concepts 3 final exam

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Which serum electrolyte values alert you to the possibility of hyperaldosteronism? -serum sodium 150, serum potassium 2.5 -serum sodium 140, serum potassium 5.0 -serum sodium 130, serum potassium 2.5 -serum sodium 130, potassium 7.5

-serum sodium 150, serum potassium 2.5

A client with mild preeclampsia is told that she must remain on bedrest at home. The client starts to cry and tells the nurse that she has two small children at home who need her. How should the nurse respond? -"how do you plan to manage getting child care help?" -"Are you worried about how you will be able to handle this problem?" -"you can get a neighbor to help out and your husband can do the housework in the evening" -"you can prepare light meals and the children can go to nursery school a few hours each day"

-"how do you plan to manage getting child care help?"

A pregnant client attends a first-trimester class on eating well for pregnancy. Which statement should indicate to a nurse that the client requires additional teaching? -"I should gain around 30 pounds by my due date" -"my strange craving to eat laundry starch is a normal part of pregnancy" -"I need about an extra 300 calories per day during my pregnancy" -"frozen foods are more nutritious than canned foods"

-"my strange craving to eat laundry starch is a normal part of pregnancy"

At 36 weeks gestation a multigravida client is diagnosed with polyhydramnios. The nurse has instructed the client about possible complications related to polyhydramnios. The nurse determines that the client needs further instructions when the client says: -"because I have polyhydramnios, I can expect to have more edema in my feet" -"polyhydramnios has been associated with gestational disorders in the fetus" -"I need to watch for signs of preterm labor" -"polyhydramnios has been associated with renal disorders of the fetus"

-"polyhydramnios has been associated with renal disorders of the fetus"

A postpartum client, who is 24 hours post-vaginal birth and breastfeeding, asks a nurse when she can begin exercising to regain her pre pregnancy body shape. Which response by the nurse is correct? -"simple abdominal and pelvic exercises can begin right now" -"you will need to wait until after your 6 week postpartum check up" -"once your lochia has stopped you can begin exercising" -"you should not exercise while you are breastfeeding"

-"simple abdominal and pelvic exercises can begin right now"

A breastfeeding woman calls the pediatric nurse with the following complaint: "I woke up this morning with a terrible cold. I don't want my baby to get sick. Which kind of formula should I give the baby until I get better?" Which of the following replies by the nurse is appropriate at this time? -"Any formula brand is satisfactory, but it is essential that it be mixed with water that has been boiled for at least 5 minutes" -"Don't forget to pump your breasts every 3 hours while you are feeding the baby the prescribed formula" -"the best way to keep you baby from getting sick is for you to keep breastfeeding them rather than switching to formula" -"In addition to feeding the baby formula, you should wear a surgical mask when you around your baby"

-"the best way to keep you baby from getting sick is for you to keep breastfeeding them rather than switching to formula"

Which statement, if made by the parents of a newborn with an esophageal atresia, indicates to the nurse that the parents understand the condition? -"the muscles around the stomach are too tight" -"the esophagus doesn't lead to the stomach" -"there is a hole in the roof of the baby's mouth" -"part of the bowel is outside the stomach"

-"the esophagus doesn't lead to the stomach"

A client, who is 2 weeks postpartum, calls her obstetrician's nurse and states that she has had a whitish discharge for 1 week but today she is "bleeding and saturating a pad about every ½ hour." Which of the following is an appropriate response by the nurse? -"that is normal. You are starting to menstruate again" -"you should stay on complete bed rest until the bleeding subsides" -"pushing during a bowel movement may have loosened your stitches" -"the physician should see you. please come in whenever you are ready"

-"the physician should see you. please come in whenever you are ready"

The client is admitted to the unit. A vaginal exam reveals that she is 3 cm dilated. Which of the following statements would the nurse expect her to make? -"I can't decide what to name the baby" -"it feels good to push with each contraction" -"don't touch me. I'm trying to concentrate" -"when can I get my epidural?"

-"when can I get my epidural?"

A client who has a child with Tay-Sachs disease is pregnant and is to have an amniocentesis to determine if the fetus has the disease. The nurse counsels her to plan for the procedure at the optimum time during her pregnancy. When is the best time? -6 to 8 weeks gestation -14 to 16 weeks gestation -18 to 20 weeks gestation -22 to 24 weeks gestation

-14 to 16 weeks gestation

Four newborns are in the neonatal nursery, none of whom is crying or in distress. Which of the babies should the nurse report to the neonatologist? -16 hour old baby who has yet to pass meconium -16 hour old baby whose blood glucose is 50 mg/dL -2 day old baby who is breathing irregularly at 70 breaths per minute -2 day old baby who is secreting a milky discharge from both nipples

-2 day old baby who is breathing irregularly at 70 breaths per minute

In caring for an immediate postpartum woman, you notice petechiae and oozing from the IV site. You monitor her closely for which clotting disorder? -DIC -hemorrhage -HELLP syndrome -amniotic fluid embolism

-DIC

The client who is 4 months pregnant finds a lump in her breast and the biopsy is positive for stage II cancer of the breast. Which treatment would the nurse anticipate the HCP recommending to the client? -a lumpectomy to be performed after the baby is born -a modified radical mastectomy -radiation therapy to the chest wall only -chemotherapy only until the baby is born

-a modified radical mastectomy

When entering the room of a client in active labor to answer the call light, the nurse identifies that the client is ashen gray, is clutching her chest, and is dyspneic. What should the nurse do after pressing the emergency light in the client's room? -administer oxygen by face mask -check for rupture of membranes -begin cardiopulmonary resuscitation -increase the rate of IV fluids

-administer oxygen by face mask

Postpartum overdistention of the bladder and urinary retention can lead to which complications? -after birth hemorrhage and eclampsia -fever and increased blood pressure -after birth hemorrhage and UTI -UTI and uterine rupture

-after birth hemorrhage and UTI

Which of the following instructions should be included in the nurse's teaching regarding oral contraceptives? -weight gain should be reported to the doctor -an alternative method of birth control is needed when taking antibiotics -if the client misses one or more pills, two pills should be taken per day for one week -changes in the menstrual flow should be reported to the doctor

-an alternative method of birth control is needed when taking antibiotics

A client, who is a primigravida at 10 weeks gestation, reports mild uterine cramping and slight vaginal spotting without passage of tissue. When assessed, no cervical dilation is noted. Which is the best action by the nurse? -anticipate that the woman will be sent home and placed on bedrest -prepare the woman for a dilation and curettage -notify a grief counselor to assist the woman with the imminent loss of her fetus -tell the woman that the doctor will most likely perform a cerclage to help maintain the pregnancy

-anticipate that the woman will be sent home and placed on bedrest

A nurse is assessing a 1 day old sleeping baby in the well-baby nursery. Which of the following assessments should the nurse report to the neonatologist? -temperature 97.9 -blood pressure 77/46 -respiratory rate 52 -apical heart rate 179

-apical heart rate 179

A nurse in the newborn nursery observes a yellowish skin color of an infant whose mother had a cesarean birth. What is the immediate nursing action? -notify the health care provider -ascertain how many hours ago the neonate was born -take a heel blood sample and send it to the lab -cover the eyes and place the neonate under high intensity light

-ascertain how many hours ago the neonate was born

Which priority intervention should the nurse implement for the 38 weeks gestation client who is receiving epidural anesthesia? -place the client in the fetal position -assess the client's respiratory rate -pre-hydrate the client with IV fluids -ensure the client has been NPO for 4 hours

-assess the client's respiratory rate

While the nurse is caring for a multiparous client in active labor at 36 weeks gestation, the client tells the nurse "I think my water just broke." What should the nurse do first? -turn the client to the right side -assess the color, amount, and odor of the fluid -assess the fetal heart rate pattern -check the client's cervical dilation

-assess the fetal heart rate pattern

Four hours after a difficult labor and birth, a primiparous woman refuses to feed her baby, stating that she is too tired and just wants to sleep. What should the nurse do? -assist the woman with initiating breastfeeding and remain with her as long as necessary -recognize this behavior as the taking-hold stage -record the behavior as ineffective maternal-newborn attachment -take the baby back to the nursery, reassuring her that rest is a priority at this time

-assist the woman with initiating breastfeeding and remain with her as long as necessary

Four babies have just been admitted into the neonatal nursery. Which of the babies should the nurse assess first? -baby with respirations 42, oxygen saturation 96% -baby with apgar score 9/9, weight of 4,660 g -baby with temperature of 98.0, length 21 in -baby with glucose level of 55 mg/dL, heart rate 121

-baby with apgar score 9/9, weight of 4,660 g

Which recommendation is the American Cancer Society's guideline for the early detection of breast cancer? -beginning at age 18 years, have a biannual clinical breast examination -beginning at age 30, perform monthly breast self exams -beginning at age 40, receive a yearly mammogram -beginning at age 50, have a breast sonogram every five years

-beginning at age 40, receive a yearly mammogram

The partner of a woman in labor is having difficulty timing the frequency of contractions and asks the nurse to review the procedure. How should the timing of contractions be performed? -end of one contraction to the end of the next contraction -end of one contraction to the beginning of the next contraction -beginning of one contraction to the end of the next contraction -beginning of one contraction to the beginning of the next contraction

-beginning of one contraction to the beginning of the next contraction

Regarding fetal positioning during labor, nurses should be aware that: -position is a measure of the degree of descent of the presenting part of the fetus through the birth canal -birth is imminent when the presenting part is at +4 or +5 cm below the ischial spines -the largest transverse diameter of the presenting part is the suboccipitobregmatic diameter -engagement is the term used to describe the beginning of labor

-birth is imminent when the presenting part is at +4 or +5 cm below the ischial spines

The nurse is discharging four Rh-negative clients from the maternity unit. The nurse knows that further teaching is needed when the client who had which of the following deliveries asks why she has not received her Rhogam shot? -abortion at 10 weeks gestation -fetal demise at 24 weeks gestation -birth of Rh-negative twins at 35 weeks gestation -delivery of a 40 week gestation Rh-positive baby

-birth of Rh-negative twins at 35 weeks gestation

Newborn Zoe's temperature drops when she is placed on the cool plastic surface of the weight scales. This is an example of heat loss via: -conduction -convection -evaporation -radiation

-conduction

During a visit to the prenatal clinic, a pregnant client at 32 weeks gestation has heartburn. The client needs further instruction when she says she must do what? -avoid highly seasoned foods -avoid lying down right after eating -eat small, frequent meals -consume liquids only between meals

-consume liquids only between meals

A neonate is being admitted to the well-baby nursery. Which of the following findings should be reported to the neonatologist? -umbilical cord with 3 vessels -diamond-shaped anterior fontanelle -cryptorchidism -cafe au lait spot

-cryptorchidism

A client with diabetes asks the nurse for advice regarding methods of birth control. Which method of birth control is most suitable for the client with diabetes? -IUD -oral contraceptives -diaphragm -contraceptive sponge

-diaphragm

While evaluating an external monitor tracing of a woman in active labor whose labor is being induced, the nurse notes that the fetal heart rate begins to decelerate at the onset of several contractions and returns to baseline before each contraction ends. The nurse should: -change the woman's position -discontinue oxytocin -insert an internal monitor -document

-document

The nurse instructs a primigravid client about the importance of sufficient vitamin A in her diet. The nurse knows that the instructions have been effective when the client indicates that she should include which foods in her diet? -buttermilk and cheese -strawberries and broccoli -egg yolks and squash -oranges and tomatoes

-egg yolks and squash

A nurse is caring for a postpartum client who is 15 years old. The nurse has concerns about this client's ability to parent a newborn because the nurse recognizes that the client is: -developing autonomy -motivated to follow rules established by outside sources -career oriented -egocentric

-egocentric

A client, who is gravida 2, para 1, ruptures her membranes spontaneously with a large amount of clear fluid. A nurse performs a vaginal examination and discovers a loop of umbilical cord in the vagina. Which immediate action should be taken by the nurse? -place the client on her left side -attempt to replace the cord -elevate the client's hips -cover the cord with a dry, sterile gauze

-elevate the client's hips

A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months. These symptoms are most likely related to: -endometriosis -premenstrual syndrome (PMS) -primary dysmenorrhea -secondary dysmenorrhea

-endometriosis

A multigravid client is admitted at 16 weeks gestation with a diagnosis of hyperemesis gravidarum. The nurse should explain to the client that hyperemesis gravidarum is thought to be related to high levels of which hormone? -progesterone -estrogen -somatotropin -aldosterone

-estrogen

Following a positive pregnancy test, a client begins discussing the changes that will occur in the next several months with the nurse. The nurse should include which information about changes the client can anticipate in the first trimester? -differentiating the self from the fetus -enjoying the role of nurturer -preparing for the reality of parenthood -experiencing ambivalence about pregnancy

-experiencing ambivalence about pregnancy

A primiparous client who gave birth vaginally 8 hours ago desires to take a shower. The nurse anticipates remaining near the client to assess for which problem? -fatigue -fainting -diuresis -hygiene needs

-fainting

A client who is at 38 weeks gestation presents to labor and delivery and states "I have water leaking down my legs." Which assessment by the nurse is most appropriate in this situation? -deep tendon reflexes -fern test -blood pressure check -urine test for protein

-fern test

A pregnant client is concerned because she is now 14 days over her due date. A nurse should monitor the client for which most concerning problem for a post-term fetus? -meconium-stained amniotic fluid -macrosomia -birth trauma -fetal demise

-fetal demise

A male neonate born prematurely and who is small for gestational age is placed in the ICU. On assessment, the nurse would expect this neonate to display: -firm cartilage to the edge of the ear pinna -elbows that can be brought to the midline of the chest with resistance past the midline -fine downy hair over the upper arms and back -prominent creases on the soles and heels

-fine downy hair over the upper arms and back

A nurse should recommend which preconceptual supplement as a preventative measure to decrease the incidence of neural tube defects? -folic acid supplementation -iron supplements -vitamin C supplementation -vitamin B6 supplementation

-folic acid supplementation

A nurse has administered Methergine 0.2 mg PO to a grand multipara who delivered vaginally 30 minutes earlier. Which of the following outcomes indicates that the medication is effective? -blood pressure 120/80 -pulse rate 80 bpm and regular -fundus firm at umbilicus -increase in prothrombin time

-fundus firm at umbilicus

A nurse identifies the following outcome for a newly delivered full-term infant, "area around umbilical cord will remain dry and free of erythema." To accomplish this outcome, which intervention should the nurse include in the plan of care? -give the infant sponge baths until the cord falls off -apply a lubricating lotion to the cord twice daily -cover the cord with a transparent dressing to prevent urine contact -move the cord in a circular fashion with each diaper change

-give the infant sponge baths until the cord falls off

The female unlicensed assistive personnel (UAP) informs the nurse she has helped the 1 day postpartum client change her peri-pad three times in the last 4 hours. Which action should the nurse implement? -ask the UAP why the nurse was not notified earlier -go to the room and check the client immediately -instruct the UAP to massage the client's uterus -document the finding in the client's chart

-go to the room and check the client immediately

Because of the high discomfort level during the transition phase of labor, nursing care should directed toward: -helping the client maintain control -decreasing the rate of IV fluids -administering prescribed medication -having the client breathe in a uniform pattern

-helping the client maintain control

A nurse assesses a client who is 15 years old, gravida 1, para 0, and is 11 weeks gestation. Which prenatal laboratory test would indicate a risk factor for this client? -white blood cell count = 12,000 -hematocrit = 32% -hemoglobin = 9 gm/dL -random serum glucose = 105 gm/dL

-hemoglobin = 9 gm/dL

A client calls the emergency room stating that she thinks she is in labor. The nurse should tell the client that labor has probably begun when: -her contractions are 2 minutes apart -she has back pain and a bloody discharge -she experiences abdominal pain and frequent urination -her contractions are 5 minutes apart

-her contractions are 5 minutes apart

A baby is delivered following a pregnancy complicated by gestational diabetes. What should the nurse observe the baby for? -infection -hyperglycemia -acidosis -hypoglycemia

-hypoglycemia

A woman, at 32 weeks gestation, delivers a 3 lb 8 oz baby boy two hours after arriving at the hospital. What is the baby at risk for because of his gestational age? -mental retardation and seizures -hypothermia and respiratory distress -acrocyanosis and decreased lanugo -patent ductus arteriosus and pneumonia

-hypothermia and respiratory distress

When assessing a patient for amenorrhea, the nurse should be aware that this is unlikely to be caused by: -anatomic abnormalities -type I diabetes -lack of exercise -hysterectomy

-lack of exercise

A client, who is a 38 year old gravida 4, para 2, has an ultrasound at 34 weeks gestation, which reveals marginal placenta previa. The client has some bright red spotting, but no contractions or abdominal pain. A nurse should anticipate that the expected management for a client with marginal placenta previa will be: -limiting activity to bedrest, with bathroom privileges -preparing for an immediate cesarean delivery -doing a contraction stress test for fetal well-being -inducing labor with misoprostol

-limiting activity to bedrest, with bathroom privileges

The nurse is examining a child with fetal alcohol syndrome. Which assessment finding should the nurse expect? -macrocephaly -low nasal bridge with short upturned nose -clubbing of fingers -short philtrum with thick upper lip

-low nasal bridge with short upturned nose

A woman is practicing natural family planning methods. She asks a nurse about the most likely time for her to conceive. The nurse explains that conception is most likely to occur when: -estrogen levels are low -luteinizing hormone is high -the endometrial lining is thin -progesterone level is low

-luteinizing hormone is high

To reduce the risk of hypoglycemia in a full-term newborn weighing 2,900 g, what should the nurse do? -maintain the infant's temperature above 97.7 -feed the infant glucose water every 3 hours until breastfeeding well -assess blood glucose levels every 3 hours for the first twelve hours -encourage the mother to breastfeed every 4 hours

-maintain the infant's temperature above 97.7

A woman, who wishes to breastfeed, advises the nurse that she had a breast reduction one year earlier. Which of the following responses by the nurse is appropriate? -advise the woman that unfortunately she will be unable to breastfeed -examine the woman's breasts to see where the incision was placed -monitor the baby's daily weights for excessive weight loss -inform the woman that reduction surgery rarely affects breast milk transfer

-monitor the baby's daily weights for excessive weight loss

A woman in labor has just received an epidural block. The most important nursing intervention is to: -limit parenteral fluids -monitor the fetus for possible tachycardia -monitor the maternal blood pressure for hypotension -monitor the maternal pulse for bradycardia

-monitor the maternal blood pressure for hypotension

While performing a newborn assessment, the nurse identifies the following when the bassinet is bumped: an extension of the arms, with fingers forming the shape of a "C". How would the nurse document this finding? -babinski's reflex -grasping reflex -moro reflex -tonic neck

-moro reflex

A woman presents to a health care clinic complaining of a lump in her breast. Which finding is highly suggestive of breast cancer? -pain in her breasts bilaterally prior to menses -newly retracted right nipple -left breast larger than the right -milky discharge expressed from both breasts

-newly retracted right nipple

The nurse is performing a postpartum assessment on a client who delivered 4 hours ago. The nurse notes a firm uterus at the umbilicus with heavy lochial flow. Which of the following nursing actions is appropriate? -massage the uterus -notify the obstetrician administer an oxytocic as ordered -assist the client to the bathroom

-notify the obstetrician

A patient has undergone an amniocentesis for evaluation of fetal well-being. Which intervention would be included in the nurse's plan of care after the procedure? SATA: -perform ultrasound to determine fetal positioning -observe the patient for possible uterine contractions -administer Rhogam to the patient if she is Rh-negative -perform a mini catheterization to obtain a urine specimen to assess for bleeding

-observe the patient for possible uterine contractions -administer Rhogam to the patient if she is Rh-negative

A client in labor is being prepared for a cesarean birth. Which is the most important nursing intervention before anesthesia is administered? -prepare the abdomen -obtain informed consent -initiate an IV infusion -insert an indwelling urinary catheter

-obtain informed consent

A primigravida has just given birth. The nurse is aware that she has type AB Rh-negative blood. Her newborn's blood is type B positive. What should the plan of care include? -determining the father's blood type -preparing for a maternal blood transfusion -observing the newborn for signs of ABO incompatibility -obtaining an order to administer Rhogam to the mother

-obtaining an order to administer Rhogam to the mother

In the past, women were told to choose between psychotic medication and breastfeeding their infant. Current beliefs are that although most drugs will diffuse into the breast milk, there are few instances in which breastfeeding must be discontinued. Several factors are known to influence the amount of drug an infant will receive via breast milk. Which is not one of these factors? -amount of milk produced -composition of the milk -concentration of the medication -offering of single or both breasts

-offering of single or both breasts

Which symptom would the nurse expect to observe in a postpartum client with a vaginal hematoma? -pain -bleeding -warmth -redness

-pain

A 23 year old client, who is gravida 3, para 2, delivered a baby by vacuum-assisted vaginal delivery 2 days ago. As part of the discharge teaching class, for which condition should the nurse instruct the client to call a physician? SATA: -pain that is not well controlled by prescription pain medication -pain in her calves when walking -foul smelling lochia -lochia serosa that is soaking less than a pad every 3 hours -soaking more than a pad an hour with lochia

-pain that is not well controlled by prescription pain medication -pain in her calves when walking -foul smelling lochia -soaking more than a pad an hour with lochia

The nurse is developing a standard care plan for the post-cesarean client. Which of the following should the nurse plan to implement? -maintain client in left lateral recumbent position -teach sitz bath use on second postoperative day -perform active range of motion exercises until ambulating -assess central venous pressure during first postoperative day

-perform active range of motion exercises until ambulating

The nurse is caring for a client who is in the taking-in phase of the postpartum period. The area of health teaching that the client will be most responsive to is: -perineal care -infant feeding -infant hygiene -family planning

-perineal care

A client has just completed the second stage of labor and has begun the third stage of labor. Which nursing action has priority at this time? -promotion of the bonding process -administration of an oxytocic medication -encouraging client to push -physical assessment of the neonate

-physical assessment of the neonate

The labor and delivery nurse is performing a vaginal examination and assesses a prolapsed cord. Which intervention should the nurse implement first? -place the client in Trendelenburg position -ask the father to leave the delivery room -request the client not to push during contractions -prepare the client for emergency c-section

-place the client in Trendelenburg position

A nurse is admitting a full-term pregnant client presenting with bright red vaginal bleeding and intense abdominal pain. Her blood pressure on admission is 150/96 mmHg and her pulse is 109 beats per minute. Which problem should the nurse suspect that the client is likely experiencing? -placenta previa -placenta abruption -bloody show -succenturiate placenta

-placenta abruption

A newborn client has a myelomeningocele. The nurse places this client in what position? -dorsal recumbent position -fowler position -prone position -supine position

-prone position

A full-term newborn was just born. Which nursing intervention is important for the nurse to perform first? -remove wet blankets -assess apgar score -insert eye prophylaxis -elicit the moro reflex

-remove wet blankets

Four days after delivery, a client develops complications of postpartum hemorrhage. The most common cause of late postpartum hemorrhage is: -uterine atony -retained placental fragments -cervical laceration -perineal tears

-retained placental fragments

Postpartum fatigue is more than just feeling tired; it is a complex phenomenon affected by a combination of physiologic, psychologic, and situational variables. Which of these is not a contributing factor to postpartum fatigue? -long labor or cesarean birth -infant care demands -social isolation due to lack of visitors -anemia or infection

-social isolation due to lack of visitors

When developing a teaching plan for a client who is 8 weeks pregnant, the nurse would suggest what foods to meet the client's need for increased folic acid? SATA: -spinach -bananas -seafood -yogurt -beans

-spinach -beans

A client, who is 36 years old, has been trying to get pregnant for about 5 months. At her physician appointment, she states that she knows she should take folic acid supplements but dislikes taking pills. Which foods that are high in folic acid should a nurse suggest? SATA: -salmon -spinach -orange juice -asparagus -chicken

-spinach -orange juice -asparagus

A client asks a nurse about the most common problem associated with the use of an intrauterine device (IUD). What should the nurse respond? -perforation of the uterus -spontaneous device expulsion -discomfort associated with coitus -development of vaginal infections

-spontaneous device expulsion

After an emergency birth, the nurse encourages the woman to breastfeed her newborn. The primary purpose of this activity is to: -facilitate maternal-newborn interaction -stimulate the uterus to contract -prevent neonatal hypoglycemia -initiate the lactation cycle

-stimulate the uterus to contract

The doctor suspects that the client has an ectopic pregnancy. Which symptom is consistent with a diagnosis of a ruptured ectopic pregnancy? -painless vaginal bleeding -abdominal cramping -throbbing pain in the upper quadrant -sudden, stabbing pain in the lower quadrant

-sudden, stabbing pain in the lower quadrant

A pregnant client asks the nurse about types of exercises that are allowed during pregnancy. The nurse should tell the client that which exercise is safest? -swimming -scuba diving -low-impact gymnastics -bicycling with legs in the air

-swimming

A client at 36 weeks gestation presents to labor and delivery complaining of headache for the past two days. She also states that her face "seems more swollen than usual." What should be the nurse's first action? -obtain a urine sample -place the client on a fetal heart monitor -notify the MD of the client's concerns -take the client's blood pressure

-take the client's blood pressure

A physician orders Methergine for a postpartum client. Which intervention should the nurse take prior to administering this medication? -take the client's blood pressure -take the client's blood glucose level -check the client's pulse -have the client empty her bladder

-take the client's blood pressure

A primigravid client at 30 weeks gestation has been admitted to the hospital with premature rupture of membranes without contractions. Her cervix is 2cm dilated and 50% effaced. Which factor is most important for the nurse to assess next? -RBC count -degree of discomfort -urinary output -temperature

-temperature

The nurse working in a woman's health clinic is returning phone calls. Which client should the nurse contact first? -the 16 year old client who is complaining of severe lower abdominal cramping -the 27 year old primigravida client who is complaining of blurred vision -the 48 year old perimenopausal client who is expelling dark red blood clots -the 68 year old client who thinks her uterus is falling out of her vagina

-the 27 year old primigravida client who is complaining of blurred vision

The charge nurse is making assignments in the labor and delivery department. Which client should be assigned to the most experienced nurse? -the 26 week gestational client who is having braxton hicks contractions -the 32 week gestational client who is having triplets and is on bedrest -the 38 week gestational client whose contractions are 2 minutes apart -the 39 week gestational client who has late decelerations on the fetal monitor

-the 39 week gestational client who has late decelerations on the fetal monitor

A nurse from the medical-surgical unit is assigned to the postpartum unit. Which client should the charge nurse assign to the medical-surgical nurse? -the client who has developed mastistitis and is trying to breastfeed -the client who had a vaginal hysterectomy and oophorectomy -the client who is having difficulty bonding with her infant -the unmarried client who is giving her child up for adoption

-the client who had a vaginal hysterectomy and oophorectomy

Which client should the postpartum nurse assess first after receiving the morning shift report? -the client who is complaining of perineal pain when urinating -the client who saturated multiple peri-pads during the night -the client who is refusing to have the newborn in the room -the client who is crying because the baby will not nurse

-the client who saturated multiple peri-pads during the night

The charge nurse has received laboratory results for clients on the postpartum unit. Which client would warrant intervention by the nurse? -the client whose white blood cell count is 18,000 -the client whose serum creatinine level is 0.8 mg/dL -the client whose platelet count is 410,000 -the client whose serum glucose level is 280 mg/dL

-the client whose serum glucose level is 280 mg/dL

After delivering a full-term infant, a breastfeeding mother, who is preparing for discharge, asks a nurse if there is any type of contraceptive method that should be avoided while she is breastfeeding. Which contraceptive device should the nurse advise the client to avoid? -a diaphragm -an intrauterine device (IUD) -the combined oral contraceptive (COC) pill -the progesterone only mini pill

-the combined oral contraceptive (COC) pill

If a pregnant woman presents with abdominal pain that may require surgery, it is important for the nurse to understand that: -the diagnosis of appendicitis may be difficult because the normal signs and symptoms mimic some normal changes in pregnancy -rupture of the appendix is less likely in pregnant women because of the close monitoring -surgery for intestinal obstructions should be delayed as long as possible because it usually affects the pregnancy -when pregnancy takes over, a woman is less likely to have ovarian problems that require invasive responses

-the diagnosis of appendicitis may be difficult because the normal signs and symptoms mimic some normal changes in pregnancy

Which time frame is most appropriate for the nursery nurse to initiate breastfeeding? -the first period of reactivity -the first period of inactivity -the second period of inactivity -the second period of reactivity

-the first period of reactivity

As the client reaches 6 cm dilation, the nurse notes late decelerations on the fetal monitor. What is the most likely explanation of this pattern? -the baby is sleeping -the umbilical cord is compressed -there is head compression -there is uteroplacental insufficiency

-there is uteroplacental insufficiency

A client at 12 weeks gestation arrives in the prenatal clinic complaining of cramping and vaginal spotting. A pelvic examination reveals that the cervix is closed. Which probable diagnosis should the nurse expect? -missed abortion -inevitable abortion -incomplete abortion -threatened abortion

-threatened abortion

The nurse is assisting a health care provider examining an infant with developmental dysplasia of the hip perform an Ortolani maneuver. The nurse understands that this maneuver is performed for which purpose? -to assess for hip instability -to assess for movement of the hips -to push the femoral head out of the acetabulum -to ensure that hyperextension and full range of motion exist

-to assess for hip instability

The obstetric client's fetal heart rate is 80-90 during the contractions. The first action the nurse should take is: -reposition the monitor -turn the client to her left side -ask the client to ambulate -prepare the client for delivery

-turn the client to her left side

A multigravida visits the clinic because she suspects that she is pregnant but is unable to tell the nurse when her last menstrual period began. The client has a history of preterm delivery. The nurse instructs the client that the gestational age of the fetus can be estimated by: -amniocentesis -percutaneous umbilical blood sampling -alpha-fetoprotein level -ultrasonography

-ultrasonography

A client has been receiving magnesium sulfate for severe preeclampsia for 12 hours. Her deep tendon reflexes are 0 and her respiratory rate is 10. Which of the following situations could be a precipitating factor in these findings? -apical heart rate 104 -urinary output 240 mL/12 hrs -blood pressure 160/120 -temperature of 100 degrees

-urinary output 240 mL/12 hrs

The nurse is assessing a pregnant client in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which assessment finding should the nurse expect to note if this condition is present? -soft abdomen -uterine tenderness -absence of abdominal pain -painless, bright red vaginal bleeding

-uterine tenderness

Which of the following is an expected lab finding for a patient with stage 4 chronic kidney disease? -BUN 250 -creatinine 1.0 -potassium 4.9 -hemoglobin 14.0

-BUN 250

The nurse is caring for a client diagnosed with acute renal failure. Which laboratory values are most significant for diagnosing ARF? -BUN and creatinine -WBC and hemoglobin -potassium and sodium -bilirubin and ammonia level

-BUN and creatinine

A client diagnosed 8 months ago with hepatitis B is suspected of having chronic hepatitis. What serologic marker would you expect to be present if this client is indeed a carrier of the disease? -anti-HCV antibodies -anti-HBs antibodies -HBsAg antibodies -HAV antibodies

-HBsAg antibodies

the pap smear reports of a 23 year old female client indicates the presence of atypical cells. which diagnostic testing would be beneficial in the client? -pap smear test and HPV test -pap smear test every 3 years -HPV test -pap smear test and HPV test every 5 years

-HPV test

What is the most common transmission route of hepatitis C? -blood transfusion -sharps injury -long-term dialysis -IV drug use

-IV drug use

What insulin has no peak but a duration of 24 hrs? -NPH -Novolog -Lantus -Humulin N

-Lantus

The nurse correlates which clinical manifestation to cholecystitis? -retroperitoneal pain -absence of bowel sounds -diarrhea -RUQ pain

-RUQ pain

which stage of testicular cancer invades blood vessels that supply the testicles? -T1 -T2 -T3 -T4

-T4

The nurse recognizes which of the following patients is at the highest risk of developing bladder cancer? -a 75 year old male with a history of diabetes -a 40 year old female with a 20 year smoking history -a 30 year old female who works as a hairdresser -a 52 year old female with a history of frequent UTIs

-a 40 year old female with a 20 year smoking history

When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect: -a blood pressure of 130/70 -a blood glucose level of 130 -bradycardia -a blood pressure of 176/88

-a blood pressure of 176/88

The nurse understands that type 1 diabetes is caused by which of the following conditions? SATA: -gestational diabetes -a history of mumps or rubella -family history of autoimmune disorders -autoimmune destruction of the beta cells of the pancreas -obesity

-a history of mumps or rubella -autoimmune destruction of the beta cells of the pancreas

The client is reporting chills, fever, and left costovertebral pain. Which diagnostic test should the nurse expect the HCP to prescribe first? -a midstream of urine for culture -a sonogram of the kidney -an intravenous pyelogram for renal calculi -a CT scan of the kidneys

-a midstream of urine for culture

A nonstress test is performed on a client who is pregnant, and the results of the test indicate non-reactive findings. The health care provider prescribes a contraction stress test, and the results are documented as negative. How should the nurse document this finding? -a normal test result -an abnormal test result -a high risk for fetal demise -the need for a cesarean delivery

-a normal test result

which female patient is at high risk for endometrial cancer? SATA: -a patient who is obese -a patient with liver cirrhosis -a patient who is 20 years old -a patient who is on tamoxifen -a patient who is on progesterone therapy

-a patient who is obese -a patient with liver cirrhosis -a patient who is on tamoxifen

NPH

-a type of immediate-acting insulin -onset: 1-2 hrs -peak: 4-12 hrs -duration: 18-24 hrs

lantus, toujeo, basaglar/glargine

-a type of long-acting insulin -onset: 1-1.5 hrs -peak: none -duration: 20-24 hrs

levemir/detemir

-a type of long-acting insulin -onset: 1-2 hrs -peak: none -duration: 24 hrs

degludec/tresiba

-a type of long-acting insulin -onset: 1 hr -peak: 8 days -duration: 24-42 hrs

novolog/aspart

-a type of rapid-acting insulin -onset: 10-20 min -peak: 40-50 min -duration: 3-5 hrs

humalog/lispro

-a type of rapid-acting insulin -onset: 15-30 min -peak: 30-90 min -duration: 3-5 hrs

apidra/glulisine

-a type of rapid-acting insulin -onset: 20-30 min -peak: 30-60 min -duration: 1-2.5 hrs

regular humulin/regular novalin

-a type of short-acting insulin -onset: 30-60 min -peak: 2-5 hrs -duration: 5-8 hrs

During the admission of a 35 year old client with advanced ovarian cancer, the nurse recognizes which symptoms as typical of the disease? -diarrhea -hypermenorrhea -abnormal bleeding -abdominal distention

-abdominal distention

a client admitted to the hospital has a dark/bronze hyperpigmentation, hyperkalemia, and hyponatremia. what endocrine disorder does the nurse suspect this client has? -cushing's disease -hyperparathyroidism -hashimoto's -addison's disease

-addison's disease

A nurse is checking a client who has a urinary tract infection (UTI). Which statements should the nurse expect the client to make? SATA: -"I urinate large amounts" -"I need to urinate frequently" -"it burns when I urinate" -"my urine smells sweet" -"I need to urinate urgently"

-"I need to urinate frequently" -"it burns when I urinate" -"I need to urinate urgently"

After a health education session about testicular self-examination (TSE), a client has questions for the nurse. Which statement indicates the need for further teaching regarding TSE? -"A change in my testicles doesn't always mean it's cancer" -"I should examine myself once every few months" -"If I feel something bumpy, I should call my provider" -"If my testicles feel heavy after sexual activity that is not okay"

-"I should examine myself once every few months"

The nurse is discussing storage of insulin vials with the client. Which statement indicates the client understands the teaching concerning the storage of insulin? -"I will keep my unopened vials of insulin in the refrigerator" "I can keep my insulin in the trunk of my car so I will have it at all times" -"it is alright to put my unopened insulin vials in the freezer" -"if I prefill my insulin syringes, I must use them within 1-2 days"

-"I will keep my unopened vials of insulin in the refrigerator"

the nurse is teaching a patient about physical activities recommended for glycemic control. which statement made by the patient indicates a need for further teaching? SATA: -"I will take up anaerobic exercise to control diabetes" -"I should adjust my medication dose and carbohydrate intake when I am keeping an exercise regimen" -"I should work out at least 120 min every week" -"I should adapt myself to moderate intensity exercise along with strength training" -"I should ingest carbohydrates if my pre-exercise blood sugar level is less than 100 mg/dL"

-"I will take up anaerobic exercise to control diabetes" -"I should work out at least 120 min every week"

A nurse is providing instruction to a couple undergoing zygote intrafallopian transfer (ZIFT). The nurse is aware that instruction has been effective when the woman states: -"my egg will be fertilized and then placed into my uterus" -"my husband's sperm will be inserted into my uterus" -"my husband's sperm and my egg will be placed into my fallopian tube" -"a fertilized egg will be placed into my fallopian tube"

-"a fertilized egg will be placed into my fallopian tube"

The nurse hears a mother telling a friend on the telephone about umbilical cord care. Which of the following statements made by the mother indicates effective teaching? -"daily soap and water cleansing is best" -"alcohol helps it dry and kill germs" -"an antibiotic ointment applied daily prevents infection" -"he can have a tub bath each day"

-"alcohol helps it dry and kill germs"

the client with hyperaldosteronism is being treated with spironolactone therapy. what precautions should you teach this client? -"avoid salt substitutes" -"avoid adding salt to food" -"avoid excessive exposure to sunlight" -"avoid acetaminophen"

-"avoid salt substitutes"

The nurse is teaching a client with newly diagnosed type 1 diabetes about insulin therapy. Which statement indicates the client needs more teaching concerning insulin therapy? -"if I have a headache or start getting nervous, I will drink some orange juice" -"if I pass out at home, a family member should give me a glucagon injection" -"because I am taking my insulin daily I do not have to adhere to a diabetic diet" -"I will check my blood glucose with my glucometer at least once a day"

-"because I am taking my insulin daily I do not have to adhere to a diabetic diet"

Which statement made by the client indicates that the mother understands the limitations of breastfeeding her newborn? -"breastfeeding my infant consistently every 3-4 hours stops ovulation and my period" -"breastfeeding my baby immediately after drinking alcohol is safer than waiting for the alcohol to clear my breast milk" -"I can start smoking cigarettes while breastfeeding because it will not affect my breast milk" -"when I take a warm shower after I breastfeed, it relieves the pain from being engorged between breastfeedings"

-"breastfeeding my infant consistently every 3-4 hours stops ovulation and my period"

A patient with newly diagnosed diabetes has peripheral neuropathy. Which key points should the nurse include in the teaching plan for this patient? SATA: -"clean and inspect your feet every day" -"be sure that your shoes fit properly" -"nylon socks are best to prevent friction on your toes from shoes" -"only a podiatrist should trim your toenails" -"report any nonhealing skin breaks to your health care provider" -"use a thermometer to check the temperature of water before taking a bath"

-"clean and inspect your feet every day" -"be sure that your shoes fit properly" -"report any nonhealing skin breaks to your health care provider" -"use a thermometer to check the temperature of water before taking a bath"

The 48 year old client with diabetes mellitus is being treated for her third episode of acute pyelonephritis in the past year. She asks what she could do to help prevent these infections. What is your best response? -"test your urine daily for the presence of ketone bodies and proteins" -"use tampons rather than sanitary napkins during your menstrual period" -"drink more water and try to empty your bladder at least every 2-3 hrs while you are awake" -"inject your insulin in larger doses or more frequently to keep your blood sugar lower so the microorganisms have less nutrients for growth"

-"drink more water and try to empty your bladder at least every 2-3 hrs while you are awake"

The client with type 2 diabetes is admitted into the medical department with a wound on the left leg that will not heal. The HCP prescribes sliding-scale insulin. The client tells the nurse "I don't want to have to take shots. I take pills at home." Which statement would be the nurse's best response? -"If you can't keep your glucose under control with pills, you must take insulin" -"you should discuss the insulin order with your HCP because you don't want to take it" -"you are worried about having to take insulin. I will sit down and we can talk" -"during illness you may need to take insulin to keep your blood glucose levels down"

-"during illness you may need to take insulin to keep your blood glucose levels down"

The client has just been diagnosed with acute glomerular nephritis. Which question should you ask this client in attempting to establish a cause? -"are you sexually active?" -"do you have pain or burning on urination?" -"has anyone in your family had chronic kidney problems?" -"have you had any type of infection within the last 2 weeks?"

-"have you had any type of infection within the last 2 weeks?"

A client with newly diagnosed Grave's disease prepares for discharge. The nurse knows the client understood the discharge teaching by which client statements? SATA: -"Grave's disease typically affects people who are male" -"hyperthyroidism increases metabolism of all organs" -"I may experience mood swings after I get back home" -"I will avoid crowds while taking PTU" -"my parathyroid hormone level is elevated with Grave's disease"

-"hyperthyroidism increases metabolism of all organs" -"I may experience mood swings after I get back home" -"I will avoid crowds while taking PTU"

The nurse is admitting a client diagnosed with acute renal failure (ARF). Which question is most important for the nurse to ask during the admission interview? -"have you recently traveled outside the United States?" -"did you recently begin a vigorous exercise program?" -"is there a chance you have been exposed to a virus?" -"what over the counter medications do you take regularly?"

-"what over the counter medications do you take regularly?"

A client diagnosed with hepatitis A asks you how the infection may have been contracted. What is your best response? -"some medications have been known to induce hepatitis A" -"you may have been exposed through contaminated shellfish" -"you may have been infected through a recent blood transfusion" -"you have had Epstein-Barr virus before, and hepatitis A can co-infect you"

-"you may have been exposed through contaminated shellfish"

What should you emphasize when providing discharge instructions to the client who has undergone a nephrectomy? -"be sure to limit your intake of fluid to no more than 2000 mL/day" -"test your urine daily for ketone bodies and blood" -"you should never participate in contact sports" -"avoid all alcoholic beverages"

-"you should never participate in contact sports"

A male client has just been diagnosed with type 1 diabetes. When teaching the client and family how diet and exercise affect insulin requirements, the nurse should include which statement? -"you'll need more insulin when you exercise or increase your food intake" -"you'll need less insulin when you exercise or reduce your food intake" -"you'll need less insulin when you increase your food intake" -"you'll need more insulin when you exercise or decrease your food intake"

-"you'll need less insulin when you exercise or reduce your food intake"

A nurse is instructing a group of female clients about breast self examination. The nurse instructs the client to perform the examination: -at the onset of menstruation -every month during ovulation -weekly at the same time of day -1 week after menstruation begins

-1 week after menstruation begins

A patient is scheduled to take 7 units of Humulin R at 0830. You administer Humulin R at 0900 in the right thigh. When do you expect this medication to peak? -1300 -0930 -1100 -1700

-1100

Your patient's blood glucose level is 215. The patient is about to eat lunch. Per sliding scale, you administer 4 units of insulin lispro subcutaneously at 1130. As the nurse, you know the patient is most at risk for hypoglycemia at what time? -1145 -1230 -1430 -1630

-1230

A patient is scheduled to take 10 units of Humulin N at 1100. When is the patient most susceptible for hypoglycemia? -1900 -1300 -1130 -1500

-1900

Which of the following clients is most at risk of developing hepatitis B? -24 year old college student who has had several sexual partners -54 year old woman who takes acetaminophen daily for headaches -33 year old businessman who travels frequently -72 year old woman who has eaten raw shellfish

-24 year old college student who has had several sexual partners

The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro? -7:00 -6:20 -6:45 -6:00

-6:45

Which of the following hormones are secreted by the posterior pituitary? -ADH and oxytocin -PRL, GH, ACTH, TSH -thyroxine -adrenaline

-ADH and oxytocin

A client with chronic kidney disease (CKD) being hemodialyzed suddenly becomes short of breath and complains of chest pain. The client is tachycardic, pale, and anxious, and the nurse suspects air embolism. What are the priority nursing actions? SATA: -administer oxygen to the client -continue dialysis at a slower rate after checking the lines for air -notify the primary health care provider and rapid response team -stop dialysis, turn the client on the left side with head lower than feet -bolus the client with 500 mL of normal saline to break up the air embolus

-administer oxygen to the client -notify the primary health care provider and rapid response team -bolus the client with 500 mL of normal saline to break up the air embolus

The nurse interviews a client suspected of having testicular cancer. The nurse knows that which factors increase the client's risk of testicular cancer? SATA: -age of 19 years old -brother had testicular cancer -eight sexual partners last year -hispanic and asian ethnicity -history of undescended testicle

-age of 19 years old -brother had testicular cancer -history of undescended testicle

Which abnormal laboratory value associated with liver failure is correct? SATA: -albumin level is decreased -total bilirubin is elevated -platelets are increased -partial thromboplastin time is prolonged -ammonia level is decreased -decreased alkaline phosphatase -prolonged prothrombin time

-albumin level is decreased -total bilirubin is elevated -partial thromboplastin time is prolonged -prolonged prothrombin time

The client is diagnosed with an acute episode of ureteral calculi. Which client problem is priority when caring for this client? -fluid volume loss -knowledge deficit -impaired urinary elimination -alteration in comfort

-alteration in comfort

Which of the following assessment findings is expected in a client with premenstrual syndrome (PMS) who is receiving danazol? -breast tenderness -hirsutism -increased libido -amenorrhea

-amenorrhea

The nurse is reviewing a prescription for metformin. The nurse should immediately contact the prescribing health care provider to report a contraindication if the prescription is for which client? -an 82 year old client diagnosed with type 2 diabetes -a 37 year old woman who takes oral contraceptives -a 16 year old client with a diagnosis of anorexia nervosa -a 50 year old client who underwent surgery 2 weeks ago

-an 82 year old client diagnosed with type 2 diabetes

The nurse is aware that which of the following is the most common cause of hyperaldosteronism? -excessive sodium intake -a pituitary adenoma -deficient potassium intake -an adrenal adenoma

-an adrenal adenoma

The nurse is assessing a client admitted with complaints related to chronic kidney dysfunction. The nurse recognizes that this client is most likely to present with which of the resulting symptoms? -anemia -hypertension -diabetes mellitus -clinical depression

-anemia

A primapara's baby has developed jaundice as a result of ABO incompatibility. Because it is her first pregnancy, the client cannot understand why her baby is affected. The nurse's best response would be based on which of the following statements? -anti-A and anti-B antibodies are naturally occurring; thus, they can affect a first pregnancy -because she has had no previous pregnancies, she must have had a blood transfusion with incompatible blood -it is rare for the newborn with a first pregnancy to experience hemolytic disease -with ABO incompatibility, the mother becomes sensitized early in pregnancy; thus a first pregnancy can be affected

-anti-A and anti-B antibodies are naturally occurring; thus, they can affect a first pregnancy

A client contracts hepatitis from contaminated food. During the icteric (acute) phase of the client's illness, the nurse would expect serologic testing to reveal: -hepatitis B surface antigen (HBsAg) -anti-hepatitis B core immunoglobulin M (anti-HBc IgM) -anti-hepatitis A virus immunoglobulin G (anti-HAV IgG) -anti-hepatitis A virus immunoglobulin M (anti-HAV IgM)

-anti-hepatitis A virus immunoglobulin M (anti-HAV IgM)

The nurse is caring for a client following a modified radical mastectomy. Which assessment finding would indicate that the client is experiencing a complication related to this surgery? -sanguineous drainage in the jackson-pratt drain -pain at the incisional site -complaints of decreased sensation near the operative site -arm edema on the operative side

-arm edema on the operative side

Select all the signs and symptoms associated with hepatitis: -arthralgia -bilirubin 1 mg/dL -ammonia 15 mcg/dL -dark urine -vision changes -yellowing of the sclera -fever -loss of appetite

-arthralgia -dark urine -yellowing of the sclera -fever -loss of appetite

long-acting insulin

-basal insulin, used in combination with rapid-acting or short-acting insulin

A cervical radiation implant is placed in the client for treatment of cervical cancer. The nurse initiates what most appropriate activity order for this client? -bed rest -out of bed ad lib -out of bed in chair only -ambulation to bathroom only

-bed rest

when can a pregnant woman begin doing kick counts and what is normal and abnormal findings?

-begin at 28 weeks -normal: 3 kicks/hr -abnormal: <3 kicks/hr

which value in the patient's laboratory report indicates the presence of hyperosmolar hyperglycemic state? -serum pH 7.32 -serum osmolality of 290 -plasma glucose level of 500 -bicarbonate concentration of 18

-bicarbonate concentration of 18

which of the following clinical manifestations alerts the nurse to possible preeclampsia? -bright red vaginal bleeding -contractions that do not ease with walking -clear fluid leaking from vagina -black dots/floaters in the client's field of vision

-black dots/floaters in the client's field of vision

A client with end stage cirrhosis develops severe vomiting and is admitted to a medical-surgical unit. What complication of cirrhosis should the nurse be alert for in this client? -intrahepatic bile stasis -bleeding esophageal varices -decreased excretion of bilirubin -the accumulation of plasma within the peritoneal cavity

-bleeding esophageal varices

The nurse administered 12 units of Regular insulin to the patient with type I diabetes at 0700. Which meal would prevent the client from experiencing hypoglycemia? -breakfast -lunch -supper -bedtime snack

-breakfast

The nurse is admitting a client diagnosed with primary adrenal cortex insufficiency (Addison's disease). Which clinical manifestations should the nurse expect to see? -moon face, buffalo hump, and hyperglycemia -hirsutism, fever, and irritability -bronze pigmentation, hypotension, anorexia -tachycardia, bulging eyes, and goiter

-bronze pigmentation, hypotension, and anorexia

which of the following STI's is the most common and fastest spreading? -gonorrhea -syphilis -HPV -chlamydia

-chlamydia

A client who is in labor is admitted 30 hours after her membranes ruptured. For what condition does the nurse anticipate that the client is most at risk? -cord prolapse -placenta previa -chorioamnionitis -abruptio placentae

-chorioamnionitis

One of the most common serious complications of post peritoneal dialysis is peritonitis. The nurse knows that aside from abdominal pain, nausea, and vomiting, peritonitis can also cause: -dark red drainage in the peritoneal fluid -cloudy drainage in the peritoneal fluid -fruity smelling peritoneal drainage -reduced volume of drained peritoneal fluid

-cloudy drainage in the peritoneal fluid

a client has an abnormal pap smear that is positive for precancerous cells. what diagnostic test will be performed next? -laparoscopy -colposcopy -hysterectomy -dilation and curettage

-colposcopy

he client is in the preicteric phase of hepatitis. Which signs and symptoms should the nurse expect the client to exhibit during this phase? -clay colored stools and jaundice -normal appetite and pruritus -afebrile and left upper quadrant pain -complaints of fatigue and diarrhea

-complaints of fatigue and diarrhea

the loss of heat from the body surface to a cooler surface in direct contact is called: -radiation -convection -evaporation -conduction

-conduction

the flow of heat from the body surface to cooler ambient air is called: -radiation -convection -evaporation -conduction

-convection

Five hours after birth, a neonate is transferred to the nursery, where the nurse intervenes to prevent hypothermia. What is a common source of radiant heat loss? -low room humidity -cold weight scale -cool incubator walls -cool room temperature

-cool incubator walls

immediate-acting insulin

-covers insulin needs for approximately half the day or overnight, used in combination with rapid-acting or short-acting insulin

a client admitted to the hospital has abnormal fat distribution, virilization, moon face, buffalo hump, and abdominal striae. what endocrine disorder does the nurse suspect this client has? -cushing's disease -hyperparathyroidism -hashimoto's -addison's disease

-cushing's disease

After falling off a ladder and suffering a brain injury, a client develops SIADH. Which of the following findings indicate the effectiveness of the treatment he's receiving? SATA: -decrease in body weight -rise in blood pressure and drop in heart rate -absence of wheezes in the lungs -increased urine output -decreased urine osmolality

-decrease in body weight -increased urine output -decreased urine osmolality

The nurse expects to observe which of the following altered laboratory values in a patient diagnosed with renal failure? -decreased calcium -increased calcium -decreased phosphorus -increased hematocrit

-decreased calcium

Like the preterm infant, the newborn with postmaturity syndrome is at high risk for cold stress due to: -absence of vernix -decreased subcutaneous fat -extended posture -parchment like skin

-decreased subcutaneous fat

The overweight client diagnosed with type 2 diabetes reports to the clinic nurse that he has lost 35 pounds in the last 4 months. Which action should the nurse implement first? -determine if the client has had an increase in hypoglycemic reactions -instruct the client to make an appointment with the HCP -ask the client if he has been trying to lose weight or has it happened naturally -check the client's last weight in the chart with the weight obtained at the clinic

-determine if the client has had an increase in hypoglycemic reactions

which statement is true regarding the anterior fontanel? SATA: -triangular shaped -diamond shaped -it will appear sunken -it closes between 8-12 weeks -closes at 18 months

-diamond shaped -closes at 18 months

a patient reports frequent and urgent urination. upon palpation, an enlarged prostate is observed. which test should be performed to confirm benign prostatic hyperplasia? -urinalysis -digital rectal exam -alpha-fetoprotein levels -prostate-specific androgen (PSA) levels

-digital rectal exam

A nurse is caring for a client with an internal radiation implant. When caring for the client, the nurse should observe which of the following principles? -limit time with the client to 1 hr per shift -do not allow pregnant women in the client's room -remove the dosimeter badge when entering the client's room -individuals younger than 16 years old may be allowed to go in the room as long as they are 6 feet away from the client

-do not allow pregnant women in the client's room

Select all the ways a person can become infected with hepatitis B: -contaminated food/water -during the birth process -IV drug use -undercooked pork or wild game -hemodialysis -sexual intercourse

-during the birth process -IV drug use -hemodialysis -sexual intercourse

A client with a brain tumor develops diabetes insipidus. Which data should the nurse expect to find? SATA: -dark urine with increased specific gravity -high blood serum osmolality -weight gain with edema -increased thirst -sodium level <135 -urine output 30 mL/hr or less

-high blood serum osmolality -increased thirst

A client is suspected of having hepatitis. Which diagnostic test result will assist in confirming this diagnosis? -elevated hemoglobin level -elevated serum bilirubin level -elevated BUN -decreased erythrocyte sedimentation rate

-elevated serum bilirubin level

abnormal uterine bleeding, mucosanguinous vaginal discharge, and low back/pelvic pain are signs of: -endometrial cancer -ovarian cancer -gonorrhea -syphilis

-endometrial cancer

Which clinical manifestations alert you to the possibility of anterior pituitary hyperfunction? -enlarged hands and feet; heat intolerance -bradycardia, hypotension, and somnolence -chronic constipation and darkening of the skin -hyponatremia, hyperkalemia, and hypercalcemia

-enlarged hands and feet; heat intolerance

Which clinical manifestation in a client with renal impairment is associated with polycystic kidney disease rather than an infectious process? -flank pain -periorbital edema -bloody and cloudy urine -enlarged or protruding abdomen

-enlarged or protruding abdomen

The nurse administered 25 units of Humulin N to a client with type 1 diabetes at 1600. Which intervention should the nurse implement? -assess the client for hypoglycemia around 1800 -ensure the client eats the nighttime snack -check the client's serum blood glucose level -serve the client a supper tray

-ensure the client eats the nighttime snack

Which of the following is secreted from the adrenal medulla? -aldosterone -cortisol -epinephrine -vasopressin

-epinephrine

Based on an understanding of drugs, the nurse plans to instruct a client with amenorrhea to use which of the following drugs? -danazol -progesterone -estrogen -naproxen

-estrogen

A woman has just started receiving external radiation therapy. When the nurse enters the room, she notes that the client is scrubbing the area vigorously with soap and water. When asked about her actions, the woman replies that she is trying to get rid of the ugly purple marks. What is the best action for the nurse at this time? -explain that the purple marks must stay on her because they tell the doctors where to beam the radiation -suggest that alcohol will make it easier to remove the marks -say, "you feel the marks are ugly." -ask her if she checked with her physician before trying to remove the purple marks

-explain that the purple marks must stay on her because they tell the doctors where to beam the radiation

A nurse is obtaining information on a newly admitted client who has been diagnosed with diabetes insipidus. Which data should the nurse expect to collect? SATA: -extreme polyuria -excessive thirst -elevated systolic blood pressure -low urine specific gravity -bradycardia -elevated serum potassium level

-extreme polyuria -excessive thirst -low urine specific gravity

an infant weighing 1000 g or less is considered:

-extremely low birth weight (ELBW)

Which clinical manifestation in a client with a urinary tract infection alerts you to the possibility of acute pyelonephritis? -burning on urination -cloudy, dark urine -fever and chills -hematuria

-fever and chills

A 58 year old patient with type 2 diabetes was admitted to the acute care unit with a diagnosis of COPD exacerbation. When the RN prepares a care plan for this patient, what would she be sure to include? SATA: -fingerstick blood glucose checks before meals and at bedtime -sliding scale insulin dosing as prescribed -bed rest until the COPD exacerbation is resolved -teaching about the Atkins diet for weight loss -demonstration of the components of foot care -discussing the relationship between illness and glucose levels

-fingerstick blood glucose checks before meals and at bedtime -sliding scale insulin dosing as prescribed -demonstration of the components of foot care -discussing the relationship between illness and glucose levels

a child is diagnosed with nephrotic syndrome. what does the nurse expect the urine to look like? -dark red -amber -clear -frothy

-frothy

The nurse is caring for the client diagnosed with type 2 diabetes. The client is complaining of a headache, jitteriness, and nervousness. Which action should the nurse implement first? -check the client's serum blood glucose level -give the client a glass of orange juice -determine when the last antidiabetic medication was administered -assess the client's blood pressure and apical pulse

-give the client a glass of orange juice

Cushing's disease is manifested by the excessive secretion of corticosteroids. The hormones involved are: -glucocorticoids and aldosterone -adrenocorticotropic hormone (ACTH) -glucocorticosteroids, aldosterone, and androgens -catecholamines

-glucocorticosteroids, aldosterone, and androgens

If a gallstone becomes lodged in the common bile duct, the nurse should anticipate that the client's stools would most likely be: -green -gray -black -yellow

-gray

A new breastfeeding mother is concerned about her small breasts, and whether she can produce enough milk. The nurse teaches the mother that the best indication that her baby is receiving adequate nutrition is that the baby: -is hungry and wants to eat every 2-3 hours -sleeps for 4-6 hours between feedings -gains 2 ounces per week -has 6-8 wet diapers

-has 6-8 wet diapers

What should a male client over age 52 do to help ensure early identification of prostate cancer? -have a digital rectal examination and prostate specific antigen test done yearly -have a transrectal ultrasound every 5 years -perform monthly testicular self examinations, especially after age 50 -have a CBC and BUN and creatinine levels checked yearly

-have a digital rectal examination and prostate specific antigen test done yearly

The newly diagnosed client with chronic renal failure recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse assesses the client during dialysis for: -hypertension, tachycardia, fever -hypotension, bradycardia, hypothermia -restlessness, irritability, generalized weakness -headache, deteriorating level of consciousness, twitching

-headache, deteriorating level of consciousness, twitching

The nurse suspects that the client has a bladder infection based on the client's exhibiting an early sign or symptom such as: -chills -hematuria -flank pain -incontinence

-hematuria

ou are preparing to review a teaching plan for a patient with type 2 diabetes. To determine the patient's level of compliance with his prescribed antidiabetic regimen, which value would you be sure to review? -fasting blood glucose level -oral glucose tolerance results -hemoglobin A1C level -fingerstrick blood glucose levels

-hemoglobin A1C level

which test measures the amount of glucose that binds to RBCs in a nonpregnant adult patient? -oral glucose tolerance test -hemoglobin A1C test -fasting plasma glucose test -random plasma glucose

-hemoglobin A1C test

The nurse is caring for a patient with known hepatitis B. A second type of hepatitis is discovered. What type of hepatitis would it be? -hepatitis A -hepatitis C -hepatitis D -hepatitis E

-hepatitis D

A nursing student is listing the types of hepatitis that are transmitted through infected blood and body fluids. Which example listed by the nursing student indicates a need for further instruction? -hepatitis C -hepatitis D -hepatitis E -hepatitis G

-hepatitis E

A client is admitted with Laennec's cirrhosis. What data in the client's past history should you inquire about in taking a current history from this client? -history of gallstones -history of alcohol abuse -history of viral hepatitis -history of heart disease

-history of alcohol abuse

A client, age 41, visits the gynecologist. After examining her, the physician suspects cervical cancer. The nurse reviews the client's history for risk factors for this disease. Which history finding is a risk factor for cervical cancer? -onset of sporadic sexual activity at age 17 -spontaneous abortion at age 19 -pregnancy complicated with eclampsia at age 27 -human papillomavirus (HPV) infection at age 32

-human papillomavirus (HPV) infection at age 32

the client is being admitted with acute adrenal insufficiency (addisonian crisis). what medication should you be prepared to administer? -sodium bicarbonate -pancuronium bromide -hydrocortisone sodium succinate -insulin, 20 units and dextrose 20%

-hydrocortisone sodium succinate

what clinical manifestation is the nurse most likely to see in a patient with a pheochromocytoma? SATA: -bradycardia -hypotension -hypoglycemia -hyperhidrosis -hypermetabolism

-hyperhidrosis -hypermetabolism

gigantism and acromegaly indicate what endocrine disorder? -hyperthyroidism -hyperpituitarism -grave's disease -hashimoto's

-hyperpituitarism

grave's disease is associated with what endocrine disorder? -hypopituitarism -hypothyroidism -hyperthyroidism -hyperpituitarism

-hyperthyroidism

A nurse is assessing a client with Addison's disease. The nurse should review laboratory reports for which condition? -hypokalemia -hypernatremia -hypoglycemia -decreased BUN

-hypoglycemia

this is the term for partial disintegration of the endometrium: -oligomenorrhea -hypomenorrhea -metrorrhagia -menorrhagia

-hypomenorrhea

it is determined that a patient has decreased mineralocorticoids due to hypopituitarism. which laboratory abnormality is most important for the nurse to monitor? -hypoglycemia -hyponatremia -decreased cortisol levels -decreased catecholamine levels

-hyponatremia

The nurse is caring for a client diagnosed with rule-out acute renal failure. Which condition predisposes the client to developing prerenal failure? -diabetes mellitus -hypotension -aminoglycosides -benign prostatic hypertrophy

-hypotension

a patient with a pheochromocytoma has undergone unilateral adrenalectomy. what is the priority in the postoperative patient? -excessive sweating -weight loss -hypotension -premature ventricular contractions

-hypotension

hashimoto's is associated with: -hypopituitarism -hyperthyroidism -diabetes insipidus -hypothyroidism

-hypothyroidism

Which of the following is a prerenal cause of acute kidney injury? -acute glomerulonephritis and neoplasms -septic shock and nephrotoxic injury from medications -pyelonephritis and calculi formation -hypovolemia and myocardial infarction

-hypovolemia and myocardial infarction

a patient with BPH is diagnosed with bladder damage from the outlet obstruction and asks the nurse why that occurred. which could be the cause for the bladder damage? -urinary stasis -painful urination -mineral deposits in the bladder -incomplete emptying of bladder

-incomplete emptying of bladder

The client is diagnosed with acute renal failure. Which signs and symptoms indicate to the nurse that the client is in the recovery period? SATA: -increased alertness and no seizure activity -increase in hemoglobin and hematocrit -denial of nausea and vomiting -decreased urine specific gravity -increased serum creatinine level

-increased alertness and no seizure activity -increase in hemoglobin and hematocrit -denial of nausea and vomiting

which assessment changes should the nurse anticipate in an adult patient with increased secretion of growth-stimulating hormone? SATA: -increased bone density -weight loss -increased risk of fractures -menstrual irregularities -coarse facial features

-increased bone density -menstrual irregularities -coarse facial features

the laboratory reports of a patient with kidney disease indicate an increase in BUN levels. Which could be the reason behind this condition? -decreased erythropoietin production -decreased GI absorption -increased protein intake and breakdown -increased production of nonvolatile acids

-increased protein intake and breakdown

the nurse is caring for a patient with adrenal insufficiency. which assessment changes can be anticipated? -increased body weight -decreased blood glucose -increased blood pressure -increased serum potassium

-increased serum potassium

During a routine physical examination, a firm mass is palpated in the right breast of a 35 year old woman. Which of the following findings would suggest cancer of the breast as opposed to fibrocystic disease? -history of early menarche -cyclic changes in mass size -history of anovulatory cycles -increased vascularity of the breast

-increased vascularity of the breast

The primary cause of anemia in a client with chronic renal failure is: -poor iron absorption -destruction of red blood cells -lack of intrinsic factor -insufficient erythropoietin

-insufficient erythropoietin

which birth control options are 99% effective when used properly? SATA: -diaphragm/cervical cap -intrauterine device -estrogen hormone patch -implant -condom

-intrauterine device -estrogen hormone patch -implant

which is true regarding long-acting insulin? -it is a dose of prandial insulin used prior to eating or used as correction insulin for blood glucose elevations -it is a dose of basal insulin used in combination with rapid acting or short acting -it covers insulin needs for approximately half the day or overnight -it is a dose of prandial insulin used for meals eaten within 30-60 min after admin

-it is a dose of basal insulin used in combination with rapid acting or short acting

Nursing interventions for Ryan following his circumcision include: -administering an analgesic -applying a topical anesthetic to the site -keeping him in the nursery for 1 hour -loosely wrapping the diaper around him

-keeping him in the nursery for 1 hour

what clinical manifestation does a nurse expect to see in a client diagnosed with diabetic ketoacidosis? -tachypnea -hypertension -kussmaul's respirations -hypoglycemia

-kussmaul's respirations

The surgical treatment of choice for the patient with symptomatic gallbladder disease is? -cholecystectomy -choledocholithotomy -cholecystoduodenostomy -laparoscopic cholecystectomy

-laparoscopic cholecystectomy

what is the most common surgical procedure used to treat mild endometriosis? -laparoscopy -colposcopy -hysterectomy -oophorectomy

-laparoscopy

an infant weighing 4000 g or more at birth is considered:

-large for gestational age (LGA)

Which of the following symptoms would the nurse anticipate observing in a client with pancreatitis? -hypertension, elevated WBC, and peripheral edema -left upper quadrant abdominal pain, nausea, and vomiting -hypoglycemia, tachycardia, and cyanosis -decreased WBC, clubbing of fingernails, and mid-epigastric discomfort

-left upper quadrant abdominal pain, nausea, and vomiting

A 48 year old male patient is screened for diabetes at a clinic and has a fasting blood glucose level of 120 mg/dL. The nurse plans to teach this patient about: -self-monitoring of blood glucose -using low doses of regular insulin -lifestyle change to lower blood glucose -effects of oral hypoglycemic medications

-lifestyle changes to lower blood glucose

A client's current condition requires rapid reduction of blood sugar levels. Which type of insulin will have the most rapid onset of action? -NPH -NPH 70%, regular 30% -regular -lispro

-lispro

What does the nurse expect to find in a patient with syndrome of inappropriate antidiuretic hormone (SIADH)? SATA: -low blood osmolality -increased serum osmolality -low urine specific gravity -hyponatremia -decreased urine output

-low blood osmolality -hyponatremia -decreased urine output

The nurse is preparing to care for a client receiving peritoneal dialysis. Which of the following would be included in the nursing plan of care to prevent the major complication associated with peritoneal dialysis? -monitor the clients level of consciousness -maintain strict aseptic technique -add heparin to the dialysate solution -change the catheter site dressing daily

-maintain strict aseptic technique

The nurse in the medical department is preparing to administer Humalog, a rapid-acting insulin to a client diagnosed with type 1 diabetes. Which intervention should the nurse implement? -ensure the client is wearing a medic alert bracelet -administer the dose according to the Regular insulin sliding scale -assess the client for hyperosmolar hyperglycemic nonketotic coma -make sure the client eats the food on the meal tray that is at bedside

-make sure the client eats the food on the meal tray that is at bedside

this is the term for excessive menstrual bleeding: -oligomenorrhea -hypomenorrhea -metrorrhagia -menorrhagia

-menorrhagia

this is the term for intermenstrual bleeding, or bleeding in between periods: -oligomenorrhea -hypomenorrhea -metrorrhagia -menorrhagia

-metrorrhagia

Which should be included in the client's plan of care during dialysis therapy? -limit the client's visitors -monitor the client's blood pressure -pad the side rails of the bed -keep the client on NPO status

-monitor the client's blood pressure

a client with hypothyroidism has dry, thin, and coarse hair, thin lateral eyebrows, perioribital edema, coarse dry skin, and facial puffiness. what does the nurse suspect this client has due to decreased activity of the thyroid gland? -hashimoto's -thyroid storm -myxedema -grave's disease

-myxedema

A female client with a history of hypothyroidism is brought to the ED. Assessment and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face. Knowing these findings suggest hypothyroidism, the nurse prepares to take emergency action to prevent the potential complication of: -thyroid storm -cretinism -myxedema coma -hashimoto's thyroiditis

-myxedema coma

The nurse instructs the perimenopausal client that it is a priority to stop taking the prescribed estrogen if which of the following occurs? -spotting between menstrual periods -painful intercourse -breast tenderness -nausea and vomiting

-nausea and vomiting

The nurse correlates which clinical manifestation with the pathophysiology of acute pyelonephritis? SATA: -nausea and vomiting -hematuria -flank pain -fever -abdominal pain

-nausea and vomiting -hematuria -flank pain -fever

Which clinical manifestations should the nurse expect to assess for the client diagnosed with a ureteral renal stone? -dull aching flank pain and microscopic hematuria -nausea, vomiting, pallor, and cool clammy skin -gross hematuria and dull suprapubic pain with voiding -the client will be asymptomatic

-nausea, vomiting, pallor, and cool clammy skin

The nurse is reviewing orders for a newly admitted patient with type 1 diabetes. It is a priority for the nurse to follow up with the provider about which order? -novolog insulin subcutaneous at bedtime -novolog insulin subcutaneous 15 minutes prior to meals -basal insulin subcutaneous at bedtime -correctional and nutritional insulin administered immediately after the meal

-novolog insulin subcutaneous at bedtime

The nurse recognizes which client as being at greatest risk for the development of carcinoma of the liver? -middle aged client with a history of diabetes mellitus -young adult client with a history of blunt liver trauma -older adult client with a history of cirrhosis -older adult client with malnutrition

-older adult client with a history of cirrhosis

this is the term for decreased menstruation, amount, or duration: -oligomenorrhea -hypomenorrhea -metrorrhagia -menorrhagia

-oligomenorrhea

You administered 5 units of Humalog at 0800. What is the onset and duration of this medication? -onset 15 min, duration 3 hrs -onset 2 hrs, duration 16 hrs -onset 30 min, duration 1 hr -onset 2 hrs, duration 24 hrs

-onset 15 min, duration 3 hrs

Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 pm, the client has a blood glucose level of 250 mg/dL and receives 8 U of regular insulin. The nurse should expect the dose's: -onset to be at 2 pm and its peak to be at 3 pm -onset to be at 2:15 pm and its peak to be at 3 pm -onset to be at 2:30 pm and its peak to be at 4 pm -onset to be at 4 pm and its peak to be at 6 pm

-onset to be at 2:30 pm and its peak to be at 4 pm

Giving instructions for breast self-examination is particularly important for clients with which of the following medical problems? -cervical dysplasia -a dermoid cyst -endometrial polyps -ovarian cancer

-ovarian cancer

which of the following are signs of chlamydia? SATA: -painful urination -thick yellow vaginal discharge -chancre sores -foul smelling vaginal discharge

-painful urination -thick yellow vaginal discharge

The nurse is teaching a young male client to recognize the most common early sign of testicular cancer. The nurse emphasizes the fact that he should be aware of which of the following? -lumbar pain -urinary frequency -urinary urgency -painless testicular enlargement

-painless testicular enlargement

When auscultating the chest of a preterm newborn, the nurse hears crackles and a continuous systolic murmur. The nurse should suspect the presence of: -bronchopulmonary dysplasia -patent ductus arteriosus -pulmonary atelectasis -ventricular septal defect

-patent ductus arteriosus

Which of the following manifestations are associated with acute glomerulonephritis? -normal blood pressure, generalized edema, oliguria -periorbital edema, hypertension, dark-colored urine -fatigue, elevated serum lipid levels, elevated serum protein levels -temperature elevation, circulatory congestion, normal BUN and creatinine levels

-periorbital edema, hypertension, dark-colored urine

The client receiving dialysis is complaining of being dizzy and light-headed. Which action should the nurse implement first? -place the client in the trendelenburg position -turn off the dialysis machine immediately -bolus the client with 500 mL of normal saline -notify the doctor as soon as possible

-place the client in the trendelenburg position

A client is admitted to the hospital and has a diagnosis of early stage chronic renal failure. Which of the following would the nurse expect to note on assessment of the client? -polyuria -polydipsia -oliguria -anuria

-polyuria

A registered nurse is caring for a client following a liver biopsy with the assistance of a student nurse. The RN evaluates that the student understands the postprocedure care when the student nurse: -plans to monitor vital signs every hour -promotes ambulation 1 hr after the procedure -positions the client on the right side -encourages the client to cough and deep breathe immediately following the procedure

-positions the client on the right side

A patient has completed the hepatitis B vaccine series. What blood result below would demonstrate the vaccine series was successful at providing immunity to hepatitis B? -positive IgG -positive HBsAg -positive IgM -positive anti-HBs

-positive anti-HBs

Which nursing diagnosis is priority for the client who has undergone a TURP? -potential for sexual dysfunction -potential for an altered body image -potential for chronic infection -potential for hemorrhage

-potential for hemorrhage

short-acting insulin

-prandial insulin used for meals eaten within 30-60 min after administration, used in combination with long-acting insulin

rapid-acting insulin

-prandial insulin used within 0-15 min prior to eating or used as correction insulin for blood glucose elevations, used in combination with long-acting insulin

this is the term for hypertension and proteinuria that develops after 20 weeks: -eclampsia -preeclampsia -fetal demise -ectopic pregnancy

-preeclampsia

The client diagnosed with type 1 diabetes is complaining of a dry mouth, extreme thirst, and increased urination. Which action should the nurse implement? -administer one amp of IV 50% glucose -prepare to administer IV Regular insulin -inject Humulin N subcutaneously in the abdomen -hang an IV infusion of D5W at a keep vein open rate

-prepare to administer IV Regular insulin

In reviewing diagnostic results of a patient with suspected hepatitis, the nurse correlates which result is consistent with hepatitis A? -prolonged prothrombin time -decreased WBC count -presence of IgM anti-HAV -detectable serum HBV DNA

-presence of IgM anti-HAV

an infant born at <37 weeks and weighs 2000 g or less is considered:

-preterm

A client at 24 weeks gestation arrives to the ER complaining of increased vaginal discharge, abdominal and pelvic pain, pelvic pressure, and vaginal bleeding. Based on these clinical manifestations, what does the nurse suspect? -fetal demise -ectopic pregnancy -preeclampsia -preterm labor

-preterm labor

this is the term for an erection lasting more than 3 hours and is considered a medical emergency: -erectile dysfunction -torsion -BPH -priapism

-priapism

which hormone therapy may reduce the risk of ovarian cancer? -estrogen replacement therapy -androgen replacement therapy -progesterone replacement therapy -estrogen and progesterone replacement therapy

-progesterone replacement therapy

what is the nursing priority when administering care to a client with severe hyperthyroidism? -assess for recent emotional trauma -provide a calm, nonstimulating environment -provide diversionary activity -encourage ROM exercises

-provide a calm, nonstimulating environment

A newborn undergoing phototherapy experiences increased urine output and loose stools. The nurse should: -decrease the phototherapy unit's level of irradiance -immediately discontinue phototherapy -provide extra fluids to prevent dehydration recognize this is a normal occurrence needing no intervention

-provide extra fluids to prevent dehydration

the loss of heat from the body surface to a cooler solid surface not in direct contact but in relative proximity is called: -radiation -convection -evaporation -conduction

-radiation

Immediately after birth, the nurse notes the following on a male newborn: respirations 78, apical heart rate 160, nostril flaring, mild intercostal retractions, and grunting at the end of expiration. Which of the following should the nurse do? -call the assessment data to the physicians attention -start oxygen per nasal cannula at 2L/min -suction the infant's mouth and nares -recognize this as the normal first period of reactivity

-recognize this as the normal first period of reactivity

The client with glomerular nephritis has a glomerular filtration rate (GFR), as measured by a 24 hr creatinine clearance of 40 mL/min. What is your interpretation of this finding? -excessive glomerular filtration; client at risk for dehydration -excessive glomerular filtration; client at risk for fluid overload -reduced glomerular filtration; client at risk for dehydration -reduced glomerular filtration; client at risk for fluid overload

-reduced glomerular filtration; client at risk for fluid overload

A client diagnosed with diabetic ketoacidosis has been admitted to the ICU. The client is prescribed an IV insulin drip, so the nurse knows that what type of insulin will be administered? -insulin glargine -regular -lispro -NPH

-regular

Richard is a newborn who has experienced symptomatic hypoglycemia and required an IV infusion of dextrose. His condition has stabilized, and the physician has changed him to oral feedings. As Richard begins oral feedings, the nurse should anticipate that the physician orders will include: -administering long-acting epinephrine -discontinuing IV after first formula feeding -giving a bolus infusion of 10% dextrose -reinstituting frequent glucose monitoring during transition

-reinstituting frequent glucose monitoring during transition

Which of the following is a priority for the nurse to include in the instructions for a client starting estrogen hormone replacement therapy for menopause? -report an increase in weight of 3 pounds or more to your doctor -take extra safety precautions to protect yourself from injury and falls -you may have greater frequency and urgency in urination -remember to do a breast self-examination every month

-remember to do a breast self-examination every month

A client with chronic renal failure is receiving hemodialysis three times a week. In order to protect the fistula, the nurse should: -take the blood pressure in the arm with the fistula -report the loss of a thrill or bruit on the arm with the fistula -maintain a pressure dressing on the shunt -start a second IV in the arm with the fistula

-report the loss of a thrill or bruit on the arm with the fistula

A patient in the outpatient clinic has positive serologic testing for anti-HCV. Which action by the nurse is appropriate? -schedule the client for HCV genotype testing -teach the patient that the HCV will resolve in 2-4 months -administer immunoglobulin and the HCV vaccine -instruct the patient on self administration of interferon

-schedule the client for HCV genotype testing

a teratogenic drug, such as Methotrexate, is most likely to cause learning deficits during which phase of fetal development? -conception through week 2 -weeks 3-8 -first trimester -second and third trimesters

-second and third trimesters

The nurse providing care for the patient post motor vehicle accident with a suspected injury to the renal system anticipates which of the following orders? -perform an electrocardiogram -send a urinalysis to the laboratory -administer diuretics -administer antihypertensives

-send a urinalysis to the laboratory

Which test is most specific for renal function? -renal scan -serum creatinine -creatinine clearance -blood urea nitrogen (BUN)

-serum creatinine

In a 29 year old client who is being successfully treated for Cushing's syndrome, the nurse would expect a decline in: -serum glucose -hair loss -bone mineralization -menstrual flow

-serum glucose

The most specific laboratory result in the patient with acute pancreatitis is an elevation in which laboratory value? -serum bilirubin -serum lipase -serum trypsin -serum lactase

-serum lipase

On assessment of the patient with a renal calculus passing down the ureter, what should the nurse expect the patient to report? -a history of chronic UTIs -dull, costovertebral flank pain -severe, colicky back pain radiating to the groin -a feeling of bladder fullness with urgency and frequency

-severe, colicky back pain radiating to the groin

for what complications is the client with hypercortisolism at greater risk? -skin breakdown, infection, GI ulceration -anorexia, constipation, hypotension -kidney stones, weight loss, cataracts -diabetes insipidus, bradycardia, arthritis

-skin breakdown, infection, GI ulceration

the nurse is caring for a patient with a blood pressure of 250/140 from an adrenal tumor. what medication should the nurse request when contacting the provider? -sodium nitroprusside (nipride) -kayexalate -pasireotide -dexamethasone

-sodium nitroprusside (nipride)

the patient with hyperaldosteronism is being treated for hypertension. what medication should the nurse anticipate? -metoprolol -lisinopril -spironolactone -furosemide

-spironolactone

Which intervention is most important for the nurse to implement for the client diagnosed with rule-out renal calculi? -assess the client's neurological status every 2 hrs -strain all urine and send any sediment to the laboratory -monitor the client's BUN and creatinine levels -take a 24 hr dietary recall during the client interview

-strain all urine and send any sediment to the laboratory

Your client who had a transsphenoidal hypophysectomy 2 days ago now has nuchal rigidity. What is your best first action? -encourage the client to do active range of motion exercises for the neck -document the finding as the only action -take the client's temperature -administer pain medication

-take the client's temperature

a client is diagnosed with acute glomerulonephritis. what does the nurse expect the client's urine to look like? -clear -frothy -cloudy -tea colored

-tea colored

a client with hyperthyroidism arrives to the ER with tachycardia, fever, systolic hypertension, abdominal pain, irritability, tremors, and changes in level of consciousness. what does the nurse suspect this client is experiencing due to increased thyroid function? -thyroid storm -grave's disease -addisonian crisis -shock

-thyroid storm

Which of the following is true regarding the fontanels of the newborn? -the anterior is triangular shaped; the posterior is diamond shaped -the posterior closes at 18 months; the anterior closes at 8-12 weeks -the anterior is large in size when compared to the posterior fontanel -the anterior is bulging, the posterior appears sunken

-the anterior is large in size when compared to the posterior fontanel

The nurse is caring for a client with chronic pyelonephritis. Which assessment data support the diagnosis of chronic pyelonephritis? -the client has fever, chills, flank pain, and dysuria -the client complains of fatigue, headaches, and increased urination -the client had a group B beta-hemolytic strep infection last week -the client has an acute viral pneumonia infection

-the client complains of fatigue, headaches, and increased urination

which of the following client's condition can be managed with estrogen therapy? -the client with hot flashes, type II diabetes, and central weight gain -the client with prolonged irregular bleeding, dysuria, and difficult defecation -the client with excess bleeding during menses, pain during intercourse, and dysmenorrhea -the client with severe abdominal cramping, nausea, and vomiting during 24 to 48 hrs of onset of menses

-the client with hot flashes, type II diabetes, and central weight gain

Which assessment data best indicates that the client with type 1 diabetes is adhering to the medical treatment regimen? -the client's fasting blood glucose is 100 mg/dL -the client's urine specimen has no ketones -the client's glycosylated hemoglobin is 5.8% -the client's glucometer is 120 mg/dL

-the client's glycosylated hemoglobin is 5.8%

A 36 year old patient's lab work shows anti-HAV and IgG present in the blood. As the nurse you would interpret this blood work as? -the patient has an active infection of hepatitis A -the patient has recovered from a previous hepatitis A infection and is now immune to it -the patient is in the preicteric phase of viral hepatitis -the patient is in the icteric phase of viral hepatitis

-the patient has recovered from a previous hepatitis A infection and is now immune to it

When taking a health history for a new patient, which information given by the patient would indicate that screening for hepatitis C is appropriate? -the patient had a blood transfusion after surgery in 1998 -the patient reports a one time use of IV drugs 20 years ago -the patient eats frequent meals in fast-food restaurants -the patient recently traveled to an underdeveloped country

-the patient reports a one time use of IV drugs 20 years ago

when mixing insulins, which insulin should be drawn up first?

-the regular insulin

The school nurse is teaching a class about type 2 diabetes to elementary school teachers. Which information is most important for the nurse to discuss with the teachers? -the importance of not allowing students to eat candy in the classroom -the increase in the number of students developing type 2 diabetes -the signs and symptoms of hypoglycemia and the immediate treatment -the need to have the students run or walk for 20 min during recess

-the signs and symptoms of hypoglycemia and the immediate treatment

A client exhibits severe tachycardia, fever, dehydration, and heart failure. The nurse recognizes that these signs are consistent with what thyroid-associated health condition? -hashimoto's disease -thyroid storm -myxedema -subclinical hyperthyroidism

-thyroid storm

which of the following is true regarding the posterior fontanel? SATA: -triangular shaped -diamond shaped -closes between 8-12 weeks -closes at 18 months

-triangular shaped -closes between 8-12 weeks

a female client comes into the clinic with complaints of vaginal discharge that is frothy and green/yellow in color. what STI does the nurse suspect? -bacterial vaginosis -gonorrhea -chlamydia -trichomoniasis

-trichomoniasis

what type of diabetes is an absolute lack of insulin and considered insulin dependent?

-type I diabetes

what type of diabetes is caused by insulin deficiency or insulin resistance?

-type II diabetes

Which client responses demonstrate to you that treatment for diabetes insipidus is effective? -urine output is increased; specific gravity is increased -urine output is increased; specific gravity is decreased -urine output is decreased; specific gravity is increased -urine output is decreased; specific gravity is decreased

-urine output is decreased; specific gravity is increased

A patient with hepatitis B is being discharged in 2 days. In the discharge teaching plan, the nurse should include instructions to: -avoid alcohol for the first 3 weeks -use a condom during sexual intercourse -have family members get an injection of immunoglobulin -follow a low protein, moderate carbohydrate, moderate fat diet

-use a condom during sexual intercourse

what are signs of placental abruption?

-vaginal bleeding -abdominal pain -uterine tenderness -boardlike abdomen

Tony was diagnosed with hepatitis A. The information from the health history that is most likely linked to hepatitis A is: -exposed with arsenic compounds at work -working as a local plumber -working at a hemodialysis clinic -dish washer in restaurants

-working as a local plumber

Which of the following symptoms during the icteric phase of viral hepatitis should the nurse expect the client to inhibit? -watery stool -yellow sclera -tarry stool -shortness of breath

-yellow sclera

how long is the 1st trimester

1-13 weeks

how long is the 2nd trimester

14-26 weeks

how long is the 3rd trimester

27-40 weeks

If an infant experiences an apneic episode, the first nursing activity should be to: -apply gentle tactile stimulation -call the physician -increase the rate of prescribed oxygen -suction the mouth and nose with a bulb syringe

apply gentle tactile stimulation

what is a sign of placenta previa?

painless bright red vaginal bleeding


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