EAQ

The nurse reviews the serum lab values of a client. The nurse suspects hypofunctioning of the adrenal gland bsaed on which results? Select all that apply A. Increased calcium B. Decreased cortisol C. Decreased sodium D. Decreased potassium E. Increased glucose

A., B., C. Hypofunction of adrenal gland = increased calcium and bicarb, decreased sodium and cortisol Potassium is decreased w/ hyperfunctioning and so is increased glucose

Which mechanism of action explains how proplythiouracil (PTU) manages hyperthyroidism? A. It binds previously formed thyroid hormones B. It decreases production of thyroid hormones C. Vascularity of the thyroid gland is decreased D. The need for thyroid iodine supplements is reduced

B.

A young male client receiving dialysis states "My wife would at least get some insurance money if I died" Which response would the nurse use? A. "I can appreciate and understand how you feel" B. "You feel so bad you wish you were dead" C. "We all have days where we feel like that" D. "You need time to adjust to the treatments"

B. I don't understand therapeutic communication

Which dietary instruction would the nurse provide a client receiving continuous ambulatory peritoneal dialysis (CAPD) for chronic glomerulonephritis? A. Low calorie foods B. High-quality protein C. Increased fluid intake D. Foods rich in potassium

B. It'll replace the protein lost during dialysis

Which clients are likely to have dysfunction of the parathyroid gland? Select all that apply A. Client 1 - skin infection, petechiae B. Client 2 - infertility, less facial hair C. Client 3 - Red stretch marks, hump on shoulder D. Client 4 - Brittle fingernails, fatigue E. Client 5 - Increased facial hair, irregular menstrual cycles,

B., D. Parathyroid dysfunction cay have problems with sexual and reproductive functions Brittle nails and fatigue are also with parathyroid dysfunction

For which potential complications would the nurse monitor a client receiving continuous ambulatory peritoneal dialysis (CAPD) for end stage kidney disease? Select all that apply A. Pruritis B. Oliguria C. Tachycardia D. Cloudy outflow D. Abdominal pain

C., D., E. These are symptoms of peritonitis Oliguria is a sign of kidney failure

In which medical conditions with the nurse expect the clients chloride levels in the 24 hour urine sample test to increase? Select all that apply A. Heart failure B. Emphysema C. Hypokalemia D. Pyloric obstruction E. Adrenal insufficiency

C., E.

The home health nurse is educating a client with adrenal insufficiency regarding the disease process and medication safety. Which statement made by the client indicates a need for further education? A. "I should not skip any doses of my medication." B. " it is important to never switched brands of medication." C. " I should weigh myself every day and report weight gain D. " I only need a medical alert bracelet when in the hospital."

D.

Which symptom is indicative of the need for dialysis in the child with chronic kidney disease? A. Hypotension B. Hypokalemia C. Hypovolemia D. Hypercalcemia

C.

Which rationale accurately explains why insulin is prescribed for clients in acute renal failure? A. It promotes transfer of potassium into cells to lower serum potassium levels B. Insulin is required because the alpha cells of the pancreas cease to function with renal failure C. It is necessary to manage the elevated blood glucose levels that accompany renal failure D. Insulin reduces the accumulated toxins by lowering the metabolic rate

A. Insulin promotes potassium transfer into cells

The nurse is teaching a nursing student about how to care for a client who underwent stereotactic radiosurgery for a pituitary adenoma. Which statement indicates effective learning? A. I will assess for bleeding B. I will monitor cardiac output C. I will monitor serum osmolarity D. I will assess for glucose levels in nasal discharge

C. a client who underwent stereotactic radiosurgery for a pituitary adenoma may experience transient diabetes insipidus. Serum and urine osmolarity should be losely monitored. Bleeding is a complication from a hypophysectomy. Cardiac output is for patients after a thyroid surgery because they may experience hypothyroidism Glucose levels in nasal discharge should be monitored for meningitis in a client who underwent hypophysectomy for a pituitary adenoma

The nurse is providing postoperative care for a client one hour after an adrenalectomy. Maintenance steroid therapy has not begun yet. The nurse would monitor the client for which complication? A. Hypotension B. Hyperglycemia C. Sodium retention D. Potassium excretion

A.

Which intervention would prevent urinary stasis and formation of renal calculi in an immobile client? A. Increasing oral fluid intake B. Maintaining bedrest after discharge C. Limiting fluid intake D. Voiding at least every hour

A.

A client receiving a hemodialysis treatment asks the nurse which substances are being removed. Which substance can the nurse report is being removed during hemodialysis? A. Blood B. Sodium C. Glucose D. Bacteria

B.

A client who has renal failure asked the nurse why anemia keeps recurring. Which reason would the nurse explain to the client? A. increase in blood pressure B. Decrease in erythropoietin C. Increase in serum phosphate levels D. Decrease in sodium concentration

B.

A client with renal failure receives prescriptions for vitamin D and calcium supplements. The client asked the nurse "why do I need to take the news?" The nurse explains that, with renal failure, which condition exist? A. A decrease in the inactive forms of vitamin D in the body B. A decrease in the active metabolite of vitamin D in the body C. An increase in the conversion of skin cholesterol into vitamin D D. An increase in the vitamin D-associated intestinal absorption of calcium

B.

The nurse is giving discharge teaching instructions to a client with diabetes who had a total hypophysectomy. Which statement made by the client indicates that further teaching is necessary? A. "there is a risk that I could become permanently sterile" B. "my insulin dose will need to be increased from now on" C. "I must have cortisone therapy for the rest of my life" D. "Lifelong thyroxine replacement therapy will be required"

B.

The nurse estimates that a client admitted in the oliguric phase of acute kidney injury had a urinary output of 200 mL over the past 12 hours. The clients plan of care indicates a fluid restriction of 900 mL of free water per 24 hours. Which statement explains the amount of prescribed fluid? A. The fluid equals the expected urinary output for the next 24 hours B. The fluid prevents the development of pneumonia and a high fever C. The fluid compensates for insensible fluid loss and the expected urinary output D. The fluid reduces hyperkalemia, which can lead to life-threatening cardiac dysrhythmias

C.

The nurse is teaching a nursing student how to care for a patient that underwent stereotactic radiosurgery for a pituitary adenoma. Which statement made by the student indicates affective learning? A. "I will assess for bleeding" B. "I will monitor cardiac output" C. "I will monitor serum osmolarity" D. "I will assess for glucose levels in nasal discharge"

C.

The nurse is caring for a client with Addison disease. Which dietary modifications to the nurse include in the clients teaching plan? A. Increase potassium intake to replace renal losses B. Increase protein intake to heal the adrenal tissue and the cure of the disease. C. Take supplemental vitamins to supply energy and assist in regaining the weight that was lost D. Consume extra salt to replace the amount being lost due to a lack of sufficient aldosterone needed to conserve sodium

D.

The primary health care provider for a client with chronic kidney disease prescribed immediate hemodialysis for the first time. Which clinical manifestation indicates the need for immediate hemodialysis in this client? A. Ascites B. Acidosis C. Hypertension D. Hyperkalemia

D. kidneys are failing to regulate potassium and this can cause cardiac failure

During the oliguric phase of AKI, for which abnormal finding would the nurse monitor in the client? A. Hypothermia B. Hyperphosphatemia C. Hypocalcemia D. Hyperkalemia

D. potassium builds up

Which complication would the nurse be concerned about if there is removal of the parathyroid glands during a thyroidectomy? A. Tetany B. Myxedema C. Hypovolemic shock D. Adrenocortical stimulation

A. If the parathyroid glands are removed then calcium levels will decrease and cause tetany Loss of the thyroid gland may cause myxedema The other things are not affected by the parathyroid gland

Which clinical findings would the nurse expect to find during the assessment of a child with acute glomerulonephritis (AGN)? Select all that apply A. Flank pain B. Periorbital edema C. Intermittent fever D. Increased urine volume E. Decreased joint mobility

A., B. Flank pain is caused by inflammatory and degenerative changes in renal tissue Filtration is decreased thus there is edema

Which symptoms indicating a thyroid storm would the nurse monitor a client for? Select all that apply A. Increased heart rate B. Increased temperature C. Decreased respirations D. Increased pulse deficit E. Decreased blood pressure

A., B. Thyroid storm is severe hyperthyroidism excessive amount of thyroxine increase the metabolic rate

Which cause of Cushings syndrome would the nurse consider before assessing the client for physiological responses? A. Pituitary hypoplasia B. Hyperplasia of the adrenal cortex C. Deprivation of adrenocortical hormones D. Insufficient ACTH production

B. Hyperplasia of the adrenal cortex leads to increased secretion of cortical hormones which causes signs of Cushings disease Pituitary hypoplasia is a malfunction of the pituitary that results in Simmonds disease, which has clinical manifestations like Addison's disease. Inadequate ACTH production results in Addison's signs and symptoms. Cushings is cause by excessive cortical homones not deprivation

Which clinical manifestations in a client indicate a hyperfunctional thyroid gland? Select all that apply A. Anemia B. Diarrhea C. Weight loss D. Decreased appetite E. Distant heart sounds

B., C. The others are characteristics of hypothyroidism

A client with acute kidney injury is moved into the diuretic phase after 1 week of therapy. During this phase, which clinical indicators would the nurse assess? Select all that apply A. Skin rash B. Dehydration C. Hypovolemia D. Hyperkalemia E. Metabolic acidosis

B., C. Unless fluids are replaced these are both possible

The nurse is caring for a patient who is scheduled for a bilateral adrenalectomy. Which medication would the nurse expect to be prescribed for this client? A. Methimazole B. Regular insulin C. Pituitary extract D. Hydrocortisone

D. Hydrocortisone is a glucocorticoid. A client undergoing a bilateral adrenalectomy must be given adrenocortical hormones so that adjustment to the sudden lack of these hormones that occurs with this surgery. Methimazole is used for hyperthyroidism Pituitary hormones won't be affected by this surgery Pancreas is not affected either

A client with end stage renal disease has a mature AV fistula. Which interventions would the nurse include in the client's plan of care? Select all that apply A. Auscultate the fistula for the presence of bruits B. Palpate the site to identify the presence of a thrill C. Irrigate the fistula with saline to maintain patency D. Avoid drawing blood from the affected extremity E. Keep the fistula clamped until ready to perform dialysis

A., B., D. Bruit and thrill presence indicates patency of the AV fistula.

Identify the primary causes of adrenal insufficiency. Select all that apply A. Hemorrhage B. Tuberculosis C. Pituitary tumors D. Postpartum pituitary necrosis E. Acquired immunodeficiency syndrome (AIDS)

A., B., E. The other two are secondary cases

The nurse is assessing a client with a suspected thyroid disorder. Which diagnostic studies will be used to confirm that the thyroid disorder is autoimmune in origin? Select all that apply A. Free thyroxine B. Thyroglobulin antibody C. Thyroid peroxidase antibody D. Thyroid-stimulating antibody E. Thyroid-stimulating hormone

B., C., D. All of these are used in a thyroid antibody test which differentiates other forms of thyroiditis from autoimmune thyroid disease Free thyroxine can measure total T4 but not determine origin TSH levels are used to determine thyroid dysfunction but can not determine origin either

A client with end-stage renal failure begins hemodialysis for the first time. Which prescribed hemodialysis protocol would the nurse implement when the client reports nausea and a headache and then appears to be confused? A. Administer an analgesic for the headache B. Administer an antiemetic for the nausea C. Decrease the rate of hemodialysis exchange D. Discontinue the procedure immediately

C. These are symptoms of disequilibrium syndrome

A client with kidney dysfunction is about to undergo renal testing using a contrast medium. Which interventions would be in the client's plan of care? Select all that apply A. Assessing the client for a history of cirrhosis B. Asking the client about known shellfish allergies C. Assessing for a history of lactic acidosis D. Evaluating the client's hydration status by checking blood pressure and respiratory rate E. Discontinuing metformin for 24 hours from the time of the contrast medium administration

A., B., D. Clients with cirrhosis have higher risk of kidney failure after the procedure. Shellfish allergy because of the contrast dye Metformin discontinued 48 hours after the procedure

Which goals are appropriate when caring for a client with hyperplasia of the pituitary tissue? Select all that apply A. To alleviate headache B. To replace lost sodium C. To eliminate visual disturbances D. To check the urine specific gravity E. To return hormone levels to normal

A., C., E. client with hyperplasia of pituitary tissue (tissue overgrowth) will lead to oversecretion of pituitary hormones resulting in hyperpituitarism. Client w/ hyperpituitarism will have headaches and visual disturbances Sodium replacement is important for IAHS syndrome Checking urine specific gravity because it might be low with hyperaldosteronism

Which clinical manifestation occurs in a client with vasopressin deficiency? A. Impotence B. Hypotension C. Amenorrhea D. Decreased libido

B. Vasopressin regulates fluid level and blood pressure Impotence, Amenorrhea, and decreased libido are manifestations of luteinizing and FSH deficiencies

Which action would the nurse take before a client's scheduled hemodialysis treatment? A. Obtain the client's urine specimen to evaluate kidney function B. Weigh the client to establish a baseline for later comparison C. Administer medications that are scheduled to be given within the next hour D. Explain that the peritoneum serves as a semipermeable membrane to remove wastes

B. used to determine net fluid loss from dialysis

Which test result would the nurse anticipate in the lab reports of a client with a diagnosis of end stage renal disease? A. Arterial pH of 7.5 B. Hematocrit of 54% C. Potassium of 6.3 D. Creatinine of 1.2

C. Clients with end stage renal disease have impaired potassium excretion

The laboratory reports of a client with adrenal adenoma show high urine aldosterone levels and a low specific gravity of urine. The serum potassium is 2.8 mEq. Which other findings may be present? Select all that apply A. Hypernatremia B. hypertension C. hypoglycemia D. Hypercalcemia E. Metabolic Alkalosis

A., B., E. Adrenal adenoma may cause primary hyperaldosteronism, which may result in high aldosterone in the urine, low specific gravity in the urine, and hypokalemia. Increased aldosterone levels may result in sodium retention. Sodium retention leads to increased BP causing HTN. High aldosterone levels can also cause metabolic alkalosis Hypoglycemia - deficiency of ACT hormone Hypercalcemia - associated w/ adrenal insufficiency

When reviewing lab results for a client with heart failure who has been receiving furosemide daily, the nurse notes BUN of 42 and creatinine of 1.1. Which action is a priority? A. Administer the furosemide as scheduled B. Start strict intake and outtake measurements C. Send a urine specimen for specific gravity testing D. Notify the health care provider about the results

D. Elevation in BUN and creatinine because of hypovolemia by diuresis or poor renal perfusion

A client is diagnosed with hyperthyroidism and is treated with I-131. Before discharge the nurse teaches the client to observe for signs and symptoms of therapy-induced hypothyroidism. Which signs and symptoms would be included in the teaching? Select all that apply A. Fatigue B. Dry skin C. Insomnia D. Intolerance to heat E. Progressive weight gain

A., B., E. Fatigue and weight gain are caused by decreased metabolic rate associated with hypothyroidism. Dry skin is caused by decreased glandular function associated with hypothyroidism. Insomnia and heat intolerance is with hyperthyroidism

Which client is most likely to have hyperfunction of the adrenal gland? A. Client 1 - Sodium 136; Calcium 5.1; Bicarb 25; Cortisol 10 B. Client 2 - Sodium 130; Calcium 6.1; Bicarb 33; Cortisol 2 C. Client 3 - Sodium 150; Calcium 3.9; Bicarb 20; Cortisol 15 D. Client 4 - Sodium 130; Calcium 6.1; Bicarb 20; Cortisol 15

C. Sodium - 135-145 Calcium - 4.5-5.5 Bicarb - 23-30 Cortisol - 3-13 Client 1 is all in normal range Hyperfunction of the adrenal gland = increased sodium and cortisol, decreased calcium and bicarb Client 2 is hypofunction of the adrenal gland aka the opposite values Client 4 is neither

The client is prescribed potassium iodide solution before surgery for a subtotal thyroidectomy. Which explanation will the nurse give as to why this medication should be taken? A. The metabolic rate of the body will increase B. It will reduce the risk of hemorrhage during surgery C. It will maintain the functioning of the parathyroid glands D. The amount of thyroid hormones being secreted will decrease

B. Potassium iodide aids in decreasing vascularity of the thyroid gland and decreases the risk for hemorrhage

The nurse is assessing a client with a moon shaped face and thin arms and legs. The nurse expects what other findings? Select all that apply A. Weight loss B. Gastric ulcer C. Pain in bones D. Poor appetite E. Muscle weakness

B., C., E. Cushings causes: gastric ulcer from rise in cortisol bone pain from osteoporosis muscle weakness increase in appetite and weight gain

Which lab test provides evidence consistent with a client having renal impairment? Select all that apply A. Albuminin - 4.7 B. Creatinine - 2.0 C. Potassium - 5.9 D. Cholesterol - 120 E. BUN - 32

B., C., E. Renal impairment is marked by increased creatinine, potassium, and BUN

Which clinical manifestations would the nurse expect to identify in a client with a diagnosis of Cushing syndrome? Select all that apply A. Polyuria B. Truncal obesity C. Hypotension D. Sleep disturbance E. Thin arms and legs

B., D., E. Truncal obesity and thin arms and legs are key features of Cushings. Sleep disturbance is caused by altered diurnal secretion of cortisol. Polyuria is with diabetes mellitus and primary aldosteronism HTN is with Cushings not hypotension