MedSurg Exam 3
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| show | History of a prior injury to a specific body part
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| A nurse is educating an osteoporotic patient taking alendronate (Fosamax). Which instruction should the nurse stress? | show 🗑
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| show | Muscle biopsy positive for muscle degeneration
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| show | Increases excretion of uric acid
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| The physician orders antinuclear antibodies for a patient with suspected rheumatoid arthritis. Which information will the nurse provide to the patient in preparation for this study? | show 🗑
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| show | Reports of claustrophobia
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| show | Loss of bone, which may cause fragile bones
Thickening of the tendons, causing loss of strength
Bony deposits in the joints, causing pain and altered movement
Hardening of cartilage, causing more friction in joints
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| show | Degeneration of articular cartilage
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| A nurse explains to a patient with rheumatoid arthritis that the drug leflunomide (Arava) is a disease-modifying antirheumatic drug (DMARD). Which action of this medication is correct? | show 🗑
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| A nurse is caring for a patient with osteoarthritis. Which is the best recommendation by the nurse to this patient to control chronic pain? | show 🗑
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| An older patient with osteoarthritis complains of stomach discomfort and shortness of breath after years of taking aspirin for pain relief. Which change in pain control medication would be most appropriate for the home health care nurse to suggest? | show 🗑
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| show | Put an extension on the toilet seat.
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| After a procedure, a patient rejects the use of the continuous passive motion machine, saying, “I did not march when I was a child, and I am not marching now.” Which benefits of CPM should the nurse point out to encourage the patient to use this machine? | show 🗑
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| show | Bones, ligaments, cartilage, and tendons
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| show | A 30-year-old woman who plays tennis
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| show | Provides protection to body parts
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| Which characteristic should a nurse recognize as diagnostic of rheumatoid arthritis? | show 🗑
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| A patient asks why systemic glucocorticoid medications are used as the last choice for the treatment of rheumatoid arthritis. Which reply by the nurse is the most informative? | show 🗑
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| A nurse, in conjunction with a patient, establishes a plan to treat the pain associated with arthritis. Which strategy is the most effective? | show 🗑
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| show | Promotes bone formation and improves strength
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| A nurse is organizing a teaching plan for a patient with gout. Which problem should the nurse caution this patient he is at an increased risk for? | show 🗑
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| A nurse is educating a patient with gout about a low-purine diet. Which food choice by the patient would indicate the need for further teaching? | show 🗑
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| show | Quality of pulses in the affected limb
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| show | Eat smaller, more frequent meals.
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| Which instruction should a nurse include in a teaching plan for a patient with carpal tunnel syndrome? | show 🗑
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| show | “I will ask my husband to tie my shoes for me.”
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| show | Walking the fingers of the affected arm up the wall
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| show | Decrease inflammation.
Balance activity and rest.
Promote adaptation to limitations.
Supply patient education and support.
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| show | Moist heat application
Instruction with a transcutaneous electrical nerve stimulation (TENS) unit
Measures to increase range of motion
Measures to increase strength
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| Which signs of progressive systemic sclerosis do the anonym CREST represent? (Select all that apply.) | show 🗑
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| show | “It measures the growth hormone in the presence of oral glucose levels at specified times.”
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| A family member of a patient who is in adrenal crisis asks why the IV cortisone is continued after the initial IV push of Solu-Cortef, which seemed to stop the symptoms. Which reply is the best explanation by the nurse? | show 🗑
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| A patient is receiving the medication octreotide (Sandostatin) as a treatment for acromegaly. Which information should the nurse explain regarding this medication? | show 🗑
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| Which instruction should a nurse provide when a patient starts taking a saturated solution of potassium iodide (SSKI)? | show 🗑
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| show | Wash their hands with soap and water after every voiding for the next 24 hours.
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| A patient asks about his laboratory test, which showed a high level of thyroid-stimulating hormone (TSH) and a low level of T4. Which reply offers the most accurate explanation? | show 🗑
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| A patient has been given an antithyroid drug called propylthiouracil. Which appropriate nursing implementations should be included? | show 🗑
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| show | Age-related reduction in metabolic rate
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| show | Test for sensitivity
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| Which statement explains why a nurse should recommend the use of salt that is iodized when providing dietary education to patients? | show 🗑
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| A nurse makes a list of symptoms that a patient who is taking methimazole (Tapazole), a thionamide drug, should report. Which situation should this list include? (Select all that apply.) | show 🗑
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| Which statement explains why hypothyroidism is frequently overlooked in older adults? (Select all that apply.) | show 🗑
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| show | Avoid sneezing.
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| show | Growth hormone
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| Which classic symptoms pertain to diabetes insipidus (DI)? | show 🗑
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| show | Regulates the excretion of potassium and sodium
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| show | Nephrogenic DI does not respond to ADH.
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| Which statement by a woman with Addison disease would indicate altered body image? | show 🗑
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| A 14-year-old adolescent male patient has been diagnosed with Addison disease. Which effect of Addison disease should this patient be aware of? | show 🗑
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| Which cardinal indication is related to pheochromocytoma? | show 🗑
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| show | Confusion and tachycardia
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| show | Rising slowly from a lying position
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| Which information should a nurse include when planning education to a patient with Addison disease? | show 🗑
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| A patient with long-term asthma develops Cushing syndrome. Which cause of this condition is most likely? | show 🗑
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| Which findings are expected when assessing a patient with Cushing syndrome? | show 🗑
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| Which statement by a patient diagnosed with Cushing syndrome leads a nurse to conclude that teaching has been effective? | show 🗑
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| A nurse is assessing a patient with Simmonds cachexia. Which symptom should the nurse anticipate the patient will exhibit? | show 🗑
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| show | Excessive height
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| show | Maintaining strict intake and output fluids
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| Which situation can bring on an addisonian crisis? | show 🗑
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| On which information should discharge planning for a patient who underwent a hypophysectomy focus? | show 🗑
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| A mother of a 6-foot, 2-inch, 16-year-old girl who is being treated for hyperpituitarism says, “I can’t stand it that my beautiful daughter is a freak.” Which reply is the nurse’s best response? | show 🗑
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| show | “You must become familiar with the signs and symptoms of inadequate or excessive hormone replacement.”
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| show | Report suspected meningitis to the head nurse.
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| show | Dropping blood pressure
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| show | Headache
Weight gain
Muscle cramps
Weakness
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| show | Cessation of menses
Milk production
Changing facial features
Weight gain
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| A physician ordered T3 and T4 tests for a young woman complaining of fatigue, weight gain, muscle aches and pains, and constipation. Which laboratory test results will help confirm the diagnosis of hypothyroidism? | show 🗑
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| A patient with a hyperthyroid complains of fatigue but still cannot get to sleep. Which is the best suggestion by the nurse? | show 🗑
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| show | It usually subsides after medication for hyperthyroidism is started.
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| show | “Your thyroid gland is overactive, but there are ways to treat it through medicine or surgery.”
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| A nurse assessing a patient after a subtotal thyroidectomy notes that the patient’s color is poor, the pulse and respirations are rapid, and the patient feels warm to the touch. Which action is the best initial implementation by the nurse? | show 🗑
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| show | Disturbed sleep pattern
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| show | “Know the signs and symptoms of hyperthyroidism.”
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| Which patient recommendation should a nurse include when preparing to present presurgical teaching of a patient scheduled for a subtotal thyroidectomy? | show 🗑
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| show | “We have it there as a precautionary measure in the unlikely event that you have difficulty breathing.”
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| Which action is the most appropriate for the nurse to implement when assessing for hemorrhage in a post-thyroidectomy patient? | show 🗑
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| Which statement correctly reflects how foods, such as soybeans, turnips, and rutabagas, affect people with thyroid disorders? | show 🗑
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| A nurse taking the blood pressure of a patient who had a total thyroidectomy 2 days earlier notes that the patient’s hand goes into a carpopedal spasm. Which disorder should the nurse recognize this movement as an indication of? | show 🗑
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| Which action should a nurse implement to address dry skin in the patient with hypothyroidism? | show 🗑
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| Which t action should a nurse implement to initiate the Chvostek sign? | show 🗑
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| show | Poor muscle tone, bone pain, urinary calculi, and fractures
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| Which problem is the priority nursing concern for a patient with hyperparathyroidism? | show 🗑
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| Which intervention is necessary to assist a patient with hypothyroidism to understand how he can live a full and normal life? | show 🗑
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| show | To decrease the level of hormone in the blood before surgery
To help reduce the risk of hemorrhage during surgery
To decrease the threat of a thyroid storm
To reduce exophthalmia
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| Which information should a nurse caring for a patient with hyperthyroidism include when developing a plan of care? (Select all that apply.) | show 🗑
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| A nurse explains that type 1 diabetes mellitus is a disease in which the body does not produce enough insulin. What statement provides the reason that blood glucose is elevated? | show 🗑
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| A patient newly diagnosed with type 2 diabetes mellitus asks the nurse why she has to take a pill instead of insulin. The nurse explains that in type 2, the body still makes insulin. Which other information is pertinent for the nurse to relay? | show 🗑
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| A patient tells a nurse that she eats “huge” amounts of food but stays hungry most of the time. Which explanation should the nurse provide as the cause of hunger experienced by persons with type 1 diabetes? | show 🗑
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| show | Increased fatty acid levels
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| The self-care goal of a patient with diabetes is to keep the blood sugar within normal limits. Which factor causes hyperglycemia to occur? | show 🗑
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| show | “What’s hard about exercise, diet, and medicine?”
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| When a patient with type 2 diabetes says, “Why in the world are they looking at my hemoglobin? I thought my problem was with my blood sugar.” Which information should the nurse explain about the level of hemoglobin A1c? | show 🗑
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| A patient with type 2 diabetes shows a blood sugar reading of 68 at 6 AM. Which action should the nurse implement based on the reading of 72 mg/dL? | show 🗑
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| show | Disorder of carbohydrates, fats, and proteins metabolism
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| show | Temperature, 97.4 F; pulse, 110 beats/min; respirations, 26 breaths/min and deep
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| show | A 2-hour long exercise class at the spa this morning
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| Which guideline should be included as part of a teaching plan in preparation for discharge of a patient with type 1 diabetes needing guidelines for exercise? | show 🗑
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| A nurse preparing to administer insulin to a patient who has type 1 diabetes. The physician has prescribed two types of insulin, Which procedure is appropriate for the nurse to follow when preparing these medications? | show 🗑
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| A patient has come into the emergency department accompanied by a friend who states that the patient had been acting very strangely and seems confused. The friend states that the patient has diabetes and takes insulin. | show 🗑
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| show | “That test indicates that we need to perform more tests that are specific for diabetes.”
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| A nurse is formulating a teaching plan for a 22-year-old woman taking rosiglitazone (Avandia). Which information should the nurse include in this plan to caution the patient? | show 🗑
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| show | Hold the insulin until after the blood draw.
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| show | “Okay. Let’s talk about what you eat and drink and how you manage your diabetes.”
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| A patient with type 1 diabetes asks why his 0700 insulin has been changed from NPH insulin to 70/30 premixed insulin. Which reply is the best explanation by the nurse that explains about 70/30 insulin mixture? | show 🗑
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| show | Develop an exercise plan because regular exercise helps control blood glucose levels.
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| Which situation has most likely occurred in a patient who has been diagnosed with endogenous hypoglycemia? | show 🗑
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| Which time correctly identifies how long it takes for Humulin R 20 units to peak? | show 🗑
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| A nurse suspects that a patient with type 1 diabetes may be experiencing the Somogyi phenomenon. Which symptom supports this suspicion? | show 🗑
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| A patient has been admitted with (HHNS). The blood glucose level is very high (880 mg/dL) on admission. The physician believes that the condition is the result of large amounts of glucose solutions administered intravenously (IV) during renal dialysis. | show 🗑
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| Which functional causes relate to hypoglycemia? (Select all that apply.) | show 🗑
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| show | Wash and carefully dry the feet every day.
Protect the feet from extreme temperatures.
Buy shoes that are comfortable and supportive.
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| show | Macular degeneration
End-stage renal disease (ESRD)
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| show | Symptoms of hypoglycemia are present.
Low blood glucose levels are documented when symptoms are present.
Symptoms improved when the blood glucose level rises.
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