Finals.docx

1. The nurse performing an assessment of a client notes that the thyroid gland is enlarged. The nurse would chart this finding as A. Goiter B. Fibroma C. Graves disease D. Hyperthyroidism 2. The nurse counseling a client in the prevention of goiter would suggest an increased intake of A. Calcium B. Iodine C. Potassium D. Protein 3. As part of the care plan to meet the needs of a client with myxedema,the nurse would. a A. Setbthe thermostat between 23 degrees celcius and 25 C to provide a comfortable climate B. Suggest the consumption of dense fruit tondecrease diarrhea C. Plan a strenuous exercise regimen to decrease weight D. Apply an astringent to the client's skin to promote dryness 4. In a newly admitted client with thyrotoxicosis, the nurse would plan to address the clinical manifestation of D A. Fluid overload B. Hypothermia C. Respiratory distress D. Tachycardia 5. In a clie with Graves disease receiving radioiodine the nurse would monitor for what common complication A. Hypothyroidism B. Skin breakdown C. Pulmonary emboli D. Urinary tractbinfection

6. PTU is prescribed for a client with Graves disease to decrease circulating thyroid hormone. The nurse should teach the client to immediately report which of the following signs and symptoms A A. Sore throat ans B. Painful excessive menstruation C. Constipation D. Increased urine output 7. Patient Ang Hi Rap was diagnosed with hypothyroidism. All but one of the following management will the nurse provide to the client A. Provide roughage and fluid B. Provide a warm environment C. Low calorie diet D. Administer propanolol to manage tachycardia ans 8. The drug of choice for client diagnosed with hypothyroidism is A. Levothyroxine sodium ans B. Thyroglobulin C. Methimazole D. Prophylthiouracil 9. The client is taking prophylthiouracil. What would be the most important nursing instructions A. Instruct client to report symptoms like B. Instruct the client to the medication with meals to avoid GI upset C. Instruct the client thar he can take the aspirin during episodes of fever. This is the only drug allowed if the client is taking PTU D. Instruct the client to take the medication at the same time each day preferably in yhe morning without food 10. The client is for thyroidectomy. The doctor orders Lugol's solution. What is the rationale of the order: A. To reduce rhe vascularity of thyroid gland ans B. To prevent sudden increase of hormones secreted by the thyroid gland C. To assist in anesthetic purposes

D. To prevent sudden depletion of parathyroid gland hormones 11. The nurse assess the patient who undergone thyroidectomy. Assessment includes muscle spasm, chvostek's sign, trousseau, tingling sensation, diarrhea and deep tendonReflex hyperactivity. The nurse assumes that it is caused by: A. Sudden depletion of T3 and T4 B. A side effects of preoperative medication C. Accidental removal of parathyroid gland ans D. Due to insufficient diet if client containing calcium 12. The client is aware that the diabetic diet comprises of A. CHO 50- 60%, fats:20-30%,CHON 10-20% ans. B. CHO:60-80%, fats: 20-30%,CHON 5-10% C. CHo: 40-50%, fats: 20-40%,CHON 10-20% D. cho: 30-60% fats:10-30%, CHON 5-10% 13. Thw nurse is aware that the classis signs of hyperglycemia include all of the following except: A. Excessive urination B. Excessive hunger C. Excessive thirst D. Excessive sweating ans 14. Which of the following nursing considerations is the most important to consider regarding oral hypoglycemia agents A. Administer in an empty stomach B. Drink plenty of fluids after taking the medication C. Never administer to pregnant mother ans D. Monitor hyperglycemia few hours after taking the medication 15. Kaussmaul's respiration can bw seen in all of the following conditions except A. Hyperglycemia B. Diabetes mellitus C. Diabetes insipidus D. DKA ans

16. The nurse is correct when she verbalized that a decreased secretion of adrenal cortex hormones especially glucocorticoids and mineralocorticoids is known as A. Addison's disease B. Cushing's disease C. Conn's disease D. Pheochromocytoma 17. There are also specific abnormalities regarding hormones released by tha adrenal gland. The client was diagnosed with pheochromocytoma. The nurse is aware that the laboratory test for the client is: A. Percutaneous transrenal test B. Cathecolamine testing C. VMA ans D. Adrenal hormone secretion 18. What is the specimen use for this test? A. Urine ans B. Plasma C. Serum D. Sweat 19. Patient Rey was diagnosed with cushing's disease. Proper assessment should be conducted to allow for proper management. All of the following are assessment findings for client with Cushing's disease except: A. Trunkal obesity B. Moon face C. Buffalo hump D. Weight loss ans 20. Which of the following nursing interventions will the nurse omit for client with Cushing's A. Administer prescribe medications like aminoglutetimide to inhibit adrenal hyperfunctioning B. Prepare client for surgical management pituitary surgery and adrenalectomy C. Provide a low CHO,low Na and high proteIn diet

D. Administer IV glucocorticoids usually hydrocortisone ans 21. The client diagnosed with hyperpituitarism and was scheduled for removal of the pituitary gland when suddenly the patient complains that there. Is seepage of clear fluid from the nose. What would be the best nursing intervention A. Get sample and send it to the lab to check for glucose it might indicate CSF B. Administer glucocorticoid as ordered immediately C. Document findings and inform the charge nurse D. Notify the physician immediately 22. You assess a patient with diabetes insipidus with severe DHN and was rushed to the emergency roon. As a nurse you are aware that the most common drug use for patient with DI Is: A. Vasopressin B. Spironolactone C. Furosemide D. Manitol 23. Nan Lo Ko was diagnosed with hypopituitarism. Which of the ff. Assesment is not related to this disease A. Large hands and feet anns B. Poor development of secondary sex characteristics C. Premature aging D. Retarded physical growth 24. Fluid and electrolyte balance are controlled by hormones in the pituitary gland a disorder in which there is continued release of antidiuretic hormone is: A. Hyperaldosteronism B. SIADH ans C. DI D. Hypopituitarism 25. Due to frequent exposure to stress, a clients with hypothyroidism experiences myxedema coma. The priority management would be A. Administer IVF as prescibe B. Administer IV glucose as prescribe

C. Keep the client warm D. Maintain patent airway 26. Because of decrease hormone secretion and combination of different factors, the client was diagnosed with hypoparathyroidism. The patient will likely manifest all but one A. Tremors B. Polyuria ans C. Chvostek's sign D. Limb muscle spasm situation: An 8 year old boy is admitted in the hospital unconscious due to severe ketoacidosis 27. Thw mother asks the nurse why the child smells like he has been drinking. Thw nurse would explain that the smell is due to the release of: A. Amino acid B. Glycogen C. Acetone D. Urea 28. The nurse has been teaching the parents about insulin. The nurse would judge the teaching about why insulin needs to injected as successful when the father states that the child cannot take the oral insulin because it: A. Can't be digested in the stomach B. Doesn't come in pill form C. Is destroyed in the stomach before it can work ans D. It will cause stomach upset 29. When preparing to give the child his dose of combined regular and NPH humulin insulin, the burse should : A. Premix the insulins in a vial and then withdraw the amount needed in one syringe B. Use two syringes in one for each type of insulin C. Withdraw NPH insulin first then withdraw the regular insulin into one syringe D. Withdraw rhe regular insulin first then wirhdraw the NPH insulin into one syringe 30. The client undergoes a subtotal thyroidectomy. Which of the ff. techniques enable the nurse to assess her wound for bleeding

A. Gently slip a hand behind her neck and check for blood on the back of her neck and on the bed linens B. Carry out a routine dressing change every 2 hours for atleast 12 hours and then every 4 hours for the next 2 days C. Carefully loosen the dressing on both ends and have the client turn her head to one side while observing for bleeding D. Check the BP, pulse and respiratory rate every hour for the first 24 hours 31. The client undergoes a subtotal thyroidectomy. Which of the ff. items should the nurse kept in the bedside A. Equipment to begin a parenteral nutrition B. Cut down tray C. Equipment for tube feeding D. Tracheostomy set 32. Which of the ff. medications should be available to provide emergency treatment for a client who develops tetany after a thyroidectomy: A. Sodium phosphate B. Calcium gluconate C. Echothiopate iodide D. Sodium bicarbonate 33. Patient Rio underwent removal of the thyroid gland signs of laryngeal nerve damage include: A. DOB B. Restlessness C. Frequent swallowing D. Hoarseness 34. The nurse should teach the client to prevent corneal irritation From mild exopthalmos by: A. Massaging the eye at regular intervals B. Instilling an opthalmic anesthetic as ordered C. Wearing dark colored glasses ans D. Covering eyes with moistened gauze pads

35. The nurse asked the client to state her name as soon as she regains consciousness after a subtotal thyroidectomy. The nurse does this primarily to monitor for signs of : A. Internal hemorrhage B. Decreasing level of consciousness C. Laryngeal nerve damage D. Upper airway obstruction 36. A client with DM ask the nurse to recommend something to remove corns from his toes. The nurse should advised him to: A. Apply a high quality corn plaster to the area B. Consult his doctor or podiatrist about removing the corn C. Apply iodine to the corn before peeling them off D. Soak his feet to borax solution to peel off the corn 37. The diabetic client who is taking insulin Lispro humalog injections would be advised to eat: A. Within 10-15 mins after the injection ans B. One hour after injection C. At any time D. 2 hours before the injection 38. The client with type 1 DM is thought to take NPH at 5pm each day. The client should be instructed that the greatest risk for hypoglycemia will occur at what time? A. 11am shortly before lunch B. 1pm shortly after lunch C. 6pm shortly after dinner D. 1am while sleeping ans. 39. During a home visit, a diabetic client cries and says i just cannot stand the thought of having to give myself a shot everyday. Which of the following would be the best response: A. If you do not give yourself an insulin you will die B. We can teach your daughter to give the shot so you will not to do it C. I can arrange to have a home care nurse to give you the shot everyday D. What is it about the insulin shots that bothers you

40. Initial treatment for CSF leak after transphenoidal hypophysectomy would most likely involve? A. Repacking the nose B. Returning the client to surgery C. Enforcing bed rest with HOB elevated ans D. Administering high dose of corticosteroid therapy 41. Which statement should the nurse make when teaching the client about taking oral corticosteroid: A. Take your medication with a full glass of water B. Take your medication on an empty stomach C. Take medication at bed time to increase absorption D. Take your medication with meals or with an antacid ans 42. A client wirt cushing's needs to modify dietary intake to control symptom. In addirion to increasing protein. Which strategy would be most appropriate A. Increase calories B. Restrict Na ans C. Restrict potassium D. Reduce fat to 10% 43. After bilateral adrenalectomy for cushing's disease the physician tells the client That she needs periodic testosterone injections. She asks the nurse what is that for? Did he forget i'm a woman. What is ypur response? A. Testosterone is needed to balance the reproductive cycle B. Testosterone is needed to restore the body's Na and K balance C. Testosterone is given to promote protein anabolism ans D. Testosterone is given to stabilize mood swings 44. The primary feature of pheochromocytoma's effect on blood pressure is A. Systolic hypertension B. Diastolic hypertension C. Hypertension that is resistant to drugs D. Wide pulse pressure

45. The client with pheochromocytoma should be instructed to avoud activitiea that precipitate hypertensive crisis or paroxysms, such as,: A. Jogging B. Valsalva maneuver ans C. Anxiety D. Hypoglycemia 46. Rotating injection sites when administering insulin prevent which of the following complications: A. Insulin edema B. Insulin lipodystrophy C. Insulin resistance D. Systemic allergic reactions 47. A client with DM demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client's anxiety would be to: A. Administer a sedative B. Make sure the client knows all the correct medical terms to understand what is happening C. Ignore the signs and symptoms of anxiety so that they will soon disappear D. Convey empathy, trust and respect towards the client 48. A clinical instructor teaches the class for the public about DM. Which individual does the nurse asses as being at highest risk for developing diabetes: A. The 50 year old client who does not get any physical exercise B. The 56 year old client who drinks three glasses of wine each evening C. The 42 year old who is 50pounds overweight ans D. The 38 year old client who smokes one pack of cigarette per day 49. A male client has just been diagnosed with type 1 DM. When teaching the client and family how diet and exercise affect insulin requirement, nurse Inanggi should include which guideline: A. You will need more insulin when you exercise or increase your food intake ans B. You will need less insulin when you exercise or reduce your food intake C. Ypu will need less insulin when you increase your food intake D. You will need more insulin when you exercise or decrease your food intake

50. At a senior citizens meeting, a burse talks with a client who has type 1 DM. Which statement by the client during the conversation is most predictive of a potential impaired skin integrity? A. I give my insulin to myself in my thighs B. Sometimes when i put my shoes on, i don't know where my toes are ans C. Here are my up and down glucose readings that I wrote on my calendar D. If I bathe more than once a week my skin feels to dry