Published - Thu, 23 Feb 2023

NCLEX-RN Exam Questions - Part 132

1. An IDDM clients condition stabilizes. He begins to receive a daily injection of NPH insulin at 6:30 AM. The nurse can most likely expect a hypoglycemic reaction to occur that same day at:

A) 8:30 AM - 10:30 AM
B) 2:30 PM - 4:30 PM
C) 7:30 PM - 9:30 PM
D) 10:30 PM - 11:30 PM

2. After several days, an IDDM clients serum glucose stabilizes, and the registered nurse continues client teaching in preparation for his discharge. The nurse helps him plan an American Diabetes Association diet and explains how foods can be substituted on the exchange list. He can substitute 1 oz of poultry for:

A) One frankfurter
B) One ounce of ham
C) Two slices of bacon
D) One-fourth cup dry cottage cheese

3. When discussing the relationship between exercise and insulin requirements, a 26-year-old client with IDDM should be instructed that:

A) When exercise is increased, insulin needs are increased
B) When exercise is increased, insulin needs are decreased
C) When exercise is increased, there is no change in insulin needs
D) When exercise is decreased, insulin needs are decreased

4. A 64-year-old client is admitted to the hospital with benign prostatic hypertrophy (BPH). He has a history of adult-onset diabetes and hypertension and is scheduled to undergo a resection of the prostate. When recording his health history, the nurse asks about his chief complaint. The most serious symptom that may accompany BPH is:

A) Acute urinary retention
B) Hesitancy in starting urination
C) Increased frequency of urination
D) Decreased force of the urinary stream

5. A client undergoes a transurethral resection, prostate (TURP). He returns from surgery with a three-way continuous Foley irrigation of normal saline in progress.The purpose of this bladder irrigation is to prevent:

A) Bladder spasms
B) Clot formation
C) Scrotal edema
D) Prostatic infection

1. Right Answer: B
Explanation: (A) This time describes the time of onset of NPH insulins action, rather than its peak effect. (B) NPH insulin, an intermediateacting insulin, usually begins to lower serum glucose levels about 2 hours after administration. The action of NPH insulin peaks 814 hours after administration. It has a 2030 hour duration. (C) The time stated is not the time of peak action for NPH insulin administered at 6:30 AM. (D) The time stated is not the time of peak action for NPH insulin administered at 6:30 AM.

2. Right Answer: D
Explanation: (A) A frankfurter is a high-fat meat on the diabetic exchange list. (B) Ham is a medium-fat meat on the diabetic exchange list, unless it is a center-cut slice. (C)One strip of bacon equals onefatexchange rather than ameatexchange. Dietary substitutions should occur within exchange lists and not between exchange lists.(D) Diabetic meat-exchange lists are categorized into leanmeat foods, medium-fat meats, and high-fat meats. Cottage cheese (dry, 2% butterfat), one-fourth cup, can substitute for one lean-meat exchange.

3. Right Answer: B
Explanation: (A) If the clients insulin is increased when activity level is increased, hypoglycemia may result. (B) Exercise decreased the blood sugar by promoting uptake of glucose by the muscles. Consequently, less insulin is needed to metabolize ingested carbohydrates. Extra food may be required for extra activity. (C) This statement directly contradicts the correct answer and is inaccurate. (D) When exercise is decreased, the clients insulin dose does not need to be altered unless the blood sugar becomes unstable.

4. Right Answer: A
Explanation: (A) Acute urinary retention requires urgent medical attention. If measures such as a warm tub bath or warm tea do not occur after 6 hours, the client should go to the ED for catheterization. (B, C, D) This choice is a symptom of BPH, but it is not serious or life threatening.

5. Right Answer: B
Explanation: (A) The purpose of bladder irrigation is not to prevent bladder spasms, but to drain the bladder and decrease clot formation and obstruction. (B) A three-way system of bladder irrigation will cleanse the bladder and prevent formation of blood clots. A catheter obstructed by clots or other debris will cause prostatic distention and hemorrhage. (C) Scrotal edema seldom occurs after TURP. Bladder irrigation will not prevent this complication. (D) Prostatic infection seldom occurs after TURP. Bladder irrigation will not prevent this complication.

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