Exam 2 study guides
A patient with renal failure secondary to diabetic nephropathy has been admitted to the medical unit. What is the most life-threatening effect of renal failure for which the nurse should monitor the patient?
Retention of potassium
A diabetic educator is discussing "sick day rules" with a newly diagnosed type 1 diabetic. The educator is aware that the client will require further teaching when the client states what?
"I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours."
During a teaching session on the care of the diabetic client, the nurse should make which statement to explain the differences in insulin?
"Insulins have different onsets and durations of action."
An occupational health nurse is screening a group of workers for diabetes. What statement should the nurse interpret as suggestive of diabetes?
"Lately, I drink and drink and can't seem to quench my thirst."
A client diagnosed with pernicious anemia asks why vitamin B12 is administered by injection. What is the best response to the client?
"Oral forms of vitamin B12 will not be absorbed"
A 72-year-old client has been diagnosed with benign prostatic hypertrophy (BPH) and will begin treatment with tamsulosin. The client admits that he is skeptical about the drug's ability to relieve his distressing symptoms. The nurse should respond in what way?
"Tamsulosin can relax your prostate and your bladder neck, making it easier to pass urine."
A diabetes nurse educator is presenting current recommendat levels of caloric intake. What should the nurse describe?
50% to 60% of calories from carbohydrates, 20% to 30% from fat, and the remaining 10% to 20% from protein
A nurse on a busy medical unit provides care for many clients who require indwelling urinary catheters at some point during their hospital care. The nurse should recognize a heightened risk of injury associated with indwelling catheter use in which client?
A client who has Alzheimer disease and who is acutely agitated
A client with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the client should prioritize what question when addressing potential complications?
A) Do you feel any muscle twitches or spasms?
A client has a low erythrocyte count. How may a colony-stimulating factor affect the client's erythrocyte count?
A) It stimulates growth of red blood cells.
The medical nurse is aware that patients with sickle cell anemia benefit from understanding what situations can precipitate a sickle cell crisis. When teaching a patient with sickle cell anemia about strategies to prevent crises, what measures should the nurse recommend?
Avoiding cold temperatures and ensuring sufficient hydration
The nurse is planning the care of a client with a nutritional deficit and a diagnosis of megaloblastic anemia. The nurse should recognize that this client's health problem is due to what?
Abnormalities in the structure and function RBCs
A diabetic nurse is working for the summer at a camp for adolescents with diabetes. When providing information on the prevention and management of hypoglycemia, what action should the nurse promote?
Always carry a form of fast-acting sugar.
A client's low hemoglobin level has necessitated transfusion of PRBCs. Prior to administration, what action should the nurse perform?
Assess the client's vital signs to establish baselines.
A nurse is caring for a client who is two days postoperative after abdominal surgery. What nursing intervention would be important to promote wound healing at this time?
Assist in moving to prevent strain on the suture line.
The nurse is providing care for an older adult client whose current medication regimen includes levothyroxine. As a result, the nurse should be aware of the heightened risk of adverse effects when administeri an IV dose of what medication?
Benzodiazepines
When a client has an increased serum level of ionized calcium hormone will be released?
Calcitonin
A client has had frequent watery stools (diarrhea for an extended period of time. The client also has decreased skin turgor and dark urine. Based on these data, which nursing diagnosis would be appropriate?
Deficient fluid volume
A patient is being treated for AKI and the patient daily weights have been ordered. The nurse notes a weight gain of 3 pounds over the past 48 hours. What nursing diagnosis is suggested by this assessment finding?
Excess fluid volume
An adult client has been diagnosed with iron deficiency anemia. What nursing diagnosis is most likely to apply to this client's health status?
Fatigue related to decreased oxygen-carrying capacity
Before administering a prescribed 20 units of NPH insulin to a client, the nurse should implement which intervention?
Have a colleague confirm the dosage.
A client asks the nursing assistant for a bedpan. When the client is finished, the nursing assistant notifies the nurse that the client has bright ted streaking of blood in the stool. The nurse's assessment should focus on what potential cause?
Hemorrhoids
A client has started aminoglycoside therapy. It is time for a client's next dose of an aminoglycoside. What action should the nurse take when learning the client's creatinine level is 3.9 mg/dL?
Hold the medication and assess the urine output.
A client has been successfully treated for kidney stones and is preparing for discharge. The nurse recognizes the risk of recurrence and has planned the client's discharge education accordingly. What preventative measure should the nurse encourage the client to adopt?
Increase fluid intake
A nurse is providing education to a patient with iron deficiency anemia who has been prescribed iron supplements. What should the nurse include in health education?
Iron will cause the stools to darken in color.
The nurse in the primary care clinic is teaching a 52-year-old female client, newly diagnosed with hypothyroidism, how to levothyroxine at home. Select all of the client's statements that indicate an understanding of the medication instructions.
Levothyroxine is a synthetic form of thyroid hormone used to treat hypothyroidism. The dose of levothyroxine is determined by periodic assessment of serum thyroid hormone levels. Adjustments in dose are made until the maintenance dose for long-term therapy is achieved. The client should report heart palpitations, nervousness, insomnia, or chest pain to the health care provider because these are adverse effects that result from excessive thyroid stimulation and the drug dose may need to be adjusted. The drug should be taken with a full glass of water to prevent esophageal atresia. For best absorption, levothyroxine should be taken in morning, before breakfast, on an empty stomach.
A school nurse is teaching a group of high school students about risk factors for diabetes. Which of the following actions has the greatest potential to reduce an individual's risk for developing diabetes?
Lose weight, if obese.
The nurse is caring for a client scheduled for a colonoscopy. The nurse should assist the client into what position during this diagnostic test?
Lying on the left side with legs drawn toward the chest
A nurse is providing care to a client who has undergone a colonoscopy. What would be most appropriate for the nurse to do after the procedure?
Monitor for rectal bleeding
A nurse is teaching basic "survival skills" to a patient newly diagnose with type 1 diabetes. What topic should the nurse address?
Recognition of hypoglycemia and hyperglycemia
The nurse is planning the care of a client with hyperthyroidism. What should the nurse specify in the client's meal plan?
Small, frequent meals, high in protein and calories
The nurse caring for a client receiving a transfusion notes that 15 minutes after the infusion of packed red blood cells (PRBCs) has begun, the client is having difficulty breathing and complains of severe chest tightness. What is the most appropriate initial action for the nurse to take?
Stop the transfusion immediately
A client with type 1 diabetes has told the nurse that his most recent urine test for ketones was positive. What is the nurse's most plausible conclusion based on this assessment finding?
The client's insulin levels are inadequate.
The nurse is discussing macrovascular complications of diabetes with a patient. The nurse would address what topic during this dialogue?
The fact that patients with diabetes have an elevated risk of myocardial infarction
A patient underwent an open bowel resection 2 days ago and the nurse's most recent assessment of the patient's abdominal incision reveals that it is dehiscing. What factor should the nurse suspect may have caused the dehiscence?
The patient has vomited three times in the past 12 hours.
The nurse in the urgent care clinic is providing discharge instruction to a 29-year-old female client with a urinary tract infection who has been prescribed trimethoprim-sulfamethoxazole (TMP-SMZ) 160 mg TMP/800 mg SMZ orally every 12 hours.
To be most effective, anti-infective medications must be taken as instructed The client should notify the health care provider of any adverse effects, such as a rash, that may indicate an allergic reaction. Because this anti-infective medication can decrease the effectiveness of oral contraceptives, another form of birth control should be used when taking TMP-SMZ. The client should notify the health care provider if the symptoms are not improving after 5 to 7 days because a change of drug therapy may be needed. The client taking an anti-infective medication such as TMP-SMZ should be instructed to take each dose with a full glass of water, not just sips of water. The client should take the fully prescribed course of anti-infectives and should not stop the medication, even if symptoms subside. Stopping the medication before the fully prescribed course is complete can result in the return of the intec hon.
A nurse is caring for a newly admitted client with a suspected Gl bleed. The nurse assesses the client's stool after a bowel movement and notes it to be a tarry-black color. This finding is suggestive of bleeding from what location?
Upper GI tract
A nurse is carrying out an order to remove an indwelling catheter. What is the first step of this skill?
Wash hands and put on gloves
A client is postoperative day 1 following gastrostomy. The nurse is planning interventions to address the nursing diagnosis of Risk for Infection Related to Presence of Wound and Tube. What intervention is mast appropriate?
Wash the area around the tube with soap and water daily
The nurse is assessing a client diagnosed with Graves disease. What physical characteristics of Graves disease would the nurse expect to find?
bulging eyes
The nurse should educate the client prescribed a stimulant cathartic to be alert for which common adverse effect?
diarrhea
The nurse is caring for a patient suspected of having renal dysfunction. When reviewing laboratory results for this patient, the nurse interprets the presence of which substances in the urine as most suggestive of pathology?
glucose and protein
A patient has returned to the floor after having a thyroidectomy for thyroid cancer. The nurse knows that sometimes during thyroid surgery the parathyroid glands can be injured or removed. What laboratory finding may be an early indication of parathyroid gland injury or removal?
hypocalcemia
What information should the nurse provide a client newly prescribed propylthiouracil about its primary mode of action?
inhibits production of thyroid hormone
The nurse is preparing to check for tube placement in the client's stomach as well as measure the residual volume. What is the main purpose of these nursing actions?
prevent aspiration
A client with a recent diagnosis of hypothyroidism is being treated for an unrelated injury. When administering medications to the client, the nurse should know that the client's diminished thyroid function may have what effect?
prolong duration of effect
A 42-year-old woman comes to the clinic complaining of occasional urinary incontinence when she sneezes. The clinic nurse should recognize what type of incontinence?
stress incontinence