NU222 Final Exam Prep
Which question from the nurse during a patient interview will provide focused information about a possible thyroid disorder?
"Have you had a recent unplanned weight gain or loss?"
Which statement by a 50-year-old female patient indicates to the nurse that further assessment of the thyroid function may be necessary?
"I feel a lump in my throat when I swallow"
The nurse admits a patient to the hospital in Addisonian crisis. Which patient statement supports the need to plan additional teaching?
"I had the flu earlier this week, so I couldn't take the hydrocortisone."
Which patient statement indicates to the nurse that additional instruction is needed for a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH)?
"I need to shop for foods low in sodium and avoid adding salt to food."
A 29-year-old woman with systemic lupus erythematosus has been prescribed 2 weeks of high-dose prednisone therapy. Which information about the prednisone is most important for the nurse to include?
"The prednisone dose should be decreased gradually."
Which question will the nurse in the endocrine clinic ask to help determine a patient's risk factors for goiter?
"What medications are you taking?"
A client with a history of hypertension has just had a total hip replacement. The provider orders Hydrochlorothiazide 35 mg oral solution po / day. The label on the solution reads hydrochlorothiazide 50 mg / 5 ml how many milliliters should the nurse pour to administer the correct dose? Record your answer using one decimal place.
3.5
The nurse is evaluating an electrocardiogram ECG tracing. Which graphic shows the QT interval?
From the beginning of the QRS until the end of the T wave.
The nurse is admitting a patient with a basal skull fracture. The nurse notes ecchymosis around both eyes and clear drainage from the patient's nose. Which admission order should the nurse question?
Insert a nasogastric tube to low suction
A patient is admitted with tetany. Which laboratory value should the nurse plan to monitor?
Ionized calcium
What action should the nurse take when providing care for a patient who has an adrenocortical adenoma causing hyperaldosteronism?
Monitor the blood pressure every 4 hours
In preparation for which test should the nurse teach the patient to minimize physical and emotional stress?
A 24-hour urine test for free cortisol
After receiving a change of shift report at 0700, the nurse should assess which Client First?
A 63 year old with multiple sclerosis who has an oral temperature of 101.8 F and flank pain
After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?
A 70-year-old female patient taking levothyroxine (Synthroid) who has an irregular pulse of 134
A 44-year-old female patient with Cushing syndrome is admitted for adrenalectomy. Which intervention by the nurse will be helpful for patient problem of disturbed body image related to changes in appearance?
A Remind the patient that most of the physical changes caused by Cushing syndrome will resolve after surgery
A nurse receives a report at the beginning of a day shift. Which client does the nurse assess for?
A client reporting shortness of breath and dyspnea
A nurse cares for several clients who are being monitored by Telemetry. Which client does the nurse assess first?
A client with a rhythm change from atrial flutter to ventricular fibrillation
A new nurse reviews their client assignment for the day including a new admission arriving to the unit now. Which client does the nurse assess first?
A newly admitted client with acute flank pain and hematuria
Diagnosis of myasthenia gravis is confirmed by evaluating the client's response to an intravenous injection of the cholinesterase inhibitor edrophonium last. If the client responds positively, what would the nurse expect?
A rapid and dramatic increase in muscle strength
A nurse cares for a client who is 1 hour Post open abdominal surgery and has evisceration of the abdominal wound and the client's intestinal Loops are visible. Place each option in order from first action to last.
A. I'm serve the client for signs of shock B. Place the client in supine position C. Ask another nurse to notify the health care provider D. Cover the wound with gauze moistened with saline. BDCA
A patient who had a subtotal thyroidectomy earlier today develops laryngeal stridor and a cramp in the right hand upon returning to surgical nursing unit. Which collaborative action will the nurse anticipate next?
Administer IV calcium gluconate
A patient is admitted with diabetes insipidus. Which action will be appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/VN)?
Administer prescribed subcutaneous DDAVP
A registered nurse RN prepared a client for surgery. A practical nurse assists with completion of tasks. Which task must the registered nurse perform?
Administering midazolam 5 mg IVP prior to the procedure
Which measure is likely to provide the most relief from the pain associated with renal colic?
Administering morphine
A registered nurse RN delegates care to a practical nurse PN on a medical-surgical unit. The nurse manager rounds on the unit. Which action observed being performed by the PN would require the nurse manager to discuss appropriate delegation with the RN?
Admitting an alert, hemodynamically stable client from the post-anasthesia care unit
A patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which patient information is important for the nurse to communicate to the health care provider before the test?
Allergies to iodine and shellfish
A patient seen in the emergency department for severe headache and acute confusion has a serum sodium level of 118 mEq/L The nurse should anticipate the need for which diagnostic test?
Antidiuretic hormone
Which nursing assessment of a 70-year-old patient is most important to make during initiation of thyroid replacement with levothyrox(Synthroid)?
Apical pulse rate
A client has had a cardiac catheterization. The femoral dressing has a bright bloody drainage. What should the nurse do first?
Apply pressure to the site
A client is experiencing the classic signs and symptoms of acute coronary artery disease. Space what is the nurses priority intervention?
Apply supplemental oxygen
A client is admitted to the hospital with Cushing's syndrome. Space which nursing interventions are appropriate for this client?
Assess for peripheral edema
A client with a history of cardiac problems reports severe chest pain what should be the nurse's first response?
Assess the clients pain
A client in the emergency department has symptoms of anxiety, the racing heart, and dyspnea. The cardiac monitor shows sinus tachycardia with a heart rate of 122 what is the most appropriate action of the nurse?
Assess the clients vital signs and O2 saturation
After undergoing a cardiac catheterization a client has a large puddle of blood under his buttocks. What is the nurses priority action?
Assess the groin site
Arrived on the unit after a thyroidectomy. Which action should the nurse take first?
Assess the patient's respiratory effort
Treatment for a 69 year old patient admitted with symptomatic sinus bradycardia would involve the following parameters and priorities for the Cardiac Care nurse including.
Atropine and pacing if the patient is hemodynamically compromised
A client recovering from a spinal cord injury has a great deal of spasticity. Which medication would the nurse anticipate to relieve spasticity?
Baclofen
A client recovering from a spinal cord injury, has a great deal of spasticity. Which medication would the nurse anticipate to relieve spasticity?
Baclofen
he nurse is caring for a patient following an adrenalectomy. What is the highest priority in the immediate postoperative period?
Balancing fluid and electrolytes
Which prescribed medication should the nurse expect will have rapid effects on a patient admitted to the emergency department in thyroid storm?
Blood pressure medication
A patient who had radical neck surgery to remove a malignant tumor developed hypoparathyroidism. What topic should the nurse plan teach the patient?
Calcium supplements to normalize serum calcium levels
A client has recently experienced an embolic stroke, and is now stable. The client has been started on Dabigatran Pradaxa. What information should the nurse provide to this client?
Dabigatran helps prevent blood clots from forming in the presence of atrial fibrillation
A client who is receiving multiple medications for a myocardial infarction reports severe nausea. Assessment reveals that the heartbeat is irregular and slow. The nurse should recognize these symptoms as toxicity related to which medication question?
Digoxin
Which problem should the nurse anticipate for a patient admitted to the hospital with diabetes insipidus?
Disturbed sleep pattern
During the physical examination, the nurse cannot feel the patient's thyroid gland. What action should the nurse take?
Document that the thyroid was nonpalpable
A registered nurse (RN) is caring for a patient with a goiter and possible hyperthyroidism. Which action by the RN indicates that the charge nurse needs to provide the RN with additional teaching?
The RN palpates the neck to assess thyroid size
Which client would be most appropriate for the nurse to assign to an unlicensed assistive Personnel UAP for morning care?
Elderly client with COPD who is receiving oxygen therapy for dyspnea
The rapid response team arrives in the room of a client who has had a cardiac arrest the nurse should first apply which piece of monitoring equipment?
Electrocardiogram ECG electrodes
A nurse is caring for a client with a complete tea 5 spinal cord injury. Apply an assessment, the nurse notes flushed skin, diaphoresis above T5, and a blood pressure of 174 over 100 m m HG. Which nursing intervention is most appropriate for this client?
Elevate the head of the bed 45 degrees
Which nursing action will be included in the plan of care for a patient with Graves' disease who has exophthalmos?
Elevate the head of the patient's bed to reduce periorbital fluid
patient is taking spironolactone (Aldactone), a drug that blocks the action of aldosterone on the kidney, for hypertension. What additional effect of the medication should the nurse monitor?
Elevated serum potassium
A patient with primary hyperparathyroidism has a serum phosphorus level of 1.7 mg/dl (0.55 mmol/L) and calcium of 14 mg/dL (3.5 mmol/L) Which nursing action should be included in the plan of care?
Encourage 4000 mL of fluids daily
A client with a spinal cord injury says he is having difficulty recognizing the symptoms of a urinary tract infection UTI. Which assessment finding is an early symptom of UTI in a client with a spinal cord injury?
Fever and change in urine clarity
A patient develops carpopedal spasms and tingling of the lips following a parathyroidectomy. Which action will provide the patient with rapid temporary relief from the symptoms?
Have the patient rebreathe from a paper bag
What finding should the nurse plan to assess for in a patient diagnosed with a pheochromocytoma?
Headache
The nurse is caring for a patient with a possible pituitary tumor who is scheduled for a computed tomography scan with contrast. information about the patient is important to discuss with the health care provider before the test?
History of renal insufficiency
On the third day after a partial thyroidectomy a client exhibits muscle twitching and hyperirritability of the nervous system. when questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance commonly follows thyroid surgery?
Hypocalcemia
A client with Addison's disease is scheduled for discharge after being hospitalized for an adrenal crisis. Which statement by the client indicates that client teaching has been effective?
I need to call my healthcare provider to discuss my steroid needs before I have dental work
The nurse is teaching a client how to apply nitroglycerin topical ointment. Which statement indicates that the client needs additional clarification of the instructions?
Ill carefully massage the ointment into the skin
A patient has just arrived in the postanesthesia recovery unit (PACU) after a thyroidectomy. Which information about the patient is most important to communicate to the surgeon?
Increased neck swelling
Which finding for a patient who has hypothyroidism and hypertension indicates that the nurse should contact the health care pr administering levothyroxine (Synthroid)?
Increased thyroxine (T4) level
A young adult patient who is being seen in the clinic has excessive secretion of the anterior pituitary hormones Which laboratory test result should the nurse expect?
Increased urinary cortisol
Which finding indicates to the nurse that the current therapies are effective for a patient who has acute adrenal insufficiency?
Increasing serum sodium levels
After obtaining the information shown in the accompanying figure regarding a patient with Addison's disease, which prescribed action will the nurse take first? Assessment Reports fatigue BP 76/40 mm Hg Heart rate 126 beats/min Sodium 123 mEq L Bronze-colored skin Poor skin turgor Respirations 24 breaths/min Potassium 5.1 mEq/L Glucose 62 mg/dl. Oxygen saturation 94%
Infuse 5% dextrose and 0.9% saline
Which finding by the nurse when assessing a patient with a large pituitary adenoma is most important to report to the health care?
Nausea and projectile vomiting
Which finding by the nurse when assessing a patient with Hashimoto's thyroiditis and a goiter will require the most immediate action?
New-onset changes in the patient's voice
The client is scheduled to have a kidney, ureter, and bladder KUB radio graph. What should the nurse explain to the client about this procedure?
No special preparation is required for this examination
A client is scheduled for surgery at 8 a.m. 08:00. while completing the preoperative checklist the nurse sees that the surgical consent form isn't signed. It's time to administer the preoperative analgesic which nursing action takes the highest priority in this situation?
Notify the surgeon that the client hasnt signed
The nurse has just received morning change of shift report on four clients. In what order from first to last should the nurse perform the actions? All options must be used. A. Notify the healthcare provider about a client who has a serum potassium level of 6.2 meq/l. b. Assess the client who has been vomiting according to the report from the Night Nurse. see. Discuss the plan for the day with the unlicensed assistive personnel UAP. d. Begin discharge paperwork for a client who is eager to go home.
Notify, Assess, discuss, begin
Which intervention will the nurse include in the plan of care for a patient with syndrome of inappropriate antidiuretic hormone (SIADH)?
Offer the patient hard candies to suck on
A nurse is caring for an older client who is admitted with an electrolyte imbalance. Which laboratory value should be a priority concern for the nurse?
PaCO2 51mm Hg
A patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL. What should the nurse anticipate will be tested next?
Parathyroid hormone
Which information obtained by the nurse in the endocrine clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider?
Patient stopped taking the medication 2 days ago
The cardiac telemetry unit charge nurse receives status reports from other nursing units about four patients who need cardiac monitoring. Which patient should be transferred to the cardiac unit first?
Patient with tetany who has a new order for IV calcium chloride
A client is experiencing autonomic dysreflexia. What nursing action should be performed first?
Place the patient in Fowlers position?
A client is admitted to the hospital with an exacerbation of multiple sclerosis after an MRI revealed Progressive demyelination. Space the nurse should assess for which symptom?
Progressive weakness of the extremities
A nurse is caring for a 71 year old male client who complains that he cannot pass urine. A bladder scan reveal 600 mL of urine present in the bladder. A serum prostate-specific antigen PSA test indicates a level of 29 G/l . The Physician place has an indwelling catheter and a urine analysis returns positive for nitrates oh, leukocytes, and bacteria. Which conditions should the nurse suspect?
Prostate enlargement and a urinary tract infection UTI
A post-operative client is receiving Heparin after developing thrombophlebitis. The nurse monitors the client carefully for bleeding and other adverse effects of Heparin. If the client starts to exhibit signs of excessive bleeding, the nurse should expect to administer an antidote that is specific to Heparin. Which agent fits this description?
Protamine sulfate
A nurse is completing management rotation in the Intensive Care Unit and is working with an experienced Icu nurse. One clients work supervisor calls to "check up" on the client. The nurse offers to transfer the call to the client's family members. The experienced Icu nurse recognizes this action as?
Protection of the clients privacy
A patient who was admitted with myxedema coma and diagnosed with hypothyroidism is improving. Discharge is expected to o days. Which teaching strategy is likely to result in effective patient self- management at home?
Provide written reminders of information taught
A patient is being admitted with a diagnosis of Cushing syndrome. Which finding will the nurse expect during the assessment?
Purplish streaks on the abdomen
Cardiac Telemetry shows that a client who is up to the bathroom has converted from a normal sinus rhythm with a rate of 72 BPM to atrial fibrillation with a ventricular response rate of 100 BPM. In what order from first to last should the nurse perform the following interventions. All options must be used.
a. Assess the client to bed b. Assess Vital Signs c. Obtain a stat 12 lead electrocardiogram EKG d. Initiate intravenous access Assess the client in bed, assess vital signs, initiate IV access, obtain 12 lead EKG
Which information will the nurse teach a patient who has been newly diagnosed with Graves' disease?
Restriction of iodine intake is needed to reduce thyroid activity
Identify the following 6 second cardiac Rhythm strip
Sinus Bradycardia
A patient who has hyperthyroidism is treated with radioactive iodine (RAI) What information should the nurse include in discharge teaching?
Symptoms of hypothyroidism will occur as the RAI therapy takes effect
A staff member says she is really busy and asks the charge nurse to double-check a dose of insulin which she has drawn up the nurse holds up a bottle of lente insulin but the charge nurse notices a bottle of Lantus insulin on the medication car. This nurse has made multiple medication errors in the charge nurse is concerned that she isn't safe. What should the charge nurse do?
Tell the nurse that she'd like to start at the beginning to be on the safe side
Which assessment finding for an adult admitted with Graves' Disease requires the most rapid intervention by the nurse?
Temperature 103.8° F
Which assessment finding in a patient who had a bilateral adrenalectomy requires the most rapid action by the nurse?
The blood pressure (BP) is 88/50 mm Hg
Which information is most important for the nurse to communicate rapidly to the health care provider about a patient possible syndrome of inappropriate antidiuretic hormone (SIADH)?
The patient has a serum sodium level of 118 mEq/L
The nurse is caring for a patient admitted with diabetes insipidus (DI). Which information is most important to report to the health care provider?
The patient is confused and lethargic
Which additional information will the nurse need to consider when reviewing the laboratory results for a patient's total calcium level?
The serum albumin
Which laboratory value should the nurse review to determine whether a patient's hypothyroidism is caused by a problem with the pituitary gland?
Thyroid-stimulating hormone (TSH) level
A client is returned to his room after a subtotal thyroidectomy. Space which piece of equipment is most important for the nurse to keep at the client's bedside?
Tracheostomy set
And unemployed client cannot afford prescription medications and has not taken the prescribed levothyroxine for some time. The client reports I've been getting sick or by the day which symptom is most likely related to not taking this medication?
Tympanic temperature of 94
A client with a new ileal conduit asks what the disadvantages are to this type of stoma. The nurse explains that the client may experience which disadvantage?
Urine drains from it continuously
The client with a head injury receives Mannitol during surgery to help decrease intracranial pressure. Which finding indicates that the drug is having the desired effect?
Urine output increases
A lethal rhythm is identified by the CCU nurse when viewing her patients monitor. Knowing that this Rhythm usually occur in diseased hearts or in patients with hypokalemia and requires immediate treatment to prevent a terminal event the nurse identifies this Rhythm as?
Ventricular tachycardia
After completion of peritoneal dialysis, the nurse should assess the client for?
Weight loss
A client is admitted to the healthcare facility with acute chest pain when obtaining the client's health history which question would be most helpful for the nurse to ask?
What were you doing when the pain started
A client is admitted to the healthcare facility with acute chest pain. When obtaining the client's health history which question would be most helpful for the nurse to ask?
What were you doing when the pain started
