Gastrointestinal Questions
1. An adult who has cholecystitis reports clay colored stools and
moderate jaundice. Which is the best explanation for the presence
of clay colored stools and jaundice?
1. There is an obstruction in the pancreatic duct.
2. There are gallstones in the gallbladder.
3. Bile is no longer produced by the gallbladder.
4. There is an obstruction in the common bile duct.
2. Atropine 0.5 mg is ordered for a client having an acute attack of
cholecystitis. What is the primary purpose of this drug for this client?
To
1. decrease skeletal muscle spasms.
2. increase gastrointestinal peristalsis
3. decrease smooth muscle contractions
4. decrease anxiety
3. An adult male is admitted to the hospital complaining of burning
epigastric pain. He reports to the nurse that he has gained 14 pounds
over the last two months. Which nursing response is best?
1. “Why were you eating more?”
2. “Has the weight gain been intentional?”
3. “Does your weight usually fluctuate this much?”
4. “How did your eating habits change?”
4. An adult male client is admitted with a diagnosis of probable
duodenal ulcer. Which of the following laboratory tests would it be
most essential for the nurse to assess immediately?
1. Hemoglobin and Hematocrit
2. SGPT and SGOT
3. Na and K
4. BUN and creatinine
5. An adult client is to have a gastroduodenoscopy in the morning.
The nurse’s instructions should include the information that he will
be
1. given a general anesthetic during the procedure.
2. given a local anesthetic to ease the discomfort during the
procedure.
3. asked to assist by coughing during the procedure.
4. asked to assist by performing a Valsalva maneuver during the
procedure.
6. Which nursing intervention is essential immediately following a
gastroduodenoscopy?
1. Force fluids.
2. Position him supine.
3. Instruct him not to eat or drink.
4. Encourage coughing and deep breathing.
7. A barium enema is ordered for an adult male client. The nurse is
teaching him what to expect regarding the procedure. Which
statement should be included in the teaching?
1. Fecal matter must be cleansed from the bowel for good
visualization.
2. There will be no food restrictions before the test.
3. He will not have to change positions during the procedure.
4. He will be asked to drink barium during the procedure.
8. An abdomino-perineal resection with a transverse colostomy is
planned for an adult male client. Neomycin sulfate p.o. is ordered
prior to surgery. The primary purpose for administering this drug is
to reduce
1. electrolyte imbalances.
2. bacterial content in the colon.
3. peristaltic action in the colon.
4. feces in the bowel.
9. In preparation for an abdomino-perineal resection the client is
placed on a low residue diet. Which of the following food lists is
appropriate for him to eat on a low residue diet?
1. Ground lean beef, soft boiled eggs, tea.
2. Lettuce, spinach, corn.
3. Prunes, grapes, apples.
4. Bran cereal, whole wheat toast, coffee.
10. The nurse is caring for a client who has had a colostomy. Which
of the following client behaviors is indicative of a willingness to be
involved in self-care following a colostomy?
1. Discussing the cost of his hospitalization.
2. Asking what time the surgeon will be in.
3. Asking questions about the equipment being used.
4. Complaining about the noise in the adjacent room.
11. An adult is admitted with a duodenal ulcer. On the second day
after admission, the client develops severe, persistent pain radiating
to the shoulder. What action should the nurse take first?
1. Notify the physician.
2. Place client in a high-Fowler’s position to decrease pressure on the
gastric area and shoulder.
3. Examine the client for board-like rigidity of the abdomen.
4. Administer ordered prn pain medication.
12. The client with a duodenal ulcer is ready for discharge. Which
statement made by the client indicates a need for more teaching
about his diet?
1. “It’s a good thing I gave up drinking alcohol last year.”
2. “I will have to drink lots of milk and cream every day.”
3. “I will stay away from cola drinks after I am discharged.”
4. “Eating three nutritious meals and snacks every day is okay.”
13. A young college student comes to the emergency room with
nausea, vomiting and severe abdominal pain of six hours duration.
While examining the client the physician asks her to stand on her
toes and drop to her heels with a thump. Which of the following
interpretations of this procedure is the most accurate?
1. An irritated bowel will become less tender.
2. If the client has an acute inflammation she will feel localized pain
in the inflamed area.
3. This procedure will create more flaccid abdominal muscles
allowing easier abdominal exam.
4. The client with appendicitis will experience brief relief following
this action.
14. The nurse is admitting a client with a diagnosis of appendicitis to
the surgical unit. Which question is it essential to ask?
1. “When did you last eat?”
2. “Have you had surgery before?”
3. “Have you ever had this type of pain before?”
4. “What do you usually take to relieve your pain?
15. The client with appendicitis asks the nurse for a laxative to help
relieve her constipation. The nurse explains to her that laxatives are
not given to persons with possible appendicitis. What is the primary
reason for this?
1. Laxatives will decrease the spread of infection.
2. Laxatives are not given prior to any type of surgery.
3. The patient does not have true constipation. She only has
pressure.
4. Laxatives could cause rupture of the appendix.
16. The nurse is preparing a client with Crohn’s disease for discharge.
Which statement he makes indicates he needs further teaching?
1. “Stress can make it worse.”
2. “Since I have Crohn’s disease I don’t have to worry about colon
cancer.”
3. “I realize I shall always have to monitor my diet.”
4. “I understand there is a high incidence of familial occurrence with
this disease.”
17. A client is admitted to the hospital with ulcerative colitis.
Admitting orders include a low residue diet. Which food would be
contraindicated for this client?
1. Roast beef.
2. Fresh peas.
3. Mashed potatoes.
4. Baked chicken.
18. An adult client is to have a sigmoidoscopy in the morning. What
should the nurse plan to do?
1. Give him an enema 1 hour before the examination.
2. Keep him NPO for 8 hours before the examination.
3. Order a low fat, low residue diet for breakfast.
4. Administer enemas until clear this evening.
19. A client with pancreatitis tells the nurse that he fears nighttime.
Which of the following statements most likely relates to the client’s
concerns?
1. The pain is worse at night and aggravated in the recumbent
position.
2. He is afraid of the dark.
3. The mattress is uncomfortable.
4. The pain increases after a day of activity.
20. The client has had a liver biopsy. The nurse should position him
on his right side with a pillow under his rib cage. What is the primary
reason for this position?
1. To immobilize the diaphragm.
2. To facilitate full chest expansion.
3. To minimize the danger of aspiration.
4. To reduce the likelihood of bleeding
21. During preparation for bowel surgery, a male client receives an
antibiotic to reduce intestinal bacteria. Antibiotic therapy may
interfere with synthesis of which vitamin and may lead to
hypoprothrombinemia?
a. vitamin A
b. vitamin D
c. vitamin E
d. vitamin K
22. When evaluating a male client for complications of acute
pancreatitis, the nurse would observe for:
a. increased intracranial pressure.
b. decreased urine output.
c. bradycardia.
d. hypertension.
23. A male client with a recent history of rectal bleeding is being
prepared for a colonoscopy. How should the nurse position the client
for this test initially?
a. Lying on the right side with legs straight
b. Lying on the left side with knees bent
c. Prone with the torso elevated
d. Bent over with hands touching the floor
24. The nurse is caring for a male client with cirrhosis. Which
assessment findings indicate that the client has deficient vitamin K
absorption caused by this hepatic disease?
a. Dyspnea and fatigue
b. Ascites and orthopnea
c. Purpura and petechiae
d. Gynecomastia and testicular atrophy
25. Which condition is most likely to have a nursing diagnosis of
fluid volume deficit?
a. Appendicitis
b. Pancreatitis
c. Cholecystitis
d. Gastric ulcer
26. Which diagnostic test would be used first to evaluate a client
with upper GI bleeding?
a. Endoscopy
b. Upper GI series
c. Hemoglobin (Hb) levels and hematocrit (HCT)
d. Arteriography
27. When preparing a male client, age 51, for surgery to treat
appendicitis, the nurse formulates a nursing diagnosis of Risk for
infection related to inflammation, perforation, and surgery. What is
the rationale for choosing this nursing diagnosis?
a. Obstruction of the appendix may increase venous drainage and
cause the appendix to rupture.
b. Obstruction of the appendix reduces arterial flow, leading to
ischemia, inflammation, and rupture of the appendix.
c. The appendix may develop gangrene and rupture, especially in a
middle-aged client.
d. Infection of the appendix diminishes necrotic arterial blood flow
and increases venous drainage.
28. To prevent gastroesophageal reflux in a male client with hiatal
hernia, the nurse should provide which discharge instruction?
a. “Lie down after meals to promote digestion.”
b. “Avoid coffee and alcoholic beverages.”
c. “Take antacids with meals.”
d. “Limit fluid intake with meals.”
29. The nurse caring for a client with small-bowel obstruction
would plan to implement which nursing intervention first?
a. Administering pain medication
b. Obtaining a blood sample for laboratory studies
c. Preparing to insert a nasogastric (NG) tube
d. Administering I.V. fluids
30. A female client with dysphagia is being prepared for discharge.
Which outcome indicates that the client is ready for discharge?
a. The client doesn’t exhibit rectal tenesmus.
b. The client is free from esophagitis and achalasia.
c. The client reports diminished duodenal inflammation.
d. The client has normal gastric structures.
31. A male client undergoes total gastrectomy. Several hours after
surgery, the nurse notes that the client’s nasogastric (NG) tube has
stopped draining. How should the nurse respond?
a. Notify the physician
b. Reposition the tube
c. Irrigate the tube
d. Increase the suction level
32. What laboratory finding is the primary diagnostic indicator for
pancreatitis?
a. Elevated blood urea nitrogen (BUN)
b. Elevated serum lipase
c. Elevated aspartate aminotransferase (AST)
d. Increased lactate dehydrogenase (LD)
33. A male client with cholelithiasis has a gallstone lodged in the
common bile duct. When assessing this client, the nurse expects to
note:
a. yellow sclerae.
b. light amber urine.
c. circumoral pallor.
d. black, tarry stools.
34. Nurse Hannah is teaching a group of middle-aged men about
peptic ulcers. When discussing risk factors for peptic ulcers, the
nurse should mention:
a. a sedentary lifestyle and smoking.
b. a history of hemorrhoids and smoking.
c. alcohol abuse and a history of acute renal failure.
d. alcohol abuse and smoking.
35. While palpating a female client’s right upper quadrant (RUQ),
the nurse would expect to find which of the following structures?
a. Sigmoid colon
b. Appendix
c. Spleen
d. Liver
36. Nina was diagnosed with peptic ulcer. The physician says that she
has developed the most common type of peptic ulcer. When
obtaining a history from this client, the nurse should expect the
reported pain to:
a. intensify when the client vomits
b. occur one to three hours after meals
c. increase when the client eats fatty foods
d. begin in the epigastrium and radiate across the abdomen
37. After an acute episode of upper GI bleeding, a client vomits and
complains of severe epigastric pain. The nursing assessment reveals
an absence of bowels sounds, pulse rate of 134, and shallow
respirations of 32 per minute. In addition to calling the physician, the
nurse should:
a. Keep the client NPO
b. Start oxygen per nasal cannula at 3 to 4 L per minuta
c. Place the client in the supine position with the legs elevated
d. Ask the client whether any red or black stools have been noted.
38. After a subtotal gastrectomy, a client develops dumping
syndrome. In addition, about 1 and ½ hours after the initial attack,
the client experiences a second period of feeling “shaky”. The nurse
recognizes that this latter effect is caused by:
a. A second more extensive rise in glucose
b. An overwhelmed insulin- adjusting mechanism
c. A distention of the duodenum from an excessive amount of chyme
d. An overproduction of insulin that occurs in response to the rise on
blood glucose
39. A 40-year old client is admitted with biliary cancer. The
associated jaundice gets progressively worse. The nurse should be
most concerned about the potential complication of:
a. Pruritus
b. Bleeding
c. Flatulence
d. Hypokalemia

40. When teaching the client about the diet following a
pancreatoduodenectomy (Whipple’s procedure performed for
cancer of the pancreas, the statement the nurse should include
would be:
a. “There are no dietary restrictions; you may eat what you desire”
b. “your diet should be low in calories to prevent taxing your
pancreas”
c. “Meals should be restricted in protein because of your
compromised liver function”
d. “Low fat meals should be eaten because of interference with your
fat digestion mechanism.”
41. A client with a long history of alcohol abuse is admitted to the
hospital with ascites, jaundice and confusion. A diagnosis of hepatic
cirrhosis is made. A nursing priority would be to:
a. Institute safety measures
b. Monitor respiratory status
c. Measure abdominal girth daily
d. Test stool specimens of blood
42. Which nursing action is most appropriate for a client hospitalized
with acute pancreatitis?
a. Withholding all oral intake, to decrease a pancreatic secretions
b. Administering demerol, as prescribed, to relieve severe pain
c. Limiting I.V. fluids, as ordered, to decrease cardiac workload
d. Keeping the client supine to increase comfort
43. When preparing a client, age 50 for surgery to treat appendicitis,
the nurse formulates a nursing diagnosis of Risk for Infection related
to inflammation, perforation, and surgery. What is the rationale for
choosing this nursing diagnosis?
a. Obstruction of the appendix may increase venous drainage and
cause the appendix to rupture.
b. Obstruction of the appendix reduces arterial flow, leading to
ischemia, inflammation, and rupture of the appendix
c. The appendix may develop gangrene and rupture, especially in the
middle-aged clients.
4. Infection of the appendix diminishes necrotic arterial blood flow
and increases venous drainage
44. A client with acute liver failure exhibits confusion, a declining
level of consciousness, and slowed respirations. The nurse finds him
very difficult to arouse. The diagnostic information which best
explains the client’s behaviour is:
a. Elevated liver enzymes and low serum protein level
b. Subnormal serum glucose and elevated serum ammonia levels
c. Subnormal clotting factors and platelet count.
d. Elevated blood urea nitrogen and creatinine levels and
hyperglycemia.
45. While preparing a client for an upper GI endoscopy
(esophagogastroduodenoscopy), the nurse should implement which
interventions?
1. Administer a preparation to cleanse the GI tract, such as Golytely
or Fleets Phospha-Soda.
2. Tell the client he shouldn’t eat or drink for 6 to 12 hours before
the procedure.
3. Tell the client he must be on a clear liquid diet for 24 hours before
the procedure
4. Inform the client that he’ll receive a sedative before the
procedure.
5. Tell the client that he may eat and drink immediately after the
procedure.
a. 123
b. 124
c. 24
d. 234
46. A client with gastric ulcer disease asks the nurse why the health
care provider has prescribed metronidazole (Flagyl). The nurse
explains, “Antibiotics are prescribed to:
a. augment the immune response.”
b. potentiate the effect of antacids.”
c. treat Helicobacter pylori infection.”
d. reduce hydrochloric acid secretion.”
47. A nurse is caring for a client with cirrhosis of the liver. Which
laboratory test should the nurse monitor that, when abnormal,
might identify a client who may benefit from neomycin enemas?
a. Ammonia level
b. Culture and sensitivity
c. White blood cell count
d. Alanine aminotransferase level
48. The nurse is caring for a client with a diagnosis of chronic
gastritis. The nurse monitors the client, knowing that this client is at
risk for which vitamin deficiency?
a. Vitamin A
b. Vitamin B12
c. Vitamin C
d. Vitamin E
49. The nurse is reviewing the record of a client with a diagnosis of
cirrhosis and notes that there is documentation of the presence of
asterixis. How should the nurse assess for its presence?
a. Dorsiflex the client’s foot.
b. Measure the abdominal girth.
c. Ask the client to extend the arms.
d. Instruct the client to lean forward.
50. The nurse is reviewing the laboratory results for a client with
cirrhosis and notes that the ammonia level is elevated. Which diet
does the nurse anticipate to be prescribed for this client?
a. Low-protein diet
b. High-protein diet
c. Moderate-fat diet
d. High-carbohydrate diet
Endocrine Disorders
51. Nurse Ronn is assessing a client with possible Cushing’s
syndrome. In a client with Cushing’s syndrome, the nurse would
expect to find:
a. Hypotension.
b. Thick, coarse skin.
c. Deposits of adipose tissue in the trunk and dorsocervical area.
d. Weight gain in arms and legs.
52. A male client with primary diabetes insipidus is ready for
discharge on desmopressin (DDAVP). Which instruction should nurse
Lina provide?
a. “Administer desmopressin while the suspension is cold.”
b. “Your condition isn’t chronic, so you won’t need to wear a
medical identification bracelet.”
c. “You may not be able to use desmopressin nasally if you have
nasal discharge or blockage.”
d. “You won’t need to monitor your fluid intake and output after
you start taking desmopressin.”
53. Nurse Wayne is aware that a positive Chvostek’s sign indicate?
a. Hypocalcemia
b. Hyponatremia
c. Hypokalemia
d. Hypermagnesemia
54. In a 29-year-old female client who is being successfully treated
for Cushing’s syndrome, nurse Lyzette would expect a decline in:
a. Serum glucose level.
b. Hair loss.
c. Bone mineralization.
d. Menstrual flow.
55. A male client has recently undergone surgical removal of a
pituitary tumor. Dr. Wong prescribes corticotropin (Acthar), 20 units
I.M. q.i.d. as a replacement therapy. What is the mechanism of
action of corticotropin?
a. It decreases cyclic adenosine monophosphate (cAMP)
production and affects the metabolic rate of target organs.
b. It interacts with plasma membrane receptors to inhibit
enzymatic actions.
c. It interacts with plasma membrane receptors to produce
enzymatic actions that affect protein, fat, and carbohydrate
metabolism.
d. It regulates the threshold for water resorption in the kidneys.
56. Capillary glucose monitoring is being performed every 4 hours
for a female client diagnosed with diabetic ketoacidosis. Insulin is
administered using a scale of regular insulin according to glucose
results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl
for which he receives 8 U of regular insulin. Nurse Vince should
expect the dose’s:
a. Onset to be at 2 p.m. and its peak to be at 3 p.m.
b. Onset to be at 2:15 p.m. and its peak to be at 3 p.m.
c. Onset to be at 2:30 p.m. and its peak to be at 4 p.m.
d. Onset to be at 4 p.m. and its peak to be at 6 p.m.
57. A female client with Cushing’s syndrome is admitted to the
medical-surgical unit. During the admission assessment, nurse Tyzz
notes that the client is agitated and irritable, has poor memory,
reports loss of appetite, and appears disheveled. These findings are
consistent with which problem?
a. Depression
b. Neuropathy
c. Hypoglycemia
d. Hyperthyroidism
58. Nurse Ruth is assessing a client after a thyroidectomy. The
assessment reveals muscle twitching and tingling, along with
numbness in the fingers, toes, and mouth area. The nurse should
suspect which complication?
a. Tetany
b. Hemorrhage
c. Thyroid storm
d. Laryngeal nerve damage
59. After undergoing a subtotal thyroidectomy, a female client
develops hypothyroidism. Dr. Smith prescribes levothyroxine
(Levothroid), 25 mcg P.O. daily. For which condition is levothyroxine
the preferred agent?
a. Primary hypothyroidism
b. Graves’ disease
c. Thyrotoxicosis
d. Euthyroidism
60. Which of these signs suggests that a male client with the
syndrome of inappropriate antidiuretic hormone (SIADH) secretion is
experiencing complications?
a. Tetanic contractions
b. Neck vein distention
c. Weight loss
d. Polyuria
61. A female client with a history of pheochromocytoma is
admitted to the hospital in an acute hypertensive crisis. To reverse
hypertensive crisis caused by pheochromocytoma, nurse Lyka
expects to administer:
a. phentolamine (Regitine).
b. methyldopa (Aldomet).
c. mannitol (Osmitrol).
d. felodipine (Plendil).
62. A male client with a history of hypertension is diagnosed with
primary hyperaldosteronism. This diagnosis indicates that the client’s
hypertension is caused by excessive hormone secretion from which
of the following glands?
a. Adrenal cortex
b. Pancreas
c. Adrenal medulla
d. Parathyroid
63. Nurse Troy is aware that the most appropriate for a client with
Addison’s disease?
a. Risk for infection
b. Excessive fluid volume
c. Urinary retention
d. Hypothermia
64. Acarbose (Precose), an alpha-glucosidase inhibitor, is
prescribed for a female client with type 2 diabetes mellitus. During
discharge planning, nurse Pauleen would be aware of the client’s
need for additional teaching when the client states:
a. “If I have hypoglycemia, I should eat some sugar, not dextrose.”
b. “The drug makes my pancreas release more insulin.”
c. “I should never take insulin while I’m taking this drug.”
d. “It’s best if I take the drug with the first bite of a meal.”
65. A female client whose physical findings suggest a hyperpituitary
condition undergoes an extensive diagnostic workup. Test results
reveal a pituitary tumor, which necessitates a transphenoidal
hypophysectomy. The evening before the surgery, nurse Jacob
reviews preoperative and postoperative instructions given to the
client earlier. Which postoperative instruction should the nurse
emphasize?
a. “You must lie flat for 24 hours after surgery.”
b. “You must avoid coughing, sneezing, and blowing your nose.”
c. “You must restrict your fluid intake.”
d. “You must report ringing in your ears immediately.”
66. Dr. Kennedy prescribes glipizide (Glucotrol), an oral antidiabetic
agent, for a male client with type 2 diabetes mellitus who has been
having trouble controlling the blood glucose level through diet and
exercise. Which medication instruction should the nurse provide?
a. “Be sure to take glipizide 30 minutes before meals.”
b. “Glipizide may cause a low serum sodium level, so make sure
you have your sodium level checked monthly.”
c. “You won’t need to check your blood glucose level after you start
taking glipizide.”
d. “Take glipizide after a meal to prevent heartburn.”
67. For a diabetic male client with a foot ulcer, the physician orders
bed rest, a wet-to-dry dressing change every shift, and blood glucose
monitoring before meals and bedtime. Why are wet-to-dry dressings
used for this client?
a. They contain exudate and provide a moist wound environment.
b. They protect the wound from mechanical trauma and promote
healing.
c. They debride the wound and promote healing by secondary
intention.
d. They prevent the entrance of microorganisms and minimize
wound discomfort.
68. When instructing the female client diagnosed with
hyperparathyroidism about diet, nurse Gina should stress the
importance of which of the following?
a. Restricting fluids
b. Restricting sodium
c. Forcing fluids
d. Restricting potassium
69. Which nursing diagnosis takes highest priority for a female
client with hyperthyroidism?
a. Risk for imbalanced nutrition: More than body requirements
related to thyroid hormone excess
b. Risk for impaired skin integrity related to edema, skin fragility,
and poor wound healing
c. Body image disturbance related to weight gain and edema
d. Imbalanced nutrition: Less than body requirements related to
thyroid hormone excess
70. A male client with a tentative diagnosis of hyperosmolar
hyperglycemic nonketotic syndrome (HHNS) has a history of type 2
diabetes that is being controlled with an oral diabetic agent,
tolazamide (Tolinase). Which of the following is the most important
laboratory test for confirming this disorder?
a. Serum potassium level
b. Serum sodium level
c. Arterial blood gas (ABG) values
d. Serum osmolarity
71. A male client has just been diagnosed with type 1 diabetes
mellitus. When teaching the client and family how diet and exercise
affect insulin requirements, Nurse Joy should include which
guideline?
a. “You’ll need more insulin when you exercise or increase your
food intake.”
b. “You’ll need less insulin when you exercise or reduce your food
intake.”
c. “You’ll need less insulin when you increase your food intake.”
d. “You’ll need more insulin when you exercise or decrease your
food intake.”
72. Nurse Noemi administers glucagon to her diabetic client, then
monitors the client for adverse drug reactions and interactions.
Which type of drug interacts adversely with glucagon?
a. Oral anticoagulants
b. Anabolic steroids
c. Beta-adrenergic blockers
d. Thiazide diuretics
73. Which instruction about insulin administration should nurse
Kate give to a client?
a. “Always follow the same order when drawing the different
insulins into the syringe.”
b. “Shake the vials before withdrawing the insulin.”
c. “Store unopened vials of insulin in the freezer at temperatures
well below freezing.”
d. “Discard the intermediate-acting insulin if it appears cloudy.”
74. Nurse Perry is caring for a female client with type 1 diabetes
mellitus who exhibits confusion, light-headedness, and aberrant
behavior. The client is still conscious. The nurse should first
administer:
a. I.M. or subcutaneous glucagon.
b. I.V. bolus of dextrose 50%.
c. 15 to 20 g of a fast-acting carbohydrate such as orange juice.
d. 10 U of fast-acting insulin.
75. For the first 72 hours after thyroidectomy surgery, nurse Jamie
would assess the female client for Chvostek’s sign and Trousseau’s
sign because they indicate which of the following?
a. Hypocalcemia
b. Hypercalcemia
c. Hypokalemia
d. Hyperkalemia
76. A nurse is assessing a client with a diagnosis of diabetes
insipidus. Which of the following is not a sign of diabetes insipidus?
a. Excessive thirst
b. Increased blood glucose
c. Dry mucous membranes
d. Increased urine output
77. A client is admitted with a head injury. The nurse identifies that
the client’s urinary retention catheter is draining large amounts of
clear, colorless urine. What does the identify as the most likely
cause?
a. Increased serum glucose
b. Deficient renal perfusion
c. Inadequate ADH secretion
d. Excess amounts of IV fluid
78. A nurse is caring for two clients newly diagnosed with diabetes.
One client has type 1 diabetes and the other client has type 2
diabetes. The nurse determines that the main difference between
newly diagnosed type 1 and type 2 diabetes is that in type 1
diabetes:
a. onset of the disease is slow.
b. excessive weight is a contributing factor.
c. complications are not present at the time of diagnosis.
d. treatment involves diet, exercise, and oral medications.
79. A client is scheduled for an adrenalectomy. Which nursing
intervention should the nurse anticipate will be ordered for this
client?
1. Administer IV steroids.
2. Provide a high-protein diet.
3. Collect a 24-hour urine specimen.
4. Withhold all medications for 48 hours.
80. A nurse is caring for a newly admitted client with a diagnosis of
Cushing syndrome. Why should the nurse monitor this client for
clinical indicators of diabetes mellitus?
1. Cortical hormones stimulate rapid weight loss.
2. Tissue catabolism results in a negative nitrogen balance.
3. Glucocorticoids accelerate the process of gluco-neogenesis.
4. Excessive adrenocorticotropic hormone secretion damages
pancreatic tissue.
81. A nurse is caring for a client with a diagnosis of Cushing
syndrome. What is the most common cause of Cushing syndrome
that the nurse should consider before assessing this client for
physiological responses?
a. Pituitary hypoplasia
b. Hyperplasia of the adrenal cortex
c. Deprivation of adrenocortical hormones
d. Insufficient adrenocorticotropic hormone production
82. A nurse is assessing a female client with Cushing syndrome. All of
the following are manifestation of Cushing syndrome except:
a. Hirsutism
b. Bronze like skin
c. Buffalo hump
d. Edema
83. A nurse is caring for a client with the clinical manifestation of
hypotension associated with a diagnosis of Addison disease. Which
hormone is impaired in its production as a result of this disease?
a. Estrogens
b. Androgens
c. Glucocorticoids
d. Mineralocorticoids
84. A health care provider writes orders addressing the needs of a
client with Addison disease. Which outcome does the nurse
conclude is the main focus of treatment for this client?
a. Decrease in eosinophils
b. Increase in lymphoid tissue
c. Restoration of electrolyte balance
d. Improvement of carbohydrate metabolism
85. A nurse is caring for a client with Addison disease. Which
information should the nurse include in a teaching plan as a means
of encouraging this client to modify dietary intake?
a. Increased amounts of potassium are needed to replace renal
losses.
b. Increased protein is needed to heal the adrenal tissue and thus
cure the disease.
c. Supplemental vitamins are needed to supply energy and assist in
regaining the lost weight.
d. Extra salt is needed to replace the amount being lost due to lack
of sufficient aldosterone to conserve sodium.
86. The nurse provides instructions to a client newly diagnosed with
type 1 diabetes
mellitus. The nurse recognizes accurate understanding of measures
to prevent
diabetic ketoacidosis when the client makes which statement?
a. “I will stop taking my insulin if I’m too sick to eat.”
b. “I will decrease my insulin dose during times of illness.”
c. “I will adjust my insulin dose according to the level of glucose in
my urine.”
d. “I will notify my health care provider (HCP) if my blood glucose
level is
higher than 250 mg/dL.”
87. A client is admitted to a hospital with a diagnosis of diabetic
ketoacidosis
(DKA). The initial blood glucose level was 950 mg/dL. A continuous
intravenous infusion of short-acting insulin is initiated, along with
intravenous
rehydration with normal saline. The serum glucose level is now 240
mg/dL. The
nurse would next prepare to administer which item?
a. Ampule of 50% dextrose
b. NPH insulin subcutaneously
c. Intravenous fluids containing dextrose
d. Phenytoin (Dilantin) for the prevention of seizures
88. The nurse is monitoring a client newly diagnosed with diabetes
mellitus for signs
of complications. Which sign, if exhibited in the client, would
indicate
hyperglycemia?
a. Polyuria
b. Diaphoresis
c. Hypertension
d. Increased pulse rate
89. A client is admitted to an emergency department, and a
diagnosis of myxedema coma is made. Which action would the nurse
prepare to carry out initially?
a. Warm the client.
b. Maintain a patent airway.
c. Administer thyroid hormone.
d. Administer fluid replacement.
90. The nurse is caring for a client admitted to the emergency
department with diabetic ketoacidosis (DKA). In the acute phase, the
nurse plans for which priority intervention?
a. Correct the acidosis.
b. Administer 5% dextrose intravenously.
c. Apply a monitor for an electrocardiogram.
d. Administer short-duration insulin intravenously.