Diabetes Mellitus
Endocrine Disorders
Hepatic Disorders
Renal Disorders
Miscellaneous:
Older Adult
100
The nurse has been teaching a patient with diabetes mellitus how to perform self-monitoring of blood glucose (SMBG). During evaluation of the patient’s technique, the nurse identifies a need for additional teaching when the patient does which of the following?
A) Chooses a puncture site in the center of the finger pad B) Washes hands with soap and water to cleanse the site to be used C) Warms the finger before puncturing the finger to obtain a drop of blood D) Tells the nurse that the result of 120 mg/dl indicates good control of diabetes
100
The patient has an order to receive 45 mg of prednisone by mouth daily. Available are 10-mg tablets. How many tablets should the nurse prepare to give?
A) 1.6 B) 2 C) 4.5 D) 6
100
The health care provider orders lactulose for a patient with hepatic encephalopathy. The nurse will monitor for effectiveness of this medication for this patient by assessing which of the following?
A) Relief of constipation B) Relief of abdominal pain C) Decreased liver enzymes D) Decreased ammonia levels
100
Which of the following nursing diagnoses is a priority in the care of a patient with renal calculi?
A) Acute pain B) Deficient fluid volume C) Risk for constipation D) Risk for powerlessness
100
Urinary incontinence is a normal part of aging.
A) True B) False
200
The nurse is assigned to the care of a 64-year-old patient diagnosed with type 2 diabetes. In formulating a teaching plan that encourages the patient to actively participate in management of the diabetes, which of the following should be the nurse’s initial intervention?
A) Assess patient’s perception of what it means to have diabetes. B) Ask the patient to write down current knowledge about diabetes. C) Set goals for the patient to actively participate in managing his diabetes. D) Assume responsibility for all of the patient’s care to decrease stress level.
200
The nurse would monitor for which of the following adverse changes in the patient’s laboratory values as a result of being treated with dexamethasone (Decadron)?
A) Sodium 130 mEq/L B) Calcium 8.2 mg/dl C) Potassium 4.9 mEq/L D) Blood glucose 162 mg/dl
200
The family of a patient newly diagnosed with hepatitis A asks the nurse what they can do to prevent becoming ill themselves. Which of the following responses by the nurse is most appropriate?
A) “The hepatitis vaccine will provide immunity from this exposure and future exposures.” B) “I am afraid there is nothing you can do since the patient was infectious before admission.” C) “You will need to be tested first to make sure you don’t have the virus before we can treat you.” D) “An injection of immunoglobulin will need to be given to prevent or minimize the effects from this exposure.”
200
Eight months after the delivery of her first child, a 31-year-old woman has sought care because of occasional incontinence that she experiences when sneezing or laughing. Which of the following measures should the nurse first recommend in an attempt to resolve the woman’s incontinence?
A) Kegel exercises B) Use of adult incontinence pads C) Intermittent self-catheterization D) Dietary changes including fluid restriction
200
A friend brings an older adult homeless client to a free health-screening clinic because the friend is unable to continue administering the client’s morning and evening insulin for type 1 diabetes mellitus. When advocating for this client, which action by the nurse is most appropriate?
A) Notify Adult Protective Services about the client’s condition and living situation. B)Ask where the client lives and if someone else can administer the insulin. C) Contact the unit social worker to arrange for someone to give the client’s insulin at a local homeless shelter. D) Have the client return to the screening clinic mornings and evenings to receive the insulin injections.
300
The nurse is beginning to teach a diabetic patient about vascular complications of diabetes. Which of the following information would be appropriate for the nurse to include?
A) Macroangiopathy does not occur in type 1 diabetes but rather in type 2 diabetics who have severe disease. B) Microangiopathy is specific to diabetes and most commonly affects the capillary membranes of the eyes, kidneys, and skin. C) Renal damage resulting from changes in large- and medium-sized blood vessels can be prevented by careful glucose control. D) Macroangiopathy causes slowed gastric emptying and the sexual impotency experienced by a majority of patients with diabetes.
300
The surgeon was unable to spare a patient’s parathyroid gland during a thyroidectomy. Which of the following assessments should the nurse prioritize when providing postoperative care for this patient?
A) Assessing the patient’s white blood cell levels and assessing for infection B) Monitoring the patient’s hemoglobin, hematocrit, and red blood cell levels C) Monitoring the patient’s serum calcium levels and assessing for signs of hypocalcemia D) Monitoring the patient’s level of consciousness and assessing for acute delirium or agitation
300
A patient with type 2 diabetes and cirrhosis asks the nurse if it would be okay to take silymarin (milk thistle) to help minimize liver damage. The nurse responds based on knowledge that:
A) Milk thistle may affect liver enzymes and thus alter drug metabolism. B) Milk thistle is generally safe in recommended doses for up to 10 years. C) There is unclear scientific evidence for the use of milk thistle in treating cirrhosis. D) Milk thistle may elevate the serum glucose levels and is thus contraindicated in diabetes.
300
A patient with a history of end-stage renal disease secondary to diabetes mellitus has presented to the outpatient dialysis unit for his scheduled hemodialysis. Which of the following assessments should the nurse prioritize before, during, and after his treatment?
A) Level of consciousness B) Blood pressure and fluid balance C) Temperature, heart rate, and blood pressure D) Assessment for signs and symptoms of infection
300
An elderly male patient visits his primary care provider because of burning on urination and production of urine that he describes as “foul smelling.” The health care provider should assess the patient for which of the following factors that may dispose him to urinary tract infections (UTIs)?
A) High-purine diet B) Sedentary lifestyle C) Benign prostatic hyperplasia (BPH) D) Recent use of broad-spectrum antibiotics
400
A patient is admitted with diabetes mellitus, malnutrition, and cellulitis. The patient’s potassium level is 5.6 mEq/L. The nurse considers that which of the following could be a contributing factor for this lab result (select all that apply)?
A) The level may be increased as a result of dehydration that accompanies hyperglycemia. B) The patient may be excreting extra sodium and retaining potassium because of malnutrition. C) The level is consistent with renal insufficiency that can develop with renal nephropathy. D) The level may be raised as a result of metabolic ketoacidosis caused by hyperglycemia.
400
Which of the following is a nursing priority in the care of a patient with a diagnosis of hypothyroidism?
A) Providing a dark, low-stimulation environment B) Closely monitoring the patient’s intake and output C) Patient teaching related to levothyroxine (Synthroid) D) Patient teaching related to radioactive iodine therapy
400
A 54-year-old patient admitted with diabetes mellitus, malnutrition, osteomyelitis, and alcohol abuse has a serum amylase level of 280 U/L and a serum lipase level of 310 U/L. To which of the following diagnoses does the nurse attribute these findings?
A) Malnutrition B) Osteomyelitis C) Alcohol abuse D) Diabetes mellitus
400
A patient is recovering in the intensive care unit (ICU) after receiving a kidney transplant approximately 24 hours ago. Which of the following is an expected assessment finding for this patient during this early stage of recovery?
A) Hypokalemia B) Hyponatremia C) Large urine output D) Leukocytosis with cloudy urine output
400
A 67-year-old woman who has a long-standing diagnosis of incontinence is in the habit of arriving 20 minutes early for church in order to ensure that she gets a seat near the end of a row and close to the exit so that she has ready access to the restroom. Which of the following tasks of the chronically ill is the woman enacting (select all that apply)?
A) Controlling symptoms B) Preventing social isolation C) Preventing and managing a crisis D) Denying the reality of the problem E) Adjusting to changes in the course of the disease
500
Lab results are back for a 54-year-old patient with a 15-year history of diabetes. Which of the following lab results follows the expected pattern accompanying macrovascular disease as a complication of diabetes?
A) Increased triglyceride levels B) Decreased low-density lipoproteins C) Increased high-density lipoproteins D) Decreased very-low-density lipoproteins
500
The nurse is providing discharge instructions to a patient with diabetes insipidus. Which of the following instructions regarding desmopressin acetate (DDAVP) would be most appropriate?
A) The patient can expect to experience weight loss resulting from increased diuresis. B) The patient should alternate nostrils during administration to prevent nasal irritation. C) The patient should monitor for symptoms of hypernatremia as a side effect of this drug. D) The patient should report any decrease in urinary elimination to the health care provider.
500
When caring for a patient with liver disease, the nurse recognizes the need to prevent bleeding resulting from altered clotting factors and rupture of varices. Which of the following nursing interventions would be appropriate to achieve this outcome (select all that apply)?
A) Use smallest gauge possible when giving injections or drawing blood. B) Teach patient to avoid straining at stool, vigorous blowing of nose, and coughing. C) Advise patient to use soft-bristle toothbrush and avoid ingestion of irritating food. D) Apply gentle pressure for the shortest possible time period after performing venipuncture. E) Instruct patient to avoid aspirin and NSAIDs to prevent hemorrhage when varices are present.
500
Which of the following assessment findings is a consequence of the oliguric phase of acute kidney injury (AKI)?
A) Hypovolemia B) Hyperkalemia C) Hypernatremia D) Thrombocytopenia
500
A 72-year-old woman is diagnosed with diabetes. The nurse recognizes that management of diabetes in the older adult:
A) does not require as tight glucose control as in younger diabetics B) is usually not treated unless the patient becomes severely hyperglycemic C) does not include treatment with insulin because of limited dexterity and vision D) usually requires that a younger family member be responsible for care of the patient
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