Adult 1: Exam 2 practice questions
What preoperative instruction should the nurse give to the patient scheduled for a subtotal thyroidectomy? a. How to support the head with the hands when turning in bed b. Coughing should be avoided to prevent pressure on the incision c. Head and neck will need to remain immobile until the incision heals d. Any tingling around the lips or in the fingers after surgery is expected and temporary
a. How to support the head with the hands when turning in bed
when caring for a patient with metabolic syndrome, the nurse should give the highest priority to teaching the patient about which treatment plan?
achieving a normal weight
which tissue requires insuliin to enable movement of glucose into the tissue cells?
adipose and skeletal muscle
a patient with diabetes calls the clinic because she has nausea and flu like symptoms. which advice from the nurse will be the best for this patient?
administer the usual insulin dosage
the nurse should observe the patient for symptoms of ketoacidosis when
an insulin deficit causes the body to metabolize large amounts of fatty acids rather than glucose for energy
Lispro insulin (Humalog) with NPH (Humulin N) insulin is ordered for a patient with newly diagnosed type 1 diabetes. When should the nurse administer lispro insulin?
at mealtime or within 15 minutes of meals
what is a cause of primary hypothyroidism in adults
autoimmune induced atrophy of the thyroid gland
a patient with hypoparathyroidism from surgical treatment of hyperparathyroidism is preparing for discharge. what should the nurse teach the patient?
calcium supplements with vitamin D can effectively maintain calcium balance
the following interventions are planned for a patient with diabetes. What intervention can the nurse delegate to unlicensed assistive personnel (UAP)?
check that the bath water is not too hot
what characteristics is related to Hashimoto's thyroiditis?
chronic autoimmune thyroiditis with antibody destruction of thyroid tissue
the nurse assesses the technique of the patient with diabetes for self monitoring of blood glucose (SMBG) 3 months after intial instruction. Which error in the performance of SMBG noted by the nurse requires intervention?
cleaning the puncture site with alcohol before the puncture
when teaching a patient with diabetes about insulin administration, the nurse should include which instruction?
consistently use the same size of insulin syringe to avoid dosing errors
In a patient with central diabetes insipidus, administration of aqueous vasopressin during a water deprivation test will result in a a. decrease in body weight b. increase in urinary output c. decrease in blood pressure d. increase in urine osmolality
d. increase in urine osmolality
the patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). what manifestations should the nurse expect to find?
decreased urinary output
a patient with acromegaly is treated with a transpheniodal hypophysectomy. what should the nurse do postoperatively?
ensure that any clear nasal drainage is tested for glucose and protein
which statement accurately describes grave's disease
exophthalmos occurs in grave's disease
when the patient with parathyroid disease has symptomss of hypocalcemia, what is a measure that can be used to temporarily raise serum calcium levels?
have patient rebreathe into paper bag
a patient who has recently had a calcium oxalate renal stone had a bone density study, which showed a decrease in her bone density. what endocrine problem could this patient have?
hyperparathyroidism
during discharge teaching for the patient with addison's disease, which patient statement indicates the need for further teaching?
if my weight goes down, my dosage of steroid is probably too high
the nurse determines that a patient with a 2 hour OGTT of 152 mg/dL has
impaired glucose tolerance
what is an appropriate nursing intervention for the patient with hyperparathyroidism
increase fluid intake to 3000-4000 mL daily
a patient suspected of having acromegaly has an increased plasma growth hormone (GH) level. In acromegaly, what would the nurse expect the patient's diagnostic results to show?
increased levels of plasma insulin like growth factor (1GF-1)
a patient is admitted to the hospital with acute thyrotoxicosis. on physical assessment of the patient, what should the nurse expect to find?
increased temperature and signs of heart failure
a patient is scheduled for a bilateral adrenalectomy, during the postoperative period, what should the nurse expect related to the administration of corticosteroids?
increased to promote adequate response to the stress of surgery
In addition to promoting the transport of glucose from the blood into the cell, what does insulin do?
increases amino acid transport into cells and protein synthesis
a 72 year old woman is diagnosed with diabetes. what does the nurse recognize about managing diabetes in the older adult?
it is harder to achieve strict glucose control than in younger patients
a patient with mild iatrogenic cushing syndrome is on an alternate day regimen of corticosteroid therapy. what does the nurse explain to the patient about this regimen?
it minimizes hypothalamic pituitary adrenal suppression
the nurse has identified the nursing diagnosis of fatigue for a patient with hypothyroidism. what should the nurse do while caring for this patient?
monitor for vital signs and cardiac rhythm response to activity
during care of the patient with SIADH, what should the nurse do?
monitor neurologic status at least every 2 hours
a patient taking insulin had recorded fasting glucose levels above 200 mg/dL (11.1 mmol/L) on awakening for the last 5 mornings. What should the nurse have the patient do first?
monitor the glucose level at bedtime and beween 2 and 4 AM and on arising
what is the priority nursing intervention during the management of the patient with pheochromocytoma?
monitoring bp
what should the goals of nutrition therapy for the patient with type 2 diabetes include?
normal serum glucose and lipid levels
in type 1 diabetes, glucose has an osmotic effect when insulin deficiency prevents the use of glucose for energy. Which classic symptom is caused by osmotic effect of glucose?
polydipsia
a patient with hypothyroidism is treated with levothyroxine (synthroid). what should the nurse include when teaching the patient about this therapy?
provide written instructions for all information related to the drug therapy
the nurse is assessing a newly admitted patient with diabetes. Which observation should be addressed as the priority by the nurse?
rapid respirations with deep inspiration
what assessment findings are common in a patient with a prolactinoma?
signs of increased intracranial pressure, including headache, nausea, vomiting
cortisol, glucagon, epinephrine, and growth hormone are referred to as counterregulatory hormones because they...
stimulate glucose output by the liver
two days after a self managed hypoglycemic episode at home, the patient tells the nurse that his blood glucose levels since the episode has been between 80 and 90 mg/dL. what is the best response by the nurse?
that is a good range for your glucose levels
when caring for a patient with nephrogenic diabetes insipidus, what should the nurse expect the treatment to include?
thiazide diuretics
when teaching the patient with type 1 diabetes, what should the nurse emphasize as the major advantage of using an insulin pump?
tight glycemic control can be maintained.
during assessmen tof the patient with acromegaly, what should the nurse expect the patient to report?
undesirable changes in appearance
the patient with diabetes insipidus is brought to the emergency department (ED) with confusion and dehydration after excretion of a large volume of urine today even though several liters of fluid were consumed. what is a diagnostic test that the nurse should expect to be done first to help make a diagnosis?
water deprivation test
a patient with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. The nurse determines that additional teaching is needed when the patient does what?
withdraw the NPH dose in the syringe first
the patient with diabetes has been diagnosed with autonomic neuropathy. what problems should the nurse assess for in this patient?
-erectile dysfunction - vomiting undigested food - painless myocardial infarction
a patient with diabetes inspipidus is treated with nasal desmopressin acetate (DDAVP). The nurse determines that the drug is not having an adequate therapeutic effect when the patient experiences
a urine specific gravity of 1.002
a patient with diabetes is found unconscious at home and a family member calls the clinic. After determining that a glucometer is not available, what should the nurse advise the family member to do?
administer glucagon 1 mg intramuscularly (IM) or subcutaneously
a patient with newly diagnosed type 2 diabetes has been given a prescription to start an oral hypoglycemic medication. The patient tells the nurse she would rather control her blood sugar with herbal therapy. Which action should the nurse take?
advise the patient to discuss using herbal therapy with her HCP before using it
individualized nutrition therapy for patients using conventional, fixed insulin regimens should include teaching the patient to...
eat regular meals at regular times
a patient is admitted to the hospital with a diagnosis of cushing syndrome. on physical assessment of the patient, what should the nurse expect to find?
hypertension, peripheral edema, and petechiae
a patient with grave's disease asks the nurse what causes the disorder. what is the best response by the nurse?
in genetically susceptible persons, antibodies are formed that cause excessive thyroid hormone secretion
which statement best describes atherosclerotic disease affecting the cerebrocascular, cardiovascular, and peripheral vascular systems in patients with diabetes?
it occurs with a higher frequency and earlier onset than in the nondiabetic population
the home care nurse should intervene to correct a patient whose insulin administration includes...
mixing an evening dose of regular insulin with insulin glargine in 1 syringe for administration
when providing discharge instructions to a patient who has had a subtotal thyroidectomy for hyperthyroidism, what should the nurse teach the patient?
substantially reduce calorie intake compared to what was eaten before surgery
what disorders and diseases are related to macrovascular complications of diabetes?
- coronary artery disease - ulceration and amputation of the lower extremities
a black woman with a history of breast cancer has panhypopituitarism from radiation therapy for a primary pituitary tumor. which medications should the nurse teach her about needing for the rest of her life?
- cortisol - vaspressin - Levothyroxine (Synthroid) - Growth hormone (somatropin)
which characteristics most accurately describe the use of RAI?
- often causes hypothyroidism over time - treatment of choice in nonpregnant adults - decreases thyroid hormone secretion by damaging thryoid gland
a patient has been diagnosed with hypoparathyroidism. what manifestations should the nurse expect to observe
- skeletal pain - dry scaly skin - personality changes - abdominal cramping - muscle spasms and stiffness
the patient with type 2 diabetes is being put on acarbose (Precose) and wants to know about taking it. What should the nurse include in this patient's teaching?
- take it with the first bite of each meal - effectiveness is measured by 2 hour postprandial glucose - it delays glucose absorption from the gastrointestinal tract
what assessment findings occur with diabetic ketoacidosis (DKA)
- thirst - ketonuria - dehydration - metabolic acidosis - kussmaul respirations - sweet, fruity breath odor
a patient who is on corticosteroid therapy for treatment of an autoimmune disorder has the following drugs ordered. which one is used to prevent corticosteroid induced osteoporosis?
Alendronate (Fosamax)
Which class of oral glucose-lowering agents (OA) is most commonly used for people with type 2 diabetes because it reduces hepatic glucose production and enhances tissue uptake of glucose? a. Insulin b. Biguanide c. Meglitinide d. Sulfonylurea
B. Biguanide
a nurse working in an outpatient clinic plans a screening program for diabetes. what reccomendation for screening should be included?
FPG for all people at age 45 years and then every 3 years
when caring for a patient with primary hyperaldosteronism, the nurse would question an HCP's prescription for which drug?
Furosemide (Lasix)
the patient with type 2 diabetes has had trouble controlling his blood glucose with several OAs but wants to avoid the risks of insulin. The health care provider told him a medication will be prescribed that will increase insulin synthesis and release from the pancreas, inhibit glucagon secretion, and slow gastric emptying. Which medication will have to be injected?
Glucagon like peptide 1 receptor agonist, exenatide extended release (Bydureon)
a patient with addison's disease comes to the ED with reports of nausea, vomiting, diarrhea, and fever. what interprofessional care should the nurse expect?
IV administration of hydrocortisone
what medication is given in thyrotoxicosis to block the effects of the sympathetic nervouus stimulation of the thyroid hormones?
Propranolol (Inderal)
which patient should the nurse plan to teach how to prevent or delay the development of diabetes
a 34 year old woman whose parents both had type 2 diabetes
a patient with type 1 diabetes uses 20 U of Novolin 70/30 (NPH/ regular) in the morning and at 6:00 PM. when teaching the patient about this regimen, what should the nurse emphasize?
a set meal pattern with a bedtime snack is necessary to prevent hypoglyemia
during a routine health screening, a patient is found to have fasting plasma glucose (FPG) of 132 mg/dL (7.33 mmol/L). At a follow up visit, a diagnosis of diabetes would be based on which laboratory results?
- A1C of 7.5% - FPG> (=) 127 mg/dL (7.0 mmol/L)
what describes the primary difference in treatment for diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS)
HHS requires greater fluid replacement to correct the dehydration
To prevent hyperglycemia or hypoglycemia related to exercise, what should the nurse teach the patient using glucose-lowering agents about the best time for exercise? a. Plan activity and food intake related to blood glucose levels b. When blood glucose is greater than 250 mg/dL and ketones are present c. When glucose monitoring reveals that the blood glucose is in the normal range d. When blood glucose levels are high, because exercise always has a hypoglycemic effect
a. Plan activity and food intake related to blood glucose levels
As a precaution for vocal cord paralysis from damage to the recurrent laryngeal nerve during thyroidectomy surgery, what equipment should be in the room in case it is needed for this emergency situation? a. Tracheostomy tray b.. IV calcium gluconate C. Oxygen equipment d. Paper and pencil for communication
a. Tracheostomy tray
A patient with SIADH is treated with water restriction and administration of IV fluids. The nurses evaluates that treatment has been effective when the patient experiences a. increased urine output, decreased serum sodium, and increased urine specific gravity b. increased urine output, increased serum sodium, and decreased urine specific gravity c. decreased urine output, increased serum sodium, and decreased urine specific gravity d. decreased urine output, decreased serum sodium, and increased urine specific gravity
b. increased urine output, increased serum sodium, and decreased urine specific gravity
what characterizes type 2 diabetes?
beta-cell exhaustion; insulin resistance; genetic predisposition; altered production of adipokines; inherited defect in insulin receptors; inappropriate glucose production by the liver
When replacement therapy is started for a patient with long-standing hypothyroidism, it is most important for the nurse to monitor the patient for a. insomnia b. weight loss c. nervousness d. dysrhythmias
d. dysrhythmias
the nurse is teaching the patient with prediabetes ways to prevent or delay the development of type 2 diabetes. What information should be included?
- exercise regularly - maintain a healthy weight - monitor for polyuria, polyphagia, and polydipsia
the patient with diabetes has a blood glucose level of 248 mg/dL. which assessmentfindings would be related to this blood glucose level?
- headache - abdominal cramps - increase in urination - weakness and fatigue
Following the teaching of foot care to a patient with diabetes, the nurse determines that additional instruction is needed when the patient makes which statement? a. "I should wash my feet daily with soap and warm water." b. "I should always wear shoes to protect my feet from injury." c. "If my feet are cold, I should wear socks instead of using a heating pad." d. "I'll know if I have sores or lesions on my feet because they will be painful."
d. "I'll know if I have sores or lesions on my feet because they will be painful."
which laboratory resultes indicate the patient has prediabetes?
fasting glucose result of 120 mg/dL (6.7 mmol/L)