Med-surg: neuro, endocrine & renal worksheet with answers

Why should insulin injection sites be rotated?

1. ATo avoid building up an immune response to the insulin
2. BTo prevent fatty lumps that absorb insulin unevenly
3. CTo make the insulin work faster each time
4. DTo stop the insulin from spreading to other organs

Which symptom is the classic warning sign of bladder cancer?

1. ABurning pain on passing urine
2. BPainless visible blood in the urine
3. CLeaking urine when coughing
4. DSevere loin pain that comes in waves

Which blood glucose level is commonly used to define hypoglycaemia in a person with diabetes?

1. ABelow 1.0 mmol/L (about 18 mg/dL)
2. BBelow 7.0 mmol/L (about 126 mg/dL)
3. CBelow 4.0 mmol/L (about 70 mg/dL)
4. DBelow 10 mmol/L (about 180 mg/dL)

A patient with multiple sclerosis says their symptoms get worse after a hot bath. What should the nurse explain?

1. AThis shows that the disease has entered a new progressive stage
2. BHeat can briefly worsen MS symptoms, which settle when they cool down
3. CThey should take very cold baths to reverse the damage
4. DHot baths cause new areas of damage in the brain

Why is once-daily prednisolone usually taken in the morning with food?

1. ABecause it causes drowsiness and is safer to take during the day
2. BTo match the natural cortisol rhythm and protect the stomach
3. CBecause it cannot be absorbed at night
4. DBecause food doubles the strength of the dose

A patient taking dapagliflozin (an SGLT2 inhibitor) is vomiting, with blood ketones of 4.5 mmol/L but a glucose of only 11 mmol/L. What should be suspected?

1. AEuglycaemic diabetic ketoacidosis
2. BHypoglycaemia caused by the vomiting
3. CA normal side effect needing no action
4. DHyperosmolar hyperglycaemic state

A patient with acute glomerulonephritis has a BP of 190/115 mmHg, a severe headache and blurred vision. Which is the priority?

1. ARecheck the BP at the next routine round
2. BUrgent escalation for BP control and close neuro checks
3. CEncourage a walk to relieve the headache
4. DGive extra oral fluids to correct the low urine output

A patient with a brain tumour on high-dose dexamethasone has a capillary glucose of 16 mmol/L (288 mg/dL). They have no history of diabetes. What is the best explanation?

1. AA lab error, because steroids lower blood glucose
2. BSteroid-induced hyperglycaemia, which needs monitoring and treatment
3. CNormal for this patient, so no action is needed
4. DA sign that the brain tumour has now spread to the pancreas