PRELIM
Hyperosmolarity of the blood can cause
cellular shrinking
cellular swelling
 
When ECF sodium is decreased, the adrenal gland
secretes aldosterone to cause the kidneys to
Reabsorb water alone
Reabsorb potassium and sodium
Reabsorb sodium and then water
Basing from your answer in number 11, what do you
think will happen to the serum potassium level?
It will increase
It will decrease
It will remain within the normal range.
Correct answer
It will increase
A client is manifesting edema formation on both
upper and lower extremities. The following
mechanisms may explain its occurrence, EXCEPT:
Increased hydrostatic pressure in the IVC
Decreased oncotic pressure within the IVC
Increased ADH secretion
Increased oncotic pressure within IVC
 
Hypertonic IV fluids can cause cerebral and
pulmonary fluid overload due to what specific fluid
shifting?
Movement of fluids from interstitial compartment
and intracellular compartment to the intravascular
compartment.
Movement of fluids from the intravascular
compartment to the interstitial and intracellular
compartments
Movement of fluids from the transcellular fluid
compartments to the interstitial compartments
 
Correct answer
Movement of fluids from interstitial compartment
and intracellular compartment to the intravascular
compartment.
 
Signs and symptoms of ECF fluid volume deficit do
not include which of the following?
Weight loss, poor skin turgor
Thirst, dry mouth and mucous membrane
Oliguria, dark concentrated urine
Decreased hematocrit, decreased specific gravity of
urine
Monitoring of urine output.
Lab tests revealed that client Rosa’s serum sodium Auscultation of the lungs for adventitious sounds or
level is 170 mEq/L. Which clinical manifestation abnormal breath sounds.
would you expect to assess? Assessing skin integrity.
Tented skin turgor and thirst Auscultation for abnormal heart sounds.
Bounding pulse
Muscle weakness and paresthesia Correct answer
  Assessing skin integrity.
R-A-A-S occurs as a compensatory mechanism in  
clients with low blood volume and low blood A patient with cerebral edema would most likely be
pressure. The following are the expected effects of ordered what type of solution?
this mechanism in the conversion of Angiotensin I to 3% saline solution
Angiotensin II, EXCEPT D5W
Peripheral vasodilation 0.45%NaCl
Increase in the absorption of sodium  
Decrease urine output Correct answer
Increase blood volume 3% saline solution
   
Correct answer Following surgery, the nurse has administered
Peripheral vasodilation albumin to a client. The nurse would evaluate this
  intervention to be effective if which of the following
________ solutions cause cell dehydration and help assessments is obtained?
increase fluid in the extracellular space. Heart rate 96
hypotonic Respirations 24
hypertonic Increase in urine output
isotonic Blood pressure of 80/70
   
The nurse is caring for a client with a diagnosis of A client, with a sodium level of 178 mEq/L, is
dehydration. The client is receiving intravenous (IV) ordered to be started on 0.45% NaCl. What is the
fluids. Which assessment data would indicate to the most IMPORTANT nursing intervention for this
nurse that the dehydration remains unresolved? client?
An oral temperature of 36.8 C Maintain patent IV
A urine specific gravity of 1.043 Give rapidly to ensure fluids levels are shifted
A urine output that is pale yellow properly
D. A blood pressure of 120/80 mmHg Clarify doctor's order because 0.45% saline is
  contraindicated in hypernatremia
An 18-year-old client is admitted for signs and Give slowly and watch for signs and symptoms of
symptoms of hypervolemia, isotonic in nature. The cerebral edema
client informed the nurse that she is asthmatic and
has been taking a corticosteroid inhaler ever since Correct answer
she was a child. Basing from your knowledge, what Give slowly and watch for signs and symptoms of
sodium imbalance is this client prone to manifest? cerebral edema
hyponatremia  
hypernatremia The nurse prepares intravenous fluid for a client.
Which mechanism should the nurse recall that
Correct answer represents the movement of fluid across cell
hypernatremia membranes from an area of less concentration to an
  area of higher concentration?
The client is receiving albumin supplementation. diffusion
Expected priority nursing responsibilities with this active transport
type of medical management include the following, filtration
EXCEPT osmosis
  Hypercalcemia administration goes unmonitored, the client may
When ECF sodium is elevated, what is released to Hyperkalemia manifest
decrease serum osmolality? Hyponatremia Decreased skin turgor
aldosterone Hypernatremia Increased specific gravity and increased hematocrit
ADH Crackles upon auscultation of the lungs and signs of
ANF Correct answer cerebral edema
Hypernatremia Decreased blood pressure
Correct answer    
ADH Hypoosmolarity of the blood can lead to Correct answer
  cellular shrinking Crackles upon auscultation of the lungs and signs of
Which of the following clients would not be a cellular swelling cerebral edema
candidate for a hypotonic solution?  
A client with hypernatremia.  When assessing a patient for electrolyte balance, You noticed that in a client who has severe burns,
A client with increased intracranial pressure. the nurse is aware that etiologies for hyponatremia the fluid is starting to accumulate in the client’s
A client whose arm tissues are tented. include: abdominal tissues. There is no change in his weight.
water gain What do you suspect?
Correct answer diuretic therapy It is a normal effect after a burn injury.
A client with increased intracranial pressure. diaphoresis Hypervolemia
  all of the choices Third spacing
A diuretic is administered to the client for fluid
volume excess management. Upon the client’s Third spacing occurs when fluid moves out of the Correct answer
serum sodium level, it is 115 mEq/L. This serum intravascular space into the interstitial space. Based Third spacing
sodium level tells us that that the client is upon this fluid shift, the nurse will expect the client to  
Hyponatremic demonstrate 1A client has developed hyponatremia as a result of
Hypernatremic hypertension SIADH. Which type of IV fluid would the nurse most
Having a normal level of sodium bradycardia likely to administer initially?
  hypervolemia D5W
A nurse in the medical-surgical unit is giving a client hypovolemia 0.45%NaCl
with a low blood pressure a hypertonic solution.   D10W
What is the expected effect of its administration? The nurse is determining a client’s fluid balance. 0.9%NaCl
It increases the osmotic pressure within the blood. Which of the following is best indicator of fluid ---------------------------------------
It increases the osmotic pressure within cells volume excess or deficit? A client is diagnosed with hypoparathyoidism. The
It increases the hydrostatic pressure within the Blood pressure nurse would assess for what electrolyte imbalance
cells. Intake and output as a result?
  Skin turgor Hypocalcemia
Fluids would be likely to leave out of the blood Daily weight Hypercalcemia
vessel or the intravascular compartment (IVC) if, Hyperkalemia
Hydrostatic pressure is less than the osmotic Correct answer Hypernatremia
pressure within the IVC. Daily weight  
Hydrostatic pressure is greater than the osmotic   Potassium chloride intravenously is prescribed for a
pressure within the IVC. D5W solutions are sometimes considered a client with hypokalemia. The following are the
Osmotic pressure is high in the IVC. hypotonic solution as well as an isotonic solution actions the nurse should take to plan for the
D. Osmotic pressure is less than the hydrostatic because after the body metabolizes the dextrose, preparation and administration of the potassium,
pressure in the interstitial compartment. free water remains within serum. EXCEPT
  true Assessment and monitoring of urine output prior
Correct answer false and during administration, respectively
Hydrostatic pressure is greater than the osmotic   Preparing the medication for bolus administration
pressure within the IVC. Intravenous rehydration is a management for clients Monitoring the IV site for signs of infiltration or
  with moderate to severe fluid volume deficit. That phlebitis
Aldosterone secretion in response to fluid loss will said, hypotonic solutions may be given if the client is Ensuring that the medication is diluted in the
result in which one of the following electrolyte suffering from hypertonic fluid deficit. If this IV appropriate volume of fluid
imbalances?  
Related to the client's hypocalcemic state, the Acidosis Lower serum potassium level
parathyroid hormone is stimulated for release as a Hypothyroidism Increase the serum potassium level
compensatory effect. What consequent disorders   Reduce cerebral edema
would the nurse consider for this particular In clients whose serum calcium level is 12 mg/dl, the Prevent tetany
compensation? following may be administered to the client, EXCEPT  
Hyperkalemia and hypernatremia Corticosteroids A client is receiving oral potassium supplement. How
Osteoporosis, Osteodystrophy and calcium stones Furosemide should the supplement be administered?
Hyperphosphatemia and hypocalcemia Vitamin D3 Undiluted
Anemia and pruritus Plain NSS Diluted
    On an empty stomach
The nurse reviews a client’s electrolyte results and The doctor ordered calcium gluconate to be given Every 2 weeks
notes a potassium level of 5.5 mEq/L. The nurse slowly through intravenous infusion. This medication  
understands that a potassium value at this level has to be diluted with The nurse monitors the serum electrolyte levels of
would be noted with which condition? D5W solution client who is taking digitalis/digoxin as a
Traumatic burn injuries 0.9% NaCl management for Heart Failure. Which of the
Cushing’s disease LR solutions following imbalances is a common cause of digitalis
Overuse of laxatives 3% NaCl toxicity?
diarrhea   Hyponatremia
  The nurse reviews a client’s electrolyte results and Hypocalcemia
The client is manifesting circumoral numbness, notes a potassium level of 2.7 mEq/L. Which of the Hypokalemia
paresthesia on extremities, and weakness of following would the nurse note on the cardiac Hyperkalemia
muscles. The following may be administered to the monitor as a result of this laboratory value?  
client, EXCEPT ST elevation The nursing care plan states to observe for
IV fluid of Plain NSS Peaked P wave hyperkalemia. The nurse should recognize that the
Calcium gluconate Prominent U wave greatest risk of hyperkalemia is
D5W Peaked T wave tetany
    cardiac arrest
A known hypertensive client is taking an ACE The following are ECG changes in hyperkalemia, fluid overload
inhibitor. What potassium imbalance would the client except internal bleeding
be at risk of developing? Presence of U wave  
Hyperkalemia Elevated ST segment Correct answer
Hypokalemia Prolonged QRS complex cardiac arrest
  Peaked T wave  
Correct answer Correct answer Which of the following findings would the nurse
Hyperkalemia Presence of U wave expect to assess in a patient with hypokalemia?
    hypertension
The nurse is caring for a bedridden client admitted A client’s lab work shows that he/she has a high pH below 7.35
with a serum calcium level of 13 mg/dl. Which of the PTH level. Which condition is the client at risk for? hypoglycemia
following is the most appropriate nursing action? Hyperkalemia increased DTR (hyperreflexia)
Provide passive ROM exercises and encourage Hypocalcemia  
fluid intake Hypokalemia Correct answer
Teach the client to increase intake antacids Hypercalcemia hypoglycemia
Measure intake and output  
  A decrease in the aldosterone level, as in Addison’s For the 1st 72 hours after thyroidectomy, the nurse
Provide meticulous skin care disease, would lead to what potassium imbalance? should assess the client for possible risk of
Correct answer Hyperkalemia Hypocalcemia
Provide passive ROM exercises and encourage Hypokalemia Hypercalcemia
fluid intake   Hypokalemia
  The physician orders regular insulin, 10 "u" added to Hyperkalemia
The state of hyperkalemia is associated with 50 ml. of 50% dextrose to be given intravenously to  
Catabolism a client with renal failure. The expected outcome is
Alkalosis to
A client manifests a serum calcium level of 13
mEq/L. What hormone is stimulated to act on this
abnormality to maintain balance?
Parathyroid Hormone
Aldosterone
Calcitonin
Renin
 
The client manifested signs and symptoms of
dysrhythmia secondary to hyperkalemia. Which
medication would you anticipate that the physician
will order specific for this manifestation?
Kayexalate
Calcium gluconate
Insulin and dextrose
Potassium chloride
Correct answer
Calcium gluconate
 
Hypoactive bowel sounds and subsequent
manifestation of constipation are commonly seen in
clients with
Hypocalcemia and hyperkalemia
Hypercalcemia and hypokalemia
Hypercalcemia and hyperkalemia
Hypocalcemia and hypokalemia
 
An elderly client is ordered to receive 4 bags of
PRBC because of anemia. As a nurse, you would
anticipate that the physician may order for what
particular medication after the last blood bag?
Potassium supplements
Sodium bicarbonate
Calcium gluconate
Keto-analogues
 
The hyperglycemic client is experiencing metabolic
acidosis. Which of the following serum potassium
levels may result?
4.0 mEq/L
3.0 mEq/L
6.0 mEq/L
4.5 mEq/L
Correct answer
6.0 mEq/L
 
You are taking care of a client who is in albumin
supplementation. As the nurse, you would anticipate
what particular calcium imbalance if this
supplementation goes unmonitored?
Hypocalcemia
Hypercalcemia
 
Correct answer
Hypocalcemia
 
If kidneys are responsible in metabolizing Vit. D, its
inability to do so because of damage, would lead to
Hyperkalemia
Hypophosphatemia
Hypocalcemia
Hypokalemia
 
A client’s lab test revealed that her serum calcium is
2.5 mEq/L. Which assessment data does the nurse
document when a client diagnosed with
hypocalcemia develops a carpopedal spasm after
the blood-pressure cuff is inflated?
Positive Trousseau's sign
Positive Chvostek's sign
Tetany
Paresthesia
 
The client had undergone multiple blood transfusion.
On the 5th day, the client manifested signs and
symptoms of tetany. This pathophysiologic change
could be caused by
Release of too much calcium from red blood cells,
increasing serum calcium level
Binding of calcium to hemoglobin decreasing
oxygen saturation and calcium level
Binding of calcium to citrate contained in the blood
bag, decreasing serum calcium level
Release of potassium from red blood cells because
of breakdown of red blood cells
 
The client with hyperkalemia is manifesting
arrhythmias as observed in the cardiac monitor.
What medication would you anticipate as the nurse
to be administered to the client to specifically
address this manifestation?
Insulin plus dextrose
Kayexalate
Calcium gluconate
Salbutamol
Correct answer
Calcium gluconate
MIDTERM
Bleeding precautions are imparted to the client
taking anti-coagulants. The following are included,
except
Telling the client to avoid playing basketball
Telling the client to avoid playing chess
Using soft-bristled toothbrush
Avoiding smoking
 
Which instruction should be included in discharge
teaching for Mr. Pedro with a new prescription for
simvastatin (Zocor)?
Flushing occurs in almost all individuals
Sedation is common but will decrease with time
Liver enzyme levels should be monitored every few
months
Watch closely for occurrence of postural
hypotension
 
Your knowledge in the anatomy of the heart will tell
you that acute pulmonary edema caused by heart
failure is usually a result of damage to which of the
following areas of the heart?
left atrium
right atrium
left ventricle
right ventricle
 
Which of the following instructions should be
included in the discharge teaching for a client
discharged with a transdermal nitroglycerin patch?
"Apply the patch to a nonhairy, scarless area of the
upper torso or arms."
"If you get a headache, remove the patch for 4
hours and then reapply."
"If you get chest pain, apply a second patch right
next to the first patch."
 
Mr. Pedro got hold of his prescribed nitroglycerin
(NTG) tablets. The following are the proper ways of
using nitroglycerin tablets except:
Take a maximum of 3 doses at 5-minute interval
Offer sips of water before giving sublingual nitrates
Store nitroglycerin tablets in dark-colored, air-tight
container
Discard nitroglycerin tablets if it causes burning
sensation when placed under the tongue
Correct answer
Discard nitroglycerin tablets if it causes burning
sensation when placed under the tongue
 
Which of the following terms is used to describe the Preload, afterload, & cerebral blood flow suggest would most likely help the client deal with
amount of stretch on the myocardium at the end of Preload, afterload, & renal blood flow this problem?
diastole? Preload, afterload, contractility, & heart rate. Visit her friend earlier in the day.
afterload Preload, afterload, cerebral blood flow, & heart rate. Rest for at least an hour before climbing the stairs.
stroke volume   Take a nitroglycerin tablet before climbing the
cardiac output In clients taking Coumadine, intake of green leafy stairs.
preload vegetables is minimized for what reason? Lie down once she reaches the friend's apartment.
  Increased possibility of the client manifesting loose  
Beta-Adrenergic Blocking agents’ therapeutic effect bowel movement after intake Which of the following terms describes the force
is Green leafy vegetables interfere with proper against which the left ventricle must expel blood?
Reduction of heart rate absorption of Coumadine afterload
Increase of myocardial contractility Green leafy vegetables are high in vitamin K cardiac output
Increased conduction of electrical impulses through Green leafy vegetables are high in fiber overload
the heart   preload
Bronchoconstriction What effects do vasodilating medications have on  
  preload and afterload? When do coronary arteries primarily receive blood
Correct answer Decrease preload and decrease afterload flow?
Reduction of heart rate Increase preload and decrease afterload During inspiration
  Increase afterload and increase preload During diastole
A client with an MI of the anterior wall of the left Decrease preload and increase afterload During expiration
ventricle most likely has an occlusion of the During systole
right marginal artery Correct answer  
left circumflex artery. Decrease preload and decrease afterload The client is given heparin. Basing from her
left anterior descending artery   knowledge of what heparin is, nurse’s
right anterior descending artery. When teaching about nitrate administration, the responsibilities should include checking for occult
  nurse should instruct the client to: bleeding. What manifestation would alert the nurse?
Which of the following heart chamber has the change positions slowly Tea or cola-colored urine
thickest muscle layer? take pulse weekly Yellow stool
Right ventricle reduce salt intake Greenish vomitus
Left atrium chew the sustained release tablets Frothy sputum
Right atrium    
Left ventricle Aspirin is administered to the pt experiencing an MI Which of the following is a potential side effect of IV
  because of its: furosemide (lasix)?
 If a client is taking a noncardioselective beta blocker antipyretic action drowsiness
like propranolol, what should be included in the antiplatelet action diarrhea
client’s history taking and assessment and is analgesic action cystitis
deemed as a contraindication? hearing loss
History of surgery During the previous few months, a 56-year-old
A diagnosis of Chronic Obstructive Pulmonary woman felt brief stabs of chest pain while working in A client with angina pectoris secondary to
Diseases her garden and has had frequent episodes of atherosclerotic disease asks why he experiences
A diagnosis of Diabetes Mellitus indigestion. She comes to the hospital after chest pain with exertion. The nurse informs him that
Post MI experiencing severe anterior chest pain while raking exertion
  leaves. Her evaluation confirms a diagnosis of stable Increases the heart’s oxygen demands
Sympathetic stimulation constricts peripheral arterial angina pectoris. After stabilization and treatment, the Causes vasoconstriction of the heart
blood vessels and client is discharged from the hospital. At her follow- Increases blood flow to the mesenteric area
Increases afterload up appointment, she is discouraged because she is Reduces the effect of medications on blood vessels
Decreases afterload experiencing pain with increasing frequency. She  
Has no effect on afterload states that she is visiting an invalid friend twice a Subcutaneous heparin should be administered in
Has no effect on preload week and now cannot walk up the second flight of the:
  steps to the friend's apartment without pain. Which flank
Myocardial oxygen consumption increases as which of the following measures that the nurse could abdominal fat
of the following parameters increase? thigh
buttock
 
If the Purkinje system is damaged, conduction of the
electrical impulses is impaired through the
atria
AV node
ventricles
bundle of His
 
When teaching a client about propranolol
hydrochloride, the nurse should base the information
on the knowledge that propranolol hydrochloride:
Blocks beta-adrenergic stimulation and thus causes
decreased heart rate, myocardial contractility, and
conduction.
Increases norepinephrine secretion and thus
decreases blood pressure and heart rate.
Is a potent arterial and venous vasodilator that
reduces peripheral vascular resistance and lowers
blood pressure.
Is an angiotensin-converting enzyme inhibitor that
reduces blood pressure by blocking the conversion
of angiotensin I to angiotensin II.
 
The “patch-free” period for nitro patch is instituted to
prevent development of
decreased preload
Irritation of the skin
Arrhythmias
Tolerance to the medication
 
In teaching a patient about coronary artery disease,
the nurse explains that the changes that occur in this
disorder involve
diffuse involvement of plaque formation in coronary
veins.
formation of fibrous tissue around coronary arteries.
accumulation of lipid and fibrous tissue within the
coronary arteries.
chronic vasoconstriction of coronary arteries leading
to permanent vasospasm.
 
Atherosclerosis impedes coronary blood flow by
which of the following mechanisms?
Plaques obstruct the vein
Plaques obstruct the artery
Blood clots form outside the vessel wall
Hardened vessels dilate to allow the blood to flow
through
Correct answer
Plaques obstruct the artery
  Epinephrine
A client is given heparin. After its administration, the  
client manifests severe bleeding. What should be What is the most common complication of MI?
given to the client to counter this hazardous side- cardiogenic Shock
effect? heart failure
Vit K arrhythmias
Coumadin pericarditis
Tissue plasminogen activator  
protamine sulfate Which of the following blood tests is most indicative
of cardiac damage?
Correct answer CK
protamine sulfate LDH
  MYOGLOBIN
ACE inhibitors like Captopril is given to a client with TROPONIN I
angina or MI for the purpose of A nurse is caring for a client with a diagnosis of
Decreasing peripheral resistance through peripheral myocardial infarction (MI). The client calls the nurse
vasodilation because the client is experiencing chest pain. The
Increasing peripheral resistance through peripheral nurse administers a sublingual nitroglycerin tablet as
constriction prescribed. The chest pain is unrelieved by the
Decreasing travel of electrical impulses from the SA nitroglycerin. The next nursing action is which of the
node down to the Purkinjie fibers following?
Increasing travel of electrical impulses from the SA Administer another nitroglycerin tablet
node down to the Purkinjie fibers Increase the flow rate of the oxygen
Contact the physician
A patient who is recovering from an acute Call the client's family
myocardial infarction (AMI) asks the nurse about  
when sexual intercourse can be resumed. Which A patient who is being admitted to the emergency
response by the nurse is best? department with intermittent chest pain gives the
"Most patients are able to enjoy intercourse without following list of medications to the nurse. Which
any complications." medication has the most immediate implications for
"Sexual activity uses about as much energy as the patient's care?
climbing two flights of stairs." Sildenafil (Viagra)
"The doctor will provide sexual guidelines when Furosemide (Lasix)
your heart is strong enough." Captopril (Capoten)
"Holding and cuddling are good ways to maintain Warfarin (Coumadin)
intimacy after a heart attack."  
  A client with no history of heart disease has
The following are contraindications of thrombolytic experienced acute myocardial infarction and has
agents, except been given thrombolytic therapy with tissue
Stroke in the last 3 months plasminogen activator. What assessment finding
Thrombocytopenia should the nurse identify as the most likely indicator
Surgery within the last 30 days that the client is experiencing complications of this
Lumbar puncture in the last 7 days therapy?
  Tarry stools
As it decreases mortality in most cases in the Nausea and vomiting
emergent management of acute MI, oxygen Orange-colored urine
administration is often followed by the administration Decreased urine output
of  
Aspirin More than 6 premature ventricular contractions
  would cause to nurse to implement which
Nitroglycerin intervention?
Morphine Start IV morphine
Administer lidocaine or amiodarone, an anti-
arrythmic, as prescribed
Place the client in modified trendelenburg position
Call an anesthesiologist to administer the anti-
arrythmic medication
 
Streptokinase is the least preferred thrombolytic
agent over tPAs because
It poses an allergic risk
It causes more bleeding as an adverse effect
It is more expensive than other thrombolytic agents
It has a shorter shelf-life than any other thrombolytic
agents
Correct answer
It poses an allergic risk
 
Aspirin is administered to the client experiencing an
MI because of its:
Antipyretic action
Antithrombotic action
Analgesic action
Antiplatelet action
Forty minutes after arrival to the emergency room, a
patient suffering an MI is to have emergent
percutaneous transluminal coronary angioplasty
(PTCA) to
Decrease cardiac workload
Cure elevated cholesterol
Reperfuse the area of myocardium deprived of
oxygen
 Remove the area of ischemia from the myocardium
Thrombolytic therapy is administered in less than 30
minutes from the onset of manifestations, with an
effectiveness at highest if given within the first 2
hours of onset of symptoms. After 12 hours after
symptom manifestation, its administration is not
anymore advisable as it,
Causes further chest pain
Puts the client at risk of intracranial bleeding
Causes ventricular arrythmias
Renders the medication ineffective
 
When ventricular fibrillation occurs in a CCU, the
first person reaching the client should
Administer oxygen
Defibrillate the client.
Initiate CPR.
Administer sodium bicarbonate intravenously.
 
Offering of bedpan to clients suffering from MI is
often contraindicated because
It causes the client to strain causing bradycardia
It is uncomfortable for the client
It stimulates a vagal response causing tachycardia
It invades the privacy of the client.
Anticoagulants and anti-platelet agents will be given
to a client post PTCA and stenting. These are given
primarily to
Prevent coronary artery vasospasm
Prevent thrombus formation on the stent
Enhance excretion of the radiopaque dye used
during cardiac catheterization
Prevent constriction of the affected coronary artery
During cardioversion, electrical shock delivery is is
synchronized with the
T wave
R wave
P wave
Q wave
 
The nurse teaches the client that the major
difference between angina and pain associated with
myocardial infarction (MI) is that:
Angina is relieved with nitroglycerin and rest.
Angina can be fatal.
MI pain always radiates to the left arm or jaw.
MI pain cannot be treated.
 
After an anterior wall myocardial infarction, which of
the following problems is indicated by auscultation of
crackles in the lungs?
Left side of the heart
Right side of the heart
Mitral valve
Pulmonic valve
 
A client is admitted to the ER with crushing chest
pain. A diagnosis of acute coronary syndrome is
suspected. The nurse expects that the client's initial
treatment will include which medication?
Gabapentin
Midazolam
Alprazolam
Aspirin
 
12-lead ECG is a diagnostic tool used to evaluate
the electrical activity of the heart. Which of the
following ECG results would reveal that there is
myocardial ischemia?
ST segment elevation and peaked T wave
ST segment depression and inverted T wave
ST segment depression and peaked T wave
ST segment depression and abnormal Q wave
Correct answer
ST segment depression and inverted T wave
For clients manifesting cardiogenic shock with
severely diminishing cardiac output, dobutamine and
dopamine may be given. In this specific case,
dopamine will be given at low dose. What
therapeutic effect would this result to?
Renal arterial dilation
Coronary arterial dilation
Pulmonary arterial dilation
Cerebral arterial dilation
 
A patient who has had a myocardial infarction (MI)
state that he is prone to constipation. The nurse
advises him to establish a regular bowel regimen
because straining or bearing down to have a bowel
movement may
Lead to disease progression
Cause shortness of breath
Trigger a vagal response
Worsen edema
 
Range-of-motion exercises following acute episodes
of Myocardial Infarction is instituted to
Increase cardiac workload
Prevent dizziness
Prevent clot formation
Enhance platelet aggregation
Correct answer
Prevent clot formation
 
What is the primary reason for administering
morphine to a client with an MI?
To sedate the client
To decrease the client's pain
To decrease the client's anxiety
To decrease oxygen demand on the client's heart
Correct answer
To decrease oxygen demand on the client's heart
 
Which of the following EKG changes on the patient
with chest pain indicates the highest level of
damage?
T wave inversion
T wave enlargement
ST segment elevation
Q wave widening Increasing red blood cell production Protects the neutrophils from macrophages
Increasing production of platelets Protects the heart from damage by elastase
Correct answer    
Q wave widening The term “bloater” in clients with Chronic Bronchitis Hypercapnia has what effect on pulmonary blood
  is derived from vessels?
You recommend to your client post MI to eat small, The client’s accumulation of fats on tissues Pulmonary vasodilation 
easily digested meals. The rationale for this is to The client’s barrel chest Pulmonary vasoconstriction
Prevent constipation The client’s edema formation Pulmonary edema
Prevent increase in the workload of the heart The client’s tendency to increase food consumption Pulmonary hypotension
Decrease ingestion of sodium due to increased expenditure of energy
  Correct answer
When administered a thrombolytic drug to the client Correct answer Pulmonary vasoconstriction
experiencing an MI, the nurse explains to him that The client’s edema formation  
the purpose of this drug is to: The term ‘blue” of “blue bloaters” in clients with
Keep him well hydrated Clients with Emphysema are also called ‘pink Chronic bronchitis is derived from
Dissolve clots he may have puffers”. The term “pink” is derived from The client retaining carbon dioxide than oxygen,
Prevent kidney failure Adequate exhalation of carbon dioxide which causes deprivation of tissues with
Treat potential cardiac arrhythmias Adequate inhalation of oxygen early in the disease oxygenated blood
  process The client retaining O2 but trapped within airways
A patient with ST-segment elevation is admitted to Blushing due to retention of carbon dioxide on The client exhaling too much oxygen causing
the emergency department (ED) and diagnosed as superficial tissues cyanosis
having an ST-segment-elevation myocardial Increased fragility of superficial capillaries due to The client exhaling too much carbon dioxide
infarction (STEMI). Which question should the nurse retention of oxygen through pursed-lips
ask to determine whether the patient is a candidate
for thrombolytic therapy? Correct answer Correct answer
"Do you have any allergies?" Adequate inhalation of oxygen early in the disease The client retaining carbon dioxide than oxygen,
"Do you take aspirin on a daily basis?" process which causes deprivation of tissues with
"What time did your chest pain begin?"   oxygenated blood
"Can you rate your chest pain using a 0 to 10 Elevating the edematous extremities is  
scale?" contraindicated in clients with congestive heart The term" blue bloaters" is used to describe clients
  failure who are already with?
Passive and active Range-of-motion exercises are ambulatory Left-sided heart failure
most desired post MI. However, isometric exercises emaciated Chronic bronchitis
are mostly contraindicated because they cause constipated Emphysema
vagal stimulation dyspneic Pulmonary hypertension
muscle cramps  
clot formation In normal ventilation, the diaphragm moves
increase in the heart's workload Correct answer ________________ during inhalation.
dyspneic Downward as it contracts
  Upward as it relaxes
The nurse assessing the CBC of a patient with Sideward as it contracts
The following conditions occur in the
chronic bronchitis identifies a typical feature of this  
pathophysiology of Chronic Bronchitis, except
disease, which is A hypercapneic client may manifest acidosis
Excessive mucus production
Decreased platelets because
Decrease in cilia function
Decreased WBC count Low serum oxygen level increases respiratory rate,
Loss of elastic recoil of the lungs/alveoli
Increased eosinophils blowing off excess carbon dioxide
Hypercapnia
Increased RBC count Excess carbon dioxide binds with water to form
 
  carbonic acid
Alpha 1 - antitrypsin has a protective role in the
The body compensates when there is hypoxemia. In Excess hydrogen ions bind with water to form
physiology of our bodies as it
what manner does it compensate? carbonic acid
Protects the liver from damage by elastase
Increasing production of white blood cells Low oxygen causes reabsorption of hydrogen ions
Protects the lungs from damage by elastase
Increasing carbon dioxide inhalation in the renal system
 
The nurse is assessing a client diagnosed with
emphysema. Clinical manifestations include the
following, except
Use of accessory muscles when breathing
Cachexia
Cough with minimal amounts of sputum
hypocapnia
 
Chronic Bronchitis is defined as
Under COPD where clients manifest productive
cough for at least 3 months a year for 2 consecutive
years.
Deficiency of alpha1-antitrypsin
Manifestation of productive cough in clients for at
least 3 years
Manifestation of productive cough for 3 consecutive
years at 2 years interval
Correct answer
Under COPD where clients manifest productive
cough for at least 3 months a year for 2 consecutive
years.
 
A patient is newly diagnosed with COPD due to
chronic bronchitis. You're providing education to the
patient about this disease process. Which statement
by the patient indicates they understood your
teaching about this condition?
"If I stop smoking, it will cure my condition."
“Complications from this condition can lead to
pulmonary hypertension and right-sided heart
failure."
"I'm at risk for low levels of red blood cells due to
hypoxia and may require blood transfusions during
acute illnesses."
My respiratory system is stimulated to breathe due
to high carbon dioxide levels rather than low oxygen
levels.”
 
Weight loss in COPD, particularly in clients with
Emphysema, is most likely related to
Presence of respiratory infection
Dietary restrictions such as low-fat diet
Dyspnea interfering with eating and causing energy
depletion
Abdominal distention due to presence of abdominal
gas secondary to air hunger
The morning weight for a client with emphysema
indicates that the client has gained 5 pounds in less
than a week, even though his oral intake has been
modest. The client's weight gain may reflect which  
associated complication of COPD? The nurse conscientiously monitors the potassium
Polycythemia level of a client receiving digoxin because she knows
Cor pulmonale that if there is hypokalemia, the serum level of
Left-sided heart failure digoxin will
Hypercapnia increase
  decrease
In the respiratory system, gas exchange occurs in
the nose Correct answer
the trachea increase
pulmonary-capillary bed   
bronchi In Emphysema, destruction of the alveolar walls
  causes the following, except
A nurse plans care for a client with chronic Impaired diffusion of oxygen and carbon dioxide
obstructive pulmonary disease, knowing that the Decrease in alveolar elastic recoil
client is most likely to experience what type of acid- Air trapping on inhalation resulting to oxygen
base imbalance? retention
Respiratory acidosis Impairment of exhalation of carbon dioxide
Respiratory alkalosis  
Metabolic acidosis Correct answer
Metabolic alkalosis Air trapping on inhalation resulting to oxygen
  retention
A client with pulmonary edema has been on diuretic  
therapy. The client has an order for additional A patient is presenting with chronic obstructive
furosemide (Lasix) in the amount of 40 mg IV push. pulmonary disease. The patient has a chronic
Knowing that the client also will be started on productive cough with dyspnea on excretion. Arterial
digoxin (Lanoxin), a nurse checks the client’s most blood gases show a low oxygen level and high
recent: carbon dioxide level in the blood. On assessment,
Digoxin level the patient has cyanosis in the lips and edema in the
Sodium level abdomen and legs. Based on your nursing
Potassium level knowledge and the patient's symptoms, you suspect
Creatinine level the patient suffers from what type of COPD?
 Smoking is a salient cause of COPD as it does the Chronic Bronchitis
following, except Emphysema
Damages the cilia Pneumonia
Increases mucous secretions in the airways Cystic fibrosis
Causes hypersecretion and hyperplasia of the  
mucous glands and goblet cells A client is receiving digoxin (Lanoxin) in the
Increases the amount of O2 in the terminal alveoli treatment of heart failure. The nurse would
  particularly assess the client for signs of digitalis
Prolonged expiration is manifested by clients with toxicity, namely
COPD for what purpose? Thrombocytopenia and weight gain
Expiration of retained carbon dioxide and to prevent Anorexia, and nausea, flickering lights
collapsed airways Diarrhea and hypotension
Expiration of retained oxygen and to prevent Fatigue and muscle twitching
collapsed airways
To contract abdominal muscles Correct answer
To expand the chest for maximum lung expansion Anorexia, and nausea, flickering lights
 
Correct answer
Expiration of retained carbon dioxide and to prevent
collapsed airways
Upon auscultation for heart sounds, the nurse
informed the physician of the presence of S3 heart
sounds. This implies
Presence of PVCs
Ventricular hypertrophy
Rapid ventricular filling
Atrial hypertrophy
 
Correct answer
Rapid ventricular filling
 
Clients with Emphysema are also called “puffers”
because they
Are cachexic and are easily fatigued
Retaining fatty pads around cheeks
Have barrel chests
Are trying to exhale the retained carbon dioxide
 
Which assessment would be most appropriate for a
patient who is receiving a loop diuretic for heart
failure?
Monitor liver function studies
Monitor for hypotension
Encourage the patient to spend time outdoors to aid
in vitamin D absorption
Restrict the intake of potassium  It allows the person with TB to appoint a person to
1A patient with emphysema may present with all of
the following symptoms EXCEPT?
barrel chest
hyperinflation of the lungs
hypoventilation
hypercapnia
SEMI-FINALS
For a client who has a chest tube connected to a
closed water-seal drainage system, the nurse should
include which action in the plan of care?
Measuring and documenting the drainage in the
collection chamber
Maintaining continuous bubbling in the water-seal
chamber
Keeping the collection chamber at chest level
Milking the chest tube every hour
 
The nurse enters the room of a client with COPD.
The client’s oxygen through nasal cannula is running
at a rate of 6L/minute, the skin color is pink, and the
RR is 9/minute and shallow. What is the nurse’s
initial action?
Take the heart rate and the blood pressure
Call the physician
lower the oxygen rate
position the client in orthopneic position
Correct answer
lower the oxygen rate
 
Which one of the following findings is characteristic
of a tension pneumothorax?
Tracheal deviation toward the affected side
Symmetry of the thorax and equal breath sounds
Tracheal deviation toward the unaffected side
Decreased heart rate and decreased respirations
Correct answer
Tracheal deviation toward the unaffected side
 
How does DOTS work in relation to the whole
course of TB treatment?
It allows a person with TB to be accompanied by an
assigned person to go to the health center daily for
administration of medications.
It assigns one person to watch and ensure the client
with TB takes the medications weekly.
supervise him/her to take the medications daily.
It assigns a person to observe and ensure that the
client with TB takes the correct medications daily
without fail.
 
 
The physician has ordered O2 at 2 liters/minute via
nasal cannula. O2 amounts greater than 2 liters /
minute are contraindicated in the client with COPD
because
Higher concentrations result in severe headache.
Hypercapnic drive is necessary for breathing
Higher levels will be required later to raise the pO2.
Hypoxic drive is needed for breathing.
 
Nurse Mickey is administering a purified protein
derivative (PPD) test to a homeless client. Which of
the following statements concerning PPD testing is
true?
A positive reaction indicates that the client has
active tuberculosis (TB).
A positive reaction indicates that the client has been
exposed to the disease
A negative reaction always excludes the diagnosis
of TB.
The PPD can be read within 12 hours after the
injection.
 
After insertion of the chest tube, the client becomes
hypotensive with neck vein distention, mediastinal
shift absent breath sounds and diaphoresis. The
nurse suspects a tension pneumothorax. For what
cause of tension pneumothorax should the nurse
check?
Infection of the lung
Kinked or obstructed chest tube
Excessive water in the water-seal chamber
Excessive chest tube drainage
While helping a client with a chest tube reposition in
the bed, the chest tube on her right chest becomes
dislodged. What is your immediate nursing
intervention?
Stay with the patient and monitor their vital signs
while another nurse notifies the physician.
Place a sterile dressing over the site and tape it on
three sides and notify the physician.
Attempt to re-insert the tube.
Keep the site open to air and notify the physician.
 
The nurse is instructing a patient about pursed-lip
breathing and the patient asks the nurse about its
purpose. The nurse should tell the patient that the
primary purpose of pursed lip breathing is to,
Promote oxygen intake
Strengthen the diaphragm
Strengthen the abdominal muscles
Promote carbon dioxide elimination
Correct answer
Promote carbon dioxide elimination
 What should the nurse conclude who observes
constant bubbling in the water-seal chamber of a
closed chest drainage system.
The system is functioning normally
The patient has pneumothorax
The system has an air leak
The chest tube is obstructed
Correct answer
The system has an air leak
 
Benefits of Interferon Gamma Release Assay (IGRA)
include the following, except
It tells whether the client has latent or active TB.
The client does not have to return for result reading.
There will be no false positive result for those who
received BCG vaccine.
 
A client with emphysema is prescribed corticosteroid
therapy on a short-term basis for acute bronchitis.
The client asks the nurse how the steroids will help
him. The nurse responds by saying that the
corticosteroids will do which of the following?
Promote bronchodilation.
Help the client to cough.
Prevent respiratory infection.
Decrease inflammation in the airways.
The nurse is preparing to suction a client via an
endotracheal tube. The nurse should plan to limit
suctioning time to a max of which time period?
5 sec
10 sec
30 sec
60 sec
 
Which client statement indicates to the nurse that
the client understands the discharge teaching for
ethambutol (Myambutol)?
"Constipation will be a problem, so I will increase
the fiber in my diet."
"Dizziness and drowsiness are common adverse
effects with this drug."
"I will need to have my vision checked periodically
while I am taking this drug."
"This medication may cause my bodily secretions to
turn red-orange-brown."
Correct answer
"I will need to have my vision checked periodically
while I am taking this drug."
 
What is the mode of transmission of pulmonary
tuberculosis (PTB)?
Through droplet transmission
Through fomites
Through airborne transmission
Correct answer
Through airborne transmission
 A client has a positive reaction to the PPD test. The
nurse correctly interprets this reaction to mean that
the client has:
Active TB
Had contact with or exposure to Mycobacterium
tuberculosis
Developed a resistance to tubercle bacilli
Developed passive immunity to TB.
A patient with a chest tube has no fluctuation of
water in the water seal chamber. What could be the
cause of this?
This is an expected finding.
The lung may have re-expanded or there is a kink in
the system.
The system is broken and needs to be replaced.
There is an air leak in the tubing.
Correct answer
The lung may have re-expanded or there is a kink in
the system.
 
How should the nurse, in preparing to perform
postural drainage, ascertain the best position to
facilitate clearing the lungs?
Inspection of lung expansion
Chest X-ray
ABG levels
auscultation of lung fields
Correct answer
auscultation of lung fields
 
A client has active TB. Which of the following
symptoms will he exhibit?
Chest and lower back pain
Chills, fever, night sweats, and hemoptysis
Fever of more than 38C and nausea
Headache
Correct answer
Chills, fever, night sweats, and hemoptysis  non-compliance.
The nurse is teaching a client with Chronic
Bronchitis about breathing exercises. Which of the
following should the nurse include in the teaching?
Make inhalation longer than exhalation
Exhale through an open mouth
Use diaphragmatic breathing
Use chest breathing
 
The most comfortable position for the client with
COPD is,
Semi-fowler's position
Sitting upright leaning forward
Lateral position
High fowler's position
 
Correct answer
Sitting upright leaning forward
 A patient is taking Streptomycin. Which finding
below requires the nurse to notify the physician?
Patient reports a change in vision.
Patient reports a metallic taste in the mouth.
The patient has ringing in their ears.
The patient has a persistent dry cough.
 
A male adult client with chronic bronchitis is
admitted with an acute respiratory infection.
Prescribed respiratory treatment includes chest
physiotherapy. When should the nurse perform this
procedure?
Immediately before a meal
At least 2 hours before or after a meal
When bronchospasms occur
When secretions have mobilized
 
INH treatment is associated with the development of
peripheral neuropathies. Which of the following
interventions would the nurse teach the client to help
prevent this complication?
Adhere to a low cholesterol diet
Supplement the diet with pyridoxine (vitamin B6)
Get extra rest
Avoid excessive sun exposure.
 
The primary purpose of DOTS is
To prevent drug resistance by ensuring treatment
compliance.
To allow client to have much freedom in the whole
course of the treatment regimen.
To make the health care provider’s job in tracking
To prevent unnecessary trips of the to the barangay
health center
 
A patient has a chest tube for treatment of a
pneumothorax in the left lung. Which finding during
your assessment requires immediate nursing
intervention?
The water seal chamber has intermittent bubbling.
The patient has slight tracheal deviation to the right
side
The water seal chamber fluctuates while the patient
inhales and exhales
The patient complains of tenderness at the chest
tube insertion site
 
Correct answer
The patient has slight tracheal deviation to the right
side
 
During the suctioning procedure, the client’s heart
rate may also
increase
decrease
Correct answer
Decrease
Which action by the nurse represents proper
nasopharyngeal/nasotracheal suctioning technique?
Lubricate the suction catheter with petroleum jelly
before and between insertion.
Apply suction intermittently while inserting the
suction catheter
Rotate the catheter while applying suction
Hyper oxygenate with 100% oxygen for 30 minutes
before and after suctioning
 
What information should the nurse provide to a client
prescribed rifampin (Rifadin)?
Oral contraception is the preferred method of birth
control when using rifampin.
The patient will only need to take this medication for
the prescribed 14-day period.
A nonharmful adverse effect of this medication is
red-orange discoloration of urine, sweat, tears, skin,
salvia, and feces.
Peripheral neuropathy is an expected side effect,
and the patient should report any numbness or
tingling of the extremities.
 
A client is receiving corticosteroid inhaler. When
teaching the client regarding possible complications
of this form of treatment, the nurse would include
which of the following?
weight loss
skin rash
Oral fungal infection(thrush)
Hypoglycemia
----------------------------------------------------
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?
tetany
hemorrhage
thyroid storm
laryngeal nerve damage
 
A goal of care for a client with Hyperthyroidism is to
maintain comfort by modifying the physical
environment. This can be achieved by telling him/her
to
Use a warm blanket at night
Maintain the room temperature at low-normal levels
Wear wool socks to bed
Use a humidifier in her bedroom
 
A client is receiving radioactive iodine treatment for
hyperthyroidism. What will you include in your
patient education to this client about this type of
treatment?
Taste changes and swollen salivary glands
Constipation
excessive thirst
sun protection
 
The nurse suspects accidental removal of the
parathyroids, which causes
tetany
adrenocortical stimulation
myxedema
hypovolemic shock
Correct answer
tetany
 
A clinic nurse is performing an assessment on a
client who has hypothyroidism. The nurse would
expect to note which clinical manifestation?
complaints of difficulty sleeping
complaints of diarrhea
significant weight loss since the last clinic visit
complains of intolerance to cold weather
 
A client is post-op from a thyroidectomy for
treatment of Grave’s Disease. When you walk into
the client’s room to perform an assessment, which of
the following findings causes the MOST concern and
needs nursing intervention?
The patient complains of a pain rating of 4 on 1-10
at the surgical site.
The patient is positioned in supine position
The patient’s Foley catheter is draining 50 cc of
urine per hour
The patient is splinting the neck while moving,
coughing, and sneezing
 
During preoperative teaching for a female client who
will undergo subtotal thyroidectomy, the nurse
should include which statement?
“The head of your bed must remain flat for 24 hours
after surgery.”
“You should avoid deep breathing and coughing
after surgery.”
“You won’t be able to swallow for the first day or
two.”
“You must avoid hyperextending your neck after
surgery.”
A client with thyroid cancer undergoes
thyroidectomy. After surgery, the client develops
peripheral numbness and tingling, muscle twitching
and spasms. The nurse should expect to administer,
as ordered,
thyroid supplement
An analgesic
A calcium channel blocker
IV calcium gluconate
A physician has prescribed propylthiouracil (PTU) for
a client with hyperthyroidism and the nurse develops
a plan of care for the client. A priority nursing
assessment to be included in the plan regarding this
medication is to assess for:
relief of pain
signs of renal toxicity
signs and symptoms of hyperglycemia
signs and symptoms of hypothyroidism
 
A client is 6 hours post-op from a thyroidectomy. The
surgical site is clean, dry and intact with no
excessive swelling noted. What position is best for
this patient to be in?
Fowler's
Prone
semi-fowler's
trendelenburg
 
The purpose of propylthioracil, which was ordered
for Irene would be
Interfere with the synthesis of thyroid hormone
Produce atrophy of the thyroid gland
Increase the uptake of iodine
Decrease the secretion of thyroid-stimulating
hormone
The physician has ordered serum thyroxine (T4)
concentration and serum cholesterol tests for a client
who is treated for adult-onset Myxedema. Which of
the following findings should the nurse expect?
Decreased serum T3 and T4, and decreased serum
cholesterol
Decreased serum T3 and T4, and increased serum
cholesterol
Increased serum T3 and T4, and increased serum
cholesterol
Increased serum T3 and T4, and decreased serum
cholesterol
 
Below are interventions in the plan of care for a
client with hypothyroidism, except
Providing a warm, comfortable environment for the
client.
Instructing the client to consume a high-fat diet.
Instructing the client about thyroid replacement
therapy.
Encouraging the client to increase fluid intake and
to include high-fiber foods in the diet.
 
A client is being educated on how to take his/her
anti-thyroid medication. Which of the following
statements is INCORRECT?
“I will continue taking aspirin daily.”
“I will on guard about signs and symptoms of
hypothyroidism.”
"It may take a while before I notice that the
medication is helping my condition
“I will avoid foods containing high levels of iodine.”
 
The medication which abolishes the tremors
exhibited by patients with Hyperthyroidism is
nifedipine
propanolol
heparin
calcium channel blockers
 
A patient with hyperthyroidism is taking
propylthiouracil (PTU). The nurse will monitor the
patient for:
gingival hyperplasia
dyspnea and a dry cough.
blurred vision and nystagmus
fever and sore throat.
 
To check for laryngeal damage post thyroidectomy,
the nurse should
Ask the client to do deep breathing every hour and
check for hyperventilation
Auscultate chest and check for wheezing sound
Ask the client to speak every hour and check for
voice hoarseness and changes
Ask the client to sing
 
A patient was recently discharged home for
treatment of hypothyroidism. The client is re-
admitted with signs and symptoms of the following:
heart rate 42, blood pressure 70/56, blood glucose
55, and body temperature of 96.8 ‘F. The patient is
very fatigued and drowsy. The family reports the
patient has not been taking the ordered thyroid
replacement since being discharged home from the
hospital. Which of the following conditions is this
client most likely experiencing?
thyroid storm
myxedema coma
iodism
toxic nodular goiter
 
A client with exophthalmos asks the nurse on how to
prevent damage to her protruding eyes. The
following should be relayed to the client, except
Elevating the head of the bed.
Limiting intake of salt.
Wearing of sunglasses when going out and awake
Exposing eyes to atmospheric air during sleep to
prevent damage to the cornea
Nurse Ruth assesses a client post thyroidectomy for
frequent swallowing, repeated clearing of the throat.
This assesses for presence of
tetany
hemorrhage
thyroid storm
laryngeal nerve damage
 
Correct answer
hemorrhage
 
After thyroidectomy, which of the following is the
priority assessment to observe laryngeal nerve
damage?
hoarseness of voice
difficulty in swallowing
tetany
fever
 
A client is being discharged home for treatment of
hypothyroidism. Which medication is most commonly
prescribed for this condition?
tapazole
PTU (propylthiouracil)
levothyroxine (synthroid)
propanolol
 
Of what precautions should a client receiving
radioactive iodine be made aware?
Drink plenty of fluids, especially those high in
calcium.
Avoid close contact with children or pregnant
women for one week after administration of drug.
Be aware of the symptoms of tachycardia,
increased metabolic rate, and anxiety
Wear a mask if around children or pregnant women.
 
Which medication order should the nurse question in
the client diagnosed with untreated hypothyroidism?
thyroid hormones
oxygen
sedatives
laxatives
 
An incoherent female client with a history of
hypothyroidism is brought to the emergency
department by the rescue squad. Physical and
laboratory findings reveal hypothermia,
hypoventilation, respiratory acidosis, bradycardia,
hypotension, and nonpitting edema of the face and
pretibial area. Knowing that these findings suggest
severe hypothyroidism, nurse Libby prepares to take
emergency action to prevent the potential
complication of:
thyroid storm
cretinism
myxedema coma
hashimoto's thyroiditis
 A clinic nurse is performing an assessment on a
client who has hypothyroidism. The nurse would
expect to note which clinical manifestation?
complaints of difficulty sleeping
complaints of diarrhea
significant weight loss since the last clinic visit
complaints of intolerance to cold weather
 
Which medication order should the nurse question in
the client diagnosed with untreated hypothyroidism?
thyroid hormones
oxygen
sedatives
laxatives
 
An immediate postoperative goal for thyroidectomy
is to prevent thyroid storm. The nurse should write
on the nursing care plan to observe for
hoarseness
tetany
bradycardia
an elevated temperature  Stopping the drug suddenly may cause acute
 
A physician prescribes levothyroxine sodium
(Synthroid), 0.15 mg orally daily, for a client with
hypothyroidism. The nurse will prepare to administer
this medication:
in the morning to prevent insomnia
only when the client complains of fatigue and cold
intolerance
at various times during the day to prevent tolerance
from occurring
three times daily in equal doses of 0.5 mg each to
ensure consistent serum drug levels
 
Correct answer
in the morning to prevent insomnia
 
During preoperative teaching for a female client who
will undergo subtotal thyroidectomy, the nurse
should include which statement?
The head of your bed must remain flat for 24 hours
after surgery.”
"You should avoid deep breathing and coughing
after surgery.”
“You won’t be able to swallow for the first day or
two.”
"You must avoid hyperextending your neck after
surgery.”
 
In a 29-year-old female client who is being
successfully treated for Cushing’s syndrome, nurse
Lyzette would expect a decline in:
Serum glucose level.
Hair loss.
bone density
menstrual flow
Correct answer
Serum glucose level.
 
What is the most common cause of Cushing
syndrome?
Endogenous glucocorticoid
Exogenous glucocorticoid
Pituitary gland adenoma Elevating the head of the bed
Tuberculosis
  Correct answer
A client who has been taking 80 mg of prednisone, a Administering IV Solu-Cortef
glucocorticoid, each day has been warned by his  
nurse to carefully follow a plan for the gradual A client with Addison's disease comes to the clinic
reduction of the dose rather than stopping the drug for a follow-up visit. When assessing this client, the
suddenly. What is the rationale for this instruction? nurse should stay alert for signs and symptoms of:
calcium and phosphorus abnormalities
adrenal insufficiency chloride and magnesium abnormalities
Sudden changes in glucocorticoid dosing may sodium and chloride abnormalities
reverse the therapeutic effects of the drug. sodium and potassium abnormalities
Sudden cessation of a glucocorticoid can result in  
adrenal gland hyperplasia The client is receiving prednisone as a lifetime
  supplementation for Addison’s disease. This is best
The most common cause of Cushing’s disease is given
adrenal tumors in the morning
ectopic ACTH production by tumors, usually of the in the evening
lung or pancreas at noon time
secreting pituitary adenoma in the afternoon
 
Correct answer A client is diagnosed with Cushing’s disease. The
secreting pituitary adenoma doctor ordered for the administration of calcium
  gluconate. The client asked for its purpose. As the
A client with Addison's disease will most likely nurse, how would you explain its necessity to this
exhibit which symptom? client’s treatment regimen?
Hypertension The client is at risk for osteoporosis because of a
bronze pigmentation possible decrease in serum calcium level
hirsutism The client is at risk for fractures because of
purple striae immobility
  The client is at risk for hyperkalemia
Cushing’s syndrome is a hormone disorder caused The client is at risk for fractures because of
by high levels of what hypercalcemia
Y Chromosomes  
Fiber in the digestive tract What IV fluid replacement would be most
Cortisol in the blood appropriate for patients with Addison’s disease?
Unprotected sexual contact D5W
  D5LR
Which of the following is not a typical sign and D5NSS
symptom of Cushing's Syndrome? D50W
Hyperpigmentation of the skin
hirsutism
Correct answer
purplish striae D5NSS
moon face  
  A patient known to having Addison’s disease has a
Which of the following is a nursing PRIORITY when
major dispute with a family member which had
caring for a client in Addisonian Crisis? caused him to be depressed. As the nurse, what
Administering IV Solu-Cortef
should you monitor this patient for?
Checking blood glucose emotional crisis
Monitoring low urine specific gravity
addisonian crisis 
thyroid crisis
financial crisis
 
In clients with Cushing’s disease or syndrome, what
electrolyte imbalances should you conscientiously
monitor?
Decreased sodium, increased potassium
Increased sodium, decreased potassium
Increased sodium, increased calcium
Decreased sodium, decreased potassium
A nurse is caring for a client with Addison's disease.
Which of the following nursing considerations should
be employed when caring for this client?
avoid sodium in the client’s diet
monitor increases in glucose level
document the specific gravity of urine
monitor increases in blood pressure
Correct answer
document the specific gravity of urine
 
Which of the following abnormal electrolyte
imbalances is EXPECTED with Addisonian Crisis?
Potassium level of 3.2
Sodium level of 112
High Blood glucose level
Low calcium level
 
Which of the following below is NOT a sign or
symptom of Addisonian Crisis?
Low blood pressure
hypokalemia
hyponatremia
hypercalcemia
 
The diet preferred for a client with Cushing
syndrome, in response to the electrolyte changes
will be
Low in sodium, high in potassium
High in sodium, low in potassium
High in sodium, high in potassium
Low in sodium, low in potassium
 
A patient with Cushing's syndrome will be
undergoing an adrenalectomy. Which of the
following will be included in the patient's discharge
teaching after the procedure?
Glucocorticoid replacement therapy for life
Avoiding food sources of iodine
Antibiotic therapy
Signs and symptoms of Grave's Disease
 
A nurse is admitting a client with a diagnosis of
Addison's disease to the hospital. On assessment,
the nurse would expect to note which finding that is
a manifestation of this disorder?
peripheral edema
excessive facial hair
lower than normal blood glucose level
high blood pressure
The following are effects of cortisol release, except
Decreased inflammatory responses
Increased immune response
Increased BP through sensitivity of the blood
vessels to epinephrine
Increased glucose level
 
A client is admitted to the hospital for evaluation for
Addison's disease. Which laboratory test result best
supports a diagnosis of Addison's disease?
BUN level of 12 mg/dl
Blood glucose level of 90 mg/dl
Serum sodium level of 134 mEq/L
Serum potassium level of 5.8 mEq/L
Correct answer
Serum potassium level of 5.8 mEq/L
 
A client diagnosed with Addison’s disease receiving
glucocorticoid therapy should be informed that stress
can have a damaging effect or consequence. This
damaging effect is
Hypoaldorsteronism
Cushing’s syndrome
Addisonian crisis
Diabetes mellitus
 A client with Addison's disease is scheduled for
discharge after being hospitalized for an adrenal
crisis. Which statements by the client would indicate
that client teaching has been effective?
"I have to take my steroids for 10 days."
"I need to weigh myself daily to be sure I don't eat
too many calories.
"I will call the doctor if I suddenly feel profoundly
weak or dizzy."
"If I feel like I have the flu, I'll carry on as usual
because this is an expected response."
The nurse is assessing a client with possible
Cushing's syndrome. In a client with Cushing's
syndrome, the nurse would expect to find?
Hypotension
Thick, coarse skin
deposits of adipose tissue/fats in the trunk and
dorsocervical area
weight gain in arms and legs
Correct answer
deposits of adipose tissue/fats in the trunk and
dorsocervical area
The physician ordered ECG monitoring in a client
with Cushing’s disease. What could be the possible
results?
Peaked T wave
Widened QRS complex
Absence of P wave
Presence of prominent U wave
Correct answer
Presence of prominent U wave
 
Addison’s Disease is:
Increased secretion of cortisol
Increased secretion of aldosterone and cortisol
Decreased secretion of cortisol
Decreased secretion of cortisol and aldosterone
 
Which of the following nursing implications is most
important in a client being medicated for Addison's
disease?
Administer oral forms of the drug with food to
minimize its ulcerogenic effect.
Monitor capillary blood glucose for hyperglycemia
Instruct the client to never abruptly discontinue the
medication.
Teach the client to consume a diet that is high in
potassium, low in sodium, and high in protein.
 
A client is diagnosed with Cushing’s syndrome.
Among the choices below, what could be a possible
cause of this syndrome?
Prolonged administration of glucocorticoid to a
client with rheumatoid arthritis
Tumors on the pituitary gland causing increased
amount of ACTH
Tumor in the lungs
Tumor in the adrenal cortex
Correct answer
Prolonged administration of glucocorticoid to a
client with rheumatoid arthritis
 
Osteoporosis may be manifested by clients
diagnosed with Cushing’s disease or syndrome. The
pathophysiologic causes are the following, except
The effect of osteoclasts on bones in response to
aldosterone release
The effect of osteoclasts on bones in response to
cortisol release
The imbalance between sodium and calcium
Hypocalcemia
FINALS
The nurse knows that glucagon may be given in the
treatment of hypoglycemia because it:
Inhibits gluconeogenesis
Stimulates the release of insulin
Increases blood glucose levels
Provides more storage of glucose
 
A client is receiving insulin lispro at 7:30 AM. The
nurse ensures that the client has breakfast by which
time?
8:45 am
7:45 am
8:55 am
9:00 am
 
A 28-yr-old male client with type 1 diabetes reports
how he manages his exercise and glucose control.
Which behavior indicates that the nurse should
implement additional teaching?
The client always carries hard candies when
engaging in exercise
The client goes for a vigorous walk when his
glucose is 200 mg/dL
The client has a peanut butter sandwich before
going for a bicycle ride.
The client increases daily exercise when ketones
are present in the urine.
 
A client is observed to have deteriorating level of
consciousness. Glucose test yield a glucose level of
49 mg/dl. You would anticipate that the initial
management for this client is
Oral intake of 10-15 grams of simple carbohydrate
Subcutaneous insulin injection
Subcutaneous glucagon or D50W
 
A client with newly diagnosed type 2 diabetes
mellitus asks the nurse what type 2 means in
relation to diabetes. The nurse explains to the
patient that type 2 diabetes differs from type 1
diabetes primarily in that with type 2 diabetes,
the client is totally dependent on an outside source
of insulin
there is a decreased insulin secretion and cellular
resistance to insulin that is produced
the immune system destroys the pancreatic insulin-
producing cells
the insulin precursor that is secreted by the
pancreas is not activated by the liver
A client recovering from DKA asks the nurse how
acidosis occurs. The best response by the nurse is
that,
insufficient insulin leads to cellular starvation, and
as cells rupture, they release organic acids into the
blood.
when an insulin deficit causes hyperglycemia, then
proteins are produced by the liver, causing acidic
by-products.
 
excess glucose in the blood is metabolized by the
liver into acetone, which is acidic.
an insulin deficit promotes breakdown of fat stores,
which produces large amounts of acidic ketones.
Correct answer
an insulin deficit promotes breakdown of fat stores,
which produces large amounts of acidic ketones.
An agitated, confused female client arrives in the
emergency department. Her history includes type 1
diabetes mellitus, hypertension, and angina pectoris.
Assessment reveals pallor, diaphoresis, headache,
and intense hunger. A stat blood glucose sample
measures 42 mg/dl, and the client is treated for an
acute hypoglycemic reaction. After recovery, the
nurse teaches the client to treat hypoglycemia by
ingesting:
2 to 5 g of a simple carbohydrate
10 to 15 g of a simple carbohydrate
18 to 20 g of a simple carbohydrate
25 to 30 g of a simple carbohydrate.
 
A client received 6 units of REGULAR INSULIN 3
hours ago. The nurse would be MOST concerned if
which of the following were observed?
kussmaul respirations and diaphoresis
anorexia and lethargy
diaphoresis and trembling
headache and polyuria
 
Nurse Andy has finished teaching a client with
diabetes mellitus how to administer insulin. He
evaluates the learning has occurred when the client
makes which statement?
"I should check my blood sugar immediately prior to
the administration.”
"I should provide direct pressure over the site
following the injection."
"I should use the abdominal area only for insulin
injections."
Trauma, infection, psychological stressors, intake of
steroids in clients with Diabetes Mellitus will
Increase his/her insulin need
Decrease his/her insulin need
 
A newly diagnosed type 1 diabetic client likes to run
3 miles several mornings a week. Which teaching
will the nurse implement about exercise for this
client?
"You should not take the morning NPH insulin
before you run."
"Plan to eat breakfast about an hour before your
run."
 
"Afternoon running is less likely to cause
hypoglycemia."
"You may want to run a little farther if your glucose
is very high."
A 1200-calorie diet and exercise are prescribed for a
patient with newly diagnosed type 2 diabetes. The
patient tells the nurse, "I hate to exercise! Can't I just
follow the diet to keep my glucose under control?"
The nurse teaches the patient that the major
purpose of exercise for diabetics is to
Increase energy and sense of well-being, which will
help with body image.
Facilitate weight loss, which will decrease
peripheral insulin resistance
Improve cardiovascular endurance, which is
important for diabetics
Set a successful pattern, which will help in making
other needed changes.
 
Which of these is the most helpful in evaluating this
patient’s long term glucose management?
The patient’s food diary
Urine specific gravity
Hemoglobin A1c
Fasting blood glucose level
 
A patient who has type 1 diabetes plans to swim
laps for an hour daily at 1:00PM. The clinic nurse will
plan to teach the patient to
check glucose level before, during, and after
swimming.
delay eating the noon meal until after the swimming
class.
increase the morning dose of NPH insulin
time the morning insulin injection so that the peak
occurs while swimming.
 
Long-acting insulin (Lantus) is not food dependent
considering that
The client does not manifest hypoglycemia as a
side-effect
The client loses his/her ability to absorb food while
taking this type of insulin
It does not have a peak action
It is a fast-acting insulin
 
This is the hyperglycemic episode early in the
morning brought about by the increase in the release
of the counterregulatory hormones in response to
the hypoglycemia occurring around 2-3 am.
Somogyi phenomenon
Hyperglycemic coma
Dawn phenomenon
Lipodystrophy
 
This is a hyperglycemic episode upon morning
awakening brought about by the excessive release
of growth hormone and cortisol early in the morning
Somogyi phenomenon
Hyperglycemic coma
Dawn phenomenon
Lipodystrophy
 
Clients with type 1 diabetes may require which of the
following changes to their daily routine during
periods of infection?
No changes
Less insulin
More insulin
Oral antidiabetic agents
 
The nurse imparts teaching to the client about
management of hypoglycemic episodes post insulin
therapy. Health teachings include the following
except,
Carrying fast-acting simple carbohydrate with the
client
Be knowledgeable about the signs and symptoms of
hypoglycemia
ingest high-fat food if food sources of simple
carbohydrates are not available
 
When teaching a diabetic patient, the nurse should
emphasize that exercise
Prevents mental deterioration
Often decreases insulin requirement
Prevent muscle dystrophy
Often improve visual acuity
Correct answer
Often decreases insulin requirement
 
The nurse is teaching a client how to mix regular
insulin and NPH insulin in the same syringe. Which
action, if performed by the client, indicates the need
for further teaching?
Withdraws the NPH insulin first
Withdraws the regular insulin first
Injects air into NPH insulin vial first
Injects an amount of air equal to the desired dose of
insulin into each vial
The nurse is providing education to a group of
clients newly diagnosed with type 1 diabetes
mellitus. One client asks why the glycosylated
hemoglobin blood test (HbA1c) is done. What is the
nurse’s best response?
HbA1c measures hemoglobin level in addition to
blood glucose level
HbA1c is used to assess long-term
glycemic/glucose control, particularly in 2-3 months
HbA1c provides information about conditions that
effect a red blood cell's life span
HbA1c provides information about serum protein
and albumin
The nurse teaches the diabetic patient who rides a
bicycle to work every day to administer morning
insulin into the
thigh
buttock
arm
abdomen
A client is brought to the emergency department in
an unresponsive state, and a diagnosis of
hyperglycemic hyperosmolar nonketotic syndrome is
made. The nurse would immediately prepare to
initiate which of the following anticipated physician's
prescriptions?
Endotracheal intubation
100 units of NPH insulin
Intravenous infusion of normal saline
Intravenous infusion of sodium bicarbonate
 
A client with type 1 diabetes mellitus has influenza.
The nurse should instruct the client to:
Increase the frequency of self-monitoring (blood
glucose testing) because there is a possibility of a
spike in blood glucose level
Reduce food intake to diminish nausea.
Discontinue that dose of insulin if unable to eat.
Take half of the normal dose of insulin
 
A 37-year-old forklift operator presents with
shakiness, sweating, anxiety, and palpitations and
tells the nurse he has type 1 diabetes mellitus.
Which of the follow actions should the nurse do first?
Inject 1 mg of glucagon subcutaneously
Administer 50 mL of 50% glucose I.V.
Give 4 to 8 oz of orange juice
Give the client ½ teaspoon sugar.
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?
“You’ll need more insulin when you exercise or
increase your food intake.”
“You’ll need less insulin when you exercise or
reduce your food intake.”
“You’ll need less insulin when you increase your
food intake.”
“You’ll need more insulin when you exercise or
decrease your food intake.”
Dr. Lao orders insulin lispro (Humalog) 10 units for
Alicia, a client with diabetes mellitus. When will the
nurse administer this medication?
When the client is eating
Fifteen minutes before meals
When the meal trays are on the way to the unit
30 minutes before meals
Correct answer
Fifteen minutes before meals
 
Blood sugar is well controlled when Hemoglobin This phase happens before the nurse meets the Diarrhea
A1C is: patient and is a time for building self-awareness. Hypertension
Below 7%  pre interaction phase   
Between 12%-15% orientation phase These are oral hypoglycemic medications which
Less than 180 mg/dL termination phase cause a decrease in glucose production in the liver,
Between 90 and 130 mg/dL working phase increase in insulin sensitivity by acting on adipose
  tissue, and an increase in musculoskeletal glucose
Kenny, a patient with DM, is taught to rotate the A nurse is contemplating the use of self-disclosure. utilization.
sites of his insulin injections because, if only one site The expected outcome of this strategy is that the Alpha-glucosidase inhibitors
is used, patient will: Biguanides
There is more pain be informed about expected behaviors Meglitinides
Disfiguring scar tissue forms express previously withheld feelings Thiazolidinediones
The rate and amount of absorption decreases foster a mutually supportive relationship with the
Capillary trauma causes hematoma development nurse
  recognize that the nurse can empathize through Correct answer
Correct answer shared experiences Thiazolidinediones
The rate and amount of absorption decreases  
The nurse assists the patient to develop coping
During which phase of the therapeutic relationship Correct answer skills, positive self-concept and independence in
the nurse defines the boundaries of the nurse client express previously withheld feelings order to change the behavior of the client to one that
relationship?   is adaptive and appropriate. This occurs during what
working A patient with type 2 diabetes is scheduled for an phase of the nurse-client relationship
problem identification outpatient coronary catheterization. Which orientation
orientation information obtained by the nurse when admitting preorientation
termination the patient indicates a need for a change in the termination
  patient's regimen? working
This is done by the introduction of the roles and The patient's most recent hemoglobin A1C was 6%.  
expectations, agreement on the time, place and The patient takes metformin (Glucophage) every If an OHA delays the carbohydrate digestion in the
length of sessions and the purpose of the morning. small intestine, it should be
relationship between the nurse and the client. The patient uses captopril (Capoten) for Taken an hour after ingestion of food
Formulation of contract hypertension. Taken an hour before ingestion of food
Therapeutic use of self The patient's admission blood glucose is 128 mg/dl. Taken with first bite of food
Self-disclosure Taken with an antacid
Positive regard
  Correct answer
The nurse teaches a client newly diagnosed with Correct answer Taken with first bite of food
type 1 diabetes about storing Humulin N insulin. The patient takes metformin (Glucophage) every  
Which statement indicates to the nurse that the morning. A client recently diagnosed with diabetes mellitus is
client understood the discharge teaching?   taking Humulin NPH insulin daily. The client asks the
“I should keep the insulin in the cabinet during the Acceptance, trust and boundaries are established nurse how to store the unopened vials of insulin
day only.” during which phase of the therapeutic nurse-client which will not be used for one month.  The nurse
“I know I have to keep my insulin in the refrigerator relationship? should tell the client to take which action?
at all times.” termination Freeze the insulin.
“I can store the open insulin bottle at room orientation Refrigerate the insulin.
temperature for 1 month.” working Store the insulin in a dark, dry place.
“The best place for my insulin is on the windowsill, preinteraction Keep the insulin at room temperature.
but in the cupboard is just as good.”  
Because of its mechanism of action, acarbose, an Correct answer
Correct answer alpha-glucosidase inhibitor, has the following side- Refrigerate the insulin.
“I can store the open insulin bottle at room effects, except  
temperature for 1 month.” Abdominal cramps
  Flatulence
As it can cause extreme hypoglycemia, a client The nurse should caution the client with diabetes Alpha-glucosidase inhibitors
taking diamicron, a sulfonylurea, is advise not to mellitus who is taking a sulfonylurea that alcoholic  
Ingest alcoholic beverages beverages should be avoided while taking these Biguanides
Administer it together with an antihypertensive drugs because they can cause which of the Meglitinides
medication following? Thiazolidinediones
Go through cardiac catheterization hypokalemia  
Ingest aspirin hyperkalemia Sympathy is the ability to understand another
  hypocalcemia person's thoughts and feelings in a situation from
The nurse must uphold confidentiality at all times hypoglycemia their point of view, rather than your own.
regardless of the situation.   true
true This is the phase of the nurse-client relationship false
false where the nurse gathers information through  
perusing the chart of the client, knowing client Which phase of the nurse client relationship includes
Correct answer history and planning for the first interaction. in-depth exploration of the client’s feelings and
false working phase participation in identifying his or her own problems?
  orientation phase working
Which of the following terms describes the termination phase termination
relationship that has occurred when the nurse preorientation phase orientation
responds to the client based on his/her personal   beginning
unconscious needs, conflicts and projects his/her When teaching the diabetic client about foot care,  
own unresolved conflicts unto the client? the nurse should instruct the client to do which of the Which of the following behaviors occurs when the
self-disclosure following? nurses voice or body language is consistent with the
transference Avoid going barefoot. words he or she speaks?
countertransference Buy shoes a half size smaller empathy
exploitation Cut toenails at angles genuine interest
Use heating pads for sore feet trust
Correct answer   congruence
countertransference One of the clients on the psychiatric unit has made  
  comments to the nursing student that he finds her A diabetic client has undergone cardiac
The student nurses are taught that they should have cute and wants to know more about her. Which of catheterization and his dose of metformin is withheld
an unconditional and non-judgmental attitude and the following terms is applied to the situation when for 48 hours. One crucial nursing responsibilities in
the relationship with mental health clients. The the client unconsciously shows the same types of this particular situation is
students are expected to call the client by name and feelings for the nurse that he or she has for a Renal function monitoring
spend time with the client. These actions are significant other? Deep tendon reflex monitoring
examples of which of the following? transference Educating client about increasing fluid intake
value countertransference Monitoring client’s visual acuity
positive regard exploitation  
empathy self-disclosure To provide structure is to intervene when the client
excepting loses control of his own feelings and behaviors by
Correct answer medications, offering self, restrain, seclusion and by
Correct answer transference assisting client to observe a consistent daily
positive regard   schedule. This occurs during what phase of the
  To provide structure is to intervene when the client nurse-client relationship.
This component of the nurse-client relationship loses control of his own feelings and behaviors by orientation
shows that the nurse does not respond negatively medications, offering self, restrain, seclusion and by preorientation
and become punitive when the client exhibits anger assisting client to observe a consistent daily termination
and violent behaviors. schedule. working
trust true  
empathy false Clinical manifestations of diabetic neuropathy
countertransference   include the following, except
acceptance These are oral hypoglycemic agents which delay the gastric paresis
  absorption of glucose. Microalbuminuria
paresthesia
non healing wounds and ulcers
 
A student nurse asks, “What is so wrong about being
sympathetic with a patient who has also lost a parent
like I did?” The clinical instructor responds:
“There is a fine line between empathy and
sympathy that when crossed makes you less able to
be therapeutic.”
“Rather than discussing the loss of your parent with
the patient, you can talk to me about it whenever
you need to.”
“I’ll provide you with some excellent materials that
I’m sure will help you to understand why sympathy
is less therapeutic.”
“Sympathy indicates that you are sharing your
personal feelings and that changes the focus of the
communication from the patient to you