Exam 4 practice Questions

propylthiouracil (PTU) is prescribed for a client with graves disease. which symptom should the nurse teach the client to report 1-sore throat 2-excessive menstruation 3-constipation 4-increase urine output

1

the client dx with lung cancer is being discharged. which statement indicates more teaching is required 1-"it doesn't matter if I smoke now. I already have cancer" 2-"I should see the oncologist at my scheduled appointment" 3-"if I begin to run a fever, I should notify the hcp" 4-"I should plan for periods of rest throughout the day"

1

the parents of an adolescent boy are concerned their son seems to need 9 hours of sleep a night. what should the nurse tell the parents 1-"as long as he seems otherwise well, this sounds like a typical teenager" 2-"adolescents only need 8 hours of sleep a night; anything over this is excessive" 3-"your son is probably engaged in too many activities and is wearing himself out" 4-"the side of many drugs is sleepiness"

1

the client is one hour postoperative thyroidectomy. which intervention should the nurse implement? 1-check the posterior neck for bleeding 2-assess the client for chvosteks sign 3-monitor the clients serum calcium level 4-change the clients surgical dressing

1 -incision for a thyroidectomy allows the blood to drain dependently by gravity to the back of the clients neck

the nurse is assessing an older adult client diagnosed with hyperthyroidism. which symptom of hyperthyroidism will the nurse expect to find? SATA 1-depression 2-anxiety 3-weight loss 4-palpitation 5-irritability

1,2,3

the nurse is teaching the client about relaxation techniques. which interventions should be included in the teaching? SATA 1-intrust the client to contract and relax the muscles 2-explain the important of playing soothing music 3-use all 5 senses when using guided imagery 4-discuss the need to eliminate all stress in the clients life 5- insist the client write about his or her feelings in a journal

1,2,3 1-PMR is systematic contraction and relaxing of the muscles 2-soothing music with the rate of 50 to 60 bpm can slow the clients hr and relax client 3-guided imagery is helpful to dec anxiety -NOT 4 BC stress is not always harmful-abscene of all stress=death. not 5 bc the nurse cannot insist the client do anything

the nurse is caring for a client with a hx of hypothyroidism. which clinical manifestations indicates to the nurse the progression to myxedemic crisis? SATA 1-hypothermia 2-hypoglycemia 3-hypotension 4-hypoventilation 5-irritability

1,2,3,4

The nurse will monitor which client(s) with hypothyroidism most carefully for myxedema coma? SATA 1- a client was in a motor vehicle accident 2- a client undergoing an emergency appendectomy 3-a client who just lost a spouse of 30 years 4- a client taking opioids several times a day 5- a client being treated for bronchitis

1,2,3,4,5 myxedema coma can be precipitated by opioids, stress, trauma, infections

the nurse writes a problem of impaired gas exchange for a client dx with lung cancer. which interventions would be included in the plan of care? SATA 1-apply o2 via nasal canula 2- have the dietitian plan for 6 small meals per day 3- place client in respiratory isolation 4-assess vital signs for fever 5- listen to lung sounds every shift

1,2,4,5 -resp distress is a common finding in clients with a dx of lung cancer-admin of o2 will help the client use lung capacity that is available -clients with lunger cancer frequently become fatigue trying to eat -clients with lung cancer are at risk for developing an infection from lowered resistance as result of the tumor blocking secretions-therefore monitoring for the presence of a fever, is important -assessment of lung sounds should be completed on a routine and prn basis

the nurse is caring for a client with hypothyroidism, which findings will the nurse report to the HCP? SATA 1-hair loss 2-cold intolerance 3-weight gain 4-constipation 5-nervousness

1,5

the client diagnosed with leukemia is being admitted for an induction course of chemotherapy. which lab values indicate a dx of leukemia? 1-a left shift in the WBC count differential 2-a large number of WBC that decreases after the administration of antibiotics 3-an abnormally low Hb and hct level 4-RBC that are larger than normal

1- a left shift indicates immature WBC are being produced and released into the circulating blood volume

the nurse reviews the laboratory data of a client. the data reveal increased blood and urine levels of T3 and T4. the nurse will suspect the client will be treated for which complication? 1. hyperthyroidism 2. Addisons disease 3. Cushings syndrome 4. hypopituitarism

1-hyperthyroidism causes high levels of T3 and T4

the client dx with lung cancer has been told the cancer has metastasized to the brain. which intervention should the nurse implement? 1-discuss implementing an advance directive 2-explain the use of chemotherapy for brain involvement 3-teach the client to discontinue driving 4- have the significant other make decisions for the client

1-situation indicates a terminal process, and the client should make decisions for the end of life

a 10 year old child proudly tells the nurse that brushing and flossing her teeth is her responsibility. How does the nurse interpret the statement? 1-she is too young to be given this responsibility 2-she is most likely capable of this responsibility 3-she should have assumed this responsibility much sooner 4-she is probably just exaggerating the responsibility

2

a client with hyperthyroidism develops a high fever, extreme tachycardia, and altered mental status. which condition will the nurse suspect the client is developing? 1- hepatic coma 2-thyroid storm 3- myxedema coma 4- HHS

2

the nurse and a client have just discussed the clients recent diagnosis of hypothyroidism and its causes and effects. Which statement indicates to the nurse the clients needs further instructions? 1- "Now I see-my clumsiness is caused by a hormone problem" 2-"I just eat too much. That is why I am depressed and overweight" 3- "No wonder I am constipated. I am predisposed to it no matter what I eat" 4- "I am not cold all the time because I am getting older. I have a metabolic problem"

2

the nurse is completing a health assessment of a 42 year old female with suspected graves disease. when conducting a focused assessment, what should the nurse assess the client for? 1-anorexia 2-tachycardia 3-weight gain 4-cold skin

2

the parent of a preschooler reports that the child creates a scene every night at bedtime. what is the best course of action? 1-allow the child to stay up later one or two nights a week 2-establish a set bedtime and follow a routine 3-encourage activity play before bedtime 4-give the child a cookie if bedtime is pleasant

2

which medication should be available to provide emergency tx if a client develops tetany after a subtotal thyroidectomy? 1-sodium phosphate 2-calcium gluconate 3-echothiophate iodine 4-sodium bicarbonate

2

which intervention should the nurse employ to reduce trauma caused by vaccine administration? 1-use a 5/8 inch needle 2- simultaneously administer vaccines at separate sites with a second nurse 3-aspirate to verify needle placement 4-breastfeed right before administering the vaccines

2 simultaneous injection reduces the anxiety from anticipation of the next injection

a 34 y/o female is diagnosed with hypothyroidism. which information should the nurse obtain from conducting a focused assessment? SATA 1-rapid pulse 2-decreased energy and fatigue 3-weight gain of 10 lb 4-fine, thin hair with hair loss 5-constipation 6-menorrhagia

2,3,5,6

a client with a long hx of smoking is suspected of having lung cancer. the nurse knows which intervention is most important at this point to increase the clients chances of survival, should the client prove to have lung cancer? 1-bronchoscopy with hopes of early detection 2-chest x-ray, with hopes of early detection 3- high-dose chemotherapy, should the client be shown to have cancer 4-smoking cessation, should the client be known to have cancer

2- detecting cancer early when the cells may be premalignant and potentially curable would be most beneficial...tumor must be at least 1cm in diameter before it is detectable on a chest x ray. if cancer is detected, bronchoscopy would help identify cell type. chemotherapy has minimal effect on long term survival. smoking cessation wont reverse the process but can prevent further decompensation

the nurse is instructing the client with hypothyroidism who takes levothyroxine 100 mcg, digoxin, and simvastatin. the nurse judges that the teaching regarding the use of these medication is effective if the client will take: 1-levothyroixine with breakfast and the other medications after 2-leveothyroixine before breakfast and the other medications 4 hours later 3-all medications together 1 hour after eating 4-all medications before going to bed

2--must be given at same time each day on an empty stomach, preferably 1/2 to 1 hour before breakfast. the client should separate other medications by 4-5 hours

the nurse is caring for clients on an oncology unit. which neutropenia precautions should be implemented? 1-hold all venipuncture sites for at least five minutes 2-limit fresh fruits and flowers 3-place all clients in reverse isolation 4-have the clients use a soft bristle toothbrush

2-fresh fruits and flowers may carry bacteria or insects on the skin of the fruit or dirt on the leaves, so restricted around clients with low WBC

the nurse writes a nursing problem of altered nutrition for a client dx with leukemia who has received a tx regimen of chemotherapy and radiation. which nursing intervention should be implemented? 1-administer an antidiarrheal medication prior to meals 2-monitor the clients serum albumin levels 3-assess for signs and symptoms of infection 4-provide skin care to irradiated areas

2-serum albumin is a measure of the protein content in the blood that is derived from the foods eaten; albumin monitors nutritional status

what is the primary intervention by the nurse while caring for a client with terminal lung cancer? 1-offering emotional support 2-ensuring pain control 3-providing nutritional support 4-preparing the clients will

2-the client with terminal lung cancer may have extreme pleuritic pain and should be treated to reduce comfort.

a client with a benign lung tumor is scheduled for removal of the tumor. which statement made by the client demonstrates tot he nurse a proper understanding of the reason for the procedure? 1-"it will facilitate pain control" 2-"it will prevent further lung compression" 3-"it will help to prevent metastatic cancer" 4-"it is for cosmetic purposes"

2-tumor is removed to prevent further compression the lung tissue as the tumor grows, which could lead to respiratory decompensation.

a client with hyperthyroidism is to have a thyroidectomy. the HCP prescribed propranolol. in reviewing the clients hx, the nurse notes the client has asthma. what should the nurse do next? 1-take the clients pulse and withhold the propranolol if <100 bpm 2-count the clients respirations and withhold the propranolol if <20 per min 3-contact the HCP and discuss the prescription for propranolol because of the clients history of having asthma 4-instruct the client to make position changes slowly

3

after teaching a group of parents of preschoolers attending a well child clinical about oral hygiene and tooth brushing, the nurse determines that the teaching has been successful when the parents state that children can begin to brush their teeth without help at which age? 1-3 years 2-5 years 3-7 years 4-8 years

3

the nurse is caring for a client newly diagnosed with hyperthyroidism. which nursing intervention is priority to decrease the clients anxiety? 1-keeping the client warm 2-encouraging the client to increase activity 3-providing a calm, restful environment 4-placing the client in semi-fowlers position

3

following a subtotal thyroidectomy, the nurse asks the client to speak immediately upon regaining consciousness. the client is not able to make a sound. the nurse determines the client is experiencing which complication of surgery? 1-internal hemorrhage 2-decreasing LOC 3-laryngeal nerve damage 4-upper airway obstruction

3 -asking the client to speak helps assess for signs of laryngeal nerve damage

which s/s indicate the client with hypothyroidism is not taking enough thyroid hormone? 1-complaints of weight loss and fine tremors 2-complaints of excessive thirst and urination 3-complains of consitpation and being cold 4-complaints of delayed wound healing and belching

3 -if the client were not taking enough thyroid hormone, the client would exhibit s/s of hypothyroidism

the parents of a 9 month old bring the infant to the clinic for a regular checkup. the infant has received no immunizations. which vaccine if prescribed would the nurse question? 1-DTaP 2-haemohilus influenzare type b (hib) 3-MMR 4-inactivated influenza (flu)

3 MMR is a live vaccine-not allowed to give live vaccines to children under 12 mo

The nurse is caring for a for a client who has hypothyroidism. which health care provider prescription will the nurse question? 1- administer levothyroxine 2-monitor hR 3-maintain a cool room temp 4- check cholesterol levels

3 clients with hypothyroidism experience cold intolerance

A client is suspected of having hypothyroidism. which diagnostic tests is most appropriate for the nurse to monitor? 1-liver function studies and sodium level 2- hemoglobin A1c and calcium level 3- Thyroxine (T4) and thyroid-stimulating hormone (TSH) levels 4- 24-hour urine collection for cortisol and bacteria

3- T4 and TSH are diagnostic tests for hypothyroidism

which medication is contraindicated for a client diagnosed with leukemia? 1-bactrim, a sulfa antibiotic 2- morphine, a narcotic analgesic 3- Epogen, a biologic response modifier 4- Gleevec, a genetic blocking agent

3- stimulates bone marrow to produce RBC. the bone marrow in the area of malignancy is leukemia, so stimulating this would be generally ineffective for the desired results and who have the potential to stimulate malignant growth

which client is at the highest risk for developing lymphoma? 1-client dx with chronic lung disease who is taking a steroid 2- client dx with breast cancer who has extensive lymph involvement 3-client who received a kidney transplant several years ago 4-the client who has a ureteral stent placements for a neurogenic bladder

3--clients who received a transplant must take immunosuppressive medications to prevent rejection of the organ, this blocks the immune system from protecting the body against cancers & other diseases. high incidence of lymphoma among transplant patients

a client with hyperthyroidism is to be treated with radioactive iodine. following the tx, what should the nurse do 1-monitor for s/s of hyperthyroidism 2-rest for 1 week to prevent complications of the medication 3-take thyroxine replacement for the remainder of the clients life 4-assess for hypertension and tachycardia resulting from altered thyroid activity

3--lifelong thyroid hormone replacement

a client with graves has exophthalmos. what should the nurse teach the client to do to prevent corneal irritation? 1-massage the eyes every 4 hours 2-instill an ophthalmic anesthetic as prescribed 3-wear dark-colored glasses when awake 4-cover both eyes with moistened gauze pads at night

3--wear sunglasses to protect the eyes from corneal irritation

a client has been diagnosed with lung cancer. when the fam members re informed of the diagnosis, they begin crying and shouting. which statement by the nurse to the family is best? 1-"I understand this is shocking and not the news you wanted to hear." 2-"please remain calm. you need to be strong for your loved one." 3-"if you do not calm down, I will have to have you removed from the unit." 4-"I can tell you are very upset. please sit and talk with me about your feelings."

4

a client is being evaluated for hypothyroidism. to plan care, the nurse should ask the client about which sign or symptom 1-corneal abrasion 2-weight loss 3-diarrhea 4-fatigue

4

the nurse is taking the social hx from a client dx with small cell carcinoma of the lung. which info is significant for this disease? 1-client worked with asbestos for a short time many years ago 2- the client has no family hx for this type of lung cancer 3- the client has numerous tattoos covering both upper and lower arms 4-the client has smoked two packs of cigarettes a day for 20 years

4-- smoking is number one risk factor for developing cancer of the lung

the nurse is completing a care plan for a client dx with leukemia. which independent problem should be addressed 1-infection 2-anemia 3-nutriton 4-grieving

4--grieving is an independent problem and the nurse can assess and treat this problem with or without collaboration

the occupational health nurse is caring for a client with a superficial burn on the arm. the client prefers holistic medicine-which medicinal plant should the nurse recommend? 1-black cohosh 2-fennel 3-witch hazel 4-aloe vera

4-aloe vera has been used to promote wound healing, and has some anti fungal properties as well as helps soothe pain from superficial burn