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LPN Level 3 med surg endocrine exam
ATI LPN Level 3 med surg endocrine exam
Total Questions : 37
Showing 10 questions Sign up for moreA nurse is caring for a client who has type 1 diabetes mellitus. The nurse misread the client's morning fasting blood glucose level as 210 mg/dL instead of 120 mg/dL and administered the insulin dose appropriate for a reading over 200 mg/dL. Which of the following actions should the nurse identify as the priority?
Explanation
A. Give the client 15 to 20 g of carbohydrate: While administering a carbohydrate source is appropriate to treat hypoglycemia, the nurse should first confirm whether the client is experiencing hypoglycemia by checking their blood glucose level.
B. Notify the nurse manager: Reporting the error is important but not the priority. The client's safety takes precedence over reporting.
C. Check the client's blood glucose level: This is the priority action to determine if hypoglycemia has occurred due to the incorrect insulin dose. Immediate identification of hypoglycemia ensures timely treatment.
D. Complete an incident report: Incident reports are essential for documenting errors, but they are a secondary step after ensuring the client's safety.
A nurse is reinforcing teaching with a client about taking high doses of oral glucocorticoids for over ten years to treat rheumatoid arthritis. Which of the following information should the nurse include in the teaching?
Explanation
A. Monitor for compression fractures of the back and neck: Long-term use of glucocorticoids increases the risk of osteoporosis, leading to compression fractures. Monitoring for these complications is critical for early intervention.
B. Glucocorticoids will boost immunity: Glucocorticoids suppress immune function, increasing susceptibility to infections. This statement is incorrect.
C. Plan to check blood glucose levels for hypoglycemia once each year: Glucocorticoids often cause hyperglycemia, not hypoglycemia, necessitating frequent monitoring, especially in individuals at risk of diabetes.
D. Limit the intake of calcium-rich foods while taking the medication: Calcium-rich foods are encouraged to mitigate the risk of glucocorticoid-induced osteoporosis, making this advice inappropriate.
A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus. The nurse determines that teaching has been effective when the client identifies which of the following manifestations of hypoglycemia? (Select all that apply.)
(Select All that Apply.)
Explanation
A. Clammy: Hypoglycemia often causes diaphoresis, resulting in clammy skin.
B. Tachycardia: The release of epinephrine in response to hypoglycemia leads to tachycardia.
C. Blurry Vision: Neuroglycopenia from insufficient glucose to the brain can result in visual disturbances like blurry vision.
D. Dry Skin: Dry skin is more indicative of hyperglycemia or dehydration, not hypoglycemia.
E. Warm/Hot Skin: Warm or hot skin is associated with fever or hyperglycemia, not hypoglycemia.
A nurse is caring for a client who has a new onset of diabetes mellitus and is experiencing uncontrolled blood glucose levels. The client informs the nurse about their strict dietary compliance. Which should the nurse anticipate the provider prescribing for treatment?
Explanation
A. Insulin injections daily: Uncontrolled blood glucose levels, despite dietary compliance, indicate that the pancreas may not be producing adequate insulin. Daily insulin is necessary to control hyperglycemia in this situation.
B. Fluid restrictions: Fluid restrictions are not indicated unless the client has comorbidities like heart or renal failure.
C. Oral hypoglycemic medications: Oral medications are often ineffective for Type 1 diabetes or severe cases of Type 2 diabetes with marked hyperglycemia.
D. Peritoneal dialysis therapy: This is a treatment for end-stage renal disease, not uncontrolled diabetes mellitus.
A nurse is caring for a client who is taking levothyroxine for hypothyroidism. Which of the following indicates the client's dose is too high?
Explanation
A. Weight gain: Excessive levothyroxine leads to hyperthyroidism, which typically causes weight loss, not gain.
B. Bradycardia: Bradycardia is a symptom of hypothyroidism, not hyperthyroidism from excessive levothyroxine.
C. Decreased temperature: Low body temperature is a sign of hypothyroidism, not hyperthyroidism.
D. Tachypnea: Overdosing on levothyroxine can cause hyperthyroidism, leading to increased metabolic rate and symptoms such as tachypnea.
A nurse is preparing to administer levothyroxine 275 mcg PO to a client. The amount available is levothyroxine 137 mcg/tablet. How many tablets should the nurse administer? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Explanation
Dose required: 275 mcg
Dose available: 137 mcg/tablet
Tablets required = 275137
= 2.007137275​
=2.007
rounded to 2 tablets.
A nurse is reinforcing teaching for a client who has type 1 diabetes mellitus about foot care. Which of the following client statements should indicate to the nurse an understanding of the instructions?
Explanation
A. "I'll put lotion between my toes.": This increases the risk of fungal infections and should be avoided.
B. "I'll check my feet every day for sores and bruises.": Daily foot inspections help identify injuries or infections early, crucial for clients with diabetes due to poor healing and neuropathy.
C. "I'll wear sandals in warm weather.": Open-toed shoes can lead to foot injuries or exposure to harmful elements, which should be avoided.
D. "I'll soak my feet in warm, soapy water every night before I go to bed.": Soaking can cause skin maceration and increase the risk of infection, especially in clients with diabetes.
A nurse is reinforcing teaching with a client who has hypothyroidism and a prescription for levothyroxine. Which of the following statements should the nurse make to the client?
Explanation
A. "Levothyroxine will decrease your metabolic rate and body temperature.": Levothyroxine increases the metabolic rate and body temperature by correcting hypothyroidism. This statement is incorrect.
B. "Take levothyroxine at dinner time daily.": Levothyroxine is best taken on an empty stomach in the morning to optimize absorption.
C. "Tremors, nervousness, and insomnia can indicate that your dose is too high.": These symptoms are consistent with hyperthyroidism, which can result from excessive levothyroxine dosage.
D. "Take this medication until manifestations of hypothyroidism are gone and then discontinue.": Levothyroxine is usually a lifelong therapy and should not be stopped without provider guidance.
A nurse receives a new prescription from the provider that reads "Give regular insulin 14 units and NPH insulin 28 units subcutaneously at breakfast." How many syringes should the nurse prepare?
__________syringe
Explanation
Both regular insulin and NPH insulin can be mixed in one syringe, as they are compatible. The nurse should draw up regular insulin first (14 units) and then NPH insulin (28 units) to ensure accuracy. Only 1 syringe is required.
A nurse is reinforcing teaching about preventing long-term complications of retinopathy and neuropathy with an older adult client who has diabetes mellitus. Which of the following actions is the most important for the nurse to include in the teaching?
Explanation
A. "Examine your feet carefully every day.": Daily foot exams are crucial to prevent complications like infections, but controlling blood glucose is more important for preventing retinopathy and neuropathy.
B. "Maintain stable blood glucose levels.": Tight glucose control is the most critical action to reduce the risk of long-term complications, such as retinopathy and neuropathy.
C. "Wear closed-toed shoes daily.": This protects the feet but does not address the root cause of neuropathy and retinopathy.
D. "Plan to have an eye examination once per year.": Annual eye exams are essential for detecting retinopathy early, but stable blood glucose levels are the key to preventing its development.
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