1 :

Hint : 💉 Control glucose to prevent damage

Correct Answers:

  • "Maintain stable blood glucose levels."


Rationale :

🔶 Maintaining stable blood glucose levels is the most important strategy to prevent long-term complications of diabetes.

🔶 Chronic hyperglycemia damages small blood vessels, leading to retinopathy and neuropathy.

🔶 While actions like wearing closed-toed shoes or foot inspection help prevent injuries, they do not address the underlying cause of complications.

🔶 Stable glucose control reduces the risk of microvascular damage, which preserves vision and nerve function.

🔶 Clients should be educated on frequent monitoring and maintaining HbA1c below 7% to reduce complications.


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2 :

Hint : 😠 Hyper = anxious and moody

Correct Answers:

  • Frequent mood changes


Rationale :

🟡 Clients with hyperthyroidism often experience mood instability, including anxiety, irritability, and restlessness.

🟡 These changes are due to increased levels of thyroid hormones, which speed up metabolism and nervous system activity.

🟡 Unlike hypothyroidism, which slows down function, hyperthyroidism causes emotional lability and agitation.

🟡 Other expected symptoms may include weight loss, heat intolerance, and tachycardia.

🟡 Recognizing these emotional and behavioral changes is essential for diagnosis and treatment planning.


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3 :

Hint : 🧪 Divide dose by concentration

Correct Answers:

  • 40


Rationale :

✍️The ordered dose is 40 mg

✍️The available concentration is 5 mg/5 mL, equivalent to 1 mg/mL.

🔷 Using the formula:

♦️Dose ÷ Concentration = Volume

→ 40 mg ÷ 1 mg/mL

👉= 40 mL.


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4 :

Hint : 🧬 Low TSH = overactive thyroid

Correct Answers:

  • Thyroid stimulating hormone (TSH) level


Rationale :

🔶 In Graves' disease, excessive production of T3 and T4 suppresses TSH via negative feedback.

🔶 TSH levels are decreased, while T3 and T4 levels are elevated in hyperthyroidism.

🔶 TSH is secreted by the pituitary to stimulate the thyroid, but high thyroid hormone levels signal the pituitary to stop releasing TSH.

🔶 This laboratory pattern is a hallmark diagnostic indicator of primary hyperthyroidism.

🔶 Identifying this abnormality confirms excess thyroid hormone production as the source of symptoms.


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5 :

Hint : 🏃 Avoid insulin in active muscle

Correct Answers:

  • "I should avoid injecting insulin into my thigh if I am going to go running."


Rationale :

🟢 Injecting into a working muscle group like the thigh can increase insulin absorption, leading to hypoglycemia during exercise.

🟢 Patients are advised to use non-active sites such as the abdomen when planning physical activity.

🟢 This prevents unexpected drops in blood glucose that could cause dizziness or fainting.

🟢 Educating clients on safe injection practices ensures better insulin control and exercise safety.

🟢 Clients should also be aware of signs of hypoglycemia and carry fast-acting carbs when active.


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6 :

Hint : 🌕 Cortisol causes fat redistribution

Correct Answers:

  • Excess adipose tissue in the trunk, slender extremities, and moon face


Rationale :

🔷 Cushing syndrome is caused by prolonged exposure to high cortisol levels, whether endogenous or from steroid therapy.

🔷 This leads to central obesity, slender arms and legs, and a moon-shaped face.

🔷 Other common signs include buffalo hump, purple striae, thin skin, and easy bruising.

🔷 The condition is also associated with hyperglycemia, hypertension, and immunosuppression.

🔷 Early recognition helps prevent complications like osteoporosis and diabetes.


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7 :

Hint : ⚖️ Low calcium = high phosphate

Correct Answers:

  • Phosphate 5.7 mg/dL


Rationale :

🟡 Hypoparathyroidism leads to low calcium and high phosphate levels due to insufficient parathyroid hormone (PTH).

🟡 PTH normally promotes calcium reabsorption and phosphate excretion by the kidneys.

🟡 Without adequate PTH, phosphate accumulates, and calcium drops, causing symptoms like tetany and seizures.

🟡 A phosphate level of 5.7 mg/dL is elevated, which confirms this metabolic imbalance.

🟡 These lab values guide management, including calcium supplements and vitamin D therapy.


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8 :

Hint : 👣 Daily check = diabetic foot care

Correct Answers:

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


Rationale :

🔶 Daily foot checks are crucial in diabetes to identify cuts, blisters, or ulcers early.

🔶 Neuropathy reduces pain sensation, so injuries may go unnoticed and lead to serious infections.

🔶 Early detection helps prevent amputation and hospitalization.

🔶 Clients should also be taught to wash and dry feet thoroughly, trim nails carefully, and wear protective shoes.

🔶 Lotion may be used but should be avoided between toes to prevent fungal growth.


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9 :

Hint : 🕒 Peak time = snack time

Correct Answers:

  • 1500


Rationale :

🟢 NPH insulin peaks 6–8 hours after administration, increasing the risk of hypoglycemia during that time.

🟢 If administered at 0700, the peak would occur between 1300 and 1500, requiring a snack to prevent low blood sugar.

🟢 1500 is the best time for a planned snack to offset the insulin peak.

🟢 Offering food at this time maintains blood glucose levels and prevents dizziness, tremors, or fainting.

🟢 Monitoring blood sugar around peak insulin times is also important for tight glycemic control.


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10 :

Hint : 🍬 Use quick sugar for tremors

Correct Answers:

  • 4 oz of regular soda


Rationale :

✳️ A blood glucose level of 60 mg/dL indicates mild hypoglycemia, and the client is symptomatic with hand tremors, which requires quick treatment using a fast-acting carbohydrate.

✳️ Regular soda contains simple sugars that are quickly absorbed into the bloodstream and can rapidly raise blood glucose levels.

✳️ The recommended intervention for hypoglycemia (if the patient is conscious) is 15 grams of fast-acting carbohydrate, and 4 oz of regular soda provides about this amount.

✳️ Once the blood glucose level is stabilized, the nurse should follow up with a long-acting carbohydrate to maintain levels and prevent recurrence.

✳️ Glucose tablets or hard candy are also acceptable, but the immediate, rapid absorption from regular soda makes it the most efficient choice in this scenario.


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Total Questions: 10

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