Care Mgmt 1 FINAL Practice Questions

1) The nurse has just completed teaching a client about postoperative leg exercises to prevent which postoperative complication? A) Pneumonia B) Pulmonary embolism C) Atelectasis D) Ileus

B) Pulmonary embolism Leg exercises help to prevent the formation of blood clots that could become a pulmonary embolism.

9) The nurse cares for an older adult and recognizes the client is at increased risk for developing infection. Which condition poses the greatest risk of infection in the client? A) Diabetes mellitus B) Eczema C) Glaucoma D) Emphysema

A) Diabetes mellitus Diabetes mellitus, often found in older adult clients, increases the risk of infection and delayed healing. Eczema, glaucoma, and emphysema are common in the older adult; however, these do not pose the greatest risk of infection in the client.

18) The nurse cares for a client with an intravenous infusion of D5NS. Which complications will the nurse closely monitor the client for? Select all that apply. A) Increased serum sodium B) Decreased serum potassium C) Fluid overload D) Hypotension E) Increased serum chloride

A) Increased serum sodium C) Fluid overload E) Increased serum chloride D5NS is a hypertonic intravenous solution, which promotes osmosis of fluid out of the cells. Complications of D5NS therapy is hypernatremia (elevated serum sodium), fluid overload, and hyperchloremia (increased serum chloride). Hypotension and hypokalemia (decreased serum potassium) are not complications of D5NS therapy.

18) The nurse in the clinic receives a call from a client diagnosed with diabetes mellitus who states his blood sugar is 275 mg/dl and he doesn't feel well. Which is the first thing the nurse should tell the client to do? A) Obtain a urine specimen and check it for ketones. B) Immediately go to the emergency department to be admitted. C) Drink a large beverage that has sugar and electrolytes and recheck the blood sugar. D) Ask the client if he has a headache or irritability.

A) Obtain a urine specimen and check it for ketones. The client has developed hyperglycemia and also states he doesn't feel well, so the nurse should first have the client check his urine for ketones to see if he is developing diabetic ketoacidosis.

1) The nurse is interviewing a client with a suspected endocrine disorder. Which question by the nurse would BEST obtain subjective data related to this client's possible diagnosis? A) "I noticed that your blood pressure is 97/76 today. Was it this low the last time your blood pressure was measured?" B) "Can you tell me more about the tingling you are experiencing in your feet?" C) "Your skin appears very tanned. Did you recently go to the beach?" D) "Does your face twitch when you touch your cheek?

B) "Can you tell me more about the tingling you are experiencing in your feet?" A client's description of a tingling feeling is subjective data.

6) The nurse plans teaching for the client on methods of encouraging fluid intake. Which statements will the nurse include? Select all that apply. A) "Consume 180 mL of water daily." B) "Limit your alcohol intake." C) "Avoid excess amounts of fluids high in salt." D) "Moderate caffeine intake is acceptable." E) "Consume 6-8 glasses of water daily."

B) "Limit your alcohol intake." C) "Avoid excess amounts of fluids high in salt." E) "Consume 6-8 glasses of water daily." When teaching a client on methods of encouraging fluid intake, the nurse will suggest the client consume 6-8 glasses of water daily, and avoid excess amounts of fluids high in salt. 180 mL of fluid is not enough fluid intake daily and caffeine promotes diuresis, which is counter-productive to fluid intake.

The nurse is caring for a client who just had 1,500 mL of fluid removed during a paracentesis. The client asks the nurse why his belly still feels so big even though that large amount of fluid was removed. Which is the nurse's BEST answer to this client? A) "The skin of your belly stretched while you had fluid in your abdomen and it will take a while for your belly to return to its normal size." B) "Only a certain amount of fluid can be removed from our abdomen at a time to prevent your body from going into shock." C) "Removing that much fluid helps to get rid of the excess fluid. Now the rest of the fluid will drain into your lymphatic system." D) "It was important to limit the amount of fluid that was removed to prevent infection from occurring."

B) "Only a certain amount of fluid can be removed from our abdomen at a time to prevent your body from going into shock." Draining very large amounts of fluid can cause hypovolemia, which could then lead to shock so the amount of fluid drained during a paracentesis is limited to 1,500 mL.

7) A client diagnosed with acromegaly is scheduled for a growth hormone test. When the client arrives for the test, the nurse notes that the client appears to have been crying. The nurse shares with the client this observation and the client begins to cry again and tells the nurse about some serious family problems. Which should the nurse do at this time in relation to the client's growth hormone test? A) After the client's growth hormone test has been completed, discuss with the client possible resources available to assist with the family problems that the client is experiencing. B) Explain to the client that the growth hormone test will not be accurate if performed when the client is emotionally upset, so the test needs to be rescheduled. C) Wait until the client calms down to have the test performed. D) Report to the healthcare provider that the client's emotional state must be taken into account when interpreting the growth hormone test.

B) Explain to the client that the growth hormone test will not be accurate if performed when the client is emotionally upset, so the test needs to be rescheduled. The growth hormone test should be rescheduled because the result will be inaccurate if the client is not fasting or well rested, or is physical or emotionally stressed.

20) The nurse is working with a client who has just been diagnosed with diabetes mellitus and informs the client to adhere to which principles that will be most helpful at preventing complications of this disease? Select all that apply. A) Monitor your blood glucose levels at least once each week. B) Make sure to take your oral antidiabetic medications as ordered. C) Exercise at least an hour a day. D) Make sure that meals and snacks are eaten at regular times. E) See your healthcare provider (HCP) regularly even if you don't feel ill.

B) Make sure to take your oral antidiabetic medications as ordered. D) Make sure that meals and snacks are eaten at regular times. E) See your healthcare provider (HCP) regularly even if you don't feel ill. Oral antidiabetic drugs or insulin need to be taken as prescribed to prevent complications. Food intake should be regulated so that it matches the insulin or oral antidiabetic medications that are taken. It is important for the client to see the HCP regularly to ensure that complications are not developing or to catch early signs of complications.

2) The client calls the clinic complaining of an unusual problem. Which client statement to the nurse is most suggestive of a subjective symptom related to an endocrine problem? A) "I don't have as much energy as I used to. I get out of breath going up stairs." B) "Recently I have noticed little purple spots on my legs." C) "All I want to eat are salty things and I'm adding salt to everything I eat." D) "My belly seems to be growing bigger every day and it's hard to breathe."

C) "All I want to eat are salty things and I'm adding salt to everything I eat." Salt cravings is suggestive of Addison disease, an endocrine disorder

4) The nurse is teaching a client on the importance of monitoring intake and output at home. Which statement will the nurse include in the client teaching? A) "Weigh at two different times during the day in order to see a change." B) "If your weight goes up more than one pound in a day, contact your health care provider." C) "If you notice sticky mucus membranes, contact your health care provider." D) "Weigh with two different scales in order to compare results."

C) "If you notice sticky mucus membranes, contact your health care provider." Explanation: Sticky mucus membranes may indicate a fluid volume deficit and the client should report this finding to the health care provider. The nurse should teach the client to weigh at the same time during the day, using the same scale, wearing similar clothing in order to provide accurate weights. The nurse will teach the client that if their weight goes up by more than 0.9-1.3 kg (2-3 lb.) per day to contact the health care provider.

8) The healthcare provider has ordered a radioactive iodine (RA) uptake exam for a client who has complained of constipation, fatigue, and weight gain. The client asks the nurse to explain again why this test has been ordered in relation to these symptoms. Which is the nurse's BEST response to this client? A) "This test is used to check all of the endocrine glands that could cause you to have these symptoms." B) "Your symptoms are related to possible problems with your adrenal gland, so this test will evaluate if this is the problem." C) "Your symptoms are suggestive of a thyroid problem. Iodine is taken up exclusively by the thyroid gland, so it is used to evaluate if this gland is responsible for your problems." D) "The pituitary gland puts out iodine that is taken up by the thyroid, so this test will tell if your thyroid is producing enough of this."

C) "Your symptoms are suggestive of a thyroid problem. Iodine is taken up exclusively by the thyroid gland, so it is used to evaluate if this gland is responsible for your problems." Iodine is taken up by the thyroid, so the RA uptake test is done to see if the thyroid is functioning properly.

13) The client diagnosed with diabetes mellitus calls the nurse to complain about dizziness that occurs upon standing. The nurse informs the client that this may be caused by which initial complication related to diabetes mellitus? A) Hypertension B) Impaired peripheral circulation C) Diabetic autonomic neuropathy D) Diabetic nephropathy

C) Diabetic autonomic neuropathy Neuropathy caused by diabetes leads to postural hypotension, which causes the client to have dizziness when standing.

9) The nurse is caring for a client with a large abdomen. Which assessment technique would assist the nurse in determining whether the client is experiencing ascites or the large abdomen is related to obesity? A) Weigh the client weekly. B) Check the client's feet for pedal edema. C) Measure the client's abdomen daily. D) Measure the amount of food the client eats with each meal.

C) Measure the client's abdomen daily. Frequent measurement of abdominal girth allows the nurse to see if the abdomen is growing quickly, which is seen in ascites but not in obesity.

4) A client calls the clinic and asks to speak to the nurse. The client states, "I don't understand why you keep telling me that my thyroid is overactive when my TSH level is so low." How does the nurse BEST explain this to the client? A) "You are correct. We should have said that your thyroid was underactive, not overactive." B) "I will recheck your lab reports to make sure that they are correct." C) "Well, that's just the way it works. You just have to know what the number means." D) "TSH stands for thyroid stimulating hormone, so if it is low it means that your thyroid is working hard and producing more hormone than it needs to."

D) "TSH stands for thyroid stimulating hormone, so if it is low it means that your thyroid is working hard and producing more hormone than it needs to." Explaining to the client the relationship between TSH and thyroid function is the best response to the client who asks about a lab test.

12) The nurse is discussing glucose control with a client who reports consistently elevated capillary blood glucose levels. The client appears unconcerned and says, "I don't see why this is a problem. I feel fine." Which is the nurse's BEST response to this client? A) "That's good. I'm glad that nothing has happened to you yet." B) "Most people with diabetes never develop complications." C) "I know you say you that you feel fine but you don't know just how sick you are." D) "While you may feel good right now, complications usually appear after many years of poor glucose control."

D) "While you may feel good right now, complications usually appear after many years of poor glucose control." Informing the client that complications will occur years from now is important to help the client understand why glucose control must be established now.

14) The nurse is caring for a client who has just been diagnosed with diabetes mellitus. The client tells the nurse that she went to the doctor with symptoms of a urinary tract infection and ended up being admitted with diabetes mellitus. She then tells the nurse that her father had diabetes and he ended up dying with kidney failure. The client says, "It looks like that's what is going to happen to me. My kidneys are already messed up." Which is the nurse's BEST response to this client's statement? A) "It does appear that your disease is progressing quite quickly. Do you have anyone in your family who would donate a kidney for you?" B) "I wouldn't worry about that right now. Your first job is to get used to having diabetes." C) "Have you had any other symptoms of kidney failure such as edema or high blood pressure?" D) "Your current infection was caused by the diabetes, but watching your blood sugar in the future will help prevent complications."

D) "Your current infection was caused by the diabetes, but watching your blood sugar in the future will help prevent complications." The nurse is correct to help the client see the connection between good blood sugar control and prevention of complications.

12) The nurse is setting up an intravenous infusion for a client and the nurse has set the IV pump according to the health care provider's orders. How will the nurse best verify that the drops/minute rate is correct? A) Verify the tubing size and adjust accordingly. B) Verify the flow rate on the infusion pump. C) Count the drops in the drip chamber for 6 seconds and multiply by 10. D) Count the drops in the drip chamber for 15 seconds and multiply by 4.

D) Count the drops in the drip chamber for 15 seconds and multiply by 4. In order to verify that the drops/minute rate is correct, the nurse will count the drops in the drip chamber for 15 seconds and multiply by 4.