Quiz 16 CV and DM

28. A nurse is reinforcing teaching with a client who has angina pectoris about starting therapy with nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching?

"I'll dial 911 if one tablet does not relieve my pain."

29. A nurse is caring for a client who is newly-admitted and has angina. The client asks the nurse, "Why am I taking nitroglycerin?" Which of the following responses should the nurse make?

"Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart."

16. The nurse is providing teaching to a patient with heart failure who has been prescribed nifedipine, a calcium channel blocker. Which statement by the nurse is accurate?

"This medication reduces the resistance your heart has to pump against."

30. A nurse is reinforcing teaching about warfarin with a client who has a new onset of atrial fibrillation. Which of the following statements should the nurse include in the teaching?

"Warfarin helps prevent strokes in clients who have atrial fibrillation."

10. A client with type 2 diabetes mellitus has been admitted for surgery, and the health care provider has placed the client on insulin in lieu of the current dose of metformin (Glucophage). The client wants to know the purpose of taking the insulin. What is the nurse's best response?

"Your body is under more stress, so you'll need insulin to ensure glycemic control."

13. Which of the following statements is true about insulin. Select all that apply.

-Insulin is administered subcutaneously. -Abdomen provides the fastest absorption. -Heat, massage and exercise increase absorption.

18. The nurse is providing teaching to a patient who will be discharged with oral warfarin sodium (Coumadin). The nurse informs the patient that he will need to undergo which regular blood tests? (Select all that apply.)

-PT (prothrombin). -INR (international normalized ratio).

9. A client with type 1 diabetes mellitus received regular insulin at 7:00 am. The client should be monitored for hypoglycemia at which time?

10:00 am.

25. A nurse is caring for a client who has hypertension and is to start taking atenolol. The nurse should instruct the client to monitor for which of the following findings as an adverse effect of this medication?

Bradycardia.

24. A nurse is assisting with care of a client who has a prescription for 3,000 mL of intravenous fluids over the next 24 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number)

125 mL/hr.

11. A nurse cares for a client who has diabetes mellitus. The nurse administers 6 units of regular insulin and 10 units of NPH insulin at 0800. At which time should the nurse assess the client for potential problems related to the NPH insulin?

1400.

23. ​A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client. What is the sequence of events the nurse should follow? (Move the steps of mixing insulin on the left into the box on the right, placing them in the selected order of performance. All steps must be used.)

1st. Inspect vials for contaminants. 2nd. Roll NPH vial between palms of hands. 3rd. Inject air into NPH insulin vial. ​4th. Inject air into regular insulin vial. 5th. Withdraw short-acting insulin into syringe. 6th. Add intermediate insulin to syringe.

19. A nurse is administering heparin, subcutaneous twice daily, to a patient in cardiogenic shock. What is the expected action of this drug?

Anticoagulant to prevent blood clots.

14. A patient has diabetes with hypertension and is admitted for frequent bouts of hypoglycemia. Which prescription drug might be causing the hypoglycemia?

Atenolol (Tenormin).

15. Just before breakfast, the nurse accidentally administers 4 units of insulin glargine (Lantus) instead of 4 units of insulin aspart (Novolog). The patient has type 2 diabetes. What are the possible consequences for this patient's blood glucose?

Blood glucose after breakfast will increase more than usual.

12. The nurse reads a physician's written order for a client with diabetes mellitus that states: "Give Regular insulin, 20 units, PO BID." What is the nurse's most appropriate response?

Call the physician to clarify the order, since you know that Regular insulin is made ineffective in the gastrointestinal tract and cannot be given PO.

27. A nurse is reviewing the laboratory results of a client who is taking a loop diuretic and notes the client's potassium level is 3.0 mEq/L. Which of the following physiological responses should the nurse expect related to the client's hypokalemia?

Cardiac dysrhythmias.

4. A client presents with diaphoresis, palpitations, jitters, and tachycardia approximately 1 ½ hours after taking his regular morning insulin. Which of the following treatment is appropriate for this client?

Check blood glucose level, and administer carbohydrates.

3. A nurse is caring for a client who has type 1 diabetes mellitus. The nurse misread the client's morning fasting blood glucose level as 210 mg/dL instead of 120 mg/dL and administered the insulin dose appropriate for a reading over 200 mg/dL. Which of the following actions should the nurse identify as the priority?

Check the client's blood glucose level.

17. A nurse should anticipate that a patient taking Vasotec, an angiotensin-converting enzyme (ACE) inhibitor, should have which positive outcome to this drug?

Decreased blood pressure.

22. A patient who has sustained a hemorrhagic stroke is placed on a protocol of 60 mg of calcium channel blocker (nimodipine) every 4 hours. The patient's pulse is 82 beats/min before the administration of the prescribed dose. Which action should the nurse implement?

Give the full dose as prescribed without further assessment.

2. A nurse is reinforcing teaching for a client who has type 2 diabetes mellitus and is prescribed glipizide. The client should be taught that glipizide works in which of the following ways?

Glipizide stimulates the pancreas to release adequate insulin.

21. A licensed practical nurse (LPN) is caring for a patient who is being treated with digoxin (Lanoxin). The nurse assesses the patient's apical pulse before administering a dose of the medication and finds that the rate is 58 beats per minute. What should be the INITIAL action by the nurse?

Hold the dose of the medication.

8. A 32-year-old client with diabetes mellitus is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using the mealtime coverage?

Lispro (Humalog).

20. An older adult patient with hypertension has been taking atenolol (Tenormin) for several weeks and reports feeling depressed. Which action is most appropriate for the nurse to take?

Notify the health care provider so that another drug may be substituted.

5. The nurse plans an evening snack of milk, crackers, and cheese for an average-sized client who is receiving Humulin N insulin. This snack provides:

Nourishment to counteract late insulin activity.

7. Which type of insulin is most appropriate when giving a diabetic client's insulin intravenously?

Regular insulin (Humulin R).

1. A nurse is collecting data from a client who has diabetes mellitus. The client is confused, flushed, and has an fruity odor on his breath. The nurse should anticipate a prescription for which of the following types of insulin to treat the client?

Regular.

26. A nurse is assisting with a presentation about caring for clients who are receiving diuretic therapy. The nurse should explain that which of the following medications can put clients at risk for hyperkalemia?

Spironolactone.

6. A 55-year-old client with type 2 diabetes is obese and hasn't been successful at controlling the condition by diet alone. The physician has prescribed sitaglipin (Januvia). The nurse knows that sitaglipin is commonly used for type 2 diabetes because it:

Stimulates the pancreas to secrete more insulin.