Med Surg II CH. 22 (Quiz 4)

The nurse is managing a patient with hyperglycemia. Which findings would the nurse expect to note to support this diagnosis? (Select all that apply.) a. Anorexia b. Abdominal pain c. Bradycardia d. Fluid overload e. Change in level of consciousness f. Kussmaul respirations

a. Anorexia b. Abdominal pain e. Change in level of consciousness f. Kussmaul respirations

A patient is admitted with diabetic ketoacidosis. The nurse requests the practitioner to order a glycosylated hemoglobin (HbA1c). What information does this test provide to the health care team? a. It is an indicator of the patient's average blood glucose level over the previous 3 to 4 months. b. It compares blood glucose levels with serum hemoglobin over the previous 3 to 4 weeks. c. It is an indicator of the patient's highest blood ketone level over the past month. d. It associates the serum and urine glucose levels and is an indicator of kidney involvement.

a. It is an indicator of the patient's average blood glucose level over the previous 3 to 4 months.

The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes. The nurse observes that the patient is extremely dehydrated. To make this assessment, what did the nurse evaluate? a. Skin turgor b. Nail bed color c. Capillary refill d. Skin temperature

a. Skin turgor

A patient is admitted in thyrotoxicosis. Which laboratory tests would the nurse expect to be ordered for this patient? (Select all that apply.) a. Total serum triiodothyronine (TT3) b. Total serum thyroxine (TT4) c. Free urine thyroid-stimulating hormone d. Total urine thyroxine e. Thyroglobulin (Tg) f. Free thyroxine (T4)

a. Total serum triiodothyronine (TT3) b. Total serum thyroxine (TT4) e. Thyroglobulin (Tg) f. Free thyroxine (T4)

A patient has been admitted who is suspected of having thyrotoxicosis. Which laboratory findings would confirm this diagnosis? a. Very low thyroid-stimulating hormone (TSH) b. Decreased T3 uptake ratio c. Increased serum osmolality d. Decreased urine osmolality

a. Very low thyroid-stimulating hormone (TSH)

A nurse is teaching a patient with diabetes mellitus. The patient asks the nurse what is an acceptable HbA1c level for him. What should the nurse tell the patient? a. "An acceptable level is less than 5.4%." b. "An acceptable level is less than 6.5%." c. "An acceptable level is determined by your practitioner." d. "It is dependent on your age."

b. "An acceptable level is less than 6.5%."

The nurse is caring for a patient with a traumatic brain injury. Yesterday the patient weighed 62 kg and today the patient weighs 60 kg. How much fluid loss does this change in weight reflect? a. 1 L b. 2 L c. 4 L d. 10 L

b. 2 L

A patient has been admitted with a brain mass. The practitioner suspects it might be a pituitary tumor and orders a computed tomography (CT) scan. What area of brain should be scanned to confirm this diagnosis? a. Frontal lobe b. Base of the skull c. Temporal lobe d. Anterior fossa

b. Base of the skull

A patient has been admitted with uncontrolled atrial fibrillation and muscle wasting. The practitioner suspects the patient may have a thyroid disorder. The nurse auscultates a bruit over the thyroid. What does this finding indicate? a. Normal function b. Enlargement of the thyroid c. Hypoplasia of the thyroid d. Tumor of the thyroid

b. Enlargement of the thyroid

A patient is admitted with severe hyperglycemia due new-onset type 1 diabetes mellitus. The nurse notes a sweet-smelling odor on the patient's exhaled breath. What causes this phenomenon? a. Metabolic alkalosis b. Ketoacidosis c. Glycosylation d. Dehydration

b. Ketoacidosis

A patient is admitted with hyponatremia. The practitioner suspects the patient may have syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and orders a serum ADH level for the next morning. Which medications must be stopped or withheld at least 8 hours prior to the test? a. Insulin and furosemide b. Morphine and carbamazepine c. Digoxin and potassium d. Heparin and lopressor

b. Morphine and carbamazepine

A patient has been admitted with abdominal pain. The patient's fasting blood glucose is 120 mg/dL. Which statement regarding this finding is accurate? a. This is a normal finding in critically patients. b. This finding is indicative of prediabetes. c. This finding is indicative of diabetes. d. This finding is indicative of diabetic ketoacidosis.

b. This finding is indicative of prediabetes.

The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes. Which laboratory results would the nurse note confirming this diagnosis? a. Glycated Hemoglobin A1c of 3% b. Absence of ketones in the urine c. Presence of ketones in the blood d. Fasting glucose of 105 mg/dL

c. Presence of ketones in the blood

A patient is admitted with hypernatremia secondary to neurogenic diabetes insipidus. The patient's serum osmolality is 350 mOsm/kg. What does this finding indicate? a. The patient is overhydrated. b. The patient's serum osmolality is normal. c. The patient is dehydrated. d. The patient is hypothyroid.

c. The patient is dehydrated.

The nurse is caring for a patient with a traumatic brain injury. The nurse suspects the patient is developing diabetes insipidus. Which test or procedures would confirm this diagnosis? a. Skull radiographs b. Serum glucose level c. Water deprivation test d. Antidiuretic hormone (ADH) stimulation test

d. Antidiuretic hormone (ADH) stimulation test

A patient is admitted with hypernatremia secondary to diabetes insipidus (DI). Which test would help the practitioner differentiate between central and nephrogenic DI? a. Water deprivation test b. Serum osmolality c. Thyroid-stimulating hormone test d. Antidiuretic hormone (ADH) test

d. Antidiuretic hormone (ADH) test

A patient is reporting a headache, fatigue, abdominal pain, and blurred vision. The nurse knows that these signs may indicate the patient has what problem? a. Hypothyroidism b. Pituitary tumor c. Cushing syndrome d. Hyperglycemia

d. Hyperglycemia

A patient is admitted with severe hyperglycemia due to new-onset type 1 diabetes mellitus. Which signs and symptoms obtained as part of the patient's history might indicate the presence of hyperglycemia? a. Recent episodes of tachycardia and missed heart beat b. Decreased urine output accompanied by peripheral edema c. Periods of hyperactivity with weight gain d. Increased thirst and increased urinary output

d. Increased thirst and increased urinary output

A patient is admitted with hypernatremia secondary to diabetes insipidus (DI). The practitioner suspects the patient has nephrogenic DI. Which finding would confirm this diagnosis? a. A slight increase in urine osmolality b. A decrease in urine output c. A decrease in serum osmolality d. No change in urine osmolality

d. No change in urine osmolality

A patient has been admitted who is suspected of having thyrotoxicosis. Which sign or symptom would support this diagnosis? a. Moist, shiny buccal membranes b. Presence of a headache with fatigue and weakness c. Lack of visibility of the thyroid gland in the anterior neck d. Presence of a bruit upon auscultation of the thyroid

d. Presence of a bruit upon auscultation of the thyroid