AG1 Exam 2 Review

1. 1. A nurse is caring for a client receiving TPN via a central line. Which actions should the nurse take? Select all that apply.

• A. Change TPN tubing and bag every 24 hours.

• B. Check blood glucose every 8 hours. 

• C. Stop the TPN abruptly if the bag runs out.

•  D. Monitor for signs of fluid overload.

• E. Use an infusion pump to administer the solution.

A nurse is teaching a newly diagnosed Type 1 diabetic client about insulin administration. Which statement indicates the need for further teaching?

• A. I will rotate injection sites within the same anatomical area.

• B. I will check my blood glucose before each meal and at bedtime.

• C. I will store my unopened insulin in the refrigerator.

• D. I will use the same needle for multiple injections to reduce waste.

Which findings should alert the nurse that a client with enteral feedings via a nasogastric tube is experiencing aspiration? Select all that apply.

• A. Coughing during feeding

• B. Decreased urine output

• C. Crackles in lung fields

• D. Shortness of breath

• E. Increased gastric residual volume

Which of the following would the nurse include in discharge teaching for a patient with newly diagnosed T1DM regarding sick-day management? Select all that apply.

• A. Stop taking insulin if vomiting

• B. Check blood glucose levels more frequently

• C. Check for ketones in blood or urine

• D. Drink 8 ounces of fluid every hour

• E. Skip meals until feeling better

A patient with diabetes is undergoing aerobic exercise. What teaching should the nurse include to prevent hypoglycemia?

• A. Avoid eating before exercising

• B. Take extra insulin dose before working out

• C. Consume a 10-15g carbohydrate snack before beginning

• D. Drink protein shakes immediately after exercise

A patient with Type 2 DM presents with acanthosis nigricans on the neck and axillae. What is the best nursing interpretation?

• A. Sign of insulin resistance

• B. Sign of autoimmune beta-cell destruction

• C. Indicator of diabetic nephropathy

• D. Indicator of hypoglycemic episodes

A 63-year-old patient with Type 2 Diabetes Mellitus (T2DM) is admitted with a glucose level of 435 mg/dL, dry mucous membranes, and confusion. Labs show no ketones in urine. What complication is most likely?

• A. Diabetic Ketoacidosis (DKA)

• B. Hypoglycemia

• C. Diabetic Hyperosmolar Hyperglycemic Syndrome (HHS)

• D. Lactic Acidosis

The nurse receives an order to begin enteral nutrition via a nasogastric tube. Which actions should be taken before starting the feeding? Select all that apply.

• A.  Check placement via pH or X-ray verification.

• B. Assess bowel sounds. 

• C. Flush the tube with 60 mL of air.

• D. Measure gastric residual volume.

• E. Place the client in high Fowlers position.

A nurse is monitoring a client receiving TPN and notes the client is experiencing shortness of breath and crackles on auscultation. What should the nurse do first?

• A. Slow the TPN infusion rate.

• B. Notify the provider.

• C. Check blood glucose level.

• D. Stop the TPN infusion.

• E. Administer diuretics.

A nurse is caring for a client with newly diagnosed T2DM. Which client statement indicates a need for further teaching?

• A. I will avoid skipping meals to prevent low blood sugar.

• B. I will monitor my feet every day for any cuts or sores.

• C. I can stop taking my medications once my glucose normalizes.

• D. I will attend regular follow-ups to monitor my A1C levels.