*Med surg exam 3

A patient is admitted to the hospital with a diagnosis of acute glomerulonephritis. Which question is most important for the nurse to ask the patient?

"Have you recently had strep throat?" this will increase the risk for glomerulonephritis.

What are the dietary protein recommendations for a person receiving dialysis?

- Normal for HD patient - Increased for PD patient

What are the types of organ rejection?

-Hyperacute (antibody-mediated, humoral) rejection,Occurs minutes to hours after transplant - Acute rejection, Occurs days to months after transplant- Chronic rejection, -Chronic rejection, Process occurs over months or years Process occurs over months or years and is irreversible and is irreversible

What are the advantages of kidney transplant over dialysis?

-Reverses many of pathophysiologic changes associated with renal disease associated with renal disease -Eliminates dependence on dialysis -Eliminates dependence on dialysis- Less expensive than dialysis after first year -Less expensive than dialysis after first year

In which order do the events of the positive feedback mechanism of estradiol chronologically occur? 1. Estradiol levels are increased during the menstrual cycle. 2. Follicle-stimulating hormone levels in serum drop. 3. Death of follicle has occurred. 4. Follicle-stimulating hormone (FSH) production and release is increased. 5. Estradiol levels are increased as a result of follicle-stimulating hormone.

1, 4, 5, 3, 2 In the positive feedback mechanism of estradiol, the level of estradiol is increased during the menstrual cycle. This results in increased production and release of FSH. FSH further increases the level of estradiol until the death of the follicle. This death results in a drop of serum FSH.

Clinical characteristics of Type 1 Diabetes Mellitus (IDDM)and needs are (check all that apply) : 1. Can become hyperglycemic easily (brittle diabetic). 2. Can go into ketoacidosis 3. Need insulin 4. Need dialysis to promote kidney function.

1. Can become hyperglycemic easily (brittle diabetic). 2. Can go into ketoacidosis 3. Need insulin

List six important teaching aspects for clients who are beginning corticosteroid therapy.

1. Continue medication until weaning plan is begun by a provider. 2. Monitor serum potassium, glucose and sodium frequently 3. Weight daily 4. Report weight gain of >5lb per week 5. Monitor BP and pulse closely 6. Teach symptoms of Cushing Syndrome

Which of the following are characteristics of Diabetes Insipidus? Check all that apply. 1. Excretion of large amounts of urine. 2. A deficiency of antidiuretic hormone. 3. Hypernatremic 4. Weight gain

1. Excretion of large amounts of urine. 2. A deficiency of antidiuretic hormone. 3. Hypernatremic

What are three symptoms of hypothyroidism? Select those that apply. 1. Fatigue 2. Cold intolerance 3. Weight loss 4. Weight gain

1. Fatigue 2. Cold intolerance 4. Weight gain

A thyroid storm is characterized(select all that apply): 1. Fever 2. Bradycardia 3. Agitation and anxiety 4. Hypertension

1. Fever 3. Agitation and anxiety 4. Hypertension

What would the treatment for a patient with low blood sugar be? 1. Give oral glucose 2. If difficulty swallowing glucose (non-oral method) 3. Insulin according to a sliding scale. 4. Metformin

1. Give oral glucose 2. If difficulty swallowing glucose (Glucagon injection)

Mr. Smith is an insulin-dependent diabetic. His wife called 911 because her husband was "acting funny". He arrives to the ER via ambulance stretcher. His workup reveals a blood sugar of 800mg/dL,ketones are assent in his urine, and he is dehydrated and has altered mental status. Based on these data, what is y our evaluation of Mr.Smith? 1. He has diabetic ketoacidosis (DKA). 2. He is in hyperosmolar nonketotic coma (HNKC). 3. He has acute renal failure. 4. He has diabetic retinopathy.

1. He has diabetic ketoacidosis (DKA).

Which lab test would the nurse review to determine the patient's blood sugar history during the prior 3 months? 1. HgB A1C 2. CBC 3. Hgb 4. Blood Glucose

1. HgB A1C

The patient asks why patients with diabetes have trouble with wound healing. The best answer is: 1. High blood glucose contributes to damage of the smallest vessels, the capillaries. 2. Cellular reproduction is impaired by diuretics. 3. Insulin interferes with cellular repair. 4. All of the above.

1. High blood glucose contributes to damage of the smallest vessels, the capillaries.

Mrs. Kirland comes into the clinic and states she might be having trouble with her diabetes management. She states she often feels nauseated, is restless, perspires, is fatigued, and is hungry. Her pulse is about 90 beats per minute. What do these signs indicate? 1. Hypoglycemia. 2. Hyperglycemia. 3. Diabetic nephropathy. 4. Diabetic retinopathy.

1. Hypoglycemia.

Which of the following are true statements about Graves' Disease (Goiter): (select all that apply) 1. It is excessive activity of the thyroid gland resulting in an elevated level of circulating thyroid hormones. 2. It is thought to be an autoimmune disease. 3. Appearance is generally a diffuse goiter and exophthalmos. 4. There is no treatment.

1. It is excessive activity of the thyroid gland resulting in an elevated level of circulating thyroid hormones. 2. It is thought to be an autoimmune disease. 3. Appearance is generally a diffuse goiter and exophthalmos.

Marissa has been diagnosed with diabetes mellitus type 2. She asks the nurse what this means. The nurse responds with: (check all that apply) 1. It means your pancreas does not use insulin properly. 2. Your blood glucose rises higher than normal. 3. You may have to take Metformin to help control your blood glucose. 4. You can continue to eat whatever you want.

1. It means your pancreas does not use insulin properly. 2. Your blood glucose rises higher than normal. 3. You may have to take Metformin to help control your blood glucose.

Reversal of an Addison crisis calls for: 1. Parenteral hydrocortisone 2. Glucose gel 3. Bacitracin topical 4. Metformin

1. Parenteral hydrocortisone

What diagnostic test is used to determine thyroid activity? 1. T3, T4 2. HgA1c 3. K+ 4. CBC

1. T3, T4

syndrome of inappropriate antidiuretic hormone (SIADH) a syndrome in which secretion of VASOPRESSIN (anti diuretichormone) is not inhibited by hypotonicity of extracellular fluid and HYPONATREMIA is produced. 1. True 2. False

1. True

Which type of diabetes always requires insulin replacement? 1. Type 1, IDDM 2. Type 2 NIDDM 3. Cushings 4. Addisons

1. Type 1, IDDM

Name the necessary elements to include in teaching a new diabetic.

1. Underlying pathophysiology of the disease,mgmt. and treatment. 2. Careful meal planning 3. Exercise program 4. Hyper and hypoglycemia 5. Sick-day management 6. If on insulin (insulin administration and mgmt.

What are three symptoms of hyperthyroidism? Select those that apply. 1. Weight loss 2. Heat intolerance 3. Diarrhea 4. Weight gain

1. Weight loss 2. Heat intolerance 3. Diarrhea

When making rounds at night, the nurse notes that an insulin-dependent client is complaining of a headache,slight nausea, and minimal trembling. The client's hand is cool and moist. What is the client most likely experiencing? 1. Hyperglycemia 2. Hypoglycemia/insulin reaction 3. Thyroid storm 4. Cushing's Syndrome

2. Hypoglycemia/insulin reaction

The nurse knows that post operatively, to be prepared for the which of the following life threatening concerns? Select the best answer. 1. Elevated glucose 2. Laryngeal edema 3. Excessive bleeding 4. Hoarseness

2. Laryngeal edema

Glucose transportation into the cells through cell membranes takes place in which order? 1. Storage of proinsulin in the pancreas 2. Secretion of proinsulin by beta cells 3. Transformation of proinsulin into active insulin 4. Attachment of insulin to cell receptors

2. Secretion of proinsulin by beta cells 1. Storage of proinsulin in the pancreas 3. Transformation of proinsulin into active insulin 4. Attachment of insulin to cell receptors Proinsulin is a prohormone that is secreted by beta cells and is stored in the beta cells of islets of Langerhans of the pancreas. Active insulin is a protein made up of 51 amino acids; it is produced when C-peptide is removed from the proinsulin. Insulin attaches to receptors present on the target tissues, such as adipose tissue or muscle, where the promotion of glucose transport into the cells through cell membranes occurs.

Which type of diabetes sometimes does not require medication? 1. Type 1 IDDM 2. Type 2 NIDDM

2. Type 2 NIDDM

Because of the lack of insulin in diabetics, the body cannot use carbohydrates for energy and instead uses proteins and fats. Which sign of diabetes does this metabolism cause? 1. Polydipsia. 2. Overhydration. 3. Weight loss. 4. Paresthesia

3. Weight loss. Weight loss is due to using up proteins and fats, which results in acidosis and the buildup of ketones.

A nursing plan and intervention for patients with Grave's disease would include: 1. Provide a calm and restful atmosphere. 2. Observe for signs of thyroid storm (life-threatening) 3. Prepare patient that after treatment the patient will need daily hormone replacement. 4. All of the above.

4. All of the above.

Cushing Syndrome characteristics include: 1. Moon face appearance and buffalo hump. 2. Cause is usually chronic administration of corticosteroids. 3. Can be also caused by adrenal, pituitary, or hypothalamus tumors. 4. All of the above.

4. All of the above.

Nursing assessment of diabetic patients includes the assessment of which body system if you are assessing for hypertension and peripheral vascular disease? 1. Sensory/neurological. 2. Musculoskeletal. 3. Metabolic. 4. Cardiovascular.

4. Cardiovascular Cardiovascular assessment includes assessing for hypertension, PVD, and coronary artery disease.

In which order do the events of antidiuretic hormone (ADH) secretion stimulated by plasma osmolarity occur? 1. Osmoreceptors are activated. 2. Water is reabsorbed from renal tubules. 3. Plasma osmolarity is increased. 4. Antidiuretic hormone (ADH) is released. 5. Extracellular fluid is decreased.

5, 3, 1, 4, 2 Decrease in extracellular fluid increases the plasma osmolarity. This increased plasma osmolarity activates the osmoreceptors. These osmoreceptors stimulate the release of ADH. The water is reabsorbed from the renal tubules and urine becomes more concentrated when ADH is released.

Which information would the nurse include in a teaching plan about what causes diabetic acidosis? A A breakdown of fat stores for energy B Ingestion of too many highly acidic foods C Excessive secretion of endogenous insulin D Increased amounts of cholesterol in the extracellular compartment

A A breakdown of fat stores for energy In the absence of insulin, which facilitates the transport of glucose into cells, the body breaks down proteins and fats to supply energy; ketones, a byproduct of fat metabolism, accumulate, causing metabolic acidosis (pH less than 7.35). The pH of food ingested has no effect on the development of acidosis. The opposite of excessive secretion of endogenous insulin is true. Cholesterol level has no effect on the development of acidosis.

Which action would the nurse include in the plan of care for a client undergoing a transsphenoidal hypophysectomy? Select all that apply. One, some, or all responses may be correct. A Assessing for clear nasal drainage B Maintaining strict intake and output C Increasing daily dietary fiber intake D Elevating the head of the bed 30 degrees E Instructing on the use of an incentive spirometer

A Assessing for clear nasal drainage B Maintaining strict intake and output C Increasing daily dietary fiber intake D Elevating the head of the bed 30 degrees E Instructing on the use of an incentive spirometer The plan of care for a client who underwent a transsphenoidal hypophysectomy would include assessing for clear nasal drainage as this is a sign of cerebrospinal fluid leak. Strict intake and output would be maintained to monitor fluid balance because the pituitary gland produces hormones that regulate fluid volume. Daily dietary fiber would be increased to reduce the risk for constipation and straining postoperatively. The head of the bed would always be elevated at least 30 degrees to decrease intracranial pressure. Any client would perform incentive spirometry after surgery.

Which exogenous conditions are responsible for increased cortisol secretion? Select all that apply. One, some, or all responses may be correct. A Asthma B Adrenal adenomas C Cancer chemotherapy D Organ transplantation E Carcinomas of the lung

A Asthma C Cancer chemotherapy D Organ transplantation Asthma, cancer chemotherapy, and organ transplantation are the exogenous conditions responsible for increased cortisol secretion. This is because when adrenocorticotropic hormone or glucocorticoids are administered for the treatment of these conditions, it promotes cortisol secretion in the client, thus causing Cushing syndrome. Adrenal adenomas and carcinomas of the lung are endogenous conditions in which the endogenous secretions increase the cortisol levels in the client, thereby also causing Cushing syndrome.

The nurse would observe a client for which side effect when administering androgen therapy? A Baldness B Headaches C Gastric irritation D Orthostatic hypotension

A Baldness Androgen therapy may cause baldness, gynecomastia, and acne. Headaches, gastric irritation, and orthostatic hypotension are associated with bromocriptine, which is used to treat hyperpituitarism.

Why is blood glucose self-monitoring preferred over urine glucose testing?- A Blood glucose monitoring is more accurate. B Blood glucose monitoring is easier to perform. C Blood glucose monitoring is done by the client. D Blood glucose monitoring is not influenced by medications.

A Blood glucose monitoring is more accurate. Blood glucose testing is a more direct and accurate measure; urine testing provides an indirect measure that can be influenced by kidney function and the amount of time the urine is retained in the bladder. Whereas blood and urine testing is relatively simple, testing the blood involves additional knowledge. Both procedures can be done by the client. Whether or not it is influenced by medications is not a factor. Although some urine tests are influenced by medications, there are methods to test urine to bypass this effect.

Which anatomical area in the brain regulates a client's verbal expression? A Broca's area B Wernicke's area C Association area D Supplemental area

A Broca's area Broca's area in the cerebrum regulates verbal expression. Wernicke's area integrates auditory language. Association areas have many functions like sensory input, integration of visual and auditory inputs, past experiences, judgment, and reasoning. Supplemental areas facilitate proximal muscle activity.

The nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. Which interventions would the nurse include to decrease the risk of complications? Select all that apply. One, some, or all responses may be correct. A Examine the feet daily. B Wear well-fitting shoes. C Perform regular exercise. D Powder the feet after showering. E Visit the primary health care provider weekly. F Test bathwater with the toes before bathing.

A Examine the feet daily. B Wear well-fitting shoes. C Perform regular exercise. Clients with diabetes often have peripheral neuropathies and are unaware of discomfort or pain in the feet; the feet should be examined every night for signs of trauma. Well-fitting shoes prevent pressure and rubbing that can cause tissue damage and the development of ulcers. Daily exercise increases the uptake of glucose by the muscles and improves insulin use. Powdering the feet after showering may cause a paste-like residue between the toes that may macerate the skin and promote bacterial and fungal growth. Generally, visiting the primary health care provider weekly is unnecessary. Clients with diabetes often have peripheral neuropathy and are unable to accurately evaluate the temperature of bathwater, which can result in burns if the water is too hot.

Identify the primary causes of adrenal insufficiency. Select all that apply. One, some, or all responses may be correct. A Hemorrhage B Tuberculosis C Pituitary tumor D Postpartum pituitary necrosis E Acquired immunodeficiency syndrome (AIDS)

A Hemorrhage B Tuberculosis E Acquired immunodeficiency syndrome (AIDS) The primary causes of adrenal insufficiency are hemorrhage, tuberculosis, and AIDS. Pituitary tumors and postpartum pituitary necrosis are the secondary cases of adrenal insufficiency.

What is the function of the scrotum? A Holds the testes B Produces sperm C Secretes semen D Transports sperm

A Holds the testes

Which gland secretes gonadotropin-releasing hormone to help control the events of puberty? A Hypothalamus B Thyroid C Anterior pituitary D Posterior pituitary

A Hypothalamus The hypothalamus releases gonadotropin-releasing hormone (GnRH), which stimulates the anterior pituitary gland. This gland exerts hormonal influence on the events of puberty. GnRH travels through a network of capillaries to the anterior pituitary gland, where it stimulates the production and secretion of follicle-stimulating hormone and luteinizing hormone, but the anterior pituitary itself does not secrete GnRH. The posterior pituitary and thyroid glands have no involvement in the neuroendocrine events of puberty.

Which is the target tissue for the parathyroid hormone? A Intestines B All body cells C Mammary glands D Sympathetic effectors

A Intestines The target tissue of the parathyroid hormone is the intestines. Growth hormone acts on all body cells. The mammary gland is the target tissue of oxytocin. Epinephrine and norepinephrine act on the sympathetic effectors.

The nurse is teaching a client newly diagnosed with type 1 diabetes about self-care. Which is the primary long-term goal? A Maintaining normoglycemia B Complying with the diabetic diet C Adhering to an exercise program D Developing a nonstressful lifestyle

A Maintaining normoglycemia Maintaining normoglycemia is a realistic goal because it decreases the risk of complications such as neuropathy, retinopathy, and atherosclerosis. A regimen of insulin, exercise, and diet will help the client achieve this goal. Compliance with a diabetic diet is an objective because it will help achieve the long-term goal; diet alone is insufficient to achieve normoglycemia. Adherence to an exercise program is an objective because it will help achieve the long-term goal; exercise alone is insufficient to achieve normoglycemia. Development of a lower stress lifestyle is a worthwhile goal, but developing a non-stressful lifestyle is not realistic.

A client is scheduled for a lumbar puncture. What nursing care should be implemented after the procedure? A Maintaining the client in the supine position for several hours B Encouraging the client to ambulate every hour for at least 6 hours C Keeping the client in the Trendelenburg position for at least 2 hours D Placing the client in the high-Fowler position immediately after the procedure

A Maintaining the client in the supine position for several hours Rationale: Staying flat may help to prevent spinal fluid leakage and post procedure headache; this is recommended, even though some people develop a headache despite this precaution. Encouraging the client to ambulate every hour for at least 6 hours may predispose to spinal fluid leakage; the client should be kept flat for 6 to 12 hours. The Trendelenburg position may increase intracranial pressure and is not appropriate. Placing the client in the high-Fowler position immediately after the procedure may predispose to spinal fluid leakage; the client should be kept flat.

The nurse provides education about signs and symptoms of hypoglycemia to a client with newly diagnosed type 1 diabetes. The nurse concludes that the teaching was effective when the client acknowledges the need to drink orange juice when experiencing which symptoms? A Nervous and weak B Thirsty with a headache C Flushed and short of breath d Nausea and abdominal cramps

A Nervous and weak Nervousness and weakness are the most commonly reported symptoms of hypoglycemia and are related to increased sympathetic nervous system activity. Feeling flushed and short of breath are adaptations of hyperglycemia. Being thirsty, having a headache, being nauseated, or having abdominal cramps are symptoms of hyperglycemia.

Which hormone is release from the posterior pituitary gland? A Oxytocin B Prolactin C Growth hormone D Luteinizing hormone

A Oxytocin Acts on the uterus and mammary glands. It is produced by the posterior pituitary gland.

Which hormones are secreted by the posterior pituitary gland? Select all that apply. One, some, or all responses may be correct. A Oxytocin B Prolactin C Corticotropin D Antidiuretic hormone E Melanocyte-stimulating hormone

A Oxytocin D Antidiuretic hormone Oxytocin and antidiuretic hormone (vasopressin) are secreted by the posterior pituitary gland. Prolactin, corticotropin, and melanocyte-stimulating hormones are secreted by the anterior pituitary gland.

The assessment and clinical findings for a patient showing decreased production of all hormones from the anterior pituitary. What is this condition called? A Panhypopituitarism B Pituitary hypofunction C Selective hypopituitarism D Secondary pituitary dysfunction

A Panhypopituitarism which is an extremely rare condition in which a person has a decreased production of all of the pituitary hormones. Pituitary hypofunction is the condition in which one or more hormones of the anterior pituitary gland are under-secreted. Selective hypopituitarism is the condition in which there is a decrease in only one anterior pituitary hormone.

Which gland secretes melatonin? A Pineal gland B Thyroid gland C. Adrenal gland D. Parathyroid gland

A Pineal gland The pineal gland secretes the hormone melatonin, which regulates the circadian rhythm and reproductive system at the onset of puberty.

Which instruction would the nurse provide to a 6' 0", 160-pound client newly diagnosed with type 1 diabetes who wants to self-administer injections with an insulin pen? Select all that apply. One, some, or all responses may be correct. A Prime the needle with two units. B Use a 29-gauge insulin needle. C Give the injection at a 45-degree angle. D Refrain from recapping the needle. EDial the pen to deliver the unit dose.

A Prime the needle with two units. B Use a 29-gauge insulin needle. C Give the injection at a 45-degree angle. D Refrain from recapping the needle. EDial the pen to deliver the unit dose. The nurse should instruct the client to prime the needle with two units of insulin to remove air from the needle. Insulin needles range between 28 and 31 gauges, and a 29-gauge insulin needle would be appropriate to use. Thin clients (such as a 6' 0" client who weighs 160 pounds) should be instructed to administer the injection at a 45-degree angle. Clients are advised not to recap needles to prevent accidental needlestick injuries. Clients would dial the pen to deliver the prescribed unit dose.

The nurse teaches the client about endocrine functioning of part of the image labeled A. Which information from the client indicates successful learning? A Promotes growth B Promotes stress response C Increases serum calcium levels D Increases intestinal calcium absorption

A Promotes growth Part A is the pituitary gland. Growth hormone secreted by the pituitary gland promotes protein anabolism (growth and tissue repair). The adrenal medulla releases epinephrine and norepinephrine during the stress response. Secreted by the parathyroid gland, parathormone increases serum calcium levels and also increases the intestinal absorption of calcium.

The nurse is educating a client about managing hypoglycemia unawareness. Which information would the nurse provide? A Refrain from alternative testing sites B Use any available meter to monitor levels. C Initiate continuous blood glucose monitoring. D Calibrate the meter before managing hypoglycemia.

A Refrain from alternative testing sites When the client is managing hypoglycemia, the same site should be used to obtain blood glucose levels. This provides consistent readings because blood glucose levels are changing rapidly. The client should use his or her meter to monitor blood glucose levels for consistency. Continuous blood glucose monitoring should be implemented when the client is stable, not during hypoglycemic episodes. The client should calibrate the meter once a day, but not when hypoglycemic. The client needs a meter that can provide instant results without waiting for tests to be performed on the meter itself.

What are key assessment findings in a patient suspected of having diabetes insipidus? Select all that apply. A Tachycardia B Hemodilution C Increased thirst D Dry mucous membranes E High specific urine gravity

A Tachycardia C Increased thirst D Dry mucous membranes Tachycardia, increased thirst, and dry mucous membranes are findings typical of diabetes insipidus. The patient's blood is hemoconcentrated due to the significant fluid loss. The urine is diluted, resulting in a low specific gravity.

Which adverse effect can be seen in a female client with gonadotropin deficiency and who is undergoing hormone replacement therapy? A Thrombosis B Hypotension C Dehydration D Increased thirst

A Thrombosis A female client with gonadotropin deficiency is treated by replacement therapy of combined hormones, namely estrogen and progesterone. The side effect of this therapy is the increased risk of thrombosis or formation of blood clots in deep veins. Hypertension is a side effect of estrogen-progesterone therapy, not hypotension. Dehydration and increased thirst could indicate vasopressin deficiency.

Which medication is a beta-adrenergic blocker used to reduce intraocular pressure? A. Timolol B. Travoprost C. Carbachol C. Apraclonidine

A Timolol Rationale: Glaucoma is manifested by increased intraocular pressure. Timolol is a beta-adrenergic blocker used in the treatment of glaucoma. Carbachol is a cholinergic agonist used to treat glaucoma. Travoprost is a prostaglandin agonist, and apraclonidine is an adrenergic agonist used in the treatment of glaucoma.

What are some symptoms of embolic stroke and brain infarction?

A change in mental status functional weakness or disability.

What is an embolic brain stroke associated with?

A clot in the brain which causes permanent damage.

Which clinical findings should the nurse expect when assessing a client with hyperthyroidism? Select all that apply. A Diarrhea B Listlessness C Weight loss D Bradycardia E Decreased appetite

A diarrhea C weight loss Excessive thyroid hormones increase the metabolic rate, causing an increase in intestinal peristalsis. Excessive thyroid hormones increase the metabolic rate, causing weight loss. Appetite increases (polyphagia) with hyperthyroidism in an effort to meet metabolic needs. Other symptoms of hyperthyroidism are diaphoresis, heat intolerance, and palpitations.

The rapid response team is called to the cafeteria. They find a 22-year-old with a known seizure disorder having a tonic-clonic seizure. What actions will be taken during the seizure? (select all that apply) A establish IV access B insert an oral airway C gently holds the arms to prevent injury D administer the patient's intranasal midazolam E turn the person on to their side and pad their head

A establish IV access D administer the patient's intranasal midazolam E turn the person on to their side and pad their head Rationale: This patient has an established seizure disorder. Establish IV access. If they have midazolam nasal spray or midazolam autoinjector, this should be given. Nothing should be put in the patient's mouth during a seizure. No part of the body should be restrained. The patient should be turned on their side and their head protected from injury on the hard floor.

What condition is seen in patients with an enlarged thyroid gland (Graves Disease)?

A goiter

What is the result of a growth hormone deficiency?

A growth hormone deficiency causes decreased bone density and pathological fractures.

What are some behaviors that would be exhibited by a patient who has suffered a left brain stroke?

A left brain stroke survivor is aware of the deficiency and failure in mental functioning and is very cautious. Survivors of left brain damage will experience communication problems and have difficulty with words. After a stroke a patient will be much slower while undertaking actions and will not be able to accomplish tasks quickly.

What is hyperkalemia?

A most serious complication that can occur in AKI or CKD because it can cause life-threatening cardiac dysrhythmias.

When distinguishing between persons with type 1 and type 2 diabetes the nurse is aware that: A persons with type 1 diabetes require insulin B. autoantibodies to pancreatic B-cells are found in type 2 diabetes C. persons with type 1 diabetes may be managed with metformin alone D. hyperosmolar hyperglycemia syndrome is more common in type 1 diabetes

A persons with type 1 diabetes require insulin

What is a subtotal thyroidectomy?

A surgical procedure that involves the removal of 90% of the thyroid gland.

What are the manifestations of a thrombotic stroke?

A thrombotic stroke has the clinical manifestation of a decreased level of consciousness in the first 24 hours.

What is a nodular goiter?

A thyroid hormone secreting nodule that functions independently of TSH stimulation.

What are the symptoms of a thyroid stimulating hormone deficiency?

A thyroid-stimulating hormone deficiency results in hirsutism and menstrual abnormalities.

What is the result of a thyroid stimulating hormone deficiency?

A thyroid-stimulating hormone deficiency results in hirsutism, weight gain, and menstrual abnormalities.

Which instruction would the nurse provide a client needing to collect a clean-catch urine specimen? A) "Urinate a small amount, stop flow, and then fill one half of the specimen cup" B) "collect a sample of the last urine voided during the night" C) "if anticipating a delay in delivery, keep the urine sample in a warm, dry area" D) "send the urine sample to the lab within 6 hours of collection"

A) "Urinate a small amount, stop flow, and then fill one half of the specimen cup"

Which statement made by the nurse regarding the gross anatomy and physiology of the kidneys indicates the need for additional teaching? A) "the right kidney is a little longer and narrower than the left kidney" B) "the existence of three kidneys with normal function is normal" C) "the presence of a single kidney with normal kidney function is normal" D) "the urinary bladder lies directly behind the pubic bone"

A) "the right kidney is a little longer and narrower than the left kidney" The left side kidney is slightly longer and narrower compared to the right side.

Which instruction would the nurse include in a health practices teaching plan for a female client with a history of recurrent urinary tract infections? A) "wear cotton underwear or lingerie" B) " void at least every 6 hours around the clock "C) "increase foods containing alkaline ash in the diet D) "wipe the perineum from the back to front after toileting"

A) "wear cotton underwear or lingerie" Cotton allows air to circulate and does not retain moisture the way that synthetic fibers do, microorganisms multiply in warm, moist environment.

which is the concentration of estradiol in the blood during the follicular phase of the menstrual cycle? A) 130 pg/mL B) 159 pg/mL C) 165 pg/mL D) 171 pg/mL

A) 130 pg/mL in the follicular phase of the menstrual cycle, 20 to 150 pg/mL of estradiol is released.

which value indicates a normal vaginal pH? A) 4.2 B) 6.8 C) 7.5 D) 9.3

A) 4.2 Normal vaginal pH ranges from 3.5-5 clients with a higher vaginal pH are more prone to infections (6.8, 7.5, and 9.3)

How long will a clients ovum stay viable for fertilization after its release? A) 72 hours B) 84 hours C) 96 hours D) 112 hours

A) 72 hours An ovum can be fertilized up to 72 hours after its release. The ovum disintegrates after 72 hours, and menstruation begins soon after. The ovum cannot be viable for 84, 96 or 112 hours, and fertilization will not occur

Which defining characteristic is associated with the Somogy effect? Select all that apply. A) Documented morning hyperglycemia B) Caused by not rotating insulin injection sites C) Avoided by consuming a bedtime snack D) Treated with a lower dose of insulin in the evening E) Documented hypoglycemia between 2:00 AM and 4:00 AM F) Required adjustment of administration time of evening insulin

A) Documented morning hyperglycemia C) Avoided by consuming a bedtime snack D) Treated with a lower dose of insulin in the evening E) Documented hypoglycemia between 2:00 AM and 4:00 AM Rationale: Hyperglycemia in the morning can be caused by the Somogyi effect, which can be stimulated by too much insulin in the evening. During the night, typically between 2:00 AM and 4:00 AM, hypoglycemia occurs (5), which stimulates a release in counterregulatory hormones in an attempt to raise the blood sugar. What results is rebound hyperglycemia resulting in higher blood sugar readings upon awakening (1). The Somogyi effect must be differentiated from dawn phenomenon, which also results in higher morning blood sugar readings. The treatment for Somogyi effect includes consuming a bedtime snack (3) or reducing the evening insulin dose (4), whereas the treatment for dawn phenomenon is an increase in the evening insulin dose or an adjustment in the timing of the evening insulin dose (6). Not rotating insulin injection sites does not result in either the Somogyi effect or dawn phenomenon (2). In fact, current recommendations are to use the same anatomic injection site (e.g., the abdomen) for one week before moving to another anatomic injection site.

Which lab value would the nurse assess when preparing a client for a renal biopsy? Select all that apply: A) Hematocrit B) Hemoglobin C) platelet count D) Prothrombin time (PT) with international normalized ratio (INR) E) Partial thromboplastin time (PTT)

A) Hematocrit B) Hemoglobin C) platelet count D) Prothrombin time (PT) with international normalized ratio (INR) E) Partial thromboplastin time (PTT) The hematocrit and hemoglobin would be checked before and after the procedure to determine blood loss. The nurse would also check the patient's platelets, PT/INR and PTT to determine if the patient is at risk for hemorrhage.

Which hormone is crucial for ovulation and complete maturation of the ovarian follicles: A) Luteinizing hormone B) Follicle-stimulating hormone C) Gonadotropin-releasing hormone D) Human chorionic gonadotropin hormone

A) Luteinizing hormone Ovulation and complete maturation of ovarian follicles can only take place in the presence of luteinizing hormone. However, follicle-stimulating hormone initiates maturation of the follicles.

Which glands help in lubricating the female urinary meatus? A) Skene glands B) Prostate glands C) Cowper glands D) Bartholin glands

A) Skene glands Located along the urinary meatus and help lubricate the urinary meatus

Which clinical manifestation of a UTI would the nurse teach to a male client with a history of recurrent urinary tract infections (UTIs) when preparing for a discharge after a ureterolithotomy? A) Urgency or frequency of urination B) An increase of ketones in the urine C) the inability to maintain an erection D) pain radiating to the external genitalia

A) Urgency or frequency of urination Urgency or frequency of urination occurs with a urinary tract infection because of bladder irritability, burning on urination and fever are additional signs of UTI.

Which instruction on infection prevention would the nurse include when providing discharge education to a client who received a cadaveric renal transplant? Select all that apply A) avoid eating from buffets B) obtain annual flu vaccinations C) Perform regular hand hygiene D) stay away from a temp greater than 100.5

A) avoid eating from buffets B) obtain annual flu vaccinations C) Perform regular hand hygiene D) stay away from a temp greater than 100.5 Patients who receive an organ transplant need to take immunosuppressant medications for the rest of their lives to prevent organ rejection. These medications put the client at an increased risk for infection.

which characteristic of urine changes in the presence of a urinary tract infection (UTI)? A) clarity B) viscosity C) glucose level D) specific gravity

A) clarity cloudy urine indicates drainage associated with infection. Viscosity is a characteristic that is not measurable in urine. Urinary glucose levels are not affected by UTIs. Specific gravity yields info related to fluid balance

Which method(s) is a barrier type of contraception? Select all that apply A) condom B) diaphragm C) Lea's shield D) Spermicidal foam E) Coitus interruptus

A) condom B) diaphragm C) Lea's shield A condom prevents the entrance of sperm A diaphragm is a cervical covering to prevent sperm from reaching the egg. Lea's shield is a reusable vaginal contraceptive made of silicone.

Where is the blood pressure cuff placed on a client with a dialysis access fistula in the right arm? A on the left arm B over the fistula C below the fistula D above the fistula

A) on the left arm If the fistula is on the right arm, then the left arm should be used for blood pressure cuff placement. Blood pressure cuffs or other restrictive devices should not be placed on the arm with a dialysis access fistula including above, below or over the fistula.

Which phase of a woman's sexual response is characterized by elevation of the uterus? A) plateau phase B) Orgasmic phase C) excitation phase D) resolution phase

A) plateau phase elevation of the uterus is a characteristic of the plateau phase of a women's sexual response. The plateau occurs after the excitation phase, and excitation is maintained through the plateau phase, wherein the vagina expands and the uterus is elevated. The orgasmic phase is characterized by uterine and vaginal contractions. In the excitation phase the clitoris is congested and vaginal lubrication increases. The resolution phase is characterized by returning to the preexisting state.

Which statement reflects the nurse's suspicions regarding a client's cloudy urine noted on a urinalysis report? A) the client has a urinary infection B) the client has a biliary obstruction C) the client has a diabetic ketoacidosis D) the client has been on a starvation diet

A) the client has a urinary infection Urine becomes cloudy when an infection is present due to the presence of leukocytes.

Which instruction would the nurse include when teaching the client how to perform peritoneal dialysis and the importance of preventing peritonitis? Select all that apply: A) wear a mask during the procedure B) clean the catheter exit site every day C) maintain meticulous aseptic technique D) wash your hands before the exchange E) store supplies in a clean and dry location

A) wear a mask during the procedure B) clean the catheter exit site every day C) maintain meticulous aseptic technique D) wash your hands before the exchange E) store supplies in a clean and dry location

What is the maximum amount of time the nurse should allow an older adult with a cerebrovascular accident (also known as "brain attack") to remain in one position? A. 1 to 2 hours B 3 to 4 hours C 15 to 20 minutes D 30 to 40 minutes

A. 1 to 2 hours 1 to 2 hoursChange of position at least every 1 or 2 hours helps prevent the respiratory, urinary, and cutaneous complications of immobility [1] [2]. Too protracted a period of time in one position, such as every 3 to 4 hours, increases the potential for respiratory, urinary, and neuromuscular impairment; prolonged physical pressure increases the possibility of skin breakdown. Fifteen to 20 minutes and 30 to 40 minutes are unnecessarily short time intervals; too frequent repositioning may interfere with the client's rest. Test-Taking Tip: Read the question carefully before looking at the answers: (1) Determine what the question is really asking; look for key words; (2) Read each answer thoroughly and see if it completely covers the material asked by the question; (3) Narrow the choices by immediately eliminating answers you know are incorrect.

Which blood glucose levels would the nurse identify as hypoglycemia? A. 68 mg/dL B. 78 mg/dL C. 88 mg/dL D. 98 mg/dL

A. 68 ng/dL Normal blood glucose is 72-108 Blood glucose less than 72 ng/dL is considered low.

Which diagnosis does the nurse expect in a patient who presents with hematuria, progressive uremia, and sensorineural deafness? A. Alport syndrome B. Nephrotic syndrome C. Goodpasture syndrome D. Polycystic kidney disease

A. Alport syndrome Hematuria, ocular changes, and sensorineural deafness are clinical manifestations of Alport syndrome.

Which disorder is an extrarenal cause of nephrotic syndrome? Select all that apply: A. Amyloidosis B. Scleroderma C. Diabetes Mellitus D. Hodgkin lymphoma E. Infective endocarditis

A. Amyloidosis C. Diabetes mellitus D. Hodgkin's lymphoma

Which action would the nurse take first when teaching the patient with type 2 diabetes to become an active participant in his or her own care? A. Assess the patient's understanding of the disease B. Make a list of food restrictions for proper diabetes management C. Refer the patient to a nutritionist D. Set long term goals to decrease the risk of complications

A. Assess the patient's understanding of the disease For teaching to be effective, the first step is assessing the patient. Assessing the patient's knowledge of diabetes mellitus and lifestyle preference when planning a teaching program.

The nurse would instruct the patient with diabetes to fast for which period of time when scheduled for a fasting blood glucose level at 8:00 am. A. At least eight hours B. 4:00 am on the day of the test C. After dinner the evening before the test D. 7:00 am on the day of the test.

A. At least eight hours Fasting is defined as no caloric intake for at least 8 hours. Typically a patient is prescribed NPO for eight hours before determination of the fasting glucose level. For this reason, the patient who has a lab draw at 8:00 am should not have food or beverages containing any calories after midnight.

Which medical condition places a patient at a higher risk for an embolic stroke? A. Atrial fibrillation B. Atherosclerosis C. Cancer of the brain D. Anticoagulant therapy

A. Atrial fibrillation can cause a significant number of embolic strokes. Cancer of the brain is related to a mass in the cranium and not the blood vessels.

A client is scheduled for head and neck surgery. Although the healthcare provider has explained the surgery, the client still has moderate to severe anxiety. Which action should the nurse take initially? A Attempt to discover what the client is concerned about. B Elaborate on what the healthcare provider has already said. C Teach the client to use the suction equipment preoperatively. D Plan for postoperative communication because a tracheostomy is likely.

A. Attempt to discover what the client is concerned about. Various aspects of hospitalization and diagnosis may cause the client to become anxious. The nurse should identify what concerns the client the most. Anxiety interferes with learning, and it is the healthcare provider's responsibility to explain the surgery. Teaching the client to use the suction equipment preoperatively may cause the client unnecessary anxiety. A tracheostomy may not be performed; it depends on the type of surgery.

A client with a history of peripheral artery disease arrives on the postoperative unit. The nurse performs a focused peripheral vascular assessment and is unable to palpate pedal pulses on the operative leg. What should the nurse do next? Select all that apply. A. Attempt to palpate pulses on the nonoperative leg B. Compare the current assessment to baseline data C. Assess for color, movement, and sensation. D. Obtain a doppler to assess for pulses E. Administer pain medication

A. Attempt to palpate pulses on the nonoperative leg B. Compare the current assessment to baseline data C. Assess for color, movement, and sensation. D. Obtain a doppler to assess for pulses

which type of surgery involves opening the skull with a drill A. Burr hole B. Craniotomy C. Craniectomy D. Cranioplasty

A. Burr hole Opening into the cranium with a drill. A craniotomy is a cranial surgery that involves opening up the cranium with the removal of a bone flap and opening the dura to remove the lesion. A craniectomy is an excision into the crainium to cut away a bone flap. A cranioplasty is the repair of a cranial defect caused by trauma.

Escherichia coli is resistant to which medications? Select all that apply A. Ciprofloxacin (Cipro) B. Fosfomycin (Monurol) C. Fluconazole (Diflucan) D. Trimethoprim (Primsol) E. Sulfamethoxazole (Gantranol)

A. Ciprofloxacin (Cipro) D. Trimethoprim (Primsol) E. Sulfamethoxazole (Gantranol) E. coli is resistant to trimethoprim and sulfamethoxazole. These are used in combination to treat uncomplicated or initial urinary tract infections (UTI). Ciprofloxacin is a fluoroquinolone derivative that is used to treat complicated UTIs. Amphotericin is the preferred therapy in patients with UTI secondary to fungi.

The nurse is assessing a patient newly diagnosed with type 2 diabetes. Which symptom reported by the patient correlates with the diagnosis? A. Excessive thirst B. Gradual weight gain C. Overwhelming fatigue D. Recurrent blurred vision

A. Excessive thirst The classic symptoms of diabetes are polydipsia (excessive thirst), polyuria, (excessive urine output), and polyphagia (increased hunger). Weight gain, fatigue, and blurred vision may all occur with type 2 diabetes, but are not classic manifestations.

Which interventions would the nurse include in the care for a patient who underwent transsphenoidal excision of the pituitary gland? (select all that apply) A. Frequent monitoring of serum and urine osmolarity B. Assessment of visual acuity and extraocular movement C. keeping the patient in a recumbent position at all times. D. Teaching the patient about the need for lifelong hormone therapy. E. Instructing the patient to blow their nose frequently to relieve cerebral pressure.

A. Frequent monitoring of serum and urine osmolarity B. Assessment of visual acuity and extraocular movement D. Teaching the patient about the need for lifelong hormone therapy.

Which lobe of the brain is affected if a patient has Broca's aphasia? A. Frontal lobe B. Parietal lobe C. Occipital lobe D. Temporal lobe

A. Frontal lobe Broca's aphasia causes the patient to speak in short fragments and is caused by damage to the frontal lobe of the brain. The parietal lobe, occipital lobe, and temporary lobes of the brain are not associated with Broca's aphasia.

Which lobe of the cerebrum includes the Broca speech center? A. Frontal lobe B. Parietal lobe C. Occipital lobe D. Temporal lobe

A. Frontal lobe Rationale: The broca speech center is located in the frontal lobe and is responsible for the formation of word into speech. The parietal lobe aids in the processing of spatial awareness and receiving and processing information about temperature, taste and touch. The primary visual center is in the occipital lobe, the auditory center for interpreting sound is present in the temporal lobe.

The nurse anticipates that a patient with an enlarged thyroid gland will be diagnosed with which endocrine disorder? A. Goiter B. Fibroma C. Hypothyroidism D. Hyperparathyroidism

A. Goiter Rationale: A goiter is an enlarged thyroid gland. ~Fibroma is a fibrous encapsulated connective tissue tumor. ~With hypothyroidism the patient is often tired and lethargic, there also may be some personality and mental changes including impaired memory, slowed speech, decreased initiative and somnolence. ~Hyperparathyroidism is a condition involving an increased parathyroid hormone secretion

Which action would the nurse suggest when a client reports feeling faint and lightheaded upon rising to a standing position after a discectomy and fusion surgery? A. Have the client sit on the edge of the bed so the nurse can hold the client upright. B. Have the client slide to the floor with assistance to avoid injuring the client because of a fall. C. Have the client bend forward to increase the blood flow to the brain. D. Have the client lie down immediately, so the nurse may obtain the clients blood pressure.

A. Have the client sit on the edge of the bed so the nurse can hold the client upright. Sitting maintains alignment of the back and allows the nurse to support the client until the orthostatic hypotension subsides. Sliding to the floor and bending forward will induce flexion of the vertebrae, which can traumatize the spinal cord. Rapid movement can flex the vertebrae, which will traumatize the spinal cord, taking the BP at this time is not necessary.

The nurse would assess which perimeter before giving levothyroxine for the first time to a patient newly diagnosed with hypothyroidism? A. Heart rate B. Intake and output C. Temperature D. Blood pressure

A. Heart rate Rationale: When thyroid hormone therapy is initiated, patients must be monitored carefully for increased pulse. The nurse should report a pulse greater than 100 BPM, or an irregular heartbeat. The nurse should also promptly report chest pain, nervousness, tremors or insomnia.

A nurse is caring for a newly admitted client with a diagnosis of Graves disease. In preparing a teaching plan, the nurse anticipates which diet will be prescribed for this client? A. High-calorie diet B Low-sodium diet C High-roughage diet D Mechanical-soft diet

A. High-calorie diet Because of the individual's increased metabolic rate, a high-calorie diet is needed to meet the energy demands of the body and prevent weight loss. Sodium is not restricted because clients with hyperthyroidism perspire heavily and lose sodium. Gastrointestinal motility is increased and does not require the additional stimulus of increased roughage. Modification of dietary consistency is unnecessary.

A patient has sustained a stroke on the right side of the brain. What clinical manifestation does the nurse determine to be associated with this type of injury? A. Impulsiveness B. Impaired speech C. Slow performance D. Paralyzed right side

A. Impulsiveness A patient who sustains a stroke on the right side of the brain shows impulsiveness. Impaired speech, slow performance, and a paralyzed right side occur when a patient has had a stroke on the left side of the brain.

To promote optimal absorption of the medication, the nurse would recommend for a patient to take levothyroxine at which time of the day? A. In the morning before breakfast B. In the morning with food C. During the late afternoon before dinner D. In the evening with a bedtime snack

A. In the morning before breakfast For maximum absorption, levothyroxine should be taken in the morning on an empty stomach, approximately 30 minutes before breakfast.

Which phrase describes the function of the limbic system? A. Influence emotional behavior B. Regulate autonomic functions C. Facilitate automatic movements D. Relay sensory and motor inputs for cerebrum

A. Influence emotional behavior Located lateral to the hypothalamus, the limbic system influences emotional behavior and basic drives such as feeding and sexual behaviors.

Which information will a transcranial Doppler (TCD) ultrasonography provide?A. It measures the velocity of blood flow. B. It identifies red blood cells. C. It visualizes blood vessels. D. It measures oxygenation.

A. It measures the velocity of blood flow. TCD is used to measure the velocity of blood flow in the cerebral arteries. A lumbar puncture identifies red blood cells in the cerebral spinal fluid. A CT scan visualizes the cerebral blood vessels. The LICOX system is used to measure brain oxygenation and temperature.

The nurse finds a victim under the wreckage of a collapsed building. The individual is conscious, supine, breathing satisfactorily, reports experiencing back pain and an inability to move the legs. Which action would the nurse implement first? A. Leave the individual lying on the back with instructions not to move, and seek additional help. B. Roll the individual onto the abdomen, place a pad under the head and cover with any material available C. Gently raise the individual to a sitting position to determine whether the pain either diminishes or increases in intensity. D. Gently lift the individual onto a flat piece of lumber, using any transportation, rush to the closest medical institution.

A. Leave the individual lying on the back with instructions not to move, and seek additional help. Rationale:The nurse would not move the individual without use of a backboard, to avoid additional spinal cord damage. Moving a person whose spinal cord has been injured may cause irreversible paralysis. A back injury precludes changing the person's position. The client has a suspected back injury; do not move the person. The client needs a flat board; however, one rescuer should not move the person without help.

Which structure helps to bend light rays and allow them to fall onto the retina? A. Lens B. Zonule C. Cornea D. Aqueous humor

A. Lens The lens is a biconvex structure located behind the iris. Its primary function is to bend light rays, allowing them to fall onto the retina. The zonule is a series of microscopic wire-like threads that holds the lens in place. The cornea is responsible for the majority of the light refraction necessary for clear vision. The aqueous humor provides nutrition to ocular tissues and maintains intraocular pressure.

Which rationale would the nurse use to explain the cane's purpose to a client with hemiparesis who voices a reluctance to use a cane? A. Maintain balance and improve stability B. Relieve pressure on weight-bearing joints C. Prevent further injury to weakened muscles D. Aid in controlling involuntary muscle movements

A. Maintain balance and improve stability Hemiparesis creates instability. Using a cane provides a wider base of support and therefore greater stability. Hemiparesis affects muscle strength on one side of the body. The joints are not directly affected. Activity should strengthen, not injure the weakened muscles. The use of a cane will not prevent involuntary movements if they are present.

Which structure is a component of the auditory ossicles? A. Malleolus B. Vestibule C. Tympanic membrane D. External acoustic meatus

A. Malleolus Rationale: The malleolus along with the incus and stapes constitutes the auditory ossicles. The vestibule is present in the inner ear and is an organ of balance. The tympanic membrane (eardrum) is part of the middle ear. The external acoustic meatus is a component of the external ear.

What behavioral response to a disaster would the nurse treat first, in an attempt to avoid mass hysteria? A. Panic B. Coma C. Euphoria D. Depression

A. Panic People in a panic may initiate group panic reactions or mass hysteria, even those who appear to be in control. Comatose individuals will not cause panic in others. Euphoric individuals will not adversely affect others. Depressed people will be quiet and not affect others.

Which hormone regulates blood levels of calcium? A. Parathyroid hormone (PTH) B. Luteinizing hormone (LH) C. Thyroid stimulating hormone TSH) D. Adrenocorticotropic hormone (ACTH)

A. Parathyroid hormone (PTH) PTH regulates the blood levels of calcium and phosphorus.

Which of the following are risk factors for Type 2 diabetes? Select all that apply. A. Physical inactivity (exercise less than 3 times a week). B. Obesity C. Age 45 or older D. Gestational diabetes or having had a baby >9 lbs E. A diet that includes sugar and carbohydrates.

A. Physical inactivity (exercise less than 3 times a week). B. Obesity C. Age 45 or older D. Gestational diabetes or having had a baby >9 lbs You're at risk for type 2 diabetes Links to an external site. if you: Have prediabetes. Are overweight. Are 45 years or older. Have a parent, brother, or sister with type 2 diabetes. Are physically active less than 3 times a week. Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed over 9 pounds. Are an African American, Hispanic or Latino, American Indian, or Alaska Native person. Some Pacific Islanders and Asian American people are also at higher risk. If you have non-alcoholic fatty liver disease you may also be at risk for type 2 diabetes.

Which type of rehabilitation is an essential component to a client's recovery from Guillain-Barre syndrome. A. Physical therapy B. Speech exercises C Fitting with a vertebral brace D. Follow up on cataract progression

A. Physical therapy Rehabilitation needs for a client with Guillain-Barre syndrome focuses on physical therapy and exercise for the lower extremities because of muscle weakness and discomfort. A client with Guillain Barre syndrome does not need speech or swallowing exercises.

Which nursing intervention would the nurse implement for a client newly diagnosed with myasthenia gravis who voiced concerns about fluctuations in physical condition and generalized weakness? A. Preplan the spacing of activities throughout the day. B. Restrict activities and encourage bedrest. C. Teach the client about limitations imposed by the disorder. D. Have a family member stay at the bedside to give the client support. Preplan the spacing of activities throughout the day.

A. Preplan the spacing of activities throughout the day. Rationale: Spacing activities encourages maximum functioning within the limits of the client's strength and endurance. Bed rest and limited activity may lead to muscle atrophy and calcium depletion. Teaching the limitations imposed by the disorder is necessary for lifelong psychological adjustment but does not address the client's concerns at this time. Staff should permit the client to have a member of the family stay and give the client support if requested by the client or family, but this intervention does not address the concerns voiced by the client.

Which disorder includes the inflammation of renal parenchyma and the collecting system? A. Pyelonephritis B Interstitial cystitis C. Urethral diverticula D. Glomerulonephritis

A. Pyelonephritis Pyelonephritis is an inflammation of the renal parenchyma and the collecting system. Interstitial cystitis is a chronic, painful inflammatory disease of the bladder. Urethral diverticula are the localized outpouchings of the urethra. Glomerulonephritis is the inflammation of the glomeruli.

Which actions would the nurse include in the plan of care at this time? Select all that apply. A. Safety precautions B. Intravenous access C. Oxygen supplementation D. High protein diet E. Consult with physical therapy F. Pain control G. Blood sugar checks ac and hs H. Monitor serum CO2 levels

A. Safety precautions B. Intravenous access Rationale: Metabolic acidosis results from the kidneys' impaired ability to excrete excess acid as well as reabsorb and regenerate HCO3−. Safety precautions must be implemented due to central nervous system depression related to metabolic acidosis, which may manifest as muscle weakness, dizziness, and confusion. Serum electrolytes can provide important information about a patient's acid-base balance. Decrease in the serum HCO3− is reported as decreased CO2 on an electrolyte panel and indicates metabolic acidosis. An IV access must be maintained for emergent fluid and medication needs that the patient may not be able to take orally due to lethargy and confusion.

A patient is admitted to the hospital with acute adrenal insufficiency. Which laboratory tests would the nurse expect the health care provider to prescribe? Select all that apply. A. Sodium B. Cortisol C. Albumin D. Potassium E. Liver function

A. Sodium B. Cortisol D.Potassium Due to cortisol and aldosterone deficiencies, the nurse would expect the health care provider to prescribe laboratory tests for sodium, cortisol, and potassium levels. Albumin level and liver function are not essential for the care of this patient.

Which clinical manifestations indicate a client who sustained head and chest injuries, but responded to medical treatment, is ready for transfer to a critical care unit? A. Stabilized vital signs and complaints of pain B. Pale and alert, remains restless C. Increasing temperature and apprehension D. Fluctuating vital signs and drowsy, but easily roused

A. Stabilized vital signs and complaints of pain Stable vital signs is the major indicator predicting transfer will not jeopardize the clients condition. Although complaints of pain are a concern, they do not place the client in physiologic jeopardy. Restlessness and pallor may be early signs of shock, the client needs further assessment. An increasing temperature is a sign of increasing intracranial pressure, delay transfer of the client at this time. Fluctuating vital signs and drowsiness indicate an unstable client with potentially increasing intracranial pressures.

Which action would be appropriate to implement when collecting a 24-hour urine test? A. Start the time of the test after discarding the first voiding. B. Discard the last voiding in the 24-hour period for the test. C.Insert a urinary retention catheter to promote the collection of urine. D. Strain the urine after each voiding before adding the urine to the container.

A. Start the time of the test after discarding the first voiding. The first voiding is discarded because that urine was in the bladder before the test began and should not be included.

Which rationale would the nurse give when a nursing student asks why enemas are contraindicated in patients with hypothyroidism and coronary artery disease (CAD)? A. To avoid vagus nerve stimulation B. To avoid olfactory nerve stimulation C. To avoid abducens nerve stimulation D. To avoid hypoglossal nerve stimulation

A. To avoid vagus nerve stimulation Constipation is a common problem associated with hypothyroidism. The use of enemas, however is contraindicated because they result in vagus nerve stimulation for patients with a history of cardiac disease.

Why is it important patients diagnosed with diabetic ketoacidosis (DKA) get an IV of normal saline right away? A. To correct fluid and electrolyte imbalance, raise blood pressure and restore urine output. B. To establish a vein in order to prepare for other medications. C. To decrease urine output and increase ketones. D. To increase metabolic acidosis.

A. To correct fluid and electrolyte imbalance, raise blood pressure and restore urine output. The risk for DKA is highest with Type 1 diabetes. Diabetic ketoacidosis (DKA) is a serious complication of diabetes that can be life-threatening. DKA is most common among people with type 1 diabetes Links to an external site.. People with type 2 diabetes Links to an external site. can also develop DKA. DKA develops when your body doesn't have enough insulin to allow blood sugar into your cells for use as energy. Instead, your liver breaks down fat for fuel, a process that produces acids called ketones. When too many ketones are produced too fast, they can build up to dangerous levels in your body. DKA usually develops slowly. Early symptoms include: Being very thirsty. Urinating a lot more than usual.

A patient who underwent percutaneous transluminal angioplasty (PTA) to treat lower leg peripheral artery disease is prescribed a low dose of aspirin daily. Which action is the desired effect of this medication? A. To prevent agglutination B. To stimulate collateral circulation C. To decrease liver production of vitamin K D. To control pain resulting from the procedure.

A. To prevent agglutination Rationale: Aspirin is prescribed for its antiplatelet effect. It interferes with platelet agglutination (sticking together to form a blood clot)

In women, which disorder of the urinary system is caused by Trichomonas? A Urethritis B Interstitial cystitis C. Urethral diverticula D. Chronic pyelonephritis

A. Urethritis Urethritis is an inflammation of the urethra from a bacterial or viral infection, which may be caused by Trichomonas and monilial infection in women and chlamydial infection and gonorrhea in men. Interstitial cystitis is a chronic, painful inflammatory disease of the bladder. It is also called painful bladder syndrome. The symptoms of interstitial cystitis are urinary urgency, frequency, and pain in the bladder. Urethral diverticula are localized outpouchings of the urethra. They are usually caused by enlargement of obstructed periurethral glands. Chronic pyelonephritis is associated with small, atrophic, and shrunken kidneys. It is usually caused by recurring infection of the upper urinary tract.

Which information would the nurse correct before completing written discharge instructions for a patient with urethritis? A. Use vaginal deodorant sprays. B. Take metronidazole (Flagyl) as prescribed C. Clean the peroneal area from front to back D. Avoid sexual intercourse for at least seven days.

A. Use vaginal deodorant sprays.

Which artery would be obstructed if a patient sustained a stroke and is experiencing cranial nerve deficits? A. Vertebral Artery B. Middle Cerebral Artery C. Anterior Cerebral Artery D. Posterior Cerebral Artery

A. Vertebral Artery The vertebral artery supplies blood to the posterior part of the circle of Willis. Any impairment in the vertebral artery leads to cranial nerve deficits.

Which of the following are actions the nurse should take FIRST upon arrival of a patient with symptoms of a stroke? A. VItal signs and onset of patient symptoms. B. The last time patient ate and medications taken that day. C. Pulse oximetry and urine output. D. Neuro assessment and weight.

A. Vital signs and onset of patient symptoms. The responsibility of a nurse is to assess, and that starts with vital signs. and ABC's. Is the BP elevated? Is the airway patent? What observations have you made? Next step is to determine WHEN the symptoms began. If this patient is having stroke symptoms the nurse should anticipate a CT or MRI will be ordered by the provider to determine if the stroke is Ischemic (clot or blockage) or hemorrhagic (bleed). The provider must know what type of stroke it is because only the ischemic stroke is treated with TPA or alteplase. The patient with a hemorrhagic stroke may need surgical evacuation of the bleed. TPA or alteplase can only be given within hours from the start of the patients symptoms so TIME IS OF THE ESSENCE. TIA's (also called mini-strokes) are temporary and need to be treated as an emergency even though symptoms are resolved. A TIA can be a signal something is wrong and needs to be investigated. Some times a bigger stroke is precipitated by a TIA as a warning.

Which of the following are expected findings in a urinalysis result? A. pH 4.6-8 B. SG 1.005-1.030 C. Clear amber yellow color D. Glucose E. Ketones F. Blood G. Protein

A. pH 4.6-8 B. SG 1.005-1.030 C. Clear amber yellow color

A patient is in a MVA with abdominal trauma and significant blood loss. What category of renal problem would you anticipate? A.Prerenal B.Intrarenal C.Postrenal D.Prerenal and postrenal.

A.Prerenal

Which hormonal deficiency causes diabetes insipidus in a client?

ADH deficiency causes diabetes insipidus.

Which of the following statements is accurate in differentiating between AKI (Acute Kidney Injury) and CKD (Chronic Kidney Disease)? A. The primary cause of death in patients with CKD is infection. B. An important diagnostic test in CKD is: GFR < 60 mL/min/1.73m2 for >3 months and /or kidney damage > 3 months. C. CKD is generally acute and reversible. D. The most common cause of AKI is diabetic nephropathy.

AKI: Onset: Sudden Common cause:Acute tubular necrosis Diagnosis criteria: Acute reduction in urine output and or elevation in serum creatinine Reversibility: Potentially Cause of death: Infection CKD Onset: gradually over years Common cause: diabetic nephropathy Diagnosis criteria: GFR >60 mL/min.1.73 m2 for >3 months and or kidney damage>3 months Reversibility: Progressive and irreversible Cause of death: cardiovascular disease

________is a medical emergency. It is brought on by sudden withdrawal of steroids or a stressful event(trauma, severe infection).

Addison crisis

What is Erythropoietin (EPO)?

Administered IV or subcutaneously Increased hemoglobin and hematocrit in 2 to 3 weeks Increased hemoglobin and hematocrit in 2 to 3 weeks

What is agraphia?

Agraphia is difficulty writing.

What is the result of an adrenocorticotropic hormone deficiency?

An adrenocorticotropic hormone deficiency causes postural hypotension, hypoglycemia, and anorexia.

A client is admitted for hypertension, and serum electrolyte studies have yielded abnormal results. The scheduled workup includes a scan for an aldosteronoma. What gland is affected in aldosteronoma? A. Adrenal cortex B. Kidney cortex C. Thyroid gland D. Pituitary gland

An aldosteronoma is an aldosterone-secreting adenoma of the A. adrenal cortex.

What symptoms are seen in an antidiuretic hormone deficiency?

An antidiuretic hormone deficiency causes excessive urine output and a low urine specific gravity.

What is embolic stroke related to?

An embolic stroke is mostly related to heart conditions such as atrial fibrillation, myocardial infarction, and infective endocarditis.

What is a multinodular goiter?

An enlarged thyroid gland with two or more nodules suggests a metabolic rather than a neoplastic process. Positive family history and continuing nodular enlargement are additional risk factors for malignancy.

What hormones does the adrenal gland secrete?

Androgens, corticosteroids, catecholamines.

What does the presence of bilirubin in the urine indicate?

Anorexia nervosa, diabetic ketoacidosis, and prolonged fasting.

Which kind of stroke can anticoagulant therapy cause?

Anticoagulant therapy can cause hemorrhagic strokes.

What are the three classifications of urine outputs?

Anuric- < 100 mL/day Oliguric- <400 mL/day Nonoliguric-> 400 mL/day

What is aphasia?

Aphasia is difficulty speaking or understanding speech.

Which condition results in visual distortion? A. Myopia B. Hyperopia C. Presbyopia D. Astigmatism

Astigmatism Rationale: Astigmatism is caused by unevenness in the cornea; this condition results in visual distortion. Myopia (nearsightedness) results in blurred vision of distant objects. Hyperopia (farsightedness) results in the clear vision of distant objects and the blurred vision of close objects. Presbyopia is a condition related to older adults, resulting in an inability to focus on near objects.

How is atherosclerosis a risk for stroke?

Atherosclerosis causes narrowing of the blood vessels and reduces cranial blood flow and is a risk factor for thrombotic stroke.

To ensure a quality specimen and an accurate test result, which instruction would the nurse give a client who is scheduled to undergo urine endocrine testing? A "Start the urine collection when the bladder is full." B "Store the urine specimen in a cooler with ice." C "Store the urine specimen in a home refrigerator." D "Save the urine specimen that begins the collection."

B "Store the urine specimen in a cooler with ice." The urine specimen that is collected for endocrine testing should be stored in a cooler with ice to prevent bacterial growth in the specimen. The nurse should instruct the client to start the urine collection after emptying the bladder. The client should be instructed not to store the urine specimen in a home refrigerator with other food and drinks because it could lead to cross-contamination. The client should be instructed to refrain from saving the urine specimen that begins the collection because the timing for urine collection starts from after the initial voiding specimen.

Which assessment finding would the nurse expect in a patient with hypothyroidism? A Diaphoresis B Constipation C Heat intolerance D Palpitations

B Constipation Constipation is a common symptom of hypothyroidism.

An adult client is brought to the emergency department by a friend who states, "We were all partying at a club, and all of a sudden my friend collapsed." Vital signs revealed a temperature of 99.2° F, pulse of 152, respiratory rate of 32, blood pressure of 163/92. After performing a physical assessment and collecting a health history from the client, what action should the nurse take next? A.Reassess the client and allow the friend to stay. B Inform the healthcare provider of the client's status and prepare to start an intravenous (IV) line. C. Assign the client to a private room and put a cool cloth on the client's forehead. D. Place the client in a dimly lit room and perform a neurologic assessment every 15 minutes.

B Inform the healthcare provider of the client's status and prepare to start an intravenous (IV) line. Inform the healthcare provider of the client's status and prepare to start an intravenous (IV) line.4-methylenedioxy-methamphetamine (Ecstasy) is a drug of abuse that has both stimulant and hallucinogenic properties. Stimulants have the ability to cause dehydration by increasing activity and diaphoresis via increased adrenalin release. The client is displaying symptoms of dehydration; the healthcare provider must be informed so an IV can be prescribed. Letting the friend stay and reassessing the client in one hour are inappropriate; the client's vital signs indicate the need for immediate attention. Placing the client in a private room with a cool cloth on the head is inappropriate; the client's vital signs are indicative of a problem. Performing a neurologic assessment every 15 minutes is inappropriate at this time. The client's vital signs indicate a need for immediate medical attention.

Which molecule excessively accumulates in the blood to precipitate the signs and symptoms associated with a diabetic coma? A Sodium bicarbonate, causing alkalosis B Ketones as a result of rapid fat breakdown, causing acidosis C Nitrogen from protein catabolism, causing ammonia intoxication D Glucose from rapid carbohydrate metabolism, causing drowsiness

B Ketones as a result of rapid fat breakdown, causing acidosis Ketones are produced when fat is broken down for energy. Although rarely used, sodium bicarbonate may be administered to correct the acid-base imbalance resulting from ketoacidosis; acidosis is caused by excess acid, not excess base bicarbonate. Diabetes does not interfere with removal of nitrogenous wastes. Carbohydrate metabolism is impaired in the client with diabetes.

A deficiency in which hormone causes breast atrophy in female clients? A Growth hormone B Luteinizing hormone C Thyroid-stimulating hormone D Adrenocorticotropic hormone

B Luteinizing hormone A luteinizing hormone deficiency causes atrophy of the breasts.

Which muscles help move the eye diagonally downward towards the middle of the head? Select all that apply. A Lateral rectus muscle B Medial rectus muscle C Inferior oblique muscle D Inferior rectus muscle E Superior oblique muscle

B Medial rectus muscle C Inferior oblique muscle Rationale: The inferior rectus muscle together with the medial rectus moves the eye diagonally downward towards the middle of the head. The lateral rectus muscle together with the medial rectus muscle holds the eye straight. The medial rectus muscle helps in turning the eye towards the nose. The inferior oblique muscle will pull the eye upward. The superior oblique muscle pulls the eye downward.

Which musculoskeletal problem would a nurse expect to find in a patient with Cushing syndrome? A Striae B Osteoporosis C Osteoarthritis D Rheumatoid arthritis

B Osteoporosis Excess cortisol levels deplete calcium from the bones causing weakness and osteoporosis. Striae are skin changes that happen due to weight gain. Osteoarthritis and rheumatoid arthritis are disorders of the joints less likely to be found with Cushing syndrome.

After administering glucagon to an unconscious patient, the nurse would place the patient in which position? A Supine B Side lying C High fowler D. Semi fowler

B Side lying Nausea is a common reaction after glucagon injection. The patient should be placed in the side lying position to prevent aspiration should the patient vomit. The supine, high-fowler and semi-fowler positions are not advisable because of the risk of aspiration of vomitus.

Goals of managing the patient with diabetes include select all that apply: A keeping target A1C greater than 9% B Teaching self monitoring of glucose levels C preventing complications of hypoglycemia D monitoring for ophthalmologic complications E maintaining the LDL cholesterol greater than 100 mg/dL (2.6 mmol/l)

B Teaching self monitoring of glucose levels C preventing complications of hypoglycemia D monitoring for ophthalmologic complications

Which test helps a primary health care provider distinguish between conductive and sensorineural hearing loss? A Whisper test B Weber test C Tympanometry D Electrocochleography

B Weber test Tuning fork tests help in differentiating conductive and sensorineural hearing loss. The Weber test and the Rinne test are two of the most common tuning fork tests performed to make this distinction. The whisper test provides general information about the client's hearing ability. Tympanometry is used to diagnose middle ear effusions. An electrocochleography is used to record electric activity in the cochlea and the auditory nerve.

A patient with multiple sclerosis receives natalizumab every 6 months and modafinil and dalfampridine daily what assessment findings would indicate that the treatment plan was successful? Select all that apply: A blurred vision B improved walking C Decreased fatigue D no change in spacisitity E reduced exacerbation frequency

B improved walking C Decreased fatigue E reduced exacerbation frequency Rationale: Multiple Sclerosis patients have difficulty with vision, continence, constipation, spasticity, walking, fatigue, lack of concentration, and lack of coordination. MS has exacerbations and remissions leading to worse symptoms with each exacerbation. Natalizumab decreases the frequency and severity of exacerbations. Modafinil reduces fatigue, and dalfampridine enhances walking. Establishing a treatment plan with goals related to the reduction of these symptoms and reduction of exacerbations will increase the quality of life for a MS patient.

which term is used to indicate an absence of menstruation? A) Gonorrhea B) Amenorrhea C) Dysmenorrhea D) Ectopic pregnancy

B) Amenorrhea

Which part of the female reproductive system produces testosterone? A) Uterus B) Ovary C) Fallopian tube D) Ovarian tube

B) Ovary testosterone is an androgen, and in females, androgens are produced by the ovaries and adrenal glands. ~The uterus hold the fetus during pregnancy. ~Fallopian tubes facilitate fertilization of oocyte and sperm. ~An ovarian follicle is a collection of oocytes in the ovary

which structure of the penis would the nurse tell the parents is removed when educating new parents about circumcision? A) Glans B) Prepuce C) Epididymis D) Vas deferens

B) Prepuce The prepuce is a fold of skin that goes over the glans.

Which structure surrounding the male urethra would the nurse describe to a client scheduled for a dilation of the urethra? A) Epididymis B) Prostate gland C) seminal vesicle D) Bulbourethral gland

B) Prostate gland The prostate gland is shaped like a ring, with the urethra passing through its center. The epididymis lies along the top and sides of the testes. The seminal vesicles are on the posterior surface of the bladder. The bulbourethral gland lies below the prostate.

Which procedure involves the examination of the ureters and the renal pelvises? A) Cystogram B) Pyelogram C) Urethrogram D) voiding cystourethrogram

B) Pyelogram a pyelogram is a retrograde examination of the ureters and the pelvis of both kidneys.

Which action is promoted by vasopressin? A) sodium reabsorption B) Reabsorption of water C) Tubular secretion of sodium D) Red blood cell production

B) Reabsorption of water vasopressin is also known as an antidiuretic hormone. It helps in the reabsorption of water into the capillaries. Aldosterone promotes sodium reabsorption. Natriuretic hormones promote tubular secretion of sodium. Erythropoietin stimulates bone marrow to make red blood cells

Which disorder is a primary glomerular disease? A) diabetic glomerulopathy B) chronic glomerulonephritis C) Hemolytic-uremic syndrome D) systemic lupus erythematosus

B) chronic glomerulonephritis

which food item would the nurse instruct a client whose pathology report states a urinary calculus is composed of uric acid to avoid? A) milk B) liver C) cheese D) veggies

B) liver A low purine diet controls the development of uric acid stones. Patients with uric acid stones should avoid foods high in purine, such as organ meats and extracts.

In which component of the nephron does furosemide decrease fluid reabsorption? select all that apply: A) Glomerulus B) loop of henle C) distal tubules D) proximal tubules E) Bowman capsule (BC)

B) loop of henle C) distal tubules D) proximal tubules Furosemide, known as "loop diuretic", inhibits sodium and chloride reabsorption from the ascending loop of Henle, proximal tubules, and distal tubules.

which part of the female reproductive system secretes androgens? A) uterus B) ovaries C) fallopian tube D) ovarian follicle

B) ovaries the ovaries and adrenal glands produce androgens in women. The fetus develops in the uterus during pregnancy. The fallopian tubes facilitate fertilization of the ooctye and sperm. the ovarian follicle is a collection of oocytes in the ovary.

Which clinical manifestations does the nurse expect in a hospitalized patient diagnosed with Graves' disease? A. Anemia B. Dysrhythmia C. Systolic murmurs D. Distant heart sounds E. Systolic hypertension

B, C, E Graves' disease is a term used to describe hyperthyroidism. Clinical manifestations associated with this disease process include tachycardia, dysrhythmia, systolic murmurs, and systolic hypertension.

Which of the following patients is most at risk for Type 2 diabetes? A. A 6-year-old recovering from a viral infection. B. A 28-year-old with a BMI of 49. C. A 76-year-old with cardiac disease. D. A 55-year-old with lung cancer.

B. A 28-year-old with a BMI of 49. A. A 6-year-old girl is recovering from a viral infection with a family history of diabetes. More susceptible to Type 1 with a virus. B. A 28-year-old male with a BMI of 49. Correct answer. The big guy! Tx- diet and exercise first. C. A 76-year-old female with a history of cardiac disease. Type 2 is mostly lifestyle. Not just solely because of cardiac disease. D. A 55-year-old with lung cancer. Cancer is not a risk factor. The answer is B. Remember, Type 2 diabetes risk factors are related to lifestyle....being obese is a risk factor (BMI >30 in males is considered obese). So, the 28-year-old male with a BMI of 49 is most at risk for Type 2.

Immediately after cataract surgery a client reports feeling nauseated. What should the nurse do? A. Provide some dry crackers to eat B. Administer the prescribed antiemetic C. Explain that this is expected after surgery D. Encourage deep breathing until the nausea subsides

B. Administer the prescribed antiemetic Rationale:An antiemetic will prevent vomiting; vomiting increases intraocular pressure and should be avoided. Aggressive intervention is required rather than dry crackers. Explaining that this is expected after surgery is incorrect. Deep breathing will not minimize nausea; aggressive intervention is required to prevent vomiting.

The nurse finds that the patient is unable to recognize familiar objects after a stroke. What term does the nurse chart in the patient's medical record? A. Alexia B. Agnosia C. Aphasis D. Agraphia

B. Agnosia Agnosia is the inability to recognize familiar objects by sight, touch, or hearing.

Which action would the nurse confirm before approving a client's transfer to radiology for MRI? A. The client received the scheduled pre procedure medications B. All metal objects such as jewelry, hair ornaments, and clothing containing metal were removed. C. Infusion of IV fluids completed per preprocedure hydration protocol D. The client emptied the bladder, donned a gown which opens in the front and removed underwear.

B. All metal objects such as jewelry, hair ornaments, and clothing containing metal were removed. The client must remove all metal before entering the MRI area because the MRI emits a strong magnetic field. All scheduled medications may not be necessary before the the test. Prehydration is not necessary for an MRI and may cause interruptions for the client to void. Testing with contrast requires prehydration, such as CT scans. The client should have the opportunity to void before going to the test.

The nurse reviews the laboratory results of a patient with primary hypothyroidism. The nurse would expect to find: A. A low TSH B. An elevated TSH C. An elevated free T4 D. Decrease low-density lipoproteins (LDL)

B. An elevated TSH

Which of the following statements is accurate in differentiating between AKI (Acute Kidney Injury) and CKD (Chronic Kidney Disease)? A.The primary cause of death in patients with CKD is infection. B.An important diagnostic test in CKD is: GFR < 60 mL/min/1.73m2 for > 3 months and /or kidney damage > 3 months. C.CKD is generally acute and reversible. D.The most common cause of AKI is diabetic nephropathy.

B. An important diagnostic test in CKD is: GFR < 60 mL/min/1.73m2 for > 3 months and /or kidney damage > 3 months.

The nurse is caring for a client immediately after a subtotal thyroidectomy. How will the nurse assess for unilateral injury of the laryngeal nerve? A. Checking the throat for edema B. Asking the client to say what the current time is C. Eliciting spasms of the facial muscles D Palpating the neck for seepage of blood

B. Asking the client to say what the current time is Rationale: If the laryngeal nerve is damaged during surgery, the client will be hoarse and have difficulty speaking. ~Checking the throat for edema does not indicate injury to the laryngeal nerve; this is part of the assessment for a compromised airway. ~Eliciting the Chvostek sign assesses for hypocalcemia resulting from inadvertent removal of the parathyroid glands. ~Palpating the neck for seepage of blood assesses for bleeding and possible hemorrhage, not laryngeal nerve injury

Which part of the brain is primarily associated with life support and basic functions of the body? A. Cerebrum B. Brainstem C. Cerebellum D. Cerebral cortex

B. Brain stem Rationale: The brainstem, which connects the brain to the CNS, is concerned primarily with life support and basic functions, such as breathing and movement. The cerebrum controls intelligence, creativity, and memory. The cerebellum is concerned with coordination of movement. The cerebral cortex is part of the cerebrum, which is involved with almost all of the higher functions of the brain.

Which test is used to diagnose diseases of the vestibular system? A. Rinne test B. Caloric reflex test C. Pure tone audiometry D. Auditory brainstem response

B. Caloric reflex test The caloric test stimulus is used to check for nystagmus, nausea and vomiting, falling, or vertigo. These conditions are associated with diseases of the vestibular system. The Rinne test is a tuning fork test, which aids in differentiating between conductive and sensorineural hearing loss. Pure-tone audiometry determines the client's hearing range in terms of decibels (dB) and Hertz (Hz). This test is used to diagnose conductive and sensorineural hearing loss. An auditory brain stem response test provides diagnostic information related to acoustic neuromas, brain stem problems, and strokes.

Which part of the brain primarily regulates muscle functioning and coordinates movement? A. Cerebrum B. Cerebellum C. Epithalamus D. Hypothalamus

B. Cerebellum Rationale: the cerebellum regulates motor movements, resulting in smooth and balanced muscular activity. The cerebrum is associated with higher brain functions, such as thought and action. The epithalamus acts as a connection between the motor pathways and regulates emotions. The hypothalamus regulates body temperature and secretions of the endocrine gland.

A patient who sustained a stroke is to have a diagnostic test to determine cerebral blood flow. For what diagnostic test does the nurse prepare the patient? A. Echocardiography B. Cerebral angiography C. Magnetic resonance angiography D. Computed tomography angiography

B. Cerebral angiography Cerebral angiography is performed to assess cerebral blood flow. Cerebral angiography helps find blood vessel blockages present in the head and neck.

A patient is suspected of having a subarachnoid hemorrhage. For which diagnostic test will the nurse prepare the patient, as the most reliable diagnostic study to identify the source of subarachnoid hemorrhage? A. Cardiac imaging B. Cerebral angiography C. Magnetic resonance angiography D. CT angiography

B. Cerebral angiography Cerebral angiography is the most reliable diagnostic study to identify the source of a subarachnoid hemorrhage, this test helps to identify cervical and cerebrovascular occlusions. Cardiac imaging, magnetic resonance angiography and CT angiography are not as definitive for identifying the source of a subarachnoid hemorrhage.

Which structure lies inside and parallel to the sclera? A. Lense B. Choroid C. Conjunctiva D. Ciliary processes

B. Choroid Rationale:" The choroid is a highly vascular structure that nourishes the ciliary body, the iris, and the outermost portion of the retina. It lies parallel to the sclera. The lens is located behind the iris. The conjunctiva covers the inner surface of the eyelids and extends over the sclera. The ciliary processes lie behind the peripheral part of the iris.

The nurse reviews the assessment findings of a patient with atherosclerosis and notes an ankle brachial index (ABI) of 0.8, decreased doppler pressures, aspirin intolerance, and arterial stenosis. Which treatment would likely be prescribed for this patient? A. Nifedipine B. Clopidogrel C. Furosemide D. Doxycycline

B. Clopidogrel (Plavix) Rationale: The patient's symptoms suggest peripheral artery disease (PAD), which is treated with antiplatelet drugs, Because the patient has an aspirin intolerance, clopidogrel would be beneficial. ~Furosemide is a diuretic and is used to treat hypertension. ~Doxycycline is used to treat aortic aneurysms.

Which action would the nurse test when assessing a client's eyes to ensure formation of a single image of close objects? A. Mydriasis B. Convergence C. Accommodation D. Pupillary constriction and dilation

B. Convergence Rationale: The nurse would be testing for the convergence action of the eyes to determine if a client sees only a single image of close objects. Mydriasis is pupil dilation and occurs when exposed to reduced light or looking at a distance. The process of maintaining a clear visual image when the client's gaze shifts from a distant object to a near object is accommodation. Pupillary constriction and dilation control the amount of light that enters the eye.

Which hormone is formed from cholesterol? A. Insulin B. Cortisol C. Prolactin D. Growth hormone

B. Cortisol Rationale: All lipid soluble hormones are synthesized from cholesterol. Cortisol, a lipid soluble hormone is secreted by the adrenal cortex.

The nurse reviews the treatments for lower extremity peripheral artery disease (PAD). Which therapy involves percutaneous transluminal angioplasty (PTA) and cold therapy? A. Stent B. Cryoplasty C. Atherectomy D. Endothelial progenitor cell therapy

B. Cryoplasty Rationale: Cryoplasty involves percutaneous transluminal angioplasty and cold therapy that uses a special balloon filled with liquid nitrous oxide. Expansion of gas causes cooling that prevents restenosis.

Which disorder is caused by the deficiency of antidiuretic hormone? A. Acromegaly B. Diabetes Insipidus C. Cushing syndrome D. Syndrome of inappropriate antidiuretic hormone?

B. Diabetes Insipidus Rationale: Diabetes insipidus is caused by a deficiency of ADH

A nurse observes dorsiflexion of the big toe and fanning of other toes when the lateral side of a client's foot is stroked with an applicator stick during a neurologic examination. What should the nurse document in the client's medical record? A. Has intact plantar reflexes B. Exhibits a positive Babinski sign C. Demonstrates normal sensory function D. Able to perform active range of motion

B. Exhibits a positive Babinski sign Rationale: This is a positive Babinski sign, it is expected in infants but suggests upper motor neuron disease of the pyramidal tract in adults. The plantar reflex involves flexion of the toes and plantar flexion of the feet. Demonstrates normal sensory function is incorrect, positive Babinski is not an indication of normal sensation. Able to perform active range of motion is inaccurate. Babinski reflex is not caused by intentional movement. Active range of motion is a type of exercise, not a reflex.

The nurse is interviewing a client with a tentative diagnosis of Parkinson disease. Which description would the nurse give to the client about the onset of symptoms? A. Suddenly B. Gradually C. Overnight D. Irregularly

B. Gradually THe onset of this disease is not sudden but rather insidious, with a prolonged course of gradual progression. The onset is slow and gradual. The onset is not irregular, there is a gradual, regular progression of symptoms.

A patient's T3 and T4 levels are decreased, and the TSH (thyroid-stimulating hormone) level is increased. The nurse suspects what condition? A. Hypoparathyroidism B. Hypothyroidism C. Hyperthyroidism D. Hyperparathyroidism

B. Hypothyroidism A decrease in the level of thyroid hormone, evidenced by below-normal T3 and T4 levels and increased TSH, indicates hypothyroidism. TSH increases as the body attempts to compensate for decreased thyroid production by trying to stimulate more T3 and T4 production. .

The nurse would expect to find what clinical manifestation in a patient admitted with a left-hemispheric stroke? A. Impulsivity B. Impaired speech C. Left-sided neglect D. Short attention span

B. Impaired speech Clinical manifestations of left hemispheric stroke damage include right hemiplegia, impaired speech/language, impaired right/left discrimination and slow and cautious performance.

Which of the following is correct regarding treatment for Type 2 Diabetes Mellitus? A. Insulin and oral diabetic medications are administered routinely for treatment. B. Insulin may be needed during illness or surgery. C. Insulin is never used for Type 2 DM. D. Oral medications are always the first line of treatment for Type 2 DM.

B. Insulin may be needed during illness or surgery. Patient with DM TYpe 2 are generally started on diet and exercise plans (not automatically put on oral anti- glycemics). If the patient is started on oral medications, metformin is a common one. If a patient is on metformin and contrast media is ordered with a procedure, you must make sure the renal function lab results are normal before starting them back on Metformin. Another oral treatment for type 2 DM is Actos. Actos can only be used on patients who are able to make their own insulin. Patients with CHF should not be given Actos. A patient with type 2 DM may need insulin during illness or surgery because the stress of either may increase the patients glucose.

The nurse is preparing to insert a nasogastric tube for a nauseated patient with a small bowel obstruction. Which is the correct technique to determine the proper length of tube to be inserted? A. Measure distance from tip of the nose to earlobe, to 3 inches above navel. B. Measure distance from tip of the nose to earlobe, to xyphoid process of the sternum. C. Measure distance from earlobe to tip of the nose, to xyphoid process of the sternum. D.Measure distance from earlobe to the tip of the nose, to 3 inches above navel.

B. Measure distance from tip of the nose to earlobe, to xyphoid process of the sternum.

Which action would be taken when the nurse observes a client experiencing a seizure while making rounds? A. Hyperextend the client's neck B. Move obstacles away from the client C. Restrain the client's body movements D. Attempt to place an airway in the client's mouth

B. Move obstacles away from the client Rationale: Moving obstacles away from the client helps the client avoid hitting objects and thus prevents trauma during the tonic-colonic phase of the seizure. Hyperextending the neck is contraindicated; it may injure the client. Restraining the client's body movements is contraindicated; it may injure the client. Attempting to place an airway in the client's mouth during the tonic-colonic phase of the seizure can cause injury.

When making rounds, a nurse observes a client who is experiencing a seizure. What should the nurse do? A Hyperextend the client's neck B Move obstacles away from the client C Restrain the client's body movements D Attempt to place an airway in the client's mouth

B. Move obstacles away from the client Moving obstacles away from the client helps the client avoid hitting objects and thus prevents trauma during the tonic-clonic phase of the seizure [1] [2]. Hyperextending the neck is contraindicated; it may injure the client. Restraining the client's body movements is contraindicated; it may injure the client. Attempting to place an airway in the client's mouth during the tonic-clonic phase of the seizure can cause injury.

Multiple sclerosis involves changes in the____________ which is responsible for electrical impulses to transmit quickly and efficiently along the cells of the nerves. A. Cerebral spinal fluid B. Myelin Sheath C. Platelets D. Muscle

B. Myelin Sheath Multiple sclerosis is a disease that impacts the brain, spinal cord and optic nerves, which make up the central nervous system and controls everything we do. The exact cause of MS is unknown, but we do know that something triggers the immune system to attack the CNS. The resulting damage to myelin sheath Links to an external site., the protective layer insulating wire-like nerve fibers, disrupts signals to and from the brain. This interruption of communication signals causes unpredictable symptoms such as numbness, tingling, mood changes, memory problems, pain, fatigue, blindness and/or paralysis. Everyone's experience with MS is different and these losses may be temporary or long lasting. Patients often present with complaints of diplopia and slurred speech. Paralysis is a late symptom of MS.

The nurse recognizes which type of goiter in a patient whose assessment findings include a diffuse enlargement of the thyroid gland, normal thyroid levels and no significant medical history? A. Nodular B. Nontoxic C Toxic nodular D. Multinodular

B. Nontoxic A non toxic goiter is an enlargement of the thyroid gland without any malignancy or other inflammatory process. Normal levels of thyroid hormone are associated with a nontoxic goiter.

A patient with lower extremity peripheral artery disease (PAD) undergoes a balloon angioplasty with stent placement. Which medication coating on the stent would prevent restenosis? A. Bosentan B. Paclitaxel C. Doxycycline D. Amphetamine

B. Paclitaxel Rationale: A stent is expandable medallic device that helps in keeping the artery open. The stent should be covered with paclitaxel. Paclitaxel limits the amount of new tissue growth in the stent and reduces the risk of restenosis. ~Bosentan is used to treat critical ischemia. ~Doxycycline is used to treat infection ~Amphetamines should not be administered because they may cause a vasoconstrictive effect.

After a cerebrovascular accident (also known as brain attack) a client is unable to differentiate between heat or cold and sharp or dull sensory stimulation. What lobe of the brain should the nurse conclude is likely affected? A. Frontal B. Parietal C. Occipital D. Temporal

B. Parietal Rationale: Sensory impulses from temperature, touch and pain travel via the spinothalamic pathway to the thalamus and then to the postcentral gyrus of the parietal lobe, the somatosensory area.

Which medication is the only oral agent approved for the treatment of interstitial cystitis? A Penicillin (Amoxicillin) B Pentosan (Elmiron) C Nortriptyline (Allegron) D Amitriptyline (Elavil)

B. Pentosan (Elmiron) Pentosan is the only oral agent used in the treatment of interstitial cystitis. Penicillin is used in the treatment of streptococcal infection as seen in acute poststreptococcal glomerulonephritis. Nortriptyline and amitriptyline are tricyclic antidepressants that may be used to reduce burning pain and urinary frequency.

To control the side effects of corticosteroid therapy, the nurse teaches the patient who is taking corticosteroids to: A. Limit calcium intake B. Perform glucose monitoring for hyperglycemia C. Avoid immunizations due to high risk for infections D. Stop steroids immediately if the patient gains weight

B. Perform glucose monitoring for hyperglycemia

Which intervention would the nurse include in the plan of care for a patient diagnosed with peripheral artery disease? A. Soak patient's feet daily B. Place pillows under the calves C. Apply compression stockings D. Apply wet to dry dressings on any foot ulcer

B. Place pillows under the calves Placing pillows under the calves will keep the heels off of the bed and will reduce the pressure that may cause ulceration. Other interventions include keeping the patients feet clean and dry, do not soak feet (soaking causes maceration). Footwear should be lightweight and roomy, do not use compression stockings. Cover ulcers with dry, sterile dressings.

Which principles of body mechanics would the nurse use when providing care for an immobilized client? A. Bending at the waist to provide the power for lifting. B. Placing the feet apart to increase the stability of the body C. Keeping the body straight when lifting to reduce pressure on the abdomen D. Relaxing the abdominal muscles while using the extremities to prevent strain.

B. Placing the feet apart to increase the stability of the body Reason: Placing the feet apart creates a wider base of support and brings the center of gravity closer to the ground. This improves stability. The nurse should avoid bending at the waist because the movement strains the lower back muscles; the muscles of the thighs and buttocks should provide the power of lifting. Prevent pressure on the abdomen by tightening the abdominal and gluteal muscles to form an internal girdle; keeping the body straight does not reduce strain on the abdominal musculature. Relaxing the abdominal muscles with physical activity increases back strain.

Which action would the nurse take while a client is seizing on the hallway floor? A. Hold the clients extremities firmly B. Protect the clients head from injury C. Insert an airway between the clients teeth D. Have staff members move the client to a soft surface

B. Protect the clients head from injury The rhythmic contraction and relaxation associated with a tonic-clonic seizure can cause repeated bainging of the head.

Which disorder would the nurse associate with the underlying cause of a patient's renal vein thrombosis? A. Hypertension B. Renal cell cancer C. Fibromuscular hyperplasia D. Large tumors in the peritoneal cavity

B. Renal cell cancer Rationale - Renal vein thrombosis may occur unilaterally or bilaterally. Renal cell cancer is one of the possible causes of renal vein thrombosis. Vascular changes from hypertension can lead to benign nephrosclerosis —fibromuscular hyperplasia results in renal artery stenosis. Large tumors in the peritoneal cavity are extrinsic factors that can cause urethral strictures.

Which nursing intervention would the nurse implement for a hospitalized client with multiple sclerosis who voices a concern about generalized weakness and fluctuating physical status? A. Encourage bed rest for this client B. Space activities thorough the day C. Teach the limitations imposed by the disease D. Have one of the clients relatives stay at the bedside.

B. Space activities through the day Spacing activities will encourage maximum functioning within the limits of strength and fatigue. Bed rest and limited activity may lead to muscle atrophy and calcium depletion. Stress the clients strengths, rather than limitations. Having one of the clients relatives stay at the bedside is unnecessary. The nurse's responsibility is to maintain client safety and meet client needs.

The nurse reviews the care options for patients with lower extremity peripheral artery disease (PAD) which treatment is used to stimulate blood vessel growth? A. Urokinase B. Stem cell therapy C. Plasminogen activator D. Spinal cord stimulation

B. Stem cell therapy Rationale: Stem cell therapy is used to stimulate blood vessel growth, or angiogenesis.

Which action elicits the brachioradialis reflex? A. Striking the triceps tendon above the elbow. B. Striking the radius 3-5 cm above the wrist C. Striking the patellar tendon just below the patella D. Striking the achilles tendon when the clients leg is flexed

B. Striking the radius 3-5 cm above the wrist The brachioradialis reflex can be elicited by striking the radius 3 to 5 cm above the wrist while the client's arm is relaxed. Striking the triceps tendon above the elbow elicits the triceps reflex. Striking the patellar tendon just below the patella elicits the patellar reflex. Striking the Achilles tendon elicits the Achilles tendon reflex when the client's leg is flexed.

Which class of drugs used to treat diabetes may be referred to as "insulin sensitizers"? A. Sulfonylureas B. Thiazolidinediones C. A-glycosidase inhibitors D. Dipeptidyl peptidase-4 (DDP-4) inhibitors

B. Thiazolidinediones- Thiazolidinediones are a class of drugs used to treat diabetes mellitus (DM). They are often referred to as an "insulin sensitizers." This class of drugs improves insulin sensitivity, transport, and utilization at target tissues. Sulfonylureas increase insulin production by the pancreas. α-glucosidase inhibitors slow down the absorption of carbohydrates in the small intestine. DPP-4 inhibitors enhance the activity of incretins, which stimulate the release of insulin from pancreatic β-cells. This class of drug also decreases hepatic glucose production.

A patient with lung cancer develops SIADH (syndrome of inappropriate secretion of antidiuretic hormone). What are the anticipated findings? A. Hypernatremia and hyperkalemia B. Thirst, muscle cramping and headache C. High urine output, weight gain and vomiting D. Weight gain and decreased glomerular filtration rate

B. Thirst, muscle cramping and headache Rationale: A condition in which high levels of a hormone cause the body to retain water. In this condition, the body retains water instead of excreting it normally in urine. This process upsets the body's balance of minerals called electrolytes, especially sodium. Symptoms can vary depending on how rapidly the condition develops. In some cases, nausea and vomiting, headache, confusion, weakness, and fatigue may be experienced. Treatments include fluid restriction and, possibly, medications to adjust electrolyte balance. Underlying conditions also need treatment.

Which rationale supports the nursing intervention to turn the client with paraplegia every to two hours? A. To maintain client comfort B. To prevent the development of pressure injuries C. To prevent contractures of the extremities D. To improve venous circulation in the lower extremities

B. To prevent the development of pressure injuries Pressure injuries easily develop when maintaining a particular position; the body weight, directed continuously in one region, restricts circulation and results in tissue necrosis. Denervated tissue has less perfusion and is more prone to pressure injuries. Clients often say they are comfortable and wish to remain in one position. The circulation to the lower extremities is not dramatically affected.

Which of the following hormones decreases water excretion by the kidneys by increasing water reabsorption in the collecting ducts. and also has a constricting effect on arterioles throughout the body. A. Cortisol B. Vasopressin/ADH C. Insulin D. TSH

B. Vasopressin/ADH Please refer to the hormone slide in our Monday night activity PPT (which is posted). Hint hint. :)

Which prostaglandin agonist is used in the treatment of clients with glaucoma? A. carteolol B. bimatoprost C. brinzolamide D. apraclonidine

B. bimatoprost Rationale:Bimatoprost is the prostaglandin agonist used in the treatment of glaucoma. Carteolol is the beta-adrenergic blocker used for treatment of glaucoma. Brinzolamide is the carbonic anhydrate inhibitor used for the treatment of glaucoma. Apraclonidine is the adrenergic agonist used in the treatment of glaucoma.

What do beta 2 receptors do?

Beta receptors are present in such organs as blood vessels, kidneys, bronchioles and bladder.

What are Kussmaul respirations?

Bodies attempt to compensate for Metabolic acidosis which results from the kidneys' impaired ability of to excrete excess acid (primary ammonia) and Defective reabsorption and regeneration of bicarbonate

A client newly diagnosed with type 1 diabetes asks why it is necessary to exercise on a regular basis. Which response is accurate? A "Exercise decreases insulin sensitivity." B "It stimulates glucagon production." C "Exercise improves the cellular uptake of glucose. D "It reduces metabolic requirements for glucose.""

C "Exercise improves the cellular uptake of glucose. Exercise increases the metabolic rate, and glucose is needed for cellular metabolism; therefore, excess glucose is consumed during exercise. Regular vigorous exercise increases cell sensitivity to insulin. Glucagon action raises blood glucose but does not affect cell uptake or use of glucose. Cellular requirements for glucose increase with exercise.

A nurse educator instructs a new nurse during orientation about the physiological processes of the endocrine system. Which statement made by the new nurse indicates effective learning? A "The endocrine system comprises glands with narrow ducts." B "The endocrine system comprises salivary and lacrimal glands." C "The hormones of the endocrine system exert their action by 'lock and key' mechanism." D "The hormones secreted by endocrine system exert their action on all tissues they contact."

C "The hormones of the endocrine system exert their action by 'lock and key' mechanism." The hormones recognize and adhere only to specific receptor sites on the target tissue, like a correct key alone can open its specific lock. The glands of the endocrine system are ductless and secrete hormones that are carried via the blood circulation. Salivary and lacrimal glands are not endocrine but secretory glands. The hormones are carried via blood to various tissues, but they exert their action only on specific target tissues.

Which complication is the nurse's main priority during the early postoperative period after a subtotal thyroidectomy? A Hemorrhage B Thyrotoxic crisis C Airway obstruction D Hypocalcemic tetany

C Airway obstruction Maintaining airway patency is always the priority to permit gas exchange necessary to maintain life. Although important, hemorrhage, thyrotoxic crisis, and hypocalcemic tetany do not exceed patency of the airway in priority.

The nurse administers vasopressin to a client and recalls that the medication is which type of hormone? A Growth hormone B Luteinizing hormone C Antidiuretic hormone D Thyroid-stimulating hormone

C Antidiuretic hormone Vasopressin is an antidiuretic hormone. Somatotropin is a growth hormone. Gonadotropin is a luteinizing hormone. Thyrotropin is a thyroid-stimulating hormone.

Which medication can cause diabetes insipidus? A Cabergoline B Metyrapone C Demeclocycline D Aminoglutethimide

C Demeclocycline Prolonged administration of demeclocycline may cause diabetes insipidus, because this medication decreases the production of antidiuretic hormone by the kidneys.

A college student newly diagnosed with type 1 diabetes, has a headache, changes in vision, and is anxious, but does not have the portable blood glucose monitor with him or her. Which action would the campus nurse advise the patient to take? A. Eat a piece of pizza B. Drink some diet soft drink C Eat 15 g of simple carbohydrates D Take an extra dose of rapid acting insulin

C Eat 15 g of simple carbohydrates Rationale: - When the patient with type 1 diabetes is unsure about the meaning of the symptoms he or she is experiencing, the patient should treat himself or herself for hypoglycemia to prevent seizures and coma from occurring. The patient should also be advised to check the blood glucose as soon as possible. The fat in the pizza and the diet soft drink would not allow the blood glucose to increase to eliminate the symptoms. The extra dose of rapid-acting insulin would further decrease blood glucose.

Which intervention would the nurse implement for a client who has type 1 diabetes and has an elevated blood glucose? A Administer an oral hypoglycemic. B Institute urine glucose monitoring. C Give supplemental doses of regular insulin. D Decrease the rate of the intravenous infusion.

C Give supplemental doses of regular insulin. The blood glucose level needs to be reduced; regular insulin begins to act in 30 to 60 minutes. The client has type 1, not type 2, diabetes, and an oral hypoglycemic will not be effective. Blood glucose levels are far more accurate than urine glucose levels. The rate may be increased because polyuria often accompanies hyperglycemia.

What assessment parameter would the new nurse review to determine how well a patient's diabetes has been controlled over the past two to three months? A Fasting blood glucose B Oral glucose tolerance C Glycosylated hemoglobin D Random finger stick blood glucose

C Glycosylated hemoglobin Rationale: - When the glucose level is increased, glucose molecules attach to hemoglobin in the red blood cells (RBCs) and is called glycosylated hemoglobin. This attachment lasts for the life of the RBC, two to three months. Monitoring the numbers of these attachments makes it possible to assess the average blood glucose for the previous two to three months. Fasting blood glucose, oral glucose tolerance, and random fingerstick blood glucose tests are used to measure the current blood glucose level, which is different from the glycosylated hemoglobin level.

The nurse is reviewing the medical records of several clients. Which client has a condition that is an autoimmune disorder? A Addison disease B Cushing syndrome C Hashimoto disease D Sheehan syndrome

C Hashimoto disease Hashimoto disease is an autoimmune disorder, wherein the immune system attacks the thyroid gland. Addison disease is caused by adrenal insufficiency. Cushing syndrome is caused by increased body levels of cortisol. Sheehan syndrome is hemorrhage-associated hypopituitarism after delivery of a child.

Why is 15 g of a simple sugar administered when a client with diabetes experiences hypoglycemia? A Inhibits glycogenesis B Stimulates release of insulin C Increases blood glucose levels D Provides more storage of glucose

C Increases blood glucose levels A simple sugar provides glucose to the blood for rapid action. It does not inhibit glycogenesis. It does not stimulate the release of insulin. It does not stimulate the storage of glucose.

A nurse is preparing a menu for a stroke patient with dysphagia. What food should be included in the diet? A. Milkshakes B Chicken soup C Mashed potatoes D Pureed cooked rice

C Mashed potatoes Stroke patients with dysphagia have difficulty chewing and swallowing. Thus the nurse should include mashed potatoes because the food is easy to swallow and provides enough texture. Milkshakes and all milk products should be avoided because they increase the viscosity of mucus, which leads to an increase in salivation. Chicken soup is a thin liquid that may be difficult to swallow and could trigger coughing or choking. Pureed cooked rice is bland to the taste and may stick to the palate, which poses a risk for aspiration.

Which infection control measures would the nurse provide a client regarding blood glucose monitoring? Select all that apply. One, some, or all responses may be correct A Wear gloves. B Reuse lancets. C Perform hand washing. D Clean site before fingerstick. E Share blood glucose monitor.

C Perform hand washing. D Clean site before fingerstick. The nurse would instruct the client to perform hand washing and to clean the site before the fingerstick. The nurse would wear gloves, not the client. Lancets should not be reused nor should the meter be shared.

What is the rationale for administration of ranitidine to a patient who is experiencing acute adrenal insufficiency? A Treatment of nausea B. Reduction of potassium C Prevention of gastric ulcers D. Replacement of adrenocorticotropic hormone (ACTH)

C Prevention of gastric ulcers Histamine blockers including ranitidine are administered to prevent ulcers in patients with acute adrenal insufficiency. The medication is not indicated for treatment of nausea. The medication will not reduce potassium. The medication will not replace adrenocorticotropic hormone.

A nurse begins planning for the discharge of a client who had a brain attack (cerebrovascular accident, CVA) with residual hemiparesis and hemianopsia. Which information should the nurse include in the discharge teaching plan for this client? A. Necessity for bed rest at home B. Use of oxygen (O2 therapy at home) C Significance of a safe environment D. Need for decrease protein in the diet

C Significance of a safe environment Rationale: Safety becomes a priority when the client has hemiparesis (paralysis on one side) and hemianopsia (abnormal visual field)

The nurse conducts a home visit with a patient with Parkinson's disease taking levodopa/carbidopa daily. The patient has stopped eating meals with his family and has lost 3 pounds since the last visit a week ago. What action would the nurse take? A. plan 6 small high protein meals per day B. Provide information on a high fat ketogenic diet C evaluate their ability to eat, swallow and use of assistive devices. D. Collaborate with the HCP about every other day levodopa/carbidopa dosing.

C evaluate their ability to eat, swallow and use of assistive devices.Rationale: Patients with Parkinson's disorder have trouble with the coordinated act of eating, often require assistive devices to eat, and have difficulty swallowing. Diet is of major concern as malnutrition can occur without adequate calories and nutrient intake. The uncoordinated movements and tremors and slow eating can be embarrassing for the patient who may be isolating from the family. The nurse must determine if physical difficulty with the act of eating is causing the weight loss or if depression or another organic cause is to blame. Identifying the root of the problem would start with assessing the patient's abilities. Ketogenic diets are for headaches. Protein makes levodopa less effective, so protein should be limited to the evening meal. Reducing levodopa/carbidopa dosing will increase the tremors and bradykinesia.

A patient with diabetes has a serum glucose level of 824 mg/dL and is unresponsive. After assessing the patient, the nurse suspects diabetes-related ketoacidosis rather than hyperosmolar hyperglycemia syndrome based on the findings of: A polyuria B severe dehydration C rapid deep respirations D decreased serum potassium

C rapid deep respirations

Which statement indicates the nurse has a correct understanding of kidney ultrasonography? A) "Kidney ultrasonography primarily makes use of iodinated contrast dye" B) "Kidney ultrasonography is performed on the client with an empty bladder" C) "Kidney ultrasonography makes use of sound waves and has minimal risk" D) "Kidney ultrasonography provides three-dimensional info regarding kidneys"

C) "Kidney ultrasonography makes use of sound waves and has minimal risk" Ultrasonography makes use of sound waves, when reflected from the internal organs of varying densities produce images of the kidneys, bladder and other structures.

Which response would the nurse use after receiving instructions regarding dressing changes and care of a recently inserted nephrostomy tube when the client states: "I hope I can handle all this at home; it's a lot to remember"? A) "I'm sure you can do it B) "Oh, a family member can do it for you" C) "You seem to be nervous about going home" D) "perhaps you can stay in the hospital another day"

C) "You seem to be nervous about going home" The reflection conveys acceptance and encourages further communication.

Which hormone influences kidney function? A) Renin B) Bradykinin C) Aldosterone D) Erythropoietin

C) Aldosterone Released from the adrenal cortex, aldosterone influences kidney function. Renin, bradykinin, and erythropoietin are kidney hormones

Which statement described erythropoietin? A) Erythropoietin is released by the pancreas B) an erythropoietin deficiency causes diabetes C) An erythropoietin deficiency is associated with renal failure D) Erythropoietin is released only when there is adequate blood flow

C) An erythropoietin deficiency is associated with renal failure Erythropoietin is produced by the kidneys; its deficiency occurs in renal failure. Erythropoietin is released by the kidneys, not the pancreas. Erythropoietin deficiency causes anemia. Erythropoietin is secreted in response hypoxia, which results in decreased oxygenated blood flow to this tissue

The nurse is providing education to a client about the most common causes of goiters. Which causative factor will the nurse review in the teaching? A) Thyroiditis B) Tumors C) Iodine deficiency D) Infiltrative disease

C) Iodine deficiency

Which hormones is crucial in maintaining the implanted ovum at its site? A) Inhibin B) Estrogen C) Progesterone D) Testosterone

C) Progesterone Progesterone is necessary to maintain an implanted egg. Inhibin regulates the release of follicle stimulating hormone and gonadotropin releasing hormone.

Which process is a function of the kidney hormones? A) prostaglandin increases blood flow and vascular permeability B) Bradykinin regulates intrarenal blood flow via vasodilation or vasoconstriction C) Renin raises blood pressure because of angiotensin and aldosterone secretion D) Erythropoietin promotes calcium absorption in the gastrointestinal tract

C) Renin raises blood pressure because of angiotensin and aldosterone secretion Renin is a kideny hormone that raises blood pressure as a result of angiotensin and aldosterone secretion. Prostaglandin is a kidney hormone that regulates intrarenal blood flow vasodilation or vasoconstriction

Which med is used to treat syphilis is contraindicated in pregnancy? A) Amoxicillin B) Clotrimazole C) Tetracycline D) Metronidazole

C) Tetracycline Tetracycline can be administered to clients with syphilis who are allergic to penicillin G. This medication is contraindicated in pregnant women, because if can cause birth defects or staining/discoloration to the fetus' developing teeth if given during the 2nd trimester. Amoxicillin is an antibiotic that can treat syphilis and is safe in pregnancy. Clotrimazole is used to treat candidiasis. Metronidazole is used to treat bacterial vaginosis.

which issue must be addressed before a client with syphilis can be treated? A) portal of entry B) size of chancre C) existence of allergies D) names of sexual contacts

C) existence of allergies Although the treatment of choice is penicillin, clients who are allergic must be given other antimicrobial agents to avoid an anaphylactic reaction.

Which test helps identify reproductive tract fibroids, tumors, and fistulas? A) mammography B) Ultrasonography C) hysterosalpingography D) computed tomography

C) hysterosalpingography Hysterosalpingography is an x-ray used to evaluate tubal anatomy and patency and is further used to identify uterine problems such as fibroids, tumors and fistulas.

which term would the nurse document in client's medical record after observing reduced urinary output? A) Anuria B) dysuria C) oliguria D) nocturia

C) oliguria a reduced urinary output of less than 400mL in a 24-hour interval is called oliguria.

which successful outcome would the nurse expect in a client diagnosed with invasive cancer of the bladder who has brachytherapy scheduled? A) decrease in urine output B) increase in pulse strength C) shrinkage of the tumor when scanned D) increase in the quantity of white blood cells (WBCs)

C) shrinkage of the tumor when scanned Brachytherapy involves implanting isotope seeds in, or next to, the tumor. The isotope seeds interfere with cell multiplication, which should control the growth and metastasis of cancerous tumors. Radiation affects healthy as well as abnormal cells, urinary output will increase with successful therapy. With Brachytherapy of the bladder, an increase in pulse strength is not a sign of success. The radioactive isotope seeds may affect the client's bone marrow sites, resulting in reduction of WBC's

which information would he nurse include when teaching about why women are more susceptible to urinary tract infections that men? A) Inadequate fluid intake B) poor hygienic practices C) the length of the urethra D) the disruption of mucous membranes

C) the length of the urethra The length of the urethra is shorter in women than in men, therefore microorganisms have a shorter distance to travel to reach the bladder.

Which prescribed diagnostic test would the nurse expect to confirm a tentative urinary tract infection diagnosis in a client recovering from deep, partial thickness burns who develops chills, fever, flank pain, and malaise? A) cystoscopy B) specific gravity and pH of the urine C) urinalysis and urine culture and sensitivity D) creatinine clearance and albumin/globulin (A?G) ratio

C) urinalysis and urine culture and sensitivity A culture of the urine will identify the microorganism and sensitivity will identify the most appropriate antibiotic.

Which intervention is the best approach to condom use for prevention of sexually transmitted infection? A) use of spermicide B) use of oil-based lubricants C) use of condom with oral sex D) use of natural membrane condoms

C) use of condom with oral sex Condoms should be used with all sexual encounters, including oral sex to reduce sexually transmitted infection.

The brain requires a continuous supply of blood and oxygen. If it is interrupted, how quickly does cellular death occur? A. 30 seconds B. 2 minutes C. 5 minutes D. 30 minutes

C. 5 minutes Cellular death occurs within 5 minutes of a disruption of blood flow. If the blood flow to the brain is totally interrupted (ex cardiac arrest), neurologic metabolism is altered in 30 seconds, metabolism stops in 2 minutes, cell death occurs in 5 minutes. Cellular death occurs much more quickly than in 30 minutes.

The most common cause of acute kidney injury (AKI) is caused by _______________ which can lead to ___________________. A. Acute tubular necrosis , kidney failure B. kidney stones, obstruction C. Acute tubular necrosis , kidney failure D. Decreased cardiac output, abnormal hemoglobin formation. E. Excess fluid volume, infection.

C. Acute tubular necrosis , kidney failure Tubular necrosis and kidney failure are correct! There are three major reasons why kidneys might be injured: Lack of blood flow to the kidneys blockage to the flow of urine (which can cause infection) or kidney damage from infection, medications, poisons or autoimmune disorders. The retention of urea, nitrogen and other toxins that healthy kidneys filter, can lead to kidney failure which can be fatal when the kidneys aren't functioning properly. Patients with AKI can recover with treatment. Patients with CKD can expect their disease to progress and it is not reversible.

Which term would the nurse use in a report to describe the absence of menstrual periods in a 35-year-old nonpregnant client? A. Rhinorrhea B. Menopause C. Amenorrhea D. Dyspareunia

C. Amenorrhea Rationale: The absence of menstrual periods in a nonpregnant client younger than 55 years old.

A patient has sustained a head injury and is suspected to have increased intracranial pressure. Which factor does the nurse recognize will improve cerebral blood flow? A. An increase in blood viscosity B. A decrease in carbon dioxide levels C. An increase in hydrogen ion concentration D. A high partial pressure of arterial oxygen

C. An increase in hydrogen ion concentration An increase in hydrogen ion concentration results in increased cerebral blood flow. A decrease in blood viscosity will increase cerebral blood flow. An increase in carbon dioxide levels results in increased cerebral blood flow. A partial pressure of oxygen in arterial blood (PaO 2) less than 50 mm Hg increases the cerebral blood flow.

Which type of thyroid cancer is the least likely to respond to treatment and has the poorest prognosis? A. Papillary B. Follicular C. Anaplastic D. Medullary

C. Anaplastic The patient with anaplastic thyroid cancer has a poor prognosis because the cancer is aggressive and resistant to therapy.

Which medication does the nurse expect to be beneficial for a patient who smokes one pack of cigarettes each day and has a history of cough, crackles, and hematuria? A. Colestipol B. Floxuridine C. Azathioprine D. Acetohydroxamic acid

C. Azathioprine Cough, crackles, and hematuria are clinical manifestations of Goodpasture syndrome, which is found in smokers. Azathioprine is used in the management of Goodpasture syndrome. Colestipol is used in the treatment of hyperlipidemia, which is a clinical manifestation of nephrotic syndrome. FUDR is used for treating renal cancers. Acetohydroxamic acid is used in the treatment of renal calculi.

The nurse would include which food item when discussing goitrogens when teaching a class about thyroid problems? A. Carrots B. Tomatoes C. Cauliflower D. Bell peppers

C. Cauliflower Goitrogens are foods or drugs that contain thyroid inhibiting substances which increase the likelihood of goiter development.

What is the priority action for the nurse to take if the patient with type 2 diabetes reports headache, nervousness, and dizziness? A. administer glucagon B give insulin as ordered C. Check the patient's glucose level. D. Assess for other signs of neurologic stroke

C. Check the patients glucose level.

A nursing priority for a patient who underwent removal of a pheochromocytoma includes: A. Assessing for weight gain B. Administering IV calcium C. Close monitoring of blood pressure D. Restricting fluid and sodium intake

C. Close monitoring of blood pressure

The nurse identifies that a patient is in the initial stage of Raynaud's disorder. Which assessment finding is consistent with the early stage of this condition? A. Throbbing, tingling, and swelling of the limbs B Chronic ischemic pain and ulcers on both feet C. Color changes of fingers from white to blue to red D. Hypertension, hyperglycemia, and inflamed arteries

C. Color changes of fingers from white to blue to red Rationale: the vasospasm-induced color changes (from white to blue to red) of the fingers, toes, ears and nose are the usual characteristics of Raynaud's disorder. Decreased perfusion leads to pallor (white) followed by cyanotic (bluish purple) digits that further turn red when blood flow is restored. In the later phases of the disease, the patient may complain about numbness and coldness along with throbbing, tingling, and swelling. Chronic ischemic pain and ulceration may indicate peripheral artery disease, whereas hypertension, hyperglycemia and inflamed arteries may indicate one or more cardiovascular disorder.

Which radiologic study is used to obtain three-dimensional brain images? A. Electromyography B. Cerebral angiography C. Computed tomography (CT) D. Transcranial doppler

C. Computed tomography (CT) A CT scan provides a rapid means of obtaining radiographic images of the brain to provide a three dimensional representation of the intracranial contents. Electromyography is used to record electrical activity associated with innervations of skeletal muscle. Cerebral angiography is used to view vascular lesions or tumors. Transcranial doppler evaluates blood flow velocities of the intracranial blood vessels.

A patient in the urgent care reports a stabbing headache around his left eye and nasal stuffiness. He says "this pain is horrible, it is worse than my heart attack last year." The provider orders sumatriptan nasal spray now for headache relief. The nurse would take what action? A. Administer a puff to each nostril now. B. Take vital signs prior to administration. C. Contact the provider about administering the medication to this patient. D. Teach the patient to self-administer the medication at the start of the migraine.

C. Contact the provider about administering the medication to this patient. RationaleThe patient is experiencing a cluster headache. While triptans are appropriate for relieving an ongoing headache, sumatriptan causes vasoconstriction and is contraindicated for patients with an MI. The provider should be notified of this patient's history. Sumatriptan inhaler is given as one puff in one nare only. Verapamil would be used for the prevention of cluster headaches, sumatriptan is not prescribed to prevent cluster headaches. The nurse should take vital signs, but this patient should not take the medication, so the first action would be to verify the correct order.

The nurse caring for a client with acute renal failure is most concerned about which finding? A. HCO3 26mEq/L B. Potassium 4.2 mmol/L C. Creatinine 2.7 mg/dL D. BUN 22 mg/dL

C. Creatinine 2.7 mg/dL

Which treatment would be done for a patient diagnosed with hyperthyroidism who presents with nonmalignant neck nodules that are less than 3 cm in size? A. Iodine therapy B. Subtotal thyroidectomy C. Endoscopic thyroidectomy D. Radioactive iodine therapy

C. Endoscopic thyroidectomy Endoscopic thyroidectomy is a surgical procedure on a patient's neck nodules that are less than 3 cm in size and non-malignant.

Which organism would the nurse present as the primary cause of healthcare-associated urinary tract infections (UTIs) when providing evidence-based practice guidelines for the nursing staff? A Pseudomonas B Streptococcus C Escherichia coli D Methicillin-resistant Staphylococcus aureus (MRSA)

C. Escherichia coli E-coli is the most reported organism, and Pseudomonas is second. Catheter-associated UTIs are the most frequent hospital-acquired UTI. MRSA and Streptococcus are not usually the organisms in hospital-acquired UTIs.

Which clinical manifestation is a classic finding in Graves' disease? a. gingivitis b. cretinism c. exophthalmos d. Muscular dystrophy

C. Exophthalmos Exophthalmos is the protrusion of eyeballs from the orbits; it results from increased fat deposits and fluid in orbital tissues. It is a classic clinical manifestation in Graves' disease. Gingivitis, cretinism, and muscular dystrophy are not classic clinical manifestations associated with Graves' disease.

A patient was brought to the emergency department with a sudden onset of a severe headache different from any other headache previously experienced. A. Embolic stoke B. Thrombotic stroke C. Hemorrhagic stroke D. Transient ischemic attack (TIA)

C. Hemorrhagic stroke Headache is common in a patient who has a hemorrhagic stroke, either a subarachnoid hemorrhage or an intracerebral hemorrhage. A headache may occur with an ischemic embolic stroke, but severe neurologic deficits are the initial symptoms. The ischemic thrombotic stroke manifestations progress in the first 72 hours as an infarction and cerebral edema increases. A TIA is a transient loss of neurologic function, usually without a headache.

When feeding a patient with a stroke on the left side, in which position would the nurse place the patient? A. Right lateral position B. Low fowlers position C. High fowlers position D. Trendelenburg position

C. High fowlers position A person in a high Fowler position is sitting straight up or leaning slightly back. The legs may either be straight or bent. A high Fowler position is sitting upright. This helps in feeding as well as swallowing for the patient. Sitting in a chair with the head flexed forward also serves a similar purpose , right lateral, low Fowler and Trendelenburg positions are not appropriate for feeding.

When providing care for a patient has glomerulonephritis, the nurse would monitor for the presence of which commonly recurring clinical manifestations? A. Fever and edema B. Urinary tract infections C. Hypertension and edema D. Upper respiratory infections

C. Hypertension and edema Hypertension and edema, along with headaches and oliguria, are common complications of glomerulonephritis and tend to recur. Fever, UTI, and upper respiratory infections are not primarily associated with glomerulonephritis.

The nurse teaching the patient with Addison disease determines additional teaching is needed when the patient states: A. I should take my prednisone twice a day B. I should call my HCP if I develop vomiting and diarrhea. C. If I get influenza, I should decrease my prednisone dosage. D. I will pick up my emergency hydrocortisone from the pharmacy.

C. If I get influenza, I should decrease my prednisone dosage.

Which behavior would be exhibited by a patient who has suffered a right brain stroke? A Very cautious B. Difficulty with words C. Impulsive and impatient D. Accomplishes tasks quickly

C. Impulsive and impatient A patient who has suffered a stroke on the right side of the brain will behave impulsively and act impatiently.

Which term would the nurse use to document a patient's involuntary or accidental urine loss? A. Dysuria B. Intermittency C. Incontinence D. Postvoid dribbling

C. Incontinence Involuntary or accidental urine loss or leakage is referred to incontinence. Dysuria refers to painful or difficult urination. Intermittency is the interruption of the urinary stream while voiding. Postvoid dribbling is urine loss after completion of voiding.

A patient reports a recent onset of pain in the calf when climbing the stairs. The pain is relieved when the patient sits and rests for about two minutes. Which condition would the nurse suspect? A. Muscle cramping B. Venous insufficiency C. Intermittent claudication D. Sore muscles from overexertion

C. Intermittent claudication Rationale: Intermittent claudication feels like a cramp and is caused by decrease atrial blood flow to an extremity during an activity. It may be caused by an atrial spasm, atherosclerosis, or occlusion of an artery to the limb. Symptoms are usually relieved by a few minutes of rest, and definitive treatment depends on the cause.

A patient who sustained a stroke is having a severe headache, vomiting, hypertension, dysphagia, dysarthria, vomiting, and eye movement disturbances. What type of stroke does the nurse determine to correlate with these clinical manifestations? A. Embolic stroke B. Thrombotic stroke C. Intracerebral hemorrhage D. Subarachnoid hemorrhage

C. Intracerebral hemorrhage Symptoms such as headaches, high blood pressure, vomiting, dysarthria, and eye movement disturbances indicate intracerebral hemorrhage.

Which condition is associated with involuntary and rapid twitching of the eyeball? A. Ptosis B. Anisocoria C. Nystagmus D. Enophthalmos

C. Nystagmus Rationale: Nystagmus is characterized by an involuntary and rapid twitching of the eyeball. Ptosis is characterized by drooping of the eyelids. Anisocoria is characterized by normally noticable differences in the size of the pupils and is a normal finding in 5% of the population. Enophthalmos is characterized by the sunken appearance of the eye.

Which substance is released in response to low serum levels of calcium? A. Renin B. Erythropoietin C. Parathyroid hormone D. Atrial natriuretic peptide

C. Parathyroid hormone Rationale: If serum calcium levels decline, the parathyroid gland releases parathyroid hormone to maintain calcium homeostasis.

Which nursing intervention would be included in the plan of care of a patient with a diagnosis of hypothyroidism? A Providing a dark, low-stimulation environment B. Closely monitoring of the patient's intake and output C. Patient teaching related to levothyroxine D. Patient teaching related to radioactive iodine (RAI) therapy

C. Patient teaching related to levothyroxine Levothyroxine is the drug of choice to treat hypothyroidism. A euthyroid state is most often achieved in patients with hypothyroidism by the administration of the medication.

Which definition would a nurse use to describe photophobia? A. Double vision B. Foreign body sensation C. Persistent abnormal intolerance to light D. Gradual or sudden inability to see clearly

C. Persistent abnormal intolerance to light

Which is a secondary cause of adrenal insufficiency? A. Hemorrhage B. Tuberculosis C. Pituitary tumors D. Metastatic cancer

C. Pituitary tumors Rationale: Adrenal insufficiency is also called Addison Disease.

Which deficit is associated with left-hemispheric stroke? A. Overestimation of physical abilities B. Difficulty judging position and distance C. Slow and possibly fearful performance of tasks D. Impulsivity and impatience at performing tasks.

C. Slow and possibly fearful performance of tasks Patients with left hemispheric stroke are commonly slower in organization and performance of tasks and may have a fearful, anxious response to a stroke. Overconfidence, spatial disorientation, and impulsivity are more commonly associated with right-hemispheric stroke.

Which treatment may help prevent amputation in patients with critical limb ischemia? A. Nifedipine B. Pseudoephedrine C. Spinal cord stimulation D. Oxygen via nasal cannula

C. Spinal cord stimulation Rationale: Spinal cord stimulation helps to manage pain and prevents the need for amputation in patients with critical limb ischemia.

Which initial objective would the nurse establish with the client when a health care provider prescribes a diagnostic workup for a client who may have myasthenia gravis? A. The client will adhere to the teaching plan. B. The client will achieve psychological adjustment. C. The client will maintain present muscle strength. D. The client will prepare for a possible myasthenic crisis.

C. The client will maintain present muscle strength. Rationale: Until confirming the diagnosis, the primary goal should be to maintain appropriate activity and prevent muscle atrophy. It is too early to develop a teaching plan; the establishment of the diagnosis has not yet occurred. The response to achieve psychological adjustment is too early; the client cannot adjust without a confirmed diagnosis. The response prepare for a possible myasthenic crisis is an intervention and not an objective.

Which of the following is correct about status epilepticus? A. The patients never experience an aura. B. The patient should be placed in restraints. C. The emergency response system should be activated if the patient seizes more than 5 min. D. The patient will be given Demerol for the seizure activity.

C. The emergency response system should be activated if the patient seizes more than 5 min. Status epilepticus is a seizure that lasts more than 5 minutes and is a medical emergency as oxygenation can be compromised during a seizure. Many patients experience an aura of some type prior to a seizure. A common treatment for status epilepticus is Ativan (lorazepam) , valium/diazepam or midazolam (Versed). The patient should be placed in a side-lying position so they don't aspirate sputum or vomit and are never to be put in restraints (could cause injury as they have tonic-clonic activity). Never put anything in their mouth either. Remain with the patient, talk calmly to them and keep them safe from injury. Padded rails for the beds can be ordered by the nurse.

Which rationale would explain why a patient is not responding well to clopidogrel (Plavix) therapy? A. The patient eats low-sodium food B. The patient has peripheral artery disease C. The patient takes omeprazole medication D. The patient experiences aspirin intolerance

C. The patient takes omeprazole medication Rationale: Omeprazole interacts with clopidogrel and reduces the therapeutic action of clopidogrel by half. Therefore clopidogrel should not be administered with omeprazole. Clopidogrel is an antiplatelet drug and is used to treat peripheral artery disease.

Which parameter would indicate the optimal intended effect of therapy with levothyroxine? A. Blood pressure of 120/78 mm/hg B. Weightloss of 5 lbs. C. Thyroid stimulating hormone (TSH) within normal limits D. White blood count 8000 mm3

C. Thyroid stimulating hormone (TSH) within normal limits Rationale: Levothyroxine is the drug of choice to treat hypothyroidism. In a young and otherwise healthy patient the maintenance replacement dosage is based on the patient's laboratory findings. A normal TSH level 9between 0.4-4mIu/l) indicates optimal intended effects of the medication.

Which of the following statements is correct for using a doppler to assess for pedal pulses? A. Ultrasound conduction get is not needed when using a doppler B. A monophasic sound is normal: C. Tilt the probe at a 45 degree angle D. Apply firm pressure on the probe while searching for the pulse

C. Tilt the probe at a 45 degree angle

Which condition may a patient have experienced if the patient was exhibiting symptoms of a stroke for 45 minutes before the symptoms resolved? A. Embolic brain stroke B. Acute brain infarction C. Transient ischemic attack D. Subarachnoid hemorrhage

C. Transient ischemic attack A transient ischemic attack is a transient episode of neurologic symptoms without acute brain infarction. Symptoms typically last less than one hour.

Which finding is consistent with a left-hemispheric stroke? A. Impaired judgement B. Unilateral weakness of the left extremities C. Unilateral weakness of the right extremities D. Spatial-perceptual deficits

C. Unilateral weakness of the right extremities Rationale: A patient with left-hemispheric stroke will have unilateral weakness of the right extremities. A patient with a right hemispheric stroke will have impaired judgement, unilateral weakness of the left extremities and spatial perceptual deficits.

Which structure is the middle layer of the eye? A. Sclera B. Retina C. Uveal tract D. Transparent cornea

C. Uveal tract Rationale: the uveal tract (which consists of the iris, choroid, and ciliary body) is considered the middle layer of the eyeball. The sclera is a part of the tough outer layer of the eyeball. The retina is the innermost layer of the eyeball. The outermost layer of the eyeball consists of the transparent cornea.

Which cranial nerve is responsible for the client's equilibrium? A. Vagus B. Trochlear C. Vestibulocochlear D. Glossopharyngeal

C. Vestibulocochlear The vestibulocochlear nerve located in the pons-medulla junction is responsible for equilibrium of the body. The vagus nerve located in the medulla is responsible for sensations from the pharynx, larynx, thoracic, and abdominal viscera. The trochlear nerve located in the lower midbrain is responsible for eye movement with superior oblique muscles. The glossopharyngeal nerve located in the medulla is responsible for taste and sensations from the posterior one third of the tongue and the pharynx.

After thyroid surgery, the nurse suspects damage to the parathyroid glands when the patient develops: A. hyperthermia and severe tachycardia B. hypercalcemia and shortness of breath C. laryngospasms and tingling in the hands and feet. D. hypophosphatemia, hypertension

C. laryngospasms and tingling in the hands and feet.

You are caring for a patient with newly diagnosed type 2 diabetes who was started on metformin. What information should you include in discharge teaching? Select all that apply A. need to reduce physical activity B. eliminate all forms of sugar from the diet C. use of a portable glucose monitor D. hypoglycemia prevention, symptoms, and treatment E. procedures that require IV contrast media are contraindicated.

C. use of a portable glucose monitor D. hypoglycemia prevention, symptoms, and treatment

What acid-base imbalance would you anticipate in a patient with CKD? Why? A.Respiratory Acidosis B.Respiratory Alkalosis C.Metabolic Acidosis D.Metabolic Alkalosis

C.Metabolic Acidosis Rationale: In CKD the patient is unable to excrete acid and is unable to absorb sodium bicarbonate.

What does cabergoline do?

Cabergoline inhibits the release of growth hormone and prolactin by stimulating dopamine receptors in the brain.

What hormone does the thyroid gland secrete?

Calcitonin which is a hormone produced by the thyroid gland that interacts with bone tissue.

What is the leading cause of death after kidney transplant?

Cardiovascular disease

Match each potential CVAD complication with its most likely manifestations. 1. Catheter migration 2. Pneumothorax 3. Catheter occlusion 4. Embolism A. Respiratory distress, increased pulse, decreased BP B. Increased external catheter length C. Respiratory distress, decreased or absent breath sounds D. Inability to infuse fluids or aspirate blood return

Catheter migration-B) increased external catheter length Pneumothorax-C) Respiratory distress decreased or absent breath sounds. Catheter occlusion-D) Inability to infuse fluids or aspirate blood return. Embolism-A) Respiratory distress, increased pulse, decreased BP

What happens with acute brain infarction?

Cell death occurs and symptoms may not resolve.

What is the definition of menopause?

Cessation of menstruation after 55 years of age.

What is the difference between chronic and acute kidney problems:

Chronic-at least 3 months (GFR < 60) Acute-hours or days

What are the clinical manifestations of Goodpasture syndrome?

Clinical manifestations of Goodpasture syndrome include primary symptoms of cough, rhonchi, crackles and mild shortness of breath.

What are the clinical manifestations of Polycystic kidney disease

Clinical manifestations of PKD are hematuria, hypertension, and feeling of heaviness in the abdomen.

What are the manifestations of a subarachnoid hemorrhage?

Clinical manifestations such as stiff neck and cranial never deficits indicate a subarachnoid hemorrhage.

What do increased red blood cells in the urine indicate?

Cystitis

When teaching a client with type 2 diabetes, which statement by the nurse reflects accurate information about preparing for a serum glucose test? A "Eat your usual breakfast." B"Have clear liquids for breakfast." C "Take your medication before the test." D "Do not ingest anything before the test."

D "Do not ingest anything before the test." Fasting before the test is indicated for accurate and reliable results; food before the test will increase serum glucose levels through metabolism of the nutrients. Food should not be ingested before the test; food will increase the serum glucose level, negating accuracy of the test. Instructing the client to have clear liquids for breakfast is inappropriate; some clear fluids contain simple carbohydrates, which will increase the serum glucose level. Medications are withheld before the test because of their influence on the serum glucose level.

Which gland is affected in aldosteronoma? A Kidney cortex B Thyroid gland C Pituitary gland D Adrenal cortex

D Adrenal cortex An aldosteronoma is an aldosterone-secreting adenoma of the adrenal cortex. An aldosteronoma is not a tumor of the kidney cortex. An aldosteronoma is not a tumor of the thyroid gland. An aldosteronoma is not a tumor of the pituitary gland.

A deficiency in which hormone reduces the growth of axillae and pubic hair in female clients? A Growth hormone B Antidiuretic hormone C Thyroid-stimulating hormone D Adrenocorticotropic hormone

D Adrenocorticotropic hormone An adrenocorticotropic hormone deficiency causes a reduced growth of axillae and pubic hair in women. A growth hormone deficiency causes decreased muscle strength and decreased bone density.

The nurse is preparing a community stroke awareness program. The nurse knows which ethnic group has the highest incidence of stroke? A Asians B Mexicans C Caucasians D African Americans

D African Americans African Americans have twice the incidence of stroke related to hypertension, obesity, and diabetes. Caucasians, Mexicans, and Asians have a lower risk of stroke than do African Americans.

Which nursing intervention is beneficial to the patient who presents with renal trauma caused by a sports injury? A Restricting dietary salt B Maintaining fluid restriction C Performing a follow-up urine culture D Assessing the cardiovascular status and monitoring for shock

D Assessing the cardiovascular status and monitoring for shock Assessing the cardiovascular status will determine any perturbations in the heart. Monitoring for shock is important in patients with renal trauma because it prevents any unwanted renal or extrarenal side effects. -Restricting dietary salt is an important intervention in managing edema in patients with nephrotic syndrome. Maintaining fluid restriction is useful in patients with polycystic kidney disease. Performing a follow-up urine culture is important in patients with acute pyelonephritis. All these interventions are secondary in managing renal trauma caused by a sports injury.

Which nursing intervention is appropriate during the first 24 hours after a thyroidectomy when the nurse is concerned about thyroid storm? A Perform range-of-motion exercises. B Humidify the room air continuously. C Assess for hoarseness every 2 hours. D Check vital signs every 2 hours after they stabilize.

D Check vital signs every 2 hours after they stabilize. Checking vital signs helps detect complications such as thyrotoxic crisis, hemorrhage, and respiratory obstruction that may occur early in the postoperative period. Range-of-motion exercises should not begin until 2 to 4 days postoperatively because they can disrupt the suture line. A humidifier can contribute to the spread of bacteria and infection and is contraindicated. Hoarseness and voice weakness usually are temporary and not life threatening; it is appropriate to observe for thyroid storm, hemorrhage, and respiratory obstruction in the first 24 hours.

Which sign or symptom would the nurse expect to find on assessment of a client with a blood glucose level of 55 mg/dL? A Increased thirst B Abdominal pain C Frequent urination D Cold, clammy skin

D Cold, clammy skin A client with a blood glucose level of 55 mg/dL indicates hypoglycemia. Clinical manifestations would include cold, clammy skin; tachycardia; nervousness; and slurred speech. A client with hyperglycemia would present with increased thirst (polydipsia), abdominal pain, increased urination (polyuria), and polyphagia.

At which frequency would a pt with diabetes have A1C levels obtained? A once a week B Once a month C Every two months D Every 3-6 months

D Every 3-6 months Patients with diabetes should have their A1C levels drawn every 3-6 months as it measures the average daily blood glucose levels over a three month period.

A 28-year-old patient who's mother has Huntington disease is discussing family planning with the nurse. The patient says that they want to have a child but are concerned. What statement will the nurse make? A both parents must have the gene for your child to inherit this disease B if you have the Huntington mutation, you will not be able to have children. C only about 1 in 10 people who have the gene will pass it on to their children. D Genetic testing can be done to determine if you can pass this trait on to a child.

D Genetic testing can be done to determine if you can pass this trait on to a child.Rationale: This patient is younger than the age when Huntington's disease manifests symptoms. Concern about passing the disorder can cause families to question their reproductive choices. The mutation is autosomal dominant and only 1 parent needs to carry it. 50% of their children can have the mutation. If they have the mutation, they will get the disorder. Since the patient has not shown symptoms and may not for many more years, they can be tested to see if they have the mutation and can pass it to any future children.

The nurse educator is providing information about different insulin types. Which type of insulin can be safely mixed with regular human insulin in the same syringe? A Insulin glargine B Insulin detemir C Insulin lispro mix 75/25 D Isophane insulin neutral protamine hagedorn (NPH)

D Isophane insulin neutral protamine hagedorn (NPH) Isophane insulin NPH is safe to mix with regular human insulin. No other insulin type should be mixed with insulin glargine, insulin detemir, or insulin lispro mix 75/25. "clear to cloudy"

A patient is scheduled for a total thyroidectomy. What information does the nurse include when teaching this patient about recovery after the procedure?A Exercise will be restricted for up to six months. B. A low- or no-sodium diet will be prescribed. C. Physical therapy will need to be continued. D Life-long hormone replacement will be needed.

D Life-long hormone replacement will be needed. This patient will need life-long thyroid hormone replacement with levothyroxine because the entire thyroid gland will be missing after surgery. Exercise will not be restricted for six months. Lengthy exercise restriction or physical therapy generally is not indicated following a thyroidectomy. A sodium-restricted diet would not ordinarily be necessary.

Which procedure is preferred to find out the composition of a thyroid nodule and ascertain the need for further surgical intervention? A Mass spectrometry B Computed tomography scans C Glycosylated hemoglobin test D Needle biopsy

D Needle biopsy Needle biopsy is an ambulatory surgical procedure. A fine needle is used to aspirate the contents of thyroid nodules to study the composition and ascertain the need for further surgical interventions. Mass spectrometry is an assay in which several different hormone concentrations can be simultaneously analyzed. Computed tomography scans are useful for evaluation of ovaries, adrenal glands, and the pancreas. The average blood glucose level over 2 to 3 months is revealed by a glycosylated hemoglobin test.

Which cells produce the thyrocalcitonin hormone? A Islet cells B Adrenal cells C Pituitary cells D Parafollicular cells

D Parafollicular cells Parafollicular cells produce thyrocalcitonin hormone. This hormone helps in the regulation of serum calcium levels. -Islet cells are responsible for the production of hormones such as insulin and glucagon. -Adrenal cells are responsible for the production of hormones such as cortisol and aldosterone. -Pituitary cells are responsible for the production of growth hormone, prolactin, and adrenocorticotropic hormone.

Which information would the nurse provide to a client taking dulaglutide? A Give with insulin. B Administer medication orally. C Works without exercise. D Perform self-injection weekly.

D Perform self-injection weekly. Dulaglutide is an injection that, unlike insulin, is only administered subcutaneously once a week. It is not administered with insulin, it is not an oral medication, and it works with modified diet and exercise.

Before having surgery, a client with type 1 diabetes insulin requirements are elevated but well controlled. Which insulin requirements would the nurse anticipate for this client postoperatively? A Decrease B Fluctuate C Increase sharply D Remain elevated

D Remain elevated Emotional and physical stress may cause insulin requirements to remain elevated in the postoperative period. Insulin requirements will remain elevated rather than decrease. Fluctuating insulin requirements usually are associated with noncompliance, not surgery. A sharp increase in the client's insulin requirements may indicate sepsis, but this is not expected.

Which client response is most important for the nurse in the postanesthesia care unit to monitor when caring for a client who had a thyroidectomy? A Urinary retention B Signs of restlessness C Decreased blood pressure D Signs of respiratory obstruction

D Signs of respiratory obstruction The first and most important observation should be for respiratory obstruction. If this occurs, treatment must be instituted immediately. Urinary retention is a later concern; urinary retention will not occur in the immediate postoperative period. Signs of restlessness may result from the anesthesia; however, it is not life threatening and usually passes. The blood pressure is not significantly affected by this type of surgery; however, surgery itself can influence blood pressure. If the blood pressure significantly increases, other symptoms of thyroid crisis (storm) will be present.

Which information would the nurse provide a client with diabetes mellitus (DM) regarding alcohol consumption? A Before meals B One drink per week C Complete abstinence D With or shortly after meals

D With or shortly after meals A person with DM should only drink alcohol with or shortly after meals to prevent alcohol-induced delayed hypoglycemia. Alcohol should not be consumed before meals. The client with DM does not need to limit to one drink per week nor completely abstain from drinking.

Which client statement indicates understanding of content taught about removing his or her three-way indwelling catheter and continuous bladder irrigation (CBI)? A) "I probably will have diluted urine" B) "I probably will be unable to urinate" C) "I probably will produce dark red urine" D) "I probably will experience some burning on urination"

D) "I probably will experience some burning on urination" Because of the trauma to the mucus membranes of the urinary tract, burning on urination is an expected response that should subside gradually.

Which statement indicates the client with chronic kidney disease understands the purpose of using continuous ambulatory peritoneal dialysis (CAPD)? A) "the treatment provides continuous contact of dialyzer and blood to clear toxins by ultrafiltration B) "the treatment exchanges and cleanses blood by correction of elctrolytes and excretion of creatinine." C) "the treatment decreases the need for immobility, because the fluids clear the toxins in short and intermittent periods." D) "the treatment uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion

D) "the treatment uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion

Which term refers to the Cowper gland? A) Skene gland B) Prostate gland C) Bartholin gland D) Bulbourethral gland

D) Bulbourethral gland Cowper glands are accessory glands of the male reproductive system; they are also referred to as the bulbourethral glands

Which hormone would the nurse explain as stimulating the release of estrogen and progesterone after fertilization? A) Inhibin B) testosterone C) follicle-stimulating hormone (FSH) D) Human chorionic gonadotropin (hCG)

D) Human chorionic gonadotropin (hCG) After fertilization, hCG stimulates the corpus luteum to produce estrogen and progesterone.

Which part of the kidney produces the hormone bradykinin? A) kidney tissues B) kidney parenchyma C) renin-producing granular cells D) Juxtaglomerular cells of the arterioles

D) Juxtaglomerular cells of the arterioles the juxtaglomerular cells of the arterioles produce the hormone bradykinin, which increases blood flow and vascular permeability

which medication turns urine reddish-orange in color? A) amoxicillin B) Ciprofloxacin C) Nitrofurantoin D) Phenazopyridine

D) Phenazopyridine a topical anesthetic that is used to pain or burning sensation associated with urination. It also imparts a characteristic orange or red color to urine.

Which part of the nephron secretes creatinine for elimination? A) Glomerulus B) Loop of Henle C) collecting duct D) Proximal tubule

D) Proximal tubule The proximal tubule of the nephron secretes creatinine and hydrogen ions

Which report by the client post transrectal prostate biopsy needs to be communicated to the health care provider as a possible sign of infection? A) Soreness B) Rust-colored semen C) light rectal bleeding D) discharge from the penis

D) discharge from the penis Discharge from the penis should be communicated to the health care provider for possible infection because discharge is an indication of infection.

which condition would be indicated by the presence of ketones in the urine of a client? A) cystitis B) heart failure C) urinary calculi D) fat metabolism

D) fat metabolism The body of a client who is ingesting fewer calories than are needed for maintenance produces ketones from fat metabolism as an alternate source of fuel for muscles and organs.

which finding in a urinalysis indicates a urinary tract infection? A) crystals B) bilirubin C) ketones D) leukoesterase

D) leukoesterase Leukoesterase are released by white blood cells in response to an infection or inflammation. The presence of this chemical in the urine indicates a urinary tract infection.

which lab test would the nurse discuss the need to monitor throughout the course of prostate cancer when a client asks, "How much more blood will they need? Don't they have enough? A) Albumin B) creatinine C) Blood urea nitrogen (BUN) W

D) prostate specific antigen (PSA) The PSA is an indication of the presence of prostate cancer, the higher the level, the greater the tumor burden.

Which factor would the nurse explain as a reason why women are at a greater risk than men for contracting a urinary tract infection? A) Altered urinary pH levels B) Hormonal secretions C) Juxtaposition of the bladder D) proximity of the urethra and anus

D) proximity of the urethra and anus Because a woman's urethra is closer to the anus than a mans, it is at a greater risk of becoming contaminated.

At which rate must blood flow in the brain be maintained for normal functioning? A. 200-400 mL/min B. 400-600 mL/min C. 650-750 mL/min D. 750-1000 mL/min

D. 750-1000 mL/min Rationale:- Blood flow must be maintained at 750 to 1000 mL/min (55 mL/100 g of brain tissue), or 20% of the cardiac output, for optimal brain functioning. Anything below that level, neurologic metabolism is altered.

You have been assigned a patient with Chronic Kidney Disease. Which of the following labs should the nurse expect for a patient with this diagnosis? A. A white blood count < 1000 B. A low hemoglobin because fewer blood cells are created. C. Low potassium (hypokalemia) D. A low hemoglobin because fewer blood cells are created. E. High calcium (Hypercalcemia)

D. A low hemoglobin because fewer blood cells are created. Diabetes and high blood pressure are the most common causes of kidney disease. Patients with CKD produce less erythropoietin which signals the bone marrow to produce more RBC's which carry oxygen to every cell in the body. As a result, patients with CKD are often fatigued, have a low hemoglobin due to a lack of RBC's and may complain of itchy skin. CKD is progressive and irreversible whereas AKD is reversible if treated quickly.

A 50-year-old male client has difficulty communicating because of expressive aphasia after a cerebrovascular accident (CVA, also known as a "brain attack"). When the nurse asks the client how he is feeling, his wife answers for him. How should the nurse address this behavior? A. Ask the wife how she knows how the client feels. B.Instruct the wife to let the client answer for himself. C.When the wife leaves return to speak with the client. D. Acknowledge the wife but look at the client for a response.

D. Acknowledge the wife but look at the client for a response. The client must have the opportunity to practice language skills, though the family participation must be accepted and recognized. The spouse should therefore be included and involved in the clients care. Asking the spouse how they know the clients feelings, instructing the spouse to answer for himself and returning to speak with the client after the spouse leaves, demeans the spouse and cuts off communication.

A nurse providing care in a hospital witnesses a client's spouse shaking the client vigorously because the client has had an episode of incontinence. Because of the suspicion of physical abuse, legally, the nurse should discuss the concerns with: A. The client B. The client's spouse C. The primary health care provider D. Adult protective services

D. Adult protective services The nurse has a legal responsibility to report suspicions of abuse to the appropriate agency, which in this instance is Adult Protective Services.

The nurse reviews the dietary history of a patient who is a vegetarian and suspects that which food is the cause of the patient's goiter? A. green beans B. Lettuce C. Cucumber D. Broccoli

D. Broccoli Rationale: Goitrogens (foods or drugs that containing thyroid inhibiting substances) can cause a goiter. Broccoli is a goitrogen.

The nurse practitioner notes that the thyroid gland is enlarged and auscultates both lobes of the thyroid. For what is the nurse practitioner listening? A. Rush B. Gurgle C. Murmur D. Bruit

D. Bruit If the thyroid is enlarged, either unilaterally or bilaterally, the nurse uses the bell of the stethoscope to auscultate over each lobe for a bruit. Bruits are most often found with a toxic goiter, hyperthyroidism, or thyrotoxicosis. Rush and gurgle are distracters for this question. A murmur is assessed during a cardiac assessment.

Which nutrient must be strictly managed in patients with diabetes? A Fats B. Proteins C. Folic Acid D. Carbohydrates

D. Carbohydrates Carbohydrates must be strictly managed in patients with diabetes as this is the key to glucose control. Fats must be taken in low to moderate amounts, but not strictly managed.

The patient is recovering from a stroke and is confined to bed for most of the day. For which condition is this patient at risk? A. Fatigue B. Malnutrition C. Dehydration D. Constipation

D. Constipation A patient with poor physical mobility will have problems with constipation due to immobility and weak abdominal muscles. Fatigue is related to participation in physical activity. Malnutrition and dehydration are related to access to food and the ability to feed oneself.

Which mechanism is involved in poststreptococcal glomerulonephritis? A. Infiltration of tissues with amyloid B. Colonization and infection of lower urinary tract C. Deposition of immunoglobulin A (IgA) in the glomeruli D. Deposition of immune complexes and activation of complement

D. Deposition of immune complexes and activation of complement Deposition of immune complexes and activation of complement cause inflammation, resulting in poststreptococcal glomerulonephritis. Infiltration of tissues with amyloid causes amyloidosis. Colonization and infection of the patient's normal flora of lower urinary tract via the ascending urethral route causes acute pyelonephritis. Deposition of IgA in the glomeruli results in immunoglobulin nephropathy.

Which intervention would the nurse implement after determining that a client who sustained a cerebrovascular accident (CVA) needs assistance with eating for optimum nutrition? A. Request that the client's food be pureed. B. Feed the client to conserve the client's energy. C. Have a family member assist the client with each meal. D. Encourage the client to participate in the feeding process.

D. Encourage the client to participate in the feeding process. Rationale: as part of the rehabilitative process after a cerebrovascular accident (CVA), clients should be encouraged to participate in their own care to the extent that they are able to extend their abilities by establishing short-term goals. A client with a CVA may or may not have dysphagia; altering the consistency of the food without the need to do so may make it less palatable. Making the client feel hopeless discourages independence. Having a family member assist the client with each meal is unrealistic; family members may be unable to because of other responsibilities.

Which assessment would the nurse teach a patient to report as part of the warning signs of stroke, using the mnemonic FAST? A. Foot drop B. Arm strength C. Orientation D. Facial drooping

D. Facial drooping The fast mnemonic, a quick and easy way to remember the signs of stroke according to the American Stoke Association, includes facial drooping, arm weakness, speech difficulties, and time.

How many times is handwashing performed during the CVAD dressing change validation? A. Twice B. Three times C. Five times D. Four times

D. Four times

Which condition presents with a sudden onset of a headache, vomiting, and decreased level of consciousness? A. Embolic stroke B. Brain infarction C. Cerebral edema D. Hemorrhagic stroke

D. Hemorrhagic stroke Clinical manifestations of hemorrhagic stroke include sudden onset of symptoms like headache and vomiting and change in mental status. Cerebral edema has a gradual onset, and the brain swells.

Which surgery will a client undergo if the pituitary gland must be removed? A. Mastectomy B. Prostatectomy C. Thyroidectomy D. Hypophysectomy

D. Hypophysectomy Hypophysectomy is the surgical removal of the pituitary gland (hypophysis) or its tumor.

Which part of the brain would the nurse suspect is injured in a client with a head injury whose temperature assessments do not correspond with the clients condition? A. Pons B. Medulla C. Thalamus D. Hypothalamus

D. Hypothalamus Rationale: The hypothalamus controls the body temperature. Damage to the hypothalamus may cause abnormalities in the body temperature values during a physical assessment. The pos is responsible for maintaining the level of consciousness. The medulla controls heart rate and breathing. The thalamus performs motor and sensory functions.

Which of the following steps should be completed prior to tracheostomy suctioning? A. Remove disposable inner cannula B. Don clean gloves and face shield C. Turn on the suction vacuum to 120-140 mm Hg D. Increase the supplemental oxygen level

D. Increase the supplemental oxygen level

A client with Parkinsonism takes an anticholinergic medication for morning stiffness and tremors in the right arm. During a visit to the clinic, the client complained of some numbness in the left hand. Which intervention would the nurse implement for this client? A. Refer the client to the primary health care provider, only if other neurological deficits are present B. Ask the primary health care provider to increase the client's dosage of the anticholinergic medication. C. Stress the importance of having the client call the primary health care provider as soon as possible. D. Make immediate arrangements for further medical evaluation by the clients primary care provider.

D. Make immediate arrangements for further medical evaluation by the clients primary care provider. Rationale: Numbness, a sensory deficit, is inconsistent with Parkinsonism; further medical evaluation is necessary. Numbness, even in the absence of other problems, may be indicative of an impending "brain attack" (cerebrovascular accident [CVA]). Parkinsonism does not have this symptom. Increasing the dosage of the anticholinergic medication will not be helpful. Stressing the importance of having the client call the primary health care provider as soon as possible can cause a delay in the client receiving immediate medical attention.

A client's parathyroid glands are removed. What clinical manifestation is indicative of the fluid and electrolyte imbalance associated with this surgery? A. Constipation B. Hypoactive reflexes C. Increased specific gravity D. Muscle spasms

D. Muscle spasms Rationale: Removal of the parathyroids causes hypocalcemia and associated neuromuscular irritability. Constipation is a sign of hypercalcemia. Hypoactive reflexes are signs of hypercalcemia. Increased specific gravity is a sign of fluid volume deficit.

Which patient statement demonstrates an understanding of the role of exercise in managing diabetes? A. I cannot exercise if I am taking insulin and metformin B. Exercise increases insulin resistance, so I will need a higher dose of insulin C. It is better to exercise before a meal if I take medication that causes hypoglycemia. D. My insulin dose may need to be changed if I have low glucose levels after exercising.

D. My insulin dose may need to be changed if I have low glucose levels after exercising.

Which type of nerve cell helps the client's pupil constrict? A. Motor B. Sensory C. Sympathetic D. Parasympathetic motor

D. Parasympathetic motor Rationale: The parasympathetic motor nerves located in the midbrain help in pupil constriction. The motor nerves help in eye movement. The sensory nerves help in sensory perception. The sympathetic nerves help in involuntary functions of the body.

A patient is diagnosed with peripheral artery disease (PAD). The nurse anticipates which medication will be prescribed? A. Sildenafil B. Bosentan C. Cilostazol D. Simvastatin

D. Simvastatin Rationale: Lipid management is essential in the patient with PAD. Statins such as simvastatin lower the low density lipoprotein (LDL) and triglyceride levels and are used to treat peripheral artery disease. Sildenafil and Cilostazol are used to treat Buerger disease. Bosentan is used as an endothelin receptor antagonist in patients with Raynaud's.

Which hormone is released from the pancreas? A Oxytocin B Prolactin C. Calcitonin D. Somatostatin

D. Somatostatin which is produced by the pancreas and inhibits the release of insulin and glucagon.

Which complication is prevented from occuring by performing punctal occlusion after the administration of eyedrops? A. Tearing B. Infection C. Allergic reaction D. Systemic absorption

D. Systemic absorption Punctal occlusion prevents systemic absorption of the medication. For example, systemic absorption of beta-blockade used to treat glaucoma can affect heart rate and blood pressure. Punctal occlusion does not prevent tearing, infection, or allergic reaction.

Which nursing action would be included in the plan of care for a client scheduled to have a computed tomography (CT) scan of the brain? A. Withholding routine medications B. Administering the prescribed sedative C. Explaining that all metal must be removed D. Telling the client what to expect during the test

D. Telling the client what to expect during the test Knowing what to expect decreases anxiety. Routine medications are not withheld. A sedative is not necessary for a CT scan. Removing metal is for a magnetic resonance imaging (MRI) test.

Which cerebral lobe includes the speech area that allows the client to process words into coherent thoughts? A Limbic lobe B Frontal lobe C Occipital lobe D Temporal lobe

D. Temporal lobe Rationale Wernicke's area (language area), which allows processing of words into coherent thought and understanding of written or spoken words, is located in the temporal lobe. The limbic lobe controls the emotional and visceral patterns in the brain. The frontal lobe consists of Broca's area, which is the speech area responsible for formation of words into speech. The occipital lobe contains the primary visual center.

A patient with type 2 diabetes who takes oral hypoglycemics at home is admitted to the hospital with an infection and asks why insulin injections have been prescribed. Which explanation would the nurse provide? A. Insulin acts synergistically with the antibiotic that was prescribed. B. Insulin should have been prescribed for the patient to take at home C. Oral hypoglycemic medications are contraindicated in patients with infections D. The infection increases the glucose level, resulting in a need for more insulin

D. The infection increases the glucose level, resulting in a need for more insulin. - When the body is under stress, as in an acute illness, the need for insulin is more than oral hypoglycemics can provide. Insulin injections are usually required until the illness resolves. Insulin does not act synergistically with antibiotics, the patient did not need insulin at home, and oral hypoglycemics are not contraindicated in patients with infections.

Which health problem does the nurse identify from an older client's history that increases the client's risk factors for a cerebrovascular accident (CVA, also known as "brain attack")? A. Glaucoma B. Hypothyroidism C. Continuous nervousness D. Transient Ischemic Attacks (TIAs)

D. Transient Ischemic Attacks (TIAs) TIAs are temporary neurologic deficits related to cerebral hypoxia; about one third of the people who have TIAs will have a brain attack (CVA) within 2 to 5 years. Glaucoma, hypothyroidism, and continuous nervousness are not risk factors associated with a CVA.

Which nursing action has the highest priority when preparing to transfer an unconscious client who sustained a head injury from the emergency department to a neurological trauma unit? A. notify the receiving unit of the transfer B. Having the clients records ready for the transfer C. Verifying that the family has been notified of the transfer D. Validating availability of a bag valve mask during the transfer.

D. Validating availability of a bag valve mask during the transfer. Validating availability of a BVM during transfer is vital in case respiratory distress, increased ICP compressed the brainstem, which contains the medulla, the respiratory center(Respiratory status is priority)

Which group has the highest rate of meningococcal infection? A. Infants B. Toddlers C. Older adults D. Young adults

D. Younger adults Those between the ages of 16 and 21 years, many of whom are young adults, are most at risk for meningococcal infection and are the main target group for vaccination. Infants and toddlers can contract meningococcal infection, but it is not as prevalent in these groups as in the young adult population. Older adults do not have a higher prevalence of meningococcal infection than young adults; however, individuals in this group who are immunocompromised may benefit from receiving the vaccination or boosters.

After admitting a patient with diabetic ketoacidosis to the emergency department which nursing intervention is a priority? A. administer intravenous insulin B. administer oxygen C. insert a foley catheter D. establish IV access

D. establish IV access Because fluid imbalance in a patient with DKA is potentially life threatening, the initial goal of therapy is to establish IV access and begin fluid and electrolyte replacement. Insulin is administered IC only after a potassium level is determined, because insulin administration may cause hypokalemia. Obtaining IV access is a priority.

What is the terrible triad?

DIabetes, heart disease, kidney disease

What is the link between kidney disease and dibetes?

Diabetes causes high blood glucose which can damage the kidneys and leads to kidney disease. Hypertension leads to damage of blood vessels within the kidney as well throughout the body. This damage impairs the kidneys ability to filter fluid and waste from the blood, leading to an increase in fluid volume.

What does the presence of ketones indicate?

Diabetic ketoacidosis

What is the most common cause of Chronic kidney disease(CKD) ?

Diabetic nephropathy

What determines ultrafiltration or the amount of weight (from fluid) to be removed?

Difference between last post dialysis weight and present predialysis weight

What is alexia?

Difficulty reading

What is intrarenal failure?

Direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood supply.

What is the role that estrogen plays as a hormone?

Estrogen plays a vital role in the development and maintenance of secondary sexual characteristics.

What causes Cushing's syndrome?

Excessive production of adrenocorticotropic hormone.

Describe follicular thyroid cancer:

Follicular cancer first metastasizes into the cervical lymph nodes and then spreads to the neck, lungs, and bones. Is less aggressive than anaplastic thyroid cancer.

What is the best indicator for clinical manifestations of CKD?

GFR

What does increased specific gravity of the urine indicate?

Heart failure

Describe hematuria in regards to chronic kidney disease?

Hematuria arises from injury in the glomerular filtration barrier, results in passage of red blood cells into the urinary space which causes oxidative stress, inflammation, and structural damage to the kidney.

What are primary causes of adrenal insufficiency?

Hemorrhage Tuberculosis Acquired immune deficiency syndrome Metastatic cancer

A patient who was given high-dose IV Decadron(dexamethasone) is at risk for this.

Hyperglycemia

What labs can be abnormal in someone with hyperparathyroidism?

Hyperparathyroidism is an increase in parathormone that causes an increase in serum calcium

What is both a cause and a symptom of kidney disease?

Hypertension

A nurse is caring for a client with Cushing syndrome. Which cardiovascular complication should the nurse assess for in this client? A. Hypertension B. Chest pain C Tachycardia D. Atrial fibrillation

Hypertension Hypertension is a cardiovascular complication found in clients with Cushing syndrome due to increased metabolic demands and catecholamines. ~Chest pain is seen in clients with hyperthyroidism and hypothyroidism. Tachycardia and atrial fibrillation are manifestations of dysrhythmias, which are associated with hypothyroidism or hyperthyroidism, parathyroidism, and pheochromocytoma.

What is hypoparathyroidism?

Hypoparathyroidism is a decrease in parathormone that in turn causes a decrease in serum calcium.

What are some of the complications of hemodialysis?

Hypotension, muscle cramps, loss of blood, hepatitis C

What classifies a nodule as a toxic nodular goiter?

If it cause hyperthyroidism

What are manifestations of right-hemispheric stroke?

Impulsivity, left sided neglect and short attention span are manifestations of right sided brain damage.

What labs can be abnormal in someone with hyperthyroidism?

In hyperthyroidism, T3 and T4 production are increased, and TSH is decreased.

Where are alpha receptors located?

In organs such as eyes, skin and liver

What causes syndrome of inappropriate antidiuretic hormone?

Increased production of antidiuretic hormone.

What is the primary causes of death for AKI and CKD?

Infection & Cardiovascular disease

What is ineffective endocarditis characterized by?

Infective endocarditis results in glomerulonephritis rather than nephrotic syndrome.

What are the three phases of a PD cycle, also called an exchange?

Inflow, dwell, drain

What does somatostatin do?

Inhibits the production and release of growth hormone

What are some of the water soluble hormones which are formed by amino acids?

Insulin (secreted by pancreas), prolactin, growth hormone (secreted by the pituitary gland)

What are the causes of intrarenal AKI?

Intrarenal Causes of AKI: Most common in hospitalized patients is Acute Tubular Necrosis Interstitial Nephritis: Allergies- Antibiotics (sulfonamides, rifampin), NSAIDS, ACE inhibitors Infections: bacterial, viral or funga lNephrotoxic Injury: Chemicals, Contrast, Drugs (aminoglycosides gentamicin, amikacin, amphohericin B), Blood Transfusion Reaction, crush injury Other: Toxemia of pregnancy, Systemic Lupus Erythematosus

What causes acromegaly?

Is caused by excessive production of growth hormone.

Which of the following types of stroke occurs 80% of the time or more? TIA (transient ischemic attack) Ischemic Hemorrhagic Ischemic

Ischemic The ischemic stroke occurs most often followed by the Hemorrhagic (about 13% of the time). The Ischemic being most common once diagnosed, will be administered TPA or Alteplase if the patients onset of symptoms are within the 4? hour period of time. The patient should not be given TPA or alteplase if outside the timeframe and NEVER give this drug to a patient with a hemorrhagic stroke because it would exacerbate the bleeding! A TIA is a temporary (hence the word transient) or mini stroke and the patient returns to normal but they need to get to the doctor because it could happen again and the next time be a big stroke! Based on answering correctly Ischemic strokes are the most common. These patients after diagnosis with a CT can or MRI, will receive TPA or alteplase, within a specific time frame, to bust the clot. IF the patient has an ischemic stroke due to atrial fibrillation, they will most likely be discharged on warfarin or something similar to prevent future clots which are caused when the afib causes the blood to pool because the heart isn't pumping adequately. Patients with hemorrhagic strokes are less common (about 13%) and are never to be given TPA or alteplase, warfarin or ASA products because it would exacerbate the bleeding. TIA's are temporary loss of sensation and considered "mini strokes" and the patient returns to normal within minutes to hours. This is still considered a medical emergency because it's a signal something is wrong and a stroke could follow. Remember after any stroke, the gag reflex must be present before oral meds, food or liquid can be given to the patient in order to prevent aspiration.

What is the role of amlyn?

It decreases glucagon secretion, but not insulin, it also decrease gastric motility and endogenous glucose releasee from the liver.

What is urokinase used for in patients with PAD?

It is recommended to reduce the complications associated with a thrombectomy.

What is plasminogen activator used for in patients with PAD?

It is used if a surgical thrombectomy is not recommended.

What is radioactive iodine therapy?

It limits the thyroid secretion by damaging thyroid tissue, this has a delayed effect on the thyroid gland.

What is the role of ACTH?

It promotes the adrenal cortex's growth and stimulates corticosteroid release.

What is the role Triiodothyronine (T3)?

It regulates the metabolic rate of all cells and processes of cell growth and tissue differentiation. It does not influence insulin or glucagon secretion.

Describe papillary thyroid cancer:

It tends to grow slowly, is less aggressive than anaplastic thyroid cancer.

What are MRI and CT used for in diagnosis of stroke?

Magnetic resonance angiography and computed tomography angiography are performed for the diagnosis of a stroke and to assess the extent of involvement.

Describe medullary thyroid cancer:

Medullary thyroid cancer is a type of multiple endocrine neoplasia (MEN) it is often poorly differentiated and associated with early metastasis.

What does metyrapone and aminoglutethimide do?

Metyrapone and aminoglutethimide decrease cortisol production.

What is diffusion and osmosis?

Movement of solutes from an area of greater concentration to an area of lesser greater concentration to an area of lesser concentration concentration Movement of water across a Movement of water across a semipermeable membrane from a region of semipermeable membrane from a region of low solute concentration to a more low solute concentration to a more concentrated solution.concentrated solution.

What are the A1C ranges for type 2 diabetes?

Normal: Below 5.7 BG below 99 Pre diabetes: 5.7-6.4 BG 100-125 Diabetes: 6.5 or above BG 126 and above

What is one of the most difficult problems associated with HD?

Obtaining vascular access

What treatment is recommended for myocardial ischemia?

Oxygen supplementation is recommended to treat myocardial ischemia.

What is Dyspareunia?

Pain during sexual intercourse.

Which renal replacement therapy has the most number of complications?

Peritoneal dialysis PD

What is the most common complication for Peritoneal dialysis?

Peritonitis: The primary clinical manifestations of peritonitis are abdominal pain, rebound tenderness,and cloudy peritoneal effluent with a WBC count greater than 100 cells/μL (more than 50%neutrophils) or demonstration of bacteria in the peritoneal effluent by Gram stain or culture. GI manifestations of peritonitis may include diarrhea,vomiting, abdominal distention, and hyperactive bowel sounds. Fever may or may not be present.

Place the following steps in order of performance during a CVAD dressing change. A. Use chlorhexidine to scrub the insertion site and surrounding skin with a back-and-forth motion, vertically and horizontally, for at least 30 seconds. B. Place Biopatch® and transparent dressing. C. Assess the catheter, insertion site, and surrounding skin for complications D. Remove mask, discard gloves, and perform hand hygiene. E. Use the sterile technique to open the CVAD dressing kit.

Place the following steps in order of performance during a CVAD dressing change. C. Assess the catheter, insertion site, and surrounding skin for complications E. Use the sterile technique to open the CVAD dressing kit. A. Use chlorhexidine to scrub the insertion site and surrounding skin with a back-and-forth motion, vertically and horizontally, for at least 30 seconds. B. Place Biopatch® and transparent dressing. D. Remove mask, discard gloves, and perform hand hygiene.

Place the following steps in order of performance during insertion of a nasogastric (NG) tube. A. Assess the patency of each nares. Instruct patient to relax and breathe normally while occluding one naris. B. Check to be sure the tube is not positioned or coiled in the back of the throat. C. Attach NG tube to suction as ordered. D. Coordinate and assist with verification of tube placement via x-ray. E. Verify physician's orders and gather supplies. F. Encourage the patient to swallow by taking small sips of water and an advance tube as the patient swallows.

Place the following steps in order of performance during a nasogastric (NG) tube insertion. E. Verify physician's orders and gather supplies. A. Assess the patency of each nares. Instruct patient to relax and breathe normally while occluding one naris. F. Encourage the patient to swallow by taking small sips of water and an advance tube as the patient swallows. B. Check to be sure the tube is not positioned or coiled in the back of the throat. D. Coordinate and assist with verification of tube placement via x-ray.

What are the causes of post renal AKI?

Postrenal Causes of AKI: BPH Calculi formation Bladder or Prostate Cancer Strictures Trauma (back, pelvis, perineum)

What are the three categories of renal problems?

Pre renal Intrarenal Post renal

What are the causes of pre-renal AKI?

Prerenal Causes of AKI: Decreased CO: MI, HF, Dysrhythmias, shock, MI Decreased PVR: Septic shock, Anaphylaxis, Neurologic Injury Hypovolemia: Burns, dehydration, GI losses, hemorrhage, excessive diuresis Decreased renovascular Blood Flow: Embolism, Renal artery thrombosis

What hormones are produced by the anterior pituitary gland?

Prolactin, growth hormone, Luteinizing hormone

What measures are used to prevent contractures in patients?

Proper positioning with supportive devices and range of motion.

What is a strong marker for the progression of chronic kidney disease?

Proteinuria is a strong marker for progression of chronic kidney disease, and it is also a marker of increased cardiovascular morbimortality. Filtration of albumin by the glomerulus is followed by tubular reabsorption, and thus, the resulting albuminuria reflects the combined contribution of these 2 processes. A healthy kidney doesn't let albumin pass from the blood into the urine. A damaged kidney lets some albumin pass into the urine.

What is the first sign of kidney damage?

Proteinuria is the first sign of kidney damage. Urinalysis can detect, RBC's, WBC's protein, casts and glucose

What medication should not be given to patients with critical limb ischemia?

Pseudoephedrine should not be given to patients with critical limb ischemia because it may produce vasoconstrictive effects.

After a stroke, the patient has the inability to understand words. What is the medical term for this? A. Global aphasia B. Receptive aphasia (Wernicke's) C. Expressive aphasia (Broca's) D. Homonymous Hemianopia

Receptive aphasia (Wernicke's) Damage to the temporal lobe of the brain may result in Wernicke's aphasia (expressive), the most common type of fluent aphasia. People with Wernicke's aphasia (RECEPTIVE) may speak in long, complete sentences that have no meaning, adding unnecessary words and even creating made-up words. They don't understand words. For example, someone with Wernicke's aphasia may say, "You know that smoodle pinkered and that I want to get him round and take care of him like you want before." The use of a picture board can help with communication.

What hormone is released in response to decreased renal perfusion?

Renin is a hormone released in response to decreased renal perfusion; this hormone is responsible for regulating blood pressure.

Identify criteria used in the classification of acute kidney injury using the acronym RIFLE (Risk, Injury, Failure, Loss, End-stage renal disease).

Risk (R) (Cr 1.5x, OR GFR by 25%, UO< 0.5 mL/kg/hr for 6 hours,) Injury (I) Failure (F) (Cr 3x, OR GFR by 75% UO< 0.3mL/kg/hr for 24 hours,) Loss (L) End-stage renal disease (complete loss of kidney function x 3 months) R=Risk= First Stage of AKI I=Injury=Second Stage of AKI F=Failure = Third Stage of AKI ~This system relies on changes in the serum creatinine or glomerular filtration rates and/or urine output. ~The RIFLE criteria allows the identification of AKI patients hospitalized in numerous settings, enables monitoring of AKI severity. It is a good predictor of patient outcomes.

What is scleroderma characterized by?

Scleroderma is characterized by widespread alterations of connective tissue and vascular lesions in many organs

Define chronic kidney disease and delineate its five stages based on the GFR:

Stage 1-.90 GFR-diagnosis and treatment, CVD risk reduction, slow progression. Stage 2 60-89-estimation of progression 3a 45-59 evaluation and treatment of complications 3b 30-44-more aggressive treatment of complications 4 15-29-preparations for RRT (dialysis or transplant) 5 less than 15 or dialysis-RRT if uremia present and patient desires treatment necessary to maintain life.

What is the role of luteinizing hormone?

Stimulates the production of sex hormones, promotes the growth of reproductive organs and stimulates the reproductive process.

What is the role of TSH?

Stimulates the release of thyroid hormones and the growth and functioning of the thyroid gland.

What is postrenal failure?

Sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumor, or injury

What can cause a goiter?

Sulfonamide which is a goitrogen.

What is the role that testosterone plays as a hormone?

Testosterone is important for bone strength and the development of muscle mass.

What do crystals in the urine indicate?

That the specimen has been allowed to stand.

What is the function of the Bowman Capsule (BC)?

The BC is the site of the collection of glomerular filtrate and contains the glomerulus

Which body parts have both alpha and beta receptors?

The bladder and pancreas.

What is pre-renal failure?

The blood flow to the kidney is compromised

What is the frontal lobe of the brain responsible for?

The brain's frontal lobe is related to reasoning, planning, parts of speech, movement, emotions, and problem-solving.

What are the clinical manifestations of nephrotic syndrome?

The clinical manifestations of nephrotic syndrome include peripheral edema, massive proteinuria, hypoalbuminemia and hyperlipidemia. One of the causes of nephrotic syndrome: Diabetes (caused by a systemic disease)

What functions is the frontal area of the brain responsible for?

The frontal area is the area of abstract thinking and muscular movements.

What is the role of the glomerlulus?

The glomerulus is the site of glomerular filtration.

Hormone disorders of the anterior pituitary due to problems in what structure?

The hypothalamus is referred to as secondary pituitary dysfunction.

Which body part has only alpha receptors?

The liver

What functions is the occipital area of the brain responsible for?

The occipital area of the brain is where nerve impulses translate into sight.

What is an atherectomy?

The process of removing obstructing plaque.

What are the functions of the hypothalamus?

The regulation of endocrine and autonomic functions.

What do pancreatic polypeptides target?

The regulation of pancreatic exocrine function and metabolism of absorbed nutrients.

What functions is the temporal area of the brain responsible for?

The temporal area is the area where nerve impulses translate into sound.

What are endocrine glands?

They are ductless glands that produce hormones that are secreted into the blood. Examples of this are the thyroid, pituitary, and parathyroid glands.

What is echocardiography used for?

This test useful in determining cardiac chamber sizes, wall motions, flow intensities and also estimating the ejection fraction (EF). Echocardiography is performed for cardiac assessment.

What is spinal cord stimulation used for in patients with PAD?

To help control pain and prevent amputation in patients with peripheral artery disease.

What is endothelial progenitor cell therapy used for?

To stimulate blood vessel growth.

What is radioactive iodine therapy used for?

Treating hyperthyroidism by gradually shrinking the thyroid.

What do the presence of casts in the urine indicate?

Urinary calculi

Why is Heparin used in hemodialysis?

When blood comes in contact with a foreign material (such as the dialyzer), it has a tendency to clot.

What is an assessment of the functioning of an AV fistula?

a thrill (buzzing sensation) can be felt by palpating the fistula, and a bruit(rushing sound) can be heard with a stethoscope.

A kidney transplant recipient has had fever, chills, and dysuria over the past 2 days. What is the first action that the nurse should take? a. Assess temperature and initiate workup to rule out infection. b. Reassure the patient that this is common after transplantation. c. Provide warm covers to the patient and give 1 gram oral acetaminophen. d. Notify the nephrologist that the patient has manifestations of acute rejection.

a. Assess temperature and initiate workup to rule out infection. Rationale: The nurse must be astute in the observation and assessment of kidney transplant recipients because prompt diagnosis and treatment of infections can improve patient outcomes. Fever, chills, and dysuria indicate an infection. Assess the temperature. The patient should undergo diagnostic testing to rule out an infection.

Which catecholamine receptor is responsible for increased heart rate? a. Beta-1 receptor b. Beta-2 receptor c. Alpha-1 receptor d. Alpha-2 receptor

a. Beta-1 receptor Rationale: Beta 1 receptors are responsible for increased heart rate.

Which clinical manifestation is seen in a male client as a result of deficiency of gonadotropin? a. Decreased fertility b. Increased muscle mass c. Increased bone density d. Decreased urine specific gravity

a. Decreased fertility

Which factors would place a patient at a higher risk for prostate cancer (select all that apply)? a. Older than 65 years b. Asian or Native American c. Long-term use of an indwelling urethral catheter d. Father diagnosed and treated for early-stage prostate cancer e. Previous history of undescended testicle and testicular cancer

a. Older than 65 years d. Father diagnosed and treated for early-stage prostate cancer Age, ethnicity, and family history are risk factors for prostate cancer. The incidence of prostate cancer rises markedly after age 50. The median age at diagnosis is 66 years old. The incidence of prostate cancer worldwide is higher in Blacks than in any other ethnic group (except Jamaican men of African descent). A family history of prostate cancer, especially cancer in first degree relatives (e.g., fathers, brothers), is associated with an increased risk.

Which hormone has both inhibiting and releasing action? a. Prolactin b. Somatostatin c. Somatotropin d. Gonadotropin

a. Prolactin The hypothalamus secretes prolactin has both inhibiting and releasing action. It is produced by the anterior pituitary gland, it targets the ovaries and mammary glands in women and testes in men.

Nutritional support and management are essential across the entire continuum of chronic kidney disease. Which statements are true related to nutritional therapy? (select all that apply) a. Sodium and salt may be restricted in someone with advanced CKD. b. Fluid is not usually restricted for patients receiving peritoneal dialysis. c. Decreased fluid intake and a low-potassium diet are part of the diet for a patient receiving hemodialysis. d. Decreased fluid intake and a low-potassium diet are part of the diet for a patient receiving peritoneal dialysis. e. Decreased fluid intake and a diet in protein-rich foods are part of a diet for a patient receiving hemodialysis.

a. Sodium and salt may be restricted in someone with advanced CKD. b. Fluid is not usually restricted for patients receiving peritoneal dialysis. c. Decreased fluid intake and a low-potassium diet are part of the diet for a patient receiving hemodialysis. Rationale: Water and any other fluids are not routinely restricted before Stage 5 end-stage renal disease (ESRD). Patients receiving hemodialysis have a more restricted diet than do patients receiving peritoneal dialysis. Patients receiving hemodialysis are taught about the need for a dietary restriction of potassium- and phosphate-rich foods. Patients receiving peritoneal dialysis may actually need potassium replacement because of the higher losses of potassium with peritoneal dialysis. Sodium and salt restriction is common for all patients with CKD. For those receiving hemodialysis, as their urinary output decreased, fluid restrictions are enhanced. Intake depends on the daily urine output. In general, 600 mL (from insensible loss) plus an amount equal to the previous day's urine output is allowed for a patient receiving hemodialysis. Patients are taught to limit fluid intake so that weight gains between dialysis sessions (i.e., interdialytic weight gain) are no more than 1 to 2 kg. For the patient who is undergoing dialysis, protein is not routinely restricted. For CKD stages 1 through 4, many clinicians encourage a diet with normal protein intake. However, patients are taught to avoid high-protein diets and supplements because they may overstress the diseased kidneys.

Which are appropriate therapies for patients with diabetes mellitus (select all that apply)? a. Use of statins to reduce CVD risk b. Use of diuretics to treat nephropathy c. Use of B-blockers to treat retinopathy d. Use of serotonin agonists to decrease appetite e. Use of ACE and ARB inhibitors to treat nephropathy

a. Use of statins to reduce CVD risk e. Use of ACE and ARB inhibitors to treat nephropathy

Common psychosocial problems a patient may have post stroke include (select all that apply) a. depression. b. disassociation. c. sleep problems. d. intellectualization. e. denial of severity of stroke.

a. depression. c. sleep problems. e. denial of severity of stroke Rationale: The patient with a stroke may have many losses, including sensory, intellectual, communicative, functional, role behavior, emotional, social, and vocational. Some patients have long-term depression, manifesting symptoms, including anxiety, weight loss, fatigue, poor appetite, and sleep problems. The time and energy needed to perform previously simple tasks can result in anger and frustration. Reactions vary considerably but may involve fear, apprehension, denial of the severity of stroke, depression, anger.

Normal findings expected by the nurse on physical assessment of the urinary system include (select all that apply) a. nonpalpable bladder b. nonpalpable left kidney c. auscultation of renal artery bruit d. no CVA tenderness elicited by a kidney punch e. full bladder percusses as dullness above the symphysis pubis

a. nonpalpable bladder b. nonpalpable left kidney d. no CVA tenderness elicited by a kidney punch e. full bladder percusses as dullness above the symphysis pubis

Nurses can screen patients at risk for developing chronic kidney disease. Those considered to be at increased risk include (select all that apply) a. older black patients. b. patients more than 60 years old. c. those with a history of pancreatitis. d. those with a history of hypertension.e. those with a history of type 2 diabetes.

a. older black patients. b. patients more than 60 years old. d. those with a history of hypertension.e. those with a history of type 2 diabetes. Rationale: Risk factors for CKD include diabetes, hypertension, age older than 60 years, cardiovascular disease, ethnic minority (e.g., Black, Native American), family history of CKD, and exposure to nephrotoxic drugs

During physical assessment of the urinary system, the nurse a. performs a fist percussion to detect tenderness in the flank area. b. expects a dull percussion sound when 100 mL of urine is present in the bladder. c. percusses above the symphysis pubis to determine the level of urine in the bladder. d. palpates the lower pole of the right kidney as a smooth mass that descends on expiration.

a. performs a fist percussion to detect tenderness in the flank area.

A patient is admitted to the hospital with chronic kidney disease. The nurse understands that this condition is characterized by a. progressive irreversible destruction of the kidneys. b. a rapid decrease in urine output with an elevated BUN. c. an increasing creatinine clearance with a decrease in urine output. d. prostration, somnolence, and confusion with coma and imminent death.

a. progressive irreversible destruction of the kidneys. Rationale: Chronic kidney disease (CKD) involves progressive, irreversible loss of kidney function. A focus on stages 1 through 4 before the need for dialysis (stage 5) includes the control of hypertension, hyperparathyroid disease, CKD-MBD, anemia, and dyslipidemia.

An ESRD patient receiving hemodialysis is considering asking a relative to donate a kidney for transplantation. In helping the patient decide about treatment, the nurse informs the patient that a. successful transplantation usually provides better quality of life than that offered by dialysis. b. if rejection of the transplanted kidney occurs, no further treatment for the renal failure is available. c. hemodialysis replaces the normal functions of the kidneys, and patients do not have to live with the continual fear of rejection. d. the immunosuppressive therapy after transplantation makes the person ineligible to receive other treatments if the kidney fails.

a. successful transplantation usually provides a better quality of life than that offered by dialysis. Rationale: Kidney transplantation is extremely successful, with 1-year graft survival rates of about 90% for deceased donor organs and 95% for live donor organs. An advantage of kidney transplantation over dialysis is that it reverses many of the pathophysiologic changes associated with renal failure when normal kidney function is restored. It also eliminates the dependence on dialysis and the need for the accompanying dietary and lifestyle restrictions. Transplantation is less expensive than dialysis after the first year.

What is a stent?

an expandable mesh-like structure designed to keep the vessel or artery open after balloon angioplasty.

The nurse cares for a client with an abnormal cortisol level. The nurse recalls which information about cortisol? a. Cortisol metabolizes free fatty acids. b. Cortisol stimulates gluconeogenesis. c. Cortisol stimulates protein synthesis. d. Cortisol levels decline in stressful conditions.

b. Cortisol stimulates gluconeogenesis. Rationale: Cortisol maintains the blood glucose concentration by stimulating the liver for glucogenesis. Glucogeneis involves the formation of glucose from amino acids and fatty acids. Cortisol metabolizes free fatty acids and inhibits protein synthesis. The blood levels of cortisol increase in stressful conditions.

During the oliguric phase of AKI, the nurse monitors the patient for (select all that apply) a. hypotension. b. ECG changes. c. hypernatremia. d. pulmonary edema. e. urine with high specific gravity.

b. ECG changes. d. pulmonary edema. Rationale: The nurse monitors the patient in the oliguric phase of acute renal injury for the following: • Hypertension and pulmonary edema: When urinary output decreases, fluid retention occurs. The severity of the symptoms depends on the extent of the fluid overload. In the case of reduced urine output (i.e., anuria, oliguria), the neck veins may become distended with a bounding pulse. Edema and hypertension may develop. Fluid overload can eventually lead to HF, pulmonary edema, and pericardial and pleural effusions. • Hyponatremia: Damaged tubules cannot conserve sodium. Consequently, the urinary excretion of sodium may increase, resulting in normal or below-normal serum sodium levels. • Electrocardiographic changes and hyperkalemia: Initially, signs of hyperkalemia are apparent on electrocardiogram (ECG), including peaked T waves and a widening of the QRS complex. • Urinary specific gravity: Urinary specific gravity is fixed at about 1.010.

Which organ has only beta-1 receptors? a. Liver b. Heart c. Bladder d. Pancreas

b. Heart The heart has only beta 1 receptors, which increases heart rate and contractility.

Which is the etiological factor of nephrogenic diabetes insipidus (DI)? a. Meningitis b. Lithium therapy c. Graves disease d. Sulfonamide therapy

b. Lithium therapy Rationale: Lithium therapy is the etiological factor of nephrogenic diabetes insipidus.

Which visual system assessment technique provides a magnified view of the retina and optic nerve head? a. Keratometry b. Ophthalmoscopy c. Visual acuity testing d. Confrontation visual filed test

b. Ophthalmoscopy Rationale: Ophthalmoscopy provides a magnified view of the retina and optic nerve head. Keratometry measures corneal curvature. Visual acuity testing determines distance and near vision acuity. The confrontation visual field test determines if a client has a full field of vision without obvious scotomas.

Which gland is an exocrine gland? a. Thyroid gland b. Salivary gland c. Pituitary gland d. Parathyroid gland

b. Salivary gland Exocrine glands are glands with ducts that produce enzymes but not hormones. These glands secrete enzymes into ducts. The salivary gland secreting saliva is an example of an exocrine gland.

Which hormone would the nurse identify as inhibiting insulin and glucagon secretion? a. Amylin b. Somatostatin c. Triiodothyronine (T3) d. Pancreatic polypeptide

b. Somatostatin Somatostatin is a hormone that inhibits insulin and glucagon secretion, as well as growth hormone, thyroid stimulationg hormone and cholecystokinin.

A patient with kidney disease has oliguria and a creatinine clearance of 40 mL/min. These findings most directly reflect abnormal function of a. tubular secretion b. glomerular filtration c. capillary permeability d. concentration of filtrate

b. glomerular filtration Rationale: The amount of blood filtered each minute by the glomeruli is expressed as the glomerular filtration rate (GFR). The normal GFR is about 125 mL/min.

Bladder training in a male patient who has urinary incontinence after a stroke includes a. limiting fluid intake. b. helping the patient to stand to void. c. keeping a urinal in place at all times. d. catheterizing the patient every 4 hours.

b. helping the patient to stand to void. Rationale: In the acute stage of stroke, the primary urinary problem is poor bladder control and incontinence. A bladder retraining program consists of (1) adequate fluid intake, with the greatest fluid intake between 7:00 AM and 7:00 PM; and (2) scheduled toileting every 2 hours with the use of a urinal, commode, or bathroom, (3) assisting with clothing and mobility; and (4) encouraging the usual position for urinating.

The nurse explains to the patient with chronic bacterial prostatitis who is undergoing antibiotic therapy that (select all that apply) a. all patients require hospitalization. b. the course of treatment is generally 8-12 weeks. c. a-adrenergic blockers can help with pain d. long-term therapy may be needed in immunocompromised patients. e. if the condition is not treated appropriately, he is at risk for prostate cancer.

b. the course of treatment is generally 8-12 weeks d. long-term therapy may be needed in immunocompromised patients. Patients with chronic bacterial prostatitis are usually given antibiotics for 4 to 12 weeks. Antibiotics may be given for a lifetime if the patient is immunocompromised. Although patients with chronic bacterial prostatitis tend to have much discomfort, the pain resolves as the infection is treated. If the patient with acute bacterial prostatitis has a high fever or other signs of impending sepsis, hospitalization and IV antibiotics are prescribed.

For a patient who is suspected of having a stroke, the most important piece of information that the nurse can obtain is a. time of the patient's last meal b. time at which stroke symptoms first appeared. c. patient's hypertension history and management. d. family history of stroke and other cardiovascular diseases.

b. time at which stroke symptoms first appeared. Rationale: During initial evaluation, the most crucial point in the patient's history is the time since onset of stroke symptoms. If the stroke is ischemic, recombinant tissue plasminogen activator (tPA) must be given within 3 to 4½ hours of the onset of signs of ischemic stroke; tPA reestablishes blood flow through a blocked artery and prevents brain cell death in patients with acute onset of ischemic stroke.

Which patient has the highest risk for having a stroke? a. An obese 45-year old Native American. b.A 65-yr-old black man with hypertension. c. A 35-yr-old Asian American women who smokes. d. A 32-yr-old white women taking oral contraceptives.

b.A 65-yr-old black man with hypertension. Rationale: Nonmodifiable risk factors for stroke include age (older than 65 years), male gender, and ethnicity (incidence is highest in Blacks; next highest in Hispanics, Native Americans/Alaska Natives, and Asian Americans; and next highest in white people). Modifiable risk factors for stroke include hypertension (most important), heart disease (especially atrial fibrillation), smoking, abdominal obesity, metabolic syndrome, and lack of physical exercise.

3. If a patient is in the diuretic phase of AKI, the nurse must monitor for which serum electrolyte imbalances? a. Hyperkalemia and hyponatremia b. Hyperkalemia and hypernatremia c. Hypokalemia and hyponatremia d. Hypokalemia and hypernatremia

c. Hypokalemia and hyponatremia Rationale: In the diuretic phase of AKI, the kidneys have recovered the ability to excrete wastes but not the ability to concentrate urine. Hypovolemia and hypotension can result from massive fluid losses. Because of the large losses of fluid and electrolytes, monitor the patient for hyponatremia, hypokalemia, and dehydration.

A patient recovering from a radical prostatectomy for prostate cancer expresses the fear that he will have erectile dysfunction. In responding to this patient, the nurse should keep in mind that a. testosterone therapy will improve his libido b. PD5 inhibitors are not recommended in prostatectomy patients. c. erectile dysfunction can occur even with a nerve-sparing procedure. d. he will not be able to ejaculate which will decrease his desire for sex

c. erectile dysfunction can occur even with a nerve-sparing procedure. Two major adverse outcomes after a radical prostatectomy are ED and urinary incontinence. The incidence of ED depends on the patient's age, preoperative sexual function, whether nerve-sparing surgery was done, and the HCP's expertise. are ED and urinary incontinence. The incidence of ED depends 2 on the patient's age, preoperative sexual function, whether nerve-sparing surgery was done, and the HCP's expertise.

A patient is having word finding difficulty and weakness in his right arm. What area of the brain is most likely involved? a. brainstem. b. vertebral artery. c. left middle cerebral artery. d. right middle cerebral artery.

c. left middle cerebral artery. Rationale: If the middle cerebral artery is involved in a stroke, the expected manifestations include aphasia, motor and sensory deficit, and hemianopsia on the dominant side and include neglect, motor and sensory deficit, and hemianopsia on the nondominant side.

When discussing a male patient's reproductive organs the nurse should: a. arrange to have male nurses care for the patient b. look away and avoid eye contact with the patient c. maintain non judgemental attitude toward his sexual practices d. use medical terms and anatomic names for his genitalia and sexual organs.

c. maintain non judgemental attitude toward his sexual practices

In assessing a patient for testicular cancer, the nurse understands that the manifestations of this disease often include a. painful ejaculation b urinary incontinence c. painless mass in the scrotal area. d. rapid onset of dysuria with scrotal swelling and fever.

c. painless mass in the scrotal area. Manifestations of testicular cancer include a painless lump in the scrotum, scrotal swelling, and a feeling of heaviness. The scrotal mass usually is not tender and is very firm. Some patients have a dull ache or heavy sensation in the lower abdomen, perianal area, or scrotum.

To assess the patency of a newly placed arteriovenous graft for dialysis, the nurse should (select all that apply) a. monitor the BP in the affected arm. b. irrigate the graft daily with low-dose heparin. c. palpate the area of the graft to feel a normal thrill. d. listen with a stethoscope over the graft to detect a bruit. e. assess the pulses and neurovascular status distal to the graft.

c. palpate the area of the graft to feel a normal thrill. d. listen with a stethoscope over the graft to detect a bruit. e. assess the pulses and neurovascular status distal to the graft. Rationale: A thrill can be felt on palpation of the area of anastomosis of the arteriovenous graft, and a bruit can be heard with a stethoscope. The bruit and thrill are created by arterial blood rushing into the vein. The BP should not be taken in the arm with the AV graft

The nurse explains to the patient with a stroke who is scheduled for angiography that this test is used to determine the a. presence of increased ICP. b. site and size of the infarction. c. patency of the cerebral blood vessels. d. presence of blood in the cerebrospinal fluid.

c. patency of the cerebral blood vessels. Rationale: Angiography provides visualization of cerebral blood vessels and can help estimate perfusion and detect filling defects in the cerebral arteries.

A patient having TIAs is scheduled for a carotid endarterectomy. The nurse explains that this procedure is done to a. decrease cerebral edema. b. reduce the brain damage that occurs during a stroke in evolution. c. prevent a stroke by removing atherosclerotic plaques blocking cerebral blood flow. d. provide a circulatory bypass around thrombotic plaques obstructing cranial circulation.

c. prevent a stroke by removing atherosclerotic plaques blocking cerebral blood flow. Rationale: In a carotid endarterectomy, the atheromatous lesion is removed from the carotid artery to improve blood flow.

A diagnostic study that indicates renal blood flow, glomerular filtration, tubular function, and excretion is a(n) a. IVP b. VCUG c. renal scan d. loopogram

c. renal scan Rationale: A renal scan is used to evaluate the anatomic structures, perfusion, and function of kidneys. The scan shows the location, size, and shape of the kidneys and helps assess blood flow, glomerular filtration, tubular function, and urinary excretion. In some facilities, a numerical value ("split" renal function) may be assigned (i.e., percent contributed by each kidney).

The nurse should explain to the patient who has erectile dysfunction (ED) that (select all that apply) a. the most common cause is benign prostatic hypertrophy. b. only men who are 65 years or older benefit from PDE5 inhibitors. c. there are medications and devices that can be used to help with erections. d. psychologic problems like anxiety and depression can cause this condition. e. If men take a PDE5 inhibitor, they may experience a headache and nasal congestion.

c. there are medications and devices that can be used to help with erections. d. psychologic problems like anxiety and depression can cause this condition. e. If men take a PDE5 inhibitor, they may experience a headache and nasal congestion.

Diminished ability to concentrate urine, associated with aging of the urinary system, is attributed to a. a decrease in bladder sensory receptors b. a decrease in the number of functioning nephrons c. decreased function of the loop of Henle and tubules d. thickening of the basement membrane of Bowman's capsule

c. thickening of the basement membrane of Bowman's capsule Rationale: Older adults have decreased function of the loop of Henle and tubules, which results in the loss of normal diurnal excretory pattern because of a decreased ability to concentrate urine and because of less concentrated urine.

A renal stone in the pelvis of the kidney will alter the function of the kidney by interfering with the a. structural support of the kidney b. regulation of the concentration of urine c. entry and exit of blood vessels at the kidney d. collection and drainage of urine from the kidney

d. collection and drainage of urine from the kidney Rationale: the outer layer of the kidney is the cortex, and the inner layer is the medulla. The medulla consists of a number of pyramids. The apices (tops) of these pyramids are called papillae, through which urine passes to enter the calyces. The minor calyces widen and merge to form major calyces, which form a funnel-shaped sac called the renal pelvis. The minor and major calyces transport urine to the renal pelvis, from which it drains through the ureter to the bladder.

The factor related to cerebral blood flow that most often determines the extent of cerebral damage from a stroke is the a. O2 content of the blood. b. amount of cardiac output. c. level of CO2 in the blood. d. degree of collateral circulation.

d. degree of collateral circulation. Rationale: The extent of the stroke depends on the rapidity of onset, size of the lesion, and presence of collateral circulation.

The nurse identifies a risk for urinary calculi in a patient who relates a past health history that includes a. hyperaldosteronism b. serotonin deficiency c. adrenal insufficiency d. hyperparathyroidism

d. hyperparathyroidism Rationale: Excessive levels of circulating parathyroid hormone (PTH) usually lead to hypercalcemia and hypophosphatemia. In the kidneys, the excess calcium cannot be reabsorbed, so the calcium levels in the urine increase (i.e., hypercalciuria). This excess urinary calcium, along with a large amount of urinary phosphate, can lead to calculi formation.

RIFLE defines the first 3 stages of AKI based on changes in a. blood pressure and urine osmolality. b. fractional excretion of urinary sodium. c. estimation of GFR with the MDRD equation. d. serum creatinine or urine output from baseline.

d. serum creatinine or urine output from baseline. Rationale: The RIFLE classification describes the stages of AKI. RIFLE standardizes the diagnosis of AKI. Risk (R) is the first stage of AKI, followed by injury (I), which is the second stage, and then increases in severity to the last or third stage of failure (F). The 2 outcome variables are loss (L) and end-stage renal disease (E). The first 3 stages are characterized by the serum creatinine level and urine output.

On reading the urinalysis results of a dehydrated patient, the nurse would expect to finda. a pH of 8.4 b. RBCs of 4/hpf c. color: yellow, cloudy d. specific gravity of 1.035

d. specific gravity of 1.035 Rationale: Normal specific gravity of urine is 1.003 to 1.030; the concentrating ability of the kidneys is maximal in producing morning urine (1.025 to 1.030). A high urinary specific gravity value indicates dehydration.

Information provided by the patient that would help distinguish a hemorrhagic stroke from a thrombotic stroke includes a. sensory changes. b. a history of hypertension. c. presence of motor weakness. d. sudden onset of severe headache.

d. sudden onset of severe headache. Rationale: A hemorrhagic stroke usually causes a sudden onset of symptoms, which include neurologic deficits, headache, nausea, vomiting, decreased level of consciousness, and hypertension. Ischemic stroke symptoms may progress in the first 72 hours as infarction and cerebral edema increase.

Postoperatively, a patient who has had a laser prostatectomy has continuous bladder irrigation with a 3-way urinary catheter with a 30-mL balloon. When he reports bladder spasms with the catheter in place, the nurse should a. deflate the balloon to 35 mL to decrease bulk in the bladder. b. stop the irrigation and notify the HCP of possible obstruction c. deflate the balloon and then reinflate to ensure that the catheter is patent. d. tell him spasms are expected and he should not try to urinate around the catheter.

d. tell him spasms are expected and he should not try to urinate around the catheter. Bladder spasms occur because of irritation of the bladder mucosa from the insertion of the resectoscope, presence of a catheter, or clots that cause obstruction of the catheter. The nurse should teach the patient not to urinate around the catheter because this increases spasms.

What are foods high in potassium?

oranges, bananas, melons, tomatoes, prunes, raisins, deep green and yellow vegetables, beans and legumes.

What hormone does the parathyroid produce?

parathyroid hormone (PTH)

What hormones does the thyroid gland secrete?

thyroid hormone (T3 and T4) and calcitonin

What hormone is produced by the right atrium of the heart in response to increased blood volume?

~Atrial natriuretic peptide is produced by the right atrium of the heart in response to increased blood volume. This hormone then acts on the kidneys to promote sodium excretion, which decreases the blood volume

What hormone is released by the kidneys in response to poor blood flow?

~Erythropoietin is released by the kidneys in response to poor blood flow to the kidneys; it stimulates the production of red blood cells.

What is Nifedipine used for?

~Nifedipine is a calcium channel blocker used to reduce the severity of a vasospastic attack.