Pathos exam 4
The nurse is caring for a client with end-stage renal disease (ESRD) on hemodialysis. Which factor does the nurse recognize is the leading cause of this disease? A) Diabetes B) Hypertension C) Heredity D) Autoimmune disease
A
The nurse is performing risk assessments for chronic kidney disease (CKD) at a community health fair. Which concept should guide the assessments? A) African Americans have a higher incidence of CKD than Caucasians. B) Caucasians have a higher incidence of CKD than Native Americans. C) Non-Hispanics have a higher incidence of CKD than Hispanics. D) African Americans progress more slowly to end-stage renal disease than the general population.
A
The nurse should expect to assess which laboratory value in the patient with prerenal acute kidney disease? A) Low urine sodium concentration B) High fractional excretion of sodium C) High fractional excretion of urea D) Low urine osmolality
A
When planning care for a patient with heart failure, the nurse keeps in mind that this condition may lead to: A) prerenal AKI. B) intrinsic AKI. C) postrenal AKI. D) glomerulonephritis.
A
Which finding would alert the nurse that a patient with diabetes may be in the early stages of developing diabetic nephropathy? A) Albuminuria B) Increased glomerular filtration rate C) Hypotension D) Cardiac disease
A
Which intervention should be included in the nursing plan of care for a patient with prerenal acute kidney injury? A) Provide intravenous fluids. B) Administer antihypertensive medication. C) Limit fluid intake. D) Prepare for dialysis.
A
Which response by a patient with chronic kidney disease indicates to the nurse that more teaching about the disease is needed? A) "CKD can cause me to have a high blood count." B) "CKD can progress quickly to ESRD." C) "Bone fractures may occur." D) "I need to modify my risk factors for cardiovascular disease."
A
The nurse is assessing a client diagnosed with Cushing disease. Which findings are consistent with the client's diagnosis? A) Round, red face B) Buffalo hump C) Bruising D) Poor wound healing E) Hyperactivity
A,B,C,D
The nurse is caring for a client with a hormone imbalance. Which manifestations does the nurse attribute to this condition? Select all that apply. A) Hypertension B) Anxiety C) Weight gain D) Fluid retention E) Contusion
A,B,C,D
The nurse cares for a client with a glomerular disorder. Which typical assessment findings does the nurse anticipate in the client? Select all that apply. A) Proteinuria B) Hypertension C) Hematuria D) Oliguria E) Edema
A,C,E
A client with diabetes and hypertension is placed on lisinopril for treatment of hypertension. Which laboratory results does the nurse recognize may result from the client's medications? Select all that apply. A) K+ 2.8 mEq/L B) K+ 5.5 mEq/L C) Na+ 128 mEq/L D) Cl- 120 mEq/L E) Creatinine 2.2 mg/dL
A,E
The community health nurse is providing education to a group of adults on prevention of bladder cancer. Which modifiable risk factor will the nurse identify as the mostimportant in the prevention of bladder cancer? A) Obesity B) Smoking C) Hyperlipidemia D) Sedentary lifestyle
B
The nurse cares for four clients with cystitis. Which client represents a complicated cystitis case? A) Middle-age adult female who has hypertension. B) Young adult female who is pregnant. C) Older adult female who has impaired mobility. D) Older adult female who lives in a skilled nursing facility.
B
The nurse examines a newborn male and notes the urethral opening on the dorsal surface of the penis. Which condition does the nurse suspect? A) Hypospadias B) Epispadias C) Cryptorchidism D) Hydrocele
B
The urinalysis of a patient with acute interstitial nephritis is likely to have which characteristics? A) Hematuria with red blood cell casts, dysmorphic red blood cells, proteinuria B) Leukocyturia with leukocyte casts or urinary eosinophils C) Renal tubular epithelial cells and muddy brown casts D) Few cells with little or no casts or proteinuria
B
When assessing a patient for modifiable risk factors for chronic kidney disease, the nurse should ask which question? A) "What is your age?" B) "Do you use NSAIDs?" C) "Were you born prematurely?" D) "Do you have a family history of kidney disease?"
B
When assessing acute kidney injury in the pediatric population using the pRIFLE criteria, the nurse observes which parameters? A) Serum creatinine levels B) Changes in glomerular filtration rate C) Blood urea nitrogen levels D) Urinary output
B
Which physician order should the nurse question on a patient with hyperkalemia secondary to chronic kidney disease? A) Renal replacement therapy B) Administration of a potassium-sparing diuretic C) Discontinuing ACE inhibitors D) Administering potassium binders
B
A client is admitted to a medical unit with the primary diagnosis of acute pyelonephritis. Which assessment findings does the nurse anticipate? Select all that apply. A) Headache B) Fever C) Chills D) Abdominal pain E) Costovertebral angle pain
B,C,E
A nurse cares for a client diagnosed with a serous cystadenoma of the pancreas. What statement will the nurse include when teaching the client about the condition? A) "This type of cyst usually causes pain and nausea." B) "This type of cyst is usually surgically removed." C) "This type of cyst is rarely cancerous." D) "This type of cyst may be cancerous."
C
When the nurse is assessing the glomerular filtration rate (GFR) of a patient, which method is more accurate when the patient's GFR is normal or mildly decreased? A) Cockcroft-Gault equation B) Modification of Diet in Renal Disease C) Chronic Kidney Disease-Epidemiology Collaboration D) RIFLE
C
Which concept should the nurse keep in mind when developing a plan of care for the patient with intrinsic acute kidney injury (AKI)? A) This condition is potentially and easily reversible. B) This condition in not reversible. C) This condition may not result in prompt recovery. D) This condition is caused by chronic kidney disease.
C
Which finding should the nurse expect when assessing the patient with acute kidney injury? A) Peripheral neuropathy B) Enlarged kidney C) Normal hemoglobin D) Bone pain
C
Which finding would lead the nurse to suspect infantile hypertrophic pyloric stenosis (IHPS) in a 4-week-old infant? A) Diarrhea B) No visible peristalsis C) Projectile vomiting D) Lack of stool
C
Which laboratory value alerts the nurse that a patient is in stage 3 of chronic kidney disease (CKD)? A) GFR > 90 mL/min/1.73m2 B) GFR 60-89 mL/min/1.73m2 C) GFR 30-59 mL/min/1.73m2 D) GFR 15-29 mL/min/1.73m2
C
The nurse is providing education about prenatal nutrition to a client who is 25 weeks pregnant. Which nutrient will the nurse review as being critical for maternal and fetal euthyroidism? A) Calcium B) Vitamin D C) Folic acid D) Iodine
D
The nurse researcher is examining the factors that lead to liver cancer. What does the nurse recognize begins the process of cellular transformation in liver cancer? A) Autoimmunity B) Allergic reaction C) Infection D) Inflammation
D
The nursing plan of care for a patient with stage 4 chronic kidney disease (CKD) includes: A) controlling blood pressure and diabetes. B) treating hyperphosphatemia. C) cardiovascular risk reduction. D) preparation for renal replacement therapy.
D
The nurse cares for a client with liver failure and impaired bilirubin clearance. What does the nurse know is true regarding bilirubin? A) It is the waste product of red blood cell destruction. B) It is the by-product of protein metabolism. C) It is produced in the small bile ducts. D) It is produced in the hepatic duct.
A
The nurse cares for a client with postinfectious glomerulonephritis (PIGN). Which infection does the nurse recognize as most commonly causing this condition? A) Group A beta-hemolytic streptococcus B) Beta-hemolytic E. coli C) Alpha-hemolytic streptococcus D) Cocciodiodes immitis
A
The nurse caring for a patient with uncontrolled diabetes notes deep and rapid respirations. The nurse documents this respiratory pattern as: A) Kussmaul respiration. B) Cheyne-Stokes respiration. C) shortness of breath. D) orthopnea.
A
Which statement by a patient indicates to the nurse that more teaching is needed about the phases of HBV infection? A) "Chronic infection is the immune tolerant phase." B) "In the immune active phase I will be HBsAg positive." C) "I will be HBcAb positive in all phases." D) "I will develop HBeAb in the inactive phase."
A
Which statement by the parent of a child with an eating disorder indicates that more teaching is needed? A) "Diabetes is not connected to eating disorders in children." B) "Diabetic complications can be accelerated in children with eating disorders." C) "If my child develops diabetes, the rate of complications may be higher than usual." D) "My child may experience uncontrolled diabetes."
A
A client is diagnosed with primary glomerulonephritis. Which conditions does the nurse recognize that are classified as primary glomerulonephritis? Select all that apply. A) Minimal change disease B) Crescentic glomerulonephritis C) Membranous glomerulonephritis D) Lupus nephritis E) Postinfectious glomerulonephritis
A,B,C
The nurse cares for a client with tuberous sclerosis. In addition to renal impairment, which findings does the nurse expect in this client? Select all that apply. A) Early-onset gout B) Skin tumors C) Cognitive impairment D) Visual impairment E) Seizures
B,C,E
A nurse manager plans training for staff nurses on early recognition of urinary tract infections (UTIs) in older adults. What will the nurse say is a frequent manifesting symptom of UTI in the older adult? A) Fever B) Abdominal pain C) Confusion D) Dysuria
C
How should the nurse respond when a patient asks how he could have chronic kidney disease (CKD) when he has not had symptoms of the disease? A) "Symptoms of CKD are often vague." B) "CKD comes on suddenly." C) "Your current urinary tract infection may have caused your CKD." D) "You must have had symptoms that you did not report."
A
The nurse cares for a client with a renal neoplasm. What location of the body does the nurse recognize is the most likely origin of this disease? A) Renal cortex B) Renal pelvis C) Renal medulla D) Renal fascia
A
The nurse cares for a client with chronic pyelonephritis. What is the nurse's understanding of the most frequent cause of this condition? A) Vesicoureteral reflux B) Papillary necrosis C) Nephrolithiasis D) Tubulointerstitial injury
A
The nurse cares for a client with portal hypertension who is diagnosed with asterixis. Which assessment finding corresponds with the client's diagnosis of asterixis? A) Muscle tremor and downward flap of the hand B) Flaccid muscles and upward flexion of the hand C) Discoloration of the abdominal skin D) Increased abdominal circumference
A
The nurse is assessing a patient with hyperglycemic hyperosmolar syndrome (HHS). Which finding would differentiate HHS from diabetic ketoacidosis (DKA)? A) Lack of ketonuria B) Electrolyte imbalances C) Fluid volume deficit D) Hyperglycemia
A
The nurse is caring for an older adult who reports recent urinary incontinence. What is the nurse's understanding about urinary incontinence in the older adult? A) It is not a normal outcome of aging. B) It is the expected result of muscle atrophy. C) It generally occurs at night only. D) It most commonly occurs with position changes.
A
During a head and neck assessment, the nurse notes that the client's neck is enlarged, which is later confirmed to be due to a goiter. The client's serum thyroid levels are within normal limits. Which type of goiter does the nurse suspect? A) Toxic multinodular goiter B) Endemic goiter C) Nontoxic diffuse goiter D) Chronic autoimmune thyroiditis
C
The nurse is providing education to a client about the most common causes of goiters. Which causative factor will the nurse review in the teaching? A) Thyroiditis B) Tumors C) Iodine deficiency D) Infiltrative disease
C
The nurse assessing a patient with acute interstitial nephritis is most likely to note which findings? A) Lymphocytopenia B) Leukocytosis C) Neutropenia D) Eosinophilia
D
The nurse examines the urinalysis results of a client suspected of having nephritis. Which finding will the nurse expect if the client has a glomerular injury? A) Hematuria B) Glucosuria C) Ketonuria D) Albuminuria
D
The nurse is assessing a patient suspected of having hepatitis A. To elicit information about the likely mode of transmission, which question would be most appropriate for the nurse to ask? A) "Have you had a blood transfusion?" B) "Do you share needles?" C) "Are you sexually active?" D) "Have you recently eaten shellfish?"
D
The nurse is assessing a patient with globus sensation. Which symptom would this patient describe? A) Pressure in the mid-chest B) Gnawing discomfort of the upper abdomen C) Pain with swallowing D) A fullness or lump in the throat
D
The plan of care for a patient in diabetic ketoacidosis, with a blood glucose level of 450 mg/dL, should include strategies for: A) administration of short-acting subcutaneous insulin. B) administration of long-acting subcutaneous insulin. C) administration of oral hypoglycemic agents. D) administration of intravenous short-acting insulin.
D
To prevent complications in the patient with ascites, who is receiving daily furosemide and spironolactone, the nurse should implement which intervention? A) Restrict sodium. B) Restrict fluids. C) Monitor weights. D) Monitor electrolyte and creatinine levels.
D
What is the most appropriate action for the nurse to take when a patient with ulcerative colitis develops excessive episodes of bloody diarrhea? A) Send a stool sample to the laboratory to rule out infectious causes. B) Encourage increased fluid intake to prevent dehydration. C) Administer anti-inflammatory drugs to reduce inflammation. D) Call the physician, as this is a life-threatening condition.
D
Which assessment data is the nurse likely to observe in a patient with chronic kidney disease? A) Serum creatinine of 0.7 mg/dL B) BUN:creatinine ratio of 10:1 C) Serum phosphorous of 3.1 mg/dL D) Parathyroid hormone of 62 pg/mL
D
Which finding indicates to the nurse that a patient with hepatitis B has a resolved infection? A) Presence of HBsAG B) Presence of HBcAg IgM C) Presence of HBsAG for more than 6 months D) Loss of HBsAG and development of HBsAb
D
While admitting a patient with acute kidney injury, the patient reports to the nurse that he has had no urinary output during the last 24 hours. Which of the following would the nurse record in the medical record? A) The patient is anuric. B) The patient is oliguric. C) The patient is nonoliguric. D) The patient has a normal GFR.
A
Which intravenous solution should the nurse prepare to infuse in the patient with ascites who has had 5.5 liters of fluid removed during paracentesis? A) 25% albumin B) 10% dextrose C) 0.45% normal saline D) Lactated Ringer's
A
Which manifestation would the nurse expect to assess in the patient with regurgitation? A) Sour taste in the mouth B) Forceful evacuation of gastric contents C) Difficulty swallowing D) Pain with swallowing
A
Which manifestations would the nurse expect to assess in the patient with a type IV paraesophageal hernia? A) Dyspnea, reduced exercise tolerance, bowels sounds heard at left lung base B) Occasional heartburn, sour taste in throat, reduced exercise tolerance C) Sour taste in throat, dyspnea, halitosis D) Halitosis, epigastric pain, burning in throat
A
Which of the cardinal symptoms of GI disorders would be expected in a patient with a defect of the esophagus? A) Pain, altered ingestion, bleeding B) Altered motility, altered ingestion, bleeding C) Pain, altered ingestion, vomiting D) Vomiting, altered swallowing, bleeding
A
Which patient statement indicates to the nurse that the patient needs more teaching about type 2 diabetes? A) "Type 2 diabetes is also call juvenile-onset diabetes." B) "I am not dependent on insulin to control my blood glucose levels." C) "Most people with diabetes have type 2 diabetes." D) "From time-to-time, I may need insulin to control my blood glucose levels."
A
Which patient statement is typical of data collected on patients during the prodromal stage of hepatitis? A) "I am tired, have a low grade fever, and just don't feel right." B) "I have gained 5 pounds over the last two weeks." C) "My stools are clay-colored." D) "I have left-sided abdominal pain and nausea."
A
The nurse is caring for a client with thyroid dysfunction. Which statement about the normal function of the thyroid does the nurse know to be true? A) Thyroid releasing hormone and thyroid stimulating hormone are released by the thyroid. B) The functional unit of the thyroid is the thyroid follicle. C) Hormone secretion of the thyroid is regulated through positive feedback mechanisms. D) Thyroid function is regulated by the hypothalamus and amygdala.
B
The nurse is providing education to a client with a parathyroid disorder about the function of parathyroid hormone (PTH) in the body. Which statements will the nurse include in the teaching? Select all that apply. A) "PTH decreases intestinal calcium resorption." B) "PTH increases renal calcium resorption." C) "PTH promotes the release of calcium from the bone." D) "PTH directly affects calcium resorption in the small bowel." E) "PTH stimulates the production of vitamin D metabolite 1,25-(OH)2D."
B,C,E
The nurse cares for a client with diabetes recently diagnosed with diabetic nephropathy. Which findings does the nurse recognize are the result of the client's diagnosis of diabetic nephropathy? Select all that apply. A) Leukocytosis B) Glucosuria C) Hyperfiltration D) Proteinuria E) Chronic kidney disease
C,D,E
A client is diagnosed with renal papillary adenoma. Which characteristic of this condition does the nurse recognize is true? A) It is difficult to differentiate from a malignancy. B) It is associated with tuberous sclerosis. C) It is very aggressive and often deadly. D) It is a hereditary disease of the proximal tubule.
D
Which laboratory finding indicates to the nurse that a patient has an impaired fasting glucose (IFG)? A) Increased insulin and decreased glucagon levels two hours after fasting B) An blood glucose level 2 hours after an oral glucose tolerance test that is high but not diagnostic of diabetes C) A fasting blood glucose level is diagnostic for diabetes D) A fasting blood glucose level or A1c higher than normal but not diagnostic for diabetes
D
While the nurse is collecting the client's personal history, the client states, "I've been taking prednisone for years and I hate it. I am stopping it today." How will the nurse respond? A) "Continuing with therapy is a personal choice." B) "You may no longer experience the benefits of treatment." C) "The side effects of prednisone are difficult for you." D) "Discontinuing treatment suddenly is extremely dangerous."
D
A child with corrosive esophagitis following ingestion of a corrosive liquid is treated with esophageal dilation. The nurse is providing discharge instructions to the parent. Which of the following statements indicates to the nurse that the parent needs more teaching? A) "More dilations may be needed as my child grows." B) "No further dilations will be needed." C) "My child should be evaluated if he develops swallowing problems." D) "I need to childproof my house."
A
A patient with hypopharyngeal diverticula will most likely report: A) regurgitation of undigested food. B) regurgitation of digested food. C) vomiting of digested food. D) nausea.
A
The nurse is teaching a community health class about thyroid disorders. Which statement about the prevalence of thyroid disorders will the nurse include in the teaching? Select all that apply. A) "An estimated 20 million people in the United States have some form of thyroid disease." B) "Women are 5-8 times more likely than men to have thyroid problems." C) "About one third of people who have thyroid disorders are asymptomatic." D) "One woman in eight will develop a thyroid disorder before the age of 18." E) "Up to 60% of people with thyroid disease are unaware of their condition."
A,B,E
A client is suspected of having renal cell carcinoma (RCC). Which manifestation will the nurse likely assess? Select all that apply. A) Hematuria B) Dysuria C) Abdominal mass D) Weight loss E) Urinary frequency
A,C,D
A client with cholelithiasis asks the nurse, "What caused this?" Which factors might the nurse include in the response? Select all that apply. A) Diet B) Culture C) Gender D) Body weight E) Age
A,D
An older adult client with type 2 diabetes and hypertension asks the nurse, "What should my blood pressure goal be?" How should the nurse respond? A) "Less than 190/88 mmHg." B) "Less than 150/90 mmHg." C) "Less than 140/88 mmHg." D) "Less than 130/90 mmHg."
B
The nurse is reviewing a client's medication and learns that the client has been taking prednisone. What is the nurse's understanding of the effect of prednisone on the adrenal glands? A) Prednisone therapy results in destruction of the adrenal medulla, thereby decreasing corticotropin releasing hormone. B) Prednisone therapy can lead to significant toxicity, resulting in dehydration, fever, and hyponatremia. C) Prednisone therapy increases cortisol and decreases adrenocorticotropic hormone via negative feedback principles. D) Prednisone therapy increases sodium and water resorption and potassium and hydrogen excretion.
C
The nurse suspects an elevated bilirubin level in a patient who exhibits which findings? A) Pale itchy skin B) Icterus with green-colored stools C) Yellow skin and pruritus D) Xanthomas and pale urine
C
The nurse works on a pediatric renal unit and cares for several clients with renal disorders. Which glomerular disorder does the nurse recognize as the most common primary glomerular disorder in children? A) Autosomal dominant polycystic kidney disease B) Autosomal recessive polycystic kidney disease C) Idiopathic nephrotic syndrome D) Hemolytic uremic syndrome
C
A client with liver failure is diagnosed with cirrhosis. What is the nurse's understanding of the primary dysfunction related to this condition? A) Fatty deposits lead to thrombi and obstructed blood flow. B) Fatty deposits lead to impaired metabolism and malnutrition. C) Fibrosis leads to constriction and increased vessel pressures. D) Fibrosis leads to impaired absorption of electrolytes and acid-base dysfunction.
D
A public health nurse is examining the incidence rates of gallbladder cancer in the United States. Which population does the nurse learn is at greatest risk for developing this type of cancer? A) Infants B) Children C) Adults D) Older adults
D
The nurse is caring for a client about to undergo treatment for hyperparathyroidism. Which priority intervention can the nurse anticipate while caring for this client? A) Educating the client regarding medication adherence B) Supporting the management of the client's symptoms C) Recommending self-care and exercise techniques D) Reviewing pre- and post-operative instructions
D
Which findings would the nurse utilize to identify the level of acute kidney injury in a patient? A) Blood urea nitrogen levels B) Ratio of fluid intake to fluid output C) Blood pressure readings D) Serum creatinine levels and urinary output
D
When planning care for a patient with liver disease, the nurse keeps in mind that the leading cause of chronic liver disease is: A) alcoholism. B) hepatitis C. C) environmental toxins. D) hepatotoxic drugs.
A
When taking a health history from a patient with acute liver failure, the nurse most likely expects to find: A) recent use of high doses of acetaminophen. B) infection with hepatitis B. C) high consumption of alcoholic beverages. D) exposure to toxins.
A
Which laboratory values should the nurse expect in a patient with diabetic ketoacidosis? A) Plasma glucose level of 200 mg/dL B) Ketonuria C) Serum bicarbonate > 18 mEq/L D) Arterial pH > 7.3
B
Which nursing intervention should be included in the care plan for a patient with acute liver failure with encephalopathy? A) Have the patient lie flat in bed. B) Perform frequent neurological checks. C) Initiate a fluid restriction. D) Administer lactulose.
B
When teaching a patient newly diagnosed with type 1 diabetes about autonomic nervous system symptoms of hypoglycemia, which would the nurse include? A) Sweating and tremors B) Irritability and confusion C) Incoordination and difficulty speaking D) Visual disturbances and drowsiness
A
Which data indicates a diagnosis of diabetes in a patient being assessed for unexplained weight loss? A) A1C > 6.5% B) Symptoms of diabetes plus casual plasma glucose concentration > 150mg/dL C) Fasting plasma glucose < 126 mg/dL D) 2-hour plasma glucose > 150 mg/dL
A
Which of the following concepts should the nurse keep in mind when preparing a plan of care for a patient with hepatitis C virus (HCV) infection? A) The initial infection is always highly symptomatic. B) Most HCV infections become chronic. C) Antibodies to HCV are protective. D) There is only one genotype of HCV infection in the United States.
B
Which of the following should the nurse include when preparing a community program on hepatitis E? A) Adolescents are at lowest risk for HEV. B) Mortality is high for pregnant women with HEV. C) HEV is transmitted through the parenteral route. D) The incubation for HEV is 8 to 12 weeks.
B
What is the most appropriate response by the nurse when a 20-year-old woman pregnant with her first child and diagnosed with gestational diabetes mellitus (GDM) asks if she will develop diabetes in the future? A) "There is a chance that you may develop diabetes in the next 10-20 years, so monitoring would be appropriate." B) "It is impossible to tell-we don't know anything about the risk factors for diabetes." C) "Your risk for developing diabetes in the future is high because you are young." D) "You cannot develop gestational diabetes (GDM) in future pregnancies, this only happens with your first pregnancy."
A
When developing a care plan for a patient with type 1 diabetes, the nurse should consider which pathophysiological concept? A) In type 1 diabetes, there is a complete lack of insulin secretion. B) In type 1 diabetes, there is a relative deficiency in insulin. C) In type 1 diabetes, there is insulin resistance. D) In type 1 diabetes, there is an over secretion of insulin.
A
A patient, with an inability to swallow following a stroke, is receiving full-strength formula through a nasogastric feeding tube and is experiencing diarrhea. Which is the most likely cause of the diarrhea? A) Osmotic causes B) Secretory causes C) Inflammatory bowel D) Motility causes
A
A woman in her 26th week of pregnancy is undergoing a one-step 75-gram oral glucose tolerance test (OGTT). Which finding indicates that gestational diabetes is present? A) A fasting plasma glucose level of 92 mg/dL B) A 1-hour plasma glucose level of 160 mg/dL C) A 2-hour plasma glucose level of 145 mg/dL D) A 3-hour plasma glucose level of 135 mg/dL
A
Auscultation of bowel sounds in a patient with a small bowel obstruction will most likely reveal: A) hyperactive, high-pitched bowel sounds. B) absence of bowel sounds. C) intermittent gurgles and clicks. D) hypoactive, infrequent bowel sounds.
A
The nurse is reviewing the function of the thyroid with a client who has abnormal calcitonin levels. Which statement will the nurse include in the teaching? A) "Special cells within the thyroid secrete calcitonin." B) "Special cells with the thyroid absorb calcitonin." C) "Calcitonin is converted to a different hormone within the thyroid." D) "Calcitonin acts as a catalyst within the thyroid for chemical reactions."
A
The nurse is reviewing the mechanism of goiter development in a client with nontoxic multinodular goiters. Which statement best describes this process? A) Thyroid enlargement occurs due to several growth factors, in addition to thyroid stimulating hormone (TSH), that cause some thyroid follicles to proliferate more than others. B) Overall thyroid enlargement occurs without associated hypo- or hyperthyroidism, and is not induced by cysts, inflammation, or neoplasia. C) Iodine deficiency causes some thyroid follicles to grow more quickly than to others, resulting in nodular changes and sequelae. D) TSH receptor antibodies (TRAb) stimulate the TSH receptor to cause thyroid growth, goiter formation, and excessive secretion of thyroid hormones.
A
The nurse palpates a client's abdomen and notes the liver below the costal margin. What does this finding indicate? A) Hepatomegaly B) Atrophy of the liver C) Normal liver placement D) Portal hypertension
A
The nurse should expect to administer which medication regimen to a patient with an ulcer that is H. pylori positive? A) Proton pump inhibitors, clarithromycin, amoxicillin B) Proton pump inhibitors, bismuth salts, metronidazole C) H2 receptor antagonist, proton pump inhibitors, clarithromycin D) H2 receptor antagonist, amoxicillin, clarithromycin
A
The nurse would expect a patient with a diagnosis of portopulmonary syndrome to exhibit: A) mean pulmonary artery pressure greater than or equal to 25 mmHg. B) pulmonary vascular resistance less than 240 dyne/s/cm-5. C) pulmonary capillary wedge pressure 25 mmHg or more. D) transpulmonary gradient less than 12 mmHg.
A
To detect crepitus in a patient with an esophageal perforation, the nurse should: A) palpate the chest. B) inspect the chest. C) percuss the chest. D) auscultate the chest.
A
A client with liver disease displays alterations in coagulation. Which coagulation factors does the nurse understand may be impaired due to the client's liver dysfunction of clotting factor synthesis? Select all that apply. A) I B) II C) VIII D) VII E) X
A,B,D,E
The nurse is reviewing the past medical history of a client diagnosed with Hashimoto thyroiditis. Which conditions does the nurse understand to be caused by thyroiditis? Select all that apply. A) Fatigue B) Weight gain C) Laryngitis D) Bacterial infection E) Constipation
A,B,E
A nurse cares for a client with alcoholic hepatitis. Which early manifestations of liver impairment does the nurse recognize on assessment? Select all that apply. A) Indigestion B) Jaundice C) Diffuse abdominal pain D) Ascites E) Bleeding impairment
A,C
The nurse is caring for a client with liver cancer whose diagnosis was delayed after months of non-specific complaints. What leads to delayed diagnosis of liver damage? Select all that apply. A) The deeper location of the liver in the abdomen. B) The superficial location of the liver in the abdomen. C) The regenerative properties of the liver. D) The vascular nature of the liver. E) The size of the liver.
A,C,D
The nurse is caring for a client diagnosed with hyperparathyroidism. Which potential causes does the nurse identify for this condition? Select all that apply. A) Adenomas B) Hypercalcemia C) Hypothyroidism D) Hyperplasia E) Chronic kidney disease
A,D
The nurse cares for a client with impaired liver function. Impaired metabolism of which substances may occur based on the client's condition? Select all that apply. A) Carbohydrates B) Vitamins C) Minerals D) Proteins E) Fats
A,D,E
The nurse cares for a client with liver failure and monitors the client for hepatic encephalopathy. Which findings does the nurse recognize as the earliest signs of hepatic encephalopathy? Select all that apply. A) Restlessness B) Confusion C) Disorientation D) Agitation E) Impaired judgment
A,D,E
When preparing a nursing care plan for an adolescent with diabetes, which concept should the nurse keep in mind? A) More insulin is needed as adolescents begin to engage in sports. B) More insulin is needed as more growth hormone is released during adolescence. C) More insulin is needed as the adolescents ingests less calories. D) More insulin is needed during sleep in adolescents.
B
Which concept should the nurse keep in mind when planning care for a patient with hepatitis D (HDV)? A) The patient also has hepatitis C. B) The HDV virus is cleared when the HBV virus is cleared. C) Coinfection with HAV and HBV reduces the risk of cirrhosis. D) Coinfection with HCV and HDV lowers HCV vital titers.
B
The staff development nurse is teaching a class on diabetes to newly hired nurses at General Hospital. The nurse explains that during glycogenolysis which of the following occurs? A) Insulin increases, glucagon decreases. B) Insulin decreases, glucagon and norepinephrine/epinephrine increase. C) Insulin and growth hormone increase, cortisol decreases. D) Insulin decreases; glucagon, cortisol, growth hormone and epinephrine increase.
B
When assessing the liver of a patient, in which quadrant should the nurse percuss? A) Upper left quadrant B) Upper right quadrant C) Lower right quadrant D) Lower left quadrant
B
Which finding should the nurse expect when assessing a patient with symmetrical distal polyneuropathy due to diabetes? A) Distal sensory loss in one limb B) Distal pain in lower legs that worsens at night C) Sharp, shooting pain in the distal legs D) Leg pain that progresses from proximal to distal
B
When palpating an infant's liver, what does the nurse understand is true? A) The infant's liver is located deeper than an adult. B) Palpation of the infant's liver is easier than palpation of an adult. C) The infant's liver is small in comparison to other abdominal organs. D) Palpation of the infant's liver is not recommended.
B
When performing a succession splash in a patient suspected of having a gastric outlet obstruction, which result would suggest this diagnosis? A) A splashing sound auscultated in upper abdomen 1 hour after a meal B) A splashing sound auscultated in upper abdomen 3 hours after a meal C) No splashing sound auscultated in upper abdomen 3 hours after a meal D) No splashing sound auscultated in upper abdomen 1 hour after a meal
B
When planning care for a patient with esophageal varices, which action would be a priority for the nurse? A) Discussing the importance of Alcoholics Anonymous meetings B) Assessing for signs and symptoms of hemorrhage C) Teaching the patient signs of bleeding to report D) Encouraging rest periods to reduce fatigue
B
When planning care for a patient with melena, the nurse expects which appearance of the stool? A) Coffee ground appearance of the stool B) Black and tarry stools C) Bright red blood in the stool D) Visually undetectable blood
B
How should the nurse respond when a patient with diabetes asks about the role of beta cells in the pancreas? A) "Beta cells secrete glucagon." B) "Beta cells secrete insulin." C) "Beta cells secrete somatostatin." D) "Beta cells secrete pancreatic polypeptide."
B
On initial diagnosis, the patient with stomach cancer will most likely have which findings? A) Dysphagia and nausea B) Weight loss and abdominal pain C) Early satiety and occult bleeding D) A palpable right upper quadrant mass and severe pain
B
The ethics committee at General Hospital is discussing issues involved in genomic screening of patients with type 2 diabetes. Which factor should be considered by the interdisciplinary team when making a decision about implementing genomic screening? A) Genomic screening is less costly than frequent HbA1c level testing. B) Genomic screening may reduce the time required to find the best treatment regimen. C) Nutrition and exercise programs do not offer better use of limited financial resources. D) HbA1c testing provides results that reduce the time required to find the best treatment regimen.
B
The nurse cares for a client with chronic alcohol abuse. Which laboratory finding does the nurse recognize as evidence of liver damage? A) Albumin 3.5 g/dL B) ALT 50 unit/L C) ALP 45 unit/L D) AST/SGOT 30 unit/dL
B
The nurse is performing an abdominal assessment on a client. The nurse understands that which endocrine gland is located in the abdomen? A) Pituitary B) Pancreas C) Liver D) Kidneys
B
The nurse is performing an assessment on a client with Graves disease. Which assessment manifestation does the nurse expect to assess? A) Dry, cold skin B) Orbital tissue inflammation C) Hair loss D) Weight gain
B
The nurse is recommending lifestyle changes to reduce symptoms in a patient with GERD. Which response indicates to the nurse that more teaching is needed? A) "I am overweight and need to lose weight." B) "I love my morning coffee so I am glad I don't need to eliminate it." C) "Smaller meals may reduce my reflux." D) "I should remain upright for a while after meals."
B
A nurse working in oncology notes an overall increase in clients with pancreatic cancer. What does the nurse associate with the overall increase in pancreatic cancer? Select all that apply. A) Multicultural population B) Diabetes mellitus C) Obesity D) Aging population E) Hypercholesterolemia
B,C,D
A client with liver failure is diagnosed with malnutrition. Which vitamin deficiencies does the nurse understand the client is at greatest risk for developing? Select all that apply. A) C B) K C) A D) D E) E
B,C,D,E
The nurse is assessing a client with primary hyperparathyroidism. Which signs and symptoms will the nurse anticipate to assess? Select all that apply. A) Exophthalmos B) Weakness C) Fatigue D) Depression E) Neuropathy
B,C,D,E
The nurse is caring for a client with a disorder of the endocrine system. The nurse understands that the endocrine system regulates which functions? Select all that apply. A) Cognition B) Growth C) Reproduction D) Metabolism E) Fluid and electrolyte balance
B,C,D,E
The nurse would expect to assess which finding in the patient with type I hepatorenal syndrome? A) Previous diagnosis of renal disease B) Recent ingestion of a nephrotoxic drug C) Ascites D) Serum creatinine level of 1.5 mg/dL
C
The public health nurse is conducting a community screening for diabetes. Which of the following people does the nurse identify as being at highest risk for type 1 diabetes? A) A person with an affected sibling B) A person with an affected father C) A person with multiple affected first-degree relatives D) A person with an affected mother
C
What characteristic of pain would the nurse expect in a patient with acute appendicitis? A) Dull, achy upper abdominal pain B) Intermittent and sharp upper left quadrant pain C) Crampy and steady right lower quadrant pain D) Sharp central abdominal pain
C
What finding would the nurse expect to assess in a patient in the prodromal phase of hepatitis? A) Decreased PT B) Decreased liver transaminases C) Elevated serum bilirubin D) Decreased INR
C
When conducting community screening for diabetes, which population should the community health nurse recognize as being at highest risk? A) Hispanics/Latinos B) Caucasians C) African Americans D) Asian Americans
C
Which finding should the nurse expect when assessing a patient with severe portopulmonary syndrome? A) An S4 heart sound (fourth heart sound) B) A murmur of mitral regurgitation C) An accentuated S2 (second heart sound) D) A murmur of pulmonic stenosis
C
Which finding would the nurse expect in a patient with a gastric ulcer? A) Burning pain during the night B) Burning pain on an empty stomach C) Burning pain precipitated by food D) Burning pain relieved by food
C
Which of the following laboratory findings should the nurse anticipate in the infant with infantile hypertrophic pyloric stenosis (IHPS)? A) Respiratory alkalosis B) Respiratory acidosis C) Metabolic alkalosis D) Metabolic acidosis
C
Which physical finding should the nurse expect to assess in a patient with alcoholic liver disease? A) Dyslipidemia B) Insulin resistance C) Palmar erythema D) Hyperglycemia
C
The nurse is providing education for a client with adrenal insufficiency about the anatomy and function of the adrenal glands. Which statements will the nurse include in the material? Select all that apply. A) "The outer layer of the adrenal gland is referred to as the zona reticularis." B) "The adrenal gland's inner layer is responsible for the production of adrenaline." C) "The adrenal cortex layers include the zona glomerulosa, zona fasciculata, and zona reticularis." D) "The zona glomerulosa is responsible for the production of aldosterone." E) "The adrenal gland produces cortisol, which increases gluconeogenesis."
C,D,E
A client with portal hypertension has bluish veins just under the skin of the abdomen that radiate out across the umbilicus. Which pathophysiological factors does the nurse recognize causes this condition? Select all that apply. A) Elevated bilirubin levels B) Impaired clearance of ammonia C) Increased fluid in the abdomen D) Impaired metabolism of estrogens E) Increased abdominal pressure
C,E
A child diagnosed with type 1 diabetes six months ago is being seen in the clinic because the mother has questions about why her child has not needed insulin for the past week. Which response by the mother indicates that more teaching is needed? A) "I still need to check my child's blood glucose levels." B) "The honeymoon period will most likely end in a few months." C) "This period of insulin production is temporary." D) "My child no longer has diabetes."
D
A client with end-stage liver failure is admitted with severe cirrhosis. What is the nurse's understanding of the pathophysiology of cirrhosis? A) Increased oncotic pressure B) Impaired removal of bilirubin C) Impaired conversion of ammonia to urea D) Increased vascular permeability
D
In planning care for a patient with chronic gastritis, the nurse would anticipate which of the following vitamin deficiencies? A) Vitamin B1 B) Vitamin B3 C) Vitamin B7 D) Vitamin B12
D
The nurse reviews the health care provider prescriptions for a client diagnosed with acute pancreatitis. Which prescription will the nurse question? A) Oxygen as needed B) Opioid analgesic as needed C) Intravenous colloid infusion D) Clear liquid diet as tolerated
D
