MSN Endocrine Quiz 1

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| By Catherine Halcomb
Catherine Halcomb
Community Contributor
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  • 1/15 Questions

    A clinic nurse is evaluating a client with type 1 diabetes who intends to enroll in a tennis class. Which statement made by the client indicates that the client understands the effects of exercise on insulin demand?

    • “I will carry a high-fat, high-calorie food, such as a cookie.”
    • “I will administer 1 unit of lispro insulin prior to playing tennis.”
    • “I will eat a 15-gram carbohydrate snack before playing tennis.”
    • “I will decrease the meal prior to the class by 15-grams of carbohydrates.”
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Msn Endocrine Quiz 1 - Quiz

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  • 2. 

    Two hours after taking a regular morning dose of Insulin Regular (Humulin R®), a client presents to a clinic with diaphoresis, tremors, palpitations, and tachycardia. Which nursing action is most appropriate for this client?

    • Check pulse oximetry and administer oxygen at 2 L per nasal cannula.

    • Administer a baby aspirin, one sublingual nitroglycerin tablet, and obtain an electrocardiogram (ECG).

    • Check blood glucose level and provide carbohydrates if less than 70 mg/dL (3.8 mmol/L).

    • Check vital signs and administer atenolol (Tenormin®) 25 mg orally if heart rate is greater than 120 beats per minute.

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  • 3. 

    A nurse is caring for a client with type 2 diabeteson a telemetry unit. The client is scheduled for cardiac rehabilitation exercises (cardiac rehab). The nurse notes that the client’s blood glucose level is 300 mg/dL and the urine is positive for ketones. Which nursing action should be included in the nurse’s plan of care?

    • Send the client to cardiac rehab because exercise will lower the client’s blood glucose level.

    • Administer insulin and then send the client to cardiac rehab with a 15-gram carbohydrate snack.

    • Delay the cardiac rehab because blood glucose levels will decrease too much with exercise.

    • Cancel the cardiac rehab because blood glucose levels will increase further with exercise.

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  • 4. 

    A nurse administers 15 units of glargine (Lantus®) insulin at 2100 hours to a Hispanic client when the client’s fingerstick blood glucose reading was 110 mg/dL. At 2300 hours, a nursing assistant reports to the nurse that an evening snack was not given because the client was sleeping. Which instruction by the nurse is most appropriate?

    • “You will need to wake the client to check the blood glucose and then give a snack. All diabetics get a snack at bedtime.”

    • “It is not necessary for this client to have a snack because glargine insulin is absorbed very slowly over 24 hours and doesn’t have a peak.”

    • “The next time the client wakes up, check a blood glucose level and then give a snack.”

    • “I will need to notify the physician because a snack at this time will affect the client’s blood glucose level and the next dose of glargine insulin.”

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  • 5. 

    A nurse is teaching a client who has been newly diagnosed with type 2 diabetes mellitus (DM). Which teaching point should the nurse emphasize?

    • Use the arm when self-administering NPH insulin.

    • Exercise for 30 minutes daily, preferably after a meal.

    • Consume 30% of the daily calorie intake from protein foods.

    • Eat a 30-gram carbohydrate snack prior to strenuous activity.

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  • 6. 

    A nurse is evaluating a client’s outcome. The client’s nursing care plan includes the nursing diagnosis of fluid volume deficit related to hyperosmolar hyperglycemic nonketotic syndrome (HHNS) secondary to severe hyperglycemia. The nurse knows that the client has a positive outcome when which serum laboratory value has decreased to a normal range?

    • Glucose

    • Sodium

    • Osmolality

    • Potassium

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  • 7. 

    A client with type 1 diabetes mellitus is scheduled for a total hip replacement. In reviewing the client’s orders the evening prior to surgery, a nurse notes that the physician did not write an order to change the client’s daily insulin dose. Which nursing action is most appropriate?

    • Notify the physician who wrote the insulin order in the client’s medical record.

    • Write an order to decrease the morning insulin dose by one-half of the prescribed morning dose.

    • Do nothing because the physician would want the client to receive the usual insulin dose prior to surgery.

    • Inform the day shift nurse to check the client’s fingerstick glucose before surgery and hold the morning dose of insulin.

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  • 8. 

    A nurse administers a usual morning dose of 4 units of regular insulin and 8 units of NpH insulin at 7:30 a.m. to a client with a blood glucose level of 110 mg/dL. Which statements regarding the client’s insulin are correct?

    • The onset of the regular insulin will be at 7:45 a.m. and the peak at 1:00 p.m.

    • The onset of the regular insulin will be at 8:00 a.m. and the peak at 10:00 a.m.

    • The onset of the NPH insulin will be at 8:00 a.m. and the peak at 10:00 a.m.

    • The onset of the NPH insulin will be at 12:30 p.m. and the peak at 11:30 p.m.

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  • 9. 

    A friend brings an older adult homeless client to a free health-screening clinic because the friend is unable to continue administering the client’s morning and evening insulin for type 1 diabetes mellitus. When advocating for this client, which action by the nurse is most appropriate?

    • Notify Adult Protective Services about the client’s condition and living situation.

    • Ask where the client lives and if someone else can administer the insulin.

    • Contact the unit social worker to arrange for someone to give the client’s insulin at a local homeless shelter.

    • Have the client return to the screening clinic mornings and evenings to receive the insulin injections.

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  • 10. 

    A nurse evaluates a client who is being treated for diabetic ketoacidosis (DKA). Which finding indicates that the client is responding to the treatment plan?

    • Eyes sunken, skin flushed

    • Skin moist with rapid elastic recoil

    • Serum potassium level is 3.3 mEq/L

    • ABG results are pH 7.25, PaCO2 30, HCO3 17

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  • 11. 

    A nurse is documenting nursing diagnoses for a client with elevated growth hormone (GH) levels. Which nursing diagnosis is least likely to be included in the client’s plan of care?

    • Fluid volume deficit related to polyuria

    • Insomnia related to soft tissue swelling

    • Impaired communication related to speech difficulties

    • Disturbed body image related to undersized hands, feet, jaw, and soft body tissue

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  • 12. 

    A client has developed syndrome of inappropriate antidiuretic hormone (SIADH) secondary to a pituitary tumor. The client’s symptoms include thirst, weight gain, and fatigue. The client’s serum sodium is 127 mEq/L. Which physician order should the nurse anticipate when treating SIADH?

    • Elevate the head of the bed

    • Administer vasopressin intravenously (IV)

    • Fluid restriction of 800 to 1,000 mL per day

    • 0.3% sodium chloride IV infusion

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  • 13. 

    Which finding should the nurse anticipate when assessing a client newly diagnosed with diabetes insipidus (DI)?

    • Polyuria

    • Weight gain

    • Hyperglycemia

    • Profuse sweating and flushed skin

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  • 14. 

    An agitated client is admitted to the emergency department (ED) with tachycardia, dyspnea, and intermittent chest palpitations. The client has a blood pressure of 170/110 mm Hg and heart rate of 130 beats per minute. The client’s health history reveals thinning hair, recent 10-lb. weight loss, increased appetite, fine hand and tongue tremors, hyperreflexic tendon reflexes, and smooth moist skin. A physician writes orders for the client. Which order should the nurse implement first?

    • Obtain 12-lead electrocardiogram (ECG).

    • Administer propranolol (Inderal®) 2 mg intravenously q10–15min or until symptoms are controlled.

    • Administer propylthiouracil (PTU) 600 mg oral loading dose followed by 200 mg orally q4h.

    • Obtain thyroid-stimulating hormone (TSH), free T4, and cardiac enzyme levels.

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  • 15. 

    Which nursing diagnosis should a nurse include when developing a plan of care for a client with hypothyroidism?

    • Diarrhea related to gastrointestinal hypermotility

    • Imbalance nutrition: less than body requirements related to calorie intake insufficient for metabolic rate

    • Activity intolerance related to increased metabolic rate

    • Anxiety related to forgetfulness, slowed speech, and impaired memory loss

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  • Current Version
  • Apr 08, 2025
    Quiz Edited by
    ProProfs Editorial Team
  • Apr 08, 2025
    Quiz Created by
    Catherine Halcomb
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