NUR 3320 Exam 2: Review Questions
A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse 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 •The glycosylated Hb test provides an objective measure of glycemic control over a 3-month period. •The test helps identify trends or practices that impair glycemic control, and it doesn't require a fasting period before blood is drawn. •The nurse can't conclude that the result occurs from poor dietary management or inadequate insulin coverage.
The nurse is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus? A.antidiuretic hormone (ADH). B.thyroid stimulating hormone (TSH). C.Follicle stimulating hormone (FSH). D.luteinizing hormone (LH).
A •ADH is the hormone clients with diabetes insipidus lack. • • The client's TSH, FSH, and LH levels won't be affected.
When caring for a male client with diabetes insipidus, the nurse expects to administer: A.vasopressin (Pitressin Synthetic). B.Furosemide (Lasix). C.Regular insulin D.10% dextrose
A •Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin) production, the nurse should expect to administer synthetic vasopressin for hormone replacement therapy. •Furosemide, a diuretic, is contraindicated because a client with diabetes insipidus experiences polyuria. •Insulin and dextrose are used to treat diabetes mellitus and its complications, not diabetes insipidus.
The patient is prescribed 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 •The client should take glipizide twice a day, 30 minutes before a meal, because food decreases its absorption. •The drug doesn't cause hyponatremia and therefore doesn't necessitate monthly serum sodium measurement. •The client must continue to monitor the blood glucose level during glipizide therapy.
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 104° F, tachycardia, and extreme restlessness. What is the most likely cause of these signs? A.Diabetic ketoacidosis B. Thyroid crisis C.Hypoglycemia D.Tetany
B •Thyroid crisis usually occurs in the first 12 hours after thyroidectomy and causes exaggerated signs of hyperthyroidism, such as high fever, tachycardia, and extreme restlessness. •Diabetic ketoacidosis is more likely to produce polyuria, polydipsia, and polyphagia •Hypoglycemia to produce weakness, tremors, profuse perspiration, and hunger. •Tetany typically causes uncontrollable muscle spasms, stridor, cyanosis, and possibly asphyxia.
The nurse should expect a client with hypothyroidism to report which health concerns? A.Increased appetite and weight loss B.Puffiness of the face and hands C.Nervousness and tremors D.Thyroid gland swelling
B •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).
The nurse 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, course skin. C.Deposits of adipose tissue in the trunk and dorsocervical area. D.Weight gain in arms and legs.
C •Because of changes in fat distribution, adipose tissue accumulates in the trunk, face (moonface), and dorsocervical areas (buffalo hump). •Hypertension is caused by fluid retention. •Skin becomes thin and bruises easily because of a loss of collagen. •Muscle wasting causes muscle atrophy and thin extremities.
A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should the nurse recognize as an adverse drug reaction? A.Dysuria B.Leg cramps C.Tachycardia D.Blurred vision
C •Levothyroxine, a synthetic thyroid hormone, is given to a client with hypothyroidism to simulate the effects of thyroxine. •Adverse effects of this agent include tachycardia. •The other options aren't associated with levothyroxine.
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. The nurse 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 7 p.m.
C •Regular insulin, which is a short-acting insulin, has an onset of 30 to 60 minutes and a peak of 1-5 hours, duration 6-10 hours. •Because the nurse gave the insulin at 2 p.m., the expected onset would be from 2:30 p.m. to 3 p.m. and the peak from 4 p.m. to 6 p.m.
