Endocrine System Disorders | NCLEX Quiz 96

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| By Santepro

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Quizzes Created: 468 | Total Attempts: 2,477,691

Questions: 10 | Attempts: 1,364 | Updated: Mar 21, 2023

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All questions are shown, but the results will only be given after you’ve finished the quiz. You are given 1 minute per question, a total of 10 minutes in this quiz.

Questions and Answers

1.

Knowing that gluconeogenesis helps to maintain blood levels. a nurse should:
- A.
  
  Document weight changes because of fatty acid mobilization
- B.
  
  Evaluate the patient’s sensitivity to low room temperatures because of decreased adipose tissue insulation
- C.
  
  Protect the patient from sources of infection because of decreased cellular protein deposits
- D.
  
  Do all of the above
Correct Answer
D. Do all of the above

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.

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2.

Clinical manifestations associated with a diagnosis of type 1 DM include all of the following except:
- A.
  
  Hypoglycemia
- B.
  
  Hyponatremia
- C.
  
  Ketonuria
- D.
  
  Polyphagia
Correct Answer
A. Hypoglycemia

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.

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3.

The lowest fasting plasma glucose level suggestive of a diagnosis of DM is:
- A.
  
  90mg/dl
- B.
  
  115mg/dl
- C.
  
  126mg/dl
- D.
  
  180mg/dl
Correct Answer
C. 126mg/dl

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.

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4.

Rotation sites for insulin injection should be separated from one another by 2.5 cm (1 inch) and should be used only every:
- A.
  
  Third day
- B.
  
  Week
- C.
  
  2-3 weeks
- D.
  
  2-4 weeks
Correct Answer
C. 2-3 weeks

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.

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5.

A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction is:
- A.
  
  Blurred vision
- B.
  
  Diaphoresis
- C.
  
  Nausea
- D.
  
  Weakness
Correct Answer
B. Diaphoresis

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.

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6.

Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the following except:
- A.
  
  Integumentary inspection for the presence of brown spots on the lower extremities
- B.
  
  Observation for paleness of the lower extremities
- C.
  
  Observation for blanching of the feet after the legs are elevated for 60 seconds
- D.
  
  Palpation for increased pulse volume in the arteries of the lower extremities
Correct Answer
D. Palpation for increased pulse volume in the arteries of the lower extremities

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.

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7.

The nurse expects that a type 1 diabetic may receive ____ of his or her morning dose of insulin preoperatively:
- A.
  
  10-20%
- B.
  
  25-40%
- C.
  
  50-60%
- D.
  
  85-90%
Correct Answer
C. 50-60%

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.

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8.

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:
- A.
  
  1130 and 1330
- B.
  
  1330 and 1930
- C.
  
  1530 and 2130
- D.
  
  1730 and 2330
Correct Answer
B. 1330 and 1930

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.

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9.

A bedtime snack is provided for Albert. This is based on the knowledge that intermediate-acting insulins are effective for an approximate duration of:
- A.
  
  6-8 hours
- B.
  
  10-14 hours
- C.
  
  16-20 hours
- D.
  
  24-28 hours
Correct Answer
C. 16-20 hours

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.

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10.

Albert refuses his bedtime snack. This should alert the nurse to assess for:
- A.
  
  Elevated serum bicarbonate and a decreased blood pH.
- B.
  
  Signs of hypoglycemia earlier than expected.
- C.
  
  Symptoms of hyperglycemia during the peak time of NPH insulin.
- D.
  
  Sugar in the urine
Correct Answer
B. Signs of hypoglycemia earlier than expected.

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.

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Current Version
Mar 21, 2023

Quiz Edited by
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Oct 04, 2017

Quiz Created by
Santepro

Endocrine System Disorders | NCLEX Quiz 96

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

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

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

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

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

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

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

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

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