WorksheetsNUR2474 Module 7 Review
Total questions: 45
Worksheet time: 2hrs 15mins
A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which change to the nursing care plan?
Instruct the patient to limit activity and weekly exercise.
Glycemic control is adequate; no changes are needed.
Refer the patient to a diabetes educator because the result reflects poor glycemic control.
Hypoglycemia is a risk; teach the patient the symptoms.
A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect?
Decreased insulin resistance
Inhibition of carbohydrate digestion
Inhibition of ketone formation
Promotion of insulin secretion
Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same syringe?
“It is not necessary to rotate the NPH insulin vial when it is mixed with regular insulin.”
“Rotate subcutaneous injection sites each day among the arm, thigh, and abdomen.”
“The order of drawing up insulin does not matter as long as the insulin is refrigerated.”
“Draw up the clear regular insulin first, followed by the cloudy NPH insulin.”
A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these outcomes related to the therapeutic effects of the medication?
Peak effect achieved in 2 to 4 hours
Mealtime coverage of blood glucose
Less frequent blood glucose monitoring
Blood glucose control for 24 hours
A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse take?
Advise the patient to lie down with the legs elevated.
Take the patient’s blood pressure.
Check the patient’s capillary blood sugar.
Give the patient’s PRN dose of insulin.
A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse?
“This insulin needs to be mixed with regular insulin to enhance the effects.”
“To achieve tight glycemic control, this is the only type of insulin you’ll need.”
“Inject this insulin with your first bite of food, because it is very fast acting.”
“The duration of action for this insulin is about 8 to 10 hours, so you’ll need a snack.”
A patient newly diagnosed with type 1 diabetes asks a nurse, “How does insulin normally work in my body?” The nurse explains that normal insulin has which action in the body?
It stimulates the liver to convert glycogen to glucose.
It promotes the passage of glucose into cells for energy.
It promotes the synthesis of amino acids into glucose.
It stimulates the pancreas to reabsorb glucose.
A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is teaching hypoglycemia awareness and should warn the patient about the presence of which symptom?
Tachycardia
Muscle cramps
Chills
Vomiting
A nurse assesses a patient who is taking pramlintide [Symlin] with mealtime insulin. Which finding requires immediate follow-up by the nurse?
Pedal edema
Skin rash
Itching
Sweating
Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value?
Sodium (Na) level of 131 mEq/dL
Hemoglobin (Hgb) level of 9.5 gm/dL
Creatinine (Cr) level of 2.1 mg/dL
Platelet count of 120,000/mm3
A nurse caring for a patient who has diabetic ketoacidosis recognizes which characteristics in the patient? (Select all that apply.)
Arterial blood pH of 7.35 to 7.45
Plasma osmolality of 300 to 320 mOsm/L
Altered fat metabolism leading to ketones
Sudden onset, triggered by acute illness
Type 2 diabetes
A patient with Graves’ disease is treated with iodine-131 therapy. Which statement by the patient would indicate understanding of the treatment’s effects?
“I’ll have to isolate myself from my family so I don’t expose them to radiation.”
“I’m looking forward to feeling better immediately after this treatment.”
“I’ll tell my doctor if I have fatigue, hair loss, or cold intolerance.”
“I’ll need to take this drug on a daily basis for at least 1 year.”
A nurse is caring for a patient with decreased triiodothyronine (T3) and thyroxine (T4) and elevated thyroid-stimulating hormone (TSH) levels. The nurse knows the patient is likely suffering from what?
Hypothyroidism
Thyrotoxicosis
Hyperthyroidism
Graves’ disease
A patient has been given instructions about levothyroxine [Synthroid]. Which statement by the patient indicates understanding of these instructions?
“I’ll be glad when I don’t have to take this medication in a few months.”
“I’ll plan to double my dose if I gain more than 1 pound per day.”
“It is best to take the medication with food so I don’t have any nausea.”
“I’ll take this medication in the morning so as not to interfere with sleep.”
Which manifestations should a nurse investigate first when monitoring a patient who is taking levothyroxine [Synthroid]?
Tremors
Insomnia
Irritability
Tachycardia
Which finding in a patient taking levothyroxine [Synthroid] and warfarin [Coumadin] would require follow-up by a nurse?
Cardiac dysrhythmias
Excessive bruising
Shortness of breath
Weight loss of 5 kg
Which statement is the most important for a nurse to make to a patient who is taking methimazole?
“You may experience some muscle soreness with this medicine.”
“You need to notify your doctor if you have a sore throat and fever.”
“Another medication can be given if you experience any nausea.”
“Headache and dizziness may occur but not very frequently.”
A nurse should consider which diagnostic test a priority to obtain before a patient receives iodine-131?
White blood cell (WBC) count
Electrocardiogram (ECG)
Creatinine level
Beta human chorionic gonadotropin (hCG) test
The patient reports that she had to switch pharmacies to save money. She noticed that her “thyroid pill” looks different. The nurse anticipates that the healthcare provider will order what?
Beta human chorionic gonadotropin (hCG) test
Creatinine level
Electrocardiogram (ECG)
Thyroid stimulating hormone (TSH)
The healthcare provider orders 150 mcg of levothyroxine [Synthroid] PO every morning. The medication available is levothyroxine [Synthroid] 75-mcg tablets. How many tablets will the nurse administer?
0.5
2
1
4
Which statements about levothyroxine [Synthroid] are correct? (Select all that apply.)
Levothyroxine should be taken at night to avoid adverse effects.
Levothyroxine can affect the metabolism of other medications.
Levothyroxine brands should not be changed if possible.
Levothyroxine can be given by IV but is usually taken orally.
Levothyroxine should be taken with food.
During the follicular phase of the menstrual cycle, estrogen has which effects on the female reproductive organs?
Maturation of a corpus luteum
Ripening of an ovarian follicle
Proliferation of the endometrium
Monthly menstrual bleeding
A nurse is teaching a postmenopausal patient taking estrogen/progestin therapy (EPT) about breast self-examination (BSE). Which of these instructions should the nurse give?
“Feel each breast while lying on the opposite side.”
“There are no risks for breast cancer, so BSE is not necessary.”
“Examine your breasts by looking at them in the mirror.”
“Do your breast self-examination the first day of each month.”
Which therapeutic effect is the purpose of a progestin medication in menopausal hormone therapy (HT)?
To reduce urogenital atrophy
To suppress endometrial proliferation
To prevent adverse cardiac events
To relieve vasomotor symptoms
A patient takes fluoxetine [Prozac] for premenstrual disorder (PMD). Which priority assessment allows the nurse to evaluate the effectiveness of this treatment?
Reports of mood improvement
Decreased craving for carbohydrates
Less abdominal bloating
Reduction in breast tenderness
The nurse is providing teaching regarding Duavee (conjugated estrogens/bazedoxifene). Which statement by the patient indicates that the teaching was effective?
“I know I am at an additional risk for increased growth of my uterus lining.”
“I will have to set an alarm to take my medication four times per day.”
“I am prepared to take this medication for the rest of my life.”
“I understand that the combination product should help protect me from the side effects of the estrogen.”
What is the primary difference between the selective estrogen receptor modulators tamoxifen and raloxifene?
Raloxifene does not produce hot flashes.
Raloxifene does not protect against breast cancer.
Raloxifene does not increase the risk for thromboembolism.
Raloxifene does not increase the risk for uterine cancer.
Which patient may be given progestin therapy during pregnancy?
A woman pregnant with triplets during her first pregnancy
A woman who is trying to achieve pregnancy through planned intercourse
A woman who is 8 weeks pregnant and diagnosed with corpus luteum deficiency syndrome
A woman experiencing severe nausea and vomiting during pregnancy
Which beneficial metabolic effects does estrogen have in nonreproductive tissues? (Select all that apply.)
It suppresses bone resorption.
It promotes and suppresses coagulation.
It reduces low-density lipoproteins (LDLs).
It reduces fat deposits in the liver.
It improves glomerular filtration rates.
The Women’s Health Initiative (WHI) landmark trial data led to which recommendations about hormone replacement therapy? (Select all that apply.)
Postmenopausal women should avoid smoking, exercise regularly, and control hypertension.
Estrogen and progesterone should be used only to prevent cardiovascular events.
There are benefits to using HRT short term to reduce vasomotor symptoms.
Treatment with HRT for longer than 5 years increases the risk for pulmonary embolus and stroke.
Estrogen/progestin therapy (EPT) is preferred as the primary treatment to prevent loss of bone mass.
Progestins may be used to treat which conditions? (Select all that apply.)
Endometrial hyperplasia
Endometriosis
Amenorrhea
Dysfunctional uterine bleeding
Breast cancer
A nurse teaches a health education class to male adolescents. Which of these topics should be a priority for the nurse to include?
Pituitary gland regulation of sexual development
Effects of performance-enhancing androgens
Self-esteem issues related to delayed onset of puberty
Adoption of healthy lifetime hygienic practices
Which application instruction is the priority for a nurse to provide to a patient starting to use AndroGel testosterone gel?
“Wait about 5 or 6 hours before showering or swimming.”
“Squeeze the entire packet into your palms and then rub the gel into your skin.”
Wash your hands after applying the gel to prevent transfer to others.”
“Apply the gel to clean, dry skin of the shoulders or upper arms.”
Which measurements should a nurse obtain to evaluate the effects of androgen therapy on the epiphyses of a patient with hypogonadism?
Body mass/fat ratio indices
Periodic hand and wrist x-rays
Monthly height and weight
Blood testosterone levels
Androgens are prescribed for a patient with anemia. The nurse is aware that the action of the androgen in this patient is what?
Increase in bone formation
Prevention of blood loss
Promoting synthesis of erythropoietin
Iron replacement
A nurse monitors for which adverse cardiovascular effects in a male patient taking testosterone [Androderm]? (Select all that apply.)
Postural hypotension
Decrease in high-density lipoprotein (HDL) levels
Atrial fibrillation
Prolonged QT interval
Pedal edema and weight gain
A nurse identifies therapeutic goals for androgen therapy for which patients? (Select all that apply.)
A female patient with acquired immunodeficiency syndrome (AIDS)
A male patient with prostate cancer
A male patient with hypogonadism
A female patient with breast engorgement
A female patient with breast cancer
A patient is scheduled to start taking sildenafil [Viagra]. A nurse should recognize that the patient is at risk for developing an adverse cardiac event if the patient’s history reveals which of these conditions?
Prosthetic mitral valve
Varicose veins
Hypertension
Angina
A patient in the emergency department reports taking sildenafil [Viagra] and nitroglycerin 1 hour before sexual activity. Which finding should the nurse immediately report to the physician?
Blood pressure (BP) of 70/50 mm Hg
Respiratory rate of 26 breaths per minute
Body temperature of 100.4°F (38°C)
White blood cell (WBC) count of 3200 units/L
Which statement should a nurse include when providing teaching to a patient who is scheduled to start taking dutasteride [Avodart]?
“You may notice immediate relief of your urinary symptoms.”
“You cannot donate blood while on this medication or for 6 months after stopping it.”
“Protect yourself from sun exposure to avoid any skin sensitivity.”
“Dutasteride will increase both ejaculatory volume and libido over time.”
When assessing a patient who takes finasteride [Proscar], a nurse should monitor for which adverse effect?
Muscle weakness
Hair loss
Increased libido
Ejaculatory dysfunction
A patient taking sildenafil [Viagra] asks a nurse what action to take if priapism occurs. Which response should the nurse make?
“Wait until the following day and notify the doctor.”
“Seek emergency help, because permanent damage can occur.”
“Take an additional half-strength dose of sildenafil.”
“The condition usually resolves in 12 hours or less.”
Which assessment should a nurse monitor more frequently in a patient who takes both an alpha blocker for BPH and metoprolol [Lopressor]?
Blood glucose level
Blood pressure
Urine output
Hemoglobin level
A nurse is educating a patient about sildenafil [Viagra]. The nurse should instruct the patient that which adverse effect would be a priority for the patient to report to his prescriber?
Dyspepsia
Diarrhea
Hearing loss
Flushing
A nurse should recognize that which therapies would be beneficial to a patient with BPH? (Select all that apply.)
Sildenafil [Viagra]
Botulinum [Botox]
Alfuzosin [Uroxatral]
Saw palmetto
Tolterodine [Detrol]
