NURS 5434 PREVENTION CASE PRACTICE
EXAMINATION 2026 QUESTIONS WITH
ANSWERS GRADED A+
◍ Long-Term Complications: The client learns that there are a number of
things they can do to reduce the risk for the numerous long-term
complications associated with diabetes. The client understands that
cardiovascular complications are a major cause of death in diabetics.Which
lab value indicates that the client is working to reduce her risk for
cardiovascular disease?
A. Fasting blood glucose of 120 mg/dl (6.66 mmol/L).
B. Glycosylated hemoglobin at 9% (75 mmol/mol).
C. Low-density lipoprotein (LDL) cholesterol of 80 mg/dl (2.07 mmol/L).
D. High-density lipoprotein (HDL) cholesterol of 30 mg/dl (0.78 mmol/L)..
Answer: C. Low-density lipoprotein (LDL) cholesterol of 80 mg/dl (2.07
mmol/L).Rationale: Desired level is <100 mg/dl (2.59 mmol/L). Increases
risk of heart disease are these serum lipid levels: Total cholesterol >200
mg/dL (5.18 mmol/L), Triglycerides ≥150 mg/dL (1.69 mmol/L), LDL
cholesterol >130 mg/dL (3.37 mmol/L), HDL cholesterol <40 mg/dL (1.04
mmol/L) in men or <50 mg/dL (1.29 mmol/L) in women.
◍ a nurse is caring for client who has a bruise on her left upper arm. The client
states, "the bruise is from when my partner grabbed my arm" Which of the
following responses should the nurse make?.
Answer: "your partner grabbed your arm and caused the bruise" nurse
should restate the main idea of what the client is expressing; this conveys
that the nurse was listening and allows the client to have a clear idea of what
was said, which can help to avoid misunderstanding
◍ The client tells the nurse that they will make sure they drink plenty of water
, and will take a little extra regular insulin before beginning strenuous
exercise.What is the best response by the nurse?
A. Remind the client that they should also carry a simple carbohydrate snack
with them.
B. Acknowledge the client's understanding of correct pre-exercise measures.
C. Advise the client that extra insulin should not generally be taken before
exercise.
D. Teach the client that the extra insulin will give her more energy..
Answer: C. Advise the client that extra insulin should not generally be taken
before exercise.Rationale: Exercise may cause hypoglycemia during or after
the activity. Therefore, additional carbohydrates may be needed before,
during, or after exercise. Clients should perform self-monitoring of blood
glucose levels to determine the effects of exercise on blood glucose levels.
In addition, it is important to remember that exercise in the client with
uncontrolled diabetes results in hyperglycemia and may lead to ketosis.
Diabetics with ketonuria and a blood glucose of 250 mg/dL (11.10 mmol/L)
or above should avoid exercise.
◍ The nurse observes the client administer their morning dose of insulin. The
client pinches the skin on the front of their thigh and inserts the needle at a
90-degree angle.What action should the nurse implement?
A. Advise the client to remove the needle and reinsert it at a 45-degree
angle.
B. Instruct the client to pull the plunger back slightly before injecting the
insulin.
C. Tell the client to remove the needle, and draw up a new dose of insulin.
D. Encourage the client to inject the insulin with the needle in place, as
inserted..
Answer: D. Encourage the client to inject the insulin with the needle in
place, as inserted.Rationale: The client has performed the steps for
subcutaneous injection correctly. Since aspiration is not necessary, the client
is ready to inject the insulin.
◍ A Complication Occurs: The client is discharged with controlled blood
, glucose levels and sufficient knowledge of diet and insulin therapy. The
client will continue to attend the series of classes on diabetes management
offered at the hospital by the diabetes educator.Two months later, the
client's college roommate calls the nurse late at night in a panic and reports
that the client described feeling like their heart is beating out of their chest.
The client was weak and shaky, so the roommate brought some juice but the
client became confused and lethargic before they could drink it, and now the
client will not wake up.What is the best nursing action?
A. Advise the roommate to stay with the client, remain calm, and check the
client's pulse, respirations, and skin color.
B. Tell the roommate to immediately find the dorm supervisor while she
calls an ambulance.
C. Ask the roommate if the client has emergency supplies such as Glucagon
or cake icing available.
D. Instruct the roommate to hold the client's head up and put small sips of
juice in the side of their mouth..
Answer: C. Ask the roommate if the client has emergency supplies such as
Glucagon or cake icing available.Rationale: The client is experiencing
symptoms of hypoglycemia, which include disorientation, tremors,
palpitations, lightheadedness, confusion, cool, clammy skin, slurred speech,
and lethargy. Since she is not arousable, the roommate should first be
instructed to use any emergency supplies readily available. These might
include Glucagon, which is administered subcutaneously or IM, or a
concentrated glucose paste which can be squeezed in the mouth and
absorbed through the mucosa.
◍ The client's blood glucose level is stabilized, and they are transported to the
acute care facility where blood glucose is monitored carefully. The
admitting physician suspects that the client is experiencing Somogyi's
effect.What technique should the nurse use to assess for this occurrence?
A. Obtain preprandial and postprandial blood glucose measurements.
B. Compare a baseline glycosylated Hgb to a current measurement.
C. Compare venous blood glucose levels to capillary blood glucose levels.
, D. Monitor blood glucose levels during the night and before breakfast..
Answer: D. Monitor blood glucose levels during the night and before
breakfast.Rationale: Somogyi's effect is the term for rebound morning
hyperglycemia after night-time hypoglycemia. It is often caused by too
much insulin or the lack of an adequate bedtime snack.
◍ What is the mechanism that results in Kussmaul respirations?
A. To compensate for metabolic acidosis, the respirations are deep and
rapid.
B. To overcome respiratory acidosis, the respirations are fast and shallow.
C. Injury to the brain's respiratory center results in periods of apnea.
D. Hypoxemia causes labored, gasping, and irregular respirations..
Answer: A. To compensate for metabolic acidosis, the respirations are deep
and rapid.Rationale: To compensate for the ketoacidosis (metabolic
acidosis), the lungs attempt to remove CO2 through a pattern of deep, rapid
respirations referred to as Kussmaul respirations.
◍ A nurse is planning a primary prevention program for the older adults at a
local community center. Which of the following information should the
nurse include as a primary prevention strategy?.
Answer: increase intake of dietary fiberincreasing intake of dietary fiber is
an intervention that will prevent constipation and other gastrointestinal
problems; therefore, it is appropriate for the nurse to include this
information as primary prevention
◍ a nurse is reviewing the med list of an older adult upon admission and notes
that he is taking fluoxetine for depression. The nurse should identify that
fluoxetine can increase effects of which of the following meds that is also on
client list?.
Answer: Warfarin to prevent complications from polypharmacy, the nurse
should review the client's medications and identify potential interactions;
nurse should recognize that this client's antidepressant medication,
fluoxetine, can increase the effects of his anticoagulant medication,
warfarin, which could lead to a potential toxicity
EXAMINATION 2026 QUESTIONS WITH
ANSWERS GRADED A+
◍ Long-Term Complications: The client learns that there are a number of
things they can do to reduce the risk for the numerous long-term
complications associated with diabetes. The client understands that
cardiovascular complications are a major cause of death in diabetics.Which
lab value indicates that the client is working to reduce her risk for
cardiovascular disease?
A. Fasting blood glucose of 120 mg/dl (6.66 mmol/L).
B. Glycosylated hemoglobin at 9% (75 mmol/mol).
C. Low-density lipoprotein (LDL) cholesterol of 80 mg/dl (2.07 mmol/L).
D. High-density lipoprotein (HDL) cholesterol of 30 mg/dl (0.78 mmol/L)..
Answer: C. Low-density lipoprotein (LDL) cholesterol of 80 mg/dl (2.07
mmol/L).Rationale: Desired level is <100 mg/dl (2.59 mmol/L). Increases
risk of heart disease are these serum lipid levels: Total cholesterol >200
mg/dL (5.18 mmol/L), Triglycerides ≥150 mg/dL (1.69 mmol/L), LDL
cholesterol >130 mg/dL (3.37 mmol/L), HDL cholesterol <40 mg/dL (1.04
mmol/L) in men or <50 mg/dL (1.29 mmol/L) in women.
◍ a nurse is caring for client who has a bruise on her left upper arm. The client
states, "the bruise is from when my partner grabbed my arm" Which of the
following responses should the nurse make?.
Answer: "your partner grabbed your arm and caused the bruise" nurse
should restate the main idea of what the client is expressing; this conveys
that the nurse was listening and allows the client to have a clear idea of what
was said, which can help to avoid misunderstanding
◍ The client tells the nurse that they will make sure they drink plenty of water
, and will take a little extra regular insulin before beginning strenuous
exercise.What is the best response by the nurse?
A. Remind the client that they should also carry a simple carbohydrate snack
with them.
B. Acknowledge the client's understanding of correct pre-exercise measures.
C. Advise the client that extra insulin should not generally be taken before
exercise.
D. Teach the client that the extra insulin will give her more energy..
Answer: C. Advise the client that extra insulin should not generally be taken
before exercise.Rationale: Exercise may cause hypoglycemia during or after
the activity. Therefore, additional carbohydrates may be needed before,
during, or after exercise. Clients should perform self-monitoring of blood
glucose levels to determine the effects of exercise on blood glucose levels.
In addition, it is important to remember that exercise in the client with
uncontrolled diabetes results in hyperglycemia and may lead to ketosis.
Diabetics with ketonuria and a blood glucose of 250 mg/dL (11.10 mmol/L)
or above should avoid exercise.
◍ The nurse observes the client administer their morning dose of insulin. The
client pinches the skin on the front of their thigh and inserts the needle at a
90-degree angle.What action should the nurse implement?
A. Advise the client to remove the needle and reinsert it at a 45-degree
angle.
B. Instruct the client to pull the plunger back slightly before injecting the
insulin.
C. Tell the client to remove the needle, and draw up a new dose of insulin.
D. Encourage the client to inject the insulin with the needle in place, as
inserted..
Answer: D. Encourage the client to inject the insulin with the needle in
place, as inserted.Rationale: The client has performed the steps for
subcutaneous injection correctly. Since aspiration is not necessary, the client
is ready to inject the insulin.
◍ A Complication Occurs: The client is discharged with controlled blood
, glucose levels and sufficient knowledge of diet and insulin therapy. The
client will continue to attend the series of classes on diabetes management
offered at the hospital by the diabetes educator.Two months later, the
client's college roommate calls the nurse late at night in a panic and reports
that the client described feeling like their heart is beating out of their chest.
The client was weak and shaky, so the roommate brought some juice but the
client became confused and lethargic before they could drink it, and now the
client will not wake up.What is the best nursing action?
A. Advise the roommate to stay with the client, remain calm, and check the
client's pulse, respirations, and skin color.
B. Tell the roommate to immediately find the dorm supervisor while she
calls an ambulance.
C. Ask the roommate if the client has emergency supplies such as Glucagon
or cake icing available.
D. Instruct the roommate to hold the client's head up and put small sips of
juice in the side of their mouth..
Answer: C. Ask the roommate if the client has emergency supplies such as
Glucagon or cake icing available.Rationale: The client is experiencing
symptoms of hypoglycemia, which include disorientation, tremors,
palpitations, lightheadedness, confusion, cool, clammy skin, slurred speech,
and lethargy. Since she is not arousable, the roommate should first be
instructed to use any emergency supplies readily available. These might
include Glucagon, which is administered subcutaneously or IM, or a
concentrated glucose paste which can be squeezed in the mouth and
absorbed through the mucosa.
◍ The client's blood glucose level is stabilized, and they are transported to the
acute care facility where blood glucose is monitored carefully. The
admitting physician suspects that the client is experiencing Somogyi's
effect.What technique should the nurse use to assess for this occurrence?
A. Obtain preprandial and postprandial blood glucose measurements.
B. Compare a baseline glycosylated Hgb to a current measurement.
C. Compare venous blood glucose levels to capillary blood glucose levels.
, D. Monitor blood glucose levels during the night and before breakfast..
Answer: D. Monitor blood glucose levels during the night and before
breakfast.Rationale: Somogyi's effect is the term for rebound morning
hyperglycemia after night-time hypoglycemia. It is often caused by too
much insulin or the lack of an adequate bedtime snack.
◍ What is the mechanism that results in Kussmaul respirations?
A. To compensate for metabolic acidosis, the respirations are deep and
rapid.
B. To overcome respiratory acidosis, the respirations are fast and shallow.
C. Injury to the brain's respiratory center results in periods of apnea.
D. Hypoxemia causes labored, gasping, and irregular respirations..
Answer: A. To compensate for metabolic acidosis, the respirations are deep
and rapid.Rationale: To compensate for the ketoacidosis (metabolic
acidosis), the lungs attempt to remove CO2 through a pattern of deep, rapid
respirations referred to as Kussmaul respirations.
◍ A nurse is planning a primary prevention program for the older adults at a
local community center. Which of the following information should the
nurse include as a primary prevention strategy?.
Answer: increase intake of dietary fiberincreasing intake of dietary fiber is
an intervention that will prevent constipation and other gastrointestinal
problems; therefore, it is appropriate for the nurse to include this
information as primary prevention
◍ a nurse is reviewing the med list of an older adult upon admission and notes
that he is taking fluoxetine for depression. The nurse should identify that
fluoxetine can increase effects of which of the following meds that is also on
client list?.
Answer: Warfarin to prevent complications from polypharmacy, the nurse
should review the client's medications and identify potential interactions;
nurse should recognize that this client's antidepressant medication,
fluoxetine, can increase the effects of his anticoagulant medication,
warfarin, which could lead to a potential toxicity
