NU 310 PrepU Ch.46-52

A client with diabetes mellitus has a blood glucose level of 40 mg/dL. Which rapidly absorbed carbohydrate would be most effective?

1/2 cup fruit juice or regular soft drink

A client with peptic ulcer disease must begin triple medication therapy. For how long will the client follow this regimen?

10-14 days

An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting:

10-15 g of a simple carbohydrate

A client weighs 215 lbs and is 5' 8" tall. The nurse calculate this client's body mass index (BMI) as what?

215/68in.^2 X 703= 32.7

A nurse is reviewing the medical records of several patients and their risk for health problems. The nurse determines that the patient with which body mass index (BMI) would have the lowest risk?

23

A nurse caring for adults with obesity recognizes that obesity is classified based on BMI. Which BMI does the nurse recognize as Class II obesity?

35 kg/m2 (35-39.9 kg/m2)

A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well controlled?

6.5%

A client with newly diagnosed hypertension asks what to do to decrease the risk for related cardiovascular problems. Which risk factor is not modifiable by the client?

Age

A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate?

Albumin

An older client underwent a lumpectomy for a breast lesion that was determined to be malignant. Which factors in the client's history may have increased the risk of breast cancer?

All options are correct. Being female, being older than 50 years of age, and having a family history of breast cancer are the most common risk factors. Additional factors include obesity, and having no children or having children after 30 years of age.

The nurse is caring for a patient with cirrhosis of the liver and observes that the patient is having hand-flapping tremors. What does the nurse document this finding as?

Asterixis

A nurse cares for an obese client taking phentermine for weight loss. What client teaching will the nurse include when discussing precautions about the medication?

Do not drink alcohol while taking this medication

A nurse provides nutritional teaching to a client who is scheduled to have bariatric surgery. Which statements will the nurse include on fluid intake after the procedure? Select all that apply.

Drink plenty of water. Avoid drinking liquid calories. Drink frequent, small amounts. Drink liquids 30-60 minutes after eating.

A nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. To reverse hypoglycemia, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand?

Glucagon

The nurse determines that teaching for the client with peptic ulcer disease has been effective when the client makes which statement?

I have learned some relaxation strategies that decrease my stress

A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says:

I should become involved in a weight loss program

Review the following four examples of ideal body weight (IBW), actual weight, and body mass index (BMI). Using three criteria for each example, select the body weight that indicates morbid obesity.

IBW=145 lbs; weight=290 lbs; BMI=31 kg/m2

A nursing student is caring for a client with gastritis. Which of the following would the student recognize as a common cause of gastritis? Choose all that apply.

Ingestion of strong acids. Overuse of aspirin. Irritating foods.

The nurse assesses a patient who has an obvious goiter. What type of deficiency does the nurse recognize is most likely the cause of this?

Iodine

A patient has been diagnosed with acute gastritis and asks the nurse what could have caused it. What is the best response by the nurse? (Select all that apply.)

It can be caused by ingestion of strong acids. You may have ingested some irritating foods. Is it possible that you are over using aspirin?

The nurse is administering medications to a client that has elevated ammonia due to cirrhosis of the liver. What medication will the nurse give to detoxify ammonium and to act as an osmotic agent?

Lactulose

Which type of insulin acts most quickly?

Lispro

A nurse cares for a client who is post op bariatric surgery. Which position will the nurse place the client in order to best promote comfort?

Low Fowler's

A client is suspected to have a pituitary tumor due to signs of diabetes insipidus. What initial test does the nurse help to prepare the client for?

MRI

A client with obesity is prescribed liraglutide for weight loss. Which common side effect will the nurse include in the client teaching?

Nausea

Peptic ulcer disease occurs more frequently in people with which blood type?

O

Which medication classification represents a proton (gastric acid) pump inhibitor?

Omeprazole

In what location would the nurse palpate for the liver?

RUQ

What is the only insulin that can be given intravenously?

Regular

Which of the following interventions are appropriate for clients with gastritis? Select all that apply.

Use a calm approach to reduce anxiety. Discourage cigarette smoking. Notify the physician of indicators of hemorrhagic gastritis. Provide general education about how to prevent recurrences.

The nurse cares for a client who is post op bariatric surgery whose bowel sounds have returned and is tolerating oral intake. What teaching will the nurse provide the client about the nutrition required at this time? Select all that apply.

You need to drink plenty of water in between meals. Eat slowly. You will have six small meals per day.

Which statement is true regarding gestational diabetes?

a glucose challenge test should be performed between 24 and 28 weeks.

A client is suspected of having cirrhosis of the liver. What diagnostic procedure will the nurse prepare the client for in order to obtain a confirmed diagnosis?

a liver biopsy

A patient is scheduled for a Billroth I procedure for ulcer management. What does the nurse understand will occur when this procedure is performed?

a partial gastrectomy is performed with anastomosis of the stomach segment to the duodenum.

The nurse is assisting the physician with a procedure to remove ascitic fluid from a client with cirrhosis. What procedure does the nurse ensure the client understands will be performed?

abdominal paracentesis

When administering insulin to a client with type 1 diabetes, which of the following would be most important for the nurse to keep in mind?

accuracy of the dosage

A client comes to the clinic after developing a headache, abdominal pain, nausea, hiccupping, and fatigue about 2 hours ago. The client tells the nurse that the last food was buffalo chicken wings and beer. Which medical condition does the nurse find to be most consistent with the client's presenting problems?

acute gastritis

What intervention does the nurse anticipate providing for the patient with ascites that will help correct the decrease in effective arterial blood volume that leads to sodium retention?

albumin infusion

A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately?

an irregular apical pulse

A client with obesity is suspected of having nonalcoholic fatty liver disease. Which diagnostic labs does the nurse anticipate the client needing? Select all that apply.

aspirate aminotransferase. Alanine aminotransferase.

When caring for a client with an acute exacerbation of a peptic ulcer, the nurse finds the client doubled up in bed with severe pain in the right shoulder. What is the initial appropriate action by the nurse?

assess the client's abdomen and VS

A nurse is providing discharge instruction for a client who is postoperative bariatric surgery. What statement will the nurse include when providing teaching aimed at decreasing the risk of gastric ulcers?

avoid taking non-steroidal anti-inflannatory drugs.

The nurse is evaluating a client's ulcer symptoms to differentiate ulcer as duodenal or gastric. Which symptom should the nurse at attribute to a duodenal ulcer?

awakening in pain

A client is prescribed tetracycline to treat peptic ulcer disease. Which instruction would the nurse give the client?

be sure to wear sunscreen while taking this medicine

The nurse is assessing a client with a bleeding gastric ulcer. When examining the client's stool, which characteristic would the nurse be most likely to find?

black and tarry appearance

Trousseau sign is elicited

by occluding the blood flow to the arm for 3 minutes with the use of a BP cuff

When caring for a client with advanced cirrhosis and hepatic encephalopathy, which assessment finding should the nurse report immediately?

change in the client's handwriting and/or cognitive performance

A nurse cares for a client who is 5 feet 11 inches tall and weighs 225 pounds. What statement describes the client's BMI?

class one obesity (30-34.9 kg/m2)

A nurse is caring for a client with cholelithiasis. Which sign indicates obstructive jaundice?

clay colored stool

Which of the following clients is at highest risk for peptic ulcer disease?

client with blood type O

The nurse is working with a client who has difficulty controlling blood sugar. The client is classified as overweight. The client does not adhere to a low-calorie diet and forgets to take medications and check blood glucose level. The client's glycohemoglobin is 8.5%. When establishing a goal for the client, what action will the take first?

collaborates with the client to establish an agreed upon goal

Which diagnostic test is done to determine suspected pituitary tumor?

computed tomography scan

A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic nephropathy. Which of the following suggestions would be most important?

control blood glucose levels.

A nurse cares for a client who has secondary obesity. Which condition is the most likely to result in secondary obesity?

cushing's disease

Which of the following is an age-related change that may affect diabetes? Select all that apply.

decreased vision, taste changes, decreased vision

Which of the following appears to be a significant factor in the development of gastric cancer?

diet

What test should the nurse prepare the client for that will locate stones that have collected in the common bile duct?

endoscopic retrograde cholangiopancreatography (ERCP)

A health care provider suspects that a client has peptic ulcer disease. With which diagnostic procedure would the nurse most likely prepare to assist?

endoscopy

A nurse explains the role of the ovaries. Which hormones would be included in that discussion?

estrogen and progesterone

Which of the following would the nurse expect to find in a client with severe hyperthyroidism?

exophthalmos

Which medication is classified as a histamine-2 receptor antagonist?

famotidine

A health care provider suspects that a thyroid nodule may be malignant. The nurse knows to prepare information for the patient based on the usual test that will be ordered to establish a diagnosis. What is that test?

fine-needle biopsy of the thyroid gland

Which type of deficiency results in macrocytic anemia?

folic acid

A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are effective only if the client:

has type 2 diabetes

The nurse is assessing a client with an ulcer for signs and symptoms of hemorrhage. The nurse interprets which condition as a sign/symptom of possible hemorrhage?

hematemesis

The nurse identifies which type of jaundice in an adult experiencing a transfusion reaction?

hemolytic

Which type of jaundice seen in adults is the result of increased destruction of red blood cells?

hemolytic

A client with severe peptic ulcer disease has undergone surgery and is several hours postoperative. During assessment, the nurse notes that the client has developed cool skin, tachycardia, labored breathing, and appears to be confused. Which complication has the client most likely developed?

hemorrhage

A client has an elevated serum ammonia concentration and is exhibiting changes in mental status. The nurse should suspect which condition?

hepatic encephalopathy

The nurse is preparing to interview a client with cirrhosis. Based on an understanding of this disorder, which question would be most important to include?

how often do you drink alcohol?

The nurse is assessing a client in the clinic who appears restless, excitable, and agitated. The nurse observes that the client has exophthalmos and neck swelling. What diagnosis do these clinical manifestations correlate with?

hyperthyroidism

On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance most commonly follows thyroid surgery?

hypocalcemia

A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which condition when caring for this client?

hypoglycemia

The typical triad of manifestations seen in a client diagnosed with pheochromocytoma does not include which of the following?

hypotension

A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply.

hypotension. hypothermia. hypoventilation.

The nurse is educating the client with diabetes on setting up a sick plan to manage blood glucose control during times of minor illness such as influenza. Which is the most important teaching item to include?

increase frequency of glucose self monitoring.

A 60-year-old client comes to the ED reporting weakness, vision problems, increased thirst, increased urination, and frequent infections that do not seem to heal easily. The physician suspects that the client has diabetes. Which classic symptom should the nurse watch for to confirm the diagnosis of diabetes?

increased hunger

A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. What are classic symptoms associated with diabetes?

increased thirst, hunger and urination

The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine?

increases ability for glucose to get into the cell and lower blood sugar

A nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare with absorption at other sites?

insulin is absorbed more rapidly at abdominal injection sites.

A nurse cares for a client who is obese. The health care provider prescribes orlistat in an effort to help client lose weight, along with diet and exercise. When teaching the client about this medication, what will the nurse include?

it binds with enzymes to help prevent digestion of fat.

A nurse is teaching a client recovering from diabetic ketoacidosis (DKA) about management of "sick days." The client asks the nurse why it is important to monitor the urine for ketones. Which statement is the nurse's best response?

ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy.

The preferred preparation for treating hypothyroidism includes which of the following?

levothyroxine (Synthroid)

A client with a lengthy history of alcohol addiction is being seen for jaundice. The appearance of jaundice would most likely indicate:

liver disorder

A physician orders spironolactone (Aldactone), 50 mg by mouth four times daily, for a client with fluid retention caused by cirrhosis. Which finding indicates that the drug is producing a therapeutic effect?

loss of 2.2 lb (1 kg) in 24 hours

What is the recommended dietary treatment for a client with chronic cholecystitis?

low-fat diet

A client with hyperparathyroidism declines surgery and is to receive hormone replacement therapy with estrogen and progesterone. Which instruction is most important for the nurse to include in the client's teaching plan?

maintain a moderate exercise program

Which intervention is the most critical for a client with myxedema coma?

maintaining a patient airway

A client with cirrhosis has a massive hemorrhage from esophageal varices. Balloon tamponade is used temporarily to control hemorrhage and stabilize the client. In planning care, the nurse gives the highest priority to which goal?

maintaining the airway

When performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. Which of the following interventions should the nurse consider?

measure abdominal girth according to a set routine

A nurse is planning care for a client who will be arriving to the unit postoperatively from bariatric surgery. In an effort to decrease the risk of venous thromboembolism (VTE), which health care provider orders does the nurse anticipate?

mechanical compression and prophylactic anticoagulation

A client is undergoing diagnostics for an alteration in thyroid function. What physiologic function is affected by altered thyroid function?

metabolic rate

A nurse educator is providing an in-service to a group of nurses working on a medical floor that specializes in liver disorders. What is an important education topic regarding ingestion of medications?

metabolism of medications

A client with obesity is diagnosed with type 2 diabetes. In order to promote weight loss in the client and aid in glucose management, which medication will the nurse anticipate the health care provider ordering?

metformin

A client is receiving long-term treatment with high-dose corticosteroids. Which of the following would the nurse expect the client to exhibit?

moon face

Which is a true statement regarding gastric cancer?

most clients are asymptomatic during the early stage of the disease.

Hypocalcemia is associated with which of the following manifestations?

muscle twitching

An incoherent client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and periorbital area. Knowing that these findings suggest severe hypothyroidism, the nurse prepares to take emergency action to prevent the potential complication of:

myxedema coma

Which assessment would a nurse perform on a client with Cushing's syndrome who is at high risk of developing a peptic ulcer?

observe stool color

Which of the following medications is classified as a proton pump inhibitor (PPI)?

omeprazole

The nurse recognizes that the client diagnosed with a duodenal ulcer will likely experience

pain 2-3 hours after a meal

Which action would be appropriate when evaluating a client's neck for thyroid enlargement?

palpate the thyroid gland gently

The nurse is conducting a community education class on gastritis. The nurse includes that chronic gastritis caused by Helicobacter pylori is implicated in which disease/condition?

peptic ulcers

A client is in the hospital for the treatment of peptic ulcer disease. The client reports vomiting and a sudden severe pain in the abdomen. The nurse then assesses a board-like abdomen. What does the nurse suspect these symptoms indicate?

perforation of the peptic ulcer

During a follow-up visit to the physician, a client with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and:

phosphorus

A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder?

pituitary tumor

Which clinical characteristic is associated with type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus)?

presence of islet cell antibodies

The nurse is caring for a client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease?

purpura and petechiae

Which liver function study is used to show the size of the liver and hepatic blood flow and obstruction?

radioisotope liver scan

A client with type 1 diabetes has been on a regimen of multiple daily injection therapy. He's being converted to continuous subcutaneous insulin therapy via an insulin pump. While teaching the client about continuous subcutaneous insulin therapy, the nurse should tell him that the regimen includes the use of:

rapid-acting insulin only

A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide?

reduce fluid accumulation and venous pressure

Which of the following is the most successful treatment for gastric cancer?

removal of the tumor.

A nurse is caring for a client with a kidney disorder. What hormone released by the kidneys initiates the production of angiotensin and aldosterone to increase blood pressure and blood volume?

renin

Clients with chronic liver dysfunction have problems with insufficient vitamin intake. Which may occur as a result of vitamin C deficiency?

scurvy

The diabetic client asks the nurse why shoes and socks are removed at each office visit. Which assessment finding is most significant in determining the protocol for inspection of feet?

sensory neuropathy

A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?

serum glucose level of 52 mg/dl

Which of the following are characteristics associated with the Zollinger-Ellison syndrome (ZES)? Select all that apply.

severe peptic ulcers. Extreme gastric hyper-acidity. Gastrin-secreting tumors of the pancreas.

A client is recovering from gastric surgery. Toward what goal should the nurse progress the client's enteral intake?

six small meals daily with 120 mL fluid between meals

The nurse is concerned about potassium loss when a diuretic is prescribed for a patient with ascites and edema. What diuretic may be ordered that spares potassium and prevents hypokalemia?

spironolactone (Aldactone)

A nurse cares for a client who is post op from bariatric surgery. Once able, the nurse encourages oral intake for what primary purpose?

stimulate GI peristalsis

A postpartum client is receiving intravenous oxytocin (Pitocin) after birth. Why will this medication be used for this client after the birth of her child?

stimulates the contraction of the uterus and prevents bleeding

Which category of oral antidiabetic agents exerts the primary action by directly stimulating the pancreas to secrete insulin?

sulfonylureas

A nurse is assessing a postoperative client for hemorrhage. What responses associated with the compensatory stage of shock should be reported to the healthcare provider?

tachycardia and tachypnea

The nurse is caring for a patient with hyperthyroidism who suddenly develops symptoms related to thyroid storm. What symptoms does the nurse recognize that are indicative of this emergency?

temperature of 102F

Which of the following factors would a nurse identify as a most likely cause of diabetic ketoacidosis (DKA) in a client with diabetes?

the client has eaten and has not taken or recieved

A male client, aged 42 years, is diagnosed with diabetes mellitus. He visits the gym regularly and is a vegetarian. Which of the following factors is important when assessing the client?

the client's consumption of carbohydrates

A nurse is caring for a client with cirrhosis. The nurse assesses the client at noon and discovers that the client is difficult to arouse and has an elevated serum ammonia level. The nurse should suspect which situation?

the client's hepatic function is decreasing

Ammonia, the major etiologic factor in the development of encephalopathy, inhibits neurotransmission. Increased levels of ammonia are damaging to the body. The largest source of ammonia is from:

the digestion of dietary and blood proteins

A client with obesity is prescribed orlistat for weight loss. The client asks the nurse, "I understand the medication prevents digestion of fat, but what happens if I eat fat?" What is the nurse's best response?

the fat is passed in your stools

The nurse observes that a client's medical report indicates that the client has Cushing syndrome. During inspection, the nurse notes that the client's BMI is 31, waist circumference is 40 inches, and localized fat pads exist around the neck and upper part of the back. Which of the following must the nurse keep in mind while planning the client's care?

the nurse recognizes that the client's obesity may be specifically related to the endocrine disorder. The nurse performs a thorough nutritional assessment.

When describing the difference between endocrine and exocrine glands, which of the following would the instructor include as characteristic of endocrine glands?

the secretions are released directly into the blood stream

A client with obesity is prescribed lorcaserin for weight loss. The client reports dry mouth. What is the nurse's best response?

this is an expected finding with this medication.

A client is returned to his room after a subtotal thyroidectomy. Which piece of equipment is most important for the nurse to keep at the client's bedside?

tracheotomy set

A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason?

underlying problem of insulin resistance

Which intervention is essential when performing dressing changes on a client with a diabetic foot ulcer?

using sterile technique during the dressing change

Which of the following is the most effective strategy to prevent hepatitis B infection?

vaccine

Which medication is used to decrease portal pressure, halting bleeding of esophageal varices?

vasopressin

A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery?

vitamin K

A nurse cares for clients with obesity. Which clinical measurements use quantified measurements to diagnose obesity? Select all that apply.

waist circumference. BMI. Weight.

A middle-aged female client is overweight and sedentary, has slightly elevated blood pressure, and is seeking ways to begin exercise. The client wishes to lose weight and improve her blood pressure. The nurse plans an exercise program in which the client

walks for 30 minutes three times this week and is re-evaluated.

A student accepted into a nursing program must begin receiving the hepatitis B series of injections. The student asks when the next two injections should be administered. What is the best response by the instructor?

you must have the second one in 1 month and the third in 6 months

A nurse cares for a female client of childbearing age who will undergo bariatric surgery. When teaching the client about precautions after surgery, which teaching will the nurse include that is specific to this population?

you should avoid pregnancy for at least 18 months after surgery.