Med Surg Final

A client is evaluated for type 1 diabetes. Which client comment correlates best with this disorder?

"I'm thirsty all the time. I just can't get enough to drink."

The nurse is preparing a client for a neurological examination by the physician and explains tests the physician will be doing, including the Romberg test. The client asks the purpose of this particular test. The correct reply by the nurse is which of the following?

"It is a test for balance."

A nurse is preparing a client for lumbar puncture. The client has heard about post-lumbar puncture headaches and asks how to avoid having one. The nurse tells the client that these headches can be avoided by doing which of the following after the procedure?

"Remain prone for 2 to 3 hours."

A nurse is caring for a client with diabetes mellitus. The client has a blood glucose level of 40 mg/dL. Which of the following rapidly absorbed carbohydrate would be most effective?

1/2 cup fruit juice or regular soft drink

A nurse is caring for a client with lower back pain who is scheduled for myelography using metrizamide (a water-soluble contrast dye). After the test, the nurse should place the client in which position?

Head of the bed elevated 45 degrees

A physician orders blood glucose levels every 4 hours for a 4-year-old child with brittle type 1 diabetes. The parents are worried that drawing so much blood will traumatize their child. How can the nurse best reassure the parents?

"Your child will need less blood work as his glucose levels stabilize."

Which of the following values is a normal intracranial pressure in mm Hg?

12 (normal is from 10-15)

A nurse is teaching a client with diabetes mellitus about self-management of his condition. The nurse should instruct the client to administer 1 unit of insulin for every:

15 g of carbohydrates.

A health care provider prescribes short-acting insulin for a patient, instructing the patient to take the insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R, taken at 6:30 AM will reach peak effectiveness by:

8:30 AM.

Which of the following is true regarding gestational diabetes?

A glucose challenge test should be performed between 24 to 28 weeks.

A patient is brought to the emergency department with a possible stroke. What initial diagnostic test for a stroke, usually performed in the emergency department, would the nurse prepare the patient for?

Noncontrast computed tomogram

Which of the following medications is considered a glitazone?

Actos

A client is transferred to the intensive care unit after evacuation of a subdural hematoma. Which nursing intervention reduces the client's risk of increased intracranial pressure (ICP)?

Administering a stool softener as ordered

The school nurse notes a 6-year-old running across the playground with his friends. The child stops in midstride, freezing for a few seconds. Then the child resumes his progress across the playground. The school nurse suspects what in this child?

An absence seizure

The nurse is caring for a client with a significant allergy history to various medications and shellfish. Because the client needs to have a diagnostic study with contrast, which medication classification is anticipated?

Antihistamine

Which of the following terms refers to the inability to coordinate muscle movements, resulting difficulty walking?

Ataxia

A child is brought into the emergency department with vomiting, drowsiness, and blowing respirations. The father reports that the symptoms have been progressing throughout the day. The nurse suspects diabetic ketoacidosis (DKA). Which action should the nurse take first in the management of DKA?

Begin fluid replacements.

The nurse is performing an assessment of cranial nerve function and asks the patient to cover one nostril at a time to see if the patient can smell coffee, alcohol, and mint. The patient is unable to smell any of the odors. The nurse is aware that the patient has a dysfunction of which cranial nerve?

CN I

The NP worked with a registered dietician to customize an 1800 caloric diabetic diet for 53 y/o man with special dietary needs? Which of the following percent distribution of calories should be provided?

Carbohydrates 50%, fat 25%, and protein 20%

Which of the following would be inconsistent as a cause of DKA?

Competency in injecting insulin

If a patient has a lower motor neuron lesion, the nurse would expect which of the following upon physical assessment?

Decreased muscle tone

A client with long-standing type 1 diabetes is admitted to the hospital with unstable angina pectoris. After the client's condition stabilizes, the nurse evaluates the diabetes management regimen. The nurse learns that the client sees the physician every 4 weeks, injects insulin after breakfast and dinner, and measures blood glucose before breakfast and at bedtime. Consequently, the nurse should formulate a nursing diagnosis of:

Deficient knowledge (treatment regimen).

Low levels of the neurotransmitter serotonin lead to which of the following disease processes?

Depression

The nurse is caring for a patient with a history of transient ischemic attacks (TIAs) and moderate carotid stenosis who has undergone a carotid endarterectomy. Which of the following postoperative findings would cause the nurse the most concern?

Difficulty swallowing

The nurse is caring for a client hospitalized after a motor vehicle accident. The client has a comorbidity of Parkinson's disease. Why should the nurse closely monitor the condition and the drug regimen of a client with Parkinson's disease?

Drugs administered may cause a wide variety of adverse effects.

A nurse is caring for a client with deteriorating neurologic status. The nurse is performing an assessment at the beginning of the shift that reveals a falling blood pressure and heart rate, and the client makes no motor response to stimuli. Which documentation of neuromuscular status is most appropriate?

Flaccidity

Which of the following cerebral lobes is the largest and controls abstract thought?

Frontal

The nurse is educating the diabetic client on setting up a sick plan to manage blood glucose control during times of minor illness such as influenza. Which is the most important teaching item to include?

Increase frequency of glucose self-monitoring.

The nurse is caring for a client with Guillain-Barré syndrome. Which assessment finding would indicate the need for oral suctioning?

Increased pulse rate, adventitious breath sounds

A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia?

Increased urine output

The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action?

It enhances transport of glucose across the cell wall

A nurse is preparing to administer an antiseizure medication to a client. Which of the following is an appropriate antiseizure medication?

Lamictal

A nurse is assisting during a lumbar puncture. How should the nurse position the client for this procedure?

Lateral recumbent, with chin resting on flexed knees

The nurse is caring for a patient diagnosed with a hemorrhagic stroke. The nurse recognizes that which of the following interventions is most important?

Maintaining a patent airway

A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?

Metformin

A patient is admitted to a specialty care unit with a diagnosis of an upper motor neuron lesion. The nurse assesses the patient and documents the presence of:

Muscle spasticity.

The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer?

NPH

A nurse is completing a neurological assessment and determines that the client has significant visual deficits. A brain tumor is considered. Considering the functions of the lobes of the brain, which area will most likely contain the neurologic deficit?

Occipital

A nurse conducts the Romberg test on a patient by asking the patient to stand with feet close together and eyes closed. As a result of this posture, the patient suddenly sways to one side and is about to fall when the nurse intervenes and saves the patient from being injured. In which of the following ways should the patient's action be interpreted by the nurse?

Positive Romberg test, indicating a problem with equilibrium

Lispro (Humalog) is an example of which type of insulin?

Rapid-acting

A client is admitted to the unit with diabetic keto acidosis (DKA). Which insulin would the nurse expect to administer intravenously?

Regular

A patient with neurological infection develops cerebral edema from syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following is an important nursing action for this patient?

Restricting fluid intake and hydration

A patient has been newly diagnosed with type 2 diabetes, and the nurse is assisting with the development of a meal plan. What step should be taken into consideration prior to making the meal plan?

Reviewing the patient's diet history to identify eating habits and lifestyle and cultural eating patterns

The nurse is caring for a patient having a hemorrhagic stroke. What position in the bed will the nurse maintain this patient?

Semi-Fowler's

Laboratory studies indicate a client's blood glucose level is 185 mg/dl. Two hours have passed since the client ate breakfast. Which test would yield the most conclusive diagnostic information about the client's glucose use?

Serum glycosylated hemoglobin (Hb A1c)

A client with diabetes mellitus is receiving an oral antidiabetic agent. Which of the following aspects should the nurse observe when caring for this client?

Signs of hypoglycemia

A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia?

Sweating, tremors, and tachycardia

A male client, aged 42 years, is diagnosed with diabetes mellitus. He visits the gym regularly and is a vegetarian. Which of the following factors is important when assessing the client?

The client's consumption of carbohydrates

The pancreas continues to release a small amount of basal insulin overnight, while a person is sleeping. The nurse knows that, if the body needs more sugar:

The pancreatic hormone glucagon will stimulate the liver to release stored glucose.

A nurse is preparing to administer two types of insulin to a client with diabetes mellitus. Which of the following demonstrates that the nurse understands the correct procedure for preparing this medication?

The short-acting insulin is withdrawn before the intermediate-acting insulin.

A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason?

Underlying problem of insulin resistance

A patient is scheduled for standard EEG testing to evaluate a possible seizure disorder. Nursing interventions prior to the procedure include which of the following?

Withholding antiseizure medications for 24 to 48 hours prior to the exam

A nurse is providing dietary instructions to a client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:

consuming a low-carbohydrate, high-protein diet and avoiding fasting.

Lower motor neuron lesions cause

flaccid muscle paralysis.

A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? (Select all that apply.)

• Little endogenous insulin • Younger than 30 years of age • Ketosis-prone