Med-Surg Ch.79 (Part 2)
A nurse is reinforcing teaching with a client who has DM about food choices. Which of the following client statements indicates the teaching has been understood?
-"I should replace white bread with whole-grain bread"
A nurse is reinforcing teaching with a client who has type 2 DM about foot care. Which of the following statements by the client indicates an understanding of the teaching?
-"I'll be sure to wear cotton socks every day"
**A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about the pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching?
-"My cells are resistant to the effects of insulin."
**A 13-year-old adolescent who has type 1 diabetes mellitus is reluctant to self-administer insulin during school. Which of the following responses by the school nurse demonstrates understanding of age-appropriate concerns?
-"There is a private area available to use.
A nurse is reinforcing teaching with a client who had a vaginal hysterectomy with a bilateral oophorectomy. Which of the following pieces of information should the nurse include in the teaching?
-"Use a water based lube when having sex"
**A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about exercise. Which of the following statements should the nurse include in the teaching?
-"Wear a medical alert identification tag when you exercise."
A nurse is reinforcing teaching with a client who has type 2 DM. The client states "I eat pasta every day. I can't imagine giving it up." Which of the following responses should the nurse make?
-"You do not have to give up pasta; just adjust the amount you eat."
**The nurse is explaining to a client diagnosed with diabetes how to identify when diabetes is controlled. Which is an accurate statement to use as a teaching point?
-"You will feel well when your diabetes is controlled."
The nurse is reading a client's fasting plasma glucose (FPG) test results. Which of the following results indicates diabetes?
-130 mg/dL
Which of the following clients would be most susceptible to experiencing ketoacidosis?
-A client with type 1 diabetes
**The nurse, administering insulin to clients in a nursing home, must recognize signs that an insulin is unusable. Which insulin is safe to be administered?
-A prefilled syringe that is milky white
A nurse is planning to reinforce teaching with a client who is being evaluated for Addison's disease about the adrenocorticotropic hormone (ACTH) stimulation test. The nurse should base her instructions to the client on which of the following information?
-ACTH is a hormone produced by the pituitary gland
A nurse is caring for a client in the late stage of ketoacidosis. The nurse notices that the client's breath has a characteristic fruity odor. Which substance is responsible for the fruity smell in the breath?
-Acetone
A nurse is preparing to administer a morning dose of insulin aspart to a client who has type 1 diabetes mellitus for a group of clients. Which of the following actions should the nurse include?
-Administer insulin when breakfast arrives
The nurse is administering acarbose (Precose), an oral antidiabetic agent to a client. What category of drug is this mediaction?
-Alpha-glucosidase inhibitors
A nurse is assigned to care for and monitor any complications in a 40 year old client with chronic diabetes. Which is a macrovascular complication of diabetes?
-Arteriosclerosis
A nurse is reinforcing dietary teaching with a client who has DM. Which of the following actions should the nurse take first?
-Ask the client to identify the types of food she prefers.
What does pramlintide injected at meal times improve?
-Average blood glucose levels (HA1c and eAG)
A nurse is administering a Lantus insulin injection to a 50 year old diabetic client. Which of the following precautions should the nurse keep in mind when administering the insulin injection? (Select all that apply)
-Avoid mixing Lantus with other types of insulin -Roll the syringe before administration of the medicine -Check the color of the vial or prefilled syringes before using them
A nurse is reviewing the lab values for a client who has hyperglycemic hyperosmolar nonketotic syndrome. Which of the following lab values is consistent with hyperglycemic hyperosmolar nonketotic syndrome?
-Blood glucose 320 mg/dL
A nurse is collecting data from a client who develops a fruits breath odor, dry mouth and extreme thirst. Which of the following additional data should the nurse expect?
-Blood glucose using a glucometer
A nurse is reviewing the lab reports for a client and notes an elevated thyroid stimulating hormone (TSH) level. When collecting data from the client, which of the following findings should the nurse expect?
-Bradycardia
A nurse is caring for a client who is postop following a parathyriodextomy to treat hyperparathyroidism. Which of the following lab values should the nurse expect to decrease the therapeutic effect of the procedure?
-Calcium
A nurse is preparing a 24-hour urine specimen for a client with suspected pheochromocytoma. Which of the following lab tests from the 24-hour urine specimen should the nurse use to determine the client's condition?
-Catecholamine metabolites
A nurse is assisting with the plan of care for a client who has Cushing's syndrome due to chronic corticosteroid use. Which of the following actions should the nurse include in the plan of care?
-Check for hypertension
A client is diagnosed with type 1 diabetes. Which of the following accurately describes a consideration related to the occurrence of this disorder?
-Classic symptoms are nearly always present
A 30 year old client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following statements is true regarding SIADH? (Select all that apply)
-Clients with SIADH usually have concentrated urine -Chemotherapy may be a possible cause of the disease -Weight gain may occur due to fluid retention
A nurse is caring for a client who is postop following a bilateral adrenalectomy. The nurse should expect to administer glucorticoids following the procedure to enhance which of the following therapeutic effects?
-Compensate for decreased cortisol levels
A diabetic client is admitted to the healthcare facility in a stage of insulin shock. Which can lead to insulin shock?
-Consuming alcohol along with insulin injections
A nurse is caring for a client who has type 1 DM and a capillary blood glucose reading of 48mg/dL. Which of the following findings should the nurse expect?
-Diaphoresis
A nurse is collecting data from a client who has Graves' disease. Which of the following findings should the nurse expect to display?
-Difficulty sleeping
A nurse is caring fro a client with Addison's disease. Which nursing consideration should be employed when caring for this client?
-Document the specific gravity of urine
A nurse is reinforcing discharge teaching with a client who has a transsphenoidal hypophysectomy. Which of the following instructions should the nurse include? (Select all that apply)
-Eat a high fiber diet -Notify the provider of any sweet tasting drainage
A nurse is assisting with a presentation about nutrition habits that prevent type 2 diabetes mellitus for a group of clients. Which of the following should the nurse include? (Select all that apply)
-Eat less meat and processed foods -Decrease intake of saturated fats -Increase daily fiber intake -Include omega-3 fatty acids in the diet
A nurse is assisting with the plan of care for a client who has type 2 DM. Which of the following interventions should the nurse include in the plan?
-Encourage the client to control weight
A nurse is reviewing the health record of a client who has hyperglycemia-hyperosmolar state (HHS). Which of the following factors can cause HHS?
-Evidence of recent myocardial infections -BUN 35 mg/dL -Takes a calcium channel blocker -Age 77 years
Obesity mean...
-Excess body fat
Overweight means...
-Excess body weight
Polyphagia is...
-Excessive hunger
Polydipsia is...
-Excessive thirst
Polyuria is...
-Excessive urination
A nurse is reviewing lab results for a client who has DM. Which of the following results indicates that the client is controlling the diabetes?
-Fasting blood glucose 95 mg/dL
A nurse is checking a client with Graces' disease for the development of thyroid storm. The nurse should report which of the following findings to the provider?
-Fever
A nurse is collecting data from a client who has diabetic ketoacidosis and ketones in the urine. The nurse should expect which of the following findings? (Select all that apply)
-Fruity odor breath -Abdominal pain -Kussamal respirations -Metabolic acidosis
What type of diabetes occurs during pregnancy and disappears on delivery?
-Gestational diabetes
The nurse caring for clients with diabetes causes unique microvascular changes in the capillary walls resulting in diminished blood flow and poor oxygenation of tissues that are highly vascular. Which of the following organs would the nurse monitor for damage?
-Heart
**The nurse administers an intermediate-acting insulin to a client with diabetes. Which insulin is intermediate acting?
-Humulin N
A nurse is assisting with the care of a client who has Addison's disease and comes to the ED reporting nausea, vomiting, diarrhea, and abdominal pain. To prevent an Addisonian crisis, the nurse should expect the provider to prescribe which of the following medications?
-Hydrocortisone
A nurse is assisting with the care of a client who has been diagnosed with an Addisonian crisis and has a BP of 74/42 mmHg. Which of the following medication prescriptions should the nurse anticipate?
-Hydrocortisone
A nurse is assisting with the care of a client who has Addison's disease and was admitted with muscle weakness and dehydration, as well as nausea and vomiting for the past 2 days. Which of the following prescribed medications should the nurse plan to administer?
-Hyfrocortisone
**The stimulus for secretion of glucagon is:
-Hypoglycemia
A nurse is conducting a home visit with an older adult client who has DM and takes regular insulin SQ before each meal. The client appears disoriented and weak and has slurred speech. Which of the following conditions should the nurse consider first when responding to these manifestations?
-Hypoglycemia
A nurse is monitoring a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings should the nurse expect?
-Hyponatremia
A nurse is collecting data form a client who has Addison's disease. Which of the following should the nurse expect?
-Hypotension
How is prediabetes determined?
-If the BGM falls between 100 and 125 mg/dL
What range should diabetes be diagnosed?
-If the level is about 126 mg/dL
When should you check the fasting blood glucose level (FPG)?
-In the morning before eating
When should you check the glucose tolerance test (OGTT)?
-In the morning with a follow-up test 2 hr after drinking high glucose drink
A nurse is reinforcing teaching with a client who has hyperthyroidism about managing this disorder. Which of the following recommendations should the nurse include?
-Increase her caloric intake with meals
A nurse is collecting data from a client who has manifestations of acromegaly. Which of the following findings should the nurse expect?
-Increased head size
**A nurse is caring for a client who has type 2 diabetes mellitus and is displaying manifestations of hyperglycemia. Which of the following findings indicate that the client has hyperglycemia.
-Increased urination
A nurse is caring for a client who has Cushing's disease. Clients who have Cushing's disease are at increased risk for which of the following? (Select all that apply)
-Infection -Gastric ulcer -Bone fractures
A nurse is instructing a 50 year old diabetic client about the steps to be followed for self-administration of insulin. Which instruction should be included in the clients teaching?
-Inform the client about the type of syringe to use.
The nurse is caring for clients with endocrine disorders knows that the endocrine system is intricately in regulating nearly all body processes. What hormone aids the transport of glucose into cells and decreases blood glucose levels?
-Insulin
A nurse is monitoring a client following a thyroidectomy. Which of the following findings should the nurse identify as an indication of hypoparathyroidism?
-Involuntary muscle spasms
A nurse is preparing a diet plan for a 50 year old client with a simple goiter. Which should be included in the client's diet to decrease the enlargement of the thyroid gland?
-Iodine
A nurse is reinforcing teaching with a client who has type 1 DM about hypoglycemia. Which of the following manifestations should the nurse include in the teaching?
-Irritability
How should insulin be cared for?
-Keep refrigerated -Roll and invert insulin between your hands -Do NOT Shake
A nurse is caring for a client who has DKA. Which of the following findings should the nurse expect?
-Kussmaul respirations
When caring for a client with diabetic neuropathy, for which of the following signs should the nurse monitor the client?
-Lack of sensation
**A nurse is instructing the parents of a 5-year-old diabetic client on how to manage recurring hypoglycemia. Which instruction, as indicated by the physician, should be included in parent teaching?
-Learn to use a glucagon emergency kit.
A nurse is assisting with a plan for community health screening for a group of clients who are at the risk of type 2 DM. Which of the following client groups should the nurse include in the screening?
-Men and women who are obese
A nurse is assisting with the plan of care for a client who is experiencing the Somogyi effect and takes intermittent-acting insulin. Which of the following actions should the nurse include in the plan?
-Monitor the client's nighttime blood glucose levels
What organs can be severely damaged by diabetes?
-Nephropathy -Retinopathy
A nurse is reinforcing teaching with a client who has Addison's disease and is taking hydrocortisone. Which of the following instructions should the nurse include? (Select all that apply)
-Notify the provider of any illness or stress -Report any manifestations of weakness or dizziness -Do not discontinue the medication suddenly
A nurse is caring for a client who has urolithiasis and requires further diagnostic testing after an initial assessment indicated hypercalcemia. The nurse should explain that which of the following structures controls calcium concentration?
-Parathyroid gland
A nurse is reinforcing teaching about foot care with a client who has diabetes mellitus. Which of the following information should the nurse include in the teaching? (Select all that apply)
-Perform nail care after bathing -Trim toenails straight across -Wear closed toe shoes
The nurse is administering amitriptyline (Elavil) to a client with diabetes. Which of the following side effects of this disease is this medication used to treat?
-Peripheral neuropathy
**A nurse is instructing a 25-year-old diabetic client regarding preventive foot care measures. Which information should be included in client teaching?
-Place lamb's wool between overlapping toes to prevent irritation.
The nurse is teaching the parents of a juvenile diagnosed with type 1 diabetes the three "poly's" of diabetes symptoms. Which of the following describes excessive hunger?
-Polyphagia
A nurse is caring for a client who has diabetes insipidus. For which of the following findings should the nurse monitor?
-Polyuria
What is considered a risk factor for future diabetes?
-Prediabetes
What type of diabetes refers to the conditions of impaired glucose homeostasis (IGH) that occurs when blood glucose levels are higher than normal but not high enough for the definitive diagnosis or diabetes mellitus?
-Prediabetes
A nurse is collecting data from a client who is recovering form a thyroidectomy and has harsh, high-pitched respiratory sounds. Which of the following actions should the nurse take?
-Prepare for a tracheostomy
A nurse is collecting data from a client who has Cushing's syndrome. Which of the following skin manifestations should the nurse expect to find?
-Purple striae on the chest and abdomen
A 30 year old diabetis client comes to the healthcare facility with vomiting, fever, high blood glucose concentrations. After further evaluation and blood tests, the client's condition is diagnosed as ketoacidosis. Which of the following symptoms should the nurse monitor when caring for the client?
-Respiratory depression
The nurse is teaching a client how to recognize the symptoms of a hypoglycemia reaction. Which of the following is a symptom of this condition?
-Sweating
A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism caused by an adenoma. Which of the following findings should the nurse report to the provider?
-Tachycardia & HTN -Laryngeal stridor and horseness -Positive Trousseau's sign
A nurse is preparing for the transfer of a client from the PACU following a subtotal thyroidectomy. Which of the following pieces of equipment should the nurse have available at the client's bedisde?
-Tracheostomy tray
A nurse is reinforcing teaching with a client who has Addison's disease about healthy snacks. Which of the following food choices by the client indicates an understanding of the teaching?
-Turkey and cheese sandwich
What type of diabetes is insulin-dependent (IDDM) or juvenile diabetes?
-Type 1
A nurse is educating a diabetic client about the streps for self administration of insulin. In which of the following types of diabetes should the nurse inform the client that lifelong insulin administration is essential?
-Type 1 diabetes mellitus
What type of diabetes is non-insulin dependent (NIDDMI) or adult-onset diabetes?
-Type 2
A nurse is asked to check the blood glucose level of a diabetic client using a Glucometer. Which of the following guidelines should be followed for blood glucose monitoring? (Select all that apply)
-Use the lateral aspect of the fingertip for testing -Check the calibration number on the strip bottle with the meter -Rotate the site of lancing for each test
A 25 year old client with symptoms of excessive thirst and an increase in urine is diagnosed with diabetes insipidus. For which of the following client's hormone levels should the nurse monitor?
-Vasopressin
A nurse is caring for a 60 year old client affected with hypoparathyroidism. When checking the laboratory report, the nurse finds that the clients calcium level was very low. Which vitamin regulates calcium level in the body?
-Vitamin D
A nurse if caring for a client who is scheduled to receive peritoneal dialysis. Which of the following actions should the nurse take?
-Warm the dialysate solution to room temperature prior to administration
A nurse is contributing to the plan of care for a client who is scheduled to receieve TPN. Which of the following actions should the nurse recommend including in the plan?
-Weigh the client daily -Obtain a serum blood glucose q4h -Change IV tubing q24h
At the beginning of a shift, a nurse is collecting data on a client who has Cushing's disease. Which of the following finding's is the nurse's priority?
-Weight gain
What are the 3 poly's of type 1 diabetes?
-polyuria, polydipsia, polyphagia
