NURS 323 Midterm UPDATED ACTUAL Questions and CORRECT
Answers
Question: Your patient is ordered for Novolog at 0730. Breakfast trays come at 0800. When should you
give this insulin to the patient. a. 0730 when it is ordered b. With their breakfast tray and make sure they eat
c. 0830 d. 0700
Correct Answer: b. With their breakfast tray and make sure they eat Rationale: Novolog is a fast-acting
insulin. You should administer it right before they eat and make sure they eat their food right away to avoid
dropping their blood sugar.
Question: Which of the following oral agents for diabetes treatment puts a patient at the greatest risk for
hypoglycemia? a. Metformin (Glucophage) b. Acarbose (Precose) c. Glipizide (Glucotrol) d. Canagliflosin
(Invokana)
Correct Answer: c. Glipizide (Glucotrol)
Question: Mrs. Potter is taking the following medications
Correct Answer: furosemide (Lasix), spironalactone (Aldactone), & Klor-Con. What is the biggest
concern by the nurse related to all of these medications being taken together? a. Hypokalemia b.
Hyperkalemia c. Hypernatremia d. Hyponatremia: b. Hyperkalemia
Question: What medical problems could experience difficulty with nonselective beta blockers? Select all
that apply a. Diabetes b. Hypertension c. Asthma/COPD d. Pheochromocytoma
Correct Answer: a and c
Question: What of the following may indicate your patient is hypoglycemic? Select all that apply a.
Confusion b. Seizures c. Diaphoresis d. Bradycardia e. Tachycardia
Correct Answer: a, b, c, and e
Question: Which intravenous (IV) fluid would be most appropriate for treating isotonic volume
contraction? A. 0.9% sodium chloride B. 5% dextrose and water C. 0.225% sodium chloride D. 3% sodium
chloride and water
Correct Answer: A. 0.9% sodium chloride
Question: The nurse is caring for a patient receiving IV therapy with a 3% sodium chloride infusion at 75
mL/hr. The nurse should closely monitor for which adverse effect of treatment? A. Blood urea nitrogen of
22 mg/dL B. Tenting of the skin and dry mucous membranes C. Distended neck veins and ankle edema D.
Sodium level of 140 mEq/L
Correct Answer: C. Distended neck veins and ankle edema Rationale: 3% sodium chloride is an
hypertonic solution. This means water will leave the cells and enter the blood vessels. This can lead to fluid
volume overload.
Question: The nurse is preparing to administer IV potassium to a patient with hypokalemia. Which
prescription is the most appropriate? A. Potassium chloride 30 mEq in 100 mL IV over 1 hour B. Potassium
chloride 10 mEq in 100 mL IV over 30 minutes C. Potassium chloride 10 mEq in 100 mL IV over 1 hour D.
Potassium chloride 10 mEq IV push over 1 minute
Correct Answer: C. Potassium chloride 10 mEq in 100 mL IV over 1 hour
, Question: The nurse is caring for a patient receiving oral magnesium gluconate. Which symptom indicates
a common adverse effect of this medication? A. Headache B. Wheezing C. Loose stools D. Urinary
retention
Correct Answer: C. Loose stools
Question: A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse
should make which change to the nursing care plan? A. Refer the patient to a diabetes educator because the
result reflects poor glycemic control. B. Glycemic control is adequate; no changes are needed. C.
Hypoglycemia is a risk; teach the patient the symptoms. D. Instruct the patient to limit activity and weekly
exercise.
Correct Answer: A. Refer the patient to a diabetes educator because the result reflects poor glycemic
control.
Question: A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse
expect the patient to have if the medication is achieving the desired therapeutic effect? A. Inhibition of
carbohydrate digestion B. Promotion of insulin secretion C. Decreased insulin resistance D. Inhibition of
ketone formation
Correct Answer: B. Promotion of insulin secretion
Question: Which instruction should the nurse provide when teaching a patient to mix regular insulin and
NPH insulin in the same syringe? A. "Draw up the clear regular insulin first, followed by the cloudy NPH
insulin." B. "It is not necessary to rotate the NPH insulin vial when it is mixed with regular insulin." C.
"The order of drawing up insulin does not matter as long as the insulin is refrigerated." D. "Rotate
subcutaneous injection sites each day among the arm, thigh, and abdomen."
Correct Answer: A. "Draw up the clear regular insulin first, followed by the cloudy NPH insulin."
Question: A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should
include which of these outcomes related to the therapeutic effects of the medication? A. Blood glucose
control for 24 hours B. Mealtime coverage of blood glucose C. Less frequent blood glucose monitoring D.
Peak effect achieved in 2 to 4 hours
Correct Answer: A. Blood glucose control for 24 hours
Question: A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which
action should the nurse take? A. Take the patient's blood pressure. B. Give the patient's PRN dose of
insulin. C. Check the patient's capillary blood sugar. D. Advise the patient to lie down with the legs
elevated.
Correct Answer: C. Check the patient's capillary blood sugar. Rationale: The patient is exhibiting signs of
hypoglycemia. Remember that the peak of NPH insulin can be 6-14 hours after administration.
Question: A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by
the nurse? A. "Inject this insulin with your first bite of food, because it is very fast acting." B. "The duration
of action for this insulin is about 8 to 10 hours, so you'll need a snack." C. "This insulin needs to be mixed
with regular insulin to enhance the effects." D. "To achieve tight glycemic control, this is the only type of
insulin you'll need."
Correct Answer: A. "Inject this insulin with your first bite of food, because it is very fast acting."
Question: A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work
in my body?" The nurse explains that normal insulin has which action in the body? A. It stimulates the
Answers
Question: Your patient is ordered for Novolog at 0730. Breakfast trays come at 0800. When should you
give this insulin to the patient. a. 0730 when it is ordered b. With their breakfast tray and make sure they eat
c. 0830 d. 0700
Correct Answer: b. With their breakfast tray and make sure they eat Rationale: Novolog is a fast-acting
insulin. You should administer it right before they eat and make sure they eat their food right away to avoid
dropping their blood sugar.
Question: Which of the following oral agents for diabetes treatment puts a patient at the greatest risk for
hypoglycemia? a. Metformin (Glucophage) b. Acarbose (Precose) c. Glipizide (Glucotrol) d. Canagliflosin
(Invokana)
Correct Answer: c. Glipizide (Glucotrol)
Question: Mrs. Potter is taking the following medications
Correct Answer: furosemide (Lasix), spironalactone (Aldactone), & Klor-Con. What is the biggest
concern by the nurse related to all of these medications being taken together? a. Hypokalemia b.
Hyperkalemia c. Hypernatremia d. Hyponatremia: b. Hyperkalemia
Question: What medical problems could experience difficulty with nonselective beta blockers? Select all
that apply a. Diabetes b. Hypertension c. Asthma/COPD d. Pheochromocytoma
Correct Answer: a and c
Question: What of the following may indicate your patient is hypoglycemic? Select all that apply a.
Confusion b. Seizures c. Diaphoresis d. Bradycardia e. Tachycardia
Correct Answer: a, b, c, and e
Question: Which intravenous (IV) fluid would be most appropriate for treating isotonic volume
contraction? A. 0.9% sodium chloride B. 5% dextrose and water C. 0.225% sodium chloride D. 3% sodium
chloride and water
Correct Answer: A. 0.9% sodium chloride
Question: The nurse is caring for a patient receiving IV therapy with a 3% sodium chloride infusion at 75
mL/hr. The nurse should closely monitor for which adverse effect of treatment? A. Blood urea nitrogen of
22 mg/dL B. Tenting of the skin and dry mucous membranes C. Distended neck veins and ankle edema D.
Sodium level of 140 mEq/L
Correct Answer: C. Distended neck veins and ankle edema Rationale: 3% sodium chloride is an
hypertonic solution. This means water will leave the cells and enter the blood vessels. This can lead to fluid
volume overload.
Question: The nurse is preparing to administer IV potassium to a patient with hypokalemia. Which
prescription is the most appropriate? A. Potassium chloride 30 mEq in 100 mL IV over 1 hour B. Potassium
chloride 10 mEq in 100 mL IV over 30 minutes C. Potassium chloride 10 mEq in 100 mL IV over 1 hour D.
Potassium chloride 10 mEq IV push over 1 minute
Correct Answer: C. Potassium chloride 10 mEq in 100 mL IV over 1 hour
, Question: The nurse is caring for a patient receiving oral magnesium gluconate. Which symptom indicates
a common adverse effect of this medication? A. Headache B. Wheezing C. Loose stools D. Urinary
retention
Correct Answer: C. Loose stools
Question: A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse
should make which change to the nursing care plan? A. Refer the patient to a diabetes educator because the
result reflects poor glycemic control. B. Glycemic control is adequate; no changes are needed. C.
Hypoglycemia is a risk; teach the patient the symptoms. D. Instruct the patient to limit activity and weekly
exercise.
Correct Answer: A. Refer the patient to a diabetes educator because the result reflects poor glycemic
control.
Question: A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse
expect the patient to have if the medication is achieving the desired therapeutic effect? A. Inhibition of
carbohydrate digestion B. Promotion of insulin secretion C. Decreased insulin resistance D. Inhibition of
ketone formation
Correct Answer: B. Promotion of insulin secretion
Question: Which instruction should the nurse provide when teaching a patient to mix regular insulin and
NPH insulin in the same syringe? A. "Draw up the clear regular insulin first, followed by the cloudy NPH
insulin." B. "It is not necessary to rotate the NPH insulin vial when it is mixed with regular insulin." C.
"The order of drawing up insulin does not matter as long as the insulin is refrigerated." D. "Rotate
subcutaneous injection sites each day among the arm, thigh, and abdomen."
Correct Answer: A. "Draw up the clear regular insulin first, followed by the cloudy NPH insulin."
Question: A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should
include which of these outcomes related to the therapeutic effects of the medication? A. Blood glucose
control for 24 hours B. Mealtime coverage of blood glucose C. Less frequent blood glucose monitoring D.
Peak effect achieved in 2 to 4 hours
Correct Answer: A. Blood glucose control for 24 hours
Question: A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which
action should the nurse take? A. Take the patient's blood pressure. B. Give the patient's PRN dose of
insulin. C. Check the patient's capillary blood sugar. D. Advise the patient to lie down with the legs
elevated.
Correct Answer: C. Check the patient's capillary blood sugar. Rationale: The patient is exhibiting signs of
hypoglycemia. Remember that the peak of NPH insulin can be 6-14 hours after administration.
Question: A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by
the nurse? A. "Inject this insulin with your first bite of food, because it is very fast acting." B. "The duration
of action for this insulin is about 8 to 10 hours, so you'll need a snack." C. "This insulin needs to be mixed
with regular insulin to enhance the effects." D. "To achieve tight glycemic control, this is the only type of
insulin you'll need."
Correct Answer: A. "Inject this insulin with your first bite of food, because it is very fast acting."
Question: A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work
in my body?" The nurse explains that normal insulin has which action in the body? A. It stimulates the
