Chapter 41 Prep U: Disorders of endocrine control of growth and metabolism

Select the most common symptoms of diabetes. Select all that apply.

Polydipsia Polyuria Polyphagia

A 62-year-old man who is overweight has just been diagnosed with type 2 diabetes. The nurse educator is instructing him in the ways his diabetes can be controlled. The nurse should initially prioritize which action?

Helping the client make meaningful changes to his diet and activity level.

When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptom does the client report that the nurse would find associated with this disorder?

Increase in appetite

When providing nutrition education to the client with diabetes, the nurse should include which statement regarding fat intake?

"If you have diabetes, avoiding saturated fats is important."

A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to?

A hypermetabolic state

When educating a client with possible glucocorticoid dysfunction, the nurse will explain that the CRH controls the release of ACTH. The best time to perform the blood test to measure peak ACTH levels would be

06:00 to 08:00 AM

A 15-year-old child with type 1 diabetes asks nurse about the potential to "lose sight." Which response would be the most appropriate?

: Explain that many people with diabetes experience some complications like retinopathy, but these are best prevented with tight control of glucose levels.

The nurse is working in a pediatric clinic. Which child would the nurse recognize as having isosexual precocious puberty

A 5-year-old black female with developing breasts and pubic hair

Which pediatric assessment finding would the nurse recognize as an example of precocious puberty?

A 7-year-old female with early menarche

The mother of 6-year-old male and female fraternal twins has brought her son to see a pediatrician because he is nearly 4 inches shorter than his sister. Which phenomenon would the physician most likely suspect as contributing factor to the boy's short stature?

A shortage of hypothalamic GHRH production

When educating a client about type 1 diabetes, the nurse will mention that this type is caused by which mechanism?

Autoimmune destruction of pancreatic beta cells

A client with diabetic retinopathy develops a retinal bleed and asks the nurse, "How can I prevent this from happening again?" What response provides the most effective information?

Maintain healthy blood pressure and blood sugar levels.

A client hospitalized with type 1 diabetes has been administered a scheduled dose of regular insulin. What are the primary actions of insulin? Select all that apply.

Fat storage Glucose uptake by muscle and adipose tissue Protein synthesis

Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur?

Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen

The family of a client in the hospital with diabetes mellitus that is out of control asks the nurse to explain the client's recent weight loss while eating more than usual. How will the nurse respond?

Glucose is unused without insulin, so body fats are used for energy

A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes. The best diagnostic indicator that would support the client's response would be:

Glycosylated hemoglobin, hemoglobin A1C (HbA1C

An extremely lethargic client arrives by ambulance at the emergency department. His blood glucose level is 32 mg/dL (1.78 mmol/L). The nurse will anticipate that this client will be diagnosed with:

Hypoglycemia

A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing?

Increased levels of ACTH

A client with diabetes asks the nurse for advice in controlling between-meal blood glucose levels. Which of these might the nurse suggest as a long-acting insulin to provide a consistent basal level?

Insulin glargine

An overweight, 14-year-old boy feels tired all the time. He sleeps 12 to 14 hours a day and has a voracious appetite but no energy to burn off the calories. He has been diagnosed with hypothyroidism brought about by the accumulation of a nonpitting mucosal edema. For which life-threatening condition should his care team be prepared?

Myxedema coma

A parent arrives in the endocrinology clinic with her 8-year-old son, concerned about his rapid development and tall stature. What significant assessment finding does the nurse recognize is important to report to the physician related to the development of precocious puberty?

Significant genital enlargement

A 33-year-old female client presents with pronounced enlargement of the hands and facial features. The client is diagnosed with acromegaly. What is the most common cause of acromegaly in adults? Select all that apply.

Somatotroph adenoma Increased growth hormone

A young adult woman is reporting an unusual deposit of fat on her upper back, a rounded appearance to her face, increasing weakness, and development of "stretch marks." The nurse should anticipate what treatment given these manifestations

Surgical removal of the client's pituitary tumor

Which statement best describes a secondary disorder of endocrine function?

The disorder occurs when the target organ is normal, but stimulating hormones alter its function.

A 3-year-old girl has just been diagnosed with type 1A diabetes. Her parents are currently receiving education from the diabetes education nurse. How can the nurse best explain to the parents the etiology (cause) of their daughter's diabetes?

The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin."

The nurse is taking a health history from a client with acromegaly. The client informs the nurse that he is waking up several times a night and has been told he has sleep apnea. What does the nurse inform the client is the rationale for this syndrome?

There is an increase in pharyngeal soft tissue accumulation.

A client with type 1 diabetes mellitus wishes to stop taking insulin injections. What option is appropriate?

Using an insulin infusion pump

A client with Graves disease has ophthalmopathy and asks the nurse if the eyes will stay like this forever. What is the best response by the nurse?

With treatment of the hyperthyroid state, the ophthalmopathy usually tends to stabilize."

The obstetrical nurse is caring for a client who has been treated for gestational diabetes. When teaching the client about the causes of gestational diabetes, the nurse should include which risk factor in the teaching?

Woman with a family history of diabetes

A client with type 1 diabetes has started a new exercise routine. Knowing there may be some increased risks associated with exercise, the health care provider should encourage the client to:

carry a snack with a rapidly absorbed form of glucose to prevent profound hypoglycemia.

The nurse screening for diabetes mellitus at a health fair obtains these results. Which client should be referred to a primary health care provider for further evaluation?

random blood glucose 195 mg/dl (10.8 mmol/l)