NURSING 120 FINAL EXAM
The nurse is caring for the diabetic client who complains of sweating at night and who has
hyperglycemic episodes in the morning. The nurse suspects that the client is experiencing the
Somogyi effect. What interventions would the nurse potentially implement? Select all that
apply
A. Provide an evening snack
B. Increase the client's protein intake
C. Decrease nighttime insulin doses
D. Provide an evening snack and check blood sugars every 2 hours
E. Monitor insulin regimens
A nurse prepares to administer prescribed regular and NPH insulin. Place the nurse's actions in
the correct order to administer these medications.1. Inspect bottles for expiration dates.2.
Gently roll the bottle of NPH between the hands.3. Wash your hands.4. Inject air into the
regular insulin.5. Withdraw the NPH insulin.6. Withdraw the regular insulin.7. Inject air into the
NPH bottle.8. Clean rubber stoppers with an alcohol swab.
A. 1, 3, 8, 2, 4, 6, 7, 5
B. 2, 3, 1, 8, 7, 5, 4, 6
C. 3, 1, 2, 8, 7, 4, 6, 5
D. 8, 1, 3, 2, 4, 6, 7, 5
A nurse reviews the medication list of a client recovering from a computed tomography (CT)
scan with IV contrast to rule out small bowel obstruction. Which medication would alert the
nurse to contact the provider and withhold the prescribed dose?
A. Glimepiride (Amaryl)
B. Glipizide (Glucotrol)
C. Pioglitazone (Actos)
D. Metformin (Glucophage)
The diabetic client asks the nurse, "Why is exercise important for me?" What is the best
response by the nurse?"
A. "Exercise increases your insulin sensitivity."
B. "As long as you lose weight through dieting, exercise can be limited."
,C. "Exercise can help decrease your blood pressure and increase your lipid levels."
D. "You are a type 1 diabetic so exercising is not a priority
A nurse assesses a client with diabetes mellitus and notes that the client only responds to a
sternal rub by moaning, has a capillary blood glucose of 33 g/dL (1.8 mmol/L), and has an
intravenous line that is infiltrated with 0.45% normal saline. What action would the nurse take
first?
A. Encourage the patient to drink orange juice.
B. Administer 25 mL dextrose 50% (D50) IV push.
C. Insert a new intravenous access line.
D. Administer 1 mg of intramuscular glucagon.
A preoperative nurse assesses a client who has type 1 diabetes mellitus prior to a surgical
procedure. The client's blood glucose level is 160 mg/dL (8.9 mmol/L). What action would the
nurse take?
A. Administer a bolus of regular insulin IV.
B. Document the finding in the client's chart.
C. Draw blood gases to assess the metabolic state.
D. Call the surgeon to cancel the procedure.
A nurse teaches a client about self-monitoring of blood glucose levels. Which statement would
the nurse include in this client's teaching to prevent bloodborne infections?
A. "Wash your hands after completing each test."
B. "Use gloves when monitoring your blood glucose."
C. "Do not share your monitoring equipment."
D. "Blot excess blood from the strip with a cotton ball.
The nurse is educating the diabetic client on macrovascular complications. What education will
the nurse provide to the diabetic client to prevent macrovascular complications? Select all that
apply
A. Increase carbohydrate consumption
B. Monitor for protein in the urine
C. Goal BP of 155/90 or less
D. Smoking cessation
E. Discuss the importance of weight loss
,After teaching a client who has diabetes mellitus and proliferative retinopathy, nephropathy,
and peripheral neuropathy, the nurse assesses the client's understanding. Which statement
made by the client indicates a correct understanding of the teaching?
A. "I will exercise more frequently because I have so many complications."
B. "I should look into swimming or water aerobics to get my exercise."
C. "I have so many complications; exercising is not recommended."
D. "I used to run for exercise; I will start training for a marathon."
The client is in HHS and is receiving a bolus of 0.9% NS infusing at a rate of 1000 mL/hr. The
doctor's order states: "Give a 2 Liter bolus and then decrease IV fluids to 150 mL/hr." How long
will the bolus infuse for?
- (give the answer in hours) - 2 hours
The nurse is caring for a patient with type 2 diabetes. That patient has recently had insulin
injections added to his medication regimen due to elevated A1C levels. Which of the following
statements made by this patient indicates an understanding of teaching regarding A1C? Select
all that apply
A. "My A1C level should be between 7 and 8%."
B. "Next time I need to remain NPO after midnight for more accurate results."
C. "I will need to get my A1C checked twice a year."
D. "Lowering my A1C means that I am managing my diabetes better."
E. "I will need to get my A1C checked quarterly due to my medication change."
A nurse cares for a client who has diabetes mellitus. The nurse administers 6 units of regular
insulin and 10 units of NPH insulin at 07:00. At which time would the nurse assess the client for
potential problems related to the NPH insulin?
A. 23:00
B. 08:00
C. 20:00
D. 16:00
A nurse reviews the chart and new prescriptions for a client with diabetic ketoacidosis:
Vital Signs and AssessmentLaboratory ResultsMedicationsBlood pressure: 90/62 mm HgPulse:
120 beats/minRespiratory rate: 28 breaths/minUrine output: 20 mL/hr via catheterSerum
potassium: 2.6 mEq/L (2.6 mmol/L)Potassium chloride 40 mEq/L (40 mmol/L) IV bolus
STATIncrease IV fluid to 100 mL/hr
What action would the nurse take?
, A. Increase the intravenous flow rate before administering the potassium.
B. Administer the potassium and then consult with the provider about the fluid prescription.
C. Administer the potassium first before increasing the infusion flow rate.
D. Increase the intravenous rate and then consult with the provider about the potassium
prescription.
An emergency department nurse assesses a client with ketoacidosis. Which clinical
manifestation would the nurse correlate with this condition?
A. Extremity tremors followed by seizure activity
B. Severe orthostatic hypotension
C. Oral temperature of 102° F (38.9° C)
D. Increased rate and depth of respiration
At 4:45 PM, a nurse assesses a client with diabetes mellitus who is recovering from an
abdominal hysterectomy 2 days ago. The nurse notes that the client is confused and
diaphoretic. The nurse reviews the assessment data provided in the chart below:
Capillary Blood Glucose Testing (AC/HS)Dietary IntakeAt 06:30—95At 11:30—70At 16:30—
47Breakfast: 10% eaten—patient states that she is not hungryLunch: 5% eaten—patient is
nauseous; vomits once
After reviewing the client's assessment data, which action is appropriate at this time?
A. Administer dextrose 50% intravenously and reassess the client.
B. Provide a glass of orange juice and encourage the client to eat dinner.
C. Assess the client's oxygen saturation level and administer oxygen.
D. Reorient the client and apply a cool washcloth to the client's forehead.
The client has an order for Humalog 30 units SQ before meals. Your supply is a 3 mL prefilled
cartridge, 100 units/mL. How many mLs will you administer?
- (Round to the tenths) - 0.3 mL
An adult client comes into the clinic for a fasting blood glucose test. The results of this test are
127mg/dL. Which of the following interventions would be most appropriate?
A. Start the patient on metformin (Glucophage) as ordered
B. Repeat another fasting blood glucose in a few weeks.
C. Take a finger stick blood sugar in 1 hour for accuracy
D. Send the patient home as this is a normal finding
The nurse is caring for the diabetic client who complains of sweating at night and who has
hyperglycemic episodes in the morning. The nurse suspects that the client is experiencing the
Somogyi effect. What interventions would the nurse potentially implement? Select all that
apply
A. Provide an evening snack
B. Increase the client's protein intake
C. Decrease nighttime insulin doses
D. Provide an evening snack and check blood sugars every 2 hours
E. Monitor insulin regimens
A nurse prepares to administer prescribed regular and NPH insulin. Place the nurse's actions in
the correct order to administer these medications.1. Inspect bottles for expiration dates.2.
Gently roll the bottle of NPH between the hands.3. Wash your hands.4. Inject air into the
regular insulin.5. Withdraw the NPH insulin.6. Withdraw the regular insulin.7. Inject air into the
NPH bottle.8. Clean rubber stoppers with an alcohol swab.
A. 1, 3, 8, 2, 4, 6, 7, 5
B. 2, 3, 1, 8, 7, 5, 4, 6
C. 3, 1, 2, 8, 7, 4, 6, 5
D. 8, 1, 3, 2, 4, 6, 7, 5
A nurse reviews the medication list of a client recovering from a computed tomography (CT)
scan with IV contrast to rule out small bowel obstruction. Which medication would alert the
nurse to contact the provider and withhold the prescribed dose?
A. Glimepiride (Amaryl)
B. Glipizide (Glucotrol)
C. Pioglitazone (Actos)
D. Metformin (Glucophage)
The diabetic client asks the nurse, "Why is exercise important for me?" What is the best
response by the nurse?"
A. "Exercise increases your insulin sensitivity."
B. "As long as you lose weight through dieting, exercise can be limited."
,C. "Exercise can help decrease your blood pressure and increase your lipid levels."
D. "You are a type 1 diabetic so exercising is not a priority
A nurse assesses a client with diabetes mellitus and notes that the client only responds to a
sternal rub by moaning, has a capillary blood glucose of 33 g/dL (1.8 mmol/L), and has an
intravenous line that is infiltrated with 0.45% normal saline. What action would the nurse take
first?
A. Encourage the patient to drink orange juice.
B. Administer 25 mL dextrose 50% (D50) IV push.
C. Insert a new intravenous access line.
D. Administer 1 mg of intramuscular glucagon.
A preoperative nurse assesses a client who has type 1 diabetes mellitus prior to a surgical
procedure. The client's blood glucose level is 160 mg/dL (8.9 mmol/L). What action would the
nurse take?
A. Administer a bolus of regular insulin IV.
B. Document the finding in the client's chart.
C. Draw blood gases to assess the metabolic state.
D. Call the surgeon to cancel the procedure.
A nurse teaches a client about self-monitoring of blood glucose levels. Which statement would
the nurse include in this client's teaching to prevent bloodborne infections?
A. "Wash your hands after completing each test."
B. "Use gloves when monitoring your blood glucose."
C. "Do not share your monitoring equipment."
D. "Blot excess blood from the strip with a cotton ball.
The nurse is educating the diabetic client on macrovascular complications. What education will
the nurse provide to the diabetic client to prevent macrovascular complications? Select all that
apply
A. Increase carbohydrate consumption
B. Monitor for protein in the urine
C. Goal BP of 155/90 or less
D. Smoking cessation
E. Discuss the importance of weight loss
,After teaching a client who has diabetes mellitus and proliferative retinopathy, nephropathy,
and peripheral neuropathy, the nurse assesses the client's understanding. Which statement
made by the client indicates a correct understanding of the teaching?
A. "I will exercise more frequently because I have so many complications."
B. "I should look into swimming or water aerobics to get my exercise."
C. "I have so many complications; exercising is not recommended."
D. "I used to run for exercise; I will start training for a marathon."
The client is in HHS and is receiving a bolus of 0.9% NS infusing at a rate of 1000 mL/hr. The
doctor's order states: "Give a 2 Liter bolus and then decrease IV fluids to 150 mL/hr." How long
will the bolus infuse for?
- (give the answer in hours) - 2 hours
The nurse is caring for a patient with type 2 diabetes. That patient has recently had insulin
injections added to his medication regimen due to elevated A1C levels. Which of the following
statements made by this patient indicates an understanding of teaching regarding A1C? Select
all that apply
A. "My A1C level should be between 7 and 8%."
B. "Next time I need to remain NPO after midnight for more accurate results."
C. "I will need to get my A1C checked twice a year."
D. "Lowering my A1C means that I am managing my diabetes better."
E. "I will need to get my A1C checked quarterly due to my medication change."
A nurse cares for a client who has diabetes mellitus. The nurse administers 6 units of regular
insulin and 10 units of NPH insulin at 07:00. At which time would the nurse assess the client for
potential problems related to the NPH insulin?
A. 23:00
B. 08:00
C. 20:00
D. 16:00
A nurse reviews the chart and new prescriptions for a client with diabetic ketoacidosis:
Vital Signs and AssessmentLaboratory ResultsMedicationsBlood pressure: 90/62 mm HgPulse:
120 beats/minRespiratory rate: 28 breaths/minUrine output: 20 mL/hr via catheterSerum
potassium: 2.6 mEq/L (2.6 mmol/L)Potassium chloride 40 mEq/L (40 mmol/L) IV bolus
STATIncrease IV fluid to 100 mL/hr
What action would the nurse take?
, A. Increase the intravenous flow rate before administering the potassium.
B. Administer the potassium and then consult with the provider about the fluid prescription.
C. Administer the potassium first before increasing the infusion flow rate.
D. Increase the intravenous rate and then consult with the provider about the potassium
prescription.
An emergency department nurse assesses a client with ketoacidosis. Which clinical
manifestation would the nurse correlate with this condition?
A. Extremity tremors followed by seizure activity
B. Severe orthostatic hypotension
C. Oral temperature of 102° F (38.9° C)
D. Increased rate and depth of respiration
At 4:45 PM, a nurse assesses a client with diabetes mellitus who is recovering from an
abdominal hysterectomy 2 days ago. The nurse notes that the client is confused and
diaphoretic. The nurse reviews the assessment data provided in the chart below:
Capillary Blood Glucose Testing (AC/HS)Dietary IntakeAt 06:30—95At 11:30—70At 16:30—
47Breakfast: 10% eaten—patient states that she is not hungryLunch: 5% eaten—patient is
nauseous; vomits once
After reviewing the client's assessment data, which action is appropriate at this time?
A. Administer dextrose 50% intravenously and reassess the client.
B. Provide a glass of orange juice and encourage the client to eat dinner.
C. Assess the client's oxygen saturation level and administer oxygen.
D. Reorient the client and apply a cool washcloth to the client's forehead.
The client has an order for Humalog 30 units SQ before meals. Your supply is a 3 mL prefilled
cartridge, 100 units/mL. How many mLs will you administer?
- (Round to the tenths) - 0.3 mL
An adult client comes into the clinic for a fasting blood glucose test. The results of this test are
127mg/dL. Which of the following interventions would be most appropriate?
A. Start the patient on metformin (Glucophage) as ordered
B. Repeat another fasting blood glucose in a few weeks.
C. Take a finger stick blood sugar in 1 hour for accuracy
D. Send the patient home as this is a normal finding
