Endocrine

A nurse is caring for a client who is receiving liothyronine (Cytomel) for treatment of hypothyroidism. Which of the following should the nurse recognize as a therapuetic response? 1. loss of appetite 2. increase in daily weight 3. improvement of overall mood 4. decrease in body temperature

Improvement of overall mood; depression, lethargy, and fatigue are symptoms of hypothyroidism.

A nurse is caring for a client who has hypercortisolism. Which of the following is a manifestation of this diagnosis? 1. butterfly rash on the face 2. moon face 3. positive chvostek's sign 4. muscle hypertrophy

Moon face; hypercortisolism is also called Cushing's syndrome

A nurse administers a daily dose of NPH insulin (Humulin N) at 0730. If the client reports anorexia and refuses breakfast following the dose, the nurse will plan to observe the client closely for hypoglycemic reaction at: 1. 0830 2. 1130 3. 1330 4. 1730

1330; this intermediate-acting insulin peaks at 6-14 hours.

A nurse is caring for a client who is prescribed 15 units NPH insulin to be administered at 0700. What time of day should the nurse plan to offer a snack? 1. 0500 2. 0900 3. 1000 4. 1500

1500; eight hours after NPH administration is the middle of the peak time for intermediate acting insulins.

Which of the following client lab tests may reveal risk factors for metabolic syndrome? 1. liver function studies and bilirubin 2. fasting glucose and lipid profile 3. CBC and BUN 4. basic metabolic profile and troponin I

Fasting glucose and lipid profile

A nurse is assisting a client who has hypothyroidism with meal planning. The nurse should reinforce with the client that she should increase her daily intake of: 1. fiber 2. monounsaturated fats 3. protein 4. polyunsaturated fats

Fiber; constipation is a manifestation of hypothyroidism so fiber should be increased.

A nurse is caring for a client who has Addison's disease. For which of the following manifestations should the nurse observe? 1. intention tremors 2. hyperpigmentation 3. hirsutism 4. purple striations

Hyperpigmentation; insufficient cortisol causes pituitary gland to secrete ACTH which results in increased pigmentation. Addison's also results in loss of body hair.

A nurse is caring for a client who has Cushing's syndrome. Which of the following findings is a manifestation of this diagnosis? 1. weight loss 2. hypotension 3. diaphoresis 4. hyperpigmentation

Hyperpigmentation; manifestations of Cushing's are weight gain, hypertension, thinning skin, and hyperpigmentation

A nurse is caring for a client who has Cushing's syndrome. Which of the following findings is a manifestation of this diagnosis? 1. weight loss 2. hypotension 3. diaphoresis 4. hyperpigmentation

Hyperpigmentation; manifestations of Cushing's are weight gain, hypertension, thinning skin.

A nursing is caring for a client who has Cushing's disease and is reviewing nutrition therapy. Which of the following dietary modifications should be included in this discussion? 1. limit potassium rich foods in the diet 2. increase protein intake 3. increase caloric intake 4. decrease fat intake to 5% of total calories

Increase protein intake; minimizes the muscle wasting and osteoporosis that comes with Cushing's. Caloric intake should be reduced and sodium should be limited.

A nurse is caring for a client who take prednisone (Deltasone) and has developed an infection. The nurse should expect that the provider will: 1. increase the dosage of prednisone 2. discontinue prednisone therapy 3. decrease the dosage of prednisone 4. make no changes to the dosage

Increase the dosage of prednisone; infection increases the body's need for glucocorticoids.

A nurse is caring for a client who has Cushing's syndrome. Which of the following manifestations should the nurse expect the client to report? 1. increased bruising 2. weight loss 3. hyperpigmentation 4. double vision

Increased bruising; skin is fragile and easily bruised. May develop ecchymoses, petechiae, and striae

A nurse is reviewing the lab results for a client who has primary hyperparathyroidism. the nurse expects that which of the following findings is associated with this diagnosis? 1. decreased calcium level 2. increased magnesium level 3. decreased parathyroid hormone level 4. increased phosphate level

Increased magnesium level; with primary hyperparathyroidism, there is an increase in calcium, magnesium, and parathyroid hormone, while there is a decrease in phosphate level

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin. The nurse should take which of the following actions first when mixing the two types of insulin? 1. inject 10 units air into regular insulin bottle 2. inject 20 units air into NPH insulin bottle 3. withdraw 10 units air from regular insulin bottle 4. withdraw 20 units air from NPH insulin bottle

Inject 20 units of air into the NPH insulin bottle; this is the intermediate-acting insulin.

A nurse is administering 10 units of regular insulin and 20 units of NPH insulin. The nurse should take which of the following actions first when mixing the two types of insulin? 1. inject 10 units of air into regular insulin bottle 2. inject 20 units air into NPH insulin bottle 3. withdraw 10 units of air from regular insulin bottle 4. withdraw 20 units air from NPH insulin bottle

Injection 20 units air into NPH insulin bottle

A nurse is caring for a client who is diabetic. Which of the following is a manifestation of mild hypoglycemia? 1. irritability 2. clammy skin 3. drowsiness 4. rapid pulse

Irritability; typical indicative of blood glucose less than 60 mg/dL.

A nurse is caring for a client who has a new diagnosis of hyperthyroidism (Grave's disease). Which of the following are expected lab findings? 1. low TSH 2. normal T3 3. normal T4 4. low thyroid antibody titer

Low TSH;

A nurse is collecting data from a client who the provider suspects may have syndrome of inappropriate antidiuretic hormone. When obtaining a medical history, the nurse should ask for additional information about which condition? 1. osteoarthritis 2. lung cancer 3. liver cirrhosis 4. dyspepsia

Lung cancer; some treatments for lung cancer cause secretion of antidiuretic hormone.

A nurse is caring for a client who has hypoparathyroidism. Which of the following is a manifestation of this diagnosis? 1. flaccid muscles 2. numbness of the hands 3. negative Chvostek's sign 4. hypercalcemia

Numbness of the hands; numbness and tingling of mouth or hands and feet results from hypocalcemia

A nurse is caring for a client who has hyperparathyroidism. Based on this diagnosis, the nurse is aware that the client is at risk for which of the following? 1. impaired skin integrity 2. fluid retention 3. pathologic fractures 4. dysphagia

Pathologic fractures; hyperparathyroidism results in release of calcium and phosphate into the blood, decreasing bone density.

A nurse is reviewing lab results for a client who has hypoparathyroidism. The nurse expects that which of the following values is associated with this diagnosis? 1. Vitamin D 25 2. magnesium 1.8 3. calcium 9.8 4. phosphate 5.7

Phosphate 5.7; this is above expected range and is expected with hypoparathyroidism.

A nurse is caring for a client who has hypothyroidism and is prescribed a synthetic hormone replacement. Which of the following manifestations indicates the prescribed dosage is too high? 1. decreased temperature 2. bradypnea 3. decreased appetite 4. photophobia

Photophobia; photophobia is a manifestation of hyperthyroidism

A nurse is caring for a client who has hypothyroidism and is prescribed a synthetic hormone replacement. Which of the following manifestations indicates the prescribed dosage is too high? 1. decreased temperature 2. bradypnea 3. decrease appetite 4. photophobia

Photophobia; this is a manifestation of hyperthyroidism and indicates the the dosage is too high.

A nurse is caring for a client who has severe head injury. Which of the following findings indicates to the nurse that the client may be developing diabetes insipidus? 1. serum sodium 115 2. urine specific gravity 1.028 3. urine output 250 mL/hr 4. blood glucose 198

Urine output 250 mL/hr; DI is a disorder of the anterior pituitary gland- the decrease in ADH results in high urine output of very dilute urine.

A nurse is caring for a client diagnosed with diabetes insipidus. Which of the following is an expected finding? 1. urine specific gravity 1.004 2. bounding peripheral pulses 3. bradycardia 4. moist mucous membranes

Urine specific gravity 1.004; urine will be dilute with specific gravity less than 1.005. Other expected findings are weak pulses, tachycardia, and dry mucous membranes

A nurse is discussing care of a client who has type 1 diabetes mellitus. Which of the following situations should the nurse instruct the AP to report immediately? 1. dizziness when standing 2. the client refuses breakfast and requests to sleep 3. client asks the AP to trim his broken toenail 4. the client report urine that is dark yellow in color

The client refuses breakfast and requests to sleep; missing breakfast means that the client may experience hypoglycemia.

A nurse is collecting data from a client who has hypocalcemia. Which of the following findings should the nurse expect? 1. decreased deep tendon reflexes 2. skeletal muscle weakness 3. hypoactive bowel sounds 4. tingling of the lips

Tingling of the lips; tingling and twitching in the extremities and face (lips, nose, and ears) occur with hypocalcemia

A nurse is reviewing the serum calcium level of a client who had a total thyroidectomy. The serum calcium level is below normal. Which of the following manifestations may indicate the first sign of hypocalcemia? 1. tingling toes and fingers 2. muscle twitching 3. hyperactive bowel sounds 4. loss of bone density

Tingling toes and fingers; this is the first sign. Muscle twitching, hyperactive bowel sounds, and loss of bone density occur as hypocalcemia progresses.

A nurse administers desmopressing (DDAVP) to a client who has a diagnosis of diabetes insipidus. Which of the following indicates the desired therapeutic effect? 1. serum sodium 146 2. blood glucose 80 3. urine specific gravity 1.015 4. BUN 15

Urine specific gravity; diabetes insipidus causes dilute urine, so a therapeutic effect would be urine specific gravity within expected reference range 1.010-1.025

A client who is 1 day postop following a thyroidectomy reports severe muscle spasms of the lower extremities. Which action should the nurse implement? 1. check pedal pulses 2. verify most recent calcium level 3. request medical order for relaxant 4. administer oral potassium supplement

Verify most recent calcium level; thyroidectomy puts client at risk for hypocalcemia d/t disruption of parathyroid gland during surgery. Parathyroid glands are responsible for calcium regulation.

A nurse assesses a female client who has signs of obesity. Which of the following indicates the client is obese? 1. body fat of 22% 2. BMI of 28 3. waist circumference of 32 inches 4. weight 28% above ideal body weight

Weight 28% above ideal body weight; weight should not be over 20% of ideal weight. BMI of 28 is classified as overweight, not obese. Obese women have waist circumference greater than 35 inches.

A nurse is caring for a client diagnosed with myxedema. Which of the following are findings associated with this diagnosis? 1. weight loss, diarrhea 2. weight gain, slurred speech 3. tachycardia, hyperreflexia 4. heat intolerance, pitting edema

Weight gain, slurred speech; symptoms are related to a generalized decrease in the metabolic rate.