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This chapter is from the book

This chapter is from the book

Apply Your Knowledge

The nurse reviewing for the licensure exam must be able to apple knowledge to meet client needs. Utilization of information found in this chapter will help the graduate to answer questions found on the NCLEX.

Exam Questions

  1. The client is admitted to the hospital with a prolactinoma. Which symptom is not associated with a pituitary tumor?

    1. Amenorrhe
    2. Headache
    3. Blurred vision
    4. Weight loss
  2. Which of the following is the drug commonly used to treat a prolactinoma?

    1. Gemcitabine (Gemzar)
    2. Gefitinib (Iressa)
    3. Cabergoline (Dostinex)
    4. Ganciclovir (Cytovene)
  3. The client is admitted with Hashimoto’s thyroiditis. The nurse is aware that he will exhibit signs of which of the following?

    1. Hyperthyroidism
    2. Hypothyroidism
    3. Hypoparathyroidism
    4. Hyperparathoidism
  4. Management of hyperthyroidism might include a prescription for which of the following?

    1. Propylthiouracil (PTU)
    2. Fludrocortisone (Florinef)
    3. Levothyroxine (Synthyroid)
    4. Glipizide (Glucotrol)
  5. The client is admitted to the recovery room following a thyroidectomy. Which of the following actions by the nurse indicates understanding of care of the client with a thyroidectomy?

    1. The nurse offers extra blankets.
    2. The nurse places a tracheostomy tube at the bedside.
    3. The nurse insists that the client refrain from talking.
    4. The nurse administers pain medication every four hours.
  6. The nurse is checking for hypoparathyroidism. To check for hypoparathyroidism, the nurse can check for the positive presence of which of the following signs?

    1. Kernig’s
    2. Chadwick
    3. McBurney’s
    4. Chvostek’s
  7. A client with Cushing’s disease often complains of which of the following?

    1. Anorexia
    2. Difficulty swallowing
    3. Hirsutism
    4. Hot flashes
  8. The most indicative test for diabetes mellitus is which of the following?

    1. Two hour post-prandial
    2. Dextrostix
    3. Glucose tolerance test
    4. Hemoglobin A-1C
  9. The diabetic is being maintained on rosiglitazone (Avandia). Which lab test should be checked frequently?

    1. TSH levels (thyroid-stimulating hormone levels)
    2. AST levels (aspartate aminotransferase levels)
    3. HCG levels (human gonaditropin levels)
    4. LDH levels (lactic dehyrogenase levels)
  10. The nurse is preparing to administer NPH insulin to the diabetic client. The nurse is aware that the onset of NPH insulin is which of the following?

    1. Five minutes
    2. Thirty minutes
    3. Ninety minutes
    4. Four hours

Answers to Exam Questions

  1. Answer D is correct. Prolactinoma tumors are tumors arising from hyperplasia of the pituitary gland that are prolactin hormone–based. Amenorrhea and anovulation are associated with prolactinomas because the pituitary gland assists with stimulation of the ovaries and ovulation, so answer A is incorrect. Because the pituitary is located in the center of the skull, adjacent to the brain, answers B and C are associated with increased intracranial pressure. Answer D is incorrect because weight gain can occur, not weight loss.
  2. Answer C is correct. Dostinex is used to shrink the prolactin-based tumor. Answers A and B are antineoplastic drugs. Answer D is an antiviral medication.
  3. Answer B is correct because in Hashimoto’s thyroiditis, antibodies against thyroid hormone are produced, which leads to a decrease in thyroid hormone release. For this reason answers A, C, and D are incorrect.
  4. Answer A is correct. Propylthiouracil (PTU) is an antithyroid medication. Answer B is incorrect because this is a cortisone preparation. Answer C is incorrect because this drug is used for hypothyroidism. Answer D is incorrect because this drug is used to treat diabetes.
  5. Answer B is correct. The thyroid is located anterior to the trachea; therefore, laryngeal stridor and airway obstruction is a risk following a thyroidectomy. Answer A is incorrect because this action is not necessary. The need for extra blankets is associated with hypothyroidism, but is not directly associated with thyroid surgery. Answer C is incorrect because the client can talk. Answer D is incorrect because pain medication should be offered as needed, not every four hours.
  6. Answer D is correct. The test for Chvostek’s sign is performed by tapping the facial nerve (C7) and the trigeminal nerve (C5) and observing for grimacing. Answer A is incorrect because Kernig’s sign is nuchal (neck) rigidity associated with meningitis. Answer B is incorrect because Chadwick’s sign is a bluish vagina associated with hormonal changes. Answer C is incorrect because McBurney’s sign is rebound tenderness associated with appendicitis.
  7. Answer C is correct. Hirsutism is facial hair. This is associated with hypersecretion of cortisol. Answers A, B, and D are not associated with Cushing’s disease.
  8. Answer C is correct. The most indicative test of diabetes is the glucose tolerance test. Answers A and B are used to detect an elevated blood glucose level, but are not the best to detect diabetes. Answer D is incorrect because this test detects compliance.
  9. Answer B is correct. Liver enzymes such as AST should be assessed along with renal function (creatinine levels) and cardiac function. Answer A is not correct because this medication does not alter thyroid function. Answer C is not correct because HCG levels are not affected by rosiglitazone (Avandia). This hormone is associated with pregnancy. Answer D is incorrect because an elevated LDH is associated with muscle trauma. It is, however, elevated in a myocardial infarction.
  10. Answer C is correct. NPH insulin onset is 90–120 minutes. Answer A is incorrect because Novalog insulin onset is 5–10 minutes. B is incorrect because regular insulin onset is 15–30 minutes. D is incorrect and is not associated with the onset of any insulin.
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