NUR 221 exam 2 questions with correct answers
A patient diagnosed with type 1 diabetes is receiving a continuous subcutaneous insulin
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infusion via an insulin pump contacts the clinic to report mechanical failure of the
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infusion pump. The nurse instructs the patient to begin monitoring for signs of what
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possible complication?
v v
A. Adrenal insufficiency
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B. Diabetic ketoacidosis
v v
C. Hyperosmolar, hyperglycemic state
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D. Hypoglycemia - answer-B. Diabetic ketoacidosis
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Which laboratory values would be more common in patients with diabetic ketoacidosis?
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A. Blood glucose >1000 mg/dL
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B. Negative ketones in the urine
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C. Normal anion gap
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D. pH 7.24 - answer-D. pH 7.24
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Which nursing diagnosis is a high-priority for both diabetic ketoacidosis and
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hyperosmolar hyperglycemic syndrome?
v v v
A. Activity intolerance
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B. Fluid volume deficient
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C. Hyperthermia
v
D. Impaired nutrition, more than body requirements - answer-B. Fluid volume deficient
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A continuous insulin intravenous infusion is started, and hourly bedside glucose
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monitoring is ordered for a patient who presented to the emergency department
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experiencing diabetic ketoacidosis. What is the targeted blood glucose value after the
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first hour of therapy?
v v v v
A. 70 to 120 mg/dL
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B. A decrease of 25 to 50 mg/dL compared with admitting values
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C. A decrease of 50 to 75 mg/dL compared with admitting values
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D. Less than 200 mg/dL - answer-C. A decrease of 50 to 75 mg/dL compared with
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admitting values
v v
,The nurse is caring for a 27-year-old patient with a diagnosis of head trauma. The nurse
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notes that the patient's urine output has increased tremendously over the past 18 hours.
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The nurse suspects that the patient may be developing what complication of the injury?
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A. Diabetes insipidus
v v
B. Diabetic ketoacidosis
v v
C. Hyperosmolar hyperglycemic syndrome
v v v
D. Syndrome of inappropriate secretion of antidiuretic hormone - answer-A. Diabetes
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insipidus
v
In the management of diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome,
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vwhen is an intravenous (IV) solution that contains dextrose started?
v v v v v v v v v
A. Never; normal saline is the only appropriate solution in diabetes management
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B. When the blood sugar reaches 70 mg/dL
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C. When the blood sugar reaches 150 mg/dL
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D. When the blood glucose reaches 250 mg/dL - answer-D. When the blood glucose
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reaches 250 mg/dL
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A 32-year-old patient is admitted to the critical care unit with a diagnosis of diabetic
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ketoacidosis. Following aggressive fluid resuscitation and intravenous (IV) insulin
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administration, the blood glucose begins to normalize. In addition to glucose monitoring,
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which of the following electrolytes requires close monitoring?
v v v v v v v v
A. Calcium
v
B. Chloride
v
C. Potassium
v
D. Sodium. - answer-C. Potassium
v v v v
A patient is admitted to the oncology unit with a small cell lung carcinoma. During the
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admission, the patient is noted to have a significant decrease in urine output
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accompanied by shortness of breath, edema, and mental status changes. The nurse is
v v v v v v v v v v v v v
aware that this clinical presentation is consistent with what diagnosis?
v v v v v v v v v v
A. Adrenal crisis
v v
B. Diabetes insipidus
v v
C. Myxedema coma
v v
D. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) - answer-D.
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Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
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What differences would you expect to see in patients experiencing hyperosmolar
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hyperglycemic syndrome rather than diabetic ketoacidosis?
v v v v v v
, A. Lower serum glucose, lower osmolality, and greater ketosis
v v v v v v v v
B. Lower serum glucose, lower osmolality, and milder ketosis
v v v v v v v v
C. Higher serum glucose, higher osmolality, and greater ketosis
v v v v v v v v
D. Higher serum glucose, higher osmolality, and no ketosis - answer-D. Higher serum
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glucose, higher osmolality, and no ketosis
v v v v v v
Which of the following statements is true about the medical management of diabetic
v v v v v v v v v v v v
ketoacidosis?
v
A. Serum lactate levels are used to guide insulin administration.
v v v v v v v v v
B. Sodium bicarbonate is a first-line medication for treatment.
v v v v v v v v
C. The degree of acidosis is assessed through continuous pulse oximetry.
v v v v v v v v v v
D. Volume replacement and insulin infusion often correct the acidosis. - answer-D.
v v v v v v v v v v v
Volume replacement and insulin infusion often correct the acidosis.
v v v v v v v v v
A 20-year-old with a history of type 1 diabetes and an eating disorder is found
v v v v v v v v v v v v v v
unconscious. In the emergency department, the following lab values are obtained:
v v v v v v v v v v v
Glucose648 mg/dL v
pH6.88
P a CO 2 20 mm Hg
v v v v v v
P a O 2 95 mm Hg
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HCO 3 - undetectablev v v
Anion gap>31 v
Na + 127 mEq/L
v v v
K + 3.5 mEq/L
v v v
Creatinine1.8 mg/dL v
After the patient's airway and ventilation have been established, what is the next priority
v v v v v v v v v v v v v
intervention for this patient?
v v v v
A. Administration of a 1-L normal saline fluid bolus.
v v v v v v v v
B. Administration of 0.1 unit of regular insulin IV push followed by an insulin
v v v v v v v v v v v v v
infusion.
C. Administration of 20 mEq KCl in 100 mL.
v v v v v v v v
D. IV push administration of 1 amp of sodium bicarbonate. - answer-A. Administration of
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va 1-L normal saline fluid bolus.
v v v v v
A patient who experienced head trauma was admitted to the surgical intensive care unit
v v v v v v v v v v v v v
following a motorcycle crash. What assessment that will assist the nurse in early
v v v v v v v v v v v v v
identification of an endocrine disorder commonly associated with this condition?
v v v v v v v v v v
A. Daily weight
v v
A patient diagnosed with type 1 diabetes is receiving a continuous subcutaneous insulin
v v v v v v v v v v v v
infusion via an insulin pump contacts the clinic to report mechanical failure of the
v v v v v v v v v v v v v v
infusion pump. The nurse instructs the patient to begin monitoring for signs of what
v v v v v v v v v v v v v v
possible complication?
v v
A. Adrenal insufficiency
v v
B. Diabetic ketoacidosis
v v
C. Hyperosmolar, hyperglycemic state
v v v
D. Hypoglycemia - answer-B. Diabetic ketoacidosis
v v v v v
Which laboratory values would be more common in patients with diabetic ketoacidosis?
v v v v v v v v v v v
A. Blood glucose >1000 mg/dL
v v v v
B. Negative ketones in the urine
v v v v v
C. Normal anion gap
v v v
D. pH 7.24 - answer-D. pH 7.24
v v v v v v
Which nursing diagnosis is a high-priority for both diabetic ketoacidosis and
v v v v v v v v v v
hyperosmolar hyperglycemic syndrome?
v v v
A. Activity intolerance
v v
B. Fluid volume deficient
v v v
C. Hyperthermia
v
D. Impaired nutrition, more than body requirements - answer-B. Fluid volume deficient
v v v v v v v v v v v
A continuous insulin intravenous infusion is started, and hourly bedside glucose
v v v v v v v v v v
monitoring is ordered for a patient who presented to the emergency department
v v v v v v v v v v v v
experiencing diabetic ketoacidosis. What is the targeted blood glucose value after the
v v v v v v v v v v v v
first hour of therapy?
v v v v
A. 70 to 120 mg/dL
v v v v
B. A decrease of 25 to 50 mg/dL compared with admitting values
v v v v v v v v v v v
C. A decrease of 50 to 75 mg/dL compared with admitting values
v v v v v v v v v v v
D. Less than 200 mg/dL - answer-C. A decrease of 50 to 75 mg/dL compared with
v v v v v v v v v v v v v v v
admitting values
v v
,The nurse is caring for a 27-year-old patient with a diagnosis of head trauma. The nurse
v v v v v v v v v v v v v v v
notes that the patient's urine output has increased tremendously over the past 18 hours.
v v v v v v v v v v v v v v
The nurse suspects that the patient may be developing what complication of the injury?
v v v v v v v v v v v v v v
A. Diabetes insipidus
v v
B. Diabetic ketoacidosis
v v
C. Hyperosmolar hyperglycemic syndrome
v v v
D. Syndrome of inappropriate secretion of antidiuretic hormone - answer-A. Diabetes
v v v v v v v v v v
insipidus
v
In the management of diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome,
v v v v v v v v v
vwhen is an intravenous (IV) solution that contains dextrose started?
v v v v v v v v v
A. Never; normal saline is the only appropriate solution in diabetes management
v v v v v v v v v v v
B. When the blood sugar reaches 70 mg/dL
v v v v v v v
C. When the blood sugar reaches 150 mg/dL
v v v v v v v
D. When the blood glucose reaches 250 mg/dL - answer-D. When the blood glucose
v v v v v v v v v v v v v
reaches 250 mg/dL
v v v
A 32-year-old patient is admitted to the critical care unit with a diagnosis of diabetic
v v v v v v v v v v v v v v
ketoacidosis. Following aggressive fluid resuscitation and intravenous (IV) insulin
v v v v v v v v v
administration, the blood glucose begins to normalize. In addition to glucose monitoring,
v v v v v v v v v v v v
which of the following electrolytes requires close monitoring?
v v v v v v v v
A. Calcium
v
B. Chloride
v
C. Potassium
v
D. Sodium. - answer-C. Potassium
v v v v
A patient is admitted to the oncology unit with a small cell lung carcinoma. During the
v v v v v v v v v v v v v v v
admission, the patient is noted to have a significant decrease in urine output
v v v v v v v v v v v v v
accompanied by shortness of breath, edema, and mental status changes. The nurse is
v v v v v v v v v v v v v
aware that this clinical presentation is consistent with what diagnosis?
v v v v v v v v v v
A. Adrenal crisis
v v
B. Diabetes insipidus
v v
C. Myxedema coma
v v
D. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) - answer-D.
v v v v v v v v v v
Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
v v v v v v v v
What differences would you expect to see in patients experiencing hyperosmolar
v v v v v v v v v v
hyperglycemic syndrome rather than diabetic ketoacidosis?
v v v v v v
, A. Lower serum glucose, lower osmolality, and greater ketosis
v v v v v v v v
B. Lower serum glucose, lower osmolality, and milder ketosis
v v v v v v v v
C. Higher serum glucose, higher osmolality, and greater ketosis
v v v v v v v v
D. Higher serum glucose, higher osmolality, and no ketosis - answer-D. Higher serum
v v v v v v v v v v v v
glucose, higher osmolality, and no ketosis
v v v v v v
Which of the following statements is true about the medical management of diabetic
v v v v v v v v v v v v
ketoacidosis?
v
A. Serum lactate levels are used to guide insulin administration.
v v v v v v v v v
B. Sodium bicarbonate is a first-line medication for treatment.
v v v v v v v v
C. The degree of acidosis is assessed through continuous pulse oximetry.
v v v v v v v v v v
D. Volume replacement and insulin infusion often correct the acidosis. - answer-D.
v v v v v v v v v v v
Volume replacement and insulin infusion often correct the acidosis.
v v v v v v v v v
A 20-year-old with a history of type 1 diabetes and an eating disorder is found
v v v v v v v v v v v v v v
unconscious. In the emergency department, the following lab values are obtained:
v v v v v v v v v v v
Glucose648 mg/dL v
pH6.88
P a CO 2 20 mm Hg
v v v v v v
P a O 2 95 mm Hg
v v v v v v
HCO 3 - undetectablev v v
Anion gap>31 v
Na + 127 mEq/L
v v v
K + 3.5 mEq/L
v v v
Creatinine1.8 mg/dL v
After the patient's airway and ventilation have been established, what is the next priority
v v v v v v v v v v v v v
intervention for this patient?
v v v v
A. Administration of a 1-L normal saline fluid bolus.
v v v v v v v v
B. Administration of 0.1 unit of regular insulin IV push followed by an insulin
v v v v v v v v v v v v v
infusion.
C. Administration of 20 mEq KCl in 100 mL.
v v v v v v v v
D. IV push administration of 1 amp of sodium bicarbonate. - answer-A. Administration of
v v v v v v v v v v v v v
va 1-L normal saline fluid bolus.
v v v v v
A patient who experienced head trauma was admitted to the surgical intensive care unit
v v v v v v v v v v v v v
following a motorcycle crash. What assessment that will assist the nurse in early
v v v v v v v v v v v v v
identification of an endocrine disorder commonly associated with this condition?
v v v v v v v v v v
A. Daily weight
v v
