Chapter 41 Pathophysiology NCLEX-Style Review Questions
A client diagnosed with type 2 diabetes has been instructed about managing his condition with diet. Which statements by the client indicate a need for additional education? Select all that apply. -"I need to carefully limit my protein consumption." -"I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads." -"I need to avoid adding salt to my foods." -"I can drink 8 to 10 glasses of water daily without concern for calories." -"I need to limit the amount of foods that I eat that contain trans fats."
"I need to carefully limit my protein consumption.", "I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads."
The mother of a 2-year-old newly diagnosed with type 1 diabetes asks why insulin has to be given by injection. The best response by the nurse is: -"Insulin is destroyed by the stomach contents and has to be administered by injection." -"Insulin needs to go directly into the vein to work best." -"When your child gets old enough, you will not have to administer injections." -"Your child is not old enough to swallow the pills needed to treat her diabetes."
"Insulin is destroyed by the stomach contents and has to be administered by injection."
The nurse is working in a pediatric clinic. Which child would the nurse recognize as having isosexual precocious puberty? -A 5-year-old black female with developing breasts and pubic hair -A 10-year-old black female who has begun menstruating -A 9-year-old white female who has small breast buds -A 14-year old white female who has not yet developed secondary sex characteristics
A 5-year-old black female with developing breasts and pubic hair
The health care provider is reviewing diurnal variation pattern in adrenocorticotropic (ACTH) levels. Select the typical diurnal variation pattern in adrenocorticotropic (ACTH) levels. -ACTH peaks in correspondence with food intake. -ACTH peaks in the morning and declines throughout the day. -ACTH maintains a consistent level regardless of the time of day. -ACTH increases in the morning and peaks again in the evening hours.
ACTH peaks in the morning and declines throughout the day.
A 48-year-old male client diagnosed with type 2 diabetes presents with the following: • Blood glucose level of 46 mg/dL (2.55 mmol/L) • Very lethargic • Has cool, clammy skin. Select the most appropriate intervention. -Place sugared breath mints in the client's mouth -Encourage the client to sit up and drink 12 ounces of orange juice -Administer scheduled dose of insulin -Administer injectable glucagon
Administer injectable glucagon
The health care provider is teaching a client about the metabolic effect of cortisol. The most appropriate information to provide would be: -Regulation of behavior and emotion -Regulation of anti-inflammatory reactions -Breakdown of proteins and fats -Suppression of the immune response to invasive pathogens
Breakdown of proteins and fats
Which complication of acromegaly can be life threatening? -Bone overgrowth causes arthralgias -Cardiac structures increase in size -Splayed teeth result in impaired chewing -Vertebral changes result in kyphosis
Cardiac structures increase in size
Which disorder is a result of excess cortisol? -Turner syndrome -Cushing syndrome -Hashimoto disease -Marfan syndrome
Cushing syndrome
Management of hyperthyroidism would include which interventions? Select all that apply. -Drug therapy directed toward decreasing the gland's function -Lifelong glucocorticoid and mineralocorticoid therapies -Excision of the existing cancerous tumor -Eradication of the gland with radioactive iodine -Surgical removal of part of the gland or the entire gland
Drug therapy directed toward decreasing the gland's function, Eradication of the gland with radioactive iodine, Surgical removal of part of the gland or the entire gland
A client with a suspected diagnosis of primary hypothyroidism would most likely demonstrate which serum laboratory value? -Elevated thyroid-stimulating hormone (TSH) and decreased thyroxine (T4) -Decreased thyroid-stimulating hormone (TSH) and thyroxine (T4), and low T3 -Elevated thyroid-stimulating hormone (TSH), thyroxine (T4), and T3 -Decreased thyroid-stimulating hormone (TSH) related to poor thyroid function
Elevated thyroid-stimulating hormone (TSH) and decreased thyroxine (T4)
A 25-year-old female client exhibits exophthalmos of both eyes. The health care provider recognizes this as a manifestation of: -Acquired hypothyroidism -Graves disease -Hashimoto thyroiditis -Myxedema
Graves disease
Which interventions would be included in the plan of care for a client experiencing myxedema coma? Select all that apply. -Initiation of thyroid replacement therapy -Frequent monitoring of cardiac functions -Reversal of hypoglycemia -Oxygen therapy to support ineffective respirations -Rewarming to manage hypothermia
Initiation of thyroid replacement therapy, Frequent monitoring of cardiac functions, Reversal of hypoglycemia, Oxygen therapy to support ineffective respirations
Select the most appropriate intervention for the nurse to teach a client diagnosed with distal symmetric neuropathy related to diabetes. -Wear comfortable, open-toed shoes -Rotate insulin injection sites once a week -Decrease daily walking activity -Inspect the feet for blisters daily
Inspect the feet for blisters daily
The diagnosis of type 1 diabetes would be confirmed by which principle? -Small amounts of insulin are produced daily. -Insulin is not available for use by the body. -Insulin is present in large amounts for use by the body. -Insulin is produced but unavailable for use in the body.
Insulin is not available for use by the body.
A nurse is teaching a client with newly diagnosed type 1 diabetes about the importance of blood glucose control to decrease the risk of which potential chronic complications of diabetes? Select all that apply. -Nephropathy -Retinopathy -Gastroparesis -Anxiety disorder -Neuropathy
Nephropathy, Retinopathy, Gastroparesis, Neuropathy
The nurse is assessing a female client with a diagnosis of primary adrenal cortical insufficiency. Which manifestation should the nurse anticipate? -Anorexia and increased excitability -Pale skin and increased hunger -Sparse axillary and pubic hair -Weight gain and fluid retention
Sparse axillary and pubic hair
A client is managing his type 2 diabetes with exercise and diet. He has a fasting blood sugar level (FBS) of 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (.05). Based on these findings, which of the following can the nurse assume? -The client is at risk for an insulin reaction. -The client is at risk for developing hyperglycemia. -The client needs to modify his diet related to the low readings. -The client is achieving normal glycemic control.
The client is achieving normal glycemic control.
Which statement best describes a secondary disorder of endocrine function? -The disorder occurs when the target organ becomes dysfunctional. -The disorder occurs when the target organ is normal, but stimulating hormones alter its function. -The disorder occurs in the target gland responsible for producing the hormone. -The disorder occurs from hypothalamic dysfunction resulting in understimulation of the target organ.
The disorder occurs when the target organ is normal, but stimulating hormones alter its function.
Which manifestations regarding hypothyroidism are accurate? Select all that apply. -Weight gain -Anorexia -Diarrhea -Onset of symptoms is gradual -Oily skin
Weight gain, Anorexia, Onset of symptoms is gradual
The nurse is educating a newly diagnosed client with Hashimoto thyroiditis who is to be discharged from the acute care facility. What should the nurse be sure to include in the education to prevent complications? -The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention. -The client should be informed that if he observes an increase in fatigue, an extra dose of his thyroid medication should be taken. -The client should skip a dose of the thyroid supplement if he has symptoms of fever or restlessness. -The client should not participate in any exercise activity that could utilize more thyroid hormone.
The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.