Review Questions

Question 1

A 28 year old male patient with type 1 diabetes 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 candies 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 sandwich before going for a bicycle ride
D. The patient increases daily exercise when ketones are present in the urine

Answer 1

D. The patient increases daily exercise when ketones are present in the urine

Question 2

A patient with type 2 diabetes 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 intolerance test
C. Fasting blood glucose level
D. Glycosylated hemoglobin level

Answer 2

D. Glycosylated hemoglobin level

Question 3

A 32 year old patient with diabetes is starting on intensive insulin therapy.  Which type of insulin will the nurse discuss using for mealtime coverage?
A. Lispro (Humalog)
B. Glargine (Lantus)
C. Detemir (Levemir)
D. NPH (Humulin N)

Answer 3

A. Lispro (Humalog)

Question 4

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 HCP 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 of 0.1 units/kg/hr

Answer 4

A. Place the patient on a cardiac monitor

Question 5

A 54 year old patient is admitted with DKA. Which admission order should the nurse implement first?
A. Infuse 1 L of normal saline
B. Give sodium bicarbonate 50 mEq IV push
C. Administer regular insulin 10 U IV push
D. Start a regular insulin infusion at 0.1 units/kg/hr

Answer 5

A. Infuse 1 L of normal saline per hour

Question 6

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 BG 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 daibetes who has severe peripheral neuropathy and complains of burning foot pain

Answer 6

C. 60 year old with hypersomolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa

Question 7

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. Hgb A1C
D. Antidiuretic hormone level

Answer 7

D. Antidiuretic hormone level

Question 8

A 60 year old patient is taking spironolactone, 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

Answer 8

C. Elevated serum potassium

Question 9

A 35 year old patient with a possible pituitary adenoma is scheduled for a 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 shellfish
C. Recent weight loss of 20 pounds
D. Complaint of ongoing headaches

Answer 9

B. Allergies to iodine and shellfish

Question 10

A 42 year old female 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 breathe every 2 hours postoperativelly
B. remain on bed rest for the first 48 hours after the surgery
C. be positioned flat with sandbags at the head postoperatively
D. avoid bending at the waist for 10 days

Answer 10

D. Avoid bending at the waist for 10 days

Question 11

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 the extremities for edema
B. Measure urine volume every hour
C. Check hematocrit every 2 hours for 8 hours
D. Monitor continous pulse oximetry for 24 hours

Answer 11

B. Measure urine volume every hour

Question 12

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

Answer 12

D. level of consciousness

Question 13

True or false:

A type 2 diabetic patient cannot develop DKA?

Answer 13

False

Question 14

True or false:

A type 1 diabetic cannot develop hypersomolar, hyperglycemic syndome?

Answer 14

True

Question 15

You walk into your patient’s room. She is confused, slow to respond, and diaphoretic. Which of the following treatments is inappropriate?
A. Administer 4-6 oz of orange juice
B. Offer a hard candy
C. Adminster 1 mg Glucagon IM
D. Administer 20-50 mL 50% Dextrose solution IV push

Answer 15

B. Offer a hard candy

Question 16

The nurse determines that demeclocycline is effective for a patient with SIADH based on the finding that the patient's
A. weight has increased
B. urinary output is increased
C. peripheral edema is decreased
D. urine specific gravity is increased

Answer 16

B. Urinary output is increased

Question 17

The nurse should determine that additional instruction is needed for a 60 year old patient with chronic 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 than 1 quart of liquids a day.”
D. “I will eat foods high in potassium because diuretics cause potassium loss.”

Answer 17

A. “I need to shop for foods low in sodium and avoid adding salt to food.”

Question 18

An expected nursing diagnosis for a 30 year old patient admitted to the hospital with symptoms of DI 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

Answer 18

D. sleep pattern disturbance related to frequent waking to void

Question 19

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

Answer 19

D. purplish streaks on the abdomen

Question 20

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

Answer 20

B. Reassure the patient that the physical changes are very common in patients with Cushing Syndrome

Question 21

A 38 year old male patient is admitted to the hospital in Addisonian crisis. Which patient statement supports a nursing diagnosis of ineffective self-health management related to lack of knowledge about management of Addison’s disease?
A. “I frequently eat at restaurants and my food has a lot of added salt.”
B. “I had the stomach flu earlier this week, so I couldn’t take the hydrocortisone.”
C. “I always double my dose of hydrocortisone on the days that I go for a long run.”
D. “I take twice as much hydrocortisone in the morning dose as I do in the afternoon.”

Answer 21

B. “I had the stomach flu earlier this week, so I couldn’t take the hydrocortisone.”

Question 22

Which intervention will the nurse include in the plan of care for a 52 year old male patient with SIADH?
A. Monitor for peripheral edema
B. Offer patient hard candies to suck on
C. Encourage fluid to 2-3 liters per day
D. Keep head of bed elevated to 30 degrees

Answer 22

B. Offer patient hard candies to suck on

Question 23

The nurse is caring for a patient admitted with DI. Which information is most important to report to the health care provider?
A. The patient is confused and lethargic
B. The patient reports a recent head injury
C. The patient has a urine output of 400 mL/hr
D. the patient’s urine specific gravity is 1.003

Answer 23

A. The patient is confused and lethargic

Question 24

Which assessment finding of a 42 year old patient who had a bilateral adrenalectomy requires the most rapid action by the nurse?
A. The blood glucose is 176 mg/dL
B. The lungs have bibasilar crackles
C. The blood pressure is 88/50 mmHg
D. The patient reports a 5/10 incisional pain

Answer 24

C. The blood pressure is 88/50 mmHg

Question 25

Which information is most important for the nurse to communicate rapidly to the health care provider about a patient admitted with possible SIADH?
A. The patient has a recent weight gain of 9 lb
B. The patient complains of dyspnea with activity
C. The patient has a urine specific gravity of 1.025
D. The patient has a serum sodium level of 118 mEq/L

Answer 25

D. The patient has a serum sodium level of 118 mEq/L