Lisette's NCLEX MED SURG Study
g g g g
Ag25-year-
oldgphysicalgfitnessginstructorgisgfeelinggincreasinglygtiredgandgseeksgmedicalgcare.gTypeg1gdiabet
esgisgdiagnosed.gThegnursegexplainsgthatgthegincreasedgfatiguegisgthegresultgof:
1. Increasedgmetabolismgatgthegcellularglevel
2. Increasedgglucosegabsorptiongfromgthegintestine
3. Decreasedgproductiongofginsulingbygthegpancreas
4. Decreasedgglucosegsecretiongintogthegrenalgtubulesg(Nugentg31)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.g-
g3gInsulingfacilitatesgtransportgof gglucosegacrossgthegcellgmembranegtogmeetgmetabolicgneedsgandg
preventgfatigue.
1gWithgdiabetesgtheregisgdecreasedgcellulargmetabolismgbecausegofgthegdecreasegingglucosegenteri
nggthegcells.
2gGlucosegisgnotgabsorbedgfromgthegintestinalgtractgbygthegcells;gfatiguegisgcausedgbygdecreased,gn
otgincreased,gcellularglevelsgofgglucose.
4gFiltrationgandgexcretiongofgglucosegbygthegkidneysgdognotgregulategenergyglevels;gifginsulingproduc
tiongisgadequate,gglucosegdoesgnotgspillgintogthegurine.g(Nugentg113)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.
,Ag49-year-
oldgfemalegisgadmittedgtogtheghospitalgwithgagpossiblegdiagnosisgofgAddison'sgdisease.gWhatgisgangi
mportantgnursinggresponsibilitygduringgag24-
hourgurinegcollectiongforgthegclientgsuspectedgofghavinggAddison'sgdisease?
1. Keepgthegclientgquietgandgreducegstress
2. Assessgthegclientgforgsignsgandgsymptomsgofgedema
3. Monitorgthegclientgforgangelevationgingbloodgpressure
4. Restrictgthegclient'sgfluidgintakegduringgthegdaygofgthegtestg(Nugentg29)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.g-
g1gStressgandgactivitygincreasegthegsecretiongof gACTHgandgadrenocorticalghormones,gelevatinggthe
gurinegvaluesgforgthegbyproductsgof gtheseghormones,gthusginvalidatinggthegtestgresults.
2 ClientsgwithgAddison'sgdiseasegaregchronicallygdehydratedgandgdognotghavegedema.
3 Becausegofgfluidgdeficits,gthegclientgwillgbeghypovolemicgandgthegbloodgpressuregwillgbeg
decreased.
4 Adequategfluidgintakegisgnecessarygforgurinegproduction;gAddison'sgdiseaseginvolvesgsaltgwasti
nggandgdehydration,gwhichgnecessitatesgangincreasedgfluidgintake,gnotgagrestrictiongofgfluidgintak
e.g(Nugentg111)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.
Ag62-year-
oldgclientgisgadmittedgforghypertension,gandgserumgelectrolytegstudiesghavegyieldedgabnormalgresul
ts.gThegscheduledgworkupgincludesgagscangforgangaldosteronoma.gThegnursegconcludesgthatgthisgs
cangisgorderedgtogrulegoutgdiseasegofgthe:
,1. Kidneygcortex
2. Thyroidggland
3. Pituitaryggland
4. Adrenalgcortexg(Nugentg28-29)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.g-
g4gAngaldosteronomagisgangaldosterone-secretinggadenomagof gthegadrenalgcortex.
1 Angaldosteronomagisgnotgagtumorgofgthegkidneygcortex.
2 Angaldosteronomagisgnotgagtumorgofgthegthyroidggland.
3 Angaldosteronomagisgnotgagtumorgofgthegpituitaryggland.g(Nugentg110)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.
Agclientgdemonstratesgsignsgandgsymptomsgofgagtransfusiongreaction.gThegnursegimmediatelygstop
sgtheginfusiongandgnext:
1. Obtainsgbloodgpressuregingbothgarms
2. Sendsgagurinegspecimengtogtheglaboratory
3. Hangsgagbaggofgnormalgsalinegwithgnewgtubing
, 4. Monitorsgthegintakegandgoutputgeverygfifteengminutesg(Nugentg17)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.g-
g3gThegtubinggmustgbegreplacedgtogavoidginfusinggthegbloodgleftgingthegoriginalgtubing;gthegnormalgs
alineginfusiongwillgmaintaingangopenglinegforganygfurthergIVgtreatment.
1gAllgvitalgsignsgshouldgbegtakengeventually;gbloodgpressuregmaygbegtakengongeithergarm,gnotgnece
ssarilygboth.
2gAgurinegsamplegisgcollectedgaftergthegbloodgtransfusiongisgstopped,gthegtubinggreplaced,gandgagba
ggofgnormalgsalineghung.gThegspecimengwillgbeganalyzedgtogdeterminegkidneygfunction.
4gAlthoughgthegintake,gandgespeciallygthegoutput,gshouldgbegmonitoredgtogassessgkidneygfunction,gt
hisgisgnotgthegpriority.g(Nugentg97)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.
Agclientgdevelopsginternalgbleedinggaftergabdominalgsurgery.gWhichgsignsgandgsymptomsgofghemor
rhagegshouldgthegnursegexpectgthegclientgtogexhibit?gSelectgallgthatgapply.
1. Pallor
2. Polyuria
3. Bradypnea
4. Tachycardia
5. Hypertensiong(Nugentg20)
g g g g
Ag25-year-
oldgphysicalgfitnessginstructorgisgfeelinggincreasinglygtiredgandgseeksgmedicalgcare.gTypeg1gdiabet
esgisgdiagnosed.gThegnursegexplainsgthatgthegincreasedgfatiguegisgthegresultgof:
1. Increasedgmetabolismgatgthegcellularglevel
2. Increasedgglucosegabsorptiongfromgthegintestine
3. Decreasedgproductiongofginsulingbygthegpancreas
4. Decreasedgglucosegsecretiongintogthegrenalgtubulesg(Nugentg31)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.g-
g3gInsulingfacilitatesgtransportgof gglucosegacrossgthegcellgmembranegtogmeetgmetabolicgneedsgandg
preventgfatigue.
1gWithgdiabetesgtheregisgdecreasedgcellulargmetabolismgbecausegofgthegdecreasegingglucosegenteri
nggthegcells.
2gGlucosegisgnotgabsorbedgfromgthegintestinalgtractgbygthegcells;gfatiguegisgcausedgbygdecreased,gn
otgincreased,gcellularglevelsgofgglucose.
4gFiltrationgandgexcretiongofgglucosegbygthegkidneysgdognotgregulategenergyglevels;gifginsulingproduc
tiongisgadequate,gglucosegdoesgnotgspillgintogthegurine.g(Nugentg113)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.
,Ag49-year-
oldgfemalegisgadmittedgtogtheghospitalgwithgagpossiblegdiagnosisgofgAddison'sgdisease.gWhatgisgangi
mportantgnursinggresponsibilitygduringgag24-
hourgurinegcollectiongforgthegclientgsuspectedgofghavinggAddison'sgdisease?
1. Keepgthegclientgquietgandgreducegstress
2. Assessgthegclientgforgsignsgandgsymptomsgofgedema
3. Monitorgthegclientgforgangelevationgingbloodgpressure
4. Restrictgthegclient'sgfluidgintakegduringgthegdaygofgthegtestg(Nugentg29)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.g-
g1gStressgandgactivitygincreasegthegsecretiongof gACTHgandgadrenocorticalghormones,gelevatinggthe
gurinegvaluesgforgthegbyproductsgof gtheseghormones,gthusginvalidatinggthegtestgresults.
2 ClientsgwithgAddison'sgdiseasegaregchronicallygdehydratedgandgdognotghavegedema.
3 Becausegofgfluidgdeficits,gthegclientgwillgbeghypovolemicgandgthegbloodgpressuregwillgbeg
decreased.
4 Adequategfluidgintakegisgnecessarygforgurinegproduction;gAddison'sgdiseaseginvolvesgsaltgwasti
nggandgdehydration,gwhichgnecessitatesgangincreasedgfluidgintake,gnotgagrestrictiongofgfluidgintak
e.g(Nugentg111)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.
Ag62-year-
oldgclientgisgadmittedgforghypertension,gandgserumgelectrolytegstudiesghavegyieldedgabnormalgresul
ts.gThegscheduledgworkupgincludesgagscangforgangaldosteronoma.gThegnursegconcludesgthatgthisgs
cangisgorderedgtogrulegoutgdiseasegofgthe:
,1. Kidneygcortex
2. Thyroidggland
3. Pituitaryggland
4. Adrenalgcortexg(Nugentg28-29)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.g-
g4gAngaldosteronomagisgangaldosterone-secretinggadenomagof gthegadrenalgcortex.
1 Angaldosteronomagisgnotgagtumorgofgthegkidneygcortex.
2 Angaldosteronomagisgnotgagtumorgofgthegthyroidggland.
3 Angaldosteronomagisgnotgagtumorgofgthegpituitaryggland.g(Nugentg110)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.
Agclientgdemonstratesgsignsgandgsymptomsgofgagtransfusiongreaction.gThegnursegimmediatelygstop
sgtheginfusiongandgnext:
1. Obtainsgbloodgpressuregingbothgarms
2. Sendsgagurinegspecimengtogtheglaboratory
3. Hangsgagbaggofgnormalgsalinegwithgnewgtubing
, 4. Monitorsgthegintakegandgoutputgeverygfifteengminutesg(Nugentg17)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.g-
g3gThegtubinggmustgbegreplacedgtogavoidginfusinggthegbloodgleftgingthegoriginalgtubing;gthegnormalgs
alineginfusiongwillgmaintaingangopenglinegforganygfurthergIVgtreatment.
1gAllgvitalgsignsgshouldgbegtakengeventually;gbloodgpressuregmaygbegtakengongeithergarm,gnotgnece
ssarilygboth.
2gAgurinegsamplegisgcollectedgaftergthegbloodgtransfusiongisgstopped,gthegtubinggreplaced,gandgagba
ggofgnormalgsalineghung.gThegspecimengwillgbeganalyzedgtogdeterminegkidneygfunction.
4gAlthoughgthegintake,gandgespeciallygthegoutput,gshouldgbegmonitoredgtogassessgkidneygfunction,gt
hisgisgnotgthegpriority.g(Nugentg97)
Nugent,gPatriciagM.gMosby'sgReviewgQuestionsgforgthegNCLEX-
RN®gExamination,g7thgEdition.gMosby,g2011.gVitalBookgfile.
Agclientgdevelopsginternalgbleedinggaftergabdominalgsurgery.gWhichgsignsgandgsymptomsgofghemor
rhagegshouldgthegnursegexpectgthegclientgtogexhibit?gSelectgallgthatgapply.
1. Pallor
2. Polyuria
3. Bradypnea
4. Tachycardia
5. Hypertensiong(Nugentg20)
