Endo & Immune NCLEX review test

. A nursing student is assigned to a client who begins to make homosexual remarks and invitations to the student relative to meeting after discharge. The student's best response would be: "I am here as your nurse to meet your treatment needs. You are entitled to your sexual orientation, but discussion of it is not acceptable to me as part of your care." "I am going to tell my instructor about this conversation so that I can be reassigned NOW!" "I am uncomfortable dealing with people like you, so just be quiet and let's get this over as quickly as possible." "Your chosen lifestyle makes me uncomfortable. I will be back with your medication."

"I am here as your nurse to meet your treatment needs. You are entitled to your sexual orientation, but discussion of it is not acceptable to me as part of your care."

A client with a severe allergic disorder says, "I am sick of being sick." Which "I" statement when used by the nurse is most effective? "I don't think that attitude is very helpful." "I want you to feel more positive." "I can't believe you really feel that way." "I think you sound pretty frustrated."

"I think you sound pretty frustrated."

After teaching a client with HIV infection using antiretroviral drugs, the nurse recognizes that further teaching is needed when the client says: "If I develop a constant headache that is not relieved by aspirin or acetaminophen, I should report it within 24 hours." "I should not use any over-the-counter drugs without checking with my health care provider." "If my viral load becomes undetectable, I will no longer be able to transmit HIV to others." "I should never skip doses of my medication, even if I develop side effects."

"If my viral load becomes undetectable, I will no longer be able to transmit HIV to others." Rationale: Even if the viral load is low or undetectable, the client can still infect others.

A child is scheduled to receive an MMR vaccine. The nurse is gathering information from the child's mother before giving the vaccine. Which of the following questions by the nurse is the most important at this time? "Did your child complete his DPT series? "Was your child delivered by cesarean?" "Is your child allergic to eggs?" "Are you still breast-feeding your child?"

"Is your child allergic to eggs?"

A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse would be most accurate in stating: "Your insulin regimen needs to be altered significantly." "It tells us about your sugar control for the last 3 months." "It looks like you aren't following the prescribed diabetic diet." "The test needs to be repeated following a 12-hour fast."

"It tells us about your sugar control for the last 3 months."

Which of these teachings or instructions would be appropriate for a client who will undergo a patch test in a few minutes? (Select ALL that apply) "You must observe the site for any wheal formation." "Keep the patch on for two days, then come back to the clinic." "A concentrated form of the allergen will be applied to your skin." "A needle will be used to apply a strong allergen into your skin."

"Keep the patch on for two days, then come back to the clinic." "A concentrated form of the allergen will be applied to your skin."

Your young client reports that diabetes is causing her to "have no life at all . . . It's too hard." Your helpful response is: "Let's talk about how you can fit diabetes into your life." "Yes, you must make many sacrifices in order to live." "It's hard, but with a complete change in your lifestyle, you can live a long life." "What's so hard about it? It's just exercise, diet, and medicine."

"Let's talk about how you can fit diabetes into your life."

A female client whose physical findings suggest a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal hypophysectomy. The evening before the surgery, the nurse reviews preoperative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize? "You must lie flat for 24 hours after surgery." "You must report ringing in your ears immediately." "You must avoid coughing, sneezing, and blowing your nose." "You must not change position in bed to prevent complications.

"You must avoid coughing, sneezing, and blowing your nose."

An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting: 2 to 5 g of a simple carbohydrate. 25 to 30 g of protein. 10 to 15 g of a simple carbohydrate. 18 to 20 g of fats.

10 to 15 g of a simple carbohydrate.

The nurse administered regular insulin to a client at 7:00 am. She would plan to give a snack to the client at around: 10:00 am. 11:30 am. 8:00 am. 3:00 pm.

10:00 am

The nurse is caring for a female client with type 1 diabetes mellitus who exhibits confusion, light-headedness, diaphoresis, and aberrant behavior. The client is still conscious. The nurse should first administer: I.V. bolus of dextrose 50%. 10 U of fast-acting insulin. 15 to 20 g of a fast-acting carbohydrate such as orange juice. I.M. or subcutaneous glucagon.

15 to 20 g of a fast-acting carbohydrate such as orange juice.

A client has a glycosylated hemoglobin A (HA1c) level of 11%. The nurse knows that is approximately equivalent to _______mg.

242

The client with AIDS has several manifestations, but the two main criterion in diagnosing this disease are: A markedly decreased T4 count and opportunistic infections. Positive ELISA test and presence of Kaposis sarcoma. The presence of pneumocystis jirovecii pneumonia and wasting syndrome. Positive Western blot and signs of a viral infection.

A markedly decreased T4 count and opportunistic infections.

A client is admitted to the emergency room with urticaria on his torso. He is scratching his arms and also complains of an "upset stomach." His physician suspects an allergic disorder. Which of these methods would best identify which substance the client is allergic to? Evaluation of the client's rashes and other symptoms. A thorough physical and medical history. Radioallergosorbent test (RAST). Eosinophil count.

A thorough physical and medical history

The nurse is teaching a client who has an allergy to bee venom regarding the use of an EpiPen. Which of the following instructions should be included in the teaching plan? (Select ALL that apply) Advise the client to use a Medic-Alert bracelet, if available. Instruct the client to check the expiration date on the EpiPen. Tell the client that the site most commonly used for injection is the thigh. Encourage the client to stay home and never do outdoor activities.

Advise the client to use a Medic-Alert bracelet, if available. Instruct the client to check the expiration date on the EpiPen. Tell the client that the site most commonly used for injection is the thigh.

During a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise? At least once a week. At least three times a week. At least five times a week. Every day.

At least three times a week.

A client with a history of having an anaphylactic reaction to dust and pollen can be taught to prevent future attacks by: Always wearing a mask when outside the house. Avoiding exposure to known allergens. Listing all possible allergens in the house. Wearing a Medic-Alert band.

Avoiding exposure to known allergens.

During the tilt-table test for a client with chronic fatigue syndrome (CFS), the nurse must monitor the client's: Lower extremities. Urine output. Blood pressure. Joint for swelling.

Blood pressure.

A client with a diagnosis of hyperparathyroidism will be monitored for which of the following cardinal signs and symptoms? (Select ALL that apply) Elevated blood pressure. Moon face. Intolerance to heat. Bone pain. Pathologic fractures

Bone pain Pathologic fractures

A client who underwent a total thyroidectomy procedure has a positive Chvostek's sign. Which of the following medications will the nurse anticipate to administer? Calcium gluconate. Epinephrine. Potassium sulfate. Glucagon.

Calcium gluconate.

The type of immunotherapy wherein the client with an allergy is given increasing doses of an injected allergen over several weeks is called: Intravenous fluid therapy. Desensitization. Diet therapy. SLIT management.

Desensitization

A client received 6 units of regular insulin 3 hours ago. The nurse would be MOST concerned if which of the following was observed? Headache and polyuria. Diaphoresis and trembling. Cloudy urine. Flushed face and acetone breath.

Diaphoresis and trembling.

The nurse should expect a client with hypothyroidism to report which health concerns? Moist skin. Increased appetite and weight loss. Increased tolerance to exercise. Dry hands and face.

Dry hands and face.

A client is diagnosed with Sjogren's syndrome. The nurse caring for her knows that the most common symptom of this condition is: Moist skin. Dry mouth. Elevated blood pressure. Dizziness.

Dry mouth.

Which of these blood tests would be done initially to identify HIV infection? Enzyme-linked immunosorbent assay (ELISA). Western blot. Total T-cell count. ASO titer.

Enzyme-linked immunosorbent assay (ELISA).

The definitive diagnosis for an AIDS-infected client who has developed cryptosporidiosis is made by: Examining the stool for ova and parasites. Culturing the blood for clostridium difficile. Culturing the urine for parasites. Examining the oral cavity for thrush.

Examining the stool for ova and parasites.

Which of the following is the best dietary advice to maximize the immune function in healthy people? Avoid polyunsaturated fatty acids. Include immune-enhancing formulas. Increase intake of essential fatty acids. Follow a balanced and varied diet.

Follow a balanced and varied diet.

When instructing a female client diagnosed with hyperparathyroidism about diet, the nurse should stress the importance of which of the following? Increasing calcium intake. Forcing fluids. Restricting sodium intake. Restricting potassium.

Forcing fluids. Rationale: Hyperparathyroidism can cause renal stones. Fluid intake must be increased to prevent formation of renal calculi.

The nurse is preparing to suction the tracheostomy of a client with AIDS. Which of these personal protective equipment (PPE) should the nurse wear? Mask and gown. Mask and gloves. Gloves and gown. Gloves and mask with eye shield.

Gloves and mask with eye shield.

When reviewing the medical history of a client with HIV, the nurse may find which information that may directly relate to the client's current diagnosis? He had surgery 6 months ago. He went to Thailand for a vacation. He smokes marijuana. He is a heroin addict. He breeds poodles.

He is a heroin addict.

Dexamethasone (Decadron) is prescribed for a client with a severe allergic disorder. While taking this medication, the client must be monitored for: Hyperglycemia. Hypotension. Decreased appetite. Weight loss.

Hyperglycemia

You are drawing up a teaching plan for a client who has type I diabetes. The doctor has ordered two types of insulin—10 U of regular and 35 U of NPH. The proper procedure to draw up the medication is to: Inject air into the NPH, draw it up to 35 U, then inject air into the clear and withdraw to 45 U. Draw up the insulins in two separate syringes so that there can be no confusion. Draw up the regular insulin before drawing up the NPH insulin. Inject 35 U air into NPH, inject 10 U air into regular, withdraw 10 U regular, and withdraw 35 U NPH.

Inject 35 U air into NPH, inject 10 U air into regular, withdraw 10 U regular, and withdraw 35 U NPH.

Which of the following medications should the nurse NOT administer to a client with Addison's disease? (Select ALL that apply) Steroids. Insulin. Sodium chloride IV. Anti-hypertensives.

Insulin Anti-hypertensives.

A client with an allergic disorder has developed angioedema. The priority management for this client involves: Administering intravenous fluids. Monitoring the blood pressure. Maintaining a patent airway. Auscultating apical pulses.

Maintaining a patent airway.

Which of these signs suggest that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications? Weight loss. Tetanic contractions. Neck vein distention. Polyuria.

Neck vein distention.

When caring for a client after a subtotal thyroidectomy, which of these findings indicate an accidental removal of the parathyroid glands? Intolerance to heat. Fatigue and malaise. Throat dryness. Numbness and tingling of the face and hands

Numbness and tingling of the face and hands

Which of these food items commonly cause allergies? (Select ALL that apply) Nuts. Tapioca. Apple juice. Fish. Rice. Strawberries.

Nuts. Fish. Strawberries.

A client with AIDS is treated for oral candidiasis. The nurse assisting in his care would prepare which of the following medications commonly used to treat such condition? Nystatin swish and swallow. Vitamin B complex given around-the-clock. Memantine (Namenda). Clarithromycin (Biaxin).

Nystatin swish and swallow.

A characteristic sign of autoimmune disorders is: High fever. Weight loss with diarrhea. Periodic coughing. Periods of exacerbations and remissions.

Periods of exacerbations and remissions.

Insulin forces which of the following electrolytes out of the plasma and into the cells? Magnesium. Potassium. Calcium. Phosphorus.

Potassium

Which of the following client statements indicate a worsening of syndrome of inappropriate antidiuretic hormone (SIADH)? Severe thirst. Weight loss. Pulmonary congestion. Diluted urine.

Pulmonary congestion.

A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for Injury. To complete the nursing diagnosis statement for this client, which "related-to" phrase should the nurse add? Related to bone demineralization resulting in pathologic fractures. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces. Related to tetany secondary to a decreased serum calcium level. Related to exhaustion secondary to an accelerated metabolic rate.

Related to bone demineralization resulting in pathologic fractures.

Prior to a vanillylmandelic acid (VMA) test, the client is given instructions about food intake. Which of the following food items will be allowed before the test? (Select ALL that apply) Rice. Banana cake. Vanilla ice cream. Oatmeal. Chocolate chip cookies.

Rice Oatmeal

The nurse is aware that which of the following is the most appropriate nursing diagnosis for a client with Addison's disease? Excessive fluid volume. Risk for Hyperglycemia. Altered Urinary Elimination:Retention Risk for Infection.

Risk for Infection.

A diabetic client refuses his bedtime snack. This should alert the nurse to assess for: Elevated serum bicarbonate and a decreased blood pH. Signs of hypoglycemia earlier than expected. Symptoms of hyperglycemia during the peak time of NPH insulin. Sugar in the urine.

Signs of hypoglycemia earlier than expected.

A male client with primary diabetes insipidus is taking desmopressin (DDAVP). Which of the following observations by the nurse requires reporting to the physician? The client tells the nurse that he feels lighter. The client refused to perform range of motion exercises. The client's urine output has decreased. The client has gained 3 pounds over a period of 2 days.

The client has gained 3 pounds over a period of 2 days.

A client with an allergic disorder has an order for Sudafed. Which of these client conditions would be considered a contraindication for taking Sudafed? The client is hypertensive. The client is allergic to dust. The client is an elderly female. The client has rhinorrhea.

The client is hypertensive. Rationale: While sudafed is given to some clients with allergies, it should be used with caution in clients who are hypertensive because it can increase the blood pressure.

A client with hypothyroidism is taking Synthroid. Which of the following observations would alert the nurse to a possible side effect of the medication? The client is quietly watching TV in her room. The client is actively conversing with her nurse. The client tells the nurse that her heart is 'racing.' The client is complaining of feeling thirsty.

The client tells the nurse that her heart is 'racing.'

For a diabetic male client with a foot ulcer, the physician orders bed rest, a wet-to-dry dressing change every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used for this client? They contain exudate and provide a moist wound environment. They debride the wound and promote healing. They prevent the entrance of microorganisms and minimize wound discomfort. They protect the wound from mechanical trauma and promote healing.

They debride the wound and promote healing.

Early this morning, a female client had a subtotal thyroidectomy. During the evening rounds, the nurse assesses the client who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? Diabetic ketoacidosis. Hypoglycemia. Thyroid crisis. Tetany.

Thyroid crisis.

A client arrives at the clinic for a scheduled skin test to help in diagnosing his allergy. The nurse assisting the client calls the physician and expects that the skin test will be postponed primarily because the client: Had a full breakfast. Took Tylenol 2 tablets this morning. Took Benadryl for itching. Is anxious about needles.

Took Benadryl for itching.

The nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find: Weight gain in arms and legs. Hypotension. Truncal obesity. Thick, coarse skin.

Truncal obesity.

A client with an autoimmune disorder is admitted to the medical-surgical unit. She presents with weakness, fatigue, and painful joints. Further assessment reveals a "butterfly" rash on her face. When giving home-care instructions to this client, the nurse would include which of the following? (Select ALL that apply) Limit sun exposure to five hours per day Use a wide-brimmed hat when under the sun Avoid exposure to infection Take prescribed non-steroidal anti-inflammatory medications

Use a wide-brimmed hat when under the sun Avoid exposure to infection Take prescribed non-steroidal anti-inflammatory medications

When administering Lugol's solution, the nurse must instruct the client to take the medication: Using a straw. With an antibiotic. On a PRN-basis. Every-other-day.

Using a straw.

A client with AIDS comes into the clinic with a suspected case of candidiasis. Which of the signs and/or symptoms would the nurse observe in the client that would likely confirm a diagnosis of candidiasis? Non-pruritic rash on the arms. Red, swollen eyes. Greenish urine. White plaque on the tongue that may bleed.

White plaque on the tongue that may bleed.

A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma, the nurse expects to administer: mannitol (Osmitrol). phentolamine (Regitine). felodipine (Plendil). methyldopa (Aldomet).

phentolamine (Regitine).