Summary Nursing
Advanced Skills Test
Bank: Chapter 1 to 8
(NCLEX-Style Q&A) with
well elaborated
explanation and
solution
,The nurse explains to a client with thyroid disease that the thyroid gland normally
produces:
1. iodine and thyroid-stimulating hormone (TSH).
2. thyrotropin-releasing hormone (TRH) and TSH.
3. TSH, T3, and calcitonin.
4. T3, T4, and calcitonin. - CORRECT ANSWERS -4. T3, T4, and calcitonin.
The thyroid gland normally produces thyroid hormone (T3 and T4) and calcitonin. TSH
is produced by the pituitary gland to regulate the thyroid gland. TRH is produced by the
hypothalamus gland to regulate the pituitary gland.
A client is seen in the clinic with a possible parathormone deficiency. Diagnosis of this
condition includes the analysis of serum electrolytes. Which electrolytes would the
nurse expect to be abnormal?
1. Sodium
2. Potassium
3. Calcium
4. Chloride
5. Glucose
6. Phosphorous - CORRECT ANSWERS -3. Calcium
6. Phosphorous
A client with a parathormone deficiency has abnormal calcium and phosphorous values
because parathormone regulates these two electrolytes. Potassium, chloride, sodium,
and glucose aren't affected by a parathormone deficiency.
A client is being returned to the room after a subtotal thyroidectomy. Which piece of
equipment is most important for the nurse to keep at the client's bedside?
1. Indwelling urinary catheter kit
2. Tracheostomy set
3. Cardiac monitor
4. Humidifier - CORRECT ANSWERS -2. Tracheostomy set
After a subtotal thyroidectomy, swelling of the surgical site (the tracheal area) may
obstruct the airway. Therefore, the nurse should keep a tracheostomy set at the client's
,bedside in case of a respiratory emergency. Although an indwelling urinary catheter and
a cardiac monitor may be used for a client after a thyroidectomy, the tracheostomy set
is more important. A humidifier isn't indicated for this client.
When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that
secretes excessive catecholamine, the nurse is most likely to detect:
1. a blood pressure of 130/70 mm Hg.
2. a blood glucose level of 130 mg/dl.
3. bradycardia.
4. a blood pressure of 176/88 mm Hg. - CORRECT ANSWERS -4. a blood pressure of
176/88 mm Hg.
Pheochromocytoma, a tumor of the adrenal medulla that secretes excessive
catecholamine, causes hypertension, tachycardia, hyperglycemia, hypermetabolism,
and weight loss. It isn't associated with the other options.
Which nursing diagnosis takes highest priority for a client with hyperthyroidism?
1. Risk for imbalanced nutrition: More than body requirements related to thyroid
hormone excess
2. Risk for impaired skin integrity related to edema, skin fragility, and poor wound
healing
3. Disturbed body image related to weight gain and edema
4. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
- CORRECT ANSWERS -4. Imbalanced nutrition: Less than body requirements related
to thyroid hormone excess
In the client with hyperthyroidism, excessive thyroid hormone production leads to
hypermetabolism and increased nutrient metabolism. These conditions may result in a
negative nitrogen balance, increased protein synthesis and breakdown, decreased
glucose tolerance, and fat mobilization and depletion. This puts the client at risk for
marked nutrient and calorie deficiency, making Imbalanced nutrition: Less than body
requirements the most important nursing diagnosis. Options 2 and 3 may be appropriate
for a client with hypothyroidism, which slows the metabolic rate.
A client with Addison's disease comes to the clinic for a follow-up visit. When assessing
this client, the nurse should stay alert for signs and symptoms of:
1. calcium and phosphorus abnormalities.
2. chloride and magnesium abnormalities.
, 3. sodium and chloride abnormalities.
4. sodium and potassium abnormalities. - CORRECT ANSWERS -4. sodium and
potassium abnormalities.
In Addison's disease, a form of adrenocortical hypofunction, aldosterone secretion is
reduced. Aldosterone promotes sodium conservation and potassium excretion.
Therefore, aldosterone deficiency increases sodium excretion, predisposing the client to
hyponatremia, and inhibits potassium excretion, predisposing the client to hyperkalemia.
Because aldosterone doesn't regulate calcium, phosphorus, chloride, or magnesium, an
aldosterone deficiency doesn't affect levels of these electrolytes directly.
Which important instruction concerning the administration of levothyroxine (Synthroid)
should the nurse teach a client?
1. "Take the drug on an empty stomach."
2. "Take the drug with meals."
3. "Take the drug in the evening."
4. "Take the drug whenever convenient." - CORRECT ANSWERS -1. "Take the drug on
an empty stomach."
The nurse should instruct the client to take levothyroxine on an empty stomach (to
promote regular absorption) in the morning (to help prevent insomnia and to mimic
normal hormone release).
A client is diagnosed with the syndrome of inappropriate antidiuretic hormone (SIADH).
The nurse should anticipate which laboratory test result?
1. Decreased serum sodium level
2. Decreased serum creatinine level
3. Increased hematocrit
4. Increased blood urea nitrogen (BUN) level - CORRECT ANSWERS -1. Decreased
serum sodium level
In SIADH, the posterior pituitary gland produces excess antidiuretic hormone
(vasopressin), which decreases water excretion by the kidneys. This, in turn, reduces
the serum sodium level, causing hyponatremia. In SIADH, the serum creatinine level
isn't affected by the client's fluid status and remains within normal limits. Typically, the
hematocrit and BUN level decrease.
During preoperative teaching for a client who will undergo subtotal thyroidectomy, the
nurse should include which statement?
Advanced Skills Test
Bank: Chapter 1 to 8
(NCLEX-Style Q&A) with
well elaborated
explanation and
solution
,The nurse explains to a client with thyroid disease that the thyroid gland normally
produces:
1. iodine and thyroid-stimulating hormone (TSH).
2. thyrotropin-releasing hormone (TRH) and TSH.
3. TSH, T3, and calcitonin.
4. T3, T4, and calcitonin. - CORRECT ANSWERS -4. T3, T4, and calcitonin.
The thyroid gland normally produces thyroid hormone (T3 and T4) and calcitonin. TSH
is produced by the pituitary gland to regulate the thyroid gland. TRH is produced by the
hypothalamus gland to regulate the pituitary gland.
A client is seen in the clinic with a possible parathormone deficiency. Diagnosis of this
condition includes the analysis of serum electrolytes. Which electrolytes would the
nurse expect to be abnormal?
1. Sodium
2. Potassium
3. Calcium
4. Chloride
5. Glucose
6. Phosphorous - CORRECT ANSWERS -3. Calcium
6. Phosphorous
A client with a parathormone deficiency has abnormal calcium and phosphorous values
because parathormone regulates these two electrolytes. Potassium, chloride, sodium,
and glucose aren't affected by a parathormone deficiency.
A client is being returned to the room after a subtotal thyroidectomy. Which piece of
equipment is most important for the nurse to keep at the client's bedside?
1. Indwelling urinary catheter kit
2. Tracheostomy set
3. Cardiac monitor
4. Humidifier - CORRECT ANSWERS -2. Tracheostomy set
After a subtotal thyroidectomy, swelling of the surgical site (the tracheal area) may
obstruct the airway. Therefore, the nurse should keep a tracheostomy set at the client's
,bedside in case of a respiratory emergency. Although an indwelling urinary catheter and
a cardiac monitor may be used for a client after a thyroidectomy, the tracheostomy set
is more important. A humidifier isn't indicated for this client.
When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that
secretes excessive catecholamine, the nurse is most likely to detect:
1. a blood pressure of 130/70 mm Hg.
2. a blood glucose level of 130 mg/dl.
3. bradycardia.
4. a blood pressure of 176/88 mm Hg. - CORRECT ANSWERS -4. a blood pressure of
176/88 mm Hg.
Pheochromocytoma, a tumor of the adrenal medulla that secretes excessive
catecholamine, causes hypertension, tachycardia, hyperglycemia, hypermetabolism,
and weight loss. It isn't associated with the other options.
Which nursing diagnosis takes highest priority for a client with hyperthyroidism?
1. Risk for imbalanced nutrition: More than body requirements related to thyroid
hormone excess
2. Risk for impaired skin integrity related to edema, skin fragility, and poor wound
healing
3. Disturbed body image related to weight gain and edema
4. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
- CORRECT ANSWERS -4. Imbalanced nutrition: Less than body requirements related
to thyroid hormone excess
In the client with hyperthyroidism, excessive thyroid hormone production leads to
hypermetabolism and increased nutrient metabolism. These conditions may result in a
negative nitrogen balance, increased protein synthesis and breakdown, decreased
glucose tolerance, and fat mobilization and depletion. This puts the client at risk for
marked nutrient and calorie deficiency, making Imbalanced nutrition: Less than body
requirements the most important nursing diagnosis. Options 2 and 3 may be appropriate
for a client with hypothyroidism, which slows the metabolic rate.
A client with Addison's disease comes to the clinic for a follow-up visit. When assessing
this client, the nurse should stay alert for signs and symptoms of:
1. calcium and phosphorus abnormalities.
2. chloride and magnesium abnormalities.
, 3. sodium and chloride abnormalities.
4. sodium and potassium abnormalities. - CORRECT ANSWERS -4. sodium and
potassium abnormalities.
In Addison's disease, a form of adrenocortical hypofunction, aldosterone secretion is
reduced. Aldosterone promotes sodium conservation and potassium excretion.
Therefore, aldosterone deficiency increases sodium excretion, predisposing the client to
hyponatremia, and inhibits potassium excretion, predisposing the client to hyperkalemia.
Because aldosterone doesn't regulate calcium, phosphorus, chloride, or magnesium, an
aldosterone deficiency doesn't affect levels of these electrolytes directly.
Which important instruction concerning the administration of levothyroxine (Synthroid)
should the nurse teach a client?
1. "Take the drug on an empty stomach."
2. "Take the drug with meals."
3. "Take the drug in the evening."
4. "Take the drug whenever convenient." - CORRECT ANSWERS -1. "Take the drug on
an empty stomach."
The nurse should instruct the client to take levothyroxine on an empty stomach (to
promote regular absorption) in the morning (to help prevent insomnia and to mimic
normal hormone release).
A client is diagnosed with the syndrome of inappropriate antidiuretic hormone (SIADH).
The nurse should anticipate which laboratory test result?
1. Decreased serum sodium level
2. Decreased serum creatinine level
3. Increased hematocrit
4. Increased blood urea nitrogen (BUN) level - CORRECT ANSWERS -1. Decreased
serum sodium level
In SIADH, the posterior pituitary gland produces excess antidiuretic hormone
(vasopressin), which decreases water excretion by the kidneys. This, in turn, reduces
the serum sodium level, causing hyponatremia. In SIADH, the serum creatinine level
isn't affected by the client's fluid status and remains within normal limits. Typically, the
hematocrit and BUN level decrease.
During preoperative teaching for a client who will undergo subtotal thyroidectomy, the
nurse should include which statement?
