MED SURG Ch. 57 NCLEX questions

Which assessment has the highest priority for the nurse to perform for a client with syndrome of inappropriate antidiuretic hormone (SIADH) receiving tolvaptan therapy for 24 hours? A. Evaluating serum sodium levels B. Evaluating serum potassium levels C. Examining the skin and sclera for jaundice D. Examining the IV site for indications of phlebitis

A

Which of the following are the priority precautions the nurse will teach the client who remains at continuing risk for adrenal hypofunction and is taking hormone replacement therapy to prevent harm related to the disorder? Select all that apply. A. "Avoid crowds and people who are ill." B. "Check your heart rate for irregular or skipped beats twice daily." C. "Do not choose low-sodium versions of prepared foods." D. "Get up slowly from sitting or lying positions." E. "Keep a source of glucose, such as candy, with you at all times." F. "Never skip your hormone replacement drugs."

A. "Avoid crowds and people who are ill." B. "Check your heart rate for irregular or skipped beats twice daily." C. "Do not choose low-sodium versions of prepared foods." D. "Get up slowly from sitting or lying positions." E. "Keep a source of glucose, such as candy, with you at all times." F. "Never skip your hormone replacement drugs."

A 30-year-old male client having an annual health physical reports that all of the following changes have developed during the past year. Which ones alert the nurse to possible pituitary hyperfunction? Select all that apply. A. 15-lb weight gain B. Decreased libido C. Four sinus infections D. Frequent constipation E. Increased foot callus formation F. Occasional dripping of clear fluid from both breasts G. Severely sprained ankle from a volleyball injury

A. 15-lb weight gain B. Decreased libido F. Occasional dripping of clear fluid from both breasts

Which electrolyte laboratory values indicate to the nurse monitoring a client with adrenal insufficiency undergoing IV therapy with hydrocortisone that the client is responding positively to this drug therapy? A. Serum sodium 147 mEq/L (mmol/L); serum potassium 7.1 mEq/L (mmol/L) B. Serum sodium 137 mEq/L (mmol/L); serum potassium 4.9 mEq/L (mmol/L) C. Serum sodium 127 mEq/L (mmol/L); serum potassium 2.8 mEq/L (mmol/L) D. Serum sodium 119 mEq/L (mmol/L); serum potassium 6.2 mEq/L (mmol/L)

B. Serum sodium 137 mEq/L (mmol/L); serum potassium 4.9 mEq/L (mmol/L)

Which precaution is most important for the nurse to teach a female client to prevent harm while undergoing drug therapy with estrogen and progesterone for hypopituitarism? A. "Use a barrier method of contraception to prevent an unplanned pregnancy." B. "Wear a hat with a brim and use sunscreen when outdoors." C. "Do not smoke or use nicotine in any form." D. "Avoid drinking caffeinated beverages."

C

Which urine characteristics indicate to the nurse that the client being managed for diabetes insipidus is responding appropriately to interventions? A. Urine output volume increased; urine specific gravity increased B. Urine output volume increased; urine specific gravity decreased C. Urine output volume decreased; urine specific gravity increased D. Urine output volume decreased; urine specific gravity decreased

C. Urine output volume decreased; urine specific gravity increased

A nurse caring for a client with Cushing syndrome who must remain on continued glucocorticoid therapy for another health problem will use which of the following actions to prevent harm? A. Urging the client to salt his or her food B. Testing voided urine for the present of glucose C. Using nonadhesive methods to secure an IV access D. Ensuring the prescribed glucocorticoid drug is given on an empty stomach

C. Using nonadhesive methods to secure an IV access

A client preparing for surgery to remove a cortisol-secreting tumor from the adrenal gland asks the nurse whether the physical changes from the excessive cortisol will go away as a result of the surgery so she can look like herself again. What is the nurse's best response? A. "The surgery is to remove the tumor, not reconstructive surgery." B. "You will notice a great difference in your appearance starting within a week after surgery." C. "All the changes will resolve but may take a year or longer to completely disappear." D. "The fatty changes and acne will resolve with time but the stretch marks only fade."

D