NCLEX Endocrine Questions (15-20)

NCLEX Endocrine Questions

15. Which of the following should the nurse include in the discharge instructions to be given to a client on continuous insulin infusion through insulin pump?

a) change needle site every 2 to 3 days
b) check blood sugar level daily
c) push button on the device to self-administer insulin after each meal
d) the machine gives continuous small doses of insulin, so there is no need to check blood sugar levels

16. A client with diabetes mellitus is self-administering NPH insulin from a vial kept at room temperature. The client asks a nurse about the length of time an unrefrigerated vial of insulin will remain its potency. The most appropriate response to the client is which of the following?

a) two weeks
b) one month
c) two months
d) six months

17. Which of the following is the appropriate initial action by the nurse when preparing insulin administration?

a) injecting air into the regular insulin
b) withdrawing the cloudy insulin first before the clear insulin
c) injecting air into the cloudy insulin but withdrawing the clear insulin first
d) withdrawing the clear insulin and cloudy insulin in separate syringes

18. The client with insulin-dependent diabetes mellitus (IDDM) has been brought to the emergency room. What should the nurse watch for if blood pH is 7.28

a) lactic acidosis
b) ketoacidosis
c) metabolic alkalosis
d) respiratory acidosis

19. A client has been diagnosed to have Type II diabetes mellitus. She experiences hypoglycemia. After receiving a glass of orange juice, what should the nurse give next?

a) peanut butter sandwich
b) 1 tablespoon sugar
c) 1 cup skim milk
d) a cup chocolate drink

20. Which of the following laboratory test best indicate compliance of the diabetic client and insulin therapy?

a) 2-hour postprandial blood glucose
b) fasting blood glucose
c) glycosylated hemoglobin
d) oral glucose tolerance test




NCLEX Endocrine Questions:
ANSWERS AND RATIONALE

15) B
- insulin lowers blood sugar levels. Insulin pump gives small doses of insulin continuously and the patient can bolus himself before each meal.

16) B
- insulin, when stored at room temperature is potent for 30 days (1 month).

17) C
- this action ensures prevention of contamination of the rapid-acting insulin. In case of emergency (DKA), rapid effect of the clear insulin is maintained. Injecting air into the cloudy insulin will promote easy aspiration of the medication, once the syringe already contains the clear insulin.

18) B
- ketoacidosis is characterized by low blood pH. Type I diabetic clients are prone to ketoacidosis.

19) A
- orange juice provides quick source of glucose; slices of bread provide sustained supply of glucose. This will be followed with skim milk as source of protein, to inhibit breakdown of fats. This in turn, prevents ketoacidosis.

20) C
- glycosylated hemoglobin (HbA1c) is the best indicator of diabetic control. It reflects blood glucose level for the past 3 to 4 months.


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