Prep U 33 51 52 34
A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?
Metformin
A client with pheochromocytomais scheduled for an adrenalectomy. Which of the following would the nurse perform preoperatively?
Monitor blood pressure (BP) frequently.
The nurse is completing discharge teaching with a patient with hyperthyroidism who has been treated with radioactive iodine (RAI) at an outpatient clinic. The nurse instructs the patient to do which of the following?
Monitor for symptoms of hypothyroidism.
Which type of cell secretes glucagon and promotes gluconeogenesis?
Alpha
The nurse is aware that the clinical symptoms of a patient with hypoparathyroidism are the result of the initial physiological response of:
Hypocalcemia.
The nurse is caring for four clients on the medical-surgical unit of the hospital. What client is mostly likely to be receiving treatment for sickle cell crisis?
A 19-year-old African American male
he nurse is caring for four clients on the medical-surgical unit of the hospital. What client is mostly likely to be receiving treatment for sickle cell crisis?
A 19-year-old African American male
consuming a low-carbohydrate, high-protein diet and avoiding fasting.
A nurse is providing dietary instructions to a client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:
The adrenal cortex is responsible for producing which substances?
Glucocorticoids and androgen
Which cell of haematopoiesis is responsible for the production of red blood cells (RBCs) and platelets?
Myeloid stem cell
The term that is used to refer to a primitive cell, capable of self-replication and differentiation, is which of the following?
Stem cell
A client receiving a blood transfusion complains of shortness of breath, appears anxious, and has a pulse of 125 beats/minute. What is the best action for the nurse to take after stopping the transfusion and awaiting further instruction from the healthcare provider?
Ensure there is an oxygen delivery device at the bedside.
Which instruction about insulin administration should a nurse give to a client?
"Always follow the same order when drawing the different insulins into the syringe."
A patient will need a blood transfusion for the replacement of blood loss from the gastrointestinal tract. The patient states, "That stuff isn't safe!" What is the best response from the nurse?
"I understand your concern. The blood is carefully screened but is not completely risk free."
The nurse is administering lispro (Humalog) insulin. Based on the onset of action, how soon should the nurse administer the injection prior to breakfast?
10 to 15 minutes
A 6 months' pregnant patient was evaluated for gestational diabetes mellitus. The doctor considered prescribing insulin based on the serum glucose result of:
138 mg/dL, 2 hours postprandial.
Which client is not a candidate for blood donation according to the American Heart Association?
26 year old female with hemoglobin 11.0 g/dL
What is the duration of regular insulin?
4 to 6 hours
A nurse working in the ED at a level 1 trauma center is notified that casualties from a multivehicle car accident are currently in transit. The nurse notes that her heart is pounding and her mouth is dry. What gland is responsible for your physiologic response?
Adrenal medulla
A client is hospitalized 3 days prior to a total hip arthroplasty and reports a high level of pain with ambulation. The client has been taking warfarin at home, which is now discontinued. To prevent the formation of blood clots, it is important for the nurse to
Administer the prescribed enoxaparin (Lovenox)
A client is hospitalized 3 days prior to a total hip arthroplasty and reports a high level of pain with ambulation. The client has been taking warfarin at home, which is now discontinued. To prevent the formation of blood clots, it is important for the nurse to
Administer the prescribed enoxaparin (Lovenox).
A patient with chronic renal failure is examined by the nurse practitioner for anemia. The nurse knows to review the laboratory data for a decreased hemoglobin level, red blood cell count, and which of the following?
Decreased level of erythropoietin
A client with anemia has been admitted to the medical-surgical unit. Which assessment findings are characteristic of iron deficiency anemia?
Dyspnea, tachycardia, and pallor
The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the absorption?
Eating calf's liver with a glass of orange juic
A patient is being evaluated for a diagnosis of pheochromocytoma. He is scheduled for epinephrine and norepinephrine laboratory tests. Which of the following plasma levels is a positive value that is diagnostic for pheochromocytoma?
Epinephrine @ 450 pg/mL
A patient with leukemia has developed a cough and increased fatigue. What is the primary nursing intervention?
Evaluate the patient for potential infection.
A nurse should perform which intervention for a client with Cushing's syndrome?
Explain that the client's physical changes are a result of excessive corticosteroids.
A patient with acute myeloid leukemia (AML) is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. In which complication do the donor's lymphocytes recognize the patient's body as foreign and set up reactions to attack the foreign host?
Graft-versus-host disease
When assessing a female patient with a disorder of the hematopoietic or the lymphatic system, which of the following assessments is most essential?
Health history, such as bleeding, fatigue, or fainting
A patient is diagnosed with Addison's disease, a condition that results in insufficient production of cortisol. Which of the following is the most important function of cortisol that the nurse needs to consider when caring for a patient with Addison's disease?
Helps the body adjust to stress
A client with hypothyroidism is afraid of needles and doesn't want to have his blood drawn. What should the nurse say to help alleviate his concerns?
I'll stay here with you while the technician draws your blood.
A client receiving a blood transfusion experiences an acute hemolytic reaction. Which nursing intervention is the most important?
Immediately stop the transfusion, infuse normal saline solution, call the physician, and notify the blood bank
Which of the following statements is correct regarding glargine (Lantus) insulin?
It cannot be mixed with any other type of insulin.
The nurse knows to advise the patient with hyperparathyroidism that he or she should be aware of signs of the common complication of:
Kidney Stones
A nursing instructor is evaluating a student caring for a neutropenic patient. The instructor concludes that the nursing student demonstrates accurate knowledge of neutropenia based on which of the following interventions?
Monitoring the patient's temperature and reviewing the patient's complete blood count (FBC) with differential
A client was admitted to the hospital with a pathologic pelvic fracture. The client informs the nurse that he has been having a strange pain in the pelvic area for a couple of weeks that was getting worse with activity prior to the fracture. What does the nurse suspect may be occurring based on these symptoms?
Multiple myeloma
A patient who is diagnosed with type 1 diabetes would be expected to:
Need exogenous insulin.
An older adult patient that has diabetes type 2 comes to the emergency department with second-degree burns to the bottom of both feet and states, "I didn't feel too hot but my feet must have been too close to the heater." What does the nurse understand is most likely the reason for the decrease in temperature sensation?
Peripheral neuropathy
A nurse is caring for a client in addisonian crisis. Which medication order should the nurse question?
Potassium chloride
A client at the clinic has just been diagnosed with iron deficiency anemia. What would you recommend the client consume to promote the absorption of iron?
Rich sources of vitamin C
Which type of lymphocyte is responsible for cellular immunity?
T lymphocyte
A patient is taking prednisone 60 mg per day for the treatment of an acute exacerbation of Crohn's disease. The patient has developed lymphopenia with a lymphocyte count of less than 1,500 mm3. What should the nurse monitor the client for?
The onset of a bacterial infection
The pancreas continues to release a small amount of basal insulin overnight, while a person is sleeping. The nurse knows that, if the body needs more sugar:
The pancreatic hormone glucagon will stimulate the liver to release stored glucose.
The nurse auscultates a bruit over the thyroid glands. What does the nurse understand is the significance of this finding?
The patient may have hyperthyroidism.
Which of the following is accurate regarding the use of corticosteroids for immune hemolytic anemia? Select all that apply.
They decrease the macrophages ability to clear the antibody-coated RBCs. If the hemoglobin returns to normal, the corticosteroid dose can be lowered.
A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason?
Underlying problem of insulin resistance
When evaluating a patient's symptoms that are consistent with a diagnosis of leukemia, the nurse is aware that a common feature of all leukemias is which of the following?
Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements
A nurse on a hematology/oncology floor is caring for a client with aplastic anemia. Which of the following would not be included in the client's discharge instructions
Use a disposable razor when shaving.
The nurse is teaching a patient about self-administration of insulin and mixing of regular and neutral protamine Hagedorn (NPH) insulin. Which of the following is important to include in the teaching plan?
When mixing insulin, the regular insulin is drawn up into the syringe first.
Hypokalemia and hypoglycemia
Which combination of adverse effects should a nurse monitor for when administering I.V. insulin to a client with diabetic ketoacidosis?
"Test your blood glucose every 4 hours
Which instruction should a nurse give to a client with diabetes mellitus when teaching about "sick day rules"?
A patient with sickle cell anemia has a
low hematocrit
A nurse is assessing a client with multiple myeloma. The nurse should keep in mind that clients with multiple myeloma are at risk for
pathologic bone fractures.
A nurse should expect a client with hypothyroidism to report
puffiness of the face and hands.
A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of:
sodium and potassium abnormalities.
A client with hyperparathyroidism declines surgery and is to receive hormone replacement therapy with estrogen and progesterone. Which instruction is most important for the nurse to include in the client's teaching plan?
"Maintain a moderate exercise program."
A client with acromegaly is complaining of severe headaches. What does the nurse suspect is the cause of the headaches that is related to the acromegaly?
A pituitary tumor
A clinical nurse specialist (CNS) is orienting a new graduate registered nurse to an oncology unit where blood product transfusions are frequently administered. In discussing ABO compatibility, the CNS presents several hypothetical scenarios. The new graduate knows that the greatest likelihood of an acute hemolytic reaction would occur when giving:
A-positive blood to an A-negative client.
A client with sickle cell disease informs the nurse that he is having chest pain. The nurse hears the client coughing, wheezing, and breathing rapidly. What does the nurse suspect is occurring with this client?
Acute chest syndrome
Following a thyroidectomy, a patient develops a carpopedal spasm while the nurse is taking a BP reading on the left arm. Which of the following actions by the nurse is appropriate?
Administer the IV calcium gluconate ordered.
For a client diagnosed with idiopathic thrombocytopenia purpura (ITP), which nursing intervention is appropriate?
Administering stool softeners, as ordered, to prevent straining during defecation
The nurse is preparing a client for a thyroid test. Which medications should the nurse document on the laboratory slip that the client is taking that may affect the thyroid test?
Aspirin
When teaching a patient with iron deficiency anemia about appropriate food choices, the nurse will encourage the patient to increase the dietary intake of which of the following foods?
Beans, dried fruits, and leafy green vegetables
hen teaching a patient with iron deficiency anemia about appropriate food choices, the nurse will encourage the patient to increase the dietary intake of which of the following foods?
Beans, dried fruits, and leafy green vegetables
A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client?
Blood glucose level 1,100 mg/dl
Which of the following is a symptom of Hemochromatosis?
Bronzing of the skin
During physical examination of a client with a suspected endocrine disorder, the nurse assesses the body structures. The nurse gathers this data based on the understanding that it is an important aid in which of the following?
Detecting evidence of hormone hypersecretion.
A nurse is preparing to palpate a client's thyroid gland. Which action by the nurse is appropriate?
Encircle the client's neck with both hands, have the client slightly extend his neck, and ask him to swallow.
A patient comes to the clinic with complaints of severe thirst. The patient has been drinking up to 10 L of cold water a day, and the patient's urine looks like water. What diagnostic test does the nurse anticipate the physician will order for diagnosis?
Fluid deprivation test
A patient with ESRD is taking recombinant erythropoietin for the treatment of anemia. What laboratory study does the nurse understand will have to be assessed at least monthly related to this medication?
Hemoglobin level
A nurse is preparing to discharge a patient with coronary artery disease (CAD) and hypertension (HTN) who is at risk for type 2 diabetes. Which of the following information is important to include in the discharge teaching?
How to control blood glucose through lifestyle modification with diet and exercise
A client with a history of Addison's disease and flulike symptoms accompanied by nausea and vomiting over the past week is brought to the facility. His wife reports that he acted confused and was extremely weak when he awoke that morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. What should the nurse expect to administer by I.V. infusion?
Hydrocortisone
Which of the following may occur in the postoperative period of an adrenalectomy because of sudden withdraw of excessive amounts of catecholamines?
Hypoglycemia
The thymus gland secretes thymosin and thymopoietin, which aid in developing T lymphocytes, a type of white blood cell involved in immunity. Which of the following best identifies the location of this gland?
In the upper part of the chest above or near the heart
A nurse practitioner provides nutritional information for a patient diagnosed with an iron-deficiency anemia. Select the best advice the nurse would give.
Increase the intake of green, leafy vegetables.
A 60-year-old patient comes to the ED with complaints of weakness, vision problems, increased thirst, increased urination, and frequent infections that do not seem to heal easily. The physician suspects that the patient has diabetes. Which of the following classic symptoms should the nurse watch for to confirm the diagnosis of diabetes?
Increased hunger
A nurse is teaching a patient recovering from diabetic ketoacidosis (DKA) about management of "sick days." The patient asks the nurse why it is important to monitor the urine for ketones. Which of the following statements is the nurse's best response?
Ketones accumulate in the blood and urine when fat breaks down. Ketones signal a deficiency of insulin that will cause the body to start to break down stored fat for energy.
he nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the posterior superior iliac crest. What position will the nurse place the p
Lateral position with one leg flexed
During the review of morning lab values on a patient complaining of severe fatigue and a red, swollen tongue, the nurse suspects chronic, severe iron deficiency anemia based on which of the following findings?
Low ferritin level
What type of cancer is the most common type of secondary malignancy in patients with Hodgkin's disease?
Lung
Which of the following terms refers to a form of white blood cell involved in immune response?
Lymphocyte
What clinical manifestations does the nurse recognize would be associated with a diagnosis of hyperthyroidism? (Select all that apply.)
Muscular fatigability An elevated systolic blood pressure Weight loss.
The nurse suspects that a patient with diabetes has developed proliferative retinopathy. The nurse confirms this by the presence of which of the following diagnostic signs?
Neovascularization into the vitreous humor
A client with a diagnosis of pernicious anemia comes to the clinic complaining of numbness and tingling in their arms and legs. What do these symptoms indicate?
Neurologic involvement
A nurse is caring for a client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client?
Pallor, tachycardia, and a sore tongue
Which action would be most appropriate when evaluating a client's neck for thyroid enlargement?
Palpate the thyroid gland gently.
Which of the following terms refers to an abnormal decrease in white blood cells, red blood cells, and platelets?
Pancytopenia
A client has a dysfunction in one of his glands that is causing a decrease in the level of calcium in the blood. What gland should be evaluated for dysfunction?
Parathyroid gland
Under normal conditions, the adult bone marrow produces approximately 70 billion neutrophils. What is the major function of neutrophils?
Phagocytosis
During an assessment of a patient with SIADH, the nurse notes the unexpected result of:
Pitting edema in the lower extremities.
The nursing instructor is discussing disorders of the hematopoietic system with the pre-nursing pathophysiology class. What disease would the instructor list with a primary characteristic of erythrocytosis?
Polycythemia Vera
A nurse is teaching a diabetic support group about the causes of type 1 diabetes. The teaching is determined to be effective when the group is able to attribute which of the following factors as a cause of type 1 diabetes?
Presence of autoantibodies against islet cells
A nurse working on a medical-surgical unit is caring for a client with Cushing's syndrome. After receiving repot, the nurse reads through the client's nursing diagnoses and prioritizes her interventions. Which of the following would the nurse not include in her plan of care?
Provide a high-sodium diet.
The nurse obtains a unit of blood for the client, Donald D. Smith. The name on the label on the unit of blood reads Donald A. Smith. All the other identifiers are correct. The nurse
Refuses to administer the blood
You are assisting your client with multiple myeloma to ambulate. What is the most important nursing diagnosis to help prevent fractures in this client?
Safety
Patients with hyperthyroidism are characteristically:
Sensitive to heat
The diabetic client asks the nurse why shoes and socks are removed at each office visit. Which assessment finding is most significant in determining the protocol for inspection of feet?
Sensory neuropathy
Which findings should a nurse expect to assess in client with Hashimoto's thyroiditis?
Weight gain, decreased appetite, and constipation
When instructing a client diagnosed with hyperparathyroidism about diet, the nurse should stress the importance of:
encouraging fluids.
A patient with severe anemia is complaining of the following symptoms: tachycardia, palpitations, exertional dyspnea, cool extremities, and dizziness with ambulation. Lab results reveal low hemoglobin and hematocrit levels. Based on the assessment data, which of the following nursing diagnoses is most appropriate for this patient?
ineffective tissue perfusion related to inadequate hemoglobin and hematocrit
A female client is being successfully treated for Cushing's syndrome. The nurse should expect a decline in:
serum glucose level.
Sweating, tremors, and tachycardia
A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia?
A 16-year-old patient newly diagnosed with type 1 diabetes has a very low body weight despite eating regular meals. The patient is upset because friends frequently state, "You look anorexic." Which of the following statements would be the best response by the nurse to help this patient understand the cause of weight loss due to this condition?
Your body is using protein and fat for energy instead of glucose."
