NUR133 EXAM2 CARDIAC AND DIABETES - CP ch 25, 31, 51, 63, 64

Which of the following is the treatment of choice for acoustic neuromas? A. surgery B. radiation C. chemotherapy D. palliation

A

A nurse is teaching a client who has a new prescription for clopidogrel. Which of the following instructions should the nurse include in the teaching? (select all that apply) A. avoid the consuming of grapefruit while taking this medication B. monitor for the presence of black, tarry stools C. take this medication when you have pain D. schedule a weekly PT test E. limit food sources containing vitamin K while taking this medication

AB

Which surgical procedure involves flattening the anterior curvature of the cornea by removing a stromal lamella layer? A. photorefractive keratectomy (PRK) B. laser-assisted stromal in situ keratomileusis (LASIK) C. keratoconus D. keratoplasty

B

Which surgical procedure involves flattening the anterior curvature of the cornea by removing a stromal lamella? A. photorefractice keratectomy (PRK) B. laser-assisted in situ keratomileusis (LASIK) C. keratoconus D. keratoplasty

B

Which manifestation is most problematic for the client diagnosed with Ménière disease? A. Tinnitus B. Diaphoresis C. Vertigo D. Hearing loss

C

Which term refers to hypertension in which blood pressure that is controlled with therapy becomes uncontrolled (abnormally high) when the therapy is discontinued? A. essential B. primary C. rebound D. secondary

C

Which of the following are modifiable risk factors? A. age B. gender C. race D. genetics E. weight

E

Lantus insulin peaks in 8 hours. T or F?

F

Which insulin should never be mixed?

Lantus levemir

Which insulin was given if 8 hours after administration, the patient is hypoglycemic?

NPH

Levemir and Lantus are long acting insulins - T or F?

T

the ____________________ is how long the blood-glucose-lowering effect of the insulin injection will last

duration

The insulin that has no peak but has a duration of 24 hours _______________ (_______________) & _________________ (________________)

glargine Lantus detemir Levemir

What is the lethal complication associated with glucophage (metformin)?

lactic acidosis

Does glucophage (metformin) cause hypoglycemia?

no

Which term describes high blood pressure from an identified cause, such as renal disease? A. primary hypertension B. secondary hypertension C. rebound hypertension D. hypertensive emergency

B

A nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare with absorption at other sites? A. insulin is absorbed more slowly at abdominal injection sites than at other sites B. insulin is absorbed rapidly regardless of the injection site C. insulin is absorbed more rapidly at abdominal injection sites than at other sites D. insulin is absorbed unpredictably at all injection sites

C

A client is diagnosed with otitis externa. Which instruction is most appropriate for the nurse to give? A. keep the ear covered with a scarf B. avoid using cold water when shampooing hair C. avoid swimming for 7 to 10 days D. keep a dry cotton ball in the ear canal

C

A client with chronic open-angle glaucoma is now presenting with eye pain and intraocular pressure of 50 mm Hg. An immediate iridotomy is scheduled. Which of the following describes the desired effects of this procedure? A. reverse optic nerve damage B. restore vision C. improve outflow drainage D. to relieve pain

C

A client with high blood pressure is receiving an antihypertensive drug. The nurse knows that antihypertensive drugs commonly cause fatigue and dizziness, especially on rising. When developing a client teaching plan to minimize orthostatic hypotension, the nurse should include which instruction? A. "avoid drinking alcohol and straining at stool, and eat a low protein snack at night" B. "wear elastic stockings, change positions quickly, and hold onto a stationary object when rising" C. "flex your calf muscles, avoid alcohol, and change positions slowly" D. "rest between demanding activities, eat plenty of fruits and vegetables, and drink 6 to 8 cups of fluid daily"

C

A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse is most accurate in stating: A. "the test must be repeated following a 12 hour fast" B. "it looks like you aren't following the ordered diabetic diet" C. "it tells us about your sugar control for the last 3 months" D. "your insulin regimen must be altered significantly"

C

A client, newly admitted to the nursing unit, has a primary diagnosis of renal failure. When assessing the client, the nurse notes a blood pressure (BP) of 180/100. The nurse knows that this is what kind of hypertension? A. primary B. essential C. secondary D. malignant

C

A diabetic patient has a serum glucose level of 824 mg/dl (45.7 mmol/L) and is unresponsive. Following assessment of the patient, the nurse suspects diabetic ketoacidosis rather than hyperosmolar hyperglycemic syndrome based on the finding of A. polyuria B. severe dehydration C. rapid, deep respirations D. decreased serum potassium

C

A legally blind client is in pre-op area prior to an appendectomy. What steps does the nurse take to effectively communicate with this client? A. make direct eye contact with the client when communicating B. sit near the client to provide reassurance of the strange surroundings C. notify the client prior to touching the client D. inform the client that the nurse will be working nearby

C

The nurse observes a client during an exercise stress test (bicycle). Which finding indicates a positive test and the need for further diagnostic testing? A.Dizziness and leg cramping B. BP changes; 148/80 mm Hg to 166/90 mm Hg C. ST-segment changes on the ECG D. Heart rate changes; 78 bpm to 112 bpm

C

The nurse should monitor for which manifestation in a client who has had LASIK surgery? A. excessive tearing B. cataract formation C. halos and glare D. stye formation

C

The nurse should monitor for which manifestation in a client who has undergone LASIK? A. excessive tearing B. cataract formation C. halos and glare D. stye formation

C

The patient has a heart rate of 72 bpm with a regular rhythm. Where does the nurse determine the impulse arises from? A. The AV node B. The Purkinje fibers C. The sinoatrial node D. The ventricles

C

What does decreased pulse pressure reflect? A. tachycardia B. reduced distensibility of the arteries C. reduced stroke volume D. elevated stroke volume

C

What kind of otitis media is a pathogen-free fluid behind the tympanic membrane, resulting from irritation associated with respiratory allergies and enlarged adenoids? A. purulent otitis media B. infectious otitis media C. serous otitis media D. sterile otitis media

C

When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true? A. pressures must be equal in both arms B. pressures may vary 10 mm Hg or more between arms C. pressures should not differ more than 5 mm Hg between arms D. pressures may vary, with the higher pressure found in the left arm

C

When undergoing testing of visual acuity with a Snellen chart, the client can read the line labeled 20/50 but misses three letters on the line. The nurse documents this finding as which of the following? A. 20/20 +30 B. 20/20/50 C. 20/50 -3 D. 20/50

C

Which intervention is essential when performing dressing changes on a client with a diabetic foot ulcer? A. applying a heating pad B. deriding the wound three times per day C. using sterile technique during the dressing change D. cleaning the wound with a povidone-iodine solution

C

Which statement is true regarding gestational diabetes? A. it occurs in the majority of pregnancies B. onset usually occurs in the first trimester C. a glucose challenge test should be performed between 24 to 28 weeks D. there is a low risk for perinatal complications

C

Which term refers to swelling of the optic disc due to increased intracranial pressure? A. ptosis B. chemosis C. papilledema D. photophobia

C

Which test uses a tuning fork shifted between two positions to assess hearing? A. whisper B. watch tick C. rinne D. weber

C

You are admitting a 30 year old who has a hearing impairment. The client is accompanied by family members. What information would be important to ask the family members to help you care for you client? A. how the client lost their hearing B. what allergies the client has C. the client's preferred method of communication D. how much the client weighs

C

You are doing discharge teaching with a client after a stapedectomy. Why would it be important for you to advise the client to refrain from blowing the nose? A. it may cause sudden headaches B. it may cause vertigo C. it may dislodge the prosthesis D. it may cause excessive drainage

C

You are monitoring the results of laboratory tests performed on a client admitted to the cardiac ICU with a diagnosis of myocardial infarction. Which test would you expect to show elevated levels? A. RBC B. Platelets C. Enzymes D. WBC

C

A major role for nursing in the management of glaucoma is health education. Which of the following is the most important teaching point that the nurse should advise the patient of? A. keep all follow-up appointments B. keep a record of eye pressure measurements C. adhere to the medication regimen D. participate in the decision-making process

C

Which nursing suggestion would be most helpful to the client with recurrent otitis externa? A. use a cotton applicator to ensure that the ear canal is dry B. place ear plugs into the ears before swimming C. flush the ear with hydrogen peroxide D. avoid lying on the side of the affected ear

B

A client who is newly diagnosed with hypertension is going to be starting antihypertensive medicine. What is one of the main things the client and the client's spouse should watch for? A. dizziness B. persistent cough C. blurred vision D. tremor

A

A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication? A. bradycardia B. tremor C. cough D. constipation

A

The nurse is performing an assessment of a patient's ears. When looking at the tympanic membrane, the nurse observes a health membrane. What should the appearance be? A. pearly gray and translucent B. white and cloudy C. pink with white exudate D. dark yellow with cerumen

A

CS is an obese 54 year old Native American female with family history of HTN. She presents today with a BP of 152/80 for the third time in a row. Which stage of hypertension is she in? A. stage I B. stage II C. no stage, her BP is normal

B

A client comes to the emergency department, reporting that a bee has flown into his ear and is stuck. The client reports a significant amount of pain. Which of the following would be most appropriate to use to remove the bee? A. Mineral oil B. Irrigation C. Hair pin D. Tweezers

A

A client comes to the walk-in clinic complaining of a "bug in my ear." What action should be take when there is an insect in the ear? A. instillation of mineral oil B. instillation of carbide peroxide C. instillation of hot water D. use of a small forceps

A

A client comes to the walk-in clinic complaining of a "bug in my ear." What action should be taken when there is an insect in the ear? A. Instillation of mineral oil B. Instillation of carbamide peroxide C. Instillation of hot water D. Use of a small forceps

A

A client has a history of hearing loss and is returning for an annual hearing examination. During client education, the nurse explains that hearing involves which areas of the ear? A. all sections B. outer section C. middle section D. inner section

A

A client has developed diabetic retinopathy and is seeing the physician regularly to prevent further loss of sight. From where do the nerve cells of the retina extend? A. optic nerve B. oculomotor nerve C. trochlear nerve D. trigeminal nerve

A

A client has noticed recently having clearer vision at a distance than up close. What is the term used to describe this client's visual condition? A. hyperopia B. emmetropia C. myopia D. astigmatism

A

A client is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The client's blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV nitroprusside. Upon assessment, which finding requires immediate intervention by the nurse? A. numbness and weakness in left arm B. nausea and severe headache C. chest pain score of 3 (on a scale of 1 to 10) D. urine output of 40 mL over the past hour

A

A client is being evaluated after noticing a decline in hearing. The client's level of hearing loss will be determined by a hearing test administered by an audiologist. The description of hearing loss is based on the: A. intensity of the first heard sound B. location of the aural abnormality C. depth of tone used in testing D. physician's estimation

A

A client is brought to the emergency department with reports of a bad headache and an increase in blood pressure. The blood pressure reading obtained by the nurse is 260/180 mm Hg. What is the therapeutic goal for reduction of the mean blood pressure? A. reduce the blood pressure by 20% to 25% within the first hour of treatment B. reduce the blood pressure to about 140/80 mm Hg C. rapidly reduce the blood pressure so the client will not suffer a stroke D. reduce the blood pressure by 50% within the first hour of treatment

A

A client is newly diagnosed with otitis externa. Which information should the nurse teach the client before the client leaves the clinic? A. proper instillation of prescribed ear drops B. side effects of oral antibiotics C. cleaning ear canal with cotton-tipped applicator after showering D. strategies to cope with temporary sensorineural hearing loss

A

A client is taking 50 mg of oral spironolactone twice a day to assist with blood pressure control. While the nurse is performing the morning assessment, the client reports nausea, genera muscle cramps, and weakness. The ECG strip shows a peaked, narrow T-wave, which is a change. What electrolyte imbalance does the nurse suspect? A. hyperkalemia B. hypokalemia C. hypernatremia D. hyponatremia

A

A client newly diagnosed with otitis media reports that the pain and pressure in the ear has suddenly disappeared. What is the best action by the nurse? A. Assess the tympanic membrane. B. Educate the client on the therapeutic effects of medications. C. Document the effectiveness of medications. D. Irrigate the ear.

A

A client suffered trauma to the sclera and is being treated for a subsequent infection. During client education, the nurse indicates where the sclera is attached. Which structure would not be included? A. eyelids B. cornea C. iris D. pupil

A

A client who is blind is awaiting elective surgery. What should the nurse do to promote this client's control over their hospital environment? A. ask the client where to store his or her self-care items B. keep personal care items where the nurse knows their location C. arrange the meal tray in a way that is easiest for the nurse to assist the client D. open all containers without prompting to be helpful

A

A client who was recently diagnosed with prehypertension is to meet with a dietitian and return for a follow-up with the cardiologist in 6 months. What would this client's treatment likely include? A. non pharmacological interventions B. pharmacological interventions C. procedural interventions D. observation only

A

A client with a history of type 1 diabetes is demonstrating fast, deep, labored breathing and has fruity odored breath. What could be the cause of the client's current serious condition? A. ketoacidosis B. hyperosmolar hyperglycemic nonketotic syndrome C. hepatic disorder D. all options are correct

A

A client with diabetes mellitus has a blood glucose of 644 mg/dl. The nurse interprets that this client is most at risk of developing which type of acid base imbalance? A. metabolic acidosis B. metabolic alkalosis C. respiratory acidosis D. respiratory alkalosis

A

A client with multiple sclerosis is being seen by a neuroophthalmologist for a routine eye exam. The nurse explains to the client that during the examination, the client will be asked to maintain a fixed gaze on a stationary point while an object is moved from a point on the side, where it can't be seen, toward the center. The client will indicate when the object becomes visible. The nurse further explains that the test being performed is called a: A. perimetry test B. color vision test C. slit-lamp examination D. retinal angiography

A

A health care provider prescribes short-acting insulin for a patient, instructing the patient to take insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R taken at 6:30 AM will reach peak effectiveness by: A. 8:30 AM B. 10:30 AM C. 12:30 PM D. 2:30 PM

A

A health care provider prescribes short-acting insulin for a patient, instructing the patient to take the insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R taken at 0630 AM will reach peak effectiveness by: A. 0830 AM B. 1030 AM C. 1230 PM D. 0230 PM

A

A nurse in a clinic is caring for a client whose partner states the client woke up this morning, did not recognize him, and did not know where she was. The client reports chills and chest pain that is worse upon inspiration. Which of the following actions is the nursing priority? A. obtain baseline vital signs and oxygen saturation B. obtain a sputum culture C. obtain a complete history from the client D. provide a pneumococcal vaccine

A

A nurse is assessing a pediatric client in a public health clinic. The parent states that the client has been sneezing and rubbing the eyes. The nurse observes the client's eyes and documents objective symptoms of watery and red eyes. When reporting to the physician the assessment findings, which word is appropriate? A. signs and symptoms of conjunctivitis B. signs and symptoms of ptosis C. signs and symptoms of nystagmus D. signs and symptoms of proptosis

A

A nurse is caring for a client who has a new diagnosis of essential hypertension. The nurse should monitor the client for which of the following findings that is consistent with this diagnosis? A. vertigo B. uremia C. blurred vision D. dyspnea

A

A nurse is caring for a client who is to receive thrombolytic therapy. Which of the following factors should the nurse recognize as a contraindication to the therapy? A. hip arthroplasty 2 weeks ago B. elevated sedimentation rate C. incident of exercise-induced asthma 1 week ago D. elevated platelet count

A

A nurse is caring for a client who was recently admitted to the emergency department following a head-on motor vehicle crash. The client is unresponsive, has spontaneous respirations of 22/min, and has a laceration on his forehead that is bleeding. Which of the following is the priority nursing action at this time? A. keep neck stabilized B. insert nasogastric tube C. monitor pulse and blood pressure frequently D. establish IV access and start fluid replacement

A

A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis to indicate? A. albumin B. bacteria C. red blood cells D. white blood cells

A

A nurse is completing discharge teaching to a client following middle ear surgery. Which of the following statements by the client indicates understanding of the teaching? A. "I should restrict rapid movements and avoid bending from the waist for several weeks" B. "I should wait until the day after surgery to wash my hair" C. "I will remove the dressing behind my ear in 7 days" D. "my hearing should be back to normal right after my surgery"

A

A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed hypertension. While discussing dietary changes, which point would the nurse emphasize? A. it takes 2 to 3 months for the taste buds to adapt to decreased salt intake B. the taste buds never adapt to decreased salt intake C. there is usually no need to change alcohol consumption for clients with hypertension D. a person with hypertension should never consume alcohol

A

A nurse is performing an eye examination. Which question would not be included in the examination? A. "are you able to raise both eyebrows?" B. "have you experienced blurred, double, or distorted vision?" C. "do any family members have any eye conditions?" D. "what medications are you taking?"

A

A nurse is providing discharge teaching for a client who has a prescription for furosemide 40 mg PO daily. The nurse should instruct the client to take this medication at which of the following times of day? A. morning B. immediately after lunch C. immediately before dinner D. bedtime

A

A nurse is providing teaching for a client who has a new diagnosis of dry macular degeneration. Which of the following instructions should the nurse include in the teaching? A. increase intake of deep yellow and orange vegetables B. administer eye drops twice daily C. avoid bending at the waist D. wear an eye patch at night

A

A nurse is teaching a client who is taking metformin XR for type II diabetes mellitus. Which of the following instructions should the nurse include in the teaching? A. "take the medication with a meal" B. "you may crush or chew the medication" C. "this medication may cause an increase in perspiration" D. "this medication may turn your urine orange"

A

A nurse is teaching a client with severe hypertension about the damage this condition can cause to the body. What system/organs will the nurse note are particularly targeted for damage due to severe hypertension? A. sensory B. musculoskeletal C. gastrointestinal D. integumentary

A

A nurse is teaching a diabetic support group about the causes of type 1 diabetes. The teaching is determined to be effective when the group is able to attribute which factor as a cause of type 1 diabetes? A. presence of autoantibodies against islet cells B. obesity C. rare ketosis D. altered glucose metabolism

A

A nurse is teaching a group of clients about influenza. Which of the following client statements indicates an understanding of the teaching? A. "I should wash my hands after blowing my nose to prevent spreading the virus" B. "I need to avoid drinking fluids if I develop symptoms" C. "I need a flu shot every 2 years because of the different flu strains" D. "I should cover my mouth with my hand when I sneeze"

A

A patient has been diagnosed with hyphema. Which of the following medication classifications stabilizes clot formation at the side of hemorrhage? A. antifibrinolytics B. corticosteroids C. antiplatelets D. diuretics

A

A patient has been diagnosed with hyphema. Which of the following medication classifications stabilizes clot formation at the site of hemorrhage? A. antifibrinolytics B. corticosteroids C. antiplatelets D. diuretics

A

A patient is being treated for hypertensive emergency. When treating this patient, the priority goal is to lower the mean blood pressure (BP) by which percentage in the first hour? A. up to 25% B. 35% C. 40% D. 45%

A

A patient is participating in aural rehabilitation. The nurse understands that this type of training emphasizes which of the following? A. listening skills B. social skills C. occupational skills D. functional skills

A

A patient is scheduled to take 10 units of Humulin N at 1100. When is the patient most susceptible for hypoglycemia? A. 1900 B. 1300 C. 1130 D. 1500

A

A patient is to have an angiography done using fluorescein as a contrast agent to determine if the patient has macular edema. What laboratory work should the nurse monitor prior to the angiography? A. BUN and creatinine B. AST and ALT C. hemoglobin and hematocrit D. platelet count

A

A recommended follow-up for a person initially diagnosed with prehypertension is for a blood pressure (BP) recheck within which timeframe? A. 1 year B. 2 years C. confirm within 2 months D. evaluate within 1 month

A

A young client is being seen by a pediatric ophthalmologist due to a recent skateboarding accident that resulted in trauma to the right cornea, and is now at risk for developing an infection. Which nursing intervention would be contraindicated for a client at risk for infection? A. to ensure correct application of antibiotic ointment, gently drag tip of tube along lower lid while squeezing ointment on to lid B. avoid using a container of ophthalmic medication for anyone other than the client C. change gauze eye bandages using aseptic technique D. wash hands before examining the eyes or performing any procedure about the face

A

After a fall at home, a client hits their head on the corner of the table. Shortly after the accident, the client arrives at the ED, unable to see out of their left eye. The client tells the nurse that symptoms began with seeing spots or moving particles in the field of vision but that there was no pain in the eye. The client is very upset that the vision will not return. What is the most likely cause of this client's symptoms? A. retinal detachment B. angle-closure glaucoma C. eye trauma D. chalazion

A

After being sick for 3 days, a client with a history of diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should evaluate which diagnostic test results to prevent dysrhythmias? A. serum potassium level B. serum calcium level C. serum sodium level D. serum chloride level

A

An initial, convenient assessment of an older adult client's complaint of hearing loss would be inspection, using an otoscope, for the presence of impacted cerumen. Which of the following is a primary cause of an external ear disorder in the elderly? A. conduction problem B. sensorineural loss C. mixed cause D. psychogenic issue

A

Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difficulty seeing near objects. The nurse documents this as which of the following? A. myopia B. astigmatism C. hyperopia D. emmetropia

A

Changes in pressure at high altitude can cause discomfort in the ears. Which structure within the middle ear is instrumental in equalizing pressure? A. eustachian tubes B. fallopian tubes C. semicircular canals D. incus tubes

A

During an initial assessment, the nurse measures the client's apical pulse and compares it to the peripheral pulse. The difference between the two is known as pulse: A. deficit. B. rhythm. C. volume. D. quality.

A

Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for receiving oxygenated blood from the lungs? A. left atrium B. left ventricle C. right atrium D. right ventricle

A

Hearing aids help with which of the following problems? A. makes sounds louder B. improves discrimination of words C. improves understanding of speech D. improves communication skills

A

If untreated, squamous cell carcinoma of the external ear can spread through the temporal bone causing which of the following? A. facial nerve paralysis B. Nystagmus C. Motor impairment D. Diplopia

A

If untreated, squamous cell carcinoma of the external ear can spread through the temporal bone, causing A. facial nerve paralysis B. nystagmus C. motor impairment D. diplopia

A

Insulin is secreted by which of the following types of cells? A. beta cells B. melanocytes C. neural cells D. basal cells

A

It is appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine A. increases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood B. decreases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood C. increases the heart rate, constricts arterioles, and increases the heart's ability to eject blood D. decreases circulating blood volume

A

Loud, persistent noise has been found to cause which symptoms? A. constriction of peripheral blood vessels. B. increased blood pressure. C. increased heart rate. D. decreased gastrointestinal activity.

A

Officially, hypertension is diagnosed when the client demonstrates a systolic blood pressure greater than ____________ mm Hg and a diastolic blood pressure greater than ________mm Hg over a sustained period A. 140, 90 B. 130, 80 C. 110, 60 D. 120, 70

A

Primary or essential hypertension accounts for about 95% of all hypertension diagnoses with an unknown etiology. Secondary hypertension accompanies specific conditions that create hypertension as a result of tissue damage. Which condition contributes to secondary hypertension? A. arterial vasoconstriction B. hepatic function C. calcium deficit D. acid-base imbalance

A

TJ was given insulin at 0730 AM. At 1130 AM, TJ became tired, lightheaded, cold, and clammy. What insulin did TJ most likely receive that would explain his symptoms? A. regular insulin B. NPH insulin C. lispro D. Lantus insulin

A

The client is admitted for a scheduled cardiac catheterization. On the morning of the procedure, while assessing the client's morning laboratory values, the nurse notes a blood urea nitrogen (BUN) of 34 mg/dL and a creatinine of 4.2 mg/dL. What priority reason will the nurse notify the healthcare provider? A. The client is at risk for renal failure due to the contrast agent that will be given during the procedure. B. These values show a risk for dysrhythmias. C.The client is over-hydrated, which puts him at risk for heart failure during the procedure. D. The client is at risk for bleeding.

A

The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine? A. increases ability for glucose to get into the cell and lowers blood sugar B. creates an overall feeling of well-being and lowers risk of depression C. decreases need for pancreas to produce more cells D. decreases risk of developing insulin resistance and hyperglycemia

A

The client with a diagnosis of heart failure reports frequently awakening during the night with the need to urinate. What explanation will the nurse offer to explain the urination? A. Edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys. B. When the client is in the recumbent position, more pressure is put on the bladder with the result of increased need to urinate. C. The blood pressure is lower when the client is recumbent and this causes the kidneys to work harder; therefore, more urine is produced. D. Fluid that is held in the lungs during the day becomes part of the circulation at night and the kidneys produce an increased amount of urine.

A

The nurse cares for a client prescribed warfarin orally. The nurse reviews the client's prothrombin time (PT) level to evaluate the effectiveness of the medication. Which laboratory values should the nurse also evaluate? A. international normalized ratio (INR) B. partial thromboplastic time (PTT) C. complete blood count (CBC) D. Sodium

A

The nurse is administering lispro insulin. Based on the onset of action, how long before breakfast should the nurse administer the injection? A. 10 to 15 minutes B. 30 to 40 minutes C. 1 to 2 hours D. 3 hours

A

The nurse is administering medications on a medical-surgical unit. A client is ordered to receive 40 mg oral nadolol for the treatment of hypertension. Before administering the medication, the nurse should A. check the client's heart rate B. check the client's serum K+ level C. check the client's urine output D. weigh the client

A

The nurse is assessing a patient's blood pressure. What does the nurse document as the difference between the systolic and the diastolic pressure? A. Pulse pressure B. Auscultatory gap C. Pulse deficit D. Korotkoff sound

A

The nurse is assessing an older client's vision. The nurse integrates knowledge of which of the following during the assessment? A. the power of the lens to accommodate will be decreased B. increased fat will be around the orbit C. the skin around the eyes will be more elastic D. the depth of the eyeball will be increased, leading to myopia

A

The nurse is caring for a client experiencing hearing loss. The nurse uses the otoscope to assess the ear canal and tympanic membrane and notes a significant accumulation of cerumen. Which documentation of hearing loss type would be most accurate? A. conductive B. mixed C. central D. sensorineural

A

The nurse is caring for a client with a damaged tricuspid valve. The nurse knows that the tricuspid valve is held in place by which of the following? A. Chordae tendineae B. Atrioventricular tendons C. Semilunar tendineae D. Papillary tendons

A

The nurse is caring for a patient with Ménière's disease who is hospitalized with severe vertigo. What medication does the nurse anticipate administering to shorten the attack? A. Meclizine (Antivert) B. Furosemide (Lasix) C. Cortisporin otic solution D. Gentamicin (Garamycin) intravenously

A

The nurse is caring for an older adult client who has come to the clinic for a yearly physical. When assessing the client, the nurse notes the blood pressure (BP) is 140/93. The nurse knows that in older clients what happens that may elevate the systolic BP? A. loss of arterial elasticity B. decrease in blood volume C. increase in calcium intake D. decrease in cardiac output

A

The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action? A. it carries glucose into body cells B. it aids in the process of gluconeogenesis C. it stimulates the pancreatic beta cells D. it decreases the intestinal absorption of glucose

A

The nurse is developing a plan of care for a client with Meniere's disease and identifies a nursing diagnosis of excess fluid volume related to fluid retention in the inner ear. Which intervention would be most appropriate to include in the plan of care? A. limit foods that are high in sodium B. encourage intake of caffeinated fluids C. administer prescribed antihistamine D. restrict high-potassium foods

A

The nurse is developing a plan of care for a patient with severe vertigo. What expected outcome statement would be a priority for this patient? A. patient will experience no falls due to balance disorder B. patient will take medications as prescribed C. patient will perform exercises as prescribed D. patient will have decreased fear and anxiety

A

The nurse is instructing a client's family members on the most incapacitating symptom of Meniere's disease. Which nursing instruction associated with the symptom is most helpful? A. assist the client when ambulating B. keep a bucket beside the bed C. ensure low lighting in the room D. sit in front of the client when speaking

A

The nurse is instructing a client's family members on the most incapacitating symptom of Ménière's disease. Which nursing instruction associated with the symptom is most helpful? A. Assist the client when ambulating. B. Keep a bucket beside the bed. C. Ensure low lighting in the room. D. Sit in front of the client when speaking.

A

The nurse is obtaining a visual history from a client who has noted an increase in glare and changes in color perception. Which assessment would the nurse anticipate to confirm a definitive diagnosis? A. identification of opacities on the lens B. identification of white circle around the cornea C. identification of yellowish aging spot on the retina D. identification of redness of the sclera

A

The nurse is preparing an education plan for a patient newly diagnosed with hypertension. What should be included in the education plan? A. engage in regular aerobic physical activity such as brisk walking (at least 30 min/day most days of the week) B. eliminate alcoholic beverages from the diet C. reduce sodium intake to no more than 5 grams/day D. maintain a normal body weight with BMI between 18 and 25 kg/m^2

A

The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer? A. NPH B. iletin II C. lispro (Humalog) D. glargine (Lantus)

A

The nurse is teaching a client about the functionality of heart muscle. What factor may decrease a client's myocardial contractility? A. Acidosis B. Alkalosis C. Sympathetic activity D. Administration of digoxin

A

The nurse prepares to auscultate heart sounds. What nursing intervention will be most effective to assist with this procedure? A. Explain to the client that the nurse will be listening to different areas of the chest and may listen for a long time, but that does not mean that anything abnormal is heard. B. Ask the client to sit on the edge of the bed and hold breath while the nurse listens. C. Insist that the family members leave the room if they must speak to each other while the nurse is auscultating heart sounds. D. Ask the client to take deep breaths through the mouth while the nurse auscultates heart sounds.

A

What is the term for the ability of the cardiac muscle to shorten in response to an electrical impulse? A. contractility B. depolarization C. repolarization D. diastole

A

When obtaining the health history from a client with retinal detachment, a nurse expects the client to report: A. light flashes and floaters in front of the eye B. a recent driving accident while changing lanes C. headaches, nausea, and redness of the eyes D. frequent episodes of double vision

A

When treating hypertensive emergencies, the nurse identifies the most appropriate route of administration for antihypertensive agents as being which of the following? A. continuous IV infusion B. sublingual C. intramuscular D. oral

A

Which clinical characteristic is associated with type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus)? A. blood glucose can be controlled through diet and exercise B. client is usually thin at diagnosis C. client is prone to ketosis D. clients demonstrate islet cell antibodies

A

Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis? A. hypokalemia and hypoglycemia B. hypocalcemia and hyperkalemia C. hyperkalemia and hyperglycemia D. hypernatreia and hypercalcemia

A

Which condition is characterized by the formation of abnormal spongy bone around the stapes? A. Otosclerosis B. Middle ear effusion C. Chronic otitis media D. Otitis externa

A

Which condition is characterized by the formation of abnormal spongy bone around the stapes? A. otosclerosis B. middle ear effusion C. chronic otitis media D. otitis externa

A

Which instructions regarding swimming should the nurse give to a client who is recovering from otitis external? select all that apply A. wear soft plastic earplugs B. wear a scarf C. avoid cold water D. insert a loose cotton earplug in the external ear

A

Which is a by-product of fat breakdown in the absence of insulin and accumulates in the blood and urine? A. ketones B. creatinine C. hemoglobin D. cholesterol

A

Which of the following best defines stroke volume? A. the amount of blood ejected with each heartbeat B. amount of blood pumped by the ventricle in liters per minute C. degree of stretch of the cardiac muscle fibers at the end of diastole D. ability of the cardiac muscle to shorten in response to an electrical impulse

A

Which of the following is an involuntary rhythmic movement of the eyes that is also associated with vestibular dysfunction? A. Nystagmus B. Vertigo C. Tinnitus D. Presbycusis

A

Which of the following is the role of the nurse toward a patient who is to undergo eye examinations and tests? A. ensuring that the patient receives eye care to preserve his or her eye function and prevent further visual loss B. conducting various tests to determine the function and the structure of the eyes C. determining if further action is warranted D. advising the patient on the diet and exercise regimen to be followed

A

Which of the following medications needs to be withheld for 5 to 7 days prior to cataract surgery? A. coumadin B. prednisone C. lasix D. glucophage

A

Which of the following surgical procedures involves taking a piece of silicone plastic or sponge and sewing it into the sclera at the site of a retinal tear? A. scleral buckle B. pars plana vitrectomy C. pneumatic retinopexy D. phacoemulsification

A

Which of the following types of conjunctivitis is preceded by symptoms of an upper respiratory infection? A. viral B. allergic C. toxic D. vernal

A

Which of the following would be inconsistent as a component of metabolic syndrome? A. hypotension B. hypertension C. elevated triglyceride levels D. abdominal obesity

A

Which portion of the middle ear equalizes pressure? A. Eustachian tube B. Ossicles C. Auricle D. Cochlea

A

Which statement about fluid replacement is accurate for a client with hyperosmolar hyperglycemic nonketotic syndrome? A. administer 2 to 3 L of IV fluid rapidly B. administer 10 L of IV fluid over the first 24 hours C. administer a dextrose solution containing normal saline solution D. administer IV fluid slowly to prevent circulatory overload and collapse

A

Which statement describes benign paroxysmal positional vertigo (BPPV)? A. The vertigo is usually accompanied by nausea and vomiting; generally, however, hearing is not impaired. B. The onset of BPPV is gradual. C. BPPV is caused by tympanic membrane infection. D. BPPV is stimulated by the use of certain medications, such as acetaminophen.

A

Which term refers to the absence of the natural lens? A. aphakia B. scotoma C. keratoconus D. hyphema

A

Which terms refers to the progressive hearing loss associated with aging? A. prebycusis B. exostoses C. otalgia D. sensorineural hearing loss

A

Which type of glaucoma presents an ocular emergency? A. acute angle-closure glaucoma B. normal tension glaucoma C. ocular hypertension D. chronic open-angle glaucoma

A

Within the heart, several structures and several layers all play a part in protecting the heart muscle and maintaining cardiac function. The inner layer of the heart is composed of a thin, smooth layer of cells, the folds of which form heart valves. What is the name of this layer of cardiac tissue? A. endocardium B. myocardium C. pericardium D. epicardium

A

You administered 5 units of Humalog at 0800. What is the ONSET and DURATION of this medication? A. onset: 15 minutes, duration: 3 hours B. onset: 2 hours, duration: 16 hours C. onset: 30 minutes, duration: 1 hour D. onset: 2 hours, duration: 24 hours

A

You are doing an admission assessment on a client who is having outpatient testing done for cardiac problems. What should you ask this client during your assessment? A. "Have you had any episodes of dizziness or fainting?" B. "Have you had any episodes when you are to nauseous?" C. "Have you had any episodes of mottling in your hands?" D. "Have you had any episodes of pain radiating into your lower extremities?"

A

You are the clinic nurse doing assessments on your clients before they have outpatient diagnostic testing done. What would you document when assessing the client's pulse? A. Rate, quality, and rhythm B. Pressure, rate, and rhythm C. Rate, rhythm, and volume D. Quality, volume, and rate

A

The nurse is instructing a patient with Meniere's disease on dietary management to include as an adjunct to other more traditional therapies. The nurse would include which of the following? select all that apply A. limit foods high in salt and sugar B. avoid aspirin and aspirin products C. avoid coffee, tea, and soft drinks D. avoid high-fiber foods

ABC

The nursing instructor is teaching nursing students about myocardial contractility and ejection fractions. What diagnostic tests can determine client ejection fractions? Select all that apply. A. Echocardiogram B. Cardiac catheterization C. Magnetic resonance imaging D. Positron emission tomography scan E. troponin levels

ABC

A nurse is reviewing the health record of a client who has hyperglycemic-hyperosmolar state (HHS). The nurse should identify that which of the following data confirm this diagnosis? (select all that apply) A. evidence of recent myocardial infarction B. BUN 35 mg/dL C. takes a calcium channel blocker D. age 77 years E. no insulin production

ABCD

A nurse is providing discharge teaching to a client who has experienced diabetic ketoacidosis. Which of the following information should the nurse include in the teaching? (select all that apply) A. drink 2 L fluids daily B. monitor blood glucose every 4 hr when ill C. administer insulin as prescribed when ill D. notify the provider when blood glucose is 200 mg/dL E. report ketones in the urine after 24 hr of illness

ABCE

A nurse in the critical care unit is completing an admission assessment of a client who has a gunshot wound to the head. Which of the following assessment findings are indicative of increased ICP? (select all that apply) A. headache B. dilated pupils C. tachycardia D. decorticate posturing E. hypotension

ABD

A nurse in a clinic is caring for a client who has been experiencing mild to moderate vertigo due to benign paroxysmal vertigo for several weeks. Which of the following actions should the nurse recommend to help control the vertigo? (select all that apply) A. reduce exposure to bright lighting B. move head slowly when changing positions C. do not eat fruit high in potassium D. plan evenly spaced daily fluid intake E. avoid fluids containing caffeine

ABDE

A nurse is assessing a client following a gunshot wound to the chest. For which of the following findings should the nurse monitor to detect a pneumothorax? (select all that apply) A. tachypnea B. deviation of the trachea C. bradycardia D. decreased use of accessory muscles E. pleuritic pain

ABE

A nurse is caring for a client who has hypertension and develops epistaxis. Which of the following actions should the nurse take? (select all that apply) A. apply pressure to the nares B. place ice to the bridge of the client's nose C. instruct the client to blow his nose D. tilt the client's head backward E. move the client into high-fowler's position

ABE

A nurse is reviewing the health record of a client who has severe otitis media. Which of the following are expected findings? (select all that apply) A. enlarged adenoids B. report of recent colds C. client prescription of daily furosemide D. light reflex visible on otoscopic exam in the affected ear E. ear pain relieved by meclizine

ABE

Which statements are true when the nurse is measuring blood pressure? select all that apply A. using a BP cuff that is too small will give a higher BP measurement B. the client's arm should be positioned at the level of the heart C. using a BP cuff that is too large will give a higher BP measurement D. the client's BP should be measured 1 hour before consuming alcohol E. the client should sit quietly while BP is being measured

ABE

A nurse is monitoring a group of clients for increased risk for developing pneumonia. Which of the following clients should the nurse expect to be at risk? (select all that apply) A. client who has dysphagia B. client who has AIDS C. client who was vaccinated for pneumococcus and influenza 6 months ago D. client who is postoperative and has received local anesthesia E. client who has a closed head injury and is receiving ventilation F. client who has myasthenia graves

ABEF

The nurse is performing an assessment on a patient to determine the effects of hypertension on the heart and blood vessels. What specific assessment data will assist in determining this complication? (select all that apply) A. heart rate B. respiratory rate C. heart rhythm D. character of apical and peripheral pulses E. lung sounds

ACD

A nurse is caring for a group of clients. Which of the following clients are at risk for a pulmonary embolism? (select all that apply) A. a client who has a BMI of 30 B. a female client who is postmenopausal C. a client who has a fractured femur D. a client who is a marathon runner E. a client who has chronic atrial fibrillation

ACE

A 60-year-old client comes to the ED reporting weakness, vision problems, increased thirst, increased urination, and frequent infections that do not seem to heal easily. The physician suspects that the client has diabetes. Which classic symptom should the nurse watch for to confirm the diagnosis of diabetes? A. numbness B. increased hunger C. fatigue D. dizziness

B

A client comes to the clinic for an ophthalmologic screening, which will include measurement of intraocular pressure (IOP) with a tonometer. Which statement about this procedure is true? A. the client will direct the gaze forward while the physician rests the tonometer on the scleral surface B. the tonometer will register the force required to indent or flatten the corneal apex C. a topical anesthetic will be administered after the examination D. the client should wear dark glasses for several hours after the procedure

B

A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously? A. glargine B. regular C. NPH D. lente

B

A client is color blind. The nurse understands that this client has a problem with: A. rods B. cones C. lens D. aqueous humor

B

A client is receiving long-term intravenous therapy with gentamicin for a chronic wound infection. Which of the following would be most important for the nurse to ensure? A. obtain specimens for wound cultures daily B. arrange for audiograms twice a week C. monitor complete blood counts every other day D. assess intravenous access site daily

B

A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together? A. magnesium level B. potassium level C. calcium level D. sodium level

B

A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isoprene insulin suspension (NPH) to be taken before breakfast. At about 4:30 pm, the client experiences headache, sweating, tremor, pallor and nervousness. What is the most probable cause of these signs and symptoms? A. serum glucose level of 450 mg/dl B. serum glucose level of 52 mg/dl C. serum calcium level of 8.9 mg/dl D. serum calcium level of 10.2 mg/dl

B

A client with diabetes mellitus is receiving an oral anti diabetic agent. The nurse observes for which symptom when caring for this client? A. polyuria B. hypoglycemia C. blurred vision D. polydipsia

B

A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are effective only if the client: A. prefers to take insulin orally B. has type 2 diabetes C. has type 1 diabetes D. is pregnant and has type 2 diabetes

B

A client with type 1 diabetes reports waking up in the middle of the night feeling nervous and confused, with tremors, sweating, and a feeling of hunger. Morning fasting blood glucose readings have been 110 to 140 mg/dl. The client admits to exercising excessively and skipping meals over the past several weeks. Based on these symptoms, the nurse plans to instruct the client to A. administer an increased dose of neutral protamine Hagedorn in the evening B. check blood glucose at 3:00 am C. eat a complex carbohydrate snack in the evening before bed D. skip the evening neutral protamine Hagedorn insulin dose on days when exercising and skipping meals

B

A client you are caring for has a hearing loss. The client tells you he is self-conscious about his hearing loss. What advice should the nurse give a self-conscious client with hearing loss to protect his self-esteem? A. pretend to follow conversations by nodding the head B. be forthright and inform others about the hearing deficit C. follow lip movements closely D. avoid excess socializing

B

A nures is performing an otoscopic examination on a client. Which finding would the nurse document as abnormal? A. Umbo in the center of the tympanic membrane B. External auditory canal erythema C. Tympanic membrane pearly gray D. Manubrium superior to the umbo

B

A nurse conducted a history and physical for a newly admitted patient who states, "my arms are too short. I have to hold my book at a distance to read." The nurse knows that the patient is most likely experiencing: A. opacity in the lens B. loss of accommodative power in the lens C. shrinkage of the vitreous body D. decreased eye muscle tone

B

A nurse instructs a client to refrain from blinking after administering eye drops based on which rationale? A. blinking keeps substances from entering the eye B. blinking causes the eye drop to be expelled from the conjunctival sac C. blinking limits the size of the conjunctival sac for the needed amount of eye drop D. blinking slows absorption of the instilled eye drops

B

A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia? A. cheyne-stokes respirations B. increased urine output C. decreased appetite D. diaphoresis

B

A nurse is caring for a client who has a new prescription for heparin therapy. Which of the following statements by the client should indicate an immediate concern for the nurse? A. "I am allergic to morphine" B. "I take antacids several times a day" C. "I had a blood clot in my legs several years ago" D. "it hurts to take a deep breath"

B

A nurse is caring for a client who has chronic venous insufficiency and a prescription for thigh-high compression stockings. Which of the following actions should the nurse take? A. elevate the legs for 10 min, two to three times daily while wearing stockings B. apply the stockings in the morning upon awakening an before getting out of bed C. roll the stockings down to the knees to relieve discomfort on the legs D. remove the stockings while out of bed for 1 hr, four times a day, to allow the legs to rest

B

A nurse is caring for a client who has dyspnea and will receive oxygen continuously. Which of the following oxygen devices should the nurse use to deliver a precise amount of oxygen to the client? A. nonrebreather mask B. venturi mask C. nasal cannula D. simple face mask

B

A nurse is caring for a client who has increased ICP and a new prescription for mannitol. For which of the following adverse effects should the nurse monitor? A. hyperglycemia B. hyponatremia C. hypervolemia D. oliguria

B

A nurse is caring for a client who has type 1 diabetes mellitus. The nurse misread the client's morning blood glucose level as 210 mg/dl instead of 120 mg/dl and administered the insulin dose appropriate for a reading over 200 mg/dl before the client's breakfast. Which of the following actions is the nurse's priority? A. give the client 15 to 20 g of carbohydrate B. monitor the client for hypoglycemia C. complete an incident report D. notify the nurse manager

B

A nurse is caring for a client who is receiving warfarin for anticoagulant therapy. Which of the following laboratory test results indicates to the nurse that the client needs an increase in the dosage? A. aPTT 38 seconds B. INR 1.1 C. PT 22 seconds D. D-dimer negative

B

A nurse is caring for an older adult client who has diabetes mellitus and reports a gradual loss of peripheral vision. The nurse should recognize this as a manifestation of which of the following diseases? A. cataracts B. open-angle glaucoma C. macular degeneration D. angle-closure glaucoma

B

A nurse is checking laboratory values on a client who has crackles in the lower lobes, 2+ pitting edema, and dyspnea with minimal exertion. Which laboratory value does the nurse expect to be abnormal? A. Potassium B. B-type natriuretic peptide (BNP) C. C-reactive protein (CRP) D. Platelet count

B

A nurse is educating a client about monitoring blood pressure readings at home. What will the nurse be sure to emphasize? A. "avoid smoking cigarettes for 8 hours prior to taking blood pressure" B. "sit quietly for 5 minutes prior to taking blood pressure" C. "sit with legs crossed when taking your blood pressure" D. "be sure the forearm is well supported above the heart level while taking blood pressure"

B

A nurse is orienting a newly licensed nurse who is caring for a client who is receiving mechanical ventilation and is on pressure support ventilation (PSV) mode. Which of the following statements by the newly licensed nurse indicates an understanding of PSV? A. "it keeps the alveoli open and prevents atelectasis" B. "it allows preset pressure delivered during spontaneous ventilation" C. "it guarantees minimal minute ventilator" D. "it delivers a preset ventilatory rate and tidal volume to the client"

B

A nurse is performing a monofilament sensory assessment of a client who has diabetes mellitus. When performing this assessment, for which of the following complications is the nurse monitoring? A. nephropathy B. neuropathy C. radiculopathy D. retinopathy

B

A nurse is preparing a client with type 1 diabetes for discharge. The client can care for himself; however, he's had a problem with unstable blood glucose levels in the past. Based on the client's history, he should be referred to which health care worker? A. home health nurse B. dietitian C. psychiatrist D. social worker

B

A nurse is preparing to administer a morning dose of insulin aspart to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse implement? A. check blood glucose immediately after breakfast B. administer insulin when breakfast arrives C. hold breakfast for 1 hr after insulin administration D. clarify the prescription because insulin should not be administered at this time

B

A nurse is providing teaching for a client who has a new diagnosis of hypertension and a new prescription for spironolactone 25 mg/day. Which of the following statements by the client indicates an understanding of the teaching? A. "I should eat a lot of fruits and vegetables, especially bananas and potatoes" B. "I will report any changes in heart rate to my provider" C. "I should replace the salt shaker on my table with a salt substitute" D. "I will decrease the dose of this medication when I no longer have headaches and facial redness"

B

A nurse is providing teaching for a client who is newly diagnosed with type 2 diabetes mellitus and has a prescription for glipizide. Which of the following statements by the nurse best demonstrates the action of glipizide? A. "glipizide absorbs the excess carbohydrates in your system" B. "glipizide stimulates your pancreas to release insulin" C. "glipizide replaces insulin that is not being produced by your pancreas" D. "glipizide prevents your liver from destroying your insulin"

B

A nurse is providing teaching for a client who is scheduled for a bone marrow biopsy of the iliac crest. Which of the following statements made by the client indicates an understanding of the teaching? A. "this test will be performed while I am lying flat on my back" B. "I will need to stay in bed for about an hour after the test" C. "this test will determine which antibiotic I should take for treatment" D. "I will receive general anesthesia for the test"

B

A nurse is reviewing laboratory reports of a client who has hyperglycemic-hyperosmolar state (HHS). The nurse should expect which of the following findings? A. serum pH 7.2 B. serum osmolarity 350 mOsm/L C. serum potassium 3.8 mg/dL D. serum creatinine 0.8 mg/dL

B

A nurse is reviewing the prescriptions for a client who has a pneumothorax. Which of the following actions should the nurse perform first? A. assess the client's pain B. obtain a large-bore IV needle for decompression C. administer lorazepam D. prepare for chest tube insertion

B

A nurse is reviewing the serum laboratory findings for a client who has hypertension and is prescribed hydrochlorothiazide. Which of the following findings should the nurse report to the provider? A. sodium 136 mEq/L B. potassium 2.3 mEq/L C. chloride 99 mEq/L D. calcium 10 mg/dl

B

A nurse is teaching a client who is newly diagnosed with hypertension and diabetes mellitus. What will the nurse specific about this client's target blood pressure? A. 145/95 or lower B. 130/80 or lower C. 150/95 or lower D. 125/85 or lower

B

A nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. To reverse hypoglycemia, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand? A. epinephrine B. glucagon C. 50% dextrose D. hydrocortisone

B

A patient has been diagnosed with a fungal infection causing external otitis. What is the most common fungal infection in the ear? A. Staphylococcus aureus B. Aspergillus C. Pseudomonas D. Streptococcus

B

A patient has serous otitis media with significant hearing loss in the right ear. The patient states, "I have not been able to hear for 2 months." What procedure does the nurse anticipate preparing the patient for? A. Irrigation of the ear B. Myringotomy C. Removal of cerumen with a cerumen curette D. Instillation of otic solution

B

A patient is flying overseas for 1 week for business and packed antihypertensive medications in a suitcase. After arriving at the intended destination, the patient found that the luggage had been stolen. If the patient cannot take the medication, what condition becomes a concern? A. isolated systolic hypertension B. rebound hypertension C. angina D. left ventricular hypertrophy

B

An aging client is brought to the eye clinic by the son. The son states he has seen his parent holding reading materials at an increasing distance to focus properly. What age-related changes does this indicate? A. cataract B. presbyopia C. myopia D. macular degeneration

B

An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, 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: A. 2 to 5 g of. simple carbohydrate B. 10 to 15 g of a simple carbohydrate C. 18 to 20 g of a simple carbohydrate D. 25 to 30 g of a simple carbohydrate

B

Following an ophthalmologic exam, an anxious client asks the nurse, "how serious is a refraction error?" Which of the following is the best response from the nurse? A. "it is nothing serious" B. "it means corrective lenses are required" C. "simple surgery can fix this problem" D. "this is normal for anyone your age"

B

High doses of which medication can produce bilateral tinnitus? A. meclizine B. aspirin C. promethazine D. dimenhydrinate

B

Loud, persistent noise has what effect on the body? A. Dilation of peripheral blood vessels B. Increased blood pressure C. Decreased heart rate D. Decreased gastrointestinal activity

B

The nurse asks a client to follow the movement of a pencil up, down, right, left, and both ways diagonally. The nurse is assessing which of the following? A. pupillary reaction B. extraocular muscle function C. eyelid drooping D. eyeball oscillation movements

B

The nurse caring for a client with Meniere's disease needs to assist with what when the client is experiencing an attack? A. sleeping B. ADLs C. coughing D. URIs

B

The nurse identifies the nursing diagnosis of deficient knowledge related to a new hearing aid for a client. After teaching a client about caring for his new hearing aid, the nurse determines that the outcome has been achieved when the client states which of the following? A. "I need to wipe the ear mold daily with a moist washcloth" B. "I need to keep my ear canal clean and dry" C. "I should wash the receiver with soap and water once a week" D. "I should insert the ear mold when it is wet"

B

The nurse is administering a beta blocker to a patient in order to decrease automaticity. Which medication will the nurse administer? A. Diltiazem B. Metoprolol C. Amiodarone D. Propafenone

B

The nurse is administering a ophthalmic ointment to a patient with conjunctivitis. What disadvantage of the application of an ointment does the nurse explain to the patient? A. it does not work as rapidly as eye drops do B. blurred vision results after application C. it has a lower concentration than eye drops D. it has more side effects than eye drops

B

The nurse is administering an insulin drip to a patient is ketoacidosis. What insulin does the nurse know is the only one that can be used intravenously? A. NPH B. regular C. lispro D. lantus

B

The nurse is assisting the client in planning care during exacerbations of Meniere's disease. Which diet would the nurse identify as appropriate at this time? A. a high protein diet B. a low sodium diet C. a low fat diet D. a calorie controlled diet

B

The nurse is caring for a client on a monitored telemetry unit. During morning assessment, the nurse notes abnormal ECG waves on the telemetry monitor. Which action would the nurse do first? A. Call the physician with a report. B. Assess the client. C. Assess for mechanical dysfunction. D. Reposition the client.

B

The nurse is caring for a client who is prescribed medication for the treatment of hypertension. The nurse recognizes that which medication conserves potassium? A. furosemide B. spironolactone C. chlorothiazide D. chlorthalidone

B

The nurse is caring for a client with hypertension. The nurse is correct to realize that a 24 hour urine is ordered to determine if the cause of hypertension is related to the dysfunction of which of the following? A. the thyroid gland B. the adrenal gland C. the pituitary gland D. the thymus

B

The nurse is caring for a patient with systolic blood pressure of 135 mm Hg. This finding would be classified as A. normal B. prehypertension C. stage 1 hypertension D. stage 2 hypertension

B

The nurse is creating a community teaching demonstration focusing on the cause of blood pressure. When completing the visual aid, which body structures represent the mechanism of blood pressure? A. lung and arteries B. heart and blood vessels C. brain and sympathetic nervous system D. kidneys and autonomic nervous system

B

The nurse is examining the area behind the patient's auricle and sees a flaky scaliness. What disorder does the nurse suspect the patient has? A. Sebaceous cysts B. Seborrheic dermatitis C. Tophi D. Acute external otitis

B

The nurse is examining the area behind the patient's auricle and sees a flaky scaliness. What disorder does the nurse suspect the patient has? A. sebaceous cysts B. seborrheic dermatitis C. tophi D. acute external otitis

B

The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety? A. use a pillbox to store daily medication B. sit on the edge of the chair and rise slowly C. do not operate a motor vehicle D. take the medication at the same time daily

B

The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes? A. onset most common during adolescence B. insulin production insufficient C. less common than type 1 diabetes D. little to relation to pre-diabetes

B

The nurse is reviewing the results of a client's audiometric testing. The nurse determines that the client has a mild hearing loss based on the result signifying which loss of decibels? A. 20 B. 30 C. 45 D. 80

B

The nurse is teaching a class on diseases of the ear. What would the nurse teach the class is the most characteristic symptom of otosclerosis? A. The client being distressed in the mornings B. A progressive, bilateral loss of hearing C. A red and swollen ear drum D. The client describing a recent upper respiratory infection

B

The nurse is teaching a class on diseases of the ear. What would the nurse teach the class is the most characteristic symptom of otosclerosis? A. the client being distressed in the mornings B. a progressive, bilateral loss of hearing C. a red and swollen ear drum D. the client describing a recent upper respiratory infection

B

The nurse on a cruise ship is assessing clients for motion sickness. Which of the following is a common misconception? A. Repeated motion is the cause. B. Once symptoms occur, they will always be present. C. Medications help the symptoms. D. Pallor and diaphoresis is a first symptom.

B

The school nurse is testing the kindergarten class with the Snellen chart. What is the nurse testing the children for? A. near vision B. visual acuity C. hearing D. color vision

B

There are four major types of ophthalmic procedures to complete a glaucoma examination. If the health care provider wants to inspect the optic nerve, the nurse would prepare for: A. tonometry B. ophthalmoscopy C. gonioscopy D. perimetry

B

There are four major types of ophthalmic procedures to complete a glaucoma examination. If the health care provider wants to inspect the optic nerve, the nurse would prepare the patient for: A. tonometry B. ophthalmoscopy C. gonioscopy D. perimetry

B

To avoid the side effects of corticosteroids, which medication classification is used as an alternative in treating inflammatory conditions of the eyes? A. miotics B. non steroidal anti-inflammatory drugs (NSAIDs) C. mydriatics D. cycloplegics

B

When administering insulin to a client with type 1 diabetes, which of the following would be most important for the nurse to keep in mind? A. duration of the insulin B. accuracy of the dosage C. area for insulin injection D. technique for injecting

B

When assessing the pressure of the anterior chamber of the eye, a nurse normally expects to find a pressure of: A. 5 to 10 mm Hg B. 10 to 20 mm Hg C. 20 to 30 mm Hg D. over 30 mm Hg

B

When the patient tells the nurse that his vision is 20/200, and asks what that means, the nurse informs the patient that a person with 20/200 vision: A. sees an object from 200 feet away that a person with normal vision sees from 20 feet away B. sees an object from 20 feet away that a person with normal vision sees from 200 feet away C. sees an object from 20 feet away that a person with normal vision sees from 20 feet away D. sees an object from 200 feet away that a person with normal vision sees from 200 feet away

B

Which client statement would lead the nurse to suspect that the client is experiencing bacterial conjunctivitis? A. "my eyes feel like they are on fire" B. "my eyelids were stuck together this morning" C. "it feels like there is something stuck in my eye" D. "my eyes hurt when I'm in the bright sunlight"

B

Which clinical manifestation of type 2 diabetes occurs if glucose levels are very high? A. hyperactivity B. blurred vision C. oliguria D. increased energy

B

Which diagnostic test distinguishes between conductive and sensorineural hearing loss? A. Whisper test B. Rinne test C. Audiometry D. Weber test

B

Which diuretic medication conserves potassium? A. furosemide B. spironolactone C. chlorothiazide D. chlorthalidone

B

Which electrolyte replacement should the nurse anticipate being ordered by the health-care provider in the client with DKA who has just been admitted to the ICU? A. glucose B. potassium C. calcium D. sodium

B

Which is a correct rationale for encouraging a client with otitis external to eat soft foods? A. chewy foods, such as red meat, may react with prescribed analgesics and antibiotics B. chewing may cause discomfort C. chewing may lead to further complications, such as otitis media D. chewing may cause excessive draining

B

Which nursing suggestion would be most helpful to the client with recurrent otitis externa? A. Use a cotton applicator to ensure that the ear canal is dry. B. Place ear plugs into the ears before swimming C. Flush the ear with hydrogen peroxide D. Avoid lying on the side of the affected ear

B

A client is admitted with hyperosmolar hyperglycemic syndrome (HHNS). Which laboratory finding should the nurse expect in this client? A. arterial pH 7.25 B. plasma bicarbonate 12 mEq/L C. blood glucose level 1,100 mg/dl D. blood urea nitrogen (BUN) 15 mg/dl

C

A nurse is planning care for a client who is receiving mechanical ventilation. Which of the following modes of ventilation that increases the effort of the client's respiratory muscles should the nurse include in the plan of care? (select all that apply) A. assist-control B. synchronized intermittent mandatory ventilation C. continuous positive airway pressure D. pressure support ventilation E. independent lung ventilation

BCD

A nurse in the emergency department is assessing a client who has a suspected flail chest. Which of the following findings should the nurse expect? (select all that apply) A. bradycardia B. cyanosis C. hypotension D. dyspnea E. paradoxic chest movement

BCDE

A nurse is assessing a client who has diabetic ketoacidosis and ketones in the urine. The nurse should expect which of the following findings? A. weight gain B. fruit odor of breath C. abdominal pain D. kussmaul respirations E. metabolic acidosis

BCDE

A nurse is caring for a male older adult client who has a new diagnosis of glaucoma. Which of the following should the nurse recognize as risk factors associated with this disease? (select all that apply) A. gender B. genetic predisposition C. hypertension D. age E. diabetes mellitus

BCDE

A nurse is giving a presentation to a community group about preventing atherosclerosis. Which of the following should the nurse include as a modifiable risk factor for this disorder? (select all that apply) A. genetic predisposition B. hypercholesterolemia C. hypertension D. obesity E. smoking

BCDE

A nurse is caring for a client who has a closed-head injury with ICP readings ranging from 16 to 22 mm Hg. Which of the following actions should the nurse take to decrease the potential for raising the client's ICP? (select all that apply) A. suction the endotracheal tube frequently B. decrease the noise level in the client's room C. elevate the client's head on two pillows D. administer a stool softener E. keep the client well hydrated

BD

A nurse is screening a male client for hypertension. The nurse should identify that which of the following actions by the client increase his risk for hypertension? (select all that apply) A. drinking 8 oz of nonfat milk daily B. eating popcorn at the movie theater C. walking 1 mile daily at 12 min/mile pace D. consuming 36 oz beer daily E. getting a massage once a week

BD

A nurse is assessing a client who has a pulmonary embolism. Which of the following manifestations should the nurse expect to find? (select all that apply) A. bradypnea B. pleural friction rub C. hypertension D. petechiae E. tachycardia

BDE

A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (select all that apply) A. polyuria B. blurred vision C. polydipsia D. tachycardia E. moist, clammy skin

BDE

A nurse is caring for a client who is experiencing respiratory distress. Which of the following early manifestations of hypoxemia should the nurse recognize? (select all that apply) A. confusion B. pale skin C. bradycardia D. hypotension E. elevated blood pressure

BE

Your patient is on glucophage (metformin) for PCOS, which lab value should be monitored? _____________ _____________ _____________ _____________

BUN creatinine lactic acid liver enzymes

A 16 year old client newly diagnosed with type 1 diabetes has a very low body weight despite eating regular meals. The client is upset because friends frequently state, "you look anorexic." Which statement by the nurse would be the best response to help this client understand the cause of weight loss due to this condition? A. "I will refer you to a dietitian who can help you with your weight" B. "you may be having undiagnosed infections, causing you to lose extra weight" C. "your body is using protein and fat for energy instead of glucose" D. "don't worry abut what your friends think; the carbohydrates you eat are being quickly digested, increasing your metabolism"

C

A 52-year-old comes to the clinic for a follow-up examination after being diagnosed with glaucoma. The client states, "I'm hoping that I don't have to use these drops for very long." Which response by the nurse would be most appropriate? A. "most clients need to use the drops for only about a few months" B. "if the drops don't work, surgery may be needed to cure your condition" C. "you'll need to use the drops for the rest of your life to control the glaucoma" D. "these drops are just the first step to make sure that your vision doesn't get worse"

C

A client complains of vertigo. The nurse anticipates that the client may have a problem with which portion of the ear? A. external ear B. middle ear C. inner ear D. tympanic membrane

C

A client has been referred to an ophthalmologist for suspected macular degeneration. The nurse knows to prepare what test for the physician to give the client? A. Ishihara polychromatic plates B. visual field C. amsler grid D. slit lamp

C

A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should: A. provide instructions on eye patching B. assess the client's visual acuity C. demonstrate eyedrops instillation D. teach about intraocular lens cleaning

C

A client has undergone enucleation. What complication of enucleation should be addressed by the nurse? A. hypotension B. nausea and vomiting C. hemorrhage D. pneumonia

C

A client is admitted to the health care center with abdominal pain, nausea and vomiting. The medical reports indicate a history of type 1 diabetes. The nurse suspects the client's symptoms to be those of diabetic ketoacidosis (DKA). Which action will help the nurse confirm the diagnosis? A. assess the client's ability to take a deep breath B. assess the client's ability to move all extremities C. assess the client's breath odor D. assess for excessive sweating

C

A nurse in an urgent care clinic is obtaining a history from a client who has type 2 diabetes mellitus and a recent diagnosis of hypertension. This is the second time in 2 weeks that the client experienced hypoglycemia. Which of the following client data should the nurse report to the provider? A. takes psyllium daily as a fiber laxative B. drinks skim milk daily as a bedtime snack C. takes metoprolol daily after meals D. drinks grapefruit juice daily with breakfast

C

A nurse is caring for a client who has a deep-vein thrombosis (DVT) and has been taking unfractionated heparin for 1 week. Two days ago, the provider also prescribed warfarin. The client asks the nurse about receiving both heparin and warfarin at the same time. Which of the following statements should the nurse give? A. "I will remind your provider that you are already receiving heparin" B. "your laboratory findings indicated that two anticoagulants were needed" C. "it takes 3 to 4 days before the therapeutic effects of warfarin are achieved, and then the heparin can be discontinued" D. "only one of these medications is being given to treat your deep vein thrombosis"

C

A nurse is caring for a client who has blood glucose 52 mg/dL. The client is lethargic but arousable. Which of the following actions should the nurse perform first? A. recheck blood glucose in 15 min B. provide a carbohydrate and protein food C. provide 4 oz of grape juice D. report findings to the provider

C

A nurse is caring for a client who has just been admitted following surgical evacuation of a subdural hematoma. Which of the following is the priority assessment? A. glasgow coma scale B. cranial nerve function C. oxygen saturation D. pupillary response

C

A nurse is caring for a client who is admitted to the emergency department with a blood pressure of 266/147 mm Hg. The client reports a headache and double vision. The client states that she ran out of her diltiazem 3 days ago, and is unable to purchase more. Which of the following actions should the nurse take first? A. administer acetaminophen for headache B. provide teaching regarding the importance of not abruptly stopping an antihypertensive C. obtain IV access and prepare to administer an IV antihypertensive D. call social services for a referral for financial assistance in obtaining prescribed medication

C

A nurse is giving discharge teaching to a client with an eye injury. Which statement about preventing eye injuries should the nurse include? A. "use a lighter or matches if you need to look at a car battery at night" B. "when working in a workshop, you don't need to wear safety goggles unless you're the person using the tools" C. "direct all spray nozzles away from your face before spraying" D. "make sure you stand next to, not in front, of a moving lawn mower"

C

A nurse is preparing to administer IV fluids to a client who has diabetic ketoacidosis. Which of the following actions should the nurse take? A. administer an IV infusion of regular insulin at 0.3 unit/kg/hr B. administer an IV infusion of 0.45% sodium chloride C. rapidly administer an IV infusion of 0.9% sodium chloride D. add glucose to the IV infusion when serum glucose is 350 mg/dL

C

A nurse is preparing to administer morning doses of insulin glargine and regular insulin to a client who has a blood glucose 278 mg/dL. Which of the following actions should the nurse take? A. draw up the regular insulin and then the glargine insulin in the same syringe B. draw up the glargine insulin and then the regular insulin in the same syringe C. draw up and administer regular and glargine insulin in separate syringes D. administer the regular insulin, wait 1 hr, and then administer the glargine insulin

C

A nurse is preparing to perform the whisper test to assess a client's gross auditory acuity. Which of the following would be most appropriate for the nurse to do? A. Stand at a position diagonal to the client. B. Have the client use a finger to occlude the ear to be tested. C. Stand about 1 to 2 feet away from the ear to be tested. D. Speak a phrase in a low normal tone of voice.

C

A nurse is reviewing blood pressure classifications with a group of nurses at an in-service meeting. Which of he following should the nurse include as a risk factor for the development of hypertension? A. high-density lipoprotein (HDL) level of 70 mg/dl B. a diet high in potassium C. obstructive sleep apnea (OSA) D. taking benazepril

C

A nurse is reviewing prescriptions for a client who has acute dyspnea and diaphoresis. The client states she is anxious and is unable to get enough air. Vital signs are heart rate 117/min, respirations 38/min, temperature 38.4 C (101.2F), and blood pressure 100/54 mm Hg. Which of the following nursing actions is the priority? A. notify the provider B. administer heparin via IV infusion C. administer oxygen therapy D. obtain a spiral CT scan

C

A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance? A. ranitidine B. guaifenesin C. prednisone D. atorvastatin

C

A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dl. Which of the following information should the nurse include? A. discard the NPH solution if it appear cloudy B. shake the insulin vigorously before loading the syringe C. expect the NPH insulin to peak in 6 to 14 hours D. freeze unopened insulin vials

C

A nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include fasting blood glucose of 120 mg/dl, temp of 101 F, pulse of 88 bpm, respirations of 22, and blood pressure of 100/72. Which finding would be of most concern to the nurse? A. pulse B. respiration C. temperature D. blood pressure

C

A patient has been diagnosed with bacterial conjunctivitis that was sexually transmitted. The nurse informs the patient that the isolated organism is which of the following? A. streptococcus pneumonia B. haemophilus influenzae C. chlamydia trachomatis D. staphylococcus aureus

C

A patient is scheduled to take 7 units of Humulin R at 0830. You administer Humulin R at 0900 in the right thigh. When do you expect this medication to peak? A. 1300 B. 0930 C. 1100 D. 1700

C

According to the DASH diet, how many servings of vegetables should a person consume each day? A. 2 or fewer B. 2 or 3 C. 4 or 5 D. 7 or 8

C

After a physical examination, the provider diagnosed a patient with a grade 4 heart murmur. When ausculatating a murmur, what does the nurse expect to hear? A. Easily heard with no palpable thrill. B. Quiet but readily heard. C. Loud and may be associated with a thrill sound similar to (a purring cat). D. Very loud; can be heard with the stethoscope half-way off the chest.

C

Aging is positively correlated to the incidence of hypertension. This is due to three of the following four structural or functional changes. Which choice is not considered a cause? A. atherosclerosis B. decreased elasticity of the major blood vessels C. increased ability to exert diastolic pressure D. increased arterial resistance to left ventricular ejection

C

During an initial assessment, the nurse notes a symptom of a mild case of bacterial conjunctivitis and documents in the electronic medical record that the client is displaying which of the following? A. blurred vision B. elevated intraocular pressure C. mucopurulent ocular discharge D. severe pain

C

For a client with hyperglycemia, which assessment finding best supports a nursing diagnosis of: deficient fluid volume? A. cool, clammy skin B. jugular vein distention C. increased urine osmolarity D. decreased serum sodium level

C

Health teaching for a patient who suffers from motion sickness would include recommending the use of which one of the following over-the-counter drugs? A. Scopolamine B. Phenergan C. Dramamine D. Ephedrine

C

It is important for a nurse to understand cardiac hemodynamics. For blood to flow from the right ventricle to the pulmonary artery, the following must occur: A. The atrioventricular valves must open. B. The pulmonic valve must be closed. C. Right ventricular pressure must be higher than pulmonary arterial pressure. D. Right ventricular pressure must decrease with systole.

C

Miotic eye solutions are often ordered in the treatment of glaucoma. Which is the best nursing rationale for the use of this medication? A. constricts intraocular vessels B. paralyzes ciliary muscles C. constricts pupil D. dilates the pupil

C

On ocular examination, the health care provider notes severely elevated IOP, corneal edema, and a pupil that is fixed in a semi-dilated position. The nurse knows that these clinical signs are diagnostic of the type of glaucoma known as: A. chronic open-angle B. normal tension C. acute angle-closure D. chronic angle-closure

C

Patients with type 1 diabetes mellitus may require which of the following changes to their daily routine during times of infection? A. no change B. less insulin C. more insulin

C

Primary risk factors for hypertension include all of the following except? A. diabetes B. stress C. pregnancy D. metabolic syndrome E. family history

C

The nurse is caring for a client ordered for multiple eye screening. Following which procedure will the nurse instruct the client on a yellow coloring to the skin and urine as being normal? A. ultrasonography B. retinal imaging C. retinal angiography D. retinoscopy

C

The nurse is caring for an elderly client with left-sided heart failure. When auscultating lung sounds, which adventitious sound is expected? A. Wheezes B. Rhonchi C. Crackles D. Coarseness

C

The nurse is performing an assessment of the visual fields for a patient with glaucoma. When assessing the visual fields in acute glaucoma, what would the nurse expect to find? A. clear cornea B. constricted pupil C. marked blurring of vision D. watery ocular discharge

C

The nurse is teaching a client about self-administration of insulin and about mixing regular and neutral protamine Hagedorn (NPH) insulin. Which information is important to include in the teaching plan? A. if two different types of insulin are ordered, they need to be given in separate injections B. when mixing insulin, the NPH insulin is drawn up into the syringe first C. when mixing insulin, the regular insulin is drawn up into the syringe first D. there is no need to inject air into the bottle of insulin before withdrawing the insulin

C

A nurse is caring for a client who has a new diagnosis of cataracts. Which of the following manifestations should the nurse expect? (select all that apply) A. eye pain B. floating spots C. blurred vision D. white pupils E. bilateral red reflexes

CD

A nurse is teaching foot care to a client who has diabetes mellitus. Which of the following information should the nurse include in the teaching? (select all that apply) A. remove calluses using over-the-counter remedies B. apply lotion between toes C. perform nail care after bathing D. trim toenails straight across E. wear closed-toe shoes

CDE

A nurse is caring for a client who has hypertension and diabetes mellitus. The client's blood pressure this morning was 150/92 mm Hg. When the client asks the nurse what his or her blood pressure should be, what is the nurse's most appropriate response? A. "your blood pressure is fine. just keep doing what you're doing" B. "the current recommendation is for everyone to have blood pressure of 140/90 mm Hg or lower" C. "the lower the better. blood pressure of 120/90 mm Hg is best for everyone" D. "clients with diabetes should have a lower blood pressure goal. you should strive for 130/80 mm Hg"

D

A nurse is caring for a client who has suspected Meniere's disease. Which of the following is an expected finding? A. presence of purulent lesion in the external ear canal B. feeling of pressure in the ear C. bulging, red bilateral tympanic membranes D. unilateral hearing loss

D

A nurse is orienting a newly licensed nurse on performing routine assessment of a client who is receiving mechanical ventilation via an endotracheal tube. Which of the following information should the nurse include in the teaching? A. apply a vest restraint if self-exubation is attempted B. monitor ventilator settings every 8 hours C. document tube placement in centimeters at the angle of the jaw D. assess breath sounds every 1 to 2 hours

D

A nurse is performing an otoscopic examination of a client. Which of the following is an unexpected finding? A. pearly, gray tympanic membrane (TM) B. malleus visible behind the TM C. presence of soft cerumen in the external canal D. fluid bubble seen behind the TM

D

A client has been diagnosed with prediabetes and discusses treatment strategies with the nurse. What can be the consequences of untreated prediabetes? A. CVA B. type 2 diabetes C. cardiac disease D. all options are correct

D

A client tells the nurse that she has been working hard for the past 3 months to control her type 2 diabetes with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check: A. urine glucose level B. fasting blood glucose level C. serum fructosamine level D. glycosylated hemoglobin level

D

A client with a conductive hearing disorder caused by ankylosis of the stapes in the oval window undergoes a stapedectomy to remove the stapes and replace the impaired bone with a prosthesis. After the stapedectomy, the nurse should provide which client instruction? A. "lie in bed with your head elevated, and refrain from blowing your nose for 24 hours" B. "try to ambulate independently after about 24 hours" C. "shampoo your hair everyday for 10 days to help prevent infection" D. "don't fly in an airplane, climb to high altitudes, make sudden movements, or expose yourself to loud sounds for 30 days"

D

A diabetic client visits a walk-in clinic and asks the nurse to take a blood pressure (BP) reading. The measurements are 150/90 mm Hg. Which of the following would the nurse expect as the treatment to normalize the client's BP? A. smoking cessation programs B. low-fat diet C. daily exercise D. drug therapy

D

A nurse in a clinic is assessing a client who has sinusitis. Which of the following techniques should the nurse use to identify manifestations of this disorder? A. percussion of posterior lobes of lungs B. auscultation of the trachea C. inspection of the conjunctiva D. palpation of the orbital areas

D

A nurse in a clinic is caring for a client who has suspected anemia. Which of the following laboratory test results should the nurse expect? A. iron 90 mcg/dK B. RBC 6.5 million/uL C. WBC 4,800 mm^3 D. Hgb 10 g/dL

D

A nurse is assessing a client who has chronic peripheral arterial disease (PAD). Which of the following findings should the nurse expect? A. edema around the ankles and feet B. ulceration around the medial malleoli C. scaling eczema of the lower legs with stasis dermatitis D. pallor on elevation of the limbs, and rubor when the limbs are dependent

D

A nurse is assigned to care for a postoperative client with diabetes mellitus. During the assessment interview, the client reports that he's impotent and says he's concerned about the effect on his marriage. In planning this client's care, the most appropriate intervention would be to: A. encourage the client to ask questions about personal sexuality B. provide time for privacy C. provide support for the spouse or significant other D. suggest referral to a sex counselor or other appropriate professional

D

A nurse is providing postoperative teaching to a client following cataract surgery. Which of the following statements should the nurse include in the teaching? A. "you can resume playing golf in 2 days" B. "you need to tilt your head back when washing your hair" C. "you can get water in your eyes in 1 day" D. "you need to limit your housekeeping activities"

D

A nurse is reviewing discharge instructions for a client who experienced a pneumothorax. Which of the following statements should the nurse use when teaching the client? A. "notify your provider if you experience weakness" B. "you should be able to return to work in 1 week" C. "you need to wear a mask when in crowded areas" D. "notify your provider if you experience a productive cough"

D

A nurse is teaching a client who has been a new diagnosis of severe peripheral arterial disease. Which of the following instructions should the nurse include? A. wear tightly fitted insulated socks with shoes when going outside B. elevate both legs above the heart when resting C. apply a heating pad to both legs for comfort D. place both legs in dependent position while sleeping

D

A nurse is teaching an older adult client who has diabetes mellitus about preventing the long-term complications of retinopathy and nephropathy. Which of the following instructions should the nurse include? A. "have an eye examination once per year" B. "examine your feet carefully every day" C. "wear compression stockings daily" D. "maintain stable blood glucose levels"

D

A nurse practitioner in an emergency room receives a telephone call from a mother whose 4 year old child has a mosquito stuck in his external ear canal. Which of the following is the best information the nurse could give the mother? A. irrigate the ear canal with warm water to flush out the insect B. use an aural suction cup to pull out the insect C. insert a cotton-tipped application (e.g. Q-tip) to trap the insect and slowly pull the applicator backward D. instill a few drops of warmed mineral oil to cover the insect

D

A patient who is 6 months pregnant was evaluated for gestational diabetes mellitus. The doctor considered prescribing insulin based on the serum glucose result of: A. 90 mg/dl before meals B. 120 mg/dl, 1 hour postprandial C. 80 mg/dl, 1 hour postprandial D. 138 mg/dl 2 hours postprandial

D

An elderly client with macular degeneration has received injections or angiogenesis inhibitors. Which assessment finding would indicate the condition is worsening? A. blurred vision B. burning sensation of the eyes C. loss of peripheral field vision D. central vision impairment

D

Following cataract removal, discharge instructions will be provided to the client. Which of the following instructions is most important? A. apply protective patch to both eyes at bedtime B. only sleep on back C. avoid washing face and eyes for first 24 hours D. avoid any activity that can increase intraocular pressure

D

It is determined that a patient is legally blind and will be unable to drive any longer. Legal blindness refers to a best-corrected visual acuity (BCVA) that does not exceed what reading in the better eye? A. 20/50 B. 20/100 C. 20/150 D. 20/200

D

It is determined that a patient is legally blind and will be unable to drive any longer. Legal blindness refers to a best-corrected visual acuity (BCVA) that does not exceed what reading in their better eye? A. 20/50 B. 20/100 C. 20/150 D. 20/200

D

Mr. Smith is a 76 year old male with type 2 DM and HTN who presents with the following lipid profile: HDL 35 mg/dl, LDL 150 mg/dl, triglycerides 201 mg/dl. Which of the following medication will be the best choice of lipid lowering agent? A. niacin B. cholestyramine C. ezetimibe D. simvastatin

D

Nursing students are reviewing information about the causes associated with low vision and blindness. The students demonstrate a need for additional review when they identify which of the following as a common cause in older adults? A. macular degeneration B. diabetic retinopathy C. glaucoma D. presbyopia

D

The nurse auscultates the PMI (point of maximal impulse) at which anatomic location? A. 3 cm to the right of the sternum B. 5 cm to the left of the lower end of the sternum C. 2.5 cm to the left of the xiphoid process D. left midclavicular line, fifth intercostal space

D

The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order? A. provides best information on the body's ability to maintain normal blood funcioning B. best indicator for the nutritional state of the client C. is less costly than performing daily blood sugar test D. reflects the amount of glucose stored in hemoglobin over past several months

D

The nurse is talking with a patient diagnosed with Meniere's disease about the patient's symptoms. What symptom does the patient inform the nurse is the most troublesome? A. nausea B. diarrhea C. tinnitus D. vertigo

D

The nurse is working in the triage section of a walk-in clinic. Which triad of common symptoms, when placed together, indicate Ménière's disease? A. Blurred vision, vertigo, nausea B. Syncope, vertigo, ear pain C. Disorientation, vertigo, nausea D. Hearing loss, vertigo, tinnitus

D

The ophthalmologist tells a patient that he has increased intraocular pressure (IOP). The nurse understands that increased pressure resulting from optic nerve damage is indicated by a reading of: A. 0 to 50 mm Hg B. 6 to 10 mm Hg C. 11 to 20 mm Hg D. >21 mm Hg

D

When discussing diseases of the middle ear, the nursing instructor distinguishes the different types of otitis media. What generally causes purulent otitis media? A. irritation associated with respiratory allergies and enlarged adenoids B. bronchial tree C. outer ear D. upper respiratory infections

D

Which action by the nurse has the highest priority when caring for a client diagnosed with vertigo? A. Encourage the client to keep his or her eyes open. B. Administer antivertiginous medication as ordered. C. Encourage the client to stare straight ahead, focusing on one object. D. Educate the client on using the call light for assistance with ambulation.

D

Which are included as marker(s) of medication effectiveness in glaucoma control? select all that apply A. lowering intraocular pressure to the target pressure B. stable appearance of the optic nerve head C. visual field D. opacity of the lens

D

Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension? A. "a glass of red wine each day will lower my blood pressure" B. "I should eliminate caffeine from my diet to lower my blood pressure" C. "if I include less fat in my diet, I'll lower my blood pressure" D. "limiting my salt intake to 2 grams per day will improve my blood pressure"

D

Which information should be included in the teaching plan for a client receiving glargine, a "peakless" basal insulin? A. administer the total daily dosage in two doses B. draw up the drug first, then add the regular insulin C. it is rapidly absorbed and has a fast onset of action D. do not mix with other insulins

D

Which medication classification increases aqueous fluid outflow in the client with glaucoma? A. beta-blockers B. alpha-adrenergic-agonists C. carbonic anhydrase inhibitors D. cholinergics

D

Which of the following factors would a nurse identify as a most likely cause of diabetic ketoacidosis (DKA) in a client with diabetes? A. the client continues medication therapy despite adequate food intake B. the client has not consumed sufficient calories C. the client has been exercising more than usual D. the client has eaten and has not taken or received insulin

D

Which of the following is the primary pacemaker for the myocardium? A. atrioventricular junction B. bundle of His C. purkinje fibers D. sinoatrial node

D

Which symptoms may a client with Meniere's disease report before an attack? A. nystagmus B. low blood pressure C. photosensitivity D. a full feeling in the ear

D

Which term refers to surgical repair of the tympanic membrane? A. tympanotomy B. myringotomy C. ossiculoplasty D. tympanoplasty

D

The point at which the insulin is working at its maximum, when hypoglycemia is most likely to occur is the ____________________

peak

When mixing NPH and regular insulin, which should be drawn up first?

regular

the only insulin that can be given IV is _______________

regular