NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
1. A client is brought to the emergency department in an unresponsive state, and a diagnosis of
hyperosmolar hyperglycemic syndrome is made. The nurse would immediately prepare to initiate which
anticipated health care provider's prescription?
1. Endotracheal intubation
2. 100 units of NPH insulin
3. Intravenous infusion of normal saline
4. Intravenous infusion of sodium bicarbonate
Answer:
3. Intravenous infusion of normal saline
Rationale:
The primary goal of treatment in hyperosmolar hyperglycemic syndrome (HHS) is to rehydrate the client
to restore fluid volume and to correct electrolyte deficiency. Intravenous (IV) fluid replacement is
similar to that administered in diabetic ketoacidosis (DKA) and begins with IV infusion of normal saline.
Regular insulin, not NPH insulin, would be administered. The use of sodium bicarbonate to correct
acidosis is avoided because it can precipitate a further drop in serum potassium levels. Intubation and
mechanical ventilation are not required to treat HHS.
2. An external insulin pump is prescribed for a client with diabetes mellitus. When the client asks the
nurse about the functioning of the pump, the nurse bases the response on which information about the
pump?
1. It is timed to release programmed doses of either short-duration or NPH insulin into the
bloodstream at specific intervals.
2. It continuously infuses small amounts of NPH insulin into the bloodstream while regularly
monitoring blood glucose levels.
NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
,NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
3. It is surgically attached to the pancreas and infuses regular insulin into the pancreas. This
releases insulin into the bloodstream.
4. It administers a small continuous dose of short-duration insulin subcutaneously. The client can
self- administer an additional bolus dose from the pump before each meal.
Answer:
4. It administers a small continuous dose of short-duration insulin subcutaneously. The client can self-
administer an additional bolus dose from the pump before each meal.
Rationale:
NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
,NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
An insulin pump provides a small continuous dose of short-duration (rapid- or short-acting) insulin
subcutaneously throughout the day and night. The client can self-administer an additional bolus dose
from the pump before each meal as needed. Short-duration insulin
3. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department.
Which findings support this diagnosis? Select all that apply.
1. Increase in pH
2. Comatose state
3. Deep, rapid breathing
4. Decreased urine output
5. Elevated blood glucose level
Answers:
2. Comatose state
3. Deep, rapid breathing
5. Elevated blood glucose level
Rationale:
Because of the profound deficiency of insulin associated with DKA, glucose cannot be used for energy
and the body breaks down fat as a secondary source of energy. Ketones, which are acid byproducts of
fat metabolism, build up and the client experiences a metabolic ketoacidosis. High serum glucose
contributes to an osmotic diuresis and the client becomes severely dehydrated. If untreated, the client
will become comatose due to severe dehydration, acidosis, and electrolyte imbalance. Kussmaul's
respirations, the deep rapid breathing associated with DKA, is a compensatory mechanism by the body.
The body attempts to correct the acidotic state by blowing off carbon dioxide (CO2), which is an acid. In
the absence of insulin, the client will experience severe hyperglycemia. Option 1 is incorrect because in
acidosis the pH would be low. Option 4 is incorrect because a high serum glucose will result in an
osmotic diuresis and the client will experience polyuria.
NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
, NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
4. The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and
ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose
should be taken if which symptom or symptoms develop? Select all that apply.
1. Polyuria
2. Shakiness
3. Palpitations
4. Blurred vision
5. Lightheadedness
6. Fruity breath odor
Answers:
2. Shakiness
3. Palpitations
5. Lightheadedness
Rationale:
Shakiness, palpitations, and lightheadedness are signs/symptoms of hypoglycemia and would indicate
the need for food or glucose. Polyuria, blurred vision, and a fruity breath odor are manifestations of
hyperglycemia.
5. A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the
treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety?
1. Administer a sedative.
2. Convey empathy, trust, and respect toward the client.
3. Ignore the signs and symptoms of anxiety, anticipating that they will soon disappear.
4. Make sure that the client is familiar with the correct medical terms to promote understanding of
what is happening.
NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
questions and answers with rationale100% verified 2022
update
1. A client is brought to the emergency department in an unresponsive state, and a diagnosis of
hyperosmolar hyperglycemic syndrome is made. The nurse would immediately prepare to initiate which
anticipated health care provider's prescription?
1. Endotracheal intubation
2. 100 units of NPH insulin
3. Intravenous infusion of normal saline
4. Intravenous infusion of sodium bicarbonate
Answer:
3. Intravenous infusion of normal saline
Rationale:
The primary goal of treatment in hyperosmolar hyperglycemic syndrome (HHS) is to rehydrate the client
to restore fluid volume and to correct electrolyte deficiency. Intravenous (IV) fluid replacement is
similar to that administered in diabetic ketoacidosis (DKA) and begins with IV infusion of normal saline.
Regular insulin, not NPH insulin, would be administered. The use of sodium bicarbonate to correct
acidosis is avoided because it can precipitate a further drop in serum potassium levels. Intubation and
mechanical ventilation are not required to treat HHS.
2. An external insulin pump is prescribed for a client with diabetes mellitus. When the client asks the
nurse about the functioning of the pump, the nurse bases the response on which information about the
pump?
1. It is timed to release programmed doses of either short-duration or NPH insulin into the
bloodstream at specific intervals.
2. It continuously infuses small amounts of NPH insulin into the bloodstream while regularly
monitoring blood glucose levels.
NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
,NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
3. It is surgically attached to the pancreas and infuses regular insulin into the pancreas. This
releases insulin into the bloodstream.
4. It administers a small continuous dose of short-duration insulin subcutaneously. The client can
self- administer an additional bolus dose from the pump before each meal.
Answer:
4. It administers a small continuous dose of short-duration insulin subcutaneously. The client can self-
administer an additional bolus dose from the pump before each meal.
Rationale:
NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
,NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
An insulin pump provides a small continuous dose of short-duration (rapid- or short-acting) insulin
subcutaneously throughout the day and night. The client can self-administer an additional bolus dose
from the pump before each meal as needed. Short-duration insulin
3. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department.
Which findings support this diagnosis? Select all that apply.
1. Increase in pH
2. Comatose state
3. Deep, rapid breathing
4. Decreased urine output
5. Elevated blood glucose level
Answers:
2. Comatose state
3. Deep, rapid breathing
5. Elevated blood glucose level
Rationale:
Because of the profound deficiency of insulin associated with DKA, glucose cannot be used for energy
and the body breaks down fat as a secondary source of energy. Ketones, which are acid byproducts of
fat metabolism, build up and the client experiences a metabolic ketoacidosis. High serum glucose
contributes to an osmotic diuresis and the client becomes severely dehydrated. If untreated, the client
will become comatose due to severe dehydration, acidosis, and electrolyte imbalance. Kussmaul's
respirations, the deep rapid breathing associated with DKA, is a compensatory mechanism by the body.
The body attempts to correct the acidotic state by blowing off carbon dioxide (CO2), which is an acid. In
the absence of insulin, the client will experience severe hyperglycemia. Option 1 is incorrect because in
acidosis the pH would be low. Option 4 is incorrect because a high serum glucose will result in an
osmotic diuresis and the client will experience polyuria.
NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
, NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
4. The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and
ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose
should be taken if which symptom or symptoms develop? Select all that apply.
1. Polyuria
2. Shakiness
3. Palpitations
4. Blurred vision
5. Lightheadedness
6. Fruity breath odor
Answers:
2. Shakiness
3. Palpitations
5. Lightheadedness
Rationale:
Shakiness, palpitations, and lightheadedness are signs/symptoms of hypoglycemia and would indicate
the need for food or glucose. Polyuria, blurred vision, and a fruity breath odor are manifestations of
hyperglycemia.
5. A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the
treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety?
1. Administer a sedative.
2. Convey empathy, trust, and respect toward the client.
3. Ignore the signs and symptoms of anxiety, anticipating that they will soon disappear.
4. Make sure that the client is familiar with the correct medical terms to promote understanding of
what is happening.
NURS 618 Disease Management I|medsurg Endorine exam
questions and answers with rationale100% verified 2022
update
