HTHSCI 3PA2A Tutorial Questions

A nurse is teaching the parents of a child newly diagnosed with diabetes to identify the signs and symptoms of hypoglycemia. Which response by the parents indicates the teaching has been effective? A. "Irritability, shakiness, hunger, headache, and dizziness are signs to look for." B. "Drowsiness, dry mouth, and increased urine output need to be reported." C. "Abdominal pain, nausea and vomiting, and constipation are the most common findings." D. "We will report immediately any signs of urinary frequency."

A. "Irritability, shakiness, hunger, headache, and dizziness are signs to look for."

Which of the following scenarios best describes a hallucination? A. A person feels insects crawling on their skin B. A person believes that the radio is sending them secret messages C. A person believes they have been elected prime minister and can levitate D. A person thinks they are being targeted by their neighbours to be assassinated

A. A person feels insects crawling on their skin

How does the polyol pathway contribute to the chronic complications of diabetes mellitus? A. It leads to intracellular accumulation of osmotically active sorbitol and fructose which damages cells of the eyes, nerves and RBCs B. It involves irreversible binding of glucose to proteins, lipids and nucleic acids which damages components of the microcirculation leading to retinopathy C. It promotes the synthesis of DAG which increases pro-inflammatory gene expression and endothelial ET-1 production resulting in blood flow abnormalities D. It promotes the O-linked glycosylation of proteins and transcription factors, resulting in altered gene expression contributing to insulin resistance

A. It leads to intracellular accumulation of osmotically active sorbitol and fructose which damages cells of the eyes, nerves and RBCs

Women who become pregnant for the first time at a later reproductive age (35 years of age or older) are at risk for what complications? Select all answers that apply. A. Preterm labour B. Multiple gestation C. Development of seizures D. Chromosomal abnormalities E. All of the above

A. Preterm labour B. Multiple gestation D. Chromosomal abnormalities

A nurse is assessing several postpartum clients. Which clients are at risk for developing post-partum hemorrhage? Select all that apply. A. Twin birth B. Over-distended bladder C. Hypertonic uterine dystocia D. Retained placental fragments E. Mild gestational hypertension

A. Twin birth B. Over-distended bladder D. Retained placental fragments

The client with diabetes mellitus is going home following angioplasty. The nurse observes that the client walks to the restroom barefoot, although slippers are in reach. The nurse determines that the client is at increased risk for: A. Injury related to potential for falls with walking barefoot B. Infection related to impaired tissue perfusion and walking barefoot C. Impaired cerebral perfusion related to potential for hypoglycemia D. Poor post-angioplasty care in the community

B. Infection related to impaired tissue perfusion and walking barefoot

Which of the following is a clinical manifestation of somatic neuropathy? A. Erectile dysfunction in males B. Loss of proprioception resulting in ataxia C. Urine retention and recurrent UTI's D. Dysfunctional sweating & thermoregulation

B. Loss of proprioception resulting in ataxia

The following week, MJ complains of severe headaches during her OB/GYN visit. She is now 30 weeks gestation. MJ's BP is 160/110 with proteinurea (2+ on dipstick). How would you classify MJ's condition? A. GHTN B. Preeclampsia C. Eclampsia D. HELLP syndrome

B. Preeclampsia

An intensive care nurse is assessing a patient with suspected sepsis. Which predisposing factors would you expect to be found in a patient with septic shock? A. A 45 year old with a history of renal insufficiency B. A 65 year old with a history of cancer who is recovering from an abdominal peritoneal resection C. A 27 year old with pyelonephritis responding to treatment with an antibiotic D. A 50 year old with community acquired tuberculosis

B. A 65 year old with a history of cancer who is recovering from an abdominal peritoneal resection

Which statement best describes schizophrenia? A. A disorder that results in a person having more than one personality B. A disorder that interferes with a person's ability to communicate with others and to think clearly C. A disorder that interferes with a person's ability to control his or her impulses D. A disorder that is triggered when a person experiences two or more traumatic events within a short period of time

B. A disorder that interferes with a person's ability to communicate with others and to think clearly

Which of the following statements is FALSE? A. HHNKS is mainly associated with T2DM B. Abdominal pain is a common feature of HHNKS C. Severe dehydration is common in HHNKS D. Despite total body potassium deficit, serum potassium is usually normal to elevated at presentation in HHNKS

B. Abdominal pain is a common feature of HHNKS

Which of the following is an indication of a complication of septic shock? A. Anaphylaxis B. Acute respiratory distress syndrome (ARDS) C. Chronic obstructive pulmonary disease (COPD) D. Mitral valve prolapse

B. Acute respiratory distress syndrome (ARDS)

Which statement supports role of dopamine in schizophrenia? A. Typical antipsychotic drugs are highly effective in treating both positive and negative symptoms B. Amphetamine and cocaine can induce symptoms of schizophrenia: e.g. delusions & hallucinations C. High doses of dopamine antagonists can induce Parkinson-like symptoms D. Most cannabis users do not develop schizophrenia

B. Amphetamine and cocaine can induce symptoms of schizophrenia: e.g. delusions & hallucinations

Which of the following hallucinations is most common? A. Visual B. Auditory C. Gustatory D. Tactile E. Olfactory

B. Auditory

A client with Type 1 diabetes mellitus requests a medication for headache soon after returning from an early morning x-ray procedure. The nurse observes the client is upset about the headache, angry at missing breakfast and has moist hands. What priority action should the nurse take at this time? A. Administer the headache medication and arrange for a breakfast tray B. Check the client's blood glucose level and be prepared to give 175 mL of juice immediately C. Acknowledge his dissatisfaction, offer to obtain a snack and give the headache medication D. Administer the headache medication and review the day's lab test results

B. Check the client's blood glucose level and be prepared to give 175 mL of juice immediately

Which of the following factors increase a client's risk for preeclampsia? A. Maternal age less than 40 years B. Excessive weight gain during pregnancy C. History of headaches and migraines D. Multiparity

B. Excessive weight gain during pregnancy

MJ is a 34 year old pregnant woman @ 29 weeks gestation. During her latest antenatal visit, her blood pressure was noted to be 150/90 mmHg (compared to 125/70 at 26 weeks ); with no proteinurea. MJ would be described as having which of the following? A. Pre-existing hypertension B. Gestational hypertension C. Severe gestational hypertension D. Pre-eclampsia E. Eclampsia

B. Gestational hypertension

A client with schizophrenia receiving antipsychotic drug therapy is moving her mouth, protruding her tongue, and grimacing as she watches television. The nurse determines that the client is experiencing? A. Pseudo-parkinsonism B. Tardive dyskinesia C. Hypertensive crisis D. Neuroleptic malignant syndrome

B. Tardive dyskinesia

Which of the following statements regarding mortality related to sepsis is CORRECT? A. Females are more likely to die from sepsis than males B. Those who are admitted to hospital with sepsis are more likely to die than those that acquire it during a visit C. The largest cohort of patients that experience mortality as a result of sepsis are <1 yrs of age D. The most common co-morbidities in sepsis patients includes diabetes and cancers

B. Those who are admitted to hospital with sepsis are more likely to die than those that acquire it during a visit ??

When treating a hypoglycemic episode, you should give: A. 4 teaspoons of sugar B. 175 ml of Diet Coca-Cola C. 6 jelly beans D. Half an apple

C. 6 jelly beans

A nurse in a maternity unit is reviewing the records of the clients on the unit. Which client would the nurse identify as being at greatest risk for developing disseminated intravascular coagulation? A. A primigravida with mild preeclampsia B. A primigravida who delivered a macrosomic infant 3 hours ago C. A gravida 2 who was recently diagnosed with dead fetus syndrome D. A gravida 4 who delivered 8 hours ago and has lost 400 mL of blood

C. A gravida 2 who was recently diagnosed with dead fetus syndrome

The pathogenesis of hyperglycemia in DKA includes all the following mechanisms EXCEPT? A. Increased glycogenolysis in the liver B. Increased serum glucagon C. Decreased lipolysis in adipose tissue D. Decreased glucose uptake in the muscles

C. Decreased lipolysis in adipose tissue

A 25 year old female client is brought to her doctor by her mother. Described as "odd" since she lost her job a year ago, the patient has complained of hearing voices and believes that her body is a receiving antenna for a foreign spy operation. Her mother notes she has been isolating herself in her room. She is alert, and oriented but suspicious and guarded on examination. Her affect is flat and her speech reveals loose associations. A complete medical workup is negative. Which of the following symptoms is considered a "negative symptom" of schizophrenia? A. Auditory hallucinations B. Delusions C. Flat affect D. Loose associations E. Paranoia

C. Flat affect

A pregnant client is making her first antepartum visit. She has a 2 year old son born at 40 weeks, a 5 year old daughter born at 38 weeks, and 7 year old twin daughters born at 35 weeks. She had a spontaneous abortion 3 years ago at 10 weeks. Using the GTPAL format, what does the nurse document about the client's obstetric history? A. G4 T3 P2 A1 L4 B. G5 T2 P2 A1 L4 C. G5 T2 P1 A1 L4 D. G4 T3 P1 A1 L4

C. G5 T2 P1 A1 L4

A client's insulin requirements may increase in all of the following EXCEPT: A. During puberty B. By stress or sickness C. In renal impairment D. With a high carbohydrate meal

C. In renal impairment

Which of the following is the most important goal of nursing care for a client who is in shock? A. Manage fluid overload B. Manage increased cardiac output C. Manage inadequate tissue perfusion D. Manage vasoconstriction of vascular beds

C. Manage inadequate tissue perfusion

What finding would explain the presence of positive symptoms in a patient experiencing psychosis? A. Decreased blood flow and glucose metabolism in the prefrontal cortex B. Increased ventricular volume and widening of sulci C. Excessive neuronal activity in the left globus pallidus D. Increased neuronal activity in the amygdala

D. Increased neuronal activity in the amygdala

Which of the following would be the most appropriate plan of action for a client with septic shock? A. Halt all interventions until the underlying infective agent has been identified and appropriate antibiotics administered B. Use aggressive immunomodulatory measures to reduce the systemic inflammatory response that is contributing to shock C. Provide early cardiovascular support with IV fluids and vasoactive agents to maintain CVP, MAP and ultimately tissue perfusion; administer broad spectrum antibiotics D. Intubate the patient to improve blood O2 saturation and provide packed red blood cells to increase blood O2 carrying capacity.

C. Provide early cardiovascular support with IV fluids and vasoactive agents to maintain CVP, MAP and ultimately tissue perfusion; administer broad spectrum antibiotics

The nurse is caring for a hospitalized patient who has been taking haloperidol (Haldol) for 3 days. To assess the patient for NMS (neuroleptic malignant syndrome), the nurse should assess the patient's: A. Blood pressure B. Serum sodium C. Temperature D. Weight

C. Temperature

Sepsis is the most common cause of DIC. All of the following statements concerning this life threatening complication are true EXCEPT: A. The rapidity of onset is determined by the intensity of the trigger and is related to the condition of the patient's liver, bone marrow and endothelium B. In the early phase, the patient may demonstrate manifestations of thrombosis and microemboli C. Though a coagulopathy is present, excessive blood loss rarely results in hemorrhagic shock D. The most critical intervention for DIC is the early identification and treatment of the underlying disorder

C. Though a coagulopathy is present, excessive blood loss rarely results in hemorrhagic shock

A client with schizophrenia is prescribed the neuroleptic drug clozapine (Clozaril). A nurse assesses the results of which laboratory study to monitor for adverse effects from this medication? A. Platelet count B. Blood glucose level C. White blood cell count D. Liver function studies

C. White blood cell count

What percentage of all people with diabetes have T2DM? A. Less than 10% B. 20 - 25% C. 40 - 50% D. 90 - 95%

D. 90 - 95%

A client with a long history of type 1 diabetes mellitus is being treated for bronchitis and sinusitis. The nurse observes deep, rapid, labored respirations, fruity odour on the client's clothes, and dry skin. Which action should the nurse take next? A. Assess breath sounds for additional signs of response to treatment of the infection B. Assess blood glucose level for signs of hypoglycemia C. Encourage the client to rest frequently and to drink 8 to 10 glasses of fluids daily D. Assess blood glucose level for hyperglycemia and check urine for ketones

D. Assess blood glucose level for hyperglycemia and check urine for ketones

Which of the following is the priority intervention for eclampsia? A. Induce labour with an oxytocic drug once seizures subside B. Administer labetalol IV to manage the hypertensive emergency C. Administer magnesium sulfate to relax the uterus D. Delivery of the fetus in a safe and timely manner

D. Delivery of the fetus in a safe and timely manner

A client experiencing delusions says to a nurse, "The federal guards were sent to kill me." The nurse's best response is: A. I don't believe this is true B. The guards are not out to kill you C. What makes you think the guards were sent to hurt you? D. I don't know anything about the guards. Do you feel afraid that people are trying to hurt you?

D. I don't know anything about the guards. Do you feel afraid that people are trying to hurt you?

Which of the following findings are consistent with a diagnosis of PCOS? Elevated levels of: A. Estrogen, insulin, and progesterone B. FSH, insulin, LH, and SHBG C. FSH, LH, SHBG, and testosterone D. Insulin, DHEA-S, testosterone, and estrogen E. FSH, progesterone, and SHBG

D. Insulin, DHEA-S, testosterone, and estrogen

Which of the following environmental factors cause schizophrenia? A. Substance use/abuse B. Lack of skills for coping with stress C. Bad parenting D. None of the above

D. None of the above

Which of the following theories is NOT associated with schizophrenia? A. Neurochemical hypotheses B. Neurobiological hypotheses C. Genetic hypotheses D. Psychosocial theories

D. Psychosocial theories

Which of the following is most likely to be observed in cases of HHNKS? A. Bicarbonate ion level ≤ 15 mmol/L B. Kussmaul-Kein respiration C. Arterial pH ≤ 7.3 D. Serum osmolality > 320 mmol/kg

D. Serum osmolality > 320 mmol/kg

A home nurse visits a pregnant client who has been diagnosed with mild preeclampsia. Which assessment finding indicates a worsening of the preeclampsia and the need to notify the physician? A. Urinary output has increased B. Dependent edema has resolved C. Blood pressure reading is at the prenatal baseline D. The client complains of a headache and blurred vision

D. The client complains of a headache and blurred vision