Adults Exam 3

12.The nurse is developing a care plan for the client diagnosed with type 1 diabetes. The nurse identifies the problem "high risk for hyperglycemia related to noncompliance with the medication regimen." Which statement is an appropriate short-term goal for the client? 1.The client will have a blood glucose level between 90 and 140 mg/dL. 2.The client will demonstrate appropriate insulin injection technique. 3.The nurse will monitor the client's blood glucose levels four (4) times a day. 4.The client will maintain normal kidney function with 30-mL/hr urine output.

1

13.The occupational health nurse is teaching a class on the risk factors for developing osteoarthritis (OA). Which is a modifiable risk factor for developing OA? 1.Being overweight. 2.Increasing age. 3.Previous joint damage. 4.Genetic susceptibility.

1

20.The nurse is discussing the importance of an exercise program for pain control to a client diagnosed with OA. Which intervention should the nurse include in the teaching?1.Wear supportive tennis shoes with white socks when walking. 2.Carry a complex carbohydrate while exercising. 3.Alternate walking briskly and jogging when exercising. 4.Walk at least 30 minutes three (3) times a week.

1

24.The nurse is caring for the following clients.After receiving the shift report, which client should the nurse assess first? 1.The client with a total knee replacement who is complaining of a cold foot. 2.The client diagnosed with osteoarthritis who is complaining of stiff joints. 3.The client who needs to receive a scheduled intravenous antibiotic. 4.The client diagnosed with back pain who is scheduled for a lumbar myelogram.

1

27.Which signs/symptoms indicate to the nurse the client has developed osteoporosis? 1.The client has lost one (1) inch in height. 2.The client has lost 12 pounds in the last year. 3.The client's hands are painful to the touch. 4.The client's serum uric acid level is elevated

1

28.The unlicensed assistive personnel (UAP) is caring for a client who is having a seizure. Which action by the UAP would warrant immediate intervention by the nurse? 1.The assistant attempts to insert an oral airway. 2.The assistant turns the client on the right side. 3.The assistant has all the side rails padded and up. 4.The assistant does not leave the client's bedside.

1

29.Which foods should the nurse recommend to a client when discussing sources of dietary calcium? 1.Yogurt and dark-green, leafy vegetables. 2.Oranges and citrus fruits. 3.Bananas and dried apricots. 4.Wheat bread and bran.

1

3.The nurse administered 28 units of Humulin N, an intermediate-acting insulin, to a client diagnosed with type 1 diabetes at 1600. Which intervention should the nurse implement? 1.Ensure the client eats the bedtime snack. 2.Determine how much food the client ate at lunch. 3.Perform a glucometer reading at 0700. 4.Offer the client protein after administering insulin.

1

3.Which client would the nurse identify as being most at risk for experiencing a cerebrovascular accident (CVA)? 1.A 55-year-old African American male. 2.An 84-year-old Japanese female. 3.A 67-year-old Caucasian male. 4.A 39-year-old pregnant female.

1

30.Which intervention is an example of asecondary nursing intervention when discussing osteoporosis? 1.Obtain a bone density evaluation test. 2.Perform non-weight-bearing exercises regularly. 3.Increase the intake of dietary calcium. 4.Refer clients to a smoking cessation program.

1

33.The nurse is teaching a class to pregnant teenagers. Which information is most important when discussing ways to prevent osteoporosis? 1.Take at least 1,200 mg of calcium supplements a day. 2.Eat foods low in calcium and high in phosphorus. 3.Osteoporosis does not occur until around age 50 years. 4.Remain as active as possible until the baby is born.

1

36.The client diagnosed with Parkinson's disease is prescribed carbidopa/levodopa (Sinemet). Which intervention should the nurse implement prior to administering the medication? 1.Discuss how to prevent orthostatic hypotension. 2.Take the client's apical pulse for one (1) full minute. 3.Inform the client that this medication is for short-term use. 4.Tell the client to take the medication on an empty stomach.

1

38.The occupational health nurse is concerned about preventing occupation-related acquired seizures. Which intervention should the nurse implement? 1.Ensure that helmets are worn in appropriate areas. 2.Implement daily exercise programs for the staff. 3.Provide healthy foods in the cafeteria. 4.Encourage employees to wear safety glasses.

1

40.The nurse enters the room as the client is beginning to have a tonic-clonic seizure. What action should the nurse implement first? 1.Note the first thing the client does in the seizure. 2.Assess the size of the client's pupils. 3.Determine if the client is incontinent of urine or stool. 4.Provide the client with privacy during the seizure.

1

43.The client is prescribed phenytoin (Dilantin), an anticonvulsant, for a seizure disorder. Which statement indicates the client understands the discharge teaching concerning this medication? 1."I will brush my teeth after every meal." 2."I will check my Dilantin level daily." 3."My urine will turn orange while on Dilantin." 4."I won't have any seizures while on this medication."

1

47.The nurse asks the male client with epilepsy if he has auras with his seizures. The client says, "I don't know what you mean. What are auras?" Which statement by the nurse would be the best response? 1."Some people have a warning that the seizure is about to start." 2."Auras occur when you are physically and psychologically exhausted." 3."You're concerned that you do not have auras before your seizures?" 4."Auras usually cause you to be sleepy after you have a seizure."

1

7.The client diagnosed with atrial fibrillation has experienced a transient ischemic attack (TIA).Which medication would the nurse anticipate being ordered for the client on discharge? 1.An oral anticoagulant medication. 2.A beta blocker medication. 3.An anti-hyperuricemic medication. 4.A thrombolytic medication.

1

7.The home health nurse is completing the admission assessment for a 76-year-old client diagnosed with type 2 diabetes controlled with 70/30 insulin. Which intervention should be included in the plan of care? 1.Assess the client's ability to read small print. 2.Monitor the client's serum prothrombin time (PT) level. 3.Teach the client how to perform a hemoglobin A1c test daily. 4.Instruct the client to check the feet weekly.

1

70.The nurse is caring for the client who had a right shoulder replacement. Which data warrant immediate intervention? 1.The client's hemoglobin is 8.1 g/dL. 2.The client's white blood cell count is 9,000/mm3. 3.The client's creatinine level is 0.8 mg/dL. 4.The client's potassium level is 4.2 mEq/L.

1

76.The nurse and the unlicensed assistive personnel (UAP) are caring for clients on a medical-surgical unit. Which task should not be assigned to the UAP? 1.Feed the 69-year-old client diagnosed with Parkinson's disease who is having difficulty swallowing. 2.Turn and position the 89-year-old client diagnosed with a pressure ulcer secondary to Parkinson's disease. 3.Assist the 54-year-old client diagnosed with Parkinson's disease with toilet-training activities. 4.Obtain vital signs on a 72-year-old client diagnosed with pneumonia secondary to Parkinson's disease.

1

77.The charge nurse is making assignments. Which client should be assigned to the newgraduate nurse? 1.The client diagnosed with aseptic meningitis who is complaining of a headache and the light bothering his eyes. 2.The client diagnosed with Parkinson's disease who fell during the night and is complaining of difficulty walking. 3.The client diagnosed with a cerebrovascular accident whose vitals signs are P 60, R 14, and BP 198/68. 4.The client diagnosed with a brain tumor who has a new complaint of seeing spots before the eyes.

1

65.Which interventions should be included in the discharge teaching for a client who had a total hip replacement? Select all that apply. 1.Discuss the client's weight-bearing limits. 2.Request the client demonstrate use of assistive devices. 3.Explain the importance of increasing activity gradually. 4.Instruct the client not to take medication prior to ambulating. 5.Tell the client to ambulate with open-toed house shoes.

1, 2, 3

81.The nurse writes a concept of "impaired mobility" for a client diagnosed with a fractured right hip. Which would the nurse include in the plan of care? Select all that apply. 1.Request a physical therapy referral. 2.Administer enoxaparin (Lovenox) subcutaneously. 3.Utilize a gait belt when ambulating the client. 4.Assess the client's pain levels on a 1-to- 10 scale. 5.Provide a high-carbohydrate, high-fat, high-sodium diet.

1, 2, 3, 4

83.The client who has sustained a left-sided cerebrovascular accident (stroke) has residual right-sided paralysis. The nurse identifies a concept of impaired functional ability. Which should be included in the care map? Select all that apply. 1.Refer to the occupational therapist. 2.Assess the client for neglect of the right side. 3.Place the client in a room where the door is on the left side. 4.Teach the client to call for assistance prior to getting out of bed. 5.Encourage the client to participate in physical therapy daily

1, 2, 3, 4

9.The diabetic educator is teaching a class on diabetes type 1 and is discussing sick-day rules. Which interventions should the diabetes educator include in the discussion? Select all that apply. 1.Take diabetic medication even if unable to eat the client's normal diabetic diet. 2.If unable to eat, drink liquids equal to the client's normal caloric intake. 3.It is not necessary to notify the health-care provider (HCP) if ketones are in the urine. 4.Test blood glucose levels and test urine ketones once a day and keep a record. 5.Call the health-care provider if glucose levels are higher than 180 mg/dL.

1, 2, 5

4.The client diagnosed with a right-sided cerebrovascular accident is admitted to the rehabilitation unit. Which interventions should be included in the nursing care plan? Select all that apply. 1.Position the client to prevent shoulder adduction. 2.Turn and reposition the client every shift. 3.Encourage the client to move the affected side. 4.Perform quadriceps exercises three (3) times a day. 5.Instruct the client to hold the fingers in a fist.

1, 3

45.The client has been newly diagnosed with epilepsy. Which discharge instructions should be taught to the client? Select all that apply. 1.Keep a record of seizure activity. 2.Take tub baths only; do not take showers. 3.Avoid over-the-counter medications. 4.Have anticonvulsant medication serum levels checked regularly. 5.Do not drive alone; have someone in the car.

1, 3, 4

14.The client is diagnosed with osteoarthritis.Which sign/symptom should the nurse expect the client to exhibit? 1.Severe bone deformity. 2.Joint stiffness. 3.Waddling gait. 4.Swan-neck fingers.

2

17.Which finding is considered to be one of the warning signs of developing Alzheimer's disease? 1.Difficulty performing familiar tasks. 2.Problems with orientation to date, time, and place. 3.Having problems focusing on a task. 4.Atherosclerotic changes in the vessels.

2

18.Which client goal is most appropriate for a client diagnosed with OA? 1.Perform passive range-of-motion exercises. 2.Maintain optimal functional ability. 3.Client will walk three (3) miles every day. 4.Client will join a health club.

2

18.Which information should be shared with the client diagnosed with stage I Alzheimer's disease who is prescribed donepezil (Aricept), a cholinesterase inhibitor? 1.The client must continue taking this medication forever to maintain function. 2.The drug may delay the progression of the disease, but it does not cure it. 3.A serum drug level must be obtained monthly to evaluate for toxicity. 4.If the client develops any muscle aches, the HCP should be notified.

2

2.The nurse is assessing a client experiencing motor loss as a result of a left-sided cerebrovascular accident (CVA). Which clinical manifestation would the nurse document? 1.Hemiparesis of the client's left arm and apraxia. 2.Paralysis of the right side of the body and ataxia. 3.Homonymous hemianopsia and diplopia. 4.Impulsive behavior and hostility toward family.

2

35.Which assessment data should the nurse expect to observe for the client diagnosed with Parkinson's disease? 1.Ascending paralysis and pain. 2.Masklike facies and pill rolling. 3.Diplopia and ptosis. 4.Dysphagia and dysarthria.

2

42.The unlicensed assistive personnel (UAP) is attempting to put an oral airway in the mouth of a client having a tonic-clonic seizure. Which action should the primary nurse take? 1.Help the UAP to insert the oral airway in the mouth. 2.Tell the UAP to stop trying to insert anything in the mouth. 3.Take no action because the UAP is handling the situation. 4.Notify the charge nurse of the situation immediately.

2

5.The client has glossopharyngeal nerve (cranial nerve IX) paralysis secondary to a stroke. Which referral would be most appropriate for this client? 1.Hospice nurse. 2.Speech therapist. 3.Physical therapist. 4.Occupational therapist.

2

71.The nurse is assessing the client who is postoperative total knee replacement.Which assessment data warrant immediate intervention? 1.T 99 ̊F, HR 80, RR 20, and BP 128/76. 2.Pain in the unaffected leg during dorsiflexion of the ankle. 3.Bowel sounds heard intermittently in four quadrants. 4.Diffuse, crampy abdominal pain.

2

72.The nurse is working on an orthopedic floor. Which client should the nurse assess first after the change-of-shift report? 1.The 84-year-old female with a fractured right femoral neck in Buck's traction. 2.The 64-year-old female with a left total knee replacement who has confusion. 3.The 88-year-old male post-right total hip replacement with an abduction pillow. 4.The 50-year-old postop client with a continuous passive motion (CPM) device.

2

73.The client diagnosed with Parkinson's disease (PD) is being admitted with a fever and patchy infiltrates in the lung fields on the chest x-ray. Which clinical manifestations of PD would explain these assessment data? 1. Masklike facies and shuffling gait. 2.Difficulty swallowing and immobility. 3.Pill rolling of fingers and flat affect. 4.Lack of arm swing and bradykinesia.

2

8.The client with type 2 diabetes controlled with biguanide oral diabetic medication is scheduled for a computed tomography (CT) scan with contrast of the abdomen to evaluate pancreatic function. Which intervention should the nurse implement? 1.Provide a high-fat diet 24 hours prior to test. 2.Hold the biguanide medication for 48 hours prior to test. 3.Obtain an informed consent form for the test. 4.Administer pancreatic enzymes prior to the test.

2

83.The nurse is conducting a support group for clients diagnosed with Parkinson's disease and their significant others. Which information regarding psychosocial needs should be included in the discussion? 1.The client should discuss feelings about being placed on a ventilator. 2.The client may have rapid mood swings and become easily upset. 3.Pill-rolling tremors will become worse when the medication is wearing off. 4.The client may automatically start to repeat what another person says.

2

9.The client is diagnosed with expressive aphasia.Which psychosocial client problem would the nurse include in the plan of care? 1.Potential for injury. 2.Powerlessness. 3.Disturbed thought processes. 4.Sexual dysfunction.

2

15.The client diagnosed with OA is a resident in a long-term care facility. The resident is refusing to bathe because she is hurting. Which instruction should the nurse give the unlicensed assistive personnel (UAP)? 1.Allow the client to stay in bed until the pain becomes bearable. 2.Tell the UAP to give the client a bed bath this morning. 3.Try to encourage the client to get up and go to the shower. 4.Notify the family the client is refusing to be bathed.

3

19.To which member of the health-care team should the nurse refer the client diagnosed with OA who is complaining of not being able to get in and out of the bathtub? 1.Physiatrist. 2.Social worker. 3.Physical therapist. 4.Counselor.

3

2.The client diagnosed with type 1 diabetes has a glycosylated hemoglobin (A1c) of 8.1%. Which interpretation should the nurse make based on this result? 1.This result is below normal levels. 2.This result is within acceptable levels. 3.This result is above recommended levels. 4.This result is dangerously high.

3

22.The nurse is admitting the client with OA to the medical floor. Which statement by the client indicates an alternative form of treatment for OA? 1."I take medication every two (2) hours for my pain." 2."I use a heating pad when I go to bed at night." 3."I wear a copper bracelet to help with my OA." 4."I always wear my ankle splints when I sleep.

3

23.The client is complaining of joint stiffness,especially in the morning. Which diagnostic tests should the nurse expect the health-care provider to order to R/O osteoarthritis? 1.Full-body magnetic resonance imaging scan. 2.Serum studies for synovial fluid amount. 3.X-ray of the affected joints. 4.Serum erythrocyte sedimentation rate (ESR).

3

25.The nurse is discussing osteoporosis with a group of women. Which factor will the nurse identify as a nonmodifiable risk factor? 1.Calcium deficiency. 2.Tobacco use. 3.Female gender. 4.High alcohol intake.

3

28.The client is being evaluated for osteoporosis.Which diagnostic test is the most accuratewhen diagnosing osteoporosis? 1.X-ray of the femur. 2.Serum alkaline phosphatase. 3.Dual-energy x-ray absorptiometry (DEXA). 4.Serum bone Gla-protein test.

3

35.The client is taking calcium carbonate (Tums) to help prevent further development of osteoporosis. Which teaching should the nurse implement? 1.Encourage the client to take Tums with at least eight (8) ounces of water. 2.Teach the client to take Tums with the breakfast meal only. 3.Instruct the client to take Tums 30 to 60 minutes before a meal. 4.Discuss the need to get a monthly serum calcium level.

3

39.The client is scheduled for an electroenceph-alogram (EEG) to help diagnose a seizure disorder. Which preprocedure teaching should the nurse implement? 1.Tell the client to take any routine antiseizure medication prior to the EEG. 2.Tell the client not to eat anything for eight (8) hours prior to the procedure. 3.Instruct the client to stay awake for 24 hours prior to the EEG. 4.Explain to the client that there will be some discomfort during the procedure

3

41.The client who just had a three (3)-minute seizure has no apparent injuries and is oriented to name, place, and time but is very lethargic and just wants to sleep. Which intervention should the nurse implement? 1.Perform a complete neurological assessment. 2.Awaken the client every 30 minutes. 3.Turn the client to the side and allow the client to sleep. 4.Interview the client to find out what caused the seizure.

3

44.The client is admitted to the intensive care unit (ICU) experiencing status epilepticus. Which collaborative intervention should the nurse anticipate? 1.Assess the client's neurological status every hour. 2.Monitor the client's heart rhythm via telemetry. 3.Administer an anticonvulsant medication by intravenous push. 4.Prepare to administer a glucocorticosteroid orally.

3

46.Which statement by the female client indicates that the client understands factors that may precipitate seizure activity? 1."It is all right for me to drink coffee for breakfast." 2."My menstrual cycle will not affect my seizure disorder." 3."I am going to take a class in stress management." 4."I should wear dark glasses when I am out in the sun."

3

48.The nurse educator is presenting an in-service on seizures. Which disease process is the leading cause of seizures in the elderly? 1.Alzheimer's disease. 2.Parkinson's disease (PD). 3.Cerebral Vascular Accident (CVA, stroke). 4.Brain atrophy due to aging.

3

6.The nurse and an unlicensed assistive personnel (UAP) are caring for a client with right-sided paralysis. Which action by the UAP requires the nurse to intervene? 1.The assistant places a gait belt around the client's waist prior to ambulating. 2.The assistant places the client on the back with the client's head to the side. 3.The assistant places a hand under the client's right axilla to move up in bed. 4.The assistant praises the client for attempting to perform ADLs independently.

3

6.The nurse is assessing the feet of a client with long-term type 2 diabetes. Which assessment data warrant immediate intervention by the nurse? 1.The client has crumbling toenails. 2.The client has athlete's foot. 3.The client has a necrotic big toe. 4.The client has thickened toenails.

3

62.The client one (1) day postoperative total hip replacement complains of hearing a "popping sound" when turning. Which assessment data should the nurse report immediately to the surgeon? 1.Dark red-purple discoloration. 2.Equal length of lower extremities. 3.Groin pain in the affected leg. 4.Edema at the incision site.

3

64.The nurse finds small, fluid-filled lesions on the margins of the client's surgical dressing. Which statement is the most appropriate scientific rationale for this occurrence? 1.These were caused by the cautery unit in the operating room. 2.These are papular wheals from herpes zoster. 3.These are blisters from the tape used to anchor the dressing. 4.These macular lesions are from a latex allergy.

3

73.The nurse identifies the concept of impaired functional ability for a client diagnosed with rheumatoid arthritis. Which intervention should the nurse implement? 1.Teach the client to apply antiembolism (TED) hose. 2.Administer the nonsteroidal medication before the morning meal. 3.Encourage the client to perform low-impact exercises daily. 4.Refer the client to occupational therapy for gait training.

3

17.The client diagnosed with OA is prescribed a nonsteroidal anti-inflammatory drug (NSAID). Which instruction should the nurse teach the client? 1.Take the medication on an empty stomach. 2.Make sure to taper the medication when discontinuing. 3.Apply the medication topically over the affected joints. 4.Notify the health-care provider if vomiting blood.

4

26.The client diagnosed with osteoporosis asks the nurse, "Why does smoking cigarettes cause my bones to be brittle?" Which response by the nurse is most appropriate? 1."Smoking causes nutritional deficiencies,which contribute to osteoporosis." 2."Tobacco causes an increase in blood supply to the bones, causing osteoporosis." 3."Smoking low-tar cigarettes will not cause your bones to become brittle." 4."Nicotine impairs the absorption of calcium,causing decreased bone strength."

4

27.The nurse is discussing seizure prevention with a female client who was just diagnosed with epilepsy. Which statement indicates the client needs more teaching? 1."I will take calcium supplements daily and drink milk." 2."I will see my HCP to have my blood levels drawn regularly." 3."I should not drink any type of alcohol while taking the medication." 4."I am glad that my periods will not affect my epilepsy."

4

32.The client newly diagnosed with osteoporosis is prescribed calcitonin by nasal spray. Which assessment data indicate to the nurse an adverseeffect of the medication? 1.The client complains of nausea and vomiting. 2.The client is drinking two (2) glasses of milk a day. 3.The client has a runny nose and nasal itching. 4.The client has had numerous episodes of nosebleeds.

4

5.The nurse is planning care for a client experiencingagnosia secondary to a cerebrovascular accident. Which collaborative intervention will be included in the plan of care? 1.Observe the client swallowing for possible aspiration. 2.Position the client in a semi-Fowler's position when sleeping. 3.Place a suction setup at the client's bedside during meals. 4.Refer the client to an occupational therapist for evaluation.

4

61.The nurse is preparing the preoperative client for a total hip replacement (THR). Which intervention should the nursing implement postoperatively? 1.Keep an abduction pillow in place between the legs at all times. 2.Cough and deep breathe at least every four (4) to five (5) hours. 3.Turn to both sides every two (2) hours to prevent pressure ulcers. 4.Sit in a high-seated chair for a flexion of less than 90 degrees.

4

63.The nurse is discharging a client who had a total hip replacement. Which statement indicates further teaching is needed? 1."I should not cross my legs because my hip may come out of the socket." 2."I will call my HCP if I have a sudden increase in pain." 3."I will sit on a chair with arms and a firm seat." 4."After three (3) weeks, I don't have to worry about infection."

4

66.The nurse is caring for the client who has had a total hip replacement. Which data indicate the surgical treatment is effective? 1.The client states the pain is at a "3" on a 1-to-10 scale. 2.The client has a limited ability to ambulate. 3.The client's left leg is shorter than the right leg. 4.The client ambulates to the bathroom.

4

67.The nurse is caring for a client six (6) hourspostoperative right total knee replacement. Which data should the nurse report to the surgeon? 1.A total of 100 mL of red drainage in the autotransfusion drainage system. 2.Pain relief after using the patient-controlled analgesia (PCA) pump. 3.Cool toes, distal pulses palpable, and pale nailbeds bilaterally. 4.Urinary output of 60 mL of clear yellow urine in three (3) hours

4

68.The client who had a total knee replacement is being discharged home. To which multidisciplinary team member should the nurse refer the client? 1.The occupational therapist. 2.The physiatrist. 3.The recreational therapist. 4.The home health nurse.

4

75.The nurse caring for a client diagnosed with Parkinson's disease writes a problem of "impaired nutrition." Which nursing intervention would be included in the plan of care? 1.Consult the occupational therapist for adaptive appliances for eating. 2.Request a low-fat, low-sodium diet from the dietary department. 3.Provide three (3) meals per day that include nuts and whole-grain breads. 4.Offer six (6) meals per day with a soft consistency.

4

78.The nurse is planning the care for a client diagnosed with Parkinson's disease. Which would be a therapeutic goal of treatment for the disease process? 1.The client will experience periods of akinesia throughout the day. 2.The client will take the prescribed medications correctly. 3.The client will be able to enjoy a family outing with the spouse. 4.The client will be able to carry out activities of daily living.

4

79.The nurse researcher is working with clients diagnosed with Parkinson's disease. Which is an example of an experimental therapy? 1.Stereotactic pallidotomy/thalamotomy. 2.Dopamine receptor agonist medication. 3.Physical therapy for muscle strengthening. 4.Fetal tissue transplantation.

4

8.The client has been diagnosed with a cerebrovascular accident (stroke). The client's wife is concerned about her husband's generalized weakness. Which home modification should the nurse suggest to the wife prior to discharge? 1.Obtain a rubber mat to place under the dinner plate. 2.Purchase a long-handled bath sponge for showering. 3.Purchase clothes with Velcro closure devices. 4.Obtain a raised toilet seat for the client's bathroom.

4

81.The nurse is admitting a client with the diagnosis of Parkinson's disease. Which assessment data support this diagnosis? 1.Crackles in the upper lung fields and jugular vein distention. 2.Muscle weakness in the upper extremities and ptosis. 3.Exaggerated arm swinging and scanning speech. 4.Masklike facies and a shuffling gait.

4

A pt with Parkinson's disease is prescribed Sinemet therapy. Improvement in which of the following indicates effective therapy? a) Mood b) Muscle rigidity c) Appetite d) Alertness

B

A pt with Parkinson's disease has decreased tongue mobility and an inability to move the facial muscles. The nurse recognizes that these impairments common contribute to the nursing diagnosis of: a. disuse syndrome related to loss of muscle control. b. self-care deficit related to bradykinesia and rigidity. c. impaired verbal communication related to difficulty articulating. d. impaired oral mucous membranes related to inability to swallow.

C

Which goal is the most realistic and appropriate for a client diagnosed with Parkinson's disease? a) To cure the disease b) To stop the progression of the disease c) To begin preparation for terminal care d) To maintain optimal body function

D

12.A client diagnosed with a subarachnoid hemorrhage has undergone a craniotomy for repair of a ruptured aneurysm. Which intervention will the intensive care nurse implement? 1.Administer a stool softener bid. 2.Encourage the client to cough hourly. 3.Monitor neurological status every shift. 4.Maintain the dopamine drip to keep BP at 160/90.

1

69.The nurse is caring for a client with a right total knee repair. Which intervention should the nurse implement? 1.Monitor the continuous passive motion machine. 2.Apply thigh-high TED hose bilaterally. 3.Place the abductor pillow between the legs. 4.Encourage the family to perform ADLs for the client.

1

14.The elderly client is admitted to the intensive care department diagnosed with severe HHNS.Which collaborative intervention should the nurse include in the plan of care? 1.Infuse 0.9% normal saline intravenously. 2.Administer intermediate-acting insulin. 3.Perform blood glucometer checks daily. 4.Monitor arterial blood gas (ABG) results.

1

17.The client diagnosed with type 1 diabetes is found lying unconscious on the floor of the bathroom. Which intervention should the nurse implement first? 1.Administer 50% dextrose (IVP). 2.Notify the health-care provider. 3.Move the client to the ICU. 4.Check the serum glucose level.

1

1.An 18-year-old female client, 5′4′′ tall, weighing 113 kg, comes to the clinic for a nonhealing wound on her lower leg, which she has had for two (2) weeks. Which disease process should the nurse suspect the client has developed? 1.Type 1 diabetes. 2.Type 2 diabetes. 3.Gestational diabetes. 4.Acanthosis nigricans.

2

11.The nurse at a freestanding health-care clinic is caring for a 56-year-old male client who is homeless and is a type 2 diabetic controlled with insulin. Which action is an example of client advocacy? 1.Ask the client if he has somewhere he can go and live. 2.Arrange for someone to give him insulin at a local homeless shelter. 3.Notify Adult Protective Services about the client's situation. 4.Ask the HCP to take the client off insulin because he is homeless.

2

15.Which electrolyte replacement should the nurse anticipate being ordered by the health-care provider in the client diagnosed with diabetic ketoacidosis (DKA) who has just been admitted to the ICU? 1.Glucose. 2.Potassium. 3.Calcium. 4.Sodium.

2

18.Which assessment data indicate the client diagnosed with diabetic ketoacidosis is responding to the medical treatment? 1.The client has tented skin turgor and dry mucous membranes. 2.The client is alert and oriented to date,time, and place. 3.The client's ABG results are pH 7.29, Paco2 44, HCO3 15. 4.The client's serum potassium level is 3.3 mEq/L.

2

19.The UAP on the medical floor tells the nurse the client diagnosed with DKA wants something else to eat for lunch. Which intervention should the nurse implement? 1.Instruct the UAP to get the client additional food. 2.Notify the dietitian about the client's request. 3.Request the HCP increase the client's caloric intake. 4.Tell the UAP the client cannot have anything else.

2

21.A family member brings the client to the emergency department reporting that the 78-year-old father has suddenly become very confused and thinks he is living in 1942, that he has to go to war, and that someone is trying to poison him. Which question should the nurse ask the family member? 1."Has your father been diagnosed with dementia?" 2."What medication has your father taken today?" 3."What have you given him that makes him think it's poison?" 4."Does your father like to watch old movies on television?"

2

21.The HCP prescribes glucosamine and chondroitin for a client diagnosed with OA. What is the scientific rationale for prescribing this medication? 1.It will help decrease the inflammation in the joints. 2.It improves tissue function and retards breakdown of cartilage. 3.It is a potent medication which decreases the client's joint pain. 4.It increases the production of synovial fluid in the joint

2

31.The female client diagnosed with osteoporosis tells the nurse she is going to perform swim aerobics for 30 minutes every day. Which response is most appropriate by the nurse? 1.Praise the client for committing to do this activity. 2.Explain to the client walking 30 minutes a day is a better activity. 3.Encourage the client to swim every other day instead of daily. 4.Discuss with the client how sedentary activities help prevent osteoporosis.

2

1.A 78-year-old client is admitted to the emergency department (ED) with numbness and weakness of the left arm and slurred speech. Which nursing intervention is priority? 1.Prepare to administer recombinant tissue plasminogen activator (rt-PA). 2.Discuss the precipitating factors that caused the symptoms. 3.Schedule for a STAT computed tomography (CT) scan of the head. 4.Notify the speech pathologist for an emergency consult.

3

10.The client received 10 units of Humulin R,a fast-acting insulin, at 0700. At 1030 the unlicensed assistive personnel (UAP) tells the nurse the client has a headache and is really acting "funny." Which intervention should the nurse implement first? 1.Instruct the UAP to obtain the blood glucose level. 2.Have the client drink eight (8) ounces of orange juice. 3.Go to the client's room and assess the client for hypoglycemia. 4.Prepare to administer one (1) ampule 50% dextrose intravenously.

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10.Which assessment data would indicate to the nurse that the client would be at risk for a hemorrhagic stroke? 1.A blood glucose level of 480 mg/dL. 2.A right-sided carotid bruit. 3.A blood pressure (BP) of 220/120 mm Hg. 4.The presence of bronchogenic carcinoma.

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13.The client diagnosed with type 2 diabetes is admitted to the intensive care unit (ICU) with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) coma. Which assessment data should the nurse expect the client to exhibit? 1.Kussmaul's respirations. 2.Diarrhea and epigastric pain. 3.Dry mucous membranes. 4.Ketone breath odor.

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20.The emergency department nurse is caring for a client diagnosed with HHNS who has a blood glucose of 680 mg/dL. Which question should the nurse ask the client to determine the cause of this acute complication? 1."When is the last time you took your insulin?" 2."When did you have your last meal?" 3."Have you had some type of infection lately?" 4."How long have you had diabetes?"

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21.The nurse is discussing ways to prevent diabetic ketoacidosis with the client diagnosed with type 1 diabetes. Which instruction is most importantto discuss with the client? 1.Refer the client to the American Diabetes Association. 2.Do not take any over-the-counter (OTC) medications. 3.Take the prescribed insulin even when unable to eat because of illness. 4.Explain the need to get the annual flu and pneumonia vaccines.

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22.The charge nurse is making client assignments in the intensive care unit. Which client should be assigned to the most experienced nurse? 1.The client with type 2 diabetes who has a blood glucose level of 348 mg/dL. 2.The client diagnosed with type 1 diabetes who is experiencing hypoglycemia. 3.The client with DKA who has multifocal premature ventricular contractions. 4.The client with HHNS who has a plasma osmolarity of 290 mOsm/L.

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74.The client diagnosed with PD is being discharged on carbidopa/levodopa (Sinemet),an antiparkinsonian drug. Which statement is the scientific rationale for combining these medications? 1.There will be fewer side effects with this combination than with carbidopa alone. 2.Dopamine D requires the presence of both of these medications to work. 3.Carbidopa makes more levodopa available to the brain. 4.Carbidopa crosses the blood-brain barrier to treat Parkinson's disease.

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80.The client diagnosed with Parkinson's disease is being discharged. Which statement made by the significant other indicates an understanding of the discharge instructions? 1."All of my spouse's emotions will slow down now just like his body movements." 2."My spouse may experience hallucinations until the medication starts working." 3."I will schedule appointments late in the morning after his morning bath." 4."It is fine if we don't follow a strict medication schedule on weekends."

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82.Which is a common cognitive problem associated with Parkinson's disease? 1.Emotional lability. 2.Depression. 3.Memory deficits. 4.Paranoia.

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34.The 84-year-old client is a resident in a long-term care facility. Which intervention should be implemented to help prevent complications secondary to osteoporosis? 1.Keep the bed in the high position. 2.Perform passive range-of-motion exercises. 3.Turn the client every two (2) hours. 4.Provide nighttime lights in the room.

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37.The male client is sitting in the chair and his entire body is rigid with his arms and legs contracting and relaxing. The client is not aware of what is going on and is making guttural sounds. Which action should the nurse implement first? 1.Push aside any furniture. 2.Place the client on his side. 3.Assess the client's vital signs. 4.Ease the client to the floor.

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11.The 85-year-old client diagnosed with a stroke is complaining of a severe headache. Which intervention should the nurse implement first? 1.Administer a nonnarcotic analgesic. 2.Prepare for STAT magnetic resonance imaging (MRI). 3.Start an intravenous infusion with D5W at 100 mL/hr. 4.Complete a neurological assessment.

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16.The client diagnosed with HHNS was admitted yesterday with a blood glucose level of 780 mg/dL. The client's blood glucose level is now 300 mg/dL. Which intervention should the nurse implement? 1.Increase the regular insulin IV drip. 2.Check the client's urine for ketones. 3.Provide the client with a therapeutic diabetic meal. 4.Notify the HCP to obtain an order to decrease insulin.

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16.The client has been diagnosed with OA for the last seven (7) years and has tried multiple medical treatments and alternative treatments but still has significant joint pain. Which psychosocialclient problem should the nurse identify? 1.Severe pain. 2.Body image disturbance. 3.Knowledge deficit. 4.Depression.

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23.Which arterial blood gas results should the nurse expect in the client diagnosed with diabetic ketoacidosis? 1.pH 7.34, Pao2 99, Paco2 48, HCO3 24. 2.pH 7.38, Pao2 95, Paco2 40, HCO3 22. 3.pH 7.46, Pao2 85, Paco2 30, HCO3 26. 4.pH 7.30, Pao2 90, Paco2 30, HCO3 18.

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5.The nurse is discussing the importance ofexercising with a client diagnosed with type 2 diabetes whose diabetes is well controlled with diet and exercise. Which information should the nurse include in the teaching about diabetes? 1.Eat a simple carbohydrate snack before exercising. 2.Carry peanut butter crackers when exercising. 3.Encourage the client to walk 20 minutes three (3) times a week. 4.Perform warm-up and cool-down exercises.

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What is the priority nursing assessment in the first 24 hours after admission of the client with a thrombolytic stroke? A) Cholesterol b) Pupil size and pupillary response c) Bowel sounds d) Echocardiogram

Answer = B

During the first 24 hours after thrombolytic treatment for ischemic stroke, the primary goal is to control the patient's: a) Pulse b) Respiratory c)Blood pressure d)Temperature

Answer = C

When obtaining a health history and physical assessment for a patient with possible multiple sclerosis (MS), the nurse should: a. confirm patient information with family members. b. ask about a recent history of memory loss. c. question the patient about any leg weakness or spasm. d. determine whether hypertension has caused problems

Answer = C

During the first 24 hours after thrombolytic treatment for ischemic stroke, the primary goal is to control the patient's: a) Pulse b) Respiratory c)Blood pressure d)Temperature

C

The nurse is caring for a pt with Guillain Barre syndrome, the priority nursing concern is: a) Assisting with ambulation b) Assessing peripheral pulses c) Administering antibiotics on time d) Maintaining an airway

D

24.The client is admitted to the ICU diagnosed with DKA. Which interventions should the nurse implement? Select all that apply. 1.Maintain adequate ventilation. 2.Assess fluid volume status. 3.Administer intravenous potassium. 4.Check for urinary ketones. 5.Monitor intake and output.

all answers