Endocrine/Diabetes NCLEX Questions

Endocrine/Diabetes NCLEX Questions ScienceMedicineNursing wendilynhawk Save Endocrine NCLEX questions 121 terms awebstePreview Diabetes Mellitus NCLEX Style Ques...Teacher 36 terms ssandholmPreview Endocrine/diabetic medication NCL...17 terms wendilynhawk Preview Endocr 24 terms Ann 571. The client is brought to the ED in an unresponsive state, and a diagnosis of HHNS. The nurse would immediately prepare to initiate which anticipated healthcare provider's prescription?

1.Endotracheal intubation 2.100 units of NPH insulin 3.intravenous infusion of normal saline 4.intravenous infusion of sodium bicarbonate 3.Primary goal achievement of HHNS is to rehydrate the client to restore fluid volume and to correct electrolyte deficiency.

• An external insulin pump is prescribed for a client with DM and the client asks the nurse about the functioning of the pump. The nurse bases

the response on which info about the pump?

1.is timed to release programmed doses of short-duration or NPH insulin into the bloodstream at specific intervals 2.continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels 3.is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases insulin into the bloodstream 4.gives a small continues dose of short-duration insulin subcutaneously, and the client can self administer a bolus with an additional dose from the pump before each meal 4.And insulin pump provides a small continuous dose of short - duration (rapid or short acting) insulin subcutaneously throughout the day and night, and the client can self-administered a bolus with an additional dose from the pump before each meal as needed. short - duration insulin is used in an insulin pump. And external pump is not attach surgically to the pancreas.

• The client with a diagnosis of DKA is being treated in the ED. Which findings would the nurse expect to know as confirming this diagnosis?

Select all that apply.

1.increase in pH 2.comatose state 3.deep, rapid breathing 4.decreased urine output 5.elevated blood glucose level 6.low plasma bicarbonate level

3, 5, 6

In DKA, the arterial pH is lower than 7.35, plasma bicarbonate is lower than 15 mEq/L, The blood glucose level is higher than 250 mg/dL, and ketones are present in the blood and urine. The client would be experiencing polyuria, and Kussmaul's respirations would be present. A comatose state may occur if DKA is not treated, but coma would not confirm the diagnosis.

• The nurse teaches a client with DM about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an

understanding of the teaching by stating a form of glucose should be taken if which symptoms develop? Select all that apply.

1.polyuria 2.shakiness 3.palpitations 4.blurred vision 5.lightheadedness 6.fruity breath odor

2, 3, 5

Shakiness, palpitations, and lightheadedness are signs of hypoglycemia and would indicate the need for food or glucose.Polyuria, blurred vision, and a fruity breath order are signs of hyperglycemia.

• A client with DM demonstrates acute anxiety when first admitted to the hospital for treatment of hyperglycemia. What is the MOST

appropriate intervention to decrease the clients anxiety?

1.administer a sedative 2.convey empathy, trust, and respect for the client 3.ignore the signs and symptoms of anxiety so that they will soon disappear 4.make sure the client knows all the correct medical terms to understand what is happening 2.The most appropriate intervention is to address the clients feelings related to the anxiety.

• The nurse provides instructions to a newly diagnosed with type I DM. The nurse recognizes accurate understanding of measures to prevent

DKA when the client makes which statement?

• "I will stop taking my insulin if I'm too sick to eat."
• "I will decrease my insulin dose during times of illness."
• "I will adjust my insulin dose according to the level of glucose in the urine."
• "I will notify my HCP if my blood glucose level is higher than 250 mg/dL."

4.During illness, the client should monitor blood glucose levels and should notify the HCP if the level is higher than 250mg/dL. Insulin should never be stopped. In fact, insulin may need to be increased during times of illness. Dosage should not be adjusted without the HCP's advice and are usually adjusted on the basis of BG levels, not urinary glucose readings.

• The client is admitted to a hospital with a diagnosis of DKA. Initial BG level was 950 mg/dL. A continuous intravenous infusion of short -

acting insulin is initiated, along with intravenous rehydration with NS. The serum glucose level is now 240 mg/dL. The nurse would next prepare to administer which item?

1.ampule of 50?xtrose 2.NPH insulin subcutaneously 3.intravenous fluids containing dextrose 4.phenytoin (Dilantin) for the prevention of seizures 3.During management of DKA, when the BG level falls to 250 to 300 mg/dL, the infusion rate is reduced and a dextrose solution is added to maintain a BG level of about 250 mg/dL, or until the client recovers from ketosis.50?xtrose is used to treat hypoglycemia. NPH insulin is not used to treat DKA. Phenytoin is not usual treatment measure for DKA.

• The nurse is monitoring a client newly diagnosed with DM for signs of complications. Which sign, if exhibited in the client, would indicate

hyperglycemia?

1.polyuria 2.diaphoresis 3.hypertension 4.increased pulse rate 1.Classic symptoms of hyperglycemia include polydipsia, polyurea, and polyphagia.

• The nurse is preparing a plan of care for a client with DM who has hyperglycemia. The nurse places highest priority on which client

problem?

1.lack of knowledge 2.inadequate fluid volume 3.compromised family coping 4.in adequate consumption of nutrients 2.And increased BG level will cause the kidneys to excrete the glucose in the urine. This glucose is accompanied by fluids and electrolytes, causing an osmotic diuresis since leading to dehydration. This fluid loss must be replaced when it becomes severe.

• The home health nurse visits the client with a diagnosis of type one DM. The client relates a history of vomiting and diarrhea and tells the

nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching?

1.I need to stop my insulin.

2.I need to increase my fluid intake.

3.I need to monitor my blood glucose every 3 to 4 hours.

4.I need to call the HCP because of the symptoms.

1.When the client with DM is unable to eat normally because of illness, the client should take the prescribed medication. The client should consume additional fluids and should notify the HCP. The client should monitor the BG level every 3 to 4 hours. The patient also monitor the urine for ketones.

• The nurse is caring for a client after hypophysectomy and no it's clear nasal drainage from the clients nostril. The nurse should take which

initial action?

1.lower the head of the bed.

2.test the drainage for glucose.

3.obtain a culture of the drainage.

4.continue to observe the drainage.

2.After hypophysectomy, The client should be monitored for rhinorrhea, which could indicate a cerebral fluid leak. If this occurs, the drainage should be collected and tested for the presence of cerebrospinal fluid.(Hypophysectomy or hypophysis is the removal of the pituitary gland).

• After several diagnostic tests, a client is diagnosed with diabetes insipidus (DI). The nurse performs an assessment on the client, knowing

that which symptom is most indicative of this disorder?

1.fatigue 2.diarrhea 3.polydipsia 4.weight gain 3.DI is characterized by hyposecretion of antidiuretic hormone, and the kidney tubules fail to reabsorb water. Polydipsia and polyuria are classic symptoms of DI. The urine is pale, and the specific gravity is low. Anorexia and weight loss occur.

• A client is admitted to the ED, and a diagnosis of myxedema coma is made. Which action would the nurse prepare to carry out initially?

1.warm the client 2.maintain a patent airway 3.administer thyroid hormone 4.administer fluid replacement 2.The initial nursing action would be to maintain a patent airway. 02 would be administered, followed by fluid replacement, keeping the client warm, monitoring vital signs, and administering thyroid hormones by the intravenous route.Myxedema coma is a rare but serious disorder that results from persistently low thyroid production.

• The nurse is caring for a client admitted to the ED with DKA. In the acute phase, the nurse plans for which priority intervention?

1.correct the acidosis 2.administer 5?xtrose intravenously 3.apply a monitor for an electrocardiogram 4.administer short - duration insulin intravenously 4.Lack of insulin is the primary cause of DKA. Treatment consists of insulin administration (short of rapid acting), intravenous fluid administration (NS initially), and K+ replacement, followed by correcting the acidosis. Applying in ECG monitor is not the priority action.