Nursing 320 Final Exam

Diabetes mellitus is the leading cause of: (select all the apply) A) Adult blindness B) Non-Traumatic amputations C) End-stage renal disease D) Hypertension

A, B, C

Diabetes mellitus pathophysiology can be described as (select all the apply) A) Autoimmune disorder B) Lack of insulin production/secretion C) Defect in insulin receptors D) Gluconeogenesis

A, B, C

Postrenal cause of Acute Kidney Injury include: (Select all the apply) A) Ureteral calculi B) Bladder tumor C) Reflux back into the kidney D) Trauma

A, B, C

The 3 "P"s of Diabetes Mellitus includes (select all that apply) A) Polyphagia B) Polydipsia C) Polyuria D) Polydystrophy

A, B, C

Which of the following occurs with Chronic Kidney Disease? (select all the apply) A) Anemia B) Azotemia C) Acidosis D) Aortic aneurysm

A, B, C

Common causes of HHS include (select all the apply) A) UTI's B) Pneumonia C) Newly diagnosed Type 1 DM D) Macrovascular changes

A and B

Prerenal causes of AKI include (select all the apply) A) Decreased cardiac output B) Severe hypovolemia C) Urethral obstruction D) Acute glomerulonephritis

A and B

A postoperative patient has had a total of 180 mL of urine output over the past 8 hours. The nurse should monitor for A) Acute kidney injury B) Liver cirrhosis C) Diabetes mellitus D) Rheumatoid arthritis

A

After a transurethral resection of the prostate (TURP) the catheter is pulled taut and secured to the leg to... A) Prevent bleeding B) Reduce bladder spasms C) Limit discomfort D) Promote urinary driange

A

An autoimmune disease that causes excess secretion of thyroid hormone A) Graves disease B) SIADH C) Cushing syndrome D) Myxedema

A

During the oliguric phase A) Urine output is less than 400 mL/day B) The nurse should monitor for osmotic diuresis C) BUN and creatinine are normal D) The kidneys excrete large amounts of potassium

A

During which phase would the nurse expect to administer furosemide? A) Oliguric B) Recovery C) Diuretic

A

Positive Chvostek's sign and Trousseau's sign indicate: A) Hypocalcemia B) Hypercalcemia C) Hypokalemia D) Hyperkalemia

A

Signs and Symptoms of Hypothyroidism include: A) Coarse, dry skin, muscle aches, anorexia, cold intolerance B) Moist skin, anorexia, dyspnea, heath intolerance C) Warm, moist skin, swelling of the neck, weight loss D) Restlessness, weight gain, exophthalmos, cold intolerance

A

The absorption of SQ insulin is faster/best in the A) Abdomen B) Arm C) Thigh D) Buttock

A

Thyroid stimulating hormone (TSH) is secreted by the ______ gland in response to low levels of T3 and T5 A) Pituitary B) Hypothalamus C) Thyroid D) Adrenal

A

What is the action of Metformin (Glycophage)? A) Decrease insulin resistance B) Slow digestion of carbs C) Increase pancreatic enzyme secretion D) Slow GI motility

A

Which action will the nurse take to assess for adequate blood flow thought a patient's left arm arteriovenous fistula? A) Auscultate for a bruit at the fistula site B) Assess the rate of the left radial pulse C) Compare blood pressures in the left and right arms D) Irrigate the fistula site with saline every 8 hours

A

Which anti-diabetic medication stimulates the pancreases to secrete insulin A) Glipizide B) Glucagon C) Metformin D) Dextrose

A

Which lab value increase during the recovery phase? A) GFR B) Creatinine C) BUN D) Potassium

A

Which lab values will be increased during the oliguric phase? A) BUN and creatinine B) Creatinine and GFR C) GFR and BUN D) Potassium and GFR

A

Which of the following statements indicates appropriate teaching for a female with a history of UTI A) I will be sure to try and urinate every 3 to 4 hours B) I will wipe from back to front after using the bathroom C) I will be sure to drink 1/2 to 1 liter of fluid a day D) I will use the bathtub instead of the shower

A

A patient is diagnosed with urethritis. What should the nurse expect to do before initiating antibiotic therapy A) Obtain a specimen for culture and sensitivity B) Start a 24-hour urine collection C) Teach the patient how to perform perineal care D) Prepare for urinary catheterization

A

A patient is in the clinic for follow-up of acute pyelonephritis. Which teaching does the nurse reinforce? A) Complete all antibiotic medications B) Report episodes of nocturia C) Stop taking the antibiotics when pain is relived D) Strain all urine

A

A patient is receiving sliding scale, rapid-acting insulin. The best time to administer is: A) Within 15 minutes of mealtime B) Within an hour of mealtime C) 30 to 45 minutes before mealtime D) Immediately following the meal

A

A patient strains to pass scant urine has normal fluid intake, and a distended bladder. A cause of these symptoms is A) Urethral stricture B) Hydroureter C) Hydronephrosis D) PKD

A

Which of the following hormone work to oppose insulin? (select all that apply) A) Cortisol B) Epinephrine C) Testosterone D) Growth hormone

A, B, D

Diagnosis of Diabetes mellitus is made using at least one of following (select all the apply) A) Hgb A1C or 6.5% higher B) Fasting Plasma Glucose (FPG) >/= 126 mg/dL C) OGTT of 200 mg/dL using a glucose load of 75 Gms D) Random plasma glucose level of >200 mg/dL

All

Nursing interventions during the Oliguric phase include (select all that apply) A) Daily weight B) Monitor heart rhythm C) Strict I&O D) Monitor lab values

All

Which of the following should be included in the patient teaching plan for Diabetes Mellitus (select all the apply) A) Foot care B) Sick day plan C) Meal planning D) Medications

All

A life-threatening complication of pyelonephritis that the nurse should be aware of is.... A) Over-distention B) Urosepsis C) Pyuria D) Cardiac arrest

B

A patient with diabetes reports a headache and feeling weak, skin is cool and clammy. What should the nurse do first A) Give glucagon B) Check the patient's blood glucose C) Give insulin D) Administer Dextrose 50%

B

After extracorporeal shock wave lithotripsy, the nurse needs to A) Call the provider if there s trace blood in the urine B) Strain the urine C) Start a patient-controlled analgesic (PCA) D) Place patient on fluid restriction

B

Excess parathyroid hormone (PTH) leads to A) Hypocalcemia B) Hypercalcemia C) Anemia D) Hyperphosphatemia

B

Ketones in the blood & urine, Kussmaul's respirations, pH <7.30, occurs more often in Type 1 DM A) HHS B) DKA C) Prediabetes D) Hypoglycemic response

B

Over use of the same injection site for insulin therapy can cause A) Allergic reaction B) Lipodystrophy C) Somogyi effect D) Insulodystrophy

B

Rebound hyperglycemia in the morning due to the release of counterregulatory hormones is known as A) Dawn effect B) Somogyi effect C) Carbonara effect D) Hypersensiti vity effect

B

The development of Goiter is related to: A) Normal aging process B) Lack of dietary iodine C) Increase in BP D) Hypercalcemia

B

The insulin regimen that most closely mimics endogenous insulin production is: A) Mealtime insulin (bolus) regimen B) Basal-Bolus intensive therapy C) Basal Background insulin regimen D) Combination insulin injection therapy

B

The most common organism causing UTI is A) Staph saprophyticus B) E coli C) Enterococcus D) Klebsiella

B

The nurse teaches the female patient who has frequent UTIs that she should a. take tub baths with bubble bath b. urinate before and after sexual intercourse c. take prophylactic sulfonamides for the rest of her life d. restrict fluid intake to prevent the need for frequent voiding

B

The nursing is caring for four patients with CKD. Which patient should the nurse assess first? A) Patient with BP 158/90 B) Patient with Kussmaul respirations C) Patient with skin pruritis D) Patient with halitosis and stomatitis

B

Urinary diversion procedures in which the ureters are attached to a resected section of small intestine to create a stoma A) Cystostomy B) Ileal conduit C) Ileostomy D) Cutaneous ureterostomy

B

What is the most accurate indicator of fluid loss or gain? A) Urine output B) Weight C) Skin turgor D) Health history

B

Which of the following is a priority nursing diagnosis for a patient with renal calculi A) Impaired urinary elimination B) Acute pain C) Infection D) Deficient knowledge

B

Which of the following symptoms do you expect to see in a patient diagnosed with acute pyelonephritis? A) Jaundice and flank pain B) Costovertebral angle tenderness and chills C) Hematemesis D) Polyuria and nocturia

B

Why would the nurse monitor a client with a diagnosis of Cushing syndrome for symptoms of diabetes mellitus A) Cortical hormones stimulate rapid weight loss B) Glucocorticoids accelerate the process of gluconeogenesis C) Tissues catabolism results in a negative nitrogen balance D) Excess adrenocorticotropic damages pancreatic tissue

B

You administered 10 U rapid-acting (Novolog) insulin at 7:30 am. When will patient be at highest risk for hypoglycemia? A) After breakfast 8:15 am B) Mid-morning 9:30 am C) At lunch time 12:00 pm D) Mid-afternoon 2:30 pm

B

Which findings are most likely in a patient with severe hyperthyroidism. Select all the apply A) Respiratory rate of 12 B) Fine tremors of hands C) Heart rate of 120 D) BP of 160/90

B, C, D

A patient had a cystectomy with the creation of a continent urinary reservoir ( Indiana Pouch). Pt, teaching will include A) Application of ostomy appliances B) Empty ostomy pouch every 2 hours C) Catheterization technique and schedule D) Analgesic use before emptying pouch

C

A patient is admitted with renal calculi. Which of the following actions should the nurse do first? A) Encourage the patient to increase oral fluids B) Obtain supplies to measure and strain all urine C) Assess and treat the patient's pain D) Obtain consent for a Lithotripsy

C

A patient is diagnosed with Cushing syndrome. The nurse would monitor the patient for which cardiovascular complication? A) Chest pain B) Tachycardia C) Hypertension D) Atrial fibrillation

C

A patient with type 2 DM is asked what he will do if his blood sugar drops below 70. Which is correct? A) I will call my doctor right away B) I will get another blood sugar, just to double check C) Take an oral form of glucose D) I will stop my activity until it gets better

C

After a nephrectomy, the patient has a large urine output because of adrenal insufficiency. What does the nurse anticipate the priority intervention for this patient will be? A) ACE inhibitors to control hypertension B) Straight catheterization to measure residual urine C) IV fluids and corticosteroids D) Lasix to improve urine output

C

Insulin is produced by which cells? A) Pancreatic alpha cells in the lsets of Langerhans B) Beta Cells of the endothelium C) Pancreatic Beta cells in the lslets of Langerhans D) Liver Beta Cells in the Kuppfer cells

C

Lispro (Humalog), Aspart (Novolog) are both examples of: A) Short-acting insulin B) Intermediate-acting unsulin C) Rapid- acting insulin D) Long-acting insulin

C

Reduced urinary output A) Anuria B) Dysuria C) Oliguria D) Nocturia

C

Signs and symptoms of new-onset chills, fever, flank pain, CVA tenderness, urinary urgency/frequency are indicative of A) Acute glomerular nephritis B) Complicated cystitis C) Acute pyelonephritis D) Uncomplicated lower urinary tract infection

C

The nurse finds that a patient with diabetes mellitus is sweating and confused. The nurse should immediately provide: A) More insulin B) A protein snack C) A fast-acting carbohydrate D) A cool compress

C

Which disease process is also known as adrenal insufficiency? A) Conn's disease B) cushing syndrome C) Addison's disease D) Graves disease

C

Which drug is used to treat hypothyroidism? A) SSKI B) Methimazole C) Levothyroxine D) Calcitonin

C

Which finding are expected when assessing a patient who has a ureteral calculi? A) Foul odor and dark urine B) Urgency and mild aching pain C) Hematuria and sharp pain D) Frequency with small amounts of urine

C

Which of the following is the best indicator of kidney function? A) BUN B) Creatinine C) GFR D)Albumin

C

Why is urine strained when someone has renal calculi? A) Check for blood B) Check for infection C) Capture the stone D) Aids in correct analgesic administration

C

Which findings are associated with UTI in the older adult (Select all the apply) A) High fever B) Urinary urgency C) Confusion D) Slight rise in temperature

C and D

A patient on phenazopyridine (Pyridium) for cystitis reports orange-red urine. The nurse should best respond A) "Your urine is concentrated. Take only half a dose" B) Drink 500 ml of fluid every 3 hours to lighten your urine C) Stop the medication and come see us for a UA D) continue taking the med, this is an expected effect on the medication

D

A patient with type 1 diabetes has excessive thirst. Which term should the nurse use to document this finding? A) Polymyalgia B) Polyuria C) Polyphagia D) Polydipsia

D

Diabetes Mellitus is chronic multisystem disease relation to A) Abnormal insulin production B) Abnormal response of counterregulatory C) Impaired insulin utilization D) Both abnormal insulin production & utilization

D

Insulin resistance and/or decreased production occurs later in life; slow on set A) Prediabetes B) Gestational Diabetes C) Type 1 DM D) Type 2 DM

D

Which is not a symptom of hypoglycemia? A) Cool, clammy skin B) Anxiety, confusion, loss of consciousness C) Headache D) Feverish, hypertension, and tachycardic

D

Which is the only form of insulin that can be given IV? A) NPH B) Glargine C) Glulisine D) Regular

D

Which of the following is an indicator that a patient has successfully passed a kidney stone? A) Voiding clear amber urine B) No hematemesis or urinary tract infections C) Absence of epigastric pain, nausea, and vomiting D) Absence of colicky pain in the flank and groin

D

Which of the following symptoms is consistent with Addison's disease? A) Fluid overload B) Hypertension C) Hypernatremia D) Hyperkalemia

D

Which patient statement indicates understanding of potential symptoms following removal of three-way indwelling catheter A) I will have diluted urine B) I will be unable to urinate C) I will produce dark red urine D) I will experience some burning on urination

D

Why is a low-sodium, high-potassium diet prescribed for a patient with cushing syndrome? A) The patient will gain excessive weight if sodium is limited B) An inadequate intake of potassium contributed to the disease C) This type of diet increases emotionally stability D) Excess aldosterone and cortisone causes retention of Na+ and loss of K+

D

Your patient is unconscious with a finger stick glucose of 38. What will you do? A) Give 10 U reg insulin B) Give a complex carb C) Give orange juice and crackers D) GIve glucagon SQ or IM

D