Endocrine HW Qs

Question 1

The nurse is teaching a 12-year-old child about the action of insulin injections. Which statement indicates the child understands how insulin works in the body?
A. ‘Glucose is released as fats break down.’
B. ‘It keeps glucose from being stored in the liver.’
C. ‘Glucose is carried into cells where it is used for energy.’
D. ‘It stops the wasting of blood glucose by converting it to glycogen.’

Answer 1

C. ‘Glucose is carried into cells where it is used for energy.’

Question 2

A client states, ‘I keep my insulin in the refrigerator because that is where my parents kept it.’ Which reason will the nurse include when explaining why insulin should be stored at room temperature?
A. Its potency and effectiveness are maximized.
B. Absorption is enhanced and local irritation is decreased.
C. It is more convenient and drawing insulin into the syringe is facilitated.
D. Adherence of insulin to the syringe and resistance upon injection are decreased.

Answer 2

B. Absorption is enhanced and local irritation is decreased.

Question 3

A client who receives NPH insulin every morning reports feeling nervous at 4:30 PM. The nurse observes that the client’s skin is moist and cool. Which condition is the client likely experiencing?
A. Hyperosmolar hyperglycemic nonketotic state
B. Ketoacidosis
C. Glycogenesis
D. Hypoglycemia

Answer 3

D. Hypoglycemia

Question 4

The nurse administers a tube of glucose gel to a client who is hypoglycemic. Which explanation would the nurse share regarding the reversal of hypoglycemia?
A. It liberates glucose from hepatic stores of glycogen.
B. It provides a glucose source that is rapidly absorbed.
C. Insulin action is blocked as it competes for tissue sites.
D. Glycogen is supplied to the brain as well as other vital organs.

Answer 4

B. It provides a glucose source that is rapidly absorbed.

Question 5

Several hours after administering insulin, the nurse assesses the client’s response to the insulin. Which client responses are indicative of a hypoglycemic reaction? Select all that apply. One, some, or all responses may be correct.
A. Tremors
B. Anorexia
C. Confusion
D. Glycosuria
E. Diaphoresis

Answer 5

A. Tremors
C. Confusion
E. Diaphoresis

Question 6

A client with type 1 diabetes receives 30 units of neutral protamine Hagedorn (NPH) insulin at 7:00 AM. At 3:30 PM, the client becomes diaphoretic, weak, and pale. With which condition would the nurse determine that these physiological responses are associated?
A. Diabetic coma
B. Hyperosmolar hyperglycemic nonketotic syndrome
C. Diabetic ketoacidosis
D. Hypoglycemic reaction

Answer 6

D. Hypoglycemic reaction

Question 7

In addition to clients who are receiving insulin for type 1 diabetes, the nurse will assess for signs and symptoms of hypoglycemia in clients who have which diagnosis?
A. Liver failure
B. Anemia
C. Hyperthyroidism
D. Stage 3 hypertension

Answer 7

A. Liver failure

Question 8

The nurse is caring for a client with type 1 diabetes. Which signs or symptoms may indicate that the client has insulin-induced hypoglycemia? Select all that apply. One, some, or all responses may be correct.
A. Excessive hunger
B. Weakness
C. Diaphoresis
D. Excessive thirst
E. Deep respirations

Answer 8

A. Excessive hunger
B. Weakness
C. Diaphoresis

Question 9

A client with diabetes presents to the emergency department with a 3-hour history of profound weakness and nervousness. According to the spouse, the client became confused shortly after self-administering the morning dose of 10 units of regular insulin and 25 units of NPH insulin. The client had a light breakfast and no additional intake since that time. Which condition would the nurse identify as the likely cause of the client’s signs and symptoms?
A. Hyperglycemia
B. Hyperinsulinemia
C. Hypoglycemia
D. Hypoinsulinemia

Answer 9

C. Hypoglycemia

Question 10

A client with type 1 diabetes experiences tremors, pallor, and diaphoresis. These signs and symptoms are manifestations of which cause?
A. Overeating
B. Viral infection
C. Aerobic exercise
D. Missed insulin dose

Answer 10

C. Aerobic exercise

Question 11

Which finding would lead the nurse to recheck the blood glucose level of a diabetic client before administering a mealtime insulin dose? Select all that apply. One, some, or all responses may be correct.
A. Confusion
B. Drowsiness
C. Diaphoresis
D. Nervousness
E. Heart rate 110 beats/min

Answer 11

A. Confusion
B. Drowsiness
C. Diaphoresis
D. Nervousness
E. Heart rate 110 beats/min

Question 12

A nurse is assessing a client diagnosed with diabetic ketoacidosis. The client is on a prescribed regular insulin infusion at 0.1 units/kg/hr. The client appears restless and verbalizes tingling to the extremities. Which action does the nurse perform next?
A. Check the client capillary blood glucose
B. Stop the regular insulin infusion
C. Increase the infusion to 0.15 units/kg/hr
D. Give the client 4 oz of fruit juice

Answer 12

A. Check the client capillary blood glucose

Question 13

Which response would a nurse give to a client taking an oral hypoglycemic tablet daily who asks if an extra tablet should be taken before exercise?
A. “You will need to decrease your exercise.”
B. “An extra tablet will help your body use glucose correctly.”
C. “When taking medicine, your diet will not be affected by exercise.”
D. “No, but you should observe for signs of hypoglycemia while exercising.”

Answer 13

D. “No, but you should observe for signs of hypoglycemia while exercising.”

Question 14

Which complication of diabetes would the nurse suspect when a health care provider prescribes one tube of glucose gel for a client with type 1 diabetes?
A. Diabetic acidosis
B. Hyperinsulin secretion
C. Insulin-induced hypoglycemia
D. Idiosyncratic reactions to insulin

Answer 14

C. Insulin-induced hypoglycemia

Question 15

The nurse is caring for a client who reports sweating, tachycardia, and tremors. The laboratory report of the client reveals serum cortisol less than normal and a blood glucose level of 60 mg/dL. Which medication would be administered to this client?
A. Glucagon
B. Kayexalate
C. Hydrocortisone
D. Insulin with dextrose in normal saline

Answer 15

A. Glucagon

Question 16

A client with type 2 diabetes takes one glyburide tablet daily. The client asks whether an extra tablet should be taken before exercise. Which response will the nurse provide?
A. ‘You will need to decrease how much you are exercising.’
B. ‘An extra pill will help your body use glucose when exercising.’
C. ‘The amount of medication you need to take is not related to exercising.’
D. ‘Do not take an extra pill because you may become hypoglycemic when exercising.’

Answer 16

D. ‘Do not take an extra pill because you may become hypoglycemic when exercising.’

Question 17

The nurse concludes that a client has a hypoglycemic reaction to insulin. Which clinical findings support this conclusion? Select all that apply. One, some, or all responses may be correct.
A. Irritability
B. Glycosuria
C. Dry, hot skin
D. Heart palpitations
E. Fruity odor of breath

Answer 17

A. Irritability
D. Heart palpitations

Question 18

A client with diabetes asks how exercise will affect insulin and dietary needs. Which effects of exercise would the nurse share?
A. Increases the amount of insulin needed and increases the need for carbohydrates
B. Increases the amount of insulin needed and decreases the need for carbohydrates
C. Decreases the amount of insulin needed and increases the need for carbohydrates
D. Decreases the amount of insulin needed and decreases the need for carbohydrates

Answer 18

C. Decreases the amount of insulin needed and increases the need for carbohydrates

Question 19

The health care provider prescribes an oral hypoglycemic medication for the client with type 2 diabetes. Which statement will the nurse need to consider when developing the teaching plan?
A. Oral hypoglycemics work by decreasing absorption of carbohydrates.
B. Oral hypoglycemics work by stimulating the pancreas to produce insulin.
C. Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control.
D. Serious adverse effects are not a problem for oral hypoglycemics.

Answer 19

C. Clients taking oral hypoglycemics may subconsciously relax dietary rules to gain a sense of control.

Question 20

The nurse is teaching a 10-year-old child with type 1 diabetes about insulin requirements. Which statement by the nurse correctly identifies when insulin needs decrease?
A. ‘Insulin needs often decrease when puberty is reached.’
B. ‘When there is an infection is present, the body requires less insulin.’
C. ‘Emotional stress can cause insulin needs to decrease.’
D. ‘Increased muscle activity, such as exercise, causes insulin needs to decrease.’

Answer 20

D. ‘Increased muscle activity, such as exercise, causes insulin needs to decrease.’

Question 21

The nurse is caring for a client with diabetes type I who received a prescribed dose of regular insulin 30 minutes prior to the meal. The client reports nausea and vomiting. Which action should the nurse take?
A. Administer another dose of regular insulin
B. Encourage the client to eat a small amount of carbohydrates
C. Assess blood glucose level
D. Notify the healthcare provider

Answer 21

C. Assess blood glucose level

Question 22

Which independent nursing action would be included in the plan of care for a client after an episode of ketoacidosis?
A. Monitoring for signs of hypoglycemia resulting from treatment
B. Withholding glucose in any form until the situation is corrected
C. Giving fruit juices, broth, and milk as soon as the client is able to take fluids orally
D. Regulating insulin dosage according to the client’s urinary ketone levels

Answer 22

A. Monitoring for signs of hypoglycemia resulting from treatment

Question 23

Which manifestation would the nurse include when teaching a client about ketoacidosis? Select all that apply. One, some, or all responses may be correct.
A. Confusion
B. Hyperactivity
C. Excessive thirst
D. Fruity-scented breath
E. Decreased urinary output

Answer 23

A. Confusion
C. Excessive thirst
D. Fruity-scented breath

Question 24

Which purpose of insulin would a nurse identify when caring for a client prescribed insulin added to a solution of 10% dextrose in water after an intravenous solution containing potassium inadvertently was infused too rapidly?
A. Glucose with insulin increases metabolism, which accelerates potassium excretion.
B. Increased potassium causes a temporary slowing of the pancreatic production of insulin.
C. Increased insulin accelerates the excretion of glucose and potassium, thereby decreasing the serum potassium level.
D. Potassium follows glucose into the cells of the body, thereby raising the intracellular potassium level.

Answer 24

D. Potassium follows glucose into the cells of the body, thereby raising the intracellular potassium level.

Question 25

Which rationale accurately explains why insulin is prescribed for clients in acute renal failure?
A. It promotes transfer of potassium into cells to lower serum potassium levels.
B. Insulin is required because the alpha cells of the pancreas cease to function with renal failure.
C. It is necessary to manage the elevated blood glucose levels that accompany renal failure.
D. Insulin reduces the accumulated toxins by lowering the metabolic rate.

Answer 25

A. It promotes transfer of potassium into cells to lower serum potassium levels.

Question 26

Intravenous fluids and insulin are prescribed to treat a client’s diabetic ketoacidosis. The client develops peripheral paresthesias and shortness of breath. The cardiac monitor shows the appearance of a U wave. Which complication would the nurse suspect?
A. Hypokalemia
B. Hypoglycemia
C. Hypernatremia
D. Hypercalcemia

Answer 26

A. Hypokalemia

Question 27

Which rationale explains why intravenous (IV) potassium is prescribed in addition to regular insulin for clients in diabetic ketosis?
A. Potassium loss occurs rapidly from diaphoresis present during coma.
B. Potassium is carried with glucose to the kidneys to be excreted in the urine in increased amounts.
C. Potassium is quickly used up during the rapid series of catabolic reactions stimulated by insulin and glucose.
D. Serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the intracellular fluid compartment.

Answer 27

D. Serum potassium levels will decrease as potassium ions shift from the extracellular fluid to the intracellular fluid compartment.

Question 28

The nurse adds 20 mEq of potassium chloride to the intravenous solution of a client with diabetic ketoacidosis. Which purpose would this medication serve?
A. Treats hyperpnea
B. Prevents flaccid paralysis
C. Prevents hypokalemia
D. Treats cardiac dysrhythmias

Answer 28

C. Prevents hypokalemia

Question 29

A client is diagnosed with acute kidney failure secondary to dehydration. An intravenous (IV) infusion of 50% glucose with regular insulin is prescribed to address which purpose?
A. To correct hyperkalemia
B. To increase urinary output
C. To prevent respiratory acidosis
D. To increase serum calcium levels

Answer 29

A. To correct hyperkalemia

Question 30

An adolescent with type 1 diabetes mellitus is admitted to the intensive care unit in ketoacidosis with a blood glucose level of 170 mg/dL (9.4 mmol/L). A continuous insulin infusion is started. Which adverse reaction to the infusion is most important for the nurse to monitor?
A. Hypokalemia
B. Hypovolemia
C. Hypernatremia
D. Hypercalcemia

Answer 30

A. Hypokalemia

Question 31

Which information would the nurse provide to a client with type 1 diabetes who requests information about the differences between penlike insulin delivery devices and syringes?
A. “The penlike devices have a shorter injection time.”
B. “Penlike devices provide a more accurate dose delivery.”
C. “The penlike delivery system uses a smaller-gauge needle.”
D. “Penlike devices cost less by having reusable insulin cartridges.”

Answer 31

B. “Penlike devices provide a more accurate dose delivery.”

Question 32

Which is the priority short-term goal when teaching a client with type 1 diabetes who is placed on an insulin pump to control the diabetes?
A. “The client will adhere to the medical regimen.”
B. “The client will remain normoglycemic for 3 weeks.”
C. “The client will demonstrate correct use of the insulin pump.”
D. “The client will list three self-care activities that are necessary to control the diabetes.”

Answer 32

C. “The client will demonstrate correct use of the insulin pump.”

Question 33

Which statement by the nurse is most appropriate regarding the greatest advantage of using an insulin pump?
A. ‘Independence is fostered.’
B. ‘Fear of daily injections is allayed.’
C. ‘Dietary restrictions are minimized.’
D. ‘Blood glucose monitoring can be eliminated.’

Answer 33

A. ‘Independence is fostered.’

Question 34

The nurse is teaching a school-age child how to use an insulin pump. Which instruction by the nurse is most important for the child to understand?
A. The needle must be changed every day.
B. A blood glucose check is necessary once a day.
C. The pump is an attempt to mimic the way a healthy pancreas works.
D. Subcutaneous pockets near the abdomen are used to implant the pump.

Answer 34

C. The pump is an attempt to mimic the way a healthy pancreas works.

Question 35

Which advice will the nurse give the client to avoid lipodystrophy when self-administering insulin therapy?
A. Exercise regularly.
B. Rotate injection sites.
C. Use the Z-track technique.
D. Vigorously massage the injection site.

Answer 35

B. Rotate injection sites.

Question 36

The nurse identifies a nontender 5-cm indurated region on the upper arm of a client with type 1 diabetes. The client says to the nurse, ‘That is where I give myself insulin shots.’ The nurse concludes that the nodule is a result of which condition?
A. Callus
B. An allergy
C. An infection
D. Lipodystrophy

Answer 36

D. Lipodystrophy

Question 37

The nurse plans to teach a client with type 1 diabetes about the use of an insulin pump. Which information will the nurse include in client teaching?
A. Insulin pumps mimic the way a healthy pancreas works.
B. The insulin pump’s needle should be changed every day.
C. Pumps are implanted in a subcutaneous pocket near the abdomen.
D. The insulin pump’s advantage is that it only requires glucose monitoring once a day.

Answer 37

A. Insulin pumps mimic the way a healthy pancreas works.

Question 38

A nurse receives a prescription to administer regular insulin U-500 to a client with diabetes mellitus. How will the nurse administer this medication?
A. Intravenously using an infusion pump
B. Subcutaneously using an insulin pump
C. Intramuscularly using a U-100 syringe
D. Subcutaneously using a U-500 syringe

Answer 38

D. Subcutaneously using a U-500 syringe

Question 39

A nurse is educating a client on insulin administration. Which statement made by the client indicates further teaching is required?
A. I will inject the insulin in the same site every day
B. The best injection area is around my abdomen
C. I will squeeze my skin together to inject the medication
D. Gentle pressure should be applied to the site after injection

Answer 39

A. I will inject the insulin in the same site every day

Question 40

A nurse is preparing to withdraw insulin into a syringe in the medication room. The nurse notes an open, full vial of regular insulin with no labeled expiration date. Which action does the nurse take?
A. Discard the vial and request a new one from the pharmacy
B. Label the vial with the current date and withdraw the medication
C. Withdraw the medication and discard the vial
D. Store the medication in the refrigerator and notify the pharmacy

Answer 40

A. Discard the vial and request a new one from the pharmacy

Question 41

The nurse is preparing to administer insulin to a client with diabetes. In which order will the nurse perform the actions associated with insulin administration?
1. Wash hands with soap and water.
2. Rotate the vial of insulin between the palms of the hands.
3. Wipe the top of the insulin vial with an alcohol swab.
4. Instill air into the vial of insulin equal to the desired dose.
5. Withdraw the correct amount of insulin from the inverted vial.

Answer 41

1. Wash hands with soap and water.
2. Rotate the vial of insulin between the palms of the hands.
3. Wipe the top of the insulin vial with an alcohol swab.
4. Instill air into the vial of insulin equal to the desired dose.
5. Withdraw the correct amount of insulin from the inverted vial.

Question 42

The nurse mixes a short-acting and an intermediate-acting insulin in the same syringe. List the actions in the order the nurse will perform them.
1. Put air into the intermediate-acting insulin vial.
2. Put air into the short-acting insulin vial.
3. Withdraw the prescribed amount of short-acting insulin.
4. Withdraw the prescribed amount of intermediate-acting insulin.

Answer 42

1. Put air into the intermediate-acting insulin vial.
2. Put air into the short-acting insulin vial.
3. Withdraw the prescribed amount of short-acting insulin.
4. Withdraw the prescribed amount of intermediate-acting insulin.

Question 43

A nurse is preparing to administer insulin to a client with diabetes mellitus type 1. The client has regular insulin and insulin glargine prescribed. How will the nurse prepare these medications?
A. Draw up the glargine insulin before the regular insulin
B. Mix the insulins in a larger syringe
C. Use a separate syringe for each insulin
D. Draw up the regular insulin before the glargine insulin

Answer 43

C. Use a separate syringe for each insulin

Question 44

The nurse is preparing to administer a client’s prescribed NPH and regular insulins. Which action should the nurse take first when mixing the insulins in one syringe?
A. Draw up the NPH
B. Draw up the regular insulin
C. Inject air into the NPH
D. Inject air into the regular insulin

Answer 44

C. Inject air into the NPH

Question 45

The nurse is preparing to administer a client’s prescribed insulins and needs to mix NPH and lispro. Which of the following actions should the nurse take first?
A. Inject air into the long-acting insulin
B. Draw up the short-acting insulin
C. Draw up the long-acting insulin
D. Inject air into the short-acting insulin

Answer 45

A. Inject air into the long-acting insulin

Question 46

A client with type 1 diabetes mellitus has a finger-stick glucose level of 258 mg/dL (14.3 mmol/L) at bedtime. A prescription for sliding-scale regular insulin exists. Which would the nurse do?
A. Call the health care provider.
B. Encourage intake of fluids.
C. Administer the insulin as prescribed.
D. Give the client 4 ounces of orange juice.

Answer 46

C. Administer the insulin as prescribed.

Question 47

The nurse is caring for a client who has a prescription for an insulin sliding scale to manage the client’s hyperglycemia. At 11 am, the client’s blood glucose level was 285 mg/dL (15.8 mmol/L). According to the following sliding scale parameters, how many units of insulin should the nurse administer?
* For glucose less than 140, give 0 units of insulin aspart.
* For glucose between 140 to 180, give 2 units of insulin aspart.
* For glucose between 181 to 220, give 4 units of insulin aspart.
* For glucose between 221 to 260, give 6 units of insulin aspart.
* For glucose between 261 to 300, give 8 units of insulin aspart.
* For glucose greater than 300, notify the health care provider.
A. 2 units
B. 4 units
C. 6 units
D. 8 units

Answer 47

D. 8 units

Question 48

The nurse plans to teach a fifth-grader with type 1 diabetes how to self-administer lispro and glargine insulin. Which action would the nurse include in the teaching plan?
A. Alternate the sites until the best one to use is found.
B. Self-administer the injections after being taught the technique.
C. Draw up the insulin glargine and then draw up the insulin lispro.
D. Learn to use the needle and syringe by practicing on an insulin pad first.

Answer 48

D. Learn to use the needle and syringe by practicing on an insulin pad first.

Question 49

A client has type 2 diabetes controlled with oral antidiabetic medications. When admitted for elective surgery, the health care provider prescribes regular insulin. Which information would the nurse include when teaching the client about the addition of insulin?
A. ‘You will need a higher serum glucose level while on bed rest.’
B. ‘The stress of surgery may cause hypoglycemia.’
C. ‘With insulin, dosage can be adjusted to your changing needs during recovery from surgery.’
D. ‘The possibility of surgical complications is greater when a client takes oral hypoglycemics.’

Answer 49

C. ‘With insulin, dosage can be adjusted to your changing needs during recovery from surgery.’

Question 50

Which instruction about medications would the nurse include when teaching a client with type 1 diabetes who tells the nurse, “I take guaifenesin cough syrup when I have a cold”?
A. “Substitute an elixir for the cough syrup.”
B. “Increase fluid intake and use a humidifier to control the cough.”
C. “The small amounts of sugar in medications are not a concern with diabetes.”
D. “Include the glucose in the cough syrup when calculating daily carbohydrate allowance.”

Answer 50

D. “Include the glucose in the cough syrup when calculating daily carbohydrate allowance.”

Question 51

Which instruction will the nurse provide to a client with type 2 diabetes who develops gout when teaching about the administration of allopurinol?
A. “Allopurinol masks symptoms of hypoglycemia.”
B. “Increase your oral hypoglycemic medications.”
C. “Increase attention to diabetic foot care.”
D. “Monitor blood glucose levels more frequently.”

Answer 51

D. “Monitor blood glucose levels more frequently.”

Question 52

How will the nurse respond to a client with a new diagnosis of type 1 diabetes who becomes agitated and says, “I am scared of shots. If that is my only option, I’ll just have to go into a coma and die!” when told that lifelong insulin will be needed?
A. “Injections are not the only option available for insulin.”
B. “It won’t be so bad; you will get used to it if you will only try.”
C. “This is one of those times when you need to act like an adult.”
D. “Clients have the right to refuse treatment, but I need you to sign this form that removes us from liability for your decision.”

Answer 52

A. “Injections are not the only option available for insulin.”

Question 53

Which response would a nurse give to a client diagnosed with type 1 diabetes who states, “I hate shots. Why can’t I take the insulin in tablet form?”
A. “Your diabetic condition is too serious for oral insulin.”
B. “Insulin is poorly absorbed orally, so it is not available in a tablet.”
C. “Insulin by mouth causes a high incidence of allergic and adverse reactions.”
D. “Once your diabetes is controlled, your primary health care provider might consider oral insulin.”

Answer 53

B. “Insulin is poorly absorbed orally, so it is not available in a tablet.”

Question 54

The nurse is planning to teach an adolescent about diabetes and self-administration of insulin. Which would the nurse complete first?
A. Establish realistic goals.
B. Assess the adolescent’s intellectual ability.
C. Determine what the adolescent knows about diabetes.
D. Gather the equipment that will be needed for the demonstration.

Answer 54

C. Determine what the adolescent knows about diabetes.

Question 55

Which response by the nurse would be most appropriate to promote a sense of control in a 6-year-old child who is about to receive an injection?
A. ‘This won’t hurt, so you shouldn’t cry.’
B. ‘Which arm should I use to give you the medicine?’
C. ‘I know you’re grown up. You won’t cry, will you?’
D. ‘Close your eyes. You won’t even know what’s happening.’

Answer 55

B. ‘Which arm should I use to give you the medicine?’

Question 56

Which statement made by a client recently diagnosed with type 1 diabetes indicates that further education is necessary regarding the teaching plan?
A. ‘I will need to have my eyes and vision examined once a year.’
B. ‘I will need to check my blood sugar at home to evaluate my response to my treatment plan.’
C. ‘I can improve metabolic and cardiac risk factors of this disease if I follow a healthy diet and exercise routine.’
D. ‘Once I get my glucose levels under control, there is a good chance that I will be able to switch from insulin to an oral medication.’

Answer 56

D. ‘Once I get my glucose levels under control, there is a good chance that I will be able to switch from insulin to an oral medication.’

Question 57

A client who is taking an oral hypoglycemic daily for type 2 diabetes develops an infection with anorexia. Which advice will the nurse provide to the client? Select all that apply. One, some, or all responses may be correct.
A. Avoid solid food.
B. Continue to take the oral medication.
C. Drink fluids throughout the day.
D. Monitor capillary glucose levels.
E. Do not take medication until tolerating food.

Answer 57

B. Continue to take the oral medication.
C. Drink fluids throughout the day.
D. Monitor capillary glucose levels.

Question 58

During a teaching session about insulin injections, a client asks the nurse, ‘Why can’t I take the insulin in pills instead of taking shots?’ How will the nurse respond?
A. ‘Insulin cannot be manufactured in pill form.’
B. ‘Insulin is destroyed by gastric juices, rendering it ineffective.’
C. ‘Your health care provider decides the route of administration.’
D. ‘Your health care provider will prescribe pills when you are ready.’

Answer 58

B. ‘Insulin is destroyed by gastric juices, rendering it ineffective.’

Question 59

A nurse is administering insulin glargine to a client with diabetes type I. The client asks the nurse why insulin is the only option for therapy. Which statement by the nurse is appropriate?
A. Your body does not produce an adequate amount of insulin
B. Insulin is better at controlling the disease than oral pills
C. Your body has a resistance to insulin
D. Oral pills take longer to produce therapeutic effects than insulin

Answer 59

A. Your body does not produce an adequate amount of insulin

Question 60

The client is newly diagnosed with type 1 diabetes mellitus. Which of these approaches would be the best strategy for the nurse to use when teaching insulin injection techniques?
A. Give written pre and post tests
B. Allow another diabetic to assist
C. Ask questions during practice
D. Observe a return demonstration

Answer 60

D. Observe a return demonstration

Question 61

Intravenous (IV) insulin is prescribed for a client. Which insulin can be administered IV? Select all that apply. One, some, or all responses may be correct.
A. Lispro insulin
B. Aspart insulin
C. Regular insulin
D. Glargine insulin
E. Glulisine insulin

Answer 61

A. Lispro insulin
B. Aspart insulin
C. Regular insulin
E. Glulisine insulin

Question 62

At 9 am, the nurse administers 10 units of insulin aspart subcutaneously to a client with a blood sugar of 322 mg/dL. At approximately what time should the nurse expect the insulin to peak?
A. At 9:30 am
B. At 10:00 am
C. At noon
D. This insulin does not peak because it acts over 24 hours.

Answer 62

B. At 10:00 am

Question 63

Which insulin will the nurse prepare for the emergency treatment of ketoacidosis?
A. Glargine
B. NPH insulin
C. Insulin aspart
D. Insulin detemir

Answer 63

C. Insulin aspart

Question 64

At the client’s request, the nurse performs a fingerstick to test the client’s blood glucose and the results are 322 mg/dL (17.9 mmol/L). Following the insulin sliding scale orders, the nurse administers 3 units of insulin lispro at 11:00 AM. When does the nurse anticipate the insulin lispro will begin to act?
A. 3:00 pm
B. 11:15 am
C. 1:00 pm
D. 12:00 PM

Answer 64

B. 11:15 am

Question 65

Which insulin would the nurse conclude has the fastest onset of action?
A. NPH insulin
B. Insulin lispro
C. Regular insulin
D. Insulin glargine

Answer 65

B. Insulin lispro

Question 66

A client with diabetes mellitus is scheduled to receive an intravenous (IV) administration of 25 units of insulin in 250 mL normal saline. Which type of insulin would the nurse recognize as compatible with IV solutions?
A. NPH insulin
B. Insulin lispro
C. Insulin detemir
D. Insulin glargine

Answer 66

B. Insulin lispro

Question 67

The nurse is caring for a client with diabetes mellitus. The client reports feeling hungry and thirsty. The client’s most recent blood glucose level was 175 mg/dL. Which type of insulin should the nurse anticipate being prescribed for this client?
A. Glucagon
B. Lispro
C. Exenatide
D. Sitagliptin

Answer 67

B. Lispro

Question 68

An adolescent with diabetes had a 6:30 AM fasting blood glucose level of 180 mg/dL (10.0 mmol/L). Which nursing action is a priority?
A. Encourage the adolescent to start exercising.
B. Ask the adolescent to obtain an immediate glucometer reading.
C. Inform the adolescent that a complex carbohydrate such as cheese should be eaten.
D. Tell the adolescent that the prescribed dose of rapid-acting insulin should be administered.

Answer 68

D. Tell the adolescent that the prescribed dose of rapid-acting insulin should be administered.

Question 69

Which period of time would a nurse recognize as the greatest risk of hypoglycemia when caring for a client who receives regular insulin daily at 8:00 AM?
A. 8:30 AM to 9:30 AM
B. 8:00 PM to 12:00 AM
C. 1:00 PM to 8:00 PM
D. 10:00 AM to 1:00 PM

Answer 69

D. 10:00 AM to 1:00 PM

Question 70

Daily regular insulin has been prescribed for a client with type 1 diabetes. The nurse administers the insulin at 8 AM. When will the nurse monitor the client for a potential hypoglycemic reaction?
A. At breakfast
B. Before lunch
C. Before dinner
D. In the early afternoon

Answer 70

B. Before lunch

Question 71

The nurse is planning an evening snack for a child receiving NPH insulin. The nurse offers a snack for which reason?
A. It encourages the child to stay on the diet.
B. Energy is needed for immediate utilization.
C. Extra calories will help the child gain weight.
D. Nourishment helps counteract late insulin activity.

Answer 71

D. Nourishment helps counteract late insulin activity.

Question 72

Which purpose is served by an evening snack of milk, crackers, and cheese for a client who is receiving NPH insulin?
A. Encouragement to stay on the diet
B. Food to counteract late insulin activity
C. Added calories to promote weight gain
D. High carbohydrates to provide nourishment for immediate use

Answer 72

B. Food to counteract late insulin activity

Question 73

A client with type 1 diabetes self-administers neutral protamine Hagedorn (NPH) insulin every morning at 8:00 AM. The nurse evaluates that the client understands the action of the insulin when the client identifies which time range as the highest risk for hypoglycemia?
A. 9:00 AM to 10:00 AM
B. 10:00 AM to 11:00 AM
C. Noon to 8:00 PM
D. 8:00 PM to midnight

Answer 73

C. Noon to 8:00 PM

Question 74

The nurse teaches an adolescent about administration of intermediate-acting insulin and regular insulin. Which response indicates the adolescent understands when to administer the second dose of NPH insulin?
A. At lunch
B. At dinnertime
C. 1 hour after lunch
D. 1 hour after dinner

Answer 74

B. At dinnertime

Question 75

The nurse teaches an adolescent with type 1 diabetes about peak action of NPH insulin and the risk for hypoglycemia. The nurse determines teaching has been effective when the adolescent identifies insulin peak action within which time frame?
A. 1 to 2 hours
B. 2 to 4 hours
C. 5 to 10 hours
D. 4 to 12 hours

Answer 75

D. 4 to 12 hours

Question 76

A child with type 1 diabetes is receiving 15 units of regular insulin and 20 units of NPH insulin at 7:00 AM each day. Which time would the nurse anticipate a hypoglycemic reaction from the NPH insulin to occur?
A. Before noon
B. In the afternoon
C. Within 30 minutes
D. During the evening

Answer 76

B. In the afternoon

Question 77

A child is prescribed insulin glargine before breakfast. Which instruction is most appropriate for the nurse to give the parents regarding a bedtime snack?
A. ‘Offer a snack to prevent hypoglycemia during the night.’
B. ‘Give the child a snack if signs of hyperglycemia are present.’
C. ‘Avoid a snack because the child is being treated with long-acting insulin.’
D. ‘Keep a snack at the bedside in case the child gets hungry during the night.’

Answer 77

A. ‘Offer a snack to prevent hypoglycemia during the night.’

Question 78

The nurse is teaching a client about an oral hypoglycemic medication. The nurse should place priority emphasis on which of the following points?
A. Consulting with the health care provider about dose changes based on blood glucose
B. Distinguishing signs and symptoms of hypoglycemia and hyperglycemia
C. Adherence with recommended diet plan
D. Taking the medication at specified times

Answer 78

D. Taking the medication at specified times

Question 79

A client takes an oral hypoglycemic agent daily. For which condition is an oral hypoglycemic agent indicated?
A. Ketosis
B. Obesity
C. Pancreatitis
D. Reduced insulin production

Answer 79

D. Reduced insulin production

Question 80

Which statement made by a client prescribed metformin extended release to control type 2 diabetes mellitus indicates the need for further education?
A. “I will take the medication with food.”
B. “I must swallow my medication whole and not crush or chew it.”
C. “I will notify my doctor if I develop muscular or abdominal discomfort.”
D. “I will stop taking metformin for 24 hours before and after having a test involving dye.”

Answer 80

D. “I will stop taking metformin for 24 hours before and after having a test involving dye.”

Question 81

The nurse prepares to administer extended-release metformin to an older adult who has asked that it be crushed because it is difficult to swallow. Which rationale will prompt the nurse to ask the provider for a different form of metformin?
A. This medication has a wax matrix frame that is difficult to crush.
B. The medication has an unpleasant taste, which most clients find intolerable if crushed.
C. If crushed, this medication irritates mucosal tissue and can cause oral and esophageal ulcer formation.
D. Extended-release formulations are designed to be released slowly and crushing the tablet will prevent this from occurring.

Answer 81

D. Extended-release formulations are designed to be released slowly and crushing the tablet will prevent this from occurring.

Question 82

The health care provider prescribes metformin as monotherapy for the client with type 2 diabetes. The nurse will teach the client to monitor for which adverse effect?
A. Weight gain
B. Constipation
C. Lactic acidosis
D. Hypoglycemia

Answer 82

C. Lactic acidosis

Question 83

Which mechanism of action explains how glyburide decreases serum glucose levels?
A. Stimulates the pancreas to produce insulin
B. Accelerates the liver’s release of stored glycogen
C. Increases glucose transport across the cell membrane
D. Decreases absorption of glucose from the gastrointestinal system

Answer 83

A. Stimulates the pancreas to produce insulin

Question 84

A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should the nurse provide?
A. “Yes, it is an oral insulin and has the same actions and properties as intermediate insulin.”
B. “Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same manner as insulin.”
C. “No, it is not an oral insulin and can be used only when some beta cell function is present.”
D. “No, it is not an oral insulin, but it is effective for those who are resistant to injectable insulins.”

Answer 84

C. “No, it is not an oral insulin and can be used only when some beta cell function is present.”

Question 85

A nurse is reviewing prescribed medications for a client diagnosed with diabetic ketoacidosis. Which medication will the nurse clarify with the healthcare provider?
A. Regular insulin
B. Potassium
C. 0.9% sodium chloride
D. Glipizide

Answer 85

D. Glipizide

Question 86

A nurse is educating a client with diabetes type 2 about newly prescribed glipizide. Which statement by the nurse best describes the action of glipizide?
A. “This medication absorbs the excess carbohydrates from your intestinal tract.”
B. “This medication will inhibit the release of glucose stored in the liver.”
C. “This medication will stimulate your pancreas to release insulin.”
D. “This medication works by increasing the ability of the cells to uptake glucose.”

Answer 86

C. “This medication will stimulate your pancreas to release insulin.”

Question 87

A nurse is reviewing laboratory data for a client taking pramlintide for diabetes management. Which clinical finding indicates medication effectiveness?
A. Postprandial glucose of 160 mg/dL
B. Hemoglobin A1c of 8.5%
C. Fasting blood glucose of 135 mg/dL
D. Preprandial glucose of 150 mg/dL

Answer 87

A. Postprandial glucose of 160 mg/dL

Question 88

The nurse is preparing to teach a client with type 2 diabetes mellitus about their newly prescribed exenatide pen. Which instructions should the nurse include? Select all that apply.
A. Take the exenatide immediately after meals.
B. You may experience some weight loss.
C. Take any oral medications 1 hour before the exenatide.
D. Inject yourself in the abdominal or thigh area.
E. After use, store the injector pen in the refrigerator.

Answer 88

B. You may experience some weight loss.
C. Take any oral medications 1 hour before the exenatide.
D. Inject yourself in the abdominal or thigh area.

Question 89

Which medication will the nurse expect the health care provider to prescribe to a client who had a thyroidectomy and is pale with spasms of the hand when taking the blood pressure?
A. Calcium
B. Magnesium
C. Bicarbonate
D. Potassium chloride

Answer 89

A. Calcium

Question 90

Which alteration is the likely cause of thyrotoxic crisis (thyroid storm) in a client who has had treatment with propylthiouracil for hyperthyroidism followed by thyroid ablation with 131I?
A. Deficiency of iodine
B. Decreased serum calcium
C. Increased sodium retention
D. Excessive hormone replacement

Answer 90

D. Excessive hormone replacement

Question 91

Which mineral deficiency would a nurse suspect in a client who reports tingling in the fingers and around the mouth and exhibits carpopedal spasm and tremors after a surgical thyroidectomy ?
A. Potassium
B. Calcium
C. Magnesium
D. Sodium

Answer 91

B. Calcium

Question 92

A client with thyroid cancer is scheduled for a thyroidectomy. Which information will the nurse teach the client?
A. The dietary intake of carbohydrates must be restricted.
B. Thyroxine replacement therapy will be required indefinitely.
C. Chemotherapy will be used in conjunction with the surgery.
D. A tracheostomy is required for clients having this procedure.

Answer 92

B. Thyroxine replacement therapy will be required indefinitely.

Question 93

A client is admitted to the hospital for a subtotal thyroidectomy. When discussing postoperative medication therapy with the client, which advice will the nurse include in the teaching?
A. ‘You will be taking iodine daily to increase the formation of thyroid hormone.’
B. ‘After your body adjusts to postsurgical status, you will be weaned off this medication.’
C. ‘The propylthiouracil that is prescribed will stimulate the secretion of thyroid-stimulating hormone.’
D. ‘If you develop palpitations, nervousness, or tremors, the dose of thyroid hormone may need to be decreased.’

Answer 93

D. ‘If you develop palpitations, nervousness, or tremors, the dose of thyroid hormone may need to be decreased.’

Question 94

A client is experiencing both tingling of the extremities and tetany. The nurse will review the client’s laboratory report to check for which electrolyte abnormality?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypochloremia

Answer 94

B. Hypocalcemia

Question 95

Which finding in a client with hypothyroidism and hypertension who reports taking an extra dose of levothyroxine indicates the need to obtain a thyroid function panel? Select all that apply. One, some, or all responses may be correct.
A. Tremors
B. Diaphoresis
C. Nervousness
D. Temperature 101°F
E. Heart rate 116 beats/min

Answer 95

A. Tremors
B. Diaphoresis
C. Nervousness
D. Temperature 101°F
E. Heart rate 116 beats/min

Question 96

Which clinical manifestation exhibited by a client taking levothyroxine for hypothyroidism for 3 months would cause a nurse to suspect that a decrease in dosage is needed? Select all that apply. One, some, or all responses may be correct.
A. Tremors
B. Bradycardia
C. Somnolence
D. Heat intolerance
E. Decreased blood pressure

Answer 96

A. Tremors
D. Heat intolerance

Question 97

An infant with congenital hypothyroidism receives levothyroxine for 3 months. Which finding would indicate to the nurse that the medication is effective?
A. The infant is alert and interactive.
B. The skin is cool to the touch.
C. The baby’s fine tremor has ceased.
D. The baby’s thyroid stimulating hormone level has increased.

Answer 97

A. The infant is alert and interactive.

Question 98

A client is taking thyroxine to manage hypothyroidism. Which developments indicate to the nurse that the dosage should be reduced? Select all that apply. One, some, or all responses may be correct.
A. Diaphoresis
B. Weight gain
C. Tachycardia
D. Nervousness
E. Cold intolerance

Answer 98

A. Diaphoresis
C. Tachycardia
D. Nervousness

Question 99

When a female client becomes hypothyroid, levothyroxine is prescribed. The client asks whether she can become pregnant while taking levothyroxine. How will the nurse respond?
A. ‘If you become pregnant, thyroid abnormalities will develop in the fetus.’
B. ‘Yes, but you will have a high-risk pregnancy.’
C. ‘This medication causes infertility for the length of time that it is taken.’
D. ‘This medicine will not interfere with your ability to become pregnant.’

Answer 99

D. ‘This medicine will not interfere with your ability to become pregnant.’

Question 100

A 43-year-old female client is prescribed thyroid replacement hormone following a thyroidectomy. Which adverse effects should the nurse instruct the client to report immediately to the healthcare provider?
A. Tinnitus and dizziness.
B. Tachycardia and chest pain.
C. Dry skin and intolerance to cold.
D. Weight gain and increased appetite.

Answer 100

B. Tachycardia and chest pain.

Question 101

A nurse is providing care to a client diagnosed with a myocardial infarction. The client has a history of hypothyroidism and hypertension. Which prescribed medication will the nurse clarify before administering it to the client?
A. Morphine
B. Levothyroxine
C. Aspirin
D. Labetalol

Answer 101

B. Levothyroxine

Question 102

The nurse is preparing to administer 6:00 AM medications to a client. The client is prescribed levothyroxine 125 mcg PO daily for hypothyroidism. The medication package states levothyroxine tablet 0.125 mg. Which action is appropriate?
A. Administer the medication
B. Call the pharmacy and ask them to deliver the correct dose
C. Hold the medication until the healthcare provider arrives
D. Call the healthcare provider and request that the time of administration be changed

Answer 102

A. Administer the medication

Question 103

The nurse is reinforcing teaching about levothyroxine for a client newly-diagnosed with hypothyroidism. Which information should the nurse make sure to reinforce about this medication?
A. The medication must be stored in a dark container.
B. The medication should be taken in the morning.
C. The medication will decrease the client’s heart rate.
D. The medication may decrease the client’s energy level.

Answer 103

B. The medication should be taken in the morning.

Question 104

The nurse understands that the prescribed levothyroxine is effective when the client with hypothyroidism makes which statement?
A. “I still feel lethargic and fatigued.”
B. “I have to change my sheets in the morning because I sweat a lot at night.”
C. “I have been having daily, formed bowel movements.”
D. “I was reprimanded at work after becoming angry with my boss.”

Answer 104

C. “I have been having daily, formed bowel movements.”

Question 105

The nurse is providing instructions to a client with a new prescription for levothyroxine 50 mcg daily to treat hypothyroidism. Which of the following is important for the nurse to include in the discharge instructions?
A. It can be taken with an antacid if stomach upset occurs.
B. It should be taken in the morning.
C. It must be stored in a dark container.
D. It may decrease the client’s energy level.

Answer 105

B. It should be taken in the morning.

Question 106

A client has been diagnosed with hypothyroidism. Which medication should the nurse administer to treat the client’s bradycardia?
A. Epinephrine
B. Adenosine
C. Levothyroxine
D. Atropine

Answer 106

C. Levothyroxine

Question 107

Propylthiouracil and potassium iodide are prescribed for the client with hyperthyroidism. Which statement would the nurse include in the client’s plan of care?
A. Administer propylthiouracil and potassium iodide on an empty stomach.
B. Assess the client for signs of infection and bleeding every shift.
C. Stop the medications 2 weeks before thyroid surgery.
D. Discontinue the medications if the heart rate is maintained within the expected range for 48 hours.

Answer 107

B. Assess the client for signs of infection and bleeding every shift.

Question 108

The health care provider prescribes propylthiouracil (PTU) for a client with hyperthyroidism. Which action of PTU will the nurse include in teaching?
A. Increases the uptake of iodine
B. Causes the thyroid gland to atrophy
C. Interferes with the synthesis of thyroid hormone
D. Decreases the secretion of thyroid-stimulating hormone (TSH)

Answer 108

C. Interferes with the synthesis of thyroid hormone

Question 109

A client with hyperthyroidism is being treated with propylthiouracil (PTU). Which instruction will the nurse include in the teaching plan regarding this medication? Select all that apply. One, some, or all responses may be correct.
A. ‘Avoid abrupt discontinuation of the medication.’
B. ‘Monitor your weight, pulse, and mood routinely.’
C. ‘You can expect an immediate response to this medication.’
D. ‘Also take an iodine replacement to aid metabolism of the medication.’
E. ‘Report side effects, such as sore throat, fever, joint pain, or oral lesions.’

Answer 109

A. ‘Avoid abrupt discontinuation of the medication.’
B. ‘Monitor your weight, pulse, and mood routinely.’
E. ‘Report side effects, such as sore throat, fever, joint pain, or oral lesions.’

Question 110

Which mechanism of action explains how propylthiouracil (PTU) manages hyperthyroidism?
A. It binds previously formed thyroid hormones.
B. It decreases production of thyroid hormones.
C. Vascularity of the thyroid gland is decreased.
D. The need for thyroid iodine supplements is reduced.

Answer 110

B. It decreases production of thyroid hormones.

Question 111

A client being treated for hyperthyroidism with propylthiouracil (PTU) asks the nurse how the medication works. Which is the best response to give the client?
A. It decreases the amount of thyroid-stimulating hormone circulating in the blood.
B. It increases the amount of thyroid-stimulating hormone circulating in the blood.
C. It enhances the amount of T4 and diminishes the amount of T3 produced by the thyroid.
D. It inhibits the synthesis of T3 and T4 by the thyroid gland.

Answer 111

D. It inhibits the synthesis of T3 and T4 by the thyroid gland.

Question 112

Which explanation will the nurse give as to why potassium iodide solution should be taken before a subtotal thyroidectomy?
A. “The metabolic rate of the body will increase.”
B. “It will reduce the risk of hemorrhage during surgery.”
C. “It will maintain the functioning of the parathyroid glands.”
D. “The amount of thyroid hormones being secreted will decrease.”

Answer 112

B. “It will reduce the risk of hemorrhage during surgery.”

Question 113

A client is scheduled to have a thyroidectomy. Which medication is indicated for decreasing the size and vascularity of the thyroid gland before surgery?
A. Vasopressin
B. Levothyroxine
C. Propylthiouracil
D. Potassium iodide

Answer 113

D. Potassium iodide

Question 114

A client with hyperthyroidism is to receive potassium iodide solution before a subtotal thyroidectomy is performed. Which purpose would the nurse include when explaining why this medication is prescribed?
A. Decreases the total basal metabolic rate
B. Maintains the function of the parathyroids
C. Blocks the formation of thyroxine by the thyroid gland
D. Decreases the size and vascularity of the thyroid gland

Answer 114

D. Decreases the size and vascularity of the thyroid gland

Question 115

A nurse has administered oral radioactive iodine to a client with thyroid cancer. What instructions will the nurse provide to the client upon discharge?
A. Do not share utensils with your family members
B. Remain isolated until instructed by your healthcare provider
C. Limit your fluid intake for the first several days
D. Use a bedside commode for your elimination needs

Answer 115

A. Do not share utensils with your family members

Question 116

The nurse is providing preoperative teaching for a client preparing for a thyroidectomy about the medication saturated solution of potassium iodide drops. Which information is important for the nurse to include?
A. Mix the medication with juice or milk.
B. Take the medication on an empty stomach.
C. Store the medication in the refrigerator.
D. The medication will enlarge the thyroid gland

Answer 116

A. Mix the medication with juice or milk.

Question 117

The parents of a child with cystic fibrosis tell the nurse they have switched to natural pancreatic enzymes because of financial issues. Which response by the nurse is most appropriate?
A. ‘You don’t need to give the enzymes now that your child is in school.’
B. ‘Natural enzymes don’t have any side effects and can be taken without regard to meals.’
C. ‘If you are using generic enzymes, you will need to give twice as many to achieve the required effect.’
D. ‘Natural enzymes are not as effective as the brand-name product. This is something you need to discuss with your health care provider.’

Answer 117

D. ‘Natural enzymes are not as effective as the brand-name product. This is something you need to discuss with your health care provider.’

Question 118

Which medications would the nurse anticipate teaching the parents about for a preschooler newly diagnosed with cystic fibrosis? Select all that apply. One, some, or all responses may be correct.
A. Steroids
B. Antibiotics
C. Antihistamines
D. Pancreatic enzymes
E. Fat-soluble vitamins

Answer 118

B. Antibiotics
D. Pancreatic enzymes
E. Fat-soluble vitamins

Question 119

Which advice about the administration of vitamins A, D, E, and K will the nurse teach the parents of a toddler with newly diagnosed cystic fibrosis?
A. Offer them in a water-miscible form.
B. Give them during meals and snack times.
C. The dosage is based on the child’s height and weight.
D. Present them to the child with fruit juice rather than milk.

Answer 119

A. Offer them in a water-miscible form.

Question 120

Which time for medication scheduling would a nurse teach to a client prescribed the oral pancreatic enzymes pancrelipase?
A. At bedtime
B. With meals
C. One hour before meals
D. On arising each morning

Answer 120

B. With meals

Question 121

The nurse is reviewing discharge instructions with the parent of an infant with cystic fibrosis. Which statement indicates the parents know how to administer the pancreatic enzyme replacement?
A. ‘We should give the medication with feedings.’
B. ‘We should put crushed enteric-coated pills in the formula.’
C. ‘We need to give the medication every 6 hours, even during the night.’
D. ‘We should feed the granules from the capsule in applesauce every morning.’

Answer 121

A. ‘We should give the medication with feedings.’

Question 122

When would the nurse plan to administer pancrelipase to a child with cystic fibrosis?
A. With meals and snacks
B. In the morning and at bedtime
C. On awakening and every 3 hours while the child is awake
D. After each bowel movement and after postural drainage is performed

Answer 122

A. With meals and snacks

Question 123

A 12-year-old child with cystic fibrosis is prescribed four pancrelipase capsules five times a day. The nurse explains to the child they would take the medication with meals and snacks to accomplish which goal?
A. Enhance oxygenation
B. Limit excretion of fats
C. Facilitate nutrient utilization
D. Prevent iron-deficiency anemia

Answer 123

C. Facilitate nutrient utilization

Question 124

The nurse is giving instructions to the parents of a child who has cystic fibrosis. Which information should the nurse emphasize about administration of pancreatic enzymes?
A. Administer each time a high-carbohydrate meal is eaten
B. Crush the tablet and sprinkle on food three times a day
C. Dispense once daily with breakfast
D. They are to be taken with every meal or snack

Answer 124

D. They are to be taken with every meal or snack

Question 125

The nurse evaluates that teaching for the oral pancreatic enzymes pancrelipase is understood when the client identifies which time for medication scheduling?
A. At bedtime
B. With meals
C. One hour before meals
D. On arising each morning

Answer 125

B. With meals

Question 126

Which parameter would the nurse monitor to evaluate the effectiveness of desmopressin acetate (DDAVP) administered to a client with diabetes insipidus?
A. Arterial blood pH
B. Intake and output
C. Fasting serum glucose
D. Pulse and respiratory rates

Answer 126

B. Intake and output

Question 127

A client with hyperthyroidism is to receive methimazole. Which information would the nurse provide?
A. Initial improvement will take several weeks.
B. Few side effects are associated with this medication.
C. This medication may be taken at any time during the day.
D. Large loading doses are used initially to normalize thyroid function.

Answer 127

A. Initial improvement will take several weeks.

Question 128

A nurse is assessing a client with hyperthyroidism and is taking prescribed methimazole. Which client statement indicates a therapeutic response to the medication?
A. “My intolerance to cold has improved.”
B. “I no longer feel heart palpitations.”
C. “I don’t get constipated as easily.”
D. “I have lost a few pounds.”

Answer 128

B. “I no longer feel heart palpitations.”

Question 129

A nurse is providing education on the use of subcutaneous octreotide to a client who will be administering the medication at home. What will the nurse include in the teaching?
A. Store any remaining medication at room temperature
B. Inject the medication into the gluteal area
C. Administer the medication between meals
D. Use the medication immediately after removing it from the refrigerator

Answer 129

C. Administer the medication between meals

Question 130

A nurse is providing care to a client with diabetes insipidus. The client is on a prescribed vasopressin infusion with orders to titrate as needed. The nurse decreases the dose of vasopressin based on which clinical finding?
A. Increased blood pressure
B. Decreased urine osmolarity
C. Reduced volume of urine output
D. Elevated heart rate

Answer 130

C. Reduced volume of urine output

Question 131

The nurse is providing education to the parents of a 10-year-old child who is diagnosed with diabetes insipidus (DI) and has been prescribed vasopressin. What important information should the nurse include regarding this medication?
A. The child will need intravenous therapy for several weeks.
B. The parents must closely monitor the child’s fluid intake.
C. The child may experience brief episodes of chest pain.
D. The child should be observed for signs of dehydration.

Answer 131

B. The parents must closely monitor the child’s fluid intake.