Evolve Endocrine

Several hours after administering insulin, the nurse is assessing a client for an adverse response to the insulin. Which client responses are indicative of a hypoglycemic reaction? (Select all that apply.)

Confusion Tremors Diaphoresis

A nurse is caring for a client who is admitted to the hospital with the diagnosis of primary hyperparathyroidism. Which action should be included in this client's plan of care?

Ensuring a large fluid intake

A client is being prepared for discharge from an ambulatory surgical clinic after a cataract extraction and an intraocular lens implant. Which statement indicates to the nurse that the discharge teaching was effective?

I should call the clinic if my eye begins to hurt."

The nurse is caring for a client with rheumatoid arthritis. When should the nurse expect the client to experience increased pain and limited movement of the joints?

In the morning on awakening

The health care provider prescribes propylthiouracil (PTU) for a client with hyperthyroidism. The nurse explains that this drug:

Interferes with the synthesis of thyroid hormone

The nurse is teaching a diabetic client about the advantages of using an insulin pump. What information should the nurse include? (Select all that apply.)

It can improve A1c levels Clients can exercise without eating more carbohydrates

A client with untreated type 1 diabetes mellitus may lapse into a coma because of acidosis. An increase in which component in the blood is a direct cause of this type of acidosis?

Ketones

A client with Ménière disease is advised to eat a sodium-restricted diet to reduce endolymphatic fluid. Which food selection provides evidence that the nurse's teaching was effective?

Macaroni

Which medication should the nurse anticipate will be prescribed to relieve anxiety and apprehension in a client with pulmonary edema?

Morphine

A client has been diagnosed with hyperthyroidism. The nurse expects the client to exhibit which clinical manifestations? (Select all that apply.)

Nervousness Increased appetite

A client has surgery to repair a fractured right hip. Where should the nurse stand when assisting the client to ambulate?

On the client's left side

A client is scheduled for a labyrinthectomy to treat Ménière syndrome. What expected outcome of the procedure should be included in preoperative teaching?

Permanent irreversible deafness

A nurse raises three of four of the client's bedside rails at night. Which psychosocial outcome does the nurse hope to achieve through the use of side rails?

Support a sense of security

Which clinical findings should the nurse expect when assessing a client with hyperthyroidism? (Select all that apply.)

Tachycardia Exophthalmos

A client exhibits blurred and double vision with muscular weakness, and diagnostic tests are prescribed. The client is informed that a diagnosis of multiple sclerosis (MS) has been made. The client becomes visibly upset. How should the nurse respond?

That must have really shocked you. Tell me what the health care provider told you about it."

A client with hyperthyroidism asks the nurse about the tests that will be prescribed. Which diagnostic tests should the nurse include in a discussion with this client?

Thyroid stimulating hormone (TSH) assay and triiodothyronine (T3)

A client is taught how to recognize indications of a hypoglycemic reaction. Which signs and symptoms identified by the client indicate to the nurse that the teaching was effective? (Select all that apply.)

Weakness Nervousness Increased perspiration

The health care provider prescribes daily fasting blood glucose levels for a client with diabetes mellitus. The goal of treatment is that the client will have glucose levels within the range of:

70 to 105 mg/dL of blood

A male client with a brain attack (cerebrovascular accident) has regained control of bowel movements but still is incontinent of urine. To help reestablish bladder control, the nurse should encourage the client to:

Assume a standing position for voiding

A nurse teaches a client who has had a thyroidectomy for thyroid cancer to observe for signs of surgically induced hypothyroidism. What should be included in the teaching plan? (Select all that apply.)

Dry skin Lethargy Sensitivity to cold

While a nurse is teaching a client with diabetes about food choices, the client states, "I do not like broccoli." The nurse suggests that a food that can be substituted for the broccoli is:

Green beans

A client has a tentative diagnosis of Cushing syndrome. The nurse's physical assessment of this client is likely to reveal the presence of:

Hypertension and moon face

Clients who have casts applied to the lower extremities must be monitored for complications. Which finding during assessment of the extremities of these clients is indicative of a complication? (Select all that apply.)

Numbness Prolonged capillary refill

The nurse is caring for a client who has undergone a total hip replacement. The nurse recognizes which clinical manifestations indicate a pulmonary embolism. (Select all that apply.)

Unilateral chest pain Sudden onset of shortness of breath

A nurse identifies that the client is experiencing a hypoglycemic reaction. Which nursing intervention should the nurse implement to relieve the symptoms associated with this reaction?

give 4 oz of fruit juice

A nurse is caring for an anxious, fearful client. Which client response indicates sympathetic nervous system control?

Skin pallor

A nurse mixes a short-acting and an intermediate-acting insulin in the same syringe to administer to a client with diabetes. List the actions in the order the nurse should perform them.

1.Put air into the intermediate-acting insulin vial. 2.Put air into the short-acting insulin vial. 3.Withdraw the prescribed amount of short-acting insulin. 4.Withdraw the prescribed amount of intermediate-acting insulin. 5.Don a pair of clean gloves

What should the nurse take into consideration when planning nursing care for a client experiencing an acute episode of rheumatoid arthritis?

Bony ankylosis of a joint is irreversible and causes immobility

A urine specimen is needed to test for the presence of ketones in a client who is diabetic. What should the nurse do when collecting this specimen from a urinary retention catheter?

Clamp the catheter, cleanse the port, and use a sterile syringe to remove urine.

A nurse is caring for a client admitted to the hospital for diabetic ketoacidosis. Which clinical findings related to this event should the nurse document in the client's clinical record? (Select all that apply.)

Acetone breath Decreased arterial carbon dioxide level

A client experiences a traumatic brain injury. Which finding identified by the nurse indicates damage to the upper motor neurons?

Babinski response

When caring for a client with a head injury that may have involved the medulla, the nurse bases assessments on the knowledge that the medulla controls a variety of functions. (Select all that apply.).

Breathing Pulse rate

A client with glaucoma asks a nurse about future treatment and precautions. What information should the nurse's explanation include?

Continuation of therapy for life

A client with myasthenia gravis is receiving pyridostigmine bromide (Mestinon) to control symptoms. Recently, the client has begun experiencing increased difficulty in swallowing. What nursing action is most effective in preventing aspiration of food?

Coordinate meal times with the peak effect of the medication

A client with Cushing syndrome asks why a low-sodium, high-potassium diet has been prescribed. The nurse explains that

Excessive aldosterone and cortisone cause the retention of sodium and loss of potassium

A nurse is performing range-of-motion exercises with a client who had a brain attack (stroke). The nurse places the client's hand in the position exhibited in the picture. This position is known as:

Extension

The nurse has provided teaching to a client with impaired balance who uses a walker when ambulating. The nurse observes the client transferring from a sitting to a standing position and using the walker. The nurse evaluates that further teaching is required when the client:

Holds both handles of the walker while rising to the standing position

A nurse teaches self-care to a client who had a cast applied for a fracture of the right ulna and radius. The nurse instructs the client to notify the primary health care provider immediately if the client experiences:

Increasing pain at the injury site

A client is admitted to the hospital with a diagnosis of diabetic ketoacidosis. What is the initial intervention that the nurse should expect the health care provider to prescribe for this client?

Intravenous (IV) fluids

A client has a brain attack (cerebrovascular accident [CVA]) that involves the right cerebral cortex and cranial nerves. What areas of paralysis should the nurse expect the client to exhibit? (Select all that apply.)

Left leg Left arm

Which clinical indicator does a nurse identify when assessing a client with hemiplegia?

Paralysis of one side of the body

A client has a compound fracture of the femur. The nurse should assess the client for the typical signs and symptoms of a fat embolus. In comparison to thromboembolism, which clinical indicator is unique to a fat embolus?

Pinpoint red spots on the chest

What should a nurse do immediately when a client returns from the post-anesthesia care unit following a subtotal thyroidectomy?

Place a tracheostomy set at the bedside.

A client has a shoulder immobilizer after surgical repair of a fractured humerus. What should be included in the nurse's instruction to the client about the appropriate use of the immobilizer?

Release the wristband to exercise the forearm and hand routinely

A client is admitted to the hospital with a diagnosis of acute Guillain-Barré syndrome. What frequent assessment does the nurse determine is most important for a client with this syndrome?

Respiratory exchange

A client is diagnosed with Parkinson disease and receives a prescription for levodopa (L-dopa) therapy. The nurse concludes that the medication is appropriate for this client because it:

Restores the dopamine levels in the brain

A client who is taking an oral hypoglycemic daily for type 2 diabetes develops the flu and is concerned about the need for special care. What should the nurse advise the client?

Take the oral medication, drink fluids, and monitor capillary glucose levels.

A client who has a long leg cast for a fractured bone is to be discharged from the emergency department. When discussing pain management, the nurse should advise the client to take the prescribed as needed oxycodone and acetaminophen (Percocet):

When the discomfort begins

The nurse is providing immediate postoperative care to a client who had a thyroidectomy. The nurse should monitor the client for which clinical manifestation?

Signs of respiratory obstruction

A client has rotator cuff surgery. What should be included when the nurse performs a neurovascular assessment of the affected extremity immediately after surgery? (Select all that apply.)

Skin color Movement of the hand Sensations in the extremity

A client who had a tonic-clonic seizure of unknown etiology is to begin taking phenytoin (Dilantin). The nurse should instruct the client to:

Brush the teeth and gums three times daily