1. A client is seen in the clinic for the first time since being newly diagnosed with diabetes. Which
findings should the nurse associate as a complication of diabetes? Select all that apply. A. burning
sensation in the client's toes
B.
C.
D.
E.
visual acuity 60/20
protein in the client's urine
blood pressure 110/60
a sore on the client's foot that is not healing
2. A client who has type 1 diabetes returns to the clinic for follow-up after dietary counseling. The client
states that he has been managing his diabetes very closely. Which lab result indicates that the client is
maintaining tight control of the diabetes?
A.
B.
C.
D.
Fasting BS changes from 7.5 to 6
Self-monitoring of BG at bedtime changes from 2.5 to 5
A1C change from 9% to 6%
Urine ketones change from 0 to 3
3.The RN assigns the LPN a client diagnosed with diabetes. Which findings should the RN instruct the LPN to report
immediately? (Select all that apply).
A. Fingerstick BG 247
B. Cold clammy skin
C. Crackles at the end of inspiration
D. Numbness in the fingertips and toes
E. Unsteady gait, slurred speech
4.The nurse is reviewing the current medication list of a client, newly diagnosed with type 1 diabetes, who
will be prescribed insulin. Which medications should the RN discuss with the healthcare provider?
(Select all that apply).
A. Prednisone
B. Atenolol
C. Clarithromycin
D. Acetaminophen
E. Ibuprofen
F. Pantoprazole sodium
5.Which client should the nurse assess first?
A.
B.
C.
D.
Client diagnosed with hyperthyroidism exhibiting exophthalmos
Client with type 1 diabetes who has an inflamed foot ulcer
Client with Cushing's disease exhibiting moon face
Addison's disease with tremors and diaphoresis
6. A client is admitted to the hospital with a diagnosis of Addison's crisis. The nurse places a peripheral saline lock.
Regarding which prescriptions should the nurse question the healthcare provider? (Select all that apply).
A. IV D5NS at 300 mL/hr for 3 hrs
B. Hydrocortisone sodium succinate 100 mg IV push
C. Potassium 20 mEq in 100 mL saline IV over 60 minutes
D. 50% dextrose intravenous push
E. 10% calcium chloride 5 mL intravenously over 10 minutes
7. Which of the following patients are at risk for developing Cushing's Syndrome?
A. A patient with a tumor on the pituitary gland, which is causing too much ACTH to be secreted.
B. A patient taking glucocorticoids for several weeks.
C. A patient with a tuberculosis infection.
D. A patient who is post-opt from an adrenalectomy.
8. In Cushing's Disease and Syndrome there are:
A. Increased cortisol production
B. Low potassium and glucose levels
C. Increased production of aldosterone and cortisol
D. Decreased production of cortisol and aldosterone
9. Which of the following is not a typical sign and symptom of Cushing's Syndrome?
A. Hyperpigmentation of the skin
B. Hirsutism
C. Purplish striae
D. Moon Face
10 In Cushing's disease, the _______ is secreting too much ACTH (Adrenocorticotropic hormone) which is causing
an increase in cortisol production.
A. Adrenal cortex
B. Pituitary gland
C. Thyroid gland
D. Hypothalamus
11. Which of the following below is NOT a sign or symptom of Addisonian Crisis?*
A. Low blood pressure
B. Severe pain in the stomach, legs, and lower back
C. Hypokalemia
D. Hyponatremia
12. The ______ ______secretes ACTH which causes the ______ ______ to produce cortisol.*
A. Hypothalamus, adrenal medulla
B. Thalamus, pituitary gland
C. Pituitary gland, adrenal cortex
D. Adrenal cortex, pituitary gland
A patient is admitted with thyroid storm. Which sign and symptoms are NOT present with this conditionSELECT ALL THAT APPLY?*
A. Temperature of 104.9'F
B. Heart rate of 125 bpm
C. Respirations of 42
D. Heart rate of 20 bpm
E. Intolerance to cold
F. Restless
14. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses
the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What
is the most likely cause of these signs? a. Diabetic ketoacidosis
b. Thyroid crisis
c. Hypoglycemia
d. Tetany
15. Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse
should include information about which hormone lacking in clients with diabetes insipidus? a.
antidiuretic hormone (ADH).
b. thyroid-stimulating hormone (TSH).
c. follicle-stimulating hormone (FSH).
d. luteinizing hormone (LH).
16. A patient with hyperthyroidism is taking propylthiouracil (PTU). The nurse will monitor the patient for:
A)
B)
C)
D)
gingival hyperplasia and lycopenemia.
dyspnea and a dry cough.
blurred vision and nystagmus.
fever and sore throat.
17. A patient with SIADH is treated with water restriction and administration of IV fluids. The nurses evaluate
that treatment has been effective when the patient experiences
a.
b.
c.
d.
increased urine output, decreased serum sodium, and increased urine specific gravity
increased urine output, increased serum sodium, and decreased urine specific gravity
decreased urine output, increased serum sodium, and decreased urine specific gravity
decreased urine output, decreased serum sodium, and increased urine specific gravity
18. A patient is admitted to the hospital with a diagnosis of Cushing syndrome. On physical assessment of the
patient, the nurse would expect to find a. HTN, peripheral edema, and petechiae
b. weight loss, buffalo hump, and moon face with acne
c. abdominal and buttock striae, truncal obesity, and hypotension
d. anorexia, signs of dehydration, and hyper pigmentation of the skin
19. What is a typical finding of hyperosmolar hyperglycemic syndrome (HHS)?
A. Occurs in type 1 diabetes as the presenting symptom
B. Slow onset resulting in a blood glucose level greater than 600 mg/dL
C. Ketone bodies higher than 4+ in urine
D. Signs and symptoms of diabetes insipidus
20. A diabetic patient has a serum glucose level of 824 mg/dL (45.7 mmol/L) and is unresponsive. After
assessment of the patient, you suspect DKA rather than HHS based on the finding of A. polyuria.
B. severe dehydration.
C. rapid, deep respirations.
D. decreased serum potassium.
21. What is a finding in DKA that is not seen in hyperosmolar hyperglycemic syndrome (HHS)?
A. Glucose level above 400 mg/dL
B. Hyperkalemia
C. Ketones in blood
D. Urine output of 30 mL/hr
22. The patient in the emergency department is diagnosed with diabetic ketoacidosis. Which laboratory
value is essential for you to monitor?
A.
B.
C.
D.
Magnesium (Mg)
Hemoglobin (Hb)
White blood cells (WBCs)
Potassium (K)
23. The patient has type 1 diabetes mellitus and is found unresponsive with cool and clammy skin. What action is
a priority?
A.
B.
C.
D.
Obtain a serum glucose level.
Give hard candy under the tongue.
Administer glucagon per standing order.
Notify the health care provider.
24. Laboratory results are available for a 54-year-old patient with a 15-year history of diabetes. Which result
follows the expected pattern accompanying macrovascular disease as a complication of diabetes?
A. Increased triglyceride levels
B. Decreased low-density lipoprotein levels
C. Increased high-density lipoprotein levels
D. Decreased very-low-density lipoprotein levels
25. Which patient population is most at risk for DKA?*
A.
B.
C.
D.
Middle-aged adults who are obese
Older-adults with Type 2 diabetes
Newly diagnosed diabetes
None of the options
1.
2.
3.
A,C,E
C
B,E
4.
5.
6.
A,B,C
D
7.
B
8.
A
A
B
C
C
D,E
B
A
D
B
A
B
C
C
D
C
A
C
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
C,E