After teaching a client with type 2 diabetes mellitus, the nurse assesses the client’s understanding. Which statement made by the client indicates a need for additional teaching?
Question 1 After teaching a client with type 2 diabetes mellitus, the nurse assesses the client’s understanding. Which statement made by the client indicates a need for additional teaching?Since my diabetes is controlled with diet and exercise , I must be seen only if an sick
• Question 2 When doing a skin assessment, the nurse applies the ABCDE rule to examine the skin. The “C” stands for:color changes
• Question 3
A nurse teaches a client with diabetes mellitus about foot care. Which statements should the nurse include in this client’s teaching? (Select all that apply.)
a.Do not walk around barefoot.”
b.Soak your feet in a tub each evening.”
c.”Trim toenails straight across with a nail clipper.”
d.Treat any blisters or sores with Epsom salts.”
e.Wash your feet every other day.
• Question 4 A nurse collaborates with the interdisciplinary team to develop a plan of care for a client who is newly diagnosed with diabetes mellitus. Which team members should the nurse include in this interdisciplinary team meeting? (Select all that apply.)
a.Registered dietitian
b.Clinical pharmacist
c.Occupational therapist
d.Health care provider
e.Speech-language pathologist
• Question 5 A nurse assesses a client who is recovering from a total thyroidectomy and notes the development of stridor. Which action should the nurse take first?
a.Reassure the client that the voice change is temporary.
b.Document the finding and assess the client hourly.
c.Place the client in high-Fowler’s position and apply oxygen.
d.Contact the provider and prepare for intubation
• Question 6 A nurse assesses a client who has a large abdomen and a rounded face. Which additional assessment finding would lead the nurse to suspect that this client has Cushing’s syndrome rather than obesity related to an imbalance of food intake and metaboic needs?
A. large thighs and upper arms
B. pendulous abdomen and large hips
C. abdominal striae and ankle enlargement
D. posterior neck fat pad and thin extremities
• Question 7 A diabetic patient is admitted with a blood glucose level of 476 mg/dL and an order reads, ” Insulin drip, Regular insulin 0.03 units per Kg. per hour.”The patient weighs 176 pounds. How many units of insulin should the patient receive each hour?
• Question 8 A nurse cares for a client who presents with bradycardia secondary to hypothyroidism. Which medication should the nurse anticipate being prescribed to the client?
a. Atropine sulfate
b. Levothyroxine sodium (Synthroid)
c. Propranolol (Inderal)
d. Epinephrine (Adrenalin)
• Question 9 An emergency department nurse assesses a client with ketoacidosis. Which clinical manifestation should 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
• Question 10 A nurse assesses clients who are at risk for diabetes mellitus. Which client is at greatest risk?
a.A 29-year-old Caucasian
b.A 32-year-old African-American
c.A 44-year-old Asian
d.A 48-year-old American Indian
• Question 11 A client is complaining of dry eyes that makes it difficult to wear his contact lenses. What question would you anticipate the nurse would ask the patient?
Assess for contact lenses
Suggest saline eye drops
Check the medication list
Ask about eyeglass usage
• Question 12 After change-of-shift report, which patient should the nurse assess first?
a. A 23-year-old patient with cystic fibrosis who has pulmonary function testing scheduled
b. A 46-year-old patient on bed rest who is complaining of sudden onset of shortness of breath
c. A 77-year-old patient with tuberculosis (TB) who has four antitubercular medications due in 15 minutes
d. A 35-year-old patient who was admitted the previous day with pneumonia and has a temperature of 100.2° F (37.8° C)
• Question 13When assisting a blind person with his meals, it is most important for the nurse to:
Go in clock wise direction or motion
• Question 14 What instructions should be given to the patient with a hordeolum?
hordeolum (stye) Management includes applying warm compresses four times a day and an antibacterial ointment. When the lesion opens, the pus drains and the pain subsides.
• Question 15 A nurse should include which instructions when teaching a patient with repeated hordeolum how to prevent further infection?
• Question 16 A nurse cares for a client who has a family history of diabetes mellitus. The client states, “My father has type 1 diabetes mellitus. Will I develop this disease as well?” How should the nurse respond?
a. “Yourrisk of diabetes is higher than the general population, but it may not occur.”
b. “No genetic risk is associated with the development of type 1 diabetes mellitus.”
c. “The risk for becoming a diabetic is 50% because of how it is inherited.”
d. “Female children do not inherit diabetes mellitus, but male children will.”
• Question 17 After teaching a client who has diabetes mellitus and proliferative retinopathy, nephropathy, and peripheral neuropathy, the nurse assesses the client’s understanding. Which statement made by the client indicates a correct understanding of the teaching?
a. “I have so many complications; exercising is not recommended.”
b. “I will exercise more frequently because I have so many complications.”
c. “I used to run for exercise; I will start training for a marathon.”
d. “I should look into swimming or water aerobics to get my exercise.”
• Question 18 A nurse cares for a client who has diabetes mellitus. The nurse administers 6 units of regular insulin and 10 units of NPH insulin at 0700. At which time should the nurse assess the client for potential problems related to the NPH insulin?
a. 0800
b. 1600
c. 2000
d. 2300
• Question 19 The nurse is caring for a patient who is 2 days post-op following the removal of a 3.6 cm. acoustic neuroma. The patient complains one side of his mouth is drooping. The most likely cause is:
nerve damage
• Question 20 A nurse cares for a client experiencing diabetic ketoacidosis who presents with Kussmaul respirations. Which action should the nurse take?
a. Administration of oxygen via face mask
b. Intravenous administration of 10% glucose
c. Implementation of seizure precautions
d. Administration of intravenous insulin
• Question 21 After teaching a young adult client who is newly diagnosed with type 1 diabetes mellitus, the nurse assesses the client’s understanding. Which statement made by the client indicates a correct understanding of the need for eye examinations?
Diabetes can cause blindness, so I should see the ophthalmologist yearly.
• Question 22 A nurse assesses a client who is recovering from a subtotal thyroidectomy. On the second postoperative day the client states, “I feel numbness and tingling around my mouth.” What action should the nurse take?
a. Offer mouth care.
b. Loosen the dressing.
c. Assess for Chvostek’s sign.
d. Ask the client orientation questions
• Question 23 A nurse cares for a client with excessive production of thyrocalcitonin (calcitonin). For which electrolyte imbalance should the nurse assess?
a. Potassium
b. Sodium
c. Calcium
d. Magnesium
• Question 24 A nurse assesses a client with diabetes mellitus who self-administers subcutaneous insulin. The nurse notes a spongy, swelling area at the site the client uses most frequently for insulin injection. Which action should the nurse take?
a. Apply ice to the site to reduce inflammation.
b. Consult the provider for a new administration route.
c. Assess the client for other signs of cellulitis.
d. Instruct the client to rotate sites for insulin injection.
• Question 25 A nurse cares for a client who has excessive catecholamine release. Which assessment finding should the nurse correlate with this condition?
a. Decreased blood pressure
b. Increased pulse
c. Decreased respiratory rate
d. Increased urine output
• Question 26 Simple aids the nurse can use to communicate with a hearing impaired patient include: ( Select all that apply).
• Question 27 A nurse collaborates with an unlicensed assistive personnel (UAP) to provide care for a client who is prescribed a 24-hour urine specimen collection. Which statement should the nurse include when delegating this activity to the UAP?
a. “Note the time of the client’s first void and collect urine for 24 hours.”
b. “Add the preservative to the container at the end of the test.”
c. “Start the collection by saving the first urine of the morning.”
d. “It is okay if one urine sample during the 24 hours is not collected.”
• Question 28 A nurse assesses a client who has diabetes mellitus and notes the client is awake and alert, but shaky, diaphoretic, and weak. Five minutes after administering a half-cup of orange juice, the client’s clinical manifestations have not changed. Which action should the nurse take next?
Give the client another 1/2 cup of orange juice.
Question 29 Which of the following hormones are affected in primary Cushings disease?
• Question 30 After teaching a client with diabetes mellitus to inject insulin, the nurse assesses the client’s understanding. Which statement made by the client indicates a need for additional teaching?
a. “The lower abdomen is the best location because it is closest to the pancreas.”
b. “I can reach my thigh the best, so I will use the different areas of my thighs.”
c. “By rotating the sites in one area, my chance of having a reaction is decreased.”
d. “Changing injection sites from the thigh to the arm will change absorption rates.”
• Question 31 Hearing loss is a side effect of many different of drugs. Select all classes of drugs that can cause a hearing loss
• Aspirin
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• antibiotics,
• Loop diuretics
• Medicines used to treat cancer.
• Question 32 Which of the following patients is most likely to have a recommendation to increase the sodium in her diet?
• Question 33 A client who is diagnosed with Addison’s disease is admitted to the hospital. Which of the following would the nurse expect to find when assessing the client?
1. Moon face, buffalo hump, and hyperglycemia.
2. Hirsutism, fever, and irritability.
3. Bronze pigmentation, hypotension, and anorexia.
4. Tachycardia, bulging eyes, and goiter.
• Question 34 A nurse cares for a client with diabetes mellitus who asks, “Why do I need to administer more than one injection of insulin each day?” How should the nurse respond?
a.“You need to start with multiple injections until you become moreproficient at self-injection.”
b. “A single dose of insulin each day would not match your blood insulin levels and your food intake patterns.”
c.“A regimen of a single dose of insulin injected each day wouldrequire that you eat fewer carbohydrates.”
d.“A single dose of insulin would be too large to be absorbed,predictably putting you at risk for insulin shock.”
• Question 35 A nurse teaches a client about self-monitoring of blood glucose levels. Which statement should the nurse include in this client’s teaching to prevent bloodborne infections?
a. “Wash your hands after completing each test.”
b. “Do not share your monitoring equipment.”
c. “Blot excess blood from the strip with a cotton ball.”
d. “Use gloves when monitoring your blood glucose.”
• Question 36 A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the nurse include in this client’s plan of care to delay the onset of microvascular and macrovascular complications?
a. “Maintain tight glycemic control and prevent hyperglycemia.”
b. “Restrict your fluid intake to no more than 2 liters a day.”
c. “Prevent hypoglycemia by eating a bedtime snack.”
d. “Limit your intake of protein to prevent ketoacidosis.”
• Question 37 A nurse teaches a client who has been prescribed a 24-hour urine collection to measure excreted hormones. The client asks, “Why do I need to collect urine for 24 hours instead of providing a random specimen?” How should the nurse respond?
A) “This test will assess for a hormone secreted on a circadian rhythm.”
B) “The hormone is diluted in urine; therefore, we need a large volume.”
C) “We are assessing when the hormone is secreted in large amounts.”
D) “To collect the correct hormone, you need to urinate multiple times.”
• Question 38 At 4:45 p.m., a nurse assesses a client with diabetes mellitus who is recovering from an abdominal hysterectomy 2 days ago. The nurse notes that the client is confused and diaphoretic. The nurse reviews the assessment data provided in the chart below:
Capillary Blood Glucose Testing (AC/HS) Dietary
Intake
At 0630: 95
At 1130: 70
At 1630: 47 Breakfast: 10% eaten – client states she is not hungry
Lunch: 5% eaten – client is nauseous; vomits once
After reviewing the client’s assessment data, which action is appropriate at this time?
a.Assess the client’s oxygen saturation level and administer oxygen.
b.Reorient the client and apply a cool washcloth to the client’s forehead.
c.Administer dextrose 50% intravenously and reassess the client.
d.Provide a glass of orange juice and encourage the client to eat dinner.
• Question 39 The most common cause of central vision loss in older patients is:
• Question 40 A nurse cares for a client with diabetes mellitus who is visually impaired. The client asks, “Can I ask my niece to prefill my syringes and then store them for later use when I need them?” How should the nurse respond?
A.) “Yes. Prefilled syringes can be stored for 3 weeks in the refrigerator in a vertical position with the needle pointing up.”
B) “Yes. Syringes can be filled with insulin and stored for a month in a location that is protected from light.”
C) “Insulin reacts with plastic, so prefilled syringes are okay, but you will need to use glass syringes.”
D) “No. Insulin syringes cannot be prefilled and stored for any length of time outside of the container.”
• Question 41 A nurse plans care for a client with hypothyroidism. Which priority problem should the nurse plan to address first for this client?
a. Heat intolerance
b. Body image problems
c. Depression and withdrawal
d. Obesity and water retention
• Question 42 A nurse assesses a client with diabetes mellitus 3 hours after a surgical procedure and notes the client’s breath has a “fruity” odor. Which action should the nurse take?
a. Encourage the client to use an incentive spirometer.
b. Increase the client’s intravenous fluid flow rate.
c. Consult the provider to test for ketoacidosis.
d. Perform meticulous pulmonary hygiene care.
• Question 43 A nurse teaches a client with hyperthyroidism. Which dietary modifications should the nurse include in this client’s teaching? (Select all that apply.)
a. Increased carbohydrates
b. Decreased fats
c. Increased calorie intake
d. Supplemental vitamins
e. Increased proteins
• Question 44 A nurse assesses a client who has a 15-year history of diabetes and notes decreased tactile sensation in both feet. Which action should the nurse take first?
a. Document the finding in the client’s chart.
b. Assess tactile sensation in the client’s hands.
c. Examine the client’s feet for signs of injury.
d. Notify the health care provider.
• Question 45 A nurse cares for a client who is recovering from a parathyroidectomy. When taking the client’s blood pressure, 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 magnesium: 1.7 mEq/L
c. Serum sodium: 122 mEq/L
d. Serum calcium: 6.9 mg/dL
• Question 46 During the early post operative period following surgery for Cushings disease, new nurse questioned the order for high dose IV steroids. Which explanation would the senior nurse most likely provide?
• Question 47 A nurse plans care for a client who has hypothyroidism and is admitted for pneumonia. Which priority intervention should the nurse include in this client’s plan of care?
a. Monitor the client’s intravenous site every shift.
b. Administer acetaminophen (Tylenol) for fever.
c. Ensure that working suction equipment is in the room.
d. Assess the client’s vital signs every 4 hours.
• Question 48 A nurse cares for a client who is prescribed a drug that blocks a hormone’s receptor site. Which therapeutic effect should the nurse expect?
a. Greater hormone metabolism
b. Decreased hormone activity
c. Increased hormone activity
d. Unchanged hormone response
• Question 49 A nurse is caring for a client who was prescribed high-dose corticosteroid therapy for 1 month to treat a severe inflammatory condition. The client’s symptoms have now resolved and the client asks, “When can I stop taking these medications?” How should the nurse respond?
a. “It is possible for the inflammation to recur if you stop the medication.”
b. “Once you start corticosteroids, you have to be weaned off them.”
c. “You must decrease the dose slowly so your hormones will work again.”
d. “The drug suppresses your immune system, which must be built back up.”
• Question 50 A nurse assesses a client with Cushing’s disease. Which assessment findings should the nurse correlate with this disorder? (Select all that apply.)
a. Moon face
b. Weight loss
c. Hypotension
d. Petechiae
e. Muscle atrophy
• Question 51 A nurse assesses a client who is prescribed levothyroxine (Synthroid) for hypothyroidism. Which assessment finding should alert the nurse that the medication therapy is effective?
a. Thirst is recognized and fluid intake is appropriate.
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.
• Question 52 A nurse assesses a client who has diabetes mellitus. Which arterial blood gas values should the nurse identify as potential ketoacidosis in this client?
a. pH 7.38, HCO3– 22 mEq/L, PCO2 38 mm Hg, PO2 98 mm Hg
b. pH 7.28, HCO3– 18 mEq/L, PCO2 28 mm Hg, PO2 98 mm Hg
c. pH 7.48, HCO3– 28 mEq/L, PCO2 38 mm Hg, PO2 98 mm Hg
d. pH 7.32, HCO3– 22 mEq/L, PCO2 58 mm Hg, PO2 88 mm Hg
• Question 53 After teaching a client who is recovering from a complete thyroidectomy, the nurse assesses the client’s understanding. Which statement made by the client indicates a need for additional instruction?
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 the rest of my life.”
d. “I can receive pain medication if I feel that I need it.”
• Question 54 A nurse provides diabetic education at a public health fair. Which disorders should the nurse include as complications of diabetes mellitus? (Select all that apply.)
a. Stroke
b. Kidney failure
c. Blindness
d. Respiratory failure
e. Cirrhosis
• Question 55 A nurse prepares to administer prescribed regular and NPH insulin. Place the nurse’s actions in the correct order to administer these medications.
a. Inspect bottles for expiration dates.
b. Gently roll the bottle of NPH between the hands.
c. Wash your hands.
d. Inject air into the regular insulin.
e. Withdraw the NPH insulin.
f. Withdraw the regular insulin.
g. Inject air into the NPH bottle.
h. Clean rubber stoppers with an alcohol swab.
• Question 56 A nurse reviews laboratory results for a client with diabetes mellitus who is prescribed an intensified insulin regimen:
• Fasting blood glucose: 75 mg/dL
• Postprandial blood glucose: 200 mg/dL
• Hemoglobin A1c level: 5.5%
How should the nurse interpret these laboratory findings?
a. Increased risk for developing ketoacidosis
b. Good control of blood glucose
c. Increased risk for developing hyperglycemia
d. Signs of insulin resistance
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