Adult Health II Exam II

The nurse is caring for a client with a TURP. Which expected outcome indicates the client's condition is improving? A. The client is using the maximum amount allowed by the PCA pump. B. The client's bladder spasms are relieved by medication. C. The client's scrotum is swollen and tender with movement. D. The client has passed a large, hard, brown stool this morning.

B. The client's bladder spasms are relieved by medication.

The client asks, "What does an elevated PSA test mean?" On which scientific rationale should the nurse base the response? A. An elevated PSA can result from several different causes. B. An elevated PSA can be only from prostate cancer. C. An elevated PSA can be diagnostic for testicular cancer. D. An elevated PSA is the only test used to diagnose BPH.

A. An elevated PSA can result from several different causes. An elevated PSA can be from urinary retention, BPH, prostate cancer, or prostate infarct.

A nurse is caring for a client with type 1 diabetes mellitus. Which client complaint would alert the nurse to the presence of a possible hypoglycemic reaction ? A. Tremors B. Anorexia C. Hot, Dry skin D. Muscle cramps

A. Tremors Decreased blood glucose levels produce autonomic nervous system symptoms, which are manifested classically as nervousness, irritability, and tremors. Option C is more likely to occur with hyperglycemia. Options B and D are unrelated to the signs of hyperglycemia

When obtaining a health history from a patient with acute pancreatitis, the nurse asks the patient specifically about a history of A. smoking B. alcohol use C. diabetes mellitus D. high-fat dietary intake

B. Alcohol Use Pancreatitis is associated with alcoholism.

The nurse is caring for a client with cirrhosis of the liver. The client has developed ascites and requires a paracentesis. Which of the following symptoms is associated with ascites and should be relieved by the paracentesis? A. Pruritus. B. Dyspnea. C. Jaundice. D. Peripheral neuropathy.

B. Dyspnea Ascites (fluid buildup in the abdomen) puts pressure on the diaphragm, resulting in difficulty breathing and dyspnea. Paracentesis (surgical puncture of the abdominal cavity to aspirate fluid) is done to remove fluid from the abdominal cavity and thus reduce pressure on the diaphragm in order to relieve the dyspnea. Pruritus, jaundice, and peripheral neuropathy are signs of cirrhosis that aren't relieved or treated by paracentesis.

Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? A. Diabetic ketoacidosis B. Thyroid crisis C. Hypoglycemia D. Myxedema coma

B. Thyroid crisis usually occurs in the first 12 hours after thyroidectomy and causes exaggerated signs of hyperthyroidism, such as high fever, tachycardia, and extreme restlessness. Diabetic ketoacidosis is more likely to produce polyuria, polydipsia, and polyphagia; hypoglycemia, to produce weakness, tremors, profuse perspiration, and hunger. Tetany typically causes uncontrollable muscle spasms, stridor, cyanosis, and possibly asphyxia.

The nurse observes red urine and several large clots in the tubing of the normal saline continuous irrigation catheter for the client who is one (1) day postoperative TURP. Which intervention should the nurse implement? A. Remove the indwelling catheter. B. Titrate the NS irrigation to run faster. C. Administer protamine sulfate IVP. D. Administer vitamin K slowly.

B. Titrate the NS irrigation to run faster. Increasing the irrigation fluid will flush out the clots and blood.

The nurse is taking care of a client who is prescribed insulin Lispro. The nurse should administer the insulin: A. Two hours after a meal. B. When a meal is readily available. C. Without a meal. D. via IV.

B. When a meal is readily available. Insulin Lispro is a rapid-acting insulin with an onset of 5-15minutes, it is important to have a meal ready to prevent hypoglycemia.

The nurse is caring for a patient with a diagnosis of hypothyroidism. Which nursing diagnosis should the nurse most seriously consider when analyzing the needs of the patient? A. High risk for aspiration related to severe vomiting B. Diarrhea related to increased peristalsis C. Hypothermia related to slowed metabolic rate D. Oral mucous membrane, altered related to disease process

c. Hypothermia related to slowed metabolic rate Thyroid hormone deficiency results in reduction in the metabolic rate, resulting in hypothermia, and does predispose the older adult to a host of other health-related issues. One quarter of affected elderly experience

The nurse is caring for the client diagnosed with ascites from hepatic cirrhosis. What information should the nurse report to the health-care provider? A. A decrease in the client's daily weight of one (1) pound. B. An increase in urine output after administration of a diuretic. C. An increase in abdominal girth of two (2) inches. D. A decrease in the serum direct bilirubin to 0.6 mg/dL.

c. An increase in abdominal girth of two (2) inches. An increase in abdominal girth would indicate that the ascites is increasing, meaning that the client's condition is becoming more serious and should be reported to the health-care provider.

You are performing discharge teaching with a patient who is going home on levothyroxine. Which statement by the patient causes you to re-educate the patient about this medication? A. "I will take this medication at bedtime with a snack." B. "I will never stop taking the medication abruptly." C. "If I have palpitations, chest pain, intolerance to heat, or feel restless, I will notify the doctor." D. "I will not take this medication at the same time I take my Carafate."

A. "I will take this medication at bedtime with a snack." This medication is life-long and must be taken in the morning before eating at the same time every day.

The client returned from surgery after having a TURP and has a P 110, R 24, BP90/40, and cool and clammy skin. Which interventions should the nurse implement? Select all that apply. A. Assess the urine in the continuous irrigation drainage bag. B. Decrease the irrigation fluid in the continuous irrigation catheter. C. Lower the head of the bed while raising the foot of the bed. D. Contact the surgeon to give an update on the client's condition. E. Check the client's postoperative creatinine and BUN.

A. Assess the urine in the continuous irrigation drainage bag. C. Lower the head of the bed while raising the foot of the bed. D. Contact the surgeon to give an update on the client's condition. The nurse should assess the drain postoperatively. The head of the bed should be lowered and the foot should be elevated to shunt blood to the central circulating system. The surgeon needs to be notified of the change in condition.

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. Ca+ level: 6 mg/dL Patients who've had a thyroidectomy are at risk for HYPOparathyroidism, and the symptoms listed in the question are classic signs of hypocalcemia. A normal calcium level is 8.6 to 10.0 mg/dL. Therefore, due to the patient's signs and symptoms and low calcium level of 6 mg/dL this warrants a nursing intervention.

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. Calcium level 6mg/dL C. (+) Trousseau's sign D. Tingling and numbness of lips and fingers

The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) about substances to avoid. Which items should the nurse include on this list? Select all that apply. A. Coffee B. Chocolate C. Peppermint D. Milk E. Fried chicken F. Scrambled eggs

A. Coffee B. Chocolate C. Peppermint D. Milk E. Fried chicken Foods that decrease lower esophageal sphincter (LES) pressure and irritate the esophagus will increase reflux and exacerbate the symptoms of GERD and therefore should be avoided. Aggravating substances include coffee, chocolate, peppermint, milk (ACIDIC) , fried or fatty foods, carbonated beverages, and alcohol. Options 4 and 6 do not promote this effect.

A patient is admitted to the hospital with a diagnosis of primary hyperparathyroidism. A nurse checking the patient's lab results would expect which of the following changes in laboratory findings? A. Elevated serum calcium. B. Low serum parathyroid hormone (PTH). C. Elevated serum vitamin D. D. Low urine calcium.

A. Elevated calcium. The parathyroid glands regulate the calcium level in the blood. In hyperparathyroidism, the serum calcium level will be elevated. Parathyroid hormone levels may be high or normal but not low. The body will lower the level of vitamin D in an attempt to lower calcium. Urine calcium may be elevated, with calcium spilling over from elevated serum levels. This may cause renal stones.

A client is admitted to the medical-surgical floor with a diagnosis of acute pancreatitis. His blood pressure is 136/76 mm Hg, pulse 96 beats/minute, respirations 22 breaths/minute, temperature 99°F (38.3°C), and he has been experiencing severe vomiting for 24 hours. His past medical history reveals hyperlipidemia and alcohol abuse. The physician prescribes a nasogastric (NG) tube for the client. Which of the following is the primary purpose for insertion of the NG tube? A. Empty the stomach of fluids and gas to relieve vomiting. B. Prevent spasms at the sphincter of Oddi. C. Prevent air from forming in the small and large intestines. D. Remove bile from the gallbladder.

A. Empty the stomach of fluids and gas to relieve vomiting. An NG tube is no longer routinely inserted to treat pancreatitis, but if the client has protracted vomiting, the NG tube is inserted to drain fluids and gas and relieve vomiting. An NG tube doesn't prevent spasms at the sphincter of Oddi (a valve in the duodenum that controls the flow of digestive enzymes) or prevent air from forming in the small and large intestine. The common bile duct connects to the pancreas and the gall bladder, and a T tube rather than an NG tube would be used to collect bile drainage from the common bile duct.

You are taking care of a pt with severe liver disease. Upon assessment you notice they are stuporous and they have a sweet odorous breath. What is your first priority? A. Expect the provider to order lactulose. B. Check vital signs. C. Administer IV dextrose. D. Insert an NG tube.

A. Expect the provider to order lactulose. Mental deterioration (Stupor), fetor hepaticus (sweet breath), as well as asterixis (hand flapping) are all signs of hepatic encephalopathy, when there is a buildup of ammonia in the bloodstream as a result of liver damage. Lactulose syrup is given to decrease ammonia levels by binding with it and being excreted via the stool. The lactulose is titrated to the number of BMs the patient has and monitoring lab values.

Which type of hepatitis is transmitted by the fecal-oral route via contaminated food, water, or direct contact with an infected person?" A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Hepatitis D

A. Hep A The hepatitis A virus is in the stool of infected people for up to 2 weeks before symptoms develop. Hepatitis B and Hepatitis C are spread through contact with infected blood and body fluids. Hepatitis D infection only causes infection in people who are also infected with Hepatitis B or C

The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer? A. Bradycardia B. Numbness in the legs C. Nausea and vomiting D. A rigid, boardlike abdomen

D. A rigid, boardlike abdomen Perforation of an ulcer is a surgical emergency and is characterized by sudden, sharp, intolerable severe pain beginning in the mid-epigastric area and spreading over the abdomen, which becomes rigid and boardlike. Nausea and vomiting may occur. Tachycardia may occur as hypovolemic shock develops. Numbness in the legs is not an associated finding.

The nurse is monitoring a client admitted to the hospital with a diagnosis of appendicitis who is scheduled for surgery in 2 hours. The client begins to complain of increased abdominal pain and begins to vomit. On assessment, the nurse notes that the abdomen is distended and bowel sounds are diminished. Which is the most appropriate nursing intervention? A. Notify the health care provider (HCP). B. Administer the prescribed pain medication. C. Call and ask the operating room team to perform surgery as soon as possible. D. Reposition the client and apply a heating pad on the warm setting to the client's abdomen.

A. Notify the health care provider (HCP). On the basis of the signs and symptoms presented in the question, the nurse should suspect peritonitis and notify the HCP. Administering pain medication is not an appropriate intervention. Heat should never be applied to the abdomen of a client with suspected appendicitis because of the risk of rupture. Scheduling surgical time is not within the scope of nursing practice, although the HCP probably would perform the surgery earlier than the prescheduled time.

A patient with a history of peptic ulcer disease has presented to the emergency department reporting severe abdominal pain and has a rigid, boardlike abdomen that prompts the health care team to suspect a perforated ulcer. What intervention should the nurse anticipate? A. Providing IV fluids and inserting a nasogastric (NG) tube B. Administering oral bicarbonate and testing the patient's gastric pH level C. Performing a fecal occult blood test and administering IV calcium gluconate D. Starting parenteral nutrition and placing the patient in a high-Fowler's position

A. Providing IV fluids and inserting a nasogastric (NG) tube. A perforated peptic ulcer requires IV replacement of fluid losses and continued gastric aspiration by NG tube. Nothing is given by mouth, and gastric pH testing is not a priority. Calcium gluconate is not a medication directly relevant to the patient's suspected diagnosis, and parenteral nutrition is not a priority in the short term.

The client is diagnosed with hypothyroidism. Which signs/symptoms should the nurse expect the client to exhibit? A. Complaints of extreme fatigue and hair loss. B. Exophthalmos and complaints of nervousness. C. Complaints of profuse sweating and flushed skin. D. Tetany and complaints of stiffness of the hands.

A. a decrease in thyroid hormomne causes decreased metabolism, which leads to fatigue and hair loss. B. & C. Signs of hyperthryoidism D. Signs of parathyroidism

Which signs/symptoms should make the nurse suspect the client is experiencing a thyroid storm? A. Obstipation and hypoactive bowel sounds. B. Hyperpyrexia and extreme tachycardia. C. Hypotension and bradycardia. D. Decreased respirations and hypoxia.

B. Hyperpyrexia (high fever) and heart rate above 130 beats per minute are signs of thyroid storm, a severely exaggerated hyperthyroidism. A. These are signs of myxedema (hypothyroidism) coma. Obstipation is extreme constipation. C. Decreased blood pressure and slow heartrate are signs of myxedema coma. D. These are signs/symptoms of myxedema coma.

A patient was recently discharged home for treatment of hypothyroidism and was ordered to take Synthroid for treatment. The patient is re-admitted with signs and symptoms of the following: heart rate 42, blood pressure 70/56, blood glucose 55, and body temperature of 96.8 'F. The patient is very fatigued and drowsy. The family reports the patient has not been taking Synthroid since being discharged home from the hospital. Which of the following conditions is this patient most likely experiencing? A. Thryoid Storm B. Myxedema Coma C. Iodism D. Toxic Nodular Goiter

B. Myxedema coma Clinical manifestations include subnormal temperature, hypotension, hypoventilation. Nursing priorities include altered cardiac output and tissue perfusion, and ineffective respiratory pattern.

A client who has been diagnosed with calculi reports that the pain is intermittent and less colicky. Which of the following nursing actions is most important at this time? A. Report hematuria to the physician B. Strain the urine carefully C. Administer meperidine (Demerol) every 3 hours D. Apply warm compresses to the flank area

B. Strain the urine carefully. Intermittent pain that is less colicky indicates that the calculi may be moving along the urinary tract. Fluids should be encouraged to promote movement, and the urine should be strained to detect passage of the stone. Hematuria is to be expected from the irritation of the stone. Analgesics should be administered when the client needs them, not routinely. Moist heat to the flank area is helpful when renal colic occurs, but it is less necessary as pain is lessened.

A patient with hepatitis B is being discharged in 2 days. In the discharge teaching plan the nurse should include instructions to: A. Avoid alcohol for the first 3 weeks B. Use a condom during sexual intercourse C. Have family members get an injection of immunoglobin D. Follow a low-protein, moderate-carbohydrate, moderate-fat diet

B. Use a condom during sexual intercourse. Hepatitis B virus may be transmitted by mucosal exposure to infectious blood, blood products, or other body fluids (e.g., semen, vaginal secretions, saliva). Hepatitis B is a sexually transmitted disease that is acquired through unprotected sex with an infected person. Condom use should be taught to patients to prevent transmission of hepatitis B.

A 60 year old patient has an abrupt onset of anorexia, nausea and vomiting, hepatomegaly, and abnormal liver function studies. Serologic testing is negative for viral causes of hepatitis. During assessment of the patient, it is most important for the nurse to question the patient regarding A. any prior exposure to people with jaundice B. the use of all prescription and OTC (over the counter) medications C. treatment of chronic diseases with corticosteroids D. exposure to children recently immunized for hepatitis B

B. the use of all prescription and OTC (over the counter) medications Overdose of OTC medications can cause liver disease. A and D assess for the exposure to hepatitis. Hepatitis was ruled out this is inappropriate. C is incorrect because corticosteroids do not commonly cause liver disease.

"A patient with newly diagnosed type 2 diabetes mellitus asks the nurse what ""type 2"" means in relation to diabetes. The nurse explains to the patient that type 2 diabetes differs from type 1 diabetes primarily in that with type 2 diabetes A. the pt is totally dependent on an outside source of insulin B. there is a decreased insulin secretion and cellular resistance to insulin that is produced C. the immune system destroys the pancreatic insulin-producing cells D. the insulin precursor that is secreted by the pancreas is not activated by the liver

B. there is a decreased insulin secretion and cellular resistance to insulin that is produced In type 2 diabetes, the pancreas produces insulin, but the insulin is insufficient for the body's needs or the cells do not respond to the insulin appropriately. The other information describes the physiology of type 1 diabetes

"The nurse is caring for a patient who is alert and oriented whose blood glucose level is 55mg/dL. What is the likely nursing response?" A. Administer a glucagon injection B. Give a small meal C. Administer 10-15 g of a carbohydrate D. Give a small snack of high protein food"

C. Administer 10-15g of carbs Pt is alert and oriented. 10-15g of carb replacement can be 1 tube glucose paste, 4-6 oz fruit juice, 2-3 glucose tabs. Recheck BG in 15 minutes, repeat dose if BG<70.

An unconscious pt was brought to the ED and is cool, pale, diaphoretic with a BG of 42. What is the best nursing intervention for this pt? A. Immediately give 15-20grams carbohydrate replacement. B. Re-check blood glucose after 15 minutes. C. Administer IV 50% Dextrose in water slowly. D. Initiate CPR.

C. Administer IV 50% Dextrose in water slowly. This pt is unconscious and does not have an intact gag reflex and therefore cannot ingest a carb replacement. It will be important to recheck a BG eventually but it is not the most appropriate at this time. CPR is not warranted at this time.

The patient with chronic gastritis is being put on a combination of medications to eradicate H. pylori. Which drugs does the nurse know will probably be used for this patient? A. Antibiotic(s), antacid, and corticosteroid B. Antibiotic(s), aspirin, and antiulcer/protectant C. Antibiotic(s), proton pump inhibitor, and bismuth D. Antibiotic(s) and nonsteroidal antiinflammatory drugs (NSAIDs)

C. Antibiotic(s), proton pump inhibitor, and bismuth To eradicate H. pylori, a combination of antibiotics, a proton pump inhibitor, and possibly bismuth (for quadruple therapy) will be used. Corticosteroids, aspirin, and NSAIDs are drugs that can cause gastritis and do not affect H. pylori.

A patient is admitted with complaints of palpations, excessive sweating, and unable to tolerate heat. In addition, the patient voices concern about how her appearance has changed over the past year. The patient presents with protruding eyeballs and pretibial myxedema on the legs and feet. Which of the following is the likely cause of the patient's signs and symptoms? A. Thyroiditis B. Deficiency of iodine consumption C. Grave's Disease D. Hypothyroidism

C. Graves disease

A female patient has a sliding hiatal hernia. What nursing interventions will prevent the symptoms of heartburn and dyspepsia that she is experiencing? A. Keep the patient NPO. B. Put the bed in the Trendelenberg position. C. Have the patient eat 4 to 6 smaller meals each day. D. Give various antacids to determine which one works for the patient.

C. Have the patient eat 4 to 6 smaller meals each day. Eating smaller meals during the day will decrease the gastric pressure and the symptoms of hiatal hernia. Keeping the patient NPO or in a Trendelenberg position are not safe or realistic for a long period of time for any patient. Varying antacids will only be done with the care provider's prescription, so this is not a nursing intervention.

A patient is being discharged home for treatment of hypothyroidism. Which medication is most commonly prescribed for this condition? A. Tapazole B. PTU (Propylthiouracil) C. levothyroxine D. Inderal

C. Levothyroxine

The nurse is caring for a hospitalized client with a diagnosis of ulcerative colitis. Which finding, if noted on assessment of the client, should the nurse report to the health care provider (HCP)? A. Hypotension B. Bloody diarrhea C. Rebound tenderness D. A hemoglobin level of 12 mg/dL (120 mmol/L)

C. Rebound tenderness Rebound tenderness may indicate peritonitis. Bloody diarrhea is expected to occur in ulcerative colitis. Because of the blood loss, the client may be hypotensive and the hemoglobin level may be lower than normal. Signs of peritonitis must be reported to the HCP.

A patient is recovery from a parathyroidectomy. Which of the following findings causes concern and requires nursing intervention? A. The patient is in Semi-Fowler's position. B. The patient's calcium level is 8.9 mg/dL. C. The patient's voice is hoarse. D. The patient is drowsy but arouses to name.

C. The patient's voice is hoarse. Hoarseness may indicate a compromised airway.

A patient has an extremely high T3 and T4 level. Which of the following signs and symptoms DO NOT present with this condition? A. Weight loss B. Intolerance to heat C. Smooth skin D. Hair loss

D

A patient with type 1 diabetes has received diet instruction as part of the treatment plan. The nurse determines a need for additional instruction when the patient says, A. "I may have an occasional alcoholic drink if I include it in my meal plan." B. "I will need a bedtime snack because I take an evening dose of NPH insulin." C. "I will eat meals as scheduled, even if I am not hungry, to prevent hypoglycemia." D. "I may eat whatever I want, as long as I use enough insulin to cover the calories.

D. ""I may eat whatever I want, as long as I use enough insulin to cover the calories." Most patients with type 1 diabetes need to plan diet choices very carefully. Patients who are using intensified insulin therapy have considerable flexibility in diet choices but still should restrict dietary intake of items such as fat, protein, and alcohol. The other patient statements are correct and indicate good understanding of the diet instruction."

During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the nurse should include which statement? A. "The head of your bed must remain flat for 24 hours after surgery." B. "You should avoid deep breathing and coughing after surgery." C. "You won't be able to swallow for the first day or two." D. "You must avoid hyperextending your neck after surgery."

D. "You must avoid hyperextending your neck after surgery." To prevent undue pressure on the surgical incision after subtotal thyroidectomy, the nurse should advise the client to avoid hyperextending the neck. The client may elevate the head of the bed as desired and should perform deep breathing and coughing to help prevent pneumonia. Subtotal thyroidectomy doesn't affect swallowing.

A nurse on a surgical floor is caring for a post-operative client who has just had a subtotal thyroidectomy. Which of the following assessments should be completed first on the client? A. Assess for signs of tetany by checking for Chvostek's and Trousseau's signs B. Assess dressing (if present) and the area under the client's neck and shoulders for drainage. C. Administer analgesic pain medications as ordered, and monitor their effectiveness. D. Assess respiratory rate, rhythm, depth, and effort.

D. Assess respiratory rate, rhythm, depth, and effort. All of the above assessments have importance, but airway and breathing in a client should always be addressed first when prioritizing care. Assess for signs of latent tetany due to calcium deficiency, including tingling of toes, fingers, and lips; muscular twitches; positive Chvostek's and Trousseau's signs; and decreased serum calcium levels. However, tetany may occur in 1 to 7 days after thyroidectomy so # 1 is not the highest priority. Assessing for hemorrhage is always important, but the danger of hemorrhage is greatest in the first 12 to 24 hours after surgery, and as this client is immediately post operative it is not the main concern at this time. Pain medication is important but according to Maslow, pain is a psychosocial need to be addressed after a physiologic need.

A client has undergone esophagogastroduodenoscopy. The nurse should place highest priority on which item as part of the client's care plan? A. Monitoring the temperature B. Monitoring complaints of heartburn C. Giving warm gargles for a sore throat D. Assessing for the return of the gag reflex

D. Assessing for the return of the gag reflex The nurse places highest priority on assessing for return of the gag reflex. This assessment addresses the client's airway. The nurse also monitors the client's vital signs and for a sudden increase in temperature, which could indicate perforation of the gastrointestinal tract. This complication would be accompanied by other signs as well, such as pain. Monitoring for sore throat and heartburn are also important; however, the client's airway is the priority.

The female client in an outpatient clinic is being sent home with a diagnosis of urinary tract infection (UTI). Which instruction should the nurse teach to prevent a recurrence of a UTI? A. Clean the perineum from back to front after a bowel movement. B. Take warm tub baths instead of hot showers daily. C. Void immediately preceding sexual intercourse. D. Avoid coffee, tea, colas, and alcoholic beverages.

D. Avoid coffee, tea, colas, and alcoholic beverages. Avoid beverages that irritate the urinary tract.

The nurse is caring for a client with ulcerative colitis. Which finding does the nurse determine is consistent with this diagnosis? A. Hypercalcemia B. Hypernatremia C. Frothy, fatty stools D. Decreased hemoglobin

D. Decreased hemoglobin Ulcerative colitis is an inflammatory disease of the large colon. Findings associated with ulcerative colitis include diarrhea with up to 10 to 20 liquid bloody stools per day, weight loss, anorexia, fatigue, increased white blood cell count, increased erythrocyte sedimentation rate, dehydration, hyponatremia, and hypokalemia (not hypercalcemia). Because of the loss of blood, clients with ulcerative colitis commonly have decreased hemoglobin and hematocrit levels. Clients with ulcerative colitis have bloody diarrhea, not steatorrhea (fatty, frothy, foul-smelling stools).

The elderly client recovering from a prostatectomy has been experiencing stress incontinence. Which independent nursing intervention should the nurse discuss with the client? A. Establish a set voiding frequency of every two (2) hours while awake. B. Encourage a family member to assist the client to the bathroom to void. C. Apply a transurethral electrical stimulator to relieve symptoms of urinary urgency. D. Discuss the use of a "bladder drill," including a timed voiding schedule.

D. Discuss the use of a "bladder drill," including a timed voiding schedule. Use of the bladder training drill is helpful in stress incontinence. The client is instructed to void at scheduled intervals. After consistently being dry, the interval is increased by 15 minutes until the client reaches an acceptable interval.

The nurse caring for a 54-year-old patient hospitalized with diabetes mellitus would look for which of the following laboratory test results to obtain the BEST information on the patient's past glucose control? A. prealbumin level B. urine ketone level C. fasting glucose level D. glycosylated hemoglobin level

D. HbA1C A glycosylated hemoglobin level detects the amount of glucose that is bound to red blood cells (RBCs). When circulating glucose levels are high, glucose attaches to the RBCs and remains there for the life of the blood cell, which is approximately 120 days. Thus the test can give an indication of glycemic control over approximately 2 to 3 months.

A patient is 6 hours post-opt from a thyroidectomy. The surgical site is clean, dry and intact with no excessive swelling noted. What position is best for this patient to be in? A. Fowler's B. Prone C. Trendelenburg D. Semi-Fowler's

D. Semi fowlers Thyroidectomy is performed to treat hyperthyroidism. HUGE potential of airway impairment. Post-op priorities include monitoring for potential bleeding and hematoma formation, maintain in a semi-fowlers position, support head and neck with pillows, assess for s/s of hypocalcemia (Chovstek's and Trusseau's; keep calcium gluconate bedside just in case).

Which nursing intervention should be included in the plan of care for the client diagnosed with hyperthyroidism? A. Increase the amount of fiber in the diet. B. Encourage a low-calorie, low-protein diet. C. Decrease the client's fluid intake to 1,000 mL/day. D.. Provide six (6) small, well-balanced meals a day.

D. The client with hyperthyroidism has an increased appetite; therefore, well-balanced meals served several times throughout the day will help with the client's constant hunger A. Fiber should be increased in the client diagnosed with hypothyroidism because the client experiences constipation secondary to decreased metabolism. B. The client with hyperthyroidism should have a high-calorie, high-protein diet. C. The client's fluid intake should be increased to replace fluids lost through diarrhea and excessive sweating.

The benefits of using an insulin pump include all of the following except: A. By continuously providing insulin they eliminate the need for injections of insulin B. They simplify management of blood sugar and often improve A1C C. They enable exercise without compensatory carbohydrate consumption D. They help with weight loss

D: They help with weight loss. Using an insulin pump has many advantages, including fewer dramatic swings in blood glucose levels, increased flexibility about diet, and improved accuracy of insulin doses and delivery; however, the use of an insulin pump has been associated with weight gain.

A patient reports they do not eat enough iodine in their diet. What condition are they most susceptible to? a. Pheochromocytoma b. Hyperthyroidism c. Thyroid Storm d. Hypothyroidism

D: hypothyroidism