Hinkle PrepU: Kaplan Preparation

Question 86 A client presents to the emergency department ( ED ) reporting severe right upper quadrant pain . The client states that the family doctor said the pain was caused by gallstones . The ED nurse should recognize what possible complication of gallstones ?

Gangrene of the gallbladder

Question 74 A client was diagnosed with rheumatoid arthritis 1 year ago , but has achieved adequate symptom control with celecoxib , a COX - 2 selective NSAID . The nurse should recognize that this drug , like other NSAIDs , influences what aspect of the pathophysiology of nociceptive pain ?

Inhibiting transduction by blocking the formation of prostaglandins in the periphery

Question 31 A client has sustained a traumatic brain injury with involvement of the hypothalamus . The health care team is concerned about the complication of diabetes insipidus . Which of the following would be an appropriate nursing intervention to monitor for early signs of diabetes insipidus ?

Record intake and output .

Question 27 The result of which diagnostic study is decreased in the client diagnosed with rheumatoid arthritis ?

Red blood cell count

Question 72 A client with neurologic infection develops cerebral edema from syndrome of inappropriate antidiuretic hormone ( SIADH ) . Which is an important nursing action for this client ?

Restricting fluid intake and hydration

Question 14 A client is diagnosed with syndrome of inappropriate antidiuretic hormone ( SIADH ) . Laboratory results reveal serum sodium level 130 mEq / L and urine specific gravity 1.030 . Which nursing intervention helps prevent complications associated with SIADH ?

Restricting fluids to 800 ml / day

Question 97 A patient was bitten by a tick 3 months ago and is now having muscle aches as well as joint pain and swelling . The patient is having difficulty with self care and requires assistance with activities of daily living ( ADLs ) . What stage of Lyme disease does the nurse recognize the patient is in ?

Stage III

Question 91 A new nursing graduate is working at the hospital in the medical - surgical unit . The preceptor observes the nurse emptying a patient's wound drain without gloves on . What important information should the preceptor share with the new graduate about standard precautions ?

Standard precautions should be used with all patients to reduce the risk of transmission of bloodborne pathogens .

Question 40 Which type of burn is similar to a sunburn ?

Superficial partial - thickness

Question 47 Which of the following is a factor affecting an increase in urine osmolality ?

Syndrome of inappropriate antidiuretic hormone release ( SIADH )

Question 48 Which oncologic emergency involves the failure in the negative feedback mechanism that normally regulates the release of antidiuretic hormone ( ADH ) ?

Syndrome of inappropriate antidiuretic hormone release ( SIADH )

Question 49 Which of the following endocrine disorder causes the patient to have dilutional hyponatremia ?

Syndrome of inappropriate antidiuretic hormone secretion ( SIADH )

Question 30 A client has sustained a traumatic brain injury with involvement of the hypothalamus . The nurse is concerned about the development of diabetes insipidus . Which of the following would be an appropriate nursing intervention to monitor for early signs of diabetes insipidus ?

Take daily weights .

Question 75 The nurse is caring for a client with a history of a renal transplant who has just been diagnosed with chronic rhinosinusitis . While being admitted to the clinic , the client asks , " Will this chronic infection hurt my new kidney ? " What should the nurse know about chronic rhinosinusitis in this client ?

Taking immunosuppressive drugs can contribute to chronic rhinosinusitis .

Question 34 A client with early stage rheumatoid arthritis asks the nurse what to do to help ease the symptoms of the disease . What would be the best response by the nurse ?

The health care provider could prescribe anti - inflammatory drugs . "

Question 4 A nurse assesses a client shortly after living donor kidney transplant surgery . Which postoperative finding must the nurse report to the physician immediately ?

Urine output of 20 ml / hour

Question 20 A nurse is caring for a client who underwent a lumbar laminectomy 2 days ago . Which finding requires immediate intervention ?

Urine retention or incontinence

Question 28 A client has undergone a kidney transplant . The nurse is concerned about a compromised immune system in this client for which reason ?

Use of anti - rejection drugs

Question 29 A client with a traumatic brain injury has developed increased intracranial pressure resulting in diabetes insipidus . The expected treatment would consist of which of the following ?

Vasopressin therapy .

Question 76 A nurse is planning client education for a client being discharged home with a diagnosis of rheumatoid arthritis . The client has been prescribed antimalarials for treatment , so the nurse knows to teach the client to self - monitor for what adverse effect ?

Visual changes

Question 15 A nurse is managing the care of a client with osteoarthritis . What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis ?

administration of nonsteroidal anti - inflammatory drugs ( NSAIDs )

Question 23 Total parental nutrition ( TPN ) should be used cautiously in clients with pancreatitis because they

cannot tolerate a high glucose concentration .

Question 99 A client with a history of peptic ulcer disease is diagnosed with rheumatoid arthritis . What medication will the nurse anticipate will be prescribed to produce an anti - inflammatory effect and protect the stomach lining ?

celecoxib

During the acute phase of a burn , a nurse should assess :

circulatory status .

Question 70 The nurse is caring for a client who underwent a kidney transplant . The client appears anxious and tearful and states , " My body is going to reject the new kidney , I know I'm going to die . " What is the best response by the nurse ?

" I understand your concerns , let's talk about them . "

Question 83 A client with gallstones has been prescribed ursodeoxycholic acid ( UDCA ) . The nurse understands that additional teaching is needed regarding this medication when the client states :

" I will take this medication for 2 weeks and then gradually stop taking it . "

Question 10 A nurse is teaching a client recovering from addisonian crisis about the need to take fludrocortisone acetate and hydrocortisone at home . Which statement by the client indicates an understanding of the instructions ?

" I'll take two - thirds of the dose when I wake up and one - third in the late afternoon . "

Question 69 A nurse is preparing a client for endoscopic retrograde cholangiopancreatography ( ERCP ) . The client asks what this test is used for . Which statements by the nurse explains how ERCP can determine the difference between pancreatitis and other biliary disorders ? Select all that apply .

" It can evaluate the presence and location of ductal stones and aid in stone removal . " " It can assess the anatomy of the pancreas and the pancreatic and biliary ducts . " " It can detect unhealthy tissues in the pancreas and assess for abscesses and pseudocysts . "

Question 60 A client with rheumatoid arthritis expresses not feeling the need to take medication any longer since being in remission without symptoms . What is the best response by the nurse ?

" It is important that you continue to take your medication to avoid an acute exacerbation . "

Question 16 A client asks the nurse what the difference is between osteoarthritis ( OA ) and rheumatoid arthritis ( RA ) . Which response is correct ?

" OA is a noninflammatory joint disease . RA is characterized by inflamed , swollen joints .

Question 32 A client who has been exposed to the human immunodeficiency virus ( HIV ) tests negative . Which explanation by the nurse would be most appropriate ?

" Your body may not have developed antibodies yet , so we need to follow up . "

Question 46 A nursing student has been assigned to care for a client with pancreatic cancer . The student is aware that the risk for pancreatic cancer is most directly proportional to

Age

Question 87 A client is brought to the ED by paramedics , who report that the client has partial - thickness burns on the chest and legs . The client has also suffered smoke inhalation . What is the priority in the care of a client who has been burned and suffered smoke inhalation ?

Airway management

Question 51 Which of the following is the most severe form of hypersensitivity reaction ?

Anaphylaxis

Question 42 A client with calculi in the gallbladder is said to have

Cholelithiasis

Question 11 Which findings indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus ?

Confusion and seizures Correct response

Question 64 What interventions can the nurse encourage the client with diabetes insipidus to do in order to control thirst and compensate for urine loss ?

Consume adequate amounts of fluid .

Question 5 When preparing a client with acquired immunodeficiency syndrome ( AIDS ) for discharge to home , the nurse should be sure to include which instruction ?

" Avoid sharing such articles as toothbrushes and razors . "

Question 65 A client with end - stage renal disease is scheduled to undergo a kidney transplant using a sibling donated kidney . The client asks if immunosuppressive drugs can be avoided . Which is the best response by the nurse ?

" Even a perfect match does not guarantee organ success . "

Question 111 A client's assessment and diagnostic testing are suggestive of acute pancreatitis . When the nurse is performing the health interview , what assessment question ( s ) addresses likely etiologic factors ? Select all that apply .

" How many alcoholic drinks do you typically consume in a week ? " " Have you ever been tested for diabetes ? " " Have you ever been diagnosed with gallstones ? " Would you say that you eat a particularly high - fat diet ? "

Question 90 A patient develops gastrointestinal bleeding from a gastric ulcer and requires blood transfusions . The patient states to the nurse , " I am not going to have a transfusion because I don't want to get AIDS . " What is the best response by the nurse ?

" I understand your concern . The blood is screened very carefully for different viruses as well as HIV . "

A nurse is providing dietary instructions to a client with a history of pancreatitis . Which instruction is correct ?

" Maintain a high - carbohydrate , low - fat diet . "

Question 54 Azathioprine ( Imuran ) has been prescribed for the client with severe rheumatoid arthritis . The dose prescribed is 2 mg / kg / day orally in two divided doses . The medication available is a 50 - mg scored tablet . The client weighs 110 pounds . How many milligrams will the nurse prepare per dose for the client ?

50

Question 43 Pharmacologic therapy frequently is used to dissolve small gallstones . It takes about how many months of medication with UDCA or CDCA for stones to dissolve ?

6 to 12

Question 94 A patient is ordered desmopressin ( DDAVP ) for the treatment of diabetes insipidus . What therapeutic response does the nurse anticipate the patient will experience ?

A decrease in urine output

Question 36 Which client is more at risk of becoming infected with human immunodeficiency virus ( HIV ) ?

A person having casual intercourse with multiple partners

Question 13 Before discharge , what should a nurse instruct a client with Addison's disease to do when exposed to periods of stress ?

Administer hydrocortisone I.M.

Question 110 What concepts does the nurse understand about gerontologic considerations related to acute pancreatitis ? Select all that apply .

As the client ages , there is an increased mortality rate for acute pancreatitis . As the client ages , there is an increased risk for the development of multiple organ dysfunction syndrome . As the client ages , the pattern of complications related to acute pancreatitis changes .

Question 92 A client with an arm cast reports pain . What nursing interventions should the nurse provide in order to reduce the incidence of complications ? Select all that apply .

Assess the fingers for color and temperature . Assess for a pressure sore Determine the exact site of the pain .

Question 95 The nurse is monitoring for fluid and electrolyte changes in the emergent phase of burn injury for a patient . Which of the following will be an expected outcome ? Select all that apply .

Base - bicarbonate deficit Elevated hematocrit level Sodium deficit

Question 84 The nurse is caring for a client who has just returned from the ERCP removal of gallstones . The nurse should monitor the client for signs of what complications ?

Bleeding and perforation

Question 66 The nurse recognizes that many risk factors exist for the development of hypovolemic shock . Which are considered " internal " risk factors ? Select all that apply .

Burns Dehydration

Question 41 Which of the following is a common complication of an electrical burn injury ?

Cardiac dysrhythmias

Question 6 A client is diagnosed with syndrome of inappropriate antidiuretic hormone ( SIADH ) . The nurse informs the client that the physician will order diuretic therapy and restrict fluid and sodium intake to treat the disorder . If the client doesn't comply with the recommended treatment , which complication may arise ?

Cerebral edemal

Question 71 Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex ?

Cushing syndrome

Question 104 A nurse cares for a client who has secondary obesity . Which condition is the most likely to result in secondary obesity ?

Cushing's disease

Question 22 Which is an age - related change of the hepatobiliary system ?

Decreased blood flow

Question 59 A client received 2 units of packed red blood cells while in the hospital with rectal bleeding . Three days after discharge , the client experienced an allergic response and began to itch and break out with hives . What type of reaction does the nurse understand could be occurring ?

Delayed hypersensitivity response

Question 88 What should the nurse suspect when hourly assessment of urine output on a client post craniotomy exhibits a urine output from a catheter of 1,500 mL for two consecutive hours ?

Diabetes insipidus

Question 63 A client sustained a head injury when falling from a ladder . While in the hospital , the client begins voiding large amounts of clear urine and reports being very thirsty . The client states feeling weak and having experienced an 8 - pound weight loss since admission . What condition does the nurse expect the client to be tested for ?

Diabetes insipidus ( DI )

Question 101 The nurse cares for a client with gallstones that need to be removed but is not a surgical candidate or endoscopic candidate . What procedure does the nurse recognize as being a possible treatment option for the client ?

ESWL

Question 82 A client has been treated in the hospital for an episode of acute pancreatitis . The client has acknowledged the role that his alcohol use played in the development of his health problem , but has not expressed specific plans for lifestyle changes . What is the nurse's most appropriate response ?

Encourage the client to connect with a community - based support group .

Question 62 The nurse is caring for a client suspected of having stones that have collected in the common bile duct . What test should the nurse prepare the client for that will locate these stones ?

Endoscopic retrograde cholangiopancreatography ( ERCP )

Question 80 The nurse providing care for a client with Cushing syndrome has identified the nursing diagnosis of risk for injury related to weakness . How should the nurse best reduce this risk ?

Establish fall - prevention measures .

Question 39 A client with rheumatoid arthritis is prescribed a tumor necrosis factor ( TNF ) -alpha inhibitor . What medication might be prescribed ?

Etanercept

Question 78 A client with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion ( SIADH ) is being cared for on the critical care unit . What is the priority nursing diagnosis for a client with this condition ?

Excess fluid volume

Question 24 Which is a clinical manifestation of diabetes insipidus ?

Excessive thirst

Question 12 A nurse should perform which intervention for a client with Cushing's syndrome ?

Explain that the client's physical changes are a result of excessive corticosteroids .

Question 53 Stress ulcers occur frequently in acutely ill patient . Which of the following medications would be used to prevent ulcer formation ? Select all that apply .

Famotidine ( Pepcid ) Nizatidine Lansoprazole

Question 107 A gerontologic nurse is assessing a client who has numerous comorbid health problems . What assessment finding ( s ) should prompt the nurse to suspect a UTI ? Select all that apply .

Fever New onset of confusion .

Question 89 The nurse is caring for a client who has developed SIADH . What intervention is most appropriate ?

Fluid restriction

Question 73 The nurse is caring for a client who has a diagnosis of syndrome of inappropriate antidiuretic hormone secretion ( SIADH ) . The plan of care includes assessment of specific gravity every 4 hours . The results of this test will allow the nurse to assess what aspect of the client's health ?

Fluid volume status

Question 100 Chemical burns of the eye are immediately treated by :

Flushing the lids , conjunctiva , and cornea with tap water or normal saline .

Question 114 A nurse is caring for a client with mildlacute pancreatitis . Which health care provider prescriptions will the nurse question as it relates to evidence - based practices in the treatment of acute pancreatitis ? Select all that apply .

Full liquid diet as tolerated . Nasogastric tube to intermittent wall suction for removal of gastric secretions . Initiate enteral feedings if tolerated .

Question 102 A client with suspected biliary obstruction due to gallstones reports changes to the color of his stools . Which stool color does the nulse recognize as common to biliary obstruction ?

Gray

Question 113 The nurse cares for a client with extensive burn injuries . Which parameter ( s ) would the nurse evaluate to determine if the client is receiving adequate fluid resuscitation ? Select all that apply .

Heart rate Urine output

Question 79 The health care provider has ordered a fluid deprivation test for a client suspected of having diabetes insipidus . During the test , the nurse should prioritize what assessments ?

Heart rate and blood pressure

Question 17 A client is admitted to undergo lumbar laminectomy for treatment of a herniated disk . Which action should the nurse take first to promote comfort preoperatively ?

Help the client assume a more comfortable position .

Question 98 A patient is diagnosed with Addison's disease , a condition that results in insufficient production of cortisol . Which of the following is the most important function of cortisol that the nurse needs to consider when caring for a patient with Addison's disease ?

Helps the body adjust to stress

Question 77 A nurse caring for a client with diabetes insipidus is reviewing laboratory results . What is an expected urinalysis finding ?

Highly dilute urine

Question 50 A patient has been placed on corticosteroid therapy for an Addison's disease . The nurse should be aware of which of the following side effects with this type of therapy ? Select all that apply .

Hypertension Alterations in glucose metabolism Poor wound healing

Question 109 A client has experienced several autoimmune disorders over the last 25 years , and lately has developed a new set of symptoms . What assessments would the nurse expect to find with a client with suspected Addison disease ? Select all that apply .

Hypoglycemia Depression Hypotension

Question 37 A nurse is caring for a client diagnosed with human immunodeficiency virus ( HIV ) . The client wants to know when medication for the disease will begin . What is the nurse's best response ?

If the client has a CD4 T - cell count less than 350 cells / mm³ .

Question 103 Which are true about Lyme disease ? Select all that apply .

If untreated , the disease moves through three stages . Early stage symptoms may include a red macule or papule at the site of the tick bite , a characteristic bullseye rash with round rings around the center , headache , neck stiffness , pain , fever , chills , malaise , nausea , vomiting , and sore throat . Cardiac and neurologic symptoms occur mid - stage , followed by arthritis and joint problems .

Question 45 A student nurse is preparing a plan of care for a client with chronic pancreatitis . What nursing diagnosis related to the care of a client with chronic pancreatitis is the priority ?

Impaired nutrition : less than body requirements response

Question 61 The nurse is caring for a client with chronic pancreatitis . Which symptom would indicate the client has developed secondary diabetes ?

Increased appetite and thirst

Question 3 When planning care for a client with burns on the upper torso , which nursing diagnosis should take the highest priority ?

Ineffective airway clearance related to edema of the respiratory passages

Question 8 Which sign suggests that a client with the syndrome of inappropriate antidiuretic hormone ( SIADH ) secretion is experiencing complications ?

Jugular vein distention .

Question 85 A client with ongoing back pain , nausea , and abdominal bloating has been diagnosed with cholecystitis secondary to gallstones . The nurse should anticipate that the client will undergo what intervention ?

Laparoscopic cholecystectomy

Question 18 A client was undergoing conservative treatment for a herniated nucleus pulposus , at L5 - S1 , which was diagnosed by magnetic resonance imaging . Because of increasing neurologic symptoms , the client undergoes lumbar laminectomy . The nurse should take which step during the immediate postoperative period ?

Logroll the client from side to side .

Question 38 From the following profiles of clients , which client would be most likely to undergo the diagnostic test of cholecystography ?

Mark , suspected of having stones in the gallbladder

Question 44 A client is receiving long - term treatment with high - dose corticosteroids . Which of the following would the nurse expect the client to exhibit ?

Moon face

Question 96 A nurse is assessing a patient's urinary output as an indicator of diabetes insipidus . The nurse knows that an hourly output of what olume over 2 hours may be a positive indicator ?

More than 200 ml / h

Question 56 Which assessment would a nurse perform on a client with Cushing syndrome who is at high risk of developing a peptic ulcer ?

Observe stool color .

Question 81 The nurse is caring for a client at risk for an addisonian crisis . For what associated signs and symptoms should the nurse monitor the client ? Select all that apply .

Pallor Rapid respiratory rate Hypotension

Question 33 A nurse is preparing a presentation to a local community group about allergic disorders . Which medication would the nurse include as the most common cause of anaphylaxis ?

Penicillin

Question 68 A nurse is teaching a client about the cause of acute pancreatitis . The nurse evaluates the teaching as effective when the client correctly identifies which condition as a cause of acute pancreatitis ?

Self - digestion of the pancreas by its own proteolytic enzymes

Question 35 A client at the walk - in clinic reports exposure to human immunodeficiency virus ( HIV ) . The client wants to know the precise sources through which the HIV infection is transmitted . What is the nurse's best response ?

Semen

Question 9 A nurse is caring for a client in acute addisonian crisis . Which test result does the nurse expect see ?

Serum potassium level of 6.8 mEq / L

Question 7 A client is diagnosed with syndrome of inappropriate antidiuretic hormone ( SIADH ) . The nurse should anticipate which laboratory test result ?

Serum sodium level of 124 mEq / L

Question 93 The nurse is admitting a patient to the intensive care unit with a diagnosis of acute pancreatitis . What does the nurse expect was the reason the patient came to the hospital ?

Severe abdominal pain

Question 67 The nurse is conducting a musculoskeletal assessment on a client documented to have rheumatoid arthritis . Which would the nurse anticipate finding when inspecting the client's fingers ?

Soft , subcutaneous nodules along the tendons

Question 105 A client has undergone a renal transplant and returns to the health care agency for a follow - up evaluation . Which finding would lead to the suspicion that the client is experiencing rejection ?

Tenderness over transplant site

Question 106 A client with severe environmental allergies is scheduled for an immunotherapy injection . What should be included in teaching the client about this treatment ?

The client will remain in the clinic to be monitored for 30 minutes following the injection .

Question 25 Which statement reflects treatment of HIV infection ?

Treatment of HIV infection for an individual client is based on the client's clinical condition , CD4 T cell count , and HIV RNA ( viral load ) .

Question 55 The nurse has four clients that come to the clinic for healthcare . Which client has the highest risk factor for HIV infection ?

a 26 - year - old inmate who receives tattoos in prison

Question 57 A middle - aged obese female presents to the ED with severe radiating right - sided flank pain , nausea , vomiting , and fever . A likely cause of these symptoms is :

acute cholecystitis

Question 58 A client with acute pancreatitis has jaundice with diminished bowel sounds and a tender distended abdomen . Additionally , lab results indicate hypovolemia . What will the physician order to treat the large amount of protein - rich fluid that has been released into the client's tissues and peritoneal cavity ? Select all that apply .

diuretics albumin

Question 112 Specific potential complications are common to specific types of burns . Which burns can impair ventilation ?

face , neck , chest

Question 52 The nurse is working with a client with allergies . What will the nurse use to confirm allergies and decrease the risk of anaphylaxis ?

intradermal testing

Question 26 Osteoarthritis is known as a disease that .

is the most common and frequently disabling of joint disorders .

Question 19 A nurse is working on a surgical floor . The nurse must logroll a client following a :

laminectomy .

Question 108 A client comes to the emergency department complaining of difficulty breathing and feeling strange after eating a shrimp cocktail . The client is leaning forward with a respiratory rate of 36 breaths per minute . The nurse suspects anaphylaxis . What is the nurse's priority action ?

maintaining an open airway

Question 21 A nurse receives her client care assignment . Following the report , she should give priority assessment to the client :

who , following a kidney transplant , has returned from hemodialysis with a sodium level of 110 mEq / L and a potassium level of 2.0 mEq / L .