Download NURS 487 WEEK 8 Midterm Latest 2025 Exam 2 With Answers Graded A+ Complete 100 Questions and more Exams Nursing in PDF only on Docsity!
NURS 487 WEEK 8 Midterm Latest 2025 Exam 2
With Answers Graded A+ Complete 100 Questions
The nurse assesses a patient diagnosed with schizophrenia. Which assessment finding would the nurse regard as a negative symptom of schizophrenia? A. Auditory hallucinations B. Delusions of grandeur C. Poor personal hygiene D. Psychomotor agitation C. Poor personal hygiene in DI if oral fluid intake cannot keep up with urinary losses, severe fluid volume deficit results as manifested as? Hypotension Somogyi effect early-morning hyperglycemia that occurs as a result of nighttime hypoglycemic episodes
- this is why we check blood sugar 2 - 3am if its low at this time it the somogyi effect Dawn phenomenon Early morning glucose elevation produced by the release of growth hormone, which decreases peripheral uptake of glucose resulting in elevated morning glucose levels. Admin of insulin at a later time in day will coordinate insulin peak with the hormone release. How much insulin is secreted daily?
40 - 50 units type 1 diabetes mellitus diabetes in which no beta-cell production of insulin occurs due to progressive destruction of beta cells and the patient is dependent on insulin for survival
- typically diagnosed before 30 peak age is 11 - 13
- onset is usually rapid so initial manifestations are acute type 2 diabetes Diabetes of a form that develops especially in adults and most often obese individuals and that is characterized by high blood glucose resulting from impaired insulin utilization coupled with the body's inability to compensate with increased insulin production. gestational diabetes a form of diabetes mellitus that occurs during some pregnancies (3%)
- most women will have normal BG 6 weeks postpartum Prediabetes a condition in which the blood sugar level is higher than normal, but not high enough to be classified as type 2 diabetes
- impaired glucose tolerance or impaired fasting glucose Myxedema coma
- Medical emergency seen in individuals with chronic hypertension
- can be triggered by an infection or cold exposure
- metabolic acidosis
- ketonemia Who: usually Type 1 but can occur in type 2
- happens more often in younger individuals HHS triad
- severe hyperglycemia
- elevated serum osmolality Who: type 2 often present following longer course of illness
- happens more often in the elderly The nurse assesses a client suspected of having major depressive disorder (MDD). Which client symptom would eliminate this diagnosis? The client has maxed-out charge cards and exhibits promiscuous behaviors. A client who is diagnosed with major depressive disorder asks the nurse what causes depression. Which is the nurse's most accurate response? "The exact cause of depressive disorders is unknown. A number of things, including genetic, biochemical, and environmental influences, likely play a role." A client is diagnosed with Cyclothymic Disorder. Which client behaviors should the nurse expect to assess? The client has endured periods of elation and dysphoria lasting for more than 2 years.
The nurse learns at report that a newly admitted client experiencing mania is demonstrating grandiose delusions. The nurse should recognize that which client statement provides supportive evidence of this symptom? "I'm the world's most perceptive attorney." A newly admitted client is diagnosed with Bipolar Disorder: Manic Episode. Which symptom related to altered thought is the nurse most likely to assess? Flight of ideas A family member is seeking advice about an elderly parent who seems to worry unnecessarily about everything. The family member asks, "Should I seek psychiatric help for my mother?" Which is the nurse's most appropriate reply? "Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning." A client presents in the emergency department with complaints of overwhelming anxiety. Which of the following is the priority nursing assessment? Cardiac status How would the nurse best describe the major maladaptive client response to panic disorder? Clients perceive having no control over life situations. Bipolar 2 is distinct from Bipolar 1 based on which diagnostic feature? Less intense mania
The nurse is caring for a client who has clinical manifestations of hypothyroidism. Which of the following laboratory tests is most accurate to evaluate thyroid function? Thyroid-stimulating hormone (TSH) level The nurse is caring for a client with possible syndrome of inappropriate antidiuretic hormone (SIADH). The client is confused and reports a headache, muscle cramps, and twitching. Which of the following initial laboratory results should the nurse anticipate? Decreased serum sodium A patient is admitted to the intensive care unit with a closed head injury sustained in a motorcycle accident. The injury has caused severe damage to the posterior pituitary. Which of the following complications should the nurse anticipate? Dehydration from polyuria While checking the laboratory results for a patient diagnosed with Graves' disease, the nurse would expect the T3 level to be abnormally: High What is the purpose of the glycosylated hemoglobin (hemoglobin A1c) test? Monitoring long-term serum glucose control - gives you an average blood glucose reading The nurse is caring for a client with acute kidney injury who is dehydrated with symptoms of oliguria, anemia, and hyperkalemia. Which of the following prescribed actions should the nurse take first? Place the client on a cardiac monitor. Since hyperkalemia can cause fatal cardiac dysrhythmias, the initial action should be to monitor the cardiac rhythm. ESA's will take time to correct the hyperkalemia and anemia. The catheter allows monitoring of the urine output, but does not correct the cause of the renal failure.
The nurse is caring for a client who is diagnosed with nephrotic syndrome and has 3+ ankle and leg edema with ascites. Which of the following nursing diagnoses is a priority for the client? Excess fluid volume related to low serum protein levels The client has massive edema, so the priority problem at this time is the excess fluid volume. The other nursing diagnoses also are appropriate, but the focus of nursing care should be resolution of the edema and ascites. Which of the following nursing actions is most helpful in decreasing the risk for hospital-acquired infection (HAI) of the urinary tract in clients admitted to the hospital? Avoid unnecessary catheterizations. Since catheterization bypasses many of the protective mechanisms that prevent urinary tract infection (UTI), avoidance of catheterization is the most effective means of reducing HAI. The other actions will also be helpful, but are not as useful as decreasing urinary catheter use. The nurse is admitting a client with acute glomerulonephritis. Which of the following assessments is most important for the nurse to include? Recent sore throat and fever Acute glomerulonephritis frequently occurs after a streptococcal infection such as strep throat. It is not caused by hypertension, urinary tract infection (UTI), or kidney stones. After noting lengthening QRS intervals in a client with acute kidney injury (AKI), which of the following actions should the nurse take first? Check the client's most recent blood potassium level. The increasing QRS interval is suggestive of hyperkalemia, so the nurse should check the most recent potassium and then notify the client's health care provider. The BUN and creatinine will be elevated in a client with AKI, but they would not directly affect the electrocardiogram (ECG). Documentation of the QRS interval also is appropriate, but interventions to decrease the potassium level are needed to prevent life-threatening bradycardia.
Reduced renal artery blood flow (↓blood flow to kidneys) Causes: Hypotension, Hypo-perfusion, Cardiogenic Shock, Sepsis, Shock, heart disease Intrarenal AKI direct damage to the kidneys (renal parenchyma) or tubular necrosis by inflammation, toxins, drugs, infection, or reduced blood supply Postrenal AKI occurs with urinary tract obstructions that affect the kidneys bilaterally - kidney stones What would be an intrarenal cause of AKI for a patient with hematuria, proteinuria, and uncontrolled hypertension? nephritic syndrome A 42 - year-old male is involved in a motor vehicle accident that has resulted in pre-renal failure. What is the most likely cause of this patient's condition? Inadequate renal blood flow What is a common cause of post-renal AKI? BPH What is a priority action for a patient with hyperkalemia ECG - monitor heart rhythm
What are some clinical manifestations of the oliguric or maintenance phase: decreased urine output uremia hyperkalemia metabolic acidosis The nurse is caring for a client who has an obstruction of the common bile duct. Which of the following findings should the nurse monitor in this client? Steatorrhea Steatorrhea fat in the feces Glycogenolysis breakdown of glycogen to glucose occurs in liver Gluconeogenesis The formation of glucose from noncarbohydrate sources, such as amino acids. this is done in liver Glycogenesis formation of glycogen
Acute Liver Failure Labs
- Increased Bilirubin, liver enzymes (ALT and AST) ammonia, INR and DECREASED albumin Alcoholic Hepatitis
- inflammation of the liver from alcohol misuse
- "fatty" liver
- heavy drinking (4+ a day) for at least 6 months you'll see acute onset of jaundice, elevated liver enzymes, change in mental status, coagulopathies nurse is caring for a client with liver failure who has 4+ pitting edema of the feet and legs. Which of the following assessments is priority for the nurse to monitor? albumin What is the most common disorder associated with upper GI bleeding? Esophageal varices Esophageal varices are the most common disorder associated with upper GI bleeding. Diverticulosis could lead to bleeding, but it would be lower GI rather than upper. Hemorrhoids can lead to bleeding, but they would be lower GI. Cancer could lead to upper GI bleeding, but peptic ulcers and varices are identified as more common. The primary causes of duodenal ulcers include H. pylori infection and NSAIDS Infection with H. pylori and chronic use of NSAIDs are the major causes of duodenal ulcers. Consuming spicy foods, trauma, and antibiotics do not lead to duodenal ulcer disease.
The nurse is obtaining a history from a client who is admitted with jaundice. Which of the following statements is most indicative of a need for client teaching? "I use acetaminophen every 4 hours for chronic pain." Chronic use of high doses of acetaminophen can be hepatotoxic and may have caused the client's jaundice. The other client statements require further assessment by the nurse, but do not indicate a need for client education. A 19 - year-old presents with abdominal pain in the right lower quadrant. Physical examination reveals rebound tenderness and a low-grade fever. What might a possible diagnosis be? Appendicitis :Appendicitis is manifested originally with periumbilical pain that then migrates to the right lower quadrant pain with rebound tenderness. A low-grade fever is common. Colon cancer may be asymptomatic, followed by bleeding. Pancreatitis is manifested by vomiting. Hepatitis would be manifested by upper abdominal pain, not lower. A 45 - year-old male complains of heartburn after eating and difficulty swallowing. These symptoms support which diagnosis? Hiatal hernia Regurgitation, dysphagia, and epigastric discomfort after eating are common in individuals with hiatal hernia. Pyloric stenosis is manifested by projectile vomiting. Gastric cancer is not manifested by heartburn. Achalasia is a form of functional dysphagia caused by loss of esophageal innervation. The icteric phase of hepatitis is characterized by which clinical manifestations? Jaundice, dark urine, enlarged liver The icteric phase is manifested by jaundice, dark urine, and clay-coloured stools. The liver is enlarged, smooth, and tender, and percussion causes pain. Fatigue and vomiting occur during the prodromal stage. Resolution occurs in the recovery phase. Fulminant liver failure does not involve icterus. A 50 - year-old is diagnosed with gastroesophageal reflux (GERD). What is the cause of this condition?
2: pessimistic view of the world 3: belief that negative reinforcement will continue in future People treated with Cytokines are at high risk for .... depression diathesis-stress model both biology and life events contribute to development of depressive disorders neurotransmitters depression norepinephrine, serotonin, dopamine serotonin Affects mood, hunger, sleep, and arousal - helps to regulate stress with ACH neuroendocrine hormonal activity in the brain and nervous system psychotic features Features characterized by delusions, hallucinations, and formal thought disorder. Labs for depression
CRP and interleukin 6 may be elevated and 1/3 of those with major depression have elevated inflammation markers Neurotransmitters for Anxiety disorders Increased serotonin and NE and decreased GABA Neurotransmitters rt Bipolar disorder NE, serotonin and dopamine to little =depression and to much= mania What is the most common physical abnormality associated with bipolar disorder? Hypothyroidism delirious mania A grave form of mania characterized by severe clouding of consciousness and representing an intensification of the symptoms associated with mania. The symptoms of delirious mania have become relatively rare since the availability of antipsychotic medications. Is schizophrenia curable? remission and recovery are increasingly common outcomes with early detection and treatment however is a chronic or recurring disorder that is managed but rarely cured Prodromal beginning of onset that may go unrecognized
- can appear one month to a year before psychotic break
Hallucinations perception of a sensory experience for which no external stimulus exists negative symptoms of schizophrenia the absence of appropriate behaviours - negative symptoms contribute to poor social functioning and social with-drawl
- disturbed sleep
- flat affect
- poor concentration
- poor hygiene positive symptoms of schizophrenia delusions and hallucinations also disorganized thoughts and bizarre behaviour neologism new word or expression that have a meaning for the patient but a different or nonexistent meaning to others Echolalia pathological repeating of another's words often seen in catatonia
clang associations choosing words based on their sound rather than their meaning, often rhyming or having a similar beginning sound Depersonalization feelings of detachment from one's mental processes or body Derealization the sense that one's surroundings are unreal or detached boundary impairment an impaired ability to sense where one's body or influence ends and another's begins catatonia a state of unresponsiveness to one's outside environment, usually including muscle rigidity, staring, and inability to communicate diagnostic of schizophrenia lower brain volume and more CSF
- enlarged ventricles, temporal lobe reduction - grey matter is reduced personality disorders psychological disorders characterized by inflexible and enduring behavior patterns that impair social functioning
