Question 1

Which client is at the greatest risk for developing hypothyroidism?

Accepted Answer

A) A 21-year-old woman who has a mother with Graves disease 
B) A 32-year-old man who has an uncle with type 1 diabetes mellitus 
C) A 57-year-old woman whose aunt had systemic lupus erythematosus 
D) A 72-year-old man whose father had cardiovascular disease

Question 2

What collaborative interventions are likely to improve outcomes for an 11-year-old client diagnosed with type 2 diabetes mellitus? Select all that apply.

Accepted Answer

A) Weaning off oral medications 
B) Food intake based on age,sex,and physical activity 
C) Obtaining adequate rest and sleep 
D) Physical activity to be at least 30 to 60 minutes per day most days of the week 
E) Family participation in the lifestyle change

Question 3

The nurse,teaching a class to a group of community members about the importance of weight loss in decreasing the risk of type 2 diabetes mellitus,is asked why weight loss reduces the risk associated with the development of this health problem.Which response by the nurse is most appropriate?

Accepted Answer

A) "Excess body weight impairs the body's release of insulin." 
B) "The amount of food taken in by those who are overweight requires more insulin to adequately metabolize,resulting in diabetes." 
C) "The physical inactivity associated with obesity causes a reduced ability by the body to produce insulin." 
D) "Thin people are less likely to become diabetic."

Question 4

The nurse is caring for a client who complains of jaundice and pruritus.The healthcare provider suspects that the client has liver disease.What modifiable risk factor for cirrhosis of the liver might the nurse see in the client's history?

Accepted Answer

A) Smokes two packs of cigarettes per day 
B) Drinks a six-pack of beer each evening 
C) History of occupational exposure to hepatic toxins 
D) Family history of fatty liver disease

Question 5

The nurse suspects that a client is experiencing hypothyroidism.Which question should the nurse ask during the health history?

Accepted Answer

A) "Is your skin often clammy?" 
B) "Do you have brown,shiny patches on your legs?" 
C) "Are you intolerant to heat?" 
D) "Have you had unexplained weight gain?"

Question 6

The destruction of which types of cells in the islets of Langerhans cause type 1 diabetes mellitus?

Accepted Answer

A) Alpha cells 
B) Beta cells 
C) Delta cells 
D) Gamma cells

Question 7

The nurse is caring for a woman who is at 14 weeks' gestation with her first child.The woman asks the nurse,"Am I at risk for osteoporosis since my baby takes calcium from my body?" What response by the nurse is correct?

Accepted Answer

A) "You may lose small amounts of bone mass with each pregnancy,but if you only have one child,the bone loss should not be significant enough to cause osteoporosis." 
B) "When bone mass is lost during pregnancy,it is very difficult to restore,and you may be at increased risk for osteoporosis later in life.You should take a calcium supplement to prevent this." 
C) "If you eat a diet that is rich in calcium,any bone mass that is lost during pregnancy and breastfeeding will be restored within several months of weaning the child." 
D) "The baby won't require enough calcium during development to affect your bone mass or cause osteoporosis."

Question 8

The nurse is caring for a 76-year-old client with type 2 diabetes who is recovering from surgery following a hip fracture.In addition to blood glucose level,what should the nurse recognize as a sign of hyperosmolar hyperglycemic state (HHS)?

Accepted Answer

A) Excessive sweating 
B) Increased urine output 
C) Insomnia 
D) Edema

Question 9

The nurse is concerned that a client with potential hepatic failure is at risk for developing ascites.Which assessment finding supports the development of liver failure as manifested by ascites?

Accepted Answer

A) Increased abdominal girth 
B) Gallbladder pain 
C) Yellow-tinged skin 
D) Bleeding and bruising easily

Question 10

Increasing circulating levels of thyroid hormone heighten the sympathetic nervous system's physiologic response to stimulation.What effect does this have on the cardiac system?

Accepted Answer

A) Increases stroke volume 
B) Decreases cardiac rate 
C) Lengthens the QRS interval 
D) Decreases blood pressure

Question 11

A client with hyperthyroidism is scheduled for surgery in a few days.Which collaborative intervention would address cardiovascular symptoms that may prevent the client from undergoing the procedure?

Accepted Answer

A) Nothing,because there is little effect on the quality of life in older adults. 
B) Administration of antithyroid medications with propranolol 
C) The ingestion of radioactive iodine,I-131 
D) A combination treatment with levothyroxine (Synthroid)and amiodarone (Cordarone)

Question 12

A new mother brings her 2-week-old infant in for a checkup because he looks jaundiced and his stools are white.The provider suspects the infant might have biliary atresia.What findings does the nurse anticipate upon assessment of the infant?

Accepted Answer

A) Above average weight gain 
B) Increased urine output 
C) Abdominal distention 
D) Reduced rooting reflex

Question 13

The nurse is counseling a couple who is planning a pregnancy.The woman was diagnosed with type 1 diabetes when she was 14 years old.She is now 27.Which examination should the nurse prepare the woman to have before,during,and after the pregnancy?

Accepted Answer

A) Gastrointestinal examination for gastric hypotony 
B) Neural examination for diabetic peripheral neuropathy 
C) Eye examination for diabetic retinopathy 
D) Renal examination for urinary incontinence

Question 14

The client with diabetes mellitus reports having difficulty trimming the toenails because they are thick and ingrown.What should the nurse recommend to this client?

Accepted Answer

A) Make an appointment with a podiatrist. 
B) Offer to file the tops of the nails to reduce thickness after cutting. 
C) Cut the nails straight across with a clipper after the bath. 
D) Make an appointment with a nail shop for a pedicure.

Question 15

The nurse is providing care for a young adult client with exophthalmos.Which nursing diagnosis would be the most appropriate for this client?

Accepted Answer

A) Disturbed Body Image 
B) Ineffective Coping 
C) Risk for Injury 
D) Activity Intolerance

Question 16

The nurse is caring for a 34-year-old woman who is pregnant with her third child.The client was diagnosed with hypothyroidism between her second and third pregnancies.What special considerations should the nurse include when caring for this client?

Accepted Answer

A) The client may need to change her dosage of levothyroxine (Synthroid). 
B) The client is at higher risk for gestational diabetes. 
C) The client may need to add a folic acid supplement to her medication regimen. 
D) The client is at higher risk for diabetes insipidus.

Question 17

What is the primary cause of loss of height in individuals with osteoporosis?

Accepted Answer

A) Collapse of vertebral bodies 
B) Decrease in length of long bones 
C) Flexion of the knees and hips 
D) Cervical lordosis

Question 18

The healthcare provider prescribes sitagliptin (Januvia)for a client with type 2 diabetes mellitus.For which potential side effect should the nurse monitor in this client?

Accepted Answer

A) Elevated blood lipid levels 
B) Hyperglycemia 
C) Pancreatitis 
D) Renal insufficiency

Question 19

A client newly diagnosed with type 1 diabetes mellitus tells the nurse that the diagnosis must be wrong because the client is not overweight,eats all of the time,and is thin.Which response by the nurse is most appropriate?

Accepted Answer

A) "Thin people can be diabetic,too." 
B) "Your condition makes it impossible for you to gain weight." 
C) "Your lab tests indicate the presence of diabetes." 
D) "You are eating large quantities because your condition makes it difficult for your body to obtain energy from the foods taken in."

Question 20

The nurse identifies the nursing diagnosis Imbalanced Nutrition: Less Than Body Requirements as appropriate for a client with osteoporosis.Which client statement indicated to the nurse that this nursing diagnosis was appropriate?

Accepted Answer

A) "I like to remove all of the fat from the meat I eat." 
B) "I am trying to eat a low-carb diet." 
C) "I plan to start eating out less." 
D) "I am allergic to dairy products."

Exam 12: Metabolism