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NR 325 Exam 1 Questions and Answers With Explanation ; Chamberlain College of Nursing LATEST Graded A+
Typology: Exams
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1) A 79-year-old man has been admitted with benign prostatic hyperplasia. What is most appropriate to include in the nursing plan of care?
The patient's age and diagnosis indicate a likelihood of nocturia, so leaving the light on in the bathroom is appropriate. Fluids should be encouraged because dehydration is more common in older patients. 2) A patient gives the nurse health information before a scheduled intravenous pyelogram (IVP). Which item has the most immediate implications for the patient's care?
Iodine-based contrast dye is used during IVP and for many computed tomography (CT) scans. The nurse will need to notify the health care provider before the procedures so that the patient can receive medications such as antihistamines or corticosteroids before the procedures are started. 3) A patient passing bloody urine is scheduled for a cystoscopy with cystogram. Which description of the procedure by the nurse is accurate?
that will visualize the blood supply to the kidneys."
be inserted through the tube into your kidney."
inspect the bladder, and instill a dye that will outline your bladder on x-ray."
distribution of the isotope in your kidneys and bladder will be checked." ANS: C In a cystoscope and cystogram procedure, a cystoscope is inserted into the bladder for direct visualization, and then contrast solution is injected through the scope so that x- rays can be taken. 4) Which nursing action is essential for a patient immediately after a renal biopsy?
hypoglycemia.
function.
minutes. ANS: D A pressure dressing is applied and the patient is kept on the affected side for 30 to 60 minutes to put pressure on the biopsy side and decrease the risk for bleeding. 5) Which assessment of a 62-year-old patient who has just had an intravenous pyelogram (IVP) requires immediate action by the nurse?
The increased respiratory rate indicates that the patient may be experiencing an allergic reaction to the contrast medium used during the procedure. The nurse should immediately assess the patient's oxygen saturation and breath sounds. 6) Which statement by a nurse to a patient newly diagnosed with type 2
diabetes is correct?
diabetes.
diabetes.
diabetes.
hyperglycemic coma. ANS: C For some patients with type 2 diabetes, changes in lifestyle are sufficient to achieve blood glucose control. 7) A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?
The glycosylated hemoglobin (A1C or HbA1C) test shows the overall control of glucose over 90 to 120 days. 8) A 55-year-old female patient with type 2 diabetes has a nursing diagnosis of imbalanced nutrition: more than body requirements. Which goal is most important for this patient?
The complications of diabetes are related to elevated blood glucose, and the most important patient outcome is the reduction of glucose to near-normal levels. 9) A 38_ year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to
The change in exercise will affect blood glucose, and the patient will need to monitor glucose carefully to determine the need for changes in diet and insulin administration. 10) Which statement by the patient indicates a need for additional instruction in administering insulin?
abdomen each day."
see."
bottle."
insulin." ANS: A Rotating sites is no longer recommended because there is more consistent insulin absorption when the sa 11) A patient receives aspart (NovoLog) insulin at 8:00 AM. Which time will it be most important for the nurse to monitor for symptoms of hypoglycemia? a. 10:00 AM b. 12:00 AM c. 2:00 PM
d. 4:00 PM ANS: A The rapid-acting insulins peak in 1 to 3 hours. me site is used consistently 12) Which information will the nurse include when teaching a 50- year-old patient who has type 2 diabetes about glyburide (Micronase, DiaBeta, Glynase)?
media. ANS: B The sulfonylureas stimulate the production and release of insulin from the pancreas 13) When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the health care provider prescribes prednisone (Deltasone). The nurse will anticipate that the patient may
Glucose levels increase when patients are taking corticosteroids, and insulin may be required to control blood glucose. 14) The health care provider suspects the Somogyi effect in a 50- year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?
d. Administer a larger dose of long-acting insulin. ANS: C If the Somogyi effect is causing the patient's increased morning glucose level, the patient will experi 15) Which information will the nurse include in teaching a female patient who has peripheral arterial disease, type 2 diabetes, and sensory neuropathy of the feet and legs?
The patient is taught to avoid high heels and that leather shoes are preferred. ence hypoglycemia between 2:00 and 4:00 AM. 16) A 56-year-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with possible syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would expect the initial laboratory results to include a(n)
When water is retained, the serum sodium level will drop below normal, causing the clinical manifestations reported by the patient. 17) A patient who had radical neck surgery to remove a malignant tumor developed hypoparathyroidism. The nurse should plan to teach the patient about
Oral calcium supplements are used to maintain the serum calcium in normal range and prevent the complications of hypocalcemia 18) Which finding for a patient who has hypothyroidism and hypertension indicates that the nurse should contact the health care provider before administering levothyroxine (Synthroid)?
An increased thyroxine level indicates the levothyroxine dose needs to be decreased. 19) A 37-year-old patient is being admitted with a diagnosis of Cushing syndrome. Which findings will the nurse expect during the assessment?
b.Bronzed appearance of the skin c. Purplish streaks on the abdomen d. Decreased axillary and pubic hair ANS: C Purplish-red striae on the abdomen are a common clinical manifestation of Cushing syndrome 20) A 44-year-old female patient with Cushing syndrome is admitted for adrenalectomy. Which intervention by the nurse will be most helpful for a nursing diagnosis of disturbed body image related to changes in appearance?
with Cushing syndrome.
with Cushing syndrome.
importance than appearance.
syndrome will resolve after surgery. ANS: D The most reassuring communication to the patient is that the physical and emotional changes caused by the Cushing syndrome will resolve after hormone levels return to normal postoperatively. 21) Which finding indicates to the nurse that the current therapies are effective for a patient with acute adrenal insufficiency?
Clinical manifestations of Addison's disease include hyponatremia and an increase in sodium level indicates improvement.
22) A 38-year-old male patient is admitted to the hospital in Addisonian crisis. Which patient statement supports a nursing diagnosis of ineffective self-health management related to lack of knowledge about management of Addison's disease?
hydrocortisone."
run."
afternoon." ANS: B The need for hydrocortisone replacement is increased with stressors such as illness, and the patient needs to be taught to call the health care provider because medication and IV fluids and electrolytes may need to be given 23) Which intervention will the nurse include in the plan of care for a 52-year-old male patient with syndrome of inappropriate antidiuretic hormone (SIADH)?
c.Encourage fluids to 2 to 3 liters per day. d. Keep head of bed elevated to 30 degrees. ANS: B Sucking on hard candies decreases thirst for a patient on fluid restriction. 24) A patient has just arrived on the unit after a thyroidectomy. Which action should the nurse take first?
a.Observe the dressing for bleeding.
Airway obstruction is a possible complication after thyroidectomy because of swelling or bleeding at the site or tetany. 25) A 37-year-old patient has just arrived in the postanesthesia recovery unit (PACU) after a thyroidectomy. Which information is most important to communicate to the surgeon?
The neck swelling may lead to respiratory difficulty, and rapid intervention is needed to prevent airway obstruction 26) Which assessment finding of a 42-year-old patient who had a bilateral adrenalectomy requires the most rapid action by the nurse?
The decreased BP indicates possible adrenal insufficiency. The nurse should immediately notify the health care provider so that corticosteroid medications can be administered. Which information is most important for the nurse to communicate rapidly to the health care provider about a patient admitted with possible syndrome of inappropriate antidiuretic hormone (SIADH)? a. The patient has a recent weight gain of 9 lb. b. The patient complains of dyspnea with activity.
c. The patient has a urine specific gravity of 1.025. d. The patient has a serum sodium level of 118 mEq/L. 27) After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?
244 mg/dL
pulse of 134
scheduled dose of hydrocortisone (Solu-Cortef).
hormone (SIADH) who has a serum sodium level of 130 mEq/L ANS: B Initiation of thyroid replacement in older adults may cause angina and cardiac dysrhythmias. The patient's high pulse rate needs rapid investigation by the nurse to assess for and intervene with any cardiac problems.