MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
. A patient 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 notifying 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 until talking with the health care provider. - ansC
Rationale: Spironolactone is a potassium-sparing diuretic and will help to increase the patient's potassium level.
The nurse does not need to talk with the doctor before giving the spironolactone, although the health care provider should be
notified about the low potassium value.
The furosemide will further decrease the patient's potassium level and should be held until the nurse talks with the health care
provider.
A 1200-calorie diet and exercise are prescribed for a patient with newly diagnosed type 2 diabetes. The patient tells the nurse, "I
hate to exercise! Can't I just follow the diet to keep my glucose under control?" The nurse teaches the patient that the major purpose
of exercise for diabetics 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 diabetics.
d. set a successful pattern, which will help in making other needed changes. - ansb. facilitate weight loss, which will decrease
peripheral insulin resistance.
Rationale: Exercise is essential to decrease insulin resistance and improve blood glucose control. Increased energy, improved
cardiovascular endurance, and setting a pattern of success are secondary benefits of exercise, but they are not the major reason.
A 32-year-old patient has early alcoholic cirrhosis diagnosed by a liver biopsy. When planning patient teaching, the priority
information for the nurse to include is the need for
a. vitamin B supplements.
b. abstinence from alcohol.
c. maintenance of a nutritious diet.
d. long-term, low-dose corticosteroids. - ansB
Rationale: The disease progression can be stopped or reversed by alcohol abstinence.
,MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
The other interventions may be used when cirrhosis becomes more severe to decrease symptoms or complications, but the priority
for this patient is to stop the progression of the disease.
A 37-year-old forklift operator presents with shakiness, sweating, anxiety, and palpitations and tells the nurse he has type 1 diabetes
mellitus. Which of the follow actions 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 reaction.
A 60 year old patient has an abrupt onset of anorexia, nausea and vomiting, hepatomegaly, and abnormal liver function studies.
Serologic testing is negative for viral causes of hepatitis. During assessment of the patient, it is most important for the nurse to
question the patient regarding
A. any prior exposure to people with jaundice
B. the use of all prescription and OTC (over the counter) medications
C. treatment of chronic diseases with corticosteriods
D. exposure to children recently immunized for hepatitis B - ansA and D assess for exposure to hepatitis. Hepatitis was ruled out this
is inappropriate.
C is incorrect because corticosteroids do not commonly cause liver disease
B is correct because overdose of medications can cause liver disease.
A 63-year-old patient is newly diagnosed with type 2 diabetes. When developing an education plan, the nurse's first action should be
to
a. assess the patient's perception of what it means to have type 2 diabetes.
b. demonstrate how to check glucose using capillary blood glucose monitoring.
c. ask the patient's family to participate in the diabetes education program.
,MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
d. discuss the need for the patient to actively participate in diabetes management. - ansA
Rationale: Before planning education, the nurse should 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 individualized to each patient.
A client has just had surgery for colon cancer. Which of the following disorders might the client develop?
a. Peritonitis
b. Diverticulosis
c. Partial bowel obstruction
d. Complete bowel obstruction - ansa. Peritonitis
Bowel spillage could occur during surgery, resulting in peritonitis. Complete or partial bowel obstruction may occur before bowel
resection. Diverticulosis doesn't result from surgery or colon cancer.
A client has recently been diagnosed with Type I diabetes and asks the nurse for help formulating a nutrition plan. Which of the
following recommendations would the nurse make to help the client increase calorie consumption to offset absorption problems?
a. Eating 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 consumption of simple carbohydrates
d. Skip meals to help lose weight - ansA
Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals.
A client is admitted to the medical-surgical floor with a diagnosis of acute pancreatitis. His blood pressure is 136/76 mm Hg, pulse
96 beats/minute, respirations 22 breaths/minute, temperature 99°F (38.3°C), and he has been experiencing severe vomiting for 24
hours. His past medical history reveals hyperlipidemia and alcohol abuse. The physician prescribes a nasogastric (NG) tube for the
client. Which of the following is the primary purpose for insertion of the NG tube?
A. Empty the stomach of fluids and gas to relieve vomiting.
, MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
B. Prevent spasms at the sphincter of Oddi.
C. Prevent air from forming in the small and large intestines.
D. Remove bile from the gallbladder. - ansCorrect answer: A
An NG tube is no longer routinely inserted to treat pancreatitis, but if the client has protracted vomiting, the NG tube is inserted to
drain fluids and gas and relieve vomiting.
An NG tube doesn't prevent spasms at the sphincter of Oddi (a valve in the duodenum that controls the flow of digestive enzymes)
or prevent air from forming in the small and large intestine.
The common bile duct connects to the pancreas and the gall bladder, and a T tube rather than an NG tube would be used to collect
bile drainage from the common bile duct.
A client is brought to the emergency room in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic
syndrome is made. The nurse would immediately prepare to initiate which of the following anticipated physician's orders?
a) endotracheal intubation
b) 100 units of NPH insulin
c) intravenous infusion of normal saline
d) intravenous infusion of sodium bicarbonate - ansc) intravenous infusion of normal saline
The primary goal of treatment in hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is to rehydrate the client to restore fluid
volume and to correct electrolyte deficiency.
Intravenous fluid replacement is similar to that administered in diabetic ketoacidosis (DKA) and begins with IV infusion of normal
saline.
Regular insulin, not NPH insulin, would be administered. The use of sodium bicarbonate to correct acidosis is avoided because it
can precipitate a further drop in serum potassium levels. Intubation and mechanical ventilation are not required to treat HHNS.
A client who recently underwent cranial surgery develops syndrome of inappropriate antidiuretic hormone (SIADH). Which of the
following symptoms should the nurse anticipate?
A. Edema and weight gain.
B. Excessive urinary output.
C. Fluid loss and dehydration.
D. Low urine specific gravity. - ansCorrect answer: A
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
. A patient 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 notifying 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 until talking with the health care provider. - ansC
Rationale: Spironolactone is a potassium-sparing diuretic and will help to increase the patient's potassium level.
The nurse does not need to talk with the doctor before giving the spironolactone, although the health care provider should be
notified about the low potassium value.
The furosemide will further decrease the patient's potassium level and should be held until the nurse talks with the health care
provider.
A 1200-calorie diet and exercise are prescribed for a patient with newly diagnosed type 2 diabetes. The patient tells the nurse, "I
hate to exercise! Can't I just follow the diet to keep my glucose under control?" The nurse teaches the patient that the major purpose
of exercise for diabetics 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 diabetics.
d. set a successful pattern, which will help in making other needed changes. - ansb. facilitate weight loss, which will decrease
peripheral insulin resistance.
Rationale: Exercise is essential to decrease insulin resistance and improve blood glucose control. Increased energy, improved
cardiovascular endurance, and setting a pattern of success are secondary benefits of exercise, but they are not the major reason.
A 32-year-old patient has early alcoholic cirrhosis diagnosed by a liver biopsy. When planning patient teaching, the priority
information for the nurse to include is the need for
a. vitamin B supplements.
b. abstinence from alcohol.
c. maintenance of a nutritious diet.
d. long-term, low-dose corticosteroids. - ansB
Rationale: The disease progression can be stopped or reversed by alcohol abstinence.
,MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
The other interventions may be used when cirrhosis becomes more severe to decrease symptoms or complications, but the priority
for this patient is to stop the progression of the disease.
A 37-year-old forklift operator presents with shakiness, sweating, anxiety, and palpitations and tells the nurse he has type 1 diabetes
mellitus. Which of the follow actions 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 reaction.
A 60 year old patient has an abrupt onset of anorexia, nausea and vomiting, hepatomegaly, and abnormal liver function studies.
Serologic testing is negative for viral causes of hepatitis. During assessment of the patient, it is most important for the nurse to
question the patient regarding
A. any prior exposure to people with jaundice
B. the use of all prescription and OTC (over the counter) medications
C. treatment of chronic diseases with corticosteriods
D. exposure to children recently immunized for hepatitis B - ansA and D assess for exposure to hepatitis. Hepatitis was ruled out this
is inappropriate.
C is incorrect because corticosteroids do not commonly cause liver disease
B is correct because overdose of medications can cause liver disease.
A 63-year-old patient is newly diagnosed with type 2 diabetes. When developing an education plan, the nurse's first action should be
to
a. assess the patient's perception of what it means to have type 2 diabetes.
b. demonstrate how to check glucose using capillary blood glucose monitoring.
c. ask the patient's family to participate in the diabetes education program.
,MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
d. discuss the need for the patient to actively participate in diabetes management. - ansA
Rationale: Before planning education, the nurse should 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 individualized to each patient.
A client has just had surgery for colon cancer. Which of the following disorders might the client develop?
a. Peritonitis
b. Diverticulosis
c. Partial bowel obstruction
d. Complete bowel obstruction - ansa. Peritonitis
Bowel spillage could occur during surgery, resulting in peritonitis. Complete or partial bowel obstruction may occur before bowel
resection. Diverticulosis doesn't result from surgery or colon cancer.
A client has recently been diagnosed with Type I diabetes and asks the nurse for help formulating a nutrition plan. Which of the
following recommendations would the nurse make to help the client increase calorie consumption to offset absorption problems?
a. Eating 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 consumption of simple carbohydrates
d. Skip meals to help lose weight - ansA
Eating small meals with two or three snacks may be more helpful in maintaining blood glucose levels than three large meals.
A client is admitted to the medical-surgical floor with a diagnosis of acute pancreatitis. His blood pressure is 136/76 mm Hg, pulse
96 beats/minute, respirations 22 breaths/minute, temperature 99°F (38.3°C), and he has been experiencing severe vomiting for 24
hours. His past medical history reveals hyperlipidemia and alcohol abuse. The physician prescribes a nasogastric (NG) tube for the
client. Which of the following is the primary purpose for insertion of the NG tube?
A. Empty the stomach of fluids and gas to relieve vomiting.
, MEDSURG DIABETES NCLEX STYLE PRACTICE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
B. Prevent spasms at the sphincter of Oddi.
C. Prevent air from forming in the small and large intestines.
D. Remove bile from the gallbladder. - ansCorrect answer: A
An NG tube is no longer routinely inserted to treat pancreatitis, but if the client has protracted vomiting, the NG tube is inserted to
drain fluids and gas and relieve vomiting.
An NG tube doesn't prevent spasms at the sphincter of Oddi (a valve in the duodenum that controls the flow of digestive enzymes)
or prevent air from forming in the small and large intestine.
The common bile duct connects to the pancreas and the gall bladder, and a T tube rather than an NG tube would be used to collect
bile drainage from the common bile duct.
A client is brought to the emergency room in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic
syndrome is made. The nurse would immediately prepare to initiate which of the following anticipated physician's orders?
a) endotracheal intubation
b) 100 units of NPH insulin
c) intravenous infusion of normal saline
d) intravenous infusion of sodium bicarbonate - ansc) intravenous infusion of normal saline
The primary goal of treatment in hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is to rehydrate the client to restore fluid
volume and to correct electrolyte deficiency.
Intravenous fluid replacement is similar to that administered in diabetic ketoacidosis (DKA) and begins with IV infusion of normal
saline.
Regular insulin, not NPH insulin, would be administered. The use of sodium bicarbonate to correct acidosis is avoided because it
can precipitate a further drop in serum potassium levels. Intubation and mechanical ventilation are not required to treat HHNS.
A client who recently underwent cranial surgery develops syndrome of inappropriate antidiuretic hormone (SIADH). Which of the
following symptoms should the nurse anticipate?
A. Edema and weight gain.
B. Excessive urinary output.
C. Fluid loss and dehydration.
D. Low urine specific gravity. - ansCorrect answer: A
