Adult Test #4
What is the nurse's best first response when a client with a suspected endocrine disorder says, "I can't, you know, satisfy my wife anymore."? - "Would you like to speak with a counselor?" - "Do you use any over the counter or recreational drugs?" - "Don't worry. It happens to everyone occasionally." - "Can you please tell me more?"
"Can you please tell me more?"
Which question asked by a 48-year-old client with sleep apnea whose blood glucose level is elevated suggests to the nurse the possibility of a growth hormone excess? - "Does everyone's feet get bigger during menopause?" - "Why do I feel thirsty all the time?" - "How can I make my skin less itchy?" - "Do you think if I lost weight my sleep apnea would improve?"
"Does everyone's feet get bigger during menopause?"
Which statement made by the client who is going home after a transsphenoidal hypophysectomy indicates to the nurse correct understanding of actions to prevent complications from this treatment? - "I will keep the cat food bowl on my counter so that I do not have to bend over." - "While I am awake, I will be sure to cough and deep breathe at least every 2 hours." - "Whenever I am out-of-doors in the sunshine, I will wear dark glasses." - "If the dressing gets wet, I will wash the incision line and redress it immediately."
"I will keep the cat food bowl on my counter so that I do not have to bend over."
After instructing a client about the correct procedure for a 24-hour urine test, which client statement indicates to the nurse a need for further teaching? - "I will not eat any fatty foods when I am collecting urine for this test." - "To end the collection, I must empty my bladder and add this urine to the collection." - "I won't save the first urine sample of the day." - "I need to keep the urine container cool in a separate refrigerator or cooler."
"I will not eat any fatty foods when I am collecting urine for this test."
Which statement made by a client about thyroid hormone replacement therapy (HRT) indicates to the nurse that further teaching is needed? - "I will take the medication every morning." - "I will have more energy with this medication." - "If I often am constipated and feel tired, I may need an increased dose." - "If I continue to lose weight, I may need an increased dose."
"If I continue to lose weight, I may need an increased dose."
Which statement made by a client who is undergoing therapy with radioactive iodine (RAI) for Graves disease indicates a lack of understanding about the disorder and its treatment? - "Luckily, I have my own bathroom, so I won't be exposing the rest of my family to radiation. - "If this treatment works, maybe I will stop sweating all the time. - "It will be great to lose my "bug-eyed" appearance. - "I hope I don't gain too much weight when my thyroid function is normal.
"It will be great to lose my "bug-eyed" appearance.
Which factor is most important for the nurse to assess before providing instruction to a client newly diagnosed with diabetes about the disease and its management? - Current energy level and rest patterns - Sexual orientation - Current lifestyle for diet and exercise - Education and literacy levels
- Education and literacy levels
Which client assessment findings indicate to the nurse that leukemia may be present? (Select all that apply.) - Multiple bruises - Fever - Night sweats - Fatigue - Frequent colds - Severe epistaxis
- Multiple bruises - Fever - Night sweats - Fatigue - Frequent colds
What is the nurse's best response when family members of a client with hyperthyroidism express concern about the client's frequent mood swings? - "Mood swings are common should diminish with treatment." - "The medications will make the mood swings disappear completely." - "Your family member is sick. You must be patient." - "Do the client's mood swings make you feel angry?"
"Mood swings are common should diminish with treatment."
A nurse is giving a group presentation on cancer prevention and factors that cause cancer. Which statement by a client indicates understanding the education provided? - "Nearly 1/3 of cancers in the United States are related to tobacco use." - "Most cancer is hereditary." - "Red meat helps to prevent cancer development." - "If I eat a healthy diet and exercise I will not develop cancer."
- "Nearly 1/3 of cancers in the United States are related to tobacco use."
Which specific action is a priority for the nurse to teach a client with diabetes who has peripheral neuropathy to prevent harm? - "Wear a medical alert bracelet." - "Never reuse insulin syringes." - "Drink at least 3 L of fluids daily." - "Never go barefoot."
- "Never go barefoot."
What is the nurse's best response when a client, who has been taking high-dose corticosteroid therapy for a month for a problem that has now resolved, asks you why she needs to continue taking the corticosteroid? - "It is possible for your health problem to recur when corticosteroid therapy is halted suddenly." - "Corticosteroids are a type of hormone, and once you have been started on a replacement hormone, you must continue the hormone replacement therapy for the rest of your life." - "The drug suppressed your immune system while you were taking it. Slowly decreasing the dose over time prevents your immune system from starting up too quickly and causing allergic reactions." - "The drug suppressed your own adrenal gland secretion of corticosteroids. Slowly decreasing the dose over time allows your adrenal glands to start adequate secretion again."
"The drug suppressed your own adrenal gland secretion of corticosteroids. Slowly decreasing the dose over time allows your adrenal glands to start adequate secretion again."
What is the nurse's best response when a client with Cushing syndrome screams at her husband, bursts into tears, throws her water pitcher against the wall, and then says "I feel like I am going crazy"? - "You must learn to control your behavior. Because you are disturbing others, I am going to keep the door to your room closed and restrict your visitors." - "You are probably feeling this way because you are frightened about having a chronic disease. Would you like some information about a support group?" - "I will tell your primary health care provider order a psychiatric consult for you." - "You feel this way because of your high hormone levels. Your health care provider can prescribe an antianxiety drug for you."
"You feel this way because of your high hormone levels. Your health care provider can prescribe an antianxiety drug for you."
Which precaution will the nurse include when providing instructions to the female client with hypothyroidism who is prescribed to take thyroid hormone replacement therapy (HRT)? - "If you miss a dose, double your next day's dose." - "Avoid over-the-counter medications unless prescribed by your primary health care provider." - "Stop this drug immediately if you discover you are pregnant." - "Increase the amount of fiber in your diet to prevent the side effect of constipation."
- "Avoid over-the-counter medications unless prescribed by your primary health care provider."
The client who wants to use Truvada for preexposure prophylaxis (PreP) asks the nurse why testing is needed for HIV status before starting this drug. How does the nurse respond? - "The side effects of this drug are worse if you have a detectable HIV viral load." - "If you take this drug and are HIV positive, your risk for co-infection with the hepatitis B virus is increased." - "Although this drug can help prevent HIV infection, it is not enough by itself to control "the disease if you are HIV positive." - Some people have a genetic mutation that increases the risk for life- threatening reactions "while taking this drug if they are also HIV positive."
- "Although this drug can help prevent HIV infection, it is not enough by itself to control "the disease if you are HIV positive."
An 85-year-old client tells the nurse that she does not perform breast self- exam because there is no history of breast cancer in her family. What is the nurse's best response? - "You are correct. Breast cancer is an inherited type of malignancy and your family history indicates a low risk for you." - "Breast cancer can be found more frequently in families; however, the risk for general, nonfamilial breast cancer increases with age." - "Because your breasts are no longer as dense as they were when you were younger, your risk for breast cancer is now decreased." - "Examining your breasts once per year when you have your mammogram is sufficient screening for someone with your history."
- "Breast cancer can be found more frequently in families; however, the risk for general, nonfamilial breast cancer increases with age."
Which precaution is most important for the nurse to teach a client who has cardiovascular autonomic neuropathy (CAN) from diabetes to prevent harm? - "Change positions slowly when moving from sitting to standing." - "Avoid drinking caffeine or caffeinated beverages." - "Be sure to take your blood pressure drug daily." - "Check your hands and feet weekly for chronic excessive sweating."
- "Change positions slowly when moving from sitting to standing."
Which statement made by the nurse during an admission assessment for a client who is HIV positive demonstrates a nonjudgmental approach in discussing sexual practices and behaviors? - "Have you had sex with men or women or both?" - "I hope you use condoms to protect your partners." - "You must tell me all of your partners' names, so I can let them know about possibly being infected." - "You don't participate in anal intercourse, do you?"
- "Have you had sex with men or women or both?"
Which question is most relevant to ask a male client suspected to have a gonadotropin deficiency? - "How often do you need to shave your face?" - "Are you experiencing any pain during sexual intercourse?" - "Have you gained or lost any weight recently?" - "Do you work with or have hobbies that involve exposure to chemicals?"
- "How often do you need to shave your face?"
Which statement made by the client alerts the nurse to the possibility of hypothyroidism? - "I seem to feel the heat more than other people." - "Food just doesn't taste good without a lot of salt." - "I am always tired, even when I get 10 or 12 hours of sleep." - "My grandmother had thyroid problems."
- "I am always tired, even when I get 10 or 12 hours of sleep."
A client with erectile dysfunction has been prescribed a PDE-5 inhibitor. Which client statement demonstrates that nursing teaching about the medication has been effective? - "I can drink a little bit of alcohol before intercourse to help me out." - "I have to be sure to be careful when I sit up or stand up." - "I will have my partner take this medication about 30 minutes before intercourse." - "I need to increase fiber in my diet to avoid constipation."
- "I have to be sure to be careful when I sit up or stand up."
Which statement by a client indicates to the nurse correct understanding of what to do when the sensations of hunger and shakiness occur? - "I will give myself a dose of glucagon." - "I will eat three graham crackers." - "I will sit down and rest." - "I will drink a glass of water."
- "I will eat three graham crackers."
Which client statement allows the nurse to recognize whether the client receiving brachytherapy for ovarian cancer understands the treatment? - "I may lose my hair during this treatment." - "I must be positioned in the same way during each treatment." - "I will have a radioactive device in my body for a short time." - "I will be placed in a semiprivate room for company."
- "I will have a radioactive device in my body for a short time."
The nurse is educating a group of young men about testicular self- examination (TSE). Which statement by a member of the group indicates teaching has been effective? - "I will examine my testicles right before taking a shower." - "I will squeeze each testicle in my hand to feel any abnormalities." - "I only need to report large masses to my primary health care provider." - "I will look and feel for any lumps or changes to my testes."
- "I will look and feel for any lumps or changes to my testes."
The nurse is performing discharge teaching for a client who is recovering from a total abdominal hysterectomy (TAH). Which client statement indicates a need for clarification? - "I cannot jog for 2 to 6 weeks." - "I must take my temperature twice a day for the first few days after surgery." - "I will need to find a new form of birth control." - "I will no longer have menstrual periods."
- "I will need to find a new form of birth control."
What is the nurse's best response to a client newly diagnosed with type 1 diabetes who asks why insulin is only given by injection and not as an oral drug? - "Oral insulin is so weak that it would require very high dosages to be effective." - "Injected insulin works faster than oral drugs to lower blood glucose levels." - "Insulin is a "high alert drug" and could more easily be abused if it were available as an oral agent." - "Insulin is a small protein that is destroyed in by stomach acids and intestinal enzymes."
- "Insulin is a small protein that is destroyed in by stomach acids and intestinal enzymes."
A client had a total abdominal hysterectomy 2 days ago and is to be discharged on antibiotics. What does the nurse include in discharge teaching? - "After your first day at home, you can stop them if you do not have a fever." - "It is important to take them as directed until they are all gone." - "Stop the antibiotic if you feel nauseated because it will lose its effectiveness." - "You will need to take the drug until your incision heals."
- "It is important to take them as directed until they are all gone."
A client expresses fear and anxiety over the life changes associated with diabetes, stating, "I am scared that I can't do it all and will get so sick that I will be a burden on my family." What is the nurse's best response? - "Let's tackle it piece by piece. What is most scary to you?" - "It is overwhelming, isn't it?" - "Many people live with diabetes and do it just fine." - "Let's see how much you can learn today, so you are less nervous."
- "Let's tackle it piece by piece. What is most scary to you?"
What action will the nurse advise to prevent harm for a client with diabetes who has a 3-cm callus on the ball of the right foot? - "Apply an over-the-counter callus-dissolving pad and follow the package directions." - "Make an appointment with a pedicurist and have them cut or file off the callus." - "Make an appointment with your podiatrist as soon as possible." - "Soak your feet nightly in warm water and peel of a little of the callus every day."
- "Make an appointment with your podiatrist as soon as possible."
Which statement made by a client who is learning about self-injection of insulin indicates to the nurse that clarification is needed about injection site selection and rotation? - "If I change my injection site from the thigh to an arm, the inulin absorption may be different." - "By rotating sites within one area, my chance of having skin changes is less." - "I can reach my thigh best, so I will use different areas of the same thigh." - "The abdominal site is best because it is closest to the pancreas."
- "The abdominal site is best because it is closest to the pancreas."
What is the nurse's best response to a client newly diagnosed with diabetes who asks why he is always so thirsty? - "Without insulin, glucose is excreted rather than used in the cells. The loss of glucose directly triggers thirst, especially for sugared drinks." - "Without insulin, glucose combines with blood cholesterol, which damages the kidneys, making you feel thirsty even when no water has been lost." - "The extra glucose in the blood makes the blood thicker, which then triggers thirst so that the water you drink will dilute the blood glucose level." - "The extra glucose in the blood increases the blood sodium level, which increases your sense of thirst."
- "The extra glucose in the blood makes the blood thicker, which then triggers thirst so that the water you drink will dilute the blood glucose level."
Which statement made to the nurse by an assistive personnel (AP) assigned to care for an HIV-positive client indicates a breach of confidentiality and requires further education by the nurse? - "I told family members they need to wash their hands when they enter and leave the room." - "The other assistive personnel and I were out in the hallway discussing our concern about getting HIV from our client." - "Yes, I understand the reasons why I have don't need to wear gloves when I feed the client." - "The client's spouse told me she got HIV from a blood transfusion."
- "The other assistive personnel and I were out in the hallway discussing our concern about getting HIV from our client."
A client who had an anterior colporrhaphy is being discharged. What does the nurse tell the client before her discharge? - "Avoid lifting more than 25 lb (11.3 kg)." - "Do not have sexual intercourse for at least 2 weeks." - "Return to the clinic in 6 weeks for suture removal." - "Use a pillow to splint your abdomen."
- "Use a pillow to splint your abdomen."
Which point is most important for the nurse to include when teaching assistive personnel (AP) about protecting themselves from HIV exposure when caring for HIV-positive clients? - "Wear gloves when in contact with clients' mucous membranes or nonintact skin." - "Wear full protective gear when providing any care to HIV-positive clients." - "Always wear a mask when entering an HIV-positive client's room." - "Talk to the employee health nurse about starting preexposure prophylaxis."
- "Wear gloves when in contact with clients' mucous membranes or nonintact skin."
How will the nurse reply when a client with type 2 diabetes tells the nurse that he would like to have a 12-ounce glass of beer with supper but believes that is now impossible? - "If you gave up dessert, you can still have one beer." - "You can have a beer with a meal if you test yourself for hyperglycemia an hour later." - "There are nonalcoholic beers available that you can substitute for a regular beer." - "You can have a beer with a meal if you test yourself for hypoglycemia an hour later."
- "You can have a beer with a meal if you test yourself for hypoglycemia an hour later."
What is the nurse's best response to a client with type 2 diabetes controlled with metformin who asks why now that he is recovering from surgery, is he prescribed to receive insulin therapy for a few days? - "You just need insulin temporarily because the stress of surgery causes increased blood glucose levels for a day or two." - "Your presurgical testing indicates that you now have type 1 diabetes and require daily insulin." - "Your insurance doesn't permit metformin to be used during hospitalization." - "You must take insulin from now on because the surgery has aggravated the intensity of your diabetes."
- "You just need insulin temporarily because the stress of surgery causes increased blood glucose levels for a day or two."
A 40-year-old man who has a mother who was diagnosed with breast cancer at age 45, a father who was diagnosed with smoking-related lung cancer at age 55, a 33-year-old sister with breast cancer, and a 38-year- old sister with ovarian cancer, asks if he should be concerned for his cancer risk. What is the nurse's best response? - "Your risk is not affected by this family history because most of the cancers arose in female sex-associated tissues." - "You have two first-degree relatives and two second-degree relatives with cancer, which increases your general risk for cancer." - "Your risk for breast cancer is increased; however, your risk for lung cancer is not affected by this history." - "Your risk for cancer is affected by your parents' cancer development; your sisters' cancers have no bearing on your risk."
- "Your risk for breast cancer is increased; however, your risk for lung cancer is not affected by this history."
When (at which time) will the nurse plan to monitor for hypoglycemia in a client with type 1 diabetes received regular insulin at 7:00 a.m.? - 2:00 p.m. - 11:00 a.m. - 7:30 p.m. - 7:30 a.m.
- 11:00 a.m.
The nurse has just received report on a group of clients. Which client is the nurse's first priority? - A 50 year old with type 2 diabetes with a blood pressure of 150/90 mm Hg. - A 26 year old with type 1 diabetes whose insulin pump is beeping "occlusion." - A 30 year old with type 1 diabetes who is reporting thirst. - A 40 year old with type 2 diabetes who has a blood glucose of 150 mg/dL (8.3 mmol/L).
- A 26 year old with type 1 diabetes whose insulin pump is beeping "occlusion."
The nurse has just received report on a group of clients. Which client is the nurse's first priority? - A 45 year old taking metformin who has abdominal cramps. - A 40 year old taking glyburide who is dizzy and sweaty. - A 50 year old taking repaglinide who has nausea and back pain. - A 55 year old taking pioglitazone who has bilateral ankle swelling.
- A 45 year old taking metformin who has abdominal cramps.
Which client will the nurse prioritize when teaching about prostate cancer screening? - A 22-year-old Indian American - A 30-year-old Hispanic American - A 45-year-old Native American - A 50-year-old African American
- A 50-year-old African American
Which cancer screening or prevention activity is most important for the nurse to include when assessing a 20-year-old client who has Down syndrome? - Encouraging him to eat more fruit and leafy, green vegetables - Teaching him how to perform self-testicular examination - Assessing his skin for bruises and petechaie - Testing his stool for occult blood
- Assessing his skin for bruises and petechaie
For which client will the nurse question the prescription for long-term androgen therapy? - A 66 year old with impotence that is resistant to standard erectile dysfunction therapy. - A 52 year old with a history of prostate cancer treatment. - A 40 year old who also has syndrome of inappropriate antidiuretic hormone (SIADH). - A 30 year old who is taking antiviral therapy for HIV disease.
- A 52 year old with a history of prostate cancer treatment.
The nurse is caring for four clients. With which client does the nurse discuss prostate cancer screening? - A 23 year old with a history of urinary tract infections - A 33 year old who sustained an injury to the external genitalia - A 46 year old with uncontrolled hypertension - A 57 year old who has fathered four children
- A 57 year old who has fathered four children
Which client does the nurse caution to avoid self-monitoring of blood glucose (SMBG) at alternate sites? - A 45-year-old client with type 1 diabetes mellitus - A 75-year-old client whose blood glucose levels show little variation - An 80-year-old client with type 2 diabetes mellitus - A 55-year-old client who has hypoglycemic unawareness
- A 75-year-old client whose blood glucose levels show little variation
A client with testicular cancer is worried about sterility and the ability to conceive children later. To which resource does the nurse refer the client before surgery takes place? - American Cancer Society - A psychologist - RESOLVE: The National Infertility Association - A sperm bank facility
- A sperm bank facility
The nurse teaches a client that intraperitoneal chemotherapy will be delivered to which part of the body? - Veins of the legs - Lung - Heart - Abdominal cavity
- Abdominal cavity
Which signs and symptoms in a client who has hyperthyroidism indicate to the nurse possible progression to a thyroid storm? (Select all that apply.) - Abdominal pain and nausea - Tachycardia - Elevated temperature - Somnolence - Slow respiratory rate - Elevated systolic blood pressure
- Abdominal pain and nausea - Tachycardia - Elevated temperature - Elevated systolic blood pressure
For which symptoms will the nurse instruct the family and client who is being treated for diabetes insipidus (DI) to call 911 or go to the nearest emergency department? (Select all that apply.) - Acute confusion - Decreased urine output - Hypotension - Persistent headache - Hyperglycemia - Weigh gain of more than 2.2 lb (1 kg) in 24 hours
- Acute confusion - Decreased urine output - Persistent headache - Weigh gain of more than 2.2 lb (1 kg) in 24 hours
A client has undergone transurethral resection of the prostate (TURP). Which intervention does the nurse incorporate in the postoperative plan of care? (Select all that apply.) - Administer antispasmodic medications. - Encourage urination around the catheter if pressure is felt. - Perform intermittent urinary catheterization every 4 to 6 hours. - Place in a supine position with his knees flexed. - Assist to mobilize as soon as permitted.
- Administer antispasmodic medications. - Assist to mobilize as soon as permitted.
An 18-year-old female is diagnosed with possible toxic shock syndrome (TSS) and has these vital signs: T 103.2° F (39.6° C), P 124 beats/min, R 36 breaths/min, BP 84/30 mm Hg. Which primary health care provider request does the nurse implement first? - Administer corticosteroids as prescribed. - Give cefazolin as prescribed. - Begin infusion of normal saline IV - Obtain blood cultures × 2 sites.
- Administer corticosteroids as prescribed.
Clients who have deficiencies of which hormones will the nurse assess for increased risk of life-threatening consequences? - Prolactin and prolactin inhibiting hormone (PIH) - Adrenocorticotrophicn hormone (ACTH) and thyroid-stimulating hormone (TSH) - Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) - Growth hormone (GH) and melanocyte-stimulating hormone (MSH)
- Adrenocorticotrophicn hormone (ACTH) and thyroid-stimulating hormone (TSH)
A 74-year-old client recovering from lung cancer surgery tells the nurse, "I don't understand why I have lung cancer. I have never even touched a cigarette." Which factor may explain the cause? - A diagnosis of diabetes - Advancing age - A history of cardiac disease - A history of military service
- Advancing age
A client who is undergoing chemotherapy for breast cancer reports problems with concentration and memory. Which nursing intervention is indicated at this time? - Explain that this occurs in some clients and is usually permanent. - Inform the client that a small glass of wine may help her relax. - Protect the client from infection. - Allow the client an opportunity to express her feelings.
- Allow the client an opportunity to express her feelings.
After returning from transurethral resection of the prostate, the client's urine in the continuous bladder irrigation system is a burgundy color. Which client needs does the nurse anticipate will be prescribed after the surgeon sees the client? (Select all that apply.) - Antispasmodic drugs - Emergency surgery - Encouragement of oral fluids - Increased intermittent irrigation - Monitoring for anemia
- Antispasmodic drugs - Monitoring for anemia
Which action is most important for the nurse to take first after finding a client who has severe hypothyroidism to be unresponsive to attempts to waken her and have a heart rate of 46 beats/min? - Initiating the Rapid Response Team - Assessing temperature - Increasing the IV infusion rate - Applying oxygen by mask
- Applying oxygen by mask
The nurse has received in report that a client receiving chemotherapy has severe neutropenia. Which intervention does the nurse plan to implement? (Select all that apply.) - Assess for fever. - Observe for bleeding. - Administer pegfilgrastim. - Do not permit fresh flowers or plants in the room. - Do not allow the client's 16-year-old son to visit. - Teach the client to omit raw fruits and vegetables from the diet.
- Assess for fever. - Administer pegfilgrastim. - Do not permit fresh flowers or plants in the room. - Teach the client to omit raw fruits and vegetables from the diet.
Which action has the highest priority for the nurse to take when a client with type 1 diabetes arrives in the emergency department breathing deeply and stating, "I can't catch my breath." and has vital signs of: T 98.4° F (36.9° C), P 112 beats/min, R 38 breaths/min, BP 91/54 mm Hg, and O2 saturation 99% on room air? - Assessing blood glucose level - Assessing arterial blood gas (ABG) values - Connecting a cardiac monitor - Administering oxygen
- Assessing blood glucose level
A client with benign prostatic hyperplasia is being discharged with a prescription for prazosin. Which teaching will the nurse include? (Select all that apply.) - Avoid drugs used to treat erection problems. - Be careful when changing positions. - Keep all appointments for follow-up laboratory testing. - Hearing tests will need to be conducted periodically. - Take the medication in the afternoon.
- Avoid drugs used to treat erection problems. - Be careful when changing positions. - Keep all appointments for follow-up laboratory testing.
The nurse is caring for a female client with uterine leiomyoma. What is the most likely assessment finding the nurse anticipates? - Pain - Constipation - Anxiety - Bleeding
- Bleeding
The nurse recognizes that a client's hemangiosarcoma originated in which tissue? - Blood vessel - Epithelial tissue - Cartilage - Skeletal muscle
- Blood vessel
Which cancer type does the nurse interpret from a client's pathology report that indicates "stage 2 rhabdomyosarcoma"? - Bone - Brain - Breast - Muscle
- Bone
A client is diagnosed with melanoma. Which areas would the nurse anticipate that this client's tumor might metastasize? (Select all that apply.) - Liver - Brain - Kidneys - Lymph nodes - Lungs - Gastrointestinal tract
- Brain - Lymph nodes - Lungs - Gastrointestinal tract
Which conditions or factors will the nurse teach at a community seminar as probable transmission routes for HIV? (Select all that apply.) - Breast-feeding - Having unprotected intercourse with multiple partners - Being bitten by mosquitos - Sitting on public toilets - Using injection drugs - Changing a diaper on an HIV positive child
- Breast-feeding - Having unprotected intercourse with multiple partners - Using injection drugs
Which laboratory results does the nurse expect to decrease in a client who has untreated HIV-III (AIDS)? (Select all that apply.) - CD4+ T-cell - CD8+ T-cell - Total white blood cell count - Lymphocytes - HIV antibodies - Viral load
- CD4+ T-cell - Total white blood cell count - Lymphocytes
For which change reported by a client taking bromocriptine therapy to manage hyperpituitarism will the nurse notify the primary health care provider immediately to prevent harm? - Increased sleepiness - Constipation - Headache - Chest pain
- Chest pain
Which warning signs of cancer would the nurse specifically teach in a wellness course directed to a group of older adults? (Select all that apply.) - Chronic diarrhea - Severe heartburn - Curd-like vaginal discharge - Difficulty swallowing with meals - Persistent hoarseness - Loss of skin turgor
- Chronic diarrhea - Severe heartburn - Difficulty swallowing with meals - Persistent hoarseness
For which assessment finding in a client who had a transsphenoidal hypophysectomy yesterday will the nurse notify the primary health care provider immediately? - Dry lips and oral mucosa on examination - Client report of a headache and stiff neck - Urine specific gravity of 1.016 - Nasal drainage that tests negative for glucose
- Client report of a headache and stiff neck
The RN working on an oncology unit has just received report on these clients. Which client will the nurse assess first? - Client with chemotherapy-induced neutropenia who has just been admitted with an elevated temperature. - Client with lymphoma who will need administration of an antiemetic before receiving chemotherapy. - Client with metastatic breast cancer who is scheduled for external beam radiation in 1 hour. - Client with xerostomia associated with laryngeal cancer who needs oral care before breakfast.
- Client with chemotherapy-induced neutropenia who has just been admitted with an elevated temperature.
Which statements about the transmission of HIV are true? (Select all that apply.) - The most common transmission route is casual contact. - Clients with HIV-III and no drug therapy are very infectious. - HIV may be transmitted only during the end stages of the disease. - Newly infected clients with a high viral load are very infectious. - HIV-positive clients who have an undetectable viral load appear to not transmit the disease. - Even with appropriate drug therapy, most clients infected with HIV live only about 5 years after diagnosis.
- Clients with HIV-III and no drug therapy are very infectious. - Newly infected clients with a high viral load are very infectious. - HIV-positive clients who have an undetectable viral load appear to not transmit the disease.
Which concept is the highest priority for the nurse to consider in planning care for the client with HIV-III who has candidial stomatitis? - Gas exchange - Cellular regulation - Comfort - Nutrition
- Comfort
Which instruction is appropriate for the nurse to convey to the client with chemotherapy-induced neuropathy? - Bathe in cold water. - Wear cotton gloves when cooking. - Consume a diet high in fiber. - Make sure shoes are snug.
- Consume a diet high in fiber.
Which action immediately after a hypophysectomy will the nurse instruct a client to avoid to prevent harm? (Select all that apply.) - Coughing - Deep breathing - Wearing makeup - Talking - Using dental floss - Bending at the waist
- Coughing - Bending at the waist
The nurse is teaching a client how to prevent vulvovaginitis. What information does the nurse include? - Wear snug-fitting polyester undergarments to prevent chafing. - Cleanse the inner labia daily with soap and water. - Do not have unprotected sex with multiple partners. - Monthly douching may help reduce symptoms.
- Do not have unprotected sex with multiple partners.
The nurse is teaching the client about skin protection during radiation therapy. What teaching will the nurse include? (Select all that apply.) - Do not wash the irradiated area. - Do not remove the ink markings on your skin. - Protect the area by wearing clothing. - Avoid exposure to sun and heat. - Avoid all lotions to the area. - Try to take walks in the early morning or later evening.
- Do not remove the ink markings on your skin. - Protect the area by wearing clothing. - Avoid exposure to sun and heat. - Try to take walks in the early morning or later evening.
Which signs and symptoms does the nurse expect to find in a client diagnosed with Pneumocystis jiroveci infection? - Dyspnea, tachypnea, persistent dry cough, and fever - Cough with copious thick sputum, fever, and dyspnea - Substernal chest pain and difficulty swallowing - Fever, persistent cough, and vomiting blood
- Dyspnea, tachypnea, persistent dry cough, and fever
What is the nurse's best action when noticing that the phlebotomist, who plans to draw blood from the client with severe hypercortisolism, displays symptoms of a cold? - Asking the phlebotomist to delay the blood draw - Ensuring the phlebotomist wears a facemask while in the client's room - Placing a facemask on the client - Monitoring the client closely for cold-like symptoms
- Ensuring the phlebotomist wears a facemask while in the client's room
When educating a client with B-cell lymphoma, a nurse tells the client that a virus can contribute to the development of their cancer. Which virus is linked with B-cell lymphoma? - Hepatitis B virus - Human papilloma virus - Human lymphotrophic virus type II - Epstein-Barr virus
- Epstein-Barr virus
What is the nurse's best action when finding that a client who has had diabetes for 15 years has decreased sensory perception in both feet? - Documenting the finding as the only action - Explaining to the client that peripheral neuropathy is now present - Testing the sensory perception of the client's hands - Examining both feet for indications of injury
- Examining both feet for indications of injury
The nurse is teaching a client undergoing radiation therapy for laryngeal cancer. Which potential side effects will the nurse include? (Select all that apply.) - Fatigue - Changes in hair color - Change in taste - Changes in skin of the neck - Difficulty swallowing - Difficulty urinating
- Fatigue - Change in taste - Changes in skin of the neck - Difficulty swallowing
Which part of the HIV infection process is disrupted by the antiretroviral drug class of nucleoside reverse transcriptase inhibitors (NRTIs)? - Activating the viral enzyme "integrase" within the infected host's cells - Binding of the virus's gp120 protein to one of the CD4+ coreceptors - Clipping the newly generated viral proteins into smaller functional pieces - Forming counterfeit bases that prevent DNA synthesis and viral replication
- Forming counterfeit bases that prevent DNA synthesis and viral replication
Which actions or behaviors represent to the nurse that a client is engaging in secondary cancer prevention practices? (Select all that apply.) - Having a mole removed from the neck - Obtaining a colonoscopy every 5 years - Eating a diet high in fiber and low in animal fat - Getting a mammogram or breast MRI annually - Having a health checkup, including chest x-ray, annually - Electing to have both ovaries removed a person who has a BRCA2 mutation
- Getting a mammogram or breast MRI annually - Having a health checkup, including chest x-ray, annually
For which new-onset symptom or behavior will the nurse teach a client taking thyroid hormone replacement therapy (HRT) to report immediately to the primary health care provider? - Runny nose - Calf muscle cramping - Anorexia - Hand tremors
- Hand tremors
The oncology nurse is caring for a group of clients receiving chemotherapy. The client with which sign/symptom is displaying bone marrow suppression? - Hemoglobin of 7.4 g/dL (74 mmol/L) and hematocrit of 21.8% - Potassium level of 2.9 mEq/L (2.9 mmol/L) and diarrhea - 250,000 platelets/mm3 (250 × 109/L) - 5000 white blood cells/mm3 (5 × 109/L)
- Hemoglobin of 7.4 g/dL (74 mmol/L) and hematocrit of 21.8%
Which changes in laboratory values will the nurse expect to see in a client who has tumor causing excess secretion of aldosterone? (Select all that apply.) - Hyperkalemia - Hypokalemia - Hypernatremia - Hyperglycemia - Hypoglycemia - Hyponatremia
- Hypokalemia - Hypernatremia
What is the nurse's best response when a client with diabetes who is being treated for hypoglycemic asks why people without diabetes don't become severely hypoglycemic even after fasting for 8 hours? - In a person without diabetes, fasting for 8 hours converts proteins into glycose (gluconeogenesis) so that hypergycemia develops rather than hypoglycemia. - Lipolysis (fat breakdown) in fat stores occurs faster in the nondiabetic person, which converts fatty acids into glucose to maintain blood glucose levels. - In a person without diabetes, the secretion of glucagon prevents hypoglycemia by promoting glucose release from liver storage sites (glycogenolysis). - Normal metabolism is so slow when a person without diabetes fasts that blood glucose does not enter cells to be used for energy. As a result, hypoglycemia does not occur.
- In a person without diabetes, the secretion of glucagon prevents hypoglycemia by promoting glucose release from liver storage sites (glycogenolysis).
When caring for a client receiving chemotherapy, the nurse plans care during the nadir of bone marrow activity to prevent which complication? - Drug toxicity - Polycythemia - Infection - Dose-limiting side effects
- Infection
With which antiretroviral drug class will the nurse teach clients to prevent harm by reporting any new onset muscle weakness and muscle pain to the immunity health care provider? - Protease inhibitors - Integrase inhibitors - Fusion inhibitors - Nucleoside reverse transcriptase inhibitors
- Integrase inhibitors
Which client assessment finding indicates to the nurse the possible presence of diabetic autonomic neuropathy? - Increased thirst - Loss of sensation in both feet - Intermittent constipation - Hyperglycemia
- Intermittent constipation
Which practices are generally recommended to prevent sexual transmission of HIV? (Select all that apply.) - Latex or polyurethane condoms for genital and anal intercourse - Natural-membrane condoms for genital and anal intercourse - Water-based lubricant with a latex condom - Oral contraceptives taken consistently - Latex dental dam genital and anal intercourse - Latex gloves for finger or hand contact with the vagina or rectum
- Latex or polyurethane condoms for genital and anal intercourse - Water-based lubricant with a latex condom - Latex dental dam genital and anal intercourse - Latex gloves for finger or hand contact with the vagina or rectum
Which common cancers will the nurse inform clients are related to tobacco use? (Select all that apply.) - Lung cancer - Bladder cancer - Cardiac cancer - Skin cancer - Cancer of the tongue - Cancer of the larynx
- Lung cancer - Bladder cancer - Cancer of the tongue - Cancer of the larynx
The nurse is caring for a client receiving chemotherapy who reports anorexia. Which measure does the nurse use to best monitor for cachexia? - Monitor weight. - Trend red blood cells and hemoglobin and hematocrit. - Monitor platelets. - Observe for motor deficits.
- Monitor weight.
Which new-onset symptoms will the nurse instruct a client with diabetes who is prescribed to take the sodium-glucose cotransport inhibitor, empagliflozin, to report to the diabetes health care provider to prevent harm? (Select all that apply.) - Muscle weakness and dizziness on standing - Redness and tenderness of the perineum - Redness and tenderness at the injection site - Sensations of hunger, tremors, sweating, and confusion - Rapid weight gain and shortness of breath - Pain and burning on urination
- Muscle weakness and dizziness on standing - Redness and tenderness of the perineum - Sensations of hunger, tremors, sweating, and confusion - Pain and burning on urination
Which client symptom appearing after a head injury suffered in a car crash is most relevant for the nurse to consider the possibility of diabetes insipidus (DI)? - No change in urine output with minimal fluid intake. - New-onset hypertension. - The client's headache is gradually increasing in intensity. - The client reports extreme salt craving.
- No change in urine output with minimal fluid intake.
A client is being discharged after a total abdominal hysterectomy (TAH). What principle guides the nurse in planning discharge care and teaching? - Clients in their childbearing years generally adapt better. - No special home equipment will be necessary for the client. - Psychological reactions would be evident by discharge. - The client can resume normal activities upon discharge.
- No special home equipment will be necessary for the client.
Which signs, symptoms, or behaviors will the nurse expect to find when assessing a client who has just been diagnosed with hypothyroidism? (Select all that apply.) - Warm, moist skin - Nonpitting edema of hands and feet - Goiter - Decreased deep tendon reflexes - Agitation and inability to sleep - Pulse rate below 60 beats/min
- Nonpitting edema of hands and feet - Decreased deep tendon reflexes - Pulse rate below 60 beats/min
Which medication does the nurse plan to administer to a client before chemotherapy to decrease the incidence of nausea and vomiting? - Morphine - Ondansetron - Naloxone - Diazepam
- Ondansetron
Which items are most important for the nurse to ensure are in the room when a client returns from having a thyroidectomy? (Select all that apply.) - Furosemide - Oxygen - Calcium gluconate - Suction - Hypertonic saline - Emergency tracheotomy kit
- Oxygen - Calcium gluconate - Suction - Emergency tracheotomy kit
Which assessment finding is the priority for the nurse to report to the health care provider? - Hematuria - Penile discharge - Painless testicular lump - Decrease increase in libido
- Painless testicular lump
What effect does a "passenger" mutation in a gene have on cancer development? - Passenger mutations are another term for proto-oncogene gene mutations. - These mutations protect against cancer development by reversing the effects of initiation. - Passenger mutations do not affect cancer development but can serve as targets for specific cancer therapies. - These mutations enhance the effectiveness of carcinogens causing direct DNA damage of a normal cell, increasing the likelihood of cancer development.
- Passenger mutations do not affect cancer development but can serve as targets for specific cancer therapies.
Which action is appropriate for the nurse to delegate to the assistive personnel (AP) when caring for clients with diabetes? - Assessing a client who reports tremors and irritability - Performing a blood glucose check on a client who requires insulin - Verifying the infusion rate on a continuous infusion insulin pump - Monitoring a client who reports palpitations and anxiety
- Performing a blood glucose check on a client who requires insulin
Which assessment is a priority for the nurse to make when a client with diabetic ketoacidosis (DKA) who is being monitored while receiving an insulin infusion begins to show an irregular heart beat with inverted T- waves? - Rate of IV infusion - Urine output - Potassium level - Breath sounds
- Potassium level
Which client problem does the nurse determine as the priority for the client experiencing chemotherapy-induced peripheral neuropathy? - Potential for lack of understanding related to side effects of chemotherapy - Potential for injury related to sensory and motor deficits - Potential for ineffective coping strategies related to loss of motor control - Altered sexual function related to erectile dysfunction
- Potential for injury related to sensory and motor deficits
What will the nurse include in teaching to assist the client with BPH to address incontinence? - Request a prescription for sildenafil. - Use analgesic medications as needed to maintain comfort. - Practice Kegel exercises to improve muscle control. - Perform routine self-catheterization and bladder retraining.
- Practice Kegel exercises to improve muscle control.
Which statements regarding hyperthyroidism are accurate? (Select all that apply.) - Produces symptoms of a hypermetabolic state. - Can be diagnosed by the presence of a goiter - Most common form is Graves disease. - Is much more common among women than among men. - Often occurs weeks after exposure to ionizing radiation. - Has a sudden onset of symptoms.
- Produces symptoms of a hypermetabolic state. - Most common form is Graves disease. - Is much more common among women than among men.
Which assessment finding in a client with diabetes mellitus indicates to the nurse that the disease is damaging the kidneys? - Protein in the urine during a random urinalysis - White blood cells (WBCs) in the urine during a random urinalysis - Glucose in the urine during hyperglycemia - Ketone bodies in the urine during acidosis
- Protein in the urine during a random urinalysis
When caring for the client with chemotherapy-induced mucositis, which intervention will be most helpful? - Administering a biological response modifier - Encouraging oral care with commercial mouthwash - Providing oral care with a disposable mouth swab - Maintaining NPO until the lesions have resolved
- Providing oral care with a disposable mouth swab
The nurse is caring for a client with end-stage ovarian cancer who needs clarification on the purpose of palliative surgery. Which outcome will the nurse teach the client is the goal of palliative surgery? - Cure of the cancer - Relief of symptoms or improved quality of life - Allowing other therapies to be more effective - Prolonging the client's survival time
- Relief of symptoms or improved quality of life
Which changing trends in a client's serum laboratory values indicate to the nurse that thyroid hormone replacement therapy for hypothyroidism is effective? - Rising thyroglobulin (Tg) levels; declining thyrotropin receptor antibody (TRAb) levels - Rising thyroid hormone (TH) levels; declining thyroid-stimulating hormone (TSH) levels - Declining thyroid hormone (TH) levels; rising thyroid-stimulating hormone (TSH) levels - Declining thyroglobulin (Tg) levels; rising thyrotropin receptor antibody (TRAb) levels
- Rising thyroid hormone (TH) levels; declining thyroid-stimulating hormone (TSH) levels
A client reports taking a supplement that his partner recommended for benign prostatic hyperplasia (BPH). Which supplement does the nurse anticipate the client is taking? - Magnesium - Calcium - Saw palmetto - Feverfew
- Saw palmetto
A client is scheduled for a total hysterectomy with a laparoscopic vaginal approach after a diagnosis of microinvasive cervical cancer. What psychological and/or social changes does the nurse expect this client to experience? - Because the surgery does not affect a visible site, altered body image issues are not as common. - The client will be actively involved in her own care in the immediate postoperative period. - Sexual counseling may be needed, especially if the client has doubts about her ability to feel like a woman and engage in sexual activities. - The client would demonstrate reality testing and would experience a grief reaction immediately after her surgery.
- Sexual counseling may be needed, especially if the client has doubts about her ability to feel like a woman and engage in sexual activities.
Which client circumstance would prompt the nurse to create a three- generation pedigree to more fully explore the possibility of increased genetic risk for cancer? - Smoked for 20 years but quit 5 years ago - Strong family history of breast cancer - Most family adult members are overweight - Personal history of excessive sun exposure
- Strong family history of breast cancer
The nurse is teaching a client how to adapt to physical and psychological changes after surgery for ovarian cancer. Which factor is included in the teaching plan? (Select all that apply.) - Suggesting the use of support groups and counseling - Encouraging the expression of grief and fears - Offering vaginal dilators - Refraining from sexual intercourse for 6 weeks after surgery. - Recommending the use of oil-based lubricants for vaginal dryness
- Suggesting the use of support groups and counseling - Encouraging the expression of grief and fears - Refraining from sexual intercourse for 6 weeks after surgery.
Which action will the nurse recommend to a client with type 1 diabetes on insulin therapy who has been having a morning fasting blood glucose (FBG) level of 160 mg/dL (8.9 mmol/L) and is diagnosed with "dawn phenomenon" to achieve better control? - Avoid eating any carbohydrate with your evening meal." - Take your evening insulin dose right before going to bed instead of at supper time." - Eat a bedtime snack containing equal amounts of protein and carbohydrates." - Inject the insulin into your arm rather than into the abdomen around the navel."
- Take your evening insulin dose right before going to bed instead of at supper time."
How will the nurse interpret the finding on a client's pathology report that indicates a cancerous tumor is aneuploid? - The tumor is fast growing. - Metastasis has already occurred. - The tumor is completely undifferentiated. - The tumor has an abnormal number of chromosomes.
- The tumor has an abnormal number of chromosomes.
How will the nurse interpret the finding on a client's pathology report that a cancerous tumor has a mitotic index of 8%? - The tumor is slow-growing. - Metastasis has already occurred. - The tumor has not yet undergone carcinogenesis. - The tumor has an abnormal number of chromosomes.
- The tumor is slow-growing.
How will the nurse evaluate the level of glycemic control for a client with diabetes whose laboratory values include a fasting blood glucose level of 82 mg/dL (mmol/L) and an A1c of 5.9%? - The client's glucose control for the past 24 hours has been poor but the overall control is good. - The client's glucose control for the past 24 hours has been good but the overall control is poor. - The values indicate that the client has managed his or her disease well. - The values indicate that the client has poorly managed his or her disease.
- The values indicate that the client has managed his or her disease well.
Which conditions does the nurse teach a client are some of the seven warning signs of cancer? (Select all that apply.) - Menstrual bleeding that has decreased - Thickening of breast tissue in one area - Indigestion regardless of food type eaten - Increased pigmentation with deeper coloring in a mole - Difficulty starting the stream of urine for the past 6 months - Heavy nosebleeds independent of trauma to the nasal mucosa
- Thickening of breast tissue in one area - Indigestion regardless of food type eaten - Increased pigmentation with deeper coloring in a mole - Difficulty starting the stream of urine for the past 6 months - Heavy nosebleeds independent of trauma to the nasal mucosa
What is the first action a nurse should take after sustaining a needlestick injury after injecting a client who is known to be HIV positive? - Send the syringe and needle to the laboratory for analysis of viral load. - Go to the employee clinic for postexposure prophylaxis. - Thoroughly scrub and flush the puncture site. - Inform the charge nurse.
- Thoroughly scrub and flush the puncture site.
Which laboratory test does the nurse analyze to determine the effectiveness of combination antiretroviral drug therapy in an HIV-positive client? - Western blot analysis - Viral load testing - Enzyme-linked immunosorbent assay - Fourth generation testing
- Viral load testing
A client newly diagnosed with type 1 diabetes says she is not ready to learn everything about diabetes control right now. Which information has the greatest priority for the nurse to teach this client and her family for now to prevent harm? (Select all that apply.) - What to do when ill? - Symptoms and treatment of hypoglycemia - Importance of regular exercise - Causes of type 1 diabetes - Dietary control of blood glucose - Insulin administration
- What to do when ill? - Symptoms and treatment of hypoglycemia - Insulin administration
Which assessment finding in a client who had a parathyroidectomy yesterday indicates to the nurse that immediate action is needed? - Apical pulse of 92 beats/min - Bilateral leg muscle twitching - Hypoactive bowel sounds - Dry mouth
Bilateral leg muscle twitching
The nurse has just received report on a group of clients. Which client is the nurse's first priority? - A 42 year old with diabetes insipidus who has a dose of desmopressin due. - A 50 year old with pituitary adenoma who is reporting a severe headache. - A 35 year old with hyperaldosteronism who has a serum potassium of 3.0 mEq/L (3.0 mmol/L). - A 28 year old with acute adrenal insufficiency who has a blood glucose of 36 mg/dL (2.0 mmol/L).
A 28 year old with acute adrenal insufficiency who has a blood glucose of 36 mg/dL (2.0 mmol/L).
With which client will the nurse be aware of an increased risk for hypoparathyroidism? - A 50-year-old man starting on insulin therapy for type 2 diabetes mellitus - A 35-year-old woman who had radiation therapy for Graves disease - A 28-year-old woman with pregnancy-induced hypertension - A 55-year-old man with moderate heart failure after myocardial infarction
A 35-year-old woman who had radiation therapy for Graves disease
Which factor or condition does the nurse expect to result in an increase in a client's production of thyroid hormones (TH)? - Protein-calorie malnutrition - Getting 8 hours of sleep nightly - Cold environmental temperatures - Chronic constipation
Cold environmental temperatures
The nurse reviews the vital signs of a client diagnosed with Graves disease and notes that the client's temperature is 99.6° F (37.6° C). After notifying the primary health care provider, what is the nurse's best next action? - Assessing cardiac status - Administering acetaminophen - Initiating the Rapid Response Team - Observing for the presence of chills
Assessing cardiac status
Which trends in serum electrolyte values will the nurse expect to find in a client who has untreated hypoparathyroidism? - Above normal calcium levels; below normal phosphorus levels - Below normal calcium levels; below normal phosphorus levels - Below normal calcium levels; above normal phosphorus levels - Above normal calcium levels; above normal phosphorus levels
Below normal calcium levels; above normal phosphorus levels
Rank the safety of sexual practices, with 1 being the safest practice and 6 being the least safe. a. Mutual masturbation with latex gloves b. Oral sex without condom c. Abstinence d. Vaginal sex with male condom use e. Monogamy f. Unprotected anal sex
C, E, A, D, B, F
Which action in the plan of care for a client who is hospitalized for pituitary function testing would be most appropriate for the nurse to delegate to an experienced assistive personnel (AP)? - Checking the client's blood glucose levels every 4 hours - Teaching the client about a hormone suppression test - Assessing the client for symptoms of hypopituitarism - Monitoring the client's response to the IV insulin given during a stimulation test
Checking the client's blood glucose levels every 4 hours
Which assessment finding in a client with hyperaldosteronism indicates to the nurse that the condition is becoming more severe? - pH is now 7.43. - Temperature is now elevated. - Client reports numbness and tingling around the mouth. - Urine output for the past 24 hours has increased.
Client reports numbness and tingling around the mouth.
Which action is most important for the nurse to perform when caring for an older client decreased antidiuretic hormone (ADH) production? - Stressing the important of fiber in the diet - Inspecting feet and legs for ulcers - Encouraging fluids every 2 hours - Planning for weight-bearing activities
Encouraging fluids every 2 hours
Which type of drug therapy will the nurse prepare to teach about to a client who has mild hyperparathyroidism? - Antipyretics - Furosemide diuretics - Calcium supplements - Opioid analgesics
Furosemide diuretics
Which laboratory findings will the nurse use to validate the statement of a client with diabetes that therapy instructions for glucose control "have been followed to the letter" for the past 2 months? - Glycosylated hemoglobin (HbA1c) - Random blood glucose level - Fasting blood glucose level - Fasting blood insulin level
Glycosylated hemoglobin (HbA1c)
Which client assessment finding indicates to the nurse the need to assess further for a possible endocrine problem? - Increased facial hair and absent menses in a 28-year-old nonpregnant woman - Dry skin on the shins of a 70-year-old woman - Increased appetite in a 40-year-old man who started an aerobic exercise program 1 week ago - Male-pattern baldness in a 32-year-old man
Increased facial hair and absent menses in a 28-year-old nonpregnant woman
What effect on circulating levels of sodium and glucose does the nurse expect in a client who has been taking an oral cortisol preparation for 2 years because of a respiratory problem? - Increased sodium; decreased glucose - Decreased sodium; decreased glucose - Increased sodium; increased glucose - Decreased sodium; increased glucose
Increased sodium; increased glucose
Which primary health care provider order will the nurse perform first for a client with syndrome of inappropriate antidiuretic hormone (SIADH) who has a serum sodium level of 105 mEq/L (105 mmol/L)? - Drawing blood for hemoglobin and hematocrit levels - Measuring serial weights at the same daily with the client wearing the same amount of clothing - Administering an infusion of 150 mL hypertonic saline over the next 3 hours - Inserting an indwelling catheter and monitoring urine output
Inserting an indwelling catheter and monitoring urine output
In collaboration with the registered dietitian nutritionist, which dietary alterations will the nurse instruct a client with Cushing disease to make? - Low carbohydrate, high calorie, and low sodium - High carbohydrate, low potassium, and fluid restriction - Low protein, high carbohydrate, and low calcium - High protein, high carbohydrate, and low potassium
Low carbohydrate, high calorie, and low sodium
Which action does the postanesthesia care unit (PACU) nurse perform first when caring for a client who has just arrived after a total thyroidectomy? - Assessing the wound dressing for bleeding - Monitoring oxygen saturation - Hyperextending the neck - Administering morphine for pain
Monitoring oxygen saturation
Which laboratory finding in a client with a possible pituitary disorder will the nurse report to the health care provider immediately? - Blood glucose 148 mg/dL (7.4 mmol/L) - Blood urea nitrogen (BUN) 40 mg/dL (14.3 mmol/L) - Serum potassium 3.2 mEq/L (3.2 mmol/L) - Serum sodium 110 mEq/L (110 mmol/L)
Serum sodium 110 mEq/L (110 mmol/L)
Which change in serum electrolyte values in the past 12 hours for a client with syndrome of inappropriate antidiuretic hormone (SIADH) being treated with tolvaptan will the nurse report immediately to the health care provider? - Serum potassium decreases from 4.2 mEq/L to 3.8 mEq/L. - Serum calcium increases from 9.5 mg/dL to 10.2 mg/dL. - Serum chloride decreases from 109 mEq/L to 99 mEq/L. - Serum sodium increases from 122 mEq/L to 140 mEq/L.
Serum sodium increases from 122 mEq/L to 140 mEq/L.
Which client report of changes in appearance indicates to the nurse that a client's adrenal insufficiency is related to direct malfunction of the adrenal glands? - Skin darkening - Dry, cracked lips - 5-lb weight loss - Thinning pubic hair
Skin darkening
Why is a goiter often present in clients who have Graves disease? - The autoantibodies stimulate blood vessel growth and blood storage within the thyroid gland, increasing its overall size. - The excessive autoantibodies bind to the thyroid-stimulating hormone receptor sites, which increases the number and size of glandular cells in the thyroid gland. - The autoantibodies stimulate the inflammatory and immune responses to increase the number of white blood cells circulating in the thyroid gland, which increases tissue size without increasing the number of glandular cells. - The low circulating levels of thyroid hormones stimulates the feedback system and triggers the anterior pituitary gland to secrete more thyroid- stimulating hormone, which increases the numbers and size of glandular cells in the thyroid gland.
The excessive autoantibodies bind to the thyroid-stimulating hormone receptor sites, which increases the number and size of glandular cells in the thyroid gland.
Which assessment finding in a client with diagnosis of diabetes insipidus (DI) indicates to the nurse that desmopressin therapy is effective? - Urine output of 30 to 50 mL/hr - Blood glucose level of 110 mg/dL (6.1 mmol/L) - Potassium level of 3.9 mEq/L (mmol/L) - Respiratory rate of 20 breaths/min
Urine output of 30 to 50 mL/hr
