Chapter 19 Adaptive Quizzing

The nurse instructs a client with type 2 diabetes about risk for infections. Which statement, if made by the client, would indicate that teaching was successful?

"I may not realize that a sore has developed on the bottom of my foot." -A client with type 2 diabetes may have sensory deficits (loss of pain) related to neuropathy

A client is diagnosed with type 1 diabetes mellitus. Which information should the nurse include when teaching the client about the pathophysiology of this medical condition?

"The cells in the pancreas that produce insulin have been destroyed."

Which client is most likely to develop hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)?

Older adult with type 2 diabetes mellitus and renal disease

A client is experiencing thyrotoxic crisis. Which medications should the nurse prepare to administer? Select all that apply.

-Iodine -Beta Blockers

A client is diagnosed with hyperosmolar hyperglycemic nonketotic syndrome (HHNKS). Which clinical manifestations will the nurse expect? Select all that apply.

-Stupor -Hypokalemia -Severe Dehydration

A client has syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Upon assessment, which findings would the nurse expect to observe? Select all that apply.

-Thirst -Confusion -Muscle Twitching -Dyspnea on excretion

A client develops secondary hyperparathyroidism. The nurse is caring for which client?

One with end-stage chronic renal disease

Upon reviewing the laboratory results, the nurse finds low levels of thyroid hormones (T3and T4) and high levels of thyroid-stimulating hormone (TSH). The nurse is caring for which client?

One with primary hypothyroidism

Which client should the nurse most closely monitor for the development of myxedema coma?

One with untreated hypothyroidism

Which client is at highest risk for developing type 2 diabetes mellitus?

A 68-year-old black female who is obese and sedentary -The 68-year-old client has four risk factors: age (65--74 years), black race, obese, and physical inactivity.

A client has hypoparathyroidism. Which treatment should the nurse implement?

Administration of calcium

A nurse is caring for a client with acromegaly. The nurse is caring for which client?

An adult -Acromegaly occurs in adults, usually in the age group of 40 to 59 years

A client has insulin shock. How should the nurse interpret this finding?

Blood sugar is low -Hypoglycemia (low blood sugar) in diabetes is sometimes called insulin shock or insulin reaction

Two clients, one with type 1 diabetes mellitus and one with type 2, both have polydipsia, polyphagia, and polyuria. How should the nurse interpret these findings?

Both have hyperglycemia. -Polydipsia, polyphagia, and polyuria all are caused by hyperglycemia in diabetes mellitus.

A client has visual changes that began in one eye and then progressed to the second eye. These assessment findings support which condition?

Pituitary adenoma

Which macrovascular complications of diabetes mellitus should the nurse monitor for in a client with diabetes?

Cerebrovascular accident

A client has neurogenic diabetes insipidus. Which information should the nurse remember when planning care for this client?

It results from low levels of antidiuretic hormone (ADH).

Which finding would indicate to the nurse that a client with diabetes has a microvascular complication?

Nonproliferative retinopathy

A client had a closed-head injury and is now having polyuria with a low urine specific gravity. Which complication does the nurse suspect the client is experiencing?

Diabetes insipidus

Which condition does the nurse suspect in a patient who reports polyuria, nocturia, and polydipsia?

Diabetes insipidus -A patient with diabetes insipidus will exhibit polyuria, nocturia, and polydipsia due to a decrease in antidiuretic hormone levels

Which clinical manifestation should the nurse expect to find in a client with Graves disease?

Double vision

What pathophysiologic process should the nurse consider when planning care for children with giantism and adults with acromegaly?

Excessive production of growth hormone

The diagnoses on a client's chart include gastroparesis in addition to type 1 diabetes. Which information from the client indicates that the gastroparesis is symptomatic today?

I can't eat this bedtime snack; I'm still full from dinner.

A client experienced a thyroid storm. Which pathophysiologic mechanism should the nurse consider when administering treatments to this client?

Increased catecholamines leading to heart failure

Which information from the nurse indicates the most accurate understanding of the defects causing diabetes mellitus?

Insulin secretion or action -Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both

A client has a pituitary adenoma. Which information should the nurse remember when planning care for this client?

It is usually microscopic.

A client with hypothyroidism has now run out of hormone replacement. What signs and symptoms will the client most likely experience in the next 2 or 3 days?

Lethargy, cold intolerance, and bradycardia

Which laboratory result for thyroid-stimulating hormone (TSH) would the nurse expect to find in a client with Graves disease?

Low level in the blood

Which information should the nurse include in the teaching session about the treatment of Addison disease?

Medication treatment will be lifelong. -The treatment of Addison disease involves lifetime glucocorticoid and possibly mineralocorticoid replacement therapy, together with dietary modifications and correction of any underlying disorders

Which initial finding will alert the nurse that a client with diabetes is experiencing kidney dysfunction?

Microalbuminuria

A client is hospitalized with a malignant tumor that secretes parathyroid hormone. What signs or symptoms should the nurse monitor to detect the resulting electrolyte imbalance?

Serum calcium, renal stones, and urine pH

A client has small cell carcinoma of the lungs, which secretes large amounts of antidiuretic hormone (ADH), producing the syndrome of inappropriate ADH (SIADH). The family asks why fluid restrictions must be followed. What is the nurse's best response?

The blood has too much water in it, and restricting fluids helps correct the excess.

A nurse is teaching the staff about the difference between diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic nonketotic syndrome (HHNKS). Which information should the nurse include in the teaching session?

The degree of insulin deficiency is more profound in DKA, and the degree of fluid deficiency is more marked in HHNKS.

A client, who has type 1 diabetes, introduces the nurse to a family member. The family member wants to know what caused the client's diabetes. What is the nurse's best response?

The immune system turned against the pancreas cells and destroyed them, so the body can't make any insulin. -Type 1 diabetes involves autoimmune destruction of the pancreatic beta cells. Type 1 diabetes does not involve insulin resistance; insulin resistance is associated with type 2

A nurse is caring for a client with Addison disease and notices weakness. How should the nurse interpret this finding?

This is a result of hypocortisolism.