Professional Documents
Culture Documents
1. In counseling a client with ulcerative colitis for 25 years 6. The nurse explains to a client with Crohn’s disease who
about health plans, the nurse would include the advice that is recovering from a fourth bowel resection that because of
the client should the multiple resections, the client may develop
A. Avoid red meat A. malabsorption syndrome
C. peritonitis
C. obtain genetic counseling B. ulcerative colitis
B. reduce physical exercise
2. The out-patient clinic nurse is caring for a 66-year-old 7. Which nursing observation would suggest that a client
woman with insulin-dependent diabetes mellitus (IDDM). has developed an Addisonian crisis?
Because the client is unwilling to perform blood glucose A. Muscular weakness and fatigue.
monitoring, she tests her urine for sugar and acetone. The
nurse knows that blood glucose monitoring is preferred
over urine testing for glucose because
A. the renal threshold for glucose is elevated in the elderly.
B. blood glucose monitoring is easier and less costly for C. Dark pigmentation of the skin.
clients to perform. B. Restlessness and rapid, weak pulse.
C. urine testing for glucose provides false-positive
readings.
D. determination of the color on a reagent strip varies from
person to person. D. Gastrointestinal disturbances and anorexia
3. The Clinical instructor is supervising a student nurse 8. Which information should the nurse recognize as being
administering an enema to a patient. During the the MOST pertinent to the diagnosis of cholecystitis?
administration, it is MOST important for the Student nurse A. Flatulence.
to take which of the following actions?
A. Place the solution 20 inches above the anus.
B. Adjust the temperature of the solution.
C. Insert the tube six inches.
D. Position the patient left side-lying (Sim's) with knee
flexed.
C. Right upper abdominal pain.
4. Which of the following types of foods should the nurse B. Nausea and vomiting.
encourage in the diet of a client with hypoparathyroidism?
A. High in phosphorus.
D. Dyspepsia.
C. Low in sodium. 9. The nurse recognizes that the teaching about the
B. High in calcium. pathophysiology of ulcerative colitis needs reinforcement
when the 13 year old client says
A. “ulcerative colitis involves contiguous areas of bowel”
B. “I will grow out of my disease”
C. “I know that physical exertion and fatigue can bring on
an attack”
D. Low in potassium. D. “My symptoms with the disease will come and go”
5. The nurse suggests that the client not eat or drink 10. The nurse should caution the client with
anything just before going to bed. The appropriateness of hypothyroidism to avoid
this comment is based on which of these understandings A. warm environmental temperatures.
about GERD?
A. The client is less likely to awaken during the night with
heartburn if the stomach is empty.
B. Early-morning vomiting will be less of a problem if the C. increased physical exercise.
stomach is empty. B. narcotic sedatives.
C. Drinking or eating before lying down causes decreased
respirations due to increased pressure on the lungs.
D. The client may develop fluid overload if fluids are taken
just before going to bed.
controlled the past 6-8 weeks."
D. "I must follow my diet carefully for several days before
the test."
27. The nurse checks for placement of a nasogastric (NG) D. Heating pad.
tube before beginning a tube feeding for a client. Which of
the following results would indicate to the nurse that the 33. During evaluation, a client presents with coarse, dry,
tube feeding can begin? brittle hair and elevated blood pressure. When evaluating
A. A small amount of white mucus is aspirated from the the client’s head and neck area, the nurse would look
NG tube. specifically for
B. The pH of the contents removed from the NG tube is 3. a. bulging eyes.
C. No bubbles are seen when the nurse inverts the NG tube c. clear nasal drainage.
in water. b. cataracts.
D. The client says he can feel the NG tube in the back of d. dental caries.
his throat.
34. The nurse is caring for a client who is receiving a tube
28. A 46-year-old man with newly diagnosed diabetes feeding around the clock. Which of the following nursing
mellitus says to the nurse, "I know that I have to take good actions is MOST appropriate?
care of my feet. When I buy new shoes, is there anything A. Rinse the bag and change the formula every four hours.
special I should do?" Which of the following responses by B. Rinse the bag and change the formula every shift.
the nurse is BEST? C. Change the bag and formula every shift.
A. "It is best to buy new shoes in the morning." D. Rinse the bag and change the formula every two hours.
B. "Have each foot measured every time you buy new
shoes." 35. A 25-year-old primigravida with type I diabetes
C. "Buy shoes one half size larger than your foot size so the mellitus is reviewing her insulin regimen with the nurse.
fit is roomy." The nurse explains to the client that her insulin needs will
D. "Buy vinyl shoes because they won't lose their shape A. increase during pregnancy and decrease after delivery.
easily." B. decrease during pregnancy and increase after delivery.
C. increase during pregnancy and remain increased after
29. A client is admitted with irritable bowel syndrome. The delivery.
nurse would anticipate the client's history to reflect which D. decrease during pregnancy and fluctuate after delivery.
b. skin breakdown.
36. A client asks what the difference is between his gastric d.urinary tract infection.
ulcer and his friend's duodenal ulcer. The nurse's response
should be based on which of the following statements? 42. A client with a peptic ulcer had a partial gastrectomy
A. "Gastric ulcers have an increased association with and vagotomy (Billroth I). In planning the discharge
clients who experience increased psychological pressures." teaching, the client should be cautioned by the nurse about
B. "The pain of a duodenal ulcer usually occurs two to four which of the following?
hours after meals." A. Sit up for at least 30 minutes after eating.
C. "Clients with gastric ulcers often gain weight, as food B. Avoid fluids between meals.
alleviates the pain." C. Increase the intake of high-carbohydrate foods.
D. "Antacids such as Maalox are seldom prescribed for D. Avoid eating large meals that are high in simple sugars
clients with duodenal ulcers. " and liquids.
37. A client was admitted for regulation of her insulin 43. The nurse should explain to a client that tolbutamide
dosage. The client takes 15 units of Humulin insulin at 8 (Orinase) is effective for diabetics who
AM every day. At 4 PM, which of the following nursing A. can no longer produce any insulin.
observations would indicate a complication from the
insulin?
A. Acetone odor to the breath, polyuria, and flushed skin.
B. Irritability, tachycardia, and diaphoresis. C. are unable to administer their injections.
C. Headache, nervousness, and polydipsia. B. produce minimal amounts of insulin.
D. Tenseness, tachycardia, and anorexia.
38. A patient is admitted to the surgical unit with a D. have a sustained decreased blood glucose.
diagnosis of rule out intestinal obstruction. The nurse is
preparing to insert a NG tube as ordered. In which of the 44. A client with newly diagnosed type I diabetes mellitus
following positions would it be BEST for the nurse to place is being seen by the home health nurse. The physician
this patient during the procedure? orders include: 1,200-calorie ADA diet, 15 units of NPH
A. Head of bed elevated 30º - 45º. insulin before breakfast, and check blood sugar qid. When
the nurse visits the client at 5 PM, the nurse observes the
man performing a blood sugar analysis. The result is 50
mg/dL. The nurse would expect the client to be
A. confused with cold, clammy skin and a pulse of 110.
C. Side-lying with head elevated 15º. B. lethargic with hot dry skin and rapid, deep respirations.
B. Head of bed elevated 60º - 90º. C. alert and cooperative with a BP of 130/80 and
respirations of 12.
D. short of breath, with distended neck veins and a
bounding pulse of
D. Lying flat with head turned to the left side. 96.
39. A client received six units of regular insulin three hours 45. In making emergency equipment available at the
ago. The nurse would be MOST concerned if which of the bedside of a client who has undergone subtotal
following was observed? thyroidectomy, the nurse would include
A. Kussmaul respirations and diaphoresis. A. an electrocardiogram (ECG) monitor.
C. an intra-aortic balloon pump.
B. a defibrillator.
C. Diaphoresis and trembling. D. a tracheostomy set.
B. Anorexia and lethargy.
46.The nurse teaching a type 2 diabetic client how to
manage the disease while on a prescribed diet and taking an
oral antidiabetic agent would recognize that the client has
an accurate understanding of diabetes management when
the client states
A. “I must exercise at least 1 hour daily to help bring
D. Headache and polyuria. down my sugar.”
B. “I’m really happy I can take insulin pills; it’s much
40. The home health care nurse is caring for a 30-year-old easier than an injection.”
woman with type I diabetes mellitus. The client has been C. “I must decrease my total daily fat intake to less than
maintained on a regimen of NPH and regular insulin and a 45% of my total calories.”
1,800-calorie diabetic diet with normal blood sugar levels. D. “I can use oral medications for my diabetes as long as
Morning self-monitoring blood sugar (SMBG) readings the my pancreas can still produce insulin.”
past two days were 205 mg/dL and 233 mg/dL. The nurse
expects the physician to 47. The physician orders ranitidine hydrochloride (Zantac)
A. reduce the client's diet to 1,500 calorie ADA. 150 mg PO qd for a client. The nurse should advise the
B. order 3 additional units of NPH insulin at 10 PM. client the BEST time to take this medication is
C. order an additional 10 units of regular insulin at 8 PM. A. before breakfast.
D. eliminate the client's bedtime snack.
b. Graves’ disease.
D. at hs. d. Myxedema.
48. The nurse is performing discharge teaching for a client 54. An adult client has regular insulin ordered before
with Addison's disease. It is MOST important for the nurse breakfast. The nurse notes that the client's blood glucose
instruct the client about level is 68 mg/dL, and the client is nauseated. Which of the
A. signs and symptoms of infection. following actions should the nurse take?
A. Immediately give the client orange juice to drink.
B. Administer the insulin on time.
C. seizure precautions. C. Withhold the insulin and notify the physician.
B. fluid and electrolyte balance. D. Return the breakfast tray to the kitchen.
C. Tracheostomy set-up. 56. The nurse is caring for a client with Cushing's
B. Calcium gluconate for IV administration. syndrome. Which of the following nursing actions would
be of HIGHEST priority?
A. Implement measures to prevent skin breakdown.
B. Plan measures to prevent infections.
D. Suction equipment. C. Teach the client signs and symptoms of hyperglycemia.
D. Instigate measures to prevent fluid overload.
50. The nurse knows that the client with drug-induced
Cushing's syndrome should FIRST be instructed about 57. The nurse caring for a female client who had a total
A. compression fractures from increased calcium excretion. thyroidectomy 2 days ago would know to assess for tetany
B. decreased resistance to stress. if:
C. the schedule for gradual withdrawal of the drug. a. the assessment indicates decreasing diastolic blood
D. changes in secondary sex characteristics. pressure.
b. the client reports that her mouth has an odd sensation.
51. The client is exhibiting symptoms of myxedema. The c. the client reports a loss of appetite.
nursing assessment should reveal d. the client reports increased thirst.
A. increased pulse rate.
58. The nursing diagnosis Impaired Urinary Elimination
has been assigned to the client with hyperparathryoidism.
To address this diagnosis, the nurse would
a. encourage the client to start and stop the urine stream.
b. force fluids.
C. fine tremors. c. not administer fluids with meals.
B. decreased temperature. d. withhold acidic juices in the diet.
67. A client had surgery for cancer of the colon, and a 73. The nurse is caring for a two-month-old infant. A pH
colostomy was performed. Prior to discharge, the client probe test indicates that the infant has reflux. Which
states that he will no longer be able to swim. The nurse's nursing action is MOST appropriate?
response would be based on which of the following? A. Hold the next feeding.
A. Swimming is not recommended; the client should begin
looking for other areas of interest.
B. Swimming is not restricted if the client wears a
watertight dressing over the stoma.
C. The client cannot go into water that is over the stoma
area; he can C. Maintain a normal feeding schedule.
B. Teach the mother CPR.
go into water only up to that area.
D. There are no restrictions on the activity of a client with a
A. common duct obstruction.
C. spasm of the biliary tree.
B. perforation of the gallbladder.
D. infarct of the hepatic vein.
D. Elevate the head of the bed. 80. A client returned to the nursing unit after
cholecystectomy with common bile duct exploration has
74. The nurse providing education to a client newly bile leaking from around the wound. The most appropriate
diagnosed with diabetes mellitus about an exercise program nursing intervention at this time would be to
would remind the client to A. assess the client further, asking about pain.
A. reduce fluid intake before exercising. B. reassure the client that this is normal and reinforce the
C. refrain from eating until 30 minutes after dressing.
exercising. C. monitor the client for elevations in blood pressure and
B. ensure that blood sugar level is above 100. pulse.
D. set exercise periods for different times during the D. encourage the client to change position in bed.
day.
81.For a client with a history of recurrent UTI who is
75. The nurse is teaching a client with newly diagnosed prescribed an acid-ash diet, the nurse would advise the
diabetes mellitus how to treat hypoglycemia at home. The client to include
nurse should instruct the client to do which of the following a. carbonated beverages.
actions if symptoms of hypoglycemia are experienced? c. alcohol.
A. Eat a candy bar. b. coffee.
B. Drink 1/2-cup fruit juice followed by a protein snack. d. cranberry juice.
C. Inject 10 units of Humulin R.
D. Inject glucagon. 82. The nurse teaching self-catheterization technique
should include the importance of:
76. The nurse caring for a client admitted for treatment of a. sterile technique.
diabetic ketoacidosis (DKA) assesses Kussmaul’s b. drinking at least 500 ml of fluid within 2 hours of
respirations, which are catheterization.
A. rapid and short. c. using the Credé maneuver before catheterization.
C. irregular and gasping. d. catheterizing every 3 to 4 hours.
B. slow and shallow.
D. fast and deep. 83. During a bladder training program for a client with
spinal cord injury using intermittent catheterization, the
77. Following treatment for Addison's disease in a seven- client suddenly complains of a throbbing headache. Noting
year-old patient, the nurse plans for the client's discharge. that the client’s blood pressure is elevated, the nurse
The mother asks how long her daughter must continue initially would
receiving replacement therapy. The nurse's response should a. place the client flat in bed.
be c. notify the physician immediately.
A. "For approximately six months." b. catheterize the client.
d. Limit fluids for the remainder of the day.