saunders HESI EXIT questions and
Answers
ENDOCRINE -
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 -
✔️3
treatment in hyperosmolar hyperglycemic syndrome (HHS) is to rehydrate the client
to restore fluid volume and to correct electrolyte deficiency.
The use of sodium bicarbonate to correct acidosis is avoided because it can
precipitate a further drop in serum potassium level
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.
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. -
✔️4
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 -
✔️2,3,5
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 -
✔️2,3,5
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. -
✔️2
The nurse provides instructions to a client newly diagnosed with type 1 diabetes
mellitus. The nurse recognizes accurate understanding of measures to prevent
diabetic ketoacidosis when the client makes which statement?
1. "I will stop taking my insulin if I'm too sick to eat."
2. "I will decrease my insulin dose during times of illness."
3. "I will adjust my insulin dose according to the level of glucose in my urine."
4. "I will notify my health care provider (HCP) if my blood glucose level is higher than
250 mg/dL (14.2 mmol/L)." -
✔️4
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The
initial blood glucose level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV)
infusion of short-acting insulin is initiated, along with IV rehydration with normal
saline. The serum glucose level is now decreased to 240 mg/dL (13.7 mmol/L). The
nurse would next prepare to administer which medication?
1. An ampule of 50% dextrose
2. NPH insulin subcutaneously
3. IV fluids containing dextrose
4. Phenytoin for the prevention of seizures -
✔️3
when the blood glucose level falls to 250 to 300 mg/dL (14.2 to 17.1 mmol/L), the IV
infusion rate is reduced and a dextrose solution is added to maintain a blood glucose
level of about 250 mg/dL
The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of
complications. Which sign or symptom, if exhibited in the client, indicates that the
client is at risk for chronic complications of diabetes if the blood glucose is not
adequately managed?
1. Polyuria
2. Diaphoresis
3. Pedal edema
4. Decreased respiratory rate -
✔️1
, Classic symptoms of hyperglycemia include polydipsia, polyuria, and polyphagia.
The nurse is preparing a plan of care for a client with diabetes mellitus who has
hyperglycemia. The nurse places priority on which client problem?
1. Lack of knowledge
2. Inadequate fluid volume
3. Compromised family coping
4. Inadequate consumption of nutrients -
✔️2
The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus.
The client relates a history of vomiting and diarrhea and tells the nurse that no food
has been consumed for the last 24 hours. Which additional statement by the client
indicates a need for further teaching?
1. "I need to stop my insulin."
2. "I need to increase my fluid intake."
3. "I need to monitor my blood glucose every 3 to 4 hours."
4. "I need to call the health care provider (HCP) because of these symptoms." -
✔️1
The nurse is caring for a client after hypophysectomy and notes clear nasal drainage
from the client's nostril. The nurse should take which initial action?
1. Lower the head of the bed.
2. Test the drainage for glucose.
3. Obtain a culture of the drainage.
4. Continue to observe the drainage. -
✔️2
hypophysectomy is the surgical removal of the pituitary gland
client should be monitored for rhinorrhea, which could indicate a cerebrospinal fluid
leak. If this occurs, the drainage should be collected and tested for the presence of
cerebrospinal fluid. Cerebrospinal fluid contains glucose, and if positive, this would
indicate that the drainage is cerebrospinal fluid.
The nurse is admitting a client who is diagnosed with syndrome of inappropriate
antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118
mmol/L). Which health care provider prescriptions should the nurse anticipate
receiving? Select all that apply.
1. Initiate an infusion of 3% NaCl.
2. Administer intravenous furosemide.
3. Restrict fluids to 800 mL over 24 hours.
4. Elevate the head of the bed to high Fowler's.
5. Administer a vasopressin antagonist as prescribed. -
✔️1,3,5
3% is hypertonic: for the sodiumd < 120
Fluid restriction is a useful strategy aimed at correcting dilutional hyponatremia.
Vasopressin is an ADH; vasopressin antagonists are used to treat SIADH
Answers
ENDOCRINE -
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 -
✔️3
treatment in hyperosmolar hyperglycemic syndrome (HHS) is to rehydrate the client
to restore fluid volume and to correct electrolyte deficiency.
The use of sodium bicarbonate to correct acidosis is avoided because it can
precipitate a further drop in serum potassium level
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.
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. -
✔️4
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 -
✔️2,3,5
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 -
✔️2,3,5
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. -
✔️2
The nurse provides instructions to a client newly diagnosed with type 1 diabetes
mellitus. The nurse recognizes accurate understanding of measures to prevent
diabetic ketoacidosis when the client makes which statement?
1. "I will stop taking my insulin if I'm too sick to eat."
2. "I will decrease my insulin dose during times of illness."
3. "I will adjust my insulin dose according to the level of glucose in my urine."
4. "I will notify my health care provider (HCP) if my blood glucose level is higher than
250 mg/dL (14.2 mmol/L)." -
✔️4
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The
initial blood glucose level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV)
infusion of short-acting insulin is initiated, along with IV rehydration with normal
saline. The serum glucose level is now decreased to 240 mg/dL (13.7 mmol/L). The
nurse would next prepare to administer which medication?
1. An ampule of 50% dextrose
2. NPH insulin subcutaneously
3. IV fluids containing dextrose
4. Phenytoin for the prevention of seizures -
✔️3
when the blood glucose level falls to 250 to 300 mg/dL (14.2 to 17.1 mmol/L), the IV
infusion rate is reduced and a dextrose solution is added to maintain a blood glucose
level of about 250 mg/dL
The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of
complications. Which sign or symptom, if exhibited in the client, indicates that the
client is at risk for chronic complications of diabetes if the blood glucose is not
adequately managed?
1. Polyuria
2. Diaphoresis
3. Pedal edema
4. Decreased respiratory rate -
✔️1
, Classic symptoms of hyperglycemia include polydipsia, polyuria, and polyphagia.
The nurse is preparing a plan of care for a client with diabetes mellitus who has
hyperglycemia. The nurse places priority on which client problem?
1. Lack of knowledge
2. Inadequate fluid volume
3. Compromised family coping
4. Inadequate consumption of nutrients -
✔️2
The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus.
The client relates a history of vomiting and diarrhea and tells the nurse that no food
has been consumed for the last 24 hours. Which additional statement by the client
indicates a need for further teaching?
1. "I need to stop my insulin."
2. "I need to increase my fluid intake."
3. "I need to monitor my blood glucose every 3 to 4 hours."
4. "I need to call the health care provider (HCP) because of these symptoms." -
✔️1
The nurse is caring for a client after hypophysectomy and notes clear nasal drainage
from the client's nostril. The nurse should take which initial action?
1. Lower the head of the bed.
2. Test the drainage for glucose.
3. Obtain a culture of the drainage.
4. Continue to observe the drainage. -
✔️2
hypophysectomy is the surgical removal of the pituitary gland
client should be monitored for rhinorrhea, which could indicate a cerebrospinal fluid
leak. If this occurs, the drainage should be collected and tested for the presence of
cerebrospinal fluid. Cerebrospinal fluid contains glucose, and if positive, this would
indicate that the drainage is cerebrospinal fluid.
The nurse is admitting a client who is diagnosed with syndrome of inappropriate
antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118
mmol/L). Which health care provider prescriptions should the nurse anticipate
receiving? Select all that apply.
1. Initiate an infusion of 3% NaCl.
2. Administer intravenous furosemide.
3. Restrict fluids to 800 mL over 24 hours.
4. Elevate the head of the bed to high Fowler's.
5. Administer a vasopressin antagonist as prescribed. -
✔️1,3,5
3% is hypertonic: for the sodiumd < 120
Fluid restriction is a useful strategy aimed at correcting dilutional hyponatremia.
Vasopressin is an ADH; vasopressin antagonists are used to treat SIADH
