Intracranial Regulation, Digestion, Endocrine - Passpoint

The nurse is caring for a client in the medical unit. The nurse receives a health care provider's order for hydrocortisone 100 mg intravenously at a rate of 10 cc/hour for a client in acute adrenal crisis. The nurse understands that this treatment is common in clients with which disease process?

Addison's disease

The client is to undergo a series of diagnostic tests to determine if the client's cognitive impairment is treatable. Which state can lead to nonreversible cognitive impairment?

Alzheimer's disease

To reduce the risk of dumping syndrome, what should the nurse teach the client to do?

Decrease the carbohydrate content of meals.

Which action should be the priority when caring for a school-age child admitted to the pediatric unit with the diagnosis of Guillain-Barré syndrome?

Evaluate the child's bilateral muscle strength.

A client with peptic ulcer disease is taking ranitidine. What is the expected outcome of this drug?

Limit gastric acid secretion.

What should the nurse teach a client about how to avoid the dumping syndrome? Select all that apply.

Reduce fluids with meals, but take fluids between meals. Obtain adequate amounts of protein and fat with each meal. Eat in a relaxing environment.

After stabilization of Addison's disease, the nurse teaches the client about stress management. What should the nurse instruct the client to do?

Use relaxation techniques such as music.

A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for

decreased body temperature and cold intolerance.

A nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse expects to find

deposits of adipose tissue in the trunk and dorsocervical area.

Which is an expected outcome for a client with Parkinson's disease who has had a pallidotomy?

improved functional ability

A client with Parkinson's disease is prescribed levodopa (L-dopa) therapy. Improvement in which area indicates effective therapy?

muscle rigidity

Which client requires immediate nursing intervention? The client who

presents with a rigid, boardlike abdomen.

A nurse is caring for a client who has left homonymous hemianopsia following a recent cerebral vascular accident (CVA). Which nursing diagnosis should take the highest priority?

risk for injury

An adolescent client scheduled for an emergency appendectomy is to be transferred directly from the emergency department to the operating room. Which statement by the client should the nurse interpret as most significant?

"All of a sudden it does not hurt at all."

To prevent gastroesophageal reflux in a client with hiatal hernia, the nurse should provide which discharge instruction?

"Avoid coffee and alcoholic beverages."

A college student asks the nurse about the student's grandfather, who just received a diagnosis of Huntington's disease. The student wants to know if the student will have the disease too. What should the nurse tell the student? Select all that apply.

"Huntington's disease is an autosomal dominant disease." "Huntington's disease doesn't skip a generation."

Which statement indicates that the client with peptic ulcer disease understands how to effectively adjust the response to work-related stress?

"I will have to improve my ability to cope with stress."

The nurse develops a teaching plan for the client about how to prevent the transmission of hepatitis A. Which discharge instruction is appropriate for the client?

Ask family members to wash their hands frequently.

A nurse is talking to a neighbor who asks about reoccurring symptoms of gnawing epigastric pain following meals and heartburn. Recognizing these symptoms, what suggestion could the nurse make?

Avoid alcohol and nonsteroidal anti-inflammatory medications.

A client with a history of Addison's disease is experiencing weakness and headache. The vital signs are blood pressure of 100/60 and heart rate of 80. Laboratory values are Na 130, potassium 4.8, and blood glucose 70. Which solution would the nurse expect to administer?

I.V. normal saline and glucocorticoids

After teaching a group of schoolteachers about seizures, the teachers role-play a scenario involving a child experiencing a generalized tonic-clonic seizure. Which action, when performed first, indicates that the nurse's teaching has been successful?

Remove any nearby objects that could harm the child.

The client with Cushing's disease needs to modify dietary intake to control symptoms. In addition to increasing protein, which strategy would be most appropriate?

Restrict sodium.

When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect

a blood pressure of 176/88 mm Hg.

Which client should receive the pictured examination first?

a client with facial drooping and left-sided weakness

Which nursing goal is appropriate for the client with hepatitis B? The client will:

adhere to measures to prevent the spread of infection to others.

A nurse is caring for a client who underwent a subtotal gastrectomy. To manage dumping syndrome, the nurse should advise the client to

drink liquids only between meals.

The nurse is teaching the client with Addison's disease to anticipate the need for increased glucocorticoid supplementation. When will the client likely need to increase the dose of glucocorticoids?

having oral surgery

Which outcomes indicate effective management of a conscious client who is being treated with recombinant tissue plasminogen therapy during the initial phase of an ischemic cerebral vascular accident (CVA)? Select all that apply.

headache reduced responds to comfort measures no signs or symptoms of bleeding

A client who has a history of Crohn's disease is admitted to the hospital with fever, diarrhea, cramping, abdominal pain, and weight loss. The nurse should review the client's laboratory reports to determine which potential complication of the client's symptoms?

hypokalemia

The nurse is caring for a client with hypothyroidism. The client notes, "The provider mentioned that I would need to take medication for this condition. What medication will I be prescribed?" What medication does the nurse anticipate the healthcare provider ordering?

levothyroxine

A nurse is assessing the abdomen of a client who was admitted to the emergency department with suspected appendicitis. Identify the area of the abdomen that the nurse would palpate last.

lower right quadrant

The nurse should assess a child with newly diagnosed hyperthyroidism for which signs or symptoms? Select all that apply.

rapid pulse heat intolerance

A female client is being successfully treated for Cushing's syndrome. The nurse should expect a decline in

serum glucose level.

The nurse is assessing a client recovering from a hemorrhagic cerebral vascular accident (CVA) that occurred 7 days ago. Which assessment finding should be reported to the healthcare provider?

worsening headache

Which client statement indicates a need for further instruction about a duodenal ulcer?

"I will need to take an antacid before every meal."

Which client would be considered to be at the highest risk for respiratory failure?

A client with Guillain-Barré syndrome

Which is an initial sign of Parkinson's disease?

tremor

When providing family education for those who have a relative with Alzheimer's disease about minimizing stress, which suggestion is most relevant?

Maintain consistency in environment, routine, and caregivers.

A nurse is teaching a client with adrenal insufficiency about corticosteroids. Which statement by the client indicates a need for additional teaching?

"I may stop taking this medication when I feel better."

The nurse is assessing a client with hepatitis A and notices that the aspartate transaminase (AST) and alanine transaminase (ALT) lab values have increased. Which statement by the client indicates the need for further instruction by the nurse?

"I take acetaminophen for arthritis pain."

A client newly diagnosed with hypothyroidism asks the nurse how long it will be necessary to take the prescribed levothyroxine. What should the nurse tell the client?

"It will be necessary to take the medication for the rest of your life."

The client in the early stage of Alzheimer's disease and his adult son attend an appointment at the community mental health center. While conversing with the nurse, the son states, "I'm tired of hearing about how things were 30 years ago. Why does Dad always talk about the past?" What should the nurse tell the son?

"Your dad lost his short-term memory, but he still has his long-term memory."

The nurse is preparing a client with pheochromocytoma for surgery. What intervention would be appropriate?

Administer propranolol.

The serum calcium level remains low in a client with hypoparathyroidism despite taking calcium supplements. What should the nurse ask the client related to these findings?

Have you been taking vitamin D along with your calcium supplements?

The nurse assesses a client who has Alzheimer's disease. Her hair is dirty; her clothing is soiled and has an odor of urine. What should the nurse do?

Help the client with her bath, allowing her to do as much for herself as she is able.

A client with Parkinson's disease needs a long time to complete morning care, but becomes annoyed when the nurse offers assistance and refuses all help. Which action is the nurse's best initial response in this situation?

Praise the client for the desire to be independent and give extra time and encouragement.

A client diagnosed with peptic ulcer disease has an H. pylori infection. The client is following a 2-week drug regimen that includes clarithromycin along with omeprazole and amoxicillin. How should the nurse instruct the client to take these medications?

Take the drugs for the entire 2-week period.

The nurse is caring for a client with a diagnosis of cerebrovascular accident (CVA) with left-sided hemiparesis. What would be important nursing measures in the acute phase of care? Select all that apply.

Turn and position every 2 hours. Perform passive range of motion on the affected side. Support the affected side with pillows.

In developing a teaching plan for the client with a hiatal hernia, the nurse's assessment of which work-related factors would be most useful?

body mechanics used in lifting

A client is admitted with inflammatory bowel syndrome (Crohn's disease). When planning care for the healthcare team, which would be included? Select all that apply.

corticosteroid therapy antidiarrheal medications

The nurse is caring for a client with possible Cushing's syndrome undergoing diagnostic testing. The health care provider orders lab work and a dexamethasone suppression test. Which parameter would the nurse assess on the dexamethasone suppression test?

cortisol levels before and after the system is challenged with a synthetic steroid

The nurse is obtaining a health history from a client who has a sliding hiatal hernia associated with reflux. The nurse should ask the client about the presence of which symptom?

heartburn

A client has had sucralfate prescribed as treatment for peptic ulcer disease. Which statement indicates that the client understands how to take the medication?

"It's important that I take this drug on an empty stomach."

The nurse is caring for a client who had a cerebrovascular accident (CVA) and needs to be fed. What instruction would the RN give the unlicensed assistive personnel (UAP), who will feed the client?

"Position the client in a sitting position before feeding."

During a home visit, a client who is 75 years of age tells the nurse, "Lately I'm getting forgetful about things. For one thing, I can't remember names. Do you think I'm getting Alzheimer's disease?" Which response by the nurse is the most therapeutic?

"Tell me more about your forgetfulness. It's not unusual for forgetfulness to occur."

The nurse is developing a plan of care for a client with Crohn's disease who is receiving total parenteral nutrition (TPN). Which interventions should the nurse include? Select all that apply.

Weigh the client daily. Monitor the IV infusion rate hourly. Tape all IV tubing connections securely.

A client is seen in the clinic for newly diagnosed hypothyroidism. Which topics should the nurse include in a client teaching plan? Select all that apply.

high-fiber, low-calorie diet use of stool softeners thyroid hormone replacements

A client with severe inflammatory bowel disease is receiving total parenteral nutrition (TPN). When administering TPN, the nurse must take care to maintain the ordered flow rate because giving TPN too rapidly may cause

hyperglycemia.

Before undergoing a subtotal thyroidectomy, a client receives potassium iodide (Lugol's solution) and propylthiouracil (PTU). The nurse should expect the client's symptoms to subside

in 1 to 2 weeks.

A client is recovering from a gastric resection for peptic ulcer disease. Which outcome indicates that the goal of adequate nutritional intake is being achieved 3 weeks following surgery? The client:

increases food intake and tolerance gradually.

he nurse asks a school-age child with Guillain-Barré syndrome to cough and also assesses the child's speech for decreased volume and clarity. The underlying rationale for these assessments is to determine which finding?

involvement of facial and cranial nerves

A nursing coordinator calls the intensive care unit (ICU) to inform the department that a client with a suspected pheochromocytoma will be admitted from the emergency department. The ICU nurse should prepare to administer which drug to the client?

nitroprusside

The nurse is performing the initial assessment on a middle age woman recently diagnosed with Cushing's syndrome. The nurse reviews the history and physical (see chart). The nurse should develop a plan with the client to manage which effects? Select all that apply.

risk for injury slow healing changes in physical appearance risk for infection

When helping the client who has had a cerebrovascular accident (CVA) learn self-care skills, the nurse should:

teach the client to put on clothing on the affected side first.

Which statement indicates to the nurse that the client with Crohn's disease understands the needed nutritional modifications?

"A diet high in vitamins and protein is important."

During preoperative teaching for a client who will undergo subtotal thyroidectomy, the nurse should include which statement?

"You must avoid hyperextending your neck after surgery."

An older adult who has been previously well asks the nurse, "I notice I have tremors. Is this just normal for my age?" What should the nurse tell the client?

"You should report this to the health care provider because it may indicate a problem."

When a client has an acute attack of diverticulitis, what should the nurse do first?

Assess the client for signs of peritonitis.

The nurse is assisting a client from the bed to a chair when the client begins having a generalized seizure. Which action should the nurse take first?

Assist the client to a side-lying position on the floor.

A client had a resection of the terminal ileum 3 years ago. While obtaining a health history and physical assessment, the nurse finds that the client has weakness, shortness of breath, and a sore tongue. Which additional information from the client indicates a need for client teaching?

"I take a vitamin B12 tablet every day."

A client with epilepsy is having a seizure. During the active seizure phase, the nurse should

place the client on their side, remove dangerous objects, and protect their head.

The nurse develops a health education program about preventing the transmission of hepatitis B. The nurse evaluates that the teaching has been effective when the participants identify which activities to be high risk for acquiring hepatitis B?

sharing needles for drug use