NURS 1245 Practice Quiz

A client who has been newly diagnosed with type 1 diabetes asks the nurse, "Why do I have to take two shots of insulin? One shot isn't enough?" What should the nurse should tell the client? - "I'll ask the health care provider (HCP) to change your insulin schedule." - "Two shots will give you better control and decrease complications." - "A single shot of long-acting insulin would be preferable." - "You might be able to change to oral medications soon."

"Two shots will give you better control and decrease complications."

The nurse is caring for an immobile client. Which intervention should the nurse prioritize? repositioning the client from side to side keeping the skin clean and dry with gentle soap gently massaging the skin around the pressure areas rubbing moisturizing lotion over the pressure areas

keeping the skin clean and dry with gentle soap

A nurse is caring for an elderly client with a pressure ulcer on the sacrum. When teaching the client about dietary intake which foods should the nurse emphasize? legumes and cheese whole grain products fruits and vegetables lean meats and low-fat milk

lean meats and low-fat milk

A client concerned about being diagnosed with type 2 diabetes tells a nurse, "My parent suffered with diabetes for many years and finally died of kidney failure in spite of treatment. Why should I try if I'm going to go through the same thing?" What is the nurse's most appropriate response? "It sounds like your parent's diabetes wasn't under very good control." "There are no guarantees about how diabetes will progress." "Your parent didn't get the proper treatment." "Are you worried that you'll have the same experience as your parent?"

"Are you worried that you'll have the same experience as your parent?"

A client says, "I hate the idea of being an invalid after they cut off my leg." Which response by the nurse would be the most therapeutic? "At least you'll still have one good leg to use." "Tell me more about how you're feeling." "Let's finish the preoperative teaching." "You're lucky to have a wife to care for you."

"Tell me more about how you're feeling."

The nurse has been assigned to a client who has had diabetes for 10 years. The nurse gives the client's usual dose of regular insulin at 7 a.m. At 10:30 a.m., the client has light-headedness and sweating. The nurse should contact the physician, report the situation, background, and assessment, and recommend intervention for: -Metabolic acidosis. -Hyperglycemia. -Ketoacidosis. -Hypoglycemia.

-Hypoglycemia.

The nurse is offering further education to a client about the management of COPD. Which outcomes would indicate the teaching has been effective? Select all that apply. The client demonstrates pursed-lip breathing and coughing exercises. The client schedules follow-up physician appointments. The client exercises daily for 2 hours. The client maintains smoking cessation. The client continues to smoke four cigarettes a day.

The client schedules follow-up physician appointments. The client maintains smoking cessation. The client demonstrates pursed-lip breathing and coughing exercises.

A client is admitted with a diagnosis of diabetic ketoacidosis. An insulin drip is initiated with 50 units of insulin in 100 ml of normal saline solution administered via an infusion pump set at 10 ml/hour. The nurse determines that the client is receiving how many units of insulin each hour? Record your answer using a whole number.

5 units (50/100 *10)

When referred to a podiatrist, a client newly diagnosed with diabetes mellitus asks, "Why do you need to check my feet when I'm having a problem with my blood sugar?" The nurse's most helpful response to this statement is - "Diabetes can affect sensation in your feet and you can hurt yourself without realizing it." - "It's easier to get foot infections if you have diabetes." - "The circulation in your feet can help us determine how severe your diabetes is." - "The physician wants to be sure your shoes fit properly so you won't develop pressure sores."

Diabetes can affect sensation in your feet and you can hurt yourself without realizing it.

Mr. Jay presents with a day of severe abdominal pain. He is scheduled for a CT scan with contrast. One of his home medications is metformin (Glucophage). Once the test is completed the nurse anticipates: Placing Mr. Jay on a fluid restriction Holding the metformin (Glucophage) for 48 hours Placing Mr. Jay on a regular diet Giving the metformin (Glucophage) immediately

Holding the metformin (Glucophage) for 48 hours

A nurse is teaching a new diabetic client to administer insulin. How will the nurse evaluate if the teaching interventions were appropriate? Watch the client identify the appropriate method of injection site rotation on a picture. Ask the client to explain the rationale for injection site rotation. Listen to the client correctly describe the insulin injection procedure. Observe the client demonstrate an insulin injection and correctly identify the injection site rotation.

Observe the client demonstrate an insulin injection and correctly identify the injection site rotation.

A client is admitted to the emergency department with crushing chest injuries sustained in a car accident. The nurse is assessing the client's respiratory status. Which sign indicates a possible complication that the nurse should report to the health care provider immediately? absent breath sounds on the affected side increased fremitus pain on the affected side of 6 on a scale of 1 to 10 when the client breathes oxygen saturation of 70 % on room air

absent breath sounds on the affected side

A nurse is reviewing the medications used by a client who has chronic bronchitis and a history of high blood pressure and prostate enlargement. The nurse should verify that the client understands that which medications should be avoided because of the risks they pose? Select all that apply. generic pseudoephedrine tablets albuterol and ipratropium by metered-dose inhaler tamsulosin guaifenesin with dextromethorphan liquid lisinopril tablets

guaifenesin with dextromethorphan liquid lisinopril tablets generic pseudoephedrine tablets

An infant requires tracheal suctioning after the nurse assesses airway congestion. Which is the priority initial action when performing the procedure? instilling saline solution oxygenation prior to the procedure inserting a suction catheter to the appropriate length donning clean gloves

oxygenation prior to the procedure

A school-age child experiences symptoms of excessive polyphagia, polyuria, and weight loss. The physician diagnoses type 1 diabetes and admits the child to the facility for insulin regulation. The physician orders an insulin regimen of insulin and isophane insulin administered subcutaneously. How soon after administration can the nurse expect the regular insulin to begin to act? 4 to 8 hours 1 to 2 hours 8 to 10 hours ½ to 1 hour

½ to 1 hour

A nurse in a diabetes clinic receives phone calls from four clients with type 1 diabetes. The nurse returns the call of the client reporting what symptoms as highest priority? "My blood sugar was 55 mg/dL (3 mmol/L) , so I didn't take my insulin." "I'm thirsty all the time, and I'm urinating a lot." "I'm nauseated this morning and can keep only fluids down." "I noticed that my urine has a foul odor, and I have a fever."

"I noticed that my urine has a foul odor, and I have a fever."

When caring for a patient with a 3-cm stage I pressure ulcer on the coccyx, which action may the nurse institute independently? Using normal saline solution to clean the ulcer and applying a protective dressing as necessary Applying an antibiotic cream to the area three times per day Using a povidone-iodine wash on the ulceration three times per day Massaging the area with an astringent every 2 hour

Using normal saline solution to clean the ulcer and applying a protective dressing as necessary

A client with diabetes begins to cry and says, "I just can't stand the thought of having to give myself a shot every day." What would be the best response by the nurse? - "If you don't give yourself your insulin shots, you'll be at greater risk for complications." -"We can teach a family member to give the shots so you won't have to do it." -"I can arrange to have a home care nurse give you the shots every day." -"What is it about giving yourself the insulin shots that bothers you?"

"What is it about giving yourself the insulin shots that bothers you?"

A nurse is teaching a client about type 2 diabetes mellitus. What information would reduce a client's risk of developing this disease? - "Prevent developing hypertension by reducing stress and limiting salt intake." - "Maintain weight within normal limits for your body size and muscle mass." - "Follow a high-protein diet including meat, dairy, and eggs." - "You should stop cigarette smoking."

- "Maintain weight within normal limits for your body size and muscle mass."

The nurse is receiving results of a blood glucose level from the laboratory over the telephone. What should the nurse do? - Repeat the results to the caller from the laboratory, write the results on scrap paper, and then transfer the results to the medical record. - Request that the laboratory send the results by e-mail to transfer to the client's medical record. -Indicate to the caller that the nurse cannot receive results from lab tests over the telephone and ask the lab to bring the written results to the nurses' station. -Write down the results, read back the results to the caller from the laboratory, and receive confirmation from the caller.

-Write down the results, read back the results to the caller from the laboratory, and receive confirmation from the caller.

Every morning, a client with type 1 diabetes receives 15 units of Humulin 70/30. What does this type of insulin contain? 70 units of neutral protamine Hagedorn (NPH) insulin and 30 units of regular insulin 70% regular insulin and 30% NPH insulin 70 units of regular insulin and 30 units of NPH insulin 70% NPH insulin and 30% regular insulin

70% NPH insulin and 30% regular insulin

To prevent oral complications when using a fluticasone metered-dose inhaler, a nurse should instruct the client to do what? Select all that apply. Add a spacer to the metered dose inhaler. Keep the mouth piece from becoming contaminated. Use the inhaler only as needed. Use the inhaler before meals. Rinse out the mouth after using the inhaler.

Add a spacer to the metered dose inhaler. Keep the mouth piece from becoming contaminated. Rinse out the mouth after using the inhaler.

A nurse is providing dietary instructions to a client with diabetes. What is most important for the nurse to include in teaching for prevention of hypoglycemia? - Avoid delaying or skipping meals. - Increase protein intake in the morning. - Drink orange juice if lightheadedness occurs. - Reduce carbohydrate intake when drinking alcohol.

Avoid delaying or skipping meals.

A client with diabetes is being tested for glycosylated hemoglobin. How would the nurse explain the reason for this diagnostic test? -It determines the fasting blood glucose level. -It determines the average blood glucose level in the previous 2-3 months. -It is used to identify a reduction in hemoglobin because of high glucose levels. -It determines the ratio of glucose to hemoglobin.

It determines the average blood glucose level in the previous 2-3 months.

A client is coming to the clinic for a follow-up appointment after taking metformin for 9 months. After reviewing the client's HbA1C level of 8.5%, the nurse anticipates what response from the healthcare provider? Refer to diabetes education for an insulin pump. Switch the client to a different oral antidiabetic agent. Order an additional oral antidiabetic agent. Satisfaction with the medication's effectiveness.

Order an additional oral antidiabetic agent.

The nurse is caring for a comatose older adult with stage 3 pressure injuries over two bony prominences. Which intervention should be added to the plan of care? Place lamb's wool under the lift sheet. Turn the client every 2 to 4 hours. Use an egg crate mattress. Place the client on a pressure redistribution bed.

Place the client on a pressure redistribution bed.

Which statement would be appropriate for a nurse documenting a stage 1 pressure ulcer found on a client who is immobilized? The client's skin is intact with non-blanchable redness of a localized area over a bony prominence. The client's skin has partial loss of dermis presenting as a shallow open ulcer with a red pink wound bed. The client's skin is a shiny, dry ulceration with bruising noted. The client's subcutaneous tissue is visible with a blood blistered wound bed.

The client's skin is intact with non-blanchable redness of a localized area over a bony prominence.

A nurse is planning care for a client newly diagnosed with diabetes mellitus type 1. Which statement illustrates an appropriate outcome criterion? The client will take medication as scheduled. The client will follow verbal instructions. The client will not experience any complications. The client will correctly demonstrate blood glucose testing prior to discharge.

The client will correctly demonstrate blood glucose testing prior to discharge.

A nurse is providing care for a client who has a sacral pressure ulcer with a wet-to-damp dressing. Which guideline is appropriate for a wet-to-damp dressing? The dressing should keep the wound moist. The wet-to-damp dressing should be tightly packed into the wound. The dressing should be allowed to dry out before removal. A plastic sheet-type dressing should cover the wet dressing.

The dressing should keep the wound moist.

An adolescent with insulin-dependent diabetes is being taught the importance of rotating the sites of insulin injections. The nurse should judge that the teaching was successful when the adolescent identifies which complication that can result of using the same site? development of resistance to insulin and need for increased amounts damage to nerves and painful neuritis destruction of the fat tissue and poor absorption thickening of the subcutis and too-rapid insulin uptake

destruction of the fat tissue and poor absorption

An adolescent with well-controlled type 1 diabetes has assumed complete management of the disease and wants to participate in gymnastics after school. To ensure safe participation, the nurse should instruct the client to adjust the therapeutic regimen by: increasing morning dosage of intermediate-acting insulin. eating a snack before each gymnastics practice. measuring blood glucose level after each gymnastics practice. measuring urine glucose level before each gymnastics practice.

eating a snack before each gymnastics practice.

The community health nurse is working with a client who has limited mobility. Which interventions would the nurse implement for primary prevention of skin breakdown? Select all that apply. care of a Stage II ulcer on the client's right heel encouragement of the client to walk around the home three times a day education of the client on turning frequently in the bed if lying down assistance with the client scheduling a visit to the healthcare provider instruction on the application of lotion for dry skin on extremities

encouragement of the client to walk around the home three times a day education of the client on turning frequently in the bed if lying down instruction on the application of lotion for dry skin on extremities

A nurse is assessing a client at the beginning of the shift. Which signs of hypoxia would alert the nurse to take further action? decreased pulse rate, increased blood pressure, and capillary refill time of 4 seconds pallor, hypotension, and bradypnea eupnea, oxygen saturation of 95%, and orthopnea increased pulse rate, oxygen saturation of 88%, and circumoral cyanosis

increased pulse rate, oxygen saturation of 88%, and circumoral cyanosis

A nurse is instructing a patient with asthma on the use of an inhaler with a spacer. The patient asks what the purpose of the spacer is. The nurse's best response is: "You should ask your physician to explain the purpose of the spacer." "The spacer traps medicine from the inhaler, then breaks up and slows down the medication particles, so you get more medication." "The physician has ordered the spacer and wants me to show you how to use it." "The spacer is a better way for you to receive the medication from the inhaler and you don't have to inhale when using it."

"The spacer traps medicine from the inhaler, then breaks up and slows down the medication particles, so you get more medication."

A client with newly diagnosed type 2 diabetes is admitted to the metabolic unit. The primary goal for this admission is education. Which goal should the nurse incorporate into their teaching plan? - weight reduction through diet and exercise - an eye examination every 2 years until age 50 - maintenance of blood glucose levels between 180 and 200 mg/dl (9.9 and 11.1 mmol/L) - smoking reduction but not complete cessation

- weight reduction through diet and exercise

While caring for a client who's immobile, a nurse documents this information in the client's chart: "Turned client from side to back every 2 hours." "Skin intact; no redness noted." "Client up in chair three times today." "Improved skin turgor noted." Which nursing diagnosis accurately reflects this information? Risk for impaired skin integrity related to immobility Impaired skin integrity related to immobility Constipation related to immobility Disturbed body image related to immobility

Risk for impaired skin integrity related to immobility

A nurse evaluates a new patient as having a Braden scale score of 9. What is the nurse's interpretation of this finding? The patient is at severe risk for pressure ulcer development and prevention precautions must be instituted immediately The patient is at no risk for pressure ulcer development and should be re-evaluated weekly or when any conditions change The patient is at not risk for pressure ulcer development and prevention planning is not needed The patient is at moderate risk for pressure ulcer development, should have some prevention precautions started, and should be re-evaluated daily

The patient is at severe risk for pressure ulcer development and prevention precautions must be instituted immediately?

The nurse is caring for a client that is experiencing increasing shortness of breath. The client is pale and slight circumoral cyanosis is developing. Which laboratory test best measures the adequacy of tissue oxygenation?\ red blood cell count arterial blood gases pulmonary function test hemoglobin level

arterial blood gases

The nurse is conducting an assessment of an elderly client who is blind. What would the nurse expect to be present in the client's medical history? -diabetes mellitus -systemic lupus erythematosus -cerebrovascular accident -cancer

diabetes mellitus

A nurse is teaching a school-age child with diabetes and her parents about managing diabetes during illness. The nurse determines that the parents understand the instruction when they indicate that they will make which treatment plan modification on days when the child is ill? decreasing the sliding scale insulin monitoring morning ketone levels holding all carbohydrate-containing foods increasing the frequency of blood glucose monitoring

increasing the frequency of blood glucose monitoring

The nurse is bathing a client and discovers a pressure ulcer on the buttocks (see photo). Which nursing intervention, following completion of the bath, is completed first? Position the client off of the ulcer. Massage the ulcerated area vigorously. Place antibiotic cream over the ulcerated area. Notify the health care provider and await orders.

Position the client off of the ulcer.

A client tells the nurse he is experiencing dyspnea. Which position will the nurse place the client in? Sims' position supine position Trendelenburg position high Fowler's position

high Fowler's position

After being sick for three days, a client with a history of diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). Which diagnostic test will the nurse prioritize in monitoring? serum sodium level serum chloride level serum potassium level serum calcium level

serum potassium level

The laboratory comes to draw an Hgb A1c. The client asks the nurse what this test represents. Which statement would be correct? - "This blood test is done to measure hyperglycemia in your system for 3 to 4 days after you were diagnosed with diabetic ketoacidosis (DKA)." -"This test is done to determine length of time that will be needed to correct the diabetic ketoacidosis (DKA) state." -"This test is needed to determine which insulin will be needed to prevent another diabetic ketoacidosis (DKA) episode." -"This test reflects the average blood glucose over a period of approximately 2-3 months."

-"This test reflects the average blood glucose over a period of approximately 2-3 months."

Which combination of adverse effects should a nurse monitor for when administering I.V. insulin to a client with diabetic ketoacidosis? hypernatremia and hypercalcemia hypokalemia and hypoglycemia hypocalcemia and hyperkalemia hyperkalemia and hyperglycemia

hypokalemia and hypoglycemia