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Transcript of Ramont2e Rev TIF Ch38
7/26/2019 Ramont2e Rev TIF Ch38
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Ramont, Niedringhous, Comprehensive Nursing Care 2nd Edition Update Test
Bank
Chapter 38Question 1
Type: MCSA
When the client eats lunch, serum glucose levels rise. As the pancreas releases insulin to push glucose into the
cell, serum glucose levels decline. Normal serum glucose levels signal the pancreas to stop secreting insulin. The
nurse describes this process as:
1 Positive feedbac.
2 !omeostasis.
3 Negative feedbac.
! "iabetes mellitus.
Corre"t #ns$er: #
Rationa%e 1: Negative feedbac is the signal sent b$ the bod$ to turn off hormone secretion in order to maintainhomeostasis. The normal serum glucose level acts as a negative feedbac mechanism for the pancreas, turning of
the secretion of insulin. !omeostasis is the balance the bod$ affects in order to maintain normal function. Positiv
feedbac stimulates the bod$ to do something. "iabetes mellitus is a disease process characteri%ed b$ abnormal
glucose metabolism.
Rationa%e 2: Negative feedbac is the signal sent b$ the bod$ to turn off hormone secretion in order to maintainhomeostasis. The normal serum glucose level acts as a negative feedbac mechanism for the pancreas, turning of
the secretion of insulin. !omeostasis is the balance the bod$ affects in order to maintain normal function. Positiv
feedbac stimulates the bod$ to do something. "iabetes mellitus is a disease process characteri%ed b$ abnormalglucose metabolism.
Rationa%e 3: Negative feedbac is the signal sent b$ the bod$ to turn off hormone secretion in order to maintain
homeostasis. The normal serum glucose level acts as a negative feedbac mechanism for the pancreas, turning ofthe secretion of insulin. !omeostasis is the balance the bod$ affects in order to maintain normal function. Positiv
feedbac stimulates the bod$ to do something. "iabetes mellitus is a disease process characteri%ed b$ abnormal
glucose metabolism.
Rationa%e !: Negative feedbac is the signal sent b$ the bod$ to turn off hormone secretion in order to maintainhomeostasis. The normal serum glucose level acts as a negative feedbac mechanism for the pancreas, turning of
the secretion of insulin. !omeostasis is the balance the bod$ affects in order to maintain normal function. Positiv
feedbac stimulates the bod$ to do something. "iabetes mellitus is a disease process characteri%ed b$ abnormal
glucose metabolism.
&%o'a% Rationa%e:
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
http://slidepdf.com/reader/full/ramont2e-rev-tif-ch38 2/16
Cogniti(e )e(e%: )nderstanding
C%ient Need: Ph$siological -ntegrit$
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: -mplementation
)earning -ut"ome: "efine homeostasis and negative feedbac mechanisms.
Question 2
Type: MCSA
The nurse revieing the client/s medical record learns that the client/s th$roid0stimulating hormone,
adrenocorticotropic hormone, follicle0stimulating hormone, leuteini%ing hormone, and groth hormone levels are
belo normal limits. The nurse recogni%es that all of these hormones are secreted, or stimulated to secrete, as the
result of the action of hat gland1
1 Posterior pituitar$ gland
2 Pineal gland
3 Anterior pituitar$ gland
! Th$mus gland
Corre"t #ns$er: #
Rationa%e 1: Th$roid0stimulating hormone, adrenocorticotropic hormone, follicle0stimulating hormone,
leuteini%ing hormone, and groth hormone are all secreted, or their secretion is stimulated, b$ the anterior pituitar$ gland. The posterior pituitar$ gland secretes antidiuretic hormone and o2$tocin. The pineal gland
secretes melatonin. The th$mus gland secretes th$min and th$mosin.
Rationa%e 2: Th$roid0stimulating hormone, adrenocorticotropic hormone, follicle0stimulating hormone,leuteini%ing hormone, and groth hormone are all secreted, or their secretion is stimulated, b$ the anterior
pituitar$ gland. The posterior pituitar$ gland secretes antidiuretic hormone and o2$tocin. The pineal gland
secretes melatonin. The th$mus gland secretes th$min and th$mosin.
Rationa%e 3: Th$roid0stimulating hormone, adrenocorticotropic hormone, follicle0stimulating hormone,leuteini%ing hormone, and groth hormone are all secreted, or their secretion is stimulated, b$ the anterior
pituitar$ gland. The posterior pituitar$ gland secretes antidiuretic hormone and o2$tocin. The pineal gland
secretes melatonin. The th$mus gland secretes th$min and th$mosin.
Rationa%e !: Th$roid0stimulating hormone, adrenocorticotropic hormone, follicle0stimulating hormone,leuteini%ing hormone, and groth hormone are all secreted, or their secretion is stimulated, b$ the anterior
pituitar$ gland. The posterior pituitar$ gland secretes antidiuretic hormone and o2$tocin. The pineal gland
secretes melatonin. The th$mus gland secretes th$min and th$mosin.
&%o'a% Rationa%e:
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
http://slidepdf.com/reader/full/ramont2e-rev-tif-ch38 3/16
Cogniti(e )e(e%: &emembering
C%ient Need: Ph$siological -ntegrit$
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: Assessment
)earning -ut"ome: "escribe the structure and function of the endocrine s$stem.
Question 3
Type: MCSA
The nurse is caring for an adult client ith a pituitar$ tumor resulting in acromegal$. Which of the folloing
assessment findings ould be consistent ith this diagnosis1
1 Sudden groth spurt to seven feet or more
2 (nlarged hands, feet, and internal organs
3 -ncreased muscular strength in the upper bod$
! -ncrease in on gender se2ual hormone levels
Corre"t #ns$er: '
Rationa%e 1: Adults, hose epiph$sis has closed, cannot undergo a sudden groth spurt, but ill have enlarged
hands, feet, and internal organs. This results from h$persecretion of groth hormone.
Rationa%e 2: Adults, hose epiph$sis has closed, cannot undergo a sudden groth spurt, but ill have enlargedhands, feet, and internal organs. This results from h$persecretion of groth hormone.
Rationa%e 3: Adults, hose epiph$sis has closed, cannot undergo a sudden groth spurt, but ill have enlargedhands, feet, and internal organs. This results from h$persecretion of groth hormone.
Rationa%e !: Adults, hose epiph$sis has closed, cannot undergo a sudden groth spurt, but ill have enlarged
hands, feet, and internal organs. This results from h$persecretion of groth hormone.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Appl$ing
C%ient Need: Ph$siological -ntegrit$
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: Assessment)earning -ut"ome: 3ist disorders of the pituitar$ gland and nursing interventions for clients ith pituitar$
disorders.
Question !
Type: MCSA
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
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The nurse caring for a client recentl$ diagnosed ith s$ndrome of inappropriate antidiuretic hormone 4S-A"!5
ould establish hich of the folloing goals until the cause of the s$ndrome could be found and treated1
1 Client ill maintain strict fluid restrictions.
2 Client ill gain 0' pounds per ee.
3 Client ill severel$ limit sodium intae.
! Client ill elevate the feet to reduce edema.
Corre"t #ns$er:
Rationa%e 1: S-A"! is caused b$ e2cessive production of antidiuretic hormone, usuall$ caused b$ a brain tumor
or closed head in6ur$. As a result, the nephron reabsorbs e2cessive amounts of fluid, overloading the circulating blood volume, diluting the blood, and decreasing osmolarit$, resulting in eight gain ithout edema. Sodium
levels are diluted, causing them to appear reduced, and clients often have s$mptoms of h$ponatremia, so salt
intae is encouraged.
Rationa%e 2: S-A"! is caused b$ e2cessive production of antidiuretic hormone, usuall$ caused b$ a brain tumor
or closed head in6ur$. As a result, the nephron reabsorbs e2cessive amounts of fluid, overloading the circulating
blood volume, diluting the blood, and decreasing osmolarit$, resulting in eight gain ithout edema. Sodium
levels are diluted, causing them to appear reduced, and clients often have s$mptoms of h$ponatremia, so saltintae is encouraged.
Rationa%e 3: S-A"! is caused b$ e2cessive production of antidiuretic hormone, usuall$ caused b$ a brain tumor
or closed head in6ur$. As a result, the nephron reabsorbs e2cessive amounts of fluid, overloading the circulating
blood volume, diluting the blood, and decreasing osmolarit$, resulting in eight gain ithout edema. Sodiumlevels are diluted, causing them to appear reduced, and clients often have s$mptoms of h$ponatremia, so salt
intae is encouraged.
Rationa%e !: S-A"! is caused b$ e2cessive production of antidiuretic hormone, usuall$ caused b$ a brain tumoror closed head in6ur$. As a result, the nephron reabsorbs e2cessive amounts of fluid, overloading the circulating
blood volume, diluting the blood, and decreasing osmolarit$, resulting in eight gain ithout edema. Sodium
levels are diluted, causing them to appear reduced, and clients often have s$mptoms of h$ponatremia, so salt
intae is encouraged.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Anal$%ing
C%ient Need: Ph$siological -ntegrit$
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: Planning
)earning -ut"ome: 3ist disorders of the pituitar$ gland and nursing interventions for clients ith pituitar$disorders.
Question .
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
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Type: MCMA
The nurse caring for a client diagnosed ith diabetes insipidus plans hich of the folloing nursing
interventions1 Select all that appl$.
*tandard Te/t: Select all that appl$.
1 (ncourage use of e2tra salt in the diet.
2 Administer -7 fluids and increase oral intae of fluids.
3 Test urine output for protein and glucose.
! Administer insulin as ordered.
. "ail$ eights
Corre"t #ns$er: ',8
Rationa%e 1: The client ith diabetes insipidus has e2tremel$ high urine output that is ver$ dilute ith increasing
sodium levels. Care should be focused on increasing fluid intae to replace fluid lost b$ the idne$ and reducesodium intae, and the urine ill be tested for specific gravit$. "ail$ eights are the indicated to determine fluid
status. "iabetes insipidus is not related to diabetes mellitus, so this client ill not re9uire insulin, and findings of
protein or glucose in the urine ould be abnormal.
Rationa%e 2: The client ith diabetes insipidus has e2tremel$ high urine output that is ver$ dilute ith increasingsodium levels. Care should be focused on increasing fluid intae to replace fluid lost b$ the idne$ and reduce
sodium intae, and the urine ill be tested for specific gravit$. "ail$ eights are the indicated to determine fluid
status. "iabetes insipidus is not related to diabetes mellitus, so this client ill not re9uire insulin, and findings of protein or glucose in the urine ould be abnormal.
Rationa%e 3: The client ith diabetes insipidus has e2tremel$ high urine output that is ver$ dilute ith increasing
sodium levels. Care should be focused on increasing fluid intae to replace fluid lost b$ the idne$ and reduce
sodium intae, and the urine ill be tested for specific gravit$. "ail$ eights are the indicated to determine fluidstatus. "iabetes insipidus is not related to diabetes mellitus, so this client ill not re9uire insulin, and findings of
protein or glucose in the urine ould be abnormal.
Rationa%e !: The client ith diabetes insipidus has e2tremel$ high urine output that is ver$ dilute ith increasing
sodium levels. Care should be focused on increasing fluid intae to replace fluid lost b$ the idne$ and reducesodium intae, and the urine ill be tested for specific gravit$. "ail$ eights are the indicated to determine fluid
status. "iabetes insipidus is not related to diabetes mellitus, so this client ill not re9uire insulin, and findings of
protein or glucose in the urine ould be abnormal.
Rationa%e .: The client ith diabetes insipidus has e2tremel$ high urine output that is ver$ dilute ith increasing
sodium levels. Care should be focused on increasing fluid intae to replace fluid lost b$ the idne$ and reduce
sodium intae, and the urine ill be tested for specific gravit$. "ail$ eights are the indicated to determine fluid
status. "iabetes insipidus is not related to diabetes mellitus, so this client ill not re9uire insulin, and findings of protein or glucose in the urine ould be abnormal.
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
http://slidepdf.com/reader/full/ramont2e-rev-tif-ch38 6/16
&%o'a% Rationa%e:
Cogniti(e )e(e%: Appl$ing
C%ient Need: Ph$siological -ntegrit$
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: Planning
)earning -ut"ome: 3ist disorders of the pituitar$ gland and nursing interventions for clients ith pituitar$
disorders.
Question 0
Type: MCSA
The nurse has instructed the client on dietar$ changes re9uired secondar$ to a diagnosis of h$poparath$roidism,
and determines that the client understood hen he selects hich of the folloing foods for lunch1
1 ogurt, cabbage salad ith broccoli, and tofu burger
2 Cheeseburger, french fries, and diet Coe
3 Milshae, chicen salad, and gelatin
! Spaghetti ith meat sauce, lettuce salad, and apple 6uice
Corre"t #ns$er:
Rationa%e 1: "air$ products, tofu, so$, cabbage and broccoli are all high in calcium, and reflect that the client
understood the nurse/s instructions and the need for increased calcium intae.
Rationa%e 2: "air$ products, tofu, so$, cabbage and broccoli are all high in calcium, and reflect that the clientunderstood the nurse/s instructions and the need for increased calcium intae.
Rationa%e 3: "air$ products, tofu, so$, cabbage and broccoli are all high in calcium, and reflect that the client
understood the nurse/s instructions and the need for increased calcium intae.
Rationa%e !: "air$ products, tofu, so$, cabbage and broccoli are all high in calcium, and reflect that the clientunderstood the nurse/s instructions and the need for increased calcium intae.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Anal$%ingC%ient Need: !ealth Promotion and Maintenance
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: (valuation
)earning -ut"ome: (2plain th$roid and parath$roid disorders.
Question
Type: MCSA
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
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The nurse caring for a client ho had a th$roidectom$ earlier toda$ assists the client to roll onto the side to
e2amine for:
1 Wrinles.
2 *leeding.
3 "iaphoresis.
! *ruising.
Corre"t #ns$er: '
Rationa%e 1: The client must be rolled over in order to see if there has been an$ bleeding because blood ill run
along the folds of the nec and collect on the bed linen.
Rationa%e 2: The client must be rolled over in order to see if there has been an$ bleeding because blood ill run
along the folds of the nec and collect on the bed linen.
Rationa%e 3: The client must be rolled over in order to see if there has been an$ bleeding because blood ill run
along the folds of the nec and collect on the bed linen.
Rationa%e !: The client must be rolled over in order to see if there has been an$ bleeding because blood ill runalong the folds of the nec and collect on the bed linen.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Appl$ing
C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: Assessment
)earning -ut"ome: -dentif$ nursing care needed for clients ith th$roid and parath$roid disorders.
Question 8
Type: MCMA
The nurse admits a client diagnosed ith ;raves/ disease ho ill undergo surger$ in the morning. Which of the
folloing assessment findings ould the nurse consider consistent ith the diagnosis1 Select all that appl$.
*tandard Te/t: Select all that appl$.
1 Client reports ala$s feeling cold.
2 Tach$cardia
3 -ncreased appetite
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
http://slidepdf.com/reader/full/ramont2e-rev-tif-ch38 8/16
! Weight loss
. Constipation
Corre"t #ns$er: ',#,8
Rationa%e 1: The client ith ;raves/ disease has h$persecretion of th$roid hormone, resulting in an increased
metabolic rate, causing the client to feel arm, lose eight despite an increased appetite, and e2periencetach$pnea, !e also might report diarrhea due to increased boel motilit$.
Rationa%e 2: The client ith ;raves/ disease has h$persecretion of th$roid hormone, resulting in an increasedmetabolic rate, causing the client to feel arm, lose eight despite an increased appetite, and e2perience
tach$pnea, !e also might report diarrhea due to increased boel motilit$.
Rationa%e 3: The client ith ;raves/ disease has h$persecretion of th$roid hormone, resulting in an increased
metabolic rate, causing the client to feel arm, lose eight despite an increased appetite, and e2periencetach$pnea, !e also might report diarrhea due to increased boel motilit$.
Rationa%e !: The client ith ;raves/ disease has h$persecretion of th$roid hormone, resulting in an increasedmetabolic rate, causing the client to feel arm, lose eight despite an increased appetite, and e2perience
tach$pnea, !e also might report diarrhea due to increased boel motilit$.
Rationa%e .: The client ith ;raves/ disease has h$persecretion of th$roid hormone, resulting in an increased
metabolic rate, causing the client to feel arm, lose eight despite an increased appetite, and e2perience
tach$pnea, !e also might report diarrhea due to increased boel motilit$.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Appl$ing
C%ient Need: Ph$siological -ntegrit$C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: Assessment
)earning -ut"ome: -dentif$ nursing care needed for clients ith th$roid and parath$roid disorders.
Question
Type: MCMA
The nurse is caring for an adolescent ith t$pe diabetes mellitus ho ass, <Wh$ do - have to stic needles in
m$self1 Wh$ can/t - 6ust tae a pill1< -n responding to the client, the nurse ould include hat information1
Select all that appl$.
*tandard Te/t: Select all that appl$.
1 The pills stimulate the pancreas to secrete insulin, and a t$pe diabetic/s pancreas doesn/t mae insulin.
2 -nsulin can/t be taen orall$ because the stomach acids ould destro$ it.
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
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3 -nsulin is re9uired onl$ until earl$ adulthood, hen the condition stabili%es.
! Control of eight and obtaining ade9uate e2ercise ill eliminate the need for insulin.
. Proper administration of insulin reduces ris of complications.
Corre"t #ns$er: ,',=
Rationa%e 1: T$pe diabetics do not produce insulin, so oral medications ould have no effect, because the$
stimulate insulin production. -nsulin must be in6ected because it cannot be taen orall$, due to destruction b$
stomach acids. Maintaining stable blood glucose levels ithin normal limits ill help to reduce the ris ofcomplications. -nsulin ill be re9uired throughout the client/s life, and eight control ill reduce the amount of
insulin re9uired but ill not eliminate the need for insulin in6ections.
Rationa%e 2: T$pe diabetics do not produce insulin, so oral medications ould have no effect, because the$
stimulate insulin production. -nsulin must be in6ected because it cannot be taen orall$, due to destruction b$stomach acids. Maintaining stable blood glucose levels ithin normal limits ill help to reduce the ris of
complications. -nsulin ill be re9uired throughout the client/s life, and eight control ill reduce the amount of
insulin re9uired but ill not eliminate the need for insulin in6ections.
Rationa%e 3: T$pe diabetics do not produce insulin, so oral medications ould have no effect, because the$stimulate insulin production. -nsulin must be in6ected because it cannot be taen orall$, due to destruction b$
stomach acids. Maintaining stable blood glucose levels ithin normal limits ill help to reduce the ris of
complications. -nsulin ill be re9uired throughout the client/s life, and eight control ill reduce the amount ofinsulin re9uired but ill not eliminate the need for insulin in6ections.
Rationa%e !: T$pe diabetics do not produce insulin, so oral medications ould have no effect, because the$
stimulate insulin production. -nsulin must be in6ected because it cannot be taen orall$, due to destruction b$
stomach acids. Maintaining stable blood glucose levels ithin normal limits ill help to reduce the ris of
complications. -nsulin ill be re9uired throughout the client/s life, and eight control ill reduce the amount ofinsulin re9uired but ill not eliminate the need for insulin in6ections.
Rationa%e .: T$pe diabetics do not produce insulin, so oral medications ould have no effect, because the$
stimulate insulin production. -nsulin must be in6ected because it cannot be taen orall$, due to destruction b$stomach acids. Maintaining stable blood glucose levels ithin normal limits ill help to reduce the ris of
complications. -nsulin ill be re9uired throughout the client/s life, and eight control ill reduce the amount of
insulin re9uired but ill not eliminate the need for insulin in6ections.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Appl$ingC%ient Need: !ealth Promotion and Maintenance
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: -mplementation
)earning -ut"ome: "ifferentiate beteen t$pes of diabetes mellitus and treatment for each.
Question 1
Type: MCSA
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
http://slidepdf.com/reader/full/ramont2e-rev-tif-ch38 10/16
The nurse oring in a ph$sician/s office revies the client/s laborator$ results and sees that the fasting blood
sugar on the last to blood tests as '' and > mg?dl. The nurse concludes the client ill be classified as:
1 T$pe diabetic.
2 T$pe ' diabetic.
3 Prediabetic.
! ;estational diabetic.
Corre"t #ns$er: #
Rationa%e 1: The client ith a fasting blood sugar beteen ++ and '= mg?dl on to occasions is classified as
prediabetic, and is often found to be overeight and insulin0resistant.
Rationa%e 2: The client ith a fasting blood sugar beteen ++ and '= mg?dl on to occasions is classified as
prediabetic, and is often found to be overeight and insulin0resistant.
Rationa%e 3: The client ith a fasting blood sugar beteen ++ and '= mg?dl on to occasions is classified as
prediabetic, and is often found to be overeight and insulin0resistant.
Rationa%e !: The client ith a fasting blood sugar beteen ++ and '= mg?dl on to occasions is classified as prediabetic, and is often found to be overeight and insulin0resistant.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Appl$ing
C%ient Need: Ph$siological -ntegrit$C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: Assessment
)earning -ut"ome: "ifferentiate beteen t$pes of diabetes mellitus and treatment for each.
Question 11
Type: MCSA
The client ith t$pe ' diabetes is training to prepare for a marathon, and is brought to the urgent care center ith
h$pogl$cemia. The nurse/s instructs are based on the noledge that:
1 (2tra medication is needed prior to running
2 The client ill need to reduce the distance run each da$.
3 (2ercise reduces blood sugar, and less medication might be re9uired.
! With a diagnosis of diabetes, the client should not run a marathon.
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
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Corre"t #ns$er: #
Rationa%e 1: (2ercise loers blood sugar, so the ph$sician might need to ad6ust the client/s dosage, or might havethe client administer medication based on blood sugar levels instead of taing a preset amount each da$. Clients
ith diabetes can be as active as the$ choose to be, so long as their blood sugar and medication are adapted to the
increased e2ercise levels.
Rationa%e 2: (2ercise loers blood sugar, so the ph$sician might need to ad6ust the client/s dosage, or might havethe client administer medication based on blood sugar levels instead of taing a preset amount each da$. Clients
ith diabetes can be as active as the$ choose to be, so long as their blood sugar and medication are adapted to the
increased e2ercise levels.
Rationa%e 3: (2ercise loers blood sugar, so the ph$sician might need to ad6ust the client/s dosage, or might havethe client administer medication based on blood sugar levels instead of taing a preset amount each da$. Clients
ith diabetes can be as active as the$ choose to be, so long as their blood sugar and medication are adapted to the
increased e2ercise levels.
Rationa%e !: (2ercise loers blood sugar, so the ph$sician might need to ad6ust the client/s dosage, or might have
the client administer medication based on blood sugar levels instead of taing a preset amount each da$. Clientsith diabetes can be as active as the$ choose to be, so long as their blood sugar and medication are adapted to the
increased e2ercise levels.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Appl$ing
C%ient Need: !ealth Promotion and Maintenance
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: -mplementation
)earning -ut"ome: -dentif$ topics to include hen teaching clients ith diabetes mellitus about self0care.
Question 12
Type: MCSA
The nurse teaches the client ho to self0administer insulin, and determines further teaching is needed hen the
client states:
1 <- should rotate the site - use for in6ections.<
2 <- should dra bac on the plunger before in6ecting the insulin.<
3 <- ill clean the site using an antiseptic ipe, and rub in a circle.<
! <- should never in6ect insulin in an area ith a bruise.<
Corre"t #ns$er: '
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
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Rationa%e 1: "raing bac on the plunger is contraindicated for clients administering insulin because it causestissue trauma. The other statements are correct.
Rationa%e 2: "raing bac on the plunger is contraindicated for clients administering insulin because it causes
tissue trauma. The other statements are correct.
Rationa%e 3: "raing bac on the plunger is contraindicated for clients administering insulin because it causes
tissue trauma. The other statements are correct.
Rationa%e !: "raing bac on the plunger is contraindicated for clients administering insulin because it causes
tissue trauma. The other statements are correct.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Anal$%ing
C%ient Need: !ealth Promotion and Maintenance
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: (valuation
)earning -ut"ome: -dentif$ topics to include hen teaching clients ith diabetes mellitus about self0care.
Question 13
Type: MCSA
The nurse teaches the nel$ diagnosed diabetic client that the best means of reducing the ris of complications is
to:
1 (2ercise regularl$ for a minimum of #+ minutes a da$.
2 See the doctor ever$ si2 months.
3 (at properl$.
! Maintain stable blood sugar level.
Corre"t #ns$er: 8
Rationa%e 1: Maintaining stable blood sugar levels ithin normal limits is the single most important a$ toreduce the ris of complications. -n order to maintain a stable blood sugar level the other options 4eating properl$
ade9uate follo up ith ph$sician and e2ercising5 are good strategies to use.
Rationa%e 2: Maintaining stable blood sugar levels ithin normal limits is the single most important a$ to
reduce the ris of complications. -n order to maintain a stable blood sugar level the other options 4eating properl$ade9uate follo up ith ph$sician and e2ercising5 are good strategies to use.
Rationa%e 3: Maintaining stable blood sugar levels ithin normal limits is the single most important a$ to
reduce the ris of complications. -n order to maintain a stable blood sugar level the other options 4eating properl$
ade9uate follo up ith ph$sician and e2ercising5 are good strategies to use.
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
http://slidepdf.com/reader/full/ramont2e-rev-tif-ch38 13/16
Rationa%e !: Maintaining stable blood sugar levels ithin normal limits is the single most important a$ toreduce the ris of complications. -n order to maintain a stable blood sugar level the other options 4eating properl$
ade9uate follo up ith ph$sician and e2ercising5 are good strategies to use.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Appl$ing
C%ient Need: !ealth Promotion and MaintenanceC%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: -mplementation
)earning -ut"ome: (2plain complications of diabetes and ho to decrease the ris for them.
Question 1!
Type: MCSA
The nurse is caring for an elderl$ diabetic client ith secondar$ diagnoses of h$pertension, congestive heart
failure, chronic renal failure, and right leg neuropath$ hen the client sa$s, <That/s eird. All of a sudden -/m
seeing things floating in front of m$ e$es.< The nurse attributes the client/s s$mptoms to:
1 Al%heimer/s disease.
2 (levated potassium secondar$ to renal failure.
3 "iabetic retinopath$.
! Neuropath$.
Corre"t #ns$er: #
Rationa%e 1: The client might be e2periencing small tears in the retina that rupture and create tissue damage andscarring, hich manifest initiall$ as floaters. &apid intervention is re9uired to prevent blindness.
Rationa%e 2: The client might be e2periencing small tears in the retina that rupture and create tissue damage and
scarring, hich manifest initiall$ as floaters. &apid intervention is re9uired to prevent blindness.
Rationa%e 3: The client might be e2periencing small tears in the retina that rupture and create tissue damage and
scarring, hich manifest initiall$ as floaters. &apid intervention is re9uired to prevent blindness.
Rationa%e !: The client might be e2periencing small tears in the retina that rupture and create tissue damage and
scarring, hich manifest initiall$ as floaters. &apid intervention is re9uired to prevent blindness.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Anal$%ing
C%ient Need: Ph$siological -ntegrit$
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: Assessment
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
http://slidepdf.com/reader/full/ramont2e-rev-tif-ch38 14/16
)earning -ut"ome: (2plain complications of diabetes and ho to decrease the ris for them.
Question 1.
Type: MCSA
The nurse teaches the nel$ diagnosed diabetic about diet control, and determines that the client understood the
information hen she identifies hich of the folloing as a <free< food1
1 "ill picles
2 Tomatoes
3 Carrots
! ;elatin
Corre"t #ns$er:
Rationa%e 1: "ill picles are considered free foods because the$ contain less than '+ calories and = grams or less
of carboh$drates per serving. The e$ is the serving si%e, so to slices of seet picles or tablespoon of picle
relish ould fall ithin these guidelines. The other options are not free foods, and must be rationed in the diet.
Rationa%e 2: "ill picles are considered free foods because the$ contain less than '+ calories and = grams or lessof carboh$drates per serving. The e$ is the serving si%e, so to slices of seet picles or tablespoon of picle
relish ould fall ithin these guidelines. The other options are not free foods, and must be rationed in the diet.
Rationa%e 3: "ill picles are considered free foods because the$ contain less than '+ calories and = grams or lessof carboh$drates per serving. The e$ is the serving si%e, so to slices of seet picles or tablespoon of picle
relish ould fall ithin these guidelines. The other options are not free foods, and must be rationed in the diet.
Rationa%e !: "ill picles are considered free foods because the$ contain less than '+ calories and = grams or less
of carboh$drates per serving. The e$ is the serving si%e, so to slices of seet picles or tablespoon of piclerelish ould fall ithin these guidelines. The other options are not free foods, and must be rationed in the diet.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Appl$ing
C%ient Need: !ealth Promotion and Maintenance
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: (valuation)earning -ut"ome: -dentif$ topics to include hen teaching clients ith diabetes mellitus about self0care.
Question 10
Type: MCSA
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
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The nurse admits a client at ' a.m. ith a histor$ of Addison/s disease. After calling the ph$sician and receiving a
order for dail$ cortisone, the nurse learns that the client <ran out of steroid medication to da$s ago.< The client
sa$s he is fine but that he feels ea. The nurse/s priorit$ action is to:
1 Wait until morning to give the ordered cortisone preparation.
2 Administer the cortisone preparation immediatel$.
3 Call the ph$sician immediatel$ and advise him of the missed cortisone.
! Place a note on the chart for the ph$sician to see in the morning about the missed dosages of cortisone.
Corre"t #ns$er: #
Rationa%e 1: This client is at ris for Addisonian crisis because of the abrupt ithdraal of cortisone compounde
b$ the stress of hospital admission. The nurse should notif$ the ph$sician immediatel$ for orders to reduce the
client/s ris of this life0threatening reaction. The ph$sician might order a higher level of cortisone, so it is best no
to give the ordered dosage until after notification.
Rationa%e 2: This client is at ris for Addisonian crisis because of the abrupt ithdraal of cortisone compounde
b$ the stress of hospital admission. The nurse should notif$ the ph$sician immediatel$ for orders to reduce the
client/s ris of this life0threatening reaction. The ph$sician might order a higher level of cortisone, so it is best noto give the ordered dosage until after notification.
Rationa%e 3: This client is at ris for Addisonian crisis because of the abrupt ithdraal of cortisone compounde
b$ the stress of hospital admission. The nurse should notif$ the ph$sician immediatel$ for orders to reduce the
client/s ris of this life0threatening reaction. The ph$sician might order a higher level of cortisone, so it is best noto give the ordered dosage until after notification.
Rationa%e !: This client is at ris for Addisonian crisis because of the abrupt ithdraal of cortisone compounde
b$ the stress of hospital admission. The nurse should notif$ the ph$sician immediatel$ for orders to reduce the
client/s ris of this life0threatening reaction. The ph$sician might order a higher level of cortisone, so it is best noto give the ordered dosage until after notification.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Appl$ing
C%ient Need: Safe (ffective Care (nvironment
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: -mplementation)earning -ut"ome: "iscuss disorders of the adrenal glands and nursing care needed for these clients.
Question 1
Type: MCSA
When assessing the client nel$ diagnosed ith Addison/s disease, before treatment has begun, the nurse ould
find hat sin color most consistent ith the diagnosis1
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.
7/26/2019 Ramont2e Rev TIF Ch38
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1 Pale
2 C$anotic
3 @aundiced
! *ron%e
Corre"t #ns$er: 8
Rationa%e 1: Clients ith Addison/s disease, prior to beginning treatment, often present ith a bron%e color to the
sin that is similar to a deep suntan especiall$ prevalent on the hands, elbos, and nees.
Rationa%e 2: Clients ith Addison/s disease, prior to beginning treatment, often present ith a bron%e color to thesin that is similar to a deep suntan especiall$ prevalent on the hands, elbos, and nees.
Rationa%e 3: Clients ith Addison/s disease, prior to beginning treatment, often present ith a bron%e color to the
sin that is similar to a deep suntan especiall$ prevalent on the hands, elbos, and nees.
Rationa%e !: Clients ith Addison/s disease, prior to beginning treatment, often present ith a bron%e color to thesin that is similar to a deep suntan especiall$ prevalent on the hands, elbos, and nees.
&%o'a% Rationa%e:
Cogniti(e )e(e%: Appl$ing
C%ient Need: Ph$siological -ntegrit$
C%ient Need *u':
Nursing+ntegrated Con"epts: Nursing Process: Assessment
)earning -ut"ome: "iscuss disorders of the adrenal glands and nursing care needed for these clients.
&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an
Cop$right '+' b$ Pearson (ducation, -nc.