Metabolism - RNSG 1533 Exam Questions With Complete
Solutions
"Peakless" basal or very long-acting insulins Correct Answer
-insulin is absorbed very slowly over 24 hours and can be given
once a day.
-Because the insulin is in a suspension with a pH of 4, it cannot
be mixed with other insulins because this would cause
precipitation.
-originally approved to be given once a day at bedtime;
however, it has now been approved to be given once a day at
any time of the day but must be given at the same time each day
to prevent overlap of action.
A 12-year-old client who has had type 1 diabetes since infancy
tests his glucose level before lunch and has a reading of 245
mg/dL (13.6 mmol/L). What will the nurse do next? Select all
that apply. Correct Answer Ask client to take the prescribed
bolus dose plus additional aspart insulin per the sliding scale.
Ensure the client's lunch tray is present on the unit prior to
giving insulin.
Rationale:
Aspart insulin is rapid-acting and has an onset of about 10
minutes. It is given on a set schedule as a bolus dose prior to
meals to offset the effect of carbohydrates. When the blood
glucose level is above a desired range (usually 180 mg/dL [10
mmol/L]), additional "correction" dosing of the aspart is added
,to the bolus dose. Because the onset is rapid, the nurse should
ensure the lunch tray is present before the dose is given. It is not
necessary for the nurse to recheck the blood glucose level if the
client has successfully performed testing independently. This
client has lived with diabetes for 12 years, and questioning the
ability to check the level could negatively affect the nurse-client
relationship. Milk, graham crackers, and peanut butter can be
given for a low blood glucose level, not an elevated level. There
is no need to assess for symptoms, because there is already an
objective assessment finding (i.e., the blood glucose reading) on
which to base the treatment plan.
A 2-month-old infant is at risk for an ileus after surgery to
correct intussusception. What should be included in a focused
assessment for this complication? Select all that apply. Correct
Answer assessment of bowel sounds
characteristics of the first stool
measurement of gastric output
Rationale:
A postoperative ileus is a functional obstruction of the bowel.
Assessment of bowel sounds, the first stool, and the amount of
gastric output provide information about the return of gastric
function. Measurement of urine specific gravity provides
information about fluid and electrolyte status; bilirubin levels
provide information about liver function, and neither of these
tests need to be included in a focused assessment for ileus.
A child and parents are being seen in the office after discharge
from the hospital. The child was newly diagnosed with type 2
diabetes. When talking with the child and parents, which
, statement by the nurse would be most appropriate? Correct
Answer "Young people can usually be managed with an oral
agent, meal planning, and exercise."
A client has a health problem that is attributable to alterations in
the normal process of endocytosis. What outcome of these
alterations should the nurse most likely identify? Correct
Answer The client's cells lack the necessary nutrients to sustain
cellular activity.
Rationale:
Endocytosis is the process of incorporating proteins, pathogens,
particles, or nutrients from the extracellular space. Failure of this
process could plausibly lead to inadequate nutrition for the cell.
Endocytosis is unrelated to cell division or a transition toward
hydrophilia. Hormone release involves exocytosis.
A client has received dietary instructions as part of the treatment
plan for diabetes type 1. Which statement by the client would
alert the nurse of needing additional instructions? Correct
Answer "I can eat whatever I want as long as I cover the
calories with sufficient insulin."
A client is concerned about bone strength and development and
asks the nurse if dietary sources of vitamin D will cause
immediate activity within the skeletal system. The best response
by the nurse would be: Correct Answer "Vitamin D has little
or no activity until it has been converted to physiologically
active compounds."
Rationale:
Solutions
"Peakless" basal or very long-acting insulins Correct Answer
-insulin is absorbed very slowly over 24 hours and can be given
once a day.
-Because the insulin is in a suspension with a pH of 4, it cannot
be mixed with other insulins because this would cause
precipitation.
-originally approved to be given once a day at bedtime;
however, it has now been approved to be given once a day at
any time of the day but must be given at the same time each day
to prevent overlap of action.
A 12-year-old client who has had type 1 diabetes since infancy
tests his glucose level before lunch and has a reading of 245
mg/dL (13.6 mmol/L). What will the nurse do next? Select all
that apply. Correct Answer Ask client to take the prescribed
bolus dose plus additional aspart insulin per the sliding scale.
Ensure the client's lunch tray is present on the unit prior to
giving insulin.
Rationale:
Aspart insulin is rapid-acting and has an onset of about 10
minutes. It is given on a set schedule as a bolus dose prior to
meals to offset the effect of carbohydrates. When the blood
glucose level is above a desired range (usually 180 mg/dL [10
mmol/L]), additional "correction" dosing of the aspart is added
,to the bolus dose. Because the onset is rapid, the nurse should
ensure the lunch tray is present before the dose is given. It is not
necessary for the nurse to recheck the blood glucose level if the
client has successfully performed testing independently. This
client has lived with diabetes for 12 years, and questioning the
ability to check the level could negatively affect the nurse-client
relationship. Milk, graham crackers, and peanut butter can be
given for a low blood glucose level, not an elevated level. There
is no need to assess for symptoms, because there is already an
objective assessment finding (i.e., the blood glucose reading) on
which to base the treatment plan.
A 2-month-old infant is at risk for an ileus after surgery to
correct intussusception. What should be included in a focused
assessment for this complication? Select all that apply. Correct
Answer assessment of bowel sounds
characteristics of the first stool
measurement of gastric output
Rationale:
A postoperative ileus is a functional obstruction of the bowel.
Assessment of bowel sounds, the first stool, and the amount of
gastric output provide information about the return of gastric
function. Measurement of urine specific gravity provides
information about fluid and electrolyte status; bilirubin levels
provide information about liver function, and neither of these
tests need to be included in a focused assessment for ileus.
A child and parents are being seen in the office after discharge
from the hospital. The child was newly diagnosed with type 2
diabetes. When talking with the child and parents, which
, statement by the nurse would be most appropriate? Correct
Answer "Young people can usually be managed with an oral
agent, meal planning, and exercise."
A client has a health problem that is attributable to alterations in
the normal process of endocytosis. What outcome of these
alterations should the nurse most likely identify? Correct
Answer The client's cells lack the necessary nutrients to sustain
cellular activity.
Rationale:
Endocytosis is the process of incorporating proteins, pathogens,
particles, or nutrients from the extracellular space. Failure of this
process could plausibly lead to inadequate nutrition for the cell.
Endocytosis is unrelated to cell division or a transition toward
hydrophilia. Hormone release involves exocytosis.
A client has received dietary instructions as part of the treatment
plan for diabetes type 1. Which statement by the client would
alert the nurse of needing additional instructions? Correct
Answer "I can eat whatever I want as long as I cover the
calories with sufficient insulin."
A client is concerned about bone strength and development and
asks the nurse if dietary sources of vitamin D will cause
immediate activity within the skeletal system. The best response
by the nurse would be: Correct Answer "Vitamin D has little
or no activity until it has been converted to physiologically
active compounds."
Rationale:
