Question 5281)
A client is admitted to the hospital with recently diagnosed Type I diabetes
mellitus and is to have fasting blood work drawn this morning. At 7:00 A.M., the lab has not
arrived to draw the blood. The client’s dose of regular insulin is scheduled for 7:30 A.M. What is
the best action for the nurse to take?
A. Give the insulin as ordered
B. Withhold the insulin until the lab comes and the client will be eating within 15 to 30 minutes
C. Withhold the insulin until the blood has been drawn and the client has eaten
D. Do not administer insulin until the blood work has been drawn and the results have been called back to the unit
Answer: B
Explanation: The onset of regular insulin is within 30 minutes. It should not be given until the client can eat within
15 to 30 minutes so that he will not develop hypoglycemia
Question 5282)
An adolescent with newly diagnosed Type I diabetes mellitus asks the nurse if he
can continue to play football. What is the best answer for the nurse to give?
A. “Now that you have diabetes, you should not play football because you may get a cut that will not heal.”
B. “If you work with your physician to regulate the insulin dosage and your diet, you should be able to play football.”
C. “It would be better for you to work as equipment manager so you will not be under as much stress.”
D. “You can probably continue to play football if you can regulate it so that you have the same amount of exercise
each day.”
Answer: B
Explanation: Diabetes is not a contraindication for sports. Changes in activity level will alter the utilization of
glucose, so he will need to work closely with his physician to regulate exercise, insulin, and diet control.
Question 5283)
The client is a 62-year-old woman who is 30 pounds overweight. She comes to the
doctor’s office complaining of headaches, frequent hunger, excessive thirst, and urination. The
presenting complaints suggest that the nurse should assess for other signs of which condition?
A. Hypothyroidism
B. Acute pyelonephritis
C. Addison’s disease
D. Diabetes mellitus
Answer: D
Explanation: The symptoms are the cardinal symptoms of diabetes mellitus: polydipsia, polyphagia, and polyuria.
The client with hypothyroidism would have fatigue and weight gain and would complain of being cold all the time.
The person with acute pyelonephritis would probably complain of frequent urination and flank pain and might have
a fever. The person with Addison’s disease would have polyuria and low blood sugar and might go into hypovolemic
shock.
Question 5284)
An elderly client with Type 2 diabetes mellitus develops an ingrown toenail. What
is the best action for the nurse to take?
A. Put cotton under the nail and clip the nail straight across
B. Elevate the foot immediately
C. Apply warm, moist soaks
D. Notify the physician
Answer: D
Explanation: An ingrown toenail may cause infection, which can be very serious for the diabetic client. The
physician should be notified. It is not appropriate for the practical nurse to initiate treatment
Question 5285) A woman with hypothyroidism asks the nurse why the doctor told her she cannot
have a sedative. The nurse’s response is based on which of the following facts?
A. Sedatives potentiate thyroid replacement medication.
B. Clients with hypothyroidism have increased susceptibility to all sedative drugs.
C. Sedatives will have a paradoxical effect on clients with hypothyroidism.
D. Sedatives would cause fluid retention and hypernatremia
Answer: B
Explanation: In hypothyroidism, the metabolic rate is decreased. This causes an increased susceptibility to sedative
drugs.
Question 5286)
The nurse is caring for several clients who have burns over different parts of the
body. The client who has burns over which part of the body is most at risk of life-threatening
complications?
A. Lower torso
B. Upper part of the body
C. Hands and feet
D. Perineum
Answer: B
Explanation: Persons with burns of the upper part of the body frequently have respiratory involvement. Airway
problems increase the mortality rate.
Question 5287)
The nurse is caring for several clients who have burns. Which of the following
persons with burns has the poorest prognosis?
A. A 20-year-old with second- and third-degree burns over 60% of the body
B. An 80-year-old with second- and third-degree burns over 50% of the body
C. A 35-year-old with second- and third-degree burns over 60% of the body
D. A 2-year-old with second- and third-degree burns over 30% of the body
Answer: B
Explanation: The very old and the very young are at the highest risk and have the highest mortality rate. The very
old are half-dehydrated before the burn occurred and have greater difficulty with the fluid shifts. The very young
have a greater percentage of their body weight that is supposed to be water. They have more difficulty with the
fluid shifts that occur following a burn.
Question 5288)
Which of the following clients should have his clothing removed immediately?
A. A 32-year-old man who was burned while working on high-tension wires
B. A 14-year-old boy who suffered severe smoke inhalation during a fire at school
C. A 78-year-old man who was burned during a fire that started when the client fell asleep while smoking
D. A 19-year-old student who spilled chemicals on himself in the chemistry lab at school
Answer: D
Explanation: Clothing should be removed from persons with chemical burns so that they will not be further
contaminated. A flame burn should be smothered, and if necessary, the area should be soaked with water, but the
clothing should not be removed until the person is in the emergency room. A person who suffered from smoke
inhalation does not have an immediate need to remove clothing. A person who received an electrical burn does not
have an immediate need to remove clothing
Question 5289)
A 28-year-old man received severe burns of the chest, abdomen, back, legs, and
hands when the house caught fire. In the emergency room, a nasogastric tube was inserted, and
the client was ordered NPO. What is the primary reason for the nurse to keep this client NPO?
A. To prevent the deadly complication of aspiration
B. To make the client more comfortable
C. To help prevent paralytic ileus
D. To help prevent excessive fluid loss
Answer: C
Explanation: Burn victims are very prone to paralytic ileus. The client will remain NPO until bowel sounds have
returned.
Question 5290)
The nurse is ordered to insert an indwelling catheter in a severely burned client
for which reason?
A. To prevent contamination of burned areas
B. To measure hourly urine output
C. To prevent urinary tract infection
D. To detect internal injuries quickly
Answer: B
Explanation: Measurement of urine output is a high priority. Fluid replacement is based on output. The goal is to
prevent the client from going into shock by maintaining a urine output of 50 to 100 mL/hr.
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