NU 185: MED-SURGE II PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION

NU 185: MED-SURGE II PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION 1. A client is admitted for removal of a goiter. Which nursing intervention should receive priority during the postoperative period? *Exam Cram Endocrine - answer Assessing the Clients Airway 2. A client is admitted for treatment of hypoparathyroidism. Based on the client's diagnosis, the nurse would anticipate an order for? *Exam Cram Endocrine - answer Calcium 3. A client with Addison's Disease will most likely exhibit which symptom? *Exam Cram Endocrine - answer Bronze Pigmentation 4. A client w/ Cushing's Syndrome should be instructed to? *Exam Cram Endocrine - answer Limit the Sodium in her DIet 5. The client w/ a suspected pituitary tumor will most likely exhibit symptoms of? *Exam Cram Endocrine - answer Alteration in Visual Acuity 6. A diabetic client has been maintained on GLucophage (Metformin) for regulation of his blood glucose levels. Which teaching should be included in the plan of care? *Exam Cram Endocrine - answer Report changes in Urinary Pattern 7. A client w/ diabetes experiences Somogyi's effect. To prevent this complication, the nurse should instruct the client to? *Exam Cram Endocrine - answer Eat a protein and carbohydrate snack at bedtime 8. Which item should be kept at the bedside of a client who has just returned from having a thyroidectomy? *Exam Cram Endocrine - answer A tracheostomy set 9. Which vitamin is directly involved in the metabolism of the hormones secreted by the parathyroid? *Exam Cram Endocrine - answer Vitamin D 10. A client w/ acromegaly will most likely experience which symptom? *Exam Cram Endocrine - answer Bone Pain 11. A diabetic client is taking Lantus Insulin for regulation of his blood glucose levels. The nurse should know that this insulin will most likely be administered? *Exam Cram Endocrine - answer At Night 12. A client w/ Polyuria, Polydipsia, and Polyphagia is diagnosed w/ diabetes mellitus. The nurse would expect that these symptoms are r/t? *Exam Cram Endocrine - answer Hyperglycemia 13. Which laboratory test conducted on the client w/ Diabetes Mellitus indicates compliance? *Exam Cram Endocrine - answer Hgb A-1C 14. A client hospitalized with acute glomerulonephritis has a positive ASO titer. The nurse understands that the client's current illness is due to a... *Exam Cram Renal - answer Prior Bacterial Infection 15. The physician has prescribed hydralazine (Apresoline) for a client with acute glomerulonephritis. Which finding indicates that the drug is having the desired effect? *Exam Cram Renal - answer The clients bp has decreased 16. A client with acute glomerulonephritis requests a snack. Which snack is suitable given the client's dietary restrictions? *Exam Cram Renal - answer Applesauce 17. The physician has ordered Prednisone 50 mg daily to promote diuresis in a client with nephrotic syndrome. The nurse should administer the medication... *Exam Cram Renal - answer With a snack or glass of milk 18. A client receiving Gentamicin (Garamycin) IVPB has a morning peak level of 12 micrograms/mL. The nurse should...*Exam Cram Renal - answer Notify the physician because the level is too high 19. The nurse is teaching the client with an ileal conduit regarding skin care to prevent excoriation. In addition to applying a well-fitted collection bag the client should be told to empty the collection bag... *Exam Cram Renal - answer When it is one third full 20. A client with end stage renal disease has been managed by peritoneal dialysis. Which finding should be reported to the doctor immediately? *Exam Cram Renal - answer The client complains of abdominal pain and nausea 21. The nurse notes dark red blood and a few clots in the catheter of a client two days after transurethral prostatectomy (TURP). The nurse should first... *Exam Cram Renal - answer Apply traction to the urethral catheter 22. A client is admitted with a tentative diagnosis of bladder cancer. Which finding most likely contributed to the development of bladder cancer? *Exam Cram Renal - answer Two PPD cigarette use for 25 years 23. The nurse is providing dietary instructions to a client with oxalate renal calculi. The nurse should tell the client to avoid which of the following snacks... *Exam Cram Renal - answer Strawberries 24. Insulin kept at room temperature will last approximately... *Endocrine - answer 1 Month 25. How can you keep the insulin needle syringe clean? *Endocrine - answer By keeping it capped when you're not using it. Cleaning it with alcohol removes the coating that helps the needle slide into the skin easily 26. Sulfonylureas (Glyburide) *Endocrine - answer Action Site: Pancreas Action: More insulin release from Pancreas Side Effects: Low Blood Sugar, Weight Gain Considerations: Some given on either empty stomach or w/ food Interactions: Beta blockers mask low blood sugar symptoms. Glyburide & Cipro=Severe Low Blood Sugar 27. Biguanides (Glucophage/Metformin) *Endocrine - answer Action Site: Liver Action: Less liver glucose production Side Effects: Abdl Fullness, Gas, Diarrhea, & NV Considerations: Take w/ Meal Interactions: Contrast Iodine Dye can lead to acute renal failure. Hold 48 hrs before iodine test. Alcohol raises risk of lactic acidosis 28. Alpha-Glucosidase (Precose/Acarbose) *Endocrine - answer Action Site: Small Intestine Action: Delays carbohydrate digestion & absorption Side Effects: Abd Fullness, Gas, Diarrhea Considerations: Take w/ Meal. Treat low blood sugar w/ glucose tabs or milk Interactions: Less effective with other drugs that affect digestion for example metamucil 29. Thiazolidinediones TZD's (Actos/Pioglitazone and Avandia/Rosiglitazone) *Endocrine - answer Action Site: Liver, Muscle, Fat Action: Less liver glucose production. More insulin sensitivity. Lowers Triglycerides. Side Effects: Headache, NV, Edema Considerations: Take w/ Meal. Onset-4 weeks, Avoid w/ Severe CAF. Increases Liver Enzymes Interactions: Less effective when taken w/ oral contraceptives 30. Meglitinides (Prandin/Repaglinide) *Endocrine - answer Action Site: Pancreas Action: More Insulin Production Side Effects: Low Blood Sugar Considerations: Take before each meal. Do not take if meal is skipped Interactions: N/A 31. Rapid Acting: Humalog (Lispro) Novolog (Aspart) Apidra (Glulisine) *Endocrine - answer Onset: 15-30 minutes Peak: 30-90 minutes Duration: 3-4 hours 32. Short Acting: Novolin Regular *Endocrine - answer Onset: 30-60 minutes Peak: 2.5-5 hours Duration: 3-6 hours 33. Intermediate Acting: Novolin NPH *Endocrine - answer Onset: 1.5-4 hours Peak: 4-12 hours Duration: Up to 24 hours 34. Long Acting *Don't Mix*: Lantus (Glargine) Levemir (Detemir) *Endocrine - answer Onset: 1-2 hours Peak: No Peak Duration: 24 35. What Insulin what you give IV *Endocrine - answer Regular Insulin 36. Who would Long Acting Insulin be good for? *Endocrine - answer Sedentary Lifestyle, Type 2, Elderly 37. What are the six kinds of diabetic medications in pill form? *Endocrine - answer sulfonylureas, metformin, thiazolidinediones, alpha-glucosidase inhibitors, repaglinide and nateglinide. 38. Sick Day Guidelines for Diabetics, Call your HCP or go to ER if any of the following occur... *Endocrine - answer -You feel to sick to eat normally and are unable to keep down any food for more than 6 hours -Severe Diarrhea -Lose 5 lbs or More -Temperature over 101 degrees F -Blood Glucose is lower than 60 mg/dl or remains over 300 mg/dl -Moderate to Large Amounts of Ketones in the Urine Trouble breathing -Sleepy or Cannot Think Clearly 39. Hypoglycemia *Endocrine - answer *Low Blood Glucose* -Causes: Too little food, too much insulin or diabetes medicine, or extra activity Onset: Sudden, may progress to insulin shock -S/S: Shaking, Fast Heartbeat, Sweating, Dizziness, Anxious, Hunger, Impaired Vision, Weakness/Fatigue, Headache, Irritable -What can you do? Drink half of a glass of juice, soft drink, or 1 glass of milk. Eat some soft candies (No Chocolate).After 30 mins check blood glucose.Then eat a light snack, 1/2 peanut butter or meat sandwich and 1/2 glass of milk 40. Hyperglycemia *Endocrine - answer *High Blood Glucose* -Causes: Too much food, too little insulin or diabetic medicine, or illness and stress -Onset: Gradual, may progress to diabetic coma -S/S: Polydipsia, Polyuria, Polyphagia, Dry Skin, Blurred Vision, Drowsiness, Decreased Healing -What can you do? Test blood glucose, if over 200 mg/dl for various tests or for 2 days, call your doctor 41. Nursing Goals for A Patient w/ an Endocrine Disorder *Endocrine - answer Prevention of injury Fluid and electrolyte balance Maintenance of hormone balance Reduction of stress Use of effective coping skills Knowledge of self care Normal bowel function Adequate activity tolerance Good mental status Healthy body image