NURS 215 EXAM 3 (ARIZONA COLLEGE OF NURSING), Exams of Nursing

Download NURS 215 EXAM 3 (ARIZONA COLLEGE OF NURSING) and more Exams Nursing in PDF only on Docsity! 1 | P a g e NURS 215 EXAM 3 (ARIZONA COLLEGE OF NURSING) 2024-2025 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED RATIONALES ANSWERS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST|LATEST UPDATE |GUARANTEED PASS The nurse and nursing student are caring for a client undergoing a severe stressor with release of epinephrine into the bloodstream. Which of these effects on blood glucose levels does the nurse teach the student epinephrine will cause? Blood glucose will elevate. A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis? Hypoglycemia The nurse has just completed teaching a client newly diagnosed with type 1 diabetes about rapid-acting insulin. The nurse determines that teaching was effective when the client selects: Lispro The nurse screening for diabetes mellitus at a health fair does not have enough supplies for all of the clients attending. Which clients should be given screening priority? Male age 45, BMI 32 • Female age 30, history GDM • Male age 65, hypertension 2 | P a g e The critical care nurse has just admitted a client with diabetic ketoacidosis (DKA) whose blood glucose level is 877 mg/dL. The client's breath has a fruity odor and the client is confused. Which of these does the nurse set as the priority at this time? Administration of intravenous fluids A patient with diabetes asks the nurse for advice in controlling between-meal blood glucose levels. Which of the following might the nurse suggest as a long-acting insulin to provide a consistent basal level? Glargine (Lantus) When caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which of these organs does the nurse recognize is reliant on glucose as the major energy source? Brain Which of the following pregnant women likely faces the greatest risk of developing gestational diabetes? A client who: Is morbidly obese (defined as greater than 100 pounds over ideal weight) Which of the following clients would be considered to be exhibiting manifestations of "prediabetes"? A middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL. A hospital client with a diagnosis of type 1 diabetes has been administered a scheduled dose of regular insulin. Which of the following effects will result from the action of insulin? Promotion of glucose uptake by target cells In which situation would an increase of glucagon be expected? NPO before surgery When providing nutrition education to the client with diabetes, the nurse should include which of these statements regarding fat intake? "If you have diabetes, avoiding saturated fats is important." A client is managing his diabetes with exercise and diet. The health care provider reviews the client's most recent lab results: fasting blood sugar level at 80 mg/dL and a hemoglobin A1C of 5%. Select the response that best identifies the client. The client is achieving normal glycemic control. The nurse screening for diabetes mellitus at a health fair obtains these results. Which client should be referred to a primary healthcare provider for further evaluation? Random blood glucose 195 mg/dl 5 | P a g e When maltose is not broken down into two glucose molecules in the gastrointestinal tract, which of the following may occur? Diarrhea The physiological rationale for hanging normal saline (0.9% NS) or 5% dextrose in water (D5W) to a client who has been experiencing diarrhea includes: Facilitating the absorption of osmotically active particles A student is comparing the different parts of the gastrointestinal (GI) tract. Which of the following statements demonstrates understanding? "The mouth is the receptacle where initial digestive processes take place." While explaining digestion and absorption of nutrients to a client, the nurse mentions that the brush border enzymes would facilitate absorption of which of the following foods? Garlic toast While reviewing the colonic absorption and role of flora in the GI system, the instructor will stress that the large intestine contains: a complex microbial system that contains hundreds of different species. Which of the following statements is true concerning food digestion? Protein digestion begins in the stomach. A nurse explains to her patient that food is moved along the gastrointestinal (GI) tract with intermittent contractions that mix the food and move it along. These movements are found in which of the following organs? Small intestine Which of the following functions is performed by saliva? Antimicrobial protection During a lecture about the function of the intestine related to food digestion, the faculty mentions that when the students consume foods high in acid, the intestines will: stimulate the release of secretin which then inhibits release of gastrin. A student identifies enterocytes on a microscope slide of tissue. The student explains that these cells secrete which of the following? Brush border enzymes Which of the following statements is true concerning gastric enterocytes? They secrete enzymes that aid in digestion of proteins. 6 | P a g e While studying the esophagus, a student is able to correctly state which of the following to a faculty member? "The smooth muscle layers provide the peristaltic movements needed to move food along the length of the esophagus." Which of the following statements is true concerning the digestion of carbohydrates? Carbohydrates are broken down into monosaccharides before being absorbed. Carbohydrates are broken down into monosaccharides before being absorbed. Hypothalamus A client asks the nurse to explain the digestive tract layers because the client is experiencing upper GI problems. When talking about the mucosa layer, the nurse will emphasize that the roles/functions of this layer consist of: Select all that apply. • Production of mucus to protect and lubricate the inner lining • Beginning of the digestive process by secreting enzymes to break food down Which nerve plexus controls the motility along the length of the gut? Myenteric An anatomy student is studying the stomach. The student explains that the funnel-shaped portion that connects with the intestine is which of the following? Pyloric region A patient with pancreatitis has decreased production of pancreatic enzymes such as trypsin. The dietitian knows that the patient may have difficulty digesting which of the following foods? Fried chicken and deviled eggs Which of the following would help a nurse best explain an "incretin effect"? "It is an increase in insulin release after ingestion of food." A client has developed a ruptured appendix. The nurse is aware the client is at high risk for: Peritonitis A patient is diagnosed with Crohn's disease. The nurse instructs the patient on which of the following types of dietary needs? High-calorie, vitamin, and protein diet A client in a nursing home complains to her nurse that she is not feeling well. When asked to describe how she feels, the client states that she really is not hungry anymore and seems to have indigestion a lot. The nurse checks the client's chart and finds that her vital signs are normal, but that she has lost weight over the past 2 months. She also notes that there is a history of gastric cancer in the client's family. The nurse notifies the physician and expects to receive what orders? (Select all that apply.) 7 | P a g e • Schedule a barium radiograph and an endoscopy • Order cytologic studies to be done during the endoscopy A nurse is conducting a health promotion class on healthy cooking. The nurse includes the importance of ensuring that all hamburgers are cooked completely before ingesting to prevent which of the following? Escherichia coli Upon admission, a patient tells the nurse that he takes aspirin every 4 hours every day. The nurse determines that this patient is at risk for which of the following? Peptic ulcer The incidence of stomach cancer has significantly decreased in the United States, yet it remains the leading cause of death worldwide. The nurse understands the reason for the high mortality rate in stomach cancer is because of which of the following reasons? Patients have few early symptoms of the disease. Which of the following signs/symptoms would lead the nurse to suspect the post-op client has developed a mechanical bowel obstruction? Select all that apply. • Sluggish to absent bowel sounds • Increase in abdominal distention • Nausea and vomiting • Continuous abdominal pain Celiac disease commonly presents in infancy as failure to thrive. It is an inappropriate T-cell-mediated immune response, and there is no cure for it. What is the treatment of choice for celiac disease? Removal of gluten from the diet A teenager who has a history of achalasia will likely complain of which of the following clinical manifestations? Feeling like there is food stuck in the back of the throat A nurse administering a patient's medication tells the patient that a proton pump inhibitor has been added. When the patient asks the purpose of the medication, the nurse responds that it is to prevent which of the following? Stress ulcer An elderly patient presents with loose mucousy stools. The nurse suspects the patient has Clostridium difficile. What is a priority assessment for the nurse? Ask the patient about his or her antibiotic use. The nurse has been providing dietary teaching to a client diagnosed with irritable bowel syndrome. The nurse determines that the teaching was effective when the client selects: A bran muffin, fruit, and orange juice. 10 | P a g e A patient in the rehabilitation ward is recovering from a recent stroke. The patient has difficulty swallowing and has been ordered diagnostic testing to determine the extent of the difficulty. The nurse would expect which of the following to occur in treating the patient? Select all that apply. • Endoscopy • Barium esophagoscopy • Multidisciplinary approach A client is admitted to the hospital with a suspected diagnosis of strangulated bowel. The nurse anticipates the client will need: Surgery to release the bowel Which of the following characteristics differentiates inflammatory diarrhea from the noninflammatory type? Infection of intestinal cells The body uses common physiologic responses that are common to gastrointestinal (GI) disorders. A nurse would expect to see which of the following physiologic responses known to be protective by removing noxious agents from the body? Vomiting A patient with a history of peptic ulcer disease presents to the emergency department with the following symptoms: early satiety, feeling of epigastric fullness and heaviness after meals, weight loss, and vomiting. The nurse suspects that the peptic ulcer has caused which of the following problems? Obstruction A patient presents with a perforated peptic ulcer. Which of the following complications would be a priority for the nurse? Assessment of a rigid, boardlike abdomen Which of the following is a major complication of persistent gastroesophageal reflux? Strictures The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function. Stimulation tests Select the statement that best explains the function of hormone receptors. Hormone receptors recognize a specific hormone and translate the signal into a cellular response. The nurse is caring for a client who has been diagnosed with severe chronic obstructive pulmonary disease and has been taking oral steroids for several years. The nurse is aware that the client is at risk for: Suppression of the client's hypothalamic-pituitary-target cell system 11 | P a g e As part of maintaining homeostasis, hormones secreted by endocrine cells are inactivated continuously to: Prevent accumulation When caring for a client with anemia and a decrease in red blood cells (RBCs), the nurse recognizes which of these hormones will stimulate the bone marrow to produce additional RBCs? Erythropoietin The nurse is caring for a client with diabetes. Which of these findings is cause for concern leading the nurse to initiate client education? Hemoglobin A1 C level is 8.7. The nurse is planning to collect a 24-hour urine sample for hormone assay. In which of these situations does the nurse collaborate with the health care provider to find an alternate type of testing? Client has anuria. A client who is referred to the endocrinologist's office for an evaluation of his hormone levels asks what regulates the hormone levels. The best response would be that hormone levels in the body are primarily regulated by: The hypothalamic-pituitary-target cell system Which gland is often referred to as the master gland because it secretes many hormones? Pituitary The physician is assessing a client with a preliminary diagnosis of endocrine disorder. Further assessment findings identify abnormalities with emotion, pain, body temperature, and neural input. The physician determines the need to further assess the: Hypothalamus A nursing instructor is teaching a group of students about the action of hormones. The instructor determined that teaching was effective when the students' recognize the local action of hormones as: Paracrine Which of the following hormones cross cell membranes to connect to nuclear receptors? Select all that apply. • Vitamin D • Thyroid hormones • Glucocorticoids Cyclic adenosine monophosphate (cAMP) performs which of the following roles in the functioning of the endocrine system? Acting as a second messenger to mediate hormone action on target cells 12 | P a g e The nurse explains to a client in labor who has demonstrated ineffective contractions impeding progression of labor that the health care provider has added oxytocin infusion to the orders. Which of these does the nurse teach the client is the purpose of oxytocin? To stimulate contraction of the uterus The nurse is teaching a new diabetic about fingerstick blood glucose testing. When the client obtains a pre-meal fingerstick reading of 206 mg/dL, which teaching by the nurse is most appropriate? This is an elevated reading - let's talk about adherence to insulin and diet. Hormones are chemical messengers that: regulate body functions. Release and synthesis of anterior pituitary hormones are mainly regulated by the inhibiting or releasing actions of the: hypothalamus The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body? Negative feedback loop What is the most common mechanism of hormone control? Negative feedback Which of the following organ systems is matched with the preferred type of imaging? Magnetic resonance imaging (MRI) of the pituitary gland Which of the following manifestations would a nurse expect when assessing a child with insufficient growth hormone (GH) secretion? Rank below 10% on the growth chart When comparing the endocrine and nervous system functions, the nurse knows that the endocrine system: Select all that apply. • Glands are widely scattered throughout the body • Takes longer to respond to innervations but has prolonged actions when they arrive • Releases hormones into the blood that is transported throughout the body Which of the following structures controls the functions of the greatest number of target glands and cells? Pituitary gland A patient experiences an increase in thyroid hormone as a result of a thyroid tumor. Which of the following hormonal responses demonstrates the negative feedback mechanism? Decreased thyroid-stimulating hormone (TSH) 15 | P a g e A client with severe hypothyroidism is presently experiencing hypothermia. What nursing intervention is a priority in the care of this client? Slow rewarming of the client to prevent vasodilation and vascular collapse Which test can the nurse prepare the client for to determine the differentiation between a benign and a malignant thyroid disease? Fine-needle aspiration biopsy The nurse is caring for a 42-year-old male client who is admitted for treatment of heart failure. He has abnormally large hands and feet and a broad face with a protruding jaw. Based on these signs and symptoms, the nurse identifies which of the following endocrine disturbances as the most likely cause for these physical changes? Acromegaly A client arrives in the clinic and states to the nurse, "I am tired all the time and have gained weight. My hair is so dry it is breaking." The nurse assesses that the client's face is puffy with edematous eyelids and the outer third of the eyebrows are thinning. What lab test will the nurse prepare the client for that is characteristic of this disorder? T4 and TSH Which classification of medication does the nurse prepare to administer to the client with hyperthyroidism that will block the effects of the hyperthyroid state on sympathetic nervous system function? Beta-adrenergic blocking agent The nurse is performing an assessment for a client who has hyperthyroidism that is untreated. When obtaining vital signs, what is the expected finding? Heart rate 110 and bounding Which disorder is a result of excess cortisol? Cushing syndrome When educating a client with possible glucocorticoid dysfunction, the nurse will explain that the CRH controls the release of ACTH. The best time to perform the blood test to measure peak ACTH levels would be: 06:00 to 08:00 AM The newborn-nursery nurse is obtaining a blood sample to determine if a newborn has congenital hypothyroidism. What long-term complication is the nurse aware can occur if this test is not performed and the infant has congenital hypothyroidism? Cretinism 16 | P a g e One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisol- releasing hormone (CRH) and which of the following? ACTH Which of the following residents of a long-term facility is exhibiting clinical manifestations of hypothyroidism? An 80-year-old woman who has uncharacteristically lost her appetite of late and often complains of feeling cold The nurse is providing discharge instructions for a client with Graves' disease who has ophthalmopathy. What should the nurse be sure to include in the instructions to decrease exacerbation of this clinical manifestation? The client should be strongly urged not to smoke. Which effect of thyroid hormone deficit alters the function of all major organs in the body? Decreases metabolism The nurse is preparing a client for testing to determine if the client has Cushing syndrome. What tests are included in the screening process? Select all that apply. • 24-hour urine secretion of cortisol • Dexamethasone suppression test • Plasma levels of ACTH The nurse is caring for several clients who are taking growth hormone replacement therapy. Which client does the nurse recognize is most at risk for side effects? A 45-year-old obese client with an elevated serum IGF-1 concentration The nurse is providing education for a client diagnosed with hypothyroidism. What information about diet should the nurse be sure to include in this information? The client should maintain a low cholesterol diet. Which of the following individuals displays the precursors to acromegaly? An adult with an excess of growth hormone due to an adenoma The nurse is reviewing the assessment data of four clients. Select the client who would be diagnosed with precocious puberty. A 7-year-old female with early menarche Which test can the nurse prepare the client for to determine the differentiation between a benign and a malignant thyroid disease? Fine-needle aspiration biopsy 17 | P a g e A lung cancer client with small cell carcinoma may secrete an excess of which hormone causing an ectopic form of Cushing syndrome due to a nonpituitary tumor? ACTH A 33-year-old client has been admitted to the hospital for the treatment of Graves disease. Which of the following assessments should the client's care team prioritize? Assessment of the client's vision and oculomotor function Which of the following pathophysiologic phenomena may result in a diagnosis of Cushing disease? Excess ACTH production by a pituitary tumor A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to begin replacement therapy. Regarding which type of replacement will the nurse educate the client? Cortisol replacement therapy. A 25-year-old female client exhibits exophthalmos of both eyes. The health care provider recognizes this as a manifestation of: Graves disease A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to? A hypermetabolic state When educating a client with possible glucocorticoid dysfunction, the nurse will explain that the CRH controls the release of ACTH. The best time to perform the blood test to measure peak ACTH levels would be: 06:00 to 08:00 AM A child has been removed from a home in which she has experienced severe neglect and emotional abuse, and has been placed in foster care. The child has psychosocial dwarfism and the foster parents ask the nurse what this means for the future of the child. What is the best response by the nurse? A child has been removed from a home in which she has experienced severe neglect and emotional abuse, and has been placed in foster care. The child has psychosocial dwarfism and the foster parents ask the nurse what this means for the future of the child. What is the best response by the nurse? The nurse is caring for a 42-year-old male client who is admitted for treatment of heart failure. He has abnormally large hands and feet and a broad face with a protruding jaw. Based on these signs and symptoms, the nurse identifies which of the following endocrine disturbances as the most likely cause for these physical changes? Acromegaly