1.

The lowest fasting plasma glucose level suggestive of a diagnosis of DM is:

a. 100mg/dl c. 200mg/dl
b. 126mg/dl d. 180mg/dl
2. Which test results should the nurse check to ascertain how well the client is managing her diabetes mellitus overall?
a. Blood glucose level c. Glycosylated haemoglobin
b. Glucose tolerance test d. Radioimunnoassay of insulin
3. The nurse is discussing the treatment regimen for a client newly diagnosed with Type 1 Diabetes Mellitus. During the
discussion of insulin administration, the client asks the nurse, “Why can’t I just take a pill like my friend does?” Which of the
following statement indicates the client understands the nurse’s explanation?
a. “My body does not produce insulin; therefore I must receive the injections.”
b. “I will be on insulin for a short while, and then I can take the pills.”
c. “The pills are not as effective as the insulin injections.”
d. “When my body starts making insulin again, I can stop taking the injections.”
4. The mother of an 11 year old child with IDDM asks why her child cannot avoid all those “shots” and take pills as her uncle
does. Which of the following is the nurse’s best reply?
a. “the pills work with an adult pancreas only”
b. “the drugs affect fat and protein metabolism, not sugar”
c. “Your child needs insulin replaced, and the oral hypoglycemics only add to an existing supply of insulin”
d. “Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral
hypoglycemics”
5. During a routine check-up, an insulin-dependent diabetic has his glycosylated haemoglobin checked. The results indicate a
level of 11%. Based on this result, what teaching should the nurse emphasize?
a. Rotation of injection sites
b. Insulin mixing and preparation
c. Daily blood sugar monitoring
d. Regular high protein diet
6. The nurse is caring for a woman at 37 weeks gestation. The client was diagnosed with insulin-dependent diabetes mellitus
at age 7. The client states, “I am so thrilled that I will be breastfeeding my baby.” Which of the following responses by the
nurse is best?
a. “You will probably need less insulin while you are breastfeeding.”
b. “You will need to initially increase your insulin after the baby is born.”
c. “You will be able to take an oral hypoglycemic instead of insulin after the baby is born.”
d. “You will probably require the same dose of insulin than you are now taking.”
7. A 67-year old client with non-insulin dependent diabetes should be instructed to contact the out-patient clinic immediately
if the following findings are present
a. Temperature of 37.5 degrees Celsius with painful urination
b. An open wound on their heel
c. Insomnia and daytime fatigue
d. Nausea with 2 episodes of vomiting
8. Nausea Mrs. Moore, 62-year-old, with diabetes is in the emergency department. She stepped on a sharp sea shell while
walking barefoot along the beach. Mrs. Moore did not notice that the object pierced the skin until later that evening. What
problem does the client most probably have?
a. Nephropathy c. Carpal tunnel syndrome
b. Macroangiopathy d. Peripheral neuropathy
9. Nurse Tina notes that the client has decreased tactile sensation in both feet among one of her diabetic patients. What is the
nurse’s best first action?
a. Review the diet of the patient c. Examine the client’s feet for signs of injury
b. Test sensory perception in the client’s hands d. Encourage insulin injections
10. The following interventions are performed when an injury occurs to the foot of a diabetic client except:
a. Wash the area with mild soap and water c. Cover with a wet sterile dressing with adhesive
b. Call health care provider d. Wear white cotton socks
11. Which of the following nursing interventions should be implemented when performing foot care to a patient with DM?
a. Inspect the feet carefully and daily for calluses, corns, blisters, abrasions, redness, and nail abnormalities
b. Bathe the feet daily in hot water
c. Use lanolin, nivea cream, or other cream moisturizers especially between the toes to prevent maceration
d. Wear well-fitting, compressive shoes and socks-long enough, wide enough, soft, supple and high-heeled
12. A client complains of some discomfort after a below knee amputation. Which action by the nurse is appropriate to do
initially?
a. Conduct guided imagery or distraction
b. Ensure that the stump is elevated for the initial day
c. Wrap the stump snugly in an elastic bandage
d. Administer opioid narcotics as ordered
13. An amputee client will be taught to use crutches until he can manage with prosthesis independently. Which of the following
crutch-walking instructions would be INCORRECT?
a. Extend the arms while holding weights to strengthen the triceps
b. The crutches should be 16 inches less than the client’s total height
c. The axillary bars on the crutches should support the clients weight
d. None of the above
14. The nurse is teaching a client who is taking insulin about the signs of hyperglycemia. The signs of hyperglycemia include:

1
 a. Kaussmaul’s breathing c. Dry, flaky skin
b. Excessive hunger d. High blood pressure
15. A client with DM demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most
appropriate intervention to decrease the client’s anxiety would be to:
a. Administer sedative
b. Make sure the client knows all the correct medical terms to understand what is happening
c. Ignore the signs and symptoms of anxiety so that they will soon disappear
d. Convey empathy, trust and respect toward the client
16. Manifestations of hypoglycaemia include which of the following?
a. Lethargy c. Nausea and vomiting
b. Confusion d. Shaky feeling and dizziness
17. The insulin that would be administered in patients with DKA is:
a. Human NPH Insulin c. Insulin lispro injection
b. Human Regular insulin d. Insulin glargine injection
18. A nurse performs physical assessment on a client with DM 2. Findings include a fasting blood glucose of 120mg/dl,
temperature of 101, pulse of 88, respirations of 22, and a BP of 140/80. Which finding would be of most concern of the
nurse?
a. Pulse c. Respiration
b. BP d. Temperature
19. While examining the oral cavity of a client, the nurse detects a fruity odor to the client’s breath. The nurse should do which
of the following?
a. Instruct to use mouthwash after meals c. Document the finding as the only action
b. Instruct client on good oral hygiene d. Notify physician
20. The nurse practitioner would expect which manifestation as a side effect of Metformin?
a. GI upset c. Hyperglycemia
b. Photophobia d. Skin eruptions
21. The client with Type 1 DM is switching from an animal-source regular insulin to a synthetically derived human regular
insulin. What precaution should you explain?
a. Human insulin should only be administered in the umbilical area
b. Do not mix human regular insulin with any other type of insulin
c. Adjustments in insulin timing may be needed with human insulin
d. You may notice the need to increase the dose to achieve the same level of glucose control
22. Insulin forces which of the following electrolytes out of the plasma and into the cells?
a. Calcium c. Phosphorus
b. Magnesium d. Potassium
23. Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis.
Insulin is administered using a scale of regular insulin according to glucose results. At 2 pm, the client has a capillary glucose
level of 250mg/dl for which he receives 8 U of regular insulin. Nurse Charlene should expect the dose’s:
a. Onset to be at 2pm and its peak at 3pm
b. Onset to be at 2:15pm and its peak to be at 3pm
c. Onset to be at 2:30pm and its peak at 4pm
d. Onset to be at 4 pm and its peak to be at 6pm
24. The nurse teaches the diabetic client about NPH and regular insulin. Which statement indicates that the client understood
the instructions?
a. “I’ll draw up NPH insulin first”
b. “I must keep the insulin in the refrigerator”
c. “I’ll draw up the regular insulin first”
d. “Exercise will slow down the absorption of insulin”
25. The physician orders 36 units of NPH and 12 units of regular insulin. The nurse plans to administer these drugs in 1 syringe.
Identify the steps in this procedure by listing them in priority order.
1. Inject air equal to NPH dose into NPH vial
2. Invert regular insulin bottle and withdraw regular insulin dose
3. Inject air equal to regular dose into regular insulin bottle
4. Invert NPH vial and withdraw NPH dose

a. 1-2-3-4 c. 1-4-2-3
b. 1-4-3-2 d. 1-3-2-4
26. Rotation sites for insulin injection should be separated from one another by 2.5cm or 1 inch and should be used only every:
a. Third day c. 2-3 weeks
b. Week d. 2-4 weeks
27. What is the best reason for the nurse in instructing the client to rotate injection sites for insulin?
a. Lipodystrophy can result and is extremely painful
b. Poor rotation technique can cause superficial haemorrhaging
c. Lipodystrophic areas can result, causing erratic insulin absorption rates from these
d. Injection sites can never be reused
28. A client is taking NPH insulin daily every morning. The nurse instructs the client that the most common time for a
hypoglycemic reaction to occur is:
a. 2 to 4hours after administration c. 12 to 16 hours after administration
b. 4 to 12 hours after administration d. 18 to 24 hours after administration

2
29. An 11 year old boy has recently been diagnosed with diabetes. The nurse’s teaching plan for daily injections should be
based on which of the following?
a. The parents do not need to learn the procedure
b. He is old enough to give most of his own injections
c. Self-injections will be possible when he is closer to adolescence
d. He can learn about self-injections when he is able to reach all injection sites
30. An external insulin pump is prescribed for a client with diabetes mellitus. The client asks Eddie about the function of the
pump. He bases the response on the information that the pump:
a. is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin
into the bloodstream.
b. is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals
c. continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose
levels
d. gives a small continuous dose of regular insulin, and the client can self-bolus with an additional dosage from the pump
prior to each meal.
31. A 23-year old patient has history of IDDM. The patient takes NPH insulin 30 “u” q AM. The nurse knows that patients taking
NPH insulin should eat a snack at which of the following times of day in order to avoid a hypoglycemic reaction?
a. Mid-morning c. Early evening
b. Mid-afternoon d. Before bedtime
32. A client newly diagnosed with DM has been stabilized with insulin injections daily. A nurse prepares a discharge teaching
plan regarding the insulin. The teaching plan should reinforce which of the following concept?
a. Increase the amount of insulin prior to unusual exercise
b. Acetone in the urine will signify a need for insulin
c. Always keep insulin vials refrigerated
d. Systematically rotate insulin injection sites
33. A client has been diagnosed with goiter. The nurse looks for documentation of which of the following in the client's medical
record?
a. decreased wound healing c. enlarged thyroid gland
b. chronic fatigue d. heart damage
34. You are teaching a client about avoiding goitrogens inorder to decrease their risk of having goiter. Which among the
following foods should you instruct the client to avoid?
a. Cabbage c. Strawberries
b. Radishes d. All of the above
35. Which among the following health teachings on how to avoid goiter is NOT appropriate?
a. Encourage client to take in food rich in iodine such as seafood
b. Instruct client to avoid goitrogenic foods such as peanuts and cabbage
c. Instructing client to add iodized salt while the food is being cooked
d. None of the above
36. A patient is admitted to the Endocrine unit. The patient states that he has recently lost 15 lbs over two and one-half
months, although there has been no change in his eating habits, and if anything, his appetite has increased. The patient also
complains of palpitations, and says that his “eyes look like they are going to pop out”. Based on this data, the nurse can
infer that this patient is most likely exhibiting symptoms of:
a. Hyperparathyroidism c. Hypothyroidism
b. Hyperthyroidism d. Addisonian crisis
37. Which statement made by the client alerts the nurse to the possibility of hypothyroidism?
a. “My sister has thyroid problems”
b. “I seem to feel the heat more than other people”
c. “Food just doesn’t taste good without a lot of salt”
d. I am always tired, even when I get 10 or 12 hours of sleep”
38. The nurse is obtaining a health history on a 36-year old female who reports an increase in appetite, weight loss, intolerance
to heat, and nervousness. On physical assessment, the client is noted to have thin hair and moist skin. Based on this
information, the nurse would suspect which of the following?
a. Hypothyroidism c. Hypoparathyroidism
b. Hyperthyroidism d. Hyperparathyroidism
39. Marie is admitted to the hospital because of easy fatigability for the past few months. After a series of examinations, a
diagnosis of hyperthyroidism was confirmed. As assessment was made. The least symptom she would experience is:
a. Fine tremors of the hands c. Palpitation
b. Hyperactive d. Drowsiness
40. Nurse Oliver should expect a client with hypothyroidism to report which health concerns?
a. Increased appetite and weight loss c. Nervousness and tremors
b. Puffiness of the face and hands d. Thyroid gland swelling
41. A clinic nurse is performing an assessment on a client who has hypothyroidism. The nurse would expect to note which
clinical manifestation?
a. complaints of difficulty sleeping
b. complaints of diarrhea
c. significant weight loss since the last clinic visit
d. complaints of intolerance to cold weather

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42. A nurse is monitoring a client with acute hypothyroidism for signs of hypocalcemia. Which of the following would the nurse
note if hypocalcemia is present?
a. hypoactive deep tendon reflexes c. positive Trousseau's sign
b. positive Homan's sign d. negative Chvostek's sign
43. In contrast to hyperthyroidism, underproduction of thyroxin results in:
a. Grave’s disease c. Cushing’s disease
b. Diabetes insipidus d. Myxedema
44. What is the priority nursing diagnosis for the client newly diagnosed with hyperthyroidism?
a. Decreased cardiac output related to tachycardia
b. Disturbed body image related to weight loss
c. Hyperthermia related to hypermetabolism
d. Fatigue related to energy depletion
45. What is the priority nursing diagnosis for the client with hypothyroidism?
a. Hypothermia
b. Disturbed Body image
c. Disturbed thought process
d. Imbalanced Nutrition: More than Body Requirements
46. Which clinical manifestation indicates to the nurse the treatment for the client with hypothyroidism is effective?
a. The client is thirsty
b. The client’s weight has been the same for 3 weeks
c. The client’s total white blood cell count is 6000 cells/mm3
d. The client has had a bowel movement every day for 1 week
47. Which nursing diagnosis takes highest priority for a female client with hyperthyroidism?
A. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess
B. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing
C. Body image disturbance related to weight gain and edema
D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
48. To maintain skin integrity of a patient with hyperthyroidism, the following nursing interventions should be instituted
except:
a. Assess skin frequently to detect diaphoresis
b. Bathe frequently with cool water; change linens when damp
c. Use soap to prevent drying and use lubricant skin lotions over pressure points
d. Protect and relieve pressure from bony prominences while immobilized or while hypothermia blanket is used
49. In collaboration with the dietician, what dietary modification should the nurse suggest for the client with hyperthyroidism?
a. Decrease calories and proteins and increase carbohydrates
b. Eliminate carbohydrates and increase proteins and fats
c. Increase calories, proteins, and carbohydrates
d. No dietary modification is needed
50. The nurse is providing care to a client with myxedema coma. Priority nursing care would include which of the following?
a. Measures to decrease body temperature
b. Measures to decrease heart rate
c. Measures to maintain airway, fluid and electrolyte balance, and cardiovascular status
d. Measure to decrease blood pressure
51. A client was admitted to the emergency room and a diagnosis of myxedema coma is made. Which action would the nurse
prepare to carry out initially?
a. Warm the client c. Maintain oxygenation
b. Administer fluid replacement d. Administer thyroid hormone
52. During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the nurse should include which
statement?
a. “The head of your bed must remain flat for 24 hours after surgery.”
b. “You should avoid deep breathing and coughing after surgery.”
c. “You won’t be able to swallow for the first day or two.”
d. “You must avoid hyperextending your neck after surgery.”
53. A patient, after 3 months, was readmitted to the hospital for thyroidectomy. Prior to surgery, the doctor prescribed Lugol’s
solution. When administering this medication, the nurse should remember the following consideration except:
a. Not to administer it for more than 10 days
b. Telling the patient to take it using a straw
c. Crushing the tablet then giving it with sweets to mask the metallic taste
d. Instructing the patient to report a brassy taste, sore gums and coryza
54. Lucy undergoes Subtotal Thyroidectomy for Grave’s Disease. In planning for the client’s return from the OR, the nurse
would consider that in a subtotal thyroidectomy:
a. The entire thyroid gland is removed
b. A small part of the gland is left intact
c. One parathyroid gland is also removed
d. A portion of the thyroid and four parathyroid glands are removed
55. Before a post- thyroidectomy client returns to her room from the OR, the nurse plans to set up emergency equipment,
which should include:
a. A crash cart with bed board c. An airway and rebreathing mask
b. A tracheostomy set and oxygen d. Two ampules of sodium bicarbonate

4
56. A client is returning from a subtotal thyroidectomy for the treatment of hyperthyroidism. The immediate priority in
assessing this client would include which of the following?
a. Assess for respiratory distress c. Assess neurological status
b. Asses fluid volume status d. Assess for pain
57. A nurse taking care of a patient from the OR. You asked questions as soon as the patient regained consciousness from
thyroidectomy primarily to assess the evidence of:
a. Thyroid storm c. Damage to the laryngeal nerve
b. Mediastinal shift d. Hypocalcemia tetany
58. A nurse is caring for a client following thyroidectomy and is monitoring for complications. Which of the following if noted in
the client, would indicate a need for physician notification?
a. surgical pain in the neck area
b. voice hoarseness
c. numbness and tingling around the mouth
d. weakness of the voice
59. A nurse is monitoring a client for complications following thyroidectomy. The nurse notes that the client's voice is very
hoarse, and the client is concerned about the hoarseness and asks the nurse about it. The nurse makes which response to
alleviate the client's concern?
a. hoarseness and weak voice indicate permanent damage to the nerves
b. this complication is expected
c. this problem is temporary and will probably subside in a few days
d. it is best that you not talk at all until the problem is further evaluated
60. 8 hours post thyroidectomy, the nurse assesses the patient for laryngeal nerve damage by:
a. Asking the patient to hyperextend the knees and palpating for hematoma or edema
b. Asking the patient to state his name
c. Asking the patient to make small sips of water and observe if the patient can swallow without difficulty
d. Testing the patient’s gag and swallow reflex
61. The nurse is caring for a 45 year old patient who had a thyroidectomy 12 hours ago for treatment of Grave’s disease. The
nurse would be most concerned if which of the following was observed?
a. BP of 140/80 mmHg; RR of 16cpm; Oral Temp of 99 Degrees F
b. The patient supports his head and neck when turning his head to the right
c. The client spontaneously flexes his wrist when the blood pressure is obtained
d. The client is drowsy and complains of a sore throat
62. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who
now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of
these signs?
a. Diabetic ketoacidosis c. Hypoglycemia
b. Thyroid crisis d. Tetany
63. The doctor prescribed an anti-thyroid drug which would be:
a. Cytomel c. Synthroid
b. Tapazole d. Tagamet
64. The client is receiving an antithyroid medication to treat hyperthyroidism. Which of the following should be included in
client education regarding the initiation of this therapy?
a. “Increased need for sleep or not tolerating cold like you used to can occur when taking this medication. If it does, notify
your physician.”
b. “Nausea and vomiting are serious complication of the medication you are taking.”
c. “Take your pulse everyday, as you were taught. If it is too fast, call your doctor”
d. “This medication may cause dyspnea or vertigo. Notify your health care provider if this occurs.”
65. After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr. Smith prescribes levothyroxine
(Levothroid), 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent?
a. Primary hypothyroidism c. Thyrotoxicosis
b. Graves’ disease d. Euthyroidism
66. A client on antithyroid drug therapy presents palpitations and dry mouth. He as cough. What medication would you
discourage?
a. Benzocaine lozenge
b. Guaiafenessin
c. Ibuprofen
d. Pseudoepinephrine
67. When should PTU be given?
a. Only at bedtime
b. As a single dose
c. Every 2 hours
d. In divided doses around the clock
68. Which of the following are possible actions of thyroid hormones?
a. decreases potency of anticoagulants
b. increases the effectiveness of digitalis
c. increases potency of anticoagulants
d. anti-inflammatory effect
69. Iodine solution may cause which of the following effect?
a. Yellow eyes
b. Staining of teeth

5
 c. Loss of teeth
d. Graying of hair
70. Which of the following are evidences of iodine toxicity?
a. Swelling of the buccal mucosa, excessive salivation, coryza, skin eruptions
b. Gum bleeding, drooling, inflammation of the tongue, skin discoloration
c. Decreased salivation, staining of the teeth, coryza, pruritus
d. Swelling of the gums, exophthalmos, brittle nails, dry skin and hair
71. A client has been newly diagnosed with hypothyroidism and will take levothyroxine (Synthroid) 50 mcg/day by mouth. As
part of the teaching plan, the nurse emphasizes that this medication:
a. Should be taken in the morning
b. May decrease the client’s energy level
c. Must be stored in a dark container
d. Will decrease the client’s heart rate
72. A client newly diagnosed of hypothyroidism is placed on Levothyroxine 0.1 mg PO daily. Follow-up should include:
a. Weekly CBC monitoring
b. The client should come back in 4-6 weeks
c. The client should have weekly determination of levothyroxine levels
d. Client should have monthly CBC to rule out agranulocytosis
73. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding
should nurse Hans recognize as an adverse drug effect?
a. Dysuria
b. Leg cramps
c. Tachycardia
d. Blurred vision
74. Which medication should the nurse be prepared to administer to a client with bradycardia as a result of hypothyroidism?
a. Atropine sulfate
b. Levothyroxine sodium
c. Propranolol
d. Epinephrine

77. A client admitted with pheochromocytoma. The nurse assesses the client’s blood pressure frequently. This is based on the
knowledge that pheochromocytoma of the adrenal medulla releases excessive amounts of:
a. Renin
b. Aldosterone
c. Catecholamines
d. Glucocorticoids
78. When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive
catecholamine, nurse April is most likely to detect:
a. a blood pressure of 130/70 mm Hg
b. a blood glucose level of 130 mg/dl
c. bradycardia
d. a blood pressure of 176/88 mm Hg
79. The nurse is performing an admission assessment on a client admitted with a diagnosis of pheochromocytoma. The nurse
assesses for major symptoms associated with pheochromocytoma when the nurse:
a. Tests the client’s urine for glucose
b. Obtains the client’s weight
c. Palpates the skin for its temperature
d. Takes the client’s blood pressure
80. The primary feature of pheochromocytoma’s effect on blood pressure is:
a. Systolic hypertension
b. Diastolic hypertension
c. Hypertension that is resistant to treatment with drugs
d. Widening pulse pressure
81. A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse
hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer:
A. phentolamine (Regitine)
B. methyldopa (Aldomet)
C. mannitol (Osmitrol)
D. felodipine (Plendil)
82. A nurse is caring for a client with pheochromocytoma. The client asks for a snack and something warm to drink. The most
appropriate choice for this client to meet nutritional need would be which of the following?
a. Graham crackers and warm milk
b. Toast with peanut butter and cocoa
c. Crackers with cheese and tea
d. Vanilla wafers and coffee with cream and sugar
83. What are signs of thyroid crisis from Graves’ disease?
a. Weight gain to 155 lbs with height of 5'8"
b. Heart rate 90 beats/min and respiratory rate 16 breaths/min
c. Hot and moist skin with protrusion of eyeballs
d. Constipation and amenorrhea

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84. When caring for client in thyroid crisis, the nurse would question an order for:
a. IV fluid
b. Propanolol (Inderal)
c. Prophylthiouracil
d. A hyperthermia blanket
85. The client with hypothyroidism as a result of Hashimoto’s thyroiditis asks the nurse how long she will have to take thyroid
medication. What is the nurse’s best response?
a. “You will need to take the thyroid medication until the goiter is completely gone”
b. “the thyroiditis will be cured with antibiotics, and then you will no longer need the thyroid medication”
c. “you will need thyroid replacement hormone therapy for the rest of your life because thyroid gland function will not
return”
d. “When you thyroid function studies indicate a normal blood level of thyroid hormones, you will be able to discontinue
the medication”
86. You see Mrs. Dizon in the clinic. She is 45 years old with a history of hypothyroidism and has been treated with L-thyroxine
0.15mg daily. From your assessment of hypothyroidism, the following nursing interventions are included except:
a. Encourage to increase fluid intake
b. Recommend low residue diet
c. Encourage increased mobility within the patient’s exercise tolerance
d. Monitor bowel function by recording frequency and consistency of stool
87. Instructions given to Mrs. Dizon include the following except:
a. The need to receive antithyroid therapy for the duration of her life
b. How and when to take medications
c. Signs and symptoms of insufficient and excessive medications, reinforce teaching by providing written instructions
d. Energy conservation techniques and the need to increase activity
88. An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad.
Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and
nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby
prepares to take emergency action to prevent the potential complication of:
a. Thyroid storm
b. Cretinism
c. Myxedema coma
d. Hashimoto’s thyroiditi
89. Hashimoto's disease is:
a. Chronic inflammation of the thyroid gland
b. Diagnosed most frequently in Asian-Americans and Pacific Islanders
c. A form of hyperthyroidism
d. A rare form of hypothyroidism

90. A client being admitted to a hospital unit complaining of severe pain in the lower abdomen and is lying on the bed with his
knees flexed. Admission vital signs reveal an oral temperature of 101.2F. Which of the following would confirm a diagnosis
of appendicitis?
A. Pain localized at a position halfway between the umbilicus and the right iliac crest
B. The client describes the pain as occurring 2 hours after eating
C. The pain subsides after eating
D. The pain is in the left lower quadrant
91. An elderly client presents with fever, leukocytosis, lower left quadrant pain, and diarrhea alternating with constipation. The
nurse concludes that these are frequently seen I clients with:
A. Appendicitis
B. Diverticulitis
C. Peptic ulcer disease
D. Irritable bowel syndrome
92. A client says to the nurse, “My doctor told me my ulcer may have been caused by bacteria. I thought ulcers were caused by
diet and too much stress.” Which of the following responses by the nurse is the best?
A. If it was caused by bacteria, you would have a fever as a result of the inflammatory process.
B. We know that ulcers are communicable. They can be spread easily. Be careful you don’t spread it to your children
C. Diet and stress have nothing to do with developing an ulcer.
D. Even though the bacteria H. pylori causes inflammation, other factors may cause increased in the stomach
93. In caring for a client with a hiatal hernia, which of the following should be included in a teaching plan regarding causes?
A. To avoid heavy lifting
B. A dietary plan based on soft foods
C. Its prevalence in young adults
D. Its prevalence in fair-skinned individuals
94. An elderly male client is worried about bright red blood in his stool along with feeling tired and worn out. The nurse
determines that these symptoms are characteristics of:
A. Ascending (right-sided) colon cancer
B. Descending (left-sided) colon cancer
C. Gallbladder disease
D. Gastric ulcers
95. A client states, “My doctor told me to quit taking aspirin since I’ve developed this ulcer. I have to take aspirin to keep my
arthritis from hurting. I don’t know what to do.” Which response on the part of the nurse is best?

7
 A. Let’s worry about treating your ulcer your arthritis will have to eat
B. Aspirin is one of the medications that makes an ulcer worse; another medicine can be ordered by the doctor for your
arthritis
C. Go ahead and take the aspirin if it helps, but watch closely for bleeding
D. The doctor knows what is best for you, and you should follow those instructions
96. The nurse is caring for a female client during recuperation following development of duodenal ulcer. The client suddenly
experiences severe abdominal pain, increased heart rate, increased respiratory rate, and diaphoresis. On palpation, the
abdomen is rigid; bowels sounds are faint and diminished. Which of the following nursing actions is appropriate?
A. Immediately place her in high Fowler’s position to facilitate breathing
B. Help her walk to the bathroom to get rid of any flatus
C. Check to see if she has food allergies and see if she ate anything to which she might be allergic
D. Establish IV access and call the doctor to report the assessment data
97. A female client complains of a burning, cramping pain in the top part of the abdomen that becomes worse in the middle of
the afternoon and sometimes awakens her at night. She reports that eating something usually helps the pain go away but
that the pain is now becoming more intense. Which of the following is the best conclusion for the nurse to draw?
A. These symptoms are consistent with an ulcer
B. The client is probably developing cholelithiasis
C. The client probably has indigestion and needs to watch what she eats
D. A snack before bed should be recommended
98. Which of the following clients would be most at risk for an intestinal obstruction?
A. A Jewish client who smokes and consumes large amounts of caffeine
B. An elderly client who is on bedrest because of postoperative abdominal surgery
C. An individual eating a low-fiber, high-fat diet
D. An adult diagnosed with cirrhosis of the liver
99. A client is complaining of dyspepsia, frequent belching, and increased salivation. The nurse suspects which of the following?
A. Peptic ulcer disease
B. Ulcerative colitis
C. Rolling hiatal hernia
D. Gastroesophageal reflux disease
100. A client presents to the clinic with “bad pain” in the middle of the abdomen, vomiting, and not knowing what is wrong.
Palpation reveals rebound tenderness with increased pain halfway between the umbilicus and the top of the pelvis. The
client seems to have less pain when lying on the left side and flexing the knees. What is the best conclusion for the nurse to
draw?
A. To make sure the client does not have an impaction, an enema should be given.
B. Since the client is vomiting, the problem is probably gastroenteritis
C. The client should be checked for possible appendicitis
D. Since the client has been vomiting, nourishment may help
101. A client with Zollinger-Ellison syndrome thinks she has a rare form of cancer. The nurse explains that this syndrome is
characterized by which of the following?
A. A destruction of the mucus-protecting cells of the stomach that could lead to an ulcer
B. A condition that causes increased secretion of pepsin and hydrochloric acid
C. A twisting of the bowel that leads to intestinal obstruction
D. Crohn’s disease, which is an inflammatory bowel disorder
102. A client who is exhibiting borborygmi, cramping, pain, vomiting, and diarrhea has a diagnosis of peptic ulcer disease with
recent surgical treatment. The client is probably experiencing which of the following?
A. Dumping syndrome C. Perforation of the stomach
B. Complications of the PUD D. Peritonitis
103. A client diagnosed with peptic ulcer disease wants to know why he is being given antibiotics. The nurse’s best answer would
be:
A. Antibiotics help calm the stomach and decrease the symptoms
B. Antibiotics decrease dumping syndrome, which can lead to PUD
C. H. pylori is a bacterial cause for PUD and antibiotics will treat the cause
D. The excess acid can be decreased when the stomach is sterile
104. Which of the following foods should be avoided in a client with peptic ulcer disease?
A. Vegetables C. Fruits
B. Meats D. Chocolate
105. The nurse explains to a family that a main physiologic reason for weight loss in a client with Crohn’s disease is which of the
following?
A. The symptoms of anorexia prevent the client from eating
B. The inflammation of the disease decreases the appetite
C. The thickening and congestion of the bowel wall results in malabsorption
D. The skip lesions interfere with food passage through the bowel
106. The nurse explains to a certified nursing assistant who is also a nursing student that the reason elderly clients are more
prone to diverticulitis is because of:
A. Poor, deficient diet
B. Chronic diarrhea
C. Frequent laxative use
D. Sedentary lifestyle