,NU 185 Verified Exam 4 — Medical-Surgical
Nursing II | Galen College of Nursing | Q & A |
2026/2027 Edition
1. A client with Type 1 diabetes mellitus asks the nurse why they must take insulin for life.
Which statement by the nurse is most accurate?
A) "Your pancreas produces some insulin, but not enough."
B) "Your body's cells are resistant to insulin."
C) "Your pancreas no longer produces insulin."
D) "You can stop insulin if you lose weight and exercise."
Correct Answer: "Your pancreas no longer produces insulin."
Rationale: Type 1 diabetes mellitus is characterized by the complete absence of insulin
production due to autoimmune destruction of pancreatic beta cells. These patients are insulin-
dependent for life. Options A and B describe Type 2 diabetes, and Option D is incorrect because
weight loss and exercise do not restore insulin production in Type 1 DM .
2. A client with diabetes reports sweating, tremors, and palpitations. The client's blood glucose
is 55 mg/dL. What should the nurse do first?
A) Administer glucagon subcutaneously
B) Give 15 grams of fast-acting carbohydrate (e.g., 4 oz orange juice)
,C) Call the healthcare provider
D) Administer IV dextrose 50% push
Correct Answer: Give 15 grams of fast-acting carbohydrate (e.g., 4 oz orange juice)
Rationale: The client is conscious with hypoglycemia. The Rule of 15: give 15 g fast-acting
carbohydrate (orange juice, glucose tablets, soda, hard candy), recheck glucose in 15 minutes,
repeat if still <70 mg/dL. Glucagon is for unconscious patients or those unable to swallow. IV
dextrose is for severe hypoglycemia with inability to take oral. Notifying the provider is not the
first action .
3. A nurse is assessing a client with diabetic ketoacidosis (DKA). Which finding is most
characteristic?
A) Blood glucose 250 mg/dL, pH 7.38, HCO3 24
B) Blood glucose 600 mg/dL, pH 7.28, HCO3 14
C) Blood glucose 80 mg/dL, pH 7.48, HCO3 30
D) Blood glucose 150 mg/dL, pH 7.40, HCO3 22
Correct Answer: Blood glucose 600 mg/dL, pH 7.28, HCO3 14
Rationale: DKA presents with hyperglycemia (>250 mg/dL), metabolic acidosis (pH <7.30, HCO3
<15), ketonemia, and anion gap >12. Option B meets these criteria. Option A is normal. Option C
suggests hypoglycemia with metabolic alkalosis. Option D is normal .
, 4. A client with diabetes experiences Somogyi's effect. To prevent this complication, the nurse
should instruct the client to:
A) Increase the insulin dose at bedtime
B) Eat a protein and carbohydrate snack at bedtime
C) Skip the evening insulin dose
D) Exercise vigorously before bedtime
Correct Answer: Eat a protein and carbohydrate snack at bedtime
Rationale: Somogyi's effect is rebound hyperglycemia caused by nocturnal hypoglycemia. A
protein and carbohydrate snack at bedtime helps prevent nocturnal hypoglycemia. Increasing
insulin would worsen the problem, skipping insulin would cause hyperglycemia, and vigorous
exercise before bed could further lower glucose .
5. A client with hyperthyroidism (Graves' disease) is prescribed propylthiouracil (PTU). Which
finding requires immediate nursing action?
A) Weight loss of 2 pounds in 1 week
B) Heart rate of 90 beats per minute
C) Sore throat and fever
D) Mild heat intolerance
Correct Answer: Sore throat and fever
Nursing II | Galen College of Nursing | Q & A |
2026/2027 Edition
1. A client with Type 1 diabetes mellitus asks the nurse why they must take insulin for life.
Which statement by the nurse is most accurate?
A) "Your pancreas produces some insulin, but not enough."
B) "Your body's cells are resistant to insulin."
C) "Your pancreas no longer produces insulin."
D) "You can stop insulin if you lose weight and exercise."
Correct Answer: "Your pancreas no longer produces insulin."
Rationale: Type 1 diabetes mellitus is characterized by the complete absence of insulin
production due to autoimmune destruction of pancreatic beta cells. These patients are insulin-
dependent for life. Options A and B describe Type 2 diabetes, and Option D is incorrect because
weight loss and exercise do not restore insulin production in Type 1 DM .
2. A client with diabetes reports sweating, tremors, and palpitations. The client's blood glucose
is 55 mg/dL. What should the nurse do first?
A) Administer glucagon subcutaneously
B) Give 15 grams of fast-acting carbohydrate (e.g., 4 oz orange juice)
,C) Call the healthcare provider
D) Administer IV dextrose 50% push
Correct Answer: Give 15 grams of fast-acting carbohydrate (e.g., 4 oz orange juice)
Rationale: The client is conscious with hypoglycemia. The Rule of 15: give 15 g fast-acting
carbohydrate (orange juice, glucose tablets, soda, hard candy), recheck glucose in 15 minutes,
repeat if still <70 mg/dL. Glucagon is for unconscious patients or those unable to swallow. IV
dextrose is for severe hypoglycemia with inability to take oral. Notifying the provider is not the
first action .
3. A nurse is assessing a client with diabetic ketoacidosis (DKA). Which finding is most
characteristic?
A) Blood glucose 250 mg/dL, pH 7.38, HCO3 24
B) Blood glucose 600 mg/dL, pH 7.28, HCO3 14
C) Blood glucose 80 mg/dL, pH 7.48, HCO3 30
D) Blood glucose 150 mg/dL, pH 7.40, HCO3 22
Correct Answer: Blood glucose 600 mg/dL, pH 7.28, HCO3 14
Rationale: DKA presents with hyperglycemia (>250 mg/dL), metabolic acidosis (pH <7.30, HCO3
<15), ketonemia, and anion gap >12. Option B meets these criteria. Option A is normal. Option C
suggests hypoglycemia with metabolic alkalosis. Option D is normal .
, 4. A client with diabetes experiences Somogyi's effect. To prevent this complication, the nurse
should instruct the client to:
A) Increase the insulin dose at bedtime
B) Eat a protein and carbohydrate snack at bedtime
C) Skip the evening insulin dose
D) Exercise vigorously before bedtime
Correct Answer: Eat a protein and carbohydrate snack at bedtime
Rationale: Somogyi's effect is rebound hyperglycemia caused by nocturnal hypoglycemia. A
protein and carbohydrate snack at bedtime helps prevent nocturnal hypoglycemia. Increasing
insulin would worsen the problem, skipping insulin would cause hyperglycemia, and vigorous
exercise before bed could further lower glucose .
5. A client with hyperthyroidism (Graves' disease) is prescribed propylthiouracil (PTU). Which
finding requires immediate nursing action?
A) Weight loss of 2 pounds in 1 week
B) Heart rate of 90 beats per minute
C) Sore throat and fever
D) Mild heat intolerance
Correct Answer: Sore throat and fever
