exam 4

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A nurse is reinforcing teaching for a client who has dysphagia related to a stroke. Which of the following instructions should the nurse provide?

Remain upright for 45 min following a meal

A nurse is reviewing data for a client who has DIC. Which of the following findings should the nurse expect?

excessive thrombosis and bleeding

A nurse is reviewing a client's med record. Which of the following lab tests should the nurse examine to determine risk factors for metabolic syndrome?

fasting glucose and triglycerides

A nurse is collecting data on a client who has hyperthyroidism. Which of the following manifestations should the nurse expect the client to report?

frequent mood changes

A nurse is collecting data from a female client who reports heavy menstrual periods. The client has a hemoglobin level of 8 g/dl. and hematocrit of 28%. Which of the following should the nurse expect?

pale mucous membranes

A nurse is assisting in planning care for a client who has advanced multiple myeloma. When planning care the nurse should recognize that the client is at risk for which of the following complications?

pathologic fracture

A nurse is reviewing the lab report of a client who has hypoparathyroidism. The nurse should expect which of the following values?

phosphate 5.7 mg/dl

A nurse is caring for a client who has dysphagia following a stroke. Which of the following is the priority action for the nurse to take when feeding the client?

place the client in the upright position

A nurse is collecting data from a client who has leukemia. WHich of the following findings has the highest priority?

platelet count 125000/mm3

A nurse is caring for a client who has Cushing's syndrome. Which of the following clinical manifestations should the nurse expect to observe? (SATA)

-buffalo hump -purple striations -moon face

A nurse is reinforcing teaching with a female client who has thrombocytopenia. Which of the following instructions should the nurse include? SATA

-lubricate lips with water-soluble ointment -brush teeth with a soft toothbrush -blow nose gently

A nurse is preparing to administer a client's daily dose of NPH insulin at 0730. The nurse should expect this type of insulin to peak within which of the following timeframes after administration?

4-14 hr

A nurse is reinforcing teaching with a client who has a new diagnosis of aplastic anemia. When discussing the pathology of this disease, which of the following instructions should the nurse include in the teaching?

Aplastic anemia results from decreased bone marrow production of RBCs

A nurse is assisting with the plan of care for a client who is 4 hr posop from a subtotal thyroidectomy. Which of the following implementations should the nurse recommend?

Check for bleeding on the dressing at the back of the neck

A nurse is assisting with the care of a client who has septic shock and is at risk for DIC. Which of the following nursing statements indicates an understanding of the condition?

DIC is caused by abnormal coagulation involving fibrinogen

A nurse is assisting with the care of a client who is 1 day postop following a thyroidectomy and reports severe muscle spasms of the lower extremities. Which of the following actions should the nurse take?

Determine the client's calcium level

A nurse is assisting with the plan of care for a client who had a subtotal thyroidectomy. In which of the following positions should the nurse plan to place the client?

Fowler's position

A nurse is reinforcing teaching for a client who has diabetes mellitus and has a prescription for insulin detemir injections once a day. Which of the following statements by the client indicates an understanding of the teaching?

I can inject my insulin detemir in the evening before bedtime

A nurse is reinforcing teaching with a client who has iron deficiency anemia and is to start taking ferrous sulfate twice a day. Which of the following statement by the client indicate an understanding of the teaching?

I will take the medication with OJ

A nurse is reinforcing teaching with a client who is scheduled for a blood test to measure her thyroid-stimulating hormone (TSH) level. Which of the following statements should the nurse give?

The test determines whether your thyroid gland is overactive, appropriately active or underactive

A nurse in the ED is assisting with the care of a client who is comatose. The provider suspects ketoacidosis. Which of the following findings should the nurse expect?

acetone odor to breath

A nurse is assisting with the plan of care for a client who has leukemia and whose platelet count is 50,000 mm3. Which of the following interventions should the nurse include in the plan of care?

administer a stool softner

A nurse is reinforcing teaching with a client who has type 1 DM about self-care during illness. Which of the following instructions should the nurse include in the teaching?

administer your usual daily dose of insulin

A nurse is caring for a client who is postoperative following a thyroidectomy. Which of the following is a priority for the nurse to monitor during the first 24 hr of care for this client?

airway patency

A nurse is reviewing a client's admission lab values. The client has thrombocytopenia with a platelet count of 34.000/mm3. Which of the following actions should the nurse take?

apply pressure 3-10 min following venipunctures

A nurse is assisting with the plan of care for a client who has hypothyroidism with myxedema. Which of the following interventions should the nurse include in the plan of care?

apply warm blankets

A nurse is planning a menu for a client who has folic acid deficiency anemia and is selecting food high in folic acid. Which of the following should the nurse include?

asparagus

A nurse is collecting data from a client who has anemia and a hemoglobin level of 7.2 g/dl. Which of the following findings should the nurse expect?

brittle fingernails

A nurse is reviewing lab findings for a client admitted with multiple myeloma. The nurse should expect to see an increase in which of the following laboratory tests?

calcium

A nurse is reinforcing discharge teaching about nutrition with a client who has a new diagnosis of diabetes mellitus. Which of the following statements should be included in the teaching?

carbs should comprise 45-65& of daily caloric intake

A nurse is caring for a client who has a hemoglobin of 10.8 g/dl and hematocrit of 30%. The nurse should expect the client is at risk for which of the following conditions?

cellular hypoxia

A nurse is collecting data from an older adult female client who has chronic hypothyroidism. WHich of the following findings should the nurse report to the provider immediately?

decreased level of consciousness

A nurse is monitoring a client who is receiving chemo and has a platelet count of 22,000 mm3. Which of the following findings should the nurse identify as the priority?

ecchymosis

A nurse is reinforcing teaching with a client who has a new prescription for epoetin alfa. The nurse should reinforce to the client to take which of the following dietary supplements with this medication?

iron

A nurse is collecting data from a client who has Cushing's syndrome. Which of the following findings should the nurse expect?

hyperpigmentation

A nurse is caring for a client who is postop and has a history of Addison's disease. For which of the following manifestations should the nurse monitor?

hypotension

A nurse is assisting with teaching a group of clients about monitoring for diabetic peripheral neuropathy. Which of the following client statements indicates understanding of the information?

i might lose awareness of when I'm stepping on a harmful object

A nurse is reviewing the lab report of a client who has hyperparathyroidism. The nurse should expect which of the following findings?

increased magnesium level

A nurse is preparing to administer insulin lispro to a client who has type 1 DM. Which of the following actions should the nurse plan to take?

inject lispro 15 min before a meal

A nurse is assisting with the plan of care for a client who has thrombocytopenia. Which of the following interventions should the nurse include in the plan of care?

monitor LOC q 4 hr

A nurse is reinforcing teaching with a client who has DM type 1 about sick day management. Which of the following is the priority action for the nurse to recommend to the client?

monitor blood glucose levels q 4 hrs

A nurse reviewing the lab of a client who had a total thyroidectomy discovers that his calcium level is 7mg/dl. Which of the following client findings should the nurse expect?

muscle tetany

A nurse is reinforcing teaching with a client who has thrombocytopenic disorder. Which of the following information should the nurse include?

notify the dentist of condition prior to invasive procedure

The nurse caring for the patient with SIADH (syndrome of inappropriate antidiuretic hormone). The nurse knows that a priority action is to

restrict fluids to 800 ml

A nurse is planning a diet for a client who has iron deficiency. To increase the client's iron intake, which of the following foods should the nurse provide in the client's diet?

roast beef

A nurse is caring for a client whose history reveals the clinical manifestations of pernicious anemia. The nurse should anticipate a prescription for which of the following diagnostic tests?

schilling test

A nurse is collecting data from a client who has diabetes insipidus. Which of the following findings should the nurse expect?

tachycardia

A nurse is caring for a client who is taking levothyroxine for hypothyroidism. Which of the following indicates the client's dose is too high?

tachypnea

A nurse is reviewing the med record of a client who has hyperthyroidism (graves disease). Which of the following serum lab findings should the nurse expect to be below expected reference range?

thyroid stimulating hormone (TSH)

A nurse is reinforcing teaching with a client who has DM about foot care. Which of the following instructions should the nurse include?

wear cotton socks


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