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    Exam Review

    1. A client with type 1 diabetes is to receive a short-acting insulin and an intermediate-acting insulin subcutaneously before breakfast. The nurse would administer the insulin at which site as the preferred site?
      A)
      Arms
      B)
      Thighs
      C)
      Abdomen
      D)
      Upper buttock
    2. The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes?
      A)
      Little relation to prediabetes
      B)
      Insufficient insulin production
      C)
      Less common than type 1 diabetes
      D)
      Onset most common during adolescence
    3. A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which symptom when caring for this client?
      A)
      Polyuria
      B)
      Blurred vision
      C)
      Polydipsia
      D)
      Hypoglycemia
    4. The nurse is teaching a client about self-administration of insulin and about mixing regular and neutral protamine Hagedorn (NPH) insulin. Which information is important to include in the teaching plan?
      A)
      When mixing insulin, the regular insulin is drawn up into the syringe first.
      B)
      If two different types of insulin are ordered, they need to be given in separate injections.
      C)
      There is no need to inject air into the bottle of insulin before withdrawing the insulin.
      D)
      When mixing insulin, the NPH insulin is drawn up into the syringe first.
    Page 1 of 10

    Exam Review

    1. When referred to a podiatrist, a client newly diagnosed with diabetes mellitus asks, "Why do you need to check my feet when I'm having a problem with my blood sugar?" The nurse's most helpful response to this statement is:
      A)
      "It's easier to get foot infections if you have diabetes."
      B)
      "Diabetes can affect sensation in your feet and you can hurt yourself without realizing it."
      C)
      "The physician wants to be sure your shoes fit properly so you won't develop pressure sores."
      D)
      "The circulation in your feet can help us determine how severe your diabetes is."
    2. Which is a by-product of fat breakdown in the absence of insulin and accumulates in the blood and urine?
      A)
      Creatinine
      B)
      Cholesterol
      C)
      Hemoglobin
      D)
      Ketones
    3. A school nurse is teaching a group of high school students about risk factors for diabetes. What action has the greatest potential to reduce an individual's risk for developing diabetes?
      A)
      Lose weight, if obese
      B)
      Undergo eye examinations regularly
      C)
      Stop using tobacco in any form
      D)
      Have blood glucose levels checked annually
    4. A nurse is caring for a client with type 1 diabetes who is being discharged home tomorrow. What is the best way to assess the client's ability to prepare and self-administer insulin?
      A)
      Observe the client drawing up and administering the insulin.
      B)
      Ask the client to describe the process in detail.
      C)
      Review the client's first hemoglobin A1C result after discharge.
      D)
      Provide a health education session reviewing the main points of insulin delivery.
    Page 2 of 10

    Exam Review

    1. A nurse is teaching basic "survival skills" to a client newly diagnosed with type 1 diabetes. What topic should the nurse address?
      A)
      Recognition of hypoglycemia and hyperglycemia
      B)
      Management of diabetic ketoacidosis
      C)
      Signs and symptoms of diabetic nephropathy
      D)
      Effects of surgery and pregnancy on blood sugar levels
    2. A nurse is preparing to administer insulin to a child who's just been diagnosed with type 1 diabetes. When the child's mother stops the nurse in the hall, she's crying and anxious to talk about her son's condition. The nurse's best response is:
      A)
      "If you'll wait in your son's room, the physician will talk with you as soon as he's free."
      B)
      "Everything will be just fine. I'll be back in a minute and then we can talk."
      C)
      "I can't talk now. I have to give your son his insulin as soon as possible."
      D)
      "I'm going to give your son some insulin. Then I'll be happy to talk with you."
    3. A recently widowed diabetic person comments that her blood sugar levels are running higher than usual. Which is the best response from the nurse?
      A)
      "This must be a stressful time for you."
      B)
      "People who eat alone tend to eat more."
      C)
      "Cooking lower carbohydrate meals for one person is a challenge."
      D)
      "Quit checking your blood sugars for now."
    4. A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms?
      A)
      Polyuria, polydipsia, hypotension, and hypernatremia
      B)
      Kussmaul's respirations, dry skin, hypotension, and bradycardia
      C)
      Coma, anxiety, confusion, headache, and cool, moist skin
      D)
      Polyuria, polydipsia, polyphagia, and weight loss
    Page 3 of 10

    Exam Review

    1. Which intervention is essential when performing dressing changes on a client with a diabetic foot ulcer?
      A)
      Cleaning the wound with a povidone-iodine solution
      B)
      Using sterile technique during the dressing change
      C)
      Debriding the wound three times per day
      D)
      Applying a heating pad
    2. A client with type 2 diabetes normally achieves adequate glycemic control through diet and exercise. Upon being admitted to the hospital for a cholecystectomy, however, the client has required insulin injections on two occasions. The nurse would identify what likely cause for this short-term change in treatment?
      A)
      Alterations in bile metabolism and release have likely caused hyperglycemia.
      B)
      The client has likely overestimated her ability to control her diabetes using nonpharmacologic measures.
      C)
      The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars.
      D)
      Stress has likely caused an increase in the client's blood sugar levels.
    3. The physician orders an opioid analgesic for a client with a traumatic injury. The nurse would monitor the client closely for which of the following as the priority
      A)
      Hypotension
      B)
      Joint inflammation
      C)
      Respiratory depression
      D)
      Allergic reactions
    4. Which elements of assessment of a traumatic musculoskeletal injury should be included when a client is evaluated.
      A)
      Observe for swelling, external bleeding, or bruising.
      B)
      All should be included.
      C)
      Check the sensation of the injured part
      D)
      Palpate the peripheral pulses
    Page 4 of 10

    Exam Review

    1. After a bone density test, an older adult female client tells the nurse, "I don't understand why I have osteoporosis because I eat well and take my calcium." What does the nurse explain as the reason that the client may have osteoporosis?
      A)
      The loss is from withdrawal of estrogen and a decrease in activity levels.
      B)
      Everyone gets osteoporosis and there is nothing you can do to prevent it.
      C)
      In order to prevent bone loss, women have to take hormones.
      D)
      Men lose more bone mass than women but women still lose some.
    2. A client presents to a clinic reporting of a leg ulcer that isn't healing; subsequent diagnostic testing suggests osteomyelitis. The nurse is aware that the most common pathogen to cause osteomyelitis is what?
      A)
      Escherichia coli
      B)
      Pseudomonas
      C)
      Proteus
      D)
      Staphylococcus aureus
    3. The nurse is reading the admission note for a client with a bone fracture that requires surgery. The note indicates the presence of crepitus. The nurse interprets this as being:
      A)
      Bleeding
      B)
      a closed fracture
      C)
      a crackling sound
      D)
      ecchymosis.
    4. Which term refers to moving away from midline?
      A)
      Eversion
      B)
      Abduction
      C)
      Adduction
      D)
      Inversion
    Page 5 of 10

    Exam Review

    1. The nurse is performing a musculoskeletal assessment of a client in a nursing home who had a stroke 2 years ago and who has right-sided hemiplegia. The nurse notes that the girth of the client's right calf is 2 inches less in diameter than the left calf. The nurse attributes the decreased girth to:
      A)
      edema in left lower extremity.
      B)
      atrophy of right calf muscle.
      C)
      increased use of left calf muscle.
      D)
      bruising in right lower extremity.
    2. A client undergoes an arthroscopy at the outpatient clinic. After the procedure, the nurse provides discharge teaching. Which response by the client indicates the need for further teaching?
      A)
      "Elevating my leg will reduce swelling after the procedure."
      B)
      "My physician may prescribe pain pills after the procedure."
      C)
      "I should use my heating pad this evening to reduce some of the pain in my knee."
      D)
      "I may notice some bruising or swelling in my knee."
    3. A client experiences a musculoskeletal injury that involves the structure that connects a muscle to the bone. The nurse understands that this injury involves which structure?
      A)
      Tendon
      B)
      Joint
      C)
      Ligament
      D)
      Cartilage
    4. A client has had a cast placed for the treatment of a humeral fracture. The nurse's most recent assessment shows signs and symptoms of compartment syndrome. What is the nurse's most appropriate action?
      A)
      Arrange for a STAT assessment of the client's serum calcium levels.
      B)
      Perform active range of motion exercises.
      C)
      Contact the primary provider immediately.
      D)
      Assess the client's joint function symmetrically.
    Page 6 of 10