Question

A nurse is caring for a client who has type 1 diabetes mellitus. The nurse misread the client's morning fasting blood glucose level as 210 mg/dL instead of 120 mg/dL and administered the insulin dose appropriate for a reading over 200 mg/dL. Which of the following actions should the nurse identify as the priority?

Answer 1

Correct Answers:

Check the client's blood glucose level.

Rationale :

🔵 Client safety is the top priority after a medication error; checking blood glucose ensures hypoglycemia is identified early.

🔵 Hypoglycemia can occur due to excess insulin, especially when based on incorrect readings.

🔵 Blood glucose confirmation must occur before any treatment is initiated (e.g., giving carbs).

🔵 Assessment before action is essential in nursing processes.

🔵 This step helps guide further interventions like dextrose or carb administration.

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Answer 2

Correct Answers:

Monitor for compression fractures of the back and neck.

Rationale :

🟢 Long-term glucocorticoids cause bone demineralization, leading to osteoporosis.

🟢 Compression fractures in the spine are a common complication due to weakened vertebrae.

🟢 Patients on steroids should be educated on fall prevention and bone health.

🟢 Vitamin D and calcium support is often recommended.

🟢 Monitoring allows for early detection and management of bone damage.

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Answer 3

Correct Answers:

Clammy
Tachycardia
Blurry Vision

Rationale :

🔴 Clammy: Diaphoresis is a key symptom of hypoglycemia due to sympathetic nervous system response.

🔴 Tachycardia: Caused by adrenaline release as the body responds to low glucose.

🔴 Blurry Vision: Brain and visual centers are deprived of glucose, impairing focus.

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Answer 4

Correct Answers:

Insulin injections daily

Rationale :

🔶 Persistent hyperglycemia despite diet indicates insulin deficiency or resistance.

🔶 Insulin therapy is required when oral agents or lifestyle modifications fail.

🔶 Early intervention with insulin improves outcomes and reduces complications.

🔶 This step is especially necessary in new-onset or type 1 diabetes.

🔶 Without insulin, glucose remains in circulation and damages tissues.

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Answer 5

Correct Answers:

Tachypnea

Rationale :

⚪ High doses of levothyroxine can cause hyperthyroidism, which raises metabolic rate.

⚪ Tachypnea is the body’s response to increased oxygen demand and metabolic activity.

⚪ Other signs include heat intolerance, tremors, and palpitations.

⚪ Monitoring vital signs helps evaluate medication effectiveness or toxicity.

⚪ Adjustments in dose may be required based on symptoms.

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Answer 6

Correct Answers:

2

Rationale :

🟡 Required dose = 275 mcg; Available dose = 137 mcg/tablet.

🟡 275 ÷ 137 = approximately 2.007 → round to 2 tablets.

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Answer 7

Correct Answers:

"I'll check my feet every day for sores and bruises."

Rationale :

🟣 Daily foot checks help detect wounds early, preventing infection and amputation.

🟣 Neuropathy in diabetes often leads to reduced pain perception, masking injuries.

🟣 Proper foot hygiene and inspection are vital to long-term diabetic management.

🟣 Moisture between toes should be avoided to prevent fungal infections.

🟣 Avoid barefoot walking or open shoes to prevent injury.

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Answer 8

Correct Answers:

"Tremors, nervousness, and insomnia can indicate that your dose is too high."

Rationale :

🟥 These symptoms reflect hyperthyroidism, a potential consequence of overmedicating.

🟥 Clients should report these changes for prompt dose adjustment.

🟥 Levothyroxine increases metabolism and central nervous activity.

🟥 Regular lab monitoring (TSH, T3, T4) is required to maintain balance.

🟥 Dose changes should only be done under medical supervision.

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Answer 9

Correct Answers:

1

Rationale :

💠 Regular and NPH insulin are compatible and can be mixed in one syringe.

💠 Regular insulin should be drawn first to avoid contamination.

💠 This ensures safe and accurate dosage preparation.

💠 Reduces the number of injections and increases compliance.

💠 Nurse must still monitor blood glucose and injection timing.

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Answer 10

Correct Answers:

"Maintain stable blood glucose levels."

Rationale :

🟠 Chronic high glucose causes microvascular damage, leading to neuropathy and retinopathy.

🟠 Glycemic control is the most effective preventive measure.

🟠 Good glucose management reduces oxidative stress and inflammation.

🟠 Foot care and eye exams are also essential, but glucose control is foundational.

🟠 Teaching should emphasize HbA1c targets and blood sugar monitoring.

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ATI LPN Medsurg Level III~Endocrine Exam

No.

2 :
A nurse is reinforcing teaching with a client about taking high doses of oral glucocorticoids for over ten years to treat rheumatoid arthritis. Which of the following information should the nurse include in the teaching?

3 :
A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus. The nurse determines that teaching has been effective when the client identifies which of the following manifestations of hypoglycemia? (Select all that apply.)

4 :
A nurse is caring for a client who has a new onset of diabetes mellitus and is experiencing uncontrolled blood glucose levels. The client informs the nurse about their strict dietary compliance. Which should the nurse anticipate the provider prescribing for treatment?

5 :
A nurse is caring for a client who is taking levothyroxine for hypothyroidism. Which of the following indicates the client's dose is too high?

6 :
A nurse is preparing to administer levothyroxine 275 mcg PO to a client. The amount available is levothyroxine 137 mcg/tablet. How many tablets should the nurse administer? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

7 :
A nurse is reinforcing teaching for a client who has type 1 diabetes mellitus about foot care. Which of the following client statements should indicate to the nurse an understanding of the instructions?

8 :
A nurse is reinforcing teaching with a client who has hypothyroidism and a prescription for levothyroxine. Which of the following statements should the nurse make to the client?

9 :
A nurse receives a new prescription from the provider that reads "Give regular insulin 14 units and NPH insulin 28 units subcutaneously at breakfast." How many syringes should the nurse prepare?

10 :
A nurse is reinforcing teaching about preventing long-term complications of retinopathy and neuropathy with an older adult client who has diabetes mellitus. Which of the following actions is the most important for the nurse to include in the teaching?

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ATI LPN Medsurg Level III~Endocrine Exam

No.

2 : A nurse is reinforcing teaching with a client about taking high doses of oral glucocorticoids for over ten years to treat rheumatoid arthritis. Which of the following information should the nurse include in the teaching?

3 : A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus. The nurse determines that teaching has been effective when the client identifies which of the following manifestations of hypoglycemia? (Select all that apply.)

4 : A nurse is caring for a client who has a new onset of diabetes mellitus and is experiencing uncontrolled blood glucose levels. The client informs the nurse about their strict dietary compliance. Which should the nurse anticipate the provider prescribing for treatment?

5 : A nurse is caring for a client who is taking levothyroxine for hypothyroidism. Which of the following indicates the client's dose is too high?

6 : A nurse is preparing to administer levothyroxine 275 mcg PO to a client. The amount available is levothyroxine 137 mcg/tablet. How many tablets should the nurse administer? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

7 : A nurse is reinforcing teaching for a client who has type 1 diabetes mellitus about foot care. Which of the following client statements should indicate to the nurse an understanding of the instructions?

8 : A nurse is reinforcing teaching with a client who has hypothyroidism and a prescription for levothyroxine. Which of the following statements should the nurse make to the client?

9 : A nurse receives a new prescription from the provider that reads "Give regular insulin 14 units and NPH insulin 28 units subcutaneously at breakfast." How many syringes should the nurse prepare?

10 : A nurse is reinforcing teaching about preventing long-term complications of retinopathy and neuropathy with an older adult client who has diabetes mellitus. Which of the following actions is the most important for the nurse to include in the teaching?

2 :
A nurse is reinforcing teaching with a client about taking high doses of oral glucocorticoids for over ten years to treat rheumatoid arthritis. Which of the following information should the nurse include in the teaching?

3 :
A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus. The nurse determines that teaching has been effective when the client identifies which of the following manifestations of hypoglycemia? (Select all that apply.)

4 :
A nurse is caring for a client who has a new onset of diabetes mellitus and is experiencing uncontrolled blood glucose levels. The client informs the nurse about their strict dietary compliance. Which should the nurse anticipate the provider prescribing for treatment?

5 :
A nurse is caring for a client who is taking levothyroxine for hypothyroidism. Which of the following indicates the client's dose is too high?

6 :
A nurse is preparing to administer levothyroxine 275 mcg PO to a client. The amount available is levothyroxine 137 mcg/tablet. How many tablets should the nurse administer? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

7 :
A nurse is reinforcing teaching for a client who has type 1 diabetes mellitus about foot care. Which of the following client statements should indicate to the nurse an understanding of the instructions?

8 :
A nurse is reinforcing teaching with a client who has hypothyroidism and a prescription for levothyroxine. Which of the following statements should the nurse make to the client?

9 :
A nurse receives a new prescription from the provider that reads "Give regular insulin 14 units and NPH insulin 28 units subcutaneously at breakfast." How many syringes should the nurse prepare?

10 :
A nurse is reinforcing teaching about preventing long-term complications of retinopathy and neuropathy with an older adult client who has diabetes mellitus. Which of the following actions is the most important for the nurse to include in the teaching?