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5. A nurse at the weight loss clinic assesses a client who has a large
abdomen and a rounded face. Which additional assessment finding would
lead the nurse to suspect that the client has Cushings syndrome rather
than obesity?
a. The liver cannot rid the body of ammonia that is made by the
breakdown of protein in the digestive system.
b. The liver heals better with a high carbohydrates diet rather than
protein.
c. Most people have too much protein in their diets. The amount of this
diet is better for liver healing.
d. Because of portal hyperemesis, the blood flows around the liver and
ammonia made from protein collects in the brain causing hallucinations.
8. Which of the drug of choice for pain controls the patient with acute
pancreatitis?
A. Morphine
B. NSAIDS
C. Meperidine
D. Codeine
9. During the first 24 hours after thyroid surgery, the nurse should
include in her care:
10. An adult, who is newly diagnosed with Graves disease, asks the nurse,
Why do I need to take Propanolol (Inderal)? Based on the nurses
understanding of the medication and Graves disease, the best response
would be:
11. What is the best reason for the nurse in instructing the client to
rotate injection sites for insulin?
12. On discharge, the nurse teaches the patient to observe for signs of
surgically induced hypothyroidism. The nurse would know that the patient
understands the teaching when she states she should notify the MD if she
develops:
a. Intolerance to heat
b. Dry skin and fatigue
c. Progressive weight gain
d. Insomnia and excitability
a. Regular insulin
b. Potassium
c. Sodium bicarbonate
d. Calcium gluconate
16. Nurse Jocelyn is caring for a client with nasogastric tube that is
attached to low suction. Nurse Jocelyn assesses the client for symptoms
of which acid-base disorder?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic acidosis
d. Metabolic alkalosis
a. nodular consistency
b. asymmetry
c. tenderness
d. palpable upon swallowing
a. dry skin
b. lethargy
c. insomnia
d. sensitivity to cold
a. extreme thirst
b. nightmares
c. weakness
d. diaphoresis
22. Before a post- thyroidectomy client returns to her room from the OR,
the nurse plans to set up emergency equipment, which should include:
23. The day after her surgery Joy asks the nurse how she might lose
weight. Before answering her question, the nurse should bear in mind that
long-term weight loss best occurs when:
24. The nurse teaches Joy, an obese client, the value of aerobic exercises
in her weight reduction program. The nurse would know that this teaching
was effective when Joy says that exercise will:
25. A home health nurse is at the home of a client with diabetes and
arthritis. The client has difficulty drawing up insulin. It would be most
appropriate for the nurse to refer the client to
a. Intolerance to heat
b. Dry skin and fatigue
c. Progressive weight loss
d. Insomnia and excitability
31. A nurse at the weight loss clinic assesses a client who has a large
abdomen and a rounded face. Which additional assessment finding would
lead the nurse to suspect that the client has Cushings syndrome rather
than obesity?
32. The nurse is attending a bridal shower for a friend when another
guest, who happens to be a diabetic, starts to tremble and complains of
dizziness. The next best action for the nurse to take is to:
33. What is the best reason for the nurse in instructing the client to
rotate injection sites for insulin?
34. During the first 24 hours after thyroid surgery, the nurse should
include in her care:
36. The client with Type 2 diabetes controlled with biguanide oral
diabetic medication is scheduled for a computed tomography (CT) with
contrast of the abdomen to evaluate pancreatic function. Which
intervention should the nurse implement?
37. The nurse is developing a care plan for the client diagnosed with
Type 1 diabetes. The nurse identifies the problem high risk for
a. The client will have a blood glucose level between 90 and 140 mg/dL.
b. The client will demonstrate appropriate insulin injection technique.
c. The nurse will monitor the clients blood glucose levels four times a
day.
d. The client will maintain normal kidney function with 30 mL/hr urine
output.
38. Which assessment data indicate that the client diagnosed with
diabetic ketoacidosis is responding to the medical treatment?
a. The client has tented skin turgor and dry mucous membranes.
b. The client is alert and oriented to date, time, and place.
c. The clients ABGs results are pH 7.29, PaCO2 44, HCO3 15.
d. The clients serum potassium level is 3.3 mEq/L.
40. The nurse is discussing ways to prevent diabetic ketoacidosis with the
client diagnosed with Type 1 diabetes. Which instruction would be most
important to discuss with the client?
41. The nursing assistant on the medical floor tells the primary nurse
that the client diagnosed with DKA wants something else to eat for
lunch. What action should the nurse implement?
42. The client diagnosed with HHS was admitted yesterday with a blood
glucose level of
780 mg/dL. The clients blood glucose level is now 300 mg/dL. Which
intervention should the nurse implement?
43. The charge nurse is making client assignments in the intensive care
department. Which client should be assigned to the most experienced
nurse?
a. The client with Type 2 diabetes who has a blood glucose level of 348
mg/dL.
b. The client diagnosed with Type 1 diabetes who is experiencing
hypoglycemia.
c. The client with DKA who has multifocal premature ventricular
contractions.
d. The client with HHS who has a plasma osmolarity of 290 mOsm/L.
44. The client diagnosed with Type 2 diabetes is admitted to the intensive
care department with hyperosmolar hyperglycemic nonketonic state coma
(HHS). Which assessment data would the nurse expect the client to
exhibit?
a. Kussmauls respirations.
b. Diarrhea and epigastric pain.
c. Dry mucous membranes.
d. Ketone breath odor.
a. Diabetes insipidus.
b. Crohns disease.
c. Narcotic addiction.
d. Peritonitis.
46. Which client problem has priority for the client diagnosed with acute
pancreatitis?
47. The client diagnosed with Type 1 diabetes is found lying unconscious
on the floor of the bathroom. Which intervention should the nurse
implement first?
49. The nurse is caring for a client with long-term Type 2 diabetes and
is assessing the feet.
Which assessment data would warrant immediate intervention by the
nurse?
51. The client diagnosed with Type 2 diabetes comes to the emergency
department. The clients blood glucose is 680 mg/dL and the client is
diagnosed with HHS. Which question should the nurse ask the client to
determine the cause of this acute complication?
53. The home health nurse is completing the admission assessment for a
76-year-old client diagnosed with Type 2 diabetes that must be controlled
with 70/30-combination insulin.
Which intervention should be included in the plan of care?
55. The male client diagnosed with chronic pancreatitis calls and reports
to the clinic nurse that he has been having a lot of gas, along with
frothy and very foul-smelling stools. Which action should the nurse take?
c. The loop diuretic to the client who has a serum potassium level of 3.9
mEq/L.
d. The beta blocker to the client who has an apical pulse of 68 bpm.
60. The client diagnosed with acute pancreatitis is being discharged home.
Which statement by the client indicates the teaching has been effective?
a. Glucose.
b. Potassium.
c. Calcium.
d. Sodium.
62. Which arterial blood gas would the nurse expect in the client
diagnosed with diabetic ketoacidosis?
63. The client diagnosed with acute pancreatitis is in pain. Which position
should the nurse assist the client to assume to help decrease the pain?
68. The client is diagnosed with diabetes insipidus. Which laboratory value
should be monitored by the nurse?
a. Serum sodium.
b. Serum calcium
c. Urine glucose.
d. Urine white blood cells
69. The nurse is admitting a client diagnosed with primary adrenal cortex
insufficiency (Addisons disease). When assessing the client, which clinical
manifestations would the nurse expect to find?
71. The client is admitted to the medical unit with a diagnosis of rule
out diabetes insipidus
(DI). Which instructions should the nurse teach regarding a fluid
deprivation test?
72. The client diagnosed with Cushings disease has undergone a unilateral
adrenalectomy.
Which discharge instructions should the nurse teach?
73. The nurse writes a problem of altered body image for a 34-year-
old client diagnosed with Cushings disease. Which interventions should be
implemented?
a. Monitor blood glucose levels q.i.d before meals and at bedtime.
b. Perform a head-to-toe assessment every shift.
c. Use therapeutic communication to allow the client to discuss feelings.
d. Assess bowel sounds and temperature every 4 hours.
74. The home health nurse is admitting a client diagnosed with cancer of
the pancreas.
Which information is the most important for the nurse to discuss with the
client?
75. The nurse is planning the care of a client diagnosed with Addisons
disease. Which interventions should be included?
79. The nurse is caring for a client diagnosed with diabetes insipidus
(DI). Which nursing intervention should be implemented?
80. Which statement made by the client would make the nurse suspect
that the client is experiencing hyperthyroidism?
81. The unlicensed nursing assistant complains to the nurse that she has
filled the water pitcher 4 times during the shift for a client diagnosed
with a closed head injury and the client has asked for the pitcher to be
filled again. Which intervention should the nurse do first?
83. The nurse is caring for clients on a medical floor. Which client
should be assessed first?
85. The client diagnosed with a pituitary tumor has developed syndrome
of inappropriate
antidiuretic hormone (SIADH). Which interventions would the nurse
implement?
86. Which medication order would the nurse question in the client
diagnosed with untreated hypothyroidism?
a. Thyroid hormones.
b. Oxygen.
c. Sedatives.
d. Laxatives.
a. Discuss the information the client told the nurse with the health-care
provider and significant other.
b. Explain that it is possible that the client would seize if he drank fluid
beyond the restrictions.
c. Notify the health-care provider of the clients wishes and give the
client fluids as desired.
d. Allow the client an extra drink of water and explain that the nurse
could get into trouble if the client tells the health-care provider.
88. The nurse is admitting a client to the neurological intensive care unit
who is postoperative transsphenoidal hypophysectomy . Which data would
warrant immediate intervention?
a. The client is alert to name but is unable to tell the nurse the
location.
b. The client has an output of 2500 mL since surgery and an intake of
1000 mL.
c. The clients vital signs are T 97.6, P 88, R 20, and BP 130/80.
d. The client has a 3-cm amount of dark-red drainage on the turban
dressing.
a. Call a meeting and educate the staff on the new delivery system that
will be used.
b. Organize a committee of nurses to investigate the various types of
delivery systems.
c. Wait until another unit has implemented the new system and see if it
works out.
d. Discuss with the nursing staff if a new delivery system should be
adopted.
90. The charge nurse of an intensive care unit is making assignments for
the night shift.
Which client should be assigned to the most experienced intensive care
nurse?
92. The nurse is developing a plan of care for the client diagnosed with
acquired immunodeficiency syndrome (AIDS) who has developed an infection
in the adrenal gland. Which problem would have the highest priority?
93. The nurse identifies the client problem risk for imbalanced body
temperature for the client diagnosed with hypothyroidism. Which
intervention would be included in the client problem?
97. The client, an 18-year-old female, 54 tall, weighing 113 kg, comes
to the clinic for a wound on her lower leg that has not healed for the
last two weeks. Which disease process would the nurse suspect that the
client has developed?
a. Type 1 diabetes.
b. Type 2 diabetes.
c. Gestational diabetes.
d. Acanthosis nigricans.
a. The thyroid hormone to the client that does not have a T3, T4 level.
b. The regular insulin to the client with a blood glucose level of 210
mg/dL.
c. The loop diuretic to the client with a potassium level of 3.3 mEq/L.
d. The cardiac glycoside to the client who has a digoxin level of 1.4
mg/dL.
100. Which signs/symptoms would make the nurse suspect that the client
is experiencing a thyroid storm?