New Info After Exam 2

A nurse is preparing to administer a dose of a new prescription of prednisone to a client who has COPD. The nurse should monitor for which of the following adverse effects of this medication? (Select all that apply.) *

****A. Hypokalemia * B. Tachycardia ****C. Fluid retention ****D. Nausea ****E. Black, tarry stools

A nurse is completing discharge teaching for a client who has an infection due to Helicobacter pylori (H. pylori). Which of the following statements by the client indicates understanding of the teaching?

* A. "I will continue my prescription for corticosteroids." * B. "I will schedule a CT scan to monitor improvement." **** C. "I will take a combination of medications for treatment." * D. "I will have my throat swabbed to recheck for this bacteria."

A nurse in a clinic is instructing a client about a fecal occult blood test, which requires mailing three specimens. Which of the following statements by the client indicates understanding of the teaching?

* A. "I will continue taking my warfarin while I complete these tests." * B. "I'm glad I don't have to follow any special diet at this time." ****C. "This test determines if I have parasites in my bowel." * D. "This is an easy way to screen for colon cancer."

A nurse is instructing a client on the use of an incentive spirometer. Which of the following statements by the client indicates an understanding of the teaching? *

* A. "I will place the adapter on my finger to read my blood oxygen saturation level" * B. "I will lie on my back with my knees bent" *****C. "I will rest my hand over my abdomen to create resistance" * D. "I will take in a deep breath and hold it before exhaling"

A nurse is completing discharge teaching to a client who is postoperative following fundoplication. Which of the following statements by the client indicates understanding of the teaching?

* A. "When sitting in my lounge chair after a meal, I will lower the back of it." * B. "I will try to eat three large meals a day." *****C. "I will elevate the head of my bed on blocks." * D. "When sleeping, I will lay on my left side."

A nurse is teaching a client who has tuberculosis. Which of the following statements should the nurse include in the teaching?

* A. "You will need to continue to take the multimedication regimen for 4 months." * B. "You will need to provide sputum samples every 4 weeks to monitor the effectiveness of the medication * C. "You will need to remain hospitalized for treatment." *****D. "You will need to wear a mask at all times."

A nurse is caring for a client who has a new diagnosis of tuberculosis and has been placed on a multimedication regimen. Which of the following instructions should the nurse give the client related to ethambutol?

* A. "Your urine can turn a dark orange." * B. "Watch for a change in the sclera of your eyes." ****C. "Watch for any changes in vision." * D. "Take vitamin B6 daily."

18 A student with type 1 diabetes tells the nurse she is feeling light-headed. The student's blood sugar is 60 mg/dl. Using the 15-15 rule, the nurse should give: Mark only one oval.

* A. 15 ml or juice and give another 15 ml in 15 minutes ***** B. 15 g of carbohydrates and retest the blood sugar in 15 minutes * C. 15 g of carbohydrates and 15 g of protein * D. 15 oz. of juice and retest in 15 minutes

6 A nurse is reviewing the manifestations of hyperthyroidism with a client. Which of the following findings should the nurse include? (Select all that apply.)

* A. Anorexia ***B. Heat intolerance * C. Constipation ****D. Palpitations ***E. Weight loss * F. Bradycardia

17 An 11-year-old child has been diagnosed with Graves' disease and is to start drug therapy. Which of the following instructions should the nurse include in the teaching plan for the child's mother and teacher? Mark only one oval.

* A. Continue with the same amount of schoolwork and homework * B. Understand that mood swings are rare with this disorder * C. Limit the amount of food that is offered to the child *****D. Provide the child with a calm. nonstimulatung environment.

A nurse is completing discharge teaching with a client who has Crohn's disease. Which of the following instructions should the nurse include in the teaching?

* A. Decrease intake of calorie‑dense foods. ****B. Drink canned protein supplements. * C. Increase intake o high fiber foods. * D. Take a bulk‑forming laxative daily.

5 A nurse in a provider's office is reviewing the health record of a client who is being evaluated for Graves' disease. The nurse should identify that which of the following laboratory results is an expected finding?

* A. Decreased thyrotropin receptor antibodies **** B. Decreased thyroid‑stimulating hormone (TSH) * C. Decreased free thyroxine index * D. Decreased triiodothyronineption 1

.The nurse is reviewing the laboratory results of a client with hypothyroidism. An unexpected finding is" Mark only one oval.

* A. Decreased thyroxine(T4) and increased thyroid-stimulating hormone(TSH) levels *****B. Decreased TSH and increased T4 levels * C. Decreased creative phosphokinase levels * D. Absence of ant thyroid antibodies

8 A nurse in a provider's office is reviewing laboratory results of a client who is being evaluated for secondary hypothyroidism. Which of the following laboratory findings is expected for a client who has this condition?

* A. Elevated serum T4 * B. Decreased serum T3 ****C. Elevated serum thyroid stimulating hormone * D. Decreased serum cholesterol

A nurse is planning to instruct a client on how to perform pursed‑lip breathing. Which of the following should the nurse include in the plan of care?

* A. Take quick breaths upon inhalation. * B. Place your hand over your stomach. *****C. Take a deep breath in through your nose. * D. Puff your checks upon exhalation.

9 A nurse is reinforcing teaching with a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following information should the nurse include in the teaching? (Select all that apply.)

* A. Weight gain is expected while taking this medication. **** B. Medication should not be discontinued without the advice of the provider. **** C. Follow‑up serum TSH levels should be obtained. **** D. Take the medication on an empty stomach. * E. Use fiber laxatives for constipation.

A nurse is caring for a client who has a new diagnosis of gastroesophageal reflux disease (GERD). The nurse should anticipate prescriptions for which of the following medications? (Select all that apply.)

**** A. Antacids ****B. Histamine2 receptor antagonists C. Opioid analgesics D. Fiber laxatives ****E. Proton pump inhibitors

A nurse is teaching a client who has hepatitis B about home care. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

**** A. Limit physical activity. **** B. Avoid alcohol. * C. Take acetaminophen for comfort. * D. Wear a mask when in public places. **** E. Eat small frequent meals.

4 A nurse is reviewing the laboratory findings for a client who might have hyperthyroidism. The nurse should identify an elevation which of the following substances as an indication that the client has this disorder

**** A. Triiodothyronine * B. Plasma-free metanephrine * C. Urine cortisol * D. Urine osmolality

2 A nurse is preparing to administer a new prescription for isoniazid (INH) to a client who has tuberculosis. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication?

*****A. "You might notice yellowing of your skin." * B. "You might experience pain in your joints." * C. "You might notice tingling of your hands." * D. "You might experience a loss of appetite."

A nurse is discharging a client who has COPD. Upon discharge, the client is concerned that he will never be able to leave his house now that he is on continuous oxygen. Which of the following is an appropriate response by the nurse? *

****A. "There are portable oxygen delivery systems that you can take with you" * B. "When you go out, you can remove the oxygen and then reapply it when you get home" * C. "You probably will not be able to go out as much as you used to " * D. "Home health services will come to see you so you will not need to get out"

A nurse is providing discharge teaching to a client who has experienced diabetic ketoacidosis. Which of the following information should the nurse include in the teaching? (Select all that apply.)

****A. Drink 2 L fluids daily. **** B. Monitor blood glucose every 4 hr. when ill. ****C. Administer insulin as prescribed when ill. 4 D. Notify the provider when blood glucose is 200 mg/dL. **** blood glucose is 200 mg/dL. **** E. Report ketones in the urine

1 A nurse is presenting information to a group of clients about nutrition habits that prevent type 2 diabetes mellitus. Which of the following should the nurse include in the information? (Select all that apply.)

****A. Eat less meat and processed foods. **** B. Decrease intake of saturated fats. **** C. Increase daily fiber intake. 17 D. Limit saturated fat intake to 15% of daily caloric intake. ****E. Include omega‑3 fatty acids in the diet.

7 A nurse in a provider's office is planning care for a client who has anew diagnosis of Graves' disease and a new prescription for methimazole. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

****A. Monitor CBC. * ***B. Monitor triiodothyronine (T3). * C. Instruct the client to increase consumption of shellfish. **** D. Advise the client to take the medication at the same time every day. * E. Inform the client that an adverse effect of this medication is iodine toxicity.

3 A nurse is providing information about tuberculosis to a group of clients at a local community center. Which of the following manifestations should the nurse include in the teaching? (Select all that apply.)

****A. Persistent cough * B. Weight gain ****C. Fatigue * D. Night sweats ****E. Purulent sputum

.A nurse is providing discharge teaching to a client who has COPD and a new prescription for albuterol. Which of the following statements by the client indicates an understanding of the teaching?

****C. "I can have an increase in my heart rate while taking this medication." * D. "I can have mouth sores while taking this medication." * A. "This medication can increase my blood sugar levels " * B. "This medication can decrease my immune response"

7 A nurse is providing instructions to a client who has Graves' disease and has a new prescription for propranolol. Which of the following information should the nurse include?

* A. "An adverse effect of this medication is jaundice." **** B. "Take your pulse before each dose." * C. "The purpose of this medication is to decrease production of thyroid hormone." * D. "You should stop taking this medication if you have a sore throat."

A nurse is teaching about pernicious anemia with a client who has chronic gastritis. Which of the following information should the nurse include in the teaching?

*A. Pernicious anemia is caused when the cells producing gastric acid are damaged. **** B. Expect a monthly injection of vitamin B12. * C. Plan to take vitamin K supplements. * D. Pernicious anemia is caused by an increased production of intrinsic factor.

A nurse is teaching a client who has a hiatal hernia. Which of the following client statements indicates an understanding of the teaching?

1 A. "I can take my medications with soda." ****B. "Peppermint tea will increase my indigestion." 3 C. "Wearing an abdominal binder will limit my symptoms." 4 D. "I will drink hot chocolate at bedtime to help me sleep." 5 E. "I can lift weights as a way to exercise."

* A adolescent is to receive radioactive iodine for Graves' diseases. Which statement by the client reflects the need for more teaching?

1 A. "I plan to talk on Facebook since I have to keep several feet from my friends for 3 days" 2 B. "Taking radioactive iodine will not affect my ability to have children in the future" *****C. The advantage of radioactive iodine is that I will not need future medication for my disease" 4 D. "I should try to use a separate bathroom from the rest of my family for several days."

A nurse is planning care for a client who has a new prescription for total parenteral nutrition (TPN). Which of the following interventions should be included in the plan of care? (Select all that apply.)

1 A. Obtain a capillary blood glucose four times daily. 2 B. Administer prescribed medications through a secondary port on the TPN IV tubing. 3 C. Monitor vital signs three times during the 12‑hr shift 4 D. Change the TPN IV tubing every 24 hr. 5 E. Ensure a daily a PTT is obtained.

1 A nurse is caring for a client who has blood glucose 52 mg/dL. The client is lethargic but arousable. Which of the following actions should the nurse perform first?

14 A. Recheck blood glucose in 15 min. 15 B. Provide a carbohydrate and protein food. **** C. Provide 4 oz. grape juice. 17 D. Report findings to the provider.

* The nurse should instruct the family of a child with newly diagnosed hyperthyroidism to:

A. Keep their home warmer than usual. * B. Encourage plenty of outdoor activities *****C. Promote interactions with one friend instead of groups * D. Limit bathing to prevent skin irritations

9.A nurse in a provider's office is assessing a client who has hypothyroidism and recently began treatment with thyroid hormone replacement therapy. Which of the following findings should indicate to the nurse that the client might need a decrease in the dosage of the medication?

Mark only one oval. ****6 A. Hand tremors 7 B. Bradycardia 8 C. Pallor 9 D. Slow speech

3 A nurse is caring for a client who asks why the provider bases his medication regimen on his HbA1c instead of his log of morning fasting blood glucose results. Which of the following responses should the nurse make?

* A. "HbA1c measures how well insulin is regulating your blood glucose between meals." ****B. "HbA1c indicates how well you have regulated your blood glucose over the past 120 days." * C. "HbA1c is the first test your doctor prescribed to determine that you have diabetes." * D. "HbA1c determines if your doctor should adjust your insulin dosage."

A home health nurse is teaching client who has active tuberculosis. The provider has prescribed the following medication regimen: isoniazid 250 mg PO daily, rifampin500 mg PO daily, pyrazinamide750 mg PO daily, and ethambutol1 mg PO daily. Which of the following client statements indicate the client understands the teaching? (Select all that apply.)

* A. "I can substitute one medication for another if I run out because they all fight infection." *** B. "I will wash my hands each time I cough." ****C. "I will wear a mask when I am in a public area." * D. "I am glad I don't have to have any more sputum specimens." * E. "I don't need to worry where I go once I start taking my medications."

12 A nurse is providing medication teaching for a client who has Addison's disease and is taking hydrocortisone. Which of the following instructions should the nurse include? (Select all that apply.)

* A. Take the medication on an empty stomach. ****B. Notify the provider of any illness or stress. ****C. Report any manifestations of weakness or dizziness. ****D. Do not discontinue the medication suddenly. * E. Eat a low‑sodium diet.

A nurse is providing discharge teaching to a client who has a new prescription for aluminum hydroxide. Which of the following information should the nurse include in the teaching?

* A. Take the medication with food. * B. Monitor for diarrhea. *****C. Wait 1 hr. before taking other oral medications. * D. Maintain a low‑fiber diet.

A nurse is completing discharge teaching with a client who is 3 days postoperative following a transverse colostomy. Which of the following should the nurse include in the teaching?

* A. Mucus will be present in stool for 5 to 7 days after surgery * B. Expect 500 to 1,000 mL of semi liquid stool after 2 weeks. ****C. Stoma should be moist and pink. * D. Change the ostomy bag when it is ¾ full.

19 An overweight adolescent has been diagnosed with type 2 diabetes. To increase the client's self-efficacy to manage their disease, the nurse should: Mark only one oval.

* A. Provide the client with a written daily food and exercise plan * B. Discuss eliminating junk food in the home with the parents * C. Arrange for the school nurse to weigh the child weekly ***** D. Utilize a peer with type 2 diabetes to role model lifestyle changes

A nurse is assessing an older adult client in an extended care facility. The nurse should recognize which of the following findings is a manifestation of an obstruction of the large intestine due to a fecal impaction?

* A. The client reports he had a bowel movement yesterday. **** B. The client is having small, frequent liquid stools. * C. The client is flatulent. * D. The client indicates he vomited once this morning.

A nurse is providing discharge teaching to a client who is postoperative following open cholecystectomy with T‑tube placement. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

* A. Take baths rather than showers. **** B. Clamp T‑tube for 1 hr. before and after meals. * C. Keep the drainage system above the level of the abdomen. * D. Expect to have the T‑tube removed 3 days postoperatively. **** E. Report brown‑green drainage to the provider.

21 A client with type 1 diabetes mellitus asks the nurse about taking ginseng at home. The nurse should tell the client: Mark only one oval.

* A. "No there are no therapeutic benefits of ginseng" **** B. "Taking ginseng will increase the risk of hypoglycemia" * C. "You can take the ginseng to help improve your memory" * D. "You can take ginseng if you take it with a carbohydrate"

* A nurse is planning care for a client who has Cushing's disease. The nurse should recognize that clients who have Cushing's disease are at increased risk for which of the following? (Select all that apply.)

****A. Infection ****B. Gastric ulcer * C. Renal calculi ****Bone fractures * E. Dysphagia