4100 NCLEX Final Exam Two Competency Certification Study Guide Exam Questions with Certified for Accuracy Answers 2024/2025
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Course
NSG 4100
Institution
NSG 4100
4100 NCLEX Final Exam Two Competency Certification Study Guide Exam Questions with Certified for Accuracy Answers 2024/2025
The nurse is performing an assessment on a client with pheochromocytoma. Which assessment data would indicate a potential complication associated with this disorder?
1....
4100 NCLEX Final Exam Two Competency
Certification Study Guide Exam Questions with
Certified for Accuracy Answers 2024/2025
The nurse is performing an assessment on a client with pheochromocytoma. Which
assessment data would indicate a potential complication associated with this disorder?
1. A urinary output of 50 ml/hour
2.A coagulation time of 5 minutes
3. A heart rate that is 90 beats/minute and irregular
4. A blood urea nitrogen level of 20 mg/dl (7.1 mmol/L) - correct answer 3
Rationale:
Pheochromocytoma is a catecholamine-producing tumor usually found in the adrenal
medulla, but extraadrenal locations include the chest, bladder, abdomen, and brain; it is
typically a benign tumor but can be malignant. Excessive amounts of epinephrine and
norepinephrine are secreted. The complications associated with pheochromocytoma
include hypertensive retinopathy and nephropathy, myocarditis, increased platelet
aggregation, and stroke. Death can occur from shock, stroke, kidney failure,
dysrhythmias, or dissecting aortic aneurysm. An irregular heart rate indicates the
presence of a dysrhythmia. A coagulation time of 5 minutes is normal. A urinary output
of 50 ml/hour is an adequate output. A blood urea nitrogen level of 20 mg/dl (7.1
mmol/L) is a normal finding.
The nurse performs a physical assessment on a client with type 2 diabetes mellitus.
Findings include a fasting blood glucose level of 120 mg/dl (6.8 mmol/L), temperature of
101°F (38.3°C), pulse of 102 beats/minute, respirations of 22 breaths/minute, and blood
pressure of 142/72 mm Hg. Which finding would be the priority concern to the nurse?
1. Pulse
2. Respiration
3. Temperature
,4. Blood pressure - correct answer 3
In the client with type 2 diabetes mellitus, an elevated temperature may indicate
infection. Infection is a leading cause of hyperosmolar hyperglycemic syndrome in the
client with type 2 diabetes mellitus. The other findings are within normal limits.
A client has just been admitted to the nursing unit following thyroidectomy. Which
assessment is the priority for this client?
1. Hypoglycemia
2. Level of hoarseness
3. Respiratory distress
4. Edema at the surgical site - correct answer 3
Rationale:
Thyroidectomy is the removal of the thyroid gland, which is located in the anterior neck.
It is very important to monitor airway status, as any swelling to the surgical site could
cause respiratory distress. Although all of the options are important for the nurse to
monitor, the priority nursing action is to monitor the airway.
The nurse teaches the client, who is newly diagnosed with diabetes insipidus, about the
prescribed intranasal desmopressin. Which statements by the client indicate
understanding? Select all that apply.
1. "This medication will turn my urine orange."
2. "I should decrease my oral fluids when I start this medication."
3."The amount of urine I make should increase if this medicine is working."
4.
"I need to follow a low-fat diet to avoid pancreatitis when taking this medicine."
5.
,"I should report headache and drowsiness to my health care provider since these
symptoms could be related to my desmopressin." - correct answer 2, 5
Rationale:
In diabetes insipidus, there is a deficiency in antidiuretic hormone (ADH), resulting in
large urinary losses. Desmopressin is an analog of ADH. Clients with diabetes insipidus
drink high volumes of fluid (polydipsia) as a compensatory mechanism to counteract
urinary losses and maintain fluid balance. Once desmopressin is started, oral fluids
should be decreased to prevent water intoxication. Therefore, clients with diabetes
insipidus should decrease their oral fluid intake when they start desmopressin.
Headache and drowsiness are signs of water intoxication in the client taking
desmopressin and should be reported to the health care provider. Desmopressin does
not turn urine orange. The amount of urine should decrease, not increase, when
desmopressin is started. Desmopressin does not cause pancreatitis.
A client with Cushing's syndrome verbalizes concern to the nurse regarding the
appearance of the buffalo hump that has developed. Which statement should the nurse
make to the client?
1."Don't be concerned; this problem can be covered with clothing."
2."Usually these physical changes slowly improve following treatment."
3."This is permanent, but looks are deceiving and are not that important."
4."Try not to worry about it; there are other things to be concerned about." - correct
answer 2
Rationale:The client with Cushing's syndrome should be reassured that most physical
changes resolve with treatment. All other options are not therapeutic responses.
The nurse is caring for a client after thyroidectomy. The nurse notes that calcium
gluconate is prescribed for the client. The nurse determines that this medication has
been prescribed for which purpose?
, Rationale:Hypocalcemia, resulting in tetany, can develop after thyroidectomy if the
parathyroid glands are accidentally removed during surgery. Manifestations develop 1 to
7 days after surgery. If the client develops numbness and tingling around the mouth,
fingertips, or toes; muscle spasms; or twitching, the health care provider is notified
immediately. Calcium gluconate should be readily available in the nursing unit.
A client with type 1 diabetes mellitus is to begin an exercise program, and the nurse is
providing instructions regarding the program. Which instruction should the nurse include
in the teaching plan?
1.Try to exercise before mealtimes.
2.Administer insulin after exercising.
3.Take a blood glucose test before exercising.
4.Exercise is best performed during peak times of insulin. - correct answer 3
Rationale:A blood glucose test performed before exercising provides the client with
information regarding the need to consume a snack before exercising. Exercising during
the peak times of insulin or before mealtime places the client at risk for hypoglycemia.
Insulin should be administered as prescribed.
A client with diabetes mellitus is being discharged following treatment for hyperosmolar
hyperglycemic syndrome (HHS) precipitated by acute illness. The client tells the nurse,
"I will call the health care provider (HCP) the next time I can't eat for more than a day or
so." Which statement reflects the most appropriate analysis of this client's level of
knowledge?
1.The client needs immediate education before discharge.
2.The client requires follow-up teaching regarding the administration of oral
antidiabetics.
3.The client's statement is inaccurate, and he or she should be scheduled for outpatient
diabetic counseling.
4.The client's statement is inaccurate, and he or she should be scheduled for
educational home health visits. - correct answer 1
Rationale:If the client becomes ill and cannot retain fluids or food for a period of 4 hours,
the HCP should be notified. The client's statement indicates a need for immediate
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