PrepU questions
A client admitted with acute diverticulitis has experienced a sudden increase in temperature and reports a sudden onset of exquisite abdominal tenderness. The nurse's rapid assessment reveals that the client's abdomen is uncharacteristically rigid on palpation. What is the nurse's best response? A. Administer a Fleet enema as prescribed and remain with the client. B. Contact the primary provider promptly and report these signs of perforation. C. Position the client supine and insert an NG tube. D. Page the primary provider and report that the client may be obstructed.
Contact the primary provider promptly and report these signs of perforation.
A client with adrenal insufficiency is gravely ill and presents with nausea, vomiting, diarrhea, abdominal pain, profound weakness, and headache. The client's family reports that the client has been doing strenuous yard work all day and was sweating profusely. Nursing management of this client would include observation for signs of: A. hyponatremia and hyperkalemia. B. hyponatremia and hypokalemia. C. hypernatremia and hyperkalemia. D. hypernatremia and hypokalemia.
hyponatremia and hyperkalemia.
A client who is being tested for syndrome of inappropriate antidiuretic hormone secretion asks the nurse to explain the diagnosis. While explaining, the nurse states that excessive antidiuretic hormone is secreted from which gland? A. Anterior pituitary B. Posterior pituitary C.Adrenal D. Thyroid
. Posterior pituitary
Which of the following is a clinical manifestation of hypothyroidism? A. A pulse rate below 60 beats/minute. B. An elevated systolic blood pressure. C. Systolic murmurs D. Exophthalmos
A pulse rate below 60 beats/minute.
A nurse understands that for the parathyroid hormone to exert its effect, what must be present? A. Decreased phosphate level B. Adequate vitamin D level C. Functioning thyroid gland D. Increased calcium level
Adequate vitamin D level
A client is transported to the emergency department for a femur fracture following a motor vehicle crash. What action by the nurse is the highest priority? A. Assess vital signs and level of consciousness. B. Administer pain medication per orders. C. Assess pedal pulses. D. Assess the diameter of the thigh every 15 minutes.
Assess vital signs and level of consciousness.
Which of the following is considered a late symptom of hypothyroidism? A. Cold intolerance B. Physical sluggishness C. Loss of libido D. Brittle nails
Cold intolerance
A client with a diagnosis of colon cancer is 2 days postoperative following bowel resection and anastomosis. The nurse has planned the client's care in the knowledge of potential complications. What assessment should the nurse prioritize? A. Close monitoring of temperature B. Frequent abdominal auscultation C. Assessment of hemoglobin, hematocrit, and red blood cell levels D. Palpation of peripheral pulses and leg girth
Frequent abdominal auscultation
A client is suspected of having acromegaly. What definitive diagnostic testing is the most reliable method of confirming acromegaly? A. A serum glucose level B. Glucose tolerance test in combination with a GH measurement C. Growth hormone levels D. Bone radiographs
Glucose tolerance test in combination with a GH measurement
An older adult female client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, the nurse should suspect which disorder? A. Diabetes mellitus B. Diabetes insipidus C. Hypoparathyroidism D. Hyperparathyroidism
Hyperparathyroidism
Which is a complication of hyperthyroidism? A. Myxedema coma B.Hypothyroidism C. Addisonian crisis D. Acromegaly
Hypothyroidism
A patient has had surgery to create an ileal conduit for urinary diversion. What is a priority intervention by the nurse in the postoperative phase of care? A. Turn the patient every 2 hours around the clock. B. Administer pain medication every 2 hours. C. Monitor urine output hourly and report output less than 30 mL/hr. D. Clean the stoma with soap and water after the patient voids.
Monitor urine output hourly and report output less than 30 mL/hr.
When caring for a client with a fracture, assessment of which of the following would be the priority? A. Neurovascular compromise B. Hormonal imbalances C. Cardiac problems D. Altered kidney function
Neurovascular compromise
A nurse is caring for a client in acute addisonian crisis. Which test result does the nurse expect to see? A. Serum potassium level of 6.8 mEq/L B. Blood urea nitrogen (BUN) level of 2.3 mg/dl C. Serum sodium level of 156 mEq/L Serum D. glucose level of 236 mg/dl
Serum potassium level of 6.8 mEq/L
A client with suspected adrenal insufficiency has been ordered an adrenocorticotropic hormone (ACTH) stimulation test. Administration of ACTH caused a marked increase in the client's cortisol levels. How should the nurse interpret this finding? A. The client's pituitary function is compromised. B. The client's adrenal insufficiency is not treatable. C. The client has insufficient hypothalamic function. D. The client would benefit from surgery.
The client's pituitary function is compromised.
A client is undergoing testing for suspected adrenocortical insufficiency. The care team should screen the client for what common cause of this health problem? A. Therapeutic use of corticosteroids B. Pheochromocytoma C. Inadequate secretion of ACTH D. Adrenal tumor
Therapeutic use of corticosteroids
A 35-year-old female client who complains of weight gain, facial hair, absent menstruation, frequent bruising, and acne is diagnosed with Cushing's syndrome. Cushing's syndrome is most likely caused by: A. an ectopic corticotropin-secreting tumor. B. adrenal carcinoma. C. a corticotropin-secreting pituitary adenoma. D. an inborn error of metabolism.
a corticotropin-secreting pituitary adenoma.
When caring for a client who's being treated for hyperthyroidism, the nurse should: A. provide extra blankets and clothing to keep the client warm. B. monitor the client for signs of restlessness, sweating, and excessive weight loss during thyroid replacement therapy. C. balance the client's periods of activity and rest. D. encourage the client to be active to prevent constipation.
balance the client's periods of activity and rest.
Because there is no one cause for Graves' disease, treatment is relegated to the management of symptoms, or in severe cases, surgery to remove the thyroid gland. Which is not a symptom of Graves' disease? A. constipation B. increased appetite C. blurred vision D. fine hand tremors
constipation
A client with Cushing's syndrome is admitted to the medical-surgical unit. During the admission assessment, the nurse notes that the client is agitated and irritable, has poor memory, reports loss of appetite, and appears disheveled. These findings are consistent with: A. depression. B. neuropathy. C. hypoglycemia. D. hyperthyroidism.
depression.
A nurse is caring for a client with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which finding would indicate that the client has developed fluid overload? A. dyspnea and hypertension B. pulmonary congestion and muscle cramps C. confusion and diarrhea D. hypertension and weight gain without edema
dyspnea and hypertension
Hyperthyroidism is caused by increased levels of thyroxine in blood plasma. A client with this endocrine dysfunction experiences: A. heat intolerance and systolic hypertension. B. weight gain and heat intolerance. C. diastolic hypertension and widened pulse pressure. D. anorexia and hyperexcitability.
heat intolerance and systolic hypertension
A female client is being successfully treated for Cushing's syndrome. The nurse should expect a decline in: A. serum glucose level. B. hair loss. C. bone mineralization. D. menstrual flow.
serum glucose level.
A client presents at the walk-in clinic reporting diarrhea and vomiting. The client has a documented history of adrenal insufficiency. Considering the client's history and current symptoms, the nurse should anticipate that the client will be instructed to increase intake of: A. sodium. B. potassium. C. simple carbohydrates. D. calcium.
sodium
A client has suffered from several autoimmune disorders over the last 25 years, and lately has developed a new set of symptoms. The client's healthcare provider suspects Addison's disease. Which symptom would the nurse not expect to see? A. weight gain B. hypoglycemia C. depression D. hypotension
weight gain
A nurse receives her client care assignment. Following the report, she should give priority assessment to the client: A. with pinkish mucus discharge in the appliance bag 2 days after an ileal conduit. B. who has a sodium level of 135 mEq/L and a potassium level of 3.7 mEq/L 7 days after a kidney transplant. C. who, following a kidney transplant, has returned from hemodialysis with a sodium level of 110 mEq/L and a potassium level of 2.0 mEq/L. D. who is experiencing mild pain from urolithiasis.
who, following a kidney transplant, has returned from hemodialysis with a sodium level of 110 mEq/L and a potassium level of 2.0 mEq/L.
A nurse is caring for a client who has a diagnosis of GI bleed. During shift assessment, the nurse finds the client to be tachycardic and hypotensive, and the client has an episode of hematemesis while the nurse is in the room. In addition to monitoring the client's vital signs and level of conscious, what would be a priority nursing action for this client? A. Place the client in a prone position. B. Provide the client with ice water to slow any GI bleeding. C. Prepare for the insertion of an NG tube. D. Notify the health care provider.
Notify the health care provider
