Exam 5 Practice Questions
When caring for the client with Laennec cirrhosis, the nurse recognizes which pathophysiologic finding to be an expected etiology of jaundice?
Impaired uptake of bilirubin
An overweight, 14-year-old boy feels tired all the time. He sleeps 12 to 14 hours a day and has a voracious appetite but no energy to burn off the calories. He has been diagnosed with hypothyroidism brought about by the accumulation of a nonpitting mucosal edema. For which life-threatening condition should his care team be prepared?
Myxedema coma presence of a nonpitting mucous type of edema caused by an accumulation of a hydrophilic mucopolysaccharide substance in the connective tissues throughout the body.
The client reports something "wrong" with his gallbladder. Which manifestation does the nurse recognize that supports the client's concern?
intolerance to greasy food and burping
A nurse is reviewing laboratory results of a client with impaired liver function and anticipating which abnormal result indicating injury to liver cells?
liver enzymes
The nurse is teaching about prevention of hepatitis A. Which group does the nurse suggest will benefit from this vaccine?
people who live in or travel to areas with high rates of hepatitis A infections
A client is suspected of having the onset of alcoholic liver disease. The nurse should be assessing for which manifestation related to the necrosis of liver cells?
rapid onset of jaundice
A client presents with a perforated peptic ulcer. For which complication will the nurse assess as the priority?
rigid, board-like abdomen
The nurse knows that the client with which complication of diabetes has the greatest risk for the development of foot ulcers?
sensory neuropathy
Inflammatory bowel disease (IBD) is used to designate two related inflammatory intestinal disorders: Crohn disease and ulcerative colitis. The nurse recognizes the difference between the distribution pattern between Crohn disease and ulcerative colitis. Which pattern describes Crohn's disease?
skip lesions
The nurse teaches the client that which of these contributed to the development of acute cholelithiasis?
stasis of the bile
Following the analysis of colonoscopy with biopsy, a client is diagnosed with colorectal cancer. Which treatment modality will be the mainstay of this client's treatment regimen?
surgery
A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need:
surgery to release the bowel.
Primary biliary cirrhosis is an autoimmune disease that destroys the small intrahepatic bile ducts causing cholestasis. It is insidious in onset and is a progressive disease. What are the earliest symptoms of the disease?
unexplained pruritus (itchiness). Also dark urine and light stool.
A rare condition caused by gastrin-secreting tumors most commonly found in the small intestine or pancreas is called:
zollinger-Ellison syndrome
A nurse is reviewing the admission assessment data of a client diagnosed with acute gastritis. The nurse determines that the condition most likely occurred as a result of:
Arthritis treated with high levels of nonsteroidal anti-inflammatory (NSAIDs) agents
The nurse is caring for a client with hepatitis and jaundice. The nurse recognizes that without sufficient circulating bile salts the client will have intolerance to which ingested substance?
Fats
A teenager has been diagnosed with failure to thrive possibly due to malabsorption syndrome. In addition to having diarrhea and bloating, the client more than likely has what hallmark manifestation of malabsorption?
Fatty, yellow-gray, foul-smelling stools
Crohn disease has a distinguishing pattern in the gastrointestinal (GI) tract. The surface has granulomatous lesions surrounded by normal-appearing mucosal tissue. A complication of the pattern includes:
Fistula formation
Antibody testing has confirmed that a client is positive for hepatitis A virus (HAV). Which statement suggests the client understands the new diagnosis?
"I don't know why I didn't bother to get vaccinated against this."
A middle-aged adult is diagnosed with diverticular disease based on recent history and the results of a computed tomography (CT) scan. Which statement demonstrates an accurate understanding of this diagnosis?
"I suppose I should try to eat a bit more fiber in my diet."
A child has been removed from a home in which she has experienced severe neglect and emotional abuse, and has been placed in foster care. The child has psychosocial dwarfism and the foster parents ask the nurse what this means for the future of the child. What is the best response by the nurse?
"The prognosis of the child depends on an improvement in behavior and catch-up growth."
A young child develops type 1A diabetes. The parents ask, "They tell us this is genetic. Does that mean our other children will get diabetes?" The best response by the health care provider would be:
"This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes."
A client with Graves disease has ophthalmopathy and asks the nurse if the eyes will stay like this forever. What is the best response by the nurse?
"With treatment of the hyperthyroid state, the ophthalmopathy usually tends to stabilize."
Following an oral glucose tolerance, a 36-year-old mother of 4 has been diagnosed with gestational diabetes mellitus (GDM), a problem that was not present in any of her previous pregnancies. What should her primary care provider tell her about this new health problem?
"Your baby could become too large or have low blood sugars if we're not vigilant about controlling your sugars."
Which manifestation indicates a client is at risk for developing diabetes mellitus?
2 hour oral GTT 175mg/dL. Laboratory values that are considered normal are hemoglobin A1C less than 6.5 percent, fasting plasma glucose of (FPG) less than 100 mg/dL or less than 140 mg/dL 2 hours after an oral glucose tolerance test (GTT).
Select the client at greatest risk for developing colorectal cancer.
A 64-year-old female whose mother had colorectal cancer
A client has begun to display manifestations of hepatic encephalopathy. The family is concerned and asks the nurse what caused this condition to develop. Which is the best response by the nurse?
Accumulation of ammonia in the blood
Given the fact that acute pancreatitis can result in severe, life-threatening complications, the nurse should be assessing the client for which complication?
Acute tubular necrosis
A 40-year-old client tells the nurse that a parent died of gastric cancer and that the client wants to do everything one can do to avoid the disease. Which recommendation should the nurse provide?
Avoid smoked and preserved foods.
The results of a 44-year-old obese man's recent diagnostic workup have culminated in a new diagnosis of type 2 diabetes. Which pathophysiologic process underlies the client's new diagnosis?
Beta cell exhaustion due to long-standing insulin resistance
A client with acromegaly comes to the clinic and informs the nurse that she is having a productive cough and a low grade fever. This is the client's fourth visit in 1 year for the same problem. What condition does the nurse understand results from this client's enlarged cartilaginous structures?
Bronchitis
When assessing the nutritional intake of a client with generalized pancreatic cancer, which statement by the client is consistent with the disease and food intake?
Client states pain becomes worse with food intake
An older adult client has been placed on a broad-spectrum antibiotic for a recurrent urinary tract infection. Which potential problem would the nurse anticipate in this client?
Colonization of Clostridium difficile
A health care provider suspects a client has developed diverticular disease. Which diagnostic test is usually prescribed to confirm the diagnosis?
Computed tomography (CT) scan
A 24-year-old woman undergoing a screening test is found to have elevated levels of AST, ALT, and IgG, but no antibody-specific markers for viral hepatitis. A liver biopsy reveals inflammation and cellular damage. Which treatment is most likely to be effective for her?
Corticosteroids and immunosuppressant drugs
A client tells his health care provider that his body is changing. It used to be normal for his blood glucose to be higher during the latter part of the morning. However, now his fasting blood glucose level is elevated in the early AM (07:00). The health care provider recognizes the client may be experiencing:
Dawn phenomenon =increased levels of fasting blood glucose or insulin requirements, or both, between 5 AM and 9 AM without preceding hypoglycemia. The Somogyi effect describes a cycle of insulin-induced posthypoglycemic episodes.
A client newly diagnosed with pancreatic cancer is admitted to begin treatment. Which pain descriptors can be associated with adenocarcinomas of the pancreas?
Dull epigastric pain accompanied by back pain, worse when lying flat and relieved by sitting forward.
A client is admitted with chronic gastritis. The nurse expects which invasive test to be performed to establish the presence of Helicobacter pylori (H. pylori)?
Endoscopic biopsy
A 15-year-old child with type 1 diabetes asks nurse about the potential to "lose sight." Which response would be the most appropriate?
Explain that many people with diabetes experience some complications like retinopathy, but these are best prevented with tight control of glucose levels.
Advances in technology have made it possible to assess hypothalamic-pituitary function by newly developed imaging and radioimmunoassay methods. When baseline tests are not sufficient, what suppression test gives information about combined hypothalamic-pituitary function?
GH suppression test
The nurse is caring for a client with diabetes. Which of these findings is cause for concern, leading the nurse to initiate client education?
Hemoglobin A1C level is 8.7%. should be 6% to 7% in clients with diabetes.
A client is diagnosed with Crohn disease. The nurse instructs the client on which type of dietary needs?
High-calorie, vitamin, and protein diet
When caring for the client with acute pancreatitis, which alterations does the nurse recognize is consistent with the disease?
Hyperglycemia
A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing?
Increased levels of ACTH
Which metabolic abnormality can lead to the development of type 2 diabetes?
Insulin resistance
Which maternal factor contributes to an infant having macrosomia, hypoglycemia, and hyperbilirubinemia?
Maternal diabetes
A client has been admitted to the hospital with an exacerbation of peptic ulcer disease. The nurse is aware the client is at risk for: Select all that apply.
Perforation, hemorrhage and obstruction
A client is admitted with an abrupt onset of referred pain to the epigastric area, with an episode of nausea. On the nurse's initial assessment, the client is lying still and taking shallow breaths, with a rigid abdomen. Which problem is the client experiencing?
Peritonitis
When teaching a group of nursing students about the liver, the nurse relates that Kupffer cells function to remove harmful substances or cells from the portal blood and venous sinusoids through which process?
Phagocytosis
While caring for a client undergoing diagnostic testing for possible liver failure, the nurse asks the student nurse what clinical manifestations of liver failure she should assess for. Which answers are accurate? Select all that apply.
Sweet, musty breath. Multiple bruising noted on the body.
A child is born with dwarfism to normal-sized parents. The nurse is explaining how growth hormone (GH) plays a central role in the increase in stature that characterizes childhood and adolescence. What is the first step in the growth hormone chain of events?
The hypothalamus secretes GH-releasing hormone.
A client with long-standing type 2 diabetes is surprised to see high blood sugar readings while recovering from an emergency surgery. Which factor may have contributed to the client's inordinately elevated blood glucose levels?
The stress of the event caused the release of adrenal cortical hormones
A client with diabetes has been injured. The nurse will be educating the client that healing of the injury may be delayed due to which diabetic complications? Select all that apply.
Vascular impairment. Chronic nephropathy. Explanation:Sensory loss decreases awareness of minor trauma and infection, and vascular disease impairs circulation of blood with substances needed for effective healing.
Rotavirus is most severe in children under 24 months of age. What is a typical symptom of rotavirus infection?
Vomiting that disappears around the second day but diarrhea continues
When explaining acute pancreatitis to a newly diagnosed client, the nurse will emphasize that the pathogenesis begins with an inflammatory process whereby:
activated pancreatic enzymes escape into surrounding tissues, causing autodigestion of pancreatic tissue.
The nurse is caring for a client with liver disease who has edema throughout the body. When reviewing the medical record, the nurse recognizes that which altered diagnostic test is consistent with development of edema?
decreased albumin (a plasma protein)
An older adult client's traumatic injuries required the use of opioid analgesics, which he began taking 6 days ago. He now reports sudden abdominal pain and is experiencing fecal incontinence and watery diarrhea. The nurse should assess for:
fecal impaction caused by pain medication
A client with chronic pancreatitis is experiencing an episode of recurring epigastric pain. The nurse teaches the client to limit which type of meal to avoid further episodes?
fried chicken and french fries
When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptom does the client report that the nurse would find associated with this disorder?
increase in appetite
