Nurs Exam 4
A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements by the client indicates an understanding of the teaching?
"I will apply lotion to the dry areas of my feet, avoiding application between my toes." -lotion is appropriate for dry areas of the feet, but the client should avoid applying lotion between the toes, as this area is prone to bacterial growth
A nurse is providing teaching for a client who has type 1 diabetes mellitus about how to prevent complications during illness. Which of the following statements indicates that the client understands the teaching?
"I will call my doctor if my blood sugar is more than 250 mg/dL." -the client should call the provider if blood glucose levels exceed 250 mg/dL during illness
A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include?
"Take this medication on an empty stomach." -to promote proper absorption, the client should take the medication on an empty stomach and not eat or drink anything for 30 to 60 min after taking it
A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following statements by the client indicates an understanding of the information about this test?
"This test is a good indicator of my average blood glucose levels." -HbA1c reflects the client's glucose levels over a 120-day period, which is the life span of RBCs
A nurse is providing teaching to a client who has type 2 diabetes mellitus about pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching?
"my cells are resistant to the effects of insulin."
A nurse is providing teaching to a client who has type 1 diabetes mellitus about exercise. Which of the following statements should the nurse include in the teaching?
"wear a medical alert identification tag when you exercise." -the client should wear a medical alert identification tag in the event of a hypoglycemic response, because exercise can potentiate the effects of insulin and cause the blood glucose levels to decrease
A nurse is managing the care of a client who is postoperative and experiencing acute adrenal insufficiency. Which of the following actions should the nurse take?
administer IV hydrocortisone sodium succinate
A nurse is planning preoperative care for a client who has pheochromocytoma. Which of the following interventions should the nurse anticipate as being the priority?
avoid palpating the abdomen -the greatest risk to this client is injury from hypertensive crisis. Therefore, the priority intervention is to avoid palpating the abdomen, which can cause a sudden release of catecholamines, causing a hypertensive crisis
A nurse is reviewing the laboratory values of a client who has diabetic ketoacidosis. The nurse should understand that which of the following laboratory values is consistent with diabetic ketoacidosis?
bicarbonate level 12 mEq/L -the client who has diabetic ketoacidosis should have a bicarbonate level less than 15 mEq/L because the client has an increased production of counter-regulatory hormones that lead to metabolic acidosis
A nurse is caring for a client undergoing screening for primary Cushing's disease. The nurse should expect that which of the following laboratory findings to be elevated?
blood glucose
A nurse is providing teaching for a client who has diabetes mellitus. Which of the following findings associated with diabetic ketoacidosis (DKA) should the nurse include?
blood glucose levels greater than 300 mg/dL -blood glucose levels above 300 mg/dL are an expected finding of DKA
A nurse is providing discharge teaching for a client who has diabetes insipidus and has a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching?
blow nose gently prior to using the nasal spray
A nurse caring for a client who is postoperative following a parathyroidectomy to treat hyperpararthyroidism. Which of the following laboratory values should the nurse expect to decrease as a therapeutic effect of the procedure?
calcium
A nurse is planning care for a client who has Cushing's Syndrome due to chronic corticosteroid use. Which of the following actions should the nurse include in the plan of care?
check the client's urine specific gravity
A nurse is caring for a client who is postoperative following a bilateral adrenalectomy. the nurse should expect to administer glucocorticoids following the procedure to enhance which of the following therapeutic effects?
compensate for decrease in cortisol levels
A nurse is preparing a teaching plan for a client who has diabetes insipidus and is receiving intranasal desmopressin. Which of the following information should the nurse include in the teaching plan?
occurrence of nocturia indicates the need for a dosage adjustment -the initial dose of desmopressin is administered in the evening; the provider will increase the dosage until the client no longer experiences nocturia.
A nurse is reviewing laboratory values for a client who has diabetic ketoacidosis (DKA). Which of the following results should the nurse expect?
pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L -metabolic acidosis
A nurse is caring for a client who has diabetes insidious. For which of the following findings should the nurse monitor?
polyuria
A nurse is preparing to administer propranolol by IV bolus to a client experiencing a thyroid storm. Which of the following findings indicates the client is having a therapeutic response?
reduction of the effects of thyroid hormone on the heart
To screen a client for pheochromocytoma, a nurse schedules a vanillylmandelic acid test. When teaching the client about this test, which of the following instructions should the nurse include?
restrict coffee intake 2 to 3 days prior to the test -the client should avoid coffee and tea (even if they are decaffeinated), bananas, chocolate, and vanilla for 2 to 3 days prior to the test
A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect?
serum calcium 12.8 mg/dL -A client who has adrenal insufficiency has a serum calcium level above the expected reference range
A nurse is performing an assessment on a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following assessment data should the nurse report?
serum sodium 110 mEq/L -a client who has SIADH retains fluids, which causes dilutional hyponatremia
A nurse is providing teaching to a client who has type 1 diabetes mellitus about hypoglycemia. Which of the following manifestations should the nurse include in the teaching?
shakiness
A nurse is teaching a client who has an autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following effects should the nurse include? (Select all that apply.)
-osteoporosis -moon-shaped face -increased risk of infection
A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism caused by an adenoma. Which of the following findings should the nurse report to the provider? (select all that apply)
-tachycardia and hypertension -laryngeal stridor and hoarseness -a positive Trousseau's sign is correct
A nurse is preparing to give a client information about an adrenocorticotropic hormone (ACTH) stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders?
Addison's disease -the ACTH stimulation test is the standard test for Addison's disease. It measures the cortisol response to ACTH. The response is absent or very decreased in clients who have primary adrenal insufficiency
A nurse is caring for a client who has type 2 diabetes mellitus and is admitted with hyperglycemic-hyperosmolar state (HHS). Which of the following laboratory findings should the nurse expect?
blood glucose of 846 mg/dL and serum pH of 7.40 -with HHS, the client produces enough insulin to prevent ketosis, but not enough to prevent hyperglycemia -therefore, the serum pH is within the expected reference range, but the blood glucose is greater than 600 mg/dL!!
A nurse is assessing a client who has Addison's disease. Which of the following skin manifestations should the nurse expect to find?
bronze pigmentation of skin
A nurse is assessing a client who has diabetes mellitus and reports feeling anxious. Which of the following findings should the nurse expect if the client is hypoglycemic?
cool, clammy skin -hypoglycemia causes cool, clammy skin, in addition to anxiety, nervousness, tachycardia, and confusion
A nurse is assessing a client who has Graves' disease. Which of the following findings should the nurse expect the client to display?
difficulty sleeping
A nurse is preparing insulin for a client who has diabetes mellitus. The client is to receive evening doses of insulin glargine and regular insulin. Which of the following actions should the nurse take to administer these two medications safely?
draw up the insulin glargine and the regular insulin into separate syringes -the nurse should not mix insulin glargine with any other insulin in the same syringe due to the low pH of its diluent
A nurse is monitoring the laboratory values of a client who has diabetes mellitus and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy?
fasting blood glucose 96 mg/dL -this is within the expected reference range for a fasting blood glucose level and indicates that insulin therapy is effective
A nurse is checking laboratory values to determine if a client who has diabetes is adhering to the treatment plan. Which of the following tests should the nurse use to make this determination?
glycosylated hemoglobin levels (HbA1c) -checking glycosylated hemoglobin levels, or HbA1c, is an accurate method to determine if the client is routinely compliant. Glycosylated hemoglobin refers to hemoglobin that is connected to glucose. Since the life span of an RBC is 4 months, this value will not be affected by recent changes in the client's diet or medication
A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect?
hirsutism
A nurse is monitoring a client who has Graves' disease for the development of thyroid storm. the nurse should report which of the following findings to the provider?
hypertension
A nurse is monitoring a client who has syndrome of inappropriate antidiuretic secretion (SIADH). Which of the following findings should the nurse expect?
hyponatremia
A home health nurse is assessing a client who is on lifelong hormone replacement therapy for treatment of hypothyroidism. The client has not been taking his medication regularly. Which of the following findings should the nurse expect?
hypotension
A nurse is assessing a client who has manifestations of acromegaly. Which of the following findings should the nurse expect?
increased head size
A nurse is assessing a client who has diabetes insipidus. The nurse should expect which of the following findings?
increased hematocrit -an increased hematocrit level is an expected finding related to dehydration
A nurse is caring for a client who has type 2 diabetes mellitus and is displaying manifestations of hyperglycemia. Which of the following findings should indicate to the nurse that the client has hyperglycemia?
increased urination (polyuria)
A nurse is planning dietary teaching for a client who has type 1 diabetes mellitus. Which of the following information should the nurse include regarding alcohol consumption?
ingest alcohol with meals to reduce alcohol-induced hypoglycemia -alcohol prevents liver production of glucose. Consuming carbohydrates while drinking alcoholic beverages helps prevent hypoglycemia
A nurse is monitoring a client's status 24 hr after a total thyroidectomy. Which of the following findings should the nurse report to the provider?
laryngeal stridor
A nurse is planning a community health screening for a group of clients who are at risk for type 2 diabetes mellitus. Which of the following clients should the nurse include in the screening?
men and women who are obese
A nurse is planning care for a client who is experiencing the Somogyi effect and takes intermittent-acting insulin. Which of the following actions should the nurse include in the plan?
monitor the client's nighttime blood glucose levels
A nurse is caring for a client who has diabetes mellitus and developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to his feet?
monitor the temperature of bath water with a thermometer
A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia?
tingling and numbness of the hands and feetH -hypocalcemia causes paresthesias, usually starting in the hands and feet
A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings?
tremors -findings of hyperthyroidism include tremors, diaphoresis, and insomnia.
A nurse is providing teaching to a client who has Addison's disease about healthy snack foods. Which of the following food choices by the client indicates an understanding of the teaching?
turkey and cheese sandwich
A nurse is preparing a 24-hour urine specimen for a client who is suspected to have pheochromocytoma. Which of the following laboratory tests from the 24-hour urine specimen should the nurse use to determine the client's condition?
vanillylmandelic acid (VMA) -the nurse should expect the 24-hr urine specimen to test for VMA. This test is used to determine if the client has pheochromocytoma, which measures the level of catecholamine metabolites in a 24-hr urine sample. Pheochromocytoma is a tumor of the adrenal gland that causes excess release of the catecholamines epinephrine and norepinephrine, which are hormones that regulate blood pressure and heart rate
A nurse is caring for a client who is taking propylthiouracil (PTU). The nurse should recognize that the client has met the treatment goals when she reports an increase in which of the following effects?
weight -weight gain is common
