337 Exam 3 Practice Question

Which assessment question by the nurse best addresses thyroid function? "Can you describe the amount of stress you have at home and work?" "Do you experience fatigue even if you have slept a long time?" "Do you have to get up at night to urinate?" "Have you experienced any blurred or double vision?"

"Do you experience fatigue even if you have slept a long time?"

The nurse caring for a patient experiencing a type IV hypersensitivity reaction. Which assessment finding(s) would the nurse expect the patient to exhibit? Low back pain and fever Bilateral joint stiffness Wheezing and hypotension A raised, red, itchy rash on the skin

A raised, red, itchy rash on the skin

A client suffered a brain injury after falling off a ladder has recently developed SIADH. Which finding indicates that treatment received is effective? Decreased urine osmolality

Decreased urine osmolality

You are caring for a diabetic patient who is exhibiting shakiness, headache, clammy skin, and drowsiness. What condition do you think this patient is experiencing? Hyperglycemia Anxiety DKA Hypoglycemia

Hypoglycemia

Which immunoglobulin is responsible for Type I hypersensitivity reactions? IgG IgE IgA IgM

IgE

The nurse is providing nutrition instructions to a client who is recently diagnosed with hypothyroidism. Which information should the nurse include? Increase fluid and fiber intake Eat foods high in calories and protein Implement snacks in between meals Avoid starchy fruits and vegetables

Increase fluid and fiber intake

A patient is hospitalized with DKA (diabetic Ketoacidosis). Lab data includes a blood glucose of 280 mg/dL and signs of dehydration. Which order should be implemented first? Administer 40 mEq of potassium by mouth Monitor vital signs every 30 minutes for 2 hours Infuse 500mL bolus of 0.9% NS Obtain arterial blood gases

Infuse 500mL bolus of 0.9% NS

Tetany is a clinical manifestation related to _______ calcium levels and is usually due to a _______ gland dysfunction. High; thyroid Low; parathyroid High; parathyroid Low; thyroid

Low; parathyroid

When teaching a client with rheumatoid arthritis (RA) about proper positioning, what should the nurse teach the client to avoid when resting or sleeping? Using a flat pillow under the head Lying on a firm mattress Elevation of an inflamed joint Positions of flexion

Positions of flexion

Which clinical manifestation would the nurse expect to assess in a client experiencing Grave's disease? Tachycardia Constipation Hypotension Lethargy

Tachycardia

A patient with HIV reports fever, nonproductive cough, and fatigue. The patient's CD4 count is 184 cells/mcL. How should the nurse interpret these findings? This is an expected finding because the patient has tested positive for HIV. The patient is now in the latent stages of HIV infection. These findings provide evidence that the patient has seroconverted. The patient is diagnosed with acquired immunodeficiency syndrome (AIDS).

The patient is diagnosed with acquired immunodeficiency syndrome (AIDS).

After the home health nurse has taught a patient and family about how to use glargine (Lantus) and regular insulin safely, which action by the patient best indicates the teaching has been successful? The patient administers the glargine 30 to 45 minutes before eating each meal. When using an insulin pen, the patient does not prime the device. The patient draws up the regular insulin and then the glargine in the same syringe. The patient rotates injections within one anatomic site using a checker-board pattern approach.

The patient rotates injections within one anatomic site using a checker-board pattern approach.

What should be included in the plan of care for a patient with Cushing disease? Assessing for signs of hyperkalemia Monitoring blood pressure for hypotension Therapeutic communication related to body image changes Dietary teaching on low protein food choices

Therapeutic communication related to body image changes

The nurse is caring for a patient with human immunodeficiency virus (HIV) who just started antiretroviral therapy. How should the nurse explains the purpose of this therapy? These medications interrupt the replication of the virus at various stages of its life cycle. These medications provide extra antibodies to help the patient's own immune system fight the HIV. These medications kill the viral microorganisms that have infected the patient's T cells. These medications treat opportunistic infections that occur in a patient with HIV.

These medications interrupt the replication of the virus at various stages of its life cycle.

Acquired immunity is the development of immunity, either active or passive. True False

True

The somogyi effect occurs if the blood glucose level drops too low in the early morning hours, hormones such as growth hormone and cortisol are released. These help reverse the low blood sugar level but lead to blood glucose levels that are higher than normal in the morning True False

True

A college student who has type 1 diabetes normally walks each evening for exercise. The student now plans to take an hour cross-fit class every day at 3:00 PM. The clinic nurse teaches the patient to have a snack before exercising and carry a source of glucose. delay eating the noon meal until after the class. increase the morning dose of insulin on days of the class. time the morning insulin injection so the peak occurs while in class.

have a snack before exercising and carry a source of glucose

What potential side effect of corticosteroid therapy would be of most concern to the nurse caring for a patient who is receiving high-dose oral corticosteroid therapy after a kidney transplant? slow blood pressure increased urine output infection decreased blood glucose

infection

Which of the following assessment findings in a patient with Cushing syndrome would require an immediate response from the nurse? blood pressure of 148/92 fasting blood glucose of 135 mg/dl serum potassium level of 2.4 mEq/L serum pH of 7.44

serum potassium level of 2.4 mEq/L

In HHS(hyperosmolar hyperglycemia syndrome) ketones are absent or minimal in blood and urine due to the client having enough endogenous insulin available True False

True

Based on demographic characteristics, which patient is most at risk for developing a new diagnosis of rheumatoid arthritis? A 63-year-old man A 21-year-old woman A 26-year-old man A 55-year-old woman

A 55-year-old woman

Which endocrine gland secretes cortisol? Ovaries Thyroid Adrenal Cortex Adrenal Medulla

Adrenal Cortex

Primary endocrine disorders are diseases that are occurring in the target glands itself, such as Graves disease? True False

True

Which is the nurse's PRIORITY action when managing a client experiencing a type I hypersensitivity? Reducing pain Airway management Decreasing a fever Management of pruritis

Airway management

_______________ is a complication of diabetes that is caused by damage to blood vessels secondary to chronic hyperglycemia Ketoacidosis Angiopathy Dawn Phenomenon Infection

Angiopathy

On Monday morning, an employee who works in an area where abrasive film is cut into rolls or discs tells the occupational health nurse that she has been experiencing increasing symptoms of skin itching and rashes during the work week that resolve over the weekend. In what order should the following interventions be implemented? A.Investigate the employee's work area and processes B.Conduct a focused history and physical assessment of the employee C.Consult with the occupational medicine physician D.Arrange alternate duty for the employee in consultation with the supervisor.

B. Conduct a focused history and physical assessment of the employee

A nurse is caring for a client who is receiving a unit of packed red blood cells. Which findings lead the nurse to suspect a transfusion reaction caused by incompatible blood? Cyanosis Backache Bradycardia Hypertension

Backache

To monitor for complications of type 2 diabetes, which tests will the nurse schedule at least annually for patient with this disease? (Select all that apply) Chest x-ray Blood pressure Serum creatinine Urinalysis to check for albumin Monofilament testing of the foot.

Blood pressure Serum creatinine Urinalysis to check for albumin Monofilament testing of the foot.

There are serum blood tests that are used to diagnose diabetes mellitus. Which blood test is not indicative of a diabetes diagnosis? Fasting blood glucose of 128 mg/dL Creatinine 1.8 mg/dL and BUN 32 mg/dL Hemoglobin A1C of 7.2% Random blood glucose 218 mg/dL

Creatinine 1.8 mg/dL and BUN 32 mg/dL

An unresponsive patient who has diabetes is brought to the emergency department with deep, labored respirations. Additional findings include: blood glucose 450 mg/dL, arterial pH 7.2, and urinalysis showing presence of ketones and glucose. The nurse concludes this information is consistent with Somogyi effect Diabetic ketoacidosis Addisonian crisis Hyperosmolar hyperglycemic syndrome

Diabetic ketoacidosis

Immune responses that are initiated through specific antigen recognition by B cells are termed cell-mediated immunity. True False

False

The pathophysiology of diabetes mellitus includes abnormal insulin production that is insufficient to meet needs, no insulin at all, both or impaired insulin utilization True False

True

The nurse who works in a rheumatology clinic cares for many patients with rheumatoid arthritis and systemic lupus erythematosus. When considering the mechanisms of action and potential adverse effects of many medications given to treat these conditions, what nursing diagnosis should the nurse add to the patient's plan of care? Risk for impaired gas exchange Risk for infection Risk for falls Risk for fluid volume imbalance

Risk for infection

With type 2 DM the body does not make enough insulin and/or becomes resistant to it. Which risk factors increases one's susceptibility to develop DM type 2? Viruses or stressful life events Having certain human leukocyte antigen types Younger age, less than 35 years old Sedentary lifestyle; overweight

Sedentary lifestyle; overweight

The nurse is caring for a client with Cushing's syndrome. During change of shift report, which lab values would be important to communicate to the oncoming staff nurse? Serum potassium, sodium, and glucose levels

Serum potassium, sodium, and glucose levels

What are clinical manifestations of hypothyroidism? Select all that apply. Weight gain Low exercise tolerance Increased metabolic processes Increased sensitivity to opioids

Weight gain Low exercise tolerance Increased sensitivity to opioids

Hypoglycemic unawareness in some patients can be the result of use of beta blockers. loop diuretics. thiazides. acetaminophen.

beta blockers.

What symptoms does the nurse recognize as most common among patients with rheumatoid arthritis? abdominal obesity and amenorrhea dizziness, dyspnea, and tachycardia fatigue, stiffness, and limited joint mobility anemia and butterfly rash

fatigue, stiffness, and limited joint mobility

A client with a type 1 diabetes reports diaphoresis, palpitations, hunger, and a headache. The client also reports administering a subcutaneous injection of regular insulin 3 hours ago and then skipping lunch. You would suspect that the client is experiencing: an insulin allergy. hyperglycemia. hypoglycemia. insulin resistance.

hypoglycemia.

Which patient statement indicates the need for further teaching about potential triggers of a disease exacerbation in patients with systemic lupus erythematous (SLE)? "I don't have to worry if I get strep throat as long as I take antibiotics." "I need to avoid direct sunlight." "I should consult with my doctor before trying to get pregnant." "I need to work on managing stress in my life."

"I don't have to worry if I get strep throat as long as I take antibiotics."

The nurse instructs a patient with type 1 diabetes mellitus about a healthy eating plan. Which statement made by the patient indicates teaching was successful? "I plan to lose 25 pounds this year by following a high protein diet." "I may have a hypoglycemic reaction if I drink alcohol on an empty stomach." "If I use an insulin pump, I will not have to limit the amount of saturated fat in my diet." "I should avoid all carbohydrates."

"I may have a hypoglycemic reaction if I drink alcohol on an empty stomach."

A client with Addison's disease is being discharged after having an Addison's crisis. Which statement by the client indicates understanding of instructions? "I need to call my doctor to discuss increasing my corticosteroid dose in events of stress/illness." "I need to weigh myself daily to be sure I do not eat too many calories." "I have to stop my corticosteroids if I develop dizziness or fatigue." "I need to increase foods that are high in potassium in my diet."

"I need to call my doctor to discuss increasing my corticosteroid dose in events of stress/illness."

The health care provider prescribes levothyroxine (Synthroid) for a patient with hypothyroidism. After teaching regarding this drug, the nurse determines that further instruction is needed when the patient says " I will report any chest pain or difficulty breathing to the doctor right away." "I can expect to return to normal function with the use of this drug." " I can expect the medication dose may need to be adjusted." "I only need to take this drug until my systems are improved."

"I only need to take this drug until my systems are improved."

A patient receives aspart (NovoLog) insulin at 8:00 AM. At what time would it be most important for the nurse to monitor for symptoms of hypoglycemia? 10:00 AM 1:00 PM 7:00 PM 4:00 PM

10:00 AM

Counter-regulatory hormones oppose insulin and increase blood glucose. These include all of the following except? Glucagon Growth Hormone Antidiuretic Hormone Cortisol

Antidiuretic Hormone

The nurse is aware that counter-regulatory hormones oppose insulin and increase blood glucose. These hormones include all of the following Except? Antidiuretic hormone (ADH) Growth hormone Cortisol Glucagon

Antidiuretic hormone (ADH)

The client is experiencing rhinorrhea, water eyes, and itchy throat due to seasonal allergic rhinitis. Which initial treatment does the nurse anticipate? Inhaled corticosteroids Antibiotic Antihistamine Oral steroids

Antihistamine

An employee who works in a nickel-plated abrasive department presents to the occupational health nurse with several small red, scaly lesions on his hands. After consulting with occupational medicine, it is determined the employee has contact dermatitis. What is the best course of action for the nurse to take next? A.Collaborate with management to find a different work department for this employee B.Observe the employee's work process and use of PPE C.Advise the product engineers that they will need to substitute nickel with another metal D.Instruct the employee to take diphenhydramine before work.

B. Observe the employee's work process and use of PPE

Which of the following symptoms is most consistent with a type III hypersensitivity reaction? Runny nose and sneezing after a hike in the fall Rash on hands a day after wearing latex gloves Bilateral joint and muscle pain, fatigue, flank pain, and facial rash Tachycardia, fever, and back pain after a blood transfusion

Bilateral joint and muscle pain, fatigue, flank pain, and facial rash

A patient with Addison's disease was admitted with acute adrenal insufficiency. Which finding best indicates current therapies are effectively treating the condition? Blood pressure is 110/60 Blood glucose level is 64 mg/dL Heart rate is 110 beats per minute Serum potassium level is 5.4 mEq/L

Blood pressure is 110/60

A nurse is following the progress of a client being treated for hypothyroidism. Which of the following indicates that the thyroid replacement therapy has been inadequate? Bradycardia Weight loss

Bradycardia

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

Glycosylated hemoglobin (A1C)

What are clinical manifestations of hyperthyroidism? Select all that apply. Goiter Diarrhea Intolerance to cold Nervousness

Goiter Diarrhea Nervousness

The nurse is caring for a newly admitted client with Diabetes Insipidus. When forming the plan of care, which nursing diagnosis is anticipated? Fluid volume loss Impaired physical mobility Fluid volume excess Self-care deficit

Fluid volume loss

The endocrine system assist with communication and coordination of systems in body. Endocrine glands secrete hormones directly into the blood. What is the main role of hormones? Growth, development, and regulation

Growth, development, and regulation

Which recommendation should the nurse include in the plan of care regarding the main goal of nutrition therapy for a type 2 diabetic patient? Limit saturated fats to 20% of total calories per day Maintain blood glucose levels to as near normal as safely possible Encourage client to consume less than 100G of carbs per day Protein should be less that 10% of total calories per day

Maintain blood glucose levels to as near normal as safely possible

A patient has begun immunotherapy for the treatment of intractable environmental allergies. When administering the patient's immunotherapy, what is the nurse's priority action? Assess the patient's need for analgesia. Monitor the patient's fluid balance. Monitor for signs and symptoms of an adverse reaction. Assess the patient for changes in level of consciousness.

Monitor for signs and symptoms of an adverse reaction.

When reviewing lab results for a patient with systemic lupus erythematosus (SLE), the nurse notes a creatinine level of 2.1 mg/dL. What complication of SLE is the nurse concerned may have developed in this patient? Pericarditis Arthritis Pleural effusion Nephritis

Nephritis

A nurse is caring for a client who is being discharged after a thyroidectomy. Which discharge instruction would be appropriate for this client? Take thyroid replacement medication as prescribed. Carry injectable epinephrine at all times. Avoid all over the counter medications. Report signs and symptoms of hypoglycemia.

Take thyroid replacement medication as prescribed.