Patho Exam 3 (Endocrine, Reproductive, & GI Disorders)

A client diagnosed with dysmenorrhea is prescribed ibuprofen and hormonal contraceptives. Which outcome in the client indicates the effectiveness of the therapy? 1. No painful experience during the first 2 days of her menstrual period 2. No behavioral change during the luteal phase of the menstrual cycle 3. No formation of multiple regions of unreleased egg on the ovarian surface 4. All of the above

1

A client has exposure to the Neisseria gonorrhoeae organism and becomes infected. Which symptom would be noted in the client immediately after the infection? 1. Dysuria 2. Abdominal pain 3. Copious discharge 4. None of the above

1

A client is diagnosed with condyloma acuminata. Which test should the nurse expect will be beneficial to detect the viral genome? 1. Biopsy 2. Papanicolaou (Pap) smear 3. Colposcopy 4. None of the above

1

A client tells a nurse, "My erections lasts for several hours and are painful. "Which medication found in the client's prescription is responsible? 1. Sildenafil 2. Finasteride 3. Tamsulosin 4. Pyridoxine

1

A nurse is caring for a 19-year-old female client who has never had a menstrual cycle and has a webbed neck, short stature, and a broad shield-like chest. What is the most probable cause of the client's condition? 1. Turner syndrome 2. Sheehan's syndrome 3. Asherman's syndrome 4. Mayer-Rokitansky-Hauser syndrome

1

The clinical reports of a client indicate high levels of bilirubin. What should the nurse infer from the report? 1. The client has stones in the common bile duct. 2. The client has decreased pancreatic enzymes. 3. Both A and B 4. None of the above

1

Which diagnostic test would be beneficial to rule out ectopic ACTH-secreting tumors in the body? 1. Chest x-ray 2. Octreotide scintigraphy 3. Contrast-enhanced MRI 4. Abdominal CT scan

2

Which condition is commonly seen in the case of protein loss in clients with liver cirrhosis? 1. Pruritus 2. Muscle wasting 3. Hypersplenism 4. Skin telangiectasias

3

Which infection would be detected by testing the swab samples of lesions on a Tzanck smear? 1. Neisseria gonorrhoeae 2. Treponema pallidum 3. Human papillomavirus (HPV) 4. None of the above

3

Which side effect will the nurse observe in a client who is on epinephrine therapy? 1. Gastrocolic reflex 2. Injuries to the gastric epithelium 3. Suppression of the urge to defecate 4. Decreased gastrointestinal secretions

3

A primary healthcare provider suspects diverticular disease in a client. Which diagnostic test would the primary health care provider order to visualize the lower bowel? 1. Biopsy 2. Chest x-ray 3. Colonoscopy 4. Sigmoidoscopy

4

What is the mode of transmission for the hepatitis D virus? 1. Blood transfusion 2. Oral-fecal route 3. Sexual contact 4. Both A and C

4

Which diagnostic test should the primary health care provider order to get the most accurate information related to appendicitis? 1. Urinalysis 2. Abdominal X-ray 3. Abdominal ultrasound 4. Computerized tomography scan

4

Which disorder can occur due to HIV? 1. Varicocele 2. Hypospadias 3. Cryptorchidism 4. Testicular cancer

4

Which is a common risk factor that leads one susceptible to forming gallstones? 1. Estrogen level 2. Obesity 3. Oral contraceptives 4. Liver enzymes 5. All of the above

5

The nurse is caring for a client with seizures, severely elevated blood pressure, and impaired mentation. The primary health-care provider suspects the client's condition is an endocrine disorder. A 24-hour urinalysis report shows an excess amount of catecholamine metabolites. What might be the diagnosis of the client? 1. The client has a pineal tumor. 2. The client has pheochromocytoma. 3. The client has Cushing's syndrome. 4. The client has multiple endocrine neoplasia.

2

The nurse is reviewing the medical records of different clients. Client Client 1 Client 2 Client 3 Client 4 Gender Male Female Male Female Waist circumference 38 inches 37 inches 32 inches 30 inches Triglyceride levels 100 mg/dL 160 mg/dL 130 mg/dL 120 mg/dL Which client does the nurse expect to have metabolic syndrome? 1. Client 1 2. Client 2 3. Client 3 4. Client 4

2

The nurse reviews the laboratory reports of a client and concludes that the client has diabetes. Which finding helped the nurse to reach this conclusion? 1. A fasting plasma glucose level of 100 mg/dL 2. A glycated hemoglobin (HbA1c) value of 7 3. A postprandial blood glucose level of 170 mg/dL 4. All of the above

2

The nursing instructor is discussing the physical assessment findings for hemorrhoids. Which statement made by the student nurse indicates effective learning? 1. "Presence of anal fistulas is observed." 2. "Presence of blood in stools may be observed." 3. "McBurney's point indicates tenderness." 4. "Auscultation of the abdomen indicates high pitched bowel sounds."

2

The nursing instructor teaches a group of student nurses about the diagnosis of irritable bowel syndrome. After the teaching session, the nursing instructor asks the student nurse to determine the presence of lactose intolerance in a client with irritable bowel syndrome. Which intervention by the student nurse indicates effective learning? 1. The student nurse performs a complete blood analysis of the client. 2. The student nurse performs a hydrogen breath test on the client. 3. The student nurse performs an upper endoscopy in the client. 4. The student nurse performs an abdominal computerized tomography scan of the client.

2

What is the significance of propulsive movements in the large intestine? 1. Absorption of water 2. Initiation of defecation 3. Absorption of electrolytes 4. Accumulation of bacteria in the feces

2

Where does the liver release its bile? 1. Cystic duct 2. Hepatic duct 3. Pancreatic duct 4. All of the above

2

Which diagnostic test helps in detecting the natural insulin secretion from the pancreas? 1. Urinalysis 2. C-peptide test 3. Islet cell autoantibodies 4. Both B and C

2

Which diagnostic test will help the nurse to confirm pancreatitis in the client? 1. Urinalysis 2. Serum amylase test 3. Complete blood count 4. Barium contrast studies

2

Which type of hepatitis is caused by a deoxyribonucleic acid (DNA) virus? 1. Hepatitis A (HAV) 2. Hepatitis B (HBV) 3. Hepatitis C (HCV) 4. Hepatitis D (HDV)

2

While assessing a male client, a nurse observes that the client has a small penis, long legs, short trunk, enlarged breast tissues, small testicles, and sexual dysfunction. What reason does the nurse suspect from these findings? 1. Mumps infection 2. Presence of an extra X chromosome 3. Prolonged consumption of antihypertensive agents 4. Increased cellular growth and size of the prostate gland

2

While assessing a young female client for reproductive disorders, a nurse understands that the client has amenorrhea. Which specific question should the nurse ask the client? 1. "Do you have frequent vaginal infections?" 2. "Do you have any thyroid gland disorders?" 3. "Do you have diabetes mellitus?" 4. "Do you have continuous or intermittent pelvic pain?"

2

The nurse observes hyperpigmented, velvety macular lesions on the neck during the assessment of a diabetic client. What does the nurse infer from this observation? 1. The client has lipoatrophy. 2. The client has lipohypertrophy. 3. The client has acanthosis nigricans. 4. The client has pigmented pretibial papules.

3

The nurse observes sweating, dizziness, and disorientation in the client and consults the primary health-care provider while caring for a diabetic client. Which treatment option would be most beneficial to the client? 1. Administering 25 g of glucose intravenously 2. Administering 1 mg of glucagon subcutaneously 3. Administering 50 mL of 50% dextrose intravenously 4. Both A and B

3

The nurse reviews the laboratory reports of a diabetic client and concludes that the client has diabetic nephropathy. Which finding supports the nurse's conclusion? 1. Ketones in urine 2. Glucose in urine 3. Albumin in urine 4. All of the above

3

The primary health-care provider suggests the hepatitis C virus (HCV) genotyping test to a client with liver disease. What is the rationale for this? 1. To predict prognosis 2. To determine the severity of the disease 3. To predict the likelihood of response and the duration of treatment 4. To detect the presence of antibodies against two or more antigens

3

Which complication should be suspected in a client who has an obstruction of the common bile duct? 1. Cholecystitis 2. Pancreatic cancer 3. Jaundice 4. All the above

3

Which condition can cause ischemia of the testicle? 1. Priapism 2. Hematocele 3. Testicular torsion 4. Cryptorchidism

3

Which diagnostic procedure would a primary health-care provider use to confirm advanced chronic pancreatitis with exocrine insufficiency in a client? 1. Ultrasound 2. Cholecystogram 3. Fecal chymotrypsin 4. Endoscopic retrograde cholangiopancreatography (ERCP)

3

Which diagnostic test is useful for detecting hyperactivity of the thyroid gland during an evaluation of a thyroid disorder? 1. Sestamibi scan 2. Ultrasound 3. Radioactive iodine scan 4. CT scan of the anterior neck

3

Which disorder is characterized by the presence of cobblestoning upon examining the colon? 1. Volvulus 2. Appendicitis 3. Crohn's disease 4. Ulcerative colitis

3

Which factors may lead to an acute inflammation of the pancreas? 1. Excessive alcohol intake 2. High triglyceride level 3. Both A and B 4. None of the above

3

Which gland secretes a lubricating fluid that coats the urethra during sexual arousal? 1. Pituitary gland 2. Prostate gland 3. Bulbourethral gland 4. Thyroid gland

3

Which hormone stimulates the Leydig cells of the testes to secrete testosterone? 1. Prolactin 2. Thyroid hormone 3. Luteinizing hormone 4. Follicle-stimulating hormone

3

Which laboratory test can assess a client's blood to rule out the possibility of ovarian cancer? 1. Estrogen 2. Urine calcium oxalate 3. Carcinoembryonic antigen 125 (CA-125) 4. Follicle-stimulating hormone (FSH)

3

Which medication does the primary health-care provider prescribe for the treatment of prolactinoma in a client with hyperpituitarism? 1. Conivaptan 2. Furosemide 3. Bromocriptine 4. Levothyroxine

3

While caring for a neonate immediately following a vaginal birth, a nurse finds that the mother has gonorrhea. Which prescription should the nurse anticipate to be most beneficial to the neonate? 1. Vitamin K1 (Mephyton, Aquamephyton) 2. Vitamin D and iron supplements 3. Tetracycline ophthalmic ointment (Ocudox) 4. Hepatitis B (RECOMBIVAX HB) vaccine

3

While preparing a client for the oral glucose tolerance test (OGTT), the nurse asks the client to ingest soda which contains 80 g of carbohydrates. After 2 hours, the nurse measures the postprandial blood glucose level and concludes that the client has diabetes. Which blood glucose finding supports the nurse's conclusion? 1. 160 mg/dL 2. 190 mg/dL 3. 250 mg/dL 4. None of the above

3

The nurse is assessing the blood glucose levels of a client at regular intervals. The nurse finds 55 mg/dL of blood glucose at 2 am and150 mg/dL at 7 am. Which mechanism does the nurse suspect behind the change in the glucose levels in the client? 1. Somogyi effect 2. Dawn phenomenon 3. Prediabetes 4. None of the above

1

The nurse observes a diabetic client who has a wound that has not healed for a long time. Which condition does the nurse suspect in the client? 1. Immunosuppression 2. Peripheral neuropathy 3. Transient ischemic attack 4. Accelerated atherosclerosis

1

The nurse suspects hepatic encephalopathy in a client with severe liver dysfunction. Which symptom may support the nurse's conclusion? 1. Stupor 2. Ascites 3. Hematemesis 4. Spider angiomata

1

The nursing instructor is teaching a group of student nurses about the importance of inserting a nasogastric tube in clients with large bowel obstruction. Which statement made by the student nurse indicates effective learning? 1. "A nasogastric tube relieves pressure caused by bowel obstruction." 2. "A nasogastric tube is primarily used to deliver medications directly to the client's stomach." 3. "A nasogastric tube removes free air present under the client's diaphragm." 4. "A nasogastric tube removes the mechanical obstruction in the large intestine."

1

The nursing instructor is teaching a group of student nurses about the treatment plan for Crohn's disease. Which statement made by the student nurse indicates effective learning? 1. "Cholestyramine should be prescribed to clients with ileal disease." 2. "Loperamide should be administered in clients to reduce abdominal cramps." 3. "Propantheline dicyclomine should be used to relieve chronic diarrhea." 4. "Multivitamin supplements are contraindicated since the clients have decreased absorption."

1

The nursing instructor is teaching a group of student nurses about the use of antibiotics in a client diagnosed with appendicitis. Which statement made by the student nurse indicates effective learning? 1. "Antibiotics should be administered before an operation and should be continued until 48 hours after the operation." 2. "Antibiotics should not be administered before diagnosis, as they interfere with the diagnostic signs." 3. "Antibiotics should be administered only after restoring the fluid and electrolyte balance." 4. "Antibiotics should only be used when there is no need for surgical removal of the appendix."

1

A client complains of fatigue and arthralgia to the nurse. On physical assessment, the nurse finds that the client has hyperpigmentation of the skin. Which lab test should the nurse suggest for safe and effective care of the client? 1. Bilirubin levels 2. Serum ferritin levels 3. Ceruloplasmin levels 4. Immunoglobulins level

2

A female client is admitted to the hospital with a complaint of abdominal pain that originates in the umbilical region and radiates to the right lower quadrant. The primary health care provider has ordered a urinalysis. How will this help the primary health care provider in diagnosing the client's condition? 1. By ruling out the possibility of calcium stones within the appendix 2. By ruling out the possibility of a kidney stone or pyelonephritis 3. By ruling out the possibility of ectopic pregnancy 4. By ruling out the possibility of a gynecological disorder

2

A nurse is assessing a client who has had pain in the right upper quadrant for4 hours. The client reports that the pain is radiating to the upper thoracic region. A laboratory report suggests elevated liver enzymes and serum bilirubin. What condition should the nurse suspect from the findings? 1. Biliary tract disorder 2. Biliary colic 3. Cholecystitis 4. Acute pancreatitis

2

A nurse observes that a newborn has an abnormally positioned urethral orifice of the penis. Which disorder will the nurse suspect in the newborn? 1. Orchitis 2. Hypospadias 3. Cryptorchidism 4. Testicular torsion

2

A registered nurse is teaching about the medications for benign prostatic hyperplasia (BPH) to a group of student nurses. Which statement of a student nurse indicates the need for further teaching? 1. "Alpha-blockers improve urine flow." 2. "Alpha-blockers reduce the size of the prostate." 3. "Tamsulosin is a typical example of an alpha-blocker." 4. "Alpha-blockers relax the smooth muscles in the prostate."

2

After assessing a client with biliary cirrhosis, the nurse suspects xanthelasmas. Which laboratory test will support the nurse's conclusion? 1. Endoscopy 2. Lipid levels 3. Bilirubin levels 4. Prothrombin time

2

After examining an elderly client's penis, a nurse finds the presence of scar tissue in the corpora cavernosum. On further assessment, the nurse confirms Peyronie's disease in the client. Which finding supports the nurse's confirmation? 1. Small intrascrotal testes 2. Presence of a curved penis 3. Dilatation of the veins within the scrotum 4. Excessive growth of the prostate gland

2

After providing a volume replacement in a client, a nurse still finds the client to be hypotensive. Which action should the nurse perform in the client to provide effective care? 1. Initiate use of a nasogastric suction 2. Initiate use of a central catheter 3. Initiate use of a transhepatic T-tube 4. Initiate use of a percutaneous transhepatic biliary catheter

2

After reviewing the medical records of a 35-year-old female client, the nurse concludes that the client has metabolic syndrome. Which findings helped the nurse to reach this conclusion? 1. Triglyceride level of 140 mg/dL, waist circumference of 32 inches, and fasting blood glucose level 80 mg/dL 2. High-density lipoprotein (HDL) cholesterol of 40 mg/dL, blood pressure of 138/90 mm Hg, and fasting blood glucose level of 130 mg/dL 3. Fasting blood glucose of 90 mg/dL, triglyceride level of 120 mg/dL, and waist circumference of 30 inches. 4. Blood pressure of 120/80 mm Hg, waist circumference of 34 inches, and triglyceride level of 130 mg/dL

2

The client with alcoholic liver disease is experiencing bruising, nosebleed, and hematemesis. Which treatment option does the nurse suspect to be effective in this client? 1. Diuretics 2. Vitamin K 3. Band ligation 4. Phototherapy

2

The laboratory report of a client shows arterial blood pH of 7.6, blood glucose level of 650 mg/dL, and serum bicarbonate level of 17 mEq/L. What does the nurse infer from these laboratory findings? 1. The client has diabetic ketoacidosis. 2. The client has hyperosmolar hyperglycemic syndrome. 3. The client has prediabetes. 4. None of the above

2

The nurse is caring for a client with immune mediated type 1 diabetes. What would the nurse expect to be the cause for this condition in the client? 1. The client has hyperinsulinism. 2. The client has destruction of beta cells. 3. The client has insulin resistance. 4. Both A and B

2

What is a characteristic feature of ulcerative colitis? 1. Presence of pseudopolyps 2. Continuous areas of inflammation in the large intestine 3. Both A and B 4. None of the above

3

Which cells secrete inhibin hormone? 1. Sperm cells 2. Leydig cells 3. Sertoli cells 4. White blood cells

3

Which stage in the viral life cycle of hepatitis involves the production of antibodies? 1. Stage 1 2. Stage 2 3. Stage 3 4. Stage 4

4

Which symptom is associated with hyperosmolar hyperglycemic syndrome? 1. Severe dehydration 2. Stupor 3. Confusion 4. All of the above

4

A nurse finds increased glucose levels in a client who has chronic pancreatitis. What should the nurse interpret from the finding? 1. The client's beta cells are damaged. 2. The client has decreased pancreatic enzymes. 3. The client has high bile salts in the blood. 4. The client's gallbladder was surgically removed.

1

A registered nurse is teaching a client with dysmenorrhea about her treatment plan. Which statement made by the client indicates the need for further teaching? 1. "I should avoid the use of oral contraceptives." 2. "I should take ibuprofen as prescribed." 3. "I should consume a low-fat diet." 4. "I should perform regular exercise."

1

In a client diagnosed with large bowel obstruction, an abdominal x-ray is performed, which shows the presence of free air under the diaphragm. After the diagnosis, the nurse initiates prophylactic antibiotic therapy and fluid replacement therapy per the directions of the primary healthcare provider. Which outcome in the client indicates the effectiveness of the therapy? 1. The client has normal levels of serum amylase. 2. The client has a normal count of red blood cells. 3. The client no longer experiences abdominal cramps. 4. The client no longer experiences chronic diarrhea.

1

In a client diagnosed with terminal ileal disease, the nurse administers cholestyramine. Which outcome in the client indicates the effectiveness of the medication? 1. The urinalysis report shows normal amounts of bile acids. 2. The hematocrit report shows normal red blood cell count. 3. The client no longer experiences abdominal cramps. 4. The client no longer experiences chronic diarrhea.

1

In a client diagnosed with terminal ileal disease, the primary health care provider prescribed sulfasalazine. Which outcome in the client indicates the effectiveness of the therapy? 1. The client's gastrointestinal wall is normalized. 2. The client's hematocrit percentage is normal. 3. The client is able to absorb bile acids. 4. The client's urinalysis results show normal values.

1

The mother of an adolescent diabetic client tells the nurse, "My daughter is skipping insulin doses frequently because she is concerned about weight gain." Which condition does the nurse document for this client? 1. Insulin purging 2. Autonomic neuropathy 3. Peripheral neuropathy 4. Psychological insulin resistance

1

The nursing instructor taught a group of student nurses about the physical examination of clients with appendicitis. In the practical session, the instructor asks one of the student nurses to assess the signs of rebound tenderness in the client. Which assessment by the student nurse indicates effective learning? 1. The student nurse deeply palpates the client's abdomen and then removes pressure. 2. The student nurse palpates the left lower quadrant of the abdomen. 3. The student nurse asks the client to be in the supine position and actively flex the right thigh at the hip. 4. The student nurse asks the client to rotate his or her flexed right hip both internally and externally.

1

The primary health care provider asks a client to lie down facing upwards and flex the right thigh at the hip. The client says, "I cannot do this. This position is hurting my abdomen." Which sign of appendicitis would the nurse suspect in this client? 1. Psoas sign 2. Rovsing sign 3. Obturator sign 4. Rebound tenderness

1

The registered nurse is teaching a group of student nurses about managing hyperosmolar hyperglycemic syndrome (HHS) in clients. Which response of a student nurse indicates effective learning? 1. "Fluids should be administered before administering intravenous (IV) insulin to the client." 2. "IV insulin should be administered until blood glucose is 150 mg/dL." 3. "IV insulin administration should be followed by subcutaneous insulin." 4. "Fluid administration should be followed by IV fluid administration."

1

The registered nurse is teaching a group of student nurses about the functions of the liver. Which response of the student nurse indicates the need for further teaching? 1. "The liver synthesizes glucagon." 2. "The liver synthesizes thrombopoietin." 3. "The liver synthesizes angiotensinogen." 4. "The liver synthesizes insulin-like growth factor 1."

1

The registered nurse is teaching about the pathophysiology of nonalcoholic fatty liver disease (NAFLD) to student nurses. Which statement made by the student nurse indicates effective learning? 1. "NAFLD is linked to metabolic syndrome." 2. "Exposure to vinyl chloride can cause NAFLD." 3. "Increased level of adiponectin is associated with NAFLD." 4. "NAFLD is caused by accumulation of fat in the adipose tissue."

1

Upon physical examination, the nurse detects abdominal tenderness, increased bowel sounds accompanied by signs of borborygmi, abdominal distension, and tympany on percussion. Which diagnostic test will confirm Crohn's disease in the client? 1. Colonoscopy 2. Urinalysis 3. Complete blood count 4. Chest X-ray

1

Which antidiabetic medication is a sulfonylurea? 1. Glipizide (Glucotrol) 2. Pioglitazone (Actos) 3. Repaglinide (Prandin) 4. Metformin (Glucophage)

1

Which artery provides engorgement of the glans during erection? 1. Dorsal 2. Cavernous 3. Bulbourethral 4. Both A and C

1

Which congenital condition occurs due to thyroid hormone deficiency during embryonic development and early neonatal life? 1. Cretinism 2. Pheochromocytoma 3. Sheehan's syndrome 4. Fetal alcohol syndrome

1

Which disorder of the large intestine may require laparoscopic surgery to unwind the intestine? 1. Volvulus 2. Appendicitis 3. Hemorrhoids 4. Diverticular disease

1

Which hormone is released by the pancreas? 1. Glucagon 2. Secretin 3. Both A and B 4. None of the above

1

Which hormone produced by the intestine triggers the release of pancreatic enzymes? 1. Secretin 2. Somatostatin 3. Insulin 4. All of the above

1

Which is the largest serous membrane in the body? 1. Peritoneum 2. Submucosal layer 3. Columnar epithelium 4. Circular muscle layer

1

Which is the most common complication expected in clients with type 1diabetes? 1. Diabetic ketoacidosis 2. Hyperosmolar hyperglycemic syndrome 3. Metabolic syndrome 4. None of the above

1

Which medication is associated with the growth of endometrial polyps? 1. Tamoxifen 2. Ibuprofen 3. Haloperidol 4. Metoclopramide

1

Which part of the gastrointestinal (GI) tract is involved in the production of protective mucous? 1. Goblet cells 2. Submucosal layer 3. Circular muscle layer 4. Columnar epithelial cells

1

Which sexually transmitted disease is known as the great imposter? 1. Syphilis 2. Chlamydia 3. Gonorrhea 4. All of the above

1

While assessing a client who has liver dysfunction, the nurse finds that the client has shifting abdominal dullness. Which condition does the nurse suspect in the client? 1. Ascites 2. Splenomegaly 3. Spider angiomata 4. Esophageal varices

1

While assessing a male client, a nurse observes swelling in the scrotum due to the collection of serous fluid. Which condition does the nurse suspect in the client? 1. Hydrocele 2. Epispadias 3. Hematocele 4. Hypospadias

1

Why does the nurse use the C-peptide test for a type 1 diabetic client? 1. To evaluate residual pancreatic function 2. To monitor the status of pancreatic beta cells 3. To monitor the red blood cell count 4. None of the above

1

Which symptoms does the nurse observe in a client with hyperosmolar hyperglycemic syndrome (HHS)? Select all that apply. 1. Polyuria 2. Confusion 3. Polydipsia 4. Hypertension 5. Anorexia

1,2,3

The nurse suspects nocturnal hypoglycemia in a diabetic client. Which symptoms can the nurse expect to observe in this client? Select all that apply. 1. Sleep disturbance 2. Vivid nightmares 3. Severe dehydration 4. Morning headache 5. All of the above

1,2,4

Which symptoms are associated with autonomic neuropathy? Select all that apply. 1. Anhidrosis 2. Gastroparesis 3. Microalbuminuria 4. Paresthesias in feet 5. Postural hypotension

1,2,5

After reviewing the laboratory reports of a client with diabetes, the nurse finds that the client has diabetic ketoacidosis. Which findings support the nurse's conclusion? Select all that apply. 1. Client's arterial blood pH of 6 2. Trace elements of ketones in urine 3. Serum bicarbonate level of 12 mEq/L 4. Blood glucose level of 300 mg/dL 5. None of the above

1,3,4

Which condition shows an elevated level of white blood cells? Select all that apply. 1. Appendicitis 2. Constipation 3. Diverticular disease 4. Large bowel obstruction 5. Irritable bowel syndrome

1,3,4

A client with diabetes is prescribed exenatide (Byetta). What are the immediate effects of the drug that could be observed in the client? Select all that apply. 1. Weight loss 2. Delay in gastric emptying 3. Glucose-dependent insulin secretion 4. Improved beta cell mass and function 5. Suppression of postprandial glucagon

2,3,5

A client is brought to the hospital because of severe abdominal pain, nausea, and vomiting. The client reports increased pain in the abdomen and in the epigastric region radiating to the back when lying supine. Upon physical assessment, the nurse finds that the client has fever and hypotension. What should the nurse infer from these findings? 1. The client has cholelithiasis. 2. The client has cholecystitis. 3. The client has acute pancreatitis. 4. The client has chronic pancreatitis.

3

A client tells the nurse, "I've been feeling excessively thirsty for the last 2 days." On examination, the nurse finds the client has poor skin turgor, low blood pressure, and dry skin. A computed tomography scan of the client's head shows a pituitary tumor. Which treatment does the nurse expect to be prescribed by the primary health-care provider? 1. Bromocriptine 2. Growth hormone 3. Arginine vasopressin 4. Adrenocorticotropic hormone

3

A female client reports missed menstrual periods after discontinuing hormonal contraceptives. What could be the reason behind the missed menstrual periods? 1. Obstruction in the cervix 2. Damage to the fallopian tube 3. Hypothalamic-pituitary-ovarian dysfunction 4. Extra growth of uterine tissue

3

A night-shift nurse documents "primigravida" for a client. Which client is being referred to by the nurse? 1. The client who hasn't had a pregnancy. 2. The client who had multiple pregnancies. 3. The client who is carrying her first pregnancy. 4. The client who has delivered a baby after her first pregnancy.

3

A nurse is administering cholestyramine (Questran) to a client who is diagnosed with biliary disease. Which test should the primary health-care provider prescribe for the client to ensure safety in the client? 1. Liver function test 2. Serum cholesterol 3. Both A and B 4. None of the above

3

A nurse is caring for a client who reports abdominal distention and pain in the right upper quadrant. The nurse suspects a biliary disorder in the client. Which medication should the nurse expect the health-care provider to prescribe for the client to relieve pain? 1. Morphine 2. Codeine 3. Dilaudid 4. None of the above

3

A nurse is caring for a client who was newly diagnosed with the herpes simplex viral infection and who has been prescribed acyclovir (Zovirax). Which would be the accurate nursing intervention for the client? 1. Administering the medication once a day before dinner 2. Administering the medication with some water once a day 3. Administering the medication three times daily for 7 to 10 days 4. Administering the medication three times daily for 15 to 20 days

3

A nurse is reviewing the medical records of a client and finds that the client has multiple clusters of fleshy growths on the vagina. What should the nurse interpret from these findings? 1. The client has chancroid. 2. The client has granuloma inguinale. 3. The client has condyloma acuminata. 4. None of the above

3

A physical examination of a client exhibits Cullen sign and Grey-Turner sign. Which condition should the nurse suspect in the client? 1. Acute cholecystitis 2. Biliary disorders 3. Acute pancreatitis 4. Emphysematous cholecystitis

3

The nurse is assessing the medical records of different clients with diabetes. Client Client 1 Client 2 Client 3 Client 4 Blood pressure (BP) 130/90 mm Hg 128/90 mm Hg 115/75 mm Hg 140/90 mm Hg Low-density lipid (LDL) levels 140 mg/dL 120 mg/dL 100 mg/dL 130 mg/dL High-density lipid (HDL) levels 40 mg/dL 50 mg/dL 70 mg/dL 45 mg/dL Triglycerides 170 mg/dL 160 mg/dL 140 mg/dL 175 mg/dL Which client has a reduced risk of cardiovascular disease? 1. Client 1 2. Client 2 3. Client 3 4. Client 4

3

Which physical finding in a client will lead a nurse to suspect paraphimosis? 1. Inflammation of the testes 2. Enlargement of the prostate glands 3. Abnormal prolonged erection of the penis 4. Permanent retracted position of the foreskin behind the penis

4

A client is diagnosed with multiple endocrine neoplasia. Which sign or symptom observed in the client indicates the presence of pituitary tumors? 1. Bone pain 2. Galactorrhea 3. Gynecomastia 4. Visual disturbances

4

A client who is scheduled for a hysteroscopy asks a nurse about the procedure involved in this technique. Which statement made by the client indicates effective understanding? 1. "A radiopaque dye is used during a hysteroscopy." 2. "A scope is inserted into the uterus to take a small amount of tissue." 3. "A scope is inserted through a small surgical incision in the abdomen." 4. "A thin telescopic type device is inserted via the vagina into the uterus."

4

A digital rectal examination (DRE) in a client reveals the enlargement of the prostate gland that is firm, painless, and generalized. Which medications will the nurse anticipate from the primary health-care provider to treat the client? 1. Alpha-blockers 2. 5-alpha-reductase inhibitors 3. Phosphodiesterase inhibitors 4. Both A and B

4

A nurse instructor is teaching a group of nursing students about laparoscopic cholecystectomy. Which statement of a student nurse indicates effective learning? 1. "The client should be on bed rest for 2 weeks." 2. "The client will have severe pain after the surgery." 3. "The procedure has a high risk of complications." 4. "The client has to stay in the health care setting for less than 24 hours after the surgery."

4

A nurse instructor is teaching a group of nursing students about the pathophysiology of cholecystitis. The nursing instructor asks, "What happens during chronic cholecystitis?" Which statement of a student nurse indicates effective learning? 1. "The gallbladder is filled with purulent effusion." 2. "Perforation and gangrene are developed on the wall of the gallbladder." 3. "The gallstone passes from the cystic duct into the common bile duct." 4. "The gallbladder becomes thickened and functions poorly."

4

A nurse is assessing a client who has condyloma acuminata. Which medication should the nurse find in the client's prescription? 1. Benzathine penicillin 2. Topical podophyllin 3. Trichloroacetic acid 4. Both B and C

4

After reviewing the laboratory reports of a client, a nurse finds that the client has chronic pelvic inflammatory disorder (PID). Which condition should the nurse anticipate in the client? 1. Meningitis 2. Condyloma acuminata 3. Mild salpingitis 4. Inflammation of the fallopian tubes

4

The laboratory report of a client is as given below. Which condition does the nurse suspect in the client? Serum albumin 4 g/dL Indirect bilirubin 1.5mg/dL Prothrombin time 14 sec Alkaline phosphatase 100 U/mL 1. Coagulopathy 2. Biliary cirrhosis 3. Hypoalbuminemia 4. Gilbert's Disease

4

The nurse finds that the symptoms of thyroid dysfunction in a client are due to abnormal pituitary activity. The client's laboratory report shows a low TSH level, which supports the nurse's finding. What type of endocrine disorder is likely present in the client? 1. Primary hypothyroidism 2. Tertiary hyperthyroidism 3. Primary hyperthyroidism 4. Secondary hypothyroidism

4

The nurse finds ursodiol in a client's prescription. Which condition does the nurse suspect in the client? 1. Gilbert's syndrome 2. Alcoholic liver disease 3. Crigler-Najjar syndrome 4. Primary biliary cirrhosis

4

The nursing students are learning about precautions to be taken while caring for a client with suspected appendicitis. Which statement made by the student nurse indicates effective learning? 1. "The client should not be given IV fluids." 2. "The client should avoid taking ampicillin." 3. "The client should be given a laxative." 4. "The client should avoid taking pain medications."

4

Which complication is suspected in a client whose blood sugar is less than 30 mg/dL? 1. Bradycardia 2. Anhidrosis 3. Anorexia 4. Seizure

4

Which disorder is caused by an increase in the hormones that are secreted from the adrenal gland? 1. Addison's disease 2. Hypothyroidism 3. Diabetes mellitus 4. Cushing's syndrome

4

Which medical condition needs careful use of hormone replacement? 1. Breast cancer 2. Cardiac disease 3. Venous thrombus 4. All of the above

4