AMS Exam 1 - Confidential

AMS Exam 1 - Confidential Course Name: - Current Date and Time: Tue, Sep 24, 2019 @ 19:35:21 Security Options: •Secure Exam • Randomize Sequence • Randomize All Choices • Time Limit: 83 minutes Enabled Options: • Calculator • Numbering •Show 5 Min Alarm ____________________________________________________________________________ Question #: 1 When the nurse inspects the feet of a diabetic, a tack is found sticking in the sole of one foot. The client denies feeling anything unusual in the foot. Which is the best rationale for this finding? A. In diabetes, the autonomic nerves are affected. B. Motor neuropathy causes muscles to weaken and atrophy. C. High blood sugar decreases blood circulation to nerves. D. Nephropathy is a common complication of diabetes mellitus. ____________________________________________________________________________ Question #: 2 On initial nursing rounds, the diabetic client reports "not feeling well." Later, the nurse finds the client to be diaphoretic and in a stuporous state. Which is the immediate action taken by the nurse? A. Call the physician. B. Obtain a glucometer reading. C. Administer fruit juice. D. Start an IV of dextrose. ____________________________________________________________________________ Question #: 3 A recently widowed diabetic comments that blood sugar levels are running higher than usual. Which is the best response from the nurse? A. "People who eat alone tend to eat more." B. "Cooking lower carbohydrate meals for one person is a challenge." C. "This must be a stressful time for you." D. "Quit checking your blood sugars for now." ____________________________________________________________________________ Question #: 4 The nurse understands that a client with diabetes mellitus is at greater risk for developing which of the following complications? A. High blood pressure B. Urinary tract infections C. Lifelong obesity D. Elevated triglycerides ____________________________________________________________________________ Question #: 5 Which assessment finding is most important in determining nursing care for a client with diabetes mellitus? A. Respirations of 12 breaths/minute B. Cloudy urine C. Blood sugar 170 mg/dL D. Fruity breath ____________________________________________________________________________ Question #: 6 Which of the following would the nurse most likely assess in a client with diabetes who is experiencing autonomic neuropathy? A. Skeletal deformities B. Paresthesias C. Erectile dysfunction D. Soft tissue ulceration ____________________________________________________________________________ Question #: 7 A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well controlled? A. 6.5% B. 7.5% C. 8.0% D. 8.5% ____________________________________________________________________________ Question #: 8 The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes? A. Onset most common during adolescence B. Insufficient insulin production C. Less common than type 1 diabetes D. Little relation to prediabetes ____________________________________________________________________________ Question #: 9 A male client, aged 42 years, is diagnosed with diabetes mellitus. He visits the gym regularly and is a vegetarian. Which of the following factors is important when assessing the client? A. The client's consumption of carbohydrates B. History of radiographic contrast studies that used iodine C. The client's mental and emotional status D. The client's exercise routine ____________________________________________________________________________ Question #: 10 The nurse is providing information about foot care to a client with diabetes. Which of the following would the nurse include? A. "Wash your feet in hot water every day." B. "Use a razor to remove corns or calluses." C. "Be sure to apply a moisturizer to feet daily." D. "Wear well-fitting comfortable rubber shoes." ____________________________________________________________________________ Question #: 11 A client with Addison's disease is being discharged from the hospital and is being instructed about the dietary regimen. What type of diet should the nurse provide about in written and verbal instructions? A. Low-carbohydrate, low-protein diet B. Low-fat, high-protein diet C. Low-protein, high-carbohydrate diet D. High-protein, moderate-carbohydrate diet ____________________________________________________________________________ Question #: 12 What statement made by the client indicates further instruction by the nurse is required about taking corticosteroid therapy for adrenal insufficiency? A. "I will take the corticosteroid medication until my adrenal glands begin to work." B. "I will not omit any of the doses of my medication." C. "I will seek medical attention for dosage readjustments whenever I am under stress." D. "I will get plenty of rest and avoid exposure to infection." ____________________________________________________________________________ Question #: 13 A client with severe hypoparathyroidism is experiencing tetany. What medication, prescribed by the physician for emergency use, will the nurse administer to correct the deficit? A. Sodium bicarbonate B. Fludrocortisone C. Calcium gluconate D. Methylprednisolone ____________________________________________________________________________ Question #: 14 The nurse is caring for a client with hypoparathyroidism. When the nurse taps the client's facial nerve, the client's mouth twitches and the jaw tightens. What is this response documented as related to the low calcium levels? A. Positive Chvostek's sign B. Positive Trousseau's sign C. Positive paresthesias D. Positive Babinski's sign ____________________________________________________________________________ Question #: 15 What life-threatening outcome should the nurse monitor for in a client who is not compliant with taking his antithyroid medication? A. Thyrotoxic crisis B. Myxedema coma C. Diabetes insipidus D. Syndrome of inappropriate antidiuretic hormone secretion ____________________________________________________________________________ Question #: 16 A client is taking methimazole every 8 hours around the clock for the treatment of severe hyperthyroidism. The client has been taking the medication for 2 months. What should the nurse instruct the client to report immediately? Select all that apply. A. Sore throat B. Unusual bleeding C. Fever D. Pain in the leg E. Cough ____________________________________________________________________________ Question #: 17 The nurse is administering a medication to a client with hyperthyroidism to block the production of thyroid hormone. The client is not a candidate for surgical intervention at this time. What medication should the nurse administer to the client? A. Levothyroxine B. Spironolactone C. Propylthiouracil D. Propranolol ____________________________________________________________________________ Question #: 18 The nurse is assessing a client in the clinic who appears restless, excitable, and agitated. The nurse observes that the client has exophthalmos and neck swelling. What diagnosis do these clinical manifestations correlate with? A. Hypothyroidism B. Hyperthyroidism C. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) D. Diabetes insipidus (DI) ____________________________________________________________________________ Question #: 19 A client with acromegaly is complaining of severe headaches. What does the nurse suspect is the cause of the headaches that is related to the acromegaly? A. A pituitary tumor B. A decrease in release in the growth hormone C. A decrease in the glucose level D. An increase in cerebral edema ____________________________________________________________________________ Question #: 20 A client with Addison's disease has a blood glucose level above 80 mg/dL 30 minutes after receiving 15 g of carbohydrates for symptoms of hypoglycemia. Which of the following would the nurse do now? A. Inform the physician immediately. B. Give the client milk and graham crackers. C. Instruct the client to remain in bed. D. Check the client's blood glucose level before each meal. ____________________________________________________________________________ Question #: 21 The nurse is performing an assessment of the thyroid gland. In order to decrease the risk that the nurse will stimulate the release of large amounts of thyroid hormone, what should the nurse be sure to do? A. Palpate firmly in order to feel the thyroid gland. B. Palpate gently without repeated attempts. C. Continue to palpate the gland until it is felt for enlargement. D. Not palpate the thyroid and just listen for a bruit. ____________________________________________________________________________ Question #: 22 A client is admitted to the hospital and will be undergoing tests to determine if he has an abdominal mass. What should the nurse be sure to document when asking about allergies? A. If the client is allergic to beef B. If the client is allergic to pork C. If the client is allergic to seafood D. If the client is allergic to grapefruit ____________________________________________________________________________ Question #: 23 The nurse is caring for a client with diabetes who developed hypoglycemia. What can the nurse administer to the client to raise the blood sugar level? A. Insulin B. Glucagon C. Cortisone D. Estrogen ____________________________________________________________________________ Question #: 24 A client who is frightened of needles has been told that he will have to have an intravenous (IV) line inserted. The client's blood pressure and pulse rate increase, and the nurse observes the pupils dilating. What does the nurse recognize has occurred with this client? A. The client is developing an infection. B. The client is having a response to dehydration. C. The client is in a hypertensive crisis. D. The client is showing the fight-or-flight response. ____________________________________________________________________________ Question #: 25 A client is experiencing an increase in blood glucose levels. The nurse understands that which of the following hormones would be important in lowering the client's blood glucose level? A. Insulin B. Parathormone C. Melatonin D. Calcitonin ____________________________________________________________________________ Question #: 26 The nurse is reviewing the plan of care for a client with a disorder of the thyroid gland. Which diagnostic test would the nurse expect the physician to order to evaluate thyroid hormones? A. Magnetic resonance imaging B. Radioimmunoassay C. Computed tomography (CT) D. Cortisol level determination ____________________________________________________________________________ Question #: 27 A client is suspected of having leukemia and is having a series of laboratory and diagnostic studies performed. What does the nurse recognize as the hallmark signs of leukemia? Select all that apply. A. Diarrhea B. Nausea and vomiting C. Frequent infections D. Fatigue from anemia E. Easy bruising ____________________________________________________________________________ Question #: 28 A client with sickle cell disease informs the nurse that he is having chest pain. The nurse hears the client coughing, wheezing, and breathing rapidly. What does the nurse suspect is occurring with this client? A. Vaso-occlusive crisis B. Pneumocystis pneumonia C. Acute chest syndrome D. Acute muscular strain ____________________________________________________________________________ Question #: 29 The registered nurse (RN) and licensed practical nurse (LPN) are preparing an educational program for clients who may be at risk for the development of iron-deficiency anemia. Which clients would receive the greatest benefit from this program? Select all that apply. A. A young female client with bulimia nervosa B. An older adult client on a fixed income C. A client with Crohn's disease D. A client who lives in a nursing home E. A client who is a vegetarian ____________________________________________________________________________ Question #: 30 The LPN is following a plan of care for a client who is being treated for hypovolemic anemia and is at risk for hypovolemic shock. The nurse assesses vital signs and O2 saturation and observes the saturation at 89% for 3 minutes. What should the first action by the nurse be? A. Notify the charge nurse. B. Prepare to assist with intubation. C. Give oxygen per nasal cannula D. Place the client in the supine position. ____________________________________________________________________________ Question #: 31 A client is being treated in the hospital for hypovolemia related to a bleeding peptic ulcer. The nurse obtains a blood pressure reading of 88/62 mm Hg, heart rate of 112 beats/minute, and a respiratory rate of 24 breaths/minute. What is the first action by the nurse? A. Administer blood. B. Notify the physician. C. Insert two large-bore intravenous catheters. D. Administer a colloid solution. ____________________________________________________________________________ Question #: 32 A client comes to the walk-in clinic complaining of weakness and fatigue. While assessing this client, the nurse finds evidence of petechiae and ecchymoses. The nurse notes that the spleen appears enlarged. What would the nurse suspect is wrong with this client? A. Aplastic anemia B. Pernicious anemia C. Iron-deficiency anemia D. Agranulocytosis ____________________________________________________________________________ Question #: 33 A client diagnosed with polycythemia vera has come into the clinic because he has developed a nighttime cough, fatigue, and shortness of breath. From these clinical manifestations, what complication would the nurse suspect in this client? A. Stroke B. Tissue infarction C. Congestive heart failure D. Pulmonary embolus ____________________________________________________________________________ Question #: 34 The nurse caring for an older adult with a diagnosis of leukemia would encourage the client to use an electric razor. What is the rationale for this statement by the nurse? A. Trauma and microabrasions from a nonelectric razor may contribute to anemia. B. Fragile tissues and altered clotting mechanisms may result in hemorrhage. C. The client is at risk for spontaneous and uncontrolled bleeding. D. The client is at risk for infection from microorganisms. ____________________________________________________________________________ Question #: 35 The client was admitted to the emergency department after an accident with a chain saw. The client is exhibiting signs and symptoms of acute hypovolemic anemia from severe blood loss. What signs and symptoms would the nurse assess for? A. Malabsorption disorders B. Postural hypotension C. Fatigue D. Reduced urine output ____________________________________________________________________________ Question #: 36 A client is taking a medication that has the side effect of depressing the hematopoietic system. What signs of leukopenia should the nurse monitor for while the client is taking this drug? A. Fever, sore throat, and chills B. Nausea and vomiting C. Diarrhea, diaphoresis, and fever D. Intolerance to heat and rash ____________________________________________________________________________ Question #: 37 A client is scheduled for a bone marrow aspiration and is extremely apprehensive about having the procedure done. The nurse explains that there may be a feeling of pressure or discomfort when puncturing the bone. What intervention can the nurse provide to assist with this concern? A. Inform the client that he will not be able to move and will have to tolerate the discomfort for 20 minutes. B. Inform the client that if he is concerned that he will move when the bone is punctured, soft wrist restraints can be used if the client approves. C. Assist the client with focused imagery to avoid focusing on the procedure and any discomfort associated with it. D. Suggest chewing gum or eating candy in order to focus on something other than the discomfort. ____________________________________________________________________________ Question #: 38 A client is scheduled for a Schilling test in the morning. What diagnostic results would be indicated if the test is positive? Select all that apply. A. Iron-deficiency anemia B. Pernicious anemia C. Sickle-cell anemia D. A gastric ulcer ____________________________________________________________________________ Question #: 39 A client is brought to the emergency department with suspected bleeding esophageal varices. Which hemoglobin level should the nurse immediately report to the physician? A. 13.0 g/dL B. 10.2 g/dL C. 5.0 g/dL D. 11.4 g/dL ____________________________________________________________________________ Question #: 40 The nurse is discussing vitamin replacement with a client in the clinic. Which vitamin should the nurse discuss with the client in order to increase the absorption of folic acid and iron? A. Vitamin B12 B. Vitamin C C. Vitamin B6 D. Vitamin E ____________________________________________________________________________ Question #: 41 A client is seeing the physician at the clinic and tells the nurse he is fatigued and short of breath with minimal exertion. What lab study may reflect a decrease in transport of oxygen? A. Erythrocyte count B. Leukocyte count C. Platelet count D. Albumin level ____________________________________________________________________________ Question #: 42 A client's family member asks what hematopoiesis is. What should the nurse tell the family member? A. The manufacture and development of blood cells B. The production of lymphatic fluid in the body C. The making of red blood cells and lymph D. The development of lymph in the bone marrow ____________________________________________________________________________ Question #: 43 The nurse is caring for a client who is undergoing bone marrow aspiration to determine the blood cell formation status. What nursing intervention should the nurse provide to the client during the test? A. Administer oral radioactive vitamin B12 to the client. B. Administer a nonradioactive B12 injection. C. Collect urine for 24 to 48 hours after the client receives the nonradioactive B12 D. Support the client and monitor the status ____________________________________________________________________________ Question #: 44 Parents arrive at the clinic with their young child and inform the nurse the child has just been diagnosed with sickle cell disease. The parents ask the nurse how could this happen and which one of them is the carrier. What is the best response by the nurse? A. "Most likely, the father is the carrier of the gene." B. "The trait is passed down through the mother." C. "The child must inherit two defective genes, one from each parent." D. "It is an acquired, not hereditary disorder." ____________________________________________________________________________ Question #: 45 The nurse is instructing a client about taking a liquid iron preparation for the treatment of iron-deficiency anemia. What should the nurse include in the instructions? A. Do not take the medication with orange juice because it will delay absorption of the iron B. Iron may cause indigestion and should be taken with an antacid such as Mylanta C. Dilute the liquid preparation with another liquid such a juice and drink it with a straw D. Discontinue the use of iron if your stools turn black ____________________________________________________________________________ Question #: 46 At 2100, the nurse hangs a bag of Normal Saline 500 ml to infuse at 50ml/hr. At what time should the nurse expect the bag of Normal Saline to be empty? 1 1. 0700 ____________________________________________________________________________ Question #: 47 A child weighs 52 pounds. How many kilograms does the child weigh? 1 1. 23.6 ____________________________________________________________________________ Question #: 48 The baby drinks 5.2 ounces of milk. How many milliliters did the baby drink? 1 1. 156 ____________________________________________________________________________ Question #: 49 The provider prescribed: Penicillin at 2.4mcg/kg/dose. The pharmacy supplies Penicillin 250 mg in 500mL of D5W. The client weighs 90kg. How many milliliters should the nurse administer? (ROUND TO THE NEAREST HUNDREDTH) 1 1. 0.43 ml/dose ____________________________________________________________________________ Question #: 50 The provider prescribed: Dilantin 175 mg PO every 6 hours. The nurse has Dilantin 100mg per 5 ml. How many milliliters should the nurse administer? (ROUND TO THE NEAREST WHOLE NUMBER) 1 1.