Milena Milo

Question 1

A young adult client newly diagnosed with type 1 diabetes mellitus has been taught about self-care. Which statement by the client indicates a good understanding of needed eye examinations?

a. “At my age, I should continue seeing the ophthalmologist as I usually do.”
b. “I will see the eye doctor whenever I have a vision problem and yearly after age 40.”
c. “My vision will change quickly now. I should see the ophthalmologist twice a year.”
d. “Diabetes can cause blindness, so I should see the ophthalmologist yearly.”

Answer 1

d. “Diabetes can cause blindness, so I should see the ophthalmologist yearly.”

Question 2

A client’s father has type 1 diabetes mellitus. The client asks if she is in danger of developing the disease as well. Which is the nurse’s best response?

a. “Your risk of diabetes is higher than that of the general population, but it may not occur.”
b. “No genetic risk is associated with the development of type 1 diabetes.”
c. “The risk for becoming diabetic is 50% because of how it is inherited.”
d. “Female children do not inherit diabetes, but male children will.”

Answer 2

a. “Your risk of diabetes is higher than that of the general population, but it may not occur.”

Question 3

A client has newly diagnosed diabetes. To delay the onset of microvascular and macrovascular complications in this client, th
e nurse stresses that the client take which action?

a. Control hyperglycemia.
b. Prevent hypoglycemia.
c. Restrict fluid intake.
d. Prevent ketosis.

Answer 3

a. Control hyperglycemia

Question 4

During assessment of a client with 15-year history of diabetes, the nurse notes that the client has decreased tactile sensation in both feet. Which action does the nurse take first?

a. Document the finding in the client’s chart.
b. Test sensory perception in the client’s hands.
c. Examine the client’s feet for sings of injury.
d. Notify the health care provider.

Answer 4

c. Examine the client’s feet for sings of injury.

Question 5

A client has diabetes mellitus. Her daughter has recently been diagnosed with Graves’ disease. The client asks the nurse if she is responsible for the fact that her daughter has Graves’ disease. Which is the best response of the nurse?

a. “No connection is known between Graves’ disease and diabetes, so you can be certain that the fact that you have diabetes did not cause your daughter to have Graves’ disease.”
b. “An association has been noted between Graves’ disease and diabetes, but the fact that you have diabetes did not cause your daughter to have Graves’ disease.”
c. “Graves’ disease is associated with autoimmune diseases such as rheumatoid arthritis, but not with a disease such as diabetes.”
d. “Unfortunately, Graves’ disease is associated with diabetes, and your diabetes could have led to your daughter having Graves’ disease.”

Answer 5

b. “An association has been noted between Graves’ disease and diabetes, but the fact that you have diabetes did not cause your daughter to have Graves’ disease.”

Question 6

A client with diabetes asks why more than one injection of insulin is required each day. Which is the nurse’s best response?

a. “You need to start with multiple injections until you become more proficient at self-injection.”
b. “A single dose of insulin each day would not match your blood insulin levels and your food intake patterns closely enough.”
c. “A regimen of a single dose of insulin injected each day would require that you could eat no more than one meal each day.”
d. “A single dose of insulin would be too large to be absorbed predictably, so you would be in danger of unexpected insulin shock.”

Answer 6

b. “A single dose of insulin each day would not match your blood insulin levels and your food intake patterns closely enough.”

Question 7

In preparing a staff in-service presentation about diabetes mellitus, the nurse includes which information?

a. Diabetes increases the risk for development of epilepsy.
b. The cure for diabetes is the administration of insulin.
c. Diabetes increases the risk for development of cardiovascular disease.
d. Carbohydrate metabolism is altered in diabetes, but protein metabolism is normal.

Answer 7

c. Diabetes increases the risk for development of cardiovascular disease.

Question 8

A client with diabetes has frequent blood glucose readings higher than 300 mg/dL. Which action does the nurse teach the client about self-care?

a. Check urine ketones when blood glucose readings are high.

Answer 8

a. Check urine ketones when blood glucose readings are high.

Question 9

Three hours after surgery, the nurse notes that the breath of the client with type 1 diabetes has a “fruity” odor. Which is the nurse’s best first action?

c. Test the serum for ketone bodies.

Answer 9

c. Test the serum for ketone bodies.

Question 10

When performing an assessment, the nurse detects a fruity odor on the client’s breath. What does the nurse do next?

a. Assess the client’s blood sugar level.
b. Assess the client’s stool for occult blood.
c. Instruct the client in oral hygiene techniques.
d. Assess the client for petechiae, itching, and jaundice.

Answer 10

a. Assess the client’s blood sugar level.

Question 11

A client has been diagnosed with hypothyroidism. Which medication is the nurse prepared to administer to treat the client’s bradycardia?

a. Atropine sulfate
b. Levothyroxine sodium (Synthroid)
c. Propranolol (Inderal)
d. Epinephrine (Adrenalin)

Answer 11

b. Levothyroxine sodium (Synthroid)

Question 12

A client has hypothyroidism and has been started on levothyroxine (Synthroid). Which assessment finding leads the nurse to conclude that the treatment is effective?

a. Thirst is recognized and the client drinks fluids appropriately.
b. Weight has been the same for 3 weeks.
c. Total white blood cell count is 6000 cells/mm3.
d. Heart rate is 70 beats/min and regular.

Answer 12

d. Heart rate is 70 beats/min and regular.

Question 13

A client scheduled for a partial thyroidectomy asks the nurse why she is being given an iodine preparation before surgery. Which is the nurse’s best response?

a. “Iodine will help make the internal surgical environment sterile.”
b. “It is given to stimulate the storage of excess thyroid hormones.”
c. “This will replace the hormones you will lose after your operation.”
d. “It will prevent excessive bleeding during surgery.”

Answer 13

d. “It will prevent excessive bleeding during surgery.”

Question 14

Twelve hours after a total thyroidectomy, the client develops stridor. Which is the nurse’s priority intervention?

a. Reassure the client that the voice change is temporary.
b. Document the finding and assess the client hourly.
c. Hyperextend the client’s neck and apply oxygen.
d. Prepare for emergency tracheostomy and call the health care provider.

Answer 14

d. Prepare for emergency tracheostomy and call the health care provider.

Question 15

On the second postoperative day after a subtotal thyroidectomy, the client tells the nurse that he feels numbness and tingling around his mouth. Which is the nurse’s priority intervention?

a. Offer mouth care.
b. Loosen the dressing.
c. Assess Chvostek’s sign.
d. Assess the client hourly.

Answer 15

c. Assess Chvostek’s sign.

Question 16

The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimotos thyroiditis. When assessing this patient, what sign or symptom would the nurse expect?

A) Fatigue

Answer 16

A) Fatigue

Question 17

Which client statement alerts the nurse to the possibility of hypothyroidism?

a. “My sister has thyroid problems.”
b. “I seem to feel the heat more than other people.”
c. “Food just doesn’t taste good without a lot of salt.”
d. “I am always tired, even with 10 or 12 hours of sleep.”

Answer 17

d. “I am always tired, even with 10 or 12 hours of sleep.”

Question 18

A client has hypothyroidism. Which problem does the nurse address as a priority for this client?

a. Heat intolerance
b. Body image problems
c. Depression and withdrawal
d. Obesity

Answer 18

c. Depression and withdrawal

Question 19

A client being treated for hypothyroidism has been admitted for pneumonia. Which activity does the nurse include as a priority in this client’s care plan?

a. Monitor the client’s IV site every shift.
b. Administer acetaminophen (Tylenol) for fever.
c. Ensure that working suction equipment is in the room.
d. Assess vital signs every 4 hours.

Answer 19

c. Ensure that working suction equipment is in the room.

A client with hypothyroidism who develops another illness is at risk for myxedema coma. In this emergency situation, maintaining an airway is a priority. The nurse should ensure that suction is available in the client’s room because it may be needed if myxedema coma develops. The other interventions are necessary for any client with pneumonia, but having suction available is a safety feature for this client.

Question 20

A client has been admitted with hypoparathyroidism. The client’s serum laboratory values are as follows: calcium, 7.2 mg/dL; sodium, 144 mEq/L; magnesium, 1.2 mEq/L; potassium, 5.7 mEq/L. Which medications does the nurse anticipate administering? (Select all that apply.)

a. Potassium chloride orally
b. Calcium chloride IV
c. 3% NS IV solution
d. 50% magnesium sulfate
e. Calcitriol (Rocaltrol) orally

Answer 20

b. Calcium chloride IV

d. 50% magnesium sulfate

Question 21

The nurse is reviewing client medical histories. Which client is at greatest risk for hyperparathyroidism?

a. Client with pregnancy-induced hypertension
b. Client receiving dialysis for end-stage kidney disease
c. Older adult client with moderate heart failure
d. Older adult client on home oxygen therapy

Answer 21

b. Client receiving dialysis for end-stage kidney disease

Question 22

A client has hyperparathyroidism. Which intervention is the priority for the nurse to add to the client’s plan of care?

a. Instruct the client to place both hands behind the neck when moving.
b. Use a lift sheet to assist the client with position changes.
c. Instruct the client to use a soft-bristled toothbrush.
d. Strain all urine for at least 24 hours and send stones to the laboratory.

Answer 22

b. Use a lift sheet to assist the client with position changes.

Question 23

When taking the blood pressure of a client after a parathyroidectomy, the nurse notes that the client’s hand has gone into flexion contractions. Which laboratory result does the nurse correlate with this condition?

a. Serum potassium, 2.9 mEq/L
b. Serum potassium, 5.8 mEq/L
c. Serum sodium, 122 mEq/L
d. Serum calcium, 6.9 mg/dL

Answer 23

d. Serum calcium, 6.9 mg/dL

Question 24

Which dietary modification does the nurse provide for a client with hyperthyroidism?

a. Decreased calories and proteins and increased carbohydrates
b. Elimination of carbohydrates and increased proteins and fats
c. Increased calories, proteins, and carbohydrates
d. Supplemental vitamins and reduction of calories

Answer 24

c. Increased calories, proteins, and carbohydrates

Question 25

An adult client has been diagnosed with a deficiency of gonadotropin and growth hormone. Which fact reported in the client’s history could have contributed to this problem?

a. Mother with adult-onset diabetes mellitus
b. Experienced head trauma 5 years ago
c. Severe allergy to shellfish and iodine
d. Has used oral contraceptives for 5 years

Answer 25

b. Experienced head trauma 5 years ago

Question 26

A client has a hypofunctioning anterior pituitary gland. Which hormones does the nurse expect to be affected by this? (Select all that apply.)

a. Thyroid-stimulating hormone
b. Vasopressin
c. Follicle-stimulating hormone
d. Calcitonin
e. Growth hormone

Answer 26

a. Thyroid-stimulating hormone
c. Follicle-stimulating hormone
e. Growth hormone

Question 27

A client thought to have a problem with the pituitary gland is given a stimulation test using insulin. A short time later, blood analysis reveals elevated levels of growth hormone (GH) and adrenocorticotropic hormone (ACTH). Which is the nurse’s interpretation of this finding?

a. Pituitary hypofunction
b. Pituitary hyperfunction
c. Pituitary-induced diabetes mellitus
d. A normal pituitary response to insulin

Answer 27

d. A normal pituitary response to insulin

Question 28

An adult client has been diagnosed with a deficiency of gonadotropin and growth hormone. Which fact reported in the client’s history could have contributed to this problem?

a. Mother with adult-onset diabetes mellitus
b. Experienced head trauma 5 years ago
c. Severe allergy to shellfish and iodine
d. Has used oral contraceptives for 5 years

Answer 28

b. Experienced head trauma 5 years ago

Question 29

Which safety measure does the nurse use for the adult client who has growth hormone deficiency?

a. Avoid intramuscular medications.
b. Place the client in protective isolation.
c. Use a lift sheet to reposition the client.
d. Assist the client to change positions slowly.

Answer 29

c. Use a lift sheet to reposition the client.

Question 30

An 18-year-old male patient with a small stature is scheduled for a growth hormone stimulation test. In preparation for the test, the nurse will obtain

a. ice in a basin.
b. glargine insulin.
c. a cardiac monitor.
d. 50% dextrose solution.

Answer 30

d. 50% dextrose solution.

Question 31

The male client with hypopituitarism asks the nurse how long he will have to take testosterone hormone replacement therapy. Which is the nurse’s best answer?

a. “When your blood levels of testosterone are normal, the therapy is no longer needed.”
b. “When your beard thickens and your voice deepens, the dose is decreased, but treatment will continue forever.”
c. “When your sperm count is high enough to demonstrate fertility, you will no longer need this therapy.”
d. “When you start to have undesirable side effects, the dose is decreased to the lowest possible level, and treatment is continued until you are 50 years old.”

Answer 31

b. “When your beard thickens and your voice deepens, the dose is decreased, but treatment will continue forever.”

Question 32

Which conditions may cause hypopituitarism? (Select all that apply.)

a. Benign pituitary tumors
b. Diplopia
c. Anorexia nervosa
d. Hypotension
e. Shock
f. Weight gain

Answer 32

a. Benign pituitary tumors
c. Anorexia nervosa
d. Hypotension
e. Shock

Question 33

A client who had a trans-sphenoidal hypophysectomy 2 days ago now has nuchal rigidity. Which is the nurse’s priority action?

a. Have the client do active range-of-motion exercises for the neck.
b. Document the finding and monitor the client.
c. Take the client’s temperature and other vital signs.
d. Assess using a pain scale and administer pain medication.

Answer 33

c. Take the client’s temperature and other vital signs.

Question 34

The nurse is caring for a client who has undergone a hypophysectomy. Which is the nurse’s priority postoperative intervention?

a. Keep the head of the bed flat and the client supine.
b. Instruct the client to cough, turn, and deep breathe hourly.
c. Report clear or yellow drainage from the nose or incision site.
d. Apply petroleum jelly to the client’s lips to avoid mouth dryness.

Answer 34

c. Report clear or yellow drainage from the nose or incision site.

Question 35

A client just diagnosed with acromegaly is scheduled for a hypophysectomy. Which statement made by the client indicates a need for clarification regarding this treatment?

c. “I hope I can go back to wearing size 8 shoes instead of size 12.”

Answer 35

c. “I hope I can go back to wearing size 8 shoes instead of size 12.”

Question 36

A client is going home after an endoscopic transnasal hypophysectomy. Which statement by the client indicates an adequate understanding of discharge instructions?

a. “I will wear dark glasses whenever I am outdoors.”
b. “I will keep food on upper shelves so I do not have to bend over.”
c. “I will wash the incision line every day with peroxide and redress it immediately.”
d. “I will remember to cough and deep breathe every 2 hours while I am awake.”

Answer 36

b. “I will keep food on upper shelves so I do not have to bend over.”

Question 37

A client with suspected syndrome of inappropriate antidiuretic hormone (SIADH) has a serum sodium of 114 mEq/L. Which action by the nurse is best?

a. Consult with the registered dietitian about increased dietary sodium.
b. Restrict the client’s fluid intake to 900 mL/24 hr.
c. Handle the client gently by using turn sheets for repositioning.
d. Instruct the nursing assistants to measure intake and output.

Answer 37

b. Restrict the client’s fluid intake to 900 mL/24 hr.

Question 38

A client has received vasopressin (DDAVP) for diabetes insipidus. Which assessment finding indicates a therapeutic response to this therapy?

a. Urine output is increased; specific gravity is increased.
b. Urine output is increased; specific gravity is decreased.
c. Urine output is decreased; specific gravity is increased.
d. Urine output is decreased; specific gravity is decreased.

Answer 38

c. Urine output is decreased; specific gravity is increased.

Question 39

The new nurse is assessing a client with suspected pheochromocytoma. Which action by the nurse requires the precepting nurse to intervene?

a. Auscultating, palpating, and percussing the client’s abdomen
b. Taking the client’s blood pressure for reports of chest pain
c. Assessing the client’s diet for red wine and aged cheeses
d. Limiting visitors while the client is sleeping

Answer 39

a. Auscultating, palpating, and percussing the client’s abdomen

Pheochromocytomas are found on the adrenal glands or in the abdomen. Palpation of a pheochromocytoma can cause intense release of catecholamines and can precipitate a hypertensive crisis. The experienced nurse should intervene if the new nurse attempts this. The other actions would be appropriate.

Question 40

In preparing a staff in-service presentation about diabetes mellitus, the nurse includes which information?

a. Diabetes increases the risk for development of epilepsy.
b. The cure for diabetes is the administration of insulin.
c. Diabetes increases the risk for development of cardiovascular disease.
d. Carbohydrate metabolism is altered in diabetes, but protein metabolism is normal.

Answer 40

c. Diabetes increases the risk for development of cardiovascular disease.

Question 41

A client with diabetes asks the nurse why it is necessary to maintain blood glucose levels no lower than about 60 mg/dL. Which is the nurse’s best response?

a. “Glucose is the only fuel used by the body to produce the energy that it needs.”
b. “Your brain needs a constant supply of glucose because it cannot store it.”
c. “Without a minimum level of glucose, your body does not make red blood cells.”
d. “Glucose in the blood prevents the formation of lactic acid and prevents acidosis.”

Answer 41

b. “Your brain needs a constant supply of glucose because it cannot store it.”

Question 42

A client with untreated diabetes mellitus has polyuria, is lethargic, and has a blood glucose of 560 mg/dL. The nurse correlates the polyuria with which finding?

a. Serum sodium, 163 mEq/L
b. Serum creatinine, 1.6 mg/dL
c. Presence of urine ketone bodies
d. Serum osmolarity, 375 mOsm/kg

Answer 42

d. Serum osmolarity, 375 mOsm/kg

Question 43

A client with diabetes has a serum creatinine of 1.9 mg/dL. The nurse correlates which urinalysis finding with this client?

a. Ketone bodies in the urine during acidosis
b. Glucose in the urine during hyperglycemia
c. Protein in the urine during a random urinalysis
d. White blood cells in the urine during a random urinalysis

Answer 43

c. Protein in the urine during a random urinalysis

Question 44

A client with newly diagnosed type 2 diabetes is admitted to the metabolic unit. The primary goal for this admission is education. Which goal should the nurse incorporate into her teaching plan?

A- Maintenance of blood glucose levels between 180 and 200 mg/dl
B- Smoking reduction but not complete cessation
C- An eye examination every 2 years until age 50
D- Weight reduction through diet and exercise

Answer 44

D- Weight reduction through diet and exercise

Question 45

Which action by a new registered nurse (RN) caring for a patient with a goiter and possible Peripheral neuropathy thyroidism indicates that the charge nurse needs to do more teaching?

a. The RN checks the blood pressure on both arms.
b. The RN palpates the neck thoroughly to check thyroid size.
c. The RN lowers the thermostat to decrease the temperature in the room.
d. The RN orders nonmedicated eye drops to lubricate the patient’s bulging eyes.

Answer 45

b. The RN palpates the neck thoroughly to check thyroid size.

Palpation can cause the release of thyroid hormones in a patient with an enlarged thyroid and should be avoided. The other actions by the new RN are appropriate when caring for a patient with an enlarged thyroid.

Question 46

The nurse is monitoring a client with hypoglycemia. Glucagon provides which function?

a. It enhances the activity of insulin, restoring blood glucose levels to normal more quickly after a high-calorie meal.
b. It is a storage form of glucose and can be broken down for energy when blood glucose levels are low.
c. It converts excess glucose into glycogen, lowering blood glucose levels in times of excess.
d. It prevents hypoglycemia by promoting release of glucose from liver storage sites.

Answer 46

d. It prevents hypoglycemia by promoting release of glucose from liver storage sites.

Question 47

The nurse is teaching a client about self-monitoring of blood glucose levels. To prevent bloodborne infection, which statement by the nurse is best?

a. “Wash your hands after completing the test.”
b. “Do not share your monitoring equipment.”
c. “Blot excess blood from the strip.”
d. “Use gloves during monitoring.”

Answer 47

b. “Do not share your monitoring equipment.”

Question 48

Which question will provide the most useful information to a nurse who is interviewing a patient about a possible thyroid disorder?

a. “What methods do you use to help cope with stress?”
b. “Have you experienced any blurring or double vision?”
c. “Have you had a recent unplanned weight gain or loss?”
d. “Do you have to get up at night to empty your bladder?”

Answer 48

c. “Have you had a recent unplanned weight gain or loss?”

Because thyroid function affects metabolic rate, changes in weight may indicate hyperfunction or hypofunction of the thyroid gland. Nocturia, visual difficulty, and changes in stress level are associated with other endocrine disorders.

Question 49

During the physical examination of a 36-year-old female, the nurse finds that the patient’s thyroid gland cannot be palpated. The most appropriate action by the nurse is to

a. palpate the patient’s neck more deeply.
b. document that the thyroid was nonpalpable.
c. notify the health care provider immediately.
d. teach the patient about thyroid hormone testing.

Answer 49

b. document that the thyroid was nonpalpable.

Question 50

Which laboratory value should the nurse review to determine whether a patient’s hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland?

a. Thyroxine (T4) level
b. Triiodothyronine (T3) level
c. Thyroid-stimulating hormone (TSH) level
d. Thyrotropin-releasing hormone (TRH) level

Answer 50

c. Thyroid-stimulating hormone (TSH) level

Question 51

A new nurse is palpating a client’s thyroid gland. Which action requires intervention from the nurse’s mentor?

a. The nurse stands behind, instead of in front of, the client.
b. The client is asked to swallow while the nurse finds the thyroid gland.
c. The nurse palpates the right lobe with his or her left hand.
d. The client is placed in a sitting position with the chin tucked down.

Answer 51

c. The nurse palpates the right lobe with his or her left hand.

Question 52

A 44-year-old patient is admitted with tetany. Which laboratory value should the nurse monitor?

a. Total protein
b. Blood glucose
c. Ionized calcium
d. Serum phosphate

Answer 52

c. Ionized calcium

Tetany is associated with hypocalcemia. The other values would not be useful for this patient.

Question 53

A client with hypothyroidism as a result of Hashimoto’s thyroiditis asks the nurse how long she will have to take thyroid medication. Which is the nurse’s best response?

a. “You will need to take the thyroid medication until the goiter is completely gone.”
b. “Thyroiditis is cured with antibiotics. Then you won’t need thyroid medication.”
c. “You’ll need thyroid pills for life because your thyroid won’t start working again.”
d. “When blood tests indicate normal thyroid function, you can stop the medication.”

Answer 53

c. “You’ll need thyroid pills for life because your thyroid won’t start working again.”

Question 54

A client has undergone a complete thyroidectomy. Which statement by the client indicates that further instruction is needed?

a. “I may need calcium replacement after surgery.”
b. “After surgery, I won’t need to take thyroid medication.”
c. “I’ll need to take thyroid hormones for life.”
d. “I can receive pain medication if I feel that I need it.”

Answer 54

b. “After surgery, I won’t need to take thyroid medication.”

Question 55

A client who has used insulin for diabetes control for 20 years has a spongy swelling at the site used most frequently for insulin injection. Which is the nurse’s best action?

a. Apply ice to this area for 20 minutes.
b. Document the finding in the client’s chart.
c. Assess the client for other signs of cellulitis.
d. Instruct the client to use a different site for injection.

Answer 55

d. Instruct the client to use a different site for injection.

Question 56

A client with diabetes is prescribed insulin glargine once daily and regular insulin four times daily. One dose of regular insulin is scheduled at the same time as the glargine. How does the nurse instruct the client to administer the two doses of insulin?

a. “Draw up and inject the insulin glargine first, then draw up and inject the regular insulin.”
b. “Draw up and inject the insulin glargine first, wait 20 minutes, then draw up and inject the regular insulin.”
c. “First draw up the dose of regular insulin, then draw up the dose of insulin glargine in the same syringe, mix, and inject the two insulins together.”
d. “First draw up the dose of insulin glargine, then draw up the dose of regular insulin in the same syringe, mix, and inject the two insulins together.”

Answer 56

a. “Draw up and inject the insulin glargine first, then draw up and inject the regular insulin.”

Question 57

A client on an intensified insulin regimen consistently has a fasting blood glucose level between 70 and 80 mg/dL, a postprandial blood glucose level below 200 mg/dL, and a hemoglobin A1c level of 5.5%. Which is the nurse’s interpretation of these findings?

a. Increased risk for developing ketoacidosis
b. Increased risk for developing hyperglycemia
c. Signs of insulin resistance
d. Good control of blood glucose

Answer 57

d. Good control of blood glucose

Question 58

A client has been newly diagnosed with diabetes mellitus. Which statement made by the client indicates a need for further teaching regarding nutrition therapy?

a. “I should be sure to eat moderate to high amounts of fiber.”
b. “Saturated fats should make up no more than 7% of my total calorie intake.”
c. “I should try to keep my diet free from carbohydrates.”
d. “My intake of plain water each day is not restricted.”

Answer 58

c. “I should try to keep my diet free from carbohydrates.”

Question 59

A client newly diagnosed with type 2 diabetes tells the nurse that since increasing fiber intake, he is having loose stools, flatulence, and abdominal cramping. Which is the nurse’s best response?

a. “Decrease your intake of water and other fluids until your stools firm up.”
b. “Decrease your intake of fiber now and gradually add it back into your diet.”
c. “You must have allergies to high-fiber foods and will need to avoid them.”
d. “Taking an antacid 1 hour before or 2 hours after meals will help this problem.”

Answer 59

b. “Decrease your intake of fiber now and gradually add it back into your diet.”

Question 60

A client in the emergency department has been diagnosed with ketoacidosis. Which manifestation does the nurse correlate with this condition?

a. Increased rate and depth of respiration
b. Extremity tremors followed by seizure activity
c. Oral temperature of 102° F (38.9° C)
d. Severe orthostatic hypotension

Answer 60

a. Increased rate and depth of respiration

Question 61

The nurse determines that which arterial blood gas values are consistent with ketoacidosis in the client with diabetes?

a. pH 7.38, HCO3–22 mEq/L, PCO238 mm Hg, PO298 mm Hg
b. pH 7.28, HCO3–18 mEq/L, PCO228 mm Hg, PO298 mm Hg
c. pH 7.48, HCO3–28 mEq/L, PCO238 mm Hg, PO298 mm Hg
d. pH 7.28, HCO3–22 mEq/L, PCO258 mm Hg, PO288 mm Hg

Answer 61

b. pH 7.28, HCO3–18 mEq/L, PCO228 mm Hg, PO298 mm Hg

Question 62

A client has diabetic ketoacidosis and manifests Kussmaul respirations. What action by
the nurse takes priority.?

a. Administration of oxygen by mask or nasal cannula
b. Intravenous administration of 10% glucose
c. Implementation of seizure precautions
d. Administration of intravenous insulin

Answer 62

d. Administration of intravenous insulin

Question 63

A nurse is providing health education to an adolescent newly diagnosed with type 1 diabetes mellitus and her family. The nurse teaches the patient and family that which of the following nonpharmacologic measures will decrease the body’s need for insulin?

A) Adequate sleep
B) Low stimulation
C) Exercise
D) Low-fat diet

Answer 63

C) Exercise

Question 64

 The nurse is teaching a client with diabetes about exercise. Which statement by the client indicates a need for further teaching?

a. “I won’t exercise if I find ketones in my urine.”
b. “If my blood glucose is over 200, I should not exercise.”
c. “Exercise will help me keep my blood glucose down.”
d. “My risks for heart disease can be modified with exercise.”

Answer 64

b. “If my blood glucose is over 200, I should not exercise.”

Question 65

Which statement by a client with type 2 diabetes indicates a need for further teaching about diabetic management and follow-up care?

a. “I need to have an annual appointment, even if my glucose levels are in good control.”
b. “Because my diabetes is controlled with diet and exercise, I have to be seen only if I am sick.”
c. “I can still develop complications, even though I do not have to take insulin at this time.”
d. “If I have surgery or get very ill, I may have to receive insulin injections for a short time.”

Answer 65

b. “Because my diabetes is controlled with diet and exercise, I have to be seen only if I am sick.”

Question 66

The nurse is teaching a patient that the body needs iodine for the thyroid to function. What food would be the best source of iodine for the body?

A) Eggs
B) Shellfish
C) Table salt
D) Red meat

Answer 66

C) Table salt

The major use of iodine in the body is by the thyroid.

Question 67

 A patient has been admitted to the critical care unit with a diagnosis of thyroid storm. What should the nurse include in this patients immediate care? Select all that apply.

A) Administering diuretics to prevent fluid overload
B) Administering beta blockers to reduce heart rate
C) Administering insulin to reduce blood glucose levels
D) Applying interventions to reduce the patients temperature
E) Administering corticosteroids

Answer 67

B) Administering beta blockers to reduce heart rate
D) Applying interventions to reduce the patients temperature

Thyroid storm necessitates interventions to reduce heart rate and temperature.

Question 68

Hypothyroidism s/s:

Answer 68

• Fatigue
• Increased sensitivity to cold
• Constipation
• Dry skin
• Weight gain
• Puffy face
• Hoarseness
• Muscle weakness
• Elevated blood cholesterol level
• Muscle aches, tenderness and stiffness
• Pain, stiffness or swelling in your joints
• Heavier than normal or irregular menstrual periods
• Thinning hair
• Slowed heart rate
• Depression
• Impaired memory
• Enlarged thyroid gland (goiter)

Question 69

 A client being treated for hypothyroidism has been admitted for pneumonia. Which activity does the nurse include as a priority in this client’s care plan?

a. Monitor the client’s IV site every shift.
b. Administer acetaminophen (Tylenol) for fever.
c. Ensure that working suction equipment is in the room.
d. Assess vital signs every 4 hours.

Answer 69

c. Ensure that working suction equipment is in the room.

Question 70

 A client with hypothyroidism as a result of Hashimoto’s thyroiditis asks the nurse how long she will have to take thyroid medication. Which is the nurse’s best response?

a. “You will need to take the thyroid medication until the goiter is completely gone.”
b. “Thyroiditis is cured with antibiotics. Then you won’t need thyroid medication.”
c. “You’ll need thyroid pills for life because your thyroid won’t start working again.”
d. “When blood tests indicate normal thyroid function, you can stop the medication.”

Answer 70

c. “You’ll need thyroid pills for life because your thyroid won’t start working again.”

Question 71

A client has hypothyroidism. Which problem does the nurse address as a priority for this client?

a. Heat intolerance
b. Body image problems
c. Depression and withdrawal
d. Obesity

Answer 71

c. Depression and withdrawal

Question 72

Which client statement alerts the nurse to the possibility of hypothyroidism?

a. “My sister has thyroid problems.”
b. “I seem to feel the heat more than other people.”
c. “Food just doesn’t taste good without a lot of salt.”
d. “I am always tired, even with 10 or 12 hours of sleep.”

Answer 72

d. “I am always tired, even with 10 or 12 hours of sleep.”

Question 73

The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimotos thyroiditis. When assessing this patient, what sign or symptom would the nurse expect?

A) Fatigue
B) Bulging eyes
C) Palpitations
D) Flushed skin

Answer 73

A) Fatigue

Question 74

 A nurse works in a walk-in clinic. The nurse recognizes that certain patients are at higher risk for different disorders than other patients. What patient is at a greater risk for the development of hypothyroidism?

A) A 75-year-old female patient with osteoporosis
B) A 50-year-old male patient who is obese
C) A 45-year-old female patient who used oral contraceptives
D) A 25-year-old male patient who uses recreational drugs

Answer 74

A) A 75-year-old female patient with osteoporosis

Question 75

 A patient with a recent diagnosis of hypothyroidism is being treated for an unrelated injury. When administering medications to the patient, the nurse should know that the patients diminished thyroid function may have what effect?

A) Anaphylaxis
B) Nausea and vomiting
C) Increased risk of drug interactions
D) Prolonged duration of effect

Answer 75

D) Prolonged duration of effect

In all patients with hypothyroidism, the effects of analgesic agents, sedatives, and anesthetic agents are prolonged.