Endocrine Disorders NCLEX
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Question 1 of 5.
The nurse is reviewing information for the client with type 1 DM. The nurse concludes that the client may be experiencing the Somogyi phenomenon, as evidenced by which finding?
A. 02:00 blood glucose between 80-110 mg/dL and morning levels between 80-100 mg/dL
B. 02:00 blood glucose between 50-60 mg/dL and morning levels between 48-62 mg/dL
C. 02:00 blood glucose between 130-140 mg/dL and morning levels between 180-200 mg/dL
D. 02:00 blood glucose between 45-62 mg/dL and morning levels between 200-305 mg/dL
Explanation: The nurse should conclude that the low blood glucose in the middle of the night (45-62 mg/dL) and a rebound morning hyperglycemia (200-305 mg/dL) are signs of Somogyi phenomenon, also known as Somogyi effect.
Question 2 of 5.
The client diagnosed with type 1 diabetes is receiving Humalog, a rapid-acting insulin, by sliding scale. The order reads blood glucose level: <150, zero (0) units; 151 to 200, three (3) units; 201 to 250, six (6) units; >251, contact health-care provider. The unlicensed assistive personnel (UAP) reports to the nurse the client's glucometer reading is 189. How much insulin should the nurse administer to the client?
Answer: 3 units
Explanation: Per the sliding scale, a glucose of 189 (151–200 range) requires 3 units of Humalog.
Question 3 of 5.
The diabetic educator is teaching a class on diabetes type 1 and is discussing sick-day rules. Which interventions should the diabetes educator include in the discussion? Select all that apply.
A. Take diabetic medication even if unable to eat the client's normal diabetic diet.
B. If unable to eat, drink liquids equal to the client's normal caloric intake.
C. It is not necessary to notify the health-care provider (HCP) if ketones are in the urine.
D. Test blood glucose levels and test urine ketones once a day and keep a record.
E. Call the health-care provider if glucose levels are higher than 180 mg/dL.
Explanation: Continuing insulin and consuming caloric liquids (e.g., juice) prevent DKA during illness. Ketones require HCP notification, daily testing is insufficient, and 180 mg/dL is too low for notification.
Question 4 of 5.
The elderly client is admitted to the intensive care department diagnosed with severe HHNS. Which collaborative intervention should the nurse include in the plan of care?
A. Infuse 0.9% normal saline intravenously.
B. Administer intermediate-acting insulin.
C. Perform blood glucometer checks daily.
D. Monitor arterial blood gas (ABG) results.
Explanation: IV normal saline corrects severe dehydration in HHNS, a priority collaborative intervention. Insulin is secondary, daily glucose checks are insufficient, and ABGs are less critical in HHNS.
Question 5 of 5.
The UAP on the medical floor tells the nurse the client diagnosed with DKA wants something else to eat for lunch. Which intervention should the nurse implement?
A. Instruct the UAP to get the client additional food.
B. Notify the dietitian about the client's request.
C. Request the HCP increase the client's caloric intake.
D. Tell the UAP the client cannot have anything else.
Explanation: Notifying the dietitian ensures the client's nutritional needs are met within DKA dietary restrictions. Additional food, caloric increases, or denial are inappropriate without consultation.
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