Chapters 48, 49, 51, 52, 53, 54 Endocrine and Reproductive

A patient who is on corticosteroid therapy for treatment of an autoimmune disorder has the following drugs ordered. Which one is used to prevent corticosteroid-induced osteoporosis? a. Potassium b. Furosemide (Lasix) c. Alendronate (Fosamax) d. Pantoprazole (Protonix)

C

From where is the hormone glucagon secreted? a. F cells of the islets of Langerhans b. β-cells of the islets of Langerhans c. α-cells of the islets of Langerhans d. Delta cells of the islets of Langerhans

C

The patient is describing a feeling of something coming down her vagina and having a backache. What is most likely the cause of this discomfort? a. Cystocele b. Dysmenorrhea c. Uterine prolapse d. Abdominal distention

C

What is a potential adverse effect of palpation of an enlarged thyroid gland? a. Carotid artery obstruction b. Damage to the cricoid cartilage c. Release of excessive thyroid hormone into circulation d. Hoarseness from pressure on the recurrent laryngeal nerve

C

In establishing screening programs for populations at high risk for STIs, the nurse recognizes that which microorganism causes nongonococcal urethritis in men and cervicitis in women? a. Treponema pallidum b. Neisseria gonorrhoeae c. Chlamydia trachomatis d. Herpes simplex virus (HSV)

C

A patient with diabetes is found unconscious at home, and a family member calls the clinic. After determining that a glucometer is not available, what should the nurse advise the family member to do? a. Have the patient drink some orange juice. b. Administer 10 U of regular insulin subcutaneously. c. Call for an ambulance to transport the patient to a medical facility. d. Administer glucagon 1 mg intramuscularly (IM) or subcutaneously.

D

A 20-year-old patient with PID is crying and tells the nurse that she is afraid she will not be able to have children as a result of the infection. What is the nurse's best response to this patient? a. "I would not worry about that now. Our immediate concern is to cure the infection you have." b. "PID increases the possibility of infertility. Would you like to talk about what it means to you?" c. "Sterility following PID is possible but not common, and it is too soon to know what the effects will be." d. "The infection can cause more serious complications, such as abscesses and shock, that you should be more concerned about."

B

A 44-year-old female patient has breast cancer with estrogen receptor-negative cells. Which genomic assay test can be used to provide information about the likely recurrence and need for chemotherapy? a. CA 27-29 b. TNM system c. Oncotype DX d. Direct to consumer

C

A 29-year-old woman is at the clinic with heavy menstrual bleeding. What finding would the nurse expect in this patient's assessment? a. Pain with each menstrual period b. Excessive bleeding at irregular intervals c. Bleeding between regular menstrual cycles d. Increased duration or amount of menstrual bleeding

D

In a patient with central diabetes insipidus, what is the expected outcome of administering ADH during a water deprivation test? a. Decrease in body weight b. Increase in urinary output c. Decrease in blood pressure d. Increase in urine osmolality

D

What should the nurse teach the patient about what occurs after having a vasectomy? a. The amount of ejaculate will be noticeably decreased. b. He may have difficulty maintaining an erection for several months. c. The testes will gradually decrease production of sperm and testosterone. d. An alternative form of contraception must be used until semen examination shows no sperm

D

What should the nurse include when teaching the patient with acute PID how to care for herself? a. Rest in a semi-Fowler's position. b. Perform vaginal irrigations every 4 hours. c. Use tampons to contain the vaginal drainage. d. Ambulate frequently to promote drainage of exudate.

A

When caring for a patient with metabolic syndrome, the nurse should give the highest priority to teaching the patient about which treatment plan? a. Achieving a normal weight b. Performing daily aerobic exercise c. Eliminating red meat from the diet d. Monitoring the blood glucose periodically

A

Which benign breast disorder occurs most often during lactation and is commonly caused by Staphylococcus aureus? a. Mastitis b. Ductal ectasia c. Fibroadenoma d. Senescent gynecomastia

A

What describes the use of high-dose brachytherapy radiation (select all that apply)? a. May be completed in 5 days b. A primary treatment after mastectomy of breast c. Alternative to traditional radiation therapy for early-stage breast cancer d. Used to treat possible local residual cancer cells following a mastectomy e. Used to reduce tumor size and stabilize metastatic lesions for pain relief

A, C

A patient with abdominal pain and irregular vaginal bleeding is admitted to the hospital with a suspected ectopic pregnancy. Before actual diagnosis, what is the most appropriate action by the nurse? a. Provide analgesics for pain relief. b. Monitor vital signs, pain, and bleeding frequently. c. Offer support for the patient's emotional response to the loss of the pregnancy. d. Explain the need to obtain a blood sample for β-human chorionic gonadotropin monitoring.

B

A patient with type 1 diabetes uses 20 U of Novolin 70/30 (NPH/regular) in the morning and at 6:00 pm. When teaching the patient about this regimen, what should the nurse emphasize? a. Hypoglycemia is most likely to occur before the noon meal. b. A set meal pattern with a bedtime snack is necessary to prevent hypoglycemia. c. Flexibility in food intake is possible because insulin is available 24 hours a day. d. Premeal glucose checks are required to determine needed changes in daily dosing.

B

When caring for a patient with nephrogenic diabetes insipidus, what should the nurse expect the treatment to include? a. Fluid restriction b. Thiazide diuretics c. A high-sodium diet d. Metformin (Glucophage)

B

When caring for a patient with primary hyperaldosteronism, the nurse would question an HCP's prescription for which drug? a. Ketoconazole b. Furosemide (Lasix) c. Eplerenone (Inspra) d. Spironolactone (Aldactone)

B

Which treatment for BPH uses a low-wave radiofrequency to precisely destroy prostate tissue? a. Laser prostatectomy b. Transurethral needle ablation (TUNA) c. Transurethral microwave thermotherapy (TUMT) d. Transurethral electrovaporization of prostate (TUVP)

B

7. What is released in the normal response to increased serum osmolality? a. Aldosterone from the adrenal cortex, which stimulates sodium excretion by the kidney b. ADH from the posterior pituitary gland, which stimulates the kidney to reabsorb water c. Mineralocorticoids from the adrenal gland, which stimulate the kidney to excrete potassium d. Calcitonin from the thyroid gland, which increases bone resorption and decreases serum calcium levels

B

8. A patient with SIADH is treated with water restriction. Which findings would indicate that treatment has been effective? a. Increased urine output, decreased serum sodium, and increased urine specific gravity b. Increased urine output, increased serum sodium, and decreased urine specific gravity c. Decreased urine output, increased serum sodium, and decreased urine specific gravity d. Decreased urine output, decreased serum sodium, and increased urine specific gravity

B

Cortisol, glucagon, epinephrine, and growth hormone are referred to as counterregulatory hormones because they a. Decrease glucose production b. Stimulate glucose output by the liver c. Increase glucose transport into the cells d. Independently regulate glucose level in the blood

B

Serum tumor markers that may be elevated on diagnosis of testicular cancer and used to monitor the response to therapy include a. tumor necrosis factor (TNF) and C-reactive protein (CRP). b. α-fetoprotein (AFP) and human chorionic gonadotropin (hCG). c. PSA and PAP. d. carcinoembryonic antigen (CEA), antinuclear antibody (ANA) and human epidermal growth factor receptor 2 (HER-2).

B

A woman who has been postmenopausal for 10 years calls the clinic because of vaginal bleeding. The nurse schedules a visit for the patient and informs her to expect to have which diagnostic procedure? A. ENDOMETRIAL BIOPSY B. ABDOMINAL RADIOGRAPHY A LASER TO THE CERVIX ONLY A ROUTINE PELVIC EXAM AND PAP SMEAR

A

When teaching a 24-year-old woman who wants to learn BSE, the nurse knows that it is important to do what? a. Provide time for a return demonstration. b. Emphasize the statistics related to breast cancer survival and mortality. c. Have the woman set a consistent monthly date for performing the examination. d. Inform the woman that professional examinations are not necessary unless she finds an abnormality.

A

The patient calls the office and says that she thinks she has a "yeast infection." What signs or symptoms does the nurse expect in this patient (select all that apply)? a. Intense itching and dysuria b. Hemorrhagic cervix and vagina c. Pruritic, frothy greenish or gray discharge d. Thick, white, cottage cheese-like discharge e. Mucopurulent discharge and postcoital spotting

A, D

Which manifestations are characteristic of the late or tertiary stage of syphilis (select all that apply)? a. Heart failure b. Tabes dorsalis c. Aortic aneurysms d. Mental deterioration e. Generalized cutaneous rash f. Destructive skin, bone, and soft tissue lesions

A,B ,C D, F

The patient with diabetes has been diagnosed with autonomic neuropathy. What problems should the nurse assess for in this patient (select all that apply)? a. Painless foot ulcers b. Erectile dysfunction c. Burning foot pain at night d. Loss of fine motor control e. Vomiting undigested food f. Painless myocardial infarction

B, E

On admission to the ambulatory surgical center, a patient with BPH informs the nurse that he is going to have a laser treatment of his enlarged prostate. The nurse plans patient teaching with the knowledge that the patient will need to know what? a. The effects of general anesthesia b. The possibility of short-term incontinence c. Home management of an indwelling catheter d. Monitoring for postoperative urinary retention

C

What is the rationale for the regular use of nonsteroidal antiinflammatory drugs (NSAIDs) during the first several days of the menstrual period for women who have primary dysmenorrhea? a. They suppress ovulation and the production of prostaglandins that occur with ovulation. b. They cause uterine relaxation and small vessel constriction, preventing cramping and abdominal congestion. c. They inhibit the production of prostaglandins believed to be responsible for menstrual pain and associated symptoms. d. They block the release of luteinizing hormone, preventing the increase in progesterone associated with maturation of the corpus luteum.

C

What is an appropriate nursing intervention for the patient with hyperparathyroidism? a. Pad side rails as a seizure precaution. b. Increase fluid intake to 3000 to 4000 mL daily. c. Maintain bed rest to prevent pathologic fractures. d. Monitor the patient for Trousseau's and Chvostek's signs.

B

Which abnormal assessment findings are related to thyroid dysfunction (select all that apply)? a. Tetanic muscle spasms with hypofunction b. Heat intolerance caused by hyperfunction c. Exophthalmos associated with excessive secretion d. Hyperpigmentation associated with hypofunction e. A goiter with either hyperfunction or hypofunction f. Increase in hand and foot size associated with excessive secretion

B, C, E

A patient has fibrocystic changes in her breast. The nurse explains to the patient that this condition is significant because it a. often turns to cancer over time. b. can be controlled with hormone therapy. c. makes it more difficult to examine the breasts. d. will eventually cause atrophy of normal breast tissue.

C

A 44-year-old woman undergoing a total abdominal hysterectomy asks whether she will need to take estrogen until she reaches the age of menopause. What is the best response by the nurse? a. "Yes, it will help prevent the more intense symptoms caused by surgically induced menopause." b. "You are close enough to normal menopause that you probably won't need additional estrogen." c. "Because your ovaries won't be removed, they will continue to secrete estrogen until your normal menopause." d. "There are so many risks associated with estrogen replacement therapy that it is best to begin menopause now."

C

An 18-year-old patient with irregular menstrual periods, hirsutism, and obesity has been diagnosed with polycystic ovary syndrome (PCOS). What is an accurate rationale for the expected treatment? a. Hirsutism may be treated with leuprolide to decrease an altered body image. b. The medication used will cure the hormonal abnormality of excess testosterone. c. Untreated PCOS leads to cardiovascular disease and abnormal insulin resistance. d. Since weight loss will improve all the symptoms, this will be the first treatment tried.

C

When taking a nursing history from a patient with BPH, the nurse would expect the patient to report a. nocturia, dysuria, and bladder spasms. b. urinary frequency, hematuria, and perineal pain. c. urinary hesitancy, postvoid dribbling, and weak urinary stream. d. urinary urgency with a forceful urinary stream and cloudy urine.

C

Which patient should the nurse plan to teach how to prevent or delay the development of diabetes? a. An obese 40-year-old Hispanic woman b. A 20-year-old man whose father has type 1 diabetes c. A 34-year-old woman whose parents both have type 2 diabetes d. A 12-year-old boy whose father has maturity-onset diabetes of the young (MODY)

C

A patient suspected of having acromegaly has an increased plasma growth hormone (GH) level. In acromegaly, what would the nurse expect the patient's diagnostic results to show? a. Hyperinsulinemia b. Plasma glucose of less than 70 mg/dL (3.9 mmol/L) c. Decreased GH levels with an oral glucose challenge test d. Increased levels of plasma insulin-like growth factor-1 (IGF-1)

D

A patient undergoing either a mastectomy or a lumpectomy for treatment of breast cancer can usually expect to undergo what other treatment? a. Chemotherapy b. Radiation therapy c. Hormonal therapy d. Sentinel lymph node dissection (SLNB)

D

The patient with diabetes insipidus is brought to the emergency department (ED) with confusion and dehydration after excretion of a large volume of urine today even though several liters of fluid were consumed. What is a diagnostic test that the nurse should expect to be done first to help make a diagnosis? a. Blood glucose b. Serum sodium level c. CT scan of the head d. Water deprivation test

D

What is a cause of primary hypothyroidism in adults? a. Malignant or benign thyroid nodules b. Surgical removal or failure of the pituitary gland c. Surgical removal or radiation of the thyroid gland d. Autoimmune-induced atrophy of the thyroid gland

D

What occurs during treatment of the patient with an intrauterine radioactive implant? a. All care should be provided by the same nurse. b. The patient may ambulate in the room as desired. c. There can be unlimited number and duration of visitors. d. The patient is restricted to bed rest with turning from side to side.

D

When providing discharge instructions to a patient who had a subtotal thyroidectomy for hyperthyroidism, what should the nurse teach the patient? a. Never miss a daily dose of thyroid replacement therapy. b. Avoid regular exercise until thyroid function is normalized. c. Use warm saltwater gargles several times a day to relieve throat pain. d. Substantially reduce caloric intake compared to what was eaten before surgery.

D

The patient is suspected of having endometriosis and/or uterine leiomyoma. What best describes what is found with these conditions? a. Endometriosis and uterine leiomyoma increase in incidence with the onset of menopause. b. Danazol and Lupron (GnRH analog) are used to treat endometriosis and leiomyomas to create a pseudopregnancy. c. Treatment of endometriosis and leiomyomas depends on the severity of symptoms and the woman's desire to maintain her fertility. d. The presence of ectopic uterine tissue that bleeds and causes pelvic and abdominal adhesions, cysts, and pain is known as uterine leiomyoma.

C

To ensure accurate results of a fasting blood glucose analysis, the nurse instructs the patient to fast for at least how long? a. 2 hours b. 4 hours c. 8 hours d. 12 hours

C

Following a TURP, a patient has continuous bladder irrigation. Four hours after surgery, the catheter is draining thick, bright red clots and tissue. What should the nurse do? a. Release the traction on the catheter. b. Clamp the drainage tube and notify the patient's health care provider (HCP). c. Manually irrigate the catheter until the drainage is clear. d. Increase the rate of the irrigation and take the patient's vital signs.

D

The patient with type 1 diabetes is in the clinic to check his long-term glycemic control. Which test should be used? a. Water deprivation test b. Fasting blood glucose test c. Oral glucose tolerance test d. Glycosylated hemoglobin (A1C)

D

Which diagnostic test is most accurate and advantageous in terms of time and expense in diagnosing breast cancer? a. Mammography b. Excisional biopsy c. Fine-needle aspiration d. Core (core needle) biopsy

D

Identify the 4 screening guidelines for breast cancer recommended by the American Cancer Society. a. b. c. d.

a. Women ages 40 to 44 years should have the choice to start annual breast cancer screening with mammograms if they wish to do so. b. Women aged 45 to 54 years should get mammograms every year. c. Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually. d. Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer. In women with increased risk, decisions for additional and more frequent testing should be determined with the HCP.

What accurately describes prostate cancer detection and/or treatment (select all that apply)? a. The symptoms of lumbosacral pain and lower urinary tract symptoms may be present. b. Orchiectomy is a treatment option for all patients with prostatic cancer except those with stage IV tumors. c. Palpation of the prostate reveals hard and asymmetric enlargement with areas of induration or nodules. d. The preferred hormonal therapy for treatment of prostate cancer includes estrogen and androgen receptor blockers. e. Early detection of prostate cancer is increased with annual rectal examinations and serum prostatic acid phosphatase (PAP) measurements. f. An annual prostate examination is recommended starting at age 45 years for black men with a first-degree relative with prostate cancer at an early age.

A, C, F

Which hormones are secreted by the anterior pituitary gland (select all that apply)? a. Prolactin b. Melatonin c. Somatostatin d. Parathyroid hormone e. Growth hormone (GH) f. Gonadotropic hormones g. Antidiuretic hormone (ADH) h. Melanocyte-stimulating hormone i. Thyroid-stimulating hormone (TSH) j. Adrenocorticotropic hormone (ACTH)

A, E, F, I, J

A 66-year-old male patient is experiencing ED. He and his wife have used tadalafil (Cialis), but because he had priapism, they decided to change treatment to an intraurethral device. How should the nurse explain how this device works? a. The device relaxes smooth muscle in the penis. b. Blood is drawn into corporeal bodies and held with a ring. c. The device is implanted into corporeal bodies to firm the penis. d. The device directly applies drugs that increase blood flow in the penis.

D

A female patient with a purulent vaginal discharge is seen at an outpatient clinic. The nurse suspects a diagnosis of gonorrhea. How would this STI be treated? a. Oral acyclovir (Zovirax) b. Penicillin G Benzathine given IM c. Need a confirmatory test result before treatment d. Ceftriaxone IM with oral azithromycin (Zithromax)

D

A patient asks the nurse what the difference is between benign prostatic hyperplasia (BPH) and prostate cancer. The best response by the nurse includes what information about BPH? a. BPH is a benign tumor that does not spread beyond the prostate gland. b. BPH is a precursor to prostate cancer but does not yet show any malignant changes. c. BPH is an enlargement of the gland caused by an increase in the size of existing cells. d. BPH is a benign enlargement of the gland caused by an increase in the number of normal cells.

D

Before undergoing a TURP, what should the patient be taught? a. This surgery requires an external incision. b. The procedure is done under local anesthesia. c. Recurrent urinary tract infections are likely to occur. d. An indwelling catheter will be used to maintain urinary output until healing is complete.

D

How do hormones respond following the ingestion of a high-protein, carbohydrate-free meal? a. Both insulin and glucagon are inhibited because blood glucose levels are unchanged. b. Insulin is inhibited by low glucose levels, and glucagon is released to promote gluconeogenesis. c. Insulin is released to facilitate the breakdown of amino acids into glucose, and glucagon is inhibited. d. Glucagon is released to promote gluconeogenesis, and insulin is released to facilitate movement of amino acids into muscle cells.

D

Lispro insulin (Humalog) with NPH (Humulin N) insulin is ordered for a patient with newly diagnosed type 1 diabetes. When should the nurse administer lispro insulin? a. Only once a day b. 1 hour before meals c. 30 to 45 minutes before meals d. At mealtime or within 15 minutes of meals

D

Premenstrual syndrome (PMS) is most likely to be diagnosed in a woman with which occurrence? a. Symptoms can be controlled with the use of progesterone. b. The woman has symptoms only when oral contraceptives are used. c. Symptoms can be correlated with altered serum levels of estrogen and progesterone. d. The woman has consistent syndrome complex with symptoms ending after menses begins.

D

The couple has not been able to become pregnant. The wife has not been diagnosed with any infertility problems. Which treatment will the nurse expect to teach the couple about if the problem is the most common testicular problem causing male infertility? a. Antibiotics b. Semen analysis c. Avoidance of scrotal heat d. Surgery to correct the problem

D

The cremasteric reflex is absent in which problem of the scrotum and testes? a. Hydrocele b. Varicocele c. Spermatocele d. Testicular torsion

D

The female patient is admitted with a new diagnosis of Cushing syndrome with elevated serum and urine cortisol levels. Which assessment findings should the nurse expect to see in this patient? a. Hair loss and moon face b. Decreased weight and hirsutism c. Decreased muscle mass and thick skin d. Elevated BP and blood glucose

D

The patient is a perimenopausal woman who has an unexpected and unwanted pregnancy. She wants an abortion. What should the nurse teach her about the effects of an abortion? a. D&C will be done in the hospital. b. She will feel much better afterward. c. The products of conception will pass immediately. d. She will need someone to support her through her loss.

D

The patient with a large rectocele is undergoing surgery. What nursing interventions will be the priority postoperatively? a. An ice pack to relieve swelling b. An enema each day to relieve constipation c. Administration of a stool softener each night d. Perineal care after each urination or defecation

D

Which STI actively occurring at the time of delivery would indicate the need for a cesarean section delivery of the woman's baby? a. Syphilis b. Gonorrhea c. Chlamydia d. Genital herpes

D

Which laboratory results indicate the patient has prediabetes? a. Glucose tolerance result of 132 mg/dL (7.3 mmol/L) b. Glucose tolerance result of 240 mg/dL (13.3 mmol/L) c. Fasting blood glucose result of 80 mg/dL (4.4 mmol/L) d. Fasting blood glucose result of 120 mg/dL (6.7 mmol/L)

D

Which statement about the adrenal medulla hormones is accurate? a. Overproduction of androgens may cause masculinization in women. b. Both the adrenal medulla and the thyroid gland have a negative feedback system to the hypothalamus. c. Cortisol levels would be altered in a person who normally works a night shift from 11:00 pm to 7:00 am and sleeps from 8:00 am to 3:00 pm. d. Catecholamines are considered hormones when they are secreted by the adrenal medulla and neurotransmitters when they are secreted by nerve cells.

D

While examining a patient's breasts, the nurse notes multiple, bilateral mobile lumps. To assess the patient further, what is the most appropriate question by the nurse? a. "Do you have a high caffeine intake?" b. "When did you last have a mammogram?" c. "Is there a history of breast cancer in your mother or sisters?" d. "Do the size and tenderness of the lumps change with your menstrual cycle?"

D

When teaching the patient with type 1 diabetes, what should the nurse emphasize as the major advantage of using an insulin pump? a. Tight glycemic control can be maintained. b. Errors in insulin dosing are less likely to occur. c. Complications of insulin therapy are prevented. d. Frequent blood glucose monitoring is unnecessary.

A

Which statement accurately describes Graves' disease? a. Exophthalmos occurs in Graves' disease. b. It is an uncommon form of hyperthyroidism. c. Manifestations of hyperthyroidism occur from tissue desensitization to the sympathetic nervous system. d. Diagnostic testing in the patient with Graves' disease will reveal an increased thyroid-stimulating hormone (TSH) level

A

The nurse is teaching the patient with prediabetes ways to prevent or delay the development of type 2 diabetes. What information should be included (select all that apply)? a. Exercise regularly. b. Maintain a healthy weight. c. Have BP checked regularly. d. Assess for visual changes on a monthly basis. e. Monitor for polyuria, polyphagia, and polydipsia.

A, B, C

What assessment findings occur with diabetic ketoacidosis (DKA) (select all that apply)? a. Thirst b. Ketonuria c. Dehydration d. Metabolic acidosis e. Kussmaul respirations f. Sweet, fruity breath odor

A, B, C, D, E, F

A black woman with a history of breast cancer has panhypopituitarism from radiation therapy for a primary pituitary tumor. Which medications should the nurse teach her about needing for the rest of her life (select all that apply)? a. Cortisol b. Vasopressin c. Sex hormones d. Levothyroxine (Synthroid) e. Growth hormone (somatropin [Omnitrope]) f. Dopamine agonists (bromocriptine [Parlodel])

A, B, D, E

During routine health screening, a patient is found to have fasting plasma glucose (FPG) of 132 mg/dL (7.33 mmol/L). At a follow-up visit, a diagnosis of diabetes would be made based on which laboratory results (select all that apply)? a. A1C of 7.5% b. Glycosuria of 3+ c. FPG ≥127 mg/dL (7.0 mmol/L). d. Random blood glucose of 126 mg/dL (7.0 mmol/L) e. A 2-hour oral glucose tolerance test (OGTT) of 190 mg/dL (10.5 mmol/L)

A, C

Which characteristics describe transurethral resection of the prostate (TURP) (select all that apply)? a. Best used for a very large prostate gland b. Inappropriate for men with rectal problems c. Involves an external incision prostatectomy d. Uses transurethral incision into the prostate e. Most common surgical procedure to treat BPH f. Resectoscopic excision and cauterization of prostate tissue

E, F

A young woman is admitted to the hospital with acute pelvic inflammatory disease (PID). During the nursing history, the nurse notes which risk factor as being most significant for this patient? a. Lack of any method of birth control b. Sexual activity with multiple partners c. Use of a vaginal sponge for contraception d. Recent antibiotic-induced monilial vaginitis

B

During discharge teaching for the patient with Addison's disease, which patient statement indicates the need for further teaching? a. "I should always call the doctor if I develop vomiting or diarrhea." b. "If my weight goes down, my dosage of steroid is probably too high." c. "I should double or triple my steroid dose if I undergo rigorous physical exercise." d. "I need to carry an emergency kit with injectable hydrocortisone in case I can't take my medication by mouth."

B

Following a mastectomy, a patient develops lymphedema of the affected arm. What does the nurse teach the patient to do? a. Avoid skin-softening agents on the arm. b. Protect the arm from any type of trauma. c. Abduct and adduct the arm at the shoulder hourly. d. Keep the arm positioned so that it is in straight and dependent alignment.

B

On admission of a victim of sexual assault to the ED, what should be the first priority of the nurse? a. Contact a rape support person for the patient. b. Assess the patient for urgent medical problems. c. Question the patient about the details of the assault. d. Tell the patient what procedures and treatments will be performed.

B

The following interventions are planned for a patient with diabetes. Which intervention can the nurse delegate to unlicensed assistive personnel (UAP)? a. Discuss complications of diabetes. b. Check that the bath water is not too hot. c. Check the patient's technique for drawing up insulin. d. Teach the patient to use a meter for self-monitoring of blood glucose.

B

The health care provider of a patient with a positive biopsy of a 2-cm breast tumor has recommended a lumpectomy with radiation therapy or a modified radical mastectomy as treatment. The patient says that she does not know how to choose and asks the female nurse what she would do if she had to make the choice. What is the best response by the nurse to this patient? a. "It doesn't matter what I would do. It is a decision you have to make for yourself." b. "There are advantages and disadvantages of both procedures. What do you know about these procedures?" c. "I would choose the modified radical mastectomy because it would ensure that the entire tumor was removed." d. "The lumpectomy maintains a nearly normal breast, but the survival rate is not as good as it is with a mastectomy."

B

The nurse provides discharge teaching to a patient after a TURP and determines that the patient understands the instructions when he makes which statement? a. "I should use daily enemas to avoid straining until healing is complete." b. "I will avoid heavy lifting, climbing, and driving until my follow-up visit." c. "At least I don't have to worry about developing cancer of the prostate now." d. "Every day I should drink 10 to 12 glasses of liquids, such as coffee, tea, or soft drinks."

B

The nurse would be most concerned when the patient's breast examination reveals which finding? a. A large, tender, moveable mass in the upper inner quadrant b. An immobile, hard, nontender lesion in the upper outer quadrant c. A 2-to 3-cm, firm, defined, mobile mass in the lower outer quadrant d. A painful, immobile mass with reddened skin in the upper outer quadrant

B

The patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What manifestation should the nurse expect to find? a. Decreased body weight b. Decreased urinary output c. Increased plasma osmolality d. Increased serum sodium levels

B

What is the most common way to determine a diagnosis of chlamydial infection in a male patient? a. Cultures for chlamydial organisms are positive. b. The nucleic acid amplification test (NAAT) is positive. c. Gram stain smears and cultures are negative for gonorrhea. d. Signs and symptoms of epididymitis or proctitis are also present.

B

What is the priority nursing intervention during the management of the patient with pheochromocytoma? a. Administering IV fluids b. Monitoring BP c. Administering β-adrenergic blockers d. Monitoring intake and output and daily weights

B

What manifestations of endocrine problems in the older adult are commonly attributed to the aging process? a. Tremors and paresthesias b. Fatigue and mental impairment c. Hyperpigmentation and oily skin d. Fluid retention and hypertension

B

Which class of oral glucose-lowering agents (OA) is most commonly used for people with type 2 diabetes because it reduces hepatic glucose production and enhances tissue uptake of glucose? a. Insulin b. Biguanide c. Meglitinide d. Sulfonylurea

B

Which statement best describes atherosclerotic disease affecting the cerebrovascular, cardiovascular, and peripheral vascular systems in patients with diabetes? a. It can be prevented by tight glucose control. b. It occurs with a higher frequency and earlier onset than in the nondiabetic population. c. It is caused by hyperinsulinemia related to insulin resistance common in type 2 diabetes. d. It cannot be modified by reducing risk factors, such as smoking, obesity, and high fat intake.

B

What disorders and diseases are related to macrovascular complications of diabetes (select all that apply)? a. Chronic kidney disease b. Coronary artery disease c. Microaneurysms and destruction of retinal vessels d. Ulceration and amputation of the lower extremities e. Capillary and arteriole membrane thickening specific to diabetes

B, D

A 30-year-old female patient was brought to the emergency department (ED) after a seizure at work. During the assessment, she mentions hair loss and menstrual irregularities. What diagnostic tests would be helpful to determine if endocrine problems are a cause of her problem (select all that apply)? a. Thyroglobulin b. Luteinizing hormone (LH) c. PTH d. FSH e. MRI of the head f. ACTH suppression

B, D, E

A patient is scheduled for a bilateral adrenalectomy. During the postoperative period, what should the nurse expect related to the administration of corticosteroids? a. Reduced to promote wound healing b. Withheld until symptoms of hypocortisolism appear c. Increased to promote an adequate response to the stress of surgery d. Reduced with excessive hormone release during surgical manipulation of adrenal glands

C

A patient taking insulin has recorded fasting glucose levels above 200 mg/dL (11.1 mmol/L) on awakening for the last 5 mornings. What should the nurse have the patient to do first? a. Increase the evening insulin dose to prevent the dawn phenomenon. b. Use a single-dose insulin regimen with an intermediate-acting insulin. c. Monitor the glucose level at bedtime, between 2:00 am and 4:00 am, and on arising. d. Decrease the evening insulin dosage to prevent night hypoglycemia and the Somogyi effect.

C

A patient who had a mastectomy and is undergoing radiation for treatment of breast cancer has a nursing diagnosis of disturbed body image. What is an appropriate nursing intervention for this patient? a. Provide the patient with information about surgical breast reconstruction. b. Restrict visitors and phone calls until the patient feels better about herself. c. Arrange for a Reach-to-Recovery visitor or similar resource available in the community. d. Encourage the patient to obtain a permanent breast prosthesis as soon as she is discharged from the hospital.

C

A patient with mild iatrogenic Cushing syndrome is on an alternate-day regimen of corticosteroid therapy. What does the nurse explain to the patient about this regimen? a. It maintains normal adrenal hormone balance. b. It prevents ACTH release from the pituitary gland. c. It minimizes hypothalamic-pituitary-adrenal suppression. d. It provides a more effective therapeutic effect of the drug.

C

A premarital blood test for syphilis reveals that a woman has a positive Venereal Disease Research Laboratory (VDRL) test. How should the nurse advise the patient? a. A single dose of penicillin will cure the syphilis. b. She should question her fiancé about prior sexual contacts. c. Additional testing to detect specific antitreponemal antibodies is necessary. d. A lumbar puncture to evaluate cerebrospinal fluid (CSF) is needed to rule out active syphilis.

C

A woman at the health clinic tells the nurse that she does not do breast self-examination (BSE) because it just seems too much of a bother. What is the best response by the nurse about BSE? a. BSE is the most common way that breast cancer is discovered. b. It reduces mortality from breast cancer in women under the age of 50 years. c. It is useful to help women learn how their breasts normally look and feel. d. BSE has little value in detecting cancer and is not recommended anymore.

C

A young woman who runs vigorously as a form of exercise has not had a menstrual period in more than 6 months. What should the nurse teach her? a. Normal periods will return when she stops running. b. Uterine balloon therapy may be necessary to promote uterine sloughing of the overgrown endometrium. c. Progesterone or combined oral contraceptives should be used to prevent persistent overgrowth of the endometrium. d. Unopposed progesterone production causes an overgrowth of the endometrium that increases her risk for endometrial cancer.

C

Although an 18-year-old girl knows that abstinence is one way to prevent STIs, she does not consider that as an alternative. She asks the nurse at the clinic if there are other measures for preventing STIs. What should the nurse teach her? a. Abstinence is the only way to prevent STIs. b. Voiding immediately after intercourse will decrease the risk for infection. c. A vaccine can prevent genital warts and cervical cancer caused by some strains of HPV. d. Thorough hand washing after contact with genitals can prevent oral-genital spread of STIs.

C

Fertility and normal reproductive function can be maintained when a cancer of the cervix is successfully treated with which therapy? a. External radiation therapy b. Internal radiation implants c. Conization or laser surgery d. Cryotherapy or subtotal hysterectomy

C

The current incidence of sexually transmitted infections (STIs) is related in part to what? a. Increased social acceptance of homosexuality b. Increased virulence of organisms that cause STIs c. Use of oral agents rather than condoms as contraceptives d. Increased microorganism resistance to common antibiotics

C

The nurse assesses the technique of the patient with diabetes for self-monitoring of blood glucose (SMBG) 3 months after initial instruction. Which error in the performance of SMBG noted by the nurse requires intervention? a. Doing the SMBG before and after exercising b. Puncturing the finger on the side of the finger pad c. Cleaning the puncture site with alcohol before the puncture d. Holding the hand down for a few minutes before the puncture

C

What describes the primary difference in treatment for diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS)? a. DKA requires administration of bicarbonate to correct acidosis. b. Potassium replacement is not necessary in management of HHS. c. HHS requires greater fluid replacement to correct the dehydration. d. Glucose is withheld in HHS until the blood glucose reaches a normal level.

C

What medication is given in thyrotoxicosis to block the effects of the sympathetic nervous stimulation of the thyroid hormones? a. Potassium iodine b. Propylthiouracil c. Propranolol (Inderal) d. Radioactive iodine (RAI)

C

When teaching a patient with premenstrual dysphoric disorder (PMDD) about managing the disorder, the nurse includes the need to a. limit dietary intake of caffeine and refined sugar. b. use estrogen supplements during the luteal phase. c. supplement the diet with vitamin B6, calcium, and magnesium. d. limit exercise and physical activity when symptoms are present.

C

Following the teaching of foot care to a patient with diabetes, the nurse determines that additional instruction is needed when the patient makes which statement? a. "I should wash my feet daily with soap and warm water." b. "I should always wear shoes to protect my feet from injury." c. "If my feet are cold, I should wear socks instead of using a heating pad." d. "I'll know if I have sores or lesions on my feet because they will be painful."

D

In addition to promoting the transport of glucose from the blood into the cell, what does insulin do? a. Enhances the breakdown of adipose tissue for energy b. Stimulates hepatic glycogenolysis and gluconeogenesis c. Prevents the transport of triglycerides into adipose tissue d. Increases amino acid transport into cells and protein synthesis

D

SLNB is planned for a patient undergoing a modified radical mastectomy for breast cancer. What does the nurse teach the patient and her family about the purpose of this specific procedure? a. SLNB provides metastatic lymph nodes to test for responsiveness to chemotherapy. b. If cancer cells are found in any sentinel nodes, a complete axillary lymph node dissection will be done. c. If 1 sentinel lymph node is positive for malignant cells, all the sentinel lymph nodes will be removed. d. A radioisotope shows which lymph nodes are most likely to have metastasis, and all those nodes are removed.

D

The home care nurse should intervene to correct a patient whose insulin administration includes : a. warming a prefilled refrigerated syringe in the hands before administration. b. storing syringes prefilled with NPH and regular insulin needle-up in the refrigerator. c. placing the insulin bottle currently in use in a small container on the bathroom countertop. d. mixing an evening dose of regular insulin with insulin glargine in 1 syringe for administration.

D

The patient with type 2 diabetes has had trouble controlling his blood glucose with several OAs but wants to avoid the risks of insulin. The health care provider (HCP) told him a medication will be prescribed that will increase insulin synthesis and release from the pancreas, inhibit glucagon secretion, and slow gastric emptying. Which medication will have to be injected? a. Dopamine receptor agonist, bromocriptine (Cycloset) b. Dipeptidyl peptidase-4 (DPP-4) inhibitor, sitagliptin (Januvia) c. Sodium-glucose co-transporter 2 (SGLT2) inhibitor, canagliflozin (Invokana) d. Glucagon-like peptide-1 receptor agonist, exenatide extended release (Bydureon)

D

What accurately demonstrates that hormones of one gland influence the function of hormones of another gland? a. Increased insulin levels inhibit the secretion of glucagon. b. Increased cortisol levels stimulate the secretion of insulin. c. Increased testosterone levels inhibit the release of estrogen. d. Increased atrial natriuretic peptide (ANP) levels inhibit the secretion of aldosterone.

D

What assessment findings are common in a patient with a prolactinoma? a. Gynecomastia in men b. Profuse menstruation in women c. Excess follicle-stimulating hormone (FSH) and luteinizing hormone (LH) d. Signs of increased intracranial pressure, including headache, nausea, and vomiting

D

What is an explanation that the nurse should give to the wife of the patient who asks what her husband's diagnosis of paraphimosis means? a. Painful, prolonged erection b. Inflammation of the epididymis c. Painful downward curvature of an erect penis d. Retracted tight foreskin preventing return over the glans

D

When replacement therapy is started for a patient with long-standing hypothyroidism, what is most important for the nurse to monitor for in the patient? a. Insomnia b. Weight loss c. Nervousness d. Dysrhythmias

D

Which patient has the highest risk of breast cancer? a. 60-year-old obese man b. 58-year-old woman with sedentary lifestyle c. 55-year-old woman with fibrocystic breast changes d. 65-year-old woman with a sister diagnosed with breast cancer

D

Why should the nurse encourage serologic testing for human immunodeficiency virus (HIV) in the patient with syphilis? a. Syphilis is harder to treat in patients with HIV infection. b. The presence of HIV infection increases the risk of contracting syphilis. c. Central nervous system (CNS) involvement is common in patients with HIV infection and syphilis. d. The incidence of syphilis is increased in those with high rates of indiscriminate sexual activity and drug use.

D

A patient is seeking medical intervention for ED. Why should he be thoroughly evaluated? a. It is important to determine if ED is reversible before treatment is started. b. Psychologic counseling can reverse the problem in 80% to 90% of the cases. c. Most treatments for ED are contraindicated in patients with systemic diseases. d. New invasive and experimental techniques currently used have unknown risks.

A

A patient with diabetes calls the clinic because she has nausea and flu-like symptoms. Which advice from the nurse will be the best for this patient? a. Administer the usual insulin dosage. b. Hold fluid intake until the nausea subsides. c. Come to the clinic immediately for evaluation and treatment. d. Monitor the blood glucose every 1 to 2 hours and call if it rises over 150 mg/dL (8.3 mmol/L).

A

Two days after a self-managed hypoglycemic episode at home, the patient tells the nurse that his blood glucose levels since the episode have been between 80 and 90 mg/dL. Which is the best response by the nurse? a. "That is a good range for your glucose levels." b. "You should call your HCP because you need to have your insulin increased." c. "That level is too low in view of your recent hypoglycemia and you should increase your food intake." d. "You should take only half your insulin dosage for the next few days to get your glucose level back to normal."

A

What preoperative instruction should the nurse give to the patient scheduled for a subtotal thyroidectomy? a. How to support the head with the hands when turning in bed b. Coughing should be avoided to prevent pressure on the incision c. Head and neck will have to remain immobile until the incision heals d. Any tingling around the lips or in the fingers after surgery is expected and temporary

A

A patient has been diagnosed with hypoparathyroidism. What manifestations should the nurse expect to observe (select all that apply)? a. Skeletal pain b. Dysrhythmias c. Dry, scaly skin d. Personality changes e. Abdominal cramping f. Muscle spasms and stiffness

A, C, D, E, F

The patient with diabetes has a blood glucose level of 248 mg/dL. Which assessment findings would be related to this blood glucose level (select all that apply)? a. Headache b. Unsteady gait c. Abdominal cramps d. Emotional changes e. Increase in urination f. Weakness and fatigue

A, C, E, F

The nurse has identified the nursing diagnosis of fatigue for a patient with hypothyroidism. What should the nurse do while caring for this patient? a. Assess for changes in orientation, cognition, and behavior. b. Monitor for vital signs and cardiac rhythm response to activity. c. Monitor bowel movement frequency, consistency, shape, volume, and color. d. Help in developing well-balanced meal plans consistent with energy expenditure level.

B

The nurse is assessing a newly admitted patient with diabetes. Which observation should be addressed as the priority by the nurse? a. Bilateral numbness of both hands b. Rapid respirations with deep inspiration c. Stage II pressure injury on the right heel d. Areas of lumps and dents on the abdomen

B

When teaching the patient with diabetes about insulin administration, the nurse should include which instruction? a. Pull back on the plunger after inserting the needle to check for blood. b. Consistently use the same size of insulin syringe to avoid dosing errors. c. Clean the skin at the injection site with an alcohol swab before each injection. d. Rotate injection sites from arms to thighs to abdomen with each injection to prevent lipodystrophies.

B

When the patient with parathyroid disease has symptoms of hypocalcemia, what is a measure that can be used to temporarily raise serum calcium levels? a. Administer IV normal saline. b. Have patient rebreathe in a paper bag. c. Administer oral phosphorus supplements. d. Administer furosemide (Lasix) as ordered.

B

During the immediate postoperative period after a modified radical mastectomy, the nurse initially institutes which exercises for the affected arm? a. Have the patient brush or comb her hair with the affected arm. b. Perform full passive range-of-motion (ROM) exercises to the affected arm. c. Ask the patient to flex and extend the fingers and wrist of the operative side. d. Have the patient crawl her fingers up the wall, raising her arm above her head.

C

What describes hypospadias? a. Scrotal lymphedema b. Undescended testicle c. Ventral urinary meatus d. Inflammation of the prepuce

C

A patient with Graves' disease asks the nurse what caused the disorder. What is the best response by the nurse? a. "The cause of Graves' disease is not known, although it is thought to be genetic." b. "It is usually associated with goiter formation from an iodine deficiency over a long period." c. "Antibodies develop against thyroid tissue and destroy it, causing a deficiency of thyroid hormones." d. "In genetically susceptible persons, antibodies are formed that cause excessive thyroid hormone secretion."

D

The nurse determines that a patient with a 2-hour OGTT of 152 mg/dL has a. diabetes. b. elevated A1C. c. impaired fasting glucose. d. impaired glucose tolerance.

D

What characteristic is related to Hashimoto's thyroiditis? a. Enlarged thyroid gland b. Viral-induced hyperthyroidism c. Bacterial or fungal infection of thyroid gland d. Chronic autoimmune thyroiditis with antibody destruction of thyroid tissue

D

What differentiates chronic bacterial prostatitis from acute prostatitis? a. Postejaculatory pain b. Frequency, urgency, and dysuria c. Symptoms of a urinary tract infection (UTI) d. Most common reason for recurrent UTIs in adult men

D

What is most important for the nurse to teach the female patient with genital warts? a. Have an annual Papanicolaou (Pap) test. b. Apply topical acyclovir faithfully as directed. c. Have her sexual partner treated for the condition. d. Use a contraceptive to prevent pregnancy, which may worsen the disease.

A

Which stage of syphilis is identified by the absence of clinical manifestations and a positive fluorescent treponemal antibody absorption (FTA-Abs) test? a. Latent b. Primary c. Secondary d. Late (tertiary)

A

The patient with type 2 diabetes is being put on acarbose (Precose) and wants to know about taking it. What should the nurse include in this patient's teaching (select all that apply)? a. Take it with the first bite of each meal. b. It is not used in patients with heart failure. c. Endogenous glucose production is decreased. d. Effectiveness is measured by 2-hour postprandial glucose. e. It delays glucose absorption from the gastrointestinal (GI) tract.

A, D, E

A 22-year-old woman with multiple sexual partners seeks care after several weeks of having painful and frequent urination and vaginal discharge. Although the results of a culture of cervical secretions are not yet available, the nurse explains to the patient that she will be treated as if she has gonorrhea and chlamydia to prevent a. damage to the fallopian tubes. b. endocarditis and aortic aneurysms. c. disseminated gonococcal infection. d. polyarthritis and generalized adenopathy.

A

A 47-year-old patient who has hypogonadism has decided to try the testosterone gel Testim. What should the nurse teach the patient and his wife about this gel? a. Wash the hands with soap and water after applying it. b. His wife should apply it to help him feel better about using it. c. Do not wear clothing over the area until it has been absorbed. d. The gel may be taken buccally if it is not effective on the abdomen.

A

A 72-year-old woman is diagnosed with diabetes. What does the nurse recognize about managing diabetes in the older adult? a. It is harder to achieve strict glucose control than in younger patients. b. Treatment is not warranted unless the patient develops severe hyperglycemia. c. It does not include treatment with insulin because of limited dexterity and vision. d. It usually requires that a younger family member be responsible for care of the patient.

A

A couple seeks assistance from an infertility specialist for an evaluation of infertility. What does the nurse inform the couple they can expect during the initial visit? a. Physical and psychosocial functioning examinations b. Assessment of tubal patency with a hysterosalpingogram c. Pelvic ultrasound for the woman and semen analysis for the man d. Postcoital testing to evaluate sperm numbers and motility in cervical and vaginal secretions

A

A patient with a positive breast biopsy tells the nurse that she read about tamoxifen on the Internet and asks about its use. The best response by the nurse includes which information? a. Tamoxifen is the treatment of choice if the tumor has receptors for estrogen on its cells. b. Tamoxifen is the primary treatment for breast cancer if axillary lymph nodes are positive for cancer. c. Tamoxifen is used only to prevent the development of new primary tumors in women with high risk for breast cancer. d. Because tamoxifen has been shown to increase the risk for uterine cancer, it is used only when other treatment has not been successful.

A

A patient with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. The nurse determines that additional teaching is needed when the patient does what? a. Withdraws the NPH dose into the syringe first b. Injects air equal to the NPH dose into the NPH vial first c. Removes any air bubbles after withdrawing the first insulin d. Adds air equal to the insulin dose into the regular vial and withdraws the dose

A

As a precaution for vocal cord paralysis from damage to the superior laryngeal nerve during thyroidectomy surgery, what is the most important equipment to have in the room in case it is needed for this emergency situation? a. Tracheostomy tray b. Oxygen equipment c. IV calcium gluconate d. Paper and pencil for communication

A

During assessment of the patient with vulvar cancer, what should the nurse expect to find? a. Soreness and itching of the vulva b. Labial lesions with purulent exudate c. Severe excoriation of the labia and perineum d. Painless, firm nodules embedded in the labia

A

During care of the patient with SIADH, what should the nurse do? a. Monitor neurologic status at least every 2 hours. b. Teach the patient receiving diuretic therapy to restrict sodium intake. c. Keep the head of the bed elevated to prevent antidiuretic hormone (ADH) release. d. Notify the health care provider (HCP) if the patient's BP decreases more than 20 mm Hg from baseline.

A

In a patient with an elevated serum cortisol, what should the nurse expect other laboratory findings to reveal? a. Hypokalemia b. Hyponatremia c. Hypoglycemia d. Decreased serum triglycerides

A

Patients with which STI are most likely to avoid obtaining and following treatment measures for their infection? a. Syphilis b. Gonorrhea c. HPV infection d. Genital herpes

A

The best prognosis is indicated in the patient with breast cancer when diagnostic studies reveal a. negative axillary lymph nodes. b. aneuploid DNA tumor content. c. cells with high S-phase fractions. d. an estrogen receptor-and progesterone receptor-negative tumor.

A

The extent of urinary obstruction caused by BPH can be determined by which diagnostic study? a. Uroflowmetry b. A cystometrogram c. Transrectal ultrasound d. Postvoiding catheterization

A

The laboratory result of a specimen from a patient is positive for fluorescent treponemal antibodies (FTA). What would the nurse expect the patient's diagnosis to be? a. Syphilis b. Gonorrhea c. Genital warts d. Genital herpes

A

To prepare a woman who has been raped for physical examination, what should the nurse do first? a. Ensure that a signed informed consent is obtained from the patient. b. Provide a private place for the patient to talk about what happened to her. c. Instruct the patient not to wash, eat, drink, or urinate before the examination. d. Administer prophylaxis for sexually transmitted infections (STIs) and tetanus.

A

To prevent hyperglycemia or hypoglycemia related to exercise, what should the nurse teach the patient using glucose-lowering agents about the best time for exercise? a. Plan activity and food intake related to blood glucose levels b. When blood glucose is greater than 250 mg/dL and ketones are present c. When glucose monitoring reveals that the blood glucose is in the normal range d. When blood glucose levels are high, because exercise always has a hypoglycemic effect

A

When teaching a patient with problems of pelvic support to perform Kegel exercises, what should the nurse tell the patient to do? a. Contract the muscles used to stop rectal gas expulsion. b. Tighten the lower abdominal muscles over the bladder area. c. Squeeze all of the perineal muscles as if trying to close the vagina. d. Lie on the floor and do leg lifts to strengthen the abdominal muscles.

A

Which manifestations of menopause are related to estrogen deficiency (select all that apply)? a. Cessation of menses b. Breast engorgement c. Vasomotor instability d. Reduction of bone fractures e. Decreased cardiovascular risk

A, C

A 56-year-old patient is undergoing a mammoplasty for breast reconstruction following a mastectomy 1 year ago. During the preoperative preparation of the patient, what is important for the nurse to do? a. Determine why the patient is choosing reconstruction surgery rather than the use of an external prosthesis. b. Ensure that the patient has realistic expectations about the outcome and complications of the surgery. c. Inform the patient that implants used for breast reconstruction have been shown to cause immune-related diseases. d. Let the patient know that, although the shape will be different from the other breast, the nipple can be reconstructed from other erectile tissue.

B

A patient with hypothyroidism is treated with levothyroxine (Synthroid). What should the nurse include when teaching the patient about this therapy? a. Explain that alternate-day dosage may be used if side effects occur. b. Provide written instruction for all information related to the drug therapy. c. Tell the patient that the drug must be taken until the hormone balance is reestablished. d. Assure the patient that a return to normal function will occur with replacement therapy.

B

In type 1 diabetes, glucose has an osmotic effect when insulin deficiency prevents the use of glucose for energy. Which classic symptom is caused by the osmotic effect of glucose? a. Fatigue b. Polydipsia c. Polyphagia d. Recurrent infections

B

A patient is admitted to the hospital with a diagnosis of Cushing syndrome. On physical assessment of the patient, what should the nurse expect to find? a. Hypertension, peripheral edema, and petechiae b. Weight loss, buffalo hump, and moon face with acne c. Abdominal and buttock striae, truncal obesity, and hypotension d. Anorexia, signs of dehydration, and hyperpigmentation of the skin

A

Which cancer is associated with intrauterine exposure to diethylstilbestrol (DES) or metastasis from another gynecologic cancer? a. Vaginal b. Ovarian c. Cervical d. Endometrial

A

The patient with diabetes is brought to the emergency department by his family members, who say that he has had an infection, is not acting like himself, and he is more tired than usual. Number the nursing actions in the order of priority for this patient. _______ a. Establish IV access. _______ b. Check blood glucose. _______ c. Ensure patent airway. _______ d. Begin continuous regular insulin drip. _______ e. Administer 0.9% NaCl solution at 1 L/hr. _______ f. Establish time of last food and medication(s).

3, 2, 1, 5, 4, 6

A nurse working in an outpatient clinic plans a screening program for diabetes. What recommendations for screening should be included? a. OGTT for all minority populations every year b. FPG for all persons at age 45 years and then every 3 years c. Testing people under the age of 21 years for islet cell antibodies d. Testing for type 2 diabetes in all overweight or obese persons

B

What should the goals of nutrition therapy for the patient with type 2 diabetes include? a. Ideal body weight b. Normal serum glucose and lipid levels c. A special diabetic diet using dietetic foods d. Five small meals per day with a bedtime snack

B

A patient with a stage 0 cervical cancer identified from a Papanicolaou (Pap) test asks the nurse what this finding means. The nurse's response should include which information? a. Atypical cells characteristic of inflammation are present. b. Cancer cells have extended beyond the cervix to the upper vagina. c. Cancer cells are present and are confined to the epithelial layer of the cervix. d. This is a common finding on Pap testing, and she will be examined often to see if the abnormal cells spread beyond the cervix.

C

A patient with diabetes insipidus is treated with nasal desmopressin acetate (DDAVP). The nurse determines that the drug is not having an adequate therapeutic effect when the patient experiences a. headache and weight gain. b. nasal irritation and nausea. c. a urine specific gravity of 1.002. d. an oral intake greater than urinary output.

C

A patient with hypoparathyroidism from surgical treatment of hyperparathyroidism is preparing for discharge. What should the nurse teach the patient? a. Milk and milk products should be increased in the diet. b. Parenteral replacement of parathyroid hormone will be needed for life. c. Calcium supplements with vitamin D can effectively maintain calcium balance. d. Bran and whole-grain foods should be used to prevent gastrointestinal (GI) effects of replacement therapy.

C

Any patient undergoing gynecologic surgery may need assistance in coping with a disturbed body image. With which surgery will this most likely be expected to occur? a. Vaginectomy b. Hemivulvectomy c. Pelvic exenteration d. Radical hysterectomy

C

During assessment of the patient with acromegaly, what should the nurse expect the patient to report? a. Infertility b. Dry, irritated skin c. Undesirable changes in appearance d. An increase in height of 2 to 3 inches a year

C

The nurse should observe the patient for symptoms of ketoacidosis when : a. illnesses causing nausea and vomiting lead to bicarbonate loss with body fluids. b. glucose levels become so high that osmotic diuresis promotes fluid and electrolyte loss. c. an insulin deficit causes the body to metabolize large amounts of fatty acids rather than glucose for energy. d. the patient skips meals after taking insulin, leading to rapid metabolism of glucose and breakdown of fats for energy.

C

The patient at the urgent care facility reports a fishy smell of her vaginal discharge. What does the nurse suspect will be diagnosed? a. Cervicitis b. Trichomoniasis c. Bacterial vaginosis d. Vulvovaginal candidiasis

C

When caring for a patient after a radical prostatectomy with a perineal approach, what is the priority nursing intervention the nurse should use to prevent complications? a. Use chemotherapy to prevent metastasis. b. Administer sildenafil (Viagra) as needed for erectile dysfunction (ED). c. Provide wound care after each bowel movement to prevent infection. d. Insert a smaller indwelling urinary catheter to prevent urinary retention.

C

Which endocrine gland secretes cortisol in a diurnal pattern? a. Ovaries b. Thyroid c. Adrenal cortex d. Adrenal medulla

C

Which therapies for BPH are done on an outpatient basis (select all that apply)? a. Intraprostatic urethral stents b. TUNA c. Photovaporization of the prostate (PVP) d. Transurethral incision of prostate (TUIP) e. TUMT

B, C, D, E

What are characteristics of HSV infection (select all that apply)? a. Treatment with acyclovir can cure genital herpes. b. Herpes simplex virus type 2 (HSV-2) is capable of causing only genital lesions. c. Recurrent symptomatic genital herpes may be precipitated by sexual activity and stress. d. To prevent transmission of genital herpes, condoms should be used when lesions are present. e. The primary symptom of genital herpes is painful vesicular lesions that rupture and ulcerate.

C, E

A patient who recently had a calcium oxalate renal stone had a bone density study, which showed a decrease in her bone density. What endocrine problem could this patient have? a. SIADH b. Hypothyroidism c. Cushing syndrome d. Hyperparathyroidism

D

What is the most common screening intervention for detecting BPH in men over age 50 years? a. Prostate-specific antigen (PSA) level b. Urinalysis c. Cystoscopy d. Digital rectal examination

D

Which characteristics most accurately describe the use of RAI (select all that apply)? a. Decreases release of thyroid hormones b. Often causes hypothyroidism over time c. Blocks peripheral conversion of T4 to T3 d. Treatment of choice in nonpregnant adults e. Often used with iodine to produce euthyroid before surgery f. Decreases thyroid hormone secretion by damaging thyroid gland

B, D, F

What characterizes type 2 diabetes (select all that apply)? a. β-cell exhaustion b. Insulin resistance c. Genetic predisposition d. Altered production of adipokines e. Inherited defect in insulin receptors f. Inappropriate glucose production by the liver

A, B, C, D, E, F

Which factors are associated with endometrial cancer (select all that apply)? a. Obesity b. Smoking c. Family history d. Early sexual activity e. Early menarche and late menopause f. Unopposed estrogen-only replacement therapy

A, B, E, F

A patient with acromegaly is treated with a transsphenoidal hypophysectomy. What should the nurse do postoperatively? a. Ensure that any clear nasal drainage is tested for glucose and protein. b. Maintain the patient flat in bed to prevent cerebrospinal fluid (CSF) leakage. c. Aid the patient with tooth brushing every 4 hours to keep the surgical area clean. d. Encourage deep breathing, coughing, and turning to prevent respiratory complications.

A

Individualized nutrition therapy for patients using conventional, fixed insulin regimens should include teaching the patient to a. eat regular meals at regular times. b. restrict calories to promote moderate weight loss. c. eliminate sucrose and other simple sugars from the diet. d. limit saturated fat intake to 30% of dietary calorie intake.

A

What are 2 effects of hypokalemia on the endocrine system? a. Decreased insulin and aldosterone release b. Decreased glucagon and increased cortisol release c. Decreased release of ANP and increased ADH release d. Decreased release of parathyroid hormone and increased calcitonin release

A

A patient has a low serum T3 level. The health care provider (HCP) orders measurement of the TSH level. If the TSH level is elevated, what does this indicate? a. The cause of the low T3 level is most likely primary hypothyroidism. b. The negative feedback system is failing to stimulate the anterior pituitary gland. c. The patient has an underactive thyroid gland that is not receiving TSH stimulation. d. A tumor on the anterior pituitary gland that is causing increased production of TSH.

A

What is an appropriate outcome for a patient who undergoes an anterior colporrhaphy? a. Maintain normal bowel patterns b. Adjust to temporary ileal conduit c. Urinate within 8 hours postoperatively d. Have healing of excoriated vaginal and vulvar tissue

A

What is the effect of finasteride (Proscar) in the treatment of BPH? a. A reduction in the size of the prostate gland b. Relaxation of the smooth muscle of the urethra c. Increased bladder tone that promotes bladder emptying d. Relaxation of the bladder detrusor muscle promoting urine flow

A

A patient is diagnosed and treated for a Gardnerella vaginalis infection at a clinic. For her treatment to be effective, what does the nurse tell the patient? a. Her sexual partner should be examined and treated. b. Her sexual partner must use a condom during intercourse. c. She should wear pads to prevent reinfection as long as she has vaginal drainage. d. A vaginal suppository should be used in the morning so that it will fight the infection all day.

A

A patient undergoing a modified radical mastectomy for cancer of the breast is going to use tissue expansion and an implant for breast reconstruction. What should the nurse teach the patient about tissue expansion? a. Injections of sterile saline into the expander will be needed over weeks to months. b. The expander cannot be placed until healing from the mastectomy is complete. c. This method of breast reconstruction uses the patient's own tissue to replace breast tissue. d. The nipple from the affected breast will be saved to be grafted onto the reconstructed breast.

A

A patient is admitted to the hospital with acute thyrotoxicosis. On physical assessment of the patient, what should the nurse expect to find? a. Hoarseness and laryngeal stridor b. Bulging eyeballs and dysrhythmias c. Increased temperature and signs of heart failure d. Lethargy progressing suddenly to impaired consciousness

C

A 51-year-old woman suffered a wrist fracture when she slipped on the ice. She has her uterus and is interested in starting hormone replacement therapy (HRT), as she is having menopause symptoms. What should the nurse include when discussing the risks and benefits of HRT with this patient? a. Taking only progesterone is suggested for a woman with a uterus. b. Taking both estrogen and progesterone may decrease her bone loss. c. The risk of breast cancer and cardiovascular disease is decreased with HRT. d. Taking estrogen and progesterone will increase the risk of endometrial cancer.

B

A female patient returns to the clinic with a recurrent urethral discharge after being treated for a chlamydial infection 2 weeks ago. Which statement by the patient indicates the most likely cause of the recurrence of her infection? a. "I took the doxycycline twice a day for a week." b. "I haven't told my boyfriend about my infection yet." c. "I had a couple of beers while I was taking the medication." d. "I've only had sexual intercourse once since I finished the medication."

B

A patient has been diagnosed with ovarian cancer. In planning care for the patient, the nurse recognizes that treatment of the patient depends on what? a. Results of a direct-needle biopsy of the ovary b. Results of a laparotomy with multiple biopsies c. Whether the patient desires to maintain fertility d. The findings of metastasis by ultrasound or CT scan

B

A patient with Addison's disease comes to the ED with reports of nausea, vomiting, diarrhea, and fever. What interprofessional care should the nurse expect? a. IV administration of vasopressors b. IV administration of hydrocortisone c. IV administration of D5W with 20 mEq KCl d. Parenteral injections of adrenocorticotropic hormone (ACTH)

B

A patient with a 10-week pregnancy is admitted to the emergency department (ED) with vaginal bleeding and abdominal cramping. What does the nurse recognize about this situation? a. The patient will require a blood transfusion. b. The patient is most likely having a spontaneous abortion. c. The patient must undergo an immediate dilation and curettage (D&C). d. Placing the patient on bed rest is usually successful in preventing further bleeding.

B

A patient with continuous bladder irrigation after a prostatectomy tells the nurse that he has bladder spasms and leaking of urine around the catheter. What should the nurse do first? a. Slow the rate of the irrigation. b. Assess the patency of the catheter. c. Encourage the patient to try to urinate around the catheter. d. Administer a belladonna and opium (B&O) suppository as prescribed.

B

A patient with newly diagnosed type 2 diabetes has been given a prescription to start an oral hypoglycemic medication. The patient tells the nurse she would rather control her blood sugar with herbal therapy. Which action should the nurse take? a. Teach the patient that herbal therapy is not safe and should not be used. b. Advise the patient to discuss using herbal therapy with her HCP before using it. c. Encourage the patient to give the prescriptive medication time to work before using herbal therapy. d. Teach the patient that if she takes herbal therapy, she will have to monitor her blood sugar more often.

B

14. Common nonspecific manifestations that may alert the nurse to endocrine dysfunction include a. goiter and alopecia. b. exophthalmos and tremors. c. weight loss, fatigue, and depression. d. polyuria, polydipsia, and polyphagia.

C

A 20-year-old woman is a college softball player who participates in strenuous practices and a heavy class schedule. She is describing an absence of menses. What could be contributing to her amenorrhea? a. Decreased sexual activity b. Excess prostaglandin production c. Strenuous exercise or elevated stress d. Endometrial cancer or uterine fibroids

C

A 55-year-old man with a history of prostate cancer in his family asks the nurse what he can do to decrease his risk of prostate cancer. What should the nurse teach him about prostate cancer risks? a. Nothing can decrease the risk because prostate cancer is primarily a disease of aging. b. Treatment of any enlargement of the prostate gland will help prevent prostate cancer. c. Substituting fresh fruits and vegetables for high-fat foods in the diet may lower the risk of prostate cancer. d. Using a natural herb, such as saw palmetto, has been found to be an effective protection against prostate cancer.

C

A couple has not conceived using at-home ovulation testing with basal body temperature. What therapy would most likely be used next to treat this infertile couple? a. Surgery to reduce endometriosis b. Intrauterine insemination with sperm from the husband c. Selective estrogen receptor modulator (clomiphene [Clomid]) d. Assisted reproductive technologies (e.g., in vitro fertilization [IVF])

C

Which tissues require insulin to enable movement of glucose into the tissue cells (select all that apply)? a. Liver b. Brain c. Adipose d. Blood cells e. Skeletal muscle

C, E

Which characteristics describe an intraductal papilloma (select all that apply)? a. Associated with breast trauma b. Occurs in 10% of women ages 15 to 40 years c. Is more common in women ages 30 to 50 years d. Has multicolored, sticky nipple discharge e. Is associated with an increased cancer risk f. Has wartlike growth in mammary ducts near nipple

C, E, F

During evaluation and treatment of gonorrhea in a young man at the health clinic, what is it most important for the nurse to question the patient? a. A prior history of STIs b. When the symptoms began c. The date of his last sexual activity d. The names of his recent sexual partners

D

During the physical assessment of a female patient with human papilloma virus (HPV) infection, what should the nurse expect to find? a. Purulent vaginal discharge b. Painful perineal vesicles and ulcerations c. A painless, indurated lesion on the vulva d. Multiple coalescing gray warts in the perineal area

D