ATI RN 231 Custom Assessment Detailed 60 Question Analysis Unit 2 Exam 2023 update |Carrington College Sacramento ADN

ATI RN 231 Custom Assessment Detailed 60 Question Analysis Unit 2 Exam 2023 update |Carrington College Sacramento ADN Custom Assessment Detailed Question Analysis Assessment: RN 231 - Unit 2 Exam - 2.4.17(2) (AR)_Cloned Assessment # : Date Test : 5/02/2023 Institution : Carrington College Sacramento ADN # of Questions : 60 Program Type : ADN KR-20 : N/A Group Size : 22 Group Score : 86.5% Student Question Question Type Student Answer Is Correct leah, rebecca l A nurse is monitoring a client who was admitted with a severe burn injury and is receiving IV fluid resuscitation therapy. The nurse should identify a decrease in which of the following findings as an indication of adequate fluid replacement? Multiple Choice Heart rate Yes leah, rebecca l A nurse is caring for a client who is 1 day postoperative following a 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? Multiple Choice Chvostek's sign Yes leah, rebecca l A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client? Multiple Choice Regular insulin Yes leah, rebecca l 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? Multiple Choice Serum T<sub>4</sub> No leah, rebecca l A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take? Multiple Choice Administer oral corticosteroids. No Student Question Question Type Student Answer Is Correct leah, rebecca l A nurse is assisting a client who has hypothyroidism with meal planning. Which of the following foods should the nurse recommend that the client add to her diet? Multiple Choice Baked chicken No leah, rebecca l A nurse is monitoring a client who is postoperative following a thyroidectomy. Which of the following data should the nurse identify as the priority to monitor? Multiple Choice Airway patency Yes leah, rebecca l A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect? Multiple Choice Urine specific gravity 1.002 Yes leah, rebecca l A nursing is providing dietary teaching for a client who has Cushing's disease. Which of the following recommendations should nurse include in the teaching? Multiple Choice Restrict sodium intake. Yes leah, rebecca l A nurse is assessing a client who has Graves' disease. The nurse should expect which of the following laboratory results? Multiple Choice Decreased thyroxine (T<sub>4</sub>) level No leah, rebecca l A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider? Multiple Choice 0.9% sodium chloride IV bolus Yes leah, rebecca l A nurse is assessing a client who has thyrotoxicosis after taking too high of a level of levothyroxine. Which of the following manifestations should the nurse expect? Multiple Choice Heat intolerance Yes leah, rebecca l A nurse is preparing to administer levothyroxine 100 mcg PO daily. Available is levothyroxine 50 mcg tablets. How many tablets should the nurse administer daily? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) Fill in the Blank Numeric 2 Yes leah, rebecca l 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? Multiple Choice Tremors, nervousness, and insomnia may indicate your dose is too high. Yes leah, rebecca l A nurse is planning care for a client who is postoperative following a thyroidectomy. Which of the following interventions should the nurse include in the plan? Multiple Choice Check the client’s voice every 2 hr. Yes leah, rebecca l 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? Multiple Choice Tingling of the extremities Yes leah, rebecca l A nurse is teaching a client who has a new diagnosis of hyperparathyroidism. The nurse should include in the teaching that the client is at risk for which of the following complications? Multiple Choice Pathologic fractures Yes leah, rebecca l A nurse is reviewing the laboratory results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism? Multiple Choice A client who has a magnesium of 1.8 mEq/L No leah, rebecca l A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortisolism? Multiple Choice Moon face Yes leah, rebecca l A nurse is admitting a client who has sustained severe burn injuries in a grease fire. The nurse shades in a diagram indicating the burned surface areas. Using the Rule of Nines, the nurse should estimate that the client has burned what percentage of body surface area? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) Fill in the Blank Numeric 45 No leah, rebecca l A nurse in an emergency department is reviewing the medical record of a client who has an extensive burn injury. The nurse should expect which of the following laboratory findings in this client? Multiple Choice Hyperkalemia Yes leah, rebecca l The critical care nurse is caring for a client with a head injury secondary to a motorcycle accident who, on morning rounds, is responsive to painful stimuli and assumes decorticate posturing. Two hours later, which data would warrant immediate intervention by the nurse? Multiple Choice The client is aimlessly thrashing in the bed when a noxious stimuli is applied. No leah, rebecca l The nurse enters the room, and the client is beginning to have a tonic-clonic seizure. Which action should the nurse implement first? Multiple Choice Pad the siding of the client's bed rails. No leah, rebecca l The charge nurse on the endocrine surgical unit is making assignments. Which task should be delegated/assigned to the team members? Multiple Choice Request the licensed practical nurse (LPN) assess the client who is hypoglycemic. No leah, rebecca l The nurse is working in an endocrinology unit. Which client warrants immediate intervention by the nurse? Multiple Choice The client with syndrome of inappropriate antidiuretic hormone (SIADH) who has urine output of 50 mL over the past two hours. No leah, rebecca l The nurse is working on an endocrinology unit. Which client should the nurse assess first? Multiple Choice The client who is one day postoperative thyroidectomy who has neck edema. Yes leah, rebecca l A charge nurse is discussing staff nurses’ responsibilities in preplanning for response to a disaster. Which of the following responsibilities should the nurse include in the discussion? Multiple Choice Identify community resources that are available. Yes leah, rebecca l The client is admitted to the endocrinology unit newly diagnosed with an acute exacerbation of central diabetes insipidus (DI). Which intervention is the priority nursing intervention? Multiple Choice Obtain the client's baseline weight. No leah, rebecca l The unlicensed assistive personnel (UAP) tells the nurse the client who had a thyroidectomy has a T 104°F, P 128, RR 26, B/P 164/88. Which intervention should the nurse implement first? Multiple Choice Assess the client's vital signs and surgical dressing. Yes leah, rebecca l Which client should the endocrinology nurse assess first after receiving the shift report? Multiple Choice The client who is one day postoperative transphenoidal hypophysectomy who has clear drainage from the nose. Yes leah, rebecca l The unlicensed assistive personnel (UAP) has just taken the blood pressure of a client who had a thyroidectomy. The UAP tells the nurse that the client’s hand turned into a claw when the blood pressure was taken. Which intervention should the nurse implement first? Multiple Choice Prepare to administer intravenous calcium gluconate. No leah, rebecca l The nurse is administering medications on an endocrinology unit. Which medication should the nurse question administering? Multiple Choice The propranolol to the client diagnosed with hypothyroidism. Yes leah, rebecca l The charge nurse of a surgical unit has been notified of an external disaster with multiple casualties. Which client should the charge nurse request to be discharged from the hospital to make room for clients from the disaster? Multiple Choice The client who had a total abdominal hysterectomy 2 days ago and PCA machine has been discontinued. Yes leah, rebecca l A client was admitted to the critical care unit with diabetic ketoacidosis (DKA). Glucose is 349 mg/dL, potassium is 3.7 mEq/L, and pH is 7.18. Which of the following interventions would the nurse expect? (Select all that apply.) Multiple Response NS 1.5 L IV fluid bolus Yes leah, rebecca l A client was admitted to the critical care unit with diabetic ketoacidosis (DKA). Glucose is 349 mg/dL, potassium is 3.7 mEq/L, and pH is 7.18. Which of the following interventions would the nurse expect? (Select all that apply.) Multiple Response Regular insulin infusion at 5 units/hr Yes leah, rebecca l A client was admitted to the critical care unit with diabetic ketoacidosis (DKA). Glucose is 349 mg/dL, potassium is 3.7 mEq/L, and pH is 7.18. Which of the following interventions would the nurse expect? (Select all that apply.) Multiple Response Potassium 20 mEq/L in NS Yes leah, rebecca l The nurse is caring for an elderly client following surgery who is exhibiting signs on anesthesia-related delirium. The family member at the bedside asks how long this delirious state will last. The most appropriate response by the nurse is: Multiple Choice The delirium may last up to two days in elderly clients. Yes leah, rebecca l A client who has undergone preadmission testing has had blood drawn for serum laboratory studies, including a complete blood count, coagulation studies, and electrolytes and creatinine levels. Which laboratory result should be reported to the surgeon's office by the nurse, knowing that it could cause surgery to be postponed? Multiple Choice Hemoglobin, 8.0 g/dL Yes leah, rebecca l The nurse is reviewing a surgeon's prescription sheet for a preoperative client that states that the client must be nothing by mouth (NPO) after midnight. The nurse should call the surgeon to clarify that which medication should be given to the client and not withheld? Multiple Choice Conjugated estrogen No leah, rebecca l The nurse is caring for a client with a severe burn who is scheduled for an autograft to be placed on the lower extremity. The nurse creates a postoperative plan of care for the client and should include which intervention in the plan? Multiple Choice Elevate and immobilize the grafted extremity. Yes leah, rebecca l The nurse is assessing a client who had abdominal surgery earlier in the day. Which preexisting medical condition would place the client at most risk for postoperative complications? Multiple Choice Osteoporosis No leah, rebecca l An 85-year-old client is hospitalized for a fractured right hip. During the postoperative period, the client's appetite is poor and the client refuses to get out of bed. Which nursing statement would be most appropriate to make to the client? Multiple Choice It is important for you to get out of bed so that calcium will go back into the bone. Yes leah, rebecca l The nurse assesses a preoperative client. Which question should the nurse ask the client to help determine the client's risk for developing malignant hyperthermia in the perioperative period? Multiple Choice Do you or any of your family members have problems with general anesthesia? Yes leah, rebecca l The nurse is assessing a postoperative client following bowel resection. The client has a nasogastric tube (NGT) connected to wall suction. The nurse is concerned the client will develop hypokalemia and prepares to administer potassium in IV fluid. Prior to the administration of potassium, the nurse understands which of the following should be assessed? Multiple Choice Renal function Yes leah, rebecca l The nurse is caring for a client admitted to the hospital after sustaining a head injury. In which of the following positions should the nurse place the client to prevent increased intracranial pressure (IICP)? Multiple Choice With the head of the bed elevated at least 30 degrees. Yes leah, rebecca l The nurse is caring for a client with a history of epilepsy who suddenly begins to experience a tonic-clonic seizure and loses consciousness. What is the nurse’s priority action? Multiple Choice Turn the client's head to the side. Yes leah, rebecca l A client with new-onset status epilepticus is prescribed phenytoin. After teaching the client about this treatment regimen, the nurse assesses the client’s understanding. Which statement indicates that the client understands the teaching? Multiple Choice Even when my seizures stop, I will take this drug. Yes leah, rebecca l The nurse is providing medication teaching to a patient with epilepsy who is taking phenytoin. Which statement best indicates that the nurse’s teaching has been successful? Multiple Choice I should visit the dentist every 3 to 6 months while taking this medication. Yes leah, rebecca l The nurse is caring for a newly admitted client with seizure disorder and has recently had a tonic-clonic seizure. In planning care for this client, it is most important that the nurse ensure which of following? Multiple Choice The client has intravenous access. Yes leah, rebecca l A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.) Multiple Response Headache No leah, rebecca l A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.) Multiple Response Pupillary changes No leah, rebecca l A nurse enters a client’s room and finds him on the floor in the clonic phase of a tonic–clonic seizure. Which of the following actions should the nurse take? Multiple Choice Place a pillow under the client’s head. Yes leah, rebecca l The nurse is caring for a client in acute thyroid storm/crisis. The client is febrile with a temperature of 101.9 degrees Fahrenheit. The nurse prepares to administer an antipyretic medication knowing that which is contraindicated in this client? Multiple Choice Aspirin Yes leah, rebecca l The nurse is providing discharge instructions for a client newly diagnosed with Cushing's disease. The client displays appropriate knowledge of this disease by stating which of the following? Multiple Choice I understand that this disease will cause me to have a slow heart rate and low blood pressure. No leah, rebecca l When a patient is admitted to the PACU, what are the priority interventions the nurse performs? Multiple Choice Assess for airway patency and quality of respirations, and obtain vital signs Yes leah, rebecca l The nurse is caring for a patient undergoing surgery for a knee replacement. What is critical to the patient's safety during the procedure (select all that apply)? Multiple Response Universal protocol is followed No leah, rebecca l The nurse is caring for a patient undergoing surgery for a knee replacement. What is critical to the patient's safety during the procedure (select all that apply)? Multiple Response The circulating nurse is a registered nurse No leah, rebecca l The nurse is caring for a patient undergoing surgery for a knee replacement. What is critical to the patient's safety during the procedure (select all that apply)? Multiple Response The patients's allergies are conveyed to the surgical team No leah, rebecca l After Thyroid surgery, the nurse suspects damage or removal of the parathyroid glands when the patient develops Multiple Choice laryngospasms and tingling in the hands and feet Yes leah, rebecca l Important nursing interventions when caring for a patient with Cushing syndrome include (select all that apply) Multiple Response Restricting protein intake No leah, rebecca l Important nursing interventions when caring for a patient with Cushing syndrome include (select all that apply) Multiple Response Observing for signs of hypotension No leah, rebecca l Important nursing interventions when caring for a patient with Cushing syndrome include (select all that apply) Multiple Response Protecting the patient from exposure to infection No leah, rebecca l The nurse teaches the patient that the best time to take corticosteroids for replacement purposes is: Multiple Choice Every other day on awakening No leah, rebecca l The healthcare provider prescribes levothyroxine (Synthroid) for a patient with hypothyroidism. After teaching regarding this drug, the nurse determines that further instructions is needed when the patient says : Multiple Choice I only need to take this drug until my symptoms improve Yes leah, rebecca l For which patient with pneumonia would the nurse suspect aspiration as the likely cause of pneumonia (Select all that apply) Multiple Response Patient with seizures No leah, rebecca l For which patient with pneumonia would the nurse suspect aspiration as the likely cause of pneumonia (Select all that apply) Multiple Response Patient with head injury No leah, rebecca l For which patient with pneumonia would the nurse suspect aspiration as the likely cause of pneumonia (Select all that apply) Multiple Response Patient who had thoracic surgery No leah, rebecca l For which patient with pneumonia would the nurse suspect aspiration as the likely cause of pneumonia (Select all that apply) Multiple Response Patient who had myocardial infarction No leah, rebecca l A patient has been receiving high-dose corticosteroids and broad-spectrum antibiotics for treatment secondary to a traumatic injury and infection. The nurse plans care for the patient knowing that the patient is most susceptible to: Multiple Choice Candidiasis Yes leah, rebecca l The nurse identifies a flail chest in a trauma patient when: Multiple Choice paradoxic chest movement occurs during respiration Yes Batalla, Arnel A nurse is monitoring a client who was admitted with a severe burn injury and is receiving IV fluid resuscitation therapy. The nurse should identify a decrease in which of the following findings as an indication of adequate fluid replacement? Multiple Choice Urine output No Batalla, Arnel A nurse is caring for a client who is 1 day postoperative following a 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? Multiple Choice Chvostek's sign Yes Batalla, Arnel A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client? Multiple Choice Regular insulin Yes Batalla, Arnel 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? Multiple Choice Thyroid stimulating hormone (TSH) Yes Batalla, Arnel A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take? Multiple Choice Administer oral corticosteroids. No Batalla, Arnel A nurse is assisting a client who has hypothyroidism with meal planning. Which of the following foods should the nurse recommend that the client add to her diet? Multiple Choice Ripe bananas No Batalla, Arnel A nurse is monitoring a client who is postoperative following a thyroidectomy. Which of the following data should the nurse identify as the priority to monitor? Multiple Choice Airway patency Yes Batalla, Arnel A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect? Multiple Choice Urine specific gravity 1.002 Yes Batalla, Arnel A nursing is providing dietary teaching for a client who has Cushing's disease. Which of the following recommendations should nurse include in the teaching? Multiple Choice Restrict sodium intake. Yes Batalla, Arnel A nurse is assessing a client who has Graves' disease. The nurse should expect which of the following laboratory results? Multiple Choice Decreased thyroid-stimulating hormone (TSH) level Yes Batalla, Arnel A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider? Multiple Choice 0.9% sodium chloride IV bolus Yes Batalla, Arnel A nurse is assessing a client who has thyrotoxicosis after taking too high of a level of levothyroxine. Which of the following manifestations should the nurse expect? Multiple Choice Heat intolerance Yes Batalla, Arnel A nurse is preparing to administer levothyroxine 100 mcg PO daily. Available is levothyroxine 50 mcg tablets. How many tablets should the nurse administer daily? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) Fill in the Blank Numeric 2 Yes Batalla, Arnel 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? Multiple Choice The medication decreases the overproduction of the thyroid hormone thyroxine. No Batalla, Arnel A nurse is planning care for a client who is postoperative following a thyroidectomy. Which of the following interventions should the nurse include in the plan? Multiple Choice Check the client’s voice every 2 hr. Yes Batalla, Arnel 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? Multiple Choice Tingling of the extremities Yes Batalla, Arnel A nurse is teaching a client who has a new diagnosis of hyperparathyroidism. The nurse should include in the teaching that the client is at risk for which of the following complications? Multiple Choice Pathologic fractures Yes Batalla, Arnel A nurse is reviewing the laboratory results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism? Multiple Choice A client who has a vitamin D of 25 ng/mL No Batalla, Arnel A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortisolism? Multiple Choice A client who has a positive Chvostek’s sign. No Batalla, Arnel A nurse is admitting a client who has sustained severe burn injuries in a grease fire. The nurse shades in a diagram indicating the burned surface areas. Using the Rule of Nines, the nurse should estimate that the client has burned what percentage of body surface area? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) Fill in the Blank Numeric 31.5 Yes Batalla, Arnel A nurse in an emergency department is reviewing the medical record of a client who has an extensive burn injury. The nurse should expect which of the following laboratory findings in this client? Multiple Choice Hyperkalemia Yes Batalla, Arnel The critical care nurse is caring for a client with a head injury secondary to a motorcycle accident who, on morning rounds, is responsive to painful stimuli and assumes decorticate posturing. Two hours later, which data would warrant immediate intervention by the nurse? Multiple Choice The client is aimlessly thrashing in the bed when a noxious stimuli is applied. No Batalla, Arnel The nurse enters the room, and the client is beginning to have a tonic-clonic seizure. Which action should the nurse implement first? Multiple Choice Note the time the client's seizure began. Yes Batalla, Arnel The charge nurse on the endocrine surgical unit is making assignments. Which task should be delegated/assigned to the team members? Multiple Choice Tell the LPN to perform an in and out urinary catheterization for the client diagnosed with acromegaly. Yes Batalla, Arnel The nurse is working in an endocrinology unit. Which client warrants immediate intervention by the nurse? Multiple Choice The client with pheochromocytoma who complains of a throbbing headache. Yes Batalla, Arnel The nurse is working on an endocrinology unit. Which client should the nurse assess first? Multiple Choice The client who is one day postoperative thyroidectomy who has neck edema. Yes Batalla, Arnel A charge nurse is discussing staff nurses’ responsibilities in preplanning for response to a disaster. Which of the following responsibilities should the nurse include in the discussion? Multiple Choice Identify community resources that are available. Yes Batalla, Arnel The client is admitted to the endocrinology unit newly diagnosed with an acute exacerbation of central diabetes insipidus (DI). Which intervention is the priority nursing intervention? Multiple Choice Monitor the client's intake and output. No Batalla, Arnel The unlicensed assistive personnel (UAP) tells the nurse the client who had a thyroidectomy has a T 104°F, P 128, RR 26, B/P 164/88. Which intervention should the nurse implement first? Multiple Choice Assess the client's vital signs and surgical dressing. Yes Batalla, Arnel Which client should the endocrinology nurse assess first after receiving the shift report? Multiple Choice The client who is one day postoperative transphenoidal hypophysectomy who has clear drainage from the nose. Yes Batalla, Arnel The unlicensed assistive personnel (UAP) has just taken the blood pressure of a client who had a thyroidectomy. The UAP tells the nurse that the client’s hand turned into a claw when the blood pressure was taken. Which intervention should the nurse implement first? Multiple Choice Prepare to administer intravenous calcium gluconate. No Batalla, Arnel The nurse is administering medications on an endocrinology unit. Which medication should the nurse question administering? Multiple Choice The propranolol to the client diagnosed with hypothyroidism. Yes Batalla, Arnel The charge nurse of a surgical unit has been notified of an external disaster with multiple casualties. Which client should the charge nurse request to be discharged from the hospital to make room for clients from the disaster? Multiple Choice The client who had a total abdominal hysterectomy 2 days ago and PCA machine has been discontinued. Yes Batalla, Arnel A client was admitted to the critical care unit with diabetic ketoacidosis (DKA). Glucose is 349 mg/dL, potassium is 3.7 mEq/L, and pH is 7.18. Which of the following interventions would the nurse expect? (Select all that apply.) Multiple Response NS 1.5 L IV fluid bolus No Batalla, Arnel A client was admitted to the critical care unit with diabetic ketoacidosis (DKA). Glucose is 349 mg/dL, potassium is 3.7 mEq/L, and pH is 7.18. Which of the following interventions would the nurse expect? (Select all that apply.) Multiple Response Regular insulin infusion at 5 units/hr No Batalla, Arnel A client was admitted to the critical care unit with diabetic ketoacidosis (DKA). Glucose is 349 mg/dL, potassium is 3.7 mEq/L, and pH is 7.18. Which of the following interventions would the nurse expect? (Select all that apply.) Multiple Response Sodium bicarbonate 50 mmol IV push No Batalla, Arnel The nurse is caring for an elderly client following surgery who is exhibiting signs on anesthesia-related delirium. The family member at the bedside asks how long this delirious state will last. The most appropriate response by the nurse is: Multiple Choice The delirium may last up to two days in elderly clients. Yes Batalla, Arnel A client who has undergone preadmission testing has had blood drawn for serum laboratory studies, including a complete blood count, coagulation studies, and electrolytes and creatinine levels. Which laboratory result should be reported to the surgeon's office by the nurse, knowing that it could cause surgery to be postponed? Multiple Choice Hemoglobin, 8.0 g/dL Yes Batalla, Arnel The nurse is reviewing a surgeon's prescription sheet for a preoperative client that states that the client must be nothing by mouth (NPO) after midnight. The nurse should call the surgeon to clarify that which medication should be given to the client and not withheld? Multiple Choice Prednisone Yes Batalla, Arnel The nurse is caring for a client with a severe burn who is scheduled for an autograft to be placed on the lower extremity. The nurse creates a postoperative plan of care for the client and should include which intervention in the plan? Multiple Choice Elevate and immobilize the grafted extremity. Yes Batalla, Arnel The nurse is assessing a client who had abdominal surgery earlier in the day. Which preexisting medical condition would place the client at most risk for postoperative complications? Multiple Choice Alcohol abuse Yes Batalla, Arnel An 85-year-old client is hospitalized for a fractured right hip. During the postoperative period, the client's appetite is poor and the client refuses to get out of bed. Which nursing statement would be most appropriate to make to the client? Multiple Choice It is important for you to get out of bed so that calcium will go back into the bone. Yes Batalla, Arnel The nurse assesses a preoperative client. Which question should the nurse ask the client to help determine the client's risk for developing malignant hyperthermia in the perioperative period? Multiple Choice Do you or any of your family members have problems with general anesthesia? Yes Batalla, Arnel The nurse is assessing a postoperative client following bowel resection. The client has a nasogastric tube (NGT) connected to wall suction. The nurse is concerned the client will develop hypokalemia and prepares to administer potassium in IV fluid. Prior to the administration of potassium, the nurse understands which of the following should be assessed? Multiple Choice Renal function Yes Batalla, Arnel The nurse is caring for a client admitted to the hospital after sustaining a head injury. In which of the following positions should the nurse place the client to prevent increased intracranial pressure (IICP)? Multiple Choice With the head elevated on a pillow No Batalla, Arnel The nurse is caring for a client with a history of epilepsy who suddenly begins to experience a tonic-clonic seizure and loses consciousness. What is the nurse’s priority action? Multiple Choice Turn the client's head to the side. Yes Batalla, Arnel A client with new-onset status epilepticus is prescribed phenytoin. After teaching the client about this treatment regimen, the nurse assesses the client’s understanding. Which statement indicates that the client understands the teaching? Multiple Choice Even when my seizures stop, I will take this drug. Yes Batalla, Arnel The nurse is providing medication teaching to a patient with epilepsy who is taking phenytoin. Which statement best indicates that the nurse’s teaching has been successful? Multiple Choice I should visit the dentist every 3 to 6 months while taking this medication. Yes Batalla, Arnel The nurse is caring for a newly admitted client with seizure disorder and has recently had a tonic-clonic seizure. In planning care for this client, it is most important that the nurse ensure which of following? Multiple Choice The client has intravenous access. Yes Batalla, Arnel A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.) Multiple Response Headache No Batalla, Arnel A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.) Multiple Response Pupillary changes No Batalla, Arnel A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.) Multiple Response Disorientation No Batalla, Arnel A nurse enters a client’s room and finds him on the floor in the clonic phase of a tonic–clonic seizure. Which of the following actions should the nurse take? Multiple Choice Place a pillow under the client’s head. Yes Batalla, Arnel The nurse is caring for a client in acute thyroid storm/crisis. The client is febrile with a temperature of 101.9 degrees Fahrenheit. The nurse prepares to administer an antipyretic medication knowing that which is contraindicated in this client? Multiple Choice Aspirin Yes Batalla, Arnel The nurse is providing discharge instructions for a client newly diagnosed with Cushing's disease. The client displays appropriate knowledge of this disease by stating which of the following? Multiple Choice I should avoid crowds or people who are sick and wash my hands frequently. Yes Batalla, Arnel When a patient is admitted to the PACU, what are the priority interventions the nurse performs? Multiple Choice Assess for airway patency and quality of respirations, and obtain vital signs Yes Batalla, Arnel The nurse is caring for a patient undergoing surgery for a knee replacement. What is critical to the patient's safety during the procedure (select all that apply)? Multiple Response Universal protocol is followed Yes Batalla, Arnel The nurse is caring for a patient undergoing surgery for a knee replacement. What is critical to the patient's safety during the procedure (select all that apply)? Multiple Response The patients's allergies are conveyed to the surgical team Yes Batalla, Arnel After Thyroid surgery, the nurse suspects damage or removal of the parathyroid glands when the patient develops Multiple Choice laryngospasms and tingling in the hands and feet Yes Batalla, Arnel Important nursing interventions when caring for a patient with Cushing syndrome include (select all that apply) Multiple Response Monitoring Blood glucose Yes Batalla, Arnel Important nursing interventions when caring for a patient with Cushing syndrome include (select all that apply) Multiple Response Protecting the patient from exposure to infection Yes Batalla, Arnel The nurse teaches the patient that the best time to take corticosteroids for replacement purposes is: Multiple Choice On arising and in the late afternoon Yes Batalla, Arnel The healthcare provider prescribes levothyroxine (Synthroid) for a patient with hypothyroidism. After teaching regarding this drug, the nurse determines that further instructions is needed when the patient says : Multiple Choice I only need to take this drug until my symptoms improve Yes Batalla, Arnel For which patient with pneumonia would the nurse suspect aspiration as the likely cause of pneumonia (Select all that apply) Multiple Response Patient with seizures Yes Batalla, Arnel For which patient with pneumonia would the nurse suspect aspiration as the likely cause of pneumonia (Select all that apply) Multiple Response Patient with head injury Yes Batalla, Arnel For which patient with pneumonia would the nurse suspect aspiration as the likely cause of pneumonia (Select all that apply) Multiple Response Patient who is receiving nasogastric tube feeding Yes Batalla, Arnel A patient has been receiving high-dose corticosteroids and broad-spectrum antibiotics for treatment secondary to a traumatic injury and infection. The nurse plans care for the patient knowing that the patient is most susceptible to: Multiple Choice Candidiasis Yes Batalla, Arnel The nurse identifies a flail chest in a trauma patient when: Multiple Choice paradoxic chest movement occurs during respiration Yes Berthiaume, Nicole M A nurse is monitoring a client who was admitted with a severe burn injury and is receiving IV fluid resuscitation therapy. The nurse should identify a decrease in which of the following findings as an indication of adequate fluid replacement? Multiple Choice Heart rate Yes Berthiaume, Nicole M A nurse is caring for a client who is 1 day postoperative following a 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? Multiple Choice Chvostek's sign Yes Berthiaume, Nicole M A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client? Multiple Choice Regular insulin Yes Berthiaume, Nicole M 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? Multiple Choice Thyroid stimulating hormone (TSH) Yes Berthiaume, Nicole M A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take? Multiple Choice Restrict fluid intake. No Berthiaume, Nicole M A nurse is assisting a client who has hypothyroidism with meal planning. Which of the following foods should the nurse recommend that the client add to her diet? Multiple Choice Whole grains Yes Berthiaume, Nicole M A nurse is monitoring a client who is postoperative following a thyroidectomy. Which of the following data should the nurse identify as the priority to monitor? Multiple Choice Airway patency Yes Berthiaume, Nicole M A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect? Multiple Choice Urine specific gravity 1.002 Yes Berthiaume, Nicole M A nursing is providing dietary teaching for a client who has Cushing's disease. Which of the following recommendations should nurse include in the teaching? Multiple Choice Restrict sodium intake. Yes Berthiaume, Nicole M A nurse is assessing a client who has Graves' disease. The nurse should expect which of the following laboratory results? Multiple Choice Decreased triiodothyronine (T<sub>3</sub>) level No Berthiaume, Nicole M A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider? Multiple Choice 0.9% sodium chloride IV bolus Yes Berthiaume, Nicole M A nurse is assessing a client who has thyrotoxicosis after taking too high of a level of levothyroxine. Which of the following manifestations should the nurse expect? Multiple Choice Heat intolerance Yes Berthiaume, Nicole M A nurse is preparing to administer levothyroxine 100 mcg PO daily. Available is levothyroxine 50 mcg tablets. How many tablets should the nurse administer daily? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) Fill in the Blank Numeric 2 Yes Berthiaume, Nicole M 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? Multiple Choice Tremors, nervousness, and insomnia may indicate your dose is too high. Yes Berthiaume, Nicole M A nurse is planning care for a client who is postoperative following a thyroidectomy. Which of the following interventions should the nurse include in the plan? Multiple Choice Check the client’s voice every 2 hr. Yes Berthiaume, Nicole M 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? Multiple Choice Tingling of the extremities Yes Berthiaume, Nicole M A nurse is teaching a client who has a new diagnosis of hyperparathyroidism. The nurse should include in the teaching that the client is at risk for which of the following complications? Multiple Choice Pathologic fractures Yes Berthiaume, Nicole M A nurse is reviewing the laboratory results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism? Multiple Choice A client who has a phosphate of 5.7 mg/dL Yes Berthiaume, Nicole M A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortisolism? Multiple Choice Moon face Yes Berthiaume, Nicole M A nurse is admitting a client who has sustained severe burn injuries in a grease fire. The nurse shades in a diagram indicating the burned surface areas. Using the Rule of Nines, the nurse should estimate that the client has burned what percentage of body surface area? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) Fill in the Blank Numeric 40.5 No Berthiaume, Nicole M A nurse in an emergency department is reviewing the medical record of a client who has an extensive burn injury. The nurse should expect which of the following laboratory findings in this client? Multiple Choice Hyperkalemia Yes Berthiaume, Nicole M The critical care nurse is caring for a client with a head injury secondary to a motorcycle accident who, on morning rounds, is responsive to painful stimuli and assumes decorticate posturing. Two hours later, which data would warrant immediate intervention by the nurse? Multiple Choice The client extends the upper and lower extremities in response to painful stimuli. Yes Berthiaume, Nicole M The nurse enters the room, and the client is beginning to have a tonic-clonic seizure. Which action should the nurse implement first? Multiple Choice Pad the siding of the client's bed rails. No Berthiaume, Nicole M The charge nurse on the endocrine surgical unit is making assignments. Which task should be delegated/assigned to the team members? Multiple Choice Ask the unlicensed assistive personnel (UAP) to assist feeding the client with an adrenalectomy who has paralytic ileus. No Berthiaume, Nicole M The nurse is working in an endocrinology unit. Which client warrants immediate intervention by the nurse? Multiple Choice The client with syndrome of inappropriate antidiuretic hormone (SIADH) who has urine output of 50 mL over the past two hours. No Berthiaume, Nicole M The nurse is working on an endocrinology unit. Which client should the nurse assess first? Multiple Choice The client who is one day postoperative thyroidectomy who has neck edema. Yes Berthiaume, Nicole M A charge nurse is discussing staff nurses’ responsibilities in preplanning for response to a disaster. Which of the following responsibilities should the nurse include in the discussion? Multiple Choice Identify community resources that are available. Yes Berthiaume, Nicole M The client is admitted to the endocrinology unit newly diagnosed with an acute exacerbation of central diabetes insipidus (DI). Which intervention is the priority nursing intervention? Multiple Choice Administer intravenous hypotonic saline. Yes Berthiaume, Nicole M The unlicensed assistive personnel (UAP) tells the nurse the client who had a thyroidectomy has a T 104°F, P 128, RR 26, B/P 164/88. Which intervention should the nurse implement first? Multiple Choice Administer acetaminophen PO STAT. No Berthiaume, Nicole M Which client should the endocrinology nurse assess first after receiving the shift report? Multiple Choice The client who is one day postoperative transphenoidal hypophysectomy who has clear drainage from the nose. Yes Berthiaume, Nicole M The unlicensed assistive personnel (UAP) has just taken the blood pressure of a client who had a thyroidectomy. The UAP tells the nurse that the client’s hand turned into a claw when the blood pressure was taken. Which intervention should the nurse implement first? Multiple Choice Assess the client for signs/symptoms of hypoparathyroidism. Yes Berthiaume, Nicole M The nurse is administering medications on an endocrinology unit. Which medication should the nurse question administering? Multiple Choice The desmopressin acetate to the client diagnosed with diabetes insipidus. No Berthiaume, Nicole M The charge nurse of a surgical unit has been notified of an external disaster with multiple casualties. Which client should the charge nurse request to be discharged from the hospital to make room for clients from the disaster? Multiple Choice The client who had a total abdominal hysterectomy 2 days ago and PCA machine has been discontinued. Yes Berthiaume, Nicole M A client was admitted to the critical care unit with diabetic ketoacidosis (DKA). Glucose is 349 mg/dL, potassium is 3.7 mEq/L, and pH is 7.18. Which of the following interventions would the nurse expect? (Select all that apply.) Multiple Response NS 1.5 L IV fluid bolus No Berthiaume, Nicole M A client was admitted to the critical care unit with diabetic ketoacidosis (DKA). Glucose is 349 mg/dL, potassium is 3.7 mEq/L, and pH is 7.18. Which of the following interventions would the nurse expect? (Select all that apply.) Multiple Response Sodium bicarbonate 50 mmol IV push No Berthiaume, Nicole M The nurse is caring for an elderly client following surgery who is exhibiting signs on anesthesia-related delirium. The family member at the bedside asks how long this delirious state will last. The most appropriate response by the nurse is: Multiple Choice The delirium will clear up as soon as the client gets back into her home environment. No Berthiaume, Nicole M A client who has undergone preadmission testing has had blood drawn for serum laboratory studies, including a complete blood count, coagulation studies, and electrolytes and creatinine levels. Which laboratory result should be reported to the surgeon's office by the nurse, knowing that it could cause surgery to be postponed? Multiple Choice Serum creatinine, 1.4 mg/dL No Berthiaume, Nicole M The nurse is reviewing a surgeon's prescription sheet for a preoperative client that states that the client must be nothing by mouth (NPO) after midnight. The nurse should call the surgeon to clarify that which medication should be given to the client and not withheld? Multiple Choice Cyclobenzaprine No Berthiaume, Nicole M The nurse is caring for a client with a severe burn who is scheduled for an autograft to be placed on the lower extremity. The nurse creates a postoperative plan of care for the client and should include which intervention in the plan? Multiple Choice Maintain the grafted extremity in a flat position. No Berthiaume, Nicole M The nurse is assessing a client who had abdominal surgery earlier in the day. Which preexisting medical condition would place the client at most risk for postoperative complications? Multiple Choice Peptic ulcer disease No Berthiaume, Nicole M An 85-year-old client is hospitalized for a fractured right hip. During the postoperative period, the client's appetite is poor and the client refuses to get out of bed. Which nursing statement would be most appropriate to make to the client? Multiple Choice It is important for you to get out of bed so that calcium will go back into the bone. Yes Berthiaume, Nicole M The nurse assesses a preoperative client. Which question should the nurse ask the client to help determine the client's risk for developing malignant hyperthermia in the perioperative period? Multiple Choice Do you or any of your family members have problems with general anesthesia? Yes Berthiaume, Nicole M The nurse is assessing a postoperative client following bowel resection. The client has a nasogastric tube (NGT) connected to wall suction. The nurse is concerned the client will develop hypokalemia and prepares to administer potassium in IV fluid. Prior to the administration of potassium, the nurse understands which of the following should be assessed? Multiple Choice Bowel sounds No Berthiaume, Nicole M The nurse is caring for a client admitted to the hospital after sustaining a head injury. In which of the following positions should the nurse place the client to prevent increased intracranial pressure (IICP)? Multiple Choice With the head of the bed elevated at least 30 degrees. Yes Berthiaume, Nicole M The nurse is caring for a client with a history of epilepsy who suddenly begins to experience a tonic-clonic seizure and loses consciousness. What is the nurse’s priority action? Multiple Choice Obtain an oral airway for the client. No Berthiaume, Nicole M A client with new-onset status epilepticus is prescribed phenytoin. After teaching the client about this treatment regimen, the nurse assesses the client’s understanding. Which statement indicates that the client understands the teaching? Multiple Choice Even when my seizures stop, I will take this drug. Yes Berthiaume, Nicole M The nurse is providing medication teaching to a patient with epilepsy who is taking phenytoin. Which statement best indicates that the nurse’s teaching has been successful? Multiple Choice I should visit the dentist every 3 to 6 months while taking this medication. Yes Berthiaume, Nicole M The nurse is caring for a newly admitted client with seizure disorder and has recently had a tonic-clonic seizure. In planning care for this client, it is most important that the nurse ensure which of following? Multiple Choice The client has intravenous access. Yes Berthiaume, Nicole M A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.) Multiple Response Headache Yes Berthiaume, Nicole M A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.) Multiple Response Slurred speech Yes Berthiaume, Nicole M A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.) Multiple Response Pupillary changes Yes Berthiaume, Nicole M A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.) Multiple Response Disorientation Yes Berthiaume, Nicole M A nurse enters a client’s room and finds him on the floor in the clonic phase of a tonic–clonic seizure. Which of the following actions should the nurse take? Multiple Choice Apply a face mask for oxygen administration. No Berthiaume, Nicole M The nurse is caring for a client in acute thyroid storm/crisis. The client is febrile with a temperature of 101.9 degrees Fahrenheit. The nurse prepares to administer an antipyretic medication knowing that which is contraindicated in this client? Multiple Choice Aspirin Yes Berthiaume, Nicole M The nurse is providing discharge instructions for a client newly diagnosed with Cushing's disease. The client displays appropriate knowledge of this disease by stating which of the following? Multiple Choice I should avoid crowds or people who are sick and wash my hands frequently. Yes Berthiaume, Nicole M When a patient is admitted to the PACU, what are the priority interventions the nurse performs? Multiple Choice Assess for airway patency and quality of respirations, and obtain vital signs Yes Berthiaume, Nicole M The nurse is caring for a patient undergoing surgery for a knee replacement. What is critical to the patient's safety during the procedure (select all that apply)? Multiple Response Universal protocol is followed Yes Berthiaume, Nicole M The nurse is caring for a patient undergoing surgery for a knee replacement. What is critical to the patient's safety during the procedure (select all that apply)? Multiple Response The patients's allergies are conveyed to the surgical team Yes Berthiaume, Nicole M After Thyroid surgery, the nurse suspects damage or removal of the parathyroid glands when the patient develops Multiple Choice laryngospasms and tingling in the hands and feet Yes Berthiaume, Nicole M Important nursing interventions when caring for a patient with Cushing syndrome include (select all that apply) Multiple Response Monitoring Blood glucose Yes Berthiaume, Nicole M Important nursing interventions when caring for a patient with Cushing syndrome include (select all that apply) Multiple Response Protecting the patient from exposure to infection Yes Berthiaume, Nicole M The nurse teaches the patient that the best time to take corticosteroids for replacement purposes is: Multiple Choice On arising and in the late afternoon Yes Berthiaume, Nicole M The healthcare provider prescribes levothyroxine (Synthroid) for a patient with hypothyroidism. After teaching regarding this drug, the nurse determines that further instructions is needed when the patient says : Multiple Choice I only need to take this drug until my symptoms improve Yes Berthiaume, Nicole M For which patient with pneumonia would the nurse suspect aspiration as the likely cause of pneumonia (Select all that apply) Multiple Response Patient with seizures Yes Berthiaume, Nicole M For which patient with pneumonia would the nurse suspect aspiration as the likely cause of pneumonia (Select all that apply) Multiple Response Patient with head injury Yes Berthiaume, Nicole M For which patient with pneumonia would the nurse suspect aspiration as the likely cause of pneumonia (Select all that apply) Multiple Response Patient who is receiving nasogastric tube feeding Yes Berthiaume, Nicole M A patient has been receiving high-dose corticosteroids and broad-spectrum antibiotics for treatment secondary to a traumatic injury and infection. The nurse plans care for the patient knowing that the patient is most susceptible to: Multiple Choice Histoplasmosis No Berthiaume, Nicole M The nurse identifies a flail chest in a trauma patient when: Multiple Choice paradoxic chest movement occurs during respiration Yes Correia, Jessica A nurse is monitoring a client who was admitted with a severe burn injury and is receiving IV fluid resuscitation therapy. The nurse should identify a decrease in which of the following findings as an indication of adequate fluid replacement? Multiple Choice Heart rate Yes Correia, Jessica A nurse is caring for a client who is 1 day postoperative following a 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? Multiple Choice Chvostek's sign Yes Correia, Jessica A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to treat this client? Multiple Choice Regular insulin Yes Correia, Jessica 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? Multiple Choice Thyroid stimulating hormone (TSH) Yes Correia, Jessica A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take? Multiple Choice Weigh the client daily. Yes Correia, Jessica A nurse is assisting a client who has hypothyroidism with meal planning. Which of the following foods should the nurse recommend that the client add to her diet? Multiple Choice Whole grains Yes Correia, Jessica A nurse is monitoring a client who is postoperative following a thyroidectomy. Which of the following data should the nurse identify as the priority to monitor? Multiple Choice Airway patency Yes Correia, Jessica A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect? Multiple Choice Urine specific gravity 1.002 Yes Correia, Jessica A nursing is providing dietary teaching for a client who has Cushing's disease. Which of the following recommendations should nurse include in the teaching? Multiple Choice Restrict sodium intake. Yes Correia, Jessica A nurse is assessing a client who has Graves' disease. The nurse should expect which of the following laboratory results? Multiple Choice Decreased thyroid-stimulating hormone (TSH) level Yes Correia, Jessica A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider? Multiple Choice 0.9% sodium chloride IV bolus Yes Correia, Jessica A nurse is assessing a client who has thyrotoxicosis after taking too high of a level of levothyroxine. Which of the following manifestations should the nurse expect? Multiple Choice Heat intolerance Yes Correia, Jessica A nurse is preparing to administer levothyroxine 100 mcg PO daily. Available is levothyroxine 50 mcg tablets. How many tablets should the nurse administer daily? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) Fill in the Blank Numeric 2 Yes Correia, Jessica 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? Multiple Choice Tremors, nervousness, and insomnia may indicate your dose is too high. Yes Correia, Jessica A nurse is planning care for a client who is postoperative following a thyroidectomy. Which of the following interventions should the nurse include in the plan? Multiple Choice Check the client’s voice every 2 hr. Yes Correia, Jessica 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? Multiple Choice Tingling of the extremities Yes Correia, Jessica A nurse is teaching a client who has a new diagnosis of hyperparathyroidism. The nurse should include in the teaching that the client is at risk for which of the following complications? Multiple Choice Pathologic fractures Yes Correia, Jessica A nurse is reviewing the laboratory results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism? Multiple Choice A client who has a phosphate of 5.7 mg/dL Yes Correia, Jessica A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortisolism? Multiple Choice Moon face Yes Correia, Jessica A nurse is admitting a client who has sustained severe burn injuries in a grease fire. The nurse shades in a diagram indicating the burned surface areas. Using the Rule of Nines, the nurse should estimate that the client has burned what percentage of body surface area? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) Fill in the Blank Numeric 31.5 Yes Correia, Jessica A nurse in an emergency department is reviewing the medical record of a client who has an extensive burn injury. The nurse should expect which of the following laboratory findings in this client? Multiple Choice Hyperkalemia Yes Correia, Jessica The critical care nurse is caring for a client with a head injury secondary to a motorcycle accident who, on morning rounds, is responsive to painful stimuli and assumes decorticate posturing. Two hours later, which data would warrant immediate intervention by the nurse? Multiple Choice The client extends the upper and lower extremities in response to painful stimuli. Yes Correia, Jessica The nurse enters the room, and the client is beginning to have a tonic-clonic seizure. Which action should the nurse implement first? Multiple Choice Note the time the client's seizure began. Yes Correia, Jessica The charge nurse on the endocrine surgical unit is making assignments. Which task should be delegated/assigned to the team members? Multiple Choice Tell the LPN to perform an in and out urinary catheterization for the client diagnosed with acromegaly. Yes Correia, Jessica The nurse is working in an endocrinology unit. Which client warrants immediate intervention by the nurse? Multiple Choice The client with syndrome of inappropriate antidiuretic hormone (SIADH) who has urine output of 50 mL over the past two hours. No Correia, Jessica The nurse is working on an endocrinology unit. Which client should the nurse assess first? Multiple Choice The client who is one day postoperative thyroidectomy who has neck edema. Yes Correia, Jessica A charge nurse is discussing staff nurses’ responsibilities in preplanning for response to a disaster. Which of the following responsibilities should the nurse include in the discussion? Multiple Choice Identify community resources that are available. Yes Correia, Jessica The client is admitted to the endocrinology unit newly diagnosed with an acute exacerbation of central diabetes insipidus (DI). Which intervention is the priority nursing intervention? Multiple Choice Obtain the client's baseline weight. No Correia, Jessica The unlicensed assistive personnel (UAP) tells the nurse the client who had a thyroidectomy has a T 104°F, P 128, RR 26, B/P 164/88. Which intervention should the nurse implement first? Multiple Choice Assess the client's vital signs and surgical dressing. Yes Correia, Jessica Which client should the endocrinology nurse assess first after receiving the shift report? Multiple Choice The client who is one day postoperative transphenoidal hypophysectomy who has clear drainage from the nose. Yes Correia, Jessica The unlicensed assistive personnel (UAP) has just taken the blood pressure of a client who had a thyroidectomy. The UAP tells the nurse that the client’s hand turned into a claw when the blood pressure was taken. Which intervention should the nurse implement first? Multiple Choice Assess the client for signs/symptoms of hypoparathyroidism. Yes Correia, Jessica The nurse is administering medications on an endocrinology unit. Which medication should the nurse question administering? Multiple Choice The propranolol to the client diagnosed with hypothyroidism. Yes Correia, Jessica The charge nurse of a surgical unit has been notified of an external disaster with multiple casualties. Which client should the charge nurse request to be discharged from the hospital to make room for clients from the disaster? Multiple Choice The client who had a total abdominal hysterectomy 2 days ago and PCA machine has been discontinued. Yes Correia, Jessica A client was admitted to the critical care unit with diabetic ketoacidosis (DKA). Glucose is 349 mg/dL, potassium is 3.7 mEq/L, and pH is 7.18. Which of the following interventions would the nurse expect? (Select all that apply.) Multiple Response NS 1.5 L IV fluid bolus No Correia, Jessica A client was admitted to the critical care unit with diabetic ketoacidosis (DKA). Glucose is 349 mg/dL, potassium is 3.7 mEq/L, and pH is 7.18. Which of the following inte