1.
The client with a neurological
impairment experiences urinary incontinence. Which nursing action would be most
helpful in assisting the client to adapt to this alteration?
A.
Establishing a toileting schedule
B.
Inserting a Foley catheter
C.
Using adult diapers
D.
Padding the bed with an absorbent
cotton pad
2.
A client with a history of Addison's
disease and hydrocortisone flulike symptoms accompanied by nausea and vomiting
over the past week is brought to the facility. When he awoke this morning, his
wife noticed that he acted confused and was extremely weak. The client's blood
pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is
101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. Which of
the following would the nurse expect to administer by I.V. infusion?
A.
Insulin
B.
Hydrocortisone
C.
Potassium
D.
Hypotonic saline
3.
A nurse is monitoring a client
receiving chlorpropamide (Diabenese). The nurse knows that which of the
following is not a therapeutic outcome for this client?
A.
A decrease in polyuria.
B.
A fasting blood glucose of 110
mg/dL.
C.
A decrease in polyphagia.
D.
A glycosylated hemoglobin of 10%
4.
A client with aldosteronism is being
treated with spironolactone (Aldactone). Which of the following indicates to
the nurse that the medication is effective?
A.
A decrease in blood pressure
B.
A decrease in sodium excretion
C.
A decrease in plasma potassium
D.
A decrease in body metabolism
5.
The nurse in the health care clinic
is providing medication instructions to a client with a seizure disorder who
will be taking divalproex sodium (Depakote). The nurse instructs the client
about the importance of retuning to the clinic for monitoring of which of the
following laboratory study?
A.
Liver function studies
B.
Renal function studies
C.
Blood glucose level
D.
Electrolytes
6.
A nurse performs a physical assessment
on a client with type 2 diabetes mellitus. Findings include a fasting blood
glucose of 120 mg/dL, temperature of 101o F, pulse of 88, respirations of 22,
and blood pressure of 140/84 mm Hg. Which finding would be of most concern to
the nurse?
A.
Pulse
B.
Blood pressure
C.
Respiration
D.
Temperature
7.
A client with a known history of
type 2 diabetes mellitus has a fingerstick blood glucose level of 460 mg/dL.
The client is noticeably lethargic, and the family states that the client has
had increases thirst over the last day or two. The home care nurse would
anticipate that which additional finding would be present with further testing
if the client is experiencing diabetic ketoacidosis?
A.
Presence of ketone bodies
B.
Elevated serum bicarbonate level
C.
Rise in serum pH
D.
Hyponatremia
8.
A nurse is developing a plan of care
for a client with Cushing’s syndrome. The client has a nursing diagnosis of
Excess Fluid Volume. The nurse understands that which of the following is
unnecessary to include in the plan of care?
A.
Monitor daily weight.
B.
Monitor intake and output.
C.
Maintain a low-potassium and
high-sodium diet.
D.
Monitor jugular venous pressure and
extremities for edema.
9.
A 9-year-old child with diabetes
mellitus is hospitalized for dosage regulation of insulin. The child appears to
be very manipulative and has been observed sneaking food and trying to talk the
mother into providing sweets. Based on this behavior, when the child complains
of hypoglycemia, the most appropriate nursing action would be to:
A.
Test the urine for glucose
B.
Obtain a blood glucose level
C.
Administer orange juice with sugar
D.
Ask the child the last time food was
eaten
183. 2
B","This is inaccurate and does not reflect the present status. ","A quick check of the blood glucose level will confirm whether the client is hypoglycemic. ","Although this might be appropriate to counter hypoglycemia, it does not determine whether the client is being hypoglycemic or is being manipulating. ","Although this might be appropriate to counter hypoglycemia, it does not determine whether the client is being hypoglycemic or is being manipulating. " (SR 1904)
10.
For the first 72 hours after
thyroidectomy surgery, the nurse would assess the client for Chvostek's sign
and Trousseau's sign because they indicate which of the following?
A.
Hypocalcemia
B.
Hypercalcemia
C.
Hypokalemia
D.
Hyperkalemia
11.
A middle-age female complains of
anxiety, insomnia, weight loss, the inability to concentrate, and eyes feeling
"gritty." Thyroid function tests reveal the following:
thyroid-stimulating hormone (TSH) 20 μl U/ml, thyroxine 20 μg/dl, and
triiodothyronine 253 μg/dl. A 6-hr radioactive iodine uptake test shows a
diffuse uptake of 85%. Based on these assessment findings, the nurse would
suspect which of the following?
A.
Thyroiditis
B.
Graves' disease
C.
Hashimoto's thyroiditis
D.
Multinodular goiter
12.
A client who is scheduled to have
surgery to remove an aldosterone-secreting adenoma wonders what will happen if
he refuses to have the surgery. The nurse would base a response on the fact
that:
A.
The tumor must be removed to prevent
heart and kidney damage
B.
Surgery will prevent the tumor from
metastasizing to other organs
C.
Radiation therapy can be just as
effective as surgery if the tumor is small
D.
Chemotherapy is as reliable as
surgery to treat adenomas of this type in some cases
13.
A client has abnormal amounts of
circulating thyronine and thyroxine. The nurse understands that the client may
have a deficiency of which of the following dietary elements?
A.
Calcium
B.
Magnesium
C.
Phosphorus
D.
Iodine
14.
A client with diabetes mellitus who
takes insulin is seen in the health care clinic. The client tells the nurse
that after giving the insulin injection, the insulin seems to leak through the
skin. The nurse most appropriately would determine the problem by asking the
client which of the following?
A.
“Are you using a 1-inch needle to
give the injection?”
B.
“Are you placing an air bubble in
the syringe before injection?”
C.
“Are you aspirating before you
inject the insulin?”
D.
“Are you rotating the injection
site?”
15.
The nurse is providing instructions
to a client with a diagnosis of Addison’s disease regarding the administration
of prescribed glucocorticoids. The nurse would instruct the client
A.
To avoid taking the medication if
nausea occurs.
B.
To stop the medication if side
effects occur.
C.
That minimal side effects will occur
form the use of this medication.
D.
That an increase dose of medication
may be needed during times of stress.
16.
A nurse develops a plan of care for
a client with hyperparathyroidism who is receiving calcitonin salmon (Calcimar).
Which of the following outcome criteria has the highest priority regarding this
medication?
A.
Absence of side effects
B.
Achievement of normal serum calcium
levels
C.
Relief of pain
D.
Verbalization of appropriate
medication knowledge
17.
A child brought to the hospital with
ketoacidosis is to receive regular insulin via an intravenous infusion. Which
of the following intravenous solutions would the nurse expect the physician to
order initially?
A.
2.5% dextrose.
B.
5% dextrose.
C.
0.45% saline.
D.
0.9% saline.
18.
Late in the postoperative period
after the removal of an aldosteronoma the nurse would expect the client's blood
pressure to:
A.
Gradually return to near normal
levels
B.
Rise quickly above preoperative
levels
C.
Fluctuate greatly during this entire
period
D.
Drop very low, then rise rapidly to
normal levels
19.
A client has impaired function of
the posterior pituitary gland. The nurse plans care knowing that the client may
exhibit altered secretion of which of the following hormones?
A.
Antidiuretic hormone
B.
Growth hormone
C.
Follicle-stimulating hormone
D.
Luteinizing hormone
20.
A nurse teaches a client with
diabetes mellitus about differentiating between hypoglycemia and ketoacidosis.
The client demonstrates an understanding of the teaching by stating that
glucose will be taken if which of the following symptoms develops?
A.
Fruity breath odor
B.
Shakiness
C.
Blurred vision
D.
Polyuria
21.
A nurse has provided home care
measures to the client with diabetes mellitus. Which statement by the client
indicates a need for further instructions?
A.
“I should perform my exercise at
peak insulin time.”
B.
“I should always carry a
quick-acting carbohydrate when I exercise.”
C.
“I should always wear a Medic Alert
bracelet.”
D.
“I should avoid exercising at times
when a hypoglycemic reaction is likely to occur.”
22.
For a client in addisonian crisis,
it would be very risky for a nurse to administer:
A.
potassium chloride.
B.
normal saline solution.
C.
hydrocortisone.
D.
fludrocortisone.
23.
A nurse is caring for a client who
is scheduled to have a thyroidectomy and provides instructions to the client
about the surgical procedure. Which of the following statements by the client
would indicate an understanding of the nurse’s instructions?
A.
“I definitely will have to continue
taking antithyroid medications after this surgery.”
B.
“I need to place my hands behind my
neck when I have to cough or change positions.”
C.
“I need to turn my head and neck
front, back, and laterally every hour for the first 12 hours after surgery.”
D.
“I expect to experience some
tingling of my toes, fingers, and lips after surgery.”
24.
The nurse is performing an
assessment on a client with a diagnosis of hyperthyroidism. Which assessment
finding would the nurse expect to note in this client?
A.
Periorbital edema
B.
Coarse facial features
C.
Dry skin
D.
Bulging eyeballs
25.
After a thyroidectomy a client
should be observed for the possible complication of thyroid crisis, which would
be evidenced by:
A.
An increased pulse deficit
B.
A decreased blood pressure
C.
A decreased pulse rate and
respirations
D.
An increased temperature and pulse
rate
26.
Following a thyroidectomy the client
exhibits carpopedal spasm and some tremors. The client complains of tingling in
the fingers and around the mouth. The nurse should notify the physician and
expect to administer:
A.
Potassium iodide
B.
Calcium gluconate
C.
Magnesium sulfate
D.
Potassium chloride
27.
Which of the following would be most
appropriate when responding to a mother who asks how to manage her child's
morning hyperglycemia?
A.
Tell the mother that this is normal
and to continue with the ordered doses.
B.
Ask the mother what her child's
blood glucose levels have been for the last few days.
C.
Inform the mother that this is
unusual and the child needs to be seen in the emergency room now.
D.
Question the mother if her child has
been avoiding sweets.
28.
A client has a tumor that is
interfering with the function of the hypothalamus. The nurse would expect that
the client would exhibit which of the following clinical problems?
A.
Glucocorticoid excess or deficit
B.
Mineralocorticoid excess or deficit
C.
Antidiuretic hormone excess or
deficit
D.
Melatonin excess or deficit
29.
A patient is prescribed
chlorpropamide (Diabinese). The nurse should notify the physician if the
patient reports being allergic to
A.
aspirin.
B.
penicillin.
C.
iodine.
D.
sulfur.
30.
A client with diabetes mellitus is
prone to breaking down fats for conversion to glucose. The nurse determines
that this response currently is occurring if the client has elevated levels of
which of the following substances?
A.
Glucose
B.
Ketones
C.
Glucagon
D.
Lactic dehydrogenase
31.
A client who has had a subtotal
thyroidectomy does not understand how hypothyroidism could develop when the
problem was hyperthyroidism. The nurse should base a response on the knowledge
that:
A.
Hypothyroidism is a gradual slowing
of the body's function
B.
There will be a decrease in
pituitary thyroid-stimulating hormone
C.
There is less thyroid tissue to
supply thyroid hormone after surgery
D.
Atrophy of tissue remaining after
surgery reduces secretion of thyroid hormones
32.
A client with a seizure disorder has
been prescribed phenytoin (Dilantin). Which of the following facts should the
nurse include in the teaching plan?
A.
The use of phenytoin can lead to the
development of diabetes.
B.
It is appropriate to substitute
various brands of phenytoin as long as the dosage is the same.
C.
It will be necessary for the client
to take potassium supplements to prevent hypokalemia.
D.
The client should use a soft
toothbrush and floss teeth daily.
33.
A 66-year-old female who has
diabetes mellitus and has sustained a large laceration on her left wrist asks
the nurse, "How long will it take for my scars to disappear?" Which
of the following statements would be the nurse's best response?
A.
"The contraction phase of wound
healing can take 2 to 3 years."
B.
"Wound healing is very
individual but within 4 months the scar should fade."
C.
"With your history and the type
and location of the injury, it's hard to say."
D.
"If you don't develop an
infection, the wound should heal anywhere between 1 and 3 years."
34.
A nurse is assessing the learning
readiness of a client newly diagnosed with diabetes mellitus. Which client
behavior indicates to the nurse that the client is not ready to learn?
A.
The client complains of fatigue
whenever the nurse plans a teaching session.
B.
The client asks if the spouse can
attend the teaching session.
C.
The client asks for written
materials about diabetes mellitus before class.
D.
The client asks appropriate
questions about what will be taught.
35.
A nurse needs to maintain food and
fluid intake to minimize the risk of dehydration in a frail, older, client with
diabetes mellitus who has gastroenteritis. The most appropriate nursing
intervention is to
A.
Offer water only, until the client
is able to tolerate solid foods.
B.
Withhold all fluids until vomiting
has ceased for at least 4 hours.
C.
Encourage the client to take 8 to 12
oz of fluid every hour while awake.
D.
Maintain a clear liquid diet for at
least 5 days before advancing to solids to allow inflammation of the bowel to
dissipate.
36.
When glucagon is administered for
reversal of the hypoglycemic state, it acts by:
A.
Liberating glucose from hepatic
stores of glycogen
B.
Supplying glycogen to the brain and
other vital organs
C.
Competing for insulin and blocking
its action at tissue sites
D.
Providing a glucose substitute for
rapid replacement of deficits
37.
During the first 24 hours after a
client is diagnosed with addisonian crisis, which of the following should the
nurse perform frequently?
A.
Weigh the client.
B.
Test urine for ketones.
C.
Assess vital signs.
D.
Administer oral hydrocortisone.
38.
The nurse is preparing to discharge
a client who has had a parathyroidectomy. The discharge instructions include
medication administration of oral calcium supplements that the client will need
daily. Which statement by the nurse would be appropriate regarding the oral
calcium supplement therapy?
A.
Store the tablets in the
refrigerator to maintain potency.
B.
Check the pulse daily; if it is
fewer than 60 beats per minute, do not take the tablets.
C.
Take the tablets following a meal.
D.
Avoid sunlight because the
medication can cause skin color change.
39.
The type of insulin that is used for
the emergency treatment of ketoacidosis is:
A.
Regular insulin
B.
Insulin zinc suspension
C.
Isophane insulin suspension
D.
Insulin zinc suspension extended
40.
A nurse is caring for a
postoperative parathyroidectomy client. Which client complaint would indicate
that a serious, life-threatening complication might be developing, requiring
immediate notification of the physician?
A.
Difficulty in voiding
B.
Abdominal cramps
C.
Laryngeal stridor
D.
Mild to moderate incisional pain
41.
Which of the following statements by
the mother of an 8-year-old child who is unconscious secondary to ketoacidosis
would the nurse interpret as supportive of a diagnosis of insulin-dependent
diabetes?
A.
"He has become almost
hyperactive in the past month."
B.
"He started to wet his bed at
night for the first time in 3 years."
C.
"He seems to be gaining weight
lately."
D.
"He has lost his appetite in
the past 2 weeks."
42.
A client is diagnosed with type 1
diabetes mellitus. The nurse understands that which of the following factors is
not believed to be a cause of the beta cell destruction that accompanies this
disorder?
A.
Genetic factors
B.
Autoimmune factors
C.
Primary failure of glucagon
secretion
D.
Viruses
43.
A client has an endocrine system
dysfunction of the pancreas. The nurse plans care knowing that the client will
exhibit impaired secretion of which of the following substances?
A.
Amylase
B.
Lipase
C.
Trypsin
D.
Insulin
44.
Parathyroid hormone (PTH) has which
effects on the kidney?
A.
Stimulation of calcium reabsorption
and phosphate excretion
B.
Stimulation of phosphate
reabsorption and calcium excretion
C.
Increased absorption of vitamin D
and excretion of vitamin E
D.
Increased absorption of vitamin E
and excretion of vitamin D
45.
A client with diabetes mellitus has
a blood glucose level of 644 mg/dL. The nurse interprets that this client is
most at risk of developing which type of acid-base imbalance?
A.
Respiratory acidosis
B.
Respiratory alkalosis
C.
Metabolic acidosis
D.
Metabolic alkalosis
46.
After several diagnostic tests, a
client is diagnosed with diabetes insipidus. A nurse performs an assessment on
the client, knowing that which symptom is indicative of this disorder?
A.
Diarrhea
B.
Polydipsia
C.
Weight
D.
gain Fatigue
47.
The client received 20 units of NPH
insulin subcutaneously at 8 AM. The nurse should assess the client for a
hypoglycemic reaction at
A.
10 AM.
B.
11 AM.
C.
5 PM.
D.
11 PM.
48.
The client with diabetes mellitus
has been instructed in the dietary exchange system. The client asks the nurse
if bacon is allowed in the diet. Which nursing response is most appropriate?
A.
“Bacon is much too high in fat.”
B.
“Bacon is not allowed.”
C.
“One strip of bacon may be eaten if
you eliminate one teaspoon of butter.”
D.
“Bacon may be eaten if you eliminate
one meat item from your diet.”
49.
A nurse is interviewing a client
with type 2 diabetes mellitus. Which statement by the client indicates an
understanding of treatment for this disorder?
A.
“I am taking oral insulin instead of
shots.”
B.
“The medications I’m taking help
release the insulin I already make.”
C.
“By taking these medications, I am
able to eat more.”
D.
“When I become ill, I need to
increase the number of pills I take.”
50.
A 37-year-old Hispanic client visits
the clinic for the first time. She is about 12 weeks pregnant, and this is her
first pregnancy. The nurse instructs the client that one test that will most
likely be ordered is a:
A.
Glucose tolerance test.
B.
Chorionic villi sampling.
C.
Urine culture and sensitivity.
D.
Hepatitis D test.
51.
A client with diabetes mellitus
reports to the health care clinic for a glycosylated hemoglobin A1c level.
Which of the following laboratory results indicate client compliance with the
prescribed diabetic regimen?
A.
5%
B.
8%
C.
10%
D.
15%
52.
Capillary glucose monitoring is
being performed every 4 hours for a client diagnosed with diabetic
ketoacidosis. Insulin is administered using a scale of regular insulin
according to glucose results. At 2 p.m., the client has a capillary glucose
level of 250 mg/dl for which he receives 8 U of regular insulin. The nurse
should expect the dose's:
A.
onset to be at 2 p.m. and its peak
to be at 3 p.m.
B.
onset to be at 2:15 p.m. and its
peak to be at 3 p.m.
C.
onset to be at 2:30 p.m. and its
peak to be at 4 p.m.
D.
onset to be at 4 p.m. and its peak
to be at 6 p.m.
53.
A nurse is completing an assessment
on an older client who is being admitted for a diagnostic workup for primary
hyperparathyroidism. Which client complaint would be characteristic of this
disorder?
A.
Diarrhea
B.
Polyuria
C.
Polyphagia
D.
Weight gain
54.
The nurse teaches the client with
diabetes mellitus about the importance of maintaining stable blood glucose
levels. What dietary constituent has been found to minimize the rise in blood
glucose level after meals?
A.
Dietary fiber.
B.
Dairy products.
C.
Vitamin-fortified foods.
D.
Organ meats.
55.
A nurse is preparing a plan of care
for the client with diabetes mellitus and plans to instruct the client
regarding the symptoms of hypoglycemia. Which of the following symptoms would
the nurse list on the instruction sheet that will be given to the client?
A.
Elevated pulse, lethargy, warm, dry
skin
B.
Elevated pulse, shakiness, cool
clammy skin
C.
Slow pulse, lethargy, warm dry skin
D.
Slow pulse, confusion, increased
urine output
56.
The mother of a newly diagnosed
diabetic child is being taught the principles of the diabetic diet. Which of
the following statements by the mother indicates effective teaching?
A.
"By spreading the calories
throughout the day in small frequent meals, the risk of hyperglycemia is eliminated."
B.
"Most children find it
difficult to eat all the calories required on their diets in three main
meals."
C.
"Snacks are used to keep blood
glucose at acceptable levels during times when the insulin level peaks."
D.
"Snacks are used to offset the
desire for sweets and to keep the meals smaller so he can eat better."
57.
When developing the teaching plan
for an adolescent with insulin-dependent diabetes, which of the following would
the nurse expect to include about the relationship among exercise, diet, and
insulin?
A.
"Before running, inject your
insulin into the leg muscle for quicker absorption.
B.
"If your blood glucose is 240
ng/dLmg/dL or above, do not run."
C.
"You will need to take extra
insulin before you go running."
D.
"Do not eat your snack before
running because you'll get a stomachache.
58.
A client with type 1 diabetes
mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In
discussing the result with the client, the nurse would be most accurate in
stating:
A.
"The test needs to be repeated
following a 12-hour fast."
B.
"It looks like you aren't
following the prescribed diabetic diet."
C.
"It tells us about your sugar
control for the last 3 months."
D.
"Your insulin regimen needs to
be altered significantly."
59.
A child with diabetes mellitus who
is also learning-disabled has trouble correctly measuring the required insulin
dose. The child frequently draws up 42 units of insulin instead of the
prescribed 24 units. The most appropriate intervention to ensure dosage safety
would be to:
A.
Teach the child to use a magnifying
glass to read the numbers on the syringe
B.
Exchange the insulin syringe the child
has been using for a tuberculin syringe
C.
Provide the child with preset
syringe guides that were developed for the blind
D.
Allow the child to have the number
written down on paper when filling the syringe
60.
A client is diagnosed with Cushing’s
syndrome. The nurse understands that this client has excesses of which of the
following substances?
A.
Calcium
B.
Cortisol
C.
Epinephrine
D.
Norepinephrine
61.
A nurse monitoring a client who has
returned to the nursing unit following a myelogram. Which of the following
client complaints would indicate the need to notify the physician?
A.
Headache
B.
Neck stiffness
C.
Feelings of fatigue
D.
Backache
62.
A nurse is caring for a client
admitted to the hospital with uncontrolled type 1 diabetes mellitus. As part of
the nursing care plan the nurse monitors for diabetic ketoacidosis. In the
event that diabetic ketoacidosis does occur, the nurse would anticipate that
the most likely medication to be prescribed would be
A.
Regular insulin.
B.
NPH insulin.
C.
Glucagon.
D.
Glyburide (DiaBeta)
63.
A client has over activity of the
thyroid gland. The nurse anticipates that the client will experience which of
the following effects from this hormonal excess?
A.
Low blood glucose levels
B.
Nutritional deficiencies
C.
Weight gain
D.
Increased body fat stores
64.
A client is scheduled for digital
subtraction angiography. The nurse is providing instructions to the client
regarding the test and informs the client that the test is performed to
A.
Provide information about the blood
vessels.
B.
Inject medication on the bone.
C.
Detect lesions on the brain.
D.
Examine the cerebral spinal column.
65.
A physician prescribes levothyroxine
sodium (Synthroid), 0.15 mg PO daily, for a client with hypothyroidism. A nurse
will prepare to administer this medication
A.
3 times a day in equal doses of 0.5
mg each to ensure consistent serum drug levels.
B.
In the morning to prevent
sleeplessness.
C.
Only when the client complains of
fatigue and cold intolerance.
D.
At various times during the day to
prevent tolerance from occurring.
66.
A nurse has provided instructions to
a client, who is newly diagnosed with diabetes mellitus and who will be taking
insulin, about measuring blood glucose levels. The nurse determines that the
client understands the procedure for checking blood glucose levels when the
client states to do which of the following?
A.
“I should check my blood glucose
level every day at five PM.”
B.
“I should check my blood glucose
level before each meal and at bedtime.”
C.
“I should check my blood glucose
level two hours after each meal.”
D.
“I should check my blood glucose
level one hour after each meal.”
67.
A client newly diagnosed with
diabetes mellitus has been stabilized with insulin injections daily. A nurse
prepares a discharge teaching plan regarding the insulin. The teaching plan
should reinforce which of the following concepts?
A.
Increase the amount of insulin
before unusual exercise.
B.
Ketones in the urine signify a need
for less insulin.
C.
Always keep insulin vials
refrigerated.
D.
Systematically rotate insulin
injection sites.
68.
A nurse is assigned to care for a
client with type 1 diabetes mellitus. The nurse would monitor for which sign of
hypoglycemia when assessing this client’s status during the shift?
A.
Anorexia
B.
Tremors
C.
Hot, dry skin
D.
Muscle cramps
69.
A home care nurse is visiting a
client newly diagnosed with diabetes mellitus. The client tells the nurse that
he is planning to eat a dinner meal at a local restaurant this week. The client
asks the nurse if eating at a restaurant will affect diabetic control and if
this is allowed. Which nursing response is most appropriate?
A.
“You are not allowed to eat in
restaurants.”
B.
“If you plan to eat in a restaurant,
you need to skip the lunchtime.”
C.
“You should order a half-portion
meal and have fresh fruit for dessert.”
D.
“You should increase your daily dose
of insulin by half on the day that you plan to eat in the restaurant.”
70.
A client with newly diagnosed type 1
diabetes mellitus is learning about diabetic foot care. The nurse should
instruct the client to avoid:
A.
lotions.
B.
antiperspirants.
C.
foot soaks.
D.
nail files.
71.
The nurse is caring for a client
following a thyroidectomy. The nurse notes that calcium gluconate is prescribed
for the client. The nurse determines that this medication has been prescribed
to
A.
Treat thyroid storm.
B.
Prevent cardiac irritability.
C.
Stimulate release of parathyroid
hormone.
D.
Treat hypocalcemic tetany
72.
A client is diagnosed with
dysfunction of the adrenal medulla. The nurse monitors for changes in client
status related to altered production and secretion of which of the following
substances?
A.
Cortisol
B.
Epinephrine
C.
Aldosterone
D.
Androgens
73.
A client with diabetes mellitus is
scheduled to have a fasting blood glucose level drawn in the morning. The nurse
tells the client not to eat or drink after midnight. When the client asks for
further information about fluid and food intake, the nurse clarifies by stating
that which of the following would be acceptable to consume before the test?
A.
Water
B.
Coffee without any milk
C.
Tea without any sugar
D.
Clear liquids such as apple juice
74.
A nurse is monitoring the client
following thyroidectomy for signs of hypocalcemia. Which of the following
signs, if noted in the client, most likely would indicate the presence of
hypocalcemia?
A.
Tingling around mouth
B.
Flaccid paralysis
C.
Negative Chvostek’s sign
D.
Bradycardia
75.
A nurse is providing home care
instructions to the client with a diagnosis of Cushing’s syndrome and prepares
a list of instructions for the client. Which of the following is inappropriate
to include on the list?
A.
Take the medications exactly as
prescribed.
B.
Read the labels on the
over-the-counter medications before purchase.
C.
Understand the signs and symptoms of
hypoadrenalism.
D.
Understand the signs and symptoms of
hyperadrenalism.
76.
The client treated for an episode of
hyperthermia is being discharged to home. The nurse determines that the client
needs clarification of discharge instructions if the client stated to
A.
Stay in cool environment when
possible.
B.
Increase fluid intake.
C.
Monitor voiding for adequacy of
urine output.
D.
Resume full activity level.
77.
Which of the following is
appropriate to include in a teaching plan for a 9-year-old who has had diabetes
for several years?
A.
Beginning recognition of symptoms of
hypoglycemia.
B.
Measurement of insulin accurately in
the syringe.
C.
Beginning ability to give own
injections with adult supervision.
D.
Assumption of responsibility for
self-care.
78.
The nurse has formulated a nursing
diagnosis of Imbalanced Nutrition: Less Than Body Requirements for unconscious
client. Which of the following outcomes indicates to the nurse that the goals
have not yet been fully met?
A.
Stable weight.
B.
Intake equaling output.
C.
Blood urea nitrogen of 12 mg/dL
D.
Total protein of 4.5 g/dL
79.
A test to measure long-term control
of diabetes mellitus has been prescribed for a client. The nurse tells the
client that long-term control can be measures because chronic high blood
glucose levels lead to irreversible glucose binding onto which of the following
items?
A.
Muscle tissue
B.
Adipose tissue
C.
Red blood cells
D.
Platelets
80.
A nurse is developing a plan of care
for an older client that addresses interventions to prevent cold discomfort and
the development of accidental hypothermia. The nurse documents which desired
outcome in the plan of care?
A.
The client remains in a fetal
position when in bed.
B.
The client complains of coolness in
the hands and feet only.
C.
The client’s body temperature is
98°F.
D.
The client’s fingers and toes are
cool to touch.
81.
A client with diabetes mellitus
visits a health care clinic. The client’s diabetes mellitus previously had been
well controlled with glyburide (DiaBeta), 5 mg PO daily, but recently the
fasting blood glucose has been running 180 to 200 mg/dL. Which medication, if
added to the client’s regimen, may have contributed to the hyperglycemia?
A.
Prednisone (Deltasone)
B.
Atenolol (Tenormin)
C.
Phenelzine (Nardil)
D.
Allopurinol (Zyloprim)
82.
A nurse is preparing to provide
instructions to a client with Addison’s disease regarding diet therapy. The
nurse knows that which of the following diets most likely would be prescribed
for this client?
A.
High fat intake
B.
Normal sodium intake
C.
Low protein intake
D.
Low carbohydrate intake
83.
A home health nurse visits a client
with a diagnosis of type 1 diabetes mellitus. The client relates a history of
vomiting and diarrhea and tells the nurse that no food or medication has been
consumed for 36 hours. Which additional statement by the client indicates a
need for further teaching?
A.
“Ï need to stop my insulin.”
B.
“I need to increase my fluid
intake.”
C.
“I need to call the physician
because of these symptoms.”
D.
“I need to monitor my blood glucose
every 3 to 4 hours.”
84.
The mother of a 10-year-old girl
with diabetes asks the nurse's advice about whether or not her child, who has
always been compliant with treatment, should be allowed to go trick-or-treating
on Halloween with several friends. Which of the following would be the nurse's
best response?
A.
"No, it would be a
life-threatening emergency if she eats sweets."
B.
"You must go with her and watch
her so she doesn't eat any sweets."
C.
"Yes, just give her a little
extra insulin before she goes."
D.
"Yes, she needs to be with
friends and do the things other children do."
85.
A patient is to begin taking
alendronate (Fosamax). Which of the following statements should be included in
the patient's teaching plan?
A.
Crush the medication and mix with
food.
B.
Take the medication with one swallow
of water.
C.
Dissolve the medication under the
tongue.
D.
Remain upright for 30 minutes after
swallowing the medication.
86.
An emergency room nurse is reviewing
the laboratory results of a client suspected of having diabetic ketoacidosis.
Which of the following laboratory results would the nurse expect to note in
this disorder?
A.
Absent ketones in the urine
B.
Blood glucose level of 500 mg/dL
C.
Venous blood pH of 8
D.
Serum bicarbonate of 22 mEq/L
87.
A nurse is reviewing the orders of a
client with a diagnosis of diabetes mellitus who was admitted to the hospital
because of an infected foot ulcer. The nurse would expect to note which of the
following in the physician’s orders?
A.
A decreased amount of NPH insulin
daily
B.
An increased amount of NPH insulin
daily
C.
An increased calorie diet
D.
A decreased calorie diet
88.
After having trouble breast-feeding,
a 6-week-old female infant exhibits dry scaly skin and a protruding tongue. A
diagnosis of congenital hypothyroidism is made. The mother asks the nurse why
the child was not diagnosed with this condition at birth. Which of the
following would be the nurse's best response?
A.
"We had the results of the
newborn screen, but you did not bring the baby in for the 2-week checkup."
B.
"Your baby had little need for
thyroid hormone until she was 1 month old."
C.
"Newborns generally receive
enough thyroid hormone from the mother to get by the first few weeks."
D.
"We could not reach you at home
to give you the results of tests taken at birth."
89.
A nursing instructor asks a nursing
student to identify the risk factors associated with the development of
thyrotoxicosis. The instructor determines that the student understands the risk
factors if the student states that which of the following clients are at risk
for thyrotoxicosis?
A.
A client with hypothyroidism
B.
A client with Grave’s disease who is
having surgery
C.
A client with diabetes mellitus
scheduled for debridement of a foot ulcer
D.
A client with diabetes insipidus
scheduled for a diagnostic test
90.
The nurse is preparing to administer
an intravenous insulin injection. The vial of regular insulin has been
refrigerated. On inspection of the vial, the nurse finds the medication frozen.
The nurse should
A.
Wait for the insulin to thaw at room
temperature.
B.
Check the temperature settings of
the refrigerator.
C.
Discard the insulin and obtain
another vial.
D.
Rotate the vial between the hands
until the medication becomes liquid.
91.
A nurse in the health care clinic is
reviewing the record of a client with diabetes mellitus who is seen by the
physician. The nurse notes that the physician has prescribed metformin
(Glucophage). Which of the following preexisting disorders, if noted in the
client’s record, would indicate a need to collaborate with the physician before
instructing the client to take medication?
A.
Hypertension
B.
Foot ulcer
C.
Emphysema
D.
Hypothyroidism
92.
The client with a neurological
problem has a nursing diagnosis of Hyperthermia. Which measure would the nurse
avoid while trying to lower the client’s body temperature?
A.
Giving tepid sponge baths
B.
Administering acetaminophen
(Tylenol) per protocol
C.
Applying hypothermia blanket
D.
Placing ice packs in axilla and
groin areas
93.
A registered nurse is caring for a
client with a diagnosis of Cushing’s syndrome. A licensed practical nurse is
working with the registered nurse for the day. The registered nurse determines
that the licensed practical has an understanding of Cushing’s syndrome when the
licensed practical nurse states that the condition is caused by
A.
Excessive amounts of cortisol.
B.
Decreased amount of cortisol.
C.
Excessive amounts of antidiuretic
hormone.
D.
Decreased amounts of antidiuretic
hormone.
94.
Which of the following signs and
symptoms would be seen 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
95.
Acarbose (Precose), an
alpha-glucosidase inhibitor, is prescribed for a client with type 2 diabetes
mellitus. During discharge planning, the nurse would be aware of the client's
need for additional teaching when the client states:
A.
"If I have hypoglycemia, I
should eat some sugar, not dextrose."
B.
"The drug makes my pancreas
release more insulin."
C.
"I should never take insulin
while I'm taking this drug."
D.
"It's best if I take the drug
with the first bite of a meal."
96.
A hospitalized client with type 1
diabetes mellitus received NPH and regular insulin 2 hours ago (at 7:30 AM).
The client calls the nurse and reports that he is feeling hungry, shaky, and
weak. The client ate breakfast at 8 AM and is due to eat lunch at noon. In the
space provided, write the numbers representing each action in order from first
of highest priority to last or lowest priority.
A.
Give the client ½ cup of fruit juice
to drink.
B.
Check the client’s blood glucose
level.
C.
Take the client’s vital signs.
D.
Give the client a small snack of
carbohydrate and protein.
E.
Document the client’s complaints,
actions taken, and outcome.
97.
Because diet and exercise have
failed to control a 63-year-old client's blood glucose level, the client is
prescribed glipizide (Glucotrol). After oral administration, the onset of
action is:
A.
15 to 30 minutes
B.
30 to 60 minutes
C.
1 to 1½ hours
D.
2 to 3 hours
98.
The client with Cushing’s syndrome
verbalizes concern to the nurse regarding the appearance of the buffalo hump
that has developed. Which statement by the nurse is most appropriate?
A.
“This is permanent, but looks are
deceiving and not that important.”
B.
“Don’t be concerned; this problem
can be covered with clothing.”
C.
“Try not to worry about it; there
are other things to be concerned about.”
D.
”Usually these physical changes
slowly improve following treatment.”
99.
A client suspected of having
Cushing’s syndrome is schedules for adrenal venography. A nurse has provided
instructions to the client regarding the test. Which statement by the client
indicates a need for further instructions?
A.
“I may feel a burning sensation
after the dye is injected.”
B.
“The insertion site will be
anesthetized locally.”
C.
“I need to sign an informed
consent.”
D.
“I will be placed in a high-sitting
position for the test.”
100.The nurse is performing an assessment on a client with a
diagnosis of myxedema (hypothyroidism). Which of the following assessment
findings would the nurse expect to note on this client?
A.
Thin, silky hair
B.
Dry skin
C.
Fine muscle tremors
D.
Bulging eyeballs
101.A client with a tentative diagnosis of hyperosmolar
hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes
(non-insulin-dependent) that is being controlled with an oral diabetic agent,
tolazamide (Tolinase). Which laboratory test is the most important for
confirming this disorder?
A.
Serum potassium level
B.
Serum sodium level
C.
Arterial blood gas (ABG) values
D.
Serum osmolarity
102.The client with diabetes mellitus says he eats a lot of pasta
products such as macaroni and spaghetti. He asks if he can still eat them.
Which of the following would be the nurse's best response?
A.
"Because you're overweight,
it's better to eliminate pasta from your diet."
B.
"Pasta can be a part of your
diet. It's included in the bread and cereal exchange."
C.
"Pasta can be included in your
diet but it shouldn't be served with sauces."
D.
"Eating pasta can cause
hyperglycemia, so it's better to eliminate it."
103.The nurse is assessing a client with a diagnosis of goiter.
Which of the following would the nurse expect to note during the assessment of
the client?
A.
Client complaints of slow wound
healing
B.
Client complaints of chronic fatigue
C.
An enlarged thyroid gland
D.
The presence of heart damage
104.Which of the following would the nurse expect to assess in
an elderly client with Hashimoto's thyroiditis?
A.
Weight loss, increased appetite, and
hyperdefecation
B.
Weight loss, increased urination,
and increased thirst
C.
Weight gain, decreased appetite, and
constipation
D.
Weight gain, increased urination,
and purplish-red striae
105.A client is admitted to the hospital with a diagnosis of
Addison’s disease. The nurse would assess for which of the following problems
associated with this disorder?
A.
Hypotension
B.
Hirsutism
C.
Obesity
D.
Edema
106.The client has just undergone computerized tomography
scanning with a contrast medium. The nurse would evaluate that the client
understands postprocedure care if the client verbalized to
A.
Eat lightly for the remainder of the
day.
B.
Rest quietly for the remainder of
the day.
C.
Hold medications for at least 4
hours.
D.
Increase fluid intake for the day.
107.After surgery to remove a pituitary tumor, a client develops
diabetes insipidus. Which drug would the nurse expect to administer?
A.
vasopressin (Pitressin)
B.
furosemide (Lasix)
C.
Regular insulin (Humulin R)
D.
dextrose 10% in water
108.A nurse is reviewing the assessment findings on a client
admitted to the hospital with a diagnosis of diabetic insipidus. The nurse
understands that which of the following is unassociated with this disorder?
A.
Complaints of excessive thirst
B.
Polydipsia
C.
Polyuria
D.
Concentrated urine
109.A 28-year-old woman is scheduled for a glucose tolerance
test (GTT). She asks the nurse what result indicates diabetes mellitus. The
nurse should respond that the minimum parameter for indication of diabetes
mellitus is a 2-hour blood glucose level greater than:
A.
120 mg/dl
B.
150 mg/dl
C.
200 mg/dl
D.
250 mg/dl
110.Before discharge, a client with Addison's disease should be
instructed to do which of the following when exposed to periods of stress?
A.
Administer hydrocortisone I.M.
B.
Drink 8 oz of fluids.
C.
Perform capillary blood glucose
monitoring four times daily.
D.
Continue to take his usual dose of
hydrocortisone.
111.When undertaking diabetic teaching, the nurse understands
that the earliest manifestation of diabetic nephropathy is:
A.
Polyuria.
B.
Ketonuria.
C.
Asymptomatic proteinuria.
D.
Increasing glycosuria.
112.Which of the following would indicate that a client has
developed water intoxication secondary to treatment for diabetes insipidus?
A.
Confusion and seizures
B.
Sunken eyeballs and spasticity
C.
Flaccidity and thirst
D.
Tetany and increased blood urea
nitrogen (BUN) levels.
113.A client with hyperparathyroidism declines surgery and is to
receive hormone replacement therapy with estrogen and progesterone. Which of
the following instructions would be most important to include in the client's
teaching plan?
A.
Maintain a moderate exercise
program.
B.
Rest as much as possible.
C.
Lose weight.
D.
Jog at least 2 miles per day.
114.A nurse is caring for a client admitted to the emergency
room with diabetic ketoacidosis (DKA). In the acute phase the priority nursing
action is to prepare to
A.
Administer regular insulin
intravenously.
B.
Administer 5% dextrose
intravenously.
C.
Correct the acidosis.
D.
Apply an electrocardiogram.
115.A physician has prescribed propylthiouracil for a client
with hyperthyroidism. A nurse develops a plan of care for the client. A
priority nursing assessment to be included in the plan regarding this
medication is to assess for
A.
Signs and symptoms of
hypothyroidism.
B.
Signs and symptoms of hyperglycemia.
C.
Relief of pain.
D.
Signs of renal toxicity.
116.A client who currently is taking levothyroxine sodium
(Synthroid) complains of cold intolerance, constipation, dry skin, weight gain,
and puffy eyes. Based on these findings, the nurse would anticipate which of
the following prescriptions?
A.
Increase levothyroxine sodium dosage
after checking the T4 level.
B.
Decrease levothyroxine sodium dosage
after T4 level.
C.
Discontinue levothyroxine sodium
because the client is having an adverse reaction.
D.
No change in medication because
these are common side effects that will diminish with time.
117.Which of the following is the most critical intervention
needed for a client with myxedema coma?
A.
Administering an oral dose of
levothyroxine (Synthroid)
B.
Warming the client with a warming
blanket
C.
Measuring and recording accurate
intake and output
D.
Maintaining a patent airway
118.Which outcome would indicate successful treatment of
diabetes insipidus?
A.
Fluid intake of less than 2,500 ml
in 24 hours
B.
Urine output of more than 200
ml/hour
C.
Blood pressure of 90/50 mm Hg
D.
Pulse rate of 126 beats/minute
119.The nurse recognizes that a client with diabetes mellitus
understands the teaching about the treatment of hypoglycemia when the client
says, "If I become hypoglycemic I should initially eat:
A.
Hard candy and fruit juice."
B.
A slice of bread and sugar."
C.
Chocolate candy and a banana."
D.
Peanut butter crackers and a glass
of milk."
120.When administering spironolactone (Aldactone) to a client
who has had a unilateral adrenalectomy, the nurse should instruct the client
about which possible adverse effect of the drug?
A.
Breast tenderness
B.
Menstrual irregularities
C.
Increased facial hair
D.
Hair loss
121.In addition to the individual who has insulin-dependent
diabetes mellitus, the nurse is aware that acute hypoglycemia also can develop
in the client who is diagnosed with:
A.
Liver disease
B.
Hypertension
C.
Type 2 diabetes
D.
Hyperthyroidism
122.When educating the client with adult-onset diabetes mellitus
about activity level, the nurse bases the information on the knowledge that
exercise affects the body's physiologic functioning relative to glucose usage
in which of the following ways?
A.
Exercise helps avoid hypoglycemia.
B.
Exercise stimulates insulin
overproduction.
C.
Exercise decreases the renal
threshold for glucose.
D.
Exercise increases the use of
glucose by muscles.
123.Which instructions should be included in the discharge
teaching plan for a client after thyroidectomy for Graves' disease?
A.
Keep an accurate record of intake
and output.
B.
Use nasal desmopressin acetate
(DDAVP).
C.
Be sure to get regular follow-up
care.
D.
Be sure to exercise to improve
cardiovascular fitness.
124.When assessing a client with Graves' disease, the nurse
should expect to find:
A.
Constipation, dry skin, and weight
gain
B.
Lethargy, weight gain, and
forgetfulness
C.
Weight loss, exophthalmos, and
restlessness
D.
Weight loss, protruding eyeballs,
and lethargy
125.Following a unilateral adrenalectomy, the nurse would assess
for hyperkalemia shown by which of the following?
A.
Muscle weakness
B.
Tremors
C.
Diaphoresis
D.
Constipation
126.A client is being returned to his room after a subtotal
thyroidectomy. Which piece of equipment is most important for the nurse to
bring to this client's bedside?
A.
Indwelling urinary catheter kit
B.
Tracheostomy set
C.
Cardiac monitor
D.
Humidifier
127.The nurse provides dietary instructions to a client with
diabetes mellitus regarding the prescribed diabetic diet. Which statement if
made by the client indicates a need for further teaching?
A.
“I need to drink diet soft drinks.”
B.
“I’ll eat a balanced meal plan.”
C.
“I need to purchase specific diabetic
foods.”
D.
“I’ll snack on fruit instead of
cake.”
128.Which of the following would the nurse expect to assess in a
child with ketoacidosis?
A.
Slow, bounding pulse rate.
B.
Deep, rapid respirations.
C.
Diaphoretic warm skin.
D.
Elevated blood pressure.
For answers and rationale click the link below:
