Prepu endocrine
A client has been diagnosed with hyperthyroidism and presents with heat intolerance and a blood pressure of 174/70 mm Hg; she is 3 months pregnant. The nurse anticipates that the physician will order which medication for this client? a) Lisinopril b) Methimazole c) Levothyroxine sodium d) Radioactive iodine
B
The nurse is admitting a client with newly diagnosed diabetes mellitus and left-sided heart failure. Assessment reveals low blood pressure, increased respiratory rate and depth, drowsiness, and confusion. The client reports headache and nausea. Based on the serum laboratory results below, how would the nurse interpret the client's acid-base balance? a) Respiratory alkalosis. b) Metabolic acidosis. c) Metabolic alkalosis. d) Respiratory acidosis.
B
A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse is most accurate in stating: a) "It looks like you aren't following the ordered diabetic diet." b) "The test must be repeated following a 12-hour fast." c) "It tells us about your sugar control for the last 3 months." d) "Your insulin regimen must be altered significantly."
C
A nurse is teaching a client with diabetes mellitus about self-management of his condition. The nurse should instruct the client to administer 1 unit of insulin for every: a) 20 g of carbohydrates. b) 10 g of carbohydrates. c) 15 g of carbohydrates. d) 25 g of carbohydrates.
C
Bone resorption is a possible complication of Cushing's disease. To help the client prevent this complication, the nurse should recommend that the client: a) limit dietary vitamin D intake. b) perform isometric exercises. c) maintain a regular program of weight-bearing exercise. d) increase the amount of potassium in the diet.
C
During a follow-up visit to the physician, a client with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and: a) phosphorus. b) magnesium. c) potassium. d) sodium.
A
A nurse observes a second nurse documenting a peripheral blood glucose level that the second nurse did not actually collect from a client with diabetes. What is the priority action by the nurse observing this situation? a) Document the nurse's behavior on the client's chart. b) Strike through the entry that the nurse documented. c) Discuss the observation with the other nurse. d) Do the blood glucose level on the client for the other nurse.
C
A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should anticipate which laboratory test result? a) Serum blood urea nitrogen (BUN) level of 8.6 mg/dl b) Serum sodium level of 124 mEq/L c) Serum creatinine level of 0.4 mg/dl d) Hematocrit of 52%
B
The health care provider (HCP) has prescribed insulin detemir for a client with type 2 diabetes requiring insulin. The nurse should tell the client: a) "You may increase the carbohydrates in your diet when using this insulin." b) "You do not mix insulin detemir; the solution is clear." c) "You do not need to rotate injection sites with this insulin." d) "You may refill the detemir insulin pen."
B
The nurse understands that the difference between diabetic coma and hyperosmolar hyperglycemic coma is that clients in diabetic coma can experience which of the following? a) Increased blood glucose b) Kussmaul respirations c) Glycosuria d) Fluid loss
B
The emergency department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG? a) Nitrogen b) Carbonic acid c) Bicarbonate d) Lactate
C
Every morning, a client with type 1 diabetes receives 15 units of Humulin 70/30. What does this type of insulin contain? a) 70% NPH insulin and 30% regular insulin b) 70% regular insulin and 30% NPH insulin c) 70 units of neutral protamine Hagedorn (NPH) insulin and 30 units of regular insulin d) 70 units of regular insulin and 30 units of NPH insulin
A
Several hours into a shift, a nurse on a very busy medical-surgical unit privately asks the charge nurse to change her assignment. She is frustrated because she has had to devote so much time and energy to helping a newly licensed nurse provide discharge teaching for clients with diabetes mellitus. The charge nurse should: a) insist that the nurse follow through with the assignment. b) offer to assist with the discharge teaching needs. c) reassign the new graduate to another staff member. d) try to provide the staff member with a float nurse.
B
When discussing recent onset of feelings of sadness and depression in a client with hypothyroidism who has just started to take thyroid hormone replacement, the nurse should inform the client that these feelings are: a) the effects of thyroid hormone replacement therapy and will diminish over time. b) most likely related to low thyroid hormone levels and will improve with treatment. c) related to thyroid hormone replacement therapy and will not diminish over time. d) a normal part of having a chronic illness.
B
While reviewing the day's charts, a nurse who's been under a great deal of personal stress realizes that she forgot to administer insulin to client with diabetes mellitus. She's made numerous errors in the past few weeks and is now afraid her job is in jeopardy. What is her best course of action? a) Report the error and request a private meeting with the unit manager. b) Report the error, complete the proper paperwork, and meet with the unit manager. c) Contact the physician and follow his instructions. d) Administer the medication immediately and chart it as given on time.
B
A coworker asks another nurse if a client received their pathology report. The coworker is not directly involved in the care of the client. How should the nurse respond? Select all that apply. a) "Let me log into the computer and I will let your read it." b) "Client information can only be shared with those who are involved in the care." c) "You need to review the hospital policy related to client privacy." d) "I can't give you that information." e) "It was benign, but don't repeat what I said."
B C D
A client's glucose level is 365 mg/dL (365 mmol/dL). The physician orders 10 units of regular insulin to be administered. The bottle of regular insulin is labeled 100 units/ml. How many milliliters of insulin should the nurse administer? Record your answer using one decimal place.
0.1
A client with diabetes is taking insulin lispro injections. The nurse should advise the client to eat: a) 1 hour after the injection. b) 2 hours before the injection. c) within 10 to 15 minutes after the injection. d) at any time because timing of meals with lispro injections is unnecessary.
C
A nurse is assessing a client with hyperparathyroidism. Which finding should the nurse report immediately to the physician? a) Urinary output of 30 mL/hour b) Blood pressure of 138/80 mm Hg c) Client reports loss of appetite d) Client reports flank pain
D
Which health promotion activity should the nurse to suggest that the client with cirrhosis add to the daily routine at home? a) Abstain from drinking alcohol. b) Take a sleeping pill at bedtime. c) Supplement the diet with daily multivitamins. d) Limit contact with other people whenever possible.
A
