Upgrade to remove ads
Hesi Lewis Questions- Diabetes Mellitus
Get Quizlet's official HESI A2 - 1 term, 1 practice question, 1 full practice test
Terms in this set (43)
The nurse is caring for a patient diagnosed with diabetes mellitus (DM) who has developed insulin resistance. Which class of glucose-lowering agents can reduce insulin resistance?
Thiazolidinediones are often referred to as "insulin sensitizers." These agents improve insulin sensitivity, transport, and utilization at target tissues. Because they do not increase insulin production, thiazolidinediones do not cause hypoglycemia when used alone. Examples of thiazolidinediones include rosiglitazone and pioglitazone. DPP-IV inhibitors inactivate the hormone incretin. Dopamine agonists activate dopamine receptors and α-glucosidase inhibitors delay carbohydrate absorption in the small intestine.
The nurse has taught a patient admitted with diabetes, cellulitis, and osteomyelitis about the principles of foot care. The nurse evaluates that the patient understands the principles of foot care if the patient makes what statement?
I should look at the condition of my feet every day."
Patients with diabetes mellitus need to inspect their feet daily for broken areas that are at risk for infection and delayed wound healing. The patient should not walk barefoot. Properly fitted (not tight) shoes should be worn at all times. Water temperature should be tested with the hands first.
A patient with type 2 diabetes wants to stop taking metformin (Glucophage) and manage the diabetes with diet and exercise. The patient states that cutting out carbohydrates was featured on television recently as a treatment for diabetes and is considering the paleo diet. Which responses by the nurse are most appropriate?
"Weight loss for overweight patients is recommended as a management strategy for type 2 diabetes."
You should maintain a healthy balance of nutrients to maintain blood glucose and overall health."
There is no ideal number of carbohydrates to consume, so you should individualize your meal plan."
Weight loss is recommended for overweight patients with type 2 diabetes. Dietary goals for patients with type 2 diabetes include maintaining a healthy balance of nutrients to maintain blood glucose levels without spikes. The American Diabetes Association recognizes that there is no ideal number of carbohydrates for every patient and recommends that patients customize their diets with their health care providers to maintain dietary control of diabetes. Patients with diabetes need to be concerned with blood sugars, lipid levels, weight, and maintaining blood pressure goals to lower cardiovascular risks. Carbohydrates are found in grains, fruits, vegetables, and low-fat dairy products.
A nurse teaches a student nurse about pancreas transplantation. While caring for a patient whose pancreas has been transplanted, which instruction given by the student nurse strongly suggests ineffective learning?
Regular monitoring of glucose level is required
After pancreatic transplantation, homeostasis of glucose level is achieved. There is no need for regular monitoring of the glucose level. Pancreatic transplantation helps in maintaining a normal glucose level, so exogenous insulin is not required. Many dietary restrictions can be lifted. Lifetime immunosuppression is very important to avoid organ rejection, which may happen after pancreatic transplantation.
Which condition may be observed due to incorrect fluid replacement with hypotonic fluids in patients with diabetic ketoacidosis?
Incorrect fluid replacement especially with hypotonic fluids may cause a sudden drop in serum sodium resulting in cerebral edema. Polyuria is a manifestation of diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome. Hypokalemia may be seen with severe dehydration. Metabolic acidosis is observed with diabetic ketoacidosis due to fluid losses.
The patient has a prescription for repaglinide. The nurse instructs the patient to take the medication at which time?
Immediately before meals
Repaglinide is an oral antidiabetic agent that should be given any time from 30 minutes to just before meals. It is given on a fixed schedule rather than only when blood sugars are elevated. The medication will not be effective if administered after meals or at bedtime
The nurse is educating a diabetic patient about the use of premixed insulin neutral protamine hagedorn /regular 70/30. What should the nurse inform the patient about using this insulin?
Rotate the injection within one anatomic site for a week.
The nurse should teach the patient to rotate the injection within one anatomic site, such as the abdomen, for at least one week before using a different site to allow for better absorption of insulin. It is important to gently roll the insulin bottle between the palms 10 to 20 times to warm the insulin and resuspend the particles. Injections must be administered at a 45- to 90-degree angle, depending on the thickness of the patient's fat pad. The fastest subcutaneous absorption is from the abdomen, followed by the arm, thigh, and buttock.
The newly diagnosed patient with type 2 diabetes has been prescribed metformin. What should the nurse tell the patient to best explain how this medication works?
Decreases rate of hepatic glucose production; augments glucose uptake by tissues, especially muscles
Metformin is a biguanide that decreases the rate of hepatic glucose production and augments glucose uptake by tissues, especially muscles. Sulfonylureas and meglitinides increase insulin production from the pancreas. α-glucosidase inhibitors slow the absorption of carbohydrate in the intestine. Glucagon-like peptide receptor agonists increase insulin synthesis and release from the pancreas, inhibit glucagon secretion, and decrease gastric emptying.
Which statements best describe glargine? .
There is no pronounced peak action time.
It should be administered subcutaneously
If it does not achieve glycemic goals, the administration of a mealtime insulin may be required.
Glargine is a long-acting (background) insulin that lacks a peak action time. Glargine is often administered once a day via subcutaneous injection. Mealtime insulin may also be added if glargine is not adequate to achieve glycemic goals. The medication is not administered orally with food and water. Glargine must not be diluted or mixed with other insulin or solution in the same syringe.
The nurse provides education to a patient with type 1 diabetes. Which statement made by the patient indicates a need for further instruction?
"I'll check my blood sugar level after every meal."
Fingerstick blood glucose testing should be performed before meals. Checking the blood glucose after meals will yield inaccurate results. This is of essential concern if the patient is basing insulin dosage on fingerstick blood glucose results. Having a snack nearby during exercise, eating meals and snacks at regular times, and eating high-fiber, low-fat foods are all correct in regard to diabetes management.
The nurse is discussing a healthy eating plan for a patient with diabetes. What should the nurse include in the teaching about diabetes and diet?
Consume carbohydrates with alcohol.
The nurse should inform the patient to eat carbohydrates when drinking alcohol to reduce the risk for alcohol-induced hypoglycemia. Nutritive and nonnutritive sweeteners may be included in a healthy meal plan in moderation. The amount of daily protein in the diet for people with diabetes should be 15% to 20% of the total calories consumed. High-protein diets are not recommended as a weight loss method for people with diabetes. There is no evidence that a person with diabetes should consume more fiber than an individual who does not have diabetes. The current recommendation for the general population is 25 to 30 g/day.
Which class of drugs used to treat diabetes mellitus (DM) may be referred to as "insulin sensitizers"?
Thiazolidinediones are a class of drugs used to treat diabetes mellitus (DM). They are often referred to as an "insulin sensitizers." This class of drugs improves insulin sensitivity, transport, and utilization at target tissues. Sulfonylureas increase insulin production by the pancreas. α-glucosidase inhibitors slow down absorption of carbohydrate in the small intestine. DPP-4 inhibitors enhance the activity of incretins, which stimulate release of insulin from pancreatic β-cells. This class of drug also decreases hepatic glucose production.
The patient with diabetes should consume fiber as part of a healthy diet. The current recommendation for persons with diabetes is
25 to 30 g/day
The American Diabetes Association (ADA) recommends that diabetics consume 25 to 30 grams of fiber daily. This is the same level recommended for the nondiabetics, because there is no evidence that a higher intake of fiber is essential. Forty to 45 grams is too much fiber for the patient to consume, and 10 to 25 grams is not enough fiber.
After a teaching session with the registered nurse, the newly diagnosed patient with type 1 diabetes mellitus is correct when he or she makes which statement?
"I will need to be medicated with insulin for the rest of my life."
Type 1 diabetes is caused by destruction of pancreatic β-cells, which causes permanent insulin insufficiency and eventual absence. Weight loss and recovery will not affect insulin production. Exogenous insulin is not absorbed in the GI system and therefore must be given parenterally.
A patient with diabetes who takes long-acting and mealtime insulin calls the ambulatory center with complaints of an upper respiratory infection. The patient has a decreased appetite, fever, and cough. Which instructions should the nurse give the patient?
Any illness can cause a hormone response that can result in hyperglycemia."
"If you are sick, you should check your blood sugar every four hours, even if you are not eating regularly."
Any illness or surgery can cause a regulatory hormonal response that may lead to hyperglycemia. Patients with diabetes and concurrent illnesses should check their blood sugar at least every four hours, despite current eating patterns, to monitor for hyperglycemia. Many clinics will ask a patient to report to his or her health care provider for two blood glucose readings over 300 mg/dL in a row, not just one. Common illnesses such as an upper respiratory illness or the flu can cause changes in glucose requirements. Patients should be encouraged to continue their insulin injectables as prescribed and monitor for hyperglycemia or hypoglycemia. These patients should supplement with carbohydrate-containing foods or beverages as necessary.
The patient received regular insulin eight units subcutaneously (SQ) at 0900. The nurse plans to monitor this patient for signs of hypoglycemia during which time?
1100 and 1400
Regular insulin exerts peak action in two to five hours, placing the patient at greatest risk for hypoglycemia between 1100 and 1400. At this time, the nurse should offer the patient a snack. 1000 and 1100, 1200 and 1300, and 1300 and 1500 are not consistent with peak action of insulin administered at 0900.
A patient calls the health care provider's office at 8:00 AM and states, "I just experienced an episode of low blood sugar, which responded to oral glucose tablets." To help identify the cause of the low blood sugar, an appropriate question the nurse should ask is:
"Were you more active than usual yesterday?"
The glucose-lowering effects of exercise can last up to 48 hours, so it is possible for hypoglycemia to occur after activity, particularly if exercise is at a greater intensity or time than normal. Asking the patient about activity level would be the most appropriate question for the nurse to ask. Ketones can be found in the urine with elevated blood glucose levels and may indicate the presence of diabetic ketoacidosis. Ketones would not be of concern with hypoglycemia. Taking a lower dose of insulin would result in higher blood glucose. Fever and illness can lead to hyperglycemia as well.
A patient with type 1 diabetes mellitus reports feeling shaky and lightheaded. The patient's skin is pale and sweaty. The nurse should take what immediate action?
Providing the patient with a glucose tablet
The described symptoms represent mild-to-moderate hypoglycemia. Rapid treatment involves providing the alert and awake patient with a rapid-dissolving buccal glucose tablet or, if unavailable, a glass of glucose-containing liquid such as orange juice. The patient is experiencing hypoglycemia when the blood sugar is already low. Therefore, insulin should not be given. Administering glucagon is not necessary; the patient is awake and able to take food and fluids orally. After consuming a simple sugar, the patient requires a complex carbohydrate snack and protein to sustain the blood glucose and prevent rebound hypoglycemia.
A patient hospitalized with diabetes mellitus has become shaky, anxious, and diaphoretic. Which action should the nurse implement first?
Check the blood glucose level.
The blood glucose level should be checked with the first signs of hypoglycemia because it can be reversed easily, but can be life threatening if not treated. In the hospital setting, it is convenient to check the blood glucose. A 15 g snack should be provided after the blood glucose has been determined to be low. The health care provider should be notified after the blood glucose level is known. The patient is exhibiting signs of decreased blood glucose. Administration of insulin will lower further the blood glucose.
To demonstrate an understanding of Somogyi effect, the nurse correctly identifies which defining characteristics?
Hyperglycemia in the morning can be caused by the Somogyi effect, which can be stimulated by too much insulin in the evening. During the night, typically between 2:00 AM and 4:00 AM, hypoglycemia occurs, which stimulates a release in counterregulatory hormones in an attempt to raise the blood sugar. What results is rebound hyperglycemia resulting in higher blood sugar readings upon awakening. The Somogyi effect must be differentiated from dawn phenomenon, which also results in higher morning blood sugar readings. The treatment for Somogyi effect includes consuming a bedtime snack or reducing the evening insulin dose, whereas the treatment for dawn phenomenon is an increase in the evening insulin dose or an adjustment in the timing of the evening insulin dose. Not rotating insulin injection sites does not result in either the Somogyi effect or dawn phenomenon. In fact, current recommendations are to use the same anatomical injection site (e.g., the abdomen) for one week before moving to another anatomical injection site.
An unlicensed assistive personnel (UAP) reports to the nurse that a patient's blood glucose level at 0800 before breakfast was 324 mg/dL. The nurse is reviewing the electronic medical record and notices that the patient received a high dose of insulin the previous night before bedtime. The nurse recognizes that the patient's hyperglycemia is most likely due to which problem with insulin therapy?
The Somogyi effect occurs when a patient receives a high dose of insulin that produces a decline in blood glucose levels during the night. As a result, counterregulatory hormones are released, stimulating lipolysis, gluconeogenesis, and glycogenolysis, which in turn produce rebound hyperglycemia. Lipodystrophy is atrophy or hypertrophy of the subcutaneous tissue. Allergic reactions related to insulin occur as local inflammatory reactions and do not produce hyperglycemia. The dawn phenomenon is characterized by hyperglycemia that is present on awakening; however, it is caused by growth hormone and cortisol excretion during the early morning hours, regardless of the amount of insulin given at nighttime
A patient with type 2 diabetes mellitus (DM) is prescribed an oral hyperglycemic agent. The nurse provides the patient with a list of food items with a high glycemic index (GI). What should the nurse include on the list?
Cornflake cereal with regular milk and white bread sandwich with potato stuffing
Glycemic index (GI) is the term used to describe the rise in blood glucose levels after a person consumes a food containing carbohydrates. Foods with high GI raise glucose levels higher and more quickly than foods with a low GI. Cornflake cereal, white bread, and potatoes have a GI above 70. Baked beans, parboiled rice, oatmeal, sweet corn, and green pea soup have a medium GI ranging from 56 to 69. Apples, oat bran cereal, regular milk, and raw sweet potatoes have a low GI of about 55 or less.
A patient with type 2 diabetes who takes metformin daily to manage blood sugar is scheduled for an intravenous pyelogram (IVP). Which question by the nurse is most important to ask the patient when preparing for the procedure?
When was the last time you took your metformin?"
During an IVP, contrast dye is injected so that the urinary system can be visualized. To reduce risk of kidney injury, metformin should be discontinued a day or two before the procedure and for 48 hours following the procedure. Medication administration adherence, dosage, and history are important to assess, but will not affect the interaction.
The nurse provides dietary instructions to a patient with type 1 diabetes mellitus. Which statement made by the patient indicates a need for further teaching?
If I go over my calories, I can just increase my insulin."
The goal of dietary therapy for the patient with diabetes mellitus is to attain and maintain an ideal body weight and a stable blood glucose level. Each patient should be prescribed a specific caloric intake and insulin regimen to help him or her achieve this goal. Insulin dosage should not be increased to account for an increased caloric intake. A bedtime snack for people taking evening NPH insulin, planning for an occasional low-calorie dessert, and eating at scheduled times are all part of correct diabetes management.
The nurse has taught a patient who was admitted with diabetes, cellulitis, and osteomyelitis about the principles of foot care. The nurse determines that additional teaching is necessary when the patient makes which statement
Taking a hot bath every day will help with my circulation."
Hot water may injure tissue related to decreased sensation and should be avoided. Patients with diabetes mellitus should inspect the feet daily for broken areas that are at risk for delayed wound healing, avoid walking barefoot, and have a podiatrist for foot care.
A patient with type 2 diabetes has a urinary tract infection (UTI). The unlicensed assistive personnel (UAP) reported to the nurse that the patient's blood glucose is 642 mg/dL and the patient is hard to arouse. When the nurse assesses the urine, there are no ketones present. What collaborative care should the nurse expect for this patient?
Cardiac monitoring to detect potassium changes
This patient has manifestations of hyperosmolar hyperglycemic syndrome (HHS). Cardiac monitoring will be needed because of the changes in the potassium level related to fluid and insulin therapy and the osmotic diuresis from the elevated serum glucose level. Routine insulin would not be enough and exercise could be dangerous for this patient. Extra insulin will be needed. The type of antibiotic will not affect HHS. There will be a large amount of IV fluid administered, but it will be given slowly because this patient is older and may have cardiac or renal compromise, requiring hemodynamic monitoring to avoid fluid overload during fluid replacement.
A nurse is providing discharge teaching to a patient with a new diagnosis of type I diabetes mellitus who will need to give self-injections of insulin at home. What statement by the patient indicates to the nurse that the discharge teaching was effective?
I need to rotate sites of injection to allow for better absorption of the insulin."
Teaching the patient to rotate the injection within and between sites is important to allow for better insulin absorption. The lower forearm is not an injection site for subcutaneous insulin administration. The abdomen, arm, thigh, and buttock are the preferred sites. Intermediate-acting insulin is normally cloudy, and the patient should gently roll the bottle between the palms of hands to mix the insulin. The patient should push the plunger all the way down and leave the needle in place for 5 seconds to ensure that all of the insulin has been injected before removing the needle.
A nurse is providing education for a patient with a new diagnosis of type I diabetes mellitus. Therapy for the patient will require subcutaneous insulin injections several times per day. When teaching the patient how to administer subcutaneous insulin, what education is the most accurate?
Avoid injecting insulin intramuscularly, because rapid and unpredictable absorption could result in hypoglycemia."
Patient education for administration of insulin for diabetes should include teaching the patient to avoid intramuscular injections because of the rapid and unpredictable absorption that could result in hypoglycemia. The use of an alcohol swab on the site before self-injection is no longer recommended. Routine hygiene such as washing with soap and water is adequate. Patients should be taught to avoid injection sites that will be exercised, because doing so could increase body heat and circulation, increase the rate of insulin absorption, and speeding up the onset of action, resulting in hypoglycemia. Patients should be taught to rotate the injection within and between sites, not to use one site, to allow for better insulin absorption.
A patient with type 2 diabetes mellitus (DM) receives a prescription for metformin. The nurse identifies that which statement is characteristic of this medication?
It decreases hepatic glucose production.
The primary action of metformin is to reduce glucose production by the liver. Metformin often causes weight loss instead of weight gain. Metformin can be administered in conjunction with sulfonylureas. Metformin is preferred for the initial management of type 2 diabetes.
The nurse is monitoring a family caregiver who is learning to inject pramlintide prescribed for glucose control. The nurse should intervene when noting which caregiver action?
Preparing the injection site on the back of the arm with an alcohol wipe
Pramlinitide is administered subcutaneously before major meals. Because of the variation of absorption from injection sites in the arm, only the thigh or abdomen are appropriate sites for this medication. Gently rolling an insulin vial before drawing up a dose aids in mixing insulin solution. To ease in withdrawal of the dose, adding equal amounts of air into the vial before removing the dose will equalize pressure within the vial. Pramlintide should not be mixed in the same syringe with any other insulin.
The nurse has been teaching a patient newly diagnosed with diabetes mellitus to test his or her own blood glucose level. During evaluation of his or her technique, the nurse determines that the teaching has been adequate when the patient performs which task?
Hangs the arm in the dependent position for one minute before puncturing
Hanging the hand down will promote blood flow to the finger and allow for an adequate blood sample. A blood sugar of 65 mg/dL is considered low and does not necessarily mean the diabetes is well controlled. The patient should select a site on the side of a fingertip, not on the center of a finger pad, and the site should be washed with soap and warm water.
A patient prescribed metformin complains of an "upset stomach" after ingestion of the medication. The nurse asks a student nurse what suggestion he or she would make. What is the most appropriate suggestion by the student?
Take metformin with food to decrease gastrointestinal (GI) side effects."
The student nurse should suggest that the patient take metformin with food to decrease GI side effects. It is not within the nurse's scope of practice to prescribe medications such as diphenhydramine for nausea. Advising the patient to stop the medication immediately may result in a hyperglycemic response and should not be done without medication prescriber guidance. Getting the patient's blood glucose checked will not address the complaints of GI distress.
The nurse is caring for a patient in an outpatient diabetes clinic. Which statement by the patient indicates an understanding of the teaching?
"I will be sure to measure my finger stick blood glucose level four times a day, and more frequently when I am ill."
When a patient with diabetes is ill, it is recommended he or she continues checking blood sugar every four hours and more frequently to prevent hyperglycemia and hypoglycemia during illness. The diabetic patient should adhere to the sick day rules, which indicate to continue with your basal dosing of insulin and continue to correct a finger stick blood sugar greater than 200. The patient also should be checking urine ketones for two blood sugars over 250 in a row.
After discussing prevention of type 1 diabetes complications with the nurse, the patient is correct when making which statement?
It is important that I take my blood pressure medication to help prevent kidney damage."
Patients with diabetes who have albumin in their urine should receive angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor antagonists to treat hypertension, which would also delay the progression of nephropathy. Dietary fat intake will not affect kidney function. Hot water bottle use increases the risk of tissue damage because of the diabetic's neuropathy and delayed healing. Diabetics should have an eye examination once a year to screen for retinopathy.
A patient with diabetes mellitus is scheduled for a fasting blood glucose level at 8:00 AM. The nurse instructs the patient to only drink water after what time?
Midnight before the test
The nurse is teaching a patient with diabetes about proper dietary recommendations. The nurse determines that the patient understands the teaching when he or she makes which statement?
I should have no more than 60 grams of carbohydrates in each meal."
The percent of dietary calories that should be eaten as carbohydrates is 55% to 60%. Protein calories make up 12% to 20% of calories; less than 30% of calories should derive from fat. Each meal should contain 45 to 60 grams of carbohydrates; protein intake is unchanged, and saturated fat should be minimized. Alcohol intake should also be limited to one drink per day for women and two per day for men.
A nurse is caring for a patient with diabetes mellitus who is in an inpatient unit. The primary health care provider has ordered regular insulin. The nurse is preparing the medication for subcutaneous injection. What is the most effective site for subcutaneous injection of insulin?
The abdomen is the preferred injection site; it provides the fastest subcutaneous absorption. The thigh, upper arm, and buttock are other sites that may be used for subcutaneous injection, but the abdomen is the best site.
The nurse is assigned to care for a patient with type 2 diabetes. To encourage the patient to become an active participant in his or her care, what action should the nurse take?
Assess the patient's understanding of the disease
For teaching to be effective, the first step is assessing the patient. Teaching can be individualized once the nurse is aware of what a diagnosis of diabetes means to the patient. Food restrictions, nutritionist referral, and setting long-term goals can occur once the nurse is confident the patient understands what it means to have diabetes.
The nurse has been teaching a patient with diabetes mellitus how to perform self-monitoring of blood glucose (SMBG). During evaluation of the patient's technique, the nurse identifies a need for additional teaching when the patient does what?
Chooses a puncture site in the center of the finger pad
The patient should select a site on the sides of the fingertips, not on the center of the finger pad, because this area contains many nerve endings and would be unnecessarily painful. Washing hands, warming the finger, and knowing the results that indicate good control all show understanding of the teaching.
The nurse is teaching a patient with type 2 diabetes about exercise as a method to control blood glucose levels. The nurse knows the patient understands when the patient elicits which exercise plan?
I will take a brisk 30-minute walk five days per week and do resistance training three times a week."
The best exercise plan for the person with type 2 diabetes is for 30 minutes of moderate activity five days per week and resistance training three times a week. Brisk walking is moderate activity. Fishing and teaching are light activity and running is considered vigorous activity.
The nurse is educating the patient regarding administration of meal-time insulin, aspart. Which statement by the patient indicates correct knowledge of the onset of action of this medication?
"I will administer my aspart within 15 minutes of eating my meal."
Aspart is rapid-acting insulin, onsets within five minutes, and peaks within an hour. The patient is instructed to administer it when food is in front of him or her, making the option "I will administer aspart within 15 minutes of eating" correct. If the patient administers the aspart 30 or 60 minutes before the food arriving, the patient may experience hypoglycemia. The patient may have hyperglycemia if he or she waits 30 minutes until after eating to administer the insulin.
The nurse is reviewing diabetic self-care management with a patient newly diagnosed with diabetes. The patient is in need of further education when stating to the nurse:
To toughen my skin so I do not get pressure sores, I should rub my feet down with rubbing alcohol after my bath."
The nurse is preparing the care plan for a patient with diabetes who is on bromocriptine therapy. Which intervention included in the care plan will be beneficial for the patient?
Assisting the patient when changing position
Bromocriptine is a dopamine agonist that may cause orthostatic hypotension, which in turn causes the patient to become dizzy when changing position. Therefore, the nurse should assist the patient when changing position to prevent accidental falls. Bromocriptine does not reduce absorption of vitamin K. Hence, the nurse does not provide vitamin K-rich food to the patient. The nurse does not monitor thyroid hormone levels, because bromocriptine does not impair thyroid functioning. Bromocriptine does not increase the risk of myocardial infarction.
This set is often in folders with...
Diabetes NCLEX questions
Chapter 49: Nursing Management: Diabetes Mellitus…
Potter & Perry Ch. 44 Nutrition
Adaptive Quizzing Week 12 Diabetes Mellitus
Other sets by this creator
CHAPTER 50 Care of Patients with Musculo…
Chapter 63: Care of Patients with Problems of the…
Med Surg Chap 50 Nursing management: Endocrine
HESI OBSTETRICS/MATERNITY PRACTICE EXAM