NCLEX Questions W11

1. A patient presents with a blood pressure of 162/88 mm Hg, heart rate of 100 bpm, triglycerides of 378 mg/dL, and HDL of 25 mg/dL. Which of the following are characteristics of metabolic syndrome? (Select all that apply.) A. blood pressure of 162/88 mm Hg B. heart rate of 100 bpm C. triglycerides of 378 mg/dL D. HDL of 25 mg/dL

A, C, D

11. A client diagnosed with type 2 diabetes is prescribed pramlintide. How will this drug assist in controlling the client's blood sugar? A. It slows gastric emptying. B. It blocks the absorption of food. C. It absorbs with the insulin. D. It increases the release of insulin.

A.

13. The parent of a child with diabetes asks the nurse why a quick-acting sugar given by mouth is better in the regulation of insulin than the use of intravenous glucose for a low blood sugar. Which statement by the nurse represents the most appropriate response to the question? A. "The ingestion of food allows the digestive tract to stimulate vagal activity and the release of incretins." B. "The combination of insulin and food will yield a higher blood sugar than intravenous glucose." C. "Both food and intravenous glucose will produce similar changes in the gastrointestinal tract to increase blood sugar." D. "You are mistaken. The intravenous glucose yields a higher blood glucose through the release of incretins."

A.

15. A client who regularly takes metformin has developed a severe infection. How will the infection change the established diabetic regimen? A. Metformin is contraindicated in the presence of an infection. B. Metformin will be given more frequently to decrease blood sugar. C. Metformin will result in better regulation of blood sugar. D. Metformin will allow the client to decrease the absorption of glucose.

A.

7. A patient who is newly diagnosed with diabetes mellitus demonstrates extreme anxiety. The most appropriate intervention to decrease the patient's anxiety would be to do which of the following? A. convey empathy, trust, and respect toward the patient B. administer an antianxiety medication C. ensure that the patient knows the correct medical terminology to understand what is going on D. ignore the signs and symptoms of anxiety so they will disappear more quickly

A.

8. The nurse is assessing a patient who has just begun taking glyburide. Which of the following is a therapeutic outcome for this patient? (Select all that apply.) A. a glycosylated hemoglobin (hemoglobin A1C) of 10% B. a decrease in polyuria C. a decrease in polyphagia D. a fasting blood glucose of 108 mg/dL

B, C, D

10. A 58-year-old woman with type 2 diabetes mellitus takes glyburide (DiaBeta) 5 mg by mouth daily, and this drug controls her diabetes well. However, recently, her fasting blood glucose has measured between 200 and 220 mg/dL. Which of the following medications may have been added to the patient's regimen? A. atenolol B. prednisone C. enalapril maleate D. levothyroxine sodium

B.

10. The nurse is providing education to the parents of a child who has been newly diagnosed with type 1 diabetes. What distinguishing characteristic of the disorder does the nurse include in the teaching? A. Blood glucose levels can be controlled by diet. B. Exogenous insulin is required for life. C. Oral agents can control blood sugar. D. The disease always starts in childhood.

B.

12. What is the expected action of sitagliptin on type 2 diabetes? A. It blocks the S phase of the cell cycle. B. It slows the rate of inactivation of the incretin hormones. C. It inhibits insulin release. D. It inhibits hydrogen, potassium, and ATPase.

B.

3. A patient is taking NPH insulin once daily in the morning. What is the most likely time for a hypoglycemic reaction? A. 1 to 3 hours after administration B. 4 to 12 hours after administration C. 12 to 18 hours after administration D. 18 to 24 hours after administration

B.

3. The nurse is monitoring a patient newly diagnosed with type 2 diabetes mellitus taking repaglinide for complications. Which of the following, if exhibited by the patient, would indicate hypoglycemia and require immediate treatment? A. polyuria B. diaphoresis C. decreased heart rate D. hypertension

B.

5. When teaching a patient who has recently received a diagnosis of diabetes how to self-administer short-acting and intermediate-acting insulin subcutaneously, which of the following instructions is correct? A. Understand that the order of drawing up the two insulins into the syringe does not matter. B. Draw the short-acting insulin into the syringe first, followed by the intermediate-acting insulin. C. Draw the intermediate-acting insulin into the syringe first, followed by the short-acting insulin. D. Give yourself two injections because mixing these insulins together is unsafe.

B.

12. During a teaching session on the care of the client with diabetes, the nurse should make which statement to explain the differences in insulin? A. "Insulin is prescribed based on the insurer's criteria for reimbursement." B. "Insulin is prescribed based on the client's age." C. "Insulins have different onsets and durations of action." D. "Insulin type is matched with the appropriate oral hypoglycemic agent."

C.

14. A client has been prescribed acarbose. What is the advantage of acarbose over alternative drugs? A. It can replace the use of insulin. B. The client does not have to limit food intake. C. It delays the digestion of complex carbohydrates. D. It prevents alkalosis.

C.

16. The nurse knows that the lunch trays are usually distributed at approximately 12:15. The nurse should plan to administer the client's prescribed 4 units of regular insulin at what time? A. 12:15 B. 12:10 C. 11:45 D. 11:15

C.

2. A man with type 2 diabetes mellitus has a blood glucose of more than 500 mg/dL. He is complaining of excessive urination, extreme thirst, and weakness, and he also notes recent weight loss. The nurse would expect to find which diagnosis in his chart? A. hypoglycemia B. diabetic ketoacidosis C. hyperglycemic hyperosmolar nonketotic syndrome D. hypothyroidism

C.

4. A patient with newly diagnosed type 1 diabetes is beginning daily insulin injections. The nurse is preparing to teach the patient about insulin injections. What should the nurse include in the teaching plan? A. Understand that ketones in the urine indicate the need for a decrease in the number of units of insulin. B. Administer the insulin at the same time every day regardless of meals. C. Rotate the insulin injection sites. D. Increase the insulin dosage just prior to exercise.

C.

9. A patient with type 2 diabetes calls the nurse to report the following symptoms: blood glucose of 378 mg/dL, excessive urination, and feelings of becoming drowsier. To determine a possible diagnosis, which of the following questions is most important? A. "Has there been any change in diet?" B. "Has there been any fever?" C. "Have there been any ketones in the urine?" D. "Have you increased the amount of fluid intake?"

C.

1. A patient with type 2 diabetes is scheduled to have a cardiac catheterization in 1 week, and the nurse makes a preprocedure phone call. The nurse instructs the patient to stop taking which medication 2 days before the procedure? A. sitagliptin B. insulin C. glyburide D. metformin

D.

11. The nurse is preparing to administer insulin intravenously to a client with a blood glucose level over 600 mg/dL (33.33 mmol/L). What type of insulin will the nurse most likely give? A. NPH insulin B. Lente insulin C. Ultralente insulin D. Regular insulin

D.

2. A patient who has just arrived at the emergency department may be suffering from diabetic ketoacidosis. Which of the following would confirm the diagnosis? A. elevated serum potassium B. increased respiratory rate C. increased pH D. elevated blood glucose level

D.

4. A patient with type 2 diabetes begins taking sitagliptin for the management of blood glucose levels. Which statement by the patient indicates an understanding of this medication? A. "I will take two doses in the morning if my blood sugar is high." B. "By taking this medication, I am able to eat more." C. "Now that I am taking this medication, I don't have to exercise anymore." D. "I will take this medicine once a day."

D.

5. The nurse caring for a patient with diabetes mellitus has lipodystrophy of the abdomen. What should the nurse assess? A. Does the patient administer the injection at a 45-degree angle? B. Does the patient aspirate for blood prior to giving the injection? C. Does the patient pinch the skin appropriately? D. Does the patient rotate sites for giving each injection?

D.

6. Based on the action of pramlintide, which of the following is a primary nursing intervention? A. Administer glucagon during the peak of action. B. Assess blood sugar at 2.4 hours after medication administration. C. Assess respiratory status for the onset of an upper respiratory infection. D. Provide a meal immediately after the administration of the subcutaneous injection.

D.

6. Which of the following insulins cannot be administered in a continuous subcutaneous insulin infusion pump? A. insulin lispro B. insulin aspart C. insulin glulisine D. insulin glargine

D.

7. A nurse is caring for a patient who is "nothing by mouth" (NPO) before surgery scheduled at 10:00 am. He routinely receives 30 units of Humulin 70/30 every morning at 7:00 am. What is the appropriate nursing action in this situation? A. Administer 30 units of Humulin 70/30 subcutaneously. B. Hold the insulin because the patient is NPO. C. Give the patient a light breakfast and administer the insulin as ordered. D. Contact the physician for a presurgery insulin order.

D.

8. The nurse is educating a patient about proper foot care. Which instruction does the nurse include in the teaching plan? A. Always use a pumice stone on callused areas of the feet. B. Use a heavy moisturizing cream on the feet at all times. C. Wash feet in cold water only. D. Always have a podiatrist cut toenails.

D.

9. A patient with DKA is admitted to the hospital. Which of the following does the nurse expect to see? A. increased pH and increased heart rate B. increased respiratory rate and decrease in urine output C. elevated potassium and increase in blood pressure D. elevated blood glucose and decreased plasma bicarbonate

D.