MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
. A pa�ent with cirrhosis who is being treated with spironolactone (Aldactone) and furosemide (Lasix)
has a serum sodium level of 135 mEq/L (135 mmol/L) and serum potassium 3.2 mEq/L (3.2 mmol/L).
Before no�fying the health care provider, the nurse should
a. administer the furosemide and withhold the spironolactone.
b. give both drugs as scheduled.
c. administer the spironolactone.
d. withhold both drugs un�l talking with the health care provider. - ansC
Ra�onale: Spironolactone is a potassium-sparing diure�c and will help to increase the pa�ent's
potassium level.
The nurse does not need to talk with the doctor before giving the spironolactone, although the health
care provider should be no�fied about the low potassium value.
The furosemide will further decrease the pa�ent's potassium level and should be held un�l the nurse
talks with the health care provider.
A 1200-calorie diet and exercise are prescribed for a pa�ent with newly diagnosed type 2 diabetes. The
pa�ent tells the nurse, "I hate to exercise! Can't I just follow the diet to keep my glucose under control?"
The nurse teaches the pa�ent that the major purpose of exercise for diabe�cs is to
a. increase energy and sense of well-being, which will help with body image.
b. facilitate weight loss, which will decrease peripheral insulin resistance.
c. improve cardiovascular endurance, which is important for diabe�cs.
d. set a successful patern, which will help in making other needed changes. - ansb. facilitate weight loss,
which will decrease peripheral insulin resistance.
,MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
Ra�onale: Exercise is essen�al to decrease insulin resistance and improve blood glucose control.
Increased energy, improved cardiovascular endurance, and se�ng a patern of success are secondary
benefits of exercise, but they are not the major reason.
A 32-year-old pa�ent has early alcoholic cirrhosis diagnosed by a liver biopsy. When planning pa�ent
teaching, the priority informa�on for the nurse to include is the need for
a. vitamin B supplements.
b. abs�nence from alcohol.
c. maintenance of a nutri�ous diet.
d. long-term, low-dose cor�costeroids. - ansB
Ra�onale: The disease progression can be stopped or reversed by alcohol abs�nence.
The other interven�ons may be used when cirrhosis becomes more severe to decrease symptoms or
complica�ons, but the priority for this pa�ent is to stop the progression of the disease.
A 37-year-old forkli� operator presents with shakiness, swea�ng, anxiety, and palpita�ons and tells the
nurse he has type 1 diabetes mellitus. Which of the follow ac�ons should the nurse do first?
A. Inject 1 mg of glucagon subcutaneously.
B. Administer 50 mL of 50% glucose I.V.
C. Give 4 to 6 oz (118 to 177 mL) of orange juice.
D. Give the client four to six glucose tablets. - ansCorrect answer: C
Because the client is awake and complaining of symptoms, the nurse should first give him 15 grams of
carbohydrate to treat hypoglycemia. This could be 4 to 6 oz of fruit juice, five to six hard candies such as
Lifesavers, or 1 tablespoon of sugar. When a client has worsening symptoms of hypoglycemia or is
unconscious, treatment includes 1 mg of glucagon subcutaneously or intramuscularly, or 50 mL of 50%
glucose I.V. The nurse may also give two to three glucose tablets for a hypoglycemic reac�on.
,MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
A 60 year old pa�ent has an abrupt onset of anorexia, nausea and vomi�ng, hepatomegaly, and
abnormal liver func�on studies. Serologic tes�ng is nega�ve for viral causes of hepa��s. During
assessment of the pa�ent, it is most important for the nurse to ques�on the pa�ent regarding
A. any prior exposure to people with jaundice
B. the use of all prescrip�on and OTC (over the counter) medica�ons
C. treatment of chronic diseases with cor�costeriods
D. exposure to children recently immunized for hepa��s B - ansA and D assess for exposure to hepa��s.
Hepa��s was ruled out this is inappropriate.
C is incorrect because cor�costeroids do not commonly cause liver disease
B is correct because overdose of medica�ons can cause liver disease.
A 63-year-old pa�ent is newly diagnosed with type 2 diabetes. When developing an educa�on plan, the
nurse's first ac�on should be to
a. assess the pa�ent's percep�on of what it means to have type 2 diabetes.
b. demonstrate how to check glucose using capillary blood glucose monitoring.
c. ask the pa�ent's family to par�cipate in the diabetes educa�on program.
d. discuss the need for the pa�ent to ac�vely par�cipate in diabetes management. - ansA
Ra�onale: Before planning educa�on, the nurse should assess the pa�ent's interest in and ability to self-
manage the diabetes.
A�er assessing the pa�ent, the other nursing ac�ons may be appropriate, but planning needs to be
individualized to each pa�ent.
, MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
A client has just had surgery for colon cancer. Which of the following disorders might the client develop?
a. Peritoni�s
b. Diver�culosis
c. Par�al bowel obstruc�on
d. Complete bowel obstruc�on - ansa. Peritoni�s
Bowel spillage could occur during surgery, resul�ng in peritoni�s. Complete or par�al bowel obstruc�on
may occur before bowel resec�on. Diver�culosis doesn't result from surgery or colon cancer.
A client has recently been diagnosed with Type I diabetes and asks the nurse for help formula�ng a
nutri�on plan. Which of the following recommenda�ons would the nurse make to help the client
increase calorie consump�on to offset absorp�on problems?
a. Ea�ng small meals with two or three snacks may be more helpful in maintaining blood glucose levels
than three large meals.
b. Eat small meals with two or three snacks throughout the day to keep blood glucose levels steady
c. Increase consump�on of simple carbohydrates
d. Skip meals to help lose weight - ansA
Ea�ng small meals with two or three snacks may be more helpful in maintaining blood glucose levels
than three large meals.
A client is admited to the medical-surgical floor with a diagnosis of acute pancrea��s. His blood
pressure is 136/76 mm Hg, pulse 96 beats/minute, respira�ons 22 breaths/minute, temperature 99°F
(38.3°C), and he has been experiencing severe vomi�ng for 24 hours. His past medical history reveals
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
. A pa�ent with cirrhosis who is being treated with spironolactone (Aldactone) and furosemide (Lasix)
has a serum sodium level of 135 mEq/L (135 mmol/L) and serum potassium 3.2 mEq/L (3.2 mmol/L).
Before no�fying the health care provider, the nurse should
a. administer the furosemide and withhold the spironolactone.
b. give both drugs as scheduled.
c. administer the spironolactone.
d. withhold both drugs un�l talking with the health care provider. - ansC
Ra�onale: Spironolactone is a potassium-sparing diure�c and will help to increase the pa�ent's
potassium level.
The nurse does not need to talk with the doctor before giving the spironolactone, although the health
care provider should be no�fied about the low potassium value.
The furosemide will further decrease the pa�ent's potassium level and should be held un�l the nurse
talks with the health care provider.
A 1200-calorie diet and exercise are prescribed for a pa�ent with newly diagnosed type 2 diabetes. The
pa�ent tells the nurse, "I hate to exercise! Can't I just follow the diet to keep my glucose under control?"
The nurse teaches the pa�ent that the major purpose of exercise for diabe�cs is to
a. increase energy and sense of well-being, which will help with body image.
b. facilitate weight loss, which will decrease peripheral insulin resistance.
c. improve cardiovascular endurance, which is important for diabe�cs.
d. set a successful patern, which will help in making other needed changes. - ansb. facilitate weight loss,
which will decrease peripheral insulin resistance.
,MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
Ra�onale: Exercise is essen�al to decrease insulin resistance and improve blood glucose control.
Increased energy, improved cardiovascular endurance, and se�ng a patern of success are secondary
benefits of exercise, but they are not the major reason.
A 32-year-old pa�ent has early alcoholic cirrhosis diagnosed by a liver biopsy. When planning pa�ent
teaching, the priority informa�on for the nurse to include is the need for
a. vitamin B supplements.
b. abs�nence from alcohol.
c. maintenance of a nutri�ous diet.
d. long-term, low-dose cor�costeroids. - ansB
Ra�onale: The disease progression can be stopped or reversed by alcohol abs�nence.
The other interven�ons may be used when cirrhosis becomes more severe to decrease symptoms or
complica�ons, but the priority for this pa�ent is to stop the progression of the disease.
A 37-year-old forkli� operator presents with shakiness, swea�ng, anxiety, and palpita�ons and tells the
nurse he has type 1 diabetes mellitus. Which of the follow ac�ons should the nurse do first?
A. Inject 1 mg of glucagon subcutaneously.
B. Administer 50 mL of 50% glucose I.V.
C. Give 4 to 6 oz (118 to 177 mL) of orange juice.
D. Give the client four to six glucose tablets. - ansCorrect answer: C
Because the client is awake and complaining of symptoms, the nurse should first give him 15 grams of
carbohydrate to treat hypoglycemia. This could be 4 to 6 oz of fruit juice, five to six hard candies such as
Lifesavers, or 1 tablespoon of sugar. When a client has worsening symptoms of hypoglycemia or is
unconscious, treatment includes 1 mg of glucagon subcutaneously or intramuscularly, or 50 mL of 50%
glucose I.V. The nurse may also give two to three glucose tablets for a hypoglycemic reac�on.
,MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
A 60 year old pa�ent has an abrupt onset of anorexia, nausea and vomi�ng, hepatomegaly, and
abnormal liver func�on studies. Serologic tes�ng is nega�ve for viral causes of hepa��s. During
assessment of the pa�ent, it is most important for the nurse to ques�on the pa�ent regarding
A. any prior exposure to people with jaundice
B. the use of all prescrip�on and OTC (over the counter) medica�ons
C. treatment of chronic diseases with cor�costeriods
D. exposure to children recently immunized for hepa��s B - ansA and D assess for exposure to hepa��s.
Hepa��s was ruled out this is inappropriate.
C is incorrect because cor�costeroids do not commonly cause liver disease
B is correct because overdose of medica�ons can cause liver disease.
A 63-year-old pa�ent is newly diagnosed with type 2 diabetes. When developing an educa�on plan, the
nurse's first ac�on should be to
a. assess the pa�ent's percep�on of what it means to have type 2 diabetes.
b. demonstrate how to check glucose using capillary blood glucose monitoring.
c. ask the pa�ent's family to par�cipate in the diabetes educa�on program.
d. discuss the need for the pa�ent to ac�vely par�cipate in diabetes management. - ansA
Ra�onale: Before planning educa�on, the nurse should assess the pa�ent's interest in and ability to self-
manage the diabetes.
A�er assessing the pa�ent, the other nursing ac�ons may be appropriate, but planning needs to be
individualized to each pa�ent.
, MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
A client has just had surgery for colon cancer. Which of the following disorders might the client develop?
a. Peritoni�s
b. Diver�culosis
c. Par�al bowel obstruc�on
d. Complete bowel obstruc�on - ansa. Peritoni�s
Bowel spillage could occur during surgery, resul�ng in peritoni�s. Complete or par�al bowel obstruc�on
may occur before bowel resec�on. Diver�culosis doesn't result from surgery or colon cancer.
A client has recently been diagnosed with Type I diabetes and asks the nurse for help formula�ng a
nutri�on plan. Which of the following recommenda�ons would the nurse make to help the client
increase calorie consump�on to offset absorp�on problems?
a. Ea�ng small meals with two or three snacks may be more helpful in maintaining blood glucose levels
than three large meals.
b. Eat small meals with two or three snacks throughout the day to keep blood glucose levels steady
c. Increase consump�on of simple carbohydrates
d. Skip meals to help lose weight - ansA
Ea�ng small meals with two or three snacks may be more helpful in maintaining blood glucose levels
than three large meals.
A client is admited to the medical-surgical floor with a diagnosis of acute pancrea��s. His blood
pressure is 136/76 mm Hg, pulse 96 beats/minute, respira�ons 22 breaths/minute, temperature 99°F
(38.3°C), and he has been experiencing severe vomi�ng for 24 hours. His past medical history reveals
