Lewis's Medical Surgical Nursing 11th Edition
Harding Test Bank Exam 2025–2026 Accurate
Real Exam Questions and Verified Correct
Answers JUST RELEASED
The health care provider suspects the Somogyi effect in a 50-yr-old patient whose
6:00 AMblood glucose is 230 mg/dL. Which action will the nurse teach the patient to
take?
a. Avoid snacking right before bedtime.
b. Increase the rapid-acting insulin dose.
c. Check the blood glucose during the night.
d. Administer a larger dose of long-acting insulin. - answer>>>ANS: C
If the Somogyi effect is causing the patient's increased morning glucose level, the
patient will
experience hypoglycemia between 2:00 and 4:00 AM. The dose of insulin will be
reduced, rather than increased. A bedtime snack is used to prevent hypoglycemic
episodes during the
night.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process:
Planning MSC: NCLEX: Physiological Integrity
Which action should the nurse take after a patient treated with intramuscular
glucagon for hypoglycemia regains consciousness?
a. Assess the patient for symptoms of hyperglycemia.
b. Give the patient a snack of peanut butter and crackers.
c. Have the patient drink a glass of orange juice or nonfat milk.
d. Administer a continuous infusion of 5% dextrose for 24 hours. - answer>>>ANS:
B
e. Rebound hypoglycemia can occur after glucagon administration, but having
a meal containing
complex carbohydrates plus protein and fat will help prevent hypoglycemia.
Orange juice and
nonfat milk will elevate blood glucose rapidly, but the cheese and crackers will
stabilize blood
glucose. Administration of IV glucose might be used in patients who were unable to
take in nutrition orally. The patient should be assessed for symptoms of
hypoglycemia after glucagon
1|Page
,administration.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which question during the assessment of a patient who has diabetes will help the
nurse identify autonomic neuropathy?
a. "Do you feel bloated after eating?"
b. "Have you seen any skin changes?"
c. "Do you need to increase your insulin dosage when you are stressed?"
d. "Have you noticed any painful new ulcerations or sores on your feet?" -
answer>>>ANS: A
Autonomic neuropathy can cause delayed gastric emptying, which results in a
bloated feeling
for the patient. The other questions are also appropriate to ask but would not help in
identifying autonomic neuropathy.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which information will the nurse include in teaching a female patient who has
peripheral arterial disease, type 2 diabetes, and sensory neuropathy of the feet and
legs?
a. Choose flat-soled leather shoes.
b. Set heating pads on a low temperature.
c. Use a callus remover for corns or calluses.
d. Soak feet in warm water for an hour each day. - answer>>>ANS: A
The patient is taught to avoid high heels and that leather shoes are preferred. The
feet should
be washed, but not soaked, in warm water daily. Heating pad use should be
avoided. Commercial callus and corn removers should be avoided. The patient
should see a specialist to treat these problems.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which finding indicates a need to contact the health care provider before the
nurse administers
metformin (Glucophage)?
a. The patient's blood glucose level is 174 mg/dL.
2|Page
, b. The patient is scheduled for a chest x-ray in an hour.
c. The patient has gained 2 lb (0.9 kg) in the past 24 hours.
d. The patient's estimated glomerular filtration rate is 42 mL/min. - answer>>>ANS: D
The glomerular filtration rate indicates possible renal impairment, and metformin
should not
be used in patients with significant renal impairment. The other findings are not
contraindications to the use of metformin.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
A patient who has diabetes and reports burning foot pain at night receives a
new prescription.
Which information should the nurse teach the patient about amitriptyline?
a. Amitriptyline decreases the depression caused by your foot pain.
b. Amitriptyline helps prevent transmission of pain impulses to the brain.
c. Amitriptyline corrects some of the blood vessel changes that cause pain.
d. Amitriptyline improves sleep and makes you less aware of nighttime
pain. - answer>>>ANS: B
Tricyclic antidepressants (TCAs) decrease the transmission of pain impulses to
the spinal cord
and brain. TCAs also improve sleep quality and are used for depression, but that is
not the major purpose for their use in diabetic neuropathy. TCAs do not affect the
blood vessel changes that contribute to neuropathy.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
A patient who has type 2 diabetes is being prepared for an elective coronary
angiogram. Which information would the nurse anticipate might lead to rescheduling
the test?
a. The patient's most recent A1C was 7.5%.
b. The patient's blood glucose is 128 mg/dL.
c. The patient took the prescribed metformin today.
d. The patient took the prescribed enalapril 4 hours ago. - answer>>>ANS: C
To avoid lactic acidosis, metformin should be discontinued a day or 2 before the
coronary angiogram and should not be used for 48 hours after IV contrast media
are administered. The
3|Page
Harding Test Bank Exam 2025–2026 Accurate
Real Exam Questions and Verified Correct
Answers JUST RELEASED
The health care provider suspects the Somogyi effect in a 50-yr-old patient whose
6:00 AMblood glucose is 230 mg/dL. Which action will the nurse teach the patient to
take?
a. Avoid snacking right before bedtime.
b. Increase the rapid-acting insulin dose.
c. Check the blood glucose during the night.
d. Administer a larger dose of long-acting insulin. - answer>>>ANS: C
If the Somogyi effect is causing the patient's increased morning glucose level, the
patient will
experience hypoglycemia between 2:00 and 4:00 AM. The dose of insulin will be
reduced, rather than increased. A bedtime snack is used to prevent hypoglycemic
episodes during the
night.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process:
Planning MSC: NCLEX: Physiological Integrity
Which action should the nurse take after a patient treated with intramuscular
glucagon for hypoglycemia regains consciousness?
a. Assess the patient for symptoms of hyperglycemia.
b. Give the patient a snack of peanut butter and crackers.
c. Have the patient drink a glass of orange juice or nonfat milk.
d. Administer a continuous infusion of 5% dextrose for 24 hours. - answer>>>ANS:
B
e. Rebound hypoglycemia can occur after glucagon administration, but having
a meal containing
complex carbohydrates plus protein and fat will help prevent hypoglycemia.
Orange juice and
nonfat milk will elevate blood glucose rapidly, but the cheese and crackers will
stabilize blood
glucose. Administration of IV glucose might be used in patients who were unable to
take in nutrition orally. The patient should be assessed for symptoms of
hypoglycemia after glucagon
1|Page
,administration.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which question during the assessment of a patient who has diabetes will help the
nurse identify autonomic neuropathy?
a. "Do you feel bloated after eating?"
b. "Have you seen any skin changes?"
c. "Do you need to increase your insulin dosage when you are stressed?"
d. "Have you noticed any painful new ulcerations or sores on your feet?" -
answer>>>ANS: A
Autonomic neuropathy can cause delayed gastric emptying, which results in a
bloated feeling
for the patient. The other questions are also appropriate to ask but would not help in
identifying autonomic neuropathy.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which information will the nurse include in teaching a female patient who has
peripheral arterial disease, type 2 diabetes, and sensory neuropathy of the feet and
legs?
a. Choose flat-soled leather shoes.
b. Set heating pads on a low temperature.
c. Use a callus remover for corns or calluses.
d. Soak feet in warm water for an hour each day. - answer>>>ANS: A
The patient is taught to avoid high heels and that leather shoes are preferred. The
feet should
be washed, but not soaked, in warm water daily. Heating pad use should be
avoided. Commercial callus and corn removers should be avoided. The patient
should see a specialist to treat these problems.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which finding indicates a need to contact the health care provider before the
nurse administers
metformin (Glucophage)?
a. The patient's blood glucose level is 174 mg/dL.
2|Page
, b. The patient is scheduled for a chest x-ray in an hour.
c. The patient has gained 2 lb (0.9 kg) in the past 24 hours.
d. The patient's estimated glomerular filtration rate is 42 mL/min. - answer>>>ANS: D
The glomerular filtration rate indicates possible renal impairment, and metformin
should not
be used in patients with significant renal impairment. The other findings are not
contraindications to the use of metformin.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
A patient who has diabetes and reports burning foot pain at night receives a
new prescription.
Which information should the nurse teach the patient about amitriptyline?
a. Amitriptyline decreases the depression caused by your foot pain.
b. Amitriptyline helps prevent transmission of pain impulses to the brain.
c. Amitriptyline corrects some of the blood vessel changes that cause pain.
d. Amitriptyline improves sleep and makes you less aware of nighttime
pain. - answer>>>ANS: B
Tricyclic antidepressants (TCAs) decrease the transmission of pain impulses to
the spinal cord
and brain. TCAs also improve sleep quality and are used for depression, but that is
not the major purpose for their use in diabetic neuropathy. TCAs do not affect the
blood vessel changes that contribute to neuropathy.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
A patient who has type 2 diabetes is being prepared for an elective coronary
angiogram. Which information would the nurse anticipate might lead to rescheduling
the test?
a. The patient's most recent A1C was 7.5%.
b. The patient's blood glucose is 128 mg/dL.
c. The patient took the prescribed metformin today.
d. The patient took the prescribed enalapril 4 hours ago. - answer>>>ANS: C
To avoid lactic acidosis, metformin should be discontinued a day or 2 before the
coronary angiogram and should not be used for 48 hours after IV contrast media
are administered. The
3|Page
