Metabolism

Which outcome indicates that treatment of a client with diabetes insipidus has been effective?

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

A school nurse is called to assess a 12-year-old child with type 1 diabetes mellitus who is experiencing lightheadedness, tachycardia, and pallor during physical education class. What is the priority action by the nurse?

Give the child some fruit juice to drink.

A 12-year-old child has hyperthyroidism. The nurse understands that the most common cause of hyperthyroidism in children is:

Graves disease

Which laboratory values for a newly admitted client indicate a diagnosis of diabetes mellitus? Select all that apply.

Hemoglobin A1C 9.1% (.09) 2 hour oral GTT 245 mg/dL (13.6 mmol/L)

Signs and symptoms of what would necessitate discontinuation of dantrolene therapy?

Hepatic dysfunction

The sympathetic and the parasympathetic nervous systems are continuously at work in our bodies. This continual action gives a basal activity to all parts of the body. This basal activity is referred to as:

Tone

True or False: Nondepolarizing NMJ blockers are metabolized in the serum.

True

True or false? Bone may take up toxic substances from the circulation, which can be viewed as a protective mechanism.

True

The nurse is teaching the client how to administer insulin. Which instruction should the nurse include?

"First withdraw clear, then cloudy insulin when mixing insulins in the same syringe."

During a visit to the clinic, the adolescent client with hypothyroidism tells the nurse that she takes her levothyroxine "whenever I think about it...sometimes I miss a dose, but not very often." What is the best response by the nurse?

"I know it's hard to remember medicines, but it is really important for you to take it before breakfast each day to control your hypothyroidism."

A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement by the client indicates the need for additional discharge teaching?

"I will increase my fluid and calcium intake."

A 31-year-old female has been recently diagnosed with type 2 diabetes mellitus, and is attending a diabetes education class. Which statement by the woman demonstrates an accurate understanding of her health problem?

"I'll have to control my blood sugars, my blood pressure, and my cholesterol in order to make sure I don't develop sight problems."

Which statement would help a nurse best explain an "incretin effect"?

"It is an increase in insulin release after ingestion of food."

The nurse has told the 14-year-old adolescent with diabetes that the doctor would like to have a hemoglobin A1C test performed. Which comment by the client indicates that she understands what this test is for?

"This will tell my doctor what my average blood glucose level has been over the last 2 to 3 months."

Which female client is at risk for amenorrhea?

18-year-old with anorexia nervosa

A pregnant woman with type 2 diabetes is scheduled for a laboratory test of glycosylated hemoglobin (HbA1C). What does the nurse tell the client is a normal level for this test?

6%

A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they identify which of the following?

A primary function of the female breast is to produce milk.

A 60 year-old man has long managed his type 1 diabetes effectively with a combination of vigilant blood sugar monitoring, subcutaneous insulin administration, and conscientious eating habits. This morning, however, his wife has noted that he appears pale and clammy and appears to be in a stupor, though he is responsive. She suspects that he has made an error in his insulin administration and that he is experiencing a hypoglycemic episode. Which action should be the wife's first choice?

Administration of 15 to 20 g of glucose in a concentrated carbohydrate source.

The critical care nurse has just admitted a client with diabetic ketoacidosis (DKA) whose blood glucose level is 877 mg/dL (48.67 mmol/L). The client's breath has a fruity odor and the client is confused. Which of these does the nurse set as the priority at this time?

Administration of intravenous fluids

A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of:

Antidiuretic hormone (ADH) and oxytocin

The common bile duct opens into which part of the gastrointestinal tract?

Duodenum

Which statement best conveys an aspect of the role of cerebrospinal fluid (CSF)?

CSF cushions the brain and provides a near-water medium for diffusion of nutrients.

Which condition does the school nurse know is of highest health concern for school-aged children?

Childhood obesity

A student is studying gallbladder function. Which gastrointestinal hormone stimulates contraction of the gallbladder?

Cholecystokinin

A nurse cares for a client who is 5 feet 11 inches tall and weighs 225 pounds. What statement describes the client's BMI?

Class I obesity

An adult client with a possible growth hormone (GH)-secreting tumor is undergoing testing. If a glucose load is given, which response by the body would confirm the client has a GH-secreting tumor?

Elevated GH level after a glucose load

A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to begin replacement therapy. Regarding which type of replacement will the nurse educate the client?

Cortisol replacement therapy

The nurse is providing care for a client with a diagnosis of cirrhosis, and she notes that the client's sclerae are jaundiced. The nurse recalls that jaundice is a pigment that can accumulate in which part of the cell?

Cytoplasm

The nurse is caring for a client with hepatitis and jaundice. The nurse recognizes that without sufficient circulating bile salts the client will have intolerance to which ingested substance?

Fats

Which occurrence is most likely to cause increased urination?

Decrease in antidiuretic hormone

The nurse is caring for the client with pancreatic cancer. The nurse monitors the client for which complication?

Hyperglycemia due to inability to synthesize insulin

The azole antifungals are contraindicated in clients with what condition?

Increase liver enzymes

Which individualized plan does the nurse understand will be included in the initial plan of treatment for the client who seeks treatment for obesity? Select all that apply.

Lifestyle modification with behavioral therapy Increased physical activity Reduced-calorie diet

A client has monthly laboratory tests done. The nurse notes a decrease in the albumin level. What condition in the client's history could alter the albumin level?

Liver disease

The nurse is reviewing laboratory values of a 70-year-old female client and observes the client's low-density lipoprotein (LDL) level is elevated. The nurse understands a possible reason for this is:

Long-term estrogen deprivation

Which results would indicate to the nurse the possibility that a neonate has congenital hypothyroidism?

Low T4 level and high TSH level

The nurse is teaching an older client how to self-administer insulin. Which of the following would be most helpful to the client who is having difficulty drawing up the correct dosage of insulin in the syringe?

Magnifier

When performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. Which of the following interventions should the nurse consider?

Measure abdominal girth according to a set routine.

A client with diabetes insipidus is extremely dehydrated and is unable to take oral fluids. Fluid therapy is prescribed. Which intervention would be most important for the client?

Measuring the urine output every 30 minutes.

A nurse is explaining the clinical manifestations of diabetic nephropathy (diabetic glomerulosclerosis) to a client. Which statement would be the most important information for the nurse to provide?

Microalbuminuria is a predictor of future nephropathies.

A nurse observes a client moving restlessly in the hospital bed. Which type of energy expenditure can be affected by this activity?

Nonexercise activity thermogenesis (NEAT)

The nurse is caring for a client who is suffering from high levels of chronic stress. On what should the nurse focus, as a negative effect on the client's health due to chronically elevated levels of cortisol?

Osteoblast activity and protein synthesis are suppressed to refocus energy.

An older adult client is admitted for the treatment of pneumonia. The nurse notes the home medications include nasal calcitonin, vitamin D, and calcium chloride. Which disease process is this client likely treating with these medications?

Osteoporosis

A nurse who works on an oncology ward is providing care for a 68-year-old female client with a diagnosis of lung cancer with bone metastases. The client is experiencing rapid weight loss and is exhibiting the signs and symptoms of malnutrition. The nurse would recognize that which factor is most likely contributing to the client's malnutrition?

Protein mass is being lost from the liver and other organs and the liver is synthesizing fewer serum proteins

An anatomy student explains that the funnel-shaped portion of the stomach that connects with the intestine is called which region?

Pyloric region

A nurse is caring for a patient with thyrotoxicosis. The physician prescribes liotrix to the patient. Which adverse reaction to the drug should the nurse monitor for in the patient?

Tachycardia

Which statement is true concerning gastric enterocytes?

They secrete enzymes that aid in digestion of proteins.

The client is receiving ketoconazole. The nurse should be concerned about a drug-drug interaction on the basis of what other co-morbidity?

Type 2 diabetes

Which client is most at risk for a cumulative drug effect?

a client with liver failure

The nurse is admitting a 10-pound (4.5-kg) newborn to the nursery. What is important for the nurse to monitor during the transition period?

blood sugar

A client sought care because of the presence of fat in stool. What assessment should the care team prioritize?

client's synthesis and release of bile

The nurse is caring for a client with possible Cushing's syndrome undergoing diagnostic testing. The health care provider orders lab work and a dexamethasone suppression test. Which parameter would the nurse assess on the dexamethasone suppression test?

cortisol levels before and after the system is challenged with a synthetic steroid

The nurse is caring for a client with polydipsia and large amounts of urine with a specific gravity of 1.003. Which disorder is anticipated?

diabetes insipidus

The nurse assessing an adult male with impaired testosterone should evaluate which of the following as an expected finding?

fatigue

The nurse is caring for a client on the urinary unit. When providing report to the next shift, it is noted that the client has osteopenia and history of renal calculi. Which disorder would the nurse suspect?

hyperparathyroidism

The nurse is assessing a client. What assessment findings should the nurse interpret as suggesting a sympathetic response?

increase in blood pressure and decreased bowel sounds

The nurse is caring for a client diagnosed with marasmus. The nurse would expect the client to manifest:

loss of subcutaneous tissue, stunted growth, protuberant abdomen.

The nurse is admitting a client with newly diagnosed diabetes mellitus and left-sided heart failure. Assessment reveals low blood pressure, increased respiratory rate and depth, drowsiness, and confusion. The client reports headache and nausea. Based on the serum laboratory results, how would the nurse interpret the client's acid-base balance?

metabolic acidosis

A young, healthy adult helps lift a sofa to move it 25 ft (7.5 m). The nurse knows that which source of energy will the client likely use in this process?

stored adenosine triphosphate (ATP)

All cells of the body age and are replaced in a natural order. When RBCs age, they are destroyed in the spleen. During this process, the iron from their hemoglobin is released into the circulation and returned:

to the bone marrow for incorporation into new RBCs.