blood flow and increases peristalsis, excreting wastes more effectively, and enhancing problem solving and emotional stability." B. "The metabolic rate is elevated by exercise, leading to greater ability to solve problems and enhanced emotional stability." C. "Regular exercise helps improve the quality of sleep, resulting in better ability to solve problems and enhanced emotional stability." D. "Exercise results in deeper breathing which eliminates more toxins, thus enhancing problem solving and emotional stability."

The prenatal nurse is completing an assessment on a client who is currently at 20 wks. of gestation. The client indicates that she is struggling with an overwhelming sense of anxiety and fears that she is becoming depressed. Prior to becoming pregnant, the client had been taking selective serotonin reuptake inhibitor (ssri) but stopped the medication due to the pregnancy . Which intervention should the nurse suggest initially to help the client deal with anxiety? A. Asking the healthcare provider to prescribe another (ssri) that has been found not to increase the risk of birth defects. B. encouraging the client to find a good support system that can help manage the anxiety. C. Asking the healthcare provider about resuming the ssri but a lower dose D. Recommending cognitive behavioral therapy

When considering the sleep needs of a teenager versus an adult, the nurse needs to remember which differences that can impact sleep needs? A. In adolescence, sleep patterns shift, requiring more hours of sleep, whereas for adults less sleep is needed. B. Adolescents have a tendency to go to bed earlier and wake early versus older adults, who go to sleep later and wake later. C. Normal biological patterns of adolescence result in the ability to be productive on less sleep, which mirrors that of adults. D. In adolescence, normal biological patterns shift to sleeping and waking up later, whereas adult sleep patterns vary.

When considering the sleep needs of a teenager versus an adult, the nurse needs to remember which differences that can impact sleep needs? A. Normal biological patterns of adolescence result in the ability to be productive on less sleep, which mirrors that of adults. B. In adolescence, sleep patterns shift, requiring more hours of sleep, whereas for adults less sleep is needed. C. Adolescents have a tendency to go to bed earlier and wake early versus older adults, who go to sleep later and wake later. D. In adolescence, normal biological patterns shift to sleeping and waking up later, whereas adult sleep patterns vary.

Which statement demonstrates an understanding of Maslow's hierarchy of needs. When a client prioritizes a choice to react to a stressor? A. Coping with stressors is part of safety needs B. Everyone chooses to satisfy basic requirement's first C. Self esteem is the most important level of need D. Individuals might have their own priorities

Which statement describes the difference between NREM and REM sleep? A. REM sleep is characterized by four distinct stages, while NREM sleep has only one stage. B. During REM sleep, it is very difficult to awaken the sleeper, while an individual in NREM sleep is easily awakened. C. About 20% of sleep during the night is NREM sleep, while 80% is REM sleep. D. During REM sleep, the body and brain are very active, while in NREM sleep, body and brain activity is slower.

an older adult client is asking the healthcare provider for a medication to help deal with the anxiety they are feeling due to the recent deaths of two very close friends. They indicate that they use a benzodiazepine when they were younger and it worked fairly well. Which response by the nurse should address the clients request? A. A benzodiazepine is a good choice when you are older, so I'll try to get that prescribed for you. B. thank you for letting me know, I will see if the provider wants to prescribe a benzodiazepine. C. What dose of medication did you take when you were younger and how long did you take the medication? D. benzodiazepines can cause a decrease in cognition, so we need to avoid the use of these medications as possible.

A nurse is assisting with teaching a class about quality core measures. Which of the following information should the nurse include? A) A cost-effective analysis is used to identify quality core measures. B) Client satisfaction is an example of a quality core measure. C) Quality core measures are filled out by clients to evaluate health care facilities. D) Quality core measures are a standard of care for treatment.

D) Quality core measures are a standard of care for treatment.

Which is the formula for calculating a patient's BMI? A- [(weight in pounds/(height in inches X height in inches)] X 7003 B- [(weight in pounds/(height in inches X height in inches)] X 73 C- [(weight in pounds/(height in feet X height in feet)] X 703 D- [(weight in pounds/(height in inches X height in inches)] X 703

D- [(weight in pounds/(height in inches X height in inches)] X 703

A pregnant client tells the nurse that she has no idea how she is going to provide food for her to preschool-aged children in addition to the new baby. Which intervention should the nurse Implement? Select all that apply. A- Review the importance of adequate nutrition during pregnancy B- encourage the client to obtain additional employment C- discuss the financial support provided by the children's father D- recommend the women, infants, and children (wic) program E- provide information about the supplemental nutrition assistance program (snap)

D- recommend the women, infants, and children (wic) program E- provide information about the supplemental nutrition assistance program (snap)

A nurse is caring for a client who delivered a healthy baby boy by cesarean birth 24 hours ago. The nurse notes that the client correctly uses her arms to help transfer in and out of bed. Which type of exercise is the client demonstrating when performing this activity? A.Anaerobic B. Aerobic C. Isometric D. Isotonic

D. Isotonic Rationale: The client who uses her arms to aid in transfer is demonstrating isotonic activity. Aerobic exercise, such as running or hiking, conditions the cardiovascular system. Isometric activity is that in which the joint doesn't move but the muscle contracts (e.g., wall sits). Anaerobic exercise utilizes anaerobic pathways to provide additional energy for a short time because muscles are unable to use enough oxygen from the bloodstream. Sprinting is an example of anaerobic exercise. Next Question

A nurse is performing an oral health nursing assessment on an adult client. The nurse notes the presence of pyorrhea. Which does this finding indicate? A. The presence of glossitis B. The presence of fungal disease C. The presence of stomatitis D. The presence of periodontal disease

D. The presence of periodontal disease Rationale: Pyorrhea is the presence of pus at the gums when pressed. This is a manifestation of periodontal disease, not fungal disease. Stomatitis is the inflammation of the mouth, whereas glossitis is the inflammation of the tongue.

The nurse is caring for a client newly diagnosed with type 2 diabetes mellitus. Prior to any teaching about medications, the client informs the nurse, "I cannot give myself any injections." How should the nurse respond? A."Insulin administration helps with better blood glucose management." B. "It is understandable to be upset about a new medical diagnosis." C. "Why do you think you will have to give yourself injections?" D."Type 2 diabetes mellitus can usually be managed with pills, diet, and exercise."

D."Type 2 diabetes mellitus can usually be managed with pills, diet, and exercise." Rationale: The nurse should reassure the client with type 2 diabetes mellitus that the disease can be managed with oral hypoglycemic medications, diet, and exercise and may not require insulin. The nurse would not ask why the client thinks he would have to administer insulin. This is not therapeutic communication and is not the best way to obtain information. It is understandable for the client to be upset, but this statement does not alleviate the fears or provide information. Insulin administration helps with blood glucose management in type 1 diabetes mellitus.

A nurse is providing discharge instructions for a client who has been diagnosed with angina. The nurse educates the client on aerobic exercise, as per the healthcare provider's orders. The client asks the nurse, "How will I know when I am working out adequately?" Which is the correct response from the nurse? A. "The goal for aerobic exercise is to maintain target heart rate within 60-85% of resting heart rate." B. "The goal for aerobic exercise is to maintain target heart rate within 40-55% of maximum heart rate." C. "When you are performing aerobic exercise, you shouldn't be able to carry on a conversation." D. "When you are performing aerobic exercise, you should be able to carry on a conversation without labored breathing."

D."When you are performing aerobic exercise, you should be able to carry on a conversation without labored breathing." Rationale: The goal for aerobic exercise is to maintain a target heart rate within 60dash-85% of the maximum heart rate, not 60dash-85% of the resting heart rate or 40dash-55% of the maximum heart rate. However, because heart rates vary amongindividuals, the talk test (the ability to carry on a conversation while exercising) is being used to replace the target heart rate goal and is the best answer response.

A nurse is caring for a client who has pancreatic cancer that is unresponsive to treatment . The client is experiencing significant weight loss and fatigue , but when the nurse asks how they are feeling , they respond with , " Great ! I'm going to beat this cancer . " Which of the following defense mechanisms is the client using ? Regression Projection Repression Denial

Denial Denial refers to the refusal to acknowledge or accept reality about a situation despite what might be obvious to others to avoid the emotional impact . repression refers to concealing unpleasant or painful thoughts, memories , or beliefs in hopes of forgetting about them entirely. Projection refers to attributing negative or uncomfortable thoughts feelings or motives

A nurse is caring for an older adult client who reports being stressed about their health status due to problems with short - term memory , slower reaction times when driving , and urinary frequency . The nurse should recognize that the client is experiencing which of the following types of stressors ? Developmental stressors Situational stressors Adventitious stressors Socioeconomic stressors

Developmental stressors Developmental or maturational stressors vary throughout the lifespan and occur as individuals move through the stages of life older adults may experience stressors related to health problems and changes in mobility and cognition. Situational stressors typically stem from personal family and work related issues. Adventitious stressors typically result from events such as floods, earthquakes, war, and physical assault.

A nurse is conducting an educational session for clients who report experiencing stress - related disorders . A client asks the nurse which part of the body activates the stress response . Which of the following responses should the nurse provide ? Sympathetic nervous system ( SNS ) Adrenal glands Hypothalamus Adrenocorticotropic hormone

Hypothalamus Hypothalamus activates the stress response . when a stress response is triggered The hypothalamus sends signals to the pituitary and adrenal glands The adrenal glands are involved in the stress response however the hypothalamus activates this response

A nurse is assessing a client who is working at home due to COVID - 19 restrictions . The client reports abdominal cramping and bloating with diarrhea and states , " I am completely stressed out from working at home . " The nurse should identify that the client is experiencing manifestations of which of the following stress - related conditions ? Irritable bowel syndrome Food poisoning Panic disorder Major depressive disorder

Irritable bowel syndrome IBS is a condition often triggered by stress and characterized by abdominal discomfort cramping bloating and diarrhea. Panic disorder is a type of anxiety disorder characterized by sudden feelings of terror

A nurse is caring for a client who has been charged with partner violence against their spouse . The client is angry , pacing , and yells out , " I wouldn't lose my temper if my spouse would just leave me alone . It's their fault . " The nurse should identify the client is displaying which of the following defense mechanisms ? Projection Compartmentalization Repression Regression

Projection Projection involves attributing negative or uncomfortable thoughts feelings or motives unto another individual to avoid dealing with them as ones own.

A nurse is caring for a client who reports experiencing stress over an upcoming surgical procedure . Which of the following statements describes the characteristics of stress ? Stress is an easily defined phenomenon regardless of viewpoint and discipline . Stress is a condition in which the body responds to physical , emotional , or environmental changes affecting one's state of equilibrium . Stress only affects the individual and does not affect the person's family , friends , or other associates . The lack of definition regarding stress does not pose a problem for the client or the nurse .

Stress is a condition in which the body responds to physical , emotional , or environmental changes affecting one's state of equilibrium . Stress can be caused by physical emotional environmental or mental or mental Changes which can be positive or negative depending on the persons perception or appraisal of the stressor.

A nurse is planning care for a client who is recently divorced with two young children . The client reports difficulty sleeping , feeling hopeless, and being estranged from family . The nurse should plan to monitor the client for which of the following potential manifestations of chronic stress ? Systemic infection Exaggerated startle response Recurring nightmares Suicide

Suicide Chronic stress can cause or exacerbate serious health problems such as depression , anxiety , cancer , and suicide

A nurse is teaching a client about modifiable risk factors to their health. Which of the following should the nurse include as an example of a modifiable risk factor? a. Tobacco use b. Age c. Family history d. Race

A nurse teaches clients about the benefits of a healthy diet and regular exercise to achieve weight loss. Which of the following topics is the nurse teaching to the client? a. Health promotion b. Disease prevention c. Nonmodifiable risk factors d. Tertiary prevention

A charge nurse is supervising a nurse providing care to several clients. For which of the following actions by the nurse should the charge nurse intervene? a) The nurse alters the steps in a procedure established in the clinical practice guidelines b) The nurse uses a governmental website to research data. c) The nurse provides clear liquids for a client who has a prescription for a regular diet as tolerated. d) The nurse encourages a client who has been immobile for 24 hours to cough and deep breathe.

a) A nurse alters the steps in a procedure established in the clinical practice guidelines. - The charge nurse should intervene if the nurse changes the steps in a procedure established in the clinical practice guidelines. Clinical practice guidelines are developed using evidence-based practice to provide safe client care.

A nurse is teaching a class about citing references to use for evidence-based changes. Which of the following requires citing a reference to avoid plagiarism? (Select all that apply.) a) Direct quotations from a journal article b) A photograph depicting equipment c) Ideas published in a theoretical paper d) A personal website used to initiate a PICOT question e) Paraphrased sentence from an article

a) Direct quotations from a journal article b) A photograph depicting equipment c) Ideas published in a theoretical paper e) Paraphrased sentence from an article - Credit should be given to the original author for every outside source used to avoid plagiarism.

A nurse is admitting a client who has heart failure. Which of the following tools should the nurse use to implement nursing interventions for the client? a) Standard of care b) A PICOT question c) Non-peer-reviewed sources d) Critical appraisal

a) Standard of care - Standard of care is a tool used by nurses to guide the minimal level of care for clients. It is used to assist nurses in planning consistent, high-quality care and interventions for clients who have similar disorders.

A nurse is preparing to perform a procedure on a client. Which of the following resources should the nurse use to meet the standard of care? (Select all that apply.) a) The health care organization policy and procedure manual b) Information from a government website c) Article published by a peer-reviewed journal d) An open-source article paid for by the researcher e) Information on a website of a company selling the product

a) The health care organization policy and procedure manual b) Information from a governmental website c) Article published by a peer-reviewed journal - The nurse should meet the standard of care by using credible evidence such as the health care organization policy and procedure manual, information from credible government websites, and peer-reviewed applicable literature.

A nurse at a hospital is interviewing a newly admitted client. The client tells the nurse they would like to adhere to their cultural beliefs during their hospitalization. Which of the following actions should the nurse take to provide the client with culturally competent care? (Select all that apply.) a. Listen to the client's request with respect and compassion. b. Let the client know that their cultural beliefs will be checked on after the assigned nursing break. c. Reassure the client that they can practice their cultural beliefs if safe to self and others. d. Explain to the client that this is not possible in a public space. e. Provide resources to meet the client's cultural needs.

a, c, e

A client that has presented to the healthcare with symptoms of hypertension. The client tells the nurse that for the past year they have been dealing with legal ramifications of an accident while under the influence of alcohol. According to Selye's general adaption syndrome GAS. The client is which stage of adaption? a. Alarm b. Resistance c. Exhaustion d. homeostasis

A nurse at a clinic is providing free blood pressure screenings for clients. Which of the following levels of health prevention is the nurse demonstrating? a. Tertiary prevention b. Secondary prevention c. Primary prevention d. Quaternary care

A nurse is caring for a client who has type one diabetes mellitus and reports feeling anxious and having palpitations. The glucometer reads 50 mg/dL. Which of the following actions should the nurse take? a. give the client 1 tsp of honey b. give the client 4 oz of apple juice c. give the client 4 oz of skim milk d. give the client one or to glucose tablets

b After confirming hypoglycemia, the nurse should give the client 15 to 20 g of a rapid-acting, concentrated carbohydrate source, such as 4 to 6 oz of fruit juice, 8 oz of skim milk, 1 tbsp of honey, or commercially prepared glucose tablets per package instructions.

A nurse is using evidence-based research to care for a client who has diabetes mellitus. Which of the following resources should the nurse use to manage the delivery of care? a) An article published in a non-peer-reviewed journal b) Clinical Practice Guidelines c) An insulin manufacturer website d) A podcast about living with diabetes mellitus

b) Clinical Practice Guidelines - Clinical practice guidelines are evidence-based recommendations that are used as guidelines for the diagnosis and treatment of diseases.

A nurse is collaborating with an interdisciplinary team to develop a plan of care for a client. Which of the following tools should the nurse use to guide the delivery of care? a) A PICOT question b) Critical pathway c) Qualitative research d) Hierarchy of evidence

b) Critical pathway - A critical pathway is a guide used to standardize a client's medication, exams, procedures, and rehabilitation during acute care through discharge home. Critical pathways improve communication among members of the interdisciplinary team, minimize treatment delays and complications, and reduce lengths of stay and treatment costs. They provide evidence for comprehensive treatment.

"Polydipsia and polyuria related to diabetes mellitus are primarily due to: a. The release of ketones from cells during fat metabolism b. Fluid shifts resulting from the osmotic effect of hyperglycemia c. Damage to the kidneys from exposure to high levels of glucose d. Changes in RBCs resulting from attachment of excessive glucose to hemoglobin"

b. Fluid shifts resulting from the osmotic effect of hyperglycemia Rationale: The osmotic effect of glucose produces the manifestations of polydipsia and polyuria.

A nurse is discussing the Healthy People initiative with a newly licensed nurse. Which of the following information should nurse include? a. The program focuses on decreasing the occurrence of cancer in people. b. The program focuses upon issues related to global health. c. The program focuses on providing goals and data for improved public health. d. The program focuses on reducing the viruses acquired by people.

A nurse is teaching a newly licensed nurse about health literacy. Which of the following information should the nurse include? a. The client's signature on the discharge instructions ensures they understood the instructions. b. Clients who can read and write demonstrate health literacy. c. A client's comprehension of education can be affected by low health literacy. d. Health literacy affects only a small portion of clients who are cared for within the health care system.

The family of the client share with the nurse that the client has always been a hoarder, but since their father died, the behavior has gotten to the point where the home is no longer safe. Which classification of disorders related to stress and copying does the client behavior fit? a. depression and depression related disorders b. anxiety disorder c. obsessive compulsive disorder d. trauma and stressor related disorders

A nurse is teaching a client who was recently diagnosed with type one diabetes mellitus how to check blood glucose levels. Which of the following instructions should the nurse include in her teaching? 1. "Blood can be smeared from the fingertip onto the test strip." 2. "Use a syringe and needle to collect and transfer blood to the test strip." 3."To collect a sample for testing, hold the test strip next to the blood on the fingertip." 4. "Use a capillary tube to collect and transfer the blood from the fingertip."

c This allows the blood to flow over the reagent pad until the amount of blood on the strip is adequate. A sample that is too small can result in falsely low readings.

A nurse is teaching a newly licensed nurse about the purpose of peer review in scholarly publications. Which of the following statements should the nurse make? a) "This process relies on the internet to verify the accuracy of the information. b) "This process involves financial reimbursement that can bias the results." c) "This process ensures scientific quality and rigor." d) "This process ensures evidence can be translated to client care situations."

c) "This process ensures scientific quality and rigor." - Peer review allows colleagues with expertise in the subject matter and the research methodology the opportunity to review a journal article's quality and rigor and deem it worthy of publication.

A nurse is providing an in-service about research methods for a group of nurses. Which of the following methods provides the most credible evidence to support practice changes? a) A qualitative research study b) A randomized control study c) A systematic review summarizing findings of studies d) A presentation by an expert at the international conference

c) A systematic review summarizing findings of studies - According to evidence-based practice, the nurse should identify that a systematic review or meta-analysis, which summarizes findings of multiple peer-reviewed studies, provides the most credible evidence to support practice changes. A meta-analysis of research studies uses statistics to determine conclusions.

"The nurse is working with an overweight client who has a high-stress job and smokes. This client has just received a diagnosis of Type II Diabetes and has just been started on an oral hypoglycemic agent. Which of the following goals for the client which if met, would be most likely to lead to an improvement in insulin efficiency to the point the client would no longer require oral hypoglycemic agents? a. Comply with medication regimen 100% for 6 months b. Quit the use of any tobacco products by the end of three months c. Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily d. Practice relaxation techniques for at least five minutes five times a day for at least five months"

c. Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily When type II diabetics lose weight through diet and exercise they sometimes have an improvement in insulin efficiency sufficient to the degree they no longer require oral hypoglycemic agents.

A nurse is speaking to a client who smokes tobacco and has a child living in the home. The nurse should identify that the child's exposure to second-hand smoke is an example of the following risk factors? a. Cultural b. Societal c. Heredity d. Environmental

A nurse is teaching a client who has a new diagnosis of type 2 diabetes mellitus about metformin. The nurse should explain that this type of medication works by which of the following mechanisms? a. increasing insulin secretion by the pancreas b. delaying carbohydrate digestion c. increasing the cellular response to insulin d. reducing hepatic glucose production

d Biguanides reduce hepatic glucose production while increasing insulin action on muscle glucose uptake.

A nurse is reviewing self-administration of insulin using a pre-filled pen with a client who started using the pen the previous week. The client asks what can be done to help reduce injection pain. Which of the following instructions should the nurse give the client? a. Agitate the syringe slightly before injection. b. Store the pens with the needle pointing upward. c. Inserting the needle rapidly minimizes injection pain. d. Keep the pen at room temperature for a few minutes.

d Injecting room-temperature insulin is less painful than injecting cold insulin.

A nurse is teaching a client who has type one diabetes about the use of an insulin pump. Which of the following information should the nurse include in the teaching? a. the pump should remain in place while bathing b. insulin is injected intermittently based on the client's glucose level c. the pump uses intermediate-acting insulin d. the risk for developing DKA can be increased with the use of an insulin pump

d Malfunction of the pump from low battery power, occlusion of tubing or needles, or lack of insulin in the pump increases the risk of DKA, particularly if the client is not aware of it.

When taking a health history, the nurse screens for manifestations suggestive of diabetes type I. Which of the following manifestations are considered the primary manifestations of diabetes type I and would be most suggestive of diabetes type I and require follow-up investigation? a. Excessive intake of calories, rapid weight gain, and difficulty losing weight b. Poor circulation, wound healing, and leg ulcers, c. Lack of energy, weight gain, and depression d. An increase in three areas: thirst, intake of fluids, and hunger

d. An increase in three areas: thirst, intake of fluids, and hunger "The primary manifestations of diabetes type I are polyuria (increased urine output), polydipsia (increased thirst), polyphagia (increased hunger). Excessive calorie intake, weight gain, and difficulty losing weight are common risk factors for type 2 diabetes. Poor circulation, wound healing and leg ulcers are signs of chronic diabetes. Lack of energy, weight gain and depression are not necessarily indicative of any type of diabetes."

The nurse is conducting discharge teaching with a client who has been newly diagnosed with type 1 diabetes mellitus. Which statement from the client indicates the need for additional teaching? A."It is important to test my blood sugar at least four times a day." B. "I need to stay hydrated during the day." C."As long as I'm in my house, I can walk barefoot." D. "I need to be alert for infections."

C. "As long as I'm in my house, I can walk barefoot." Rationale: Clients with diabetes should always wear shoes to protect their feet from injury. The client should be alert for infection or injuries, stay well hydrated, and test the blood sugar four times a day.

The nurse is caring for a child with type 2 diabetes mellitus. Which item in this child's history should the nurse recognize as a risk factor for this disease? (Select all that apply.) A. High-fat diet B. Race C. Sex D. Obesity E.Family history

A,B,C,D Rationale: Obesity, a high-fat diet, a family history of diabetes mellitus, and race are risk factors for developing type 2 diabetes mellitus. Sex does not play a role in the risk for type 2 diabetes mellitus.

The nurse is teaching the caregivers of an adolescent with a new diagnosis of type 2 diabetes mellitus what they should do every 3 months to monitor the disease. The adolescent is currently taking metformin (Glucophage). Which information should the nurse include? (Select all that apply.) A. Discuss alcohol and drug use. B. Review blood glucose logs. C. Obtain an eye exam. D. Monitor hemoglobin A1C. E. Assess injection sites.

A,B,D Rationale: An adolescent with type 2 diabetes mellitus who takes metformin (Glucophage) should monitor the hemoglobin A1C and blood glucose logs every 3 months. The nurse should also discuss alcohol and drug abuse and its effects on type 2 diabetes mellitus every 3 months. An eye exam should be obtained annually, not quarterly. The nurse need not assess injection sites because the adolescent does not use insulin.

A client with type 1 diabetes mellitus is being taught to monitor her blood glucose level. Which factor affecting accurate glucose monitoring should the nurse include in the instruction? (Select all that apply.) A. Medication overdoses B. White blood cell (WBC) count C.Low hematocrit level D. Creatinine level E. High hematocrit level

A,C,E Rationale: Factors that affect accurate glucose monitoring include medication overdoses, a low hematocrit level, and a high hematocrit level. The WBC count and creatinine levels do not affect accurate glucose monitoring.

A community health nurse is providing education to a group of adults about the types of exercise that promote health. Which statement will the nurse include in the teaching? (Select all that apply.) A. "The talk test may be easier to use than the heart-rate calculation for determining effort in aerobicexercise." B. "Isotonic exercises like walking and swimming are also known as dynamic exercises." C. "Isometric exercise, or isolated muscle contraction, creates an increase in blood flow to all parts of thebody." D. "Anaerobic exercises are exercises where the amount of oxygen taken into the body during exercise is greater than that used to perform the activity." E. "An example of an anaerobic exercise is weightlifting."

A. "The talk test may be easier to use than the heart-rate calculation for determining effort in aerobicexercise." B. "Isotonic exercises like walking and swimming are also known as dynamic exercises." E. "An example of an anaerobic exercise is weightlifting." Rationale: An example of anaerobic exercise is weightlifting. Isotonic exercises are also known as dynamic exercises. The talk test may be easier to use than theheart-rate calculation for determining effort in aerobic exercise. Aerobic exercises, not anaerobic, are exercises where the amount of oxygen taken into the body during exercise is greater than that used to perform the activity. Isometric exercise causes a slight increase in heart rate and cardiac output, but it causes no noticeable increase in blood flow to other parts of the body.

In a professional development seminar, the educator shares barriers that they may encounter as they try to implement evidence-based practice (EBP) into their care. Which statement most accurately describes these potential barriers? (Select all that apply.) A. Client workload demands B. Nursing misperceptions about EBP C. Providing accountability for nursing care D. Ensuring credibility of the nursing profession E. Lack of access to continuing education programs

A. Client workload demands B. Nursing misperceptions about EBP E. Lack of access to continuing education programs Rationale: Potential barriers to implementation of evidence-based practice (EBP) include lack of access to continuing education programs, nursing misperceptions about EBP, and client workload demands. Benefits of EBP include providing accountability for nursing care and ensuring credibility of the nursing profession.

A client with blood glucose of 450 mg/dL is diagnosed with hyperosmolar hyperglycemic state (HHS). Which assessment finding should the nurse expect? A. Increase in urinary output B. Open wound to the foot C. Lower extremity edema D. Capillary refill of 2 seconds

A. Increase in urinary output Rationale: A client in HHS would have an increase in urinary output due to the hyperosmolarity of the blood. Capillary refill should be less than 3 seconds. Lower extremity edema occurs from fluid volume overload. A client in HHS has a fluid volume deficit. An open wound to the foot is not directly related to HHS because it can come from an injury to the foot.

The nurse is teaching a group of older adults with type 2 diabetes mellitus. Which complication of the disease should the nurse include? (Select all that apply.) A.Pulmonary disease B. Functional disabilities C. Polypharmacy D. Cognitive impairment E. Autoimmune diseases

B,C,D Rationale: Older adults diagnosed with type 2 diabetes mellitus are at an increased risk of developing other complications as compared with younger clients. These include polypharmacy, or taking other medications that can increase the risk; functional disabilities that may lead to a slower, more sedentary lifestyle; and cognitive impairment. A diagnosis of type 2 diabetes mellitus does not place a client at higher risk of pulmonary or autoimmune disease.

The nurse is caring for a 15-year-old child newly diagnosed with type 2 diabetes mellitus. Which task should the nurse expect to be completed quarterly for this child? (Select all that apply.) A. Make a foot assessment. B. Review glucose records. C. Discuss alcohol, tobacco, and drug use. D. Refer for an eye exam. E. Measure fasting glucose levels.

B,C,E Rationale: When a child is diagnosed with type 2 diabetes mellitus, certain tasks should be scheduled quarterly and annually. Discussing alcohol, tobacco, and drug use, measuring fasting glucose levels, and reviewing glucose records are completed quarterly. Referral for an eye exam and a foot assessment should be completed annually; quarterly would be too often.

The nurse preceptor is teaching a new graduate nurse about hypoglycemic agents used to treat type 2 diabetes mellitus. Which information should the preceptor include related to how these medications lower blood sugar? (Select all that apply.) A.Stimulate hormones for hemodilution B. Prevent breakdown of glycogen C. Increase breakdown of insulin D. Increase insulin secretion E. Increase uptake of glucose by cells

B,D,E Rationale: Hypoglycemic agents are used to treat individuals with type 2 diabetes mellitus. These medications lower blood sugar by stimulating or increasing insulin secretion, preventing breakdown of glycogen to glucose by the liver, and increasing peripheral uptake of glucose by making cells less resistant to insulin. Peripheral uptake is uptake by muscles and fat in the arms and legs rather than in the trunk. Some hypoglycemic agents keep blood sugar low by blocking absorption of carbohydrates in the intestines. The most recent pharmacologic therapy in treating type 2 diabetes mellitus includes the incretin effect. Incretin hormones, which are hormones released from the gut endocrine cells during meals, play a significant role in insulin secretion.

A young client is admitted for lethargy and weight loss. Which clinical manifestation supports the nurse's suspicion of diagnosis of type 1 diabetes mellitus? (Select all that apply.) A.Fever B.Blurred vision C.Weight gain D. Glucosuria E. Polyuria

B,D,E Rationale: Manifestations of type 1 diabetes mellitus are caused by the lack of insulin to transport glucose into the cells for energy. The resulting hyperglycemia leads to polyuria, glucosuria, and blurred vision. Polyuria occurs because water is drawn into the general circulation, increasing renal blood flow. Once the blood glucose exceeds the renal threshold, which is 180 mg/dL, glucose will spill into the urine. Blurred vision is caused by swelling of the lenses of the eyes in response to increased fluid volume. Clients with type 1 diabetes mellitus usually lose weight, because proteins and fats are metabolized for energy and water is lost in the urine. In addition, clients with type 1 diabetes mellitus are frequently unable to develop a fever when cellular fuel stores are depleted because of a lack of insulin.

The nurse is evaluating the plan of care for an obese client diagnosed with type 2 diabetes mellitus 6 months prior. Which finding indicates the client is successfully managing the disease? A. Hemoglobin A1C of 10.0% B. Weight loss of 40 pounds C. New foot wound with purulent drainage D. Fasting blood sugars averaging 150 mg/dL

B. Weight loss of 40 pounds Rationale: The obese client demonstrating a 40-pound weight loss over the past 6 months indicates improvement in dietary compliance with lowering carbohydrate intake and exercising. The normal hemoglobin A1C for a client with diabetes mellitus is 6?6.5%. Fasting blood sugars should be less than 100 mg/dL if the client has good control. A new foot wound with purulent drainage indicates an infection and poor circulation, so this does not show good glycemic control.

Which question is most appropriate for the nurse to consider when evaluating the impact ofevidence-based practice (EBP) on client outcomes? (Select all that apply.) A. Is the new practice beneficial to the nurse? B. Is the new practice being implemented correctly? C. Does the change in practice yield the intended results? D. Is the practice in accordance with the state's nurse practice act? E. Does the practice adhere to the American Nurses Association (ANA) standards of nursingcare?

B. Is the new practice being implemented correctly? C. Does the change in practice yield the intended results? Rationale: Evaluation seeks to answer questions including, "Is the new practice being implemented correctly?" and "Does the change in practice yield the intendedresults?" Nurses are legally bound to practice in accordance with their state's nurse practice act and to provide care that adheres to the ANA standards of nursing care; these concerns must be addressed before implementing care. The practice is intended to be beneficial to the client.

A teacher sends a child to the school nurse due to frequent thirst and urination. Upon assessment, the nurse suspects the child has type 1 diabetes mellitus. Which question should the nurse ask to gain data to support this suspicion? A."When did you last see your healthcare provider?" B."How is your appetite?" C."Do you play outside a lot?" D. "Have you noticed any bruises on your legs?"

B."How is your appetite?" Rationale: Polydipsia, polyuria, and polyphagia are the three hallmark signs of type 1 diabetes mellitus. Therefore, the nurse would ask about the child's appetite. Playing outside is not related to the onset of type 1 diabetes mellitus. Asking when the child last saw the healthcare provider is irrelevant to the current situation. Bruising to the legs can be from injuries or leukemia, not type 1 diabetes mellitus.

The nurse is discussing some barriers that they have encountered with a journal club related to the topic. Which statement by the nurse describes potential barriers? (Select all that apply.) A. I am an administrator." B. "I work in a nursing home." C. "I don't have time to do those trainings." D. "I have been in nursing 20 years; I do not need more training." E. "The hospital I work at stopped professional development based on funds."

C. "I don't have time to do those trainings." D. "I have been in nursing 20 years; I do not need more training." E. "The hospital I work at stopped professional development based on funds." Rationale: When a healthcare facility makes cuts, it has been seen that educational programs and trainings go by the wayside. The other barrier would be not making time for the staff to attend trainings that are offered. The overconfident, stuck-in-their-ways nurse is a difficult person to educate on change and an alternate way of thinking. Being an administrator or working in a nursing home is not a barrier to promoting evidence-based practice in a healthcare facility.

The nurse is caring for a child who is hospitalized for the treatment of diabetic ketoacidosis (DKA). The child's parents ask why their child is receiving potassium. Which response by the nurse is accurate? A. "Potassium is administered to treat acidosis." B "Potassium is administered to treat cerebral edema." C. "Potassium is administered to treat hypokalemia." D. "Potassium is administered to decrease blood glucose levels."

C. "Potassium is administered to treat hypokalemia." Rationale: Potassium is administered to treat hypokalemia. Insulin, not potassium, is administered to decrease blood glucose levels. Sodium bicarbonate, not potassium, is administered to treat acidosis. Mannitol, not potassium, is administered to treat cerebral edema.

The nurse is doing a case study on a client with long-term cardiovascular disease.Which would be the best way to target health promotion for treatment as it relates to evidence-based practice? A.Examining cultural views B.Following federal regulation C. Genomic standpoint D. Looking at the hospital data

C. Genomic standpoint Rationale: Targeting health promotion from a genomic standpoint allows for more accurate risk prediction, diagnosis, and treatment of a variety of health alterations, such as heart disease, stroke, cancer, diabetes, and Alzheimer disease (HHS, 2016e). Goals associated with the promotion of global health include protecting the health of the national population as well as limiting the international transmission of infectious diseases during travel. Evidence-based resources related to global health and genomics are emerging.

The nurse is developing a teaching plan for carbohydrate counting for a client newly diagnosed with type 1 diabetes mellitus. Which type of carbohydrate should the nurse instruct the client to restrict? A. Complex carbohydrates B. Dietary fructose C. Refined sugars D. Simple sugars

C. Refined sugars Rationale: Refined sugars come from sugar cane and are used as natural sweeteners. The client should restrict the intake of refined sugars. Simple sugars are found in fruit, honey, and dairy products. Dietary fructose, which comes from dietary fruit and vegetable consumption, causes a slower rise in blood glucose levels. Complex carbohydrates come from peas, beans, whole grains, and vegetables.

The healthcare provider prescribes metformin (Glucophage) to a client with newly diagnosed type 2 diabetes mellitus. Which information should the nurse provide to the client? A. This medication is used for clients who are unable to inject insulin. B. This medication is only used in the adult population due to side effects. C. This medication can take up to 3 months to show effectiveness. D. This medication is unsafe for use by pregnant and lactating women.

C. This medication can take up to 3 months to show effectiveness. Rationale: Metformin (Glucophage) is a relatively safe medication to use in the treatment of type 2 diabetes mellitus. However, it may take up to 3 months to show effectiveness. Metformin is used to stimulate insulin production, not used in place of insulin. It is safe for pregnant and lactating women and for children.

The nurse is designing a nursing clinical research study. Which research question is most appropriate for this type of study?(Select all that apply.) A. What factors influence an individual's choice to enroll in online nursing education? B.How do communication styles influence the nurse's perception of nurse educators? C. How do environmental noise levels affect the client's pain perception postanesthesia? D. Is there a relationship between acupressure and incidence of nausea in clients who are receiving chemotherapy medications? E.What is the relationship between the duration of nurse-client interaction and the client's level of satisfaction with nursing care?

C.How do environmental noise levels affect the client's pain perception postanesthesia? D. Is there a relationship between acupressure and incidence of nausea in clients who are receiving chemotherapy medications? E.What is the relationship between the duration of nurse-client interaction and the client's level of satisfaction with nursing care? Rationale: Nursing research is a systematic and strict scientific process that tests hypotheses about health-related conditions and nursing care; as an extension of nursing research, nursing clinical research seeks answers that will ultimately improve client care.

The nurse researcher is encouraging a nurse to incorporate evidence-based practice (EBP) into client care. Which action should the researcher encourage the nurse to do? A. Reviewing a client's record B. Looking at past data C. Participating in a research project D. Speaking with the hospitalist

C.Participating in a research project Rationale: It would be beneficial for the graduate nurse to participate in a research project to be a part of an EBP process, so they could see firsthand how the process works in action. Reviewing a client's chart may be a way to look at what treatment was performed, but it would not reveal if it was evidence based. Looking at past data will not provide a look at evidence-based practice. A hospitalist may be able to share their opinion of evidence-based practice, but that does not expose the nurse to the process.

A client newly diagnosed with type 2 diabetes mellitus asks the nurse how to "get rid of" this disease. How should the nurse respond? A. "Type 2 diabetes mellitus cannot be cured. It will eventually progress to type 1 diabetes." B. "You seem concerned about this diagnosis and we will do our best to help you control it." C. "You will always have type 2 diabetes mellitus. You cannot get rid of it." D. "Type 2 diabetes mellitus can sometimes be eliminated by weight loss, diet, and exercise."

D. "Type 2 diabetes mellitus can sometimes be eliminated by weight loss, diet, and exercise." Rationale: Type 2 diabetes occurs in people who live a sedentary lifestyle, are obese, and eat a high-carbohydrate diet. Therefore, the nurse would explain to the client that the disease may be eliminated with diet, exercise, and weight loss. The first statement stating the client will always have type 2 diabetes mellitus is inaccurate because the disease can be eliminated. Type 1 and type 2 diabetes mellitus are two separate disorders with commonalities. One type does not progress to the other. Although it is accurate that the client is concerned about the diagnosis, this response does not answer the client's question.

The nurse is teaching the parents of a child with a new diagnosis of type 1 diabetes mellitus. Which information should the nurse include regarding the pathophysiology of the disease? A.Delta cell destruction causes type 1 diabetes mellitus. B.Hyperglycemia happens when 50% of alpha cells are damaged. C.Beta cells need help producing insulin. D. Beta cells are destroyed.

D. Beta cells are destroyed. Rationale: Type 1 diabetes mellitus has a slow onset and symptoms are not evident until 80-90% of beta cells are destroyed, causing hyperglycemia. Beta cells are functional and need medication to help with insulin production in type 2 diabetes mellitus. Hyperglycemia happens from beta cell destruction, not alpha or delta cell destruction.

The charge nurse is providing an educational seminar for a group of nurses. Which factor should the nurse expect to be discussed as an evidence-based practice topic for older adults that correlates with Healthy People 2020? A. Screening protocols for sickle cell B. Transmission of infectious disease during travel C. Obesity prevention D. Fall-related injuries

D. Fall-related injuries Rationale: For older adults, Healthy People 2020 objectives address topics including increasing the number of individuals who are up to date on basic preventive care and decreasing the incidence of health alterations such as pressure ulcers and fall related injuries. For the general care of adults, goals associated with the promotion of global health include protecting the health of the national population as well as limiting the international transmission of infectious diseases during travel. Evidence-based resources related to newborns and infants address topics such as screening protocols for phenylketonuria and sickle cell disease.

"When an older adult is admitted to the hospital with a diagnosis of diabetes mellitus and complaints of rapid-onset weight loss, elevated blood glucose levels, and polyphagia, the gerontology nurse should anticipate which of the following secondary medical diagnoses? 1.Impaired glucose tolerance 2.Gestational diabetes mellitus 3.Pituitary tumor 4. Pancreatic tumor

"Pancreatic tumor Rationale: The onset of hyperglycemia in the older adult can occur more slowly. When the older adult reports rapid-onset weight loss, elevated blood glucose levels, and polyphagia, the healthcare provider should consider pancreatic tumor."

A 54-year-old patient admitted with type 2 diabetes, asks the nurse what "type 2" means. Which of the following is the most appropriate response by the nurse? "1. ""With type 2 diabetes, the body of the pancreas becomes inflamed." 2. "With type 2 diabetes, insulin secretion is decreased and insulin resistance is increased." 3. "With type 2 diabetes, the patient is totally dependent on an outside source of insulin." 4. "With type 2 diabetes, the body produces autoantibodies that destroy b-cells in the pancreas.""

"Right Answer: 2 Rationale: In type 2 diabetes mellitus, the secretion of insulin by the pancreas is reduced and/or the cells of the body become resistant to insulin"

A nurse is caring for a cient with type 1 diabetes mellitus. which client complaint would alert the nurse to the presence of a possible hypoglycemic reaction? "1. Tremors 2. Anorexia 3. Hot, dry skin 4. Muscle cramps

1) tremorsdecreased blood glucose levels produce autonomic nervous system symptoms, which are manifested classically as nervousness, irritability, and tremors. option 3 is more likely for hyperglycemia, and options 2 and 4 are unrelated to the signs of hypoglycemia.

A nurse is interviewing a client who recently experienced an act of workplace violence when an armed person held the workers at gunpoint before police intervened . The client now reports being anxious and fears the gunman might return . The nurse should identify that client is experiencing which of the following types of crisis ? Situational Cultural Maturational Adventitious

Adventitious Adventitious Crisis occur from natural disasters such as floods hurricanes or fire or from acts of war criminal activity or terrorism Situational crisis commonly Stems from events such as divorce job loss unexpected event or a change in circumstance

"1. A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what ""type 2"" means in relation to diabetes. The nurse explains to the patient that type 2 diabetes differs from type 1 diabetes primarily in that with type 2 diabetes a. the pt is totally dependent on an outside source of insulin b. there is a decreased insulin secretion and cellular resistance to insulin that is produced c. the immune system destroys the pancreatic insulin-producing cells d. the insulin precurosr that is secreted by the pancreas is not activated by the liver

Answer B - Rationale: In type 2 diabetes, the pancreas produces insulin, but the insulin is insufficient for the body's needs or the cells do not respond to the insulin appropriately. The other information describes the physiology of type 1 diabetes

A nurse is caring for a client with type 1 diabetes mellitus. Which client complaint would alert the nurse to the presence of a possible hypoglycemic reaction ? A. Tremors B. Anorexia C. Hot, Dry skin D. Muscle cramps

Correct Answer A Decreased blood glucose levels produce autonomic nervous system symptoms, which are manifested classsically as nervousness, irritability, and tremors. Option C is more likely to occur with hyperglycemia. Options B and D are unrealted to the signs of hyperglycemia

Which action by the nurse is considered primary prevention? A. Providing rehabilitation classes for a group of patients who have recently suffered a stroke B. Performing monthly wellness screenings for blood pressure and blood glucose levels C. Providing free testing for sexually transmitted infections in a college-based clinic D. Teaching removal of throw rugs and clutter to patients at risk for falling

"What insulin type can be given by IV? Select all that apply: A. Glipizide (Glucotrol) B. Lispro (Humalog) C. NPH insulin D. Glargine (Lantus) E. Regular insulin

E) Regular insulinThe only insulin that can be given by IV is regular insulin.

A nurse is caring for a client who has delivered a healthy newborn . The client tells the nurse that while they are somewhat stressed about being new parent , they are thrilled by the birth of their child . The nurse should identify that the client is experiencing which of the following types of a stress ? Allostatic load Distress Eustress Fight - or - flight response

Eustress Positive stress or eustress is often associated with accomplishment or achievement and generally produces feelings of well-being inspiration and motivation Allostatic load refers to elevated or fluctuating endocrine or neural responses causing excessive wear and tear on the body organs

A nurse is caring for a client whose partner was recently hospitalized with COVID - 19 . The client is experiencing manifestations related to the alarm stage of general adaptation syndrome ( GAS ) . For which of the following manifestations should the nurse monitor ? ( Select all that apply . ) Hypertension . Dilated pupils Increased state of arousal Bradycardia Lethargy

Hypertension . Dilated pupils Increased state of arousal during the alarm stage of GAS the clients fight or flight response is mobilized to meet the threat . the nurse should expect rising hormone levels during this phase to cause hypertension. Rising hormone levels during this phase cause dilated pupils as well as increased state of arousal. Horizing hormone levels during this alarm phase can cause an increase in heart rate and a heightened state of alertness

A nurse is assessing a client who was sexually assaulted 6 months ago and has been diagnosed with post traumatic stress disorder ( PTSD ) . Which of the following manifestations should the nurse expect ? ( Select all that apply . ) Intrusive memories of the event Flashbacks of the event Poor work relationships Exaggerated startle response when reminded of the event Frequent episodes of diarrhea

Intrusive memories of the event Flashbacks of the event Exaggerated startle response when reminded of the event

Which electrolyte replacement should the nurse anticipate being ordered by thehealth-care provider in the client diagnosed with DKA who has just been admitted tothe ICD? 1.Glucose. 2.)Potassium. 3.Calcium. 4.Sodium

Potassium"1.Glucose is elevated in DKA; therefore, theHCP would not be replacing glucose. 2.(CORRECT)-->The client in DKA loses potassium from increased urinary output, acidosis, cata-bolic state, and vomiting. Replacement isessential for preventing cardiac dysrhyth-mias secondary to hypokalemia. 3.Calcium is not affected in the client with DKA.4.The IV that is prescribed 0.9% normal salinehas sodium, but it is not speciﬁcally orderedfor sodium replacement. This is an isotonicsolution. TEST-TAKING HINT: Option "1" should be elim-inated because the problem with DKA iselevated glucose so the HCP would not bereplacing it. The test taker should use physiol-ogy knowledge and realize potassium is in thecell."

A nurse is using evidence-based practice to reduce pain during venipunctures for adolescent clients by asking a PICOT question: "Does providing music to adolescent clients during venipunctures decrease their discomfort compared to those clients who do not listen to music? Which of the following is a component of the "I" in this PICOT question? a) Adolescent clients b) Providing music c) Decrease discomfort d) Clients who do not listen to music

b) Providing music - Providing music refers to the intervention, or the "I" component of the PICOT question.

A nurse is using evidence-based practice to develop a PICOT question. Which of the following describes the "O" in PICOT? a) The plan of action intended to solve the problem described in the study b) The group of clients who are the focus of the study c) The desired result of the intervention to the problem d) The current way of addressing the problem

c) The desired result of the intervention to the problem - This describes "O," or outcome, which is the desired result or outcome following an intervention.

A nurse is collecting data from a group of clients regarding their feelings and experiences of living with congestive heart failure. In which of the following types of research studies is the nurse participating in? a) Translational research b) Quantitative c) Mixed methods d) Qualitative

d) Qualitative - Qualitative research is a research method that explores experiences and feelings from the perspective of the client. Data obtained from qualitative research do not undergo statistical analysis that is associated with other types of research.

A nurse has created a table of evidence to organize findings from a literature search. Which of the following components of the table provides information for implementing a change in practice? a) Title b) Author c) Research method d) Recommendations

d) Recommendations - The recommendations component of the table of evidence provides information for implementing a change in practice. Recommendations are based on research findings to improve client outcomes.

"An adolescent client with type I diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note? a) sweating and tremors b) hunger and hypertension c) cold, clammy skin and irritability d) fruity breath and decreasing level of consciousness

d) fruity breath and decreasing level of consciousness"Hyperglycemia occurs with diabetic ketoacidosis. Signs of hyperglycemia include fruity breath and a decreasing level of consciousness. Hunger can be a sign of hypoglycemia or hyperglycemia, but hypertension is not a sign of diabetic ketoacidosis. Instead, hypotension occurs because of a decrease in blood volume related to the dehydrated state that occurs during diabetic ketoacidosis. Cold, clammy skin, irritability, sweating, and tremors are all signs of hypoglycemia."

A nurse is caring for a college student admitted for acute alcohol intoxication . The client reports feeling overwhelmed and expresses an inability to cope with stressors at school . Which of the following statements should the nurse make ? "Drinking too much alcohol is not the best choice . I suggest you stop drinking. " "I can see why you're using alcohol to cope : you've got a lot going on. " "Let's talk about the coping methods that have worked for you in the past. "I've been stressed before too, but I tell myself that I can handle it. "

" Let's talk about the coping methods that have worked for you in the past . Nurses using therapeutic communication techniques and building on the clients strengths to improve coping skills. nurses use several therapeutic communication techniques to build a trusting relationship including active listening, asking open ended questions, seeking clarification, and offering observations.

The nurse is caring for a client who has normal glucose levels at bedtime, hypoglycemia at 2am and hyperglycemia in the morning. What is this client likely experiencing? A. Dawn phenomenon B. Somogyi effect C. An insulin spike D. Excessive corticosteroids"

"1. B The Somogyi effect is when blood sugar drops too low in the morning causing rebound hyperglycemia in the morning. The hypoglycemia at 2am is highly indicative. The Dawn phenomenon is similar but would not have the hypoglycemia at 2am."

"Which of the following persons would most likely be diagnosed with diabetes mellitus? A 44-year-old.. "A. Caucasian Woman B. Asian Woman C. African-American woman D. Hispanic Male

"Correct answer: African-American woman Rationale: Age-specific prevalence of diagnosed diabetes mellitus (DM) is higher for African-Americans and Hispanics than for Caucasians. Among those younger than 75, black women had the highest incidence."

"A nurse shoud recognize which symptom as a cardinal sign of diabetes mellitus? a. Nausea b. Seizure c. Hyperactivity d. Frequent urination

"D. Frequent Urination Polyphagia, polyuria, polydipsia, and weight loss are cardinal signs of DM. Other signs include irritability, shortened attention span, lowered frustration tolerance, fatigue, dry skin, blurred vision, sores that are slow to heal, and flushed skin."

A nurse is planning to use evidence-based practice (EBP) to determine the best practice for dressing changes for clients. According to EBP, in what order should the nurse perform the following steps? - The nurse conducts a literature search to determine the presence of nursing literature on how to perform dressing changes. - The nurse asks a clinical questions about methods to perform a dressing change. - The nurse notices another nurse changing a dressing and recognizes that they perform the same procedure differently. - The nurse reads, organizes, and compares the results of the scientific literature search. - The nurse implements changes for performing dressing changes and collects data to determine client outcomes. - The nurse develops recommendations about dressing changes to present to an interdisciplinary team to update the policy and procedure.

1. The nurse notices another nurse changing a dressing and recognizes that they perform the same procedure differently. 2. The nurse asks a clinical question about methods to perform a dressing change. 3. The nurse conducts a literature search to determine the presence of nursing literature on how to perform dressing changes. 4. The nurse reads, organizes, and compares the results of the scientific literature search. 5. The nurse develops recommendations about dressing changes to present to an interdisciplinary team in order to update the policy and procedure. 6. The nurse implements changes for performing dressing changes and collects data to determine client outcomes.

Which manifestation should the nurse expect to occur as a result of the impact of exercise on the respiratory system? A. Increased mental clarity B. Increased heart rate variability C. Improved quality of sleep D. Increase in the body's metabolic rate

The nurse is presenting to a community group about mental disorders that are more common among women than among men. Which disorder should the nurse include? SATA a. anxiety disorder b. phobia c. obsessive compulsive disorder d. generalized anxiety disorder e. insomnia

A, B, D

Which tool is available to the nurse to assess a client's eating habits? Select all that apply. A- Food diary B- food frequency questionnaire C- waist-to-height ratio D- body mass index E- six-item mini-nutritional assessment

A, B, E

The nurse is providing care to a client at a sleep disorder clinic. Which assessment finding does the nurse expect during REM sleep? A.Decrease in voluntary muscle tone B. Tachypnea C. Decrease in eye movement D. Tachycardia

A. Decrease in voluntary muscle tone Rationale: During REM sleep, the nurse would expect the client to have a decrease in voluntary muscle tone. A decrease in heart rate and respiratory rate is also expected, not tachycardia or tachypnea. An increase, not a decrease, in eye movement is expected during REM sleep.

The nurse is planning to collect anthropometric data from a client who is being evaluated for undernutrition. Which information should the nurse include? Select all that apply A-Height B- food allergies C- skinfold thickness D- capillary blood glucose level E- weight

A, C, E

Which nursing intervention should be implemented for a client at risk of nutritional imbalances? Select all that apply. A- Providing nutritional education B- calculating caloric needs C- reducing body Mass index D- using nutritional supplements E- promoting healthy eating habits

A, E

The nurse is teaching a client about a newly prescribed iron supplement. Which information should the nurse include? Select all that apply. A- Explain how the supplement can cause constipation B- explain the need to increase fiber in the diet C- expect the stool to turn black D- suggest that the client avoid ingesting citrus fruits with the sub E- remind the client to ingest adequate amounts of fluid each day

A- Explain how the supplement can cause constipation B- explain the need to increase fiber in the diet C- expect the stool to turn black E- remind the client to ingest adequate amounts of fluid each day

The nurse is assessing an undernourished client. Which manifestation of the integumentary system should the nurse consider an expected finding? Select all that apply A- Petechiae B- spoon shaped nails C- dry brittle hair D- constipation E- muscle wasting

A- Petechiae B- spoon shaped nails C- dry brittle hair

During a preschool screening, the caregiver of a 3-year-old child asks the nurse how many hours of sleep the child requires each night. Which response by the nurse is appropriate? A. "A 3-year-old child needs 10 to 13 hours of sleep each night." B. "A 3-year-old child needs 7 to 9 hours of sleep each night." C. "A 3-year-old child needs 8 to 10 hours of sleep each night." D. "A 3-year-old child needs 14 to 17 hours of sleep each night."

A. "A 3-year-old child needs 10 to 13 hours of sleep each night." Rationale: Growing children require more sleep than adults. The 3-year-old child requires 10 to 13 hours of sleep each night. Infants need 14 to 17 hours of sleep in 24 hours. Adolescents require 8 to 10 hours of sleep each night. Adults need 7 to 9 hours of sleep each night.

A nurse is caring for an older adult who complains of dry mouth. The client states, "Food just doesn't taste the same anymore." The nurse understands that the client's dry mouth may be the cause of the client's altered taste. Which statement is true regarding saliva and taste? A. "Decreased saliva production thins the oral mucosa and contributes to dry mouth, so a decrease in saliva will decrease taste." B. "Because saliva is produced in the tongue, a decrease in saliva will decrease taste." C. "Saliva increases taste by increasing the function of the taste buds, so a decrease in saliva will decreasetaste." D. "A decrease in saliva will decrease taste because saliva mechanically breaks down food into smallerparts."

A. "Decreased saliva production thins the oral mucosa and contributes to dry mouth, so a decrease in saliva will decrease taste." Rationale: Saliva moistens food and provides enzymes to digest starches. As saliva decreases, it contributes to thinning of the oral mucosa, contributing to dry mouth and altered taste. Saliva does not increase the function of the taste buds. Saliva is produced by the salivary glands, not the tongue. Saliva chemically breaks down food; teeth mechanically break down food.

The nurse is teaching a client who is experiencing anxiety about possible medications that can be used to manage the symptoms of anxiety. Which medication should the nurse discuss with the client? SATA A. Antipsychotic B. Antidepressant C. benzodiazepine D. Cortisol E. Beta blocker

ABCE

the nurse believes that the client with serve anxiety will benefit from cognitive behavioral therapy. Which characteristic of CBT should the nurse consider? SATA a. The client can do CBT exercises b. The client can discontinue medications c. The client can remove stressors d. The client can safety confront fears e. The client can change unhealthy thoughts

ADE

A nurse in a community clinic is interviewing a client who is distressed and reports being unable to sleep following a neighborhood fire several days ago . The client has hypertension , tachycardia , and is diaphoretic . The nurse should identify that the client is experiencing which of the following types of stress ? A. Acute stress B. Post - traumatic stress disorder ( PTSD ) C. Episodic acute stress D. Chronic stress

Acute stress Most episodes of acute stress do not have lingering affects it is when it prolonged stress levels linger could lead to issues

A nurse is caring for a client who has suction equipment in their room. The client asks the nurse, "Why do you check my suction equipment every day even though I am not using it?" Which of the following statements should the nurse make? A) "It is part of an outcome audit being performed." B) "It is part of the quality assurance plan of the unit." C) "It is part of the plan developed by your case manager." D) "It is part of the quality improvement program."

B) "It is part of the quality assurance plan of the unit."

A nurse is assisting with using the Plan-Do-Study-Act (PDSA) model to decrease client falls in a long-term care facility. The nurse should identify that developing guidelines to decrease falls is included in which of the following steps of the PDSA model? A) Do B) Plan C) Study D) Act

B) Plan

Nurse is assessing a client for physical problems that affect food intake. Which factor should the nurse consider? Select all that apply A- use of supplements B- trouble swallowing C- problems with dentition D- Financial Resources E- lactose intolerance

B, D

The nurse enters the room of a sleeping client whose eyes are rolling from side to side and whose respiratory rate and heart rate have decreased. The client is easily aroused and states, "I wasn't asleep." Which state of non-REM (NREM) sleep was the client in? A. Stage N2 B. Stage N1 C. Stage N3 D. Stage N4

B. Stage N1 Rationale: Stage N1 is the stage of light sleep in which the client is easily aroused, the respiratory rate and heart rate decrease slightly, and the eyes roll slowly from side to side. Stage N2 is the stage of light sleep in which body processes slow down and the eyes are still. Stage N3 is the stage of deep sleep in which it is difficult to arouse the client, muscles are relaxed, and reflexes are diminished. Stage N4 is the stage of deep sleep that differs from Stage N3 in the number of delta waves produced.

The nurse is working with an older adult who is having side effects from medications for an anxiety disorder. The nurse wants to refer the client psychotherapy, but the client is adamant and states "I don't want to see a psychiatrist, that's for crazy people! Which reassurance should the nurse give the client? SATA A. with therapy, you can stop taking your medications right away B. therapy can help manage symptoms of anxiety C. therapy added to medications has more success than medications alone D. other professionals offer therapy besides psychiatrist E. therapist see many people who do not have mental disorders

BCDE

A nurse is assisting on a quality improvement committee to decrease the number of client falls occurring at night. After identifying the problem, which of the following is the next step the nurse should take? A) Implement the practice change. B) Evaluate the results of the change. C) Complete a literature review. D) Communicate the outcomes with others.

C) Complete a literature review.

A nurse is assisting a quality improvement team that is using the Plan-Do-Study-Act (PDSA) model to address an increase in pressure injuries on a medical unit. Which of the following actions should the nurse identify as an example of the "Do" step of the PDSA model? A) Reviewing the data collected on clients how received the new protocol. B) Developing a plan to initiate a change in client care C) Implementing new evidence-based practice protocol D) Accepting the new protocol in the unit's policy and procedure guidelines

C) Implementing a new evidence-based practice protocol

A nurse is assisting with developing a quality improvement (QI) plan to reduce the incidence of medication errors in an acute care unit. The nurse should recognize that which of the following actions is included in the identifying step of the QI process? A) Develop a plan to implement change. B) Evaluate the results of the change C) Recognizing the need for a change D) Implementing the plan of change

C) Recognizing a need for a change

The nurse is caring for a patient newly diagnosed with celiac disease. When developing a teaching plan, which foods should the nurse include as one to avoid? Select all that apply. A- Eggs B- peanuts C- wheat D- Rye E- fruit

C- wheat

A caregiver of a 10-year-old fifth grader reports to the nurse about the current behavior of the child. The teacher reported to the caregiver that the student is falling asleep in class, is distracted in interactions with the peer group, and has trouble concentrating, leading to poor grades on assignments. The caregiver also reports that the child often plays video games late into the night. Which issue does the nurse suspect as the cause of the behavior? A. Sundown syndrome B. Nocturnal emissions C. Screen time at night D. Waking up frequently at night due to nightmares

C. Screen time at night Rationale: School-age children need 10dash-11 hours of sleep per night. They may spend more time at the computer, playing video games, and watching TV, leading to difficulty falling asleep and fewer hours of sleep. A regular and consistent sleep schedule and bedtime routine need to be established. The client is not experiencing sundown syndrome. Nocturnal emissions and nightmares are not the cause of the client's symptoms.

The nurse is preparing a presentation on risk factors for type 2 diabetes mellitus. Which ethnic group should the nurse include as being amongst the highest diagnosed with this disease? A. Caucasian Americans B. Asian Americans C.American Indians D. African Americans

C.American Indians Rationale: The ethnicities that have the highest incidence of type 2 diabetes mellitus are the American Indians and Alaska Natives at 15.9%. Incidence rates for Asian Americans, African Americans, and Caucasian Americans are 9%, 13.2%, and 7.6%, respectively.

A nurse is caring for a client who is in crisis following the breakup of a long - term relationship . The client tells the nurse , " I might as well just die . My life is over . " Which of the following actions should the nurse take first ? Explore past positive coping strategies . Establish a follow - up plan of care .. Conduct a suicidal risk evaluation . Display a neutral attitude .

Conduct a suicidal risk evaluation . The greatest risk to this client is injury to self or others. therefore the first action the nurse should take is to conduct a suicidal and homicidal risk evaluation Exploring positive coping strategies is an essential aspect of crisis intervention, but it is not the first action the nurse should take

A nurse is assisting with teaching a class about incident reports. The nurse should include that which of the following situations requires an incident report? A) A client vomits after receiving an oral medication B) A client refuses to take a medication C) A nurse administers an antibiotic to a client 25 min after the scheduled time D) A nurse administers the wrong medication to a client

D) A nurse administers the wrong medication to a client.

A nurse is assisting with teaching a class about types of research studies. The nurse should include that which of the following is an example of a randomized controlled trial (RCT)? A) A study examining environmental factors that lead to obesity. B) A study comparing a group of people who have diabetes mellitus with a group of people who do not have diabetes mellitus. C) A study examining the cause of falls in a long term care facility D) A study arbitrarily assigning people who smoke into either an experimental group or a control group to determine the effects of a new therapy to reduce smoking.

D) A study arbitrarily assigning people who smoke into either an experimental group or a control group to determine the effects of a new therapy to reduce smoking

A nurse is a member of a committee that is using evidence-based practice (EBP) to decrease the incidence of central line infections. The nurse should identify that which of the following interventions is part of the implementation step of EBP? A) Recognizing a high incidence of central line infections B) Evaluating whether the practice changes decreased the infection rate. C) Researching the best practices to reduce the rate of central line infections. D) Incorporating the new practice into client care.

D) Incorporating the new practice into client care

A nurse is discussing quality measurement with a newly licensed nurse. The nurse should include that medication reconciliation is an aspect of which of the following parts of quality measurement? A) Benchmark B) Structure C) Outcome D) Process

D) Process

Which Laboratory test measures protein levels? Select all that apply A- complete blood count B- serum electrolytes C- lipids levels D- serum albumin E- serum prealbumin

D, E

The nurse is providing education to the client on the effect of lifestyle factors on sleep. Which should the nurse include as a factor that negatively influences sleep? (Select all that apply.) A. Regular nighttime schedule B. Morning exercise C. Relaxation D. Irregular work schedule E. Evening exercise

D. Irregular work schedule E. Evening exercise Rationale: Factors that negatively impact sleep include evening exercise and an irregular work schedule. Morning exercise, relaxation, and regular nighttime schedule are known to enhance sleep

A nurse is providing discharge teaching about health promotion to a client who has a new diagnosis of type 2 diabetes mellitus . Which of the following instructions should the nurse include ? ( Select all that apply ) . Practice mindful breathing . Start each day with a to - do list . Include simple carbohydrates in the diet . Develop habits to mitigate stress . Preserve energy by reducing physical activity .

Practice mindful breathing . Start each day with a to - do list . Develop habits to mitigate stress . Complex carbohydrates, not simple

A nurse is talking about implementing self - care strategies to cope with the stress of caregiving with the partner of a client who has dementia . Which of the following strategies reported by the partner should the nurse identify as an example of effective coping ? A. Practicing deep breathing while sitting outside B. Sitting by the client's bedside and drinking coffee C. Going out onto the patio to smoke a cigarette when feeling stressed D. Drinking a glass of wine every night before falling asleep .

Practicing deep breathing while sitting outside Eating nutritious meals participating in active exercise and engaging in mindfulness activities such as deep breathing are examples of healthy coping

Risk factors for type 2 diabetes include all of the following except: a. Advanced age b. Obesity c. Smoking d. Physical inactivity"

Smoking "Additional risk factors for type 2 diabetes are a family history of diabetes, impaired glucose metabolism, history of gestational diabetes, and race/ethnicity. African-Americans, Hispanics/Latinos, Asian Americans, Native Hawaiians, Pacific Islanders, and Native Americans are at greater risk of developing diabetes than whites."

A nurse is teaching a class about searching the internet for research articles to use for evidence-based changes. Which of the following information should the nurse include? a) "Use Quackwatch to verify credible websites." b) "Avoid using websites with a .gov domain for research articles." c) "Read the abstract to understand each step of the research study." d) "Use non-peer-reviewed articles to research data."

a) "Use Quackwatch to verify credible websites." - Quackwatch is a website that monitors internet websites for misinformation and credibility. The nurse should instruct students to use resources such as Quackwatch to verify health care information.

A nurse is preparing to administer an influenza vaccine to a client. The client states that they understand being immunized will help protect them against the influenza virus. Which of the following concepts is the nurse demonstrating by administering the vaccine? a. Health promotion b. Disease prevention c. Health outcomes d. Wellness

A nurse is teaching a client who has a new prescription for antihypertensive medication. The nurse should identify that antihypertensive medications are used for which of the following types of prevention? a. Secondary b. Tertiary c. Primary d. Quaternary

A nurse is reviewing he results of routine lab test performed as a part of a client's annual physical examination. Which of the following values indicates a fasting blood glucose measurement that is outside of the expected reference range? a. 78 mg/dL b. 118 mg/dL c. 85 mg/dL d. 104 mg/dL

b This result exceeds the expected reference range for a fasting blood glucose measurement, which is generally between 74 and 106 mg/dL.

A nurse is teaching a group of guardians about primary prevention techniques. Which of the following topics should the nurse include as an example of primary prevention? a. Emphasizing the importance of well-child visits for the child b. Encouraging children who have asthma to participate in extracurricular activities c. Taking measures to decrease the risk of childhood injuries within the home d. Promoting a healthy lifestyle for children who are overweight

A college student present to the counseling center because they are having difficulty dealing with having been informed that, due to continued poor grades, they are being dismissed from the college. Which statement by the student to the nurse counselor should indicate the use of the ego defense mechanism projection? a. its really not all my fault. The major I was in and the number of credit hours I was taking would be difficult for anyone to be successful. b. while I'm very upset and my parents will be angry. I can just transfer to another school and still get my degree. c. I don't think that all of the grades are accurate, if they aren't, then I can stay in school. d. if my instructor had let me take an exam I missed when I was sick, I wouldn't be in this situation.

A home health nurse is visiting a client who lives in an older home and is concerned about their child's exposure to lead paint in the house. The nurse should identify which of the following is a potential health risk from exposure to lead paint? a. Strabismus b. Dental caries c. Accelerated growth and development d. Learning disabilities

A nurse is caring for a client who reports an improved diet, exercising 30 min a day for 5 days a week, and an overall sense of improved health. The nurse should identify that the client is describing a positive state of health known as which of the following? a. Health promotion b. Disease prevention c. Health outcomes d. Wellness

The client contacts the nurse asking to see the healthcare provider due to fears that they have " something terribly wrong" This client frequently professes the same fear that something is wrong in one body system or another, and has had multiple types of diagnostic over the years. The client also reports vague symptoms such as difficulty sleeping, headache, muscle tension, and digestive issues. Which anxiety disorder should the nurse most likely expect that the client is experiencing? a. phobias b. panic disorder c. obsessive compulsive disorder d. generalized anxiety

The nurse presents information about the "fear worry center" in the brain. Which information should the nurse include about how the fear center affects the risk for anxiety disorders? a. perfusion balances the risk for anxiety disorders b. oxygenation decreases the risk for anxiety disorders c. hormone secretion blocks the risk for anxiety disorders d. hypersensitivity increases the risk for anxiety disorders.

A nurse is teaching a newly licensed nurse about using credible databases for research studies. Which of the following sources should the nurse include? a) An internet website with a .com domain b) A local newspaper repository c) A personal podcast d) A peer-reviewed journal

d) A peer-reviewed journal - A peer-reviewed journal is a credible, scientific database of scholarly published scientific research. It is reviewed by expert peers to ensure credibility.

The nurse is delivering a presentation about evidence-based practice (EBP). Which statement best reflects the nurse's correct understanding of EBP? A."EBP incorporates clinical knowledge, expert opinion, or information resulting from research." B."EBP is the gathering of objective facts and information to advance knowledge about a specific topic." C. "EBP uses a systematic and strict scientific process to test hypotheses about health-related conditions and nursing care." D. "EBP involves combining quality research, clinical expertise, and client preferences to achieve the best client outcomes."

"EBP involves combining quality research, clinical expertise, and client preferences to achieve the best client outcomes." Rationale: Evidence-based practice (EBP) seeks to achieve optimal client outcomes by combining the best evidence from the most current researchavailable, the nurse's clinical expertise, and the client's preferences, includingneeds, values, and choices. Research involves gathering objective facts and information to advance knowledge about a specific topic. Nursing research is a systematic and strict scientific process that tests hypotheses about health-related conditions and nursing care. Evidence can be defined as clinical knowledge, expertopinion, or information resulting from research.

Which information should the nurse provide the client with type 2 diabetes mellitus? A. Inspect your feet on a daily basis for open sores. B. Treat hyperglycemia with concentrated sweets. C. Include 100 minutes per week of activity and exercise. D. Increase carbohydrate consumption in the diet.

A. Inspect your feet on a daily basis for open sores. Rationale: The client should inspect both feet every day, using a mirror if needed, to look for open sores. Hypoglycemia, not hyperglycemia, is treated with 15 grams of concentrated carbohydrates. The client should include 150 minutes of activity and exercise per week. The client should decrease carbohydrate consumption.

The nurse is developing a plan of care for a client with ineffective peripheral tissue perfusion related to microvascular changes. Which assessment finding supports this nursing diagnosis? A. Absent pedal pulses B. Capillary refill of 3 seconds C. Fasting blood glucose of 100 mg/dL D. Hemoglobin A1C of 6.4%

A.Absent pedal pulses Rationale: Absence of pedal pulses indicates the peripheral tissue is not receiving adequate oxygenation and in turn is the basis of the nursing diagnosis Tissue Perfusion: Peripheral, Ineffective. A hemoglobin A1C of 6.4%, capillary refill of 3 seconds, and fasting blood glucose of 100 mg/dL are all normal findings.

Which factor that inhibits evidence-based practice would be considered an external factor? A. Personal aversion to the idea B. Lack of support by management C. Resistance to change D. Thoughts that the process doesn't work

B. Lack of support by management Rationale: Nurses need to assess the obstacles that inhibit them from using EBP more frequently. These may include internal factors, such as beliefs ormisconceptions, or external factors, such as lack of management support. Resistance to change, a personal aversion to the idea, and a thought that the process doesn't work are all examples of internal factors.

A nurse researcheris designing a study intended to explore how certification exam preparation courses affect nursing students' success rates in passing the exam. Which element best reflects the nurse's use of a randomized control trial (RCT) design? A.Compare graduate nurses who successfully passed the certification exam with graduate nurses who did not pass the exam in order to determine whether or not completing a certification exam preparation course was a variable that contributed to test performance. B. Compare the exam performance of a control group of graduate nurses who did not complete any certification exam preparation course with a group of graduate nurses who completed a specific certification exam preparation course prior to taking the exam. C. Interview five graduate nurses who completed a certification exam preparation course and detail their experiences with the course and then identify the number of graduate nurses who successfully completed the certification exam. D.Examine a group of studies on graduate nurses who completed certification exam preparation courses and then combine and analyze the results as if they were from one large study.

B. Compare the exam performance of a control group of graduate nurses who did not complete any certification exam preparation course with a group of graduate nurses who completed a specific certification exam preparation course prior to taking the exam. Rationale: Randomized control trials (RCTs) are designed to illustrate acause-and-effect relationship by using a control group and an experimental group. An RCT is best illustrated by comparing the exam performance of a control group of graduate nurses who did not complete any certification exam preparation course with a group of graduate nurses who completed a specific certification exam preparation course prior to taking the exam. A meta-analysis examines a group of studies on a given topic and combines and analyzes the results as if they were from one large study; this design is best reflected by examining a group of studies on graduate nurses who completed certification exam preparation courses and then combining and analyzing the results as if they were from one large study. A case study is specific to one individual, issue, or event; this design is best reflected by interviewing five graduate nurses who completed a certification exam preparation course and detailing their experiences with the course, as well as identifying the number of graduate nurses who successfully complete the certification exam. Case-control studies compare individuals with and without a specific condition to identify predictive variables; this design is best reflected by comparing graduate nurses who successfully passed the certification exam with graduate nurses who did not pass the exam to determine whether or not completing a certification exam preparation course contributed to the success rates.

Of which of the following symptoms might an older woman with diabetes mellitus complain? 1) anorexia 2)pain intolerance 3) weight loss 4) perineal itching

4) perineal itchingRationale: Older women might complain of perineal itching due to vaginal candidiasis.

"Excessive thirst and volume of very dilute urine may be symptoms of: A. Urinary tract infection B. Diabetes insipidus C. Viral gastroenteritis D.Hypoglycemia"

"Correct answer: B Diabetes insipidus is a condition in which the kidneys are unable to conserve water, often because there is insufficient antidiuretic hormone (ADH) or the kidneys are unable to respond to ADH. Although diabetes mellitus may present with similar symptoms, the disorders are different. Diabetes insipidus does not involve hyperglycemia."

"The nurse is teaching a community class to peole with Type 2 diabetes mellitus. Which explanation would explain the development of Type 2 diabetes? 1. The islet cells in the pancreas stop producing insulin. 2. The client eats too many foods that are high in sugar. 3 The pituitary gland does not produce vasopression. 4. The cells become resistant to the circulating insulin.

"1. This is the cause of Type 1 diabetes mellitus. 2. This may be a reason for obesity, which may lead to Type 2 diabetes, but eating too much sugar does not cause diabetes. 3. This is the explanation for diabetes insipidus, which should not be confused with diabetes mellitus. 4. (CORRECT) Normally insulin binds to special receptor sites on the cells and initiates a series of reactions involved in metabolism. In Type 2 diabetes these reactions are diminished primarily as a result of obesity and aging."

"The nurse is caring for a woman at 37 weeks gestation. The client was diagnosed with insulin-dependent diabetes mellitis (IDDM) at age 7. The client states, ""I am so thrilled that I will be breastfeeding my baby."" Which of the following responses by the nurse is best? 1. You will probably need less insulin while you are breastfeeding. 2. You will need to initially increase your insulin after the baby is born. 3. You will be able to take an oral hypoglycemic instead of insulin after the baby is born. 4. You will probably require the same dose of insulin that you are now taking."

"1. breastfeeding has an antidiabetogenic effect, less insulin is needed. (correct) 2. insulin needs will decrease due to antidiabetogenic effect of breastfeeding and physiological changes during immediate postpartum period. 3. client has IDDM, insulin required. 4. during third trimester insulin requirements increase due to increased insulin resistance"

A client with diabetes melllitus has a blood glucose of 644mg/dl. The nurse intreprets that this client is most at risk of developing which type of acid base imbalance? " A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory Acidosis D. Respiratory Alkalosis"

"Correct Answer: A, Metabolic Acidosis Rationale: DM can lead to metabolic acidosis. When the body does not have sufficient circulating insulin, the blood glucose level rises. At the same time, the cells of the body use all available glucose. The body then breaks down glycogen and fat for fuel. The by-products of fat metabolism are acidotic and can lead to the condition known as diabetic ketoacidosis."

Blood sugar is well controlled when Hemoglobin A1C is... a. Below 7% b. Between 12%-15% c. Less than 180 mg/dL d. Between 90 and 130 mg/dL"

"a. Below 7% A1c measures the percentage of hemoglobin that is glycated and determines average blood glucose during the 2 to 3 months prior to testing. Used as a diagnostic tool, A1C levels of 6.5% or higher on two tests indicate diabetes. A1C of 6% to 6.5% is considered prediabetes."

"A client who is started on metformin and glyburide would have initially presented with which symptoms? "a. Polydispisa, polyuria, and weight loss b. weight gain, tiredness, & bradycardia c. irritability, diaphoresis, and tachycardia d. diarrhea, abdominal pain, and weight loss

"a. Polydispisa, polyuria, and weight loss"Symptoms of hyperglycemia include polydipsia, polyuria, and weight loss. Metformin and sulfonylureas are commonly ordered medications. Weight gain, tiredness, and bradycardia are symptoms of hypothyroidism. Irritability, diaphoresis, and tachycardia are symptoms of hypoglycemia. Symptoms of Crohn's disease include diarrhea, abdominal pain, and weight loss."

a nurse is interviewing a client with type 2 diabetes mellitus. which statement by the client indicated an understanding of the treatment for this disorder? 1. ""i take oral insulin instead of shots"" 2. ""by taking these medications I am able to eat more"" 3. ""when I become ill, I need to increase the number of pills I take"" 4. ""the medications I'm taking help release the insulin I already make""

4.)Clients with type 2 diabetes mellitus have decreased or imparied insulin secretion. Oral hypoglycemic agents are given to these clients to facilitate glucose uptake. Insulin injections may be given during times of stress-induced hyperglycemia. Oral insulin is not available because of the breakdown of the insulin by digestion. Options 1, 2 and 3 are incorrect

"Which of the following is accurate pertaining to physical exercise and type 1 diabetes mellitus? "1. Physical exercise can slow the progression of diabetes mellitus. 2. Strenuous exercise is beneficial when the blood glucose is high. 3. Patients who take insulin and engage in strenuous physical exercise might experience hyperglycemia. 4. Adjusting insulin regimen allows for safe participation in all forms of exercise."

1) physical exercise can slow the progression of diabetes mellitusRationale: Physical exercise slows the progression of diabetes mellitus, because exercise has beneficial effects on carbohydrate metabolism and insulin sensitivity. Strenuous exercise can cause retinal damage, and can cause hypoglycemia. Insulin and foods both must be adjusted to allow safe participation in exercise.

"A client is admitted to the hospital with signs and symptoms of diabetes mellitus. Which findings is the nurse most likely to observe in this client? Select all that apply: "1. Excessive thirst 2. Weight gain 3. Constipation 4. Excessive hunger 5. Urine retention 6. Frequent, high-volume urination

1, 4, 6 Rationale: Classic signs of diabetes mellitus include polydipsia (excessive thirst), polyphagia (excessive hunger), and polyuria (excessive urination). Because the body is starving from the lack of glucose the cells are using for energy, the client has weight loss, not weight gain. Clients with diabetes mellitus usually don't present with constipation. Urine retention is only a problem is the patient has another renal-related condition.

The nurse is caring for a client with long-term Type 2 diabetes and is assessing the feet. Which assessment data would warrant immediate intervention by the nurse? 1)The client has crumbling toenails 2)The client has athlete's feet 3)The client has a necrotic big toe 4)The client has thickened toenails."

3) Nectrotic big toe"1)Crumbling toenails indicate tinea unguium, which is a fungus infection of the toenail. 2)Athlete's foot is a fungal infection that is not life threatening. 3)A necrotic big toe indicates "dead" tissue. The client does not feel pain in the lower extremity and does not realize there has been an injury and therefore does not seek treatment. Increased blood glucose levels decrease oxygen supply that is needed to heal the wound and increase the risk for developing an infection. 4)Big, thick toenails are fungal infections and would not require immediate intervention by the nurse; 50% of the adult population has this."

"What will the nurse teach the client with diabetes regarding exercise in his or her treatment program? 1. During exercise the body will use carbohydrates for energy production, which in turn will decrease the need for insulin. 2. With an increase in activity, the body will use more carbohydrates; therefore more insulin will be required. 3. The increase in activity results in an increase in the use of insulin; therefore the client should decrease his or her carbohydrate intake. 4. Exercise will improve pancreatic circulation and stimulate the islets of Langerhans to increase the production of intrinsic insulin.

1. During exercise the body will use carbohydrates for energy production, which in turn will decrease the need for insuli"Rationale: As carbohydrates are used for energy, insulin needs decrease. Therefore during exercise, carbohydrate intake should be increased to cover the increased energy requirements. The beneficial effects of regular exercise may result in a decreased need for diabetic medications in order to reach target blood glucose levels. Furthermore, it may help to reduce triglycerides, LDL cholesterol levels, increase HDLs, reduce blood pressure, and improve circulation."

"The nurse administered 28 units of Humulin N, an intermediate-acting insulin, to a client diagnosed with Type 1 diabetes at 1600. Which action should the nurse implement? 1. Ensure the client eats the bedtime snack. 2. Determine how much food the client ate at lunch. 3. Perform a glucometer reading at 0700. 4. Offer the client protein after administering insulin.

1: ensure the client eats the bedtime snack"1. Humulin N peaks in 6-8 hours, making the client at risk for hypoglycemia around midnight, which is why the client should receive a bedtime snack. This snack will prevent nighttime hypoglycemia. (Correct) 2. The food intake at lunch will not affect the client's blood glucose level at midnight. 3. The client's glucometer reading should be done around 2100 to assess the effectiveness of insulin at 1600. 4. Humulin N is an intermediate-acting insulin that has an onset in 2-4 hours but does not peak until 6-8 hours."

"A nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose of 120 mg/dL, temp of 101 F, pulse of 88 bpm, respirations of 22, and blood pressure of 100/72. Which finding would be of most concern to the nurse? "1. Pulse 2. Respiration 3. Temperature 4. Blood pressure"

3) temp. An elevated temperature may indicate infection. Infection is a leading cause of hyperglycemic hyperosmolar nonketotic syndrome or diabetic ketoacidosis. The other findings noted in the question are within normal limits.

A nurse is preparing a teaching plan for a client with diabetes Mellitus regarding proper foot care. Which instruction is included in the plan? 1. Soak feet in hot water 2. apply a moisturizing lotion to dry feet but not between the toes 3. Always have a podiatrist cut your toenails, never cut them yourself 4. avoid using mild soap on the feet

2. The client is instructed to use a moisturizing lotion on the feet and to avoid applying the lotion between the toes.

"The nurse is discharging a client diagnosed with diabetes insipidus. Which statement made by the client warrants further intervention? 1."I will keep a list of my medications in my wallet and wear a Medi bracelet." 2."I should take my medication in the morning and leave it refrigerated at home." 3."I should weigh myself every morning and record any weight gain." 4."If I develop a tightness in my chest, I will call my health-care provider."

2."I should take my medication in the morning and leave it refrigerated at home.""1.The client should keep a list of medication being taken and wear a Medic Alert bracelet. 2. Medication taken for DI is usually every 8-12 hours, depending on the client. Theclient should keep the medication close at hand. 3.The client is at risk for ﬂuid shifts. Weighing every morning allows the client to follow theﬂuid shifts. Weight gain could indicate too much medication. 4.Tightness in the chest could be an indicator that the medication is not being tolerated; if this occurs the client should call the health-care provider"

A client with type I diabetes is placed on an insulin pump. The most appropriate short-term goal when teaching this client to control the diabetes is: 1) adhere to the medical regimen 2) remain normoglycemic for 3 weeks 3) demonstrate the correct use of the administration equipment. 4) list 3 self care activities that are necessary to control the diabetes"

3.) is correct "1) this is not a short-term goal 2) this is measurable, but it's a long-term goal 3) this is a short-term goal, client oriented, necessary for the client to control the diabetes, and measurable when the client performs a return demonstration for the nurse 4) although this is measurable and a short-term goal, it is not the one with the greatest priority when a client has an insulin pump that must be mastered before discharge"

"The nurse is teaching a class on atherosclerosis. Which statement describes the scien-tiﬁc rationale as to why diabetes is a risk factor for developing atherosclerosis? 1.Glucose combines with carbon monoxide, instead of with oxygen, and this leads tooxygen deprivation of tissues. 2.Diabetes stimulates the sympathetic nervous system, resulting in peripheralconstriction that increases the development of atherosclerosis. 3.Diabetes speeds the atherosclerotic process by thickening the basement membraneof both large and small vessels. 4.The increased glucose combines with the hemoglobin, which causes deposits of plaque in the lining of the vessels.

3.Diabetes speeds the atherosclerotic process by thickening the basement membraneof both large and small vessels."1.Glucose does not combine with carbonmonoxide.2.Vasoconstriction is not a risk factor for devel-oping atherosclerosis. 3.This is the scientiﬁc rationale why diabetesmellitus is a modiﬁable risk factor for atherosclerosis. 4.When glucose combines with the hemoglobinin a laboratory test called glycosylated hemo-globin, the result can determine the client'saverage glucose level over the past three (3)months"

A client with diabetes mellitus demonstratees acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client's anxiety would be to 1. administer a sedative 2. make sure the client knows all the correct medical terms to understand what is happening 3. ignore the signs and symptoms of anxiety so that they will soon disappear 4. convey empathy, trust, and respect toward the client

4. The most appropriate intervention is to address the client's feelings related to the anxiety

which are symptoms of hypoglycemia? A. irritability, B. drowsiness c. Abdominal pain D. nausea and vomiting

A. Irritability: signs of hypoglycemia include irritability, shaky feeling, hunger, headache, dizziness. Other symptoms are hyperglycemia.

"The risk factors for type 1 diabetes include all of the following except: a. Diet b. Genetic c. Autoimmune d. Environmental"

A: Type 1 diabetes is a primary failure of pancreatic beta cells to produce insulin. It primarily affects children and young adults and is unrelated to diet.

An external insulin pump is prescribed for a client with DM. The client asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump: a. Gives small continuous dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dosage from the pump before each meal. b. Is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals. c. Is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream. d. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels"

ANSWER A. An insulin pump provides a small continuous dose of regular insulin subcutaneously throughout the day and night, and the client can self-administer a bolus with additional dosage from the pump before each meal as needed. Regular insulin is used in an insulin pump. An external pump is not attached surgically to the pancreas.

One of the benefits of Glargine (Lantus) insulin is its ability to: a.Release insulin rapidly throughout the day to help control basal glucose. b. Release insulin evenly throughout the day and control basal glucose levels. c. Simplify the dosing and better control blood glucose levels during the day. d. Cause hypoglycemia with other manifestation of other adverse reactions.

B)Release insulin evenly throughout the day and control basal glucose levels"Glargine (Lantus) insulin is designed to release insulin evenly throughout the day and control basal glucose levels.

A patient is admitted with diabetes mellitus, has a glucose level of 380 mg/dl, and a moderate level of ketones in the urine. As the nurse assesses for signs of ketoacidosis, which of the following respiratory patterns would the nurse expect to find?" A-Central apnea B-Hypoventilation C-Kussmaul respirations D- Cheyne-Stokes respirations"

C-Kussmaul respirationsIn diabetic ketoacidosis, the lungs try to compensate for the acidosis by blowing off volatile acids and carbon dioxide. This leads to a pattern of Kussmaul respirations, which are deep and nonlabored.

The nurse is caring for a client with a long-term history of type 1 diabetes mellitus who has developed peripheral vascular disease. The nurse is unable to palpate the client's pedal pulses and the skin is cold to the touch. Which long-term goal is most appropriate for this client? A. The client will remain free of injury. B. The client's skin integrity will remain intact. C. The client will remain free from infection. D. The client's fasting blood glucose levels will stay between 70 and 110 mg/dL.

B. The client's skin integrity will remain intact. Rationale: The client has impaired circulation as evidenced by cold skin and absent pedal pulses that indicate a risk for impaired skin integrity due to gangrene. There is no evidence the client is at risk for injury or has an infection. Having fasting blood glucose levels in the normal range indicates good disease management, but it does not relate to the impaired circulation.

"The guidelines for Carbohydrate Counting as medical nutrition therapy for diabetes mellitus includes all of the following EXCEPT: a. Flexibility in types and amounts of foods consumed b. Unlimited intake of total fat, saturated fat and cholesterol c. Including adequate servings of fruits, vegetables and the dairy group d. Applicable to with either Type 1 or Type 2 diabetes mellitusb. Unlimited intake of total fat, saturated fat and cholesterol"

B. You want to be careful of how much you eat in any food group.

"A client is taking Humulin NPH insulin daily every morning. The nurse instructs the client that the mostlikely time for a hypoglycemic reaction to occur is: A) 2-4 hours after administration B) 4-12 hours after administration C) 16-18 hours after administration D) 18-24 hours after administration

B: Rationale: Humulin is an intermediate acting insulin. The onset of action is 1.5 hours, it peaks in 4-12 hours, and its duration is 24 hours. Hypoglycemic reactions to insulin are most likely to occur during the peak time.

"A diabetic patient has a serum glucose level of 824 mg/dL (45.7 mmol/L) and is unresponsive. Following assessment of the patient, the nurse suspects diabetic ketoacidosis rather than hyperosmolar hyperglycemic syndrome based on the finding of "a. polyuria b. severe dehydration c. rapid, deep respirations ) d. decreased serum potassium"

C is correct, Signs and symptoms of DKA include manifestations of dehydration such as poor skin turgor, dry mucous membranes, tachycardia, and orthostatic hypotension. Early symptoms may include lethargy and weakness. As the patient becomes severely dehydrated, the skin becomes dry and loose, and the eyeballs become soft and sunken. Abdominal pain is another symptom of DKA that may be accompanied by anorexia and vomiting. Kussmaul respirations (i.e., rapid, deep breathing associated with dyspnea) are the body's attempt to reverse metabolic acidosis through the exhalation of excess carbon dioxide. Acetone is identified on the breath as a sweet, fruity odor. Laboratory findings include a blood glucose level greater than 250 mg/dL, arterial blood pH less than 7.30, serum bicarbonate level less than 15 mEq/L, and moderate to large ketone levels in the urine or blood ketones.

"A nurse is caring for a client admitted to the emergency department with diabetic ketoacidosis (DKA). In the acute phase, the priority nursing action is to prepare to: "A. Correct the acidosis B. Administer 5% dextrose intravenously C. Administer regular insulin inraVenously D. Apply a monitor for an electrocardiogram."

C. Administer regular insulin inraVenously Lack (absolute or relative) of insulin is the primary cause of DKA. Treatment consists of insulin administration (regular insulin), intravenous fluid administration (normal saline initially), and potassium replacement, followed by correcting acidosis. Applying an electrocardiogram monitor is not a priority action.

Which action by a parent of a 12-year-old child with a new diagnosis of type 1 diabetes mellitus indicates a need for further teaching? A.Counting carbohydrates with the child B. Allowing the child to check blood sugars C. Discouraging after-school sports D. Scheduling a baseline exam with an ophthalmologist

C. Discouraging after-school sports Rationale: Exercise is a part of blood glucose and disease management. Therefore, the nurse should reeducate the parent to allow after-school sports. The parent should involve the 12-year-old child, so counting carbohydrates with the child and allowing the child to perform self-blood glucose monitoring is appropriate. Due to potential retinopathy that can occur with diabetes, it is appropriate for the parent to schedule an ophthalmic appointment to determine baseline visual acuity.

Which finding in the medical record indicates a client has good control of type 1 diabetes mellitus? A. Blood pressure 150/90 mmHg B. Free of amputations C. Hemoglobin A1C 5.4% D. Fasting blood sugar 200 mg/dL

C.Hemoglobin A1C 5.4% Rationale: The finding that the client is maintaining a hemoglobin A1C of less than 6.5% indicates good diabetic control over the past 3 months. The client not having amputations indicates good peripheral circulation, but it does not indicate good disease management. Blood pressure of 150/90 mmHg is elevated, but it does not indicate good diabetes control. The fasting blood sugar should be under 125 mg/dL. The finding of 200 mg/dL is elevated.

A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome is made. The nurse would immediately prepare to initiate which of the following anticipated physician's prescriptions? 1. Endotracheal intubation 2. 100 units of NPH insulin 3. Intravenous infusion of normal saline 4. Intravenous infusion of sodium bicarbonate

CORRECT ANSWER: 3. Intravenous infusion of normal saline Rationale: The primary goal of treatment is hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is to rehydrate the client to restore the fluid volume and to correct electrolyte deficiency. Intravenous fluid replacement is similar to that administered in diabetic keto acidosis (DKA) and begins with IV infusion of normal saline. Regular insulin, not NPH insulin, would be administered. The use of sodium bicarbonate to correct acidosis is avoided because it can precipitate a further drop in serum potassium levels. Intubation and mechanical ventilation are not required to treat HHNS.

A client with DKA is being treated in the ED. What would the nurse suspect? 1. Comatose state 2. Decreased Urine Output 3. Increased respirations and an increase in pH. 4. Elevated blood glucose level and low plasma bicarbonate level.

Correct Answer: 4 Rationale: In DKA the arteriole pH is lower than 7.35, plasma bicarbonate is lower than 15 mEq/L, the blood glucose is higher than 250, and ketones are present in the blood and urine. The client would be experiencing polyuria and Kussmauls respirations would be present. A comatose state may occur if DKA is not treated.

The nurse is teaching a group of clients newly diagnosed with type 1 diabetes mellitus. Which information should the nurse include in the teaching? A."Monitor blood glucose levels weekly." B. "Take beta blockers daily to control blood pressure." C."Have routine pedicures performed." D. "Schedule regular ophthalmology visits."

D. "Schedule regular ophthalmology visits." Rationale: The client with type 1 diabetes mellitus is at high risk for retinal damage. Therefore, the nurse would teach the client to schedule regular ophthalmology visits to monitor vision. The nurse would not encourage the client to have regular pedicures due to possible injury that can occur from macrovascular and microvascular deficits. Blood glucose levels should be monitored several times a day, not once a week. The client would be prescribed angiotensin-converting enzyme (ACE) inhibitors to protect the kidneys from vascular damage.

The nurse is teaching a child with type 1 diabetes mellitus and his family about sick day guidelines. Which statement by the family indicates successful teaching? A."We will test for ketones when the blood glucose level reaches 160 mg/dL." B. "We will test for ketones when the blood glucose level reaches 180 mg/dL." C. "We will test for ketones when the blood glucose level reaches 200 mg/dL." D. "We will test for ketones when the blood glucose level reaches 240 mg/dL."

D. "We will test for ketones when the blood glucose level reaches 240 mg/dL. Rationale: Blood glucose levels of 160 mg/dL, 180 mg/dL, and 200 mg/dL are elevated, but they would not require testing for ketones. Once the blood glucose level exceeds 240 mg/dL, the child and family should test the urine for ketones.

The nurse is caring for a client who received a daily intermediate-acting insulin dose at 8:00 a.m. At which time of the day should the nurse provide the client a snack to prevent hypoglycemia? A. 11:00 a.m. B. 9:00 p.m. C. 6:00 p.m. D. 2:00 p.m.

D. 2:00 p.m. Rationale: Intermediate-acting (NPH) insulin peaks 6-8 hours after the injection. Therefore, the nurse would prepare a snack for the client beginning at 2:00 p.m. If the client received short-acting insulin (regular), the snack would be required between 10 a.m. and 11:00 a.m. Giving a snack at 6:00 p.m. or 9:00 p.m. may be appropriate for long-acting insulins, but it is not appropriate for intermediate-acting insulins.

"A frail elderly patient with a diagnosis of type 2 diabetes mellitus has been ill with pneumonia. The cliet's intake has been very poor, and she is admitted to the hospital for observation and management as needed. What is the most likely problem with this patient? "A. Insulin resistance has developed. B. Diabetic ketoacidosis is occuring. C. Hypoglycemia unawareness is developing. D. Hyperglycemic hyperosmolar non-ketotic coma.

D.Illness, especially with the frail elderly patient whose appetite is poor, can result in dehydration and HHNC. Insulin resisitance is inidcated by a daily insulin requirement of 200 units or more. Diabetic ketoacidosis, an acute metabolic condition, usually is caused by absent or markedly decreased amounts of insulin.

A nurse is caring for a client who has type 1 diabetes mellitus and is in need of a long-acting insulin preparation. The nurse anticipates receiving a prescription for which of the following insulins? a. insulin glargine b. insulin aspart c. insulin glulisine d. insulin lispro

a Long-acting insulin, such as insulin glargine, is intended to provide basal glucose control. The dosage is typically once daily at the same time each day.

A nurse is teaching a client who has type 1 diabetes mellitus about the peak time of neutral protamine hagedorn (MPH) inulin. Which of the following statements by the client indicates an understanding of the teaching? a. "NPH insulin peaks in 1 to 5 hours." b. "NPH insulin is peakless." c. "NPH insulin peaks in 6 to 14 hours." d. "NPH insulin peaks in 12 to 24 hours."

a NPH insulin has an onset of 60 to 120 min, peaks in 6 to 14 hr, and has a duration of 16 to 24 hr.

The nurse assisting in the admission of a client with diabetic ketoacidosis will anticipate the physician ordering which of the following types of intravenous solution if the client cannot take any fluids orally? " a. 0.45% normal saline solution b. Lactated Ringer's solution c. 0.9 normal saline solution d. 5% dextrose in water (D5W)"

a. 0.45% normal saline solution Helps to hydrate patient and keep electrolyte levels balanced

Patients with type 1 diabetes mellitus may require which of the following changes to their daily routine during times of infection? a. no change b. less insulin c. more insulin d. oral diabetic agents"

answer C: during times of infection and illness diabetic patients may need even more insulin to compensate for increased blood glucose levels.

"The nurse is discussing the importance of exercising to a client diagnosed with Type 2diabetes whose diabetes is well controlled with diet and exercise. Which informationshould the nurse include in the teaching about diabetes? 1.Eat a simple carbohydrate snack before exercising. 2.Carry peanut butter crackers when exercising. 3.Encourage the client to walk 20 minutes three (3) times a week. 4.Perform warmup and cooldown exercises

4.Perform warmup and cooldown exercises "The client diagnosed with Type 2 diabetes whois not taking insulin or oral agents does notneed extra food before exercise.2.The client with diabetes who is at risk forhypoglycemia when exercising should carry asimple carbohydrate, but this client is not atrisk for hypoglycemia.3.Clients with diabetes that is controlled by dietand exercise must exercise daily at the sametime and in the same amount to control theglucose level. 4. [correct] All clients who exercise should perform warmup and cooldown exercises to helpprevent muscle strain and injury"

b. Fluid shifts resulting from the osmotic effect of hyperglycemia Rationale: The osmotic effect of glucose produces the manifestations of polydipsia and polyuria.

The nurse is caring for a child diagnosed with type 1 diabetes mellitus. The nurse should teach the child and parents that insulin dosing is based on which item? A. Weight B. Urine output C. Diet D. Age

C. Diet Rationale: Insulin dose is based on diet, specifically carbohydrate intake. Insulin dose is not based on weight, age, or urine output.

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