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NERVOUS SYSTEM & ENDOCRINE SYSTEM

Total questions: 40

Worksheet time: 1hrs 16mins

Name
Class
Date
1.

 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?

a)

(a)   Related to bone demineralization resulting in pathologic fractures.

b)

(b)  Related to exhaustion secondary to an accelerated metabolic rate.

c)

(c)   Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces.

d)

(d)  Related to tetany secondary to a decreased serum calcium level.

2.

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?

a)

(a)   At least once a week

b)

(b)  At least three times a week

c)

(c)   At least five times a week

d)

(d)  Every day

3.

      Nurse Oliver should expect a client with hypothyroidism to report which health concerns?

a)

(a)   Increased appetite and weight loss

b)

(b)  Puffiness of the face and hands

c)

(c)   Nervousness and tremors

d)

(d)  Thyroid gland swelling

4.

       When caring for a male client with diabetes insipidus, nurse Juliet expects to administer:

a)

(a)  vasopressin (Pitressin Synthetic).

b)

(b)  furosemide (Lasix).

c)

(c)   Regular insulin.

d)

(d)  10% dextrose.

5.

         The nurse is aware that the following is the most common cause of  hyperaldosteronism?

a)

(a)   Excessive sodium intake

b)

(b)  A pituitary adenoma

c)

(c)   Deficient potassium intake

d)

(d)  An adrenal adenoma

6.

         Nurse Louie is developing a teaching plan for a male client diagnosed   with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?

a)

(a)   Antidiuretic hormone (ADH).

b)

(b)  Thyroid-stimulating hormone (TSH).

c)

(c)   Luteinizing hormone (LH).

d)

(d)  Follicle-stimulating hormone (FSH).

7.

 Emma, who weighs 210 lb (95 kg) and has been diagnosed with hyperglycemia tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client’s hyperglycemia?

a)

(a)  Acromegaly

b)

(b)  Type 1 diabetes mellitus

c)

(c)   Hypothyroidism

d)

(d)  Deficient growth hormone

8.

        Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:

a)

(a)   Increasing saturated fat intake and fasting in the afternoon.

b)

(b)  Increasing intake of vitamins B and D and taking iron supplements.

c)

(c)   Eating a candy bar if light-headedness occurs.

d)

(d)  Consuming a low-carbohydrate, high protein diet and avoiding fasting.

9.

        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:

a)

(a)   Thyroid storm.

b)

(b)  Cretinism.

c)

(c)   Myxedema coma.

d)

(d)  Hashimoto’s thyroiditis.

10.

     During preoperative teaching for a female client who will undergo   subtotal thyroidectomy, the nurse should include which statement?

a)

(a)   “The head of your bed must remain flat for 24 hours after surgery.”

b)

(b)  “You should avoid deep breathing and coughing after surgery.”

c)

(c)   “You won’t be able to swallow for the first day or two.”

d)

(d)  “You must avoid hyperextending your neck after surgery.”

11.

      Angie is an adolescent who has a seizure disorder; which of the following would not be a focus of a teaching program?

a)

(a)   Peer pressure

b)

(b)  Drug and alcohol abuse

c)

(c)   Ability to obtain a driver’s license

d)

(d)  Increased risk of infections

12.

A nurse is giving discharge instructions to a client who will be taking phenobarbital (Luminal). The nurse would educate the client in which of the following that directly correlates with the safety of the client?

a)

(a)   Take the medication with meals only.

b)

(b)  Decrease the dosage once with symptoms of dizziness and lightheadedness.

c)

(c)   Take the medication at the same time each day.

d)

(d)  Avoid using sleep aids while taking the medication.

13.

Meningitis alters intracranial physiology, causing:

a)

(a)   Cerebral edema

b)

(b)  Increased permeability of the blood-brain barrier

c)

(c)    Raised intracranial pressure

d)

(d)  All of the above changes

14.

In diagnosing seizure, which of the following is the most beneficial?

a)

Skull radiographs

b)

  EEG

c)

   Brain scan

d)

  Lumbar puncture

15.

A client with a subdural hematoma becomes restless and confused, with dilation of the ipsilateral pupil. The physician orders mannitol for which of the following reasons?

a)

(a)   To reduce intraocular pressure.

b)

(b)  To prevent acute tubular necrosis.

c)

(c)   To promote osmotic diuresis to decrease ICP.

d)

(d)  To draw water into the vascular system to increase blood pressure.

16.

Which of the following signs and symptoms of increased ICP after head trauma would appear first?

a)

(a)   Bradycardia

b)

(b)   Large amounts of very dilute urine

c)

(c)   Restlessness and confusion

d)

(d)  Widened pulse pressure

17.

The nurse is assessing the motor function of an unconscious client. The nurse would plan to use which of the following to test the client’s peripheral response to pain?

a)

(a)   Sternal rub

b)

(b)  Pressure on the orbital rim

c)

(c)   Squeezing the sternocleidomastoid muscle

d)

(d)  Nail bed pressure

18.

The client is having a lumbar puncture performed. The nurse would plan to place the client in which position for the procedure?

a)

(a)  Side-lying, with legs pulled up and head bent down onto the chest.

b)

(b)  Side-lying, with a pillow under the hip.

c)

(c)    Prone, in a slight Trendelenburg’s position.

d)

(d)  Prone, with a pillow under the abdomen.

19.

The nurse is caring for the client with increased intracranial pressure. The nurse would note which of the following trends in vital signs if the ICP is rising?

a)

(a)   Increasing temperature, increasing pulse, increasing respirations, decreasing blood pressure.

b)

(b)  Increasing temperature, decreasing pulse, decreasing respirations, increasing blood pressure.

c)

(c)   Decreasing temperature, increasing pulse, decreasing respirations, increasing blood pressure.

20.

    During the acute stage of meningitis, a 3-year-old child is restless and irritable. Which of the following would be most appropriate to institute?

a)

(a)   Limiting conversation with the child.

b)

(b)  Allowing the child to play in the bathtub.

c)

(c)    Keeping extraneous noise to a minimum.

d)

(d)  Performing treatments quickly.

21.

A nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which of the following would be included in the plan of care?

a)

(a)   No precautions are required as long as antibiotics have been started.

b)

(b)  Maintain enteric precautions.

c)

(c)   Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics.

d)

(d)  Maintain neutropenic precautions.

22.

The nurse is admitting a patient diagnosed with type 2 diabetes mellitus. The nurse should expect the following symptoms during an assessment, except:

a)

(a)   Hypoglycemia

b)

(b)   Frequent bruising

c)

(c)   Ketonuria

d)

(d)  Dry mouth

23.

Rotation sites for insulin injection should be separated from one another by 2.5 cm (1 inch) and should be used only every:

a)

(a)   Third day

b)

(b)  Every other day

c)

(c)   1-2 weeks

d)

(d)  2-4 weeks

24.

A male nurse is providing a bedtime snack for his patient. This is based on the knowledge that intermediate-acting insulins are effective for an approximate duration of:

a)

(a)   6-8 hours

b)

(b)  10-14 hours

c)

(c)   14-18 hours

d)

(d)  24-28 hours

25.

A client with a T1 spinal cord injury arrives at the emergency department with a BP of 82/40, pulse 34, dry skin, and flaccid paralysis of the lower extremities. Which of the following conditions would most likely be suspected?

a)

(a)   Autonomic dysreflexia.

b)

(b)   Hypervolemia.

c)

(c)   Neurogenic shock.

d)

(d)  Sepsis

26.

The nurse is planning care for the client in neurogenic shock. Which of the following actions would be least helpful in minimizing the effects of vasodilation below the level of the injury?

a)

(a)   Monitoring vital signs before and during position changes

b)

(b)  Using vasopressor medications as prescribed

c)

(c)   Moving the client quickly as one unit

d)

(d)  Applying Teds or compression stockings.

27.

To encourage adequate nutritional intake for a female client with Alzheimer’s disease, the nurse should:

a)

(a)  Stay with the client and encourage him to eat.

b)

(b)   Help the client fill out his menu.

c)

(c)   Give the client privacy during meals.

d)

(d)  Fill out the menu for the client.

28.

A male client is admitted with a cervical spine injury sustained during a diving accident. When planning this client’s care, the nurse should assign the highest priority to which nursing diagnosis?

a)

(a)    Impaired physical mobility

b)

(b)  Ineffective breathing pattern

c)

(c)   Disturbed sensory perception (tactile)

d)

(d)  Self-care deficit: Dressing/grooming

29.

  The nurse is caring for a male client diagnosed with a cerebral aneurysm who reports a severe headache. Which action should the nurse perform?

a)

(a)   Sit with the client for a few minutes.

b)

(b)  Administer an analgesic.

c)

(c)   Inform the nurse manager.

d)

(d)  Call the physician immediately.

30.

A28.       A male client is having tonic-clonic seizures. What should the nurse do first?

a)

(a)   Elevate the head of the bed.

b)

(b)  Restrain the client’s arms and legs.

c)

(c)   Place a tongue blade in the client’s mouth.

d)

(d)  Take measures to prevent injury.

31.

A28.       A female client with a suspected brain tumor is scheduled for computed tomography (CT). What should the nurse do when preparing the client for this test?

a)

(a)    Immobilize the neck before the client is moved onto a stretcher.

b)

(b)  Determine whether the client is allergic to iodine, contrast dyes, or shellfish.

c)

(c)   Place a cap on the client’s head.

d)

(d)  Administer a sedative as ordered.

32.

A female client is admitted in a disoriented and restless state after sustaining a concussion during a car accident. Which nursing diagnosis takes highest priority for this client’s plan of care?

a)

(a)   Disturbed sensory perception (visual)

b)

(b)  Self-care deficit: Dressing/grooming

c)

(c)   Impaired verbal communication

d)

(d)  Risk for injury

33.

  For a male client with suspected increased intracranial pressure (ICP), a most appropriate respiratory goal is to:

a)

(a)   Prevent respiratory alkalosis.

b)

(b)  Lower arterial pH.

c)

(c)   Promote carbon dioxide elimination.

d)

(d)  Maintain partial pressure of arterial oxygen (PaO2) above 80 mm Hg.

34.

A28.       The nurse is assessing the motor function of an unconscious male client. The nurse would plan to use which of the following to test the client’s peripheral response to pain?

a)

(a)  Sternal rub

b)

(b)  Nail bed pressure

c)

(c)   Pressure on the orbital rim

d)

(d)  Squeezing of the sternocleidomastoid musclea

35.

A female client admitted to the hospital with a neurological problem asks the nurse whether magnetic resonance imaging may be done. The nurse interprets that the client may be ineligible for this diagnostic procedure based on the client’s history of:

a)

(a)  Hypertension

b)

(b)  Heart failure

c)

(c)   Prosthetic valve replacement

d)

(d)  Chronic Aobstructive pulmonary disorder

36.

A28.       The nurse is positioning the female client with increased intracranial pressure. Which of the following positions would the nurse avoid?

a)

(a)  Head midline

b)

(b)  Head turned to the side

c)

(c)   Neck in neutral position

d)

(d)  Head of bed elevated 30 to 45 degrees

37.

  Explain the difference between seizure and epilepsy

4 lines
38.

Describe the nursing management of a patient during a seizure

4 lines
39.

Describe the clinical manifestations of traumatic brain injury.

4 lines
40.

Discuss the nursing measures that should be used to control ICP in severely brain-injured patients.

4 lines