NSG 320 EXAM 2 /NSG320 Exam 2 Actual
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100 Questions And Correct Answers
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Based on the clinical manifestations of Cushing syndrome, which nursing intervention would be
appropriate for a client who is newly diagnosed with Cushing syndrome?
A. Monitor blood glucose levels daily.
B. Increase intake of fluids high in potassium.
C. Encourage adequate rest between activities.
D. Offer the client a sodium-enriched menu.
- Correct Answer :Answer- A
Rationale- ushing syndrome results from a hypersecretion of glucocorticoids in the adrenal
cortex. Clients with Cushing syndrome often develop diabetes mellitus. Monitoring of serum
glucose levels assesses for increased blood glucose levels so that treatment can begin early. A
common finding in Cushing syndrome is generalized edema. Although potassium is needed, it is
generally obtained from food intake, not by offering potassium-enhanced fluids. Fatigue is
usually not an overwhelming factor in Cushing syndrome, so an emphasis on the need for rest is
not indicated A low-calorie, low-carbohydrate, low-sodium diet is not recommended.
What can insulin do? - Correct Answer :Increase serum potassium level (and blood glucose of
course)
The nurse is observing an unlicensed assistive personnel (UAP) performing morning care for a
bedridden client with Huntington disease. Which care measure is most important for the nurse
to supervise?
A. Oral Care
B. Bathing
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C. Foot Care
D. catheter care
- Correct Answer :Answer- A
Rationale- The client with Huntington disease experiences problems with motor skills such as
swallowing and is at high risk for aspiration, so the highest priority for the nurse to observe is the
UAP's ability to perform oral care safely. Options B, C, and D do not necessarily require
registered nurse (RN) supervision because they do not ordinarily pose life-threatening
consequences.
The nurse assesses a postoperative client whose skin is cool, pale, and moist. The client is very
restless and has scant urine output. Oxygen is being administered at 2 L/min, and a saline lock is
in place. Which intervention should the nurse implement first?
A. Measure the urine specific gravity.
B. Obtain IV fluids for infusion per protocol.
C. Prepare for insertion of a central venous catheter.
D. Auscultate the client's breath sounds.
- Correct Answer :Answer- B
Rationale- The client is at risk for hypovolemic shock because of the postoperative status and is
exhibiting early signs of shock. A priority intervention is the initiation of IV fluids to restore tissue
perfusion. Options A, C, and D are all important interventions but are of lower priority than
option B.
In assessing a client diagnosed with primary aldosteronism, the nurse expects the laboratory test
results to indicate a decreased serum level of which substance?
A. Sodium
B. Phosphate
C. Potassium
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D. Glucose
- Correct Answer :Answer- C
Rationale- Clients with primary aldosteronism exhibit a profound decline in serum levels of
potassium; hypokalemia; hypertension is the most prominent and universal sign. The serum
sodium level is normal or elevated, depending on the amount of water resorbed with the
sodium. Option B is influenced by parathyroid hormone (PTH). Option D is not affected by
primary aldosteronism.
What is the result of end-stage renal disease - Correct Answer :Elevated serum lipid levels
What is the result of diabetic ketoacidosis (DKA) - Correct Answer :ketonuria
What is associated with end-stage renal disease - Correct Answer :Hyperkalemia?
During the change of shift report, the charge nurse reviews the infusions being received by
clients on the oncology unit. The client receiving which infusion should be assessed first?
A. Continuous IV infusion of magnesium
B. One-time infusion of albumin
C. Continuous epidural infusion of morphine
D. Intermittent infusion of IV vancomycin
- Correct Answer :Answer- C
Rationale- All four of these clients have the potential to have significant complications. The client
with the morphine epidural infusion is at highest risk for respiratory depression and should be
assessed first. Option A can cause hypotension. The client receiving option B is at lowest risk for
serious complications. Although option D can cause nephrotoxicity and phlebitis, these problems
are not as immediately life threatening as option C.
A 55-year-old male client has been admitted to the hospital with a medical diagnosis of chronic
obstructive pulmonary disease (COPD). Which risk factor is the most significant in the
development of this client's COPD?
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A. The client's father was diagnosed with COPD in his 50s.
B. A close family member contracted tuberculosis last year.
C. The client smokes one to two packs of cigarettes per day.
D. The client has been 40 pounds overweight for 15 years.
- Correct Answer :Answer- C
Rationale- Smoking, considered to be a modifiable risk factor, is the most significant risk factor
for the development of COPD. The exact mechanism of genetic and hereditary implications for
the development of COPD is still under investigation, although exposure to similar predisposing
factors (e.g., smoking or inhaling secondhand smoke) may increase the likelihood of COPD
incidence among family members. Options B and D do not exceed the risks associated with
cigarette smoking in the development of COPD.
Which description of symptoms is characteristic of a client diagnosed with trigeminal neuralgia
(tic douloureux)?
A. Tinnitus, vertigo, and hearing difficulties
B. Sudden, stabbing, severe pain over the lip and chin
C. Unilateral facial weakness and paralysis
D. Difficulty in chewing, talking, and swallowing –
Correct Answer :Answer- B
Rationale- Trigeminal neuralgia is characterized by paroxysms of pain, similar to an electric
shock, in the area innervated by one or more branches of the trigeminal nerve (cranial V). Option
A would be characteristic of Ménière syndrome (cranial nerve VIII). Option C would be
characteristic of Bell palsy (cranial nerve VII). Option D would be characteristic of disorders of the
hypoglossal (cranial nerve XII).
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