PN2 Exam 3 Part 1

A nurse working in an outpatient clinic is assessing a client who has rheumatoid Arthritis (RA). The client reports increased joint tenderness and swelling. Which of the following findings should the nurse expect (SATA) – A. Recent influenza B. Decreased Range of motion E. Pain at rest A nurse is teaching a client who has a new diagnosis of RA. Which of the following statements should the nurse include in the teaching? A. "You can experience morning stiffness when you get out of bed" A nurse is caring for a client who has RA. Which of the following lab tests are used to diagnose this disease? (SATA) – B. Erythrocyte sedimentation rate (ESR) D. Antinuclear antibody (ANA) tier E. WBC count A nurse is assessing a client who has osteoarthritis of the knees and fingers. Which of the following manifestations should the nurse expect to find? (SATA) – A. Heerden's nodes D. Enlarged Joint Size E. Limp when walking The nurse is caring for a client who reports slow onset of a gradual loss of vision in the periphery of both eyes. What condition does the nurse anticipate? - Glaucoma A client is taking vancomycin. For which of the following side effects should the nurse assess? - Tinnitus A nurse in a clinic is assessing a client who has acquired immunodeficiency syndrome (AIDS) and a significantly decreased CD4-T-cell count. The nurse should recognize that the client is at risk for developing which of the following malignancies? - Kaposi's sarcoma Which of the following tests can be done by the nurse to assess a client's hearing? (Select all that apply.) - Rinne Weber's Cochlear Voice-whisper test The nurse begins to experience red, itchy hands after using gloves for client care. Which of the following should the nurse consider at causing these symptoms? - Latex allergy A client newly diagnosed with type 1 diabetes mellitus wears glasses for myopia and asks the nurse how frequently he should see his ophthalmologist. Which is the nurse's best answer? - "You are at risk for cataracts, glaucoma, and retinal blood vessel changes, so you should see the ophthalmologist yearly, even when you do not have a vision problem." The nurse is preparing short-acting and long-acting insulin for administration to a client. The nurse recognizes the purpose for the client taking these types of insulin is which of the following? - *b. To mimic the body's own insulin patterns The nurse is assessing a client diagnosed with type 1 diabetes mellitus for symptoms associated with diabetic ketoacidosis. Which of the following will the nurse most likely assess in this client? (Select all that apply.) - *b. Fruity breath odor *e. Kussmaul breathing *f. Abdominal discomfort Your patient's blood glucose level is 275 mg/dL. The patient is about to eat breakfast. Per sliding scale, you administer 8 units of Insulin Regular (Humulin R) subcutaneously at 0730. As the nurse, you know the patient is most at risk for hypoglycemia at what time? - 0930 A client is experiencing a loss of central vision but not a loss of peripheral vision. The nurse realizes the client should be evaluated for which of the following disease processes? - Macular degeneration During the assessment of a client with a 15-year history of DM the nurse know that the client has a decreased tactile sensation in both feet which action does the nurse take first? - Examine the clients' feet for signs of injury The nurse is teaching a client how to avoid allergic reactions. Which of the following is not an appropriate recommendation? - "Use corticosteroids daily to prevent reactions" The nurse is providing client education for a client diagnosed with diabetes mellitus. The nurse should incorporate which of the following educational points about delaying the onset of microvascular and macrovascular complications? - Controlling hyperglycemia A Client is diagnosed with rheumatoid arthritis. The nurse would expect to find which of the following during assessment? - Symmetrical Joint involvement The laboratory values of a client who has diabetes mellitus include a fasting blood glucose level of 180 mg/dL and hemoglobin A1C of 6.5%. What is the nurse's interpretations of these findings? - b. The client's glucose control for the past 24 hours has been poor, but the overall control is good. A client's 1200 glucose was inaccurately documented as 310 mg/dL instead of 130 mg/dL. This error was not noticed until 1300. The nurse administered the sliding scale insulin for a blood glucose of 310 mg/dL. What should the nurse do first? - Assess for hypoglycemia The laboratory values of a client with diabetes mellitus include a post meal blood glucose level of 145 mg/dL and hemoglobin A1C of 6.8%. What are the nurse's interpretations of these findings? - The client glucose control for the past 24 hours has been poor, but the overall control is good The nurse is instructing a client diagnosed with type 2 diabetes mellitus on activities to reduce the onset of long-term complications. Which of the following should the nurse include in these instructions? (SATA) - Stop smoking Keep blood pressure under control Attain a normal body weight Increase activity The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The nurse places priority on which client problem? - Inadequate fluid volume A client prescribed insulin to be given through a peripheral intravenous line. The nurse realizes that which of the following insulins can be administered intravenously? - Regular Metformin is prescribed for a client with type 2 diabetes mellitus. What is the most common side effect that the nurse should include in the client's teaching plan? - Gastrointestinal disturbances A nurse is caring for a client who has HIV. Which of the following laboratory values is the nurse's priority? - *a. CD4-T-cell count of less than 180 cells/mm3 A client with diabetes mellitus has a numbness and reduced sensation secondary to sever peripheral neuropathy. The nurse should teach the client which interventions to prevent injury? - Use a bath thermometer to test the water temperature A client is diagnosed with a type of diabetes that is associated with insulin resistance. Which type of diabetes is the client experiencing? - Type 2 Diabetes A client is demonstrating signs of an anaphylactic reaction. Which of the following should the nurse do? (Select all that apply.) - *a. Maintain patent airway *e. Begin administering ordered intravenous fluids c. Place the client in Trendelenburg position or High Fowlers to aid in preventing shock The nurse is caring for a client who an exacerbation of Crohn's disease. The nurse is realizes that this is which type of hypersensitivity reaction. - c. Type 3 ***A client is being discharged after surgery to correct a retinal detachment. Which symptoms will the nurse teach the client to immediately report to the health care provider? (Select all that apply.)*** - a. Purulent discharge in the affected eye e. Severe Pain in the eye. e. Pain in the eye. b. Fever of 102 F The nurse is caring for an elderly client who has experienced a sensorineural hearing loss. The nurse anticipates that the client will exhibit which symptoms? - Problems with speaking clearly The nurse is evaluating the outcome of therapy for a client with osteoarthritis. Which of the following findings indicates goals of therapy have been met? - The client's joint range of motion has improved A client is diagnosed with glaucoma and is prescribed medication to treat it. The nurse knows that which of the following best explains the purpose of the medication? - *d. This medication lowers intraocular pressure. The nurse is caring for a client receiving a blood transfusion the client becomes flushed and is wheezing what should the nurse do first? - Stop the blood transfusion and switch to normal saline A nurse assesses a client who has diabetes mellitus. Which arterial blood gas values would the nurse identify as potential diabetic ketoacidosis (DKA) in this client? - pH 7.38, HCO3 22 mEq/L, PaCO2 33 mm Hg, PaO2 98 mm Hg The nurse caring for a client with diabetes realizes that the client has a higher risk of developing cataracts. The nurse should also assess the client for indications of which other visual complications? - Diabetic retinopathy During the health history, the client says, "I have many allergies." Of the following medications, which one would be for the treatment of allergies? - Diphenhydramine hydrochloride (Benadryl) A client with Meniere's disease is experiencing sever vertigo. Which instruction should the nurse give to the client to assist in controlling the vertigo? - Decrease sodium in the diet A health care provider has accidentally been stuck with a used needle. The health care provider is going to be tested for human immunodeficiency virus (HIV). Which of the following would be the testing schedule for the health care provider? - a. Tested immediately and again at 6 months The nurse is caring for a client who is administering insulin for diabetes mellitus for the first time. The nurse is instructing the client on mixing Humulin N insulin and Humulin R insulin in one syringe. Arrange the instructions in the correct order. This is the correct order - -Gently roll both insulins between your hands -Wipe with alcohol and inject air (equal to units ordered) into the Humulin N insulin -Wipe with alcohol and inject air (equal to units ordered) into the Humulin R insulin -Withdraw the Humulin R -Withdraw Humulin N insulin -Double check the total number of units in the syringe