Review Questions for Exam 2

C

A 32-year-old client is recovering from a sickle cell crisis. The client's discomfort is controlled with pain medications and discharge planning has been initiated. What medication will the nurse anticipate to be prescribed before discharge? A) Heparin (Heparin) B) Warfarin (Coumadin) C) Hydroxyurea (Droxia) D) Tissue plasminogen activator (t-PA)

B

A client is being returned to the room after a subtotal thyroidectomy. Which piece of equipment is most important for the nurse to keep at the client's bedside? A) Indwelling urinary catheter kit B) Tracheostomy set C) Cardiac monitor D) Humidifier

C

A client is having a blood transfusion reaction. What must the nurse do in order of priority from first to last? All options must be used. 1. Notify the healthcare provider (HCP) and blood bank. 2. Complete the appropriate Transfusion Reaction Form(s). 3. Stop the transfusion. 4. Keep the IV open with normal saline infusion. A) 1, 2, 4, 3 B) 2, 4, 3, 1 C) 3, 4, 1, 2 D) 4, 2, 1, 3

B

A client on medication after a bilateral adrenalectomy calls the clinic asking to be seen for "stomach flu" with nausea and vomiting. Which response by the nurse is best? A) "Alter the dose of your medication today and tomorrow" B) "You need to go to the nearest emergency department today" C) "I will call in a prescription for an antiemetic medication for you." D) "Try to drink extra fluids until you can come in for an appointment."

B

A client who had received 25 mL of packed red blood cells (PRBCs) has low back pain and pruritus. After stopping the infusion, the nurse should take what action next? A) Administer prescribed antihistamine and an antipyretic. B) Collect blood and urine samples and send to the lab. C) Administer prescribed diuretics. D) Administer prescribed vasopressors.

B

A client with iron deficiency anemia is taking iron supplements. The nurse emphasizes to the client that the drug will have increased absorption if taken with: A) Milk. B) Orange juice. C) Food. D) Beta-carotene.

C

A client with leukemia develops thrombocytopenia following chemotherapy. Based on this specific finding, which of the following nursing interventions is the highest priority? A) Encourage the client to turn, cough, and deep breathe every 2 hours B) Monitor the client's temperature every 4 hours C) Monitor the client's platelet counts D) Encourage the client to ambulate several times a day

A

A client with pheochromocytoma is admitted for surgery. What does the nurse do for the admitting assessment? A) Avoids palpating the abdomen B) Monitors for pulmonary edema with a chest x-ray C) Obtains a 24-hour urine specimen on admission D) Places the client in a room with a roommate for distraction

C

A doctor suspects pernicious anemia in a patient presenting with a beefy red tongue. The patient reports feeling extremely fatigued and numbness and tingling in the hands. The doctor orders a peripheral blood smear. From your nursing knowledge, how will the red blood cells appear in the peripheral blood smear if pernicious anemia is present? A) Round-shaped and hypochromic B) Oval-shaped and hyperchromic C) Large and oval-shaped D) Small and hyperchromic

C

A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect? A) Dysuria B) Leg cramps C) Tachycardia D) Blurred vision

A

A patient diagnosed with a pheochromocytoma is admitted to the emergency department with a severe headache, flushing, and palpitations. The patient is now reporting abdominal pain. What action should the nurse take? A) Check blood pressure B) Palpate abdomen for mass C) Administer subcutaneous glucagon D) Prepare patient for magnetic resonance imaging (MRI)

D

A patient with primary hyperparathyroidism has a serum calcium level of 14 mg/dL (3.5 mmol/L) and a phosphorus of 1.7 mg/dL (0.55 mmol/L). Which nursing action should be included in the plan of care? A) Institute routine seizure precautions. B) Monitor for positive Chvosteks sign. C) Encourage the patient to remain on bed rest. D) Encourage 3000 to 4000 mL of oral fluids daily.

B

During a blood transfusion a client develops chills and a headache, what is the priority nursing action? A) cover the client B) stop the transfusion at once C) notify the physician immediately D) decrease the rate of blood infusion

B

Following infusion of a unit of packed red blood cells, the client has developed new onset of tachycardia, bounding pulses, crackles, and wheezes. Which action should the nurse implement FIRST? A) Maintain bed rest with legs elevated B) Place the client in high-Fowler's position C) Increase the rate of infusion of intravenous fluids D) Consult with the HCP regarding initiation of oxygen therapy.

B

Packed red blood cells have been prescribed for a client with a low hemoglobin and hematocrit levels. The nurse takes the client's temperature before hanging the blood transfusion and records 100.6 degrees orally. Which of the following is the appropriate nursing action? A) Begin the transfusion as prescribed B) Delay hanging blood and notify the physician C) Administer an antihistamine and begin the transfusion D) Administer two tablets of Tylenol and begin the transfusion

B, E, F, & G

Select ALL the signs and symptoms that can present in pernicious anemia: A) Erythema B) Paresthesia of hands and feet C) Racing thoughts D) Extreme hunger E) Depression F) Unsteady gait G) Shortness of breath with activity

C

The LPN assists in the evaluation of a client with suspected Addison's disease. What laboratory test result best supports a diagnosis of Addison's disease? A. Serum sodium level of 133 mEq/L B. BUN level of 14 mg/dl C. Serum potassium level of 5.9 mEq/L D. Blood glucose level of 90 mg/dl

D

The RN has just received change-of-shift report on the medical-surgical unit. Which client will need to be assessed first? A) Client with Hashimoto's thyroiditis and a large goiter. B) Client with hypothyroidism and an apical pulse of 51 beats/min. C) Client with parathyroid adenoma and flank pain due to a kidney stone. D) Client who had a parathyroidectomy yesterday and has muscle twitching.

B

The nurse is assessing a patient who underwent a parathyroidectomy related to hyperparathyroidism and finds positive Chvostek's and Trousseau's signs. Which action should the nurse take next? A) Take the patient's weight B) Check patient's serum calcium levels C) Assess patient's level of consciousness D) Check thyroid-stimulating hormone level

A

The nurse is caring for a client in acute addisonian crisis. Which laboratory data would the nurse expect to find? A) Hyperkalemia B) reduced BUN C) hypernatremia D) hyperglycemia

C

The nurse is caring for a client with a suspected diagnosis of aplastic anemia. Which tests should the nurse anticipate to be performed to confirm the diagnosis? A) Schilling test B) Sickle cell screen C) Bone marrow aspiration D) Complete blood cell count

B

The nurse is caring for a client with leukemia who is receiving intravenous chemotherapy. The nurse reviews the laboratory results and notes that the white blood cell count is 2000 cells/mm3, the platelet count is 150,000 cells/mm3, the clotting time is 10 minutes, and the ammonia level is 20 mcg/dL. Which nursing action would be appropriate? A) Place the client on bleeding precautions. B) Place the client on neutropenic precautions. C) Remove the rectal thermometer from the client's room. D) Instruct the dietary department to eliminate all proteins from the diet.

D

The nurse is caring for a patient who is to receive a transfusion of two units of packed red blood cells. After obtaining the first unit from the blood bank, the nurse would ask which of the following health team members in the nurses station to assist in checking the unit before administration? A) Unit Secretary B) A Phlebotomist C) A Physician's Assistant D) Another Registered Nurse

A

The nurse is providing care to a patient following a non-accidental traumatic brain injury. The patient has developed diabetes insipidus due to the injury. What medication is most often used in the management of diabetes insipidus? A) desmopressin (DDAVP) B) corticotrophin (Acthar) C) octreotide (Sandostatin) D) somatropin (Humatrope)

D

The nurse is teaching a client who has iron deficiency anemia about foods she should include in her diet. The nurse determines that the client understands the dietary modifications if she selects which items from her menu? A) Nuts and milk B) Coffee and tea C) Cooked rolled oats and fish D) Oranges and dark green leafy vegetables

B

The nurse would assess a client who has undergone a small bowel resection of the ileum for development of which type of anemia? A) Sickle cell anemia B) Vitamin B12 deficiency anemia C) Anemia of chronic disease D) Aplastic anemia

C

The patient with diabetes insipidus is brought to the emergency department with confusion and dehydration after excretion of a large volume of urine today even though several liters of fluid were drunk. What is a diagnostic test that the nurse should expect to be done to help make a diagnosis? A) Blood glucose B) Serum sodium level C) Urine specific gravity D) Computed tomography (CT) of the head

A

The patient with which of the following is most at risk for folic acid deficiency? A) Alcoholism B) Sprue C) Gastrectomy D) Peptic ulcer disease

B

The underlying disorder of which anemia is a result of the defective secretion of the intrinsic factor, which is essential for the absorption of vitamin B12? A) Microcytic B) Pernicious C) Hypochromic D) Hemolytic

D

To screen a client for pheochromocytoma, a nurse schedules a vanillylmandelic acid test. When teaching the client about this test, which of the following instructions should the nurse include? A) "Start fasting at midnight prior to the day of the test." B) "Begin the 24-hour urine collection with the first morning urination." C) "Take low-dose aspirin for pain during the testing period D) "Restrict coffee intake 2 to 3 days prior to the test."

D

Which client does the nurse assign as a roommate for a client with aplastic anemia? A) A 34-year-old with idiopathic thrombocytopenia who is taking steroids B) A 23-year-old with sickle cell disease who has two draining leg ulcers C) A 30-year-old with leukemia who is receiving induction chemotherapy D) A 28-year-old with glucose-6-phosphate dehydrogenase (G6PD) deficiency anemia who is receiving mannitol (Osmitrol)

C

Which condition resulting from untreated pernicious anemia (PA) is fatal? A) Brain hypoxia B) Liver hypoxia C) Heart failure D) Renal failure

A, E, F & H

Which of the following nursing interventions and client instructions are appropriate in caring for a client with pancytopenia? (Select all that apply.) A) Restrict fresh fruits and vegetables in the diet B) Restrict all visitors C) Insert a Foley to monitor I&O D) Restrict fluids E) Report low-grade temperature F) Hold firm pressure for 5 min following necessary venipunctures G) Report an ANC (absolute neutrophil count) of 2,500/mm3 H) Administer epoetin alfa (Procrit) as prescribed

C

You are providing diet teaching to a patient with low iron levels. Which foods would you encourage the patient to eat regularly? A) Herbal tea, apples, and watermelon B) Sweet potatoes, artichokes, and packaged meat C) Egg yolks, beef, and legumes D) Chocolate, cornbread, and cabbage

C

A client presents with elevations in triiodothyronine (T3) and thyroxine (T4), and a decrease in thyroid stimulating hormone levels (TSH). Which is the nurse's priority intervention? A) Administer levothyroxine (Synthroid). B) Administer liothyronine (Cytomel). C) Monitor the apical pulse. D) Assess for Trousseaus' sign.

B

A client has undergone a transsphenoidal hypophysectomy. Which intervention does the nurse implement to avoid increasing intracranial pressure (ICP) in the client? A) Encourages the client to cough and deep-breathe B) Instructs the client not to strain during a bowel movement C) Instructs the client to blow the nose for postnasal drip D) Places the client in the Trendelenburg position

D

A client is admitted to the health care facility for evaluation for Addison's disease. Which laboratory test result best supports a diagnosis of Addison's disease? A) BUN level of 12 mg/dl B) Blood glucose level of 90 mg/dl C) Serum sodium level of 134 mEq/L D) Serum potassium level of 5.8 mEq/L

A

A client receiving a transfusion of packed red blood cells (PRBCs) begins to vomit. The client's blood pressure is 90/50 from a baseline of 125/78. The client's temperature is 100.8F orally from a baseline of 99.2F orally. The nurse determines that the client may be experiencing which complication of a blood transfusion? A) Septicemia B) Hyperkalemia C) Circulatory overload D) Delayed transfusion reaction

B

A client with thrombocytopenia has neurologic checks prescribed every hour. The nurse shares with a curious unlicensed assistant which reason for frequent neurologic assessment? A) To determine if the coagulopathy is related to a neurologic disorder B) To monitor for signs of intracranial bleeding C) To evaluate the effectiveness of pharmacological interventions D) To correlate increasing platelet counts with the neurologic status

A

A client is receiving a unit of packed red blood cells. Before the transfusion started, the client's blood pressure was 90/50 mm Hg, pulse rate 100 bpm, respirations 20 breaths/min, and temperature 98°F (36.7°C). Fifteen minutes after the transfusion starts, the client's blood pressure is 92/54 mm Hg, pulse 100 bpm, respirations 18 breaths/min, and temperature is 101.4°F (38.6°C). The nurse should first: A) Stop the transfusion. B) Raise the head of the bed. C) Obtain a prescription for antibiotics. D) Offer the client a cool washcloth.

A

A comatose patient is admitted to the emergency department after an automobile accident. The nurse notes a Medic-Alert identification bracelet that states the patient has hemophilia. What should the nurse do first? A) Notify the physician of the bracelet. B) Tape the bracelet to the patients arm. C) Call the phone number on the bracelet. D) Remove the bracelet, and give it to the patients family member.

A

A patient has been admitted to your unit with salt-losing adrenogenital syndrome. The patient is taking fludrocortisone (Florinef) for replacement therapy in combination with a glucocorticoid. You would know that high dose fludrocortisone requires the nurse to monitor for what? A) Development of hypokalemia B) An increase in sodium and water retention along with potassium depletion C) A toxic effect that may occur with the combination of a glucocorticoid D) Sodium and water depletion along with potassium retention

C

A patient is admitted to the hospital with thyrotoxicosis. On physical assessment of the patient, what should the nurse expect to find? A) Hoarseness and laryngeal stridor B) Bulging eyeballs and dysrhythmias C) Elevated temperature and signs of heart failure D) Lethargy progressing suddenly to impairment of consciousness

D

About ten minutes after the nurse begins an infusion of packed RBCs, the patient complains of chills, chest and back pain, and nausea. His face is flushed, and he's anxious. Which is the priority nursing action? 1. Administering antihistamines STAT for an allergic reaction. 2. Notifying the physician of a possible transfusion reaction. 3. Obtaining a urine and serum specimen to send to the lab immediately. 4. Stopping the transfusion and maintaining a patent IV catheter.

D

After a person has a subtotal gastrectomy for chronic gastritis, which type of anemia will result? A) Iron deficiency B) Aplastic C) Folic acid D) Pernicious

C

All of the following are treatments for myxedema coma EXCEPT? A) Corticosteroids B) IV glucose C) Hypotonic IV solutions D) IV Synthroid

B

An ACTH stimulation test is commonly used to diagnose: A) Grave's disease B) Adrenal insufficiency and Addison's disease C) Cystic fibrosis D) Hashimoto's disease

A, D & E

Which of the following are subjective signs and symptoms of hypothyroidism? (Select all that apply.) A) Fatigue B) Weight gain C) Hyperlipidemia D) Constipation E) Cold intolerance

A

Because of drug interactions, the nurse should monitor a patient who is taking warfarin and levothyroxine for which condition? A) Bleeding B) Dysrhythmias C) Insomnia D) Tachycardia

B

Before starting a transfusion of packed red blood cells for an anemic patient, the nurse would arrange for a peer to monitor his or her other assigned patients for how many minutes when the nurse begins the transfusion? A) 5 minutes B) 15 minutes C) 60 minutes D) 30 minutes

A

Which of the following complications would the nurse know to monitor for in the patient with primary thrombocythemia? A) Bleeding and clot formation B) HA and dizziness C) Stroke and syncope D) Infection and DVT

B

Which symptoms should the nurse expect a client to exhibit who is diagnosed with a pheochromocytoma? A) Cyanosis, fever, classic signs of shock B) Headache, diaphoresis, palpitations C) Numbness, tingling, cramps in extremities D) Nausea, vomiting, muscular weakness

A

Halfway through the administration of blood, the female client complains of lumbar pain. After stopping the infusion the nurse should: A) Increase the flow of normal saline B) Assess the pain further C) Notify the blood bank D) Obtain vital signs.

C

In the administration of a drug such as levothyroxine (Synthroid), the nurse should teach the client: A) That therapy typically lasts about 6 months. B) That weekly laboratory tests for T4 levels will be required. C) To report weight loss, anxiety, insomnia, and palpitations. D) That the drug may be taken every other day if diarrhea occurs.

C

The client diagnosed with sickle cell anemia is experiencing a vaso-occlusive sickle cell crisis secondary to an infection. Which medical treatment should the nurse anticipate the HCP ordering for the client? A) Administer meperidine (Demerol) intravenously. B) Admit the client to a private room and keep in reverse isolation. C) Infuse D5W 0.33% NS at 150 mL/hr via pump. D) Insert a 22-French Foley catheter with a uri-meter.

B

The client is admitted to the intensive care department diagnosed with myxedema coma. Which assessment data warrant immediate intervention by the nurse? A) Serum blood glucose level of 74 mg/dL. B) Pulse oximeter reading of 90%. C) Telemetry reading showing sinus bradycardia. D) The client is lethargic and sleeps all the time.

B

The client is taking fludrocortisone (Florinef) for adrenal hypofunction. The nurse instructs the client to report which symptom while taking this drug? A) Anxiety B) Headache C) Nausea D) Weight loss

C

The client was dx with iron-deficiency anemia is prescribed ferrous gluconate orally. Which should the nurse teach the client? A) Take Imodium, and anti diarrheal, OTC for diarrhea B) Limit exercise for several weeks until a tolerance is achieved C) The stools may be very dark, and this can mask blood D) Eat only red meats and organ meats for protein

A

The client with O+ blood is in need of an emergency transfusion but the lab does not have any O+ blood available. Which potential unit of blood could be given to the client? A) O- unit B) A+ unit C) B+ unit D) Any Rh+ unit

D

The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy . The nurse notes that the platelet count is 20,000/ul. Based on the laboratory result, which intervention will the nurse document in the plan of care? A) Monitor closely for signs of infection B) Monitor the temperature every 4 hours C) Initiate protective isolation precautions D) Use soft small toothbrush for mouth care

B

Which assessment finding made by the nurse may indicate the onset of hypoparathyroidism? A) Constipation B) Positive Chvostek's sign C) Blood pressure of 160/90 mm Hg D) Shortened attention span

A

Which newly admitted patient should the nurse assign as a roommate for a patient who has aplastic anemia? A) A patient with severe heart failure B) A patient who has right leg cellulitis C) A patient who has viral pneumonia D) A patient with multiple abdominal drains

D, C, E, B, F, A

A unit of packed red blood cells has been prescribed for a client with low hemoglobin and hematocrit levels. The nurse notifies the blood bank of the order, and a blood specimen is drawn from the client for typing and cross-matching. The nurse receives a telephone call from the blood bank and is informed that he unit of blood is ready for administration. Arrange the actions in order of priority that the nurse should take to administer the blood. A) Hang the bag of blood B) Obtain the unit of blood from the bank C) Ensure that an informed consent has been signed D) Verify the physician's order for the blood transfusion E) Insert an 18 or 19-gauge IV catheter into the client F) Ask a licensed nurse to assist in confirming blood compatibility and verifying client identity.

B

A woman who is pregnant and has hyperthyroidism is best managed by a specialty team who will most likely treat her with: A) Methimazole B) Propylthiouracil (PTU) C) Radioactive iodine D) Nothing, treatment is best delayed until after her pregnancy ends

C

An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of: A) Thyroid storm. B) Cretinism. C) Myxedema coma. D) Hashimoto's thyroiditis.

B

Which statement is the scientific rationale for infusing a unit of blood in less than four hours? A) The blood will coagulate if left out of the refrigerator for longer than four hours. B) The blood has the potential for bacterial growth if allowed to infuse longer. C) The blood components begin to break down after four hours. D) The blood will not be affected; this is a laboratory procedure.

D

When methimazole is started for hyperthyroidism it may take ________ to see a total reversal of hyperthyroid symptoms. A) 2 to 4 weeks B) 1 to 2 months C) 3 to 4 months D) 6 to 12 months

D

When replacement therapy is started for a patient with long-standing hypothyroidism, what is most important for the nurse to monitor the patient for? A) Insomnia B) Weight loss C) Nervousness D) Dysrhythmias

B

Which anemia is manifested with pancytopenia? A) Thalassemia B) Aplastic anemia C) Megaloblastic anemia D) Anemia of chronic disease

D

The nurse and unlicensed nursing assistant are caring for clients on an oncology floor. Which nursing task would be delegated to the unlicensed nursing assistant? A) Assess the urine output on a client who has had a blood transfusion reaction. B) Take the first 15 minutes of vital signs on a client receiving a unit of PRBCs. C) Auscultate the lung sounds of a client prior to a transfusion. D) Assist a client who received 10 units of platelets in brushing teeth.

C

The nurse determines that a client is having a transfusion reaction. After the nurse stops the transfusion, which action should be taken NEXT? A) Remove the intravenous (IV) line. B) Run a solution of 5% dextrose in water. C) Run normal saline at a keep-vein-open rate. D) Obtain a culture of the tip of the catheter device removed from the client.

B

The nurse is conducting a dietary assessment on a client who is on a vegan diet. The nurse provides dietary teaching and should focus on foods high in which vitamin that may be lacking in a vegan diet? A) Vitamin A B) Vitamin B12 C) Vitamin C D) Vitamin E

A, C & E

A patient with aplastic anemia has a nursing diagnosis of impaired oral mucous membrane. The etiology of this diagnosis can be related to the effects of what deficiencies (select all that apply)? A) RBCs B) Ferritin C) Platelets D) Coagulation factor VIII E) White blood cells (WBCs)

C

A patient with diabetes insipidus is treated with nasal desmopressin acetate (DDAVP). The nurse determines that the drug is not having an adequate therapeutic effect when the patient experiences A) headache and weight gain. B) nasal irritation and nausea. C) a urine specific gravity of 1.002. D) an oral intake greater than urinary output.

A

A patient with pheochromocytoma reports the onset of a severe headache. The nurse observes that the patient is very diaphoretic. Which assessment data should the nurse obtain next? A) Blood pressure B) Body temperature C) Capillary glucose D) O2 saturation

D

The nurse educates the client diagnosed with iron deficiency anemia. Which client statement indicates the client needs further teaching? A) "I cook my food in iron pots." B) "I am a vegetarian and eat every type of fruit and vegetables." C) "I will increase my intake of meats and leafy green vegetables." D) "I don't have to worry about diet because I take iron preparations."

B

The nurse has identified the nursing diagnosis of fatigue for a patient who is hypothyroid. What should the nurse do while caring for this patient? A) Monitor for changes in orientation, cognition, and behavior. B) Monitor for vital signs and cardiac rhythm response to activity. C) Monitor bowel movement frequency, consistency, shape, volume, and color. D) Assist in developing well-balanced meal plans consistent with level of energy expenditure.

C

A 52-year-old woman is admitted with a new diagnosis of gastrointestinal (GI) bleed. The physician has ordered the client to receive 2 units of packed red blood cells (PRBCs) for a hemoglobin (Hgb) of 6.8g/dL. The nurse begins the infusion of the first unit at 100mL/hr. Fifteen minutes after the start of the infusion, the client complains that she is feeling chilled, is short of breath, and is experiencing lumbar pain rated 8 on a 1-10 scale. Which of the following should be the nurse's FIRST action. A) Obtain vital signs and notify the physician of potential reaction B) Slow the infusion to 75mL/hr and reassess in 15 minutes C) Stop the infusion and run normal saline (NS) to keep the vein open (KVO) D) Administer PRN pain medication as ordered, apply oxygen at 2 L/min, and provide an additional blanket

B

A client had a parathyroidectomy 18 hours ago. Which finding requires immediate attention? A) Edema at the surgical site B) Hoarseness C) Pain on moving the head D) Sore throat

B

A client presents at the emergency department complaining of a raspy voice, cold intolerance, and fatigue. Laboratory tests indicate an elevated thyroid stimulating hormone (TSH) and low T3 and T4 levels. After the client is admitted to the telemetry unit, which intervention is most important for the nurse to implement? A) Assess for presence of non-pitting edema. B) Administer prescribed dose of levothyroxine. C) Offer additional blankets and a warm drink. D) Note client's most recent hemoglobin level.

C

A nurse assesses a client who is recovering from a transsphenoidal hypophysectomy. The nurse notes nuchal rigidity. Which action should the nurse take first? A) Encourage range-of-motion exercises. B) Document the finding and monitor the client. C) Take vital signs, including temperature. D) Assess pain and administer pain medication.

C

A patient in her twenties with Graves' disease who takes methimazole (Tapazole) tells a nurse that she is trying to conceive and asks about disease management during pregnancy. What will the nurse tell her? A) Methimazole is safe to take throughout pregnancy. B) Propylthiouracil should be taken throughout her pregnancy. C) The patient should discuss changing to propylthiouracil from now until her second trimester with her provider. D) The patient should discuss therapy with iodine-131 instead of medications with her provider.

B

A patient with a hematologic disorder has a smooth, shiny, red tongue. which laboratory result would the nurse expect to see? A) Neutrophils 45% B) Hgb 9;6 C) WBC 13,500 D) RBC 6.4

A

A patient with acromegaly is treated with a transsphenoidal hypophysectomy. What should the nurse do postoperatively? A) Ensure that any clear nasal drainage is tested for glucose. B) Maintain the patient flat in bed to prevent cerebrospinal fluid (CSF) leakage. C) Assist the patient with toothbrushing every 4 hours to keep the surgical area clean. D) Encourage deep breathing, coughing, and turning to prevent respiratory complications.

C

The nurse instructs a client who is taking iron supplements that: A) Iron supplements should be taken on an empty stomach. B) A daily bulk laxative such as psyllium hydrophilic mucilloid should be avoided. C) The stools will become darker. D) Liquid iron supplements will not discolor teeth.

D

The nurse is administering packed red blood cells (PRBCs) to a client. The nurse should first: A) Discontinue the I.V. catheter if a blood transfusion reaction occurs. B) Administer the PRBCs through a percutaneously inserted central catheter line with a 20-gauge needle. C) Flush PRBCs with 5% dextrose and 0.45% normal saline solution. D) Stay with the client during the first 15 minutes of infusion.

B

The nurse is caring for clients on an oncology unit. Which neutropenia precautions should be implemented? A) Hold all venipuncture sites for at least five (5) minutes B) Limit fresh fruits and flowers C) Place all clients in reverse isolation D) Have the clients use a soft-bristle toothbrush

B

The nurse devises a teaching plan for the patient with aplastic anemia. Which of the following is the most important concept to teach for health maintenance? A) Eat animal protein and dark leafy vegetables each day B) Avoid exposure to others with acute infection C) Practice yoga and meditation to decrease stress and anxiety D) Get 8 hours of sleep at night and take naps during the day

C

What causes the atrophy of gastric mucosal cells that result in pernicious anemia? A) Erythrocyte destruction B) Folic acid malabsorption C) Vitamin B12 malabsorption D) Poor nutritional intake

B

What is an appropriate nursing intervention for the patient with hyperparathyroidism? A) Pad side rails as a seizure precaution B) Increase fluid intake to 3,000 to 4,000 mL daily C) Maintain bed rest to prevent pathologic fractures D) Monitor the patient for Trousseau's and Chvostek's signs

A, B, C & D

When a blood transfusion is terminated following a reaction, what actions must the nurse take? (Select all that apply.) A) Send freshly collected urine samples to the laboratory. B) Return the remainder of the blood component unit to the blood bank. C) Return the intravenous administration set to the blood bank. D) Alert Risk Management about the incident. E) Report the incident to the Infection Control Manager.

B

When a client with thrombocytopenia has a severe headache, what does the nurse interpret that this may indicate? A) Stress of the disease B) Cerebral bleeding C) Migraine headache D) Sinus congestion

A

When assessing for potential adverse effects of fludrocortisone (Florinef), the nurse monitors for signs and symptoms of which condition? A) Hypokalemia B) Hypovolemia C) Hyponatremia D) Hypercalcemia

A & D

Which action indicates that the parents of a 12-month-old with iron deficiency anemia understand how to administer iron supplements? (Select all that apply.) A) They administer iron supplements in combination with fruit juice. B) They administer iron supplements with meals. C) They report dark stools. D) They brush the child's teeth after administering the iron supplements. E) They decrease dietary intake of foods fortified with iron.

D

Which intervention for the client with sickle cell disease prevents vascular occlusion? A) Assessing pulse oximetry every 2 hours B) Administering morphine sulfate every 6 hours C) Keeping the room temperature at or below 68o F. D) Maintaining an oral fluid intake of at least 4500 mL/day