Kidney, Male reproductive, Diabetes
A diabetes nurse educator is teaching a group of clients with type 1 diabetes about "sick day rules." What guideline applies to periods of illness in a diabetic client? Select one: a. Eat three substantial meals a day, if possible. b. Do not eliminate insulin when nauseated and vomiting. c. Reduce food intake and insulin doses in times of illness. d. Report elevated glucose levels greater than 150 mg/dL (8.3 mmol/L).
b
A nurse is amending a client's plan of care in light of the fact that the client has recently developed ascites. What should the nurse include in this client's care plan? Select one: a. Administration of beta-adrenergic blockers as prescribed b. Administration of diuretics as prescribed c. Vitamin B12 injections as prescribed d. Mobilization with assistance at least 4 times daily
b
A client with ESKD receives continuous ambulatory peritoneal dialysis. The nurse observes that the dialysate drainage fluid is cloudy. What is the nurse's most appropriate action? Select one: a. Flush the peritoneal catheter with normal saline. b. Inform the health care provider and assess the client for signs of infection. c. Administer a bolus of IV normal saline as prescribed. d. Remove the catheter promptly and have the catheter tip cultured.
b
A nurse is assessing a client who has been diagnosed with cholecystitis, and is experiencing localized abdominal pain. When assessing the characteristics of the client's pain, the nurse should anticipate that it may radiate to what region? Select one: a. Left upper chest b. Right shoulder c. Neck or jaw d. Inguinal region
b
A nurse is caring for a client with a blocked bile duct from a tumor. What manifestation of obstructive jaundice should the nurse anticipate? Select one: a. Watery, blood-streaked diarrhea b. Decreased cognition c. Orange and foamy urine d. Increased abdominal girth
c
A client with type 2 diabetes normally achieves adequate glycemic control through diet and exercise. Upon being admitted to the hospital for a cholecystectomy, however, the client has required insulin injections on two occasions. The nurse would identify what likely cause for this short-term change in treatment? Select one: a. The client has likely overestimated her ability to control her diabetes using nonpharmacologic measures. b. Stress has likely caused an increase in the client's blood sugar levels. c. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars. d. Alterations in bile metabolism and release have likely caused hyperglycemia.
b
A client has been admitted to the critical care unit with a diagnosis of toxic hepatitis. When planning the client's care, the nurse should be aware of what potential clinical course of this health problem? Place the following events in the correct sequence. 1. Fever rises. 2. Hematemesis. 3. Clotting abnormalities. 4. Vascular collapse. 5. Coma. Select one: a. 1, 2, 3, 4, 5 b. 3, 1, 2, 5, 4 c. 1, 2, 5, 4, 3 d. 2, 3, 1, 4, 5
a
A client has just returned to the floor following a transurethral resection of the prostate. A triple-lumen indwelling urinary catheter has been inserted for continuous bladder irrigation. What, in addition to balloon inflation, are the functions of the three lumens? Select one: a. Continuous inflow and outflow of irrigation solution b. Intermittent inflow and continuous outflow of irrigation solution c. Intermittent inflow of irrigation solution and prevention of hemorrhage d. Continuous inflow and intermittent outflow of irrigation solution
a
A client returns to the floor after a laparoscopic cholecystectomy. The nurse should assess the client for signs and symptoms of what serious potential complication of this surgery? Select one: a. Bile duct injury b. Diabetic coma c. Wound evisceration d. Decubitus ulcer
a
A medical nurse is caring for a client with type 1 diabetes. The client's medication administration record includes the administration of regular insulin three times daily. Knowing that the client's lunch tray will arrive at 11:45 AM, when should the nurse administer the client's insulin? Select one: a. 11:15 AM b. 11:50 AM c. 11:45 AM d. 10:45 AM
a
A nurse is assessing an elderly client with gallstones. The nurse is aware that the client may not exhibit typical symptoms, and that particular symptoms that may be exhibited in the elderly client may include what? Select one: a. Signs and symptoms of septic shock b. Chills and jaundice c. Fever and pain d. Nausea and vomiting
a
A nurse is caring for a client with hepatic encephalopathy. While making the initial shift assessment, the nurse notes that the client has a flapping tremor of the hands. The nurse should document the presence of what sign of liver disease? Select one: a. Asterixis b. Palmar erythema c. Constructional apraxia d. Fetor hepaticus
a
An adult client has been admitted to the medical unit for the treatment of acute pancreatitis. What nursing action should be included in this client's plan of care? Select one: a. Measure the client's abdominal girth daily. b. Monitor the client for signs of dysphagia. c. Encourage activity as tolerated. d. Limit the use of opioid analgesics.
a
The nurse is assessing a client suspected of having developed acute glomerulonephritis. The nurse should expect to address what clinical manifestation that is characteristic of this health problem? Select one: a. Hematuria b. Glucosuria c. Precipitous decrease in serum creatinine levels d. Hypotension unresolved by fluid administration
a
The nurse is discussing macrovascular complications of diabetes with a client. The nurse would address what topic during this dialogue? Select one: a. The fact that clients with diabetes have an elevated risk of myocardial infarction b. The need for frequent eye examinations for clients with diabetes c. The need to monitor urine for the presence of albumin d. The relationship between kidney function and blood glucose levels
a
The nurse's review of a client's most recent laboratory results indicates a bilirubin level of 3.0 mg/dL (51 mmol/L). The nurse assesses the client for Select one: a. jaundice. b. malnutrition. c. hypokalemia. d. bleeding.
a
A client is admitted to the unit with acute cholecystitis. The health care provider has stated that surgery will be scheduled in 4 days. The client asks why the surgery is being put off for a week when he has a "sick gallbladder." What rationale would underlie the nurse's response? Select one: a. Surgery is delayed until the client can eat a regular diet without vomiting. b. Surgery is delayed until the acute symptoms subside. c. The client requires aggressive nutritional support prior to surgery. d. Time is needed to determine whether a laparoscopic procedure can be used.
b
A client newly diagnosed with type 2 diabetes is attending a nutrition class. What general guideline should the nurse teach the clients at this class? Select one: a. Protein should constitute 30% to 40% of caloric intake. b. Most calories should be derived from carbohydrates. c. Animal fats should be eliminated from the diet. d. Low fat generally indicates low sugar.
b
A client who has undergone liver transplantation is ready to be discharged home. Which outcome of health education should the nurse prioritize? Select one: a. The client will obtain measurement of drainage from the T-tube. b. The client will take immunosuppressive agents as required. c. The client will exercise three times a week. d. The client will monitor for signs of liver dysfunction.
b
A nurse is caring for a client newly diagnosed with type 1 diabetes. The nurse is educating the client about self-administration of insulin in the home setting. The nurse should teach the client to do what action? Select one: a. Avoid using the same injection site more than once in 2 to 3 weeks. b. Cleanse the injection site thoroughly with alcohol prior to injecting. c. Avoid mixing more than one type of insulin in a syringe. d. Inject at a 45-degree angle.
b
A nurse is caring for a client who has been admitted for the treatment of advanced cirrhosis. What assessment should the nurse prioritize in this client's plan of care? Select one: a. Measurement of abdominal girth and body weight b. Assessment for variceal bleeding c. Monitoring of results of liver function testing d. Assessment for signs and symptoms of jaundice
b
A nurse is providing health education to an adolescent newly diagnosed with type 1 diabetes mellitus and her family. The nurse teaches the client and family that what nonpharmacologic measures will decrease the body's need for insulin? Select one: a. Adequate sleep b. Exercise c. Low stimulation d. Low-fat diet
b
A student with diabetes tells the school nurse that he is feeling nervous and hungry. The nurse assesses the child and finds he has tachycardia and is diaphoretic with a blood glucose level of 50 mg/dL (2.8 mmol/L). What should the school nurse administer? Select one: a. A combination of protein and carbohydrates, such as a small cup of yogurt b. Half a cup of juice followed by cheese and crackers c. Half a sandwich with a protein-based filling d. Two teaspoons of sugar dissolved in a cup of apple juice
b
An uncircumcised 78-year-old male has presented at the clinic complaining that he cannot retract his foreskin over his glans. On examination, it is noted that the foreskin is very constricted. The nurse should recognize the presence of what health problem? Select one: a. Peyronie's disease b. Phimosis c. Bowen disease d. Priapism
b
The nurse is caring for a client receiving hemodialysis three times weekly. The client has had surgery to form an arteriovenous fistula. What is most important for the nurse to be aware of when providing care for this client? Select one: a. The client feels best immediately after the dialysis treatment. b. Taking a BP reading on the affected arm can damage the fistula. c. Using a stethoscope for auscultating the fistula is contraindicated. d. The client should not feel pain during initiation of dialysis.
b
A 15 year old is admitted to the renal unit with a diagnosis of postinfectious glomerular disease. The nurse should recognize that this form of kidney disease may have been precipitated by what event? Select one: a. Menarche b. Hypersensitivity to an immunization c. Streptococcal infection d. Psychosocial stress
c
A client has been diagnosed with pancreatic cancer and has been admitted for care. Following initial treatment, the nurse should be aware that the client is most likely to require which of the following? Select one: a. Intensive physical therapy b. Inpatient rehabilitation c. Hospice care d. Rehabilitation in the home setting
c
A client is 24 hours postoperative following prostatectomy and the urologist has ordered continuous bladder irrigation. What color of output should the nurse expect to find in the drainage bag? Select one: a. Tea colored b. Amber c. Light pink d. Red wine colored
c
A client who is scheduled for an open prostatectomy is concerned about the potential effects of the surgery on his sexual function. What aspect of prostate surgery should inform the nurse's response? Select one: a. Modern surgical techniques have eliminated the risk of erectile dysfunction following prostatectomy. b. Erectile dysfunction after prostatectomy is expected, but normally resolves within several months. c. All prostatectomies carry a risk of nerve damage and consequent erectile dysfunction. d. Erectile dysfunction is common after prostatectomy as a result of hormonal changes.
c
A client with liver disease has developed ascites; the nurse is collaborating with the client to develop a nutritional plan. The nurse should prioritize which of the following in the client's plan? Select one: a. Increased potassium intake b. High-protein, low-fat diet c. Reduction in sodium intake d. Fluid restriction to 2 L per day
c
A client with ongoing back pain, nausea, and abdominal bloating has been diagnosed with cholecystitis secondary to gallstones. The nurse should anticipate that the client will undergo what intervention? Select one: a. Extracorporeal shock wave therapy (ESWL) b. Intracorporeal lithotripsy c. Laparoscopic cholecystectomy d. Methyl tertiary butyl ether (MTBE) infusion
c
A client's abdominal ultrasound indicates cholelithiasis. When the nurse is reviewing the client's laboratory studies, what finding is most closely associated with this diagnosis? Select one: a. Decreased serum alkaline phosphatase level b. Increased blood urea nitrogen (BUN) c. Increased bilirubin d. Decreased serum cholesterol
c
A community health nurse is caring for a client whose multiple health problems include chronic pancreatitis. During the most recent home visit, the nurse learns that the client is experiencing severe abdominal pain and has vomited 3 times in the past several hours. What is the nurse's most appropriate action? Select one: a. Teach the client about the importance of abstaining from alcohol. b. Insert an NG tube, if available, and stay with the client. c. Administer a PRN dose of pancreatic enzymes as prescribed. d. Arrange for the client to be transported to the hospital.
c
A diabetes nurse educator is presenting current recommendations for levels of caloric intake. What should the nurse describe? Select one: a. 20% to 30% of calories from carbohydrates, 50% to 60% from fat, and the remaining 10% to 20% from protein b. 10% of calories from carbohydrates, 50% from fat, and the remaining 40% from protein c. 50% to 60% of calories from carbohydrates, 20% to 30% from fat, and the remaining 10% to 20% from protein d. 10% to 20% of calories from carbohydrates, 20% to 30% from fat, and the remaining 50% to 60% from protein
c
A nurse is caring for a client with type 1 diabetes who is being discharged home tomorrow. What is the best way to assess the client's ability to prepare and self-administer insulin? Select one: a. Ask the client to describe the process in detail. b. Provide a health education session reviewing the main points of insulin delivery. c. Observe the client drawing up and administering the insulin. d. Review the client's first hemoglobin A1C result after discharge.
c
A public health nurse has been asked to provide a health promotion session for men at a wellness center. What should the nurse inform the participants about testicular cancer? Select one: a. It is most common among men over 55. b. It is one of the least curable solid tumors. c. It is highly responsive to treatment. d. It typically does not metastasize.
c
A student nurse is caring for a client who has a diagnosis of acute pancreatitis and who is receiving parenteral nutrition. The student should prioritize which of the following assessments? Select one: a. BUN and creatinine levels b. Fluid output c. Blood glucose levels d. Oral intake
c
The nurse is planning client teaching for a client with ESKD who is scheduled for the creation of a fistula. The nurse should teach the client what information about the fistula? Select one: a. "The fistula can be used 5 to 7 days after the surgery for dialysis treatment." b. "The arm should be immobilized for 4 to 6 days." c. "A vein and an artery in your arm will be attached surgically." d. "One needle will be inserted into the fistula for each dialysis treatment."
c
A client has been brought to the emergency department by paramedics after being found unconscious. The client's Medic Alert bracelet indicates that the client has type 1 diabetes and the client's blood glucose is 22 mg/dL (1.2 mmol/L). The nurse should anticipate what intervention? Select one: a. IV bolus of 5% dextrose in 0.45% NaCl b. Subcutaneous administration of 12 to 15 units of regular insulin c. Subcutaneous administration of 10 units of Humalog d. IV administration of 50% dextrose in water
d
A client is receiving care in the intensive care unit for acute pancreatitis. The nurse is aware that pancreatic necrosis is a major cause of morbidity and mortality in clients with acute pancreatitis. Consequently, the nurse should assess for what signs or symptoms of this complication? Select one: a. Increased abdominal girth accompanied by decreased level of consciousness b. Abdominal pain unresponsive to analgesics c. Sudden increase in random blood glucose readings d. Fever, increased heart rate, and decreased blood pressure
d
A client on the medical unit has a documented history of polycystic kidney disease (PKD). What principle should guide the nurse's care of this client? Select one: a. The client is likely to respond favorably to lithotripsy treatment of the cysts. b. The client will eventually require surgical removal of the renal cysts. c. The disease is self-limiting and cysts usually resolve spontaneously in the fifth or sixth decade of life. d. The client's disease is incurable and the nurse's interventions will be supportive.
d
A client who had surgery for gallbladder disease has just returned to the postsurgical unit from postanesthetic recovery. The nurse caring for this client knows to immediately report what assessment finding to the health care provider? Select one: a. Acute pain with movement b. Drainage of bile-colored fluid onto the abdominal dressing c. Decreased breath sounds d. Rigidity of the abdomen
d
A client with a history of injection drug use has been diagnosed with hepatitis C. When collaborating with the care team to plan this client's treatment, the nurse should anticipate what intervention? Select one: a. Administration of immune globulins b. Rest and watchful waiting c. Administration of fresh-frozen plasma (FFP) d. A regimen of antiviral medications
d
A client with esophageal varices is being cared for in the ICU. The varices have begun to bleed. The client has Ringer lactate at 150 cc/hr infusing. The nurse should also anticipate what intervention? Select one: a. Oxygen by nasal cannula b. Administering diuretics c. Positioning the client supine d. Administering volume expanders
d
A client with portal hypertension has been admitted to the medical floor. The nurse should prioritize what assessments? Select one: a. Blood glucose monitoring q4h b. Assessments for signs and symptoms of venous thromboembolism c. Assessment of blood pressure and assessment for headaches and visual changes d. Daily weights and abdominal girth measurement
d
A diabetic nurse is working for the summer at a camp for adolescents with diabetes. When providing information on the prevention and management of hypoglycemia, what action should the nurse promote? Select one: a. Check blood sugar at least every 24 hours. b. Perform exercise prior to eating, whenever possible. c. Eat a meal or snack every 8 hours. d. Always carry a form of fast-acting sugar.
d
An older adult client with type 2 diabetes is brought to the emergency department by his daughter. The client is found to have a blood glucose level of 600 mg/dL (33.3 mmol/L). The client's daughter reports that the client recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing action would be a priority? Select one: a. Administering sodium bicarbonate intravenously b. Administration of antihypertensive medications c. Reversing acidosis by administering insulin d. Fluid and electrolyte replacement
d
The nurse is caring for a client who has just returned from the ERCP removal of gallstones. The nurse should monitor the client for signs of what complications? Select one: a. Acidosis and hypoglycemia b. Gangrene of the gallbladder and hyperglycemia c. Pain and peritonitis d. Bleeding and perforation
d
The nurse is working on the renal transplant unit. To reduce the risk of infection in a client with a transplanted kidney, it is imperative for the nurse to do what? Select one: a. Instruct the client to wear a face mask. b. Ensure immediate function of the donated kidney. c. Bar visitors from the client's room. d. Wash hands carefully and frequently.
d
the nurse coming on shift on the medical unit is taking a report on four clients. What client does the nurse know is at the greatest risk of developing ESKD? Select one: a. A client with severe chronic obstructive pulmonary disease b. A client with a history of polycystic kidney disease c. A client who is morbidly obese with a history of vascular disorders d. A client with diabetes mellitus and poorly controlled hypertension
d