1. An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, nurse Lily teaches the client to treat hypoglycemia by ingesting:
a. 2 to 5 g of a simple carbohydrate.
b. 10 to 15 g of a simple carbohydrate.
c. 18 to 20 g of a simple carbohydrate.
d. 25 to 30 g of a simple carbohydrate.
2. A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, nurse Julia 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. Related to bone demineralization resulting in pathologic fractures
b. Related to exhaustion secondary to an accelerated metabolic rate
c. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces
d. Related to tetany secondary to a decreased serum calcium level
3. Nurse John is assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview, the client reports that he’s impotent and says he’s concerned about its effect on his marriage. In planning this client’s care, the most appropriate intervention would be to:
a. Encourage the client to ask questions about personal sexuality.
b. Provide time for privacy.
c. Provide support for the spouse or significant other.
d. Suggest referral to a sex counselor or other appropriate professional.
4. 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. At least once a week
b. At least three times a week
c. At least five times a week
d. Every day
5. Nurse Oliver should expect a client with hypothyroidism to report which health concerns?
a. Increased appetite and weight loss
b. Puffiness of the face and hands
c. Nervousness and tremors
d. Thyroid gland swelling
6. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect?
b. Leg cramps
d. Blurred vision
7. A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, nurse Richard would suspect which of the following disorders?
a. Diabetes mellitus
b. Diabetes insipidus
8. When caring for a male client with diabetes insipidus, nurse Juliet expects to administer:
a. vasopressin (Pitressin Synthetic).
b. furosemide (Lasix).
c. regular insulin.
d. 10% dextrose.
9. The nurse is aware that the following is the most common cause of hyperaldosteronism?
a. Excessive sodium intake
b. A pituitary adenoma
c. Deficient potassium intake
d. An adrenal adenoma
10. A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, nurse Sharmaine would be most accurate in stating:
a. “The test needs to be repeated following a 12-hour fast.”
b. “It looks like you aren’t following the prescribed diabetic diet.”
c. “It tells us about your sugar control for the last 3 months.”
d. “Your insulin regimen needs to be altered significantly.”
11. Following a unilateral adrenalectomy, nurse Betty would assess for hyperkalemia shown by which of the following?
a. Muscle weakness
12. 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. antidiuretic hormone (ADH).
b. thyroid-stimulating hormone (TSH).
c. follicle-stimulating hormone (FSH).
d. luteinizing hormone (LH).
13. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?
a. Diabetic ketoacidosis
b. Thyroid crisis
14. For a male client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume?
a. Cool, clammy skin
b. Distended neck veins
c. Increased urine osmolarity
d. Decreased serum sodium level
15. When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, nurse April is most likely to detect:
a. a blood pressure of 130/70 mm Hg.
b. a blood glucose level of 130 mg/dl.
d. a blood pressure of 176/88 mm Hg.
16. A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?
a. Infusing I.V. fluids rapidly as ordered
b. Encouraging increased oral intake
c. Restricting fluids
d. Administering glucose-containing I.V. fluids as ordered
17. A female client has a serum calcium level of 7.2 mg/dl. During the physical examination, nurse Noah expects to assess:
a. Trousseau’s sign.
b. Homans’ sign.
c. Hegar’s sign.
d. Goodell’s sign.
18. Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?
a. Fluid intake is less than 2,500 ml/day.
b. Urine output measures more than 200 ml/hour.
c. Blood pressure is 90/50 mm Hg.
d. The heart rate is 126 beats/minute.
19. Jemma, 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?
b. Type 1 diabetes mellitus
d. Deficient growth hormone
20. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:
a. Increasing saturated fat intake and fasting in the afternoon.
b. Increasing intake of vitamins B and D and taking iron supplements.
c. Eating a candy bar if light-headedness occurs.
d. Consuming a low-carbohydrate, high-protein diet and avoiding fasting.
21. 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. Thyroid storm.
c. myxedema coma.
d. Hashimoto’s thyroiditis.
22. A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. Nurse Jack explains that these medications are only effective if the client:
a. prefers to take insulin orally.
b. has type 2 diabetes.
c. has type 1 diabetes.
d. is pregnant and has type 2 diabetes.
23. When caring for a female client with a history of hypoglycemia, nurse Ruby should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description?
a. sulfisoxazole (Gantrisin)
b. mexiletine (Mexitil)
c. prednisone (Orasone)
d. lithium carbonate (Lithobid)
24. After taking glipizide (Glucotrol) for 9 months, a male client experiences secondary failure. Which of the following would the nurse expect the physician to do?
a. Initiate insulin therapy.
b. Switch the client to a different oral antidiabetic agent.
c. Prescribe an additional oral antidiabetic agent.
d. Restrict carbohydrate intake to less than 30% of the total caloric intake.
25. During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the nurse should include which statement?
a. “The head of your bed must remain flat for 24 hours after surgery.”
b. “You should avoid deep breathing and coughing after surgery.”
c. “You won’t be able to swallow for the first day or two.”
d. “You must avoid hyperextending your neck after surgery.”
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