Adults I Exam Questions

Management of hyperthyroidism might include a prescription for which of the following?

Propylthiouricil (PTU)

Which of the following complications of diabetes is termed "macrovascular": ?

stroke

While teaching a patient to self-administer insulin, the patient asks the nurse, "Why are you telling me to rotate my sites when I inject the insulin? If I use the same area for injection every day, it will probably cause me less pain." The nurse's best response is:

" Injecting insulin into the same area causes scarring and delays the absorption of the drug."

The American Diabetes Association has agreed that hypoglycemia is "officially" diagnosed when the blood glucose is:

70 mg/dL or below

The nurse teaches the newly diagnosed patient with diabetes mellitus that which of the following guidelines will decrease the body's need for insulin?

Exercise

Which nursing instruction should the nurse discuss with the patient who is receiving glucocorticoids for Addison's Disease

Explain the dose may need to be increased during times of stress or infection

A patient with thyroid cancer undergoes a thyroidectomy. After surgery, the patient develops peripheral numbness and tingling and muscle twitching and spasms. The nurse should expect to administer:

IV calcium gluconate

To achieve consistency with the body's natural secretion of cortisol, the home care nurse instructs the patient to take her corticosteroid medication:

In the early morning between 7am and 8am

The nurse teaches the newly diagnosed patient with type 2 diabetes which of the following general guidelines?

control calorie intake to attain a reasonable body weight

The patient who has long-standing hypothyroidism is at particular risk to develop what additional health problem?

coronary artery disease

Which is the best indicator for determining whether a client with Addison's disease is receiving the correct amount of glucocorticoid replacement?

daily weight

Following a transsphenoidal hypophysectomy the nurse should assess the client for:

cerebrospinal fluid leak

To check for hypoparathyroidism, the nurse can check for the positive presence of which of the following signs?

chvostek's

Which signs and symptoms indicate the client with hypothyroidism is not taking enough thyroid hormone?

complaints of constipation and being cold

Which of the following guidelines applies to periods of illness ("sick day rules") in a diabetic patient?

do not eliminate insulin when nauseated and vomiting

An 83-year-old patient with type 2 diabetes presents to the emergency room with a blood glucose level of 623 mg/dL. The patient's daughter reports that the patient recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is made. The nurse gives priority to which nursing action?

fluid and electrolyte replacement

A patient with a long-standing history of Type 2 DM is admitted to the hospital. What blood test will provide the most accurate information about how well controlled the patient's blood glucose has been of the past 3 months?

glycated hemoglobin (hemoglobin A1C)

Which of the following assessments would indicate the patient was experiencing a thyroid storm?

heart rate 140 beats/min, temperature 39 degrees Celsius, confusion

During treatment for diabetic ketoacidosis, which include intravenous insulin therapy and intravenous fluid replacement therapy, the nurse monitors for what electrolyte imbalance?

hypokalemia

The client is admitted with Hashimoto's thyroiditis. The nurse is aware that he will exhibit signs of which of the following.

hypothyroidism

The nurse is teaching family members of a patient with hepatitis A virus. Family members were exposed to the patient and, therefore, should receive immunoglobulin. The nurse should tell the family that immunoglobulin...?

must be administered within 2 weeks of exposure

Which of the following is the most significant risk factor for the development of type 2 diabetes mellitus?

obesity

A client who has undergone a subtotal thyroidectomy is subject to complications in the first 48 hours after surgery. The nurse should obtain and keep at the bedside equipment to:

perform a tracheotomy

The nurse is developing a plan of care for the client with viral hepatitis. The nurse should review laboratory reports for which of the following abnormal laboratory values?

prolonged prothrombin time

A patient is diagnosed with Grave's disease. The nurse is aware the patient may have which of the following characteristics?

pronounced expothalamus

The nurse should teach the family members that which of the following are symptoms of mild hypoglycemia?

sweating and treamors

The patient has returned from surgery following a total parathyroidectomy. The nurse should assess for which of the complications following this surgery?

tetany

In planning the care for a patient exhibiting symptoms associated with hepatitis B, the nurse anticipates that the patient will be maintained on bed rest until

the hepatic enlargement and elevated levels of bilirubin and enzymes have disappeared

The client is to have a transsphenoidal hypophysectomy to remove a large, invasive pituitary tumor. The nurse should instruct the client that the surgery will be performed through an incision in the:

upper gingival mucosa in the space between the upper gums and lip

A client with diabetes is taking a short-acting insulin insulin (Novulin R). The nurse should advise the client to eat:

within 20-30 minutes after the injection

A male patient informs the nurse that he is feeling nervous and hungry. The nurse further assesses the patient and finds he is tachycardic and diaphoretic. The nurse should administer which of the following?

Fruit juice, 4 to 6 oz

The nurse is providing an in-service on thyroid disorders. One of the attendees asks the nurse, "Why don't the people in the United States get goiters as often? Which statement by the nurse is the best response?

Iodized salt helps prevent the development of goiters in the United States

The nurse is assessing a client with a diagnosis of diabetic ketoacidosis (DKA). Which of the following signs and symptoms will he/she likely observe?

Kussmaul breathing - deep, rapid breaths with periods of apnea

Which of the following is a priority outcome for the client with Addison's disease?

Maintenance of medication complicance

Which of the following is appropriate for the nurse explaining the etiology of type 1diabetes to the patient?

"Destruction of special cells in the pancreas stops insulin production. The level of glucose (sugar) in the bloodstream increases because the body lacks insulin which "carries" glucose molecules into the cell to be used for energy."

The nurse discussing "sick day rules" with a newly diagnosed patient with type 1 diabetes is aware that the patient will require further teaching when he states:

"I will not take my insulin on the days when I am sick, but I will check my blood sugar every 2 hours."

The client is being treated with NPH insulin at 8:00AM. The nurse should offer a snack at:

2pm

A patient with chronic obstructive pulmonary disease (COPD) presents to the emergency room with muscle weakness, hypotension, hypoglycemia, and fatigue. The patient's family reports that the patient recently stopped taking all medications because the medications were too expensive. The nurse reviews the list of medications provided by the family and notes that the patient had been taking prednisone daily. Based upon this information, the nurse's assessment findings are consistent with characteristics associated with:

Addison's disease

Hypoglycemia is prevented by a consistent pattern of eating, administering insulin, and exercising. However, all patients with DM should be prepared for an unexpected episode of hypoglycemia. What are the most effective interventions that an adult with DM can do to prepare for unexpected hypoglycemia?

Always wear an alert bracelet and carry a simple form of sugar with them

Teaching patients with DM proper foot care helps prevent foot complications that can result in chronic wounds or amputation. The following foot care practice is an important part of patient education.

Daily visual and manual inspection of one's feet

The nurse is assessing a patient with possible Cushing's syndrome. In a patient with Cushing's syndrome, the nurse would expect to find:

Deposits of adipose tissue in the trunk and dorsocervical area

The nurse is assessing a patient's self-care skills to determine if further diabetes teaching is required. A patient who has been an insulin-dependent diabetic is best assessed by the nurse through:

Direct observation of the self-care skill.

The nurse is providing teaching to a patient with acute viral hepatitis about to be discharged to her home. Which activity guideline is most appropriate?

Maintain bed rest except for trips to the bathroom

A patient with Cushing's syndrome is scheduled to have a dexamethasone suppression test. The nurse explains that this test will involve administration of dexamethasone:

Orally at 11 PM, and a plasma cortisol level at 8 AM the next morning