Nokea
The client with DM is to receive insulin IV at 1.5 units per hour. The insulin bag contains 10 units of insulin in 100 mL of NS. The nurse should set the infusion pump to deliver how many milliliters per hour?
- A. 1.0 mL/hr
- B. 1.5 mL/hr
- C. 2.0 mL/hr
- D. 2.5 mL/hr
Correct Answer: B
Rationale: 10 units : 100 mL :: 1.5 units : X mL; 10X = 150; X = 1.5 mL/hr.
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When the client asks the nurse why regular exercise is recommended for diabetic clients, the best answer is that exercise tends to facilitate which positive outcome?
- A. Regular exercise helps to control weight.
- B. Regular exercise helps to decrease appetite.
- C. Regular exercise helps to reduce blood glucose levels.
- D. Regular exercise helps to improve circulation to the feet.
Correct Answer: C
Rationale: Exercise increases insulin sensitivity, reducing blood glucose levels in diabetes.
Which signs/symptoms should the nurse expect to assess in the 31-year-old client who has a sustained release of growth hormone (GH)?
- A. An enlarged forehead, maxilla, and face.
- B. A six (6)-inch increase in height of the client.
- C. The client complaining of a severe headache.
- D. A systolic blood pressure of 200 to 300 mm Hg.
Correct Answer: A
Rationale: Excess GH (acromegaly) causes facial and bone enlargement (e.g., forehead, maxilla). Height increase occurs pre-puberty, headaches are nonspecific, and extreme hypertension is unrelated.
When the client practices self-administration of the insulin, which action is correct?
- A. Piercing the skin at a 30-degree angle
- B. Using a syringe calibrated in minims
- C. Using a 29-gauge needle on the syringe
- D. Rotating abdominal sites for each injection
Correct Answer: D
Rationale: Rotating abdominal sites prevents lipodystrophy and ensures consistent insulin absorption.
The nurse reviews the HCP's orders for the newly admitted client diagnosed with DKA. Which order should the nurse question?
- A. Administer D5W intravenously (IV) at 125 mL per hour
- B. Administer KCL 10 mEq in 100 mL NaCl IV now
- C. Give sodium bicarbonate IV per pharmacy dosing if arterial pH is less than 7.0
- D. Start regular insulin infusion per protocol; titrate based on hourly glucose level
Correct Answer: A
Rationale: In DKA, the blood glucose level is above 300 mg/dL. Additional glucose will increase the glucose level further. Initially 0.45% or 0.9% sodium chloride (NaCl) is administered for fluid resuscitation.
The nurse is assessing the client who has type 2 DM. Which findings indicate to the nurse that the client is experiencing HHNS? Select all that apply.
- A. Serum osmolality 364 mOsm/kg
- B. Blood glucose level 160 mg/dL
- C. Very dry mucous membranes
- D. Blood pressure of 90/42 mm Hg
- E. Urine output 500 mL past 8 hours
Correct Answer: A,C,D
Rationale: A serum osmolality of 364 mOsm/kg, very dry mucous membranes, and a BP of 90/42 indicate HHNS due to elevated osmolality, dehydration, and hypotension from osmotic diuresis.