NR 325 EXAM 1 COMPLETE QUESTIONS | VERIFIED
ANSWERS | DETAILED RATIONALES |
1. A nurse is preparing to administer regular insulin and NPH insulin to
a patient with diabetes. Which action demonstrates correct insulin
mixing technique?
A. Draw up the NPH insulin first, then the regular insulin
B. Inject air into the regular insulin vial first, then draw up the NPH
C. Draw up the clear regular insulin before the cloudy NPH insulin
D. Shake the NPH vial vigorously to ensure proper mixing
Answer: C
Rationale: When mixing regular insulin and NPH insulin, the nurse
should draw up the clear (regular) insulin before the cloudy (NPH)
insulin to prevent contamination of the regular insulin vial with NPH. Air
should be injected into the NPH vial first, then into the regular vial,
before drawing up the medications .
2. A patient with type 1 diabetes asks the nurse about exercise safety.
Which statement indicates the patient needs additional teaching?
A. "I will check my blood glucose before, during, and after swimming."
B. "I can go for a vigorous walk when my glucose is 200 mg/dL."
C. "I should have a snack before starting my bicycle ride."
D. "I will not exercise if I have ketones in my urine."
,Answer: B
Rationale: Exercise when blood glucose is elevated (200 mg/dL) may
actually increase blood glucose levels further. Patients should be taught
to avoid exercise when blood glucose is above 250 mg/dL or when
ketones are present, as this can worsen hyperglycemia .
3. A patient with type 2 diabetes is scheduled for a follow-up visit.
Which test best evaluates the effectiveness of diabetes treatment over
the past several months?
A. Fasting blood glucose level
B. Oral glucose tolerance test
C. Urine dipstick for glucose
D. Glycosylated hemoglobin (HbA1c)
Answer: D
Rationale: The HbA1c test reflects average blood glucose control over
the previous 90-120 days, providing the best assessment of long-term
glycemic control. Fasting blood glucose only shows a snapshot of
current glucose levels .
4. A nurse is assessing a patient with Graves' disease. Which finding
should the nurse expect?
A. Cold intolerance and weight gain
B. Bradycardia and constipation
C. Difficulty sleeping and anxiety
D. Dry skin and periorbital edema
,Answer: C
Rationale: Graves' disease is characterized by hyperthyroidism with
overproduction of thyroid hormone. Manifestations include difficulty
sleeping, anxiety, weight loss, heat intolerance, and tachycardia due to
increased metabolism .
5. What is the most important assessment for a nurse to perform
when caring for a patient with a neurological condition?
A. Blood pressure monitoring
B. Level of consciousness (LOC)
C. Respiratory rate
D. Capillary refill
Answer: B
Rationale: Level of consciousness is the most important neurological
assessment as it provides the earliest indicator of changes in
neurological status. LOC assessment includes orientation to person,
place, time, and situation .
6. A patient is prescribed levothyroxine for hypothyroidism. Which
teaching point is most important for the nurse to include?
A. Take the medication at bedtime with a snack
B. Take the medication in the morning before breakfast
C. The medication works immediately to relieve symptoms
D. Soy products enhance the effectiveness of the medication
Answer: B
, Rationale: Levothyroxine should be taken in the morning on an empty
stomach, at least 30-60 minutes before breakfast, for optimal
absorption. It may take several weeks to achieve therapeutic effect, and
patients should not abruptly stop taking it .
7. A patient with chronic kidney disease has a potassium level of 6.2
mEq/L. Which intervention should the nurse anticipate?
A. Administration of oral potassium supplements
B. Hyperkalemia protocol including insulin and dextrose
C. Restricting IV fluids to 500 mL per day
D. Administration of potassium-sparing diuretics
Answer: B
Rationale: The hyperkalemia protocol includes regular insulin IV to shift
potassium back into cells, D50 IV to prevent hypoglycemia, sodium
bicarbonate, and possibly calcium gluconate to protect the heart. Renal
patients cannot effectively excrete potassium .
8. A patient is scheduled for an intravenous pyelogram (IVP). Which
information provided by the patient has the most immediate
implications for care?
A. The patient has not eaten for 8 hours
B. The patient reports allergies to shellfish and penicillin
C. The patient complains of flank pain
D. The patient used a laxative the previous night
Answer: B
ANSWERS | DETAILED RATIONALES |
1. A nurse is preparing to administer regular insulin and NPH insulin to
a patient with diabetes. Which action demonstrates correct insulin
mixing technique?
A. Draw up the NPH insulin first, then the regular insulin
B. Inject air into the regular insulin vial first, then draw up the NPH
C. Draw up the clear regular insulin before the cloudy NPH insulin
D. Shake the NPH vial vigorously to ensure proper mixing
Answer: C
Rationale: When mixing regular insulin and NPH insulin, the nurse
should draw up the clear (regular) insulin before the cloudy (NPH)
insulin to prevent contamination of the regular insulin vial with NPH. Air
should be injected into the NPH vial first, then into the regular vial,
before drawing up the medications .
2. A patient with type 1 diabetes asks the nurse about exercise safety.
Which statement indicates the patient needs additional teaching?
A. "I will check my blood glucose before, during, and after swimming."
B. "I can go for a vigorous walk when my glucose is 200 mg/dL."
C. "I should have a snack before starting my bicycle ride."
D. "I will not exercise if I have ketones in my urine."
,Answer: B
Rationale: Exercise when blood glucose is elevated (200 mg/dL) may
actually increase blood glucose levels further. Patients should be taught
to avoid exercise when blood glucose is above 250 mg/dL or when
ketones are present, as this can worsen hyperglycemia .
3. A patient with type 2 diabetes is scheduled for a follow-up visit.
Which test best evaluates the effectiveness of diabetes treatment over
the past several months?
A. Fasting blood glucose level
B. Oral glucose tolerance test
C. Urine dipstick for glucose
D. Glycosylated hemoglobin (HbA1c)
Answer: D
Rationale: The HbA1c test reflects average blood glucose control over
the previous 90-120 days, providing the best assessment of long-term
glycemic control. Fasting blood glucose only shows a snapshot of
current glucose levels .
4. A nurse is assessing a patient with Graves' disease. Which finding
should the nurse expect?
A. Cold intolerance and weight gain
B. Bradycardia and constipation
C. Difficulty sleeping and anxiety
D. Dry skin and periorbital edema
,Answer: C
Rationale: Graves' disease is characterized by hyperthyroidism with
overproduction of thyroid hormone. Manifestations include difficulty
sleeping, anxiety, weight loss, heat intolerance, and tachycardia due to
increased metabolism .
5. What is the most important assessment for a nurse to perform
when caring for a patient with a neurological condition?
A. Blood pressure monitoring
B. Level of consciousness (LOC)
C. Respiratory rate
D. Capillary refill
Answer: B
Rationale: Level of consciousness is the most important neurological
assessment as it provides the earliest indicator of changes in
neurological status. LOC assessment includes orientation to person,
place, time, and situation .
6. A patient is prescribed levothyroxine for hypothyroidism. Which
teaching point is most important for the nurse to include?
A. Take the medication at bedtime with a snack
B. Take the medication in the morning before breakfast
C. The medication works immediately to relieve symptoms
D. Soy products enhance the effectiveness of the medication
Answer: B
, Rationale: Levothyroxine should be taken in the morning on an empty
stomach, at least 30-60 minutes before breakfast, for optimal
absorption. It may take several weeks to achieve therapeutic effect, and
patients should not abruptly stop taking it .
7. A patient with chronic kidney disease has a potassium level of 6.2
mEq/L. Which intervention should the nurse anticipate?
A. Administration of oral potassium supplements
B. Hyperkalemia protocol including insulin and dextrose
C. Restricting IV fluids to 500 mL per day
D. Administration of potassium-sparing diuretics
Answer: B
Rationale: The hyperkalemia protocol includes regular insulin IV to shift
potassium back into cells, D50 IV to prevent hypoglycemia, sodium
bicarbonate, and possibly calcium gluconate to protect the heart. Renal
patients cannot effectively excrete potassium .
8. A patient is scheduled for an intravenous pyelogram (IVP). Which
information provided by the patient has the most immediate
implications for care?
A. The patient has not eaten for 8 hours
B. The patient reports allergies to shellfish and penicillin
C. The patient complains of flank pain
D. The patient used a laxative the previous night
Answer: B
