Mattys med surg 4 exam

Following hypophysectomy, a client complains of being very thirsty and having to urinate frequently. The initial nursing action is to: 1. Document the complaints 2. Increase fluid intake. 3. Check the urine specific gravity. 4. Check for urinary glucose.

3. Check the urine specific gravity.

Myxedema is a result of untreated?

Hypothyroidism

A nurse reviews laboratory results for a client with diabetes mellitus who presents with polyuria, lethargy, and a blood glucose of 560 mg/dL. Which laboratory result should the nurse correlate with the client's polyuria? a. Serum sodium: 163 mEq/L b. Serum creatinine: 1.6 mg/dL c. Presence of urine ketone bodies d. Serum osmolarity: 375 mOsm/kg

d. Serum osmolarity: 375 mOsm/kg

A nurse reviews the laboratory results of a client who is receiving intravenous insulin. Which should alert the nurse to intervene immediately? a. Serum chloride level of 98 mmol/L b. Serum calcium level of 8.8 mg/dL c. Serum sodium level of 132 mmol/L d. Serum potassium level of 2.5 mmol/L

d. Serum potassium level of 2.5 mmol/L

A nurse is reviewing discharge teaching with a client who has Cushing's syndrome. Which statement by the client indicates that the instructions related to dietary management were understood? 1. "I can eat foods that contain potassium." 2. "I will need to limit the amount of protein in my diet." 3. "I am fortunate that I can eat all the salty foods I enjoy." 4. "I am fortunate that I do not need to follow any special diet."

1. "I can eat foods that contain potassium."

A client has just been admitted with a diagnosis of myxedema coma. If all of the following interventions were prescribed, the nurse would place highest priority on completing which of the following first? 1. Administering oxygen 2. Administering thyroid hormone 3. Warming the client 4. Giving fluid replacement

1. Administering oxygen

A nurse is collecting data on a client with a diagnosis of hypothyroidism. Which of these behaviors, if present in the client's history, would the nurse determine as being likely related to the manifestations of this disorder? 1. Depression 2. Nervousness 3. Irritability 4. Anxiety

1. Depression

A 60-kg client has sustained third-degree burns over 40% of the body. Using the Parkland (Baxter) formula, the minimum fluid requirements are which during the first 24 hours after the burn? 1.1200 mL of 5% dextrose in water solution 2.2400 mL of 0.45% normal saline solution 3.4800 mL of lactated ringers 4.9600 mL of lactated Ringer's solution

4.9600 mL of lactated Ringer's solution

A client sustains a burn injury to the entire right and left arms, the right leg, and the anterior thorax. According to the rule of nines, the nurse would assess that this injury constitutes which body percentage?Fill in the blank.........%

54%

What is an RN expected to find on a lab report for a patient diagnosed with DKA?SATA a. Ketones present in the urine b. creat 2.5 c. BUN 22 d. metabolic alkalosis e. anion gap 15

a. Ketones present in the urine b. creat 2.5 e. anion gap 15

What are nursing interventions for a patient with thyroid storm? SATA a. Maintain a patent airway b. Monitor the patient for chest pain c. Watch for hypothermia d. Maintain a quiet environment

a. Maintain a patent airway b. Monitor the patient for chest pain d. Maintain a quiet environment

A nurse prepares to administer prescribed regular and NPH insulin. Place the nurses actions in the correct order to administer these medications. 1. Inspect bottles for expiration dates. 2. Gently roll the bottle of NPH between the hands. 3. Wash your hands. 4. Inject air into the regular insulin. 5. Withdraw the NPH insulin. 6. Withdraw the regular insulin. 7. Inject air into the NPH bottle. 8. Clean rubber stoppers with an alcohol swab. a. 1, 3, 8, 2, 4, 6, 7, 5 b. 3, 1, 2, 8, 7, 4, 6, 5 c. 8, 1, 3, 2, 4, 6, 7, 5 d. 2, 3, 1, 8, 7, 5, 4, 6

b. 3, 1, 2, 8, 7, 4, 6, 5

To prevent complications in the patient with Cushing syndrome, the nurse monitors the patient for a. hypotension b. hypoglycemia c. cardiac arrhythmias d. decreased cardiac output

c. cardiac arrhythmias

which of the following would be a nursing priority for a client just DX with Addison's disease? a. avioding unnecessary activity b. encouraging client to wear a med alert tag c. ensuring the client is adequately hydrated d. explaining that the client will need life long hormone therapy

c. ensuring the client is adequately hydrated

A patient with Cushings diease needs to be assessed for? a. hypovolema b. hypoglycemia c. hypervolemia d. hyperalbunemia

c. hypervolemia

What is a priority nursing intervention for a patient who experienced an inhalation injury? a. fluid replacement b. replace electrolyes c. maintain a patent airway d. q2 hour turn

c. maintain a patent airway

An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of: a. Thyroid storm. b. Cretinism. c. myxedema coma. d. Hashimoto's thyroiditis.

c. myxedema coma.

A nurse assesses a client with diabetes mellitus who self-administers subcutaneous insulin. The nurse notes a spongy, swelling area at the site the client uses most frequently for insulin injection. Which action should the nurse take? a. Apply ice to the site to reduce inflammation. b. Consult the provider for a new administration route. c. Assess the client for other signs of cellulitis. d. Instruct the client to rotate sites for insulin injection.

d. Instruct the client to rotate sites for insulin injection.

In a patient with central diabetes insipidus, administration of aqueous vasopressin during a water deprivation test will result in a a. decrease in body weight b. increase in urinary output c. decrease in blood pressure d. increase in urine osmolality

d. increase in urine osmolality

A nurse is caring for a client after thyroidectomy and monitoring for signs of thyroid storm. The nurse understands that which of the following is a manifestation associated with this disorder? 1. Bradycardia 2. Hypotension 3. Constipation 4. Hypothermia

2. Hypotension

The nurse is caring for a client who was admitted to the burn unit after sustaining a burn injury covering 30% of the body. What is the most appropriate time frame for the emergent phase? 1.The entire period of time during which rehabilitation occurs 2.The period from the time the client is stable to the time when all burns are covered with skin 3.The period from the time the burn was incurred to the time when the client is admitted to the hospital 4.The period from the time the burn was incurred to the time when the client is considered physiologically stable

4.The period from the time the burn was incurred to the time when the client is considered physiologically stable

What is an expected lab value for a patient diagnosed with HHS? a. BUN 40 b. creat 1.2 c. Metabolic acidosis d. NA 150

a. BUN 40

A nurse notes in the medical record that a client with Cushing's syndrome is experiencing fluid overload. Which interventions should be included in the plan of care? Select all that apply. 1. Monitoring daily weight 2. Monitoring intake and output 3. Maintaining a low-potassium diet 4. Monitoring extremities for edema 5. Maintaining a low-sodium diet

1. Monitoring daily weight 2. Monitoring intake and output 4. Monitoring extremities for edema 5. Maintaining a low-sodium diet

The nurse is preparing to care for a burn client scheduled for an escharotomy procedure being performed for a third-degree circumferential arm burn. The nurse understands that which finding is the anticipated therapeutic outcome of the escharotomy? 1. Return of distal pulses 2. Brisk bleeding from the site 3. Decreasing edema formation 4. Formation of granulation tissue

1. Return of distal pulses

Which of the following clients is at risk for developing thyrotoxicosis?1. A client with hypothyroidism 2. A client with Graves' disease who is having surgery 3. A client with diabetes mellitus scheduled for debridement of a foot ulcer 4. A client with diabetes insipidus scheduled for an invasive diagnostic test

2. A client with Graves' disease who is having surgery

A client is brought to the ED with partial-thicken as burns to his face, neck, arms and chest after trying to put out a car fire. The nurse should implement which nursing actions for this client? (SATA) 1. Restrict fluids 2. Assess for airway patency 3. Administer oxygen as prescribed 4. Place a cooling blanket on the client 5. Elevate extremities if no fractures are present 6. Prepare to give oral pain medication as prescribed

2. Assess for airway patency 3. Administer oxygen as prescribed 5. Elevate extremities if no fractures are present

A nurse is monitoring a client with Graves' disease for signs of thyrotoxic crisis (thyroid storm). Which of the following signs and symptoms, if noted in the client, will alert the nurse to the presence of this crisis? Select all that apply. 1. Bradycardia 2. Fever 3. Sweating 4. Agitation 5. Pallor

2. Fever 3. Sweating 4. Agitation

A client with Cushing's disease is being admitted to the hospital after a stab wound to the abdomen. The nurse plans care and places highest priority on which potential problem? 1. Nervousness 2. Infection 3. Concern about appearance 4. Inability to care for self

2. Infection

A nurse is collecting data on a client admitted to the hospital with a diagnosis of myxedema. Which data collection technique will provide data necessary to support the admitting diagnosis? 1. Auscultation of lung sounds 2. Inspection of facial features 3. Percussion of the thyroid gland 4. Palpation of the adrenal glands

2. Inspection of facial features

After several diagnostic tests, a client is diagnosed with diabetes insipidus. The nurse understands that which symptom is indicative of this disorder? 1. Diarrhea 2. Polydipsia 3. Weight gain 4. Blurred vision

2. Polydipsia

The nurse is administering fluids IV as prescribed to a client who sustained superficial partial-thickness burn injuries of the back and legs. In evaluating the adequacy if fluid resuscitation, the nurse understands that which assessment would provide the most reliable indicator for determining the adequacy? 1. Vital signs 2. Urine output 3. Mental status 4. Peripheral pulses

2. Urine output

A nurse is caring for a client experiencing thyroid storm. Which of the following would be a priority concern for this client? 1. Inability to cope with the treatment plan 2. Lack of sexual drive 3. Self-consciousness about body appearance 4. Potential for cardiac disturbances

4. Potential for cardiac disturbances

A client is admitted to the hospital emergency department after receiving a burn injury in a house fire. The skin on the client's trunk is tan, dry, and hard. It is edematous but not very painful. The nurse determines that this client's burn should be classified as which type?1.Superficial 2.Full-thickness 3.Deep partial-thickness 4.Partial-thickness superficial

2.Full-thickness Full-thickness burns involve the epidermis, the full dermis, and some of the subcutaneous fat layer. The burn appears to be a tan or fawn color, with skin that is hard, dry, and inelastic. Edema is severe, and the accumulated fluid compresses tissue underneath because of eschar formation. Some nerve endings have been damaged, and the area may be insensitive to touch, with little or no pain.

A client is seen in the ambulatory care clinic for a superficial burn to the arm. On assessing the skin at the burn injury, what will the nurse observe? 1.White color 2.Pink or red color 3.Weeping blisters 4.Insensitivity to pain and cold

2.Pink or red color

A client with Cushing's syndrome verbalizes concern to the nurse regarding the appearance of the buffalo hump that has developed. Which response by the nurse is appropriate? 1. "Don't be concerned, this problem can be covered with clothing." 2. "This is permanent, but looks are deceiving and not that important." 3. "Usually, these physical changes slowly improve following treatment." 4. "Try not to worry about it. There are other things to be concerned about."

3. "Usually, these physical changes slowly improve following treatment."

An adult client was burned in an explosion. The burn initially affected the client's entire face and the upper half of the anterior torso and there were circumferential burns to the lower half of both arms. The client's clothes caught on fire and the client ran, causing subsequent burn injuries to the posterior surface of the head and upper half of the posterior torso. Using the rule of mines, what would be the extent of the burn injury? 1. 18% 2. 24% 3. 36% 4. 48%

3. 36%

A client is undergoing fluid replacement after being burned on 20% of her body 12 hours ago. The nursing assessment reveals blood pressure of 90/50, a pulse of 110, and a urine output of 20ml over the past hour. The nurse reports the findings to the health care provider and anticipates which prescription? 1. Transfusing 1 unit of packed red blood cells 2. Administering a diuretic to increase urine output 3. Increasing the amount of IV lactated ringers solution administered per hour 4. Changing the IV lactated ringers solution to one that contains 5% dextrose in water

3. Increasing the amount of IV lactated ringers solution administered per hour

A nurse would expect to note which interventions in the plan of care for a client with hypothyroidism? Select all that apply. 1. Provide a cool environment for the client. 2. Instruct the client to consume a high-fat diet. 3. Instruct the client about thyroid replacement therapy. 4. Encourage the client to consume fluids and high-fiber foods in the diet. 5. Instruct the client to contact the health care provider if episodes of chest pain occur. 6. Inform the client that iodine preparations will be prescribed to treat the disorder.

3. Instruct the client about thyroid replacement therapy. 4. Encourage the client to consume fluids and high-fiber foods in the diet. 5. Instruct the client to contact the health care provider if episodes of chest pain occur.

A client arrives at the emergency department following a burn injury that occurred in the basement at home, and an inhalation injury is suspected. What would the nurse anticipate to be prescribed for the client? 1. 100% oxygen via an aerosol mask 2. Oxygen via nasal cannula 6L 3. Oxygen via nasal cannula at 15L 4. 100% oxygen via a tight-fitting nonrebreather face mask

4. 100% oxygen via a tight-fitting nonrebreather face mask

The nurse is caring for a client who sustained superficial partial-thickness burns on the anterior lower legs and anterior thorax. Which finding does the nurse expect to note during the resuscitation/emergent phase of the burn injury? 1. Decreased heart rate 2. Increased urinary output 3. Increased blood pressure 4. Elevated hematocrit levels

4. Elevated hematocrit levels

A nursing student notes in the medical record that a client with Cushing's syndrome is experiencing body image disturbances. The need for additional education regarding this problem is identified when the nursing student suggests which nursing intervention? 1. Encouraging the client's expression of feelings 2. Evaluating the client's understanding of the disease process 3. Encouraging family members to share their feelings about the disease process 4. Evaluating the client's understanding that the body changes need to be dealt with

4. Evaluating the client's understanding that the body changes need to be dealt with

Which nursing measure would be effective in preventing complications in a client with Addison's disease? 1. Restricting fluid intake 2. Offering foods high in potassium 3. Checking family support systems 4. Monitoring the blood glucose

4. Monitoring the blood glucose

A nurse in a burn treatment center is caring for a client who is admitted with severe burns to both lower extremities and is scheduled for an escharotomy. The client's spouse asks the nurse what the procedure entails. Which of the following nursing statements is appropriate? A. Large incisions will be made in the eschar to improve circulation B. I can call the doctor back if you want me to C. A piece of skin will be removed and grafted over the burned area D. Dead tissue will be surgically removed

A. Large incisions will be made in the eschar to improve circulationRelief pressure and remove dead skin

Which of the following symptoms is not typical of Cushing's syndrome?Answers: A. Osteoporosis B. Weight loss C. Diabetes D. Mood instability

B. Weight loss

A nurse assesses a client who has diabetes mellitus and notes the client is awake and alert, but shaky, diaphoretic, and weak. Five minutes after administering a half-cup of orange juice, the client's clinical manifestations have not changed. Which action should the nurse take next? a. Administer another half-cup of orange juice. b. Administer a half-ampule of dextrose 50% intravenously. c. Administer 10 units of regular insulin subcutaneously. d. Administer 1 mg of glucagon intramuscularly.

a. Administer another half-cup of orange juice.

A nurse assesses a client who is experiencing diabetic ketoacidosis (DKA). For which manifestations should the nurse monitor the client? (SATA) a. Deep and fast respirations b. Decreased urine output c. Tachycardia d. Dependent pulmonary crackles e. Orthostatic hypotension

a. Deep and fast respirations c. Tachycardia e. Orthostatic hypotension

A nurse can expect to find these lab values for a patient with graves disease. SATA a. Elevated T3 and T4 levels b. Decreased TSH c. Increased TSH d. Decreased T3 and T4 levels

a. Elevated T3 and T4 levels b. Decreased TSH

Which outcome indicates that treatment of a male client with diabetes insipidus has been effective? a. Fluid intake is less than 2,500 ml/day. b. Urine output measures more than 200 ml/hour. c. Blood pressure is 90/50 mm Hg. d. The heart rate is 126 beats/minute.

a. Fluid intake is less than 2,500 ml/day.

A patient is admitted to the hospital with a diagnosis of Cushing syndrome. On physical assessment of the patient, the nurse would expect to find a. HTN, peripheral edema, and petechiae b. weight loss, buffalo hump, and moon face with acne c. abdominal and buttock striae, truncal obesity, and hypotension d. anorexia, signs of dehydration, and hyper pigmentation of the skin

a. HTN, peripheral edema, and petechiae

An emergency department nurse assesses a client with ketoacidosis. Which clinical manifestation should the nurse correlate with this condition? a. Increased rate and depth of respiration b. Extremity tremors followed by seizure activity c. Oral temperature of 102 F (38.9 C) d. Severe orthostatic hypotension

a. Increased rate and depth of respiration

Signs and symptoms of DI, SATA a. altered mental status b. ataxia c. moist mucous membranes d. hypotension e. bradycardia

a. altered mental status b. ataxia d. hypotension

Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus? a. antidiuretic hormone (ADH). b. thyroid-stimulating hormone (TSH). c. follicle-stimulating hormone (FSH). d. luteinizing hormone (LH).

a. antidiuretic hormone (ADH).

The nurse expects to see the following lab results for a patient with diabetes insipidus: SATA a. decreased urine specific gravity (< 1.005) b. decreased osmolality (< 200) c. alkalotic pH d. decreased serum electrolytes e. increased blood osmolality

a. decreased urine specific gravity (< 1.005) b. decreased osmolality (< 200) e. increased blood osmolality

SATA: lab findings for a patient who has been burned a. hyperglycemia b. elevated hematocrit c. elevated sodium d. decreased protein/albumin e. decreased potassium

a. hyperglycemia b. elevated hematocrit d. decreased protein/albumin

What are expected findings in a patient that is experiencing myxedema coma? SATA a. hypothermia b. hyponatremia c. hypertension d. hypoglycemia e. tachycardia

a. hypothermia b. hyponatremia d. hypoglycemia

A patient with Cushings is at an increased risk for broken bones and osteoporosis. What should the RN encourage the client to eat to prevent these complications? SATA a. leafy greens b. soda c. brocoli d. chicken e. cheese

a. leafy greens c. brocoli e. cheese

What are underlying conditions of SIADH? SATA a. malignancy b. head injury c. stroke d. TB e. decreased intratoracic pressure

a. malignancy b. head injury c. stroke d. TB

When caring for a male client with diabetes insipidus, nurse Juliet expects to administer: a. vasopressin (Pitressin Synthetic). b. furosemide (Lasix). c. regular insulin. d. 10% dextrose.

a. vasopressin (Pitressin Synthetic).

A nurse teaches a client with diabetes mellitus about sick day management. Which statement should the nurse include in this client's teaching? a. When ill, avoid eating or drinking to reduce vomiting and diarrhea. b. Monitor your blood glucose levels at least every 4 hours while sick. c. If vomiting, do not use insulin or take your oral antidiabetic agent. d. Try to continue your prescribed exercise regimen even if you are sick.

b. Monitor your blood glucose levels at least every 4 hours while sick.

Nurse Oliver should expect a client with hypothyroidism to report which health concerns? a. Increased appetite and weight loss b. Puffiness of the face and hands c. Nervousness and tremors d. Thyroid gland swelling

b. Puffiness of the face and hands

Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? a. Diabetic ketoacidosis b. Thyroid crisis c. Hypoglycemia d. Myxedema coma

b. Thyroid crisis

What does the anion gap tell the provider regarding a patient in DKA? a. When the blood sugar is at a safe low to d/c the insulin drip b. When the patient is no longer in an acidotic state c. When the patient blood sugar is below 250 d. When the RN can increase the rate of insulin

b. When the patient is no longer in an acidotic state

An RN with a patient diagnosed with DKA is expected to: a. check for signs of fluid overload b. administer isotonic solution rapidly for the first few hours c. start the patient on IV insulin d. start the patient on continuous IV fluids e. start the patient on fluids with D5 once the BS reaches 150

b. administer isotonic solution rapidly for the first few hours c. start the patient on IV insulin d. start the patient on continuous IV fluids

A patient with SIADH is treated with water restriction and administration of IV fluids. The nurses evaluates that treatment has been effective when the patient experiences a. increased urine output, decreased serum sodium, and increased urine specific gravity b. increased urine output, increased serum sodium, and decreased urine specific gravity c. decreased urine output, increased serum sodium, and decreased urine specific gravity d. decreased urine output, decreased serum sodium, and increased urine specific gravity

b. increased urine output, increased serum sodium, and decreased urine specific gravity

A nurse assesses a client who has diabetes mellitus. Which arterial blood gas values should the nurse identify as potential ketoacidosis in this client? a. pH 7.38, HCO3 22 mEq/L, PCO2 38 mm Hg, PO2 98 mm Hg b. pH 7.28, HCO3 18 mEq/L, PCO2 28 mm Hg, PO2 98 mm Hg c. pH 7.48, HCO3 28 mEq/L, PCO2 38 mm Hg, PO2 98 mm Hg d. pH 7.32, HCO3 22 mEq/L, PCO2 58 mm Hg, PO2 88 mm Hg

b. pH 7.28, HCO3 18 mEq/L, PCO2 28 mm Hg, PO2 98 mm Hg

A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? a. Infusing I.V. fluids rapidly as ordered b. Encouraging increased oral intake c. Restricting fluids d. Administering glucose-containing I.V. fluids as ordered

c. Restricting fluids

All of the following are symptoms of Cushing's syndrome except: a. Severe fatigue and weakness b. Hypertension and elevated blood glucose c. A protruding hump between the shoulders d. Hair loss

d. Hair loss