Exam 2 material
What extra equipment should the nurse provide at the bedside of a new postoperative thyroidectomy patient? A. Tracheotomy tray B. Ventilator C. Water-sealed drainage system D. Large bandage scissors
A
When assisting with the care of a patient with hyperthyroidism, the nurse will? A. provide a cool environment. B. anticipate ordering a low-calorie diet. C. limit daily caffeine intake. D. encourage intake of bran products.
A
Why would a patient with hyperthyroidism be prescribed the drug methimazole (Tapa-zole)? A. To block the production of thyroid hormones B. To limit the effect of the pituitary on the thyroid C. To destroy part of the hyperactive thyroid tissue D. To stimulate the pineal gland
A
A patient recently completed radiation treatment for throat cancer and presents to the health care provider's office with symptoms indicating possible hypothyroidism. Which symptom(s) would most likely be exhibited and/or reported? (Select all that apply.) A. Lethargy B. Cold intolerance C. Nervousness D. Weight gain E. Inability to sleep
A,B,D
A nurse teaches a client with Cushing's disease. Which dietary requirements should the nurse include in this client's teaching? (Select all that apply.) A. Low sodium B. Low carbs C. Low calcium D. Low protein E. Low calorie
A,B,E
What are the three major life-threatening complications postoperatively of a thyroidectomy? (Select all that apply.) A. Thyroid crisis (storm) B. SIADH C. Tetany D. Hypoglycemia E. Hemorrhaging F. Seizures
A,C,E
What should the nurse include in provisions for the postoperative care of the patient who had a thyroidectomy? (Select all that apply.) A. Checking for bleeding at the sides and the back of the head B. Turning, coughing every hour C. Maintaining anatomic position of the head when moving a patient D. Assessing ability to speak by asking him or her to recite name and address every hour E. Assisting a patient to hyperextend the head to assess for muscle damage F. Doing voice check every 2 hours
A,C,F
To which diet should a patient with Cushing syndrome adhere? A. Less potassium B. Less sodium C. More carbohydrates D. More calories
B
What information should be obtained from the patient before an iodine-131 test? A. Allergy to sulfa drugs B. Status of possible pregnancy C. Presence of metal in the body D. Use of prescription drugs for hypertension
B
When a patient is receiving vasopressin (Pitressin), the nurse will monitor for which therapeutic response? A. Increased serum albumin levels B. Decreased urinary output C. Increased serum potassium levels D. Improved appetite
B
Which medication is used to treat hyperthyroidism? A. Levothyroxine (Synthroid) B. Propylthiouracil (Propacil) C. Liotrix (Thyrolar) D. Liothyronine (Cytomel)
B
A nurse cares for a client with a hypofunctioning anterior pituitary gland. Which hormones should the nurse expect to be affected by this condition? (Select all that apply.) A. Calcitonin B. Thyroid-stimulating hormone C. Follicle-stimulating hormone D. Vasopressin E. Growth hormone
B,C,E
The adrenal cortex secretes glucocorticoids. The most important is cortisol. What is it involved in? (Select all that apply.) A. Releasing androgens and estrogens B. Glucose metabolism C. Decreasing the level of potassium in the blood stream D. Providing extra reserve energy during stress E. Increasing retention of sodium in the blood stream
B,D
A nurse assesses a client on the medical-surgical unit. Which statement made by the client should alert the nurse to the possibility of hypothyroidism? A. "Food just doesn't taste good without a lot of salt." B. "I seem to feel the heat more than other people." C. "I am always tired, even with 12 hours of sleep." D. "My sister has thyroid problems.
C
A nurse cares for a client who possibly has syndrome of inappropriate antidiuretic hormone (SIADH). The client's serum sodium level is 114 mEq/L. Which action should the nurse take first? A. Handle the client gently by using turn sheets for re-positioning. B. Consult with the dietitian about increased dietary sodium. C. Restrict the client's fluid intake to 600 mL/day. D. Instruct unlicensed assistive personnel to measure intake and output.
C
A nurse prepares to administer insulin to a client at 1800. The client's medication administration record contains the following information: • Insulin glargine: 12 units daily at 1800 • Regular insulin: 6 units QID at 0600, 1200, 1800, 2400 Based on the client's medication administration record, which action should the nurse take? A. First draw up the dose of regular insulin, then draw up the dose of insulin glargine in the same syringe, mix, and inject the two insulins together. B. Draw up and inject the insulin glargine first, wait 20 minutes, and then draw up and inject the regular insulin. C. Draw up and inject the insulin glargine first, and then draw up and inject the regular insulin. D. First draw up the dose of insulin glargine, then draw up the dose of regular insulin in the same syringe, mix, and inject the two insulins together.
C
A nurse reviews the laboratory results of a client who is receiving intravenous insulin. Which should alert the nurse to intervene immediately? A. Serum chloride level of 98 mmol/L B. Serum calcium level of 8.8 mg/dL C. Serum potassium level of 2.5 mmol/L D. Serum sodium level of 132 mmol/L
C
A patient with a history of Graves disease is admitted to the unit with shortness of breath. The nurse notes the patient's vital signs: T 103° F, P 160, R 24, BP 160/80. The nurse also notes distended neck veins. What does the patient most likely have? A. Cushing crisis B. Pulmonary embolism C. Thyroid storm D. Hypertensive crisis
C
Which condition would require mineralocorticoid replacement? A. Addison's disease B. Glomerulonephritis C. Myxedema D. Diabetes insipidus
A
A nurse assesses a client with Cushing's disease. Which assessment findings should the nurse correlate with this disorder? (Select all that apply.) A. Hypotension B. Petechiae C. Muscle atrophy D. Moon face E. Weight loss
B,C,D
A nurse cares for a client with excessive production of thyrocalcitonin (calcitonin). For which electrolyte imbalance should the nurse assess? A. Magnesium B. Calcium C. Potassium D. Sodium
B
A nurse cares for a client who is recovering from a hypophysectomy. Which action should the nurse take first? A. Report clear or light yellow drainage from the nose. B. Instruct the client to cough, turn, and deep breathe. C. Keep the head of the bed flat and the client supine. D. Apply petroleum jelly to lips to avoid dryness.
A
A nurse cares for a client who is recovering from a parathyroidectomy. When taking the client's blood pressure, the nurse notes that the client's hand has gone into flexion contractions. Which laboratory result does the nurse correlate with this condition? A. Serum calcium: 6.9 mg/dL B. Serum potassium: 2.9 mEq/L C. Serum magnesium: 1.7 mEq/L D. Serum sodium: 122 mEq/L
A
A nurse reviews the chart and new prescriptions for a client with diabetic ketoacidosis: Vital Signs and Assessment Laboratory Results Medications Blood pressure: 90/62 mm Hg Pulse: 120 beats/min Respiratory rate: 28 breaths/min Urine output: 20 mL/hr via catheter Serum potassium: 2.6 mEq/L Potassium chloride 40 mEq IV bolus STAT Increase IV fluid to 100 mL/hr Which action should the nurse take? A. Increase the intravenous rate and then consult with the provider about the potassium prescription. B. Administer the potassium first before increasing the infusion flow rate. C. Administer the potassium and then consult with the provider about the fluid order. D. Increase the intravenous flow rate before administering the potassium.
A
A nurse reviews the medication list of a client recovering from a computed tomography (CT) scan with IV contrast to rule out small bowel obstruction. Which medication should alert the nurse to contact the provider and withhold the prescribed dose? A. Metformin (Glucophage) B. Pioglitazone (Actos) C. Glipizide (Glucotrol) D. Glimepiride (Amaryl)
A
In diabetes insipidus, a deficiency of which hormone causes clinical manifestations? A. antidiuretic hormone (ADH) B. thyroid-stimulating hormone (TSH) C. follicle-stimulating hormone (FSH) D. adrenocorticotropic hormone (ACTH)
A
The nurse discovers the type 1 diabetic (IDDM) patient drowsy and tremulous, the skin is cool and moist, and the respirations are 32 and shallow. These are signs of: A. hypoglycemic reaction; give 6 oz of orange juice. B. hyperglycemic reaction; give ordered regular insulin. C. hyperglycemic hyperosmolar nonketotic reaction; squeeze glucagon gel in buccal cavity. D. hypoglycemic reaction; give ordered insulin.
A
A 27-year-old patient with hypothyroidism is referred to the dietitian for dietary consultation. What should nutritional interventions include? A. Caffeine-rich beverages B. Calorie-restricted meals C. Fluid restrictions D. Frequent small meals high in carbohydrates
B
A nurse assesses a client who is recovering from a subtotal thyroidectomy. On the second postoperative day the client states, "I feel numbness and tingling around my mouth." What action should the nurse take? A. Loosen the dressing. B. Assess for Chvostek's sign. C. Ask the client orientation questions. D. Offer mouth care.
B
A nurse cares for a client who has excessive catecholamine release. Which assessment finding should the nurse correlate with this condition? A. Decreased blood pressure B. Increased pulse C. Decreased respiratory rate D. Increased urine output
B
After teaching a client with acromegaly who is scheduled for a hypophysectomy, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching? A. "I will wear slip-on shoes after surgery to limit bending over." B. "I hope I can go back to wearing size 8 shoes instead of size 12." C. "I am glad no visible incision will result from this surgery." D. "I will no longer need to limit my fluid intake after surgery."
B
The human insulin whose onset of action occurs within ____ minutes is lispro (Humalog). A. 30 B. 15 C. 45 D. 60
B
The nurse caring for a 75-year-old man who has developed diabetes insipidus following a head injury will include in the plan of care provisions for: A. discouraging daytime naps. B. protecting patient from injury. C. limiting fluids to 1500 mL a day. D. encouraging physical exercise.
B
After teaching a client who is recovering from a complete thyroidectomy, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional instruction? A. "I'll need to take thyroid hormones for the rest of my life." B. "I may need calcium replacement after surgery." C. "After surgery, I won't need to take thyroid medication." D. "I can receive pain medication if I feel that I need it."
C
As the nurse is shaving a patient who is 2 days postoperative from a thyroidectomy, the patient has a spasm of the facial muscles. What should the nurse recognize this as? A. Trousseau sign B. Homans sign C. Chvostek sign D. Montgomery sign
C
At 4:45 p.m., a nurse assesses a client with diabetes mellitus who is recovering from an abdominal hysterectomy 2 days ago. The nurse notes that the client is confused and diaphoretic. The nurse reviews the assessment data provided in the chart below: Capillary Blood Glucose Testing (AC/HS) Dietary Intake At 0630: 95 At 1130: 70 At 1630: 47 Breakfast: 10% eaten - client states she is not hungry Lunch: 5% eaten - client is nauseous; vomits once After reviewing the client's assessment data, which action is appropriate at this time? A. Assess the client's oxygen saturation level and administer oxygen. B. Reorient the client and apply a cool washcloth to the client's forehead. C. Administer dextrose 50% intravenously and reassess the client. D. Provide a glass of orange juice and encourage the client to eat dinner.
C
It is 2:00 PM and a patient who has been NPO since 12:00 AM for a bronchoscopy is complaining of a headache and shakiness and is extremely irritable. Vital signs are within normal limits, and a one touch glucose reads 50 mg/dL. Which action is most important for the nurse to take? A. Have the patient eat a snack and drink milk. B. Obtain an A1c test. C. Administer glucagon subcutaneously. D. Call the bronchoscopy room to follow up with the delay.
C
Which medication is used in the treatment of hypothyroidism? A. Methimazole (Tapazole) B. Propylthiouracil (Propacil) C. Levothyroxine (Synthroid) D. Radioactive iodine
C
A nurse provides diabetic education at a public health fair. Which disorders should the nurse include as complications of diabetes mellitus? (Select all that apply.) A. Resp Failure B. Cirrhosis C. Kidney failure D. Blindness E. Stroke
C,D,E
Which of the following are signs and symptoms of hypoglycemia? (Select all that apply.) A. Fruity breath B. Deep respirations C. Diaphoresis D. Irritability E. Tremors F. Dry mouth
C,D,E
A nurse assesses a client diagnosed with adrenal hypofunction. Which client statement should the nurse correlate with this diagnosis? A. "I cannot seem to drink enough water." B. "I get hungry even after eating a meal." C. "I no longer have an appetite for anything." D. "I have a terrible craving for potato chips."
D
A nurse cares for a client who has hypothyroidism as a result of Hashimoto's thyroiditis. The client asks, "How long will I need to take this thyroid medication?" How should the nurse respond? A. "When blood tests indicate normal thyroid function, you can stop the medication." B. "You will need to take the thyroid medication until the goiter is completely gone." C. "Thyroiditis is cured with antibiotics. Then you won't need thyroid medication." D. "You'll need thyroid pills for life because your thyroid won't start working again."
D
A nurse prepares to administer prescribed regular and NPH insulin. Place the nurse's actions in the correct order to administer these medications. 1. Inspect bottles for expiration dates. 2. Gently roll the bottle of NPH between the hands. 3. Wash your hands. 4. Inject air into the regular insulin. 5. Withdraw the NPH insulin. 6. Withdraw the regular insulin. 7. Inject air into the NPH bottle. 8. Clean rubber stoppers with an alcohol swab. A. 1, 3, 8, 2, 4, 6, 7, 5 B. 2, 3, 1, 8, 7, 5, 4, 6 C. 8, 1, 3, 2, 4, 6, 7, 5 D. 3, 1, 2, 8, 7, 4, 6, 5
D
A nurse reviews laboratory results for a client with diabetes mellitus who is prescribed an intensified insulin regimen: • Fasting blood glucose: 75 mg/dL • Postprandial blood glucose: 200 mg/dL • Hemoglobin A1c level: 5.5% How should the nurse interpret these laboratory findings? A. Increased risk for developing ketoacidosis B. Signs of insulin resistance C. Increased risk for developing hyperglycemia D. Good control of blood glucose
D
A patient has returned to his room after a thyroidectomy with signs of thyroid crisis. During thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of the potentially lethal complication of: A. bradycardia. B. severe nausea and vomiting. C. delirium with restlessness. D. congestive heart failure.
D
A patient with type 1 diabetes was prescribed a glucocorticoid for chronic obstructive pulmonary disease. Which will the nurse expect in the treatment plan? A. A decrease in the amount of insulin needed B. An increase in the need for carbohydrates C. No change in the amount of insulin needed D. An increase in the insulin needed
D
After teaching a client who is recovering from an endoscopic trans-nasal hypophysectomy, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching? A. "I will wear dark glasses to prevent sun exposure." B. "I shall cough and deep breathe every 2 hours while I am awake." C. "I must wash the incision with peroxide and redress it daily." D. "I'll keep food on upper shelves so I do not have to bend over."
D
What is the postoperative position for a person who has had a thyroidectomy? A. Prone B. Side-lying C. Supine D. Semi-Fowler
D
Arrange the steps of drawing up a short-acting and a long-acting insulin in the same syringe. (Separate letters by a comma and space as follows: A, B, C, D) a. Draw up amount of shorter-acting insulin b. Check insulin dose with a second licensed nurse c. Inject the desired amount of air into the long-acting insulin d. Clean rubber stopper of both vials with alcohol e. Draw up desired amount of longer-acting insulin f. Inject the desired amount of air into the short-acting insulin
D,C,F,A,B
