Unit 3 - PrepU Metabolism

a. Acromegaly

A female client with hyperglycemia who weighs 210 lb (95 kg) tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that the client has large hands and a hoarse voice. Which disorder would the nurse suspect as a possible cause of the client's hyperglycemia? a. Acromegaly b. Type 1 diabetes mellitus c. Hypothyroidism d. Deficient growth hormone

a. The client's consumption of carbohydrates

A male client, aged 42, is diagnosed with diabetes mellitus. He visits the gym regularly and is a vegetarian. Which of the following factors is important when assessing the client? a. The client's consumption of carbohydrates b. History of radiographic contrast studies that used iodine c. The client's mental and emotional status d. The client's exercise routine

c. Erectile dysfunction may be due to testosterone insufficiency.

After teaching a group of students about erectile dysfunction, the instructor determines that the teaching was successful when the students identify which of the following as true? a. Erectile dysfunction is unrelated to anxiety or depression. b. Erectile dysfunction is primarily a normal response to aging. c. Erectile dysfunction may be due to testosterone insufficiency. d. Erectile dysfunction rarely occurs in clients with diabetes mellitus.

b. Hypothalamus

Production of melanin is controlled by a hormone secreted by which gland? a. Thyroid b. Hypothalamus c. Adrenal d. Parathyroid

b. increases tubular reabsorption of water.

Vasopressin is administered to the client with diabetes insipidus because it: a. decreases blood pressure. b. increases tubular reabsorption of water. c. increases release of insulin from the pancreas. d. decreases glucose production within the liver.

b. Measure abdominal girth according to a set routine.

When performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. Which of the following interventions should the nurse consider? a. Report the condition to the physician immediately. b. Measure abdominal girth according to a set routine. c. Provide the client with nonprescription laxatives. d. Ask the client about food intake.

b. carbohydrate

A client in cardiac rehabilitation would like to eat the right foods to ensure adequate endurance on the treadmill. Which nutrient is most helpful for promoting endurance during sustained activity? a. protein b. carbohydrate c. fat d. water

b. vitamins B6 and B12, folate, iron, and copper

A client has extreme fatigue and is malnourished, and laboratory tests reveal a hemoglobin level of 8.5 g/dL (85 g/L). The nurse should specifically ask the client about the intake of food high in which nutrients? a. vitamins A, E, and C b. vitamins B6 and B12, folate, iron, and copper c. thiamine, riboflavin, and niacin d. vitamins A and B

b. Impaired nutrition: less than body requirements

A student nurse is preparing a plan of care for a client with chronic pancreatitis. What nursing diagnosis related to the care of a client with chronic pancreatitis is the priority? a. Disturbed body image b. Impaired nutrition: less than body requirements c. Nausea d. Anxiety

d. Record intake and output.

A client has sustained a traumatic brain injury with involvement of the hypothalamus. The health care team is concerned about the complication of diabetes insipidus. Which of the following would be an appropriate nursing intervention to monitor for early signs of diabetes insipidus? a. Assess frequent vital signs. b. Reposition frequently. c. Assess for pupillary response frequently. d. Record intake and output.

d. a warning about the drug's delayed therapeutic effect, which occurs in 14 to 30 days.

A client diagnosed with anxiety disorder is ordered buspirone. Teaching instructions for buspirone should include: a. a warning that immediate sedation can occur with a resultant drop in pulse. b. a reminder of the need to schedule blood work 1 week after initiating therapy to check blood levels of the drug. c. a warning about medication-related incidence of neuroleptic malignant syndrome. d. a warning about the drug's delayed therapeutic effect, which occurs in 14 to 30 days.

a. Syndrome of inappropriate antidiuretic hormone

A 12-year-old boy arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. He is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder would be most associated with these symptoms? a. Syndrome of inappropriate antidiuretic hormone b. Diabetes insipidus c. Hyposecretion of somatotropin d. Hypersecretion of somatotropin

b. bran muffin, skim milk, stir-fried broccoli

A 42-year-old female is interested in making dietary changes to reduce her risk of colon cancer. What dietary selections should the nurse suggest? a. croissant, granola and peanut butter squares, whole milk b. bran muffin, skim milk, stir-fried broccoli c. granola, bagel with cream cheese, cauliflower salad d. oatmeal-raisin cookies, baked potato with sour cream, turkey sandwich

a. Regular insulin

A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer? a. Regular insulin b. Lispro c. NPH d. Detemir

42

A client has been prescribed a protein intake of 0.6 g/kg of body weight. The client weighs 154 pounds. The nurse calculates the daily protein intake to be how many grams? Enter the correct number ONLY.

d. Serum potassium level of 5.8 mEq/L (5.8 mmol/L)

A client is admitted to the health care facility for evaluation for Addison's disease. Which laboratory test result best supports a diagnosis of Addison's disease? a. Blood urea nitrogen (BUN) level of 12 mg/dl (0.7 mmol/L) b. Blood glucose level of 90 mg/dl (4.9 mmol/L) c. Serum sodium level of 134 mEq/L (134 mmol/L) d. Serum potassium level of 5.8 mEq/L (5.8 mmol/L)

d. Liver biopsy

A client is being prepared to undergo laboratory and diagnostic testing to confirm the diagnosis of cirrhosis. Which test would the nurse expect to be used to provide definitive confirmation of the disorder? a. Coagulation studies b. Magnetic resonance imaging c. Radioisotope liver scan d. Liver biopsy

c. Measurement of blood hormone levels

A client is scheduled for a thyroid panel. The nurse understands that this test would involve which of the following? a. Radiograph of the neck b. Radioactive iodine uptake test c. Measurement of blood hormone levels d. Scan using an injected radioactive substance

b. "You must avoid coughing, sneezing, and blowing your nose."

A client whose physical findings suggest a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal hypophysectomy. The evening before the surgery, the nurse reviews preoperative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize? a. "You must lie flat for 24 hours after surgery." b. "You must avoid coughing, sneezing, and blowing your nose." c. "You must restrict your fluid intake." d. "You must report ringing in your ears immediately."

d. control the amount of protein intake to 59 to 70 g/day.

A client with chronic renal failure is undergoing hemodialysis. Postdialysis, the client weighs 59 kg. The nurse should teach the client to: a. increase sodium in the diet to 4 g/day. b. limit total calories consumed each day to 1,000. c. increase fluid intake to 3,000 mL each day. d. control the amount of protein intake to 59 to 70 g/day.

a. within 10 to 15 minutes after the injection.

A client with diabetes is taking insulin lispro injections. The nurse should advise the client to eat: a. within 10 to 15 minutes after the injection. b. 1 hour after the injection. c. at any time because timing of meals with lispro injections is unnecessary. d. 2 hours before the injection.

b. Hypoglycemia

A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which symptom when caring for this client? a. Polyuria b. Hypoglycemia c. Blurred vision d. Polydipsia

d. Nervousness, diaphoresis, and confusion

A nurse expects to find which signs and symptoms in a client experiencing hypoglycemia? a. Polyuria, headache, and fatigue b. Polyphagia and flushed, dry skin c. Polydipsia, pallor, and irritability d. Nervousness, diaphoresis, and confusion

d. increased possibility of drug toxicity due to higher drug plasma concentrations

A nurse is administering pain medication to an 80-year-old man. What altered drug response might be expected due to the client's age? a. decreased gastric pH causing stomach irritation b. increased possibility of drug toxicity due to increased distribution of water-soluble drugs c. increased excretion of drugs, leading to possible increased serum levels/toxicity d. increased possibility of drug toxicity due to higher drug plasma concentrations

b. An irregular apical pulse

A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately? a. Pitting edema of the legs b. An irregular apical pulse c. Dry mucous membranes d. Frequent urination

a. The child exhibits no manifestations of discomfort.

A nurse is caring for a child with intussusception. What is an expected outcome for a goal to relieve acute pain from abdominal cramping? a. The child exhibits no manifestations of discomfort. b. The child is very still. c. The child has a normal bowel movement. d. The child has not vomited in 3 hours.

a. Liver function

A nurse is caring for a client diagnosed with bipolar disorder who has been prescribed divalproex. The nurse knows that the client should have which test completed before initiation of drug therapy? a. Liver function b. Thyroid level c. White blood cell (WBC) count d. Cardiac enzymes

c. Small intestine

A nurse is caring for a client who has a malabsorption disease. The nurse should understand that which structure in the gastrointestinal system absorbs the majority of digested food and minerals? a. Stomach b. Large intestine c. Small intestine d. Liver

c. metabolism

A nurse is preparing to administer a prescribed drug to a client who has liver disease. The nurse expects a reduction in dosage based on the understanding that what might be altered? a. absorption b. distribution c. metabolism d. excretion

a. Take the insulin at around the same time each day at a meal.

A nurse is teaching a client with diabetes mellitus about self-management. Which of the following would be correct about the administration of lispro insulin? a. Take the insulin at around the same time each day at a meal. b. Increase the insulin amount with the ingestion of alcohol. c. Take once daily in the evening. d. Can be mixed with regular insulin in the same syringe for injection.

d. enhances protein synthesis.

A nurse should encourage a client with a wound to consume foods high in vitamin C because this vitamin: a. restores the inflammatory response. b. enhances oxygen transport to tissues. c. reduces edema. d. enhances protein synthesis.

c. "When I do not finish a meal, I must make up the carbohydrates right then."

After a school-age child with type 1 diabetes attends a teaching session about nutrition, the nurse determines that the teaching has been effective when the child makes which statement? a. "If I do not eat all my meal, I can make up the carbohydrates at the next meal." b. "If I am not hungry for a meal, I can eat the carbohydrates for a snack later." c. "When I do not finish a meal, I must make up the carbohydrates right then." d. "When I do not finish a meal, I just need to take more insulin."

a. a thyroid hormone antagonist.

For a client with hyperthyroidism, treatment is most likely to include: a. a thyroid hormone antagonist. b. thyroid extract. c. a synthetic thyroid hormone. d. emollient lotions.

c. Glycosylated hemoglobin level

During a follow-up visit 3 months after a new diagnosis of type 2 diabetes, a client reports exercising and following a reduced-calorie diet. Assessment reveals that the client has only lost 1 pound and did not bring the glucose-monitoring record. Which value should the nurse measure? a. Fasting blood glucose level b. Glucose via a urine dipstick test c. Glycosylated hemoglobin level d. Glucose via an oral glucose tolerance test

c. "As endocrine functions become more stable throughout childhood, alterations become more apparent."

Eve, 2 years old, and her parents are at the office for a follow-up visit. She has had excessive hormone levels in her recent bloodwork and her parents question why this was not found sooner. What is the best response of the nurse? a. "It takes time to determine the level of functioning of endocrine glands." b. "Have there been signs and symptoms that you should have reported to the doctor?" c. "As endocrine functions become more stable throughout childhood, alterations become more apparent." d. "Endocrine disorders are hard to detect and you are lucky that we have found it when we did."

d. Maintaining room temperature in the low-normal range

For a client with Graves' disease, which nursing intervention promotes comfort? a. Restricting intake of oral fluids b. Placing extra blankets on the client's bed c. Limiting intake of high-carbohydrate foods d. Maintaining room temperature in the low-normal range

a. the action that the drug has on body cells

How is pharmacodynamics best defined? a. the action that the drug has on body cells b. the method by which a drug is distributed through the body c. the time that elapses between absorption and excretion of a drug d. the way that the liver or kidneys alter the chemical structure of a drug

c. Synthesis of glucose from noncarbohydrate sources.

Insulin is a hormone secreted by the Islets of Langerhans and is essential for the metabolism of carbohydrates, fats, and protein. The nurse understands the physiologic importance of gluconeogenesis, which refers to the: a. Transport of potassium. b. Release of glucose. c. Synthesis of glucose from noncarbohydrate sources. d. Storage of glucose as glycogen in the liver.

a. 100

Morbid obesity is defined as being how many pounds over the person's ideal body weight? a. 100 b. 90 c. 75 d. 50

c. Propylthiouracil

The nurse is administering a medication to a client with hyperthyroidism to block the production of thyroid hormone. The client is not a candidate for surgical intervention at this time. What medication should the nurse administer to the client? a. Levothyroxine b. Spironolactone c. Propylthiouracil d. Propranolol

b. Restrict sodium.

The client with Cushing's disease needs to modify dietary intake to control symptoms. In addition to increasing protein, which strategy would be most appropriate? a. Increase calories. b. Restrict sodium. c. Restrict potassium. d. Reduce fat to 10%.

d. decreased catabolism.

The most important intervention in the nutritional support of a client with a burn injury is to provide adequate nutrition and calories. The nurse recognizes this intervention is to promote a. increased metabolic rate. b. increased glucose demands. c. increased skeletal muscle breakdown. d. decreased catabolism.

b. brittle nails

The nurse is assessing a client's nutritional status before surgery. Which observation would indicate poor nutrition in a 5-foot 7-inch (170 cm) female client who is 21 years of age? a. poor posture b. brittle nails c. dull expression d. weight of 128 lb (58.1 kg)

a. Serum sodium level c. Serum potassium level d. Blood glucose level e. White blood cell count

The nurse is caring for a client with Cushing's disease. During change of shift report, which assessment laboratory data would the nurse anticipate communicating? Select all that apply. a. Serum sodium level b. Hemoglobin and hematocrit c. Serum potassium level d. Blood glucose level e. White blood cell count f. Creatinine clearance total

b. Diabetes insipidus

The nurse is caring for a client with polydipsia and large amounts of urine with a specific gravity of 1.003. Which disorder is anticipated? a. Diabetes mellitus b. Diabetes insipidus c. Diabetic ketoacidosis d. SIADH secretion

b. Risk factors and prevention of diabetes mellitus

The nurse is discussing diabetes mellitus with the family members of a client recently diagnosed. In order to promote the health of the family members, what would be the most important information for the nurse to include? a. Medications used to treat diabetes mellitus b. Risk factors and prevention of diabetes mellitus c. The severity of the client's disease d. The cellular metabolism of glucose

a. decreased thyroxine (T4) and increased thyroid-stimulating hormone (TSH) levels.

The nurse is reviewing the laboratory results of a client with hypothyroidism. An expected finding is: a. decreased thyroxine (T4) and increased thyroid-stimulating hormone (TSH) levels. b. decreased TSH and increased T4 levels. c. decreased creatine phosphokinase levels. d. absence of antithyroid antibodies.

c. "His stomach can hold approximately 10 ounces."

The nurse is teaching a new mother about the changes in her newborn's gastrointestinal tract. The nurse determines that additional teaching is needed when the mother makes which statement? a. "The newborn's gut is sterile at birth." b. "He needs to get food orally to make vitamin K." c. "His stomach can hold approximately 10 ounces." d. "The muscle opening that leads into of the stomach is not mature."

d. burping the infant during and after the feeding

The nurse judges that the mother has understood the teaching about care of an infant with colic when the nurse observes the mother doing which action? a. holding the infant prone while feeding b. holding the infant in her lap to burp c. placing the infant prone after the feeding d. burping the infant during and after the feeding

b. saturated fat

The nurse should instruct a client with heart disease to avoid which foods that contribute to increases in serum cholesterol? a. polyunsaturated fat b. saturated fat c. monounsaturated fat d. phospholipids

a. cannot tolerate high-glucose concentration.

Total parental nutrition (TPN) should be used cautiously in clients with pancreatitis because such clients: a. cannot tolerate high-glucose concentration. b. are at risk for gallbladder contraction. c. are at risk for hepatic encephalopathy. d. can digest high-fat foods.

b. handle TPN using strict aseptic technique.

Total parenteral nutrition (TPN) is prescribed for a client who has recently had a significant small and large bowel resection and is currently not taking anything by mouth. The nurse should: a. administer TPN through a nasogastric or gastrostomy tube. b. handle TPN using strict aseptic technique. c. auscultate for bowel sounds prior to administering TPN. d. designate a peripheral intravenous (IV) site for TPN administration.

False

True or False: More patients experience hyperthyroidism than hypothyroidism.

a. Hypokalemia and hypoglycemia

Which combination of adverse effects should a nurse monitor for when administering I.V. insulin to a client with diabetic ketoacidosis? a. Hypokalemia and hypoglycemia b. Hypocalcemia and hyperkalemia c. Hyperkalemia and hyperglycemia d. Hypernatremia and hypercalcemia

a. The client will maintain normal fluid and electrolyte balance.

Which indicates that the client with diabetes insipidus understands how to manage care? a. The client will maintain normal fluid and electrolyte balance. b. The client will select a diabetic diet correctly. c. The client will state dietary restrictions. d. The client will exhibit serum glucose level within normal range.

b. body mass index (BMI)-for-age

Which method would be most appropriate for the nurse use to determine if a 2-year-old is obese? a. weight-for-length charts b. body mass index (BMI)-for-age c. abdominal girths d. skinfold thickness measurements

a. Observe the color of stool.

Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome? a. Observe the color of stool. b. Monitor bowel patterns. c. Monitor vital signs every 4 hours. d. Observe urine output.

a. Intradermal

Which parenteral route of administration has the longest absorption time? a. Intradermal b. Intravenous c. Subcutaneous d. Intramuscular

c. Flushed, warm skin

Which would a nurse expect to assess in a client experiencing hyperthyroidism? a. Slow and deep tendon reflexes b. Bradycardia c. Flushed, warm skin d. Intolerance to cold