Acute Care Exam 3
A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia? A. Strong, bounding pulses B. Decreased bowel sounds C. Tingling and numbness of the hands and feet D. Diminished DTR
C. Tingling and numbness of the hands and feet
A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings? A. Cold intolerance B. Lethargy C. Tremors D. Sunken eyes
C. Tremors
A nurse is caring for a client who is taking propylthiouracil. The nurse should identify that the client has met the treatment foals when she reports an increase in which of the following manifestations? A. Sweating B. Stools C. Weight D. Appetite
C. Weight
The nurse is teaching a client about taking a new prescription for pyridostigmine. Which statements by the nurse indicate correct information about this drug? A. "Avoid opioids and other sedating drugs when taking this medication." B. "Report increased mucous secretions and sweating immediately to the primary health care provider." C. "Take the prescribed medication after meals to increase intestinal absorption." D. "Avoid taking antibiotics, especially neomycin, while on this medication." E. "Maintain exact same dose of this medication every day."
A. "Avoid opioids and other sedating drugs when taking this medication." B. "Report increased mucous secretions and sweating immediately to the primary health care provider." D. "Avoid taking antibiotics, especially neomycin, while on this medication."
A nurse is teaching a client who is scheduled for a kidney transplant about organ rejection. Which of the following statements should the nurse include? (Select all that apply.) A. "Expect an immediate removal of the donor kidney for a hyperacute rejection." B. "You might need to begin dialysis to monitor your kidney function for a hyperacute rejection." C. "A fever is a manifestation of an acute rejection." D. "Fluid retention is a manifestation of an acute rejection." E. "Your provider will increase your immunosuppressive medications for a chronic rejection."
A. "Expect an immediate removal of the donor kidney for a hyperacute rejection." C. "A fever is a manifestation of an acute rejection." D. "Fluid retention is a manifestation of an acute rejection."
A nurse is developing a plan of care for a client who is scheduled for cerebral angiography with contrast media. Which of the following statements by the client should the nurse report to the provider? (Select all that apply.) A. "I think I might be pregnant." B. "I take warfarin." C. "I take antihypertensive medication." D. "I am allergic to shrimp" E. "I ate a light breakfast this morning."
A. "I think I might be pregnant." B. "I take warfarin." D. "I am allergic to shrimp" E. "I ate a light breakfast this morning."
The nurse provides health teaching for a client beginning glatiramer acetate therapy. Which statement by the client indicates a need for additional teaching? A. "I'll take this drug with food every morning." B. "I'll look for signs of skin reaction at the injection site." C. "I'll stay away from kids who have colds." D. "I'll avoid large crowds so I don't get sick."
A. "I'll take this drug with food every morning."
The nurse is teaching a client about self-management measures to help prevent low back pain. Which teaching should be included? Select all that apply. A. "Losing weight can decrease strain on your back." B. "Avoid twisting at your waist." C. "Exercise on a regular basis, including walking." D. "Don't bend at your waist when lifting a heavy object." E. "Eat foods high in calcium and vitamin D to prevent bone loss."
A. "Losing weight can decrease strain on your back." B. "Avoid twisting at your waist." C. "Exercise on a regular basis, including walking." D. "Don't bend at your waist when lifting a heavy object." E. "Eat foods high in calcium and vitamin D to prevent bone loss."
A 48 y/o African-American man is newly diagnosed with hypertension and Stage 1 chronic kidney disease. His primary health care provider has prescribed a thiazide diuretic. The client reports that he has increased his activity and changed his diet, which resulted in a 10 lb weight loss in the past 2 months. The client says he feels well and does not want to take any drugs. What is the nurse's best response? A. "Reducing your blood pressure may slow or prevent progressive of your CKD." B. "Your primary health care provider prescribed the diuretics because it will reverse the damage caused by kidney disease." C. "Taking medications is a personal decision, and you have the right to decline this prescription." D. "Because your lifestyle changes have resulted in weight loss, this intervention is all that is needed to reduce your risk for progression of kidney disease."
A. "Reducing your blood pressure may slow or prevent progressive of your CKD."
A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include? A. "Take this medication on an empty stomach." B. "Take this medication with an antacid." C. "Change position slowly while taking this medication." D. "Limit your fluid intake while taking this medication."
A. "Take this medication on an empty stomach."
A client who is scheduled for kidney transplantation surgery is assessed by the nurse for risk factors of surgery. Which of the following findings increase the client's risk of surgery? (Select all that apply.) A. >70 y/o B. BMI of 41 C. Administer NPH insulin each morning D. Past h/o lymphoma E. BP averaging 120/70 mmHg
A. >70 y/o B. BMI of 41 C. Administer NPH insulin each morning D. Past h/o lymphoma
A nurse managing the care of a client who is postoperative and has acute adrenal insufficiency. Which of the following actions should the nurse take? A. Administer IV hydrocortisone sodium B. Give oral spironolactone C. Infuse 1 unit of platelets D. Restrict daily fluid intake
A. Administer IV hydrocortisone sodium
A nurse is admitting a client for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. Which of the following actions is the nurse's priority? A. Administering a supplemental dose of hydrocortisone. B. Instructing the client about coughing and deep breathing. C. Collecting additional information about the client's history of Addison's disease. D. Inserting an indwelling urinary catheter.
A. Administering a supplemental dose of hydrocortisone.
Which drug category can cause AKI? (Select all that apply) A. Antibiotics B. Cardiac glycoside C. NSAIDs D. Antihypercholesterolemic drugs E. PPIs
A. Antibiotics C. NSAIDs
A nurse is assessing a client who has end-stage kidney disease. Which of the following findings should the nurse expect? (Select all that apply.) A. Anuria B. Marked azotemia C. Crackles in the lung D. Increased calcium level E. Proteinuria
A. Anuria B. Marked azotemia C. Crackles in the lung E. Proteinuria
A nurse is beginning a physical assessment of a client who has a new diagnosis of MS. Which of the following findings should the nurse expect? (Select all that apply.) A. Areas of paresthesia B. Involuntary eye movement C. Alopecia D. Increased salavation E. Ataxia
A. Areas of paresthesia B. Involuntary eye movement E. Ataxia
A nurse is planning care for a client who has Stage 4 chronic kidney disease. Which of the following actions should the nurse include in the plan of care? (Select all that apply.) A. Assess for JVD B. Provide frequent mouth rinses C. Auscultate for pleural friction rub D. Provide a high-sodium E. Monitor for dysrhythmias
A. Assess for JVD B. Provide frequent mouth rinses C. Auscultate for pleural friction rub E. Monitor for dysrhythmias
Which actions/intervention are most important for the nurse to perform when caring for a 70 y/o client who is scheduled for a contrast-medium enhanced CT scan? Select all that apply A. Assess for coexisting conditions of pre-existing diabetes, heart failure, and establishing CKD B. Assess the hourly UOP for at least 6 hours before the procedure C. Assess creatinine clearance using a 24 hour urine collection test D. Alert the primary health care provider to a serum creatinine that has increased from 0.2-0.4 mg/dL (20-40 mcmol/L) in the previous 24 hours E. Alert the primary health care provider to a GFR <60 mL/L/min/1.73 F. Assess for hypovolemia, including evaluation of the MAP G. Collaborate with primary health care provider to determine whether isotonic fluid should be infused before the test H. Discuss with the primary health care provider about whether the client's prescribed diuretic should be held immediately before the test
A. Assess for coexisting conditions of pre-existing diabetes, heart failure, and establishing CKD E. Alert the primary health care provider to a GFR <60 mL/L/min/1.73 F. Assess for hypovolemia, including evaluation of the MAP G. Collaborate with primary health care provider to determine whether isotonic fluid should be infused before the test
The nurse is caring for a client diagnosed with Guillain- Barre syndrome. Which assessment findings require the nursing action? Select all that apply. A. BP 80/42 B. Respiratory rate of 24 C. Shallow breathing pattern D. Peripheral oxygen saturation (SpO2) of 85% E. Diminished breath sounds in all lung fields
A. BP 80/42 C. Shallow breathing pattern D. Peripheral oxygen saturation (SpO2) of 85% E. Diminished breath sounds in all lung fields
A nurse is caring for a client who is taking *propylthiouracil*. Which of the following findings should the nurse monitor for as an adverse effect of this medication? A. Bradycardia B. Insomnia C. Heat intolerance D. Weight loss
A. Bradycardia
The nurse should expect which normal finding in an RRT access device? A. Bruit B. Murmur C. Irregular pulsation D. Coolness to touch
A. Bruit
A nurse is reviewing the laboratory report of a client who has acute kidney injury. Which of the following findings should the nurse expect? A. Bun 30mg/dL B. UOP 40 mL in past 3 hr C. Potassium 3.6 mEq/L D. Calcium 9.8 mg/dL E. Hct 30%
A. Bun 30mg/dL B. UOP 40 mL in past 3 hr E. Hct 30%
A nurse is planning postprocedure care for a client who received hemodialysis. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A. Check BUN and blood creatinine B. Administer medications the nurse withheld prior to dialysis C. Observe for findings of hypovolemia D. Assess the access site for bleeding E. Evaluate BP on the arm with AV access
A. Check BUN and blood creatinine B. Administer medications the nurse withheld prior to dialysis C. Observe for findings of hypovolemia D. Assess the access site for bleeding
Which findings suggest a client with SKD may have developed pericarditis? A. Chest pain B. Increased serum potassium level C. Friction rub D. Hypotension E. Muffled heart sounds
A. Chest pain C. Friction rub E. Muffled heart sounds
A nurse is teaching a client about protein needs when on dialysis. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) A. Consume 35 kcal/kg of body weight to maintain body protein stores. B. Take phosphate binders when eating protein-rich foods. C. Increase biologic sources of protein (eggs, milk, and soy.) D. Increase protein intake by 50% of the recommended dietary allowance (RDA). E. Consume daily protein intake in the morning.
A. Consume 35 kcal/kg of body weight to maintain body protein stores. B. Take phosphate binders when eating protein-rich foods. C. Increase biologic sources of protein (eggs, milk, and soy.) D. Increase protein intake by 50% of the recommended dietary allowance (RDA).
What is the leading cause of CKD? A. Diabetes mellitus B. Renal calculi C. Hypertension D. Infection
A. Diabetes mellitus
A nurse is caring for a client who has pheochromocytoma. Which of the following actions should the nurse take? A. Elevate the head of the client's bed B. Palpate the client's abdomen C. Monitor the client for hypotension D. Check the client's urine specific gravity
A. Elevate the head of the client's bed
A nurse is monitoring the laboratory values of a client who has diabetes mellitus and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy? A. Fasting blood glucose 96 mg/dL B. Postprandial blood glucose 195 mg/dL C. Casual blood glucose 210 mg/dL D. Preprandial blood glucose 60 mg/dL
A. Fasting blood glucose 96 mg/dL
Which complications are routinely addressed in the client with AKI? A. Fluid overload B. Acid-base imbalance C. Anabolic processes D. Infection E. Dehydration
A. Fluid overload B. Acid-base imbalance D. Infection
A nurse in a provider's office is assessing a client who has hypothyroidism and recently began treatment with thyroid hormone replacement therapy. Which of the following findings should indicate to the nurse that the client might need a decrease in the dosage of the medication? A. Hand tremors B. Bradycardia C. Pallor D. Slow speech
A. Hand tremors
A nurse is reviewing the medical history of a client who has ESKD. The nurse should identify that which of the following factors in the client's history is a contraindication for receiving hemodialysis? A. History of hemophilia B. Difficulty with ambulation C. Decreased WBC D. Iodine allergy
A. History of hemophilia
Clients with long-term kidney dysfunction may develop which condition? A. Hyperparathyroidism B. Diabetes insipidus C. Thromnocytopenia D. Hypoparathyroidism
A. Hyperparathyroidism
A nurse is caring for a client who has Type 2 DM and will have excretory urography. Prior to the procedure, which of the following actions should the nurse take? (Select all that apply.) A. Identify an allergy to seafood. B. Withhold metformin for 24 hrs. C. Administer an enema D. Obtain a blood coagulation profile. E. Assess for asthma
A. Identify an allergy to seafood. B. Withhold metformin for 24 hrs. C. Administer an enema E. Assess for asthma
Which statements made by a client who has diabetes insipidus indicates to the nurse that more teaching is needed? Select all that apply. A. If I gain more than 2lb (1 kg) in a day. I'll limit my fluid intake. B. If I become thirstier, I'll take another dose of the drug C. I'll avoid aspirin and aspirin-containing substances D. I'll stop taking the drug for 24 hours before I have any dental work performed E. I'll limit my intake of salt and sodium to no more than 2g daily F. I'll wear my medical alert bracelet at all times
A. If I gain more than 2lb (1 kg) in a day. I'll limit my fluid intake. C. I'll avoid aspirin and aspirin-containing substances D. I'll stop taking the drug for 24 hours before I have any dental work performed E. I'll limit my intake of salt and sodium to no more than 2g daily
A nurse is planning care for a client who has Cushing's disease. The nurse should recognize that clients who has Cushing's disease are at increased risk for which of the following? (Select all that apply.) A. Infection B. Gastric ulcer C. Renal calculi D. Bone fractures E. Dysphagia
A. Infection B. Gastric ulcer D. Bone fractures
A nurse is monitoring a client's status 24 hr after a total thyroidectomy. Which of the following findings should the nurse report to the provider? A. Laryngeal stridor B. Productive cough C. Pain with hyperextension of the neck D. Hoarse, weak voice
A. Laryngeal stridor
A nurse is reviewing the health record of a client who has SIADH. Which of the following laboratory findings should the nurse expect? (Select all that apply.) A. Low sodium B. High potassium C. Increases urine osmolality D. High urine sodium E. Increased urine specific gravity
A. Low sodium C. Increases urine osmolality D. High urine sodium E. Increased urine specific gravity
Which hormone changes does the nurse expect when a client receives a continuous cortisol infusion for 24 hours when his or her endocrine feedback mechanisms are functions normally? A. Lower than normal adrenocorticotropic hormone (ACTH) levels; lower than normal corticotropin-releasing hormone (CRH) levels. B. Lower than normal adrenocorticotropic hormone (ACTH) levels; higher than normal corticotropin-releasing hormone (CRH) levels. C. Higher than normal adrenocorticotropic hormone (ACTH) levels; lower than normal corticotropin-releasing hormone (CRH) levels. D. Higher than normal adrenocorticotropic hormone (ACTH) levels; higher than normal corticotropin-releasing hormone (CRH) levels.
A. Lower than normal adrenocorticotropic hormone (ACTH) levels; lower than normal corticotropin-releasing hormone (CRH) levels.
A nurse is planning care for a client who will undergo peritoneal dialysis. Which of the following actions should the nurse take? (Select all that apply.) A. Monitor blood glucose levels B. Report cloudy dialysate return. C. Warm the dialysate in a microwave oven D. Assess for SOB E. Check the access site for dressing for wetness F. Maintain medical asepsis when accessing the catheter insertion site
A. Monitor blood glucose levels B. Report cloudy dialysate return. D. Assess for SOB E. Check the access site for dressing for wetness
A nurse is planning care for a client who has ESKD. Which of the following should the nurse include in the plan of care? (Select all that apply.) A. Monitor the client's weight daily. B. Encourage the client to comply with fluid restrictions. C. Evaluate intake and output. D. Instruct the client on restricting calories from carbohydrates. E. Monitor for constipation
A. Monitor the client's weight daily. B. Encourage the client to comply with fluid restrictions. C. Evaluate intake and output. E. Monitor for constipation
A nurse is caring for a client who has primary adrenal insufficiency and is preparing to undergo an ACTH stimulation test. Which of the following findings should the nurse expect after an IV injection of cosyntropin? A. No change in plasma cortisol B. Elevated fasting blood glucose C. Decrease in sodium D. increase in UOP
A. No change in plasma cortisol
A nurse in an intensive care unit is planning care for a client who has myxedema coma. Which of the following actions should the nurse include? (Select all that apply.) A. Observe cardiac monitor for dysrhythmias B. Observe for evidence of UTI C. Initiate IV fluids using 0.9% sodium chloride D. Administer a levothyroxine IV bolus E. Provide warmth using a heating pad
A. Observe cardiac monitor for dysrhythmias B. Observe for evidence of UTI C. Initiate IV fluids using 0.9% sodium chloride
A nurse is planning postoperative care for a client following a kidney transplant. Which of the following actions should the nurse include? (Select all that apply.) A. Obtain daily weights B. Assess dressings for bloody drainage C. Replace hourly urine output with IV fluids D. Expect oliguria in the first 4 hrs E. Monitor blood electrolytes
A. Obtain daily weights B. Assess dressings for bloody drainage C. Replace hourly urine output with IV fluids E. Monitor blood electrolytes
A client with a history of seizures is placed on seizure precautions. Which emergency equipment will the nurse provide at the bedside? A. Oropharyngeal airway B. Oxygen C. Nasogastric tube D. Suction setup E. Padded tongue blade
A. Oropharyngeal airway B. Oxygen D. Suction setup
A nurse is teaching a client who has an autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following effects should the nurse include? (Select all that apply.) A. Osteoporosis B. Moon-shaped face C. Increase risk of infection D. Hearing loss E. Weight loss
A. Osteoporosis B. Moon-shaped face C. Increase risk of infection
The clinic nurse is caring for a pt complaining that his hands "tremble" and he is no longer able to be as detailed with his work. The nurse notices him rolling his thumb against his first few fingers while he is at rest. The nurse documents this assessment correctly as A. Pill-rolling tremor B. Intention tremor C. Cogwheel tremor D. Kinetic tremor
A. Pill rolling tremor
Acute kidney injury that develops from hypovolemic shock would be classified as which type of injury? A. Prerenal B. Intrarenal C. Postrenal D. Instrinsic
A. Prerenal
A nurse is planning care for a client who has post-renal AKI d/t metastatic cancer. The client has a blood creatinine of 5mg/dL. Which of the following interventions should the nurse include in the plan? (Select all that apply.) A. Provide a high-protein diet. B. Assess the urine for blood. C. Monitor for intermittent anuria. D. Weigh the client once per week E. Provide NSAIDs for pain
A. Provide a high-protein diet. B. Assess the urine for blood. C. Monitor for intermittent anuria.
A nurse is completing discharge teaching about diet and fluid restrictions to a client who has a calcium oxalate-based kidney stone. Which of the following instructions should the nurse include in the teaching? A. Reduce intake of spinach B. Decrease broccoli intake C. Increase vitamin C supplements D. Limit consumption of purine substances
A. Reduce intake of spinach
A nurse has administered propranolol by IV bolus to a client who is having a thyroid storm. Which of the following findings indicates that the client is having a therapeutic response? A. Reduction of the effects of thyroid hormone on the heart B. Blockage of the release of thyroid hormone from the thyroid gland C. Increase in the heart's sensitivity to thyroid hormone D. Increase in the uptake of thyroid hormone by the thyroid gland
A. Reduction of the effects of thyroid hormone on the heart
A nurse is teaching a client who has stage 2 chronic kidney disease about dietary management. Which of the following information should the nurse include in the instructions? A. Restrict protein intake. B. Maintain a high-phosphorus diet. C. Increase intake of foods high in potassium. D. Limit dairy products to 1 cup/day.
A. Restrict protein intake.
A nurse is preparing to initiate hemodialysis for a client who has acute kidney injury. Which of the following actions should the nurse take? (Select all that apply.) A. Review the medications the client currently takes. B. Assess the AV fistula C. Calculate the client's hourly UOP D. Measure the client's daily weight E. Check blood electrolytes F. Use the access site area for venipuncture
A. Review the medications the client currently takes. B. Assess the AV fistula D. Measure the client's daily weight E. Check blood electrolytes
A nurse is reinforcing teaching with a client who has Parkinson's disease and has a new prescription for bromocriptine. Which of the following instructions should the nurse include? A. Rise slowly when standing B. Expect urine to become dark-colored C. Avoid foods containing tyramine D. Report any skin discoloration
A. Rise slowly when standing
Which levels should the nurse routinely monitor to assess the nutritional status of a client with acute kidney injury? (Select all that apply.) A. Serum protein B. Prealbumin C. Albumin D. Urine glucose E. Weight
A. Serum protein B. Prealbumin
Myoglobin release into the circulation is associated with which condition? (Select all that apply.) A. Skeletal muscle damage B. Intrinsic kidney injury C. Dark red urine D. Increased GFR E. Seizure activity
A. Skeletal muscle damage
A nurse is assessing a client who has SIADH. Which of the following findings should the nurse report to the provider? A. Sodium 110 mEq/L B. 2+ DTR C. Potassium 3.7mEq/L D. Urine specific gravity 1.025
A. Sodium 110 mEq/L
A nurse is reviewing laboratory results for a client who has Addison's disease. Which of the following lab results should the nurse expect for this client? (Select all that apply.) A. Sodium 130 mEq/L B. Potassium 6.1 mEq/L C. Calcium 11.6 mg/dL D. Blood uria nitrogen (BUN) 28 mg/dL E. Fasting blood glucose 148 mg/dL
A. Sodium 130 mEq/L B. Potassium 6.1 mEq/L C. Calcium 11.6 mg/dL D. Blood uria nitrogen (BUN) 28 mg/dL
A nurse is reviewing the lab findings of a client who has Cushing's disease. Which of the following findings should the nurse expect for this client? (Select all that apply.) A. Sodium 150 mEq/L B. Potassium 3.3 mEq/L C. Calcium 8.0 mg/dL D. Lymphocyte count 35% E. Fasting glucose 145 mg/dL
A. Sodium 150 mEq/L B. Potassium 3.3 mEq/L C. Calcium 8.0 mg/dL E. Fasting glucose 145 mg/dL
A nurse is performing an admission assessment of a client who has severe chronic kidney disease. Which of the following findings should the nurse expect? A. Tachypnea B. Hypotension C. Exophthalmos D. Insomnia
A. Tachypnea
A nurse is reviewing the laboratory findings for a client who might have hyperthyroidism. The nurse should identify an elevation in which of the following substances as an indication that the client has this disorder? A. Triiodothyronine B. Plasma-free metanephrine C. Urine cortisol D. Urine osmolality
A. Triiodothyronine
A nurse in an emergency department is caring for a client who reports costoverterbal angle tenderness, N/V. Which of the following lab values should the nurse report to the provider? A. WBC 15,000/mm B. BUN 15 mg/dL C. Urine specific gravity 1.020 D. Urine pH 5.5
A. WBC 15,000/mm
At the beginning of a shift, a nurse is assessing a client who has Cushing's disease. Which of the following findings is the priority? A. Weight gain B. Fatigue C. Fragile skin D. Joint pain
A. Weight gain
The nurse is providing discharge teaching for a client who had diabetes insipidus and has a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching? A. "Depress the pump once before using the nasal spray for the first time." B. "Blow your nose gently prior to using the nasal spray." C. "Administer the nasal spray while in a side-lying position." D. "Instill the medication four times per day."
B. "Blow your nose gently prior to using the nasal spray."
A nurse is caring for a client who asks why the provider bases his medication regimen on his HbA1c instead of his log of morning fasting blood glucose results. Which of the following responses should the nurse make? A. "HbA1c measures how well insulin is regulating your blood glucose between meals." B. "HbA1c indicates how well you have regulated your blood glucose over the past 120 days." C. "HbA1c is the first test your doctor prescribed to determine that you have diabetes." D. "HbA1c determines if your doctor should adjust your insulin dosage."
B. "HbA1c indicates how well you have regulated your blood glucose over the past 120 days."
The nurse is providing discharge teaching for a client who has chronic kidney disease. Which of the following statements should the nurse identify as an indication that the client understands the teaching? A. "I will consume foods that are high in protein." B. "I will decrease my intake of foods that are high in phosphorus." C. "I will limit my intake of foods that are high on iron." D. "I will add salt to the foods I consume."
B. "I will decrease my intake of foods that are high in phosphorus."
A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following statements should the nurse identify as an indication that the client understands the information about this test? A. "I need to fast after midnight the night before the test. B. "This test's result is a good indicator of my average blood glucose levels." C. "A level of eight to ten percent suggests adequate blood glucose control." D. "I will use my hemoglobin A1c level to adjust my daily insulin."
B. "This test's result is a good indicator of my average blood glucose levels."
A nurse is providing education to a client who is to undergo an EEG the next day. Which of the following information should the nurse include in the teaching? A. "Do not wash your hair the morning of the procedure." B. "Try to stay awake most of the night prior to the procedure." C. "The procedure will take approximately 15 minutes." D. "You will need to lie flat for 4 hours after the procedure."
B. "Try to stay awake most of the night prior to the procedure."
A nurse is providing education regarding cyclosporine for a client who had a kidney transplant 2 days ago. Which of the following statements should the nurse make? A. "You might have hair loss due to the medication therapy you'll be taking." B. "You will need to continue taking this medication to protect your new kidneys." C. "Use an OTC anti-inflammatory medication for aches and pains." D. "Your risk for infection will increase if you stop taking this medication."
B. "You will need to continue taking this medication to protect your new kidneys."
A client with *early* dementia asks the nurse to find her mother, who is deceased. What is the nurse's *most appropriate* response? A. "We can call her in a little while if you want." B. "Your mother died over 20 years ago." C. "What did your mother look like?" D. "I'll ask your father to find her when he visits?"
B. "Your mother died over 20 years ago."
A nurse is caring for a client who is postprocedure following lumbar puncture and reports throbbing headache when sitting upright. Which of the following actions should the nurse take? (Select all that apply.) A. Use the GCS when assessing the pt. B. Assist the client to a supine position C. Administer an opioid medication D. Encourage the client to increase fluid intake E. Instruct the client to perform deep breathing and coughing exercises
B. Assist the client to a supine position C. Administer an opioid medication D. Encourage the client to increase fluid intake
A nurse in an emergency department is assessing a client who has myasthenia gravis. The client reports recent increasing muscle weakness and the nurse suspects the client is having a myasthenic crisis. Which of the following actions is the nurse's priority? A. Administer artificial tears B. Assist with a tensilon test C. Administer immunosuppressants D. Assist with plasmapheresis
B. Assist with a tensilon test
A nurse is teaching a client who has a new diagnosis of acute pyelonephritis. Which of the following instructions should the nurse include in the teaching? A. Drink up to 1,500 mL of fluid per day B. Avoid the use of NSAIDs for pain C. Check peripheral blood glucose levels twice per day D. Increase dietary protein intake
B. Avoid the use of NSAIDs for pain
Hyperkalemia associated with AKI may lead to which problem? A. Excessive thirst B. Cardiac arrest C. Skeletal muscle weakness D. Dysphagia
B. Cardiac arrest
The ED nurse is caring for a pt with MG. The pt is in crisis and the physician orders edrophonium (Tensilon) to be given, but the pt symptoms dont get any better. What type of crisis isn't he pt having? A. Myasthenia crisis B. Cholinergic crisis C. Mid life crisis D. Personal crisis
B. Cholinergic crisis
A nurse is assessing a client who has diabetes mellitus and reports feeling anxious. Which of the following findings should the nurse expect if the client is hypoglycemic? A. Rapid, deep respirations B. Cool, clammy skin C. Abdominal cramping D. Orthostatic hypotension
B. Cool, clammy skin
A nurse is caring for a pt diagnosed with small cell lung cancer. The nurse understands the pt may also present with which endocrine disorder? A. Adrenal crisis B. Cushing's syndrome C. DI D. SIADH
B. Cushing's syndrome
A nurse in a provider's office is reviewing laboratory results of a client who is being evaluated for secondary hypothyroidism. Which of the following laboratory findings is expected for a client who has this condition? A. Elevated serum T4 B. Decreased Serum T3 C. Elevates serum thyroid stimulating hormone D. Decreased serum cholesterol
B. Decreased Serum T3
A nurse is assessing a client for changes in the LOC using the GCS. The client opens his eyes when spoken to, speaks incoherently, and moves his extremities when pain is applied. Which of the following GCS scored should the nurse document? A. E2+V3+M5=10 B. E3+V4+M4=11 C. E4+V5+M6=15 D. E2+V2+M4=8
B. E3+V4+M4=11
A nurse is reviewing client lab data. Which of the following findings is expected for a client who has Stage 4 chronic kidney disease? A. BUN 15mg/dL B. GFR 20L/min C. Blood crt 1.1 mg/dL D. Blood potassium 5/0mEq/L
B. GFR 20L/min
The nurse assesses an older adult with a diagnosis of severe, late-stage Alzheimer's disease. Which assessment findings would the nurse expect for this client? A. Acute Confusion B. Hallucinations C. Wandering D. Urinary incontinence E. Difficulty eating
B. Hallucinations D. Urinary incontinence E. Difficulty eating
A nurse is monitoring a client who has a kidney biopsy for postoperative complications. Which of the following complications should the nurse identify as causing the greatest risk to the client? A. Infection B. Hemorrhage C. Hematuria D> Pain
B. Hemorrhage
The nurse is caring for a pt newly diagnosed with ALS. Which statement by the pt indicates the need for further teaching? A. I need to live my life to the fullest while i still have the strength to move on my own B. I'll sure be glad when I'm cured. I'm ready to get back to mountain climbing C. It's probably important for me to fill out an advance directive sooner rather than later. D. It's strange to know I probably wont be around in five years
B. I'll sure be glad when I'm cured. I'm ready to get back to mountain climbing.
A client has been started on intermittent hemodialysis (IHD) to treat acute kidney failure. The nurse will closely monitor the client for which complications associated with IHD? (Select all that apply.) A. Infection B. Increased cardiac output C. Air embolism D. Acute myocardial infarction E. Hemorrhage
B. Increased cardiac output D. Acute myocardial infarction
A nurse is assessing a client who has diabetes insipidus. The nurse should expect which of the following findings? A. Decreased HR B. Increased hct C. High urine specific gravity D. Low BUN
B. Increased hct
A nurse is caring for a client who experience a traumatic head injury and has an intraventricular catheter (ventriculostomy) for ICP monitoring. The nurse should monitor the client for which of the following complications related to the ventriculostomy? A. Headache B. Infection C. Aphasia D. HTN
B. Infection
A nurse is planning teaching for a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include? A. Consume no more than three servings of alcohol per day B. Ingest alcohol with food to reduce alcohol-induced hypoglycemia C. Increase insulin dosage before planned exercise D. Rest 3 days between periods of vigorous exercise
B. Ingest alcohol with food to reduce alcohol-induced hypoglycemia
A nurse is caring for a client who has MS. Which of the following findings should the nurse expect? A. Fluctuations in BP B. Loss of cognitive function C. Ineffective cough D. Drooping eyelids
B. Loss of cognitive function
A nurse is reinforcing teaching with a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Weight gain is expected while taking this medication B. Medication should not be discontinued without the advice of the provider C. Follow-up serum TSH levels should be obtained D. Take the medication on an empty stomach E. Use fiber laxatives for constipation
B. Medication should not be discontinued without the advice of the provider C. Follow-up serum TSH levels should be obtained D. Take the medication on an empty stomach
A nurse is collecting an admission history from a female client who has hypothyroidism. Which of the following findings should the nurse expect? (Select all that apply.) A. Diarrhea B. Menorrhagia C. Dry skin D. Increased libido E. Hoarseness
B. Menorrhagia C. Dry skin E. Hoarseness
A nurse is caring for a client who has diabetes mellitus has developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to the client's feet? A. Examine the skin and feet weekly for alterations in skin integrity B. Monitor the temperature of bath water with a thermometer C. Shop for shoes early in the day D. Round the edges of toenails when trimming
B. Monitor the temperature of bath water with a thermometer
A nurse is providing medication teaching for a client who has Addison's Disease and is taking hydrocortisone. Which of the following instructions should the nurse include? (Select all that apply.) A. Take the medication on an empty stomach B. Notify the provider of any illness or stress C. Report any manifestations of weakness or dizziness D. Do not discontinue the medication suddenly E. Eat a low-sodium diet
B. Notify the provider of any illness or stress C. Report any manifestations of weakness or dizziness D. Do not discontinue the medication suddenly
A nurse is assessing a client during a water deprivation test. For which of the following complications should the nurse monitor the client? A. Bradycardia B. Orthostatic hypotension C. Neck vein distention D. Crackles in lungs
B. Orthostatic hypotension
A nurse is caring for a client who has a hard cervical collar for a complete cervical spinal cord injury. Which assessment finding will the nurse report to the primary health care provider? A. Purulent drainage from the pin sites on the client's forehead B. Painful pressure injury under the collar C. Inability to move legs or feet D. Oxygen saturation of 95% on room air
B. Painful pressure injury under the collar
In peritoneal dialysis, which structure acts as the permeable membranes to remove wastes and water? A. Liver B. Peritoneal membrane C. Stomach D. Intestinal villi
B. Peritoneal membrane
A nurse is assessing a client for manifestations of Parkinson's disease. Which of the following are expected findings? (Select all that apply.) A. Decreased vision B. Pill-rolling tremor of the fingers C. Shuffling gait D. Drooling E. Bilateral ankle edema F. Lack of facial expression
B. Pill-rolling tremor of the fingers C. Shuffling gait D. Drooling F. Lack of facial expression
A nurse is developing a plan of care for the nutritional needs of a client who has stage IV Parkinson's disease. Which of the following actions should the nurse include? (Select all that apply.) A. Provide three large balanced meals daily. B. Record diet and fluid intake daily. C. Document weight every other week. D. Offer cold fluids such as milkshakes. E. Offer nutritional supplements between meals.
B. Record diet and fluid intake daily. C. Document weight every other week. E. Offer nutritional supplements between meals.
Sodium polystyrene sulfonate (Kayexalate) can be administered through which routes? (Select all that apply.) A. Intravenous B. Rectal C. Oral D. Intramuscular E. Subcutaneous
B. Rectal C. Oral
A nurse in an acute care facility is admitting a client who has acute adrenal insufficiency. Which of the following prescriptions should the nurse anticipate? (Select all that apply.) A. IV therapy with 0.45% sodium chloride B. Regular insulin C. Hydrocortisone sodium succinate D. Sodium polystyrene sulfonate E. Furosemide
B. Regular insulin C. Hydrocortisone sodium succinate D. Sodium polystyrene sulfonate E. Furosemide
Which two activities are the primary function of renal replacement therapy? (Select all that apply.) A. Addition of free fatty acids B. Removal of wastes C. Addition of nutrients D. Removal of excess water E. Removal of lipids
B. Removal of wastes D. Removal of excess water
The client is a 62 y/o admitted 2 days ago with traumatic injuries and hypovolemic shock from a car crash. The nurse reviewing the client's daily laboratory test results notices the following values. Which result is most important to report to the primary health care provider immediately? A. Serum sodium 132 mEq/L (mmol/L) B. Serum potassium 6.9 mEq/L (mmol/L) C. Blood urea nitrogen 24 mg/dL (mmol/L) D. Hematocrit 32% (0.32 volume fraction); Hemoglobin 9.2 g/dL (92 g/L)
B. Serum potassium 6.9 mEq/L (mmol/L)
Serum osmolality is determined in large part by which factor? A. Urea levels B. Sodium levels C. Potassium levels D. Creatinine levels
B. Sodium levels
The nurse is preparing to administer Sinemet to a client whose highest blood pressure is 88/50 while lying in bed. What is the nurse's *priority* action at this time? A. Instruct the client to get out of bed slowly B. Withhold the drug until contacting the primary health care provider C. Ask the client about the presence of hallucinogens D. Take the client's apical pulse and temperature
B. Withhold the drug until contacting the primary health care provider
A nurse is teaching a client who has Parkinson's disease about taking carbidopa-levodopa. Which of the following statements should the nurse identify as an indication that the client understands the teaching? A. "I should expect a slight increase in my blood pressure while taking this medication." B. "I should take my medication with a high-protein food." C. "I should expect my urine to be a darker color." D. "I should expect it to take a week for this medication to work."
C. "I should expect my urine to be a darker color."
A nurse is teaching a client who has type 1 diabetes mellitus about how to prevent complications during illness. Which of the following statements should the nurse identify as an indication that the client understands the teaching? A. "I should stop taking my insulin if I feel nauseous." B. "I will test my urine for protein when I start to feel ill." C. "I will call my doctor if my blood sugar is more than 250 milligrams per deciliter." D. "I should check my blood glucose level every 8 hours."
C. "I will call my doctor if my blood sugar is more than 250 milligrams per deciliter."
A nurse is providing teaching to a client who has CKD. Which of the following statements by the client indicates an understanding of the teaching? A. "I will check my blood pressure once per week." B. "I will take a magnesium antacid if I get constipated." C. "I will weigh myself every morning." D. "I will use a salt substitute in my diet."
C. "I will weigh myself every morning."
A nurse is teaching a client who is postoperative following a kidney transplant and is taking cyclosporine. Which of the following instructions should the nurse include? A. "Decrease your intake of protein-rich foods." B. "Take this medication with grapefruit juice." C. "Monitor for and report a sore throat to your provider." D. "Expect your skin to turn yellow."
C. "Monitor for and report a sore throat to your provider."
A nurse is teaching a client who has Grave's disease and a new prescription for *propranolol*. Which of the following client statements indicates effective teaching? A. "Propranolol helps increase blood flow to my thyroid gland." B. "Propranolol is used to prevent excess glucose in my blood." C. "Propranolol will decrease my tremors and fast heart beat." D. "Propranolol promotes a decrease of thyroid hormone in my body."
C. "Propranolol will decrease my tremors and fast heart beat."
A nurse is monitoring a client hemodialysis. The nurse should recognize that which of the following factors places the client at risk for seizures? A. Hypokalemia B. A rapid increase of chatecholamines C. A rapid decrease in fluid D. Hypercalcemia
C. A rapid decrease in fluid
A nurse is planning to teach a client who is being evaluate for Addison's disease about the ACTH stimulation test. The nurse should base her instructions to the client on which of the following? A. The ACTH stimulation test measures the response by kidneys to ACTH B. In the presence of primary adrenal insufficiency, plasma cortisol levels rise in response to administration of ACTH C. ACTH is a hormone produced by the pituitary gland D. The client is instructed to take a dose of ACTH by mouth the evening before the test
C. ACTH is a hormone produced by the pituitary gland
The nurse is caring for a client with chronic confusion who often yells and screams when touched. Which nursing intervention is *most appropriate* when caring for this client? A. Provide a large clock and calendar for the patient to read B. Use removable restraints such as roll-waist belt to prevent wandering C. Approach the patient so the nurse can be seen clearly D. Place the patient in a room close to the nurses' station for frequent observation
C. Approach the patient so the nurse can be seen clearly
A nurse is caring for a client who develops disequilibrium syndrome after receiving hemodialysis. Which of the following actions should the nurse take? A. Administer an opioid medication B. Monitor for HTN C. Assess LOC D. Increase the dialysis exchange rate
C. Assess LOC
A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect? A. Moon face B. Weight cain C. Calcium 12.8 mg/dL D. Sodium 150 mEq/L
C. Calcium 12.8 mg/dL
A nurse is assessing a client who has CKD and has completed her third peritoneal dialysis (PD) treatment. Which of the following findings should the nurse report to the provider? A. Greater outflow of dialysate than inflow B. Weight loss C. Cloudy dialysate effluent D. Report of pain during inflow
C. Cloudy dialysate effluent
A nurse is caring for a client who has AKI. Which of the following serum laboratory findings should the nurse report to the provider? A. Potassium 5.0 mEq/L B. Calcium 9.0mg/L C. Creatinine 4.0 mg/dL D. Amylase 84 units/L
C. Creatinine 4.0 mg/dL
A nurse is teaching about diet restrictions to a client who has acute kidney injury and is on hemodialysis. Which of the following recommendations should the nurse include in the teaching? A. Limit calcium intake to 2,500 mg/day. B. Decrease total fat intake to 45% of daily calories. C. Decrease potassium intake to 60-70 mEq/kg. D. Limit sodium intake to 4.5 g/day.
C. Decrease potassium intake to 60-70 mEq/kg.
Dietary protein intake is monitored in clients with renal dysfunction for which reason? A. Dietary sources of protein include excess triglyceride levels B. The client's weight must be controlled, and limiting protein is the easiest way to do this C. Dietary protein intake increases nitrogenous waste products D. The client requires twice the usual protein intake
C. Dietary protein intake increases nitrogenous waste products
A nurse is teaching a client who has diabetes mellitus about insulin injections. The client's prescription includes evening doses of insulin glargine and regular insulin. Which of the following instructions should the nurse include? A. Inject the insulins intramuscularly B. Shake the insulins vigorously prior to administration C. Draw up the insulins into separate syringes D. Expect the insulins to appear cloudy
C. Draw up the insulins into separate syringes
A nurse is providing discharge teaching for a client who has a transsphenoidal hypophysectomy. Which of the following instructions should the nurse include? (Select all that apply.) A. Brush your teeth after every meal or snack B. Avoid bending at the knees C. Eat a high-fiber diet D. Notify the provider of any sweet-tasting drainage E. Notify the provider of a diminished sense of smell
C. Eat a high-fiber diet D. Notify the provider of any sweet-tasting drainage
A nurse is caring for a client who is 6 hr postoperative following a transsphenoidal hypophysectomy. The nurse should test the client's nasal drainage for the presence of which of the following? A. RBC's B. Ketones C. Glucose D. Streptococci
C. Glucose
A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect? A. Decreased BP B. Weight loss C. Hirsutism D. Increased skin thickness
C. Hirsutism
A MAP below 65 mmHg may result in which condition? A. Increased renal perfusion and increased GFR B. Release of substances that produce local vasodilation C. Inadequate renal perfusion pressure D. Renal artery obstruction
C. Inadequate renal perfusion pressure
A nurse is planning care for a client who has CKD and potassium level of 7.3 mEq/L. Which of the following interventions should the nurse plan to take? A. Initiate an IV infusion of lactated ringer's solution B. Give spironolactone 50 mg PO BID C. Infuse regular insulin in dextrose 10% in water D. Administer supplemental phosphorus
C. Infuse regular insulin in dextrose 10% in water
A nurse is caring for a client who has multiple sclerosis. Which of the following findings should the nurse expect? A. Hypoactive DTR B. Ascending paralysis C. Intention tremors D. Increased lacrimation
C. Intention tremors
A nurse administered captopril to a client during a renal scan. Which of the following actions should the nurse take? A. Assess for HTN B. Limit the client's fluid intake C. Monitor for orthostatic hypotension D. Encourage early ambulation
C. Monitor for orthostatic hypotension
A nurse is caring for a client who has advancing ALS. Which of the following interventions is the nurse's priority? A. Provide for frequent rest periods throughout the day. B. Medicate for pain on a regular schedule C. Monitor pulse oximetry findings D. Administer baclofen for spasticity
C. Monitor pulse oximetry findings
The nurse is preparing a teaching plan for a client with migraine headaches. Which of these foods or food additives that may trigger a migraine will the nurse include in the teaching? A. Sugar B. Salt C. Monosodium glutamate (MSG) D. Caffeine E. Wine F. Tyramine
C. Monosodium glutamate (MSG) D. Caffeine E. Wine F. Tyramine
Which drug category is a common cause of prerenal kidney injury? A. Antibiotics B. Cardiac glycosides C. NSAIDs D. Antihypercholesterolemic drugs
C. NSAIDs
A nurse is reviewing the results of a client's urinalysis. The findings indicate the urine is positive for leukocyte esterase and nitrates. Which of the following actions should the nurse take? A. Repeat the test early the next morning. B. Start a 24-hr urine collection for creatinine clearance C. Obtain a clean-catch urine specimen for culture and sensitivity D. Insert an indwelling urinary catheter to collect a urine specimen.
C. Obtain a clean-catch urine specimen for culture and sensitivity
A client who performs home continuous ambulatory peritoneal dialysis reports that the drainage (effluent) has become cloudy in the past 24 hours. What is the nurse's best first action? A. Remove the peritoneal catheter B. Notify the nephrology health care provider immediately C. Obtain a sample of effluent for culture and sensitivity D. Explain to the client the need to keep the dialysate in the refrigerator to prevent bacterial overgrowth
C. Obtain a sample of effluent for culture and sensitivity
A client with acute kidney injury is at higher risk for which pulmonary disorder? A. Asthma B. COPD C. Pneumonia D. Emphysema
C. Pneumonia
A nurse is planning care for a client who has prerenal acute kidney injury (AKI) following abdominal aortic aneurysm repair. UOP is 60 mL in the past 3 hr, and BP is 92/58 mmHg. The nurse should expect which of the following interventions? A. Prepare the client for a CT scan with contrast dye B. Plan to administer nitroprusside C. Prepare to administer a fluid challenge D. Plan to position the client in trendelenberg
C. Prepare to administer a fluid challenge
The hypercatabolic processes in clients with AKI make restriction of which nutrients an important consideration? A. Carbohydrates B. Fats C. Proteins D. Essential fatty acids
C. Proteins
A nurse is caring for a client who displays manifestations of stage III Parkinson's disease. Which of the following action should the nurse include? A. Recommend a community support group B. Integrate a daily exercise routine. C. Provide a walker for ambulation. D. Perform ADLs for the client.
C. Provide a walker for ambulation.
A nurse is assessing a client who has a pre-renal AKI. Which of the following findings should the nurse expect? (Select all that apply.) A. Reduced BUN B. Elevated cardiac enzymes C. Reduced UOP D. Elevated blood crt E. Elevated blood calcium
C. Reduced UOP D. Elevated blood crt
When reviewing the laboratory values of a client who has COPD and pneumonia, the nurse observes these findings. Which one foes the nurse report to the provider immediately? A. International normalized ratio (INR) 2.1 B. Serum chloride 96 mEq/L (mmol/L) C. Serum sodium 117 mEq/L(mmol/L) D. pH 7.28
C. Serum sodium 117 mEq/L(mmol/L)
A client with ESRD has been admitted for treatment of a different diagnosis. the nurse would expect which intervention due to the presence of ESRD? A. Encouraging fluid intake B. High-protein diet C. Sodium-restrict diet D. Potassium supplementation
C. Sodium-restrict diet
A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements should the nurse identify as an indication that the client understands the teaching? A. "I will let my feet air dry after washing." B. "I will wear sandals to allow air to circulate around my feet." C. "I will buy over-the-counter medicine to treat the calluses on my feet." D. "I will apply lotion to the dry areas of my feet, but not between my toes."
D. "I will apply lotion to the dry areas of my feet, but not between my toes."
To screen a client for pheochromocytoma, a nurse schedules a vanillylmandelic acid test. When teaching the client about this test, which of the following instructions should the nurse include? A. "Start fasting at midnight prior to the day of the test." B. "Begin the 24-hr urine collection with the first morning urination." C. "Take low-dose aspirin for pain during the testing period." D. "Restrict coffee intake 2-3 days prior to the test."
D. "Restrict coffee intake 2-3 days prior to the test."
A nurse is teaching a client who will have an XRAY of the kidneys, ureters, and bladder. Which of the following statements should the nurse include in the teaching? A. "You will receive contrast dye during the procedure." B. "An enema is necessary before the procedure." C. "You will need to lie in a prone position during the procedure." D. "The procedures determines whether you have a kidney stone."
D. "The procedures determines whether you have a kidney stone."
A nurse is teaching a client who has MS and a new prescription for baclofen. Which of the following statements should the nurse include in the teaching? A. "This medication will help with your tremors." B. "This medication will help with your bladder function." C. "This medication can cause your skin to bruise easily." D. "This medication can cause you to experience dizziness."
D. "This medication can cause you to experience dizziness."
The acidosis associated with kidney injury is directly related to which condition? A. Hypoventilation B. Excessive excretion of bicarbonate ions C. Decreased cardiac output D. Accumulation of hydrogen ions
D. Accumulation of hydrogen ions
A nurse is teaching a client about the adrenocorticotropic hormone (ACTH) stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders? A. Diabetes insipidus B. Hyperthyroidism C. Pheochromocytoma D. Addison's disease
D. Addison's disease
Preoperative holding area, the client who is scheduled to have an adrenalectomy for hypercortisolism is prescribed to receive cortisol by IV infusion/ What is the nurse's best action? A. Request a "time out" to determine whether this is a valid prescription B. Ask the client whether he or she usually takes prednisone C. Hold the dose because the client has a high cortisol level. D. Administer the drug as prescribed
D. Administer the drug as prescribed
A nurse is teaching a client who has diabetes mellitus. Which of the following should the nurse include as an expected finding of diabetic ketoacidosis (DKA)? A. Decreased UOP B. Weight gain of 0.45 (1lb) in 24 hr C. Rapid, shallow respirations D. Blood glucose levels above 300 mg.dL
D. Blood glucose levels above 300 mg.dL
A nurse is planning care for a client who is postoperative following a nephrectomy. Which of the following assessments is the nurse's priority? A. Bowel sounds B. WBC count C. Pain level D. Blood pressure
D. Blood pressure (Greatest risk is injury from acute adrenal insufficiency. Monitor for hypotension of decreased in UOP)
A nurse is caring for a client who is taking for somatropin to stimulate growth. The nurse should plan to monitor the client's urine for which of the following? A. Bilirubin B. Protein C. Potassium D. Calcium
D. Calcium
The nurse is preparing a client for discharge who developed an acute kidney injury during coronary artery bypass graft surgery. The nurse notices that the client has a serum creatinine of 1.2 mg/dL (106 mcmol/L) and a GFR of 75 mL/kg/1.73. What is the priority nursing action? A. Reminding the client to remain hydrated by drinking 500 mL of an electrolyte - based solution daily B. Encouraging the client to reduce protein intake to reduce creatinine production until the follow-up visit with the nephrological occurs C. Checking the remaining values on the metabolic panel and informing the primary care provider of all results before the client is discharged D. Educating the client about the need for follow-up, including re-evaluation of serum creatinine with the PCP or nephrologist in 8-12 wks
D. Educating the client about the need for follow-up, including re-evaluation of serum creatinine with the PCP or nephrologist in 8-12 wks
Which of the following is a risk factor associated with development of MS? A. Smoking B. High fat diet C. Age greater than 70 D. Female gender
D. Female gender
A nurse is caring for a client who has Parkinson's disease and is starting to display bradykinesia. Which of the following is an appropriate action by the nurse? A. Teach the client to walk more quickly when ambulating. B. Complete passive ROM exercises daily. C. Place the client on a low-protein, low-calorie diet D. Give the client extra time to perform activities
D. Give the client extra time to perform activities
A nurse is caring for a client undergoing screening for primary Cushing's disease. The nurse should expect an elevation in which of the following laboratory findings? A. Lymphocyte count B. Potassium C. Calcium D. Glucose
D. Glucose
Which priority question should the nurse ask a patient with a pituitary tumor? A. Have you had an unexpected weight loss? B. Have you noticed excessive thirst? C. Do you have any changes in your visual acuity? D. Have you experienced a change in growth of your facial hair?
D. Have you experienced a change in growth of your facial hair?
A nurse is reviewing the medical record of a client who takes desmopressin for diabetes insipidus. Which of the following findings is an adverse effect of desmopressin? A. Hypovolemia B. Hypercalcemia C. Agitation D. Headache
D. Headache
A nurse is teaching a client who has chronic kidney disease and is to begin hemodialysis. Which of the following information should the nurse include in the teaching? A. Hemodialysis restores kidney function B. Hemodialysis replaces hormonal function of the renal system C. Hemodialysis allows an unrestricted diet D. Hemodialysis returns a balance to blood electrolytes
D. Hemodialysis returns a balance to blood electrolytes
A home health nurse is assessing a client who requires lifelong hormone replacement therapy for the treatment of hypothyroidism. The client has not been taking his medication regularly. Which of the following findings should the nurse expect? A. Increased UOP B. Persistent diarrhea C. Tachycardia D. Hypotension
D. Hypotension
Continuous renal replacement therapy has which major advantage over intermittent hemodialysis? A. Better retention of solutes B. Reduced loss of metabolic products C. Greater fluid removal D. Increased hemodynamic stability
D. Increased hemodynamic stability
A nurse is providing instructions for reducing the dietary intake of potassium to a client who has CKD. Which of the following food selections should the nurse recommend? A. 1 cub cubed cantaloupe B. 1 cup boiled spinach C. One medium baked potato D. One large raw apple
D. One large raw apple
A client who sustained a recent cervical spinal cord injury reports feeling flushed. The client's BP is 180/100. What is the nurse's best action at this time? A. Perform a bladder assessment B. Insert an indwelling urinary catheter C. Turn on a fan to cool the patient D. Place the patient in a sitting position
D. Place the patient in a sitting position
A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires intranasal demopressin. Which of the following information should the nurse include in the teaching plan? A. Drink at least 3 L of fluid per day B. Weigh yourself weekly while wearing similar clothing at the same time of day C. Notify the provider of a weight loss of 0.45 (1lb) or more per week D. Report nocturia because it requires a dosage adjustment
D. Report nocturia because it requires a dosage adjustment
What is the major cause of death from AKI? A. Hyperkalemia B. Metabolic acidosis C. Fluid volume excess D. Sepsis
D. Sepsis
A nurse is caring for a client who has type 2 diabetes mellitus and has hyperglycemic-hyperosmolar state (HHS). Which of the following laboratory findings should the nurse expect? A. Serum pH 7.32 B. Blood glucose of 250 mg/dL C. Blood glucose of 425 mg/dL D. Serum pH of 7.45
D. Serum pH of 7.45
The nurse is caring for a client with trigeminal neuralgia. Which patient problem is the priority for the nurse? A. Facial twitching B. Problems with communication C. Ptosis and diplopia D. Severe facial pain
D. Severe facial pain
A nurse is caring for an older adult client who has hypothyroidism and a new prescription for *levothyroxine*. Which of the following dosage schedules should the nurse expect for this client? A. The client will start at a high dosage, and the amount will be tapers as needed. B. The client will remain on the initial dosage during the course of treatment. C. The client's dosage will be adjusted daily based on blood levels. D. The client will start on a low dosage, which can be gradually increased.
D. The client will start on a low dosage, which can be gradually increased.
The kidneys compensate for significant reductions in GFR through which mechanisms? A. Regeneration of damaged nephrons B. Hypertrophy of the remaining nephrons C. Hibernation reflex of the nephrons D. There are no compensatory mechanisms
D. There are no compensatory mechanisms
A nurse is caring for a client immediately following a kidney transplant. The nurse should identify which of the following findings as a possible indication of a delay in functioning of the transplanted kidney? A. Blood pressure 110/58 mmHg B. Incisional tenderness C. Pink and bloody urine D. Urine output 30mL/2hr
D. Urine output 30mL/2hr
When the nurse caring for a client with severe chronic kidney disease asks what dietary modifications he has made for the disease, he reports the following actions. Which action indicates to the nurse that additional client education is needed? A. Using a scale to measure protein weight B. Taking calcium and vitamin D supplements daily C. Eliminating bananas, citrus fruits, and avocados D. Using a salt-substitute instead of ordinary table salt
D. Using a salt-substitute instead of ordinary table salt
A nurse is preparing to assess a client who received hemodialysis 1 hr ago. Which of the following assessments should the nurse perform first? A. Potassium level B. Body weight C. Creatinine level D. Vital signs
D. Vital signs