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Test 4 NURS 327 Exam With Verified Questions and Answers

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Test 4 NURS 327 Exam With Verified Questions and Answers A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose le...

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©EXAM STUDY MATERIAL 8/9/2024 11:50 AM

Test 4 NURS 327 Exam With Verified
Questions and Answers

A client with status asthmaticus requires endotracheal intubation and mechanical ventilation.
Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The
nurse must monitor the client's blood glucose levels hourly and watch for which early signs and
symptoms associated with hypoglycemia?
Sweating, tremors, and tachycardia
Dry skin, bradycardia, and somnolence
Bradycardia, thirst, and anxiety

Polyuria, polydipsia, and polyphagia - answer✔✔Sweating, tremors, and tachycardia
Explanation:

Sweating, tremors, and tachycardia, thirst, and anxiety are early signs of hypoglycemia. Dry
skin, bradycardia, and somnolence are signs and symptoms associated with hypothyroidism.
Polyuria, polydipsia, and polyphagia are signs and symptoms of diabetes mellitus.
The nurse suspects that a patient with diabetes has developed proliferative retinopathy. The nurse
confirms this by the presence of which of the following diagnostic signs?
Decreased capillary permeability
Microaneurysm formation
Neovascularization into the vitreous humor

The leakage of capillary wall fragments into surrounding areas - answer✔✔Neovascularization
into the vitreous humor
Explanation:

, ©EXAM STUDY MATERIAL 8/9/2024 11:50 AM

Proliferative retinopathy, an ocular complication of diabetes, occurs because of the abnormal
growth of new blood vessels on the retina that bleed into the vitreous and block light. Blood
vessels in the vitreous form scar tissue that can pull and detach the retina. Neovascularization
into the vitreous humor is considered a diagnostic sign.
A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding
suggests that the client has developed hyperglycemia?
Cheyne-Stokes respirations
Increased urine output
Decreased appetite

Diaphoresis - answer✔✔Increased urine output
Explanation:

Glucose supplies most of the calories in TPN; if the glucose infusion rate exceeds the client's rate
of glucose metabolism, hyperglycemia arises. When the renal threshold for glucose reabsorption
is exceeded, osmotic diuresis occurs, causing an increased urine output. A decreased appetite and
diaphoresis suggest hypoglycemia, not hyperglycemia. Cheyne-Stokes respirations are
characterized by a period of apnea lasting 10 to 60 seconds, followed by gradually increasing
depth and frequency of respirations. Cheyne-Stokes respirations typically occur with cerebral
depression or heart failure.
A nurse is preparing a continuous insulin infusion for a child with diabetic ketoacidosis and a
blood glucose level of 800 mg/dl. Which solution is the most appropriate at the beginning of
therapy?
100 units of regular insulin in normal saline solution
100 units of neutral protamine Hagedorn (NPH) insulin in normal saline solution
100 units of regular insulin in dextrose 5% in water

100 units of NPH insulin in dextrose 5% in water - answer✔✔100 units of regular insulin in
normal saline solution
Explanation:

Continuous insulin infusions use only short-acting regular insulin. Insulin is added to normal
saline solution and administered until the client's blood glucose level falls. Further along in the
therapy, a dextrose solution is administered to prevent hypoglycemia.

, ©EXAM STUDY MATERIAL 8/9/2024 11:50 AM

A nurse is educating a client about the benefits of fruit versus fruit juice in the diabetic diet. The
client states, "What difference does it make if you drink the juice or eat the fruit? It is all the
same." What are the best responses by the nurse? Select all that apply.
"Eating the fruit instead of drinking juice decreases the glycemic index by slowing absorption."
"Eating the fruit is more satisfying than drinking the juice. You will get full faster."
"Eating the fruit will give you more vitamins and minerals than the juice will."
"Eating the fruit will lead to hyperglycemia and the fruit juice will not lead to hyperglycemia."

"The fruit has less sugar than the juice." - answer✔✔"Eating the fruit instead of drinking juice
decreases the glycemic index by slowing absorption."
"The fruit has less sugar than the juice."
Explanation:

Eating whole fruit instead of drinking juice decreases the glycemic index, because fiber in the
fruit slows absorption. A serving of juice has more sugar than a serving of fruit. Whether a fruit
is more satisfying and has more vitamins and minerals than the fruit's juice are dependent on the
types of fruit and juices. Eating fruit does not lead to hyperglycemia.
A client is receiving insulin lispro at 7:30 AM. The nurse ensures that the client has breakfast by
which time?
7:45 AM
8:00 AM
8:15 AM

8:30 AM - answer✔✔7:45 AM
Explanation:

Insulin lispro has an onset of 5 to 15 minutes. Therefore, the nurse would need to ensure that the
client has his breakfast by 7:45 AM at the latest. Otherwise, the client may experience
hypoglycemia.
A nurse is teaching a client with diabetes mellitus about self-management of his condition. The
nurse should instruct the client to administer 1 unit of insulin for every:
10 g of carbohydrates.

, ©EXAM STUDY MATERIAL 8/9/2024 11:50 AM

15 g of carbohydrates.
20 g of carbohydrates.

25 g of carbohydrates. - answer✔✔15 g of carbohydrates.
Explanation:

The nurse should instruct the client to administer 1 unit of insulin for every 15 g of
carbohydrates.
An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement about
diabetes mellitus is true?
Nearly two-thirds of clients with diabetes mellitus are older than age 60.
Diabetes mellitus is more common in Hispanics and Blacks than in Whites.
Type 2 diabetes mellitus is less common than type 1 diabetes mellitus.
Approximately one-half of the clients diagnosed with type 2 diabetes are obese. -
answer✔✔Diabetes mellitus is more common in Hispanics and Blacks than in Whites.
Explanation:

Diabetes mellitus is more common in Hispanics and Blacks than in Whites. Only about one-third
of clients with diabetes mellitus are older than age 60 and 85% to 90% have type 2. At least 80%
of clients diagnosed with type 2 diabetes mellitus are obese.
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 use?
Fasting blood glucose test
6-hour glucose tolerance test
Serum glycosylated hemoglobin (Hb A1c)

Urine ketones - answer✔✔Serum glycosylated hemoglobin (Hb A1c)
Explanation:

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