Endocrine

A patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage? Lispro (Humalog) Glargine (Lantus) Detemir (Levemir) NPH (Humulin N)

lispro. Rapid- or short-acting insulin is used for mealtime coverage for patients receiving intensive insulin therapy. NPH, glargine, or detemir will be used as the basal insulin.

A patient receives aspart (NovoLog) insulin at 8:00 AM. At which time would the nurse anticipate the highest risk for hypoglycemia? 10:00 AM 12:00 AM 2:00 PM 4:00 PM

10;00 am The rapid-acting insulins peak in 1 to 3 hours. The patient is not at a high risk for hypoglycemia at the other listed times, although hypoglycemia may occur.

Which nursing action is most important in assisting an older patient who has diabetes to engage in moderate daily exercise? a. Determine what types of activities the patient enjoys. b. Remind the patient that exercise improves self-esteem. c. Teach the patient about the effects of exercise on glucose level. d. Give the patient a list of activities that are moderate in intensity.

A. Because consistency with exercise is important, assessment for the types of exercise that the patient finds enjoyable is the most important action by the nurse in ensuring adherence to an exercise program. The other actions may be helpful but are not the most important in improving compliance.

A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient? a. Fasting blood glucose b. Glycosylated hemoglobin c. Oral glucose tolerance test d. Urine dipstick for glucose and ketones

B. The glycosylated hemoglobin (A1C) test shows the overall control of glucose over 90 to 120 days. A fasting blood level indicates only the glucose level at one time. Urine glucose testing is not an accurate reflection of blood glucose level and does not reflect the glucose over a prolonged time. Oral glucose tolerance testing is done to diagnose diabetes but is not used for monitoring glucose control after diabetes has been diagnosed.

Which laboratory value should the nurse review to determine whether a patient's hypothyroidism is caused by a problem with the anterior pituitary gland? a.) Thyroxine (T4) level b.) Triiodothyronine (T3) level c.) Thyroid-stimulating hormone (TSH) level d.) Thyrotropin-releasing hormone (TRH) level

C. rationale: A low TSH level indicates that the patient's hypothyroidism is caused by decreased anterior pituitary secretion of TSH. Low T3and T4 levels are not diagnostic of the primary cause of the hypothyroidism. TRH levels indicate the function of the hypothalamus.

Which question from the nurse during a patient interview will provide focused information about a possible thyroid disorder? a.) "What methods do you use to help cope with stress?" b.) "Have you experienced any blurring or double vision?" c.) "Have you had a recent unplanned weight gain or loss?" d.) "Do you have to get up at night to empty your bladder?"

C. rationale: Because thyroid function affects metabolic rate, changes in weight may indicate hyperfunction or hypofunction of the thyroid gland. Nocturia, visual difficulty, and changes in stress level are associated with other endocrine disorders.

A patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL. What should the nurse anticipate will be tested next? a.) Calcitonin b.) Catecholamine c.) Thyroid hormone d.) Parathyroid hormone

D. rationale: Parathyroid hormone (PTH) is the major controller of blood calcium levels. Although calcitonin secretion is a counter mechanism to PTH, it does not play a major role in calcium balance. Catecholamine and thyroid hormone levels do not affect serum calcium level.

Which question during the assessment of a patient who has diabetes will help the nurse identify autonomic neuropathy? a. "Do you feel bloated after eating?" b. "Have you seen any skin changes?" c. "Do you need to increase your insulin dosage when you are stressed?" d. "Have you noticed any painful new ulcerations or sores on your feet?"

a. Autonomic neuropathy can cause delayed gastric emptying, which results in a bloated feeling for the patient. The other questions are also appropriate to ask but would not help in identifying autonomic neuropathy.

The nurse is preparing to teach a 43-yr-old man who is newly diagnosed with type 2 diabetes about home management of the disease. Which action should the nurse take first? a. Assess the patient's perception of what it means to have diabetes. b. Ask the patient's family to participate in the diabetes education program. c. Demonstrate how to check glucose using capillary blood glucose monitoring. d. Discuss the need for the patient to actively participate in diabetes management.

a. Before planning teaching, the nurse should assess the patient's interest in and ability to self-manage the diabetes. After assessing the patient, the other nursing actions may be appropriate, but planning needs to be specific to each patient.

Which information will the nurse include in teaching a female patient who has peripheral arterial disease, type 2 diabetes, and sensory neuropathy of the feet and legs? a. Choose flat-soled leather shoes. b. Set heating pads on a low temperature. c. Use a callus remover for corns or calluses. d. Soak feet in warm water for an hour each day.

a. The patient is taught to avoid high heels and that leather shoes are preferred. The feet should be washed, but not soaked, in warm water daily. Heating pad use should be avoided. Commercial callus and corn removers should be avoided. The patient should see a specialist to treat these problems.

The nurse is caring for a patient during a water deprivation test. Which finding is most important for the nurse to communicate to the health care provider? a. the patient reports intense thrist. b. the patient has 5-lb weight loss c. The patient feels dizzy when sitting on the bed. d. The patient's urine osmolality does not increase.

b. A drop in the weight of more than 2 kg indicates severe dehydration, and the test should be discontinued. The other assessment data are not unusual with this test.

The nurse is caring for a patient with a possible pituitary tumor who is scheduled for a computed tomography scan with contrast. Which information about the patient is important to discuss with the health care provider before the test? a. Report of chronic headache b. History of renal insufficiency c. Recent bilateral visual field loss d. Blood glucose level of 134 mg/dL

b. Because contrast media may cause acute kidney injury in patients with poor renal function, the health care provider will need to prescribe therapies such as IV fluids to prevent this complication. The other findings are consistent with the patient's diagnosis of a pituitary tumor.

A patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which patient information is important for the nurse to communicate to the health care provider before the test? a. Bilateral poor peripheral vision b. Allergies to iodine and shellfish c. Recent weight loss of 20 pounds d. Patient reports ongoing headaches

b. Because the usual contrast media is iodine-based, the health care provider will need to know about the allergy before the CT scan. The other findings are common with any mass in the brain such as a pituitary adenoma.

which action should the nurse take after a patient treated with IM glucagon for hyperglycemia regains consciousness? a. Assess the patient for symptoms of hyperglycemia. b. Give the patient a snack of peanut butter and crackers. c. Have the patient drink a glass of orange juice or nonfat milk. d. Administer a continuous infusion of 5% dextrose for 24 hours.

b. Rebound hypoglycemia can occur after glucagon administration, but having a meal containing complex carbohydrates plus protein and fat will help prevent hypoglycemia. Orange juice and nonfat milk will elevate blood glucose rapidly, but the cheese and crackers will stabilize blood glucose. Administration of IV glucose might be used in patients who were unable to take in nutrition orally. The patient should be assessed for symptoms of hypoglycemia after glucagon administration.

Which action by the patient who is self-monitoring blood glucose indicates a need for additional teaching? a. Washes the puncture site using warm water and soap. b. Chooses a puncture site in the center of the finger pad. c. Hangs the arm down for a minute before puncturing the site. d. Says the result of 120 mg indicates good blood sugar control.

b. The patient is taught to choose a puncture site at the side of the finger pad because there are fewer nerve endings along the side of the finger pad. The other patient actions indicate that teaching has been effective.

What should the nurse teach a patient who is scheduled to complete a 24-hour urine collection for 17-ketosteroids? a.) To insert and maintain a retention catheter b.) To keep the specimen refrigerated or on ice c.) To drink at least 3 L of fluid during the 24 hours d.) To void and save the specimen to start the collection

b. The specimen must be kept on ice or refrigerated until the collection is finished. Voided or catheterized specimens are acceptable for the test. The initial voided specimen is discarded. There is no fluid intake requirement for the 24-hour collection.

A patient has been newly diagnosed with type 2 diabetes. Which information about the patient will be most useful to the nurse who is helping the patient develop strategies for successful adaptation to this disease? a.) Ideal weight b.) Value system c.) Activity level d.) Visual changes

b. When dealing with a patient with a chronic condition such as diabetes, identification of the patient's values and beliefs can assist the interprofessional team in choosing strategies for successful lifestyle change. The other information also will be useful but is not as important in developing an individualized plan for the necessary lifestyle changes.

Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is accurate? a. Insulin is not used to control blood glucose in patients with type 2 diabetes. b. Complications of type 2 diabetes are less serious than those of type 1 diabetes. c. Changes in diet and exercise may control blood glucose levels in type 2 diabetes. d. Type 2 diabetes is usually diagnosed when a patient is admitted in hyperglycemic coma.

c. For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve blood glucose control. Insulin is frequently used for type 2 diabetes, complications are equally severe as for type 1 diabetes, and type 2 diabetes is usually diagnosed with routine laboratory testing or after a patient develops complications such as frequent yeast infections.

A 26-yr-old female who has type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and reports a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. What should the nurse advise the patient to do? a. Use only the lispro insulin until the symptoms are resolved. b. Limit intake of calories until the glucose is less than 120 mg/dL. c. Monitor blood glucose every 4 hours and contact the clinic if it rises. d. Decrease carbohydrates until glycosylated hemoglobin is less than 7%.

c. Infection and other stressors increase blood glucose levels and the patient will need to test blood glucose frequently, treat elevations appropriately with lispro insulin, and call the health care provider if glucose levels continue to be elevated. Discontinuing the glargine will contribute to hyperglycemia and may lead to diabetic ketoacidosis (DKA). Decreasing carbohydrate or caloric intake is not appropriate because the patient will need more calories when ill. Glycosylated hemoglobin testing is not used to evaluate short-term alterations in blood glucose.

A patient is admitted with tetany. Which laboratory value should the nurse plan to monitor? a. Total protein b. Blood glucose c. Ionized calcium d. Serum phosphate

c. Tetany is associated with hypocalcemia.

The nurse has been teaching a patient with type 2 diabetes about managing blood glucose levels and taking glipizide (Glucotrol). Which patient statement indicates a need for additional teaching? a. "If I overeat at a meal, I will still take the usual dose of medication." b. "Other medications besides the Glucotrol may affect my blood sugar." c. "When I am ill, I may have to take insulin to control my blood sugar." d. "My diabetes won't cause complications because I don't need insulin."

d. The patient should understand that type 2 diabetes places the patient at risk for many complications and that good glucose control is as important when taking oral agents as when using insulin. The other statements are accurate and indicate good understanding of the use of glipizide.

Which additional information should the nurse consider when reviewing the laboratory results for a patient's total calcium level? a. The blood glucose b. The serum albumin c. The phosphate level d. The magnesium level

B. part of the total calcuim is bound to albumin, so hypoalbuminenia can lead go misinterpretation of calcuim levels. the other laboratory values will not affect ext calcuim interpretation

A patient seen in the emergency department for severe headache and acute confusion has a serum sodium level of 118 mEq/L. The nurse should anticipate the need for which diagnostic test? a.) Urinary 17-ketosteroids b.) Antidiuretic hormone level c.) Growth hormone stimulation test d.) Adrenocorticotropic hormone level

B. rationale: Elevated levels of antidiuretic hormone will cause water retention and decrease serum sodium levels. The other tests would not be helpful in determining the cause of the patient's hyponatremia.

During the physical examination, the nurse cannot feel the patient's thyroid gland. What action should the nurse take? a.)Palpate the patient's neck more deeply. b.)Document that the thyroid was nonpalpable. c.) Notify the health care provider immediately. d. Teach the patient about thyroid hormone testing.

B. rationale: The thyroid is usually nonpalpable. The nurse should simply document the finding. There is no need to notify the health care provider immediately about a normal finding. There is no indication for thyroid-stimulating hormone (TSH) testing unless there is evidence of thyroid dysfunction. Deep palpation of the neck is not appropriate.

A patient is taking spironolactone (Aldactone), a drug that blocks the action of aldosterone on the kidney, for hypertension. What additional effect of the medication should the nurse monitor? a.) Increased serum sodium b.) Decreased urinary output c.) Elevated serum potassium d.) Evidence of fluid overload

C. Because aldosterone increases the excretion of potassium, a medication that blocks aldosterone will tend to cause hyperkalemia. Aldosterone also promotes the reabsorption of sodium and water in the renal tubules, so spironolactone will tend to cause increased urine output, a decreased or normal serum sodium level, and signs of dehydration.

When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the health care provider prescribes prednisone. What should the nurse anticipate? a. The patient may need a diet higher in calories while receiving prednisone. b. The patient may develop acute hypoglycemia while taking the prednisone. c. The patient may require administration of insulin while taking prednisone. d. The patient may have rashes caused by metformin-prednisone interactions.

C. Glucose levels increase when patients are taking corticosteroids, and insulin may be required to control blood glucose. Hypoglycemia is not a side effect of prednisone. Rashes are not an adverse effect caused by taking metformin and prednisone simultaneously. The patient may have an increased appetite when taking prednisone but will not need a diet that is higher in calories.

The health care provider suspects the Somogyi effect in a 50-yr-old patient whose 6:00 AMblood glucose is 230 mg/dL. Which action will the nurse teach the patient to take? a. Avoid snacking right before bedtime. b. Increase the rapid-acting insulin dose. c. Check the blood glucose during the night. d. Administer a larger dose of long-acting insulin.

C. If the Somogyi effect is causing the patient's increased morning glucose level, the patient will experience hypoglycemia between 2:00 and 4:00 AM. The dose of insulin will be reduced, rather than increased. A bedtime snack is used to prevent hypoglycemic episodes during the night.

Which statement made by a 50-yr-old female patient indicates to the nurse that further assessment of thyroid function may be needed? a.) i am so thirsty that i drink all day long b.) i get up several times at night to urinate c.) i feel a lump in my throat when i swallow d.) i notice my breast are always tender lately

C. rationale: Difficulty in swallowing can occur with a goiter. Nocturia is associated with diseases such as diabetes, diabetes insipidus, or chronic kidney disease. Breast tenderness would occur with excessive gonadal hormone levels. Thirst is a sign of disease such as diabetes.

Which information about a patient who is scheduled for an oral glucose tolerance test should the nurse consider in interpreting the test results? a. The patient reports having occasional orthostatic dizziness. b. The patient takes oral corticosteroids for rheumatoid arthritis. c. The patient has had a 10 pound weight gain in the last month. d. The patient drank several glasses of water an hour previously.

b. Corticosteroids can affect blood glucose results.

An unresponsive patient who has type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemia syndrome (HHS). What should the nurse anticipate doing? a. Giving 50% dextrose b. Inserting an IV catheter c. Initiating O2 by nasal cannula d. Administering glargine (Lantus) insulin

b. HHS is initially treated with large volumes of IV fluids to correct hypovolemia. Regular insulin is administered, not a long-acting insulin. There is no indication that the patient requires O2. Dextrose solutions will increase the patient's blood glucose and would be contraindicated.

A registered nurse (RN) is caring for a patient with a goiter and possible hyperthyroidism. Which action by the RN indicates that the charge nurse needs to provide the RN with additional teaching? a. The RN checks the blood pressure in both arms. b. The RN palpates the neck to assess thyroid size. c. The RN orders saline eyedrops to lubricate the patient's bulging eyes. d. The RN lowers the thermostat to decrease the temperature in the room.

b. Palpation can cause the release of thyroid hormones in a patient with an enlarged thyroid and should be avoided. The other actions by the new RN are appropriate when caring for a patient with an enlarged thyroid.

a hospitalzied patient who is diabetic recieved 38 u nph insulin at 7 am. at 1 pm the patient has been away from the nursing unit for 2 hours, missing the lunch delivery awaiting a chest x ray. what is the best action by the nurse to prevent hypoglycemia? a. Plan to discontinue the evening dose of insulin. b. Save the lunch tray for the patient's later return. c. Request that if testing is further delayed, the patient will eat lunch first. d. Send a glass of orange juice to the patient in the diagnostic testing area.

c. Consistency for mealtimes assists with regulation of blood glucose, so the best option is for the patient to have lunch at the usual time. Waiting to eat until after the procedure is likely to cause hypoglycemia. Holding the insulin dose later will not prevent hypoglycemia form the peak of the NPH dose. A glass of juice will keep the patient from becoming hypoglycemic but will cause a rapid rise in blood glucose because of the rapid absorption of the simple carbohydrate in these items.

In preparation for which test should the nurse teach the patient to minimize physical and emotional stress? a.) A water deprivation test b.) A test for serum T3 and T4 levels c.) A 24-hour urine test for free cortisol d.) A radioactive iodine (I-131) uptake test

c. Physical and emotional stress can affect the results of the free cortisol test. Stress does not impact the other tests.

patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). What should the nurse plan to teach the patient? a.) Self-monitoring of blood glucose b.) Using low doses of regular insulin c.) lifestyle changes to lower bp d.) effects of oral hypoglycemic medications

c. The patient's impaired fasting glucose indicates prediabetes, and the patient should be counseled about lifestyle changes to prevent the development of type 2 diabetes. The patient with prediabetes does not require insulin or oral hypoglycemics for glucose control and does not need to self-monitor blood glucose.

The nurse is assessing a 22-yr-old patient experiencing the onset of symptoms of type 1 diabetes. To which question would the nurse anticipate a positive response? a. "Are you anorexic?" b. "Is your urine dark colored?" c. "Have you lost weight lately?" d. "Do you crave sugary drinks?"

c. Weight loss occurs because the body is no longer able to absorb glucose and starts to break down protein and fat for energy. The patient is thirsty but does not necessarily crave sugar-containing fluids. Increased appetite is a classic symptom of type 1 diabetes. With the classic symptom of polyuria, urine will be very dilute.

Which finding indicates a need to contact the health care provider before the nurse administers metformin (Glucophage)? a. the patient blood glucose level is 174/dl b. the patient is scheduled for a chest xray the next day c. The patient has gained 2 lb (0.9 kg) in the past 24 hours.d. d. The patient's estimated glomerular filtration rate is 42 mL/min.

d. The glomerular filtration rate indicates possible renal impairment, and metformin should not be used in patients with significant renal impairment. The other findings are not contraindications to the use of metformin.

A 28-yr-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching? a. The patient always carries hard candies when engaging in exercise. b. The patient goes for a vigorous walk when his glucose is 200 mg/dL. c. The patient has a peanut butter sandwich before going for a bicycle ride. d. The patient increases daily exercise when ketones are present in the urine.

d. When the patient is ketotic, exercise may result in an increase in blood glucose level. Patients with type 1 diabetes should be taught to avoid exercise when ketosis is present. The other statements are correct.

The nurse is assessing a 55-yr-old female patient with type 2 diabetes who has a body mass index (BMI) of 31 kg/m2.Which goal in the plan of care is most important for this patient? a. The patient will reach a glycosylated hemoglobin level of less than 7%. b. The patient will follow a diet and exercise plan that results in weight loss. c. The patient will choose a diet that distributes calories throughout the day. d. The patient will state the reasons for eliminating simple sugars in the diet.

A. The complications of diabetes are related to elevated blood glucose and the most important patient outcome is the reduction of glucose to near-normal levels. A BMI of 30.9/kg/m2 or above is considered obese, so the other outcomes are appropriate but are not as high in priority.

Which patient action indicates accurate understanding of the nurse's teaching about administration of aspart (NovoLog) insulin? a. The patient avoids injecting the insulin into the upper abdominal area. b. The patient cleans the skin with soap and water before insulin administration. c. The patient stores the insulin in the freezer after administering the prescribed dose. d. The patient pushes the plunger down while removing the syringe from the injection site.

B. Cleaning the skin with soap and water is acceptable. Insulin should not be frozen. The patient should leave the syringe in place for about 5 seconds after injection to be sure that all the insulin has been injected. the upper abdominal area is one of the preffered areas for insulin injection

What information will a review of a patient's glycosylated hemoglobin (A1C) results provide to the nurse? a.) Fasting preprandial glucose levels b.) Glucose levels 2 hours after a meal c.) Glucose control over the past 90 days d.) Hypoglycemic episodes in the past 3 months

C. rationale: Glycosylated hemoglobin testing measures glucose control over the last 3 months. Glucose testing before/after a meal or random testing may reveal impaired glucose tolerance and indicate prediabetes, but it is not done on patients who already have a diagnosis of diabetes. There is no test to evaluate for hypoglycemic episodes in the past.

A patient is scheduled in the outpatient clinic for blood cortisol testing. Which instruction should the nurse provide? a.) "Avoid adding any salt to your foods for 24 hours before the test." b.) "You will need to lie down for 30 minutes before the blood is drawn." c.) "Come to the laboratory to have the blood drawn early in the morning." d.) "Do not have anything to eat or drink before the blood test is obtained."

C. rationale: cortisol levels are usually drawn in the morning, when levels are highest. the other instructions would be given to patients who were having other endocrine testing

A young adult patient who is being seen in the clinic has excessive secretion of the anterior pituitary hormones. Which laboratory test result should the nurse expect? a.) Increased urinary cortisol b.) Decreased serum thyroxine c.) Elevated serum aldosterone d.) Low urinary catecholamines

A. rationale: Increased secretion of adrenocorticotropic hormone (ACTH) by the anterior pituitary gland will lead to an increase in serum and urinary cortisol levels. An increase, rather than a decrease, in thyroxine level would be expected with increased secretion of thyroid-stimulating hormone (TSH) by the anterior pituitary. The anterior pituitary does not control aldosterone and catecholamine levels.

Which statement by the patient who has newly diagnosed type 1 diabetes indicates a need for additional instruction from the nurse? a. "I will need a bedtime snack because I take an evening dose of NPH insulin." b. "I can choose any foods, as long as I use enough insulin to cover the calories." c. "I can have an occasional beverage with alcohol if I include it in my meal plan." d. "I will eat something at meal times to prevent hypoglycemia, even if I am not hungry."

B. Most patients with type 1 diabetes need to plan diet choices very carefully. Patients who are using intensified insulin therapy have considerable flexibility in diet choices but still should restrict dietary intake of items such as fat, protein, and alcohol. The other patient statements are correct and indicate good understanding of the diet instruction.

Which patient statement to the nurse indicates a need for additional instruction in administering insulin? a. "I can buy the 0.5-mL syringes because the line markings are easier to see." b. "I need to rotate injection sites among my arms, legs, and abdomen each day." c. "I do not need to aspirate the plunger to check for blood before injecting insulin." d. "I should draw up the regular insulin first, after injecting air into the NPH bottle."

B. Rotating sites is no longer recommended because there is more consistent insulin absorption when the same site is used consistently. The other patient statements are accurate and indicate that no additional instruction is needed.

A patient who has type 1 diabetes plans to swim laps for an hour daily at 1:00 PM. What advice should the clinic nurse plan to give the patient? a. Increase the morning dose of NPH insulin (Novolin N). b. Check glucose level before, during, and after swimming. c. Time the morning insulin injection to peak while swimming. d. Delay eating the noon meal until after finishing the swimming.

B. The change in exercise will affect blood glucose, and the patient will need to monitor glucose carefully to determine the need for changes in diet and insulin administration. Because exercise tends to decrease blood glucose, patients are advised to eat before exercising. Increasing the morning NPH or timing the insulin to peak during exercise may lead to hypoglycemia, especially with the increased exercise.

Which information will the nurse include when teaching a patient who has type 2 diabetes about glyburide? a. Glyburide decreases glucagon secretion from the pancreas. b. Glyburide stimulates insulin production and release from the pancreas. c. Glyburide should be taken even if the morning blood glucose level is low. d. Glyburide should not be used for 48 hours after receiving IV contrast media.

B. The sulfonylureas stimulate the production and release of insulin from the pancreas. If the glucose level is low, the patient should contact the health care provider before taking glyburide because hypoglycemia can occur with this class of medication. Metformin should be held for 48 hours after administration of IV contrast media, but this is not necessary for glyburide. Glyburide does not affect glucagon secretion.

An 18-yr-old male patient with small stature is scheduled for a growth hormone stimulation test. What should the nurse obtain in preparation for the test? a.) ice basin b.) glargine insulin c.) cardiac monitor d.) 50% dextorse solution

D. Hypoglycemia is induced during the growth hormone stimulation test, and the nurse should be ready to administer 50% dextrose immediately. Regular insulin is used to induce hypoglycemia. The patient does not need cardiac monitoring during the test. Although blood samples for some tests must be kept on ice, this is not true for the growth hormone stimulation test.

Which patient action indicates an accurate understanding of the nurse's teaching about the use of an insulin pump? a. The patient programs the pump for an insulin bolus after eating. b. The patient changes the location of the insertion site every week. c. The patient takes the pump off at bedtime and starts it again each morning. d. The patient plans a diet with more calories than usual when using the pump.

a. In addition to the basal rate of insulin infusion, the patient will adjust the pump to administer a bolus after each meal, with the dosage depending on the oral intake. The insertion site should be changed every 2 or 3 days. There is more flexibility in diet and exercise when an insulin pump is used, but it does not provide for consuming a higher calorie diet. The pump will deliver a basal insulin rate 24 hours a day.