Week 12 NCLEX Practice Questions

A nurse is teaching the diabetic patient about insulin therapy. Which statement by the patient indicates the teaching was effective? "I will take my long-acting insulin before a meal." "If I am not going to eat right away, it is okay to take my short-acting insulin anyway." "I need to rotate the site I use to obtain blood for glucose monitoring." "I will monitor my blood sugar weekly."

"I need to rotate the site I use to obtain blood for glucose monitoring."

The postoperative craniotomy patient has a serum osmolality of 320 mOsm/L and urine output of 400 mL/h for the past 3 hours with a urine specific gravity of 1.003. Which treatment would the nurse anticipate the practitioner ordering for this patient? 1.5 mcg desmopressin acetate (DDAVP) subcutaneously every 12 hours Insulin drip at 7 units/h 0.9 NaCl at 150 mL/h intravenously Oral vasopressin 5 units every 12 hours

1.5 mcg desmopressin acetate (DDAVP) subcutaneously every 12 hours

Which laboratory finding would suggest a differential diagnosis of hyperosmolar hyperglycemic state (HHS)? Absence of serum ketones Serum glucose of 500 mg/dL Serum potassium of 3.4 mEg/L Serum osmolality of 350 mOsm/L

Absence of serum ketones

Which patient with a fasting blood sugar of 110 mg/dL has the highest risk for development of metabolic syndrome? Asian American man with a 30-inch waist, blood pressure of 130/60 mm Hg, triglycerides of 140, HDL of 45 African American woman with a 40-inch waist, blood pressure of 140/90 mm Hg, triglycerides of 180, and high-density lipoprotein (HDL) of 25 Hispanic American woman with a 34-inch waist, blood pressure of 130/50 mm Hg, triglycerides of 145, HDL of 40 Native American man with a 28-inch waist, blood pressure of 120/50 mm Hg, triglycerides of 130, HDL of 50

African American woman with a 40-inch waist, blood pressure of 140/90 mm Hg, triglycerides of 180, and high-density lipoprotein (HDL) of 25

The nurse is trying to decrease the temperature of the patient in thyroid storm. Which treatment should the nurse question? Cold packs to the groin and axilla Tepid water sponge bath Aspirin suppository Circulating fan at the bedside

Aspirin suppository

The stress of critical illness triggers the hypothalamic-pituitary axis (HPA). Which statement accurately reflects the results of this action? HPA activity continues to increase as illness-related stress progresses. Corticotropin (ACTH) is released from the anterior pituitary, stimulating the release of cortisol and resultant increase in fat and carbohydrate metabolism. Catecholamine release results in vasodilation and control of stress-induced hypertension. Secretion of antidiuretic hormone (ADH) is reduced to promote reabsorption of water and maintain circulating volume.

Corticotropin (ACTH) is released from the anterior pituitary, stimulating the release of cortisol and resultant increase in fat and carbohydrate metabolism.

A patient admitted with hyperglycemic hyperosmolar state (HHS). The admission blood glucose is 785 mg/dL. The patient is started on an insulin drip at 7 units/h at 9:00. A blood sugar check at 1000 yields a glucose level of 745 mg/dL. Which action would be appropriate at this time? Increase the insulin drip to 14 units/h and recheck her glucose in 1 hour. Leave the insulin drip at 7 units/h and recheck her glucose in 30 minutes. Leave the insulin drip at 7 units/h and recheck her glucose in 1 hour. Increase the insulin drip to 9 units/h and recheck her glucose in 1 hour.

Increase the insulin drip to 14 units/h and recheck her glucose in 1 hour.

An older female patient admitted with weight gain, depression, and cold intolerance has respiratory acidosis and hypoventilation. She is unarousable. Which treatment would the nurse anticipate the practitioner ordering for this patient? Sodium iodine 1 g IV every 12 hours Reserpine 1 mg every 24 hours Propranolol 1 mg IV every 4 hours Levothyroxine 100 mcg IV followed by 75 mg/day

Levothyroxine 100 mcg IV followed by 75 mg/day

Which clinical manifestations are indicative of thyroid storm? Hyperthermia, diarrhea, elevated TSH, and normal T3 and T4 Bradycardia, hypothermia, normal TSH, and elevated T3 and T4 Hypotension, elevated TSH and T4, and subnormal T3 Tachycardia, hyperthermia, subnormal TSH, and elevated T3 and T4

Tachycardia, hyperthermia, subnormal TSH, and elevated T3 and T4

The presence of hyperglycemia in critical illness is associated with an increased mortality rate. Which statement best describes the mechanism(s) responsible for increased glucose levels? The liver releases glucagon in response to the body's increased energy needs, resulting in gluconeogenesis. The pancreas decreases insulin production, resulting in increased glucose available to the tissues. Increased secretion of antidiuretic hormone (ADH) results in diuresis, causing increased glucose levels in the serum. The tissues are unable to use circulating glucose secondary to increased serum potassium levels.

The liver releases glucagon in response to the body's increased energy needs, resulting in gluconeogenesis