CNA WRITTEN TEST QUESTIONS

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CNA WRITTEN TEST QUESTIONS

60 terms ROSETTAJPreview med su 24 terms han The nurse is working with an overweight client who has a high-stress job and smokes. This client has just received a diagnosis of Type II Diabetes and has just been started on an oral hypoglycemic agent. Which of the following goals for the client which if met, would be most likely to lead to an improvement in insulin efficiency to the point the client would no longer require oral hypoglycemic agents?

• Comply with medication regimen 100% for 6 months
• Quit the use of any tobacco products by the end of three months
• Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily
• Practice relaxation techniques for at least five minutes five times a day for at least five months
• Lose a pound a week until weight is in normal range for height and exercise 30 minutes daily

When type II diabetics lose weight through diet and exercise they sometimes have an improvement in insulin efficiency sufficient to the degree they no longer require oral hypoglycemic agents.The nurse assisting in the admission of a client with diabetic ketoacidosis will anticipate the physician ordering which of the following types of intravenous solution if the client cannot take fluids orally?

• 0.45% normal saline solution
• Lactated Ringer's solution
• 0.9 normal saline solution
• 5% dextrose in water (D5W)
• 0.45% normal saline solution

You are doing some teaching with a client who is starting on a sulfonylurea antidiabetic agent. The client mentions that he usually has a couple of beers each night and takes an aspirin each day to prevent heart attack and/or strokes. Which of the following responses would be best on the part of the nurse?

• As long as you only drink two beers and take one aspirin, this should not be a problem
• The aspirin is alright but you need to give up drinking any alcoholic beverages
• Aspirin and alcohol will cause the stomach to bleed more when on a sulfonylurea drug
• Taking alcohol and/or aspirin with a sulfonylurea drug can cause development of hypoglycemia
• Taking alcohol and/or aspirin with a sulfonylurea drug can cause development of hypoglycemia

Alcohol and/or aspirin taken with a sulfonylurea can cause development of hypoglycemia.Which of the following things must the nurse working with diabetic clients keep in mind about Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)?

• This syndrome occurs mainly in people with Type I Diabetes
• It has a higher mortality rate than Diabetic Ketoacidosis
• The client with HHNS is in a state of overhydration
• This condition develops very rapidly
• It has a higher mortality rate than Diabetic Ketoacidosis

HHNS occurs only in people with Type II Diabetes. It is a medical emergency and has a higher mortality rate than Diabetic Ketoacidosis. This condition develops very slowly over hours or days.Which one of the following methods/techniques will the nurse use when giving insulin to a thin person? [Hint]

• Pinch the skin up and use a 90 degree angle
• Use a 45 degree angle with the skin pinched up
• Massage the area of injection after injecting the insulin
• Warm the skin with a warmed towel or washcloth prior to the injection
• Pinch the skin up and use a 90 degree angle

The best angle for a thin person is 90 degrees with the skin pinched up. The area is not massaged and it is not necessary to warm it.

The nurse is performing discharge teaching for a patient with Addison's disease. It is MOST important for the nurse to instruct the patient about:

• signs and symptoms of infection
• fluid and electrolyte balance
• seizure precautions
• steroid replacement
• steroid replacement

steroid replacement is the most important information the client needs to know.

Prediabetes is associated with all of the following except:

• Increased risk of developing type 2 diabetes
• Impaired glucose tolerance
• Increased risk of heart disease and stroke
• Increased risk of developing type 1 diabetes

D: Increased risk of developing type 1 diabetes

Persons with elevated glucose levels that do not yet meet the criteria for diabetes are considered to have prediabetes and are at increased risk of developing type 2 diabetes. Weight loss and increasing physical activity can help people with prediabetes prevent or postpone the onset of type 2 diabetes.Which of the following diabetes drugs acts by decreasing the amount of glucose produced by the liver?

• Sulfonylureas
• Meglitinides
• Biguanides
• Alpha-glucosidase inhibitors
• Biguanides

Biguanides, such as metformin, lower blood glucose by reducing the amount of glucose produced by the liver. Sulfonylureas and Meglitinides stimulate the beta cells of the pancreas to produce more insulin. Alpha-glucosidase inhibitors block the breakdown of starches and some sugars, which helps to reduce blood glucose levels

A patient is admitted to the hospital with a diagnosis of primary hyperparathyroidism. A nurse checking the patient's lab results would expect which of the following changes in laboratory findings?

• Elevated serum calcium.
• Low serum parathyroid hormone (PTH).
• Elevated serum vitamin D.
• Low urine calcium.

Answer: A

The parathyroid glands regulate the calcium level in the blood.In hyperparathyroidism, the serum calcium level will be elevated.Parathyroid hormone levels may be high or normal but not low.The body will lower the level of vitamin D in an attempt to lower calcium. Urine calcium may be elevated, with calcium spilling over from elevated serum levels. This may cause renal stones.A 37-year-old forklift operator presents with shakiness, sweating, anxiety, and palpitations and tells the nurse he has type 1 diabetes mellitus.Which of the follow actions should the nurse do first?

• Inject 1 mg of glucagon subcutaneously.
• Administer 50 mL of 50% glucose I.V.
• Give 4 to 6 oz (118 to 177 mL) of orange juice.
• Give the client four to six glucose tablets.

Correct answer: C

Because the client is awake and complaining of symptoms, the nurse should first give him 15 grams of carbohydrate to treat hypoglycemia. This could be 4 to 6 oz of fruit juice, five to six hard candies such as Lifesavers, or 1 tablespoon of sugar. When a client has worsening symptoms of hypoglycemia or is unconscious, treatment includes 1 mg of glucagon subcutaneously or intramuscularly, or 50 mL of 50% glucose I.V. The nurse may also give two to three glucose tablets for a hypoglycemic reaction.A patient with cirrhosis is being treated with spironolactone (Aldactone) tid and furosemide (Lasix) bid. The patient's most recent laboratory results indicate a serum sodium of 134 mEq/L (134 mmol/L) and a serum potassium of 3.2 mEq/L (3.2 mmol/L). Before notifying the physician, the nurse should

• administer only the furosemide
• administer both drugs as ordered
• administer only the spironolactone
• Withhold the furosemide and spironolactone
• administer only the spironolactone

The potassium level is dangerously low. Lasix is potassium depleting, while spironolactone is potassium sparing. You would hold the Lasix and call the physician. This is a good NCLEX question that integrates this course with pharmacology.