NURS 223 Questions
A 62-year-old female client presents to the emergency department and is diagnosed with acute heart failure syndrome. Which assessment finding would the nurse expect? A. Productive cough with frothy sputum. B. Shortness of breath and bradycardia. C. Increased urination and dry skin. D. Slowed breathing and dehydration.
A
A client has had severe heartburn associated with persistent gastroesophageal reflux for many years. Which statement made by the client leads the nurse to suspect the client is having a complication related to his reflux? The client is having: A. difficulty in swallowing with feelings that food is "stuck" in the throat. B. burning sensation a half-hour after a meal. C. substernal chest pain that radiates to the shoulder and arm. D. "hoarseness" unrelieved by coughing or taking a drink of water.
A
A client presents with a perforated peptic ulcer. Which complication would be a priority for the nurse to assess for? A. Assessment of a rigid, boardlike abdomen B. Flatulence with bouts of diarrhea C. Blood pressure of 120/80 mm Hg D. Complaint of burning pain on an empty stomach
A
A client who has been taking 80 mg of prednisone, a glucocorticoid, each day has been warned by his primary care provider to carefully follow a plan for the gradual reduction of the dose rather than stopping the drug suddenly. What is the rationale for this directive? A. Stopping the drug suddenly may cause acute adrenal insufficiency B. Stopping the drug suddenly may "shock" the HPA axis into overactivity C. Sudden cessation of a glucocorticoid can result in adrenal gland necrosis D. Sudden changes in glucocorticoid dosing may reverse the therapeutic effects of the drug
A
After several months of persistent heartburn, an adult client has been diagnosed with gastroesophageal reflux disease (GERD). Which treatment regimen is likely to be prescribed for this client's GERD? A. Proton pump inhibitors; avoiding large meals; remaining upright after meals B. Weight loss and administration of calcium channel blocking medications C. Anti-inflammatory medications; avoiding positions that exacerbate reflux; a soft-textured diet D. Surgical correction of the incompetent pylorus and limiting physical exercise
A
An older adult client with a history of severe constipation tells the nurse that he has been experiencing watery stool and fecal incontinence the last 2 days. The nurse suspects this client may be experiencing which problem? A. Fecal impaction B. C. Diff C. Intestinal obstruction D. Viral infection
A
During assessment of a patient diagnosed with pheochromocytoma, the nurse auscultates a blood pressure of 210/110 mm Hg. What is the nurse's best action? A. Administer an alpha blocker. B. Administer nitroprusside (Nipride). C. Ask the patient to lie down and rest. D. Assess the patient's dietary intake of sodium and fluid.
A
One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisol-releasing hormone (CRH) and: A. ACTH B. DHEA C. GH D. TSH
A
Persons with hypertension secondary to hyperaldosteronism may be treated with which medication? A. Potassium-sparing diuretics B. Alpha adrenergic antagonists C. Angiotensin-converting enzyme (ACE) inhibitors D. Beta adrenergic blockers
A
Primary adrenal insufficiency is manifested by: A. Serum sodium level of 120 mEq/L and blood glucose level of 48 mg/dL B. Truncal obesity and 3+ pitting edema in lower legs C. Hypopigmentation over neck and greater than 150/90 D. Potassium level of 2.8 mEq/L and weight gain of 3 pounds overnight
A
The nurse is caring for a patient receiving propranolol. Which clinical finding is most indicative of an adverse effect of this drug? A. Wheezing B. Urinary urgency C. A glucose level of 180 mg/dL D. A heart rate of 100 beats/min
A
The nurse is caring for a patient who has coronary heart disease (CHD). The nurse tells the patient, "Your cholesterol levels are abnormal; you are at a high risk of having a heart attack." What did the nurse discover regarding the lipoprotein levels in the patient's blood report? A. High levels of low-density lipoproteins (LDLs) B. High levels of high-density lipoproteins (HDLs) C. Low levels of very-low-density lipoproteins (VLDLs) D. Low levels of intermediate-density lipoproteins (IDLs)
A
The nurse knows that the student understands the major causes of mechanical bowel obstruction when the student states that _____ is a possible cause? A. Postoperative adhesions B. Abdominal distention C. Chemical irritation D. Ruptured appendix
A
The nurse reviews the history for a patient taking atorvastatin. What will the nurse act on immediately? A. The patient is on oral contraceptives. B. The patient takes medications with grape juice. C. The patient takes herbal therapy including kava kava. D. The patient was started on penicillin for a respiratory infection
A
The nursing student has learned in class that pericarditis is an inflammatory process of the pericardium. What is known to be the main cause of pericarditis? A. Viral infections B. Radiation C. Bacterial infections D. Connective tissue disease
A
The patient who takes insulin has just been prescribed a beta blocker drug. The nurse recognizes that the interaction of the beta blocker and the insulin may have which result? A. Masked signs of hypoglycemia B. Masked signs of hyperglycemia C. Enhanced activity of the beta blocker drug D. Decreased activity of the beta blocker drug
A
What manifestations would a nurse expect while assessing a client who has recently developed peritonitis? A. A board-like abdomen B. Sluggish bowel sounds C. Rectal bleeding D. Intermittent diarrhea
A
Which effect of thyroid hormone deficit alters the function of all major organs in the body? A. Decreases metabolism B. Enhances absorption of glucose C. Increases protein synthesis D. Causes vitamin deficiencies
A
Which long-term care resident is most likely to be exhibiting the signs and symptoms of chronic obstructive pulmonary disease (COPD)? A. An 81-year-old male who has a productive cough and recurrent respiratory infections. B. An 88-year-old female who experiences acute shortness of breath and airway constriction when exposed to tobacco smoke. C. A 79-year-old lifetime smoker who reports shortness of breath and pain on deep inspiration. D. An 81-year-old smoker who has increased exercise intolerance, a fever, and increased white blood cells.
A
Which most important complication of atherosclerosis can result in occlusion of small heart vessels? A. Thrombosis B. Fibrous plaque C. Fatty streaks D. Ulceration
A
Why does the nurse anticipate administering metoprolol rather than propranolol for diabetic patients who need a beta-blocking agent? A. Propranolol causes both beta 1 and beta 2 blockade. B. Metoprolol is less likely to cause diabetic nephropathy. C. Propranolol is associated with a higher incidence of foot ulcers. D. Metoprolol helps prevent retinopathy in individuals with diabetes.
A
A client undergoing a cardiac angiogram has also had serum thyroid panel study. The physiologic principle behind looking at thyroid panels includes which possible correlations with cardiac symptoms? Select all that apply. A. Increase in CO B. Rise in oxygen consumption C. Vasoconstriction of all arteries D. Sharp decrease in HR
A, B
A young adult has been experiencing some extreme fatigue, changes in vision, and unexpected weight loss, leading the health care provider to suspect hyperglycemia. Which clinical manifestations correlate with a diagnosis of diabetes? Select all that apply. A. Frequent thirst B. Excess urination C. Ravenous hunger D. Fruity mouth odor E. Sweat smelling like honey
A, B, C
Which clinical manifestations would support the medical diagnosis of Cushing syndrome? Select all that apply. A. Blood glucose level in 200 mg/dL range B. "Buffalo hump" on back C. Excessive facial hair growth D. Muscle hypertrophy E. Blood pressure reading less than 90/low mm Hg
A, B, C
Manifestations of heart failure are due to the decreased pumping ability of the heart. The nurse should monitor for which signs and symptoms of heart failure? Select all that apply. A. Cyanosis B. Malnutrition C. Fatigue D. Exercise intolerance E. Hyperglycemia
A, B, C, D
A nurse is reviewing common causes of constipation with a client. Select all that apply. A. Weakness of abdominal muscles B. Inadequate fluid intake C. Pregnancy D. Bed rest E. Increased dietary fiber F. Hemorrhoids G. Increased physical exercise
A, B, C, D, F
Acute pulmonary edema often occurs with heart failure. Which signs of acute pulmonary edema should the nurse monitor their clients for? Select all that apply. A. Confusion B. Respiratory crackles C. Frothy, blood-tinged sputum D. Hot, dry skin E. Rapid pulse
A, B, C, E
The nurse will monitor the client for which possible respiratory manifestations of heart failure? Select all that apply. A. Chronic, dry cough B. Cheyne-Stokes respiration C. Exertional dyspnea D. Hyperventilation E. Orthopnea
A, B, C, E
A client diagnosed with acute gastritis is having bloody emesis and pain. Which possible causes of acute gastritis should the nurse assess the client for? Select all that apply. A. Alcohol consumption B. Aspirin C. Clostridium difficile D. NSAIDs E. Acid reflux
A, B, D
The nurse must achieve which clinical objectives for a client in cardiogenic shock? Select all that apply. A. Regulate blood volume B. Correct pulmonary edema C. Increase cardiac workload and oxygen use D. Improve cardiac output E. Increase coronary perfusion
A, B, D, E
Which clients with diabetes mellitus would the nurse anticipate to have persistent elevation of blood glucose levels? Select all that apply. A. A client with COPD taking steroids B. A client with high anxiety C. A client with HTN D. A client with hx of gastric bypass E. A client with a newly diagnosed leg fracture
A, B, E
Which clinical manifestations following thyroidectomy would alert the nurse that the client is going into a life-threatening thyroid storm? Select all that apply. A. Telemetry showing HR of 184 B. Unable to close eyelids completely together C. Extremely agitated D. Temperature of 104.2 E. Bruising on knees and feet
A, C, D
A client seen in the emergency department after a motor vehicle accident complains of increasing shortness of breath. Which manifestations support the diagnosis of a possible left tension pneumothorax? Select all that apply. A. Diminished breath sounds on the left B. Reduced pulses on the right C. Hyperresonance on the left D. Subcutaneous emphysema E. Tracheal deviation to the right
A, C, D, E
Loss of pituitary function can result in deficiencies (or loss) of secretions of which hormones? Select all that apply. A. Luteinizing hormone B. Corticotropin-releasing hormone C. Growth hormone D. Follicle stimulating hormone E. Prolactin
A, C, D, E
What manifestations would the nurse expect to find when assessing a client with a right pleural effusion? Select all that apply. A. Hypoxemia B. Elevated WBC count C. Dyspnea on exertion D. Stabbing chest pain with breathing E. Diminished right breath sounds
A, C, E
Which symptoms accompanying shortness of breath indicate a client has cor pulmonale? Select all that apply. A. Warm moist skin B. Sudden sharp pain with each breath C. Jugular vein distention D. Crackles in all lung fields E. 2+ pitting edema in feet
A, C, E
What are the common side effects of fenofibrate, a fibric acid derivative? Select all that apply. A. Rash B. Constipation C. Cutaneous flushing D. Nausea and abdominal pain E. Increase in gallstone formation
A, D, E
A client in the emergency department reports sudden onset of coughing with a feeling of chest tightness. Lung sounds are diminished with wheezing in all lung fields, skin is moist, and the client appears anxious. What is the first intervention the nurse should implement? A. Educate about limiting exposure to dust. B. Administer a beta-2 agonist. C. Provide the influenza vaccine. D. Give an inhaled corticosteroid.
B
A client is admitted with an exacerbation of Crohn disease and has been experiencing a weight loss of 20 pounds in 2 weeks. The client is unable to absorb nutrients from the intestine. The nurse would expect which type of diet to be ordered for this client? A. High-calorie, low-fat diet B. Total parenteral nutrition C. Low-residue diet D. High-fiber diet
B
A client recently diagnosed with bronchiectasis asks what may have caused the condition. Which response by the nurse is accurate? A. "Your habit of cigarette smoking is the primary causative factor." B. "It may have developed after you had a severe inflammation caused by aspiration pneumonia." C. "Bronchiectasis occurred due to poor control of your asthma." D. "Obesity causes bronchiectasis by placing a strain on your heart and lungs."
B
A nurse is preparing a client for coronary bypass surgery the following week and asks the client to discontinue daily aspirin intake. Which response is best to explain the effect aspirin has on the platelets and potential bleeding problems? A. The effect is only reversible in some cases. B. The effect is not reversible for the life of the platelet. C. The effect lasts as long as its half-life. D. The effect is very similar to that of nonsteroidal anti-inflammatory drugs.
B
An adolescent male with type 1 diabetes is exasperated by his regimen of blood sugar monitoring and insulin administration, and has told his mother that he wants to scale both back. Which response by his mother is most accurate? A. "You need to be vigilant now if you want to be free of diabetes when you grow up" B. "Even though it's hard to do, you need to continue so you don't go blind or need a kidney transplant down the road" C. "Even though you might save some time and energy by doing this, remember the high blood sugars cause a lot of pain and will cause you to gain weight" D. "I know it's not fun, but you're even more susceptible to complications when you're young if you don't stay on top of your diabetes"
B
Diabetics are hospitalized for a number of reasons. What is the most common complication of diabetes requiring hospitalization? A. Diabetic ketoacidosis B. Foot problems C. Hypertensive crisis D. Macrovascular disease
B
The iatrogenic form of Cushing syndrome is caused by: A. Ectopic ACTH-secreting lung tumor B. Long-term cortisone therapy C. Benign or malignant adrenal tumor D. Pituitary tumor secreting ACTH
B
The nurse is caring for a patient with anemia related to chronic renal failure. Which agent might be used to treat the anemia? A. Filgrastim B. Epoetin alfa C. Oprelvekin 4. Sargramostim
B
The nurse is caring for several patients prescribed propranolol. In which patient condition is propranolol used with caution? A. Angina B. Diabetes C. Hypertension D. Cardiac dysrhythmias
B
The nurse is preparing to administer diltiazem and atenolol. What is the priority nursing intervention before administering these two medications to the patient? A. Obtain blood glucose B. Assess the heart rate C. Apply a pulse oximeter D. Observe for lower leg edema
B
The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis? A. Apolipoprotein B-100 B. Low-density lipoprotein (LDL) C. High-density lipoprotein (HDL) D. Very-low-density lipoprotein (VLDL)
B
The patient has been prescribed propranolol. While the nurse is updating the medical history, the patient states that he or she has a history of bronchial asthma. What is the highest priority action on the part of the nurse? A. Anticipate that the patient will be placed on a lower dose than usual of the drug. B. Notify the prescribing physician because this is a contraindication for the patient. C. Plan to monitor the patient's respiratory status frequently while he is taking the drug. D. Instruct the patient on how to monitor his or her own respiratory rate at home after discharge.
B
Which medication helps treat the inflammatory reaction of clients with asthma who are diagnosed with an acute flare of their asthma response? A. Phosphodiesterase inhibitors B. Systemic corticosteroids C. Long-acting β2-agonists D. Anticholinergic agents
B
Which pathophysiologic phenomeon may result in a diagnosis of Cushing disease? A. Autoimmune destruction of the adrenal cortex B. Excess ACTH production by a pituitary tumor C. Malfunction of the HPA system D. Hypopituitarism
B
The health care provider thinks a teenager is having clinical manifestations of irritable bowel syndrome. Which complaints would support this diagnosis? Select all that apply. A. Belching makes the pain go away B. Pain is described as "cramping" in the lower abdomen C. Pain is relieved by defecation D. Pain is most severe at night E. Pain is worse after and between meals
B, C
The parents are ready to take home their child with newly diagnosed hemophilia A. Which teaching aspects should the nurse discuss with them prior to discharge? Select all that apply. A. The signs of an MI related to bleeding in the heart vessels B. Keep the child away from contact sports like football and wrestling. C. Administration of factor VIII at home when bleeding occurs D. Aspirin should only be given for severe pain in the joints. E. Give ibuprofen (an NSAID) if the child runs a fever.
B, C
An older adult in a rehabilitation unit is at risk for constipation. Which interventions would be appropriate for the nurse to take? Select all that apply. A. Administer a cleansing enema every second day B. Encourage the client to attempt a bowel movement after a meal C. Ensure that the client's fluid intake is sufficient D. Assess the client's current medication regimen E. Schedule the client's physical activity shortly after meals
B, C, D
The nurse knows that which groups of drugs influence the renin-angiotensin-aldoseterone system (RAAS) for the treatment of hypertension? Select all that apply. A. Calcium-channel blockers B. Beta-adrenergic blockers (beta-blockers) C. Angiotensin-receptor blockers D. ACE inhibitors E. Diuretics
B, C, D
Which are beneficial effects that can be derived from simvastatin and other drugs in this class? Select all that apply. A. Improvement of liver function B. Reduction of risk of cardiovascular events C. Reduction of low-density lipoproteins (LDLs) D. Elevation of high-density lipoproteins (HDLs) E. Stabilization of the plaque in coronary arteries
B, C, D, E
The nursing student correctly identifies which major risk factors for coronary artery disease? Select all that apply. A. Decreased pulse rate B. Diabetes C. Elevated blood pressure D. Abdominal obesity E. Cigarette smoking F. Elevated HDL G. Elevated LDL
B, C, D, E, G
Which statements regarding heart failure are true? Select all that apply A. Myocardial infarction is a frequent cause of right-sided failure. B. In uncompensated right-sided heart failure, there is peripheral venous congestion and edema. C. In uncompensated left-sided heart failure, there is pulmonary congestion and edema. D. Pulmonary hypertension is a frequent cause of left-sided failure. E. In compensated heart failure, cardiac output is normal.
B, C, E
A client with cystic fibrosis reports sinus congestion and coughing up thick greenish mucus. What interventions will the nurse implement? Select all that apply. A. Bronchodilators B. Antibiotic therapy C. Pancreatic enzymes D. Chest physiotherapy E. Insulin injections
B, D
In circulatory shock, the adrenergic (or sympathetic) nervous system is activated. The nurse knows that stimulation of beta-2 adrenergic receptors will result in which responses? Select all that apply. A. Vasoconstriction in many vascular beds B. Dilation of the bronchioles C. Increase in heart rate D. Vasodilation of the skeletal muscle vascular bed E. Increased force of myocardial contraction
B, D
The nurse assesses a 65-year-old female client who reported to the emergency department with exacerbation of asthma during her daughter's wedding reception. Select all of the triggers that may have precipitated the attack. A. Lack of sleep B. Dancing C. Premenstrual hormones D. Aspirin E. Emotional stress
B, D, E
A client has developed the facial appearance that is characteristic of myxedema, along with an enlarged tongue, bradycardia, and voice changes. Which treatment modality is most likely to benefit this client? A. Beta-adrenergic blocking drugs B. Corticosteroid replacement therapy C. Synthetic preparations of T3 or T4 D. Oral or parenteral cortisol replacement
C
A nurse caring for a client with end-stage hepatitis knows the client is at risk for prolonged or excessive bleeding due to which pathophysiologic abnormality? A. Adenosine diphosphate B. Adenosine triphosphate C. Prothrombin D. Von Willebrand factor
C
A patient is taking pravastatin sodium. Which assessment finding requires immediate action by the nurse? A. Fatigue B. Headache C. Muscle pain D. Slight nausea
C
Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of: A. Cushing syndrome B. Addison disease C. Graves disease D. Cushing disease
C
In light of the presence of numerous risk factors for coronary artery disease, a client's primary care provider has recommended the client take low-dose (81 mg) aspirin daily. Doing so will reduce the client's risk of myocardial infarction by altering which stage of hemostasis? A. Blood coagulation B. Vessel spasm C. Platelet plug formation D. Clot lysis
C
In persons with a bleeding disorder caused by vascular defects, platelet counts and INR results will most often reveal which finding? A. Hypocalcemia B.Polycythemia C. Normal values D. Thrombocytopenia
C
In the ICU, a postsurgical client has developed sepsis and is being treated with multiple medications. During the mid-morning assessment, which finding leads the nurse to suspect the client may be developing a complication called disseminated intravascular coagulation (DIC)? A. Urine from the Foley catheter is bloody B. Headaches associated with light sensitivity C. Hemorrhage from the surgical site requiring deep pressure dressings D. Nausea and vomiting E. Decreased O2 saturation and diminished breath sounds in lower lobes
C
In which of the following hospital clients would the care team most realistically anticipate finding normal cholesterol levels? A. A 77-year-old female admitted for rheumatoid arthritis exacerbation who is receiving hormone replacement therapy and has a history of hypothyroidism B. A morbidly obese 50-year-old female who is taking diuretics and a beta-blocker to treat her hypertension C. A 51-year-old male with a diagnosis of hemorrhagic stroke and consequent unilateral weakness D. A 44-year-old male admitted for hyperglycemia and with a history of diabetic neuropathy
C
In which situation would an increase of glucagon be expected? A. High anxiety B. Hyperglycemia C. NPO before surgery D. Fever
C
The immune suppressive and anti-inflammatory effects of cortisol cause: A. Increased cell-mediated immunity B. Increased capillary permeability C. Inhibition of prostaglandin synthesis D. Moderate insulin resistance
C
The nurse is caring for a patient who is scheduled to receive a first dose of an alpha adrenergic antagonist drug. The nurse is prepared to monitor the patient for which effect? A. Rash B. Anorexia C. Syncope D. Vomiting
C
The nurse is caring for a patient who takes multiple cholesterol-lowering drugs. Which drug is least likely to cause systemic side effects? A. Gemfibrozil B. Simvastatin C. Colesevelam D. Nicotinic acid
C
The nurse is caring for a patient with hypercholesterolemia who is taking 20 mg of simvastatin as prescribed. After a few days, the patient's urinalysis reports indicated the presence of myoglobin. What instruction would the nurse receive from the primary health care provider? A. "Give 10 mg of medication daily." B. "Give the medication before meals." C. "Discontinue administering the medication." D. "Give the medication with 250 mL of water."
C
The term chronic obstructive pulmonary disease (COPD) can be a combination of two types of obstructive airway diseases. What disease processes have been identified as being part of COPD? A. Emphysema and asthma B. Chronic obstructive bronchitis and asthma C. Chronic bronchitis and emphysema D. Chronic obstructive bronchitis and emphysema
C
What is the most common cause of hypothyroidism? A. Goiter B. Thyroidectomy C. Autoimmune thyroiditis D. Myxedema
C
Which drug is classified as an adrenergic antagonist? A. Propofol B. Milrinone C. Propranolol D. Epinephrine
C
Which drug is the most effective for lowering low-density lipoprotein (LDL) cholesterol? A. Gemfibrozil B. Ezetimibe C. Atorvastatin D. Cholestyramine
C
Which finding indicates a positive outcome from treatment with filgrastim? A. Bone pain is eliminated. B. The cancer goes into remission. C. The neutrophil count increases. D. The red blood cell count increases.
C
Which manifestation is considered a major complication of persistent gastroesophageal reflux? A. Chest pain B. Hoarseness C. Structures D. Heartburn
C
An elderly patient with hypertension and hyperlipidemia who has been prescribed a statin medication comes for a follow-up visit after 4 months of therapy. The patient's laboratory reports show elevated blood cholesterol levels, and the urine examination reveals rhabdomyolysis. What could be the reasons for this condition? Select all that apply. A. The patient is not responding to the treatment. B. The patient is taking cyclosporine along with statins. C. The patient is eating fiber-rich food along with statins. D. The patient is taking grapefruit juice along with statins. E. The patient is taking amiodarone along with statins.
C, D, E
The nurse is providing care for a patient receiving a statin to manage cholesterol levels. For which adverse effects will the nurse monitor in this patient? Select all that apply. A. Gallstone development B. Nonalcoholic fatty liver disease C. Increased serum transaminase levels D. Unexplained muscle pain or tenderness E. Elevated creatinine kinase (CK) level with muscle pain
C, D, E
The nurse knows that which statements regarding the physiology of blood pressure are accurate? Select all that apply. A. Blood flow is equally vital to all body organs. B. Blood pressure is poorly regulated. C. Blood pressure is very variable. D. Constant elevation of blood pressure can be lethal. E. A decrease in blood flow can be an immediate threat to life.
C, D, E
Which factors increase the risk that a client will develop chronic obstructive pulmonary disease (COPD)? Select all that apply. A. Diabetes mellitus B. Obesity C. History of tobacco use D. History of myocardial infarction E. History of asthma
C, E
A client diagnosed with inflammatory diarrhea is having multiple small, bloody stools with a fever. Which could be a likely cause of this inflammatory diarrhea? A. H. Pylori B. M. tuberculosis C. S. aureus D. C. difficile
D
A client who was hospitalized with bacterial pneumonia has now developed an infection in the pleural cavity. Which terminology correctly identifies this pathophysiologic finding? A. Pneumothorax B. Chylothorax C. Hemothorax D. Empyema
D
A client with a history of acquired idiopathic thrombocytopenic purpura (ITP) arrives at the emergency department complaining of fatigue, shortness of breath, and multiple nosebleeds during the previous week. The platelet level is 10,000/μL with a significantly low hemoglobin level. The nurse would anticipate which interventions to be prescribed? A. Anti-inflammatory agents B. Factor VIII infusion C. Plasmapheresis D. Immune globulin infusion
D
A major manifestation of Cushing syndrome includes which of the following? A. Muscle hypertrophy B. Excessive salt loss C. Hair and weight loss D. Hypokalemia
D
A patient reports some adverse effects after taking beta blockers. What is the priority complaint the nurse should address? A. "I check my sugar more often because it has been high." B. "I feel dizzy when standing quickly, so I have to get up slowly." C. "I notice that my heart rate doesn't speed up as much when I exercise." D. "I stopped taking my medicine yesterday because it made me feel tired."
D
Acute respiratory failure is commonly signaled by varying degrees of hypoxemia and hypercapnia. Which physiologic findings are considered a direct result of respiratory acidosis that develops as a result of hypercapnia? A. Decreased cerebral spinal fluid pressure B. Increase in cardiac contractility C. Arterial vasoconstriction D. Increased cerebral blood flow
D
The nurse is teaching a group of nursing students about statin drugs and asks about the mechanism of action of lovastatin. Which response from the students indicates understanding? A. "It stimulates the biliary system to increase the excretion of dietary cholesterol." B. "It inhibits the absorption of dietary cholesterol in the small intestine." C. "It binds to bile in the intestinal tract forming an insoluble complex that is excreted in the feces." D. "It inhibits hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol in the liver."
D
The nurse is teaching an adult client about treatment for uncomplicated diarrhea. Which information would be most appropriate for the nurse to provide? A. Fatty foods high in calories B. Foods high in fiber content C. Full-strength infant formula as a supplement D. Oral replacement therapy
D
The spouse of a client with a history of hepatitis C admitted for upper gastrointestinal bleeding asks the nurse why these bleeding episodes occur. Having reviewed the client's laboratory values and noting a severe vitamin K deficiency, which response by the nurse would be best? A. Destruction of the liver caused by endotoxins that are digesting cells B. Liver failure that puts the client in need of a liver transplant C. Decrease in clotting factors due to the liver not producing D. The liver producing an inactive form of clotting factors
D
What is the most important factor in myocardial oxygen demand? A. Hyperthermia B. Respiratory rate C. Degree of anxiety D. Heart rate
D
Which patient's statement indicates a need for further medication instruction about colestipol? A. "I might need to take fat-soluble vitamins to supplement my diet." B. "The medication may cause constipation, so I will increase fluid and fiber in my diet." C. "I should take this medication 1 hour after or 4 hours before my other medications." D. "I should stir the powder in as small an amount of fluid as possible to maintain potency of the medication."
D
A client who is taking a diuretic asks the nurse to explain how a drug that makes her urinate more frequently can help her hypertension. The nurse will explain that diuretics exert their antihypertensive action in which ways? Select all that apply. A. By blocking the release of antidiuretic hormone from the posterior pituitary B. By inhibiting the movement of calcium into arterial smooth muscle cells C. By inhibiting the conversion of angiotensin I to angiotensin II. D. By decreasing vascular volume through the process of increasing sodium and water excretion E. By reducing peripheral vascular resistance
D, E
What are the signs and symptoms of heart failure? Select all that apply. A. Ruddy complexion B. Bradycardia C. Chronic productive cough D. Fatigue E. Fluid retention
D, E
Which conditions reflect failure of the circulatory system? Select all that apply. A. Suppression of the renin-angiotensin-aldosterone system (RAAS) B. Renal dysfunction C. Orthostasis D. Heart failure E. Circulatory shock
D, E
A toddler seems to have a little "cold" and runny nose. During the night, the parents awaken hearing a "tight" coughing sound. On arrival to the emergency department, the nurses suspect bronchial asthma based on which assessment data? Select all that apply. A. Coughing up blood-tinged sputum B. Sitting upright, leaning forward, and using accessory muscles to breathe C. Audible wheezing D. Respiratory rate—44 with prolonged exhalation E. "Crowing sound with inspiration"
b, c, d
