Nur Medical Surg 203 ECPI UNIVERSITY
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Free Nur Medical Surg 203 ECPI UNIVERSITY Questions
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.
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.
Patients with a history of pancreatic disease commonly have a history of:
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Excessive alcohol consumption
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Excessive intake of vitamin C
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Very low-fat diet
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High-protein diet
Explanation
The Correct Answer is:
A. Excessive alcohol consumption
Detailed Explanation:
Excessive alcohol consumption is one of the leading causes of pancreatic disease, particularly chronic pancreatitis. Alcohol damages pancreatic cells, promotes inflammation, and causes the premature activation of digestive enzymes within the pancreas. Over time, this leads to fibrosis, loss of exocrine and endocrine function, and impaired digestion and glucose regulation. Avoiding alcohol is a key preventive and management strategy in pancreatic disorders to prevent further pancreatic injury and systemic complications.
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.
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.
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 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.
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 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.
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.
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