WorksheetsMIDTERM EXAMINATION-Part I
Total questions: 30
Worksheet time: 2hrs 26mins
A client receiving propylthiouracil should be instructed to stop the medication immediately and call the health care provider if which sign occurs?
Diarrhea
Palpitations
Fever
Weight gain
Which statement about analgesic therapy for a client with hypothyroidism would be appropriate to use as a basis for developing the client’s care plan?
Increased dosages will be needed because the client is overweight
Analgesics are not needed because the client is already lethargic
Decreased dosages are needed because of prolonged drug degradation rates
Increased dosages will be needed because of the hypermetabolic state
After parathyroidectomy, hungry bone syndrome is manifested by which sign or symptom?
Carpopedal spasms
Weakness
Back pain
Polyuria
Which nursing intervention should be included in the discharge teaching for a client with hypoparathyroidism?
Avoiding diuretics to minimize calcium loss
Using over-the-counter vitamin D preparations
Supplementing the calcium intake
Avoiding strenuous exercise
Which nursing intervention should be included in the discharge teaching for the client receiving levothyroxine?
Checking serum glucose level twice daily
Taking the medication at night to avoid insomnia
Notifying the health care provider if diarrhea, nervousness, or increased heart rate occur
Having a blood test to monitor glycosylated hemoglobin every 3 months
Which outcome represents the best indication of good overall diabetes control?
The client reports urine glucose levels indicating no glucosuria
The client displays a glycosylated hemoglobin level within control range
The client reports urine ketone levels reflecting no ketonuria
The client records home glucose test results daily
Which examination represents the best recommendation to give a client with diabetes about eye examination?
“Examinations should be scheduled annually.”
“Examinations should be scheduled every 2 years.”
“Examinations are scheduled according to vision changes.”
“Examinations should be performed by an optometrist.”
The nurse would assess for which signs and symptoms for a client diagnosed with addisonian crisis?
Polyuria, polydipsia, and polyphagia
Tremors, tachycardia and headache
Hypotension, rapid respirations, and pallor
Positive Chvostek’s sign, photophobia, and numbness
The nursing assessment data reveal that the client has thickened heel pads, and a thick tongue, and a change in ring and shoe size. Which scientific rationale would the nurse expect as the probable explanation for the client’s symptoms?
Excessive growth hormone
Undersecretion of antidiuretic hormone
Excessive adrenocorticosteroid production
Undersecretion of the pancreatic beta cells
The nurse is a aware that which factor is the most common precipitating factor associated with the development of diabetic ketoacidosis (DKA)?
Overeating
Infection
Missed insulin dose
Psychological stress
Following a thyroidectomy, the client experiences hemorrhage. The nurse would prepare for which emergency intervention?
IV administration of calcium
Insertion of an oral airway
Creation of a tracheostomy
IV administration of thyroid hormone
A nurse is completing an assessment on an older client who is being admitted for a diagnostic workup for primary hypoparathyroidism, which client complaint would be characteristic of this disorder?
Diarrhea
Polyphagia
Polyuria
Weight gain
A nurse is caring for a postoperative parathyroidectomy client. Which client complaint would indicate a serious life-threatening complication may be developing, requiring immediate notification of the physician?
Difficulty in voiding
Laryngeal stridor
Abdominal cramps
Mild to moderate incisional pain
For which complication of thyroidectomy would the nurse monitor?
Hypercalcemia
Elevated serum T4
Respiratory obstruction
Paralytic ileus
A client is admitted with low T3 and T4 levels and an elevated thyroid-stimulating hormone level. On initial assessment, the nurse would anticipate which of the following findings?
Lethargy
Diarrhea
Heat intolerance
Skin eruptions
Postoperative thyroidectomy, nursing care includes which measure?
Have the client speak every 10 to 15 minutes if hoarseness is present
Provide a low calcium diet to prevent hypercalcemia
Check the dressing at the back of the neck for bleeding
Apply a soft cervical collar to restrict movement
A client has been receiving inhalation vasopressin therapy. What will the nurse evaluate to determine the therapeutic response to this medication?
Urine specific gravity
Blood glucose
Vital signs
Oxygen saturation levels
A diabetic client asks the nurse why the provider ordered a glycosylated hemoglobin measurement, since a blood glucose reading was just performed. You will explain to the client that the test:
Provides a more precise blood glucose value than self-monitoring
Is performed to detect complications of diabetes
Measures circulating levels of insulin
Reflects an average blood sugar for several months
A nurse assessing a client with syndrome of inappropriate antidiuretic hormone would expect to find laboratory values of:
Serum sodium = 150 mEq/L and low urine osmolality
Serum potassium= 5 mEq/L and low serum osmolality
Serum sodium= 120 mEq/L and low serum osmolality
Serum potassium = 3 mEq/L and high serum osmolality
A priority nursing diagnosis for a client admitted to the hospital with a diagnosis of diabetes insipidus is:
Sleep pattern deprivation related to nocturia
Activity intolerance related to muscle weakness
Fluid volume deficit related to intake greater than output
Risk for impaired skin integrity related to generalized edema
The nurse knows that syndrome of inappropriate antidiuretic hormone is characterized by:
Increased cellular resistance to insulin
Fluid retention and decrease serum osmolality
Decreased body weight and fluid volume deficit
Increase urinary output and hypernatremia
The nurse is teaching an adult client who has type 1 diabetes mellitus about ketoacidosis. The nurse explains that the primary cause of the development of ketoacidosis is:
A GI disturbance
Omitted meals
Not taking insulin regularly
An insulin overdosage
The nurse is teaching a person who has Addison’s disease about drug therapy for his condition. In evaluating the effectiveness of teaching regarding drug therapy, the nurse should expect him to be able to verbalize the need:
To receive alternate day therapy
To taper the steroid dose
To avoid antibiotics
For lifelong therapy
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?
Moon face
Acne
Hyperpigmentation
Supraclavicular fat pads
A 57-year-old woman was admitted to the hospital from uncontrolled diabetes. Laboratory studies reveal a fasting blood sugar of 310 mg/dl. Her admission diagnosis is type 1 diabetes mellitus. The client needs to understand that the type of diabetes that she has:
Usually causes complete fat metabolism
Often occurs in obese individuals
Is associated with the destruction of beta cells
Is rarely controlled
The nurse is caring for a client who had a thyroidectomy. The nurse must monitor for possible adverse effects. Which of the following is least likely to occur in this client?
Chvostek’s sign
Brudzinski’s sign
Laryngeal damage
Trousseau’s sign
An adult client is hospitalized for treatment of diabetes insipidus. The nurse is performing the initial assessment. Which finding should the nurse expect?
Daily urine output of 10 liters
Urine specific gravity of 1.050
Serum sodium levels of 120 mEq/L
Daily fluid intake of one to two liters
The nurse should initiate discharge planning client diagnosed with primary hypothyroidism:
When the client or family demonstrate readiness to learn self-care modalities
When informed that a date for discharge has been determined
Upon admission to a hospital unit or the emergency room
When the client’s condition is stabilized on the assigned unit
The nurse is assessing a client with Cushing’s disease. Which observation should the nurse report to the physician immediately?
Pitting edema of the legs
Irregular apical pulse
Dry mucous membrane
Frequent urination
Which nursing diagnosis is most appropriate for a client with Addison’s disease?
Risk for infection
Fluid volume excess
Urinary retention
Hypothermia
