CBQ

1. What should the nurse advice a DM patient regarding insulin use?

A. Small meal – exercise- insulin
B. Insulin – sleep- exercise
C. Sleep- exercise – insulin
D. Insulin- exercise – sleep

Answer: A
Along with medical nutrition therapy and insulin, exercise is the third component
used to treat diabetes
-Exercise, like insulin, lowers blood glucose levels, assists in maintaining normal
lipid levels, and increases circulation
-Patients with T1DM should be instructed not to perform exercise at the time
insulin is at its peak; they should exercise when blood glucose levels are between
100 and 200 mg/dL or about 30-60 minutes after meals
-They should avoid exercising when blood glucose is greater than 250 mg/dL and
ketones are present in urine
-In T1DM, glucose control can be compromised if proper adjustments are not
made in food intake or insulin administration
-Patients with T2DM who take oral hypoglycemic agents may be at risk of post
exercise hypoglycemia
Guidelines that may assist in regulating the glycemic response to exercise in
people with T1DM:
-Metabolic control before exercise: avoid exercise if fasting glucose levels are
greater than or equal to 250 mg/dL and ketosis is present or of glucose levels are
greater than 300mg/dL, regardless of whether ketosis is present. ingest added
carbs if glucose levels are less than 100
-Blood glucose monitoring before and after exercise: Identify when changes in
insulin or food intake are necessary; learn the blood glucose response to different
exercise conditions
-Food intake: Consume added carbohydrate as needed to avoid hypoglycemia;
carb-based olds should be readily available before and after exercise

2. Which of the following CAN be palpated?

A. Hypothalamus
B. Adrenal gland
C. Pituitary gland
D. Thyroid gland

Answer: D
The thyroid gland is difficult to palpate; arrange your setting to maximize your
likelihood of success. To palpate, move behind the person Ask the person to sit up
very straight and then to bend the head slightly forward and to the right. This will
relax the neck muscles on the right side. Use the fingers of your left hand to push
the trachea slightly to the right. Then curve your right fingers between the trachea
and the sternomastoid muscle, retracting it slightly, and ask the person to take a
sip of water. The thyroid moves up under your fingers with the trachea and larynx
as the person swallows. Reverse the procedure for the left side.

3. Human calcitonin given ____

a. IM
b. SQ
c. ID
 d. Push

Answer: A
Calcitonin inhibits osteoclastic bone reabsroption. Calcitonin used for pagets
disease, osteoporosis, and hypercalcemia associated with cancer. Most commonly
given by nasal spray, also available IM, SC (rotate site to prevent inflammation)
The side effects specifically occuring with the IM or SQ route of calcitonin are
nausea or facial flushing.

4. During NGT (Nasogastric Tube) insertion, the nurse noticed a resistance, what is
the suitable nursing intervention?
A. Remove the NGT.
B. Apply more power
C. Rotate the tube
D. Tape the tube

Answer: C
If resistance is met apply gentle downward pressure to advance tube but do not
force! if you meet resistance try to rotate tube and see if it advances, if still
resistant withdraw tube allow pt to rest and re lubricate the tube and insert in
other nares. If the patient starts to cough, experiences a drop in oxygen
saturation, or shows other signs of respiratory distress, withdraw the tube into the
posterior nasopharynx until normal breathing resumes. Do not force the tube or
push it against resistance.

5. What would the nurse do to determine the CORRECT distance to insert a

nasogastric tube?
a. measure from center of forehead to top of nose to end of sternum
b. measure from tip of nose to tip of earlobe to the xiphoid
c. measure from lips to tip of ear to just below the umbilicus
d. measure from tip of ear to midway between end of sternum and umbilicus

Answer: B
Take the tip of the tube and place it at the patient's nostril and extend the tube to
the tip of the earlobe and then to the tip of the xiphoid process

6. Which of the following symptoms of Schizophrenia are likely to be RESPONSIVE to

medications?
A. Anhedonia
B. Social withdrawal
C. Hallucination
D. Apathy

Answer: C
Schizophrenia is often described in terms of positive and negative (or deficit)
symptoms.
Positive symptoms are those that most individuals do not normally experience but
are present in people with schizophrenia. They can include delusions, disordered
thoughts and speech, and tactile, auditory, visual, olfactory and gustatory
hallucinations, typically regarded as manifestations of psychosis.Hallucinations are
also typically related to the content of the delusional theme Positive symptoms
generally respond well to medication
Negative symptoms are deficits of normal emotional responses or of other thought
processes, and respond less well to medication. They commonly include flat or
blunted affect and emotion, poverty of speech (alogia), inability to experience
 pleasure (anhedonia), lack of desire to form relationships (asociality), and lack of
motivation (avolition). Research suggests that negative symptoms contribute more
to poor quality of life, functional disability, and the burden on others than do
positive symptoms. People with prominent negative symptoms often have a
history of poor adjustment before the onset of illness, and response to medication
is often limited.

7.