1
NUR 170 Exam 3 (Latest Update): Concepts of
Medical-Surgical Nursing Questions and Verified Answers,
100% Correct Grade A+ (Galen)
Examy3:
Diabetes
1. ListytheycommonyriskyfactorsyforyTypey2ydiabetes.y(1307)
a. obesity,yphysicalyinactivity,yhypertension
b. firstydegreeyrelativeywithydiabetes,ybadycholesterolylevels,ypolysisticyovaryysyndrome,yhi
storyyofyvascularydisease.
2. Listytheysignsyandysymptomsyofybothyhyperglycemiayandyhypoglycemia.y(1330)
a. Hypoglycemia:yweakness,yfatigue,ydifficultyythinking,yconfusion,ybehaviorychanges,yemo
tionalyinstability,yseizures,ylossyofyconsciousness,ybrainydamage,ydeath,yshaky,yheartypoun
ding,yanxious,ysweaty,yhungry,ytingling.
b. Hyperglycemia:ywarm,ymoistyskin,ydehydration,yrapidydeepybreathing,yfruityybreath,yme
ntalystatusyvaries,yabdominalycramps,yn/v,yorthostaticyhypotension,yturgor,yketonesypositi
ve.
3. Whatyisytheydiagnosticycriteriayforydiabetes?y(1308)
a. A1C:y>6.5%
b. Fastingybloodyglucosey>126mg/dl
c. 2yhourybloodyglucoseyequalytoyorygreatery200mg/dl
d. Patientywithymanifestationsyhyperglycemia,yrandomybloodyglucosey>200mg/dL.
e. Classicysymptomsydiabetes=ypolyuria,ypolydipsia,yunexplainedyweightyloss.
4. Aypatientyisybeingyprescribedyinsulinyforytheyfirstytime.yWhatykeyyteachingyitemsyneedytoybeyincl
uded?y(1313-1319)
a. Insulinytypes,yinjectionytechnique,ysiteyofyinjection,yandypatientyresponseyallyaffectya
bdorption,yonset,ydegree,yandydurationyofyinsulinyactivity.
b. Changingyinsulinsycanyaffectybloodyglucoseylevels.
c. Howytoyadjustyinsulinydoses,yunderstandynutritionytherapyyandymonitorybloodyglucoseylev
elsyaccurately.yMustyadhereytoyinsulinyschedule.
d. Don’tymixyanyyotheryinsulinywithypremixedyinsulin.
e. Refrigerateyinsulinynotyinyuseytoymaintainypotency,ypreventyexposureytoysunlight,yandyinhibity
,2
bacterialygrowth.yAlwaysyhaveyayspareybottleyofyeachyinsulin.yInsulinyisybadyaftery30ydays.ySto
reyprefilledysyringesyupwardsytoypreventyneedlesyclogging.yRollydon’tyshakeyprefilledysyringe
s.
f. SubcutaneousyInsulinyAdministration
i. Washyyouryhands.
ii. Inspectytheybottleyforytheytypeyofyinsulinyandytheyexpirationydate.
iii. Gentlyyrollytheybottleyofyintermediate-
actingyinytheypalmsyofyyouryhandsytoymixytheyinsulin.
iv. Cleanytheyrubberystopperywithyanyalcoholyswab.
v. Removeytheyneedleycover,yandypullybackytheyplungerytoydrawyairyintoytheysyringe.yTh
eyamountyofyairyshouldybeyequalytoytheyinsulinydose.yPushytheyneedleythroughytheyr
ubberystopper,yandyinjectytheyairyintoytheyinsulinybottle.
vi. Turnytheybottleyupsideydown,yandydrawytheyinsulinydoseyintoytheysyringe.
vii. Removeyairybubblesyinytheysyringeybyytappingyonytheysyringeyoryinjectingyairybackyint
oytheybottle.yRedrawytheycorrectyamount.
viii. Makeycertainytheytipyofytheyplungeryisyonytheylineyforyyourydoseyofyinsulin.yMa
gnifiersyareyavailableytoyassistyinymeasuringyaccurateydosesyofyinsulin.
,3
ix. Removeytheyneedleyfromytheybottle.yRecapytheyneedleyifytheyinsulinyisynotygivenyim
mediately.
x. Selectyaysiteywithinyyouryinjectionyareaythatyhasynotybeenyusedyinytheypastymonth.
xi. Cleanyyouryskinywithyanyalcoholyswab.yLightlyygraspyanyareayofyskin,yandyinsertytheyne
edleyatyay90-degreeyangle.
xii. Pushytheyplungeryallytheywayydown.yThisywillypushytheyinsulinyintoyyourybody.yRel
easeytheypinchedyskin.
xiii. Pullytheyneedleystraightyoutyquickly.yDoynotyrubytheyplaceywhereyyouygaveytheysh
ot.
xiv. Disposeyofytheysyringeyandyneedleywithoutyrecappingyinyaypunctureyproofyco
ntainer.
g. NURSINGySAFTEYyPRIORITY!
i. Albiglutidey(Tanzeum)yisyonlyyadministeredyonceyperyweek,ynotydailyylikeyotheryin
cretinymimetics.
ii. AllyfouryDPP-
4yinhibitorsyandytheyincretinymimeticsyliraglutideyareyassociatedywithyanyincreasedyri
skyforypancreatitis.yWarnypatientsytakingytheseydrugsytoyimmediatelyyreportythesey
manifestationsytoytheyHCP:yJaundice;ysuddenyonsetyofyintenseyabdominalypainythat
yradiatesytoytheyback,yleftyflank,yoryleftyshoulder;yorygray-
blueydiscolorationyofytheyabdomenyoryperiumbilicalyarea.
iii. DoynotymixypramlintideyandyinsulinyinytheysameysyringeybecauseytheyPHyofytheytw
oydrugsyisynotycompatible.
iv. Doynotymixyanyyotheryinsulinytypeywithyinsulinyglargine,ywithyinsulinydetemir,yorywit
hyanyyotheryofytheypremixedyinsulinyformulations,ysuchyasyHumalogyMixy75/25.
v. Preventyhypoglycemiaybyyensuringythatyappropriateybloodyglucoseytestingypr
oductsyareyusedyforypatientsyreceivingyparenteralymaltose,yparenteralygala
ctose,yandyoralyxyloseyproducts.
vi. TeachypatientywithyhistoryyofyhypoglycemicyunawarenessyNOTytoytestyatyalt
ernativeysites.
5. Whatydoesyaydiabeticypatientyneedytoyknowybeforeyexercising?y(1321-1322)
a. Wearyappropriateyfootwear,yexamineyfeetyregularly.
b. Stayyhydrated,ydon’tyexerciseyinyextremeytemps
c. Don’tyexerciseywithiny1yhouryofyinsulinyejectionyorynearypeakytimeyofyinsulin
d. Don’tyexerciseyunlessybloodyglucoseyisyatleasty80yandylessythany250
, 4
i. Haveyaycarbysnackybeforeyexercisingyify1yhouryhasypassedysinceylastymeal
ii. Carryysimpleysugarytoyeatyduringyexerciseyifyhypoglycemiayhappens
iii. Carryyidentificationythatyyouyhaveydiabetes
e. Checkyglucoseylevelsymoreyfrequentlyyonydaysyofyexercisey,yextraycarbsyandylessyinsuliny
mayybeyneededyduringy24yhoursyafteryextensiveyexercise.
6. Whatyareythey“sickyday”yrulesyforydiabeticypatients?y(1335)
a. NotifyyMDyifyyouryill
b. Monitoryglucoseyeveryy4yhours;ytestyurineyforyketonesywhenyglucoseyabovey240
c. Continueytoytakeyinsulin,ydrinky8ytoy12yozysugaryfreeyliquidsyeveryyhouryawake
d. Eatymealsyatyregularytimes,yifycan’tydoysolidyfoodsyeatymoreyeasilyytoleratedyfoodsywithyth
eysameyamountyofycarbs
e. CallyDRyif:
NUR 170 Exam 3 (Latest Update): Concepts of
Medical-Surgical Nursing Questions and Verified Answers,
100% Correct Grade A+ (Galen)
Examy3:
Diabetes
1. ListytheycommonyriskyfactorsyforyTypey2ydiabetes.y(1307)
a. obesity,yphysicalyinactivity,yhypertension
b. firstydegreeyrelativeywithydiabetes,ybadycholesterolylevels,ypolysisticyovaryysyndrome,yhi
storyyofyvascularydisease.
2. Listytheysignsyandysymptomsyofybothyhyperglycemiayandyhypoglycemia.y(1330)
a. Hypoglycemia:yweakness,yfatigue,ydifficultyythinking,yconfusion,ybehaviorychanges,yemo
tionalyinstability,yseizures,ylossyofyconsciousness,ybrainydamage,ydeath,yshaky,yheartypoun
ding,yanxious,ysweaty,yhungry,ytingling.
b. Hyperglycemia:ywarm,ymoistyskin,ydehydration,yrapidydeepybreathing,yfruityybreath,yme
ntalystatusyvaries,yabdominalycramps,yn/v,yorthostaticyhypotension,yturgor,yketonesypositi
ve.
3. Whatyisytheydiagnosticycriteriayforydiabetes?y(1308)
a. A1C:y>6.5%
b. Fastingybloodyglucosey>126mg/dl
c. 2yhourybloodyglucoseyequalytoyorygreatery200mg/dl
d. Patientywithymanifestationsyhyperglycemia,yrandomybloodyglucosey>200mg/dL.
e. Classicysymptomsydiabetes=ypolyuria,ypolydipsia,yunexplainedyweightyloss.
4. Aypatientyisybeingyprescribedyinsulinyforytheyfirstytime.yWhatykeyyteachingyitemsyneedytoybeyincl
uded?y(1313-1319)
a. Insulinytypes,yinjectionytechnique,ysiteyofyinjection,yandypatientyresponseyallyaffectya
bdorption,yonset,ydegree,yandydurationyofyinsulinyactivity.
b. Changingyinsulinsycanyaffectybloodyglucoseylevels.
c. Howytoyadjustyinsulinydoses,yunderstandynutritionytherapyyandymonitorybloodyglucoseylev
elsyaccurately.yMustyadhereytoyinsulinyschedule.
d. Don’tymixyanyyotheryinsulinywithypremixedyinsulin.
e. Refrigerateyinsulinynotyinyuseytoymaintainypotency,ypreventyexposureytoysunlight,yandyinhibity
,2
bacterialygrowth.yAlwaysyhaveyayspareybottleyofyeachyinsulin.yInsulinyisybadyaftery30ydays.ySto
reyprefilledysyringesyupwardsytoypreventyneedlesyclogging.yRollydon’tyshakeyprefilledysyringe
s.
f. SubcutaneousyInsulinyAdministration
i. Washyyouryhands.
ii. Inspectytheybottleyforytheytypeyofyinsulinyandytheyexpirationydate.
iii. Gentlyyrollytheybottleyofyintermediate-
actingyinytheypalmsyofyyouryhandsytoymixytheyinsulin.
iv. Cleanytheyrubberystopperywithyanyalcoholyswab.
v. Removeytheyneedleycover,yandypullybackytheyplungerytoydrawyairyintoytheysyringe.yTh
eyamountyofyairyshouldybeyequalytoytheyinsulinydose.yPushytheyneedleythroughytheyr
ubberystopper,yandyinjectytheyairyintoytheyinsulinybottle.
vi. Turnytheybottleyupsideydown,yandydrawytheyinsulinydoseyintoytheysyringe.
vii. Removeyairybubblesyinytheysyringeybyytappingyonytheysyringeyoryinjectingyairybackyint
oytheybottle.yRedrawytheycorrectyamount.
viii. Makeycertainytheytipyofytheyplungeryisyonytheylineyforyyourydoseyofyinsulin.yMa
gnifiersyareyavailableytoyassistyinymeasuringyaccurateydosesyofyinsulin.
,3
ix. Removeytheyneedleyfromytheybottle.yRecapytheyneedleyifytheyinsulinyisynotygivenyim
mediately.
x. Selectyaysiteywithinyyouryinjectionyareaythatyhasynotybeenyusedyinytheypastymonth.
xi. Cleanyyouryskinywithyanyalcoholyswab.yLightlyygraspyanyareayofyskin,yandyinsertytheyne
edleyatyay90-degreeyangle.
xii. Pushytheyplungeryallytheywayydown.yThisywillypushytheyinsulinyintoyyourybody.yRel
easeytheypinchedyskin.
xiii. Pullytheyneedleystraightyoutyquickly.yDoynotyrubytheyplaceywhereyyouygaveytheysh
ot.
xiv. Disposeyofytheysyringeyandyneedleywithoutyrecappingyinyaypunctureyproofyco
ntainer.
g. NURSINGySAFTEYyPRIORITY!
i. Albiglutidey(Tanzeum)yisyonlyyadministeredyonceyperyweek,ynotydailyylikeyotheryin
cretinymimetics.
ii. AllyfouryDPP-
4yinhibitorsyandytheyincretinymimeticsyliraglutideyareyassociatedywithyanyincreasedyri
skyforypancreatitis.yWarnypatientsytakingytheseydrugsytoyimmediatelyyreportythesey
manifestationsytoytheyHCP:yJaundice;ysuddenyonsetyofyintenseyabdominalypainythat
yradiatesytoytheyback,yleftyflank,yoryleftyshoulder;yorygray-
blueydiscolorationyofytheyabdomenyoryperiumbilicalyarea.
iii. DoynotymixypramlintideyandyinsulinyinytheysameysyringeybecauseytheyPHyofytheytw
oydrugsyisynotycompatible.
iv. Doynotymixyanyyotheryinsulinytypeywithyinsulinyglargine,ywithyinsulinydetemir,yorywit
hyanyyotheryofytheypremixedyinsulinyformulations,ysuchyasyHumalogyMixy75/25.
v. Preventyhypoglycemiaybyyensuringythatyappropriateybloodyglucoseytestingypr
oductsyareyusedyforypatientsyreceivingyparenteralymaltose,yparenteralygala
ctose,yandyoralyxyloseyproducts.
vi. TeachypatientywithyhistoryyofyhypoglycemicyunawarenessyNOTytoytestyatyalt
ernativeysites.
5. Whatydoesyaydiabeticypatientyneedytoyknowybeforeyexercising?y(1321-1322)
a. Wearyappropriateyfootwear,yexamineyfeetyregularly.
b. Stayyhydrated,ydon’tyexerciseyinyextremeytemps
c. Don’tyexerciseywithiny1yhouryofyinsulinyejectionyorynearypeakytimeyofyinsulin
d. Don’tyexerciseyunlessybloodyglucoseyisyatleasty80yandylessythany250
, 4
i. Haveyaycarbysnackybeforeyexercisingyify1yhouryhasypassedysinceylastymeal
ii. Carryysimpleysugarytoyeatyduringyexerciseyifyhypoglycemiayhappens
iii. Carryyidentificationythatyyouyhaveydiabetes
e. Checkyglucoseylevelsymoreyfrequentlyyonydaysyofyexercisey,yextraycarbsyandylessyinsuliny
mayybeyneededyduringy24yhoursyafteryextensiveyexercise.
6. Whatyareythey“sickyday”yrulesyforydiabeticypatients?y(1335)
a. NotifyyMDyifyyouryill
b. Monitoryglucoseyeveryy4yhours;ytestyurineyforyketonesywhenyglucoseyabovey240
c. Continueytoytakeyinsulin,ydrinky8ytoy12yozysugaryfreeyliquidsyeveryyhouryawake
d. Eatymealsyatyregularytimes,yifycan’tydoysolidyfoodsyeatymoreyeasilyytoleratedyfoodsywithyth
eysameyamountyofycarbs
e. CallyDRyif:
