LP4 urinary/renal

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

A patient with chronic kidney disease (CKD) brings all home medications to the clinic to be reviewed by the nurse. Which medication being used by the patient indicates that patient teaching is required? a. Multivitamin with iron b. Milk of magnesia 30 mL c. Calcium phosphate (PhosLo) d. Acetaminophen (Tylenol) 650 mg

b. Milk of magnesia 30 mL

What is the location of the pituitary gland? a. Adrenal Cortex b. Sella turcica c. Heart d. Hypothalamus

b. Sella turcica

Parathormone regulates: a. The use of sugar by the cells b. The level of calcium in the bloodstream c. The reaction of the body to stress d. The secretions of the adrenal cortex

b. The level of calcium in the bloodstream

After the nurse has finished teaching a patient about self-administration of the prescribed aspart (NovoLog) insulin, which patient action indicates good understanding of the teaching? a. The patient avoids injecting the insulin into the upper abdominal area. b. The patient cleans the skin with soap and water before insulin administration. c. The patient places the insulin back in the freezer after administering the prescribed insulin dose. d. The patient pushes the plunger down and immediately removes the syringe from the injection site.

b. The patient cleans the skin with soap and water before insulin administration.

When caring for a patient having a water deprivation test, which finding is most important for the nurse to communicate to the health care provider? a. The patient complains of intense thirst. b. The patient has a 5-lb (2.3 kg) weight loss. c. The patient feels dizzy when sitting up on the edge of the bed. d. The patients urine osmolality does not change after antidiuretic hormone (ADH) is given.

b. The patient has a 5-lb (2.3 kg) weight loss.

Following an intravenous pyelogram (IVP), all of the following assessment data are obtained. Which one requires immediate action by the nurse? a. The heart rate is 58 beats/minute. b. The respiratory rate is 38 breaths/minute. c. The patient complains of a dry mouth. d. The urine output is 400 mL in the first 2 hours.

b. The respiratory rate is 38 breaths/minute

Signs and symptoms of hypoglycemia may include (select all that apply) a. flushing b. cold sweats c. shaking d. tachycardia e. irritability f. comes on slowly

b. cold sweats c. shaking d. tachycardia e. irritabiity

When caring for a patient who has an adrenocortical adenoma, causing hyperaldosteronism, the nurse should a. provide a potassium-restricted diet. b. monitor the blood pressure every 4 hours. c. monitor blood glucose level every 4 hours. d. relieve edema by elevating the extremities.

b. monitor the blood pressure every 4 hours.

Used to occur after age 40; now seen in children, teens and young adults. What type of diabetes is this? a. type I b. type II c. both

b. type II

. A patient in the oliguric phase of acute renal failure has a 24-hour fluid output of 150 mL emesis and 250 mL urine. The nurse plans a fluid replacement for the following day of ___ mL. a. 400 b. 800 c. 1000 d. 1400

c. 1000

A patient with Graves disease has exophthalmos. Which nursing action will be included in the plan of care? a. Apply eye patches to protect the cornea from irritation. b. Place cold packs on the eyes to relieve pain and swelling. c. Elevate the head of the patients bed to reduce periorbital fluid. d. Teach the patient to blink every few seconds to lubricate the cornea.

c. Elevate the head of the patients bed to reduce periorbital fluid.

the Name the two hormones released from the adrenal medulla: a. Leutinizing hormone and Oxytocin b. Cortisol and Corticotropin c. Epinephrine and Norepinephrine d. Neo-Synephrine and Epinephrine

c. Epinephrine and Norepinephrine

Which statement by a patient with stage 5 chronic kidney disease (CKD) indicates that the nurses teaching about management of CKD has been effective? a. I need to try to get more protein from dairy products. b. I will try to increase my intake of fruits and vegetables. c. I will measure my urinary output each day to help calculate the amount I can drink. d. I need to take the erythropoietin to boost my immune system and help prevent infection.

c. I will measure my urinary output each day to help calculate the amount I can drink

Which parameter will be most important for the nurse to consider when titrating the IV fluid infusion rate immediately after a patient has had kidney transplantation? a. Heart rate b. Blood urea nitrogen (BUN) level c. Urine output d. Creatinine clearance

c. Urine output

Impaired vision is a factor that can inhibit independence with self care in this type of diabetes: a. type I b. type II c. both

c. both

A patient with severe heart failure develops elevated blood urea nitrogen (BUN) and creatinine levels. The nurse will plan care to meet the goal of a. replacing fluid volume. b. preventing hypertension. c. maintaining cardiac output. d. diluting nephrotoxic substances.

c. maintaining cardiac output.

What gland releasing several tropic hormones which affect other glands? A. oxytocin B. cortisol C. pituitary gland D. hormone E. thyroid gland F. thyroid stimulating hormone (TSH) G. triiodothyronine (T3) H. endocrine gland I. hypothalamus J. hypofunction

c. pituitary gland

Amitriptyline (Elavil) is prescribed for a diabetic patient who has burning foot pain at night. Which information should the nurse include when teaching the patient about the new medication? a. Amitriptyline will decrease the depression caused by your foot pain. b. Amitriptyline will correct some of the blood vessel changes that cause pain. c. Amitriptyline will improve sleep and make you less aware of nighttime pain. d. Amitriptyline will help prevent the transmission of pain impulses to the brain.

d. Amitriptyline will help prevent the transmission of pain impulses to the brain.

Which information will the nurse include when teaching a patient who has been newly diagnosed with Graves disease? a. Exercise is contraindicated to avoid increasing metabolic rate. b. Restriction of iodine intake is needed to reduce thyroid activity. c. Surgery will eventually be required to remove the thyroid gland. d. Antithyroid medications may take several weeks to have an effect.

d. Antithyroid medications may take several weeks to have an effect.

A patient with diabetic nephropathy is admitted for a right renal biopsy. Immediately after the biopsy, which of these is an essential nursing action? a. Monitor the blood urea nitrogen (BUN) and creatinine to assess renal function. b. Check blood glucose to assess for hyperglycemia or hypoglycemia. c. Insert a straight catheter to check for gross or microscopic hematuria. d. Apply a pressure dressing and keep the patient on the affected side for 30 to 60 minutes.

d. Apply a pressure dressing and keep the patient on the affected side for 30 to 60 minutes

The adrenal medulla functions as part of the __________ ___________ ___________ a. Muscle-skeletal nervous system b. Circulatory nervous system c. Sympathetic nervous system d. Autonomic nervous system

d. Autonomic nervous system

After noting lengthening QRS intervals in a patient with acute kidney injury (AKI), which action should the nurse take first? a. Document the QRS interval. b. Notify the patients health care provider. c. Look at the patients current blood urea nitrogen (BUN) and creatinine levels. d. Check the chart for the most recent blood potassium level.

d. Check the chart for the most recent blood potassium level.

When assessing a client for Cushing's syndrome, the nurse may expect to find: a. dehydration b. hypotension c. weight loss d. hyperglycemia

d. Hyperglycemia

When teaching a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) about long-term management of the disorder, the nurse determines that additional instruction is needed when the patient says, a. I should weigh myself daily and report any sudden weight loss or gain. b. I need to limit my fluid intake to no more than 1 quart of liquids a day. c. I will eat foods high in potassium because the diuretics cause potassium loss. d. I need to shop for foods that are low in sodium and avoid adding salt to foods.

d. I need to shop for foods that are low in sodium and avoid adding salt to foods.

The nurse determines that instruction regarding prevention of future urinary tract infections (UTIs) for a patient with cystitis has been effective when the patient states, a. I can use vaginal sprays to reduce bacteria. b. I will drink a quart of water or other fluids every day. c. I will wash with soap and water before sexual intercourse. d. I will empty my bladder every 3 to 4 hours during the day.

d. I will empty my bladder every 3 to 4 hours during the day

What usually causes hypothyroidism? a. Increased secretion of TSH by the pituitary. b. Increased secretion of T3 and T4 by the thyroid c. No secretion of Parathormone by the thyroid d. Low or no secretion of T3 and T4 by the thyroid.

d. Low or no secretion of T3 and T4 by the thyroid

A patient is suspected of having a pituitary tumor causing panhypopituitarism. During assessment of the patient, the nurse would expect to find a. high blood pressure. b. elevated blood glucose. c. tachycardia and cardiac palpitations. d. changes in secondary sex characteristics.

d. changes in secondary sex characteristics.

When a patient is taking spironolactone (Aldactone), a drug that blocks the action of aldosterone on the kidney, the nurse will monitor for a. decreased urinary output. b. evidence of fluid overload. c. increased serum sodium levels. d. elevated serum potassium levels.

d. elevated serum potassium levels.

A patient with acute kidney injury (AKI) has an arterial blood pH of 7.30. The nurse will assess the patient for a. vasodilation. b. poor skin turgor. c. bounding pulses. d. rapid respirations.

d. rapid respirations

Before administration of calcium carbonate (Caltrate) to a patient with chronic kidney disease (CKD), the nurse should check the laboratory value for a. creatinine. b. potassium. c. total cholesterol. d. serum phosphate.

d. serum phosphate

Excessive production of aldosterone levels of hypertension. True false

true

This occurs when proportionately too much insulin is in the blood for the available glucose. a. HHS b. DKA c. Macroangiopathy d. Microangiopathy e. Hypoglycemia

E. Hypoglycemia

What is the control center for central nervous system (CNS) and endocrine system to maintain homeostatsis? A. oxytocin B. cortisol C. pituitary gland D. hormone E. thyroid gland F. thyroid stimulating hormone (TSH) G. triiodothyronine (T3) H. endocrine gland I. hypothalamus J. hypofunction

I. hypothalamus

The nurse obtains the following information about a patient before administration of metformin (Glucophage). Which finding indicates a need to contact the health care provider before giving the metformin? a. The patients blood glucose level is 166 mg/dL. b. The patients blood urea nitrogen (BUN) level is 60 mg/dL. c. The patient is scheduled for a chest x-ray in an hour. d. The patient has gained 2 lb (0.9 kg) since yesterday.

The patients blood urea nitrogen (BUN) level is 60 mg/dL.

A patient receives aspart (NovoLog) insulin at 8:00 AM. Which time will it be most important for the nurse to monitor for symptoms of hypoglycemia? a. 9:00 AM b. 11:30 AM c. 4:00 PM d. 8:00 PM

a. 9:00 AM

A patient who has type 1 diabetes plans to take a swimming class daily at 1:00 PM. The clinic nurse will plan to teach the patient to a. check glucose level before, during, and after swimming. b. delay eating the noon meal until after the swimming class. c. increase the morning dose of neutral protamine Hagedorn (NPH) insulin. d. time the morning insulin injection so that the peak occurs while swimming.

a. Check glucose level before, during, and after swimming.

When caring for a patient with a left arm arteriovenous fistula, which action will the nurse include in the plan of care to maintain the patency of the fistula? a. Check the fistula site for a bruit and thrill. b. Assess the rate and quality of the left radial pulse. c. Compare blood pressures in the left and right arms. d. Irrigate the fistula site with saline every 8 to 12 hours.

a. Check the fistula site for a bruit and thrill

The health care provider suspects the Somogyi effect in a patient whose 7:00 AM blood glucose is 220 mg/dL. Which action will the nurse plan to take? a. Check the patients blood glucose at 3:00 AM. b. Administer a larger dose of long-acting insulin. c. Educate about the need to increase the rapid-acting insulin dose. d. Remind the patient about the need to avoid snacking at bedtime.

a. Check the patients blood glucose at 3:00 AM.

Condition of hyperglycemia that most often occurs in the older adult patient with type 2 diabetes. a. HHS b. DKA c. Macroangiopathy d. Microangiopathy e. Hypoglycemia

a. HHS

When assessing the patient experiencing the onset of symptoms of type 1 diabetes, which question is most appropriate for the nurse to ask? a. Have you lost any weight lately? b. How long have you felt anorexic? c. Is your urine unusually dark colored? d. Do you crave fluids containing sugar?

a. Have you lost any weight lately?

A 32-year-old patient is diagnosed with polycystic kidney disease. Which information is most appropriate for the nurse to include in teaching at this time? a. Importance of genetic counseling b. Complications of renal transplantation c. Methods for treating chronic and severe pain d. Differences between hemodialysis and peritoneal dialysis

a. Importance of genetic counseling

An 88-year-old with benign prostatic hyperplasia (BPH) has a markedly distended bladder and is agitated and confused. Which of the following interventions prescribed by the health care provider should the nurse implement first? a. Insert a urinary retention catheter. b. Schedule an intravenous pyelogram. c. Administer lorazepam (Ativan) 0.5 mg PO. d. Draw blood for blood urea nitrogen (BUN) and creatinine testing.

a. Insert a urinary retention catheter.

What hormone precipitating breast milk let-down? A. oxytocin B. cortisol C. pituitary gland D. hormone E. thyroid gland F. thyroid stimulating hormone (TSH) G. triiodothyronine (T3) H. endocrine gland I. hypothalamus J. hypofunction

a. oxytocin

A patient with Graves disease is admitted to the emergency department with thyroid storm. Which of these prescribed medications should the nurse administer first? a. propranolol (Inderal) b. propylthiouracil (PTU) c. methimazole (Tapazole) d. iodine (Lugols solution)

a. propranolol (Inderal)

Which action should the nurse take first when caring for a patient who has just arrived on the unit after a thyroidectomy? a. Check the dressing for bleeding. b. Assess respiratory rate and effort. c. Take the blood pressure and pulse. d. Support the patients head with pillows.

b. Assess respiratory rate and effort.

Condition of hyperglycemia that most often occurs in a type 1 diabetic. a. HHS b. DKA c. Macroangiopathy d. Microangiopathy e. Hypoglycemia

b. DKA

Which assessment finding for a patient who takes levothyroxine (Synthroid) to treat hypothyroidism indicates that the nurse should contact the health care provider before administering the medication? a. Increased thyroxine (T4) level b. Blood pressure 102/62 mm Hg c. Distant and difficult to hear heart sounds d. Elevated thyroid stimulating hormone level

a. Increase thyroxine (T4) level

When a patient is hospitalized with acute adrenal insufficiency, which assessment finding by the nurse indicates that the prescribed therapies are effective? a. Increasing serum sodium levels b. Decreasing blood glucose levels c. Decreasing serum chloride levels d. Increasing serum potassium levels

a. Increasing serum sodium levels

A few hours after returning to the surgical nursing unit, a patient who has undergone a subtotal thyroidectomy develops laryngeal stridor and a cramp in the right hand. Which action will the nurse anticipate taking next? a. Infuse IV calcium gluconate. b. Suction the patients airway. c. Prepare for endotracheal intubation. d. Assist with emergency tracheostomy.

a. Infuse IV calcium gluconate

The nurse is caring for a patient who had kidney transplantation several years ago. Which assessment finding may indicate that the patient is experiencing adverse effects to the prescribed corticosteroid? a. Joint pain b. Tachycardia c. Postural hypotension d. Increase in creatinine level

a. Joint pain

A patient with an elevated blood urea nitrogen (BUN) and serum creatinine is scheduled for a renal arteriogram. The nurse should question an order from radiology for bowel preparation with the use of a. a Fleet enema. b. a tap-water enema. c. bisacodyl (Dulcolax) tablets. d. senna/docusate (Sennakot-S).

a. a Fleet enema

A patients urine dipstick indicates a small amount of protein in the urine. The next action by the nurse should be to a. check which medications the patient is currently taking. b. obtain a clean-catch urine for culture and sensitivity testing. c. ask the patient about any family history of chronic renal failure. d. send a urine specimen to the laboratory to test for ketones and glucose.

a. check which medications the patient is currently taking

A patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which patient information is most important for the nurse to communicate to the health care provider before the test? a. Bilateral poor peripheral vision b. Allergies to iodine and shellfish c. Recent weight loss of 20 pounds d. Complaints of ongoing headaches

b. Allergies to iodine and shellfish

A patient is admitted with a serum sodium level of 118 mEq/L. The nurse will anticipate the need for which diagnostic test? a. Urinary 17-ketosteroids b. Antidiuretic hormone level c. Growth hormone stimulation test d. Adrenocorticotropic hormone level

b. Antidiuretic hormone level

A patient with a possible urinary tract infection (UTI) gives the nurse in the clinic a urine specimen that is a red-orange color. Which action should the nurse take first? a. Notify the patients health care provider. b. Ask the patient about use of any medications. c. Question the patient about any UTI risk factors. d. Teach about the correct procedure for midstream urine collection.

b. Ask the patient about use of any medications

The nurse has been teaching the patient to administer a dose of 10 units of regular insulin and 28 units of NPH insulin. The statement by the patient that indicates a need for additional instruction is, a. I need to rotate injection sites among my arms, legs, and abdomen each day. b. I will buy the 0.5 mL syringes because the line markings will be easier to see. c. I should draw up the regular insulin first after injecting air into the NPH bottle. d. I do not need to aspirate the plunger to check for blood before injecting insulin.

a. I need to rotate injection sites among my arms, legs, and abdomen each day.

A 72-year-old patient is diagnosed with hypothyroidism and levothyroxine (Synthroid) is prescribed. Which assessment is most important for the nurse to make during initiation of thyroid replacement? a. Apical pulse rate b. Nutritional intake c. Intake and output d. Orientation and alertness

a. Apical pulse rate

Which of the following actions will the nurse plan to take first when admitting a patient who has a history of neurogenic bladder as a result of a spinal cord injury? a. Ask about the usual urinary pattern and any measures used for bladder control. b. Assist the patient to the toilet at scheduled times to help ensure bladder emptying. c. Check the patient for urinary incontinence every 2 hours to maintain skin integrity. d. Use intermittent catheterization on a regular schedule to avoid the risk of infection.

a. Ask about the usual urinary pattern and any measures used for bladder control

Which nursing action will be most helpful in decreasing the risk for hospital-acquired infection (HAI) of the urinary tract in patients admitted to the hospital? a. Avoid unnecessary catheterizations. b. Encourage adequate oral fluid intake. c. Test urine with a dipstick daily for nitrites. d. Provide thorough perineal hygiene to patients.

a. Avoid unnecessary catheterizations.

A patient with type 2 diabetes has sensory neuropathy of the feet and legs and peripheral arterial disease. Which information will the nurse include in patient teaching? a. Choose flat-soled leather shoes. b. Set heating pads on a low temperature. c. Buy callus remover for corns or calluses. d. Soak the feet in warm water for an hour every day.

a. Choose flat-soled leather shoes.

A patient who is diagnosed with nephrotic syndrome has 3+ ankle and leg edema and ascites. Which nursing diagnosis is a priority for the patient? a. Excess fluid volume related to low serum protein levels b. Activity intolerance related to increased weight and fatigue c. Disturbed body image related to peripheral edema and ascites d. Altered nutrition: less than required related to protein restriction

a. Excess fluid volume related to low serum protein levels.

A hospitalized patient with a decreased glomerular filtration rate is scheduled to have an intravenous pyelogram (IVP). Which action will be included in the plan of care? a. Monitor the urine output after the procedure. b. Assist with monitored anesthesia care (MAC). c. Give oral contrast solution before the procedure. d. Insert a large size urinary catheter before the IVP.

a. Monitor the urine output after the procedure

Which nursing action will be included in the postoperative plan of care for a patient who has had a transsphenoidal resection of a pituitary tumor? a. Monitor urine output every hour. b. Palpate extremities for dependent edema. c. Check hematocrit hourly for first 12 hours. d. Obtain continuous pulse oximetry for 24 hours.

a. Monitor urine output every hour.

A patient in the hospital has a history of functional urinary incontinence. Which nursing action will be included in the plan of care? a. Place a bedside commode near the patients bed. b. Demonstrate the use of the Cred maneuver to the patient. c. Use an ultrasound scanner to check postvoiding residuals. d. Teach the use of Kegel exercises to strengthen the pelvic floor.

a. Place a bedside commode near the patients bed.

In a patient with acute kidney injury (AKI) who requires hemodialysis, a temporary vascular access is obtained by placing a catheter in the left femoral vein. Which intervention will be included in the plan of care? a. Place the patient on bed rest. b. Start continuous pulse oximetry. c. Discontinue the retention catheter. d. Restrict the patients oral protein intake.

a. Place the patient on bed rest.

The nurse has instructed a patient who is receiving hemodialysis about appropriate dietary choices. Which menu choice by the patient indicates that the teaching has been successful? a. Scrambled eggs, English muffin, and apple juice b. Oatmeal with cream, half a banana, and herbal tea c. Split-pea soup, whole-wheat toast, and nonfat milk d. Cheese sandwich, tomato soup, and cranberry juice

a. Scrambled eggs, English muffin, and apple juice

State the location of the adrenal cortex and the adrenal medulla. a. The adrenal glands are located superior to the kidneys. b. The adrenal glands are located within the thoracic cavity. c. The adrenal glands are located within the pancreas d. The adrenal glands are located posterior to the kideys.

a. The adrenal glands are located superior to the kidneys.

A patient who is scheduled for an intravenous pyelogram (IVP) gives the nurse the following information. Which information has the most immediate implications for the patients care? a. The patient describes allergies to shellfish and penicillin. b. The patient has not had anything to eat or drink for 8 hours. c. The patient complains of costovertebral angle (CVA) tenderness. d. The patient used a bisacodyl (Dulcolax) tablet the previous night.

a. The patient describes allergies to shellfish and penicillin

When the nurse is taking a history for a patient who is a possible candidate for a kidney transplant, which information about the patient indicates that the patient is not an appropriate candidate for transplantation? a. The patient has metastatic lung cancer. b. The patient has poorly controlled type 1 diabetes. c. The patient has a history of chronic hepatitis C infection. d. The patient is infected with the human immunodeficiency virus.

a. The patient has metastatic lung cancer

Which information from the patients health history is most important for the nurse to communicate to the health care provider when a patient has an order for an oral glucose tolerance test? a. The patient uses oral contraceptives. b. The patient runs several days a week. c. The patient has a family history of diabetes. d. The patient had a viral illness 2 months ago.

a. The patient uses oral contraceptives.

A patient who has just been diagnosed with type 2 diabetes has a nursing diagnosis of imbalanced nutrition: more than body requirements. Which patient goal is most important for this patient? a. The patient will have a glycosylated hemoglobin level of less than 7%. b. The patient will have a diet and exercise plan that results in weight loss. c. The patient will choose a diet that distributes calories throughout the day. d. The patient will state the reasons for eliminating simple sugars in the diet.

a. The patient will have a glycosylated hemoglobin level in less than 7%.

What is the major function of the pituitary gland? a. The pituitary secretes hormones that in turn control the secretion of hormones by other endocrine glands. b. The pituitary controls the functions of the brain. c. The pituitary controls the cerebella activity of the brain and in turn skeletal function occurs. d. the pituitary secretes enzymes that in turn control the secretion of hormones by other cellular glands.

a. The pituitary secretes hormones that in turn control the secretion of hormones by other endocrine glands.

Name the principal action of Aldosterone a. To conserve sodium in the kidneys b. To ensure that sodium is removed from the blood c. To conserve sodium in the large intestine d. Aldosterone causes magnesium to be retained

a. To conserve sodium in the kidneys

Following rectal surgery, a patient voids about 50 mL of urine every 30 to 60 minutes. Which nursing action is most appropriate? a. Use an ultrasound scanner to check the postvoiding residual. b. Monitor the patients intake and output over the next few hours. c. Have the patient take small amounts of fluid frequently throughout the day. d. Reassure the patient that this is normal after rectal surgery because of anesthesia.

a. Use an ultrasound scanner to check the postvoiding residual.

A preschool age child has been diagnosed with a UTI. The nurse understands that children are more susceptible to UTIs because of which factors (select all that apply)? a. congenital or acquired urinary tract obstructions b. urethra is shorter and closer to the anus, especially in girls c. incomplete bladder emptying d. vesicouretereal reflux

a. congenital or acquired urinary tract obstructions b. urethra is shorter and closer to the anus, especially in girls c. incomplete bladder emptying d. vesicouretereal reflux

During assessment of a patient with decreased renal function, which of these medications taken by the patient at home will be of most concern to the nurse? a. ibuprofen (Motrin) b. warfarin (Coumadin) c. folic acid (vitamin B9) d. penicillin (Bicillin LA)

a. ibuprofen (Motrin)

A patient with symptoms of diabetes insipidus is admitted to the hospital for evaluation and treatment of the condition. An appropriate nursing diagnosis for the patient is a. insomnia related to frequent waking at night to void. b. impaired gas exchange related to fluid retention in lungs. c. excess fluid volume related to intake greater than output. d. risk for impaired skin integrity related to generalized edema.

a. insomnia related to frequent waking at night to void.

A patient needing vascular access for hemodialysis asks the nurse what the differences are between an arteriovenous (AV) fistula and a graft. The nurse explains that one advantage of the fistula is that it a. is much less likely to clot. b. increases patient mobility. c. can accommodate larger needles. d. can be used sooner after surgery.

a. is much less likely to clot

A patient is scheduled for a 24-hour urine collection for 17-ketosteroids. The nurse will need to a. keep the specimen on ice. b.insert a retention catheter. c.have the patient void and save that specimen to start the collection. d. encourage the patient to drink 2 to 3 L of fluid during the 24 hours.

a. keep the specimen on ice.

When planning teaching for a patient with benign nephrosclerosis the nurse should include instructions regarding a. monitoring and recording blood pressure. b. obtaining and documenting daily weights. c. measuring daily intake and output amounts. d. preventing bleeding caused by anticoagulants.

a. monitoring and recording blood pressure

After a patient with a pituitary adenoma has had a hypophysectomy, the nurse will plan to do discharge teaching about the need for a. oral corticosteroids to replace endogenous cortisol. b. chemotherapy to prevent reoccurrence of the tumor. c. insulin use to maintain blood glucose at normal levels. d. sodium restriction to prevent fluid retention and hypertension.

a. oral corticosteroids to replace endogenous cortisol.

when admitting a patient with acute glomerulonephritis, it is most important that the nurse ask the patient about a. recent sore throat and fever. b. history of high blood pressure. c. frequency of bladder infections d. family history of kidney stones

a. recent sore throat and fever.

The health care provider orders a clean-catch urine specimen for culture and sensitivity testing for a patient with a suspected urinary tract infection (UTI). To obtain the specimen, the nurse will plan to a. teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup. b. have the patient empty the bladder completely, and then obtain the next urine specimen that the patient is able to void. c. insert a short, small mini catheter attached to a collecting container into the urethra and bladder to obtain the specimen. d. clean the area around the meatus with a povidone-iodine (Betadine) swab, and then have the patient void into a sterile container.

a. teach the patient to clean the urethral area, void a small amount into the toilet, and then void into a sterile specimen cup.

Somatropin is given to children for impaired growth a. true b. false

a. true

Ketosis is common with this type of diabetes: a. type I b. type II c. both

a. type I

These patients are always dependent on insulin for blood sugar control. What type of diabetes is this? a. type I b. type II c. both

a. type I

The nurse notes that the patient admitted with ureteral calculus has had much less urine output than intake. On further assessment, the nurses notes that the patient's bladder is distended and suspects the development of: a. urethral obstruction b. oliguria c. chronic kidney disease d. hydronephrosis

a. uretheral obstruction

The assessment finding that indicates adequate perfusion to vital organs, especially the kidneys, is: a. urine output greater than or equal to 0.5 ml/kg/hr b. tympanic temperature within normal limits c. heart rate of 120 and 110 in a 15 minute period d. blood pressure reading of 74/50

a. urine output greater than or equal to 0.5 ml/kg/hr

Symptoms experienced by patients with hypothyroidism may include (select all that apply) a. weight gain b. feeling of warmth c. increased energy d. mental dullness e. feeling chilled f. dry, coarse skin

a. weight gain d. mental dullness e. feeling chilled f. dry, coarse skin

The result of a patients creatinine clearance test is 60 mL/min. The nurse equates this finding to a glomerular filtration rate (GFR) of _____ mL/min. a. 30 b. 60 c. 120 d. 240

b. 60

A patient with renal calculi is hospitalized with gross hematuria and severe colicky left flank pain. Which nursing action will be of highest priority at this time? a. Encourage oral fluid intake. b. Administer prescribed analgesics. c. Monitor temperature every 4 hours. d. Give antiemetics as needed for nausea.

b. Administer prescribed analgesics.

Which action should the nurse take first when teaching a patient who is newly diagnosed with type 2 diabetes about home management of the disease? a. Ask the patients family to participate in the diabetes education program. b. Assess the patients perception of what it means to have diabetes mellitus. c. Demonstrate how to check glucose using capillary blood glucose monitoring. d. Discuss the need for the patient to actively participate in diabetes management.

b. Assess the patient's perception of what it means to have diabetes mellitus.

. Following an open loop resection and fulguration of the bladder, a patient is unable to void. Which nursing action should be implemented first? a. Insert a straight catheter and drain the bladder. b. Assist the patient to take a 15-minute sitz bath. c. Encourage the patient to drink several glasses of water. d. Teach the patient how to do isometric perineal exercises.

b. Assist the patient to take a 15-minute sitz bath

A patient who has bladder cancer had a cystectomy with creation of an Indiana pouch. Which topic will be included in patient teaching? a. Application of ostomy appliances b. Catheterization technique and schedule c. Analgesic use before emptying the pouch d. Use of barrier products for skin protection

b. Catheterization technique and schedule

Which nursing action should the nurse who is caring for a patient who has had an ileal conduit for several years delegate to nursing assistive personnel (NAP)? a. Assess for symptoms of urinary tract infection (UTI). b. Change the ostomy appliance. c. Choose the appropriate ostomy bag. d. Monitor the appearance of the stoma.

b. Change the ostomy appliance

Which nursing action for a patient who has arrived for a scheduled hemodialysis session is most appropriate for the RN to delegate to a dialysis technician? a. Educate patient about fluid restrictions. b. Check blood pressure before starting dialysis. c. Assess for reasons for increase in predialysis weight. d. Determine the ultrafiltration rate for the hemodialysis.

b. Check blood pressure before starting dialysis.

An insulin-dependent diabetic patient is planning to go for a 5-mile run later in the day. What would be the most effective plan for managing blood sugars around exercise? a. Making sure to take the insulin so that it peaks while exercising b. Checking blood sugar levels before, during, and after exercise. c. Skipping the next insulin dose because exercise will decrease the blood sugar. d. Use the same schedule of blood sugar checks, food intake and insulin dosing as a day without exercise.

b. Checking the blood sugar levels before, during, and after exercise.

Which action is most important for the nurse to take in order to assist a diabetic patient to engage in moderate daily exercise? a. Remind the patient that exercise will improve self-esteem. b. Determine what type of exercise activities the patient enjoys. c. Give the patient a list of activities that are moderate in intensity. d. Teach the patient about the effects of exercise on glucose level.

b. Determine what type of exercise activities the patient enjoys.

A pregnant patient who has no personal history of diabetes, but does have a parent who is diabetic is scheduled for the first prenatal visit. Which action will the nurse plan to take on this initial visit? a. Teach about appropriate use of regular insulin. b. Discuss the need for a fasting blood glucose level. c. Schedule an oral glucose tolerance test for the twenty fourth week of pregnancy. d. Provide education about increased risk for fetal problems with gestational diabetes.

b. Discuss the need for a fasting blood glucose level.

A patient with systemic lupus erythematosus has a prescription for 2 weeks of high-dose prednisone therapy. When teaching the patient about the prednisone, which information is most important for the nurse to include? a. Call the doctor if you experience any mood alterations with the prednisone. b. Do not stop taking the prednisone suddenly; it should be decreased gradually. c. A weight-bearing exercise program will help minimize the risk for osteoporosis. d. Weigh yourself daily to monitor for weight gain caused by water or increased fat.

b. Do not stop taking the prenisone suddenly, it should be decreased gradually.

A patient with suspected acromegaly is seen at the clinic. To assist in making the diagnosis, which question should the nurse ask? a. Have you had a recent head injury? b. Do you have to wear larger shoes now? c. Are you experiencing tremors or anxiety? d. Is there any family history of acromegaly?

b. Do you have to wear larger shoes now?

Which question by the nurse will help identify autonomic neuropathy in a diabetic patient? a. Have you observed any recent skin changes? b. Do you notice any bloating feeling after eating? c. Do you need to increase your insulin dosage when you are stressed? d. Have you noticed any painful new ulcerations or sores on your feet?

b. Do you notice any bloating feeling after eating?

Which patient information will the nurse plan to obtain in order to determine the effectiveness of the prescribed calcium carbonate (Caltrate) for a patient with chronic kidney disease (CKD)? a. Blood pressure b. Phosphate level c. Neurologic status d. Creatinine clearance

b. Phosphate level

While assessing a patients urinary system, the nurse cannot palpate either kidney. Which action should the nurse take next? a. Obtain a urine specimen to check for hematuria. b. Document the information on the assessment form. c. Ask the patient about any history of recent sore throat. d. Ask the health care provider about scheduling a renal ultrasound.

b. Document the information on the assessment form

Intramuscular glucagon is administered to an unresponsive patient for treatment of hypoglycemia. Which action should the nurse take after the patient regains consciousness? a. Assess the patient for symptoms of hyperglycemia. b. Give the patient a snack of crackers and peanut butter. c. Have the patient drink a glass of orange juice or nonfat milk. d. Administer a continuous infusion of 5% dextrose for 24 hours.

b. Give the patient a snack of crackers and peanut butter.

Which information will the nurse include when teaching a patient who has type 2 diabetes about glyburide (Micronase, DiaBeta, Glynase)? a. GlyburidWhich patient statement after the nurse has completed teaching a patient with type 2 diabetes about taking glipizide (Glucotrol) indicates a need for additional teaching? a. Other medications besides the Glucotrol may affect my blood sugar. b. If I overeat at a meal, I will still take just the usual dose of medication. c. When I become ill, I may have to take insulin to control my blood sugar. d. My diabetes is not as likely to cause complications as if I needed to take insulin.e decreases glucagon secretion from the pancreas. b. Glyburide stimulates insulin production and release from the pancreas. c. Glyburide should be taken even if the morning blood glucose level is low. d. Glyburide should not be used for 48 hours after receiving IV contrast media.

b. Glyburide stimulates insulin production and release from the pancreas.

After teaching a patient with interstitial cystitis about management of the condition, the nurse determines that further instruction is needed when the patient says, a. I will have to stop having coffee and orange juice for breakfast. b. I should start taking a high potency multiple vitamin every morning. c. I will buy some calcium glycerophosphate (Prelief) at the pharmacy. d. I should call the doctor about increased bladder pain or odorous urine.

b. I should start taking a high potency multiple vitamin every morning

After the home health nurse teaches a patient with a neurogenic bladder how to use intermittent catheterization for bladder emptying, which patient statement indicates that the teaching has been effective? a. I will use a sterile catheter and gloves for each time I self-catheterize. b. I will clean the catheter carefully before and after each catheterization. c. I will need to buy seven new catheters weekly and use a new one every day. d. I will need to take prophylactic antibiotics to prevent any urinary tract infections.

b. I will clean the catheter carefully before and and after each catheterization.

A diabetic patient is admitted with ketoacidosis and the health care provider writes these orders. Which order should the nurse implement first? a. Administer regular IV insulin 30 U. b. Infuse 1 liter of normal saline per hour. c. Give sodium bicarbonate 50 mEq IV push. d. Start an infusion of regular insulin at 50 U/hr.

b. Infuse 1 liter of normal saline per hour.

Which information will the nurse include when teaching a patient about use of somatropin (Genotropin)? a. The medication will improve vaginal dryness. b. Inject the medication subcutaneously every day. c. Blood glucose levels will decrease when taking the medication. d. Stop taking the medication if swelling of the hands or feet occurs.

b. Inject the medication subcutaneously every day.

A patient with a history of benign prostatic hyperplasia (BPH) is admitted with acute urinary retention and an elevated blood urea nitrogen (BUN) and creatinine. Which of these prescribed therapies should the nurse implement first? a. Obtain renal ultrasound. b. Insert retention catheter. c. Infuse normal saline at 50 mL/hour. d. Draw blood for complete blood count.

b. Insert retention catheter.

A creatinine clearance test is ordered for a hospitalized patient with possible renal insufficiency. Which equipment will the nurse need to obtain? a. Sterile specimen cup b. Large container for urine c. Foley catheter and drainage bag d. Towelettes for perineal cleaning

b. Large container for urine

An 82-year-old man has been admitted with benign prostatic hyperplasia. Which of the following is most appropriate to include in the nursing plan of care? a. Limit fluid intake to no more than 1500 mL/day. b. Leave a light on in the bathroom during the night. c. Pad the patients bed to accommodate overflow incontinence. d. Ask the patient to use a urinal so that all urine can be measured.

b. Leave a light on in the bathroom during the night

Which of these laboratory values, noted by the nurse when reviewing the chart of a hospitalized diabetic patient, indicates the need for rapid assessment of the patient? a. Hb A1C of 5.8% b. Noon blood glucose of 52 mg/dL c. Hb A1Cof 6.9% d. Fasting blood glucose of 130 mg/dL

b. Noon blood glucose of 52 mg/dL

When the nurse is assessing a patient who is recovering from an episode of diabetic ketoacidosis, the patient reports feeling anxious, nervous, and sweaty. Which action should the nurse take first? a. Administer 1 mg glucagon subcutaneously. b. Obtain a glucose reading using a finger stick. c. Have the patient drink 4 ounces of orange juice. d. Give the scheduled dose of lispro (Humalog) insulin.

b. Obtain a glucose reading using a finger stick.

A patient returns to the clinic with recurrent dysuria after being treated with trimethoprim and sulfamethoxazole (Bactrim) for 3 days. Which action will the nurse plan to take? a. Remind the patient about the need to drink 1000 mL of fluids daily. b. Obtain a midstream urine specimen for culture and sensitivity testing. c. Teach the patient to take the prescribed Bactrim for at least 3 more days. d. Suggest that the patient use acetaminophen (Tylenol) to treat the symptoms.

b. Obtain a midstream urine specimen for culture and sensitivity testing.

When developing a plan of care for a patient with syndrome of inappropriate antidiuretic hormone (SIADH), which interventions will the nurse include? a. Encourage fluids to 2000 mL/day. b. Offer patient hard candies to suck on. c. Monitor for increased peripheral edema. d. Keep head of bed elevated to 30 degrees.

b. Offer patient hard candies to suck on.

A patient is admitted with diabetic ketoacidosis (DKA) and has a serum potassium level of 2.9 mEq/L. Which action prescribed by the health care provider should the nurse take first? a. Infuse regular insulin at 20 U/hr. b. Place the patient on a cardiac monitor. c. Administer IV potassium supplements. d. Obtain urine glucose and ketone levels.

b. Place the patient on a cardiac monitor.

When caring for a dehydrated patient with acute kidney injury who is oliguric, anemic, and hyperkalemic, which of the following prescribed actions should the nurse take first? a. Insert a urinary retention catheter. b. Place the patient on a cardiac monitor. c. Administer epoetin alfa (Epogen, Procrit). d. Give sodium polystyrene sulfonate (Kayexalate).

b. Place the patient on a cardiac monitor.

After the insertion of an arteriovenous graft (AVG) in the right forearm, a patient complains of pain and coldness of the right fingers. Which action should the nurse take? a. Elevate the patients arm above the level of the heart. b. Report the patients symptoms to the health care provider. c. Remind the patient about the need to take a daily low-dose aspirin tablet. d. Educate the patient about the normal vascular response after AVG insertion.

b. Report the patients symptoms to the health care provider.

When the nurse is caring for a patient who has been admitted with a severe crushing injury after an industrial accident, which laboratory result will be most important to report to the health care provider? a. Serum creatinine level 2.1 mg/dL b. Serum potassium level 6.5 mEq/L c. White blood cell count 11,500/L d. Blood urea nitrogen (BUN) 56 mg/dL

b. Serum potassium level 6.5 mEq/L

After the nurse manager at the endocrine clinic has completed the orientation of a new RN, which action by the new RN who is caring for a patient with a goiter and possible hyperthyroidism indicates the charge nurse needs to do more teaching? a. The RN palpates the neck to check thyroid size. b. The RN checks the blood pressure on both arms. c. The RN orders nonmedicated eye drops to lubricate the patients eyes. d. The RN lowers the thermostat to decrease the temperature in the room.

b. The RN checks the blood pressure on both arms.

While assessing a patient who has just arrived in the postanesthesia recovery unit (PACU) after a thyroidectomy, the nurse obtains these data. Which information is most important to communicate to the surgeon? a. The patient is sleepy and hard to arouse. b. The patient has increasing swelling of the neck. c. The patient is complaining of 7/10 incisional pain. d. The patients cardiac monitor shows a heart rate of 112.

b. The patient has increasing swelling of the neck.

A patient who has had a transurethral resection with fulguration for bladder cancer 3 days previously calls the nurse at the urology clinic. Which information given by the patient is most important to report to the health care provider? a. The patient is using opioids for pain. b. The patient has noticed clots in the urine. c. The patient is very anxious about the cancer. d. The patient is voiding every 4 hours at night.

b. The patient has noticed clots in the urine.

Which information obtained by the nurse when caring for a patient who has diabetes insipidus (DI) is most important to report to the health care provider? a. The patient had a recent head injury. b. The patient is confused and lethargic. c. The patient has a urine output of 400 mL/hr. d. The patients urine specific gravity is 1.003.

b. The patient is confused and lethargic.

. Which patient action indicates a good understanding of the nurses teaching about the use of an insulin pump? a. The patient changes the site for the insertion site every week. b. The patient programs the pump to deliver an insulin bolus after eating. c. The patient takes the pump off at bedtime and starts it again each morning. d. The patient states that diet will be less flexible when using the insulin pump.

b. The patient programs the pump to deliver an insulin bolus after eating.

The nurse is assessing a patient who is receiving peritoneal dialysis with 2 L inflows. Which information should be reported immediately to the health care provider? a. The patient has an outflow volume of 1800 mL. b. The patients peritoneal effluent appears cloudy. c. The patient has abdominal pain during the inflow phase. d. The patient complains of feeling bloated after the inflow.

b. The patients peritoneal effluent appears cloudy.

Name the hormone secreted from the pituitary gland that stimulates the thyroid gland. And name the two hormones produced by the thyroid gland. a. Thyroid stimulating hormone, Estrogen, ADH b. Thyroid stimulating hormone, Thyroxine (T4) and Triiodothyronine (T3) c. Epinephrine, Norepinephrine, TSH, Triiodothyronine (T3) d. Thyroxine (T4), TSH, Growth hormone

b. Thyroid stimulating hormone, Thyroxine (T4), and Triiodothyronine (T3)

What is another name for TSH is: a. Calcium b. Thyrotropin c. Thyroxine d. Thyroxine (T4), TSH, Growth Hormone

b. Thyrotorpin

Which information about a patient with newly diagnosed diabetes mellitus will be most useful to the nurse in developing strategies for successful adaptation to this disease? a. Ideal weight b. Value system c. Activity level d. Visual changes

b. Value system

A patient is hospitalized with possible syndrome of inappropriate antidiuretic hormone (SIADH). The patient is confused and reports a headache, muscle cramps, and twitching. The nurse would expect the initial laboratory results to include a. an elevated hematocrit. b. a decreased serum sodium. c. an increased serum chloride. d. a low urine specific gravity.

b. a decreased serum sodium.

A patient with nephrotic syndrome develops flank pain. The nurse will anticipate teaching the patient about treatment with a. antibiotics. b. anticoagulants. c. corticosteroids. d. antihypertensives.

b. anticoagulants

. After obtaining the health history for a 25-year-old who smokes two packs of cigarettes daily, the nurse will plan to do teaching about the increased risk for a. kidney stones. b. bladder cancer. c. bladder infection. d. interstitial cystitis.

b. bladder cancer

A patient with type 1 diabetes has been using self-monitoring of blood glucose (SMBG) as part of diabetes management. During evaluation of the patients technique of SMBG, the nurse identifies a need for additional teaching when the patient a. washes the puncture site using soap and warm water. b. chooses a puncture site in the center of the finger pad. c. hangs the arm down for a minute before puncturing the site. d. says the result of 130 mg indicates good blood sugar control.

b. chooses a puncture site in the center of the finger pad.

What adrenal cortex hormone affecting metabolism and stress response? A. oxytocin B. cortisol C. pituitary gland D. hormone E. thyroid gland F. thyroid stimulating hormone (TSH) G. triiodothyronine (T3) H. endocrine gland I. hypothalamus J. hypofunction

b. cortisol

A 78-year-old patient in a long-term care facility has these medications prescribed. After the patient is diagnosed with hypothyroidism, the nurse will need to consult with the health care provider before administration of a. docusate (Colace). b. diazepam (Valium). c. ibuprofen (Motrin). d. cefoxitin (Mefoxin).

b. diazepam (Valium)

Two days after surgery for an ileal conduit, the patient will not look at the stoma or participate in care. The patient insists that no one but the ostomy nurse specialist care for the stoma. The nurse identifies a nursing diagnosis of: a. anxiety related to effects of procedure on lifestyle. b. disturbed body image related to change in body function. c. readiness for enhanced coping related to need for information. d. self-care deficit, toileting, related to denial of altered body function.

b. disturbed body image related to change in body function.

During a physical examination, the nurse finds that a patients thyroid gland cannot be palpated. The most appropriate action by the nurse is to a. palpate the patients neck more deeply. b. document that the thyroid was nonpalpable. c. notify the health care provider immediately. d. teach the patient about thyroid hormone testing.

b. document that the thyroid was nonpalpable

A urinary tract infection (UTI) is a potential danger with an indwelling Foley catheter. The nurse can best avoid this complication by: a. collecting a weekly urine specimen b. evaluating the patient for catheter removal each shift and keeping it in for the shortest time possible c. assessing urine specific gravity d. emptying the drainage bag frequently

b. evaluating the patient for catheter removal each shift and keeping it in for the shortest time possible.

A typical patient with severe acute pyelonephritis may demonstrate which signs and symptoms (select all that apply)? a. urticaria b. fever c. vomiting d. unilateral costovertebral angle (CVA) tenderness e. dark urine f. dysuria

b. fever c. vomiting d. unilateral costovertebral angle (CVA) tenderness f. dysuria

A patient admitted to the hospital with hypertension is diagnosed with a pheochromocytoma. The nurse will plan to monitor the patient for a. flushing. b. headache. c. bradycardia. d. hypoglycemia.

b. headache

A diagnosis of hyperglycemic hyperosmolar nonketotic coma (HHNC) is made for a patient with type 2 diabetes who is brought to the emergency department in an unresponsive state. The nurse will anticipate the need to a. give 50% dextrose as a bolus. b. insert a large-bore IV catheter. c. initiate oxygen by nasal cannula. d. administer glargine (Lantus) insulin.

b. insert a large-bore IV catheter.

When teaching a diabetic patient who has just been started on intensive insulin therapy about mealtime coverage, which type of insulin will the nurse need to discuss? a. glargine (Lantus) b. lispro (Humalog) c. detemir (Levemir) d. NPH (Humulin N)

b. lispro (Humalog)

A patient with type 1 diabetes who uses glargine (Lantus) and lispro (Humalog) insulin develops a sore throat, cough, and fever. When the patient calls the clinic to report the symptoms and a blood glucose level of 210 mg/dL, the nurse advises the patient to a. use only the lispro insulin until the symptoms of infection are resolved. b. monitor blood glucose every 4 hours and notify the clinic if it continues to rise. c. decrease intake of carbohydrates until glycosylated hemoglobin is less than 7%. d. limit intake of calorie-containing liquids until the glucose is less than 120 mg/dL.

b. monitor blood glucose every 4 hours and notify the clinic if it continues to rise.

. A patient with hypertension and stage 2 chronic kidney disease (CKD) is receiving captopril (Capoten). Before administration of the medication, the nurse will check the patients a. glucose. b. potassium. c. creatinine. d. phosphate.

b. potassium

A patient with type 2 diabetes that is well-controlled with metformin (Glucophage) develops an allergic rash to an antibiotic and the health care provider prescribes prednisone (Deltasone). The nurse will anticipate that the patient may a. need a diet higher in calories while receiving prednisone. b. require administration of insulin while taking prednisone. c. develop acute hypoglycemia while taking the prednisone. d. have rashes caused by metformin-prednisone interactions.

b. require administration of insulin while taking prednisone.

A patient with hyperthyroidism is treated with radioactive iodine (RAI) at a clinic. Before the patient is discharged, the nurse instructs the patient a. that symptoms of hyperthyroidism should be relieved in about a week. b. that symptoms of hypothyroidism may occur as the RAI therapy takes effect. c. to discontinue the antithyroid medications taken before the radioactive therapy. d. about radioactive precautions to take with urine, stool, and other body secretions.

b. that symptoms of hypothyroidism may occur as RAI therapy takes effect.

A former abbreviation for this type of diabetes is NIDDM. a. type I b. type II c. both

b. type II

Approximately 90% of people with diabetes have this type a. type I b. type II c. both

b. type II

After receiving change-of-shift report about the following four patients, which patient should the nurse assess first? a. A 31-year-old with Cushing syndrome and a blood glucose level of 244 mg/dL b. A 22-year-old admitted with syndrome of inappropriate antidiuretic hormone (SIADH) who has a serum sodium level of 130 mEq/L c. A 70-year-old who recently started taking levothyroxine (Synthroid) and has an irregular pulse of 134 d. A 53-year-old who has Addisons disease and is due for a scheduled dose of hydrocortisone (Solu-Cortef).

c. A 70-year-old who recently started taking llevothyroxine (Synthroid) and has an irregular pulse of 134.

The nurse and LPN/LVN are caring for a type 2 diabetic patient who is admitted for gallbladder surgery. Which nursing action can the nurse delegate to the LPN/LVN? a. Communicate the blood glucose and insulin dose to the circulating nurse in surgery. b. Discuss the reason for the use of insulin therapy during the immediate postoperative period. c. Administer the prescribed lispro (Humalog) insulin before transferring the patient to surgery. d. Plan strategies to minimize the risk for hypo- or hyperglycemia during the postoperative hospitalization.

c. Administer the prescribed lispro (Humalog) insulin before transferring the patient to surgery.

Diabetes insipidus is caused by a lack of what pituitary hormone: a. Mineralocorticoids b. Glucocorticoids c. Antidiuretic hormone d. Insulin

c. Antidiuretic hormone

Which assessment finding for a patient who has just been admitted with acute pyelonephritis is most important for the nurse to report to the health care provider? a. Foul-smelling urine b. Complaint of flank pain c. Blood pressure 88/45 mm Hg d. Temperature 100.1 F (57.8 C)

c. Blood pressure 88/45 mm Hg

Name the hormone secreted by the Thyroid gland that controls the level of calcium being deposited in the bone? a. Parathormone b. Calcium c. Calcitonin d. Phosphotase

c. Calcitonin

A patient who has acute glomerulonephritis is hospitalized with acute kidney injury (AKI) and hyperkalemia. Which information will the nurse obtain to evaluate the effectiveness of the prescribed calcium gluconate IV? a. Urine output b. Calcium level c. Cardiac rhythm d. Neurologic status

c. Cardiac rhythm

During hemodialysis, a patient complains of nausea and dizziness. Which action should the nurse take first? a. Slow down the rate of dialysis. b. Obtain blood to check the blood urea nitrogen (BUN) level. c. Check the patients blood pressure. d. Give prescribed PRN antiemetic drugs.

c. Check the patients blood pressure.

When a patient in the outpatient clinic has an order for blood cortisol testing, which instruction will the nurse provide for the patient? a. Avoid adding any salt to your foods for 24 hours before the test. b. You will need to lie down for 30 minutes before the blood is drawn. c. Come to the laboratory to have the blood drawn early in the morning. d. Do not have anything to eat or drink before the blood test is obtained.

c. Come to the laboratory to have the blood drawn early in the morning

How will the nurse assess the flank area of a patient with pyelonephritis for tenderness? a. Push gently into the two lowest intercostal spaces. b. Palpate along both sides of the lumbar vertebral column. c. Position one hand flat at the costovertebral angle (CVA) and strike it with the other fist. d. Use two fingers to percuss the area between the iliac crest and ribs along the midaxillary line.

c. Position one hand flat at the costovertebral angle (CVA) and strike it with the other fist

When reading a patients chart, the nurse notes that the patient has dysuria. To assess whether there is any improvement, which question will the nurse ask? a. Do you have any blood in your urine? b. Do you have to urinate very frequently? c. Do you have any pain when you urinate? d. Do you have to get up at night to urinate?

c. Do you have any pain when you urinate?

A 26-year-old patient with a history of polycystic kidney disease is admitted to the surgical unit after having knee surgery. Which of the routine postoperative orders is most important for the nurse to discuss with the health care provider? a. Infuse 5% dextrose in normal saline at 75 mL/hr. b. Order regular diet after patient is awake and alert. c. Give ketorolac (Toradol) 10 mg PO PRN for pain. d. Obtain blood urea nitrogen (BUN), creatinine, and electrolytes in 2 hours.

c. Give ketorolac (Toradol) 10 mg PO PRN for pain.

. Which assessment finding for a patient who has had a cystectomy with an ileal conduit the previous day is most important for the nurse to communicate to the physician? a. Cloudy appearing urine b. Hypotonic bowel sounds c. Heart rate 102 beats/minute d. Continuous drainage from stoma

c. Heart rate 102 beats/minute

Which of the following information obtained by the nurse who is caring for a patient with end-stage renal disease (ESRD) indicates the nurse should consult with the health care provider before giving the prescribed epoetin alfa (Procrit)? a. Creatinine 1.2 mg/dL b. Oxygen saturation 89% c. Hemoglobin level 13 g/dL d. Blood pressure 98/56 mm Hg

c. Hemoglobin level 13 g/dL

What is the name of the gland that connects the pituitary gland to the brain/central nervous system? a. Frontal lobe gland b. Pleural gland c. Hypothalamus d. Pituitary

c. Hypothalamus

A patient is admitted to the hospital in Addisonian crisis. Which patient statement supports the nursing diagnosis of ineffective self-health management related to lack of knowledge about management of Addisons disease? a. I double my dose of hydrocortisone on the days that I go for a run. b. I frequently eat at restaurants, and so my food has a lot of added salt. c. I had the stomach flu earlier this week and couldnt take the hydrocortisone. d. I take twice as much hydrocortisone in the morning as I do in the afternoon.

c. I had the stomach flu earlier this week and couldn't take the hydrocortisone.

A patient who had a cystoscopy the previous day calls the urology clinic and gives the nurse all the following information. Which statement by the patient should be reported immediately to the health care provider? a. My urine still looks pink. b. My IV site is still bruised. c. I have a temperature of 101. d. I did not sleep well last night.

c. I have a temperature of 101.

An 18-year-old with newly diagnosed type 1 diabetes has received diet instruction. The nurse determines a need for additional instruction when the patient says, a. I may have an occasional alcoholic drink if I include it in my meal plan. b. I will need a bedtime snack because I take an evening dose of NPH insulin. c. I may eat whatever I want, as long as I use enough insulin to cover the calories. d. I will eat meals as scheduled, even if I am not hungry, to prevent hypoglycemia.

c. I may eat whatever I want, as long as I use enough insulin to cover the calories.

A patient with stage 2 chronic kidney disease (CKD) is scheduled for an intravenous pyelogram (IVP). Which of these orders for the patient will the nurse question? a. NPO for 6 hours before IVP procedure b. Normal saline 500 mL IV before procedure c. Ibuprofen (Advil) 400 mg PO PRN for pain d. Dulcolax suppository 4 hours before IVP procedure

c. Ibuprofen (Advil) 400 mg PO PRN for pain

When the nurse is caring for a patient who was admitted with tetany, which laboratory value should be monitored? a. Total protein b. Blood glucose c. Ionized calcium d. Serum phosphate

c. Ionized calcium

Which information noted by the nurse when caring for a patient with a bladder infection is most important to report to the health care provider? a. Dysuria b. Hematuria c. Left-sided flank pain d. Temperature 100.1 F

c. Left-sided flank pain

Complications such as a CVA and MI are the result of this a. HHS b. DKA c. Macroangiopathy d. Microangiopathy e. Hypoglycemia

c. Macroangiopathy

When a patient who has had progressive chronic kidney disease (CKD) for several years is started on hemodialysis, which information about diet will the nurse include in patient teaching? a. Increased calories are needed because glucose is lost during hemodialysis. b. Unlimited fluids are allowed since retained fluid is removed during dialysis. c. More protein will be allowed because of the removal of urea and creatinine by dialysis. d. Dietary sodium and potassium are unrestricted because these levels are normalized by dialysis.

c. More protein will be allowed because of the removal of urea and creatinine by dialysis.

Which finding by the nurse for a patient admitted with glomerulonephritis indicates that treatment has been effective? a. The patient denies pain with voiding. b. The urine dipstick is negative for nitrites. c. Peripheral and periorbital edema is resolved. d. The antistreptolysin-O (ASO) titer is decreased.

c. Peripheral and periorbital edema is resolved

When planning teaching for a patient who was admitted with myxedema coma and diagnosed with hypothyroidism, which strategy will be best for the nurse to use? a. Delay teaching until patient discharge. b. Ensure privacy by asking visitors to leave. c. Provide written handouts of all information. d. Offer multiple options for management of therapies.

c. Provide written handouts of all information.

A patient is admitted to the hospital with new onset nephrotic syndrome. Which assessment data will the nurse expect to find related to this illness? a. Poor skin turgor b. High urine ketones c. Recent weight gain d. Low blood pressure

c. Recent weight gain

Manifestations of which disease may include confusion, disorientation, headache, and hyponatremia? a. diabetes mellitus b. diabetes insipidus c. SIADH d. adrenal insufficiency

c. SIADH

A patient with chronic kidney disease cannot use salt substitutes in the diet because: a. Salt substitutes tend to cause fluid retention b. Limiting salt substitutes prevent build up of waste products in the blod c. Salt substitutes contain potassium, which the kidneys cannot excrete and accumulation may cause cardiac dysrhythmias. d. Salt substitutes interfere with transfer of fluid across capillary membranes and cause anasarca

c. Salt substitutes contain potassium, which the kidneys cannot excrete and accumulation may cause cardiac dysrhythmias.

A patient with Cushing syndrome who is admitted for adrenalectomy has a nursing diagnosis of disturbed body image related to changes in appearance caused by the effects of the disease. Which intervention by the nurse will be most helpful? a. Reassure the patient that the physical changes are very common in patients with Cushing syndrome. b. Discuss the use of diet and exercise in controlling the weight gain associated with Cushing syndrome. c. Teach the patient that most of the physical changes caused by Cushing syndrome will resolve after surgery. d. Remind the patient that the metabolic impact of Cushing syndrome is of more importance than appearance.

c. Teach the patient that most of the physical changes caused by Cushing syndrome will resolve after surgery.

The RN observes an LPN/LVN carrying out all of the following actions while caring for a patient with stage 2 chronic kidney disease. Which action requires the RN to intervene? a. The LPN/LVN administers erythropoietin subcutaneously. b. The LPN/LVN assists the patient to ambulate in the hallway. c. The LPN/LVN gives the iron supplement and phosphate binder with lunch. d. The LPN/LVN carries a tray containing low-protein foods into the patients room.

c. The LPN/LVN gives the iron supplement and phosphate binder with lunch.

A patient with type 2 diabetes is admitted for an outpatient coronary arteriogram. Which information obtained by the nurse is most important to report to the health care provider before the procedure? a. The patients admission blood glucose is 128 mg/dL. b. The patients most recent Hb A1C was 6.5%. c. The patient took the prescribed metformin (Glucophage) today. d. The patient took the prescribed captopril (Capoten) this morning.

c. The patient took the prescribed metformin (Glucophage) today.

When providing postoperative care for a patient who had a bilateral adrenalectomy, which assessment information requires the most rapid action by the nurse? a. The blood glucose is 176 mg/dL. b. The lungs have bibasilar crackles. c. The patients BP is 88/50 mm Hg. d. The patient has 5/10 incisional pain.

c. The patients BP is 88/50 mm Hg.

Two hours after a kidney transplant, the nurse obtains all of the following data when assessing the patient. Which information is most important to communicate to the health care provider? a. The urine output is 900 to 1100 mL/hr. b. The blood urea nitrogen (BUN) and creatinine levels are elevated. c. The patients central venous pressure (CVP) is decreased. d. The patient has level 8 (on a 10-point scale) incisional pain.

c. The patients central venous pressure (CVP) is decreased.

When reviewing the laboratory results for a patients total calcium level, which information will the nurse need to consider? a. The blood glucose is elevated. b. The phosphate level is normal. c. The serum albumin level is low. d. The magnesium level is normal.

c. The serum albumin level is low.

A child with diabetes is scheduled for surgery. The nurse understands that: a. Urine test results provide the best guage of diabetic control after the surgery b. The greatest danger during the surgical procedure is from diabetic ketoacidosis c. The stress of surgery causes a rise in blood glucose levels during postoperative period. d. If insulin was not required before surgery, it will likely not be required in the postoperative period.

c. The stress of surgery causes a rise in blood glucose levels during postoperative period.

Which information will the nurse include when teaching the patient with a urinary tract infection (UTI) about the use of phenazopyridine (Pyridium)? a. Take the medication for at least 7 days. b. Use sunscreen while taking the Pyridium. c. The urine may turn a reddish-orange color. d. Use the Pyridium before sexual intercourse.

c. The urine may turn a reddish-orange color

Which data obtained when assessing a patient who had a kidney transplant 8 years ago and who is receiving the immunosuppressants tacrolimus (Prograf), cyclosporine (Sandimmune), and prednisone (Deltasone) will be of most concern to the nurse? a. The blood glucose is 144 mg/dL. b. The patients blood pressure is 150/92. c. There is a nontender lump in the axilla. d. The patient has a round, moonlike face.

c. There is a nontender lump in the axilla.

When a patient has clinical manifestations of hypothyroidism, which laboratory value should the nurse review to determine whether the hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland? a. Thyroxine (T4) level b. Triiodothyronine (T3) level c. Thyroid-stimulating hormone (TSH) level d. Thyrotropin-releasing hormone (TRH) level

c. Thyroid-stimulating hormone (TSH) level

A patient undergoes a nephrectomy after having massive trauma to the kidney. Which assessment finding obtained postoperatively is most important to communicate to the surgeon? a. Blood pressure is 102/58. b. Incisional pain level is 8/10. c. Urine output is 20 mL/hr for 2 hours. d. Crackles are heard at both lung bases.

c. Urine output is 20 mL/ hr for 2 hours

Which information about a patient who was admitted 10 days previously with acute kidney injury (AKI) caused by dehydration will be most important for the nurse to report to the health care provider? a. The blood urea nitrogen (BUN) level is 67 mg/dL. b. The creatinine level is 3.0 mg/dL. c. Urine output over an 8-hour period is 2500 mL. d. The glomerular filtration rate is <30 mL/min/1.73m2.

c. Urine output over an 8-hour period is 2500 mL

When reviewing the results of a patients urinalysis, which information indicates that the nurse should notify the health care provider? a. pH 6.2 b. Trace protein c. WBC: 20-26/hpf d. Specific gravity: 1.021

c. WBC: 20-26/hpf

The nurse will plan patient care that will decrease the patients physical and emotional stress when the patient is undergoing a. a water deprivation test. b. testing for serum T3 and T4 levels. c. a 24-hour urine test for free cortisol. d. a radioactive iodine (I-131) uptake test.

c. a 24-hour urine test for free cortisol.

When evaluating the laboratory results for a patient with increased secretion of the anterior pituitary hormones, the nurse would expect to find a. decreased serum thyroxine levels. b. elevated serum aldosterone levels. c. an increase in urinary free cortisol. d. low urinary excretion of catecholamines.

c. an increase in urinary free cortisol

A patient is scheduled for an intravenous pyelogram (IVP) the next morning. The nurse should: a. have the patient eat a fat-free dinner b. drink a large amount of fluids c. assess for allergies to shellfish and iodine d. make the patient NPO until the test

c. assess for allergies to shellfish or iodine

After radical neck surgery, a patient develops hypoparathyroidism. The nurse should plan to teach the patient about a. use of bisphosphonates to reduce bone demineralization. b. including whole grains in the diet to prevent constipation. c. calcium supplementation to normalize serum calcium levels. d. having a high fluid intake to decrease risk for nephrolithiasis.

c. calcium supplementation to normalize serum calcium levels.

When working with a patient who has diabetes mellitus, the nurse reviews the results of testing for glycosylated hemoglobin (HbA1C) to evaluate for a. glucose levels 2 hours after a meal. b. circulating, nonfasting glucose levels. c. glucose control over the past 3 months. d. hypoglycemic episodes in the past 90 days.

c. glucose control over the past 3 months.

When assessing a 30-year-old man who complains of a feeling of incomplete bladder emptying and a split, spraying urine stream, the nurse asks about a history of a. bladder infection. b. recent kidney trauma. c. gonococcal urethritis. d. benign prostatic hyperplasia.

c. gonococcal urethritis

The nurse uses auscultation during assessment of the urinary system to a. check for ureteral peristalsis. b. assess for bladder distention. c. identify renal artery or aortic bruits. d. determine the position of the kidneys.

c. identify renal artery or aortic bruits

A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about a. self-monitoring of blood glucose. b. use of low doses of regular insulin. c. lifestyle changes to lower blood glucose. d. effects of oral hypoglycemic medications.

c. lifestyle changes to lower blood glucose

A client is admitted to the ER and a diagnosis of myxedema coma is made. Which of the following nursing actions does the nurse prepare to carry out initially? a. warm the client b. replace fluids c. maintain the airway d. administer an IV steroid

c. maintain the airway

A patient with Cushing syndrome returns to the surgical unit following an adrenalectomy. During the initial postoperative period, the nurse gives the highest priority to a. monitoring for infection. b. protecting the patients skin. c. maintaining fluid and electrolyte status. d. preventing severe emotional disturbances.

c. maintaining fluid and electrolyte status.

A patients renal calculus is analyzed as being very high in uric acid. To prevent recurrence of stones, the nurse teaches the patient to avoid eating a. milk and dairy products. b. legumes and dried fruits. c. organ meats and sardines. d. spinach, chocolate, and tea.

c. organ meats and sardines

Before administering sodium polystyrene sulfonate (Kayexalate) to a patient with hyperkalemia, the nurse should assess the a. blood urea nitrogen (BUN) and creatinine. b. blood glucose level. c. patients bowel sounds. d. level of consciousness (LOC).

c. patients bowel sounds

On the 4th postoperative day after a cystectomy and urinary diversion, the nurse notes mucus threads in a patient's urine. The nurse should: a. collect a specimen for culture and sensitivity b. report this to the physician when he makes rounds c. recognize and document this as a normal occurrence d. increase the patient's fluids for the next 12 hours.

c. recognize and document this as a normal occurrence

Which of these nursinng actions in the plan of care for a patient who has diabetes insipidus will be most appropriate for the RN to delegate to an expeerienced LPN/LVN? a. Titrate the infusion of 5 % dextrose in water. b. Teach patient how to use DDAVP nasal spray. c. Assess patients hydration status every 8 hours. d. Administer subcutaneous desmopressin (DDAVP).

d. Administer subcutaneous desmopressin (DDAVP).

A 78-year-old who has been admitted to the hospital with dehydration is confused and incontinent of urine. Which nursing action will be best to include in the plan of care? a. Apply absorbent incontinent pads. b. Restrict fluids after the evening meal. c. Insert an indwelling catheter until the symptoms have resloved. d. Assist the patient to the bathroom every 2 hours during the day.

d. Assist the patient to the bathroom every 2 hours during the day

Which information will be most useful to the nurse in evaluating improvement in kidney function for a patient who is hospitalized with acute kidney injury (AKI)? a. Blood urea nitrogen (BUN) level b. Urine output c. Creatinine level d. Calculated glomerular filtration rate (GFR)

d. Calculated glomerular filtration rate (GFR)

Which action will the nurse include in the plan of care for a patient who has had a ureterolithotomy and has a left ureteral catheter and a urethral catheter in place? a. Provide education about home care for both catheters. b. Apply continuous steady tension to the ureteral catheter. c. Clamp the ureteral catheter unless output from the urethral catheter stops. d. Call the health care provider if the ureteral catheter output drops suddenly.

d. Call the health care provider if the ureteral catheter output drops suddenly.

A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what type 2 means in relation to diabetes. Which statement by the nurse about type 2 diabetes is correct? a. Insulin is not used to control blood glucose in patients with type 2 diabetes. b. Complications of type 2 diabetes are less serious than those of type 1 diabetes. c. Type 2 diabetes is usually diagnosed when the patient is admitted with a hyperglycemic coma. d. Changes in diet and exercise may be sufficient to control blood glucose levels in type 2 diabetes.

d. Changes in diet and exercise may be sufficient to control blood glucose levels in type 2 diabetes.

A 72-year-old who has benign prostatic hyperplasia is admitted to the hospital with chills, fever, and vomiting. Which finding by the nurse will be most helpful in determining whether the patient has an upper urinary tract infection (UTI)? a. Suprapubic pain b. Bladder distention c. Foul-smelling urine d. Costovertebral tenderness

d. Costovertebral tenderness

The nurse observes nursing assistive personnel (NAP) taking the following actions when caring for a patient with a retention catheter. Which action requires that the nurse intervene? a. Taping the catheter to the skin on the patients upper inner thigh b. Cleaning around the patients urinary meatus with soap and water c. Using an alcohol-based hand cleaner before performing catheter care d. Disconnecting the catheter from the drainage tube to obtain a specimen

d. Disconnecting the catheter from the drainage tube to obtain a specimen.

When the nurse is caring for a patient who has had left-sided extracorporeal shock wave lithotripsy, which assessment finding is most important to report to the health care provider? a. Blood in urine b. Left flank pain c. Left flank bruising d. Drop in urine output

d. Drop in urine output

A patient with primary hyperparathyroidism has a serum calcium level of 14 mg/dL (3.5 mmol/L) and a phosphorus of 1.7 mg/dL (0.55 mmol/L). Which nursing action should be included in the plan of care? a. Institute routine seizure precautions. b. Monitor for positive Chvosteks sign. c. Encourage the patient to remain on bed rest. d. Encourage 3000 to 4000 mL of oral fluids daily.

d. Encourage 3000 to 4000 mL of oral fluids daily.

To evaluate the effectiveness of treatment for a patient with type 2 diabetes who is scheduled for a follow-up visit in the clinic, which test will the nurse plan to schedule for the patient? a. Urine dipstick for glucose b. Oral glucose tolerance test c. Fasting blood glucose level d. Glycosylated hemoglobin level

d. Glycosylated hemoglobin level

Following a parathyroidectomy, a patient develops tingling of the lips and a positive Trousseaus sign. Which action should the nurse take first? a. Administer the ordered muscle relaxant. b. Give the ordered oral calcium supplement. c. Start the PRN oxygen at 2 L/min per cannula. d. Have the patient rebreathe using a paper bag.

d. Have the patient rebreathe using a paper bag.

The nurse is interviewing a patient who has a possible thyroid disorder. Which question will provide the most useful information? a. What methods do you use to help cope with stress? b. Have you experienced any blurring or double vision? c. Do you have to get up at night to empty your bladder? d. Have you had any recent unplanned weight gain or loss?

d. Have you had any recent unplanned weight gain or loss?

When the nurse is obtaining the health history, which statement by a patient indicates further assessment of thyroid function may be necessary? a. I notice my breasts are tender lately. b. I am so thirsty that I drink all day long. c. I get up several times at night to urinate. d. I feel a lump in my throat when I swallow.

d. I feel a lump in my throat when I swallow

Complications such as retinopathy, nephropathy, and dermopathy are the result of this: a. HHS b. DKA c. Macroangiopathy d. Microangiopathy e. Hypoglycemia

d. Microangiopathy

Which patient statement after the nurse has completed teaching a patient with type 2 diabetes about taking glipizide (Glucotrol) indicates a need for additional teaching? a. Other medications besides the Glucotrol may affect my blood sugar. b. If I overeat at a meal, I will still take just the usual dose of medication. c. When I become ill, I may have to take insulin to control my blood sugar. d. My diabetes is not as likely to cause complications as if I needed to take insulin.

d. My diabetes is not as likely to cause complications as if I needed to take insulin.

When caring for a patient with a diagnosis of Cushing syndrome, which data will the nurse expect to find during the admission assessment? a. Chronically low blood pressure b. Bronzed appearance of the skin c. Decreased axillary and pubic hair d. Purplish red streaks on the abdomen

d. Purplish red streaks on the abdomen.

A 62-year-old asks the nurse for a perineal pad, stating that laughing or coughing causes leakage of urine. Which intervention is most appropriate to include in the care plan? a. Assist the patient to the bathroom q3hr. b. Place a commode at the patients bedside. c. Demonstrate how to perform the Cred maneuver. d. Teach the patient how to perform Kegel exercises.

d. Teach the patient how to perform Kegel exercises.

Which assessment finding for a 24-year-old patient admitted with Graves disease requires the most rapid intervention by the nurse? a. BP 166/100 mm Hg b. Bilateral exophthalmos c. Heart rate 136 beats/minute d. Temperature 104.8 F (40.4 C)

d. Temperature 104.8 F (40.4 C)

. Which action by a patient who is using peritoneal dialysis (PD) indicates that the nurse should provide more teaching about PD? a. The patient slows the inflow rate when experiencing pain. b. The patient leaves the catheter exit site without a dressing. c. The patient plans 30 to 60 minutes for a dialysate exchange. d. The patient cleans the catheter while taking a bath every day.

d. The patient cleans the catheter while taking a bath every day.

After the home health nurse has taught a patient and family about how to use glargine and regular insulin safely, which action by the patient indicates that the teaching has been successful? a. The patient administers the glargine 30 to 45 minutes before eating each meal. b. The patients family fills the syringes weekly and stores them in the refrigerator. c. The patient draws up the regular insulin and then the glargine in the same syringe. d. The patient disposes of the open vials of glargine and regular insulin after 4 weeks.

d. The patient disposes of the open vials of glargine and regular insulin after 4 weeks.

A patient is admitted with possible syndrome of inappropriate antidiuretic hormone (SIADH). Which information obtained by the nurse is most important to communicate rapidly to the health care provider? a. The patient complains of dyspnea with activity. b. The patient has a urine specific gravity of 1.025. c. The patient has a recent weight gain of 8 lb. d. The patient has a serum sodium level of 119 mEq/L.

d. The patient has a serum sodium level of 119 mEq/L

Which information about a patient who receives rosiglitazone (Avandia) is most important for the nurse to report immediately to the health care provider? a. The patients blood pressure is 154/92. b. The patient has a history of emphysema. c. The patients noon blood glucose is 86 mg/dL. d. The patient has chest pressure when ambulating.

d. The patient has chest pressure when ambulating.

Which action by a type 1 diabetic patient indicates that the nurse should implement teaching about exercise and glucose control? a. The patient always carries hard candies when engaging in exercise. b. The patient goes for a vigorous walk when the glucose is 200 mg/dL. c. The patient has a peanut butter sandwich before going for a bicycle ride. d. The patient increases daily exercise when ketones are present in the urine.

d. The patient increases daily exercise when ketones are present in the urine

Which information about a patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test? a. The patient reports having occasional orthostatic dizziness. b. The patient has had a 10-pound weight gain in the last month. c. The patient drank several glasses of water an hour previously. d. The patient takes oral corticosteroids for rheumatoid arthritis.

d. The patient takes oral corticosteroids for rheumatoid arthritis.

When teaching a patient scheduled for a cystogram via a cystoscope about the procedure, the nurse tells the patient, a. Your doctor will insert a lighted tube into the bladder, and little catheters will be inserted through the tube into your kidney. b. Your doctor will place a catheter into an artery in your groin and inject a dye that will visualize the blood supply to the kidneys. c. Your doctor will inject a radioactive solution into a vein in your arm and the distribution of the isotope in your kidneys and bladder will be checked. d. Your doctor will insert a lighted tube into the bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray.

d. Your doctor will insert a lighted tube into the bladder through your urethra, inspect the bladder, and instill a dye that will outline your bladder on x-ray.

The nurse teaches the diabetic patient who rides a bicycle to work every day to administer morning insulin into the a. arm. b. thigh. c. buttock. d. abdomen.

d. abdomen

A patient is admitted with severe flank pain, nausea and hematuria caused by a ureteral calculus and a lithortripsy is scheduled. The patient rates the pain at "10 out of 10" and is quite tearful. The first action by the nurse should be to a. strain all urine output b. increase the oral fluid intake c. obtain a urine specimen for culture d. administer the prescribed analgesic

d. administer the prescribed analgesic.

During preoperative teaching for a patient scheduled for transsphenoidal hypophysectomy for treatment of a pituitary adenoma, the nurse instructs the patient about the need to a. cough and deep breathe every 2 hours postoperatively. b. remain on bed rest for the first 48 hours after the surgery. c. be positioned flat with sandbags at the head postoperatively. d. avoid brushing the teeth for at least 10 days after the surgery.

d. avoid brushing the teeth for at least 10 days after the surgery.

A 26-year-old patient who is employed as a hairdresser and has a 10 pack-year history of cigarette smoking is scheduled for an annual physical examination. The nurse will plan to teach the patient about the increased risk for a. renal failure. b. kidney stones. c. pyelonephritis. d. bladder cancer.

d. bladder cancer

A new order for IV gentamicin (Garamycin) 60 mg BID is received for a patient with diabetes who has pneumonia. When evaluating for adverse effects of the medication, the nurse will plan to monitor the patients a. urine osmolality. b. serum potassium. c. blood glucose level. d. blood urea nitrogen (BUN) and creatinine.

d. blood urea nitrogen (BUN) and creatinine

To prevent the recurrence of renal calculi, the nurse teaches the patient to a. use a filter to strain all urine. b. avoid dietary sources of calcium. c. drink diuretic fluids such as coffee. d. have 2000 to 3000 mL of fluid a day.

d. have 2000 to 3000 mL of fluid a day

What chemical substance that creates specific actions within the body? A. oxytocin B. cortisol C. pituitary gland D. hormone E. thyroid gland F. thyroid stimulating hormone (TSH) G. triiodothyronine (T3) H. endocrine gland I. hypothalamus J. hypofunction

d. hormone

A patient complains of leg cramps during hemodialysis. The nurse should first a. reposition the patient. b. massage the patients legs. c. give acetaminophen (Tylenol). d. infuse a bolus of normal saline.

d. infuse a bolus of normal saline.

The nurse informs the patient undergoing cystoscopy that following the procedure, the patient a. will be NPO for 8 hours to prevent nausea and vomiting. b. is expected to be on strict bed rest for about 4 to 6 hours. c. should ask for the ordered narcotics as necessary for pain. d. may experience blood-tinged urine and urinary frequency.

d. may experience blood-tinged urine and urinary frequency

A child is admitted to the hospital with s/s of periorbital edema, fatigue, respiratory infection, and severe proteinuria. The nurse understands that these symptoms are common with: a. UTI b. glomerulonephritis c. acute renal failure d. nephrotic syndrome

d. nephrotic syndrome

When assessing the patient who has a lower urinary tract infection (UTI), the nurse will initially ask about a. nausea. b. flank pain. c. poor urine output. d. pain with urination.

d. pain with urination

A patient has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L). The nurse will anticipate the need to teach the patient about testing for a. calcitonin levels. b. catecholamine levels. c. thyroid hormone levels. d. parathyroid hormone levels.

d. parathyroid hormone levels

A patient is treated with demeclocycline (Declomycin) to control the symptoms of syndrome of inappropriate antidiuretic hormone (SIADH). The nurse determines that the demeclocycline is effective upon finding that the a. peripheral edema is decreased. b. patients weight has increased. c. urine specific gravity is increased. d. patients urinary output is increased.

d. patients urinary output is increased.

A hospitalized diabetic patient who received 34 U of NPH insulin at 7:00 AM is away from the nursing unit, awaiting diagnostic testing when lunch trays are distributed. To prevent hypoglycemia, the best action by the nurse is to a. save the lunch tray to be provided upon the patients return to the unit. b. call the diagnostic testing area and ask that a 5% dextrose IV be started. c. ensure that the patient drinks a glass of milk or orange juice at noon in the diagnostic testing area. d. request that the patient be returned to the unit to eat lunch if testing will not be completed promptly.

d. request that the patient be returned to the unit to eat lunch if testing will not be completed promptly.

. A patient with bladder cancer is scheduled for intravesical chemotherapy. In preparation for the treatment the nurse will teach the patient about a. premedicating to prevent nausea. b. where to obtain wigs and scarves. c. the importance of oral care during treatment. d. the need to empty the bladder before treatment.

d. the need to empty the bladder before treatment.

A patient is scheduled for a growth hormone stimulation test. In preparation for the test, the nurse will obtain a a. basin of ice. b. cardiac monitor. c. vial of glargine insulin. d. vial of 50% dextrose solution.

d. vial of 50% dextrose solution

What produces hormones affecting cell activity and metabolism? A. oxytocin B. cortisol C. pituitary gland D. hormone E. thyroid gland F. thyroid stimulating hormone (TSH) G. triiodothyronine (T3) H. endocrine gland I. hypothalamus J. hypofunction

e. thyroid gland

What pituitary hormone regulating thyroid hormone secretion? A. oxytocin B. cortisol C. pituitary gland D. hormone E. thyroid gland F. thyroid stimulating hormone (TSH) G. triiodothyronine (T3) H. endocrine gland I. hypothalamus J. hypofunction

f. thyroid stimulating hormone (TSH)

What is the hormone affecting cellular metabolism? A. oxytocin B. cortisol C. pituitary gland D. hormone E. thyroid gland F. thyroid stimulating hormone (TSH) G. triiodothyronine (T3) H. endocrine gland I. hypothalamus J. hypofunction

g. triiodothyronine (T3)

What is a ductless tissue secreting a hormone to regulate body functions? A. oxytocin B. cortisol C. pituitary gland D. hormone E. thyroid gland F. thyroid stimulating hormone (TSH) G. triiodothyronine (T3) H. endocrine gland I. hypothalamus J. hypofunction

h. endocrine gland

What condition in which the secretion of a hormone is below normal? A. oxytocin B. cortisol C. pituitary gland D. hormone E. thyroid gland F. thyroid stimulating hormone (TSH) G. triiodothyronine (T3) H. endocrine gland I. hypothalamus J. hypofunction

j. hypofunction


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