MCA II Exam 3 UPDATED ACTUAL
QUESTIONS AND CORRECT ANSWERS
Which type of hepatitis develops into a chronic form of the disease? select all that apply.
a. hepatitis A
b. hepatitis B
c. hepatitis C
d. hepatitis D
e. hepatitis E - CORRECT ANSWER B, C, D
Hepatitis B and C generally develop into chronic hepatitis. Hepatitis D is an incomplete virus
that can become chronic and is dependent on the presence of hepatitis B to survive. Hepatitis
A and E are acute, self-limiting infections that resolve over time and do not develop with
chronic hepatitis.
A nurse is providing postoperative care for a client who has begun taking levothyroxine after
undergoing a thyroidectomy. Which findings in the client may indicate potential thyrotoxic
crisis?
a. Elevated serum calcium
b. Sudden drop in pulse rate
c. Hypothermia and dry skin
d. Rapid heartbeat and tremors - CORRECT ANSWER d. Rapid heartbeat and tremors
Thyrotoxic crisis (thyroid storm) refers to a sudden and excessive release of thyroid
hormones, which causes pyrexia, tachycardia, and exaggerated symptoms of thyrotoxicosis;
surgery, infection, and ablation therapy can precipitate this life-threatening condition.
Hypercalcemia is not related to thyrotoxic crisis; hypocalcemia results from accidental
removal of the parathyroid glands. Tachycardia is an increased, not decreased, heart rate,
which occurs with thyrotoxic crisis because of the sudden release of thyroid hormones;
thyroid hormones increase the basal metabolic rate. Fever, not hypothermia, and diaphoresis,
not dry skin, occur with thyrotoxic crisis because of the sudden release of thyroid hormones,
which increase the basal metabolic rate.h
,Which questions would the nurse ask when assessing a client diagnosed with acromegaly?
select all that apply.
a. "have you noticed any changes to your vision?"
b. "have you ever been told that you snore loudly?"
c. "have you had any changes in your menstrual cycle?"
d. "have you noticed any chances to your bowel movements?"
e. "have you noted you consume excess amount of cruciferous vegetables?" - CORRECT
ANSWER A, B, D
It is reasonable to ask a client with acromegaly if he or she has experienced changes in his or
her vision, because pressure on the optic nerve from a pituitary adenoma can occur. some
clients with acromegaly will develop sleep apnea, secondary to upper airway narrowing and
obstruction from increased amounts of pharyngeal soft tissues. clients with acromegaly are at
an increased risk of colorectal cancer. it is not necessary to ask the client with acromegaly
about her menstrual cycle; acromegaly is the overgrowth of soft tissue and bone in the hands,
feet, and face, and does not affect the reproductive organs as some other excesses of tropic
hormones do. intake of cruciferous vegetables will not affect acromegaly; the goitrogens in
these vegetables contain thyroid-inhibiting substance and can lead to goiter if eaten in
excessive amounts.
The nurse is admitting a client with severe myxedema coma. Which interventions would the
nurse include in the plan of care? Select all that apply. One, some, or all responses may be
correct.
a. Administer intravenous (IV) levothyroxine.
b. Avoid use of corticosteroids.
c. Give IV normal saline.
d. Wait for laboratory results before treating.
e. Monitor blood pressure every 4 hours. - CORRECT ANSWER A, C
myxedema coma is a major complication of poorly treated hypothyroidism. interventions
include administering IV levothyroxine. this promotes the return of normal thyroid hormone
levels. IV normal saline corrects dehydration. corticosteriods are administered as part of the
treatment. levothyroxine is initiated before obtaining laboratory results because waiting can
cause death. the blood pressure should be monitored hourly.
,which clinical findings correspond with the secretion of antidiuretic hormone (ADH)? select
all that apply.
a. edema
b. polyuria
c. bradycardia
d. muscle cramps
e. hyponatremia - CORRECT ANSWER D, E
muscle cramps occur when sodium level is less than 124 mEq/L and are caused by osmotic
fluid shift. ADH causes water retention, which dilutes serum electrolytes such as sodium,
with a resultant hyponatremia. edema is not usually seen in syndrome of inappropriate ADH
(SIADH) because water retention is not extracellular.. a decreased urine output occurs with
SIADH because ADH causes reabsorption of fluid in the kidney glomeruli. the increased
fluid volume associated with SIADH results in tachycardia, tachypnea and crackles.
A client with cirrhosis of the liver has a prolonged prothrombin time and a low platelet count.
A regular diet is prescribed. What should the nurse instruct the client to do considering the
client's condition?
a. Avoid foods high in phytonadione
b. Check the pulse several times a day.
c. Drink a glass of milk when taking aspirin.
d. Report signs of bleeding no matter how slight. - CORRECT ANSWER d. Report
signs of bleeding no matter how slight.
One of the many functions of the liver is the manufacture of clotting factors; there is
interference in this process with cirrhosis of the liver, resulting in bleeding tendencies. The
storage of fat-soluble vitamins (A, D, E, and K), water-soluble vitamins (B1, B2, folic acid,
and cobalamin), and minerals (including iron) is compromised in cirrhosis; therefore, these
nutrients, including phytonadione, should not be limited. Should the client bleed, the pulse
rate may be increased, but it is not necessary for the client to check the pulse rate several
times daily. A client whose prothrombin time is prolonged and platelet count is low should
not be taking aspirin, even with milk.
, While assessing a postpartum client who is suspected of having a thyroid disorder, the nurse
suspects that the client has autoimmune thyroiditis. Which diagnostic studies are most
suitable for confirming the diagnosis?
a. Radioactive iodine uptake
b. computed tomography scan
c. magnetic resonance imaging
d. thyroid-stimulating hormone - CORRECT ANSWER a. Radioactive iodine uptake
the postpartum client may have silent, painless thyroiditis. radioactive iodine uptake is
suppressed in silent thyroiditis, so this test would be beneficial in diagnosing the thyroiditis. a
computed tomography scan is used to detect thyroid nodules. magnetic resonance imaging is
also used in evaluating thyroid nodules. a blood test for thyroid-stimulating hormone is used
to evaluate thyroid function.
which action is the function of antidiuretic hormone (ADH)?
a. reduces blood volume
b. decreases water loss in urine
c. increases urine output
d. initiates the thirst mechanism - CORRECT ANSWER b. decreases water loss in
urine
ADH is released by the posterior pituitary gland. it is released mainly in response to either a
decrease in blood volume or an increased concentration of sodium or other substances in the
plasma. ADH acts to decrease the production of urine by increasing the reabsorption of water
by renal tubules. A decrease in ADH would cause reduced blood fluid volume; decreased
ability of the kidneys to reabsorb water, resulting in increased urine output; and an increase in
the thirst mechanism.
the nurse is caring for a client who is experiencing an underproduction of thyroxine (T4).
with what diagnosis is this associated?
a. myxedema
b. acromegaly
c. Graves disease
QUESTIONS AND CORRECT ANSWERS
Which type of hepatitis develops into a chronic form of the disease? select all that apply.
a. hepatitis A
b. hepatitis B
c. hepatitis C
d. hepatitis D
e. hepatitis E - CORRECT ANSWER B, C, D
Hepatitis B and C generally develop into chronic hepatitis. Hepatitis D is an incomplete virus
that can become chronic and is dependent on the presence of hepatitis B to survive. Hepatitis
A and E are acute, self-limiting infections that resolve over time and do not develop with
chronic hepatitis.
A nurse is providing postoperative care for a client who has begun taking levothyroxine after
undergoing a thyroidectomy. Which findings in the client may indicate potential thyrotoxic
crisis?
a. Elevated serum calcium
b. Sudden drop in pulse rate
c. Hypothermia and dry skin
d. Rapid heartbeat and tremors - CORRECT ANSWER d. Rapid heartbeat and tremors
Thyrotoxic crisis (thyroid storm) refers to a sudden and excessive release of thyroid
hormones, which causes pyrexia, tachycardia, and exaggerated symptoms of thyrotoxicosis;
surgery, infection, and ablation therapy can precipitate this life-threatening condition.
Hypercalcemia is not related to thyrotoxic crisis; hypocalcemia results from accidental
removal of the parathyroid glands. Tachycardia is an increased, not decreased, heart rate,
which occurs with thyrotoxic crisis because of the sudden release of thyroid hormones;
thyroid hormones increase the basal metabolic rate. Fever, not hypothermia, and diaphoresis,
not dry skin, occur with thyrotoxic crisis because of the sudden release of thyroid hormones,
which increase the basal metabolic rate.h
,Which questions would the nurse ask when assessing a client diagnosed with acromegaly?
select all that apply.
a. "have you noticed any changes to your vision?"
b. "have you ever been told that you snore loudly?"
c. "have you had any changes in your menstrual cycle?"
d. "have you noticed any chances to your bowel movements?"
e. "have you noted you consume excess amount of cruciferous vegetables?" - CORRECT
ANSWER A, B, D
It is reasonable to ask a client with acromegaly if he or she has experienced changes in his or
her vision, because pressure on the optic nerve from a pituitary adenoma can occur. some
clients with acromegaly will develop sleep apnea, secondary to upper airway narrowing and
obstruction from increased amounts of pharyngeal soft tissues. clients with acromegaly are at
an increased risk of colorectal cancer. it is not necessary to ask the client with acromegaly
about her menstrual cycle; acromegaly is the overgrowth of soft tissue and bone in the hands,
feet, and face, and does not affect the reproductive organs as some other excesses of tropic
hormones do. intake of cruciferous vegetables will not affect acromegaly; the goitrogens in
these vegetables contain thyroid-inhibiting substance and can lead to goiter if eaten in
excessive amounts.
The nurse is admitting a client with severe myxedema coma. Which interventions would the
nurse include in the plan of care? Select all that apply. One, some, or all responses may be
correct.
a. Administer intravenous (IV) levothyroxine.
b. Avoid use of corticosteroids.
c. Give IV normal saline.
d. Wait for laboratory results before treating.
e. Monitor blood pressure every 4 hours. - CORRECT ANSWER A, C
myxedema coma is a major complication of poorly treated hypothyroidism. interventions
include administering IV levothyroxine. this promotes the return of normal thyroid hormone
levels. IV normal saline corrects dehydration. corticosteriods are administered as part of the
treatment. levothyroxine is initiated before obtaining laboratory results because waiting can
cause death. the blood pressure should be monitored hourly.
,which clinical findings correspond with the secretion of antidiuretic hormone (ADH)? select
all that apply.
a. edema
b. polyuria
c. bradycardia
d. muscle cramps
e. hyponatremia - CORRECT ANSWER D, E
muscle cramps occur when sodium level is less than 124 mEq/L and are caused by osmotic
fluid shift. ADH causes water retention, which dilutes serum electrolytes such as sodium,
with a resultant hyponatremia. edema is not usually seen in syndrome of inappropriate ADH
(SIADH) because water retention is not extracellular.. a decreased urine output occurs with
SIADH because ADH causes reabsorption of fluid in the kidney glomeruli. the increased
fluid volume associated with SIADH results in tachycardia, tachypnea and crackles.
A client with cirrhosis of the liver has a prolonged prothrombin time and a low platelet count.
A regular diet is prescribed. What should the nurse instruct the client to do considering the
client's condition?
a. Avoid foods high in phytonadione
b. Check the pulse several times a day.
c. Drink a glass of milk when taking aspirin.
d. Report signs of bleeding no matter how slight. - CORRECT ANSWER d. Report
signs of bleeding no matter how slight.
One of the many functions of the liver is the manufacture of clotting factors; there is
interference in this process with cirrhosis of the liver, resulting in bleeding tendencies. The
storage of fat-soluble vitamins (A, D, E, and K), water-soluble vitamins (B1, B2, folic acid,
and cobalamin), and minerals (including iron) is compromised in cirrhosis; therefore, these
nutrients, including phytonadione, should not be limited. Should the client bleed, the pulse
rate may be increased, but it is not necessary for the client to check the pulse rate several
times daily. A client whose prothrombin time is prolonged and platelet count is low should
not be taking aspirin, even with milk.
, While assessing a postpartum client who is suspected of having a thyroid disorder, the nurse
suspects that the client has autoimmune thyroiditis. Which diagnostic studies are most
suitable for confirming the diagnosis?
a. Radioactive iodine uptake
b. computed tomography scan
c. magnetic resonance imaging
d. thyroid-stimulating hormone - CORRECT ANSWER a. Radioactive iodine uptake
the postpartum client may have silent, painless thyroiditis. radioactive iodine uptake is
suppressed in silent thyroiditis, so this test would be beneficial in diagnosing the thyroiditis. a
computed tomography scan is used to detect thyroid nodules. magnetic resonance imaging is
also used in evaluating thyroid nodules. a blood test for thyroid-stimulating hormone is used
to evaluate thyroid function.
which action is the function of antidiuretic hormone (ADH)?
a. reduces blood volume
b. decreases water loss in urine
c. increases urine output
d. initiates the thirst mechanism - CORRECT ANSWER b. decreases water loss in
urine
ADH is released by the posterior pituitary gland. it is released mainly in response to either a
decrease in blood volume or an increased concentration of sodium or other substances in the
plasma. ADH acts to decrease the production of urine by increasing the reabsorption of water
by renal tubules. A decrease in ADH would cause reduced blood fluid volume; decreased
ability of the kidneys to reabsorb water, resulting in increased urine output; and an increase in
the thirst mechanism.
the nurse is caring for a client who is experiencing an underproduction of thyroxine (T4).
with what diagnosis is this associated?
a. myxedema
b. acromegaly
c. Graves disease
