Quiz 10

The patient with DM had a pancreas transplant and takes daily doses of cyclosporine (Neoral). For which key lab assessment does the nurse monitor? a. Serum electrolytes b. CBC with differential count c. Serum creatinine d. Clotting studies

C

Which statement about dietary concepts for a patient with diabetes is true? a. Alcoholic beverage consumption is unrestricted b. Carbohydrate counting is emphasized when adjusting dietary intake of nutrients c. sweeteners should be avoided because of the side effects d. both soluble and insoluble fiber foods should be limited

B

What is the basic principle of meal planning for a patient with type 1 DM? a. Five small meals per day plus a bedtime snack b. taking extra insulin when okaying to eat sweet foods c. High-protein, low-carbohydrates, and low-fiber foods d. Considering the effects and peak action times of the patient's insulin

D

In caring for Mr. D, you are vigilant for signs and symptoms for hypokalemia. What are you watching for? Select all that apply. a. fatigue b. seizure activity c. hallucinations d. muscle weakness e. hypotension f. weak pulse g. shallow respirations h. cold. clammy skin

adefg

A client with diabetes stats, " I cannot eat big meals I prefer to snack throughout the day,: What information should the nurse include in a response to this client's statement? a. Regulated food intake is basic to control. b. salt and sugar restriction us the main concern. c. small, frequent meals are better for digestion d. large meals can contribute to a weight problem.

a

The plan of are or a diabetic patient includes all o these interventions. Which intervention should you delegate to a UAP? a. Checking to make sure that the patient's bath water is not too hot b. Discussing community resources for diabetic outpatient care c. teaching the patient to perform daily foot inspection d. assessing the patient's technique for drawing insulin into a syringe

a

What do you anticipate the physician will order for initial fluid replacement>? a. Normal saline (0.9% sodium chloride) b. Half-strength saline (0.45% sodium chloride) c. Dextrose 5% in water and half-strength saline d. Normal saline with potassium chloride

a

You overhear one of the UAP talking to someone on the phone. The UAP says, "Yes, Mr. D is doing much better than when he first got here. I will tell him that you called and I will give him your message." What will you do first? a. ask the UAP about the phone conversion that you just overheard b. remind the UAP that release of information is outside of her scope of practice c. Report the UAP to the nurse manager for HIPAA violation d. Give the positive feedback for trying to help the client and the caller.

a

Which tasks are appropriate to assign to an experienced UAP? Select all that apply. a. measuring and reporting Mr. D's vital signs every 15 minutes b. checking and reporting Mr. D's blood glucose level c Bagging and labeling Mr.D's belongings d. Updating the roommate regarding Mr.D's status e. Measuring and recording the volume of Mr.D's vomitus

abce

In developing an individualized meal plan for a patient with diabetes, which goals will be focal points of the plan? Select all that apply. a. Maintaining blood glucose levels at or as close to normal range as possible b. patient food preferences c. allowing patients to eat as much as they desire d. Patient cultural preferences e. Limiting food choices only when guided by scientific evidence

abde

a 58-year-old with type 2 diabetes was admitted to your unit with a diagnosis of chronic obstructive pulmonary disease (COPD) exacerbating. when you prepare a care plan for this patient, what would you be sure to include? (select all that apply.) a. Fingerstick blood glucose checks before meals and at bedtime b. Sliding-scale insulin dosing as ordered c. bed rest unit the COPD exacerbation resolved d. Teaching about the Atkins diet for weight loss e. Demonstration of the components of foot care

abe

You are preparing to transfer Mr.D to the ICU, and you observe the cardiac monitor pattern. Which finding is of greatest concern? a. P wave precedes every QRS complex b. Ventricular dysrhythmias are occurring c. QRS complexes are occurring more frequently d. The isoelectric line shows an artifact

b

The nurse is providing discharge teaching to a patient about self-monitoring of blood glucose (SMBG). What information does the nurse include? Select all that apply. a. Only perform SMBG before breakfast b. Wash hands before using the meter c. Do a retest if the result seem unusual. d. It is okay to reuse lancets in the home setting e. Do not share the meter

BCE

The male diabetic patient asks the nurse for advice about alcohol consumption. what is the nurse's best response? a. "it is best to have alcohol near bedtime." b. "As long as your diabetes is under control you can drink as much as you like?" C. "You should drink only one alcoholic beverage with each meal." d. " Avoid more than two drinks a day and have then with or shortly after meals."

D

To clarify pertinent data, what questions are appropriate to ask Mr. D? Select all that apply. a. when did your symptoms start? b. how many times have you vomited c. what was your last blood sugar reading d. wit didn't you go to see your physician e. where does your abdomen hurt f. did you take any insulin today g. do you have any allergies?

abefg

Which tasks can you delegate to an experienced UAP to facilitate for Mr.D's transfer to the ICU? Select all that apply. a. Giving Mr.D's roommate directions to the ICU b. Independently transporting Mr.D to the ICU c. Collecting and organizing the chart and laboratory reports d. Obtaining a portable oxygen tank and cardiac monitor e. Connecting Mr.D's ECG leads to the portable cardiac monitor f. Obtaining the last set of vital sign values

adef

An insulin infusion is ordered for Mr. D to begin at 0.1 units/kg/hr. Mr.D weighs 155 lb. The pharmacy delivers a premixed bag of 100 units of regular insulin in 100 mL of normal saline. Another nurse has calculated the infusion pump setting as 10 mL/hr. What will you do next? a. Tell the nurse to obtain a pump and start the infusion as calculated b. advise the nurse to recalculate the infusion rate. c. Call the physician and ask for exact pump setting to be clarified d. allow the nurse to independently administer the infusion using her own best judgement

b

In emergency department during initial assessment of a newly-admitted patient with diabetes, the nurse discovers all of these findings. Which findings should be reported to the health care provider immediately. a. hammer toe of the left second metatarsophalangeal joint b. rapid respiratory rate with deep inspirations c.numbness and tingling bilaterally in the feet and hands d. decreased sensitivity and swelling of the abdomen

b

The nurse identifies the dietary teaching provided for a client with diabetes is understood when the client states, my diet: a. should be rigidly controlled to avoid emergencies b. can be planned around a wide variety of commonly used foods c. is based on nutritional requirements that are the same for all people d. Must not include eating any combination dishes and processed foods.

b

You are reviewing the intensive care unit admission orders. there is an order for an IV potassium infusion. related specifically to the order for potassium, which information would the UCI nurse be most interested in knowing? a. Mental status has improved with therapy b. urinary output is 60 mL/hr and urine is a clear yellow color c. Blood pressure was 100/60 mmHg on admission and is now 125/76 mmHg d. One IV site showed infiltration, but the current IV line flushes easily

b

You are reviewing the potassium values that were obtained when Mr.D first arrived in the ED. Which serum potassium level would you the most? a. 3.5 mEq/L b. 2.0 mEq/L c. 5.8 mEq/L d. 6.0 mEq/L

b

You are trying to call a report to the ICU but you are told, "We were not notified about the admission." You call the admitting clerk, but she says, "I was never notified." You ask the unit secretary and he tells you, "I forgot to do it." What should you do first? a. Report the unit secretary to the manager b. Ask the secretary to call the admission office now c. Take the secretary aside and allow him to explain his actions d. Ask the ICU to take the report regardless of the clerical omission

b

A nurse plans an evening snack of milk crackers, and cheese for a client who is receiving NPH insulin (Novolin N). What does this snack provide? a. encouragement to stay on the diet b. added calories to promote weight gain c. nourishment to counteract late insulin activity d. high-carbohydrate nourishment for immediate use

c

An LPN/LVN's assessment for two diabetic patients reveals all of these findings. Which would you instruct the LPN/LVN to report immediately? a. Fingerstick glucose reading of 185 mg/dL b. Numbness and tingling in both feet c. profuse perspiration d. Bunion on the left great toe

c

Mr.D says to you, Please don't call my mother. If she knows I'm back in the hospital, she'll make me quit school and move back home. I know I messed up, but I really don't want to move back in with my parents. what is the best therapeutic communications response? a. none of the staff will say anything, but you should tell her yourself b. Your mom loves you, and she is just concerned about your well-being c. It sounds like you want to be independent and responsible for yourself d. you are an adult and you have a right to make your own decisions

c

What is the priority nursing diagnosis for Mr. D? a. ineffective breathing pattern related to acidosis b. anxiety related to the uncertainty of the outcome c. deficient fluid volume related to hyperglycemia d. noncompliance related to medications and treatment

c

In the initial emergency care for Mr.D, which orders would you question? Select all that apply. a. Start a peripheral IV line with a large-bore catheter b. Insert a Foley catheter with a urinometer c. Administer regular insulin subcutaneously d. Maintain the client in a semi-Fowler position. e. Initiate continuous electrocardiographic (ECG) monitoring f. Encourage intake of oral fluids as tolerated

cf

You have completed the triage assessment and history taking. Now, what is your priority action? a. page the ED physician to come immediately to triage b. call the client's parents for permission to treat c. notify the client's primary care physician d. take the client immediately to a treatment room.

d