Which action is most appropriate regarding the nurse’s administration of a rapid-acting insulin to a hospitalized pt?

Give it within 15 minutes of mealtime.

During a teaching session for a patient on antithyroid drugs, the nurse will discuss which dietary instructions?

Avoiding foods containing iodine

A patient who is taking PTU for hyperthyroidism wants to know how this medicine works. RN explains that PTU works by...

It slows down the formation of thyroid hormone.

RN is teaching infection-prevention w/ a pt receiving chemo. Which statement indicates the need for further education?

“I will eat only fresh fruits and raw vegetables.”

RN providing education for pt's on immunosupressants. RN will include which information? SATA.

Pt should report any fever, sore throat, chills, or joint pain., The mouth and tongue should be carefully inspected for white patches., Pt should take an oral form with food to avoid GI distress., Pt should avoid crowds to minimize risk of infection.

The nurse knows to administer acarbose, an alpha-glucosidase inhibitor, at which time?

With the first bite of each main meal

RN is developing a plan of care for a pt who is exp anorexia & nausea after chemo. What is an appropriate outcome?

Pt will eat small, frequent feedings w/ nutrition supplements during chemo

Which information needs to be included in the RN's teaching of pt's taking thyroid medications? SATA.

Keeping a log of responses w/ HR, weight, and mood., The med should be taken at the same time every day., Nervousness, irritiability, and insomnia may occur if the dose is too high.

Pt is informed they need a "booster" shot, after receiving the full 3 shot Hep B series. RN replies....

"Your body didn't produce enough antibodies, so a booster is needed."

Pt is taking prednisone for 2 weeks and wants to stop. RN explains that he must slowly decrease his dosage, why?

Pt would experience withdrawal symptoms if he abruptly stopped the meds.

Pt is receiving chemo & knows that stomatitis is a potential adverse effect. What will RN teach her about managing this?

“Be sure to examine your mouth daily for bleeding, pain, and ulcerations.”

Pt is taking a sulfonylurea med for T2DM. When reviewing potential adverse effects, RN will include which info? SATA.

Hypoglycemia, Weight gain, Nausea

Pt in the ED was showing s/s of hypoglycemia, has a glucose level of 38 mg/dL, & is unconscious. RN will anticipate....

Administering intravenous glucose (50% dextrose)

Why do we need to get a flu vaccine each year?

The active strains of flu change each year

During tx of a pt who has breast CA, RN hears MD mention that the pt has reached the “nadir.” RN knows this term means?

The lowest level of neutrophils reached during therapy.

When giving chemo, RN keeps in mind that these drugs include which general adverse effects? SATA.

Infertility, Diarrhea, Stomatitis, Bone marrow suppression, Nausea and vomiting

Pt has been receiving IV corticosteroids for PNA. Pt's glucose level is elevated. What is the best explanation?

The corticosteroids may cause an increase in glucose levels.

Pt has thrombocytopenia after chemo. Which s/s should the RN look for? SATA.

Bruising, Increased bleeding from venipuncture sites

If a patient is hypoglycemic, the nurse prepares to administer.... SATA.

D50 injection IV, Glucose tabs, Juice and a snack

Pt who has T2DM has an endoscopy & has been NPO since 0000. What is the best action by RN regarding morning meds?

Contact the prescriber for further orders.

19 y/o F dx w/ hypothyroidism & has started levothyroxine. After 6 months, she wants to stop the meds. What does RN say?

“Meds for hypothyroidism is lifelong, & should not stop taking the meds."

While montoring a pt receiving insulin, the RN observes for which signs of hypoglycemia?

Irritiability, sweating, and confusion

The nurse is teaching a group of patients about management of diabetes. Which statement about basal dosing is correct?

“Basal dosing delivers a constant dose of insulin.”

What are important things to teach patients on chemo drugs? SATA.

Stay away from people that are sick., Teach patient how to properly wash their hands., Avoid fresh fruits and vegetables., You may experience hair loss

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Unit 9 (Immune System) and Unit 10 (Endocrine System) Review

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Questions 75

Answers

1
When teaching about hypoglycemia, RN will teach pt is aware of the early signs of hypoglycemia, including the following?
Fruity, acetone odor to the breath
Hypothermia and seizures
Nausea and diarrhea
Confusion and sweating
2
Which action is most appropriate regarding the nurse’s administration of a rapid-acting insulin to a hospitalized pt?
Give it after the meal has been completed.
Administer it once daily at the time of the midday meal.
Administer it with a snack before bedtime.
Give it within 15 minutes of mealtime.
3
During a teaching session for a patient on antithyroid drugs, the nurse will discuss which dietary instructions?
Increasing intake of sodium- and potassium-containing foods
Avoiding foods containing iodine
Using iodized salt when cooking
Restricting fluid intake to 2500 mL/day
4
Pt is to given an insulin drip for high blood sugar levels. RN knows that which type of insulin would be used for IV?
Glargine
Regular
Lispro
NPH
5
Teaching a pt taking an antithyroid medication will include the need to avoid which of these foods?
Soy products and seafood
Processed meats and cheeses
Bananas and oranges
Dairy products
6
When is the best time of day to take hypothyroid medication?
It doesn't matter when you take the medication.
30 minutes after breakfast
Lunchtime
30 minutes before breakfast
7
Epoetin Alfa would be prescribed to a patient when they develop:
Leukocytosis
Hypoglycemia
Thrombocytopenia
Anemia
8
What type of immunity occurs when antibodies pass from mother to infant during breastfeeding or through the placenta?
Natural passive immunization
Artificial active immunization
Attenuating immunization
Artificial passive immunization
9
A patient who is taking PTU for hyperthyroidism wants to know how this medicine works. RN explains that PTU works by...
It inactivates already existing thyroid hormone in the bloodstream.
It promotes the formation of thyroid hormone.
It slows down the formation of thyroid hormone.
It destroys overactive cells in the thyroid gland.
10
RN is teaching infection-prevention w/ a pt receiving chemo. Which statement indicates the need for further education?
“It is important for both my family and me to practice good handwashing.”
“I will avoid those who have recently had a vaccination.”
“I will eat only fresh fruits and raw vegetables.”
“I will report a sore throat, cough, or low-grade temperature.”
11
RN providing education for pt's on immunosupressants. RN will include which information? SATA.
Pt should report any fever, sore throat, chills, or joint pain.
The mouth and tongue should be carefully inspected for white patches.
Allergic reactions to these drugs are rare.
Pt should take an oral form with food to avoid GI distress.
Pt should avoid crowds to minimize risk of infection.
12
Pt taking PTU for hyperthyroidism asks RN when the med will start working. What is RN best answer?
Immediately
Within a few days
Within a few weeks
Within a few months
13
The duration of action for insulin glargine is:
24 hours
6 to 8 hours
1 hour
30 minutes
14
The nurse knows to administer acarbose, an alpha-glucosidase inhibitor, at which time?
With the first bite of each main meal
Once daily at bedtime
30 minutes after breakfast
30 minutes before breakfast
15
Starting T2DM tx 6 months ago, RN monitors which lab to evaluate the pt’s adherence to med therapy over the past months?
Hemoglobin levels
Hemoglobin A1C level
Fingerstick fasting blood glucose level
Serum insulin levels
16
RN is developing a plan of care for a pt who is exp anorexia & nausea after chemo. What is an appropriate outcome?
Pt will maintain normal weight by consuming healthy snacks as tolerated.
The patient will eat three balanced meals a day within 2 days.
Pt will eat small, frequent feedings w/ nutrition supplements during chemo
The patient will return to normal eating pattern within 4 weeks.
17
The lowest WBC count measured after the count has been depressed by chemotherapy.
Nadir
Hemecytosis
Thrombocytopenia
Anemia
18
Pt is concerned about the body changes from long-term prednisone therapy. Which expected effect would cause a change?
Weight loss
Pale skin color
Weight gain
Hair loss
19
Which information needs to be included in the RN's teaching of pt's taking thyroid medications? SATA.
Keeping a log of responses w/ HR, weight, and mood.
The med should be taken at the same time every day.
Take thryoid replacement meds after meals.
The med will be discontinued if the side effects are too strong.
Nervousness, irritiability, and insomnia may occur if the dose is too high.
20
Which substances contain microorganisms that trigger the formation of antibodies against specific pathogens?
Serum
Vaccine
Toxoid
Antivenom
21
A dose of long acting insulin has been ordered at bedtime. RN expects to give which type of insulin?
Lispro
NPH
Glargine
Regular
22
Pt who has been on long-term corticosteroids had sx. Which potential effect may have the most impact on pt's recovery?
Hypotension
Muscle weakness
Osteoporosis
Delayed wound healing
23
Pt is informed they need a "booster" shot, after receiving the full 3 shot Hep B series. RN replies....
"Too much time has elapsed between shots and you need a 2nd third shot."
"You had altered immune response & may not be fully protected from Hep B."
"One of the initial injections must have been ineffective."
"Your body didn't produce enough antibodies, so a booster is needed."
24
RN is evaluating the labs of a pt on chemo. The loss of which blood cell leads to lack of energy, fatigue, & hypoxemia?
Platelets
Albumin
Red blood cells
White blood cells
25
Pt is beginning levothyroxine, asks RN when the med will start working. RN tells the patient....
Immediately
Within a few months
Within a few days
Within a few weeks
26
Pt is taking prednisone for 2 weeks and wants to stop. RN explains that he must slowly decrease his dosage, why?
Cushing's syndrome may developas a reaction to a stop in medication.
Stopping suddenly can cause adrenal insufficiency
When symptoms disappear, lower dosages are needed.
Pt would experience withdrawal symptoms if he abruptly stopped the meds.
27
Pt is receiving chemo & knows that stomatitis is a potential adverse effect. What will RN teach her about managing this?
“Be sure to examine your mouth daily for bleeding, pain, and ulcerations.”
“You can take aspirin to prevent stomatitis.”
“Be sure to watch for and report black, tarry stools immediately.”
“You need to increase your intake of foods containing fiber & citric acid.”
28
Pt is taking a sulfonylurea med for T2DM. When reviewing potential adverse effects, RN will include which info? SATA.
Peripheral edema
Hypoglycemia
Weight loss
Weight gain
Nausea
Diarrhea
29
Pt wil be taking cyclosporine after transplant sx. Which of these are potential adverse effects of cyclosporine? SATA.
Fever
Hypertension
Nephrotoxicity
Fluid retention
Hypotension
30
Pt in the ED was showing s/s of hypoglycemia, has a glucose level of 38 mg/dL, & is unconscious. RN will anticipate....
Administering intravenous glucose (50% dextrose)
Having the patient eat glucose tablets
Having the patient consume fruit juice, a nondiet soft drink, or crackers
Calling the lab to order a fasting blood glucose level
31
Stimulating active immunity to a pathogen is the purpose of:
Passive immunity
Vaccinations
Using antigens for sickness
Promotes a mild form of disease in healthy people
32
Who would we administer cyclosporine to?
An organ transplant patient
A patient with adrenal issues
A patient with diabetes
A patient with skin allergies
33
Why do we need to get a flu vaccine each year?
There is not a reason to
The active strains of flu change each year
To booster our antibodies from the year before
Because Big Pharma wants to get extra money from us
34
How many doses are in the Hepatitis B vaccine series?
3 doses with a booster over 6 months
2 doses over 6 months
3 doses over 6 months
1 dose
35
1 pt has bone CA; 2nd has connective tissue CA; 3rd has vascular tissues CA. What is the correct term for these tumors?
Carcinoma
Sacroma
Lymphoma
Leukemia
36
During tx of a pt who has breast CA, RN hears MD mention that the pt has reached the “nadir.” RN knows this term means?
The lowest level of neutrophils reached during therapy.
The point at which the cytotoxic action against CA cells is the highest.
The point at which the adverse effects of chemotherapy will stop.
The highest level of neutrophils reached during therapy.
37
RN is monitoring a pt w/ severe bone marrow suppression. Which is considered a principal early sign of infection?
Elevated white blood cell count
Fever
Diaphoresis
Tachycardia
38
Corticosteroids may cause sodium retention, RN should monitor for which condition when administering corticosteroids?
Iron-deficiency anemia
Seizure disorders
Diabetes mellitus
Heart failure
39
When giving chemo, RN keeps in mind that these drugs include which general adverse effects? SATA.
Urinary retention
Infertility
Diarrhea
Stomatitis
Bone marrow suppression
Nausea and vomiting
40
Which antidiabetic drug do you need to stop or hold 72 hours around IV contrast dye?
acarbose, an alpha-glucosidase inhibitor
metformin, a biguinide
glypizida, a sulfonylurea
repaglinide, a glinide
41
Pt has been receiving IV corticosteroids for PNA. Pt's glucose level is elevated. What is the best explanation?
The antibiotics may cause an increase in glucose levels.
The hypoxia caused by the PNA causes an increased need for insulin.
The patient’s type 2 diabetes has converted to type 1.
The corticosteroids may cause an increase in glucose levels.
42
Pt has thrombocytopenia after chemo. Which s/s should the RN look for? SATA.
Ulcerations on the mucous membranes inside the mouth
Increased fatigue
Bruising
Increased bleeding from venipuncture sites
Temperature above 100.5F
43
If a patient is hypoglycemic, the nurse prepares to administer.... SATA.
D50 injection IV
A large glass of water
Glucose tabs
0.9% NS IL bolus
Juice and a snack
44
Pt who has T2DM has an endoscopy & has been NPO since 0000. What is the best action by RN regarding morning meds?
Withhold all medications as ordered.
Administer half the original dose.
Contact the prescriber for further orders.
Give the medication with a sip of water.
45
19 y/o F dx w/ hypothyroidism & has started levothyroxine. After 6 months, she wants to stop the meds. What does RN say?
“Meds for hypothyroidism is lifelong, & should not stop taking the meds."
“You can stop the medication if your symptoms have improved.”
“You need to stay on this medication until you become pregnant.”
“You need to stay on the meds for 1 year before stopping is an option."
46
Transporting glucose across the cell membrane into the cell is the primary goal of what?
Gluconeogensis
Insulin
Glucagon
Glucose
47
When admin insulin, RN must keep in mind that which is the most immediate and serious adverse effect of insulin?
Hypoglycemia
Bradycardia
Hyperglycemia
Orthostatic hypotension
48
While montoring a pt receiving insulin, the RN observes for which signs of hypoglycemia?
Increased urine output and edema
Increased HR, and fruity, actone breath
Irritiability, sweating, and confusion
Decrease HR and RR, flushed skin
49
The nurse is teaching a group of patients about management of diabetes. Which statement about basal dosing is correct?
“With basal, you can eat what you want and then give a dose of insulin.”
“Basal dosing delivers a constant dose of insulin.”
Basal-bolus dosing is the traditional method of managing glucose levels.”
“Glargine insulin is given as a bolus with meals.”
50
What primarily differentiates insulins?
Color of solution
Delivery method
Rate of absorption
Duration of action
51
What are important things to teach patients on chemo drugs? SATA.
You may experience weight gain
Stay away from people that are sick.
Teach patient how to properly wash their hands.
Avoid fresh fruits and vegetables.
Get all vaccines up to date ASAP
You may experience hair loss
52
WHen monitoring a patient who is taking corticosteroids, the nurse observes for which adverse effects? SATA.
Hypotension
Hyperglycemia
Fragile skin
Drowsiness
Weight loss
Nervousness
53
Common side effects of chemo include: SATA.
Bone marrow suppression
Uric acid depressed levels
Infections
Hair loss
Fatigue
Nausea/Vomiting
54
If a patient's s/s of hypothyroidism persist, even though she's being treated with meds, what might cause this?
Further testing is required
The patient has hyperthyroidism
The patient is taking too much medication
The patient isn't taking enough medication
55
If extravasation occurs, what will the nurse do first?
Administer the appropriate antidote.
Stop the drug infusion without removing the IV catheter.
Aspirate residual drug or blood from the tube if possible
Remove the IV cathether immediately.
56
Pt was started levothyroxine. After 1 week, she reports that she does not feel better. Which response is correct?
“It will probably require surgery for a cure to happen.”
“Let’s review your diet; it may be causing absorption problems.”
“The full therapeutic effects may not occur for several weeks.”
“Is it possible that you did not take your medication as instructed?”
57
RN is admin insulin lispro & will keep in mind that this insulin will start to have an effect within which time frame?
1 to 2 hours
80 minutes
3 to 5 hours
15 minutes
58
Before giving a flu vaccine, it is imperative that you ask the patient their:
Medication list
Whether they ate breakfast
If they had the flu shot before
Allergies, especially to eggs
59
What is the nurse’s priority action if extravasation of an antineoplastic drug occurs during IV administration?
Remove the IV, and apply warm compresses.
Reduce the infusion rate.
Change the infusion to normal saline & inject the area with hydrocortisone.
Stop the infusion immediately, but leave the IV catheter in place.
60
The nurse is teaching patients about self-injection of insulin. Which statement is true regarding injection sites?
Give the injection in the same area each time.
Choose a different site at random for each injection.
Use the same location for about 1 week before rotating to a new location.
Avoid the abdomen because absorption there is irregular.
61
Which does not cause lipodystrophy?
From not rotating your insulin injection sites.
Eating a high fat diet.
Being HIV + and taking medicaitons.
This is a normal occurance after losing or gaining weight.
62
Why is metformin the first choice for T2DM treatment?B
It has the least amount of side effects.
Metformin is cheap.
Metformin works the best.
Because no contraindications exist.
63
During chemo, the nurse will monitor the patet for which symptoms of stomatitis?
Diarrhea and perianal pain
Severe vomiting and anorexia
Indigestion and heartburn
Pain or soreness in the mouth
64
Why do we ask a pt when they last had a tetanus shot when they break their skin?
To make an extra few bucks for the hospital
To determine which solution we wash out their wound with
To determine if they are an anti-vaxxer
To determine if they need another injection
65
If a patient is taking a medication to increase their white blood cell levels, you would expect the pt to be prescribed:
epoetin alpha (Epogen)
oprelvekin (Neumega)
filgrastim (Neupogen)
adalimumab (Humira)
66
RN is providing education about care after the chemo. Which statements are appropriate for the pt getting chemo? SATA.
Prepare for hair loss.
Hair loss is not expected with this drug.
Avoid areas with large crowds or gatherings.
Report unusual bleeding or bruising.
Report any increase in fatigue and shortness of breath.
Restrict fluid intake to reduce nausea and vomiting.
67
Pt wants to switch brands of levothyroxine, what is the RN's best response?
"You should check with your provider before switching brands."
"Levothyroxine has been standardized, so there is only one brand."
"If you do this, you should reduce the dose before starting the new med."
"It shouldn't matter if you switch brands they are all very much the same."
68
Which is a major risk factor for developing type 2 diabetes mellitus?
Hypercholesteremia
Obesity
Liver disease
Kidney disease
69
Pt w/ lymphoma, has an allergy to one of her chemo. RN expects the oncologist to follow which course of treatment?
The chemotherapy cannot be given because of the patient’s allergy.
The pt will receive reduced doses of chemo for a longer period of time.
The physician will choose another drug to use.
The chemo will be given along with other meds to treat a possible reaction
70
Which is true about chemotherapy?
Only selected chemo drugs are effective in only certain types of cancers.
Side effects can be eliminated with appropriate administration times.
A combination of drugs is usuall more effective than single-drug therapy.
Most cancer drugs have a high therapeutic index.
71
RN asks the pt, “What should you do if your fasting blood glucose is 44 mg/dL?” Which response by the pt is correct?
“I will give myself the regular insulin.”
“I will take an oral form of glucose.”
“I will call my doctor right away.”
“I will rest until the symptoms pass.”
72
3 cardinal symptoms of diabetes include: SATA.
Hypouria
Hypodipsia
Hypoplagia
Polyphagia
Polyuria
Polydipsia
73
Pt has been taking corticosteriods and has a "moon face" and facial redness. Which of these is an appropriate nursing dx
Imbalanced nutrition: Less than body requirements
Disturbed body image
Risk for infection
Deficit fluid volume
74
When teaching a patient who is starting metformin, which instruction by the nurse is correct?
“Take metformin if your blood glucose level is above 180 mg/dL.”
“Take this 60 minutes after breakfast.”
“Take the medication with food to reduce gastrointestinal (GI) effects.”
“Take the medication on an empty stomach 1 hour before meals.”
75
RN is preparing to administer insulin IV. Which statement about the administration of intravenous insulin is true?
Any form of insulin can be given IV at the same dose as subcutaneously.
Only regular insulin can be administered intravenously.
Insulin is never given intravenously.
Insulin aspart or lispro can be given IV, but there's a 50% dose reduction

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