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    Exam Review

    1. The client is admitted to the intensive care department diagnosed with myxedema coma. Which assessement data warrant immediate intervention by the nurse?
      A)Pulse oximeter reading 96%
      B)Serum blood glucose level of 74 mg/dL
      C)The client is lethargic and sleeps all the time
      D)Telemetry reading showing sinus bradycardia
    2. A client newly diagnosed with type 2 diabetes mellitus has a nursing diagnosis of Knowledge deficit: diabetes, medical regimen, diet, exercise, and self-care management skills. Which nursing goal is appropriate for this client?
      A)to use the food pyramid for meal planning
      B)to relate importance of an exercise program
      C)to maintain current weight
      D)to maintain vital signs within normal limits
    3. A nurse is in a provider's office is reviewing the health record of a client who is being evaluated for Grave's disease. Which of the following is an expected laboratory finding for this client?
      A)Decreased free thyroxine index
      B)Decreased thyroid stimulating hormone
      C)Decreased triiodothyronine
      D)Decreased thyrotropin receptor antibodies
    4. The nurse is developing a care plan for the client diagnosed with type 1 diabetes. The nurse identifies the problem "high risk for hyperglycemia related to noncompliance with the medication regimen." Which statement is an appropriate short-term goal for the client?
      A)The nurse will monitor the client's blood glucose levels four (4) times a day.
      B)The client will demonstrate appropriate insulin injection techniques
      C)The client will maintain normal kidney function with 30-ml/hr urine output.
      D)The client will have a blood glucose level between 60-110 mg/dl at 1600.
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    Exam Review

    1. The nurse should instruct clients with diabetes about "sick day management" of their disease by emphasizing which action?
      A)Use sliding scale insulin to manage hypoglycemia.
      B)Continue taking the scheduled insulin or oral hypoglycemic agent.
      C)Increase intake of carbohydrates for the duration of the illness.
      D)Report blood glucose lower than 100 mg/dL to the health care provider.
    2. The physician orders erythromycin 1 g in 100 mL of D5W to infuse in 30 minutes. Calculate the flow rate in milliliters per hour. _____________ (LABEL CORRECTLY TO RECEIVE CREDIT: DO NOT USE SPACES IN YOUR ANSWER, I.e. 33mL/hr)
    3. A nurse has provided diabetic teaching with the family of a client newly diagnosed with diabetes. The nurse determines that the family understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat
      A)Hyperglycemia occurring on "sick days"
      B)Diabetic ketoacidosis
      C)Hyperglycemia from insufficient insulin
      D)Hypoglycemia from insulin overdose
    4. Which signs/symptoms should make the nurse suspect the client is experiencing a thyroid storm?
      A)Hypotension and bradycardia
      B)Decreased respirations and hypoxia
      C)Obstipation and hypoactive bowel sounds
      D)Hyperpyrexia and extreme tachycardia
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    Exam Review

    1. A patient is admitted with a subtotal thyroidectomy. She is returned to the surgical unit after a short stay in the post anesthesia care unit. She is receiving fluids intravenously. When this patient has completely recovered from anesthesia, and her vital signs are stable, which position would be most appropriate for her?
      A)Fowler's
      B)Trendelenburg
      C)Supine
      D)Prone
    2. A patient with type 1 diabetes is prescribed a sliding scale insulin regimen using regular insulin before meals. The sliding scale is as follows: Blood glucose 150-199 mg/dL: 2 units Blood glucose 200-249 mg/dL: 4 units Blood glucose 250-299 mg/dL: 6 units Blood glucose 300-349 mg/dL: 8 units Blood glucose >350 mg/dL: Call provider The patient's blood glucose before lunch is 278 mg/dL. The patient is also prescribed 0.1 units/kg of insulin glargine (Lantus) once daily. The patient weighs 70 kg. How many total units of insulin should the nurse administer at this time? (LABEL CORRECTLY: NO SPACES IN ANSWER)
    3. The nurse is caring for a client with an autoimmune disease characterized by the production of antibodies that destroy essential enzymes needed for the production of T 3 and T4. This nurse is aware that this client is experiencing:
      A)hyperthyroidism
      B)hypothyroidism
      C)cretinism
      D)Hashimoto's thyroiditis
    4. A patient is newly diagnosed with type 1 diabetes mellitus. How should the nurse respond when the patient asks how long the insulin injections will be necessary?
      A)"You may be able to stop the injections if you exercise regularly and adhere to the prescribed diet."
      B)"Once your pancreas recovers, you may be able to discontinue the injections."
      C)"If you follow your diet closely, your blood sugar may be controlled by just taking insulin pills."
      D)"You will need insulin injections for the rest of your life."
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    Exam Review

    1. A nurse is reinforcing teaching with a client who is scheduled for a blood test to measure her thyroid-stimulating hormone (TSH) level. Which of the following statements should the nurse give?
      A)"This test detects antithyroid antibodies in your blood."
      B)"This test measures the amount of thyroid hormone that attaches to a protein in your blood."
      C)"This test measures the absorption of iodine and how it relates to the thyroid gland."
      D)"The test determines whether your thyroid gland is overactive, appropriately active, or underactive."
    2. Case Study Exhibits What is the expected therapeutic effect of radioactive lodine therapy in hyperthyroidism?
      A)Increase TSH levels
      B)Prevent thyroid cancer
      C)Destroy overactive thyroid tissue
      D)Stimulate thyroid hormone production
    3. A client has flushed skin, bulging eyes and perspiration, and states that he has been "irritable" and having palpitations. The nurse interprets these findings as suggesting:
      A)Hypoparathyroidism
      B)Cushing's Disease
      C)Hypothyroidism
      D)Hyperthyroidism
    4. The school nurse notices that a 14-year old who used to be an excellent student and very active in sports is losing weight, acting very nervous and wide bulging eyes. The teen was recently checked by the primary care provider (PCP), who noted the teen had a very low level of TSH. The nurse recognizes that the teen has which condition?
      A)Hypothyroidism
      B)Juvenile autoimmune thyroiditis
      C)Hashimoto thyroid disease
      D)Graves Disease
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    Exam Review

    1. The physician gives orders to infuse 1000 mL 0.9% NS at 200 mL/h for dehydration. Tubing drop factor is 10 gtt/mL. Calculate the flow rate in drops per minute. ______________ (LABEL CORRECTLY: DO NOT USE SPACES TO ANSWER. i.e. 24gtts/min)
    2. A client tells the nurse about experiencing symptoms of a hypoglycemic insulin reaction. Which action should the nurse take FIRST?
      A)Give the client juice or hard candy immediately.
      B)Call the health care provider.
      C)Have the client lie down and see if symptoms subside.
      D)Assess the blood glucose level, and administer glucose in the most appropriate form.
    3. Case Study #2 Patient Name: Jacob M. Age: 17 Diagnosis: Type 1 Diabetes Mellitus (T1DM) History: Diagnosed at age 10, uses insulin pump therapy, active in sports Situation: Jacob is brought to the emergency department by his coach after collapsing during basketball practice. He is unconscious, diaphoretic, and unresponsive to verbal stimuli. A bedside glucose check reveals a blood sugar of 28 mg/dL. The nurse prepares to administer glucagon 1 mg IM per emergency protocol. Which of the following best explains why oral glucose is not appropriate for Jacob at this time?
      A)He has already received insulin
      B)Oral glucose is too slow to act
      C)He is unconscious and at risk for aspiration
      D)He is allergic to glucose
    4. While assessing a client with Graves' disease, the nurse notes that the client's temperature has risen 1° F. Which action should the nurse take first?
      A)Turn the lights down and shut the client's door.
      B)Call for an immediate electrocardiogram (ECG)
      C)Administer a dose of acetaminophen
      D)Calculate the client's apical-radial pulse deficit
    Page 5 of 19

    Exam Review

    1. A nurse is caring for a client who is postoperative following a thyroidectomy. Which of the following is a priority for the nurse to monitor during the first 24 hr of care for this client?
      A)visual deficits
      B)hoarseness
      C)pain control
      D)airway patency
    2. Case Study #2 Patient Name: Jacob M. Age: 17 Diagnosis: Type 1 Diabetes Mellitus (T1DM) History: Diagnosed at age 10, uses insulin pump therapy, active in sports Situation: Jacob is brought to the emergency department by his coach after collapsing during basketball practice. He is unconscious, diaphoretic, and unresponsive to verbal stimuli. A bedside glucose check reveals a blood sugar of 28 mg/dL. VS are temp. 97 F, HR 112, RR 12, BP 104/48, 02 sat 96%. The nurse prepares to administer 1 mg of glucagon IM as per the emergency protocol. After administering glucagon, what is the nurse's next priority action?
      A)Turn the patient on his side
      B)Administer a second dose of glucagon
      C)Prepare for intubation
      D)Give a high-protein snack
    3. The home care nurse visits a client with a diagnosis of hyperparathyroidism who is taking furosemide and provides dietary instructions to the client. Which statement by the client indicates a need for additional instruction?
      A)"I need to increase my intake of dietary items that are high in calcium."
      B)"I need to eat foods high in potassium."
      C)"I need to eat small, frequent meals and snacks if nauseated."
      D)"I need to drink at least 2 to 3 L of fluid daily."
    4. The physician orders a 1,800-calorie diabetic diet and 40 units of Humulin N insulin (an intermediate-acting insulin) administered subcutaneously @ 0700 for a patient with diabetes mellitus. A mid-afternoon snack of milk and crackers is given to
      A)prevent diabetic coma
      B)improve nutrition
      C)improve carbohydrate metabolism
      D)prevent an insulin reaction
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