Endocrine System Disorders | NCLEX Quiz 96

1. Knowing that gluconeogenesis helps to maintain blood levels. a nurse should:

Document weight changes because of fatty acid mobilization

Evaluate the patient’s sensitivity to low room temperatures because of decreased adipose tissue insulation

Protect the patient from sources of infection because of decreased cellular protein deposits

Do all of the above

The correct answer is "Do all of the above." This is because gluconeogenesis is a process in which the body produces glucose from non-carbohydrate sources, such as fatty acids. This can lead to weight changes due to fatty acid mobilization. Additionally, decreased adipose tissue insulation can make patients more sensitive to low room temperatures. Gluconeogenesis also leads to decreased cellular protein deposits, which can weaken the immune system and make patients more susceptible to infections. Therefore, it is important for the nurse to document weight changes, evaluate sensitivity to low room temperatures, and protect the patient from sources of infection.

Explanation

The correct answer is "Do all of the above." This is because gluconeogenesis is a process in which the body produces glucose from non-carbohydrate sources, such as fatty acids. This can lead to weight changes due to fatty acid mobilization. Additionally, decreased adipose tissue insulation can make patients more sensitive to low room temperatures. Gluconeogenesis also leads to decreased cellular protein deposits, which can weaken the immune system and make patients more susceptible to infections. Therefore, it is important for the nurse to document weight changes, evaluate sensitivity to low room temperatures, and protect the patient from sources of infection.

2. Albert refuses his bedtime snack. This should alert the nurse to assess for:

Elevated serum bicarbonate and a decreased blood pH.

Signs of hypoglycemia earlier than expected.

Symptoms of hyperglycemia during the peak time of NPH insulin.

Sugar in the urine

Albert refusing his bedtime snack may be an indication of hypoglycemia. When blood sugar levels are low, individuals may experience a loss of appetite or refusal to eat. Therefore, the nurse should assess for signs of hypoglycemia earlier than expected, such as sweating, tremors, weakness, confusion, or dizziness. Monitoring blood glucose levels and providing appropriate treatment is necessary to prevent further complications.

Explanation

Albert refusing his bedtime snack may be an indication of hypoglycemia. When blood sugar levels are low, individuals may experience a loss of appetite or refusal to eat. Therefore, the nurse should assess for signs of hypoglycemia earlier than expected, such as sweating, tremors, weakness, confusion, or dizziness. Monitoring blood glucose levels and providing appropriate treatment is necessary to prevent further complications.

3. A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction is:

Blurred vision

Diaphoresis

Nausea

Weakness

Diaphoresis is a clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction. Hypoglycemia refers to low blood sugar levels, which can cause excessive sweating or diaphoresis as a compensatory response by the body. On the other hand, ketoacidosis is a condition characterized by high blood sugar levels and the presence of ketones in the blood. While symptoms such as blurred vision, nausea, and weakness can occur in both conditions, diaphoresis is more commonly associated with hypoglycemia.

Explanation

Diaphoresis is a clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction. Hypoglycemia refers to low blood sugar levels, which can cause excessive sweating or diaphoresis as a compensatory response by the body. On the other hand, ketoacidosis is a condition characterized by high blood sugar levels and the presence of ketones in the blood. While symptoms such as blurred vision, nausea, and weakness can occur in both conditions, diaphoresis is more commonly associated with hypoglycemia.

4. Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the following except:

Integumentary inspection for the presence of brown spots on the lower extremities

Observation for paleness of the lower extremities

Observation for blanching of the feet after the legs are elevated for 60 seconds

Palpation for increased pulse volume in the arteries of the lower extremities

The correct answer is "Palpation for increased pulse volume in the arteries of the lower extremities." In microangiopathy, there is a narrowing or blockage of small blood vessels, leading to impaired peripheral arterial circulation. This can result in paleness of the lower extremities, blanching of the feet after leg elevation, and brown spots on the skin. However, microangiopathy typically causes decreased pulse volume in the affected arteries, not increased pulse volume. Therefore, palpation for increased pulse volume would not be a relevant assessment in this case.

Explanation

The correct answer is "Palpation for increased pulse volume in the arteries of the lower extremities." In microangiopathy, there is a narrowing or blockage of small blood vessels, leading to impaired peripheral arterial circulation. This can result in paleness of the lower extremities, blanching of the feet after leg elevation, and brown spots on the skin. However, microangiopathy typically causes decreased pulse volume in the affected arteries, not increased pulse volume. Therefore, palpation for increased pulse volume would not be a relevant assessment in this case.

5. Clinical manifestations associated with a diagnosis of type 1 DM include all of the following except:

Hypoglycemia

Hyponatremia

Ketonuria

Polyphagia

The clinical manifestations associated with a diagnosis of type 1 DM include hyponatremia, ketonuria, and polyphagia. Hypoglycemia, on the other hand, is not typically associated with type 1 DM. Type 1 DM is characterized by high blood sugar levels due to the body's inability to produce insulin. Hypoglycemia, which is low blood sugar levels, is more commonly associated with type 2 DM or insulin overdose.

Explanation

The clinical manifestations associated with a diagnosis of type 1 DM include hyponatremia, ketonuria, and polyphagia. Hypoglycemia, on the other hand, is not typically associated with type 1 DM. Type 1 DM is characterized by high blood sugar levels due to the body's inability to produce insulin. Hypoglycemia, which is low blood sugar levels, is more commonly associated with type 2 DM or insulin overdose.

6. The lowest fasting plasma glucose level suggestive of a diagnosis of DM is:

90mg/dl

115mg/dl

126mg/dl

180mg/dl

A fasting plasma glucose level of 126mg/dl is suggestive of a diagnosis of DM (diabetes mellitus). This is because a fasting plasma glucose level above 126mg/dl indicates that the body is unable to properly regulate blood sugar levels, which is a characteristic of diabetes.

Explanation

A fasting plasma glucose level of 126mg/dl is suggestive of a diagnosis of DM (diabetes mellitus). This is because a fasting plasma glucose level above 126mg/dl indicates that the body is unable to properly regulate blood sugar levels, which is a characteristic of diabetes.

7. Rotation sites for insulin injection should be separated from one another by 2.5 cm (1 inch) and should be used only every:

Third day

Week

2-3 weeks

2-4 weeks

The rotation sites for insulin injection should be separated by 2.5 cm (1 inch) in order to prevent lipohypertrophy, a condition where fatty lumps develop under the skin. Using the same injection site repeatedly can lead to this condition. Therefore, it is recommended to rotate injection sites every 2-3 weeks to allow the previous site to heal and prevent the development of lipohypertrophy.

Explanation

The rotation sites for insulin injection should be separated by 2.5 cm (1 inch) in order to prevent lipohypertrophy, a condition where fatty lumps develop under the skin. Using the same injection site repeatedly can lead to this condition. Therefore, it is recommended to rotate injection sites every 2-3 weeks to allow the previous site to heal and prevent the development of lipohypertrophy.

8. The nurse expects that a type 1 diabetic may receive ____ of his or her morning dose of insulin preoperatively:

10-20%

25-40%

50-60%

85-90%

Type 1 diabetics require insulin to manage their blood sugar levels. Preoperatively, it is expected that they may receive 50-60% of their morning dose of insulin. This is because the stress of surgery can increase blood sugar levels, and reducing the dose helps prevent hypoglycemia during the procedure. Additionally, the patient may not be able to eat or drink normally before surgery, further necessitating a reduction in insulin dosage.

Explanation

Type 1 diabetics require insulin to manage their blood sugar levels. Preoperatively, it is expected that they may receive 50-60% of their morning dose of insulin. This is because the stress of surgery can increase blood sugar levels, and reducing the dose helps prevent hypoglycemia during the procedure. Additionally, the patient may not be able to eat or drink normally before surgery, further necessitating a reduction in insulin dosage.

9. Albert. a 35-year-old insulin dependent diabetic. is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830. 1230. and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of:

1130 and 1330

1330 and 1930

1530 and 2130

1730 and 2330

The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of 1330 and 1930 because NPH insulin typically peaks around 4-8 hours after administration. Since Albert is given NPH insulin at 0730, it is expected to reach its peak effect between 1330 and 1930, which falls within the 4-8 hour timeframe.

Explanation

The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of 1330 and 1930 because NPH insulin typically peaks around 4-8 hours after administration. Since Albert is given NPH insulin at 0730, it is expected to reach its peak effect between 1330 and 1930, which falls within the 4-8 hour timeframe.

10. A bedtime snack is provided for Albert. This is based on the knowledge that intermediate-acting insulins are effective for an approximate duration of:

6-8 hours

10-14 hours

16-20 hours

24-28 hours

The correct answer is 16-20 hours. This knowledge is used to determine the appropriate timing of Albert's bedtime snack. Since intermediate-acting insulins are effective for approximately 16-20 hours, providing a snack at bedtime will help prevent low blood sugar levels during the night. This ensures that Albert's blood sugar remains stable throughout the night until the next meal.

Explanation

The correct answer is 16-20 hours. This knowledge is used to determine the appropriate timing of Albert's bedtime snack. Since intermediate-acting insulins are effective for approximately 16-20 hours, providing a snack at bedtime will help prevent low blood sugar levels during the night. This ensures that Albert's blood sugar remains stable throughout the night until the next meal.