Module 7-12 Iggy/ATI/SS Practice Questions

B. Prednisone Prednisone is a glucocorticoid medication used to decrease inflammation. A common side effect of prednisone is increased blood glucose, esp in a diabetic client. Close monitoring of blood glucose is important for the diabetic client w/ additional needs for insulin or other glucose lowering medications or activities to help maintain normal blood glucose levels

A client in the hospital voices concern that the blood glucose monitor may not be working because their blood glucose is 295. After reviewing their medications, the nurse explains which of the following would cause elevated blood glucose? A. Quinidine B. Prednisone C. Atenolol D. Sulfamethoxazole-trimethoprim

A. Increase fluid intake Hyperparathyroidism is a condition where the body produces too much parathyroid hormone (PTH). PTH is instrumental in regulating and balancing phosphorus and calcium. When the individual has hyperparathyroidism, they also have hypercalcemia. Calcium levels will be over 10.5 mg/dL in hypercalcemia and hyperparathyroidism. Symptoms associated with hyperparathyroidism and hypercalcemia include bone pain, urolithiasis (kidney stones), and constipation. The kidneys have to filter all the blood with the extra calcium, so kidney stones form with hyperparathyroidism. The client with hyperparathyroidism should be taught to increase water consumption to help flush the kidneys, calcium, and the kidney stones that form out of the body.

A client recently diagnosed with hyperparathyroidism is given which teaching to help reduce symptoms associated with the condition? A. Increase fluid intake B. Take loperamide daily C. Increase calcium with vitamin D D. Perform high impact exercise

B. Give dextrose IV push The client is awake but they are not responsive as they are only responding to painful stimuli. Therefore there LOC would not indicate that you would give orange juice to them. Also their glucose levels are dangerously low so you would give the dextrose IV push because it is the best option within your scope of practice as a nurse. You would reassess blood sugar 15 minutes after. SimpleNursing.com

A client with type 1 diabetes is only responsive to painful stimuli with a blood sugar of 42, what is the first action taken by the nurse? A. Repeat the blood sugar assessment B. Give dextrose IV push C. Call the provider D. Give them some orange juice

C. Examine the clients feet for signs of injury. Diabetic neuropathy is common when the disease is of long duration. The client is at great risk for injury in any area with decreased sensation because he or she is less able to feel injurious events. Feet are common locations for neuropathy and injury. The nurse would inspect the feet for any signs of injury. After assessment, the nurse with document findings in the clients chart. Testing sensory perception in the hands may or may not be needed. The primary healthcare provider can be notified after the assessment and documentation have been completed. Iggy pg.1286-1287

A nurse assesses a client who has a 15 year history of diabetes and notes decreased tactile sensation in both feet. What action with the nurse take first? A. Document to findings and the clients chart. B. Assess tactical sensation in clients hands. C. Examine the clients feet for signs of injury. D. Notify the primary healthcare provider.

C. Request a prescription for gabapentin for the client The nurse should request a prescription for a non-opioid medication to help minimize the phantom limb pain. Gabapentin is an oral anti epileptic medication that is effective for treating sharp, burning, phantom limb pain. It is not therapeutic for the nurse to remind the client that their limb is gone because it does not address the clients pain. Changing the dressing on the clients residual limb does not address the clients pain. The nurse should only elevate the clients residual limb above the heart level within the first 48 hours following the surgery. After that time, doing so can cause a hip or knee flexion contracture.

A nurse is caring for a client who is 72 hours postoperative following an above the knee amputation and reports phantom limb pain. Which of the following actions should the nurse take? A. Remind the client that the surgery removed their limb B. Change the dressing on the clients residual limb C. Request a prescription for gabapentin for the client D. Elevate the clients residual in but the heart level

B. Check the position of the weights and ropes The first action the nurse should take when using the nursing process is to assess the client. The nurse should first check the position of the weights and ropes to investigate the cause of the muscle spasms. The weights might be too heavy, or the nurse might need to realign the client. The nurse should reposition the client to realign him and try to relieve his muscle spasms. The nurse should administer a muscle relaxant too minimize muscle spasms. The nurse should provide sensory stimulation to help the client keep his focus away from the pain of the spasms however the nurse would assess first so B is right.

A nurse is caring for a client who is in a balance suspension skeletal traction and reports to intermittent muscle spasms. Which of the following actions should the nurse take first? A. Reposition the client B. Check the position of the weights and ropes C. Administer a muscle relaxant D. Provide distraction

B. Semi-fowlers with a pillow under the knees Williams position- the client in semi Fowler's position with the knees flexed by pillows . Has been found to relieve low back pain caused by a bulging disk and nerve root involvement.

A nurse is caring for a client who received a lower back injury during a fall and describes sharp pain in the back and down the left leg. In which of the following positions should the nurse plan to place the client to attempt to decrease the pain? A. Prone without use of pillows B. Semi-fowlers with a pillow under the knees C. Supine with the head flat D. High-fowlers with the knees flat on the bed

B. Report weight gain to the provider Methimazole is an anti-thyroid medication prescribed for the treatment of hyperthyroidism. While the desired outcome is the reversal of symptoms of hyperthyroid, which includes gaining weight, significant changes in weight should be reported to the health care provider. The client taking this medication needs to be monitored for development of hypothyroidism which may cause weight gain (along with other hypothyroid symptoms). Monitoring the weight gain will help determine if it is just a consequence of gradual decline in thyroid hormone or if the client has developed hypothyroidism.

A nurse is performing a follow-up assessment for a client taking methimazole for hyperthyroidism. On assessment the nurse documents a weight gain of 8 pounds over the past two weeks. Which action is most important by the nurse? A. Offer suggestions to alternate the drug schedule ever other day B. Report weight gain to the provider C. Do nothing since weight gain signifies drug efficacy D. Instruct the client to maintain a low salt diet

C. Ensure the client lies flat for up to 12 hours The client should lie flat for up to 12 hours to prevent cerebrospinal fluid leakage from the puncture site, which can cause a headache. The nurse should instruct the client to report complications of a lumbar puncture such as voiding difficulties, fever, stiffness of the back or neck, nausea and vomiting. The client should increase fluid intake to replace the cerebrospinal fluid the provider removed during the procedure. The nurse should apply pressure to the site and then apply an adhesive bandage not a pressure dressing.

A nurse is planning care for a client following a lumbar puncture. Which of the following actions should the nurse plan to take? A. Apply a pressure dressing to the site for 8 hours B. Restrict clients fluid intake for 24 hours C. Ensure the client lies flat for up to 12 hours D. Inform the client that neck stiffness is an expected outcome of the procedure

B. "Your brain needs a constant supply of glucose because it cannot store it. " Because the brain cannot synthesize or store significant amounts of glucose, a continuous supply from the body circulation is needed to meet the fuel demands of the central nervous system. The nurse would want to educate the patient to prevent hypoglycemia. The body can use other sources of fuel, including fat and protein, and glucose is not involved in the production of red blood cells. Glucose in the blood will encourage glucose metabolism but it is not directly responsible for lactic acid formation. Iggy pg 1289-1291

A nurse is teaching a client with diabetes mellitus who asked, why is it necessary to maintain my blood glucose levels no lower than about 60 mg/dL? How should the nurse respond? A. "Glucose is the only fuel used by the body to produce the energy that it needs." B. "Your brain needs a constant supply of glucose because it cannot store it. " C. "Without a minimum level of glucose, your body can not make red blood cells. " D. "Glucose in the blood prevents the formation of lactic acid and prevents acidosis."

D. 7.4% A client diagnosed with diabetes would have an A1C of 6.5% or greater. All listed values are below that except for 7.4% Iggy pg 1273 lab profile

A nurse reviews the laboratory test values for a client with a new diagnosis of diabetes mellitus type two. Which A1C value with the nurse expect? A. 5.0% B. 5.7% C. 6.2% D. 7.4%

B. Hypothyroidism Laboratory results of elevated TSH with decreased free thyroxine and T4 indicates hypothyroidism. The elevation of TSH shows a need for thyroid hormone so the pituitary is producing more TSH to stimulate the thyroid to produce more hormone that it is lacking, namely free thyroxine and T4. Unfortunately, the thyroid is not working properly due to hypothyroidism and cannot produce these hormones despite being stimulated to produce.

The nurse analyzes the laboratory results for thyroid function and notices elevation of thyroid stimulating hormone (TSH) and decreased free thyroxine index and T4. The nurse will expect medication which will treat which thyroid condition? A. Grave's Disease B. Hypothyroidism C. Hyperthyroidism D. Hypoparathyroidism

A. Activity intolerance related to fatigue, weakness and slowed metabolism Hashimoto's thyroiditis is an autoimmune condition where the immune system attacks the thyroid. This causes a decrease in thyroid hormone leading to hypothyroidism. Except for the cause, the symptoms of Hashimoto's thyroiditis is the same as hypothyroidism. The symptoms include constipation, fatigue, weakness, hair loss, skin dryness, depression, bradycardia, weight gain, sensitivity to cold, and swelling in the extremities. Unfortunately, with Hashimoto's thyroiditis, treatment with synthetic hormones is generally ineffective against these symptoms.

The nurse is caring for a client diagnosed with hypothyroidism secondary to Hashimoto's thyroiditis. After analyzing assessment data, the nurse will select which of the following nursing diagnoses? A. Activity intolerance related to fatigue, weakness and slowed metabolism B. Fluid volume deficit related to dehydration and poor skin turgor C. Insomnia related to hyperactive state D. Risk for bleeding related compromised immunologic state

C. Hypocalcemia The parathyroid glands are on the thyroid gland and will be removed if a client has a total thyroidectomy. Since the parathyroid glands produce parathyroid hormone, if that hormone is decreased in the bloodstream, so will calcium. Decreased calcium in the body is called hypocalcemia and is defined as serum calcium < 8.8 mg/dL. Symptoms of hypocalcemia include a positive Chvostek's sign or Trousseau's sign, twitches, spasms, muscle weakness, muscular cramping, fatigue, tingling feeling, confusion, and irritability. Treatment is administration of oral or IV calcium, depending on the severity of symptoms.

The nurse is caring for a client who underwent thyroidectomy with removal of parathyroid tissue following a diagnosis of thyroid cancer. The nurse notices twitches and spasms along the left lateral facial region. The nurse suspects which adverse outcome of the surgery? A. Hypercalcemia B. Hyperkalemia C. Hypocalcemia D. Spread of cancer to mandibular glands

B. Hypocalcemia The parathyroid glands are on the thyroid gland and will be removed if a client has a total thyroidectomy. Since the parathyroid glands produce parathyroid hormone, if that hormone is decreased in the bloodstream, so will calcium. Decreased calcium in the body is called hypocalcemia and is defined as serum calcium < 8.8 mg/dL. Symptoms of hypocalcemia include a positive Chvostek's sign or Trousseau's sign, twitches, spasms, muscle weakness, muscular cramping, fatigue, tingling feeling, confusion, and irritability. Treatment is administration of oral or IV calcium, depending on the severity of symptoms.

The nurse is caring for a client who underwent thyroidectomy with removal of parathyroid tissue following a diagnosis of thyroid cancer. The nurse notices twitches and spasms along the left lateral facial region. The nurse suspects which adverse outcome of the surgery? A. Hypercalcemia B. Hypocalcemia C. Hyperkalemia D. Spread of cancer to mandibular glands

C. Elevated leukocyte count Appendicitis is an acute inflammatory disorder that frequently results in elevation of leukocytes (white blood cells). Serum electrolytes are not affected because the client does not usually have diarrhea. Thrombocyte (platelet) count in unrelated to this GI disorder.

The nurse reviews the laboratory results for a client who has possible appendicitis. Which laboratory test finding would the nurse expect? A. Decreased potassium levels B. Increased sodium levels C. Elevated leukocyte count D. Decreased thrombocyte count

A. No throw rugs B. Keep hallways lit D. Rubber mat in the shower E. Ambulate frequently with assistive devices A client with osteoporosis is at a high risk for falling and acquiring fractures with falls. Instructions to help prevent falls should include no throw rugs, unless the rugs are room size large with rubber backing and skid-proof; hallways should be kept well lit; a rubber mat should be used in the shower; and the client should ambulate frequently with assistive devices and not without help. The client should never use furniture to move around or when ambulating to keep balance. The client should wear low heeled shoes with a rubber sole or non-skid socks when ambulating. The client should always use handrails when ambulating up or down stairs as well. The client's walkways should be free of clutter.

When preparing an osteoporosis client's home to help prevent falls, which instructions should the nurse include? Select all that apply. A. No throw rugs B. Keep hallways lit C. Use furniture to keep balance when ambulating D. Rubber mat in the shower E. Ambulate frequently with assistive devices

A. Asian descent B. Current smoker C. Menopausal E. Caucasian descent G. Excessive caffeine consumption High risk factors for developing osteoporosis include caucasian and asian descent, menopausal women, smoking, drinking alcohol, and excessive caffeine consumption, a diet low in calcium, and poor nutrition. Bones help provide support and protection of the body's organs. Osteopenia occurs when bones become weakened and without treatment usually leads to osteoporosis. The lack of calcium in the bones leads to less bone density and bone loss. Osteoporosis usually happens as men and women get older and occurs more frequently in older women. With osteoporosis, clients may have a fracture before being diagnosed with osteoporosis.

Which of these are high risk factors for developing osteoporosis? Select all that apply. A. Asian descent B. Current smoker C. Menopausal D. Diet high in calcium E. Caucasian descent F. Balance nutritional diet G. Excessive caffeine consumption