Midterm Part 2

Question 1

The 40-year-old client diagnosed with hyperthyroidism is being
treated with radioactive iodine therapy. Which interventions should the nurse discuss with the client? Select all the apply:

E. Inform the client after therapy the client will not have to take any medication
B. Teach the iodine therapy will have to be tapered slowly over one (1) week
D. Instruct to flush the toilet 3 times after urination
A. Explain it will take up to a month for symptoms of hyperthyroidism to subside
C. Discuss the client will have to be hospitalized during the radioactive therapy

Answer 1

A. Explain it will take up to a month for symptoms of hyperthyroidism to subside

Question 2

Which of the following below is NOT a sign or symptom of Addisonian Crisis?

A. Hypokalemia
B. Low blood pressure
C. Hyponatremia
D. Severe pain in the stomach, legs, and lower back

Answer 2

A. Hypokalemia

Question 3

The nurse is teaching a group of clients diagnosed with diabetes mellitus. Which lesson regarding foot care should be included? Select al that apply.

E. Use an over-the-counter corn removal kit to remove corns or calluses
B. Rub feet vigorously with a towel after bathing ot ensure dryness
C . Wash your feet daily and dry well between the toes
D. Check your feet for cuts, blisters, redness, swelling, or nail problems
F. Cut toenails straight across and file along the curves of the toes

Answer 3

C . Wash your feet daily and dry well between the toes
D. Check your feet for cuts, blisters, redness, swelling, or nail problems
F. Cut toenails straight across and file along the curves of the toes

Question 4

A type of fracture that is straight across the bone.
C. Spiral
B. Transverse
D. Impacted
A. Oblique

Answer 4

B. Transverse

Question 5

A patient is diagnosed with hyperparathyroidism. Which of the following signs and symptoms would you NOT find in this patient? Select all that apply:
A. Bone fracture
B. Calcium level of 51mg/dL
C. Renal calculi
D. Positive Trousseau’s Sign
E. Calcium level 6mg/dL
F. Tingling and numbness of lips and fingers

Answer 5

B. Calcium level of 51mg/dL
D. Positive Trousseau’s Sign
F. Tingling and numbness of lips and fingers

Question 6

Which nursing diagnosis is most appropriate for a client with Addison’s disease?

A. Urinary retention
B. Risk for infection
C. Excessive fluid volume
D. Hypothermia

Answer 6

B. Risk for infection

Question 7

The nurse cares for a client who is experiencing exophthalmos as a complication of Graves’ disease. Which nursing action(s) should
be included in the client’s plan of care? Select al that apply.

A. Recommend the use of dark glasses to prevent irritation
B. Teach avoidance of eye movement to prevent further damage
C. Administer artificial tears to moisten the conjunctiva
D. If eyelids don’t’ close during sleep, tightly tape them shut

Answer 7

A. Recommend the use of dark glasses to prevent irritation
C. Administer artificial tears to moisten the conjunctiva
D. If eyelids don’t’ close during sleep, tightly tape them shut

Question 8

A patient is started on Tapazole (Methimazole) for treatment of Grave’s Disease. Which statement by the patient indicates they understood your teaching about this medication?

A. If I experience fast heart, excessive sweating, or fever, I will notify the doctor immediately because I may be experiencing toxicity of the medication.”
B. “This medication can cause high blood glucose.”
C. I know it may take awhile before l feel relief of symptoms, therefore, I will never abruptly stop taking my medication.”
D. I will make sure my diet is rich in foods containing iodine.”

Answer 8

C. I know it may take awhile before l feel relief of symptoms, therefore, I will never abruptly stop taking my medication.”

Question 9

The nurse si caring for apatient complaining of palpitations, diaphoresis, and unable ot tolerate heat. The patient presents exophthalmos and bipedal edema. According to the signs and symptoms, the nurse suspects the patient to have:

A. Grave’s Disease
B. Deficiency of iodine consumption
C. Hypothyroidism
D. Thyroiditis

Answer 9

C. Hypothyroidism

Question 10

A ailing 69-year-old woman with a diagnosis of type 2diabetes mellitus has been ill with community acquired pneumonia. The client’s intake has been very poor, and she is admitted to the hospital for observation and management as needed. What is the most likely problem with this patient?

D. Hyperglycemic hyperosmolar nonketotic syndrome.
C. Hypoglycemia unawareness is developing.
B. Diabetic ketoacidosis is occurring.
A. Insulin resistance has developed.

Answer 10

D. Hyperglycemic hyperosmolar nonketotic syndrome.

Question 11

Shamcey, female client with type 1diabetes mellitus is
experiencing minor illness with the flu. Nurse Benjie should instruct the client:

C. To skip taking insulin fi she cannot eat.
D. To take half of the normal dose of her insulin.
B. To try to reduce food intake to diminish nausea.
A. To increase the frequency of self - monitoring (blood glucose testing).

Answer 11

A. To increase the frequency of self - monitoring (blood glucose testing).

Question 12

Is a muscle injury caused by inappropriate lifting or sudden acceleration-deceleration.

A. Puncture
B.Contusion
C. strain
D. Sprain

Answer 12

C. strain

Question 13

Mrs. Gene has type 1 diabetes and receives insulin for glycemic control. She tells Nurse Bern that she likes to have a glass of wine with dinner. What will the best plan of Nurse Bern for client education include?

A. The alcohol could cause serious liver disease.
B. The alcohol could predispose you to hypoglycemia.
C. The alcohol could cause pancreatic disease.
D. The alcohol could predispose you to hyperglycemia.

Answer 13

B. The alcohol could predispose you to hypoglycemia.

Question 14

Which of the following patients are at risk for developing Cushing’s Syndrome?

A. A patient with a tuberculosis infection.
B. A patient with a tumor on the pituitary gland.
C. A patient taking glucocorticoids for several weeks.
D. A patient who is post-op from an adrenalectomy.

Answer 14

C. A patient taking glucocorticoids for several weeks.

Question 15

The 3rd floor nurse is reviewing lab results for a client with Syndrome of Inappropriate Antidiuretic Hormone (SIADH) and notes a sodium level of 132 mEq/L. The nurse continues to monitor the client closely for which of the following abnormal signs/symptoms?

A. Bilateral pupil constriction to light.
B. Decreased level of consciousness.
C. Palpitations in the chest.
D. Complaints of excessive thirst.

Answer 15

B. Decreased level of consciousness.

Question 16

Which statement made by the patient makes the nurse suspect the client is experiencing hyperthyroidism?

A. “I feel very cold all the time and I cannot take it.”
B. “I have noticed all my collars are getting tighter.”
C. “My skin is really becoming thin and brittle.”
D. “I have a bowel movement about every 3 to 4 days.”

Answer 16

B. “I have noticed all my collars are getting tighter.”

Question 17

Is a ligament injury caused by excessive stretching.

A. Strain
B. Sprain
C. Puncture
D. Contusion

Answer 17

B. Sprain

Question 18

Which of the following abnormal electrolyte imbalances is EXPECTED with Addisonian Crisis?

A. Potassium level of 3.2
B. Blood glucose level of 120
C. Phosphate level of 1.2
D. Sodium level of 112.

Answer 18

D. Sodium level of 112.

Question 19

Nurse Prinze provides care for a client, Athena, who is diagnosed with Addison’s disease. Which clinical manifestation does the nurse anticipate for this client due to primary adrenocortical insufficiency? Select all that apply.

A. Skin color that is tanned in appearance.
B. Weight loss.
C. Increased body or facial hair
D. Buffalo humps.

Answer 19

A. Skin color that is tanned in appearance.
B. Weight loss.
C. Increased body or facial hair

Question 20

The nurse notices clear nasal drainage in a patient newly admitted with facial trauma, including a nasal fracture. What should the nurse do first?

A. Test the drainage for the presence of glucose.
B. Suction the nose to maintain airway clearance.
C. Document the findings and continue monitoring.
D. Apply a drip pad and reassure the patient this is normal.

Answer 20

A. Test the drainage for the presence of glucose.

Question 21

The patient will be undergoing radioactive iodine treatment. The patient asks the nurse regarding the purpose of the treatment. Which of the following statements will be the best response of the nurse:

A. “It is a surgical removal of the thyroid gland.”
B. “It decreases the vascularity of the thyroid gland.”
C. “It replaces the thyroid hormones being lost.”
D. “It stops the thyroid from synthesizing T3 and T4.”

Answer 21

B. “It decreases the vascularity of the thyroid gland.”

Question 22

A type of fracture where the bone has splintered into several fragments.

A. Simple
B. Compound
C. Comminuted
D. Greenstick

Answer 22

C. Comminuted

Question 23

A 42-year-old female patient reports that she has gained weight and that her face and body are rounder, while her legs and arms have become thinner. A tentative diagnosis of Cushing’s disease is made. When examining the client, the nurse would expect to find:

A. Orthostatic hypotension
B. Muscle hypertrophy in the extremities
C. Bruised areas of the skin
D. Decreased body hair

Answer 23

C. Bruised areas of the skin

Question 24

A client suspected of having hyperthyroidism. Which signs and/or symptoms are expected to be present in this client? Select all that apply.

Bradycardia
Heart palpitations
Anxiety
Weight gain
Protrusion of the eyeballs

Answer 24

Heart palpitations
Anxiety
Protrusion of the eyeballs

Question 25

Nurse Bruceli is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

A. Thyroid Storm
B. Hemorrhage
C. Laryngeal nerve damage
D. Tetany

Answer 25

D. Tetany

Question 25

Which of the following are treatment options for hyperthyroidism? Please select all that apply:

A. Thyroidectomy
B. Methimazole
C. Cytomel
D. Radioactive Iodine

Answer 25

A. Thyroidectomy
B. Methimazole
D. Radioactive Iodine

Question 26

A patient is 8 hours post-op from a thyroidectomy. The surgical site is clean, dry, and intact with no excessive swelling and signs of infection. The nurse should position the patient to:

A. Semi-Fowler’s
B. Trendelenburg
C. High-Fowler’s
D. Prone

Answer 26

A. Semi-Fowler’s

Question 27

The nurse is giving instruction to a group of adolescents about preventing trauma. Which of the following safety equipment should be included? Select all that apply.

Foot pads
Helmets
Seat belts
Gown
Clean Gloves
Hard hats

Answer 27

Helmets
Seat belts

Question 28

The nurse cares for a client admitted to the hospital due to confusion. The client has a non-metastatic lung mass and a diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). Which action(s) should the nurse implement? Select all that apply.

Fluid restriction
Strict record of fluid intake and output
Seizure precautions
Salt restriction in the diet
Fluid bolus (normal saline)

Answer 28

Fluid restriction
Strict record of fluid intake and output
Seizure precautions

Question 29

A patient reports they do not eat enough iodine in their diet. What important condition are they most susceptible to?

Hypothyroidism
Thyroid Storm
Hyperthyroidism
Pheochromocytoma

Answer 29

Hypothyroidism

Question 30

Nurse Wayne is aware that a positive Chvostek’s sign indicates:

A. Hypocalcemia
B. Hyponatremia
C. Hypokalemia
D. Hypermagnesemia

Answer 30

A. Hypocalcemia

Question 31

A patient is receiving treatment for pheochromocytoma. What type of diet is best for this patient?

A. Low sodium and high potassium diet
B. Low calorie and high fiber diet
C. Fluid restriction diet
D. High calorie diet

Answer 31

D. High calorie diet

Question 32

J has type 2 diabetes. Nurse Martha has taught him about the illness and evaluates learning has occurred when the client makes which statement?

A. “My cells have increased their receptors, but there is enough insulin.”
B. “My cells cannot use the insulin my pancreas makes.”
C. “My beta cells cannot produce enough insulin for my cells.”
D. “My peripheral cells have increased sensitivity to insulin.”

Answer 32

B. “My cells cannot use the insulin my pancreas makes.”

Question 33

The nurse is caring for a client with suspected Graves’ disease. Which assessment finding requires priority intervention?

Order and bulging eyes
Heat intolerance
Pulse of 110/min, irregular rhythm
Agitation and confusion

Answer 33

Agitation and confusion

Question 34

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 glucose level of 90 mg/dl
B. Serum potassium level of 5.8 mEq/L
C. BUN level of 12 mg/dl
D. Serum sodium level of 134 mEq/L

Answer 34

B. Serum potassium level of 5.8 mEq/L

Question 35

The nurse cares for a client with type II diabetes mellitus. The client is alert and oriented but shaky, pale, and diaphoretic. The client’s fingerstick glucose is 50 mg/dL (2.8 mmol/L). Which of the following is the best next step the nurse can take?

A. Administer dextrose 50 mg IV push
B. Inject the client with glucagon 2 mg intramuscularly.
C. Verify fingerstick blood glucose with a serum blood draw.
D. Give the client 6 oz of orange juice or low-fat milk.

Answer 35

D. Give the client 6 oz of orange juice or low-fat milk.

Question 36

Nurse Rci makes a home visit to the client with diabetes mellitus. During the visit, Nurse Mat notes the client’s additional insulin vials are not refrigerated. What is the best action by the nurse at this time?

A. Instruct the client to label each vial with the date when opened.
B. Tell the client there is no need to keep additional vials.
C. Have the client place the insulin vials in the refrigerator.
D. Have the client discard the vials.

Answer 36

C. Have the client place the insulin vials in the refrigerator.

Question 37

Which of the following is correct information regarding the pancreas?

A. Alpha cells secrete glucagon that increases blood sugar during stress.
B. Beta cells secrete insulin that increases blood sugar during stress.
C. Alpha cells secrete glucagon that decreases blood sugar during stress.
D. Beta cells secrete alanine that increases blood sugar during stress.

Answer 37

A. Alpha cells secrete glucagon that increases blood sugar during stress.

Question 38

Is a soft tissue trauma that is characterized as bleeding into the soft tissues that causes hematoma.

A. Strain
B. Contusion
C. Sprain
D. Puncture

Answer 38

B. Contusion

Question 39

Which of the following is the priority of a client with Addisonian crisis?

A. Controlling hypertension
B. Preventing irreversible shock
C. Preventing infection
D. Relieving anxiety

Answer 39

B. Preventing irreversible shock

Question 40

The thyroid hormones, T3 and T4, play many roles in the human body. Which of the following functions are performed by T3 and T4? Note select all that apply.

A. Regulating TSH produced by the anterior pituitary gland
B. Decreasing the body’s temperature
C. Increasing the heart rate
D. Storing calories
E. Stimulating the Sympathetic Nervous System

Answer 40

A. Regulating TSH produced by the anterior pituitary gland
C. Increasing the heart rate
E. Stimulating the Sympathetic Nervous System

Question 41

A patient was rushed to the Fermin Memorial Hospital emergency department following a motorcycle accident in which the motorcycle fell on the rider’s leg. A femur fracture is confirmed by imaging. The ER nurse notes swelling in the affected leg. The patient complains of unbearable pain and a feeling of tightness in the affected leg. Which of the following conditions does the ER nurse expect?

A. Compartment syndrome
B. Fluid volume overload
C. Hypertensive crisis
D. Fat embolism

Answer 41

A. Compartment syndrome

Question 42

Ximena, a female patient with Cushing’s syndrome, is admitted to the medical-surgical unit of CON Hospital. During admission, she manifested agitation, irritability, poor memory, loss of appetite, and disheveled appearance. These symptoms are consistent with which of the following problems?

A. Depression
B. Neuropathy
C. Hypoglycemia
D. Hyperthyroidism

Answer 42

A. Depression

Question 43

Which clinical manifestation should the nurse anticipate when providing care for Diana who is diagnosed with Cushing syndrome? Select all that apply.

A. Easy bruising.
B. Increased potassium.
C. Increased blood pressure.
D. Decreased weight.
E. Edema

Answer 43

A. Easy bruising.
C. Increased blood pressure.
E. Edema

Question 44

A client is admitted to the intensive care unit with diagnoses of a brain tumor complicated by transient diabetes insipidus. Which client data related to this complication should the nurse expect? Select all that apply.

Dark amber urine with sediment
Recent weight gain
Reports of excessive thirst
High serum osmolality
Low urine specific gravity

Answer 44

High serum osmolality
Low urine specific gravity

Question 45

A client with Addison’s disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of:

Chloride and magnesium abnormalities
Calcium and phosphorus abnormalities
Sodium and chloride abnormalities
Sodium and potassium abnormalities

Answer 45

Calcium and phosphorus abnormalities

Question 46

Which of the following is a best indicator for determining whether a client with Addison’s disease is receiving the correct amount of corticosteroid replacement?

A. Daily weight
B. Temperature
C. Thirst
D. Skin turgor

Answer 46

A. Daily weight

Question 47

Which hormones of the adrenal glands supplement the sex hormones from the gonads?

A. Mineralocorticoids, such as aldosterone
B. Glucocorticoids, such as cortisol
C. Gonad corticoids, such as the androgens
D. Epinephrine and norepinephrine

Answer 47

C. Gonad corticoids, such as the androgens

Question 48

In regards to question 6, you are also educating the patient about the post-operative care for a bilateral adrenalectomy. Which statement by the patient indicates they understood your instructions?

A. “I will have to take glucocorticoids and mineralocorticoids daily for 2 years.”
B. “When I experience signs of stress, I will have to take mineralocorticoids as needed.”
C. “I will have to take mineralocorticoids daily for 2 years.”
D. “I will have to take glucocorticoids and mineralocorticoids daily for life.”

Answer 48

D. “I will have to take glucocorticoids and mineralocorticoids daily for life.”

Question 49

A patient with Addison’s Disease should consume which of the following diets?

A. Low potassium and high protein
B. High fat and fiber
C. Low carbs, high protein, and increased sodium
D. High protein, carbs, and adequate sodium

Answer 49

D. High protein, carbs, and adequate sodium

Question 50

The nurse is planning care for a 52-year-old male client in acute Addisonian crisis. Which nursing diagnosis should receive the highest priority?

A. Impaired physical mobility
B. Decreased cardiac output
C. Risk for infection
D. Imbalanced nutrition: less than body requirement

Answer 50

B. Decreased cardiac output