NURS405A Exam 1

A nurse is instructing the spouse of a client who suffered a stroke about the use of eating devices the client will be using. During the teaching, the spouse starts to cry and states, "One minute he is laughing, and the next he's crying; I just don't understand what's wrong with him." Which statement is the best response by the nurse? A. "Emotional lability is common after a stroke, and it usually improves with time." B. "This behavior is common in clients with stroke. Which does your spouse do more often? Laugh or cry?" C. "You seem upset, and it may be hard for you to focus on the teaching, I'll come back later." D. "You sound stressed; maybe using some stress management techniques will help."

A. "Emotional lability is common after a stroke, and it usually improves with time."

A patient has been diagnosed with Cushing's syndrome. The nurse would expect which of the following features to be present upon physical examination? Select all that apply. A. "Moon face" B. Truncal obesity C. "Buffalo hump" D. Purple striae E. Thin extremities

A. "Moon face" B. Truncal obesity C. "Buffalo hump" D. Purple striae E. Thin extremities

A patient had a carotid endarterectomy yesterday and when the nurse arrived in the room to perform an assessment, the patient states, "All of a sudden, I am having trouble moving my right side." What concern should the nurse have about this complaint? A. A thrombus formation at the site of the endarterectomy B. Surgical wound infection C. Bleeding from the endarterectomy site D. This is a normal occurrence after an endarterectomy and would not be a concern.

A. A thrombus formation at the site of the endarterectomy

A nurse understands that for the parathyroid hormone to exert its effect, what must be present? A. Adequate vitamin D level B. Increased calcium level C. Functioning thyroid gland D. Decreased phosphate level

A. Adequate vitamin D level

Which of the following would the nurse expect to find in a client with severe hyperthyroidism? A. Exophthalmos B. Buffalo hump C. Tetany D. Striae

A. Exophthalmos

A client undergoes cerebral angiography for evaluation of a subarachnoid hemorrhage. Which findings indicate spasm or occlusion of a cerebral vessel by a clot? A. Hemiplegia, seizures, and decreased level of consciousness B. Difficulty breathing or swallowing C. Nausea, vomiting, and profuse sweating D. Tachycardia, tachypnea, and hypotension

A. Hemiplegia, seizures, and decreased level of consciousness

A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply. A. Hypotension B. Hyperventilation C. Hypoventilation D. Hypertension E. Hypothermia

A. Hypotension C. Hypoventilation E. Hypothermia

Which are contraindications for the administration of tissue plasminogen activator (t-PA)? Select all that apply. A. Intracranial hemorrhage B. Major abdominal surgery within 10 days C. Age 18 years or older D. Ischemic stroke E. Systolic BP less than or equal to 185 mm Hg

A. Intracranial hemorrhage E. Systolic BP less than or equal to 185 mm Hg

A client is admitted with weakness, expressive aphasia, and right hemianopia. The brain MRI reveals an infarct. The nurse understands these symptoms to be suggestive of which of the following findings? A. Left-sided cerebrovascular accident (CVA) B. Right-sided cerebrovascular accident (CVA) C. Completed Stroke D. Transient ischemic attack (TIA)

A. Left-sided cerebrovascular accident (CVA)

A client is receiving long-term treatment with high-dose corticosteroids. Which of the following would the nurse expect the client to exhibit? A. Moon face B. Weight loss C. Hypotension D. Pale thick skin

A. Moon face

When preparing teaching plan for a client with an endocrine disorder, the nurse includes information about hormone regulation. Which of the following would the nurse include? A. Most disorders result from over- or underproduction of the hormone. B. The gland becomes enlarged leading to a deficiency of the hormone. C. Hormone secretion occurs as a straight-line continuous process. D. The gland slows hormone secretion when the hormone level decreases.

A. Most disorders result from over- or underproduction of the hormone.

A client is brought to the emergency department in a confused state, with slurred speech, characteristics of a headache, and right facial droop. The vital signs reveal a blood pressure of 170/88 mm Hg, pulse of 92 beats/minute, and respirations at 24 breaths/minute. On which bodily system does the nurse focus the nursing assessment A. Neurovascular system B. Cardiovascular system C. Respiratory system D. Endocrine system

A. Neurovascular system

A client has a dysfunction in one of his glands that is causing a decrease in the level of calcium in the blood. What gland should be evaluated for dysfunction? A. Parathyroid gland B. Thyroid gland C. Thymus gland D. Adrenal gland

A. Parathyroid gland

Which interventions would be recommended for a client with dysphagia? Select all that apply. A. Test the gag reflex before offering food or fluids. B. Assist the client with meals. C. Place food on the affected side of the mouth. D. Allow ample time to eat.

A. Test the gag reflex before offering food or fluids. B. Assist the client with meals. C. Place food on the affected side of the mouth. D. Allow ample time to eat.

A patient having an acute stroke with no other significant medical disorders has a blood glucose level of 420 mg/dL. What significance does the hyperglycemia have for this patient? A. This is significant for poor neurologic outcomes. B. The patient has new onset diabetes. C. The patient has liver failure. D. The patient has developed diabetes insipidus due to the location of the stroke.

A. This is significant for poor neurologic outcomes.

A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder? A. pituitary disorder B. parathyroid disorder C. adrenal disorder D. thyroid disorder

A. pituitary disorder

The nurse is caring for a client with a history of transient ischemic attacks (TIAs) and moderate carotid stenosis who has undergone a carotid endarterectomy. Which postoperative finding would cause the nurse the most concern? A. Mild neck edema B. Difficulty swallowing C. Neck pain rated 3 of 10 (on a 0 to 10 pain scale) D. Blood pressure 128/86 mm Hg

B. Difficulty swallowing

Cardiac effects of hyperthyroidism include A. bradycardia. B. palpitations. C. decreased pulse pressure. D. decreased systolic blood pressure.

B. palpitations.

A patient presents to the emergency room with complaints of having an "exploding headache" for the last 2 hours. The patient is immediately seen by a triage nurse who suspects the patient is experiencing a stroke. Which of the following is a possible cause based on the characteristic symptom? A. Small artery thrombosis B. Cardiogenic emboli C. Cerebral aneurysm D. Large artery thrombosis

C. Cerebral aneurysm

A client sustained a head injury when falling from a ladder. While in the hospital, the client begins voiding large amounts of clear urine and reports being very thirsty. The client states feeling weak and having experienced an 8-pound weight loss since admission. What condition does the nurse expect the client to be tested for? A. Pituitary tumor B. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) C. Diabetes insipidus (DI) D. Hypothyroidism

C. Diabetes insipidus (DI)

A healthcare provider orders several drugs for a client with hemorrhagic stroke. Which drug order should the nurse question? A. Dexamethasone B. Phenytoin C. Heparin sodium D. Methyldopa

C. Heparin sodium

The most common type of goiter is caused by lack of which of the following? A. Sodium B. Potassium C. Iodine D. Calcium

C. Iodine

A client has experienced an ischemic stroke that has damaged the lower motor neurons of the brain. Which of the following deficits would the nurse expect during assessment? A. Visual agnosia B. Auditory agnosia C. Lack of deep tendon reflexes D. Limited attention span and forgetfulness

C. Lack of deep tendon reflexes

The nurse is caring for a client diagnosed with a hemorrhagic stroke. The nurse recognizes that which intervention is most important? A. Elevating the head of the bed to 30 degrees B. Administering a stool softener C. Maintaining a patent airway D. Monitoring for seizure activity

C. Maintaining a patent airway

A patient is brought to the emergency department with a possible stroke. What initial diagnostic test for a stroke, usually performed in the emergency department, would the nurse prepare the patient for? A. 12-lead electrocardiogram B. Carotid ultrasound study C. Noncontrast computed tomogram D. Transcranial Doppler flow study

C. Noncontrast computed tomogram

Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client (who now has nausea) and records a temperature of 105°F (40.5°C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? A. Tetany B. Hypoglycemia C. Thyroid crisis D. Diabetic ketoacidosis

C. Thyroid crisis

A 35-year-old female client who complains of weight gain, facial hair, absent menstruation, frequent bruising, and acne is diagnosed with Cushing's syndrome. Cushing's syndrome is most likely caused by: A. adrenal carcinoma. B. an inborn error of metabolism. C. a corticotropin-secreting pituitary adenoma. D. an ectopic corticotropin-secreting tumor.

C. a corticotropin-secreting pituitary adenoma.

The nurse is aware that the best time of day for the total large corticosteroid dose is between: A. 4:00 PM and 6:00 PM B. 8:00 PM and 9:00 PM C. 4:00 AM and 5:00 AM D. 7:00 AM and 8:00 AM

D. 7:00 AM and 8:00 AM

A nurse is assigned to care for a patient with increased parathormone secretion. Which of the following serum levels should the nurse monitor for this patient? A. Glucose B. Sodium C. Potassium D. Calcium

D. Calcium

Which terms refers to blindness in the right or left half of the visual field in both eyes? A. Nystagmus B. Scotoma C. Diplopia D. Homonymous hemianopsia

D. Homonymous hemianopsia

The nurse assesses a patient who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease? A. Glucose of 100 mg/dL B. A blood pressure reading of 135/90 mm Hg C. Sodium of 140 mEq/L D. Potassium of 6.0 mEq/L

D. Potassium of 6.0 mEq/L

While providing information to a community group, the nurse tells them the primary initial symptoms of a hemorrhagic stroke are: A. Foot drop and external hip rotation B. Weakness on one side of the body and difficulty with speech C. Confusion or change in mental status D. Severe headache and early change in level of consciousness

D. Severe headache and early change in level of consciousness

A client with a history of diabetes insipidus seeks medical attention for an exacerbation of symptoms. Which laboratory finding indicates to the nurse that the client has been restricting fluids in an attempt to control the symptoms? A. Phosphate level of 5.0 mg/dL B. Blood glucose level of 60 mg/dl C. Potassium level of 2.9 mmol/L D. Sodium level of 150 mEq/L

D. Sodium level of 150 mEq/L

When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect: A. bradycardia. B. a blood pressure of 130/70 mm Hg. C. a blood glucose level of 130 mg/dl. D. a blood pressure of 176/88 mm Hg.

D. a blood pressure of 176/88 mm Hg.

A nurse is caring for a client with a kidney disorder. What hormone released by the kidneys initiates the production of angiotensin and aldosterone to increase blood pressure and blood volume? A. cholecystokinin B. gastrin C. erythropoietin D. renin

D. renin