medical surgical [endocrine and Dermatological] learning system

A nurse is planning to administer fluids to a client who has 25% total body surface area burns. The client has no prior medical history. Which of the following intravenous fluids should the nurse identify as contraindicated for this client?

0.45 % sodium chloride

A nurse is reviewing the laboratory values for a client who has hyperglycemic hyperosmolar nonketotic syndrome. Which of the following laboratory values is consistent with hyperglycemic hyperosmolar nonketotic syndrome?

Blood glucose 320 mg/dl

A nurse is assisting with the plan of care for a client who has type 2 diabetes mellitus. Which of the following interventions should the nurse include in the plan?

Encourage the client to control weight

A nurse is assisting with the admission of a client who is bedridden and was admitted from home. The nurse notes a shallow crater in the epidermis of the client's sacral area. The nurse should document that the client has a pressure ulcer at which of the following stages?

II

A nurse is caring for a client who has a lesion on the back of his right hand. The client asks the nurse which type of skin cancer is the most serious. Which of the following should the nurse make?

Melanomas

A nurse is caring for a client who has smoke inhalation and full-thickness burns covering 63% of her body. Which of the following nursing actions is the nurse's priority?

Monitor respiratory status.

A nurse is assisting with the plan of care for a client who is experiencing the Somogyi effect and takes intermittent- acting insulin. Which of the following actions should the nurse

Monitor the clients night time blood glucose levels.

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about the pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching?

My cells are resistant to the effects of insulin

A nurse is reinforcing discharge teaching with a client who is postoperative following surgical excision of a basal cell carcinoma. Which of the following findings should the nurse include as an indication of malignancy of a mole?

Ulcerations

A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism caused by an adenoma. Which of the following findings should the nurse report to the provider? (Select all that apply.)

[A] tachycardia and hypertension. [D] laryngeal stridor and hoarseness [E] positive trousseau sign

A nurse is contributing to the plan of care for a client who is scheduled to receive total parenteral nutrition (TPN). Which of the following actions should the nurse recommend including in the plan? (Select all that apply.)

[A] weigh the client daily [B] Obtain serum blood glucose every 4 hours [D] change IV Tubing every 24 hours

A nurse is assisting with the development of an education session about malignant melanoma for a group of clients. The nurse should include that which of the following clients has an increased risk of developing malignant melanoma?

a client who has a light complexion

A nurse in a provider's office is caring for a client who has a new diagnosis of herpes zoster. The nurse should anticipate a prescription for which of the following medications?

acyclovir

A nurse is caring for a client who has regular occupational exposure to sunlight and presents to the clinic for evaluation of several skin lesions. Which of the following findings should alert the nurse to the possibility of malignant melanoma?

an irregularly shaped brown lesion with light blue areas on the neck

A nurse is reinforcing dietary teaching with a client who has diabetes mellitus. Which of the following should the nurse take first?

asks the client to identify the types of food she prefers.

A nurse is assisting with the development of a program to educate clients about measures to reduce the risk of skin cancer. Which of the following instructions should the nurse include?

avoid exposure to the midday sun

A nurse is caring for a client who has deep partial- and full- thickness burns and requires a topical antimicrobial drug. The goal of this medication therapy is to reduce which of the following out comes?

bacterial growth

A nurse is collecting data from a client who develops a fruity breath odor, dry mouth, and extreme thirst. Which of the following additional data should the nurse collect?

blood glucose using a glucometer

A nurse is reviewing the laboratory reports for a client and notes an elevated thyroid-stimulating hormone (TSH) level. When collecting data from the client, which of the following findings should the nurse expect?

bradycardia

A nurse is caring for a client who is In postoperative following a parathyroidectomy to treat hyperparathyroidism. Which of the following laboratory values should the nurse expect to decrease as a therapeutic effect of the procedure?

calcium

A nurse is preparing a 24-hour urine specimen for a client with suspected pheochromocytoma. Which of the following laboratory tests from the 24-hour urine specimen should the nurse use to determine the client's condition?

catecholamines metabolites.

A nurse is assisting with the plan of care for a client who has Cushing's syndrome due to chronic corticosteroid use. Which of the following actions should the nurse include in the plan of care?

check for hypertension

A nurse in a dermatology clinic is using the ABCDE while screening several of a client's skin lesions for skin cancer. Which of the following findings should the nurse report to the provider?

color variation within a lesion

A nurse is caring for a client who is postoperative following a bilateral adrenalectomy. The nurse should expect to administer glucocorticoids following the procedure to enhance which of the following therapeutic effects?

compensate for decreased cortisol levels

A nurse is caring for a client who has type 1 diabetes mellitus and a capillary glucose reading of 48 mg/dL. Which of the following findings should the nurse expect?

diaphoresis

A nurse is collecting data from a client who has Graves' disease. Which of the following findings should the nurse expect the client to display?

difficulty sleeping

A nurse is reinforcing teaching with a group of clients about skin cancer. The nurse should explain that basal cell carcinoma originates from which of the following tissues?

epidermis

A nurse is screening a client for skin cancer. When reinforcing teaching with the client about skin cancer risk, which of the following risk factors should the nurse include?

excessive exposure to ultraviolet light

A nurse is reviewing laboratory results for a client who has diabetes mellitus. Which of the following results indicates that the client is controlling the diabetes?

fasting blood glucose 95 mg/dl

A nurse is checking a client with Graves' disease for the development of thyroid storm. The nurse should report which of the following findings to the provider?

fever

A nurse is checking laboratory values to determine if a client who has diabetes mellitus is adhering to the treatment plan. Which of the following tests should the nurse use to make this determination?

glycosylated hemoglobin levels.

A nurse is assisting with the care of a client who has Addison's disease and comes to the emergency department reporting nausea, vomiting, diarrhea, and abdominal pain. To prevent an Addisonian crisis, the nurse should expect the provider to prescribe which of the following medications?

hydrocortisone

A nurse is assisting with the care of a client who has Addison's disease and was admitted with muscle weakness and dehydration, as well as nausea and vomiting for the past 2 days. Which of the following prescribed medications should the nurse plan to administer?

hydrocortisone

A nurse is assisting with the care of a client who has been diagnosed with an Addisonian crisis and has a blood pressure of 74/42 mmHg. Which of the following medication prescriptions should the nurse anticipate?

hydrocortisone

A nurse is conducting a home visit with an older adult client who has diabetes mellitus and takes regular insulin subcutaneously before each meal. The client appears disoriented and weak and has slurred speech. Which of the following conditions should the nurse consider first when responding to these manifestations?

hypoglycemia

A nurse is monitoring a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings should the nurse expect?

hyponatremia

A nurse is collecting data from a client who has Addison's disease. Which of the following findings should the nurse expect?

hypotension

A nurse is reinforcing teaching with a client who has burn injuries to his trunk about what to expect from the prescribed hydrotherapy. Which of the following statements by the client indicates an understanding of the teaching?

i will be on a special shower table

A nurse is reinforcing teaching with a client who has diabetes mellitus about food choices. Which of the following client statements indicates the teaching has been understood?

idk

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about foot care. Which of the following statements by the client indicates an understanding of the teaching?

ill be sure to wear cotton socks every day

A nurse in an urgent care clinic is caring for a client who has a snakebite on her arm. Which of the following actions should the nurse take?

immobilize the limb at the level of the heart

A nurse is reinforcing teaching with a client who has hyperthyroidism about managing this disorder. Which of the following recommendations should the nurse include?

increase her caloric intake with meals

A nurse is collecting data from a client who has manifestations of acromegaly. Which of the following findings should the nurse expect?

increased head size

A nurse is caring for a client who has type 2 diabetes mellitus and is displaying manifestations of hyperglycemia. Which of the following findings indicate that the client has hyperglycemia?

increased urination

A nurse is assisting with planning care for a client who has deep partial-thickness and full-thickness thermal burns over 40% of his total body surface. The client is in the acute phase of burn injury. Which of the following interventions should the nurse include in the plan?

initiate range of motion exercises

A nurse is monitoring a client following a thyroidectomy. Which of the following findings should the nurse identify as an indication of hypoparathyroidism?

involuntary muscle spasms

A community health nurse is reinforcing teaching about melanoma with a group of clients. Which of the following characteristics of lesions associated with melanoma should the nurse include in the teaching?

irregular borders

A nurse is collecting data from a client who has an arm lesion. Which of the following characteristics is a clinical manifestation of malignant melanoma?

irregularly shaped with blue tones

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus hypoglycemia. Which of the following manifestations should the nurse include in the teaching?

irritability

A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which of the following findings should the nurse expect?

kussmaul respirations

A nurse is caring for a client who has been applying silver sulfadiazine cream to a deep partial-thickness arm burn for the past 2 weeks. The nurse should monitor the client for which of the following adverse effects?

leukopenia

A nurse is caring for an adolescent client who has burn wounds on her face and hands. Which of the following statements by the client indicates that she has adapted to her changed body image?

may i go with my family to the visitors lounge?

A nurse is assisting with a plan for community health screening for a group of clients who are at risk of type 2 diabetes mellitus. Which of the following client groups should the nurse include in the screening?

men and women who are obese

A nurse in an urgent care center is collecting data from an infant who has laryngotracheobronchitis. Which of the following findings should the nurse report to the provider as an indication of impending airway obstruction?

nasal flaring

A nurse in a provider's office is collecting data from a client who has skin lesions. The nurse notes that the lesions are 0.5 cm (0.20 in) in size, elevated, and solid with distinct The nurse should document these findings as which of the following skin lesions?

papules

A nurse is caring for a client who has urolithiasis and requires further diagnostic testing after an initial assessment indicated hypercalcemia. The nurse should explain that which of the following structures controls calcium concentration?

parathyroid gland

A nurse is caring for a client whose wounds are covered with a heterograft dressing. I n response to the client's questions about the dressing, the nurse explains that it is obtained from which of the following sources?

pig skin

A nurse is caring for a client who has diabetes insipidus. For which of the following findings should the nurse monitor?

polyuria

A nurse is collecting data from a client who is recovering from a thyroidectomy and has harsh, high-pitched respiratory sounds. Which of the following actions should the nurse take?

prepare for a tracheostomy

A nurse is collecting data from a client who has Cushing's syndrome. Which of the following skin manifestations should the nurse expect to find?

purple striae on the chest and abdomen

A nurse in an urgent care clinic is collecting data from a client who has extensive burns, including on her face. Which of the following data should the nurse collect first?

respiratory rate

A nurse is reinforcing teaching with a client who is wheelchair-bound and his caregiver about ways to reduce the risk of pressure ulcer formation. Which of the following instructions should the nurse include?

shift your weight in the wheelchair every 15 minutes

A nurse is assisting with the care of a client who is in the resuscitation phase following a major burn. Which of the following laboratory findings should the nurse expect?

sodium 132 meq/L

A nurse is contributing to the plan of care for a client who has been admitted for the treatment of a malignant melanoma of the upper leg without metastasis. The nurse should expect the provider to perform which of the following procedures?

surgical excision

A nurse on a surgical unit is caring for 4 clients who have healing wounds. Which of the following wounds should the nurse expect to heal by primary intention?

surgical incision

A nurse is collecting data from a client who sustained superficial partial-thickness and deep partial-thickness burns 72 hours ago. Which of the following findings should the nurse report to the provider?

temperature of 39.1 C (102.4 F)

A nurse is reinforcing discharge teaching about foot care with a client who has diabetes mellitus. Which of the following instructions should the nurse include in the teaching?

test water temperature with wrist

A nurse is collecting data from a client who is 3 days postoperative following abdominal surgery. The client's incision is slightly edematous, appears pink with crusting on the edges, and is draining serosanguinous fluid. Which of the following statements describes this incision?

the incision is showing signs of healing without complications

A nurse is observing the skin of a client who has frostbite. The client has small blisters that contain bland, and the skin of the affected area does not blanch. The nurse should classify this injury as which of the following?

third degree frostbite

A nurse is preparing for the transfer of a client from the postanesthesia care unit (PACU) following a subtotal thyroidectomy. Which of the following pieces of equipment should the nurse have available at the client's bedside?

tracheostomy tray

A nurse is reinforcing teaching with a client who has Addison's disease about healthy snacks. Which of the following food choices by the client indicates an understanding of the teaching?

turkey and cheese sandwich

A nurse is reinforcing teaching with a client who had a vaginal hysterectomy with a bilateral oophorectomy. Which of the following pieces of information should the nurse include in the teaching?

use a water based lubricant when having sexual intercourse

A nurse is reinforcing teaching with a client who has a large wound healing by secondary intention. The nurse should instruct the client that which of the following nutrients promotes wound healing?

vitamin C

A nurse is caring for a client who is scheduled to receive peritoneal dialysis. Which of the following actions should the nurse take?

warm the dialysate solution to room temperature prior to administration

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about exercise. Which of the following statements should the nurse include in the teaching?

wear a medical alert identification tag when you exercise

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus. The client states, " I eat pasta every day. I can't imagine giving it up." Which of the following responses should the nurse make?

you don't have to give up pasta just adjust the amount you eat