[Diabetes and Other Endocrine] Medical-Surgical Nursing Review Questions
A 30-year-old female has been diagnosed with Cushing's syndrome. The nurse knows the patient is most likely to exhibit which symptoms? A. Hypertension and hirsutism B. Kyperkalemia and obesity C. Hypotension and anemia D. Menstrual irregularities and hypoglycemia
A
As part of the plan of care for a patient with SIADH, the nurse will: A. initiate fluid restriction of 800-1000 ml/day. B. maintain the head of the bed no more than 30 degrees. C. administer intravenous hypotonic saline. D. maintain the patient in a private room.
A
During the nurse's review of a patient's blood glucose log, the patient's wife states, "He has always been a brittle diabetic." To address this comment, the nurse first must assess the: A. timing and frequency of the patient's meals and snacks. B. wife's willingness to use artificial sweeteners in cooking and baking. C. patient's understanding of the presence of sugar alcohols in food. D. glycemic load of the patient's most recent meal or snack.
A
Glipizide (Glucotrol) has been prescribed for a patient with type 2 diabetes mellitus. The patient asks the nurse how glipizide helps control her diabetes. The nurse's response is based on the knowledge that glipizide: A. increases insulin secretion by the pancreas. B. speeds gastric emptying of fatty foods. C. slows the absorption of carbohydrates in the small intestine. D. reduces glucose production by the liver.
A
Matthew Kelly, age 48, is admitted to the medical-surgical unit with a 2-week history of fatigue. Assessment reveals 2+ pitting edema to the lower extremities, heart rate 116 beats per minute, and blood pressure 210/105 mm Hg. Initial laboratory results include serum sodium 150 mEq/liter and serum potassium 2.8 mEq/liter. Which additional symptoms would the nurse expect to assess in Mr. Kelly? A. Pounding headache B. Bradycardia C. Oliguria D. Muscle twitching
A
The nurse is caring for several patients with diabetes. The nurse knows the patient who is most likely to develop hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is the one who is taking which long-term steroids? A. Corticosteroids B. Vitamin K C. Antihypertensives D. Warfarin (Coumadin)
A
The nurse is discussing a patient's insulin regimen with a new graduate. Which statement by the new graduate indicates additional teaching is needed? A. "The patient is going for surgery in the morning, so I'll hold the Lantus tonight." B. "The patient is going for surgery in the morning, so I'll get an order to hold this evening's NPH." C. "The patient just returned from surgery and will be NPO, so please review the insulin orders with me." D. "The patient has an order to use his own insulin pump, so I'll document in the medical record."
A
The nurse is providing discharge instructions for a patient with Cushing's syndrome. The nurse understands instructions for home care must include: A. stress reduction and management strategies. B. use of calcium supplementation to avoid tetany. C. need for adequate calories due to increased metabolism. D. safe handling and administration of propylthiouracil (PTU).
A
The nurse knows a patient with severe, long-standing hypothyroidism may display which of the following? A. Myxedema B. Exopthalmos C. Goiter D. Truncal obesity
A
The nurse will monitor the day-to-day effectiveness of acarbose (Precose) by assessing the patient's: A. 2-hour postprandial blood glucose. B. fasting blood glucose. C. hemoglobin A1C. D. Somogyi effect.
A
The nurse would anticipate which of the following as a possible complication of thyroidectomy? A. Hypocalcemia, hemorrhage B. Tachycardia, anuria C. Hypotension, pleural effusion D. Hyperkalemia, hypovolemia
A
Valerie March, age 23, is admitted to the medical unit with ketoacidosis. Serum glucose is 922 g/dL. Ms. March describes unexplained loss of 10 pounds in the preceding 2 weeks, as well as excessive thirst and frequent urination. She is diagnosed with type 1 diabetes mellitus and intravenous insulin is initiated. After intravenous insulin indiscontinued, rapid-acting insulin by subcutaneous injection is ordered for Ms. March. The nurse will administer which of the following medications? A. Lispro (Humalog) B. Glargine (Lantus) C. Regular (Novolin R) D. Lente (Humulin L)
A
Valerie March, age 23, is admitted to the medical unit with ketoacidosis. Serum glucose is 922 g/dL. Ms. March describes unexplained loss of 10 pounds in the preceding 2 weeks, as well as excessive thirst and frequent urination. She is diagnosed with type 1 diabetes mellitus and intravenous insulin is initiated. To assess Ms. March's long-term maintenance of serum glucose within the target range, the nurse will monitor results of which ordered laboratory test? A. Hemoglobin A1C B. Glucose tolerance testing C. Pancreatic enzymes D. Serum insulin
A
A 16-year-old male patient complains he has "not hit his growth spurt yet." The patient's mother admits, "We've been relieved that he's not shown any interest in dating yet." The nurse suspects the patient may have: A. Hyposecretion by the posterior pituitary gland B. A secondary disorder of the anterior pituitary gland C. Hypersecretion of hormones from the testes D. A tertiary disorder of the adrenal medulla
B
A 74-year-old patient who underwent thyroidectomy is experiencing a thyroid crisis. When initiating emergency measures for the patient, the nurse will perform which of the following as a first priority? A. Monitoring vital signs B. Maintaining airway patency C. Stabilizing hemodynamic status D. Assessing recent output
B
A patient with acromegaly asks the nurse about the cause of this disorder. The nurse's response is based on knowledge acromegaly develops due to pathology of which gland? A. Thyroid B. Pituitary C. Pineal D. Adrenal
B
A patient with diabetes is unresponsive. Laboratory results reveal serum glucose of 816 gm/dL. The nurse suspects diabetic ketoacidosis (DKA) rather than hyperosmolar hyperglycemic nonketotic syndrome (HHNK) because of which assessment finding? A. Polyuria B. Rapid, deep respirations C. Petechiae D. Peripheral edema
B
A patient with type 2 diabetes mellitus has been diagnosed with microalbuminuria. Which of the following would the nurse expect to see on the patient's medication regimen? A. Atenolol (Tenormin) B. Losartan (Cozaar) C. Amlodipine (Norvasc) D. Terazosin (Hytrin)
B
A patient with type 2 diabetes mellitus is to begin taking an oral anti-diabetic medication. As part of medication teaching, the nurse can tell the patient that which of the following medications taken by the patient is least likely to cause low blood glucose? A. Glimepiride (Amaryl) B. Metformin (Glucophage) C. Glipizide (Glucotrol) D. Micronized glyburide (Glynase)
B
Matthew Kelly, age 48, is admitted to the medical-surgical unit with a 2-week history of fatigue. Assessment reveals 2+ pitting edema to the lower extremities, heart rate 116 beats per minute, and blood pressure 210/105 mm Hg. Initial laboratory results include serum sodium 150 mEq/liter and serum potassium 2.8 mEq/liter. The nurse correctly identifies Mr. Kelly's endocrine abnormality as a disorder of which organ? A. Posterior pituitary B. Adrenal medulla C. Anterior pituitary D. Adrenal cortex
B
The nurse is caring for a patient with diabetes insipidus (DI). The primary care provider has ordered intravenous fluid replacement. The nurse recognizes which of the following as an appropriate solution for this purpose? A. Hypertonic saline B. Dextrose 5% in water C. 0.9% saline D. Dextrose 5% in lactated ringers
B
The nurse is discussing the difference between Cushing's syndrome and Addison's disease with a new graduate. Which of the following will the nurse identify as a characteristic of Addison's disease? A. Gynecomastia in men B. Salt craving C. Menstrual irregularities in women D. Acne
B
The nurse is providing dietary education for a patient with hyperthyroidism. Which of the following instructions by the nurse is appropriate for this patient? A. "Choose high-fiber food sources to stimulate the GI tract." B. "Avoid caffeine-containing liquids to decrease sleep disturbances." C. "Limit carbohydrate intake to allow use of stored protein." D. "Plan three full meals a day and take mineral supplements."
B
The nurse is providing instruction on self-monitoring of blood glucose to a patient newly diagnosed with diabetes mellitus type 1. Which of the following statements by the nurse is correct? A. "Because you have type 1 diabetes, you should monitor your blood glucose at least once a day." B. "Be sure to monitor your blood glucose before and after exercise." C. "When you are sick, you should monitor your blood glucose at least every 12 hours." D. "Because you will have an insulin pump, you should monitor your blood glucose 1-2 times daily."
B
The nurse recognizes the potential for secondary diabetes in a patient with a diagnosis of: A. Addison's disease. B. hyperthyroidism. C. hypopituitarism. D. Hashimoto's thyroiditis.
B
Valerie March, age 23, is admitted to the medical unit with ketoacidosis. Serum glucose is 922 g/dL. Ms. March describes unexplained loss of 10 pounds in the preceding 2 weeks, as well as excessive thirst and frequent urination. She is diagnosed with type 1 diabetes mellitus and intravenous insulin is initiated. The nurse is aware the onset of a rapid-acting insulin is 15 minutes and the peak action occurs how long after administration? A. 30-45 minutes B. 60-90 minutes C. 2-3 hours D. 4-6 hours
B
A 62-year-old is admitted to the medical unit. When considering the results of physical assessment, the nurse suspects the patient has Graves's disease because of the presence of: A. dry eyes. B. pigeon chest. C. exophthalamos. D. hirsutism.
C
A patient is diagnosed with insulin resistance syndrome. The nurse recognizes this patient patient is at greatest risk for which of the following? A. Renal insufficieny B. Pancreatic cancer C. Cardiovascular disease D. Liver failure
C
Following surgery for thyroid cancer, a patient receives an order for levothyroxine (Synthroid). In providing drug education for this patient, the nurse will include the need to take the medication: A. in the evening when GI motility is greater. B. with milk or food to minimize gastric irritation. C. in the morning 30 minutes before food. D. within 1 hour of the mid-day meal.
C
Gladys Burns, age 54, is admitted to the medical-surgical unit with a diagnosis of hypoparathyroidism. She was found unresponsive in a homeless shelter. Ms. Burns has a 20-year history of alcoholism. Assessment by the nurse reveals muscle contractions of the fingers and a positive Chvostek's sign. The nurse identifies which electrolyte disorder as contributing to the assessment findings for Ms. Burns? A. Hypernatremia B. Hypomagnesemia C. Hypocalcemia D. Hyperkalemia
C
Gladys Burns, age 54, is admitted to the medical-surgical unit with a diagnosis of hypoparathyroidism. She was found unresponsive in a homeless shelter. Ms. Burns has a 20-year history of alcoholism. Assessment by the nurse reveals muscle contractions of the fingers and a positive Chvostek's sign. The nurse identifies which of the following as a possible cause of hypoparathyroidism? A. Neck trauma or radiation B. Chronic renal failure C. Hypomagnesemia D. Parathyroid adenoma
C
The nurse is caring for a patient who has received long-term corticosteroid treatment for Addison's disease. The nurse is aware of the patient's risk for injury related to development of what potential complication related to this treatment? A. Osteogenesis imperfecta B. Osteosarcoma C. Osteoporosis D. Osteomalacia
C
The nurse is caring for a patient with type 2 diabetes mellitus who appears confused and irritable. The nurse's assessment reveals the patient is also diaphoretic. The nurse determines the patient is hypoglycemic. What treatment will the nurse initiate? A. Administer 1 mg glucagon by intramuscular injection. B. Provide the patient peanut butter and crackers. C. Have the patient drink 8 ounce of low-fat milk. D. Administer 50 ml 50% glucose intravenously.
C
The nurse is providing a self-care class for patients with diabetes on the medical unit. What should the nurse tell these patients about "sick day" care for diabetes management? A. "Continue to check your blood glucose daily if you are sick." B. "Report to the health care provider glucose over 110 mg/dL on two consecutive tests." C. "Patients with type 2 diabetes may need insulin on sick days to prevent hyperglycemia." D. "Immediately discontinue oral agents if you are eating less than normal."
C
The nurse is providing diabetes education for a newly diagnosed patient who is Hispanic. During discussion about portion size, the patient comments, "The amounts of rice and beans are so small, and that's not how we like to eat." The nurse's response is based on the knowledge: A. low-carbohydrate diets are recommended for people with diabetes. B. cultural preferences often cannot be accommodated in the diabetic diet. C. serving sizes that exceed the plate method contribute to hyperglycemia. D. beans are considered a protein source for people with diabetes.
C
The nurse is providing education at a community center for a group of persons with diabetes mellitus. Which of the following statements by the nurse should be included in the discussion of diabetic diet? A. "High-protein diets are recommended for weight loss." B. "Saturated fat should equal about 10% of total calories." C. "Include a minimum of 130 grams of carbohydrates daily." D. "Lean red meat is an excellent source of polyunsaturated fat."
C
The nurse is teaching a patient with diabetes how to read food labels. The nurse notes foods labeled "sugar free" may affect blood glucose because they: A. may contain excess sodium. B. are based on a 2,000 calorie-a-day diet. C. may contain carbohydrates. D. are measured by grams rather than ounces.
C
The nurse should assess the patient with SIADH for which of the following? A. Sudden weight loss B. Increased serum sodium C. High urine specific gravity D. High urine output
C
The nurse's postoperative monitoring for a patient following thyroidectomy is based on recognition of which of the following as the most critical potential complicaton? A. Seizures B. Neck stiffness C. Bleeding D. Pain
C
Valerie March, age 23, is admitted to the medical unit with ketoacidosis. Serum glucose is 922 g/dL. Ms. March describes unexplained loss of 10 pounds in the preceding 2 weeks, as well as excessive thirst and frequent urination. She is diagnosed with type 1 diabetes mellitus and intravenous insulin is initiated. To assess Ms. March's long-term maintenance of serum glucose within the target range, the nurse will monitor results of which ordered laboratory test? A. "This is an allergic reaction. I will call the provider about discontinuing the insulin." B. "You need to clean the site more carefully before you inject the insulin." C. "This reaction is usually a short-term response. I will call the provider for an antihistamine order." D. "You may have a site infection. I will call the provider for a topical antibiotic order."
C
What additional equipment should the nurse ensure is present in the room of patient who has had a total thyroidectomy? A. Thoracotomy tray B. Central line insertion tray C. Tracheostomy tray D. Chest tube insertion tray
C
Gladys Burns, age 54, is admitted to the medical-surgical unit with a diagnosis of hypoparathyroidism. She was found unresponsive in a homeless shelter. Ms. Burns has a 20-year history of alcoholism. Assessment by the nurse reveals muscle contractions of the fingers and a positive Chvostek's sign. A nursing plan of care for Ms. Burns would include teaching the patient about which of the following? A. Phosphorus supplements B. Limited dietary potassium C. Restrictions to physical activity D. Rebreathing techniques
D
Matthew Kelly, age 48, is admitted to the medical-surgical unit with a 2-week history of fatigue. Assessment reveals 2+ pitting edema to the lower extremities, heart rate 116 beats per minute, and blood pressure 210/105 mm Hg. Initial laboratory results include serum sodium 150 mEq/liter and serum potassium 2.8 mEq/liter. Mr. Kelly's admitting diagnosis is pheochromocytoma. The nurse knows the patient's hypertension is related to excess secretion of which of the following hormones? A. Dopamine and smoatostatin B. Adrenocorticotropin and epinephrine C. Noreprinephrine and thyrotropin-releasing hormone D. Epinephrine and norepinephrine
D
The health care provider has encouraged a patient with long-term type 2 diabetes mellitus to increase his exercise as part of a diabetes management program. In providing additional education for this patient, the nurse includes which of the following statements? A. "Be sure to drink plenty of fruit juice during your exercise." B. "Remember to double your insulin dose before exercising." C. "Use a new pair of walking shoes for a better fit." D. "Remember that exercise will lower your blood glucose."
D
The nurse is caring for a patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse recognizes electrolyte abnormalities in this patient may present as: A. double vision. B. bradycardia. C. tachypnea. D. abdominal cramps.
D
The nurse is caring for a patient with chronic adrenal insufficiency. The nurse would expect this disorder to be treated with which of the following medications? A. Propylthiouracil (PTU) B. Chlorpropamide (Diabinese) C. Desmopressin acetate (DDAVP) D. Hydrocortisone (Cortef)
D
The nurse is caring for a patient with newly diagnosed hypothyroidism. Which of the following is an appropriate nursing diagnosis to include in the plan of care for this patient? A. Diarrhea related to GI hypermotility B. Activity intolerance related to fatigue and heat intolerance C. Imbalanced nutrition: less than body requirements related to inadequate food intake D. Impaired memory related to hypometabolism
D
The nurse is teaching a patient with a new diagnosis of diabetes mellitus about disease management. Which of the following "survival skills" should the nurse identify as a priority for this patient? A. Weight loss B. Limited physical activity C. Eliminating sugar from the diet D. Self-monitoring of blood glucose
D
The nurse knows the older adult who experiences thyroid problems requires additional monitoring because the: A. basal ganglion response decreases with advancing age. B. amount of thyroid secretions increases with advancing age. C. size of thyroid gland increases with advancing age. D. basal metabolic rate decreases with advancing age.
D
The nurse who routinely cares for ethnically diverse patients knows the highest incidence of diabetes mellitus occurs in which of the following groups? A. African Americans B. Hispanics C. Asians D. Native Americans
D
To help the patient with diabetes mellitus avoid injury to the feet, the nurse will encourage the patient to: A. avoid using wool socks. B. use commercial products to promptly remove calluses or corns. C. wash feet daily with an antibacterial scrub such as chlorhexadine. D. avoid going barefoot.
D
Valerie March, age 23, is admitted to the medical unit with ketoacidosis. Serum glucose is 922 g/dL. Ms. March describes unexplained loss of 10 pounds in the preceding 2 weeks, as well as excessive thirst and frequent urination. She is diagnosed with type 1 diabetes mellitus and intravenous insulin is initiated. The nurse is teaching Ms. March about insulin self-injection. The nurse knows which of the following is the site of fastest absorption? A. Upper outer arm B. Buttock C. Mid-lateral thigh D. Abdomen
D