Exam 3 Practice Questions
Which hormone is primarily responsible for regulating the body's metabolic rate? a. Thyroxine (T3) b. Triiodothyronine (T3) c. Calcitonin d. Parathyroid Hormone (PTH)
Triiodothyronine (T3)
Immediately following a liver biopsy, the nurse places a client in which position? a. prone b. supine c. on the right side d. on the left side
on the right side
A nurse cares for a patient who has cirrhosis of the liver. Which action should the nurse take to decrease the presence of ascites? a. Provide a low-sodium diet. b. Weigh the client daily. c. Increase oral fluid intake. d. Monitor intake and output.
Provide a low-sodium diet.
A triage nurse in the emergency department is assessing a client who presented with reports of general malaise. Assessment reveals the presence of jaundice and increased abdominal girth. What assessment question best addresses the possible etiology of this client's presentation? a. "To the best of your knowledge, are your immunizations up to date?" b. "Have you ever worked in an occupation where you might have been exposed to toxins?" c. "How many alcoholic drinks do you typically consume in a week?" d. "Has anyone in your family ever experienced symptoms similar to yours?"
"How many alcoholic drinks do you typically consume in a week?"
A patient has received dietary instructions as part of the treatment plan for diabetes type 1. Which statement by the patient would alert the nurse of needing additional instructions? a. "I'll likely need a bedtime snack because I take an evening dose of NPH insulin." b. "I should eat meals as scheduled, even if I'm not hungry, to prevent hypoglycemia." c. "I can have an occasional low-calorie drink as long as I include it in my meal plan." d. "I can eat whatever I want as long as I cover the calories with sufficient insulin."
"I can eat whatever I want as long as I cover the calories with sufficient insulin."
The nurse obtains a history from a patient with a diagnosis of cirrhosis. Which statement from the patient is most directly to the development of the diagnosis? a. "Since my spouse left me five months ago, I have been eating terribly." b. "I have been drinking about a fifth of vodka a day for the last few years." c. "For the past several weeks,I have not slept for more than five hours a night." d. "My spouse was a heavy smoker, and I am concerned about second-hand smoke"
"I have been drinking about a fifth of vodka a day for the last few years."
The nurse is providing discharge instructions to a patient who was newly diagnosed with Chron's disease about dietary changes to implement during exacerbations. Which statement made by the patient indicates a need for further education? a. "I will need to avoid caffeinated beverages" b. "I am going to learn some stress reducing techniques" c. "I should increase the fiber in my diet" d. "I can have exacerbations and remissions with Chron's disease"
"I should increase the fiber in my diet"
The physician has prescribed insulin lispro (Humalog) for sliding scale coverage for a patient diagnosed with diabetes mellitus. What statement indicated the patient understands the action of the drug? a. "I will need to carry candy or some form of sugar with me at all times." b. "I can save my dessert from supper for a bedtime snack" c. "I will make sure I eat breakfast within 5 minutes of taking my Humalog" d. "I will eat a snack around three o'clock each afternoon"
"I will make sure I eat breakfast within 5 minutes of taking my Humalog" (double-check)
The results of a patient's recent endoscopy indicate the presence of peptic ulcer disease (PUD). Which teaching point should the nurse provide to the patient based on this new diagnosis? a. "It would likely be beneficial for you to eliminate drinking alcohol." b. "You'll need to drink at least two to three glasses of milk daily." c. "Many people find that a minced or pureed diet eases their symptoms of PUD." d. "Your medications should allow you to maintain your present diet while minimizing symptoms."
"It would likely be beneficial for you to eliminate drinking alcohol."
The nurse is teaching a patient about their newly diagnosed Type 1 diabetes mellitus. What statement indicated the patient understands their new diagnosis? a. "Special B cells in the pancreas that make insulin are being destroyed by my own body's T calls. b. "With Type 1 diabetes, sometimes your pancreas makes too much insulin" c. "Type 1 diabetes had caused my pancreas to no longer make glucose" d. "Type 1 diabetes is temporary and I will only need to use insulin for a short time"
"Special B cells in the pancreas that make insulin are being destroyed by my own body's T calls.
The nurse is preparing to insert a nasogastric (NG) tube into a 68-year-old female patient who is nauseated and vomiting. She has an abdominal mass and suspected small intestinal obstruction. The patient asks the nurse why this procedure is necessary. What response by the nurse is most appropriate? a. "The tube is just a standard procedure before many types of surgery to the abdomen." b. "The tube will push past the area that is blocked and thus help to stop the vomiting." c. "The tube will let us measure your stomach contents so that we can plan what type of IV fluid replacement would be best." d. "The tube will help to drain the stomach contents and prevent further vomiting."
"The tube will help to drain the stomach contents and prevent further vomiting."
A nurse assesses clients at a community health fair. Which client is at greatest risk for the development of hepatitis B? a. A 46-year-old woman who takes acetaminophen daily for headaches b. An 82-year-old woman who recently ate raw shellfish for dinner c. A 20-year-old college student who has had several sexual partners d. A 63-year-old businessman who travels frequently across the country
A 20-year-old college student who has had several sexual partners
The nurse is caring for a woman recently diagnosed with viral hepatitis A. Which individual should the nurse refer for an immunoglobin (IG) injection? a. A relative with a history of hepatitis A who visits the patient daily b. A caregiver who lives in the same household with the patient c. A friend who delivers meals to the patient and family each week d. A child living in the home who received the hepatitis A vaccine 3 months ago
A caregiver who lives in the same household with the patient
A female patient with diabetes has a decreased level of consciousness and a finger stick glucose level of 39 mg/dL. What is the priority of care? a. Administering a 500-ml bolus of normal saline solution b. Placing a Salem sump tube and providing tube feedings c. Providing a high-protein, high-caloric snack d. Administering 1 ampule of 50% dextrose solution
Administering 1 ampule of 50% dextrose solution (double-check)
A patient's health history is suggestive of inflammatory bowel disease. Which of the following would suggest Crohn disease, rather than ulcerative colitis, as the cause of the client's signs and symptoms? a. Severe diarrhea b. An absence of blood in stool c. A pattern of distinct exacerbations and remissions d. nvolvement of the rectal mucosa
An absence of blood in stool
A nurse is assessing a patient with Cushing's syndrome. Which observation should the nurse report to the physician immediately? a. Dry mucous membranes b. Frequent urination c. An irregular apical pulse d. Pitting edema of the legs
An irregular apical pulse
A patient with IBD would be encouraged to increase fluids, use vitamins and iron supplements, and follow a diet designed to reduce inflammation. Select the meal choice that would be recommended for a low-residue diet. a. Salami on whole grain bread and V-8 juice b. A fruit salad with yogurt c. A peanut butter sandwich and fruit cup d. Broiled chicken with low-fiber pasta
Broiled chicken with low-fiber pasta
The nurse is administering total parenteral nutrition (TPN) to a patient who underwent a partial gastrectomy for a tumor in the stomach. Which of the nurse's assessments most directly addresses a major complication of TPN? a. Having the client frequently rate his or her hunger on a 10-point scale b. Monitoring the client's level of consciousness each shift c. Checking the client's capillary blood glucose levels regularly d. Measuring the client's heart rhythm at least every 6 hours
Checking the client's capillary blood glucose levels regularly
What assessment finding of a patient with acute pancreatitis would indicate a bluish discoloration around the umbilicus? a. Cullen's sign b. Rovsing's sign c. Grey-Turner's sign d. Homan's sign
Cullen's sign
Which disease is more likely to cause weight gain and central obesity? a. Addison's disease b. Cushing's disease c. Hyperthyroidism d. Type 1 diabetes
Cushing's disease
A nurse cares for a patient who is prescribed lactulose (Heptalac). The client states, I do not want to take this medication because it causes diarrhea. How should the nurse respond? a. Diarrhea is expected; thats how your body gets rid of ammonia. b. You may take Kaopectate liquid daily for loose stools. c. Do not take any more of the medication until your stools firm up. d. We will need to send a stool specimen to the laboratory.
Diarrhea is expected; thats how your body gets rid of ammonia.
A group of nurses have attended an in-service on the prevention of occupationally acquired diseases that affect health care providers. What action has the greatest potential to reduce a nurse's risk of acquiring hepatitis C in the workplace? a. Performing meticulous hand hygiene at the appropriate moments in care b. Wearing an N95 mask when providing care for clients on airborne precautions c. Adhering to the recommended schedule of immunizations d. Disposing of sharps appropriately and not recapping needles
Disposing of sharps appropriately and not recapping needles
The nurse is admitting a 68-year-old man with severe dehydration and frequent watery diarrhea that was sent to test for C.Diff. He just completed a 10-day outpatient course of antibiotic therapy for bacterial pneumonia. It is most important for the nurse to take which action? a. Don gloves and gown before entering the patient's room b. Wear a mask to prevent transmission of infection. c. Wipe equipment with ammonia-based disinfectant. d. Instruct visitors to use the alcohol-based hand sanitizer
Don gloves and gown before entering the patient's room
Gastroesophageal reflux disease (GERD) weakens the lower esophageal sphincter, predisposing older persons to risk for impaired swallowing. In managing the symptoms associated with GERD, the nurse should assign the highest priority to which of the following interventions? a. Eat small, frequent meals, and remain in an upright position for at least 30 minutes after eating b. Eat larger, infrequent meals and walk or do light exercises after all meals c. Decrease daily intake of vegetables and water, and ambulate frequently d. Drink coffee diluted with milk at each meal and remain in an upright position for 30 minutes
Eat small, frequent meals, and remain in an upright position for at least 30 minutes after eating
A client with a history of Addison's disease and flu-like symptoms accompanied by nausea and vomiting over the past week is brought to the facility. His wife reports that he acted confused and was extremely weak when he awoke that morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. What should the nurse expect to administer by IV infusion? a. Morphine b. Insulin c. Potassium d. Hydrocortisone
Hydrocortisone
A nurse assesses a client on the medical-surgical unit. Which statement made by the client should alert thenurse to the possibility of hypothyroidism? a. I am always tired, even with 12 hours of sleep. b. I seem to feel the heat more than other people. c. My sister has thyroid problems. d. Food just doesnt taste good without a lot of salt
I am always tired, even with 12 hours of sleep.
The patient with sudden pain in the left upper quadrant radiating to the back and vomiting was diagnosed with acute pancreatitis. What intervention(s) should the nurse expect to include in the patient's plan of care? a. Insert an NG and maintain NPO status to allow pancreas to rest. b. Administer acetaminophen (Tylenol) every 4 hours for pain relief. c. Immediately start enteral feeding to prevent malnutrition d. Initiate early prophylactic antibiotic therapy to prevent infection.
Insert an NG and maintain NPO status to allow pancreas to rest.
A nurse cares for a patient with hepatic portal-systemic encephalopathy (PSE). The patient is thin and cachectic in appearance, and the family expresses distress that the patient is receiving little dietary protein. How should the nurse respond? a. Low dietary protein is needed to prevent fluid from leaking into the abdomen. b. A low-protein diet will help the liver rest and will restore liver function. c. Less protein in the diet will help prevent confusion associated with liver failure. d. Increasing dietary protein will help the client gain weight and muscle mass.
Less protein in the diet will help prevent confusion associated with liver failure.
A patient recently diagnosed with thyroid cancer underwent a partial thyroidectomy and a significant amount of the parathyroid was also removed during surgery. As the nurse, which response should the nurse prioritize when taking care of the post-op patient to avoid potential complications? a. "After I felt dizzy, but now I am feeling better" b."My eye keeps twitching and I can't control it" c. "I don't feel like my muscle and bones are aching as much" d. " I was feeling flushed after the surgery"
My eye keeps twitching and I can't control it"
During the first 24 hours after a patient is diagnosed with Addisonian crisis, which should the nurse perform frequently? a. Administer insulin b. Obtain vital signs c. Weigh the patient d. Measure abdominal girth
Obtain vital signs
The nurse explains to the patient with gastroesophageal reflux disease that this disorder: a. Often involves relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the esophagus b. Results in acid erosion and ulceration of the esophagus caused by frequent vomiting c. Will require surgical wrapping or repair of the pyloric sphincter to control the symptoms d. Is the protrusion of a portion of the stomach into to esophagus through an opening in the diaphragm
Often involves relaxation of the lower esophageal sphincter, allowing stomach contents to back up into the esophagus
The nurse is doing an assessment on a client with a history of duodenal ulcer. To determine whether the problem is currently active, the nurse should assess for which symptom that is most consistent with a duodenal ulcer? a. Pain relieved by food intake b. weight gain c. Pain radiating to the right shoulder d. Nausea and vomiting
Pain relieved by food intake
The nurse teaching a patient about a high protein diet. The nurse determines additional teaching is required when the patient chooses what from the menu? a. Peanut butter and jelly sandwich, chips, and fruit drink b. grilled chicken salad with avocado and skim milk c. turkey and cheese sandwich, and low fat yogurt d. baked salmon, lima beans, and custard
Peanut butter and jelly sandwich, chips, and fruit drink
A 63-year-old client with type 2 diabetes mellitus is admitted for treatment of an ulcer on the heel of the left foot that has not healed with wound care. The nurse observes that the entire left foot is darker in color than the right foot. Which additional symptom should the nurse expect to find? a. Pedal pulses will be weak or absent in the left foot. b. Flexion and extension of the left foot will be limited. c. The client will state that the left foot is usually warm. d. Capillary refill of the client's left toes will be brisk.
Pedal pulses will be weak or absent in the left foot.
A patient is admitted to the hospital with a diagnosis of severe acute diverticulitis. Which nursing intervention has the highest priority? a. Assess the client's temperature. b. Administer IV fluids. c. Place the client on NPO status. d. Obtain a stool specimen.
Place the client on NPO status.
The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Where should the nurse anticipate the location of the client's pain? a. Right lower quadrant radiating to the back b. Right upper quadrant radiating to the left scapula and shoulder c. Right upper quadrant radiating to the right scapula and shoulder d. Right lower quadrant radiating to the umbilicus
Right upper quadrant radiating to the right scapula and shoulder
The nurse is caring for a patient who has normal glucose levels at bedtime, hypoglycemia at 2am, and hyperglycemia in the morning. What is this patient likely experiencing? a. Excessive Corticosteroids b. Insulin Spike c. Dawn Phenomenon d. Somogyi Effect
Somogyi Effect
A nurse is caring for a patient who has been admitted with liver disease and ascites. Which diuretic medication would most often be used for a patient with ascites? a. Lasix b. Lactulose c. Spironolactone d, Ammonia
Spironolactone
A nurse cares for a patient who has hypothyroidism as a result of Hashimotos thyroiditis. The patient asks, "How long will I need to take this thyroid medication?" How should the nurse respond? a. Thyroiditis is cured with antibiotics. Then you wont need thyroid medication. b. Youll need thyroid pills for life because your thyroid wont start working again. c. When blood tests indicate normal thyroid function, you can stop the medication. d. You will need to take the thyroid medication until the goiter is completely gone.
You'll need thyroid pills for life because your thyroid wont start working again.
The nurse is monitoring a patient with a diagnosis of a peptic ulcer. Which assessment finding should the nurse immediately report to the PCP to indicate a perforated ulcer? a. bradycardia b. nausea c. numbness in legs d. a rigid, board-like abdomen
a rigid, board-like abdomen
A nurse educator is teaching a group of recent nursing graduates about their occupational risks for contracting hepatitis B. What preventative measure should the educator promote? a. Annual B12 injections b. annual immunizations c. consumption of a vitamin rich diet d. Annual vitamin K injections
annual immunizations
A patient has undergone esphagogastroduodenoscopy (EGD). The nurse should place highest priority on which item as part of the patient's care plan? a. assessing for the return of the gag reflex b. monitoring the temperature c. monitoring complaints of heartburn d. giving warm gargles for a sore throat
assessing for the return of the gag reflex
A health care provider and nurse are discussing treatment options with a client diagnosed with severe ulcerative colitis. When providing client teaching during early treatment, the symptoms of which diagnosis would be discussed? a. gastritis b. bowel herniation c. bowel perforation d. Bowel out pouching
bowel perforation
What hormone deficiency is responsible for Addison's disease? a. cortisol b. thyroxine c. insulin d. growth hormone
cortisol
A patient has recently been diagnosed with SIADH Which clinical finding would the nurse expect to find? a. decreased urine output b. increased serum osmolality c. increased urine output d. increased serum sodium
decreased urine output
The nurse determines that a patient has experience the beneficial effects of therapy with famotidine (Pepcid) when which symptom is relieved? a. epigastric pain b. vomitting c. belching d. difficulty swallowing
epigastric pain
An illeostomy was just created in a patient with ulcerative colitis, the nurse assess the patient in the immediate postoperative period for which mostfrequent complication of this type of surgery? a. fluid and electrolyte imbalance b. folate deficiency c. malabsorption of fat d. intestinal obstruction
fluid and electrolyte imbalance
Hyperthyroidism is caused by increased levels of thyroxine in blood plasma. The nurse understands that a client with this endocrine dysfunction experiences: a. lethargy and weakness b. cold intolerance and constipation c. heat intolerance and systolic hypertension d. anorexia and hypoexcitability
heat intolerance and systolic hypertension
The patient admitted with acute pancreatitis has passed the acute stage and is now able to tolerate solid foods. What type of diet will increase caloric intake without stimulating pancreatic enzymes beyond the ability of the pancreas to respond? a. high carb, high protein, high fat diet b. low sodium, high potassium, low fat diet c. low carb, high potassium diet d. high carb, low fat diet
high carb, low fat diet
Which of the following symptoms is more commonly seen with patients with Addison's disease compared to Cushing's syndrome? a. weight gain b. moon face c. hyperpigmentation d. hypertension
hyperpigmentation
A nurse is preparing to hang the initial bag of the total parenteral nutrition (TPN) solution via the central line of a malnourished patient for a continuous dose. The nurse ensure the availability of which medical equipment before hanging the solution? a. dressing tray b. glucometer c. infusion pump d. nebulizer
infusion pump
The nurse provides care for a patient diagnosed with acute cholecystitis. The patient says, "My stomach hurts all the way up to my right shoulder and I am having some nausea. I even vomited twice!" Which prescription does the nurse carry out first? a. NPO b. Trimethobenzamide 200 mg rectally TID c. morphine 15mg IM q4hrs PRN d. insert NG tube and attach to intermittent low suction
insert NG tube and attach to intermittent low suction (double check)
The nurse is caring for a patient following a Billroth II operative procedure. Which postoperative prescription should the nurse question and verify? a. irrigating the nasogastric tube b. leg exercises c. early ambulation d. coughing and deep breathing exercises
irrigating the nasogastric tube
The nurse is providing discharge instructions to a patient that just had a gastrectomy and states the patient should do which of the following to prevent dumping syndrome? a. limit fluids between meals b. sit in a high-fowler's position during meals c. eat high-carbohydrate foods d. ambulate following meals
limit fluids between meals
An older client with a history of hyperparathyroidism and severe osteoporosis is hospitalized. The nurse caring for the client plants first to address which problem? a. urinary retention b. constipation c. need for teaching about the disorder d. possibility of injury
possibility of injury
The nurse is providing care for a patient with a recent traverse colostomy. Which observation requires immediate notification to the PCP? a. stoma is beefy, red, and shiny b. purple discoloration of the stoma c. skin excoriation around stoma d. semiformal stool found in the ostomy pouch
purple discoloration of the stoma
The nurse understand's which factor is the mostly likely source of a patient that was diagnosed with hepatitis D? a. overly exerting oneself b. receiving a blood transfusion c. eating infecting shellfish d. practicing poor hygiene
receiving a blood transfusion
A client with liver disease has developed ascites; the nurse is collaborating with the client to develop a nutritional plan. The nurse should prioritize which of the following in the client's plan? a. increased potassium diet b. reduction in sodium intake c. increased fiber intake d. high protein, low fat diet
reduction in sodium intake
What diagnostic test is most appropriate to determine thyroid activity? a. thyroid scan b. serum TSH level c. serum T3 and T4 levels d. ultrasound
serum T3 and T4 levels
A client comes to the ED with severe abdominal pain, nausea, and vomiting. The physician plans to rule out acute pancreatitis. The nurse would expect the diagnosis to be confirmed by an elevated result on which laboratory test? a. serum amylase b. serum potassium c. serum bilirubin d. serum calcium
serum amylase
