MDII Multidimensional II
Please answer it in nursing perspective
A client tells the nurse he is thirty’. The lab results
A. syndrome of inappropriate antidiuretic hormone secretion (SIADH)
B. Diabetes insipidus
C. Diabetes mellitus
2. The client has just received a round of chemotherapy and will discharged home. The nurse is educating the client about the concerns of neutropenia and the continuing risk for infection. Which of the following statements would not be appropriate given the client’s situation?
A. “If you experience a fever. Treat it with over-the-counter medication and report it to your physician if symptoms don’t resolve in 48 hours’
B. “bathe daily, or wash armpits and perineal area twice daily with antimicrobial soap.”
C. “Wash your hands thoroughly with an antimicrobial soap before you eat and drink.”
D. “Avoid crowds and other large gatherings of people who might be ill.”
3. A nurse is providing client and family education for a client diagnosed with irritable bowel syndrome. Which of the following is important to include in the education? (Selection all that apply)
A. Adhere to prescribed medications
B. Modify diet
C. Limit fluid intake
D. Stress reduction
E. Limit physical activity
4. After completion of external radiation treatment for cancer, a client tells the oncology nurse about an upcoming vacation to the beach to celebrate. What response by the nurse is most appropriate to the client?
A.” Have a wonderful time and enjoy your vacation”
B. “Remember you should not drink alcohol for a year.”
C. “Avoid submerging in saltwater on the radiation site.”
D.” Protect your skin, avoid exposure of the radiation area to direct sunlight.”
5. A client was admitted with the following arterial blood gas(ABG). How does the nurse interpret these results?
PaC02 30mm Hg
Hc03 17 mEq/L
Pa02 92 mm Hg
A. Respiratory acidosis with full metabolic compensation
B. Metabolic acidosis with full respiratory compensation
C. Respiratory alkalosis with full metabolic compensation
D. Metabolic alkalosis with full respiratory compensation
6. A client is diagnosed with metastatic cancer. The family asks the nurse. “What the difference between hospice and palliative care?” The nurse correctly responds with which statement?
A. “Palliative care is to prevent and treat symptoms and side effects of cancer treatments.”
B.” Hospice is for clients with a prognosis of less than 12 months to live.”
C.” Hospice care allows for continued chemotherapy treatments, and palliative care does not.”
D. “Palliative care requires revaluation every 30 days.”
7. The nurse is assessing a client recently diagnosed with leukemia. Which of the following assessment finding would support that diagnosis?
A. Blood in stool
B. Blood in urine
C. Cough or hoarseness
D. Petechiae or ecchymosis
8. Which of the following teaching instructions would not be accurate as a prevention strategy to reduce the risk of oral cancer?
A.” Avoid sun exposure to lip.”
B. “Stop use of tobacco and alcohol.”
C. “Avoid exposure to human papillomavirus (HPV).”
9. A nurse is caring for a client admitted with mild acute pancreatitis. Which of the following are treatment options for the early stages of mild acute pancreatitis? (Select all that apply)
A. Assess and manage pain
B. Nothing by mouth for 24 to 48 hours
C. Measure and document accurate intake and output
D. Encourage early oral nutrition
E. Assess labs for amylase and lipase levels
10. A nurse is caring for a client recently diagnosed with thyroid cancer. Which of the following lab results will validate this diagnosis?
A. Decreased serum thyroglobulin (TG)
B. Increased serum phosphorus level
C. Increased serum thyroglobulin (TG) level
D. Increased serum calcium level
11. A. A nurse is caring for an adolescent client who has a long history of diabetes mellitus and being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected. The nurse should anticipate using which of the following types of insulin to be given intravenously to treat client?
A. Insulin detemir
C. NPH insulin
D. Insulin glargine
12. A client underwent a colon resection with colostomy placement. Which of the following would the surgeon consult post-operatively for colostomy management?
A. Wound Ostomy Continence Nurse
C. Physical therapy
D. Respiratory therapy
13. The laboratory values of a client with diabetes mellitus include a fasting glucose level of 92 mg/dL and hemoglobin A1C of 5.9%. What are the nurse’s interpretations of these findings?
A. The client’s glucose control for the fasting has been poor, and the overall control is poor.
B. The values indicate that the client needs further disease management education
C. The client’s glucose control for the fasting glucose and past 90 days demonstrates good control
D. The values indicate that the client has poorly managed their disease.
14. A nurse is providing care to a client that is diagnosed with hypokalemia. After reviewing the client’s current medications. Which of the following might have contributed to hypokalemia?
D. Loop diuretics
15. Which of the following is a life-threatening emergency and serious complication of untreated or poorly treated hypothyroidism?
A. Thyroid storm
B. Myxedema coma
C. Endemic goiter
D. Multinodular toxic goiter
16. A nurse is caring for a client recently diagnosed with colorectal cancer . Which of the following lab values would confirm the diagnosis?
A. Decreased white blood count
B. Increased carcinoembryonic antigens ( CEA)
C. Increased serum creatinine
D. Decreased albumin
17. A nurse is caring for a client recently diagnosed with diabetes insipidus. Which of the following medication would be appropriate for this disorder?
D. Growth hormone antagonist
18.The nurse is providing discharge education to a client diagnosed with anorexia nervosa. Which statement by the client would indication the client needs further education?
A. “ I need to keep a food journal of my progress, food intake, and timing of meals.”
B. “If I feel constipated I will start an over-the- counter oral laxative .”
C. “ I will take my multivitamins, zinc, and iron as prescribed to prevent malnutrition
D.”I will schedule an outpatient session with a counselor to talk about my fear of gaining weight.”
19. A nurse is providing teaching to a client about hyperglycemia. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations specific to hyperglycemia? (Select all that apply)
20.The nurse is assessing a client diagnosed with type 1 diabetes mellitus for symptoms associated with diabetic ketoacidosis. Which of following will the nurse most likely assess in this client? ( select all that apply)
A. Fluid overload
B. Fruity breath odor
C. Kussmaul breathing
D. Altered mental status
21. The nurse instructs the client on prologed cortisol therapy to report which signs and symtoms?
A. Anorexia and muscle twitches
B. Hypotension and fluid loss
C. Weight gain and moon face
D. Anuria and hypoglycemia
22.A nurse is caring for a client in the emergency room after a motor vehicle accident. The client is unconscious with a cervical collar in place. The client has been diagnosed with syndrome of inappropriate antidiuretic hormone ( SIADH)secretion. Which of the following lab values validates the diagnosis?
A. Decreased urine osmolality
B.Increased serum sodium
Decreased glomerular filtration rate
D. Decreased serum sodium
23. A nurse caring for a client who has diverticulitis. Which of the following is a clinical manifestation of diverticulitis?
A. Localized lower abdominal pain
B. Generalized upper abdominal pain
24. The nurse is providing care for a client who underwent a parathyroidectomy two days ago . To prevent complications with this surgery, which laboratory value requires close monitoring by the nurse?
A. Serum sodium levels
B. Serum blood glucose levels
C.Serum potassium levels
D. Serum calcium levels
25.A client complains of weight gain, has thin extremities, a buffalo hump, moon face, and a protruding abdomen. The nurse realizes that this client is most likely to be diagnosed with which disease process?
A. Addison’s disease
B. Cushing’s syndrome
26. Which nursing intervention helps to prevent adrenocortical insufficiency?
Reducing high dose steroid therapy gradually
Administer diuretic therapy
Discontinuing high dose steroid therapy quickly
Teaching the client about a low sodium diet
27.The nurse would incorporate which of the following into the plan of care as a primary prevention strategy for reduction of the risk for cervical cancer?
Colonoscopy at age 50 and every 10 years as follow up
Yearly prostate specific anitigen ( PSA) and digital rectal exam for men aged 50 and over
Administering the human papillomavirus(HPV) vaccine
Yearly mammography for women age 40 years and older
28. The nurse knows which statement is true about age related charges and the endocrine system in older adults?
The thyroid gland enlarges
Adrenal glands enlarge
Thyroid hormone secretion decreases
Decreased hormone sensitivity
29.An 8months old infant is hospitalized with severe diarrhea, The nurse knows that which of the following is the following is the major problem associated with severe diarrhea
a. Electrolyte and fluid loss
b. presence of excessive flatus
c. pain in the abdominal area
d. irritation of the perineal and rectal area
30. The nurse is caring for a client with end stage renal failure. PaO2 is 94 mm hg,Arterial blood gases indicate that she is experiencing metabolic acidosis with partial respiratory compensation. Which of the following arterial blood gases support this?
PH=7.37, PaCO2=33mm hg, HCO3=18 mEq/L
PH=7.33,PaCO2=31mm hg, HCO3=19 mEq/L
PH=7.47, PaCO2=50mm hg, HCO3=30 mEq/L
PH=7.32, PaCO2=48mm hg, HCO3=18 mEq/L
31. The nurse is caring for a diabetic client with a blood glucose of 56mg/dL. The client is difficult to arouse. What action would the nurse take?
Give a complex carbohydrate and monitor the client
Give a glass of orange juice with three sugar packets mixed in and monitor the client.
Administer 50% dextrose (D500IV push per order and monitor the client
Give a glass of milk and monitor the client
32. The nurse is caring for a client with a new diagnosis of adrenal insufficiency. Which of the following would the nurse expert upon assessment? Select all that apply
33. A nurse is caring for a client with an opioid overdose. The client is difficult to arouse. The vita signs include blood pressure 90/60 mm Hg respirations 10/minute heart rate 60beat /minute. The arterial blood gas (ABG) result includes a PH 7.34. Pa Co2 48mm Hg Hco324mEq/L pa02 of 76mm Hg. How would the nurse interpret this result?
Respiratory acidosis with partial metabolic compensation and hypoxemia
Metabolic acidosis not compensated with normal oxygenation.
Respiratory alkalosis not compensated with hypoxemia
Respiratory acidosis not compensated with hypoxemia
34. The nurse is caring for a 46year old female client who presented to the emergency department with dizziness . Nausea , vomting , and fatigue over the past few days . The client has recently been diagnosed with breast cancer and has been undergoing chemotherapy . The client labs reveal the folowing . Na 150 mEq/MlL , potassium 3.0 mEqmL , calcium 15mg/dl . Which of the following imbalances is the client exhibiling ?
Hypernatremia, hypokalemia, hypercalcemia
Hypervolemia, hypercalemia , hyperkalemia
Hypovolemia and hypercalcemia
35. A medcation order state, administer 100 mEq of potassium chloride po twice a day . Available is potassium chloride oral soluttion 40mEq15ML. How many ML should the nurse administer per dose? Rcord answer as a whole number. Do not use a trailing
36. The nurse is providing care to a client diagnosed with fluid volume deficit. Which of the following assessment dates is greatest cancer?
There is prolonged skin tenting over the sterum
The blood pressure is 86/40 mm Hg
Urine output is 40 ml over the last hour
Oral fluid intake is 100 ml for the last 8 hours
37. A nurse is caring for a 57years old Hispanic male who was recently diagnosed with cushing disease . Which of the following lab tests validates the diagnosed?
Elevated lymphocyte count
Elevated urine cortisol level
Decrease late – night salivary cortisol test
Decrease urine specific gravity
38. A nurse is teaching a client with diabetes mellitius who asks , why is it necessary to maintain my blood gulcose levels no lowe than about 60 mg/ dl ( 3.3mmol/l ? How would the nurse respond ?
Your brain needs a constant suppy of glucose because it cannot store it.
Glucose in the blood prevent the formation of lactic and prevent acidosis
Glucose is the only fuel used by the body to produce the energy that it needs
Without a minimum level of glucose , your body does not make red blood cells.
39. After chemotherapy for cancer, a client develops chemotherapy induced nausea and vomiting (CINV). For this client, the nurse should give the highest priority to which action in the plan of care?
A. With holding fluids for the first 4-6 hrs after chemotherapy administration
B. Administering an antiemetic medication as prescribed
C. Serving small portions of bland food
D. Encouraging rhythmic breathing exercises
40. A nurse assesses a client who is recovering from an ileostomy placement. Which clinical manifestation would alert the nurse to contact the health care provider urgently.
A. A bluish stoma
B. Liquid stool
C. Blood smeared output
D. Ostomy pouch intact
41. A nurse is educating a newly diagnosed type 1 diabetic client. Which education topic is the nurse’s priority.
A. Sexual dysfunction can develop
B. Carbohydrate counting
C. Exercise vigorously only if blood glucose is 100-250 mg/dl
D. Signs and symptoms of hypoglycemia
42. The nurse is caring for a client diagnosed with diverticulitis. Which of the following orders would be expected for this client?
An enema to attempt to flush out the undigested food trapped in the diverticula. Which of the following orders would be expected for this client?
Laxatives to ensure passage of fecal matter through the intestines.
Stool softeners to prevent constipation which will lead to further complications.
A diet consisting of protein from seeds and nuts
43. A 56-year-old male was recently diagnosed with type 2 diabetes. Which of the following diagnostic tests would correlate with this diagnosis? (Select all that apply).
A. Increased random blood glucose
B. Increased hemoglobin A1c
C. Increased fasting blood glucose
D. Increased hemoglobin
44. A 42 year old female presents to the emergency room with mid-upper abdominal pain radiating to her right shoulder, rebound tenderness, nausea and dyspepsia. Based on the client’s presentation, which of the following does the nurse anticipate is the client’s diagnosis
A. Diverticular disease
45. A client was admitted with the following arterial blood gas (ABG). How does the nurse interpret these results?
A. PH 7.32
B. PaC02 50 mm Hg
C. Hc03 30 mEq/L
D. Pa02 75 mm Hg
46. A client was admitted with the following arterial blood gas (ABG). How does the nurse interpret these result?
PaC02 30 mm Hg
Hc03 18 mEq/L
Pa02 85 mm Hg
Metabolic acidosis with partial respiratory compensation
Metabolic alkalosis with partial respiratory compensation
Respiratory alkolosis with partial metabolic compensation
Respiratory acidosis with partial metabolic compensation
47. A nurse is caring for a client admitted for an exacerbation of Crohn’s disease. A nasogastric (NG) tube has been placed and is connected to suction, and the client is currently receiving an infusion of total parenteral nutrition via a peripherally inserted central catheter (PICC) line. Which of the following actions should the nurse take?
A. Monitor the flow rate of the parenteral nutrition carefully and increase the rate as needed if it falls behind.
B. Monitor laboratory values and asses for abnormal respiratory or cardiac functioning.
C. Place the parenteral nutrition solution on a warming device during infusion.
D. Remove unused parenteral nutrition after 12 hours of use.
48. A nurse is reviewing lab values for a client and notes a potassium level of 2.3 mEq/L What is the nurse’s priority?
A. Place seizure pads on the bed
B. Initiate fall precautions
C. Assess the clients cardiovascular status
D. Order a high potassium diet
49. A 28-year -old female presented to the emergency room with complaints of abdominal pain, nausea, and vomiting for the past 24 hours. The client is afebrile, heart rate is 130 beats/minute, and blood pressure is 90/60mm Hg. During the pain assessment, the client rates her pain a “10” on a scale of 0-10. The nurse notes the client’s pain to be in the right lower quadrant region. Based on the assessment findings, which of the assessment findings, which of the following would the nurse anticipate as the client’s diagnosis?
A. Ulcerative colitis
B. Crohn’s disease
50. A nurse is caring for a client recently diagnosed with cirrhosis. Which of the following are appropriate nursing interventions for this client? (select all that apply)
A. Strict bedrest for 48 hours
B. Allow moderate alcohol intake in diet
C. Monitor lab values.
D. Pain management
E. fiber restriction from diet
51. Which of the following signs or symptoms indicate a possible upper gastrointestineal (GI0) bleed? Select all that apply?
a .increased blood pressure
b. Weak peripherial pulse
C. Bright red or coffee ground vomitus
d. increased hemoglobin and hematocrit
52. A nurse cares for a dying client, which manifestation of active dying would the nurse treat first?
53. A nurse is planning to educate a client diagnosed with fluid volume overload. Which of the following would the nurse educate the client to determine gains and losses in fluid?
a. skin turgor
b. monitor daily weights
c. presence of edema
d. Appearance of mucous membranes
54. A nurse is caring for a client who recently underwent a colon resection for colorectal cancer. The client is post op day two and has developed a fever. Vital signs are a temperature of 102 degrees F, heart rate 126 beats /minutes, blood pressure 100/50 mm hg. The client is complaining of increased abdominal pain. Based on this information, which of the following conditions is the client exhibiting?
a.Deep vein thrombosis
b. intestinal obstruction
55. A nurse is caring for 60 years old female that underwent a surgical procedure and is post op day four. The client has no active bowel sounds no bowel movement and no movement and no flatulence. Which of the following does the nurse suspect the client experiencing ?
a. perforated colon
c. Non-mechanical bowel obstruction
56. The graduate nurse is caring for a client with suspected appendicitis. What intervention by this graduate nurse would be inappropriate or contraindicated in the care of this client?
a. Contacting the health care provider immediately if the client reports sudden relief of pain
b. Positioning the client in semi fowlers
c. Administer an edema for constipation
d. Administer pain medication every 4 hours PRN as ordered.
57. A nurse is caring for a client recently diagnosed with Addisonian crisis, Which of the following signs and symptoms are consistent with this diagnosis?
a. severe hypotension
c. Vascular resistance
58. A client was admitted with the following arterial blood gas(ABG). How does the nurse interpret these results?
PaCO2 29mm hg
PaO2 88 mm Hg
a. Respiratory alkalosis with full metabolic compensation
b. Respiratory acidosis with full metabolic compensation
c. Metabolic alkalosis with full respiratory compensation
d. Respiratory acidosis with full respiratory compensation
59. A client was admitted with the following arterial blood gas(ABG). How does the nurse interpret these results?
PaCO2 50mm hg
PaO2 90 mm Hg
a. Respiratory alkalosis with full metabolic compensation
b. Respiratory acidosis with full metabolic compensation
c. Metabolic acidosis with full respiratory compensation
d. Metabolic alkalosis with full respiratory compensation
60. A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following findings wound indicate to the nurse that the client peristalsis in returning?
a. Hypoactive bowel sounds in two quadrants
b. Abdominal distention
c. Request for a cup of tea and some toast
d. passage of flatus
61. The nurse is evaluating the serum laboratory results on the following four clients. Which of the following clients would the nurse assess first?
a. a client who osteoporosis with a serum calcium level of 8.1 mg/dL
b. A client with dehydration with a serum sodium level 134mEq/L
c. A client admitted with abdominal; pain and vomiting with a potassium level 2.8mEq/L
d. A client with alcoholism and liver failure with a magnesium level of 1.6mEq/L
62. Which of these laboratory results would be most important for a nurse to monitor for a client with lower gastrointestinal bleed?
a. bleeding time
b. platelet level
c. potassium level
d. Hemoglobin and hematocrit
63. Which laboratory report of the highest concern for the nurse to monitor for a client with bone marrow suppression receiving chemotherapy?
a. urine specific gravity
b. white blood cell ( WBC) count
d. serum prostate specific antigen( PSA)
64.An older adult client reports lack of energy and needs several naps throughout the day, which problem may these symptoms be associated with that is often seen in older adults?
a. underproduction of glucagon
b. overproduction of cortisol
65. A client assessment reveals fatigue, poor memory and weight gain. The lab results reveal elevated thyroid stimulating hormone TSH and decreased T3 and T4 levels. The nurse knows that these are manifestation of which disorder?
66. The nurse is assessing a client a client that display a positive Chvostek sign.Which of the following is this assessment finding a clinical manifestation of?
d. Hy permahnesemia
67. A nurse is caring for a client that has recently been diagnosed with ulcerative colitis. Which of the following statement by the client would indicate an understanding of the disease process?
a. I have to avoid eating nuts and seeds
b. I am at a lower risk of developing cancer
c. it is caused by an inflammatory process of the gastrointestinal tract
d. Diet modification can cure the disease
68. A nurse is preparing to administer levothyroxine 125mcg po daily. Available is levothyroxine 50mcg tablets. How many tablets should the nurse administer per dose? Record answer to the nearest tenth, or one decimal place. Use a leading zero if it applies. Do not use a trailing zero.
69. The nurse is providing discharge instructions to a client with Hepatitis B. Which of the following statements demonstrates an understanding of the discharge instructions?
a. All food handling practices are the same when traveling overseas.
b. chronic hepatitis will not lead to liver cirrhosis or liver cancer
c. I won’t share my shaving razors with my spouse
d. I don’t have to consider safe sex practices with this form of hepatitis
70. A nurse is caring for a client who was prescribed high dose corticosteroid therapy for one month to treat a severe inflammatory condition in the intestines from irritable bowel syndrome. The client symptoms have now resolved. And the client asks, when can I stop taking these medication? How would the nurse respond?
a. The inflammation can’t recur if you stop the medication
b. The drug must be stopped abruptly
c. Once you start corticosteroids, you must be tapered off the medication
d. The medication can be stopped when you start feeling better
71.The nurse is caring for a client diagnosed with cholelithiasis. Which of the following nursing instructions should be included as part of the discharge teaching?
a. call the provider if you have ten or more bloody in a 24 hour period
b. removing gluten from your diet can reduce cramping
c. reduce foods high in uric acid from your diet, like anchovies and venison
d. you should limit high fat meats and fried foods from your diet.
72. A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement would the nurse include in this clients plan of care to delay the onset of microvascular complication?
a. prevent hypoglycemia by eating a bedtime snack
b. restrict your fluid intake to no more than 2 L a day
c. Limit your intake of protein to prevent ketoacidosis
d. maintain tight glycemic control and prevent hyperglycemia
73.A nurse is preparing to administer cephalexin suspension 2 grams po daily given in four doses. Available is cephalexin suspension 250mg/5ml. How many ml should the nurse administer in one dose? ( record answer as a whole number. Do not use a trailing zero?
74. Which of the following surgical procedures is appropriate for a client with chronic pancreatitis?
c. radical pancreatectomy
75.A client with history of vomiting complain of muscles weakness. Heart palpitation and nausea. The clients laboratory findings are as follows: Na 140mEq/L and potassium 26mEq/L. which of the following electrolyte imbalance is the client exhibiting?