A client comes into the emergency room with complaints of an enlarged tongue. The tongue appears smooth and beefy red in color. The nurse also observes a 5-cm incision on the upper left quadrant of the abdomen. When questioned, the patient states, "I had a partial gastrostomy 2 years ago." Based on this information, the nurse attributes these symptoms to which of the following problems?

Vitamin A deficiency

Folic acid deficiency

Vitamin B12 deficiency

Vitamin C deficiency

Answer and Explanation

The Correct Answer is C

A. Vitamin A Deficiency:
Symptoms: Enlarged tongue and smooth, beefy red appearance.
Relevance: Vitamin A deficiency is not typically associated with an enlarged tongue. It is more commonly linked to night blindness and skin issues.

B. Folic Acid Deficiency:
Symptoms: Enlarged tongue and smooth, beefy red appearance.
Relevance: Folic acid deficiency can lead to megaloblastic anemia and glossitis (inflammation of the tongue), which may present as an enlarged, smooth, and red tongue.

C. Vitamin B12 Deficiency:
Symptoms: Enlarged tongue and smooth, beefy red appearance.
Relevance: Vitamin B12 deficiency can cause pernicious anemia and glossitis, resulting in an enlarged, smooth, and red tongue.

D. Vitamin C Deficiency:
Symptoms: Not typically associated with an enlarged tongue.
Relevance: Vitamin C deficiency is more commonly associated with symptoms like scurvy, which includes bleeding gums, joint pain, and skin issues, but not specifically an enlarged tongue.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. "The parathyroid has no effect on calcium levels in the body; this will just help prevent osteoporosis":
Explanation: This statement is incorrect. The parathyroid gland plays a crucial role in calcium homeostasis. Hypoparathyroidism, characterized by decreased parathyroid hormone (PTH) production, leads to low blood calcium levels, not high levels.

B. "The reason you have hypoparathyroidism is that you were diagnosed with hypothyroidism, and when the thyroid doesn't work, neither does the parathyroid, so you need these supplements."
Explanation: This statement is incorrect. The parathyroid and thyroid are separate glands with distinct functions. Hypoparathyroidism is not a result of hypothyroidism.

C. "A decrease in parathyroid hormone causes low calcium levels, so your body to break down bones to maintain normal calcium levels, and this will prevent that from happening."
Explanation: This is the correct statement. Hypoparathyroidism leads to a decrease in PTH, resulting in low blood calcium levels. Without sufficient PTH, the body may resort to breaking down bones to maintain calcium levels.

D. "An increase in parathyroid hormone causes your body to move calcium into the cells to reduce blood calcium levels, so you have to replace the levels in the blood."
Explanation: This statement is incorrect. An increase in parathyroid hormone (PTH) typically leads to increased blood calcium levels by promoting the release of calcium from bones and reducing calcium excretion by the kidneys. This describes hyperparathyroidism, not hypoparathyroidism.

A. 1645 B. 1615 C. 1545 D. 1600

Correct Answer is B

Explanation

A.Regular insulin typically begins to take effect 30 minutes after administration. Administering insulin at the time of the meal (1645) would not allow enough time for the insulin to reach its onset of action, potentially resulting in the blood glucose level being high during the meal.

B.Regular insulin has an onset of action of 30 minutes. By administering the insulin at 1615, it will start to take effect by 1645, when the meal arrives, and help ensure the insulin action aligns with the meal, preventing postprandial hyperglycemia.

C.Administering insulin at 1545 would be too early and could lead to the insulin peaking before the meal, which could result in hypoglycemia if the insulin peak occurs before the patient has food to absorb the glucose.

D.Administering insulin at 1600 would result in the insulin starting to work too soon, with the onset happening before the meal and possibly leading to hypoglycemia if the insulin peaks before the meal is consumed.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is instructing a client with newly diagnosed hypo-parathyroidism about this disorder. The nurse explains to the patient that the physician has prescribed daily supplements of calcium and vitamin D. Which education by the nurse is appropriate for this patient?

Correct Answer is C

Explanation

Correct Answer is B

Explanation

A client is being treated on the medical unit for a sickle cell crisis. The nurse's most recent assessment reveals an oral temperature of 100.5°F and a new onset of fine crackles on lung auscultation. What is the nurse's most appropriate action?

The nurse teaches a diabetic client about Sick Day Rules. Which patient statement or statements indicate understanding of the Sick Day Rules? (SELECT ALL THAT APPLY)

A male client with type 1 diabetes mellitus with a hemoglobin A1c test result of 12.7%. In discussing the result with the client, the nurse would be most accurate in stating:

A client diagnosed with type 1 diabetes states he is not comfortable with self-injections and asks the nurse if oral an anti- diabetic agent can be prescribed instead. Which of the following responses from the nurse is appropriate?

A nurse is conducting a class on how to self-manage insulin regimens. A client asks how long a vial of insulin can be stored at room temperature before it "goes bad." What would be the nurse's best answer?

A client with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this patient?

The nurse is caring for a patient with Addison's disease who is scheduled for discharge. When teaching the patient about hormone replacement therapy, the nurse should address what topic?