Exam 2 Study Set
When evaluating a client's arterial blood gases (ABGs), which value is consistent with metabolic alkalosis?
pH 7.48
A client concerned about being diagnosed with type 2 diabetes tells a nurse, "My parent suffered with diabetes for many years and finally died of kidney failure in spite of treatment. Why should I try if I'm going to go through the same thing?" What is the nurse's most appropriate response?
Are you worried that you will have the same experience as your parent
The nurse is caring for a client with possible Cushing's syndrome undergoing diagnostic testing. The health care provider orders lab work and a dexamethasone suppression test. Which parameter would the nurse assess
Cortisol levels before and after the system is challenged with a synthetic steroid
The nurse is caring for a client with possible Cushing's syndrome undergoing diagnostic testing. The health care provider orders lab work and a dexamethasone suppression test. Which parameter would the nurse assess on the dexamethasone suppression test?
Cortisol levels before and after the system is challenged with a synthetic steroid
A nurse working in a community clinic is discussing lifestyle modifications with a client. The client has been advised to lose weight because of a BMI greater than 25. Which statement by the nurse would be most therapeutic in helping the client?
"I can offer you some information outlining a variety of ways to lose weight."
A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/d| (2.2 mmol/L). A family member reports the client has been skipping meals in an effort to lose weight. What is the next action by the nurse?
Administer 1 ampule of 50% dextrose solution /V
After a 3-month trial of dietary therapy, a client with type 2 diabetes still has blood glucose levels above 180 mg/dl (9.99mmol/L). The physician adds glyburide, 2.5 mg P.O. daily, to the treatment regimen. The nurse should instruct the client to take the glyburide:
At breakfast
Which combination of adverse effects should a nurse monitor for when administering I.V. insulin to a client with diabetic ketoacidosis?
Hypokalemia & hypoglycemia
A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse is most accurate in stating
It tells us about your sugar control for the last 3 months
A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?
Restricting fluids
A client has been diagnosed with metabolic alkalosis. The nurse should anticipate what finding from the client's arterial blood gases?
Serum bicarbonate of 28 mEq/L
A client is admitted to the health care facility for evaluation for Addison's disease. Which laboratory test result best supports a diagnosis of Addison's disease?
Serum potassium level of 5.8 mEq/L (5.8 mmol/L)
A client is brought to the emergency department after wandering on the street. The client is confused and reports double vision, headache, and shakiness. Laboratory data reveal a serum blood glucose of 52 mg/dL (52 mmol/L). Which questions, asked by the nurse, may reveal more data related to the client's condition? Select all that apply.
a. What have you eaten today b. Do you take insulin or oral antidiabetic medication c. Have you ever felt this way before
A client with hyperglycemia who weighs 210 lb (95 kg) tells the nurse that their spouse sleeps in another room because the client's snoring keeps the spouse awake. The nurse notices that the client has large hands and a hoarse voice. Which disorder would the nurse suspect as a possible cause of the client's hyperglycemia?
acromegaly
A client is being evaluated for hypothyroidism. During the assessment, the nurse should stay alert for?
decreased body temperature and cold intolerance.
Which goal is a priority for the diabetic client who is taking insulin and has nausea and vomiting from a viral illness or influenza?
obtaining adequate food intake
Which goal is priority for the diabetic client who is taking insulin and has nausea and vomiting from a viral illness or influenza?
obtaining adequate food intake
A client who is 12 hours post total thyroidectomy reports tingling around the mouth. Which assessment is the priority?
Calcium level
A nurse should expect to administer which medication to a client with gout?
Colchicine
The nurse is caring for a client with multiple organ failure who is in metabolic acidosis. Which pair of organs is responsible for regulatory processes and compensation?
-lung -kidneys
A coworker asks another nurse if a client received their pathology report. The coworker is not directly involved in the care of the client. How should the nurse respond? Select all that apply.
-you need to review the hospital policy related to pt privacy -I am sorry but I am not at liberty to give you that information -information can only be shared if you are involved in the pt care
The client with type 1 diabetes mellitus is taught to take Isophane insulin suspension NPH at 1700 each day. The client should be instructed that the greatest risk for hypoglycemia will occur at about what time?
0100, while sleeping
A client with Addison disease has fluid and electrolyte loss due to inadequate fluid intake and fluid loss. As the client's oral intake increases, which fluids would be most appropriate?
Chicken broth and juice
A nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse expects to find
Deposits of adipose tissue in the trunk and dorsocervical area
A client has been admitted to the hospital for the treatment of diabetic ketoacidosis, a problem that was accompanied by a random blood glucose reading of 31.9 mmol/L (575 mg/dL), vomiting, and shortness of breath. This client has experienced which of the following phenomena?
Exacerbation
A client with a progressively enlarging neck comes into the clinic. The client mentions that they have been in a foreign country for the previous 3 months and that they didn't eat much while there because they didn't like the food. The client also mentions that they become dizzy when lifting their arms to do normal household chores or when dressing. What endocrine disorder should the nurse expect the physician to diagnose?
Goiter
A physician orders acarbose, an alpha-glucosidase inhibitor, for a client with type 2 diabetes. Which Statement by the client indicates a need for additional teaching?
If experience hypoglycemia, I should eat something sweet
Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?
Thyroid crisis
A nurse is evaluating the effectiveness of teaching a client about how to self-administer insulin. Which action indicates that additional teaching is necessary?
Waits 30 minutes to eat breakfast after injecting rapid-acting insulin
A client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should the nurse provide?
You may not be able to use desmopresin nasally if you have nasal discharge or blockage
The nurse in the primary care office is teaching a 48-year-old female client about their new diagnosis of chronic fatigue syndrome. Select the potential nursing interventions from each of the following categories that the nurse should perform. Select all that apply. Note: Each category must have at least 1 option selected.
a. Activity: i. Encourage utilization of energy conservation measures ii. Encourage the pt to slowly rise to standing position b. Coping strategies: i. Discuss stress management activities ii. Encourage partipation in decisions regarding care iii. Encourage participation in a
The unlicensed assistive personnel (UAP) records a capillary blood glucose of 253 mg/dL (14.04 mmol/L) and the nurse administered insulin for coverage to the client. The UAP reports to the nurse that the blood glucose was incorrect. What actions should the nurse take? Select all that apply.
a. Obtain a current blood glucose level b. Observe the client for hypoglycemia c. Report the incident to the healthcare provider d. Complete an incident report
The nurse is planning care for a client who is to have a subtotal thyroidectomy. Which medication should be available to provide emergency treatment if a client develops tetany?
Calcium gluconate
A client arrives in the clinic with a possible parathyroid hormone (PTH) deficiency. When analyzing client lab data, which electrolytes would the nurse anticipate to be abnormal? Select all that apply.
-calcium -phosphorus
A client with type 1 diabetes must undergo bowel resection in the morning and is therefore NPO. The client's capillary blood glucose (CBG) reading at 0630 is 315, and the insulin orders include insulin glargine 35 units daily in AM and regular insulin 8 units for this CBG reading. How should the nurse proceed while caring for the client on the morning of surgery?
Administer both the insulin glargine and the regular insulin doses
A nurse obtained a client's fasting blood sugar (FBS) at 0700, which was 144 mg/dL (8 mmol/L). The client has an order for regular insulin 8 units every morning. What should the nurse do next?
Administer the insulin as ordered
A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client?
Blood glucose level 1, 100mg/dI (61.05 mmol/L)
A client with hypothyroidism is afraid of needles and doesn't want to have their blood drawn. What should the nurse say to help alleviate the client's concerns?
I will stay here with you while the technician draws your blood
The nurse teaches a client with diabetes mellitus about proper foot care. Which statement indicates the client understands the teaching?
I will wear cotton socks with well-fitting shoes
The nurse reviews insulin administration with a client. Which statement best indicates that the client will continue to perform the procedure correctly?
I wrote down the steps in case I forget what to write down
The nurse is evaluating a client with hyperthyroidism who is taking propyithlouracil (PTU) 100 mg a day in three divided doses for maintenance therapy. Which statement from the client indicates the drug is effective?
I'm able to sleep and rest at night
An admitting nurse on a rehabilitation unit notices that an elderly client with a fractured hip and severe hypothyroidism is dirty and disheveled and that their personal hygiene is very poor. As the nurse gathers admission data, the nurse further notes that the client has few personal connections, is depressed, and doesn't seem to care about personal appearance. How should the nurse improve the client's performance of self-care activities?
Provide initial and routine hygienic care, then evaluate the pt daily treatment
The nurse administers lactulose to a client with cirrhosis. What is the expected outcome from the administration of lactulose?
Reduced serum ammonia levels
A nurse explains to a client with thyroid disease that the thyroid gland normally produces?
T3, thyroxine (T4), and calcitonin.
When teaching a client when to take glipizide to maximize the effectiveness of the drug, the nurse should instruct the client to perform which action?
Take glipizide 30 minutes before
The nurse is teaching a client about levothyroxine. Which instruction should a nurse offer the client?
Take the drug on an empty stomach.
A client with status asthmaticus requires endotrachel intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms are associated with hypoglycemia.
a. Sweating, tremors, and tachycardia
