MKC SWE Study Material| 331 QUESTIONS|
WITH COMPLETE SOLUTIONS
A client is brought to the ED in an unresponsive state, and a dX of hyperglycemic
hyperosmolar nonketotic syndrome is made. The nurse would IMMEDIATELY prepare
to initiate which anticipated health care provider's prescription?
a) endotracheal intubation
b) 100 units of NPH insulin
c) IV infusion of normal saline
d) IV infusion of sodium bicarbonate ...Answer Is...C
An external insulin pump is prescribed for a client with DM and the client asks the nurse
about the functioning of the pump. The nurse bases the response on which information
about the pump?
a) is timed to release programmed doses of short-duration or NPH insulin into the
bloodstream at specific intervals
b) continuously infuses small amounts of NPH insulin into the bloodstream while
regularly monitoring blood glucose levels
c) is surgically attached to the pancreas and infuses regular insulin into the pancreas,
which in turn releases the insulin into the bloodstream
d) gives a small continuous dose of short-duration insulin subQ-- and the client can self-
administer a bolus with an additional dose from the pump before each meal ...Answer
Is...D
A client with a diagnosis of DKA is being treated in the ED. Which findings would the
nurse expect to note as confirming this diagnosis? SATA:
a) increase in pH
b) comatose state
c) deep, rapid breathing
d) decreased urine output
e) elevated blood glucose level
f) low plasma bicarbonate level ...Answer Is...C, E, F
The nurse teaches a client with DM 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 symptoms develop? SATA:
,a) polyuria
b) shakiness
c) palpitations
d) blurred vision
e) lightheadedness
f) fruity breath odor ...Answer Is...B, C, E
A client with DM demonstrates acute anxiety when first admitted to the hospital for the
treatment of hyperglycemia. What is the MOST APPROPRIATE intervention to
decrease the client's anxiety?
a) administer a sedative
b) convey empathy, trust, and respect toward the client
c) ignore the signs and symptoms of anxiety so that they will soon disappear
d) make sure that the client knows all the correct medical terms to understand what is
happening ...Answer Is...B
The nurse provides instructions to a client newly dX with type I DM. The nurse
recognizes accurate understanding of measures to prevent DKA when the client makes
which statement?
a) I will stop taking my insulin if I'm too sick to eat
b) i will decrease my insulin dose during times of illness
c) i will adjust my insulin dose according to the level of glucose in my urine
d) i will notify my HCP if my blood glucose level is higher than 250 mg/dL ...Answer
Is...D
A client is admitted to a hospital with a dX of DKA. The initial blood glucose level was
950 mg/dL. A continuous intravenous infusion of short-acting insulin is initiated, along
with IV rehydration with normal saline. The serum glucose level is now 240 mg/dL. The
nurse would next prepare to administer which item?
a) ampule of 50% dextrose
b) NPH insulin subcutaneously
c) IV fluids containing dextrose
d) Phenytoin (Dilantin) for the prevention of seizures ...Answer Is...C
The nurse is monitoring a client newly dX with DM for signs of complications. Which
sign, if exhibited in the client, would indicate hyperglycemia?
a) polyuria
b) diaphoresis
c) hypertension
d) increased pulse rate ...Answer Is...A
,The nurse is preparing a plan of care for a client with DM who has hyperglycemia. The
nurse places highest priority on which client problem?
a) lack of knowledge
b) inadequate fluid volume
c) compromised family coping
d) inadequate consumption of nutrients ...Answer Is...B
The home health nurse visits a client with a dX of type 1 DM. 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?
a) i need to stop my insulin
b) i need to increase my fluid intake
c) i need to monitor my blood glucose every 3 to 4 hours
d) i need to call the HCP because of these symptoms ...Answer Is...A
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?
a) lower the head of the bed
b) test the drainage for glucose
c) obtain a culture of the drainage
d) continue to observe the drainage ...Answer Is...B
After several diagnostic tests, a client is dX with diabetes insipidus. The nurse performs
an assessment on the client, knowing that which symptom is most indicative of this
disorder?
a) fatigue
b) diarrhea
c) polydipsia
d) weight gain ...Answer Is...C
A client is admitted to an ED and a diagnosis of myxedema coma is made. Which action
would the nurse prepare to carry out initially?
a) warm the client
b) maintain a patent airway
c) administer thyroid hormone
d) administer fluid replacement ...Answer Is...B
The nurse is caring for a client admitted to the ED with DKA. In the acute phase, the
nurse plans for which priority intervention?
, a) correct the acidosis
b) admin 5% dextrose IV
c) apply a monitor for an EKG
d) administer short-duration insulin IV ...Answer Is...D
A client with type 1 DM calls the nurse to report current episodes of hypoglycemia with
exercising. Which statement by the client indicates an inadequate understanding of the
peak action of NPH insulin and exercise?
a) the best time for me to exercise is after i eat
b) the best time for me to exercise is after breakfast
c) the beset time for me to exercise is mid to late afternoon
d) the best time for me to exercise is after my morning snack ...Answer Is...C
The nurse is completing an assessment on a client who is being admitted for a dX
workup for primary hyperparathyroidsim. which client complaint would be characteristic
of this disorder?
a) diarrhea
b) polyuria
c) polyphagia
d) weight gain ...Answer Is...B
The nurse is caring for a post-op parathyroidectomy client. Which client complaint would
indicate that a life-threatening complication may be developing, requiring notification of
the health care provider immediately?
a) laryngeal stridor
b) abdominal cramps
c) difficulty in voiding
d) mild to moderate incisional pain ...Answer Is...A
A client is dX with pheochromocytoma. The nurse understands that this is a condition
that has which characteristic?
a) causes profound hypotension
b) is manifested by severe hypoglycemia
c) is not curable and is treated symptomatically
d) causes the release of excessive amounts of catecholamines ...Answer Is...D
The nurse is monitoring a client who was dX with type 1 DM and is being treated with
NPH and regular insulin. Which client complaint(s) would alert the nurse to the presence
of a possible hypoglycemic reaction? SATA:
a) tremors
b) anorexia
WITH COMPLETE SOLUTIONS
A client is brought to the ED in an unresponsive state, and a dX of hyperglycemic
hyperosmolar nonketotic syndrome is made. The nurse would IMMEDIATELY prepare
to initiate which anticipated health care provider's prescription?
a) endotracheal intubation
b) 100 units of NPH insulin
c) IV infusion of normal saline
d) IV infusion of sodium bicarbonate ...Answer Is...C
An external insulin pump is prescribed for a client with DM and the client asks the nurse
about the functioning of the pump. The nurse bases the response on which information
about the pump?
a) is timed to release programmed doses of short-duration or NPH insulin into the
bloodstream at specific intervals
b) continuously infuses small amounts of NPH insulin into the bloodstream while
regularly monitoring blood glucose levels
c) is surgically attached to the pancreas and infuses regular insulin into the pancreas,
which in turn releases the insulin into the bloodstream
d) gives a small continuous dose of short-duration insulin subQ-- and the client can self-
administer a bolus with an additional dose from the pump before each meal ...Answer
Is...D
A client with a diagnosis of DKA is being treated in the ED. Which findings would the
nurse expect to note as confirming this diagnosis? SATA:
a) increase in pH
b) comatose state
c) deep, rapid breathing
d) decreased urine output
e) elevated blood glucose level
f) low plasma bicarbonate level ...Answer Is...C, E, F
The nurse teaches a client with DM 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 symptoms develop? SATA:
,a) polyuria
b) shakiness
c) palpitations
d) blurred vision
e) lightheadedness
f) fruity breath odor ...Answer Is...B, C, E
A client with DM demonstrates acute anxiety when first admitted to the hospital for the
treatment of hyperglycemia. What is the MOST APPROPRIATE intervention to
decrease the client's anxiety?
a) administer a sedative
b) convey empathy, trust, and respect toward the client
c) ignore the signs and symptoms of anxiety so that they will soon disappear
d) make sure that the client knows all the correct medical terms to understand what is
happening ...Answer Is...B
The nurse provides instructions to a client newly dX with type I DM. The nurse
recognizes accurate understanding of measures to prevent DKA when the client makes
which statement?
a) I will stop taking my insulin if I'm too sick to eat
b) i will decrease my insulin dose during times of illness
c) i will adjust my insulin dose according to the level of glucose in my urine
d) i will notify my HCP if my blood glucose level is higher than 250 mg/dL ...Answer
Is...D
A client is admitted to a hospital with a dX of DKA. The initial blood glucose level was
950 mg/dL. A continuous intravenous infusion of short-acting insulin is initiated, along
with IV rehydration with normal saline. The serum glucose level is now 240 mg/dL. The
nurse would next prepare to administer which item?
a) ampule of 50% dextrose
b) NPH insulin subcutaneously
c) IV fluids containing dextrose
d) Phenytoin (Dilantin) for the prevention of seizures ...Answer Is...C
The nurse is monitoring a client newly dX with DM for signs of complications. Which
sign, if exhibited in the client, would indicate hyperglycemia?
a) polyuria
b) diaphoresis
c) hypertension
d) increased pulse rate ...Answer Is...A
,The nurse is preparing a plan of care for a client with DM who has hyperglycemia. The
nurse places highest priority on which client problem?
a) lack of knowledge
b) inadequate fluid volume
c) compromised family coping
d) inadequate consumption of nutrients ...Answer Is...B
The home health nurse visits a client with a dX of type 1 DM. 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?
a) i need to stop my insulin
b) i need to increase my fluid intake
c) i need to monitor my blood glucose every 3 to 4 hours
d) i need to call the HCP because of these symptoms ...Answer Is...A
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?
a) lower the head of the bed
b) test the drainage for glucose
c) obtain a culture of the drainage
d) continue to observe the drainage ...Answer Is...B
After several diagnostic tests, a client is dX with diabetes insipidus. The nurse performs
an assessment on the client, knowing that which symptom is most indicative of this
disorder?
a) fatigue
b) diarrhea
c) polydipsia
d) weight gain ...Answer Is...C
A client is admitted to an ED and a diagnosis of myxedema coma is made. Which action
would the nurse prepare to carry out initially?
a) warm the client
b) maintain a patent airway
c) administer thyroid hormone
d) administer fluid replacement ...Answer Is...B
The nurse is caring for a client admitted to the ED with DKA. In the acute phase, the
nurse plans for which priority intervention?
, a) correct the acidosis
b) admin 5% dextrose IV
c) apply a monitor for an EKG
d) administer short-duration insulin IV ...Answer Is...D
A client with type 1 DM calls the nurse to report current episodes of hypoglycemia with
exercising. Which statement by the client indicates an inadequate understanding of the
peak action of NPH insulin and exercise?
a) the best time for me to exercise is after i eat
b) the best time for me to exercise is after breakfast
c) the beset time for me to exercise is mid to late afternoon
d) the best time for me to exercise is after my morning snack ...Answer Is...C
The nurse is completing an assessment on a client who is being admitted for a dX
workup for primary hyperparathyroidsim. which client complaint would be characteristic
of this disorder?
a) diarrhea
b) polyuria
c) polyphagia
d) weight gain ...Answer Is...B
The nurse is caring for a post-op parathyroidectomy client. Which client complaint would
indicate that a life-threatening complication may be developing, requiring notification of
the health care provider immediately?
a) laryngeal stridor
b) abdominal cramps
c) difficulty in voiding
d) mild to moderate incisional pain ...Answer Is...A
A client is dX with pheochromocytoma. The nurse understands that this is a condition
that has which characteristic?
a) causes profound hypotension
b) is manifested by severe hypoglycemia
c) is not curable and is treated symptomatically
d) causes the release of excessive amounts of catecholamines ...Answer Is...D
The nurse is monitoring a client who was dX with type 1 DM and is being treated with
NPH and regular insulin. Which client complaint(s) would alert the nurse to the presence
of a possible hypoglycemic reaction? SATA:
a) tremors
b) anorexia
