Title REF - POST TEST - ENDO (Mr. Chavez) SC ✅

D. is pregnant and has type 2 diabetes. 15. For a client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume? A. Cool, clammy skin B. Distended neck veins C. Increased urine osmolarity D. Decreased serum sodium level 16. A client becomes upset when the physician diagnoses diabetes mellitus as the cause of current signs and symptoms. The client tells the nurse, "This must be a mistake. No one in my family has ever had diabetes." Based on this statement, the nurse suspects the client is using which coping mechanism? A. Denial B. Withdrawal C. Anger D. Resolution 17. A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms? A. Coma, anxiety, confusion, headache, and cool, moist skin. B. Kussmaul's respirations, dry skin, hypotension, and bradycardia. C. Polyuria, polydipsia, hypotension, and hypernatremia. D. Polyuria, polydipsia, polyphagia, and weight loss. 18. The nurse is caring for a client who's hypoglycemic. This client will have a blood glucose level: A. below 70 mg/dl. B. between 70 and 120 mg/dl. C. between 120 and 180 mg/dl. D. over 180 mg/dl. 19. Every morning a client with type 1 diabetes receives 15 units of Humulin 70/30. What does this type of insulin contain? A. 70 units of neutral protamine Hagedorn (NPH) insulin and 30 units of regular insulin B. 70 units of regular insulin and 30 units of NPH insulin C. 70% NPH insulin and 30% regular insulin D. 70% regular insulin and 30% NPH insulin 20. A client with type 1 diabetes is scheduled to receive 30 U of 70/30 insulin. There is no 70/30 insulin available. As a substitution, the nurse may give the client: A. 9 U regular insulin and 21 U neutral protamine Hagedorn (NPH). B. 21 U regular insulin and 9 U NPH. C. 10 U regular insulin and 20 U NPH. D. 20 U regular insulin and 10 U NPH. 21. A client with diabetes mellitus has a prescription for 5 U of U-100 regular insulin and 25 U of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms? A. Hyperglycemia B. Hypoglycemia C. Hyperuricemia D. Hypochondria 22. A client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse would be most accurate in stating: A. "The test needs to be repeated following a 12-hour fast." B. "It looks like you aren't following the prescribed diabetic diet." C. "It tells us about your sugar control for the last 3 months." D. "Your insulin regimen needs to be altered significantly." 23. A client with diabetes mellitus must learn how to self-administer insulin. The physician has prescribed 10 U of U-100 regular insulin and 35 U of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction? A. "Inject insulin into healthy tissue with large blood vessels and nerves." B. "Rotate injection sites within the same anatomic region, not among different regions." C. "Administer insulin into areas of scar tissue or hypotrophy whenever possible." D. "Administer insulin into sites above muscles that you plan to exercise heavily later that day." 24. A client tells the nurse that she has been working hard for the last 3 months to control her type 2 diabetes mellitus with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check: A. urine glucose level. B. fasting blood glucose level. C. serum fructosamine level. D. glycosylated hemoglobin level. 25. A nurse administers glucagon to her diabetic client, then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon? A. Oral anticoagulants B. Anabolic steroids C. Beta-adrenergic blockers D. Thiazide diuretics 26. Laboratory studies indicate a client's blood glucose level is 185 mg/dl. Two hours have passed since the client ate breakfast. Which test would yield the most conclusive diagnostic information about the client's glucose utilization? A. A. A fasting blood glucose test B. A 6-hour glucose tolerance test C. A test of serum glycosylated hemoglobin (Hb A1c) D. A test for urine ketones 27. The nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare to absorption at other sites? A. Insulin is absorbed more slowly at abdominal injection sites than at other sites. B. Insulin is absorbed rapidly regardless of the injection site. C. Insulin is absorbed more rapidly at abdominal injection sites than at other sites. D. Insulin is absorbed unpredictably at all injection sites. 28. A diabetic client develops sinusitis and otitis media accompanied by a fever of 100.8° F (38.2° C). What effect may this have on his need for insulin? A. It will have no effect. B. It will decrease the need for insulin. C. It will increase the need for insulin. D. It will cause wide fluctuations in the need for insulin. 29. A client with diabetes mellitus has just been prescribed insulin. When teaching the client about hypoglycemia, the nurse should mention that this reaction may cause: A. polyuria, fatigue, and headache. B. nervousness, diaphoresis, and confusion. C. polydipsia, pallor, and irritability. D. polyphagia and flushed, dry skin. 30. The nurse administered neutral protamine Hagedorn (NPH) insulin to a diabetic client at 7 a.m. At what time would the nurse expect the client to be most at risk for a hypoglycemic reaction? A. 10 a.m. B. Noon C. 4 p.m. D. 10 p.m. 31. When teaching a client about insulin administration, the nurse should include which instruction? A. "Administer insulin after the first meal of the day." B. "Inject insulin at a 45-degree angle into the deltoid muscle." C. "Shake the insulin vial vigorously before withdrawing the medication." D. "Draw up clear insulin first when mixing two types of insulin in one syringe." 32. Which instruction about insulin administration should the nurse give to a client? A. "Always follow the same order when drawing the different insulins into the syringe." B. "Shake the vials before withdrawing the insulin." C. "Store unopened vials of insulin in the freezer at temperatures well below freezing." D. 65 "Discard the intermediate-acting insulin if it appears cloudy." 33. Which of the following instructions should be included in the teaching plan for a client requiring insulin? A. Administer insulin after the first meal of the day. 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B. Administer insulin at a 45-degree angle into the deltoid muscle. C. Shake the vial of insulin vigorously before withdrawing the medication. D. Draw up clear insulin first when mixing two types of insulin in one syringe. 34. The nurse expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which other laboratory finding should the nurse anticipate? A. Elevated serum acetone level B. Serum ketone bodies C. Serum alkalosis D. Below-normal serum potassium level 35. A client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide (Tolinase). Which of the following is the most important laboratory test for confirming this disorder? A. Serum potassium level B. Serum sodium level C. Arterial blood gas (ABG) values D. Serum osmolarity 36. Which nursing diagnosis is most appropriate for a client with Addison's disease? A. Risk for infection B. Excessive fluid volume C. Urinary retention D. Hypothermia 37. A client with a history of Addison's disease and hydrocortisone flulike symptoms accompanied by nausea and vomiting over the past week is brought to the facility. When he awoke this morning, his wife noticed that he acted confused and was extremely weak. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. Which of the following would the nurse expect to administer by I.V. infusion? A. Insulin B. Hydrocortisone C. Potassium D. Hypotonic saline 38. The nurse is planning care for a 52-year-old male client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority? A. Risk for infection B. Decreased cardiac output C. Impaired physical mobility D. Imbalanced nutrition: Less than body requirements 39. The nursing care for the client in addisonian crisis should include which of the following interventions? A. Encouraging independence with activities of daily living (ADLs) B. Allowing ambulation as tolerated C. Offering extra blankets and raising the heat in the room to keep the client warm D. Placing the client in a private room 40. The adrenal cortex is responsible for producing which substances? A. Glucocorticoids and androgens B. Catecholamines and epinephrine C. Mineralocorticoids and catecholamines D. Norepinephrine and epinephrine 41. Following a unilateral adrenalectomy, the nurse would assess for hyperkalemia shown by which of the following? A. Muscle weakness B. Tremors C. Diaphoresis D. Constipation 42. A client with addison’s disease is prescribed prednisone (Deltasone) daily. Which statement best explains why the nurse should instruct the client to take this drug in the morning? A. Taking the drug at the same time every day establishes a regular routine, reducing the risk of forgetting a dose. B. Prednisone has a longer half-life with morning administration, making it more effective. C. Morning administration of prednisone mimics the body's natural corticosteroid secretion pattern. D. Prednisone is best absorbed when taken on an empty stomach first thing in the morning. 43. A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of: A. calcium and phosphorus abnormalities. B. chloride and magnesium abnormalities. C. sodium and chloride abnormalities. D. sodium and potassium abnormalities. 44. A client is admitted to the health care facility for evaluation for Addison's disease. Which laboratory test result best supports a diagnosis of Addison's disease? A. Blood urea nitrogen (BUN) level of 12 mg/dl B. Blood glucose level of 90 mg/dl C. Serum sodium level of 134 mEq/L D. Serum potassium level of 5.8 mEq/L 45. The nurse is caring for a client in acute addisonian crisis. Which laboratory data would the nurse expect to find? A. Hyperkalemia B. Reduced blood urea nitrogen (BUN) C. Hypernatremia D. Hyperglycemia 46. When teaching a client with Cushing's syndrome about dietary changes, the nurse should instruct the client to increase intake of: A. fresh fruits. B. dairy products. C. processed meats. D. cereals and grains. 47. A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which of the following glands? A. Adrenal cortex B. Pancreas C. Adrenal medulla D. Parathyroid 48. The nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find: A. hypotension. B. hyperpigmentation of the skin. C. deposits of adipose tissue in the trunk and dorsocervical area. D. weight gain in arms and legs. 49. A client with Cushing's syndrome is admitted to the medical-surgical unit. During the admission assessment, the nurse notes that the client is agitated and irritable, has poor memory, reports loss of appetite, and appears disheveled. These findings are consistent with which problem? A. Depression B. Neuropathy C. Hypoglycemia D. Hyperthyroidism 50. Which of the following laboratory test results would suggest to the nurse that a client has a corticotropin-secreting pituitary adenoma? A. High corticotropin and low cortisol levels B. Low corticotropin and high cortisol levels C. High corticotropin and high cortisol levels D. Low corticotropin and low cortisol levels TOP RANK REVIEW ACADEMY, INC. Page 3 | 3