Endocrine ATI practice test: Med-surge

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

- serum pH of 7.45; a client who has HHS produces enough insulin to prevent ketosis, but not enough to prevent hypoglycemia. therefore, the serum pH is within the expected reference range. Glucose levels will be above 600 mg/dL

A nurse is teaching a client who has diabetes mellitus about insulin injections. The client's prescription includes evening doses of insulin glargine and regular insulin. Which of the following instructions should the nurse include? - 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 insulin glargine is not compatible with other insulins

A nurse is teaching a client about glycosylated hemoglobib (HbA1c) testing. Which of the following statements should the nurse identify as an indication that the client understands the information about this test? - I need to fast after midnight the night before the test - This test's results is a good indicator of my average blood sugar levels - a level of 8-10% suggests adequate blood glucose control - I will use my hemoglobin A1c level to adjust my daily insulin doses

- This test's result is a good indicator of my average blood sugar levels; HbA1c reflects reflects the client's glucose levels or a 120-day period, which is the lifespan of RBCs. - HbA1c 5.7% or less indicates no diabetes mellitus less than 7% indicates good diabetes control 8-9% indicates fair diabetes control 9% or greater indicates poor diabetes control

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

- Urine specific gravity 1.025

A nurse is managing the care of a client who is postoperative and has 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 providing discharge teaching for a client who has diabetes insipidus 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 - blow your nose gently prior to using the nasal spray - administer the spray while in side-lying position - instill the medication four times per day

- blow your nose gently prior to using medication; this action prevents dilution of the medication with nasal secretions

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

A nurse is caring for a client who has pheochromocytoma. Which of the following actions should the nurse take? - 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 - pheochromocytoma: a small vascular tumor of the adrenal medulla, causing irregular secretion of epinephrine and norepinephrine, leading to attacks of raised blood pressure, palpitations, and headache

A nurse is monitoring the 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 - casual blood glucose 210 mg/dL - preprandial blood glucose 60 mg/dL

- fasting blood glucose 96 mg/dL; this is within the expected reference range for a fasting blood glucose level and indicates that insulin therapy is effective

A home health nurse is assessing a client who requires lifelong replacement hormone therapy for the 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 with hypothyroidism, along with bradypnea, dysrhythmias, cold intolerance, and cool, dry skin.

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

- ingest alcohol with food to reduce alcohol-induced hypoglycemia; alcohol inhibits the liver from producing glucose. consuming carbs while drinking alcoholic beverages helps prevent hypoglycemia

A nurse is teaching a client who has autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following effects should the nurse include? SATA - osteoporosis - moon-shaped face - increased risk of infection - hearing loss - weight loss

- osteoporosis: due to the suppression of bone formation and the acceleration of bone resorption that corticosteroid therapy can cause - moon-shaped face: long-term corticosteroid therapy causes characteristics of iatrogenic cushing's syndrome, including a moon-shaped face, potbelly, and a buffalo hump - increased risk of infection: suppression of the immune system, it reduces the phagocytic actions of macrophages and neutrophils, thus increasing the risk of infection

A nurse has administered propranolol by IV bolus to a patient who is having a thyroid storm. Which of the following findings indicates that 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 hearts 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 that excessive thyroid stimulation causes

A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires intranasal desmopressin. Which of the following 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 0.45kg (1 Ib) or more per week - report nocturia because it requires a dosage adjustment

- report nocturia because it requires a dosage adjustment ; the client should receive the initial dose of desmopressin in the evening , the provider will increase the dosage until the client no longer has nocturia

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, insomnia, heat intolerance, restlessness, and irritability

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

Calcium 12.8 mg/dL a client who has adrenal insufficiency has a calcium level above the expected reference range