NSG 320 EXAM 2 /NSG320 Exam 2 Actual Exam
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A client has experienced several autoimmune disorders over the last 25 years, and lately has
developed a new set of symptoms. What assessments would the nurse expect to find with a
client with suspected Addison disease? Select all that apply.
Weight gain
Increased appetite
Hypoglycemia
Depression
Hypotension
- Correct Answer :Hypoglycemia
Depression
Hypotension
Explanation:
Addison disease is characterized by muscle weakness, anorexia, GI symptoms, fatigue,
emaciation, hypotension, low blood glucose levels, low serum sodium levels, high serum
potassium levels, and dark pigmentation of the mucous membranes and the skin, especially of
the knuckles, knees, and elbows. Depression, emotional lability, apathy, and confusion may also
be present.
A nurse is caring for a client who has developed agranulocytosis as a result of taking
propylthiouracil to treat hyperthyroidism. The nurse should understand that this client is at
increased risk for which of the following conditions?
Excessive bleeding
Ecchymosis
Infection
Hyperglycemia
- Correct Answer :infection
A+ TEST BANK 1
, NSG 320 EXAM 2
Agranulocytosis is a failure of the bone marrow to make enough white blood cells, cauing
neutropenia and lowering the body defenses against infection
A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse
should identify which of the following findings as an indication that the medication is effective?
A decrease in blood sugar
A decrease in blood pressure
A decrease in urine output
A decrease in specific gravity
- Correct Answer :A decrease in urine output
The major manifestations of diabetes insipidus are excessive urination and extreme thirst.
Vasopressin is used to control frequent urination, increased thirst, and loss of water associated
with diabetes insipidus. A decreased urine output is the desired outcome
A nurse is assessing a client who has diabetes insipidus. Which of the following findings should
the nurse expect?
Dehydration
Polyphagia
Hyperglycemia
Bradycardia
- Correct Answer :Dehydration
Diabetes insipidus causes excessive excretion of dilute urine, resulting in dehydration.
Polyphagia and hyperglycemia are found in diabetes mellitus.
Tachycardia, not bradycardia, is a manifestation of diabetes insipidus.
A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism.
The nurse should anticipate an elevation of which of the following laboratory values?
Thyroid stimulating hormone (TSH)
Free T4
Serum T4
Serum T3
- Correct Answer :Thyroid stimulating hormone (TSH)
A+ TEST BANK 2
, NSG 320 EXAM 2
The nurse should anticipate that TSH will be elevated.
Free T4 will be decreased
Serum T4 will be decreased
Serum T3 will be decreased
A nurse is proving teaching to a client who has a new diagnosis of hypothyroidism. On which of
the following medications should the nurse prepare to instruct the client?
Radioactive iodine
Levothyroxine
Sumatriptan
Levofloxacin
- Correct Answer :Levothyoxine
Levothyroxine is a synthetic thyroid hormone that is chemically identical to thyroxine (T4). It is
used in the treatment of hypothyroidism. The nurse should be prepared to instruct the client on
the use of this medication
Radioactive iodine is an anti-thyroid med that treats thyroid cancer, hyperthyroidism, and is used
as a diagnostic aid for thyroid function studies
Sumatriptan is an anti-migraine agent used for acute treatment migraine and cluster headaches.
Levofloxacin is a broad spectrum anti-infective of the quinolone class that is used to treat
infections of the sinuses, skin, lungs, ears, airways, bones, joints, and urinary tract
A nurse is caring for a client who had total thyroidectomy and a serum calcium level of 7.6
mg/dL. Which of the following findings should the nurse expect?
Tingling of the extremities
Hypoactive deep tendon reflexes
Shorted QT intervals
Constipation
- Correct Answer :Normal range: 8.8 - 10.4
Tingling of the extremities
A serum calcium level of 7.6 mg/dL is below the expected reference range, indicating
hypocalcemia. A client who undergoes a total thyroidectomy is at risk for parathyroid injury
A+ TEST BANK 3
, NSG 320 EXAM 2
which can lead to hypocalcemia. The nurse should monitor the client for reports of tingling and
numbness of the extremities and around the mouth, muscle tremors, cramps, and cardiac
dysrhythmias
A nurse is assessing a client who has hyperthyroidism. The nurse should expect the client to
report which of the following manifestations?
Sensitivity to cold
Constipation
Frequent mood changes
Weight gain of 4.5 kg (10 lb) in 3 weeks
- Correct Answer :Frequent mood changes
Hyperthyroidism develops when the thyroid gland produces an excess of the thyroid hormones
that regulate the metabolic rate. Clients experience emotional lability that fluctuates between
emotional hyperexcitability and irritability. They often cannot sit quietly.
A nurse is caring for a client who is 1 day postoperative following subtotal thyroidectomy. The
client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For
which of the following findings should the nurse assess the client?
Chvostek's sign
Babinski's sign
Brudzinski's sign
Kernig's sign
- Correct Answer :Chvostek's sign
The nurse should suspect that the client has hypocalcemia, a possible complication following
subtotal thyroidectomy. Manifestations of hypocalcemia include numbness and tingling in the
hands, the soles of the feet, and around the lips, typically appearing between 24 and 48 hr after
surgery. To elicit Chvostek's sign, the nurse should tap the client's face at a point just below and
in front of the ear. A positive response would be twitching of the ipsilateral (same side only)
facial muscles, suggesting neuromuscular excitability due to hypocalcemia.
A nurse is teaching about levothyroxine with a client who has primary hypothyroidism. Which of
the following statements should the nurse use when teaching the client?
"Take this medication until your symptoms are gone and then discontinue"
"Tremors, nervousness, and insomnia may indicate your dose is too high"
"Symptoms improve immediately after starting the medication"
A+ TEST BANK 4