endocrine prepU CHA

A client is admitted with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Which laboratory finding should the nurse expect in this client?

blood glucose level 1,100 mg/dl (61.05 mmol/L)

A client has been diagnosed with hypothyroidism. Which statement by the client would demonstrate appropriate teaching by the nurse?

"I will increase fiber and fluids in my diet."

A physician orders acarbose, an alpha-glucosidase inhibitor , for a client with type 2 diabetes . Which statement by the client indicates a need for additional teaching?

"If I experience hypoglycemia, I should eat something sweet."

A nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse expects to find

deposits of adipose tissue in the trunk and dorsocervical area.

A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl (2.2 mmol/L). A family member reports the client has been skipping meals in an effort to lose weight. What is the next action by the nurse?

Administer 1 ampule of 50% dextrose solution IV.

A nurse should expect to administer which medication to a client with gout?

colchicine

The nurse is teaching the client how to administer insulin. Which instruction should the nurse include?

"First withdraw clear, then cloudy insulin when mixing insulins in the same syringe."

A client with hyperthyroidism is to have a thyroidectomy. The health care provider (HCP) has prescribed propranolol. In reviewing the client's history, the nurse notes that the client has asthma. What should the nurse do next?

Contact the HCP and discuss the prescription for propranolol because of the client's history of having asthma.

A client on prolonged bed rest has developed a pressure ulcer. The wound shows no signs of healing even though the client has received skin care and has been turned every 2 hours. What is the best action by the nurse?

Evaluate client protein levels.

The client who has undergone a bilateral adrenalectomy is concerned about persistent body changes and unpredictable moods. What should the nurse teach the client about these changes?

The body and mood will gradually return to normal.

Which information should the nurse include in the teaching plan of a female client with bilateral adrenalectomy?

The client will need steroid replacement for the rest of her life.

When obtaining the nursing history of a client who has type 1 diabetes mellitus, the nurse should assess the client for which early symptom of diabetic nephropathy?

microalbuminuria

During a follow-up visit to the physician, a client with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and

phosporus

A client is admitted to the health care facility for evaluation for Addison's disease. Which laboratory test result best supports a diagnosis of Addison's disease?

serum potassium level of 5.8 mEq/L (5.8 mmol/L)

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should anticipate which laboratory test result?

serum sodium level of 124 mEq/L

Parathyroid hormone (PTH) has which effects on the kidney?

stimulation of calcium reabsorption and phosphate excretion

When evaluating teaching a client how to administer insulin, which action indicates that additional teaching is necessary?

waits 30 minutes to eat breakfast after injecting rapid-acting insulin

A client with diabetes is taking insulin lispro injections. At what time should the nurse advise the client to eat?

within 10 to 15 minutes after the injection.

The nurse reviews insulin administration with a client. Which statement best indicates that the client will continue to perform the procedure correctly?

"I wrote down the steps in case I forget what to do."

A 24-year-old client with diabetes mellitus sustains a large laceration that requires suturing. Which statement indicates that the client understands wound healing?

"It's so hard to predict when this scar will disappear."

The unlicensed assistive personnel (UAP) records a capillary blood glucose of 253 mg/dL (14.04 mmol/L) and the nurse administered insulin for coverage to the client. The UAP reports to the nurse that the blood glucose was incorrect. What actions should the nurse take? Select all that apply.

Obtain a current blood glucose level. Observe the client for hypoglycemia. Report the incident to the healthcare provider. Complete an incident report.

A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which gland?

adrenal cortex

Which findings indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus?

confusion and seizures

Which results would indicate that levothyroxine sodium is effectively resolving the symptoms of a client with hypothyroidism?

increased energy, weight loss, and a higher temperature and pulse rate

To provide oral hygiene for a client recovering from transsphenoidal hypophysectomy, what should the nurse instruct the client to do?

rinse with saline

The nurse is performing the initial assessment on a middle age woman recently diagnosed with Cushing's syndrome. The nurse reviews the history and physical (see chart). The nurse should develop a plan with the client to manage which effects? Select all that apply.

risk for injury slow healing changes in physical appearance risk for infection

When a nurse attempts to make sure the health care provider obtained informed consent for a thyroidectomy, the nurse realizes the client doesn't fully understand the surgery. The nurse approaches the health care provider, who curtly says, "I've told this client all about it. Just get the consent." The nurse should:

tell the health care provider the nurse cannot obtain informed consent at this point.

On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance most commonly follows thyroid surgery?

hypocalcemia

A client is scheduled for an appendectomy. What is the nurse's highest priority when planning preoperative teaching for this client?

The client should begin coughing and deep-breathing exercises as soon as the client is able to follow instructions.

A medical nurse educator is reviewing a client's recent episode of metabolic acidosis with members of the nursing staff. What should the educator describe about the role of the kidneys in metabolic acidosis?

The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance.

A nurse is providing home care to a client with a foot ulcer related to diabetes. The client needs daily insulin injections. Family caregivers do not possess the technical skills to inject insulin. Which should the nurse keep in mind?

The nurse needs to be creative in integrating the technical and relational aspects of care.

The nurse is caring for a client with possible Cushing's syndrome undergoing diagnostic testing. The health care provider orders lab work and a dexamethasone suppression test. Which parameter would the nurse assess on the dexamethasone suppression test?

cortisol levels before and after the system is challenged with a synthetic steroid