,NUR170/NUR 170 Exam 3 |
Medical-Surgical Nursing | Galen College |
1. The pancreas is located in which abdominal quadrant?
A) Right upper quadrant
B) Left upper quadrant
C) Right lower quadrant
D) Left lower quadrant
Correct Answer: Left upper quadrant
Rationale: The pancreas is a retroperitoneal organ located in the left upper quadrant (LUQ) of the
abdomen, extending horizontally across the posterior abdominal wall. The right upper quadrant
contains the liver and gallbladder. The lower quadrants contain intestinal structures. This anatomical
knowledge is foundational for understanding pancreatic function in metabolism.
2. Which cells of the pancreas secrete insulin?
A) Alpha cells of the islets of Langerhans
B) Beta cells of the islets of Langerhans
C) Delta cells of the islets of Langerhans
D) Acinar cells
Correct Answer: Beta cells of the islets of Langerhans
Rationale: Beta cells within the islets of Langerhans produce and secrete insulin, which lowers blood
glucose by facilitating cellular glucose uptake. Alpha cells secrete glucagon (raises blood glucose),
delta cells secrete somatostatin, and acinar cells secrete digestive enzymes. This distinction is critical
for understanding diabetes pathophysiology.
3. A client with type 1 diabetes is admitted with a blood glucose of 450 mg/dL, pH 7.25, and positive
serum ketones. Which condition is the client most likely experiencing?
,A) Hyperglycemic hyperosmolar state (HHS)
B) Diabetic ketoacidosis (DKA)
C) Hypoglycemia
D) Somogyi effect
Correct Answer: Diabetic ketoacidosis (DKA)
Rationale: DKA is characterized by hyperglycemia (>250 mg/dL), metabolic acidosis (pH <7.3), and
positive serum ketones. It occurs in type 1 diabetes due to absolute insulin deficiency. HHS presents
with extreme hyperglycemia but without significant ketosis or acidosis. Hypoglycemia presents with
low blood glucose. The Somogyi effect is rebound hyperglycemia following hypoglycemia.
4. A client with type 2 diabetes is scheduled for a cardiac catheterization. Which medication should
the nurse question if ordered to be given on the morning of the procedure?
A) Metformin
B) Lisinopril
C) Aspirin
D) Atorvastatin
Correct Answer: Metformin
Rationale: Metformin should be held before procedures involving IV contrast dye to prevent lactic
acidosis. Renal function should be assessed before restarting the medication. Lisinopril (ACE inhibitor),
aspirin, and atorvastatin are typically continued unless specifically ordered to hold. This is a critical
safety consideration for diabetic clients undergoing contrast studies.
5. A nurse is teaching a client with type 1 diabetes about insulin administration. Which injection site
has the fastest rate of absorption?
A) Thigh
B) Abdomen
C) Upper arm
D) Buttock
, Correct Answer: Abdomen
Rationale: The abdomen has the fastest absorption rate for subcutaneous insulin due to increased
vascularity and consistent blood flow. The upper arm and thigh have slower absorption, and the
buttock has the slowest. Site rotation within the same anatomical region is recommended to prevent
lipohypertrophy.
6. A client with type 2 diabetes who is taking metformin (Glucophage) is seen in the diabetic clinic.
Which statement by the client indicates a need for further teaching?
A) "I take my metformin with meals to prevent stomach upset"
B) "I should not drink alcohol while taking this medication"
C) "I can stop taking my medication once my blood sugar is normal"
D) "I need to have my kidney function checked regularly"
Correct Answer: "I can stop taking my medication once my blood sugar is normal"
Rationale: Metformin is a maintenance medication for type 2 diabetes; it should not be discontinued
when blood glucose normalizes without provider guidance. Taking metformin with food reduces GI
upset. Alcohol should be avoided due to lactic acidosis risk. Renal function monitoring is essential as
metformin is renally excreted. The incorrect statement reflects a dangerous misconception about
diabetes management.
7. A client with diabetes reports numbness and tingling in both feet. The nurse recognizes this as
which complication?
A) Retinopathy
B) Nephropathy
C) Peripheral neuropathy
D) Gastroparesis
Correct Answer: Peripheral neuropathy
Medical-Surgical Nursing | Galen College |
1. The pancreas is located in which abdominal quadrant?
A) Right upper quadrant
B) Left upper quadrant
C) Right lower quadrant
D) Left lower quadrant
Correct Answer: Left upper quadrant
Rationale: The pancreas is a retroperitoneal organ located in the left upper quadrant (LUQ) of the
abdomen, extending horizontally across the posterior abdominal wall. The right upper quadrant
contains the liver and gallbladder. The lower quadrants contain intestinal structures. This anatomical
knowledge is foundational for understanding pancreatic function in metabolism.
2. Which cells of the pancreas secrete insulin?
A) Alpha cells of the islets of Langerhans
B) Beta cells of the islets of Langerhans
C) Delta cells of the islets of Langerhans
D) Acinar cells
Correct Answer: Beta cells of the islets of Langerhans
Rationale: Beta cells within the islets of Langerhans produce and secrete insulin, which lowers blood
glucose by facilitating cellular glucose uptake. Alpha cells secrete glucagon (raises blood glucose),
delta cells secrete somatostatin, and acinar cells secrete digestive enzymes. This distinction is critical
for understanding diabetes pathophysiology.
3. A client with type 1 diabetes is admitted with a blood glucose of 450 mg/dL, pH 7.25, and positive
serum ketones. Which condition is the client most likely experiencing?
,A) Hyperglycemic hyperosmolar state (HHS)
B) Diabetic ketoacidosis (DKA)
C) Hypoglycemia
D) Somogyi effect
Correct Answer: Diabetic ketoacidosis (DKA)
Rationale: DKA is characterized by hyperglycemia (>250 mg/dL), metabolic acidosis (pH <7.3), and
positive serum ketones. It occurs in type 1 diabetes due to absolute insulin deficiency. HHS presents
with extreme hyperglycemia but without significant ketosis or acidosis. Hypoglycemia presents with
low blood glucose. The Somogyi effect is rebound hyperglycemia following hypoglycemia.
4. A client with type 2 diabetes is scheduled for a cardiac catheterization. Which medication should
the nurse question if ordered to be given on the morning of the procedure?
A) Metformin
B) Lisinopril
C) Aspirin
D) Atorvastatin
Correct Answer: Metformin
Rationale: Metformin should be held before procedures involving IV contrast dye to prevent lactic
acidosis. Renal function should be assessed before restarting the medication. Lisinopril (ACE inhibitor),
aspirin, and atorvastatin are typically continued unless specifically ordered to hold. This is a critical
safety consideration for diabetic clients undergoing contrast studies.
5. A nurse is teaching a client with type 1 diabetes about insulin administration. Which injection site
has the fastest rate of absorption?
A) Thigh
B) Abdomen
C) Upper arm
D) Buttock
, Correct Answer: Abdomen
Rationale: The abdomen has the fastest absorption rate for subcutaneous insulin due to increased
vascularity and consistent blood flow. The upper arm and thigh have slower absorption, and the
buttock has the slowest. Site rotation within the same anatomical region is recommended to prevent
lipohypertrophy.
6. A client with type 2 diabetes who is taking metformin (Glucophage) is seen in the diabetic clinic.
Which statement by the client indicates a need for further teaching?
A) "I take my metformin with meals to prevent stomach upset"
B) "I should not drink alcohol while taking this medication"
C) "I can stop taking my medication once my blood sugar is normal"
D) "I need to have my kidney function checked regularly"
Correct Answer: "I can stop taking my medication once my blood sugar is normal"
Rationale: Metformin is a maintenance medication for type 2 diabetes; it should not be discontinued
when blood glucose normalizes without provider guidance. Taking metformin with food reduces GI
upset. Alcohol should be avoided due to lactic acidosis risk. Renal function monitoring is essential as
metformin is renally excreted. The incorrect statement reflects a dangerous misconception about
diabetes management.
7. A client with diabetes reports numbness and tingling in both feet. The nurse recognizes this as
which complication?
A) Retinopathy
B) Nephropathy
C) Peripheral neuropathy
D) Gastroparesis
Correct Answer: Peripheral neuropathy
