405 Test 3 Practice Questions

A patient is being educated on how to take their anti-thyroid medication. Which of the following statements are INCORRECT? A. "I will continue taking aspirin daily." B. "I will take this medication at the same time every day." C. "It may take a while before I notice that the medication is helping my condition." D. "I will avoid foods containing high levels of iodine

A. "I will continue taking aspirin daily." Explanation: The patient needs to be instructed NOT to take aspirin because it increases thyroid hormones. All the other statements are correct.

You are performing discharge teaching with a patient who is going home on Synthroid (Levothyroxine). Which statement by the patient causes you to re-educate the patient about this medication? A. "I will take this medication at bedtime with a snack." B. "I will never stop taking the medication abruptly." C. "If I have palpitations, chest pain, intolerance to heat, or feel restless, I will notify the doctor." D. "I will not take this medication at the same time I take my Carafate."

A. "I will take this medication at bedtime with a snack." Explanation: Synthroid is best taken in the MORNING on an empty stomach. All the other statements are correct about taking Synthroid.

Which patient is most at risk for developing Syndrome of Inappropriate Anti-diuretic Hormone (SIADH)? A. A patient diagnosed with small cell lung cancer. B. A patient whose kidney tubules are failing to reabsorb water. C. A patient with a tumor on the anterior pituitary gland. D. A patient taking Declomycin.

A. A patient diagnosed with small cell lung cancer.

A patient with SIADH is undergoing IV treatment of a hypertonic IV solution of 3% saline and IV Lasix. Which of the following nursing findings requires intervention? A. Assessment finding of crackles throughout the lung fields. B. Patient reports urinating more frequently. C. Potassium level of 5.0. D. Sodium level of 136.

A. Assessment finding of crackles throughout the lung fields. Explanation: Remember that when administering a hypertonic solution you have to do this very slowly and watch for volume overload. Hypertonic solutions pull fluid from the cell (which is already water intoxicated) and place it back into the vascular system...therefore, crackles in the lungs are a sign there is too much fluid in the body and the heart can not compensate so the fluid is backing up into the lungs. This would require intervention.

A patient with hypothyroidism is having pain 6 on 1-10 scale in the right hip due to recent hip surgery. Which of the following medications are NOT appropriate for this patient? Select all that apply: A. Fentanyl B. Tylenol C. Morphine D. Dilaudid

A. Fentanyl C. Morphine D. Dilaudid Explanation: Patients who have hypothyroidism are very sensitive to narcotics and should take NON-NARCOTICS for pain relief. Fentanyl, Morphine, and Dilaudid are all narcotics, whereas, Tylenol is not.

Signs and Symptoms of myxedema coma include all of the following EXCEPT? Select all that apply: A. Fever B. Bradycardia C. Sodium level less than 135 D. Blood glucose level greater than 350 E. Hypothermia

A. Fever D. Blood glucose level greater than 350

A patient with Cushing's syndrome will be undergoing an adrenalectomy. Which of the following will be included in the patient's discharge teaching after the procedure? A. Glucocorticoid replacement therapy B. Avoiding avocadoes and pears C. Declomycin therapy D. Signs and symptoms of Grave's Disease

A. Glucocorticoid replacement therapy

Which of the following signs and symptoms causes concern and requires nursing intervention for a patient who recently had a thyroidectomy? A. Heart rate of 120, blood pressure 220/102, temperature 103.2 'F B. Heart rate of 35, blood pressure 60/43, temperature 95.3 'F C. Soft hair, irritable, diarrhea D. Constipation, drowsiness, goiter

A. Heart rate of 120, blood pressure 220/102, temperature 103.2 'F Explanation: A patient is at risk for experiencing thyroid storm after a thyroidectomy because of manipulation of the thryroid gland that could cause excessive T3 and T4 to enter into the bloodstream during removal of the gland. Therefore, heart rate of 120, blood pressure 220/102, temperature 103.2 'F are classic signs of thyroid storm and this requires nursing intervention.

Select all that apply: Which of the following are signs and symptoms of Grave's Disease: A. Heat Intolerance B. Weight gain C. Bradycardia D. Goiter E. Pretibial Myxedema F. Cold intolerance G. Ophthalmopathy changes H. Fast Heart Rate

A. Heat Intolerance D. Goiter E. Pretibial Myxedema G. Ophthalmopathy changes H. Fast Heart Rate

Which of the following aid in diagnosing the risk of anaphylaxis? A. Intradermal testing B. Nasal smear C. Punch biopsy D. Peripheral blood smears

A. Intradermal testing

A nursing instructor is evaluating a student caring for a neutropenic client. The instructor concludes that the nursing student demonstrates accurate knowledge of neutropenia based on which intervention? A. Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential B. Monitoring the client's breathing and reviewing the client's arterial blood gases C. Monitoring the client's heart rate and reviewing the client's hemoglobin D. Monitoring the client's blood pressure and reviewing the client's hematocrit

A. Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential

Primary gout is often caused by an inherited disorder in which type of metabolism? A. Purine B. Carbohydrate C. Fat D. Glucose

A. Purine

A patient arrives to the ER and is unable to give you a health history due to altered mental status. The family reports the patient has gained over 10 lbs in 1 week and says it is mainly "water" weight. In addition, they report the patient hasn't been able to urinate or eat within the past week as well and was recently diagnosed with small cell lung cancer. On assessment, you note the patient's HR is 115 and BP 180/92. Patient sodium level is 90. Which of the following conditions do you suspect the patient is most likely presenting with? A. SIADH B. Diabetes Insipidus C. Addison's Disease D. Fluid Volume Deficient

A. SIADH

Which of the following foods below should a patient experiencing a thyroid storm avoid? Select all that apply: A. Shrimp B. Milk C. Hard boiled eggs D. Seaweed (Kelp) E. Broccoli F. Peas

A. Shrimp B. Milk C. Hard boiled eggs D. Seaweed (Kelp)

Which of the following are treatment options for hyperthyroidism? Please select all that apply: A. Thyroidectomy B. Methimazole C. Liothyronine Sodium "Cytomel" D. Radioactive Iodine

A. Thyroidectomy B. Methimazole D. Radioactive Iodine Explanation: The answers are A, B,and D. Liothyronine Sodium "Cytomel" is a treatment for hypothyroidism. All the other options are for hyperthyroidism.

A nurse is collecting data from a client who is suspected of having an endocrine disorder and is scheduled for diagnostic testing that involves the use of a contrast medium. The nurse would inform the physician if the client stated which of the following? A. "My father had diabetes when he got older." B. "I have an allergy to shrimp and shellfish." C. "I take a multivitamin every day." D. "Years ago, I took a steroid for my asthma."

B. "I have an allergy to shrimp and shellfish." Explanation: The statement about an allergy to shrimp and shellfish would alert the nurse to the possibility of an allergy to iodine, a component of contrast media. This information needs to be reported to the physician. Although information about a family history of diabetes would be important, it would have no effect on the diagnostic testing. Certain drugs can affect diagnostic testing, but a multivitamin probably would not be a problem. Use of steroids within the past 3 months, rather than several years ago, could impact the results of thyroid testing.

A patient is started on Tapazole (Methimazole) for treatment of Grave's Disease. Which statement by the patient indicates they understood your teaching about this medication? A. "If I experience fast heart, excessive sweating, or fever, I will notify the doctor immediately because I may be experiencing toxicity of the medication." B. "I know it may take a while before I feel relief of symptoms, therefore, I will never abruptly stop taking my medication." C. "This medication can cause high blood glucose." D. "I will make sure my diet is rich in foods containing iodine."

B. "I know it may take a while before I feel relief of symptoms, therefore, I will never abruptly stop taking my medication."

Which of the following patients are at risk for developing Cushing's Syndrome? A. A patient with a tumor on the pituitary gland, which is causing too much ACTH to be secreted. B. A patient taking glucocorticoids for several weeks. C. A patient with a tuberculosis infection. D. A patient who is post-opt from an adrenalectomy

B. A patient taking glucocorticoids for several weeks.

"A patient arrives to the ER and is unable to give you a health history due to altered mental status. The family reports the patient has gained over 10 lbs in 1 week and says it is mainly "water" weight. In addition, they report the patient hasn't been able to urinate or eat within the past week as well and was recently diagnosed with small cell lung cancer. On assessment, you note the patient's HR is 115 and BP 180/92. Patient sodium level is 90. Which of the following conditions do you suspect the patient is most likely presenting with?" In the scenario above, which drug do you anticipate the patient will be started on per doctor's order? A. Desmopressin (DDAVP) IV B. Declomycin C. Diabinese D. Stimate

B. Declomycin

Which client problem relating to altered nutrition is a consequence of AIDS? A. Increased appetite B. Decreased protein absorption C. Increased secretions of digestive juices D. Decreased gastrointestinal absorption

B. Decreased protein absorption

The physician orders a patient with suspected iron-deficiency anemia a blood smear test to assess the quality of the red blood cells. How would the red blood cells appear if the patient had iron- deficiency anemia? A. Hyperchromic and macrocytic B. Hypochromic and microcytic C. Hyperchromic and macrocytic D. Hypochromic and macrocytic

B. Hypochromic and microcytic Explanation: The RBCs would appear pale (hypochromic) and small (microcytic)

The thyroid hormones, T3 and T4, play many roles in the human body. Which of the following functions are performed by T3 and T4? Note: Select all that apply: A. Storing calories B. Increasing the Heart Rate C. Stimulating the Sympathetic Nervous System D. Decreasing the body's temperature E. Regulating TSH produced by the anterior pituitary gland

B. Increasing the Heart Rate C. Stimulating the Sympathetic Nervous System E. Regulating TSH produced by the anterior pituitary gland Explanation: T3 and T4 burn calories (not store them) and increase body temperature (not decrease).

Which of the following are NOT a cause of myxedema coma? A. Illness B. Sedatives C. Iodine Toxicity D. Thyroidectom

B. Iodine Toxicity Explanation: Iodine toxicity can cause HYPERthyroidism issues not HYPOthyroidism issues

A patient taking IV Synthroid starts to complain of feeling hot and chest pain. On assessment, you find that the heart rate is 125 bpm and blood pressure is 200/103. You immediately notify the physician of the patient's condition and receive orders for lab work. Based on the patient's signs and symptoms, what is the MOST important lab result at this time to determine the cause of the patient's symptoms? A. Potassium level B. Thyroid levels C. Calcium level D. Sodium level

B. Thyroid levels Explanation: The patient is receiving IV Synthroid. Therefore, the nurse must monitor for toxicity which would present with elevated THYROID levels. Remember Synthroid is a thyroid replacement medication. This would present with the patient complaining of feeling hot, chest pain, tachycardia, and hypertension (similar signs and symptoms of HYPERthyroidism).

When evaluating a patient's symptoms that are consistent with a diagnosis of leukemia, the nurse is aware that a common feature of all leukemias is which of the following? A. Compensatory polycythemia stimulated by thrombocytopenia B. Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements C. Increased blood viscosity, resulting from an overproduction of white cells D. Reduced plasma volume in response to a reduced production of cellular elements

B. Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements

A male client comes to the clinic with complaints of pain in his right great toe. The client reports that the pain is worse at night. Assessment reveals tophi. The nurse suspects the client has: A. osteoarthritis B. gouty arthritis C. rheumatoid arthritis D. reactive arthritis.

B. gouty arthritis

A client visits the physician's office complaining of agitation, restlessness, and weight loss. The physical examination reveals exophthalmos, a classic sign of Graves' disease. Based on history and physical findings, the nurse suspects hyperthyroidism. Exophthalmos is characterized by: A. dry, waxy swelling and abnormal mucin deposits in the skin B. protruding eyes and a fixed stare. C. a wide, staggering gait. D. more than 10 beats/minute difference between the apical and radial pulse rates.

B. protruding eyes and a fixed stare. Explanation: Exophthalmos is characterized by protruding eyes and a fixed stare. Dry, waxy swelling and abnormal mucin deposits in the skin typify myxedema, a condition resulting from advanced hypothyroidism. A wide, staggering gait and a differential between the apical and radial pulse rates aren't specific signs of thyroid dysfunction

A patient is receiving treatment for myxedema coma with IV Synthroid. Which of the following findings would require nursing intervention for this patient? A. Blood glucose 75 B. Sodium level of 138 C. A physician's order for Fentanyl 0.25 mcg every 2 hours for pain D. Temperature 98.9 'F

C. A physician's order for Fentanyl 0.25 mcg every 2 hours for pain Explanation: The other options are normal readings...however, patients with myxedema coma should not receive sedatives or narcotics (Fentanyl is a narcotic) because these patients are very sensitive to them. Therefore, the nurse should intervene and question the doctor's order.

Which of the following statements are CORRECT about Grave's Disease? A. Grave's Disease is caused by independently functioning nodular goiters producing excessive amounts of T3 and T4. B. Grave's Disease is a complication of untreated hypothyroidism. C. Grave's Disease is caused by an autoimmune condition where the body produces an antibody called TSI (which acts like TSH on the body). D. Grave's Disease patients do not present with protruding eyes or a goiter, as in Toxic Nodular Goiter (TNG)

C. Grave's Disease is caused by an autoimmune condition where the body produces an antibody called TSI (which acts like TSH on the body).

A patient with Addison's Disease should consume which of the following diets? A. High fat and fiber B. Low potassium and high protein C. High protein, carbs, and adequate sodium D. Low carbs, high protein, and increased sodium

C. High protein, carbs, and adequate sodium

All of the following are treatments for myxedema coma EXCEPT? A. Corticosteroids B. IV glucose C. Hypotonic IV solutions D. IV Synthroid

C. Hypotonic IV solutions Explanation: HYPERtonic or normal saline solutions are used to treat myxedema coma due to the present of hyponatremia....not HYPOtonic solutions.

A nurse is performing the health history and physical assessment of a client who has a diagnosis of rheumatoid arthritis (RA). What assessment finding is most consistent with the clinical presentation of RA? A. Cool joints with decreased range of motion B. Signs of systemic infection C. Joint stiffness, especially in the morning D. Visible atrophy of the knee and shoulder joints

C. Joint stiffness, especially in the morning

A patient, with a history of gastric bypass surgery 6 months ago, reports feeling very fatigued and is having food cravings for clay and dirt. On assessment, you note the patient has nail changes that look "spoon-shaped". This spoon-shaped appearance of the nails is called? A. Terry's Nails B. Onychoschizia C. Koilonychias D. Leukonychia

C. Koilonychias

The nurse would instruct the client to eat which of the following foods to obtain the best supply of vitamin B12? A. Whole grains B. Green leafy vegetables C. Meats and dairy products D. Broccoli and Brussels sprouts

C. Meats and dairy products

A patient has an extremely high T3 and T4 level. Which of the following signs and symptoms DO NOT present with this condition? A. Weight loss B. Intolerance to heat C. Smooth skin D. Hair loss

D. Hair loss

A patient reports they do not eat enough iodine in their diet. What condition are they most susceptible to? A. Pheochromocytoma B. Hyperthyroidism C. Thyroid Storm D. Hypothyroidism

D. Hypothyroidism Explanation: Iodine helps make T3 and T4....if a person does not consume enough iodine they are at risk for developing HYPOTHYROIDISM

A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the nurse do? A. Monitor laboratory values daily for elevated thyroid-stimulating hormone. B. Observe for swelling of the neck, tracheal deviation, and severe pain. C. Evaluate the quality of the client's voice postoperatively, noting any drastic changes. D. Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.

D. Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.

Nurse Ruffa is providing dietary instructions to the client with systemic lupus erythematosus. Which of the following dietary items would the nurse instruct the client to avoid? A. Cantaloupe B. Turkey C. Broccoli D. Steak

D. Steak Explanation: The client with systemic lupus erythematosus (SLE) is at risk for cardiovascular disorders such as coronary artery disease and hypertension. The client is advised of lifestyle changes to reduce these risks, which include smoking cessation and prevention of obesity and hyperlipidemia. The client is advised to reduce salt, fat, and cholesterol intake.

A client with von Willebrand disease (vWD) has experienced recent changes in bowel function that suggest the need for a screening colonoscopy. What intervention should be performed in anticipation of this procedure? A. The client should not undergo the normal bowel cleansing protocol prior to the procedure. B. The client should receive a unit of fresh-frozen plasma 48 hours before the procedure. C. The client should be admitted to the surgical unit on the day before the procedure. D. The client should be given necessary clotting factors before the procedure.

D. The client should be given necessary clotting factors before the procedure.