Review questions unit 3

A type II diabetic presents to the clinic for a follow up appointment after working with a dietitian for two months. Which of the following tests would indicate improvement of blood sugar over a two to three month period? A. SMBG B. Fasting Blood Glucose level C. HgA1C D. Urine Ketone

C. HgA1C

Lispro insulin (Humalog) with NPH (Humulin N) insulin is ordered for a patient with newly diagnosed type 1 diabetes. The nurse knows that when lispro insulin is used, when should it be administered? A. Only once a day. B. 1 hour before meals C. 30 to 45 minutes before meals. D. At mealtime or within 15 minutes of meals.

D. At mealtime or within 15 minutes of meals. Lispro is a rapid-acting insulin that has onset of action of approximately 15 minutes and should be injected at the time of the meal or within 15 minutes of eating. Regular insulin is short acting with an onset of action in 30 to 60 minutes following administration and should be given 30 to 45 minutes before meals.

A nurse is reviewing the medical record of a 19-year-old female client who has a urinary tract infection (UTI) and her labs indicate that she has elevated serum potassium. Her medical history includes Asthma,frequent sexual activity, and has Anemia. Which of the following does the nurse recognize as a risk factor? A. Asthma B. Sexually Active C. Anemia D. Elevated Serum Potassium

B. Sexually Active Sexually active females have a higher risk for urinary tract infections. Intercourse promotes "milking" bacteria from the vagina and perineum and may cause minor urethral trauma that predisposes women to UTIs.

The time is 0710 and the nurse is caring for a type 1 diabetic that has glargine (Lantus) and lispro (Humalog) ordered to be given at 0700. The client's blood glucose is 134 mg/dL. Which of the following is correct? A. Administer both insulins in the same syringe. B. Administer glargine (Lantus) now and lispro (Humalog) once the breakfast arrives. C. Call the physician and question why the type I diabetic client needs two insulins. D. Administer both insulins now.

B. Administer glargine (Lantus) now and lispro (Humalog) once the breakfast arrives. Glargine (Lantus) is a long acting insulin and should never be given in the same syringe as any other medication. Lispro (Humalog) is a rapid acting insulin and should only be given right before meals.

The nurse enters the room of a client who was administered insulin with breakfast. The nurse finds the sitting up in the chair with cool, pale and sweaty skin. What is the first thing the nurse should do? A. Administer insulin immediately. B. Check the client's blood glucose C. Report the symptoms to the physician D. Treat the symptoms with simple carbohydrates

B. Check the client's blood glucose The client is exhibiting signs and symptoms of hypoglycemia. The nurse would need to check the blood glucose immediately and then begin treating the client by following the rule of 15 if the blood glucose is <70 mg/dL. Giving insulin would rapidly lower the blood glucose and could send the pt into a coma or death.

A nurse is teaching a client who has urolithiasis (renal calculi). The nurse should explain that which of the following conditions can increase the risk for renal calculi? A. Protein in the urine B. Dehydration C. Iron deficiency D. Overweight

B. Dehydration

A nurse is presenting educational materials for a group of middle-aged clients about menopausal hormone therapy (HRT) following a total hysterectomy. Which of the following information should the nurse include in the information? A. HRT will increase your risk for developing breast and endometrial cancers B. HRT will protect you from blood clots C. Black cohosh and soy will prevent symptoms of menopause including vasomotor responses D. HRT has no risk factors associated with them if they are taken at the right time

A. HRT will increase your risk for developing breast and endometrial cancers HRT has no risk factors associated with them if they are taken at the right time

First drug generally prescribed in type 2 diabetes. A. Glucosamine B. Diet pills for weight loss C. Glucophage D. Insulin

C. Glucophage

The nurse teaches an obese client that which of the following may prevent diagnosis of type 2 diabetes? A.Oral medication B. Use of Homeopathic remedies C. Life style changes D. South Beach diet

C. Life style changes

A nurse is providing teaching to a client who has had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for uterine cancer. Which of the following instructions should the nurse include in the teaching? A. A Papanicolaou (PAP) test should be performed every 6 months B. Avoid lubrication for vaginal dryness C. No sexual intercourse for 4-6 weeks D. Avoid heavy lifting for 2-3 weeks

C. No sexual intercourse for 4-6 weeks No sexual intercourse is indicated for 4-6 weeks post hysterectomy

A nurse is caring for a client who has benign prostatic hyperplasia (BPH). The nurse should expect all of the following findings except? A. Incontinence B. Nocturia C. Pain in the scrotum D. Dysuria

C. Pain in the scrotum

A nurse is caring for a middle adult female client who reports that her menstrual periods have become irregular and she has been having hot flashes. The nurse should expect the client to have which of the following manifestations associated with early menopause? A. Urinary retention B. Improvement in mood C. Sleep problems D. Elevation in body temperature above 37.8° C (100° F)

C. Sleep problems Symptoms of perimenopause include irregular menstrual cycles, mood changes, occasional vasomotor symptoms such as hot flashes, sleep problems, and vaginal dryness.

A nurse is caring for a female client who has recurrent kidney stones and is scheduled for an intravenous pyelogram. Which of the following statements by the client should the nurse report to the provider? A. "I drink at least 2 quarts of fluid every day." B. "The last time I voided it was painful and red-tinged." C. "My period ended 2 days ago." D. "I don't eat shellfish because it gives me hives."

D. "I don't eat shellfish because it gives me hives."

A nurse is providing dietary teaching to a client who has calcium oxalate kidney stones. Which of the following statements indicates an understanding of the teaching? A. "I can have almonds as a snack." B. "I can use soy milk with my cereal." C. "I may eat a sweet potato for dinner." D. "I may eat a banana with my breakfast."

D. "I may eat a banana with my breakfast."

A nurse is teaching a client about preventing osteoporosis. Which of the following statements by the client indicates a need for further teaching? A. "I will reduce my intake of sodium." B. "I will decrease my intake of caffeine." C. "I will limit my intake of soft drinks." D. "I will reduce my intake of vitamin K-rich foods."

D. "I will reduce my intake of vitamin K-rich foods."

The nurse is caring for a female teenager with reoccurring urinary tract infections. Which observation made by the nurse is most concerning? A. A tampon among her items. B. Drinking 32 oz of soda C. Eating a cranberry muffin. D. An unfinished prescription for antibiotics.

D. An unfinished prescription for antibiotics Nursing Management of UTI should focus on teaching clients to continue all medications as prescribed. Reinfections and frequent relapses may receive long-term, low-dose antibiotics. Making sure the client understands the reason for the antibiotic therapy is important to increase adherence.

A 7-yr-old girl with type I diabetes begins to experience low blood sugar on the bus ride home. Her friend alerts the school bus driver. Which of the following should the bus driver give the girl to treat her symptoms? A. Chocolate Milk B. Crackers C. Peanut M&Ms D. Apple Juice

D. Apple Juice Treating hypoglycemia begins with a source of simple carbohydrates. 4 ounces of Juice, 10 life savers, or glucose tablets are all examples of simple sugars. The rule of 15 states the client should be given three rounds of simple carbohydrates every 15 minutes until the blood glucose reaches 70 mg/dL. Then follow up with a meal or a complex carbohydrate with a protein.

Your patient has decided that non hormonal therapy is the treatment they want to control their vasomotor symptoms. Which medications would you expect the patient to be taking? A. Calcium B. Estrogen C. Flomax D. Clonidine

D. Clonidine

A nurse is caring for an older adult client who has a urinary tract infection (UTI). Which of the following manifestations should the nurse identify as a nonspecific symptom of infection in the this patient population? A. High fever B.Low back pain C. Diarrhea D. Confusion

D. Confusion Remember that characteristic manifestations of a UTI are often absent in older adults. Older adults often have nonspecific signs of infection. These signs include nonspecific abdominal pain, hypothermia or low-grade fever, sleeping more often and a decreased appetite.

A nurse is planning care for a client who has urolithiasis. Which of the following actions should the nurse take? A. Apply cold compress to the client's flank area. B. Restrict protein intake to 2 servings per day. C. Discourage ambulation. D. Encourage intake of at least 3 L of fluids per day.

D. Encourage intake of at least 3 L of fluids per day.

A nurse is presenting educational materials for a group of middle-aged clients about menopausal hormone therapy (HRT) following a total hysterectomy. Which of the following information should the nurse include in the information? A. There are no major risks associated with hormone therapy. B. HRT protects against blood clots. C. Black Cohosh and Soy provide better relief from menopause symptoms but have more risks. D. May increase the risk of breast and endometrial cancer

D. May increase the risk of breast and endometrial cancer

Advanced Interventions with a client who is diagnosed with gender dysphoria to help them optimize their well-being would include; A. Let the child identify with the opposite gender and provide support for the stresses of familial and peer responses B. Require the client to not participate in any hormonal therapies until they are at least 18 years of age. C. Ensure that the client keep the desired changes to themselves to protect their privacy D. Admit the client to a psychiatric facility for cognitive behavioral therapy.

A. Let the child identify with the opposite gender and provide support for the stresses of familial and peer responses

A nurse is teaching a client about why a Dual Energy X-ray Absorptiometry (DEXA) screening is needed. Which of the following indicates that the nurse understands the purpose of the exam? A. The DEXA scan measures bone density in bones that are most prone to fragility and fractures." B. "The DEXA scan measures bone density in the knee cap, heel, or shin." C. "This diagnostic exam is performed by a lab draw." D. "This diagnostic test is done to detect any structural defects."

A. The DEXA scan measures bone density in bones that are most prone to fragility and fractures." The DEXA scan measures the hips, spine, and forearms. These represent the most common sites of fragility from fractures and osteoporosis. It is also considered the gold standard for bone mineral density.

A nurse is caring for a client who is 2 hr postoperative following a transurethral resection of the prostate (TURP) gland. Which of the following assessments should the nurse view to be an indication of a postoperative complication? A. Urine output of 15ml/ Hr B. Pulse rate of 88/min C. Oral temperature of 37.4 degrees celsius ( 99 degrees F. ) D. An urge to void despite having an indwelling urinary catheter

A. Urine output of 15ml/ Hr

Gender dysphoria is defined as A. When the clients biological sex differs from gender identity B. When the client has had gender reassignment surgery C. When the client describes themselves as being homosexual D. When the client takes hormone therapy to live as the opposite sex

A. When the clients biological sex differs from gender identity

A newly diagnosed type I diabetic asks the nurse why she can't just take a pill like her friend to treat her diabetes. How should the nurse reply? A. "Oral agents are only used in type two diabetics." B. "You should discuss changing to oral agents instead of insulin with your doctor." C. "Your friend's insurance probably doesn't cover insulin so she takes the oral agents instead." D. "Oral agents make the beta cells function in type I diabetics."

A. "Oral agents are only used in type two diabetics." Oral anti-diabetic agents can only be used in clients who have type two diabetes and have some functioning beta cells. There is an extreme risk of hypoglycemia for type I diabetics and oral anti-diabetic agents.

A nurse is providing teaching to a client about measures to prevent urinary tract infections (UTIs). Which of the following client statements indicates a need for more teaching? A. "I will need to wipe my perineal area from front to back after urination." B. "I will need to empty my bladder every 6 hours.." C. "I will need to drink apple cider vinegar each day." D. "I need to drink at least two liters of fluid per day."

B. "I will need to empty my bladder every 6 hours.."

A nurse in a provider's office is collecting a health history from a client who is at risk for primary osteoporosis. Which of the following findings is a risk factor for the development of osteoporosis A. The patient is 32 pounds overweight. B. Breastfed 4 children and did not take vitamins during pregnancy C. Has taken diuretics for 10 years for hypertension. D. The patient has had a long stressful career.

B. Breastfed 4 children and did not take vitamins during pregnancy Breastfeeding depletes the skeletal stores of calcium unless Calcium intake is adequate.

A type II diabetic client presents to the clinic with the fever and states, "I don't know why my blood glucose has been running in the 300s." Which of the following is the best explanation that the nurse should teach the client? A. "Influenza can lead to very high blood sugars and less insulin will be needed." B. "Illness tends to stress you out and lead to high blood sugars." C. "Illness can cause hyperglycemia because hormones produced to combat the illness cause the blood sugar to rise which may require more insulin intake." D. "Illness causes the beta cells to temporarily stop functioning and causes the blood glucose to trigger glucagon storage and will require more insulin."

C. "Illness can cause hyperglycemia because hormones produced to combat the illness cause the blood sugar to rise which may require more insulin intake." Illness causes the body to produce hormones that cause a rise in blood glucose. Illness usually causes a need for insulin or an increase in clients who already use insulin got control their blood glucose. Illness does cause a rise in blood glucose but this is not the best explanation for a client.

A nurse is teaching a client who has a urinary tract infection (UTI) and is taking ciprofloxacin. Which of the following instructions should the nurse give to the client? A. "If the medicine causes an upset stomach, take an antacid at the same time." B. "Limit your daily fluid intake while taking this medication." C. "This medication can cause shortness of breath." D. "You should report any tendon discomfort you experience while taking this medication."

D."You should report any tendon discomfort you experience while taking this medication."

The diabetic educator is teaching a newly diagnosed client about monitoring blood glucose at home. Which of the following would the diabetic educator teach the patient to do at home? HgA1c SMBG

SMBG Dipstick to check for ketones Glucose Tolerance Test