PrepU Review Questions (Exam 4: Ch. 13, 15)

A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves disease. Which assessments should the nurse prioritize?

Eye health and visual acuity

A 51-year-old female client who is 2 days postoperative in a surgical unit of a hospital is at risk of developing atelectasis as a result of being largely immobile. Which teaching point by her nurse is most appropriate?

"You should breathe deeply and cough to help your lungs expand as much as possible while you're in bed."

A client has been diagnosed with dysfunction of the anterior pituitary gland. The nurse is aware that which hormones will likely be affected? Select all that apply. - Adrenocorticotropic hormone (ACTH) - Thyroid-stimulating hormone (TSH) - Growth hormone (GH) - Luteinizing hormone (LH) - Antidiuretic hormone (ADH) - Norepinephrine

- Adrenocorticotropic hormone (ACTH) - Thyroid-stimulating hormone (TSH) - Growth hormone (GH) - Luteinizing hormone (LH)

The nurse is monitoring trends in the client's arterial blood gases and recognizes that changes in ventilation will result from which of the following? Select all that apply. - Carbon dioxide - Oxygen - pH - Anion gap - Cerebrospinal fluid (CSF)

- Carbon dioxide - Oxygen - pH

The nurse is caring for a client who has sustained injury to the adrenal medulla as a result of a penetrating wound due to a trauma. Which hormones does the nurse expect to be altered as a result of the client's injury? Select all that apply. - Mineralocorticoids - Epinephrine - Norepinephrine - Glucocorticoids - Estrogen

- Epinephrine - Norepinephrine

A client with a history of heart failure and COPD (caused by 60 pack/year smoking) presents to the clinic reporting difficulty breathing. Auscultation of breath sounds reveal absent/diminished breath sounds in the right lower lobe. Which other manifestations lead the health care provider to suspect the client may have developed atelectasis? Select all that apply. - Respiratory rate—32; pulse rate—122 beats/min. - "Having a hard time catching my breath." - "Seems like I'm not making much water (decreased urine production)." - Using accessory muscles to help him breathe. - Copious amounts of thick, green sputum.

- Respiratory rate—32; pulse rate—122 beats/min. - "Having a hard time catching my breath." - Using accessory muscles to help him breathe.

Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as a thyroid storm. What are the manifestations of a thyroid storm? Select all that apply. - Tachycardia - Very low fever - Delirium - Bradycardia - Very high fever

- Tachycardia - Delirium - Very high fever

Which clinical manifestations following thyroidectomy would alert the nurse that the client is going into a life-threatening thyroid storm? Select all that apply. - Temperature of 104.2°F (40.1°C) - Telemetry showing heart rate of 184 - Unable to close eyelids completely together - Extremely agitated - Bruising on knees and feet

- Temperature of 104.2°F (40.1°C) - Telemetry showing heart rate of 184 - Extremely agitated

A student nurse is taking a test on the endocrine system. From the list of clinical manifestations, she needs to select the ones she would see in hypothyroidism. Which answers should she select? Select all that apply. - Weight gain despite loss of appetite - Nervousness with fine muscle tremors - Coarse, brittle hair - Heat intolerance - Puffy face with swollen eyelids

- Weight gain despite loss of appetite - Coarse, brittle hair - Puffy face with swollen eyelids

When comparing the endocrine and nervous system functions, the nurse knows that the endocrine system: Select all that apply. - sends signals to neurons over a short distance to muscles. - responds to neurotransmitter molecules within milliseconds. - releases hormones into the blood that is transported throughout the body. - glands are widely scattered throughout the body. - takes longer to respond to innervations but has prolonged actions when they arrive.

- releases hormones into the blood that is transported throughout the body. - glands are widely scattered throughout the body. - takes longer to respond to innervations but has prolonged actions when they arrive.

What is the normal tidal volume for a person at rest?

500 mL

A client tells the nurse that he is concerned he may be developing chronic bronchitis and asks how the diagnosis is made. The most appropriate information for the nurse to provide would be:

A diagnosis of chronic bronchitis requires a history of a chronic productive cough that has persisted for at least 3 consecutive months in at least 2 consecutive years.

Dyspnea can best be described by which of the following?

A subjective sensation felt when experiencing difficulty breathing

The health care provider is reviewing diurnal variation pattern in adrenocorticotropic (ACTH) levels. Select the typical diurnal variation pattern in adrenocorticotropic (ACTH) levels.

ACTH peaks in the morning and declines throughout the day.

The nurse is assessing a male client and finds abnormally large hands and feet, a bulbous nose, and a broad face with a protruding jaw. Based on these findings, which endocrine abnormality is most likely the cause for these physical changes?

Acromegaly

Which is the most common cause of atelectasis?

Airway obstruction

A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of:

Antidiuretic hormone (ADH) and oxytocin

A client with primary lung disease has developed right heart failure. The health care provider would document this as:

Cor pulmonale

During the admission interview the client, who is admitted with bacterial pneumonia, reveals a 20 pack per year smoking history. The nurse relates the possible cause of this pneumonia to the decreased defense of the pulmonary system caused by cigarette smoking. Smoking affects the pulmonary defense system in what way?

Damage or destruction of cilia

A client with a suspected diagnosis of primary hypothyroidism would most likely demonstrate which serum laboratory value?

Elevated thyroid-stimulating hormone (TSH) and decreased thyroxine (T4)

Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:

Graves disease

The nurse is teaching a client diagnosed with Addison disease about the importance of lifetime oral replacement therapy. Which pharmacologic agent would be the drug of choice and included in this teaching plan?

Hydrocortisone

A major manifestation of Cushing syndrome includes which of the following?

Hypokalemia

A client with a history of emphysema is experiencing hypoxemia after a taxing physical therapy appointment. Which physiologic phenomenon will occur as a consequence of hypoxemia?

Increased heart rate

A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing?

Increased levels of ACTH

The nurse is caring for a client who is immunosuppressed. Which aspect of the client's pulmonary defense mechanism is affected?

Macrophages in the alveoli

The nurse is caring for a client exhibiting bronchoconstriction. Which division of the nervous system contributes to this finding?

Parasympathetic

When a client with a history of asthma takes a walk outside on a windy day with high pollen counts, she may experience an asthma attack, resulting in an increase in respiration rate and wheezing. The body's response is likely related to which pathophysiologic principle?

Parasympathetic nervous system stimulation resulting in airway constriction

A client with a diagnosis of community-acquired pneumonia is producing copious secretions that are physically obstructing the airway. Which pathophysiologic process will result from this condition?

Perfusion without ventilation

Primary adrenal insufficiency is manifested by:

Serum sodium level of 120 mEq/L (120 mmol/L) (low) and blood glucose level of 48 mg/dL (2.66 mmol/L) (low)

A client who has been taking 80 mg of prednisone, a glucocorticoid, each day has been warned by his primary care provider to carefully follow a plan for the gradual reduction of the dose rather than stopping the drug suddenly. What is the rationale for this directive?

Stopping the drug suddenly may cause acute adrenal insufficiency.

A 6-month-old infant has been hospitalized with acute bronchiolitis. Which treatment should be prioritized in the infant's care?

Supplementary oxygen therapy

In addition to being the site of gas exchange, the lungs also perform which function?

Synthesize pulmonary surfactant

Which statement best describes a secondary disorder of endocrine function?

The disorder occurs when the target organ is normal, but stimulating hormones alter its function.

The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which statement about the role of the thyroid gland is most accurate?

The thyroid gland is responsible for increasing the metabolic rate.

A client with a 25-year history of smoking is diagnosed with emphysema. Physical assessment reveals an increased anterior-posterior chest diameter. Which term should the nurse use to document this finding?

barrel chest

The nurse is explaining to the parents of a 23-week premature infant the reason their baby needs to be on mechanical ventilation. The education is successful when the parents state that they understand their baby was born before the type II alveolar cells could mature, which has caused a:

deficiency of surfactant.

Which physiologic process best exemplifies a positive feedback mechanism?

increase in prolactin secretion that occurs with more frequent breastfeeding

With acute respiratory distress syndrome (ARDS), a client progressively increases his work of breathing. The physiologic principle behind this respiratory distress is related to:

the stiffening of the lung, making it more difficult to inflate.

Clients with chronic obstructive lung disease (COPD) may experience airway closure at the end of normal lung volumes instead of low lung volumes. This results in:

trapping of large amounts of air that cannot participate in gas exchange.