Evolve study questions-exam 3
which assessment findings are associated with cushing dz? SATA
round face dependent edema in the feet and ankles thin, translucent skin with bruising increased fatty deposition in the neck and back
which activities would nurse include when teaching adults about those that increase risk of developing bladder cancer?SATA
smoking 2 packs a day working with dyes used in rubber every day
a client on prolonged cortisone therapy for adrenal insufficiency is being discharged. which side effects would the nurse teach the client and family to expect? SATA
weak moon face weight gain
labor with herpes 2 with active lesions. plan of care
withholding oral intake (prep for csection surgery)
ingestion of which chemicals may cause chemical pneumonia
lighter fluid
burn injury and suspects atelectasis and hypoxia. age related changes would nurse associate with findings
reduced thoracic compliance
plan of care for a client who just had a posterior laminectomy
reposition client by log rolling
which action would the nurse take to prevent aspiration recurrence in a client with aspiration pneumonia who is NPO status with a ng tube and prescription abt
elevate HOB 30 degrees
a client who has been told she needs a hysterectomy for cervical cancer reports being upset about not being able to have a third child. what action would the nurse take?
ensure that other tx options are explored
CREST syndrome; clinical indicators would nurse expect to find
esophageal dysmotility spiderlike hemangiomas episodic blanching of the fingers
which rationale accurately explains why insulin is prescribed for clients in acute renal failure
it promotes transfer of potassium into cells to lower serum potassium levels
a client who has bone cancer is preparing for first radiation tx. starts crying "im so discouraged". response by nurse
its difficult to deal with your diagnosis and tx
african american:Illness is a punishment for sins. what culture
magicoreligious belief
nursing action in follow up visit minimizes side effects of fludrocortisone
monitor BP
SLE at 39 weeks gestation. what would nurse anticipate
need to dc the clients salicylate therapy
when a client with pneumonia is experiencing dyspnea because of difficulty expectorating thick resp secretions, which action by nurse is helpful
offer fluids frequently
which action would be included in the plan of care for a client with a history of parkinsonism who has recently developed rigidity, tremors, and signs of pne
passive ROM every 8 hours
clinical manifestations may indicate SLE SATA
pericarditis discoid lesions pleaural effusions
which key factor assists the nurse in assessing how a client will cope with the body image change after an above the knee amputation
personal perception of the change
which is a secondary cause of adrenal insufficiency
pituitary tumors
a nurse is caring for a client with a below the knee amputation. which action would the nurse encourage the client to take to prepare the residual limb for prosthesis
press the end of the residual limb against a pillow periodically
a client, admitted with a diagnosis of addison dz, emaciated and reports muscular weakness and fatigue. which disturbed body process would the nurse determine is root cause?
protein catabolism
which instruction would the nurse provide to a client receiving brachytherapy for prostate cancer to prevent injury
refrain from close contact with others
crushing injury to lower left leg and a below knee amp is performed. s/s of a pulmonary embolus would nurse assess for SATA
sharp CP acute onset of dyspnea
rationale supports why client with AIDS and kaposi sarcoma would wear hats and long sleeves
to maintain a normal appearance
type of hypersensitivity reaction associated with SLE
type 3
clinical manifestations consistent with sjogren syndrome SATA
xerostomia (dry mouth) keratoconjunctivitis sicca (dry eyes) tooth decay corneal ulcers vaginal dryness
i had a pap smear more than 8 years ago. i probably wouldnt be here if i had those nore often. nurse responds:
you feel as though you have neglected your health
admitted for prostatectomy. clients PSA levels have been increasing. which intervention would the nurse include in plan of care
handle gently when turning
possible PE, nurse anticipates which test
helical CT
external shunt for circulatory access, possible complication
hemorrhage
diagnostic studies findings with cushings
high levels of 17-ketosteroids in 24 hour urine test
cushing s/s
hirsutism round face buffalo hump edema *not pitting unless HF*
pcp for CKD prescribes immediate hemodialysis for 1st time. why?
hyperkalemia
hemodialysis several years, kidney transplant scheduled. pre op teaching plan
kidney may not function immediately precautions needed to prevent infection urinary cath will be present
Exaggeration of the posterior curvature of the thoracic spine. A. Kyphosis B. Lordosis C. Malignancy D. Murmurs
kyphosis
Fludrocortisone is prescribed for a client with adrenal insufficiency. Which response to the medication will the nurse teach the client to report? SATA
Edema Rapid weight gain
Hypofunction of adrenal gland. Prescribed hydrocortisone. What findings indicate dosage adjustment needed. SATA
Fluid retention Rapid weight gain
sweating, tachycardia, tremors. Low cortisol and BS of 60. Which med needs administered.
Glucagon
A client is receiving hemodialysis for CKD. Which complication would the nurse need to monitor the client
Hepatitis b
The PCP prescribes fludrocortisone for a client with adrenal hypofunction. Which med teaching about side effects and adverse effects should the nurse provide to client
Med can cause hypertension; check bp regularly
which condition results in elevated serum ACTH and urine cortisol levels
PITUITYARY cushing syndrome
A client with ESRD receives peritoneal dialysis. Which intervention would the nurse implement during a peritoneal fluid exchange.
Position the client from side to side of fluid is not draining adequately
The nurse administers sodium polystyrene sulfonate to a client with chronic renal failure. Which finding provides evidence that the intervention is effective
Potassium decreases to 4.2
client with which diagnosis will be at risk for development of a PE
a fib
which intervention would the nurse include in the plan of care for a client with addison disease
protect from exertion
which element would the nurse teach the client with CKD to limit as an intervention to control uremia associated ESRD
protein
first tx for testicular cancer
radical inguinal orchioectomy
vaginal packing protruding from client after radium implants for cervica cancer. rationale supports the need for the nurse to contact the clients pcp?
radioacitve packing will injure healthy tissue
Which throat manifestations are the key features for a client with acute viral pharyngitis? Select all that apply
scant or no tonsillar exudate slight erythema of the pharynx and tonsils
the nurse is caring for two clients with a below the knee amp. the first client was in a motor collision. second has history of chromically decreased arterial perfusion. which info would cause the nurse to conclude that the post op course for these two may differ
second client will take longer to heal
best indicator that measures to prevent post op atelectasis after abdominal surgery effectiveness
vesicular breath sounds heard over the lungs
education about care of residual limb to a client who had a below the elbow amp. what info is included
wash and dry the limb at least once a day
a young male client is undergoing dialysis tx. with his eyes lowered and his jaw clenched, he says, my wife would at least get some insurance money if i died. which response by the nurse
you feel so bad you wish you were dead
a client has a right above the knee amputation after trauma sustained in a work related accident. upon awakening from surgery, the client states "what happened to me" i dont remember a thing. which is the nurses best response
you were in a work related accident this morning
HIV associated Pneumocystis jiroveci pneumonia is to receive pentamidine intravenously daily. how would nurse ensure safety?
-report bleeding ASAP -assess BS levels daily and several times after therapy is completed
precautions implemented for herpes zoster SATA
contact standard
which percentage of cervical cancers occur during pregnancy
3%
on the first evening after a lumbar laminectomy, a client states :my feet are as numb as they were before the operation" nurse response
continue to let me know how you feel. it often takes time before that feeling subsides
a client is awaiting surgery for a herniated lumbar nucleus pulposus. which action would the nurse identify as most likely to increase pain
coughs excessively
pt a risk for PE
59 who had a knee replacement
s/s expected when assessing atelectasis
crackles at the bases
a client who has an above the knee amp reports phantom limb sensations. which response would the nurse make
describe the mechanisms in language that the client understands
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
A hypoglycemic reaction
Which exogenous conditions are responsible for increased cortisol secretion? SATA
Asthma Cancer chemotherapy Organ transplantation
Which sign and symptom is an associated complication of chronic kidney disease while undergoing peritoneal dialysis
Cloudy return dialysate
The nurse recalls which info about cortisol
Cortisol stimulates gluconeogenesis
A client with end stage renal failure begins hemodialysis for the first time. Which prescribed hemodialysis protocol would the nurse implement when the client reports nausea and a headache, then appears confused
Decrease the rate of the dialysis exchange
When receiving hemodialysis, the client may develop hyponatremia. Which clinical findings related to the potential development of hyponatremia would the nurse monitor. SATA
Diarrhea Seizures
Clinical manifestations of Cushing syndrome
Sleep disturbance
Which clinical manifestations would the nurse expect a client to exhibit with a diagnosis of Cushing syndrome? SATA
Weakness Hypertension Truncal obesity
interventions for client with herpes zoster
acyclovir silvadene gabapentin wet compress contact isolation
nursing intervention for client undergone unilateral adrenalectomy
admin temp glucocorticoid replacement therapy
which is the most probable cause for CONN syndrome in an adult client
adrenal adenoma
the nurse is caring for a client with the clinical manifestation of hypotension associated with a diagnosis of addison dz. which hormone can be impaired in its production because of this dz?
aldosterone
which alternative therapy may be beneficial for the nurse to discuss with a client who has terminal bone cancer
biofeedback
preferred med to client with hospitalized pneumococcal pneumonia
ceftriaxone
which action would the nurse first take first when a client who is receiving peritoneal dialysis reports difficulty breathing after instillation of dialysate into the peritoneal space?
check pulse oximetry
which medication taken by an older client who has been trreated for rhinitis and pharyngitis may be causing the clients new onset confusion, dry mouth, constipation
chlorpheniramine
self care teaching for a pt with stomatitis
clean teeth w swab flids through a straw avoid foods served at extreme temp
which client is at risk for hospital acquired pneumonia
client admitted to hospital 5 days ago for abdominal pain
which finding by the nurse would be most important to report to the PCP before a client undergoes a spiral CT scan for possible PE
client has poor skin turgor and dry oral mucosa
which finding would be of most concern when the nurse is assessing a client w pe diagnosis receiving heparin
client reports stools are black
med used to treat intervertebral disc disease
cyclobenzaprine
test used in diagnosis of SLE
direct immunofluroescence test
which instruction would ythe nurse give a client returning to work as a carpenter after surgery for carpal tunnel syndrome of the right hand
do stretching exercises during breaks
discontinue metformin
do this immediately prior to and for 48 hrs after any radiologic procedure involving IV iodinated contrast material because it can be nephrotoxic
when assessing a clients lower back pain, which question would the nurse ask
do you have any increase in pain during bowel movements
which client will need an eval for ovarian cancer
estradiol. 900pg/ml
Which physical assessment findings would the nurse document on a client who is experiencing Cushing triad? SATA
Bradycardia Irregular respirations Systolic hypertension Widening pulse pressure
A client who is on metformin therapy is scheduled to undergo renal CT with dye. Which instruction from the primary health care provider would the nurse anticipate reinforcing with the client
Discontinue metformin 1 day before the procedure and 48 hours after
During the infusion of dialysate during PD, the client exhibits respiratory difficulty. What should the nurse do
Drain the fluid from the clients peritoneal cavity
A client receiving peritoneal dialysis develops symptoms of severe respiratory difficulty during the infusion of the dialysate solution. Which action would the nurse take?
Drain the fluid from tje peritoneal cavity
The nurse reviews the serum lab values of a client. The nurse suspects hypofunctioning of the adrenal gland based on which results?
Increased calcium Decreased cortisol Decreased sodium
which information would the nurse include when answering a clients question about peritoneal dialysis
the dialysate maintains constant contact with the peritoneal membrane during dwell time
A client is admitted to the hospital for adrenalectomy. When teaching the client about the prescribed meds, which advice will the nurse emphasize.
Salt intake may need to be restricted
a client who has severe back pain is found to have a vertebral comp fracture. which cause would the nurse consider when planning interventions
collapase of the vertebral bodies
moon face, buffalo hump, truncal obesity. lab reports cortisol 3.0 which other manifestations may be present? SATA
edema osteoporosis muscle atrophy
adolescent with h/o fatigue, intermittent fever, weight loss, arthralgia and SLE. whats best intervention
education about diet, rest, exercise
post op teaching for prevention of PE
i will avoid crossing legs
most important to obtain in a health history from a client newly diagnosed with cervical cancer
support system
The parents of a young man suspected of having Cushing express anxiety about their sons condition. Which would the nurse respond to help better understand
He may have mood swings or depression as a result of his illness
Which clinical findings does the nurse expect when assessing a client newly admitted with a diagnosis of pheochromocytoma? SATA
Headache Palpitations Diaphoresis
for which potential complications would the nurse monitor a client receiving continuous ambulatory peritoneal dialysis for end stage kidney dz? SATA
tachycardia cloudy outflow abdominal pain
nurse is reviewing a plan of care for a client who experienced a traumatic amp of a leg the previous day. which intervention is lowest priority
teaching residual limb care
client is experiencing an exacerbation of SLE. to reduce the frequency of exacerbations, what would be important for the nurse to include in teaching plan
techniques to reduce stress
elastic bandage around the residual limb. action by the nurse when rewrapping
apply smoothly without creases
which question would the nurse ask a client who has developed pneumonia when assessing risk factors
are you diabetic
a home care nurse is visiting a client who had a below the knee amp. which client statement indicates to the nurse that further teaching is needed
at night i sleep with a pillow under my knees
scleroderma teaching plan for skin care
keep hands warm
which supports a prothesis for above the knee amp is fitting correctly
evenly darkened skin of the residual limb
oxygen in a client with pneumonia is 89 to 90 with a non rebreather mask. action by the nurse?
BIPAP
which nursing instructions would the nurse provide a diabetic client who developed renal dz? sata
BP regularly contact PCP before ibuprofen encourage yearly microalbuminuria tests
A client is being treated for pituitary Cushing syndrome. The nurse anticipates that which medication will be prescribed
Cyproheptadine
client with scleroderma state where did i get this?
exact cause is unknown, but is thought to be result from autoimmunity
The lab reports a client with adrenal Adenoma show a high urine aldosterone and low specific gravity. Potassium is 2.8. Which other findings would be present. SATA
Hypernatremia Hypertension Metabolic alkalosis
A client is admitted to the hospital for an adrenalectomy. Before the client's replacement steroid therapy is regulated fully, the nurse will monitor the client for which complication
Hypotension
which action will the nurse take when a clients CHR shows atelectasis
IS
admitted with stage 0 cervical cancer (situ). what would nurse emphasize while helping the client understand her diagnosis and prognosis
five year survival rates for this cancer are about 93%
which complications would the nurse expect in the client with a renal disorder who has a BUN/creatinine ratio of 28? SATA
fluid volume def obstructive uropathy
Labs for client with hypofunctioning of the adrenal gland:
Increased calcium Decreased cortisol Descreased sodium
which crutch gait would the nurse teach a client to use their prosthesis after a single leg an amputation 3 months ago
four point
position for client with above knee amp
functional alignment
a client with kidney dysfunction is about to undergo renal testing using a contrast medium. which interventions would be in the clients plan of care? SATA
assess for h/o cirrhosis ask shellfish allergies evaluate clients hydration status by checking BP and RR
cushings syndrome with labs: Na-149; K-3.2; Hgb-17; glucose 90. nutritional teaching plan? SATA
avoid foods high in salt eat foods high in potassium
which information will the nurse plan to include in the discharge teaching plan for a client who has been admitted for a PE and has new prescription for an oral anticoagulant SATA
avoid hot food electric shaver apply ice to areas of trauma
immediately after a bilateral adrenalectomy, a client is receiving corticosteroids that are to be continued after discharge from the hospital. which statement needs further education?
i am glad that i only have to take the med once a day --larger dose in am and second dose before 4pm to mimic expected hormone secretion
after amp, client reports extreme discomfort in the area where limb once was. goal nurse would focus
identifying actions to decrease pain in the lost limb
education for adolescent about HSV2 SATA
illness or stress can cause outbreal use lube during sex tx is to prevent outbreaks condoms to decrease transmission
client develops bacterial pneumonia and is admitted to the er. clients initial PaO2 is 80. drawn again and is 65. nurse action
increase oxygen flow rate per facility protocol
which clinical feature is indicative of hypercortisolism
increased pigmentation
which adolescents clients are at risk for testicular cancer SATA
infertility cryptorchidism klinefelter syndrome
positive family history of testicular cancer reports pain. pcp diagnosis cancer. after surgery, chemo will occur. what conditions might occur in the client after chemo? SATA
infertility heart dz metabolic syndrome
during discharge the nurse is teaching a client who underwent bilateral adrenalectomy about self management. which statements given by the client indicate effective learning? SATA
yearly flu vaccine lifelong hormonal therapy immediately notify pcp if i have fever
which responses would the client exhibit who is in addisonian crisis. SATA
hyperkalemia hyponatremia postural hypotension
Cause of cytomegalovirus
many sex partners
high priority for nurse providing education to SLE pt
instructing ways to protect the skin
activity to prepare client for crutch walking
lift weights
low back pain is a problem, which position would nurse advise a client in labor to avoid
supine
