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1. The nurse working on a high-acuity medical-surgical unit is prioritizing
care for four patients who were just admitted. Which patient should the
nurse assess first?
a. The NPO patient with a blood glucose level of 80 mg/dL who just received
20 units of 70/30 Novolin insulin
b. The patient with a pulse of 58 beats per minute who is about to
receive digoxin (Lanoxin)
c. The patient with a blood pressure of 136/92 mm Hg who complains
of having a headache
d. The patient with an allergy to penicillin who is receiving an infusion of
vancomycin (Vancocin)
2. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars
are on a sliding scale and are ordered before a meal and at bedtime. The
patient's blood sugar level is 317 mg/dL. Which formulation of insulin should
the nurse prepare to administer?
a. No insulin should be administered.
b. NPH
c. 70/30 mix
d. Lispro (Humalog)
3. A patient with type 1 diabetes recently became pregnant. The nurse
plans a blood glucose testing schedule for her. What is the recommended
monitoring schedule?
a. Before each meal and before bed
b. In the morning for a fasting level and at 4 PM for the
peak level c. Six or seven times a day
d. Three times a day, along with urine glucose testing
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4. An adolescent patient recently attended a health fair and had a serum
glucose test. The patient telephones the nurse and says, "My level was 125
mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate
response?
a. "Unless you were fasting for longer than 8 hours, this does not necessarily
mean you have diabetes."
b. "At this level, you probably have diabetes. You will need an oral glucose
tolerance test this week."
c. "This level is conclusive evidence that you have diabetes."
d. "This level is conclusive evidence that you do not have diabetes."
5. Insulin glargine is prescribed for a hospitalized patient who is diabetic.
When will the nurse administer this drug?
a. Approximately 15 to 30 minutes before each meal
b. In the morning and at 4
PM c. Once daily at
bedtime
d. After meals and at bedtime
6. A patient with type 1 diabetes who takes insulin reports taking
propranolol for hypertension. Why is the nurse concerned?
a. The beta blocker can cause insulin resistance.
b. Using the two agents together increases the risk of ketoacidosis.
c. Propranolol increases insulin requirements because of receptor
blocking. d. The beta blocker can mask the symptoms of
hypoglycemia.
7. Which statement is correct about the contrast between a carbose
and miglitol? a. Miglitol has not been associated with hepatic
dysfunction.
b. With miglitol, sucrose can be used to treat hypoglycemia.
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c. Miglitol is less effective in African Americans.
d. Miglitol has no gastrointestinal side effects.
8. A nurse counsels a patient with diabetes who is starting therapy with
an alpha- glucosidase inhibitor. The patient should be educated about
the potential for which adverse reactions? (Select all that apply.)
a. Hypoglycem
ia b.
Flatulence
c. Elevated iron levels in the blood
d. Fluid
retention e.
Diarrhea
9. The nurse is caring for a pregnant patient recently diagnosed with
hypothyroidism. The patient tells the nurse she does not want to take
medications while she is pregnant. What will the nurse explain to this
patient?
a. Hypothyroidism is a normal effect of pregnancy and usually is of no
consequence. b. Neuropsychologic deficits in the fetus can occur if the
condition is not treated.
c. No danger to the fetus exists until the third trimester.
d. Treatment is required only if the patient is experiencing symptoms.
10. A nurse is teaching a patient who has been diagnosed with
hypothyroidism about levothyroxine (Synthroid). Which statement by the
patient indicates a need for further teaching?
a. "I should not take heartburn medication without consulting my provider."
b. "I should report insomnia, tremors, and an increased heart rate to my provider."
c. "If I take a multivitamin with iron, I should take it 4 hours after the
Synthroid." d."If I take calcium supplements, I may need to decrease
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my dose of Synthroid."
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