A patient is diagnosed w/ hypothyroidism. What additional information when conducting a focused
assessment? Weight gain
Which pt will the community health nurse visit first? Pt with type 1 DM w/ acute visual changes
The client's order is for 5 units of regular insulin and 10 units of NPH (neutral protamine Hagedorn)
insulin given as a basal dose. The client also is to receive an amount prescribed from the medium-dose
sliding scale (shown image) based on morning blood glucose levels. The current bedside blood glucose
measurement is 264 mg/dL (14.7 mmol/L). How many total units of insulin would the nurse administer
to the client? Record your answer using a whole number.
21 units
A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement
by the client indicates the need for additional discharge teaching?
“I will increase my fluid & calcium intake.”
A client with hyperthyroidism is to have a thyroidectomy. The health care provider (HCP) has
prescribed propranolol. In reviewing the client's history, the nurse notes that the client has asthma.
What should the nurse do next?
Contact the HCP and discuss the prescription for propranolol because of the client's history
of having asthma.
A middle-aged female client complains of anxiety, insomnia, weight loss, the inability to concentrate,
and eyes feeling "gritty." Thyroid function tests reveal the following: thyroid-stimulating hormone (TSH)
0.02 U/ml, thyroxine 20 g/dl, and triiodothyronine 253 ng/dl. A 6-hour radioactive iodine uptake test
showed a diffuse uptake of 85%. Based on these assessment findings, the nurse should suspect:
Graves’ disease
The nurse teaches a client with type 2 diabetes mellitus about diabetic retinopathy. Which statement if
made by the client would indicate to the nurse that teaching was effective?
"Tight control of blood sugar and blood pressure can prevent damage to my eye."
A nurse is teaching a school-age child with diabetes and their parents about managing diabetes during
illness. The nurse determines that the parents understand the instruction when they indicate that they
will make which treatment plan modification on days when the child is ill?
increasing the frequency of blood glucose monitoring
A client with hypothyroidism is afraid of needles and doesn't want to have their blood drawn. What
should the nurse say to help alleviate the client's concerns?
"I'll stay here with you while the technician draws your blood."
The nurse is assessing a client with hepatitis A and notices that the aspartate transaminase (AST) and
alanine transaminase (ALT) lab values have increased. Which statement by the client indicates the
need for further instruction by the nurse
“I take acetaminophen for arthritis pain.”
A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the
nurse do?
Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.
A client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which
instruction should the nurse provide?
"You may not be able to use desmopressin nasally if you have nasal discharge or
blockage."
The client with type 2 insulin-requiring diabetes asks the nurse about having alcoholic beverages.
Which is the best response by the nurse?
"You can have one or two drinks a day as long as you have something to eat with them."
, A client has been diagnosed with hypothyroidism. Which statement by the client would demonstrate
appropriate teaching by the nurse?
“I will increase fiber & fluids in my diet.”
On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of
the nervous system. When questioned, the client reports numbness and tingling of the mouth and
fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon
immediately. Which electrolyte disturbance most commonly follows thyroid surgery?
Hypocalcemia
The nurse is caring for a client with multiple organ failure who is in metabolic acidosis. Which pair of
organs is responsible for regulatory processes and compensation?
Lungs & kidneys
A nurse obtained a client's fasting blood sugar (FBS) at 0700, which was 144 mg/dL (8 mmol/L). The
client has an order for regular insulin 8 units every morning. What should the nurse do next?
Administer the insulin as ordered
The nurse is developing a teaching plan with a client who had a bilateral adrenalectomy. What
information should the nurse include in the plan?
“the client will need steroid replacement for the rest of their life.”
A client with thyrotoxicosis says to the nurse, “I'm so irritable. I'm having problems at work because I
lose my temper very easily.” Which response by the nurse would give the client the most accurate
explanation of this behavior?
“You are experiencing:
Excess thyroid hormone in your system.”
The nurse is completing a health assessment of a client with suspected Graves disease. When
conducting a focused assessment, the nurse should assess the client for which finding?
Tachycardia
For a client with hyperthyroidism, treatment is most likely to include
a thyroid hormone antagonist.
A client with hypothyroidism has started to take thyroid hormone replacement therapy and asks the
nurse about the reason for feeling sad and depressed. What should the nurse tell the client?
“The feelings of sadness and depression are caused by:
low thyroid hormone levels and will improve with replacement therapy.”
A client is diagnosed with diabetes mellitus. Which assessment findings best support a nursing
diagnosis of ineffective coping related to diabetes mellitus? Select all that apply.
refuses to attend diabetic support meetings
changes the subject whenever diabetes is mentioned
A client’s fasting blood sugar (FBS) is 63 mg/dL (3.5 mmol/L) at 0700. The client is alert and oriented.
What should the nurse do first?
Give 15 g of carbohydrate and recheck the blood glucose in 15 minutes.
Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses
the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme
restlessness. What is the most likely cause of these signs?
Thyroid crisis
A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In
discussing the result with the client, the nurse is most accurate in stating.
"It tells us about your sugar control for the last 3 months."
assessment? Weight gain
Which pt will the community health nurse visit first? Pt with type 1 DM w/ acute visual changes
The client's order is for 5 units of regular insulin and 10 units of NPH (neutral protamine Hagedorn)
insulin given as a basal dose. The client also is to receive an amount prescribed from the medium-dose
sliding scale (shown image) based on morning blood glucose levels. The current bedside blood glucose
measurement is 264 mg/dL (14.7 mmol/L). How many total units of insulin would the nurse administer
to the client? Record your answer using a whole number.
21 units
A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement
by the client indicates the need for additional discharge teaching?
“I will increase my fluid & calcium intake.”
A client with hyperthyroidism is to have a thyroidectomy. The health care provider (HCP) has
prescribed propranolol. In reviewing the client's history, the nurse notes that the client has asthma.
What should the nurse do next?
Contact the HCP and discuss the prescription for propranolol because of the client's history
of having asthma.
A middle-aged female client complains of anxiety, insomnia, weight loss, the inability to concentrate,
and eyes feeling "gritty." Thyroid function tests reveal the following: thyroid-stimulating hormone (TSH)
0.02 U/ml, thyroxine 20 g/dl, and triiodothyronine 253 ng/dl. A 6-hour radioactive iodine uptake test
showed a diffuse uptake of 85%. Based on these assessment findings, the nurse should suspect:
Graves’ disease
The nurse teaches a client with type 2 diabetes mellitus about diabetic retinopathy. Which statement if
made by the client would indicate to the nurse that teaching was effective?
"Tight control of blood sugar and blood pressure can prevent damage to my eye."
A nurse is teaching a school-age child with diabetes and their parents about managing diabetes during
illness. The nurse determines that the parents understand the instruction when they indicate that they
will make which treatment plan modification on days when the child is ill?
increasing the frequency of blood glucose monitoring
A client with hypothyroidism is afraid of needles and doesn't want to have their blood drawn. What
should the nurse say to help alleviate the client's concerns?
"I'll stay here with you while the technician draws your blood."
The nurse is assessing a client with hepatitis A and notices that the aspartate transaminase (AST) and
alanine transaminase (ALT) lab values have increased. Which statement by the client indicates the
need for further instruction by the nurse
“I take acetaminophen for arthritis pain.”
A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the
nurse do?
Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.
A client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which
instruction should the nurse provide?
"You may not be able to use desmopressin nasally if you have nasal discharge or
blockage."
The client with type 2 insulin-requiring diabetes asks the nurse about having alcoholic beverages.
Which is the best response by the nurse?
"You can have one or two drinks a day as long as you have something to eat with them."
, A client has been diagnosed with hypothyroidism. Which statement by the client would demonstrate
appropriate teaching by the nurse?
“I will increase fiber & fluids in my diet.”
On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of
the nervous system. When questioned, the client reports numbness and tingling of the mouth and
fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon
immediately. Which electrolyte disturbance most commonly follows thyroid surgery?
Hypocalcemia
The nurse is caring for a client with multiple organ failure who is in metabolic acidosis. Which pair of
organs is responsible for regulatory processes and compensation?
Lungs & kidneys
A nurse obtained a client's fasting blood sugar (FBS) at 0700, which was 144 mg/dL (8 mmol/L). The
client has an order for regular insulin 8 units every morning. What should the nurse do next?
Administer the insulin as ordered
The nurse is developing a teaching plan with a client who had a bilateral adrenalectomy. What
information should the nurse include in the plan?
“the client will need steroid replacement for the rest of their life.”
A client with thyrotoxicosis says to the nurse, “I'm so irritable. I'm having problems at work because I
lose my temper very easily.” Which response by the nurse would give the client the most accurate
explanation of this behavior?
“You are experiencing:
Excess thyroid hormone in your system.”
The nurse is completing a health assessment of a client with suspected Graves disease. When
conducting a focused assessment, the nurse should assess the client for which finding?
Tachycardia
For a client with hyperthyroidism, treatment is most likely to include
a thyroid hormone antagonist.
A client with hypothyroidism has started to take thyroid hormone replacement therapy and asks the
nurse about the reason for feeling sad and depressed. What should the nurse tell the client?
“The feelings of sadness and depression are caused by:
low thyroid hormone levels and will improve with replacement therapy.”
A client is diagnosed with diabetes mellitus. Which assessment findings best support a nursing
diagnosis of ineffective coping related to diabetes mellitus? Select all that apply.
refuses to attend diabetic support meetings
changes the subject whenever diabetes is mentioned
A client’s fasting blood sugar (FBS) is 63 mg/dL (3.5 mmol/L) at 0700. The client is alert and oriented.
What should the nurse do first?
Give 15 g of carbohydrate and recheck the blood glucose in 15 minutes.
Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses
the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme
restlessness. What is the most likely cause of these signs?
Thyroid crisis
A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In
discussing the result with the client, the nurse is most accurate in stating.
"It tells us about your sugar control for the last 3 months."
