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    Exam Review

    1. An unresponsive patient who has type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemia syndrome (HHS). What should the nurse anticipate doing?
      A)
      Giving 50% dextrose
      B)
      Inserting an IV catheter
      C)
      Administering glargine (Lantus) insulin
      D)
      Initiating 02 by nasal cannula
    2. A nurse is caring for a male client who has peripheral vascular disease (PVD), is taking dietary supplements, and has a new prescription for warfarin. The nurse should instruct the client to stop which of the following supplements prior to starting the warfarin? (Select all that apply.)
      (SATA)
      A)
      Black cohosh
      B)
      Gingko biloba
      C)
      Flaxseed oil
      D)
      Glucosamine
      E)
      Saw palmetto
    3. A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize that which of the following are manifestations of Cushing's syndrome? (Select all that apply.)
      (SATA)
      A)
      Moon face
      B)
      Purple striations
      C)
      Buffalo hump
      D)
      Tremors
      E)
      Hypertension
    4. A nurse is caring for a client who has type 2 diabetes mellitus and their glucose levels are rising. Which of the following would indicate the client is in a hyperosmolar hyperglycemic state (HHS)?
      A)
      Hypertension
      B)
      Ketosis
      C)
      Plasma osmolarity of 350 mOsm/L
      D)
      Glucose level of 500 mg/dl
    Page 1 of 16

    Exam Review

    1. A nurse is caring for a client with type 1 diabetes mellitus who reports feeling shaky and having palpitations. When the nurse finds the client's blood glucose to be 48 mg/dL on the glucometer, he should give the client which of the following?
      A)
      Graham crackers
      B)
      1 tsp sugar
      C)
      4 oz diet soda
      D)
      4 oz skim milk
    2. A nurse is reviewing guidelines to prevent DKA during periods of illness with a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?
      A)
      "Check your urine for ketones when blood glucose levels are greater than 240 mg/dL."
      B)
      "Withhold your usual daily dose of insulin."
      C)
      "Test your blood glucose level every 8 hours."
      D)
      "Drink 240 to 360 milliliters of calorie-free liquids every 8 hours."
    3. A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. The nurse should anticipate an elevation of which of the following laboratory values?
      A)
      Free T4
      B)
      Serum T4
      C)
      Thyroid stimulating hormone (TSH)
      D)
      Serum T3
    4. A nurse is teaching a client who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?
      A)
      "My skin will be warm and moist."
      B)
      "My appetite will be decreased."
      C)
      "I will be more thirsty than usual."
      D)
      "I will feel shaky."
    Page 2 of 16

    Exam Review

    1. A nurse in an emergency department is caring for a 52-year-old male client. Exhibits Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
      ✓Ask for referral with a registered dietician.
      ✓Request for a prescription for an insulin stumlator
      ✓Diabetes mellitus
      ✓Serum glucose level
      ✓Glycosylated hemoglobin assay
      Action to Take Choices
      ✓Ask for referral with a registered dietician.
      ✕Prepare client for a digital rectal examination.
      ✕Obtain a urine sample for culture and sensitivity
      ✕Position client with feet below level of the heart
      ✓Request for a prescription for an insulin stumlator
      Potential Condition Choices
      ✕Prostate cancer
      ✓Diabetes mellitus
      ✕Urinary tract infection
      ✕Peripheral arterial disease
      Parameter to Monitor Choices
      ✕Prostate specific antigen
      ✓Serum glucose level
      ✕Temperature
      ✕Peripheral pulses
      ✓Glycosylated hemoglobin assay
    2. A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take?
      A)
      Weigh the client daily.
      B)
      Provide a low-carbohydrate diet.
      C)
      Administer oral corticosteroids.
      D)
      Restrict fluid intake.
    3. Which of the following is not a recommended method for venous thromboembolism (VTE) prophylaxis in hospitalized patients?
      A)
      Bed rest
      B)
      Early ambulation
      C)
      Subcutaneous low molecular weight heparin
      D)
      Intermittent pneumatic compression devices
    4. A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client?
      A)
      NPH insulin
      B)
      Insulin detemir
      C)
      Insulin glargine
      D)
      Regular insulin
    Page 3 of 16

    Exam Review

    1. A nurse is providing discharge instructions to a client who developed deep-vein thrombosis (DVT) postoperatively and is prescribed anticoagulant therapy. Which of the following instructions should the nurse include?
      A)
      Flexing her knees and feet frequently
      B)
      Taking an NSAID tablet daily
      C)
      Wearing loose, non-constricting stockings
      D)
      Applying cool compresses to her legs
    2. A nurse is caring for a client who is postoperative and is at risk for developing venous thromboembolism (VTE). The nurse should instruct the client to avoid which of the following unsafe actions?
      A)
      Ambulating soon after surgery
      B)
      Elevating her feet
      C)
      Flexing her ankles
      D)
      Massaging her legs
    3. A nurse is giving a presentation about preventing deep-vein thrombosis (DVT). Which of the following should the nurse include as a risk factor for this disorder? (Select all that apply.)
      A)
      Oral contraceptive use
      B)
      Hypertension
      C)
      BMI of 20
      D)
      High calcium intake
      E)
      Immobility
    4. A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (Select all that apply)
      A)
      Tachycardia
      B)
      Blurred vision
      C)
      Polydipsia
      D)
      Polyuria
      E)
      Moist, clammy skin
    Page 4 of 16

    Exam Review

    1. A nurse is assessing a client who has type 1 diabetes mellitus and finds the client lying in bed, sweating, and reporting feeling anxious. Which of the following complications should the nurse suspect?
      A)
      Hypoglycemia
      B)
      Nephropathy
      C)
      Hyperglycemia
      D)
      Ketoacidosis
    2. A nurse is assessing a 24-year-old female client. Exhibits Which of the following clinical manifestations is the client exhibiting ?
      A)
      Peripheral arterial disease
      B)
      Deep vein thrombosis
      C)
      Cellulitis
      D)
      Pulmonary embolism
      E)
      Popliteal venous aneurysm
      F)
      Vasculitis
    3. A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortisolism?
      A)
      A client who has muscle hypertrophy.
      B)
      Moon face
      C)
      A client who has a butterfly rash on his face.
      D)
      A client who has a positive Chvostek's sign
    4. A nurse is teaching a client who is taking metformin XR for type II diabetes mellitus. Which of the following instructions should the nurse include in the teaching?
      A)
      "You may crush or chew the medication."
      B)
      "This medication may turn your urine orange."
      C)
      "This medication may cause an increase in perspiration."
      D)
      "Take the medication with a meal."
    Page 5 of 16

    Exam Review

    1. A nurse observes mild hand tremors in a client who has diabetes mellitus. Which of the following actions should the nurse take after obtaining a glucose meter reading of 60 mg/dL?
      A)
      Administer IV dextrose.
      B)
      Administer 15 g of carbohydrates.
      C)
      Administer 1 mg of glucagon IM.
      D)
      Retest the blood glucose level.
    2. A nurse is caring for a client who has type 1 diabetes mellitus. The nurse misread the client's morning blood glucose level as 210 mg/dl instead of 120 mg/dL and administered the insulin dose appropriate for a reading over 200 mg/dL before the client's breakfast. Which of the following actions is the nurse's priority?
      A)
      Notify the nurse manager.
      B)
      Monitor the client for hypoglycemia.
      C)
      Complete an incident report.
      D)
      Give the client 15 to 20 g of carbohydrate
    3. A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply)
      A)
      Weigh the client daily
      B)
      Monitor for postural hypotension
      C)
      Monitor for an irregular heart rate
      D)
      Assess for neck vein distention
      E)
      Assess blood glucose level
    4. Which risk factor should the nurse focus on when teaching a patient who has a 5-cm abdominal aortic aneurysm?
      A)
      Abdominal trauma history
      B)
      Uncontrolled hypertension
      C)
      Turner syndrome
      D)
      Male gender
    Page 6 of 16