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Exam Prep Questions

1.A client is admitted for removal of a goiter. Which nursing intervention should receive priority during the post-operative period?

A.Maintaining fluid and electrolyte balance
B.Assessing the client’s airway
C.Providing needed nutrition and fluids
D.Providing pain relief with narcotic analgesics


2.A client is admitted for treatment of hypoparathyroidism. Based on the client’s diagnosis, the nurse would anticipate an order for:

A.Potassium
B.Magnesium
C.Calcium
D.Iron


3.A client with Addison’s disease will most likely exhibit which symptom?

A.Hypertension
B.Bronze pigmentation
C.Hirsutism
D.Purple striae


4.A client with Cushing’s syndrome should be instructed to:

A.Avoid alcoholic beverages
B.Limit the sodium in her diet
C.Increase servings of dark green vegetables
D.Limit the amount of protein in her diet


5.The client with a suspected pituitary tumor will most likely exhibit symptoms of:

A.Alteration in visual acuity
B.Frequent diarrhea
C.Alterations in blood glucose
D.Urticaria


6.A diabetic client has been maintained on Glucophage (metformin) for regulation of his blood glucose levels. Which teaching should be included in the plan of care?

A.Report changes in urinary pattern.
B.Allow six weeks for optimal effects.
C.Increase the amount of carbohydrates in your diet.
D.Use lotions to treat itching.


7.A client with diabetes experiences Somogyi’s effect. To prevent this complication, the nurse should instruct the client to:

A.Take his insulin each day at 1400 hours
B.Engage in physical activity daily
C.Increase the amount of regular insulin
D.Eat a protein and carbohydrate snack at bedtime


8.Which item should be kept at the bedside of a client who has just returned from having a thyroidectomy?

A.A padded tongue
B.An endotracheal tube
C.An airway
D.A tracheostomy set


9.Which vitamin is directly involved in the metabolism of the hormones secreted by the parathyroid?

A.Vitamin C
B.Vitamin D
C.Vitamin K
D.Vitamin B9


10.A client with acromegaly will most likely experience which symptom?

A.Bone pain
B.Frequent infections
C.Fatigue
D.Weight loss


11.A diabetic client is taking Lantus insulin for regulation of his blood glucose levels. The nurse should know that this insulin will most likely be administered:

A.Prior to each meal
B.At night
C.Midday
D.Prior to the evening meal


12.A client with polyuria, polydipsia, and polyphagia is diagnosed with diabetes mellitus. The nurse would expect that these symptoms are related to

A.Hypoglycemia
B.Hyperglycemia
C.Hyperparathyroidism
D.Hyperthyroidism


13.Which laboratory test conducted on the client with diabetes mellitus indicates compliance?

A.Fasting blood glucose
B.Two-hour post-prandial
C.Hgb A-1C
D.Dextrostix


Answer Rationales

1.Answer B is correct. A goiter is hyperplasia of the thyroid gland. Removal of a goiter can result in laryngeal spasms and airway occlusion. The other answers are lesser in priority.
2.Answer C is correct. The parathyroid is responsible for calcium and phosphorus absorption. Clients with hypoparathyroidism have hypocalcemia. Answers A, B, and D are not associated with hypoparathyroidism therefore they are incorrect.
3.Answer B is correct. Answer B is correct because a bronze pigmentation is a sign of Addison’s disease. Answers A, C, and D are symptoms of Cushing’s syndrome, making them incorrect.
4.Answer B is correct. A client with Cushing’s syndrome has adrenocortical hypersecretion, so she retains sodium and water. The client may drink alcohol in moderation, so answer A is incorrect, and there is no need to eat more green vegetables or limit protein, so answers C and D are incorrect.
5.Answer A is correct. The pituitary is located in the middle of the skull adjacent to the optic nerve and brain. Pressure on the optic nerve can cause an increase in intracranial pressure. Clients frequently complain of headache, nausea, vomiting, and decreasing visual acuity as the intracranial pressure increases. B, C, and D are incorrect because they are not associated with a pituitary tumor.
6.Answer A is correct. Glucophage (metformin) can cause renal complications. The client should be monitored for changes in renal function. In answer B, the medication begins working immediately, so it is incorrect. In answer C, the amount of carbohydrates should be regulated with a diabetic diet, so it is incorrect. The use of lotions in answer D is unnecessary, so it is incorrect.
7.Answer D is correct. Somogyi’s is characterized by a drop in glucose levels at approximately 2 a.m. or 3 a.m. followed by a false elevation. Eating a protein and carbohydrate snack before retiring prevents the hypoglycemia and rebound elevation. Answers A, B, and C are incorrect because they do not prevent Somogyi’s effect.
8.Answer D is correct. Laryngeal swelling is not uncommon in clients following a thyroidectomy. A tracheostomy tray should be kept available. The ventilator is not necessary, so answer A is incorrect. The endotracheal tube is very difficult, if not impossible, to intubate if swelling has already occurred, so answer B is incorrect. The airway will do no good because the swelling is in the trachea, so answer C is incorrect.
9.Answer B is correct. Vitamin D is related to absorption of calcium and phosphorus. A, C, and D are incorrect because they are not related to the absorption of calcium and phosphorus.
10.Answer A is correct. Acromegaly is an increase in secretion of growth hormone. The growth hormones cause expansion and elongation of the bones. Answers B, C, and D are not directly associated with acromegaly, so they are incorrect.
11.Answer B is correct. This insulin, unlike others, is most frequently administered at night. Its duration is 24–36 hours. A, C, and D are incorrect they are incorrect times to administer Lantus insulin.
12.Answer B is correct. The client with hyperglycemia will exhibit polyuria, polydipsia, or increased thirst, and polyphagia, or increased hunger. A, C, and D are incorrect because they are not signs of hypoglycemia.
13.Answer C is correct. The Hgb A-1C indicates that the client has been compliant for approximately three months. Answers A, B, and D tell the nurse the client’s blood glucose at the time of the test, so they are incorrect.


  

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