MDCII FINAL EXAM STUDYGUIDE 2024 ACTUAL EXAM COMPLETE QUESTIONS WITH DETAILED VERIFIED AN, Exams of Medicine

Download MDCII FINAL EXAM STUDYGUIDE 2024 ACTUAL EXAM COMPLETE QUESTIONS WITH DETAILED VERIFIED AN and more Exams Medicine in PDF only on Docsity! MDCII FINAL EXAM STUDYGUIDE 2024 ACTUAL EXAM COMPLETE QUESTIONS WITH DETAILED VERIFIED ANSWERS (100% CORRECT ANSWERS) ALREADY GRADED A+ A client with a BG of over 500 states he is always thirty and voiding. How would you describe this subjective finding? - ....ANSWER >>>>polydipsia and polyuria Fatigue, muscle stiffness, and decreased T3 and T4 may indicate - ....ANSWER >>>>hypothyroidism A patient presents with bright red blood in their stool what lab test would you expect to be ordered? - ....ANSWER >>>>CBC A patient presents with black tarry stool what lab test would you expect to be ordered? - ....ANSWER >>>>hgb and hct A spanish speaking patient comes to the ED in tears what is the appropriate intervention? - ....ANSWER >>>>get an interpreter What diagnostic test is used to confirm placement of an NG tube? - ....ANSWER >>>>Abdominal xray or KUB A patient is post op day one with no bowel sounds and not passing gas, what is suspected? - ....ANSWER >>>>non mechanical bowel obstruction A patient presents with cramping, bloating, diarrhea and constipation what would you expect she is suffering from? - ....ANSWER >>>>IBS Which would not be included in education for a diabetic patient ? - ....ANSWER >>>>fluid restriction A patient is diagnosed with thyroid cancer what lab value would be expected? - ....ANSWER >>>>increased thyroglobulin A patient with a BS of 350 is suffering from - ....ANSWER >>>>DKA A patient has a BG of 45 what intervention would you expect to be ordered - ....ANSWER >>>>D50 IV A patient had a thyroidectomy what lab value do you need to monitor post operatively ? - ....ANSWER >>>>calcium A patient is taking steroids what education is appropriate? - ....ANSWER >>>>you will be weaned off them Your caring for a patient with chronic hypercortisolism, what is most important? - ....ANSWER >>>>washing your hands A patient has a 20 year history of diabetes what is an important assessment - ....ANSWER >>>>inspect the patients feet for injury A patient with hyperthyroidism has which of the following lab values? - ....ANSWER >>>>increased t3 what is the main assessment of hypothyroidism - ....ANSWER >>>>cold intolerance Age related changes of the endocrine system result in - ....ANSWER >>>>decreased thyroid hormones Which endocrine organs are located on top of the kidneys - ....ANSWER >>>>adrenal glands The parathryoid glands are located where? - ....ANSWER >>>>posterior thyroid glands A patient with a BG of 800 is suffering from? - ....ANSWER >>>>HHS A patient states she takes several naps a day what is suspected? - ....ANSWER >>>>hypothyroid A patient with hypoparathyroid should avoid what food? - ....ANSWER >>>>milk A patient is newly diagnosed diabetic what statement shows understanding of the disorder - ....ANSWER >>>>I'm going to exercise daily with my coworker A patient was just diagnosed with type 1 diabetes what statement demonstrates A patient with hepatitis B should share razors with family members - ....ANSWER >>>>False Which statement indicates the need for further education for a patient with anorexia nervosa? - ....ANSWER >>>>If constipated I will buy an OTC laxative Low blood pressure is the biggest concern with dehydration - ....ANSWER >>>>True Which electrolyte would we monitor for a patient with a parathyroidectomy - ....ANSWER >>>>calcium We would assess cardiac function in a patient with low potassium - ....ANSWER >>>>True A patient with pancreatitis would not be NPO - ....ANSWER >>>>False We would monitor pain and lab values in a patient with cirrhosis of the liver - ....ANSWER >>>>True What is a common age-related change in the endocrine system of older adults? - ....ANSWER >>>>Thyroid hormone levels decrease What type of diabetes is associated with an autoimmune destruction of plasma beta cells? - ....ANSWER >>>>Type I diabetes A nurse is caring for a client recently diagnosed with Addison's disease. Which of the following s/s are consistent with this diagnosis? - ....ANSWER >>>>Hypotension What nursing intervention helps to prevent adrenocortical insufficiency? (Addison's disease) - ....ANSWER >>>>Reducing high-dose steroid therapy gradually 37 year old male presented with weight loss, bloating, and bruising. Client's stool test and hydrogen breath tests were positive. What condition is this - ....ANSWER >>>>malabsorption syndrome What discharge interventions are important for a hispanic client who was recently diagnosed with type II diabetes? - ....ANSWER >>>>- provide written instructions in spanish -consult the dietician to instruct in dietary restriction -consult diabetes educator -conduct a cultural assessment What food should a client with cholelithiasis avoid? - ....ANSWER >>>>french fries-fried good can aggravate pain and discomfort What lab result will validate a client diagnosed with thyroid cancer? - ....ANSWER >>>>Increased serum thyroglobulin (TG) level What signs and symptoms are consistent with prolonged cortisol therapy? - ....ANSWER >>>>weight gain and moon face What symptoms are associated with diabetic ketoacidosis? 3 - ....ANSWER >>>>-altered mental status -fruity breath odor -kussmaul respirations What are increased serum T3 and T4 levels associated with? - ....ANSWER >>>>Hyperthyroidism Patient with hep b is learning about discharge instructions, is sharing razors with the spouse show an understanding? - ....ANSWER >>>>no A patient with colon cancer would have an elevated ? - ....ANSWER >>>>CEA Which of the following labs would be most important for a nurse to monitor for a patient DX with lower GI bleed? - ....ANSWER >>>>Hemoglobin and hematocrit Myxedema coma is related to which poorly treated condition? - ....ANSWER >>>>Hypothyroidism Heat intolerance is often associated with the DX of - ....ANSWER >>>>Hyperthyroidism Reducing high-dose steroid therapy gradually helps to prevent - ....ANSWER >>>>Adrenocortical insufficiency A nurse is educating a diabetic client about proper foot care. Which of the following is correct - ....ANSWER >>>>Moisturizing cream after bathing but not in between toes A common finding in a client with Cushing's Syndrome includes - ....ANSWER >>>>Hypertension Which of the following indicates a therapeutic response to hydrocortisone for Addisonian crisis? - ....ANSWER >>>>Client becomes alert and oriented with decreased fatigue Weight gain and moon face can be associated with prolonged use of which medications? - ....ANSWER >>>>Cortisol therapy Labs that indicate a patients diabetes mellitus is well controlled - ....ANSWER >>>>Fasting glucose of 88 and A1C of 6 A GN is caring for a young child with appendicitis. Which of the following would be contraindicated? - ....ANSWER >>>>Increasing comfort by using a low heat heating pad A client with diverticulitis is now having increased abdominal pain. What do you suspect? - ....ANSWER >>>>Gastrointestinal perforation A client is post op day two following a colon resection. What are common S/S seen with peritonitis? - ....ANSWER >>>>Fever, elevated HR and hypotension Which lab value would indicate inappropriate antidiuretic hormone secretion? - ....ANSWER >>>>Decreased serum sodium A client is suspected to be in DKA. Which medication do you anticipate using IV to treat this patient? - ....ANSWER >>>>Regular insulin A young male is recently diagnosed with pancreatitis has severe pain. What are the best treatment options? - ....ANSWER >>>>IV fluids and NPO Nursing interventions for a newly diagnosed anorectal abscess - ....ANSWER >>>>pain management and sitz bath A nurse has an order for metformin 1g BID. Available is 500 MG. How many tablets should the nurse administer? - ....ANSWER >>>>2 Which finding requires urgent attention following an ileostomy placement? - ....ANSWER >>>>bluish stoma What is a common lab associated with Cushing's disease? - ....ANSWER >>>>Elevated urine cortisol level A client is scheduled for an ileostomy. What should this client be aware of following surgery? - ....ANSWER >>>>You will have to wear a collection device at all times Major concern with severe diarrhea includes - ....ANSWER >>>>electrolyte and fluid loss A patient who is dizzy and sweaty and is taking glyburide should be assessed first on a med surg unit? T or F - ....ANSWER >>>>True A client has fatigue, poor memory, stiff muscles, elevated TSH, low T3 and T4. What is this patient showing? - ....ANSWER >>>>Hypothyroidism Pt with DM, what would the nurse include in the patients plan of care to delay the onset of microvasular and macrovascular complications? - ....ANSWER >>>>Maintain tight glycemic control and prevent hyperglycemia What gland is the master gland? - ....ANSWER >>>>pituitary gland What order would be expected for a patient with diverticulitis? - ....ANSWER >>>>stool softener to prevent constipation which would lead to further complication Education for a patient diagnosed with irritable bowel syndrome? - ....ANSWER >>>>-Modify diet -stress reduction -adhere to prescribed medications What is a life threatening emergency and serious complication of untreated or poorly treated hypothyroidism? - ....ANSWER >>>>myxedema coma What does the nurse expect to find when assessing a client with Cushing's syndrome? - ....ANSWER >>>>hypertension A nurse is reviewing the orders for a client who has a new diagnosis of a small bowel obstruction. The nurse should question / withhold which of the following orders? - ....ANSWER >>>>oral medications A nurse is caring for a client who has been admitted for an exacerbation of Crohn's disease. A nasogastric (NG) tube has been placed and is to suction, and the client is currently receiving infusion of total parenteral nutrition via peripherally inserted central catheter (PICC) line. Which of the following actions should the nurse take? - ....ANSWER >>>>Monitor laboratory values and assess for abnormal respiratory or cardiac functioning. A nurse is caring for a client who presented with bright red rectal bleeding. The client had three bowel movement since his arrival two hour ago. You confirm visible blood in the stool. Which of the following diagnostic tests is needed? - ....ANSWER >>>>Complete blood count An older adult client reports lack of energy and needing several naps throughout the day. Which problem may these symptoms be associated with that is often seen in older adult? - ....ANSWER >>>>hypothyroidism A nurse is caring for a client who recently underwent a colon resection. The client has nasogastric (NG) tube to low intermittent suction. The client complaining of increasing abdominal pain. Which nursing intervention will the nurse perform first? - ....ANSWER >>>>auscultate bowel sounds A client asks the nurse when they can expect to feel improvement after starting a prescription Which of the following is a hallmark assessment finding in a client with hyperthyroidism? - ....ANSWER >>>>heat intolerance Th laboratory values of a client who has diabetes mellitus include fasting blood glucose level of 212 mg/dL and hemoglobin A1C of 5.9%. What is the nurse's interpretations of these findings? - ....ANSWER >>>>The client's glucose control for the past 24 hours has been poor, but the overall control is good A nurse is caring for a client recently diagnosed with cirrhosis. Which of the following are appropriate nursing interventions for this client? - ....ANSWER >>>>Pain management Monitor lab values The client has been diagnosed with syndrome of inappropriate antidiuretic hormone secretion. Which of the following lab values validate the diagnosis? - ....ANSWER >>>>Decreased serum sodium. A nurse is caring for a 57-year-old client who was recently diagnosed with Cushing's disease. Which of the following lab tests validate the diagnosis? - ....ANSWER >>>>Elevated urine cortisol level A client with diabetes has a blood glucose of 640 mg/dL and reports always being thirsty and having to void. The nurse knows that which terms describe this subjective finding? - ....ANSWER >>>>Polydipsia and polyuria A 56-year-old male who was recently diagnosed with Type 2 diabetes. Which of the following diagnostic tests would correlate with this diagnosis? - ....ANSWER >>>>-Increased Hemoglobin A1C level -Increased random blood glucose. -Increased fasting blood glucose. A nurse is caring for a 26-year-old female that presented to the emergency department with abdominal pain, bloating, constipation and... of diarrhea. Which of the following is the client most likely exhibiting? - ....ANSWER >>>>Irritable bowel syndrome A nurse is caring for a client who recently underwent a colon resection for colorectal cancer. The client is post-op day two and develops a fever. temperature 102, HR: 126, BP 100/50. The client is complaining of increased pain and abdomen is rigid. Based on this information, which of the following conditions is the client exhibiting? - ....ANSWER >>>>peritonitis being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to be given intravenously to treat this client? - ....ANSWER >>>>regular insulin A nurse is caring for a client recently diagnosed with diabetes with diabetes insipidus. Which of the following medications would be appropriate for this disorder? - ....ANSWER >>>>desmopressin A nurse is educating a client about genetic screening. The client asks why red-green color blindness, an X-linked recessive disorder noted in some of her family members, is expressed more frequently in males than females. How should the nurse respond? A. "Females have a decreased penetrance rate for this gene mutation and are therefore less likely to express the trait." B. "Females have two X chromosomes and one is always inactive. This inactivity decreases the effect of the gene." C. "The incidence of X-linked recessive disorders is higher in males because they do not have a second X chromosome to balance expression of the gene." D. "Males have only one X chromosome, which allows the X-linked recessive disorder to be transmitted from father to son." - ....ANSWER >>>>C. "The incidence of X-linked recessive disorders is higher in males because they do not have a second X chromosome to balance expression of the gene." A client is types and crossmatched for a unit of blood. Which statement by the nurse indicates a need for further genetic education? A. "Blood type is formed from three gene alleles: A, B, and O." B. "Each blood type allele is inherited from the mother or the father." C. "If the client's blood type is AB, then the client is homozygous for that trait." D. "If the client has a dominant and a recessive blood type allele, only the dominant will be expressed." - ....ANSWER >>>>C. "If the client's blood type is AB, then the client is homozygous for that trait." A nurse obtains health histories when admitting client to a medical-surgical unit. With which client should the nurse discuss predisposition genetic testing? A. Middle-aged woman whose mother died at age 48 of breast cancer B. Young man who has all the symptoms of rheumatoid arthritis C. Pregnant woman whose father has sickle cell disease A health care provider prescribes genetic testing for a client who has a family history of colorectal cancer. Which action should the nurse take before scheduling the client for the procedure? A. Confirm that informed consent was obtained and placed on the client's chart B. Provide genetic counseling to the client and the client's family members C. Assess if the client is prepared for the risk of psychological side effects D. Respect the client's right not to share the results of the genetic test - ....ANSWER >>>>A. Confirm that informed consent was obtained and placed on the client's chart A nurse cares for an adult client who has received genetic testing. The client's mother asks to receive the results of her daughter's genetic tests. Which action should the nurse take? A. Obtain a signed consent from the client allowing test results to be released to the mother B. Invite the mother and other family members to participate in genetic counseling with the client C. Encourage the mother to undergo genetic testing to determine if she has the same risks as her child D. Direct the mother to speak with the client and support the client's decision to share or not share the results - ....ANSWER >>>>D. Direct the mother to speak with the client and support the client's decision to share or not share the results A nurse cares for a client who has a genetic mutation that increases the risk for colon cancer. The client states that he does not want any family to know about this result. How should the nurse respond? A. "It is required by law that you inform your siblings and children about this result so that they also can be tested and monitored for colon cancer." B. "It is not necessary to tell your siblings because they are adults, but you should tell your children so that they can be tested before they decide to have children of their own." C. "It is not required that you tell anyone about this result. However, your siblings and children may also be at risk for colon cancer and this information might help them." D. "It is your decision with whom, if anyone, you discuss this test result. However, you may be held liable if you withhold this information and a family member gets colon cancer." - ....ANSWER >>>>C. "It is not required that you tell anyone about this result. However, your siblings and children may also be at risk for colon cancer and this information might help them." A. Discuss potential risks for other members of her family B. Assist the client to make a plan for prevention and risk reduction C. Disclose the information to the medical insurance company D. Recommend the client complete weekly breast self-examinations E. Assess the client's response to the test results F. Encourage support by sharing the results with family members - ....ANSWER >>>>ANSWER: A, B, E A. Discuss potential risks for other members of her family B. Assist the client to make a plan for prevention and risk reduction E. Assess the client's response to the test results A nurse completes pedigree charts for clients at a community health center. Which diagnosis should the nurse refer for carrier genetic testing? (Select all that apply) A. Huntington Disease B. Breast Cancer C. Hemophilia D. Colorectal cancer E. Sickle cell disease F. Cystic fibrosis - ....ANSWER >>>>ANSWER: C, E, F C. Hemophilia E. Sickle cell disease F. Cystic fibrosis A nurse teaches clients about patterns of inheritance for genetic disorders among adults. Which disorders have an autosomal dominant pattern of inheritance? (Select all that apply) A. Breast cancer B. Alzheimer's disease C. Hemophilia D. Huntington disease E. Marfan syndrome F. Cystic fibrosis - ....ANSWER >>>>ANSWER: A, D, E A. Breast cancer D. Huntington disease E. Marfan syndrome 1. The nurse learning about cellular regulation understands that which process occurs during the S phase of the cell cycle? a. Actual division (mitosis) b. Doubling of DNA c. Growing extra membrane d. No reproductive activity - ....ANSWER >>>>ANS: B During the S phase, the cell must double its DNA content through DNA synthesis. Actual division, or mitosis, occurs during the M phase. Growing extra membrane occurs in the G1 phase. During the G0 phase, the cell is working but is not involved in any reproductive activity is the single most preventable cause of cancer. Exposure to chemicals and oncoviruses cause fewer cancers. Which statement about carcinogenesis is accurate? a. An initiated cell will always become clinical cancer. b. Cancer becomes a health problem once it is 1 cm in size. c. Normal hormones and proteins do not promote cancer growth. d. Tumor cells need to develop their own blood supply. - ....ANSWER >>>>ANS: D Tumors need to develop their own blood supply through a process called angiogenesis. An initiated cell needs a promoter to continue its malignant path. Normal hormones and proteins in the body can act as promoters. A 1- cm tumor is a detectable size, but other events have to occur for it to become a health problem. The nurse caring for oncology clients knows that which form of metastasis is the most common? a. Bloodborne b. Direct invasion c. Lymphatic spread d. Via bone marrow - ....ANSWER >>>>ANS: A Bloodborne metastasis is the most common way for cancer to metastasize. Direct invasion and lymphatic spread are other methods. Bone marrow is not a medium in which cancer spreads, although cancer can occur in the bone marrow. A nurse is assessing a client with glioblastoma. What assessment is most important? a. Abdominal palpation b. Abdominal percussion c. Lung auscultation d. Neurologic examination - ....ANSWER >>>>ANS: D A glioblastoma arises in the brain. The most important assessment for this client is the neurologic examination. A nurse has taught a client about dietary changes that can reduce the chances of developing cancer. What statement by the client indicates the nurse needs to provide additional teaching? a. "Foods high in vitamin A and vitamin C are important." b. "I'll have to cut down on the amount of bacon I eat." c. "I'm so glad I don't have to give up my juicy steaks." d."Vegetables, fruit, and high-fiber grains are important." - ....ANSWER >>>>ANS: C To decrease the risk of developing cancer, one should cut down on the consumption of red meats and animal fat. The other statements are correct Which characteristics does this include? (Select all that apply.) a. Differentiated function b. Large nucleus-to-cytoplasm ratio c. Loose adherence d. Nonmigratory e. Specific morphology f. Orderly and specific growth - ....ANSWER >>>>ANS: A, D, E, F Normal cells have the characteristics of differentiated function, nonmigratory, specific morphology, a smaller nucleus-to-cytoplasm ratio, tight adherence, and orderly and well- regulated growth. The nurse working with oncology clients understands that interacting factors affect cancer development. Which factors does this include? (Select all that apply.) a. Exposure to carcinogens b. Genetic predisposition c. Immune function d. Normal doubling time e. State of euploidy - ....ANSWER >>>>ANS: A, B, C The three interacting factors needed for cancer development are exposure to carcinogens, genetic predisposition, and immune function. A nurse is participating in primary prevention efforts directed against cancer. In which activities is this nurse most likely to engage? (Select all that apply.) a. Demonstrating breast self-examination methods to women b. Instructing people on the use of chemoprevention c. Providing vaccinations against certain cancers d. Screening teenage girls for cervical cancer e. Teaching teens the dangers of tanning booths f. Educating adults about healthy eating habits - ....ANSWER >>>>ANS: B, C, E, F Primary prevention aims to prevent the occurrence of a disease or disorder, in this case cancer. Secondary prevention includes screening and early diagnosis. Primary prevention activities include teaching people about chemoprevention, providing approved vaccinations to prevent cancer, teaching teens the dangers of tanning beds, and educating adults on eating habits to reduce the risk of getting cancer. Breast examinations and screening for cervical cancer are secondary prevention methods. A nurse is providing community education on the seven warning signs of cancer. Which signs 4. A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months after radiation therapy for breast cancer. What response by the nurse is the most appropriate? - ....ANSWER >>>>"It is normal to be fatigued even for months afterward." A client tells the oncology nurse about an upcoming vacation to the beach to celebrate completing radiation treatment for cancer. What response by the nurse is most appropriate? - ....ANSWER >>>>"Do not expose the radiation area to direct sunlight'" 6. A client is receiving chemotherapy through a peripheral IV line. What action by the nurse is most important? - ....ANSWER >>>>Assessing the IV site and blood return every hour A client with cancer is admitted to a short-term rehabilitation facility. The nurse prepares to administer the client's oral chemotherapy medications. What action by the nurse is most appropriate? - ....ANSWER >>>>Wear personal protective equipment when handling the medications. The nurse working with oncology clients understands that which age-related change increases the older clients susceptibility to infection during chemotherapy? - ....ANSWER >>>>Decreased immune function 9. The nurse has educated a client on precautions to take with thrombocytopenia. What statement by the client indicates a need to review the information? - ....ANSWER >>>>a. "I will be careful if I need enemas for constipation." 10. A client has a platelet count of 9800/mm3 (9800 x109/L). What action by the nurse is most appropriate? - ....ANSWER >>>>Instruct the client to call for help to get out of bed A client hospitalized for chemotherapy has a hemoglobin of 6.1 mg/dL. The client is symptomatic but refuses blood transfusions. What medication does the nurse prepare administer? - ....ANSWER >>>>Epoetin Alpha 12. A nurse works with clients who have alopecia from chemotherapy. What action by the nurse takes priority? - ....ANSWER >>>>Teaching measures to prevent scalp injury 13. A client is receiving rituximab. What assessment by the nurse takes priority? - ....ANSWER >>>>Blood pressure A client is receiving rituximab and asks how it works. What response by the nurse is best? - ....ANSWER >>>>"It prevents the start of cell division in the cancer cells." A client is having a catheter places to deliver chemotherapy beads into a liver tumor via the femoral artery. Which action by the nurse is most important? - ....ANSWER >>>>Ensuring that informed consent is on the chart A nurse works on an oncology unit and delegates personal hygiene to assistive personnel (AP). What action by the AP requires intervention from the nurse? - ....ANSWER >>>>Allowing a very tired client to skip oral hygiene and sleep A client with cancer has anorexia and mucositis, and is losing weight. The client's family members continually bring favorite foods to the client and are distressed when the client won't eat them. What action by the nurse is best? - ....ANSWER >>>>Help the family show other ways to demonstrate love and caring. A client in the emergency department reports difficulty breathing. The nurse assesses the client's appearance as depicted in picture: (Prominent veins on chest (Vena Cava Syndrome)). What action is most important? - ....ANSWER >>>>Assess blood pressure and pulse 1. The nurse caring for clients who have cancer understands that the general consequences of cancer include which client problems? (Select all that apply.) - ....ANSWER >>>>Clotting abnormalities from thrombocythemia Increased risk of infection from white blood cell deficits Nutritional deficits such as early satiety and cachexia Potential for reduced gas exchange Various motor and sensory deficits Increased risk of bone fractures A nurse is preparing to administer IV chemotherapy. What supplies does this nurse need? (Select all that apply.) - ....ANSWER >>>>"Chemo" gloves Face mask Impervious gown Eye protection A client receiving radiation therapy reports severe skin itching and irritation. What action does the nurse delegate to assistive personnel? (Select all that apply.) - ....ANSWER >>>>Apply approves moisturizers tot he skin Bathe the client using mild soap Help the client pat the skin dry after a bath Make sure no clothing is rubbing he site A client has thrombocytopenia. What actions does the nurse delegate to assistive personnel (AP)? (Select all that apply.) - ....ANSWER >>>>Apply the clients shoes before getting the client out of bed C. Most people die after the age of 75. D. The most common cause of death is heart disease. E. Medicare covers the cost of death for most people. F. Most people die at home just as they wish. - ....ANSWER >>>>B, D, E 2. Which are the manifestations of death? Select all that apply A. Loss of heartbeat B. Unresponsiveness to physical or verbal stimuli C. Absence of spontaneous respirations D. Lack of deep tendon reflexes E. Irreversible brain dysfunction F. Oliguria or no urine output - ....ANSWER >>>>A, C, E 3. Which client and family have the most accurate understanding of hospice care? A. Family expects that client will resist hospice and therefore, an involuntary order is needed. B. Dying client and family believe it is important to focus on facilitating quality of life. C. Family believes that dying client receives home care when no funds are available for care in a facility. D. Client and family expect round-the-clock nursing care from hospice staff. - ....ANSWER >>>>B 4. Which action will the nurse perform when the assistive personnel (AP) reports that the client now has a "death rattle?" A. Perform oropharyngeal suctioning to remove the secretions. B. Call the health care provider and family to notify them that the client has died. C. Instruct the AP to bring a postmortem pack to the client's bedside. D. Have the AP assist the nurse in turning the client on the side to reduce gurgling. - ....ANSWER >>>>D 5. Which priority HCP-prescribed action would the nurse expect for a dying client with dyspnea, crackles on auscultation, peripheral edema, and other signs of heart failure? A. Antibiotics to prevent a possible respiratory infection B. Insertion of a urinary catheter for accurate measurement of output C. Administration of the diuretic furosemide D. Offer an electric fan as a comfort measure - ....ANSWER >>>>C 6. The client has a durable power of attorney for health care (DPOAHC), also called a health care proxy. When would the nurse contact the designated person? A. The client is discovered at 3:00 a.m. in a comatose state. 10. Which client statement represents the symptoms most feared and perceived as distressing by dying clients? A. "I'm hoping that my health care provider prescribes a lot of pain medication." B. "I fear my family will be upset when I can no longer recognize them." C. "If I become nauseated, my wife will be distressed that I can't eat or drink." D. "Being short of breath frightens me and will scare my family members." - ....ANSWER >>>>A 11. The use of cannabinoid-based medicines (CBM, medical marijuana) is increasing in palliative and end-of-life care. For which symptoms would the nurse expect to see these drugs prescribed for a dying client? Select all that apply. A. Pain B. Fatigue C. Difficulty with breathing D. Loss of appetite E. Anxiety F. Difficulty sleeping G. Decrease in urine output - ....ANSWER >>>>A, B, D, E, F 12. What is the nurse's best response when the spouse of a dying client expresses concern that the client has no appetite and eats very little? A. Keep fluids and finger foods at the bedside for easy access when a dying client is hungry or thirsty. B. Explain to the spouse that loss of appetite is normal when a client nears death and teach about the risk for aspiration. C. Encourage the spouse to feed the client as much as he will take to maintain adequate nutrition. D. Request that the health care provider prescribe a dietary nutrition consult to include foods that the client prefers. - ....ANSWER >>>>B 13. A client in hospice is deteriorating and the family is concerned about restlessness. Which are the best actions for the nurse to perform? A. Assess for pain, provide analgesics, and make the client as comfortable as possible. B. Initiate intravenous hydration to provide the client with necessary fluids. C. Notify the health care provider and request an order for transfer to the hospital. D. Encourage family members to assist the client to eat in order to gain energy. - ....ANSWER >>>>A 14. Which action is most likely to be implemented first when a client near dying tells the nurse about an uncomfortable feeling of breathlessness? A. 10 mg furosemide IV B. 2 L oxygen by nasal cannula C. Albuterol puff by metered-dose inhaler 1. A nurse assesses clients at a family practice clinic for risk factors that could lead to dehydration. Which client is at greatest risk for dehydration? - ....ANSWER >>>>A 76 year old who is cognitively impaired. 2. A nurse is caring for an older client who exhibits dehydration-induced confusion. Which intervention by the nurse is best? - ....ANSWER >>>>Assess client further for fall risk. 3. After teaching a client who is being treated for dehydration, a nurse assesses the client's understanding. Which statement indicates that the client correctly understood the teaching? - ....ANSWER >>>>"I will weigh myself each morning before I eat or drink." 4. A nurse is assessing clients on a med surg unit. Which adult client does the nurse identify as being at greatest risk for insensible water loss? - ....ANSWER >>>>Anxious client who has tachypnea. 5. A nurse is evaluating a client who is being treated for dehydration. Which assessment result does the nurse correlate with a therapeutic response to the treatment plan? - ....ANSWER >>>>Decreased orthostatic changes when standing. 6. After teaching a client who is prescribed a restricted sodium diet, a nurse assesses the client's understanding. Which food choice for lunch indicates that the client correctly understood the teaching? - ....ANSWER >>>>Grilled chicken breast with glazed carrots 7. A nurse is assessing clients for fluid and electrolyte imbalance;ances. Which client will the nurse assess first for potential hyponatremia? - ....ANSWER >>>>A 34 year old who is NPO and receiving rapid intravenous D5W infusions. A nurse teaches a client who is at risk for hyponatremia. Which statement does the nurse include in the client's teaching? - ....ANSWER >>>>"Call your primary health care provider for diarrhea." 9. A nurse is caring for a client who has the following laboratory results: potassium 2.4 mEq/L (2.4 mmol/L), magnesium 1.8 mEq/L (0.74 mmol/L), calcium 8.5 mEq/L (2.13 mmol/L), and sodium 144 mEq/L (144 mmol/L). Which assessment does the nurse complete first? - ....ANSWER >>>>Depth of respirations A nurse cares for a client who has a serum potassium of 6.5 mEq/L and is exhibiting cardiovascular changes. Which intervention will the nurse implement first? - ....ANSWER (Select all that apply.) - ....ANSWER >>>>Increased pulse rate Distended neck veins Skeletal muscle weakness Visual disturbances A nurse assess a client who is prescribed a medication that inhibits aldosterone secretion and release. For which potential complication will the nurse assess? (Select all that apply.) - ....ANSWER >>>>Serum Potassium of 5.4 mEq/L Blood osmolality of 250 mOsm/kg A nurse is assessing a client who has an electrolyte imbalance related to renal failure. For which potential complications of this electrolyte imbalance does the nurse assess? (Select all that apply.) - ....ANSWER >>>>Reports of palpitations Skeletal muscle weakness Tall, peaked T waves on ECG 4. A nurse is caring for clients with electrolyte imbalances on a medical-surgical unit. Which clinical signs and symptoms are correctly paired with the contributing electrolyte imbalance? (Select all that apply.) - ....ANSWER >>>>Hypokalemia—muscle weakness with respiratory depression Hypermagnesmia-bradycardia and hypotension Hyponatremia-decreased level of consciousness Hypomagnesmia-hyperatice deep tendon reflexes Hypernatremia-weak peripheral pulses After administering potassium chloride, a nurse evaluates the client's response. Which signs and symptoms indicate that the treatment is improving the client's hypokalemia? (Select all that apply.) - ....ANSWER >>>>Strong productive cough Active bowel sounds 6. A nurse develops a plan of care for an older client who has a fluid overload. What interventions will the nurse include in this client's care plan? (Select all that apply.) - ....ANSWER >>>>Calculate pulse pressure with each blood pressure reading. Assess for pitting edema in dependent body areas. Monitor trends in the client's daily weights. Assist the client to change positions frequently. Teach client and family how to read food labels for sodium. A nurse us caring for clients with electrolyte imbalances on a medical surgical unit. Which common causes are correctly paired with the corresponding electrolyte imbalance? (Select all that apply.) - ....ANSWER >>>>Hyperkalemia- salt substitute Hyponatremia-heart failure Hypernatremia-hyperaldosteronism Hypocalcemia-diarrhea A patient asks how chemotherapy works to treat cancer. Which response by the nurse is most appropriate? A. "Chemotherapy uses high-energy radiation to kill cancer cells." B. "Chemotherapy enhances the body's immune system to fight cancer." C. "Chemotherapy involves the use of drugs to kill rapidly dividing cancer cells." D. "Chemotherapy blocks hormones that fuel cancer growth." - ....ANSWER >>>>C. "Chemotherapy involves the use of drugs to kill rapidly dividing cancer cells." Which of the following assessment findings should the nurse expect in a patient with hypervolemia? Select all that apply. A. Edema B. Hypertension C. Tachycardia D. Dehydration E. Crackles in the lungs - ....ANSWER >>>>A. Edema B. Hypertension E. Crackles in the lungs Which of the following measures should the nurse take to prevent extravasation when administering chemotherapy? Select all that apply. A. Use a large vein for administration. B. Monitor the IV site closely for signs of infiltration. C. Administer the drug through a central venous catheter if possible. D. Use the smallest gauge needle possible. E. Administer the drug slowly. - ....ANSWER >>>>A: Larger veins are less prone to damage and infiltration. B: Close monitoring can help detect early signs of extravasation. C: Central venous catheters are often used for vesicant drugs to reduce the risk of extravasation. Wrong choices: D: A larger gauge needle is typically used to reduce the risk of extravasation. E: Administering the drug slowly does not necessarily prevent extravasation but can help manage side effects. A nurse is monitoring a patient with cancer for tumor lysis syndrome. Which lab findings would indicate the presence of this syndrome? Select all that apply. A. Hyperkalemia B. Hyperphosphatemia C. Hypocalcemia D. Hypernatremia E. Hypokalemia - ....ANSWER >>>>A: Tumor lysis syndrome leads to the release of intracellular potassium. B: The breakdown of tumor cells releases phosphate into the blood. C: Hyperphosphatemia leads to secondary hypocalcemia. Wrong Choices C. Dehydration D. Diabetic ketoacidosis E. Hypoparathyroidism - ....ANSWER >>>>A: Reduced renal function leads to impaired excretion of magnesium. B: Excessive intake of magnesium from antacids can cause hypermagnesemia. When is the patient with acute leukemia at greatest risk of developing tumor lysis syndrome? - ....ANSWER >>>>After the first cycle of chemotherapy A patient who is receiving radiation therapy for breast cancer is most likely to experience which side effect? - ....ANSWER >>>>Fatigue What is the expected outcome related to hair loss for a patient who is undergoing chemotherapy? - ....ANSWER >>>>Hair regrowth usually begins about 1 month after completion of chemotherapy. Match each chemotherapy side effect below with the correct intervention: Anemia - ....ANSWER >>>>Administer epoetin alfa subcutaneously once a week. Match each chemotherapy side effect below with the correct intervention: Neutropenia - ....ANSWER >>>>Inspect IV sites every 4 hours for signs of infection Match each chemotherapy side effect below with the correct intervention: Thrombocytopenia - ....ANSWER >>>>Avoid IM injections and venipunctures A nurse is caring for a patient at the end of life who is experiencing congestion and gurgling. What is the most appropriate nursing intervention? - ....ANSWER >>>>Position the patient on their side. What is the primary difference between hospice care and palliative care? - ....ANSWER >>>>Hospice care involves stopping all curative treatments, whereas palliative care can be provided alongside curative treatments. A patient with hyperkalemia is admitted to the hospital. Which symptom should the nurse monitor for? - ....ANSWER >>>>Muscle weakness and cramping A nurse is assessing a patient with suspected hypovolemia. Which finding is consistent with this condition? - ....ANSWER >>>>Dry mucous membranes A patient at the end of life is experiencing severe pain. The nurse knows that short-acting opioids are appropriate for which reason? - ....ANSWER >>>>They provide quick relief for breakthrough pain