ARCHER REVIEW 3 EXAM: COMPREHENSIVE
QUESTIONS WITH FULL COMPLETE
SOLUTION
The nursing student is explaining the cause of Cushing's disease. Which of the
following statements indicate a correct understanding of this illness?
A. Cushing's disease occurs when insulin is overproduced.
[5%]
B. Cushing's disease is the result of the underproduction of aldosterone.
[17%]
C. Cushing's disease occurs when androgen hormones are underproduced.
[5%]
D. Cushing's disease is the result of the increased production of pituitary
hormones.
[73%] - ANSWER - Explanation
Choice D is correct. Cushing's disease occurs when adrenocorticotropic hormones
are over secreted by the pituitary gland, increasing cortisol.
Choice A is incorrect. The overproduction of insulin does not characterize
Cushing's disease.
Choice B is incorrect. The underproduction of corticosteroid hormones is
Addison's disease.
Choice C is incorrect. Cushing's disease is unrelated to the overproduction of
androgen.
NCSBN client need Topic: Physiological Integrity, Physiologic Adaptation
,An infant is returned to the unit after a surgical repair of a cleft lip on the left side.
Which of the following positions should the nursing staff place this child in?
A. On their stomach
[5%]
B. Prone
[16%]
C. On the left side
[13%]
D. On the right side
[66%] - ANSWER - Explanation
Choice D is correct. The infant should be placed on the right side. Post-surgical
complications include vomiting and aspiration. Lateral positioning prevents
aspiration. This infant should be placed on the right side so as not to disturb the
surgical site on the left side. A cleft lip is a congenital malformation in which soft
tissue or bone fails to fully connect while the infant develops in utero. Cleft-lip
may be associated with cleft palate but can occur as an isolated abnormality.
Choice A is incorrect. Infants should not rest or sleep on their abdomen due to the
risk of sudden infant death syndrome ( SIDS). The "Back to Sleep" campaign
emphasizes this to raise awareness that infants should be put to sleep on their
back, not on the abdomen. The only exception to this guideline is in the clients
who have undergone cleft palate repair. In case of "cleft palate" repair; a prone
position or lying on the abdomen is acceptable to facilitate drainage of secretions
and prevent airway obstruction.
Choice B is incorrect. Prone is not an appropriate position for an infant who has
just had "cleft lip" surgery. If placed prone, the suture line over the lip may be
rubbed against the surface in post-cleft lip cases. However, this differs from the
,cleft palate position. Laying prone after "cleft palate" surgery is appropriate and
preferred because it helps drain secretions reduces the risk of airway obstruction
and prevents the tongue from falling backward.
Choice C is incorrect. While lateral positioning is appropriate for an infant who has
just had cleft lip surgery, this infant had surgery on their left side. Laying on the
side of the surgery is not appropriate for patient safety.
NCSBN client need Topic: Physiological Integrity, Reduction of Risk Potential
Diabetes insipidus is a potential complication of which of the following
procedures?
A. Surgical removal of the pituitary gland
[87%]
B. Reduction of thyroid gland mass
[9%]
C. Hysterectomy
[2%]
D. Dilation and curettage
[2%] - ANSWER - Explanation
Choice A is correct. Any surgery that is near the pituitary gland will present with
the risk for diabetes insipidus (DI). This is because the posterior pituitary is the
gland that regulates antidiuretic hormone (ADH), and a decreased amount of ADH
results in DI.
Choice B is incorrect. A reduction of mass on the thyroid gland would not result in
an increased risk for diabetes insipidus.
, Choice C is incorrect. A hysterectomy would not result in an increased risk for
diabetes insipidus.
Choice D is incorrect. A dilation and curettage would not result in an increased
risk for diabetes insipidus.
NCSBN Client Need: Topic: Physiological Integrity, Subtopic: Reduction of Risk
Potential, Endocrine
The nurse is implementing orders for a client undergoing a barium enema. Aside
from the radiology department, which hospital department should be notified of
the procedure?
A. The cardiac catheterization department.
[10%]
B. The dietary department.
[46%]
C. The nuclear medicine department.
[26%]
D. The hospital laboratory department.
[18%] - ANSWER - Explanation
Choice B is correct. As part of the preparations for a barium enema, the client
needs to be on NPO for 8 - 10 hours. The dietary department needs to be
informed about withholding meals within the NPO period.
Choice A is incorrect. The procedure is performed in the radiology department,
not the cardiac catheterization department. Therefore the cardiac catheterization
department does not need to be informed.
QUESTIONS WITH FULL COMPLETE
SOLUTION
The nursing student is explaining the cause of Cushing's disease. Which of the
following statements indicate a correct understanding of this illness?
A. Cushing's disease occurs when insulin is overproduced.
[5%]
B. Cushing's disease is the result of the underproduction of aldosterone.
[17%]
C. Cushing's disease occurs when androgen hormones are underproduced.
[5%]
D. Cushing's disease is the result of the increased production of pituitary
hormones.
[73%] - ANSWER - Explanation
Choice D is correct. Cushing's disease occurs when adrenocorticotropic hormones
are over secreted by the pituitary gland, increasing cortisol.
Choice A is incorrect. The overproduction of insulin does not characterize
Cushing's disease.
Choice B is incorrect. The underproduction of corticosteroid hormones is
Addison's disease.
Choice C is incorrect. Cushing's disease is unrelated to the overproduction of
androgen.
NCSBN client need Topic: Physiological Integrity, Physiologic Adaptation
,An infant is returned to the unit after a surgical repair of a cleft lip on the left side.
Which of the following positions should the nursing staff place this child in?
A. On their stomach
[5%]
B. Prone
[16%]
C. On the left side
[13%]
D. On the right side
[66%] - ANSWER - Explanation
Choice D is correct. The infant should be placed on the right side. Post-surgical
complications include vomiting and aspiration. Lateral positioning prevents
aspiration. This infant should be placed on the right side so as not to disturb the
surgical site on the left side. A cleft lip is a congenital malformation in which soft
tissue or bone fails to fully connect while the infant develops in utero. Cleft-lip
may be associated with cleft palate but can occur as an isolated abnormality.
Choice A is incorrect. Infants should not rest or sleep on their abdomen due to the
risk of sudden infant death syndrome ( SIDS). The "Back to Sleep" campaign
emphasizes this to raise awareness that infants should be put to sleep on their
back, not on the abdomen. The only exception to this guideline is in the clients
who have undergone cleft palate repair. In case of "cleft palate" repair; a prone
position or lying on the abdomen is acceptable to facilitate drainage of secretions
and prevent airway obstruction.
Choice B is incorrect. Prone is not an appropriate position for an infant who has
just had "cleft lip" surgery. If placed prone, the suture line over the lip may be
rubbed against the surface in post-cleft lip cases. However, this differs from the
,cleft palate position. Laying prone after "cleft palate" surgery is appropriate and
preferred because it helps drain secretions reduces the risk of airway obstruction
and prevents the tongue from falling backward.
Choice C is incorrect. While lateral positioning is appropriate for an infant who has
just had cleft lip surgery, this infant had surgery on their left side. Laying on the
side of the surgery is not appropriate for patient safety.
NCSBN client need Topic: Physiological Integrity, Reduction of Risk Potential
Diabetes insipidus is a potential complication of which of the following
procedures?
A. Surgical removal of the pituitary gland
[87%]
B. Reduction of thyroid gland mass
[9%]
C. Hysterectomy
[2%]
D. Dilation and curettage
[2%] - ANSWER - Explanation
Choice A is correct. Any surgery that is near the pituitary gland will present with
the risk for diabetes insipidus (DI). This is because the posterior pituitary is the
gland that regulates antidiuretic hormone (ADH), and a decreased amount of ADH
results in DI.
Choice B is incorrect. A reduction of mass on the thyroid gland would not result in
an increased risk for diabetes insipidus.
, Choice C is incorrect. A hysterectomy would not result in an increased risk for
diabetes insipidus.
Choice D is incorrect. A dilation and curettage would not result in an increased
risk for diabetes insipidus.
NCSBN Client Need: Topic: Physiological Integrity, Subtopic: Reduction of Risk
Potential, Endocrine
The nurse is implementing orders for a client undergoing a barium enema. Aside
from the radiology department, which hospital department should be notified of
the procedure?
A. The cardiac catheterization department.
[10%]
B. The dietary department.
[46%]
C. The nuclear medicine department.
[26%]
D. The hospital laboratory department.
[18%] - ANSWER - Explanation
Choice B is correct. As part of the preparations for a barium enema, the client
needs to be on NPO for 8 - 10 hours. The dietary department needs to be
informed about withholding meals within the NPO period.
Choice A is incorrect. The procedure is performed in the radiology department,
not the cardiac catheterization department. Therefore the cardiac catheterization
department does not need to be informed.
