medsurg CAQs #2
A client with type 1 diabetes is transported via ambulance to the emergency department of the hospital. The client has dry, hot, flushed skin and a fruity odor to the breath and is having Kussmaul respirations. Which complication does the nurse suspect that the client is experiencing? 1 Ketoacidosis 2 Somogyi phenomenon 3 Hypoglycemic reaction 4 Hyperosmolar nonketotic coma
1
Which is the target tissue for the parathyroid hormone? 1 Intestines 2 All body cells 3 Mammary glands 4 Sympathetic effectors
1
Which clinical findings should the nurse assess when caring for a client with hyperthyroidism? Select all that apply. 1 Lethargy 2 Tachycardia 3 Weight gain 4 Constipation 5 Exophthalmos
2, 5
Which clinical manifestation is found in a client with a deficiency of adrenocorticotropic hormone? 1 Anovulation 2 Dehydration 3 Malaise and lethargy 4 Menstrual abnormalities
3
Which assessment finding in a client signifies a mild form of hypocalcemia? 1 Seizures 2 Hand spasms 3 Severe muscle cramps 4 Numbness around the mouth
4
Which hormone is released from the posterior pituitary gland? 1 Oxytocin 2 Prolactin 3 Growth hormone 4 Luteinizing hormone
1
What other name can the nurse use for vasopressin? 1 Growth hormone 2 Luteinizing hormone 3 Antidiuretic hormone 4 Thyroid-stimulating hormone
3
What symptoms will the nurse identify when assessing a client with Graves disease? 1 Constipation, dry skin, and weight gain 2 Lethargy, weight gain, and forgetfulness 3 Weight loss, exophthalmos, and restlessness 4 Weight loss, protruding eyeballs, and lethargy
3
While a nurse is teaching a client with diabetes about food choices, the client states, "I do not like broccoli." Which food should the nurse suggest to substitute for broccoli? 1 Peas 2 Corn 3 Green beans 4 Mashed potato
3
Which cells does the nurse identify as producing thyrocalcitonin hormone? 1 Islet cells 2 Adrenal cells 3 Pituitary cells 4 Parafollicular cells
4
What are the primary causes of adrenal insufficiency? Select all that apply. 1 Hemorrhage 2 Tuberculosis 3 Pituitary tumors 4 Postpartum pituitary necrosis 5 Acquired immune deficiency syndrome
1, 2, 5
What will the nurse expect diagnostic studies of a client with Cushing syndrome to indicate? 1 Moderately increased serum potassium levels 2 Increased numbers of eosinophils in the blood 3 High levels of 17-ketosteroids in a 24-hour urine test 4 Normal to low levels of adrenocorticotropic hormone (ACTH)
3
A client is admitted with a diagnosis of chronic adrenal insufficiency. Which roommate should be avoided when assigning a room for this client? 1 A young adult client with pneumonia 2 An adolescent client with a fractured leg 3 An older adult client who had a brain attack 4 A middle-aged client who has cholecystitis
1
A primary healthcare provider prescribes a low-sodium, high-potassium diet for a client with Cushing syndrome. Which explanation should the nurse provide to the client about the need to follow this diet? 1 "The use of salt probably contributed to the disease." 2 "Excess weight will be gained if sodium is not limited." 3 "The loss of excess sodium and potassium in the urine requires less renal stimulation." 4 "Excessive aldosterone and cortisone cause retention of sodium and loss of potassium."
4
Which feature in the client indicates hypersecretion of adrenocorticotrophic hormone? 1 Moon face 2 Lower jaw protrusion 3 Heat intolerance 4 Barrel-shaped chest
1
A nurse in the postanesthesia unit is caring for a client who had a thyroidectomy. Which client response is most important for the nurse to monitor? 1 Urinary retention 2 Signs of restlessness 3 Decreased blood pressure 4 Signs of respiratory obstruction
4
A client is diagnosed with hyperthyroidism, and surgery is scheduled because the client refuses ablation therapy. While awaiting the surgical date, what instruction should the nurse teach the client? 1 Consciously attempt to calm down. 2 Eliminate coffee, tea, and cola from the diet. 3 Keep the home warm, and use an extra blanket at night. 4 Schedule activities during the day to overcome lethargy.
2
The clinical findings of a client with diabetes mellitus show decreased glucose tolerance. Which complication is anticipated in the client? 1 Cystitis 2 Thin and dry skin 3 Decreased bone density 4 Frequent yeast infections
4
A client is admitted to the hospital with a diagnosis of cancer of the thyroid gland, and a thyroidectomy is performed. What should the nurse do during the first six to eight hours after surgery? 1 Place two pillows behind the client's head. 2 Monitor for the complication of tetany resulting from hypocalcemia. 3 Assess the sides and back of the client's neck for evidence of bleeding. 4 Encourage the client to perform deep-breathing and coughing exercises.
3
A nurse is caring for a client with Cushing syndrome. Which cardiovascular complication should the nurse assess for in this client? 1 Chest pain 2 Tachycardia 3 Hypertension 4 Atrial fibrillation
3
After surgical clipping of a ruptured cerebral aneurysm, a client develops the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). What manifestations are exhibited with excessive levels of antidiuretic hormone? 1 Increased blood urea nitrogen (BUN) and hypotension 2 Hyperkalemia and poor skin turgor 3 Hyponatremia and decreased urine output 4 Polyuria and increased specific gravity of urine
3
The nurse is providing care to a client being treated for bacterial cystitis. What is the goal before discharge for this client? 1 Understand the need to drink 4 L of water per day, an essential measure to prevent dehydration 2 Be able to identify dietary restrictions and plan menus 3 Achieve relief of symptoms and maintain kidney function 4 Recognize signs of bleeding, a complication associated with this type of procedure
3
A client with type 1 diabetes receives Humulin R insulin in the morning. Shortly before lunch the nurse identifies that the client is diaphoretic and trembling. What is the nurse's most appropriate action? 1 Administer insulin to the client 2 Give the client lunch immediately 3 Encourage the client to drink fluids 4 Assess the client's blood glucose level
4
A client has a history of hypothyroidism. Which skin condition should the nurse expect when performing a physical assessment? 1 Dry 2 Moist 3 Flushed 4 Smooth
1
A 24-hour urine test is prescribed for a client who has a tentative diagnosis of pheochromocytoma. What should the nurse do first? 1 Start the time of the test after discarding the first voiding. 2 Discard the last voiding in the 24-hour time period for the test. 3 Insert a urinary retention catheter to promote the collection of urine. 4 Strain the urine following each voiding before adding the urine to the container.
1
A nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. What interventions should the nurse include to decrease the risk of complications? Select all that apply. 1 Examine the feet daily 2 Wear well-fitting shoes 3 Perform regular exercise 4 Powder the feet after showering 5 Visit the primary healthcare provider weekly 6 Test bathwater with the toes before bathing
1, 2, 3
A client is admitted to the hospital for a thyroidectomy. In which position should the nurse maintain the client after surgery? 1 Prone 2 Supine 3 Left Sims 4 Semi-Fowler
4
A client who is taking an oral hypoglycemic daily for type 2 diabetes develops the flu and is concerned about the need for special care. What should the nurse instruct the client to do? 1 Skip the oral hypoglycemic pill, drink plenty of fluids, and stay in bed. 2 Avoid food, drink clear liquids, take a daily temperature, and stay in bed. 3 Eat as much as possible, increase fluid intake, and call the office again the next day. 4 Take the oral hypoglycemic pill, drink warm fluids, and perform a serum glucose test before meals and at bedtime.
4
A nurse is caring for a client with Addison's disease. Upon assessment, which classic sign will the nurse find? 1 Ecchymosis 2 Hyperreflexia 3 Exophthalmos 4 Hyperpigmentation
4
Which statement does the nurse know is true regarding the effects of parathyroid hormone on bones for the maintenance of calcium balance? 1 Increases bicarbonate and sodium excretion 2 Enhances absorption of calcium and phosphorous 3 Increases reabsorption of calcium and magnesium 4 Increases net release of calcium into extracellular fluid
4
A nurse working in the diabetes clinic is evaluating a client's success with managing the medical regimen. What is the best indication that a client with type 1 diabetes is successfully managing the disease? 1 Reduction in excess body weight 2 Stabilization of the serum glucose 3 Demonstrated knowledge of the disease 4 Adherence to the prescription for insulin
2
A client reports their lips feel thicker, as well as joint pain and coarse facial features. What should the nurse suspect as the cause of the anterior pituitary hyperfunction? 1 Excessive secretion of growth hormone 2 Excessive secretion of prolactin hormone 3 Excessive secretion of thyroid-stimulating hormone 4 Excessive secretion of adrenocorticotropic hormone
1
A nurse is assessing a client with Cushing syndrome. Which signs should the nurse expect the client to exhibit? Select all that apply. 1 Hirsutism 2 Round face 3 Pitting edema 4 Buffalo hump 5 Hypoglycemia
1, 2, 4
Which clinical findings are observed in a client suffering from an imbalance of adrenocorticotropic hormone? Select all that apply. 1 Anorexia 2 Hyponatremia 3 Slowed cognition 4 Postural hypotension 5 Decreased muscle strength
1, 2, 4
A nurse is caring for a client with hyperthyroidism. Which laboratory test will be most beneficial in monitoring the effectiveness of drug therapy? 1 Free thyroxine (FT4) 2 Thyroxine (T4), total 3 Free triiodothyronine (FT3) 4 Triiodothyronine (T3), total
2
In order to ensure a quality specimen and an accurate test result, which instruction should the nurse give a client who is scheduled to undergo urine endocrine testing? 1 "Start the urine collection when the bladder is full." 2 "Store the urine specimen in a cooler with ice." 3 "Store the urine specimen in a home refrigerator." 4 "Save the urine specimen that begins the collection."
2
When obtaining a health history from a client recently diagnosed with type 1 diabetes, the nurse expects the client to report what clinical manifestations? 1 Irritability, polydipsia, and polyuria 2 Polyuria, polydipsia, and polyphagia 3 Nocturia, weight loss, and polydipsia 4 Polyphagia, polyuria, and diaphoresis
2
The nurse is assessing a client suspected of having hypercortisolism. Which questions should the nurse ask to help confirm the diagnosis? Select all that apply. 1 "Did you lose any weight unintentionally?" 2 "Did you notice your extremities to be thin?" 3 "Did you notice any roughness of your skin?" 4 "Did you notice any skin darkening recently?" 5 "Did the hair on your body become thicker?"
2, 5
Which drug would be effective for the treatment of pituitary Cushing's syndrome? 1 Mitotane 2 Cabergoline 3 Cyproheptadine 4 Bromocriptine mesylate
3
A client who is 60 pounds (27.2 kilograms) more than the ideal body weight is admitted to the hospital with a diagnosis of type 1 diabetes. Which concept should the nurse include in teaching about diabetes when discussing strategies to lose weight? 1 Obesity leads to insulin resistance. 2 Surplus fat causes excretion of insulin. 3 Fat cells absorb insulin and prevent its circulation to other cells. 4 Lipids accumulate in the pancreas and interfere with insulin production.
1
A client with malignant hot nodules of the thyroid gland has a thyroidectomy. What is the nurse's priority action immediately postoperative? 1 Place in semi-Fowler's position to limit edema of the neck 2 Monitor intake and output strictly to assess for fluid overload 3 Encourage coughing and deep breathing to prevent atelectasis 4 Assess level of consciousness to determine recovery from anesthesia
1
A nurse explains to a client with diabetes that self-monitoring of blood glucose is preferred to urine glucose testing. Why is blood glucose monitoring preferred? 1 Blood glucose monitoring is more accurate. 2 Blood glucose monitoring is easier to perform. 3 Blood glucose monitoring is done by the client. 4 Blood glucose monitoring is not influenced by drugs.
1
A nurse is assessing a client admitted to the hospital with a tentative diagnosis of a pituitary tumor. What signs of Cushing syndrome does the nurse identify? 1 Retention of sodium and water 2 Hypotension and a rapid, thready pulse 3 Increased fatty deposition in the extremities 4 Hypoglycemic episodes in the early morning
1
Which action by the nurse while administering human growth hormone ensures effective therapy? 1 Administration at nighttime 2 Administration via oral route 3 Administration along with meals 4 Administration by metered spray
1
Which condition is characterized by hemorrhage after a pregnant female delivers? 1 Sheehan's syndrome 2 Cushing's syndrome 3 Addison's syndrome 4 Schwartz-Bartter syndrome
1
Which medical condition could most probably result in clients developing primary diabetes insipidus (DI)? 1 Meningitis 2 Brain tumor 3 Lithium therapy 4 Defect in hypothalamus
4
A nurse is planning to teach facts about hyperglycemia to a client with diabetes. What information should the nurse include in the discussion about what causes diabetic acidosis? 1 Breakdown of fat stores for energy 2 Ingestion of too many highly acidic foods 3 Excessive secretion of endogenous insulin 4 Increased amounts of cholesterol in the extracellular compartment
1
The nurse is teaching a client newly diagnosed with diabetes about the importance of glucose monitoring. Which blood glucose levels should the nurse identify as hypoglycemia? 1 68 mg/dL (3.8 mmol/L) 2 78 mg/dL (4.3 mmol/L) 3 88 mg/dL (4.9 mmol/L) 4 98 mg/dL (5.4 mmol/L)
1
