Endocrine
Nurse Oliver should expect a client with hypothyroidism to report which health concerns?
B. Puffiness of the face and hands
What indicates to a nurse that a patient with AKI is in the recovery phase?
a. A return to normal weight
b. A urine output of 3700 mL/day
c. Decreasing sodium and potassium levels
d. Decreasing blood urea nitrogen (BUN) and creatinine levels
D. decreasing BUN and creatinine
During a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise?
B. at least three times a week
Which patient exposure by the nurse is most likely to require post-exposure prophylaxis when the patient's human immunodeficiency virus (HIV) status is unknown?
a. Needle stick with a needle and syringe used to draw blood
b. Splash into the eyes when emptying a bedpan containing stool
c. Contamination of open skin lesions with patient vaginal secretions
d. Needle stick injury with a suture needle during a surgical procedure
A. Needlestick with a needle and syringe used to draw blood
A patient who is human immunodeficiency virus (HIV)-infected has a CD4+ cell count of 400/µL. Which factor is most important for the nurse to determine before the initiation of antiretroviral therapy (ART) for this patient?
a. HIV genotype and phenotype
b. Patient's social support system
c. Potential medication side effects
d. Patient's ability to comply with ART schedule
D. Patient's ability to comply with ART schedule
A female adult client with a history of chronic hyperparathyroidism admits to being non-compliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which “related-to” phrase should the nurse add?
Acute tubular necrosis (ATN) is the most common cause of intrarenal AKI. Which patient is most likely to develop ATN?
a. Patient with diabetes mellitus
b. Patient with hypertensive crisis
c. Patient who tried to overdose on acetaminophen
d. Patient with major surgery who required a blood transfusion
D. Patient with major surgery who required a blood transfusion
The client diagnosed with type 2 diabetes is admitted to the intensive care unit with hyperosmolar hyperglycemic nonketonic syndrome (HHNS) coma. Which assessment data should the nurse expect the client to exhibit?
A. Kussmaul's respirations.
B. Diarrhea and epigastric pain.
C. Dry mucous membranes.
D. Ketone breath odor.
C. Dry mucous membranes
To evaluate the effectiveness of antiretroviral therapy (ART), which laboratory test result will the nurse review?
a. Viral load testing
b. Enzyme immunoassay
c. Rapid HIV antibody testing
d. Immunofluorescence assay
A. Viral load testing
A man asks the nurse when he should take his daily dose of levothyroxine. Which of the following instructions is most appropriate to teach him?
A. Take it before breakfast on an empty stomach.
B. Take it with meals every 8 hours in divided doses.
C. Take it every night at bedtime with a snack.
D. Take it every day at the same without regard to meals
A. Take it before breakfast on an empty stomach
A 67-year-old female client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, the nurse would suspect which of the following disorders?
D. Hyperparathyroidism
While caring for the patient in the oliguric phase of AKI, the nurse monitors the patient for associated collaborative problems. When should the nurse notify the health care provider?
a. Urine output is 300 mL/day.
b. Edema occurs in the feet, legs, and sacral area.
c. Cardiac monitor reveals a depressed T wave and elevated ST segment.
d. The patient experiences increasing muscle weakness and abdominal cramping.
D. The patient experiences increasing muscle weakness and abdominal cramping
Which assessment data indicate the client diagnosed with diabetic ketoacidosis is responding to the medical treatment?
A. The client has tented skin turgor and dry mucous membranes.
B. The client is alert and oriented to date, time, and place.
C. The client's ABG results are pH 7.29, PaCO2 44, HCO315.
D. The client's serum potassium level is 3.3 mEq/L.
B. The client is alert and oriented to date, time, and place.
A patient treated for human immunodeficiency virus (HIV) infection for 6 years has developed fat redistribution to the trunk, with wasting of the arms, legs, and face. What instructions will the nurse give to the patient?
a. Review foods that are higher in protein.
b. Teach about the benefits of daily exercise.
c. Discuss a change in antiretroviral therapy.
d. Talk about treatment with antifungal agents.
C. Discuss a change in antiretroviral therapy
A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should the nurse recognize as an adverse drug effect?
C. Tachycardia
When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, nurse April is most likely to detect:
D. A blood pressure of 176/88
A dehydrated patient is in the Injury stage of the RIFLE staging of AKI. What would the nurse first anticipate in the treatment of this patient?
a. Assess daily weight
b. IV administration of fluid and furosemide (Lasix)
c. IV administration of insulin and sodium bicarbonate
d. Urinalysis to check for sediment, osmolality, sodium, and specific gravity
B. IV admin of fluids and Lasix
The emergency department nurse is caring for a client diagnosed with HHNS who has a blood glucose of 680 mg/dL. Which question should the nurse ask the client to determine the cause of this acute complication?
A. "When is the last time you took your insulin?"
B. "When did you have your last meal?"
C. "Have you had some type of infection lately?"
D. "How long have you had diabetes?"
C. Have you had some type of infection lately?
Eight years after seroconversion, a human immunodeficiency virus (HIV)-infected patient has a CD4+ cell count of 800/µL and an undetectable viral load. What is the priority nursing intervention at this time?
a. Teach about the effects of antiretroviral agents.
b. Encourage adequate nutrition, exercise, and sleep.
c. Discuss likelihood of increased opportunistic infections.
d. Monitor for symptoms of acquired immunodeficiency syndrome (AIDS).
B. encourage adequate nutrition, exercise, and sleep
What is the biggest nursing consideration for patients taking Propylthiouracil (PTU)?
A. assess clients neurologic status
B. monitor clients output and electrolytes
C. assess for mood changes/worsening depression
D. monitor for signs of hypothyroidism
(bradycardia, anemia, CAD, slow speech and body movements, excessive sleep, and increased weight)
An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of:
C. Myxedema coma
What are intrarenal causes of acute kidney injury (AKI)? Select all that apply
a. Anaphylaxis
b. Renal stones
c. Bladder cancer
d. Nephrotoxic drugs
e. Acute glomerulonephritis
f. Tubular obstruction by myoglobin
D, E, F
The client is admitted to the ICU diagnosed with DKA. Which interventions should the nurse implement? Select all that apply.
A. Maintain adequate ventilation.
B. Assess fluid volume status.
C. Replace potassium
D. Check for urinary ketones.
E. Monitor intake and output.
A, B, C, D, E
Which of these patients being seen at the human immunodeficiency virus (HIV) clinic should the nurse assess first?
a. Patient whose latest CD4+ count is 250/µL
b. Patient whose rapid HIV-antibody test is positive
c. Patient who has had 10 liquid stools in the last 24 hours
d. Patient who has nausea from prescribed antiretroviral drugs
C. patient who has had 10 liquid stools in the last 24 hours
What are the major side effects with immunosuppressant meds? Select all that apply
A. Increased risk of bleeding
B. Increased risk of infection
C. Increased risk of malignancy
D. Increased risk of CNS depression
B, C