Prep U Exam 3

Which statement indicates that a client with diabetes mellitus understands proper foot care?

"I'll wear cotton socks with well-fitting shoes."

After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy?

6-12 months

Which statement describes emphysema?

A disease of the airways characterized by destruction of the walls of overdistended alveoli

A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl. His family reports that he has been skipping meals in an effort to lose weight. Which nursing intervention is most appropriate?

Administering 1 ampule of 50% dextrose solution, per physician's order

A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client?

Blood glucose level 1,100 mg/dl

Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse's concern? Select all that apply.

Compromised gas exchange Decreased airflow Wheezes

During a follow-up visit 3 months after a new diagnosis of type 2 diabetes, a client reports exercising and following a reduced-calorie diet. Assessment reveals that the client has only lost 1 pound and did not bring the glucose-monitoring record. Which value should the nurse measure?

Glycosylated hemoglobin level

A client with a 20-year history of hypothyroidism who has not been compliant with taking thyroid replacement therapy is brought into the ED with a diagnosis of myxedema coma. What client symptoms are consistent with this life-threatening event? Select all that apply

Hypothermia Hypotension Hypoventilation

NPH is an example of which type of insulin?

Intermediate acting

Which statement is correct regarding glargine insulin?

It cannot be mixed with any other type of insulin.

Which type of insulin acts most quickly?

Lispro

The nurse is reviewing client lab work for a critical lab value. Which value is called to the physician for additional orders?

Potassium: 5.8 mEq/L

In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances?

Respiratory acidosis

A client with nausea, vomiting, and abdominal cramps and distention is admitted to the health care facility. Which test result is most significant?

Serum potassium level of 3 mEq/L

A nurse explains to a client with thyroid disease that the thyroid gland normally produces:

T3, thyroxine (T4), and calcitonin.

A male client, aged 42 years, is diagnosed with diabetes mellitus. He visits the gym regularly and is a vegetarian. Which of the following factors is important when assessing the client?

The client's consumption of carbohydrates

A nurse is preparing to administer two types of insulin to a client with diabetes mellitus. What is the correct procedure for preparing this medication?

The short acting insulin is drawn up before the intermediate

A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason?

Underlying problem of insulin resistance

Which action should the nurse take first in caring for a client during an acute asthma attack?

administer bronchodilator as ordered

A client presents to the emergency department with fluid overload. The nurse is concerned about fluid accumulation in the lungs. On which of the following areas would the nurse focus the lung assessment?

bilateral lower lobes

The adrenal cortex is responsible for producing which substances?

glucocorticoids and androgens

Which feature(s) indicates a carpopedal spasm in a client with hypoparathyroidism?

hand flexing inward

Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis?

hypokalemia and hypoglycemia

A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate?

myxedema coma

A patient describes his chest pain as knife-like on inspiration. Which of the following is the most likely diagnosis?

pleurisy

The client has just had an invasive procedure to assess the respiratory system. What does the nurse know should be assessed on this client?

respiratory distress

The diabetic client asks the nurse why shoes and socks are removed at each office visit. Which assessment finding is most significant in determining the protocol for inspection of feet?

sensory neuropathy

A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient?

sputum and a productive cough

A client is diagnosed with hypocalcemia and the nurse is teaching the client about symptoms. What symptom would the nurse include in the teaching?

tingling sensation in the fingers

A nurse assesses a client's respiratory status. Which observation indicates that the client is having difficulty breathing?

use of accessory muscles

Which of the following is not a primary symptom of COPD?

weight gain

A nurse is preparing dietary recommendations for a client with a lung abscess. Which statement would be included in the plan of care?

"You must consume a diet rich in protein, such as chicken, fish, and beans."

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?

"Your body is using protein and fat for energy instead of glucose."

Which statement is true regarding gestational diabetes?

A glucose challenge test should be performed between 24 and 28 weeks.

Which of the following is accurate regarding status asthmaticus?

A severe asthma episode that is refractory to initial therapy

Which clinical characteristic is associated with type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus)?

Blood glucose can be controlled through diet and exercise

During the physical examination of a client with a suspected endocrine disorder, the nurse observes an abnormal bulging of the eyes. The nurse documents this finding as which of the following?

Exophthalmos

To confirm an acid-base imbalance, it is necessary to assess which findings from a client's arterial blood gas (ABG) results? Select all that apply.

HCO3 PaCO2 pH

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems?

Hypercapnia, hypoventilation, and hypoxemia

A client is admitted to the hospital and will be undergoing tests to determine if he has an abdominal mass. What should the nurse be sure to document when asking about allergies?

If the client is allergic to seafood

A priority nursing intervention for a client with hypervolemia involves which of the following?

Monitoring respiratory status for signs and symptoms of pulmonary complications.

In which statements regarding medications taken by a client diagnosed with COPD do the the drug name and the drug category correctly match? Select all that apply.

Prednisone is a corticosteroid. Ciprofloxacin is an antibiotic. Albuterol is a bronchodilator.

The pancreas continues to release a small amount of basal insulin overnight, while a person is sleeping. The nurse knows that if the body needs more sugar:

The pancreatic hormone glucagon will stimulate the liver to release stored glucose.

A nurse caring for a patient with a pulmonary embolism understands that a high ventilation-perfusion ratio may exist. What does this mean for the patient?

Ventilation exceeds perfusion.

On auscultation, which finding suggests a right pneumothorax?

absence of breath sounds in the right thorax

A nurse working in the radiology clinic is assisting with a client having an unusual arterial procedure. What assessment should the nurse notify the health care provider about?

absent distal pulses

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?

accuracy of the dosage

The nurse assesses a patient with a heart rate of 42 and a blood pressure of 70/46. What type of hypoxia does the nurse determine this patient is displaying?

circulatory hypoxia

The nurse is collaborating with a community group to develop plans to reduce the incidence of lung cancer in the community. Which of the following would be most effective?

classes at a community center that teach about smoking cessation

What interventions can the nurse encourage the client with diabetes insipidus to do in order to control thirst and compensate for urine loss?

consume adequate amounts of fluids

A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic nephropathy. Which of the following suggestions would be most important?

control blood glucose levels

A nurse is caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer

cough or change in chronic cough

A client appears to be breathing faster than during the last assessment. Which of the following interventions should the nurse perform?

count the rate of respirations

The nurse is caring for a patient with a pulmonary disorder. What observation by the nurse is indicative of a very late symptom of hypoxia?

cyanosis

Which nerve is implicated in the Chvostek's sign?

facial

A client has been recently diagnosed with type 2 diabetes, and reports continued weight loss despite increased hunger and food consumption. This condition is called:

polyphagia

While assessing a client with hypoparathyroidism, the nurse taps the client's facial nerve and observes twitching of the mouth and tightening of the jaw. The nurse would document this finding as which of the following?

positive Chovstek's sign

Resistance to a first-line antituberculotic agent in a client who has not received previous treatment is referred to as

primary drug resistance

Which is the primary reason for encouraging injection site rotation in an insulin dependent diabetic?

promote absorption

A client visits the physician's office complaining of agitation, restlessness, and weight loss. The physical examination reveals exophthalmos, a classic sign of Graves' disease. Based on history and physical findings, the nurse suspects hyperthyroidism. Exophthalmos is characterized by:

protruding eyes and a fixed stare

A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia?

sweating, tremors, and tachycardia

The nurse suctions a patient through the endotracheal tube for 20 seconds and observes dysrhythmias on the monitor. What does the nurse determine is occurring with the patient?

the patient is hypoxic from suctioning

Which hormones are secreted by the posterior lobe of the pituitary gland? Select all that apply

vasopressin, oxytocin

After lobectomy for lung cancer, a client receives a chest tube connected to a disposable chest drainage system. The nurse observes that the drainage system is functioning correctly when she notes tidal movements or fluctuations in which compartment of the system as the client breathes?

water-seal chamber

The nurse practitioner who assesses a patient with hyperthyroidism would expect the patient to report which of the following conditions?

weight loss

The nurse is performing chest auscultation for a patient with asthma. How does the nurse describe the high-pitched, sibilant, musical sounds that are heard?

wheezes

A nurse is teaching a client with adrenal insufficiency about corticosteroids. Which statement by the client indicates a need for additional teaching?

"I may stop taking this medication when I feel better."

A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement by the client indicates the need for additional discharge teaching?

"I will increase my fluid and calcium intake."

A nursing student asks the instructor why the pituitary gland is called the "master gland." What is the best response by the instructor?

"It regulates the function of other endocrine glands."

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:

"It tells us about your sugar control for the last 3 months."

A nurse is teaching a client recovering from diabetic ketoacidosis (DKA) about management of "sick days." The client asks the nurse why it is important to monitor the urine for ketones. Which statement is the nurse's best response?

"Ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. Ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy.

A client is to receive hypotonic IV solution in order to provide free water replacement. Which solution does the nurse anticipate administering?

0.45% NaCl

A nurse is teaching a client about bronchodilators. What bronchodilator actions that relieve bronchospams should the nurse include in the client teaching? Select all that apply.

Alter smooth muscle tone Reduce airway obstruction Increase oxygen distribution

For a client with an endotracheal (ET) tube, which nursing action is the most important?

Auscultating the lungs for bilateral breath sounds

You are caring for a new client on your unit who is third-spacing fluid. You know to assess for what type of edema?

Generalized

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?

Presence of autoantibodies against islet cells

A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?

Serum glucose level of 52 mg/dl

The nurse is assisting a physician with an endotracheal intubation for a client in respiratory failure. It is most important for the nurse to assess for:

Symmetry of the client's chest expansion

When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect:

a blood pressure of 176/88 mm Hg

For a client with hyperthyroidism, treatment is most likely to include:

a thyroid hormone antagonist

Which is a clinical manifestation of diabetes insipidus?

excessive thirst

An elderly client takes 40 mg of furosemide twice a day. Which electrolyte imbalance is the mostserious adverse effect of diuretic use?

hypokalemia

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?

insulin production is insufficient

What is histamine, a mediator that supports the inflammatory process in asthma, secreted by?

mast cells

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 6:30 AM will reach peak effectiveness by:

0830

A client has recently been diagnosed with malignant lung cancer. The nurse is calculating the client's smoking history in pack-years. The client reports smoking two packs of cigarettes a day for the past 11 years. The nurse correctly documents the client's pack-years as

22

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?

Dietitian

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?

Increases ability for glucose to get into the cell and lowers blood sugar

The nurse is administering an insulin drip to a patient in ketoacidosis. What insulin does the nurse know is the only one that can be used intravenously?

Regular

A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously?

Regular insulin

A nurse is instructing a client with newly diagnosed hypoparathyroidism about the regimen used to treat this disorder. The nurse should state that the physician probably will order daily supplements of calcium and:

Vitamin D

A client is on a ventilator. Alarms are sounding, indicating an increase in peak airway pressure. The nurse assesses first for

a kink in the ventilator tubing

A client with exacerbation of chronic obstructive pulmonary disease (COPD) is scheduled for a thoracentesis. Which nursing intervention would be appropriate for client saftey?

administer a pen cough supressant

A nurse is reviewing the laboratory order for a client suspected of having an endocrine disorder. The lab slip includes obtaining cortisol levels. What is being tested?

adrenal function

A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate?

albumin

A client who works construction and has been demolishing an older building is diagnosed with pneumoconiosis. This lung inflammation is most likely caused by exposure to:

asbestos

A nurse prepares to perform postural drainage. How should the nurse ascertain the best position to facilitate clearing the lungs?

auscultation

Which information should be included in the teaching plan for a client receiving glargine, which is "peakless" basal insulin?

do not mix with other insulins

A nurse explains the role of the ovaries. Which hormones would be included in that discussion?

estrogen and progesterone

Class 1 with regard to TB indicates

exposure and no evidence of infection

A client with severe hypervolemia is prescribed a loop diuretic and the nurse is concerned with the client experiencing significant sodium and potassium losses. What drug was most likely prescribed?

furosemide

The nurse is reviewing a client's history which reveals that the client has had an over secretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as which of the following?

gigantism

A woman with a progressively enlarging neck comes into the clinic. She mentions that she has been in a foreign country for the previous 3 months and that she didn't eat much while she was there because she didn't like the food. She also mentions that she becomes dizzy when lifting her arms to do normal household chores or when dressing. What endocrine disorder should the nurse expect the physician to diagnose?

goiter

A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which symptom when caring for this client?

hypoglycemia

A client with diabetes mellitus is receiving an oral antidiabetic agent. When caring for this client, the nurse should observe for signs of:

hypoglycemia

A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. What are classic symptoms associated with diabetes?

increased thirst, hunger, and urination

A client who underwent surgery 12 hours ago has difficulty breathing. He has petechiae over his chest and complains of acute chest pain. What action should the nurse take first?

initiate oxygen therapy

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?

ketoacidosis

A client with chronic obstructive pulmonary disease (COPD) is intubated and placed on continuous mechanical ventilation. Which equipment is most important for the nurse to keep at this client's bedside?

manual resuscitation bag

A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?

metformin

A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia?

nervousness, diaphoresis, confusion

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?

parathyroid gland

During a follow-up visit to the physician, a client with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and:

phosphorus