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NUR 1211 EXAM 1 /204 QUESTIONS AND
ANSWERS/2025-2026/ GRADED A+
Acute Pancreatitis Severe, boring pain radiating to the back, left flank, or shoulder; worse when lying down, improved in fetal or upright positions. Chronic Pancreatitis Progressive inflammation, fibrosis, and ductal obstruction. Other signs of Pancreatitis Nausea, vomiting, weight loss, jaundice, ascites. Ecchymoses Bluish-gray periumbilical discoloration. Tetany Hand spasm when blood pressure cuff is inflated (Trousseau's sign). Chvostek's sign Facial twitching when facial nerve is tapped.
Biliary Tract Disease Gallstones obstructing ducts. Alcohol Use Primary cause of chronic pancreatitis cases. Acute Phase Nutrition Education Rest the pancreas with NPO status; no food until pain-free. Post-Acute Phase Nutrition Education Resume a bland, high-protein, low-fat diet with no caffeine or stimulants; encourage small, frequent meals. Chronic Phase Nutrition Education Avoid alcohol and smoking entirely. Nursing Management Rest the pancreas: NPO until pain-free, use enteral or parenteral nutrition if severe. Gastric Decompression Use NG tube for severe vomiting or paralytic ileus.
Pancreatic Enzymes Amylase and lipase levels may increase with pancreatic involvement. Liver Function Tests Elevated aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) suggest common bile duct obstruction or liver dysfunction. Diet after Gallbladder Issues Begin with clear liquids and advance to solid foods as peristalsis returns; a low- fat diet is recommended Fat-soluble vitamins Take as prescribed to enhance absorption and aid with digestion. Type 1 Diabetes Autoimmune destruction of beta cells, leading to no insulin production. Insulin resistance Cells don't respond to insulin properly. Age of Onset (Type 1 Diabetes) Before age 30, often in childhood or adolescence.
Age of Onset (Type 2 Diabetes) Usually after age 30 but can occur in younger people due to obesity. Insulin (Type 1 Diabetes) Insulin-dependent (requires lifelong insulin therapy). Insulin (Type 2 Diabetes) Insulin resistance at first; may need insulin later. Risk Factors Obesity, lack of exercise, family history, age. Genetic predisposition Risk factor for diabetes. Autoimmune factors Risk factor for diabetes. Viral infections Risk factor for diabetes.
Fasting Blood Glucose Test Greater than 126 mg/dL (requires no caloric intake for at least 8 hours before testing). Oral Glucose Tolerance Test (OGTT) 2 - hour glucose level greater than 200 mg/dL after consuming a glucose drink. Glycosylated Hemoglobin (A1C) Greater than 6.5% (average blood glucose level over the past 2-3 months). Diabetic Screening Includes family history, lifestyle factors, history of vascular disease, PCOS, gestational diabetes, ethnicity, HbA1C, HDL cholesterol, triglyceride level, and blood pressure. Polyuria Frequent urination, due to high blood glucose levels causing increased thirst and fluid intake. Polydipsia Excessive thirst, due to dehydration caused by polyuria.
Polyphagia Increased hunger, due to the body's inability to use glucose for energy, leading to the breakdown of fat and muscle for fuel. Insulin Injection Tips Rotate injection sites within the same area to prevent lipohypertrophy and maintain consistent absorption; rotate every 2-3 weeks. Rapid-acting insulin Insulin lispro, aspart, glulisine, inhaled human insulin (Afrezza); onset 10 to 30 minutes; administration before meals. Short-acting insulin Regular insulin; administration 30 to 60 minutes before meals; concentrations U-100 and U-500. Intermediate-acting insulin NPH insulin; administration subcutaneous only; can be mixed with short-acting insulin. Long-acting insulin Insulin glargine, insulin detemir; administration once daily, same time each day; no peaks/troughs.
Biguanides Reduces liver glucose production and increases insulin sensitivity. Monitoring for Biguanides Check kidney and liver function, watch for lactic acidosis symptoms (myalgia, sluggishness, somnolence, and hyperventilation). Biguanides precaution Stop 24-48 hours before procedures with iodinated contrast dye, restart 48 hours after. Sulfonylureas Stimulates insulin release from the pancreas. Sulfonylureas precaution Avoid alcohol due to hypoglycemia risk. Meglitinides Stimulates insulin release, mainly for post-meal glucose control. Meglitinides precaution Take 30 minutes before meals and monitor for hypoglycemia.
Thiazolidinediones Increases insulin sensitivity and reduces liver glucose production. Thiazolidinediones precaution Monitor for edema, weight gain, and liver function. Alpha-glucosidase inhibitors Oral medication. Sodium-glucose cotransporter 2 inhibitors Subcutaneous medication. Incretin Mimetic Subcutaneous medication. Amylin mimetic Subcutaneous medication.
Hyperglycemic Hyperosmolar Syndrome (HHS) A serious condition that can happen with Type 2 diabetes, causing extremely high blood sugar without ketosis. HHS risk factors Undiagnosed or poorly managed diabetes, inadequate fluid intake or poor kidney function, older age, infections or stressful medical conditions, certain medications. HHS management Rehydration, insulin therapy, electrolyte monitoring, prevention through diabetes management. Diabetic Ketoacidosis (DKA) A serious complication of diabetes, mainly Type 1, caused by insufficient insulin leading to the body breaking down fat for fuel instead of glucose. DKA issues Hyperglycemia, dehydration due to fluid loss.
Acidosis High acidity in the blood Assessment of DKA High blood glucose levels (250-800 mg/dL) Ketoacidosis Low serum bicarbonate (HCO₃) Ketoacidosis Low blood pH Ketoacidosis Kussmaul respirations (deep, rapid breathing as the body tries to compensate for acidosis)
Increased hormone production (e.g., cortisol, glucagon, epinephrine) which raises glucose and decreases insulin's effect. Risk Factors for DKA Poor adherence to insulin regimen Management of DKA Rehydration with intravenous (IV) fluids to correct dehydration. Management of DKA IV insulin infusion to lower blood glucose and stop ketone production. Management of DKA Reverse acidosis and restore electrolyte balance (e.g., potassium). Management of DKA
Monitor closely: Blood glucose levels, Renal function and urine output, Electrolyte levels (especially potassium), Vital signs (BP, heart rate, etc.), Signs of fluid overload (monitor lungs and ECG) Hyperglycemia Blood Sugar Level: >180 mg/dL Hypoglycemia Blood Sugar Level: <70 mg/dL Symptoms of Hyperglycemia Thirst, frequent urination, fatigue, blurred vision, hot skin, fruity breath Symptoms of Hypoglycemia Shaking, sweating, fast heart rate, confusion, hunger, lack of concentration, nervousness, confusion, disorientation. Hypoglycemia Management
Eat balanced meals, exercise regularly, no alcohol or smoking monitor blood sugar, take medications as prescribed, eat carbs before workout, manage weight and stress, and attend regular checkups. Sick day rules Notify your provider when ill. Blood glucose monitoring Monitor blood glucose every 2-4 hours and test urine for ketones as advised, especially if blood glucose exceeds 240 mg/dL. Medication continuation Continue medications (insulin or oral hypoglycemics). Hydration recommendation Stay hydrated with 8-12 oz of sugar-free, non-caffeinated liquids hourly. If blood glucose is low, consume fluids with sugar.
Carbohydrate needs Meet carb needs with soft foods or liquids matching usual carb intake if solid food isn't possible. Ketones in urine Seek medical help for ketones in urine for over 24 hours. High blood glucose Seek medical help for blood glucose >250 mg/dL unresponsive to treatment. Fever management Seek medical help for fever >38.6°C (101.5°F) lasting over 24 hours or unresponsive to medication. Disorientation symptoms Seek medical help for disorientation, rapid breathing, or inability to keep liquids down.
