NUR390 EXAM 1 2026 PREMIUM REVIEW
QUESTIONS CORRECT RESPONSES
◉ The nurse is preparing to teach a 43-yr-old man who is newly
diagnosed with type 2 diabetes about home management of the
disease. Which action would the nurse take first?
1. Assess the patient's perception of what it means to have diabetes.
2. Ask the patient's family to participate in the diabetes education
program.
3. Demonstrate how to check glucose using the patient's blood
glucose monitor.
4. Discuss the need for the patient to actively participate in diabetes
management.. Answer: 1. Assess the patient's perception of what it
means to have diabetes.
Before planning teaching, the nurse would assess the patient's
interest in and ability to self-manage the diabetes. After assessing
the patient, the other nursing actions may be appropriate, but
planning needs to be specific to each patient.
◉ An unresponsive patient who has type 2 diabetes is brought to the
emergency department and diagnosed with hyperosmolar
,hyperglycemia syndrome (HHS). Which action would the nurse
anticipate taking?
1. Giving 50% dextrose
2. Inserting an IV catheter
3. Initiating O2 by nasal cannula
4. Administering glargine (Lantus) insulin. Answer: 2. Inserting an
IV catheter
HHS is initially treated with large volumes of IV fluids to correct
hypovolemia. Regular insulin is administered, not a long-acting
insulin. There is no indication that the patient requires O2.
Concentrated dextrose solutions will increase the patient's glucose
and would be contraindicated.
◉ A 26-yr-old female who has type 1 diabetes develops a sore throat
and runny nose after caring for her sick toddler. The patient calls the
clinic for advice about her symptoms and reports a glucose level of
210 mg/dL despite taking her usual glargine (Lantus) and lispro
(Humalog) insulin. Which action would the nurse advise the patient
to take?
1. Use only the lispro insulin until the symptoms are resolved.
2. Limit intake of calories until the glucose is less than 120 mg/dL.
,3. Monitor blood glucose every 4 hours and contact the clinic if it
rises.
4. Decrease carbohydrates until glycosylated hemoglobin is less than
7%.. Answer: 3. Monitor blood glucose every 4 hours and contact the
clinic if it rises.
Infection and other stressors increase glucose levels and the patient
will need to test glucose frequently, treat elevations appropriately
with lispro insulin, and call the health care provider if glucose levels
continue to be elevated. Discontinuing the glargine will contribute to
hyperglycemia and may lead to diabetic ketoacidosis (DKA).
Decreasing carbohydrate or caloric intake is not appropriate
because the patient will need more calories when ill. Glycosylated
hemoglobin testing is not used to evaluate short-term alterations in
glucose.
◉ The health care provider suspects the Somogyi effect in a 50-yr-
old patient whose 6 AM glucose is 230 mg/dL. Which action would
the nurse teach the patient to take?
1. Check the glucose during the night.
2. Avoid snacking right before bedtime.
3. Increase the rapid-acting insulin dose.
4. Administer a larger dose of long-acting insulin.. Answer: 1. Check
the glucose during the night.
, If the Somogyi effect is causing the patient's increased morning
glucose level, the patient will experience hypoglycemia between
2:00 and 4:00 AM. The dose of insulin will be reduced, rather than
increased. A bedtime snack is used to prevent hypoglycemic
episodes during the night.
◉ Which action would the nurse take after a patient treated with
intramuscular glucagon for hypoglycemia regains consciousness?
1. Assess the patient for symptoms of hyperglycemia.
2. Give the patient a snack of peanut butter and crackers.
3. Have the patient drink a glass of orange juice or nonfat milk.
4. Administer a continuous infusion of 5% dextrose for 24 hours..
Answer: 2. Give the patient a snack of peanut butter and crackers.
Rebound hypoglycemia can occur after glucagon administration, but
having a meal containing complex carbohydrates plus protein and
fat will help prevent hypoglycemia. Orange juice and nonfat milk will
elevate glucose rapidly, but the cheese and crackers will stabilize
glucose. Administration of IV glucose might be used in patients who
were unable to take in nutrition orally. The patient should be
assessed for symptoms of hypoglycemia after glucagon
administration.
QUESTIONS CORRECT RESPONSES
◉ The nurse is preparing to teach a 43-yr-old man who is newly
diagnosed with type 2 diabetes about home management of the
disease. Which action would the nurse take first?
1. Assess the patient's perception of what it means to have diabetes.
2. Ask the patient's family to participate in the diabetes education
program.
3. Demonstrate how to check glucose using the patient's blood
glucose monitor.
4. Discuss the need for the patient to actively participate in diabetes
management.. Answer: 1. Assess the patient's perception of what it
means to have diabetes.
Before planning teaching, the nurse would assess the patient's
interest in and ability to self-manage the diabetes. After assessing
the patient, the other nursing actions may be appropriate, but
planning needs to be specific to each patient.
◉ An unresponsive patient who has type 2 diabetes is brought to the
emergency department and diagnosed with hyperosmolar
,hyperglycemia syndrome (HHS). Which action would the nurse
anticipate taking?
1. Giving 50% dextrose
2. Inserting an IV catheter
3. Initiating O2 by nasal cannula
4. Administering glargine (Lantus) insulin. Answer: 2. Inserting an
IV catheter
HHS is initially treated with large volumes of IV fluids to correct
hypovolemia. Regular insulin is administered, not a long-acting
insulin. There is no indication that the patient requires O2.
Concentrated dextrose solutions will increase the patient's glucose
and would be contraindicated.
◉ A 26-yr-old female who has type 1 diabetes develops a sore throat
and runny nose after caring for her sick toddler. The patient calls the
clinic for advice about her symptoms and reports a glucose level of
210 mg/dL despite taking her usual glargine (Lantus) and lispro
(Humalog) insulin. Which action would the nurse advise the patient
to take?
1. Use only the lispro insulin until the symptoms are resolved.
2. Limit intake of calories until the glucose is less than 120 mg/dL.
,3. Monitor blood glucose every 4 hours and contact the clinic if it
rises.
4. Decrease carbohydrates until glycosylated hemoglobin is less than
7%.. Answer: 3. Monitor blood glucose every 4 hours and contact the
clinic if it rises.
Infection and other stressors increase glucose levels and the patient
will need to test glucose frequently, treat elevations appropriately
with lispro insulin, and call the health care provider if glucose levels
continue to be elevated. Discontinuing the glargine will contribute to
hyperglycemia and may lead to diabetic ketoacidosis (DKA).
Decreasing carbohydrate or caloric intake is not appropriate
because the patient will need more calories when ill. Glycosylated
hemoglobin testing is not used to evaluate short-term alterations in
glucose.
◉ The health care provider suspects the Somogyi effect in a 50-yr-
old patient whose 6 AM glucose is 230 mg/dL. Which action would
the nurse teach the patient to take?
1. Check the glucose during the night.
2. Avoid snacking right before bedtime.
3. Increase the rapid-acting insulin dose.
4. Administer a larger dose of long-acting insulin.. Answer: 1. Check
the glucose during the night.
, If the Somogyi effect is causing the patient's increased morning
glucose level, the patient will experience hypoglycemia between
2:00 and 4:00 AM. The dose of insulin will be reduced, rather than
increased. A bedtime snack is used to prevent hypoglycemic
episodes during the night.
◉ Which action would the nurse take after a patient treated with
intramuscular glucagon for hypoglycemia regains consciousness?
1. Assess the patient for symptoms of hyperglycemia.
2. Give the patient a snack of peanut butter and crackers.
3. Have the patient drink a glass of orange juice or nonfat milk.
4. Administer a continuous infusion of 5% dextrose for 24 hours..
Answer: 2. Give the patient a snack of peanut butter and crackers.
Rebound hypoglycemia can occur after glucagon administration, but
having a meal containing complex carbohydrates plus protein and
fat will help prevent hypoglycemia. Orange juice and nonfat milk will
elevate glucose rapidly, but the cheese and crackers will stabilize
glucose. Administration of IV glucose might be used in patients who
were unable to take in nutrition orally. The patient should be
assessed for symptoms of hypoglycemia after glucagon
administration.
