NUR 408 - Exam 3 - Book Questions
A nurse is teaching a postmenopausal patient taking estrogen/progestin therapy (EPT) about breast self-examination (BSE). Which of these instructions should the nurse give? "There are no risks for breast cancer, so BSE is not necessary." "Do your breast self-examination the first day of each month." "Examine your breasts by looking at them in the mirror." "Feel each breast while lying on the opposite side."
"Do your breast self-examination the first day of each month."
Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same syringe? "Draw up the clear regular insulin first, followed by the cloudy NPH insulin." "It is not necessary to rotate the NPH insulin vial when it is mixed with regular insulin." "The order of drawing up insulin does not matter as long as the insulin is refrigerated." "Rotate subcutaneous injection sites each day among the arm, thigh, and abdomen."
"Draw up the clear regular insulin first, followed by the cloudy NPH insulin."
Which of these instructions should a nurse give a patient who is to start taking clomiphene [Clomid]? "You'll need an injection of this medication 2 days before ovulation." "Have intercourse every other day for 5 to 10 days after the last dose of this medication." "It is necessary to have weekly blood draws to monitor the effects on your liver." "You'll have to have a bone density test periodically, because osteoporosis is more likely."
"Have intercourse every other day for 5 to 10 days after the last dose of this medication."
The nurse is providing teaching regarding Duavee (conjugated estrogens/bazedoxifene). Which statement by the patient indicates that the teaching was effective? "I know I am at an additional risk for increased growth of my uterus lining." "I understand that the combination product should help protect me from the side effects of the estrogen." "I will have to set an alarm to take my medication four times per day." "I am prepared to take this medication for the rest of my life."
"I understand that the combination product should help protect me from the side effects of the estrogen."
A patient has been given instructions about levothyroxine [Synthroid]. Which statement by the patient indicates understanding of these instructions? "I'll take this medication in the morning so as not to interfere with sleep." "I'll plan to double my dose if I gain more than 1 pound per day." "It is best to take the medication with food so I don't have any nausea." "I'll be glad when I don't have to take this medication in a few months."
"I'll take this medication in the morning so as not to interfere with sleep."
A patient with Graves' disease is treated with iodine-131 therapy. Which statement by the patient would indicate understanding of the treatment's effects? "I'll have to isolate myself from my family so I don't expose them to radiation." "I'm looking forward to feeling better immediately after this treatment." "I'll tell my doctor if I have fatigue, hair loss, or cold intolerance." "I'll need to take this drug on a daily basis for at least 1 year."
"I'll tell my doctor if I have fatigue, hair loss, or cold intolerance."
A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse? "Inject this insulin with your first bite of food, because it is very fast acting." "The duration of action for this insulin is about 8 to 10 hours, so you'll need a snack." "This insulin needs to be mixed with regular insulin to enhance the effects." "To achieve tight glycemic control, this is the only type of insulin you'll need."
"Inject this insulin with your first bite of food, because it is very fast acting."
A patient is receiving desmopressin [DDAVP] for the treatment of diabetes insipidus. Which instruction is the priority for a nurse to give the patient? "Reduce your water intake to prevent water intoxication." "Rotate the nostril you use daily to prevent irritation." "Weigh yourself several times each week." "You'll quickly see the results of a lower urine amount."
"Reduce your water intake to prevent water intoxication."
The nurse is teaching the patient about oral steroid therapy. Which statement by the patient indicates a need for further teaching? "I can take my full dose in the morning." "I can break up my dose and take some in the afternoon if I get tired." "I understand that I shouldn't experience many adverse effects." "When I am traveling for work I will take lower doses."
"When I am traveling for work I will take lower doses."
The patient states that when he takes hydrocortisone 24 mg in the morning, he is very tired by mid-afternoon. Which statement by the nurse is correct? "You can take 12 mg in the morning and 12 mg at night." "You can take 24 mg at night instead." "You can take 16 mg in the morning and 8 mg in the afternoon." "This is an adverse effect and you should stop taking the medication."
"You can take 16 mg in the morning and 8 mg in the afternoon."
Which statement is the most important for a nurse to make to a patient who is taking methimazole? "You need to notify your doctor if you have a sore throat and fever." "Another medication can be given if you experience any nausea." "You may experience some muscle soreness with this medicine." "Headache and dizziness may occur but not very frequently."
"You need to notify your doctor if you have a sore throat and fever."
The healthcare provider orders octreotide [Sandostatin LAR] 250 mcg IM now. The available medication is octreotide [Sandostatin LAR] 1000 mcg/mL. The nurse plans to administer how much? 0.25 mL 0.5 mL 1.25 mL 4 mL
0.25 mL
The healthcare provider orders hydrocortisone sodium succinate [Solu-Cortef] 500 mg IV now. The available medication is hydrocortisone sodium succinate [Solu-Cortef] 1000 mg/mL. How many mL will the nurse administer? 0.25 mL 0.5 mL 0.75 mL 2 mL
0.5 mL
The healthcare provider orders 150 mcg of levothyroxine [Synthroid] PO every morning. The medication available is levothyroxine [Synthroid] 75-mcg tablets. How many tablets will the nurse administer? 0.5 1 2 4
2
A nurse assesses the urine output of a patient receiving oxytocin [Pitocin]. Which finding would require immediate follow-up by the nurse? 80 mL in the past 4 hours 250 mL in the past 8 hours 150 mL in the past hour 400 mL in the past 12 hours
80 mL in the past 4 hours
Which patient may be given progestin therapy during pregnancy? A woman who is 8 weeks pregnant and diagnosed with corpus luteum deficiency syndrome A woman pregnant with triplets during her first pregnancy A woman experiencing severe nausea and vomiting during pregnancy A woman who is trying to achieve pregnancy through planned intercourse
A woman who is 8 weeks pregnant and diagnosed with corpus luteum deficiency syndrome
A nurse caring for a patient who has diabetic ketoacidosis recognizes which characteristics in the patient? (Select all that apply.) Type 2 diabetes Altered fat metabolism leading to ketones Arterial blood pH of 7.35 to 7.45 Sudden onset, triggered by acute illness Plasma osmolality of 300 to 320 mOsm/L
Altered fat metabolism leading to ketones Sudden onset, triggered by acute illness Plasma osmolality of 300 to 320 mOsm/L
Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are products of which structure? Hypothalamus Anterior pituitary gland Posterior pituitary gland Ovaries
Anterior pituitary gland
A nurse should report which finding of ovarian hyperstimulation in a woman receiving menotropins? Hirsutism and acne Ascites and weight gain Engorgement of breasts Scant and viscous cervical mucus
Ascites and weight gain
A nurse is developing a plan of care for a patient who has Addison's disease and is taking hydrocortisone [Cortef]. Which of these outcomes should receive priority in the plan? At times of stress, the patient increases the glucocorticoid dose. The patient wears a Medic Alert bracelet at all times. The patient carries an injectable form and an oral form of glucocorticoid. The patient divides the daily dose, taking two-thirds of it in the morning and one-third in the afternoon.
At times of stress, the patient increases the glucocorticoid dose.
A pediatric patient has gigantism caused by excess growth hormone (GH). Which finding would indicate to the nurse that the patient has developed an additional complication related to this condition? Blood glucose below 70 mg/dL Elevation of liver function test results Atrophy of sweat glands Enlarged heart on chest x-ray
Atrophy of sweat glands
A nurse should consider which diagnostic test a priority to obtain before a patient receives iodine-131? White blood cell (WBC) count Electrocardiogram (ECG) Beta human chorionic gonadotropin (hCG) test Creatinine level
Beta human chorionic gonadotropin (hCG) test
A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these outcomes related to the therapeutic effects of the medication? Blood glucose control for 24 hours Mealtime coverage of blood glucose Less frequent blood glucose monitoring Peak effect achieved in 2 to 4 hours
Blood glucose control for 24 hours
A patient in cardiac arrest receives vasopressin [Pitressin] during cardiopulmonary resuscitation (CPR). An increase in which finding would indicate a desired effect of the medication? Respiratory rate Blood pH Blood pressure Body temperature
Blood pressure
A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse take? Take the patient's blood pressure. Give the patient's PRN dose of insulin. Check the patient's capillary blood sugar. Advise the patient to lie down with the legs elevated.
Check the patient's capillary blood sugar.
The nurse would expect the healthcare provider to prescribe which of these medications, along with hCG, to promote ovulation in selected infertile women? Leuprolide [Lupron] Nafarelin [Synarel] Clomiphene [Clomid] Cabergoline [Dostinex]
Clomiphene [Clomid]
A nurse administers dexamethasone [Decadron], 1 mg, at 11:00 PM to a patient who has suspected adrenal dysfunction. The nurse obtains blood for which of these laboratory tests at 8:00 AM the next morning? Potassium Cortisol Glucose Sodium
Cortisol
Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value? Creatinine (Cr) level of 2.1 mg/dL Hemoglobin (Hgb) level of 9.5 gm/dL Sodium (Na) level of 131 mEq/dL Platelet count of 120,000/mm3
Creatinine (Cr) level of 2.1 mg/dL
When evaluating the effects of ergonovine [Ergotrate], the nurse expects which assessment finding? Suppressed milk reflex Decreased blood pressure Decreased uterine tone Decreased vaginal bleeding
Decreased vaginal bleeding
A nurse develops a plan of care for a pregnant patient receiving nifedipine [Procardia]. Which outcome should be included? Cervix shows softening and dilation. Whole blood glucose is 110 mg/dL or less. Delivery is postponed for at least 24 hours. Breasts are soft with no evidence of engorgement.
Delivery is postponed for at least 24 hours.
Progestins may be used to treat which conditions? (Select all that apply.) Endometrial hyperplasia Dysfunctional uterine bleeding Endometriosis Breast cancer Amenorrhea
Endometrial hyperplasia Dysfunctional uterine bleeding Endometriosis Amenorrhea
The nurse is aware that goserelin [Zoladex] has several uses, including which? (Select all that apply.) Endometriosis Dysfunctional uterine bleeding Prostate cancer Breast cancer Miscarriage prevention
Endometriosis Dysfunctional uterine bleeding Prostate cancer Breast cancer
A patient who has Cushing's syndrome is taking ketoconazole [Nizoral] as an adjunct treatment to brain radiation. A nurse should expect the patient to have which of these therapeutic responses? Increased resistance to infection Enhanced radiation effect to the brain Suppressed cortisol synthesis Increased ACTH production
Enhanced radiation effect to the brain
A patient reports unfavorable mucus. The healthcare provider would be expected to prescribe which medication to restore cervical mucus to its proper volume and consistency? hCG Progestin Estrogen Clomiphene [Clomid]
Estrogen
Which finding in a patient taking levothyroxine [Synthroid] and warfarin [Coumadin] would require follow-up by a nurse? Cardiac dysrhythmias Excessive bruising Weight loss of 5 kg Shortness of breath
Excessive bruising
The nurse is planning care for a patient with signs of acute adrenal insufficiency. What is the priority nursing diagnosis? Altered comfort Altered nutrition Fluid volume deficit Activity intolerance
Fluid volume deficit
Which nursing diagnosis should be the priority for a patient who is receiving desmopressin [DDAVP]? Activity intolerance Alteration in comfort Fluid volume imbalance Deficient knowledge
Fluid volume imbalance
When evaluating the effects of leuprolide [Lupron] in a patient who has endometriosis, a nurse should monitor the laboratory results for which hormone or hormones? Testosterone Human chorionic gonadotropin (hCG) Prolactin Follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
Follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
A patient who is infertile is taking clomiphene [Clomid]. A nurse should expect the patient to have which therapeutic response? Follicular maturation Ovarian hyperstimulation Regression of endometriosis Lower androgen levels
Follicular maturation
A nurse who is assessing a patient with polycystic ovary syndrome (PCOS) would expect to observe which findings? (Select all that apply.) High blood glucose levels Infertility Absence of menstrual cycles Weight loss Hypothyroidism
High blood glucose levels Infertility Absence of menstrual cycles
Which of these findings, if identified in a patient receiving ergonovine [Ergotrate], should a nurse report to a physician immediately? Tremors Hypertension Uterine cramping Hypoglycemia
Hypertension
A nurse is caring for a patient with decreased triiodothyronine (T3) and thyroxine (T4) and elevated thyroid-stimulating hormone (TSH) levels. The nurse knows the patient is likely suffering from what? Thyrotoxicosis Hypothyroidism Hyperthyroidism Graves' disease
Hypothyroidism
Which statements about hydrocortisone are correct? (Select all that apply.) It is a synthetic steroid identical to cortisol. It is a preferred drug for adrenocortical insufficiency. It has glucocorticoid and mineralocorticoid actions. It is given IV for chronic replacement therapy. It should not be given during times of stress.
It is a synthetic steroid identical to cortisol. It is a preferred drug for adrenocortical insufficiency. It has glucocorticoid and mineralocorticoid actions.
Which beneficial metabolic effects does estrogen have in nonreproductive tissues? (Select all that apply.) It promotes and suppresses coagulation. It improves glomerular filtration rates. It reduces low-density lipoproteins (LDLs). It suppresses bone resorption. It reduces fat deposits in the liver.
It promotes and suppresses coagulation. It reduces low-density lipoproteins (LDLs). It suppresses bone resorption.
A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse explains that normal insulin has which action in the body? It stimulates the pancreas to reabsorb glucose. It promotes the synthesis of amino acids into glucose. It stimulates the liver to convert glycogen to glucose. It promotes the passage of glucose into cells for energy.
It promotes the passage of glucose into cells for energy.
An adult patient who has GH deficiency is receiving somatropin [Nutropin]. An increase in which finding would indicate to the nurse that the patient is improving? Height (by 3 inches) Lean body mass Physical strength Joint range of motion
Lean body mass
Which statements about levothyroxine [Synthroid] are correct? (Select all that apply.) Levothyroxine should be taken with food. Levothyroxine can be given by IV but is usually taken orally. Levothyroxine brands should not be changed if possible. Levothyroxine should be taken at night to avoid adverse effects. Levothyroxine can affect the metabolism of other medications.
Levothyroxine can be given by IV but is usually taken orally. Levothyroxine brands should not be changed if possible. Levothyroxine can affect the metabolism of other medications.
A patient is taking fludrocortisone [Florinef]. A nurse should recognize that the patient is at risk for developing an electrolyte imbalance if the patient reports which symptom? Syncope Weight loss Muscle weakness Numbness and tingling
Muscle weakness
Which nursing action is the priority for a patient in preterm labor who is receiving magnesium sulfate? Documenting body temperature Obtaining deep tendon reflexes Measuring intake and output Monitoring the intensity of contractions
Obtaining deep tendon reflexes
When assessing a patient who has Cushing's syndrome, a nurse associates which clinical manifestations with this disorder? (Select all that apply.) Osteoporosis Moon face Glycosuria Ketonuria Mood swings
Osteoporosis Moon face Glycosuria Mood swings
During the follicular phase of the menstrual cycle, estrogen has which effects on the female reproductive organs? Maturation of a corpus luteum Ripening of an ovarian follicle Proliferation of the endometrium Monthly menstrual bleeding
Proliferation of the endometrium
A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect? Inhibition of carbohydrate digestion Promotion of insulin secretion Decreased insulin resistance Inhibition of ketone formation
Promotion of insulin secretion
What is the primary difference between the selective estrogen receptor modulators tamoxifen and raloxifene? Raloxifene does not protect against breast cancer. Raloxifene does not produce hot flashes. Raloxifene does not increase the risk for uterine cancer. Raloxifene does not increase the risk for thromboembolism.
Raloxifene does not increase the risk for uterine cancer.
A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which change to the nursing care plan? Refer the patient to a diabetes educator because the result reflects poor glycemic control. Glycemic control is adequate; no changes are needed. Hypoglycemia is a risk; teach the patient the symptoms. Instruct the patient to limit activity and weekly exercise.
Refer the patient to a diabetes educator because the result reflects poor glycemic control.
Which action should a nurse take when a pregnant patient develops uterine contractions after receiving dinoprostone [Cervidil] into the vaginal system? Remove the insert using the long tape. Keep the patient supine for 2 hours. Prepare for immediate delivery. Administer a tocolytic agent.
Remove the insert using the long tape.
A patient takes fluoxetine [Prozac] for premenstrual disorder (PMD). Which priority assessment allows the nurse to evaluate the effectiveness of this treatment? Decreased craving for carbohydrates Reduction in breast tenderness Less abdominal bloating Reports of mood improvement
Reports of mood improvement
Which outcome should a nurse establish for a patient who has acromegaly and is receiving octreotide [Sandostatin]? Normal urine volume Softening of facial features Increase in long-bone growth Stimulation of the milk reflex
Softening of facial features
A patient who is near term gestation is receiving oxytocin [Pitocin]. Which response should the nurse expect if the medication is having the desired therapeutic effect? Decreased force of uterine contraction Promotion of cervical ripening Stimulation of uterine smooth muscle Inhibition of milk ejection reflex
Stimulation of uterine smooth muscle
A nurse assesses a patient who is taking pramlintide [Symlin] with mealtime insulin. Which finding requires immediate follow-up by the nurse? Skin rash Sweating Itching Pedal edema
Sweating
A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is teaching hypoglycemia awareness and should warn the patient about the presence of which symptom? Vomiting Muscle cramps Tachycardia Chills
Tachycardia
Which manifestations should a nurse investigate first when monitoring a patient who is taking levothyroxine [Synthroid]? Tachycardia Tremors Insomnia Irritability
Tachycardia
The Women's Health Initiative (WHI) landmark trial data led to which recommendations about hormone replacement therapy? (Select all that apply.) There are benefits to using HRT short term to reduce vasomotor symptoms. Postmenopausal women should avoid smoking, exercise regularly, and control hypertension. Estrogen/progestin therapy (EPT) is preferred as the primary treatment to prevent loss of bone mass. Estrogen and progesterone should be used only to prevent cardiovascular events. Treatment with HRT for longer than 5 years increases the risk for pulmonary embolus and stroke.
There are benefits to using HRT short term to reduce vasomotor symptoms. Postmenopausal women should avoid smoking, exercise regularly, and control hypertension. Treatment with HRT for longer than 5 years increases the risk for pulmonary embolus and stroke.
The patient reports that she had to switch pharmacies to save money. She noticed that her "thyroid pill" looks different. The nurse anticipates that the healthcare provider will order what? Thyroid stimulating hormone (TSH) Electrocardiogram (ECG) Beta human chorionic gonadotropin (hCG) test Creatinine level
Thyroid stimulating hormone (TSH)
Which therapeutic effect is the purpose of a progestin medication in menopausal hormone therapy (HT)? To reduce urogenital atrophy To suppress endometrial proliferation To relieve vasomotor symptoms To prevent adverse cardiac events
To suppress endometrial proliferation
Which manifestation would the nurse most clearly associate with a tumor of the hypothalamus? Mood swings Unstable body temperature Irregular respirations Increased heart rate
Unstable body temperature
A patient who has diabetes insipidus is receiving desmopressin [DDAVP]. Which laboratory test should a nurse obtain to evaluate the effectiveness of the medication? Urine ketones Blood urea nitrogen (BUN) Creatinine Urine specific gravity
Urine specific gravity
