Nur Medical Surg 203 ECPI UNIVERSITY
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Free Nur Medical Surg 203 ECPI UNIVERSITY Questions
A client with diabetes asks why exercise is important. The best nurse response is:
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"Exercise increases blood sugar levels."
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"Exercise can help lower blood sugar and improve insulin sensitivity."
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"You should avoid exercise if you have diabetes."
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"Exercise has no impact on diabetes control."
Explanation
The Correct Answer is:
B. "Exercise can help lower blood sugar and improve insulin sensitivity."
Detailed Explanation:
Exercise plays a vital role in diabetes management because it helps lower blood glucose levels by promoting glucose uptake into muscle cells and enhancing insulin sensitivity. Regular physical activity also improves circulation, aids in weight control, reduces cardiovascular risk, and enhances overall well-being. Patients with diabetes should be encouraged to exercise consistently while monitoring their blood sugar levels to prevent hypoglycemia, especially when using insulin or oral hypoglycemics.
A patient with type 1 diabetes has influenza. The nurse should instruct the patient to:
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Increase the frequency of self-monitoring blood glucose levels
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Discontinue that dose of insulin if unable to eat
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Reduce food intake to diminish nausea
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Take half of the normal dose of insulin
Explanation
The Correct Answer is:
A. Increase the frequency of self-monitoring blood glucose levels
Detailed Explanation:
When a patient with type 1 diabetes is ill, such as with influenza, stress hormones like cortisol and epinephrine increase, raising blood glucose levels. The nurse should instruct the patient to check blood glucose every 3–4 hours (or more frequently if advised), maintain hydration, and continue insulin as prescribed—even if eating less. This prevents diabetic ketoacidosis (DKA), a life-threatening complication triggered by illness and inadequate insulin during periods of stress or infection.
A nurse is assessing a client with cirrhosis and notes the presence of caput medusae. This finding is best described as:
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Yellow discoloration of the skin
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Enlarged lymph nodes
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Distended veins around the umbilicus
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Dark tarry stools
Explanation
The Correct Answer is:
C. Distended veins around the umbilicus
Detailed Explanation:
Caput medusae refers to distended, tortuous veins radiating from the umbilicus, resembling a medusa’s head of snakes. It is a sign of portal hypertension, a common complication of cirrhosis. Increased pressure in the portal venous system causes blood to flow through collateral vessels, including superficial abdominal veins, leading to this visible pattern. The finding indicates advanced liver disease and impaired hepatic circulation, often accompanied by ascites, splenomegaly, and other manifestations of portal hypertension.
The nurse knows a Whipple procedure may be performed if a patient has which disorder?
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Cholecystitis
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Liver cancer
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Bowel obstruction
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Pancreatic cancer
Explanation
The Correct Answer is:
D. Pancreatic cancer
Detailed Explanation:
A Whipple procedure (pancreaticoduodenectomy) is a complex surgical operation primarily performed to treat pancreatic cancer, especially when the tumor is located in the head of the pancreas. The procedure involves removing the head of the pancreas, part of the duodenum, gallbladder, and sometimes a portion of the stomach, followed by reconnection of the digestive tract. This surgery aims to eliminate the cancerous tissue, relieve symptoms like jaundice and pain, and improve survival outcomes when the cancer is resectable.
You determine that the fingerstick blood glucose reading for a patient with diabetes is 750 mg/dL. What is your priority action?
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Immediately notify the registered nurse (RN) and the health care provider
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Check the record to verify whether the patient has type 1 or type 2 diabetes.
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Administer prescribed sliding scale insulin.
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Assess the vital signs of the patient.
Explanation
The Correct Answer is:
A. Immediately notify the registered nurse (RN) and the health care provider.
Detailed Explanation:
A blood glucose level of 750 mg/dL is a critical, life-threatening emergency that may indicate diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar syndrome (HHS). The nurse’s priority is to immediately notify the RN and healthcare provider for urgent evaluation and intervention. Rapid medical treatment, including IV fluids, insulin administration, and electrolyte correction, is necessary to prevent shock, coma, or death. Quick communication ensures life-saving measures begin without delay.
The nurse is caring for a patient being treated for new onset of gallstones. The patient asks the nurse if he will have to have surgery. How will the nurse respond?
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"You need to ask the doctor about your concerns."
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"Treatment for gallstones may include diet modification, weight loss, medication or surgery."
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"You will have to have surgery if you continue to have gallstones."
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"Tell me more about your concerns."
Explanation
The Correct Answer is:
B. "Treatment for gallstones may include diet modification, weight loss, medication or surgery."
Detailed Explanation:
The most accurate and therapeutic response is to inform the patient that treatment options for gallstones vary depending on the severity of symptoms and complications. Mild cases may be managed with dietary changes, weight management, or medications that dissolve gallstones. Surgery (cholecystectomy) is recommended if gallstones cause repeated pain, obstruction, or infection. Providing this balanced explanation addresses the patient’s concern while supporting informed decision-making about future care.
A client with cholecystitis is scheduled for a laparoscopic cholecystectomy. Which post-operative teaching should the nurse reinforce?
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"You will have a T-tube in place for several weeks after surgery."
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"You may have right shoulder pain from gas used during surgery."
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"You may resume a regular diet immediately after surgery."
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"You should remain on strict bed rest for 3 days."
Explanation
The Correct Answer is:
B. "You may have right shoulder pain from gas used during surgery."
Detailed Explanation:
After a laparoscopic cholecystectomy, carbon dioxide (CO₂) is used to inflate the abdomen for better visualization during surgery. Some of this gas may remain postoperatively, irritating the phrenic nerve and causing referred pain to the right shoulder. This discomfort is temporary and relieved by early ambulation, which helps expel residual gas and improve circulation. Patients typically recover quickly, resume light activity within a day, and gradually return to a normal diet as tolerated.
Rebound elevation of glucose levels brought on by hypoglycemia is called:
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Dawn phenomenon
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Somogyi effect
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Systemic alkalosis
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Systemic acidosis
Explanation
The Correct Answer is:
B. Somogyi effect
Detailed Explanation:
The Somogyi effect occurs when hypoglycemia triggers a rebound hyperglycemia due to the release of counter-regulatory hormones such as epinephrine, cortisol, and glucagon. This usually happens during the night when blood sugar drops too low after insulin administration, causing the body to overcompensate and raise glucose levels by morning. The result is high fasting blood sugar despite insulin therapy. Adjusting evening insulin doses or bedtime snacks can help prevent this phenomenon.
Which of the following respiratory assessments are found in a patient with DKA?
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Kussmaul
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Cheyne-Stokes
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Tachypnea
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Bradypnea
Explanation
The Correct Answer is:
A. Kussmaul
Detailed Explanation:
In diabetic ketoacidosis (DKA), the body produces excess ketones leading to metabolic acidosis. To compensate, the respiratory system increases the rate and depth of breathing to blow off carbon dioxide (an acid), resulting in Kussmaul respirations—deep, labored, and rapid breathing. This compensatory mechanism helps reduce acidosis by lowering carbon dioxide levels and temporarily stabilizing blood pH.
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.
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