Ssc 2014 Basic Med Surg Study Guide Test 1

Front 1

A patient has a peripherally inserted central catheter (PICC) inserted and is ordered to receive IV cisplatin (Plantinol). The drug has infiltrated into the tissue and redness is observed in the right lower side of the neck. What interventions, in order of priority, will the nurse perform? (Select in order of priority.)
a. Apply cold compress to the side of swelling
b. Stop the infusion and disconnect the IV line from the administration set
c. Aspirate the drug from the IV access device
d. Monitor the patient and document

Back 1

b. Stop the infusion and disconnect the IV line from the administration set.
c. Aspirate the drug from the IV access device.
a. Apply cold compress to the side of swelling.
d. Monitor the patient and document.

Front 2

The nurse is preparing to give a patient IV drug therapy. What information does the nurse need before administering the drug?
(select all that apply)
a. indications, contraindications, and precautions for IV therapy
b. appropriate dilution, pH, and osmolarity of solution
c. rate of infusion and dosage of drugs
d. generic, chemical, and brand name of the drug
e. compatibility with other IV medications
f. percentage of adverse event for the drug
g. specifics of monitoring because of immediate effect

Back 2

a. indications, contraindications, and precautions for IV therapy.
b. appropriate dilution, pH, and osmolarity of solution.
c. rate of infusion and dosage of drugs.
e. compatibility with other IV medications.
g. specifics of monitoring because of immediate effect.

Front 3

The charge nurse is reviewing IV therapy orders. What information is included in each order?
(select all that apply)
a. specific type of solution
b. rate of administration
c. specific drug dose to be added to the solution
d. method for diluting drugs for the solution
e. specific type of administration equipment

Back 3

a. specific type of solution
b. rate of administration
c. specific drug dose to be added to the solution

Front 4

The nurse is supervising a student nurse who is preparing an IV bag with IV administration tubing. Which action by the student nurse causes the nurse to intervene?
a. the student touches the drip chamber
b. the sterile cap from the distal end of the set is removed
c. the distal end is attached to a needleless connector
d. the student touches the tubing spike

Back 4

d. the student touches the tubing spike.

Front 5

Which patient is the most likely candidate for a tunneled central venous catheter?
a. patient with trauma from a motor vehicle accident
b. patient in need of IV antibiotics for several weeks
c. patient in need of permanent parental nutrition
d. patient in need of intermittent chemotherapy

Back 5

c. patient in need of permanent parental nutrition

Front 6

The nurse is helping the physician insert a central line when the patient develops chest pain and shortness of breath with decreased breath sounds and restlessness. What does the nurse do next?
a. tell the pt "relax, the procedure will soon be over" and administer pain medication
b. administer pain medication to minimize the pain of insertion and order a stat chest x-ray.
c.administer oxygen, remove the catheter, place an occlusive dressing, and order a stat chest x-ray.
d. monitor ongoing pulse oximetry and respiratory changes after placing an occlusive dressing over the catheter site.

Back 6

c.administer oxygen, remove the catheter, place an occlusive dressing, and order a stat chest x-ray.

Front 7

Which nursing interventions are key in preventing an infection in a patient with a central line? (select all that apply)
a. Assess the dressing and insertion site of the central line.
b. Use aseptic technique when administering medications and changing tubing.
c. Change the catheter every 72 hours and tubing every 24 hours.
d. Monitor the patient's temperature for any elevation and give acetaminophen as needed.
e. Use sterile technique when inserting a central line
f. Use proper hand washing and non-sterile gloves before coming into contact with a central line

Back 7

b. Use aseptic technique when administering medications and changing tubing.
e. Use sterile technique when inserting a central line.
f. Use proper hand washing and non-sterile gloves before coming into contact with a central line.

Front 8

Which safety measures does the nurse apply to decease the risk of catheter-related bloodstream infection (CR-BSI) related to needleless systems?(select all that apply)
a. Clean needleless system connections vigorously every 24 hours.
b. Do not tape connections between tubing sets.
c. Use evidence-based hand hygiene guidelines from the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA).
d. Attend educational offerings to prevent or minimize CR-BSI.
e. Use needleless systems only when necessary.
f. Discard needleless equipment in a biohazard container

Back 8

b. Do not tape connections between tubing sets.
c. Use evidence-based hand hygiene guidelines from the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA).
d. Attend educational offerings to prevent or minimize CR-BSI.

Front 9

A patient is receiving IV therapy via an infusion pump. What is a nursing responsibility related to the therapy and equipment?
a. Count the number of drops per minute.
b. Monitor the patient's infusion site and rate.
c. Check the equipment at the end of the infusion.
d. Position the container for gravity flow.

Back 9

b. Monitor the patient's infusion site and rate.

Front 10

The nurse is assessing the patient's IV insertion site. What features does the nurse look for in the assessment? (select all that apply)
a. Observe for redness and swelling
b. Check that the dressing is clean and dry.
c. Ensure that the dressing is adherent to the skin.
d. Observe for yellow discoloration.
e. Observe for hardness or drainage.

Back 10

a. Observe for redness and swelling
b. Check that the dressing is clean and dry.
c. Ensure that the dressing is adherent to the skin.
e. Observe for hardness or drainage.

Front 11

A patient's central venous IV site is covered with a transparent membrane dressing. How often does the nurse change this dressing?
a. Every 24 hours.
b. Every 48 hours.
c. At least every 7 days
d. The dressing does not need changing.

Back 11

c. At least every 7 days

Front 12

The nurse is caring for a patient with a central venous catheter. What measures does the nurse use to present air emboli when changing the administration set or connectors? (select all that apply).
a. The patient lies flat so the catheter site is beow the heart.
b. Use the pinch clamp that can be closed during the procedure.
c. Use sterile technique when handling the equipment.
d. have an assistant apply pressure at the insertion site.
e. Ask the patient to perform the Valsalva maneuver by holding the breath and bearing down.

Back 12

a. The patient lies flat so the catheter site is beow the heart.
b. Use the pinch clamp that can be closed during the procedure.
e. Ask the patient to perform the Valsalva maneuver by holding the breath and bearing down.

Front 13

After assessing the patency of the patient's IV catheter, the nurse attempts to flush the catheter and meets resistance. What does the nurse do next?
a. Get a larger-sized syringe and repeat the flush attempt.
b. Use a heparinized solution and repeat the flush attempt.
c. Gently force-flush the catheter using the push-pause method.
d. stop the flush attempt and discontinue the IV.

Back 13

d. stop the flush attempt and discontinue the IV.

Front 14

The nurse is flushing a patient's short peripheral IV catheter. What does the nurse typically use for this procedure?
a. 3 mL of normal saline
b. 5 mL of heparin
c. 10 mL of normal saline
d. 30 mL of bacteriostatic saline

Back 14

a. 3 mL of normal saline

Front 15

Place the steps of removing a peripheral catheter in the proper order.
a. Hold pressure on the sit until hemostasis is achieved.
b. Immediately cover the puncture site with dry gauze.
c. Assess the catheter tip to make sure it is intact and completely removed.
d. Slowly withdraw the catheter from the skin.
e. Lift opposite sides of the transparent dressing.
f. Document catheter removal and the apearance of the IV site.
g. Pull laterally to remove the dressing from the site while stabilizing the catheter.

Back 15

1. e. Lift opposite sides of the transparent dressing.
2. g. Pull laterally to remove the dressing from the site while stabilizing the catheter.
3. d. Slowly withdraw the catheter from the skin.
4. b. Immediately cover the puncture site with dry gauze.
5. a. Hold pressure on the sit until hemostasis is achieved.
6. c. Assess the catheter tip to make sure it is intact and completely removed.
7. f. Document catheter removal and the apearance of the IV site.

Front 16

The nurse is assessing a short peripheral catheter after removal and it appears that the catheter tip is missing. What does the nurse do next?
a. Notify the health car provider.
b. Assess the patient for symptoms of emboli.
c. Apply firm pressure to the insertion site.
d. Assess the extremity for coldness, cyanosis, or numbness

Back 16

b. Assess the patient for symptoms of emboli.

Front 17

A patient has a local complication from a peripheral IV access with 0.9% normal saline infusing at 100 mL/hour. What does the nurse assess at the insertion site? (select all that apply).
a. Blood returns in the catheter when nurse draws back on the IV access.
b. A red streak is present proximal to the site.
c. Edema is present proximal to the site.
d. A scant amount of blood is noted beneath the clear dressing at the site.
e. The Iv fluids are not infusing

Back 17

b. A red streak is present proximal to the site.
c. Edema is present proximal to the site.
e. The IV fluids are not infusing

Front 18

Which statement is true about insulin?
a. It is secreted by alpha cells i the islets of Langerhans
b. It is a catabolic horome that builds up glucagon reserves.
c. It is necessary for glucose transport across cell membranes.
d. It is stored in muscles and converted to fat for storage.

Back 18

c. It is necessary for glucose transport across cell membranes.

Front 19

Why is glucose vital to the body's cells?
a. It is used to build cell membranes.
b. It is used by cells to produce energy.
c. It affects the process of protein metabolism.
d. It provides nutrients for genetic material.

Back 19

b. It is used by cells to produce energy.

Front 20

A patient with diabetes presents to the emergency department with a blood sugar of 640 mg/dL and reports being constantly thirsty and having to urinate "all of the time." How does the nurse document this subjective finding?
a. Polydipsia and polyphagia
b. Polydipsia and polyuria
c. Polycoria and polyuria
d. Polyphagia and polyesthesia.

Back 20

b. Polydipsia and polyuria

Front 21

Which cultures tend to have a higher incidence of diabetes mellitus (DM)? (Select all that apply.)
a. Mexican American
b. African American
c. Caucasian
d. American Indian
e. Eastern European

Back 21

a. Mexican American
b. African American
d. American Indian

Front 22

According to the American Diabetes Association (ADA), which laboratory finding is most indicative of DM?
a. Fasting blood glucose = 80 mg/dL
b. 2-hour postprandial blood glucose = 110 mg/dL
c. 1-hour glucose tolerance blood glucose = 110mg/dL
d. 2-hour glucose tolerance blood glucose = 210 mg/dL

Back 22

d. 2-hour glucose tolerance blood glucose = 210 mg/dL

Front 23

In a patient with hyperglycemia, the respiratory center is triggered in an attempt to excrete more carbon dioxide and acid, thus causing a rapid and deep pattern. What is the term for this respiratory pattern?
a. Tachypnea
b. Cheyne-Strokes respiration
c. Kussmaul respiration
d. Biot respiration

Back 23

c. Kussmaul respiration

Front 24

In determining if a patient is hypoglycemic, the nurse looks for which characteristic in addition to checking the patient's blood glucose? (Select all that apply.)
a. Nausea
b. Hunger
c. Irritability
d. Palpations
e. Profuse perspiration
f. Rapid, deep respirations

Back 24

b. Hunger
c. Irritability
d. Palpations
e. Profuse perspiration

Front 25

Glucagon is used primarily to treat the patient with which disorder?
a. DKA
b. Idiosyncratic reaction to insulin
c. Severe hypoglycemia
d. HHNS

Back 25

c. Severe hypoglycemia

Front 26

Which statements about type 1 DM are accurate? (Select all that apply.)
a. It is an autoimmune disorder.
b. Most people with type 1 DM are obese.
c. Age of onset is typically younger than 30.
d. People with type 2 DM have insulin resistance.
e. It can be treated with oral antidiabetic medications and insulin

Back 26

a. It is an autoimmune disorder.
c. Age of onset is typically younger than 30.
d. People with type 2 DM have insulin resistance.

Front 27

Which statements about type 2 DM are accurate? (Select all that apply.)
a. It peaks at about the age of 50.
b. Most people with type 2 DM are obese.
c. It typically has an abrupt onset.
d. People with type 2 DM have insulin resistance.
e. It can be treated with oral anti diabetic medications and insulin.

Back 27

a. It peaks at about the age of 50.
b. Most people with type 2 DM are obese.
d. People with type 2 DM have insulin resistance.
e. It can be treated with oral anti diabetic medications and insulin.

Front 28

Which are modifiable risk factors for type 2 diabetes mellitus? (Select all that apply.)
a. Age
b. Family history
c. Working in low-stress environment
d. Maintaining ideal body weight
e. Maintaining adequate physical activity

Back 28

d. Maintaining ideal body weight
e. Maintaining adequate physical activity

Front 29

Which class of anti-diabetic medication should be taken with the first bite of a meal to be fully effective?
a. Alpha-glucosidase inhibitors, which include miglitol (Glyset)
b. Biguanides, which include metoformin (Glucophage)
c. Meglitinides, which include nateglinide (starlix)
d. sulfonylureas, which include chlorpromadine (Diabinese)

Back 29

a. Alpha-glucosidase inhibitors, which include miglitol (Glyset)

Front 30

Which class of antidiabetic medication must be held for 48 hours if the patient is having an x-ray with iodinated contrast materials?
a. Alpha-glucosidase inhibitors, which include miglitol (Glyset)
b. Biguanides, which include metoformin (Glucophage)
c. Meglitinides, which include nateglinide (Starlix)
d. Sulfonylureas, which include chlorpromadine (Diabinese)

Back 30

b. Biguanides, which include metoformin (Glucophage)

Front 31

Which class of anti-diabetic medication is most likely to cause a hypoglycemic episode because of the long duration of action?
a. Alpha-glucosidase inhibitors, which include miglitol (Glyset)
b. Biguanides, which include metoformin (Glucophage)
c. Meglitinides, which include nateglinide (Starlix)
d. Sulfonylureas, which include chlorpromadine (Diabinese)

Back 31

d. Sulfonylureas, which include chlorpromadine (Diabinese)

Front 32

Which class of anti-diabetic medication should be given 1-30 minutes before meals?
a. Alpha-glucosidase inhibitors, which include miglitol (Glyset)
b. Biguanides, which include metoformin (Glucophage)
c. Meglitinides, which include nateglinide (Starlix)
d. Sulfonylureas, which include chlorpromadine (Diabinese)

Back 32

c. Meglitinides, which include nateglinide (Starlix)

Front 33

Which statement about insulin administration is correct?
a. Insulin may be given orally, intravenously, or subcutaneously.
b. Insulin injections should be spaed no closer than one-half inch apart
c. Rotating injection sites improves absorption and prevents lipohypertrophy.
d. In a mixed-dose protocol, the longer-acting insulin should be withdrawn first.

Back 33

c. Rotating injection sites improves absorption and prevents lipohypertrophy.

Front 34

A diabetic patient is on a mixed-dose insulin protocol of 8 units regular insulin and 12 units NPH insulin at 7 AM. At 10:30 AM, the patient reports feeling uneasy, shaky, and has a headache. Which is the probable explanation for this?
a. The NOH insulin's action is peaking, and there is an insufficient blood glucose level.
b. The regular insulin's action is peaking, and there is an insufficient blood glucose level.
c. The patient cosumed too many calories at breakfast and now has an elevated blood glucose level.
d. The symptoms are unrelated to the insulin administered in the early morning or diet taken in at lunchtime.

Back 34

b. The regular insulin's action is peaking, and there is an insufficient blood glucose level.

Front 35

A 47-year-old patient with a history of type 2 DM and emphysema that reports smoking three packs of cigarettes per day is admitted to the hospital with a diagnosis of acute pneumonia. The patient is placed on the regular oral anti-diabetic agents, sliding scale insulin, and antibiotic medications. On day 2 of hospitalization, the health care providers orders prednisone therapy. What does the nurse expect the blood glucose to do?
a. Decrease
b. Stay the same
c. Increase
d. Return to normal

Back 35

c. Increase

Front 36

Which laboratory test is the best indicator of a patient's average blood glucose level and/or compliance with the DM regimen over the last 3 months?
a. Postprandial blood glucose tet
b. Oral glucose tolerance test (OGTT)
c. Casual blood glucose test
d. Glycosylated hemoglobin (HbA1c)

Back 36

d. Glycosylated hemoglobin (HbA1c)

Front 37

Which insulins are considered to have a rapid onset of action? (Select all that apply.)
a. Novolin 70/30
b. Glulisine
c. Humulin N
d. Aspart
e. Lispro

Back 37

b. Glulisine
d. Aspart
e. Lispro

Front 38

A patient with type 2 DM, usually controlled with a sulfonylurea, develops a urinary tract infection. Due to the stress of the infection, the patient must be treated with insulin. What additional information about this treatment does the nurse relay to the patient?
a. The sulfonylurea must be discontinued and insulin taken until the infection clears.
b. Insulin will now be necessary to control the patient'a diabetes for life.
c. The sulfonylurea dose must be reduced until the infection clears.
d. The insulin is necessary to supplement the sulfonylurea until the infection clears.

Back 38

d. The insulin is necessary to supplement the sulfonylurea until the infection clears.

Front 39

Neovascularization is a
a. Nephropathy
b. Neuropathy
c. Retinopathy

Back 39

c. Retinopathy

Front 40

End-stage kidney disease is a
a. Nephropathy
b. Neuropathy
c. Retinopathy

Back 40

a. Nephropathy

Front 41

Muscle weakness is a
a. Nephropathy
b. Neuropathy
c. Retinopathy

Back 41

b. Neuropathy

Front 42

Proteinuria is a
a. Nephropathy
b. Neuropathy
c. Retinopathy

Back 42

a. Nephropathy

Front 43

Hemorrhage into the eye is a
a. Nephropathy
b. Neuropathy
c. Retinopathy

Back 43

c. Retinopathy

Front 44

Pain or numbness is a
a. Nephropathy
b. Neuropathy
c. Retinopathy

Back 44

b. Neuropathy

Front 45

Hard exudate deposits is a
a. Nephropathy
b. Neuropathy
c. Retinopathy

Back 45

c. Retinopathy

Front 46

Permanent blindness is a
a. Nephropathy
b. Neuropathy
c. Retinopathy

Back 46

c. Retinopathy

Front 47

Which statements about sensory alteration in patients with diabetes are accurate? (Select all that apply.)
a. Healing of foot wounds is reduced because of impaired sensation.
b. Very few patients with diabetic foot ulcers have peripheral sensory neuropathy.
c. Loss of pain, pressure, and temperature sensation increase in the foot increases the risk for injury.
d. Sensory neuropathy causes loss of normal sweating and skin temperature regulation.
e. It can be delayed by keeping the blood glucose level as close to normal as possible.

Back 47

c. Loss of pain, pressure, and temperature sensation increase in the foot increases the risk for injury.
d. Sensory neuropathy causes loss of normal sweating and skin temperature regulation.
e. It can be delayed by keeping the blood glucose level as close to normal as possible.

Front 48

In developing an individualized meal plan for a patient with diabetes, which goals are the focus of the plan? (Select all that apply.)
a. Maintaining blood glucose levels at or as close to the normal range as possible.
b. Patient food preferences.
c. Allowing patients to eat as much as they desire.
d. Patient cultural preferences
e. Limiting food choices only when guided by specific evidence.

Back 48

a. Maintaining blood glucose levels at or as close to the normal range as possible.
b. Patient food preferences.
d. Patient cultural preferences
e. Limiting food choices only when guided by specific evidence.

Front 49

What is the basic principle of meal planing for a patient with type 1 DM?
a. Five small meals per day plus a bedtime snack.
b. Taking extra insulin when planning to eat sweet foods.
c. High-protein, low-carboydrate, and low-fiber foods
d. Considering the effects and peak action times of the patient's insulin.

Back 49

d. Considering the effects and peak action times of the patient's insulin.

Front 50

The nurse is teaching a patient with diabetes about proper foot care. Which instructions does the nurse include? (Select all that apply.)
a. Use rubbing alcohol to toughen the skin on the soles of the foot.
b. Wear open-toed shoes or sandals in warm weather to prevent perspiration.
c. Apply moisturizing cream to the feet after bathing, but not between the toes.
d. Use cold water for bathing the feet to prevent inadvertent thermal injury.
e. Do not go barefoot.
f. Inspect your feet daily.

Back 50

c. Apply moisturizing cream to the feet after bathing, but not between the toes.
e. Do not go barefoot.
f. Inspect your feet daily.

Front 51

A 25-year-old female patient with type 1 diabetes tells the nurse, "I have two kidneys and I'm still young. I expect to be around for a long time, so why should I worry about my blood sugar?" What is the nurse's best response?
a. "You have little to worry about as long as your kidneys keep making urine."
b. "You should discuss this with your physician because you are being unrealistic."
c. "You would be right if your diabetes was managed with insulin."
d. "Keeping your blood sugar under control now can help to prevent damage to both kidneys."

Back 51

d. "Keeping your blood sugar under control now can help to prevent damage to both kidneys."

Front 52

A patient with insulin-dependent diabetes is planning to travel by air and asks the nurse about preparations for the trip. What does the nurse tell the patient to do.
a. Pack insulin and syringes in a labeled, crushproof kit in the checked luggage.
b. Carry all necessary diabetes supplies in a clearly identified pack aboard the plane.
c. Ask the flight attendant to put the insulin in the galley refrigerator once on the plane.
d. Take only minimal supplies and get the prescription filled at his or her destination.

Back 52

b. Carry all necessary diabetes supplies in a clearly identified pack aboard the plane.

Front 53

A patient has been diagnosed with diabetes. Which aspects does the nurse consider in formulating the teaching plan for this patient? (Select all that apply.)
a. Covering all needed information in one teaching session.
b. Assessing visual impairment regarding insulin labels and markings on syringes.
c. Assessing manual dexterity to determine if the patient is able to draw insulin into a syringe.
d. Assessing patient motivation to learn an comprehend instructions.
e. Assessing the patient's ability to read printed material.

Back 53

b. Assessing visual impairment regarding insulin labels and markings on syringes.
c. Assessing manual dexterity to determine if the patient is able to draw insulin into a syringe.
d. Assessing patient motivation to learn an comprehend instructions.
e. Assessing the patient's ability to read printed material.

Front 54

Which are signs and symptoms of mild hypoglycemia? (Select all that apply.)
a. Headache
b. Weakness
c. Cold, clammy skin
d. Irritability
e. Pallor
f. Tachycardia

Back 54

a. Headache
b. Weakness
d. Irritability

Front 55

The nurse is preparing to administer 20 units of NPH insulin (Humulin N) along with 6 units of regular insulin (Humulin R) to a patient with diabetes. How does the nurse prepare the injection? Place the steps in order using the numbers 1 through 7.)
a. Gently roll the NPH insulin vial in the hands.
b. Wash hands.
c. Wipe off the tops of the insulin vials with an alcohol pad.
d. Inject 20 units of air into the NPH insulin vial.
e. Invert the regular insulin vial and withdraw 8 units of insulin.
f. Invert the NPH insulin vial and withdraw 20 units of insulin.
g. Inject 8 units of air into the regular insulin vial.

Back 55

1. b. Wash hands.
2. a. Gently roll the NPH insulin vial in the hands.
3. c. Give a complex carbohydrate and continue to monitor the patient.
4. d. Inject 20 units of air into the NPH insulin vial.
5. g. Inject 8 units of air into the regular insulin vial.
6. e. Invert the regular insulin vial and withdraw 8 units of insulin.
7. f. Invert the NPH insulin vial and withdraw 20 units of insulin.

Front 56

A patient with diabetes has signs and symptoms of hypoglycemia. The patient is alert and oriented with a blood glucose of 56mg/dL. What does the nurse do next?
a. Give a glass of orange juice with two packets of sugar and continue to monitor the patient.
b. Give 8 oz of skim milk and then a carbohydrate and protein snack.
c. Give a complex carbohydrate and continue to monitor the patient.
d. Administer D50 IV push and give the patient something to eat.

Back 56

b. Give 8 oz of skim milk and then a carbohydrate and protein snack.

Front 57

A patient with diabetes has signs and symptoms of hypoglycemia. The patient has a blood glucose of 56mg/dL, is not alert but responds to voice, and is confused and is unable to swallow fluids. What does the nurse do next?
a. Give a glass of orange juice with two packets of sugar and continue to monitor the patient.
b. Give a glass of orange or other type of juice and continue to monitor the patient.
c. Give a complex carbohydrate and continue to monitor the patient.
d. Administer D50 IV push.

Back 57

d. Administer D50 IV push.

Front 58

This type of insulin does not have a peak time.
a. Insulin glargine (Lantus).
b. Regular insulin.
c. NPH insulin.

Back 58

a. Insulin glargine (Lantus).

Front 59

This type of insulin is a long-acting insulin analogue given once daily for basal insulin coverage.
a. Insulin glargine (Lantus).
b. Regular insulin.
c. NPH insulin.

Back 59

a. Insulin glargine (Lantus).

Front 60

When mixing insulins, this type is always drawn up first.
a. Insulin glargine (Lantus).
b. Regular insulin.
c. NPH insulin.

Back 60

b. Regular insulin.

Front 61

This type of insulin should be given 30 minutes before meals.
a. Insulin glargine (Lantus).
b. Regular insulin.
c. NPH insulin.

Back 61

b. Regular insulin.

Front 62

This type of insulin should not be diluted or mixed with any other insulin solution.
a. Insulin glargine (Lantus).
b. Regular insulin.
c. NPH insulin.

Back 62

a. Insulin glargine (Lantus).

Front 63

The nurse is assessing a patient's urine specific gravity. The value is 1.035. How does the nurse interpret this result?
a. Overhydration
b. Dehydration
c. Normal value for an adult
d. Renal disease

Back 63

b. Dehydration

Front 64

Normal Plasma value is 3.5 to 5.0 mEq/L.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 64

b. Potassium.

Front 65

Major anion of extracellular fluid (ECF).
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 65

f. Chloride.

Front 66

Normal value is 98 to 106 mEq/L.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 66

f. Chloride.

Front 67

Main cation in ECF of the cell maintains ECF osmolarity.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 67

a. Sodium.

Front 68

Works in balance with calcium.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 68

d. Phosphorus.

Front 69

Normal plasma value is 136 to 145 mEq.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 69

a. Sodium.

Front 70

Has more activity in the cell than in the blood.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 70

e. Magnesium.

Front 71

Major cation of intracellular fluid (ICF) in the cell.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 71

b. Potassium.

Front 72

Maintains action potentials in excitable membranes.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 72

b. Potassium.

Front 73

Functions include contraction of skeletal and cardiac muscle.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 73

c. Calcium.

Front 74

Normal value is 3.0 to 4.5 mg/dL.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 74

d. Phosphorus.

Front 75

Major intracellular anion.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 75

d. Phosphorus.

Front 76

Free form is physiologically active in the body.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 76

c. Calcium.

Front 77

Normal value is 1.3 to 2.1 mEq/L.
a. Sodium.
b. Potassium.
c. Calcium.
d. Phosphorus.
e. Magnesium.
f. Chloride.

Back 77

e. Magnesium.

Front 78

A newly admitted patient with congestive heart failure has a potassium level of 5.7 mEq/L. How does the nurse identify contributing factors for the electrolyte imbalance? (Select all that apply.)
a. Assess the patient for hypokalemia.
b. Obtain a list of the patient's home medications.
c. Assess the patient for hyperkalemia.
d. Ask about the patient's method of taking medications at home.
e. Evaluate the patient's appetite.

Back 78

b. Obtain a list of the patient's home medications.
c. Assess the patient for hyperkalemia.
d. Ask about the patient's method of taking medications at home.

Front 79

A patient has chronic renal failure (CRF). Which electrolyte imbalance often associate with hypocalcemia and CRF does the nurse monitor for?
a. Hypophosphatemia
b. Hyperphosphatemia
c. Hyperkalemia
d. Hyponatremia

Back 79

b. Hyperphosphatemia

Front 80

A patient's laboratory results show a decrease in serum phosphorus level. The nurse expects to see a reciprocal increased change in serum level?
a. Calcium
b. Potassium
c. Sodium
d. Magnesium

Back 80

a. Calcium

Front 81

This is the accompanying and potentially life-threatening electrolyte-imbalance that the nurse monitors for in a patient with hyperphosphatemia.

Back 81

Hypocalcemia

Front 82

A patient has a magnesium level of 0.8 mg/dL. Which treatment does the nurse expect to be ordered for his patient?
a. Intramuscular magnesium sulfate
b. Increased intake of fruits and vegetables
c. Oral preparations of magnesium sulfate
d. IV magnesium sulfate and discontinuation of diuretic therapy.

Back 82

d. IV magnesium sulfate and discontinuation of diuretic therapy.

Front 83

A patient is hospitalized with hyperglycmia and has a blood glucose of 476 mg/dL. Which events does the nurse expect to see in this patient? (Select all that apply.)
a. Hyperventilation
b. Kussmaul respirations
c. Respiratory acidosis
d. Hypotension
e. Metabolic acidosis

Back 83

b. Kussmaul respirations
d. Hypotension
e. Metabolic acidosis

Front 84

Which statement is true about tests to measure bleeding and coagulation?
a. Heparin therapy is monitored using PT levels.
b. The International Normalized Ration (INR) measures the same process as the PTT.
c. The partial thromboplastin time (PTT) assesses the extrinsic clotting cascade.
d. Platelet aggregation is tested by mixing the patient's plasma with a substance called ristocetin.

Back 84

d. Platelet aggregation is tested by mixing the patient's plasma with a substance called ristocetin.

Front 85

True or False?
Aspirin inhibits the production of substances that can trigger platelet activation such as thromboxane.

Back 85

True

Front 86

Laboratory values for a patient with acute pancreatitis may show which abnormal findings? (Select all that apply.)
a. Increased hemoglobin
b. Decreased serum amylase
c. Increased serum lipase
d. Decreased urine nitrates
e. Increased serum amylase

Back 86

c. Increased serum lipase
e. Increased serum amylase

Front 87

Structure found around cell, bacteria, protein, and clumps.
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 87

k. Cast

Front 88

Urine is normally sterile; these multiply and grow.
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 88

m. Bacteria

Front 89

Urochrome pigment.
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 89

a. Color

Front 90

1.005 to 1.030
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 90

d. Specific gravity

Front 91

Not normally in the urine.
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 91

g. Protein

Front 92

Cells, casts, crystals, and bacteria.
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 92

i. Sediment

Front 93

Various salts.
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 93

l. Crystals

Front 94

Epithelial cells, RBC, WBC, tubular cells.
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 94

j. Cells

Front 95

Not seen in urine until blood sugar above 220 mg/dL.
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 95

f. Glucose

Front 96

Cloudiness or haziness.
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 96

c. Turbidity

Front 97

Faint ammonia.
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 97

b. Odor

Front 98

What does the BUN test measure?
a. Kidney excretion of urea nitrogen
b. GFR
c. Creatinine clearance
d. Urine output

Back 98

a. Kidney excretion of urea nitrogen

Front 99

Which test is the best indicator of kidney function?
a. Urine osmolarity
b. Serum creatinine and blood urea nitrogen
c. Urinalysis and microalbuminuria
d. 24-hour urine collection

Back 99

b. Serum creatinine and blood urea nitrogen

Front 100

Less than 7 acidic, greater than 7 alkaline.
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 100

e. pH

Front 101

Only identified by microscopic examination for protein.
a. Color
b. Odor
c. Turbidity
d. Specific gravity
e. pH
f. Glucose
g. Protein
h. Microalbuminuria
i. Sediment
j. Cells
k. Cast
l. Crystals
m. Bacteria

Back 101

h. Microalbuminuria

Front 102

The free movement of solutes (electrolytes) across a membrane called _______.
Diffusion
Excess Fluid
Filtration
Fluid loss
Hydrostatic pressure
Osmolarity
Osmolarity
Osmosis

Back 102

diffusion

Front 103

In __________, water moves down its pressure gadient through a semipermeable membrane from diluted fluid to a more concentrated fluid until equilibrium occurs.
Diffusion
Excess Fluid
Filtration
Fluid loss
Hydrostatic pressure
Osmolarity
Osmolarity
Osmosis

Back 103

osmosis

Front 104

________ occurs when water crosses the capillary membrane into the interstitial space.
Diffusion
Excess Fluid
Filtration
Fluid loss
Hydrostatic pressure
Osmolarity
Osmolarity
Osmosis

Back 104

filtration

Front 105

____________ in the vascular system is the blood pressue created in the vessels by the contraction of the heart.

Back 105

hydrostatic pressure

Front 106

________ is the number of milliosmoles in a liter of solution.

Back 106

osmolarity

Front 107

________ is the number of milliosmoles in a kilogram of solution.

Back 107

osmolarity

Front 108

What findings indicate that a patient may have hypervolemia? (Select all that apply.)
a. Increased, bounding pulse
b. Jugular venous distention
c. Diminished peripheral pulses
d. Presence of crackles
e. Excessive thirst
f. Elevated blood pressure
g. Orthostatic hypotension
h. Skin pale and cool to touch

Back 108

a. Increased, bounding pulse
b. Jugular venous distention
d. Presence of crackles
f. Elevated blood pressure
h. Skin pale and cool to touch

Front 109

The difference in concentration of particles that is greater on one side of a permeable membrane than on the other side is known as what?
a. Hydrostatic pressure
b. Concentration gradient
c. Passive transport
d. Active transport

Back 109

b. Concentration gradient

Front 110

Which intake-output record represents the norm for the average adult?
a. 500 mL of fluid per day, ingesting an additional 200 mL of fluid from food.
b. 1500 mL of fluid per day, ingesting an additional 800 mL of fluid from food.
c. 3000 mL of fluid per day, ingesting an additional 500 mL of fluid from food.
d. 5000 mL of fluid per day, ingesting an additional 100 mL of fluid from food.

Back 110

b. 1500 mL of fluid per day, ingesting an additional 800 mL of fluid from food.

Front 111

The nurse is caring for a patient with hypovolemia secondary to severe diarrhea and vomiting. In evaluating the respiratory system for this patient, what does the nurse expect to assess?
a. No changes, because the respiratory system is not involved.
b. Hypoventilation, because the respiratory system is trying to compensate for low pH.
c. Increased respiratory rate, because the body perceives hypovolemia as hypoxia.
d. Normal respiratory rate, but a decreased oxygen saturation.

Back 111

c. Increased respiratory rate, because the body perceives hypovolemia as hypoxia.

Front 112

The nurse assessing a patient notes a bounding pulse quality, neck vein distention when supine, presence of crackles in the lungs, and increasing peripheral edema. These findings reflect a condition of fluid ________.

Back 112

excess

Front 113

The nurse is reviewing orders for several patients who have risk for fluid volume excess. For which patient condition does the nurse question an order for diuretics?
a. Pulmonary edema
b. Congestive heart failure
c. End-stage renal disease
d. Ascites

Back 113

c. End-stage renal disease

Front 114

The nurse is caring for several patients at risk for falls because of fluid and electrolyte imbalances. Which task related to patient safety and fall prevention does the nurse delegate to the UAP?
a. Assess for orthostatic hypotension.
b. Orient the patient to the environment.
c. Help the incontinent patient to toilet every 1 to 2 hours.
d. Encourage family members or significant other to stay with the patient.

Back 114

c. Help the incontinent patient to toilet every 1 to 2 hours.

Front 115

Which statements are true about the electrolyte chloride and its role in the cellular environment of the body? (Select all that apply.)
a. It is a major cation in extracellular fluid (ECF).
b. It maintains plasma acid-base balance.
c. It provides electroneutrality in relation to sodium.
d. Chloride imbalances occur with alterations in body water volume.
e. Chloride concentration varies inversely with changes in bicarbonate concentration.

Back 115

b. It maintains plasma acid-base balance.
c. It provides electroneutrality in relation to sodium.
d. Chloride imbalances occur with alterations in body water volume.

Front 116

What impacts does sodium have on the body function? (Select all that apply.)
a. Maintains electroneutrality.
b. Maintains electrical membrane excitability.
c. Aids in carbohydrate and lipid metabolism.
d. Regulates water balance.
e. Regulates plasma osmolarity.

Back 116

a. Maintains electroneutrality.
d. Regulates water balance.
e. Regulates plasma osmolarity.

Front 117

__________ is a major cation of intracellular fluid (ICF) in the cell.

Back 117

Potassium

Front 118

What interentions are appropriate for a patient with mild hypernatremia cause by excessive fluid loss? (Select all that apply.)
a. Hypotonic intravenous infusion.
b 0.45% sodium chloride intravenous infusion
c. D5W intravenous infusion
d. Administration of bumetanide (Bumex)
e. Gradual reduction of serum sodium to establish to normal level.

Back 118

a. Hypotonic intravenous infusion.
e. Gradual reduction of serum sodium to establish to normal level.

Front 119

Which conditions cause a patient to be at risk for hypernatremia? (Select all that apply.)
a. Renal filure
b. Immobility
c. Use of corticosteroids
d. Watery diarrhea
e. Cushing's syndrome

Back 119

a. Renal filure
c. Use of corticosteroids
d. Watery diarrhea
e. Cushing's syndrome

Front 120

If you were walking across the Sahara Desert with an empty canteen, the amount of ADH seceted would most likely
a. increase
b. decrease
c. stay the same
d. have no affect

Back 120

a. increase

Front 121

If you placed 2 containers next to each other, separated only by a semipermeable membrane, and the solution in one container was hypotonic relative to the other, fluid in the hypotonic container would
a. move out of the hypotonic container into the other.
b. pull fluid from the other container to the hypotonic container.
c. cause osmosis to occur.
d. stay unchanged within the hypotonic container.

Back 121

a. move out of the hypotonic container into the other.

Front 122

True or False?
A patient who has gained 5 pounds is most likely retaining a little more than 2 liters of fluid.

Back 122

True.

Front 123

Lab values obtained on the patient who has gained 5 pounds and is retaining a little more than 2 liters of fluid would most likely be
a. Higher due to hemoconcentration
b. Lower due to dilution
c. Lower due hemoconcentration
d. Higher due to dilution

Back 123

b. Lower due to dilution

Front 124

Patients who are third spacing have too much fluid in the _______ space and not enough fluid in the ______ space.
a. Interstitial/Intravascular
b. Intracellular/interstitial
c. Intravascular/interstitial

Back 124

a. Interstitial/intravascular

Front 125

A normal urinary output should be at least
a. 100 mL every 8 hours
b. 240 mL every 8 hours
c. 900 mL every 24 hours
d. Equal to the patient's intake

Back 125

b. 240 mL every 8 hours

Front 126

The nurse must assess a patient experiencing excessive production of antidiuretic hormone for:
a. Polyuria
b. Dehydration
c. Hyponatremia
d. Hyperglycemia

Back 126

c. Hyponatremia

Front 127

Physical assessment of patient admited with fluid volume deficit would show which of the following?
a. Distended neck veins
b. Moist breath sounds
c. Periorbital edema
d. Anuria

Back 127

d. Anuria

Front 128

A patient with esophageal cancer is to receive total parental nutrition. A right subclavian catheter is inserted by the physician. The nurse knows that the primary reason for using a central line is that:
a. It prevents the development of phlebitis.
b. There is less chance of this infusion infiltrating.
c. It is more convenient so clients can use their hands.
d. The large amount of blood helps to dilute the concentrated solution.

Back 128

d. The large amount of blood helps to dilute the concentrated solution.