Final exam review
The nurse would anticipate using postural drainage as a treatment for which condition? a. epiglottitis b. bronchial asthma c. cystic fibrosis d. bronchopulmonary dysplasia
C
The nurse is is reinforcing discharge teaching to a client who has Cushings syndrome. Which statement by the client indicates that the instructions related to dietary management were understood? a. I can eat foods that contain potassium b. I will need to limit the amount of protein in my diet c. I am fortunate that I can eat all the salty foods I enjoy d. I am fortunate that I do not need to follow any special diet
1
The nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which action performed by the client indicates the need for further teaching? a. withdraws the NPH insulin first b. withdraws the regular insulin first c. inject air into the NPH vial first d. injects an amount of air equal to the desired dose of insulin into the vial
1 (clear to cloudy)
The home care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client, prescribed repaglinide and metformin, asks the nurse to explain these meds. 1. diarrhea can occur seconding to metformin 2. the repaglinide is not taken if a meal is skipped 3. The repaglinide is taken 30 min before eating. 4. Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes
1,2,3,4
a teacher is exposed during a mumps outbreak at a local school. the teacher had previously been immunized for mumps. the teacher possesses (blank) acquired immunity 1. artificial or natural 2. active or passive
1. artificial 2. active
A client has a disorder affecting the posterior pituitary gland. which hormone should the nurse expect to be affected in this client? a. antidiuretic hormone b. thyroid hormone c. parathyroid hormone d. adrenocorticotropic hormone
A
The nurse is planning care for a client with hyperthyroidism. Which nursing intervention is most appropriate? a. provide rest periods b. keep client warm with several blankets c. levothyroxine d. furosemide
A
The nurse recognizes that teaching is effective if a client with diabetes knows to use subcutaneous glucagon for an emergency episode of which condition. a. hypoglycemia b. ketoturia c. diabetic ketoacidosis d. hyperglycemia
A
the nurse notes that a client with type 1 diabetes mellitus has lipodystrophy on both upper thighs. which further information would the nurse obtain from the client during data collection? a. plan for injection rotation b. consistency for aspiration c. preparation of the injection site d. angle at which the medication is administered
A
which statement made by the client diagnosed with COPD indicates the nurse's discharge teaching was effective? A. I need to get an influenza vaccine each year, even when there is a shortage. b. I need to avoid pursed lip breathing if I have difficulty breathing. c. I need to restrict my cigarettes to six a day, I won't have difficulty breathing. d. I need to restrict my drinking liquids to keep from having so much phlegm.
A
The nurse is monitoring a client who has been newly diagnosed with diabetes mellitus for signs of complications. Which statement made by the client would indicate hyperglycemia and thus warrant PHCP notification? a. I am urinating a lot b. my pulse is really slow c. I am sweating for no reason d. my blood pressure is really high
A remember the 3 p (signs of hypoglycemia)
A client with a tracheostomy is dyspneic and has coarse crackles anteriorly on auscultation. What should the nurse do in this situation? Select all that apply A. suction the tracheostomy B perform routine trach care c. administer a nebulizer mist treatment d. ask the client to take a deep breath and cough
A, D
When assessing a client with pheochromocytoma, what are the expected findings? select all that apply. a. heart rate 110 b. blood pressure 164/86 c. blood glucose 126 d. temp 37C
A,B
a client asks the nurse about the characteristic of botulism. what should the nurse teach this client? select all that apply a. a paralytic illness b. an antitoxin prevents progression c. it is caused by a virus d. a symptom is mental confusion
A,B
What are characteristics of insulin glargine? select all that apply a. it has no peak action time b. it has a duration of up to 24 hours c. it cannot be mixed with other insulins d. it is not injectable e. it can be inhaled
A,B,C
The client is admitted to the hospital is diagnosed with DKA, which interventions should the nurse implement? select all that apply a. monitor potassium levels closely b. assess fluid volume status c. check urine for ketones d. monitor blood glucose e. correct respiratory alkalosis
A,B,C,D
The client with type 2 diabetes mellitus may use a variety of treatments to control their diabetes. Select all that apply A. insulin b. oral hypoglycemic medication c. nutrition therapy d. glucose monitoring e. exercise
A,B,C,D,E
which are alerts to nurses that an outbreak of a certain disease are occurring? select all that apply a. rapidly increasing incidence of disease b. unusual pattern or time for a specific disease c. lower disease rates than usually expected in an area d. clusters of clients from one area e. large numbers of fatalities occurring
A,B,D,E
A client with newly diagnosed Hopkins disease is asking the nurse for more information about it. when providing education about Hopkins disease, which statements are true? select all that apply a. survival rates are improving b. it is distinguished by the presence of Philadelphia chromosome c. it is distinguished by the presence of reed stern burg cells d. skeletal pain is common e. symptoms include painless swelling of cervical, axillary, and or inguinal nodes
A,C,E
The nurse is providing dietary teaching for a client with iron deficiency anemia. which iron rich foods should be included in the clients diet? select all that apply a. whole grains b. citrus fruits c. yogurt d. liver e. dark leafy veggies f. chicken
A,D,E,F
When assessing a client admitted to the hospital for diabetic ketoacidosis, which clinical manifestations would the nurse expect? select all that apply A. ph 7.3 b. pco2 40 c. hco3 26 d. dry skin e. respirations 16 f. headache
A,D,F
The nurse educator is asking the nursing student to recall the signs/symptoms of hypothyroidism. The nurse educator determines the the student understands this disorder if which are included in the students response? a. dry skin b. irritability c. palpatations d. weight loss e. constipation f. cold intolerance
A,E,F
The nurse is caring for a client after a thyroidectomy and notes that calcium gluconate is prescribed. The nurse determines that this med has been prescribed for which reason? a. treat thyroid storm b. prevent cardiac irritability c. treat hypocalcemia tetany d. stimulate the release of parathyroid hormone
C
The nurse is planning the care of a client diagnosed with asthma and has written a problem of "anxiety". Which nursing intervention should be implemented? A. stay with the client B. notify the healthcare provider C. administer an anxiolytic medication D. encourage the client to drink fluids
A. stay with the client
A client is admitted to the emergency department, and a diagnosis of myxedema coma is made. Which action would the nurse prepare to carry out initially? a. warm the client b. maintain a patent airway c. monitor intravenous fluids d. administer thyroid hormone
B
A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which teaching information would be the nurse reinforce upon discharge? a. keep insulin vials refrigerated at all times b. rotate the insulin injection sites systematically c. increase the amount of insulin before unusual exercise d. monitor the urine acetone level to determine the insulin dosage
B
A post cardiac surgery client with a blood urea nitrogen BUN level of 45 and a creatine level of 2.2 has a total 2 hour urine output of 25 ml. The nurse understands that the client is at risk for which condition? a. hypovolemia b. acute kidney injury c. glomerulonephritis d. urinary tract injection
B
It has been reported on the news that several cases of botulism have occurred in the area. the nurse begins receiving phone calls in the emergency department from people starting to panic. what would be the nurses best response. a. come to the emergency room for immediate treatment b. botulism is not contagious, unless exposed you are not at risk c. call 911 to receive antitoxin as soon as possible d. botulism is highly contagious and you should remain at home
B
The homecare nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse would provide which information? a. freeze the insulin b. refrigerate the insulin c. store the insulin in a dark, dry place d. keep the insulin at room temp
B
The nurse is caring for a client who had thoracic surgery yesterday and has a chest tube attached to water seal drainage. The client's family asks why they need to have a chest tube. What should the nurse include in the response? A. it allows air to enter the thoracic cavity to equalize pressures in the lung. b. it removes air from the pleural cavity and promotes re expansion of the lung c. it increases the amount of oxygen available to the lungs d. it will help the wound heal faster and reduce scarring at the site
B
The nurse is caring for a postoperative parathyroidectomy client. Which would require the nurses immediate attention? a. incision pain b. laryngeal stridor c. difficulty voiding d. abdominal cramps
B
The nurse reinforces teaching to a client with diabetes mellitus regarding differentiating between hypoglycemia and ketoacidosis. The client demonstrates understanding of the teaching by stating that glucose will be taken if which symptom develops? a. polyuria b. shakiness c. blurred vision d. fruity breath odor
B
When developing a plan of care for the client with aplastic anemia the nurse must be aware that this blood dyscrasia is manifested by what? a. increased thrombocytes b. bone marrow depression c. increased plasma volume d. decreased leukocytes
B
Which assessment data indicate that the client diagnosed with diabetic ketoacidosis is responding to the medical treatment? a. the client has tented skin turgor and dry mouth mucous membranes b. the client is alert and oriented to date, time, and place c. the client's ABG results are 7.29, paco2 44, hco3 15 d. the client's serum potassium level is 3.3 meq/L
B
Which endocrine gland is palpable? a. pancreas b. thyroid c. adrenal d. pituitary
B
Which is true about continuous subcutaneous insulin infusion pump? a. it uses only insulin preparations that are cloudy in appearance b. it allows more normal regulation of blood glucose and greater lifestyle flexibility c. it requires monitoring of blood glucose at least two to three times a day and night d. it eliminates the need for daily measurements of blood glucose levels
B
a client is wearing a continuous cardiac monitor which begins to alarm at the nurses station. the nurse sees no ECG complexes on the screen. the nurse would take which action first? a. call a code blue b check the client status and lead placement c. call the HCP d. press the recorder button on the ECG console
B
a newly diagnosed client with Hopkins disease wants to know how the disease spreads. what would be the. best response by the nurse? a. the first step is to rule out an infectious process b. it is transmitted through the lymph system c. the cause is unknown, but believed to be viral d. it spreads by the circulatory system to the spleen
B
the nurse is providing direct client care uses specific practices to reduce the chance of aqcuiring infection with HIV from clients, which practice is most effective? a. label charts and armbands HIV b. consistent use of standard precautions c. double glove before body fluid exposure d. wear a gown and gloves within 3 feet of the client
B
which statement is the scientific rationale for infusing a unit of blood in less than four hours? a. the blood will coagulate if left out of the refrigerator for > 4 hours b. the blood potentially may develop bacterial growth if infused longer c. the blood components begin to divide after 4 hours d. the blood will not be affected; this is a lab procedure
B
A 90 year old client had a hip replacement surgery two days ago. The client is anxious, has a feeling of impending doom, and is gasping for breath. The client is also hypotensive, tachycardia, with pleuritic chest pain, and has crackles heard on auscultation. What do these symptoms indicate? A. septic shock B. pulmonary embolism C. myocardial infarction D. tension pneumothorax
B pulmonary embolism
which is true of inhalation anthrax. select all that apply a. caused by a virus b. common cold or flu like symptoms c. ciprofloxacin or doxycycline used for treatment d. standard precautions e. can be spread person to person
B,C,D
the nurse is preparing to administer insulin to a client with type 1 diabetes mellitus. which sites are a consideration for this injection? select all that apply a. forearm b. buttocks c. abdomen d. anterior thigh
B,C,D (subq for insulin)
The use of biological agents are to create fear and panic. They are widely available, relatively inexpensive, and silent when used. The following are biological agents that are used. Contagious agents. a. anthrax b. smallpox c. botulism d. viral hemorrhagic fever e. tularemia f. plague
B,D,F
The nurse is reinforcing instructions to a client with diabetes mellitus who is recovering from DKA regarding measures to prevent a recurrence. which instruction is important for the nurse to emphasize? a. eat six small meals a day b. test the urine ketone level c. monitor the blood glucose levels frequently d. receive appropriate follow up health care
C
The nurse provides dietary instructions to a client with diabetes mellitus regarding the prescribed diabetic diet. Which statement made by the client indicates the need for further teaching? a. ill eat a balanced meal plan b. I need to drink diet soft drinks c. I need to buy special dietetic foods d. I will snack on fruit instead of cake
C
A client with cystic fibrosis has an ineffective airway clearance. What intervention would worsen this problem? A. hydration, fluids B. bedrest C. mucolytic medications and nebulized mist treatment D. percussion and postural drainage
B. bedrest
The nurse is auscultating the lungs in a post-operative client and hears something that sounds like a plastic bag being wrinkled when the patient takes a breath. What nursing care is essential because of this finding? A. state emergency oxygen and notify the healthcare provider B. have the client take several deep breaths and cough q2h C. notify the healthcare provider and prepare the client for a tracheostomy D. Carefully observe the client for signs of cyanosis
B. have the client take several deep breaths and cough q2h
A client with type 2 diabetes goes to the diabetes outpatient clinic for a routine checkup. The nurse notes an A1C of 14%. on what conclusion does the nurse base further assessment? a. the client has not been following the treatment regimen at home b the client adheres to the treatment regimen, but has had increased carbohydrates in the last two weeks c. the client's blood glucose levels have been elevated for the last two to three months d. the client may have had numerous hypoglycemic episodes during the last month
C
The nurse is assisting with preparing a teaching plan for the client with diabetes mellitus regarding proper foot care. Which instruction would be included in the plan of care? a. soak the feet in hot water b. avoid using soap to wash feet c. apply a moisturizing lotion to dry feet, but not between the toes d. always have a podiatrist cut your toenails never cut them yourself
C
a client with aplastic anemia is to receive an injection erythropoietin. the client asks what the injection is intended to do. which response by the nurse is best? a. it works like a blood transfusion to give you extra RBC b. it will inhibit protein that is attacking your red blood cells c. it will stimulate your body to produce its own rbcs d. it will increase your energy while your body is recovering from its anemia
C
what clinical manifestation indicates to the nurse that the client is experiencing hypoparathyroidism? a. nocturnal muscle cramps b. negative trosseau's sign c. positive chvostek's sign d. tented skin turgor
C
The client diagnosed with type 1 diabetes has a glycosylated hemoglobin (A1C) of 8.3%. which interpretation should the nurse make based on this result? A. This result is below normal levels b. this result is within acceptable levels c. this result is above recommended levels d. this result is dangerously high
C (should be below 5.7%)
The nurse caring for a client with pneumonia. With set of lab tests will be most helpful to the nurse to monitor the condition of this client? A. electrolyte and serum creatine b. complete blood count and urinalysis c. partial thromboplastin time (PTT) and serum potassium d. white blood cell count and arterial blood gases
D
A client's chest x-ray shows a suspicious area and the healthcare provider plans a bronchoscopy. How should the nurse describe the procedure to the client? A. You will be asked to use a mouthpiece to blow into the machine. B. You will need to drink a thick white liquid that will be opaque on the x-rays c. a dye will be injected to help visualize the structures of the bronchioles. do you have any allergies? d. a small tube will be placed through your nose or mouth and into the bronchi to look at your airways
D
A homeless client has been brought into the emergency department with symptoms of the plague. which antibiotic does the nurse anticipate the client should most likely recieve? a. cephalexin b. clindamycin c. vancomycin d. gentamicin
D
During a disaster with many clients, the triage nurse in the emergency department would give priority to which client? a. a less than 1% chance of survival b. a slight potential of survival c. a moderate potential of survival d. a full potential of recovery
D
For the best absorption of oral preparations, what would be best for the nurse to teach the client about taking this medication? a. take iron between meals b. take iron with milk c. take iron just before bedtime d. take iron with orange juice
D
The nurse is collecting data regarding a client after a thyroidectomy and notes the development of a hoarse and weak voice. Which nursing action is appropriate? a. check for signs of bleeding b. administer calcium gluconate c. notify the registered nurse immediately d. reassure the client that this is usually a temporary condition
D
The nurse is reinforcing discharge teaching to a client diagnosed with tuberculosis who has been taking medication for 1 week. The nurse knows that the client has understood the information by which statement? A. I can't go shopping for groceries for the next 3 months B. I need to continue medication therapy for 2 months. c. I can return to work if a sputum culture comes back negative. d. I should not be contagious after 2 to 3 weeks of medication therapy
D
What nursing interventions are appropriate for the client with exophthalmos secondary to Graves disease? a. mystic eye drops and privacy b television and other diversionary activities c. reassurance that the symptoms will resolve with treatment d. an accepting attitude and lubricating eye drops
D
When discussing the control of diabetes with a client, the nurse should include the fact that severe emotional stress requires contacting the healthcare provider because what may be required? a. an increase of calories b. a decrease in insulin c. a decrease in calories d. an increase in insulin
D
When the nurse is reinforcing instructions to a client who has been newly diagnosed with type 1 diabetes mellitus, which statement by the client would indicate that teaching has been effective? a I will stop taking my insulin if I am too sick to eat b. I will decrease my insulin dose during times of illness c. I will adjust my insulin dose according to the level of glucose in my urine d. I will notify my HCP if my blood glucose level is consistently greater than 250
D
the nurse is preparing to ambulate a postoperative client after cardiac surgery. the nurse plans to do which to enable the client to best tolerate ambulation? a. provide client with a walker b. remove the telemetry equipment c. encourage the client to cough and deep breathe d. premedicate the client with an analgesic before ambulating
D
which endocrine disorder would the nurse assess for in the client who has a closed head injury with increased intracranial pressure? a. pheochromocytoma b. hashimotos disease c. adrenal insufficiency d. diabetes insipidus
D
On auscultation of the chest, which of these findings is indicative of a left pneumothorax? A. bilateral rales B. inspiratory crackles to the left chest C. expiratory wheezes to the left chest D. assent breath sounds to the left chest
D. absent breath sounds to the left chest
The nurse is assessing an 82 year old client diagnosed with pneumonia. Which signs and symptoms should the nurse expect to assess in this client? A. frothy sputum and edema B. high fever and chills C. bradypnea and cough D. confusion and lethargy
D. confusion and lethargy
A client has epistaxis(bleeding from the nose) for almost 6 hours. The healthcare provider orders local application of phenylephrine. How will this help? A. it will raise blood pressure B. it will dilate the bronchiales C. it will enhance blood clotting D. it will constrict the blood vessels
D. it will constrict the blood vessels
a client with type 1 diabetes mellitus calls the nurse to report recurrent episodes of hypoglycemia. which statement by the client indicates a correct understanding of humbling N insulin and exercise?
D. peak is 6 to 14 hours
Cushings disease
Hypersecretion of ACTH. generalized muscle weakness, moon face, buffalo hump, obesity with thin extremities, hyPERglycemia, hyPOkalemia, hyPERtension, fragile skin
Diabetes insipidus symptoms
Hyposecretion of ADH caused by stroke, surgery, trauma. Excretion of large amounts of dilute urine, polydipsia, dehydration, muscle pain, hypotension. VASOPRESSIN or DESMOPRESSIN
Addisons disease
Hyposecretion of adrenal cortex hormone. Lethargy, fatigue, muscle weakness, weight loss, GI disturbance, hypoglycemia, hyPERkalemia, hyPERpigmentation monitor WBC, BG, K, Na, Ca. Administer glucocorticoid or mineralcorticoid
Hypothyroidism
lethargy, weakness, intolerance to cold, weight gain, dry skin and hair, bradycardia, myxedema. Levothyroxine
rapid insulin
lisper, aspart, glulisine action: 10-15 min peak: 30-90 min duration: 3-5 hrs
CAD
narrowing or obstruction of one or more coronary arteries
intermediate
NPH action: 60-120 min peak: 6-14 duration: 6-14 hours
Thyroid storm
occurs in clients with uncontrollable hyperthyroidism. beta blockers, antithyroid meds, glucocorticoi, iodides
Hypoparathyroidism
positive Trousseus sign and Chevostek
short acting insulin
regular action: 30-60 min peak: 1-5 duration: 5-10
Pheochromocytoma
Tumor in the adrenal medulla. S/S palpitations, pain in chest or abdomen, heat intolerance, tremors
hyperthyroidism
agitation, nervousness, heat intolerance, weight loss, palpitations, tachycardia, protruding eyeballs, hypertension, enlarged thyroid gland. methimazole and propylthioracil
Diabetes mellitus
chronic disorder of impaired carbohydrate, protein, and lipid metabolism caused by deficiency of insulin a
long acting
glargine, detemir action: 60-120 peak: none or 24 hours duration: 18-24 hours
Pheochromocytoma leads to?
heart attack, increased platelet, stroke, dysrhythmias. DO NOT GIVE CAFFEINE
