Exam #2: Prep Quiz
The nurse is explaining diabetes insipidus (DI) to a client with the disorder. The nurse should note that the symptoms related to this disorder are related to a deficiency in which hormone? 1) antidiuretic hormone (ADH) 2) insulin 3) growth hormone 4) thyroxin
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Which drug can be used to manage the pain of a patient with cholecystitis? 1) Toradol. 2) Metoprolol. 3) Nitroglycerine. 4) Glucophage.
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The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which complication should the nurse expect in this patient? 1) Seizures 2) Dehydration 3) Hypoglycemia 4) Hypertensive crisis
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The nurse formulating a discharge plan for a client with Addison's disease should place the highest emphasis on the importance of 1) teaching him how to cope with a chronic disease. 2) compliance with replacement therapy. 3) prevention of the complication of hypertension. 4) weight control.
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Mr. D. is admitted to the E.R. with a positive Chvostek's sign and lab findings of a low serum calcium and high serumphosphorus. Which of the following would you expect to be included in his emergency treatment? 1) Calcium gluconate I.V. to elevate calcium levels. 2) Hyperventilation to achieve mild respiratory alkalosis. 3) Calcitonin to increase PTH (parathyroid hormone) secretion. 4) Hydrocortisone to prevent laryngeal spasm.
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The nurse is reviewing laboratory data for a client with Cushing's syndrome. Which of the following laboratory abnormalities might the nurse expect to see? 1) Hyperglycemia and hypokalemia. 2) Leukopenia and anemia. 3) Hypercalcemia and hypoglycemia. 4) Hyperproteinemia and hyponatremia.
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Which of the following is the reason for the increased incidence of angina pectoris/myocardial infarction as a response to therapy for myxedema? 1) With therapy, metabolism is speeded up and the blood supply cannot meet the increased demand. 2) With therapy, atherosclerotic plaques dislodge from veins and obstruct the coronary arteries. 3) Serum cholesterol becomes severely depressed with increased metabolism. 4) With therapy, metabolism becomes subnormal and there is a reduction in blood sup
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A 24-year-old man was exposed to hepatitis A after eating in a fast-food restaurant. Which drug should be given to the man the day following exposure? 1) Immune globulin. 2) Hepatitis antigens. 3) Acyclovir. 4) Hepatitis A vaccine.
1 If you need to, you should review the different types of immunity: passive natural; passive artificial (such as immune globulin); active natural; and active artificial.
A 61-year-old male is admitted to your unit with the diagnosis of upper gastrointestinal bleeding. He has a history of alcohol abuse and prior gastrointestinal bleeding. His abdomen is distended and his liver is enlarged. He has no complaints of pain. His vomitus is bright red in color. What condition is most likely to be present? 1) Diverticula 2) Esophageal varices 3) Duodenal ulcers. 4) Colonic varices
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A 67-year-old male is admitted with complaints of generalized fatigue and weakness. His abdomen is distended with ascites present, producing shortness of breath. The liver is hard but not enlarged. Spider angiomas are noted on his chest and he has atrophied skeletal muscles. Sclera have an icteric appearance. Which condition is most likely to be responsible for the symptoms? 1. Acute hepatitis B. 2. Cirrhosis. 3. Esophageal varices. 4. Hepatorenal syndrome.
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Bilirubin becomes elevated to produce jaundice. Bilirubin levels rise when which of the following occurs? 1) Rate of red cell destruction decreases. 2) Flow of bile from liver is blocked. 3) Removal of gall bladder. 4) Large amounts of proteins are ingested.
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Cholestyramine (Questran) is prescribed for a 51-year-old female patient with cholelithiasis that has resulted in obstructive jaundice. The nurse knows that in order to administer Questran, it should be given 1. with a small amount of food. 2. by mixing it with fruit juice. 3. via a rectal suppository. 4. with at least 8 oz of water.
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The nurse is caring for a 70-year-old woman with acute pancreatitis. What is the most likely serious complication to develop in this patient? 1) Hematuria. 2) Pleural effusion. 3) Steatorrhea. 4) Obstructive jaundice.
2 People with pancreatitis must be monitored for lung complications that might be life threatening. The nurse must know also to watch for bleeding that results from severe inflammation and autodigestion of the pancreas. Also keep in mind that in a diseased pancreas the Isles of Langerhans are affected resulting in decreased insulin production and hyperglycemia. The patients are very ill and need close monitoring.
A client with hyperparathyroidism has recently been admitted to the nursing unit. The nursing diagnosis, "Altered Urinary Elimination," has been assigned to the client. Which nursing intervention should be implemented to address this diagnosis? 1) Encourage the client to start and stop the urinary stream. 2) Do not administer fluids with meals. 3) Encourage fluids. 4) Withhold acidic juices in the diet.
3 Patients with hyperparathyroidism are at risk for development of kidney stones from increased serum calcium level. High levels of calcium tend to cause precipitates in the kidney to form. By forcing fluids the nurse can help decrease the chance of this occuring. But remember that anytime we force or encourage fluids, we have to be sure to assess CV status. Increased fluids for some patients can be dangerous.
A nurse caring for a patient taking chenodeoxycholic acid should observe the patient for which common side effect of this drug? 1. Constipation. 2. Clay-colored stools. 3. Black, tarry stools. 4. Diarrhea.
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Mrs. A. is a 35-year-old housewife admitted with hyperthyroidism (Graves Disease). Which of the following dynamics would explain the manifestations of hyperthyroidism? 1) Muscular weakness and wasting of muscular mass related to a negative nitrogen balance. 2) Diarrhea related to an increase in peristaltic activity. 3) Heat intolerance related to increased metabolic activity. 4) All of the above.
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A 54-year-old female is admitted with complaints of abdominal distention, pitting edema, and black stools. Her arms and legs are thin compared to the rest of her body. She has generalized jaundice. Which disease process is most likely the cause of these signs and symptoms? 1) Portal systemic encephalopathy. 2) Acute hepatitis. 3) Biliary obstruction. 4) Cirrhosis of the liver.
4 Be sure that you know the difference between acute and chronic hepatitis and cirrhosis in relation to manifestations, complications, and prognosis. When you are answering questions such as these, a good approach is to eliminate answers that do not match data in the stem. Identify key words in the stem that you must consider when choosing an option. Note that jaundice may be a sign of each of the disorders so that piece of information will not be helpful in helping you narrow down the possibilities. The other key words will point you in the right direction. Note also that signs of malnutrition such as thin arms and legs are usually not present in an acute disorder. Be sure and analyze the stem and answers carefully, but don't read information into the question that is not there.
A patient is being treated with desmopression acetate (DDAVP) for diabetes insipidus (DI). The nurse should do what? 1) Assess intake and output very carefully. 2) Watch for water intoxication and hyponatremia. 3) Be concerned that intake does not exceed output. 4) All of the above.
4 When a person has DI it is important to assess intake and output carefully. We would expect output to exceed input and dehydration in the untreated individual. But once treatment is begun, it is important to continue to monitor I&O. - and then to watch for increased effects of the DDAVP which could include the opposite of manifestations we would see with DI. So we need to watch for retention of water and hyponatremia. We would also need to watch for signs that the DDAVP is NOT working - which would be a continuation or worsening of manifestations of DI - hypernatremia, dehydration, polydypsia and polyuria.
