NCLEX Evolve EAQ 2 Homeostasis

The nurse provides teaching regarding vitamin B12 injections to a client with pernicious anemia. Which statement by the client indicates that teaching was understood? 1 "I must take this medication for the rest of my life." 2 "I should take this vitamin, as needed, when feeling fatigued." 3 "Once my symptoms subside, I can stop taking this vitamin." 4 "I need to have this available for use during exacerbations of anemia."

1 "I must take this medication for the rest of my life." Because the intrinsic factor does not return to gastric secretions even with therapy, B12 injections will be required for the remainder of the client's life. Vitamin B12 must be taken on a regular basis for the rest of the client's life.

Which skin infection is caused by bacteria? 1 Folliculitis 2 Candidiasis 3 Herpes zoster 4 Dermatophytosis

1 Folliculitis Folliculitis is caused by bacteria. Candidiasis is a skin infection caused by a fungus. Herpes zoster is caused by a virus. Dermatophytosis is caused by a fungus.

Which function of limbic system is accurate? 1 Influence emotional behavior 2 Regulate autonomic functions 3 Facilitate automatic movements 4 Relay sensory and motor inputs for cerebrum

1 Influence emotional behavior Located lateral to the hypothalamus, the limbic system influences emotional behavior and basic drives such as feeding and sexual behaviors. The regulation of endocrine and autonomic functions is the function of the hypothalamus. The control and facilitation of learned and automatic movements is the function of the basal ganglia. The thalamus relays sensory and motor input to and from the cerebrum.

Which medication used to promote fertility would the nurse identify as a potential cause of esophageal burns? 1 Estrogen 2 Clomiphene 3 Nifedipine 4 Indomethacin

2 Clomiphene Clomiphene is a serum selective receptor modulator that may cause esophageal burns. Estrogen may cause a thromboembolism. Nifedipine may cause maternal-fetal problems. Indomethacin may cause birth defects.

Which cytokine stimulates the liver to produce fibrinogen and protein C? 1 Interleukin-1 2 Interleukin-6 3 Thrombopoietin 4 Tumor necrosis factor

2 Interleukin-6 Interleukin-6 stimulates the liver to produce fibrinogen and protein C. Interleukin-1 stimulates the production of prostaglandins. Thrombopoietin increases the growth and differentiation of platelets. Tumor necrosis factor stimulates delayed hypersensitivity reactions and allergies.

Which daily diet recommendation would the nurse reinforce with a client who has arthritis? 1 Wheat germ and yeast 2 Yogurt and blackstrap molasses 3 Multiple vitamin supplements in large doses 4 Foods from a variety of food groups

4 Foods from a variety of food groups There is no special diet for arthritis. A balanced diet, consisting of foods from all groups of the MyPlate dietary guidelines, is essential in maintaining nutrition. Limiting the diet to particular foods does not provide all the essential nutrients. If nutritional intake is adequate, large doses of multivitamins are unnecessary and are dangerous.

A child is prescribed tetracycline. The nurse understands which possible medication-related reaction is associated with this medication? 1 Kernicterus 2 Gray syndrome 3 Reye syndrome 4 Staining of teeth

4 Staining of teeth Tetracycline causes staining or discoloration of developing teeth in children. Sulfonamides may cause kernicterus in neonates. Chloramphenicol may cause Gray syndrome in infants. Aspirin may cause Reye syndrome in pediatric clients with a history of chickenpox or influenza.

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? 1 Decrease 2 Fluctuate 3Increase sharply 4Remain elevated

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.

The spouse of a client with an intracranial hemorrhage asks the nurse, "Why aren't they administering an anticoagulant?" How will the nurse respond? 1 "It is not advisable because bleeding will increase." 2 "If necessary, it will be started to enhance circulation." 3 "If necessary, it will be started to prevent pulmonary thrombosis." 4 "It is inadvisable because it masks the effects of the hemorrhage."

1 "It is not advisable because bleeding will increase." An anticoagulant should not be administered to a client who is bleeding because it will interfere with clotting and will increase hemorrhage. Anticoagulants are unsafe and will not be used to enhance the circulation or prevent pulmonary thrombosis. The response "It is inadvisable because it masks the effects of the hemorrhage" is not the reason why it is contraindicated; if given, it will increase, not mask, the effects of the hemorrhage.

Which medication is derived from a natural source and may be prescribed for the treatment of osteoporosis? 1 Calcitonin 2 Raloxifene 3 Clomiphene 4 Bisphosphonates

1 Calcitonin Calcitonin is derived from natural sources such as fish; this medication may be prescribed to prevent osteoporosis. Raloxifene is prescribed to prevent postmenopausal osteoporosis. Clomiphene is prescribed to induce ovulation. Bisphosphonates are prescribed to treat osteoporosis; this medication is not derived from natural sources.

According to the Centers for Disease Control and Prevention (CDC), which stage of the human immunodeficiency virus (HIV) disease is present in the client with a laboratory report revealing a CD4+ T-cell count of 520 cells/mm3? 1 Stage 1 2 Stage 2 3 Stage 3 4 Stage 4

1 Stage 1 According to the CDC, HIV disease is divided into four stages. A client with a CD4+ T-cell count of greater than 500 cells/mm3 is in the first stage of HIV disease. A client with a CD4+ T-cell count between 200 and 499 cells/mm3 is in the second stage of HIV disease. A client with a CD4+ T-cell count of less than 200 cells/mm3 is in the third stage of HIV disease. The fourth stage of HIV disease indicates a confirmed HIV infection with no information regarding the CD4+ T-cell counts.

Which surgical procedure involves urinary diversion in which the ureters are transplanted to a resected section of the small intestines, with one end attached to the abdominal wall? 1 Cystostomy 2 Ileal conduit 3 Ureterosigmoidostomy 4 Cutaneous ureterostomy

2 Ileal conduit An ileal conduit is the transplantation of the ureters into a resected portion of the ileum, which is then used to create a stoma on the abdominal wall for drainage of urine. Cystostomy is an opening into the bladder through the abdominal wall that allows urine to flow out. In ureterosigmoidostomy, the ureter is transplanted into the colon and urine is excreted through the rectum. In cutaneous ureterostomy, the ureter is transplanted through the abdomen and attached to the skin.

Which nursing action would be included in the plan of care for a child with acute poststreptococcal glomerulonephritis? 1 Encouraging fluids 2 Monitoring for seizures 3 Measuring abdominal girth 4 Checking for pupillary reactions

2 Monitoring for seizures Cerebral edema from hypertension or cerebral ischemia may occur, which may result in seizures. Increasing fluid intake may lead to an increase in blood pressure and edema. Measuring abdominal girth is appropriate for children with nephrotic syndrome, in which the child has hypoalbuminemia that causes fluid to shift from plasma to the abdominal cavity. Glomerulonephritis will not alter pupillary reactions.

The nurse is providing care for a client who has a permanent biliary drainage tube (T-tube) inserted to provide palliative care. Which action would the nurse take postoperatively? 1 Maintain intermittent low suction to limit trauma. 2 Cleanse the area around the insertion site to prevent skin breakdown. 3 Attach the tube to a negative-pressure drainage system to promote drainage. 4 Reposition the client frequently to increase the flow of bile through the tube.

2Cleanse the area around the insertion site to prevent skin breakdown. Bile is irritating to the skin; cleansing the area around the T-tube to prevent skin breakdown is a priority. Suction is contraindicated; drainage is via gravity. The T-tube is attached to a bag for straight drainage via gravity, not suction that uses negative pressure. Repositioning the client is vital to prevent venous and pulmonary stasis, not for facilitating the drainage of bile.

A client hospitalized for uncontrolled hypertension and chest pain was started on a daily diuretic 2 days ago upon admission, with prescriptions for a daily basic metabolic panel. The client's potassium level this morning is 2.7 mEq/L (2.7 mmol/L). Which action will the nurse take next? 1 Send another blood sample to the laboratory to retest the serum potassium level. 2 Notify the health care provider that the potassium level is above normal. 3 Notify the health care provider that the potassium level is below normal. 4 No action is required because the potassium level is within normal limits.

3 Notify the health care provider that the potassium level is below normal. The health care provider should be notified immediately because the client's potassium is below normal. The normal potassium level range is 3.5 mEq/L to 5.0 mEq/L (3.5-5.0 mmol/L). Clients on diuretic therapy require close monitoring of their electrolytes because some can cause hypokalemia, whereas others spare potassium, which can cause hyperkalemia. Retesting the serum potassium level is unnecessary and will delay the treatment required by the client.

Which term refers to the Cowper gland? 1 Skene gland 2 Prostate gland 3 Bartholin gland 4 Bulbourethral gland

4 Bulbourethral gland Cowper glands are accessory glands of the male reproductive system; they are also referred to as the bulbourethral glands. Skene glands are a part of the female reproductive system. The prostate gland is also a gland of the male reproductive system. Bartholin glands are part of the female reproductive system.