NUR296

Albert refuses his bedtime snack. This should alert the nurse to assess for: A. Elevated serum bicarbonate and a decreased blood pH. B.Signs of hypoglycemia earlier than expected. C. Symptoms of hyperglycemia during the peak time of NPH insulin. D. Sugar in the urine

C

The lowest fasting plasma glucose level suggestive of a diagnosis of DM is: A.90mg/dl B.115mg/dl C.126mg/dl D. 180mg/dl

C

Your Addison's patient is experiencing hypoglycemia. Which of the following signs & symptoms will your patient exhibit? (SATA) a. dizziness b. drowsiness c. thirsty d. fatigued e. anxious

a,d,e

A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction is: A. Blurred vision B. Diaphoresis C. Nausea D. Weakness

B

A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. Nurse Jack explains that these medications are only effective if the client: A.prefers to take insulin orally. B.has type 2 diabetes. C. has type 1 diabetes. D.Is pregnant and has type 2 diabetes

B

Rotating injection sites when administering insulin prevents which of the following complications? A Insulin edema B Insulin lipodystrophy C Insulin resistance D Systemic allergic reactions

B

Which of the following chronic complications is associated with diabetes? A Dizziness, dyspnea on exertion, and coronary artery disease B Retinopathy, neuropathy, and coronary artery disease C Leg ulcers, cerebral ischemic events, and pulmonary infarcts D Fatigue, nausea, vomiting, muscle weakness, and cardiac arrhythmia's

B

Mr. Wesley is newly diagnosed with Type I DM and is being seen by the home health nurse. The doctors orders include: 1200 calorie ADA diet, 15 units NPH insulin before breakfast, and check blood sugar qid. When the nurse visits the patient at 5 pm, the nurse observes the man performing blood sugar analysis. The result is 50 mg/dL. The nurse would expect the patient to be A. confused with cold, clammy skin and pulse of 110 B. lethargic with hot dry skin and rapid deep respirations C. alert and cooperative with BP of 130/80 and respirations of 12 D. short of breath, with distended neck veins and bounding pulse of

A

A male client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which of the following glands? A. Adrenal cortex B. Pancreas C. Adrenal medulla D. Parathyroid

A.

Clinical manifestations associated with a diagnosis of type 1 DM include all of the following except: A. Hypoglycemia B.Hyponatremia C.Ketonuria D. Polyphagia

A.

Serafica who has diabetes mellitus type 1 is found unresponsive in the clinical setting. Which nursing action is a priority? arrange from 1 to 4.Treat the client for hypoglycemia.Call the physician STAT.Assess the vital signs.Call a code. A.1, 2, 3, 4 B. 1, 3, 2, 4 C.3, 1, 2, 4 D. 4, 3, 2, 1

A.

Nurse Tamara discovers scabies when assessing a client who has just been transferred to the medical-surgical unit from the day surgery unit. To prevent scabies infection in other clients, the nurse should: A.wash hands, apply a pediculicide to the client's scalp, and remove any observable mites. B.isolate the client's bed linens until the client is no longer infectious. C.notify the nurse in the day surgery unit of a potential scabies outbreak. D.place the client on enteric precautions.

B.

Which of the following diabetes drugs acts by decreasing the amount of glucose produced by the liver? A.Alpha-glucosidase inhibitors B. Biguanides C. Meglitinides D. Sulfonylureas

B.

Which of the following patients are at risk for developing Cushing's Syndrome? A. A patient with a tumor on the pituitary gland, which is causing too much ACTH to be secreted. B. A patient taking glucocorticoids for several weeks. C. A patient with a tuberculosis infection. D. A patient who is post-opt from an adrenalectomy.

B.

Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select all that apply. A. The nurse could have given the insulin subcutaneously. B. The nurse should have contacted the physician. C. The nurse should have used regular insulin (Humulin R). D.The nurse used the correct insulin.

B,C

The nurse is admitting a client with hypoglycemia. Identify the signs and symptoms the nurse should expect. Select all that apply. A.Thirst B. Palpitations C. Diaphoresis D. Slurred speech E. Hyperventilation

B,C,D

Dr. Martinez prescribes an emollient for a client with pruritus of recent onset. The client asks why the emollient should be applied immediately after a bath or shower. How should the nurse respond? A "This makes the skin feel soft." B. "This prevents evaporation of water from the hydrated epidermis." C "This minimizes cracking of the dermis." D "This prevents inflammation of the skin.

B.

During a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise? AAt least once a week B.At least three times a week C.At least five times a week D.Every day

B.

Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? A.Diabetic ketoacidosis B.Thyroid crisis C.Hypoglycemia D.Tetany

B.

Harry is a diabetic patient who is experiencing a reaction of alternating periods of nocturnal hypoglycemia and hyperglycemia. The patient might be manifesting which of the following? A. Uncontrolled diabetes B. Somogyi phenomenon C. Brittle diabetes D. Diabetes insipidus

B.

During a visit in the hospital, the student nurses are asked which of the following persons would most likely be diagnosed with diabetes mellitus. They are correct if they answered a 44-year-old: ACaucasian woman. BAsian woman. C. African-American woman. D. Hispanic male.

C

Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find: A.Hypotension. B.Thick, coarse skin. C.Deposits of adipose tissue in the trunk and dorsocervical area. D.Weight gain in arms and legs.

C

The nurse knows that glucagon may be given in the treatment of hypoglycemia because it: A.Inhibits gluconeogenesis B.Stimulates the release of insulin C. Increases blood glucose levels D. Provides more storage of glucose

C

An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of: AThyroid storm. BCretinism. CMyxedema coma. DHashimoto's thyroiditis

C

Marlisa has been diagnosed with diabetes mellitus type 1. She asks Nurse Errol what this means. What is the best response by the nurse? Select all that apply. A. "Your alpha cells should be able to secrete insulin, but cannot." B. "The exocrine function of your pancreas is to secrete insulin." C. "Without insulin, you will develop ketoacidosis (DKA)." D. "The endocrine function of your pancreas is to secrete insulin." E."It means your pancreas cannot secrete insulin.

C,D,E

Serge who has diabetes mellitus is taking oral agents, and is scheduled for a diagnostic test that requires him to be NPO. What is the best plan of the nurse with regard to giving the client his oral medications? A. Administer the oral agents immediately after the test. B. Notify the the diagnostic department and request orders. C. Notify the physician and request orders. D. Administer the oral agents with a sip of water before the test.

C.

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.

A patient received 6 units of regular insulin 3 hours ago. The nurse would be MOST concerned if which of the following was observed? A. kussmaul respirations and diaphoresis B. anorexia and lethargy C. diaphoresis and trembling D. headache and polyuria

C. Diaphoresis and trembling indicates hypoglycemia.

For a diabetic male client with a foot ulcer, the physician orders bed rest, a wet-to-dry dressing change every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used for this client? A. They contain exudate and provide a moist wound environment. B. They protect the wound from mechanical trauma and promote healing. C. They debride the wound and promote healing by secondary intention. D. They prevent the entrance of microorganisms and minimize wound discomfort.

C. For this client, wet-to-dry dressings are most appropriate because they clean the foot ulcer by debriding exudate and necrotic tissue, thus promoting healing by secondary intention. Moist, transparent dressings contain exudate and provide a moist wound environment. Hydrocolloid dressings prevent the entrance of microorganisms and minimize wound discomfort. Dry sterile dressings protect the wound from mechanical trauma and promote healing.

A patient with diabetes has a morning glucose of 50. The patient is sweaty, cold, and clammy. Which of the following nursing interventions is the MOST important? A. Recheck the glucose level B. Give the patient ½ cup (4 oz) of fruit juice C. Call the doctor D. Keep the patient nothing by mouth

b

Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he receives 8 U of regular insulin. Nurse Vince should expect the dose's: A.Onset to be at 2 p.m. and its peak to be at 3 p.m. B.Onset to be at 2:15 p.m. and its peak to be at 3 p.m. C.Onset to be at 2:30 p.m. and its peak to be at 4 p.m. D.Onset to be at 4 p.m. and its peak to be at 6 p.m

C.Regular insulin, which is a short-acting insulin, has an onset of 15 to 30 minutes and a peak of 2 to 4 hours. Because the nurse gave the insulin at 2 p.m., the expected onset would be from 2:15 p.m. to 2:30 p.m. and the peak from 4 p.m. to 6 p.m.

A patient with Addison's Disease is being discharged home on Prednisone. Which of the following statements by the patient warrants you to re-educate the patient? A. "I will notify the doctor if I become sick or experience extra stress." B. "I will take this medication as needed when symptoms present." C. "I will take this medication at the same time every day." D. "My daughter has bought me a Medic-Alert bracelet."

b.

At the time Cherrie Ann found out that the symptoms of diabetes were caused by high levels of blood glucose, she decided to break the habit of eating carbohydrates. With this, the nurse would be aware that the client might develop what complication? A. retinopathy B. atherosclerosis C. glycosuria D. acidosis

D

Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the following except: A. Integumentary inspection for the presence of brown spots on the lower extremities B. Observation for paleness of the lower extremities C. Observation for blanching of the feet after the legs are elevated for 60 seconds D. Palpation for increased pulse volume in the arteries of the lower extremities

D

Knowing that gluconeogenesis helps to maintain blood levels, a nurse should: A.Document weight changes because of fatty acid mobilization B. Evaluate the patient's sensitivity to low room temperatures because of decreased adipose tissue insulation C. Protect the patient from sources of infection because of decreased cellular protein deposits D. Do all of the above

D

Nurse Pira is explaining to the client about Type II Diabetes. Risk factors of such condition include all of the following except: A. Advanced age B. Physical inactivity C. Obesity D. Smoking

D

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

Which of the following methods of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis? A Subcutaneous B Intramuscular C IV bolus only D. IV bolus, followed by continuous infusion

D

The physician orders 36 units of NPH and 12 units of regular insulin. The nurse plans to administer these drugs in 1 syringe. Identify the steps in this procedure by listing them in priority order. 1. Inject air equal to NPH dose into NPH vial 2. Invert regular insulin bottle and withdraw regular insulin dose 3. Inject air equal to regular dose into regular dose 4. Invert NPH vial and withdraw NPH dose. A 1, 2, 3, 4. B 1, 4, 3, 2. C 1, 4, 2, 3, D 1, 3, 2, 4.

D.

When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, nurse April is most likely to detect: A. a blood pressure of 130/70 mm Hg. B. a blood glucose level of 130 mg/dl. C. bradycardia. D.a blood pressure of 176/88 mm Hg

D.

Which nursing diagnosis takes highest priority for a female client with hyperthyroidism? A.Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess B. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing C. Body image disturbance related to weight gain and edema D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

D.

A nurse performs a physical assessment on a client with type 2 DM. Findings include a fasting blood glucose of 120mg/dl, temperature of 101, pulse of 88, respirations of 22, and a bp of 140/84. Which finding would be of most concern of the nurse? A. Pulse B. BP C. Respiration D. Temperature

D. An elevated temperature may indicate infection. Infection is a leading cause of hyperglycemic hyperosmolar nonketotic syndrome or diabetic ketoacidosis.

A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, nurse Richard would suspect which of the following disorders? A.Diabetes mellitus BDiabetes insipidus CHypoparathyroidism DHyperparathyroidism

D.Hyperparathyroidism is most common in older women and is characterized by bone pain and weakness from excess parathyroid hormone (PTH). Clients also exhibit hypercalciuria-causing polyuria. While clients with diabetes mellitus and diabetes insipidus also have polyuria, they don't have bone pain and increased sleeping. Hypoparathyroidism is characterized by urinary frequency rather than polyuria.

Rosemary has been taking Glargine (Lantus) to treat her condition. 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.

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

Dietary recommendations for your patient with Cushing's Syndrome include: Encourage fluids, high carbohydrates, moderate protein. 2.3G daily Na+, high carbohydrates, low K+ Moderate calcium, moderate protein, low potassium High K, limit carbohydrates,and reduce Na+

High K limited carbs and reduced na

Nurse Oliver should expect a client with hypothyroidism to report which health concerns? AIncreased appetite and weight loss BPuffiness of the face and hands CNervousness and tremors DThyroid gland swelling

Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight gain. Signs and symptoms of hyperthyroidism (Graves' disease) include an increased appetite, weight loss, nervousness, tremors, and thyroid gland enlargement (goiter).

In Cushing's Disease and Syndrome there are: A. Increased cortisol production B. Low potassium and glucose levels C. Increased production of aldosterone and cortisol D. Decreased production of cortisol and aldosterone

c

A nurse is preparing a plan of care for a client with DM who has hyperglycemia. The priority nursing diagnosis would be: 1. High risk for d A.High risk for deficient fluid volume B. Deficient knowledge: disease process and treatment C. Imbalanced nutrition: less than body requirements D. Disabled family coping: compromised

Increased blood glucose will cause the kidneys to excrete the glucose on the urine. This glucose is accompanied by fluids and electrolytes, causing osmotic diuresis leading to dehydration. This fluid loss must be replaced when it becomes severe. Options B, C, and D are not related specifically to the issue of the question.

A nurse is caring for a client admitted to the ER with DKA. In the acute phase the priority nursing action is to prepare to: A. Administer regular insulin intravenously B. Administer 5% dextrose intravenously C. Correct the acidosis D.Apply an electrocardiogram monitor

Lack (absolute or relative) of insulin is the primary cause of DK1. Treatment consists of insulin administration (regular insulin), IV fluid administration (normal saline initially), and potassium replacement, followed by correcting acidosis. Applying an electrocardiogram monitor is not a priority action.

Which statement is incorrect about pheochromocytoma? A. This condition can be trigger by eating foods high in Tyramine such as hamburger meat and spinach. B. Monoamine oxidase inhibitors can trigger signs and symptoms of pheochromocytoma. C. An adrenalectomy is the only surgical treatment for pheochromocytoma. D. Patients with pheochromocytoma are at risk for hypertensive crisis.

The answer is A. This statement is incorrect because hamburger meat and spinach are not high in Tyramine....foods that are aged, pickled, and fermented (cheeses, red wine, smoke/dried meat, bananas, sauerkraut, chocolate) can trigger signs and symptoms of pheochromocytoma.

A female client is brought to the emergency department with second- and third-degree burns on the left arm, left anterior leg, and anterior trunk. Using the Rule of Nines, what is the total body surface area that has been burned? A18% B27% C30% D36%

The Rule of Nines divides body surface area into percentages that, when totaled, equal 100%. According to the Rule of Nines, the arms account for 9% each, the anterior legs account for 9% each, and the anterior trunk accounts for 18%. Therefore, this client's burns cover 36% of the body surface area.

A patient is admitted with uncontrolled hypertension and the doctor suspects pheochromoctyoma. On assessment, you note the blood pressure to be 196/120 and HR 130. The patient reports feeling very anxious, sweaty, and having palpations. What do you expect the doctor will order to confirm a diagnosis of pheochromocytoma? A. Urinalysis B. Urine culture C. 24-hour urine D. 8-hour urine

The answer is C. A 24-hour urine is ordered to check for catecholamine and metanephrines (which are metabolites formed when the body breaks down catecholamines).

A patient is scheduled for a bilateral adrenalectomy. Preoperatively, the patient is ordered by the doctor to take an alpha-adrenergic blocker. After administering a dose of this medication, what type of side effect will you monitor the patient for? A. Bradypnea B. Hyperglycemia C. Reflex tachycardia D. Hypertension

The answer is C. Alpha-adrenergic blockers (Cardura, Minipress, Hyrtin) block noradrenaline which reduces catecholamine. This will help decrease blood pressure and prevent hypertensive crisis during surgery. However, a side effect of this medication is reflex tachycardia due to the decrease in blood pressure. The heart will try to compensate by increasing the heart rate.

PTH

which hormone is produced by this gland?

epi, norepi, catecholamines

which hormone is produced by this gland?

estrogen, progesterone

which hormone is produced by this gland?

During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the nurse should include which statement? A"The head of your bed must remain flat for 24 hours after surgery." B."You should avoid deep breathing and coughing after surgery." C."You won't be able to swallow for the first day or two." D."You must avoid hyperextending your neck after surgery.

To prevent undue pressure on the surgical incision after subtotal thyroidectomy, the nurse should advise the client to avoid hyperextending the neck. The client may elevate the head of the bed as desired and should perform deep breathing and coughing to help prevent pneumonia. Subtotal thyroidectomy doesn't affect swallowing.

A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? A.Infusing I.V. fluids rapidly as ordered B. Encouraging increased oral intake C. Restricting fluids D. Administering glucose-containing I.V. fluids as ordered

To reduce water retention in a client with the SIADH, the nurse should restrict fluids. Administering fluids by any route would further increase the client's already heightened fluid load.

Which of the following patients are at risk for developing Cushing's Syndrome? A. A patient with a tumor on the pituitary gland, which is causing too much ACTH to be secreted. B. A patient taking glucocorticoids for several weeks. C. A patient with a tuberculosis infection. D. A patient who is post-opt from an adrenalectomy.

The answer is option B. A patient taking glucocorticoids for several weeks. Remember that CUSHING'S DISEASE is caused by the pituitary gland producing too much ACTH which in turn increases cortisol. Cushing's SYNDROME is caused by medication therapy of glucocorticoids. An adrenalectomy is a treatment for Cushing's Disease (so this is not the answer in this case) and TB is a risk factor for developing ADDISON'S Disease.

When instructing the female client diagnosed with hyperparathyroidism about diet, nurse Gina should stress the importance of which of the following? A. Restricting fluids B. Restricting sodium C. Forcing fluids D. Restricting potassium

The client should be encouraged to force fluids to prevent renal calculi formation. Sodium should be encouraged to replace losses in urine. Restricting potassium isn't necessary in hyperparathyroidism.

t3,t4, calcitonin

Which hormone(s) is(are) produced by this gland?melatonin adh, oxytocin acth, fsh, lh.gh fsh, tsh t3,t4, calcitonin pth glucocorticoid, mineralocorticoid, sex hormones epi, norepi

A 36-year-old male is newly diagnosed with Type 2 diabetes. Which of the following treatments do you expect the patient to be started on initially? A. Diet and exercise regime B. Metformin BID by mouth C. Regular insulin subcutaneous D. None, monitoring at this time is sufficient enough

a

A patient is admitted to the ER. The patient is unconscious on arrival. However, the patient's family is with the patient and reports that before the patient became unconscious she was complaining of severe pain in the abdomen, legs, and back, and has been experiencing worsening confusion. In addition, they also report the patient has not been taking any medications. The patient was recently discharged from the hospital for treatment of low cortisol and aldosterone levels. On assessment, you note the patient's blood pressure is 70/45. What disorder is this patient most likely experiencing? A. Addisonian Crisis B. Cushing Syndrome C. Thyroid crisis D. Hashimoto thyroiditis

a

A patient who has diabetes is nothing by mouth as prep for surgery. The patient states they feel like their blood sugar is low. You check the glucose and find it to be 52. The next nursing intervention would be to: A. Administer Dextrose 50% IV per protocol B. Continue to monitor the glucose C. Give the patient 4 oz of fruit juice D. None, this is a normal blood glucose reading

a

A patient with Cushing's syndrome will be undergoing an adrenalectomy. Which of the following will be included in the patient's discharge teaching after the procedure? A. Glucocorticoid replacement therapy B. Avoiding avocadoes and pears C. Declomycin therapy D. Signs and symptoms of Grave's Disease

a

Type 1 diabetics typically have the following clinical characteristics: A. Thin, young with ketones present in the urine B. Overweight, young with no ketones present in the urine C. Thin, older adult with glycosuria D. Overweight, adult-aged with ketones present in the urine

a

Which of the following is not a typical sign and symptom of Cushing's Syndrome? A. Hyperpigmentation of the skin B. Hirsutism C. Purplish striae D. Moon Face

a

In the scenario above, what medication do you expect the patient to be started on? A. IV Solu-Cortef B. PO Prednisone C. PO Declomycin D. IV Insulin

a.

A Type 2 diabetic may have all the following signs or symptoms EXCEPT: A. Blurry vision B. Ketones present in the urine C. Glycosuria D. Poor wound healing

b

In Cushing's disease, the _______ is secreting too much ACTH (Adrenocorticotropic hormone) which is causing an increase in cortisol production. A. Adrenal cortex B. Pituitary gland C. Thyroid gland D. Hypothalamus

b

Which of the following patients is at most risk for Type 2 diabetes? A. A 6 year old girl recovering from a viral infection with a family history of diabetes. B. A 28 year old male with a BMI of 49. C. A 76 year old female with a history of cardiac disease. D. None of the options provided.

b

Which of the following statements are true regarding Type 2 diabetes treatment? A. Insulin and oral diabetic medications are administered routinely in the treatment of Type 2 diabetes. B. Insulin may be needed during times of surgery or illness. C. Insulin is never taken by the Type 2 diabetic. D. Oral medications are the first line of treatment for newly diagnosed Type 2 diabetics.

b

A patient is diagnosed with pheochromocytoma. From your nursing knowledge, you know that the patient will present with hypertension, sweating, and palpations due to excessive catecholamine production from the? A. Adrenal Cortex B. Adrenal Zona Fasciculata C. Adrenal Medulla D. Adrenal Glomerulosa

c

A patient with Addison's Disease should consume which of the following diets? A. High fat and fiber B. Low potassium and high protein C. High protein, carbs, and adequate sodium D. Low carbs, high protein, and increased sodium

c

Which of the following symptoms do NOT present in hyperglycemia? A. Extreme thirst B. Hunger C. Blood glucose <60 mg/dL D. Glycosuria

c

7. In regards to question 6, you are also educating the patient about the post-opt care for a bilateral adrenalectomy. Which statement by the patient indicates they understood your instructions? A. "I will have to take mineralocorticoids daily for 2 years." B. "I will have to take glucocorticoids and mineralocorticoids daily for 2 years." C. "When I experience signs of stress I will have to take mineralocorticoids as needed." D. "I will have to take glucocorticoids and mineralocorticoids daily for life."

d

Addison's Disease is: A. Increased secretion of cortisol B. Increased secretion of aldosterone and cortisol C. Decreased secretion of cortisol D. Decreased secretion of aldosterone and cortisol

d

The _____ ______ secrete insulin which are located in the _______. A. Alpha cells, liver B. Alpha cells, pancreas C. Beta cells, liver D. Beta cells, pancreas

d

A client with type 1 DM calls the nurse to report recurrent episodes of hypoglycemia with exercise. Which statement by the client indicated an inadequate understanding of the peak action of NPH insulin and exercise? A. "The best time for me to exercise is every afternoon." B. "The best time for me to exercise is right after I eat." C. "The best time for me to exercise is after breakfast." D. "The best time for me to exercise is after my morning snack

A hypoglycemic reaction may occur in the response to increased exercise. Clients should avoid exercise during the peak time of insulin. NPH insulin peaks at 6-14 hours; therefore afternoon exercise will occur during the peak of the medication. Options B, C, and D do not address peak action times.

A client with diabetes mellitus visits a health care clinic. The client's diabetes previously had been well controlled with glyburide (Diabeta), 5 mg PO daily, but recently the fasting blood glucose has been running 180-200mg/dl. Which medication, if added to the clients regimen, may have contributed to the hyperglycemia? A.Prednisone (Deltasone) B.Atenolol (Tenormin) C.Phenelzine (Nardil) D.Allopurinol (Zyloprim)

A

During lecture, the clinical instructor tells the students that 50% to 60% of daily calories should come from carbohydrates. What should the nurse say about the types of carbohydrates that can be eaten? A. Try to limit simple sugars to between 10% and 20% of daily calories. B. Simple carbohydrates are absorbed more rapidly than complex carbohydrates. C. Simple sugars cause rapid spike in glucose levels and should be avoided. D. Simple sugars should never be consumed by someone with diabetes.

A

In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse Lyzette would expect a decline in: A.Serum glucose level. B.Hair loss. C.Bone mineralization. D.Menstrual flow

A

Which outcome indicates that treatment of a male client with diabetes insipidus has been effective? A. Fluid intake is less than 2,500 ml/day. b. Urine output measures more than 200 ml/hour. CBlood pressure is 90/50 mm Hg. DThe heart rate is 126 beats/minute.

A

A client with DM has an above-knee amputation because of severe peripheral vascular disease, Two days following surgery, when preparing the client for dinner, it is the nurse's primary responsibility to: A Check the client's serum glucose level B Assist the client out of bed to the chair C Place the client in a high-Fowlers position D Ensure that the client's residual limb is elevated

A.

A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which "related-to" phrase should the nurse add? A.Related to bone demineralization resulting in pathologic fractures B. Related to exhaustion secondary to an accelerated metabolic rate C.Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces DRelated to tetany secondary to a decreased serum calcium level

A.

A female client has a serum calcium level of 7.2 mg/dl. During the physical examination, nurse Noah expects to assess: A.Trousseau's sign. B.Homans' sign. C.Hegar's sign. D.Goodell's sign

A.

A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer: A. phentolamine (Regitine). B. methyldopa (Aldomet). C. mannitol (Osmitrol). D.felodipine (Plendil).

A.

A female client with second- and third-degree burns on the arms receives autografts. Two days later, the nurse finds the client doing arm exercises. The nurse knows that this client should avoid exercise because it may: A dislodge the autografts. B increase edema in the arms. C increase the amount of scarring. D decrease circulation to the fingers.

A.

A male client who has suffered a cerebrovascular accident (CVA) is too weak to move on his own. To help the client avoid pressure ulcers, the nurse should: A.turn him frequently. Bperform passive range-of-motion (ROM) exercises. Creduce the client's fluid intake. Dencourage the client to use a footboard

A.

A male client with psoriasis visits the dermatology clinic. When inspecting the affected areas, the nurse expects to see which type of secondary lesion? A.Scale BCrust CUlcer DScar

A.

Acarbose (Precose), an alpha-glucosidase inhibitor, is prescribed for a female client with type 2 diabetes mellitus. During discharge planning, nurse Pauleen would be aware of the client's need for additional teaching when the client states: A. "If I have hypoglycemia, I should eat some sugar, not dextrose." B. "The drug makes my pancreas release more insulin." C. "I should never take insulin while I'm taking this drug." D. "It's best if I take the drug with the first bite of a meal."

A.

Dr. Kennedy prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a male client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide? A. "Be sure to take glipizide 30 minutes before meals." B. "Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly." C. "You won't need to check your blood glucose level after you start taking glipizide." D. "Take glipizide after a meal to prevent heartburn.

A.

Following a full-thickness (third-degree) burn of his left arm, a male client is treated with artificial skin. The client understands postoperative care of artificial skin when he states that during the first 7 days after the procedure, he will restrict: A. range of motion. B protein intake. C going outdoors. D fluid ingestion.

A.

For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek's sign and Trousseau's sign because they indicate which of the following? A. Hypocalcemia B. Hypercalcemia C. Hypokalemia D. Hyperkalemia

A.

In a female client with burns on the legs, which nursing intervention helps prevent contractures? A.Applying knee splints BElevating the foot of the bed CHyperextending the client's palms DPerforming shoulder range-of-motion exercises

A.

Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication? A.Tetany B.Hemorrhage C.Thyroid storm D.Laryngeal nerve damage

A.

When caring for a male client with diabetes insipidus, nurse Juliet expects to administer: A.vasopressin (Pitressin Synthetic). Bfurosemide (Lasix). Cregular insulin. D10% dextrose

A.

Which nursing intervention can help a client maintain healthy skin? A.Keep the client well hydrated. BAvoid bathing the client with mild soap. CRemove adhesive tape quickly from the skin. DRecommend wearing tight-fitting clothes in hot weather.

A.

While in a skilled nursing facility, a male client contracted scabies, which is diagnosed the day after discharge. The client is living at her daughter's home, where six other persons are living. During her visit to the clinic, she asks a staff nurse, "What should my family do?" The most accurate response from the nurse is: A "All family members will need to be treated." B "If someone develops symptoms, tell him to see a physician right away." C "Just be careful not to share linens and towels with family members." D "After you're treated, family members won't be at risk for contracting scabies."

A.

Your patient has an adrenal tumor and is secreting large amounts of cortisol. The patient is not a surgical candidate. What medication may be prescribed? desmopressin hydrocortisone levothyroxine mitotane

mitotane

melatonin

which hormon is produced by this gland?

glucagon and insulin

which hormone is produced by this gland?

oxytocin, adh

which hormone is produced by this gland?

salt, sex, sugar

which hormone is produced by this gland?

ACTH, FSH, LH,GH etc

which hormone is produced by this gland? (actually ant not posterior as in pic)

testosterone

which hormones re produced by this gland?

What statement or statements are INCORRECT regarding Diabetic Ketoacidosis? A. DKA occurs mainly in Type 1 diabetics. B. Ketones are present in the urine in DKA. C. Cheyne-stokes breathing will always present in DKA. D. Severe hypoglycemia is a hallmark sign in DKA. E. Options C & D

e

Jemma, who weighs 210 lb (95 kg) and has been diagnosed with hyperglycemia tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client's hyperglycemia? A.Acromegaly BType 1 diabetes mellitus CHypothyroidism DDeficient growth hormone

A. Acromegaly, which is caused by a pituitary tumor that releases excessive growth hormone, is associated with hyperglycemia, hypertension, diaphoresis, peripheral neuropathy, and joint pain. Enlarged hands and feet are related to lateral bone growth, which is seen in adults with this disorder. The accompanying soft tissue swelling causes hoarseness and often sleep apnea. Type 1 diabetes is usually seen in children, and newly diagnosed persons are usually very ill and thin. Hypothyroidism isn't associated with hyperglycemia, nor is growth hormone deficiency.

Nurse Troy is aware that the most appropriate for a client with Addison's disease? A. Risk for infection B. Excessive fluid volume C. Urinary retention D.Hypothermia

A. Addison's disease decreases the production of all adrenal hormones, compromising the body's normal stress response and increasing the risk of infection. Other appropriate nursing diagnoses for a client with Addison's disease include Deficient fluid volume and Hyperthermia. Urinary retention isn't appropriate because Addison's disease causes polyuria.

Nurse Noemi administers glucagon to her diabetic client, then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon? A.Oral anticoagulants B. Anabolic steroids C.Beta-adrenergic blockers D. Thiazide diuretics

A.As a normal body protein, glucagon only interacts adversely with oral anticoagulants, increasing the anticoagulant effects. It doesn't interact adversely with anabolic steroids, beta-adrenergic blockers, or thiazide diuretics.

The insulin that has the most rapid onset of action would be: A.Lente B. Lispro C. Ultralente D. Humulin N

B

Albert, a 35-year-old insulin dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of: A. 1130 and 1330 B. 1330 and 1930 C. 1530 and 2130 D. 1730 and 2330

B.

According to the National Diabetes Statistics Report, diabetes remains as one of the leading causes of death in the United States since 2010. 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

A,B,D

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

A,B,D

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.

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 neede4. Regular insulin is used in an insulin pump. An external pump is not attached surgically to the pancreas.

After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr. Smith prescribes levothyroxine (Levothroid), 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent? A.Primary hypothyroidism B.Graves' disease C.Thyrotoxicosis D.Euthyroidism

A.Levothyroxine is the preferred agent to treat primary hypothyroidism and cretinism, although it also may be used to treat secondary hypothyroidism. It is contraindicated in Graves' disease and thyrotoxicosis because these conditions are forms of hyperthyroidism. Euthyroidism, a term used to describe normal thyroid function, wouldn't require any thyroid preparation.

Dr. Wijangco orders insulin lispro (Humalog) 10 units for Alicia, a client with diabetes mellitus. When will the nurse administer this medication? A.When the client is eating B.Thirty minutes before meals C. fifteen minutes before meals D. When the meal trays arrive on the floor

A.The onset action for the insulin lispro (Humalog) is 10 to 15 minutes so it must be given when the client is eating to prevent hypoglycemia. It must be given when the client is eating, not when the meal trays arrive on the floor and not thirty minutes before meals.

When planning care for a male client with burns on the upper torso, which nursing diagnosis should take the highest priority? A.Ineffective airway clearance related to edema of the respiratory passages B.Impaired physical mobility related to the disease process C.Disturbed sleep pattern related to facility environment D.Risk for infection related to breaks in the skin

A.When caring for a client with upper torso burns, the nurse's primary goal is to maintain respiratory integrity. Therefore, option A should take the highest priority. Option B isn't appropriate because burns aren't a disease. Option C and D may be appropriate, but don't command a higher priority than option A because they don't reflect immediately life-threatening problems.

Blood sugar is well controlled when Hemoglobin A1C is: A. Below 5.7% B. Between 12%-15% C. Less than 180 mg/dL D. Between 90 and 130 mg/dL

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.

When a client is in diabetic ketoacidosis, the insulin that would be administered is: A.Human NPH insulin B. Human regular insulin C. Insulin lispro injection D. Insulin glargine injection

B

The nurse recognizes that additional teaching is necessary when the client who is learning alternative site testing (AST) for glucose monitoring says: A. "I need to rub my forearm vigorously until warm before testing at this site." B. "The fingertip is preferred for glucose monitoring if hyperglycemia is suspected." C. "I have to make sure that my current glucose monitor can be used at an alternate site." D. "Alternate site testing is unsafe if I am experiencing a rapid change in glucose levels."

B

A female client whose physical findings suggest a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal hypophysectomy. The evening before the surgery, nurse Jacob reviews preoperative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize? A. "You must lie flat for 24 hours after surgery." B. "You must avoid coughing, sneezing, and blowing your nose." C. "You must restrict your fluid intake." D. "You must report ringing in your ears immediately."

B. After a transsphenoidal hypophysectomy, the client must refrain from coughing, sneezing, and blowing the nose for several days to avoid disturbing the surgical graft used to close the wound. The head of the bed must be elevated, not kept flat, to prevent tension or pressure on the suture line. Within 24 hours after a hypophysectomy, transient diabetes insipidus commonly occurs; this calls for increased, not restricted, fluid intake. Visual, not auditory, changes are a potential complication of hypophysectomy.

A client is taking NPH insulin daily every morning. The nurse instructs the client that the most likely time for a hypoglycemic reaction to occur is: A. 2-4 hours after administration B.6-14 hours after administration C. 16-18 hours after administration D. 18-24 hours after administration

B.NPH is intermediate acting insulin. The onset of action is 1-2 hours, it peaks in 6-14 hours, and it's duration of action is 24 hours. Hypoglycemic reactions most likely occur during peak time.

Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications? A.Tetanic contractions B. Neck vein distention C. Weight loss D.Polyuria

B.SIADH secretion causes antidiuretic hormone overproduction, which leads to fluid retention. Severe SIADH can cause such complications as vascular fluid overload, signaled by neck vein distention. This syndrome isn't associated with tetanic contractions. It may cause weight gain and fluid retention (secondary to oliguria).

Nurse Harry documents the presence of a scab on a client's deep wound. The nurse identifies this as which phase of wound healing? AInflammatory BMigratory CProliferative DMaturation

B.The scab formation is found in the migratory phase. It is accompanied by migration of epithelial cells, synthesis of scar tissue by fibroblasts, and development of new cells that grow across the wound. In the inflammatory phase, a blood clot forms, epidermis thickens, and an inflammatory reaction occurs in the subcutaneous tissue. During the proliferative phase, the actions of the migratory phase continue and intensify, and granulation tissue fills the wound. In the maturation phase, cells and vessels return to normal and the scab sloughs off.

A 39-year-old company driver presents with shakiness, sweating, anxiety, and palpitations and tells the nurse he has Type I Diabetes Mellitus. Which of the follow actions should the nurse do first? A. Inject 1 mg of glucagon subcutaneously. B. Administer 50 mL of 50% glucose I.V. C. Give 4 to 6 oz (118 to 177 mL) of orange juice. D. Give the client four to six glucose tablets.

Because the client is awake and complaining of symptoms, the nurse should first give him 15 grams of carbohydrate to treat hypoglycemia. This could be 4 to 6 oz of fruit juice, five to six hard candies such as Lifesavers, or 1 tablespoon of sugar. When a client has worsening symptoms of hypoglycemia or is unconscious, treatment includes 1 mg of glucagon subcutaneously or intramuscularly, or 50 mL of 50% glucose I.V. The nurse may also give two to three glucose tablets for a hypoglycemic reaction.

Joko has recently been diagnosed with Type I diabetes and asks Nurse Jessica for help formulating a nutrition plan. Which of the following recommendations would the nurse make to help the client increase calorie consumption to offset absorption problems? A. Eat small meals with two or three snacks throughout the day to keep blood glucose levels steady B. Increase consumption of simple carbohydrates C. Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals D. Skip meals to help lose weight

C.

Nurse Perry is caring for a female client with type 1 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer: A. I.M. or subcutaneous glucagon. B. I.V. bolus of dextrose 50%. C. 15 to 20 g of a fast-acting carbohydrate such as orange juice. D. 10 U of fast-acting insulin

C.

A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, nurse Sharmaine would be most accurate in stating: A "The test needs to be repeated following a 12-hour fast." B "It looks like you aren't following the prescribed diabetic diet." C. "It tells us about your sugar control for the last 3 months." D "Your insulin regimen needs to be altered significantly."

C.

Clients with type 1 diabetes may require which of the following changes to their daily routine during periods of infection? A No changes B Less insulin C. More insulin D Oral antidiabetic agents

C.

For a male client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume? A Cool, clammy skin B Distended neck veins C. Increased urine osmolarity D Decreased serum sodium level

C.

A male client comes to the physician's office for treatment of severe sunburn. The nurse takes this opportunity to discuss the importance of protecting the skin from the sun's damaging rays. Which instruction would best prevent skin damage? A."Minimize sun exposure from 1 to 4 p.m. when the sun is strongest." B."Use a sunscreen with a sun protection factor of 6 or higher." C."Apply sunscreen even on overcast days." D."When at the beach, sit in the shade to prevent sunburn."

C.Sunscreen should be applied even on overcast days, because the sun's rays are as damaging then as on sunny days. The sun is strongest from 10 a.m. to 2 p.m. (11 a.m. to 3 p.m. daylight saving time) — not from 1 to 4 p.m. Sun exposure should be minimized during these hours. The nurse should recommend sunscreen with a sun protection factor of at least 15. Sitting in the shade when at the beach doesn't guarantee protection against sunburn because sand, concrete, and water can reflect more than half the sun's rays onto the skin.

Insulin forces which of the following electrolytes out of the plasma and into the cells? A Calcium B Magnesium C Phosphorus D Potassium

D.

Addison's Disease is: A. Increased secretion of cortisol B. Increased secretion of aldosterone and cortisol C. Decreased secretion of cortisol D. Decreased secretion of aldosterone and cortisol

D.

Gary has diabetes type 2. Nurse Martha has taught him about the illness and evaluates learning has occurred when the client makes which statement? A. "My cells have increased their receptors, but there is enough insulin." B. "My peripheral cells have increased sensitivity to insulin." C. "My beta cells cannot produce enough insulin for my cells." D. "My cells cannot use the insulin my pancreas makes."

D.

Steven John has type 1 diabetes mellitus and receives insulin. Which laboratory test will the nurse assess? A.Potassium B.AST (aspartate aminotransferase) C.Serum amylase D.Sodium

Insulin causes potassium to move into the cell and may cause hypokalemia. There is no need to monitor the sodium, serum amylase, and AST levels.

. What cells are responsible for secreting catecholamines? A. Chromaffin B. Langerhans C. Enkephalin D. Parietal

a

A patient has excessive catecholamines in the urine. Which of the following signs and symptoms would the patient NOT exhibit? SELECT-ALL-THAT-APPLY: A. Tachycardia B. Anxiety C. Hypoglycemia D. Thermogenesis E. Decreased Basal Metabolic Rate

c,e