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NUR 236
UNIT TEST 3
| Question | Answer |
|---|---|
| The patient is experiencing fatigue with loss of energy and is currently undergoing multiple tests to diagnose a possible endocrine disorder. She states, “I just want to know what is going on. I’m so tired of these tests.” What is the most therapeutic response? 1. “Did you talk to your health care provider about the test results?” 2. “Let me go look at your chart and find the results.” 3. “You sound really frustrated about the diagnostic testing.” 4. “I’d be tired too, if I had to deal with everything y | “You sound really frustrated about the diagnostic testing.” |
| A patient is diagnosed with a thyroid disorder. The nurse anticipates that the patient is mostly likely to have problems with: 1. metabolic rate. 2. water reabsorption. 3. bone fragility. 4. increased blood glucose. | metabolic rate |
| Which patient is most likely to have a nursing diagnosis of Altered nutrition: less than body requirements? 1. Patient with hyperthyroidism 2. Patient with decreased estrogen production 3. Patient who has type 2 diabetes 4. Patient with hypothyroidism | Patient with hypothyroidism |
| The patient is undergoing a hypertonic saline test to detect diabetes insipidus. One of the nursing responsibilities is to teach the patient to: 1. produce a urine specimen using a clean-catch technique. 2. produce a urine specimen in the marked container each hour. 3. void in the early am and discard the first urine specimen. 4. produce a urine specimen at the end of the test period. | produce a urine specimen in the marked container each hour. |
| The health care provider orders a dexamethasone suppression test to assist in the diagnosis of Cushing disease. An appropriate nursing action would be to: 1. collect a clean-catch urine specimen. 2. note the start and end time on the laboratory slip. 3. check orders for drugs to be withheld. 4. administer vasopressin SC as ordered. | check orders for drugs to be withheld. |
| A patient is being tested to determine the degree of diabetic control of blood sugar over the preceding 2–3 months. What is the correct test to make this determination? 1. Fasting blood glucose 2. 2-hour postprandial blood glucose 3. Glucose tolerance test 4. Hemoglobin A1C | Hemoglobin A1C |
| Which patient has the greatest risk for injury related to bone fracture? 1. Patient with a thyroid disorder 2. Patient with a parathyroid disorder 3. Patient with a pancreatic disorder 4. Patient with a testicular disorder | Patient with a parathyroid disorder |
| The health care provider orders laboratory tests for several serum electrolytes. Which set of electrolytes would most likely reflect parathyroid function? 1. Calcium and phosphorus 2. Sodium and magnesium 3. Potassium and chloride 4. Sodium and potassium | Calcium and phosphorus |
| The patient needs several diagnostic tests to rule out endocrine disorders. Which task would be appropriate to assign to the nursing assistant? 1. Note medications that the patient takes on the laboratory order. 2. Ask the patient if he has any questions or needs anything. 3. Instruct the patient how to obtain a clean-catch specimen. 4. Deliver the urine specimen to the laboratory. | Ask the patient if he has any questions or needs anything. |
| The health care provider orders an aldosterone urine test for a patient. No one on the unit, including the charge nurse, is familiar with this test. What should the nurse do? 1. Collect a clean-catch urine specimen and send it to the laboratory. 2. Call the health care provider and ask for clarification of the order and procedure. 3. Check the laboratory policy and procedure manual. 4. Ask the patient not to void until after the procedure is clarified. | Call the health care provider and ask for clarification of the order and procedure. |
| The nurse is teaching a patient at risk for stone formation how to avoid developing kidney stones. What information should the nurse give the patient? 1. Drink enough liquids to produce at least 3500 mL of urine every 24 hours. 2. Fluid intake should approximate urine output every 24 hours. 3. Eat a well-balanced diet with high-quality protein and fruits and vegetables. 4. Try to exercise at least four times a week and sleep 8 hours a night. | Drink enough liquids to produce at least 3500 mL of urine every 24 hours. |
| Diagnosing kidney stones sometimes involves several studies to identify and locate stones. These may include: (Select all that apply.) 1. urinalysis. 2. exploratory surgery. 3. renal angiogram. 4. CT of abdomen and pelvis. | -urinalysis -CT of abdomen and pelvis. |
| Hemodialysis is performed for the end-stage kidney disease patient. Data that indicate treatment effectiveness would be: 1. a rise in hemoglobin and hematocrit. 2. a fall in glucose and sodium levels. 3. a fall in potassium, creatinine, and urea levels. 4. an increased alertness and a sense of well-being. | a fall in potassium, creatinine, and urea levels |
| Other than taking baseline vital signs, an important nursing intervention to perform the morning of dialysis is: 1. keeping the patient NPO until after the dialysis. 2. administering 1 liter of normal saline to prevent shock. 3. giving subcutaneous heparin to prevent blood clotting during dialysis. 4. withholding blood pressure medications until the pressure has stabilized after dialysis. | giving subcutaneous heparin to prevent blood clotting during dialysis. |
| When planning nursing care for the patient who has renal failure, the nurse encourages a diet that is: 1. high in calories but low in protein and potassium. 2. high in protein, moderate in calories, and low in sodium. 3. high in fat and protein but low in potassium and sodium. 4. high in fiber, with mainly fruits and vegetables and some grains. | high in calories but low in protein and potassium. |
| A nursing intervention for the patient who has just returned from surgery with a new arteriovenous fistula is to: 1. maintain a heparin drip to prevent clotting in the fistula. 2. release the elevated extremity and perform range-of-motion exercises every 2 hours. 3. assess the fistula site for hematoma and check for bruit every 2–4 hours. 4. assess the fistula for visual signs of clotting every 2–4 hours | assess the fistula site for hematoma and check for bruit every 2–4 hours. |
| The nurse is looking at abnormal results of a urinalysis. Which finding is more specific to chronic glomerulonephritis, and is less likely to be present if the patient has acute cystitis? 1. Glucose 2. Red blood cells 3. Urinary casts 4. White blood cells | Urinary casts |
| Planning nursing care for the patient following surgery for kidney trauma may include: (Select all that apply.) 1. close monitoring for hypovolemic shock. 2. hourly urine output measurements. 3. monitoring of the size of the flank hematoma. 4. neurologic monitoring every shift. | -close monitoring for hypovolemic shock. -hourly urine output measurements. -monitoring of the size of the flank hematoma. |
| Sulfamethoxazole-trimethoprim (Bactrim) is prescribed for the patient’s cystitis. When doing discharge teaching, the nurse would be sure to instruct the patient to: 1. take the medication between meals to enhance absorption. 2. take 3000–4000 mL of fluid per day to prevent crystallization. 3. be aware that this medication might turn the urine orange or red. 4. watch for signs of jaundice associated with liver toxicity. | take 3000–4000 mL of fluid per day to prevent crystallization |
| What changes in the urinary system occur with aging that predispose elderly women to urinary frequency and infection? 1. Decreased fluid intake to prevent incontinence 2. An increased glomerular filtration rate 3. Estrogen depletion that results in structural atrophy 4. An increased bladder capacity due to loss of tone | Estrogen depletion that results in structural atrophy |
| Which signs and symptoms are associated with nephrotic syndrome? 1. Proteinuria, hyperlipidemia, hypoalbuminemia, and severe edema 2. Hematuria, frequent and urgent urination, and low back pain 3. Burning, itching, frequency of voiding, and dysuria 4. Unilateral flank pain that radiates into the genitalia and inner thigh | Proteinuria, hyperlipidemia, hypoalbuminemia, and severe edema |
| A patient has acute renal failure and is in the diuretic phase. With an increased output, there is a danger of: 1. hyponatremia 2. hyperkalemia 3. fluid overload 4. catabolism | hyponatremia |
| A patient with chronic renal failure is receiving epoetin alfa (Epogen). The purpose of this medication is to: 1. increase urinary output. 2. bind phosphate; given with meals. 3. prevent problems of calcium loss. 4. treat anemia; promotes RBC formation. | treat anemia; promotes RBC formation. |
| One of the relevant nursing problems in caring for a patient with renal failure is rapid fatigue upon activity. Which intervention would be appropriate in helping the patient accomplish activities of daily living (ADLs)? 1. Tell the patient to do as much as he can and then return later to help him finish. 2. Instruct the nursing assistant to watch him do ADLs and report back on his progress. 3. Instruct the nursing assistant to do everything for him unless he tells her that he can do it himself. 4. Asse | Assess his energy level in the morning and then direct the nursing assistant to do specific tasks for him. |
| What is characteristic of stage 1 chronic renal failure? 1. BUN and serum creatinine levels begin to rise. 2. Glomerular filtration rate falls. 3. Urine concentration is decreased and polyuria and nocturia occur. 4. Electrolyte and fluid imbalances are serious; wastes accumulate. | BUN and serum creatinine levels begin to rise |
| Which patient needs counseling about contacting all sexual partners for follow-up care? 1. Patient diagnosed with chronic glomerulonephritis 2. Patient diagnosed with hydronephrosis 3. Patient diagnosed with nephrotic syndrome 4. Patient diagnosed with urethritis | Patient diagnosed with urethritis |
| The nurse is caring for a patient with acute glomerulonephritis and observes obvious edema. What is the best rationale for frequent auscultation of the lung fields for this patient? 1. Assessing the lungs is the standard of care for any acutely ill patient. 2. The patient is on continuous bedrest and will suffer the effects of immobility. 3. Observable edema on the body surface suggests congestion in the internal organs. 4. The patient is likely to have had a preexisting throat infection. | Observable edema on the body surface suggests congestion in the internal organs. |
| The nurse is supervising a nursing student who is preparing to irrigate a nephrostomy tube. Which action would the nurse advise the student to perform first? 1. Talk to the patient and explain the procedure. 2. Read the health care provider’s order to clarify the instructions. 3. Check the chart and make sure informed consent was signed. 4. Obtain all the equipment and mentally review the procedure. | Read the health care provider’s order to clarify the instructions. |
| The health care provider orders a Foley catheter for a patient involved in a serious car accident. The nurse notes that there is bleeding at the urethral meatus. What is the priority action? 1. Obtain extra supplies to cleanse the meatus. 2. Get a bedpan and ask the patient to void. 3. Insert the Foley and closely monitor for hematuria. 4. Notify the health care provider, because there may be a tear. | Notify the health care provider, because there may be a tear. |
| Which patient has the greatest risk for acute renal failure? 1. Trauma patient with an episode of prolonged hypovolemia 2. Patient with chronic renal failure who is noncompliant with dietary restrictions 3. Patient with frequent kidney stones undergoing nephrolithotomy 4. Patient with bladder tumor and painless hematuria | Patient with chronic renal failure who is noncompliant with dietary restrictions. |
| What are signs and symptoms of hypothyroidism? (Select all that apply.) 1. Decreased appetite but increased weight 2. Bagginess under eyes and swelling of face 3. Feeling overheated 4. Pressured speech 5. Sluggish mental activity, impaired memory, depression 6. Constipation, abdominal distention, flatulence 7. Husky voice, thinning eyebrows, hair loss | Decreased appetite but increased weight Bagginess under eyes and swelling of face Sluggish mental activity, impaired memory, depression Constipation, abdominal distention, flatulence Husky voice, thinning eyebrows, hair loss |
| What are signs and symptoms of adrenal cortical insufficiency (Addison disease)? (Select all that apply.) 1. Generalized malaise 2. Muscle weakness, muscle pain 3. Orthostatic hypotension and vulnerability to cardiac dysrhythmias 4. Anorexia, nausea and vomiting, flatulence, and diarrhea 5. Anxiety, depression, and loss of mental acuity 6. Hyperglycemia | Generalized malaise Muscle weakness, muscle pain Orthostatic hypotension and vulnerability to cardiac dysrhythmias Anorexia, nausea and vomiting, flatulence, and diarrhea Anxiety, depression, and loss of mental acuity |
| The health care provider orders IV normal saline to infuse 500 mL over 6 hours. What is the pump setting? | 83 mL |
| The patient is a type 1 diabetic who has been admitted for ketoacidosis and influenza. Which assessment findings are most likely to be documented in this patient’s record? 1. Headache, thirst, and anorexia 2. Weight gain, polyuria, and dizziness 3. Diaphoresis, headache, and nervousness 4. Weakness, stomach pain, and sweating | Headache, thirst, and anorexia |
| A patient was recently diagnosed with latent autoimmune diabetes of adults (LADA). According to evidence-based management, which medication is the health care provider mostly likely to prescribe in the early phase? 1. Metformin (Glucophage) 2. Glyburide (DiaBeta) 3. Glipizide (Glucotrol) 4. NovoLog insulin | NovoLog insulin |
| What is an important safety intervention for type 1 diabetes patients? 1. Provide an 1800-calorie American Diabetes Association (ADA) diet. 2. Assess for signs of hypoglycemia after insulin is given. 3. Monitor intake and output carefully. 4. Do not allow ambulation without assistance. | Assess for signs of hypoglycemia after insulin is given. |
| Evaluation of correct balance of food, exercise, and insulin for a diabetic patient would be to: 1. assess trends of blood sugar levels. 2. assess daily weight trends. 3. determine what the blood pH is now. 4. determine if electrolytes are in balance. | assess trends of blood sugar levels. |
| An infection such as influenza can be a cause of DKA because: 1. patients continue insulin but do not eat properly. 2. use of over-the-counter decongestants interferes with insulin. 3. infection causes an increased metabolic rate and release of extra glucose. 4. the patient does not rest well or sleep because of cough and discomfort. | infection causes an increased metabolic rate and release of extra glucose. |
| Which diagnostic test would be ordered to evaluate the response to therapy at a 6-month follow-up appointment? 1. Glucose tolerance test 2. Fasting blood sugar test 3. 2-hour postprandial blood sugar test 4. Hemoglobin A1C | Hemoglobin A1C |
| The reason a patient with uncontrolled type 2 diabetes tends to gain weight is because: 1. he has a big appetite and experiences polyphagia. 2. of insulin resistance; the food he eats is not fully metabolized. 3. the excess glucose in his body makes him retain excess water. 4. he tends to become very sedentary because of little energy. | he has a big appetite and experiences polyphagia. |
| Whenever a type 1 diabetic patient knows that he is going to exercise heavily, he should: 1. skip his insulin dose both before and after the exercise. 2. drink a large quantity of water. 3. eat an extra high-protein snack to prevent hypoglycemia. 4. take extra insulin to compensate for that used during the exercise. | eat an extra high-protein snack to prevent hypoglycemia. |
| The diabetic patient undergoing surgery experiences considerable stress, which alters his blood sugar levels. For this reason, he is usually given: 1. an extra allotment of calories before surgery. 2. intravenous insulin during surgery. 3. twice as much IV fluid as the nondiabetic patient receives. 4. a large dose of long-acting insulin prior to surgery. | an extra allotment of calories before surgery. |
| One problem that occurs fairly often in elderly type 2 diabetic patients is hyperglycemic hyperosmolar syndrome (HHS). It occurs most often after: 1. abdominal surgery and nasogastric suction. 2. fractures that cause immobility. 3. multiple diagnostic tests during which patients have been NPO. 4. a febrile illness or gastrointestinal flu. | a febrile illness or gastrointestinal flu. |
| For type 1 diabetes, which statement is true? 1. Usually responds to diet and exercise only 2. Must receive exogenous insulin 3. Can be managed with oral hypoglycemics 4. Islet cell transplantation is a first-line treatment | Must receive exogenous insulin |
| Which factors make diabetic patients prone to infection? (Select all that apply.) 1. Poor control of diabetes 2. Increased function of leukocytes and phagocyte function 3. Decreased blood supply to the tissues related to atherosclerosis of blood vessels 4. Chronic neurologic and vascular changes allow organisms to enter tissues 5. Diabetic patients are overweight and have poor hygiene | Poor control of diabetes Decreased blood supply to the tissues related to atherosclerosis of blood vessels. Chronic neurologic and vascular changes allow organisms to enter tissues Diabetic patients are overweight and have poor hygiene. |
| The ADA recommends screening all adults, especially if overweight, for type 2 diabetes starting at age: 1. 21, to be repeated every 5 years. 2. 45, to be repeated every 3 years. 3. 50, to be repeated every year. 4. 60, to be repeated every 2 years. | 45, to be repeated every 3 years. |
| Which statement by a patient most strongly indicates a need for further assessment and possible diagnostic testing to screen for diabetes? 1. “Typically, I urinate a moderate amount just before I go to bed.” 2. “I seem to be really thirsty, but I guess it could be the heat.” 3. “I like to have a snack after I exercise, but I try to watch my calories.” 4. “I probably have diabetes; most of my friends have it.” | I seem to be really thirsty, but I guess it could be the heat.” |
| Which statement by a patient’s family member indicates an understanding of the signs and symptoms of hypoglycemia? 1. “He could refuse to eat because he is angry.” 2. “He could be flushed and look dehydrated.” 3. “He could be irritable because his sugar is low.” 4. “He will urinate a lot and be very thirsty.” | "He could be irritable because his sugar is low.” |
| Which viral agent is thought to attack the beta cells of the pancreas causing an onset of insulin-dependent diabetes mellitus (type 1)? 1. Herpes simplex 2. Staphylococcus aureus 3. Cytomegalovirus 4. Coxsackievirus | Coxsackievirus |
| The patient is receiving rapid-acting insulin before meals. What action by the nurse is correct? 1. Wait until the food tray is delivered to the patient before giving the insulin dose. 2. Instruct the patient to report any feelings of nausea. 3. Perform a fingerstick glucose, administer the insulin dose, and wait 30 minutes before providing the meal. 4. Assess the patient for increased thirst, hypotension, dry mucous membranes, and deep respirations prior to administering the insulin. | Wait until the food tray is delivered to the patient before giving the insulin dose. |
| Which statement by the patient indicates a need for additional teaching on diabetic foot care? 1. “I should check both feet daily for cracks, blisters, or abrasions.” 2. “I should cut the nails straight across and smooth with an emery board.” 3. “I should elevate my feet whenever possible to improve circulation.” 4. “I should soak my feet in hot water every day and use mild soap.” | “I should soak my feet in hot water every day and use mild soap.” |
| The nurse is teaching the patient how to manage his diabetes during times of minor illness, such as during mild gastrointestinal upset. What is appropriate information to tell the patient? 1. Discontinue your insulin if you are vomiting. 2. Take at least 1 cup of water or calorie-free, caffeine-free liquid each hour. 3. Test your blood sugar once or twice a day. 4. If taking an oral hypoglycemic agent, increase the dose for 2–3 days while ill. | Take at least 1 cup of water or calorie-free, caffeine-free liquid each hour. |
| The nurse is interviewing a patient to establish a database. The patient has reported being excessively thirsty but has never been diagnosed with diabetes. Which questions would be appropriate to ask the patient during this initial interview? (Select all that apply.) 1. Have you had any recent weight loss? 2. Have you become increasingly hungry over the past few months? 3. Are you having any trouble sticking to your dietary plan? 4. Do you have to urinate (go to the toilet) more than you used to? 5. Ha | Have you had any recent weight loss? Have you become increasingly hungry over the past few months? Do you have to urinate (go to the toilet) more than you used to? Have you noticed that you are more tired than you were 6 months ago? Has anyone in your family ever been told he or she has diabetes? |
| Key functions of the endocrine system | regulates metabolism and energy production controls growth and development maintains homeostatic (fluid and electrolyte balance) influence reproductive processes affects mood and stress response |
| Pituitary Gland is called: | The master gland |
| Anterior Pituitary Gland secretes: | Growth Hormone:stimulates growth Thyroid-Stimulating Hormone (TSH)-stimulates the thyroid gland Adrenocorticotrpic Hormone (ACTH)-stimulates the adrenal cortex Gonadotropins (FSH and LH)-regulate reproductive function Prolactin (PRL)-stimulates milk production |
| Posterior Pituitary Gland secretes: | Antidiuretic Hormone (ADH)-regulates water balance Oxytocin:stimulates uterine contractions and milk ejection |
| Endocrine system consists of: | Pituitary Gland Thyroid Gland Parathyroid Gland Adrenal Gland Pancreas Ovaries and Testes Pineal Gland Thymus Gland |
| Adrenal Gland is seperated into | Medulla-Inner part secretes epinepherine and Norepinephrine (flight or fight response). Cortex-outer part secretes Glucocorticoids (cortisol) controls metabolism and immune reponse and Mineralcorticoids (aldosterone): regulates sodium and potassium levels |
| What types of cells make up the pancreas? | Alpha cells: Produces Glucagon (raises blood sugar) Beta cells: produces Insulin (lowers blood sugar) |
| Thyroid gland produces: | Thyroxine (T4) and Triiodthyronine (T3): regulates metabolism Calcitonin: lowers blood calcium levels by inhibiting bone breakdown |
| Parathyroid gland produces: | Parathyroid Hormone (PTH): increases calcium levels by stimulating bone absorption. |
| Pineal Gland produces: | Melatonin:regulates sleep-wake cycle |
| Thymus Gland produces: | Thymosin: essential for immume functions (T-cell developement) |
| Long-term complications of Diabetes: | Cardiovascular disease-increased risk of MI and Stroke Nephropathy-damages kidney functions. Neuropathy-nerve damage causing pain, numbness, and foot ulcers. Retinopathy: leading cause of blindness in diabetics. |
| Types of Diabetes Mellitus: | Type 1-autoimmune destruction of beta cells Type 2-insulin resistance and progressive beta-cell dysfunction Gestational -pregnancy related insulin resistance |
| Which type of diabetes mellitus requires life long insulin? | Type 1 |
| Target range for fasting blood glucose: | 80-130 mg/dL |
| Target range for postprandial glucose (after meals): | <180 mg/dL |
Created by:
shondell1971
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