HESI Case Study: Age-Related Risks
With the understanding that Mr. Rogers' eating habits lack consistency, which physiological facts
about the client's nutrition are most concerning to the nurse? - ANS A. The development of
hypoglycemia could be life-threatening.
B. The stage II non-healing ulcer on the client's right heel could require amputation.
C. Lack of appetite and not wanting to eat alone could lead to malnutrition.
E. Dehydration exacerbated by lack of nutrition.
Which information about the client is of most concern to the nurse? - ANS Reports a new onset of
blurry vision.
Which other symptoms should the nurse expect to find in a client with a diagnosis of diabetic
retinopathy? - ANS B. Loss of vision.
C. Difficulty with color perception.
D. Reports of floaters.
The nurse understands that which information is correct regarding the prescribed insulin? - ANS
Glargine does not have a peak interval.
What conditions, other than hyperglycemia, might Mr. Rogers have? - ANS A. Osmotic diuresis.
B. Glycosuria.
C. Ketonuria.
In addition to the insulin, which of the following immediate measures would be indicated in the
treatment of Mr. Rogers? - ANS A. Potassium supplements.
C. Sodium bicarb.
E. 0.9% normal saline.
(With the following information,) the nurse sets the insulin drip to deliver how many mL/hr?
- Mr. Rogers weighs 226 lbs (102.7 kg)
- His blood glucose is 312 mg/dL
- Insulin drip is pre-mixed 100 units per 100 mL NS
, - Insulin infusion protocol (for CBG 300-329) = 4 - ANS 4
Which (possible EKG) pattern should the nurse report immediately to the HCP? - ANS ST depression
and "U" waves
(Indicates hypokalemia)
Which lab value needs to be reported immediately? - ANS Arterial pH 7.05
The nurse understands that which symptoms are associated with diabetic peripheral neuropathy? -
ANS B. Reduced ability to feel pain or temperature in the extremities.
D. Muscle weakness and difficulty walking
E. Extreme sensitivity to touch.
Which instruction related to bath safety is best? - ANS Use a bath thermometer to ensure that the
temp is below 102F.
Prior to changing the dressing on Mr. Rogers' right heel ulcer, the nurse should first take which
actions? - ANS Inspect the feet carefully for temp, sensation, and drainage.
Which actions will help to maintain skin integrity? - ANS A. Use heel protectors.
C. Use special mattress or foot cradles.
D. Apply skin moisturizers to prevent cracking.
E. Instruct the client to wear clean white socks.
It is important for the client to report which potential adverse or side effect associated with
gabapentin (Neurontin)? - ANS Tarry stool.
Which response by the client if of most concern to the nurse? - ANS "My urine had a foul smell this
morning."
The nurse should instruct the client to take which action first when collecting a urine sample? - ANS
Wipe the genital area clean.
With the understanding that Mr. Rogers' eating habits lack consistency, which physiological facts
about the client's nutrition are most concerning to the nurse? - ANS A. The development of
hypoglycemia could be life-threatening.
B. The stage II non-healing ulcer on the client's right heel could require amputation.
C. Lack of appetite and not wanting to eat alone could lead to malnutrition.
E. Dehydration exacerbated by lack of nutrition.
Which information about the client is of most concern to the nurse? - ANS Reports a new onset of
blurry vision.
Which other symptoms should the nurse expect to find in a client with a diagnosis of diabetic
retinopathy? - ANS B. Loss of vision.
C. Difficulty with color perception.
D. Reports of floaters.
The nurse understands that which information is correct regarding the prescribed insulin? - ANS
Glargine does not have a peak interval.
What conditions, other than hyperglycemia, might Mr. Rogers have? - ANS A. Osmotic diuresis.
B. Glycosuria.
C. Ketonuria.
In addition to the insulin, which of the following immediate measures would be indicated in the
treatment of Mr. Rogers? - ANS A. Potassium supplements.
C. Sodium bicarb.
E. 0.9% normal saline.
(With the following information,) the nurse sets the insulin drip to deliver how many mL/hr?
- Mr. Rogers weighs 226 lbs (102.7 kg)
- His blood glucose is 312 mg/dL
- Insulin drip is pre-mixed 100 units per 100 mL NS
, - Insulin infusion protocol (for CBG 300-329) = 4 - ANS 4
Which (possible EKG) pattern should the nurse report immediately to the HCP? - ANS ST depression
and "U" waves
(Indicates hypokalemia)
Which lab value needs to be reported immediately? - ANS Arterial pH 7.05
The nurse understands that which symptoms are associated with diabetic peripheral neuropathy? -
ANS B. Reduced ability to feel pain or temperature in the extremities.
D. Muscle weakness and difficulty walking
E. Extreme sensitivity to touch.
Which instruction related to bath safety is best? - ANS Use a bath thermometer to ensure that the
temp is below 102F.
Prior to changing the dressing on Mr. Rogers' right heel ulcer, the nurse should first take which
actions? - ANS Inspect the feet carefully for temp, sensation, and drainage.
Which actions will help to maintain skin integrity? - ANS A. Use heel protectors.
C. Use special mattress or foot cradles.
D. Apply skin moisturizers to prevent cracking.
E. Instruct the client to wear clean white socks.
It is important for the client to report which potential adverse or side effect associated with
gabapentin (Neurontin)? - ANS Tarry stool.
Which response by the client if of most concern to the nurse? - ANS "My urine had a foul smell this
morning."
The nurse should instruct the client to take which action first when collecting a urine sample? - ANS
Wipe the genital area clean.
