ATI Practice NR 325 Exam 1

NR325 Exam 1 ATI Practice Endocrine 1. A nurse is planning care for a client who has Cushing’s syndrome due to chronic corticosteroid use. Which of the following actions should the nurse involve in the plan of care? a. Check the client’s urine specific gravity. i. Rationale: to assess for fluid volume overload. 2. A nurse is providing teaching to a client who has Addison's disease about healthy snack foods. Which of the following food choices by the client indicates an understanding of the teaching? a. Turkey and cheese sandwich i. Rationale: high in protein, carbohydrates, and sodium. A client who has Addison’s requires a diet low in potassium, and high in protein, carbs, and sodium. 3. A nurse is reviewing the laboratory values of a client who has diabetic ketoacidosis. The nurse should understand that which of the following laboratory values is consistent with diabetic ketoacidosis? a. Bicarbonate level 12 mEq/L i. Rationale: DKA patients have bicarbonate levels less than 15 4. A nurse is caring for a client who has type 2 diabetes mellitus and is displaying manifestations of hyperglycemia. Which of the following findings should indicate to the nurse that the client has hyperglycemia? a. Increased urination i. Rationale: increased urination/polyuria, is a manifestation of hyperglycemia due to a deficiency of insulin, which can lead to osmotic diuresis. 5. A nurse is assessing a client who has Addison's disease. Which of the following skin manifestations should the nurse expect to find? a. Bronze pigmentation of skin i. Rationale: hormone deficiency caused by damage to the outer layer of the adrenal gland. 6. A nurse is caring for a client who has diabetes insidious. For which of the following findings should the nurse monitor? a. Polyuria i. Rationale: DI is characterized by increased thirst and increased urination. 7. A nurse is monitoring a client who has Graves' disease for the development of thyroid storm. the nurse should report which of the following findings to the provider? a. Hypertension i. Rationale: Thyroid storm patients will have an exaggerated condition of hyperthyroidism, associated with the development of a fever, hypertension, abdominal pain, and tachycardia. 8. A nurse is preparing a 24-hour urine specimen for a client who is suspected to have pheochromocytoma. Which of the following laboratory tests from the 24-hour urine specimen should the nurse use to determine the client's condition? a. Vanillylmandelic acid (VMA) 9. A nurse is caring for a client who is postoperative following a bilateral adrenalectomy. the nurse should expect to administer glucocorticoids following the procedure to enhance which of the following therapeutic effects? a. Compensate for decrease in cortisol levels i. Rationale: glucocorticoids are used to prevent an adrenal crisis caused by a sudden drop in cortisol levels. 10. A nurse is assessing a client who has Graves' disease. Which of the following findings should the nurse expect the client to display? a. Difficulty sleeping i. Rationale: a client who has graves’ disease has difficulty sleeping and anxiety due to the overproduction of thyroid hormone. 11. A nurse is providing teaching to a client who has type 1 diabetes mellitus about hypoglycemia. Which of the following manifestations should the nurse include in the teaching? a. Shakiness i. Rationale: an early manifestation of hypoglycemia is shakiness. 12. A nurse is assessing a client who has manifestations of acromegaly. Which of the following findings should the nurse expect? a. Increased head size i. Rationale: enlarged head size due to excessive production of growth hormones after the closing of the epiphyses. 13. A nurse is providing teaching to a client who has type 2 diabetes mellitus about pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching? a. "My cells are resistant to effects of insulin." i. Rationale: the client who has type 2 diabetes mellitus will have a resistance to insulin and a decrease in the secretion of insulin by the pancreatic beta cells. 14. A nurse is planning a community health screening for a group of clients who are at risk for type 2 diabetes mellitus. Which of the following clients should the nurse include in the screening? a. Men and women who are obese i. Rationale: There is a high correlation between obesity and type 2 DM. 15. A nurse is monitoring a client who has syndrome of inappropriate antidiuretic secretion (SIADH). Which of the following findings should the nurse expect? a. Hyponatremia i. Rationale: the client who has SIADH will have hyponatremia caused by the excessive release of ADH. As a result of the excessive secretion the client retains water. 16. A nurse is providing teaching to a client who has type 1 diabetes mellitus about exercise. Which of the following statements should the nurse include in the teaching? a. "Wear a medical alert identification tag when you exercise." i. Rationale: a client should wear a medical alert ID tag in the event of hypoglycemic response, because exercise can potentiate the effects of insulin and cause the blood glucose levels to decrease. 17. A nurse caring for a client who is postoperative following a parathyroidectomy to treat hyperparathyroidism. Which of the following laboratory values should the nurse expect to decrease as a therapeutic effect of the procedure? a. Calcium i. Rationale: parathyroid hormone regulates calcium, phosphorous, magnesium balance in the blood and bone. 18. A nurse is checking laboratory values to determine if a client who has diabetes is adhering to the treatment plan. Which of the following tests should the nurse use to make this determination? a. Glycosylated hemoglobin levels (HbA1c) 19. A nurse is planning care for a client who is experiencing the Somogyi effect and takes intermittent-acting insulin. Which of the following actions should the nurse include in the plan? a. Monitor the client's nighttime blood glucose levels i. Rationale: the Somogyi effect is a swing of high blood glucose levels in the morning after an extremely low blood glucose level during the night. The swing is caused by a release of stress hormones to counter low glucose levels. 20. A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism caused by an adenoma. Which of the following findings should the nurse report to the provider? (select all that apply) a. Tachycardia and hypertension b. Laryngeal stridor and hoarseness c. A positive Trousseau's sign Renal and Urinary 1. A nurse is caring for a client who is receiving peritoneal dialysis. The nurse should monitor the client for which of the following adverse effects? a. Peritonitis i. Rationale: Peritonitis is an adverse effect of peritoneal dialysis. Prevention requires sterile technique. 2. A nurse is reinforcing teaching with a client who has chronic kidney disease (CKD). Which of the following instructions should the nurse include? a. Limit fluid intake i. Rationale: a client who has CKD should limit fluid intake to prevent hypervolemia, or excessive fluid overload. 3. A nurse is caring for a client who is receiving peritoneal dialysis. The nurse notes that dialysate output is less than input, and the client's abdomen is distended. Which of the following actions should the nurse take? a. Change the client's position i. Rationale: the client is retaining the dialysate solution after the dwell time. The nurse should ensure the clamp is open and the tubing is not kinked and reposition the client to facilitate the drainage of the solution from the peritoneal cavity. 4. A nurse is reinforcing teaching about urinary tract infections (UTIs) with a client. Which of the following manifestations should the nurse include? a. Back pain i. Rationale: back pain and flank pain are manifestations of a UTI. Other manifestations include frequency, urgency, and cloudy, foul-smelling urine. 5. A nurse is reinforcing teaching with a client who has acute pyelonephritis. Which of the following instructions should the nurse include in the teaching? a. "You should complete the entire cycle of antibiotic therapy." i. Rationale: the client should take the full prescription of the antibiotic therapy to decrease the chance of regrowth of the causative organism. The should drink at least 2,000 mL of fluid per day. 6. A nurse is reinforcing teaching with a client who has a history of urinary tract infections (UTIs). Which of the following statements should indicate to the nurse the need for additional instructions? a. "I will vaginal douche daily." i. Rationale: the client should avoid vaginal douches, bubble baths, and any substances that can increase the risk of UTIs. Client should use mild soap and water to wash the peritoneal area. 7. A nurse is reinforcing teaching to a client who is preoperative prior to a transurethral resection of the prostate (TURP). Which of the following statements indicates as an understanding of the information? a. "I will feel the urge to urinate following this procedure." i. Rationale: after a TURP, the client will feel the urge to urinate. The nurse should reassure him that he will receive analgesics to help relieve his discomfort. 8. A nurse is collecting data from a client who is postoperative following a transurethral resection of the prostate (TURP). After the nurse discontinues the client's urinary catheter, which of the following findings should the nurse report to the provider? a. Decreased urinary output i. Rationale: a decrease in urine output after TURP indicates obstruction to urine flow by a clot or residual prostatic tissue and should be reported to the provider. 9. A nurse is reinforcing teaching to a client prior to a renal biopsy. Which of the following statements should the nurse make? a. "You will need to be on bedrest following this procedure." i. Rationale: the client should maintain bed rest in a supine position with a back roll for support for 2-24 hours following the procedure to reduce the risk for bleeding. 10. A nurse is reinforcing teaching with a newly licensed nurse about caring for a client who has a new left arteriovenous fistula. Which of the following statements should the nurse make? a. "Avoid taking blood pressures on the client's left arm." i. Rationale: the nurse should avoid taking blood pressure measurements on the client’s left arm, which can decrease blood flow and cause clotting. 11. A nurse is caring for a client who has a diagnosis of renal calculi and reports severe flank pain. Which of the following is the priority nursing intervention? a. Relieve the client's pain i. Rationale: the pain associated with renal calculi is severe and can lead to shock; therefore, this is the priority action. 12. A nurse is reinforcing teaching about collecting a 24-hr urine specimen for creatinine clearance with a newly licensed nurse. Which of the following instructions should the nurse include? a. Place signs in the bathroom as a reminder about the test in progress i. Rationale: the nurse should place signs in the bathroom and alert family members of the test in progress so that everyone saves the specimens appropriately throughout the test. 13. A nurse is collecting data from a client who is 1 week postoperative following a living donor kidney transplant. Which of the following findings should the nurse indicate the client is experiencing acute kidney rejection? a. BP 160/90 mmHg i. Rationale: due to the kidney’s role in fluid and blood pressure regulation, a client who is experiencing rejection can have hypertension. 14. A nurse is caring for a client who is in the oliguric-anuric stage of acute kidney injury. The client reports diarrhea, a dull headache, palpitations, and muscle tingling and weakness. Which of the following actions should the nurse take first? a. Check the client's electrolyte values i. Rationale: the nurse should check the client’s most recent potassium value, because these findings are manifestations of hyperkalemia, which can lead to cardiac dysrhythmias, therefore, this is a priority action. 15. A nurse is collecting data from a client who has an injury to the lower abdomen following a motor-vehicle crash. The nurse should identify that which of the following findings is a manifestation of bladder trauma? a. Hematuria i. Rationale: manifestations of bladder trauma include hematuria, or blood in the urine; blood at the urinary meatus; pelvic pain; and anuria, or the absence of urine. 16. A nurse is reinforcing dietary teaching with a client who has late-stage chronic kidney disease (CKD). Which of the following nutrients should the nurse instruct the client to increase in her diet? a. Calcium i. Rationale: a client who has CKD can develop hypocalcemia due to the reduced production of active vitamin D, which is needed for calcium reabsorption. The client should supplement dietary calcium. 17. A nurse is reinforcing teaching about the prostate-specific antigen (PSA) test with a client. Which of the following statements should the nurse make? a. "You should not ejaculate for 24 hours after the PSA test." i. Rationale: PSA is a glycoprotein that it manufactured in the prostate and is used to screen for prostate cancer. Ejaculation within 24 hours prior to the test can cause falsely elevated levels of PSA. 18. A nurse is reinforcing teaching with a client prior to a cystoscopy. Which of the following statements should the nurse make? a. "Expect to have pink-tinged urine after this procedure." i. Rationale: a cystoscopy is a procedure in which a scope is inserted into the urethra to diagnose or treat bladder problems. Pink-tinged urine following the procedure is expected. 19. A nurse is collecting data from a client who is postoperative following a extracorporeal shockwave lithotripsy (ESWL). The nurse should identify that which of the following findings is the priority? a. Report of palpitations/dysrhythmias i. Rationale: ABCs 20. A nurse is collecting data from a client who is receiving continuous ambulatory peritoneal dialysis. Which of the following findings should the nurse report to the provider? a. Potassium 3.0 mEq/L i. Rationale: a potassium level of 3.0 mEq/L is below the expected reference and can cause dysthymia’s. The dialysis removes fluid, waste products, and electrolytes from the blood and can cause hypokalemia.