NSG 452 Exam 1

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10. charge nurse would assign pt to an LPN working under supervision of an RN 1. 48 pt with cysitis who is taking oral antibiotics 2. 64 pt with kidney stones hwo has anew order for lithotripsy 3. 72 pt w/ urinary incontinence who needs bladder training 4. 52 pt with pylenonephritis w/severe acute flank pain

22. a pt with lung cancer has recieved oxycodone 10 mg orally for pain. when the student nurse assesses the pt, which finding would the nurse instruct the student nurse to report immediately? 1. respiratory rate of 8 to 10 breaths/min 2. decrease in pain level from 6 to 2 3. request by the pt that the room door be closed HR of 90 to 100 bpm

24. pt is admitted to the oncology unit for chemo. to prevent an acid base problem- which finding would the nurse instruct the AP to report? 1. repeated episodes of N/V 2. reports of pain associated with exertion 3. failure to eat all the food on the breakfast tray 4. pt hair loss during morning bath

29. AP reports to RN that pt with acute kidney failure had a UO of 350mL over 24 hours after recieiving fuosemide 40 mg IV push. how can this happen? 1. during the oliguric phase of acute kidney failure, pts often don't respond well to etiher fluid challenges or diuretics 2. there must be some sort of error. someone must have failed to record UO 3. pt with acute kidney failure retains sodium and water, which counteracts the action of furosemoide 4. gradual accumulation of nitrogenous waste products results in the retention of water and sodium.

43. The nurse is assessing a client with a lactose intolerance disorder for a supsected diagnsosis of hypocalcemia. which s/s would nurse expect to find? 1. twitching 2. hypoactive bowel sounds 3. negative trousseaus sign 4. hypoactive deep tendon reflexes

46. which pt is at risk for development of sodium level at 130? 1. pt on diuretic 2. pt with hyperaldosteronism 3. pt with cushing syndrome 4. pt who is taking corticosteroids

48. The nurse reviews a client's laboratory report and notes that the client's serum phosphorus (phosphate) level is 1.8 mg/dL (0.58 mmol/L). Which condition most likely caused this serum phosphorus level? 1. Malnutrition 2. Renal insufficiency 3. Hypoparathyroidism 4. Tumor lysis syndrome

496. The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client reports a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching? 1. "I need to stop my insulin." 2. "I need to increase my fluid intake." 3. "I need to monitor my blood glucose every 3 to 4 hours." 4. "I need to call my primary health care provider (PHCP) because of these symptoms."

503. The nurse is teaching a client with hyperparathyroidism how to manage the condition at home. Which response by the client indicates the need for additional teaching? 1. I should consume less than 1 liter of fluid per day. 2. I should use my treadmill or go for walks daily. 3. I should follow a moderate-calcium, high-fiber diet. 4. My alendronate helps keep calcium from coming out of my bones.

51. nurse caring for pt recieving IV diuretics suspects pt is experiencing fluid volume deficit. which assment finding would the nurse note in a pt with this condition? 1. wt loss and poor skin turgor 2. lung congestion and icnreased HR 3. decreased hematocrit and increased urine output 4. increased respirations and increased BP

512. The nurse is teaching a client with diabetes mellitus how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching? 1. Withdraws the NPH insulin first 2. Withdraws the regular insulin first 3. Injects air into NPH insulin vial first 4. Injects an amount of air equal to the desired dose of insulin into each vial

516. The primary health care provider (PHCP) prescribes exenatide for a client with type 1 diabetes mellitus who takes insulin. The nurse should plan to take which most appropriate intervention? 1. Withhold the medication and call the PHCP, questioning the prescription for the client. 2. Teach the client about the signs and symptoms of hypoglycemia and hyperglycemia. 3. Monitor the client for gastrointestinal side effects after administering the medication. 4. Withdraw the insulin from the prefilled pen into an insulin syringe to prepare for administration.

653. The nurse is reviewing a client's record and notes that the primary health care provider has documented that the client has chronic kidney disease. On review of the laboratory results, the nurse most likely would expect to note which finding? 1. Elevated creatinine level 2. Decreased hemoglobin level 3. Decreased red blood cell count 4. Increased number of white blood cells in the urine

673. The nurse receives a call from a client concerned about eliminating brown-colored urine after taking nitrofurantoin for a UTI. The nurse should make which appropriate response? 1. Continue taking the medication; the brown urine occurs and is not harmful. 2. Take magnesium hydroxide with your medication to lighten the urine color. 3. Discontinue taking the medication and make an appointment for a urine culture. 4. Decrease your medication to half the dose, because your urine is too concentrated.

674. A client with chronic kidney disease is receiving epotein alfa. which lab would inidate therapeutic effect 1. heamtrocrit of 33% 2. platelet count of 400,000 3. WBC of 6000 4. BUN of 15

675. pt with a UTi is receiving ciprofloxacin by IV. the nurse appropriately adminsters the medication by performing which action 1. infusling slowly over 60 min 2. infuse in light protective bag 3. infuse only through a central line 4. infusing rapidly has a direct IV push medication

A female patient is admitted with a diagnosis of primary hypofunction of the adrenal glands. Which nursing assessment finding supports this diagnosis? Patchy areas of pigment loss over the face2Decreased muscle strength3Greatly increased urine output4Scalp alopecia

A patient with adrenal insufficiency is to be discharged and will take prednisone 10 mg orally each day. Which instruction would the nurse be sure to teach the patient? Excessive weight gain or swelling should be reported to the health care provider.2Changing positions rapidly may cause hypotension and dizziness.3A diet with foods low in sodium may be beneficial to prevent side effects.4Signs of hypoglycemia may occur while taking this drug.

An LPN/LVN is assigned to administer a rapid-acting insulin (lispro) to a patient with type 1 diabetes. What essential information would the RN be sure to tell the LPN/LVN? Give this insulin when the food tray has been delivered and the patient is ready to eat. give this insulin when the fingerstick glucose reading is above 200 mg/dL (11.1 mmol/L). 3This insulin mimics the basal glucose control of the pancreas. 4Lispro insulin should be given subcutaneously at least 20 to 30 minutes before eating.

pt with respiratory failure is recieiving mechanical vent and continues to produce ABG results indicating resp acidocis. which change in vent setting thould the nurse expect to correct this problem 1. increase vent rate from 6 to 10 2. decrease vent rate from 10 to 6 3. increase in oxygen concentration from 30 to 40% 4. decrease oxygen concentration from 40 to 30%

The nurse is orienting a newly graduated RN who is providing care for a postoperative patient after a thyroidectomy. The new RN assesses the patient and notes laryngeal stridor with a pulse oximetry measure of 89%. What is the priority action for the nurse and new RN? 1Immediately notify the rapid response team (RRT). 2Apply oxygen by face mask. 3Prepare to suction the patient. 4Assess for numbness and tingling around the mouth.

1 airway obstructioN!!! going to lose airway soon

494. The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which sign or symptom, if frequently exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if the blood glucose is not adequately managed? 1. Polyuria 2. Diaphoresis 3. Pedal edema 4. Decreased respiratory rate

1 chronic hyperglycemia

35. 78 year old pt schedule for an intravenous pyelography test. which info should be stressed 1. after the procedure monitor UO bc contrast dye increases the risk for kidney failure in older audlts 2. the purpose of this procedure is to measure kidney size 3. bc this procedure assess kidney funciton, there is no need for a bowel prep 4. keep pt NPO after procedure bc the pt will recieve drugs that affect the gag reflex

1 greatest at risk is older and dehydrated.

The nurse is caring for a patient with hyperthyroidism who had a partial thyroidectomy yesterday. Which change in assessment would the nurse report to the health care provider immediately? Temperature elevation to 100.2°F (37.9°C) 2Heart rate increase from 64 to 76 beats/min 3Respiratory rate decrease from 26 to 16 breaths/min oximetry reading of 92%

1 may indicate thyroid crisis

which pt is at biggest risk for fluid volume deficiit? 1. pt with ileostomy 2. pt with heart failure 3. pt on long term corticosteroid therapy 4. pt recieving frequent wound irrigations

1 other options are risk for fluid volume excess

pt with acute kidney failure is to begin continuos arterviouvenous hemofiltration as soon as possible. what is priority action 1. call charge nurse and arrange to transfer to ICU 2. develop teaching plan for the patient that focuses on CAVH 3. assist pt with morning bath and mouth care before transfer 4. notify HCP that pts MAP is 68.

1 this therapy is used for seriously ill patients

An older patient with type 2 diabetes has cardiovascular autonomic neuropathy (CAN). Which instruction would the nurse provide for the assistive personnel (AP) assisting the patient with morning care? Provide a complete bed bath for this patient. 2Sit the patient up slowly on the side of the bed before standing. 3Only let the patient wash his or her face and brush his or her teeth. 4Be sure to provide rest periods between activities.

Bethanechol chloride is prescirbed for a pt w/ urinary retnetion. which disorder would be a contraindication to the administration of the medication? 1. gastric atony 2. urinary strictures 3. neurogenic atony 4. gastroesophageal reflux

Pt has fluid volume deficit related to excessive fluid loss. which action related to fluid management should be delegated by the RN to the AP 1. administer IV fluids as prescribed by HCP 2. provide straws and offer fluids between meals 3. develop a plan for added fluid intake over 24 hours 4. teaching family members to assist the pt with fluid intake

The LPN/LVN is assigned to provide care for a patient with pheochromocytoma. Which physical assessment technique would the RN instruct the LPN/LVN to avoid? Listening for abdominal bowel sounds in all four quadrants 2Palpating the abdomen in all four quadrants 3Checking the blood pressure every hour 4Assessing the mucous membranes for hydration status

Which patient should the charge nurse assign to the care of an LPN/LVN under the supervision of the RN team leader? A 51-year-old patient who has just undergone a bilateral adrenalectomy 2An 83-year-old patient with type 2 diabetes and chronic obstructive pulmonary disease 3A 38-year-old patient with myocardial infarction preparing for discharge 4A 72-year-old patient with mental status changes admitted from a long-term care facility

nurse is providing discharge insrructions to pt receiving trimethoprim-sulfamethaxazole. which instruction should be included in the list? 1. advise that sunscreen is not needed 2. drink 8-10 glasses of water/day 3. decrease the dosage when s/s are improving to prevent an allergic response 4. if urine turns dark brown, call HCP asap

the nurse reviews a pt record and determines the pt is at risk for devlopin a K+ deficit if which situation is documented 1. sustained tissue damage 2. requires ng suction 3. hx of addisons disease 4. uric acid level of 9.4

which pt will the charge nurse assign to an RN floated to the acute care unit from the surgical ICU 1. pt with kidney stones schedule for lithotripsy 2. pt who just undergone srugery for renal stent placement 3. newly admitted pt with an acute UTI 4. pt with chronic kidney failure who needs teaching on periotneal dialyssi

which specific instruction does the charge nurse give the assitive personnel helping to provide care for a pt who is at risk for meta acid? 1. check to see that the pt keeps his oxygen in place at all times 2. inform the nurse immediately if the pt respiratory rate and detph increases 3. record any episodes o freflux or constipation 4. keep the pts ice water pitcher filled at all times

The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. the nurse tells the pt that it is important to maintain the prescribed dwell time for the dialysis bc of the risk of which complications 1. peritonitis 2. hyperglycemia 3. hyperphosphatemia 4. disequilibirium syndrome

2 extended dwell time increases the risk of hyperglycemia

506. The nurse is performing an assessment on a client with pheochromocytoma. Which assessment data would indicate a potential complication associated with this disorder? 1. A urinary output of 50 mL/hr 2. A coagulation time of 5 minutes 3. A heart rate that is 90 beats per minute and irregular 4. A blood urea nitrogen level of 20 mg/dL (7.1 mmol/L)

6. nursing plan of care for an older pt with dehydration includes INT for oral health. which int are within the scope of practice for an LPN being supervised by an RN? 1. remind pt to avoid commerical mouthwashes 2. encourage mouth rinsiing with warm saline 3. assess skin turgor by pinching the skin over the back of hangd 4. observe the lips, tongue, and muscous membranes 5. providing mouth care every 2 hours while patient is awake 6. seek dietary consult to increase fluids on meal trays

1, 2, 4, 5

508. The nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose level of 70 mg/dL (3.9 mmol/L), temperature of 101° F (38.3° C), pulse of 82 beats per minute, respirations of 20 breaths per minute, and blood pressure of 118/68 mm Hg. Which finding would be the priority concern to the nurse? 1. Pulse 2. Respiration 3. Temperature 4. Blood pressure

510. A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client? 1. Hoarseness 2. Hypocalcemia 3. Audible stridor 4. Edema at the surgical site

522. The nurse provides instructions to a client who is taking levothyroxine. The nurse should tell the client to take the medication in which way? 1. With food 2. At lunchtime 3. On an empty stomach 4. At bedtime with a snack

669. Following kidney transplantation, cyclosproine is prescribed for a pt. which lab result would indicate an adverse effect from the use of this medication? 1. hemoglobin level of 14 2. creatinine level of 0.6 3. blood urea nitrogen level of 25 4. fasting blood glucose level of 99

670. nurse is providing dietary instructions to a pt who has been prescribed cyclosprine. which food should nurse restrict from diet? 1. red meats 2. orange juice 3. grapefruit jiuce 4. green, leafy veggies

672. the nurse is reviewing the laboratory results for a client recieving tracrolimus. which lab result would show the pt is having adverse effect of medciation? 1. ptoassium of 3.8 2. platelet of 300,000 3. fasting blood flucose of 200 4. wbc count of 6000

A client arrives at the emergency department with complaints of low abdominal pain and heamturuia. pt is afebrile. nurse next assesses the pt to determine hx of which condition 1. pyelonephritis 2. glomerulonephritis 3. trauma to the bladder/abdomen 4. renal cancer in pts family

A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome is made. The nurse would immediately prepare to initiate which anticipated health care provider's prescriptions? 1.Endotracheal intubation 2.100 units of NPH insulin 3.Intravenous infusion of normal saline 4.Intravenous infusion of sodium bicarbonate

A patient has newly diagnosed type 2 diabetes. Which action should the RN assign to an LPN/LVN rather than an experienced assistive personnel (AP)? Measuring the patient's vital signs every shift 2Checking the patient's glucose level before each meal 3Administering subcutaneous insulin on a sliding scale as needed 4Assisting the patient with morning care

A patient is admitted to the medical unit with possible Graves disease (hyperthyroidism). Which assessment finding by the nurse supports this diagnosis? Periorbital edema2Bradycardia3Exophthalmos4Hoarse voice

A patient with type 1 diabetes asks the nurse if he will ever be able to stop taking insulin. What is the nurse's best response? 1. "When your sugar is controlled by use of exercise and diet, you may no longer need insulin. "2"Yes, because in time your pancreas will develop the ability to make insulin again. "3"No, your pancreas no longer makes insulin so you have to take insulin on a daily basis ."4"It may be possible that you can take oral antiglycemics most days and insulin only on sick days."

An LPN/LVN is assigned to perform assessments on two patients with diabetes. Assessments reveal all of these findings. Which finding would the RN instruct the LPN/LVN to report immediately? Fingerstick glucose reading of 185 mg/dL (10.3 mmol/L) 2Numbness and tingling in both feet 3PROFUSE PERSPIRATION 4Bunion on left great toe

As the shift begins, the nurse is assigned to care for the following patients. Which patient should the nurse assess first? A 38-year-old patient with Graves disease and a heart rate of 94 beats/min 2A 63-year-old patient with type 2 diabetes and a fingerstick glucose level of 137 mg/dL (7.6 mmol/L) 3A 58-year-old patient with hypothyroidism and a heart rate of 48 beats/min 4A 49-year-old patient with Cushing disease and dependent edema rated as + 1

The patient with hyperparathyroidism who is not a candidate for surgery asks the nurse why she is receiving IV normal saline and IV furosemide. What is the nurse's best response? "This therapy is to protect your kidney function. "2"You are receiving these therapies to prevent edema formation ."3"Diuretic and hydration therapies are used to reduce your serum calcium." 4"These therapies may help to improve your candidacy for surgery."

A newly graduated nurse has just started working at the acute psychiatric unit. Which patient would be the best to assign to this nurse? Patient who is frequently admitted for borderline personality disorder and suicidal gestures 2Patient admitted yesterday for disorganized schizophrenia and psychosis 3Patient newly admitted to determine differential diagnosis of depression, dementia, or delirium 4Patient newly diagnosed with major depression and rumination about loss and suicide

31. the nurse is caring for a pt who experiences frequent generalized tonic clonic seizures associated with periods of apnea. the nurse should be alert for which acid base imbalacne 1. resp alk 2. resp acid 3. mata alk 4. meta acid

5. the nurse has delegated collection of a urinalysis specimen to an experienced AP. for which action should the nurse intervene? 1. Ap provides pt with a specimen cup 2. AP reminds pt of the need for the specimen 3. AP assists the pt to the bathroom 4. AP allows the specimen to sit for more than 1 hour

500. The nurse is caring for a client admitted to the emergency department with diabetic ketoacidosis (DKA). In the acute phase, the nurse plans for which priority intervention? 1. Correct the acidosis. 2. Administer 5% dextrose intravenously. 3. Apply a monitor for an electrocardiogram. 4. Administer short-duration insulin intravenously.

650. the nurse is collectingd data from a pt. which symptom described by the pt is characteristic of an EARY symptom of benign prostatic hyperplasia? 1. nocturia 2. scrotal edema 3. occasional constipation 4. decreased force in the stream of urine

668. Oxybutynin chloride is prescribed for a client with urge incontinence. Which sign would indicate a possible toxic effect related to this medication? 1. Pallor 2. Drowsiness 3. Bradycardia 4. Restlessness

7. HCP has written these orders for a pt with daignosis of pulmonary edema. pt morning assessnment reveals bounding peripheral pulses, wt gain of 2 lb, pitting ankle edema, and mosist crackles bilaterally. which order takes priority 1. weight pt every morning 2.. maintain accuartae I/O records 3. restrict fluids to 1500 ml/day 4. adminster furosemide 40 mg IV push

A patient with type 1 diabetes reports feeling dizzy. What should the nurse do first? Check the patient's blood pressure. 2Give the patient some orange juice. 3Give the patient's morning dose of insulin. 4Use a glucometer to check the patient's glucose level.

The nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone secretion. Which patient care actions should the nurse delegate to the experienced assistive personnel? Select all that apply. Monitor and record strict intake and output.2Provide the patient with ice chips when requested.3Remind the patient about his or her fluid restriction.4Weigh the patient every morning using the same scale.5Report a weight gain of 2.2 lb (1 kg) to the nurse.6Provide mouth care and allow the patient to swallow the rinses.

1,3,4,5

The nurse is preparing to discharge a patient with hyperpituitarism caused by a benign pituitary tumor. The patient has been prescribed the drug bromocriptine. Which key points would the nurse teach the patient about this drug? Select all that apply. Take this drug with a meal or snack to avoid gastrointestinal (GI) symptoms.2Side effects of bromocriptine include severe fatigue and reflux after meals.3Seek medical care if you experience chest pain or dizziness while taking this drug.4If the drug causes headaches, you can take over-the-counter acetaminophen.5Treatment starts with a high dose, which is gradually lowered.6The purpose of bromocriptine is to shrink your pituitary gland to normal size.

1,3,4,6

The nurse is preparing a teaching plan for a patient with type 2 diabetes who has been prescribed albiglutide. Which key points would the nurse include? Select all that apply. The drug works in the intestine in response to food intake and acts with insulin for glucose regulation .2This drug increases the cellular utilization of glucose, which lowers blood glucose levels. 3This drug is used with diet and exercise to improve glycemic control in adults with type 2 diabetes. 4The drug is an oral insulin that should be given only when the patient has something to eat immediately available. 5Albiglutide is administered by the subcutaneous route once a week. 6Albiglutide should be given with caution for a patient with a history of pancreatic problems.

1,3,5

A well-known celebrity is admitted to the psychiatric unit. Several RNs from other units drop by and express an interest in seeing the patient. What is the best response? "Please be discreet and do not interrupt the workflow."2"How did you find out that the patient was admitted to this unit?"3"Please wait. I need to call the nursing supervisor about this request."4"I'm sorry; the patient has asked that only family be allowed to visit." Correct Answer

While working in the diabetes clinic, the RN obtains the following information about an 8-year-old patient with type 1 diabetes. Which finding is most important to address when planning child and parent education? Most recent hemoglobin A1c level of 7.8% 2Many questions about diet choices from the parents 3Child's participation in soccer practice after school 2 days a week 4Morning preprandial glucose range of 55 to 70 mg/dL (3.1 to 3.9 mmol/L)

a male pt has a tentative dx of urethritis. the nusre should assess the pt for which manifestation of the disorder? 1. hematuria and pyuria 2. dysuria and proteinuria 3. hematuria and urgency 4. dysuria and penile discharge

hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. nurse should assess fo which mani? 1. warmth, redness, pain in left hand 2. eccymosis and audible bruit over fistula 3. edema and reddish discoloration of the left arm 4. pallor, diminished pulse, and pain in the left hand

new type 1 DM - understands how to prevent DKA when pt says 1. i will stop taking insulin if im too sick to eat 2. i will decrease insuln doses during times of illness 3. i will adjust my insulin dose according to the level of glucose in my urine 4. i will notify my primary HCP if my BG level is hgiher than 250

nitrofurantoin is prescribed for a pt with a UTI. this pt contracts the nurse and reports a cough, chills, fever, and difficulty breathing. the nurse should make which interpretation? 1. pt may have contracted the flu 2. pt is experiencing anaphlyxasis 3. pt is experieicning expected effects of the medication 4. pt is experiencing a pulmonary reaction requiring cessation of the meidcation

nurse is providing care for 24 female adimitted with cystitis. which INT should nurse delegate to AP 1. teach pt how to secure a clean catch urine sample 2. assess pt urine for color,odor, sediment 3. review nursing care plan and addign nursing INT 4. provide pt with a clean catch urine sample container

nurse is providing care for a pt with reflex urinary incontinence. which action could be appropriate to assign to new LPN 1. teaching pt bladder emptying by the crede method 2. demonstrate how to perform self-cath 3. discuss wehn to report side effects of bethanechol chlroide to HCP 4. reinforce importance of proper hand washing to prevent infection

problem of constipation related to compression of the intestinal tract has been identified in a pt with polycystic kidney disease. what care should nusre assign to lpn 1. instruct the pt about foods that are high in fiber 2. teach pt about foods that assist in promoting bowel regularity 3. assessing the pt for previous bowel probs and bowel routine 4. adminstering docusate sodium 100 mg by mouth twice a day

pt complains of fever, perineal pain, urinary urgency, frequency, and dysuria. to assess whether pts problem is related to bacterial prostatitis, nurse reviews the results of the prostate exam for which characteritistic of this disorder? 1. solft/swollen prostate gland 2. swollen/boggy prostate gland 3. tender/edematous prostate gland 4. tender, indurated prostate gland that is warm to the touch

pt just returned from hemodialysis. pt is complain of HA and nausea and extremely restless. what is priority nursing action 1. monitor pt 2. elevate HOB 3. assess fistula site/dressing 4. notify HCP

the AP reports to the nurse that the pts UO for past 24 hours has been only 360 mL. what is priority action 1. place 18 gauge IV in the nondominant arm 2. elevate patients HOB at least 45 degrees 3. instruct the AP to provide the pt with a pitcher of ice water 4. contact HCP immediately

which pt at most risk for fluid volume excess 1. pt taking diuretics who has tenting of the skin 2. pt with an ileostomy from a recent abdominal surgery 3. the pt who requires intermittent GI suctioning 4. pt with kidney disease and 12 year hx of diabetes mellitius

which pt is at risk for the development of a potassium level of 5.5. 1. pt with colitis 2. pt with cushings disease 3. pt who has been overusing laxatives 4. pt who has sustained a traumatic burn

A patient diagnosed with paranoid schizophrenia says, "Dr. Smith has killed several other patients, and now he is trying to kill me." What is the best response? "I have worked here a long time. No one has died. You are safe here."2"What has Dr. Smith done to make you think he would like to kill you?"3"All of the staff, including Dr. Smith, are here to ensure your safety."4"Whenever you are concerned or nervous, talk to me or any of the nurses."

4 acknowledge without disagreeing or agreeing

671. tacrolimus is prescribed for a pt who underwent kidney transplant. which instruction should the nurse include when teaching the pt about this medication? 1. eat at frequent intervals to avoid hypoglycemia 2. take medication w/ full glass of grapefruit juice 3. change positions carefully due to risk of orthostatic hypotension 4. take the oral meds every 12 hours at the same times every day

4 helps maintain a stable blood sugar

A client is admitted to the hospital with a diagnosis of benign prostatic hyperplasia, and a transurethral resection of the prostate is performed. four hours after surgery, the nurse takes the pts VS and empties the urinary drainage bag. which assessment finding indicates the need to notify the HCP? 1. red, bloody urine 2. pain rated a 2/10 3. UO of 200mL higher than intake 4. BP 100/50, pulse 130

4 s/s of potential blood loss

A 24-year-old patient with diabetes insipidus (DI) makes all of these statements when the nurse is preparing the patient for discharge from the hospital. Which statement indicates to the nurse that the patient needs additional teaching? "I will drink fluids equal to the amount of my urine output." 2"I will weigh myself every day using the same scale." 3"I will wear my medical alert bracelet at all times. "4"I will gradually wean myself off the vasopressin."

4 those with DI require lifelong vasopressin therapy

pt who has a cold is seen in the ER with an inabilty to void. because the pt has a hx of BPH the nurse determines the pt should be questioned about what medicaiton? 1. diuretics 2. antibiotics 3. antilipemics 4. decongestants

4 urinary retention can be triggered by decongestants

which prescription for a pt with hypercalcemia would the nurse questioN? 1. 0.9% salinea t 50mL/hr IV 2. furosemide 20 mg orally each morning 3. apply cardiac tele 4. Hydrochloroathiazide (HCTZ) 25 mg orally each morning

4 -calcium excretion is decreased with thiazide diurectics

A patient is recieiving IV fluid of NS at a rate of 100 mL/hr. which effect on RBC would the nurse expect?

Looks normal

A pt has urolithiasis and is passing the stones into the lower urinary tract. What is the priority nursing dx for this pt at this time? a. acute pain b. risk for infection c. risk for injury d. anxiety related to the risk for recurrent stones

8.True or False: D5W solutions are sometimes considered a hypotonic solution as well as an isotonic solution because after the body absorbs the dextrose the solution acts as a hypotonic solution.

True Sits in the bag is different than when in the body

The RN is supervising a senior student nurse who is caring for a fresh postoperative patient who had a hypophysectomy. The RN observes the student nurse perform all of these actions. For which action must the RN intervene?

avoid coughing early bc it can increase pressure and lead to cerbrospinal fluid leak

The nurse is providing care for a patient who underwent a thyroidectomy 2 days ago. Which laboratory value requires close monitoring by the nurse?

calcium

The nurse admits a patient whose assessment reveals prominent brow ridge, large hands and feet, and large lips and nose. Which pituitary hormone does the nurse suspect is elevated?

growht hormone

DM chapter 13 question 34 math

in book

511. A client has been diagnosed with hyperthyroidism. The nurse monitors for which signs and symptoms indicating a complication of this disorder? Select all that apply. 1. Fever 2. Nausea 3. Lethargy 4. Tremors 5. Confusion 6. Bradycardia

1, 2, 4, 5

23. AP reports to the nusre that a patient seems very anxious, and VS measurement included a RR of 38 breaths/min. which acid base imbalance should the nurse suspect? 1. resp acidosis 2. resp alkalosis 3. metabolic acidosis 4. metabolic alkolosis

For which endocrine disorder is PTU prescribed?

Hyperthyroidism

_______ solutions cause cell dehydration and help increase fluid in the extracellular space.

Hypertonic

487. A client is brought to the ED in an unresponsibe state w/ dx of hyperosmolar hyperglycemic syndrome. nurse would immediately prepare to initiate which HCP prescription? 1. endotrach intubation 2. 100 units of NPH insulin 3. IV infusion of NS 4. IV infusionof sodium bircarb

49. nurse is reading HCP progress notes and reads documented "insensible fluid loss of approximately 800mL daily" nurse makes a notation that insensible fluid loss occurs through which type of excretion? 1. UO 2. wound drainage 3. integumentary output 4. GI tract

The RN is orienting a newly graduated nurse who is providing diabetes education for a patient about insulin injection. For which teaching statement by the new nurse must the RN intervene? "To prevent lipohypertrophy, be sure to rotate injection sites from the abdomen to the thighs. "2"To correctly inject the insulin, lightly grasp a fold of skin and inject at a 90-degree angle. "3"Always draw your regular insulin into the syringe first before your NPH (neutral protamine Hagedorn) insulin ."4"Avoid injecting the insulin into scarred sites because those areas slow the absorption rate of insulin."

The nurse is caring for a patient who has just undergone a hypophysectomy for hyperpituitarism. Which postoperative finding requires immediate intervention? Presence of glucose in the nasal drainage 2Presence of nasal packing in the nares 3Urine output of 40 to 50 mL/hr 4Patient reports of thirst

The nurse is caring for an older patient with type 1 diabetes and diabetic retinopathy. What is the nurse's priority concern for assessing this patient? 1.Assess ability to measure and inject insulin and to monitor blood glucose levels. 2Assess for damage to motor fibers, which can result in muscle weakness. 3Assess which modifiable risk factors can be reduced. 4Assess for albuminuria, which may indicate kidney disease.

Which change in vital signs for a patient with hyperthyroidism would the nurse instruct the assistive personnel (AP) to report immediately? Rapid heart rate2Decreased systolic blood pressure3Increased respiratory rate4Decreased oral temperature

nurse is assessing the patency of a pts left arm arteriovenous fistula prior to initating hemodialysis. which finding indicates the fistula is patent? 1. palpation of a thrill over the fistula 2. presence of a radial pulse in the left wrist 3. visualization of enlarged blood vessels at the fistula site. 4. cap refill less than 3 seconds in the nailbeds of the fingers on the left hand

nurse is caring for a pt at risk for kidney disease for whom a urinalysis has been ordered. what time would the nurse instruct the AP to best collect sampe 1. first morning void 2. before any meal 3.. at bedtime 4. immediately

nurse is providing care for several pts who are at risk for acid base imbalance. which pt is most at risk for respiratory acidosis 1. 68 pt with chronic emphysema 2. 58 pt who uses antacids every day 3. 48 with anxiety 3. 48 pt with salicylate intoxication

pt is admitted to the ED following a fall from a horse, and the HCP prescribes insertion of a urinary catheter. while preparing for the porcedure, the nurse notes blood at the urinary meatus. the nusre should take which action? 1. notify the HCP before performing the catheterization 2. use small sized catheter and anesthetic gel as a lubricant 3. adminster parenteral pain medication before inserting the catheter 4. clean meatus with soap and water before opening the cath kit

pt is at risk for poor perfusion related to decreased plasma volume. which assessment finding supports the risk? 1. flattened neck veins when the pt is in the supine position 2. full and bounding pedal and psot tibial pulses 3. pitting edema located in feet, ankles, calves 4. shallow respirations with crackles on ausculation

pt with incontinenece will be taking oxybutynin chloride 5 mg PO 3x a day after discharge. which info should nurse include? 1. drink fluids or use hard candy when you expereince a dry mouth 2. be sure to notify HCP if you expereince dry mouth 3. if necessary your HCP can increase your dose to 40 mg 4. you should take this meds with meals to avoid stomach ulcers

31. pt is recieving iv piggyback doses of gentamacin every 12 hours. which would the nurses priortiy for monitoring while on this drug 1. serum creatinine and blood urea nitrogen (BUN) levels 2. pt weight every morning 3. I/O each shift 4. temp q4h

1 can be highly nephrotoxic.

nurse is admitting a pt with nephrotic syndrome. which assessment finding supports this? 1. edema formation 2. hypotension 3. increased urine output 4, flank pain

1 patho includes increased glomerular permabilty whihc allows larger molecules to pass through the membraine into the urine and be removed from the blood. this process causes loss of protein and edema formation.

A patient with newly diagnosed diabetes has peripheral neuropathy. Which key points should the nurse include in the teaching plan for this patient? Select all that apply. "Clean and inspect your feet every day. "2"Be sure that your shoes fit properly. "3"Nylon socks are best to prevent friction on your toes from shoes ."4"Only a podiatrist should trim your toenails. "5"Report any nonhealing skin breaks to your health care provider (HCP) ."6"Use a thermometer to check the temperature of water before taking a bath."

1, 2 , 5 , 6

36. the RN is discussing methods for preventing AKI. which points should RN include? SATA 1. encourage pts to avoid dehydration by drinking adequate fluis 2. instruct pts to drink extra fluids during periods of strenous exercise 3. immedaitely report UO of less than 2ml/kg/hr 4. record i/o and weight pt daily 5. question and prescription for potentially nephrotoxic drugs 6. monitor lab values that reflect kidney function

1, 2, ,4, 6 many drugs are nephrotoxic but still administered 0.5 or less for 2 hrs UO is notify HCP

518. The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide and metformin. The nurse should provide which instructions to the client? Select all that apply. 1. Diarrhea may occur secondary to the metformin. 2. The repaglinide is not taken if a meal is skipped. 3. The repaglinide is taken 30 minutes before eating. 4. A simple sugar food item is carried and used to treat mild hypoglycemia episodes. 5. Muscle pain is an expected effect of metformin and may be treated with acetaminophen. 6. Metformin increases hepatic glucose production to prevent hypoglycemia associated with repaglinide.

1, 2, 3, 4

7. nurse providing care for pt after a kidney biopsy. which actions should the nurse delegate to an expereinced AP SATA 1. check vs q4h for 24hours 2. remind pt about strict bed rest for 2 to 6 hours 3. reposition pt by log rolling with supporting back roll 4. measure and record UO 5. assess the dressing site for bleeding and check CBC results 6. teach pts to resume normal activities after 24 hours if there is no bleeding

1, 2, 3, 4,

27. nurse is teaching pt how to prevent renal trauma after an injury that required a left nephrectomy. which points should be taught SATA 1. always wear a seat belt 2. avoid contact sports 3. practice safe walking habits 4. wear protective clothing if participate in sports 5. use caution when riding a bike 6. always avoid drugs that will damage kidney

1, 2, 3, 5 drugs that harm kidney may still be prescribed, to save a pts life.

42. Potassium chloride intravenously is prescribed for a client with heart failure experiencing hypokalemia. Which actions should the nurse take to plan for preparation and administration of the potassium? Select all that apply. 1. Obtain an intravenous (IV) infusion pump. 2. Monitor urine output during administration. 3. Prepare the medication for bolus administration. 4. Monitor the IV site for signs of infiltration or phlebitis. 5. Ensure that the medication is diluted in the appropriate volume of fluid. 6. Ensure that the bag is labeled so that it reads the volume of potassium in the solution.

1, 2, 4, 5, 6

32. nurse is completing a hx for an older pt at risk for an acidosis imbalance. which question would the nurse be sure to ask? SATA 1. which drugs do you take on a daily basis 2. do you have any probs with breathing 3. when was ur last bowel mvoement 4. have u expereinced any activity intolerance or fatigue in the past 24 hours 5. over the past month have u had any dizzy or tittinitus 6. do you have episodes of droswy or decreased alertness

1, 2, 4, 6

521. The nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply. 1. Insomnia 2. Weight loss 3. Bradycardia 4. Constipation 5. Mild heat intolerance

1, 2, 5

502. The nurse is completing an assessment on a client who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which client complaints would be characteristic of this disorder? Select all that apply. 1. Polyuria 2. Headache 3. Bone pain 4. Nervousness 5. Weight gain

1, 3,

504. A client with a diagnosis of addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional health care team focus on? Select all that apply. 1. Hypotension 2. Leukocytosis 3. Hyperkalemia 4. Hypercalcemia 5. Hypernatremia

1, 3,

517. A client with DM is taking Humulin NPH insulin/regular insulin each morning. nurse provide which instructions to pt? SATA 1. hypoglycmeia may be experienced before dinnertime 2. insulin dose should be decreaesd if illness occurs 3. the insulin should be administered at room temp 4. the insulin vial needs to be shaken vigorously to break up the precipitates 5. the nph insulin should be drawn in to the syringe first, then regular insulin

1, 3,

505. The nurse is monitoring a client who was diagnosed with type 1 diabetes mellitus and is being treated with NPH and regular insulin. Which manifestations would alert the nurse to the presence of a possible hypoglycemic reaction? Select all that apply. 1. Tremors 2. Anorexia 3. Irritability 4. Nervousness 5. Hot, dry skin 6. Muscle cramps

1, 3, 4

520. A client with hyperthyroidism has been given methimazole. Which nursing considerations are associated with this medication? Select all that apply. 1. Administer methimazole with food. 2. Place the client on a low-calorie, low-protein diet. 3. Assess the client for unexplained bruising or bleeding. 4. Instruct the client to report side and adverse effects such as sore throat, fever, or headaches. 5. Use special radioactive precautions when handling the client's urine for the first 24 hours following initial administration.

1, 3, 4

498. The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which primary health care provider prescriptions should the nurse anticipate receiving? Select all that apply. 1. Initiate an infusion of 3% NaCl. 2. Administer intravenous furosemide. 3. Restrict fluids to 800 mL over 24 hours. 4. Elevate the head of the bed to high-Fowler's. 5. Administer a vasopressin antagonist as prescribed.

1, 3, 5

41. the nurse reviews a pt electrolyte lab report and notes the K+ level is 2.5. which patterns should the nurse watch for on the ECG? SATA 1. u waves 2. absent p waves 3. inverted t waves 4. depressed ST segment 5. widened QRS complex

1, 3,4

26. Pt has an order for hydrochlorothiazide (HCTZ) 10 mg orally every day. What should the nurse be sure to include in a teaching plan for this drug? SATA 1. take meds in the morning 2. this meds should be taken in two divided doses: half when you get up and half when you go to bed 3. eat foods with extra sodium every day 4. inform HCP if you notice wt gain or increased swelling 5. you should expect your UO to increase 6. your HCP may also prescribe a potassium supplement

1, 4, 5, 6

charge nurse assigned the care of a pt wiith acute kidney failure and hypernatremia to a newly grad RN. which actions can the new RN deleagete to the AP SATA 1. provide oral care every 3-4 hours 2. monitor for indications of dehydration 3. administer 0.45% saline by IV line 4. record UO when patient voids 5. assess daily weights for trends 6. help pt change positions

1, 4, 6

nurse is admitiing 72 y/o. he was alert untl recently and has become confused. over the past 36 hours the pt developed signs/symp of fluid overload. VS: pulse 112, Respiratorn 34, BP 168/94 1. increase HR, 2. weak thread pulse, 3. alert and orientated 4. pitting edema of lower extremities 5. deep respirations 6. distended neck veins 7. bilateral rhonchi 8. hyperactive bowel sounds 9. wt. loss 10. pale cool skin

1, 4, 6 , 8, 10

male pt must undergo intermittent cath. nurse is preparing pt. order of steps 1. assist pt to the bathroom and ask the pt to attempt to void 2. retract foreskin and hold penis at 60-90 degree angle 3. open the cath kit and put on sterile gloves 4. lubricate catha nd insert it through the meatus of the penis 5. position pt supine in bed or with the head slightly elevated 6. drain all the urine present in the bladder into a container 7. cleanse the galns penis starting at the meatus and working outward 8. remove the catheter, clean the penis, and measure the amount of urine returned

1, 5, 3, 2, 7, 4, 6, 8

nurse monitoring a pt recieiving periotneal dialysis notes the pts outflow is less than the inflow. which actions should be took? SATA 1. check level of drainage bag 2. reposition pt to her or his side 3. place pt in good body alignment 4. check peritoneal dialysis system for kinks 5. contact PCP 6. increase the flow rate of the peritoneal dialysis solution.

1,2,3,4

Which actions prescribed by the health care provider for the patient with Addison disease should the nurse delegate to the experienced assistive personnel (AP)? Select all that apply. Weigh the patient every morning.2Obtain fingerstick glucose before each meal and at bedtime.3Check vital signs every 2 hours.4Monitor for cardiac dysrhythmias.5Administer oral prednisone 10 mg every morning.6Record intake and output.

1,2,3,6

pt with AKI has potassium of 7,. priority actions? SATA 1. place pt on cardiac monitor 2. notify HCP 3. put pt on NPO except for ice chips 4. reviews pts meds to determine if they contain or retain potassium 5. allow an extra 500mL of IV fluid intake to dilute the electrolyte concentation

1,2,4

The nurse is providing diabetic teaching for an 18-year-old patient with newly diagnosed type 1 diabetes.Vital signs:Temperature 98.7°F (37.06°C)Pulse 98 beats/minRespirations 27 breaths/minBlood Pressure 168/94 mmHg>Which key information would the nurse be sure to include in the teaching plan for this patient?Select all that apply. Fingerstick glucose monitoring2Insulin injection3Types of oral hypoglycemic drugs4Signs of hypoglycemia and hyperglycemia5Avoidance of fast foods and carbohydrates6Need for daily foot care7Relationship of mealtime and action of insulin8Sick day procedures

1,2,4,6,7,8

A 58-year-old patient with type 2 diabetes was admitted to the acute care unit with a diagnosis of chronic obstructive pulmonary disease (COPD) exacerbation. When the RN prepares a care plan for this patient, what would he or she be sure to include? Select all that apply. Fingerstick blood glucose checks before meals and at bedtime 2Sliding-scale insulin dosing as prescribed 3Bed rest until the COPD exacerbation is resolved 4Teaching about the Atkins diet for weight loss 5Demonstration of the components of foot care 6Discussing the relationship between illness and glucose levels

1,2,5,6

Which actions should the nurse assign to the experienced LPN/LVN for the care of a patient with hypothyroidism? Select all that apply. 1Assessing and recording the rate and depth of respirations 2Auscultating lung sounds every 4 hours' 3Creating an individualized nursing care plan for the patient 4Administering sedation medications every 6 hours 5Checking blood pressure, heart rate, and respirations every 4 hours 6Reminding the patient to report any episodes of chest pain or discomfort

1,2,5,6

nurse dicussess future tx options with pt with symptomatic polycestic kidney disease. which treatment should be included in discussion. SATA 1. hemodialysis 2. peritoneal diaylsis 3. kidney transplant 4. bilateral nephrectomy 5. intense immunosuppression therapy

1,3,4

The nurse is caring for an 81-year-old adult with type 2 diabetes, hypertension, and peripheral vascular disease. Which admission assessment findings increase the patient's risk for development of hyperglycemic-hyperosmolar syndrome (HHS)? Select all that apply. Hydrochlorothiazide prescribed to control blood pressure 2Weight gain of 6 lb (2.7 kg) over the past month 3Avoids consuming liquids in the evening 4Blood pressure of 168/94 mm Hg 5Urine output of 50 to 75 mL/hr 6Glucose greater than 600 mg/dL (33.3 mmol/L)

1,3,6

The RN is caring for a patient with diabetes admitted with hypoglycemia that occurred at home. Which teaching points for treatment of hypoglycemia at home would the nurse include in a teaching plan for the patient and family before discharge? Select all that apply. Signs and symptoms of hypoglycemia include hunger, irritability, weakness, headache, and blood glucose less than 60 mg/dL (3.3 mmol/L). 2Treat hypoglycemia with 4 to 8 g of carbohydrates such as glucose tablets or 1/4 cup (60 mL) of fruit juice. 3Retest blood glucose in 30 minutes. 4Repeat the carbohydrate treatment if the symptoms do not resolve. 5Eat a small snack of carbohydrates and protein if the next meal is more than an hour away. 6If the patient has severe hypoglycemia, does not respond to treatment, and is unconscious, transport to the emergency department (ED).

1,4,5,6

The nurse is caring for a patient with diabetes who is developing diabetic ketoacidosis (DKA). Which task delegation or assignment is most appropriate? Ask the unit clerk to page the health care provider (HCP) to come to the unit. 2Ask the LPN/LVN to administer IV push insulin according to a sliding scale. 3Ask the assistive personnel (AP) to hang a new bag of normal saline. 4Ask the AP to get the patient a cup (236 mL) of orange juice.

1- lpns usually cant do IV push

29. the SN under the supervision of an RN is reviewing a pts ABG results and notes an increase in arterial partial pressure of carbon dioxide (paco2) to 51. which statement by the SN indicates acurate understating 1. when the paco2 is acutely elevated, the blood ph should be lower than normal 2. this pt should be taught to breathe and rebreathe in a paper bag 3. an elevated paco2 always means the pt has acidosis 4. when a pt paco2 is increased, the RR should decrease to compensate

1- normal is 35-45. when paco2 chagnes acutely, the Ph changes the saem degree but in the opposite direction

When providing care for a patient with Addison disease, the nurse should be alert for which laboratory value change? Decreased hematocrit 2Increased sodium level 3Decreased potassium level 4Decreased calcium level

1- pt with addison is at risk for anemia sodium would decrease and k+ and calcium levels would increase

10. pts potassium is 6.7. which INT should nurse delegate to first year student nurse? 1. administer sodium polystrene sulfonate 15 g orally 2. adminster spirnolactone 25 mg orally 3. assest ECG for tall T waves 4. adminster potassium 10 m/q orally

1- removes potassium

519. The nurse is teaching the client about his prescribed prednisone. Which statement, if made by the client, indicates that further teaching is necessary? 1. I can take aspirin or my antihistamine if I need it. 2. I need to take the medication every day at the same time. 3. I need to avoid coffee, tea, cola, and chocolate in my diet. 4. If I gain 5 pounds or more a week, I will call my doctor.

1. consult hcp

11. nurs is admitting 66 pt suspected of a UTI. which part of pts med hx supports this diagnosis 1. pts wife had a UTI 1 month ago 2. followed for prostate disease for 2 years 3. intermittent catheterization 6 months ago 4. kidney stone removal 1 year ago

13. an experienced LPN reports to the rn that a pts BP and HR have decreased and that when his face was assessed. one side twitched. what action should the RN take at this time? 1. reassess pts BP and HR 2. review morning calcium level 3. request a neuro consult today. 4. check the pts pupillary reaction to light.

nurse is caring for pt with acute kidney failure for whom volume overload has been idintified. what should delegate to AP SATA 1. measure/record VS q4h 2. weight pt each monring using standing scale 3. administer furosemide 40 mg twice a day 4. remind pt to save all urine for I/O 5. assess breath sounds q4h 6. ensure pts urinal is within reach

1.2.4.6

pt with CKD being hemodialzyed suddenly becomes SOB an complains of chest pain. pt is tachycardic, pale, anxious, and nurse suspects air embolism. what are priority nursing actions? SATA 1. administer oxygen to the pt 2. continue dialysis at a slower rate after checking the lines for air 3. notify HCP and rapid response team 4. stop dialysis, and turn pt on the left side with head lower than feet 5. bolus pt with 500 mL of normal saline to break up the air embolus

1.3.4.

The assistive personnel reports to the RN that a patient with type 1 diabetes has a question about exercise. What important points would the RN be sure to teach this patient? Select all that apply. Exercise guidelines are based on blood glucose and urine ketone levels. 2Be sure to test your blood glucose only after exercising. 3You can exercise vigorously if your blood glucose is between 100 and 250 mg/dL (5.6 and 13.9 mmol/L). 4Exercise will help resolve the presence of ketones in your urine. 5A 5- to 10-minute warm-up and cool-down period should be included in your exercise. 6For unplanned exercise, increased intake of carbohydrates is usually needed.

1.3.5.6

25. pt has an NG tube connected to intermittent wall suction. the SN asks why the pts RR and depth has decreased. what is nurses best response? 1. "its common for patients with uncomforatble equiment such an NG tubes to have a lower rate of breathign 2. pt may have metabolic alkolosis bc of the NG suction, and the decreased RR is a compensatory mechanism. 3. whenever a pt develops a respiratory acid base problem, decreasing the RR helps correct the problem 4. the pt is hypoventilating because of anxiety, and we will have to stay alert for the development of respiratory acidosis.

27. which blood test result would the nurse be sure to monitor for the pt taking hydrochlorothiazide 1. sodium 2. potassium 3. chloride 4. calcium

495. The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The nurse places priority on which client problem? 1. Lack of knowledge 2. Inadequate fluid volume 3. Compromised family coping 4. Inadequate consumption of nutrients

497. The nurse is caring for a client after hypophysectomy and notes clear nasal drainage from the client's nostril. The nurse should take which initial action? 1. Lower the head of the bed. 2. Test the drainage for glucose. 3. Obtain a culture of the drainage. 4. Continue to observe the drainage.

499. A client is admitted to an emergency department, and a diagnosis of myxedema coma is made. Which action should the nurse prepare to carry out initially? 1. Warm the client. 2. Maintain a patent airway. 3. Administer thyroid hormone. 4. Administer fluid replacement.

501. A client with DM type 1 who takes NPH daily in the morning calls the nusre to report recurrent episodes of hypoglycmeia with exercising. which statement indicates good understanding of the peak action of NPH insulin and exercise? 1. i should not exercise since i am taking insulin 2. the best time for me to exercise is after breakfast 3. the best time to exercise is mid to late afternoon 4. nph is a basal isnulin, so i should exercise in the evening

513. The home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse should tell the client to take which action? 1. Freeze the insulin. 2. Refrigerate the insulin. 3. Store the insulin in a dark, dry place. 4. Keep the insulin at room temperature.

523. The nurse should tell the client who is taking levothyroxine to notify the primary health care provider (PHCP) if which problem occurs? 1. Fatigue 2. Tremors 3. Cold intolerance 4. Excessively dry skin

524. Pt newly dx with DM who has been prescribed pramlintide. Which instruction should the nurse include in discharge? 1. inject the pramlintide at the same time you take ur other meds 2. take ur prescribed pills 1 hr before or 2 hrs after the injection 3. be sure to take the pramlintide w/ food so ur stomach isn't upset 4. make sure u take ur pramlintide asap after you eat so u don't experience a low blood sugar

528. A client with DM visits a clinic. usually well controlled with gluburide daily but today is was 160-200 BG. which meds, if added to regimen, may have contributed to the hyperglycemia? 1. atenolol 2. prednisone 3. phenelzine 4. allopurinol

9. the nurse has been floated to the tele unit for the day. the tech informs the nurse that the pt has developed prominent U waves . which lab value should be checked immediately 1, sodium 2.potassium 3. magnesium 4. calcium

A patient with diabetes has hot, dry skin; rapid and deep respirations; and a fruity odor to his breath. The charge nurse observes a newly graduated RN performing all of the following patient tasks. Which action requires that the charge nurse intervene immediately? Checking the patient's fingerstick glucose level 2Encouraging the patient to drink orange juice 3Checking the patient's order for sliding-scale insulin dosing 4Assessing the patient's vital signs every 15 minutes

The RN is serving as preceptor to a newly graduated nurse who has recently passed the RN licensure (NCLEX®) examination. The new nurse has only been on the unit for 2 days. Which patient should be assigned to the newly graduated nurse? A 68-year-old patient with diabetes who is showing signs of hyperglycemia 2A 58-year-old patient with diabetes who has cellulitis of the left ankle 349-year-old patient with diabetes who just returned from the postanesthesia care unit after a below-knee amputation 4A 72-year-old patient with diabetes who has diabetic ketoacidosis and is receiving IV insulin

The RN is the preceptor for a senior nursing student who will teach a patient with diabetes about self-care during sick days. For which statement by the student must the RN intervene? 1"When you are sick, be sure to monitor your blood glucose at least every 4 hours. "2"Test your urine for ketones whenever your blood glucose level is less than 240 mg/dL (13.3 mmol/L). "3"To prevent dehydration, drink 8 ounces (236 mL) of sugar-free liquid every hour while you are awake. "4"Continue to eat your meals and snacks at the usual times." Submit

The nurse is caring for a 25-year-old patient admitted to the acute care unit with an intense thirst and dilute, excessive straw-colored urine output (up to 15 L/day). What does the nurse suspect? Type 2 diabetes2Diabetes insipidus (DI)3Cushing disease4Addison disease

The nurse is caring for a young patient with type 1 diabetes who has sustained injuries when she tried to commit suicide by crashing her car. Her blood glucose (BG) level is 700 mg/dL (38.8 mmol/L), but she refuses insulin; however, she wants the pain medication. What is the best action? Notify the charge nurse and make arrangements to transfer to intensive care.2Explain the significance of BG and insulin and call the health care provider (HCP).3Withhold the pain medication until she agrees to accept the insulin.4Give her the pain medication and document the refusal of the insulin.

The patient tells the nurse that he drinks three or four servings of alcohol every day. He also reports frequently taking acetaminophen for stress-related headaches. Based on this information, which laboratory test results are the most important to follow up on? Renal function tests 2Liver function tests 3Cardiac enzymes 4Serum electrolytes

When the nurse must apply containment strategies for a patient with incontinence, what is the major risk? 1. Incontinence-associated dermatitis 2. Skin breakdown 3. Infection 4. Fluid imbalance

Pt has acute kidney failure and urine oputput of 1560ml for past 8 hrs. the LPN aks how much a pt with kidney failure can have such a large urine output. what is the best response 1. the pts kidney faliure was caused by hypovolemia, and we have given him IV fluids to correct the problem 2. acute kidney failure pts go through a diruetic phase when their kidneys begin to recover and may put out as much as 10L /day 3. with that muh UO there must be a mistake in pt dx 4. an increase in UO like this is an indicator that the pt is entering the recovery pahse of acute kidney failure

2 usually go through a diuretic phase 2-6 weeks after oliguric phase.

2. the nurse is reviewing the lab values for a pt with risk for urinary problems. which finding is of most concern to the nurse 1. blood urea nitrogen of 10 mg/mL 2. presence of glucose and protein in urine 3. serum creatinine of 0.6 4. urinary pH of 8

2 -when BG are greater than 220 some glucose stays in the filtrate and is present in the urine.

Bethanechol chloride is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this cholinergic medication? 1.Gastric atony 2.Urinary strictures 3.Neurogenic atony 4.Gastroesophageal reflux

2 Bethanechol chloride (Urecholine) can be hazardous to clients with urinary tract obstruction or weakness of the bladder wall. The medication has the ability to contract the bladder and thereby increase pressure within the urinary tract.

In the emergency department, during the initial assessment of a newly admitted patient with diabetes, the nurse discovers all of these findings. Which finding should be reported to the health care provider immediately? Hammer toe of the left second metatarsophalangeal joint 2Rapid respiratory rate with deep inspirations 3Numbness and tingling bilaterally in the feet and hands 4Decreased sensitivity and swelling of the abdomen

2 Kussmaul respirations are a sign of DKA!

Phenazopyridine is prescribed for a client with a urinary tract infection. The nurse evaluates that the medication is effective based on which observation? 1. urine is clear amber 2. urination is not painful 3. urge-incontinence is not present 4. reddish orange discoloration of the urine is present.

2 side effect is red/orange but not DESIRED effect

20. THe RN is teaching a pt how to perform intermittent self-cath for a long term prob with incomplete bladder emptying. what are the most important points for teaching this technique? SATA 1. always use sterile techniuqe 2. proper hand washing and cleaning of catheter reduce risk of infection 3. a small lumen and good lubrication of the catheter prevent urethral trauma 4. regular schedule for bladder emptying prevents distention and mucosal trauma 5. the social work department can help you with the purchase of sterile supply 6. if you are uncomfortable with this, a home health nurse can do it

2, 3, 4,

514. Glimepiride is prescribed for a client with diabetes mellitus. The nurse instructs the client that which food items are most acceptable to consume while taking this medication? Select all that apply. 1. Alcohol 2. Red meats 3. Whole-grain cereals 4. Low-calorie desserts 5. Carbonated beverages

2, 3, 5

what should the nurse delegate to an AP for the pt with DKA 1. check fignerstick glucose every hour 2. record I/O qhour 3. measure VS q15 min 4. assess for indicators of fluid imablance 5. notify HCP of change in glucose level 6. assist pt to reposition every 2 hours

2, 3, 6

507. The nurse is monitoring a client diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy and is recovering in the intensive care unit. Which findings should alert the nurse to the presence of a possible postoperative complication? Select all that apply. 1. Anxiety 2. Leukocytosis 3. Chvostek's sign 4. Urinary output of 800 mL/hr 5. Clear drainage on nasal dripper pad

2, 4, 5 hypocalcemia has no correlation with hypophysectomy

489, pt with DKA is being treated. which findings support this diagnosis. SATA 1. increase in pH 2. comatose state 3. deep, rapid breathing 4. decreased UO 5. elevated BG levels

2,3,5

The nurse is preparing a care plan for a patient with Cushing disease. Which abnormal laboratory values would the nurse expect? Select all that apply. Increased serum calcium level2Increased salivary cortisol level3Increased urinary cortisol level4Decreased serum glucose level5Decreased sodium level6Increased serum cortisol level

2,3,6

525. The nurse teaches the client who is newly diagnosed with diabetes insipidus about the prescribed intranasal desmopressin. Which statements by the client indicate understanding? Select all that apply. 1. "This medication will turn my urine orange." 2. "I should decrease my oral fluids when I start this medication." 3. "The amount of urine I make should increase if this medicine is working." 4. "I need to follow a low-fat diet to avoid pancreatitis when taking this medicine." 5. "I should report headache and drowsiness to my doctor since these symptoms could be related to my desmopressin."

2,5

Two assistive personnel (AP) are assisting a patient with Cushing disease to move up in bed. Which action by the APs requires the nurse's immediate intervention? Positioning themselves on opposite sides of the patient's bed 2Grasping under the patient's arms to pull him up in bed 3Lowering the side rails of the patient's bed before moving him 4Removing the pillow before moving the patient up in bed

2- those with cushing usually have paper-thin skin that is easily injured

18. which pt wouldd the charge nurse assign to the step down unit nurse who was floated to the icu for the day 1. 68 y/o on vent with acute respiatory failure and resp. acidosis 2. 72 yo with COPD and normal blood gas values who is vent dependent 3. newly admitted 56 year old with DKA recieving insulin drip 4. 38 yo pt on a vent with narcotic overdose and respiratory alkalosis

26. pt has renal cell carcinoma. nurse asked why this pt is not receiving chemo? best response 1. the progonosis for this form of cancre is very poor, and we will be proiding only comfort measures 2. nephrectomy is the prefferred tx bc chemo has been shown to have only limited effectiveness against this type of cancer 3. research has shown that the most effective tx is with radiation 4. radiofrequency abation is a minimally invasive procedure that is the best way to treat renal cell carcinoma

The nurse is responsible for the care of a patient with diabetes who is unable to swallow, is unconscious and seizing, and has a blood glucose level of less than 20 mg/dL (1.1 mmol/L). Which actions are the most appropriate responses for this patient at this time? Select all that apply. Check the chart for the patient's most recent A1c level. 2Give glucagon 1 mg subcutaneously or intramuscularly (IM). 3Repeat the dose of glucagon in 10 minutes if the patient remains unconscious. 4Apply aspiration precautions because glucagon can cause vomiting. 5Give the patient an oral simple sugar or snack. 6Notify the health care provider (HCP) immediately.

2.3.4.6

490. differentating between hypoglycemia and ketoacidosis. pt demonstrates understanding by stating that a form of glucose should be taken if which symptoms develop? SATa 1. polyuria 2. shaky 3. palpitations 4. blurred vision 5. lightheadedness 6. fruity breath odor

2.3.5. these indicate s/s of hypoglycemia and would indicate need for food or glucose. other signs indicate hyperglycemia

Which actions can the school nurse delegate to an experienced assistive personnel (AP) who is working with a 7-year-old child with type 1 diabetes in an elementary school? Select all that apply. Obtaining information about the child's usual insulin use from the parents 2Administering oral glucose tablets when the blood glucose level falls below 60 mg/dL (3.3 mmol/L) 3Teaching the child about what foods have high carbohydrate levels 4Obtaining blood glucose readings using the child's blood glucose monitor 5Reminding the child to have a snack after the physical education class 6Assessing the child's knowledge level about his or her type 1 diabetes

2.4.5

pt with end stage kidney disease who is recivieving hemodialysis 3days/week. on return from dialysis the RN notes a positive bruit and thrill at dialysis site on the left arm. bruising is noted distal and medial to the access. pt states that she has no pain/discomfort. SATA to be delegated to AP 1. check pts bp in both arms 2. weight pt on return from dialysis tx 3. reassess the pts dialysis site for a bruit and thrill 4. assist pt up to chair for meals 5. record i/o 6. report any pt bleeding to RN ASAP 7. assess pt for signs of hypotension after dialysis 8. administer evening medciation as ordered 9. place a sign over the bed stating "No BP, IV or venipunctures in left arm)

2.4.5.6.9

16. The AP asks the nusre why the pt with chronic low phospohorus level needs to much assistance with ADLs. what is the RNs best response 1. pt is low phosp because of malnutrition 2. pt is just worn out from not getting enough rest 3. pt skeletal muscles are weak bc of the low phosp. 4. the pt will do more for hinmself when his ph. level is normal

3. for which pt is the nurse most concerned about the risk for developing kidney disease? 1. a 25 y/o pt who developed a urinary tract infection during pregnancy 2. 55 pt w/ hx of kidney stones 3. 63 pt with DM type 2 4. 79 pt with stress urinary incontinence

47. nurse is caring for pt with HF who is recieing high doses of a diuretic. on assessment, nurse notes the pt has flat neck veins, generalized muscle weakness, and diminisnehd depp tendon reflexes. the nurse suspects hyponatremia. what additional signs would the nurse expect to note in a pt with hyponatremia 1. muscle twitches 2. decreased UO 3. hyperactive bowel sounds 4. increased specific gravity of urine

For several years, a patient diagnosed with hypochondriasis has undergone multiple diagnostic tests for "cancer," with no evidence of organic disease. Today he declares, "I know I have a brain tumor. My appointment is tomorrow, but I can't wait!" What is the most therapeutic response? Present reality: "Sir, you have been seen many times in this clinic and had many diagnostic tests. The results have always been negative."2Encourage expression of feelings: "Let me spend some time with you. Tell me about what you are feeling and why you think you have a brain tumor."3Set boundaries: "Sir, I will take your vital signs, but then I am going to call your case manager so that you can discuss the scheduled appointment."4Respect the patient's wishes: "Sir, sit down and I will make sure that you see the health care provider right away. Don't worry; we will take care of you."

THe RN is supervising a nurse orientating to acute unit who is discahrging a pt admitted with kideny stones who had lithotripsy. which statemnet by the new nurse needs the RN to intervene? 1. you should finish all your antibioitcs to make sure you dont get a UTI 2. remember to drink at least 3L of fluid every day to prevent another stone from forming 3. report any signs of bruising to your HCP bc this indicartes bleeding 4. you can return to work in 2 days to 6 weeks, depending on HCP order

The health care provider recently prescribed rivastigmine twice daily for a 62-year-old patient who lives at home with his wife. Based on this information, which additional assessment would the home health nurse plan to perform first? Assess for psychotic features, such as hallucinations. 2) perform a comprehensive pain assessment. 3Assess for cognitive deficits and memory loss. 4Observe for fine and gross motor deficits.

The nurse is caring for a pt with HF. on assessment pt has dyspneic, and crackles are audible on ausculatition. What other manifestations would the nurse expect to note in this pt if excess fluid vol is pressent? 1. weight loss and dry skin 2. flat neck and hand veins and decreased UO 3. an increase in BP and increased respirations 4. weakness and decreased central venous pressure

The nurse is caring for the following patients with endocrine disorders. Which patient must the nurse assess first? A 21-year-old patient with diabetes insipidus whose urine output overnight was 2000 mL 2A 55-year-old patient with syndrome of inappropriate antidiuretic hormone secretion who is demanding that the assistive personnel refill his water pitcher 3) 65-year-old patient with Addison disease whose morning potassium level is 6.2 mEq/L (6.2 mmol/L) 4A 48-year-old patient with Cushing disease with a weight gain of 1.5 lb (0.7 kg) over the past 4 days

The nurse is preparing to review a teaching plan for a patient with type 2 diabetes mellitus. To determine the patient's level of compliance with his prescribed diabetic regimen, which value would the nurse be sure to review? 1Fasting glucose level 2Oral glucose tolerance test results 3Glycosylated hemoglobin (HgbA1c) level 4Fingerstick glucose findings for 24 hours

The patient with type 2 diabetes has a health care provider prescription of NPO status for a cardiac catheterization. An LPN/LVN who is assigned to administer medications to this patient asks the supervising RN whether the patient should receive his prescribed repaglinide. What is the RN's best response? "Yes, because this drug will increase the patient's insulin secretion and prevent hyperglycemia." 2"No, because this drug may cause the patient to experience gastrointestinal symptoms such as nausea." 3"No, because this drug should be given 1 to 30 minutes before meals and the patient is NPO ."4"Yes, because this drug should be taken three times a day whether the patient eats or not."

The rn is admitting a pt with BPH to an acute unit. Pt describes an oral intake of about 1400 mL/day. what is the rns priority concern A. ask pt about his bowel movements b. have pt complete a diet diary for past 2 days c. instruct pt to increase oral intake to 2-3 L/day d. ask pt to describe his urine output

Which prescribed order for a patient with diabetes insipidus (DI) would the nurse be sure to question? Monitor and record accurate intake and output.2Check urine specific gravity.3Restrict fluids for 6 hours.4Weigh the patient every morning.

While the RN is performing an admission assessment on a patient with type 2 diabetes, the patient states that he routinely drinks three beers a day. What is the nurse's priority follow-up question at this time? "Do you have any days when you do not drink? "2"When during the day do you drink your beers? "3"Do you drink any other forms of alcohol? "4"Have you ever had a lipid profile completed?"

nurse is assessing a pt with epididymytitis. nurse anticipates which findings on physical exam? 1. fever, diarrhea, groin pain, ecchymosis 2. Nausea, painful scrotal edema, ecchymosis 3. fever, N/V, painful scrotal edema 4. diarhea, groin pain, testicular torsion, scrotal edema

nurse is caring for a pt with chronic kidney disease after hemodialysis. which pt action should deleagete to AP 1. assess pt access site for a thrill/bruit 2. montior for s/s of postdialysis bleeding 3. check pts postdialysis BP and weight 4. instruct the pt to report s/s of dialysis disequilibrium syndrome immediately

nurse is caring for a pt with risk for imcomplete emptying. which noninvasive finding best supports this problem. 1. pt is able to void additional 100 ML after nurse massages over the bladder 2. pt voids additional 350mL with insertion of an intermittent catheter 3. pt has postvoid resiudal of 275 ml documented by bedside bladder scanner. 4. pt has constant dribbling between voidings

nurse is creating a care plan for older adult patients with incontience. for which pt will a bladder training program be an appropriate int? 1. pt with functional incontinence caused by mental status changes 2. pt with stress incontinence due to weakened bladder neck support 3. pt with urge incontinence and abnormal detrusor muscle contractions 4. pt with transient incontinence related to loss of cognitive funciton

nurse who is adminstering bethanechol chloride, is monitoring for cholinergic overdose associated w/ this medication. the nurse should check the client for which sign of overdose? 1. dry skin 2. dry mouth 3. bradycardia 4. signs of dehydration

pt with CKD returns to nursing unit following hemodialysis treatment. on assessment, the nurse notes the pts temp is 101.2. which nursing action is most appropriate? 1. encourage fluid intake 2. continute to monitor VS 3. notify the HCP 4. monitor site of shunt for infection

the RN is supervising a new grad nurse who is orientating to the unit. the new nurse asks why the pt with uncomplicated cystitis is being charged with a prescription for ciprofloxacin 250 mg twice a day for only 3 days. what is the RNs best response? 1. we should check with the HCP bc the pt should take this drug for 10-14 days 2. a 3 day course of ciprofloxacin is not the appropriate tx for a pt with uncomplicated cystitis 3. research has shown that a 3 day course of ciprofloxacin is effective for uncomplicated cystitis and there is increased pt adherance to the plan of care. 4. longer courses of antiobiotic therapy are required for hospitalized pts to prevent nosocomial infections

which lab is of most concern to pt with cystitis 1. WBC of 9000 2. urinalyssi showing 1 or 2 WBC present 3. urine bacteria count of 100,000 colonies per ml 4. serum hematocrit of 36%

pt has DKA with BG of 950. a continuous IV infusion of short acting insulin is initiated, w/ IV rehydration with NS. Glucose is now 240. nurse would prepare to next administer what 1. ampule of 50% dextrose 2. nph insulin subcutaneously 3. IV fluids containing dextrose 4. phenytoin for the prevention of seizures

3 dont want fix too quickly

After reviewing medication prescriptions on an acute psychiatric unit, which prescription is the nurse most likely to question? Fluoxetine for a middle-aged patient with depression 2Chlorpromazine for a young patient with schizophrenia 3Loxapine for an older adult patient with dementia and psychosis 4Lorazepam for a young patient with generalized anxiety disorder

3 first generation antipyshcotics are usually not prescribed for older adults with psychosis secondary to dementia bc increase of death/cardiac probs

515. The nurse is giving discharge teaching for a client newly diagnosed with type 2 DM who has been prescribed metformin. Which pt statement indicates the need for further teaching 1. it is ok if i skip meals once in a while 2. i need to let my dr know if i get unusually tired 3. i need to constantly watch for signs of low blood sugar 4. i will be sure to not drink alcohol excessively while on it

3 poses little risk for hypoglycemia

526. A daily dose of prednisone is prescribed for a client. The nurse provides instructions to the client regarding administration of the medication and should instruct the client that which time is best to take this medication? 1. At noon 2. At bedtime 3. Early morning 4. Any time, at the same time, each day

3 before 9 AM

A patient comes into the walk-in clinic and tells the nurse that he would like to be admitted to an alcohol rehabilitation program. Which question is the most important to ask? "What made you decide to enter a program at this time?"2"How much alcohol do you usually consume in a day?"3"When was the last time you had a drink?"4"Have you been in a rehabilitation program before?"

3 determine if at risk for withdrawal symptoms

A patient is displaying muscle spasms of the tongue, face, and neck, and his eyes are locked in an upward gaze. He has been prescribed haloperidol. Which action will the nurse take first? Maintain eye contact and stay with him until the spasms pass .2Place the patient on aspiration precautions until the spasms subside. 3Obtain a prescription for intramuscular or IV diphenhydramine. 4Obtain a prescription for and administer an antiseizure medication.

3 it will rapidly alleviate the symptoms. (pt is expereiencing med side effects)

pt has potassium of 5.7 with CKD. watch EKG monitor for 1. St depression 2. prominent u waves 3. tall peaked t waves 4. prolonged ST segment 5. widened QRS complexes

3,5

pt is admitted to unit with SIADH. which electrolyte abnormality would the nurse monitor? 1. hypokalemia 2. hyperkalema 3. hyponatremia 4. hyperatremia

3- soldium deficit caused by excessive retention of water.

which statement realted to dehydration made by a pt with hypovolemia is theb best indicator to the nurse of the need for more teaching? 1. i will drink 2-3 l of fluids every day 2. i will drive a glass of water whenever i fill thirsty 3. i will drink coffee and cola drinks thoughout the day 4. i will avoid drinks containing alcohol

1. the rn is supervising an LPN who is taking care of pt with DM type 2. who is to have a renal CT scan with contrast tmrow morning. what should RN tell LPN. 1. remind pt that the purpose of this scan is to measure kidney function 2. tell AP to remove pts water pticher from bedside at 10 pm 3. pt metformin should be discontinued 24 hours before the procedure 4. keep pt on bedrest for at least 8 hours after returning to the unit

3. those with metformin are at risk for lactic acidosis, when given iodinated contrast media.

527. The client with hyperparathyroidism is taking alendronate. Which statements by the client indicate understanding of the proper way to take this medication? Select all that apply. 1. "I should take this medication with food." 2. "I should take this medication at bedtime." 3. "I should sit up for at least 30 minutes after taking this medication." 4. "I should take this medication first thing in the morning on an empty stomach." 5. "I can pick a time to take this medication that best fits my lifestyle as long as I take it at the same time each day."

3.4

509. The nurse is preparing pt with dx of hypothyroidism for discharge. Nurse determines pt understants discharge instructions when pt states what s/s are with his dx? SATA 1. tremors 2. wt loss 3. feeling cold 4. loss of body hair 5. persistent lethargy 6. puffiness of face

3.4.5.6

charge nurse must put two patients together. who is best suited 1. 58 pt with urothelial cancer recieving chemo 2. 63 y/o pt with kidney stones who just underwent open ureterolithotomy 3. 24 pt with acute pyelonephritis and severe flank pain 4. 76 with urge incontience and UTI

3/4

12. pt being admitted to rule out interstitial cystitis. what should the nurse plan of care for this pt include that is specific for this diagnosis 1. take daily uirne samples for urinalysis 2. maintain accurate I/O 3. obtain an admission urine sample to determine electrolyte levels 4. teach the pt about the cystoscopy procedures

14. the nurse is preparing to discharge a pt whose calcium level was low but is now barely within the normal range. which statement by the pt indicates the need for more teaching? 1. i will call my dr if i experience muscle switching/seizures 2. i will maek srue to take my vitamin d with my calcium each day 3. i will take my calcium citrate pill each morning before breakfast 4. i will avoid dairy products, brocculi, and spinach when i eat

17. the rn is reviewing the pts morning labs. what is most concern 1.K+ is 5.2 sodium is 134 3. calcium is 10.6 4. mg is 0.8

21. nurse is admitting an older adult to acute unit. which assessment factor alerts the nurse taht this pt has a risk for acidbase imablances? 1. hx of MI 1 year ago 2. antacid use for occasional indigestion 3. shortness of breath with extreme exertion 4. chronic renal insuffiencey

28 yr old female pt with cystitis requires instruction about how to prevent future UTIs. the supervising RN has assigned thist eaching to a new grad. which statement requies intervening? 1. you should always drink 2-3 L of fluid every day 2. empty your bladder reguarly even if you do not feel the urge to urinate 3. drinking cranberry juice daily will decrease the number of bacteria in your badder. 4. it is okay to soak in the tub with bubble bath bc it will keep you clean

An assistive personnel (AP) tells the nurse that while assisting with the morning care of a postoperative patient with type 2 diabetes who has been given insulin, the patient asked if she will always need to take insulin now. What is the RN's priority for teaching the patient? Explain to the patient that she is now considered to have type 1 diabetes.2Tell the patient to monitor fingerstick glucose level every 4 hours after discharge.3Teach the patient that a person with type 2 diabetes does not always need insulin.4Discuss the relationship between illness and increased glucose levels.

Assessment findings for a patient with Cushing disease include all of the following. For which finding would the nurse notify the health care provider immediately? Purple striae present on the abdomen and thighs 2Weight gain of 1 lb (0.5 kg) since the previous day 3Dependent edema rated as + 1 in the ankles and calves 4Crackles bilaterally in the lower lobes of the lungs

The experienced assistive personnel (AP) has been delegated to take vital signs and check fingerstick glucose on a postoperative patient with diabetes. Which vital sign change would the RN instruct the AP to report immediately? Blood pressure increase from 132/80 to 138/84 mm Hg 2Temperature increase from 98.4°F to 99°F (36.9°C to 37.2°C) 3Respiratory rate increase from 18 to 22 breaths/min increase from 190 to 236 mg/dL (10.6 to 13.1 mmol/L)

The nurse is instructing a senior nursing student on the techniques for palpation of the thyroid gland. What instruction would the nurse be sure to include when instructing the student about thyroid palpation? Always stand to the side of the patient. 2Instruct the patient not to swallow. 3Palpate using one hand and then the other. 4Palpate the thyroid gland for size, symmetry, shape, and presence of nodules.

Trimethoprim/Sulfamethoxazole is prescribed for a client. the nurse should instruct the pt to report which symptom if it develops during the course of this medication therapy? 1. nausea 2. diarrhea 3. headache 4. sore throat

28. the RN is providing care for a pt daignosed with dehydration and hypovolemic shock. which prescribed INT from HCP should the RN question? 1. BP q15 min 2. place 2 18 G IV lines 3. oxygen at 3L/via nasal cannula 4. IV 5% Dextrose in water (d5w) to run at 250 Ml/hr

4 to correct hypovolemic shock with dehyrdation the pt needs IV fluids that are isotonic and will increase intravascular volume. D5Wj the body reapidly metabolzies the dextrose, ad the solution becomes hypotonic.

pt newly dx with CKD begun hemodialysis. knowing the pt is at risk for disequilibrium syndrome, the nurse should assess the pt during dialyssis for which associated manifestations ? 1. HTN, tachycardia, fever 2. hypotension, bradycardia, hypothermia 3. restlessness, irritable, generalzied weakness 4. headache, deteriorating LOC and twitching

4 characetized by headache, mental confusion, decreasing LOC, N/V, twitching, possible seizures

A week after kidney transplantation, a client develops a temperature of 101°F (38.3°C), the blood pressure is elevated, and there is tenderness over the transplanted kidney. The serum creatinine is rising and urine output is decreased. The x-ray indicates that the transplanted kidney is enlarged. Based on these assessment findings, the nurse anticipates which treatment? 1. Antibiotic therapy 2. Peritoneal dialysis 3. Removal of the transplanted kidney 4. Increased immunosuppression therapy

4 removal is hyperacute rejection, which occurs within 48 hours of transplatn

nurse is caring for pt with dehydration secondary to deficient ADH. what specific gravity value supports this? 1. 1.010 2.1.035 3.1.020 4. 1.002

4 they would have dilute urine with a decreased urine specfic gravity normal ranges from 1.003-1.030 1.035 urine would indicate it is concentrated

pt with severe back pain and hematuria is found to have hydronephrosis due to urolithiasis. nurse anticipates which tx will be done to relieve the obstruction? SATA 1. peritoneal dialysis 2. analysis of the urinary stone 3. intravenous opioid analgesics 4. insertion of nephrostomy tube 5. placement of a uteral stent with ureteroscopy

4.5

the nurse is caring for pt with Crohns disease who has a calcium of 8. which patterns would nurse watch for on ECG? SATA 1. u waves 2. widened t wave 3. prominent u waave 4. prolonged QT interval 5. prolonged ST segment

4/5 shortened ST segment and widened t wave occur with hypercalcemia ST depression and prominent U waves occur with hypokalemia

RN is to adminsiter a SQ of epotein alfa 100 units/kg three times a week for a pt on dialysis. pt weight 156 lbs. epotein alfa comes from teh pharamcy in a vial 10,000 units/1 ML how many units will the RN give with each injectioN? how many ML will the RN give the patient? (round to 2 digits) what syringe would the nurse use to adminsiter medication?

7090 units 0.71 ML very small syringe (TB)

10.A patient with cerebral edema would most likely be order what type of solution? A. 3% Saline B. 0.9% Normal Saline C. Lactated Ringer's D. 0.225% Normal Saline

3.A patient is being admitted with dehydration due to nausea and vomiting. Which fluid would you expect the patient to be started on? a. 0.9% Normal Saline b. 0.33% saline c. 0.225% saline d. 5% Dextrose in 0.9% Saline

13,Which of the following is not a hypertonic fluid? A. 3% Saline B. D5W C. 10% Dextrose in Water (D10W) D. 5% Dextrose in Lactated Ringer's

7.Which of the following patients would not be a candidate for a hypotonic solution? A. Patient with Diabetic Ketoacidosis B. Patient with increased intracranial pressure C. Patient experiencing Hyperosmolar Hyperglycemia D. All of the options are correct

11.When administering a hypertonic solution the nurse should closely watch for? A. Signs of dehydration B. Pulmonary Edema C. Fluid volume deficient D. Increased Lactate level

B (also known as third spacing) sucking fluid out of cells it has got to go somewhere

6.Which of the following conditions can lead to cell lyses if not properly monitored? A. Isotonicity B. Hypotonicity C. Hypertonicity D. None of the options are correct

B. Hyperkalemia from lyses cell (BLOW UP)

12.What type of fluid would a patient with severe hyponatremia most likely be started on? A. Hypotonic B. Isotonic C. Hypertonic D. Colloid

2.The doctor orders an isotonic fluid for a patient. Which of the following is not an isotonic fluid? A. 0.9% Normal Saline B. Lactated Ringers C. 0.45% Saline D. 5% Dextrose in 0.225% saline

C. -Hypotonic

An external insulin pump is prescribed for a client with diabetes mellitus and the client asks the nurse about the functioning of the pump. The nurse bases the response on the information that the pump: a) is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals b) continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels c) is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream d) gives a small continuously dose of regular insulin subcutaneously, and the client can self-administer a bolus with an additional dose form the pump before each meal

1.When the cell presents with the same concentration on the inside and outside with no shifting of fluids this is called? A. Hypotonic B. Hypertonic C. Osmosis D. Isotonic

D. Isotonic

4.True or False: Isotonic fluids cause shifting of water from the extracellular space to the intracellular space.

False

______ fluids remove water from the extracellular space into the intracellular space.

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