Nur Medical Surg 203
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Free Nur Medical Surg 203 Questions
A nurse is preparing to administer 0.9% sodium chloride (NS) 100 mL IV to infuse over 4 hr. The drip factor of the manual IV tubing is 60 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number.)
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15 gtt/min
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25 gtt/min
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50 gtt/min
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60 gtt/min
Explanation
The Correct Answer is:
B. 25 gtt/min
Detailed Explanation:
To determine the flow rate (gtt/min), use the formula:
Flow rate = (Volume × Drip factor) ÷ Time (in minutes)
= (100 mL × 60 gtt/mL) ÷ (4 hr × 60 min)
= 6000 ÷ 240
= 25 gtt/min
The nurse should regulate the IV to deliver 25 drops per minute to ensure the solution infuses evenly over 4 hours, maintaining proper hydration and avoiding fluid overload.
A nurse is reinforcing dietary teaching to a client with diabetes. Which meal choice is most appropriate?
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Donuts and orange juice
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Grilled salmon, brown rice, and steamed broccoli
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Fried chicken, mashed potatoes, and sweet tea
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Pepperoni pizza and soda
Explanation
The Correct Answer is:
B. Grilled salmon, brown rice, and steamed broccoli
Detailed Explanation:
The meal of grilled salmon, brown rice, and steamed broccoli provides a balanced mix of lean protein, complex carbohydrates, and fiber—ideal for blood glucose control in diabetes. Salmon offers healthy omega-3 fats that support cardiovascular health, brown rice provides slow-releasing carbohydrates that prevent glucose spikes, and broccoli adds essential vitamins and fiber for digestion and satiety. This combination promotes stable blood sugar levels and overall metabolic health in diabetic patients.
The nurse misreads the 0700 POC blood glucose result as 210 mg/dL instead of 120 mg/dL on a patient with type I DM. The sliding scale regular insulin is given based on the incorrect reading. The nurse realizes the mistake 45 minutes later. What is the nurse’s priority action?
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Contact the provider
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Administer a snack with 15 grams of carbohydrates
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Complete an incident report
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Check the blood glucose level
Explanation
The Correct Answer is:
D. Check the blood glucose level
Detailed Explanation:
The priority action is to check the patient’s current blood glucose level to assess for potential hypoglycemia after the insulin administration error. Regular insulin peaks in about 2–4 hours, and verifying the glucose level immediately helps determine if corrective action (such as giving a carbohydrate snack or glucose) is needed to prevent or treat hypoglycemia. Once the patient’s safety is ensured, the nurse should notify the provider and document the error per policy.
When a patient in diabetic ketoacidosis (DKA) comes to the emergency department, blood electrolyte levels should be monitored. The nurse is aware that the most important electrolyte to monitor is:
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Sodium
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Potassium
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Calcium
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Chloride
Explanation
The Correct Answer is:
B. Potassium
Detailed Explanation:
In diabetic ketoacidosis (DKA), potassium is the most critical electrolyte to monitor closely. Although initial lab results may show normal or high potassium due to acidosis and insulin deficiency, total body potassium is actually depleted because of osmotic diuresis and cellular shifts. When insulin therapy and fluids are started, potassium moves back into the cells, which can cause life-threatening hypokalemia if not replaced. Continuous ECG and electrolyte monitoring are therefore essential during DKA treatment.
Which laboratory values would you use to assess liver function?
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BUN, creatinine, GFR
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ALT, AST, ammonia
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CBC, BMP, ABGs
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Amylase, lipase, WBC
Explanation
The Correct Answer is:
B. ALT, AST, ammonia
Detailed Explanation:
Liver function is primarily assessed using enzymes and byproducts that reflect hepatic cell integrity and metabolic performance. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are key enzymes released when hepatocytes are damaged, making them sensitive markers of liver injury. Ammonia levels rise when the liver fails to convert ammonia to urea, indicating impaired detoxification. Together, these values help evaluate inflammation, necrosis, or hepatic failure, guiding diagnosis and treatment decisions.
The patient has a large accumulation of fluid in his abdominal cavity. The nurse surmises that this patient has a diagnosis of:
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Peritonitis
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Pancreatitis
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Cirrhosis
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Diverticulitis
Explanation
The Correct Answer is:
C. Cirrhosis
Detailed Explanation:
A large accumulation of fluid in the abdominal cavity is known as ascites, which commonly occurs as a complication of cirrhosis. Cirrhosis leads to portal hypertension and hypoalbuminemia, both of which cause fluid to leak from the hepatic blood vessels into the peritoneal cavity. This fluid buildup results in visible abdominal distention, discomfort, and potential respiratory compromise. Management typically includes sodium restriction, diuretics, and sometimes paracentesis to remove excess fluid.
A nurse is reviewing the admission laboratory results of a client who has acute pancreatitis. Which of the following findings should the nurse expect?
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Decreased blood amylase level
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Decreased blood lipase level
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Increased blood calcium level
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Increased blood glucose level
Explanation
The Correct Answer is:
D. Increased blood glucose level
Detailed Explanation:
In acute pancreatitis, inflammation and injury to the pancreatic cells impair insulin production, resulting in elevated blood glucose levels. Additionally, pancreatic enzymes (amylase and lipase) are typically increased due to cell damage, but glucose elevation is a key indicator of impaired endocrine function in severe inflammation of the pancreas. Monitoring glucose helps evaluate disease severity and metabolic stability.
Insulin is most rapidly absorbed into the:
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Abdomen
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Legs
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Arms
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Buttocks
Explanation
The Correct Answer is:
A. Abdomen
Detailed Explanation:
The abdomen provides the fastest and most consistent absorption site for insulin due to its rich blood supply and thinner subcutaneous tissue compared to other areas. This makes it the preferred injection site, especially for rapid-acting or short-acting insulin. Rotation of injection sites within the same region is recommended to prevent lipodystrophy and maintain consistent absorption rates. In contrast, insulin injected into the thighs, arms, or buttocks absorbs more slowly.
Which statement by a newly diagnosed diabetic patient most strongly indicates a need for further teaching about exercise?
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"Before going to the gym, I do not need to check my blood sugar."
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"If my blood sugar is below 100 before exercising, I should eat a snack."
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"I must carry hard candy."
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"I can go swimming as part of my exercise routine."
Explanation
The Correct Answer is:
A. "Before going to the gym, I do not need to check my blood sugar."
Detailed Explanation:
Patients with diabetes should always check their blood glucose level before exercising to prevent hypoglycemia or identify dangerously high readings. Exercise lowers blood sugar by increasing glucose uptake by the muscles. If glucose is too low (<100 mg/dL), a pre-exercise snack is needed; if too high (>250 mg/dL with ketones), exercise should be postponed. Not checking blood glucose shows a lack of understanding of safe diabetes self-management practices.
The nurse carefully assesses a patient who has hyperglycemic hyperosmolar syndrome (HHS). Which sign or symptom is most likely NOT to be associated?
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Polycystic
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Polyphagia
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Polydipsia
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Polyuria
Explanation
The Correct Answer is:
A. Polycystic
Detailed Explanation:
Polycystic is not a symptom of hyperglycemic hyperosmolar syndrome (HHS). HHS is characterized by extremely high blood glucose levels, profound dehydration, and elevated serum osmolality without significant ketoacidosis. Typical manifestations include polyuria (excessive urination), polydipsia (excessive thirst), and sometimes polyphagia (increased hunger). These result from osmotic diuresis and the body’s attempt to restore fluid balance. “Polycystic” refers to cyst formation, such as in polycystic ovary syndrome (PCOS), and is unrelated to HHS.
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