Nur Medical Surg 203 ECPI UNIVERSITY
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Free Nur Medical Surg 203 ECPI UNIVERSITY Questions
What is the priority intervention for a patient with esophageal varices who is vomiting blood?
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Administer beta blockers
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Maintain airway and stabilize circulation
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Perform paracentesis
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Administer vitamin K
Explanation
The Correct Answer is:
B. Maintain airway and stabilize circulation
Detailed Explanation:
When a patient with esophageal varices is vomiting blood, the priority is to maintain the airway and stabilize circulation. Massive hematemesis can obstruct the airway and lead to aspiration or hypovolemic shock. The nurse should position the patient to protect the airway, provide oxygen, start large-bore IV lines for fluid and blood replacement, and monitor vital signs closely. Once the airway and circulation are stabilized, medications like beta blockers or procedures may follow to control bleeding.
A nurse is collecting data from a client who has diabetes mellitus. The client is confused, flushed, and has an acetone odor on his breath. The nurse should anticipate a prescription for which of the following types of insulin to treat the client?
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Glargine
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Regular
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NPH
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Detemir
Explanation
The Correct Answer is:
B. Regular
Detailed Explanation:
The patient’s symptoms—confusion, flushed skin, and an acetone (fruity) odor on the breath—are classic signs of diabetic ketoacidosis (DKA), a life-threatening complication of severe insulin deficiency. The treatment for DKA requires rapid-acting intravenous insulin, and Regular insulin is the only insulin type approved for IV administration. It quickly lowers blood glucose and stops ketone production by facilitating glucose uptake into cells. Long-acting insulins like glargine, detemir, or NPH are not used for acute DKA management.
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.
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 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.
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 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.
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.
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.
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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