NUR1460C – Module 6 – Quiz
1. A nurse is reviewing laboratory values for several clients. Which value causes the nurse to conduct nutritional assessments as a priority?
a. Albumin: 3.5 g/dL
b. Cholesterol: 142 mg
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NUR1460C – Module 6 – Quiz
1. A nurse is reviewing laboratory values for several clients. Which value causes the nurse to conduct nutritional assessments as a priority?
a. Albumin: 3.5 g/dL
b. Cholesterol: 142 mg/dL
c. Hemoglobin: 9.8 mg/dL
d. Prealbumin: 28 mg/dL
2. A nurse reviews laboratory results for a client with diabetes mellitus who presents with polyuria, lethargy, and blood glucose of 560 mg/ld. Which laboratory result should the nurse correlate with the client’s polyuria?
a. Serum sodium: 163 mEq/L
b. Serum creatinine: 1.6 mg/dL
c. Presence of urine ketone bodies
d. Serum osmolarity: 375 mOsm/kg
3. The nurse is providing education to patient about the difference between simple and complex carbohydrates. Which statement by the patient indicates a need for further education?
a. “Simple carbohydrates give me quick energy.”
b. “Complex carbohydrates come from fruit.”
c. “Complex carbohydrates take longer to break down.”
d. “Simple carbohydrates come from milk products.”
4. A nurse assesses a client with diabetes mellitus and notes the client only responds to a sternal rub by moaning, has capillary blood glucose of 33 g/dL, and has an intravenous line that is infiltrated with 0.45% normal saline. Which action should the nurse take first?
a. Administer 1 mg of intramuscular glucagon.
b. Encourage the client to drink orange juice.
c. Insert a new intravenous access line.
d. Administer 25 mL dextrose 50% (D50) IV push.
5. A client tells the nurse about losing weight and regaining it multiple times. Besides eating and exercising habits, for what additional data should the nurse assess as the priority?
a. Economic ability to join a gym.
b. Food allergies and intolerances.
c. Psychosocial influences on weight.
d. Reasons for wanting to lose weight.
6. A nurse cares for a client who is prescribed pioglitazone (Actos). After 6 months of therapy, the client reports that his urine has become darker since starting the medication. Which action should the nurse take?
a. Assess for pain or burning with urination.
b. Review the client’s liver function study results.
c. Instruct the client to increase water intake.
d. Test a sample of urine for occult blood.
7. A client just returned to the surgical unit after a gastric bypass. What action by the nurse is the priority?
a. Assess the client’s pain.
b. Check the surgical incision.
c. Ensure an adequate airway.
d. Program the morphine pump.
8. A nurse assesses a client who is recovering from a subtotal thyroidectomy. On the second postoperative day the client states, “I feel numbness and tingling around my mouth.” What action should the nurse take?
a. Offer mouth care.
b. Loosen the dressing.
c. Assess for Chvostek’s sign.
d. Ask the client orientation questions.
9. A nurse assesses a client who has a 15-year history of diabetes and notes decreased tactile sensation in both feet. Which action should the nurse take first?
a. Document the finding in the client’s chart.
b. Assess tactile sensation in the client’s hands.
c. Examine the client’s feet for signs of injury.
d. Notify the health care provider.
10. A client is in the bariatric clinic 1 month after having gastric bypass surgery. The client is crying and says, “I didn’t know it would be this hard to live like this.” What response by the nurse is best?
a. Assess the client’s coping and support systems.
b. Inform the client that things will get easier.
c. Re-educate the client on needed dietary changes.
d. Tell the client lifestyle changes are always hard.
11. After teaching a client who has diabetes mellitus and proliferative retinopathy that is recovering from a complete thyroidectomy, the nurse assesses the client’s understanding. Which statement made by the client indicates a need for additional instruction?
a. “I may need calcium replacement after surgery.”
b. “After surgery, I won’t need to take thyroid medication.”
c. “I’ll need to take thyroid hormones for the rest of my life.”
d. “I can receive pain medication if I feel that I need it.”
12. A nurse cares for a client with diabetes mellitus who asks, “Why do I need to administer more than one injection of insulin each day?” How should the nurse respond?
a. “You need to start with multiple injections until you become more proficient at self-injection.”
b. “A single dose of insulin each day would not match your blood insulin levels and your food intake patterns.”
c. “A regimen of a single dose of insulin injected each day would require that you eat fewer carbohydrates.”
d. “A single dose of insulin would be too large to be absorbed, predictably putting you at risk for insulin shock.”
13. A nurse cares for a client who has a family history of diabetes mellitus. The client states, “My father has type 1 diabetes mellitus. Will I develop this disease as well?” How should the nurse respond?
a. “Your risk of diabetes is higher than the general population, but it may not occur.”
b. “No genetic risk is associated with the development of type 1 diabetes mellitus.”
c. “The risk for becoming a diabetic is 50% because of how it is inherited.”
d. “Female children do not inherit diabetes mellitus, but male children will.”
14. A client is awaiting bariatric surgery in the morning. What action by the nurse is most important?
a. Answering questions, the client has about surgery.
b. Beginning venous thromboembolism prophylaxis.
c. Informing the client that he or she will be out of bed tomorrow.
d. Teaching the client about needed dietary changes.
15. The nurse is performing an oral examination on a patient and notices a beefy-red tongue. She knows this is a characteristic finding in?
a. anorexia nervosa.
b. malnutrition.
c. bulimia.
d. pernicious anemia.
16. A nurse teaches a client with type 1 diabetes mellitus. Which statement should the nurse include in this client’s teaching to decrease the client’s insulin needs?
a. “Limit your fluid intake to 2 liters a day.”
b. “Animal organ meat is high in insulin.”
c. “Limit your carbohydrate intake to 80 grams a day.”
d. “Walk at a moderate pace for 1 mile daily.”
17. A nurse assesses a client on the medical-surgical unit. Which statement made by the client should alert the nurse to the possibility of hypothyroidism?
a. “My sister has thyroid problems.”
b. “I seem to feel the heat more than other people.”
c. “Food just doesn’t taste good without a lot of salt.”
d. “I am always tired, even with 12 hours of sleep.”
18. After teaching a client with diabetes mellitus to inject insulin, the nurse assesses the client’s understanding. Which statement made by the client indicates a need for additional teaching?
a. “The lower abdomen is the best location because it is closest to the pancreas.”
b. “I can reach my thigh the best, so I will use the different areas of my thighs.”
c. “By rotating the sites in one area, my chance of having a reaction is decreased.”
d. “Changing injection sites from the thigh to the arm will change absorption rates.
19. A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the nurse include in this client’s plan of care to delay the onset of microvascular and macrovascular complications?
a. “Maintain tight glycemic control and prevent hyperglycemia.”
b. “Restrict your fluid intake to no more than 2 liters a day.”
c. “Prevent hypoglycemia by eating a bedtime snack.”
d. “Limit your intake of protein to prevent ketoacidosis.”
20. Based on research on aging, the nurse knows that improper nutrition may result in the onset of which specific diseases? (Select all that apply.)
a. Type 2 diabetes.
b. Atherosclerosis.
c. Osteoporosis
d. Rheumatoid arthritis.
e. Hyperthyroidism.
21. A nurse assesses a client with diabetes mellitus. Which clinical manifestation should alert the nurse to decreased kidney function in this client?
a. Urine specific gravity of 1.033
b. Presence of protein in the urine
c. Elevated capillary blood glucose level
d. Presence of ketone bodies in the urine
22. A nurse cares for a client who presents with bradycardia secondary to hypothyroidism. Which medication should the nurse anticipate being prescribed to the client?
a. Atropine sulfate.
b. Levothyroxine sodium (Synthroid).
c. Propranolol (Inderal).
d. Epinephrine (Adrenalin).
23. A nurse teaches a client with type 2 diabetes mellitus who is prescribed glipizide (Glucotrol). Which statement should the nurse include in this client’s teaching?
a. “Change positions slowly when you get out of bed.”
b. “Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs).”
c. “If you miss a dose of this drug, you can double the next dose.”
d. “Discontinue the medication if you develop a urinary infection.”
24. The nurse is helping a patient understand the difference between macronutrients and vitamins and minerals. She is correct when she lists the following items as macronutrients: (Select all that apply.)
a. Water
b. Potassium
c. Starches
d. Fiber
e. Riboflavin
25. A nurse develops a dietary plan for a client with diabetes mellitus and new-onset microalbuminuria. Which component of the client’s diet should the nurse decrease?
a. Carbohydrates
b. Proteins
c. Fats
d. Total calories
26. The nurse is providing dietary education to her patient to help him include more complex carbohydrates in his diet. Which of the following would be beneficial to include? (Select all that apply.)
a. Green beans.
b. Rice.
c. Beans.
d. Bananas.
e. Orange juice.
27. A nurse assesses a client who is recovering from a total thyroidectomy and notes the development of stridor. Which action should the nurse take first?
a. Reassure the client that the voice change is temporary.
b. Document the finding and assess the client hourly.
c. Place the client in high-Fowler’s position and apply oxygen.
d. Contact the provider and prepare for intubation.
28. The nurse is planning dietary education for her client who has been diagnosed of Diabetes. What food labeling consideration should she be aware of when planning her education? (Select all that apply.)
a. Ask patients if they read food labels.
b. Assess their level of understanding of food labels.
c. Encourage them to read the food labels.
d. Explain to them all food labels requirements are the same.
e. Encourage reading the food labels when needed.
29. A nurse assesses a client who has diabetes mellitus and notes the client is awake and alert, but shaky, diaphoretic, and weak. Five minutes after administering a half-cup of orange juice, the client’s clinical manifestations have not changed. Which action should the nurse take next?
a. Administer another half-cup of orange juice.
b. Administer a half-ampule of dextrose 50% intravenously.
c. Administer 10 units of regular insulin subcutaneously.
d. Administer 1 mg of glucagon intramuscularly.
30. A nurse assesses a client with diabetes mellitus who self-administers subcutaneous insulin. The nurse notes a spongy, swelling area at the site the client uses most frequently for insulin injection. Which action should the nurse take?
a. Apply ice to the site to reduce inflammation.
b. Consult the provider for a new administration route.
c. Assess the client for other signs of cellulitis.
d. Instruct the client to rotate sites for insulin injection.
31. A characteristic common to all hormones is that they:
a. circulate in the blood bound plasma proteins
b. influence cellular activity of specific target tissues
c. accelerate the metabolic processes of all body cells
d. enter a cell to alter the cell’s membrane or gene expression
32. A patient is receiving therapy for cancer of the kidney. The nurse monitors the patient for signs and symptoms of damage to the:
a. pancreas
b. thyroid gland c. adrenal gland
d. posterior pituitary gland
33. A patient has a serum sodium level of 152 mEq/L (152 mmol/L) The normal hormonal response to this situation is:
a. release of ADH
b. release ACTH
c. secretion of aldosterone
d. secretion of corticotropin-releasing hormone
34. All cells in the body are believed to have intracellular receptors for:
a. insulin
b. glucagon
c. growth hormone d. thyroid hormone
35. When obtaining subjective data from a patient during assessment of the endocrine system, the nurse asks specifically about:
a. energy level
b. intake of vitamin C
c. employment history
d. frequency of sexual intercourse
36. An appropriate technique to use during physical assessment of the thyroid gland is:
a. asking the patient to hyperextend the neck during palpation
b. percussing the neck for dullness to define shape and size of thyroid c. having patient swallow water during inspection and palpation
d. using deep palpation to determine the extent of a visibly enlarged thyroid
37. Endocrine disorders often go unrecognized in the older adult because:
a. symptoms are often attributed to aging
b. older adults rarely have identifiable symptoms
c. endocrine disorders are rare in the older adult
d. older adults usually have subclinical endocrine disorders that minimize symptoms
38. An abnormal finding by the nurse during an endocrine assessment would be: [Select all that apply]
a. blood pressure of 100/70 mm Hg. b. excessive facial hair on a woman
c. soft, formed stool, every other day
d. 3 lb. weight gain over the last 6 months
e. hyperpigmentation coloration of the lower legs
39. A patient has a total serum calcium level of 3 mg/dl (1.5 mEq/L). If this finding reflects hypoparathyroidism, the nurse would expect further diagnostic studies to reveal:
a. decrease serum PTH
b. increased serum ACTH
c. increased serum glucose
d. decreased serum cholesterol levels
40. The health care provider prescribes levothyroxine for the patient with hypothyroidism. After teaching regarding this drug, the nurse determines that further instruction is needed when the patient states:
a. “I can expect the medication dose may need to be adjusted.”
b. “I only need to take this drug until my symptoms are improved.”
c. “I can expect to return normal function with the use of this drug.”
d. “I will report any chest pain or difficulty breathing to my provider right away.”
41. After thyroid surgery, the nurse suspects an issue due to the removal of the parathyroid gland when the patient develops:
a. muscle weakness and weight loss
b. hyperthermia and severe tachycardia
c. hypertension and difficulty swallowing
d. laryngospasm and tingling in the hands and feet
42. Polydipsia and polyuria related to diabetes mellitus are primarily due to:
a. the release of ketones cells during fat metabolism
b. fluid shifts resulting from the osmotic effects of hyperglycemia
c. damage to the kidneys from exposure to high levels of glucose
d. changes in RBCs resulting from attachment of excessive glucose to hemoglobin
The hyperglycemia of diabetes mellitus causes an osmotic diuresis, leading to large deficits of water, sodium and potassium during acute loss of control,
43. Analyze the following diagnostic for your patient with type 2 diabetes. Which result will need further assessment?
a. A1C 9%
b. BP 126/80 mm Hg
c. FBG 130 mg/dL (7.2 mmol/L)
d. LDL cholesterol 100 mg/dL (2.6 mmoL/L)
44. Which statement by the patient with type 2 diabetes is accurate?
a. “I will limit my alcohol intake to one drink.”
b. “I am not allowed to eat any sweets because of my diabetes.”
c. “I cannot exercise because I take blood glucose-lowering medication.”
d. “The amount of fat in my diet is not important. Only carbohydrates because they raise my blood sugar.”
45. Which is the most appropriate timing regarding the nurse’s administration of rapid- acting insulin for a hospitalized patient?
a. Give it 15 minutes before the patient begins a meal.
b. Give it ½ hour before meals
c. Give it 1 hour before meals
d. The timing does not matter with rapid acting insulins
46. Which statement is appropriate for the nurse to include in patient teaching regarding type 2 diabetes?
a. “Insulin injection are never used for type 2 diabetes.”
b. “You don’t need to check your glucose levels because you don’t take insulin.”
c. “A person with type 2 diabetes usually have better control of their diabetes then those who have type 1.”
d. “A person with type 2 diabetes has functioning beta cells of the pancreas.”
47. The nurse monitoring a patient for a therapeutic response to oral antidiabetic medication will observe for:
a. Fewer episodes of diabetic ketoacidosis (DKA)
b. Weight loss of 5 pounds
c. Hemoglobin A1C levels less than7%
d. Glucose levels of 150 mg/dL
48. A patient with type 2 diabetes is scheduled for magnetic resonance imaging (MRI) with contrast. The nurse reviews the orders and notices the patient is receiving metformin (Glucophage). Which action by the nurse is appropriate?
a. Proceed with the MRI
b. Notify radiology that the patient is receiving metformin
c. Expect to hold metformin the day of the test and 48hours after the test
d. Notify the provider to hold the metformin 48 hours before the MRI is performed
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