NURS 317 Unit 3 Practice

Question 1

A client with excessive production of growth hormone level will likely exhibit which clinical manifestations? Select all that apply.
a) Large hands and feet due to increased production of GH
b) Short stature with obesity
c) Difficulty chewing food
d) Tendency to develop asthma
e) Excess thirst and urination due to decreased glucose uptake

Answer 1

a) Large hands and feet due to increased production of GH
c) Difficulty chewing food
e) Excess thirst and urination due to decreased glucose uptake

Question 2

One of the first signs that indicates an infant may have congenital hypothyroidism is:
a) No passage of meconium within the first 72 hours after birth
b) Prolonged period of physiologic jaundice
c) Full, bounding fontanels
d) Palpable mass in the neck region

Answer 2

b) Prolonged period of physiologic jaundice

Question 3

Which of the following clinical manifestations following thyroidectomy would alert the nurse that the client is going into a life-threatening thyroid storm? Select all that apply.
a) Bruising on knees and feet
b) Unable to close eyelids completely together
c) Telemetry showing heart rate of 184
d) Temperature of 104.2°F (40.1C)
e) Extremely agitated

Answer 3

c) Telemetry showing heart rate of 184
d) Temperature of 104.2°F (40.1C)
e) Extremely agitated

Question 4

The most common cause of thyrotoxicosis is Graves disease. When assessing this client, the nurse should put priority on which of the following signs/symptoms?
a) Facial myxedema with puffy eyelids
b) Ophthalmopathy
c) Complaints of muscle fatigue
d) Pulse rate of 64 beats/minute

Answer 4

b) Ophthalmopathy

Question 5

A client has just undergone a diagnostic cardiac angiogram. As part of their ordered labs, the physician has ordered a thyroid panel. The physiological principle behind ordering this lab tests includes which of the following correlations? Hyperthyroidism can cause: Select all that apply.
a) Rise in oxygen consumption
b) Increase in cardiac output
c) Sharp decrease in heart rate and blood pressure
d) Vasoconstriction of all arteries

Answer 5

a) Rise in oxygen consumption
b) Increase in cardiac output

Question 6

A client tells his health care provider that his body is changing. It used to be normal for his blood glucose to be higher during the latter part of the morning. However, now his fasting blood glucose level is elevated in the early AM (07:00). The health care provider recognizes the client may be experiencing:
a) Hyperglycemic hyperosmolar state (HHS)
b) Possible stress-related hypoglycemia
c) Dawn phenomenon
d) Somogyi effect

Answer 6

c) Dawn phenomenon

Question 7

A hospital client has been complaining of increasing fatigue for several hours, and his nurse has entered his room to find him unarousable. The nurse immediately checked the client’s blood glucose level (and reverified with a second blood glucose meter), which is 22 mg/dL (1.2 mmol/L). The nurse should prepare to administer which of the following?
a) A snack that combines simple sugars, protein, and complex carbohydrates
b) An oral solution containing glucagon and simple sugars
c) Infusion of rapid-acting insulin
d) A 50% glucose solution intravenously

Answer 7

d) A 50% glucose solution intravenously

Question 8

A diabetic client presents to the clinic. He is concerned his lower legs are “feeling funny.” Which of the following assessment findings lead the health care provider to suspect the client may have developed somatic neuropathy? Select all that apply.
a) One leg has a reddened area in the calf and has a positive Homan sign.
b) Right foot has a diminished perception of vibration; left foot is normal.
c) Both legs appear to be the same as far as numbness is involved.
d) With eyes closed, the client cannot identify where the HCP is touching his feet.
e) Bilateral cool ankles and feet.

Answer 8

c) Both legs appear to be the same as far as numbness is involved.
d) With eyes closed, the client cannot identify where the HCP is touching his feet.
e) Bilateral cool ankles and feet.

Question 9

A client is admitted in the ICU with diagnosis of hyperglycemic hyperosmolar state (HHS). The nurse caring for the client knows that the client’s elevated serum osmolality has pulled water out of this brain cells based on which of the following assessment findings? Select all that apply.
a) Weakness one side of the body
b) Increase in urine output in proportion to the increase in blood glucose
c) After the sole of the foot has been firmly stroked, the toes flex and flare out
d) Uncontrollable twitching of a muscle group
e) Unable to respond verbally to questions

Answer 9

a) Weakness one side of the body
c) After the sole of the foot has been firmly stroked, the toes flex and flare out
d) Uncontrollable twitching of a muscle group
e) Unable to respond verbally to questions

Question 10

A client with long-standing type 2 diabetes is surprised at his high blood sugar readings while recovering from an emergency surgery. Which of the following factors may have contributed to the client’s inordinately elevated blood glucose levels?
a) The tissue trauma of surgery resulted in gluconeogenesis.
b) Illness inhibited the release and uptake of glucagon.
c) Sleep disruption in the hospital precipitated the dawn effect.
d) The stress of the event caused the release of cortisol.

Answer 10

d) The stress of the event caused the release of cortisol.

Question 11

What is the nurse’s priority assessment when administering hypothalamic or pituitary agents to older adults?
a) Urinary incontinence
b) Cognitive function
c) Hydration and nutrition
d) Balance and fall risk

Answer 11

c) Hydration and nutrition

Question 12

What symptoms will the nurse instruct the patient taking octreotide (Sandostatin) to report to the health care provider?
Question options:
a) Muscle cramps
b) Alteration in consciousness
c) Changes in vision
d) Abdominal pain

Answer 12

d) Abdominal pain

Question 13

What glucocorticoids could the nurse only administer orally?
a) Hydrocortisone (Cortef)
b) Prednisone (Deltasone)
c) Triamcinolone (Aristocort)
d) Cortisone (Cortone Acetate)

Answer 13

b) Prednisone (Deltasone)

Question 14

What would be important for the nurse to teach the parents of a pediatric patient about the use of topical corticosteroids?
a) “Apply directly to open lesions.”
b) “Reapply as often as needed to keep the rash coated with the medication.”
c) “Apply the medication sparingly.”
d) “After applying cover with a bandage.”

Answer 14

c) “Apply the medication sparingly.”

Question 15

The nurse, caring for a patient experiencing stress, knows that activation of the stress reaction will cause the release of what?
a) Oxytocin
b) Aldosterone
c) Glucose
d) Adrenocorticotropic hormone (ACTH)

Answer 15

d) Adrenocorticotropic hormone (ACTH)

Question 16

The nurse is caring for an asthmatic patient prescribed zoledronic acid. What important question should the nurse ask this patient?
a) “Do you have a history of diarrhea?”
b) “Can you take aspirin without experiencing any bad effects?”
c) “Are you taking theophylline to treat your asthma?”
d) “Are you taking digoxin?”

Answer 16

b) “Can you take aspirin without experiencing any bad effects?”

Question 17

The patient is 8 weeks pregnant and requires an antithyroid medication. The nurse identifies what drug as the drug of choice for this patient?
a) Methimazole
b) Propylthiouracil
c) Alendronate
d) Radioactive iodine

Answer 17

b) Propylthiouracil

Question 18

The nurse admits a patient to the emergency department and recognizes the patient is in diabetic ketoacidosis (DKA) when what manifestations are assessed? (Select all that apply.)
a) Dehydration
b) slow and deep respirations
c) Edema
d) Fruity breath
e) Agitation

Answer 18

a) Dehydration
b) slow and deep respirations
d) Fruity breath

Question 19

The nurse, working in the emergency department, receives a patient following a motor vehicle accident whose medical history is unknown with a blood glucose level of 325 mg/dL(18 mmol/l). What rationale does the nurse provide explaining this elevated blood glucose level?
a) The stress reaction caused an increase in blood sugar.
b) The patient’s accident was caused by diabetic ketoacidosis (DKA).
c) The patient has not been taking the antidiabetic agent as prescribed.
d) The patient most likely just finished a meal.

Answer 19

a) The stress reaction caused an increase in blood sugar.

Question 20

The nurse is caring for a patient with renal dysfunction who requires an oral antidiabetic agent. What drug will the nurse expect to see ordered?
a) Chlorpromazine
b) Tolazamide
c) Chlorpropamide
d) Tolbutamide

Answer 20

d) Tolbutamide

Question 21

The physician prescribed taking blood pressure assessments on a client, lying and standing, every 4 hours, for 24 hours. Determine the percentage difference between the first two systolic readings (140 mm Hg lying and 125 mm Hg standing).
a) 9
b) 13
c) 11
d) 7

Answer 21

c) 11

140-125 = 15
15/140=11%

Question 22

The physician prescribed 60 mg of clonazepam available as a 40-mg scored tablet. The client was advised to take how many tablets for each dose? Use proportion (ratios and fractions) to solve this problem.
a) 2.5
b) 2
c) 1
d) 1.5

Answer 22

d) 1.5

Question 23

A diabetic client was prescribed an 1800-calorie ADA diet. The client can have 35% of her calories (630) in the form of carbohydrate (CHO). To maintain this same ratio, how many carbohydrate calories would she be allowed if the ADA diet was reduced to 1500 calories? Use a proportion (ratios) to solve the problem.
a) 425
b) 375
c) 525
d) 475

Answer 23

c) 525

Question 24

An elderly client takes her morning medications with 4 oz of Boost. The doctor wants her to increase her Boost intake by 50%. How many additional ounces would the client take with her morning dose of medications? Use the decimal format to estimate the percentage increase.
a) 1
b) 2 1/2
c) 2
d) 1 1/2

Answer 24

c) 2

Question 25

A nurse measured the circumference of an edematous leg and documented “15.5 inches at mid-calf, left leg” on the client’s electronic medical record. For comparison, she measured the right calf and documented “12 inches at mid-calf, right leg.” The left calf is what percentage larger than the right calf?
a) 23
b) 25
c) 22
d) 20

Answer 25

a) 23