Med surg 2 Quiz 2 practice questions
During routine health screening, a patient is found to have fasting plasma glucose (FPG) of 132 mg/dL (7.33 mmol/L). At a follow-up visit, a diagnosis of diabetes would be made based on which lab results (select all that apply) a. A1C of 7.5% b. glycosuria for 3+ c. FPG greater than or equal to 126 mg/dL (7.0 mmol/L) d. random blood glucose of 126 mg/dL (7.0 mmol/L) e. a 2 hour oral glucose tolerance test (OGTT) of 190 mg/dL (10.5 mmol/L)
a. A1C of 7.5% c. FPG greater than or equal to 126 mg/dL (7.0 mmol/L)
what characterizes type 2 diabetes? select all that apply a. B cell exhaustion b. insulin resistance c. genetic predisposition d. altered production of adipokines e. inherited defect in insulin receptors f. inappropraite glucose production by the liver
a. B cell exhaustion b. insulin resistance c. genetic predisposition d. altered production of adipokines e. inherited defect in insulin receptors f. inappropraite glucose production by the liver
During discharge teaching of a patient with Addisons disease, which statement by the patient indicates that the nurse needs to do additional teaching? a. I should always call the doctor if I develop vomiting or diarrhea b. if my weight goes down, my dosage of steroid is probably too high c. i should double or trip my steroid dose if i undergo rigorous physical activity d. i need to carry an emergency kit with injectable hydrocortisone in case i cant take my medication by mouth
a. I should always call the doctor if I develop vomiting or diarrhea
what is hte effect of finasteride (proscar) in the treatment of BPH a. a reduction in the size of the prostate gland b. relaxation of the smooth muscle and the urethra c. increased bladder tone that promotes bladder emptying d. relaxation of the bladder detrusor muscle promoting urine flow
a. a reduction in the size of the prostate gland
When caring for a patient with metabolic syndrome, what should the nurse give the highest priority to teach the patient about? a. achieving a normal weight b. performing daily aerobic exercise c. eliminating red meat from the diet d. monitoring blood glucose periodically
a. achieving a normal weight
The client diagnosed with type 1 diabetes is found lying unconscious on the floor of the bathroom. Which intervention should the nurse implement first? a. administer 50% dextrose IVP b. notify the HCP c. move the client to the ICU d. check the serum glucose level
a. administer 50% dextrose IVP dextrose is only given if the client is found unconscious and the nurse suspect hypoglycemia. This will arouse the patient immediately
The nurse is planning care for a client diagnosed with Addisons disease. Which intervention should be included? a. administer steroid medications b. place the client on fluid restriction c. provide frequent stimulation d. consult physical therapy for gait training
a. administer steroid medications
A patient with diabetes calls the clinic because she is experiencing nausea and flu like symptoms. Which advice from the nurse will be the best for this patient? a. administer the usual insulin dosage b. hold fluid intake until the nausea subsides c. come to the clinic immediately for evaluation and treatment d. monitor the blood glucose everyone one to two hours and call if it rises over 150 mg/dL (8.3 mmol/L)
a. administer the usual insulin dosage
the home health nurse is completing the admission assessment for a 76 year old client diagnosed with type 2 diabetes controlled with 70/30 insulin. Which intervention should be included in the plan of care a. assess the clients ability to read small print b. monitor the clients serum pt level c. teach the client how to perform a hemoglobin A1C test daily d. instruct the client to check the feet weekly
a. assess the clients ability to read small print
The client is diagnosed with hypothyroidism. Which s/s 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 profused sweating and flushed skin d. tetany and complaints of stiffness of the hands
a. complaints of extreme fatigue and hair loss
The nurse identifies the client problem "risk for imbalance body temp" for a client diagnosed with hypothyroidism. which intervention should be included in the plan of care? a. discourage the use of an electric blanket b. assess the clients temp q2h c. keep the room temp cool d. space activities to promote rest
a. discourage the use of an electric blanket
individualized nutrition therapy for patients using conventional, fixed insulin regimens should include teaching the patient to a. eat regular meals at regular times b. restrict calories to promote moderate weight loss c. eliminate sucrose and other simple sugars from the diet d. limit saturated fat intake to 30% of dietary calorie intake
a. eat regular meals at regular times
what pre op instructions should the nurse give to the patient scheduled for a subtotal thyroidectomy? a. how to support the head with the hands when turning in bed b. coughing should be avoided to prevent pressure on the incision c. head and neck will need to remain immobile until the incision heals d. any tingling around the lips or in the fingers after surgery is expected and temporary
a. how to support the head with the hands when turning in bed
The nurse is performing discharge teaching for a client diagnosed with cushings disease. Which statement by the client demonstrates an understanding of the instructions? a. i will be sure to notify my HCP if i start to run a fever b. before i stop taking the prednisone, i will be taught how to taper it off c. if i get weak and shaky, i need to eat some hard candy or drink some juice d. it is fine if i continue to participate in weekend games of tackle football
a. i will be sure to notify my HCP if i start to run a fever
The elderly client is admitted to the intensive care department diagnosed with severe HHNS. which collaborative intervention should the nurse include in the plan of care? a. infuse 0.9% normal saline IV b. administer intermediate-acting insulin c. perform a blood glucometer cheeks daily d. monitor arterial blood gas results
a. infuse 0.9% normal saline IV
A 72 year old woman is diagnosed with diabetes. What does the nurse recognize about the management of diabetes in the older adult? a. it is more difficult to achieve strict glucose control than in younger patients b. it usually is not treated unless the patient becomes severely hyperglycemic c. it does not include treatment with insulin because of limited dexterity and vision d. it usually requires that a younger family member be responsible for care of the patient
a. it is more difficult to achieve strict glucose control than in younger patients
The nurse is teaching the patient with prediabetes ways to prevent or delay the development of type two diabetes. What information should be included (select all that apply). a. maintain a healthy weight b. exercise for 60 minutes each day c. have BP checked regularly d. assess for visual changes on monthly basis e. monitor for polyuria, polyphagia, and polydipsia
a. maintain a healthy weight e. monitor for polyuria, polyphagia, and polydipsia
the client is admitted to the ICU diagnosed with DKA. Which intervention should the nurse implement? select all that apply a. maintain adequate ventilation b. assess fluid volume status c. administer IV potassium d. check for urinary ketones e. monitor intake and output
a. maintain adequate ventilation b. assess fluid volume status c. administer IV potassium d. check for urinary ketones e. monitor intake and output
the nurse is teaching the client diagnosed with hyperthyroidism. which information should be taught to the client? select all that apply a. notify the HCP if a 3 pound weight loss occurs in 2 weeks b. discuss ways to cope with the emotional liability c. notify the HCP if taking OTC meds d. carry a medical information card or bracelet e. teach how to take thyroid meds correctly
a. notify the HCP if a 3 pound weight loss occurs in 2 weeks b. discuss ways to cope with the emotional liability c. notify the HCP if taking OTC meds d. carry a medical information card or bracelet
Which characteristics describe the use of RAI (select all that apply)? a. often causes hypothyroidism b. decreases release of thyroid hormones c. block peripheral conversion of T4 to T3 d. treatment of choice in nonpregnant adults e. decreases thyroid secretion by damaging thyroid gland f. often used with iodine to produce euthyroid before surgery
a. often causes hypothyroidism d. treatment of choice in nonpregnant adults e. decreases thyroid secretion by damaging thyroid gland
The client diagnosed with addisons disease is admitted to the ED after a day at the lake. The client is lethargic, forgetful, and weak. Which intervention should the nurse implement? a. start an IV with an 18 gauge needle and infuse NS rapidly b. have the client wait in the waiting room until a bed is available c. obtain a permit for the client to receive a blood transfusion d. collect urinalysis and blood samples for a CBC and calcium level
a. start an IV with an 18 gauge needle and infuse NS rapidly
The patient with type 2 diabetes is being put on acarbose (precose) and wants to know why she is taking it. What should the nurse include in this patients teaching (select all that apply) a. take it with the first bite of each meal b. it is not used in patients with HF c. endogenous glucose production is decreased d. effectiveness is measured by 2 hour postprandial glucose e. it delays glucose absorption from the GI tract
a. take it with the first bite of each meal d. effectiveness is measured by 2 hour postprandial glucose e. it delays glucose absorption from the GI tract
the diabetic educator is teach a class on diabetes type 1 and is discussing sick-day rules. Which intervention should the diabetes educator include in the discussion? select all that apply a. take the diabetic medication even if unable to eat the clients normal diabetic diet b. if unable to eat, drink liquids equal to the clients normal caloric diet c. if is not necessary to notify the HCP if ketones are in the urine d. test blood glucose levels and test urine ketones once a day and keep a record e. call the HCP if glucose levels are higher than 180 mg/dL
a. take the diabetic medication even if unable to eat the clients normal diabetic diet b. if unable to eat, drink liquids equal to the clients normal caloric diet e. call the HCP if glucose levels are higher than 180 mg/dL
what accurately describes prostate cancer detection and/or treatment (select all that apply) a. the symptoms of pelvic or perineal pain, fatigue, and malaise be may be present b. palpation of the prostate reveals hard and asymmetric enlargment with areas of induration or nodules c. orchiectomy is a treatment option for all patients with prostatic cancer except those with stage IV tumors d. the preferred hormonal therapy for treament of prostate cancer includes estrogen and androgen receptor blockers e. early detection of cancer of the prostate is incrased with annual rectal examination and serum prostatic acid phosphatase (PAP) measurememts f. an annul prostate examination is recommended starting at age 45 for African American men because of the increased mortality rate from prostatic cancer in this population
a. the symptoms of pelvic or perineal pain, fatigue, and malaise be may be present b. palpation of the prostate reveals hard and asymmetric enlargment with areas of induration or nodules f. an annul prostate examination is recommended starting at age 45 for African American men because of the increased mortality rate from prostatic cancer in this population
4.Which statement by the patient with type 2 diabetes is accurate? a."I am supposed to have a meal or snack if I drink alcohol." b."I am not allowed to eat any sweets because of my diabetes." c."I do not need to watch what I eat because my diabetes is not the bad kind." d."The amount of fat in my diet is not important. Only carbohydrates raise my blood sugar."
a."I am supposed to have a meal or snack if I drink alcohol."
8.Which are appropriate therapies for patients with diabetes mellitus (select all that apply)? a.Use of statins to treat dyslipidemia b.Use of diuretics to treat nephropathy c.Use of ACE inhibitors to treat nephropathy d.Use of serotonin agonists to decrease appetite e.Use of laser photocoagulation to treat retinopathy
a.Use of statins to treat dyslipidemia c.Use of ACE inhibitors to treat nephropathy e.Use of laser photocoagulation to treat retinopathy
A patient with Addisons disease comes to the ER with complains of n/v, diarrhea, and fever. What collaborative care should the nurse expect? a. IV administration of vasopressors b. IV administration of hyrocortisone c. IV administration of D5W with 20 mEq KCl d. parenteral injections of adnreocorticotropic hormone (ACTH)
b. IV administration of hyrocortisone
Which therapies for BPH are done on an outpatient basis? (select all that apply) a. intraprostatic urethral stents b. TUNA c. TUIP d. TUMT e. VLAP
b. TUNA c. TUIP d. TUMT
A patient with continuous bladder irrigation following a prostatectomy tells the nurse that he has bladder spasms and leaking of urine around the catheter. What should the nurse do first? a. slow the rate of the irrigation b. assess the patency of the catheter c. encourage the patient to try and urinate around the catheter d. administer a belladonna and opium (B&O) suppository as prescribed
b. assess the patency of the catheter
What medication is used with thyrotoxicosis to block the effects of the sympathetic nervous stimulation of the thyroid hormones? a. potassium iodine b. atenolol (tenormin) c. Propylthiouracil (PTU) d. radioactive iodine (RAI)
b. atenolol (tenormin)
Which class of oral glucose-lowering agents is most commonly used for people with type 2 diabetes because is reduces hepatic glucose production and enhances tissue uptake of glucose? a. insulin b. biguanide c. meglitinide d. sulfonylurea
b. biguanide
The following interventions are planned for a diabetic patient. Which intervention can the nurse delegate to unlicensed assistive personnel (UAP) a. discuss complications of diabetes b. check the bath water is not too hot c. check the patients technique for drawing up insulin d. teach the patient to use a meter for self-monitoring of blood glucgose
b. check the bath water is not too hot
When teaching the patient with diabetes about insulin administration, the nurse should include which instruction for the patient? a. pull back on the plunger after inserting the needle to check for blood b. consistently use the same size of insulin syringe to avoid dosing errors c. clean the skin at the injection site with an alcohol swab before each injection d. rotate the infection sites from arms to thighs to abdomen with each injection to prevent lipodystrophies
b. consistently use the same size of insulin syringe to avoid dosing errors
what disorders and diseases are related to macrovascular complications of diabetes? select all that apply a. chronic kidney disease b. coronary artery disease c. microaneurysms and destruction or retinal vessels d. ulceration and amputation of the lower extremities e. capillary and arteriole membrane thickening specific to diabetes
b. coronary artery disease d. ulceration and amputation of the lower extremities
The pt with diabetes has been diagnosed with autnomic neurupathy. What problems should the nurse expect to find in the patient (select all that apply) a. painless foot ulcers b. erectile dysfunction c. burning foot pain at night d. loss of fine motor control e. vomiting undigested food f. painless myocardial infarction
b. erectile dysfunction e. vomiting undigested food f. painless myocardial infarction
the client with type 2 diabetes controlled with biguanide oral diabetic medication is scheduled for a CT scan with contrast of the abdomen to evaluate pancreatic function. Which intervention should the nurse implement? a. provide a high-fat diet 24 hour prior to test b. hold the biguanide med for 48 hours prior to test c. obtain an informed consent form for the test d. administer pancreatic enzymes prior to the test
b. hold the biguanide med for 48 hours prior to test
A patient has a right urethral catheter placed following a lithotripsy for a stone in the ureter. IN caring for the patient after the procedure, what is an appropriate nursing action a. milk or strip the catheter every 2 hours b. measure uretheral urinary drainage every 1 to 2 hours c. irrigate the catheter with 30 mL sterile saline every 4 hours d. encourage ambulation to promote urinary peristaltic action
b. measure uretheral urinary drainage every 1 to 2 hours
What should the goals of nutrition therapy for the patient with type two diabetes include? a. ideal body weight b. normal serum glucose and lipid levels c. a special diabetic diet using dietetic foods d. five small meals per day with a bedtime snack
b. normal serum glucose and lipid levels
The UAP on the medical floor tells the nurse the client diagnosed with DKA wants something else to eat for lunch. Which intervention should the nurse implement? a. instruct the UAP to get the client additional food b. notify the dietician about the clients request c. request the HCP increase the clients caloric intake d. tell the UAP the client cannot have anything else
b. notify the dietician about the clients request
The client is admitted to rule out cushings syndrome. Which lab tests should the nurse anticipate being ordered? a. plasma drug levels of quinidine, digoxin, and hydralazine b. plasma levels of ACTH and cortisol c. a 24 hour urine for metanephrine and catecholamine d. spot urine for creatinine and WBC
b. plasma levels of ACTH and cortisol
In type 1 diabetes there is an osmotic effect of glucose when insulin deficiency prevents the use of glucose for energy. Which classic symptom is caused by the osmotic effect of glucose? a. fatigue b. polydipsia c. polyphagia d. recurrent infections
b. polydipsia
why are the hormones cortisol, glucagon, epinephrine, and growth hormone referred to as counter regulatory hormones? a. decrease glucose production b. stimulate glucose output by the liver c. increase glucose transport into the cells d. independently regulate glucose level in the blood
b. stimulate glucose output by the liver
in providing care for the patient with adult-onset polycystic kidney disease, what should the nurse do? a. help the patient cope with the rapid progression of the disease. b. suggest genetic counseling resources for the children of the patient c. expect the pt to have polyuria and poor concentration ability of the kidneys d. implement measures for the pt deafness and blindness in addition to renal prboblems
b. suggest genetic counseling resources for the children of the patient
The client has developed cushings disease. What statement is the scientific rationale for the development of this diagnosis? a. the client has an autoimmune problem causing the destruction of the adrenal cortex b. the client has been taking steroid meds for an extended period for another diseases process c. the client has a pituitary gland tumor causing the adrenal glands to produce too much cortisol d. the client has developed an adrenal gland problem for which the HCP does not have an explanation
b. the client has been taking steroid meds for an extended period for another diseases process
which treatment for BPH uses low-wave radiofreqency to precisely destroy prostate tissue? a. laster prostatectomy b. transurethral needle ablation (TUNA) c. tranurethral microwave thermotherapy (TUMT) d. Transurethral electrovaporization of prostate (TUVP)
b. transurethral needle ablation (TUNA)
1.Polydipsia and polyuria related to diabetes mellitus are primarily due to a.the release of ketones from cells during fat metabolism. b.fluid shifts resulting from the osmotic effect of hyperglycemia. c.damage to the kidneys from exposure to high levels of glucose. d.changes in RBCs resulting from attachment of excessive glucose to hemoglobin.
b.fluid shifts resulting from the osmotic effect of hyperglycemia.
What describes the primary difference in treatment of DKA and hyperosmolar hyperglycemia syndrome (HHS) a. DKA requires administration of bicarbonate to correct acidosis b. potassium replacement is not necessary in management of HHS c. HHS requires greater fluid replacement to correct the dehydration d. administration of glucose is withheld in HHS until the blood glucose reaches a normal level
c. HHS requires greater fluid replacement to correct the dehydration
A patient asks the nurse what the difference is between BPH and prostate cancer. the best response by the nurse includes what information about BPH? a. BPH is a benign tumor that does not spread beyond the prostate gland. b. BPH is a precursor to prostate cancer but does not yet show any malignant changes c. BPH is an enlargement of the glandd caused by an increased in the size of existing cells d. BPH is a benign enlargement of the gland caused by an increase in the number of normal cells
d. BPH is a benign enlargement of the gland caused by an increase in the number of normal cells
In addition to promoting the transport of glucose from the blood into the cell, what does insulin do? a. enhances the breakdown of adipose tissue for energy b. stimulates hepatic glycogenolysis and gluconeogenesis c. prevents the transport of triglycerides into adipose tissue d. accelerates the transport of amino acids into cells and their synthesis into protein
d. accelerates the transport of amino acids into cells and their synthesis into protein
Which statement made by the client makes the nurse suspect the client is experiencing hyperthyroidism a. i just don't seem to have any appetite anymore b. i have a BM about every 3-4 hours c. my skin is really becoming dry and coarse d. i have noticed all my collars are getting tigher
d. i have noticed all my collars are getting tigher
following the teaching of foot care to a diabetic patient, the nurse determines that additional instruction is needed when the patients make which statement? a. I should wash my feet daily with soap and warm water b. i should always wear shoes to protect my feet from injury c. if my feet are cold, i should wear socks instead of using a heating pad d. ill know if i have sores or lesions on my feet because it will be painful
d. ill know if i have sores or lesions on my feet because it will be painful
The nurse determines that a patient with a 2 hour OGTT of 152 mg/dL has a. diabetes b. elevated A1C c. impaired fasting glucose d. impaired glucose tolerance
d. impaired glucose tolerance
A patient with Graves disease asks the nurse what caused the disorder. What is the best response by the nurse? a. the cause of graves disease is not known, although it is thought to be genetic b. it is usually associated with goiter formation from an iodine deficiency over a long period of time c. antibodies develop against thyroid tissue and destroy it, causing a deficiency of thyroid hormones d. in genetically susceptible persons, antibodies are formed that cause excessive thyroid hormone secretion
d. in genetically susceptible persons, antibodies are formed that cause excessive thyroid hormone secretion
The home care nurse should intervene to correct a patient whose insulin administration includes a. warming a prefilled refrigerated syringe in the hands before administration b. storing syringes prefilled with NPH and regular insulin needle-up in the refrigerator c. placing the insulin bottle currently in use in a small container on the bathroom countertop d. mixing an evening dose of regular insulin with insulin glargine in one syringe for administration
d. mixing an evening dose of regular insulin with insulin glargine in one syringe for administration
The client diagnosed with HHNS was admitted yesterday with a blood glucose level of 780 mg/dL. The clients blood glucose level is now 300 mg/dL. Which intervention should the nurse implement? a. increase the regular insulin IV drip b. check the patients urine for ketones c. provide the client with a therapeutic diabetic meal d. notify the HCP to obtain an order to decrease insulin
d. notify the HCP to obtain an order to decrease insulin
which arterial blood gas results should.d the nurse expect in the client diagnosed with DKA a. pH 7.34, PaO2 99, PaCO2 48, HCO3 24 b. pH 7.38, PaO2 95, PaCO2 40, HCO3 22 c. pH 7.46, PaO2 85, PaCO2 30, HCO3 18 d. pH 7.30, PaO2 90, PaCO2 30, HCO3 18
d. pH 7.30, PaO2 90, PaCO2 30, HCO3 18
A patient with subprapubic pain and symptoms of urinary frequency and urgency have two negative urine cultures. What is one assessment finding that would indicate interstitial cystitis? a. residual urine greater than 200 mL b. a large, atonic bladder on urodynamic testing c. a voiding pattern that indicates psychogenic urinary retention d. pain with bladder filling that is transiently relieved by urination
d. pain with bladder filling that is transiently relieved by urination
the nurse is discussing the importance of exercising with a client diagnosed with type 2 diabetes who diabetes is well controlled with diet and exercise. Which information should the nurse include in the teaching about diabetes? a. eat a simple carb snack before exercising b. carry peanut butter crackers when exercising c. encourage the client to walk 20 minutes three times a week d. perform warm up and cool down exercises
d. perform warm up and cool down exercises
Which nursing intervention should be included in the plan of care for the client diagnosed with hyperthyrodism a. increase the amount of fiber in the diet b. encourage low cal, low protein diet c. decrease the clients fluid intake to 1000 mL/day d. provide 6 small, well balanced meals per day
d. provide 6 small, well balanced meals per day
Prevention of calcium oxalate stones would include dietary restrictions of which food or drinks? a. milk and milk products b. dried beans and dried fruit c. liver, kidney, and sweetbreads d. spinach, cabbage, and tomatoes
d. spinach, cabbage, and tomatoes
When providing discharge instruction for a patient who had a subtotal thyroidectomy for hyperthyroidism, what should the nurse teach the patient? a. never miss a daily dose of thyroid replacement therapy b. avoid regular exercise until thyroid function is normalized c. use warm saltwater gargles several times a day to relive throat pain d. substantially reduced caloric intake compared to what was eaten before surgery
d. substantially reduced caloric intake compared to what was eaten before surgery
What test is required for a diagnosis of pyelonephritis? a. renal biopsy b. blood culture c. intravenous pyelogram (IVP) d. urine for culture and sensitivity
d. urine for culture and sensitivity
When caring for the patient with interstitial cystitis, what can the nurse teach the patient to do? a. avoid foods that make the urine more alkaline b. use high-potency vitamin therapy to decrease the autoimmune effects of the disorder c. always keep a voiding diary to document pain, voiding frequency, and patterns of nocturia d. use the dietary supplement calcium glycerophosphate (prelief) to decrease bladder irritation.
d. use the dietary supplement calcium glycerophosphate (prelief) to decrease bladder irritation.
2.Which statement would be correct for a patient with type 2 diabetes who was admitted to the hospital with pneumonia? a.The patient must receive insulin therapy to prevent ketoacidosis. b.The patient has islet cell antibodies that have destroyed the pancreas's ability to produce insulin. c.The patient has minimal or absent endogenous insulin secretion and requires daily insulin injections. d.The patient may have sufficient endogenous insulin to prevent ketosis but is at risk for hyperosmolar hyperglycemic syndrome.
d.The patient may have sufficient endogenous insulin to prevent ketosis but is at risk for hyperosmolar hyperglycemic syndrome.
A patient who is on corticosteroid therapy for treatment of an autoimmune disorder has the following additional drugs ordered. Which on is used to prevent corticosteroid-induced osteoporosis a. potassium b. fursemide (Lasix) c. alendronate (Foxamax) d. pantoprazole (Protonix)
c. alendronate (Foxamax)
The nurse should observe the patient for symptoms of ketoacidosis when a. illness causing nausea and vomiting lead to bicarbonate loss with body fluids b. glucose levels become so high that osmotic diuresis promotes fluid and electrolyte loss c. an insulin deficit causes the body to metabolize large amounts of fatty acids rather than glucose for energy d. the patient skips meals after taking insulin, leading to rapid metabolism of glucose and breakdown of fats for energy
c. an insulin deficit causes the body to metabolize large amounts of fatty acids rather than glucose for energy
The client diagnosed with type 2 diabetes is admitted to the intensive care unit with hyperosmolar hyperglycemia nonketonic syndrome (HHNS) coma. Which assessment data should the nurse expect the client to exhibit? a. Kussmauls respiration b. kiarrhea and epigastric pain c. dry mucous membranes d. ketones breath odor
c. dry mucous membranes
A patient is admitted to the hospital with thyrotoxicosis. On physical assessment of the patient, what should the nurse expect to find? a. hoarsness and laryngeal stridor b. bulging eyeball and dysrhythmias c. elevated temp and signs of HF d. lethargy progressing suddenly to impairment of consciouness
c. elevated temp and signs of HF
The client with cushings disease has undergone a unilateral adrenalectomy. Which discharge instructions should the nurse discuss with the client? a. instruct the client to take the glucocorticoid and mineralocorticoid meds as prescribed b. teach the client regarding sexual functioning and androgen replacement therapy c. explain the s/s of infection and when to call the HCP d. demonstrate turn, cough, and deep breathing exercises the client should perform q2h
c. explain the s/s of infection and when to call the HCP
The client received 10 units of Humulin R, a fast actign insulin, at 0700. At 1030 the UAP tells the nurse the client has a headache and is really acting "funny." Which intervention should the nurse implement first? a. Instruct the UAP to obtain the blood glucose level b. Have the client drink 8 oz of orange juice c. go to the clients room and assess the client for hypoglycemia d. prepare to administer 1 ampule 50% dextrose IV
c. go to the clients room and assess the client for hypoglycemia
The emergency department nurse is caring for a client diagnosed with HHNS who has a blood glucose of 680 mg.dL. Which question should the nurse ask the client to determine the cause of this acute complication a. when is the last time you took your insulin b. when did you have your last meal c. have you had some type of infection lately d. how long have you had diabetes
c. have you had some type of infection lately
on admission to the ambulatory surgical center, a patient with BPH informs the nurse that he is going to have a laser treatment of his enlarged prostate. The nurse plans patient teaching with the knowledge that the patient will need to know what? a. the effects of general anesthesia b. the possibility of short term incontenence c. home management of an indwelling catheter d. monitoring for postop urinary retention
c. home management of an indwelling catheter
The patient with newly diagnosed diabetes is displaying shakiness, confusion, irritability, and slurred speech. What should the nurse suspect is happening a. DKA b. HHS c. hypoglycemia d. hyperglycemia
c. hypoglycemia
A patient is scheduled for a bilateral adrenalectomy. During the post op period, what should the nurse expect related to the administration of corticosteriods? a. reduced to promote wound healing b. withheld until symptoms of hypocortisolism appear c. increased to promote an adequate response to the stress of surgery d. reduced because excessive hormones are released during surgical manipulation of adrenal glands
c. increased to promote an adequate response to the stress of surgery
A patient with mild iatrogenic cushing syndrome is on an alternate-day regimen of corticosteroid therapy. What does the nurse explain to the patient about this regimen? a. it maintains normal adrenal hormone balance b. it prevents ACTH release from the pituitary gland c. it minimizes hypothalmic pituitary adrenal supression d. it provides a more effective therapeutic effect of the drug
c. it minimizes hypothalmic pituitary adrenal supression
A patient taking insulin has recorded fasting glucose levels above 200 mg/dL (11.1 mmol/L) on awakening for the last five mornings. What should the nurse advise the patient to do first? a. increase the evening insulin dose to prevent the dawn phenomenon b. use a single-dose insulin regimen with an intermediate acting insuling c. monitor the glucose level at bedtime, between 2 AM and 4 AM, and on arising d. decrease the evening insulin dosage to prevent night hypoglycemia and the Somogyi effect
c. monitor the glucose level at bedtime, between 2 AM and 4 AM, and on arising
when caring for a patient following a radical prostectomy with a perineal approach, what is the priority nursing intervention the nurse should use to prevent complications? a. use the chemotherapeutic agents to prevent metastasis b. administer sildenafil (viagra) as needed for erectile dysfunction c. provide wound care after each bowel movement to prevent infection d. insert a small indwelling urinary catheter to prevent urinary retention
c. provide wound care after each bowel movement to prevent infection
The nurse is assessing a newly admitted diabetic patient. Which observation should be addressed as the priority by the nurse? a. bilateral numbness of both hands b. stage II pressure ulcer on the right heel c. rapid respiration with deep inspirations d. areas of lumps and dents on the abdomen
c. rapid respiration with deep inspirations
The charge nurse is making client assignments in the ICU. Which client should be assigned to the most experienced nurse? a. the client with type 2 diabetes who has a blood glucose level of 348 mg/dL b. the client diagnosed with type 1 diabetes who is experiencing hypoglycemia c. the client with DKA who has multifocal premature ventricular contractions d. the client with HHNS who has a plasma osmolarity of 290 mOsm/L
c. the client with DKA who has multifocal premature ventricular contractions
The client diagnosed with hypothyroidism is prescribed the thyroid hormone levothyroxine (synthroid). Which assessment data indicate the med has been effective? a. the client has a 3 pound weight gain b. the client has a decreased pulse rate c. the clients temp is WNL d. the client denies any diaphoresis
c. the clients temp is WNL
The nurse is preparing to administer the following meds. Which med should she question a. the thyroid hormone to the client who does not have a T3 or T4 level b. the regular insulin to the client with a blood glucose level of 210 mg/dL c. the loop diuretic with a potassium level of 3.3 mEq/L d. the cardiac glycoside to the client who has a digoxin level of 1.4 mg/dL
c. the loop diuretic with a potassium level of 3.3 mEq/L
What is the most common cause of acute pyelonephritis resulting from an ascending infection from the lower urinary tract? a. the kidney is scarred and fibrotic b. the organism is resistant to antibiotics c. there is a preexisting abnormality in the urinary tract d. the patient does not take all the antibiotics for treatment of a UTI
c. there is a preexisting abnormality in the urinary tract
The client diagnosed with Type 1 diabetes has a glycosylated hemoglobin (A1C) of 8.1%. which interpretation should the nurse make based on this result? a. this result is below normal levels b. this result is within acceptable levels c. this result is above recommended levels d. this result is dangerously high
c. this result is above recommended levels
when taking a nursing history from a patient with BPH, the nurse would expect the patient to report a. nocturia, dysuria, and bladder spasms b. urinary frequency, hematuria, and perineal pain c. urinary hesitancy, postvoid dribbling, and weak urinary stream d, urinary urgency with a forceful urinary stream and cloudy urine
c. urinary hesitancy, postvoid dribbling, and weak urinary stream
the extent of urinary obstruction caused by BPH can be determined by which diagnostic study? a. a cystometrgram b. transrectal ultrasound c. urodynamic flow studies d. postvoiding catheterization
c. urodynamic flow studies
The nurse writes a problem of "altered body image" for a 34 year old client diagnosed with cushings disease. Which intervention should be implemented? a. monitor blood glucose levels prior to meals and at bedtime b. perform a head to toe assessment on the client every shift c. use therapeutic communication to allow the client to discus feelings d. assess bowel sounds and temp q4h
c. use therapeutic communication to allow the client to discus feelings
7.A diabetic patient has a serum glucose level of 824 mg/dL (45.7 mmol/L) and is unresponsive. After assessing the patient, the nurse suspects diabetic ketoacidosis rather than hyperosmolar hyperglycemic syndrome based on the finding of a.polyuria. b.severe dehydration. c.rapid, deep respirations. d.decreased serum potassium.
c.rapid, deep respirations.
The nurse is developing a care plan for the client diagnosed with type 1 diabetes. The nurse identifies the problem "high risk for hyperglycemia related to noncompliance with the medication regimen." What statement is an appropriate short-term goal for the client a. the client will have a blood glucose level between 90 and 140 mg/dL b. the client will demonstrate appropriate insulin injection technique c. the nurse will monitor the clients blood glucose levels 4 time a day d. the client will maintain normal kidney function with 30 ml/hr urine output
a. the client will have a blood glucose level between 90 and 140 mg/dL
As a precaution for vocal cord paralysis from damage to the recurrent laryngeal nerve during thyroidectomy surgery, what equipment should be in the room in case it is needed for this emergency situation? a. trach tray b. oxygen equipment c. IV calcium gluconate d. paper and pencil for communication
a. trach tray
3.Analyze the following diagnostic findings for your patient with type 2 diabetes. Which result will need further assessment? a.A1C 9% b.BP 126/80 mm Hg c.FBG 130 mg/dL (7.2 mmol/L) d.LDL cholesterol 100 mg/dL (2.6 mmol/L)
a.A1C 9%
5.You are caring for a patient with newly diagnosed type 1 diabetes. What information is essential to include in your patient teaching before discharge from the hospital (select all that apply)? a.Insulin administration b.Elimination of sugar from diet c.Need to reduce physical activity d.Use of a portable blood glucose monitor e.Hypoglycemia prevention, symptoms, and treatment
a.Insulin administration d.Use of a portable blood glucose monitor e.Hypoglycemia prevention, symptoms, and treatment
Besides being mixed with struvite or oxalate stones, what characteristic is associated with calcium phosphate calculi? a. assocaited with alkaline urine b. genetic autosomal recessive defect c. threee times as common in women as in men d. defective GI and kidney absorption
a. assocaited with alkaline urine
an 18 year old female client, 5'4" tall, weighting 113 kg, comes to the clinic for a nonhealing wound on her lower leg, which she has had for two weeks. Which disease process should the nurse suspect the client has developed? a. Type 1 diabetes b. Type 2 diabetes c. gestational diabetes d. acanthosis nigricans
b. Type 2 diabetes
following electrohydraulic lithotripsy for treatment of renal calculi, the patient has a nursing diagnosis of risk for infection related to the introduction of bacteria following manipulation of the urinary tract. What is the most appropriate nursing intervention for this patient? a. monitor for hematuria b. encourage fluid intake of 3L/day c. apply moist heat to the flank area d. strain all urine through gauze or a special strainer
b. encourage fluid intake of 3L/day
Which s/s 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 bradycarida d. decreased respirations and hypoxia
b. hyperpyrexia and extreme tachycardia
which statement best describes atherosclerotic disease affected the cerebrovascular, cardiovascular, and peripheral vascular systems in patients with diabetes? a. it can be prevented by tight glucose control b. it occurs with a higher frequency and earlier onset than in the nondiabetic population c. it is caused by the hyperinsulinemia related to insulin resistance common in type 2 diabetes d. it cannot be modified by reduction of risk factors sch as smoking, obesity, and high fat intake
b. it occurs with a higher frequency and earlier onset than in the nondiabetic population
Which electrolyte replacement should the nurse anticipate being ordered by the HCP in the client diagnosed with DKA who has been admitted to the ICU? a. glucose b. potassium c. calcium d. sodium
b. potassium
A patient with hypothyroidism is treated with levothyroxine (synthroid). What should the nurse include when teaching the patient about this therapy? a. explain that alternate day dosage may be used if side effects occur b. provide written instructions for all information related to drug therapy c. assure the patient that a return to normal function will occur with replacement therapy d. inform the patient that the drug must be taken until the hormone balance is reestablished
b. provide written instructions for all information related to drug therapy
the client is admitted to the ICU diagnosed with myxedema coma. Which assessment data warrant immediate intervention by the nurse? a. serum blood glucose level of 74 mg/dL b. pulse ox reading of 90% c. telemetry reading showing sinus brady d. the client is lethargic and sleeps all the time
b. pulse ox reading of 90%
Which infection is asymptomatic in the male patient at first then progresses to cystitis, frequent urination, buring on voiding, and epididymitis? a. urosepsis b. renal tb c. urethral diverticula d. goodpasture syndrome
b. renal tb
The female with the UTI also has renal calculi. The nurse knows that these are most likely which type of stone? a. cystine b. struvite c. uric acid d. calcium phosphate
b. struvite
Which assessment data indicate the client diagnosed with DKA is responding to the medical treatment? a. the client has tended skin turgor and dry mucous membranes b. the client is alert and oriented times three c. the clients ABG results are pH 7.29, PaCO2 44, HCO3 15 d. the clients serum potassium level is 3.3 mEq/L
b. the client is alert and oriented times three
with which diagnosis will the patient benefit from being taught to do self-catheterization? a. renal trauma b. urethral stricture c. renal artery stenosis d. accelerated nephrosclerosis
b. urethral stricture
the nurse is admitting a client diagnosed with primary adrenal cortex insuffeciency (Addisons disease). Which clinical manifestations should the nurse expect to assess? a. moon face, buffalo hump, and hyperglycemia b. hirsutism, fever, and irritability c. bronze pigmentation, hypotension, and anorexia d. tachycardia, bulging eyes, and goiter
c. bronze pigmentation, hypotension, and anorexia
what type of urinary tract calculi are the most common and frequently obstruct the ureter? a. cystine b. uric acid c. calcium oxalate d. calcium phosphate
c. calcium oxalate
the nurse asses the diabetic patients technique of self monitoring of blood glucose (SMBG) 3 months after initial instruction. Which error in the performance of SMBG noted by the nurse requires intervention? a. doing the SMBG before and after exercising b. puncturing the finger on the side of the finger pad c. cleaning the puncture site with alcohol before the puncture d. holding the hand down for a few minutes before the puncture
c. cleaning the puncture site with alcohol before the puncture
6.What is the priority action for the nurse to take if the patient with type 2 diabetes complains of blurred vision and irritability? a.Call the physician. b.Administer insulin as ordered. c.Check the patient's blood glucose level. d.Assess for other neurologic symptoms.
c.Check the patient's blood glucose level.
which lab results would indicate the patient has prediabetes? a. glucose tolerance result of 132mg/dL b. glucose tolerance result of 240 mg/dL c. fasting blood glucose result of 80 mg/dL d. fasting blood glucose result of 120 mg/dL
d. fasting blood glucose result of 120 mg/dL
A patient is admitted to the hospital with a diagnosis of cushing syndrome. On physical assessment of the patient, what should the nurse expect to find? a. HTN, peripheral edema, and petechiae b. weight loss, buffalo hump, and moon face with acne c. abdominal and buttock striae, tuncal obesity, hypotension d. anorexia, signs of dehydration, and hyperpigmentation of the skin
a. HTN, peripheral edema, and petechiae
two days following a self-managed hypoglycemia episode at home, the patient tells the nurse that his blood glucose levels since the episode have been between 80 and 90 mg/dL. Which is the best response by the nurse? a. "that is a good range for you glucose levels" b. "you should call your health care provider because you need to have your insulin increased" c. "that level is too low in view of your recent hypoglycemia and you should increase your food intake d. "you should take only half your insulin dosage for the next few days to get your glucose level back to normal"
a. "that is a good range for you glucose levels"
Which characteristic is more likely with acute pyelonephritis than with a lower UTI a. Fever b. Dysuria c. Urgency d. frequency
a. Fever
the patient with diabetes has a blood glucose level of 248 mg/dL. Which manifestations in the patient would the nurse understand as being related to this blood glucose level? (select all that apply) a. headache b. unsteady gait c. abdominal cramps d. emotional changes e. increase in urination f. weakness and fatigue
a. headache c. abdominal cramps e. increase in urination f. weakness and fatigue
What tissues require insulin to enable movement of glucose into the tissue cells (select all that apply) a. liver b. brain c. adipose d. blood cells e. skeletal muscles
c. adipose e. skeletal muscles
The nurses adminstered 28 units of Humulin N, an intermediate-acting insulin, to a client diagnosed with type 1 diabetes at 1600. Which intervention should the nurse implement? a. ensure the client eats the bedtime snack b. determine how much food the client ate at lunch c. perform a glucometer reading at 0700 d. offer the client protein after administering insulin
a. ensure the client eats the bedtime snack
Which statement accurately describes Grave's disease? a. exophthalmos occurs in graves disease b. it is an uncommon form of hyperthyroidism c. manifestations of hyperthyroidism occur from tissue desenzitization to the sympathetic nervous system d. diagnostic testing in the patient with Grave's disease will reveal an increased thyroid-stimulating hormone (TSH) level
a. exophthalmos occurs in graves disease
the 68 year old client diagnosed with hyperthyroidism is being treated with radioactive iodine therapy. Which intervention should the nurse discuss with the client? a. explain it will take up to a month for symptoms of hyperthyroidism to subside b. teach the iodine therapy will have to be tapered slowing over one week c. discuss the client will have to be hospitalized during the radioactive therapy d. inform the client after therapy the client will not have to take any meds
a. explain it will take up to a month for symptoms of hyperthyroidism to subside
when caring for a patient with primary hyperaldosteronism, the nurse would question the HCP prescription for which drug? a. furosamide (lasix) b. amiloride (midamor) c. spironolactone (aldactone) d. aminoglutethimide (cytadren)
a. furosamide (lasix)
What are manifestations of DKA (select all that apply) a. thirst b. ketonuria c. dehydration d. metabolic acidosis e. Kussmaul respirations f. sweet, fruity breath odor
a. thirst b. ketonuria c. dehydration d. metabolic acidosis e. Kussmaul respirations f. sweet, fruity breath odor
when teaching the patient with Type 1 diabetes, what should the nurse emphasize as the major disadvantage of using an insulin pump? a. tight glycemic control can be maintained b. errors in insulin dosing are less likely to occur c. complications of insulin therapy are prevented d. frequent blood glucose monitoring is unnecessary
a. tight glycemic control can be maintained
A patient with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. The nurse determines that additional teaching is needed when the patient does what? a. withdraws the NPH dose into the syringe first b. infects air equal to the NPH dose into the NPH vial first c. removes any air bubbles after withdrawing the first insulin d. adds air equal to the insulin dose into the regular vial and withdraws the dose
a. withdraws the NPH dose into the syringe first
when replacement therapy is started for a patient with long standing hypothyroidism, what is the most important for the nurse to monitor the patient for? a. insomnia b. weight loss c. nervousness d. dysrhythmias
d. dysrhythmias
A nurse working in an outpatient clinic plans a screening program for diabetes. What recommendations for screening should be included? a. OGTT for all minority populations every year b. FPG for all individuals at age 45 and then every 3 years c. testing people under the age of 21 for islet cell antibodies d. testing for type 2 diabetes in all overweight or obese individuals
b. FPG for all individuals at age 45 and then every 3 years
to prevent hyperglycemia or hypoglycemia related to exercise, what should the nurse teach the patient using glucose-lowering agents about the best time for exercise? a. only after a 15 g carb snack is eaten b. about one hour after eating when blood glucose levels are rising c. when glucose monitoring reveals that the blood glucose is in the normal range d. when blood glucose levels are high, because exercise always has a hypoglycemic effect
b. about one hour after eating when blood glucose levels are rising
The male patient is Jewish, has a history of gout, and has been diagnosed with renal calculi. Which treatment will be used with this patient (select all that apply?) a. reduce dietary oxalate b. administer allopurinol c. administer x-penicillamin d. administer thiazide diuretics e. reduce animal protein intake f. reduce intake in milk products
b. administer allopurinol e. reduce animal protein intake
The nurse at a freestanding health care clinic is caring for a 56 year old male client who is homeless and is a type 2 diabetic controlled with insulin. Which action is an example of client advocacy? a. ask the client if he has somewhere he can go and live b. arrange for someone to give him insulin at a local homeless shelter c. notify adult protective services about the clients situation d. ask the HCP to take the client off insulin because he is homeless
b. arrange for someone to give him insulin at a local homeless shelter
Which patient should the nurse plan to teach how to prevent or delay the development of diabetes? a. an obese 50 year old hispanic woman b. a child whose father has type 1 diabetes c. a 34 year old woman whose parents both have type 2 diabetes d. a 12 year old boy whose father has maturity onset diabetes of the young (MODY)
c. a 34 year old woman whose parents both have type 2 diabetes
A patient with Type 1 diabetes uses 20 U of 70/30 neutral protamine Hagedorn (NPH/regular) in the morning and at 6 pm. When teaching the patient about this regimen, what should the nurse emphasize? a. hypoglycemia is most likely to occur before the noon meal b. flexibility in food intake is possible because insulin is available 24 hours a day c. a set meal pattern with a bedtime snack is necessary to prevent hypoglycemia d. premeal glucose checks are required to determine needed changes in daily dosing
c. a set meal pattern with a bedtime snack is necessary to prevent hypoglycemia
Which med order should the nurse question in the client diagnosed with untreated hypothyroidism a. thyroid hormones b. oxygen c. sedatives d. laxatives
c. sedatives
On assessment of the patient with renal calculus passing down the ureter, what should the nurse expect the patient to report? a. hx of chronic UTIs b. dull, costovertebral flank pain c. severe, colicky back pain radiating to the groin d. a feeling of bladder fullness with urgency and frequency
c. severe, colicky back pain radiating to the groin
A 55 year old man with a hx of prostate cancer in his family asks the nurse what he can do to decrease the risk of prostate cancer. What should the nurse teach him about prostate cancer risks? a. nothing can decrease the risk because prostate cancer is primarily a disease of aging. b. treatment of any enlargment of the prostate gland will help prevent prostate cancer. c. substituting fresh fruits and veggies for high fat foods in the diet may lower the risk of prostate cancer d. using a natural herb, saw palmetto, has been found to be an effective protection against prostate cancer
c. substituting fresh fruits and veggies for high fat foods in the diet may lower the risk of prostate cancer
the nurse is discussing ways to prevent DKA with the client diagnosed with type 1 diabetes. Which instruction is the most import to discuss with the client? a. refer the client to the American Diabetes Association b. do not take an OTC meds c. take the prescribed insulin even when unable to eat because of illness d. explain the need to get the annual flu and pneumonia vaccines
c. take the prescribed insulin even when unable to eat because of illness
The charge nurse of an ICU is making assignments for the night shift. Which client should be assigned to the most experienced intensive care nurse? a. the client diagnosed with respiratory failure who is on a ventilator and requires frequent sedation b. the client diagnosed with lung cancer and iatrogenic cushings disease with ABGs of pH 7.35, PaO2 88, PaCO2 44, and HCO3 22 c. the client diagnosed with addisons disease who is lethargic and has a BP of 80/45, P 124, and R 28 d. The client diagnosed with hyperthyroidism who has undergone a thyroidectomy two days ago and has a negative Trousseau's signs
c. the client diagnosed with addisons disease who is lethargic and has a BP of 80/45, P 124, and R 28
The nurse is assessing the feet of a client with long term type 2 diabetes. Which assessment data warrant immediate intervention by the nurse? a. the client has crumbling toe nails b. the client has athletes foot c. the client has a necrotic big toe d.the client has thickened toenails
c. the client has a necrotic big toe
A diabetic patient is found unconscious at home and a family member calls the clinic. After determining that a glucometer is not available, what should the nurse advise the family member to do? a. have the patient drink some orange juice b. administer 10 U of regular insulin subq c. call for an ambulance to transport the patient to a medical facility d. administer glucagon 1 mg IM or Subq
d. administer glucagon 1 mg IM or Subq
Lispro insulin (Humalog) with NPH insulin is ordered for a patient with newly diagnosed type 1 diabetes. The nurse knows that when lispro insulin is used, when should it be administered? a. once a day b. one hour before meals c. 30 to 45 minutes before meals d. at mealtime or within 15 minutes of meals
d. at mealtime or within 15 minutes of meals
The nurse has identified the nursing diagnosis of fatigue for the patient who is hypothyroid. What should the nurse do while caring for this patient? a. monitor for changes in orientation, cognition, and behavior d. autoimmune-induced atrophy of the thyroid glandc. monitor bowel movement frequency, consistency, shape, volume, and color d. assist in developing well balance meal plans consistent with level of energy expenditure.
d. autoimmune-induced atrophy of the thyroid gland
what is a cause of primary hypothyroidism in adults? a. malignant or benign thyroid modules b. surgical removal or failure of the pituitary gland c. surgical removal or radiation of the thyroid gland d. autoimmune-induced atrophy of the thyroid gland
d. autoimmune-induced atrophy of the thyroid gland
what characteristics is related to Hashimoto's thyroiditis a. enlarged thyroid gland b. viral induced hyperthyroidism c. bacterial or fungal infection of thyroid gland d. chronic autoimmune thyroiditis with antibody destruction of thyroid tissue
d. chronic autoimmune thyroiditis with antibody destruction of thyroid tissue
what is hte most common screening intervention for detecting BPH in men over age 50 a. PSA level b. urinalysis c. cystoscopy d. digital rectal examination
d. digital rectal examination