Final Exam Practice Questions - Messer

Question 1

Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is correct?

 Insulin is not used to control blood glucose in patients with type 2 diabetes.
 Complications of type 2 diabetes are less serious than those of type 1 diabetes.
 Changes in diet and exercise may control blood glucose levels in type 2 diabetes.
 Type 2 diabetes is usually diagnosed when the patient is admitted with a hyperglycemic coma.

Answer 1

C

Question 2

A 28-yr-old male patient with type 1 diabetes reports how he manages
his exercise and glucose control. Which behavior indicates that the
nurse should implement additional teaching?

 The patient always carries hard candies when engaging in exercise.
 The patient goes for a vigorous walk when his glucose is 200 mg/dL.
 The patient has a peanut butter sandwich before going for a bicycle ride.
 The patient increases daily exercise when ketones are present in the urine

Answer 2

D

Question 3

The nurse is assessing a 22-yr-old patient experiencing the onset of
symptoms of type 1 diabetes. To which question would the nurse
anticipate a positive response?

 “Are you anorexic?”
 “Is your urine dark colored?”
 “Have you lost weight lately?”
 “Do you crave sugary drinks?

Answer 3

C

Question 4

A patient with type 2 diabetes is scheduled for a follow-up visit in the
clinic several months from now. Which test will the nurse schedule to
evaluate the effectiveness of treatment for the patient?

 Fasting blood glucose
 Oral glucose tolerance
 Glycosylated hemoglobin
 Urine dipstick for glucose

Answer 4

C

Question 5

The nurse is assessing a 55-yr-old female patient with type 2 diabetes
who has a body mass index (BMI) of 31 kg/m2.Which goal in the plan of
care is most important for this patient?

 The patient will reach a glycosylated hemoglobin level of less than 7%.
 The patient will follow a diet and exercise plan that results in weight loss.
 The patient will choose a diet that distributes calories throughout the day.
 The patient will state the reasons for eliminating simple sugars in the diet.

Answer 5

B

Question 6

A patient who has type 1 diabetes plans to swim laps for an hour daily
at 1:00 PM. The clinic nurse will plan to teach the patient to:

 check glucose level before, during, and after swimming.
 delay eating the noon meal until after the swimming class.
 increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
 time the morning insulin injection so that the peak occurs while swimming.

Answer 6

A

Question 7

To assist an older patient with diabetes to engage in moderate daily
exercise, which action is most important for the nurse to take?

 Determine what types of activities the patient enjoys.
 Remind the patient that exercise improves self-esteem.
 Teach the patient about the effects of exercise on glucose level.
 Give the patient a list of activities that are moderate in intensity.

Answer 7

A

Question 8

The nurse identifies a need for additional teaching when the patient
who is self-monitoring blood glucose:

 washes the puncture site using warm water and soap.
 chooses a puncture site in the center of the finger pad.
 hangs the arm down for a minute before puncturing the site.
 says the result of 120 mg indicates good blood sugar control.

Answer 8

B

Question 9

if you had an elevated T3 or T4 level, what other lab value would you need?

Answer 9

TSH (to determine problem with pituitary or thyroid)

Question 10

what is most common cause of hyperthyroidism?

Answer 10

Grave’s

exophthalmos + dry eyes, goiter, pretibial myxedema

Question 11

A 62-yr-old patient with hyperthyroidism is to be treated with
radioactive iodine (RAI). Which of the following education should
the nurse provide to patient?

A) not to wash away the external markings.
B) that symptoms of hyperthyroidism should be relieved in about a week.
C) that symptoms of hypothyroidism may occur as the RAI therapy takes
effect.
D) to discontinue the antithyroid medications taken before the radioactive
therapy.

Answer 11

C

Question 12

A patient with primary hyperparathyroidism has a serum
phosphorus level of 1.7 mg/dL (0.55 mmol/L) and calcium of 14
mg/dL (3.5 mmol/L). Which nursing action should be included in the
plan of care?

A) Restrict the patient to bed rest.
B) Encourage 4000 mL of fluids daily.
C) Institute routine seizure precautions.
D) Assess for positive Chvostek’s sign.

Answer 12

B

Question 13

A patient develops carpopedal spasms and tingling of the lips
following a parathyroidectomy. Which action is most appropriate?
A) Administer the prescribed muscle relaxant.
B) Administered ordered IV Calcium Gluconate
C) Start the PRN O2 at 2 L/min per cannula.
D) Stretch the muscles with passive range of motion.

Answer 13

B

Question 14

A patient who had radical neck surgery to remove a malignant tumor
developed hypoparathyroidism. The nurse should plan to teach the
patient about which of the following?

A) bisphosphonates to reduce bone demineralization.
B) calcium supplements to normalize serum calcium levels.
C) increasing fluid intake to decrease risk for kidney stones.
D) including whole grains in the diet to prevent constipation

Answer 14

B

Question 15

A patient with hypothyroidism is hypertensive. Which finding
indicates that the nurse should contact the health care provider
before administering levothyroxine (Synthroid)?

A) Elevated thyroxine (T4) level
B) Respiratory rate of 16 breaths/minute
C) Distant and difficult to hear heart sounds
D) Elevated thyroid stimulating hormone level

Answer 15

A

Question 16

A patient has just arrived on the unit after a thyroidectomy. Which
action should the nurse take first?

A) Observe the dressing for bleeding.
B) Check the blood pressure and pulse.
C) Assess the patient’s respiratory effort.
D) Support the patient’s head with pillows.

Answer 16

C

Question 17

A nurse is admitting a patient with hypothyroidism. Which of the
following signs and symptoms will the nurse expect? (Select all that
apply)

A) Increased appetite
B) Cold Intolerance
C) Constipation
D) Hypotension
E) Bulging eyeballs
F) Slow heart rate
G) Weight loss
H) Fever
I) Rapid Respiratory Rate

Answer 17

B
C
D
F

Question 18

A patient with Grave’s Disease is day-1 post-op from abdominal
surgery. The patient states that she thinks she may have a fever,
which the nurse confirms with an oral temperature of 101.2 degrees
F. What is the next action the nurse should take?

A) Call rapid response
B) Obtain a set of vital signs.
C) Check the patient’s incision site.
D) Palpate the thyroid gland.

Answer 18

B

Question 19

The nurse obtains the following VS’s for patient (from previous
question): BP: 198/62, Heart Rate: 143 beats/minute, RR 22
breaths/minute. The patient states that she feels like she’s going to
vomit. Which of the following should the nurse do first?

A) Put the patient on a telemetry monitor
B) Administer a rapid push of metoprolol
C) Prepare ice packs for the patient
D) Palpate the patient’s thyroid gland

Answer 19

A

Question 20

Which of the following should be replaced for a person with 
hypoparathyroidism?
 Sodium
 Potassium
 Calcium
 Magnesium
 Vitamin B12
 Vitamin C
 Vitamin D

Answer 20

Calcium, Magnesium

Question 21

To determine possible causes, the nurse will ask a patient admitted
with acute glomerulonephritis about which of the following?

A) recent bladder infection.
B) history of kidney stones.
C) recent sore throat and fever.
D) history of high blood pressure.

Answer 21

C

Question 22

Which finding for a patient admitted with glomerulonephritis
indicates to the nurse that treatment has been effective?

A) The patient denies pain with voiding.
B) The urine dipstick is negative for nitrites.
C) The antistreptolysin-O (ASO) titer has decreased.
D) The periorbital and peripheral edema are resolved.

Answer 22

D

WEIGHT LOSS IS ANOTHER ANSWER

Question 23

To prevent recurrence of uric acid renal calculi, the nurse teaches
the patient to avoid eating which of the following?

A) milk and cheese.
B) sardines and liver.
C) spinach and chocolate.
D) legumes and dried fruit.

Answer 23

B

Question 24

The nurse teaches an adult patient to prevent the recurrence of
renal calculi by doing which of the following?

A) using a filter to strain all urine.
B) avoiding dietary sources of calcium.
C) drinking 2000 to 3000 mL of fluid each day.
D) choosing diuretic fluids such as coffee and tea.

Answer 24

C

Question 25

A 68-yr-old female patient admitted to the hospital with dehydration
is confused and incontinent of urine. Which nursing action should be
included in the plan of care?

A) Restrict fluids between meals and after the evening meal.
B) Insert an indwelling catheter until the symptoms have resolved.
C) Assist the patient to the bathroom every 2 hours during the day.
D) Apply absorbent adult incontinence diapers and pads over the bed
linens.

Answer 25

C

Question 26

A 55-yr-old woman admitted for shoulder surgery asks the nurse for
a perineal pad, stating that laughing or coughing causes leakage of
urine. Which intervention is most appropriate to include in the care
plan?

A) Assist the patient to the bathroom q3hr.
B) Place a commode at the patient’s bedside.
C) Demonstrate how to perform the Credé maneuver.
E) Teach the patient how to perform Kegel exercises.

Answer 26

E

Question 27

The home health nurse teaches a patient with a neurogenic bladder
how to use intermittent catheterization for bladder emptying. Which
patient statement indicates that the teaching has been effective?

A) “I will buy seven new catheters weekly and use a new one every day.”
B) “I will use a sterile catheter and gloves for each time I self-catheterize.”
C) “I will clean the catheter carefully before and after each
catheterization.”
D) “I will take prophylactic antibiotics to prevent any urinary tract
infections.”

Answer 27

C

Question 28

Which assessment finding for a patient who has just been admitted
with acute pyelonephritis is most important for the nurse to report to
the health care provider?

A) Complaint of flank pain
B) Blood pressure 90/48 mm Hg
C) Cloudy and foul-smelling urine
D) Temperature 100.1° F (57.8° C)

Answer 28

B

OTHERS ARE EXPECTED

Question 29

A 76-yr-old with benign prostatic hyperplasia (BPH) is agitated and
confused, with a markedly distended bladder. Which intervention
prescribed by the:

A) Insert a urinary retention catheter.
B) Draw blood for a serum creatinine level.
C) Schedule an intravenous pyelogram (IVP).
D) Administer lorazepam (Ativan) 0.5 mg PO.

Answer 29

A

Question 30

Which nursing action is of highest priority for a patient with renal
calculi who is being admitted to the hospital with gross hematuria
and severe colicky left flank pain?

A) Administer prescribed analgesics.
B) Monitor temperature every 4 hours.
C) Encourage increased oral fluid intake.
D) Give antiemetics as needed for nausea.

Answer 30

A

Question 31

A patient with a history of polycystic kidney disease is admitted to
the surgical unit after having shoulder surgery. Which of the routine
postoperative orders is most important for the nurse to discuss with
the health care provider?

A) Give ketorolac 10 mg PO PRN for pain.
B) Infuse 5% dextrose in normal saline at 75 mL/hr.
C) Order regular diet after patient is awake and alert.
D) Draw blood urea nitrogen (BUN) and creatinine in 2 hours.

Answer 31

A

Question 32

After change-of-shift report, which patient should the nurse assess first?

A) Patient with a urethral stricture who has not voided for 18 hours
B) Patient with a urinary tract infection who has cloudy urine
C) Patient with polycystic kidney disease whose blood pressure is 166/98 mm Hg
D) Patient who has blood in his urine immediately after returning from lithotripsy

Answer 32

A

Question 33

A nurse is working in a clinic with a nursing student. The nursing student asks why all of the older patients have to answer questions about urinary problems. The nurse’s most appropriate response is which of the following?

A) We need to screen all elderly people for urinary problems because they tend to forget.
B) People are often embarrassed about discussing urinary problems, so screening can help us identify a problem.
C) Bladder and prostate cancer become more common in advanced age, so we need to screen.
E) Urinary problems can be a sign of sexual dysfunction.

Answer 33

B