Rasmussen University Causes and Issues of Chronic Diseases Multiple Choice Questions

  

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MDC 2 FINAL EXAM
1. A nurse is teaching a patient with diabetes mellitus who asks, “why is it necessary to
maintain my blood glucose levels no lower than about 60 mg/dL (3.3 mmol/L)?” How
would the nurse respond?
a. “Glucose is the only fuel used by the body to produce the energy that it needs.”
b. “Your brain needs a constant supply of glucose because it cannot store it.”
c. “Without a minimum level of glucose, your body does not make red blood cells.”
d. “Glucose in the blood prevents the formation of lactic acid and prevents acidosis.”
2. Which of the following surgical procedures is appropriate for a patient with chronic
pancreatitis?
a. Radical pancreatectomy
b. Sphincterotomy
c. Fistulotomy
d. Proctocolectomy
3. The nurse identifies which lab result is consistent with a client’s diagnosis of
hyperthyroidism?
a. Decreased T3 and T4 levels
b. Elevated serum thyrotropin-releasing hormone (TRH) level
c. Decreased radioactive iodine uptake
d. Increased serum T3 and T4 levels
4. A nurse is caring for a patient recently diagnosed with diabetes insipidus. Which of the
following medications would be appropriate for this disorder?
a. Furosemide
b. Diltiazem
c. Vasopressin
d. Growth Hormone antagonist
5. A nurse is caring for a patient recently diagnosed with thyroid cancer. Which of the
following lab results will validate this diagnosis?
a. Increased Calcium
b. Increase phosphorus
c. Increased serum thyroglobulin level
d. Decreased thyroglobulin level
6. Which food does the nurse teach the client with hypoparathyroidism to avoid in their
diet?
a. Canned vegetables
b. Fresh fruit
c. Red meat
d. Milk
7. Which nursing intervention helps to prevent adrenocortical insufficiency
a. Administering diuretic therapy
b. Teaching the patient about a low-sodium diet
c. Discontinuing high-dose steroid therapy quickly
d. Reducing high-dose steroid therapy gradually
8. Which of the following is a common diagnostic study for patients with upper
gastrointestinal disorder?
a. Arterial blood gas
b. Liver function test
c. Barium enema
d. Esophagogastroduodenoscopy
9. A nurse is caring for a 57-year-old Hispanic male who was recently diagnosed with
Cushing’s disease. Which of the following laboratory tests validate the diagnosis?
a. Elevated lymphocyte count
b. Decreased late-night salivary cortisol test
c. Decreased urine specific gravity
d. Elevated urine cortisol level
10. A nurse is caring for a patient diagnosed with severe gastroesophageal reflux disease
(GERD). Which of the following medications would the nurse expect the provider to
order?
a. Pantoprazole
b. Metoclopramide
c. Diphenoxylate/atropine
d. Sucralfate
11. A nursing is caring for a patient recently diagnosed with pancreatitis. Which of the
following are treatment options for pancreatitis? (select all that apply)
a. Nothing by mouth
b. Pain management
c. Antacids
d. IV fluids
12. James is a 56-year-old male who was recently diagnosed with Type 2 diabetes. Which of
the following diagnostic tests would correlate with this diagnosis? (select all that apply).
a. Increased Hemoglobin A1C level
b. Increased random blood glucose
c. Increased fasting blood glucose
d. Increased hemoglobin level
13. The nurse identifies which lab result is consistent with a client’s diagnosis of
hyperthyroidism?
a. Decreased T3 and T4 levels
b. Elevated serum thyrotropin-releasing hormone (TRH) level
c. Decreased radioactive iodine uptake
d. Increased serum T3 and T4 levels
14. Which of the following is hallmark assessment finding in a client with hyperthyroidism?
a. Weight gain
b. Increased libido
c. Hearth intolerance
d. Diarrhea
15. A nurse cares for your patient with adrenal hyperfunction. The patient screams at her
husband, burst into tears, and throws her water pitcher against the wall. She then tells
the nurse, “I feel like I’m going crazy.” How would the nurse respond?
a. “I will ask your doctor to order a psychiatric consult for you.”
b. “You feel this way because of your hormone levels.”
c. “Can I bring you information about support groups.”
d. “I will close the door to your room and restrict visitors.”
16. Which statement by a patient with diabetes shows an understanding of the importance
of self-care?
a. “I really don’t like having to stick myself to check my sugar.”
b. “I plan to measure the sugar in my urine throughout the day.”
c. “I am planning on getting my spouse to exercise with me to spend time in each
other’s company.”
d. “I can use my regular cough medicine if I get a cold.”
17. Sam, a 44-year-old male, was recently diagnosed with gastric cancer. Sam has a wife and
three small children. Sam and his wife are having a difficult time dealing with the recent
diagnosis. Which of the following nursing interventions is appropriate for this patient?
a. Educate on treatment options
b. Consult the dietitian regarding nutritional needs
c. Monitor lab values for abnormalities
d. Consult social services to provide support to Sam and his family
18. A patient underwent a colon resection with colostomy placement. which of the
following would the surgeon consult post operatively for colostomy management?
a. dietitian
b. respiratory therapy
c. physical therapy
d. wound, ostomy and continence nurse
19. The nurse knows which intervention is needed for a client with pheochromocytoma?
a. Assist to chair for blood pressure monitoring
b. Education not to drink coffee or smoke
c. Education on an exercise schedule to include activities such as running
d. Encourage one glass of red wine each night to promote a good rest
20. You are providing discharge instructions to a patient who was recently diagnosed with
hiatal hernia. The patient also has a history of GERD. Which of the following should be
included in the patient and family education?
a. Remain in an upright position one to two hours after eating
b. Take antacids prior to eating
c. Drink a carbonated beverage prior to meals
d. Sleep with the head of the bed flat
21. A nurse is caring for a 29-year-old male patient with a history of alcoholism. He has been
having frequent episodes of vomiting of bright red blood. what would be appropriate for
this patient except:
a. Make the patient NPO
b. Transfusion of blood products
c. Perform gastric lavage
d. Encourage liquid intake
22. A nurse is providing patient and family education for a patient diagnosed with irritable
bowel syndrome. Which of the following is important to include in the education?
(select all that apply)
a. Modify diet
b. Stress reduction
c. Adhere to prescribed medications
d. Limit physical activity
23. Which of the following patients are at risk for developing stomatitis?
a. A 48-year-old patient diagnosed with osteoarthritis
b. A 70-year-old obese male
c. A 55-year-old male with colon cancer
d. A 50-year-old patient diagnosed with heart failure
24. A nurse is caring for a patient recently diagnosed with anorectal Abscess. Which of the
following are appropriate nursing interventions for this patient? (select all that apply).
a. Pain management
b. Sitz bath
c. Bed rest
d. Fluid restriction
25. Which of the following glands are considered the master gland?
a. Thyroid
b. Adrenal
c. Pancreas
d. Pituitary
26. The nurse knows that which statement is true about age related changes in the
endocrine system in older adults?
a. all hormone levels increase
b. thyroid hormone levels decrease
c. adrenal glands enlarge
d. the thyroid gland enlarges
27. Which of the following assessment findings is consistent with the diagnosis of diabetes
insipidus?
a. Bradycardia
b. Moist skin
c. Polydipsia
d. Hypertension
28. A nurse is caring for a patient who recently underwent a colon resection for colorectal
cancer. The patient is post op day two and develops a fever. Vital signs are temperature
of 102 degrees Fahrenheit, heart rate 126 BPM, blood pressure 100/50 mm Hg. The
patient is complaining of increased abdominal pain. Based on this information, which of
the following conditions is the patient exhibiting?
a. Deep vein thrombosis
b. Peritonitis
c. Appendicitis
d. Intestinal obstruction
29. A client with diabetes has a blood glucose of 640 mg/dL and reports always being thirsty
and having to void. The nurse knows that which terms describe this subjective finding?
a. Polydipsia and polyphagia
b. Polydipsia and polyuria
c. Polyzoaria and polyuria
d. Polyphagia and polythelia
30. The nurse is caring for a hypoglycemic diabetic client with a blood glucose of 56 mg/dL.
The client is awake but not alert. What action would the nurse take?
a. Give a glass of orange juice with three sugar packets mixed in and monitor the client
b. Give a glass of milk and monitor the client
c. Give a complex carbohydrate and monitor the client
d. Administer D50 IV push per orders and monitor the client
31. Gwen is an 89-year-old female who was diagnosed with gastric cancer three months
ago. Gwen has undergone chemotherapy and radiation Ann recently had surgery to
remove the cancer. During the surgical procedure, the surgeon discovered that the
cancer had spread to other organs. Gwen’s family is having difficulty deciding treatment
options. which of the following interventions are appropriate for Gwen’s care?
a. Schedule Patient for additional chemotherapy
b. Schedule patient for additional radiation therapy
c. Consult the palliative care nurse
d. Discharge patient to Hospice
32. The nurse explains to a diabetic client that which lab test is the best indicator of the
client’s average blood glucose level over the past three months?
a. Oral glucose tolerance test
b. Random blood glucose test
c. Glycosylated hemoglobin (HbA1c)
d. Preprandial blood glucose test
33. A nurse is caring for a patient who presented to the emergency room s/p motor vehicle
accident. The patient is unconscious with a cervical collar in place. The patient has been
diagnosed with syndrome of inappropriate anti diuretic hormone secretion. Which of
the following lab values validate the diagnosis?
a. Decrease serum sodium
b. Increase serum sodium
c. Decreased urine osmolality
d. Decreased glomerular filtration rate
34. A 40-year-old female presents to the emergency room with upper abdominal pain
radiating to her right shoulder and nausea. Upon assessment the patient’s temperature
is 101.2 degrees Fahrenheit, heart rate 110 BPM and a blood pressure is 140/82 MM
HG. Based on the patient’s presentation, which of the following do you anticipate being
the patient’s diagnosis?
a. Pancreatitis
b. Cholecystitis
c. Appendicitis
d. Diverticular disease
35. The laboratory values of a client who has diabetes mellitus include a fasting blood
glucose level of 89mg/dL and hemoglobin A1C of 6%. What is the nurse’s interpretation
of these findings?
a. The client’s glucose control for the past 24 hours has been good, but the overall
control is poor.
b. The client’s glucose control for the past 24 hours has been poor, but the overall
control is good.
c. The values indicate the client has poorly managed his or her disease.
d. The values indicate that the client has managed his or her disease well
36. Which of these laboratory results would be most important for a nurse to monitor for a
client with a lower gastrointestinal bleed?
a. Hemoglobin and hematocrit
b. Bleeding time
c. Platelet count
d. Potassium level
37. A nurse is caring for a patient who was prescribed high dose corticosteroid therapy for
one month to treat severe inflammatory condition. the patient symptoms have now
resolved, and the patient asks when can I stop taking these medications how would the
nurse respond?
a. it is possible for the inflammation to recur if you stop the medication
b. once you start corticosteroids you have to be weaned off them
c. you must decrease the dose slowly so your hormones will work again
d. the drug suppresses your immune system which must be built back up
38. Continuous muscle spasms in a patient with hypoparathyroidism are related to which
condition?
a. Nerve damage
b. Seizures
c. Tetany
d. Decreased potassium
39. A nurse is performing discharge teaching for a patient who was recently diagnosed with
gastritis. Which of the following should be included in the teaching?
a. Exercise
b. Eat three large meals each day
c. Stress reduction
d. Take NSAIDS as prescribed
40. The nurse instructs the patient who was on prolonged cortisol therapy to report which
signs and symptoms?
a. Anuria and hypoglycemia
b. weight gain and moon face
c. anorexia and muscle twitches
d. hypotension and fluid loss drain
41. A nurse is caring for a patient recently diagnosed with Addison’s disease. Which of the
following signs and symptoms are consistent with this diagnosis?
a. increase appetite
b. muscle weakness
c. weight gain
d. hypertension
42. The nurse knows that which of the following is a therapeutic response to
hydrocortisone for Addisonian crisis?
a. Weight gain
b. No signs of pitting edema
c. Increased urine output
d. Client is alert and oriented with improved lethargy
43. A nurse is caring for a patient recently diagnosed with a hiatal hernia. Which of the
following is the least invasive surgical treatment for a patient with a hiatal hernia?
a. Nissen fundoplication
b. Endoluminal fundoplication
c. Pyloroplasty
d. Vagotomy
44. A nurse is caring for a 26-year-old female that presented to the emergency Department
with abdominal pain, bloating, Constipation and bouts of diarrhea. Which of the
following is the patient most likely exhibiting?
a. Intestinal obstruction
b. Hernia
c. Malabsorption Syndrome
d. Irritable bowel syndrome
45. Which of the following is a life-threatening emergency and serious complication of
untreated or poorly treated hypothyroidism?
a. Endemic goiter
b. Thyroiditis
c. Myxedema coma
d. Multinodular toxic goiter
46. Kim is a 28-year-old female who presented to the emergency room with complaints of
abdominal pain, nausea, and vomiting for the past 24 hours. Kim is afebrile, heart rate is
130 BPM, and blood pressure is 90/60 MM HG. During the pain assessment, Kim rates
her pain attend on a scale 0-10. You note her pain to be in the periumbilical region.
Based on the assessment findings, which of the following would you anticipate being
Kim’s diagnosis.
a. Peritonitis
b. Appendants
c. Crohn’s disease
d. Ulcerative colitis
47. A nurse assesses a patient who has a 15-year history of diabetes and notes decreased
tactile sensation in both feet. What action would the nurse take first?
a.
b.
c.
d.
Document the finding in the patient’s chart
Compare extremities for deficiencies
Examine the patient’s feet for signs of injury
Notify the health care provider
48. Which of the following is a main assessment finding in a client with hypothyroidism?
a. irritability
b. cold intolerance
c. Constipation
d. fatigue
49. What Instructions does the nurse include in when teaching the diabetic client about
proper foot care?
a. use rubbing alcohol to help make the skin on the soles of the feet thicker
b. wear open toed shoes or sandals when it’s warm outside to prevent perspiration
c. use moisturizing cream on feet after bathing but not in between toes
d. use cold water for bathing the feet to prevent a thermal injury
50. A nurse is caring for a patient who has been diagnosed with diabetes type 2. Which of
the following should not be included in the discharge instructions?
a. Monitor blood glucose
b. Adhere to dietary modifications
c. Increase physical activity
d. Restrict fluid intake
51. A nurse teaches a patient who was diagnosed with diabetes melittids. Which statement
would the nurse include in this patient’s plan of care to delay the onset of microvascular
and macrovascular complications?
a. “maintain tight glycemic control and prevent hyperglycemia”
b. “restrict your fluid intake to no more than two liters a day”
c. “prevent hypoglycemia by eating a bedtime snack”
d. “limit your intake of protein to prevent ketoacidosis”
52. You are the nurse providing care for a patient who underwent thyroidectomy two days
ago. To Prevent complications with this surgery, which laboratory value requires close
monitoring by a nurse?
a. Calcium level
b. Sodium level
c. Potassium level
d. Lactate level
53. Maria is a 45-year-old Hispanic female who presented to the emergency Department
with epigastric pain she states that the pain is worse after eating Maria has a history of
obesity and diabetes Maria was diagnosed with gastroesophageal reflux disease which
of the following would be a treatment? (Select all that apply)
a. diet and lifestyle modifications
b. gastrectomy
c. protein pump inhibitors
d. prostaglandins
54. A nurse is caring for a patient who has recently been diagnosed with gastroesophageal
reflux disease. Which of the following is the surgical management approach for patients
with this condition?
a. Nissen fundoplication
b. Endoluminal fundoplication
c. Vagotomy
d. Gastroenterostomy
55. A nurse is providing discharge instructions to a patient recently diagnosed with peptic
ulcer disease. Which of the following should not be part of the discharge instructions?
a. avoid spicy foods
b. resume alcohol in moderation
c. follow medications as prescribed
d. signs and symptoms to report
56. A nurse is caring for a patient who presented with bright red rectal bleeding. The patient
had three bowel movements since his arrival 2 hours ago. You confirm visible blood in
the stool. Which of the following diagnostic tests would you anticipate the patient to
undergo?
a. Complete blood count
b. Upper GI
c. Urinalysis
d. Barium swallow
57. A client assessment reveals fatigue, poor memory, and stiff muscles with labs showing
an elevated TSH and low T3 and T4 levels. The nurse knows that these are
manifestations of which disorder.
a. hypothyroidism
b. hyperthyroidism
c. hypoparathyroidism
d. Hyperparathyroidism
58. What does the nurse expect to find when assessing a patient with Cushing syndrome?
a. Signs of dehydration
b. Facial flushing
c. Hypertension
d. Muscle hypertrophy
59. A client asked a nurse when they can expect to feel improvement after starting a
prescription for thyroid hormone for treatment of hypothyroid. How would the nurse
respond?
a. A few days
b. 2 weeks
c. 1 month
d. 3 days
60. A nurse is caring for a patient who was status post and upper endoscopic procedure.
Which of the following should be included in the post procedure assessment?
a. Fecal occult test
b. Gag reflex
c. Temperature
d. Bowel sounds
61. An older adult client reports lack of energy and needing several naps throughout the
day. Which problem may these symptoms be associated with that is often seen in older
adults?
a. Hypothyroidism
b. Hyperparathyroidism
c. Overproduction of cortisol
d. Underproduction of glucagon
62. A nurse is caring for a patient recently diagnosed with colorectal cancer which of the
following lab values would confirm this diagnosis?
a. Increase serum creatinine
b. decrease albumen
c. increase carcinoembryonic antigens (CEA)
d. decreased white blood count
63. A nurse is caring for a 60-year-old female that underwent a hysterectomy and is post op
day 2. She has no active bowel sounds and has not passed any gas. CT scan completed
shows no volvulus or intussusception found. Which of the following the suspect the
patient is experiencing?
a. Perforated colon
b. Mechanical bowel obstruction
c. Normal findings given surgical procedure
d. Non-mechanical bowel obstruction
64. A nurse cares for a patient with chronic hypercortisolism. What action would the nurse
take to prevent infection?
a. Wash hands when entering the room
b. Keep the patient in airborne isolation
c. Observe the patient for signs of weight gain
d. Access the patient’s daily chest X Ray
65. Ellen is a 65-year-old female who presented to the emergency Department with
epigastric discomfort, loss of appetite, and weight loss. she has a history of diabetes and
alcoholism. Based on Ellen symptoms and history which of the following does she likely
have.
a. peptic ulcer disease
b. gastrointestinal bleed
c. gastric cancer
d. candidiasis
66. A nurse is caring for a 56-year-old female who presented to the emergency Department
with feeling of fullness in the chest dysphagia and chest pain. She states that she has
been having these symptoms for the past couple of months. Which of the following
conditions could she be exhibiting based on her symptoms?
a. peptic ulcer disease
b. gastritis
c. hiatal hernia
d. gastroesophageal reflux disease
67. A nurse is caring for a patient who recently underwent a colon resection. The patient
has an Ng tube to low intermittent suction, upon assessment the patient is complaining
of increasing abdominal pain. Which nursing intervention will the nurse perform first?
a. Vital Signs
b. Perform a pain assessment
c. Auscultate bowel sounds
d. Assess patency of the Ng tube
68. A nurse is caring for a patient diagnosed with a bleeding gastric ulcer. Based on his
diagnosis, you would anticipate the patient stool to have which of the following
assessments?
a. Coffee-ground
b. Bright red
c. Black and tarry
d. Formed green
69. A nurse is caring for a 37-year-old male who presented to the emergency Department
with weight loss, bloating, and bruising. The patients stool test and hydrogen breath
tests were positive. Which of the following conditions is the patient exhibiting?
a. Cholecystitis
b. Malabsorption
c. Pancreatitis
d. Crohn’s disease
70. A nurse is caring for a patient that has recently been diagnosed with ulcerative colitis.
Which of the following statements by the patient would indicate an understanding of
the disease process?
a. “it is caused by an inflammatory process of the GI tract”
b. “diet modification can cure the disease”
c. “there is no cure for this disease”
d. “I am at a lower risk of developing cancer”
71. During a physical assessment of a client endocrine system, which gland can be
palpitated?
a. Pancreas
b. Thyroid
c. Adrenal glands
d. Parathyroid
72. Which of the following interventions would meet the multidimensional needs of a
patient experiencing an upper gastrointestinal disorder? (select all that apply)
a. consult the dietitian for cultural dietary needs
b. conduct a cultural assessment
c. provide an interpreter
d. provide emotional and spiritual support
73. A nurse is caring for a Hispanic patient who was recently been diagnosed with type 2
diabetes. Which of the following interventions are important to implement to improve
compliance following discharge? (select all that apply)
a. Consult the dietitian to instruct on dietary restrictions
b. Conduct a cultural assessment
c. Consult diabetes educator
d. Provide written instructions in Spanish
74. You are providing education for a patient recently diagnosed with gastroesophageal
reflux disease. Which of the following foods should the patient avoid?
a. Low-fat foods
b. Salad
c. Coffee
d. White bread
75. A nurse is caring for a patient with a nasogastric (NG) tube. Which of the following is not
an appropriate action by the nurse?
a.) Check the tube placement every 4 to 8 hours
b.) Measure and document the NG drainage
c.) Pin the tube to the client’s gown so the client can’t turn the head
d.) Provide oral care every 4 to 8 hours

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