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Level 2 - RNSG 1443 - Exam 4 Test Banks Questions With Complete Solutions
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Level 2 - RNSG 1443 - Exam 4 Test Banks Questions With Complete Solutions
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Level 2 - RNSG 1443 - Exam 4 Test BanksQuestions With Complete Solutions
A 22-year-old man tells the nurse at the health clinic that he has
recently had some problems with erectile dysfunction. Which
question should the nurse ask first to assess for possible
etiologic factors?
a. Do you experience an unusual amount of stress?
b. Do you use any recreational drugs or drink alcohol?
c. Do you have chronic cardiovascular or peripheral vascular
disease?
d. Do you have a history of an erection that lasted for 6 hours or
more? Correct Answers B
A common etiologic factor for erectile dysfunction (ED) in
younger men is use of recreational drugs or alcohol.
Stress, priapism, and cardiovascular illness also contribute to
ED, but they are not common etiologic factors in younger men.
A 26-year-old female with type 1 diabetes develops a sore throat
and runny nose after caring for her sick toddler. The patient calls
the clinic for advice about her symptoms and a blood glucose
level of 210 mg/dL despite taking her usual glargine (Lantus)
and lispro (Humalog) insulin. The nurse advises the patient to
a. use only the lispro insulin until the symptoms are resolved.
b. limit intake of calories until the glucose is less than 120
mg/dL.
,c. monitor blood glucose every 4 hours and notify the clinic if it
continues to rise.
d. decrease intake of carbohydrates until glycosylated
hemoglobin is less than 7%. Correct Answers C
Infection and other stressors increase blood glucose levels and
the patient will need to test blood glucose frequently, treat
elevations appropriately with lispro insulin, and call the health
care provider if glucose levels continue to be elevated.
Discontinuing the glargine will contribute to hyperglycemia and
may lead to diabetic ketoacidosis (DKA). Decreasing
carbohydrate or caloric intake is not appropriate because the
patient will need more calories when ill. Glycosylated
hemoglobin testing is not used to evaluate short-term alterations
in blood glucose.
A 27-year-old man who has testicular cancer is being admitted
for a unilateral orchiectomy. The patient does not talk to his wife
and speaks to the nurse only to answer the admission questions.
Which action is best for the nurse to take?
a. Teach the patient and the wife that impotence is unlikely after
unilateral orchiectomy.
b. Ask the patient if he has any questions or concerns about the
diagnosis and treatment.
c. Document the patients lack of communication on the chart
and continue preoperative care.
d. Inform the patients wife that concerns about sexual function
are common with this diagnosis. Correct Answers B
,The initial action by the nurse should be assessment for any
anxiety or questions about the surgery or postoperative care.
The nurse should address the patient, not the spouse, when
discussing the diagnosis and any possible concerns. Without
further assessment of patient concerns, the nurse should not
offer teaching about complications after orchiectomy.
Documentation of the patients lack of interaction is not an
adequate nursing action in this situation.
A 27-year-old patient admitted with diabetic ketoacidosis
(DKA) has a serum glucose level of 732 mg/dL and serum
potassium level of 3.1 mEq/L. Which action prescribed by the
health care provider should the nurse take first?
a. Place the patient on a cardiac monitor.
b. Administer IV potassium supplements.
c. Obtain urine glucose and ketone levels.
d. Start an insulin infusion at 0.1 units/kg/hr. Correct Answers
A
Hypokalemia can lead to potentially fatal dysrhythmias such as
ventricular tachycardia and ventricular fibrillation, which would
be detected with electrocardiogram (ECG) monitoring. Because
potassium must be infused over at least 1 hour, the nurse should
initiate cardiac monitoring before infusion of potassium.
Insulin should not be administered without cardiac monitoring
because insulin infusion will further decrease potassium levels.
Urine glucose and ketone levels are not urgently needed to
manage the patients care.
, A 27-year-old patient is hospitalized with new onset of Guillain-
Barr syndrome. The most essential assessment for the nurse to
carry out is
a. determining level of consciousness.
b. checking strength of the extremities.
c. observing respiratory rate and effort.
d. monitoring the cardiac rate and rhythm. Correct Answers C
The most serious complication of Guillain-Barr syndrome is
respiratory failure, and the nurse should monitor respiratory
function continuously.
The other assessments will also be included in nursing care, but
they are not as important as respiratory assessment.
A 28-year-old male patient with type 1 diabetes reports how he
manages his exercise and glucose control. Which behavior
indicates that the nurse should implement additional teaching?
a. The patient always carries hard candies when engaging in
exercise.
b. The patient goes for a vigorous walk when his glucose is 200
mg/dL.
c. The patient has a peanut butter sandwich before going for a
bicycle ride.
d. The patient increases daily exercise when ketones are present
in the urine. Correct Answers D
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