Urden questions - CBA 3
Through what mechanism does the endocrine system help maintain equilibrium? a. Control of smooth muscle b. Control of skeletal muscle c. Hormones d. Neuronal control
c. hormones
The patient complains of a metallic taste and loss of appetite. The nurse is concerned that the patient has developed what problem? a. Glycosuria b. Proteinuria c. Myoglobin d. Uremia
d. uremia
A patient is admitted with multiple trauma. Which hormone would the nurse expect to be increased in response to physiologic stress? a. Mineralocorticoid b. Corticosteroid c. Glucocorticoid d. Cortisol
d. cortisol
Which anatomic structure has influence over all areas of body functioning? a. Hypothalamus b. Pancreas c. Thyroid d. Pituitary
a. hypothalamus
Which medication is classified as a loop diuretic? a. Acetazolamide b. Furosemide c. Mannitol d. Metolazone
b. furosemide
To remove fluid during hemodialysis, a positive hydrostatic pressure is applied to the blood and a negative hydrostatic pressure is applied to the dialysate bath. What is this process called? a. Ultrafiltration b. Hemodialysis c. Reverse osmosis d. Colloid extraction
A. ultrafiltration
A patient is being treated for hypothyroidism. The nurse knows that this disorder can affect a variety of physiologic processes. What are th Increase the rate of glucose used by the cells b. Decrease fat metabolism c. Increase the body's demand for vitamins d. Decrease cardiac output e. Stimulate bone resorption f. Increase serum cholesterol levels
A, C, E
What causes the presence of myoglobin in urine? (Select all that apply.) a. Bleeding b. Traumatic damage to the skeletal muscle c. Asthmatic attack d. Rhabdomyolysis e. Cocaine abuse
A, B, D, E
A patient is admitted with Cushing syndrome. Which findings would the nurse expect to note as confirming this diagnosis? (Select all that apply.) a. Hirsutism b. Rounded face c. Hypotension d. Decreased libido e. Scleroderma f. Fatigue and weakness
A, B, D, F
A patient was admitted with diabetic ketoacidosis (DKA). Glucose is 349 mg/dL, K is 3.7 mEq/L, and pH is 7.10. Which of the following interventions would you expect? (Select all that apply.) a. NS 1.5 L IV fluid bolus b. Insulin infusion at 5 units/h c. Sodium bicarbonate 50 mmol IV push d. Vasopressin 10 units IM every 3 hours e. Potassium 20 mEq/L of IV fluid
A, B, E
What are the functions of the kidneys? (Select all that apply.) a. Formation of urine b. Blood pressure regulation c. Erythrocyte destruction d. Breakdown of prostaglandins e. Regulation of acid-base balance
A, B, E
A patient with thyrotoxicosis is admitted. 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, B, E, F
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, B, E, F
Potential recipients are matched with donors based on what factors? (Select all that apply.) a. Blood type b. Human leukocyte antigen c. Race d. Socioeconomic status e. Severity of illness f. Location of recipient g. Waiting time on the list
A, B, E, F, G
Which federal laws regulate the medical and surgical therapy involved with organ transplantation? (Select all that apply.) a. Omnibus Budget Reconciliation Act b. Uniform Anatomical Gift Act c. Hospital Conditions of Participation-Organ Donations d. Medical Examiner Laws e. Uniform Determination of Death Act
A, C
The nursing management plan for the patient with a urinary drainage catheter would include which interventions to prevent catheter-associated urinary tract infection (CAUTI)? (Select all that apply.) a. Insert urinary catheters using aseptic techniques. b. Change the urinary catheter daily. c. Review the need for the urinary catheter daily and remove promptly. d. Flush the urinary catheter q8 hours to maintain patency. e. Avoid unnecessary use of indwelling urinary catheters.
A, C, E
The nurse is caring for a patient who has had a recent heart transplant. Which signs and symptoms would alert the nurse that the patient is rejecting the transplant? (Select all that apply.) a. Shortness of breath b. Tolerance of exercise c. Disturbance in mood d. Decreased weight e. Pulmonary crackles f. Onset of hypertension g. Sudden onset of edema
A, C, E, G
Which findings may be present in the patient with significant fluid volume overload? (Select all that apply.) a. S3 or S4 may develop. b. Distention of the hand veins will disappear if the hand is elevated. c. When testing the quality of skin turgor, the skin will not return to the normal position for several seconds. d. Tachycardia with hypotension may be present. e. Dependent edema may be present.
A, E
A patient has been admitted with acute kidney injury. The nurse knows the most important consideration for evaluating the patient's fluid status is what parameter? a. Daily weights b. Urine and serum osmolality c. Intake and output d. Hemoglobin and hematocrit levels
A. daily weights
Where does the concentration and dilution of urine occur? a. In the juxtamedullary nephrons b. In the cortical nephrons c. In the peritubular capillaries d. In the internal nephron
A. in the juxtamedullary nephrons
A patient has been admitted with a severe kidney infection. The nurse suspects the patient has damage to the glomerular membrane. Which substance in the urine would confirm the nurse's suspicion? a. Creatinine b. Bicarbonate ions c. Sodium d. Albumin
D. albumin
The organ procurement organization coordinator writes orders to initiate standard donor care. Which interventions are parts of standard donor care? (Select all that apply.) a. Continue administration of osmotic agents and diuretics. b. Maintain head of bed at 30 to 40 degrees elevation. c. Continue routine pulmonary suctioning and side-to-side body positioning. d. Warming blanket to maintain body temperature above 36.5° C. e. Maintain mean arterial pressure less than 70 mm Hg.
B, C, D
Many barriers exist to increasing the number of organ donors to meet today's growing need. Which barriers are related to hospital factors? (Select all that apply.) a. Limited resources b. Lack of interest c. Failure to approve protocols d. Nurses' attitudes e. Delay in termination of life support
B, C, D, E
Not every patient with end-stage liver disease is a candidate for receiving a transplant. Which conditions are contraindications to a kidney transplant? (Select all that apply.) a. Malignancy during the past 5 years b. Active infectious process c. Advanced cardiopulmonary disease d. Recreational drug use e. Nonadherence to current medical regimen
B, C, D, E
Stimulation from what receptors will cause contraction of the detrusor muscle of the bladder? a. Bladder wall and ureters b. Bladder wall and urethra c. Ureters and urethra d. Urethra and bladder neck
b. bladder wall and urethra
The nurse is caring for a patient with diabetes insipidus, which is the result of a decrease in antidiuretic hormone (ADH). Which statements regarding the stimulation or inhibition of ADH are accurate? (Select all that apply.) a. Infection stimulates the release of ADH. b. Cold stimulates the release of ADH. c. Emesis stimulates the release of ADH. d. Opioids inhibit the release of ADH. e. Hemorrhage inhibits the release of ADH. f. Pain inhibits the release of ADH.
C, D
To prevent acid-base disturbances, what is the ratio between carbonic acid and bicarbonate? a. 10 mEq of carbonic acid to 20 mEq of bicarbonate b. 20 mEq of carbonic acid to 10 mEq of bicarbonate c. 1 mEq of carbonic acid to 20 mEq of bicarbonate d. 20 mEq of carbonic acid to 1 mEq of bicarbonate
C. 1 mEq of carbonic acid to 20 mEq of bicarbonate
A patient presents with ketoacidosis and a blood glucose level of 125 mg/dL. Diabetic ketoacidosis has been ruled out. The nurse knows that ketoacidosis can occur in which condition? a. Acute pancreatitis b. Drug overdose c. Hyperglycemic hyperosmolar state d. Hyperaldosteronism
a. acute pancreatitis
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.
a. an acceptable level is less than 5.4%
A patient is being evaluated for thyroid dysfunction. The patient's medications include aspirin, digoxin, chlorothiazide, and insulin. The nurse knows that the laboratory work may be affected by which of these medications? a. Aspirin b. Digoxin c. Insulin d. Chlorothiazide
a. aspirin
A nurse is caring for a patient who is receiving sirolimus. The nurse knows to monitor the patient for what side effect? a. Bleeding b. Diarrhea c. Rigors d. Hypotension
a. bleeding
A patient is admitted with a massive head trauma. The patient is unresponsive and on mechanical ventilation. The electroencephalogram (EEG) is negative for brain waves. The family has agreed to organ donation. How would this organ donor be classified? a. Brain-dead donor b. Donation after cardiac death c. Living related donor d. Living unrelated donor
a. brain-dead donor
What hormone do the alpha cells of the pancreas secrete? a. Glucagon b. Insulin c. Somatostatin d. Pancreatic polypeptide hormone
a. glucagon
A patient has thyroid storm. The nurse is providing medication instruction for home. The patient asks, "If I have a fever, should I take Tylenol or aspirin?" Which response would be the most appropriate? a. "Either one is fine because they do not affect the antithyroid medication." b. "Take Tylenol rather than aspirin because aspirin increases the amount of free thyroid hormone in circulation." c. "Take aspirin rather than Tylenol because Tylenol increases the amount of free thyroid hormone in circulation." d. "They both prevent the antithyroid medication from working correctly. I would recommend an NSAID."
b. "take tylenol rather than aspirin because aspirin increases the amount of free thyroid hormone in circulation"
An alert and oriented patient presents with a pulmonary artery occlusion pressure (PAOP) of 4 mm Hg, blood pressure of 88/50 mm Hg, cardiac index of 1.8, and urine output of 15 mL/h. The patient's blood urea nitrogen (BUN) is 44 mg/dL and creatinine is 3.2 mg/dL. Lungs are clear to auscultation with no peripheral edema noted. Which treatment would the nurse expect the practitioner to order? a. Lasix 40 mg intravenous push b. 0.9% normal saline at 125 mL/h c. Dopamine 15 mcg/kg/min d. Transfuse 1 U of packed red blood cells
b. 0.9% normal saline at 125 mL/h
What is the recommended nutritional intake of protein to control azotemia in the patient with acute kidney injury? a. 0.5 to 1.0 g/kg/day b. 1.2 to 1.5 g/kg/day 1.7 to 2.5 g/kg/day d. 2.5 to 3.5 g/kg/day
b. 1.2 to 1.5 g/kg/day
A patient has been diagnosed with syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The nurse is administering hypertonic saline. The nurse knows that the serum sodium should not be raised more than how many milliequivalents per day? a. 5 mEq/day b. 10 mEq/day c. 20 mEq/day d. 25 mEq/day
b. 10 mEq/day
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 diabetic ketoacidosis (DKA). The nurse knows that the top priority in the initial treatment of DKA is which intervention? a. Lowering the blood sugar as quickly as possible b. Administering intravenous fluids c. Administering sodium bicarbonate d. Determining the precipitating cause
b. administering the intravenous fluids
A patient is admitted post arrest from sudden cardiac death. According the code record the patient received a total of 6 mg of epinephrine. The nurse knows that epinephrine and norepinephrine are also secreted by which organ? a. Adrenal cortex b. Adrenal medulla c. Anterior pituitary d. Posterior pituitary
b. adrenal medulla
What hormone does the adrenal cortex secrete to maintain homeostasis? a. Androgens b. Aldosterone c. Adrenocorticotrophic hormone (ACTH) d. Corticosteroid
b. aldosterone
Patients discharged with antithyroid medications should be alerted to which potential side effect? a. Hyperthermia b. Agranulocytosis c. Tachypnea d. Diaphoresis
b. diaophoresis
A patient was admitted with heart failure. The nurse is assessing the patient for peripheral edema. The nurse presses two fingers over the tibial area, and it takes 1 minute before the indention disappears. What would the nurse note in the medical record? a. +1 pitting edema b. +2 pitting edema c. +3 pitting edema d. +4 pitting edema
c. +3 pitting edema
A patient with hyperglycemic hyperosmolar state (HHS) has a serum glucose level of 400 mg/dL and a serum sodium level of 138 mEq/L. What is the intravenous fluid of choice? a. D5W c. 0.9% NS b. 0.45% NS d. D5/NS
c. 0.9% NS
What is the dose for low-dose dopamine? a. 1 to 2 mcg/kg/min b. 1 to 2 mg/kg/min c. 2 to 3 mcg/kg/min d. 2 to 3 mg/kg/min
c. 2 to 3 mcg/kg/min
A patient is admitted with diabetic ketoacidosis (DKA). The patient's arterial blood gas indicates the patient has an uncompensated metabolic acidosis. The patient has rapid, regular respirations. Which medical intervention would the nurse expect to initiate to correct the acidosis? a. Initiate oxygen therapy via a face mask. b. Administer sodium bicarbonate. c. Administer insulin and fluids intravenously. d. Prepare for intubation.
c. administer insulin and fluids intravenously.
As serum osmolality rises, intravascular fluid equilibrium will be maintained by the release of what substance? a. Ketones b. Glucagon c. Antidiuretic hormone d. Potassium
c. antidiuretic hormone
The nurse knows that during the resuscitation of a patient with diabetic ketoacidosis (DKA), the intravenous (IV) line should be changed to a solution containing glucose when what happens? a. Patient becomes more alert b. IV insulin has been infusing for 4 hours c. Blood glucose drops to 200 mg/dL d. Blood glucose drops to 100 mg/dL
c. blood glucose drops to 200 mg/dL
A patient has been admitted with acute kidney injury. Which serum laboratory values would the nurse expect to be ordered to confirm this diagnosis? a. Sodium and potassium b. Creatinine and calcium c. Blood urea nitrogen (BUN) and creatine d. Potassium and magnesium
c. blood urea nitrogen (BUN) and creatinine
A patient has been admitted with multiple trauma due to a motor vehicle accident several weeks ago. Given the prolonged critical illness, the nurse knows the patient may no longer secrete adequate amounts of what hormone? a. Aldosterone b. Adrenocorticotropic hormone (ACTH) c. Cortisol d. Antidiuretic hormone (ADH)
c. cortisol
The nurse is teaching a patient about antiviral medications. The patient asks what is the most common viral infection in transplant recipients. What should the nurse tell the patient? a. Influenza b. Respiratory syncytial virus c. Cytomegalovirus (CMV) d. Parainfluenza
c. cytomegalovirus (CMV)
Patients who have sustained head trauma or have undergone resection of a pituitary tumor have an increased risk of developing which disorder? a. Type 1 diabetes b. Thyrotoxicosis c. Diabetes insipidus d. Myxedema coma
c. diabetes insipidus
A patient is admitted with a long history of mental illness. The patient's spouse states the patient has been drinking up to 10 gallons of water each day for the past 2 days and refuses to eat. The patient is severely dehydrated and soaked with urine. The nurse suspects the patient has which problem? a. Central diabetes insipidus (DI) b. Nephrogenic DI c. Dipsogenic DI d. Iatrogenic DI
c. dipsogenic DI
A patient who has received a transplant is being taught about cyclosporine. Which statement made by the patient would indicate the teaching was effective? a. "I know this drug prevents my immune system from working." b. "If I find the capsules are hard to swallow, I'll take the liquid." c. "I will need to watch for bruising." d. "I will need to monitor my blood pressure."
d. "I will need to monitor my blood pressure."
A patient with a history of type 2 diabetes was admitted after aneurysm repair. The patient's serum glucose levels have been elevated for the past 2 days, and the patient is concerned about becoming dependent on insulin. Which statement is the nurse's best response to the patient's concerns? a. "This surgery may have damaged your pancreas. We will have to do more evaluation." b. "Perhaps your diabetes was more serious from the beginning." c. "You will need to discuss this with your physician." d. "The stress on your body has temporarily increased your blood sugar levels."
d. "the stress on your body has temporarily increased your blood sugar levels."
A patient is admitted with extreme fatigue, vomiting, and headache. This patient has type 1 diabetes that has been well controlled with an insulin pump. The patient states, "I know it could not be my diabetes because my pump gives me 24-hour control." Which reply would be the nurse's best response? a. "You know a lot about your pump, and you are correct." b. "You're right. This is probably a virus." c. "We'll get an abdominal CT and see if your pancreas is inflamed." d. "We'll check your serum blood glucose and ketones."
d. "we'll check your serum blood glucose and ketones."
Which medication can place a patient at risk for developing syndrome of inappropriate secretion of antidiuretic hormone (SIADH)? a. Adenosine b. Diltiazem c. Heparin sodium d. Acetaminophen
d. acetaminophen
In caring for a patient with a thyrotoxicosis, the nurse would expect to observe which neurologic symptom? a. Lethargy b. Depression c. Seizures d. Agitation
d. agitation
The nurse is caring for a patient with a traumatic brain injury. The nurse suspects the patient is developing diabetes insipidus. Which test or procedure 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. Serum antidiuretic hormone level d. Antidiuretic hormone (ADH) test
d. antidiuretic hormone (ADH) test
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 skull
The neuroendocrine stress response produces which findings? (Select all that apply.) a. Elevated blood pressure b. Decreased gastric motility c. Tachycardia d. Heightened pain awareness e. Increased glucose
A, B, C, E
A patient is admitted in acute heart failure secondary to renal insufficiency. The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites. A diagnosis of renal failure is made. The nurse would expect to see elevated values in which laboratory results? (Select all that apply.) a. Blood urea nitrogen (BUN) b. Creatinine c. Glucose d. Hemoglobin and hematocrit e. Protein
A, B, D
A patient is admitted with respiratory failure and is being mechanically ventilated. The nurse understands there is a significant association between acute kidney injury and respiratory failure. How does mechanical ventilation alter kidney function? (Select all that apply.) a. Decreases blood flow to the kidney b. Decreases glomerular filtration rate (GFR) c. Damages the kidney tubular endothelium d. Decreases urine output e. Hinders flow of urine from the kidneys
A, B, D
Which factors stimulate the release of antidiuretic hormone (ADH)? (Select all that apply.) a. Hypovolemia b. Hypernatremia c. Hypothermia d. Opioids e. Emotional stress
A, D, E
Which statement regarding kidney function and aging is accurate? a. Kidney function declines with age but this usually does not affect homeostasis. b. Serum creatinine rises with age due to increased catabolism of red muscle. c. Glomerular filtration rate falls at a rate of 2 mL/min/year. d. Older adults are less susceptible to acute kidney dysfunction but more susceptible to chronic kidney dysfunction.
A. kidney function declines with age but this usually does not affect homeostasis.
Loss of albumin from the vascular space may result in which condition? a. Peripheral edema b. Extra heart sounds c. Hypertension d. Hyponatremia
A. peripheral edema
A patient was admitted with asthma who has been on steroids for a long time. The nurse knows that this patient is at risk of developing secondary Cushing syndrome. What would be the cause of this condition? a. Pharmacologic glucocorticoids b. Pharmacologic mineralocorticoids c. Cortisol d. Aldosterone
A. pharmacologic glucocorticoids
A patient is admitted with renal failure. The patient's weight upon admission was 176 lb, and the next day it is 184 lb. What is the approximate amount of fluid retained with this weight gain? a. 800 mL b. 2200 mL c. 3600 mL d. 8000 mL
C. 3600 mL
The initial filtering of the blood occurs in which structure? a. The distal tubule b. The proximal tubule c. The glomerulus d. The collecting tubule
C. The glomerulus
Ammonia, hydrogen, and ammonium are secreted in what part of the kidney? a. Loop of Henle b. Collecting duct c. Glomerulus d. Proximal tubule
C. glomerulus
A patient has been admitted after surgery for removal of a brain tumor. The nurse suspects the patient may be developing diabetes insipidus (DI). Which findings would confirm the nurse's suspicion? a. Hyperglycemia and hyperosmolarity b. Hyperglycemia and peripheral edema c. Intense thirst and passage of excessively large quantities of dilute urine d. Peripheral edema and pulmonary crackles
C. intense thirst and passage of excessively large quantities of dilute urine
What is the functional unit of the kidney called? a. Bowman capsule b. Glomerulus c. Nephron d. Distal tubule
C. nephron
Maintaining a normal range of serum potassium is important for what physiologic process? a. Fluid regulation b. Acid-base buffering c. Nervous impulse conduction d. Triggering antidiuretic hormone (ADH) release
C. nervous impulse conduction
A patient was admitted with acute heart failure who has been receiving diuretic therapy. The nurse suspects the patient is hypovolemic. What auscultatory parameter would confirm the nurse's suspicion? a. Hypertension b. Third or fourth heart sound c. Orthostatic hypotension d. Vascular bruit
C. orthostatic hypotension
When a patient's blood pressure drops, which physiologic mechanism helps maintain adequate glomerular blood flow? a. Constriction of the afferent arteriole b. Dilation of the efferent arteriole c. Dilation of the collecting tubule d. Constriction of the efferent arteriole
D. constriction to the efferent arteriole
A patient has been admitted with acute kidney injury. Which parameter would the nurse expect to find to confirm this diagnosis? a. Decreased blood urea nitrogen b. Bibasilar lung crackles c. Peripheral edema d. Decreased creatinine clearance
D. decreased creatinine clearance
A patient was admitted with multiple trauma who has been volume resuscitated. The nurse suspects the patient is fluid overloaded. Which assessment findings would confirm the nurse's suspicion? a. Venous filling of the hand veins greater than 5 seconds b. Distended neck veins in the supine position c. Presence of orthostatic hypotension d. Presence of a third heart sound
D. presence of a third heart sound
Which condition would result in an increased release of renin? a. Increased release of angiotensin I b. Increased release of angiotensin II c. Increased amount of sodium in the distal convoluted tubule d. Reduced pressure in the glomerulus
D. reduced pressure in the glomerulus
The nurse is caring for a patient with a pancreas transplant. Which statement made by the patient indicates the need for further teaching? a. "I no longer need to monitor my blood glucose levels." b. "I will need to have periodic pancreas biopsies." c. "I may feel the urge to urinate frequently." d. "I will give urine samples to monitor for rejection."
a. "I no longer need to monitor my blood glucose levels."
A patient who has received a transplant is being taught about azathioprine. Which statement made by the patient would indicate the teaching was effective? a. "I will notify my health care provider if my gums start to bleed." b. "I will make sure to increase the amount of fiber in my diet." c. "I realize I may have an increase in hair growth." d. "I know the flulike symptoms will go away as I get used to the drug."
a. "I will notify my health care provider if my gums start to bleed."
Which statement would indicate that a patient who has received an organ transplant understands the teaching about immunosuppressive medications? a. "My drug dosages will be lower because the medications enhance each other." b. "I will be less prone to side effects because I will be taking more than one drug." c. "Lower doses of these medications put me at greater risk for infection." d. "Taking more than one medication will put me at risk for developing allergies."
a. "my drug dosages will be lower because the medications enhance each other."
A patient is admitted with diabetic ketoacidosis (DKA). The patient presents with dry, cracked lips and is begging for something to drink. What reply would be the nurse's best response? a. "We can't give you anything to drink until we get your blood sugar under control." b. "You can have one cup of coffee without sugar." c. "You can drink anything you want as long as it's sugar free." d. "You can drink as much water has you can handle."
a. "we can't give you anything to drink until we get your blood sugar under control."
A patient has been admitted with hyperosmolar hyperglycemic state (HHS). The nurse knows that intravenous insulin is usually administered at what dosage? a. 0.1 U/kg/h b. 1.0 U/kg/h c. 2.0 U/kg/h d. 5.0 U/kg/h
a. 0.1 U/kg/h
The practitioner has ordered dialysis for a patient with acute heart failure who is unresponsive to diuretics. Which type of dialysis would the nurse anticipate being started on this patient? a. Intermittent ultrafiltration b. Continuous venovenous hemofiltration (CVVH) c. Continuous venovenous hemodialysis (CVVHD) d. Continuous venovenous hemodiafiltration (CVVHDF)
a. intermitten ultrafiltration
What substance is the most responsible for maintaining the colloid osmotic pressure? a. Intravascular plasma proteins b. Intracellular potassium c. Extracellular sodium d. Interstitial potassium
a. intravascular plasma proteins
When renin eventually stimulates angiotensin II, the adrenal glands then secrete what hormone? a. Aldosterone b. Adrenal stimulating hormone c. Antidiuretic hormone d. Vasopressin
a. aldosterone
After a pancreatic transplant with bladder exocrine drainage, the nurse would anticipate which order? a. Continuous bladder irrigation b. Intermittent insulin injections c. Removal of the nasogastric tube as soon as the patient is alert d. Daily hematocrit and hemoglobin levels
a. continuous bladder irrigation
Which nursing problem would be appropriate for a patient who has received a kidney transplant? a. Deficient fluid volume b. Excess fluid volume c. Urinary retention d. Decreased cardiac output
a. deficient fluid volume
A patient who receives peritoneal dialysis is admitted after a 3-day history of flulike symptoms. The patient reports muscle cramps and is noted to have a low blood pressure and tachycardia. The nurse suspects the patient may be experiencing what condition? a. Dehydration b. Peritonitis c. Fluid obstruction d. Hernias
a. dehydration
A patient with acute kidney injury (AKI) has been started on continuous venovenous hemodialysis (CVVHD). The nurse knows the hemodialyzer filter used in this type of therapy is permeable to what substance? a. Electrolytes b. Red blood cells c. Protein d. Lipids
a. electrolytes
The nurse is caring for a patient with type 1 diabetes who was admitted with complaints of increased lethargy. Serum laboratory values validate the diagnosis of diabetic ketoacidosis (DKA). Which medical intervention would the nurse expect to be ordered for this patient? a. Extensive hydration b. Oral hypoglycemic agents c. Large doses of intravenous (IV) insulin d. Limiting food and fluids
a. extensive hydration
A patient has been diagnosed with syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The nurse would expect the first line treatment to include which intervention? a. Fluid restriction b. Hypotonic intravenous fluid administration c. Administration of D5W d. Administration of vasopressin
a. fluid restriction
A patient has had a kidney transplant. The nurse knows that monitoring of which parameter would have the highest priority? a. Fluid volume b. Electrolytes c. Complete blood count d. Temperature
a. fluid volume
A patient is presenting with signs of diabetes insipidus (DI). Which findings would confirm this diagnosis? a. Hyperosmolality and hypernatremia b. Hyperosmolality and hyponatremia c. Hypoosmolality and hypernatremia d. Hypoosmolality and hyponatremia
a. hyperosmolality and hypernatremia
A patient is diagnosed with a pheochromocytoma. What signs or symptoms might the nurse expect to see in this patient? a. Hypertension and tachycardia b. Weight gain and acne c. Diarrhea and facial swelling d. Blurred vision and poor skin turgor
a. hypertension and tachycardia
A patient with chronic kidney disease was admitted with severe electrolyte disturbances. The patient had been ill and missed several hemodialysis sessions. The patient is disoriented, dizzy, cold, clammy, and complains of severe abdominal cramping. The patient's electrocardiogram appears normal. Which electrolyte disturbance would the nurse suspect the patient may be experiencing? a. Hyponatremia b. Hypokalemia c. Hypercalcemia d. Hypochloremia
a. hyponatremia
A patient is brought to the hospital with a major stab wound. After excessive blood loss, the nurse should anticipate what change in the patient's serum osmolality? a. Increase b. Decrease c. Rapid decrease than increase d. Equal to his or her sodium level
a. increase
Decreased insulin and increased glucagon result in what physiologic process? a. Increased glycogenolysis b. Decreased fat mobilization c. Decreased ketosis d. Increased glycogen storage
a. increased glycogenolysis
A patient with thyrotoxicosis has been admitted. What effect of increased T3 and T4 levels might the nurse expect to see in this patient? a. Increased oxygen consumption b. Decreased basal metabolic rate c. Decreased cardiac output d. Increased calcium levels
a. increased oxygen consumption
A patient is admitted with diabetic ketoacidosis (DKA). The nurse knows that the dehydration associated with DKA results from which pathophysiologic mechanism? a. Increased serum osmolality and urea b. Decreased serum osmolality and hyperglycemia c. Ketones and potassium shifts d. Acute renal failure
a. increased serum osmolality and urea
Which finding is expected in the patient with hypothyroidism? a. Increased T4 b. Anemia c. Decreased thyroid stimulating hormone d. Hyperglycemia
b. anemia
A patient is admitted with diabetic ketoacidosis. The nurse requests the practitioner 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 3-4 months
Which diuretics maybe combined to work on different parts of the nephron? a. Loop and thiazide diuretics b. Loop and osmotic diuretics c. Osmotic and carbonic anhydrase inhibitor diuretics d. Thiazide and osmotic diuretics
a. loop and thiazide diuretics
A patient is admitted with severe hypokalemia. On admission the patient's laboratory values are serum K, 2.2 mEq/L; blood urea nitrogen (BUN), 15 mg/dL; and creatinine, 1.2 mg/dL. Urine output is averaging 45 mL/h. The patient is given a total of 80 mEq of potassium over 4 hours. The potassium level is repeated and the result is K, 2.4 mEq/L. What other information would be beneficial at this time? a. Magnesium level b. Repeat creatinine level c. Calcium level d. Hemoglobin level
a. magnesium level
The nurse is developing a discharge education plan for a patient with syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Which topic should be included in the plan? a. Measuring intake and output b. Encouraging fluids c. A low-sodium diet d. Hypothermia management
a. measuring intake and output
A patient is admitted after a lung transplant. The nurse knows the patient is at risk for developing pneumonia. What parameter would be a priority for the nurse to monitor? a. Oxygen saturation b. Chest tube output c. Intake and output d. Blood pressure
a. oxygen saturation
A patient has been admitted with diabetic ketoacidosis, and treatment has been initiated. Which findings would lead the nurse to suspect the patient is dehydrated? a. Poor skin turgor and flat neck veins b. Dyspnea and crackles c. Presence of Chvostek and Trousseau signs d. Extra heart sounds and 3+ edema
a. poor skin turgor and flat neck veins
As a patient with diabetic ketoacidosis (DKA) receives insulin and fluids, the nurse knows careful assessment must be given to which electrolyte? a. Potassium b. Sodium c. Phosphorus d. Calcium
a. potassium
The nurse has admitted a patient with hyperglycemic hyperosmolar state (HHS). Which medical intervention would the nurse expect to see ordered for this patient? a. Rapid rehydration with intravenous fluids b. Insertion of a pulmonary artery catheter c. Administration of high-dose intravenous insulin d. Hourly monitoring of urine glucose and ketone levels
a. rapid rehydration with intravenous fluids
A patient is admitted with acute kidney injury (AKI). Which event from the patient's history was the most probable cause of the patient's AKI? a. Recent computed tomography of the brain with and without contrast b. Recent bout of acute heart failure after an acute myocardial infarction c. Twice-daily prescription of Lasix 40 mg by mouth d. Recent bout of benign prostatic hypertrophy and transurethral resection of the prostate
a. recent computed tomography of the brain with and without contrast
The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes. The nurse notes 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
When calculating the anion gap, what is the predominant cation? a. Sodium b. Potassium c. Chloride d. Bicarbonate
a. sodium
A patient with acute kidney injury has a potassium level of 6.9 mg/dL. The patient has had no urine output in the past 4 hours despite administration of Lasix 40 mg intravenous push. To correct the hyperkalemia the patient is given 50 mL of 50% dextrose in water and 10 U of regular insulin intravenous push. A repeat potassium level 2 hours later shows a potassium level of 4.5 mg/dL. What order would the nurse expect now? a. Sodium Kayexalate 15 g PO b. Nothing; this represents a normal potassium level c. Lasix 40 mg IVP d. 0.9% normal saline at 125 mL/h
a. sodium kayexalate 15g PO
A nurse is preparing a patient for a liver transplant. The patient asks which stage of the procedure is the longest and most difficult. What would the nurse tell the patient? a. Stage 1—recipient hepatectomy b. Stage 2—vascular anastomoses c. Stage 3—biliary anastomosis d. Stage 4—induction therapy
a. stage 1 - recipient hepatectomy
A patient is admitted after surgery with a history of hyperthyroidism. The nurse suspects the patient may be developing thyroid storm. Which finding would confirm this suspicion? a. Tachycardia b. Hypotension c. Decreased appetite d. Hypothermia
a. tachycardia
Who determines the medical suitability of the patient for organ donation? a. The organ procurement organization (OPO) coordinator b. The patient's family c. The admitting health care provider d. The transplant team
a. the organ procurement organization (OPO) coordinator
The nurse is caring for a patient after a heart transplant. Which finding would the nurse anticipate after cardiac transplantation? a. Two P waves on the electrocardiogram (ECG) b. High cardiac output c. Anginal pain d. Resting heart rate of 60 to 70 beats/min
a. two P waves on the electrocardiogram (ECG)
The nurse is caring for a patient with a head injury who has developed diabetes insipidus (DI). What medication would the nurse expect to be prescribed for the patient? a. Vasopressin b. Insulin c. Glucagon d. Propylthiouracil
a. vasopressin
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)
The nurse is caring for a patient after a lung transplant. Which intervention would be a priority for the nurse? a. Wean the patient from the ventilator. b. Maintain hypotensive levels. c. Start corticosteroid therapy. d. Initiate pulmonary function studies.a
a. wean the patient from the ventilator.
The Model for End-Stage Liver Disease (MELD) formula is used to calculate risk of 3-month mortality in patients 12 years old or older. What criteria is part of the MELD formula? a. Whether the patient has undergone hemodialysis at least twice in the past 2 weeks b. The number of organs in which metastasis has occurred following hepatocellular carcinoma c. The presence or absence of intractable pruritus d. The number of hours the patient is expected to live without a transplant
a. whether the patient has undergone hemodialysis at least twice in the past 2 weeks
Which statement made by a patient who has received an organ transplant indicates that the teaching was effective? a. "I will finally be able to eat a regular diet." b. "I will establish a routine for checking any skin changes." c. "I will check my blood pressure regularly to make sure it's not too high." d. "After my drug regimen is established, I won't have to worry about rejection."
b. "I will establish a routine for checking any skin changes."
The following substances, among others, are found in a patient's urine sample: urea, creatinine, sodium, chlorine, potassium, glucose, and bicarbonate ions. Which patient situation could account for this abnormal finding? a. Blood pressure of 76/30 mm Hg b. Blood glucose of 456 mg/dL c. Blood glucose of 40 mg/dL d. Blood potassium level of 4.1 mEq/L
b. blood glucose of 456 mg/dL
The practitioner has ordered continuous renal replacement therapy (CRRT) for a patient with acute kidney injury. The patient needs both the removal of fluids and a moderate amount of solutes. Which type of CRRT would the nurse anticipate being started on this patient? a. Slow continuous ultrafiltration (SCUF) b. Continuous venovenous hemofiltration (CVVH) c. Continuous venovenous hemodialysis (CVVHD) d. Continuous venovenous hemodiafiltration (CVVHDF)
b. continuous venovenous hemofiltration (CVVH)
What is the primary function of aldosterone? a. Excretion of potassium through the renal tubules b. Control of sodium and water c. Regulation of bicarbonate d. Reabsorption of sodium and potassium
b. control of sodium and water
When the brain perceives a stressful or threatening situation, the hypothalamus releases ________________________, which causes the anterior pituitary to release______________. a. cortisol; androgens b. corticotropin-releasing hormone; adrenocorticotrophic hormone (ACTH) c. ACTH; glucocorticoid hormone d. ACTH; epinephrine
b. corticotropin-releasing hormone; adrenocorticotrophic hormone (ACTH)
A patient has been admitted with a brain tumor. The patient starts to exhibit signs of an increase in antidiuretic hormone (ADH). When large amounts of ADH are released, the nurse should anticipate what change in the patient's sodium levels? a. Increase b. Decrease c. Rapid increase than decrease d. Depends on potassium level
b. decrease
A patient is admitted with diabetic ketoacidosis (DKA) and is experiencing polyuria. Which electrolyte disturbances would the nurse expect to see at this phase of DKA? a. Decreased calcium and increased phosphorus levels b. Decreased potassium and sodium levels. c. Increased sodium and decreased phosphorus levels d. Decreased calcium and potassium levels.
b. decreased potassium and sodium levels
Decreased urine osmolality is a sign of which disorder? a. Hyperglycemia b. Diabetes insipidus c. Thyroid crisis d. Syndrome of inappropriate secretion of antidiuretic hormone
b. diabetes insipidus
A patient has been admitted post thyroidectomy. The nurse knows that adequate thyroid function is dependent on which factor? a. Basal metabolic rate b. Dietary intake of iodine c. Colloid osmotic pressure d. Sodium levels in the blood
b. dietary intake of iodine
Which pathophysiologic mechanism occurs in the syndrome of inappropriate antidiuretic hormone (SIADH)? a. Massive diuresis, leading to hemoconcentration b. Dilutional hyponatremia, reducing sodium concentration to critically low levels c. Hypokalemia from massive diuresis d. Serum osmolality greater than 350 mOsm/kg
b. dilutional hyponatremia, reducing sodium concentration to critically low levels
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
The nurse is caring for a patient with type 1 diabetes who was admitted with complaints of increased lethargy. Serum laboratory values validate the diagnosis of diabetic ketoacidosis (DKA). Which symptom is most suggestive of DKA? a. Irritability b. Excessive thirst c. Rapid weight gain d. Peripheral edema
b. excessive thirst
A patient is admitted with syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The nurse understands that the hyponatremia associated with this disorder is the result of which mechanism? a. Increased cortisol release b. Excessive water reabsorption c. Excessive sodium excretion d. Decreased glucagon release
b. excessive water reabsorption
An older patient presents with a serum glucose level of 900 mg/dL, hematocrit of 55%, and no serum ketones. Immediate attention must be given to which intervention? a. Evaluating clotting factors b. Fluid administration c. Insulin administration d. Sodium replacement
b. fluid administration
The patient has been admitted from a skilled nursing facility with urinary sepsis. The patient has severe muscle wasting. What is the process by which fat and protein are converted to glucose for fuel? a. Glycogenolysis b. Gluconeogenesis c. Digestion d. Biotransformation
b. gluconeogenesis
A patient was admitted with an infection that had to be treated with an aminoglycoside antibiotic. After a few days the patient developed oliguria and elevated blood urea nitrogen and creatinine levels. The patient's vital signs are stable. The nurse would anticipate the practitioner ordering which dialysis method for this patient? a. Peritoneal dialysis b. Hemodialysis c. Continuous renal replacement therapy d. Intermittent ultrafiltration
b. hemodialysis
A patient is receiving total parenteral nutrition (TPN). During rounds the dietitian states that she believes the patient is getting too much glucose. Identify one area in which excess glucose is stored as glycogen. a. Pancreas b. Hepatic cells c. Gallbladder d. Stomach
b. hepatic cells
Which pathophysiologic mechanism occurs in the patient with type 2 diabetes? a. Lack of insulin production b. Imbalance between insulin production and use c. Overproduction of glucose d. Increased uptake of glucose in the cells
b. imbalance between insulin production and use
A patient was admitted with an infection that had to be treated with gentamicin, an aminoglycoside antibiotic. After 3 days of administration, the patient developed oliguria, and an elevated blood urea nitrogen and creatinine levels. The nurse suspects the patient has developed what type of kidney injury? a. Prerenal b. Intrarenal c. Anuric d. Postrenal
b. intrarenal
A patient is admitted with sepsis and acute kidney injury (AKI). The patient is started on continuous renal replacement therapy (CRRT). The nurse knows that fluid that is removed each hour is charted as what on the CRRT flowsheet? a. Convection b. Diffusion c. Replacement fluid d. Ultrafiltrate
d. ultrafiltrate
A patient is admitted in acute heart failure secondary to renal insufficiency. The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites. Which diagnostic tests would provide the best information about the internal kidney structures, such as the parenchyma, calyces, pelvis, ureters, and bladder? a. Kidney-ureter-bladder (KUB) b. Intravenous pyelography (IVP) c. Renal ultrasonography (ECHO) d. Renal angiography
b. intravenous pyelography (IVP)
A patient with diabetic ketoacidosis (DKA) has an insulin drip infusing, and the nurse has just administered subcutaneous insulin. The nurse is alert for signs of hypoglycemia, which would include what findings? a. Kussmaul respirations and flushed skin b. Irritability and paresthesia c. Abdominal cramps and nausea d. Hypotension and itching
b. irritability and paresthesia
A patient is admitted with severe hyperglycemia due to 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 a traumatic head injury. The patient starts to exhibit signs of a decrease in antidiuretic hormone (ADH). Which symptom would alert the nurse to this problem? a. Rapidly escalating hypertension b. Massive diuresis c. Pulmonary edema d. Hyperkalemia
b. massive diuresis
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 developed acute kidney injury (AKI) secondary to hemorrhage shock. Which intravenous solution would the nurse expect to be ordered for this patient? a. Dextrose in water b. Normal saline c. Albumin d. Lactated Ringer solution
b. normal saline
A patient has been on complete bed rest for 3 days. The practitioner has left orders to get the patient out of bed for meals. The patient complains of feeling dizzy and faint while sitting at the bedside. The nurse suspects that the patient is experiencing what problem? a. Orthostatic hypertension b. Orthostatic hypotension c. Hypervolemia d. Electrolyte imbalance
b. orthostatic hypotension
The mobilization of calcium from bone stores is accomplished through the influence of which hormone? a. Antidiuretic hormone (ADH) b. Parathyroid hormone (PTH) c. Thyroid-stimulating hormone (TSH) d. Erythropoietin
b. parathyroid hormone (PTH)
When a patient with diabetic ketoacidosis (DKA) has insulin infusing intravenously, the nurse expects a drop in the serum levels of which electrolytes? a. Sodium and potassium b. Potassium and phosphate c. Bicarbonate and calcium d. Sodium and phosphate
b. potassium and phosphate
Percussion of kidneys is usually done to assess what parameter? a. Size and shape of the kidneys b. Presence of pain in the renal area c. Presence of a fluid wave d. Patient's overall fluid status
b. presence of pain in the renal area
A patient has been admitted in acute heart failure. Which parameter would indicate to the nurse that the patient is fluid overloaded? a. Central venous pressure of 4 mm Hg b. Pulmonary artery occlusion pressure (PAOP) of 18 mm Hg c. Cardiac index of 2.5 L/min/m2 d. Mean arterial pressure of 40 mm Hg
b. pulmonary artery occlusion pressure (PAOP) of 18 mmHg
A patient is admitted with a traumatic head injury. The patient starts to exhibit signs of a decrease in antidiuretic hormone (ADH). What is the function of ADH? a. Control blood pressure b. Regulate fluid balance c. Normalize potassium levels d. Maintain homeostasis
b. regulate fluid balance
A patient has developed acute kidney injury (AKI) secondary to cardiogenic shock. Which laboratory value would the nurse find helpful in evaluating patient's renal status? a. Serum sodium b. Serum creatinine c. Serum potassium d. Urine potassium
b. serum creatinine
Chloride plays a major role in maintaining what physiologic process? a. Cellular immunity b. Serum osmolality c. Bone strength d. Adenosine triphosphate (ATP)
b. serum osmolality
The nurse has admitted a patient with hyperglycemic hyperosmolar state (HHS). Which findings would the nurse expect to observe in this patient? a. Hyperglycemia with low serum osmolality b. Severe hyperglycemia with minimal or absent ketosis c. Little or no ketosis in serum with rapidly escalating ketonuria d. Hyperglycemia and ketosis
b. severe hyperglycemia with minimal or absent ketosis
A patient was admitted with acute kidney failure. Which urinalysis value reflects a decreased ability of the kidneys to concentrate urine? a. pH of 5.0 b. Specific gravity of 1.000 c. No casts d. Urine sodium of 140 mEq/24 h
b. specific gravity of 1.000
What is the most common site for short-term vascular access for immediate hemodialysis? a. Subclavian artery b. Subclavian vein c. Femoral artery d. Radial vein
b. subclavian vein
A patient has been admitted with abdominal pain. The nurse notes that 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 ill patients. b. This finding is indicative of prediabetes, but another test should be done to confirm. c. This finding is lower than what the nurse would expect in a patient receiving intravenous fluids. d. This finding is indicative of diabetic ketoacidosis.
b. this finding is indicative of prediabetes, but another test should be done to confirm
A patient has been admitted with uncontrolled atrial fibrillation and muscle wasting. The practitioner suspects the patient may have a thyroid disorder. The nurse anticipates the practitioner will initially order which diagnostic procedure to visualize the thyroid? a. Magnetic resonance imaging (MRI) b. Ultrasound c. Biopsy d. Computed tomography (CT)
b. ultrasound
A patient was admitted with acute heart failure a few days ago. Today the patient's urine has a specific gravity of 1.040. What could be the potential cause for this value? a. Volume overload b. Volume deficit c. Acidosis d. Urine ketones
b. volume deficit
A patient is admitted with critical hypotension, hyperkalemia, hyponatremia, and hypoglycemia. The nurse knows that these symptoms are highly suggestive of which disorder? a. Myxedema b. Diabetes insipidus c. Addisonian crisis d. Cushing syndrome
c. Addisonian crisis
The nurse is caring for a patient after a liver transplant. Which finding would be of most concern to the nurse? a. Increased serum glucose b. Low aspartate aminotransferase (AST) and alanine aminotransferase (ALT) c. Elevated prothrombin time d. Decreased blood urea nitrogen and creatinine
c. elevated prothrombin time
A patient with acute kidney injury (AKI) has been started on continuous venovenous hemodiafiltration (CVVHDF). The nurse understands the patient should be closely monitored for what circuit-related complications of the therapy? a. Hypervolemia, hypothermia, and hyperkalemia b. Access dislodgment, decreased outflow pressures, and bleeding c. Filter clotting, access failure, and air embolism d. Increased overflow pressure, dehydration, and calcium loss
c. filter clotting, access failure, and air embolism
A patient reports losing weight even though she eats "everything in sight." She also reports tremors and diarrhea. The nurse suspects the patient may have what problem? a. Hypothyroidism b. Diabetes mellitus c. Hyperthyroidism d. Pituitary tumor
c. hyperthyroidism
A patient is receiving insulin due to the development of steroid-induced hyperglycemia. In addition to lowering blood glucose levels, what other physiologic effect may occur when insulin is administered? a. Breakdown of proteins b. Hypercalcemia c. Hypokalemia d. Cellular dehydration
c. hypokalemia
A patient in diabetic ketoacidosis (DKA) is comatose with a temperature of 102.2° F. The nurse suspects the patient may have which secondary disorder? a. Head injury b. Hypothalamus infarction c. Infection d. Heat stroke
c. infection
A patient with acute kidney injury (AKI) has been started on continuous venovenous hemodialysis (CVVHD). The nurse understands the patient should be closely monitored for what patient-related complications of the therapy? a. Air embolism, access failure, and blood leaks b. Decreased inflow pressure, air bubbles, and power surge c. Infection, hypotension, and electrolyte imbalances d. Catheter dislodgement, decreased outflow pressure, and acid-base imbalances
c. infection, hypotension, and electrolyte imbalances
Which nursing intervention should be initiated on all patients with the syndrome of inappropriate antidiuretic hormone (SIADH)? a. Placing the patient on an air mattress b. Forcing fluids c. Initiating seizure precautions d. Applying soft restraints
c. initiating seizure precautions
A nurse is caring for a patient who is having difficulty maintaining a normal blood sugar level. In the healthy body, how is a normal blood glucose level is maintained? a. Insulin secretion b. Cellular metabolism c. Insulin-to-glucagon ratio d. Insulin-to-thyroxine ratio
c. insulin-to-glucagon ratio
Which type of intravenous fluid will not create a shift of fluids within the vascular space? a. Hypertonic b. Hypotonic c. Isotonic d. Osmotic pressure
c. isotonic
Which statement best describes the effects of somatostatin? a. It stimulates the release of antidiuretic hormone and oxytocin. b. It suppresses the release of pancreatic polypeptide. c. It inhibits the release of insulin and glucagon. d. It inhibits the release of thyroid-stimulating hormone and thyroid hormone.
c. it inhibits the release of insulin and glucagon
A patient with chronic kidney disease receives hemodialysis treatments 3 days a week. Every 2 weeks, the patient requires a transfusion of 1 or 2 U of packed red blood cells. What is the probable reason for this patient's frequent transfusion needs? a. Too much blood phlebotomized for tests b. Increased destruction of red blood cells because of the increased toxin levels c. Lack of production of erythropoietin to stimulate red blood cell formation d. Hemodilution secondary to fluid retention
c. lack of production of erythropoietin to stimulate red blood cell formation
A patient was admitted with liver failure and acute kidney injury (AKI). Which intravenous solution should the nurse question if it were ordered for this patient? a. D5W b. 0.9% NaCl c. Lactated Ringer solution d. 0.45% NaCl
c. lactated ringer solution
A patient is admitted with massive head trauma. The patient is unresponsive and on mechanical ventilation. The electroencephalogram (EEG) is negative for brain waves. The family has agreed to organ donation. Which organs would not be considered for transplant? a. Heart b. Lung c. Liver d. Kidney
c. liver
The nursing management plan for a patient with thyrotoxicosis would include which intervention? a. Providing diversional stimuli b. Restricting fluids c. Maintaining a quiet, restful environment d. Administering thyroid supplements at the same time each day
c. maintaining a quiet, restful environment
A patient is admitted with massive head trauma. The patient is unresponsive and on mechanical ventilation. The electroencephalogram (EEG) is negative for brain waves. The family has agreed to organ donation. When the nurse turns the patient's head quickly from side to side, the patient's eyes do not move. The nurse knows this is the result of the loss of what reflex? a. Oculovestibular b. Corneal c. Oculocephalic d. Pupillary
c. oculocephalic
In a patient with a distended abdomen, differentiating ascites from solid bowel contents is accomplished by performing what assessment? a. Auscultation of bowel sounds b. Palpation of the liver margin c. Measuring abdominal girth d. Eliciting a fluid wave
d. eliciting a fluid wave
To assess whether or not an arteriovenous fistula is functioning, what must the nurse do and why? a. Palpate the quality of the pulse distal to the site to determine whether a thrill is present; auscultate with a stethoscope to appreciate a bruit to assess the quality of the blood flow. b. Palpate the quality of the pulse proximal to the site to determine whether a thrill is present; auscultate with a stethoscope to appreciate a bruit to assess the quality of the blood flow. c. Palpate gently over the site of the fistula to determine whether a thrill is present; listen with a stethoscope over this site to appreciate a bruit to assess the quality of the blood flow. d. Palpate over the site of the fistula to determine whether a thrill is present; check whether the extremity is pink and warm.
c. palpate gently over the site of the fistula to determine whether a thrill is present; listen with a stethoscope over this site to appreciate a bruit to assess the quality of the blood flow.
The nurse is caring for a critically ill patient with type 1 diabetes. The nurse understands that the patient is at risk for developing diabetic ketoacidosis (DKA) secondary to what etiology? a. Excess insulin administration b. Inadequate food intake c. Physiologic and psychologic stress d. Increased release of antidiuretic hormone (ADH)
c. physiologic and psychologic stress
An elderly patient is in a motor vehicle accident and sustains a significant internal hemorrhage. The nurse knows the patient is at risk for developing what type of acute kidney injury (AKI)? a. Intrinsic b. Postrenal c. Prerenal d. Intrarenal
c. prerenal
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. 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
The nurse understands that the onset of seizures in the patient with diabetes insipidus (DI) is indicative of which situation? a. Increased potassium levels b. Hyperosmolality c. Severe dehydration d. Toxic ammonia levels
c. severe dehydration
Glucagon release is stimulated by which physiologic factor? a. Increases in circulating insulin b. Decreases in blood amino acids c. Stimulation of the sympathetic nervous system d. High blood glucose levels
c. stimulation of the sympathetic nervous system
A patient with bronchogenic oat cell carcinoma has a drop in urine output. The laboratory reports a serum sodium level of 120 mEq/L, a serum osmolality level of 220 mOsm/kg, and urine specific gravity of 1.035. The nurse suspects the patient may be developing what problem? a. Diabetes ketoacidosis (DKA) b. Diabetes insipidus (DI) c. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) d. Hyperaldosteronism
c. syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
A patient is admitted with hypernatremia secondary to neurogenic diabetes insipidus. The nurse notes that 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.
What happens to patients that meet criteria for imminent death? a. They are placed on life support and referred to the organ procurement organizations. b. They are referred to the organ procurement organizations at the time of their death. c. They are referred to the organ procurement organizations in a timely manner. d. They are referred to a practitioner to make the decision if they are candidates for organ donation.
c. they are referred to the organ procurement organizations in a timely manner.
A nurse is initiating a patient teaching plan for a patient with hypothyroidism. The patient is currently taking salicylates, lithium, and sulfonamides. It is important that the nurse tell the patient that these medications influence thyroid levels. How are thyroid levels affected by these medications? a. They increase T3 b. They increasing T4 c. They decrease T3 d. They decrease T4
c. they decrease T3
A patient with thyrotoxicosis has been admitted. The nurse knows that when levels of T3 and T4 are elevated, the pituitary gland inhibits what hormone? a. Thyroglobulin b. Thyroid-releasing hormone (TRH) c. Thyroid-stimulating hormone (TSH) d. Calcitonin
c. thyroid-stimulating hormone (TSH)
The nurse is caring for a patient with myxedema coma. The patient's temperature is 93° F. Which intervention would the nurse include in the plan of care for this patient? a. Give aggressive therapy that includes warm peritoneal lavage. b. Allow the patient to maintain this body temperature to decrease oxygen demands. c. Use warming blankets to slowly warm the patient. d. Wait until the patient shivers to start warming.
c. use warming blankets to slowly warm the patient.
A patient is admitted in acute heart failure secondary to renal insufficiency. The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites. The nurse suspects the main cause of ascites is what condition? a. Hypervolemia b. Dehydration c. Volume overload d. Liver damage
c. volume overload
A patient weighs 140 kg and is 60 inches tall. The patient's blood sugar is being controlled by glipizide. Which topic would be important for the nurse to include in the patient's discharge education plan? a. Signs of hyperglycemia b. Proper injection technique c. Weight loss d. Increased caloric intake
c. weight loss
Which electrolytes are cations? a. Sodium, potassium, and chloride b. Sodium, chloride, and bicarbonate c. Bicarbonate, chloride, and calcium d. Sodium, potassium, and magnesium
d. sodium, potassium, magnesium
A patient is admitted with a massive head trauma. The patient is unresponsive and on mechanical ventilation. The electroencephalogram is negative for brain waves. The family has agreed to organ donation. How would the nurse check for the absence of cerebral motor reflexes? a. Performing a sternal rub b. Applying needle pricks to fingers and toes c. Clapping hands near the ears d. Applying pressure to the nail beds or supraorbital ridge
d. applying pressure to the nail beds or supraorbital ridge
One therapeutic measure for treating hyperkalemia is the administration of dextrose and regular insulin. Which statement regarding how this treatment works is accurate? a. Glucose and insulin force potassium out of the cells, lowering it on a cellular level. b. Glucose and insulin promote higher excretion of potassium in the urine. c. Glucose and insulin bind with potassium, lowering available amounts. d. Glucose and insulin force potassium into the cells, lowering it on a serum level.
d. glucose and insulin force potassium into the cells, lowering it on a serum level.
A patient with liver failure manifested by portal hypertension and ascites is hospitalized and waiting for a liver transplant. Which order should the nurse question? a. Low-sodium diet b. Low-protein diet c. ABO typing d. Human leukocyte antigen tissue typing
d. human leukocyte antigen tissue typing
Rejection that occurs within hours after the transplantation and results in immediate graft failure is referred to as what type of rejection? a. Acute b. Intermediate c. Chronic d. Hyperacute
d. hyperacute
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
The release of hormones by the pituitary gland is under the control which part of the brain? a. Cerebellum b. Occipital lobe c. Temporal lobe d. Hypothalamus
d. hypothalamus
A patient is being evaluated for thyroid dysfunction. The laboratory findings include a decreased serum free thyroxine (T4) level and an elevated thyroid-stimulating hormone (TSH) level. These findings confirm which diagnosis? a. Cushing syndrome b. Addison disease c. Thyrotoxicosis d. Hypothyroidism
d. hypothyroidism
The nurse is caring for a patient with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Which findings would confirm this diagnosis? a. Decreased ADH level and hyperkalemia b. Decreased ADH level and hypernatremia c. Increased ADH level and serum ketones d. Increased ADH level and low serum osmolality
d. increased ADH level and low serum osmolality
A patient is admitted with diabetic ketoacidosis (DKA). The nurse knows that the lack of insulin results in which process? a. Decreased glucagon release b. Decreased glycogenolysis c. Decreased ketone production d. Increased gluconeogenesis
d. increased gluconeogenesis
A patient with type 2 diabetes is admitted. He is very lethargic and hypotensive. A diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is given. Which findings support this diagnosis? a. Decreased serum glucose and increased serum ketones b. Increased urine ketones and decreased serum osmolality c. Increased serum osmolality and increased serum potassium d. Increased serum osmolality and increased serum glucose
d. increased serum osmolality and increased serum glucose
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 beats 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
The nurse is caring for a patient with type 1 diabetes who was admitted with complaints of increased lethargy. Serum laboratory values validate the diagnosis of diabetic ketoacidosis (DKA). Which statement best describes the rationale for administrating potassium supplements with the patient's insulin therapy? a. Potassium replaces losses incurred with diuresis. b. The patient has been in a long-term malnourished state. c. Intravenous (IV) potassium renders the infused solution isotonic. d. Insulin drives the potassium back into the cells.
d. insulin drives the potassium back into the cells
Laboratory results come back on a newly admitted patient: Serum blood urea nitrogen, 64 mg/dL; serum creatinine, 2.4 mg/dL; urine osmolality, 210 mOsm/kg; specific gravity, 1.002; and urine sodium, 96 mEq/L. The patient's urine output has been 120 mL since admission 2 hours ago. These values are most consistent with which diagnosis? a. Prerenal acute kidney injury b. Postrenal acute kidney injury c. Oliguric acute kidney injury d. Intrarenal acute kidney injury
d. intrarenal acute kidney injury
A patient has been admitted after a craniotomy. The patient starts to exhibit changes in the level of antidiuretic hormone (ADH). The nurse knows that ADH works primarily affects which organ? a. Liver b. Pancreas c. Stomach d. Kidney
d. kidney
A patient with acute kidney injury (AKI) has been started on continuous venovenous hemodialysis (CVVHD). The nurse understands that this type of continuous renal replacement therapy (CRRT) is indicated for the patient who needs what type of treatment? a. Fluid removal only b. Fluid removal and moderate solute removal c. Fluid removal and maximum solute removal d. Maximum fluid and solute removal
d. maximum fluid and solute removal
A patient is admitted with hypernatremia secondary to diabetes insipidus (DI). The practitioner suspects the patient has neurogenic DI. Which finding would confirm that 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 was admitted with diabetic ketoacidosis (DKA) an hour ago and is on an insulin drip. Suddenly, the nurse notices frequent premature ventricular contractions (PVCs) on the electrocardiogram. The nurse notifies the practitioner. The nurse would anticipate an order for which intervention? a. A lidocaine bolus b. Stopping the insulin drip c. Synchronizing cardioversion d. Obtaining serum electrolytes
d. obtaining the serum electrolytes
Which electrolyte abnormality is evident early in the course of kidney failure? a. Sodium b. Potassium c. Chloride d. Phosphorus
d. phosphorus
A patient is admitted with severe hyperglycemia. The patient is very lethargic and has a "fruity" odor to his breath. The nurse knows the odor on the patient's breath is indicative of which situation? a. Alcohol intoxication b. Lack of sodium bicarbonate c. Hypokalemia d. Presence of acetone
d. presence of acetone
A patient has been admitted who is suspected of having thyrotoxicosis. Which symptom would support this diagnosis? a. Lethargy despite adequate sleep b. Bradycardia not related to medications c. Constipation despite laxatives d. Weight loss despite increased appetite
d. weight loss despite increased appetite
