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


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


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



glucose metabolism.

&%o'a% Rationa%e:

&amont, Niedringhous, Comprehensive Nursing Care 'nd (dition )pdate Test *an

Cop$right '+' b$ Pearson (ducation, -nc.



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


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



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



&%o'a% Rationa%e:





Cogniti(e )e(e%: &emembering


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 *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





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.


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.


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


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


&%o'a% Rationa%e:

Cogniti(e )e(e%: Anal$%ing


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 .





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


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


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.





&%o'a% Rationa%e:



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





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 !: 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:


C%ient Need: Safe (ffective Care (nvironmentC%ient Need *u':


)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$.


1 Client reports ala$s feeling cold.

2 Tach$cardia

3 -ncreased appetite





! 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


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


&%o'a% Rationa%e:


C%ient Need: Ph$siological -ntegrit$C%ient Need *u':


)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$.


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.





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


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


&%o'a% Rationa%e:

Cogniti(e )e(e%: Appl$ingC%ient Need: !ealth Promotion and Maintenance

C%ient Need *u':


)earning -ut"ome: "ifferentiate beteen t$pes of diabetes mellitus and treatment for each.

Question 1

Type: MCSA





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 !: 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:


C%ient Need: Ph$siological -ntegrit$C%ient Need *u':


)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.





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 !: (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


&%o'a% Rationa%e:


C%ient Need: !ealth Promotion and Maintenance

C%ient Need *u':


)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: '





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


Rationa%e !: "raing bac on the plunger is contraindicated for clients administering insulin because it causes


&%o'a% Rationa%e:



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$






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$


&%o'a% Rationa%e:


C%ient Need: !ealth Promotion and MaintenanceC%ient Need *u':


)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


Rationa%e !: The client might be e2periencing small tears in the retina that rupture and create tissue damage and


&%o'a% Rationa%e:



C%ient Need *u':






)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


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


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:



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





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.



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



&%o'a% Rationa%e:


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





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:



C%ient Need *u':


)earning -ut"ome: "iscuss disorders of the adrenal glands and nursing care needed for these clients.



Ramont2e Rev TIF Ch38

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Transcript of Ramont2e Rev TIF Ch38