MED SURG FINAL EXAM ACTUAL EXAM ALL 50 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS)
A nurse is caring for a client who has blood glucose 52 mg/dL. The client is lethargic
but arousable. Which of the following actions should the nurse perform first?
A. Recheck blood glucose in 15 mins
B. Provide a carbohydrate and protein food
C. Provide 4 oz of grape fruit juice
D. Report findings to the provider - ANSWER: C
A nurse is preparing to administer a morning dose of insulin aspart to a client who
has type 1 diabetes mellitus. Which of the following actions should the nurse
implement?
A. Check blood glucose immediately after breakfast
B. Adminster insulin when breakfast arrives
C. Hold breakfast for 1 hr after insulin administration
D. Clarify the prescription because insulin should not be given at this time. -
ANSWER: B
A nurse is preparing to administer a morning dose of insulin glargine and regular
insulin to a client who has a blood glucose 278 mg/dL. Which of the following actions
should the nurse take?
A. Draw up regular insulin and then the glargine insulin in the same syringe
B. Draw up glargine insulin and then the regular insulin in the same syringe
C. Draw up and administer regular and glargine insulin in separate syringes.
D. Administer the regular insulin, wait 1 hr, and then administer the glargine insulin.
- ANSWER: C
A nurse is presenting information to a group of clients about nutrition habits that
prevent type 2 diabetes mellitus. Which of the following should the nurse include in
the information? (select all that apply)
A. Eat less meat and processed foods
B. Decrease intake of saturated fats
C. Increase daily fiber intake
D. Limit saturated fat intake to 15% of daily caloric intake.
E. Include omega-3 fatty acids in the diet - ANSWER: A, B, C, E
A nurse is teaching foot care to a client who has diabetes mellitus. Which of the
following information should the nurse include in the teaching? (select all that apply)
, A. Remove calluses using over the counter remedies
B. Apply lotion between the toes
C. Perform nail care after bathing
D. Trim toenails straight across
E. Wear closed-toe shoes - ANSWER: C, D, E
A nurse is reviewing the health record of a client who has hyperglycemic-
hyperosmolar state (HHS). The nurse should identify that which of the following data
confirm this diagnosis? (select all that apply)
A. Evidence of recent myocardial infarction
B. BUN 35 mg/dL
C. Takes a calcium channel blocker
D. Age 77
E. No insulin production - ANSWER: A, B, C, D
A nurse is assessing a client who has diabetic ketoacidosis and ketones in the urine.
The nurse should expect which of the following findings? (select all that apply)
A. Weight gain
B. Fruity odor of breath
C. Abdominal pain
D. Kussmaul respirations
E. Metabolic acidosis - ANSWER: B, C, D, E
A nurse is reviewing laboratory reports of a client who has hyperglycemic-
hyperosmolar state (HHS). The nurse should expect which of the following findings?
A. Serum pH 7.2
B. Serum osmolarity of 350
C. Serum potassium of 3.8
D. Serum creatinine of 0.8 - ANSWER: B
A nurse is preparing to administer IV fluids to a client who has diabetic ketoacidosis.
Which of the following actions should the nurse take?
A. Administer an IV infusion of regular insulin at 0.3 unit/kg/hr
B. Administer an IV infusion of 0.45% sodium chloride
C. Rapidly administer an IV infusion of 0.9% sodium chloride
D. Add glucose to the IV infusion when serum glucose is 350 - ANSWER: C
A nurse is providing discharge teaching to a client who has experienced diabetic
ketoacidosis. Which of the following information should the nurse include in the
teaching? (select all that apply)
A. Drink 2 L fluids daily
B. Monitor blood glucose every 4 hrs when ill
AND CORRECT DETAILED ANSWERS WITH RATIONALES
(VERIFIED ANSWERS)
A nurse is caring for a client who has blood glucose 52 mg/dL. The client is lethargic
but arousable. Which of the following actions should the nurse perform first?
A. Recheck blood glucose in 15 mins
B. Provide a carbohydrate and protein food
C. Provide 4 oz of grape fruit juice
D. Report findings to the provider - ANSWER: C
A nurse is preparing to administer a morning dose of insulin aspart to a client who
has type 1 diabetes mellitus. Which of the following actions should the nurse
implement?
A. Check blood glucose immediately after breakfast
B. Adminster insulin when breakfast arrives
C. Hold breakfast for 1 hr after insulin administration
D. Clarify the prescription because insulin should not be given at this time. -
ANSWER: B
A nurse is preparing to administer a morning dose of insulin glargine and regular
insulin to a client who has a blood glucose 278 mg/dL. Which of the following actions
should the nurse take?
A. Draw up regular insulin and then the glargine insulin in the same syringe
B. Draw up glargine insulin and then the regular insulin in the same syringe
C. Draw up and administer regular and glargine insulin in separate syringes.
D. Administer the regular insulin, wait 1 hr, and then administer the glargine insulin.
- ANSWER: C
A nurse is presenting information to a group of clients about nutrition habits that
prevent type 2 diabetes mellitus. Which of the following should the nurse include in
the information? (select all that apply)
A. Eat less meat and processed foods
B. Decrease intake of saturated fats
C. Increase daily fiber intake
D. Limit saturated fat intake to 15% of daily caloric intake.
E. Include omega-3 fatty acids in the diet - ANSWER: A, B, C, E
A nurse is teaching foot care to a client who has diabetes mellitus. Which of the
following information should the nurse include in the teaching? (select all that apply)
, A. Remove calluses using over the counter remedies
B. Apply lotion between the toes
C. Perform nail care after bathing
D. Trim toenails straight across
E. Wear closed-toe shoes - ANSWER: C, D, E
A nurse is reviewing the health record of a client who has hyperglycemic-
hyperosmolar state (HHS). The nurse should identify that which of the following data
confirm this diagnosis? (select all that apply)
A. Evidence of recent myocardial infarction
B. BUN 35 mg/dL
C. Takes a calcium channel blocker
D. Age 77
E. No insulin production - ANSWER: A, B, C, D
A nurse is assessing a client who has diabetic ketoacidosis and ketones in the urine.
The nurse should expect which of the following findings? (select all that apply)
A. Weight gain
B. Fruity odor of breath
C. Abdominal pain
D. Kussmaul respirations
E. Metabolic acidosis - ANSWER: B, C, D, E
A nurse is reviewing laboratory reports of a client who has hyperglycemic-
hyperosmolar state (HHS). The nurse should expect which of the following findings?
A. Serum pH 7.2
B. Serum osmolarity of 350
C. Serum potassium of 3.8
D. Serum creatinine of 0.8 - ANSWER: B
A nurse is preparing to administer IV fluids to a client who has diabetic ketoacidosis.
Which of the following actions should the nurse take?
A. Administer an IV infusion of regular insulin at 0.3 unit/kg/hr
B. Administer an IV infusion of 0.45% sodium chloride
C. Rapidly administer an IV infusion of 0.9% sodium chloride
D. Add glucose to the IV infusion when serum glucose is 350 - ANSWER: C
A nurse is providing discharge teaching to a client who has experienced diabetic
ketoacidosis. Which of the following information should the nurse include in the
teaching? (select all that apply)
A. Drink 2 L fluids daily
B. Monitor blood glucose every 4 hrs when ill
