& ANSWERS(RATED A+)
A patient diagnosed with type 1 diabetes is receiving a continuous subcutaneous insulin
infusion via an insulin pump contacts the clinic to report mechanical failure of the
infusion pump. The nurse instructs the patient to begin monitoring for signs of what
possible complication?
A. Adrenal insufficiency
B. Diabetic ketoacidosis
C. Hyperosmolar, hyperglycemic state
D. Hypoglycemia - ANSWER B. Diabetic ketoacidosis
Which laboratory values would be more common in patients with diabetic ketoacidosis?
A. Blood glucose >1000 mg/dL
B. Negative ketones in the urine
C. Normal anion gap
D. pH 7.24 - ANSWER D. pH 7.24
Which nursing diagnosis is a high-priority for both diabetic ketoacidosis and
hyperosmolar hyperglycemic syndrome?
A. Activity intolerance
B. Fluid volume deficient
C. Hyperthermia
D. Impaired nutrition, more than body requirements - ANSWER B. Fluid volume
deficient
A continuous insulin intravenous infusion is started, and hourly bedside glucose
monitoring is ordered for a patient who presented to the emergency department
experiencing diabetic ketoacidosis. What is the targeted blood glucose value after the
first hour of therapy?
A. 70 to 120 mg/dL
B. A decrease of 25 to 50 mg/dL compared with admitting values
C. A decrease of 50 to 75 mg/dL compared with admitting values
D. Less than 200 mg/dL - ANSWER C. A decrease of 50 to 75 mg/dL compared with
admitting values
,The nurse is caring for a 27-year-old patient with a diagnosis of head trauma. The nurse
notes that the patient's urine output has increased tremendously over the past 18 hours.
The nurse suspects that the patient may be developing what complication of the injury?
A. Diabetes insipidus
B. Diabetic ketoacidosis
C. Hyperosmolar hyperglycemic syndrome
D. Syndrome of inappropriate secretion of antidiuretic hormone - ANSWER A. Diabetes
insipidus
A patient who experienced head trauma was admitted to the surgical intensive care unit
following a motorcycle crash. What assessment that will assist the nurse in early
identification of an endocrine disorder commonly associated with this condition?
A. Daily weight
B. Fingerstick glucose
C. Lung sound auscultation
D. Urine osmolality - ANSWER D. Urine osmolality
Which of the following laboratory values would be found in a patient with syndrome of
inappropriate secretion of antidiuretic hormone?
A. Fasting blood glucose 156 mg/dL
B. Serum potassium 5.8 mEq/L
C. Serum sodium 115 mEq/L
D. Serum sodium 152 mEq/L - ANSWER C. Serum sodium 115 mEq/L
A patient diagnosed with pancreatic cancer has been admitted to the critical care unit
with clinical signs consistent with syndrome of inappropriate secretion of antidiuretic
hormone. The nurse anticipates that clinical management of this condition will include
what intervention?
A. Administration of 3% normal saline
B. Administration of exogenous vasopressin
C. Fluid restriction
D. Low sodium diet - ANSWER C. Fluid restriction
A patient with newly diagnosed type 1 diabetes is being transitioned from an infusion of
intravenous (IV) regular insulin to an intensive insulin therapy regimen of insulin glargine
and insulin aspart. How should the nurse manage this transition in insulin delivery?
, A. Administer the insulin glargine and continue the IV insulin infusion for 24 hours.
B. Administer the insulin glargine and discontinue the IV infusion in several hours.
C. Discontinue the IV infusion and administer the insulin aspart with the next meal.
D. Discontinue the IV infusion and administer the glargine insulin at bedtime. -
ANSWER B. Administer the insulin glargine and discontinue the IV infusion in several
hours.
The nurse is caring for a patient who underwent pituitary surgery 12 hours ago. The
nurse will give priority to monitoring the patient carefully for which possible
complication?
A. Congestive heart failure
B. Hypovolemic shock
C. Infection
D. Volume overload - ANSWER B. Hypovolemic shock
(Profound diuresis that accompanies diabetes insipidus may result in hypovolemic
shock.)
Mechanisms for development of diabetes insipidus include which of the following?
(Select all that apply.)
A. ADH deficiency
B. ADH excess
C. ADH insensitivity
D. ADH replacement therapy
E. Water deprivation - ANSWER A. ADH deficiency
C. ADH insensitivity
A college student was admitted to the emergency department after being found
unconscious by a roommate. The roommate informs emergency medical personnel that
the student has diabetes and has been experiencing flulike symptoms, including
vomiting, since yesterday. The patient had been up all night studying for exams. The
patient used the last diabetes testing supplies 3 days ago and has not had time to go to
the pharmacy to refill prescription supplies. Based upon the history, which laboratory
findings would be anticipated in this client? (Select all that apply.)
A. Blood glucose 43 mg/dL
B. Blood glucose 524 mg/dL
C. HCO 3 - 10 mEq/L
D. PaCO 2 37 mm Hg
E. pH 7.23 - ANSWER B. Blood glucose 524 mg/dL
C. HCO 3 - 10 mEq/L