question

A new client, a pharmacist in the outpatient department, wants a prescription for some kind of pharmacologic therapy to treat symptoms of tiredness and lethargy. What kinds of medications could be prescribed for the pharmacist, depending on the cause of the fatigue?

answer

-thyroid hormone supplements -antibacterial drugs -iron supplements

question

In completing the health history for a pregnant, commodities stock broker, the OB/GYN nurse asks her about signs of fatigue. Even if she were not pregnant, what nonmodifiable risk factor for fatigue would the client have?

answer

female gender

question

The home care nurse is talking with the family of the client with chronic fatigue syndrome who is confined to bed most of the time. Which goal is not appropriate for this client?

answer

helping client to surpass the previous day's exercise

question

The healthcare team is not sure about the cause of fatigue in a client, whose symptoms come and go. They have ordered a battery of tests to narrow down possible causes. Tests for what conditions could the nurse on the team expect might be ordered?

answer

-hormone levels -liver dysfunction -kidney functioning -anemia

question

A nurse is conducting a physical examination on a client complaining of chronic fatigue. Which functional system should the nurse concentrate upon?

answer

muscle strength

question

The client complains to a nurse in the walk-in clinic, "I just can't understand why I can't get a good night's sleep. I am so tired." Which assessment questions will the nurse ask to support or rule out consideration of chronic fatigue syndrome?

answer

- "have you had any symptoms of illness or injury?" - "have you tried stress reduction exercises?" - "how long have you had difficulty sleeping?"

question

The graduate student seeks help from a nurse at the college health center. Which complaints connected with fatigue would the nurse consider as neurological symptoms of that condition?

answer

-confusion -difficulty concentrating (are neurological symptoms) (muscle weakness, dyspnea, and loss of appetite are signs of physical symptoms of fatigue)

question

The public health nurse has been working with a mobility-impaired client with chronic fatigue for over a year. What newly arisen issues should the public health nurse address immediately?

answer

-safety risks -infectious disease transmission

question

A new graduate nurse is excited to put together a plan of care for an anemic teenager with complaints of fatigue. Which independent interventions could the nurse include in the plan?

answer

PLAN OF CARE - encouraging the teenager to take a yoga class -identifying foods rich in nutrients, including iron -talking to the teenager about purchasing a pedometer -pointing out methods of good sleep hygiene habits (INTERVENTION -administering medications for iron deficiency anemia )

question

A pediatric nurse is encouraging the parents of a child with fatigue to keep a journal about their child's behavior. What items should the parents include in that diary?

answer

- time falling asleep -time waking up -breakfast and other meals

question

A client, updating the health history for a nurse assisting with a comprehensive physical exam, says, "I thought I had tried every method to get rid of my fatigue. What is the cognitive behavioral therapy that you just asked about?" How can the nurse describe the CBT approach?

answer

-CBT teaches taking responsibility for change -CBT helps to identify stressors

question

A client, who recently was diagnosed with chronic fatigue syndrome, elatedly told the clinic nurse, "I've just signed up for a gym membership!" What information would be appropriate for the nurse to share?

answer

the client should be cautious about beginning exercise

question

A client is assessed to have an enlarged thyroid. Which diagnostic study would be ordered to determine the size and function of the thyroid gland?

answer

Thyroid scan with RAI

question

A female client discusses her risk factors for developing thyroid disease with the nurse. Which response demonstrates an appropriate understanding of the risk factors?

answer

"Women face a greater risk of developing thyroid disease than men."

question

What should the nurse monitor when caring for a client on thyroid hormone (TH) replacement therapy?

answer

-stable vital signs report dizziness -report of symptoms of hyperthyiroidism -improvement of symptoms of hypothyroidism

question

An adult client reports a weight gain and feeling cold. Which condition would the nurse suspect?

answer

hypothyroidism

question

What would the nurse tell a client to explain the treatment of Hashimoto disease?

answer

Medication is used to replace destroyed cells.

question

When caring for a client with Graves disease, which nursing intervention would be a priority?

answer

Encourage use of dark glasses when awake and taping the eyelids shut during sleep as needed

question

The nurse is assessing an older client and observes that both eyes are bulging anteriorly. What is the significance of this observation?

answer

Exophthalmos, indicating possible Graves disease (The situation of bilateral bulging eyes is known as exophthalmos, indicating possible Graves disease. Bulging eyes do not indicate acute shock, fluid retention, or goiters.)

question

The client had a thyroidectomy 2 weeks previously. What is an expected, priority outcome for this client?

answer

Lab values are within normal limits. (After a thyroidectomy, the client will receive thyroid hormonal replacement with regulation to achieve stable lab results of T4 and TH, so normal lab values would be a priority. Sleeping 8 hours per day is a positive outcome, not a priority outcome. Client should gain 1-2 pounds a week for a healthy weight gain. A red and swollen incision would indicate a possible infection and would not be an expected outcome after a thyroidectomy.)

question

What are the most appropriate physical assessment methods that the nurse would use to identify thyroid problems?

answer

-palpation -observation

question

The nurse is presenting a public health presentation about how common foods and spices can contribute to health. Which disease is prevented by the addition of iodine to salt?

answer

Hypothyroidism (The addition of iodine to salt prevents iodine deficiency, a cause of hypothyroidism. Using iodized salt does not prevent hyperthyroidism, thyroiditis, or exophthalmos, which is a clinical manifestation of hyperthyroidism.)

question

The nurse is helping the client with Graves disease understand how her goiter occurred. Which factors would the nurse include?

answer

- Antibodies bind to the thyroid stimulating hormones. -The thyroid gland enlarges. -The client's tissues form antibodies.

question

What would be the priorities for the nurse to include in the teaching plan for a client with Graves disease?

answer

-Tape eyelids shut at night -Take weight daily -Take antithyroid drug as prescribed -Drink six to eight glasses of water a day

question

A client diagnosed with liver cirrhosis is being treated for an infection. For which complication should the nurse monitor the client?

answer

Hepatic encephalopathy

question

Which laboratory test is prescribed for a client with suspected cirrhosis?

answer

Liver biopsy

question

Which nursing diagnosis supports a medical diagnosis of cirrhosis?

answer

Increased risk for acute confusion

question

A nurse is caring for a client with cirrhosis. Which assessment finding warrants immediate attention?

answer

Abdominal distention

question

For which manifestation should the nurse assess in a client with hepatorenal syndrome?

answer

Sodium retention

question

A nurse is caring for a client with ascites secondary to cirrhosis. Which medication is the treatment of choice?

answer

Spironolactone (Aldactone)

question

A client with end-stage cirrhosis is brought to the emergency department with declining functional status. Which treatment will relieve the client's symptoms of portal hypertension and reduce the onset of esophageal varices and ascites?

answer

Transjugular intrahepatic portosystemic shunt (TIPS) (Use of the transjugular intrahepatic portosystemic shunt (TIPS) relieves portal hypertension and reduces the onset of esophageal varices and ascites. The Sengstaken-Blakemore and Minnesota tubes are used for bleeding varices, and paracentesis is done to relieve severe ascites that does not respond to diuretic therapy.)

question

The nurse is caring for a client with cirrhosis of the liver. Which risk factors should the nurse expect to find in the client's history?

answer

-Injection drug use -Hepatitis C infection -Excessive alcohol use (Risk factors for cirrhosis of the liver include excessive alcohol use; infection with Hepatitis B, C, or D; and injection drug use. Biliary atresia (poorly formed bile ducts) and hepatitis E are not risk factors for cirrhosis of the liver.)

question

For which complication should the nurse monitor a client with portal hypertension?

answer

Esophageal varices (In portal hypertension, the venous drainage of the GI tract becomes congested, leading to esophageal varices. Hepatitis C is caused by a viral infection. Hepatic encephalopathy is due to the accumulation of toxic substances in the bloodstream, related to liver failure. Steatohepatitis, also known as fatty liver, is a condition in which fat cells build up in the liver, leading to liver enlargement and cirrhosis.)

question

A client with cirrhosis is being evaluated for discharge. Which outcome and nursing observation indicate the client is ready for discharge home?

answer

Improved coagulation studies

question

The nurse is caring for a client with cirrhosis of the liver. Which dietary support does this client need?

answer

-Fluid-restricted diet -Sodium-restricted diet -Vitamin supplements

question

The nurse is caring for a client with cirrhosis. Which assessment findings correlate with expected laboratory findings in the client?

answer

-Peripheral edema -Frequent infections -Confusion -Bruising easily

question

The nurse is planning care for a client hospitalized due to complications related to obesity. The client becomes breathless when doing very simple activities and requires frequent rest periods. Which nursing diagnosis is most appropriate for this client?

answer

Reduced tolerance of activity

question

The nurse is discussing long-term weight loss strategies with an obese client. The nurse knows to intervene when the client makes which statement?

answer

"My kids and spouse are picky eaters and will not eat vegetables."

question

The nurse is teaching a client about gastric bypass surgery. The nurse knows the client needs additional teaching when the client makes which statement?

answer

"After the bypass, I will lose weight, and I will worry less about how I eat."

question

The nurse is caring for a client admitted for bariatric surgery. Upon reviewing the chart, the nurse recognizes that some of the client's health problems are linked to obesity. Which health problems did the nurse most likely recognize?

answer

-Sleep apnea -Osteoarthritis -Polycystic ovary syndrome (PCOS) (Such reproductive disorders as PCOS are more common in obese women. Obesity is the major risk factor for the occurrence of sleep apnea. Increased weight places abnormal stress on joints, increasing the prevalence of osteoarthritis, especially in weight-bearing joints. Diverticulitis and Raynaud disease are not directly linked to obesity.)

question

A nurse is caring for a client with obesity who is trying to lose weight with medication in conjunction with diet and exercise. Which medication stimulates serotonin in the brain and causes the client to feel full?

answer

Lorcaserin (Belviq)

question

A nurse is discussing the complications of obesity with a group of clients. The nurse identifies which characteristic of body fat distribution that is associated with an increased risk of cardiovascular disease and stroke?

answer

Waist-to-hip ratio greater than 0.8 (Central obesity, defined by a waist-to-hip ratio greater than 0.8, is associated with an increased risk of such complications as cardiovascular disease, hyperlipidemia, and stroke. Clients with an excess distribution of body fat around the lower hips, thighs, and legs have a lower risk of developing cardiovascular complications. A waist-to-hip ratio less than 0.8 is an indicator of peripheral obesity, which has a decreased risk of cardiovascular complications. Excess body fat in the upper extremities is not related to an increased risk of cardiovascular complications.)

question

A nurse is counseling a female client who wishes to lose weight quickly by " just drinking diet soda and eating salads twice a day." What are the nurse's best responses with respect to the nutritional implications of the client's intended diet?

answer

-"Your body will break down protein as well as fat in order to provide glucose for energy." -"A long-term diet like this one will create a chronic protein deficiency."

question

The nurse is teaching a community group about behavioral strategies to assist in weight loss. Which strategies should the nurse mention?

answer

-Not shopping for food while hungry -Eating a salad or drinking a hot beverage before eating a meal -Avoiding eating in front of the television -Using nonfood rewards when goals are achieved

question

The nurse is providing education to a family who would like to decrease their risk factors for obesity. Which behavior is psychological and can be modified by the family?

answer

Eating due to boredom

question

The nurse is caring for a client with obesity. Which nursing interventions correlate with the client's diagnosis?

answer

-Monitor blood glucose level -Assess client's knowledge of healthy dietary choices -Monitor blood pressure

question

A nurse is planning client outcomes for a client who has a body mass index of 33 kg/m² and is planning to join a group weight loss program. Which outcome would be the most appropriate for this client?

answer

The client will lose 1 lb per week. (A weight loss of 1 lb per week is an appropriate outcome for a client. Goals should be specific and measurable and have a time frame. A weight loss of 10 lb per month is not realistic or safe for this client. Although an increase in vegetable intake is encouraged, the outcome as written does not mention how to measure increased vegetable intake. Self-esteem is important to an obese client, but it is not a measurable outcome.)

question

The nurse calculates that a client's body mass index (BMI) is 27 kg/m2. What is the nurse's best response if the client asks about the result?

answer

"Have you considered joining a weight loss program?" (A BMI of 27 indicates that the client is overweight and would benefit from a weight loss program. A normal BMI is considered to be between 18.5 and 24.9 kg/m2, so this client has a BMI above the normal range. Obesity is defined as a BMI greater than 30 kg/m². Although any BMI over normal can place a client at risk of complications of obesity, this client is not considered obese. The BMI is used to identify an overabundance of body mass in an individual, and a BMI of 27 is considered overweight.)

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