Unit 3 QUIZ Flashcards
A nurse measured the circumference of an edematous leg and documented “ 15 .5 Inches
at mid -calf, left l eg” on the client’ s electronic medical record . For comparison, she
measured the right calf and documented “ 12 inches at mid-caIf, right leg. ‘’ the left calf
is what percentage larger than the right calf?
Select one :
a.22
b.25
c. 23
d . 20
ANS: c. 23
When developing a plan of care for the patient receiving a glucocorticoid , what nursing
diagnosis would be of highest priority?
Select one:
a. Imbalanced nutrition : less than body requirements
b . Risk for infection related to immunosuppress ion
c. Deficient fluid volume related to water retention
d. Risk for injury related to muscle weakness
ANS: b . Risk for infection related to immunosuppress ion
The home health nurse provides patient teaching to his or her patient who is taking oral prednisolone. The nurse provides what instruction to reduce the occurrence of nausea?
Select one:
a. “Take before bedtime.”
b. “Split the dose into two equal doses.”
c. “Take with a meal.”
d. “Take 1 hour before meals.”
ANS: c. “Take with a meal.”
A patient is admitted to the emergency department in diabetic ketoacidosis (DKA) with
a blood glucose level of 485 mg/dl (26.9mmol/1). The physician orders an initial dose of 25 U Insulin IV. Which type of insulin will be administered?
Select one:
a. NPH insulin
b. Humulin N insulin
c. Regular insulin
d . Humulin L insulin
ANS: c. Regular insulin
A hospital client with a diagnosis of type 1 diabetes has been administered a scheduled
dose of regular insulin . Which of the following effects will result from the action of
insulin?
Select one:
a. Promotion of fat breakdown
b. Promotion of glucose uptake by target cells
c. Initiation of glycogenolysis
d. Promotion of gluconeogenesis
ANS: b. Promotion of glucose uptake by target cells
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.
Select one:
a. 525
b.375
c. 475
d.425
a. 525
1500 x .35
The signs and symptoms of abrupt cessation of pharmacologic glucocorticoids closely resemble those of: Select one: a. Cushing disease b. Graves disease c. Addison disease d. Cushing syndrome
A. Addison disease
Although the etiology differs, the adrenal cortical insufficiency resulting from the abrupt cessation of glucocorticoids is nearly identical to Addison disease in terms of physiologic effects.
Which of the following comorbidities represent the greatest risk for “the development of
foot ulcers in a diabetic client? Select all that apply.
Select one or more:
a. Smoking history averaging 2 packs/day
b. Motor neuropathy related to Improperly fitted shoes
c. Previous incidents of diabetic ketoacidosis with blood glucose levels of 400 mg/dl (22 .2
mmol/L)
d. Diabetic renal problems with severely decreased GFR
e. Bilateral distal loss of pain sensation
A. smoking history averaging 2 packs/day
B. motor neuropathy related to improperly fitted shoes
E. bilateral distal loss of pain sensation
The nurse is performing diabetes screening and recognizes what ethnic group is at higher risk for diabetes but is also predisposed to a higher normal range of blood glucose?
a. Caucasian Americans
b. Japanese Americans
c. African Americans
d. Native Americans
ANS: D. Native Americans
Diabetic retinopathy, the leading cause of acquired blindness in t he United States, is characterized by retinal: Select one: a. Hemorrhages b. Glaucoma c. Infections d. Dehydration
Ans: a. Hemorrhages
Which of the following individuals is experiencing the effects of a primary endocrine disorder? A client:
Select one:
a. Who has hypothyroidism as a result of low TSH production
b. Whose dysfunctional hypothalamus has resulted in endocrine imbalances
c. Who has low calcium levels because of the loss of his parathyroid gland
d. With adrenal cortical insufficiency due to pituitary hyposecretion of ACTH
ANS: c. Who has low calcium levels because of the loss of his parathyroid gland
A 33-year-old client has been admitted to the hospital for the treatment of Graves
disease. Which of the following assessments should the client’s care team prioritize ?
Select one:
a. Cardiac monitoring and assessment of peripheral perfusion
b. Assessment of the client’s peripheral vascular system for thromboembolism
c. Assessment of the client’s level of consciousness and neurologic status
d. Assessment of the client’s vision and oculomotor function
Ans:
D: Assessment of the client’s vision and oculomotor function
Explanation:
Ophthalmopathy occurs in a large proportion (up to one third) of clients with Graves disease and may result in permanent vision damage. This supersedes the importance of cardiac, neurologic, and peripheral vascular assessments, although these assessments are relevant to the broader effects of hyperthyroidism that the client may likely experience.
The nurse administers desmopressin t o treat a patient with diabetes insipidus. Assessment of what laboratory studies would indicate the drug is working?
a. Increased serum sodium levels
b. increased red blood cell count
c. Decreased urine specific gravity
d. Reduced urine glucose levels
Ans: A Increased serum sodium levels
Feedback:
Desmopressin produces its antidiuretic activity in the kidneys, causing the cortical and medullary parts of the collecting duct to become permeable to water, thereby increasing water reabsorption and decreasing urine formation. These activities reduce plasma osmolarity and increase blood volume.- on test
A client takes 0.125 mg of a medication, three times daily. How man y milligrams would the client take in 4 days? Select one: a. 0.375 b . 1. 125 C. 0.75 d . 1.5
ANS: D. 1.5
Which of the following residents of a long-term facility is exhibiting clinical manifestations of hypothyroidism?
Select one:
a. A 90 -year-old woman with a history of atrial fibrillation whose arrhythmia has recently
become more severe
b . A 91 -year-old man with a chronic venous ulcer and a sacral ulcer who has developed
sepsis
c. An 88 -year-old man with a history of Alzheimer disease who has become increasingly
agitated and is wandering around the facility more frequently
d . An 80-year-old woman who has uncharacteristically lost her appetite and often
complains of feeling cold
ANs:
D: An 80-year-old woman who has uncharacteristically lost her appetite of late and often complains of feeling cold
Explanation:
Loss of appetite and cold intolerance are characteristic symptoms of hypothyroidism. Arrhythmias, agitation, and infections are not typically associated with hypofunction of the thyroid gland.
The nurse administers teriparatide (Forteo) and evaluates the drug as effective in
achieving desired effects when what is assessed?
Select one:
a. Decrease in serum calcium and increase in serum phosphorous
b. Increase in serum calcium and decrease in serum phosphorous
c. Increase in serum calcium and phosphorous
d. Decrease in serum calcium and phosphorous
ANS: b. Increase in serum calcium and decrease in serum phosphorous
The physician prescribed 60 mg of clonazepam available as a 40-mg scored t ablet. The client was advised to take how many tablets for each dose? Use proportion (ratios and fractions) to solve this problem. Select one: a. 1 b. 2.5 C. 1.5 d.2
C. 1.5
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?
Select one:
a. Chlorpropamide
b. Tolbutamide
c. Chlorpromazine
d. Tolazarmide
Ans: B: Tolbutamide
Explanation:
Tolbutamide is preferred for clients with renal dysfunction, who may not be able to excrete chlorpropamide, because it is more easily cleared from the body. Tolbutamide, chlorpropamide, and tolazamide are all first-generation sulfonylureas, but tolazamide is used less frequently and is usually tried after the first two drugs have been shown to be ineffective. Chlorpromazine (Thorazine) is an antipsychotic agent.
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. 2
b. 1 1/2
c. 1
d. 2 1/2
Ans: a. 2
The iatrogenic form of Cushing syndrome is caused by:
a. Benign or malignant adrenal tumor
b. Long-term cortisone therapy
c. Ectopic ACTH -secreting lung tumor
d. Pituitary tumor secreting ACTH
ANs: b. Long-term cortisone therapy
A client tell s 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. Possible stress-related hypoglycemia
b. Dawn phenomenon
c. Hyperglycemic hyperosmolar state {HHS)
d. Somogyi effect
ANs: b. Dawn phenomenon
A nurse is working at a fertility clinic. Today she is administering ganirelix acetate (Antagon) to a woman participating in a fertility research prog ram. By what route is this drug administered? Select one : a. Subcutaneously b. Intramuscularly c. IV d . Orally
a. Subcutaneously
What assessment findings would the nurse expect to see in a patient who overdosed on
levothyroxine (Synthroid)?
Select one:
a. Buffalo hump, constipation, sodium loss
b. Nervousness, tachycardia, tremors
c. Somnolence, bradycardia, paresthesia
d. Hyperglycemia, hypertension, edema
ANS: B
Feedback:
More pronounced adverse effects of levothyroxine would be seen including tremors, headache, nervousness, palpitations, tachycardia, allergic skin reactions, diarrhea, nausea, vomiting. Somnolence, bradycardia, and paresthesia would be more likely with insufficient drug intake, which would cause hypothyroidism and other symptoms. Hyperglycemia, edema, buffalo hump, constipation, or sodium loss would not be associated with excess thyroid hormone.
The nurse is developing a plan of care for an 84-year-old diabetic patient who i s
receiving oral hydrocortisone 40 mg da ily for treatment of arthritis. What is this
patient’s priority nursing intervention?
Select one:
a. Increasing flu ids to 2,000 mL/d
b . Restricting protein in diet
c. Increasing sodium in diet
d. Monitoring blood glucose level frequently
d. Monitoring blood glucose level frequently
Impaired and delayed healing in a person with diabetes is caused by long term complications that include:
a. Chronic neuropathies
b. somogyi effect
c. fluid imbalances
d. ketoacidosis
Ans: a. Chronic neuropathies
