Exam 4 Concepts 3
A patient in the outpatient clinic is diagnosed with acute hepatitis C (HCV) infection. In planning care, which action by the nurse is appropriate?
. Schedule the patient for HCV genotype testing.
Which are appropriate therapies for patients with diabetes?
. Use of statins to reduce CVD risk c. Use of ACE inhibitors to treat nephropathy e. Use of laser photocoagulation to treat retinopathy
Which of these orders should you implement next?
.Infuse 1 liter of normal saline per hour.
Which pt should the nurse assess first after receiving change-of shift report
30 year old with abdominal distention and an apical heart rate of 136 beats/ min
Drain change of shift report the nurse learns about the following for patients which patient requires assessment first
A 55 year old patient with psoriasis and ascites who has an oral temperature of 102 degrees Fahrenheit
A nurse is reviewing the laboratory results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism?
A client who has a phosphate of 5.7 mg/dL
If you were assessing clients in a health clinic for risk factors for contracting hepatitis. Which of the following clients is at risk for developing hepatitis C?
A client who has multiple tattoos
A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective?
A decrease in urine output.
You are planning care for a client who has viral hepatitis. Which of the following actions should the nurse include in the plan of care?
A. Provide a high carbohydrate diet.
Analyze the following diagnostic findings for your patient with type 2 diabetes. Which result will need further assessment
A1C9%
A patient with acute pancreatitis is NPO and has a nasogastric tube to section which information obtained by the nurse indicates that these therapies have been effective
Abdominal pain is decreased
Differences between Addisons and Cushing's:
Addisons is too little cortisol- hypotension, low wt. Low temp., low hair-alopecia, depression, fatigue, hyponatremia, low blood glucose, lack of menses Cushing's is too much cortisol
n important preoperative nursing intervention before an adrenalectomy for hyperaldosteronism is to
Administer K+ sparing diuretics
A nurse is planning care for a client who has cirrhosis of the liver. Which of the following actions should the nurse include in the plan? SELECT ALL THAT APPLY
Administer furosemide Implement a low-sodium diet Mease the client's abdominal girth
A nurse is planning care for a patient who has cirrhosis of the liver which of the following actions should the nurse include in the plan select all that apply
Administer furosemide implement a low sodium diet measure the clients abdominal girth
A patient with cirrhosis who has scheduled doses of spironolactone (Aldactone) and furosemide (Lasix) has a serum potassium level of 3.2 mEq/L . Which action should the nurse take?
Administer the spironolactone
A patient is receiving radiation therapy for cancer of the kidney. The nurse monitors the patient for signs and symptoms of damage to the
Adrenal glands
A patient with cirrhosis has 4+ pitting edema of the feet and legs. The data indicate that it is most important for the nurse to monitor the patient's
Albumin level
A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply)
Assess blood glucose level, neck vein distension, and weigh daily
During preoperative teaching for a patient scheduled for trassphenoidal hypophysectomy for treatment of a pituitary adenoma, the nurse instructs the patient about the need to
Avoid brushing the teeth for at least 10 days after the surgery
A nurse is reviewing guidelines to prevent DKA during periods of illness with a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?
Check your urine for ketones when blood glucose levels are greater than 240 mg/DL.
Nursing management of the patient with acute pancreatitis includes select all that apply
Checking for hypocalcemia monitoring for infection especially respiratory tract infections
A nurse is providing teaching to a client who has a history of pancreatitis which of the following food choices should the nurse instruct the client to avoid
Cheddar cheese
You are teaching a client about causes of biliary cirrhosis. Which of the following information should you include when teaching about the causes of biliary cirrhosis?
D. Obstruction of the bile duct
If you were admitting a client who has hepatitis C. Which of the following precautions should the nurse implement? WHY?
D. Standard
DKA and HHNS
DKA has ketones present, Type 1 diabetes - BG of 250 < HHNS does not have ketones present, Type 2 diabetes - more life threatening due to due circulating insulin - BG of 600 <
Nurse is planning care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include in the plan of care?
Decrease fluid intake
A patient has a total serum calcium level of 3mg/dL (1.5 mEq/L). If this finding reflects hypoparathyroidism, the nurse would expect further diagnostic testing to reveal
Decreased serum PTH
A patient with diabetes has a serum glucose level of 824 mg/dL (45.7 mmol/L) and is unresponsive. After assessing the patient, the nurse suspects diabetic ketoacidosis rather than hyperosmolar hyperglycemic syndrome based on the finding of
Decreased serum potassium
hen obtaining subjective data from a patient during assessment of the endocrine system, the nurse asks specifically about
Energy level
Abnormal findings during the endocrine assessment include (select all that apply)
Excess facial hair on a woman Hyperpigmented coloration of the lower legs
A young woman who has Crohn's disease develops a fever and symptoms of urinary tract infection with tan fecal smelling urine what information will the nurse add to the a general teaching about utes in order to individualize the teaching for this patient
Fistulas can form between the bowel bladder
Polydipsia and polyuria related to diabetes are primarily due to
Fluid shifts resulting from the osmotic effect of hyperglycemia
Interviewing a client who has acute pancreatitis which of the following factors should the nurse in tyssa Pate finding in the client's history
Gallstones
A nurse is caring for a client who has cirrhosis and has a prescription for BUMETANIDE. When delivering the client's lunch try, which of the following items should the nurse identify as contraindicated for the client?
Ham sandwiches
An appropriate technique to use during physical assessment of the thyroid gland is
Having the patient swallow water during inspection and palpation of the gland
A nurse is assessing a client who has Cushing's syndrome. Which of the following findings should the nurse expect?
Hyperpigmentation
A nurse is assessing a client who is admitted for elective surgery and has a history of Addison's disease. Which of the following findings should the nurse expect?
Hyperpigmentation
The health care provider prescribed levothyroxine for a patient with hypothyroidism. After teaching about this drug, the nurse determines that further instruction is needed when the patient says
I only need to take this drug until my symptoms are improved
Which statement by the patient with type 2 diabetes is accurate?
I will limit my alcohol intake to 1 drink each day."
Which patient statement indicates the nurse is teaching about sulfasalazine for alternative client this has been affective
I will need to use sunscreen when I am outdoors
To control the side effects of corticosteroid therapy, the nurse teaches the patient who is taking corticosteroids to
Increase calcium intake 1500 mg/day
Nurse is providing discharge teaching for a client who has chronic pancreatitis. Which of the following statements should the nurse make?
Increase daily intake of protein
A characteristic common to all hormones is that they
Influence cellular activity of specific target tissues
A patient with diabetic ketoacidosis is brought to the emergency department. Which prescribed action should the nurse implement first?
Infuse 1 L of normal saline per hour
A diabetic patient is admitted with ketoacidosis and the health care provider write these orders. Which order should the nurse implement first?
Infuse 1 liter of normal saline per hour
An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to
Insert an IV catheter.
You are caring for a patient with newly diagnosed type 1 diabetes. What info is essential to include in your patient teaching before discharge from the hospital?
Insulin administration d. Use of a portable blood glucose monitor e. Hypoglycemia prevention, symptoms, and treatment
After thyroid surgery, the nurse suspects damage or removal of the parathyroid glands when the patient develops
Laryngospasms and tingling in the hands and feet
What medications would this be included in this hormone replacement plan for Bill?
Levothyroxine, Desmopressin, Cortisol, Hormone replacement-testosterone
A patient with a head injury develops SIADH. Manifestations the nurse would expect to find include
Low urine output and hyponatremia
A patient with a head injury develops SIADH. Manifestations the nurse would expect to find include:
Low urine output and hyponatremia
Nurse is planning care for a patient with acute severe pancreatitis. The highest priority patient outcome is
Maintaining normal respiratory function
Important nursing interventions when caring for a patient with Cushing syndrome include (select all that apply)
Monitor blood glucose levels, protecting patient from exposure to infection
A nurse is caring for a client who has Crohn's disease and is receiving parenteral nutrition which of the following intervention should the nurse include in the care of this client
Monitor daily laboratory values and report is needed
Which nursing action will be included in the plan of care for a patient who is being treated for bleeding esophagel varices with balloon tamponade?
Monitor the patient for SOB
Important nursing interventions when caring for a patient with Cushing syndrome include SELECT ALL THAT APPLY
Monitoring blood glucose Protecting patient from exposure to infection
After a hypophysectomy for acromegaly, immediate postoperative nursing care should focus on
Monitoring serum and urine osmolality
A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize that which of the following are manifestations of Cushing's syndrome? SELECT ALL THAT APPLY
Moon face Purple striations Buffalo hump
Which assessment finding would the nurse need to report most quickly to the health care provider regarding a patient with acute pancreatitis?
Muscle twitching and finger numbness
Nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse anticipate?
Pantoprazole 80 mg IV bolus twice daily
A patient with advanced cirrhosis with ascites is short of breath and has an increased respiratory rate. The nurse should:
Place the patient in Fowler's position to relieve pressure on the diaphragm.
The patient with advanced cirrhosis asks why his abdomen is so swollen. The nurse's response is based on the knowledge that
Portal HTN and low albumin cause fluid shifts
A nurse is teaching a client who has hepatitis a about preventing transmission of the virus which of the following strategies should the nurse include in the teaching
Practice effective hand hygiene
A nurse is caring for a client who has admitted with bleeding esophageal varices and has an esophagogastric balloon tamponade with a saying sengstaken-Blakemore tube to control the bleeding which of the following action should the nurse take
Provide frequent oral and nares care
A patient with diabetes has s serum glucose level of 824 mg/dL and is unresponsive. after assessing the patient, the nurse suspects diabetes-related ketoacidosis rather than hyperosmolar hyperglycemic syndrome based on the finding of
Rapid, deep respirations
A nurse is planning care for a client who has end stage cirrhosis of the liver with encephalopathy which of the interventions should the nurse plan to implement decrease that clients ammonia level
Reduce the clients intake of protein
A patient has a serum sodium level of 152 mEq/L (152 mmol/L). The normal hormone response to this situation is
Release of ADH
A nurse caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following prescriptions should the nurse anticipate?
Restrict fluid intake to 1,000 mL per day.
A nurse is providing dietary teaching for a client who has Cushing's disease. Which of the following recommendations should nurse include in the teaching?
Restrict sodium intake.
Nurse is discussing good food choices with a client who is recovering from an exacerbation of inflammatory bowel disease and is to start a low-lactose diet. Which of the following foods is the best choice for the client?
Soy milk
A nurse is admitting a client who has hepatitis C. Which of the following precautions should the nurse implement?
Standard
Endocrine disorders often go unrecognized in the older adult because
Symptoms are often attributed to aging
A nurse is teaching self-management to a client who has hepatitis B. Which of the following Instructions should the nurse include in the teaching?
Take planned rest periods throughout the day
A nurse is caring for a child who has Addison's disease. Which of the following actions should the nurse take?
Teach the parents about cortisol replacement therapy
A nurse is reviewing the laboratory results for four clients. The nurse should recognize that which of the following clients has a manifestation of primary hyperparathyroidism?
The client who has an increased magnesium level.
Which statement would be correct for a patient with type 2 diabetes who was admitted to the hospital with pneumonia?
The patient may have enough endogenous insulin to prevent ketosis but is at risk for hyperosmolar hyperglycemia syndrome
Which statement would be correct for a patient with type 2 diabetes who was admitted to the hospital with pneumonia?
The patient may have sufficient endogenous insulin to prevent ketosis but is at risk for hyperosmolar hyperglycemic syndrome.
The nurses came for a patient who has cirrhosis which data obtained by the nurse during the assessment will be of most concern
The patient's hand flaps back and forth when the arms are extended
The nurse administers corticosteroids to a patient with acute adrenal insufficiency. The nurse determines that treatment is effective is what is observed?
The patient's is alert and oriented
All cells in the body are believed to have intracellular receptors for
Thyroid hormone
Pt is about to undergo an abdominal paracentesis. Which of the following positions should the nurse place the client
Upright
The nurse determines that demeclocycline is effective for a patient with syndrome of inappropriate antidiuretic hormone (SIADH) based on finding that the patient's
Urinary output is increased
A nurse administers desmopressin to a client who has a diagnosis of diabetes insipidus. The nurse recognizes that which of the following laboratory findings indicate a therapeutic effect of the medication?
Urine specific gravity 1.01 A therapeutic effect of the medication would be urine specific gravity within the expected reference range, which is 1.010-1.025.
A patient is treated with demeclocycline (Declomycin) to control the symptoms of syndrome of inappropriate antidiuretic hormone (SIADH). The nurse determines that the demeclocycline is effective upon finding that the
Urine specific gravity is increased
Which information will the nurse include in teaching a patient who had a proctocolectomy and ileostomy for ulcerative colitis
Use care when eating high-fiber foods to avoid obstruction of the ileum
A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take?
Weigh the client daily
A nurse is caring for a client who has Addison's disease and is at risk of Addisonian crisis. Which if the following actions should the nurse take?
Weight the client daily
A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? SELECT ALL THAT APPLY
Weight the client daily Assess blood glucose level Assess for neck vein distention
A nurse is creating a plan of care to maintain the skin integrity of a client who experiences frequent diarrhea due to ulcerative colitis which of the following interventions should the nurse include in the plan
Wipe parianal area with warm water and apply a barrier cream
The nurse will teach a patient with chronic pancreatitis to take the prescribed pancrelipase ( Viokase)
With meals
A nurse is caring for a client who has acute pancreatitis after treating the clients pain which of the following should the nurse address is the priority intervention
Withhold oral fluids and food
A patient is scheduled for transsphenoidal hypophysectomy to treat a pituitary adenoma. During preoperative teaching, the nurse instructs the patient about the need to
avoid brushing the teeth for at least 10 days after the surgery.
A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L. Which of the following prescriptions should the nurse anticipate?
b. Restrict fluid intake to 1,000 mL per day
The nurse is planning postoperative care for Bill who was admitted to the surgical unit from the recovery room after trans-sphenoidal resection of his pituitary tumor. Which nursing action should have been included?
b. measure urine output every hour
A nurse is caring for a client who has liver cirrhosis with ascites, bleeding esophageal varices, and portal hypertension. The nurse recognized which of the following laboratory findings as indicating the client's gastrointestinal (GI) tract is digesting and absorbing blood?
elevated BUN
What is the priority action for the nurse to take if the patient with type 2 diabetes reports blurred vision and irritability?
heck the patient's blood glucose level
A diagnosis of DKA is made. The nurse will anticipate the need to (provide rationale and citation with pg. for your answer).
insert a large-bore IV catheter.
After thyroid surgery, the nurse suspects damage or removal of the parathyroid glands when the patient develops
laryngospasms and tingling in the hands and fee
