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. Stress has likely caused an increase in the client's blood sugar levels. B. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars. C. The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures. D. Alterations in bile metabolism and release have likely caused hyperglycemia.

Correct Answer is A

Explanation

A. Stress has likely caused an increase in the client's blood sugar levels:
This statement is accurate. Stress, especially related to surgery, can lead to increased levels of stress hormones, such as cortisol and catecholamines, which can elevate blood sugar levels. Surgery is a physiological stressor that can impact glucose metabolism.

B. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars:
This is the most appropriate choice. Surgery, anesthesia, and changes in fluid balance can affect blood glucose levels. The stress response to surgery can lead to fluctuations in blood sugar, and patients may need insulin during this period.

C. The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures:
This statement is not accurate. Overstimulation is not a common cause of the need for insulin in the context of surgery. The stress and physiological changes associated with surgery are more likely contributors.

D. Alterations in bile metabolism and release have likely caused hyperglycemia:
While alterations in metabolism can impact glucose regulation, in the context of surgery, the primary factors are the stress response, changes in fluid balance, and potential alterations in the ability to eat or drink normally rather than specific effects on bile metabolism.

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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 A

Explanation

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 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?

The nurse understands causes of respiratory acidosis include: (SELECT ALL THAT APPLY)

A client comes into the clinic complaining of fatigue. Blood work shows an increased bilirubin concentration and an increased reticulocyte count. What would the nurse suspect the patient has?

A client with type 1 diabetes mellitus and peripheral neuropathy is seeing the nurse to review foot care. What would be a priority instruction for the nurse to give the client?

A client has been brought to the emergency department by paramedics after being found unconscious. The client's Medic Alert bracelet indicates that the client has type 1 diabetes and the client's blood glucose is 22 mg/dL (1.2 mmol/L). The nurse should anticipate what intervention?

The nurse is caring for a female client with type 2 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:

A nurse is caring for a patient with Addison's Disease. Which of the following clinical manifestations should the nurse expect to observe? (SELECT ALL THAT APPLY)