NUR104 questions Flashcards
28 year old patient with DM 1 reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?
A) The patient always carries hard candy when engaging in exercise.
B) The patient goes for a vigorous walk when his glucose is 200 mg/dl
C) The patient has a peanut butter sandwhich before going for a bicycle ride.
D) The patient increases daily exercise when ketones are present in the urine
D. Ketones shouldn’t be in the urine
A Patient with type 2 DM is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient? A) Urine dipstick for glucose B) Oral glucose tolerance test C) Fasting blood glucose level D) Glycosylated hemoglobin level
D
A 32 year old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss for mealtime coverage? A) Lispro (Humalog) B) Glargine (Lantus) C) Detemir (Levemir) D) NPH (Humulin N)
A Lispro (Humalog)
When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergenic rash from an unknown cause. The health care provider prescribes prednisone (Delasone). The nurse will anticipate that the patient may
A) need a diet higher in calories while receiving prednisone
B) develop acute hypoglycemia while taking the prednisone
C) require administration of insulin while taking prednisone
D) have rashes caused by metformin-prednisone interactions
C. require administration of insulin while taking prednisone
a 26 year old patient with diabetes rides a bicycle to and from work every day. Which site should the nurse teach the patient to administer the morning insulin. A) Thigh B) Buttock C) Abdomen D) upper arm
D Upper arm
A 27 year old patient admitted with DKA has a serum glucose level of 732 mg/dl and serum potassium level of 3.1 mEq.L. Which action prescribed by the health care provider should the nurse take first?
A) place the patient on a cardiac monitor
B) Administer IV potassium supplements
C) Obtain urine glucose and ketone levels
D) Start an insulin infusion at 0.1 unites/kg/hr
A) place the patient on a cardiac monitor
A 54 year old patient is admitted with DKA. Which admission order should the nurse implement first
A) infuse 1 liter of NS per/hr
B) Give sodium bicarbonate 50 mEq IV push
C) Administer regular insulin 10 U by IV push
D) start a regular insulin infusion at 0.1 units/kg/hr
A) infuse 1 liter of NS per/hr
After change of shift report, which ;patient will the nurse assess first?
A) 19-year old with type 1 diabetes who was admitted with possible dawn phenomenon
B) 35 year old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dl
C) 60 year old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
D) 68 year old with type 2 DM who has severe peripheral neuropathy and complains of burning foot pain
C) 60 year old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
A 30 year old patient seen in the emergency department for severe headache and acute confusion is found to have a serum sodium level of 118 mEq/L. The nurse will anticipate the need for which diagnostic test? A) Urinary 17-ketosteroids B) Adrenocorticotropic hormone level C) Hbg A1C D) Antidiuretic hormone level
D) ADH
A 60 year old patient is taking spironolactone (Aldactone), a drug that blocks the action of aldosterone on the kidney, for hypertension. The nurse will monitor for A) increased serum sodium B) Decreased urinary output C) Elevated serum potassium D) evidence of fluid overload
C) Elevated serum potassium
A 35 year old female patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which patient information is most important for the nurse to communicate to the health care provider before the test A) Bilateral poor peripheral vision B) Allergies to iodine and shllfish C) Recent weight loss of 20 pounds D) Complaint of ongoing headaches
B) Allergies to iodine and shellfish
a 42 year old female patient is scheduled for transphenoidal hypophysectomy to treat a pituitary adenoma. During preoperative teaching, the nurse instructs the patient about the need to
A) Cough and deep breath every 2 hours postoperatively
B) Remain on bed rest for the first 48 hours after after the surgery
C) be positioned flat with sandbags at the head postoperativley
D) Avoid bending at the waist for 10 days
D- no bending at the waist for 10 days
The nurse is planning postoperative care for a patient who is being admitted to the surgical unit from the recovery room after transsphenoidal resection of a pituitary tumor. Which nursing action should be included.
A) Palpate extremities for edema
B) Measure urine volume every hour
C) Check hematocrit every 2 hours for 8 hours
D) Monitor continuous pulse oximetry for 24 hours
B) measure urine volume -watch for DI
The best determination for progress in hyperosmolar, hyperglycemic syndrome is: A) blood glucose level B) Serum Sodium level C) Serum potassium level D) Level of Consciousness
D) LOC
T/F. A Type 2 DM patient cannot develop DKA
F
T/F. A type 1 DM patient cannot develop hyperosmolar, hyperglycemic syndrome (HHS)
T
You walk into your patients room. She is confused, slow to respond, and diaphoretic. Which of the following treatments is inappropriate?
A) Administer 4-6 ox of orange juice
B) Offer a hard candy
C) Administer 1 mg glucagon IM
D) Administer 20-50 ml 50% dextrose solution IV Push
B) hard candy will take to long to provide a response.
a 42 year old patient is scheduled for transsphenoidal hypophysectomy to treat a pituitary adenoma. During preoperative teaching, the nurse instructs the patient about the need to
A) cough and deep breath every 2 hours postoperatively
B) remain on bed rest for the first 48 hours after the surgery
C) avoid brushing teeth for at least 10 days after the surgery
D) be positioned flat with sandbags at the head postoperatively
C- No teeth brushing
The nurse is planning postoperative care for a patient who is being admitted to the surgical unit from the recovery room after transsphenoidal resection of a pituitary tumor. Which nursing action should be included
A) Palpate extremities for edema
B) Measure urine volume every hour
C) Check hematocrit every 2 hours for 8 hours
D) Monitor continuous pulse oximetry for 24 hours
B- Because of ADH (urine)
The nurse determines the demeclocycline (declomycin) is effective for a patient with syndrome of inappropriate ADH (SIADH) based on finding that the patients A) weight has increased B) Urinary output is increased C) peripheral edema is decreased D) urine specific gravity is increased
B) Urinary output increased
The nurse determines that additional instruction is needed for a 60 year old patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) when the patient says which of the following?
A) I need to shop for foods low in sodium and avoid adding salt to food
B) I should weigh myself daily and report any sudden weight loss or gain
C) I need to limit my fluid intake to no more that 1 quart of liquids a day
D) I will eat foods high in potassium because diuretics cause potassium loss
A) Don’t need low salt
An expected nursing diagnosis for a 30 year old patient admitted to the hospital with symptoms of diabetes insipidus is
A) excess fluid volume related to intake greater than output
B) impaired gas exchange related to fluid retention in lungs
C) Risk for impaired skin integrity related to generalized edema
D) sleep pattern disturbance related to frequent waking to void
D) They have to get up a lot to pee
A 37 year old patient is being admitted with a diagnosis of Cushing syndrome. Which findings will the nurse expect during the assessment A) Chronically low blood pressure B) Bronzed appearance of the skin C) Decreased axillary and pubic hair D) Purplish streaks on the abdomen
D) Purple streaks on abdomen
A 44 year old female patient with Cushing syndrome is admitted for adrenalectomy. Which intervention by the nurse will be most helpful for a nursing diagnosis of disturbed body image related to changes in appearance
A) remind the patient that most of the physical changes caused by Cushing syndrome will resolve after surgery
B) Reassure the patient that the physical changes are very common in patients with cushing syndrome
C) Teach the patient that the metabolic impact of Cushing syndrome is of more importance than appearance
D) Discuss the use of diet and exercise in controlling the weight gain associated with Cushing syndrome
B) Reassure the patient that the physical changes are very common in patients with cushing syndrome
