Patho Hemato & Endocrine
A nurse assessing a client with an acute exacerbation of polycythemia vera notes coolness to the right leg and foot, pale color, and an absent right pedal pulse. Based on these findings the nurse suspects that the client has developed which complication? a. Compartment syndrome in the right leg b. Edema in the right leg c. Infection in the right leg d. Thrombosis in the right leg
d
A patient is diagnosed with hyperparathyroidism. Which of the following signs and symptoms would you NOT find in this patient? Select all that apply: a. Calcium level 6 mg/dL b. Bone fracture c. Positive Trousseau's Sign d. Tingling and numbness of lips and fingers e. Calcium level of 15 mg/dL f. Phosphate level 1.2 g. Renal calculi
a,c,d
Which clinical manifestations following thyroidectomy would alert the nurse that the client is going into a life-threatening thyroid storm? Select all that apply. a. Extremely agitated b. Unable to close eyelids completely together c. Temperature of 104.2°F (40.1°C) d. Telemetry showing heart rate of 184 e. Bruising on knees and feet
a,c,d
Which complications may be experienced by a client with diabetic neuropathies? Select all that apply. a. Foot ulcers b. Pathologic fractures c. Urinary retention d. Erectile dysfunction e. Gastroparesis
a,c,d,e
Signs and Symptoms of myxedema coma include all of the following EXCEPT? Select all that apply: a. Fever b. Bradycardia c. Sodium level less than 135 d. Blood glucose level greater than 350 e. Hypothermia
a,d
Which are examples of a negative feedback system? Select all that apply. a. Calcium and parathyroid hormone b. Somatostatin and thyroid-stimulating hormone (TSH) c. Estradiol and follicle-stimulating hormone (FSH) d. Cortisol and adrenocorticotropic hormone e. Insulin and glucagon
a,d,e
A nurse is assessing an older adult woman diagnosed with chronic hypothyroidism who has developed myxedema coma. The nurse will likely assess which lab and clinical manifestations in this client? Select all that apply. a. Hypoventilation b. Increased cardiac stimulation c. Hyperthermia d. Hypoglycemia e. Lactic acidosis f. Hyponatremia
a,d,e,f
A nurse is treating a client with aplastic anemia. Due to the replacement of normal bone marrow with malignant cells, the nurse teaches the client to prevent scratches, scrapes, and cuts. What root cause likely underlies the clients increased risk for hemorrhage? a. Neutrophilia b. Disseminated intravascular coagulation (DIC) c. Polycythemia d. Thrombocytopenia
d
A client with iron-deficiency anemia reports feeling tired all of the time. What does the nurse understand may be the cause of the fatigue that the client is experiencing? a. A decrease in lactic acid b. Alteration in carbohydrate metabolism c. Increased diffusion of electrolytes d. Chronic blood loss with inadequate iron available for recycling
d
Impaired and delayed healing in person with diabetes is caused by long-term complications that include a. Fluid imbalances b. Somogyi effect c. Ketoacidosis d. Chronic neuropathies
d
Which of the following are NOT a cause of myxedema coma? a. Illness b. Sedatives c. Iodine Toxicity d. Thyroidectomy
c
When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptom does the client report that the nurse would find associated with this disorder? a. Fatigue b. Constipation c. Increase in appetite d. Weight gain
c
Addison's Disease is: a. Increased secretion of aldosterone and cortisol b. Decreased secretion of cortisol c. Increased secretion of cortisol d. Decreased secretion of aldosterone and cortisol
d
A client with severe hypoglycemia is unconscious. Which method of providing glucose should be avoided? a. Dextrose IV b. Orange juice orally c. IM glucagon injection d. Glucose gel in the buccal
b
A client with diabetes mellitus is reporting burning pain of the feet and some numbness. These symptoms are likely due to which cause? a. Intermittent claudication b. Peripheral vascular disease c. Autonomic neuropathy d. Somatic neuropathy
d
Which finding indicates to the nurse that the current therapies are effective for a patient with acute adrenal insufficiency? a. Increasing serum sodium levels b. Decreasing serum chloride levels c. decreasing blood glucose levels d. increasing serum potassium levels
a
Which structure controls the functions of the greatest number of target glands and cells? a. Pituitary gland b. Pancreas c. Adrenal cortex d. Thyroid gland
a
Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as a thyroid storm. What are the manifestations of a thyroid storm? Select all that apply. a. Delirium b. Tachycardia c. Bradycardia d. Very low fever e. Very high fever
a,b,e
Which pathophysiologic phenomenon may result in a diagnosis of Cushing disease? a. Malfunction of the HPA system b. Hypopituitarism c. Autoimmune destruction of the adrenal cortex d. Excess ACTH production by a pituitary tumor
d
The pathophysiology student is studying erythropoiesis. Which statement demonstrates understanding of this process? a. The reticulocyte count serves as an index of erythropoietic activity of the bone marrow. b. In a 4-year-old, red blood cells are produced mainly in the vertebrae, sternum, ribs, and pelvis. c. Erythropoiesis refers to the production of red and white blood cells. d. In a 30-year-old, red blood cell production takes place in the femur.
a
What of these would be tested by a complete blood count (CBC)? a. Red blood cells and platelets b. Size and shape of blood cells c. Lymphocytes and neutrophils d. Sodium and potassium
a
The nurse determines that additional instruction is needed for a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) when the patient makes which statement? a. "I need to shop for foods low in sodium and avoid adding salt to food." b. "I should weigh myself daily and report any sudden weight loss or gain." c. "I need to limit my fluid intake to no more than 1 quart of liquids a day." d. "I should eat foods high in potassium because diuretics cause potassium loss."
a
The nurse is assessing lab values of a client with disseminated intravascular coagulation (DIC). The nurse would anticipate which abnormal laboratory result? a. Increased prothrombin time (PT) b. Increased fibrinogen c. Decreased fibrin degradation product d. Decreased partial thromboplastin time (PTT)
a
The nurse is caring for a patient admitted with diabetes insipidus (DI). Which information is most important to report to the health care provider? a. The patient is confused and lethargic. b. The patient reports a recent head injury. c. The patient has a urine output of 400 mL/hr. d. The patient's urine specific gravity is 1.003.
a
A 33-year-old client has been admitted to the hospital for the treatment of Graves disease. Which assessment should the clients care team prioritize? a. Assessment of the clients vision and oculomotor function b. Cardiac monitoring and assessment of peripheral perfusion c. Assessment of the clients level of consciousness and neurologic status d. Assessment of the clients peripheral vascular system for thromboembolism
a
A child with leukemia hears the health care provider tell the parents that the child has pancytopenia. This child asks the nurse, What does pancy mean? Am I going to die? Which response by the nurse is most appropriate for this 10-year-old child? a. This means the chemotherapy has lowered your blood counts including red blood cells, white blood cells and platelets. You are very sick, but we are working hard to make you healthy again. b. This means the chemotherapy is attacking your bone marrow and your body has to find a way to fight back. No, you are not going to die. c. This is very serious and could possibly lead to death if you start bleeding badly. d. This is just a way of saying that you are sick and need to rest more.Your medicine is fighting your cancer cells so that you will not die.
a
A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of: a. Antidiuretic hormone (ADH) and oxytocin b. Adrenocorticotropic hormone (ACTH) and vasopressin c. Somatostatin and prolactin d. Growth hormone-releasing hormone (GHRH) and dopamine
a
A client is seeking treatment for infertility. What decrease in hormone secretion from the anterior lobe of the pituitary gland that regulates fertility would the nurse recognize may cause this issue? a. Follicle stimulating hormone (FSH) b. Thyroid-stimulating hormone (TSH) c. Luteinizing hormone (LH) d. Adrenocorticotropic hormone (ACTH)
a
A client who has just undergone thyroid surgery is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these findings as manifestations of which complication? a. Thyroid storm b. Myxedema coma c. Hypothyroidism d. Addisonian crisis
a
A nurse is assessing a client who displays pale skin and nail beds. Which laboratory data should the nurse evaluate? a. Hemoglobin level b. Erythrocyte sedimentation rate c. White blood cell count d. Neutrophil count
a
A nurse performing a skin assessment on an older adult notes small pinpoint hemorrhages and purple areas of bruising over the lower extremities. The nurse documents these as the presence of which abnormality? a. Petechiae and purpura b. Senescence and skin tags c. Hyperpigmentation and lentigines d. Macular rash with keratosis
a
A patient is recovering from a thyroidectomy. The patient starts to complain of tingling and numbness in the face, toes, and fingers. Which of the following findings below warrants attention? a. Ca+ level: 6 mg/dL b. Na+ level: 145 mg/dL c. K+ level: 3.5 mg/dL d. Phosphate level: 4.3 mg/dL
a
A patient reports they do not eat enough iodine in their diet. What condition are they most susceptible to? a. Hypothyroidism b. Thyroid Storm c. Hyperthyroidism d. SIADH
a
A pregnant woman contacts her physician because she has developed sudden, severe pain and swelling in her left lower leg. The physician explains to her that her past medical includes an inherited defect in factor V Leiden, which predisposes her to the development of: a. Excessive clotting b. Platelet disorders c. Thrombocytopenia d. Abnormal bleeding
a
After having a very stressful day in pathophysiology class, the student knows that which hormone (secreted by the adrenal cortex) will help decrease the effects of stress? a. Cortisol, a glucocorticoid b. Dehydroepiandrosterone, an adrenal androgen c. Aldosterone, a mineralocorticosteroid d. Androstenedione, an adrenal androgen
a
In teaching the patient with pernicious (megaloblastic) anemia about the disease, you as the nurse explain that it results from a lack of a. intrinsic factor b. extrinsic factor c. folic acid d. cobalamin intake
a
The diagnosis of type 1 diabetes would be confirmed by which principle? a. Insulin is not available for use by the body. b. Insulin is produced but unavailable for use in the body. c. Insulin is present in large amounts for use by the body. d. Small amounts of insulin are produced daily.
a
Which assessment finding of a client constitutes a criterion for a diagnosis of metabolic syndrome? a. Has a high blood pressure that is consistently in the range of 140/90 mm Hg or greater b. States less than 30 minutes of strenuous physical activity each week c. Has a fasting triglyceride level of 100 mg/dL d. Has a resting heart rate between 85 and 95 beats/min
a
A 38-year-old female is considering the use of oral contraceptives as a method of birth control. She asks her health care provider if any risks would be involved. The best response would be: a. "There are no risks involved." b. "Have you talked about this with your partner?" c. "Yes, risks increase with age." d. "Why do you want the pill?"
c
Impaired and delayed healing in a person with diabetes is caused by long-term complications that include: a. Fluid imbalances b. Myocardial Infarction c. Chronic neuropathies d. Ketoacidosis
c
A 30-year-old client who manages type 2 diabetes with glyburide presents at the emergency room reporting headache, confusion, and tachycardia. The client has come from a party at which the client drank two beers to celebrate running a half-marathon. Which is likely to be the cause of this clients? a. Somogyi effect b. Hypoglycemia c. Hyperosmolar hyperglycemic state d. Diabetic ketoacidosis
b
A 40-yr-old patient with suspected acromegaly is seen at the clinic. To assist in making the diagnosis, which question should the nurse ask? a. "Have you had a recent head injury?" b. "Do you have to wear larger shoes now?" c. "Is there a family history of acromegaly?" d. "Are you experiencing tremors or anxiety?"
b
A 57-year-old man is diagnosed with thrombocytopenia. The nurse knows that thrombocytopenia refers to a decrease in the number of circulating platelets. The nurse also knows that thrombocytopenia can result from what? a. Increased platelet production b. Decreased platelet production c. Increased platelet survival d. Decreased sequestration of platelets
b
A client is diagnosed with diabetic ketoacidosis (DKA) in the emergency department. Which clinical manifestations will the client likely exhibit? a. Ankle edema, headache, stomach bloating, and high blood pressure b. Polyuria, polydipsia, vomitng, and fatigue c. Headache, difficulty with problem solving and disturbed behavior, and seizures d. Weakness, severe dehydration, and hemiparesis.
b
A client with type 1 diabetes has started a new exercise routine. Knowing there may be some increased risks associated with exercise, the health care provider should encourage the client to: a. monitor for respiratory disorders. b. carry a snack with a rapidly absorbed form of glucose to prevent profound hypoglycemia. c. be careful that he or she is not experiencing rebound hyperglycemia. d. watch for rapid weight loss.
b
A clients primary care provider has ordered an oral glucose tolerance test (OGTT) as a screening measure for diabetes. Which instruction should the client be given? a. "You can go to the lab at any time; just tell the technician when you last ate before they draw a blood sample." b. "The lab tech will give you a sugar solution and then measure your blood sugar levels at specified intervals." c. "Youll have to refrain from eating after midnight and then go to the lab to have your blood taken first thing in the morning." d. "Theyll take a blood sample and see how much sugar is attached to your red blood cells."
b
A male client with chronic obstructive pulmonary disease has a hematocrit of 55%. The practitioner tells the client that he has: a. Relative polycythemia b. Secondary polycythemia c. Polycythemia vera d. Primary polycythemia
b
A nurse is caring for a client who has sustained severe trauma and has developed disseminated intravascular coagulation (DIC). The nurse will explain this complication to the family based on which physiologic principle? a. Thrombocytosis as a result of widespread infection b. Widespread coagulation and bleeding in the vascular compartment c. Bleeding due to structurally weak vessels resulting from vitamin C deficiency d. Impaired platelet function due to vitamin K deficiency
b
A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves disease. Which assessments should the nurse prioritize? a. Skin integrity and distribution of adipose tissue b. Eye health and visual acuity c. Cognition and judgment d. Signs and symptoms of decreased bone density
b
A patient diagnosed with acromegaly has developed speech difficulties and asks what is causing the problem. Which response by the nurse is accurate? a. You have developed the condition from numbness of the vocal cords. b. You have developed the condition due to overgrowth of the tongue. c. You have developed the condition from an overgrowth of soft tissue in the neck. d. You have developed the condition related to upper airway narrowing.
b
A patient is being admitted with a diagnosis of Cushing syndrome. Which findings will the nurse expect during the assessment? a. Chronically low blood pressure b. Purplish streaks on the abdomen c. Bronzed appearance of the skin d. Decreased axillary and pubic hair
b
After birth, red blood cells are normally made in which location? a. Spleen b. Bone marrow c. Kidneys d. Liver
b
All cells of the body age and are replaced in a natural order. When RBCs age, they are destroyed in the spleen. During this process, the iron from their hemoglobin is released into the circulation and returned: a. to the muscles to be stored for strength. b. to the bone marrow for incorporation into new RBCs. c. to the lungs to bind with oxygen. d. to the liver to bind with oxygen.
b
An older adult client arrives with garbled speech, unilateral facial drooping, and weakness and unfortunately dies. Laboratory work reveals hematocrit of 54% (0.54). Which complication of polycythemia could most likely be associated with this clients death? a. Infection and sepsis b. Cerebral thrombosis c. Acute leukemia d. Anaphylactic reaction
b
As the nurse educating the patient about Graves Disease, which of the following statements by the patient ensures the patient understood the education about their condition? a. I could experience myxedema coma, which is life-threatening, if I abruptly stop taking my antithyroid medication. b. Graves disease is due to an excessive amount of thyroid hormone in the body. c. I will be sure to eat a lot of kelp because it helps with decreasing thyroid hormone levels. d.If I have pain I will only take aspirin.
b
In primary immune thrombocytopenia purpura (ITP), the client has which type of disorder that primarily destroys which blood component? a. Alloimmune; factor VIII b. Allergic; fibrinogen c. Autoimmune; platelets d. Immunoglobulin; B cells
c
Client with diabetic retinopathy develops a retinal bleed and asks the nurse, "How can I prevent this from happening again?" What response provides the most effective information? a. Wear glasses when reading and limit computer time. b. Maintain healthy blood pressure and blood sugar levels. c. Control stress and monitor vision changes. d. Visit your eye health professional for annual exams.
b
Clients with lung disease can develop polycythemia as a result of which condition? a. Decreased blood viscosity b. Chronic hypoxia c. Hyperventilation d. Excessive respiratory fluid loss
b
Primary adrenal insufficiency is manifested by: a. Potassium level of 2.8 mEq/L (2.8 mmol/L) and weight gain of 3 pounds overnight b. Serum sodium level of 120 mEq/L (120 mmol/L) (low) and blood glucose level of 48 mg/dL (2.66 mmol/L) (low) c. Hypopigmentation over neck and BP greater than 150/90 d. Truncal obesity and 3+ pitting edema in lower legs
b
The client with chronic kidney disease and congestive heart failure is weak and dyspneic. Lab work reveals a hemaglobin of 6.5 g/dL (65 g/L). Which type of blood product will the provider order? a. Albumin b. Packed red blood cells c. Whole blood d. Plasma
b
The emergency department nurse is concerned that the clients snake bite may trigger disseminated intravascular coagulation (DIC). If this should occur, which clinical manifestations would be seen? a. Hypertension b. Hemorrhage c. Platelet loss d. Headaches
b
The family of a client in the hospital with diabetes mellitus that is out of control asks the nurse to explain the client's recent weight loss while eating more than usual. How will the nurse respond? a. Surplus glucose is stored as glycogen in the liver. b. Glucose is unused without insulin, so body fats are used for energy. c. Fatty acids enter the glycolytic pathway to release energy. d. Lack of insulin raises circulating blood glucose levels.
b
The most common cause of thyrotoxicosis is Graves disease. When assessing this client, the nurse should put priority on which sign/symptom? a. Pulse rate of 64 beats/minute b. Ophthalmopathy c. Complaints of muscle fatigue d. Facial myxedema with puffy eyelids
b
The nurse is assessing a client diagnosed with anemia and notes that the client's skin and mucous membranes are pale. The nurse interprets this as: a. Changes in blood viscosity b. Insufficient hemoglobin c. Presence of systolic murmur d. Tissue hypoxia to the brain
b
The nurse is caring for a patient with central diabetes insipidus (DI). What does the nurse recognize is a priority focus of care? a. Decreasing renal responsiveness to antidiuretic hormone (ADH) b. Avoiding dehydration and fluid volume deficit c. Preventing treatment-related hypoglycemia d. Pacing activities and minimizing fatigue
b
The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which statement about the role of the thyroid gland is most accurate? a. The thyroid gland is responsible for regulating serum calcium levels. b. The thyroid gland is responsible for increasing the metabolic rate. c. The thyroid gland releases neurotransmitters when the flight or flight mechanism is stimulated. d. The thyroid gland promotes development of secondary sex characteristics.
b
Which assessment finding for a 33-yr-old female patient admitted with Graves' disease requires the most rapid intervention by the nurse? a. Heart rate 136 beats/min b. Temperature 103.8° F (40.4° C) c. Severe bilateral exophthalmos d. d. Blood pressure 166/100 mm Hg
b
Which assessment finding should the nurse caring for a patient with thrombocytopenia communicate immediately to the health care provider? a. the platelet count is 52,000/ul b. The patient is difficult to arouse. c. There are purpura on the oral mucosa. d. There are large bruises on the patient's back.
b
Which finding about a patient with polycythemia vera is most important for the nurse to report to the health care provider? a. Hematocrit 55% b. Calf swelling and pain c. Presence of plethora d. Platelet count 450,000/L
b
Which individuals likely are at the highest risk of megaloblastic anemia? a. An infant who is exclusively fed commercial baby formula b. A 21-year-old college student who has a poor diet that does not include meat sources c. A 69-year-old woman who takes aspirin four times daily to treat arthritis d. A 44-year-old man who lost approximately 500 mL of blood in a workplace accident
b
Which is considered a function of plasma? a. Producing waste products b. Carrying nutrients c. Eliminating plasma proteins d. Manufacturing hormones
b
Which of the following is not a sign or symptom of Diabetic Ketoacidosis? a. Positive Ketones in the urine b. Oliguria c. Polydipsia d. Abdominal pain
b
Which of the following patients is at most risk for Type 2 diabetes? a. A 6 year old girl recovering from a viral infection with a family history of diabetes. b. A 28 year old male with a BMI of 49. c. A 76 year old female with a history of cardiac disease. d. A 16 year old boy with asthma.
b
Which of the following signs and symptoms is NOT expected with Diabetes Insipidus? a. Polydipsia b. Polyphagia c. Polyuria d. Extreme thirst
b
Which of the following symptoms do NOT present in hyperglycemia? a. Glycosuria b. Blood glucose <60 mg/dL c. Hunger d. Extreme thirst
b
during the physical assessment of a patient with severe anemia, which finding is most concerning? a. anorexia b. dyspnea at rest c. bone pain d. hepatomegaly
b
A client with hypothyroidism has not taken medication for several months, informing the nurse that she lost her insurance and is unable to afford the medication. When assessing the clients temperature tolerance and skin, what does the nurse anticipate finding? Select all that apply. a. Increased perspiration b. Coarse and dry skin and hair c. Intolerance to cold d. Thin and silky skin and hair e. Decreased sweating
b,c,e
A client has been diagnosed with dysfunction of the anterior pituitary gland. The nurse is aware that which hormones will likely be affected? Select all that apply. a. Antidiuretic hormone (ADH) b. Growth hormone (GH) c. Norepinephrine d. Luteinizing hormone (LH) e. Thyroid-stimulating hormone (TSH) f. Adrenocorticotropic hormone (ACTH)
b,d,e,f
A 42-year-old male client recently diagnosed with liver cancer is noted as at high risk for bleeding abnormalities. The nurse recognizes this risk as a result of: a. increased amounts of vitamin K being produced in the liver. b. weakening of the organ walls as a result of inflammation. c. the reduction of clotting factors synthesized in the liver. d. a vitamin C deficiency in the diet.
c
A 51-year-old woman has been diagnosed with Cushing syndrome after a diagnostic workup that reveals cortisol hypersecretion. The nurse knows which assessment finding would be inconsistent with her diagnosis? a. A protruding abdomen and a "buffalo hump" on the back b. Increased blood pressure and decreased potassium levels c. Poor stress management and hyperpigmentation d. A "moon face" and muscle weakness
c
A 56-yr-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with possible syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would expect the initial laboratory results to include a(n) a. elevated hematocrit. b. increased serum chloride. c. decreased serum sodium. d. low urine specific gravity.
c
A client comes to the clinic with a runny nose and scratchy throat. The nurse is evaluating the white blood cell count, which shows an elevated number of white blood cells and an increased percentage of eosinophils. What is the most likely cause of the symptoms? a. Fungal infection b. Viral infection c. Allergic reaction d. Bacterial infection
c
A client experiences an increase in thyroid hormone as a result of a thyroid tumor. Which hormonal response demonstrates the negative feedback mechanism? a. Increased thyrotropin-releasing hormone (TRH) b. Decreased adrenocorticotropic hormone (ACTH) c. Decreased thyroid-stimulating hormone (TSH) d. Increased follicle-stimulating hormone (FSH)
c
A client has sought care because his gums began bleeding when he was flossing his teeth and they have now been bleeding for several hours. Laboratory testing has revealed a platelet count of 60 x 103/μL (60 x 109/L) and a diagnosis of thrombocytopenia. Which of the nurses assessment questions addresses the possible etiology of this health problem? a. "Do you know your blood type?" b. "Have you ever used recreational drugs?" c. "What medications are you currently taking?" d. "Are your immunizations current?"
c
A client is admitted to the emergency department with a diagnosis of polycythemia. The nurse plans to assess for symptoms related to which problem? a. Decreased ability to carry oxygen to the cells b. Inability to form blood clots c. Increased blood viscosity d. Increased risk of infection
c
A client presents to the clinic with symptoms of elevated blood pressure, dizziness, red face, pain in fingers and toes, headache, and difficulty concentrating. A blood smear reveals an increased number of erythrocytes. Based on these findings, the nurse anticipates which diagnosis? a. Hyperbilirubinemia b. Leukemia c. Polycythemia vera d. Hemolytic anemia
c
A client was involved in an auto accident and suffered massive internal injuries that resulted in a large blood loss. Select the type of anemia the client is at greatest risk to develop. a. Iron deficiency b. Hemolytic c. Blood loss d. Aplastic
c
A health care provider is assessing a client for a potential endocrine disorder. Assessment findings identify abnormalities with emotion, pain, and body temperature. Which mechanism of endocrine control will require further laboratory/diagnostic assessment? a. Cerebellum b. Anterior pituitary c. Hypothalamus d. Cerebral cortex
c
A healthy, primiparous (first-time) mother delivered a healthy infant several hours ago, but the mother has experienced postpartum hemorrhage. Which disorder is most likely to underlie the clients excessive bleeding after delivery? a. Hemophilia A b. Thrombotic thrombocytopenic purpura (TTP) c. Disseminated intravascular coagulation d. Von Willebrand disease
c
A normally healthy client is diagnosed with polycythemia vera. The nurse should prioritize assessments aimed at the early identification of which complication associated with this diagnosis? a. Vasculitis b. Hyperventilation c. Thromboembolism d. Orthostatic hypotension
c
A nurse is monitoring a client with anemia and low oxygen levels. The nurse knows that which condition stimulates the secretion of erythropoietin? a. Tachycardia b. Low blood pressure c. Hypoxia d. Inflammation
c
A patient arrives to the ER and is unable to give you a health history due to altered mental status. The family reports the patient has gained over 10 lbs in 1 week and says it is mainly "water" weight. In addition, they report the patient hasn't been able to urinate much within the past week. On assessment, you note the patient's HR is 115 and BP 180/92. Patient sodium level is 90. Which of the following conditions do you suspect the patient is most likely presenting with? a. Addisons Disease b. Diabetes Insipidus c. SIADH d. Fluid Volume Deficient
c
A patient, with a history of gastric bypass surgery 6 months ago, reports feeling very fatigued and is having food cravings for clay and dirt. On assessment, you note the patient has nail changes that look spoon-shaped. This spoon-shaped appearance of the nails is called? a. Terrys Nails b. Onychoschizia c. Koilonychias d. Leukonychia
c
An adult client with good overall health has reported headaches and dizziness in recent weeks. The nurses assessment reveals blood pressure of 158/99 mm Hg, which is unprecedented for the client. On observation, the clients skin appears reddened, though he denies feeling warm. The nurse should anticipate what further diagnostic finding? a. Normal RBC, hemoglobin, and hematocrit with alterations in morphology. b. Abnormal RBC indices coupled with low platelets. c. Elevated RBC, hemoglobin, and hematocrit. d. Further signs and symptoms of internal hemorrhage.
c
An expected patient problem for a patient admitted to the hospital with symptoms of diabetes insipidus is a. excess fluid volume related to intake greater than output. b. impaired gas exchange related to fluid retention in lungs. c. sleep pattern disturbance related to frequent waking to void. d. risk for impaired skin integrity related to generalized edema.
c
An older adult client asks the nurse why so many older people develop anemia. Which response by the nurse is most accurate? a. Cor pulmonale b. Increased erythropoiesis c. Chronic disease d. Stress
c
In the ICU, a postsurgical client has developed sepsis and is being treated with multiple medications. During the mid-morning assessment, which finding leads the nurse to suspect the client may be developing a complication called disseminated intravascular coagulation (DIC)? a. Headaches associated with light sensitivity b. Urine from the Foley catheter is bloody c. Hemorrhage from the surgical site requiring deep pressure dressings d. Nausea and vomiting e. Decreased O2 saturation and diminished breath sounds in lower lobes
c
The burn client is hypotensive and has hypoproteinemia. Which blood component will be utilized in this client=s treatment? a. Platelets-random b. Plasma c. Albumin d. Packed red blood cells
c
The client with a hemoglobin of 7.8 g/dL (78 g/L) tells the nurse that "my bones ache and my sternum is tender. The nurse understands which physiologic factor is playing a role in this clients discomfort? a. Extravascular hemolysis b. Tissue hypoxia c. Erythropoiesis d. Reduction in hemoglobin
c
The hallmark manifestations of Cushing syndrome are a moon face, a "buffalo hump" between the shoulder blades, and a protruding abdomen. What other manifestations of Cushing syndrome occur? a. Thin extremities and increased strength b. Muscle weakness and thickened extremities c. Thin extremities and muscle weakness d. Muscle wasting and thickened extremities
c
The nurse is assessing a female patient that has developed fat pads on the back of the neck, an increased abdominal girth, facial hair growth, and a "moon" face. What disorder does this assessment data indicate? a. Acromegaly b. Graves disease c. Cushing syndrome d. Conhs disease
c
The nurse is assessing a male patient diagnosed with a pituitary tumor causing panhypopituitarism. Assessment findings consistent with panhypopituitarism include a. high blood pressure. b. elevated blood glucose. c. decreased facial hair. d. tachycardia and palpitations.
c
The nurse knows that the client with which complication of diabetes has the greatest risk for the development of foot ulcers? a. Previous incidents of diabetic ketoacidosis b. Autonomic neuropathy c. Sensory neuropathy d. Microvascular disease
c
The nurse notes scleral jaundice in a patient being admitted with hemolytic anemia. The nurse will plan to check the laboratory results for the a. Schilling test. b. gastric analysis. c. bilirubin level. d. stool occult blood.
c
The nursing is reviewing assessment data of four clients. Which client is at greatest risk for developing pernicious anemia? a. A client of Italian heritage who had a colonoscopy b. A client who is recovering from a laproscopic surgical procedure c. A client who has undergone partial gastrectomy d. A client diagnosed with a neoplastic disorder
c
The signs and symptoms of abrupt cessation of pharmacologic glucocorticoids closely resemble those of which disease process? a. Cushing syndrome b. Graves disease c. Addison disease d. Cushing disease
c
Which is a sign of syndrome inappropriate antidiuretic hormone (SIADH)? a. Excessive urine output b. Increased serum osmolality c. Increased intravascular volume d. Decreased ADH
c
Which physiologic process best exemplifies a positive feedback mechanism? a. The regulation of blood glucose levels by insulin b. The release of antidiuretic hormone when sodium levels are higher than normal c. The increase in prolactin secretion that occurs with more frequent breast-feeding d. The release of parathyroid hormone in response to decreased serum calcium levels
c
Which descriptions are characteristic of iron-deficiency anemia? Select all that apply a. lack of intrinsic factor b. auto-immune disease c. most common type of anemia d. associated with chronic blood loss e. may occur with removal of the stomach f. may occur with removal of the duodenum
c,d,f
A client in the hospital following a repair of a left hip fracture is refusing to wear the intermittent pneumatic compression stockings ordered by the physician. The nurse explains to the client that the compression stockings are essential in preventing: a. Arterial emboli b. Hip displacement c. Muscle contractures d. Venous thrombosis
d
A client with diabetes will be undergoing an evaluation of the fluctuation of blood glucose over the previous 120-day span. Which test will this client undergo? a. Glucose tolerance test b. Capillary blood glucose c. Fasting blood glucose d. Glycosylated hemoglobin
d
A client is diagnosed with type 2 diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome? a. Blood pressure 148/90 mm Hg b. High-density cholesterol 35 mg/dL (0.91 mmol/L) c. Fasting blood glucose 155 mg/dL (8.60 mmol/L) d. Glycosylated hemoglobin (A1C) 5.2% (0.52)
d
A client with diabetes mellitus has sudden onset of slurred speech, incoordination, and cool, clammy skin. What will the nurse do first? a. Administer glucose b. Notify the physician and call a code blue c. Provide cheese and crackers d. Check blood glucose
d
A 15-year-old child with type 1 diabetes asks nurse about the potential to lose sight. Which response would be the most appropriate? a. Tell the client there is about a 50% chance of suffering some diabetes-related sight loss by the age of 50. b. Reassure the client that only type 2 diabetes is a risk factor for blindness. c. Tell the client to expect that eyesight loss will likely begin gradually by the age of 25. d. Explain that many people with diabetes experience some complications like retinopathy, but these are best prevented with tight control of glucose levels.
d
A 15-year-old child with type 1 diabetes asks nurse about the potential to lose sight. Which response would be the most appropriate? a. Tell the client there is about a 50% chance of suffering some diabetes-related sight loss by the age of 50. b. Tell the client to expect that eyesight loss will likely begin gradually by the age of 25. c. Reassure the client that only type 2 diabetes is a risk factor for blindness. d. Explain that many people with diabetes experience some complications like retinopathy, but these are best prevented with tight control of glucose levels.
d
A client develops hypocalcemia after thyroid surgery. Which hormonal imbalance caused this complication? a. Lack of thyrotropic-releasing hormone b. Lack of thyroid hormone c. Lack of thyroid-stimulating hormone d. Lack of parathyroid hormone
d
Which of the following signs and symptoms is not expected with diabetes insipidus? a. extreme thirst b. polydipsia c. polyuria d. polyphagia
d
A patient in the emergency department complains of back pain and difficulty breathing 15 minutes after a transfusion of packed red blood cells is started. The nurse's first action should be to a. administer oxygen therapy at a high flow rate. b. obtain a urine specimen to send to the laboratory. c. notify the health care provider about the symptoms. d. disconnect the transfusion and infuse normal saline.
d
A patient is recovering from a thyroidectomy. The patient starts to complain of tingling and numbness in the face, toes, and fingers. Which of the following findings below warrants attention? a. Phosphate level: 4.3 mg/dL b. K+ level: 3.5 mg/dL c. Na+ level: 145 mg/dL d. Ca+ level: 6 mg/dL
d
A patient is recovery from a parathyroidectomy. Which of the following findings causes concern and requires nursing intervention? a. The patients calcium level is 8.9 mg/dL. b. The patient is in Semi-Fowlers position. c. The patient is drowsy but arouses to name. d. The patient's voice is hoarse.
d
After assessment, the nurse asks how long the client has had red, pinpoint hemorrhages on the lower legs. The client responds, This is the first time I have noticed this. What is wrong with me that is causing these small hemorrhages? Which response by the nurse is most accurate? a. Your platelets are developing a deformity as they are being produced by the bone marrow. b. More than likely, you bumped something and these are a result of trauma to the vessel. c. You might have a pooling of all your platelets in the spleen. I will assess for that next. d. These hemorrhages are called petechiae and occur when platelets are deficit.
d
An overweight, 14-year-old boy feels tired all the time. He sleeps 12 to 14 hours a day and has a voracious appetite but no energy to burn off the calories. He has been diagnosed with hypothyroidism brought about by the accumulation of a nonpitting mucosus type of edema. For which life-threatening condition should his care team be prepared? a. The paraneoplastic secretion of endocrine hormones b. Thyroid storm c. Pheochromocytoma d. Myxedema coma
d
Following a lecture on hemostasis, a nursing student accidently cuts her hand while preparing dinner for her family. She watches the laceration very closely. Sure enough, the first thing she notes is: a. Clot retraction by pushing serum out of the clot and joining the edges of the broken vessel b. Limited bleeding, initially as a response to the small vessel walls being sealed by a platelet plug c. Small hair-like strands form a blood (fibrin) clot. d. Initially, it takes a few seconds for blood to appear as a result of vessel spasm.
d
Hypoglycemia has a sudden onset with a progression of symptoms. What are the signs and symptoms of hypoglycemia? a. Difficulty problem solving and muscle spasms b. Muscle spasms and headache c. Altered cerebral function and muscle spasms d. Altered cerebral function and headache
d
Primary adrenal insufficiency is manifested by: a. Truncal obesity and 3+ pitting edema in lower legs b. Hypopigmentation over neck and BP greater than 150/90 c. Potassium level of 2.8 mEq/L (2.8 mmol/L) and weight gain of 3 pounds overnight d. Serum sodium level of 120 mEq/L (120 mmol/L) (low) and blood glucose level of 48 mg/dL (2.66 mmol/L) (low)
d
The client explains to her new provider that she receives periodic phlebotomies to decrease her red blood cell mass. The provider believes the client may have: a. Beta-thalassemia b. Megaloblastic anemia c. Sickle cell disease d. Polycythemia vera
d
The endocrine system involves a number of organs and glands that secrete hormones. The posterior pituitary gland is responsible for secreting antidiuretic hormone (ADH). When the posterior pituitary gland overproduces ADH, a condition called the syndrome of inappropriate antidiuretic hormone (SIADH) develops. Which characteristics best describe SIADH? a. Polyuria, serum hypoosmolality, dilutional hyponatremia, and concentrated urine with normal intravascular volume b. Polyuria, serum hyperosmolality, dilutional hyponatremia, and concentrated urine with normal intravascular volume c. Fluid retention, serum hyperosmolality, dilutional hypernatremia, and concentrated urine with normal intravascular volume d. Fluid retention, serum hypoosmolality, dilutional hyponatremia, and concentrated urine with normal intravascular volume
d
The nurse is assessing an 83-year-old adult client for signs and symptoms of anemia. What normal, age-related change increases this clients risk for anemia? a. Aplastic anemia is common in older adults and the risks increase with each decade. b. Up to 20% of the RBCs in older adults are incapable of carrying oxygen. c. Gastrointestinal "microbleeds" are common after age 75. d. Blood cells are not replaced as quickly as they are in younger clients.
d
What are the hallmark signs of diabetes mellitus? a. Polycythemia, polydipsia, and pheochromocytoma b. Polyuria, polydipsia, and pheochromocytoma c. Polyuria, polyphagia, and polycythemia d. Polyuria, polydipsia, and polyphagia
d
What is the most common mechanism of hormone control? a. Positive feedback b. Hypothalamic-pituitary-target cell feedback c. Hypothalamic-pituitary-adrenal axis d. Negative feedback
d
When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of: a. Pancreas b. Posterior adrenal cortex c. Thyroid gland d. Anterior pituitary gland
d
When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response? a. 24-hour urine b. Antibody binding c. Agglutination d. Hormone stimulation
d
When red blood cells age, which organ is responsible for their destruction? a. Liver b. Red bone marrow c. Kidneys d. Spleen
d
Which condition can result if hypersecretion of growth hormone (GH) occurs after epiphyseal plate closure? a. Cretinism b. Gigantism c. Dwarfism d. Acromegaly
d
Which information is most important for the nurse to communicate rapidly to the health care provider about a patient admitted with possible syndrome of inappropriate antidiuretic hormone (SIADH)? a. The patient has a recent weight gain of 9 lb. b. The patient complains of dyspnea with activity. c. The patient has a urine specific gravity of 1.025. d. The patient has a serum sodium level of 118 mEq/L.
d
Which leukocyte is correctly matched with its function within the body? a. Lymphocyte—phagocytosis b. Monocyte—releases heparin c. Basophil—engulfs antigens d. Eosinophil—allergic reaction
d
Which statement best describes a secondary disorder of endocrine function? a. The disorder occurs from hypothalamic dysfunction resulting in understimulation of the target organ. b. The disorder occurs in the target gland responsible for producing the hormone. c. The disorder occurs when the target organ becomes dysfunctional. d. The disorder occurs when the target organ is normal, but stimulating hormones alter its function.
d
A patient is admitted with thyroid storm. Which sign and symptoms are NOT present with this condition-SELECT ALL THAT APPLY? a. Temperature of 104.9F b. Heart rate of 125 bpm c. Respirations of 42 d. Heart rate of 20 bpm e. Intolerance to cold f. Restless
d,e