Cushings/Addisons/FE- PREP U
A patient is being treated with loop diuretics; gastric suctioning has been initiated. The nurse understands the patient is at risk for developing which of the following electrolyte imbalances? A. Hypokalemia B. Hyponatremia C. Hypomagnesium D. Hypocalcemia
A. Hypokalemia
Hypocalcemia is associated with which of the following manifestations? A. Muscle twitching B. Bowel hypomotility C. Fatigue D. Polyuria
A. Muscle twitching
The nurse is reviewing client lab work for a critical lab value. Which value is called to the physician for additional orders? A. Potassium: 5.8 mEq/L B. Sodium: 138 mEq/L C. Calcium: 10 mg/dL D. Magnesium:2 mEq/L
A. Potassium: 5.8 mEq/L
A nurse working on a medical-surgical unit is caring for a client with Cushing's syndrome. After receiving report, the nurse reads through the client's nursing diagnoses and prioritizes her interventions. Which of the following would the nurse not include in her plan of care? A. Provide a high-sodium diet. B. Report systolic BP that exceeds 139 mm Hg or diastolic BP that exceeds 89 mm Hg. C. Examine extremities for pitting edema. D. Administer prescribed diuretics.
A. Provide a high-sodium diet.
Which of the following is considered an isotonic solution? A. 0.9% normal saline B. 3% NaCl C. Dextran in NS D. 0.45% normal saline
A. 0.9% normal saline
Which of the following is the most common cause of symptomatic hypomagnesemia? A. Alcoholism B. Burns C. Sedentary lifestyle D. IV drug use
A. Alcoholism
Air embolism is a potential complication of IV therapy. The nurse should be alert to which clinical manifestation associated with air embolism? A. Chest pain B. Jaundice C. Hypertension D. Slow pulse
A. Chest pain
The nurse is caring for a patient with a serum sodium level of 113 mEq/L. The nurse should monitor the patient for the development of which of the following? A. Confusion B. Hallucinations C. Headache D. Nausea
A. Confusion
A hypophysectomy is the treatment of choice for which endocrine disorder? A. Cushing's syndrome B. Hyperthyroidism C. Acromegaly D. Pheochromocytoma
A. Cushing's syndrome
In which of the following medical conditions would administering IV normal saline solution be inappropriate? Select all that apply. A. Heart failure B. Renal impairment C. Pulmonary edema D. Burns E. Severe hemorrhage
A. Heart failure B. Renal impairment C. Pulmonary edema
The nurse is assigned to care for a patient with a serum phosphorus level of 5.0 mg/dL. The nurse anticipates that the patient will also experience which of the following electrolyte imbalances? A. Hypocalcemia B. Hyperchloremia C. Hypermagnesemia D. Hyponatremia
A. Hypocalcemia
A client presents with fatigue, nausea, vomiting, muscle weakness, and leg cramps. Laboratory values are as follows: Na + 147 mEq/L K + 3.0 mEq/L Cl - 112 mEq/L Mg ++ 2.3 mg/dL Ca ++ 1.5 mg/dL Which of the following is consistent with the client's findings? A. Hypokalemia B. Hypophosphatemia C. Hyperchloremia D. Hypernatremia
A. Hypokalemia
A nurse is caring for a patient with acute renal failure and hypernatremia. Which of the following actions can be delegated to the nursing assistant? A. Assess the patient's daily weights for trends. B. Monitor for signs and symptoms of dehydration. C. Teach the patient about increased fluid intake. D. Provide oral care every 2-3 hours.
D. Provide oral care every 2-3 hours.
Which of the following solutions is hypotonic? A. 0.9% NaCl B. 0.45% NaCl C. Lactated Ringer's solution D. 5% NaCl
B. 0.45% NaCl
The nurse is caring for a patient in the intensive care unit (ICU) following a saltwater near-drowning event. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen dry tongue, flushed skin, and peripheral edema. The nurse anticipated that the patient's serum sodium value would be which of the following? A. 145 mEq/L B. 155 mEq/L C. 125 mEq/L D. 135 mEq/L
B. 155 mEq/L
The nurse is caring for four clients on a medical unit. The nurse is most correct to review which client's laboratory reports first for an electrolyte imbalance? A. A 72-year-old with a total knee repair B. A 52-year-old with diarrhea C. A 65-year-old with a myocardial infarction D. A 7-year-old with a fracture tibia
B. A 52-year-old with diarrhea
The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration? A. Crackles in the lung fields B. Dark, concentrated urine C. Cool and pale skin D. Distended jugular veins
B. Dark, concentrated urine
Which nerve is implicated in the Chvostek's sign? A. Spinal accessory B. Facial C. Hypoglossal D. Optic
B. Facial
An elderly client takes 40 mg of Lasix twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use? A. Hyperkalemia B. Hypokalemia C. Hypernatremia D. Hypophosphatemia
B. Hypokalemia
During his annual physical exam, your 72-year-old male client complains of muscle cramps in his calves and that he feels "tired a lot." He is taking ethacrynic acid (Edecrin) for his hypotension. Your client will be evaluated for which of the following electrolyte imbalance based on his symptoms? A. Hypercalcemia B. Hypokalemia C. Hypocalcemia D. Hyperkalemia
B. Hypokalemia
Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome? A. Monitor bowel patterns B. Observe the color of stool C. Observe urine output D. Monitor vital signs every 4 hours
B. Observe the color of stool
Which glands regulate calcium and phosphorous metabolism? A. Thyroid B. Parathyroid C. Pituitary D. Adrenal
B. Parathyroid
A client was admitted to your unit with a diagnosis of hypovolemia. When it is time to complete discharge teaching, which of the following will the nurse teach the client and his family? Select all that apply. A. Drink caffeinated beverages to retain fluid. B. Respond to thirst C. Drink water as an inexpensive way to meet fluid needs. D. Drink carbonated beverages to help balance fluid volume. E. Drink at least eight glasses of fluid each day.
B. Respond to thirst C. Drink water as an inexpensive way to meet fluid needs. E. Drink at least eight glasses of fluid each day.
The nurse is participating in the care of a patient who had a peripherally inserted central catheter (PICC) inserted in the right arm. Following catheter placement, the nurse should complete which of the following actions? A. Assess the patient's blood pressure (BP) on the right arm. B. Send the patient for a chest x-ray. C. Administer the prescribed IV fluids. D. Obtain written consent for the procedure.
B. Send the patient for a chest x-ray.
A patient with cancer is being treated on the oncology unit for bilateral breast cancer. The patient is undergoing chemotherapy. The nurse notes the patient's serum calcium level is 12.3 mg/ dL. Given this laboratory finding, the nurse should suspect which of the following statements? A. The patient's diet is lacking in calcium-rich food products. B. The patient's malignancy is causing the electrolyte imbalance. C. The patient may be developing hyperaldosteronism. D. The patient has a history of alcohol abuse.
B. The patient's malignancy is causing the electrolyte imbalance.
Trousseau's sign is elicited A. by a sharp tapping over the facial nerve just in front of the parotid gland and anterior to the ear that causes spasm or twitching of the mouth, nose, and eye. B. by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff. C. after making a clenched fist and the palm remains blanched when pressure is placed over the radial artery. D. when the foot is dorsiflexed and there is pain in the calf.
B. by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.
Early signs of hypervolemia include A. thirst. B. increased breathing effort and weight gain C. moist breath sounds. D. a decrease in blood pressure.
B. increased breathing effort and weight gain
The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium level of 2.9 mEq/L. Which of the following statements made by the patient indicates the need for further teaching? A. "I will be sure to buy frozen vegetables when I grocery shop." B. "I will take a potassium supplement daily as prescribed." C. "I can use laxatives and enemas but only once a week." D. "A good breakfast for me will include milk and a couple of bananas."
C. "I can use laxatives and enemas but only once a week."
Below which serum sodium level may convulsions or coma can occur? A. 145 mEq/L B. 142 mEq/L C. 135 mEq/L D. 140 mEq/L
C. 135 mEq/L
A 73-year-old male client was admitted to your hospital unit after 2days of vomiting and diarrhea. His wife became alarmed when he demonstrated confusion and elevated temperature and reported "dry mouth."You suspect the client is experiencing which of the following conditions? A. Hyperkalemia B. Hypervolemia C. Dehydration D. Hypercalcemia
C. Dehydration
Which of the following is a clinical manifestation of diabetes insipidus? A. Excessive activities B. Low urine output C. Excessive thirst D. Weight gain
C. Excessive thirst
A client presents with anorexia, nausea and vomiting, deep bone pain, and constipation. The following are the client's laboratory values. Na + 130 mEq/L K + 4.6 mEq/L Cl - 94 mEq/L Mg ++ 2.8 mg/dL Ca ++ 13 mg/dL Which of the following alterations is consistent with the client's findings? A. Hyponatremia B. Hyperkalemia C. Hypercalcemia D. Hypermagnesemia
C. Hypercalcemia
A 64-year-old client is brought in to the clinic feeling thirsty with dry, sticky mucous membranes; decreased urine output; fever; a rough tongue; and is lethargic. Serum sodium level is above 145 mEq/l. Should the nurse start salt tablets when caring for this client? A. No, start with the sodium chloride IV. B. Yes, this will correct the sodium deficit. C. No, sodium intake should be restricted. D. Yes, along with the hypotonic IV.
C. No, sodium intake should be restricted.
To compensate for decreased fluid volume (hypovolemia), the nurse can anticipate which response by the body? A. Bradycardia B. Increased urine output C. Tachycardia D. Vasodilation
C. Tachycardia
A 57-year-old homeless female with a history of alcohol abuse has been admitted to your hospital unitwith signs and symptoms of hypovolemia—minus the weight loss. She exhibits a localized enlargement of her abdomen. What condition could she be presenting? A. Pitting edema B. Hypovolemia C. Third-spacing D. Anasarca
C. Third-spacing
A patient with Cushing syndrome is admitted to the hospital. During the initial assessment, the patient tells the nurse, "The worst thing about this disease is how awful I look. I want to cry every time I look in the mirror." Which of the flowing statements is the best response by the nurse? A. "I do not think you look bad and I am sure your family loves you very much." B. "I can refer you to a support group. It may help you feel better to talk to someone." C. "I can show you how to change your style of dress so that the changes are not so noticeable." D. "If treated successfully, the major physical changes will disappear in time."
D. "If treated successfully, the major physical changes will disappear in time."
The normal serum value for potassium is A. 8.5 to 10.5 mg/dL. B. 135 to 145 mEq/L. C. 96 to 106 mEq/L. D. 3.5 to 5.5 mEq/L.
D. 3.5 to 5.5 mEq/L.
Following a thyroidectomy, a patient develops a carpopedal spasm while the nurse is taking a BP reading on the left arm. Which of the following actions by the nurse is appropriate? A. Administer the sedative ordered. B. Start administration of oxygen at 2 L/min per cannula. C. Administer the oral calcium supplement ordered. D. Administer the IV calcium gluconate ordered.
D. Administer the IV calcium gluconate ordered.
A nurse is reviewing the laboratory order for a client suspected of having an endocrine disorder. The lab slip includes obtaining cortisol levels. Which of the following is being tested? A. Parathyroid functioning B. Thyroid functioning C. Thymus functioning D. Adrenal functioning
D. Adrenal functioning
Which of the following is the primary hormone for the long-term regulation of sodium balance? A. Calcitonin B. Antidiuretic hormone (ADH) C. Thyroxin D. Aldosterone
D. Aldosterone
A nurse educator is reviewing peripheral IV insertion with a group of novice nurses. How should these nurses be encouraged to deal with excess hair at the intended site? A. Shave the area. B. Leave the hair intact. C. Remove the hair with a depilatory. D. Clip the hair in the area.
D. Clip the hair in the area.
Which of the following disorders is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex? A. Graves' disease B. Addison's disease C. Hashimoto's disease D. Cushing syndrome
D. Cushing syndrome
A nurse is caring for a client with hypoparathyroidism. During her assessment, the nurse elicits a positive Trousseau's sign. What does the nurse observe to verify this finding? A. Moon face and buffalo hump B. Bulging forehead C. Cardiac dysrhythmia D. Hand flexing inward
D. Hand flexing inward
Which of the following is indicative of a carpopedal spasm in a patient with hypoparathyroidism? A. Bulging forehead B. Moon face and buffalo hump C. Cardiac dysrhythmia D. Hand flexing inward
D. Hand flexing inward
Which of the following may occur in the postoperative period of an adrenalectomy because of sudden withdraw of excessive amounts of catecholamines? A. Hypertension B. Hyporeflexia C. Hyperglycemia D. Hypoglycemia
D. Hypoglycemia
Which of the following is a correct route of administration for potassium? A. Subcutaneous B. Intramuscular C. IV (intravenous) push D. Oral
D. Oral
A patient is being treated in the ICU 24 hours after having a radical neck dissection completed. The patient's serum calcium level is 7.6 mg/dL. Which of the following physical examination findings is consistent with this electrolyte imbalance? A. Negative Chvostek's sign B. Slurred speech C. Muscle weakness D. Presence of Trousseau's sign
D. Presence of Trousseau's sign
A patient with symptoms of Cushing syndrome is admitted to the hospital for evaluation and treatment. The nurse is creating a plan of care for the patient. Which of the following is an appropriate nursing diagnosis? A. Activity intolerance related to muscle cramps, cardiac dysrhythmias, and weakness B. Insomnia related to increased nighttime voiding C. Impaired nutrition: more than body requirements related to polyphagia D. Self-care deficit related to weakness, fatigue, muscle wasting, and altered sleep patterns
D. Self-care deficit related to weakness, fatigue, muscle wasting, and altered sleep patterns
Patients diagnosed with hypervolemia should avoid sweet or dry food because A. it obstructs water elimination. B. it can cause dehydration. C. it can lead to weight gain. D. it increases the patient's desire to consume fluid.
D. it increases the patient's desire to consume fluid.
