NU 238 M4 Prep U & Practice Quiz
A 31-year-old female has been recently diagnosed with type 2 diabetes mellitus, and is attending a diabetes education class. Which statement by the woman demonstrates an accurate understanding of her health problem?
- "I'm grieving the fact that I won't be able to get pregnant without causing permanent damage to my vision." - "I want to avoid going through the treatments for sight restoration that I would need if my diabetes causes damage to my vision." - "It's surprising that sugar in my blood can accumulate on the lens of my eye and cause a loss of sight." - "I'll have to control my blood sugars, my blood pressure, and my cholesterol in order to make sure I don't develop sight problems."
A 69-year-old client comes to the clinic for a routine checkup. Upon examination, the nurse practitioner informs the client that she has cataracts. The client then tells the nurse that she already knew that and her physician told her that she could use bifocals and that would take care of the problem. What would be the best response by the nurse practitioner?
- "Surgery is the only effective treatment for cataracts." - "The doctor was correct and you are doing everything you can to help with this condition." - "You are wrong and should not listen to your doctor." - "Strong bifocal lenses can often cure cataracts."
A client arrives in the clinic and informs the nurse that he is having pain in the left knee that has lasted for several weeks. The physician orders an x-ray of the left hip and knee. The client tells the nurse that the pain is in the knee, not the hip. What is the best response by the nurse?
- "The physician must have misunderstood what you were saying. We will change the order." - "The pain you are having is most likely caused by a disturbance in your nerve transmission." - "The pain you are having may be referred pain, which can cause the pain in the knee resulting from a hip problem." - "You only think that the pain is in the knee when it really is in your hip."
An adult has sought care for treatment of headaches that have been increasing in severity and frequency. Recently, the client was diagnosed with migraines. Which teaching points should the health care provider emphasize?
- "Your headaches are likely a result of a nerve disorder and, unfortunately, cannot be treated successfully." - "Weight loss and exercise are very important components of your treatment." - "It would be helpful for you to take control of your diet, sleep schedule, and stress levels." - "Stopping all of your current medications, even temporarily, should provide some relief."
Neurotransmitters like catecholamines (e.g., dopamine and epinephrine) have a reaction time of:
- 24-36 hours - Less than 10 minutes - Milliseconds - 4-7 days
While working at the triage desk in the local emergency department, which client is likely having a medical emergency and needs to be seen first?
- 45-year-old schoolteacher complaining of a red eye that is draining yellow secretions - 17-year-old high school student who has a red, itchy eye - 55-year-old truck driver complaining of sudden onset of ocular pain and blurred vision - Infant with red eyes who is irritable and refusing to eat
Which client will the nurse be assessing in relation to problems with thermoregulation?
- 68-year-old client with end-stage neurosyphilis. - 45-year-old client with a T8 fracture secondary to a diving accident. - 66-year-old client with damage to the hypothalamus secondary to a cerebral vascular accident. - 22-year-old client with damage to the cerebellum secondary to a motorcycle accident.
While lecturing about frostbite, the instructor asks the students, "Which substance prevents undue evaporation from the stratum corneum during the cold winter weather which then helps conserve body heat?" The most correct student answer is:
- A Langerhans cell, which produces antigen-presenting cells - An eccrine sweat gland - A nerve ending - Sebum, secreted by the sebaceous gland
A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to?
- A hypermetabolic state - A decrease in sympathetic nervous system activity - A decrease in the level of glucose - A decrease in oxygen consumption
A 25-year-old female client exhibits exophthalmos of both eyes. The health care provider recognizes this as a manifestation of:
- Acquired hypothyroidism - Graves disease - Hashimoto thyroiditis - Myxedema
More complex patterns of movements, such as throwing a ball or picking up a fork, are controlled by which portion of the frontal lobe?
- Primary motor cortex - Supplementary motor cortex - Reflexive circuitry - Premotor cortex
Nutrition students are studying the nervous system, which has a high rate of metabolism. What is its major fuel source?
- Protein - Glucose - Electrolytes - Ketones
Which resident of a long-term facility is exhibiting clinical manifestations of hypothyroidism?
- An 80-year-old woman who has uncharacteristically lost her appetite of late and often complains of feeling cold - A 90-year-old woman with a history of atrial fibrillation whose dysrhythmia has recently become more severe - An 88-year-old man with a history of Alzheimer disease who has become increasingly agitated and is wandering around the facility more frequently - A 91-year-old man with a chronic venous ulcer and a sacral ulcer who has developed sepsis
A nurse is teaching a client newly diagnosed with a seizure disorder. Which statement is most important for the nurse to provide regarding antiepileptic medications?
- Antiepileptic medications should never be discontinued abruptly. - Children can build up a tolerance to the medication quickly. - All antiepileptic medications should be taken with food. - Pregnant women should reduce the dose of medication or discontinue until after delivery.
Which components of the nervous system make up the central nervous system?
- Astrocytes and Schwann cells - Neurohormones and neurosecretory granules - Brain and spinal cord - Dendrites and axons
Which pain assessment tool is best to utilize when caring for children between ages 3 to 8 years?
- Behavioral distress scale - Numeric pain scale - FACES pain scale - Word graph scale
A client fell from a ladder and broke his ankle and is being seen in the emergency department for severe ankle pain with swelling and limited range of motion. What type of pain does the nurse recognize the client is experiencing?
- Chronic pain - Visceral pain - Acute pain - Subacute pain
Which disorder is a result of excess cortisol?
- Cushing syndrome - Turner syndrome - Hashimoto disease - Marfan syndrome
Select the most appropriate intervention for the nurse to teach a client diagnosed with distal symmetric neuropathy related to diabetes.
- Decrease daily walking activity - Inspect the feet for blisters daily - Rotate insulin injection sites once a week - Wear comfortable, open-toed shoes
A client has an increase in core body temperature. What assessment finding does the nurse expect?
- Decreased urination - Blue nail beds - Decreased skin temperature - Flushed skin
A sudden, traumatic, complete transection of the spinal cord results in what type of injury below the site?
- Deep visceral pain - 3+ tendon reflexes - Flaccid paralysis - Vasoconstriction
Peripheral neuropathy occurs most commonly with which disorder?
- Diabetes - AIDS - Cancer - Alcoholism
A client is experiencing pain, tingling, and numbness of the thumb and first, second, third, and half of the fourth digits of the hand. She states that she has pain in the wrist and hand, which worsens at night, and she has noticed that they have become clumsy. The nurse recognizes these manifestations as:
- Disuse syndrome - Lou Gehrig disease - Carpal tunnel syndrome - Muscular dystrophy
Which nursing intervention is the highest priority intervention for a nurse caring for a 26-year-old client diagnosed with benign paroxysmal positional vertigo?
- Fall precautions - Administer ordered antibiotic - Weber test - Skin assessment
Global or diffuse brain injury is manifested by changes in the level of consciousness.
- False - True
While assessing a client with suspected Menière disease, the nurse would expect which clinical manifestation?
- Fever - Diarrhea - Tachycardia - Vertigo
A nurse's hand-off reports states that the client has pyrexia. The nurse plans care for the client who has:
- Fever - Incontinence - Rash - Wound
A client affected by postural hypotension will likely display what symptoms?
- Flushing of skin with repositioning - Inability to sit upright due to muscle weakness - Sudden pain with movement to sitting position - Dizziness and pallor when moved to upright position
The nurse is discussing measures that a client may take to prevent barotrauma related to airplane travel. Which measure will the nurse recommend during changes in air pressure?
- Forcefully coughing - Mouth breathing - Cupping the ears with one's hands - Swallowing
Which parts of the brain make up the brain stem?
- Limbic and diencephalons - Pons and medulla oblongata - Cerebellum and reticular system - Circle of Willis and hypothalamus
An example of a single hormone that can exert effects in different tissues is erythropoietin. Erythropoietin is made in the kidney and stimulates the bone marrow to produce:
- Mast cells - Red blood cells - Natural killer cells - Platelets
Which type of receptor is mediated through vision in dim light?
- Mechanoreceptors - Photoreceptors - Chemoreceptors - Osmoreceptors
A diabetic client was visiting the endocrinologist for annual checkup. The client's blood work reveals an increased level of which lab result that reveals early signs of diabetic nephropathy?
- Oliguria - Hypokalemia - Microalbuminuria - Hyperlipidemia
Which intervention provides the most accurate information about core temperature?
- Oral temperature - Rectal temperature - Skin sensor - Axillary temperature
The nurse is providing client education to a client newly diagnosed with Parkinson disease. The nurse most accurately describes the disease progression as:
- Parkinson's has no known effective treatment. - Parkinson's disease, while chronic, will likely improve over time. - Parkinson's is a chronic condition and treatment aims to manage symptoms. - Parkinson's is an acute disorder that can be surgically corrected.
A client has been diagnosed with bacterial conjunctivitis. This type of infection is usually characterized by large amounts of what color drainage?
- Pink-red - Yellow-green - Blue-yellow - Serous
What are the hallmark signs of diabetes mellitus?
- Polyuria, polyphagia, and polycythemia - Polyuria, polydipsia, and pheochromocytoma - Polycythemia, polydipsia, and pheochromocytoma - Polyuria, polydipsia, and polyphagia
Which structures are protected by the vertebral column?
- Spinal cord, spinal nerves, and their supporting structures - Extensions of the grey matter that are for the "horns" - Intervertebral foramina near their level of origin - Neurons that send axons into nearby segments
A client arrives in the clinic and states to the nurse, "I am tired all the time and have gained weight. My hair is so dry it is breaking." The nurse assesses that the client's face is puffy with edematous eyelids and the outer third of the eyebrows are thinning. What lab test will the nurse prepare the client for that is characteristic of this disorder?
- T4 and TSH - Troponin and myoglobin levels - LDL and HDL levels - BUN and creatinine
After being thrown off the back of a bull, a bull rider can move his arms but has loss of motor function in the lumbar and sacral segments of the spinal cord. This is referred to as:
- Tetraplegia - Paraplegia - Anterior cord syndrome - Quadriplegia
Thyroid and steroid hormones, which exert their effect on target cells by way of nuclear receptors, have which of the following characteristics?
- The ability to cross the cell membrane of target cells - The ability to regulate surface receptor affinity - The selective use of a second messenger - Both lipid solubility and water solubility
The parents of which newborn require detailed information about keeping their baby appropriately warm?
- The child born 4 weeks prematurely -The child who is considered large for gestation age (LGA) - The child born at 39 weeks' gestation - The child with substantial stores of brown fat
The nurse is teaching a newly diagnosed client with diabetes about fingerstick blood glucose testing. When the client obtains a premeal fingerstick reading of 206 mg/dL (11.43 mmol/L), which teaching by the nurse is most appropriate?
- This is an elevated reading - let's talk about adherence to insulin and diet. - Blood glucose levels of 206 (11.4 mmol/L) are acceptable when you are ill. - This is a normal reading for after meals. - This reading is within normal range - continue your regimen.
The nurse explains to a client in labor who has demonstrated ineffective contractions impeding progression of labor that the health care provider has added oxytocin infusion to the orders. What does the nurse teach the client is the purpose of oxytocin?
- To contribute to maturation of fetal lungs - To stimulate contraction of the uterus - To reduce pain of uterine contractions - To protect the fetus from effects of forceful contractions
A client is unable to stick out his tongue as a result of injury to cranial nerve XII. The nurse recognizes that the client has sustained as damage to which nerve?
- Trigeminal - Hypoglossal - Gustatory - Vestibular
A client arrives in the clinic after having a tongue piercing performed and is unable to control the movement of the tongue. The nurse is aware that which nerve may have been damaged from the piercing?
- Vagus - Abducens - Hypoglossal - Trigeminal
The somatosensory system consists of three types of sensory neurons. The special somatic type of afferent sensory neurons has receptors that sense:
- Visceral fullness - Painful touch - Muscle position - Temperature
Bradykinesia occurring in Parkinson disease places the Parkinson's client most at risk for:
- Weight loss - Incontinence - Falls and injury - Emotional dysfunction
The most common cause of ischemic stroke is:
- cryptogenesis. - vasospasms. - arterial vasculitis. - thrombosis.
The nurse is caring for a client who is hearing impaired. The nurse understands that effective communication with the client includes:
- facing the client so that the client can visualize the lips. - performing hand gestures. - using exaggerated lip movements. - shouting in a loud voice.
A nurse caring for a client in myasthenic crisis identifies a priority concern as:
- monitoring for ptosis. - maintenance of airway and respiration. - monitoring for difficulty chewing. - ongoing physical therapy to maintain strength.
Which scenario would be an example of a child born with congenital insensitivity to pain? A child who:
- skinned knee from a bike accident but only told parents when it started burning. - fell off a skate board and fractured ankle but did not feel any pain, just noted swelling in foot. - develops pins-and-needles sensation after jumping out of a tree. - cries every time the wind blows because it hurts his face and ears.
As the nurse is performing a physical assessment of a client, the client begins to have seizure activity including loss of consciousness and limb jerking. The nurse's priority is to:
- stop the seizure. - protect the client from injury. - preserve brain functioning. - treat underlying disease.
The nurse understands that vestibular rehabilitation includes:
- stress reduction. - herbal remedies. - visual focusing techniques. - exercises in balance retraining.
The nurse is aware that some drugs may be prevented from entering the brain as a function of:
- the blood-brain barrier - rapid absorption in the gastric mucosa. - detoxification by the liver. - elimination by the kidneys.
PRACTICE QUIZ
PRACTICE QUIZ
PREP U
PREP U