NURS 612 Exam 1 (Perioperative, Diabetes, Endocrine)
A nurse is caring for a client who has primary renal insufficiency and is preparing to undergo an ACTH stimulation test. Which of the following findings should the nurse expect after IV injection of cosyntropin? A. No change in plasma cortisol B. Elevated fasting blood glucose C. Decrease in sodium D. Increase in urinary output
A
A nurse is preparing to recieve a client from the PACU who is postoperatively following a thyroidectomy. The nurse should ensure which of the following equipment is available? (Select all that apply.) A. Suction equipment B. Humidified oxygen C. Flashlight D. Tracheostomy tray E. Chest tube tray
A, B, D
A client is scheduled for elective surgery. To prevent the complications of hypotension and cardiovascular collapse, the nurse should report the use of which medication? A. Hydrochlorothiazide B. Prednisone C. Warfarin D. Erythromycin
B
A nurse in a provider's office is reviewing laboratory values of a client who is being evaluated for secondary hypothyroidism. Which of the following laboratory findings is expected for a client who has this condition? A. Elevated serum T4 B. decreased serum T3 C. elevated serum thyroid stimulating hormone D. decreased serum cholesterol
B
A nurse in a provider's office is reviewing the medical record of a client who is being evaluated for Grave's disease. The nurse should identify which of the following laboratory results as expected findings? A. Decreased thyrotropin receptor antibodies B. Decreased TSH C. Decreased free thyroxine index D. Decreased triiodothyronine
B
A nurse is assessing a client during a water deprivation test. For which of the following complications should the nurse monitor the client? A. Bradycardia B. Orthostatic hypotension C. Neck vein distention D. Crackles in the lungs
B
A nurse is caring for a client who has diabetes insipidus. Which of the following urinalysis laboratory findings should the nurse anticipate? a. absence of glucose b. decreased specific gravity c. presence of ketones d. presence of red blood cells
B
A nurse is reviewing laboratory reports of a client who has HHS. The nurse should expect which of the following findings? a. Serum pH 7.2 b. Serum osmolarity 350 mOsm/L c. Serum potassium 3.8 mg/dL d. Serum creatinine 0.8mg/dL
B
ADH is secreted by which gland? A. Anterior pituitary B. Posterior pituitary C. Adrenal D. Thyroid
B
A nurse is assessing a client who has diabetic ketoacidosis and ketone in the urine. The nurse should expect which of the following findings? (Select all that apply.) a. Weight gain b. fruity odor of breath c. abdominal pain d. kussmaul's respirations e. metabolic acidosis
B, C, D, E
A nurse is collecting an admission history from a female client who has hypothyroidism. Which of the following findings should the nurse expect? (Select all that apply.) A. Diarrhea B. Menorrhagia C. Dry skin D. Increased libido E. Hoarsness
B, C, E
A nurse is reviewing the manifestations of hyperthyroidism with a client. Which of the following findings should the nurse include? (Select all that apply.) A. Anorexia B. Heat intolerance C. Constipation D. Palpitations E. Weight loss F. Bradycardia
B, D, E
The nurse is concerned that a postoperative patient may have a paralytic ileus. What assessment data may indicate that the patient does have a paralytic ileus? A. Abdominal tightness B.Abdominal distention C.Absence of peristalsis D.Increased abdominal girth
C
A nurse is assessing a client who is 12 hr postoperative following a thyroidectomy. The nurse should identify which of the following findings as indicative of thyroid crisis? (Select all that apply.) a. bradycardia b. hypothermia c. dyspnea d. abdominal pain e. mental confusion
C, D, E
A nurse is assessing a client's laboratory values before surgery. Which of the following results should the nurse report to the provider? (Select all that apply.) a. Potassium 3.9 mEq/L b. Sodium 145 mEq/L c. Creatinine 2.8 mg/dL d. Blood glucose 235 mg/dL e. WBC 17,850/mm
C, D, E
A client receives a daily injection of glargine insulin at 7:00 a.m. When should the nurse monitor this client for a hypoglycemic reaction? a. Between 8:00 and 10:00 a.m. b. Between 4:00 and 6:00 p.m. c. Between 7:00 and 9:00 p.m. d. This insulin has no peak action and does not cause a hypoglycemic reaction.
D
A patient develops malignant hyperthermia. Which of the following most likely would be the first indicator of this complication? A. Body temperature rise of 2 degrees F B. Tentanus-like jaw movements C. Generalized muscle rigidity D. Heart rate over 150 beats per minute
D
A nurse is caring for a client who develops malignant hyperthermia. Which of the following actions should the nurse take? SELECT ALL THAT APPLY. a. infuse iced IV fluids b. provide 100% oxygen c. place the client on a cooling blanket d. treat the complication while continuing surgery e. administer IV Dantrolene
a, b, c, e
A nurse is assisting an anesthesiologist in the delivery of nitrous oxide by face mask to a client during the induction of anesthesia. Which of the following is the priority nursing action? a. Assess oxygen saturation b. Measure BP c. Palpate pulse rate d. check temperature
a. assess oxygen saturation
A client is scheduled to have surgery to address a cleft palate. The nurse will be preparing this client for which type of surgery? a. reconstructive b. corrective c. diagnostic d. prophylactic
a. reconstructive
A client diagnosed with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is stabilized and prepared for discharge. When preparing the client for discharge and home management, which statement indicates that the client understands his condition and how to control it? A. "I can avoid getting sick by not becoming dehydrated and by paying attention to my need to urinate, drink, or eat more than usual." B. "If I experience trembling, weakness, and headache, I should drink a glass of soda that contains sugar." C. "I will have to monitor my blood glucose level closely and notify the physician if it's constantly elevated." D. "If I begin to feel especially hungry and thirsty, I'll eat a snack high in carbohydrates."
A
A client has been brought to the emergency department by paramedics after being found unconscious. The client's Medic Alert bracelet indicates that the client has type 1 diabetes and the client's blood glucose is 22 mg/dL (1.2 mmol/L). The nurse should anticipate what intervention? a. 1 amp of D50 b. 2 glucose tablets c. 4 oz of orange juice and peanut butter crackers d. 2 packets of glucose gel
A
A nurse in a provider's office is assessing a client who has hypothyroidism and recently began treatment with thyroid hormone replacement therapy. Which of the following findings should indicate to the nurse that the client might need a decrease in the dosage of medication? A. hand tremors B. bradycardia C. pallor D. Slow speech
A
A nurse is caring for a client who is scheduled for an exploratory laparotomy. The client's temperature is 102.2 orally. Which of the following actions should the nurse take? a. Inform the surgeon of the elevated temperature b. transfer the client to the preoperative unit c. apply ice packs to the groin d. encourage the client to increase intake of clear liquids
A
A nurse is caring for a client who reports nausea and vomiting 2 days postoperative following a hysterectomy. Which of the following actions should the nurse perform first? a. Assess bowel sounds b. administer antiemetic medications c. restart prescribed IV fluids D. insert a prescribed nasogastric tube
A
A nurse is reviewing laboratory findings for a client who might have hyperthyroidism. The nurse should identify an elevation which of the following substances as an indication that the client has this disorder? A. Triiodothyronine B. Plasma-free metanephrine C. Urine cortisol D. Urine osmolality
A
A nurse suspects malignant hyperthermia in a patient who underwent surgery approximately 18 hours ago. Which of the following would the nurse identify as a late, ominous sign? A. Rapid rise in body temperature B. Oliguria C. Tachycardia D. Muscle rigidity
A
A patient has been diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following manifestations would be expected in this patient? A. Concentrated urine B. Dilute urine C.Hypernatremia D. Increased serum osmolality
A
A patient with renal failure is scheduled for a surgical procedure. When would surgery be contraindicated for this patient due to laboratory results? A. A blood urea nitrogen level of 42 mg/dL B. A creatine kinase level of 120 U/L C. A serum creatinine level of 0.9 mg/dL D. A urine creatinine level of 1.2 mg/dL
A
A postoperative client is experiencing a flash pulmonary edema. What finding in the client's sputum is consistent with this problem? A. Pink color B. Copious red blood in the sputum C. Foul smell D. Pieces of vomitus
A
During the preoperative assessment, the client mentions allergies to avocados, bananas, and hydrocodone. What is the priority action by the nurse? A. Notify the surgical team to remove all latex-based items. B. Notify the dietary department. C. Notify the physician regarding postoperative pain medications. D. Notify the nurse manager to follow up on the procedure.
A
Which are correct statements about the relationship between the hypothalamus and the pituitary gland? Select all that apply. A. Many endocrine glands respond to stimulation from the pituitary gland, which is connected by a stalk to the hypothalamus in the brain. B.Under the influence of the hypothalamus, the lobes of the pituitary gland secrete various hormones. C. The pituitary gland is called the master gland because it regulates the function of the hypothalamus and other endocrine glands. D. The hypothalamus is called the master gland because it regulates the function of the pituitary gland.
A, B
Which hormones are secreted by the posterior lobe of the pituitary gland? Select all that apply. A. Vasopressin B. Oxytocin C. Thyroid-stimulating hormone (TSH) D. Follicle-stimulating hormone (FSH) E. Luteinizing hormone (LH)
A, B
The nurse is educating the patient with diabetes about the importance of increasing dietary fiber. What should the nurse explain is the rationale for the increase? Select all that apply. a. May improve blood glucose levels b. Decrease the need for exogenous insulin c. Help reduce cholesterol levels d. May reduce postprandial glucose levels e. Increase potassium levels
A, B, C
A nurse is an intensive care unit is planning care for a client who has myxedema coma. Which of the following actions should the nurse include? (Select all that apply.) A. Observe cardiac monitor for dysrythmias B. Observe for evidence of urinary tract infections C. Initiate IV fluids for using 0.9% sodium chloride D. Administer a levothyroxine IV bolus E. Provide warmth using a heating bad
A, B, C, D
A nurse is reviewing the health records of several clients in the PACU to identify risk factors that can lead to postoperative complications. Which of the following clients are at risk for complications? (Select all that apply.) a. A client who has a WBC of 22,500/uL b. A client who uses an insulin pump c. A client who takes warfarin daily d. A client who has heart failure e. A client who has a BMI of 26
A, B, C, D
A nurse is reviewing the heath record of a client who has hyperglycemic-hyperosmolar state (HHS). The nurse should identify that which of the following data confirm this diagnosis? (Select all that apply.) a. Evidence of recent myocardial infarction b. BUN 35 mg/dL c. Age 77 years d. Takes calcium channel blocker e. no insulin production
A, B, C, D
A nurse who is caring for a female client who mainfest indications of hypovolemia while in the PACU. Which of the following findings requires action by the nurse? a. urine output less than 25mL/hr b. hematocrit 48% c. BUN 24 mg/dL d. tenting of skin over the sternum e. apical pulse rate 62/min
A, B, C, D
A nurse is caring for an older adult client who has type 2 diabetes mellitus. She suspects that the patient is exhibiting symptoms of diabetic ketoacidosis (DKA) instead of hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Which of the following are indicators of a diagnosis of DKA? Select all that apply. a. Blood glucose level of 280 mg/dL b. Arterial pH of 7 c. Plasma bicarbonate level of 26 mmol/L d. Serum osmolality of 380 mOsm/L e. Plasma bicarbonate level of 13 mEq/L
A, B, C, D, E
A nurse prepares teaching for a client with newly-diagnosed diabetes. Which statements about the role of insulin will the nurse include in the teaching? Select all that apply. a. "Insulin permits entry of glucose into the cells of the body." b. "Insulin promotes synthesis of proteins in various body tissues." c. "Insulin promotes the storage of fat in adipose tissue." d. "Insulin interferes with glucagon from the pancreas." e. "Insulin interferes with the release of growth hormone from the pituitary."
A, B, C, D, E
Which of the following is a risk factor for the development of diabetes mellitus? Select all that apply. a. Hypertension b. Obesity c. Family history d. Age greater of 45 years or older e. History of gestational diabetes
A, B, C, D, E
A nurse is planning care for a client to prevent postoperative atelectasis. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) a. encourage use of incentive spirometer every 2 hours b. instruct the client to splint the incision when coughing and deep breathing c. reposition the client every 2 hours d. administer antibiotic therapy e. assist with early ambulation
A, B, C, E
A nurse is presenting information to a group of clients about nutrition habits that prevents type 2 diabetes mellitus. Which of the following should the nurse include in the information? (Select all that apply.) a. Eat less meat and processed foods b. decrease intake of saturated fats c. increase daily fiber intake d. limit saturated fat intake to 15% of daily caloric intake e. include omega-3-fatty acids in the diet
A, B, C, E
A nurse is providing discharge teaching to a client who has experienced diabetic ketoacidosis. Which of the following information should the nurse include in the teaching? (Select all that apply.) a. drink 2 L fluids daily b. monitor blood glucose every 4 hrs when ill c. administer insulin as prescribed when ill d. notify the provider when blood glucose is 200 mg/dL e. report ketones in the urine after 24 hours of illness
A, B, C, E
A nurse in a provider's office is planning care for a client who has a new diagnosis of Graves' disease and a new prescription for methimazole. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) a. Monitor CBC b. monitor Triiodothyronine (T3) c. Instruct the client to increase consumption of shellfish d. advise the client to take the medication at the same time everyday E. inform the client that an adverse effect of this medication is iodine toxicity.
A, B, D
A nurse is providing preoperative teaching to a client who is to have abdominal surgery. Which of the following statements should the nurse make? (Select all that apply.) a. "Take your heart medication with a sip of water before surgery." b. "Splint the abdominal incision with a pillow when coughing and deep breathing." c. "Bed rest is recommended for the first 48 hours." d. "Anti embolism stockings are applied before surgery." e. "you may eat solid food up to 4 hours before surgery."
A, B, D
A nurse is caring for a client who has SIADH. Which of the following findings should the nurse expect? (Select all that apply.) a. decreased serum sodium b. urine specific gravity 1.001 c. serum osmolarity 230 mOsm/L d. polyuria e. increased thirst
A, C
A nurse is reviewing the health record of a client who has SIADH. Which of the following laboratory findings should the nurse expect? (Select all that apply.) A. Low sodium B. High potassium C. Increased urine osmolality D. High urine sodium E. Increased urine specific gravity
A, C, D, E
Which intervention should the nurse implement during the intraoperative period to protect the client from injury? Select all that apply. A. Verify scheduled procedure with client. B. Administer anti-anxiety medication. C. Cover the client with warm blankets. D. Assess the client for allergies. E. Confirm the consent form is signed.
A, D, E
During the admission history the client reports to the nurse of taking the usual dose of warfarin the previous day. What is an appropriate nursing action? a. Notify the surgeon that the client took warfarin the day before surgery. b. No action is needed, because the client takes warfarin on a continuing basis. c. Put a note on the preoperative checklist before sending the client into surgery. d. Tell the client to inform the circulating nurse before the anesthesia is administered.
A.
A client has just been diagnosed with type 2 diabetes. The health care provider has prescribed an oral antidiabetic agent that will inhibit the production of glucose by the liver and thereby aid in the control of blood glucose. What type of oral antidiabetic agent did the health care provider prescribe for this client? a. A sulfonylurea b. A biguanide c. A thiazolidinedione d. An alpha-glucosidase inhibitor
B
A client is scheduled for an invasive procedure. What priority documentation is needed regarding the procedure? A. A health history obtained by the primary physician B. A signed consent form from the client C. The medication reconciliation form D. Prescriptions for postoperative medications
B
A nurse has been caring for a client newly diagnosed with diabetes mellitus. The client is overwhelmed by what he's facing and not sure he can handle giving himself insulin. This client has been discharged and the charge nurse is insisting the nurse hurry because she needs the space for clients being admitted. How should the nurse handle the situation? A. Suggest the client find a supportive friend or family member to assist in his care. B. Ask the physician to delay the discharge because the client requires further teaching. C. Tell the charge nurse she doesn't believe this client will be safe and refuse to rush. D. Ask the physician for a referral for a diabetes nurse-educator to see the client before discharge.
B
A nurse is caring for a client who asks why the provider bases his medication regimen on his HbA1c instead of log of morning fasting blood glucose results. Which of the following responses should the nurse make? A. HbA1c measures how well insulin is regulating your blood glucose between meals B. HbA1c indicates how well your have regulated your blood glucose over that past 120 days C. HbA1c is the first test prescribed to determine that you have diabetes D. HbA1c determines if your doctor should adjust your insulin dosage
B
A nurse is completing an assessment of a client with suspected acromegaly. To assist in making the diagnosis, which question should the nurse ask? A. "Have you had a recent head injury?" B. "Has your shoe size increased recently?" C. "Do you experience skin breakouts?" D. "Is there any family history of acromegaly?"
B
A nurse is providing instructions to a client who has Graves' disease and has a new prescription for propranolol. Which of the following information should the nurse include? A. An adverse effect of this medication in jaundice B. Take your pulse before each dose C. The purpose of this medication is to decrease production of thyroid hormones. D. You should stop taking this medication if you have a sore throat.
B
During the care of a preoperative client, the nurse has given the client a preoperative benzodiazepine. The client is now requesting to void. What action should the nurse take? A. Assist the client to the bathroom. B. Offer the client a bedpan or urinal. C. Wait until the client gets to the operating room and is catheterized. D. Have the client go to the bathroom.
B
During the surgical procedure, the client exhibits tachycardia, generalized muscle rigidity, and a temperature of 103°F. The nurse should prepare to administer: A. verapamil (Isoptin) B. dantrolene sodium (Dantrium) C. potassium chloride D. acetaminophen suppository
B
Glycosylated hemoglobin reflects blood glucose concentrations over which period of time? a. 1 month b. 3 months c. 6 months d. 9 months
B
The nurse has administered preanesthetic medication. What action should the nurse take next? A. Obtain the client's signature on the consent form. B. Place the client on bed rest with the side rails up. C. Review the client's list of home medications. D. Educate the client on discharge instructions.
B
The nurse is caring for a client in the postanesthesia care unit (PACU). The client has the following vital signs: pulse 115, respirations 20, oral temperature 97.2°F, blood pressure 84/50. What should the nurse do first? A. Notify the physician. B.Assess for bleeding. C.Increase rate of IV fluids. D. Review the client's preoperative vital signs.
B
a nurse is preparing to administer a morning dose of insulin aspart to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse implement? a. check blood glucose immediately after breakfast b. administer insulin when breakfast arrives c. hold breakfast for 1 hr after insulin administration d. clarify the prescription because insulin should not be administered at this time
B
A nurse is reinforcing teaching with a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Weight gain is expected while taking this medication B. Medication should not be discontinues without the advice of the provider C. Follow-up serum TSH levels should be obtained D. Take the medications on an empty stomach E. Use fiber laxatives for constipation
B, C, D
A client asks about the purpose of withholding food and fluid before surgery. Which response by the nurse is appropriate? A. It prevents overhydration and hypertension. B. It decreases urine output so that a catheter will not be needed. C. It prevents aspiration and respiratory complications. D. It decreases the risk of elevated blood sugar and slow wound healing.
C
A client with nausea and vomiting is to receive an antiemetic that inhibits the vomiting center in the brain. Which of the following would the nurse expect the physician to order most likely? A. Odansetron (Zofran) B.Hydroxyzine (Vistaril) C. Prochlorperazine (Compazine) D. Promethazine (Phenergan)
C
A client with type 1 diabetes has been on a regimen of multiple daily injection therapy. He's being converted to continuous subcutaneous insulin therapy. While teaching the client about continuous subcutaneous insulin therapy, the nurse should tell him that the regimen includes the use of: A. intermediate- and long-acting insulins. B. short- and long-acting insulins. C. rapid-acting insulin only. D. short- and intermediate-acting insulins.
C
A nurse is preparing to administer IV fluids to a client who has diabetic ketoacidosis. Which of the following actions should the nurse take? a. Administer an IV infusion of regular insulin at 0.3 units/kg/hr b. administer an IV infusion of 0.45% sodium chloride c. rapidly administer an IV infusion of 0.9% sodium chloride d. add glucose to the IV infusion when serum glucose is 350 mg/dL
C
A nurse is preparing to administer morning doses of insulin glargine and regular insulin to a client who has a blood glucose 278 mg/dL. Which of the following actions should the nurse take? a. Draw up the regular insulin and then the glargine insulin in the same syringe b. draw up the glargline insulin then the regular insulin in the same syringe c. draw up and administer regular and glargine insulin in separate syringes d. administer the regular insulin wait 1 hour and then administer the glargine insulin
C
A nurse obtains a fingerstick glucose level of 45 mg/dl on a client newly diagnosed with diabetes mellitus. The client is alert and oriented, and the client's skin is warm and dry. How should the nurse intervene? a. Give the client 4 oz of milk and a graham cracker with peanut butter. b. Obtain a serum glucose level. c. Obtain a repeat fingerstick glucose level. d. Notify the physician.
C
A patient is prescribed Glucophage, an oral antidiabetic agent classified as a biguanide. The nurse knows that a primary action of this drug is its ability to: a. Stimulate the beta cells of the pancreas to secrete insulin. b. Decrease the body's sensitivity to insulin. c. Inhibit the production of glucose by the liver. d. Increase the absorption of carbohydrates in the intestines.
C
Health teaching for a patient with diabetes who is prescribed Humulin N, an intermediate NPH insulin, would include which of the following advice? a. "Your insulin will begin to act in 15 minutes." b. "You should expect your insulin to reach its peak effectiveness by 12 noon if you take it at 8:00 AM." c."You should take your insulin after you eat breakfast and dinner." d. "Your insulin will last 8 hours, and you will need to take it three times a day."
C
A nurse is teaching a foot care to a client who has diabetes mellitus. Which of the following information should the nurse include in the teaching? (Select all that apply.) a. Remove calluses using OTC remidies b. apply lotion between the toes c. perform nail care after bathing d. trim toenails straight across e. wear closed toed shoes
C, D, E
A nurse is caring for a client who arrived in the PACU following a total hip arthroplasty. The client is not responding to verbal stimuli. Which of the following actions should the nurse perform first? a. compare and contrast peripheral pulses b. apply a warm blanket c. assess dressings d. place the client in a lateral position
D
A nurse is planning care for client who has acromegaly and is postoperative following a transsphenoidal hypophysectomy. Which of the following interventions should the nurse include in the plan? a. maintain the client in a low-Fowler's position b. encourage deep breathing and coughing c. encourage the client to brush his teeth when awake and alert d. observe drainage for the presence of glucose
D
A nurse is providing teaching to a client who has a new diagnosis of diabetes insipidus. Which of the following client statements indicates an understanding of treatment? A. I can drink up to 2 quarts of fluid per day B. I will need to use insulin to control my blood glucose levels C. I should expect to gain weight during this illness D. Muscle weakness is a symptom of diabetes insipidus
D
A preoperative nurse is caring for a client who is having a colon resection. Which of the following actions should the nurse take? a. encourage the client to void after preoperative medication b. administer antibiotics 2 hr prior to surgical incision c. remove hair using a manual razor d. remove nail polish on fingers and toes
D
An older adult client with type 2 diabetes is brought to the emergency department by his daughter. The client is found to have a blood glucose level of 600 mg/dL (33.3 mmol/L). The client's daughter reports that the client recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing action would be a priority? A. Administration of antihypertensive medications B. Administering sodium bicarbonate intravenously C. Reversing acidosis by administering insulin D. Fluid and electrolyte replacement
D
Following a splenectomy, a client has a hemoglobin (Hb) level of 7.5 g/dl and has vertigo when getting out of bed. The nurse suspects abnormal orthostatic changes. The vital sign values that most support the nurse's analysis are: A. blood pressure of 150/100 mm Hg and pulse of 130 beats/minute. B. blood pressure of 150/100 mm Hg and pulse of 50 beats/minute. C. blood pressure of 80/40 mm Hg and pulse of 50 beats/minute. D. blood pressure of 80/40 mm Hg and pulse of 130 beats/minute.
D
The nurse is caring for a 78-year-old female client who is scheduled for surgery to remove her brain tumor. The client is very apprehensive and keeps asking when she will get her preoperative medicine. The medicine is ordered to be given "on call to OR." When would be the best time to give this medication? A. As soon as possible, in order to alleviate the client's anxiety B. As the client is transferred to the OR bed C. When the porter arrives on the floor to take the client to surgery D. After being notified by the OR and before other preoperative preparations
D
The nurse recognizes that the client most at risk for mortality associated with surgery is the: A. Client who is obese B. Client with chronic alcoholism C. Client with controlled diabetes D. Client with controlled hypertension
B
The nurse should know that, postoperatively, a general anesthetic is primarily eliminated via what organ(s)? A. The kidneys B. The lungs C. The skin D. The liver
B
A group of students are reviewing information about the relationship of the hypothalamus and the pituitary gland. The students demonstrate the need for additional study when they state which of the following? A. "The pituitary gland, as the master gland, controls the secretion of hormones by the hypothalamus." B. "The hypothalamus, a portion of the brain between the cerebrum and brain stem, creates a pathway for neurohormones." C. "Corticotropin-releasing hormone from the hypothalamus triggers ACTH secretion by the pituitary gland." D. "The hypothalamus secretes releasing hormones that stimulate or inhibit pituitary gland secretions."
A
An example of a curative surgical procedure is A. a biopsy. B. a face-lift. C. tumor excision. D. placement of gastrostomy tube.
C
A nurse is verifying informed consent for a client who is having a paracentesis. Which of the following actions should the nurse take? (Select all that apply.) A. Explain to the client the purpose of having the procedure. B. Inform the client of risks to having the procedure. C. Ensure the client understands information about the procedure. D. Witness the client signing the informed consent form. E. Determine if the client is capable of understanding the reason for the procedure.
C, D, E
A nurse is caring for a client who develops a systemic toxic reaction following a regional block. Which of the following actions should the nurse take? a. monitor serum creatinine levels b. provide airway support c. turn the client to the right side d. administer 0.9% sodium chloride 500mL IV bolus
b. provide airway support
A nurse is caring for a client who has a blood glucose 52 mg/dL. The client is lethargic but arousable. Which of the following actions should the nurse perform first? a. recheck blood glucose in 15 mins b. provide a carbohydrate and protein c. provide 4oz grape juice d. report findings to the provider
c
A nurse administered midazolam IV bolus to a client before a procedure. His BP is 86/40 mm Hg, and his pulse is 134/min. Which of the following IV medication should the nurse administer? a. Naloxone b. Morphine c. Flumazenil d. Atropine
c. Flumazenil
A nurse is caring for a client who reports a headache following an epidural regional nerve block. Which of the following actions should the nurse take? a. decrease the client's fluid intake b. apply pressure to the puncture site c. place the head of the bed flat d. instruct the client to lie prone
c. place the head of the bed flat
In which instance may a surgeon operate without informed consent? a. Invasive procedures b. Emergency situations c. Procedures requiring sedation d. Radiologic procedures
B. Emergency situations
The nurse is triaging surgical clients. Which client would the nurse document as in need of urgent surgical care? A. A client scheduled for cosmetic surgery B. A client needing cataract surgery C. A client with an acute gallbladder infection D. A client with severe bleeding
C
Nursing students are reviewing information about agents used for anesthesia. The students demonstrate understanding when they identify which of the following as an inhalation anesthetic? A. Halothane B. Fentanyl C. Succinylcholine D. Propofol
A
The nurse recognizes that the client who takes hydrochlorothiazide to manage hypertension is predisposed for which interaction with anesthesia? A. Respiratory depression B. Hypotension C. Increased risk of bleeding D. Seizures
A
When the dawn phenomenon occurs, the patient has relatively normal blood glucose until approximate what time of day? a. 3 AM b. 5 AM c. 7 AM d. 9 AM
A
Which of the following clinical signs are associated with diabetes insipidus? A. Hypotension B.Hypertension C. Bradycardia D. Oliguria
A
Which statement about fluid replacement is accurate for a client with hyperosmolar hyperglycemic nonketotic syndrome? a. Administer 2 to 3 L of IV fluid rapidly. b. Administer 10 L of IV fluid over the first 24 hours. c. Administer a dextrose solution containing normal saline solution. d. Administer IV fluid slowly to prevent circulatory overload and collapse.
A
A characteristic of type 2 diabetes includes which of the following? a. No islet cell antibodies b. Often have islet antibodies c. Little insulin d. Ketosis-prone when insulin absent
A
The nurse is educating a client scheduled for elective surgery. The client currently takes aspirin daily. What education should the nurse provide with regard to this medication? a. Continue to take the aspirin as ordered. b. Take half doses of the aspirin until 1 week after surgery. c. Aspirin should be increased until 3 days before surgery, then it should be discontinued until 3 days after surgery. d. Stop taking the aspirin 7 days before the surgery, unless otherwise directed by your physician.
D.
