HAAD QUESTIONS

EXAM CODE HAAD 2

1. A nurse prepares discharge instructions for a patient with chronic

syndrome of inappropriate antidiuretic hormone (SIADH). Which statement
indicates that the patient understands these instructions?

a. I will use a refractometer to check the specific gravity of my urine.

If the result gradually rises, I will consult my physician.
b. Ill check my pulse every morning and will contact my doctor if its
rapid or irregular.
c. I have to avoid too much sodium intake. I will read all food labels
to make sure I dont get too much of it in my diet.
d. I will weigh everyday and I will log it in a notebook. I will call my
physician whenever I gain 2 lbs or more in a day without changing my
eating habits.

2. A newborn has been diagnosed with hypothyroidism. In discussing the

condition and treatment with the family, the nurse should emphasize

a. They can expect the child will be mentally retarded

b. Administration of thyroid hormone will prevent problems
c. This rare problem is always hereditary
d. Physical growth/development will be delayed

3. At a senior citizens meeting a nurse talks with a client who has

diabetes mellitus Type 1. Which statement by the client during the
conversation is most predictive of a potential for impaired skin integrity?

a. "I give my insulin to myself in my thighs."

b. "Sometimes when I put my shoes on I don't know where my toes are."
c. "Here are my up and down glucose readings that I wrote on my
calendar."
d. "If I bathe more than once a week my skin feels too dry."

4. The nurse is attending a bridal shower for a friend when another

guest, who happens to be a diabetic, starts to tremble and complains of
dizziness. The next best action for the nurse to take is to:

a. Encourage the guest to eat some baked macaroni

b. Call the guests personal physician
c. Offer the guest a cup of coffee
d. Give the guest a glass of orange juice

5. A nurse at the weight loss clinic assesses a client who has a large
abdomen and a rounded face. Which additional assessment finding would
lead the nurse to suspect that the client has Cushings syndrome rather
than obesity?

a. large thighs and upper arms

b. pendulous abdomen and large hips
c. abdominal striae and ankle enlargement
d. posterior neck fat pad and thin extremities

6. A Sengstaken-Blakemore tube is inserted in the effort to stop the

bleeding esophageal varices in a patient with complicated liver cirrhosis.

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Upon insertion of the tube, the client complains of difficulty of breathing.

The first action of the nurse is to:

a. Deflate the esophageal balloon

b. Monitor VS
c. Encourage him to take deep breaths
d. Notify the MD

7. The husband of a client asks the nurse about the protein-restricted

diet ordered because of advanced liver disease. What statement by the
nurse would best explain the purpose of the diet?

a. The liver cannot rid the body of ammonia that is made by the
breakdown of protein in the digestive system.
b. The liver heals better with a high carbohydrates diet rather than
protein.
c. Most people have too much protein in their diets. The amount of this
diet is better for liver healing.
d. Because of portal hyperemesis, the blood flows around the liver and
ammonia made from protein collects in the brain causing hallucinations.

8. Which of the drug of choice for pain controls the patient with acute
pancreatitis?

A. Morphine
B. NSAIDS
C. Meperidine
D. Codeine

9. During the first 24 hours after thyroid surgery, the nurse should
include in her care:

a. Checking the back and sides of the operative dressing

b. Supporting the head during mild range of motion exercise
c. Encouraging the client to ventilate her feelings about the surgery
d. Advising the client that she can resume her normal activities
immediately

10. An adult, who is newly diagnosed with Graves disease, asks the nurse,
Why do I need to take Propanolol (Inderal)? Based on the nurses
understanding of the medication and Graves disease, the best response
would be:

a. The medication will limit thyroid hormone secretion.

b. The medication limit synthesis of the thyroid hormones.
c. The medication will block the cardiovascular symptoms of Graves
disease.
d. The medication will increase the synthesis of thyroid hormones.

11. What is the best reason for the nurse in instructing the client to
rotate injection sites for insulin?

a. Lipodystrophy can result and is extremely painful

b. Poor rotation technique can cause superficial hemorrhaging
c. Lipodystrophic areas can result, causing erratic insulin absorption rates
from these
d. Injection sites can never be reused
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12. On discharge, the nurse teaches the patient to observe for signs of
surgically induced hypothyroidism. The nurse would know that the patient
understands the teaching when she states she should notify the MD if she
develops:

a. Intolerance to heat
b. Dry skin and fatigue
c. Progressive weight gain
d. Insomnia and excitability

13. Which of the following would be inappropriate to include in a

diabetic teaching plan?

a. Change position hourly to increase circulation

b. Inspect feet and legs daily for any changes
c. Keep legs elevated on 2 pillows while sleeping
d. Keep the insulin not in use in the refrigerator

14. Paul is admitted to the hospital due to metabolic acidosis caused by

Diabetic ketoacidosis (DKA). The nurse prepares which of the following
medications as an initial treatment for this problem?

a. Regular insulin
b. Potassium
c. Sodium bicarbonate
d. Calcium gluconate

15. A male client with a history of cirrhosis and alcoholism is admitted

with severe dyspnea resulted to ascites. The nurse should be aware that
the ascites is most likely the result of increased

a. Pressure in the portal vein

b. Production of serum albumin
c. Secretion of bile salts
d. Interstitial osmotic pressure

16. Nurse Jocelyn is caring for a client with nasogastric tube that is
attached to low suction. Nurse Jocelyn assesses the client for symptoms
of which acid-base disorder?

a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic acidosis
d. Metabolic alkalosis

17. Dr. Marquez orders serum electrolytes. To determine the effect of

persistent vomiting, Nurse Trish should be most concerned with monitoring
the:

a. Chloride and sodium levels

b. Phosphate and calcium levels
c. Protein and magnesium levels
d. Sulfate and bicarbonate levels

18. What is a normal physical finding of the thyroid gland?

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a. nodular consistency
b. asymmetry
c. tenderness
d. palpable upon swallowing

19. The following are clinical manifestations of nontoxic goiter

(hypothyroidism), EXCEPT:

a. dry skin
b. lethargy
c. insomnia
d. sensitivity to cold

20. The following are symptoms of hypoglycemia EXCEPT:

a. extreme thirst
b. nightmares
c. weakness
d. diaphoresis

21. A clients exopthalmos continues inspite of thyroidectomy for Graves

Disease. The nurse teaches her how to reduce discomfort and prevent
corneal ulceration. The nurse recognizes that the client understands the
teaching when she says: I should:

a. Elevate the head of my bed at night

b. Avoid moving my extra-ocular muscles
c. Avoid using a sleeping mask at night
d. Avoid excessive blinking

22. Before a post- thyroidectomy client returns to her room from the OR,
the nurse plans to set up emergency equipment, which should include:

a. A crash cart with bed board

b. A tracheostomy set and oxygen
c. An airway and rebreathing mask
d. Two ampules of sodium bicarbonate

23. The day after her surgery Joy asks the nurse how she might lose
weight. Before answering her question, the nurse should bear in mind that
long-term weight loss best occurs when:

a. Fats are controlled in the diet

b. Eating habits are altered
c. Carbohydrates are regulated
d. Exercise is part of the program

24. The nurse teaches Joy, an obese client, the value of aerobic exercises
in her weight reduction program. The nurse would know that this teaching
was effective when Joy says that exercise will:

a. Increase her lean body mass

b. Lower her metabolic rate
c. Decrease her appetite
d. Raise her heart rate

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25. A home health nurse is at the home of a client with diabetes and
arthritis. The client has difficulty drawing up insulin. It would be most
appropriate for the nurse to refer the client to

a. A social worker from the local hospital

b. An occupational therapist from the community center
c A physical therapist from the rehabilitation agency
d. Another client with diabetes mellitus and takes insulin

26. Which drug would be least effective in lowering a clients serum

potassium level?

a. Glucose and insulin

b. Polystyrene sulfonate (Kayexalate)
c. Calcium glucomite
d. Aluminum hydroxide

27. Lucy undergoes Subtotal Thyroidectomy for Graves Disease. In

planning for the clients return from the OR, the nurse would consider
that in a subtotal thyroidectomy:

a. The entire thyroid gland is removed

b. A small part of the gland is left intact
c. One parathyroid gland is also removed
d. A portion of the thyroid and four parathyroids are removed

28. When a post-thyroidectomy client returns from surgery the nurse

assesses her for unilateral injury of the laryngeal nerve every 30 to 60
minutes by:

a. Observing for signs of tetany

b. Checking her throat for swelling
c. Asking her to state her name out loud
d. Palpating the side of her neck for blood seepage

29. On a post-thyroidectomy clients discharge, the nurse teaches her to

observe for signs of surgically induced hypothyroidism. The nurse would
know that the client understands the teaching when she states she should
notify the physician if she develops:

a. Intolerance to heat
b. Dry skin and fatigue
c. Progressive weight loss
d. Insomnia and excitability

30. Lucy is admitted to the surgical unit for a subtotal thyroidectomy.

She is diagnosed with Graves Disease. When assessing Lucy, the nurse
would expect to find:

a. Lethargy, weight gain, and forgetfulness

b. Weight loss, protruding eyeballs, and lethargy
c. Weight loss, exopthalmos and restlessness
d. Constipation, dry skin, and weight gain

31. A nurse at the weight loss clinic assesses a client who has a large
abdomen and a rounded face. Which additional assessment finding would

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lead the nurse to suspect that the client has Cushings syndrome rather
than obesity?

a. large thighs and upper arms

b. pendulous abdomen and large hips
c. abdominal striae and ankle enlargement
d. posterior neck fat pad and thin extremities

32. The nurse is attending a bridal shower for a friend when another
guest, who happens to be a diabetic, starts to tremble and complains of
dizziness. The next best action for the nurse to take is to:

a. Encourage the guest to eat some baked macaroni

b. Call the guests personal physician
c. Offer the guest a cup of coffee
d. Give the guest a glass of orange juice

33. What is the best reason for the nurse in instructing the client to
rotate injection sites for insulin?

a. Lipodystrophy can result and is extremely painful

b. Poor rotation technique can cause superficial hemorrhaging
c. Lipodystrophic areas can result, causing erratic insulin absorption rates
from these
d. Injection sites can never be reused

34. During the first 24 hours after thyroid surgery, the nurse should
include in her care:

a. Checking the back and sides of the operative dressing

b. Supporting the head during mild range of motion exercise
c. Encouraging the client to ventilate her feelings about the surgery
d. Advising the client that she can resume her normal activities
immediately

35. The nurse administered 28 units of Humulin N, an intermediate-acting

insulin, to a client diagnosed with Type 1 diabetes at 1600. Which action
should the nurse implement?

a. Ensure the client eats the bedtime snack.

b. Determine how much food the client ate at lunch.
c. Perform a glucometer reading at 0700.
d. Offer the client protein after administering insulin.

36. The client with Type 2 diabetes controlled with biguanide oral
diabetic medication is scheduled for a computed tomography (CT) with
contrast of the abdomen to evaluate pancreatic function. Which
intervention should the nurse implement?

a. Provide a high-fat diet 24 hours prior to test.

b. Hold the biguanide medication for 48 hours prior to test.
c. Obtain an informed consent form for the test.
d. Administer pancreatic enzymes prior to the test.

37. The nurse is developing a care plan for the client diagnosed with
Type 1 diabetes. The nurse identifies the problem high risk for

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hyperglycemia related to noncompliance with the medication regimen.

Which statement would be an appropriate short-term goal for the client?

a. The client will have a blood glucose level between 90 and 140 mg/dL.
b. The client will demonstrate appropriate insulin injection technique.
c. The nurse will monitor the clients blood glucose levels four times a
day.
d. The client will maintain normal kidney function with 30 mL/hr urine
output.

38. Which assessment data indicate that the client diagnosed with
diabetic ketoacidosis is responding to the medical treatment?

a. The client has tented skin turgor and dry mucous membranes.
b. The client is alert and oriented to date, time, and place.
c. The clients ABGs results are pH 7.29, PaCO2 44, HCO3 15.
d. The clients serum potassium level is 3.3 mEq/L.

39. The elderly client is admitted to the intensive care department

diagnosed with severe HHS. Which collaborative intervention should the
nurse include in the plan of care?

a. Infuse 0.9% normal saline intravenously.

b. Administer intermediate-acting insulin.
c. Perform blood glucometer checks daily.
d. Monitor arterial blood gas results.

40. The nurse is discussing ways to prevent diabetic ketoacidosis with the
client diagnosed with Type 1 diabetes. Which instruction would be most
important to discuss with the client?

a. Refer the client to the American Diabetes Association.

b. Do not take any over-the-counter medications.
c. Take the prescribed insulin even when unable to eat because of illness.
d. Be sure to get your annual flu and pneumonia vaccines.

41. The nursing assistant on the medical floor tells the primary nurse
that the client diagnosed with DKA wants something else to eat for
lunch. What action should the nurse implement?

a. Instruct the assistant to get the client additional food.

b. Notify the dietician about the clients request.
c. Ask the assistant to obtain a glucometer reading.
d. Tell the assistant that the client cannot have anything else.

42. The client diagnosed with HHS was admitted yesterday with a blood
glucose level of
780 mg/dL. The clients blood glucose level is now 300 mg/dL. Which
intervention should the nurse implement?

a. Increase the regular insulin IV drip.

b. Check the clients urine for urinary ketones.
c. Provide the client with a therapeutic diabetic meal.
d. Notify the HCP to obtain an order to decrease insulin therapy.

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43. The charge nurse is making client assignments in the intensive care
department. Which client should be assigned to the most experienced
nurse?

a. The client with Type 2 diabetes who has a blood glucose level of 348
mg/dL.
b. The client diagnosed with Type 1 diabetes who is experiencing
hypoglycemia.
c. The client with DKA who has multifocal premature ventricular
contractions.
d. The client with HHS who has a plasma osmolarity of 290 mOsm/L.

44. The client diagnosed with Type 2 diabetes is admitted to the intensive
care department with hyperosmolar hyperglycemic nonketonic state coma
(HHS). Which assessment data would the nurse expect the client to
exhibit?

a. Kussmauls respirations.
b. Diarrhea and epigastric pain.
c. Dry mucous membranes.
d. Ketone breath odor.

45. The nurse is discussing complications of chronic pancreatitis with a

client diagnosed with the disease. Which complication should the nurse
discuss with the client?

a. Diabetes insipidus.
b. Crohns disease.
c. Narcotic addiction.
d. Peritonitis.

46. Which client problem has priority for the client diagnosed with acute
pancreatitis?

a. Risk for fluid volume deficit.

b. Alteration in comfort.
c. Imbalanced nutrition: less than body requirements.
d. Knowledge deficit.

47. The client diagnosed with Type 1 diabetes is found lying unconscious
on the floor of the bathroom. Which intervention should the nurse
implement first?

a. Administer 50% dextrose IVP.

b. Notify the health-care provider.
c. Move the client to the ICD.
d. Check the serum glucose level.

48. The client received 10 units of Humulin R, a fast acting insulin, at

0700. At 1030 the unlicensed nursing assistant tells the nurse the client
has a headache and is really acting funny. Which action should the
nurse implement first?

a. Instruct the assistant to obtain blood glucose level.

b. Have the client drink eight (8) ounces of orange juice.
c. Go to the clients room and assess the client for hypoglycemia.
d. Prepare to administer one amp 50% Dextrose intravenously.
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49. The nurse is caring for a client with long-term Type 2 diabetes and
is assessing the feet.
Which assessment data would warrant immediate intervention by the
nurse?

a. The client has crumbling toenails.

b. The client has athletes feet.
c. The client has a necrotic big toe.
d. The client has thickened toenails.

50. The nurse is discussing the importance of exercising to a client

diagnosed with Type 2 diabetes whose diabetes is well controlled with
diet and exercise. Which information should the nurse include in the
teaching about diabetes?

a. Eat a simple carbohydrate snack before exercising.

b. Carry peanut butter crackers when exercising.
c. Encourage the client to walk 20 minutes 3 times a week.
d. Perform warm-up and cool down exercises.

51. The client diagnosed with Type 2 diabetes comes to the emergency
department. The clients blood glucose is 680 mg/dL and the client is
diagnosed with HHS. Which question should the nurse ask the client to
determine the cause of this acute complication?

a. When is the last time you took your insulin?

b. When did you have your last meal?
c. Have you had some type of infection lately?
d. How long have you had diabetes?

52. The nurse at a freestanding health clinic is caring for a 56-year-old

client who is homeless and is a Type 2 diabetic controlled with insulin.
Which action is an example of client advocacy?

a. Ask the client if he has somewhere he can go and live.

b. Arrange for someone to give him his insulin at a local homeless
shelter.
c. Notify Adult Protective Services about the clients situation.
d. Ask the health-care provider to take the client off insulin because he
is homeless.

53. The home health nurse is completing the admission assessment for a
76-year-old client diagnosed with Type 2 diabetes that must be controlled
with 70/30-combination insulin.
Which intervention should be included in the plan of care?

a. Assess the clients ability to read small print.

b. Monitor the clients serum PT level.
c. Teach the client how to perform a hemoglobin A1 test daily.
d. Instruct the client to check the feet weekly.

54. The client diagnosed with Type 1 diabetes has a glycosylated

hemoglobin (A1c) of 8.1%.
Which interpretation should the nurse make based on this result?

a. This result is below normal levels.

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b. This result is within acceptable levels.

c. This result is above recommended levels.
d. This result is dangerously high.

55. The male client diagnosed with chronic pancreatitis calls and reports
to the clinic nurse that he has been having a lot of gas, along with
frothy and very foul-smelling stools. Which action should the nurse take?

a. Explain that this is common for chronic pancreatitis.

b. Ask the client to bring in a stool specimen to the clinic.
c. Arrange an appointment with the HCP for today.
d. Discuss the need to decrease fat in the diet so that this wont happen.

56. The nurse is preparing to administer A.M. medications to the following

clients. Which medication should the nurse question before administering?

a. Pancreatic enzymes to the client who has finished breakfast.

b. The pain medication, morphine, to the client who has a respiratory
rate of 20.

c. The loop diuretic to the client who has a serum potassium level of 3.9
mEq/L.
d. The beta blocker to the client who has an apical pulse of 68 bpm.

57. The nurse is administering a pancreatic enzyme to the client

diagnosed with chronic pancreatitis. Which statement best explains the
rationale for administering this medication?

a. It is an exogenous source of protease, amylase, and lipase.

b. This enzyme increases the number of bowel movements.
c. This medication breaks down in the stomach to help with digestion.
d. Pancreatic enzymes help break down fat in the small intestine.

58. The client has just had an endoscopic retrograde

cholangiopancreatogram (ERCP).
Which post-procedure intervention should the nurse implement?

a. Assess for rectal bleeding.

b. Increase fluid intake.
c. Assess gag reflex.
d. Keep in supine position.

59. The client is being admitted to the outpatient department prior to an

endoscopic retrograde cholangiopancreatogram (ERCP) to rule out cancer of
the pancreas. Which pre-procedure instruction should the nurse teach?

a. Prepare to be admitted to the hospital after the procedure for

observation.
b. If something happens during the procedure, then emergency surgery
will be done.
c. Do not eat or drink anything after midnight the night before the test.
d. If done correctly, this procedure will correct the blockage of the
stomach.

60. The client diagnosed with acute pancreatitis is being discharged home.
Which statement by the client indicates the teaching has been effective?

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a. I should decrease my intake of coffee, tea, and cola.

b. I will eat a low-fat diet and avoid spicy foods.
c. I will check my amylase and lipase levels daily.
d. I will return to work tomorrow but take it easy.

61. Which electrolyte replacement should the nurse anticipate being

ordered by the health-care provider in the client diagnosed with DKA who
has just been admitted to the ICD?

a. Glucose.
b. Potassium.
c. Calcium.
d. Sodium.

62. Which arterial blood gas would the nurse expect in the client
diagnosed with diabetic ketoacidosis?

a. pH 7.34, PaO2 99, PaCO2 48, HCO3 24.

b. pH 7.38, PaO2 95, PaCO2 40, HCO3 22.
c. pH 7.46, PaO2 85, PaCO2 30, HCO3 26.
d. pH 7.30, PaO2 90, PaCO2 30, HCO3 18.

63. The client diagnosed with acute pancreatitis is in pain. Which position
should the nurse assist the client to assume to help decrease the pain?

a. Recommend lying in the prone position with legs extended.

b. Maintain a tripod position over the bedside table.
c. Place in side-lying position with knees flexed.
d. Encourage a supine position with a pillow under the knees.

64. The client is diagnosed with acute pancreatitis. Which health-care

providers admitting order should the nurse question?

a. Bed rest with bathroom privileges.

b. Initiate IV therapy at D5W 125 mL/hr.
c. Weigh client daily.
d. Low-fat, low-carbohydrate diet.

65. The client is admitted to the medical department with a diagnosis of

R/O acute pancreatitis. Which laboratory value should the nurse monitor
to confirm this diagnosis?

a. Creatinine and BUN.

b. Troponin and CPK-MB.
c. Serum amylase and lipase.
d. Serum bilirubin and calcium.

66. The nurse is performing discharge teaching for a client diagnosed

with Cushings disease. Which statement made by the client demonstrates
an understanding of the instructions?

a. I will be sure to notify my health-care provider if I start to run a

fever.
b. Before I stop taking the prednisone, I will be taught how to taper it
off.
c. If I get weak and shaky, I need to eat some hard candy or drink
some juice.
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d. It is fine if I continue to participate in weekend games of tackle

football.

67. The nurse is completing discharge teaching to the client diagnosed

with acute pancreatitis.
Which instruction should the nurse discuss with the client?

a. Instruct the client to decrease alcohol intake.

b. Explain the need to avoid all stress.
c. Discuss the importance of stopping smoking.
d. Teach the correct way to take pancreatic enzymes.

68. The client is diagnosed with diabetes insipidus. Which laboratory value
should be monitored by the nurse?

a. Serum sodium.
b. Serum calcium
c. Urine glucose.
d. Urine white blood cells

69. The nurse is admitting a client diagnosed with primary adrenal cortex
insufficiency (Addisons disease). When assessing the client, which clinical
manifestations would the nurse expect to find?

a. Moon face, buffalo hump, and hyperglycemia.

b. Hirsutism, fever, and irritability.

c. Bronze pigmentation, hypotension, and anorexia.

d. Tachycardia, bulging eyes, and goiter.

70. The client is admitted to rule out Cushings syndrome. Which

laboratory tests would the nurse anticipate being ordered?

a. Plasma drug levels of quinidine, digoxin, and hydralazine.

b. Plasma levels of ACTH and cortisol.
c. 24-hour urine for metanephrine and catecholamine.
d. Spot urine for creatinine and white blood cells.

71. The client is admitted to the medical unit with a diagnosis of rule
out diabetes insipidus
(DI). Which instructions should the nurse teach regarding a fluid
deprivation test?

a. The client will be asked to drink 100 mL of fluid as rapidly as

possible and then will not be allowed fluid for 24 hours.
b. The client will be given an injection of antidiuretic hormone, and urine
output will be measured for four (4) to six (6) hours.
c. The client will be NPO, and vital signs and weights will be done
hourly until the end of the test.
d. An IV will be started with normal saline, and the client will be asked
to try and hold

72. The client diagnosed with Cushings disease has undergone a unilateral
adrenalectomy.
Which discharge instructions should the nurse teach?

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a. Instruct the client to take the glucocorticosteroid and

mineralcorticosteroid medications as prescribed.
b. Teach the client regarding sexual functioning and androgen replacement
therapy.
c. Explain the signs and symptoms of infection and when to call the
health-care provider.
d. Demonstrate turn, cough, and deep-breathing exercises that the client
should perform every 2 hours.

73. The nurse writes a problem of altered body image for a 34-year-
old client diagnosed with Cushings disease. Which interventions should be
implemented?
a. Monitor blood glucose levels q.i.d before meals and at bedtime.
b. Perform a head-to-toe assessment every shift.
c. Use therapeutic communication to allow the client to discuss feelings.
d. Assess bowel sounds and temperature every 4 hours.

74. The home health nurse is admitting a client diagnosed with cancer of
the pancreas.
Which information is the most important for the nurse to discuss with the
client?

a. Determine the clients food preferences.

b. Ask the client if there is an advance directive.
c. Find out about insurance/Medicare reimbursement.
d. Explain that the client should eat as much as possible

75. The nurse is planning the care of a client diagnosed with Addisons
disease. Which interventions should be included?

a. Administer steroid medications.

b. Place the client on fluid restriction.
c. Provide frequent stimulation.
d. Consult physical therapy for gait training.

76. The nurse is giving an in-service on thyroid disorders. One of the

attendees asks the nurse, Why dont the people in the United States get
goiters as often? Which statement by the nurse is the best response?

a. It is because of the screening techniques used in the United States.

b. It is a genetic predisposition that is rare in North Americans.
c. The medications available in the United States decrease goiters.
d. Iodized salt helps prevent the development of goiters in the United
States.

77. The client with hypothyroidism is admitted to the intensive care

department diagnosed with myxedema coma. Which assessment data would
warrant immediate intervention by the nurse?

a. Serum blood glucose level of 74 mg/dL.

b. Pulse oximeter reading of 90%.
c. Telemetry reading showing sinus bradycardia.
d. The client is lethargic and sleeps all the time.

78. The nurse is admitting a client diagnosed with syndrome of

inappropriate antidiuretic hormone (SIADH). Which clinical manifestations
should be reported to the healthcare provider?
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a. Serum sodium of 112 mEq/L and a headache.

b. Serum potassium of 5.0 mEq/L and a heightened awareness.
c. Serum calcium of 10 mg/dL and tented tissue turgor.
d. Serum magnesium of 1.2 mg/dL and large urinary output.

79. The nurse is caring for a client diagnosed with diabetes insipidus
(DI). Which nursing intervention should be implemented?

a. Monitor blood glucoses before meals and at bedtime.

b. Restrict caffeinated beverages.
c. Check urine ketones if blood glucose is >250.
d. Assess tissue turgor every 4 hours.

80. Which statement made by the client would make the nurse suspect
that the client is experiencing hyperthyroidism?

a. I just dont seem to have any appetite anymore.

b. I have a bowel movement about every 3 to 4 days.
c. My skin is really becoming dry and coarse.
d. I have noticed that all my collars are getting tighter.

81. The unlicensed nursing assistant complains to the nurse that she has
filled the water pitcher 4 times during the shift for a client diagnosed
with a closed head injury and the client has asked for the pitcher to be
filled again. Which intervention should the nurse do first?

a. Tell the unlicensed nursing assistant to fill the pitcher again.

b. Instruct the unlicensed nursing assistant to start measuring I & O.
c. Assess the client for polyuria and polydipsia.
d. Check the clients BUN and creatinine levels.

82. The nurse is discharging a client diagnosed with diabetes insipidus.

Which statement made by the client warrants further intervention?

a. I will keep a list of my medications in my wallet and wear a Medi

bracelet.
b. I should take my medication in the morning and leave it refrigerated
at home.
c. I should weigh myself every morning and record any weight gain.
d. If I develop tightness in my chest, I will call my health-care
provider.

83. The nurse is caring for clients on a medical floor. Which client
should be assessed first?

a. The client diagnosed with syndrome of inappropriate antidiuretic

hormone (SIADH) who has a weight gain of 1.5 pounds since yesterday.
b. The client diagnosed with a pituitary tumor that has developed
diabetes insipidus
(DI) and has an intake of 1500 mL and an output of 1600 mL in the last
8 hours.
c. The client diagnosed with syndrome of inappropriate antidiuretic
hormone (SIADH) who is having muscle twitching.
d. The client diagnosed with diabetes insipidus (DI) who is complaining of
feeling

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84. Which nursing intervention should be included in the plan of care

for the client diagnosed with hyperthyroidism?

a. Increase the amount of fiber in the diet.

b. Encourage a low-calorie, low-protein diet.
c. Decrease the clients fluid intake to 1000 mL day.
d. Provide six (6) small, well-balanced meals a day.

85. The client diagnosed with a pituitary tumor has developed syndrome
of inappropriate
antidiuretic hormone (SIADH). Which interventions would the nurse
implement?

a. Assess for dehydration and monitor blood glucose levels.

b. Assess for nausea and vomiting and weigh daily.
c. Monitor potassium levels and encourage fluid intake.
d. Administer vasopressin IV and conduct a fluid deprivation test.

86. Which medication order would the nurse question in the client
diagnosed with untreated hypothyroidism?

a. Thyroid hormones.
b. Oxygen.
c. Sedatives.
d. Laxatives.

87. The male client diagnosed with syndrome of inappropriate antidiuretic

hormone (SIADH) secondary to cancer of the lung tells the nurse that he
would like to discontinue the fluid restriction and does not care if he
dies. Which action by the nurse would be an example of the ethical
principle of autonomy?

a. Discuss the information the client told the nurse with the health-care
provider and significant other.
b. Explain that it is possible that the client would seize if he drank fluid
beyond the restrictions.
c. Notify the health-care provider of the clients wishes and give the
client fluids as desired.
d. Allow the client an extra drink of water and explain that the nurse
could get into trouble if the client tells the health-care provider.

88. The nurse is admitting a client to the neurological intensive care unit
who is postoperative transsphenoidal hypophysectomy . Which data would
warrant immediate intervention?

a. The client is alert to name but is unable to tell the nurse the
location.
b. The client has an output of 2500 mL since surgery and an intake of
1000 mL.
c. The clients vital signs are T 97.6, P 88, R 20, and BP 130/80.
d. The client has a 3-cm amount of dark-red drainage on the turban
dressing.

89. The nurse manager of a medical/surgical unit is asked to determine if

the unit should adopt a new care delivery system. Which is an example
of an autocratic style of leadership?

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a. Call a meeting and educate the staff on the new delivery system that
will be used.
b. Organize a committee of nurses to investigate the various types of
delivery systems.
c. Wait until another unit has implemented the new system and see if it
works out.
d. Discuss with the nursing staff if a new delivery system should be
adopted.

90. The charge nurse of an intensive care unit is making assignments for
the night shift.
Which client should be assigned to the most experienced intensive care
nurse?

a. The client diagnosed with respiratory failure who is on a ventilator

and requires frequent sedation.
b. The client diagnosed with lung cancer and iatrogenic Cushings disease
with ABGs of pH 7.35, PaO2 88, PaCO2 44, and HCO3 22.
c. The client diagnosed with Addisons disease who is lethargic and has a
BP of 80/45,
PR: 24, and RR: 28.
d. The client diagnosed with hyperthyroidism who has undergone a
thyroidectomy 2 days ago and has a negative Trousseaus sign.

91. The client has developed iatrogenic Cushings disease. Which is a

scientific rationale for the development of this problem?

a. The client has an autoimmune problem that causes the destruction of

the adrenal cortex.
b. The client has been taking steroid medications for an extended period
for another disease process.
c. The client has a pituitary gland tumor that causes the adrenal glands
to produce too much cortisol.
d. The client has developed an adrenal gland problem for which the
health-care provider does not have an explanation.

92. The nurse is developing a plan of care for the client diagnosed with
acquired immunodeficiency syndrome (AIDS) who has developed an infection
in the adrenal gland. Which problem would have the highest priority?

a. Altered body image.

b. Activity intolerance.
c. Impaired coping.
d. Fluid volume deficit.

93. The nurse identifies the client problem risk for imbalanced body
temperature for the client diagnosed with hypothyroidism. Which
intervention would be included in the client problem?

a. Encourage the use of an electric blanket.

b. Protect from exposure to cold and drafts.
c. Keep the room temperature cool.
d. Space activities to promote rest.

94. The client is diagnosed with hypothyroidism. Which signs/symptoms

would the nurse expect the client to exhibit?

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a. Complaints of extreme fatigue and hair loss.

b. Exophthalmos and complaints of nervousness.
c. Complaints of profuse sweating and flushed skin.
d. Tetany and complaints of stiffness of the hands.

95. The 68-year-old client diagnosed with hyperthyroidism is being treated

with radioactive iodine therapy. Which interventions should the nurse
discuss with the client?

a. Explain that it will take up to a month for symptoms of

hyperthyroidism to subside.
b. Teach that the iodine therapy will have to be tapered slowly over 1
week.
c. Discuss that the client will have to be hospitalized during the
radioactive therapy.
d. Inform the client that after therapy the client will not have to take
any medication.

96. The nurse is assessing a client with complaints of vague upper

abdominal pain that is worse at night but is relieved by sitting up and
leaning forward. Which assessment question should the nurse ask next?

a. Have you noticed a yellow haze when you look at things?

b. Does the pain get worse when you eat a meal or snack?
c. Have you had your amylase and lipase checked recently?
d. How much weight have you gained since you saw the HCP?

97. The client, an 18-year-old female, 54 tall, weighing 113 kg, comes
to the clinic for a wound on her lower leg that has not healed for the
last two weeks. Which disease process would the nurse suspect that the
client has developed?

a. Type 1 diabetes.
b. Type 2 diabetes.
c. Gestational diabetes.
d. Acanthosis nigricans.

98. The nurse is preparing to administer the following medications. Which

medicationshould the nurse question administering?

a. The thyroid hormone to the client that does not have a T3, T4 level.
b. The regular insulin to the client with a blood glucose level of 210
mg/dL.
c. The loop diuretic to the client with a potassium level of 3.3 mEq/L.
d. The cardiac glycoside to the client who has a digoxin level of 1.4
mg/dL.

99. The client diagnosed with hypothyroidism is prescribed the thyroid

hormone levothyroxine
(Synthroid). Which assessment data indicate the medication has been
effective?

a. The client has a three (3)-pound weight gain.

b. The client has a decreased pulse rate.
c. The clients temperature is WNL.
d. The client denies any diaphoresis.

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100. Which signs/symptoms would make the nurse suspect that the client
is experiencing a thyroid storm?

a. Obstipation and hypoactive bowel sounds.

b. Hyperpyrexia and extreme tachycardia.
c. Hypotension and bradycardia.
d. Decreased respirations and hypoxia.

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