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ATI nur 285 Med Surg Exam
Total Questions : 50
Showing 10 questions, Sign in for moreA patient is transferred to the emergency department from the outpatient clinic with a diagnosis of hyperkalemia. Kayexalate was prescribed. Which of the following nursing actions will the nurse perform before administering Kayexalate?
Following an intravenous pyelogram (IVP) using contrast medium, the nurse should anticipate incorporating which of the following measures the client's plan of care?
A nurse is teaching a client who has a new diagnosis of Type 1 diabetes mellitus about self-administration of insulin. Which of the following instructions should the nurse include?
A nurse is teaching a client who has type 1 diabetes mellitus about foot care. Which of the following statements by the client indicates an understanding of the teaching?
A nurse is caring for a client who has undergone a transurethral prostatectomy. Following catheter removal, the nurse should inform the client that he should expect which of the following variations in the color of his urine?
A nurse is reviewing laboratory values for a client who has systemic lupus erythematosus (SLE). Which of the following values should give the nurse the best indication of the client's renal function?
A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic a few months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?
A nurse is caring for a client who has diabetes and a new prescription for 16 units of regular insulin and 26 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?
A nurse is teaching about self-monitoring to a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?
HbA1c 8.4% (less than 7% for diabetics)
Blood glucose 235 mg/dL (74 to 106 mg/dL)
Hemoglobin 14.2 g/dL (12 to 18 g/dL)
Hematocrit 42.6% (37 to 52%)
Total WBC count 6000/mm3 (5000 to 10,000/mm3)
HDL 75 mg/dL (greater than 55 mg/dL)
LDL 124 mg/dL (less than 130 mg/dL)
BNP 52 pg/ml (less than 100 pg/mL)
Chest X-Ray: No evidence of infiltrates
|
Urinalysis |
Result |
Expected Reference Range |
|
Appearance |
Clear |
Clear |
|
Color |
Amber |
Yellow |
|
pH |
5.8 |
4.6 to 8.0 |
|
Specific gravity |
1.012 |
1.005 to 1.030 |
|
Leucocyte esterase |
Negative |
Negative |
|
Nitrates |
None |
None |
|
Crystals |
None |
None |
|
Casts |
None |
None |
BP 120/72 mm Hg
Temperature 36.8° C (98.2° F)
Pulse rate 88/min
Respirations 20/min
Glargine U 100 25 units subcutaneous at bedtime
Fingerstick/random blood glucose before breakfast & bedtime with regular insulin subcutaneous sliding scale coverage:
Less than 160 mg/dL: no coverage
160 to 220 mg/dL: 2 units
221 to 280 mg/dL: 3 units
281 to 340 mg/dL: 6 units 341to 400 mg/dL: 8 unit Greater than 400: call physician
Aldactone 50 mg PO twice daily Digoxin 0.25 mg PO every morning Carvedilol 25 mg PO twice daily
Client received to emergency department from home yia private vehicle. Reports fatigue, blurred vision, dizziness, and headache x 2 days. Reports running out of blood glucose strips and Humulin regular insulin due to lack of financial means. States that they are afraid of possible falls from fatigue and dizziness. Lives at home alone. Orders received; will increase glargine from 20 units to 25 units at bedtime. Other meds taken at home remain the same at this time.
A nurse is caring for a client who is being admitted to the medical-surgical unit from the emergency department. The nurse is reviewing the client's medical records.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Explanation
Condition Most Likely Experiencing:
- Type 1 diabetes
Actions to Take:
- Teach the client about the signs of hyperglycemia.
- Assess the client’s feet for sensation.
Parameters to Monitor:
- Fingerstick blood glucose
- Blood pressure
Rationale: The client has a high HbA1c (8.4%) and elevated blood glucose level (235 mg/dL), indicating poor blood glucose control. Symptoms such as fatigue, blurred vision, and dizziness suggest hyperglycemia, which can occur in clients with diabetes who have not been able to maintain regular glucose monitoring or insulin administration due to financial constraints. Teaching the client about hyperglycemia symptoms and checking feet for sensation is important due to the risk of complications like neuropathy. Monitoring blood glucose and blood pressure is essential for evaluating diabetes management and preventing complications.
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