medsurg CAQs #2, Medsurg CAQ assignment #2
Which term should the nurse use in a report to describe the absence of menstrual periods in a 35-year-old non-pregnant client? 1 Rhinorrhea 2 Menopause 3 Amenorrhea 4 Dyspareunia
3
Which condition does the nurse identify in the image? 3203384640 1 Goiter 2 Myxedema 3 Exophthalmos 4 Pheochromocytoma
3
A nurse is assessing a client admitted to the hospital with a tentative diagnosis of a pituitary tumor. What signs of Cushing syndrome does the nurse identify? 1 Retention of sodium and water 2 Hypotension and a rapid, thready pulse 3 Increased fatty deposition in the extremities 4 Hypoglycemic episodes in the early morning
1
What care should be provided to a client who is scheduled to undergo surgery for hyperaldosteronism? 1 Provide increased fluids 2 Provide sodium-rich foods 3 Administer spironolactone 4 Administer sodium supplements
3
What other name can the nurse use for vasopressin? 1 Growth hormone 2 Luteinizing hormone 3 Antidiuretic hormone 4 Thyroid-stimulating hormone
3
While obtaining the client's health history, which factor does the nurse identify that predisposes the client to type 2 diabetes? 1 Having diabetes insipidus 2 Eating low-cholesterol foods 3 Being 20 pounds (9 kilograms) overweight 4 Drinking a daily alcoholic beverage
3
What will the nurse expect diagnostic studies of a client with Cushing syndrome to indicate? 1 Moderately increased serum potassium levels 2 Increased numbers of eosinophils in the blood 3 High levels of 17-ketosteroids in a 24-hour urine test 4 Normal to low levels of adrenocorticotropic hormone (ACTH)
3
Which client has Cushing's syndrome? 1 Client A 2 Client B 3 Client C 4 Client D
4
Which gland does the nurse state is an exocrine gland? 1 Thyroid gland 2 Salivary gland 3 Pituitary gland 4 Parathyroid gland
2
What are the primary causes of adrenal insufficiency? Select all that apply. 1 Hemorrhage 2 Tuberculosis 3 Pituitary tumors 4 Postpartum pituitary necrosis 5 Acquired immune deficiency syndrome
1, 2, 5
Which exogenous conditions are responsible for increased cortisol secretion? Select all that apply. 1 Asthma 2 Adrenal adenomas 3 Cancer chemotherapy 4 Organ transplantation 5 Carcinomas of the lung
1,3,4
A client is admitted to the hospital with a potential diagnosis of excess antidiuretic hormone. Which clinical indicator should the nurse identify when assessing this client? 1 Polyuria 2 Dehydration 3 Hyponatremia 4 Hyperglycemia
3
Which assessment finding in a client signifies a mild form of hypocalcemia? 1 Seizures 2 Hand spasms 3 Severe muscle cramps 4 Numbness around the mouth
4
A primary healthcare provider prescribes a low-sodium, high-potassium diet for a client with Cushing syndrome. Which explanation should the nurse provide to the client about the need to follow this diet? 1 "The use of salt probably contributed to the disease." 2 "Excess weight will be gained if sodium is not limited." 3 "The loss of excess sodium and potassium in the urine requires less renal stimulation." 4 "Excessive aldosterone and cortisone cause retention of sodium and loss of potassium."
4
Which is the target tissue for the parathyroid hormone? 1 Intestines 2 All body cells 3 Mammary glands 4 Sympathetic effectors
1
The primary healthcare provider prescribed a diagnostic study with contrast medium for an older adult who has an endocrine disorder. Which assessment result should the nurse check before the study? 1 Urinary pH 2 Serum creatinine 3 Urinary creatinine 4 Creatinine clearance
2
Which clinical manifestation is found in a client with a deficiency of adrenocorticotropic hormone? 1 Anovulation 2 Dehydration 3 Malaise and lethargy 4 Menstrual abnormalities
3
Which hormone is released from the posterior pituitary gland? 1 Oxytocin 2 Prolactin 3 Growth hormone 4 Luteinizing hormone
1
A client with diabetes asks the nurse whether the new forearm stick glucose monitor gives the same results as a finger stick. What is the nurse's best response to this question? 1 "There is no difference between readings." 2 "These types of monitors are meant for children." 3 "Readings are on a different scale for each monitor." 4 "Faster readings can be obtained from a finger stick."
1
Upon assessing a female client, the nurse discovers an abnormal endocrine finding. Which finding in the client supports the nurse's conclusion? 1 Facial hair 2 Protruding eyes 3 Pulse of 90 beats/min 4 Blood pressure of 120/80 mmHg
2
The nurse is caring for a client newly diagnosed with diabetes. When preparing the teaching plan about the importance of yearly eye examinations, the nurse should instruct the client on which eye problem most associated with diabetes? 1 Cataracts 2 Glaucoma 3 Retinopathy 4 Astigmatism
3
The nurse is caring for a client who is prescribed desmopressin acetate. What is the expected outcome in the client? 1 Sodium: 136mEq/L 2 Specific gravity: 1.005 3 Urine output: 3 L/day 4 Osmolarity: 100 mOsm/kg
3
The nurse is providing care to a client being treated for bacterial cystitis. What is the goal before discharge for this client? 1 Understand the need to drink 4 L of water per day, an essential measure to prevent dehydration 2 Be able to identify dietary restrictions and plan menus 3 Achieve relief of symptoms and maintain kidney function 4 Recognize signs of bleeding, a complication associated with this type of procedure
3
The nurse is assessing a client suspected of having hypercortisolism. Which questions should the nurse ask to help confirm the diagnosis? Select all that apply. 1 "Did you lose any weight unintentionally?" 2 "Did you notice your extremities to be thin?" 3 "Did you notice any roughness of your skin?" 4 "Did you notice any skin darkening recently?" 5 "Did the hair on your body become thicker?"
2, 5
Which clinical findings should the nurse assess when caring for a client with hyperthyroidism? Select all that apply. 1 Lethargy 2 Tachycardia 3 Weight gain 4 Constipation 5 Exophthalmos
2, 5
The nurse is assessing a client with a suspected thyroid disorder. Which diagnostic studies will be most appropriate to confirm that the thyroid disorder is autoimmune in origin? Select all that apply. 1 Free thyroxine 2 Thyroglobulin antibody 3 Thyroid peroxidase antibody 4 Thyroid-stimulating antibody 5 Thyroid-stimulating hormone
2,3,4
A client undergoes removal of a pituitary tumor through a transsphenoidal approach. What should the nurse implement postoperatively? 1 Provide oral hygiene and include brushing the teeth 2 Encourage the client to deep breathe and cough frequently 3 Maintain the head of the bed at a 30-degree angle continuously 4 Continue giving nothing by mouth until the nasal packing is removed
3
A nurse is caring for a client with endocrine problems. Which lab finding will alert the nurse that aldosterone will be released? 1 Hypokalemia 2 Hypoglycemia 3 Hyponatremia 4 Hypochloremia
3
A nurse observes that a client's urine has a sweet fruity odor. Which information is most important to evaluate when performing a further client assessment? 1 Vital signs 2 Fluid balance 3 Serum glucose level 4 Dietary calorie count
3
A nurse in the postanesthesia unit is caring for a client who had a thyroidectomy. Which client response is most important for the nurse to monitor? 1 Urinary retention 2 Signs of restlessness 3 Decreased blood pressure 4 Signs of respiratory obstruction
4
A client who is taking an oral hypoglycemic daily for type 2 diabetes develops the flu and is concerned about the need for special care. What should the nurse instruct the client to do? 1 Skip the oral hypoglycemic pill, drink plenty of fluids, and stay in bed. 2 Avoid food, drink clear liquids, take a daily temperature, and stay in bed. 3 Eat as much as possible, increase fluid intake, and call the office again the next day. 4 Take the oral hypoglycemic pill, drink warm fluids, and perform a serum glucose test before meals and at bedtime.
4
A female client is undergoing treatment for infertility. After therapy with clomiphene the client comes for follow-up visits and no results are seen. What further treatment does the nurse anticipate administering? 1 Estrogen 2 Progesterone 3 Human growth hormone 4 Human chorionic gonadotropin
4
A 24-hour urine test is prescribed for a client who has a tentative diagnosis of pheochromocytoma. What should the nurse do first? 1 Start the time of the test after discarding the first voiding. 2 Discard the last voiding in the 24-hour time period for the test. 3 Insert a urinary retention catheter to promote the collection of urine. 4 Strain the urine following each voiding before adding the urine to the container.
1
A nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. What interventions should the nurse include to decrease the risk of complications? Select all that apply. 1 Examine the feet daily 2 Wear well-fitting shoes 3 Perform regular exercise 4 Powder the feet after showering 5 Visit the primary healthcare provider weekly 6 Test bathwater with the toes before bathing
1, 2, 3
A nurse is assessing a client with Cushing syndrome. Which signs should the nurse expect the client to exhibit? Select all that apply. 1 Hirsutism 2 Round face 3 Pitting edema 4 Buffalo hump 5 Hypoglycemia
1, 2, 4
A client diagnosed with adrenal gland hypofunction is receiving fludrocortisone therapy. Which nursing intervention would help the client reduce the risk of complications? 1 Instruct the client to report severe diarrhea 2 Instruct the client to report fever and vomiting 3 Instruct the client to take the drug with meals or snacks 4 Instruct the client to regularly monitor blood pressure
4
A client is admitted to the hospital for a thyroidectomy. In which position should the nurse maintain the client after surgery? 1 Prone 2 Supine 3 Left Sims 4 Semi-Fowler
4
A client with type 1 diabetes receives Humulin R insulin in the morning. Shortly before lunch the nurse identifies that the client is diaphoretic and trembling. What is the nurse's most appropriate action? 1 Administer insulin to the client 2 Give the client lunch immediately 3 Encourage the client to drink fluids 4 Assess the client's blood glucose level
4
A nurse is teaching a client with type 1 diabetes about assessing for signs and symptoms of hypoglycemia as a result of excessive insulin. What response should the nurse instruct the client to monitor in addition to nervousness and hunger? 1 Thirst 2 Nausea 3 Anorexia 4 Sweating
4 When serum glucose decreases, the sympathetic nervous system is stimulated, resulting in a surge of epinephrine and norepinephrine; this response causes sweating, tremors, tachycardia, palpitations, nervousness, and hunger. Increased thirst (polydipsia) occurs in response to the osmotic diuresis associated with hyperglycemia. The ketosis and acidosis of diabetic ketoacidosis lead to gastrointestinal problems such as nausea, anorexia, vomiting, and abdominal cramping.
A client with malignant hot nodules of the thyroid gland has a thyroidectomy. What is the nurse's priority action immediately postoperative? 1 Place in semi-Fowler's position to limit edema of the neck 2 Monitor intake and output strictly to assess for fluid overload 3 Encourage coughing and deep breathing to prevent atelectasis 4 Assess level of consciousness to determine recovery from anesthesia
1
A client has a history of hypothyroidism. Which skin condition should the nurse expect when performing a physical assessment? 1 Dry 2 Moist 3 Flushed 4 Smooth
1
A client is admitted with a diagnosis of chronic adrenal insufficiency. Which roommate should be avoided when assigning a room for this client? 1 A young adult client with pneumonia 2 An adolescent client with a fractured leg 3 An older adult client who had a brain attack 4 A middle-aged client who has cholecystitis
1
A nurse is caring for a client with Addison's disease. Upon assessment, which classic sign will the nurse find? 1 Ecchymosis 2 Hyperreflexia 3 Exophthalmos 4 Hyperpigmentation
4
Which hormone does the nurse state has both inhibiting and releasing action? 1 Prolactin 2 Somatostatin 3 Somatotropin 4 Gonadotropin
1
Which hormone overproduction is associated with carpel tunnel syndrome in clients? 1 Growth hormone 2 Antidiuretic hormone 3 Parathyroid hormone 4 Aldosterone hormone
1
A client reports their lips feel thicker, as well as joint pain and coarse facial features. What should the nurse suspect as the cause of the anterior pituitary hyperfunction? 1 Excessive secretion of growth hormone 2 Excessive secretion of prolactin hormone 3 Excessive secretion of thyroid-stimulating hormone 4 Excessive secretion of adrenocorticotropic hormone
1
A client who is 60 pounds (27.2 kilograms) more than the ideal body weight is admitted to the hospital with a diagnosis of type 1 diabetes. Which concept should the nurse include in teaching about diabetes when discussing strategies to lose weight? 1 Obesity leads to insulin resistance. 2 Surplus fat causes excretion of insulin. 3 Fat cells absorb insulin and prevent its circulation to other cells. 4 Lipids accumulate in the pancreas and interfere with insulin production.
1
Which hormone synthesis does the nurse state is inhibited by hypokalemia? 1 Aldosterone 2 Somatostatin 3 Norepinephrine 4 Androstenedione
1 (Hypokalemia inhibits synthesis of aldosterone hormone. Somatostatin inhibits the synthesis of insulin. Norepinephrine also inhibits the synthesis of insulin. Androstenedione secretion may not be inhibited by hypokalemia.)
A client is diagnosed with hyperthyroidism, and surgery is scheduled because the client refuses ablation therapy. While awaiting the surgical date, what instruction should the nurse teach the client? 1 Consciously attempt to calm down. 2 Eliminate coffee, tea, and cola from the diet. 3 Keep the home warm, and use an extra blanket at night. 4 Schedule activities during the day to overcome lethargy.
2
A nurse is caring for a client with hyperthyroidism. Which laboratory test will be most beneficial in monitoring the effectiveness of drug therapy? 1 Free thyroxine (FT4) 2 Thyroxine (T4), total 3 Free triiodothyronine (FT3) 4 Triiodothyronine (T3), total
2
A client is admitted to the hospital with a diagnosis of cancer of the thyroid gland, and a thyroidectomy is performed. What should the nurse do during the first six to eight hours after surgery? 1 Place two pillows behind the client's head. 2 Monitor for the complication of tetany resulting from hypocalcemia. 3 Assess the sides and back of the client's neck for evidence of bleeding. 4 Encourage the client to perform deep-breathing and coughing exercises.
3
The nurse is teaching a client newly diagnosed with diabetes about the importance of glucose monitoring. Which blood glucose levels should the nurse identify as hypoglycemia? 1 68 mg/dL (3.8 mmol/L) 2 78 mg/dL (4.3 mmol/L) 3 88 mg/dL (4.9 mmol/L) 4 98 mg/dL (5.4 mmol/L)
1
Which action by the nurse while administering human growth hormone ensures effective therapy? 1 Administration at nighttime 2 Administration via oral route 3 Administration along with meals 4 Administration by metered spray
1
Which condition is characterized by hemorrhage after a pregnant female delivers? 1 Sheehan's syndrome 2 Cushing's syndrome 3 Addison's syndrome 4 Schwartz-Bartter syndrome
1
What intervention should the nurse implement when caring for a client 24 hours postthyroidectomy? 1 Check the back and sides of the operative site. 2 Support the head during mild range-of-motion (ROM) exercises. 3 Encourage the client to ventilate feelings about the surgery. 4 Advise the client that regular activities can be resumed immediately.
1
A nurse is caring for a newly admitted client with a diagnosis of Graves disease. In preparing a teaching plan, the nurse anticipates which diet will be prescribed for this client? 1 High-calorie diet 2 Low-sodium diet 3 High-roughage diet 4 Mechanical-soft diet
1
A nurse is planning to teach facts about hyperglycemia to a client with diabetes. What information should the nurse include in the discussion about what causes diabetic acidosis? 1 Breakdown of fat stores for energy 2 Ingestion of too many highly acidic foods 3 Excessive secretion of endogenous insulin 4 Increased amounts of cholesterol in the extracellular compartment
1
Which gland secretes melatonin? 1 Pineal gland 2 Thyroid gland 3 Adrenal gland 4 Parathyroid gland
1
A client with type 1 diabetes is transported via ambulance to the emergency department of the hospital. The client has dry, hot, flushed skin and a fruity odor to the breath and is having Kussmaul respirations. Which complication does the nurse suspect that the client is experiencing? 1 Ketoacidosis 2 Somogyi phenomenon 3 Hypoglycemic reaction 4 Hyperosmolar nonketotic coma
1
A nurse explains to a client with diabetes that self-monitoring of blood glucose is preferred to urine glucose testing. Why is blood glucose monitoring preferred? 1 Blood glucose monitoring is more accurate. 2 Blood glucose monitoring is easier to perform. 3 Blood glucose monitoring is done by the client. 4 Blood glucose monitoring is not influenced by drugs.
1
Which catecholamine receptor is responsible for increased heart rate? 1 Beta1 receptor 2 Beta2 receptor 3 Alpha1 receptor 4 Alpha2 receptor
1
A nurse working in the diabetes clinic is evaluating a client's success with managing the medical regimen. What is the best indication that a client with type 1 diabetes is successfully managing the disease? 1 Reduction in excess body weight 2 Stabilization of the serum glucose 3 Demonstrated knowledge of the disease 4 Adherence to the prescription for insulin
2
During a follow-up visit, the nurse finds increased intracranial pressure in a client who has undergone nasal hypophysectomy for hyperpituitarism. Which action taken by the client is responsible for this condition? 1 Using stool softeners 2 Blowing the nose and sneezing 3 Performing deep-breathing exercises 4 Bending the knees and lowering the body to pick up objects
2
In order to ensure a quality specimen and an accurate test result, which instruction should the nurse give a client who is scheduled to undergo urine endocrine testing? 1 "Start the urine collection when the bladder is full." 2 "Store the urine specimen in a cooler with ice." 3 "Store the urine specimen in a home refrigerator." 4 "Save the urine specimen that begins the collection."
2
When obtaining a health history from a client recently diagnosed with type 1 diabetes, the nurse expects the client to report what clinical manifestations? 1 Irritability, polydipsia, and polyuria 2 Polyuria, polydipsia, and polyphagia 3 Nocturia, weight loss, and polydipsia 4 Polyphagia, polyuria, and diaphoresis
2
After surgical clipping of a ruptured cerebral aneurysm, a client develops the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). What manifestations are exhibited with excessive levels of antidiuretic hormone? 1 Increased blood urea nitrogen (BUN) and hypotension 2 Hyperkalemia and poor skin turgor 3 Hyponatremia and decreased urine output 4 Polyuria and increased specific gravity of urine
3
What symptoms will the nurse identify when assessing a client with Graves disease? 1 Constipation, dry skin, and weight gain 2 Lethargy, weight gain, and forgetfulness 3 Weight loss, exophthalmos, and restlessness 4 Weight loss, protruding eyeballs, and lethargy
3
Which drug would be effective for the treatment of pituitary Cushing's syndrome? 1 Mitotane 2 Cabergoline 3 Cyproheptadine 4 Bromocriptine mesylate
3
While a nurse is teaching a client with diabetes about food choices, the client states, "I do not like broccoli." Which food should the nurse suggest to substitute for broccoli? 1 Peas 2 Corn 3 Green beans 4 Mashed potato
3
Which hormonal deficiency reduces the growth of axillae and pubic hair in female clients? 1 Growth hormone 2 Antidiuretic hormone 3 Thyroid-stimulating hormone 4 Adrenocorticotropic hormone
4
Which medical condition could most probably result in clients developing primary diabetes insipidus (DI)? 1 Meningitis 2 Brain tumor 3 Lithium therapy 4 Defect in hypothalamus
4
While caring for a client receiving fludrocortisone, the nurse suspects that the drug has caused a negative side effect. Which finding supports the nurse's conclusion? 1 Body temperature of 37˚C (98.6˚F) 2 Blood glucose of 100 mg/dL (5.5 mmol/L) 3 Serum sodium of 137 mEq/L (137 mmol/L) 4 Blood pressure of 150/90 mm Hg
4
Which type of hormonal imbalance does the nurse infer through this image? 3156378974 1 Acromegaly 2 Exophthalmos 3 Addison's disease 4 Cushing's syndrome
1
Which feature in the client indicates hypersecretion of adrenocorticotrophic hormone? 1 Moon face 2 Lower jaw protrusion 3 Heat intolerance 4 Barrel-shaped chest
1
When assessing a client with Graves disease (hyperthyroidism), what would the nurse expect to find in the client's history? 1 Diaphoresis 2 Menorrhagia 3 Dry, brittle hair 4 Sensitivity to cold 00:00:01 Question Answer Confidence ButtonsJust a guessPretty sureNailed it
1
A nurse identifies that the client is experiencing a hypoglycemic reaction. Which intervention should the nurse implement to relieve the symptoms associated with this reaction? 1 Giving 4 oz (120 mL) of fruit juice 2 Administering 5% dextrose solution intravenously (IV) 3 Withholding a subsequent dose of insulin 4 Providing a snack of cheese and dry crackers
1
A nurse is providing postoperative care for a client one hour after an adrenalectomy. Maintenance steroid therapy has not begun yet. The nurse should monitor the client for which complication? 1 Hypotension 2 Hyperglycemia 3 Sodium retention 4 Potassium excretion
1
Which clinical findings are observed in a client suffering from an imbalance of adrenocorticotropic hormone? Select all that apply. 1 Anorexia 2 Hyponatremia 3 Slowed cognition 4 Postural hypotension 5 Decreased muscle strength
1, 2, 4
Which glands secrete hormones that regulate metabolism of carbohydrates, proteins, and fats? Select all that apply. 1 Pancreas 2 Thyroid gland 3 Adrenal cortex 4 Adrenal medulla 5 Parathyroid gland
1, 2, 3
A client is diagnosed with Cushing syndrome. Which clinical manifestation does the nurse expect to increase in a client with Cushing syndrome? 1 Urine output 2 Glucose level 3 Serum potassium 4 Immune response
2
A nurse is caring for a client with Cushing syndrome. Which cardiovascular complication should the nurse assess for in this client? 1 Chest pain 2 Tachycardia 3 Hypertension 4 Atrial fibrillation
3
The clinical findings of a client with diabetes mellitus show decreased glucose tolerance. Which complication is anticipated in the client? 1 Cystitis 2 Thin and dry skin 3 Decreased bone density 4 Frequent yeast infections
4
What is a clinical manifestation in a client with hyposecretion of growth hormone? 1 Lethargy 2 Weight gain 3 Decreased libido 4 Reduced bone density
4
When assessing the laboratory values of a client with type 2 diabetes, what would the nurse expect the results to reveal? 1 Ketones in the blood but not in the urine 2 Glucose in the urine but not in the blood 3 Urine and blood positive for glucose and ketones 4 Urine negative for ketones and positive glucose in the blood
4
Which cells does the nurse identify as producing thyrocalcitonin hormone? 1 Islet cells 2 Adrenal cells 3 Pituitary cells 4 Parafollicular cells
4
Which electrolyte concentration has the potential to precipitate dysrhythmias and cardiac arrest in a client? 1 Serum sodium of 139 mEq/L (139 mmol/L) 2 Serum chloride of 100 mEq/L (100 mmol/L) 3 Serum calcium of 10.2 mg/dL (2.55 mmol/L) 4 Serum potassium of 7.2 mEq/L (7.2 mmol/L)
4 Hyperkalemia causes dysrhythmias and cardiac arrest. The normal serum potassium concentration ranges between 3.5 and 5.0 mEq/L (3.5-5.0 mmol/L). A concentration of 7.2 mEq/L (7.2 mmol/L) indicates hyperkalemia. The normal concentration of sodium in the serum ranges between 135 and 145 mEq/L (135-145 mmol/L). The normal chloride concentration ranges between 96 and 106 mEq/L (96-106 mmol/L). The normal serum calcium level ranges between 9 and 10.5 mg/dL (2.25-2.625 mmol/L).
The registered nurse instructs the new nurse in orientation regarding the physiologic processes of the endocrine system prior to client assessment. Which statement made by the new nurse indicates effective learning? 1 "The endocrine system comprises glands with narrow ducts." 2 "The endocrine system comprises salivary and lacrimal glands." 3 "The hormones of the endocrine system exert their action by 'lock and key' mechanism." 4 "The hormones secreted by endocrine system exert their action on all tissues they contact."
3
Which hormone secretion does the nurse state is an example of a positive feedback mechanism? 1 Insulin 2 Estradiol 3 Parathormone 4 Catecholamines
2
Which hormone does the nurse state binds to the receptor site on the surface of a target cell? 1 Estrogen 2 Adrenaline 3 Aldosterone 4 Hydrocortisone
4
Which statement does the nurse know is true regarding the effects of parathyroid hormone on bones for the maintenance of calcium balance? 1 Increases bicarbonate and sodium excretion 2 Enhances absorption of calcium and phosphorous 3 Increases reabsorption of calcium and magnesium 4 Increases net release of calcium into extracellular fluid
4
