NUR 667 Final Exam Practice Questions and Answers Latest Updated | Grade A+

NUR 667 Final Exam Practice Questions and Answers Latest Updated | Grade A+. A 45-year-old patient presents with a chief complaint of generalized abdominal pain. Her physical examination is remarkable for left lower quadrant tenderness. At this time, which of the following should be considered in the differential diagnosis? A. Endometriosis B. Yersinia enterocolitica infection C. Appendicitis D. GERD {{Correct Ans- A. Endometriosis -A 21-year-old student presents with complaints of fatigue, headache, anorexia, and a runny nose, all of which began about 2 weeks ago. She started taking vitamins and over-the-counter cold preparations but feels worse. The smell of food makes her nauseated. Her boyfriend had mononucleosis about 1 month ago, and she wonders if she might have it also. Examination reveals cervical adenopathy and an enlarged liver and spleen. Which of the following labs would be most helpful in the differential diagnosis at th is point? A. Stool culture B. Liver enzymes C. Antihepatitis D virusD Thyroid-stimulating hormone test {{Correct Ans- C. Antihepatitis D virus -A pt is seen with c/o diarrhea. Which of the following should be included in the pt's differentials? a. Gastroenteritis b. Inflammatory bowel disease c. Lactase deficiency d. All of the above {{Correct Ans- d. All of the above -One of the three P's of diabetes is: A. paresthesias B. polydipsia C. polycythemia D. proteinuria b. polydipsia {{Correct Ans- B. polydipsia -A client is experiencing sudden tachycardia, systolic hypertension, and a high fever after a thyroid assessment by the provider. What medication should be administered? Select all that apply. A. Antithyroid medications B. Thyroid supplements C. Vitamin D D. Iodine preparations E. Glucocorticoids {{Correct Ans- A. Antithyroid medications D. Iodine preparations E. Glucocorticoids Rationale: Thyroid storm or thyrotoxicosis may develop with poorly managed hyperthyroidism. Clinical manifestations include tachycardia, fever, systolic hypertension, abdominal pain, tremors, and changes in level of consciousness. Airway management and fluid resuscitation are priorities. Antithyroid medications may be administered along with iodine preparations. For management of tachycardia, betaadrenergic blockers may be administered. Glucocorticoids may also be administered because in high doses these medications decrease the conversion of T4 to the more active T3, as well as decreasing the release of TSH from the anterior pituitary gland. -Joyce is seen in the clinic complaining of vague symptoms of nervousness and irritability. She says that her hair will not hold a permanent wave anymore. On physical examination, the clinician finds an irregular heartbeat and brisk reflexes. The differential diagnosis should include which of the following conditions? A. Myxedema B. Thyrotoxicosis C. Cushing's syndrome D. Pan-hypopituitarism {{Correct Ans- B. Thyrotoxicosis -The nurse is caring for a client with exophthalmos. What is the anticipated cause? A. Hypothyroidism B. Hyperthyroidism C. Thyrotoxicosis D. Hypoparathyroidism {{Correct Ans- B. Hyperthyroidism -The patient experiencing thyroid storm (thyrotoxicosis) is ordered to receive beta-adrenergic agents. The nurse monitors which therapeutic effect of these medications? A. Increased respiratory rate B. Increased appetite C. Decreased heart rate D. Decreased bowel sounds {{Correct Ans- C. Decreased heart rate -A 45yo pt presents with a CC of generalized abd pain. Her physical exam is remarkable for LLQ tenderness. At this time, which of the following should be considered in the differential dx? a. Endometriosis b. Colon cancer c. Diverticulitis d. All of the above {{Correct Ans- d. All of the above -What is the mainstay of management for infectious mononucleosis? A. Antivirals B. Symptom control C. Corticosteroids D. Isolation {{Correct Ans- B. Symptom control -How long would the clinician inform the patient to rest after onset of infectious mononucleosis? A. 4 days B. 10 days C. 2 weeks D. 4 weeks {{Correct Ans- D. 4 weeks -Mandy, age 18, has infectious mononucleosis. What might you expect her blood work to reflect? A. Thrombocytopenia and elevated transaminase B. Elevated WBCs C. Decreased WBCs D. Decreased serum globulins {{Correct Ans- A. Thrombocytopenia and elevated transaminase -The clinician suspects that a patient seen in the office has hyperthyroidism. Which test should the clinician order on the initial visit? A. Sensitive thyroid-stimulating hormone (TSH) assay and T4 B. Free T4 and serum calcium C. Nuclear scintigraphy with radiolabeled iodine (123I) D. Magnetic resonance imaging {{Correct Ans- A. Sensitive thyroid-stimulating hormone (TSH) assay and T4 -Which of the following laboratory findings should the clinician expect in a patient with untreated Graves' disease? Select all that apply A. Low TSH B. Elevated T4 C. Elevated thyrotropin-releasing hormone (TRH) D. All of the above {{Correct Ans- D. All of the above Graves Disease, a form or HYPERTHYROIDISM. Labs:- 2nd most prevalent from of autoimmune thyroid disease- Suppressed TSH- detectable TSH antibodies- high thyroid uptake of radioactive Iodine -Polydipsia occurs in diabetes as a result of a high serum glucose level, which: A. interferes with the release of antidiuretic hormones B. has an osmotic effect on fluids and eventually triggers the thirst mechanism for compensation C. causes a dry mouth, increasing the client's thirst to the point of drinking compulsively D. disrupts fluid and electrolyte imbalance, increasing the thirst mechanism to compensate for fluid gain or loss {{Correct Ans- B. has an osmotic effect on fluids and eventually triggers the thirst mechanism for compensation -A patient is 66 inches in height, weighing 200 lbs, and newly diagnosed with type 2 diabetes mellitus (DM). The A1c is 7.1%. What is the best initial treatment? A. No treatment at this time B. Diet and exercise C. Diet, exercise, and metformin D. Diet, exercise, and exogenous insulin {{Correct Ans- C. Diet, exercise, and metformin -Sally, age 24, has frequent UTIs. You are teaching her about measures to prevent them. You know she has misunderstood your directions when she tells you that she will A. void after intercourse B. avoid bubble baths C. wear underwear with pantyhose D. drink 4 to 6 glasses of water per day {{Correct Ans- D. drink 4 to 6 glasses of water per day -Which medication for type 2 diabetes mellitus would be contraindicated during pregnancy? A. Insulin B. Metformin (Glucophage) C. Glipizide (Glucotrol) D. Acarbose (Precose) {{Correct Ans- C. Glipizide (Glucotrol) -A patient with type 2 diabetes comes to the clinic after reading about metformin in a magazine. Which condition that the patient also has would be a contraindication to taking metformin? A. Ulcerative colitis B. Inflammatory bowel disease C. Chronic obstructive pulmonary disease D. Renal disease {{Correct Ans- D. Renal disease -A patient presents with symptoms of infectious mononucleosis. Which lab chemistry test should the clinician order? A. Viral load B. Hemoglobin A1c C. Western blot assay D. Heterophile antibody test {{Correct Ans- D. Heterophile antibody test -Which cognitive behavioral finding would the nurse anticipate finding in a patient with cirrhosis who has hepatic encephalopathy? A. Intact short-term memory B. Intact long-term memory C. Personality changes D. Clear speech articulation {{Correct Ans- C. Personality changes -In cirrhosis, alterations in blood and lymph flow can lead to what end organ effect of the liver? A. Increased perfusion as a result of ascites B. Increased pressure leading to increased vascularity C. Cellular changes leading to malignancy D. Necrosis {{Correct Ans- D. Necrosis -The nurse is caring for a patient with cirrhosis. What signs would the nurse monitor for worsening of the disease? Select all that apply. A. Petechiae B. Increased appetite C. Laryngitis D. Pedal edema E. Jaundice {{Correct Ans- A. Petechiae D. Pedal edema E. Jaundice -Ron has cirrhosis and now presents with altered mental status after increasing protein intake because he was trying to increase muscle mass. Which of the following diseases should the clinician be concerned about? A. Hepatopulmonary syndrome B. Hepatic encephalopathy C. Hepatorenal syndrome D. Spontaneous bacterial peritonitis {{Correct Ans- B. Hepatic encephalopathy -The nurse is caring for a client with an elevated thyroid stimulating hormone (TSH) level. Which assessments are consistent with this finding? Select all that apply. A. Constipation B. Weight gain C. Edema D. Tachycardia E. Restlessness and anxiety {{Correct Ans- a. Constipation b. Weight gain c. Edema Rationale: The diagnosis of hypothyroidism is confirmed through analysis of laboratory data, including T3, T4, and TSH. If the etiology is primary hypothyroidism, the TSH level is elevated as a result of the feedback system to the hypothalamus and anterior pituitary gland caused by low circulating levels of thyroid hormones (T3 and T4). The hypometabolic state is characterized by decreased energy, increased sleep, fatigue, weight gain, decreased appetite, and susceptibility to cold temperatures. Decreased gastrointestinal activity results in constipation and abdominal distention. -What does a low level of thyroid-stimulating hormone indicate? A. Hypothyroidism B. Myxedema C. Hyperthyroidism D. Thyroid nodule {{Correct Ans- C. Hyperthyroidism -Minnie is pregnant. She has hypothyroidism and has been on the same levothyroxine medication for years. What might you expect to do with her levothyroxine medication? A. Increase the dosage B. Maintain her established dose C. Decrease her dosage D. Increase the dose during the first trimester, then decrease it during the second and third trimesters {{Correct Ans- A. Increase the dosage -Which "P" is a component of "the 3 P's" of diabetes mellitus? A. Pain B. Paresthesia C. Pallor D. Polyphagia {{Correct Ans- D. Polyphagia -A pt with T2DM comes to the clinic after reading about metformin in a magazine. Which of the following conditions that the patient also has would be a contraindication to taking metformin? A. Ketoacidosis B. Cirrhosis C. Hypoglycemic episodes D. All of the above {{Correct Ans- D. All of the above -Jane has insulin-dependent diabetes mellitus and has been experiencing hyperglycemia before dinner. A possible solution to this problem is to: A. Adjust her morning dose of rapid-acting insulin. B. Increase her midafternoon snack. C. Add physical activity between lunch and dinner. D. Reduce the amount of carbohydrates at dinner. {{Correct Ans- C. Add physical activity between lunch and dinner. -T/F Metformin is the first line of pharm treatment for T2DM. {{Correct Ans- True -A patient is 66 inches in height, weighs 200 pounds, and is newly diagnosed with type 2 diabetes mellitus (DM). Her fasting plasma glucose level is 215 mg/dL. What is the best initial treatment? A. No treatment at this time B. Diet and exercise for 6-week trial C. Diet, exercise, and oral medication D. Diet, exercise, and exogenous insulin {{Correct Ans- B. Diet and exercise for 6-week trial -The nurse is caring for a client with cirrhosis. Which clinical manifestations should the nurse expect to observe? Select all that apply. a. Altered mental status b. Metabolic alkalosis c. Altered respiratory status d. Jaundice. Petechiae {{Correct Ans- a. Altered mental status c. Altered respiratory status d. Jaundice e. Petechiae -Which action performed by a nurse while taking care of a patient with cirrhosis puts the patient at increased risk of complication? A. Providing electrolyte replacements such as potassium B. Administering diuretics. C. Increasing amounts of protein in the diet. D. Restricting sodium and fluid intake as ordered. {{Correct Ans- C. Increasing amounts of protein in the diet. -A patient comes to the office complaining of constipation. The patient lists all of the following medications. Which drug could be responsible for the constipation?