Nur Medical Surg 203 ECPI UNIVERSITY
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Free Nur Medical Surg 203 ECPI UNIVERSITY Questions
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.
A client with acute pancreatitis is experiencing severe abdominal pain. Which additional finding would concern the nurse the most?
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Nausea and vomiting
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Low-grade fever
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Tachycardia
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Absent bowel sounds
Explanation
The Correct Answer is:
D. Absent bowel sounds
Detailed Explanation:
Absent bowel sounds in a client with acute pancreatitis indicate paralytic ileus or possible peritonitis, both of which signal a worsening condition. These complications suggest that inflammation has spread beyond the pancreas, leading to decreased intestinal motility or severe infection. This finding requires immediate provider notification and further assessment for potential complications such as hemorrhage or shock. Nausea, vomiting, mild fever, and tachycardia are expected findings but less immediately life-threatening than absent bowel sounds.
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.
A nurse is preparing to administer insulin lispro to a patient who has type 1 diabetes mellitus. Which action should the nurse plan to take?
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Inject the lispro 15 minutes before a meal.
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Administer insulin lispro in the same syringe as regular-acting insulin.
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Check the patient for hypoglycemia 4 hours after the insulin lispro injection.
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Monitor the patient for polyuria after the insulin lispro injection.
Explanation
The Correct Answer is:
A. Inject the lispro 15 minutes before a meal.
Detailed Explanation:
Insulin lispro (Humalog) is a rapid-acting insulin that begins working within 10 to 15 minutes of injection, peaks in 30 to 90 minutes, and lasts about 3 to 5 hours. It must be given shortly before meals to prevent post-meal hyperglycemia and reduce the risk of hypoglycemia. Administering it too early or without food can lead to dangerously low blood glucose levels. The nurse should ensure that the patient’s meal tray is available before giving the injection.
A nurse is reinforcing teaching with a client who reports right shoulder pain following a laparoscopic cholecystectomy. Which of the following statements should the nurse make?
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"The pain results from lying in one position too long during surgery."
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"The pain is caused from the nitrous dioxide injected into the abdomen."
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"The pain will dissipate if you ambulate frequently."
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"The pain occurs as a residual pain from cholecystitis."
Explanation
The Correct Answer is:
C. "The pain will dissipate if you ambulate frequently."
Detailed Explanation:
After a laparoscopic cholecystectomy, right shoulder pain commonly occurs due to carbon dioxide (CO₂) gas used to insufflate the abdomen during surgery. The gas irritates the phrenic nerve, causing referred pain to the shoulder. The most effective relief is early and frequent ambulation, which helps the body absorb and expel the remaining CO₂ through respiration. This pain is temporary and usually resolves within 24–48 hours as the gas is reabsorbed.
A 50-year-old woman was recently diagnosed with type 2 diabetes mellitus and wants to start a healthy lifestyle to control her disease. What initial recommendation should you make?
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Develop an exercise schedule
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Engage in brisk walking.
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Lose 10 to 15 pounds.
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Maintain adequate glucose control.
Explanation
The Correct Answer is:
B. Engage in brisk walking.
Detailed Explanation:
For a newly diagnosed patient with type 2 diabetes, the initial recommendation should be to begin engaging in regular physical activity, such as brisk walking. Moderate-intensity aerobic exercise improves insulin sensitivity, enhances glucose uptake by muscle cells, helps lower blood sugar, and supports gradual weight loss. Starting with walking is safe, sustainable, and achievable for most adults. Over time, combining exercise with a balanced diet and glucose monitoring strengthens long-term diabetes management.
A nurse is caring for a client post-cholecystectomy with a T-tube in place. Which nursing action is appropriate?
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Keep the drainage bag above the level of the abdomen
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Clamp the T-tube 2 hours before and after meals
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Encourage a high-fat diet to stimulate bile flow
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Assess and record the color and amount of drainage
Explanation
The Correct Answer is:
D. Assess and record the color and amount of drainage
Detailed Explanation:
After a cholecystectomy, a T-tube is inserted to maintain bile drainage and allow the common bile duct to heal. The nurse should assess and accurately record the color, consistency, and amount of bile drainage to monitor for complications such as obstruction or infection. Normal bile drainage is greenish-yellow and gradually decreases over time. The drainage bag should remain below the abdomen to prevent backflow, and the diet should be low in fat until bile flow normalizes.
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.
Protonix 50 mg IV is ordered as a 30-minute infusion. The pharmacy sends Protonix 50 mg/100 mL IV piggyback. How many mL per hour will you set on the pump?
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100 mL/hr
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400 mL/hr
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300 mL/hr
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200 mL/hr
Explanation
The Correct Answer is:
D. 200 mL/hr
Detailed Explanation:
To calculate the infusion rate:
Volume (mL) ÷ Time (hr) = mL/hr
Given:
Volume = 100 mL
Time = 30 minutes = 0.5 hours
100 mL ÷ 0.5 hr = 200 mL/hr
Therefore, the IV pump should be set to 200 mL per hour to ensure the Protonix infuses completely over the prescribed 30-minute period.
A patient has been told they need to have a blood test called an A1c to check for diabetes. Which of the following should the nurse explain the test measures?
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The test measures the average levels of the glucose in your blood for the last 6 months.
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Cheyne-Stokes
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The test measures the average levels of the glucose in your blood for the last 3 months.
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The test measures the average levels of the glucose in your blood for the last 10 days.
Explanation
The Correct Answer is:
C. The test measures the average levels of the glucose in your blood for the last 3 months.
Detailed Explanation:
The A1c test, also known as glycosylated hemoglobin, measures the percentage of hemoglobin molecules in the blood that have glucose attached to them. Because red blood cells live about 120 days (3 months), this test reflects the average blood glucose level over that time period, helping to monitor long-term glucose control in diabetic and prediabetic patients.
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