Endocrine and Oncology

A client, who is receiving an IV vesicant agent, reports pain at the intravenous site. The nurse also notes swelling at the site. What is the priority nursing action? 1. Apply a cold compress to the IV site 2. Stop the infusion 3. Check the IV for a blood return 4. Slow the infusion

2

An elderly, bed-bound client receiving G-tube feeding at home is transported to the emergency department after onset of behavioral changes and hallucinations. Which nursing action is priority while diagnostic testing is underway? 1. Initiate seizure precautions 2. Discontinue G-tube feeding 3. Administer oxygen 4. Obtain blood work for troponin level

1

A client with type 2 diabetes, who is noncompliant, has a HbA1c of 8%. The finger stick blood sugar is 218 mg/dL (12.1 mmol/L) at 0900. The current medications prescribed are metformin and exenatide. Based on this data, what teaching should the nurse reinforce? Select all that apply. 1. Nutritional counseling to help improve diet compliance 2. HbA1c measures glycemia control over a period of 1 month 3. Blood glucose testing 4. Vigorous exercise plan to improve glucose control 5. Without glycemic control, eye complications can occur

1, 3, 5

A client has been prescribed levothyroxine sodium. What should the nurse teach the client about this medication? Select all that apply. 1. Therapy will last six month to one year. 2. Notify the primary healthcare provider of chest pain. 3. Take medication ½ hour before breakfast. 4. Do not take medication with calcium supplements. 5. Improvement of symptoms will occur within days.

2, 3, 4

A client was admitted to CCU with a diagnosis of acute coronary syndrome. Continuous cardiac monitoring has been implemented. Which assessment finding by the nurse is most significant? 1. Ventricular fibrillation 2. Ventricular tachycardia 3. 2nd degree AV block 4. Atrial fibrillation

1

A client with Cushing's disease occupies one bed in a semi-private room. When considering room assignments, which client would be the safest choice to occupy the other bed in this room? 1. Status asthmaticus receiving respiratory therapy. 2. Newly admitted client with shingles. 3. Client with 50% burn of both arms. 4. Client who is post emergency appendectomy.

1

What is priority for the client experiencing hyperparathyroid crisis? 1. Support for airway and breathing. 2. Continuous cardiac monitoring for arrhythmias. 3. Provide safety precautions. 4. Prepare for emergency tracheostomy.

1

A client diagnosed with confusion and dehydration is admitted to the medical unit. Which tasks would be best for the RN to assign to the LPN/VN? Select all that apply. 1. Insert an indwelling urinary catheter 2. Reinforce the teaching plan with the client's family 3. Maintain fluids at bedside 4. Assess I & O for adequate fluid replacement 5. Start an IV of normal saline

1, 2

Which interventions should a nurse discuss with a client for primary prevention of skin cancer from exposure to ultraviolet light? Select all that apply. 1. Use sunscreen when outdoors 2. Stay in the shade when outdoors 3. Wear wide brimmed hats when outdoors 4. Plan to be outdoors between 10 am to 2 pm 5. Have an annual skin assessment by a dermatologist

1, 2, 3

A client diagnosed with cancer has been losing weight. What should the nurse teach the client regarding methods for improving nutritional needs to maintain weight? Select all that apply. 1. Add butter to foods 2. Spread peanut butter on toast 3. Use biscuits to make sandwiches 4. Put honey on top of hot cereal 5. Eat Caesar salads once per day

1, 2, 3, 4

Which client instruction is important when the client is scheduled for a vanillylmandelic acid (VMA) test? Select all that apply. 1. Avoid caffeine for 72 hours. 2. A 24 hour urine specimen requires starting with an empty bladder. 3. Limit physical exercise throughout the test. 4. Avoid all commercially prepared foods for 24 hours prior to testing. 5. A preservative will be added to the collection container so no ice is required.

1, 2, 3, 5

A client has been admitted with advanced cirrhosis of the liver and bleeding esophageal varices. A Blakemore tube has been prescribed by the primary healthcare provider. What assessments are required for this client? Select all that apply. 1. Vital signs every 30 minutes 2. CVP measurements hourly 3. Drainage observation every shift 4. Airway patency 5. Balloon pressure every 2 hours

1, 2, 4, 5

What should the nurse include in the teaching plan for a client receiving external beam radiation? Select all that apply. 1. Small marks will be placed on the skin to mark the treatment area. 2. Lotion may be used around the treatment area to decrease dryness. 3. The radiation therapist can see, hear, and talk with you at all times during treatment. 4. Stay away from babies for 24 hours. 5. You will have to hold your breath during radiation treatment.

1, 3

A client with a severe cough is suspected of having lung cancer. When preparing the client for testing to confirm a diagnosis of cancer, which tests should a nurse anticipate? Select all that apply. 1. Chest x-ray 2. Arterial blood gas 3. Bronchoscopy 4. Computed tomography (CT) 5. Pulmonary function test

1, 3, 4

A client with acute pancreatitis is prescribed total parenteral nutrition (TPN), methylprednisolone, and sliding scale insulin. What is the rationale for the insulin prescribed? Select all that apply. 1. Impaired endocrine function of the pancreas 2. Inability of the liver to convert glucose 3. Steroid therapy side effects 4. Dextrose concentration of TPN 5. Re-establish serum potassium level

1, 3, 4

A 13 year old found unresponsive in the park is brought into the emergency department (ED). The nurse sees a medical alert bracelet stating "Diabetic", and notes a fruity smell to the breath. There are no family members available to obtain consent for treatment and attempts to call them have been unsuccessful. What action should the nurse take? 1. Obtain consent from the social worker on duty in the emergency department. 2. Begin treatment by inserting two large bore IVs for administration of normal saline. 3. Give Glucagon IM and then wait for the arrival of a parent to consent to further treatment. 4. Notify the pirmary healthcare provider.

2

A client's absolute neutrophil count (ANC) is 750/mm3. Which measure should the nurse take to protect the client? Select all that apply. 1. Prohibit the client from shaving. 2. Instruct the client to wear a mask when leaving the hospital room. 3. Remove fresh flowers and plants from the client's room. 4. Ask visitors to perform hand hygiene before entering the client's room. 5. Instruct client to avoid vigorous flossing of teeth.

2, 3, 4

What medications would the nurse anticipate for the treatment of hyperthyroidism? Select all that apply. 1. levothyroxine 2. methimazole 3. propranolol 4. iodine compounds 5. calcitonin

2, 3, 4

A client with a long standing history of diabetes presents to the emergency department (ED) with a serum blood sugar of 400 mg/dL (22.19 mmol/L). What lab values for this client are consistent with diabetic ketoacidosis (DKA)? Select all that apply. 1. Serum sodium 140 mEq/L 2. Urine specific gravity 1.005 3. Serum potassium 5.3 mEq/L 4. PaCO2 48 5. pH 7.30

2, 3, 5

A nurse is caring for a client who is diagnosed with diabetic ketoacidosis (DKA). Which primary healthcare provider prescription is appropriate during the first 24 hours of treatment for this client? You answered this question Incorrectly 1. 0.9% saline solution at 50 mL/hr 2. 3% saline solution at 125 mL/hr 3. 0.9% saline solution at 1,000 mL/hr × 2 4. Dextrose 5% in lactated Ringer's solution at 125 mL/hr when blood glucose reaches 500 mg/dL

3

What is the priority nursing assessment for a client post-op thyroidectomy? 1. Mental status changes 2. + Chvostek sign 3. Laryngospasm 4. Incisional pain

3

A client returns to the unit after having extracorporal lithotripsy. Which assessment finding by the nurse would be the best indicator that the treatment has been effective? 1. Decreased lower back pain 2. Walking without difficulty 3. Increased urinary output 4. Tiny fragments noted in strainer after voiding

4

The nurse is caring for a poorly controlled type 2 diabetic client. Lab results include a BUN of 22mg/dL (7.85 mmol/L) and a creatinine of 1.9 mg/dL (0.67 mmol/L). The nurse checks the client's blood sugar and it is 218mg/dL (12.09 mmol/L). Current medications include metformin and exenatide. What is the priority concern with this client taking metformin? 1. Metformin is not controlling the client's blood glucose. 2. Metformin and exenatide should not be administered together. 3. Metformin can cause hypoglycemia. 4. Metformin is contraindicated with an elevated creatinine level.

4

The nurse is caring for a client receiving peritoneal dialysis. Place the steps for peritoneal dialysis in the correct order. Complete exchange Access Tenckhoff catheter Warm dialysate Assess effluent Begin dwell time

Warm dialysate Access Tenckhoff catheter Begin dwell time Complete exchange Assess effluent