Med-Surg Endocrine

Front 1

A pt with DM has a hemoglobin A1C level of 9%. Based on this test result, the nurse planes to teach the pt about the need to:
1)Avoid infection
2)Take in adequate fluids
3)Prevent and recognize hypoglycemia
4)Prevent and recognize hyperglycemia

Back 1

4)Prevent and recognize hyperglycemia; 7% or less indicates good control, 7-8% indicates fair control, 8% or higher indicates poor control

Front 2

A nurse is preparing a teaching plan for a pt with DM regarding proper foot care. Which instruction is included in the plan?
1)Soak feet in hot H20
2)Avoid using a mild soap on the feet
3)Apply a moisturizing lotion to dry feet but not b/t the toes
4)Alway have a podiatrist cut your toenails; never cut them yourself

Back 2

3)Apply a moisturizing lotion to dry feet but not b/t the toes

Front 3

A pt is brought to the ER in an unresponsive state, & a dx of hyperglycemic hyperosmolar nonketotic syndrome is made. The nurse would immediately prepare to initiate which of the following anticipated MD orders?
1)Endotracheal intubation
2)100 units of NPH insulin
3)IV infusion of NS
4)IV infusion of sodium bicarbonate

Back 3

3)IV infusion of normal saline
the primary goal of tx in HHNS is to rehydrate the pt to restore fluid volume and to correct electrolyte deficiency

Front 4

An external insulin pump is prescribed for a pt with DM and the pt asks the nurse about the fxing of the pump. The nurse bases the response on the information that the pump:
1)Is timed release programmed doses of regular or NPH insulin into the bloodstream @ specific intervals
2)Continuously infuses sm amts of NPH insulin into the bldstream while regularly monitoring bld glucose levels
3)Is surgically attached to the pancreas and infuses regular insulin into the pancrea, which in turn releases the insulin into the bldstream
4)Gives a sm continuous dose of reg insulin SQ, and the pt can self-administer a bolus with an additional dose from the pump before each meal

Back 4

4)Gives a sm continuous dose of reg insuline SQ & the pt can self administer a bolus with a additional dose before each meal

Front 5

A pt newly dx with DM has been stabilized with daily insulin injections. A nurse prepares a discharge teaching plan regarding the insulin and plans to reinforce which of the following concepts?
1)Always keep insulin vials refrigerated
2)Ketones in the urine signify a need for less insulin
3)Increase the amt of insulin before unusual exercise
4)systematically rotate insulin injections within one anatomic site

Back 5

4)Systematically rotate insulin injections within one anatomic site

Front 6

A pt with a dx of DKA is being treated in the ER. Which finding would a nurse expect to note as confirming this dx?

Back 6

Elevated bld glucose level and low plasma bicarbonate level

Front 7

A nurse teaches a pt with DM about differentiating b/t hypoglycemia and ketoacidosis. The pt demostrates an understanding of teaching by that glucose will be taken if which of the following symptoms develop
1)polyuria
2)shakiness
3)blurred vision
4)fruity breath odor

Back 7

2)shakiness

Front 8

A pt with DM demostrates acute anxiety when first admitted for the tx of hyperglycemia. The appropriate intervention to decrease the pts is to:

Back 8

Convey empaty, trust, and respect toward the pt

Front 9

A nurse provides instructions to a pt newly dxd with type 1 DM. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the pt states
1)I will stop taking my insuling if i'm to sick to eat
2)I will decrease my insulin dose during time of illness
3)I will adjust my insulin dose according to the level of glucose in my urine
4)I will notify my MD if my bld glucose level is higher than 250mg/dL

Back 9

4)I will notify my MD if my bld glucose level is higher than 250mg/dL

Front 10

A pt is admitted to a hospital with a dx of DKA. The initial bld glucose level was 950. A continuous IV infusion of reg insulin is initiated, along with IV rehydration with NS. The serum glucose level is now 240. The nurse would prepare to administer which of the following?
1)Ampule of 50% dextrose
2)NPH insulin SQ
3)IV fluids containing 5% dextrose
4)Phenytoin(Dilantin) for the prevention of seizures

Back 10

3)IV fluids containing 5% dextrose

Front 11

A MD has prescribed propylthiouracil (PTU) for a pt with hyperthyroidism and the nurse develops a plan of care for the pt. A priority nursing assessment to included in the plan regarding this medication is to assess for:
1)Relief of pain
2)Signs of renal toxicity
3)S/S of hyperglycemia
4)S/S of hypothyroidism

Back 11

4)s/s of hypothyroidism

Front 12

A nurse develops a plan of care of a pt with hyperparathyroidism who is receiving calcitonin salmon (Calcimar). Which of the following outcome criteria has the highest priority regarding this medication?
1)relief of pain
2)absence of side effects
3)achievement of normal serum calcium levels
4)verbalization of appropriate medication knowledge

Back 12

3)Achievement of normal serum calcium levels

Front 13

A MD prescribes levothyroxine sodium (Synthroid), 0.15 mg QD, for a pt with hypothyroidism. The nurse will prepare to administer this medication when

Back 13

In the morning to prevent insomnia

Front 14

A nurse is monitoring a pt with diabetes insipidus and desmopressin acetate (DDAVP) has been prescribed for the pt. What would indicate a therapeutic effect of this medication?

Back 14

Decreased urine output

Front 15

A nurse is monitoring a pt newly dxd with DM of signs of complications. What would incdicate hyperglycemia and warrant DM notification?

Back 15

Polyuria