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Q&A Guide
1. A nurse is monitoring the laboratory values of a client who has
diabetes mellitus and is taking insulin. Which of the following
results indicates a therapeutic outcome of insulin therapy?
Fasting blood glucose 96 mg/dL Postprandial blood glucose 195 mg/dL Random blood glucose 210 mg/dL Preprandial blood glucose 60 mg/dL ✅ ANS: Fasting blood glucose 96 mg/dL Rationale: This is within the expected reference range of 70 to 110 mg/dL for fasting blood glucose level and indicates that insulin therapy is effective. Incorrect Option Rationales: Postprandial blood glucose 195 mg/dL: Above the expected range (< mg/dL). Random blood glucose 210 mg/dL: Above the expected range (< mg/dL). Preprandial blood glucose 60 mg/dL: Below the expected range (70– mg/dL).
Q&A Guide
2. A nurse is caring for a client following a thyroidectomy. The
nurse should assess for which of the following findings as an
indication of hypocalcemia?
Strong, bounding pulses Decreased bowel sounds Tingling and numbness of the hands and feet Diminished deep-tendon reflexes ✅ ANS: Tingling and numbness of the hands and feet Rationale: Hypocalcemia causes paresthesia, which usually starts in the hands and feet. Incorrect Option Rationales: Strong, bounding pulses: Hypocalcemia causes a weak, thready pulse. Decreased bowel sounds: Hypocalcemia increases GI motility, not decreases it. Diminished deep-tendon reflexes: Hypocalcemia causes hyperactive reflexes.
Q&A Guide
4. A nurse is assessing a client who is taking propylthiouracil.
Which of the following findings indicates that the medication has
been effective?
Increased ability to sweat Increased bowel movements Increased body weight Increased libido ✅ ANS: Increased body weight Rationale: Propylthiouracil suppresses thyroid hormone production, allowing for weight gain. Incorrect Option Rationales: Increased ability to sweat: Diaphoresis is associated with hyperthyroidism; treatment should reduce it. Increased bowel movements: Another sign of hyperthyroidism; treatment should normalize bowel activity. Increased libido: Hyperthyroidism can increase libido; successful treatment may reduce it.
Q&A Guide
5. A nurse is assessing a client who has syndrome of inappropriate
antidiuretic hormone (SIADH). Which of the following findings
should the nurse report to the provider?
Sodium 110 mEq/L 2+ deep tendon reflexes Potassium 3.7 mEq/L Urine specific gravity 1. ✅ ANS: Sodium 110 mEq/L Rationale: A client who has SIADH retains fluids, which causes dilutional hyponatremia. Incorrect Option Rationales: 2+ deep tendon reflexes: This is a normal finding. SIADH may cause hyperreflexia (3+ or 4+). Potassium 3.7 mEq/L: Within normal range (3.5 to 5 mEq/L). Urine specific gravity 1.025: Also within normal range (1.005 to 1.030).
Q&A Guide
7. A nurse is caring for a client who has diabetes mellitus and has
developed peripheral neuropathy. Which of the following
measures should the nurse recommend to prevent injuries to the
client's feet?
Examine the skin of the feet weekly for alterations in skin integrity Monitor the temperature of bath water with a thermostat Shop for shoes early in the day Round the edges of toenails when trimming them ✅ ANS: Monitor the temperature of bath water with a thermostat Rationale: Neuropathy reduces temperature sensation. Use a thermometer to avoid burns (keep water < 43.3°C / 110°F). Incorrect Option Rationales: Examine the skin of the feet weekly: Feet should be examined daily, not weekly. Shop for shoes early in the day: Shop later in the day when feet are more swollen for accurate sizing. Round toenails when trimming: Nails should be cut straight across to avoid ingrown toenails.
Q&A Guide
8. A nurse is planning teaching for a client who has type 1 diabetes
mellitus. Which of the following instructions should the nurse plan
to include?
Consume no more than three servings of alcohol per day Ingest food with alcohol to reduce alcohol-induced hypoglycemia Increase insulin dosage before planned exercise Rest for 3 days between periods of vigorous exercise ✅ ANS: Ingest food with alcohol to reduce alcohol-induced hypoglycemia Rationale: Alcohol inhibits liver glucose production. Eating carbs with alcohol helps prevent hypoglycemia. Incorrect Option Rationales: Consume no more than three servings of alcohol per day: Males should limit to 2 , females to 1. Increase insulin before exercise: Exercise lowers glucose, so insulin should often be reduced. Rest for 3 days between exercise: Clients should exercise at least 3 times/week with no more than 2 days off.
Q&A Guide
10. A nurse is caring for a client who has type 2 diabetes mellitus
and is experiencing a hyperglycemic-hyperosmolar state (HHS).
Which of the following laboratory findings should the nurse
expect?
Serum pH 7. Blood glucose 250 mg/dL Blood glucose 425 mg/dL Serum pH 7. ✅ ANS: Serum pH 7. Rationale: In HHS, there's severe hyperglycemia without ketoacidosis. Thus, pH remains within or slightly above normal. Incorrect Option Rationales: Serum pH 7.32: Suggests diabetic ketoacidosis (DKA), not HHS. Blood glucose 250 or 425 mg/dL: HHS typically presents with glucose levels
600 mg/dL.
Q&A Guide
11. A nurse is reviewing the lab results of a client undergoing
screening for primary Cushing’s disease. Which of the following
findings should the nurse expect to be elevated?
Lymphocyte count Potassium Calcium Glucose ✅ ANS: Glucose Rationale: Hyperglycemia is a hallmark of Cushing's due to increased cortisol levels. Incorrect Option Rationales: Lymphocyte count: Often decreased due to immunosuppression. Potassium: Often decreased due to aldosterone-like effects of cortisol. Calcium: Usually decreased in Cushing’s.
Q&A Guide
13. A nurse in an outpatient clinic is teaching a client who has a
diabetic foot ulcer about foot care. Which of the following
statements by the client indicates an understanding of the
teaching?
"I will let my feet air dry after washing." "I will wear sandals to allow air to circulate around my feet." "I will buy over-the-counter medicine to treat the calluses on my feet." "I will apply lotion to the dry areas of my feet but not between my toes." ✅ ANS: "I will apply lotion to the dry areas of my feet but not between my toes." Rationale: Moisture between toes can lead to fungal or bacterial growth. It's important to keep that area dry. Incorrect Option Rationales: Letting feet air dry: Feet should be thoroughly dried after washing, especially between the toes. Wearing sandals: Clients should wear closed-toe shoes for protection. Using OTC callus medication: These can damage skin and increase risk of injury.
Q&A Guide
14. A nurse is teaching a client who is scheduled for a
vanillylmandelic acid (VMA) test to screen for pheochromocytoma.
Which statement should the nurse include in the teaching?
"Start fasting at midnight prior to the day of the test." "Begin the 24-hour urine collection with the first morning urination." "Take low-dose aspirin for pain during the testing period." "Restrict coffee intake 2 to 3 days prior to the test." ✅ ANS: "Restrict coffee intake 2 to 3 days prior to the test." Rationale: Foods such as caffeine, bananas, chocolate, and vanilla can affect test results and must be avoided. Incorrect Option Rationales: Fasting: Fasting is not necessary for this test. Starting with first morning urine: The first morning void should be discarded; collection starts after that. Aspirin use: Aspirin can interfere with the results and should be avoided.
Q&A Guide
16. A nurse is assessing a client who has adrenal insufficiency.
Which of the following findings should the nurse expect?
Moon-shaped face Weight gain Calcium 12.8 mg/dL Sodium 150 mEq/L ✅ ANS: Calcium 12.8 mg/dL Rationale: Hypercalcemia is an expected finding in adrenal insufficiency. Incorrect Option Rationales: Moon face: A finding in Cushing’s syndrome, not adrenal insufficiency. Weight gain: Clients typically lose weight with adrenal insufficiency. Sodium 150 mEq/L: Sodium is usually low, not elevated, due to aldosterone deficiency.
Q&A Guide
17. A nurse is admitting a client who has hyperthyroidism. When
assessing the client, the nurse should expect which of the
following findings?
Cold intolerance Lethargy Tremors Sunken eyes ✅ ANS: Tremors Rationale: Tremors, along with anxiety, tachycardia, and insomnia, are classic signs of increased thyroid hormone levels. Incorrect Option Rationales: Cold intolerance: Seen in hypothyroidism. Hyperthyroid clients are heat- intolerant. Lethargy: These clients are more likely to be restless and irritable. Sunken eyes: Hyperthyroidism causes exophthalmos (bulging eyes), not sunken ones.
Q&A Guide
19. A nurse is teaching a client about glycosylated hemoglobin
(HbA1c) testing. Which of the following client statements indicates
an understanding of the teaching?
"I need to fast after midnight the night before the test." "The test's result is a good indicator of my average blood glucose levels." "A level of 8 to 10 percent suggests adequate blood glucose control." "I will use my hemoglobin A1c level to adjust my daily insulin doses." ✅ ANS: "The test's result is a good indicator of my average blood glucose levels." Rationale: HbA1c shows average glucose over the previous 2–3 months. Incorrect Option Rationales: Fasting before the test: Not required for HbA1c testing. 8–10% suggests control: This is too high; target is usually <7%. Using A1c for daily insulin adjustment: Daily capillary glucose checks are used, not A1c.
Q&A Guide
20. A nurse is teaching a client who has type 1 diabetes mellitus
about how to prevent complications during illness. Which of the
following statements by the client indicates an understanding of
the teaching?
"I should stop taking my insulin if I feel nauseous." "I will test my urine for protein when I start to feel ill." "I will call my doctor if my blood sugar is more than 250." "I should check my blood sugar level every 8 hours." ✅ ANS: "I will call my doctor if my blood sugar is more than 250." Rationale: Illness can increase blood sugar; the client should notify the provider for readings >250 mg/dL. Incorrect Option Rationales: Stopping insulin when nauseous: Insulin should generally not be stopped during illness. Testing urine for protein: The client should test for ketones, not protein. Checking sugar every 8 hours: It should be checked every 4 hours during illness.
