Adult 1 Test 3

70/30 insulin start, peak, end times

Start: 2 hours Peak: 2-12 hours Ends: 24 hours

50/50 insulin start, peak and end times

Start: 2 hours Peak: 2-6 hours End: 24 hours

Lente start, peak, end times

Start: 2.5 hours Peak: 6-16 hours End: 24 hours

Regular start, peak, and end times

Start: 30 minutes Peak: 2-5 hours End: 8 hours

Untralente start, peak, end times

Start: 4 hours Peak: 8-18 hours End: 30 hours

Which patient statement indicates correct understanding of contact transmission? a. "It occurs when I come into contact with pathogens in the air." b. "It occurs when I ingest a food containing an organism." c. "It occurs when I come in direct contact with a pathogen." d. "It occurs when I get bit by a tick or other insect."

c. "It occurs when I come in direct contact with a pathogen." Contact transmission means you must actually come into direct contact with the pathogen. This can occur by touching a person or an object that has the pathogen. The other three answers are not direct transmission.

What does the U in the CAUTION mnemonic of cancer warning signs stand for? a. A sore that does not heal b. Swallowing difficulty c. Bleeding or discharge that is abnormal d. Lumps in the body

c. Bleeding or discharge that is abnormal

Which of the following is NOT an aspect of Hospice care? a. The hospice patient is no longer seeking curative treatment b. Hospice is a subset of Palliative Care c. Hospice care occurs in the hospital on a palliative floor d. Hospice is a Medicare benefit

c. Hospice care occurs in the hospital on a palliative floor Although palliative units can help set up hospice for patient discharge and although a hospice patient can be admitted to a hospital palliative floor even while a hospice patient, hospice care discontinues temporarily while the patient is in the hospital and then will be continued once the patient leaves the facility. While an inpatient, palliative care can continue end of life care until the patient can return to hospice. The other three answers are true of hospice care.

A nurses teaches a client with newly diagnosed hypothyroidism about the need for thyroid hormone replacement therapy to restore normal thyroid function.Which thyroid preparation is the medication of choice for thyroid replacement therapy? a. Thyroid USP desiccated (Thyroid USP Enseals) b. Methimazole (Tapazole) c. Levothyroxine (Synthroid) d. Liothyronine (Cytomel)

c. Levothyroxine (Synthroid)

When preparing a teaching plan for a client with an endocrine. disorder, the nurse includes information about hormone regulation. Which of the following would the nurse include? a. The gland becomes enlarged leading to a deficiency of the hormone. b. Hormone secretion occurs as a straight line continuous process. c. Most disorders result from over or underproduction of the hormone. d. The gland slows hormone secretion when the hormone level decreases.

c. Most disorders result from over or underproduction of the hormone.

Which of the following poses the highest risk of contracting HIV? a. Casual contact b. Blood transfusions c. Sexual contact d. Drug use

c. Sexual contact HIV is transmitted from body fluids. While it can be transmitted via a blood transfusion, screenings of blood have made cases of blood transmitted HIV almost non-existent today. Drug users are at a higher risk due to behaviors such as sharing needles and casual contact does not transmit HIV. The highest risk is unprotected sexual activity of all types where body fluids can be exchanged.

What would an educator tell new nurses about primary immunodeficiency diseases? a. They need IVIG as treatment. b. They are the result of infection. c. Their origin is genetic. d. They can be acquired spontaneously

c. Their origin is genetic Primary immune dysfunction is from a defect in the body (genetic). Secondary immune dysfunction is caused by another disease process or treatment. For instance, the immunosuppression that occurs after chemotherapy treatment.

While doing a health history, a client tells you that her mother, grandmother, and sister died of cancer. The client wants to know what she can do to keep from getting cancer. What would be your best response?

"You can't prevent cancer, but you can have your blood analyzed for tumor markers to see what your risk level it"

A nurse is caring for a client hospitalized with AIDS. A friend comes to visit the client and privately asks the nurse about the risk of contracting HIV when visiting the client. What is the nurse's best response?

AIDS isn't transmitted by casual contact

An office worker takes a cookie that contains peanut butter. The worker begins wheezing, with an inspiratory stridor and air hunger and the occupational health nurse is called to the office. The nurse should recognize that the worker is likely suffering from which type of hypersensitivity?

Anaphylactic (type 1)

A terminally ill client has feelings of rage toward the nurse. According to Elisabeth Kübler-Ross, the patient is in which stage of dying?

Anger

Alternative and/or complimentary treatments are an important part of choosing a cancer plan of care? a. True b. False

a. True

Lantus and Levemir cannot be mixed with what and why

Any other insulins because the low pH (4.0) makes Lantus and Levemir acidic and mixing with other insulins will alter the absorption

Dying well is the goal for end of life care? a. True b. False

a. True

A client is experiencing symptoms that are suspected to be related to systemic lupus erythematosus. What cutaneous symptom occurs in about 50% of clients affected by this disease?

Butterfly shaped rash on the face over the bridge of the nose and cheeks

What can the nurse do to meet the challenges in caring for a patient with cancer?

Identify own perception of cancer and set realistic goals

Lente can't be mixed with what and why

NPH because this can cause the NPH to work like regular insulin

Therapeutic communication questions should be answered with

Open communication answers. The goal is to get them to talk more

When developing the plan of care for a client with a primary immunodeficiency, which nursing diagnosis would be the priority?

Risk for infection related to altered immune cell function

Lantus start, peak, end times

Start: 1.5 hours Peak: 2-23 hours End: 24 hours

Levemir start, peak, end times

Start: 1.5 hours Peak: 2-23 hours End: 24 hours

NPH start, peak, end times

Start: 1.5 hours Peak:4-12 hours End: 22 hours

Humalog start, peak and end times

Start: 10 minutes Peak: 1 hour End: 4 hours

Novolog start, peak, and end times

Start: 10 minutes Peak: 1 hour End: 4 hours

Novolog 70/30 start, peak, end times

Start: 15 minutes Peak: 1-6.5 hours End: 18/26 hours

Humalog 75/25 start, peak, end times

Start: 15 minutes Peak: 1-6.5 hours End: 18/26 hours

A client has received the results of a HIV antibody test, which is positive. What is the best explanation for the nurse to give to the client?

The client has been infected and has produced antibodies

Which of the following is the single largest preventable cause of cancer?

Tobacco

The partner of a HIV positive patient should be tested every? a. 3 months b. 6 months c. 9 months d. 12 months

a. 3 months Partners of HIV patients are at very high risk of transmission and should be tested every 3 months for early detection.

Which is NOT a clinical manifestation of diabetes insipidus? a. Ascites b. Weight loss c. Very high urine output d. Excessive thirst

a. Ascites

A 30 year old female client has been diagnosed withCushing's disease. What psychosocial nursing diagnosis should the nurse most likely prioritize when planning the client's care? a. Disturbed body image related to changes in physical appearance b. Spiritual distress related to changes in cognitive function c. Powerlessness related to disease progression d. Decisional conflict related to treatment options

a. Disturbed body image related to changes in physicalappearance

Which of these assessments addresses the leading cause of death among patients whohave cancer? a. Monitoring WBC counts and the patients integumentary systems b. Assessing the lower legs for redness, swelling, or pain c. Auscultating patients' lungs and monitoring O2 sat levels d. Arranging for electrocardiograms (ECGs) or cardiac telemetry

a. Monitoring WBC counts and the patients integumentary systems Treatment for cancer often include chemotherapy or radiation. Chemotherapy in particular can cause patients to become immunosuppressed and white counts are dangerously low. This puts them at risk of picking up all types of infections, even from pathogens on their own skin. This is why we often put them on granulocytopenic precautions (reverse isolation). B is incorrect because it is s/s of a DVT and cancer patients are usually on more at risk of DVT than others. C is not correct because listening to their lungs or O2 sat levels, while they can give us a good idea of respiratory status, would not let us know if the patient was compromised otherwise and D would let us know if there were cardiac issues but cancer patient do not usually die from cardiac failure

An occupational health nurse is screening a group of workers for diabetes. What statement should the nurse interpret as being suggestive of diabetes? a. "When I went to the bathroom the last few days, my urine smelled odd." b. "Lately, I drink and drink and can't seem to quench my thirst." c. "No matter how much sleep I get, it seems to take me hours to wake up." d. "I've always been a fan of sweet foods, but lately I'm turned off by them."

b. "Lately, I drink and drink and can't seem to quench my thirst."

In adults, which disorder results from excessive secretion of somatotropin (growth hormone)? a. Adrenogenital syndrome b. Acromegaly c. Dwarfism d. Cretinism

b. Acromegaly

The nurse should inform in-service participants that the first symptoms of HIV exposure include: a. Pneumonia like symptoms and increased sputum production b. Painful lesions on the vulva or shaft of the penis c. Fever, headache and malaise d. Rapid weight loss and anorexia

c. Fever, headache and malaise HIV exposure s/s do not occur immediately but slowly over time. When they do present, they are vague symptoms that could be caused by a number of other conditions/illnesses. The other three answers may occur but usually are later stage symptoms that occur as CD4 counts decrease, making the patient more prone to infections and body wasting.

A caregiver says, "I'm at the end of my rope. I can't do this anymore" What priority intervention should you make? a. Have the patient admitted to the hospital for respite period. b. Validate the care she is doing for the patient. c. Arrange for patient transfer to a hospice unit. d. Set up community support that can help meet the patient's needs

d. Set up community support that can help meet the patient's needs. While you may do one of more of the other answers (a, b, c) for short term relief, the priority would be to find help for the caregiver long term, especially since we do not know what type of illness the patient has or how long the caregiver may be needed.There are many programs that could help the caregiver in many ways, such as meals on wheels or other food resources or sitters or alternative caregivers that may be able to come in to help with patient care as examples.

Palliation refers to

relief of symptoms of disease and promotion of comfort and quality of life

A client has been taking prednisone for several weeks after experiencing a hypersensitivity reaction. To prevent adrenal insufficiency, the nurse should ensure that the client knows todo what action? a. Slowly taper down the dose of prednisone, as prescribed b. Gradually replace the prednisone with an over-the-counter(OTC) alternative c. Take the drug concurrent with levothyroxine (Synthroid) d. Take each dose of prednisone with a dose of calcium chloride.

a. Slowly taper down the dose of prednisone, as prescribed

All of the following are factors that affect our perception of death except? a. Stress levels b. Personality c. Spirituality d. Occupation

a. Stress levels

A patient states her last HIV test was 18 mths ago. A new HIV test is ordered, what do you do? a. Provide pretest counseling before getting consent b. Explain that the test has been ordered and she can opt out c. Obtain her written consent for the test d. No discussion is necessary at this test; just do the test

b. Explain that the test has been ordered and she can opt out. All testing, regardless of type, is recommended by the healthcare provided but the patient always has the right to consent or to refuse. You would explain that the test has been ordered but must ensure the patient understands she is not obligated to consent and has the right to refuse. A is not correct because you would do pretest counseling after she agreed to the test but before she gave consent so the patient would understand the ordered testing. C is not correct because you would never get her to consent before giving her the option to refuse or before you counseled her about the test and D is not correct because you will never do any type of testing without the other three things being completed.

Hospice care and palliative care are the same thing? a. True b. False

b. False

It is not appropriate for nurses to pray with dying patients and their families. a. True b. False

b. False

Older adults have the highest rate of any age group receiving early detection tests for cancer. a. True b. False

b. False

There is a family genetic link to all types of cancer? a. True b. False

b. False

When a HIV patient's CD4+ count goes below 200, it places them at greatest risk for? a. Bleeding b. Infection c. Organ failure d. No one, it's a normal value

b. Infection There are 5 stages of HIV infection from initial transmission to AIDS. In HIV, there is achronic destruction of infection fighting CD4+ cells. The lower the CD4+ count, thehigher the risk of infection. Once counts reach <200, the patient is considered to haveAIDs and is in high risk of infections of all types.

Which intervention is most appropriate when caring for a dying patient experiencing pain? a. Assess pain every 8 hours b. Prevent pain from developing c. Utilize morphine for all types of pain d. Minimize the pain response if they are confused

b. Prevent pain from developing

A client visits the physician's office complaining of agitation, restlessness, and weight loss. The physical examination reveals exophthalmos, a classic sign of Graves' disease. Based on history and physical findings, the nurse suspects hyperthyroidism. Exophthalmos is characterized by: a. Dry, waxy swelling and abnormal mucin deposits in the skin b. Protruding eyes and a fixed stare c. A wide, staggering gait d. More than 10 beats/minute difference between the apical and radial pulse rates

b. Protruding eyes and a fixed stare

The single most important risk factor for cancer is a. Family history b. Smoking c. Poverty d. Environment

b. Smoking

Which food should a person with gout choose to decrease risk of acute episodes? a. Seafood platter b. Soup and salad c. Liver and onions with side salad d. Steak and shrimp

b. Soup and salad Gout is caused by excessive amounts of uric acid and uric acid is a breakdown product of purines. Purines are found in many foods and patients with gout are taught to avoid foods high in purines to help decrease risks of exacerbations. Foods high in purines include seafood, shellfish, meats such as bacon, turkey, veal, venison and organ meats like life.

Which statement by the patient with fibromyalgia indicates that teaching has been effective? a. "My only option for treating my pain is narcotic analgesics." b. "Diagnostic tests include x-rays and blood tests." c. "I may get arthritis, which may lead to joint damage." d. "It's frustrating because it presents with normal assessments."

d. "It's frustrating because it presents with normal assessments." Fibromyalgia is often misdiagnosed since the symptoms can be resemble other direct causes. Often the patient experiences symptoms may not experience those symptoms when the exams take place so many assessments are normal. A is not correct because treatment does not usually include narcotics. Pain is often addressed with NSAIDS, muscle relaxants and anticonvulsants such as Neurontin. B is not correct because diagnostic tests do not include x-rays or blood tests. Diagnosis starts with diagnostic criteria and symptom severity indices, history and physical. C is not correct because you cannot get arthritis as it is an autoimmune disease not related to the hypersensitivity to pain from the receptors

A nurse is preparing to discharge a client with coronary artery disease and hypertension who is at risk for type 2 diabetes.Which information is important to include in the discharge teaching? a. How to self-inject insulin b. How to recognize signs of diabetic ketoacidosis c. How to monitor ketones daily d. How to control blood glucose through lifestyle modifications with diet and exercise

d. How to control blood glucose through lifestyle modifications with diet and exercise

A nurse is caring for a client with an abnormally low blood glucose concentration. What glucose level should the nurse observe when assessing lab results? a. Between 70 and 75 mg/dl b. 95 mg/dl c. Between 75 and 90 mg/dl d. Less than 70 mg/dl

d. Less than 70 mg/dl

A patient has early stage RA. What medication would the nurse expect to be ordered? a. Antimalarial agents b. Corticosteroids c. Cytoxan d. NSAIDS

d. NSAIDS NSAIDS can help with pain of RA. Antimalarial agents are not given. Cytoxan is an agent used in cancer treatments and is only used in RA for serious complications so you would not expect it to be ordered. Corticosteroids sometimes have to be used but are avoided if at all possible because of the serious side effects steroids have