Endocrine and Oncology
A client, who is receiving an IV vesicant agent, reports pain at the intravenous site. The nurse also notes
swelling at the site. What is the priority nursing action?
1. Apply a cold compress to the IV site
2. Stop the infusion
3. Check the IV for a blood return
4. Slow the infusion - ANSWER: 2
A client with a long standing history of diabetes presents to the emergency department (ED) with a serum
blood sugar of 400 mg/dL (22.19 mmol/L). What lab values for this client are consistent with diabetic
ketoacidosis (DKA)? Select all that apply.
1. Serum sodium 140 mEq/L
2. Urine specific gravity 1.005
3. Serum potassium 5.3 mEq/L
4. PaCO2 48
5. pH 7.30 - ANSWER: 2, 3, 5
The nurse is caring for a poorly controlled type 2 diabetic client. Lab results include a BUN of 22mg/dL (7.85
mmol/L) and a creatinine of 1.9 mg/dL (0.67 mmol/L). The nurse checks the client's blood sugar and it is
218mg/dL (12.09 mmol/L). Current medications include metformin and exenatide. What is the priority
concern with this client taking metformin?
1. Metformin is not controlling the client's blood glucose.
2. Metformin and exenatide should not be administered together.
3. Metformin can cause hypoglycemia.
4. Metformin is contraindicated with an elevated creatinine level. - ANSWER: 4
, A 13 year old found unresponsive in the park is brought into the emergency department (ED). The nurse sees a
medical alert bracelet stating "Diabetic", and notes a fruity smell to the breath. There are no family members
available to obtain consent for treatment and attempts to call them have been unsuccessful. What action
should the nurse take?
1. Obtain consent from the social worker on duty in the emergency department.
2. Begin treatment by inserting two large bore IVs for administration of normal saline.
3. Give Glucagon IM and then wait for the arrival of a parent to consent to further treatment.
4. Notify the pirmary healthcare provider. - ANSWER: 2
A client with Cushing's disease occupies one bed in a semi-private room. When considering room assignments,
which client would be the safest choice to occupy the other bed in this room?
1. Status asthmaticus receiving respiratory therapy.
2. Newly admitted client with shingles.
3. Client with 50% burn of both arms.
4. Client who is post emergency appendectomy. - ANSWER: 1
A client with type 2 diabetes, who is noncompliant, has a HbA1c of 8%. The finger stick blood sugar is 218
mg/dL (12.1 mmol/L) at 0900. The current medications prescribed are metformin and exenatide. Based on this
data, what teaching should the nurse reinforce? Select all that apply.
1. Nutritional counseling to help improve diet compliance
2. HbA1c measures glycemia control over a period of 1 month
3. Blood glucose testing
4. Vigorous exercise plan to improve glucose control
5. Without glycemic control, eye complications can occur - ANSWER: 1, 3, 5
A client, who is receiving an IV vesicant agent, reports pain at the intravenous site. The nurse also notes
swelling at the site. What is the priority nursing action?
1. Apply a cold compress to the IV site
2. Stop the infusion
3. Check the IV for a blood return
4. Slow the infusion - ANSWER: 2
A client with a long standing history of diabetes presents to the emergency department (ED) with a serum
blood sugar of 400 mg/dL (22.19 mmol/L). What lab values for this client are consistent with diabetic
ketoacidosis (DKA)? Select all that apply.
1. Serum sodium 140 mEq/L
2. Urine specific gravity 1.005
3. Serum potassium 5.3 mEq/L
4. PaCO2 48
5. pH 7.30 - ANSWER: 2, 3, 5
The nurse is caring for a poorly controlled type 2 diabetic client. Lab results include a BUN of 22mg/dL (7.85
mmol/L) and a creatinine of 1.9 mg/dL (0.67 mmol/L). The nurse checks the client's blood sugar and it is
218mg/dL (12.09 mmol/L). Current medications include metformin and exenatide. What is the priority
concern with this client taking metformin?
1. Metformin is not controlling the client's blood glucose.
2. Metformin and exenatide should not be administered together.
3. Metformin can cause hypoglycemia.
4. Metformin is contraindicated with an elevated creatinine level. - ANSWER: 4
, A 13 year old found unresponsive in the park is brought into the emergency department (ED). The nurse sees a
medical alert bracelet stating "Diabetic", and notes a fruity smell to the breath. There are no family members
available to obtain consent for treatment and attempts to call them have been unsuccessful. What action
should the nurse take?
1. Obtain consent from the social worker on duty in the emergency department.
2. Begin treatment by inserting two large bore IVs for administration of normal saline.
3. Give Glucagon IM and then wait for the arrival of a parent to consent to further treatment.
4. Notify the pirmary healthcare provider. - ANSWER: 2
A client with Cushing's disease occupies one bed in a semi-private room. When considering room assignments,
which client would be the safest choice to occupy the other bed in this room?
1. Status asthmaticus receiving respiratory therapy.
2. Newly admitted client with shingles.
3. Client with 50% burn of both arms.
4. Client who is post emergency appendectomy. - ANSWER: 1
A client with type 2 diabetes, who is noncompliant, has a HbA1c of 8%. The finger stick blood sugar is 218
mg/dL (12.1 mmol/L) at 0900. The current medications prescribed are metformin and exenatide. Based on this
data, what teaching should the nurse reinforce? Select all that apply.
1. Nutritional counseling to help improve diet compliance
2. HbA1c measures glycemia control over a period of 1 month
3. Blood glucose testing
4. Vigorous exercise plan to improve glucose control
5. Without glycemic control, eye complications can occur - ANSWER: 1, 3, 5
