Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A Type 1 diabetic client with a morning (fasting) glucose of 260 mg/dL has been diagnosed with the Somogyi effect from insulin administration.
What intervention should the nurse anticipate including in the plan of care?
A. Increase the nighttime insulin glargine dose.
Increasing the nighttime insulin glargine dose may exacerbate the Somogyi effect, a phenomenon where the blood sugar level drops too low overnight, causing a rebound high blood sugar level in the morning.
B. Ensure a snack is consumed at bedtime.
Consuming a snack at bedtime can help prevent the blood sugar level from dropping too low overnight, thus preventing the Somogyi effect.
C. Check the morning cortisol level.
Checking the morning cortisol level is not directly related to managing the Somogyi effect.
D. Check the glucose level at 2 a.m. and 8 a.m.
Checking the glucose level at 2 a.m. and 8 a.m. can help identify the Somogyi effect, but it does not prevent it.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Med Surg Nurs 200 Proctored Exam Roxoborouh Memorial College. Take the full exam now
Full Explanation
Choice A rationale
Increasing the nighttime insulin glargine dose may exacerbate the Somogyi effect, a phenomenon where the blood sugar level drops too low overnight, causing a rebound high blood sugar level in the morning.
Choice B rationale
Consuming a snack at bedtime can help prevent the blood sugar level from dropping too low overnight, thus preventing the Somogyi effect.
Choice C rationale
Checking the morning cortisol level is not directly related to managing the Somogyi effect.
Choice D rationale
Checking the glucose level at 2 a.m. and 8 a.m. can help identify the Somogyi effect, but it does not prevent it.
Similar Questions
The nurse is caring for a client who is being evaluated for possible deep vein thrombosis of the right extremity. Which laboratory result is of most concern to the nurse?
A. Activated Partial Thromboplastin Time (aPTT) of 25.
Activated Partial Thromboplastin Time (aPTT) of 25 is within the normal range (25-35 seconds) and is not directly related to deep vein thrombosis (DVT)89.
B. D-dimer of 500 ng/mL.
A D-dimer level of 500 ng/mL is elevated (normal range is typically less than 250 ng/mL), which can indicate the presence of a clot, such as in DVT8910.
C. Prothrombin Time (PT) of 14 seconds.
Prothrombin Time (PT) of 14 seconds is within the normal range (11-13.5 seconds) and is not directly related to DVT89.
D. Platelet count of 148,000 uL.
A platelet count of 148,000 uL is within the normal range (150,000-450,000 uL) and is not directly related to DVT89.
Full Explanation
Choice A rationale
Activated Partial Thromboplastin Time (aPTT) of 25 is within the normal range (25-35 seconds) and is not directly related to deep vein thrombosis (DVT)89.
Choice B rationale
A D-dimer level of 500 ng/mL is elevated (normal range is typically less than 250 ng/mL), which can indicate the presence of a clot, such as in DVT8910.
Choice C rationale
Prothrombin Time (PT) of 14 seconds is within the normal range (11-13.5 seconds) and is not directly related to DVT89.
Choice D rationale
A platelet count of 148,000 uL is within the normal range (150,000-450,000 uL) and is not directly related to DVT89.
A patient receives 20 units of Isophane Insulin Suspension (NPH) Insulin at 07:30. At what time are signs of hypoglycemia most likely to occur?
A. 08:30
B. 10:30
C. 14:30
Step 1: NPH insulin generally starts to act within 1 to 3 hours after injection. Step 2: Its peak effect occurs 4 to 12 hours after injection. Step 3: If the patient receives the insulin at 07:30, the peak effect would be between 11:30 (07:30 + 4 hours) and 19:30 (07:30 + 12 hours). Step 4: Hypoglycemia is most likely to occur during the peak effect of the insulin, which is between 11:30 and 19:30. Step 5: Among the given options, 14:30 falls within this range.
D. 23:00 .
A patient diagnosed with peripheral arterial disease is being educated about the benefits of walking for exercise. What information should the nurse emphasize?
A. Elevate the feet for 30 minutes after walking.
Elevating the feet for 30 minutes after walking is not specifically beneficial for a patient with peripheral arterial disease (PAD). While elevation can help with conditions like edema, it does not directly address the issues associated with PAD12.
B. Avoid exercise that increases the heart rate.
Avoiding exercise that increases the heart rate is not the best advice for a patient with PAD. Exercise, including activities that increase heart rate, can actually be beneficial. It can help improve circulation, which is often compromised in PAD12.
C. Continue walking to the point of pain.
Continuing to walk to the point of pain is beneficial for patients with PAD. Walking, especially at a high intensity, can help improve symptoms of PAD. It can increase blood flow and oxygen supply to the muscles, which can help manage PAD symptoms.
D. Do not walk if a leg ulcer develops.
While it’s important to care for any ulcers that develop and seek medical attention, stopping walking altogether if a leg ulcer develops is not necessary. Walking is a low-impact activity that can help improve mobility over time.
Full Explanation
Choice A rationale
Elevating the feet for 30 minutes after walking is not specifically beneficial for a patient with peripheral arterial disease (PAD). While elevation can help with conditions like edema, it does not directly address the issues associated with PAD12.
Choice B rationale
Avoiding exercise that increases the heart rate is not the best advice for a patient with PAD. Exercise, including activities that increase heart rate, can actually be beneficial. It can help improve circulation, which is often compromised in PAD12.
Choice C rationale
Continuing to walk to the point of pain is beneficial for patients with PAD. Walking, especially at a high intensity, can help improve symptoms of PAD. It can increase blood flow and oxygen supply to the muscles, which can help manage PAD symptoms.
Choice D rationale
While it’s important to care for any ulcers that develop and seek medical attention, stopping walking altogether if a leg ulcer develops is not necessary. Walking is a low-impact activity that can help improve mobility over time.