NUR 4311 Final NCLEX | Questions and Answers with rationale. 100%

NUR 4311 Final NCLEX | Questions and Answers with rationale. 100% HIV 1. When teaching a patient infected with HIV regarding transmission of the virus to others, which statement made by the patient would indicate a ne ...

NUR 4311 Final NCLEX | Questions and Answers with rationale. 100% HIV 1. When teaching a patient infected with HIV regarding transmission of the virus to others, which statement made by the patient would indicate a need for further teaching? •A. ” I will need to isolate any tissues I use so as not to infect my family”. •B. “ I will notify all of my sexual partners so they can get tested for HIV”. •C. “Unprotected sexual contact is the most common mode of transmission”. •D “I do not need to worry about spreading this virus to others by sweating at the gym” 2. The nurse is providing care for a patient who has been living with HIV for several years. Which assessment finding most clearly indicates an acute exacerbation of the disease? •A. a new onset of polycythemia •B. presence of mononucleosis-like symptoms •C. sharp decrease in patients CD4+ count •D. sudden increase in patients WBC count 3. A 25-year-old male patient has been diagnose with HIV. The patient does not want to take more than one antiretroviral drug. What reasons can the nurse tell the patient about for taking more than one drug? A. Together they will cure HIV. B. Viral replication can be inhibited. C. They will decrease CD4+ T cell counts. D. It will prevent interaction with other drugs. 4. The HIV-infected patient is taught health promoting activities including good nutrition; avoiding alcohol, tobacco, drug use, and exposure to infectious agents; keeping up to date with vaccines; getting adequate rest; and stress management. What is the rationale behind these interventions that the nurse knows? •A. Delay disease progression •B. Preventing disease transmission •C. Helping to cure the HIV infection •D. Enabling an increase in self-care activities 5. Transmission of HIV from an infected individual to another most commonly occurs as a result of ? •A. unprotected anal or vaginal sexual intercourse. •B. low levels of virus in the blood and high levels of CD4+ T cells. •C. transmission from mother to infant during labor and delivery and breast-feeding. •D. sharing of drug-using equipment, including needles, syringes, pipes, and straws. 6. Screening for HIV generally involves: •A. laboratory analysis of blood to detect HIV antigen. •B. electrophoretic analysis for HIV antigen in plasma •C. laboratory analysis of blood to detect HIV antibodies. •D. analysis of lymph tissues for the presence of HIV RNA. 7. The nurse is caring for a patient newly diagnosed with HIV. The patient asks what would determine the actual development of AIDS. The nurse's response is based on the knowledge that what is a diagnostic criterion for AIDS? A. Presence of HIV antibodies B. CD4+ T cell count below 200/µL C. Presence of oral hairy leukoplakia D. White blood cell count below 5000/µl 8. The patient is admitted to the ED with a fever, swollen lymph glands, sore throat, headache, malaise, joint pain, and diarrhea. What nursing measures will help identify the need for further assessment of the cause of this patient's manifestations? (Select all that apply). A. Assessment of lung sounds B. Assessment of sexual behavior C. Assessment of living conditions D. Assessment of drug and syringe use E. Assessment of exposure to an ill person 9.Which statements accurately describe HIV infection? (Select all that apply). A. Untreated HIV infection has a predictable pattern of progression. B. Late chronic HIV infection is called acquired immunodeficiency syndrome (AIDS). C. Untreated HIV infection can remain in the early chronic stage for a decade or more. D. Untreated HIV infection usually remains in the early chronic stage for 1 year or less. E. Opportunistic diseases occur more often when the CD4+ T cell count is high and the viral load is low Hemophilia 1. Which nursing interventions should the nurse implement when caring for a client diagnosed with hemophilia A? SELECT ALL THAT APPLY. a. Instruct the client to use a razor blade to shave. b. Avoid administering enemas to the client. c. Encourage participation in noncontact sports. d. Teach the client how to apply direct pressure if bleeding occurs e. Explain the importance of not flossing the gums. 2. The physician has ordered several laboratory tests to help diagnose an infant’s bleeding disorder. Which of the following tests, if abnormal, would the nurse interpret as most likely to indicate hemophilia? A.Bleeding time B.Tourniquet test C.Partial thromboplastin time (PTT) D.Clot retraction test Answer: 3. Which statements made by a patient with hemophilia during discharge teaching indicates that teaching about pain medications has NOT been effective? SELECT ALL THAT APPLY. A.“I can use low-dose aspirin.” B.“I could use celecoxib for pain.” C.“It is okay to take naproxen once a day.” D.“I can use ibuprofen for pain as needed.” 4. The unlicensed assistive personnel (UAP) asks the primary nurse, "How does someone get hemophilia A?" Which statement would be the primary nurse's best response? A."It is an inherited X-linked recessive disorder.” B."There is a deficiency of the clotting factor VIII.” C."The person is born with hemophilia A.” D."The mother carries the gene and gives it to the son.” 5.What information that the nurse includes in an in-service program about hemophilia needs further teaching? SELECT ALL THAT APPLY. A.Females with hemophilia pass the disease to their sons. B.Males with hemophilia pass the disease to their daughters. C.Males whose mothers are carriers have a 50% chance of inheriting the disease. D.Females whose mothers are carriers have a 50% chance of inheriting the disease. 6. A pediatric nurse health educator provides a teaching session to the nursing staff regarding hemophilia. Which of the following information regarding this disorder would the nurse plan to include in this discussion? A.Hemophilia is a Y linked disorder B.Females cannot inherit hemophilia C.Males inherit hemophilia from their mothers D.Hemophilia B results from a deficiency in clotting factor VIII 7. Which of the following measures should parents of a hemophilic child be taught to prepare them to initiate immediate treatment before blood loss is excessive? A.Apply heat to the area B.Withhold factor replacement C.Apply pressure for at least 5 minutes D.Immobilize and elevate the affected area 8. A child with hemophilia wishes to participate in sports. Which sport would the nurse recommend as the most appropriate for the child? A.Baseball B.Basketball C.Swimming D.Football 9. Which action does the RN delegate to the unlicensed assistive personnel (UAP)? A.Drawing a PTT from a saline lock on a client with hemophilia B.Performing a capillary fragility test on a client with liver failure C.Referring a client with a daily alcohol consumption of 12 beers a day for counseling D.Reporting any bleeding noted when catheter care is given to a client with a history of hemophilia Sickle Cell disease 1. •A child with suspected sickle cell disease (SCD) is in the clinic for laboratory studies. The parents ask the nurse what results will tell the physician that their child has SCD. The nurse responds that which of the following is increased in this disease? Hemoglobin Hematocrit Reticulocyte count platelet levels 2. THE CLINIC NURSE INSTRUCTS PARENTS OF A CHILD WITH SICKLE CELL ANEMIA ABOUT THE PRECIPITATING FACTORS RELATED TO SICKLE CELL CRISIS. Which, if identified by the parents as a precipitating factor, indicates the need for further instructions? 1.Stress 2.Trauma 3.Infection 4.Fluid overload 3. The healthcare provider is reviewing a patient’s laboratory results and notes the hemoglobin is 9 and the hematocrit is 28. Which of the following orders will the healthcare provider expect to implement first? 1.Administer PO ferrous sulfate (iron) 2.Administer cyanocobalamin (vitamin b12) IM 3.Draw blood for red blood cell indices 4.Type and cross for a blood transfusion 4. The nurse is reviewing a health care provider’s prescription for a child with sickle cell anemia who was admitted to the hospital for the treatment of vaso-occlusive crisis. Which prescriptions documented in the child's record should the nurse question? Select all that apply. 1.Restrict fluid intake 2.Position for comfort 3.Avoid strain on painful joints 4.Apply nasal oxygen at 2l/minute 5.Provide a high calorie, high protein diet 6.Give meperidine (Demerol), 25mg intravenously, every 4 hours for pain 5. The Healthcare provider is assisting a patient with severe anemia with ambulation. The patient experiences dyspnea. What should the healthcare provider do first ? 1.Ask a colleague to get a wheelchair for the patient 2.Administer oxygen to the patient 3.Quickly assist the patient back to their bed 4.Ease the patient to the floor to prevent injury • To validate the suspicion that a married male client has sleep apnea the nurse first: A- Asks the client if he experiences apnea in the middle of the night B- Questions the spouse if she is awakened by her husband’s snoring C- Places the client on a continuous positive airway pressure (CPAP) device D- Schedules the client for a sleep test When analgesics are ordered for a client with obstructive sleep apnea (OSA) following surgery, the nurse is most concerned about: A-Nonsteroidal anti-inflammatory drugs (NSAIDs) B-Opioids C-Anticonvulsants D-Antidepressants E-Adjuvants When assessing a client for obstructive sleep apnea (OSA), the nurse understands the most common symptom is: A - Headache B - Early awakening C - Impaired reasoning D - Excessive daytime sleepiness Which of the following would be most important for the nurse to monitor in a patient who has obstructive sleep apnea? a. Gastrointestinal function b. Circulatory status c. Respiratory status d. Neurological function SLEEP APNEA The nurse assigns a nursing diagnosis of ineffective breathing pattern. Which of the following sleep conditions would support this diagnosis? A- Insomnia B- Narcolepsy C- Obstructive sleep apnea D- Sleep deprivation Obstructive sleep apnea 1.To validate the suspicion that a married male client has sleep apnea the nurse first: A - Asks the client if he experiences apnea in the middle of the night B- Questions the spouse if she is awakened by her husband’s snoring C- Places the client on a continuous positive airway pressure (CPAP) device D- Schedules the client for a sleep test 2. When analgesics are ordered for a client with obstructive sleep apnea (OSA) following surgery, the nurse is most concerned about: A-Nonsteroidal anti-inflammatory drugs (NSAIDs) B-Opioids C-Anticonvulsants D-Antidepressants E-Adjuvants 3. When assessing a client for obstructive sleep apnea (OSA), the nurse understands the most common symptom is: A - Headache B - Early awakening C - Impaired reasoning D - Excessive daytime sleepiness Excessive daytime sleepiness is the most common complaint of people with OSA. Persons with severe OSA may report taking daytime naps and experiencing a disruption in their daily activities because of sleepiness. 4.Which of the following would be most important for the nurse to monitor in a patient who has obstructive sleep apnea? a. Gastrointestinal function b. Circulatory status c. Respiratory status d. Neurological function 5.The nurse assigns a nursing diagnosis of ineffective breathing pattern. Which of the following sleep conditions would support this diagnosis? A- Insomnia B- Narcolepsy C- Obstructive sleep apnea D- Sleep deprivation 6. When assessing a client for obstructive sleep apnea (OSA), the nurse understands the most common symptom is? A.Headache B.Early awakening C.Impaired reasoning D.Excessive daytime sleepiness 7. A patient with sleep apnea asks the nurse, “What can I do to get better sleep?” What is an appropriate nursing response? A.”Taking –2 sleeping pills at night will prevent sleep apneic episodes.” B.”Being overweight is a contributing factor; losing weight can often resolve apnea.” C.“Keeping your hypertension under control is beneficial for general health.” D.“High blood glucose levels contribute to the apnea; monitor your sugar carefully.” 8. To validate the suspicion that a married male client has sleep apnea the nurse first: A.Asks the client if he experiences apnea in the middle of the night B.Schedules the client for a sleep test C.Places the client on a continuous positive airway pressure (CPAP) device D.Questions the spouse if she is awakened by her husband’s snoring 9. The patient is scheduled for a sleep study test to see if the patient has mild sleep apnea. What should the nurse teach the patient to do until the test can be completed? A.Use the spouse’s continuous positive airway pressure (CPAP) mask B.Sleep in a side-lying position C.Do not use pillows when sleeping D.Take sleep medications Cystic Fibrosis 1.Select the systems below that are affected by cystic fibrosis: A. Reproductive B. Lymphatic C. Respiratory D. Gastrointestinal E. Neuro F. Integumentary 2.Cystic fibrosis is an autosomal recessive genetic disorder. Which option below best describes what most likely happens for a child to develop this condition? A. One parent, who is a carrier of the mutated gene, has to pass it to the child B. One of the parents has to have cystic fibrosis in order to pass it to their offspring C. Both of the parents must have cystic fibrosis in order for the child to develop it D. Both parents, who are carriers of the mutated gene, each pass one mutated gene to the child 3.You’re discussing nutrition with your patient who has cystic fibrosis. You explain that it is very important the patient regularly takes fat-soluble vitamins. This includes: A. Vitamin B B. Vitamin D C. Vitamin C D. Vitamin K E. Vitamin E F. Vitamin A 4.You’re providing care to an 18-year-old male who has cystic fibrosis. Select all the possible complications this patient can experience due to cystic fibrosis: A. Blood glucose 255 mg/dL B. Hearing disturbances C. Hemoptysis D. Greasy, foul smelling stools E. Weight gain F. Meconium ileus G. Excessive mucus production H. Dyspnea I. Coughing J. Hyperoxemia K. Infertility 5.A patient completed a sweat test yesterday. The results are back and are 45 mmol/L. As the nurse you know this means: A. The patient tested positive for cystic fibrosis. B. The patient tested negative for cystic fibrosis. C. The patient needs further testing because results are not conclusive. •39 mmol/L or less in patients 6 months or older are NEGATIVE for cystic fibrosis •40 to 59 mmol/L needs further testing, not conclusive •60 or more mmol/L POSITIVE for cystic fibrosis 6.The nurse is providing diet instruction to the parents of a child with cystic fibrosis. The nurse would emphasize that the diet should follow which of the following guidelines? A.Sodium restricted diet B.High-fat, high-calorie foods C.Skim milk and low-fat dairy products D.Restricted calorie 7. CF mainly affects which body system? (SELECT ALL THAT APPLY) A.Circulatory System B.Respiratory System C.Digestive System D.Nervous System E.Reproductive System 8.How is the digestive system affected by extra mucus in CF? (SELECT ALL THAT APPLY) A.The mucus can cause stomach ulcers B.The mucus can damage the bile ducts in the liver C.The mucus can damage the rectum D.The mucus can clog the ducts in the pancreas 9.How is CF diagnosed? (SELECT ALL THAT APPLY) A.Sweat Test B.Lung Volume Test C.Urine Test D.Blood Test 10.Betty is a 9-year-old girl diagnosed with cystic fibrosis. Which of the following must Nurse Archie keep in mind when developing a care plan for the child? A.Pulmonary secretions are abnormally thick B.Elevated levels of potassium are found in the sweat C.CF is an autosomal dominant hereditary disorder D.Obstruction of the endocrine gland occurs Breast cancer 1.A female client is receiving chemotherapy to treat breast cancer. Which assessment finding indicates a fluid and electrolyte imbalance induced by chemotherapy? A.Urine output of 400 mL in 8 hours B.Serum potassium level of 3.6 mEq/L C.Blood pressure of 120/64 to 130/72 mm Hg D.Dry oral mucous membranes and cracked lips Answer: D 2.You are a community health nurse planning a program on breast cancer screening guidelines for women in the neighborhood. What would you include to best promote learning and adherence of the participants? Select all that apply. A.Short audiotape on the BSE procedure B.Packet of articles from the medical literature C.Written guidelines for mammography and BSE D.Discussion of the value of early breast cancer detection E.Need to get mammogram starting at age 35 Answer: C & D 3.The nurse is teaching a group of women to perform breast self-examination. The nurse should explain that the purpose of performing the examination is to discover: A.Cancerous lumps B.Areas of thickness or fullness C.Changes from previous self-examinations D.Fibrocystic masses 4.A patient with breast cancer has a lumpectomy with sentinel lymph node biopsy that is positive for cancer. For the other tests done to determine the risk for cancer recurrence or spread, what results support a more favorable prognosis? Select all that apply. A.Well-differentiated tumor B.Estrogen receptor-positive tumor C.Involvement of two to four axillary nodes D.Overexpression of the HER2 protein E.High DNA proliferative index 5.As an oncological nurse, you know what finding is correct regarding breast cancer? A.Masses are usually felt in the upper outer quadrant beneath the nipple or axilla. B.Women who have had late menarche and early menopause are at risk for breast cancer. C.Nipple retraction is never present. D.The mass is typically painful and red. 6.The client diagnosed with breast cancer is considering whether to have a lumpectomy or a more invasive procedure, a modified radical mastectomy. Which info should the nurse discuss? A. Ask if she is afraid of general anesthesia. B. Ask how she feels about radiation and chemotherapy. C. Tell her that she will need reconstruction with either procedure. D. Find out if she has BC in her family. 7.The client has undergone a wedge resection for cancer on the left breast. Which discharge instruction should the nurse teach? A. Don't life more than 5 lbs. with left hand until released by HCP B. The cancer has been totally removed and no F/U therapy is required. C. Client should empty Hemovac every 12 hours. D. Client should arrange for an appt. with a plastic surgeon for reconstruction. 8.The client is being discharged after a left modified radical mastectomy. Which discharge instructions should the nurse include? Select all that apply: A. Notify HCP of temperature of 100 F B. Carry large purses and bundles with the right hand. C. Do not go to church or anywhere with crowds. D. Try to keep the arm as still as possible until seen by HCP. E. Have a mammogram of the right and left breast yearly. •A. Correct. Possible infection. B. Correct. Risk of lymphedema. Protect arm from injury. C. Wrong. D. Wrong. Should be taught arm climbing exercises before DC. E. Correct. Risk for more cancer is high in both breasts. 9.The classic symptoms that define breast cancer includes which of the following? (Select all that apply) A.“pink peel” skin B.Solitary, irregularly shaped mass C.Firm, non tender, nonmobile mass D.Abnormal discharge from the nipple 10.In staging and grading neoplasm TNM system is used. TNM stands for: (Select all that apply). A.Time B.Tumor C.Node D.Neoplasm E.Mode of growth F.Metastasis INTESTINAL CANCER/ colorectal cancer 1.The nurse is admitting a male client with a diagnosis of adenocarcinoma of the rectosigmoid colon. Which assessment data support this diagnosis? a.Reports up to 20 bloody stools per day b.States he has a feeling of fullness after a heavy meal c.Has diarrhea alternating with constipation d.Complains of RLQ pain with rebound tenderness 2.The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the client identifies which item as an associated risk factor? A.Age younger than 50 years B.History of colorectal polyps C.Family history of colorectal polyps D.Chronic inflammatory bowel disease 3.A client is having a diagnostic workup for colorectal cancer. Which factors in the client's history place the client at increased risk for this type of cancer? Select all that apply. A.high-fiber diet B. diet high in fats C.Minimal alcohol intake D.A diet high in carbohydrates E.A history of inflammatory bowel disease F.A maternal grandfather who had a history of heart disease 4.The nurse planning care for the client who has had an abdominal-perineal resection for cancer of the colon. Which interventions should the nurse implement? Select all that apply A.Provide meticulous skin care to stoma B.Assess the flank incision C.Maintain the indwelling catheter D.Irrigate the JP drains every shift E.Position the client semi-recumbent 5.The nurse is planning care for a postoperative client following the creation of a colostomy. Which potential client problem should the nurse include in the plan of care? a.Impaired perfusion b.Sexual Dysfunction c.Impaired gas exchange d.Altered body image 1.The nurse plans care for a client postoperatively following creation of a colostomy. Which potential client problem should the nurse include in the plan of care? a.Fear b.Anxiety c.Sexual Dysfunction d.Upset about appearance 2. The nurse is teaching a client about the risk factors associated with colorectal cancer. The nurse determines that further teaching is necessary related to colorectal cancer if the client identifies which item as an associated risk factor? a.Age younger than 50 years b.History of colorectal polyps c.Family history of colorectal cancer d.Chronic inflammatory bowel disease 3. A client is having a diagnostic workup for colorectal cancer. Which factors in the client's history place the client at increased risk for this type of cancer? Select all that apply. A.A high-fiber diet B.A diet high in fats C.Minimal alcohol intake D.A diet high in carbohydrates E.A history of inflammatory bowel disease F.A maternal grandfather who had a history of heart disease 4.The nurse is admitting a male client with a diagnosis of adenocarcinoma of the rectosigmoid colon. Which assessment data support this diagnosis? A.Reports up to 3 stools per day. B.States he has a feeling of fullness after a heavy meal C.Has diarrhea alternating with constipation. D.Complains of RLQ pain with rebound tenderness 5. The nurse planning care for the client who has had an abdominal-perineal resection for cancer of the colon. Which interventions should the nurse implement? Select all that apply. A.Provide meticulous skin care to stoma B.Assess the flank incision C.Maintain the indwelling catheter D.Irrigate the JP drains every shift E.Position the client semi-recumbent PROSTATE CANCER 1.Which of the following diagnostic tests are used to differentiate benign prostatic hypertrophy (BPH) from prostate cancer? (Select all that apply.) a. Digital rectal examination b. Prostate-specific antigen (PSA) level c. Skin integrity d. Pelvic ultrasound e. Urinary elimination 2.The nurse is providing discharge teaching for a 74-year-old client with prostate cancer that has metastasized to other areas of the body. His family will be providing care to the client at home. Which of the following is a priority teaching point for this family? a. Call the doctor before giving narcotics. b. Administer pain medication at ordered frequency. c. Assess the client's pain level using the pain scale. d. Administer pain medication when the client states the pain is severe. 3.The patient is 8 hours post-transurethral prostatectomy for cancer of the prostate. Which nursing intervention is the priority? a. Control post op pain. b. Assess abdominal dressing. c. Encourage early ambulation to prevent DVT. d. Monitor fluid and electrolyte balance. 4.A 68-year-old client has prostate cancer that has metastasized. When assessing pain levels with this client, the nurse is aware of which of the following? a. Elders experience pain the same as younger people. b. Elders are not as sensitive to pain as younger people. c. Pain levels in elders are elevated. d. Pain levels in elders may be exacerbated by pre-existing conditions. 5.Risk for urinary incontinence is a common nursing diagnosis following prostatectomy. Which of the following assessment data would the nurse need to consider to plan appropriate interventions for this diagnosis? a. Client had a Foley catheter in the past b. Client's previous urinary patterns c. Type of surgery being performed d. Client's pain tolerance Cushing’s/Adrenal Insufficiency 1.1.A client with Cushing’s disease begins to laugh loudly and inappropriately, causing the family in the room to be uncomfortable. What is the nurse’s best response? A.“Don’t mind this. The disease is causing this.” B.“I need to check the client’s cortisol level.” C.“The disease can sometimes affect emotional responses.” D.“Medication is available to help with this.” 2.A nurse is preparing to provide instructions to a client with Addison’s disease regarding diet therapy. The nurse understands that which of the following diets would likely be prescribed for this client? A.Low-protein diet B.Low-sodium diet C.High-sodium diet D.Low-carbohydrate diet 3. In a 28-year-old female client who is being successfully treated for Cushing’s syndrome, the nurse would expect a decline in: A.Serum glucose levels B.Hair loss C.Bone mineralization D.Menstrual flow 4. A client with Addison’s disease is scheduled for discharge after being hospitalized for an adrenal crisis. Which statements by the client would indicate that client teaching has been effective? Select all that apply. A.“I have to take my steroids for 10 days.” B.“I need to weigh myself daily to be sure I don’t eat too many calories.” C.“I need to call my doctor to discuss my steroid needs before I have dental work.” D.“I will call the doctor if I suddenly feel profoundly weak or dizzy.” E.“If I feel like I have the flu, I’ll carry on as usual because this is an expected response.” F.“I need to obtain and wear a Medic Alert bracelet.” 5. A client is admitted to the hospital with Cushing’s syndrome. Which nursing interventions are appropriate for this client? Select all that apply. A.Assess for peripheral edema. B.Stress the need for a high-calorie, high carbohydrate diet. C.Measure intake and output. D.Encourage oral fluid intake. E.Weigh the client daily. F.Instruct the client to avoid foods high in potassium. 6.The nursing instructor asks a student to describe the pathophysiology that occurs in Cushing's disease. Which statement by the student indicates an accurate understanding of this disorder? A."Cushing's disease results from an oversecretion of insulin." B."Cushing's Disease results from an undersecretion of mineralocorticoid hormones" C."Cushing's disease results from an undersecretion of corticotropic hormones" D."Cushing's disease results from an increased pituitary secretion of adenocorticotropic hormone" 7.The nurse is providing discharge instructions to a client who has Cushing's syndrome. Which client statement indicates that instructions related to dietary management are understood? A.I will need to limit the amount of protein in my diet B.I should eat food that have a lot of potassium in them C.I am fortunate that I can eat all the salty foods I enjoy I am fortunate that I do not need to follow any special diet 8.Which of the following nursing implications is most important in a client being medicated for Addison's disease? a. Administer oral forms of the drug with food to minimize its ulcerogenic effect. b. Monitor capillary blood glucose for hypoglycemia in the diabetic client. c. Instruct the client to never abruptly discontinue the medication. d. Teach the client to consume a diet that is high in potassium, low in sodium, and high in protein. 9.To prevent complications in the patient with Cushing syndrome, the nurse monitors the patient for a. hypotension b. hypoglycemia c. cardiac arrhythmias d. decreased cardiac output 10.A client newly diagnosed with Addison's disease is giving a return explanation of teaching done by the primary nurse. Which of the following statements indicates that patient education was effective? Select all that apply A. "I need to increase how much I drink each day." B. "I need to weigh myself if I think I am losing or gaining weight." C. "I need to maintain a diet high in sodium and low in potassium." D. "I need to take my medications each day." Hyper/hypothyroidism 1.The client is diagnosed with hyperthyroidism. Which signs/symptoms should the nurse expect the client to exhibit? (Select all that apply) •A- Complaints of extreme fatigue and hair loss. •B- Exophthalmos and complaints of nervousness. •C- Complaints of profuse sweating and flushed skin. •D- Tetany and complaints of stiffness of the hands Rational: These are the signs of hyperthyroidism 2.•Which nursing intervention should be included in the plan of care for the client diagnosed with hyperthyroidism? •A- Increase the amount of fiber in the diet. •B- Encourage a low-calorie, low-protein diet. •C- Decrease the client's fluid intake to 1,000 mL/day. •D- Provide six small, well-balanced meals a day. 3.•Which statement made by the client makes the nurse suspect the client is experiencing hyperthyroidism? •A- "I just don't seem to have any appetite anymore." •B- "I have a bowel movement about every 3 to 4 days.” • C- "My skin is really becoming dry and coarse." •D- "I have noticed all my collars are getting tighter." 4.•The 68-year-old client diagnosed with hyperthyroidism is being treated with radio active iodine therapy. Which interventions should the nurse discuss with the client? •A- Explain it will take up to a month for symptoms of hyperthyroidism to subside. •B- Teach the iodine therapy will have to be tapered slowly over one (1) week. • C- Discuss the client will have to be hospitalized during the radioactive therapy. •D- Inform the client after therapy the client will not have to take any medication. 5.•The nurse is teaching the client diagnosed with hyperthyroidism. Which information should be taught to the client? Select all that apply. (Select all that apply) •A- Notify the HCP if a three pound weight loss occurs in two days. •B- Discuss ways to cope with the emotional lability. • C- Notify the HCP if taking over-the-counter medication D- Carry a medical identification card or bracelet. •E- Teach how to take thyroid medications correctly. 6.The nurse is preparing the room for the client returning from a thyroidectomy. Which items are important for the nurse to have available for this client? Select all that apply. A.Calcium gluconate A.Emergency tracheotomy kit A.Furosemide (Lasix) A.Hypertonic saline A.Oxygen A.Suction 7.The nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply. A.Insomnia B.Weight loss C.Bradycardia D.Constipation E.Mild heat intolerance 8. The nurse manager for the medical-surgical unit is making staff assignments. Which client will be most appropriate to assign to a newly graduated RN who has completed a 6-week unit orientation? A.Client with chronic hypothyroidism and dementia who takes levothyroxine (Synthroid) daily A.Client with follicular thyroid cancer who has vocal hoarseness and difficulty swallowing A.Client with Graves’ disease who is experiencing increasing anxiety and diaphoresis A.Client with hyperparathyroidism who has just arrived on the unit after a parathyroidectomy 9.A client at the medical clinic is being evaluated for hypothyroidism. For which of these symptoms consistent with hypothyroidism does the nurse assess? Select all that apply. A. Pulse rate below 60 beats per minute B.Agitation and inability to sleep C.Increasing thermostat settings in the home D.Increase in appetite over the last year E.Bizarre or manic behavior 10.Which action does the postanesthesia care unit (PACU) nurse perform first when caring for a client who has just arrived after a total thyroidectomy? A.Assess the wound dressing for bleeding. B.Administer morphine sulfate for pain. C.Monitor oxygen saturation using pulse oximetry. D.Support the head and neck with pillows. Hypertension 1.A patient is diagnosed with primary hypertension. When taking the patient’s history, the healthcare provider anticipates the patient will report which of the following? A.“Every once in awhile I wake up at night covered in sweat” B.“Sometimes I get pain in my lower legs when I take my daily walk” C.“I have not noticed any significant changes in my health” D.“I’m starting to get out of breath when I go up a flight of stairs” 2.A patient is prescribed a calcium channel blocker to treat primary hypertension. When teaching the patient about the medication, which of these foods will the healthcare provider advise the patient to avoid? A.Grapefruit B.Eggs C.Bananas Oranges 3.A patient has been diagnosed with possible white coat hypertension. Which action will the nurse plan to take next? A.Schedule the patient for frequent BP checks in the clinic. B.Instruct the patient about the need to decrease stress levels. C.Tell the patient how to self-monitor and record BPs at home. D.Teach the patient about ambulatory blood pressure monitoring 4.Which nursing action should the nurse take first in order to assist a patient newly diagnosed with stage 1 hypertension in making needed dietary changes? A.Have the patient record dietary intake for 3 days B.Give the patient a detailed list of low-sodium foods. C.Teach the patient about foods that are high in sodium. D.Help the patient make an appointment with a dietician. 5.The nurse is monitoring a client who is taking propranolol. Which assessment finding indicated a potential adverse complication associated with this medication? A.The development of complaints of insomnia B.The development of audible expiratory wheezes C.A baseline blood pressure of 150/80 mm Hg after 2 doses of the medication D.A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of 72 beats/minute after 2 doses of the medication Myocardial infarction 1.You are educating a patient about the causes of a myocardial infarction. Which statement the patient indicates they misunderstood your teaching and requires you to re-educate? A. Coronary artery dissection can happen spontaneously and occurs more in women B. The most common cause of a myocardial infarction is a coronary spasm from illicit drug use or hypertension C. Patients who have coronary artery disease are at high risk for developing a myocardial infarction D. Both A and B are incorrect 2.´Which of the following blood tests is most indicative of cardiac damage? A.Lactate dehydrogenase B.Complete blood count (CBC) C.Troponin I D.Creatine kinase (CK) 3.The nurse is caring for a client diagnosed with a myocardial infarction who is experiencing chest pain. Which interventions should the nurse implement first? Select All that Apply A. Administer morphine sulfate Intramuscularly B. Administer an aspirin orally C. Apply oxygen via nasal cannula D. Place the client in a supine position E. Administer nitroglycerin subcutaneously 4.The intensive care department nurse is assessing the client who is 12 hours post-myocardial infarction. The nurse assesses an S3 heart sound. Which intervention should the nurse implement? A. Notify the health-care provider immediately B. Elevate the head of the client's bed C. Document this as a normal and expected finding D. Administer morphine intravenously 5.The client diagnosed with a myocardial infarction is on bedrest. The unlicensed assistive personnel is encouraging the client to move the legs. Which action should the nurse implement? A. Instruct the UAP to stop encouraging leg movements B. Report this behavior to the charge nurse as soon as possible C. Praise the UAP for encouraging the client to move legs D. Take no action concerning the UAP's behavior •A child with suspected sickle cell disease (SCD) is in the clinic for laboratory studies. The parents ask the nurse what results will tell the physician that their child has SCD. The nurse responds that which of the following is increased in this disease? 1.Hemoglobin 2.Hematocrit 3.Reticulocyte count 4. A child with suspected sickle cell disease (SCD) is in the clinic for laboratory studies. The parents ask the nurse what results will tell the physician that their child has SCD. The nurse responds that which of the following is increased in this disease? Hemoglobin Hematocrit Reticulocyte count platelet levels •A child with suspected sickle cell disease (SCD) is in the clinic for laboratory studies. The parents ask the nurse what results will tell the physician that their child has SCD. The nurse responds that which of the following is increased in this disease? 1.Hemoglobin 2.He3