Med-Surge Success Endocrine
The nurse is performing discharge teaching for a client diagnosed with Cushing's disease. Which statement by the client demonstrates an understanding of the instructions? 1. "I will be sure to notify my health-care provider if I start to run a fever." à immunosuppressed from cushings 2. "Before I stop taking the prednisone, I will be taught how to taper it off." 3. "If I get weak and shaky, I need to eat some hard candy or drink some juice." 4. "It is fine if I continue to participate in weekend games of tackle football
1. "I will be sure to notify my health-care provider if I start to run a fever." à immunosuppressed from cushings
The client diagnosed with type 1 diabetes is found lying unconscious on the floor of the bathroom. Which intervention should the nurse implement first? 1. Administer 50% dextrose (IVP). à the nurse should assume the pt is hypoglycemic and administer IVP dextrose which will rouse the pt immediately. If the collapse is the result of hyperglycemia the dextrose will not further injure the pt. 2. Notify the health-care provider. à not first intervention 3. Move the client to the ICU. à dextrose first 4. Check the serum glucose level. à treat the client first not machine. Plus, the glucometer will likely read low and a serum level will be needed which will take too long given the severity of the situation.
1. Administer 50% dextrose (IVP). à the nurse should assume the pt is hypoglycemic and administer IVP dextrose which will rouse the pt immediately. If the collapse is the result of hyperglycemia the dextrose will not further injure the pt.
The nurse is planning the care of a client diagnosed with Addison's disease. Which intervention should be included? 1. Administer steroid medications. 2. Place the client on fluid restriction. 3. Provide frequent stimulation. 4. Consult physical therapy for gait training.
1. Administer steroid medications.
The home health nurse is completing the admission assessment for a 76-year-old client diagnosed with type 2 diabetes controlled with 70/30 insulin. Which intervention should be included in the plan of care? 1. Assess the client's ability to read small print. à needs to be able to draw up insulin dose correctly 2. Monitor the client's serum prothrombin time (PT) level. 3. Teach the client how to perform a hemoglobin A1c test daily. 4. Instruct the client to check the feet weekly.
1. Assess the client's ability to read small print. à needs to be able to draw up insulin dose correctly
The client is diagnosed with hypothyroidism. Which signs/symptoms should the nurse expect the client to exhibit? 1. Complaints of extreme fatigue and hair loss. à related to decreased metabolism 2. Exophthalmos and complaints of nervousness. à hyper 3. Complaints of profuse sweating and flushed skin. à hyper 4. Tetany and complaints of stiffness of the hands. à parathyroid
1. Complaints of extreme fatigue and hair loss. à related to decreased metabolism
The nurse identifies the client problem "risk for imbalanced body temperature" for the client diagnosed with hypothyroidism. Which intervention should be included in the plan of care? 1. Discourage the use of an electric blanket. à increase risk of peripheral dilation and vascular collapse 2. Assess the client's temperature every two (2) hours. 3. Keep the room temperature cool. à pt will be cold already 4. Space activities to promote rest.
1. Discourage the use of an electric blanket. à increase risk of peripheral dilation and vascular collapse
The nurse administered 28 units of Humulin N, an intermediate-acting insulin, to a client diagnosed with type 1 diabetes at 1600. Which intervention should the nurse implement? 1. Ensure the client eats the bedtime snack. à peaks in 6-8 hrs, a bedtime snack prevents hypoglycemia. 2. Determine how much food the client ate at lunch. 3. Perform a glucometer reading at 0700. 4. Offer the client protein after administering insulin.
1. Ensure the client eats the bedtime snack. à peaks in 6-8 hrs, a bedtime snack prevents hypoglycemia.
The 68-year-old client diagnosed with hyperthyroidism is being treated with radioactive iodine therapy. Which interventions should the nurse discuss with the client? 1. Explain it will take up to a month for symptoms of hyperthyroidism to subside. à takes time to normalize 2. Teach the iodine therapy will have to be tapered slowly over one (1) week. à one dose based on weight 3. Discuss the client will have to be hospitalized during the radioactive therapy. à may stay for a few hours in the clinic but not hospitalized 4. Inform the client after therapy the client will not have to take any medication. à may destroy too much of thyroid gland and end up needing replacement therapy
1. Explain it will take up to a month for symptoms of hyperthyroidism to subside. à takes time to normalize
The elderly client is admitted to the intensive care department diagnosed with severe HHNS. Which collaborative intervention should the nurse include in the plan of care? 1. Infuse 0.9% normal saline intravenously. à need to restore fluid balance and should start with isotonic solution followed by 0.45 % saline. Will depend on individual fluid status and physical conditions such as if the pt has a condition like HF or not. 2. Administer intermediate-acting insulin. à would want to administer regular insulin because the onset is much faster 3. Perform blood glucometer checks daily. à needs to be more frequent 4. Monitor arterial blood gas (ABG) results. à not needed because no ketone breakdown
1. Infuse 0.9% normal saline intravenously. à need to restore fluid balance and should start with isotonic solution followed by 0.45 % saline. Will depend on individual fluid status and physical conditions such as if the pt has a condition like HF or not.
The client is admitted to the ICU diagnosed with DKA. Which interventions should the nurse implement? Select all that apply. 1. Maintain adequate ventilation. 2. Assess fluid volume status. 3. Administer intravenous potassium. 4. Check for urinary ketones. 5. Monitor intake and output.
1. Maintain adequate ventilation. 2. Assess fluid volume status. 3. Administer intravenous potassium. 4. Check for urinary ketones. 5. Monitor intake and output.
The nurse is teaching the client diagnosed with hyperthyroidism. Which information should be taught to the client? Select all that apply. 1. Notify the HCP if a three (3)-pound weight loss occurs in two (2) days. à meds may not be effective, and dose might need adjustment. 2. Discuss ways to cope with the emotional lability. 3. Notify the HCP if taking over-the-counter medication. à would want to ensure no interactions with antithyroid meds especially any alcohol-based OTC meds 4. Carry a medical identification card or bracelet. 5. Teach how to take thyroid medications correctly. Should not be on thyroid medications should be on anti-thyroid meds
1. Notify the HCP if a three (3)-pound weight loss occurs in two (2) days. à meds may not be effective, and dose might need adjustment. 2. Discuss ways to cope with the emotional lability. 3. Notify the HCP if taking over-the-counter medication. à would want to ensure no interactions with antithyroid meds especially any alcohol-based OTC meds 4. Carry a medical identification card or bracelet.
The nurse is planning the care of a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which interventions should be implemented? Select all that apply. 1. Restrict fluids per health-care provider order. à 500ml- 600 ml/ day 2. Assess level of consciousness every two (2) hours. à possible F and E imbalance 3. Provide an atmosphere of stimulation. à not needed, provide a safe environment 4. Monitor urine and serum osmolality. à need to establish fluid balance 5. Weigh the client every three (3) days. à daily
1. Restrict fluids per health-care provider order. à 500ml- 600 ml/ day 2. Assess level of consciousness every two (2) hours. à possible F and E imbalance 4. Monitor urine and serum osmolality. à need to establish fluid balance
The nurse is admitting a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which clinical manifestations should be reported to the health-care provider? 1. Serum sodium of 112 mEq/L and a headache. à serious risk when below 115, risk of seizures. 2. Serum potassium of 5.0 mEq/L and a heightened awareness. 3. Serum calcium of 10 mg/dL and tented tissue turgor. 4. Serum magnesium of 1.2 mg/dL and large urinary output.
1. Serum sodium of 112 mEq/L and a headache. à serious risk when below 115, risk of seizures.
Which laboratory value should be monitored by the nurse for the client diagnosed with diabetes insipidus? 1. Serum sodium. 2. Serum calcium 3. Urine glucose. 4. Urine white blood cells.
1. Serum sodium.
The client diagnosed with Addison's disease is admitted to the emergency department after a day at the lake. The client is lethargic, forgetful, and weak. Which intervention should the nurse implement? 1. Start an IV with an 18-gauge needle and infuse NS rapidly. 2. Have the client wait in the waiting room until a bed is available. 3. Obtain a permit for the client to receive a blood transfusion. 4. Collect urinalysis and blood samples for a CBC and calcium level.
1. Start an IV with an 18-gauge needle and infuse NS rapidly.
The diabetic educator is teaching a class on diabetes type 1 and is discussing sick-day rules. Which interventions should the diabetes educator include in the discussion? Select all that apply. 1. Take diabetic medication even if unable to eat the client's normal diabetic diet. à glucose will be high because the pt is sick and due to stress 2. If unable to eat, drink liquids equal to the client's normal caloric intake. à this will help prevent hypoglycemia since the pt is still receiving medications. 3. It is not necessary to notify the health-care provider (HCP) if ketones are in the urine. à can lead to metabolic acidosis need to contact HCP 4. Test blood glucose levels and test urine ketones once a day and keep a record à more than daily. 5. Call the health-care provider if glucose levels are higher than 180 mg/dL. à insulin dose may need to be adjusted to prevent hyperglycemia, contact HCP
1. Take diabetic medication even if unable to eat the client's normal diabetic diet. à glucose will be high because the pt is sick and due to stress 2. If unable to eat, drink liquids equal to the client's normal caloric intake. à this will help prevent hypoglycemia since the pt is still receiving medications. 5. Call the health-care provider if glucose levels are higher than 180 mg/dL. à insulin dose may need to be adjusted to prevent hyperglycemia, contact HCP
The nurse is developing a care plan for the client diagnosed with type 1 diabetes. The nurse identifies the problem "high risk for hyperglycemia related to noncompliance with the medication regimen." Which statement is an appropriate short-term goal for the client? 1. The client will have a blood glucose level between 90 and 140 mg/dL. à addresses the nursing diagnosis and this is within acceptable limits since the patient is noncompliant with medication. 2. The client will demonstrate appropriate insulin injection technique. à goal for knowledge deficit 3. The nurse will monitor the client's blood glucose levels four (4) times a day. à this is an intervention not a goal. 4. The client will maintain normal kidney function with 30-mL/hr urine output. à this is a long-term goal not short-term
1. The client will have a blood glucose level between 90 and 140 mg/dL. à addresses the nursing diagnosis and this is within acceptable limits since the patient is noncompliant with medication.
A patient presents with an ADH-Secreting tumor. Upon diagnostic and physical evaluation, the nurse suspects the patient is experiencing SIADH. Which are clinical manifestations of SIADH? Select all that apply. 1.Hyponatremia 2. Hypernatremia 3. Increased serum osmolality 4. Decreased serum osmolality 5. Dry mucous membranes 6. Low urine output
1.Hyponatremia 4. Decreased serum osmolality 6. Low urine output
The nurse is discharging a client diagnosed with diabetes insipidus. Which statement made by the client warrants further intervention? 1. "I will keep a list of my medications in my wallet and wear a Medic Alert bracelet." 2. "I should take my medication in the morning and leave it refrigerated at home." à keep on hand, usually taken q8hrs 3. "I should weigh myself every morning and record any weight gain." 4. "If I develop a tightness in my chest, I will call my health-care provider."
2. "I should take my medication in the morning and leave it refrigerated at home." à keep on hand, usually taken q8hrs
The nurse at a freestanding health-care clinic is caring for a 56-year-old male client who is homeless and is a type 2 diabetic controlled with insulin. Which action is an example of client advocacy? 1. Ask the client if he has somewhere he can go and live. 2. Arrange for someone to give him insulin at a local homeless shelter. 3. Notify Adult Protective Services about the client's situation. 4. Ask the HCP to take the client off insulin because he is homeless.
2. Arrange for someone to give him insulin at a local homeless shelter.
The client diagnosed with a pituitary tumor developed syndrome of inappropriate antidiuretic hormone (SIADH). Which interventions should the nurse implement? 1. Assess for dehydration and monitor blood glucose levels. à pt is in fluid overload and BG not effected. 2. Assess for nausea and vomiting and weigh daily. à N + V is an early sign à pt will hold onto fluid and need to monitor 3. Monitor potassium levels and encourage fluid intake. à pt is fluid overload and had dilutional hyponatremia. 4. Administer vasopressin IV and conduct a fluid deprivation test. à already has too much antidiuretic
2. Assess for nausea and vomiting and weigh daily. à N + V is an early sign à pt will hold onto fluid and need to monitor
The client with type 2 diabetes controlled with biguanide oral diabetic medication is scheduled for a computed tomography (CT) scan with contrast of the abdomen to evaluate pancreatic function. Which intervention should the nurse implement? 1. Provide a high-fat diet 24 hours prior to test. 2. Hold the biguanide medication for 48 hours prior to test. à this is metformin 3. Obtain an informed consent form for the test. 4. Administer pancreatic enzymes prior to the test.
2. Hold the biguanide medication for 48 hours prior to test. à this is metformin
Which signs/symptoms should make the nurse suspect the client is experiencing a thyroid storm? 1. Obstipation and hypoactive bowel sounds. 2. Hyperpyrexia and extreme tachycardia. 3. Hypotension and bradycardia. 4. Decreased respirations and hypoxia.
2. Hyperpyrexia and extreme tachycardia.
A 70-year-old is admitted with enlargement of the thyroid gland, hypertension, high TSH levels, and bulging eyes. Which intervention is most appropriate for this client? 1. Providing a blanket 2. Instilling eye ointment 3. Providing a warm bath 4. Keep temp comfortable at 85 degrees
2. Instilling eye ointment
The UAP on the medical floor tells the nurse the client diagnosed with DKA wants something else to eat for lunch. Which intervention should the nurse implement? 1. Instruct the UAP to get the client additional food. 2. Notify the dietitian about the client's request. à adjust diet to pts needs to promote adherence that will allow the pt to manage carbohydrate intake 3. Request the HCP increase the client's caloric intake. 4. Tell the UAP the client cannot have anything else.
2. Notify the dietitian about the client's request. à adjust diet to pts needs to promote adherence that will allow the pt to manage carbohydrate intake
The client is admitted to rule out Cushing's syndrome. Which laboratory tests should the nurse anticipate being ordered? 1. Plasma drug levels of quinidine, digoxin, and hydralazine. 2. Plasma levels of ACTH and cortisol. 3. A 24-hour urine for metanephrine and catecholamine. 4. Spot urine for creatinine and white blood cells (WBCs).
2. Plasma levels of ACTH and cortisol.
Which electrolyte replacement should the nurse anticipate being ordered by the health-care provider in the client diagnosed with diabetic ketoacidosis (DKA) who has just been admitted to the ICU? 1. Glucose. 2. Potassium. à Potassium is lost because of increased urine output, acidosis, and possible vomiting 3. Calcium. 4. Sodium.
2. Potassium. à Potassium is lost because of increased urine output, acidosis, and possible vomiting
The client is admitted to the intensive care department diagnosed with myxedema coma. Which assessment data warrant immediate intervention by the nurse? 1. Serum blood glucose level of 74 mg/dL. 2. Pulse oximeter reading of 90%. à hypoxemia need attention 3. Telemetry reading showing sinus bradycardia. 4. The client is lethargic and sleeps all the time.
2. Pulse oximeter reading of 90%. à hypoxemia need attention
The nurse is admitting a client to the neurological intensive care unit who is postoperative transsphenoidal hypophysectomy. Which data warrant immediate intervention? 1. The client is alert to name but is unable to tell the nurse the location. 2. The client has an output of 2,500 mL since surgery and an intake of 1,000 mL. à possible DI because head injury. 3. The client's vital signs are T 97.6°F, P 88, R 20, and BP 130/80. 4. The client has a 3-cm amount of dark-red drainage on the turban dressing.
2. The client has an output of 2,500 mL since surgery and an intake of 1,000 mL. à possible DI because head injury.
The client has developed iatrogenic Cushing's disease. Which statement is the scientific rationale for the development of this diagnosis? 1. The client has an autoimmune problem causing the destruction of the adrenal cortex. 2. The client has been taking steroid medications for an extended period for another disease process. à caused by other condition hence iatrogenic 3. The client has a pituitary gland tumor causing the adrenal glands to produce too much cortisol. 4. The client has developed an adrenal gland problem for which the health-care provider does not have an explanation.
2. The client has been taking steroid medications for an extended period for another disease process. à caused by other condition hence iatrogenic
Which assessment data indicate the client diagnosed with diabetic ketoacidosis is responding to the medical treatment? 1. The client has tented skin turgor and dry mucous membranes. à dehydrated 2. The client is alert and oriented to date, time, and place. 3. The client's ABG results are pH 7.29, Paco2 44, HCO3 15. à acidosis 4. The client's serum potassium level is 3.3 mEq/L. à low
2. The client is alert and oriented to date, time, and place.
An 18-year-old female client, 5'4" tall, weighing 113 kg, comes to the clinic for a nonhealing wound on her lower leg, which she has had for two (2) weeks. Which disease process should the nurse suspect the client has developed? 1. Type 1 diabetes. 2. Type 2 diabetes. à 248.6 lbs. and nonhealing wound is hallmark sign of T2DM 3. Gestational diabetes. 4. Acanthosis nigricans.
2. Type 2 diabetes. à 248.6 lbs. and nonhealing wound is hallmark sign of T2DM
A 55-year-old female patient presents with fatigue and tiredness. The nurse notices the patient's skin is fragile, thin, and easily breaks. Bruising and striae are noted on the patient's thighs and abdomen. She presents with a slight kyphosis and protruding abdomen. Which method of management is appropriate for this patient? 1.Increase the dose of corticosteroids 2. Unilateral or bilateral adrenalectomy 3. Increase her dose of spironolactone 4. Diet that is high in carbohydrates and low in protein
2. Unilateral or bilateral adrenalectomy
The emergency department nurse is caring for a client diagnosed with HHNS who has a blood glucose of 680 mg/dL. Which question should the nurse ask the client to determine the cause of this acute complication? 1. "When is the last time you took your insulin?" à HHNS is associated with T2DM, these patients are more likely to use oral medications rather than insulin. 2. "When did you have your last meal?" 3. "Have you had some type of infection lately?" à infection is a main cause that can lead to HHNS 4. "How long have you had diabetes?"
3. "Have you had some type of infection lately?" à infection is a main cause that can lead to HHNS
The unlicensed assistive personnel (UAP) complains to the nurse she has filled the water pitcher four (4) times during the shift for a client diagnosed with a closed head injury and the client has asked for the pitcher to be filled again. Which intervention should the nurse implement first? 1. Tell the UAP to fill the pitcher with ice cold water. 2. Instruct the UAP to start measuring the client's I&O. 3. Assess the client for polyuria and polydipsia. à possible DI 4. Check the client's BUN and creatinine levels.
3. Assess the client for polyuria and polydipsia. à possible DI
The nurse is admitting a client diagnosed with primary adrenal cortex insufficiency (Addison's disease). Which clinical manifestations should the nurse expect to assess? 1. Moon face, buffalo hump, and hyperglycemia. 2. Hirsutism, fever, and irritability. 3. Bronze pigmentation, hypotension, and anorexia. 4. Tachycardia, bulging eyes, and goiter.
3. Bronze pigmentation, hypotension, and anorexia.
The client diagnosed with type 2 diabetes is admitted to the intensive care unit (ICU) with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) coma. Which assessment data should the nurse expect the client to exhibit? 1. Kussmaul's respirations. à DKA 2. Diarrhea and epigastric pain. à not associated with HHNS 3. Dry mucous membranes. à this can happen with both HHNS and DKA because of the 3 P's 4. Ketone breath odor. à DKA
3. Dry mucous membranes. à this can happen with both HHNS and DKA because of the 3 P's
The client diagnosed with Cushing's disease has undergone a unilateral adrenalectomy. Which discharge instructions should the nurse discuss with the client? 1. Instruct the client to take the glucocorticoid and mineralocorticoid medications as prescribed. à not needed one gland is still functioning 2. Teach the client regarding sexual functioning and androgen replacement therapy. 3. Explain the signs and symptoms of infection and when to call the health-care provider. 4. Demonstrate turn, cough, and deep-breathing exercises the client should perform every two (2) hours. ( Taught post-op not a discharge)
3. Explain the signs and symptoms of infection and when to call the health-care provider.
The client received 10 units of Humulin R, a fast-acting insulin, at 0700. At 1030 the unlicensed assistive personnel (UAP) tells the nurse the client has a headache and is really acting "funny." Which intervention should the nurse implement first? 1. Instruct the UAP to obtain the blood glucose level. 2. Have the client drink eight (8) ounces of orange juice. 3. Go to the client's room and assess the client for hypoglycemia. à pt is unstable the nurse needs to take action not delegate. 4. Prepare to administer one (1) ampule 50% dextrose intravenously.
3. Go to the client's room and assess the client for hypoglycemia. à pt is unstable the nurse needs to take action not delegate.
Which medication order should the nurse question in the client diagnosed with untreated hypothyroidism? 1. Thyroid hormones. 2. Oxygen. 3. Sedatives. à inc risk with untreated hypothyroidism 4. Laxatives. à good, they might be constipated.
3. Sedatives. à inc risk with untreated hypothyroidism
The nurse is discussing ways to prevent diabetic ketoacidosis with the client diagnosed with type 1 diabetes. Which instruction is most important to discuss with the client? 1. Refer the client to the American Diabetes Association. 2. Do not take any over-the-counter (OTC) medications. 3. Take the prescribed insulin even when unable to eat because of illness. à illness increase BG à sick day rules needed to prevent DKA 4. Explain the need to get the annual flu and pneumonia vaccines.
3. Take the prescribed insulin even when unable to eat because of illness. à illness increase BG à sick day rules needed to prevent DKA
The charge nurse of an intensive care unit is making assignments for the night shift. Which client should be assigned to the most experienced intensive care nurse? 1. The client diagnosed with respiratory failure who is on a ventilator and requires frequent sedation. à could be cared for by any ICU nurse 2. The client diagnosed with lung cancer and iatrogenic Cushing's disease with ABGs of pH 7.35, Pao2 88, Paco2 44, and HCO3 22. à blood gases normal 3. The client diagnosed with Addison's disease who is lethargic and has a BP of 80/45, P 124, and R 28. à low BP and tachycardic may be a sign of Addisonian crisis which is life threatening 4. The client diagnosed with hyperthyroidism who has undergone a thyroidectomy two (2) days ago and has a negative Trousseau's sign. à negative is normal
3. The client diagnosed with Addison's disease who is lethargic and has a BP of 80/45, P 124, and R 28. à low BP and tachycardic may be a sign of Addisonian crisis which is life threatening
The nurse is caring for clients on a medical floor. Which client should be assessed first? 1. The client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) who has a weight gain of 1.5 pounds since yesterday. à expected 2. The client diagnosed with a pituitary tumor who has developed diabetes insipidus (DI) and has an intake of 1,500 mL and an output of 1,600 mL in the last 8 hours. à I and O relatively same. 3. The client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) who is having muscle twitching. à sodium balance that could potentially lead to seizure. 4. The client diagnosed with diabetes insipidus (DI) who is complaining of feeling tired after having to get up at night. à nocturia expected
3. The client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) who is having muscle twitching. à sodium balance that could potentially lead to seizure.
The nurse is assessing the feet of a client with long-term type 2 diabetes. Which assessment data warrant immediate intervention by the nurse? 1. The client has crumbling toenails. 2. The client has athlete's foot. 3. The client has a necrotic big toe. à indicates dead tissue 4. The client has thickened toenails.
3. The client has a necrotic big toe. à indicates dead tissue
The client is admitted to the medical unit with a diagnosis of rule-out diabetes insipidus (DI). Which instructions should the nurse teach regarding a fluid deprivation test? 1. The client will be asked to drink 100 mL of fluid as rapidly as possible and then will not be allowed fluid for 24 hours. 2. The client will be administered an injection of antidiuretic hormone (ADH), and urine output will be measured for four (4) to six (6) hours. 3. The client will have nothing by mouth (NPO), and vital signs and weights will be done hourly until the end of the test. 4. An IV will be started with normal saline, and the client will be asked to try to hold the urine in the bladder until a sonogram can be done.
3. The client will have nothing by mouth (NPO), and vital signs and weights will be done hourly until the end of the test.
The charge nurse is making client assignments in the intensive care unit. Which client should be assigned to the most experienced nurse? 1. The client with type 2 diabetes who has a blood glucose level of 348 mg/dL. 2. The client diagnosed with type 1 diabetes who is experiencing hypoglycemia. 3. The client with DKA who has multifocal premature ventricular contractions. à this is r/t hypokalemia and is associated with DKA. This is potentially life threatening. 4. The client with HHNS who has a plasma osmolarity of 290 mOsm/L.
3. The client with DKA who has multifocal premature ventricular contractions. à this is r/t hypokalemia and is associated with DKA. This is potentially life threatening.
The client diagnosed with hypothyroidism is prescribed the thyroid hormone levothyroxine (Synthroid). Which assessment data indicate the medication has been effective? 1. The client has a three (3)-pound weight gain. 2. The client has a decreased pulse rate. 3. The client's temperature is WNL. à pt with hypothyroidism usually have really low temps. 4. The client denies any diaphoresis.
3. The client's temperature is WNL. à pt with hypothyroidism usually have really low temps.
The nurse is preparing to administer the following medications. Which medication should the nurse question administering? 1. The thyroid hormone to the client who does not have a T3, T4 level. 2. The regular insulin to the client with a blood glucose level of 210 mg/dL. 3. The loop diuretic to the client with a potassium level of 3.3 mEq/L. 4. The cardiac glycoside to the client who has a digoxin level of 1.4 mg/dL.
3. The loop diuretic to the client with a potassium level of 3.3 mEq/L.
The client diagnosed with type 1 diabetes has a glycosylated hemoglobin (A1c) of 8.1%. Which interpretation should the nurse make based on this result? 1. This result is below normal levels. 2. This result is within acceptable levels. 3. This result is above recommended levels. à want below 7%, preferably below 6.5% 4. This result is dangerously high.
3. This result is above recommended levels. à want below 7%, preferably below 6.5%
The nurse writes a problem of "altered body image" for a 34-year-old client diagnosed with Cushing's disease. Which intervention should be implemented? 1. Monitor blood glucose levels prior to meals and at bedtime. 2. Perform a head-to-toe assessment on the client every shift. 3. Use therapeutic communication to allow the client to discuss feelings. 4. Assess bowel sounds and temperature every four (4) hours.
3. Use therapeutic communication to allow the client to discuss feelings.
Which statement made by the client makes the nurse suspect the client is experiencing hyperthyroidism? 1. "I just don't seem to have any appetite anymore." 2. "I have a bowel movement about every three (3) to four (4) days." 3. "My skin is really becoming dry and coarse." 4. "I have noticed all my collars are getting tighter." à goiter
4. "I have noticed all my collars are getting tighter." à goiter
The nurse is providing an in-service on thyroid disorders. One of the attendees asks the nurse, "Why don't the people in the United States get goiters as often?" Which statement by the nurse is the best response? 1. "It is because of the screening techniques used in the United States." 2. "It is a genetic predisposition rare in North Americans." 3. "The medications available in the United States decrease goiters." 4. "Iodized salt helps prevent the development of goiters in the United States."
4. "Iodized salt helps prevent the development of goiters in the United States."
The male client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) secondary to cancer of the lung tells the nurse he wants to discontinue the fluid restriction and does not care if he dies. Which action by the nurse is an example of the ethical principle of autonomy? 1. Discuss the information the client told the nurse with the health-care provider and significant other. 2. Explain it is possible the client could have a seizure if he drank fluid beyond the restrictions. 3. Notify the health-care provider of the client's wishes and give the client fluids as desired. 4. Allow the client an extra drink of water and explain the nurse could get into trouble if the client tells the health-care provider.
4. Allow the client an extra drink of water and explain the nurse could get into trouble if the client tells the health-care provider.
The nurse is caring for a client diagnosed with diabetes insipidus (DI). Which intervention should be implemented? 1. Administer sliding-scale insulin as ordered. 2. Restrict caffeinated beverages. 3. Check urine ketones if blood glucose is >250. 4. Assess tissue turgor every four (4) hours.
4. Assess tissue turgor every four (4) hours.
The client diagnosed with HHNS was admitted yesterday with a blood glucose level of 780 mg/dL. The client's blood glucose level is now 300 mg/dL. Which intervention should the nurse implement? 1. Increase the regular insulin IV drip. 2. Check the client's urine for ketones. 3. Provide the client with a therapeutic diabetic meal. 4. Notify the HCP to obtain an order to decrease insulin. à now okay to stop IV and give insulin based on a sliding scale.
4. Notify the HCP to obtain an order to decrease insulin. à now okay to stop IV and give insulin based on a sliding scale.
The nurse is discussing the importance of exercising with a client diagnosed with type 2 diabetes whose diabetes is well controlled with diet and exercise. Which information should the nurse include in the teaching about diabetes? 1. Eat a simple carbohydrate snack before exercising. à the pt is not taking any medications or insulin so this is not needed. 2. Carry peanut butter crackers when exercising. à pt is not at risk for hypoglycemia 3. Encourage the client to walk 20 minutes three (3) times a week. à should exercise daily 4. Perform warm-up and cool-down exercises. à will help prevent injury
4. Perform warm-up and cool-down exercises. à will help prevent injury
Which nursing intervention should be included in the plan of care for the client diagnosed with hyperthyroidism? 1. Increase the amount of fiber in the diet. 2. Encourage a low-calorie, low-protein diet. 3. Decrease the client's fluid intake to 1,000 mL/day. 4. Provide six (6) small, well-balanced meals a day. à have an increased metabolism
4. Provide six (6) small, well-balanced meals a day. à have an increased metabolism
Which arterial blood gas results should the nurse expect in the client diagnosed with diabetic ketoacidosis? 1. pH 7.34, Pao2 99, Paco2 48, HCO3 24. à resp acidosis 2. pH 7.38, Pao2 95, Paco2 40, HCO3 22. à normal 3. pH 7.46, Pao2 85, Paco2 30, HCO3 26. à alkalosis 4. pH 7.30, Pao2 90, Paco2 30, HCO3 18. à metabolic acidosis
4. pH 7.30, Pao2 90, Paco2 30, HCO3 18. à metabolic acidosis
The nurse manager of a medical-surgical unit is asked to determine if the unit should adopt a new care delivery system. Which behavior is an example of an autocratic style of leadership? 1. Call a meeting and educate the staff on the new delivery system being used. à an autocratic style is when the person in charge makes the decision w/o consulting anyone. 2. Organize a committee to investigate the various types of delivery systems. 3. Wait until another unit has implemented the new system and see if it works out. 4. Discuss with the nursing staff if a new delivery system should be adopted.
Call a meeting and educate the staff on the new delivery system being used. à an autocratic style is when the person in charge makes the decision w/o consulting anyone.
