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NSG 430 Exam Final Edition A+ Graded Exam B., Exams of Nursing

Texas State UniversityNursing

NSG 430 Exam Final Edition A+ Graded Exam B.

Typology: Exams

2024/2025

Available from 07/02/2025

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1 | P a g e
NSG 430 Exam Final Edition A+ Graded
Exam B.
WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!
A PATIENT WITH RESPIRATORY FAILURE IS INCREASINGLY LETHARGIC, WITH A
RESPIRATORY RATE OF 6
BREATHS/MIN AND AN OXYGEN SATURATION (SPO2) OF 78%. WHICH INTERVENTION
WOULD THE NURSE
ANTICIPATE?
A. ADMINISTRATION OF 100% O2 BY NON-REBREATHER MASK
B. ENDOTRACHEAL INTUBATION AND POSITIVE PRESSURE VENTILATION
C. INSERTION OF A MINI-TRACHEOSTOMY WITH FREQUENT SUCTIONING
D. INITIATION OF CONTINUOUS POSITIVE PRESSURE VENTILATION (CPAP)
ENDOTRACHEAL INTUBATION AND POSITIVE PRESSURE VENTILATION
THE PATIENT'S LETHARGY, LOW RESPIRATORY RATE, AND SPO2 INDICATE THE NEED FOR
MECHANICAL
VENTILATION WITH VENTILATOR-CONTROLLED RESPIRATORY RATE. GIVING HIGH-FLOW
O2 WILL NOT BE HELPFUL
BECAUSE THE PATIENT'S RESPIRATORY RATE IS SO LOW. INSERTION OF A MINI-
TRACHEOSTOMY WILL PROMOTE
REMOVAL OF SECRETIONS, BUT IT WILL NOT IMPROVE THE PATIENT'S RESPIRATORY RATE
OR OXYGENATION.
CPAP REQUIRES THAT THE PATIENT INITIATE AN ADEQUATE RESPIRATORY RATE TO
ALLOW ADEQUATE GAS
EXCHANGE.
WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!
THE OXYGEN SATURATION (SPO2) FOR A PATIENT WITH LEFT LOWER LOBE PNEUMONIA IS
90%. THE
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Partial preview of the text

Download NSG 430 Exam Final Edition A+ Graded Exam B. and more Exams Nursing in PDF only on Docsity!

NSG 430 Exam Final Edition A+ Graded

Exam B.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

A PATIENT WITH RESPIRATORY FAILURE IS INCREASINGLY LETHARGIC, WITH A

RESPIRATORY RATE OF 6

BREATHS/MIN AND AN OXYGEN SATURATION (SPO2) OF 78%. WHICH INTERVENTION

WOULD THE NURSE

ANTICIPATE?

A. ADMINISTRATION OF 100% O2 BY NON-REBREATHER MASK

B. ENDOTRACHEAL INTUBATION AND POSITIVE PRESSURE VENTILATION

C. INSERTION OF A MINI-TRACHEOSTOMY WITH FREQUENT SUCTIONING

D. INITIATION OF CONTINUOUS POSITIVE PRESSURE VENTILATION (CPAP)

ENDOTRACHEAL INTUBATION AND POSITIVE PRESSURE VENTILATION

THE PATIENT'S LETHARGY, LOW RESPIRATORY RATE, AND SPO2 INDICATE THE NEED FOR

MECHANICAL

VENTILATION WITH VENTILATOR-CONTROLLED RESPIRATORY RATE. GIVING HIGH-FLOW

O2 WILL NOT BE HELPFUL

BECAUSE THE PATIENT'S RESPIRATORY RATE IS SO LOW. INSERTION OF A MINI-

TRACHEOSTOMY WILL PROMOTE

REMOVAL OF SECRETIONS, BUT IT WILL NOT IMPROVE THE PATIENT'S RESPIRATORY RATE

OR OXYGENATION.

CPAP REQUIRES THAT THE PATIENT INITIATE AN ADEQUATE RESPIRATORY RATE TO

ALLOW ADEQUATE GAS

EXCHANGE.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

THE OXYGEN SATURATION (SPO2) FOR A PATIENT WITH LEFT LOWER LOBE PNEUMONIA IS

90%. THE

PATIENT HAS WHEEZES AND A WEAK COUGH EFFORT. WHICH ACTION WOULD THE NURSE

TAKE?

A. POSITION THE PATIENT ON THE LEFT SIDE.

B. ASSIST THE PATIENT WITH STAGED COUGHING.

C. PLACE A HUMIDIFIER IN THE PATIENT'S ROOM.

D. SCHEDULE A 4-HOUR REST PERIOD FOR THE PATIENT.

ASSIST THE PATIENT WITH STAGED COUGHING

THE PATIENT'S ASSESSMENT INDICATES THAT ASSISTED COUGHING IS NEEDED TO HELP

REMOVE SECRETIONS,

WHICH WILL IMPROVE OXYGENATION. A 4-HOUR REST PERIOD AT THIS TIME MAY ALLOW

THE O2 SATURATION

TO DROP FURTHER. HUMIDIFICATION WILL NOT BE HELPFUL UNLESS THE SECRETIONS

CAN BE MOBILIZED.

POSITIONING ON THE LEFT SIDE MAY CAUSE A FURTHER DECREASE IN OXYGEN

SATURATION BECAUSE

PERFUSION WILL BE DIRECTED MORE TOWARD THE MORE POORLY VENTILATED LUNG.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

A NURSE IS CARING FOR A PATIENT WITH RIGHT LOWER LOBE PNEUMONIA WHO IS

OBESE. WHICH POSITION

WILL PROVIDE THE BEST GAS EXCHANGE?

A. ON THE LEFT SIDE

B. ON THE RIGHT SIDE

C. IN THE TRIPOD POSITION

D. IN THE HIGH-FOWLER'S POSITION

ON THE LEFT SIDE

THE PATIENT SHOULD BE POSITIO NED WITH THE ―GOOD‖ LUNG IN THE DEPENDENT

POSITION TO IMPROVE

C. SUCRALFATE (CARAFATE)

D. METHYLPREDNISOLONE (SOLU-MEDROL

VANCOMYCIN (VANCOCIN)

VANCOMYCIN IS POTENTIALLY NEPHROTOXIC, AND THE NURSE SHOULD CLARIFY THE

DRUG AND DOSAGE WITH

THE HEALTH CARE PROVIDER BEFORE ADMINISTRATION. THE OTHER DRUGS ARE

APPROPRIATE FOR THE PATIENT

WITH ARDS

A PATIENT DEVELOPS INCREASING DYSPNEA AND HYPOXEMIA 2 DAYS AFTER HEART

SURGERY. WHICH

PROCEDURE WOULD THE NURSE ANTICIPATE ASSISTING WITH TO DETERMINE WHETHER

THE PATIENT HAS ACUTE

RESPIRATORY DISTRESS SYNDROME (ARDS) OR PULMONARY EDEMA CAUSED BY HEART

FAILURE?

A. OBTAINING A VENTILATION-PERFUSION SCAN

B. DRAWING BLOOD FOR ARTERIAL BLOOD GASES

C. POSITIONING THE PATIENT FOR A CHEST X-RAY

D. INSERTING A PULMONARY ARTERY CATHETER

INSERTING A PULMONARY ARTERY CATHETER

PULMONARY ARTERY WEDGE PRESSURES ARE NORMAL IN THE PATIENT WITH ARDS

BECAUSE THE FLUID IN

THE ALVEOLI IS CAUSED BY INCREASED PERMEABILITY OF THE ALVEOLAR-CAPILLARY

MEMBRANE RATHER THAN

BY THE BACKUP OF FLUID FROM THE LUNGS (AS OCCURS IN CARDIOGENIC PULMONARY

EDEMA). THE OTHER

TESTS WILL NOT HELP IN DIFFERENTIATING CARDIOGENIC FROM NONCARDIOGENIC

PULMONARY EDEMA.

A NURSE IS CARING FOR A PATIENT WITH ARDS WHO IS BEING TREATED WITH

MECHANICAL VENTILATION

AND HIGH LEVELS OF POSITIVE END-EXPIRATORY PRESSURE (PEEP). WHICH ASSESSMENT

FINDING BY THE

NURSE INDICATES THAT THE PEEP MAY NEED TO BE REDUCED?

A. THE PATIENT'S PAO2 IS 50 MM HG AND THE SAO2 IS 88%.

B. THE PATIENT HAS SUBCUTANEOUS EMPHYSEMA ON THE UPPER THORAX.

C. THE PATIENT HAS BRONCHIAL BREATH SOUNDS IN BOTH THE LUNG FIELDS.

D. THE PATIENT HAS A FIRST-DEGREE ATRIOVENTRICULAR HEART BLOCK WITH A RATE OF

BEATS/MIN.

THE PATIENT HAS SUBCUTANEOUS EMPHYSEMA ON THE UPPER THORAX.

THE SUBCUTANEOUS EMPHYSEMA INDICATES BAROTRAUMA CAUSED BY POSITIVE

PRESSURE VENTILATION

AND PEEP. BRADYCARDIA, HYPOXEMIA, AND BRONCHIAL BREATH SOUNDS ARE ALL

CONCERNS THAT NEED TO

BE ADDRESSED, BUT THEY ARE NOT SPECIFIC INDICATIONS THAT PEEP SHOULD BE

REDUCED.

WHICH STATEMENT BY THE NURSE TO THE PATIENT'S CAREGIVER ABOUT THE PURPOSE

OF POSITIVE

END-EXPIRATORY PRESSURE (PEEP) IS ACCURATE?

A. ―PEEP WILL PUSH M ORE AIR INTO THE LUNGS DURING INHALATION .‖

B. ―PEEP PREVENTS TH E LUNG AIR SACS FROM COLLAPSING DURING EX HALATION.‖

C. ―PEEP WILL PREVEN T LUNG DAMAGE WHILE THE PATIENT IS ON TH E VENTILATOR.‖

D. ―PEEP ALLOWS THE BREATHING MACHINE TO DELIVER 100% O2 TO THE LUNGS .‖

―PEEP PREVENTS THE L UNG AIR SACS FROM COLLAPSING DURING EXHA LATION.‖

RESPIRATIONS OF 34 BREATHS/MIN. WHICH ACTION WOULD THE NURSE TAKE NEXT?

A. GIVE THE SCHEDULED IV ANTIBIOTIC.

B. GIVE THE PRN ACETAMINOPHEN (TYLENOL).

C. OBTAIN OXYGEN SATURATION USING PULSE OXIMETRY.

D. NOTIFY THE HEALTH CARE PROVIDER OF THESE FINDINGS.

OBTAIN OXYGEN SATURATION USING PULSE OXIMETRY.

THE PATIENT'S INCREASED RESPIRATORY RATE IN COMBINATION WITH THE ADMISSION

DIAGNOSIS OF

GRAM-NEGATIVE SEPSIS INDICATES THAT ACUTE RESPIRATORY DISTRESS SYNDROME

(ARDS) MAY BE

DEVELOPING. THE NURSE SHOULD CHECK FOR HYPOXEMIA, A HALLMARK OF ARDS. THE

HEALTH CARE

PROVIDER SHOULD BE NOTIFIED AFTER FURTHER ASSESSMENT OF THE PATIENT. GIVING

THE SCHEDULED

ANTIBIOTIC AND THE PRN ACETAMINOPHEN WILL ALSO BE DONE, BUT THEY ARE NOT THE

HIGHEST PRIORITY

FOR A PATIENT WHO MAY BE DEVELOPING ARDS

A NURSE IS CARING FOR A PATIENT WHO IS ORALLY INTUBATED AND RECEIVING

MECHANICAL VENTILATION.

TO DECREASE THE RISK FOR VENTILATOR-ASSOCIATED PNEUMONIA, WHICH ACTION WILL

THE NURSE INCLUDE

IN THE PLAN OF CARE?

A. ELEVATE HEAD OF BED TO 30 TO 45 DEGREES.

B. GIVE ENTERAL FEEDINGS AT NO MORE THAN 10 ML/HR.

C. SUCTION THE ENDOTRACHEAL TUBE EVERY 2 TO 4 HOURS.

D. LIMIT THE USE OF POSITIVE END-EXPIRATORY PRESSURE

ELEVATE HEAD OF BED TO 30 TO 45 DEGREES.

ELEVATION OF THE HEAD DECREASES THE RISK FOR ASPIRATION. POSITIVE END-

EXPIRATORY PRESSURE IS

FREQUENTLY NEEDED TO IMPROVE OXYGENATION IN PATIENTS RECEIVING MECHANICAL

VENTILATION.

SUCTIONING SHOULD BE DONE ONLY WHEN THE PATIENT ASSESSMENT INDICATES THAT

IT IS NECESSARY.

ENTERAL FEEDINGS SHOULD PROVIDE ADEQUATE CALORIES FOR THE PATIENT'S HIGH

ENERGY NEEDS.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

A PATIENT ADMITTED WITH ACUTE RESPIRATORY FAILURE IS UNABLE TO CLEAR THICK

SECRETIONS FROM THE

AIRWAY. WHICH NURSING INTERVENTION WOULD SPECIFICALLY ADDRESS THIS PATIENT

PROBLEM?

A. ENCOURAGE USE OF THE INCENTIVE SPIROMETER.

B. OFFER THE PATIENT FLUIDS AT FREQUENT INTERVALS.

C. TEACH THE PATIENT THE IMPORTANCE OF AMBULATION.

D. TITRATE OXYGEN LEVEL TO KEEP O2 SATURATION ABOVE 93%.

OFFER THE PATIENT FLUIDS AT FREQUENT INTERVALS.

THICK, VISCOUS SECRETIONS ARE HARD TO EXPEL. ADEQUATE FLUID INTAKE (2 TO 3

L/DAY) KEEPS

SECRETIONS THIN AND EASIER TO REMOVE, SO THE BEST ACTION WILL BE TO ENCOURAGE

THE PATIENT TO

IMPROVE ORAL FLUID INTAKE. PATIENTS SHOULD BE INSTRUCTED TO USE THE INCENTIVE

SPIROMETER ON A

REGULAR BASIS (E.G., EVERY HOUR) TO FACILITATE THE CLEARANCE OF THE SECRETIONS.

THE OTHER ACTIONS

MAY BE HELPFUL IN IMPROVING THE PATIENT'S GAS EXCHANGE, BUT THEY DO NOT

ADDRESS THE THICK

SECRETIONS THAT ARE CAUSING THE POOR AIRWAY CLEARANCE.

VENTILATION. THE OTHER PATIENTS SHOULD ALSO BE ASSESSED, BUT THEIR ASSESSMENT

DATA ARE TYPICAL OF

THEIR DISEASE PROCESSES AND DO NOT SUGGEST DETERIORATION IN THEIR STATUS.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

A PATIENT WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARRIVES IN THE

EMERGENCY

DEPARTMENT REPORTING SHORTNESS OF BREATH ON MINIMAL EXERTION. WHICH

ASSESSMENT FINDING BY

THE NURSE WOULD BE MOST IMPORTANT TO REPORT TO THE HEALTH CARE PROVIDER?

A. THE PATIENT HAS BIBASILAR LUNG CRACKLES.

B. THE PATIENT IS SITTING IN THE TRIPOD POSITION.

C. THE PATIENT'S RESPIRATORY RATE IS 10 BREATHS/MIN.

D. THE PATIENT'S PULSE OXIMETRY SHOWS A 91% O2 SATURATION.

THE PATIENT'S RESPIRATORY RATE IS 10 BREATHS/MIN.

A DROP IN RESPIRATORY RATE IN A PATIENT WITH RESPIRATORY DISTRESS SUGGESTS THE

ONSET OF FATIGUE

AND A HIGH RISK FOR RESPIRATORY ARREST. THEREFORE, IMMEDIATE ACTION SUCH AS

POSITIVE-PRESSURE

VENTILATION IS NEEDED. PATIENTS WHO ARE EXPERIENCING RESPIRATORY DISTRESS

FREQUENTLY SIT IN THE

TRIPOD POSITION BECAUSE IT DECREASES THE WORK OF BREATHING. CRACKLES IN THE

LUNG BASES MAY BE

THE BASELINE FOR A PATIENT WITH COPD. AN O2 SATURATION OF 91% IS COMMON IN

PATIENTS WITH

COPD AND WILL PROVIDE ADEQUATE GAS EXCHANGE AND TISSUE OXYGENATION.

THE NURSE OBSERVES A NEW ONSET OF AGITATION AND CONFUSION IN A PATIENT WITH

CHRONIC

OBSTRUCTIVE PULMONARY DISEASE (COPD). WHICH ACTION WOULD THE NURSE TAKE

FIRST?

A. TEST FOR FACIAL SYMMETRY.

B. NOTIFY THE HEALTH CARE PROVIDER.

C. ATTEMPT TO CALM AND REORIENT THE PATIENT.

D. ASSESS OXYGENATION USING PULSE OXIMETRY.

ASSESS OXYGENATION USING PULSE OXIMETRY.

BECAUSE AGITATION AND CONFUSION ARE OFTEN THE INITIAL INDICATORS OF

HYPOXEMIA, THE NURSE'S

INITIAL ACTION SHOULD BE TO ASSESS O2 SATURATION. THE OTHER ACTIONS ARE

APPROPRIATE, BUT

ASSESSMENT OF OXYGENATION TAKES PRIORITY OVER OTHER ASSESSMENTS AND

NOTIFICATION OF THE HEALTH

CARE PROVIDER

IN PREPARATION FOR WHICH TEST WOULD THE NURSE TEACH THE PATIENT TO MINIMIZE

PHYSICAL AND

EMOTIONAL STRESS?

A. A WATER DEPRIVATION TEST

B. A TEST FOR SERUM T3 AND T4 LEVELS

C. A 24-HOUR URINE TEST FOR FREE CORTISOL

D. A RADIOACTIVE IODINE (I-131) UPTAKE TEST

A 24-HOUR URINE TEST FOR FREE CORTISOL

PHYSICAL AND EMOTIONAL STRESS CAN AFFECT THE RESULTS OF THE FREE CORTISOL

TEST. STRESS DOES NOT

IMPACT THE OTHER TESTS.

WHICH INSTRUCTION WOULD THE NURSE GIVE TO A PATIENT WHO IS SCHEDULED TO

COMPLETE A 24-HOUR

URINE COLLECTION FOR 17-KETOSTEROIDS?

A PATIENT IS ADMITTED WITH TETANY. WHICH LABORATORY VALUE WOULD THE NURSE

PLAN TO MONITOR?

A. TOTAL PROTEIN

B. BLOOD GLUCOSE

C. IONIZED CALCIUM

D. SERUM PHOSPHATE

IONIZED CALCIUM

TETANY IS ASSOCIATED WITH HYPOCALCEMIA. THE OTHER VALUES WOULD NOT BE

USEFUL FOR THIS PATIENT

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

WHICH INFORMATION ABOUT A PATIENT WHO IS SCHEDULED FOR AN ORAL GLUCOSE

TOLERANCE TEST WOULD

THE NURSE CONSIDER IN INTERPRETING THE TEST RESULTS?

A. THE PATIENT REPORTS HAVING OCCASIONAL ORTHOSTATIC DIZZINESS.

B. THE PATIENT TAKES ORAL CORTICOSTEROIDS FOR RHEUMATOID ARTHRITIS.

C. THE PATIENT HAS HAD A 10 POUND WEIGHT GAIN IN THE LAST MONTH.

D. THE PATIENT DRANK SEVERAL GLASSES OF WATER AN HOUR PREVIOUSLY.

THE PATIENT TAKES ORAL CORTICOSTEROIDS FOR RHEUMATOID ARTHRITIS.

CORTICOSTEROIDS CAN AFFECT BLOOD GLUCOSE RESULTS. THE OTHER INFORMATION

WILL NOT AFFECT THE

GLUCOSE TEST RESULTS.

A NURSE IS CARING FOR A PATIENT WITH A GOITER AND POSSIBLE HYPERTHYROIDISM.

WHICH ACTION BY THE

NURSE HAS THE POTENTIAL FOR PATIENT HARM?

A. THE NURSE CHECKS THE BLOOD PRESSURE IN BOTH ARMS.

B. THE NURSE PALPATES THE NECK TO ASSESS THYROID SIZE.

C. THE NURSE ORDERS SALINE EYE DROPS TO LUBRICATE THE PATIENT'S BULGING EYES.

D. THE NURSE LOWERS THE THERMOSTAT TO DECREASE THE TEMPERATURE IN THE

ROOM.

THE NURSE PALPATES THE NECK TO ASSESS THYROID SIZE.

PALPATION CAN CAUSE THE RELEASE OF THYROID HORMONES IN A PATIENT WITH AN

ENLARGED THYROID AND

SHOULD BE AVOIDED. THE OTHER ACTIONS BY THE NURSE ARE APPROPRIATE WHEN

CARING FOR A PATIENT

WITH AN ENLARGED THYROID.

THE NURSE IS CARING FOR A PATIENT DURING A WATER DEPRIVATION TEST. WHICH

FINDING IS MOST

IMPORTANT FOR THE NURSE TO COMMUNICATE TO THE HEALTH CARE PROVIDER?

A. THE PATIENT REPORTS INTENSE THIRST.

B. THE PATIENT HAS A 5-LB (2.3-KG) WEIGHT LOSS.

C. THE PATIENT FEELS DIZZY WHEN SITTING ON THE BED.

D. THE PATIENT'S URINE OSMOLALITY DOES NOT INCREASE

THE PATIENT HAS A 5-LB (2.3-KG) WEIGHT LOSS.

A DROP IN THE WEIGHT OF MORE THAN 2 KG INDICATES SEVERE DEHYDRATION, AND THE

TEST SHOULD BE

DISCONTINUED. THE OTHER ASSESSMENT DATA ARE NOT UNUSUAL WITH THIS TEST.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

A PATIENT WITH A POSSIBLE PITUITARY ADENOMA IS SCHEDULED FOR A COMPUTED

TOMOGRAPHY (CT)

SCAN WITH CONTRAST MEDIA. WHICH PATIENT INFORMATION IS IMPORTANT FOR THE

NURSE TO

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

WHICH INSTRUCTIONS WOULD THE NURSE INCLUDE WHEN TEACHING A PATIENT WHO IS

SCHEDULED FOR ORAL

GLUCOSE TOLERANCE TESTING IN THE OUTPATIENT CLINIC? (SELECT ALL THAT APPLY.)

A. ―YOU WILL NEED TO AVOID SMOKING BEFORE THE TEST.‖

B. ―EXERCISE SHOULD BE AVOIDED UNTIL THE TESTING IS C OMPLETE.‖

C. ―SEVERAL BLOOD SA MPLES WILL BE OBTAINED DURING THE TESTIN G.‖

D. ―YOU SHOULD FOLLO W A LOW-CALORIE DIET THE DAY BEFORE THE TEST.‖

E. ―THE TEST REQUIRE S THAT YOU FAST FOR AT LEAST 8 HOURS BEF ORE TESTING.‖

A, C, E

SMOKING MAY AFFECT THE RESULTS OF ORAL GLUCOSE TOLERANCE TESTS. BLOOD

SAMPLES ARE OBTAINED AT

BASELINE AND AT 30, 60, AND 120 MINUTES. ACCURACY REQUIRES THAT THE PATIENT BE

FASTING BEFORE

THE TEST. THE PATIENT SHOULD CONSUME AT LEAST 1500 CALORIES/DAY FOR 3 DAYS

BEFORE THE TEST. THE

PATIENT SHOULD BE AMBULATORY AND ACTIVE FOR ACCURATE TEST RESULTS.

WHICH INFORMATION PROVIDED BY A NURSE TO A PATIENT NEWLY DIAGNOSED WITH

TYPE 2 DIABETES IS

ACCURATE?

A. INSULIN IS NOT USED TO CONTROL GLUCOSE IN PATIENTS WITH TYPE 2 DIABETES.

B. COMPLICATIONS OF TYPE 2 DIABETES ARE LESS SERIOUS THAN THOSE OF TYPE 1

DIABETES.

C. CHANGES IN DIET AND EXERCISE MAY CONTROL GLUCOSE LEVELS WITH TYPE 2

DIABETES.

D. TYPE 2 DIABETES IS USUALLY DIAGNOSED WHEN A PATIENT IS ADMITTED IN

HYPERGLYCEMIC

COMA.

CHANGES IN DIET AND EXERCISE MAY CONTROL GLUCOSE LEVELS WITH TYPE 2 DIABETES.

FOR SOME PATIENTS WITH TYPE 2 DIABETES, CHANGES IN LIFESTYLE ARE SUFFICIENT TO

ACHIEVE GLUCOSE

CONTROL. INSULIN IS FREQUENTLY USED FOR TYPE 2 DIABETES, COMPLICATIONS ARE

EQUALLY SERIOUS AS FOR

TYPE 1 DIABETES, AND TYPE 2 DIABETES IS USUALLY DIAGNOSED WITH ROUTINE

LABORATORY TESTING OR

AFTER A PATIENT DEVELOPS COMPLICATIONS SUCH AS FREQUENT INFECTIONS.

WE HAVE AN EXPERT-WRITTEN SOLUTION TO THIS PROBLEM!

A PATIENT SCREENED FOR DIABETES AT A CLINIC HAS A FASTING PLASMA GLUCOSE LEVEL

OF 120 MG/DL

(6.7 MMOL/L). WHICH INFORMATION WILL THE NURSE PLAN TO TEACH THE PATIENT?

A. SELF-MONITORING OF GLUCOSE

B. USING SMALL DOSES OF REGULAR INSULIN

C. LIFESTYLE CHANGES TO LOWER THE GLUCOSE

D. EFFECTS OF ORAL HYPOGLYCEMIC MEDICATIONS

LIFESTYLE CHANGES TO LOWER THE GLUCOSE

THE PATIENT'S IMPAIRED FASTING GLUCOSE INDICATES PREDIABETES, AND THE PATIENT

WOULD BE

COUNSELED ABOUT LIFESTYLE CHANGES TO PREVENT THE DEVELOPMENT OF TYPE 2

DIABETES. THE PATIENT

WITH PREDIABETES DOES NOT REQUIRE INSULIN OR ORAL HYPOGLYCEMICS FOR GLUCOSE

CONTROL AND DOES

NOT NEED TO SELF-MONITOR GLUCOSE

A 28-YR-OLD MALE PATIENT WITH TYPE 1 DIABETES REPORTS HOW HE MANAGES HIS

EXERCISE AND

C. DARK COLORED URINE

D. CRAVING SUGARY DRINKS

WEIGHT LOSS

WEIGHT LOSS OCCURS BECAUSE THE BODY IS NO LONGER ABLE TO ABSORB GLUCOSE

AND STARTS TO BREAK

DOWN PROTEIN AND FAT FOR ENERGY. THE PATIENT IS THIRSTY BUT DOES NOT

NECESSARILY CRAVE

SUGAR-CONTAINING FLUIDS. INCREASED APPETITE IS A CLASSIC SYMPTOM OF TYPE 1

DIABETES. WITH THE

CLASSIC SYMPTOM OF POLYURIA, URINE WILL BE VERY DILUTE.

A PATIENT WITH TYPE 2 DIABETES IS SCHEDULED FOR A FOLLOW-UP VISIT IN THE CLINIC

SEVERAL MONTHS

FROM NOW. WHICH TEST WILL THE NURSE SCHEDULE TO EVALUATE THE EFFECTIVENESS

OF TREATMENT FOR THE

PATIENT?

A. FASTING BLOOD GLUCOSE

B. GLYCOSYLATED HEMOGLOBIN

C. ORAL GLUCOSE TOLERANCE TEST

D. URINE DIPSTICK FOR GLUCOSE AND KETONES

GLYCOSYLATED HEMOGLOBIN

THE GLYCOSYLATED HEMOGLOBIN (A1C) TEST SHOWS THE OVERALL CONTROL OF

GLUCOSE OVER 90 TO 120

DAYS. A FASTING LEVEL INDICATES ONLY THE GLUCOSE LEVEL AT ONE TIME. URINE

GLUCOSE TESTING IS NOT

AN ACCURATE REFLECTION OF GLUCOSE LEVEL AND DOES NOT REFLECT THE GLUCOSE

OVER A PROLONGED TIME.

ORAL GLUCOSE TOLERANCE TESTING IS DONE TO DIAGNOSE DIABETES BUT IS NOT USED

FOR MONITORING

GLUCOSE CONTROL AFTER DIABETES HAS BEEN DIAGNOSED.

THE NURSE IS ASSESSING A 55-YR-OLD FEMALE PATIENT WITH TYPE 2 DIABETES WHO HAS

A BODY MASS

INDEX (BMI) OF 32 KG/M2.WHICH GOAL IN THE PLAN OF CARE IS MOST IMPORTANT FOR

THIS PATIENT?

A. THE PATIENT WILL REACH A GLYCOSYLATED HEMOGLOBIN LEVEL OF LESS THAN 7%.

B. THE PATIENT WILL FOLLOW A DIET AND EXERCISE PLAN THAT RESULTS IN WEIGHT

LOSS.

C. THE PATIENT WILL CHOOSE A DIET THAT DISTRIBUTES CALORIES THROUGHOUT THE

DAY.

D. THE PATIENT WILL STATE THE REASONS FOR ELIMINATING SIMPLE SUGARS IN THE DIET

THE PATIENT WILL REACH A GLYCOSYLATED HEMOGLOBIN LEVEL OF LESS THAN 7%.

THE COMPLICATIONS OF DIABETES ARE RELATED TO ELEVATED GLUCOSE AND THE MOST

IMPORTANT PATIENT

OUTCOME IS THE REDUCTION OF GLUCOSE TO NEAR-NORMAL LEVELS. A BMI OF

30.9/KG/M2 OR ABOVE IS

CONSIDERED OBESE, SO THE OTHER OUTCOMES ARE APPROPRIATE BUT ARE NOT AS HIGH

IN PRIORITY.

A PATIENT WHO HAS TYPE 1 DIABETES PLANS TO SWIM LAPS FOR AN HOUR DAILY AT 1:

PM. WHICH

ADVICE WOULD THE CLINIC NURSE PLAN TO GIVE THE PATIENT?

A. INCREASE THE MORNING DOSE OF NPH INSULIN (NOVOLIN N).

B. CHECK GLUCOSE LEVEL BEFORE, DURING, AND AFTER SWIMMING.

C. TIME THE MORNING INSULIN INJECTION TO PEAK WHILE SWIMMING.

D. DELAY EATING THE NOON MEAL UNTIL AFTER FINISHING THE SWIMMING.

CHECK GLUCOSE LEVEL BEFORE, DURING, AND AFTER SWIMMING.