Sample MedSurg Exam Nursing

8/10/2019 Sample MedSurg Exam Nursing

1/16

1. Glucose is an important molecule in a cell because it is primarily used for:

a. Extraction of energyb. Synthesis of protein

c. Building of genetic materiald. Formation of cell membranes

2. Knoing that gluconeogenesis helps to maintain blood le!els" a nurse should:a. #ocument eight changes because of fatty acid mobili$ationb. E!aluate patient%s sensiti!ity to lo room temperature because of decreased adipose tissue

insulationc. &rotect the patient from the sources of infection because of decreased cellular protein depositsd. #o all of the abo!e

'. (hat is the basic underlying pathology of diabetes mellitus)a. * disruption of the cellular glycolytic pathayb. *n inability of the li!er to cataboli$e glycogenc. * failure to synthesi$e and+or utili$e insulind. *n inhibition of the con!ersion of protein to amino acid

,. * client%s blood gases re-ect diabetic acidosis. he nurse should expect:

a. /ncreased p0b. #ecreased &2

c. /ncreased &2d. #ecreased 0'

3. he loest fasting plasma glucose le!el suggesti!e of a diagnosis of #4 is:

a. 155mg+dlb. 126mg+dl

c. 255mg+dld. 175mg+dl

6. (hich test results should the nurse chec8 to ascertain ho ell the client is managing her diabetes

mellitus o!erall)

a. Blood glucose le!elb. Glucose tolerance test

c. Glycosylated haemoglobind. 9adioimunnoassay of insulin

. * parent as8s the nurse hy home blood glucose monitoring is being recommended for her child

ith diabetes. he nurse should base the explanation on hich of the folloing)a. /t is a less expensi!e method of testingb. /t is an easier method of testingc. hildren are better able to manage the diabetesd. hildren ha!e a greater sense of control o!er the diabetes

7. * client has de!eloped diabetes mellitus type 1 and no longer produces insulin. (hat cells of the

pancreas ha!e become dysfunctional)

a. Beta cellsb. *lpha cells

c. *cinar cellsd. Kup;er cells

ust

ta8e a pill li8e my friend does)? (hich of the folloing statement indicates the client understandsthe nurse%s explanation)a. =4y body does not produce insulin@ therefore / must recei!e the in>ections.?b. =/ ill be on insulin for a short hile" and then / can ta8e the pills.?c. =he pills are not as e;ecti!e as the insulin in>ections.?d. =(hen my body starts ma8ing insulin again" / can stop ta8ing the in>ections.?

15. he mother of an 11 year old child ith /##4 as8s hy her child cannot a!oid all those =shots? and

ta8e pills as her uncle does. (hich of the folloing is the nurse%s best reply)a. =the pills or8 ith an adult pancreas only?b. =the drugs a;ect fat and protein metabolism" not sugar?c. =Aour child needs insulin replaced" and the oral hypoglycemics only add to an existing supply of

insulin?

1


2/16

d. =&erhaps hen your child is older the pancreas ill produce its on insulin" and then your child

can ta8e oral hypoglycemics?11. he nurse 8nos that a client nely diagnosed ith insulindependent diabetes Cype /D ill reuire

further teaching hen hich of the folloing statements is made)a. =/ ill notify my healthcare pro!ider if my glucose le!els run higher or loer than target range.?b. =/ ill ta8e my insulin as prescribed" and / ill not miss a dose.?c. =/ ill not ta8e my insulin if / am sic8 and cannot eat.?

12. #uring a routine chec8up" an insulindependent diabetic has his glycosylated haemoglobin

chec8ed. he results indicate a le!el of 11. Based on this result" hat teaching should the nurse

emphasi$e)

a. 9otation of in>ection sitesb. /nsulin mixing and preparation

c. #aily blood sugar monitoringd. 9egular high protein diet

1'. he nurse is caring for a oman at ' ee8s gestation. he client as diagnosed ith insulin

dependent diabetes mellitus at age . he client states" =/ am so thrilled that / ill be breastfeeding

my baby.? (hich of the folloing responses by the nurse is best)a. =Aou ill probably need less insulin hile you are breastfeeding.?b. =Aou ill need to initially increase your insulin after the baby is born.?c. =Aou ill be able to ta8e an oral hypoglycemic instead of insulin after the baby is born.?d. =Aou ill probably reuire the same dose of insulin than you are no ta8ing.?

1,. linical manifestations associated ith a diagnoses of type 1 #4 include all of the folloing except:

a. 0ypoglycaemiab. 0yponatremia

c. Ketonuriad. &olyphagia

13. (hat is the physiologic basis for the polyuria manifested by indi!iduals ith untreated diabetes

mellitus)a. /nadeuate secretion of antidiuretic hormone C*#0Db. Earlystage renal failure causing a loss of urine concentrating capacityc. hronic stimulation of the detrusor muscle by the 8etone bodies in the urined. 0yper osmolarity of the extracellular -uids secondary to hyperglycemia

16. (hich of the folloing chronic complications is associated ith diabetes)a. #i$$iness" dyspnea on exertion" and coronary artery diseaseb. 9etinopathy" neuropathy" and coronary artery disease

c. eg ulcers" cerebral ischemic e!ents" and pulmonary infarctsd. Fatigue" nausea" !omiting" muscle ea8ness" and cardiac arrythmias

1. linical nursing assessment for a patient ith microangiopathy ho has manifested impaired

peripheral arterial circulation includes all of the folloing except:a. /ntegumentary inspection for the presence of bron spots on the loer extremitiesb. bser!ation for paleness of the loer extremitiesc. bser!ation for blanching of the feet after the legs are ele!ated for 65 secondsd. &alpation for increased pulse !olume in the arteries of the loer extremities

17. * 6year old client ith noninsulin dependent diabetes should be instructed to contact the out

patient clinic immediately if the folloing Hndings are presenta. emperature of '.3 degrees elsius ith painful urinationb. *n open ound on their heelc. /nsomnia and daytime fatigued. Iausea ith 2 episodes of !omiting

1ect

pierced the s8in until later that e!ening. (hat problem does the client most probably ha!e)

a. Iephropathyb. 4acroangiopathy

c. arpal tunnel syndromed. &eripheral neuropathy

25. *t a senior citi$ens meeting" a nurse tal8s ith a client ho has diabetes mellitus type 1. (hich

statement by the client during the con!ersation is most predicti!e of a potential for impaired s8in

integrity)

2


3/16

a. =/ gi!e my insulin to myself in my thighs?b. =Sometimes hen / put my shoes on / don%t 8no here my toes are?c. =0ere are my up and don glucose readings that / rote on my calendar?d. =if / bathe more than once a ee8 my s8in feels too dry?

21. Iurse ina notes that the client has decreased tactile sensation in both feet among one of her

diabetic patients. (hat is the nurse%s best Hrst action)

a. 9e!ie the diet of the patientb. est sensory perception in the client%s

hands

c. Examine the client%s feet for signs of

in>uryd. Encourage insulin in>ections

22. he folloing inter!entions are performed hen an in>ury occurs to the foot of a diabetic clientexcept:

a. (ash the area ith mild soap and

aterb. all health care pro!ider

c. o!er ith a et sterile dressing ith

adhesi!ed. (ear hite cotton soc8s

2'. (hich of the folloing nursing inter!entions should be implemented hen performing foot care to a

patient ith #4)a. /nspect the feet carefully and daily for calluses" corns" blisters" abrasions" redness" and nail

abnormalitiesb. Bathe the feet daily in hot ater

c. Jse lanolin" ni!ea cream" or other cream moisturi$ers especially beteen the toes to pre!entmacerationd. (ear ellHtting" compressi!e shoes and soc8slong enough" ide enough" soft" supple and

highheeled2,. * nurse preparing a teaching plan for a client ith diabetes mellitus regarding proper foot care.

(hich instruction is included in the plan)a. Soa8 feet in hot aterb. *pply moisturi$er lotion to dry feet but not in beteen the toesc. *lays ha!e a podiatrist cut your toenails@ ne!er cut them yourselfd. *!oid using mild soap on the feet

23. Ernest had #4 for 25 years. 0e is admitted to the hospital ith dry gangrene of the right toe. (hen

the nurse is or8ing ith the client" hat information is most important to ascertain)a. 0is age hen #4 de!eloped

b. 0is understanding of hygienic s8in measuresc. 0is techniue in administering insulind. 0is illingness to loo8 at" touch" or tal8 about his gangrene foot

26. (hen assessing a gangrenous toe" the nurse least li8ely expects hich of the folloing)a. /ntense pain in a;ected areab. Extension of the metatarsalc. hanges in s8in temperature of both feetd. 0is illingness to loo8 at" touch" or tal8 about his gangrenous foot

2. he physician orders sodium hypochlorite and boric acid C#a8in%s solutionD for a gangrene lesion

and petroleum >elly for the ad>oining healthy s8in. (hich of the folloing best describes their

actions)a. #a8in%s solution is an antiin-ammatory agent@ petroleum >elly is an antiabsorbent agentb. #a8in%s solution debrides the ound@ petroleum >elly protects the healthy tissue

c. #a8in%s solution dries out the lesion@ petroleum >elly lubricates the surrounding tissued. #a8in%s solution cleanses the ound@ petroleum >elly moisturi$es the s8in

27. 4r. Smith is scheduled for an abo!ethe8nee amputation. *fter the surgery he as transferred tothe nursing care unit. he nurse assigned to him 8nos that 2 hours after the procedure the clientshould be positioned properly to pre!ent contractures. (hich of the folloing is the best position tothe client)a. Sidelying" alternating left and right

sidesb. Sitting in a reclining chair tice a day

c. ying on abdomen se!eral times dailyd. Supine ith stump ele!ated at least '5

degrees2


4/16

b. Ensure that the stump is ele!ated for the initial dayc. (rap the stump snugly in an elastic bandaged. *dminister opioid narcotics as ordered

'5. *n amputee client ill be taught to use crutches until he can manage ith prosthesis

independently. (hich of the folloing crutchal8ing instructions ould be /I99E)a. Extend the arms hile holding eights to strengthen the tricepsb. he crutches should be 16 inches less than the client%s total heightc. he axillary bars on the crutches should support the clients eightd. Ione of the abo!e

'1. he nurse is teaching a client ho is ta8ing insulin about the signs of hyperglycemia. he signs ofhyperglycemia include:

a. Kaussmaul%s breathingb. Excessi!e hunger

c. #ry" -a8y s8ind. 0igh blood pressure

'2. * client ith #4 demonstrates acute anxiety hen Hrst admitted for the treatment of

hyperglycemia. he most appropriate inter!ention to decrease the client%s anxiety ould be to:a. *dminister sedati!eb. 4a8e sure the client 8nos all the correct medical terms to understand hat is happeningc. /gnore the signs and symptoms of anxiety so that they ill soon disappeard. on!ey empathy" trust and respect toard the client

''. 4anifestations of hypoglycaemia include hich of the folloing)

a. ethargyb. onfusion

c. Iausea and !omitingd. Sha8y feeling and di$$iness

',. * client ith ype 1 #4 calls the nurse to report recurrent episodes of hypoglycaemia hile

exercising. (hich statement by the client indicates an inadeuate understanding of the pea8 action

of I&0 insulin and exercise)a. he best time for me to exercise is e!ery afternoonb. he best time for me to exercise is after / eatc. he best time for me to exercise is after brea8fastd. he best time for me to eat is before bedtime

'3. * nurse is caring for a client ith ype #4. hich client complaint ould alert the nurse of the

presence of a possible hypoglycemic reaction)

a. 0ot" dry s8inb. 4uscle cramps

c. *norexiad. remors

'6. 4r. &ar8 is '2yearold" a badminton player and has a type 1 diabetes mellitus. *fter the game" the

client complains of diaphoresis and lightheadedness. he client as8s the nurse ho to a!oid this

reaction. he nurse ill recommend to:a. *llo plenty of time after the insulin in>ection and before beginning the matchb. Eat a carbohydrate snac8 before and during the badminton matchc. #rin8 plenty of -uids before" during" and after bed timed. a8e insulin >ust before starting the badminton match

'. Iurse im is pro!iding dietary instructions to a male client ith hypoglycaemia. o control

hypoglycemic episodes" the nurse should recommend:a. /ncreasing the saturated fat inta8e and fasting in the afternoonb. /ncreasing the inta8e of Litamins B and # and ta8ing iron supplementsc. Eating a candy bar if lightheadedness occursd. onsuming a locarbohydrate" highprotein diet and a!oid fasting

'7. * 26 year old man comes to the emergency room ith complaints of nausea" !omiting" and

abdominal pain. 0e is a ype 1 #iabetic. Four days earlier" he reduced his insulin dose hen -u

symptoms pre!ented him from eating. he nurse performs an assessment of the patient hich

re!eals poor s8in turgor" dry mucous membranes" and fruity breath odor. he nurse should be alert

for hich of the folloing problems)

a. 0ypoglycaemia b. Liral illness

,


5/16

c. Ketoacidosis d. 0yperglycemic hyperosmolar

non8etotic coma

'


6/16

,1. /f the patient%s #K* progresses" hich of the folloing symptoms might the nurse see)a. Kussmaul%s respirations and a fruity odor on the breathb. Shallo respirations and se!ere abdominal painc. #ecreased respirations and increased urine outputd. heynesto8es respirations and foulsmelling urine

,2. * male client has >ust been diagnosed ith #4 ype 1. (hen teaching the client and family ho

diet and exercise a;ect insulin reuirements" Iurse oy should include hich guideline)a. =Aou%ll need more insulin hen you exercise or increase your food inta8e?b. =Aou%ll need less insulin hen you exercise or reduce your food inta8e?

c. =Aou%ll need less insulin hen you increase your food inta8e?d. =Aou%ll need more insulin hen you exercise or decrease your food inta8e?,'. he insulin that ould be administered in patients ith #K* is:

a. 0uman I&0 /nsulinb. 0uman 9egular insulin

c. /nsulin lispro in>ectiond. /nsulin glargine in>ection

,,. (hich instruction about insulin administration should nurse Kate gi!e to a client)e. =*lays follo the same order hen draing the di;erent insulins into the syringe?f. =Sha8e the !ials before ithdraing the insulin?g. =Store unopened !ials of insulin in the free$er at temperatures ell belo free$ing?h. =#iscard the intermediateacting insulin if it appears cloudy?

,3. * nurse pro!ides instructions to a client nely diagnosed ith ype 1 #m. the nurse recogni$es

accurate understanding of measures to pre!ent #K* hen the client states:a. / ill stop ta8ing my insulin if /%m too sic8 to eatb. / ill decrease my insulin dose during times of illnessc. / ill notify my physician if my blood glucose le!el is greater than 235mg+dd. / ill ad>ust my insulin dose according to the le!el of glucose in my urine

,6. (hich of the folloing causes of 00IS is most common)

a. /nsulin o!erdoseb. 9emo!al of adrenal gland

c. Jndiagnosed" untreated

hyperpituitarismd. Jndiagnosed" untreated #4

,. * client is brought to the emergency room in an unresponsi!e state" and a diagnosis of

hyperglycemic hyperosmolar non8etotic syndrome C00ISD is made. he nurse ould prepare

immediately initiate hich of the folloing anticipated physician%s orders)

a. 155 units of I&0 insulinb. Endotracheal intubation

c. /L replacement of sodium bicarbonated. /L infusion of normal saline

,7. * nurse performs physical assessment on a client ith #4 2. Findings include a fasting blood

glucose of 125mg+dl" temperature of 151" pulse of 77" respirations of 22" and a B& of 1,5+75. (hich

Hnding ould be of most concern of the nurse)

a. &ulseb. B&

c. 9espirationd. emperature

,ection siteb. Exercise ithin an hour of administrationc. /n>ect into the muscle instead of subcutaneouslyd. Jsing refrigerated insulin ithout arming it to room temperature

35. 0ypoglycemia folloed by rebound hyperglycemia is seen in:a. Somogyi e;ectb. dan phenomenonc. diabetic 8etoacidosis C#K*Dd. hyperosmolar hyperglycemic non8etosis syndrome C00IKSD

31. (hile examining the oral ca!ity of a client" the nurse detects a fruity odor to the client%s breath. he

nurse should do hich of the folloing)

a. /nstruct to use mouthash after mealsb. /nstruct client on good oral hygiene

c. #ocument the Hnding as the only

actiond Iotify physician


7/16

a. 0uman insulin should only be administered in the umbilical areab. #o not mix human regular insulin ith any other type of insulinc. *d>ustments in insulin timing may be needed ith human insulind. Aou may notice the need to increase the dose to achie!e the same le!el of glucose control

3,. /nsulin forces hich of the folloing electrolytes out of the plasma and into the cells)

a. alciumb. 4agnesium

c. &hosphorusd. &otassium

33. apillary glucose monitoring is being performed e!ery , hours for a female client diagnosed ith

diabetic 8etoacidosis. /nsulin is administered using a scale of regular insulin according to glucose

results. *t 2 pm" the client has a capillary glucose le!el of 235mg+dl for hich he recei!es 7 J of

regular insulin. Iurse harlene should expect the dose%s:

a. nset to be at 2pm and its pea8 at

'pmb. nset to be at 2:13pm and its pea8 to

be at 'pm

c. nset to be at 2:'5pm and its pea8 at

,pmd. nset to be at , pm and its pea8 to be

at 6pm

36. he nurse teaches the diabetic client about I&0 and regular insulin. (hich statement indicates that

the client understood the instructions)

a. =/%ll dra up I&0 insulin Hrst?b. =/ must 8eep the insulin in the

refrigerator?

c. =/%ll dra up the regular insulin Hrst?d. =Exercise ill slo don the

absorption of insulin?

3. he physician orders '6 units of I&0 and 12 units of regular insulin. he nurse plans to administer

these drugs in 1 syringe. /dentify the steps in this procedure by listing them in priority order.1. /n>ect air eual to I&0 dose into I&0 !ial2. /n!ert regular insulin bottle and ithdra regular insulin dose'. /n>ect air eual to regular dose into regular insulin bottle,. /n!ert I&0 !ial and ithdra I&0 dose

a. 12',b. 1,'2

c. 1,2'd. 1'2,

37. 9otation sites for insulin in>ection should be separated from one another by 2.3cm or 1 inch and

should be used only e!ery:

a. hird dayb. (ee8

c. 2' ee8sd. 2, ee8s

3ection sites for insulin)a. ipodystrophy can result and is extremely painfulb. &oor rotation techniue can cause superHcial haemorrhagingc. ipodystrophic areas can result" causing erratic insulin absorption rates from thesed. /n>ection sites can ne!er be reused

65. * client is ta8ing I&0 insulin daily e!ery morning. he nurse instructs the client that the most

common time for a hypoglycemic reaction to occur is:

a. 2 to ,hours after administrationb. , to 12 hours after administration

c. 12 to 16 hours after administrationd. 17 to 2, hours after administration

61. *n 11 year old boy has recently been diagnosed ith diabetes. he nurse%s teaching plan for daily

in>ections should be based on hich of the folloing)a. he parents do not need to learn the procedureb. 0e is old enough to gi!e most of his on in>ectionsc. Selfin>ections ill be possible hen he is closer to adolescence

d. 0e can learn about selfin>ections hen he is able to reach all in>ection sites62. *n external insulin pump is prescribed for a client ith diabetes mellitus. he client as8s Eddie

about the function of the pump. 0e bases the response on the information that the pump:


8/16

6'. * 2'year old patient has history of /##4. he patient ta8es I&0 insulin '5 =u? *4. he nurse

8nos that patients ta8ing I&0 insulin should eat a snac8 at hich of the folloing times of day in

order to a!oid a hypoglycemic reaction)

a. 4idmorningb. 4idafternoon

c. Early e!eningd. Before bedtime

6,. * client nely diagnosed ith #4 has been stabili$ed ith insulin in>ections daily. * nurse prepares

a discharge teaching plan regarding the insulin. he teaching plan should reinforce hich of the

folloing concept)a. /ncrease the amount of insulin prior to unusual exerciseb. *cetone in the urine ill signify a need for insulinc. *lays 8eep insulin !ials refrigeratedd. Systematically rotate insulin in>ection sites

63. he only type of insulin that may be gi!en /L is:

a. rapidactingb. $inc

c. I&0d. 0umalog

66. (hen a patient ith #4 is being treated ith sulfonylurea and uses alcohol" hat reaction ould

you anticipate)

a. Bradycardic episodeb. 0yperglycemic episode

c. Lomiting" di$$inessd. Edema

6. * nurse is preparing a plan of care for a client ith #4 ho has hyperglycemia. he priority nursing

diagnosis ould be:a. 0igh ris8 for deHcient -uid !olumeb. #eHcient 8noledge: disease process and treatmentc. /mbalanced nutrition: less than body reuirementsd. #isabled family coping: compromised

67. (hich among the folloing Hndings ould strongly indicate possible cirrhosis)

a. #ry s8inb. 0epatomegaly

c. &eripheral edemad. &ruritus

6


9/16

6. he physical assessment of a 33yearold female ith endstage cirrhosis re!eals a protuberant

abdomen ith bulging -an8s and dullness to the dependent side hile lying on the right. he

appropriate terminology for documentation of this assessment is:

a. Fluid o!erloadb. 4alnutrition

c. *scitesd. #istention

. he physical assessment Hndings of spider angiomas" palmar erythema" peripheral edema" ascites

and change in mental status are consistent ith hich of the folloing disorders)

a. holelithiasisb. holecystitis

c. irrhosisd. &ancreatitis

7. (hen pro!iding discharge teaching to the client ith chronic cirrhosis" his ife as8s the nurse to

explain hy there is so much emphasis on bleeding precautions. (hich of the folloing pro!ides

the most appropriate response)a. =he li!er a;ected by cirrhosis is unable to produce clotting factors?b. =he lo protein diet ill result in reduced clotting factors?c. =he increased production of bile decreases clotting factors?d. =he reuired medications reduce clotting factors?

aundice and lasts se!eral ee8sd. 0epatitis # has a slo onset

75. (hen explaining the rationale for the use of lactulose ChronulacD syrup to the client ith chroniccirrhosis" the nurse ould use hich of the folloing statements)a. =hronulac syrup reduces constipation" hich is a freuent complaint ith cirrhosis?b. =hronulac syrup suppresses the metabolism of ammonia and aids in its elimination through the

feces?c. =hronulac syrup helps re!erse cirrhosis of the li!er?d. =hronulac syrup can be ta8en intermittently to reduce side e;ects?

71. * client is admitted ith possible li!er cancer. (hich of the tests belo ould be the most

conHrming diagnosis)

a. *bdominal ultrasoundb. *bdominal -at plate Nray

c. *lphafetoprotein mar8ersd. omputed tomography CD scan

Situation: Iurse Ielly is assessing 4r. Shic8 ho is in the early stages of cirrhosis of the li!er.

72. (hich early sign ould Iurse Ielly anticipates Hnding)

a. &eripheral edemab. *scites

c. *norexiad. aundice

7'. (hat diet should be implemented for 4r. Shic8 ho is in the early stages of cirrhosis)

a. 0igh calorie" high carbohydrateb. 0igh protein" lo fat

c. o fat" lo proteind. 0igh carbohydrate" lo sodium

7,. 4r. Shic8 complains that his s8in alays feels itchy and that he =scratches himself ra? hile he

sleeps. Iurse Ielly should recogni$e that the itching is the result of hich abnormality associated

ith cirrhosis)

a. Folic acid deHciencyb. &rolonged prothrombin time

c. /ncreased bilirubin le!eld. 0ypo8alemia

73. Fe days after" 4r. Shic8 is de!eloping ascites. Iurse Ielly should recogni$e that the pathologic

basis for the de!elopment of ascites in clients ith cirrhosis is portal hypertension and:

a. an excess serum Ia le!elb. an increased metabolism of aldosterone

c. a decreased -o of hepatic lymphd. a decreased serum albumin le!el

76. (hich of the folloing health promotion acti!ities ould be appropriate for Iurse Ielly to suggest

to his client add to the daily routine at home)

a. Supplement the diet ith multi!itaminsb. imit daily alcohol inta8e

c. a8e a sleeping pill at bedtimed. imit contact ith people

Situation: Iurse 9ihanna together ith her colleagues at San a$aro 0ospital is conducting a community

education on ho to pre!ent the transmission of hepatitis.

7. (hich of the folloing types of hepatitis is considered to be primarily a sexually transmitteddisease)

a. 0epatitis * c. 0epatitis


10/16

c. *ssigning the client in a pri!ate room d. (earing glo!es hen gi!ing direct care


11/16

=9ecipe for success: Study hile others are sleeping@ or8 hile others are loaHng@ prepare hile others

are playing@ and dream hile others are ishing.? (illiam *. (ard

1. * client admitted ith pheochromocytoma. he nurse assesses the client%s blood pressure

freuently. his is based on the 8noledge that pheochromocytoma of the adrenal medulla releases

excessi!e amounts of:


12/16

d. administering Badrenergic bloc8ing agents'. * nurse is caring for a client ith pheochromocytoma. he client as8s for a snac8 and something

arm to drin8. he most appropriate choice for this client to meet nutritional need ould be hich

of the folloing)a. Graham crac8ers and arm mil8b. oast ith peanut butter and cocoac. rac8ers ith cheese and tead. Lanilla afers and co;ee ith cream and sugar

,. he folloing inter!entions are implemented for a patient ith &heochromocytoma to reduce

anxiety except:a. 9emain ith the patient during acute episodes of hypertensionb. Ensure bed rest and ele!ate head of bed at ,3degree angle during se!er hypertensionc. /nstruct patient about use of sedati!es and relaxation exercisesd. 9educe en!ironmental stressors by pro!iding a calm" uiet en!ironment" restrict !isitors

3. * catecholaminesecreting neoplasm associated ith hyperfunction of the adrenal medulla. /t may

appear here!er chromaMn cells are located@ most are found in the adrenal medulla

a. *ddison%s diseaseb. ushing%s syndrome

c. &rimary aldosteronismd. &heochromocytoma

6. he nurse is performing an admission assessment on a client admitted ith a diagnosis of

pheochromocytoma. he nurse assesses for ma>or symptoms associated ith pheochromocytoma

hen the nurse:

a. ests the client%s urine for glucoseb. btains the client%s eight

c. &alpates the s8in for its temperatured. a8es the client%s blood pressure

. he primary feature of pheochromocytoma%s e;ect on blood pressure is:a. Systolic hypertensionb. #iastolic hypertensionc. 0ypertension that is resistant to treatment ith drugsd. (idening pulse pressure

7. &riority nursing management of the client ith pheochromocytoma ould include hich of the

folloing)

a. 4onitoring blood pressureb. 4onitoring urine output

c. 4onitoring neurological statusd. 4onitoring serum glucose le!els


13/16

d. esting the patient%s gag and sallo re-ex13. o maintain s8in integrity of a patient ith hyperthyroidism" the folloing nursing inter!entions

should be instituted except:a. *ssess s8in freuently to detect diaphoresisb. Bathe freuently ith cool ater@ change linens hen dampc. Jse soap to pre!ent drying and use lubricant s8in lotions o!er pressure pointsd. &rotect and relie!e pressure from bony prominences hile immobili$ed or hile hypothermia

blan8et is used16. he doctor prescribed an antithyroid drug hich ould be:

a. ytomelb. apa$ole

c. Synthroidd. agamet

1. (hich of the folloing are possible actions of thyroid hormones)

a. decreases potency of anticoagulantsb. increases the e;ecti!eness of digitalis

c. increases potency of anticoagulantsd. antiin-ammatory e;ect

17. * selflimiting" painful in-ammation of the thyroid gland" usually associated ith !iral infections is:

a. 0ashimoto%s thyroiditisb. ymphocytic thyroiditis

c. hronicprogressi!e thyroiditisd. Subacute thyroiditis

1


14/16

2ust doesn%t taste good ithout a lot of

salt?d. / am alays tired" e!en hen / get 15 or 12

hours of sleep?

'2. (hich medication should the nurse be prepared to administer to a client ith bradycardia as a

result of hypothyroidism)

a. *tropine sulfateb. e!othyroxine sodium

c. &ropranolold. Epinephrine

''. * client ith exophthalmos as a result of Gra!es% disease has expressed a desire for themedications to =hurry up and or8 so that my eyes ill go don?. he nurse%s response to the

client ill be based on hich of the folloing)a. 9e!ersal of exophthalmos occurs after a therapeutic le!el of the antithyroid medication is

achie!ed.b. 9e!ersal of exophthalmos occurs after treatment ith ophthalmic medications.c. hanges in the eyes as a result of Gra!es% disease are not re!ersible" e!en after treatment of

the disease.d. Exopthalmos as a result of Gra!es% disease is only a temporary symptom" and should resol!e

spontaneously.',. * client is returning from a subtotal thyroidectomy for the treatment of hyperthyroidism. he

immediate priority in assessing this client ould include hich of the folloing)

a. *ssess for respiratory distressb. *sses -uid !olume status c. *ssess neurological statusd. *ssess for pain

'3. #ischarge teaching for the client ith hypoparathyroidism should include hich of the folloing

instructions:

a. use !itamin # preparationb. a!oid strenuous ex ercisesc. supplement calcium inta8e

d. a!oid diuretics to minimi$e calcium

loss

'6. * patient is admitted to the Endocrine unit. he patient states that he has recently lost 13 lbs o!er

to and onehalf months" although there has been no change in his eating habits" and if anything"

his appetite has increased. he patient also complains of palpitations" and says that his =eyes loo8

li8e they are going to pop out?. Based on this data" the nurse can infer that this patient is most

li8ely exhibiting symptoms of:

a. 0yperparathyroidismb. 0yperthyroidism

c. 0ypothyroidismd. *ddisonian crisis

'. (hen caring for client in thyroid crisis" the nurse ould uestion an order for:

a. /L -uidb. &ropanolol C/nderalD

c. &rophylthiouracild. * hyperthermia blan8et

'7. * client is suspected to de!elop tetany after subtotal thyroidectomy. (hich of the folloing

symptoms might indicate tetany)

a. ingling in the Hngersb. &ain in the hands and feet

c. ension on the suture linesd. Bleeding on the bac8 of the dressing

'


15/16

a. (arm the clientb. *dminister -uid replacement

c. 4aintain oxygenationd. *dminister thyroid hormone

,2. he client ith hyperthyroid symptoms is ha!ing hormone studies done to conHrm the diagnosis.

(hich set of !alues indicates nonGra!e%s disease hyperthyroidism)a. Ele!ated '" ele!ated ," high S0 le!elsb. Ele!ated '" normal ," lo S0 le!elsc. Ele!ated '" lo ," lo S0 le!elsd. o '" normal ," high S0 le!els

,'. (hat is the priority nursing diagnosis for the client nely diagnosed ith hyperthyroidism)a. #ecreased cardiac output related to tachycardiab. #isturbed body image related to eight lossc. 0yperthermia related to hypermetabolismd. Fatigue related to energy depletion

,,. he nurse is caring for a ,3 year old patient ho had a thyroidectomy 12 hours ago for treatment of

Gra!e%s disease. he nurse ould be most concerned if hich of the folloing as obser!ed)a. B& of 1,5+75 mm0g@ 99 of 16cpm@ ral emp of


16/16

35. Aou see 4rs. #i$on in the clinic. She is ,3 years old ith a history of hypothyroidism and has been

treated ith thyroxine 5.13mg daily. From your assessment of hypothyroidism" the folloing

nursing inter!entions are included except:a. Encourage to increase -uid inta8eb. 9ecommend lo residue dietc. Encourage increased mobility ithin the patient%s exercise toleranced. 4onitor boel function by recording freuency and consistency of stool

31. /nstructions gi!en to 4rs. #i$on include the folloing except:a. he need to recei!e antithyroid therapy for the duration of her life

b. 0o and hen to ta8e medicationsc. Signs and symptoms of insuMcient and excessi!e medications" reinforce teaching by pro!iding

ritten instructionsd. Energy conser!ation techniues and the need to increase acti!ity

32.

Documents

Sample MedSurg Exam Nursing