front 1 A client with Cushing’s disease begins to laugh loudly and inappropriately, causing the family in the room to be uncomfortable. What is the nurse’s best response?
| back 1 C. “The disease can sometimes affect emotional responses.” |
front 2 The charge nurse is making client assignments for the medical-surgical unit. Which client will be best to assign to an RN who has floated from the pediatric unit?
| back 2 D. Client with Cushing’s syndrome who requires frequent glucose monitoring and administration of insulin |
front 3 A client with iatrogenic Cushing’s disease is a resident in a long-term care facility. Which nursing action included in the plan of care is most appropriate to delegate to unlicensed assistive personnel (UAP)?
| back 3 A. Assist with personal hygiene and skin care. |
front 4 The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH) admitted with change in mental status. To determine whether fluid restrictions have been effective, for which of these outcomes will the nurse monitor?
| back 4 C. Increased serum sodium |
front 5 A client presents to the emergency department with a history of adrenal insufficiency. The following laboratory values are obtained: Na+ 130 mEq/L (130 mmol/L), K+ 6.6 mEq/L (6.6 mmol/L), and glucose 72 mg/dL (4 mmol/L). Which prescription will the nurse implement first?
| back 5 A. Administer insulin with dextrose in normal saline. |
front 6 A client is referred to a home health agency after a transsphenoidal hypophysectomy. Which action does the RN case manager delegate to the home health aide who will see the client daily?
| back 6 D. Test any nasal drainage for the presence of glucose. |
front 7 A client with syndrome of inappropriate antidiuretic hormone (SIADH) is admitted with a serum sodium level of 105 mEq/L (105 mmol/L). Which request by the health care provider does the nurse carry out first?
| back 7 A. Administer infusion of 150 mL of 3% NaCl over 3 hours. |
front 8 A client with Cushing’s disease says that she has lost 1 pound (0.5 kg) What does the nurse do next?
| back 8 D. Weigh the client. |
front 9 The nurse is teaching a client about the expected outcome for treatment of syndrome of inappropriate antidiuretic hormone (SIADH). What does the nurse tell the client to look for?
| back 9 A. Decrease in difficulty in breathing |
front 10 The nurse and nursing student are caring for a client with pheochromocytoma who is admitted for surgery. Which of these statements by the student requires immediate intervention by the nurse?
| back 10 A. “When performing the gastrointestinal assessment, I need to palpate the client’s abdomen.” |
front 11 A client presents to the emergency department with acute adrenal insufficiency and the following vital signs: P 118 beats/min, R 18 breaths/min, BP 84/44 mm Hg, pulse oximetry 98%, and T 98.8°F oral. Which nursing intervention is the highest priority for this client?
| back 11 B. Providing isotonic fluids |
front 12 A client with a possible adrenal gland tumor is admitted for testing and treatment. Which nursing action is most appropriate for the charge nurse to delegate to the nursing assistant?
| back 12 D. Remind the client to not order coffee with meals |
front 13 The client is taking fludrocortisone (Florinef) for adrenal hypofunction. The nurse instructs the client to report which symptom while taking this drug?
| back 13 B. Headache |
front 14 The nurse is assessing a client who had a transsphenoidal hypophysectomy yesterday. Which finding requires immediate notification to the primary health care provider?
| back 14 C. Client report of a headache and stiff neck |
front 15 A client has been admitted to the medical intensive care unit with a diagnosis of diabetes insipidus (DI) secondary to lithium overdose. The client has a prescription for Desmopressin (DDAVP). Which outcome indicates a positive response to treatment?
| back 15 A. Urine output of 60–80 mL/hour |
front 16 After receiving change-of-shift report about these four clients, which client does the nurse attend to first?
| back 16 A. Client with acute adrenal insufficiency who has a blood glucose of 36 mg/dL (2.0 mmol/L) |
front 17 The nurse is planning to administer medications to a client with diabetes insipidus (DI) who has dry lips and mucous membranes and poor skin turgor. Which intervention will the nurse provide first?
| back 17 A. Encourage oral fluid intake |
front 18 When caring for a client with hypercortisolism the nurse notices that the phlebotomist, who plans to draw blood from the client, displays symptoms of a cold. What would the nurse do?
| back 18 D. Ensure the phlebotomist wears a facemask. |
front 19 A client has undergone a transsphenoidal hypophysectomy. Which intervention does the nurse implement to avoid increasing intracranial pressure (ICP) in the client?
| back 19 B. Instruct the client not to strain during a bowel movement. |
front 20 The nurse is providing discharge instructions to a client receiving spironolactone (Aldactone) therapy. Which comment by the client indicates a need for further teaching?
| back 20 C. “I will eat a banana every day.” |