Diabetes
A nurse is preparing a teaching plan for a client with diabetes Mellitus regarding proper foot care. Which instructions will be included in the plan? (Select all that apply)
A. Soak feet in hot water
B. apply a moisturizing lotion to dry feet but not between the toes
C. Feet should be examined at least once a week
D. avoid using mild soap on the feet
E. Wear proper-fitting shoes and avoid being barefoot
B. apply a moisturizing lotion to dry feet but not between the toes
E. Wear proper-fitting shoes and avoid being barefoot
A patient with Stage 5 CKD is experiencing extreme pruritus and has several areas of crystallized white deposits on the skin. As the nurse, you know this is due to excessive amounts of what substance found in the blood?
A. Calcium
B. Urea
C. Phosphate
D. Erythropoietin
B. Urea
The client is diagnosed with hypothyroidism. Which signs/symptoms should the nurse expect the client to exhibit?
A. Complaints of extreme fatigue and hair loss.
B. Exophthalmos and complaints of nervousness.
C. Complaints of profuse sweating and flushed skin.
D. Tetany and complaints of stiffness of the hands.
A. Complaints of extreme fatigue and hair loss.
The healthcare provider is assessing the glucose level of a patient with a diagnosis of diabetes. Which of these is most helpful in evaluating this patient’s long-term glucose management?
A. Fasting blood glucose level
B. Urine specific gravity
C. Glycosylated A1C
D. Patient's food diary
C. Glycosylated A1C
Before administering sodium polystyrene sulfonate (Kayexalate) to a patient with hyperkalemia, the nurse should assess _________________.
The patient's bowel sounds
A home health nurse is at the home of a client with diabetes and arthritis. The client has difficulty drawing up insulin. It would be most appropriate for the nurse to refer the client to:
A. A social worker from the local hospital
B. A physical therapist from the rehabilitation agency
C. An occupational therapist from the community center
D. Another client with diabetes mellitus and takes insulin"
C. An occupational therapist from the community center
A client with chronic renal failure has been prescribed calcium carbonate. What is the rationale for this particular medication?
A. Diminishes incidence of gastric ulcer formation
B. Alleviates constipation
C. Binds with phosphorus to lower concentration
D. Increase tubular reabsorption of sodium
C. Binds with phosphorus to lower concentration
The nurse identifies the client problem "risk for imbalanced body temperature" for the client diagnosed with hypothyroidism. Which intervention should be included in the plan of care?
A. Assess the client's temperature every two (2) hours.
B. Discourage the use of an electric blanket.
C. Keep the room temperature cool.
D. Space activities to promote rest.
B. Discourage the use of an electric blanket.
What are common electrolyte imbalances in acute renal failure? (Select all that apply)
A. Hypomagnesemia
B. Hyperkalemia
C. Hypophosphatemia
D. Hypocalcemia
B. Hyperkalemia
D. Hypocalcemia
A diabetic patient has the following presentation: unresponsive to voice or touch, tachycardia, diaphoresis, and pallor. Which of the following actions by the healthcare provider is the priority?
A. Administer 50% dextrose IV per protocol
B. Administer O2 via nasal canula
C. Provide the patient with 15 g of simple carbohydrates
D. Administer the prescribed insulin
A. Administer 50% dextrose IV per protocol
The nurse in a clinic is teaching a patient about signs and symptoms of hypoglycemia when taking metformin. Which of the following symptoms would be indicative of hypoglycemia? (select all that apply)
A. Shakiness
B. Increased thirst
C. Pallor
D. Confusion
E. Weight loss
A. Shakiness
C. Pallor
D. Confusion
A patient with a history of end-stage renal disease (ESRD) resulting from diabetes mellitus has presented to the outpatient dialysis unit for his scheduled hemodialysis. Which assessment should you 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
B. Blood pressure and fluid balance
The 68-year-old client diagnosed with hyperthyroidism is being treated with radio active iodine therapy. Which interventions should the nurse discuss with the client?
A. Teach the iodine therapy will have to be tapered slowly over one (1) week.
B. Discuss the client will have to be hospitalized during the radioactive therapy.
C. Explain it will take up to a month for symptoms of hyperthyroidism to subside.
D. Inform the client after therapy the client will not have to take any medication.
C. Explain it will take up to a month for symptoms of hyperthyroidism to subside.
Which of the following laboratory results would alert the healthcare provider that a patient who has diabetes is experiencing diabetic nephropathy?
A. A1C 6.5
B. Ketonuria
C. Decreased BUN
D. Microalbuminurea
D. Microalbuminurea
During hemodialysis, a patient complains of nausea and dizziness. Which action should the nurse take first?
A. Administer Zofran
B. Contact the provider
C. Check the patient's BP
D. Assure the patient that this is normal after dialysis
C. Check the patient's BP
"1. A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what ""type 2"" means in relation to diabetes. The nurse explains to the patient that type 2 diabetes differs from type 1 diabetes primarily in that with type 2 diabetes
a. the pt is totally dependent on an outside source of insulin
b. there is a decreased insulin secretion and cellular resistance to insulin that is produced
c. the immune system destroys the pancreatic insulin-producing cells
d. the insulin precursor that is secreted by the pancreas is not activated by the liver
b. there is a decreased insulin secretion and cellular resistance to insulin that is produced
A nurse is educating a patient in ESRD on medications to avoid. Which of the following should be included in this teaching? (Select All That Apply)
A. Ibuprofen
B. Milk of magnesia
C. Calcium carbonate
D. Vancomycin
E. Kayexalate
A. Ibuprofen
B. Milk of magnesia
D. Vancomycin
The nurse is teaching the client diagnosed with hyperthyroidism. Which information should be taught to the client? Select all that apply.
A. Notify the HCP if a three 3lb weight loss occurs in 2 days.
B. Discuss ways to cope with the emotional lability.
C. Notify the HCP if taking over-the-counter medication
D. Carry a medical identification card or bracelet.
E. Teach how to take thyroid medications correctly.
A. Notify the HCP if a three 3lb weight loss occurs in 2 days.
B. Discuss ways to cope with the emotional lability.
C. Notify the HCP if taking over-the-counter medication
D. Carry a medical identification card or bracelet.
The nurse is educating a patient on signs to watch out for with hyperparathyroidism. Which of the following symptoms should be included in this teaching? (select all that apply)
A. Bone pain
B. Changes in EKG
C. Trousseau’s sign
D. Increased phosphorus
E. Kidney stones
A. Bone pain
B. Changes in EKG
E. Kidney stones
A patient diagnosed with type 2 diabetes mellitus is admitted to the medical unit with pneumonia. The patient’s oral anti-diabetic medication has been discontinued and the patient is now receiving insulin for glucose control. Which of the following statements best explains the rationale for this change in medication?
A. Acute illnesses such as pneumonia increase the risk of insulin resistance
B. Stress related states including infections increase the risk of hyperglycemia
C. Infection decreases beta cell function so now the patient will be required to take insulin
D. Insulin administration will help prevent hypoglycemia during the illness
B. Stress related states including infections increase the risk of hyperglycemia
A patient with type 1 diabetes has received diet instruction as part of the treatment plan. The nurse
determines a need for additional instruction when the patient says ____.
a. "I should carry a few candies with me incase I feel hypoglycemic."
b. "I will need a bedtime snack because I take an evening dose of NPH insulin."
c. "I will eat meals as scheduled, even if I am not hungry, to prevent hypoglycemia."
d. "I may eat whatever I want, as long as I use enough insulin to cover the calories."
d. "I may eat whatever I want, as long as I use enough insulin to cover the calories."
Nurses need to educate patients at risk for CKD. Which individuals are considered to be at increased risk (select all that apply)?
A. Older African Americans
B. Individuals older than 60 years
C. Those with a history of pancreatitis
D. Those with a history of hypertension
E. Those with a history of type 2 diabetes
A. Older African Americans
B. Individuals older than 60 years
D. Those with a history of hypertension
E. Those with a history of type 2 diabetes
A patient is recovering from a thyroidectomy. The patient starts to complain of tingling and numbness in the face, toes, and fingers. Which of the following findings below warrants attention?
A. Phosphate 4.3
B. K 3.5
C. Na 135
D. Ca 6.5
D. Ca 6.5
A patient has recently been diagnosed with Addison's disease. Which of the following needs further teaching regarding medication education?
A. "You will take hydrocortisone and fludrocortisone in the morning"
B. "Refrain from taking antacids while taking these medications"
C. "If you are sick you should stop taking your hydrocortisone"
D. "You should measure your blood pressure often when taking these medications"
C. "If you are sick you should stop taking your hydrocortisone"
How should you assess the patency of a newly placed arteriovenous graft for dialysis?
A. Irrigate the graft daily with low-dose heparin.
B. Monitor for any increase in blood pressure in the affected arm.
C. Listen with a stethoscope over the graft for presence of a bruit.
D. Frequently monitor the pulses and neurovascular status distal to the graft.
C. Listen with a stethoscope over the graft for presence of a bruit.