CH 45: Assessment and Management of Patients with Endocrine Disorders

Beta-blockers are used in the treatment of hyperthyroidism to counteract which of the following effects? A) Sympathetic B) Gastrointestinal effects C) Respiratory effects D) Parasympathetic

A

What is the most common cause of hyperaldosteronism? A) A pituitary adenoma B) An adrenal adenoma C) Excessive sodium intake D) Deficient potassium intake

B

The nurse knows to assess a patient with hyperthyroidism for the primary indicator of: A) Constipation B) Fatigue C) Intolerance to heat D) Weight gain

C

A nurse is reviewing the laboratory order for a client suspected of having an endocrine disorder. The lab slip includes obtaining cortisol levels. What is being tested? A) thymus function B) thyroid function C) adrenal function D) parathyroid function

C

A client has a dysfunction in one of his glands that is causing a decrease in the level of calcium in the blood. What gland should be evaluated for dysfunction? A) Parathyroid gland B) Thymus gland C) Thyroid gland D) Adrenal gland

A

A middle-aged female client complains of anxiety, insomnia, weight loss, the inability to concentrate, and eyes feeling "gritty." Thyroid function tests reveal the following: thyroid-stimulating hormone (TSH) 0.02 U/ml, thyroxine 20 g/dl, and triiodothyronine 253 ng/dl. A 6-hour radioactive iodine uptake test showed a diffuse uptake of 85%. Based on these assessment findings, the nurse should suspect: A) Graves' disease. B) Hashimoto's thyroiditis. C) thyroiditis. D) multinodular goiter.

A

A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately? A) An irregular apical pulse B) Dry mucous membranes C) Pitting edema of the legs D) Frequent urination

A

A nurse should perform which intervention for a client with Cushing's syndrome? A) Explain that the client's physical changes are a result of excessive corticosteroids. B) Explain the rationale for increasing salt and fluid intake in times of illness, increased stress, and very hot weather. C) Suggest a high-carbohydrate, low-protein diet. D) Offer clothing or bedding that's cool and comfortable.

A

Before undergoing a subtotal thyroidectomy, a client receives potassium iodide (Lugol's solution) and propylthiouracil (PTU). The nurse should expect the client's symptoms to subside: A) in 1 to 2 weeks. B) in a few days. C) immediately. D) in 3 to 4 months.

A

Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client (who now has nausea) and records a temperature of 105°F (40.5°C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? A) Thyroid crisis B) Diabetic ketoacidosis C) Tetany D) Hypoglycemia

A

On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance most commonly follows thyroid surgery? A) Hypocalcemia B) Hyponatremia C) Hyperkalemia D) Hypermagnesemia

A

Which assessment would a nurse perform on a client with Cushing syndrome who is at high risk of developing a peptic ulcer? A) Observe stool color. B) Monitor vital signs every 4 hours. C) Observe urine output. D) Monitor bowel patterns.

A

Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex? A) Cushing syndrome B) Hashimoto disease C) Graves disease D) Addison disease

A

Which of the following would the nurse need to be alert for in a client with severe hypothyroidism? A) Myxedemic coma B) Addison's disease C) Acromegaly D) Thyroid storm

A

A client seeks medical attention for new onset of weight loss and heat intolerance. Which additional statements indicate to the nurse that the client is experiencing hyperthyroidism? Select all that apply. A) "I switched from knitting to glue projects since I have developed tremors in my hands." B) "I always carry an extra sweater with me since I'm always cold no matter the temperature outside." C) "Even sitting still, sometimes it feels like my heart is racing." D) "My children tell me that my eyes appear to be bigger, almost buldging, particularly when I tell them to do the dishes." E) "I use lotion on my skin 2 to 3 times a day since my skin is so dry and itchy."

A, C, and D

A client who is being tested for syndrome of inappropriate antidiuretic hormone secretion asks the nurse to explain the diagnosis. While explaining, the nurse states that excessive antidiuretic hormone is secreted from which gland? A) Anterior pituitary B) Posterior pituitary C) Adrenal D) Thyroid

B

A client with acromegaly is admitted to the hospital with complaints of partial blindness that began suddenly. What does the nurse suspect is occurring with this client? A) Glaucoma B) Pressure on the optic nerve C) Corneal abrasions D) Retinal detachment

B

A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect? A) Weight gain, constipation, and lethargy B) Weight loss, nervousness, and tachycardia C) Exophthalmos, diarrhea, and cold intolerance D) Diaphoresis, fever, and decreased sweating

B

A nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse expects to find: A) hypotension. B) deposits of adipose tissue in the trunk and dorsocervical area. C) weight gain in arms and legs. D) thick, coarse skin.

B

Surgical removal of the thyroid gland is the treatment of choice for thyroid cancer. During the immediate postoperative period, the nurse knows to evaluate serum levels of __________ to assess for a serious and primary postoperative complication of thyroidectomy. A) Potassium B) Calcium C) Magnesium D) Sodium

B

When describing the difference between endocrine and exocrine glands, which of the following would the instructor include as characteristic of endocrine glands? A) The glands play a minor role in maintaining homeostasis. B) The secretions are released directly into the blood stream. C) The glands contain ducts that produce the hormones. D) The secreted hormones act like target cells.

B

Which diagnostic test is done to determine suspected pituitary tumor? A) measurement of blood hormone levels B) computed tomography scan C) radioimmunoassay D) radiographs of the abdomen

B

A client is experiencing an increase in blood glucose levels. The nurse understands that which of the following hormones would be important in lowering the client's blood glucose level? A) Melatonin B) Parathormone C) Insulin D) Calcitonin

C

A client presents with a huge lower jaw, bulging forehead, large hands and feet, and frequent headaches. What could be causing this client's symptoms? A) panhyperpituitarism B) panhypopituitarism C) hyperpituitarism D) hypopituitarism

C

A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement by the client indicates the need for additional discharge teaching? A) "I'll call my physician if I notice tingling around my lips." B) "I will take my pain medications according to the schedule we developed." C) "I will increase my fluid and calcium intake." D) "I'll schedule a follow-up visit with my physician as soon as I get home."

C

A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder? A) parathyroid disorder B) thyroid disorder C) pituitary disorder D) adrenal disorder

C

An incoherent 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 periorbital area. Knowing that these findings suggest severe hypothyroidism, the nurse prepares to take emergency action to prevent the potential complication of: A) cretinism. B) thyroid storm. C) myxedema coma. D) Hashimoto's thyroiditis.

C

For the first 72 hours after thyroidectomy surgery, a nurse should assess a client for Chvostek's sign and Trousseau's sign because they indicate: A) hypokalemia. B) hypercalcemia. C) hypocalcemia. D) hyperkalemia.

C

Parathyroid hormone (PTH) has which effects on the kidney? A) Increased absorption of vitamin D and excretion of vitamin E B) Stimulation of phosphate reabsorption and calcium excretion C) Stimulation of calcium reabsorption and phosphate excretion D) Increased absorption of vitamin E and excretion of vitamin D

C

The nurse assesses a patient who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease? A) Sodium of 140 mEq/L B) Glucose of 100 mg/dL C) Potassium of 6.0 mEq/L D) A blood pressure reading of 135/90 mm Hg

C

The nurse obtains a complete family history of a client with a suspected endocrine disorder based on which rationale? A) It helps determine the client's general status. B) Diet and drug histories are related to the family history. C) Endocrine disorders can be inherited. D) An allergy to iodine is inherited.

C

Trousseau's sign is elicited by which of the following? A) After making a clenched fist, the palm remains blanched when pressure is placed over the radial artery. B) A sharp tapping over the facial nerve just in front of the parotid gland and anterior to the ear causes spasm or twitching of the mouth, nose, and eye. C) Carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff. D) The patient complains of pain in the calf when his foot is dorsiflexed.

C

When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect: A) a blood glucose level of 130 mg/dl. B) a blood pressure of 130/70 mm Hg. C) a blood pressure of 176/88 mm Hg. D) bradycardia.

C

When preparing teaching plan for a client with an endocrine disorder, the nurse includes information about hormone regulation. Which of the following would the nurse include? A) Hormone secretion occurs as a straight-line continuous process. B) The gland becomes enlarged leading to a deficiency of the hormone. C) Most disorders result from over- or underproduction of the hormone. D) The gland slows hormone secretion when the hormone level decreases.

C

Which intervention is the most critical for a client with myxedema coma? A) Administering an oral dose of levothyroxine (Synthroid) B) Warming the client with a warming blanket C) Maintaining a patent airway D) Measuring and recording accurate intake and output

C

A client is receiving long-term treatment with high-dose corticosteroids. Which of the following would the nurse expect the client to exhibit? A) Weight loss B) Pale thick skin C) Hypotension D) Moon face

D

A client is returned to his room after a subtotal thyroidectomy. Which piece of equipment is most important for the nurse to keep at the client's bedside? A) Cardiac monitor B) Humidifier C) Indwelling urinary catheter kit D) Tracheostomy set

D

A client with acromegaly has been given the option of a surgical approach or a medical approach. The client decides to have a surgical procedure to remove the pituitary gland. What does the nurse understand this surgical procedure is called? A) Thyroidectomy B) Ablation C) Hysteroscopy D) Hypophysectomy

D

Cardiac effects of hyperthyroidism include A) decreased systolic blood pressure. B) bradycardia. C) decreased pulse pressure. D) palpitations.

D

For the first 72 hours after thyroidectomy surgery, a nurse should assess a client for Chvostek's sign and Trousseau's sign because they indicate: A) hypokalemia. B) hypercalcemia. C) hyperkalemia. D) hypocalcemia.

D

The nurse is teaching a client about the dietary restrictions related to his diagnosis of hyperparathyroidism. What foods should the nurse encourage the client to avoid? A) Hamburger B) Bananas C) Chicken livers D) Milk

D

What life-threatening outcome should the nurse monitor for in a client who is not compliant with taking the prescribed antithyroid medication? A) Syndrome of inappropriate antidiuretic hormone secretion (SIADH) B) Myxedema coma C) Diabetes insipidus D) Thyrotoxic crisis

D