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HESI EXIT saunders questions and Answers A+ Guide

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HESI EXIT saunders questions and
Answers A+ Guide
ENDOCRINE - correct answers✅✅



A client is brought to the emergency department in an unresponsive state,
and a diagnosis of hyperosmolar hyperglycemic syndrome is made. The
nurse would immediately prepare to initiate which anticipated health care
provider's prescription?

1. Endotracheal intubation

2. 100 units of NPH insulin

3. Intravenous infusion of normal saline

4. Intravenous infusion of sodium bicarbonate - correct answers✅✅3

treatment in hyperosmolar hyperglycemic syndrome (HHS) is to rehydrate
the client to restore fluid volume and to correct electrolyte deficiency.



The use of sodium bicarbonate to correct acidosis is avoided because it can
precipitate a further drop in serum potassium level



An external insulin pump is prescribed for a client with diabetes mellitus.
When the client asks the nurse about the functioning of the pump, the nurse
bases the response on which information about the pump?

1. It is timed to release programmed doses of either short-duration or NPH
insulin into the bloodstream at specific intervals.

2. It continuously infuses small amounts of NPH insulin into the bloodstream
while regularly monitoring blood glucose levels.

3. It is surgically attached to the pancreas and infuses regular insulin into the
pancreas. This releases insulin into the bloodstream.

4. It administers a small continuous dose of short-duration insulin
subcutaneously. The client can self-administer an additional bolus dose from
the pump before each meal. - correct answers✅✅4

,HESI EXIT saunders questions and
Answers A+ Guide
A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the
emergency department. Which findings support this diagnosis? Select all that
apply.

1. Increase in pH

2. Comatose state

3. Deep, rapid breathing

4. Decreased urine output

5. Elevated blood glucose level - correct answers✅✅2,3,5



The nurse teaches a client with diabetes mellitus about differentiating
between hypoglycemia and ketoacidosis. The client demonstrates an
understanding of the teaching by stating that a form of glucose should be
taken if which symptom or symptoms develop? Select all that apply.

1. Polyuria

2. Shakiness

3. Palpitations

4. Blurred vision

5. Lightheadedness

6. Fruity breath odor - correct answers✅✅2,3,5



A client with diabetes mellitus demonstrates acute anxiety when admitted to
the hospital for the treatment of hyperglycemia. What is the appropriate
intervention to decrease the client's anxiety?

1. Administer a sedative.

2. Convey empathy, trust, and respect toward the client.

3. Ignore the signs and symptoms of anxiety, anticipating that they will soon
disappear.

,HESI EXIT saunders questions and
Answers A+ Guide
4. Make sure that the client is familiar with the correct medical terms to
promote understanding of what is happening. - correct answers✅✅2



The nurse provides instructions to a client newly diagnosed with type 1
diabetes mellitus. The nurse recognizes accurate understanding of measures
to prevent diabetic ketoacidosis when the client makes which statement?

1. "I will stop taking my insulin if I'm too sick to eat."

2. "I will decrease my insulin dose during times of illness."

3. "I will adjust my insulin dose according to the level of glucose in my urine."

4. "I will notify my health care provider (HCP) if my blood glucose level is
higher than 250 mg/dL (14.2 mmol/L)." - correct answers✅✅4



A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis
(DKA). The initial blood glucose level is 950 mg/dL (54.2 mmol/L). A
continuous intravenous (IV) infusion of short-acting insulin is initiated, along
with IV rehydration with normal saline. The serum glucose level is now
decreased to 240 mg/dL (13.7 mmol/L). The nurse would next prepare to
administer which medication?

1. An ampule of 50% dextrose

2. NPH insulin subcutaneously

3. IV fluids containing dextrose

4. Phenytoin for the prevention of seizures - correct answers✅✅3

when the blood glucose level falls to 250 to 300 mg/dL (14.2 to 17.1
mmol/L), the IV infusion rate is reduced and a dextrose solution is added to
maintain a blood glucose level of about 250 mg/dL



The nurse is monitoring a client newly diagnosed with diabetes mellitus for
signs of complications. Which sign or symptom, if exhibited in the client,
indicates that the client is at risk for chronic complications of diabetes if the
blood glucose is not adequately managed?

, HESI EXIT saunders questions and
Answers A+ Guide
1. Polyuria

2. Diaphoresis

3. Pedal edema

4. Decreased respiratory rate - correct answers✅✅1

Classic symptoms of hyperglycemia include polydipsia, polyuria, and
polyphagia.



The nurse is preparing a plan of care for a client with diabetes mellitus who
has hyperglycemia. The nurse places priority on which client problem?

1. Lack of knowledge

2. Inadequate fluid volume

3. Compromised family coping

4. Inadequate consumption of nutrients - correct answers✅✅2



The home health nurse visits a client with a diagnosis of type 1 diabetes
mellitus. The client relates a history of vomiting and diarrhea and tells the
nurse that no food has been consumed for the last 24 hours. Which
additional statement by the client indicates a need for further teaching?

1. "I need to stop my insulin."

2. "I need to increase my fluid intake."

3. "I need to monitor my blood glucose every 3 to 4 hours."

4. "I need to call the health care provider (HCP) because of these symptoms."
- correct answers✅✅1



The nurse is caring for a client after hypophysectomy and notes clear nasal
drainage from the client's nostril. The nurse should take which initial action?

1. Lower the head of the bed.

2. Test the drainage for glucose.
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