CM 2 exam 1

The nurse is caring for a patient with diabetes who is experiencing dehydration and hyperglycemia. Which prescribed intervention should the nurse consider as a priority? a. Administering intravenous fluids b. Administering glucose c. Monitoring intake and output d. Rechecking the blood glucose in 5 minutes

Administering intravenous fluids

The nurse is unable to palpate bilateral pedal pulses for a patient with type 1 diabetes mellitus. Based on this assessment finding, which question is most appropriate for the nurse to ask the patient? a. "Have you had a hemoglobin A1C drawn lately?" b. "Have you had any changes in sensation of your feet?" c. "What have your blood glucose levels readings been?" d. "Have you taken any insulin to control your blood sugars?

"Have you had any changes in sensation of your feet?"

An older adult patient is experiencing alterations in sensory and cognitive functioning. Which interview question should the nurse ask to determine the patient's sensory and cognitive functioning? a. "Have you noticed any tremors in your hands?" b. "Have you had any heart palpitations?" c. "Have you had any difficulty urinating?" d. "Have you noticed any difficulty swallowing?"

"Have you had any heart palpitations?"

The nurse is caring for a patient newly diagnosed with type 2 diabetes mellitus. Which patient statement reflects a subjective finding of type 2 diabetes? a. "I have so much energy that I cannot sleep at night." b. "I have completely lost my appetite, but I am gaining weight." c. "I am having difficulty urinating." d. "I am constantly thirsty and cannot get enough to drink."

"I am constantly thirsty and cannot get enough to drink."

During a home visit, the nurse evaluates the patient's understanding of a prescribed biguanide medication. Which patient statement indicates that additional medication instruction is required? a. "I will monitor my blood sugars to be sure I am in normal range." b. "I will take this medication with my meals." c. "I have to take the drug until my blood glucose levels are normal." d. "I have to throw out any medication past the expiration date."

"I have to take the drug until my blood glucose levels are normal."

The nurse is guiding a new nurse who is caring for a patient with hypothyroidism. Which statement made by the new nurse indicates an understanding of hypothyroidism? a. "I will provide extra safety measures to prevent bone fractures." b. "I will assess the patient's morning blood glucose." c. "I will assist the patient in finding ways to incorporate increased activity." d. "I will teach the patient some relaxation techniques, so they can sleep better."

"I will assist the patient in finding ways to incorporate increased activity."

The nurse is teaching a patient about the supplemental thyroid hormone (TH) prescribed by the healthcare provider. Which patient statement requires further teaching? a. "I will need to take the thyroid hormone until my fatigue is better." b. "If I do not take the hormone, I can experience weight gain." c. "I can experience life-threatening problems if I do not take this hormone." d. "If I continue to experience dry skin, I'll call my healthcare provider."

"I will need to take the thyroid hormone until my fatigue is better."

The nurse is teaching a patient with new-onset diabetes mellitus about nutritional management of hypoglycemia and the 15/15 rule. Which patient statement indicates an understanding of the instruction provided? a. "I should call my healthcare provider after eating 15 grams of carbohydrates." b. "After 15 minutes have gone by, I should eat 15 more grams of carbohydrates." c. "If my blood sugar goes too low, I should eat 15 grams of carbohydrates." d. "With hypoglycemia, I should take my insulin after having a snack."

"If my blood sugar goes too low, I should eat 15 grams of carbohydrates."

The nurse is caring for a patient with type 1 diabetes mellitus who just became pregnant. Which assessment finding indicates an understanding by the patient of proper disease management during pregnancy? a. Postprandial blood glucose of 250 mg/dL b. Monitoring blood glucose levels weekly c. Eating meals at different times each day d. Hemoglobin A1C of 6.0%

Hemoglobin A1C of 6.0%

The nurse is caring for an older adult patient who asks, "Are there certain endocrine disorders for which older adults have a higher risk?" Which response by the nurse addresses the patient's question? a. "Older adults have an increased risk for Addison disease." b. "Older adults have an increased risk of hypothyroidism." c. "Older adults have an increased risk of hyperthyroidism." d. "Older adults have increased risk of type 1 diabetes."

"Older adults have an increased risk of hypothyroidism."

A patient prescribed a bisphosphonate asks the nurse, "How does this medication help my osteoporosis?" Which statement provides the patient with an accurate response? a. "The medication will increase the absorption of calcium in your bones." b. "The medication will stop the loss of calcium from your bones." c. "The medication will bind with the calcium in your diet and transfer it into the bones." d. "The medication will reduce the risk of fractures."

"The medication will reduce the risk of fractures."

The nurse is caring for a patient diagnosed with type 2 diabetes. The nurse should anticipate the healthcare provider ordering which medication for oral glucose control? a. Short-acting insulin b. Long-acting insulin c. Biguanide d. Bisphosphonate

Administering intravenous fluids

The nurse is working with a group of adolescents with type 1 diabetes mellitus in a support group. An adolescent asks about alcohol consumption. Which response by the nurse is accurate? a. "Men with type 1 diabetes mellitus should drink no more than 3 alcoholic beverages per day." b. "It is difficult to tell the difference between hyperglycemia and alcohol intoxication." c. "Alcohol can increase the effects of insulin, causing severe hypoglycemia." d. "Alcohol can be consumed by people with type 1 diabetes mellitus once a week in moderation."

"Alcohol can increase the effects of insulin, causing severe hypoglycemia."

A child is diagnosed with type 1 diabetes mellitus. The parents ask the nurse what could have caused this diagnosis because there is no history of diabetes on either family side. Which question should the nurse ask first to obtain more information? a. "What types of food does your child usually eat?" b. "Has your child been ill lately with a viral infection?" c. "Does anyone in your family have lupus or Sjögren syndrome?" d. "Were either of you or anyone in the family adopted?"

"Has your child been ill lately with a viral infection?"

An 82-year-old patient reports frequent bouts of nausea and indigestion, and numbness and tingling in their feet. Which response should the nurse make to the patient? a. "These are normal signs of aging. There is no need to worry." b. "These may be signs of renal failure. Let's get your kidneys checked." c. "These may be complications of diabetes mellitus. Let's get your blood sugar checked." d. "These may be signs of hypertension. I'll check your blood pressure."

"These may be complications of diabetes mellitus. Let's get your blood sugar checked."

The nurse is teaching a patient with type 1 diabetes mellitus about carbohydrate counting. The patient is concerned because of a desire to stay with a low-carbohydrate ketogenic diet. Which instruction is most appropriate for the nurse to provide? a. "I would discuss this with the healthcare provider. Most individuals with diabetes do not do well on fad diets." b. "You should not do a low-carbohydrate diet. As an individual with diabetes, carbohydrates should be 45-65% of your total intake." c. "It should be acceptable to manage a low-carbohydrate diet if you increase your consumption of protein." d. "Cutting back on carbohydrates is what caused your pancreas to fail. You should include carbohydrates in your diet."

"You should not do a low-carbohydrate diet. As an individual with diabetes, carbohydrates should be 45-65% of your total intake."

The nurse is caring for an older adult who has a leg wound. The patient states the wound has been there for 6 months and has not healed. The nurse suspects the patient has diabetes mellitus. Based on this history, which question should the nurse ask? a. "Have you had increased thirst and urination?" b. "What remedies have you tried to heal the wound?" c. "Can you tell me what you typically eat in a day?" d. "What happened to cause the wound on your leg?"

Have you had increased thirst and urination?

A patient is prescribed a bisphosphonate for the treatment of osteoporosis. The nurse should instruct the patient to immediately report which sign or symptom to the healthcare provider? a. Calf pain or tenderness b. Headache c. Bruising d. Dizziness

Calf pain or tenderness

The nurse is teaching an adult male patient on metabolic disease prevention. Based on the increased risk factors for diseases in the male population, which disease should the nurse prioritize? a. Graves disease b. Cirrhosis c. Hashimoto disease d. Osteoporosis

Cirrhosis

The nurse is reviewing the chart of a patient suspected of having Graves disease. Which is the nurse's correct understanding of the disease process? a. Graves disease is a causative factor of hyperthyroidism. b. Graves disease is associated with hypothyroidism. c. Graves disease is an adrenal crisis associated with hyperparathyroidism. d. Graves disease is a causative factor of thyroiditis.

Graves disease is a causative factor of hyperthyroidism.

The nurse is teaching a group of parents at the elementary school about risk factors for children developing type 1 diabetes mellitus. Which risk factor should the nurse include? a. High-fat diet b. Female gender c. Overweight d. Genetic predisposition

Genetic predisposition

A patient is diagnosed with hyperglycemia. For which electrolyte imbalance should the nurse closely monitor? a. Hypercalcemia b. Hyperkalemia c. Hypermagnesemia d. Hypernatremia

Hypernatremia

The nurse is reviewing laboratory values and suspects that an older adult patient is experiencing age-related changes of the pancreas. Which result has led the nurse to this suspicion? a. Increased blood glucose b. Elevated serum sodium level c. Reduced number of platelets d. Elevated hemoglobin level

Increased blood glucose

The nurse is reviewing the chart of a patient diagnosed with hypoparathyroidism. The laboratory results reveal a decreased serum calcium level. Which other electrolyte alteration should the nurse expect? a. Decreased serum potassium b. Increased serum magnesium c. Increased serum phosphate d. Decreased serum sodium

Increased serum phosphate

The nurse is providing discharge teaching to a patient with type 1 diabetes mellitus about self-management of the disease. Which information should the nurse include in the patient teaching? a. Insulin administration technique b. Protein counting c. Daily urine testing for glucose d. Rule of 20s

Insulin administration technique

The nurse caring for a patient with diabetes is monitoring the genitourinary system for complications. Which assessment is the most effective? a. Daily weights b. Color, clarity, and odor of the urine c. Laboratory analysis of the urine d. Intake and output

Intake and output

A patient has questions about surgery to replace the need to take insulin several times a day. Which surgical intervention can be considered for patients with diabetes mellitus? a. Removing the spleen b. Islet cell transplantation c. Removing the pancreas d. Replacing a part of the liver

Islet cell transplantation

The nurse is caring for a patient diagnosed with hyperparathyroidism who is prescribed a bisphosphonate. Which statement accurately reflects why the patient is prescribed this drug? a. It decreases parathyroid hormone. b. It increases sodium level. c. It helps reduce bone loss. d. It causes excretion of calcium.

It helps reduce bone loss.

The nurse is caring for a patient with diabetes who is experiencing dehydration and tachycardia. Which assessment should the nurse implement to ensure that the patient has adequate oxygenation? a. Monitoring vital signs b. Monitoring neurologic functioning c. Monitoring intake and output d. Monitoring the patient for edema

Monitoring neurologic functioning

The nurse is caring for a patient who has new-onset type 1 diabetes mellitus and plans to incorporate some patient teaching during the day. Which assessment finding indicates a need for teaching about foot care? a. Pedicures noted on both feet b. Diminished pedal pulses c. Blood glucose level of 140 mg/dL d. Negative Babinski reflex

Pedicures noted on both feet

During a physical assessment for a patient with the diagnosis of Hashimoto disease, the nurse notes a palpable nodule on the thyroid. Which collaborative treatment should the nurse anticipate for this patient? a. Thyroidectomy b. Removal of the nodule c. Radioactive iodine therapy d. Unselectedemoval of the parathyroid gland

Removal of the nodule

The nurse is providing teaching to a patient newly diagnosed with type 1 diabetes mellitus. Which information should the nurse include about the regular monitoring of glucose levels? a. Self-monitoring of blood glucose should occur 3-4 times a day. b. Urine testing will assist in measuring hypoglycemia. c. Urine testing is used only until glucose goals are achieved. d. Self-monitoring of blood glucose is painless and noninvasive.

Self-monitoring of blood glucose should occur 3-4 times a day.

The nurse is caring for a patient diagnosed with hyperparathyroidism. Which serum electrolyte does the nurse anticipate to be elevated? a. Serum sodium b. Serum potassium c. Serum calcium d. Serum phosphate

Serum calcium

A patient with type 1 diabetes mellitus informs the nurse of a new ulcer on the bottom of their foot. After examining the foot ulcer, the nurse develops a plan of care with which nursing diagnosis? a. Health Maintenance, Ineffective b. Skin Integrity, Impaired c. Knowledge, Deficit d. Coping, Ineffective

Skin Integrity, Impaired

The nurse is caring for a patient diagnosed with hypothalamic dysfunction. Tumors have been confirmed as a possible contributing factor to the disease. The nurse should anticipate preparing the patient for which collaborative treatment? a. Surgery b. Antithyroid agent c. Biopsy of the tumor d. Thyroid agent

Surgery

The nurse is preparing to palpate the thyroid gland of a patient who presents with a new onset of weight gain. Which activity should the nurse ask the patient to do while conducting this assessment? a. Swallow b. Shrug the shoulders c. Tilt the head forward d. Cough

Swallow

The nurse is preparing to instruct a patient on the newly prescribed antithyroid medication. Which information should be included for the prescribed medication? a. Take the medication at the same time every day. b. Avoid taking aspirin with this medication. c. Take the medication 1 hour before meals. d. Count radial pulse rate for 1 minute before taking the medication.

Take the medication at the same time every day.

The nurse is teaching about metabolic disorders to community members. Which information should the nurse include that places a patient at risk for a metabolic disorder? a. Having heart disease b. Taking supplemental hormones c. Consuming a diet high in fiber d. Having a tubal ligation

Taking supplemental hormones

The nurse is planning care for a patient with type 1 diabetes mellitus and addressing the risk of infection. Which intervention will best assist in addressing this risk? a. Instructing the patient to have an oral examination annually b. Teaching the patient to use lukewarm water and soap for foot and skin care c. Monitoring sensation in extremities daily d. Promoting smoking cessation

Teaching the patient to use lukewarm water and soap for foot and skin care

The nurse is conducting a skin assessment on an older adult patient. Which consideration by the nurse indicates an understanding of age-related changes in the skin? a. Older adults perspire more due to increased activity of their sweat glands. b. Rough, dry skin indicates that the older adult has hyperthyroidism. c. Liver spots on the lower extremities indicate that the older adult most likely has diabetes mellitus. d. The older adult's skin becomes pale due to decreased melanin production and decreased dermal vascularity.

The older adult's skin becomes pale due to decreased melanin production and decreased dermal vascularity.

During an annual checkup, the nurse suspects a 5-year-old child is experiencing altered endocrine function. Which physical assessment finding supports the nurse's suspicion? a. The patient's systolic blood pressure is 90 mmHg. b. The patient's height is the same as at age 4. c. The patient is playing on the floor with other children. d. The patient is wearing eyeglasses.

The patient's height is the same as at age 4.

The nurse is assessing a patient with hypoparathyroidism for Trousseau sign. The patient asks the nurse, "Why do you have to do this test on me?" To answer this question, the nurse should understand which statement that reflects the purpose of this test? a. The test is for hypocalcemic tetany. b. The test is a thyroid gland assessment. c. Trousseau sign is a sensory function test. d. The test assesses deep tendon reflexes.

The test is for hypocalcemic tetany

the nurse is planning care for a client with multiple sclerosis. which intervention would address the nursing diagnosis of fatigue? a. encourage increased activity b. schedule pt 3 times a day c. plan activities with sufficient rest periods between them d. group activities together so care will not be interrupted

plan activities with sufficient rest periods between them

a patient is prescribed levothyroxine daily. what is the most important instruction to teach for administration of this drug? a. taper the dose and discontinue if mental and emotional problems stabilize b. take it at bedtime to avoid the side effects of nausea and flatus c. call the doctor immediately at the onset of palpitations or nervousness d. decrease the intake of juices and fruits with high potassium and calcium contents.

call the doctor immediately at the onset of palpitations or nervousness

what is the priority assessment information to obtain by a client who is being admitted with a tentative diagnosis of fractured hip? a. circulation and sensation distal to the fracture b. amount of swelling around the fracture site c. degree of bone healing that has occurred d. amount of pain that the fracture and healing are causing

circulation and sensation distal to the fracture

a client is scheduled for a routine glycosylated hemoglobin a1c test. what is important for the nurse to tell the client before this test? a. drink only water after midnight and come into the clinic early in the morning b. eat a normal breakfast and be at the clinic two hours later c. expect to be at the clinic for several hours because of the multiple blood draws d. come to the clinic at the earliest convenience to have blood drawn

come to the clinic at the earliest convenience to have blood drawn

the nurse is caring for a client who has exopthalmos associated with thyroid disease. what is the cause of exopthalmos? a. impaired vision which causes the client to squint in order to focus b. fluid in the retro orbital tissues that increases pressure behind the eyes c. increased intraocular pressure from an increase in circulating thyroid hormone d. decrease in extraocular eye movements which results in the thyroid stare

fluid in the retro orbital tissues that increases pressure behind the eyes

the nurse is providing discharge instructions to an older adult client who is recovering from a fractured hip. the client is planning to stay with an adult child who is included in the discharge teaching. which statements on the part of the client indicate appropriate understanding of the information presented by the nurse? (select all that apply) a. i have signed a contract with lifeline b. we are removing the area rugs in the hallway c. ive borrowed a toilet seat riser from the equipment closet d. i will be sure to take oxycodone before i go down stairs in the morning e. i can help with housework while im staying at my childs house

i have signed a contract with lifeline we are removing the area rugs in the hallway ive borrowed a toilet seat riser from the equipment closet

the health care provider levothyroxine for a patient with hypothyroidism. after teaching regarding this drug, which statement by the patient indicates the need for further teaching? a. i can expect the medication dose may need to be adjusted b. i only need to take this drug until my symptoms are improved c. i can expect to return to normal function with the use of this drug d. i will report chest pain or difficulty breathing to the doctor right away.

i only need to take this drug until my symptoms are improved

what statement made by the client would indicate understanding of discharge teaching for self care after hospitalization for acute pancreatitis? a. i will avoid onions caffeine and spices b. i will take the antibiotics for 2 weeks c. i will avoid alcoholic beverages d. i will get immunized prior to my vacation

i will avoid alcoholic beverages

the nurse is planning care for a client who is experiencing an alteration in mobility. which would the nurse include as an independent nursing intervention? a. instruction on the importance of proper nutrition and an active lifestyle b. administering a prescribed nsaid c. identifying necessary interventions to the home environment d. prescribing a skeletal muscle relaxant

instruction on the importance of proper nutrition and an active lifestyle

the nurse is providing care to a client who is receiving treatment for diabetic ketoacidosis (dka). which possible pathophysiologic cause should the nurse identify for the altered metabolism the client is experiencing? a. insulin deficiency b. decreased gluconeogenesis c. excess production of bicarbonate d. hypo-osmolarity

insulin deficiency

which intervention would best improve diet adherence for an older male immigrant recently diagnosed with gerd? a. scheduling low fat meal deliveries to the home b. providing printed diet information in his native language c. interviewing the client to assess his current diet d. giving a list of foods to avoid to the clients wife

interviewing the client to assess his current diet

After thyroid surgery, the nurse suspects damage or removal of the parathyroid glands when the patient develops which symptom? a. muscle weakness and weight loss. b. hyperthermia and severe tachycardia. c. hypertension and difficulty swallowing. d. laryngospasms and tingling in the hands and feet.

laryngospasms and tingling in the hands and feet

what are important nursing interventions when caring for a patient with cushing syndrome? (select all that apply) a. restricting protein intake b. monitoring blood glucose levels c. observing for signs of hypotension d. administering medication in equal doses e. protecting patient from exposure to infection

monitoring blood glucose levels protecting patient from exposure to infection

a nurse knows the clinical manifestations of a client with addison disease include which of the following? (select all that apply) a. nausea b. hypothermia c. hypertension d. hyperpigmentation e. hypotension f. hypernatremia

nausea hyperpigmentation hypotension

the multidisciplinary team is meeting to discuss care for a client who exhibits symptoms of the prodromal phase of hepatitis. lab results include a positive anti-hav igm. the nurse creates an action plan to present to the team. which interventions are appropriate? (select all that apply) a. high fat low calorie and no alcohol diet teaching b. patient education on acceptable pain medication c. early treatment with lamivudine d. referral to the liver transplant team e. family teaching for transmission prevention

patient education on acceptable pain medication family teaching for transmission prevention

while performing an endocrine assessment on a client suspected of having an endocrine disorder the nurse asks if the client has experienced recent weight changes. the nurse asks this question because he understands that alterations in which endocrine glands are most directly related to weight changes? (select all that apply) a. gonads b. pituitary glands c. thyroid gland d. adrenal gland e. parathyroid gland

pituitary glands thyroid gland adrenal gland

a young adult client complains of blurred vision and muscle spasms that have come and gone over the past several months. the physician suspects that the client has multiple sclerosis. what in the clients history would the nurse recognize as a risk factor for ms? a. the client is male. b. the client is of native american decent c. the client is of european decent d. the client takes vit d supplement dialy

the client is of european decent

the nurse is evaluating the care for a client with parkinsons disease. which finding indicates an improvement in the clients nutritional status? a. the client filled out the menu for each meal b. the client coughs frequently when drinking fluids c. the client was able to feed himself and had no weight change in 1 week d. the client had a 4 pound weight loss in 1 week

the client was able to feed himself and had no weight change in 1 week

a client is being treated with bucks traction. what are important nursing interventions for this client? a. remove the traction boot every 6 hours to provide skin care b. check and clean the pin sites at least 3 times daily c. check the area around the hip where the traction is applied d. verify that weights are in the amounts ordered and are hanging freely

verify that weights are in the amounts ordered and are hanging freely

the nurse instructs a client with parkinsons disease about levodopa/carbidopa. which client statement indicates that this teaching has been effective? a. i should eat a high protein diet when taking this medication b. when taking this medication i should sit up for several mins before going from lying to standing c. this medication will not affect my blood pressure medications d. given enough time this medication will cure my parkinsons

when taking this medication i should sit up for several mins before going from lying to standing