ATI RN
NP125 Med Surg Exam Questions
Extract:
Question 1 of 5
The patient's meal has been delivered, the nurse checks the patient's pre-meal blood sugar, and the result is 243 mg/dL. The patient is awake, alert, hungry, and able to swallow. The next step the nurse should take is:
Correct Answer: D
Rationale: Administering dextrose IVP is inappropriate for hyperglycemia. It elevates blood sugar further, risking complications like hyperosmolar hyperglycemic state. It is used to treat severe hypoglycemia instead. Glucagon stimulates glycogen breakdown into glucose, increasing blood sugar. It is contraindicated in hyperglycemia, as it would aggravate elevated glucose levels. It is a treatment for severe hypoglycemia. Holding insulin allows hyperglycemia to persist, increasing risks of complications like ketoacidosis. Insulin administration is essential to reduce the glucose level safely. Rapid-acting insulin like Humalog reduces hyperglycemia efficiently, bringing preprandial blood glucose closer to the target range of 70-130 mg/dL. Administering 4 units is a reasonable corrective dose based on the blood glucose of 243 mg/dL.
Question 2 of 5
Which diagnostic assessment method is commonly used for osteoarthritis (O
Correct Answer: A
Rationale: X-rays are commonly used to diagnose osteoarthritis as they effectively visualize joint space narrowing, osteophyte formation, and subchondral sclerosis, which are characteristic of OA. These imaging findings assist in confirming the diagnosis and assessing disease progression. Lithography is not a diagnostic tool used for OA. It primarily refers to a printing method and has no relevance to imaging joints affected by osteoarthritis or diagnosing the condition scientifically. Ultrasound can visualize soft tissues but is not routinely used for OA diagnosis. It does not provide the detailed assessment of joint degeneration seen in X-rays, making it less appropriate for identifying OA-related changes. Echocardiograms are used to assess heart function and have no application in diagnosing osteoarthritis. They are irrelevant in imaging joint structures or evaluating degenerative joint diseases scientifically.
Question 3 of 5
The patient's meal has been delivered, and the nurse checks the patient's pre-meal blood sugar. The result is 50 mg/dL. The patient is clammy, diaphoresis, and non-arousable. The next step the nurse should take is:
Correct Answer: B
Rationale: Administering 1 mg of glucagon intramuscularly stimulates glycogenolysis in the liver, increasing blood glucose levels. However, it is slower in onset compared to IV dextrose, which is critical in a non-arousable patient with a dangerously low blood glucose level of 50 mg/dL. Time efficiency is vital in this emergency. Administering 25 g of dextrose IV pushes glucose directly into the bloodstream, providing an immediate increase in blood glucose. This is the most appropriate action for a non-arousable, hypoglycemic patient. Normal blood glucose ranges between 70-100 mg/dL fasting, making this an emergency requiring prompt correction. Encouraging the patient to eat may be effective in mild hypoglycemia, but not for a critically low level like 50 mg/dL in a non-arousable patient. This delay can result in prolonged neuroglycopenic effects, worsening the patient's condition. Administering 7 units of Humalog insulin would worsen the hypoglycemia by facilitating glucose uptake into cells, which is contraindicated in this situation. Instead, glucose administration is required to correct the hypoglycemia immediately.
Question 4 of 5
If both Insulin glargine (Lantus) and insulin lispro (Humalog) are due simultaneously, the nurse can mix the two insulins in the same syringe and administer them as one injection.
Correct Answer: B
Rationale: Mixing insulin glargine and lispro in the same syringe is contraindicated due to their incompatible chemical formulations. Glargine's acidic pH alters lispro's effectiveness when mixed, impairing glycemic control. Separate administration preserves their individual pharmacokinetics and therapeutic actions. Separate injections ensure each insulin maintains its unique action profile. Glargine provides basal control, while lispro manages rapid postprandial spikes. Their chemical incompatibility mandates separate administration, optimizing glycemic management and reducing potential adverse effects from mixed formulations.
Question 5 of 5
A patient with intractable or severe nausea and vomiting from an unknown cause should be placed on a bland diet.
Correct Answer: A
Rationale: A bland diet reduces gastric irritation by avoiding substances that stimulate acid secretion or exacerbate nausea. It includes foods like rice, bananas, and toast that are easy to digest and less likely to provoke symptoms of nausea or vomiting. Opposing the bland diet recommendation for severe nausea ignores scientific evidence that supports its use. Providing a diet rich in spices or acidic foods can worsen symptoms by irritating the gastrointestinal tract further.