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Saunders NCLEX Endocrine Exam Questions And Answers
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Saunders NCLEX Endocrine Exam Questions And Answers
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Saunders NCLEX Endocrine1. A client is brought to the emergency department in an unresponsive state,
and a diagnosis of hyperosmolar hyperglycemic syndrome is made. The
nurse would immediately prepare to initiate which anticipated health care
provider's prescription?
1.
Endotracheal intubation
2.
100 units of NPH insulin
3.
Intravenous infusion of normal saline
4.
Intravenous infusion of sodium bicarbonate: Intravenous infusion of normal
saline
The primary goal of treatment in hyperosmolar hyperglycemic syndrome (HHS) is
to rehydrate the client to restore fluid volume and to correct electrolyte deficiency.
Intravenous (IV) fluid replacement is similar to that administered in diabetic
ketoacidosis (DKA) and begins with IV infusion of normal saline. Regular insulin,
not NPH insulin, would be administered. The use of sodium bicarbonate to correct
acidosis is avoided because it can precipitate a further drop in serum potassium
levels. Intubation and mechanical ventilation are not required to treat HHS.
2. An external insulin pump is prescribed for a client with diabetes mellitus.
When the client asks the nurse about the functioning of the pump, the nurse
bases the response on which information about the pump?
1.
It is timed to release programmed doses of either short-duration or NPH
insulin into the bloodstream at specific intervals.
2.
It continuously infuses small amounts of NPH insulin into the bloodstream
while regularly monitoring blood glucose levels.
3.
It is surgically attached to the pancreas and infuses regular insulin into the
pancreas. This releases insulin into the bloodstream.
4.
, Saunders NCLEX Endocrine
It administers a small continuous dose of short-duration insulin
subcutaneously. The client can self-administer an additional bolus dose
from the pump before each meal.: It administers a small continuous dose of
short-duration insulin subcutaneously. The client can self-administer an additional
bolus dose from the pump before each meal.
An insulin pump provides a small continuous dose of short-duration (rapid- or
short-acting) insulin subcutaneously throughout the day and night. The client can
self-administer an additional bolus dose from the pump before each meal as
needed. Short-duration insulin is used in an insulin pump. An external pump is not
attached surgically to the pancreas.
3. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in
the emergency department. Which findings support this diagnosis? Select
all that apply.
1.
Increase in pH
2.
Comatose state
3.
Deep, rapid breathing
4.
Decreased urine output
5.
Elevated blood glucose level: 2.
Comatose state
3.
Deep, rapid breathing
5.
Elevated blood glucose level
Because of the profound deficiency of insulin associated with DKA, glucose
cannot be used for energy and the body breaks down fat as a secondary source of
energy. Ketones, which are acid byproducts of fat metabolism, build up and the
client experiences a metabolic ketoacidosis. High serum glucose contributes to an
osmotic diuresis and the client becomes severely dehydrated. If untreated, the
client will become comatose due to severe dehydration, acidosis, and electrolyte
, Saunders NCLEX Endocrine
imbalance. Kussmaul's respirations, the deep rapid breathing associated with
DKA, is a compensatory mechanism by the body. The body attempts to correct the
acidotic state by blowing off carbon dioxide (CO2), which is an acid. In the
absence of insulin, the client will experience severe hyperglycemia. Option 1 is
incorrect because in acidosis the pH would be low. Option 4 is incorrect because a
high serum glucose will result in an osmotic diuresis and the client will experience
polyuria.
4. The nurse teaches a client with diabetes mellitus about differentiating
between hypoglycemia and ketoacidosis. The client demonstrates an
understanding of the teaching by stating that a form of glucose should be
taken if which symptom or symptoms develop? Select all that apply.
1.
Polyuria
2.
Shakiness
3.
Palpitations
4.
Blurred vision
5.
Lightheadedness
6.
Fruity breath odor: 2.
Shakiness
3.
Palpitations
5.
Lightheadedness
Shakiness, palpitations, and lightheadedness are signs/symptoms of
hypoglycemia and would indicate the need for food or glucose. Polyuria, blurred
vision, and a fruity breath odor are manifestations of hyperglycemia.
, Saunders NCLEX Endocrine
5. A client with diabetes mellitus demonstrates acute anxiety when admitted
to the hospital for the treatment of hyperglycemia. What is the appropriate
intervention to decrease the client's anxiety?
1.
Administer a sedative.
2.
Convey empathy, trust, and respect toward the client.
3.
Ignore the signs and symptoms of anxiety, anticipating that they will soon
disappear.
4.
Make sure that the client is familiar with the correct medical terms to
promote understanding of what is happening.: Convey empathy, trust, and
respect toward the client.
Anxiety is a subjective feeling of apprehension, uneasiness, or dread. The
appropriate intervention is to address the client's feelings related to the anxiety.
Administering a sedative is not the most appropriate intervention and does not
address the source of the client's anxiety. The nurse should not ignore the client's
anxious feelings.
Anxiety needs to be managed before meaningful client education can occur.
6. The nurse provides instructions to a client newly diagnosed with type 1
diabetes mellitus. The nurse recognizes accurate understanding of
measures to prevent diabetic ketoacidosis when the client makes which
statement?
1.
"I will stop taking my insulin if I'm too sick to eat."
2.
"I will decrease my insulin dose during times of illness."
3.
"I will adjust my insulin dose according to the level of glucose in my urine."
4.
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