Test #5 Davis's questions....................................

Muscular dystrophy

X linked dominant

Goal for cerebral palsy

optimal movement in communication

12 year old child is being treated for growth hormone deficiency. The child is angry and refusing to go to school because all the other children are taller. In addition, this child is belligerent tored the mother, who gives the daily injection of growth hormone. Which initial intervention should be attempted by the nurse? 1 teach the child self administration of growth hormone 2 refer the family for counseling with particular emphasis on anger management 3 assist the parents to contact the school district so that home schooling can begin and last until the child has reached normal height 4 talk to the mother about requesting the individual educational planning team to assist in planning school interventions

1

A client diagnosed with Ms asks a nurse why the symptoms she experiences change and also come and go period which statement should be the basis for the nurses response? 1 Ms involves a chronic inflammatory process affecting nerve transmission in the central nervous system with periods of exacerbations and remissions 2 Ms involves degeneration of brain cells that produce dopamine, a neurotransmitter required for movement 3 Ms involves antibody formation against the receptor cells at the neuromuscular junction causing muscle weakness 4 Ms involved small emboli originating from the heart that temporarily blocked circulation to parts of the brain causing temporary loss of brain function

1

A nurse teaches the parent of a school age child newly diagnosed with hyperthyroidism. Which immediate instructions should the nurse include in the parents teaching? 1 discontinue physical education classes at school 2 increased stimulation in the home environment 3 restrict the number of calories from carbohydrate foods 4 be sure cold weather clothing is worn even in warm weather

1

A nurse teaches the parents of a child diagnosed with Addison's disease signs of addisonian crisis. which sign identified by the parents indicates that further teaching is needed? 1 severe hypertension 2 abdominal pain 3 seizures 4 coma

1

A nursing assistant is caring for an adult client with a growth hormone deficiency period a nurse evaluates the care provided by the nursing assistant. Which safety measure should be observed by the nurse as the nursing assistant cares for this client? 1 repositioning the client using a turning sheet 2 approaching the client from the unaffected side 3 using contact precautions when caring for the client 4 getting assistance when ambulating due to the increased height of the client

1

An infant diagnosed with hypothyroidism is prescribed level thyroxine sodium. Which independent nursing intervention would assist the nurse in evaluating the effectiveness of this medication? 1 monthly assessments of growth and development 2 monthly serum calcium and thyroxin levels 3 bimonthly catecholamine levels & ECG 4 absence of thyroid excess

1

An infant with congenital adrenal hyperplasia is admitted to a nursery. Which manifestation should a nurse expect to find an initial assessment? 1 pseudohermaphroditism in the newborn girl 2 breast engorgement in both the newborn girl and boy 3 normal appearance of genitalia in both the newborn girl and boy 4 small penis with large testicles in the newborn boy

1

During the physical assessment of a child, a nurse notes that the child uses a gour maneuver to assist in position changes. Based on this observation, which condition is the nurse likely to see documented in the child's medical record? 1 muscular dystrophy 2 myleomeningocele 3 spinal cord injury 4 scoliosis

1

The nurse is caring for multiple children hospitalised with the hoemophilus influenza type B HIB. Dinners closely monitors the children for signs of meningitis knowing that H influenza type B usually causes meningitis in children younger than 1 5 years old 2 7 years old 3 9 years old 4 12 years old

1

Which is the most important for a nurse to include in the plan of care for a child with spinal bifida? 1 avoid the child's exposure to latex 2 refer for early intervention programs to minimize the likelihood of mental retardation 3 decrease the child's caloric intake to avoid obesity 4 complete a referral for physical therapy to minimize the risk of contractures

1

a 16 year old adolescent is newly diagnosed with hypothyroidism period which identifying characteristic of hypothyroidism should a nurse expect to find an assessment? 1 goiter 2 mental retardation 3 warm, moist skin 4 Short stature less than 44 inches

1

a client is admitted with muscle weakness that improves after rest period myasthenia gravis is being considered as a possible diagnosis. A nurse reviewing the laboratory results should evaluate which laboratory value that, if positive, would confirm the diagnosis? 1 acetylcholine receptor antibodies 2 ESR 3 WBC 4 carcinoembryonic antigen

1

a client who had a craniotomy 2 days earlier is receiving man it all IV to decrease intracranial pressure period which diagnostic laboratory value should be monitored while the client is receiving this medication? 1 serum osmolarity 2 WBC count 3 serum cholesterol 4 ESR

1

a nurse is assessing a client for a total thyroidectomy period which finding suggest that the patient has a positive trousseau sign? 1 a 2 b 3 c 4 d

1

a nurse is assessing an infant that has an increase in headsize without an increase in the size of facial features period when reviewing the child's medical record, which condition should the nurse expect to be documented in the child's history and physical? 1 hydrocephalus 2 plagiocephaly 3 craniosynostosis 4 hydranencephaly

1

a nurse is caring for a child who is receiving Desmopressin period which laboratory value should the nurse monitor to evaluate the therapeutic effects of Desmopressin? 1 urine volume 2 blood pressure 3 serum platelet count 4 serum sodium in potassium levels

1

a nurse is caring for a lethargic client with addisonian crisis period the client's blood pressure is 86/50 MMGH and pulse rate is 86 beats per minute period which medication order should the nurse anticipate when managing addisonian crisis? 1 hydrocortisone solu cortef 2 levothyroxine 3 Metroprolol 4 potassium chloride

1

a nurse is developing teaching materials for parents of children in the neonatal ICU. These materials include information about cerebral palsy. which points should be included about the most common cause of CP? 1 prematurity/low birth weight 2 shaken baby syndrome 3 unknown 4 intrauterine drug exposure

1

a nurse is educating the parents of a school age child, newly diagnosed with hyperthyroidism. Until the disease is under control, which instructions should be included in the education provided by the nurse? 1 discontinue physical education classes at school 2 increase stimulation in school environment 3 restrict the number of calories from carbohydrate foods 4 dress your child in cold weather clothing even in warm weather

1

a nurse is performing hourly neurological assessment checks on a client who is admitted with changes in mental status period the nurse understands that frequent assessments are used to determine if a client is developing increased intercranial pressure. Which option correctly describes the outcome if ICP untreated and progress is? 1 displacement of brain tissue 2 increase in cerebral circulation and perfusion 3 increase in serum pH 4 improved brain tissue oxygenation

1

a nurse is preparing to administer dexamethasone to a child with acute bacterial meningitis. The nurse explains to the parents that the purpose of the steroid is to 1 reduce inflammation in the brain 2 alleviate dermatologic symptoms 3 minimize swelling of the eustachian tube 4 decrease upper airway inflammation

1

a nurse is speaking with a client newly diagnosed with hyperthyroidism due to Graves' disease. The client states, there must be something else wrong. No one else in my family has hyperthyroidism. Based on the statement, the nurse should do which of the following? 1 suspect that the client is using denial as a coping mechanism. 2 question the information in the client's medical record 3 tell the client that further tests will be done to rule out other possible conditions 4 contact the health care provider regarding the lack of a family history of hyperthyroidism.

1

a nurse is teaching a client experiencing hyperparathyroidism resulting from a lack of parathyroid hormone PTH about foods to consume. Which should be included on a list of appropriate foods for a client experiencing hypoparathyroidism? 1 dark green vegetables, soybeans, and tofu 2 spinach, strawberries, and yogurt 3 whole grain bread, milk, in liver 4 rhubarb, yellow vegetables, and fish

1

a pediatric client with a spinal cord injury undergoes range of motion exercises several times each day. in teaching the parent how to do range of motion at home comma the nurse observes the client increasing the angle between the extremity and the midline period the nurse concludes that the client is safely performing 1 abduction 2 adduction 3 flexion 4 extension

1

client is scheduled for an outpatient EEG period a nurse instructs the client to prepare for the test by 1 removing all hairpins 2 avoiding eating or drinking at least 6 hours prior to the test 3 being prepared to have some of the scalp shaved 4 having blood drawn for glucose level 2 hours before the test

1

florinef is prescribed for a child with adrenocortical insufficiency. Which finding should alert the nurse that the child is having an adverse reaction to this medication? 1 hypokalemia 2 hypertension 3 weight loss 4 hyponatremia

1

glucocorticoids are prescribed for a child diagnosed with congenital adrenal hyperplasia period which manifestation should indicate to a nurse that therapy is successful? 1 feminization in girls 2 absence of symptoms of Cushing's syndrome 3 precocious penile enlargement in boys 4 increased growth rate in boys and girls

1

the child is being screened for hydrocephalus period in teaching the parents about the condition comma the nurse illustrates the location of the lateral ventricle period which line identifies the area the nurse Should point out to the parents? 1 line a 2 line b 3 line c 4 line d

1

which assessment findings should indicate to a nurse that a child may have a growth hormone deficiency? 1 a substantial deceleration in height 2 consistently being at the 5th percentile for height 3 poor linear growth but no delay in skeletal maturation 4 a male child who is 133 cm, when the mother is 173 cm tall and the father is 183 cm tall

1

which clinical change should indicate to a nurse that the therapy for a client with Addisonian crisis is effective? 1 an increase of 25MM HG in the client systolic blood pressure 2 a decrease of 25MM HG in the client systolic blood pressure 3 an increase in the client serum potassium level from 3.4 to 4.8 MEQ/DL 4 an increase in the client's total serum calcium level from 8.6 to 10.0 MG/DL

1

which gland illustrated should a nurse palpate for Graves' disease if suspected? 1 gland a 2 grand b 3 gland c 4 glende d

1

which instruction should a nurse include when teaching parents who have a child diagnosed with hyperparathyroidism? 1 monitor for muscle spasms, tingling around the mouth, and muscle cramps. 2 monitor for side effects of excess medication therapy, including dry, scaly comma and coarse skin 3 decrease intake of foods high in calcium and phosphorus 4 increase environmental stimuli and encourage participation in high-energy activities

1

which medication should a nurse plan to administer to a client during a growth hormone stimulation test? 1 insulin 2 vasopressin 3 radioactive iodine 4 radioactive isotopes

1

a client has a nursing diagnosis of, fluid volume access related to sodium retention secondary to steroid therapy as evidenced by weight gain of 12 pounds in 2 weeks and lower extremity pitting edema. a nurse determines the outcomes for this client have been met when which findings have been noted? Select all that apply 1 no edema noted 2 steroid therapy discontinued 3 ankle circumference measured daily for edema 4 clients weight down by 12 pounds since admission 5 client verbalizes the importance of a 500 milligram sodium diet

1, 4

which outcome should a nurse plan for a child diagnosed with adrenal insufficiency? Select all that apply 1 child demonstrates a positive body image 2 child demonstrates no complications related to inactivity 3 child responds to oxygen regimens to avoid hospitalization 4 child and family verbalizes causes of the disease and treatment regimen 5 child responds to activity restrictions to conserve energy

1, 4

A client recently diagnosed with Myasthenia gravis discusses treatment options with the nurse. the client is currently taking anticholinesterase and corticosteroid medications period which additional treatment options to treat this might the nurse discuss with the client? Select all that apply 1 plasmapheresis treatments 2 dopaminergic medications 3 muscle relaxants 4 anti cholinergic medications 5 thimectomy 6 endrophonium injections

1, 5

Which instructions should the nurse include in the teaching of a client who has undergone radioactive iodine therapy to treat Graves' disease? Select all that apply 1 keep scheduled appointments to frequently monitor your free T4 and thyroid stimulating hormone levels , you could develop hypothyroidism 2 seek immediate medical attention if you experience a high fever or a fast heart rate, these could indicate thyroid storm 3 continue taking your anti thyroid medications until the physician tells you to discontinue these based on your free T4 and TSH levels 4 be sure to cover your toilet seat and flush 3 times to prevent others from getting exposed to the radiation that you excrete from your body 5 if you develop hyperthyroidism it can be treated with a hormone replacement medication such as hydrocortisone

123

a nurse instructs the parent of a child diagnosed with Addison's disease period which instructions should be included by the nurse? Select all that apply 1 have the child wear a medical alert bracelet 2 encourage the child to ingest adequate fluids, particularly on hot summer days 3 include emergency cortisone treatment for addison's crisis on the school medical care plan 4 if the child vomits the dose of cortisone within 1 hour the dose is not repeated but the health care provider notified 5 administer epinephrine subq immediately if addisonian crisis should occur

123

A client who suffered a closed head injury in an industrial accident remains unresponsive period the client develops hyperthermia period which intervention should the nurse plan to treat the clients hyperthermia? Select all that apply 1 administer Tylenol 500 mg rectal Suppository 2 applied covered ice packs Axillary spaces 3 place the client on a water cooling blanket 4 administer a tepid bath 5 administer belladona and opium B&O rectal Suppository 6 administer iced Saline through a Ng tube and then apply the Ng to section

1234

A client with Ms experience is a severe exasperation of symptoms and is scheduled for 3 days of high dose intravenous methyl Prednisone sodium sucking 8 therapy period a nurse determines that the client is experiencing adverse effects related to this therapy when the client experiences symptoms of 1 hypokalemia 2 hypertension 3 insomnia 4 GI bleeding 5 hypoglycemia 6 increased mobility

1234

a nurse is discussing self care interventions with a client diagnosed with myasthenia gravis who is being discharged on anti cholinesterase medicines. which point should be included in the teaching plan for this client? Select all that apply 1 inform the primary care provider before starting new prescribed or over-the-counter medications 2 apply lubricating eye drops or eye gel if closing the eyes becomes a problem 3 alternate patching one eye of double vision or difficulty focusing occurs 4 obtaining medical alert bracelet or necklace identification to wear at all times 5 take medications with meals to enhance absorption 6 planter activities that coincide with times of maximal muscle strength

12346

which instructions should a nurse include when teaching a client who is prescribed cordisco steroid therapy for non endocrine reasons? Select all that apply 1 consume a high calcium diet at least 1500 MG/1 day 2 if edema occurs, restrict sodium intake to less than 2000 mg/day 3 avoid contact with persons who are ill or have colds 4 reduce the steroid dose at times the physical or emotional stress to avoid complications 5 polyurea, polydipsia, and Polyphagia are signs of hyperglycemia, an adverse effect of steroid therapy

1235

a clinic nurse is teaching a client who has been diagnosed with hypothyroidism period which instruction should the nurse provide regarding the use of levothyroxine sodium? Select all that apply 1 take the medication one hour before or 2 hours after breakfast 2 obtain a pulse rate before taking the medication comma and call the clinic if the pulse rate is greater than 100 beats per minute 3 report adverse effects of the medication, including weight gain, cold intolerance, and alopecia 4 use levothyroxine sodium as a replacement hormone for diminished or absent thyroid function 5 have frequent laboratory monitoring to be sure your levels of T3 and T4 decrease

124

an 18 month old, brought to the hospital with fever and decreased level of consciousness, is to have a LP. Which assessment findings should prompt a nurse to consult the health care provider prior to preparing the child for the LP? Select all that apply 1 shock 2 the possibility of ICP 3 recent exposure to another child diagnosed with Chickenpox 4 airway instability 5 seizure activity

1245

a client with multiple sclerosis is seen in an office of a primary care provider period the client states that fatigue is the president concern period a nurse performs an assessment, an reviews the clients current medications and blood laboratory results. Which findings by the nerves are most likely to contribute to the clients fatigue? Select all that apply 1 HGB 9.5 and HCT 31.8 2 taking Baclofen 50 milligrams 3 times per day 3 working 4 to 8 hours per week in the family business 4 stop taking amitriptyline 8 weeks earlier 5 presence of a cardiac murmur at the 5th intercostal space to the left of the sternum 6 greens on cane comma and right leg weakness noted when walking in room

12456

a nurse is caring for a pediatric client following a head injury period for which complication should the nurse plan to monitor the child? Select all that apply 1 seizures 2 alteration in fluid homeostasis 3 hyper alert level of consciousness 4 motor abnormalities 5 intellectual deficits 6 dysthesias

12456

What purple actiq medications should a nurse identify for meningitis? Select all that apply 1 rifampicin 2 cipro flaxen 3 ampicillin 4 Celebrex 5 ceftriaxone sodium

125

a child is admitted in thyrotoxic crisis. which manifestations should a nurse expect to observe during assessment? Select all that apply 1 delirium 2 hypothermia 3 Bradycardia 4 nausea 5 vomiting

145

a client is admitted to the hospital with a diagnosis of Cushing's syndrome. The nurse reviews the clients laboratory results period which findings would support a diagnosis of Cushing syndrome? Select all that apply 1 hypokalemia 2 eosinophelia 3 hypocalcemia 4 hyperglycemia 5 thrombocytopenia 6 elevated serum plasma cortisol

146

a 27 year old has been complaining of headaches for several days. a nurse is explaining the work of process to the family period prioritize the steps that the child would undergo comma and the nurses explanations to the family 1 family history 2 describe CT scan results 3 physical exam 4 administration of sedation 5 individual history 6 explanation of the final plan of care 7 ordering CT scan

1537426

3 year old with CP has constant involuntary rating movements that are more severe distally period which type of CP should the nurse note in the child's medical record? 1 spastic 2 athetoid 3 ataxic 4 mixed

2

A nurse completes teaching for a client who is scheduled for a subtotal thyroidectomy for a large goiter. Which client statement indicates that the client understands pre operative instructions? 1 i should keep the bed in a flat position after surgery until otherwise instructed 2 i should support my head with my hands when turning on to my side in bed 3 i should perform frequent deep breathing exercises but avoid coughing 4 i should discontinue my anti thyroid medications before surgery

2

A nurse is caring for a client who had a thyroidectomy 2 days ago period based on the findings of the clients serum laboratory report, which medication should the nurse plan to administer 1st? 1 K-dur 20 MEQ oral PO BID 2 calcium gluconate 4.5 MEQ IV 3 dolasetron (anzemet) 12.5 MG IV as needed 4 levothyroxine (Synthroid) 50MCG PO daily

2

A6 year old child is diagnosed with pheochromocytoma period which manifestation should lead a nurse to conclude that this child is in crisis? 1 systolic blood pressure of 120 mmhg 2 Rhabdomyolysis 3 urine output of 30ML/hr 4 hyperexcitability

2

I feel my client is being treated with radioactive iodine therapy for an enlarged thyroid gland. The client asks if there are any precautions that are needed during RAI therapy. which is the nurses best response? 1 no precautions are necessary. You receive radiation in the form of a capsule that will target and destroy the thyroid tissue only 2 though a pregnancy test has confirmed that you are not pregnant, use contraceptives or abstain from sexual intercourse to avoid conceiving during treatment. 3 because maximum effects may not be seen for 6 months, you will need to continue taking the antithyroid medication and Propranolol until the effects of radiation become apparent 4 although our RAI is usually affective, many individuals will need lifelong thyroid hormone replacement due to posttreatment hypothyroidism

2

a 10 year old child is admitted for testing to diagnose Cushing's syndrome period for which initial test should a nurse prepare the child and parents? 1 Glucose tolerance test 2 urine or saliva cortisol level 3 dexamethasone suppression test 4 sirum 17 hydroxyprogesteron level

2

a 12 year old child with a history of depression treated with lithium is admitted to a hospital with a diagnosis of hypothyroidism. There is no family history of thyroid disease, accidents, or injury. A nurse understands that the most likely cause of hypothyroidism in this child is : 1 idiopathic thyroid disease 2 metabolic adverse reaction to lithium 3 thyroid dysfunction caused by hormonal changes of puberty 4 metabolic reaction caused by the depressed state of the child

2

a 6 month old child is being seen for a well baby visit period the mother reports that the child has been fussy period a nurse notes on the assessment that the child is delayed on developmental milestones. During follow-up questioning, which question would it be most important for the nurse to ask? 1 is this child developing the same as the siblings 2 did you suffer any unusual stress or anxiety during pregnancy 3 have you noticed anything unusual about your baby recently 4 do you have any other children in the immediate family respond to outsiders this way

2

a child is being evaluated for possible increased ICP following head trauma. which assessment finding associated with ICP should a nurse report to a health care provider? 1 increasing alertness 2 widened pulse pressure 3 tachycardia 4 decreased systolic blood pressure

2

a client is admitted to the ICU with a blood glucose level of 400MG DL and a diagnosis of Cushing syndrome secondary to long-term steroid use for treatment of rheumatoid arthritis period a physician rates in order to discontinue the steroid medication and to start an insulin infusion to be titrated according to the clients hourly blood glucose readings. Which nursing action is most appropriate? 1 discontinue the steroid medication as ordered 2 question the physician's order to discontinue steroids 3 question the insulin infusion order 4 medicate the client for acute pain during withdrawal of the steroid medication

2

a nurse assesses a client following a total thyroidectomy an notes muscle twitching when the clients cheek is taped over the facial nerve in front of the ear period which sign should the nurse document as a positive for the client? 1 trousseaus sign 2 Chvostek's sign 3 Kernig's sign 4 grey turners sign

2

a nurse is caring for a client with syndrome of inappropriate anti diuretic hormone SIADH. The client is experiencing muscle weakness, cramps comma and muscle twitching period which laboratory finding provides an explanation for the clients symptoms? 1 serum osmolality 270 mosm/kg 2 serum sodium 120 MEQ/L 3 blood urea nitrogen BUN 9 MG/DL 4 serum chloride 98 MEQ/L

2

a nurse is monitoring a child for increased intracranial pressure ICP. The nurse determines that the child's vomiting may be a sign of increased intracranial pressure when noting that it 1 often occurs after meals 2 is projectile in nature 3 is associated with position changes 4 occurs late in the day

2

a nurse is planning the care of a client with a diagnosis of cushings disease caused by a pituitary tumor. Which nursing intervention should be included in the plan of care for a client with cushing's disease? 1 provide frequent stimulation 2 prepare the client for surgery 3 administer steroid medication 4 increase the client's fluid intake to 4000ML

2

a nurse is preparing to discharge a client following a unilateral adrenalectomy to treat hyperaldosteronism caused by an adenoma? which instruction should be included in the client's discharge teaching? 1 avoid foods high in potassium 2 self monitor the blood pressure 3 discontinue medications taken prior to the adrenalectomy 4 carry an emergency kit that includes epinephrine

2

a nurse is teaching parents about newborn screening for adrenal hyperplasia period the nurse understands that screening for congenital conditions is based on the fact that 1 screening tests are diagnostic for certain genetic conditions screening tests are completed for conditions that could lead to permanent disability or death if left untreated 3 congenital adrenal hyperplasia is not usually one of the conditions screened for comma and diagnostic testing must be completed 4 if congenital adrenal hyperplasia is detected on screening, there is no known treatment for the condition

2

a nurse is teaching the family of a child with precocious puberty to promote positive growth and development period which instructions should the nurse include in the teaching? 1 maintain a strict calorie intake to prevent weight gain 2 encourage dressing in age appropriate clothing 3 advise parents to wait until the teen years to discuss sexuality 4 emphasize that emotional and social development will correspond with adolescence

2

a nurse performs a physical examination of a school age child including testing of proprioception. which nursing documentation should be a correct documentation about proprioception? 1 able to identify objects that are placed in the hand when the eyes are closed 2 able to state the direction of a finger is moved when eyes closed 3 able to identify characters they were written on the skin 4 able to recognize 2 point separation of 2MM on the finger pads

2

a preschool age child is diagnosed with Addison disease and is placed on cortisone. following receiving teaching by the nurse on the adverse effects of this medication, which adverse effects stated by a parent indicates that further teaching is needed? 1 depression 2 weight loss 3 gastric irritation 4 increased excitability

2

an 8 year old child is diagnosed with fino chromo cytoma and is being treated preoperatively with phenoxybenzamine orally every 12 hours period which assessment finding should indicate to a nurse that the medication is effective? 1 respiratory rate of 26 breaths per minute 2 blood pressure of 112/73 MMHG 3 heart rate of 120 beats per minute when awake 4 blood glucose level of 200MG/DL

2

an agitated client is admitted to the ER with tachycardia, dyspnea, an intermittent chest palpitations. The client has a blood pressure of 170/110MM HG and heart rate of 130 beats per minute. The client's health history reveals thinning hair, recent 10 pound weight loss, increased appetite, fine hand and tongue tremors, hyper reflexes tendon reflexes, and smooth, moist skin. A physician writes orders for the client period which order should the nurse implement 1st? 1 obtain 12 lead E CG 2 administer propanolol (Inderal) 2 milligrams intravenously q10 to 15 minutes or until symptoms are controlled 3 administer propylthiouracil (PTU) 600MG oral loading dose followed by 200MG orally Q4H 4 obtain thyroid stimulating hormone TSH, free T4, and cardiac enzyme levels.

2

an experienced nurse is teaching a new nurse about the functions of the endocrine gland period the experienced nurse should instruct the new nurse that which endocrine gland regulates the secretion of thyroxine? 1 thyroid gland 2 anterior pituitary 3 posterior pituitary 4 parathyroid glands

2

an unresponsive client who suffered a brain injury is tested for the oculocephalic reflex. A nurse evaluated that the client's brainstem was functioning properly period which observation when the client's head was turned to the left side supported this conclusion? 1 conjugate eye movement to the left side 2 conjugate eye movement to the right side 3 both eyes remaining in a straight ahead stare 4 nystagmus that occured tored the left side

2

in performing an assessment of a 7 year old client, a nurse notices of the child's eyes do not open symmetrically. Rather, one eyelid overlies most of the Top of the iris period which cranial nerve should the nurse conclude is likely being effected? 1 cranial nerve 2 2 cranial nerve 3 3 cranial nerve 5 4 cranial nerve 6

2

the parents of a child with Duchenne muscular dystrophy had just learned that children with the disease have a limited life expectancy period they ask what this means for how they were raised their son. Which explanation by the nurses best. 1 because he will be cognitively impaired, there is no reason to deal with the prognosis 2 throughout his disease, we will focus on maximizing his abilities and keeping him comfortable 3 there is not enough known about this disease do you know what will happen to your son 4 nothing is likely to happen for a long time, we'll deal with it when the time comes

2

the parents of a school age child diagnosed with Addison's disease are going through a divorce period the parents asked a nurse for advice on caring for their child during this time period which is the best response by the nurse? 1 make sure the child understands that the divorce is not anyone's fault 2 your child may require additional hormone replacement during this time, you should speak with the child's physician 3 make sure you explain your feelings about the marriage and discuss what a divorce will mean to reassure the child 4 discuss the terms of the divorce and how the Visitation will be set up with the non custodial parent so the child will know that both parents will remain involved

2

the school board has asked a local neurological nursing chapter to work with them to develop educational programs tord injury prevention period the nurses explain that to affect long-term change in children's or parents behavior in injury prevention, educational efforts should 1 begin by age 7 years 2 use multi faceted interventions and be repeated overtime 3 be part of a school based curriculum 4 include negative reinforcements for dangerous behaviors

2

which instruction should the nurse reinforce to a client who is being discharged after an addisonian crisis? 1 reduce calcium intake to prevent bone reabsorption 2 take glucocorticoids in mineral corticoids as prescribed 3 increased the medication dosage when taking other medications, such as antacids 4 reduce the medication dosage during minor stress, such as a tooth extraction

2

which physician order should a nurse question for a client during the first 24 hours after a bilateral adrenalectomy? 1 bed rest 2 MS 4 mg IV q1-2 hour PRN pain 3 obtain cortisol levels daily at 0600 4 administer hydrocortisone (solu cortef) 250 MG IV q6h

2

a nurse is caring for a 2 year old child hospitalised following a traumatic injury to the head period the nurse prepares the family for long term medical follow-up with the child because such a trauma can result in hypofunction of the adenohypophysis (Anterior pituitary gland). what are the effects associated with hypofunction of the adenohypophysis? select all that apply 1 prepubertal gigantism 2 failure of the secondary sex characteristics to develop during puberty 3 growth failure 4 premature epiphyseal Fusion 5 Cushing syndrome

234

seven-year-old may have hydrocephalus secondary to a malignancy period which assessment finding should a nurse anticipate? Select all that apply 1 increased head circumference 2 headache 3 personality change 4 vomiting 5 angioedema

234

which nursing diagnosis should the nurse document in the plan of care for a client diagnosed with Cushing syndrome? Select all that apply 1 fluid and electrolyte imbalance related to hyperkalemia and hypernatremia 2 body image disturbance related to weight gain in facial hair 3 risk for infection related to a decreased inflammatory response 4 risk for injury related to weekness and fatigue 5 disturbed thought process related to mood swings an irritability

2345

clinic nurse evaluates that a client's level thyroxine dose is too low when Which findings are noted? select all that apply 1 increased appetite 2 decrease sweating 3 apathy and fatigue 4 Paresthesias 5 find tremor of fingers and tongue 6 slowed mental processes

2346

a nurse evaluates a client who has been treated for hyperaldosteronism. which clinical findings indicate that the client's treatment has been effective? Select all that apply 1 blood pressure of 128/80MM/HG 2 premature ventricular contractions 3 muscle weakness of fatigue 4 serum potassium 4.0 ME/QL 5 serum sodium 152 ME/QL 6 serum CO2 elevated

2356

which findings should the clinic nurse expect when assessing a client with Graves' disease? select all that apply 1 complaints of feeling cold 2 an enlarged thyroid gland 3 dyspnea on exertion 4 hypo tension 5 weight loss 6 irritability

2356

A client with a history of epilepsy has consecutive seizures lasting more than 5 minutes and is in status epilepticus. Which interventions should be included in this client's immediate treatment? Select all that apply 1 administer dexamethasone IV 2 administer oxygen and prepare for endotracheal intubation 3 prepare for immediate Defibrillation 4 continue to protect the patient from injury 5 administer lorazepam IV 6 transferred to a facility with expertise in treating status epilepticus

245

A nurse is caring for a client admitted in thyroid storm. In caring for this client, the nurse carefully monitors the client signs and symptoms during the administration Of IV meds and treatment measures because of the risk of overtreatment. Using a scale of 1 to 5, indicate how the nurse should verbalize the continuum of thyroid dysfunction starting with The clients admitting diagnosis 1 & ending w/the condition that could occur if the client were significantly over treated 5. 1 myxoedema coma 2 thyrotoxic crisis 3 Hypothyroidism 4 hyperthyroidism 5 Euthyroid

24531

13 year old brought to the ER following a motor vehicle crash in which the child's head hit the dashboard period the child is diagnosed with a mild head injury period when assessing the child, which score on the glass cow coma scale should the nurse expect? 1 5 2 10 3 15 4 20

3

A clinic nurse refers a client with hyperthyroidism to a dietitian period the dietitian is to teach the client how to maintain the appropriate diet until the clients hyperthyroidism is controlled with medication. Which diet should the nurse expect the dietitian to recommend? 1 no between meal snacks 2 high protein and low calories 3 high protein and high calories 4 low fat and low carbohydrates

3

A nurse is administering the water deprivation test to a client who is experiencing polyurea. After receiving 5 units of a suppressing during the water deporation test comma the client has increased urine osmolarity. The nurse concludes that the client most likely has which of the following? 1 adrenal hypofunction 2 pituitary induced diabetes melittis 3 centrally induced diabetes insipidus 4 a normal pituitary response to vasopressen

3

A parent calls a clinic nurse voicing a concern that both she and the child's teacher are unable to get the child's attention. The child stares off into space for 10 to 30 seconds it does not seem to hear anything or anyone in the environment period which type of seizures should the nurse recognize from the parents report of her child's behavior? 1 Myoclonic seizure 2 febrile seizure 3 absence seizure 4 atonic seizure

3

a 3 year old child is placed on somatropin (genotropin). for which primary adverse reaction should a nurse monitor? 1 nausea and vomiting 2 abdominal discomfort 3 hyperglycemia 4 sodium and potassium imbalance

3

a child is admitted to a hospital in pheochromocytoma crisis. which nursing intervention should take priority for this child? 1 turning frequently 2 monitoring serum catecholamine levels 3 monitoring blood pressure frequently 4 providing age appropriate diversional activities

3

a client has developed syndrome of inappropriate anti diuretic hormone SIADH secondary to a pituitary tumor. The client symptoms include thirst, wait comma and fatigue period the clients serum sodium is 127 MEQL. Which physician order should the nurse anticipate when treating SIADH? 1 elevate the head of bed 2 administer vasopressin IV 3 fluid restriction of 800 to 1000ML per day 4 0.3% sodium chloride IV infusion

3

a client is newly diagnosed with hyperthyroidism secondary to Graves' disease. In managing this illness, a clinic nurse should instruct the client to do which of the following? 1 sleep with extra blankets to prevent chilling 2 increase fiber in the diet to prevent Constipation 3 eat frequent, small meals to meet the body's energy requirements 4 exercise just prior to bedtime to promote a restful sleep at night

3

a client who is one day postoperative following a thyroidectomy calls a nurse to report numbness and tingling of the toes and fingers and around the mouth. The nurse notes find muscular twitching. Which nursing action should be performed next? 1 notify the client surgeon 2 check the dressing over the incision 3 assess for chovsteks sign 4 perform a neurological assessment

3

a nurse administers dilantin to a 12 year old diagnosed with a seizure disorder period the nurse understands that dilantin is given for treating 1 absent seizures 2 atonic seizures 3 tonic clonic seizures 4 myoclonic seizures

3

a nurse assesses a client who is lying supine following a thyroidectomy period the nurse notes that the client has voice changes and a harsh vibratory sound occurring with inspiration and expiration. Which action should the nurse take first? 1 notify the surgeon 2. check the client for signs of tracheal compression 3 place the client in a semi fowlers position 4 ask another nurse to obtain calcium gluconate for intravenous administration

3

a nurse is caring for a client who is scheduled for radioactive iodine therapy to treat hyperthyroidism. Which circumstances would warrant the immediate notification of a physician? 1 thyroid stimulating hormone level is decreased and T4 level is elevated 2 taking Propranolol daily 3 pregnancy test comes back positive 4 states in allergy to latex

3

a nurse is evaluating a clients outcome. The clients nursing care plan includes the nursing diagnosis of fluid volume deficit related to hyperosmolar hyperglycemic nonketotic syndrome HHNS secondary to severe hyperglycemia. The nurse knows that the client has a positive outcome when which serum laboratory value has decreased to a normal range? 1 glucose 2 sodium 3 osmoality 4 potassium

3

a nurse is planning teaching for a group of parents about bacterial meningitis period which statement should the nurse include when teaching the parents? 1 symptoms of meningitis often develop overtime making it easier to diagnose than other infections 2 having a seizure associated with a high temperature usually indicates a problem other than meningitis 3 certain high risk children aged 2 to 10 years and other children 11 years and older should receive the meningcoccal conjugate vaccine MCV4 4 IV antibiotics are administered to family members who may have been in close contact with the child

3

a nurse is teaching a 6 year old child, diagnosed with precocious puberty, about physiological changes that are taking place period which statement should be helpful in facilitating a positive body image for this child? 1 you may want to dress like a teenager now that you are going through puberty 2 all children will go through these changes when they become adults 3 the changes in your body are normal but occurring at an earlier stage period your friends will experience the same changes eventually 4 you are going to look older than your chronological age. Remember to always tell others your real age so they don't ask you to do things that you are not ready to do

3

a nurse working in a prenatal clinic is developing an educational and screening program pertaining to spinal bifida. To maximize the effectiveness of the program, which ethnic group should the nurse target for attendance at this program? 1 Whites 2 Blacks 3 Hispanics 4 Asian Americans

3

a nurses assessment of a client diagnosed with Cushing syndrome includes the following findings: 4 plus pitting leg edema, blood glucose 140MG/DL, irregular heart rate comma and ecchymosis on the right arm period which action should be taken by the nurse 1st? 1 way the client 2 administer insulin 3 notify the physician 4 measure the clients abdominal girth

3

an adolescent is admitted with a diagnosis of suspected Addison's disease period which assessment manifestation should the nurse expect to find if Addison's disease is the correct diagnosis? 1 long history of fatigue, weight loss, and muscle tetany 2 sudden onset of skin hypopigmentation, polydipsia, and hyperactivity 3 gradual onset of salt craving, decreased pubic an axillary hair, and irritability 4 sudden onset of increasing weight gain, hirsutism, and skin hyperpigmentation

3

an experienced nurse teaches a new nurse that Cushing syndrome in children is caused by long term steroid therapy that can be reversed by the : 1 abrupt withdrawal of steroid therapy 2 surgical removal of the adrenal glands 3 gradual withdrawal of steroid therapy 4 administration of exogenous cortisone

3

an older adolescent is diagnosed with acromegaly. which medication should the nurse expect to be prescribed for this child? 1 Somatropin (genotropin) 2 desmopressin (desmotabs) 3 somatostatin (sandostatin) 4 clozapine (Clozaril)

3

based on a child's growth chart from birth to age 12 months which diagnostic test should a nurse expect a health care provider to prescribe? 1 radiographic views of the sella turcica 2 bone age 3 insulin like growth factors IGFs 4 17 Alpha hydroxyl progesterone

3

for an adult who experienced a seizure, which notation is a nurse most likely to document in the client's medical record about the postictal period? 1 whether the client experience an aura 2 what the client was doing immediately preceding the seizure 3 what the condition of the client was immediately following the seizure 4 where kind of clonic activity started and how long the client was unresponsive

3

home health nurse is making a home visit to a client with Ms. The nurse reviews the whole medications taken by the client period which question should the nurse asked to determine effectiveness of the client's medication, Baclofen? 1 how has your appetite been 2 are you having any difficulty with having regular bowel movements 3 are you having trouble with spasms 4 does your urine look clear and not infected

3

in which situation should a nurse intervene when observing a nursing assistant caring for a client with cushing's disease? 1 when the na is bringing a low carbohydrate, low sodium, high protein snack to the client 2 when the na is seeking the assistance of another na to ambulate the client 3 when the NA is applying adhesive tape to secure a Foley catheter to the client's leg to prevent pulling 4 when the na is reassuring a crying client that mood swings often occur from hyper secretion of hormones

3

nurse is teaching a client about a scheduled EMG with nerve conduction study because the client has been experiencing weakness and tingling in the upper extremities. The nurse explains that the test? 1 includes attaching electrodes to the scalp 2 involves injection radioactive substance into the muscles of the extremities 3 requires placement of needle electrodes in the muscles through which electrical currents pass 4 includes the injection of contrast medium into the subarachnoid space

3

what should be a nurses priority when admitting a client with suspected hyperaldosteronism? 1 preparing the client for a computed tomography scan CT 2 administering medications to treat headache 3 obtaining an ECG to assess for cardiac dysrhythmias 4 protecting the client from falls due to muscle weakness

3

which laboratory test should a nurse expect a health care provider to order for a child suspected of having adrenal hyperplasia? 1 serum cortisol 2 urinary 17 hydroxycorticord 3 serum 17 Alpha hydroxyl progesterone 4 24 hour urinary catecholamine metabolites

3

which research finding supports the nursing diagnosis of risk for impaired parenting related to caring for a child with congenital adrenal hyperplasia? 1 school aged children report seeking parental support, adolescence report seeking peer support 2 most parents report that they do not attach to children with congenital conditions 3 both children adolescents report that parental involvement and support at a young age aided their self care in quality of life 4 adolescents report that parents do not allow them the independence they seek

3

the nurse is reviewing serum laboratory data for four female clients period which client would require the most immediate assessment? 1 client a 2 client b 3 client c 4 client d

3 excess of thyroid hormone

Which nursing diagnosis has the highest priority for a child diagnosed with congenital adrenal hypoplasia? 1 disproportionate growth 2 excess fluid volume 3 impaired parent infant attachment 4 knowledge deficit of lifelong medication requirements

3 impaired parent infant attachment

a client taking fiber displacement hormones was involved in an automobile accident in another state and was hospitalised for a femur fracture. The physician did not prescribe replacement hormone because the client's medication history was unknown and the client was a poor historian at the time of the accident due to pain. A week after being hospitalised, a nurse notes that the client is becoming increasingly lethargic. Vital signs show a decrease blood pressure, respiratory rate, temperature, an pulse. Which actions should be taken by the nurse? Place each nursing action in the order of priority 1 warm the client 2 administer intravenous fluids 3 assist in ventilatory support 4 administer the prescribed thyroxine

3214

A 3 year old with CP, who is cognitively intact, is hospitalised for the first time period I'm doing the child's pre admission teaching, which typical fear is should a nurse anticipate? 1 new foods, ambulances 2 strangers, sharing spaces 3 water, missing preschool 4 new places comma the dark

4

A nurse is assessing a 4 year old child diagnosed with precocious puberty. Which physical assessment manifestation should the nurse expect to find? 1 short stature 2 hypothalamic tumor 3 advanced bone age 4 pubic and Axillary hair

4

School age child is to receive oral cortisone for Addison's disease period which method of administration should the nurse teach the parent? 1 mix the medication in a full glass of water and follow with another glass of water 2 measure the amount in a teaspoon give to the child comma and follow with milk 3 use a medicine Cup to measure the amount, give to the child comma and follow with milk or water. 4 mix the medication in a small amount of orange sherbert, give to the child comma and follow with water

4

Which actions describe a nurses role in screening newborns for congenital endocrine conditions 1 teaching new parents about the screening tests which are diagnostic 2 determining which screening tests should be performed on a newborn 3 informing the parents of treatment options for their child 4 knowing the endocrine conditions and timing the collection of specific specimens for testing

4

a 12 year old child with Turner's syndrome has been taking somatropin (nutropin). which test results should indicate to the nurse that this medication is no longer appropriate for this child? 1 increase in gastric acid pH 2 urine oestrogens of 40 MCG/24 hr 3 increase in linear growth of 3 inches 4 X-ray showing closure of epiphyseal bone ends

4

a client is experiencing hypertension, nausea, increased weakness comma and signs of dehydration following a Transphenoidal hypophysectomy. which complications is the client most likely experiencing? 1 hyperglycemia 2 hypercalcemia 3 hypocalcemia 4 hypercortisolism

4

a client with epilepsy is prescribed dilantin 100MG three times per day orally as anti convulsant therapy period the most precise method for a nurse to determine if this is the proper dose for the client is 1 observation of the client 4 seizures 2 observation of the client for adverse effects 3 determining whether the client is able to participate in usual activities 4 monitoring serum phenytoin levels

4

a nurse is caring for a child immediately following insertion of a ventriculoperitoneal VP shunt for treatment of hydrocephalus period the nurses postoperative care should include? 1 Maintaining the head of bed in an elevated position 2 ensuring that the child minimizes movement of the extremities 3 providing a pressure dressing over the cephalic insertion site 4 changing the Childs position every 2 hours

4

a nurse is caring for a client who is being discharged following a transsphenoidal hypophysectomy for the removal of a pituitary tumor. which statement by the client indicates teaching has been effective regarding actions to prevent postoperative complications? 1 I will cleanse my incision twice daily with soap and water 2 I have a flat pillow so that I can sleep with my head relatively flat 3 i should cough and deep breathe at least every 2 hours while I am awake 4 my daughter has put my plants on the counter for watering so I won't be bending

4

a nurse is caring for a client who is experiencing symptoms associated with pheochromocytoma. Which intervention should be included in the care of this client? 1 offer distractions such as television or music 2 encourage frequent intake of oral fluids 3 assist with ambulation at least 3 times a day 4 administer nicardipine (Cardene) To control hypertension

4

a nurse is caring for a client who is hospitalised with adrenocortical insufficiency. the next review is the client serum laboratory values and immediately notifies the position period which serum laboratory value most likely prompted the nurse to notify the physician? 1 WBC 11.0 k/ul 2 glucose 138 MG/DL 3 sodium 148 meQ/L 4 potassium 6.2 MEQ/L

4

a nurse is documenting nursing diagnosis for a client with elevated growth hormone levels period which nursing diagnosis is least likely to be included in the client's plan of care? 1 fluid volume deficit related to polyurea 2 insomnia related to soft tissue swelling 3 impaired communication related to speech difficulties 4 disturbed body image related to undersized hands, feet, job, and soft body tissue

4

a nurse is teaching the parent of a child with growth hormone deficiency. The nurse instructs the parent on how and when to give growth hormone injections period the nurse realizes that the teaching has been successful when the parent states: 1 I will give the injection every morning when the child awakens and before breakfast 2 the upper aspect of the arm is the best choice for the injection of the medication because there will be less pain 3 soap and water will be used to clean the injection site to reduce the dermal thickening caused by using the alcohol wipes 4 the injection site will be rotated for each injection and the injection will be given at night, just before bed

4

a nurse is working with parents of a child newly diagnosed with Duchenne muscular dystrophy when the mother states she is pregnant, knows the fetus is female comma and is concerned about her unborn child also developing DMD period which response by the nurse is appropriate when responding to this woman? 1 you already have one child with the disease, it's unlikely you'll have another 2 because only your brother was diagnosed with DMD, it's highly unlikely you will have another child with DMD 3 as many as 1/3 of children born with the MD have no family history of the disease 4 if your unborn child is a girl, she may carry the gene, but will not develop DMD

4

client with Myasthenia Gravis tells the nurse that she is experiencing vision difficulties. the primary problem the nurse should assess for in this client should be 1 photophobia 2 amaurosis fugax 3 hemianopsia 4 diplopia

4

health care provider prescribes Sumatriptan sukin 8 for a client who has recurring migraine headaches period the nurse should inform the client to notify the HCP immediately if experiencing which symptoms after taking the medication? 1 flushing 2 hot sensation 3 decrease in eye sensitivity to light 4 chest pain

4

health care providers progress notes states that an infant with meningitis is in an opisthoyonus position. The nurse should expect to observe 1 resistance with specific leg movement 2 knee or hip flexion with head flexion 3 high pitched cry with neck flexion 4 hyperextension of the head and neck

4

the client is admitted to the ER with a diagnosis of myxedema coma period which order should a nurse anticipate when caring for this client? 1 administer anti thyroid medication and prepare for surgery 2 administer a beta blocker medication and apply a cooling blanket 3 administer IV fluids and a glucocorticosteroid medication 4 apply oxygen in warming blankets comma and administer IV thyroid hormone

4

the client is hospitalised with a diagnosis of meninga kochel meningitis period the client is at risk for the complication of septic emboli period which intervention by a nurse directly addresses this risk? 1 monitoring vital signs on an hourly basis 2 administering meningitis probably saccharide vaccine 3 assessing neurological function with the Glasgow coma scale every 2 hours 4 completing a vascular assessment of all extremities every 2 hours

4

the husband of a client who is being treated for hyperactivity of the adrenal gland caused the clinic because he is concerned about his wife's behavior. He states she has been throwing things, yelling at the children comma and bursting into tears at odd times period he is concerned because she thinks she might be going crazy. Which is the nurses best response? 1 bring her to the psychiatric Ward immediately period she may need to be restrained to prevent her from harming herself or others 2 tell your wife that I will ask the physician to order a psychiatric referral to have her evaluated for a psychiatric disorder 3 reassure your wife that she is not going crazy period when her prescribed medications Ricci therapeutic level this behavior should subside 4 bring her to the clinic immediately. Her behavior and feelings may be due to high hormone levels. additional medications may be needed

4

the parents of an extremely low birthweight infant have asked the nurse, how can anyone tell if our baby has cerebral palsy? the nurse explains that the diagnosis is made by 1 MRI 2 CT 3 LP 4 clinical exam

4

what is the most important factor for a nurse to consider when teaching a child with cerebral palsy? 1 age 2 type of cerebral palsy 3 the child's prior experiences with illness 4 developmental level

4

which instruction demonstrates to a supervising nurse that a new nurse lacks understanding of current practices when teaching a child who is experiencing exophathalmia? 1 telling the child to use sunglasses outdoors 2 telling the child to tape the eyelids closed at night 3 telling the child to use artificial tears 4 telling the child to maintain a darkened environment

4

which medication should a nurse plan to administer to a client admitted with addisonian crisis? 1 regular insulin 2 ketoconazole (Nizoral) 3 sodium nitroprusside (Nipride) 4 hydrocortisone (solu cortef)

4

which nursing diagnosis is most important for a nurse to include in the written plan of care for a 6 year old child with precocious puberty? 1 disturbed body image related to short stature 2 imbalanced nutrition, more than body requirements related to accelerated growth 3 effective therapeutic regimen related to dietary an medication plan adherence 4 risk for disproportionate growth related to accelerated growth and advancing bone age

4

which nursing diagnosis should a nurse include when developing a plan of care for a client with hypothyroidism 1 diarrhea related to gastrointestinal hypermotility 2 imbalanced nutrition, less than body requirements related to calorie intake insufficient for metabolic rate 3 activity intolerance related to increased metabolic rate 4 anxiety related to forgetfulness, slowed speech, an impaired memory loss

4

which safety measure should be implemented for a client who has adrenocortical insufficiency? 1 provide a room fan to keep the client cool and avoid hyperthermia 2 wear gloves when touching the darkened areas on the client's skin 3 check the clients meal tray to ensure that the client does not receive salt with meals 4 when preparing the client to ambulate, first have the client sit on the edge of the bed

4

an adolescent has been transferred to the hospital after being found unconscious on a sidewalk. Place the following interventions in order of priority 1 complete a neurological assessment 2 open the child's airway with a jaw thrust maneuver 3 meet the family 4 stabilize the child's neck and spine 5 assess the incisions and intravenous lines placed by ambulance personnel

42153

a clinic nurse assess is an adolescent female would turners syndrome. The nurse knows that the adolescent, as a result of Turner's syndrome, may experience low self esteem related to: 1 hirsutism and long legs 2 gynecomastia an pronounced scoliosis 3 short stature and lack of secondary sex characteristics 4 lower than average intelligence quotient IQ and dental abnormalities

?