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Exam 1: NUR209/ NUR 209 (New 2025/
2026 Update) Medical Surgical Nursing II
| Questions and Verified Answers| 100%
Correct| A Grade โ Fortis
QUESTION
what should a patient do if their blood sugar is 100 before they start exercising? Answer: they should eat 15g of a carbohydrate, recheck in 15 - 30 min and delay exercise if still under 100
QUESTION
what should a patient do if their blood sugar is above 250 before exercise? Answer: check urine for ketones if type 1 diabetic (delay vigorous activity is present)
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how long can hypoglycemia occur after exercise? Answer: up to 48 hours
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What is the A1C goal for diabetics? Answer: 6.5%-7.0%
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how often should a diabetic check their A1C? Answer: every 3 - 6 months
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signs of DKA Answer:
- dehydration (dry mucous membranes), tachycardia, orthostatic hypotension, fruity breath, ketonuria, and kussmaul respirations
QUESTION
what insulin is rapid acting? whats its onset and peak? Answer: Humalog and Novolog
- onset: 10 - 30 min
- peak: 30min- 3 hrs
QUESTION
what insulin is short acting, what its onset and peak? Answer: Regular, Humalin, Novalin onset: 30-60 min peak: 2 - 5 hrs
Answer: Fluids for first 24hrs = 4 x kg x % of burn 50% over 8hrs 50% over next 16hrs
QUESTION
signs of hypoxia in a burn patient Answer: restlessness, anxiety, agitation, high respiratory rate (increase work of breathing)
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normal pH Answer: 7.35-7.
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normal PaCo Answer: 35 - 45
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normal HCO Answer: 22 - 26
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how to know if patient is fully compensated? Answer: pH will be normal
QUESTION
clinical manifestations of melanoma Answer:
- irregular color, surface, border
- color (red, white, blue, black, grey, brown)
- flat, elevated, eroded, or ulcerated
- usually <1cm
QUESTION
management for pt vomiting with metastatic colon cancer Answer:
- administer antiemetic 1 hr before treatment
- eat small frequent meals
QUESTION
A patient has the following risk factors for melanoma. Which risk factor should the nurse assign as the priority focus of patient teaching?a. The patient has multiple dysplastic nevi. b. The patient is fair-skinned and has blue eyes. c. The patient's mother died of a malignant melanoma. d. The patient uses a tanning booth throughout the winter. Answer: D Because the only risk factor that the patient can change is the use of a tanning booth, the nurse should focus teaching about melanoma prevention on this factor. The other factors also will contribute to increased risk for melanoma.
Answer: 2, 3, 5 Excessive thirst, frequent urination, and unexplained weight loss are clinical symptoms of both type 1 and type 2 diabetes mellitus. Fatigue and recurrent infections are clinical manifestations of type 2 diabetes.Text Reference - p. 1157
QUESTION
Which symptom reported by a patient would lead the nurse to suspect early undiagnosed type 2 diabetes? 1Blurred vision 2Gradual weight gain 3A wound that will not heal 4Insomnia Answer: 3 Type 2 diabetes presents with vague complaints including fatigue, frequent infections, and delayed wound healing. Blurred vision is a late symptom of uncontrolled diabetes. The patient will present with weight loss. Insomnia is not related to symptoms of undiagnosed diabetes.
QUESTION
A patient is prescribed lispro therapy. Related to meal times, the nurse should instruct the patient to administer the insulin when?
- On an empty stomach, between meals
- Simultaneously with a meal
- 15 minutes after a meal
- 30 to 45 minutes before a meal Answer: 3 Lispro is a rapid-acting synthetic insulin that has an onset of action of approximately 15 minutes. Lispro should be administered 15 minutes after mealtime because its rapid action closely mimics natural insulin secretion in response to a meal. Lispro is not administered on an empty stomach or simultaneously with a meal. Short-acting regular insulin, not rapid-acting synthetic insulin, is administered 30 to 45 minutes before a meal to ensure the onset of action coincides with meal absorption.Text Reference - p. 1160
QUESTION
symptoms of type 1 diabetes Answer: polyuria, polydipsia, polyphagia
QUESTION
what is type 1 diabetes caused by? Answer:
- lack of insulin (insulin dependent)
- body develops antibodies agains insulin and B cells in pancreas
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symptoms of type 2 diabetes Answer: type 1 symptoms, plus fatigue, recurrent infections, poor wound healing, vision changes
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what is the cause of type 2 diabetes? Answer: pancreas makes some endogenous insulin but it doesn't make enough, or the body does not use it right
QUESTION
what are the risk factors for type 2 diabetes?
QUESTION
what is the rule of 15? Answer: if blood sugar less than 70 give 15g carbohydrate
- recheck in 15 min, if still under 70, give 15g more carbohydrate (repeat up to 3 times)
- once stable (100), give pt carbohydrate & protein
QUESTION
what is DKA? Answer: deficiency of body insulin resulting in hyperglycemia, formation of ketosis, acidosis, and dehydration
QUESTION
What are the symptoms of type 1 diabetes? Answer: polyuria (excessive urination), polydipsia (excessive thirst), polyphagia (excessive hunger)
QUESTION
what is type 1 diabetes? Answer:
- insulin dependent diabetes
- the body develops antibodies against insulin and/or the pancreatic B cells that make insulin
QUESTION
what is type 2 diabetes?
Answer: adult-onset or non-insulin dependent diabetes
- the pancreas makes sone insulin but they body does not make enough or use it correctly
QUESTION
what are the symptoms of type 2 diabetes? Answer: fatigue, recurrent infections, vaginal yeast or candid infections, prolonged wound healing, and vision problems
QUESTION
what is hypoglycemia? Answer: when there is too much insulin in proportion to available glucose in the blood
QUESTION
what are the assessment findings of hypoglycemia? Answer:
- blood glucose <
- cold, clammy skin
- numbness of fingers, toes, mouth
- tachycardia
- emotional changes
- headache
- nervousness, tremors
- faintness, dizziness
- unsteady gait, slurred speech
- hunger
- changes in vision
- seizures, coma
QUESTION
what type of medications make patients at a higher risk for skin cancer? Answer: Patients treated with oral methoxsalen and psoralen plus ultraviolet A radiation (PUVA)
QUESTION
patient teaching for high risk for melanoma Answer: a. Teach patients to self-examine their skin monthly b. They should have a periodic professional assessment of areas that are hard to see c. Use sunscreen d. Limit sun exposure from 10am to 4pm e. Do not use tanning beds f. Wear protective clothing
QUESTION
nursing priorities during the emergent phase of burns Answer: a. Main concerns are the onset of hypovolemic shock and edema formation b. Intubation for airway management and O c. IV access for fluid resuscitation and drug administration (at least 2 large bore IV's need to be placed)
QUESTION
what is the emergent burn phase? Answer:
- Emergent phase: first 48 hrs Goal is to maintain respiratory integrity, prevent hypovolemic shock
Establish airway IV fluids Foley catheter to know about urine output for fluid replacement NG tube Analgesics Monitor VS Tetanus vaccine
QUESTION
how to use the parkland formula Answer:
- V(ml) =4xKgx% divide ml by 2, give the patient half the ml in the first 8 hours and the other half in the last 16 hours
QUESTION
signs of hypoxia in a burn patient Answer: a. Increased agitation, anxiety, restlessness, or a change in the rate or character of the patients breathing
QUESTION
nursing management of metastatic colon cancer if patient is vomiting Answer: a. Encourage patient to eat and drink when not nauseated b. Give prophylactic antiemetic's before chemotherapy and on as-needed basis c. Teach patients to take antiemetic's on a scheduled basis for 2 - 3 days after highly emetogenic chemotherapy d. Use diversional activities (if appropriate)
QUESTION
QUESTION
what does the ADA recommend for physical activities for a person with diabetes? Answer: recommends at least 150 minutes per week of moderate physical activity a. Active housework b. Bicycling c. Bowling d. Dancing e. Gardening f. Golf g. Roller skating h. Walking briskly
QUESTION
What is hemoglobin A1C? Answer: a. A1C provides a measurement of blood glucose levels over the previous 2 - 3 months, with increases in the Hb A1C reflecting elevated blood glucose levels b. A1C is monitored regularly to determine how well the current treatment plan is working and changes can be made in the plan if glycemic goals are not achieved
QUESTION
patient teaching for a diabetic taking steroids Answer: a. Check blood sugar more often b. Increase the dose of insulin if needed c. Monitor urine or blood ketones
QUESTION
how to prevent DKA?
Answer:
- Sick day rules: (increase insulin when ill)
- monitor BS every 2 - 4 hours
- check urine for blood or ketones every 2 - 4 hours
- eat your normal diet
- 8 - 12oz water every hour
- continue insulin/ pre-established sliding scale
QUESTION
patient teaching for type 2 diabetes Answer: a. Healthy eating, regular exercise, and healthy weight, may need medication as the disease progresses
QUESTION
How to assess hypoglycemia in a sleeping or unconscious patient? Answer: a. check the blood glucose b. If pt is unconscious: subcutaneous or IM injection of 1mg glucagon or IV administration of 20 - 50ml of 50% glucose and turn the patient on their side to prevent aspiration
QUESTION
what is DKA? Answer: deficiency of body insulin resulting in hyperglycemia, formation of ketoacids, osmotic diuresis, and metabolic acidosis
QUESTION
C
Treatment with antiemetics before chemotherapy may help prevent nausea. The patient should eat small, frequent meals. Offering food and beverages during chemotherapy is likely to cause nausea. The acidity of citrus fruits may be further irritating to the stomach
QUESTION
After giving 6 oz of orange juice to a patient with hypoglycemia, the nurse finds that the patient's blood glucose level is 65 mg/dL. What would be the most appropriate nursing action in this situation? Answer: Giving 15 g of carbohydrate A patient with a blood glucose level less than 70 mg/dL should be given 15 g of carbohydrates ( to 6 oz of fruit juice) initially. If the glucose is still less than 70 mg/dL, then another 15 g of carbohydrates should be given. Dextrose (5% to 10%) is added to the fluid regimen in patients who are on treatment for diabetic ketoacidosis if the blood glucose level approaches 250 mg/dL. Administering 25 to 50 mL of 50% glucose intravenously and 1 mg IM glucagon is indicated for an unconscious patient or if the symptoms of hypoglycemia are worsening.
QUESTION
After administering an intramuscular (IM) glucagon injection in an unconscious patient, why does the nurse turns the patient on the side? Answer: to prevent aspiration
QUESTION
A patient with diabetes experiences hypoglycemia. What does the nurse educate the patient that a cause of this condition may be? Answer: Exercise without a carbohydrate-based snack
QUESTION
A patient, admitted with diabetes mellitus, has a glucose level of 380 mg/dL and a moderate level of ketones in the urine. As the nurse assesses for signs of ketoacidosis, which respiratory pattern would the nurse expect to find? Answer: Kussmaul respirations
QUESTION
There is one opening in the schedule at the dermatology clinic, and 4 patients are seeking appointments today. Which patient will the nurse schedule for the available opening? a. 38 - year old with a 7 - mm nevus on the face that has recently become darker b. 62 - year-old with multiple small, soft, pedunculated papules in both axillary areas c. 42 - year-old with complaints of itching after using topical fluorouracil on the nose d. 50 - year-old with concerns about skin redness after having a chemical peel 3 days ago Answer: A The description of the lesion is consistent with possible malignant melanoma. This patient should be assessed as soon as possible by the health care provider. Itching is common after using topical fluorouracil and redness is an expected finding a few days after a chemical peel. Skin tags are common, benign lesions after midlife.
