Ch.64 NCLEX questions

A client with diabetes mellitus who takes insulin is seen in the health care clinic. The client tells the clinic nurse that after the insulin injection, the insulin seems to leak through the skin. The nurse would appropriately determine the problem by asking the client which question? "Are you rotating the injection site?" "Are you aspirating before you inject the insulin?" "Are you using a 1-inch needle to give the injection?" "Are you placing an air bubble in the syringe before injection?"

"Are you rotating the injection site?"

The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client relates a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching? "I need to stop my insulin." "I need to increase my fluid intake." "I need to monitor my blood glucose every 3 to 4 hours." "I need to call the health care provider (HCP) because of these symptoms."

"I need to stop my insulin."

The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client makes which statement? "I will stop taking my insulin if I'm too sick to eat." "I will decrease my insulin dose during times of illness." "I will adjust my insulin dose according to the level of glucose in my urine." "I will notify my health care provider (HCP) if my blood glucose level is higher than 250 mg/dL (14.2 mmol/L)."

"I will notify my health care provider (HCP) if my blood glucose level is higher than 250 mg/dL (14.2 mmol/L)."

The nurse is caring for a client admitted to the emergency department with diabetic ketoacidosis (DKA). In the acute phase, the nurse plans for which priority intervention? Correct the acidosis. Administer 5% dextrose intravenously. Apply a monitor for an electrocardiogram. Administer short-duration insulin intravenously.

Administer short-duration insulin intravenously.

A client received 5 units of insulin aspart subcutaneously just before eating lunch at 12:00 p.m. The nurse should assess the client for a hypoglycemic reaction at which times? Between 1:00 and 3:00 p.m. 10 minutes after administration Between 4:00 p.m. and 12:00 a.m. Between 8:00 and 10:00 p.m.

Between 1:00 and 3:00 p.m.

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which findings support this diagnosis? Select all that apply. Increase in pH Comatose state Deep, rapid breathing Decreased urine output Elevated blood glucose level

Comatose state Deep, rapid breathing Elevated blood glucose level

A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety? Administer a sedative. Convey empathy, trust, and respect toward the client. Ignore the signs and symptoms of anxiety, anticipating that they will soon disappear. Make sure that the client is familiar with the correct medical terms to promote understanding of what is happening.

Convey empathy, trust, and respect toward the client.

A client with diabetes mellitus is being tested to determine long-term diabetic control. Which result should the nurse expect to see if the client's long-term control is within acceptable limits? Glycosylated hemoglobin of <6% Presence of ketones in the urine Presence of albumin in the urine Fasting blood glucose level of 150 mg/dL (8.57 mmol/L)

Glycosylated hemoglobin of <6%

A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240 mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication? An ampule of 50% dextrose NPH insulin subcutaneously IV fluids containing dextrose Phenytoin for the prevention of seizures

IV fluids containing dextrose

The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The nurse places priority on which client problem? 1.Lack of knowledge 2.Inadequate fluid volume 3.Compromised family coping 4.Inadequate consumption of nutrients

Inadequate fluid volume

A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperosmolar hyperglycemic syndrome is made. The nurse would immediately prepare to initiate which anticipated health care provider's prescription? Endotracheal intubation 100 units of NPH insulin Intravenous infusion of normal saline Intravenous infusion of sodium bicarbonate

Intravenous infusion of normal saline

The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which sign or symptom, if exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if the blood glucose is not adequately managed? Polyuria Diaphoresis Pedal edema Decreased respiratory rate

Polyuria

A test to measure long-term control of diabetes mellitus has been prescribed for a client. In instructing the client about the test, the nurse explains that long-term control can be measured because chronic high blood glucose levels lead to irreversible glucose binding onto what? Platelets Muscle tissue Adipose tissue Red blood cells (RBCs)

Red blood cells (RBCs)

The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptom or symptoms develop? Select all that apply Polyuria Shakiness Palpitations Blurred vision Lightheadedness Fruity breath odor

Shakiness Palpitations Lightheadedness

A client with type 1 diabetes mellitus is to begin an exercise program, and the nurse is providing instructions regarding the program. Which instruction should the nurse include in the teaching plan? Try to exercise before mealtimes. Administer insulin after exercising. Take a blood glucose test before exercising. Exercise is best performed during peak times of insulin.

Take a blood glucose test before exercising.