NUR 305A Final Exam Questions With
Correct Answers
Which |is |a |possible |outcome |for |the |patient |experiencing |an |age-related |decrease |in |
antidiuretic |hormone?
A.Constipation, |lethargy, |and |dry |skin
B.Greater-than-ideal |body |weight
C.Diluted |urine |and |dehydration
D.Yeast |infection |and |polydipsia |- |CORRECT |ANSWER✔✔-•ANS: |C
•Rationale: |These |are |symptoms |that |result |from |an |age-related |decrease |in |antidiuretic |
hormone. |The |other |symptoms |listed |are |not.
Which |response |in |a |client |with |diabetes |insipidus |indicates |to |the |nurse |that |another |dose |of |
desmopressin |acetate |(DDAVP) |is |needed?
A. |Urine |output |and |specific |gravity |are |increased.
B. |Urine |output |is |increased |and |urine |specific |gravity |is |decreased.
C. |Urine |output |and |specific |gravity |are |decreased.
D. |Urine |output |is |decreased |and |urine |specific |gravity |is |increased. |- |CORRECT |ANSWER✔✔-
•ANS: |B
•Rationale: |Diabetes |insipidus |(DI) |is |caused |by |a |failure |to |secrete |sufficient |amounts |of |
antidiuretic |hormone |(ADH) |to |maintain |blood |osmolarity |and |prevent |hyperosmolar |blood |
and |other |extracellular |fluid. |ADH |increases |the |amount |of |water |reabsorbed |from |urine |and |
returned |to |systemic |circulation. |Without |adequate |amounts |of |ADH, |more |water |is |excreted |
in |the |urine, |increasing |urine |volume |and |decreasing |urine |specific |gravity. |DDAVP |has |a |
similar |action |to |ADH |but |it |is |temporary. |When |urine |volume |increases |and |the |specific |
gravity |decreases, |more |drug |is |needed.
,•The |serum |electrolyte |values |for |a |client |with |syndrome |of |inappropriate |antidiuretic |
hormone |being |treated |with |tolvaptan |indicate |the |following |changes |within |the |past |12 |
hours. |Which |change |does |the |nurse |report |immediately |to |the |health |care |provider?
•A. |Serum |potassium |decrease |from |4.2 |mEq/L |to |3.8 |mEq/L
•B. |Serum |sodium |increase |from |122 |mEq/L |to |140 |mEq/L
•C. |Serum |calcium |increase |from |9.5 |mg/dL |to |10.2 |mg/dL
•D. |Serum |chloride |decrease |from |109 |mEq/L |to |99 |mEq/L |- |CORRECT |ANSWER✔✔-•ANS: |B
•Rationale: |The |purpose |of |tolvaptan |is |to |restore |a |normal |sodium |concentration |to |the |
blood |and |other |extracellular |fluid. |In |the |case |of |SIADH, |excessive |amounts |of |antidiuretic |
hormone |have |caused |more |water |to |be |absorbed, |causing |the |serum |sodium |to |be |diluted. |
When |tolvaptan |therapy |brings |the |serum |sodium |level |to |normal |levels, |it |must |be |
discontinued |to |prevent |hypernatremia. |A |serum |sodium |of |140 |mEq/L |is |within |the |normal |
range.
A |patient |is |diagnosed |with |small |cell |lung |cancer. |Which |endocrine |condition |is |consistent |
with |this |diagnosis?
A.Syndrome |of |inappropriate |antidiuretic |hormone |(SIADH)
B.Diabetes |insipidus |(DI)
C.Cushing's |syndrome
D.Adrenal |crisis |- |CORRECT |ANSWER✔✔-•Answer: |A
•Rationale: |Cancer |(especially |lung |cancers) |increases |the |risk |of |the |patient |developing |
SIADH. |Other |risk |factors |include |recent |head |trauma, |cerebrovascular |disease, |and |
tuberculosis |or |other |pulmonary |disease. |A |review |of |past |and |current |medications |is |also |
important |in |searching |for |the |cause |of |SIADH.
•Which |precaution |is |most |important |for |the |nurse |to |teach |a |client |who |is |prescribed |oral |
corticosteroids |for |hormone |replacement |therapy |after |a |unilateral |adrenalectomy?
•A. |"Do |not |stop |taking |this |drug |without |consulting |your |prescriber."
,•B. |"Avoid |crowds |and |people |who |are |ill."
•C. |"Be |sure |to |take |this |drug |with |food."
•D. |"Reduce |your |salt |intake." |- |CORRECT |ANSWER✔✔-•ANS: |A
•Rationale: |All |of |the |choices |are |precautions |that |the |nurse |should |teach |the |client |taking |an |
oral |corticosteroid |chronically. |However, |the |most |critical |precaution |is |to |not |stop |taking |the |
drug |because |chronic |corticosteroid |use |causes |atrophy |of |the |adrenal |glands. |With |adrenal |
gland |atrophy, |the |person |no |longer |makes |his |or |her |own |normal |levels |of |corticosteroids, |
which |are |essential |for |life. |Long-term |steroid |use |should |never |be |suddenly |stopped.
Which |patient |with |Cushing's |disease |is |at |greatest |risk |for |developing |heart |failure?
A.42-year-old |with |a |serum |creatinine |level |of |3.7 |mg/dL
B.59-year-old |with |a |history |of |hypertension
C.32-year-old |with |a |history |of |hepatitis |B |infection
D.60-year-old |with |pneumonia |- |CORRECT |ANSWER✔✔-•Answer: |A
•Rationale: |The |42-year-old |patient |has |compromised |kidney |function |evidenced |by |an |
elevated |serum |creatinine |level. |Preventing |fluid |overload |that |may |quickly |lead |to |pulmonary |
edema |and |heart |failure |is |a |primary |concern |for |patients |with |Cushing's |disease. |Any |patient |
with |Cushing's |disease |is |at |risk |for |developing |fluid |overload, |regardless |of |age. |However, |the |
older |adult |or |one |who |has |coexisting |cardiac |problems, |kidney |problems, |pulmonary |
problems, |or |liver |problems, |is |at |greater |risk.
Which |of |the |following |is |a |priority |nursing |intervention |for |a |patient |with |primary |adrenal |
cortex |dysfunction?
A.Monitor |vital |signs |and |the |patient's |physiologic |response |to |stress.
B.Closely |measure |fluid |intake |and |output.
C.Provide |emotional |support |during |stressful |situations.
D.Weigh |the |patient |daily. |- |CORRECT |ANSWER✔✔-•Answer: |A
, •Rationale: |The |adrenal |cortex |makes |up |about |90% |of |the |adrenal |gland. |Hormones |secreted |
from |the |adrenal |cortex |are |responsible |for |fluid |and |electrolyte |balance, |stress |response, |
metabolism |of |nutrients, |and |emotional |and |sex |hormone |responses. |Priority |nursing |
interventions |with |adrenal |cortex |dysfunction |focus |on |the |negative |feedback |mechanisms |of |
aldosterone |and |cortisol.
Which |assessment |finding |should |trigger |a |more |detailed |assessment |of |the |patient's |
endocrine |system?
A.Weight |gain
B.Changes |in |hair |texture |and |distribution
C.Fatigue
D.Poor |peripheral |pulses |- |CORRECT |ANSWER✔✔-•Answer: |B
•Rationale: |Changes |in |physical |appearance |can |reflect |an |endocrine |problem. |Obvious |
changes |identified |during |the |physical |assessment |include |hair |texture |and |distribution, |facial |
contours |and |eye |protrusion, |voice |quality, |body |proportions, |and |secondary |sexual |
characteristics. |Changes |in |weight |and |fatigue |may |also |be |associated |with |endocrine |
disorders |as |well |as |other |conditions. |Poor |peripheral |pulses |are |more |likely |associated |with |
cardiovascular |diseases.
•Which |client |assessment |finding |indicates |to |the |nurse |the |need |to |assess |further |for |a |
possible |endocrine |problem?
•A. |A |history |of |taking |oral |contraceptives |for |more |than |2 |years
•B. |A |weight |loss |of |15 |lbs |in |the |past |6 |weeks |without |dieting
•C. |The |client's |father's |diagnosis |of |prostate |cancer
•D. |A |recent |need |for |corrective |lenses |- |CORRECT |ANSWER✔✔-•ANS: |B
•Rationale: |An |unintentional |weight |loss |in |excess |of |5 |lbs |is |significant. |It |indicates |an |
increase |in |metabolic |rate |or |a |problem |with |excessive |fluid |loss, |either |of |which |could |be |
associated |with |an |endocrine |disorder. |Taking |oral |contraceptives |for |more |than |2 |years |is |not |
associated |with |endocrine |problems. |The |father's |diagnosis |of |prostate |cancer |may |increase |
the |client's |risk |or |predisposition |to |cancer |but |not |to |endocrine |problems. |Although |a |need |
Correct Answers
Which |is |a |possible |outcome |for |the |patient |experiencing |an |age-related |decrease |in |
antidiuretic |hormone?
A.Constipation, |lethargy, |and |dry |skin
B.Greater-than-ideal |body |weight
C.Diluted |urine |and |dehydration
D.Yeast |infection |and |polydipsia |- |CORRECT |ANSWER✔✔-•ANS: |C
•Rationale: |These |are |symptoms |that |result |from |an |age-related |decrease |in |antidiuretic |
hormone. |The |other |symptoms |listed |are |not.
Which |response |in |a |client |with |diabetes |insipidus |indicates |to |the |nurse |that |another |dose |of |
desmopressin |acetate |(DDAVP) |is |needed?
A. |Urine |output |and |specific |gravity |are |increased.
B. |Urine |output |is |increased |and |urine |specific |gravity |is |decreased.
C. |Urine |output |and |specific |gravity |are |decreased.
D. |Urine |output |is |decreased |and |urine |specific |gravity |is |increased. |- |CORRECT |ANSWER✔✔-
•ANS: |B
•Rationale: |Diabetes |insipidus |(DI) |is |caused |by |a |failure |to |secrete |sufficient |amounts |of |
antidiuretic |hormone |(ADH) |to |maintain |blood |osmolarity |and |prevent |hyperosmolar |blood |
and |other |extracellular |fluid. |ADH |increases |the |amount |of |water |reabsorbed |from |urine |and |
returned |to |systemic |circulation. |Without |adequate |amounts |of |ADH, |more |water |is |excreted |
in |the |urine, |increasing |urine |volume |and |decreasing |urine |specific |gravity. |DDAVP |has |a |
similar |action |to |ADH |but |it |is |temporary. |When |urine |volume |increases |and |the |specific |
gravity |decreases, |more |drug |is |needed.
,•The |serum |electrolyte |values |for |a |client |with |syndrome |of |inappropriate |antidiuretic |
hormone |being |treated |with |tolvaptan |indicate |the |following |changes |within |the |past |12 |
hours. |Which |change |does |the |nurse |report |immediately |to |the |health |care |provider?
•A. |Serum |potassium |decrease |from |4.2 |mEq/L |to |3.8 |mEq/L
•B. |Serum |sodium |increase |from |122 |mEq/L |to |140 |mEq/L
•C. |Serum |calcium |increase |from |9.5 |mg/dL |to |10.2 |mg/dL
•D. |Serum |chloride |decrease |from |109 |mEq/L |to |99 |mEq/L |- |CORRECT |ANSWER✔✔-•ANS: |B
•Rationale: |The |purpose |of |tolvaptan |is |to |restore |a |normal |sodium |concentration |to |the |
blood |and |other |extracellular |fluid. |In |the |case |of |SIADH, |excessive |amounts |of |antidiuretic |
hormone |have |caused |more |water |to |be |absorbed, |causing |the |serum |sodium |to |be |diluted. |
When |tolvaptan |therapy |brings |the |serum |sodium |level |to |normal |levels, |it |must |be |
discontinued |to |prevent |hypernatremia. |A |serum |sodium |of |140 |mEq/L |is |within |the |normal |
range.
A |patient |is |diagnosed |with |small |cell |lung |cancer. |Which |endocrine |condition |is |consistent |
with |this |diagnosis?
A.Syndrome |of |inappropriate |antidiuretic |hormone |(SIADH)
B.Diabetes |insipidus |(DI)
C.Cushing's |syndrome
D.Adrenal |crisis |- |CORRECT |ANSWER✔✔-•Answer: |A
•Rationale: |Cancer |(especially |lung |cancers) |increases |the |risk |of |the |patient |developing |
SIADH. |Other |risk |factors |include |recent |head |trauma, |cerebrovascular |disease, |and |
tuberculosis |or |other |pulmonary |disease. |A |review |of |past |and |current |medications |is |also |
important |in |searching |for |the |cause |of |SIADH.
•Which |precaution |is |most |important |for |the |nurse |to |teach |a |client |who |is |prescribed |oral |
corticosteroids |for |hormone |replacement |therapy |after |a |unilateral |adrenalectomy?
•A. |"Do |not |stop |taking |this |drug |without |consulting |your |prescriber."
,•B. |"Avoid |crowds |and |people |who |are |ill."
•C. |"Be |sure |to |take |this |drug |with |food."
•D. |"Reduce |your |salt |intake." |- |CORRECT |ANSWER✔✔-•ANS: |A
•Rationale: |All |of |the |choices |are |precautions |that |the |nurse |should |teach |the |client |taking |an |
oral |corticosteroid |chronically. |However, |the |most |critical |precaution |is |to |not |stop |taking |the |
drug |because |chronic |corticosteroid |use |causes |atrophy |of |the |adrenal |glands. |With |adrenal |
gland |atrophy, |the |person |no |longer |makes |his |or |her |own |normal |levels |of |corticosteroids, |
which |are |essential |for |life. |Long-term |steroid |use |should |never |be |suddenly |stopped.
Which |patient |with |Cushing's |disease |is |at |greatest |risk |for |developing |heart |failure?
A.42-year-old |with |a |serum |creatinine |level |of |3.7 |mg/dL
B.59-year-old |with |a |history |of |hypertension
C.32-year-old |with |a |history |of |hepatitis |B |infection
D.60-year-old |with |pneumonia |- |CORRECT |ANSWER✔✔-•Answer: |A
•Rationale: |The |42-year-old |patient |has |compromised |kidney |function |evidenced |by |an |
elevated |serum |creatinine |level. |Preventing |fluid |overload |that |may |quickly |lead |to |pulmonary |
edema |and |heart |failure |is |a |primary |concern |for |patients |with |Cushing's |disease. |Any |patient |
with |Cushing's |disease |is |at |risk |for |developing |fluid |overload, |regardless |of |age. |However, |the |
older |adult |or |one |who |has |coexisting |cardiac |problems, |kidney |problems, |pulmonary |
problems, |or |liver |problems, |is |at |greater |risk.
Which |of |the |following |is |a |priority |nursing |intervention |for |a |patient |with |primary |adrenal |
cortex |dysfunction?
A.Monitor |vital |signs |and |the |patient's |physiologic |response |to |stress.
B.Closely |measure |fluid |intake |and |output.
C.Provide |emotional |support |during |stressful |situations.
D.Weigh |the |patient |daily. |- |CORRECT |ANSWER✔✔-•Answer: |A
, •Rationale: |The |adrenal |cortex |makes |up |about |90% |of |the |adrenal |gland. |Hormones |secreted |
from |the |adrenal |cortex |are |responsible |for |fluid |and |electrolyte |balance, |stress |response, |
metabolism |of |nutrients, |and |emotional |and |sex |hormone |responses. |Priority |nursing |
interventions |with |adrenal |cortex |dysfunction |focus |on |the |negative |feedback |mechanisms |of |
aldosterone |and |cortisol.
Which |assessment |finding |should |trigger |a |more |detailed |assessment |of |the |patient's |
endocrine |system?
A.Weight |gain
B.Changes |in |hair |texture |and |distribution
C.Fatigue
D.Poor |peripheral |pulses |- |CORRECT |ANSWER✔✔-•Answer: |B
•Rationale: |Changes |in |physical |appearance |can |reflect |an |endocrine |problem. |Obvious |
changes |identified |during |the |physical |assessment |include |hair |texture |and |distribution, |facial |
contours |and |eye |protrusion, |voice |quality, |body |proportions, |and |secondary |sexual |
characteristics. |Changes |in |weight |and |fatigue |may |also |be |associated |with |endocrine |
disorders |as |well |as |other |conditions. |Poor |peripheral |pulses |are |more |likely |associated |with |
cardiovascular |diseases.
•Which |client |assessment |finding |indicates |to |the |nurse |the |need |to |assess |further |for |a |
possible |endocrine |problem?
•A. |A |history |of |taking |oral |contraceptives |for |more |than |2 |years
•B. |A |weight |loss |of |15 |lbs |in |the |past |6 |weeks |without |dieting
•C. |The |client's |father's |diagnosis |of |prostate |cancer
•D. |A |recent |need |for |corrective |lenses |- |CORRECT |ANSWER✔✔-•ANS: |B
•Rationale: |An |unintentional |weight |loss |in |excess |of |5 |lbs |is |significant. |It |indicates |an |
increase |in |metabolic |rate |or |a |problem |with |excessive |fluid |loss, |either |of |which |could |be |
associated |with |an |endocrine |disorder. |Taking |oral |contraceptives |for |more |than |2 |years |is |not |
associated |with |endocrine |problems. |The |father's |diagnosis |of |prostate |cancer |may |increase |
the |client's |risk |or |predisposition |to |cancer |but |not |to |endocrine |problems. |Although |a |need |
