practice quiz week 5 and 6

a nurse is reviewing guidelines to prevent DKA during periods of illness with a client who has type 1 DM. Which of the following instructions should the nurse include in the teaching? "Test your blood glucose level every 8 hours." "Check your urine for ketones when blood glucose levels are greater than 240 mg/dL." "Withhold your usual daily dose of insulin." "Drink 240 to 360 milliliters of calorie-free liquids every 8 hours."

"Check your urine for ketones when blood glucose levels are greater than 240 mg/dL."

the nurse is discharging a client from the hospital who has a new prescription for furosemide. Which of the following client statements indicates an understanding of the teaching? "I should eat a diet low in potassium while taking this medication." "I should limit my fluid intake while taking this medication." "My blood pressure will increase while I am taking this medication." "I need to limit my sun exposure and wear sunscreen while on this medication."

"I need to limit my sun exposure and wear sunscreen while on this medication." Limiting sun exposure and wearing sunscreen are appropriate while taking furosemide due to the adverse effect of photosensitivity.

a nurse is teaching a client who has DM about the manifestations of hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching? "I will feel shaky." "I will be more thirsty than usual." "My skin will be warm and moist." "My appetite will be decreased."

"I will feel shaky."

a nurse is providing discharge teaching to a client who will be receiving TPN at home. Which of the following instructions should the nurse include? SATA "Keep the TPN refrigerated when not in use." "Infuse 10 percent dextrose and water if the solution runs out." "Shake the TPN bag with fat emulsion if precipitate is present." "Stop using TPN once weight gain is achieved." "Maintain TPN infusion rate when behind schedule."

"Keep the TPN refrigerated when not in use." "Infuse 10 percent dextrose and water if the solution runs out." "Maintain TPN infusion rate when behind schedule."

a nurse in an ED is caring for a client who has DKA and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider? Glucocorticoid medications Dextrose 5% in 0.45% sodium chloride Oral hypoglycemic medications 0.9% sodium chloride IV bolus

0.9% sodium chloride IV bolus

a nurse is working for a home health agency is teaching a client who has DM about disease management. Which of the following glycoylated hemoglobin (HbA1c) values should the nurse include in the teaching as an indicator that the client is appropriately controlling his glucose levels? 6.3% 7.8% 8.5% 10%

6.3% The client who has diabetes mellitus needs to manage activity and diet while monitoring blood glucose levels. High levels of blood glucose cause damage to the macro and microcirculation, affecting such things as eyesight and kidney function. The goal for a client who has diabetes mellitus is to keep the HbA1c values at 6.5% or less.

a nurse is preparing to administer TPN 1800 mL to infuse over 24 hr. The nurse should set the IV pump to deliver how many ml/hr? (round whole number)

75 ml/hr 1800/24 hr = 75

a nurse is assessing clients in a health clinic for risk factors for contracting hepatitis. Which of the following clients is at risk for developing hep C? A client who eats raw shellfish A client who has multiple tattoos A client who works in a child care center A client who has recently traveled to a underdeveloped country

A client who has multiple tattoos.

a nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective? A decrease in blood sugar. A decrease in blood pressure. A decrease in urine output. A decrease in specific gravity.

A decrease in urine output. The major manifestations of diabetes insipidus are excessive urination and extreme thirst. Vasopressin is used to control frequent urination, increased thirst, and loss of water associated with diabetes insipidus. A decreased urine output is the desired response.

a nurse is caring for a client who has diabetic ketoacidosis. Which of the following manifestations should the nurse expect? Malignant hypertension Acetone odor to breath Cheyne-Stokes breathing Blood glucose level below 40 mg/dL

Acetone odor to breath

a nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? SATA Administer furosemide. Administer warfarin. Implement a low-sodium diet. Measure the client's abdominal girth. Encourage weight lifting during physical therapy.

Administer furosemide. Implement a low-sodium diet. Measure the client's abdominal girth.

a nurse is monitoring a client who is postop following a thyroidectomy. Which of the following data should the nurse identify as the priority to monitor? Airway patency. Temperature. Urination. Pain control.

Airway patency.

a nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The client states, "I don't need this medication. I am not constipated." The nurse should explain that in clients who have cirrhosis, lactulose is used to decrease levels of which of the following components in the bloodstream? Glucose Ammonia Potassium Bicarbonate

Ammonia Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma.

a nurse is reviewing the lab data of a client who has acute pancreatitis. The nurse should expect to find an elevation of which of the following values? Calcium RBC count Magnesium Amylase

Amylase

a nurse is preparing dietary instructions for a client who has episodes of biliary colic from chronic cholecystitis. Which of the following instructions should the nurse include in the teaching plan? Include foods high in starch and proteins. Include foods high in fiber. Avoid foods high in fat. Avoid foods high in sodium.

Avoid foods high in fat.

a nurse is teaching a class about preventative care to clients who are at risk for acquiring viral hepatitis. Which of the following information should the nurse include in the presentation? Avoid covering sores with bandages. Avoid handwashing after eating. Avoid foods prepared with tap water. Avoid eating meat.

Avoid foods prepared with tap water.

a nurse is providing dietary teaching for a client who takes furosemide. The nurse should recommend which of the following foods as the best source of potassium? Bananas Cooked carrots Cheddar cheese 2% milk

Bananas

a nurse is providing teaching to a client who has a new diagnosis of type 2 DM. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? SATA Polyuria Blurred vision Polydipsia Tachycardia Moist, clammy skin

Blurred vision Tachycardia Moist, clammy skin

a nurse is planning care for a client who is postop following a thyroidectomy. Which of the following interventions should the nurse include in the plan? Instruct the client to deep breathe every 4 hr. Check the client's voice every 2 hr. Place the head of the client's bed in the flat position. Hyperextend the client's neck.

Check the client's voice every 2 hr.

a nurse is planning care for a client who has a new dx of diabetes insipidus. Which of the following interventions should the nurse include in the plan of care? Measure blood glucose levels every 4 hr. Administer a diuretic. Initiate fluid restrictions. Check urine specific gravity.

Check urine specific gravity.

a nurse is caring for a client who is 1 day postop following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client? Chvostek's sign Babinski's sign Brudzinski's sign Kernig's sign

Chvostek's sign

a nurse is assessing a client who has DM. Which of the following findings is a manifestation of hypoglycemia? Bradycardia. Cool, clammy skin. Vomiting. Fruity odor on the client's breath.

Cool, clammy skin.

a nurse is planning care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include in the plan of care? Decrease the client's fluid intake. Increase the client's saturated fat intake. Increase the client's sodium intake. Decrease the client's carbohydrate intake.

Decrease the client's fluid intake.

A nurse is caring for a client who has hypoglycemia. The nurse should monitor the client for which of the following adverse effects of hypoglycemia? Decreased blood pressure. Increased urination. Fever. Metabolic acidosis.

Decreased blood pressure

a nurse is reviewing the lab results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect? Decreased sodium level Decreased phosphate level Decreased potassium level Decreased chloride level

Decreased sodium level The nurse should expect a decreased sodium level. Spironolactone is a potassium-sparing diuretic that inhibits the action of aldosterone, resulting in an increased excretion of sodium.

a nurse is assessing a client who has Diabetes insipidus. Which of the following findings should the nurse expect? Dehydration Polyphagia Hyperglycemia Bradycardia

Dehydration

a nurse prepares to replace the nearly empty container of TPN for a client when she finds that there has been a delay in receiving the new container of solution from the pharmacy. Which of the solutions should the nurse infuse until the next container of TPN solution becomes available? Lactated Ringer's 3% sodium chloride Dextrose 10% in water 0.9% sodium chloride

Dextrose 10% in water

a nurse is administering an IM injection to a client who has hep C. Before placing the syringe and needle in a puncture-resistant container, which of the following actions should the nurse take? Recap the needle. Place the cap on the bedside table and slide the needle into the cap. Wrap the needle with gauze. Dispose of the needle uncapped.

Dispose of the needle uncapped.

a nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. The nurse recognizes which of the following lab findings as indicating the client's gastrointestinal (GI) tract is digesting and absorbing blood? Elevated blood urea nitrogen (BUN) Elevated HbA1c Decreased chloride Decreased bilirubin

Elevated blood urea nitrogen (BUN). As the body digests blood, BUN rises. An elevated BUN is an indication of GI bleeding.

a nurse is interviewing a client who has acute pancreatitis. Which of the following factors should the nurse anticipate finding in the client's history? Gallstones Hypolipidemia COPD Diabetes mellitus

Gallstones The client's history might reveal biliary obstruction from a gallstone causing bile to inflame the pancreas.

a nurse is preparing a client who is scheduled to undergo a paracentesis. Into which of the following positions should the nurse assist the client for this procedure? High-Fowler's Side-lying Leaning forward Supine

High-Fowler's

a nurse is assessing a client who is receiving TPN. Which of the following findings should the nurse recognize as a complication of this therapy? Hyperglycemia Aspiration Diarrhea Stomatitis

Hyperglycemia TPN is prescribed when extensive nutritional support for prolonged periods of time is required. It is delivered through a central venous access device, usually via the internal jugular or subclavian vein. TPN contains a high concentration of dextrose, which can result in hyperglycemia. Frequent glucose monitoring should be implemented in clients receiving TPN.

a nurse is caring for a client who has esophageal varices and is hypotensive after vomiting 500 mL of blood. which of the following actions is the nurse'es priority? Elevate the client's feet. Increase the client's IV fluid rate. Initiate a dopamine IV infusion for the client. Administer a unit of packed RBCs.

Increase the client's IV fluid rate.

a nurse admits a client to the ED who reports n/v that worsens when he lies down. Antacids do not help. The provider suspects acute pancreatitis. Which of the following lab test results should the nurse expect to see? Decreased WBC Increased serum amylase Decreased serum lipase Increased serum calcium

Increased serum amylase

a nurse is assessing a client who has HF and is prescribed furosemide. Which of the following findings is an adverse effect of this medication? Weight gain Increased blood pressure Hypoglycemia Leg cramps

Leg cramps

a nurse is collecting the medical history from a client who has manifestations of SIADH. The nurse should ask the client if he has a history of which of the following conditions that can cause SIADH? Osteoarthritis Lung cancer Liver cirrhosis Dyspepsia

Lung cancer

a nurse is teaching a client about causes of biliary cirrhosis. Which of the following information should the nurse include in the teaching? Excessive alcohol consumption. Hepatitis C. Hepatotoxic medications. Obstruction of the bile duct.

Obstruction of the bile duct

A nurse is caring for a client who has diabetic ketoacidosis and hypoxia. Which of the following actions should the nurse take first? Obtain a prescription to administer intravenous fluids. Obtain a prescription to administer insulin. Obtain a prescription to check the client's glucose level. Obtain a prescription for supplemental oxygen.

Obtain a prescription for supplemental oxygen.

a nurse is assessing a client who has a craniotomy and has developed syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following manifestations should the nurse anticipate? Hypernatremia Oliguria Weight loss Increased thirst

Oliguria

a nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse anticipate? Initiate a low-residue diet. Pantoprazole 80 mg IV bolus twice daily. Ambulate twice daily. Pancrelipase 500 units/kg PO three times daily with meals.

Pantoprazole 80 mg IV bolus twice daily The nurse should anticipate a provider's prescription for a proton pump inhibitor to decrease gastric acid production, which ultimately decrease pancreatic secretions.

A nurse is caring for a client who acquired hepatitis A from consuming contaminated food. The client's mouth is an example of which of the following links in the chain of infection? Infectious agent Susceptible host Reservoir Portal of entry

Portal of entry

a nurse is caring for a client who has heart failure and a new prescription for furosemide. Which of the following lab values should the nurse review before administering furosemide? Bicarbonate Carbon dioxide Potassium Phosphate

Potassium

a nurse is reviewing the lab results of a client who takes furosemide. Which of the following results should the nurse identify as the priority finding? Potassium 2.9 mEq/L Phosphorous 4.5 mEq/L Sodium 145 mEq/L Calcium 8.2 mg/dL

Potassium 2.9 mEq/L Potassium 3.5-5.0 Phosphorous 2.5-4.5 Sodium 135-145 calcium 9.0-10.5

a nurse is caring for a client who was admitted with bleeding esophageal varices and has an esophagogastric balloon tamponade with a Sengstaken-Blakemore tube to control the bleeding. Which of the following actions should the nurse take? Ambulate the client four times per day. Encourage the client to consume clear liquids. Provide frequent oral and nares care. Keep the client in a supine position.

Provide frequent oral and nares care.

a nurse is planning care for a client who has end-stage cirrhosis of the liver with encephalopathy. Which of the following interventions should the nurse plan to implement to decrease the client's ammonia level? Administer diuretics. Restrict the client's intake of fluids. Reduce the client's intake of protein. Administer vitamin K.

Reduce the client's intake of protein. Ammonia is formed in the gastrointestinal tract by the action of bacteria on protein. Limiting dietary protein intake can assist with decreasing the client's ammonia level. Protein is necessary for healing, so strict limitation of dietary protein is not recommended.

a nurse is caring for an adolescent client who has a long history of DM and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client? NPH insulin. Insulin glargine. Insulin detemir. Regular insulin.

Regular insulin. Regular insulin is classified as a short-acting insulin. It can be given intravenously with an onset of action of less than 30 min. This is the insulin that is most appropriate in emergency situations of severe hyperglycemia or diabetic ketoacidosis.

a nurse is teaching self-management to a client who has hep B. Which of the following instructions should the nurse include in the teaching? You may donate blood 6 months after completing the medication regimen. Consume a high-protein diet. Rest frequently throughout the day. Take acetaminophen every 4 hr, as needed, for discomfort

Rest frequently throughout the day.

a nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following prescriptions should the nurse anticipate? Maintain an IV of 0.45% sodium chloride. Restrict fluid intake to 1,000 mL per day. Provide a diet containing 2 g of sodium per day. Administer desmopressin acetate 0.2 mg orally.

Restrict fluid intake to 1,000 mL per day.

a nurse is caring for a client 1 hr following a subtotal thyroidectomy. In which of the following positions should the nurse place the client? Semi-Fowler's Dorsal recumbent Supine Sims'

Semi-Fowler's

a nurse is assessing a client and discovers the infusion pump with the client's total parenteral nutrition (TPN) solution is not infusing. The nurse should monitor the client for which of the following conditions? Excessive thirst and urination. Shakiness and diaphoresis. Fever and chills. Hypertension and crackles.

Shakiness and diaphoresis

a nurse is caring for a client who requires TPN. Which of the following actions should the nurse take when finding that the TPN solution is infusing too rapidly? Turn the client on his left side. Sit the client upright. Prepare to add insulin to the TPN infusion. Stop the TPN infusion.

Sit the client upright.

a nurse is assessing a client who has diabetes insipidus. Which of the following findings is a manifestation of this diagnosis? Hypertension. Bounding peripheral pulses. Tachycardia. Hyperglycemia.

Tachycardia

A nurse is caring for a client on a medical-surgical unit. Nurses Notes 1515: Oxygen saturation 95%. The client's voice is hoarse. The client reports tingling around the mouth. Moderate serosanguinous drainage noted on neck dressing. The client has a slight tremor noted in both hands. The client's temperature has increased in 1 hr from 37.5° C (99.5° F) to 38.6° C (101.5° F). The client appears restless. A nurse is caring for a client who is postoperative following a subtotal thyroidectomy. Click to highlight the findings below that the nurse should report to the provider. Oxygen saturation 95%. The client's voice is hoarse. The client reports tingling around the mouth. Moderate serosanguinous drainage noted on neck dressing. The client has a slight tremor noted in both hands. The client's temperature has increased in 1 hr from 37.5° C (99.5° F) to 38.6° C (101.5° F).The client appears restless.

The client reports tingling around the mouth. The client has a slight tremor noted in both hands. The client's temperature has increased in 1 hr from 37.5° C (99.5° F) to 38.6° C (101.5° F).The client appears restless.

a client is about to undergo an abdominal paracentesis. In which of the following positions should the nurse place the client? Prone Supine Lateral Upright

Upright

a nurse is providing discharge for a client who has acute pancreatitis and has a prescription for fat-soluble vitamin supplements. The nurse should instruct the client to take a supplement for which of the following? Vitamin A Vitamin B1 Vitamin C Vitamin B12

Vitamin A The nurse should instruct the client that fat-soluble vitamins include vitamins A, D, E, and K. Vitamin B1, Vitamin C, Vitamin B12 = water soluble

a nurse is caring for a client who has cirrhosis and a prothrombin time of 30 seconds. Which of the following medications should the nurse plan to administer? Vitamin K Heparin Warfarin Ferrous sulfate

Vitamin K A prothrombin time of 30 seconds indicates the clotting time is prolonged and bleeding could occur. Vitamin K injection increases the synthesis of prothrombin by the liver; therefore, the nurse should plan to administer vitamin k.

a nurse is caring for a client who has cirrhosis and a new prescription for lactulose. Which of the following manifestations indicates an adverse effect of the medication? Dry mouth Vomiting Headache Peripheral edema

Vomiting