patho final questions

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? 1. Bradycardia 2. Numbness in the legs 3. Nausea and vomiting 4. A rigid, boardlike abdomen

4. A rigid, boardlike abdomen

The nurse is reviewing the laboratory results for a client with cirrhosis and notes that the ammonia level is elevated. Which diet does the nurse anticipate to be prescribed for this client? 1. Low-protein diet 2. High-protein diet 3. Moderate- fat diet 4. High-carbohydrate diet

1. Low-protein diet

The nurse is reviewing a client's record and notes that the health care provider has documented that the client has a renal function disorder. On review of the laboratory results, the nurse most likely would expect to note which finding? 1. Elevated creatinine level 2. Decreased hemoglobin level 3. Decreased red blood cell count 4. Decreased white blood cell count

1. Elevated creatinine level

The nurse is assessing a pregnant client with type 1 diabetes mellitus about her understanding regarding changing insulin needs during pregnancy. The nurse determines that further teaching is needed if the client makes which statement? 1. I will need to increase my insulin dosage during the first 3 months of pregnancy. 2. My insulin dose will likely need to be increased during the second and third trimesters. 3. Episodes of hypoglycemia are more likely to occur during the first 3 months of pregnancy. 4. My insulin needs should return to normal within 7 to 10 days after birth if i am bottle-feeding.

1. I will need to increase my insulin dosage during the first 3 months of pregnancy. Rationale: Insulin needs decrease in the first trimester of pregnancy because of increased insulin production by the pancreas and increased peripheral sensitivity to insulin. The statements in options 2,3, and 4 are accurate and signify that the client understands control of her diabetes during pregnancy.

The client is scheduled to receive 5 units of Humalog and 25 units of NPH (Isophane) insulin prior to breakfast. Which nursing intervention is most appropriate for this client? 1. Make sure the client's breakfast is available to eat before administering this insulin. 2. Offer the client a high-carbohydrate snack in 6 hours. 3. Hold the insulin if the blood glucose level is greater than 100 mg/dL. 4. Administer the medications in two separate syringes. Rationale: Humalog is a rapid-acting insulin that is administered for elevated glucose levels and should be given within 15 minutes before meals. Hypoglycemic reactions may occur rapidly if Humalog insulin is not supported by sufficient food intake

1. Make sure the client's breakfast is available to eat before administering this insulin.

The nurse is providing discharge instructions to a client who has Cushing's syndrome. Which client statement indicates that instructions related to dietary management are understood? 1. "I will need to limit the amount of protein in my diet." 2. "I should eat foods that have a lot of potassium in them." 3. "I am fortunate that I can eat all the salty foods I enjoy." 4. "I am fortunate that I do not need to follow any special diet."

2. "I should eat foods that have a lot of potassium in them."

A client has a neurological deficit involving the limbic system. Which assessment finding is specific to this type of deficit? 1. Is disoriented to person, place, and time. 2. Affect is flat, with periods of emotional lability 3. Cannot recall what was eaten for breakfast today 4. Demonstrates inability to add and subtract; does not know who is the president of the United States

2. Affect is flat, with periods of emotional lability Rationale: The limbic system is responsible for feelings (affect) and emotions. Calculation ability and knowledge of current events relate to function of the frontal lobe. The cerebral hemispheres, with specific regional functions, control orientation. Recall of recent events is controlled by the hippocampus.

The nurse provides medication instructions to a client who is taking levothyroxine (Synthroid) and should tell the client to notify the health care provider if which problem occurs? 1. Fatigue 2. Tremors 3. Cold intolerance 4. Excessively dry skin

2. Tremors

A nurse is teaching the mother of a child diagnosed with type 1 diabetes. The mother asks why her child must inject insulin and can't take pills as her uncle does. Which reply is most appropriate? 1. "Because a child's pancreas is less developed than an adult's, antidiabetic pills aren't recommended for children." 2. "Pills only affect fat and protein metabolism, not sugar." 3. "The only way to replace insulin is by injection. 4. Your child may be able to take pills when he's order

3. "The only way to replace insulin is by injection. Rationale--> In type 1 diabetes, the pancreas doesn't produce insulin, so the child must receive insulin replacement by injection. Oral antidiabetic agents stimulate the pancreas to produce more insulin and are only effective in treating type 2 diabetes. Because the pancreas in the child with type 1 diabetes doesn't produce insulin, the child will never be a candidate for oral antidiabetic agents.

The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of massive cell destruction that occurred from the chemotherapy? 1. Anemia 2. Decreased platelets 3. Increased uric acid levels 4. Decreased leukocyte count

3. Increased uric acid levels

A client has been diagnosed with gastroesophageal reflux disease (GERD). The nurse plans care, knowing that the client has dysfunction of which part of the digestive system? 1. Chief cells of the stomach 2. Parietal cells of the stomach 3. Lower esophageal sphincter (LES) 4. Upper esophageal sphincter (UES)

3. Lower esophageal sphincter (LES) Rationale: The LES is a functional sphincter that normally remains closed except when food or fluids are swallowed. If relaxation of this sphincter occurs, the client may experience symptoms of GERD

A client is taking the prescribed dose of phenytoin (Dilantin) to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/mL. Which finding would be expected as a result of this laboratory result? 1. Hypotension 2. Tachycardia 3. Slurred speech 4. No abnormal finding

3. Slurred speech

An early sign(s) of levodopa toxicity is (are) which of the following? 1. Orthostatic hypotension 2. Drooling 3. Spasmodic eye winking and muscle twitching 4. Nausea, vomiting, diarrhea

3. Spasmodic eye winking and muscle twitching

Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease. The nurse monitors the client for side/adverse effects to the medication. Which finding indicates that the client is experiencing an adverse effect? 1. Pruritis 2. Tachycardia 3. Hypertension 4. Impaired voluntary movements

4. Impaired voluntary movements

A diagnosis of Hodgkin's disease is suspected in a 12-year-old child seen in a clinic. Several diagnostic studies are performed to determine the presence of this disease. Which diagnostic test results will confirm the diagnosis of Hodgkin's disease. 1. Elevated vanillylmandelic acid urinary levels. 2. The presence of blast cells in the bone marrow. 3. The presence of Epstein-Barr virus in the blood. 4. The presence of Reed-Sternberg cells in the lymph nodes.

4. The presence of Reed-Sternberg cells in the lymph nodes. check to make sure

The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which sign, if exhibited by the client, would indicate hyperglycemia? A. Polyuria B. Diaphoresis C. Hypertension D. Increased pulse rate

A. Polyuria

The nurse evaluates that the family of a client newly diagnosed with diabetes mellitus correctly understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat which complication? A) Diabetic ketoacidosis B) Hypoglycemia from insulin overdose C) Hyperglycemia from insufficient insulin D) Hyperglycemia occurring on "sick days"

B) Hypoglycemia from insulin overdose Rationale: Glucagon is used to treat hypoglycemia resulting from insulin overdose. The family of the client is instructed in how to administer the medication. In an unconscious client, consciousness usually returns within 20 minutes of glucagon injection. After the client has regained consciousness, oral carbohydrates should be given.

Which of the following adverse effects does the nurse recognize when too much insulin has been administered? A) hypoglycemia B) Tachycardia C) convulsions D) all of the above

D) all of the above

The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which sign, if exhibited by the client, would indicate hyperglicemia A. Diaphoresis B. Polyuria C. Hypertension D. Increased pulse rate

Polyuria Rationale: classic symptoms of hyperglycemia include the three P's: polyuria, polydipsia, and polyphagia.

Which antiseizure medication may produce psychotic behavior symptoms? a) Ethosuximide (Zarontin) b) Mephobarbital (Mebaral) c) Lorazepam (Ativan) d) Gabapentin (Neurontin)

a) Ethosuximide (Zarontin)

A patient has been diagnose if SIADH. Which intervention would be most appropriate when caring for this patient? a. Administer diuretics and IV fluids that do not contain water. b. Increase fluid intake as prescribed. c. Provide stimulated environment to keep patient awake enough to have appropriate level of consciousness. d. Administer medications that stimulate ADH- induced water reabsorption.

a. Administer diuretics and IV fluids that do not contain water.

The health care provider has ordered pancrelipase, 10000 units BID to a patient with chronic pancreatitis. The nurse sure know that this drug should be administered: a. just prior to a meal b. before bedtime c. with as little liquid as possible d. with milk or an antacid

a. just prior to a meal Rationale: Pancreatic enzyme replacements should be taken with all meals and snacks because it aids with digestion.

Vasopressin is prescribed for which primary symptom? a. altered metabolism b. polyuria c. inflammation d. high WBC count

b. polyuria

Assessment is the most important step of the nursing process in preventing medication errors by which of the following? 1. Having the patient state the outcome of the medication 2. Obtaining allergy and medication history information 3. Advising the patient to question the nurse about medication 4. Planning the correct times for the patient to take medications

2. Obtaining allergy and medication history information

A male client is recovering from an ileostomy. During discharge teaching, the nurse should stress the importance of: A) increasing fluid intake to prevent dehydration B) wearing an appliance pouch only at bedtime C) consuming a low-protein, high-fiber die D) taking only enteric-coated medications

A) increasing fluid intake to prevent dehydration

A client taking lithium carbonate reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.5mEq/L.The nurse would know that this level is indicative of which finding? A) toxic B) normal C) slightly above normal D) excessively below normal

A) toxic

The nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of which condition? A. Graves' disease B. Addison's disease C. Myxedema D. Cushing's syndrome

A. Graves' disease

The community healthy nurse visits a client at home. Prednisone, 10 mg orally daily, has been prescribed for the client and the nurse teaches the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary? A. I can take aspirin or my antihistamine if I need it. B. I need to take the medication everyday, at the same time. C. I need to avoid coffee, tea, cola and chocolate in my diet. D. If I gain more than 5 pounds in a week, I will call my health care provider.

A. I can take aspirin or my antihistamine if I need it.

Which statement accurately describes the genetic implications of cystic fibrosis? A. If it is present in a child, both parents are carriers of the defective gene. B. It is inherited as an autosomal dominant trait. C. An affected child's siblings will have a 50% chance of phenotypic expression. D. It is a genetic defect most notably found through the Jewish population.

A. If it is present in a child, both parents are carriers of the defective gene.

A patient with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which sign indicates an adverse effect specific for this medication? A. Peripheral Neuropathy B. Tachycardia C. Diarrhea D. Weight gain

A. Peripheral Neuropathy Rationale: Peripheral neuropathy occurs in almost every patient taking vincristine. Peripheral neuropathy is numbness or tingling in the fingers and toes.

The nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching? A. Withdraws the NPH insulin first. B. Withdraws the regular insulin first C. Injects air into the NPH insulin vial first. D. Injects an amount of air equal to the desired dose of insulin into each vial.

A. Withdraws the NPH insulin first. Rationale: When preparing a mixture of short-acting insulin such as regular insulin with another insulin preparation, the short-acting insulin is drawn into the syringe first. This sequence will avoid contaminating the vial of short-acting insulin with insulin of another type. Options B, C, and D identify correct actions for preparing NPH and short-acting insulin.

Assessment is the most important step of the nursing process in preventing medication errors by which of the following? A. Having the patient state the outcome of the medication B. Obtaining allergy and medication history information C. Advising the patient to question the nurse about medications D. Planning the correct times for the patient to take medications

B. Obtaining allergy and medication history information

Persons with type I or type II diabetes who are not able to achieve glucose control by the use of insulin alone might be administered this insulin adjunt, resembling a natural hormone found in beta cells of the pancreas. A) Metformin (Glucophage) B) Pramlintide (Symlin) C) Novolog Mix D) Humalog Mix

B) Pramlintide (Symlin)

A patient who has been prescribed the antiparkinsonian medication carbidopa/levodopa, asks the health care provider, "Why am I getting these two medications?" How should the healthcare provider respond? A. "The levodopa turns the carbidopa into dopamine when it reaches the brain." B. "The carbidopa prevents the breakdown of the levadopa." C. "This drug combination is composed of two types of the same medication." D. "You will experience fewer side effects when you take both medications together."

B. "The carbidopa prevents the breakdown of the levadopa."

A patient who is taking corticosteroids says, "My face is getting rounder. Will this go away?" What is your best response? A. "This is a normal side effect of corticosteroids, but try to lose weight." B. "This is a common side effect and will begin to go away when the therapy stops." C. "You must be having an allergic reaction to the drug. Stop taking it and notify your prescriber." D. "As soon as you finish the therapy, your face will look normal again."

B. "This is a common side effect and will begin to go away when the therapy stops."

Ascites is the primary mechanism of body fluid imbalance in which of the following conditions? A. Salt-losing tubulopathy B. Cirrhosis C. AIDS D. Isonatremic dehydration

B. Cirrhosis

What do you do when a Parkinson's patient comes to a step and "Freezes" and does not step up? A. Let patient work through the problem by them self. B. Clap your hands or make a loud noise. C. This is not a real thing that happens with Parkinson's Disease. D. The patient can not comprehend how to do thus the patient will turn around and find a different route.

B. Clap your hands or make a loud noise. Rationale: Making a loud noise or clapping brings the patient back to reality so to speak and allows them to remember how to step up or do the function that normal people do on an everyday basis.

A patient with hemophilia came in after a fall. The nurse is aware the patient will recieve A. Iron B. Factor VIII C. a heat pack D. Vitamin K

B. Factor VIII

A patient has been placed on Levothyroxine (Synthroid). What disease process indicates treatment with this prototypical drug? A. Cushing's syndrome B. Hypothyroidism C. Acromegaly D. Depression

B. Hypothyroidism

The nurse is caring for a client who begins to experience seizure activity while in bed. Which action by the nurse contraindicated? A. Loosening restrictive clothing. B. Restraining the client's limbs C. Removing the pillow and raising padded side rails. D. Positioning the client to the side, if possible, with the head flexed forward.

B. Restraining the client's limbs Rationale: Nursing actions during a seizure include providing for privacy, loosening restrictive clothing, removing the pillow and raising padded side rails in the bed, and placing the client on one side with the head flexed forward, if possible, to allow the tongue to fall forward and facilitate drainage. The limbs are never restrained because the strong muscle contractions could cause the client harm. If the client is not in bed when seizure activity begins, the nurse lowers the client to the floor, if possible, protects the head from injury, and moves furniture that may injure the client.

A nurse prepares a teaching plan for a patient receiving an antineoplastic medication. When implementing the plan, the nurse should make which statement to the patient? A. "You can take aspirin (acetylsalicylic acid) as needed for headache." B. "You can drink alcoholic beverages in moderate amounts each evening." C. "You need to consult with the health care provider (HCP) before receiving immunizations." D. "You can receive a flu vaccine at the local health fair without HCP approval because the flu is so contagious."

C. "You need to consult with the health care provider (HCP) before receiving immunizations." Rationale: Antineoplastic medications decrease the immune system, so immunizations increase the risk of infection in these patients instead of preventing illness as they are intended to do.

When assessing a group of patients which patient might she suspect would need further diagnostic testing for cancer? a. 58-year-old female with excessive weight gain, depression, and WBC 8.3 b. 6-month-old male with a fever of 100.2 and a cough c. 26 year old female with unexplained weight loss, swollen lymph nodes, and a daily fever in the afternoon d. 40-year-old male with a blood pressure of 140/90, sweating excessively, and pulse of 95

C. 26-YEAR-OLD FEMALE WITH UNEXPLAIN WEIGHT LOSS, SWOLLEN LYMPH NODES, AND A DAILY FEVER IN THE AFTERNOON

Darbepoetin (Aranesp) is ordered for each of the following clients. The nurse would question the order for which condition? A. A client with chronic renal failure. B. A client with AIDS who is recieving anti-AIDS drug therapy. C. A client with hypertension. D. A client on chemotherap for cancer.

C. A client with hypertension. Rationale: Darbepoetin (Aranesp) and other similar drugs should not be used or are used cautiously in the clients with hypertension because they may have increased blood pressure.

A low-income patient without insurance has been prescribed several different medications over several months for seizure control without any improvement. The patient indicates she has not experienced any adverse effects. At this point the nurse should: A. Call the doctor to reevaluate the patient B. Have the doctor to change the patient's seizure medication. C. Assess for medication compliance. D. Reassure the patient that everything is fine since there are no adverse effects occurring.

C. Assess for medication compliance.

A client diagnosed with hypothyroidism is taking levothyroxine (Synthroid). The client returns to the clinic 1 week after beginning the medication and tells the nurse that the medication has not helped. What is the appropriate response to the client? A. A higher dosage is required. B. The medication may need to be changed C. Full therapeutic effect may take 1 to 3 weeks D. Full therapeutic effect may take up to 3 months

C. Full therapeutic effect may take 1 to 3 weeks

The patient is diagnosed with adrenocortical insufficiency, known as Addison's Disease. Which medication would the nurse expect the physician to prescribe for this patient? A. Metoclopramide (Reglan) B. Oseltamivir (Tamiflu) C. Hydrocortisone (Cortef) D. Betamethasone (Celestone)

C. Hydrocortisone (Cortef)

The nurse explains to the parents of a 1-year-old child admitted to the hospital in a sickle cell crisis that the local tissue damage the child has on admission is caused by which of the following? A. Autoimmune reaction complicated by hypoxia B. Lack of oxygen in the red blood cells C. Obstruction to circulation D. Elevated serum bilirubin concentration.

C. Obstruction to circulation

The nurse provides instructions to a client who is taking levothyroxine (Synthroid). The nurse should tell the client to take the medication at which time? A. With food B. At lunchtime C. On an empty stomach D. At bedtime with a snack

C. On an empty stomach Rationale: oral doses of levothyroxine (Synthroid) should be taken on an empty stomach to enhance absorption. Dosing should be done in the morning before breakfast.

After several diagnostic tests, a client is diagnosed with diabetes insipidus. The nurse performs an assessment on the client, knowing that which symptom is MOST indicative of this disorder? A. Fatigue B. Diarrhea C. Polydipsia D. Weight gain

C. Polydipsia

The RN on the hospital floor is teaching the student nurses how to care for a patient who has parkinson's disease. Which of the following interventions is incorrect? A. Provide pt with a hight calorie, high protein, high fiber soft diet with small frequent feedings B. Avoid rushing client with activities C. Teach client to eat food high in Vitamin B6 D. Administer Levodopa to treat Parinkson's

C. Teach client to eat food high in Vitamin B6 Rationale: you want to teach patient to avoid foods that are high in Vitamin B6 because they can block the effects of antiparkinsonian medication.

The nurse should plan to implement which intervention in the care of a client experiencing neutropenia related to chemotherapy? A. Restrict all visitors B. Reduce fluid intake C. Teach the patient and family about the need for hand hygiene D. Insert and indwelling catheter to prevent skin breakdown

C. Teach the patient and family about the need for hand hygiene

An 84 year old man tells the nurse that he has not had a bowel movement in four days, although he has been eating all of his meals. What is the best non-pharmacolgic treatment for the nurse to implement? A.) provide the client with meals high in protein B.) recommend yoga classes for the client C.) assist the client in walking around the floor several times a day D.) tell the client to try to eat less of his meals

C.) assist the client in walking around the floor several times a day

The nursing instructor asks a student to describe the pathophysiology that occurs in Cushing's disease. Which statement by the student indicates an accurate understanding of the disorder? A. "Cushing's disease results from an oversecretion of insulin." B. "Cushing's disease results from an undersecretion of corticotropic hormones." C. "Cushing's disease results from an undersecretion of mineralocorticoid hormones." D. "Cushing's disease results from an increased pituitary secretion of adrenocorticotropic hormone."

D. "Cushing's disease results from an increased pituitary secretion of adrenocorticotropic hormone."

The nurse is providing teaching to a patient diagnosed with iron deficiency anemia and will be taking iron supplements. Which statement made by the patient indicates the teaching was successful? A. "I should eliminate fiber rich foods from my diet." B. "I should be sure to chew the tablet before swallowing it." C. "I will take the medication on an empty stomach." D. "I need to increase my daily fluid intake."

D. "I need to increase my daily fluid intake." Rationale: Iron supplements can cause constipation so increasing fluids and fiber in the diet will help prevent this side effect. Iron supplements can cause GI irritation and are not advised to be taken on an empty stomach. They are not to be chewed upon administration.

The nurse is teaching a patient with type 2 diabetes about his treatment plan. Which statement made by the patient indicates an understanding of a treatment for this disorder? A. "I take oral insulin instead of shots." B. "By taking these medications, I am able to eat more." C. "When I become ill, I need to increase the number of pills I take." D. "The medication I am taking help release the insulin I already make."

D. "The medication I am taking help release the insulin I already make." Rationale: Clients with type 2 diabetes have decreased insulin secretion. Ora medications, such as Metformin, are given to decrease glucose production and increase sensitivity to insulin. This will cause the maintnance of blood glucose levels. Insulin injections may be given during periods of illness. Oral insulin is not available. Metformin is used conjunctively with diet, exercise, and sometimes insulin.

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? A. Bradycardia B. Numbness of the legs C. Nausea and vomiting D. A rigid, boardlike abdomen

D. A rigid, boardlike abdomen

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? A. Bradycardia B. Numbness of the legs C. Nausea and vomiting D. A rigid, boardlike abdomen

D. A rigid, boardlike abdomen

The nurse is assessing the adaptation of a client to changes in functional status after a stroke. Which observation indicates to the nurse that the client is adapting most successfully? A. Gets angry with family if they interrupt a task B. Experiences bouts of depression and irritability C. Has difficulty with using modified feeding utensils D. Consistently uses adaptive equipment in dressing self

D. Consistently uses adaptive equipment in dressing self

A client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which finding would indicate to the nurse that the client is experiencing an adverse effect related to the medication? A. Fever B. Sores in the mouth and throat C. Complaints of nausea and vomiting D. Crackles on auscultation of the lungs

D. Crackles on auscultation of the lungs

A client with non-Hodkin's lymphoma is receiving daunorubivin (DaunoXome). Which finding would indicate to the nurse that the client is experiencing an adverse effect related to the medication? A. Fever B. Sores in the mouth and throat C. Complaints of nausea and vomiting D. Crackles on auscultation of the lungs

D. Crackles on auscultation of the lungs

A client is admitted to the hospital with a suspected diagnosis of Hodgkin's disease. Which assessment finding would the nurse expect to note specifically in the client. A. Fatigue B. Weakness C. Weight gain D. Enlarged lymph nodes

D. Enlarged lymph nodes Rationale: Hodgkin's disease is a chronic progressive neoplastic disorder of lymphoid tissue characterized by the painless enlargement of lymph nodes with progression to extralymphatic sites.

The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instruction? A. Stress B. Trauma C. Infection D. Fluid Overload

D. Fluid Overload

An external insulin pump is prescribed for a client with diabetes mellitus and the client asks the nurse about the functioning of the pump. The nurse bases the response on which information about the pump? A. It is timed to release programmed doses of short-duration or NPH insulin into the bloodstream at specific intervals B. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels C. Is surgically attached to the pancreas and infuses regular insulin into the pancrea, which in turn releases the insulin into the bloodstream D. Gives a small continuous dose of short-duration insulin subcutaneously, and the client can self-administer a bolus with an additional dose from the pump before each meal

D. Gives a small continuous dose of short-duration insulin subcutaneously, and the client can self-administer a bolus with an additional dose from the pump before each meal

Mr. Jones was recently diagnosed with early-onset Alzheimer's disease after showing symptoms of the disease. His doctor prescribed the patient Aricept for the disease. Which of the following considerations is appropriate to teach the client about this drug? A. Mr. Jones should be monitored for hypertension. B. Taking this drug regularly for 6 months will reverse memory loss. C. Aricept will help with insomnia in Alzheimer's patients. D. Mr. Jones should take this drug with food/milk to prevent GI upset.

D. Mr. Jones should take this drug with food/milk to prevent GI upset.

The nurse is performing an assessment on a client with a diagnosis of pernicious anemia. Which finding would the nurse expect to note in this client? A. Dysnea B. Dusky mucous membranes C. Shortness of breath on exertion D. Red tongue that is smooth and sore

D. Red tongue that is smooth and sore

A client with pernicious anemia asks why she must take vitamin B12 injections for the rest of her life. What is the nurse's best response? a "The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient acid." b "The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient intrinsic factor." c "The reason for your vitamin deficiency is an excessive excretion of the vitamin because of kidney dysfunction." d "The reason for your vitamin deficiency is an increased requirement for the vitamin because of rapid red blood cell production."

b "The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient intrinsic factor."

What should you manifestations should you assess for to determine if a client has Parkinson's? a) increased blood pressure, loss of consciousness, and rigidity b) tremor, rigidity, bradykinesia, and postural instability c) loss of memory, apraxia, tremors, and depression d) fatigue, heat sensitivity, impaired speech, and bradykinesia

b) tremor, rigidity, bradykinesia, and postural instability

The RN is assessing an undiagnosed client with complaints of unexplained weight gain and decline in memory. The nurse notices that the client's serum TSH lab value is elevated. What would the nurse expect to be the cause of these symptoms? a. Hyperthyroidism b. Hypothyroidism c. Cushing's syndrome d. Addison's disease

b. Hypothyroidism

The nurse is caring for the client with increased intracranial pressure. The nurse would note which trend in vital signs if the intracranial pressure is rising? a. Increasing temperature, increasing pulse, increasing respirations, decreasing blood pressure b. Increasing temperature, decreasing pulse, decreasing respirations, increasing blood pressure c. Decreasing temperature, decreasing pulse, increasing respirations, decreasing blood pressure d. Decreasing temperature, increasing pulse, decreasing respirations, increasing blood pressure.

b. Increasing temperature, decreasing pulse, decreasing respirations, increasing blood pressure Rationale: A change in vital signs may be a late sign of increased intracranial pressure. Trends include increasing temperature and blood pressure and decreasing pulse and respirations. Respiratory irregularities also may occur.

A patient taking phenytoin (Dilantin) chronically for seizures should be encouraged to maintain good oral hygiene and visit the dentist every 6 months. phenytoin does which of the following in patients? a. causes cavities b. causes gingival hyperplasia c. causes mouth cancers d. builds up tartar on the teeth

b. causes gingival hyperplasia

A patient has been diagnosed with metastatic lung cancer. The patient asks the nurse, "What does metastatic mean?" The nurse's best reply is: a.) The cancer is confined to only one region of your lung. b.) The cancer has spread from the first place it started in the body to another part of the body. c.) Metastatic means it is easily curable. d.) That metastatic is the medical term for the lower portion of your lung.

b.) The cancer has spread from the first place it started in the body to another part of the body.

While caring for a patient with Alzheimer's disease who is receiving Donepezil (Aricept), the patient's daughter states, "I'm so glad we finally figured out what was wrong with mom, this new medicine can help cure her and she will go back to her normal self." What response by the nurse is most appropriate in order to provide proper education on Alzheimer's disease? a "Yes, your mother should be cured in abuot 3-6 weeks!" b "You are very wrong, there is no cure for Alzheimer's disease." c "Unfortunately, Alzheimer's is not a curable disease. Medications used in patients with Alzheimer's disease can only slow the progression of the disease." d "The purpose of the medications used in patients with Alzheimer's actually increase memory loss, improves behavior and improves activities of daily living. So, your mother should be back to her old self in no time."

c "Unfortunately, Alzheimer's is not a curable disease. Medications used in patients with Alzheimer's disease can only slow the progression of the disease."

If a patient is diagnosed with Huntington's disease, what is your top priority as an advocate for this patient? a. Insist that the patient get a secondary opinion b. Inform the patient that they only have a few months to live, so they should enjoy their time c. Advise the patient's family to participate in genetic counseling d. Inform the patient that they will be able to live a normal life

c. Advise the patient's family to participate in genetic counseling Rationale: Huntington's disease is genetic and can be passed on to offspring. Like any disease, early identification and treatment is the key. If any family member can be tested for the gene, there could be more treatment options and a better transition.

In promoting health maintenance for prevention of strokes, the nurse understands that the highest risk for the most common type of stroke is present in a. African Americans b. women who smoke c. individuals with hypertension and diabetes d. those who are obese with high dietary fat intake

c. individuals with hypertension and diabetes

A client with gastrointestinal hypermotility has a prescription to receive atropine sulfate. The nurse should withhold the medication and question the prescription if the client has a history of which disease process? a Biliary colic b Sinus bradycardia c Peptic ulcer disease d narrow-angle glaucoma

d narrow-angle glaucoma Rationale: atropine sulfate can cause a blockade of muscarinic receptors on the iris sphincter, producing mydriasis (dilation of the pupils). It also produces cycloplegia (relaxation of the ciliary muscles). It is contraindicated in clients with narrow-angle glaucoma. The other options are therapeutic reasons for using the medication.

The nurse is assessing a patient with gastroesophageal reflux disease (GERD) who is experiencing increasing discomfort. Which patient statement indicates that additional patient education about GERD is needed? a. "I take antacids between meals and at bedtime each night." b. "I quit smoking several years ago, but I still chew a lot of gum." c. "I sleep with the head of the bed elevated on 4-inch blocks." d. "I eat small meals throughout the day and have a bedtime snack."

d. "I eat small meals throughout the day and have a bedtime snack." Rationale: GERD is exacerbated by eating late at night, and the nurse should plan to teach the patient to avoid eating at bedtime. The other patient actions are appropriate to control symptoms of GERD.

The nurse is providing instructions to a client with a diagnosis of Addison's disease regarding the administration of prescribed glucocorticoids. The nurse should provide which instruction to the client? a. To stop the medication if side effects occur. b. To avoid taking the medication if nausea occurs c. That minimal side effects will occur with use of this medication d. That an increased dose of medication may be needed during times of stress

d. That an increased dose of medication may be needed during times of stress

A client who has a history of psychomotor seizures has received a prescription for Depakote. The nurse understands all of the following about this drug EXCEPT: a. The client may experience abdominal cramps and diarrhea as a side effect. b. The client may experience constipation as a side effect. c. The client will require periodic liver function tests. d. The client may experience visual abnormalities

d. The client may experience visual abnormalities Rationale: The client may experience visual abnormalities. This is not a common side effect of Depakene aka Valproic acid. All of the other possible side effects listed may occur with the use of the medication.