1052: diabetes
The nurse is assessing a client admitted with Addison's Disease. Assessment findings consist of generalized muscular weakness, hypotension, irritability, and hyperpigmentation of skin. Which lab values would the nurse expect to find? a. Hyperkalemia, hypercalcemia b. Hypokalemia, hypocalcemia c. Elevated cortisol level d. Elevated glucose level
a. hyperkalemia, hypercalcemia Addison's disease is a condition where there is not enough cortisol or aldosterone in the body. The client will have lab values reflecting hyperkalemia and hypercalcemia.
The nurse is preparing a teaching plan for a client with a new diagnosis of hypothyroidism and prescription for levothyroxine. Which adverse side effects will the nurse instruct the client? Select all that apply. a. Palpitations and/or racing heart b. Sudden weight loss c. Delirium d. Diarrhea e. Weight gain PREVSUBMITSKIP
a. palpitations and/or racing heart b. sudden weight loss e. weight gain
what is the phenomenon that between 4-6am, there is a release of hormones the impede the action of insulin, causing the liver to produce glucose, in turn raising the blood sugar? a. somogyi effect b. dawn phenomenon
b. dawn phenomenon
what percentage of calories should come from carbohydrates? a. 30% b. 40% c. 45% d. 50%
c. 45%
a patient comes into the emergency department after his daughter states that she has been unable to wake him. his vitals are as followed: HR: 134 BP: 174/109 T: 39.1 O2: 93% RA RR: 12 his daughter tells you that he recently had his thyroid removed. what condition do you suspect the doctor will diagnose the patient with? a. thyroid storm b. hypothyroidism c. rebound hyperthyroidism d. myxedema coma
a. thyroid storm thyroid storm is when the metabolic rate is extremely high, it becomes life threatening. it is a result of uncontrolled hyperthyroidism or thyroidectomy
insulin enhances the movement of which electrolyte into the cells from extracellular fluid? a. Ca+ b. K+ c. Na+ d. Ch-
b. K+
which of the following is a benefit of exercise? SELECT ALL THAT APPLY a. lowers blood pressure and cholesterol b. relieves stress c. improves circulation d. improves memory e. increases energy for daily activities f. can cure diabetes
a. lowers blood pressure and cholesterol b. relieves stress c. improves circulation e. increases energy for daily activities
Which will contribute to secondary hypoparathyroidism? a. Esophageal cancer b. Thyroidectomy c. Kidney failure d. Above the knee amputation
b. thyroidectomy Hypoparathyroidism is a condition where the body doesn't produce enough parathyroid hormone (PTH). Hypoparathyroidism can be caused by the complete removal of the thyroid, or thyroidectomy.
which of the following is not appropriate to give a conscious hypoglycemic patient? a. 2-4 glucose tablets b. 4-6 oz of fruit juice or regular soda c. 6-10 jolly ranchers d. 2-3 tsps of sugar or honey
c. 6-10 jolly ranchers you should give 6-10 lifesavers
a patient checks their preprandial goal. what should their BG be? a. no less than 80 b. between 100-130 c. between 80-130 d. between 120-130
c. between 80-130 preprandial goal is before meals
what should the patient's BG be after meals? a. over 100 b. between 100-120 c. between 120-180 d. over 180
d. over 180
the nurse is teaching the patient about dietary concerns regarding diabetes. which of the following statements would indicate that further teaching is needed? a. "because alcohol decreases glycogenesis, I need to watch for signs of hypoglycemia when drinking." b. "I should avoid non-nutritive sweeteners because they cause elevation in blood sugar" c. "just because a label says sugar free, doesn't mean it doesn't have any carbs" d. "when a label says fat-free, I need to pay attention to the amount of trans fats in the food"
b. "I should avoid non-nutritive sweeteners because they cause elevation in blood sugar" non-nutritive sweeteners have minimal to no calories, which in turn does not raise BG
when teaching a patient about exercise precautions, which of the following statements would indicate that further teaching is needed? a. "if my BG is under 100mg/dL, I will wait to exercise, eat 15-20 carbs, and reassess in 15 minutes" b. "I should exercise when my blood is high, as exercise lowers blood sugar" c. "resistance exercises is preferable for diabetics" d. "I should assess my BG after 15 minutes of exercising"
b. "I should exercise when my blood is high, as exercise lowers blood sugar" with hyperglycemia and presence of ketones, postpone exercise until BG is within normal limits and the urine is free of ketones
the nurse is providing education to the patient about hyperthyroidism. which of the following statements would indicate that the patient understands the teaching? a. "I shouldn't take my medication within 2 hours of any GI meds." b. "If I start to experience chest pain, or heat intolerance, I need to contact my HCP" c. "I should take this medication in the morning with food" d. "I can stop taking these meds as soon as my symptoms disappear"
b. "If I start to experience chest pain, or heat intolerance, I need to contact my HCP" tachycardia, chest pain, and heat intolerance are all signs of toxicity
The nurse is instructing a client with diabetes on foot care. Which instruction by the nurse is most appropriate to include? a. "You may go barefoot in familiar places." b. "Wear cotton socks and use foot powder to keep feet dry." c. "It is permissible to wear tight shoes for limited periods." d. "Trim the toenails with good scissors regularly."
b. "Wear cotton socks and use foot powder to keep feet dry." This answer is correct because clients with diabetes should be taught foot care so as to reduce complications associated with diabetic peripheral neuropathy and skin compromise of the foot. This will help reduce susceptibility to non-healing wounds and amputations. Foot care teaching for diabetics includes wearing cotton socks and use of foot powder to keep feet dry.
The nurse is alerted that dietary trays are going to be late to client rooms and will arrive at 0800 instead of 0730. The nurse plans to administer insulin aspart at 0800. What time should the nurse provide the morning meal? a. 750 b. 805 c. 830 d. 840
b. 0805 Insulin aspart is a rapid acting insulin (5 to 15 minutes). Therefore, it would be wise to provide a client's meal within 5 minutes of the administration of this insulin.
what percentage of calories should come from proteins? a. 10-15% b. 15-20% c. 20-25% d. 25-30%
b. 15-20%
if a patient has a meal with 30g of carbohydrate, how much insulin should be administered? a. 1 unit rapid acting insulin b. 2 units rapid acting insulin c. 2.5 units of rapid acting insulin d. 3 units of rapid acting insulin
b. 2 units of rapid acting insulin 12-15 grams = 1 unit of rapid acting insulin
A client who has had Addison's disease for 20 years and has been in the ICU following an event where he was found unconscious due to Addisonian crisis is being discharged home. Which discharge teaching is priority for the client? a. Showing the client how to daily check his blood pressure b. Explaining importance of wearing medical alert necklace c. Explaining the side effects of taking hydrocortisone d. Helping the client understand what Addison's disease is
b. Explaining importance of wearing medical alert necklace A client who has had Addison's disease for 10 years and was recently found unconscious from Addisonian crisis should be reminded about the importance of wearing medical alert jewelry. This helps emergency personnel be able to treat him immediately if found unable to communicate.
A nurse works in a walk-in clinic. What client is at a greater risk for the development of Type 2 diabetes? Select all that apply. a. Client with low blood pressure and heart rate b. Native Hawaiian client with family history of diabetes c. Client with polycystic ovary syndrome d. Client with body mass index of 22 e. A client with a high HDL level
b. Native Hawaiian client with family history of diabetes c. Client with polycystic ovary syndrome This answer is correct because being Native Hawaiian, Native American, Hispanic American, and non-Hispanic Black makes a client more susceptible. A family history of diabetes further increases the risk of developing diabetes. This answer is correct because clients with polycystic ovary syndrome (PCOS) are at risk for developing diabetes because of the hyperandrogenic effects and insulin resistance. Obesity in females with PCOS further increases the risks for diabetes.
which of the following are symptoms of moderate hypoglycemia? SELECT ALL THAT APPLY a. tremors b. slurred speech c. diplopia d. ALOC e. palpitations f. impaired coordination g. drowsiness
b. slurred speech c. diplopia f. impaired coordination g. drowsiness symptoms of moderate hypoglycemia include confusion, headache, vertigo, memory/concentration deficits, slurred speech, impaired coordination, emotional changes, irrational or combative behavior, diplopia, drowsiness
A nurse is instructing through Teach Back to a client learning how to perform self-blood glucose monitoring. The nurse evaluates the instruction and identifies the need for additional teaching because of which of the following client statements? a. "i will kepp a log of glucose results to monitor for trends" b. "i will try and maintain my glucose values around 110" c. "i will always wash my hands prior to puncturing the finger pad" d. "I will puncture my finger in the center of the finger pad"
d. "I will puncture my finger in the center of the finger pad" This answer is correct because the client does need further teaching since puncturing the finger pad in the center is not appropriate. The client should be taught that testing blood through a puncture to the middle of the finger pad is painful and may not have better blood flow compared to the site off-center. Rotating finger tips is also advised.
what percentage of calories should come from fats? a. 15-20% b. 20-30% c. 15-30% d. 20-35%
d. 20-35%
In planning the care for a client with Graves Disease, which nursing diagnosis will the nurse select? a. Alteration in Nutrition: More than body requirements related to hypometabolic state. b. Impaired gas exchange related to inability to perform activities of daily living without oxygen. c. Self Care deficit: Actual related to inability to bathe or dress self. d. Impaired tissue integrity: Corneal related to dryness secondary to exophthalmos.
d. Impaired tissue integrity: Corneal related to dryness secondary to exophthalmos. Exophthalmos is one of the cardinal signs of Graves' disease. Since the eye bulges anteriorly from the orbit of the eye, the client is at risk for dryness and corneal abrasions.
The nurse is discussing complications of diabetes with a client. Which condition is the most common microvascular complication associated with diabetes? a. Myocardial infarction b. Ketoacidosis c. Metabolic syndrome d. Diabetic retinopathy
d. diabetic retinopathy This answer is correct because diabetic retinopathy is the most common microvascular complication associated with diabetes and must be monitored closely. Diabetic retinopathy is a complication of uncontrolled blood glucose levels in the diabetic. Diabetic retinopathy is damage that occurs to the microvascular vessels within the retina. The retina is the light-sensitive tissue of the back of the eye. In the beginning, there may be no to little symptoms of diabetic retinopathy, but later blindness can occur. A dilated fundus examination every 6 months by an eye health care provider (HCP) is strongly encouraged for all diabetics to watch for changes in the retina.
which of the following is not a symptoms of myxedema coma? a. hypothermia b. bradycardia c. respiratory failure d. hypotension
d. hypotension
The nurse analyzes the laboratory results for thyroid function and notices elevation of thyroid stimulating hormone (TSH) and decreased free thyroxine index and T4. The nurse will expect medication which will treat which thyroid condition? a. Hyperthyroidism b. Hypophysectomy c. Graves' Disease d. Hypothyroidism
d. hypothyroidism Elevation of thyroid stimulating hormone (TSH) and decreased free thyroxine index and T4 indicate hypothyroidism. The elevation of TSH shows a need for thyroid hormone so the pituitary is producing more TSH to stimulate the thyroid to produce more hormone that it is lacking, namely free thyroxine and T4.
the nurse is providing instruction to a client on self-admistration of lispro (humalog) insulin. the nurse will stress which time frames to administer the injection of lispro insulin? a. inject lispro subcutaneous daily at noon b. inject lispro subcutaneous nightly prior to bedtime snack c. inject lispro subcutaneous 30 minutes prior to breakfast d. inject lispro subcutaneous 15 minutes prior to eating
d. inject lispro subcutaneous 15 minutes prior to eating This answer is correct because lispro is a fast-acting insulin that starts to work 15 minutes after being given. The insulin peaks in about an hour and continues to work for 2 to 4 hours. The client taking lispro should eat within 15 minutes of receiving lispro, otherwise, there is a risk of hypoglycemia.
what is the condition that describes a small, vascular tumor of the adrenal gland that causes irregular secretion of epinephrine and norepinephrine? a. hypothyroidism b. cushing syndrome c. grave's disease d. pheochromocytoma
d. pheochromocytoma
which of the following symptoms are only found in type I diabetes? SELECT ALL THAT APPLY a. polyuria b. polydipsia c. fatigue d. polyphagia e. slow healing cuts/bruises f. weight loss
d. polyphagia f. weight loss polyuria, polydipsia, and slow healing cuts/bruises are found in both type I and type II diabetes
a student is talking to her student nurse about diagnosing diabetes. which of the following statements from the student would indicate that further teaching is needed? a. "the fasting blood glucose level will be above 101mg/dL" b. "the patient's A1c will be above 6.5%" c. "the oral glucose tolerance test will be over 200 after 2 hours of fasting" d. "the patient's random plasma glucose test will be over 200mg/dL"
a. "the fasting blood glucose level will be above 101mg/dL" the blood glucose level for pre-diabetes is 101-125mg/dL. the blood glucose for diabetes is over 126mg/dL
A client with type 1 diabetes mellitus received an early AM dose of regular insulin per sliding scale. The client ate 20% of breakfast. The nurse returns at 1000 to assess the client. Which sign will the nurse observe for hypoglycemia? a. Rash b. Shakiness c. Polyuria d. Fruity acetone odor to breath
b. shakiness Hypoglycemia is low blood sugar levels. Symptoms include shakiness, nervousness, diaphoresis, irritability, tachycardia, dizziness, and hunger.
The nurse is caring for a client diagnosed with hypothyroidism secondary to Hashimoto's thyroiditis. After analyzing assessment data, the nurse will select which of the following nursing diagnoses? a. Activity intolerance related to weakness, fatigue, and slowed metabolism. b. Fluid volume deficit related to dehydration and poor skin turgor. c. Risk for insomnia related to hyperactive state. d. Risk for bleeding related to compromised immunologic status. PREVSUBMITSKIP
a. Activity intolerance related to weakness, fatigue, and slowed metabolism. Hashimoto's thyroiditis is an autoimmune condition where the immune system attacks the thyroid. Hypothyroidism secondary to Hashimoto's thyroiditis causes fatigue and weakness, related to a slowed metabolism, which may affect activity levels.
A client with Type 2 diabetes asks the nurse why insulin injections are necessary after surgery since only oral hypoglycemics are taken while at home. Which statement by the nurse best explains the likely cause for this short-term change in treatment? a. "Surgical procedures may alter normal glucose because of stress on the body." b. "Once insulin injections occur they might need to continue while at home." c. "Insulin must be given because the infusion solutions are heavily concentrated with sugars." d. "It is easier for the staff to manage blood sugars if insulin protocol is followed."
a. "Surgical procedures may alter normal glucose because of stress on the body." This answer is correct because a client with type 2 diabetes who does not generally use insulin therapy at home may need insulin while in the hospital or having surgical procedures. This is because stress from illness or surgery increases stress hormones, which elevate blood glucose levels. Anesthesia may also play a role in affecting blood glucose. Insulin administration postoperatively may be temporary and will not necessarily need to be continued at home.
the nurse is educating the patient about the importance of nutritional management. which of the following statements made by the patient would indicate that the teaching was effective? a. "I should aim to achieve optimal lipid levels by eating healthy foods" b. "tracking the amount of sugar that is in foods is the most effective way of adjusting my insulin levels" c. "My A1c levels will be under 6.5% as long as I maintain a good BG level throughout the night" d. "I can eat what I would normally eat as long as I give myself the right amount of insulin"
a. "I should aim to achieve optimal lipid levels by eating healthy foods"
The nurse is caring for a client with hypothyroidism who receives levothyroxine daily and is scheduled for a procedure under sedation. The nurse contacts the health care provider (HCP) because of the risk of adverse effects when administering which of the ordered medication? a. Benzodiazepine premedication b. Proton pump inhibitor premedication c. Diphenhydramine premedication d. Metoclopramide premedication
a. Benzodiazepine premedication Levothyroxine is a life-long therapy treatment for hypothyroidism. The benzodiazepine class of medication may increase sedation and respiratory depression when taken with levothyroxine.
The nurse receives a client from the recovery room after having a thyroidectomy. What most important interventions will the nurse perform during the next four hours? Select all that apply. a. Keep 10% calcium gluconate available b. Assess back of neck c. Have tracheostomy set-up nearby d. Ambulate within 4 hours e. Assess the client's respiratory rate and rhythm
a. Keep 10% calcium gluconate available b. Assess back of neck c. Have tracheostomy set-up nearby e. Assess the client's respiratory rate and rhythm The priority post-operative care for a client following a thyroidectomy includes assessing for bleeding at the back of the neck and keeping IV 10% calcium gluconate and tracheostomy supplies nearby.
A nurse is providing instruction with client demonstration on self-administration of insulin. Which of the following Teach Back actions will the nurse observe by the client? Select all that apply. a. Patient takes a vial and gently rotates it and states, "I will ensure that the insulin vial is never shaken." b. Patient describes where insulin will be stored, then states, " I will never freeze insulin." c. Patient looks at the hospital menu then states, " I can give myself more d. insulin, then eat anything I want." d. Patient performs mock injection site selection and states, "I will rotate sites." e. Patient states, "On days I am sick and cannot eat or am vomiting, I will skip my insulin so my blood sugar will not get too low."
a. Patient takes a vial and gently rotates it and states, "I will ensure that the insulin vial is never shaken." b. Patient describes where insulin will be stored, then states, " I will never freeze insulin." d. Patient performs mock injection site selection and states, "I will rotate sites."
The nurse is providing diabetic education on Type I diabetes to a newly diagnosed 13-year-old. Which non-pharmacological instruction will most benefit health promotion while living with Type I diabetes? a. Perform routine physical exercise. b. Do not take insulin while ill. c. 50% of daily intake should be from protein. d. Oral hypoglycemic medications may be given in-between insulin.
a. Perform routine physical exercise. This answer is correct because exercise is the most beneficial non-pharmacologic habit a teen can participate in. Only insulin and physical exercise will lower the blood glucose for this person. Routine physical exercise is beneficial for diabetics and the teen may need to learn how to take self blood sugars before and after activity and to carry forms of sugar. Exercise benefits those with Type I diabetes since it may help increase insulin sensitivity which means the body may not need as much insulin to process carbohydrates. Safely incorporating exercise will help with long-term life styles into adulthood.
The nurse is caring for a client with a diagnosis of Cushing's syndrome with a history of anterior pituitary tumor. The nurse will assess for which of the following characteristics of Cushing's syndrome? Select all that apply. a. Round face b. Hyperactive state c. Weight loss d. Swelling of feet and legs e. Acne
a. Round face d. swelling of feet and legs e. acne Cushing's syndrome manifests itself due to a pituitary tumor that secretes ACTH, which stimulates the adrenal glands to produce too much cortisol and may produce Cushing's. Classic characteristics of Cushing's syndrome include round face, fatigue, weight gain, and leg edema.
what is considered the "silent killer" of complications of diabetes mellitus? a. hypertension b. arteriosclerosis c. kidney failure d. stroke
a. arteriosclerosis
A client with diabetes type 1 is admitted to the emergency room with COVID-19-like symptoms. Which symptoms should the nurse report immediately? Select all that apply. a. Blood glucose of 475 mg/dL b. Coughing and temperature of 99.8 F c. Deep rapid breathing d. Abdominal cramping e. ABGs with pH of 7.45
a. blood glucose of 475 c. deep rapid breathing d. abdominal cramping Diabetic ketoacidosis (DKA) can occur quickly for a type 1 diabetic during illness. The nurse should be on alert for symptoms of DKA including elevated blood glucose, deep rapid breathing (Kussmaul breathing), and abdominal cramping pain.
Which will the nurse expect in a client diagnosed with hyperparathyroidism? Select all that apply. a. Bone pain b. Steatorrhea c. Serum calcium of 7.9 mg/dL d. Urolithiasis e. Constipation
a. bone pain c. urolithiasis d. constipation Hyperparathyroidism is a condition where the body produces too much parathyroid hormone (PTH). The nurse can expect clinical manifestations of bone pain, urolithiasis (kidney stones), constipation, and elevated calcium levels in a client diagnosed with hyperparathyroidism.
The home care nurse observes that the client's supply of levothyroxine has 20 extra doses in the medication bottle. What assessment finding would be most consistent with underuse of the medication levothyroxine? Select all that apply. a. Constipation and fatigue b. Diarrhea and agitation c. Tachycardia and weight loss d. Exophthalmos and fine tremors e. Feeling cold and depressed
a. constipation and fatigue e. feeling cold and depressed Levothyroxine is given to increase thyroid hormone in the body. If the client does not take the thyroid hormone, hypothyroid symptoms will appear, such as constipation and fatigue.
A nurse is trying to explain to a nursing student the differences between diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar syndrome (HHS). Which symptom(s) is/are associated with HHS? a. Disorientation b. Abdominal pain c. Sudden occurrence d. Extreme dehydration e. Kussmaul respirations f. Blood glucose >600 mg/dL
a. disorientation d. extreme dehydration f. blood glucose > 600 Symptoms associated with HHS are confusion, extreme dehydration, blood glucose of >600 mg/dL. Abdominal pain and Kussmaul respirations are associated with DKA but not HHS.
Which of the psychosocial nursing diagnoses are best for planning nursing interventions for a 30- year-old female client diagnosed with Cushing syndrome and verbalizes "I don't know why I look so ugly now." a. Decisional conflict b. Disturbed body image c. Interrupted family processes d. Impaired social interaction
a. disturbed body image Disturbed body image for a client with Cushing's syndrome will be important for the 30-year-old female. Actual changes in structure and function of the body occurs such as roundness to the face, edema, truncal obesity, abdominal striae, and the characteristic "buffalo hump" can make a client feel this way.
An older adult client with Type 2 diabetes is brought to the emergency department by his daughter. The client is found to have a blood glucose level of 623 mg/dL. The client's daughter reports that the client recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing intervention has the highest priority? a. Fluid replacement b. Reversal of altered mental status c. Insulin first then fluids d. Give sodium bicarbonate
a. fluid replacement A recent infection (gastrointestinal virus) can cause hyperglycemic hyperosmolar syndrome (HHS). The highest priority treatment is fluid replacement to address the priority of circulation.
A client recently diagnosed with hyperparathyroidism is given which teaching to help reduce symptoms associated with the condition? a. Increase water intake b. Take loperamide daily c. Increase calcium with vitamin D d. Perform high-impact exercise
a. increase water intake Clients with hyperparathyroidism are taught to increase fluid intake to reduce the impact of kidney stones on the client. Kidney stones are a common occurrence with clients with hyperparathyroidism so fluids are encouraged to help flush the kidneys
The nurse is assessing a diabetic client with frequent exacerbations of chronic obstructive pulmonary disease (COPD) who has been taking prednisone for 6 months. Which of the following indicate an adverse effect of taking prednisone? a. Increased blood glucose b. Photosensitivity c. Hair loss d. Low blood pressure
a. increased blood glucose Corticosteroids such as prednisone are used in treatment of acute exacerbations of COPD. Corticosteroids, such as prednisone, elevate blood glucose, especially in the diabetic client.
The nurse is providing instruction to a client about iodine for thyroid function. Which food would the nurse recommend as a good source of dietary iodine? a. Shrimp b. Unsalted peanuts c. Honey d. Canned fruit PREVSUBMITSKIP
a. shrimp Adequate iodine in the diet is needed for production of thyroid hormones and thyroid function. Nurses should recommend good sources of iodine, including shrimp, and other shellfish, iodized salt, cheese, cow milk, eggs, yogurt, iodized salt, saltwater fish, seaweed, and cranberries.
what is the phenomenon that when the patient takes insulin before bed and misses their bedtime snack, there is a rebound effect that occurs between 2-3am? a. somogyi effect b. dawn phenomenon
a. somogyi effect
The nurse is caring for a client who has undergone subtotal thyroidectomy. Which post-operative assessment should receive the highest priority? a. Swallowing reflex b. Swelling in lower extremities c. Respiratory rate of 22 breaths/min d. Heart rate of 98 beats/min SUBMITSKIP
a. swallowing reflex The highest priority postoperative subtotal thyroidectomy assessment is assessing the airway and swallowing reflex. This is due to the location of the surgery and risk for edema and laryngeal nerve damage
which of the following are symptoms of mild hypoglycemia? SELECT ALL THAT APPLY a. sweating b. confusion c. seizures d. emotional changes e. palpitations f. hunger g. headache
a. sweating e. palpitations f. hunger symptoms of mild hypoglycemia include sweating, palpitations, tremors, hunger, and nervousness
a 15 year old girl presents to the emergency department after her mother noticed that had been drinking more than normal. her mom states that she has been using the bathroom more frequently, and has been a lot more tired lately. upon assessment, you notice some cuts and bruises, that her mother says have been slow to heal as well. the mother also states that she has lost a lot of weight lately what type of diabetes does the pt have? a. type I b. type II c. gestational d. secondary
a. type I a unique symptom to type I is polyuria, along with extreme fatigue, and weight loss.
The nurse is caring for a client with a new diagnosis of Graves' Disease. The nurse analyzes assessment data and determines the client has which of the following physical findings that are characteristic of Graves' Disease? Select all that apply. a. 10 pound weight gain in two months b. Oligomenorrhea-reported 2 periods in six months c. Reporting being "hot" all the time d. Apical heart rate 122 e. Bulging of the eyes
b. Oligomenorrhea-reported 2 periods in six months c. Reporting being "hot" all the time d. Apical heart rate 122 e. Bulging of the eyes Graves' disease is an autoimmune disease where the body attacks the thyroid and makes it produce excess thyroid hormone. Symptoms of Graves's disease include tachycardia, heat intolerance, and amenorrhea.
A client with diabetes mellitus type 1 admitted with DKA asks the nurse, "What causes DKA to happen?" The nurse correctly explains which common causes of DKA? Select all that apply. a. Not taking oral antiglycemic medications b. Personal stress, such as starting college c. A recent, serious infection d. Having a recent stomach virus e. Taking too much regular insulin PREVSUBMITSKIP
b. Personal stress, such as starting college c. A recent, serious infection d. Having a recent stomach virus Diabetic ketoacidosis (DKA) is a very serious complication of diabetes mellitus. It occurs when ketones or blood acids increase in the bloodstream in response to elevated blood glucose levels and inadequate insulin. DKA can occur due to illness, infection, or insufficient insulin.
A client in the hospital voices concern that the blood glucose monitor may not be working because the blood glucose was 295. After reviewing the medications, the nurse explains which of the following would cause elevated blood glucose? a. Quinidine b. Prednisone c. Atenolol d. Sulfamethoxazole-trimethoprim
b. Prednisone This answer is correct because a common side effect of prednisone is increased blood glucose, especially in the diabetic client. Close monitoring of blood glucose is important for the diabetic client with additional needs for insulin or other glucose lowering medications or activity to help maintain normal blood glucose levels.
The nurse is providing instructions to a client with a new diagnosis of Graves' Disease who will also receive the prescription methimazole. What instruction will the nurse provide? Select all that apply. a. Take solu-cortef with methimazole daily to reduce adverse effects. b. Take methimazole at the same time each day. c. Follow-up with the clinic for a complete blood count in 4 weeks. d. Follow-up with the clinic for laboratory blood test for T3. e. Report fever, chills, or any other symptoms of illness to the physician.
b. Take methimazole at the same time each day. c. Follow-up with the clinic for a complete blood count in 4 weeks. d. Follow-up with the clinic for laboratory blood test for T3. e. Report fever, chills, or any other symptoms of illness to the physician. Methimazole decreases thyroid hormone in clients with hyperthyroidism. The client should be taught how to take the medication and the follow-up required.
Which are true statements about which body parts assist to increase the blood level of calcium? Select all that apply. a. Liver b. Bones c. Kidneys d. Intestines e. Pancreas
b. bones c. kidneys d. intestines Hyperparathyroidism is a condition where the body produces too much parathyroid hormone (PTH). The bones, kidneys, and intestines assist the body to increase the blood level of calcium.
which of the following medications is added to insulin infusions to prevent sudden drop of BG during the treatment of DKA? a. glucagon b. dextrose c. NS d. bicarb
b. dextrose
which of the following are symptoms of severe hypoglycemia? SELECT ALL THAT APPLY a. tremors b. disorientation c. slurred speech d. seizures e. palpitations f. loss of consciousness g. combative behavior
b. disorientation d. seizures f. loss of consciousness symptoms of severe hypoglycemia include disorientation, seizures, difficulty arousing from sleep, loss of consciouness
which of the following symptoms are only found in type II diabetes? a. polydipsia b. fatigue c. blurry vision d. ketonuria e. polyphagia f. weight gain
b. fatigue f. weight gain extreme fatigue is found in type I diabetes
which food classification system shows how fast each food will affect your blood glucose? a. carb counting b. glycemic index c. glycemic load d. calorie distribution
b. glycemic index diabetics should aim for foods that have a glycemic index of under 55
Which symptoms are most associated with hypoparathyroidism? Select all that apply. a. Constipation b. Laryngeal spasms c. Hypercalcemia d. Positive Kernig sign e. Positive Trousseau sign
b. laryngeal spasms e. positive trousseau sign Hypoparathyroidism is a condition where the body doesn't produce enough parathyroid hormone (PTH). Symptoms most associated with hypoparathyroidism are laryngeal spasm, hypocalcemia, positive Trousseau and Chvostek signs.
A client with diabetes informs the nurse of prickling, tingling, and burning sensations to lower extremities at night. The nurse expects to develop a plan of care with a focus on which medical condition? a. Albuminuria b. Peripheral neuropathy c. Raynaud's disease d. Hypernatremia
b. peripheral neuropathy This answer is correct because diabetic peripheral neuropathy is a condition in diabetics that causes prickling, tingling, and burning sensations to peripheral extremities. Diabetic peripheral neuropathy is damage that occurs to nerves caused by long-term high blood sugar. Acute sensory and chronic sensorimotor neuropathies are the most common and prone to night time exacerbation. Peripheral neuropathy causes the client to be more susceptible to injury since feeling in the extremities (particularly the feet and lower legs) is diminished to completely numb. Clients can step on nails and never feel it or know it except there is blood coming from their feet. Unfortunately, this can lead to serious infection and amputation.
A nurse is performing a follow-up assessment for a client taking methimazole for hyperthyroidism. On assessment the nurse documents a weight gain of 8 pounds over the past two weeks. Which action is most important by the nurse? a. Offer suggestions to alter the drug schedule to every other day. b. Report weight gain to the health care provider. c. Do nothing since weight gain signifies drug efficacy. d. Instruct the client to maintain a low salt diet.
b. report weight gain to HCP Methimazole is an anti-thyroid medication so weight gain in a client should be reported. Monitoring the weight gain will help determine if it is just a consequence of gradual decline in thyroid hormone or if the client has developed hypothyroidism
The nurse instructs a client on self-administration of NPH insulin and regular insulins through client teach-back and demonstration. The nurse knows the client understands the instruction through demonstration of which action? a. The client withdrew 20 Units NPH insulin first then regular insulin next b. The client withdrew 10 Units regular first, followed by 20 Units NPH insulin c. The client withdrew 20 Units NPH insulin in one syringe and 10 Units regular insulin in a second syringe d. The client withdrew 30 Units glargine insulin and stated glargine is to never be mixed.
b. the client withdrew 10 units regular first, followed by 20 units NPH insulin This answer is correct because when 10 Units of regular, clear insulin and 20 Units of NPH, cloudy insulin are ordered to be mixed with these specific steps, this is the correct method: Air is pulled up into the syringe for the 20 Units NPH, cloudy insulin and 20 units of air only placed into the NPH bottle; the needle is withdrawn;" Air is then pulled up into the syringe for the 10 Units of regular, clear insulin and 10 Units of air placed into the regular insulin bottle; the needle remains in the bottle; The 10 Units of regular, clear insulin is pulled up into the syringe. the needle is now withdrawn and placed into the NPH bottle The 20 Units of NPH, cloudy insulin is then pulled up into the syringe to make the syringe have a total of 30 Units (10 Units regular + 20 Units NPH = 30 Units*) *Note that the total units of all insulin (30 Units) should equal the 10 Units of regular, clear insulin units plus the 20 Units of NPH, cloudy insulin units after the correct amount of NPH is pulled up.
The nurse develops discharge teaching for a client with Addison's Disease. What is the most important topic in teaching about hormone replacement therapy? a. Stopping steroid doses when stress or illness occurs b. To maintain lifelong steroid replacement therapy c. Monitor liver function through monthly blood tests d. To limit dietary intake of protein and sodium
b. to maintain lifelong steroid replacement therapy Discharge teaching for a client with Addison's Disease should include the importance of maintaining lifelong steroid replacement therapy. This is because Addison's disease is a condition where there is not enough cortisol and aldosterone in the body due to adrenal dysfunction
a patient presents to the clinic, stating that he has been feeling very thirsty lately. he also states he has been experiencing blurry vision, and tingling in his hands and feet. he also states that he has felt more tired. what type of diabetes does that patient have? a. type I b. type II c. secondary d. latent autoimmune diabetes in adults
b. type II unique symptoms of type II include blurry vision, and tingling in the hands or feet
The nurse is assessing a client who voices concerns about having thyroid disease. Which question by the nurse is most appropriate? a. "Have you experienced muscle spasms or cramping?" b. "Have you experienced tingling, numbness, or changes in sensation?" c. "Have you experienced weight gain or loss during the past 3 months?" d. "Have you experienced episodes of shakiness, sweating, or extreme hunger?"
c. "Have you experienced weight gain or loss during the past 3 months?" Thyroid disorders have symptoms of weight loss (hyperthyroidism) or weight gain (hypothyroidism). Asking a client about recent weight changes will help the nurse determine if there is a thyroid disorder concern.
The nurse is instructing a Type 1 diabetic on "sick day rules" and stresses which key sick day advice? a. "You should perform more vigorous exercises to get well sooner." b. "Sick day means not to take insulin on days that you are ill." c. "The number one rule of thumb is to continue taking your insulin." d. "Limit fluids when ill because fluids will be hypotonic and more harmful."
c. "The number one rule of thumb is to continue taking your insulin." This answer is correct because diabetes type 1 is a condition where the pancreas stops producing insulin completely, necessitating the client to have lifelong insulin therapy. This includes during times of illness, when the sickness may actually elevate blood glucose levels. The first and most important rule regarding sick days for a type 1 diabetic is to continue taking insulin. Careful blood glucose monitoring (every 4 hours) and urine ketone monitoring is essential to properly control blood glucose levels during sickness. The amount of insulin taken may vary (more or less) depending on the sickness and the amount of food intake. Be in contact with the healthcare provider if the illness is prolonged, there is difficulty controlling blood glucose levels, or ketones are present in the urine.
The nurse is caring for a client with Type 1 diabetes. The client is on Sliding Scale Regular insulin subcutaneous before meals and at bedtime. The sliding scale is as follows:-60 mg/dL - 150 mg/dL, give no insulin-151 mg/dL - 200 mg/dL, give 2 units Humulin R-201 mg/dL - 250 mg/dL, give 4 units Humulin R-251 mg/dL - 300 mg/dL, give 6 units Humulin R-over 301 mg/dL, give 8 units Humulin R and notify the physician The bedside blood glucose is 210 mg/dL at 0730. How much insulin would the nurse give? a. 4 units Humulin N SQ b. 2 units Humulin R SQ c. 4 units Humulin R SQ d. 8 units Humulin R SQ
c. 4 units Humulin R SQ This answer is correct because 4 units of Humulin R is appropriate for a blood glucose range of 201-259 mg/dL and the client's current blood glucose is 201 mg/dL More insulin could cause hypoglycemia and less insulin will not adequately treat the current blood glucose.
The nurse is caring for a client who collapsed and is unresponsive after complaints of sudden lethargy, paleness, and irritability. Bedside blood sugar was 42 mg/dL. A nurse is caring for a client who has developed a hypoglycemic reaction. Which intervention will take priority? a. Offer 60cc orange juice after checking that swallowing reflex is present b. Order a venous blood sample from the lab to double check the bedside blood sugar monitor. c. Administer glucagon via parenteral route as soon as possible. d. Hang an IV of Normal Saline and give a 500 mL fluid bolus as soon as possible
c. Administer glucagon via parenteral route as soon as possible. This answer is correct because an unconscious client with hypoglycemia must have IV glucagon to increase the blood glucose to a level to cause the client to become conscious. Hypoglycemia is a complication of diabetes that can become very serious if not recognized and treated quickly. If the client becomes unconscious from diabetes, it reflects a greater decrease in blood glucose and a great need to act immediately and more invasively.
The nurse is caring for a postoperative client 24 hours following a partial thyroidectomy for persistent hyperthyroidism. What assessment data should the nurse immediately report to the health care provider? a. Change in Pulse Oximeter from 93% to 91% b. Change in respiratory rate from 30 to 22 c. Change in temperature from 99 F to 100.2 F d. Change in apical heart rate from 72 beats per minute to 94 beats per minute
c. Change in temperature from 99 F to 100.2 F Thyroid crisis or thyroid storm can occur following a partial thyroidectomy for persistent hyperthyroidism. This hypermetabolic state has symptoms including a sudden elevation in temperature.
The nurse is caring for a client just admitted to the intensive care unit for diabetic ketoacidosis (DKA). Which three priority treatments are critical during diabetic ketoacidosis? a. Potassium replacement, insulin replacement, amiodarone therapy b. Fluid replacement, bicarb replacement, hypertonic saline infusion c. Fluid replacement, insulin therapy, and electrolyte correction d. Oral rinses, fluid replacement, bicarb replacement
c. Fluid replacement, insulin therapy, and electrolyte correction Diabetic ketoacidosis (DKA) is a very serious complication of diabetes in which the body produces ketones or blood acids in response to extremely elevated blood glucose levels. The three priority treatments critical during DKA are fluid replacement, insulin therapy, and electrolyte correction.
A nurse is teaching a Type 2 diabetic client about the prescribed once daily detemir insulin injection. Which is the best time of day for the client to take the Levemir insulin? a. Midday prior to lunch b. Morning with breakfast c. Evening or bedtime d. Three hours after midday meal
c. evening or bedtime Detemir insulin is a long-acting insulin that is given once a day or twice a day to treat diabetes mellitus. Once daily detemir insulin injection should be given in the evening or bedtime.
which of the following is not a primary cause of hyperthyroidism? a. grave's disease b. heredity c. excessive TSH produced by the pituitary gland d. patients taking too much synthroid
c. excessive TSH produced by the pituitary gland this is a secondary cause of hyperthyroidism
The nurse is caring for a client who underwent thyroidectomy with removal of parathyroid tissue following a diagnosis of thyroid cancer. The nurse notices twitches and spasms along the left lateral facial region. The nurse suspects which adverse outcome of the surgery? a. Hypercalcemia b. Hyperkalemia c. Hypocalcemia d. Spread of cancer to mandibular glands
c. hypocalcemia Symptoms of hypocalcemia include a positive Chvostek's sign or Trousseau's sign, twitches, spasms, muscle weakness, muscular cramping, fatigue, tingling feeling, confusion, and irritability.
a patient presents to the clinic stating that they have been feeling lethargic lately. the patient states that he has gained weight even though he hasn't been eating as much as normal, have been feeling short of breath lately, and has noticed that his hair is getting thinner. which condition does the patient most likely have? a. hypoparathyroidism b. pre-diabetes c. hypothyroidism d. pheochromocytoma
c. hypothyroidism
which of the following statements is not true when it comes to calorie requirements? a. young type I diabetics need their calories increased to accommodate growth and development needs b. type II obese diabetics should have 500-1000 fewer calories for a weight loss of 1-2lbs a week c. loss of > 10% of body weight can lower needs for medication and improve BG levels d. each patient's caloric requirement is different
c. loss of > 10% of body weight can lower needs for medication and improve BG levels loss of > 7% of body weight can lower needs for medication and improve BG levels
