Metabolism hesi quiz

The nurse is assessing a client with hyperthyroidism. Which signs and symptoms might the nurse identify when assessing the client? Select all that apply. 1 Amenorrhea 2 Hypotension 3 Facial edema 4 Flushed appearance 5 Short attention span

1 Amenorrhea 4 Flushed appearance 5 Short attention span

The physician orders Lactulose 30 mL by mouth per day for a patient with cirrhosis. What findings below demonstrates the medication is working effectively? Select all that apply:* A. Decrease albumin levels B. Decrease in Fetor Hepaticus C. Patient is stuporous. D. Decreased ammonia blood level E. Presence of asterixis

B. Decrease in Fetor Hepaticus D. Decreased ammonia blood level

While providing mouth care to a patient with late-stage cirrhosis, you note a pungent, sweet, musty smell to the breath. This is known as:* A. Metallic Hepatico B. Fetor Hepaticus C. Hepaticoacidosis D. Asterixis

B. Fetor Hepaticus

Which of the following is NOT a role of the liver?* A. Removing hormones from the body B. Producing bile C. Absorbing water D. Producing albumin

C. Absorbing water

________ reside in the liver and help remove bacteria, debris, and old red blood cells.* A. Hepatocytes B. Langerhan cells C. Enterocytes D. Kupffer cells

D. Kupffer cells

The liver receives it blood supply from two sources. One of these sources is called the _________________, which is a vessel network that delivers blood _____________ in nutrients but ________ in oxygen.* A. hepatic artery, low, high B. hepatic portal vein, high, low C. hepatic lobule, high, low D. hepatic vein, low, high

hepatic portal vein, high, low

A client with diabetes asks how exercise will affect insulin and dietary needs. What information does the nurse share about insulin and exercise? 1 "Exercise increases the need for carbohydrates and decreases the need for insulin." 2 "Exercise increases the need for insulin and increases the need for carbohydrates." 3 "Regular physical activity decreases the need for insulin and decreases the need for carbohydrates." 4 "Intensive physical activity decreases the need for carbohydrates but does not affect the need for insulin."

1 "Exercise increases the need for carbohydrates and decreases the need for insulin."

Which statement by a client with type 2 diabetes indicates to the nurse that additional dietary teaching is needed? 1 "I can eat as much dietetic fruit as I want." 2 "I can have a lettuce salad whenever I want it." 3 "I know that half of my diet should be carbohydrates." 4 "I need to reduce the amounts of saturated fats in my diet."

1 "I can eat as much dietetic fruit as I want."

A nurse is caring for a client who has a 20-year history of type 2 diabetes. The nurse should assess for what physiologic changes associated with a long history of diabetes? 1 Blurry, spotty, or hazy vision 2 Arthritic changes in the hands 3 Hyperactive knee and ankle jerk reflexes 4 Dependent pallor of the feet and lower legs

1 Blurry, spotty, or hazy vision

A nurse is assessing a client with hypothyroidism. Which clinical manifestations should the nurse expect the client to exhibit? Select all that apply. 1 Cool skin 2 Photophobia 3 Constipation 4 Periorbital edema 5 Decreased appetite

1 Cool skin 3 Constipation 4 Periorbital edema 5 Decreased appetite

Which clinical findings should the nurse expect when assessing a client with hyperthyroidism? Select all that apply. 1 Diarrhea 2 Listlessness 3 Weight loss 4 Bradycardia 5 Decreased appetite

1 Diarrhea 3 Weight loss

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 Dry

A client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. A diagnosis of hepatic cirrhosis is made. Which is a nursing priority? 1 Institute fall prevention/safety measures. 2 Monitor respiratory status. 3 Measure abdominal girth daily. 4 Test stool specimens for blood.

1 Institute fall prevention/safety measures.

An 8-year-old child is being given insulin glargine before breakfast. What is the most appropriate information for the nurse to give the parents concerning a bedtime snack? 1 Offer a snack to prevent hypoglycemia during the night. 2 Give the child a snack if signs of hyperglycemia are present. 3 Avoid a snack because the child is being treated with long-acting insulin. 4 Keep a snack at the bedside in case the child gets hungry during the night.

1 Offer a snack to prevent hypoglycemia during the night.

A nurse is caring for a client who is receiving total parenteral nutrition. Which responses indicate that the client is experiencing hyperglycemia? Select all that apply. 1 Polyuria 2 Polydipsia 3 Paralytic ileus 4 Respiratory rate of 16 breaths/min 5 Serum glucose of 105 mg/dL (5.8 mmol/L)

1 Polyuria 2 Polydipsia 4 Respiratory rate of 16 breaths/min

A client has been taking levothyroxine for hypothyroidism for 3 months. The nurse suspects that a decrease in dosage is needed when the client exhibits which clinical manifestations? Select all that apply. 1 Tremors 2 Bradycardia 3 Somnolence 4 Heat intolerance 5 Decreased blood pressure

1 Tremors 4 Heat intolerance

A client is diagnosed with hyperthyroidism and is experiencing exophthalmia. Which measures should the nurse include when teaching this client how to manage the discomfort associated with exophthalmia? Select all that apply. 1 Use tinted glasses. 2 Use warm, moist compresses. 3 Elevate the head of the bed 45 degrees. 4 Tape eyelids shut at night if they do not close. 5 Apply a petroleum-based jelly along the lower eyelid.

1 Use tinted glasses. 3 Elevate the head of the bed 45 degrees. 4 Tape eyelids shut at night if they do not close.

A 17-year-old adolescent was recently found to have type 2 diabetes mellitus. What information will the nurse include when providing education to the family? 1 "Your teen will need insulin injections for the rest of her life." 2 "The most important interventions are good nutrition and portion control." 3 "This is a condition where the body produces antibodies against its own cells." 4 "This condition causes weight loss and increased appetite, thirst, and urination."

2 "The most important interventions are good nutrition and portion control."

Which physiologic responses should a nurse expect when assessing a client with hyperthyroidism? Select all that apply. 1 Bradycardia 2 Blurred vision 3 Cold intolerance 4 Increased appetite 5 Widened pulse pressure

2 Blurred vision 4 Increased appetite 5 Widened pulse pressure

A nurse teaches a client with type 1 diabetes about the treatment of hypoglycemia. If the teaching is effective, which foods does the client identify to manage hypoglycemia? 1 Hard candy and fruit juice 2 Cheese sandwich and sugar 3 Chocolate candy and an orange 4 Peanut butter crackers and a glass of milk

2 Cheese sandwich and sugar

A nurse administers lactulose to a client with cirrhosis of the liver. Which laboratory test change leads the nurse to determine that the lactulose is effective? 1 Decreased amylase 2 Decreased ammonia 3 Increased potassium 4 Increased hemoglobin

2 Decreased ammonia

The nurse is caring for a client with type 1 diabetes. Which signs or symptoms will indicate to the nurse that the client is experiencing hypoglycemia? Select all that apply. 1 Lethargy 2 Headache 3 Diaphoresis 4 Excessive thirst 5 Deep respirations

2 Headache 3 Diaphoresis

The nurse concludes that a client with type 1 diabetes is experiencing hypoglycemia. Which responses support this conclusion? Select all that apply. 1 Vomiting 2 Headache 3 Tachycardia 4 Cool, clammy skin 5 Increased respirations

2 Headache 3 Tachycardia 4 Cool, clammy skin

A client with a history of alcoholism and cirrhosis is admitted with severe dyspnea as a result of ascites. Which process that most likely caused the ascites should the nurse consider when planning care? 1 Increased secretion of bile salts 2 Increased pressure in the portal vein 3 Increased interstitial osmotic pressure 4 Increased production of serum albumin

2 Increased pressure in the portal vein

A 9-year-old child with type 1 diabetes is hospitalized for insulin dosage regulation. A nurse observes the child sneaking food and trying to talk family members into bringing candy. What action should the nurse take when the child complains of feeling hypoglycemic? 1 Test the urine for ketones. 2 Obtain a blood glucose level. 3 Offer orange juice with sugar. 4 Determine when the child ate last.

2 Obtain a blood glucose level.

An adolescent with a BMI of 30 reports fatigue, frequent urination, and a tingling sensation on the feet. The adolescent is then diagnosed with type 2 diabetes mellitus. Which nursing interventions would be appropriate? Select all that apply. 1 Bariatric surgery 2 Physical activities 3 Dietary restrictions 4 Dietary counseling 5 Behavior modification

2 Physical activities 4 Dietary counseling 5 Behavior modification

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 advise the client? Select all that apply. 1 Avoid solid food. 2 Take the oral medication. 3 Drink fluids throughout the day. 4 Monitor capillary glucose levels. 5 Do not take medication until tolerating food

2 Take the oral medication. 3 Drink fluids throughout the day. 4 Monitor capillary glucose levels

A nurse is developing a discharge plan for a client hospitalized with severe cirrhosis of the liver. What should be included in this plan? 1 The need for a high-protein diet 2 The use of a sedative for relaxation 3 The need to increase fluids 4 The importance of reporting personality changes to the primary healthcare provider

4 The importance of reporting personality changes to the primary healthcare provider

A nurse is teaching a young adolescent with type 2 diabetes about nutritional needs. Which statement demonstrates that the adolescent understands what was taught? 1 "I can have low-fat, low-cal candy bars." 2 "Regular soft drinks are better than diet ones." 3 "It's okay for me to eat one slice of pizza at a party." 4 "My fasting blood sugar should be no higher than 150 mg/dL (8.3 mmol/L)."

3 "It's okay for me to eat one slice of pizza at a party."

The nurse is administering lactulose to a client with a history of cirrhosis of the liver. The client asks the nurse why this medication is needed because the client is not constipated. How will the nurse respond? 1 "This medication helps you to stop drinking so much alcohol." 2 "This medication helps you relax and not feel anxious." 3 "This medication helps you lower the high ammonia level caused by your liver disease." 4 "This medication helps you keep your abdomen from being so distended."

3 "This medication helps you lower the high ammonia level caused by your liver disease."

A client with type 2 diabetes is admitted for elective surgery. The health care provider prescribes regular insulin even though oral antidiabetics were adequate before the client's hospitalization. What information does the nurse include when teaching the client about the addition of insulin? 1 "You will need a higher serum glucose level while on bed rest." 2 "The stress of surgery may cause uncontrollable periods of hypoglycemia." 3 "With insulin, dosage can be adjusted to your changing needs during recovery from surgery." 4 "The possibility of surgical complications is greater when a client takes oral hypoglycemics."

3 "With insulin, dosage can be adjusted to your changing needs during recovery from surgery."

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 Being 20 pounds (9 kilograms) overweight

What are the neurologic manifestations of hyperthyroidism? Select all that apply. 1 Fatigue 2 Diaphoresis 3 Blurred vision 4 Exophthalmos 5 Shallow respirations

3 Blurred vision 4 Exophthalmos

The nurse is caring for a client newly diagnosed with diabetes. What symptom of hypoglycemia is most common and should be taught to the client? 1 Kussmaul respirations 2 Tachycardia 3 Confusion 4 Anorexia

3 Confusion

Which neurologic manifestation in a client is associated with hyperthyroidism? 1 Confusion 2 Hearing loss 3 Exophthalmos 4 Slowness of speech

3 Exophthalmos

A client with cirrhosis of the liver develops ascites, and the health care provider prescribes spironolactone. What should the nurse monitor the client for? 1 Bruising 2 Tachycardia 3 Hyperkalemia 4 Hypoglycemia

3 Hyperkalemia

A nurse is caring for a client with an underactive thyroid gland. Which responses should the nurse expect the client to exhibit as a result of decreased levels of triiodothyronine (T 3) and thyroxine (T 4)? Select all that apply. 1 Irritability 2 Tachycardia 3 Weight gain 4 Cold intolerance 5 Profuse diaphoresis

3 Weight gain 4 Cold intolerance

A client is diagnosed as having type 2 diabetes. What is a priority teaching goal for the client? 1 To perform foot care daily 2 To administer insulin as prescribed 3 To test urine for both sugar and acetone 4 To identify pending hypoglycemia or hyperglycemia

4 To identify pending hypoglycemia or hyperglycemia

A client is prescribed metformin extended release to control type 2 diabetes mellitus. Which statement made by this client indicates the need for further education? 1 "I will take the drug with food." 2 "I must swallow my medication whole and not crush or chew it." 3 "I will notify my doctor if I develop muscular or abdominal discomfort." 4 "I will stop taking metformin for 24 hours before and after having a test involving dye."

4 "I will stop taking metformin for 24 hours before and after having a test involving dye."

A client with type 2 diabetes is taking one oral hypoglycemic tablet daily. The client asks whether an extra tablet should be taken before exercise. What is the best response by the nurse? 1 "You will need to decrease your exercise." 2 "An extra tablet will help your body use glucose correctly." 3 "When taking medicine, your diet will not be affected by exercise." 4 "No, but you should observe for signs of hypoglycemia while exercising."

4 "No, but you should observe for signs of hypoglycemia while exercising."

A nurse is assessing a malnourished client with a history of cirrhosis. The client is experiencing nausea, ascites, and gastrointestinal bleeding. What is the primary cause of the client's ascites? 1 A decrease in vitamins to maintain cell coenzyme functions 2 A decrease in iron to maintain adequate hemoglobin synthesis 3 A decrease in sodium to maintain its concentration in tissue fluid 4 A decrease in plasma protein to maintain adequate capillary-tissue circulation

4 A decrease in plasma protein to maintain adequate capillary-tissue circulation

What is a major nursing concern when caring for a client diagnosed with hyperthyroidism? 1 Monitoring for hypoglycemia 2 Protecting visitors and staff from radiation exposure 3 Providing foods to increase appetite 4 Arranging for sufficient rest periods

4 Arranging for sufficient rest periods

A nurse prepares to administer extended-release metformin to an older adult who has asked that it be crushed because it is difficult to swallow. What will prompt the nurse to ask the provider for a different form of metformin? 1 This drug has a wax matrix frame that is difficult to crush. 2 The drug has an unpleasant taste, which most clients find intolerable if crushed. 3 If crushed, this drug irritates mucosal tissue and can cause oral and esophageal ulcer formation. 4 Extended-release formulations are designed to be released slowly, and crushing the tablet will prevent this from occurring.

4 Extended-release formulations are designed to be released slowly, and crushing the tablet will prevent this from occurring.

A client with diabetes who is receiving long-term corticosteroid therapy is admitted to the hospital with leg ulcers. What increased risk does the nurse consider when assessing this client? 1 Weight loss 2 Hypoglycemia 3 Decreased blood pressure 4 Inadequate wound healing

4 Inadequate wound healing

A nurse plans to teach a fifth-grader with type 1 diabetes, who is receiving both insulin lispro and insulin glargine daily, how to self-administer the insulin. What should the child do when learning to give the injections? 1 Alternate the sites until the best one to use is found. 2 Self-administer the injections after being taught the technique. 3 Draw up the insulin glargine and then draw up the insulin lispro. 4 Learn to use the needle and syringe by practicing on an insulin pad first.

4 Learn to use the needle and syringe by practicing on an insulin pad first.

A client has been diagnosed with hyperthyroidism. The nurse expects the client to exhibit which clinical manifestations? Select all that apply. 1 Dry skin 2 Slow pulse 3 Weight gain 4 Nervousness 5 Increased appetite

4 Nervousness 5 Increased appetite

Your patient with cirrhosis has severe splenomegaly. As the nurse you will make it priority to monitor the patient for signs and symptoms of? Select all that apply:* A. Thrombocytopenia B. Vision changes C. Increased PT/INR D. Leukopenia

A. Thrombocytopenia C. Increased PT/ INR D. Leukopenia

A patient is admitted with hepatic encephalopathy secondary to cirrhosis. Which meal option selection below should be avoided with this patient?* A. Beef tips and broccoli rabe B. Pasta noodles and bread C. Cucumber sandwich with a side of grapes D. Fresh salad with chopped water chestnuts

A. Beef tips and broccoli rabe

You're providing an in-service to new nurse graduates about esophageal varices in patients with cirrhosis. You ask the graduates to list activities that should be avoided by a patient with this condition. Which activities listed are correct: Select all that apply* A. Excessive coughing B. Sleeping on the back C. Drinking juice D. Alcohol consumption E. Straining during a bowel movement F. Vomiting

A. Excessive coughing D. Alcohol consumption E. Straining during a bowel movement F. Vomiting

A patient with late-stage cirrhosis develops portal hypertension. Which of the following options below are complications that can develop from this condition? Select all that apply:* A. Increase albumin levels B. Ascites C. Splenomegaly D. Fluid volume deficient E. Esophageal varices

B. Ascites. C. Splenomegaly E. Esophageal varices

You are receiving shift report on a patient with cirrhosis. The nurse tells you the patient's bilirubin levels are very high. Based on this, what assessment findings may you expect to find during your head-to-toe assessment? Select all that apply:* A. Frothy light-colored urine B. Dark brown urine C. Yellowing of the sclera D. Dark brown stool E. Jaundice of the skin F. Bluish mucous membranes

B. Dark brown urine C. Yellowing of the sclera E. Jaundice of the skin

During your morning assessment of a patient with cirrhosis, you note the patient is disoriented to person and place. In addition while assessing the upper extremities, the patient's hands demonstrate a flapping motion. What lab result would explain these abnormal assessment findings?* A. Decreased magnesium level B. Increased calcium level C. Increased ammonia level D. Increased creatinine level

C. Increased ammonia level

A 45 year old male has cirrhosis. The patient reports concern about the development of enlarged breast tissue. You explain to the patient that this is happening because?* A. The liver cells are removing too much estrogen from the body which causes the testicles to produce excessive amounts of estrogen, and this leads to gynecomastia. B. The liver is producing too much estrogen due to the damage to the liver cells, which causes the level to increase in the body, and this leads to gynecomastia. C. The liver cells are failing to recycle estrogen into testosterone, which leads to gynecomastia. D. The liver cells are failing to remove the hormone estrogen properly from the body, which causes the level to increase in the body, and this leads to gynecomastia.

D. The liver cells are failing to remove the hormone estrogen properly from the body, which causes the level to increase in the body, and this leads to gynecomastia

1. Which condition is NOT a known cause of cirrhosis?* A. Obesity B. Alcohol consumption C. Blockage of the bile duct D. Hepatitis C E. All are known causes of cirrhosis

E. All are known causes of cirrhosis