Week 7 Review Questions

A nurse assesses clients who are at risk for diabetes mellitus. Which client is at greatest risk? A. A 44-year-old Asian American B. A 58-year-old American Indian C. A 22-year-old African American D. 19-year-old Caucasian

B. A 58-year-old American Indian

A nurse assesses a client with Cushing disease. Which assessment findings would the nurse expect? (Select all that apply.) A. Weight loss B. Moon face C. Petechiae D. Hypotension E. Muscle atrophy

B. Moon face C. Petechiae E. Muscle atrophy

Which of the following factors are not associated with the development of nephrogenic diabetes insipidus? A. Sickle cell disease B. Pituitary tumors C. Medications, including phenytoin and lithium carbonate D. Heredity

B. Pituitary tumors

A patient is admitted to the oncology unit with a small cell lung carcinoma. During the admission, the patient is noted to have a significant decrease in urine output accompanied by shortness of breath, edema, and mental status changes. The nurse is aware that this clinical presentation is consistent with what diagnosis? A. Adrenal crisis B. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) C. Myxedema coma D. Diabetes insipidus

B. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)

Which of the following patients is at the highest risk for hyperosmolar hyperglycemic syndrome? A. An 18-year-old college student with type 1 diabetes who exercises excessively B. A 45-year-old woman with type 1 diabetes who forgets to take her insulin in the morning C. An 83-year-old, long-term care resident with type 2 diabetes and advanced Alzheimer's disease who recently developed influenza D. A 75-year-old man with type 2 diabetes and coronary artery disease who has recently started on insulin injections

C. An 83-year-old, long-term care resident with type 2 diabetes and advanced Alzheimer's disease who recently developed influenza

A nurse assesses a client who is recovering from a subtotal thyroidectomy. On the first postoperative day before discharge, the client states, "I feel numbness and tingling around my mouth." What action does the nurse take? A. Loosen the dressing. B. Ask the client orientation questions. C. Assess for muscle twitching. D. Offer mouth care.

C. Assess for muscle twitching.

The nurse caring for a patient who experienced a head trauma following a fall notes that the patient's heart rate is 112 beats/min and blood pressure is 88/50 mm Hg. The patient has poor skin turgor, dry mucous membranes and appears confused and restless. The following laboratory values are reported: serum sodium is 115 mEq/L; blood urea nitrogen (BUN) 50 mg/dL; and creatinine 1.8 mg/dL. The findings are consistent with which disorder? A. Diabetes insipidus B. Syndrome of inappropriate secretion of antidiuretic hormone C. Cerebral salt wasting D. Thyroid storm

C. Cerebral salt wasting

What differences would you expect to see in patients experiencing hyperosmolar hyperglycemic syndrome rather than diabetic ketoacidosis? A. Higher serum glucose, higher osmolality, and greater ketosis B. Lower serum glucose, lower osmolality, and milder ketosis C. Higher serum glucose, higher osmolality, and no ketosis D. Lower serum glucose, lower osmolality, and greater ketosis

C. Higher serum glucose, higher osmolality, and no ketosis

Mechanisms for development of diabetes insipidus include which of the following? A. ADH replacement therapy B. ADH excess C. Water deprivation D. ADH deficiency

D. ADH deficiency

Tolvaptan has a black box warning that rapid increases in serum sodium levels have been associated with central nervous system demyelination that can lead to serious complications and death. A. Neurologic assessment B. Skin assessment C. Respiratory assessment D. Cardiac assessment

D. Cardiac assessment

A nurse reviews the laboratory results of a client who is receiving intravenous insulin. Which would alert the nurse to intervene immediately? A. Serum chloride level of 98 mEq/L (98 mmol/L) B. Serum sodium level of 132 mEq (132 mmol/L) C. Serum calcium level of 8.8 mg/dL (2.2 mmol/L) D. Serum potassium level of 2.5 mEq/L (2.5 mmol/L)

D. Serum potassium level of 2.5 mEq/L (2.5 mmol/L)

In the management of diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome, when is an intravenous (IV) solution that contains dextrose started? A. When the blood sugar reaches 150 mg/dL B. When the blood sugar reaches 70 mg/dL C. Never; normal saline is the only appropriate solution in diabetes management D. When the blood glucose reaches 250 mg/dL

D. When the blood glucose reaches 250 mg/dL

A nurse assesses a client who potentially has hyperaldosteronism. Which serum laboratory values would the nurse associate with this disorder? (Select all that apply.) A. pH 7.50 B. Sodium: 150 mEq/L (150 mmol/L) C. Potassium: 2.5 mEq/L (2.5 mmol/L) D. Potassium: 5.0 mEq/L (5.0 mmol/L) E. pH 7.28 F. Sodium: 130 mEq/L (130 mmol/L)

A, B, C

A nurse assesses clients for potential endocrine dysfunction. Which client is at greatest risk for a deficiency of gonadotropin and growth hormone? A. A 42-year-old male who experienced head trauma 3 years ago B. A 55-year-old female with a severe allergy to shellfish and iodine C. A 64-year-old male with adult-onset diabetes mellitus D. A 36-year-old female who has used oral contraceptives for 5 years

A. A 42-year-old male who experienced head trauma 3 years ago

A continuous insulin intravenous infusion is started, and hourly bedside glucose monitoring is ordered for a patient who presented to the emergency department experiencing diabetic ketoacidosis. What is the targeted blood glucose value after the first hour of therapy? A. A decrease of 50 to 75 mg/dL compared with admitting values B. Less than 200 mg/dL C. A decrease of 25 to 50 mg/dL compared with admitting values D. 70 to 120 mg/dL

A. A decrease of 50 to 75 mg/dL compared with admitting values

Which of the following would be seen in a patient with myxedema coma? A. Decreased reflexes B. Tachycardia C. Hyperventilation D. Hyperthermia

A. Decreased reflexes

Which psychosocial factor is not likely to potentially contribute to the development of diabetic ketoacidosis? A. Exposure to influenza B. Altered sleep/rest patterns C. High levels of stress D. Eating disorder

A. Exposure to influenza

What is the most significant clinical finding of acute adrenal crisis associated with fluid and electrolyte balance? A. Hyperkalemia B. Hyperglycemia. C. Fluid volume excess D. Hypernatremia

A. Hyperkalemia

A nurse cares for a client who presents with bradycardia secondary to hypothyroidism. Which medication does the nurse prepare to administer? A. Levothyroxine B. Epinephrine C. Atropine sulfate D. Propranolol

A. Levothyroxine

The nurse is preparing to give tolvaptan for a client who has syndrome of inappropriate antidiuretic hormone (SIADH). For which potentially life-threatening adverse effect would the nurse monitor? A. Rapid-onset hypernatremia B. Increased intracranial pressure C. Myocardial infarction D. Bowel perforation

A. Rapid-onset hypernatremia