d d d d
for Top Academic Achievement"
d d d d
1. Thednursedworkingdondadhigh-acuitydmedical-
surgicaldunitdisdprioritizingdcaredfordfourdpatientsdwhodweredjustdadmitted.dWhichdpatientdshoulddthednurs
edassessdfirst?
a. ThedNPOdpatientdwithdadblooddglucosedleveldofd80dmg/dLdwhodjustdreceivedd20dunitsdofd70/30dNovoli
ndinsulin.
b. Thedpatientdwithdadpulsedofd58dbeatsdperdminutedwhodisdaboutdtodreceiveddigoxind(Lanoxin)
c. Thedpatientdwithdadblooddpressuredofd136/92dmmdHgdwhodcomplainsdofdhavingdadheadache
d. Thedpatientdwithdandallergydtodpenicillindwhodisdreceivingdandinfusiondofdvancomycind(Vancocin)d-d-
dcorrectdans-d-
a.dThedNPOdpatientdwithdadblooddglucosedleveldofd80dmg/dLdwhodjustdreceivedd20dunitsdofd70/30dNovol
indinsulin.
*low/normaldBGLdanddinsulindwilldcontinuedtoddropdglucosedlevel.dAtdriskdfordhypoglycemia.
2. Adpatientdwithdtyped1ddiabetesdisdeatingdbreakfastdatd7:30dAM.dBlooddsugarsdaredondadslidingdscaledand
daredordereddbeforedadmealdanddatdbedtime.dThedpatient'sdblooddsugardleveldisd317dmg/dL.dWhichdform
ulationdofdinsulindshoulddthednursedpreparedtodadminister?
a. Nodinsulindshoulddbedadministered.
b. NPH
c. 70/30dmix
d. Lisprod(Humalog)d-d-correctdans-d-d.dLisprod(Humalog)
*highdblooddsugardneedsdrapiddactingdinsulin.
,3. Adpatientdwithdtyped1ddiabetesdrecentlydbecamedpregnant.dThednursedplansdadblooddglucosedtesting
dscheduledfordher.dWhatdisdthedrecommendeddmonitoringdschedule?
a. Beforedeachdmealdanddbeforedbed
b. Indthedmorningdfordadfastingdleveldanddatd4dPMdfordthedpeakdlevel
c. Sixdordsevendtimesdadday
d. Threedtimesdadday,dalongdwithdurinedglucosedtestingd-d-correctdans-d-c.dSixdordsevendtimesdadday
*pregnancydcandeffectdglucosedlevels.dFrequentdmonitoringdrequired.
4. Andadolescentdpatientdrecentlydattendeddadhealthdfairdanddhaddadserumdglucosedtest.dThedpatientdtele
phonesdthednursedanddsays,d"Mydleveldwasd125dmg/dL.dDoesdthatdmeandIdhaveddiabetes?"dWhatdisdthednu
rse'sdmostdaccuratedresponse?
a. "Unlessdyoudweredfastingdfordlongerdthand8dhours,dthisddoesdnotdnecessarilydmeandyoudhaveddiabetes."
b. "Atdthisdlevel,dyoudprobablydhaveddiabetes.dYoudwilldneeddandoraldglucosedtolerancedtestdthisdweek."
c. "Thisdleveldisdconclusivedevidencedthatdyoudhaveddiabetes."
d. "Thisdleveldisdconclusivedevidencedthatdyouddodnotdhaveddiabetes."d-d-correctdans-d-
a.d"Unlessdyoudweredfastingdfordlongerdthand8dhours,dthisddoesdnotdnecessarilydmeandyoudhaveddiabetes.
"
*coulddbedadnormaldleveldwithoutdfastingdandddoesdnotdmeanddiabetesdunlessditdwasdhighdfordadfastingdblo
oddglucosedlevel.
5. Insulindglarginedisdprescribeddfordadhospitalizeddpatientdwhodisddiabetic.dWhendwilldthednursedadminister
dthisddrug?
a. Approximatelyd15dtod30dminutesdbeforedeachdmeal
b. Indthedmorningdanddatd4dPM
,c. Onceddailydatdbedtime
d. Afterdmealsdanddatdbedtimed-d-correctdans-d-c.dOnceddailydatdbedtime
*goodnightdglargine
6. Adpatientdwithdtyped1ddiabetesdwhodtakesdinsulindreportsdtakingdpropranololdfordhypertension.dWhydis
dthednursedconcerned?
a. Thedbetadblockerdcandcausedinsulindresistance.
b. Usingdthedtwodagentsdtogetherdincreasesdthedriskdofdketoacidosis.
c. Propranololdincreasesdinsulindrequirementsdbecausedofdreceptordblocking.
d. Thedbetadblockerdcandmaskdthedsymptomsdofdhypoglycemia.d-d-correctdans-d-
d.dThedbetadblockerdcandmaskdthedsymptomsdofdhypoglycemia.
*betadblockersdblockdadrenalinedwhichdsignalsdthedliverdtodreleasedglucosedindthedblooddwhendglucosedisdlo
wdtodavoiddhypoglycemia.
7. Whichdstatementdisdcorrectdaboutdthedcontrastdbetweendadcarbosedanddmiglitol?
a. Miglitoldhasdnotdbeendassociateddwithdhepaticddysfunction.
b. Withdmiglitol,dsucrosedcandbeduseddtodtreatdhypoglycemia.
c. MiglitoldisdlessdeffectivedindAfricandAmericans.
d. Miglitoldhasdnodgastrointestinaldsidedeffects.d-d-correctdans-d-
a.dMiglitoldhasdnotdbeendassociateddwithdhepaticddysfunction.
*keyddifferencedisdthatdacarbosedhasdbeendassociateddwithdraredcasesdofdhepaticddysfunction
, 8. Adnursedcounselsdadpatientdwithddiabetesdwhodisdstartingdtherapydwithdandalpha-
dglucosidasedinhibitor.dThedpatientdshoulddbededucateddaboutdthedpotentialdfordwhichdadversedreactions
?d(Selectdalldthatdapply.)
a. Hypoglycemia
b. Flatulence
c. Elevateddirondlevelsdindthedblood
d. Fluiddretention
e. Diarrhead-d-correctdans-d-b.dFlatulence
e.dDiarrhea
*duedtodbuilddupdofdgassesd(flatulence)dfromdtodundigesteddcarbohydratesdreachingdthedcolondanddcausing
dandosmoticdeffectd(diarrhea)
9. Thednursedisdcaringdfordadpregnantdpatientdrecentlyddiagnoseddwithdhypothyroidism.dThedpatientdtells
dthednursedsheddoesdnotdwantdtodtakedmedicationsdwhiledshedisdpregnant.dWhatdwilldthednursedexplaindt
odthisdpatient?
a. Hypothyroidismdisdadnormaldeffectdofdpregnancydanddusuallydisdofdnodconsequence.
b. Neuropsychologicddeficitsdindthedfetusdcandoccurdifdthedconditiondisdnotdtreated.
c. Noddangerdtodthedfetusdexistsduntildthedthirddtrimester.
d. Treatmentdisdrequireddonlydifdthedpatientdisdexperiencingdsymptoms.d-d-correctdans-d-
b.dNeuropsychologicddeficitsdindthedfetusdcandoccurdifdthedconditiondisdnotdtreated.
*Thyroiddhormonesdaredcrucialdfordthednormalddevelopmentdofdthedfetaldbraindanddnervousdsystemdanddm
ustdbedtreateddindpregnancy.
10. Adnursedisdteachingdadpatientdwhodhasdbeenddiagnoseddwithdhypothyroidismdaboutdlevothyroxine
d(Synthroid).dWhichdstatementdbydthedpatientdindicatesdadneeddfordfurtherdteaching?