The rapid-acting insulins (aspartnovolog)peak in 1 to 3 hours. The patient is not at a high risk for hypoglycemia at the other listed times, although hypog... [Show More] lycemia may occur.
1. Patient with poorly controlled DM for 10 years. Which lab value will you check next?
a. Urinalysis for ketones
2.A nurse cares for a client who has a family history of diabetes mellitus. The client states, "My father has type 1 diabetes mellitus. Will I develop this disease as well?" How should the nurse respond?
a. "Your risk of diabetes is higher than the general population, but it may not occur."
b. "No genetic risk is associated with the development of type 1 diabetes mellitus."
c. "The risk for becoming a diabetic is 50% because of how it is inherited."
d. "Female children do not inherit diabetes mellitus, but male children will."
3.A patient at the clinic says, "I have always taken an evening walk, but lately my leg cramps and hurts after just a few minutes of walking. The pain goes away after I stop walking, though." The nurse should
attempt to palpate the dorsalis pedis and posterior tibial pulses.
check for the presence of tortuous veins bilaterally on the legs.
ask about any skin color changes that occur in response to cold.
assess for unilateral swelling, redness, and tenderness of either leg.
4. 2. The nurse is reviewing the lipid panel of a male client who has atherosclerosis. Which finding is most concerning?
a. Cholesterol: 126 mg/dL
b. High-density lipoprotein cholesterol (HDL-C): 48 mg/dL
c. Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL
d. Triglycerides: 198 mg/dL
5. A client is admitted with acute kidney injury (AKI) and a urine output of 2000 mL/day. What is the major concern of the nurse regarding this client's care?
a. Edema and pain
b. Electrolyte and fluid imbalance
c. Cardiac and respiratory status
d. Mental health status
6.Which statement by a client with type 2 diabetes indicates a need for further teaching about diabetic management and follow-up care?
ANS: Because my diabetes is controlled with diet and exercise, I have to be seen only if I am sick.
7.A nurse admits a client who is experiencing an exacerbation of heart failure. Which action should the nurse take first?
A. Assess respiratory status
B. draw blood to assess serum electrolytes
C. administer IV Lasix (furosemide)
D. ask client about medications
8. The blood was drawn for this client, results shows WBC 9000, Hgb 9.1, Hct 27, K 4.5, which among the following interventions will be prioritized by the nurse?
A. Administer prescribed antibiotics
B. Provide Potassium rich food
C. Administer Ferrous sulfate with orange juice
D. Administer Epogen
9. A nurse teaches a client with diabetes mellitus and a body mass index of 42 who is at high risk for coronary artery disease. Which statement related to nutrition should the nurse include in this client's teaching?
ANS: You should balance weight loss with consuming necessary nutrients.
10.A nurse is assessing a client with peripheral artery disease (PAD). The client states walking five blocks ispossible without pain. What question asked next by the nurse will give the best information?
a. Could you walk further than that a few months ago?
b. Do you walk mostly uphill, downhill, or on flat surfaces?
c. Have you ever considered swimming instead of walking?
d. How much pain medication do you take each day?
11. A client has been recently diagnosed with type 2 diabetes, and reports continued weight loss despite increased hunger and food consumption. This condition is called:
While the needed glucose is being wasted, the body's requirement for fuel continues. The person with diabetes feels hungry and eats more (polyphagia). Despite eating more, he or she loses weight as the body uses fat and protein to substitute for glucose.
12.a nurse is providing education regarding diabetes. in discussing the two types of diabetes mellitus, which statement is accurate regarding type 1 ?
-acute onset before 30
-insulin-producing pancreatic beta cells destroyed by autoimmune
-requires insulin injections
13. a client with type 2 diabetes receives 7 units of novolog and 15 units lantus at 0730. at what time will the nurse check bedside blood glucose levels to monitor for potential hypoglycemia
Check around 11 or 12 a.m.
Novolog (rapid acting) 10 min onset, 1-3 hr peak, 3-5 hr duration
Lantus (long acting) 3-4 onset, no peak, 24 hr duration
14.a client with type 1 diabetes is found lying unconscious on the floor of the bathroom. Which intervention should the nurse implement first?
A. Administer 50% dextrose IVP.
B. Notify the health-care provider.
C. Move the client to the ICU.
D. Check the serum glucose level.
15.a patient had a percutaneous angioplasty on the lower extremities for peripheral arterial disease. what assessment finding by the nurse indicates that a priority outcome for this patient has been met
a. Pain rated as 2/10 after medication
b. Remains on bedrest as directed
c. Verbalizes understanding of procedure
d. Distal pulse on affected extremity 2+/4+
16.A nurse admits a client from the emergency department. Client data are listed below:
70 years of age
History of diabetes
On insulin twice a day
Reports new-onset dyspnea and productive cough
Crackles and rhonchi heard throughout the lungs
Dullness to percussion LLL Afebrile
Oriented to person only
PaO2 on room air 65 mm Hg
What action by the nurse is the priority?
a. Administer oxygen at 4 liters per nasal cannula.
b. Begin broad-spectrum antibiotics.
c. Collect a sputum sample for culture.
d. Start an IV of normal saline at 50 mL/hr.
17.a nurse cares for a patient with right sided heart failure. the patient asks why do i need to weigh myself every day. How would the nurse respond?
a. "Weight is the best indication that you are gaining or losing fluid."
b. "Daily weights will help us make sure that you're eating properly."
c. "The hospital requires that all inpatients be weighed daily."
d. "You need to lose weight to decrease the incidence of heart failure."
18.after teaching a patient with a history of renal calculi the nurse assesses the patients understanding which statement made by the patient indicates a correct understanding of the teaching.
a. "I should drink at least 3 liters of fluid every day."
b. "I will eliminate all dairy or sources of calcium from my diet."
c. "Aspirin and aspirin-containing products can lead to stones."
d. "The doctor can give me antibiotics at the first sign of a stone."
19.a student nurse is assessing the peripheral vascular system of an older adult what action by the student would cause the faculty member to intervene?
A. assess blood pressure in both upper extremities
B. auscultating carotid arteries for bruits
C. classify capillary refill of 4 seconds as normal
D. palpating both carotid arteries at same time
20.an emergency room nurse obtains a health history of a patient. which statement by the patient would alert the nurse to the occurrence of heart failure?
“I get short of breath when I climb stairs.”
21.a nurse administers medications to a patient who has asthma. which medication classification is paired correctly with its physiologic response to the medication.
A. Cholinergic antagonist - Causes bronchodilation by inhibiting the parasympathetic nervous system
B. Cromone - Disrupts the production of pathways of inflammatory mediators
C. Corticosteroid - Relaxes bronchiolar smooth muscles by binding to and activating pulmonary beta2 receptors
D. Bronchodilator - Stabilizes the membranes of mast cells and prevents the release of inflammatory mediators
22.a patient is admitted for bilateral edema of lower extremities. legs are also warm to touch and painful, upon closer inspection, broad shallow ulcers are present. which diagnostic procedure should the nurse follow up next?
Arterial: cool to touch, thin/dry/scaly skin, hairless, thick toenails, poor or absent pulse, no edema, located at end of toes, top of feet, lateral ankle region, ”punched-out” look, little tissue granulation, noticeable margins/edges, sharp pain, pain at rest, intermittent claudication
Venous: warm to touch, thick/tough skin, brownish colored, present/typically normal pulse, yes edema and worse at end of day, located at medial parts of lower legs or medal ankle region, ulcers are swollen with drainage, granulation present, edges irregular, heavy, dull, throbbing, achy pain, pain worse when standing or sitting for long periods, elevating legs eases pain and swelling
Diagnostic tests: angiography, ankle-brachial index (ABI)
23.which statement made by the client with COPD indicates that the nurses teaching is effective
A. "I need to get an influenza vaccine each year, even when there is a shortage."
B. "I need to get a vaccine for pneumonia each year with my flu shot."
C. "If I reduce my cigarette smoking to six (6) a day, I won't have difficulty breathing."
D. "I need to restrict my drinking liquids to keep from having so much phlegm."
24.the nurse is caring for a client two hours after admission. the client has 02 saturation of 91% and with audible wheezes, using accessory muscles when breathing?
ANS: beta 2 agonist—dilation of the bronchioles to relieve symptoms
25.a nurse teaches a patient who is diagnosed with diabetes mellitus. which statement would the nurse include in this patient plan of care to delay the onset of microvascular and macrovascular complications?
a. "Maintain tight glycemic control and prevent hyperglycemia."
b. "Restrict your fluid intake to no more than 2 liters a day."
c. "Prevent hypoglycemia by eating a bedtime snack."
d. "Limit your intake of protein to prevent ketoacidosis."
26.a nurse assesses a patient 2 hours after a cardiac angiography via the left femoral artery the nruse notes that the left pedal pulse is weak what action would the nurse take
ANS: assess the color and temperature of the left leg
27.a homeless client who is admitted with productive cough, night fever and weight loss, has a diagnosis of rule out TB which type of isolation should the nurse implement?
Suspected TB should remain under airborne precautions until 3 consecutive negative AFB sputum smear results--Isolation room with an anteroom and negative air flow
28.a nurse assesses a patient admitted to the cardiac unit. which statement by the patient alerts the nurse to the possibility of right-sided heart failure?
A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right-sided heart failure?
a. "I sleep with four pillows at night."
b. "My shoes fit really tight lately."
c. "I wake up coughing every night."
d. "I have trouble catching my breath."
29.the nurse is evaluating a 3-day diet history with a patient who has an elevated lipid panel. what meal selection indicates that the patient is managing this condition well with diet?
a. A 4-ounce steak, French fries, iceberg lettuce
b. Baked chicken breast, broccoli, tomatoes
c. Fried catfish, cornbread, peas
d. Spaghetti with meat sauce, garlic bread
30.a nurse assesses a patient after administering a prescribed beta-blocker. which assessment would the nurse expect to find?
a. Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg
b. Respiratory rate decreased from 25 breaths/min to 14 breaths/min
c. Oxygen saturation increased from 88% to 96%
d. Pulse decreased from 100 beats/min to 80 beats/min
31.the nurse is assessing a patient with a diagnosis of prerenal acute kidney injury (AKI) which condition would the nurse expect to find in the patient’s recent history
b. Myocardial infarction
c. Bladder cancer
d. Kidney stones
32.the nurse is caring for four hypertensive patients prescribed with diuretic medications. which drug-laboratory value combination would the nurse report immediately to the healthcare provider
Furosemide (Lasix)/potassium: 2.1 mEq/L
Lasix is a loop diuretic and can cause hypokalemia. A potassium level of 2.1 mEq/L is quite low and should be reported immediately.
33.a nurse cares for a patient who tests positive for alpha-1 antitrypsin deficiency. the patient asks “what does this mean” how would the nurse respond?
a. "Your children will be at high risk for the development of chronic obstructive pulmonary disease."
b. "I will contact a genetic counselor to discuss your condition."
c. "Your risk for chronic obstructive pulmonary disease is higher, especially if you smoke."
d. "This is a recessive gene and should have no impact on your health."
34.a client with poorly controlled diabetes type 2 is admitted to the unit. assessment reveals non pitting edema, coughing frothy sputum and weight gain of 5 lbs over the last week. jugular vein distention is prominent, and he has exertional dyspnea. when planning for this patient care which intervention will be given priority
-left-sided heart failure, has pulmonary edema, administer diuretic, or ACE inhibitor?
35.the nurse is assessing a patient on admission to the hospital. the patients leg appears as shown below.
36.a patient has been diagnosed with tuberculosis what action by the nurse takes the highest priority
Educating the client on adherence to the treatment regimen
Encouraging the client to eat a well-balanced diet
Informing the client about follow-up sputum cultures
Teaching the client ways to balance rest with activity
37.patient with type 2 diabetes mellitus on metformin is being scheduled for a CT scan with contrast of the abdomen to evaluate pancreatic function. prior to the procedure the nurse ensures that
A. Provide a high-fat diet 24 hours prior to test.
B. Hold the biguanide medication for 48 hours prior to test.
C. Obtain an informed consent form for the test.
D. Administer pancreatic enzymes prior to the test.
38.A NURSE HAS EDUCATED A PATIENT ON ETHAMBUTOL WHAT STATEMENT BY THE PATIENT INDICATES THAT TEACHING HAS BEEN EFFECTIVE
A. "I will get up slowly when sitting to prevent me from getting dizzy."
B. "I'll increase the fiber and liquids in my diet to prevent constipation."
C. "I'll immediately report any red-orange urine to my healthcare provider."
D."I'll report any problems with blurred vision or being able to determine colors."
39.which assessment parameter does the nurse monitor in a client with chronic kidney disease to determine fluid and sodium retention status
a. Capillary refill
b. Intake and output
c. Muscle strength
d. Weight and blood pressure
40.the nurse assesses a client's legs. which assessment finding indicates venous insufficiency
Venous ulcers, cool brown skin, edema, pain, redness along vein, normal or decreased pulse, may be warmer than opposite limb, risk for pulmonary embolism
41.a nurse cares for a patient with a 40-year smoking history who is experiencing distended neck veins and dependent edema. which physiologic process would the nurse correlate with this patient's history and clinicalmanifestations
A. increased pulmonary pressure creating higher workload on right side of heart
B. exposure to irritants resulting in increased inflammation of bronchi and bronchioles
C. increased number of size of mucus glands producing large amounts of thick mucus
D. left ventricular hypertrophy creating decrease in cardiac output
42.A nurse is providing discharge teaching to a client who has COPD and a new prescription for albuterol. Which of the following statements by the client indicates an understanding of the teaching?
A. "This medication can increase my blood sugar levels."
B. "This medication can decrease my immune response."
C. "I can have an increase in my heart rate while taking this medication."
D. "I can have mouth sores while taking this medication.
43.A client has been taught to restrict dietary sodium. Which food selection by the client indicates to the nurse that teaching has been effective?
- A chicken leg, one slice of bread with butter, and steamed carrots
44.a client with type 2 diabetes is admitted for abdominal pain and nausea, history reveals that vomiting has also been persistent for the past 24 hours. blood glucose is 685 on admission, potassium is elevated, diabetic ketoacidosis is suspected. which of the following statement is true.
-can expect kussmaul breathing (rapid/deep), metabolic acidosis, IV fluid containing dextrose will be given/short duration insulin (regular) intravenously (NS or 0.45% NaCl, serum potassium will be elevated
-headache, drowsiness, coma, hypotension, tachycardia, skin warm and dry, dry mucous membranes,increased temperature,
45.The nurse observes a prominent U wave on the client’s electrocardiograph (ECG) tracing. What is the most appropriate action for the nurse to take?
a. Document the finding as a normal variant.
b. Review the client’s daily electrolyte results.
c. Move the crash cart closer to the client’s room.
d. Call for an immediate electrocardiogram.
46.a patient is admitted with long term insulin therapy has lumps of skin around his abdomen with no pain
-These are normal with long time use of insulin injections, called ‘lipohypertrophy’; tissue feels spongy and does not consistently absorb insulin. Buildup of fat.
47.a 58 year old male client has been admitted because of benign hypertrophy that led to urethral obstruction and hydronephrosis. lab results show elevated creatinine and BUN patient also has bipedal edema and has decreased urine output. which cause of kidney injury did the patient suffer from
-A patient with a history of benign prostatic hyperplasia (BPH) is admitted with acute urinary retention and an elevated blood urea nitrogen (BUN) and creatinine. Which of these prescribed therapies should the nurse implement first?
Based on the question and rationale, I believe the answer is acute urinary retention
------- Rationale: The patient's elevation in BUN is most likely associated with hydronephrosis caused by the acute urinary retention, so the insertion of a retention catheter is the first action to prevent ongoing postrenal failure for this patient. The other actions also are appropriate, but should be implemented after the retention catheter.
48.the nurse is taking care of a group of patients with ESRD, prior to running the dialysis session which client should the nurse see first
-any patient with a low-grade fever, dyspnea,
Complications: hemorrhage, hepatitis, nausea/vomiting, headache, mental confusion, muscle cramps, air embolism, sepsis
Considerations: check for thrill, vitals,
49.A nurse assesses a client who has aortic regurgitation. In which location in the illustration shown below should the nurse auscultate to best hear a cardiac murmur related to aortic regurgitation?
a. Location A- erbs point- third intercostal space on left
b. Location B
c. Location C
d. Location D
50.A client has a serum potassium level of 6.5 mmol/L, a serum creatinine level of 2 mg/dL, and a urine output of 350 mL/day. What is the best action by the nurse?
a. Place the client on a cardiac monitor immediately.
b. Teach the client to limit high-potassium foods.
c. Continue to monitor the client’s intake and output.
d. Ask to have the laboratory redraw the blood specimen. [Show Less]