Complex Care Exam 2 Practice Questions

3

A client with adrenal insufficiency reports feeling weak and dizzy, especially in the morning. What should the nurse determine is the most probable cause of these symptoms? 1. A lack of potassium 2. Postural hypertension 3. A hypoglycemic reaction 4. Increased extracellular fluid volume

2

The nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which finding in the client is consistent with the diagnosis? 1. Preservation of salt 2. Retention of water 3. Decrease of vasopressin 4. Presence of pedal edema

2

A nurse is assessing the adequacy of a client's intravenous fluid replacement therapy during the first 2 to 3 days after sustaining full-thickness burns to the trunk and right thigh. What assessment will provide the nurse with the most significant data? 1. Weights every day 2. Urinary output every hour 3. Blood pressure every 15 minutes 4. Extent of peripheral edema every 4 hours

1,2

A nurse is caring for a client after a thyroidectomy. Which symptoms indicating thyroid storm should the nurse monitor the client for? Select all that apply. 1. Increased heart rate 2. Increased temperature 3. Decreased respirations 4. Increased pulse deficit 5. Decreased blood pressure

2

After stabilization of an acute adrenal insufficiency (addisonian crisis), intravenous medications are decreased gradually, and the client now is receiving hydrocortisone by mouth. What instruction should the nurse include when performing discharge teaching? 1. Eat a diet high in sodium. 2. Take the medication with food. 3. Maintain the same dose indefinitely. 4. Eliminate a dose if side effects occur.

3

The nurse is caring for a client who is diagnosed with diabetes insipidus and is on intranasal desmopressin acetate (DDAVP). The client develops an upper respiratory tract infection during a hospital stay. Which alteration does the nurse anticipate in the client's prescription? 1. cessation of DDAVP administration 2. Reduced DDAVP dose via oral route 3. Reduced DDAVP dose via subcutaneous route 4.Continuation of DDAVP administration via nasal route

1

The primary healthcare provider prescribed carbamazepine to a client with central diabetes insipidus. The serum osmolarity is 600 mOsm (mmol)/kg. Which will be an effective outcome of the drug? 1. Decreased thirst 2. Decreased seizures 3. Decreased urine output 4.Increased serum calcium levels

3

Two clients with polydipsia and polyuria arrived at the hospital. Both were having similar symptoms but were diagnosed with different types of diabetes insipidus. Which assessment finding helped to differentiate the diagnosis? 1. Urine output 2. Specific gravity 3. Urine osmolarity 4. Serum osmolarity

4

What are the cardiovascular manifestations observed in a client with adrenal insufficiency? 1. Fatigue 2. Salt craving 3. Weight loss 4. Hyponatremia

1,2,5

A client is diagnosed with hyperthyroidism and is treated with 131-I. Before discharge the nurse teaches the client to observe for signs and symptoms of therapy-induced hypothyroidism. Which signs and symptoms should be included in the teaching? Select all that apply. 1. Fatigue 2. Dry skin 3. Insomnia 4. Intolerance to heat 5. Progressive weight gain

3

A client who is recovering from deep partial-thickness burns develops chills, fever, flank pain, and malaise. The primary healthcare provider makes a tentative diagnosis of urinary tract infection. Which diagnostic tests should the nurse expect the primary healthcare provider to prescribe to confirm this diagnosis? 1. Cystoscopy and bilirubin level 2. Specific gravity and pH of the urine 3. Urinalysis and urine culture and sensitivity 4. Creatinine clearance and albumin/globulin (A/G) ratio

2

A client with burns develops a wound infection. The nurse plans to teach the client that local wound infections primarily are treated with what type of antibiotics? 1. Oral 2. Topical 3. Intravenous 4. Intramuscular

3

A nurse is caring for a client with a history of hyperthyroidism who is now experiencing thyroid crisis (thyroid storm). What does the nurse consider to be the most likely precipitating factor in the client's current health problem? 1. Increased iodine in the blood 2. Removal of the parathyroid glands 3. High levels of the hormone triiodothyronine 4. Rebound increase in metabolism following anesthesia

2

A nurse is caring for a client with hyperthyroidism. Which laboratory test will be most beneficial in monitoring the effectiveness of drug therapy? 1. Free thyroxine (FT4) 2. Thyroxine (T4), total 3. Free triiodothyronine (FT3) 4. Triiodothyronine (T3), total

2

A nurse is caring for a client with myxedema who has undergone abdominal surgery. What should the nurse consider when administering opioids to this client? 1. Tolerance to the drug develops readily. 2. One-third to one-half the usual dose should be prescribed. 3. Opioids may interfere with the secretion of thyroid hormones. 4. Sedation will have a paradoxical effect, causing hyperactivity

3

A nurse is caring for a newly admitted client with a diagnosis of Cushing syndrome. Why should the nurse monitor this client for clinical indicators of diabetes mellitus? 1. Cortical hormones stimulate rapid weight loss. 2. Tissue catabolism results in a negative nitrogen balance. 3. Glucocorticoids accelerate the process of gluconeogenesis. 4. Excessive adrenocorticotropic hormone (ACTH) secretion damages pancreatic tissue

1,2

Fludrocortisone is prescribed for a client with adrenal insufficiency. Which responses to the medication should the nurse teach the client to report? Select all that apply. 1. Edema 2. Rapid weight gain 3. Fatigue in the afternoon 4. Unpredictable changes in mood 5. Increased frequency of urination

4

The primary healthcare provider prescribed tolvaptan to a client whose laboratory reports reveal low plasma osmolarity and continued secretion of vasopressin from syndrome of inappropriate antidiuretic hormone. During follow-up care, which finding in the client indicates a side effect of medication? 1. Decreased hyponatremia 2. Increased urine osmolarity 3. Decreased deep tendon reflexes 4. Increased demyelination of brain neurons

2,4,5

The registered nurse (RN) assigns a task to a licensed practical nurse (LPN) to take care of a client admitted with severe burns. Which tasks are being performed by the LPN in this situation? Select all that apply. 1. Performing hygiene tasks 2. Monitoring the heart rate 3. Evaluating the medical reports 4. Monitoring the blood pressure 5. Administering the oral medication

3,4

What are the neurologic manifestations of hyperthyroidism? Select all that apply. 1. Fatigue 2. Diaphoresis 3. Blurred vision 4. Exophthalmos 5. Shallow respirations

1,4,5

What interventions should the nurse implement in caring for a client with diabetes insipidus (DI) following a head injury? Select all that apply. 1. Providing adequate fluids within easy reach 2. Reporting an increasing urine specific gravity 3. Administering prescribed erythromycin 4. Assessing for and reporting changes in neurological status 5. Monitoring for constipation, weight loss, hypotension, and tachycardia

1,2,5

What interventions should the nurse implement when caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH)? Select all that apply. 1. Providing frequent oral care 2. Instituting fall risk precautions 3. Restricting fluids to 2 L per day 4. Placing the client in high-Fowler position 5. Monitoring for and reporting neurologic changes

3

Which drug would be effective for the treatment of pituitary Cushing's syndrome? 1. Mitotane 2. Cabergoline 3. Cyproheptadine 4. Bromocriptine mesylate

3

Which treatment intervention should be provided to a client diagnosed with Cushing's disease? 1. Increase cortisol levels 2. Increase sodium levels 3. Decrease blood glucose levels 4. Decrease serum calcium levels

1

A client with hyperthyroidism is to receive methimazole. What instructions does the nurse provide? 1. Initial improvement will take several weeks. 2. There are few side effects associated with this drug. 3. This medication may be taken at any time during the day. 4. Large doses are used to quickly correct the functions of the thyroid

4

A client with hyperthyroidism is to receive potassium iodide solution before a subtotal thyroidectomy is performed. What action does the nurse include when providing teaching about this drug? 1. Decreases the total basal metabolic rate 2. Maintains the function of the parathyroids 3. Blocks the formation of thyroxine by the thyroid gland 4. Decreases the size and vascularity of the thyroid gland

1,2,3

A client with small cell carcinoma of the lung develops the syndrome of inappropriate antidiuretic hormone (SIADH). What signs should the nurse expect to observe? Select all that apply. 1. Oliguria 2. Seizures 3. Vomiting 4. Polydipsia 5. Polyphagia

2

A nurse administers the drug desmopressin acetate (DDAVP) to a client with diabetes insipidus. What should the nurse monitor to evaluate the effectiveness of the drug? 1. Arterial blood pH 2. Intake and output 3. Fasting serum glucose 4. Pulse and respiratory rates

1,2,4

A nurse is assessing a client with Cushing syndrome. Which signs should the nurse expect the client to exhibit? Select all that apply. 1. Hirsutism 2. Round face 3. Pitting edema 4. Buffalo hump 5. Hypoglycemia