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35. Assume you are assigning in emergency 25 years old male patient has been admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA) The initial blood glucose level is 650mg/dL . You initiated rehydration with IV 0.9% normal saline and subcutaneous regular insulin. The serum glucose level is now decreased to 240mg/dL The nurse would next prepare to administer which medication. A. An ampule of 40% dextrose B. NPH insulin subcutaneously C. IV fluids containing dextrose D. Antibiotics for infection 36. Polydipsia and polyuria related to diabetes mellitus are mainly due to: A. The release of ketones from cells during fat metabolism. B. Fluid shifts resulting from the osmotic effect of hyperglycemia C. Damage to the kidneys from exposure to high levels of glucose. D. Changes in RBC s resulting from the attachment of excessive glucose to hemoglobin 37. A 26-old female patient with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. The nurse discusses the result with the patient, what nurse would be most accurate in stating: A. The test needs to be repeated following a 12-hour fast. B. It looks like you aren't following the prescribed diabetic diet. C. Your insulin regimen needs to be altered significantly D. It tells us about your sugar control for the last 3 months 38. A patient has been admitted in surgical ward after diagnosis the present of gastric outlet obstruction (GOO) . What is the nursing priority intervention? A. Administer of antiemetic B. Insert an NG tube for decompression C. Infusion of hypotonic IV solution D. Administration of omeprazole

45. A patient has developed hepatic encephalopathy secondary to cirrhosis and he is receiving care at the medical ward.The patient is currently taking lactulose four times daily . What is the mechanism of action of this drug? A. Prevents the complication of varices bleeding B. Prevent of potassium loss through urine C. Reduce ascites by excreting a fluid D. Reduce serum ammonia levels 46. A nurse is caring for a patient with hepatic encephalopathy .During the assessment , the nurse notes that the patient has a flapping tremor of the hands.The nurse should document the presence of what signs of liver disease. A. Asterixis C. Fetor hepaticus B. Spider angioma D. Palmar erythema 9 47. A patient with CKD has a low erythropoietir (EPO) level.The patient is at risk for? A . Hypercalcemia C. Blood clots B. Anemia D . Hyperkalemia 48. A patient with Stage 5 CKD is experiencing extreme pruritus and has several areas of crystallized white deposits on the skin. As the nurse, you know this is due to excessive amounts of what substance found in the blood? A. Calcium B. Urea C. Phosphate D Erythropoietin 49. A patient with stage 4 chronic kidney disease asks what type of diet they should I follow.Which one is an appropriate response? A. Low protein low sodium.low potassium , low phosphate diet B. High protein low sodium low potassium,high phosphate diet C. Low protein,high sodium , high potassium , high phosphate diet D. Low protein.low sodium low potassium , high phosphate diet 50. A 60-year -old male patient is admitted with a massive GI bleed.The patient is at risk for what type of acute kidney injury? A. Post-renal B. Intra-renal C. Pre-renal D. Intrinsic renal 51. A patient with acute kidney injury has 24-hour urinary output of 300 ml Based on this finding,what stage of acute renal failure is this patient in? A. Initiation B. Diuresis C. Oliguric D. Recovery

35. Assume you are assigning in emergency 25 years old male patient has been admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA) The initial blood glucose level is 650mg/dL . You initiated rehydration with IV0.9% normal saline and subcutaneous regular insulin. The serum glucose level is now decreased to 240mg/dL . The nurse would next prepare to administer which medication. A. An ampule of 40% dextrose subcutaneously C. IV fluids containing dextrose D. Antibiotics for infection 36. Polydipsia and polyuria related to diabetes mellitus are mainly due to: - A. The release of ketones from cells during fat metabolism. B. Fluid shifts resulting from the osmotic effect of hyperglycemia C. Damage to the kidneys from exposure to high levels of glucose. D. Changes in RBCs resulting from the attachment of excessive glucose to hemoglobin 37. A 26-old female patient with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. The nurse discusses the result with the patient, what nurse would be most accurate in stating: A. The test needs to be repeated following a 12-hour fast. B. It looks like you aren't following the prescribed diabetic diet. C. Your insulin regimen needs to be altered significantly D. It tells us about your sugar control for the last 3 months 38. A patient has been admitted in surgical ward after diagnosis the present of gastric outlet obstruction (GOO). What is the nursing priority intervention? A. Administer of antiemetic B. Insert an NG tube for decompression C. Infusion of hypotonic IV solution D. Administration of omeprazole

29. The nurse is caring for a male client with a chest tube and chest drainage system and the tube is accidentally disconnected from the patient. What is the most likely intervention should the nurses expected to do A. Place the end of the chest tube in a container of sterile saline B. Apply occlusive dressing and notify the physician C. Clamp the chest tube immediately D. Secure the chest tube with a tape 30. A female client is admitted to the central medical intensive care unit at Hiwot Fana compressive Specialized Hospital for treatment of chronic pulmonary obstructive disease.Which nursing diagnosis is most important for this client? A. Activity intolerance related to fatigue B. Anxiety related to the actual threat to health status C. Risk of infection related retained secretions D. Impaired gas exchange related to airflow obstruction 31. A 43 years old male client with cystic fibrosis is admitted to an acute care facility with an acute respiratory infection . Physician -prescribed respiratory treatment includes chest physiotherapy . When should the nurse perform this procedure? A. Immediately before a meal B. At least two hours after a meal C. When bronchospasms is occur D. When secretions have mobilized 32. A 23 -years-old client has been hit on the head with a baseball bat . The nurse notes clear fluid draining from his ear and nose.. Which of the following nursing interventions should be done first? A. Position the client flat in bed B. Check the fluid for dextrose with a dipstick C. Suction the noise to maintain airway patency D. Insert nasal and ear packing with sterile gauze 33. The nurse is discussing the purpose of electroence phalography (EEG) with the family of a client with massive cerebral hemorrhage and loss of consciousnes 3. It would be most accurate for the nurse to tell family members which of the following conditions? A. Extent of intracranial bleeding B. Sites of brain injury C. Activity of the brain D. Percent of function brain tissue 34. Assume you are on the duty in chronic OPD newly diagnosed with type 1 diabetes patient coming with you. You are teaching basic survival skills to the patient . What topic should be addressed for this patient? A. Signs and symptoms of diabetic nephropathy B . Management of diabetic ketoacidosis C. Effects of surgery and pregnancy on blood sugar levels D. Reco onition of h vpoglvcemia and hyperglvcemia

25. Because of the client's pleural effusion and advanced lung disease, the nurse frequently listens to the client's breath sounds . What would the nurse expect to hear when assessing the breath sounds? A. Wheezing in the upper lobes B. A friction rub posterior to the affected area C. Increased sounds over the involved area D. Decreased sounds over the involved area 26. An adult has a chest drainage system.Several hours after the chest tube was inserted the nurse observes that there is no bubbling in the water seal chamber. What is the most likely reason for the absence of bubbling? A. The client's lungs have expanded B. There is an obstruction in the tubing coming from the client. C. There is a mechanical problem in the suction control chamber D. Air is leaking into the drainage apparatus. 27. A 79-year-old client was admitted to the hospital with a diagnosis of pneumonia .The client has dyspnea. The client's ; temperature was 102^circ F , respiration was 28 breaths per minute, and pulse was 90 beats per minute. Bed rest was ordered for this client primarily to __ A. Promote thoracic expansion. B. Prevent the development of atelectasis. C. Decrease work of breathing. D. Prevent other infections. 28. An adult patient is admitted with chronic obstructive pulmonary disease (COPD). The ward nurse notes that he has neck vein distention and slight peripheral edema The nurse continues frequent assessments because she/he knows that these signs indicate the onset of which of the following? A. Pneumothorax C. Cardiogenic shock B. Cor pulmonale D. Left-sided heart failure