exam 3

A client with type 1 diabetes mellitus must learn how to self-administer insulin. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction? "Rotate injection sites within the same anatomic region." "Administer insulin into sites near muscles that you plan to exercise." "Inject insulin into subcutaneous tissue with large blood vessels nearby." "Rotate injection sites among different regions."

"Rotate injection sites within the same anatomic region."

An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, (2.3 mmol/L) and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting 2 to 5 g of a simple carbohydrate. 15 g of a simple carbohydrate. 18 to 20 g of a simple carbohydrate. 25 to 30 g of a simple carbohydrate.

15 g of a simple carbohydrate.

A client has 4000 mL removed via paracentesis. When the nurse weighs the client after the procedure, how many kilograms is an expected weight loss? Record your answer in whole numbers.

4

A client has been hospitalized with pancreatitis for 3 days. The nurse assesses the client and documents the accompanying results. The nurse realizes these findings are a manifestation of what sign? "Periumbilical area appears discolored and ecchymotic" Trousseau's sign Chvostek's sign Broca's sign Cullen's sign

Cullen's sign

A client's fasting blood sugar (FBS) is 63 mg/dL (3.5 mmol/L) at 0700. The client is alert and oriented. What should the nurse do first? Give 15 g of carbohydrate and recheck the blood glucose in 15 minutes. Give one ampule of 50% dextrose via rapid I.V. infusion. Give the prescribed dose of insulin. Give the client a large glass of orange juice with two packages of sugar.

Give 15 g of carbohydrate and recheck the blood glucose in 15 minutes.

The nurse is developing a teaching plan for the client with hepatitis A. What should the nurse tell the client to do? Avoid contact with others and sleep in a separate room. Increase carbohydrates and protein in the diet. Intensify routine exercise and increase strength. Limit caloric intake and reduce weight.

Increase carbohydrates and protein in the diet.

The nurse is providing dietary teaching for a client with diabetes. Which statement about the diet would be accurate? It is planned around a wide variety of commonly available foods. It is based on nutritional requirements that are the same for all clients. It does not include processed foods because they have too many variables. It is rigidly controlled to avoid similar diabetic emergencies.

It is planned around a wide variety of commonly available foods.

A client with a well-managed ileostomy has sudden onset of abdominal cramps, vomiting, and watery discharge from the ileostomy. What should the nurse tell the client to do? Take an antiemetic. Use 30 mL of milk of magnesia daily. Notify the health care provider (HCP). Increase fluid intake to 3 L/day.

Notify the health care provider (HCP).

An adult client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the midepigastric region along with a rigid, board-like abdomen. After obtaining the client's vital signs, what should the nurse do next? Raise the head of the bed. Notify the health care provider. Prepare to insert a nasogastric tube. Administer pain medication as prescribed.

Notify the health care provider.

The nurse is preparing a client for an ileostomy. Two weeks before the surgery, what should the nurse instruct the client to do? Follow a low-residue diet. Stop taking drugs that will interfere with clotting. Report having a temperature above 99° F (37.2° C). Limit fluids to 1,000 ml/ day.

Stop taking drugs that will interfere with clotting.

A physician orders lactulose, 30 ml three times daily, for a client with cirrhosis to treat elevated serum ammonia level. The nurse will know that this medication is effective by which finding? The client would develop diarrhea. Abdominal swelling would decrease. The client will have an increase in urine output. The client's level of consciousness (LOC) would improve.

The client's level of consciousness (LOC) would improve.

The nurse is assessing a client who has been admitted with impaired arterial circulation in the lower extremities due to diabetes mellitus. What findings would be expected? capillary refill in the toes within 3 seconds absence of dorsalis pedis pulse, coolness, and decreased sensation in the feet edema and coolness in the ankles and feet redness, inflammation, and sharp pain with calf muscle contraction

absence of dorsalis pedis pulse, coolness, and decreased sensation in the feet

A client is admitted with inflammatory bowel syndrome (Crohn's disease). When planning care for the healthcare team, which would be included? Select all that apply. antidiarrheal medications high-protein milkshakes high-fiber diet corticosteroid therapy lactulose therapy

antidiarrheal medications corticosteroid therapy

A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client? blood glucose level 1,100 mg/dl (61.05 mmol/L) blood urea nitrogen (BUN) 15 mg/dl (0.82 mmol/L) arterial pH 7.25 plasma bicarbonate 12 mEq/L (12 mmol/L)

blood glucose level 1,100 mg/dl (61.05 mmol/L)

A client who has ulcerative colitis says to the nurse, "I can't take this anymore; I'm constantly in pain, and I can't leave my room because I need to stay by the toilet. I don't know how to deal with this." Based on these comments, what judgment should the nurse make about what the client is experiencing? extreme fatigue disturbed thought difficulty coping a sense of isolation

difficulty coping

A client tells the nurse that they have been working hard for the past 3 months to control the client's type 2 diabetes with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check serum fructosamine level. fasting blood glucose level. glycosylated hemoglobin level. urine glucose level.

glycosylated hemoglobin level.

A client has been placed on long-term sulfasalazine therapy for treatment of ulcerative colitis. The nurse should encourage the client to eat which foods to help avoid the nutrient deficiencies that may develop as a result of this medication? eggs milk products green, leafy vegetables citrus fruits

green, leafy vegetables

A client with cirrhosis begins to develop ascites. Spironolactone is prescribed to treat the ascites. The nurse should monitor the client closely for which drug-related adverse effect? constipation irregular pulse dysuria hyperkalemia

hyperkalemia

A client has just returned from surgery for a gastrectomy. The nurse should position the client in which position? right or left Sims' prone supine low Fowler's

low Fowler's

What would be the priority treatment of a client who has reported severe lower right quadrant pain that has now resolved? modification of pain management strategies referral for dietary revision initiation of antibiotic therapy preparation for emergency surgery

preparation for emergency surgery

The nurse is irrigating a client's colostomy. The client has abdominal cramping after receiving about 100 mL of the irrigating solution. The nurse should first: massage the abdomen gently. remove the irrigation tube. stop the flow of solution. reposition the client on to the right side.

stop the flow of solution.

A client has a suspected slow gastrointestinal bleed. Because of this, the nurse specifically instructs the unlicensed assistive personnel to look for and report which symptom? jaundice tarry stools hypotension bright red blood in the stools

tarry stools

As the nurse administers a tap water enema, the client begins to have abdominal cramping. The nurse should first: tell the client to hold the breath and continue infusing the enema. turn the client onto the back and continue infusing the enema. temporarily stop the infusion until the cramping subsides. stop infusing the enema and allow the client to evacuate the fluid.

temporarily stop the infusion until the cramping subsides.

Which is an appropriate nursing goal for the client who has ulcerative colitis? The client: uses a heating pad to decrease abdominal cramping. maintains a daily record of intake and output. verbalizes the importance of small, frequent feedings. accepts that a colostomy is inevitable at some time in his life.

verbalizes the importance of small, frequent feedings.

Two days following a colon resection, an elderly client shows new onset of confusion. When contacting the health care provider, the nurse should make which recommendation? "Shall I collect and send a urine sample for culture and sensitivity?" "May we have a prescription for restraining this client?" "Do you want to request a computed tomography scan to rule out stroke?" "Would you like a stat potassium level done?"

"Shall I collect and send a urine sample for culture and sensitivity?"

The client with type 1 diabetes mellitus is taught to take isophane insulin suspension NPH at 1700 each day. The client should be instructed that the greatest risk of hypoglycemia will occur at about what time? 0100, while sleeping. 1100, shortly before lunch. 1300, shortly after lunch. 1800, shortly after dinner.

0100, while sleeping.

A client with extreme weakness, pallor, weak peripheral pulses, and disorientation is admitted to the emergency department. The client's partner reports that the client has been "spitting up blood." A Mallory-Weiss tear is suspected, and the nurse begins taking a client history from the client's partner. The question by the nurse that demonstrates the nurse's understanding of Mallory-Weiss tearing is "Has your partner recently fallen or injured their chest?" "Is your partner being treated for tuberculosis?" "What spices and condiments does your partner use on food?" "Has your partner had recent forceful vomiting?"

"Has your partner had recent forceful vomiting?"

The nurse finds the client who has had an ileostomy crying. The client explains to the nurse, "I'm upset because I know I won't be able to have children now that I have an ileostomy." Which response by the nurse is best? "Many women with ileostomies decide to adopt. . Perhaps you could consider that option?" "I can understand your reasons for being upset. Having children must be important to you." "Having an ileostomy doesn't necessarily mean that you can't bear children. Let's talk about your concerns." "I'm sure you will adjust to this situation with time. Try not to be too upset."

"Having an ileostomy doesn't necessarily mean that you can't bear children. Let's talk about your concerns."

Which combination of adverse effects should a nurse monitor for when administering I.V. insulin to a client with diabetic ketoacidosis? hypocalcemia and hyperkalemia hypernatremia and hypercalcemia hypokalemia and hypoglycemia hyperkalemia and hyperglycemia

hypokalemia and hypoglycemia

A nurse is caring for a client with active upper GI bleeding. What is the appropriate diet for this client during the first 24 hours after admission? increased dairy products nothing by mouth iron-rich diet ice chips only

nothing by mouth

A client with diabetes who takes insulin has a blood glucose level of 40 mg/dL (2.27 mmol/L). What should the nurse offer the client to begin to raise the blood glucose level? Select all that apply. one slice of bread one-half cup (120 mL) of orange juice one-half cup (120 mL) of regular soda one cup (240 mL) of milk one tablespoon (15 mL) of peanut butter one-quarter cup (60 mL) of tuna

one-half cup (120 mL) of orange juice one cup (240 mL) of milk one slice of bread one-half cup (120 mL) of regular soda

Capillary glucose monitoring is being performed every 4 hours for a client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m. (1400), the client has a capillary glucose level of 250 mg/dl for which the client receives 8 units of regular insulin. The nurse should expect the dose's onset to be at 2:15 p.m. (1415) and its peak to be at 3 p.m.(1500). onset to be at 2:30 p.m. (1430) and its peak to be at 4 p.m.(1600). onset to be at 4 p.m. (1600) and its peak to be at 6 p.m.(1800). onset to be at 2 p.m. (1400) and its peak to be at 3 p.m.(1500).

onset to be at 2:30 p.m. (1430) and its peak to be at 4 p.m.(1600).

Which nursing action is most appropriate for a client hospitalized with acute pancreatitis? keeping the client supine to increase comfort limiting I.V. fluids, as ordered, to decrease cardiac workload withholding all oral intake, as ordered, to decrease pancreatic secretions administering oral pain medications, as ordered, to relieve severe pain

withholding all oral intake, as ordered, to decrease pancreatic secretions

A client has been taking prescribed aspirin in large doses and reports having stomach irritation, sometimes with vomiting. Which food or beverage noted from the client's diet history should the nurse suggest the client avoid? glass of wine scrambled eggs dry toast sweetened tea

glass of wine

A client with cirrhosis of the liver is in the hospital. The nurse involves the client in developing a plan of care. What would be important aspects to include in this plan? discussing collaborative goals and involving the client in identifying and prioritizing important interventions informing the client of the extent of damage to the liver and drawing up a contract to start the rehabilitative process identifying the potential and actual problems, informing the client about options, and arranging for the client to attend Alcoholics Anonymous identifying nursing goals and explaining the importance of following these goals

discussing collaborative goals and involving the client in identifying and prioritizing important interventions