Endocrine

A nurse is caring for a client undergoing screening for primary Cushing's disease. The nurse should expect that which of the following laboratory findings to be elevated?

Blood glucose

A nurse is providing teaching for a client who has diabetes mellitus. Which of the following findings associated with diabetic ketoacidosis (DKA) should the nurse include? Decreased urine output Weight gain of 0.45 kg (1 lb) in 24 hr Rapid, shallow respirations Blood glucose levels above 300 mg/dL

Blood glucose levels greater than 300 mg/dL

A nurse is providing discharge teaching for a client who has diabetes insipidus and has a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching? "Depress the pump once before using the nasal spray for the first time." "Blow your nose gently prior to using the nasal spray." "Administer the nasal spray while in a side-lying position." "Notify the provider if you develop numbness or tingling around the mouth."

Blow nose gently prior to using the nasal spray.

A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect? Moon-shaped face Weight gain Calcium 12.8 mg/dL Sodium 150 mEq/L

Calcium 12.8 mg/dL A client who has adrenal insufficiency will have a calcium level above the expected reference range of 4.5 to 5.6 mg/dL.

A nurse is assessing a client who has diabetes mellitus and reports feeling anxious. Which of the following findings should the nurse expect if the client is hypoglycemic? Rapid, deep respirations Cool, clammy skin Abdominal cramping Orthostatic hypotension

Cool, clammy skin Hypoglycemia causes cool, clammy skin, in addition to anxiety, nervousness, tachycardia, and confusion.

A nurse is assessing a client who is taking propylthiouracil. The nurse should identify which of the following findings as an indication that the medication has been effective? Increased ability to sweat Increased bowel movements Increased body weight Increased libido

Increased body weight Propylthiouracil suppresses the production of thyroid hormones and allows for weight gain. However, excessive weight gain could indicate that the dose of propylthiouracil is too high.

A nurse is assessing a client who has diabetes insipidus. The nurse should expect which of the following findings? Decreased heart rate Increased hematocrit High urine specific gravity Low BUN level

Increased hematocrit Increased hematocrit is an expected finding of diabetes insipidus due to dehydration.

A nurse is caring for a client who is taking propylthiouracil (PTU). The nurse should recognize that the client has met the treatment goals when she reports an increase in which of the following effects?

Weight

A nurse is reviewing laboratory values for a client who has diabetic ketoacidosis (DKA). Which of the following results should the nurse expect? pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L pH 7.38, PaCO2 55 mm Hg, HCO3- 22 mEq/L pH 7.44, PaCO2 40 mm Hg, HCO3- 24 mEq/L pH 7.50, PaCO2 42 mm Hg, HCO3- 30 mEq/L

pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L Metabolic acidosis is a common manifestation of DKA, with a low pH, carbon dioxide within the expected reference range, and low bicarbonate.

A home health nurse is assessing a client who is on lifelong hormone replacement therapy for treatment of hypothyroidism. The client has not been taking his medication regularly. Which of the following findings should the nurse expect? Increased urine output Persistent diarrhea Tachycardia Hypotension

Hypotension Hypotension is an expected finding of hypothyroidism, along with bradypnea, dysrhythmias, cold intolerance, and cool, dry skin.

A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements by the client indicates an understanding of the teaching? "I will let my feet air dry after washing." "I will wear sandals to allow air to circulate around my feet." "I will buy over-the-counter medicine to treat the calluses on my feet." "I will apply lotion to the dry areas of my feet but not between my toes."

"I will apply lotion to the dry areas of my feet but not between my toes."

A nurse is providing teaching for a client who has type 1 diabetes mellitus about how to prevent complications during illness. Which of the following statements indicates that the client understands the teaching? "I should stop taking my insulin if I feel nauseous." "I will test my urine for protein when I start to feel ill." "I will call my doctor if my blood sugar is more than 250." "I should check my blood sugar level every 8 hours."

"I will call my doctor if my blood sugar is more than 250 mg/dL."

A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires intranasal desmopressin. Which of the following information should the nurse include in the teaching plan? "Drink at least 3 liters of fluid per day." "Weigh yourself weekly while wearing similar clothing at the same time of day." "Notify the provider of a weight loss of 1 pound or more per week." "Report nocturia because it requires a dosage adjustment."

"Report nocturia because it requires a dosage adjustment." The client should take the initial dose of desmopressin in the evening. The provider will increase the dosage until the client no longer has nocturia.

A nurse is teaching a client who is scheduled for a vanillylmandelic acid test to screen for pheochromocytoma. Which of the following statements should the nurse include in the teaching? "Start fasting at midnight prior to the day of the test." "Begin the 24-hour urine collection with the first morning urination." "Take low-dose aspirin for pain during the testing period." "Restrict coffee intake 2 to 3 days prior to the test."

"Restrict coffee intake 2 to 3 days prior to the test." The client should avoid coffee and tea, even if they are decaffeinated, bananas, chocolate, and vanilla for 2 to 3 days prior to the test.

A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include? "Take this medication on an empty stomach." "Take this medication with an antacid." "Change position slowly while taking this medication." "Limit your fluid intake while taking this medication."

"Take this medication on an empty stomach." To promote proper absorption, the client should take the medication on an empty stomach and not eat or drink anything for 30 to 60 min after.

A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following statements by the client indicates an understanding of the information about this test? "I need to fast after midnight the night before the test." "This test's result is a good indicator of my average blood glucose levels." "A level of 8 to 10 percent suggests adequate blood glucose control." "I will use my hemoglobin A1c level to adjust my daily insulin doses."

"This test is a good indicator of my average blood glucose levels." HbA1c reflects the client's glucose levels over a 120-day period, which is the life span of RBCs.

A nurse is preparing to give a client information about an adrenocorticotropic hormone (ACTH) stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders? Diabetes insipidus Hyperthyroidism Pheochromocytoma Addison's disease

Addison's disease

A nurse is managing the care of a client who is postoperative and experiencing acute adrenal insufficiency. Which of the following actions should the nurse take? Administer IV hydrocortisone sodium. Give oral spironolactone. Infuse 1 unit of platelets. Restrict daily fluid intake.

Administer IV hydrocortisone sodium Hydrocortisone sodium is necessary to replace the cortisol deficiency that occurs with adrenal insufficiency.

A nurse is preparing insulin for a client who has diabetes mellitus. The client is to receive evening doses of insulin glargine and regular insulin. Which of the following actions should the nurse take to administer these two medications safely? Inject the insulins intramuscularly. Shake the insulins vigorously prior to administration. Draw up the insulins into separate syringes. Expect the insulins to appear cloudy.

Draw up the insulins into separate syringes.

A nurse is planning preoperative care for a client who has pheochromocytoma. Which of the following interventions should the nurse anticipate as being the priority? Elevate the head of the client's bed. Palpate the client's abdomen. Monitor the client for hypotension. Check the client's urine specific gravity.

Elevate the head of the client's bed. The nurse should elevate the head of the client's bed to reduce blood pressure and abdominal pressure.

A nurse is monitoring the laboratory values of a client who has diabetes mellitus and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy? Fasting blood glucose 96 mg/dL Postprandial blood glucose 195 mg/dL Random blood glucose 210 mg/dL Preprandial blood glucose 60 mg/dL

Fasting blood glucose 96 mg/dL

A nurse is caring for a client undergoing screening for primary Cushing's disease. The nurse should expect an elevation in which of the following laboratory findings? Lymphocyte count Potassium Calcium Glucose

Glucose

A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect? Decreased blood pressure Weight loss Hirsutism Increased skin thickness

Hirsutism Increased hair growth, or hirsutism, is an expected finding of Cushing's disease due to increased androgen production.

A nurse is planning dietary teaching for a client who has type 1 diabetes mellitus. Which of the following information should the nurse include regarding alcohol consumption?

Ingest alcohol with meals to reduce alcohol-induced hypoglycemia.

A nurse is planning teaching for a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse plan to include? Consume no more than three servings of alcohol per day. Ingest food with alcohol to reduce alcohol-induced hypoglycemia. Increase insulin dosage before planned exercise. Rest for 3 days between periods of vigorous exercise.

Ingest food with alcohol to reduce alcohol-induced hypoglycemia. Alcohol inhibits the liver's production of glucose. Consuming carbohydrates while drinking alcoholic beverages helps prevent hypoglycemia.

A nurse is monitoring a client's status 24 hr after a total thyroidectomy. Which of the following findings should the nurse report to the provider? Laryngeal stridor Productive cough Pain with hyperextension of the neck Hoarse, weak voice

Laryngeal stridor Laryngeal stridor is a harsh, high-pitched sound with inspiration that indicates respiratory obstruction. The nurse should take immediate action to preserve the client's airway.

A nurse is caring for a client who has diabetes mellitus and developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to his feet? Examine the skin of the feet feet weekly for alterations in skin integrity. Monitor the temperature of bath water with a thermometer. Shop for shoes early in the day. Round the edges of toenails when trimming them.

Monitor the temperature of bath water with a thermometer.

A nurse is teaching a client who has an autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following effects should the nurse include? (Select all that apply.) Osteoporosis Moon-shaped face Increased risk of infection Hearing loss Weight loss

Osteoporosis Moon-shaped face Increased risk of infection

A nurse is preparing to administer propranolol by IV bolus to a client experiencing a thyroid storm. Which of the following findings indicates the client is having a therapeutic response? Reduction of the effects of thyroid hormone on the heart Blockage of the release of thyroid hormone from the thyroid gland Increase in the heart's sensitivity to thyroid hormone Increase in the uptake of thyroid hormone by the thyroid gland

Reduction of the effects of thyroid hormone on the heart Propranolol is a beta2-adrenergic blocking agent that decreases the rapid heart rate caused by excessive thyroid stimulation.

To screen a client for pheochromocytoma, a nurse schedules a vanillylmandelic acid test. When teaching the client about this test, which of the following instructions should the nurse include?

Restrict coffee intake 2 to 3 days prior to the test.

A nurse is caring for a client who has type 2 diabetes mellitus and is admitted with hyperglycemic-hyperosmolar state (HHS). Which of the following laboratory findings should the nurse expect? Serum pH 7.32 Blood glucose 250 mg/dL Blood glucose 425 mg/dL Serum pH 7.45

Serum pH 7.45

A nurse is performing an assessment on a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following assessment data should the nurse report?

Serum sodium 110 mEq/L

A nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following findings should the nurse report to the provider? Sodium 110 mEq/L 2+ deep-tendon reflexes Potassium 3.7 mEq/L Urine specific gravity 1.025

Sodium 110 mEq/L

A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia? Strong, bounding pulse Decreased bowel sounds Tingling and numbness of the hands and feet Diminished deep-tendon reflexes

Tingling and numbness of the hands and feet Hypocalcemia causes paresthesia, which usually starts in the hands and feet.

A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings? Cold intolerance Lethargy Tremors Sunken eyes

Tremors Findings of hyperthyroidism include tremors, diaphoresis, and insomnia.