exam 6

. How is Hepatitis E transmitted?* ○ A. Fecal-oral ○ B. Percutaneous ○ C. Mucosal ○ D. Body fluids

1. A 35-year-old female patient taking oral contraceptives is prescribed steroid therapy. What is a priority teaching point for this patient? a. "Consider adding another form of contraception while using both medications." b. "These medications do not interact. No changes need to be made." c. "Measure your weight daily." d. "Avoid the use of salt."

. Which of the following side effects are possible for a patient taking an anti-thyroid medication?* ○ A. Agranulocytosis and aplastic anemia ○ B. Tachycardia ○ C. Skin discoloration ○ D. Joint pain and eczema

1. A patient has ascites caused by liver failure. Which finding should the nurse report for immediate follow-up? a. Asterixis b. Jaundice c. Increased abdominal girth d. Dyspnea

1. The nurse notes new areas of ecchymosis on the arms and legs of a patient with liver cirrhosis. Which laboratory test result should the nurse monitor because of this finding? Select All That Apply. a. Complete blood count with platelets b. Coagulation studies c. Serum albumin d. Serum ammonia levels e. Serum hepatitis antibodies

A nurse is planning care for a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH) with mild manifestations. The nurse should expect the provider to prescribe which of the following medications? a. Chlorpropamide b. Tolvaptan c. Vasopressin d. Desmopressin

A nurse is preparing a 24-hour urine specimen for a client who is suspected to have pheochromocytoma. Which of the following laboratory tests from the 24-hour urine specimen should the nurse use to determine the client's condition? a. Creatinine clearance b. Vanillylmandelic acid (VMA) c. 17-hydroxycorticosteroids (17-OHCS) d. Protein

A patient diagnosed with hypercalcemia. The nurse would attribute which finding to that diagnosis? a. Oliguria b. Positive Chvostek sign c. Constipation d. Hyperactive deep tendon reflexes e. Cardiac dysrhythmias

The nurse is caring for a patient with elevated serum thyroid hormones and new-onset proptosis. Which problem would be a priority for this patient? 1. Change in appearance 2. Altered immunity 3. Weight gain 4. Fluid retention

Answer: 1 Explanation: 1. Proptosis changes the appearance of the eyes. The problem that would be a priority for the patient is a change in appearance. 2. Proptosis does not affect immune function. 3. Proptosis is associated with hyperthyroidism. There is a risk that the patient will lose weight. 4. Proptosis does not affect fluid balance.

The nurse is caring for a client who is receiving growth hormone replacement therapy. The nurse monitors the client for which option as an adverse effect of this therapy? a. Hypercalciuria b. Hypoglycemia c. Hyperglycemia d. Hyperthyroidism

The nurse is monitoring a client for signs of hypocalcemia after thyroidectomy. Which sign or symptom, if noted in the client, would most likely indicate the presence of hypocalcemia? a. Bradycardia b. Flaccid paralysis c. Tingling around the mouth d. Absence of Chvostek's sign

s/s chronic pancreatitis?

Epigastric pain radiating to the left flank and left shoulder

. ________ reside in the liver and help remove bacteria, debris, and old red blood cells.* ○ A. Hepatocytes ○ B. Langerhan cells ○ C. Enterocytes ○ D. Kupffer cells

. ___________ is an autoimmune disorder where the body attacks the thyroid gland that causes it to stop releasing T3 and T4. The patient is likely to have the typical signs/symptoms of hypothyroidism, however, they may present with what other sign as well?* ○ A. Myxedema coma; joint pain ○ B. Thyroid storm; memory loss ○ C. Hashimoto's Thyroiditis; goiter ○ D. Toxic nodular goiter (TNG); goiter

The nurse is admitting a client diagnosed with primary adrenal cortex insufficiency (Addison's disease). Which clinical manifestations should the nurse expect to assess? 1. Moon face, buffalo hump, and hyperglycemia. 2. Hirsutism, fever, and irritability. 3. Bronze pigmentation, hypotension, and anorexia. 4. Tachycardia, bulging eyes, and goiter.

1. A moon face, buffalo hump, and hyperglycemia result from Cushing's syndrome, hyperfunction of the adrenal gland. 2. Hirsutism is hair growth where it normally does not occur, such as facial hair on women. Fever and irritability, along with hirsutism, are clinical manifestations of Cushing's syndrome. 3. Bronze pigmentation of the skin, particularly of the knuckles and other areas of skin creases, occurs in Addison's disease. Hypotension and anorexia also occur with Addison's disease. 4. Tachycardia, bulging eyes, and goiter are clinical manifestations occurring with thyroid disorders.

1. A patient diagnosed with obesity asks about the appetite suppressant phentermine to assist with a weight loss program. Which information in the patient's health history might restrict the patient's ability to take this medication? a. Frequent use of alcohol b. History of narcolepsy c. A family history of thrombophlebitis d. A body mass index of 31 kg/m2

The nurse identifies the client problem "risk for imbalanced body temperature" for the client diagnosed with hypothyroidism. Which intervention should be included in the plan of care? 1. Discourage the use of an electric blanket. 2. Assess the client's temperature every two (2) hours. 3. Keep the room temperature cool. 4. Space activities to promote rest

1. External heat sources (heating pads, electric or warming blankets) should be discouraged because they increase the risk of peripheral vasodilation and vascular collapse. 2. Assessing the client's temperature every two (2) hours is not needed because the temperature will not change quickly. The client needs thyroid hormones to help increase the client's temperature. 3. The room temperature should be kept warm because the client will have complaints of being cold. 4. The client is fatigued and this is an appropriate intervention but is not applicable to the client problem of "risk for imbalanced body temperature."

Which nursing intervention should be included in the plan of care for the client diagnosed with hyperthyroidism? 1. Increase the amount of fiber in the diet. 2. Encourage a low-calorie, low-protein diet. 3. Decrease the client's fluid intake to 1,000 mL/day. 4. Provide six (6) small, well-balanced meals a day.

1. Fiber should be increased in the client diagnosed with hypothyroidism because the client experiences constipation secondary to decreased metabolism. 2. The client with hyperthyroidism should have a high-calorie, high-protein diet. 3. The client's fluid intake should be increased to replace fluids lost through diarrhea and excessive sweating. 4. The client with hyperthyroidism has an increased appetite; therefore, well-balanced meals served several times throughout the day will help with the client's constant hunger.

What is diabetes insipidus?

ADH Insufficiency polyuria, polydipsia, low urine osomolaity and specific gravity

What is SIADH?

ADH excess low urine output, increased thirst, low serum osomality, hyponatreamia, cereal edema, mental status changes, and weight gain (no edema)

Chronic deficiency of cortisol, aldosterone, and adrenal androgens is what disease?

Addisons disease

What is the transmission route of Hepatitis A?

Contaminated food, water, shellfish and feces.

What is caused by excessive amounts of circulating cortisol?

Cushings syndrome

What DX hepatic encephalopathy?

Demonstrates asterixis and has elevated ammonia levels.

What is myxedema coma?

Hyponatremia, hypoglycemia, lactic acidosis, hypothermia, cardiovascular (low BP low pulse) impaired cognition

In the scenario above, what medication do you expect the patient to be started on?* ○ A. IV Solu-Cortef ○ B. PO Prednisone ○ C. PO Declomycin ○ D. IV Insulin

What causes hypothyroidism?

Increased TSH decreased T3, T4

What should be monitored with liver cirrhosis?

Monitor AST, ALT, PTT/INR, Albumin, and Bilirubin

What is the treatment for acute pancreatitis?

Patient is to remain NPO until lipase and amylase return to normal levels and pain is controlled.

Select-ALL-that-apply: In the pancreas, the acinar cells release:* ○ A. Amylase ○ B. Somatostatin ○ C. Lipase ○ D. Protease

What is hepatitis B?

Transmitted via blood, bodily fluids, DNA virus, prevented using 3 dose vaccines, treated with limiting alcohol intake, avoiding physical activity, frequent small meals, and anti-retrovirals.

You're providing an in-service on viral hepatitis to a group of healthcare workers. You are teaching them about the types of viral hepatitis that can turn into chronic infections. Which types are known to cause ACUTE infections ONLY? Select all that apply:* ○ A. Hepatitis A ○ B. Hepatitis B ○ C. Hepatitis C ○ D. Hepatitis D ○ E. Hepatitis E

A 24 hour UA- high cortisol and androgen levels, high serum cortisol levels, increases sodium glucose and calcium, decreased potassium is a diagnosis for what?

cushions syndrome

What is pancreatitis?

inflammation of the pancreas associated with auto digestion - lipase, amylase, trypsin are activated while still in pancreas and destroy the tissue.

What are the signs and symptoms of portal hypertension?

splenomegaly, ascites, esophageal varices, hepatorenal syndrome, portal encephalopathy.

IV fluid and glucocorticoids are given as treatment for what?

what is addisonian crisis

. A patient has completed the Hepatitis B vaccine series. What blood result below would demonstrate the vaccine series was successful at providing immunity to Hepatitis B?* ○ A. Positive IgG ○ B. Positive HBsAg ○ C. Positive IgM ○ D. Positive anti-HBs

. A patient is admitted with complaints of palpations, excessive sweating, and unable to tolerate heat. In addition, the patient voices concern about how her appearance has changed over the past year. The patient presents with protruding eyeballs and pretibial myxedema on the legs and feet. Which of the following is the likely cause of the patient's signs and symptoms?* ○ A. Thyroiditis ○ B. Deficiency of iodine consumption ○ C. Grave's Disease ○ D. Hypothyroidism

. A patient is prescribed Peginterferon alfa-2a. The nurse will prepare to administer this medication what route?* ○ A. Oral ○ B. Intramuscular ○ C. Subcutaneous ○ D. Intravenous

A patient is recovery from a parathyroidectomy. Which of the following findings causes concern and requires nursing intervention?* ○ A. The patient is in Semi-Fowler's position. ○ B. The patient's calcium level is 8.9 mg/dL. ○ C. The patient's voice is hoarse. ○ D. The patient is drowsy but arouses to name.

. A patient is recovery from a parathyroidectomy. Which of the following findings causes concern and requires nursing intervention?* ○ A. The patient is in Semi-Fowler's position. ○ B. The patient's calcium level is 8.9 mg/dL. ○ C. The patient's voice is hoarse. ○ D. The patient is drowsy but arouses to name.

. A patient with Cushing's syndrome will be undergoing an adrenalectomy. Which of the following will be included in the patient's discharge teaching after the procedure?* ○ A. Glucocorticoid replacement therapy ○ B. Avoiding avocadoes and pears ○ C. Declomycin therapy ○ D. Signs and symptoms of Grave's Disease

. A patient with Hepatitis has a bilirubin of 6 mg/dL. What findings would correlate with this lab result? Select all that apply:* ○ A. None because this bilirubin level is normal ○ B. Yellowing of the skin and sclera ○ C. Clay-colored stools ○ D. Bluish discoloration on the flanks of the abdomen ○ E. Dark urine ○ F. Mental status changes

. A patient with viral Hepatitis states their flu-like symptoms have subsided. However, they now have yellowing of the skin and sclera along with dark urine. Based on this finding, this is what phase of Hepatitis?* ○ A. Icteric ○ B. Posticteric ○ C. Preicteric ○ D. Convalescent

. During your morning assessment of a patient with cirrhosis, you note the patient is disoriented to person and place. In addition while assessing the upper extremities, the patient's hands demonstrate a flapping motion. What lab result would explain these abnormal assessment findings? Decreased magnesium level Increased calcium level Increased creatinine level Increased ammonia level

From the pancreas and gallbladder, the common bile duct and pancreatic duct open into the ____________ where digestive enzymes and bile flow into the duodenum via the major duodenal papilla which is surrounded by a muscular valve that controls the release of digestive enzymes known as the ______________.* ○ A. ampulla of vater, sphincter of Oddi ○ B. papilla of vater, sphincter of Oddi ○ C. minor duodenal papilla, ampulla of vater ○ D. jejunum, sphincter of pylori

. From the pancreas and gallbladder, the common bile duct and pancreatic duct open into the ____________ where digestive enzymes and bile flow into the duodenum via the major duodenal papilla which is surrounded by a muscular valve that controls the release of digestive enzymes known as the ______________.* ○ A. ampulla of vater, sphincter of Oddi ○ B. papilla of vater, sphincter of Oddi ○ C. minor duodenal papilla, ampulla of vater ○ D. jejunum, sphincter of pylori

. In Cushing's disease, what gland is secreting too much ACTH (Adrenocorticotropic hormone) which is causing an increase in cortisol production? Adrenal Cortex, Pituitary, Hypothalamus, Thyroid

Which client problem has priority for the client diagnosed with acute pancreatitis? 1. Risk for fluid volume deficit. 2. Alteration in comfort. 3. Imbalanced nutrition: less than body requirements. 4. Knowledge deficit.

. The client will be NPO to help decrease pain, but it is not the priority problem because the client will have intravenous fluids. 2. Autodigestion of the pancreas results in severe epigastric pain, accompanied by nausea, vomiting, abdominal tenderness, and muscle guarding. 3. Nutritional imbalance is a possible client problem, but it is not priority. 4. Knowledge deficit is always a client problem, but it is not priority over

. The physician writes an order for the administration of Lactulose. What lab result indicates this medication was successful?* ○ A. Bilirubin <1 mg/dL ○ B. ALT 8 U/L ○ C. Ammonia 16 mcg/dL ○ D. AST 10 U/L

. Which of the following is NOT a role of the liver?* ○ A. Removing hormones from the body ○ B. Producing bile ○ C. Absorbing water ○ D. Producing albumin

. Which of the following patients are MOST at risk for hypoparathyroidism?* ○ A. A 75 year-old female who is diabetic and takes Os-Cal daily. ○ B. A 59 year-old male with a Mg+ level of 0.9 mg/dL. ○ C. A 85 year-old female complaining of flank pain and constipation. ○ D. A 19 year-old male with a Ca+ level of 8.9 mg/dL.

. Which of the following patients are at risk for developing Cushing's Syndrome?* ○ A. A patient with a tumor on the pituitary gland, which is causing too much ACTH to be secreted. ○ B. A patient taking glucocorticoids for several weeks. ○ C. A patient with a tuberculosis infection. ○ D. A patient who is post-opt from an adrenalectomy.

The client is diagnosed with hypothyroidism. Which signs/symptoms should the nurse expect the client to exhibit? 1. Complaints of extreme fatigue and hair loss. 2. Exophthalmos and complaints of nervousness. 3. Complaints of profuse sweating and flushed skin. 4. Tetany and complaints of stiffness of the hands.

1. A decrease in thyroid hormone causes decreased metabolism, which leads to fatigue and hair loss. 2. These are signs of hyperthyroidism. 3. These are signs of hyperthyroidism. 4. These are signs of parathyroidism

1. A patient desiring to begin a very-low-calorie diet (VLCD) for rapid weight reduction is concerned about the safety of the diet. What information should the nurse provide to the patient? a. VLCDs are not recommended for people over age 50. b. VLCDs result in significant losses of muscle mass in response to the protein restriction. c. VLCDs are safe for patients who have a lower body mass index and need to lose a small amount of weight rapidly. d. VLCDs are safest for middle-aged and senior patients.

1. A patient has abdominal pain and a serum conjugated bilirubin level of 1.2 mg/dL. What should the nurse suspect is occurring with this patient? a. A disease that requires phototherapy b. A disorder that causes large amounts of red blood cell death c. A disorder of the biliary system d. A small bowel obstruction

1. A patient has been researching medications to help achieve a weight loss goal. What is the medication classification that the nurse should review with the patient that could help meet the patient's goal? a. Lipase inhibitor b. Antiepileptic c. Anticholinergics d. Adrenergics

1. A patient is experiencing manifestations of Addisonian crisis. What should the nurse expect to provide to this patient? a. Intravenous fluids b. Warm blankets c. Thyroid replacement hormone d. Blood transfusion

1. A patient is prescribed prednisone (Dexasone) for a chronic health problem. Which sign of Cushing syndrome should the nurse instruct this patient to report to the healthcare provider? Select All That Apply. a. Fat deposits in the abdominal and clavicle regions b. Muscle weakness and wasting in the extremities c. Delayed wound healing d. Development of varicose leg veins e. Hypotension

1. A patient is suspected of having protein calorie malnutrition (PCM) with a body mass index of less than 18. Which laboratory test should the nurse expect to be prescribed for this patient? Select All That Apply. a. Serum albumin b. Lymphocyte count c. Serum electrolytes d. Complete blood count (CBC) e. Urinalysis

1. A patient planning to begin a weight loss diet asks the nurse for suggestions as to how to balance eating. What information should the nurse provide to the patient? a. The diet should reduce calories to 1000‒1600 per day, with less than 10% of the total calories coming from fat. b. The diet should be between 750 and 1000 calories per day, with less than 15% of the total calories coming from fat. c. The diet should simply cut 500 calories per day from the normal intake. d. The best diet will be between 1250

1. A patient recovering from Whipple's procedure is being transferred to the medical-surgical care area. On which intervention should the nurse focus to determine if the patient is developing a complication from the surgery? Select All That Apply. a. Assessing heart rate every 2 hours b. Monitoring urine output every hour c. Turning and repositioning every 2 hours d. Measuring blood pressure every 2 hours

1. A patient recovering from a closed head injury has a urine specific gravity of 1.010 g/mL. The previous intake and output totals were 1200 mL intake and 10,000 mL output. Which prescription from the healthcare provider should the nurse question for this patient? a. Desmopressin (Minirin) 0.2 mg by mouth daily b. Oral fluid restriction of 800 mL per day c. 3% normal saline at 100 mL per hour d. Computed tomography scan of head

1. A patient recovering from a head injury is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which should the nurse expect to be prescribed for this patient? Select All That Apply. a. Restrict fluids. b. Increase oral fluids. c. Provide a loop diuretic. d. Administer Conivaptan. e. Administer demeclocycline.

1. A patient reports often eating excessive amounts of food when alone and when not hungry, and has intense feelings of self-disgust afterward. Which health problem is this patient at risk for developing? a. Type 2 diabetes mellitus b. Type 1 diabetes mellitus c. Dehydration d. Electrolyte imbalances

1. A patient who has portal systemic encephalopathy is receiving Neomycin (neomycin sulfate). Which manifestation should indicate to the nurse that the patient's condition is improving? a. Increase in potassium level b. Asterixis c. Relief of jaundice d. Increased level of consciousness

1. A patient who has three school-age children has jaundice and is diagnosed with hepatitis A after taking a trip to Central America. Which patient statement should the nurse address with the patient? a. "I can't go home and expose my children to this." b. "We cared for several very ill people on our trip." c. "I plan to get a lot of rest in the next few days." d. "I am likely to recover fully eventually."

1. A patient who is 5 feet 5 inches tall and weighs 144 lbs. asks the nurse if this is obesity. How should the nurse respond to this patient? a. "You are a normal weight for your height." b. "Yes, you are slightly obese for your height." c. "You are slightly overweight." d. "You are moderately obese."

1. A patient with Addison disease is experiencing problems with fluid balance. What actions should the nurse take to help this patient? Select All That Apply. a. Teach to sit and stand slowly. b. Monitor cardiac monitor rhythm. c. Turn and reposition every 2 hours while awake. d. Weigh the patient daily at the same time and in the same clothing. e. Encourage oral fluid intake of 3000 mL/day and increased salt intake.

1. A patient with Addison disease is experiencing weakness and abdominal pain and has an oral temperature of 102°F and blood pressure of 70/35 mmHg. Which patient information should the nurse identify as potentially causing these manifestations? Select All That Apply. a. "I had my tonsils out last week." b. "I have a pressure ulcer from sleeping in my recliner." c. "I have been using a tanning bed." d. "I take my prednisone (Deltasone) every day." e. "I have been increasing my intake of calcium-rich foods."

1. A patient with Cushing syndrome is concerned about having a head cold every few weeks. What should the nurse do to address this patient's concern? a. Assess for protein and vitamin intake. b. Plan for frequent rest periods. c. Encourage daily weights. d. Review coping strategies.

1. A patient with a distant history of injection substance use is diagnosed with hepatitis. For which type of hepatitis should the nurse plan care for this patient? a. Hepatitis A b. Hepatitis B c. Hepatitis C d. Hepatitis D

1. A patient with a non-ACTH-producing adrenal cortex tumor is scheduled for a surgical procedure to remove the tumor. Which statement by the patient indicates that teaching about the procedure has been effective? a. "The adrenal gland with the tumor will be removed." b. "I will need to take adrenal hormones for the rest of my life." c. "The tumor will be removed by the transsphenoidal route." d. "I will receive IV cortisol in preparation for the surgery."

1. A patient with an adrenal gland alteration asks why the skin appears tan when no time is spent outdoors in the sun. What should the nurse do to address the patient's concern? a. Ask if the patient is still taking steroids prescribed for another illness. b. Ask the patient what time of day he is outdoors. c. Auscultate the patient's lung sounds. d. Palpate the patient's thyroid gland.

1. A patient with chronic pancreatitis is prescribed pancrelipase (Lipancreatin). What should the nurse instruct the patient about this medication? Select all that apply. a. Take medication with meals or snacks. b. Take the medication with milk or ice cream. c. Stop taking the medication if bowel movements increase. d. Do not crush enteric coated doses of the medication. e. Take this medication until advised otherwise by the healthcare provider.

1. A patient with epigastric pain has a serum amylase level of 369 units/L. What should the nurse do? a. Continue to monitor the patient. b. Refer the patient to a dietician. c. Contact the primary healthcare provider. d. Question the patient regarding alcohol use patterns.

1. A patient with hepatitis is receiving interferon alpha. Which manifestation indicates that the patient is experiencing an untoward effect of this medication? a. Jaundice b. Flu-like syndrome c. Gallbladder pain d. Clay-colored stools

1. A patient with hyperparathyroidism is taking digoxin (Lanoxin). For what should the nurse assess this patient? a. Toxic effects of digoxin (Lanoxin) b. Evidence the medication dose needs to be increased c. Onset of polyuria d. Muscle weakness and atrophy

1. A patient with hyperparathyroidism secondary to renal failure is prescribed calcimimetic. What should the nurse instruct the patient about this medication? a. It increases the sensitivity of the calcium-sensing receptors of the parathyroid gland to serum calcium. b. It blocks calcium receptors in the nervous and musculoskeletal systems. c. It decreases resorption of calcium in the distal renal tubule. d. It binds calcium to bile salts that are then excreted through the GI tract.

1. A patient with hyperthyroidism is experiencing vision changes. What teaching should the nurse provide to preserve this patient's sight? Select All That Apply. a. Apply eye shields. b. Instill artificial tears. c. Wear eyeglasses with tinted lenses. d. Apply warm compresses to the eyes every 4 hours. e. Notify the healthcare provider about vision changes.

1. A patient with hypothyroidism is prescribed levothyroxine sodium (Synthroid). What dietary adjustment should the nurse instruct the patient to make? Select All That Apply. a. Avoid eating walnuts. b. Avoid all grapefruit or citrus fruits. c. Restrict the intake of foods high in fiber. d. Reduce the intake of green leafy vegetables. e. Take the medication 30 minutes before eating breakfast in the morning.

1. A patient with liver failure is taking lactulose (Chronulac). Which laboratory data indicates that the medication is having the desired effect? a. Increased serum ammonia level b. Decreased serum ammonia level c. Increased serum ALT level d. Decreased serum ALT level

1. A patient with pancreatitis asks why the stools are frothy and have a foul odor. Which response should the nurse make? a. "This is a sign of malnutrition." b. "This indicates your stools have more fat in them." c. "This is a sign of peptic ulcer disease." d. "You may be developing diabetes mellitus."

1. A patient with suspected Cushing syndrome is prescribed a 24-hour urine collection. What should the nurse explain to the patient about the reason for this urine collection? a. It measures the amount of cortisol in the urine over 24 hours. b. At least 2000 mL of urine is required to perform the test. c. It identifies urine specific gravity changes over a 24-hour period. d. The 24-hour timeline reduces unwanted effects of medications excreted in the urine.

The nurse is admitting a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which clinical manifestations should be reported to the health-care provider? 1. Serum sodium of 112 mEq/L and a headache. 2. Serum potassium of 5.0 mEq/L and a heightened awareness. 3. Serum calcium of 10 mg/dL and tented tissue turgor. 4. Serum magnesium of 1.2 mg/dL and large urinary output.

1. A serum sodium level of 112 mEq/L is dangerously low, and the client is at risk for seizures. A headache is a symptom of a low-sodium level. 2. This is a normal potassium level, and a heightened level of awareness indicates drug usage. 3. This is a normal calcium level and the client is fluid overloaded, not dehydrated, so there would not be tented tissue turgor. 4. This is a normal magnesium level, and a large urinary output is desired.

The client diagnosed with Cushing's disease has undergone a unilateral adrenalectomy. Which discharge instructions should the nurse discuss with the client? 1. Instruct the client to take the glucocorticoid and mineralocorticoid medications as prescribed. 2. Teach the client regarding sexual functioning and androgen replacement therapy. 3. Explain the signs and symptoms of infection and when to call the health-care provider. 4. Demonstrate turn, cough, and deep-breathing exercises the client should perform every two (2) hours.

1. A unilateral adrenalectomy results in one adrenal gland still functioning. No hormone replacement will be required. 2. The client can still have normal physiological functioning, including sexual functioning, with the remaining gland. 3. Notifying the HCP if signs/symptoms of infection develop is an instruction given to all surgical clients on discharge. 4. Turning and coughing is taught prior to surgery, not at discharge

1. After following a structured diet, a patient diagnosed with diabetes mellitus is surprised to learn that blood glucose levels have decreased and oral medications are no longer required. What explanation regarding the impact of diet on diabetes management should the nurse give the patient? a. Less body mass means less insulin is needed to maintain constant glucose levels. b. Body mass reduces cellular resistance to insulin. c. Reduced dietary intake of carbohydrates is responsible for weight loss. d. Reduced dietary intake results in a reduced need for insulin.

The nurse is completing discharge teaching to the client diagnosed with acute pancreatitis. Which instruction should the nurse discuss with the client? 1. Instruct the client to decrease alcohol intake. 2. Explain the need to avoid all stress. 3. Discuss the importance of stopping smoking. 4. Teach the correct way to take pancreatic enzymes.

1. Alcohol must be avoided entirely because it can cause stones to form, blocking pancreatic ducts and the outflow of pancreatic juice, causing further inflammation and destruction of the pancreas. 2. Stress stimulates the pancreas and should be dealt with, but it is unrealistic to think a client can avoid all stress. By definition, the absence of all stress is death. 3. Smoking stimulates the pancreas to release pancreatic enzymes and should be stopped. 4. The client has acute pancreatitis, and pancreatic enzymes are only needed for chronic pancreatitis.

The nurse is developing a plan of care for the client diagnosed with acquired immunodeficiency syndrome (AIDS) who has developed an infection in the adrenal gland. Which client problem is highest priority? 1. Altered body image. 2. Activity intolerance. 3. Impaired coping. 4. Fluid volume deficit.

1. Altered body image is a psychosocial problem, which is not a priority over a potentially lethal physical complication, and physical changes occur over an extended period. 2. Activity intolerance will occur with adrenal gland hypofunction, but this is not a priority over dehydration. 3. Impaired coping can occur in clients with adrenal gland disorders, but it is not a priority over dehydration. 4. Fluid volume deficit (dehydration) can lead to circulatory impairment and hyperkalemia.

1. An adolescent is reported being interested in losing weight and measures weight several times a day, but at times ingests large amounts of food. What should the nurse suspect is occurring with this patient? a. Bulimia nervosa b. Early-onset anorexia nervosa c. Binge-eating disorder d. Metabolic disorder

The nurse manager of a medical-surgical unit is asked to determine if the unit should adopt a new care delivery system. Which behavior is an example of an autocratic style of leadership? 1. Call a meeting and educate the staff on the new delivery system being used. 2. Organize a committee to investigate the various types of delivery systems. 3. Wait until another unit has implemented the new system and see if it works out. 4. Discuss with the nursing staff if a new delivery system should be adopted.

1. An autocratic style is one in which the person in charge makes the decision without consulting anyone else. 2. This behavior is an example of a democratic leadership style. 3. This behavior is an example of laissez-faire leadership style. 4. This behavior is an example of democratic leadership style.

The male client diagnosed with chronic pancreatitis calls and reports to the clinic nurse he has been having a lot of "gas," along with frothy and very foul-smelling stools. Which intervention should the nurse implement? 1. Explain this is common for chronic pancreatitis. 2. Ask the client to bring in a stool specimen to the clinic. 3. Arrange an appointment with the HCP for today. 4. Discuss the need to decrease fat in the diet so this won't happen.

1. Any change in the client's stool should be a cause for concern to the clinic nurse. 2. This is not necessary because the nurse knows changes in stool occur as a complication of pancreatitis, and the client needs to see the HCP. 3. Steatorrhea (fatty, frothy, foul-smelling stool) is caused by a decrease in pancreatic enzyme secretion and indicates impaired digestion and possibly an increase in the severity of the pancreatitis. The client should see the HCP. 4. Decreasing fat in the diet will not help stop this type of stool.

The client is diagnosed with acute pancreatitis. Which health-care provider's admitting order should the nurse question? 1. Bedrest with bathroom privileges. 2. Initiate IV therapy of D5W at 125 mL/hr. 3. Weigh the client daily. 4. Low-fat, low-carbohydrate diet.

1. Bedrest will decrease metabolic rate, gastrointestinal secretion, pancreatic secretions, and pain; therefore, this HCP's order should not be questioned. 2. The client will be NPO; therefore, initiating IV therapy is an appropriate order. 3. Short-term weight gain changes reflect fluid balance because the client will be NPO and receiving IV fluids. Daily weight is an appropriate HCP's order. 4. The client will be NPO, which will decrease stimulation of the pancreatic enzymes, resulting in decreased autodigestion of the pancreas, therefore decreasing pain

The nurse writes a problem of "altered body image" for a 34-year-old client diagnosed with Cushing's disease. Which intervention should be implemented? 1. Monitor blood glucose levels prior to meals and at bedtime. 2. Perform a head-to-toe assessment on the client every shift. 3. Use therapeutic communication to allow the client to discuss feelings. 4. Assess bowel sounds and temperature everyfour (4) hours

1. Blood glucose levels do not address the problem of altered body image. 2. Head-to-toe assessments are performed to detect a physiological problem, not a psychosocial one. 3. Allowing the client to ventilate feelings about the altered body image is the most appropriate intervention. The nurse cannot do anything to help the client's buffalo hump or moon face. 4. Bowel sounds and temperature are physical symptoms.

The nurse is planning the care of a client diagnosed with Addison's disease. Which intervention should be included? 1. Administer steroid medications. 2. Place the client on fluid restriction. 3. Provide frequent stimulation. 4. Consult physical therapy for gait training.

1. Clients diagnosed with Addison's disease have adrenal gland hypofunction. The hormones normally produced by the gland must be replaced. Steroids and androgens are produced by the adrenal gland. 2. The client will have decreased fluid volume, and fluid restriction exacerbates a crisis. 3. The client requires a quiet, calm, relaxed atmosphere. 4. The client walks with a stooped posture from fatigue, but gait training is not needed

The nurse is caring for clients on a medical floor. Which client should be assessed first? 1. The client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) who has a weight gain of 1.5 pounds since yesterday. 2. The client diagnosed with a pituitary tumor who has developed diabetes insipidus (DI) and has an intake of 1,500 mL and an output of 1,600 mL in the last 8 hours. 3. The client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) who is having muscle twitching. 4. The client diagnosed with diabetes insipidus (DI) who is complaining of feeling tired after having to get up at night.

1. Clients with SIADH have a problem with retaining fluid. This is expected. 2. This client's intake and output are relatively the same. 3. Muscle twitching is a sign of early sodium imbalance. If an immediate intervention is not made, the client could begin to seize. 4. The client has to get up all night to urinate, so the client feeling tired is

The client diagnosed with acute pancreatitis is being discharged home. Which statement by the client indicates the teaching has been effective? 1. "I should decrease my intake of coffee, tea, and cola." 2. "I will eat a low-fat diet and avoid spicy foods." 3. "I will check my amylase and lipase levels daily." 4. "I will return to work tomorrow but take it easy."

1. Coffee, tea, and cola stimulate gastric and pancreatic secretions and may precipitate pain, so these foods should be avoided, not decreased. 2. High-fat and spicy foods stimulate gastric and pancreatic secretions and may precipitate an acute pancreatic attack. 3. Amylase and lipase levels must be checked via venipuncture with laboratory tests, and there are no daily tests the client can monitor at home. 4. The client will be fatigued as a result of decreased metabolic energy production and will need to rest and not return to work immediately.

The client has developed iatrogenic Cushing's disease. Which statement is the scientific rationale for the development of this diagnosis? 1. The client has an autoimmune problem causing the destruction of the adrenal cortex. 2. The client has been taking steroid medications for an extended period for another disease process. 3. The client has a pituitary gland tumor causing the adrenal glands to produce too much cortisol. 4. The client has developed an adrenal gland problem for which the health-care provider does not have an explanation.

1. Cushing's disease is not an autoimmune problem. 2. "Iatrogenic" means a problem has been caused by a medical treatment or procedure—in this case, treatment with steroids for another problem. Clients taking steroids over a period of time develop the clinical manifestations of Cushing's disease. Disease processes for which long-term steroids are prescribed include chronic obstructive pulmonary disease, cancer, and arthritis. 3. This could be a cause for primary Cushing's syndrome. 4. There is a known reason for the client to have iatrogenic Cushing's

Which statement made by the client makes the nurse suspect the client is experiencing hyperthyroidism? 1. "I just don't seem to have any appetite anymore." 2. "I have a bowel movement about every three (3) to four (4) days." 3. "My skin is really becoming dry and coarse." 4. "I have noticed all my collars are getting tighter."

1. Decreased appetite is a symptom of hypothyroidism, not hyperthyroidism. 2. Constipation is a symptom of hypothyroidism. 3. Dry, coarse skin is a sign of hypothyroidism. 4. The thyroid gland (in the neck) enlarges as a result of the increased need for thyroid hormone production; an enlarged gland is called a goiter.

The nurse is caring for a client diagnosed with diabetes insipidus (DI). Which intervention should be implemented? 1. Administer sliding-scale insulin as ordered. 2. Restrict caffeinated beverages. 3. Check urine ketones if blood glucose is >250. 4. Assess tissue turgor every four (4) hours.

1. Diabetes insipidus is not diabetes mellitus; sliding-scale insulin is not administered to the client. 2. There is no caffeine restriction for DI. 3. Checking urine ketones is not indicated. 4. The client is excreting large amounts of dilute urine. If the client is unable to drink enough fluids, the client will quickly become dehydrated, so tissue turgor should be assessed frequently.

The male client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) secondary to cancer of the lung tells the nurse he wants to discontinue the fluid restriction and does not care if he dies. Which action by the nurse is an example of the ethical principle of autonomy? 1. Discuss the information the client told the nurse with the health-care provider and significant other. 2. Explain it is possible the client could have a seizure if he drank fluid beyond the restrictions. 3. Notify the health-care provider of the client's wishes and give the client fluids as desired. 4. Allow the client an extra drink of water and explain the nurse could get into trouble if the client tells the health-care provider.

1. Discussing the information with others is not allowing the client to decide what is best for himself. 2. This could be an example of beneficence (to do good) if the nurse did this so the client has information on which to base a decision on whether to continue the fluid restriction. 3. This is an example of autonomy (the client has the right to decide for himself). 4. This is an example of dishonesty and should never be tolerated in a health-care setting.

1. During a health assessment the nurse becomes concerned that a patient is at high risk for pancreatic cancer. What assessment finding caused this concern? Select All That Apply. a. The patient smokes cigarettes. b. The patient has a body mass index of 32.5. c. The patient has been treated for osteoarthritis. d. The patient's uncle died from pancreatic cancer. e. The patient has been diagnosed with chronic pancreatitis.

The client is immediate postprocedure endoscopic retrograde cholangiopancreatogram (ERCP). Which intervention should the nurse implement? 1. Assess for rectal bleeding. 2. Increase fluid intake. 3. Assess gag reflex. 4. Keep in supine position

1. During this procedure, a scope is placed down the client's mouth; therefore, assessing for rectal bleeding is not an intervention. 2. The client's throat has been anesthetized to insert the scope; therefore, fluid and food are withheld until the gag reflex has returned. 3. The gag reflex will be suppressed as a result of the local anesthesia applied to the throat to insert the endoscope into the esophagus; therefore, the gag reflex must be assessed prior to allowing the client to resume eating or drinking. 4. The client should be in a semi-Fowler's or side-lying position to prevent aspiration.

The nurse is planning the care of a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which interventions should be implemented? Select all that apply. 1. Restrict fluids per health-care provider order. 2. Assess level of consciousness every two (2) hours. 3. Provide an atmosphere of stimulation. 4. Monitor urine and serum osmolality. 5. Weigh the client every three (3) days.

1. Fluids are restricted to 500 to 600 mL per 24 hours. 2. Orientation to person, place, and time should be assessed every two (2) hours or more often. 3. A safe environment, not a stimulating one, is provided. 4. Urine and serum osmolality are monitored to determine fluid volume status.

The client is admitted to the intensive care department diagnosed with myxedema coma. Which assessment data warrant immediate intervention by the nurse? 1. Serum blood glucose level of 74 mg/dL. 2. Pulse oximeter reading of 90%. 3. Telemetry reading showing sinus bradycardia. 4. The client is lethargic and sleeps all the time.

1. Hypoglycemia is expected in a client with myxedema; therefore, a 74-mg/dL blood glucose level is expected. 2. A pulse oximeter reading of less than 93% is significant. A 90% pulse oximeter reading indicates a Pao2 of approximately 60 on an arterial blood gas test; this is severe hypoxemia and requires immediate intervention. 3. The client with myxedema coma is in an exaggerated hypothyroid state; a low pulse is expected in a client with hypothyroidism. 4. Lethargy is an expected symptom in a client diagnosed with myxedema; therefore, this does not warrant immediate intervention.

The client diagnosed with acute pancreatitis is in pain. Which position should the nurse assist the client to assume to help decrease the pain? 1. Recommend lying in the prone position with legs extended. 2. Maintain a tripod position over the bedside table. 3. Place in side-lying position with knees flexed. 4. Encourage a supine position with a pillowunder the knees

1. Lying on the stomach will not help to decrease the client's pain. 2. This is a position used by clients with chronic obstructive pulmonary disease to help lung expansion. 3. This fetal position decreases pain caused by the stretching of the peritoneum as a result of edema. 4. Laying supine causes the peritoneum to stretch, which increases the pain.

The nurse is admitting a client to the neurological intensive care unit who is postoperative transsphenoidal hypophysectomy. Which data warrant immediate intervention? 1. The client is alert to name but is unable to tell the nurse the location. 2. The client has an output of 2,500 mL since surgery and an intake of 1,000 mL. 3. The client's vital signs are T 97.6ºF, P 88, R 20, and BP 130/80. 4. The client has a 3-cm amount of dark-reddrainage on the turban dressing

1. Neurological status is monitored every one (1) to two (2) hours. This client's neurological status appears intact. Clients waking up in an intensive care area may not be aware of their surroundings. 2. The output is more than double the intake in a short time. This client could be developing diabetes insipidus, a complication of trauma to the head. 3. These vital signs are within normal limits. 4. A transsphenoidal hypophysectomy is performed by surgical access above the gum line and through the nasal passage. There is no dressing. A drip pad is taped below the nares.

The nurse is administering a pancreatic enzyme to the client diagnosed with chronic pancreatitis. Which statement best explains the rationale for administering this medication? 1. It is an exogenous source of protease, amylase, and lipase. 2. This enzyme increases the number of bowel movements. 3. This medication breaks down in the stomach to help with digestion. 4. Pancreatic enzymes help break down fat in the small intestine.

1. Pancreatic enzymes enhance the digestion of starches (carbohydrates) in the gastrointestinal tract by supplying an exogenous (outside) source of the pancreatic enzymes protease, amylase, and lipase. 2. Pancreatic enzymes decrease the number of bowel movements. 3. The enzymes are enteric coated and should not be crushed because the hydrochloric acid in the stomach will destroy the enzymes; these enzymes work in the small intestine. 4. Pancreatic enzymes help break down carbohydrates, and bile breaks down fat.

The nurse is preparing to administer a.m. medications to clients. Which medication should the nurse question before administering? 1. Pancreatic enzymes to the client who has finished breakfast. 2. The pain medication, morphine, to the client who has a respiratory rate of 20. 3. The loop diuretic to the client who has a serum potassium level of 3.9 mEq/L. 4. The beta blocker to the client who has an apical pulse of 68 bpm.

1. Pancreatic enzymes must be administered with meals to enhance the digestion of starches and fats in the gastrointestinal (GI) tract. 2. The client's respiratory rate is within normal limits; therefore, the morphine should be administered to the client who is having pain. 3. This is a normal potassium level; therefore, the nurse does not need to question administering this medication. 4. The apical pulse is within normal limits; therefore, the nurse should not question administering this medication.

The 68-year-old client diagnosed with hyperthyroidism is being treated with radioactive iodine therapy. Which interventions should the nurse discuss with the client? 1. Explain it will take up to a month for symptoms of hyperthyroidism to subside. 2. Teach the iodine therapy will have to be tapered slowly over one (1) week. 3. Discuss the client will have to be hospitalized during the radioactive therapy. 4. Inform the client after therapy the client will not have to take any medication.

1. Radioactive iodine therapy is used to destroy the overactive thyroid cells. After treatment, the client is followed closely for three (3) to four (4) weeks until the euthyroid state is reached. 2. A single dose of radioactive iodine therapy is administered; the dosage is based on the client's weight. 3. The colorless, tasteless radioiodine is administered by the radiologist, and the client may have to stay up to two (2) hours after the treatment in the office. 4. If too much of the thyroid gland is destroyed by the radioactive iodine therapy, the client may develop hypothyroidism and have to take thyroid hormone the rest of his or her life.

The client diagnosed with a pituitary tumor developed syndrome of inappropriate antidiuretic hormone (SIADH). Which interventions should the nurse implement? 1. Assess for dehydration and monitor blood glucose levels. 2. Assess for nausea and vomiting and weigh daily. 3. Monitor potassium levels and encourage fluid intake. 4. Administer vasopressin IV and conduct a fluid deprivation test.

1. The client has excess fluid and is not dehydrated, and blood glucose levels are not affected. 2. Early signs and symptoms are nausea and vomiting. The client has the syndrome of inappropriate secretion of antidiuretic (against allowing the body to urinate) hormone. In other words, the client is producing a hormone that will not allow the client to urinate. 3. The client experiences dilutional hyponatremia, and the body has too much fluid already. 4. Vasopressin is the name of the antidiuretic hormone. Giving more increases the client's problem. Also, a water challenge test is performed, not a fluid deprivation test.

The nurse is discussing complications of chronic pancreatitis with a client diagnosed with the disease. Which complication should the nurse discuss with the client? 1. Diabetes insipidus (DI). 2. Crohn's disease. 3. Narcotic addiction. 4. Peritonitis.

1. The client is at risk for diabetes mellitus (destruction of beta cells), not diabetes insipidus, a disorder of the pituitary gland. 2. Crohn's disease is an inflammatory disorder of the lining of the gastrointestinal system, especially of the terminal ileum. 3. Narcotic addiction is related to the frequent, severe pain episodes often occurring with chronic pancreatitis, which require narcotics for relief. 4. Peritonitis, an inflammation of the lining of the abdomen, is not a common complication of chronic pancreatitis.

The client is admitted to the medical unit with a diagnosis of rule-out diabetes insipidus (DI). Which instructions should the nurse teach regarding a fluid deprivation test? 1. The client will be asked to drink 100 mL of fluid as rapidly as possible and then will not be allowed fluid for 24 hours. 2. The client will be administered an injection of antidiuretic hormone (ADH), and urine output will be measured for four (4) to six (6) hours. 3. The client will have nothing by mouth (NPO), and vital signs and weights will be done hourly until the end of the test. 4. An IV will be started with normal saline, and the client will be asked to try to hold the urine in the bladder until a sonogram can be done.

1. The client is not allowed to drink during the test. 2. This test does not require any medications to be administered, and vasopressin will treat the DI, not help diagnose it. 3. The client is deprived of all fluids, and if the client has DI the urine production will not diminish. Vital signs and weights are taken every hour to determine circulatory status. If a marked decrease in weight or vital signs occurs, the test is immediately terminated. 4. No fluid is allowed and a sonogram is not involved.

The unlicensed assistive personnel (UAP) complains to the nurse she has filled the water pitcher four (4) times during the shift for a client diagnosed with a closed head injury and the client has asked for the pitcher to be filled again. Which intervention should the nurse implement first? 1. Tell the UAP to fill the pitcher with ice cold water. 2. Instruct the UAP to start measuring the client's I&O. 3. Assess the client for polyuria and polydipsia. 4. Check the client's BUN and creatinine levels.

1. The client should have the water pitcher filled, but this is not the first action. 2. This should be done but not before assessing the problem. 3. The first action should be to determine if the client is experiencing polyuria and polydipsia as a result of developing diabetes insipidus, a complication of the head trauma. 4. This could be done, but it will not give the nurse information about DI.

The nurse is discharging a client diagnosed with diabetes insipidus. Which statement made by the client warrants further intervention? 1. "I will keep a list of my medications in my wallet and wear a Medic Alert bracelet." 2. "I should take my medication in the morning and leave it refrigerated at home." 3. "I should weigh myself every morning and record any weight gain." 4. "If I develop a tightness in my chest, I will call my health-care provider."

1. The client should keep a list of medications being taken and wear a Medic Alert bracelet. 2. Medication for DI is usually taken every eight (8) to 12 hours, depending on the client. The client should keep the medication close at hand. 3. The client is at risk for fluid shifts. Weighing every morning allows the client to follow the fluid shifts. Weight gain indicates too much medication. 4. Tightness in the chest could be an indicator the medication is not being tolerated; if this occurs, the client should notify the healthcare

The client diagnosed with Addison's disease is admitted to the emergency department after a day at the lake. The client is lethargic, forgetful, and weak. Which intervention should the nurse implement? 1. Start an IV with an 18-gauge needle and infuse NS rapidly. 2. Have the client wait in the waiting room until a bed is available. 3. Obtain a permit for the client to receive a blood transfusion. 4. Collect urinalysis and blood samples for a CBC and calcium level.

1. The client was exposed to wind and sun at the lake during the hours prior to being admitted to the emergency department. This predisposes the client to dehydration and an addisonian crisis. Rapid IV fluid replacement is necessary. 2. Sitting in the waiting area could cause the client to go into a coma and die. 3. A blood transfusion is not an appropriate intervention for this client. 4. Laboratory specimens are not priority and calcium is not a problem in clients with Addison's disease.

Which laboratory value should be monitored by the nurse for the client diagnosed with diabetes insipidus? 1. Serum sodium. 2. Serum calcium 3. Urine glucose. 4. Urine white blood cells.

1. The client will have an elevated sodium level as a result of low circulating blood volume. The fluid is being lost through the urine. Diabetes means "to pass through" in Greek, indicating polyuria, a symptom shared with diabetes mellitus. Diabetes insipidus is a totally separate disease process. 2. Serum calcium is not affected by diabetes insipidus. 3. Urine glucose is monitored for diabetes mellitus. 4. White blood cells in the urine indicate the presence of a urinary tract infection.

The client is admitted to rule out Cushing's syndrome. Which laboratory tests should the nurse anticipate being ordered? 1. Plasma drug levels of quinidine, digoxin, and hydralazine. 2. Plasma levels of ACTH and cortisol. 3. A 24-hour urine for metanephrine and catecholamine. 4. Spot urine for creatinine and white blood cells (WBCs).

1. The drugs quinidine, digoxin, and hydralazine can interfere with adrenal gland secretions and cause hypofunction. Cushing's syndrome is adrenal gland hyperfunction. 2. The adrenal gland secretes cortisol and the pituitary gland secretes adrenocorticotropic hormone (ACTH), a hormone used by the body to stimulate the production of cortisol. 3. A 24-hour urine specimen for 17-hydroxycorticosterone and 17-ketosteroid may be collected. Metanephrines and catecholamines are urine collections for pheochromocytomas. 4. Spot urinalysis and white blood cell count will not provide

The client diagnosed with hypothyroidism is prescribed the thyroid hormone levothyroxine (Synthroid). Which assessment data indicate the medication has been effective? 1. The client has a three (3)-pound weight gain. 2. The client has a decreased pulse rate. 3. The client's temperature is WNL. 4. The client denies any diaphoresis.

1. The medication will help increase the client's metabolic rate. A weight gain indicates not enough medication is being taken to put the client in a euthyroid (normal thyroid) state. 2. A decreased pulse rate indicates there is not enough thyroid hormone level; therefore, the medication is not effective. 3. The client with hypothyroidism frequently has a subnormal temperature, so a temperature WNL indicates the medication is effective. 4. Diaphoresis (sweating) occurs with hyperthyroidism, not hypothyroidism.

1. The nurse in the post anesthesia care area is concerned that a patient recovering from a subtotal thyroidectomy is experiencing postoperative complications. What finding led the nurse to come to this conclusion? Select All That Apply. a. Hoarse voice b. Restlessness and irritability c. Blood pressure 92/56 mmHg d. Heart rate 116 beats per minute e. High-pitched, squeaky sound with breathing

1. The nurse is assessing a patient who is experiencing hepatocellular failure. Which finding best indicates that the patient is developing ascites? a. Accumulation of fluid in the abdomen b. Jaundiced skin c. Ecchymosis d. Upper-right-quadrant pain

1. The nurse is assessing a patient with Cushing syndrome. Which finding should the nurse report for immediate follow-up? a. Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg b. Serum sodium 145 mEq/L and reports of muscle weakness c. Serum calcium 11 mg/dL and reports of feelings of depression d. Serum phosphorus 3 mg/dL and hirsutism

1. The nurse is assessing a patient with liver failure and jaundice. Which question should the nurse ask to determine if the cause of the jaundice is hemolytic? a. "Have you been diagnosed with a disorder of red blood cell destruction?" b. "What color is your urine?" c. "What color are your stools?" d. "Do you have any gallbladder problems?"

1. The nurse is assessing a patient with liver failure and jaundice. Which question should the nurse ask to determine if the cause of the jaundice is hemolytic? a. "Have you been diagnosed with a disorder of red blood cell destruction?" b. "What color is your urine?" c. "What color are your stools?" d. "Do you have any gallbladder problems?" e. "Portal hypertension means high blood pressure throughout my abdomen. It causes me to feel confused."

1. The nurse is caring for a patient with a Sengstaken-Blakemore tube. Which assessment finding should the nurse immediately report for follow-up? a. Left lower leg swollen and reddened b. Absent bowel sounds to lower-left quadrant c. Decreased level of consciousness d. 3 cm darkened area on left heel

1. The nurse is caring for a patient with hepatitis C who is treating the illness with licorice root. Which statement by the patient requires follow-up regarding this medication? a. "I feel so tired all the time." b. "My fingers feel numb and tingly." c. "I have a dull ache in my abdomen." d. "I have antibodies for hepatitis C in my blood."

1. The nurse is caring for a patient with hypoparathyroidism. What action should the nurse expect to perform to help this patient with a low calcium level? Select All That Apply. a. Administering calcium tablets as prescribed b. Arranging for a dietary consult regarding foods high in calcium c. Restricting fluids d. Administering intravenous IV calcium gluconate e. Administering calcimimetic

1. The nurse is caring for a patient with untreated hypothyroidism. For which health problem should the nurse assess this patient? Select all that apply. a. Elevated serum cholesterol b. Anemia c. Hyperglycemia d. Hypernatremia e. Decreased serum LDL

1. The nurse is caring for an adolescent with anorexia nervosa. What should the nurse include in this patient's plan of care? a. Provide a variety of cold or room-temperature foods. b. Serve the patient three balanced meals per day. c. Discuss weight-gain needs with the patient. d. Observe the patient's activities for 15 minutes after eating.

1. The nurse is describing the manifestations of myxedema coma to a patient with hypothyroidism. What should the nurse identify as precipitating factors for this health problem? Select All That Apply. a. Stroke b. Pneumonia c. Excessive use of thyroid replacement medications d. Excessive use of central nervous system stimulants e. Exposure to excessive heat and humidity

1. The nurse is developing a plan of care for a patient with hyperparathyroidism and a serum calcium level of 12.0 mg/dL. What should be included in the plan? Select All That Apply. a. Promoting ambulation and mobility b. Discussing a change from ordered thiazide diuretics to another type of diuretic with healthcare provider c. Teaching to increase daily oral intake of fluids d. Encouraging supplementation of fat-soluble vitamins e. Encouraging use of calcium-based antacids for indigestion

1. The nurse is helping a patient identify ways to adhere to a weight reduction plan. What should the nurse suggest to help this patient? a. Set aside small nonfood rewards when you meet a goal. b. Eat alone to reduce outside distractions. c. Drink water or a diet beverage after eating to promote feelings of fullness. d. Allow at least 45 minutes to 1 hour to promote full enjoyment of a meal.

1. The nurse is instructing a patient about the symptoms of hyperparathyroidism. Which symptom should the nurse include in this discussion? Select All That Apply. a. Abdominal pain b. Dysrhythmias c. Hypertension d. Diarrhea e. Reduced urine output

1. The nurse is instructing a patient recovering from a liver transplant. What should the nurse include in this teaching? a. Eat a high-protein diet. b. Reduce scheduled antirejection drugs to every other day if nausea occurs. c. Take acetaminophen (Tylenol) if fever develops. d. Report sore throats to the healthcare provider.

1. The nurse is planning a teaching session for a patient with a new diagnosis of adrenoleukodystrophy. What topic should the nurse include? a. Why genetic counseling is included in the plan of care b. The role of autoimmunity in the development of the disorder c. The role of anticoagulants in the development of the disorder d. The surgical site for transsphenoidal entry, using a diagram

1. The nurse is planning care for a patient scheduled for paracentesis to treat ascites. Which outcome should the nurse use for this patient's plan of care? a. The patient will have normal bilateral breath sounds. b. The patient's spleen will not rupture. c. The patient's respiratory effort will be lessened. d. The patient will not manifest symptoms of hepatomegaly.

1. The nurse is planning care for a patient with anorexia nervosa. Which problem should the nurse identify as a priority for this patient? a. Inadequate oral intake b. Feelings of adequacy c. Loss of control d. Skewed opinion of appearance

1. The nurse is preparing information for a community seminar on the hazards of obesity. Which disorder should the nurse include as being complications of obesity? Select All That Apply. a. Cardiovascular diseases b. Obstructive sleep apnea c. Diabetes mellitus type 2 d. Hypotension e. Renal insufficiency

1. The nurse is preparing to assess a patient with Cushing syndrome. Which finding should the nurse expect to assess in this patient? Select All That Apply. a. Weight gain b. Auscultatory lung crackles c. Jugular vein distention d. Peripheral edema e. Hypotension

1. The nurse is providing care to a patient recovering from a bilateral adrenalectomy. What should the nurse do to assess for the onset of adrenal insufficiency? a. Monitor strict intake and output. b. Change the dressing using clean technique. c. Question the order for cortisol administration. d. Place the patient on fluid restriction.

1. The nurse is reviewing data collected from an adolescent patient suspected of having anorexia nervosa. Which finding should the nurse identify as contributing to this diagnosis? Select All That Apply. a. Distorted body image b. Loss of control over food intake c. Purging d. Binge eating e. Normal or above average body weight

1. The nurse is reviewing health history information for a group of patients. Which patient should the nurse identify as being at the lowest risk of developing Cushing syndrome? a. The patient who received radioactive iodine treatment for hyperthyroidism b. The patient receiving treatment for rheumatoid arthritis c. The patient who has had an organ transplant d. The patient receiving chemotherapy to treat a brain tumor

1. The nurse is reviewing orders for a patient in myxedema coma. Which prescription should the nurse question before administering to this patient? Select All That Apply. a. Regular insulin IV at 5 units per hour b. Cooling blanket c. Methimazole (Tapazole) 15 mg PO daily d. Pulse oximetry and vital signs hourly e. Serum TSH level daily

1. The nurse is reviewing the laboratory results for a group of patients. Which set of results should the nurse identify as being consistent with primary hypothyroidism? a. Elevated TSH, depressed T3 and T4 b. Elevated TSH, elevated T3 and T4 c. Depressed TSH, elevated T3 and T4 d. Depressed TSH, depressed T3 and T4

1. The nurse is reviewing the manifestations of hyperparathyroidism with a patient. Which statement by the patient indicates that teaching has been effective? Select All That Apply. a. "Hyperparathyroidism can cause the kidneys to keep calcium and excrete phosphorus." b. "Calcium and phosphorus leave the bones and make them weak." c. "Calcium is deposited in soft tissues." d. "Kidney stones can develop." "The kidneys work to raise blood pH and retain potassium."

1. The nurse is reviewing the relationship between thyroid hormone and iodine. Which information should the nurse identify that is least likely to cause iodine deficiency and hypothyroidism? a. Eating large amounts of shellfish b. Using prescribed lithium carbonate c. Eating large amounts of turnips or rutabagas d. Living in an area where iodine is deficient in the soil

1. The nurse is screening a group of patients for risk factors related to thyroid cancer. Which patient should the nurse recognize as having the highest risk for developing thyroid cancer? a. A 75-year-old patient with a history of sinus infections in childhood b. A 70-year-old patient who refinishes furniture as a hobby c. An 80-year-old patient whose diet consists largely of red meat d. An 85-year-old patient who works outdoors without sunscreen

1. The nurse is teaching a patient about strategies for reducing the risk of hepatitis B transmission. Which patient statement indicates teaching has been effective? Select All That Apply. a. "I will wash my hands frequently to prevent fecal-oral transmission." b. "I will avoid alcohol." c. "I will avoid contact with blood and body fluids." d. "I will avoid contaminated food and water." e. "I will use safe sex techniques."

1. The nurse is teaching a patient about the effects of liver failure. Which patient statement about manifestations indicates that teaching was effective? Select all that apply. a. "My abdomen is becoming very large." b. "My blood sugar is sometimes too high and sometimes too low." c. "My left lower leg is red and swollen." d. "My menstrual cycle has become very irregular." e. "My skin appears yellow."

1. The nurse is teaching a patient who has a diagnosis of hypothyroidism about the importance of dietary fiber. Which statement by the patient indicates that teaching has been effective? Select All That Apply. a. "I will drink a full glass of water with my fiber pill each morning." b. "I will snack on fruit rather than potato chips." c. "I will take an over-the-counter fiber pill each morning with my levothyroxine." d. "I will increase my intake of protein sources such as meat and eggs." e. "I will read the nutrition labels and choose foods with high carbohydrate content."

1. The nurse notes that a patient who has hypoparathyroidism has a serum calcium level of 6.8 mg/dL. What would be a priority problem when planning care for this patient? a. Potential for injury b. Safety concerns because of confusion c. Changes in renal function d. Problems with oxygenation

1. The nurse prepares teaching material for a patient with Cushing syndrome. Which statement about the risk for infection should the nurse alter before teaching? a. "Epidermal hypertrophy restricts macrophage activity." b. "Cortisol affects protein synthesis." c. "Cortisol inhibits collagen synthesis." d. "The resulting edema impairs blood flow to tissues."

1. The nurse suspects that a patient has a vitamin C deficiency. What did the nurse assess to come to this conclusion? Select All That Apply. a. Delayed wound healing b. Swollen bleeding gums c. Depression d. Night blindness e. Muscle wasting

1. The nurse suspects that a patient with chronic hyperfunction of the adrenal cortex has an infection. What did the nurse assess to come to this conclusion? a. General feeling of malaise b. Recent weight loss c. Muscular tremors d. Sense of nervous energy

1. The nurse teaches a patient about the medication orlistat (Xenical). Which patient statement indicates the need for additional teaching? a. "I should take this medication 30 minutes before eating." b. "This medication will reduce the amount of fat my body absorbs." c. "I will need to take supplements of vitamins A, D, E, and K daily." d. "A low-calorie diet will need to be followed."

1. The nurse working in a bariatric clinic is explaining behavioral change strategies to a new client who is morbidly obese. Which strategies would the nurse encourage the client to incorporate if they were working on controlling the environment? (Select all that apply) a. Using nonfood rewards for meeting a goal b. Shopping from a prepared list and on a full stomach c. Chewing cites thoroughly and slowly d. Using small plates and cups to make servings look larger Eating food all in the same place

1. The patient in the icteric phase of hepatitis asks why stools are no longer brown. How should the nurse respond? a. "Your liver isn't making any of the substance that makes stools brown." b. "The pigment is backing up into your blood and turning your skin yellow." c. "It is being released into your bloodstream and turning your blood darker red." d. "The answer is not known. More research is needed regarding this question."

The client with an acute exacerbation of chronic pancreatitis has a nasogastric (N/G) tube. Which interventions should the nurse implement? Select all that apply. 1. Monitor the client's bowel sounds. 2. Monitor the client's food intake. 3. Assess the client's intravenous site. 4. Provide oral and nasal care. 5. Monitor the client's blood glucose.

1. The return of bowel sounds indicates the return of peristalsis, and the nasogastric suction is usually discontinued within 24 to 48 hours thereafter. 2. The client will be NPO secondary to the chronic pancreatitis, and the client cannot eat with a nasogastric tube. 3. The nurse should assess for signs of infection or infiltration. 4. Fasting and the N/G tube increase the client's risk for mucous membrane irritation and breakdown. 5. Blood glucose levels are monitored because clients with chronic pancreatitis can develop diabetes mellitus.

The nurse is preparing to administer the following medications. Which medication should the nurse question administering? 1. The thyroid hormone to the client who does not have a T3, T4 level. 2. The regular insulin to the client with a blood glucose level of 210 mg/dL. 3. The loop diuretic to the client with a potassium level of 3.3 mEq/L. 4. The cardiac glycoside to the client who has a digoxin level of 1.4

1. The thyroid hormone must be administered daily, and thyroid levels are drawn every six (6) months or so. 2. A blood glucose level of 210 mg/dL requires insulin administration; therefore, the nurse should not question administering this medication. 3. This potassium level is below normal, which is 3.5 to 5.5 mEq/L. Therefore, the nurse should question administering this medication because loop diuretics cause potassium loss in the urine. 4. The digoxin level is within therapeutic range—0.8 to 2 mg/dL; therefore, the nurse should administer this medication.

The nurse is providing an in-service on thyroid disorders. One of the attendees asks the nurse, "Why don't the people in the United States get goiters as often?" Which statement by the nurse is the best response? 1. "It is because of the screening techniques used in the United States." 2. "It is a genetic predisposition rare in North Americans." 3. "The medications available in the United States decrease goiters." 4. "Iodized salt helps prevent the development of goiters in the United States."

1. There is no screening for thyroid disorders, just serum thyroid levels. 2. This is not a true statement. 3. Medications do not decrease the development of goiters. 4. Almost all of the iodine entering the body is retained in the thyroid gland. A deficiency in iodine will cause the thyroid gland to work hard and enlarge, which is called a goiter. Goiters are commonly seen in geographical regions having an iodine deficiency. Most table salt in the United States has iodine added.

Which signs/symptoms should make the nurse suspect the client is experiencing a thyroid storm? 1. Obstipation and hypoactive bowel sounds. 2. Hyperpyrexia and extreme tachycardia. 3. Hypotension and bradycardia. 4. Decreased respirations and hypoxia.

1. These are signs of myxedema (hypothyroidism) coma. Obstipation is extreme constipation. 2. Hyperpyrexia (high fever) and heart rate above 130 beats per minute are signs of thyroid storm, a severely exaggerated hyperthyroidism. 3. Decreased blood pressure and slow heart rate are signs of myxedema coma. 4. These are signs/symptoms of myxedema coma.

The charge nurse of an intensive care unit is making assignments for the night shift. Which client should be assigned to the most experienced intensive care nurse? 1. The client diagnosed with respiratory failure who is on a ventilator and requires frequent sedation. 2. The client diagnosed with lung cancer and iatrogenic Cushing's disease with ABGs of pH 7.35, Pao2 88, Paco2 44, and HCO3 22. 3. The client diagnosed with Addison's disease who is lethargic and has a BP of 80/45, P 124, and R 28. 4. The client diagnosed with hyperthyroidism who has undergone a thyroidectomy two (2) days ago and has a negative Trousseau's sign.

1. This client could be cared for by any nurse qualified to work in an intensive care unit. 2. These blood gases are within normal limits. 3. This client has a low blood pressure and tachycardia. This client may be experiencing an addisonian crisis, a potentially life-threatening condition. The most experienced nurse should care for this client. 4. A negative Trousseau's sign is normal for this client.

Which medication order should the nurse question in the client diagnosed with untreated hypothyroidism? 1. Thyroid hormones. 2. Oxygen. 3. Sedatives. 4. Laxatives.

1. Thyroid hormones are the treatment of choice for the client diagnosed with hypothyroidism; therefore, the nurse should not question this medication. 2. In untreated hypothyroidism, the medical management is aimed at supporting vital functions, so administering oxygen is an appropriate medication. 3. Untreated hypothyroidism is characterized by an increased susceptibility to the effects of most hypnotic and sedative agents; therefore, the nurse should question this medication. 4. Clients with hypothyroidism become constipated as a result of decreased metabolism, so laxatives should not be questioned by the nurse.

The nurse is teaching the client diagnosed with hyperthyroidism. Which information should be taught to the client? Select all that apply. 1. Notify the HCP if a three (3)-pound weight loss occurs in two (2) days. 2. Discuss ways to cope with the emotional lability. 3. Notify the HCP if taking over-the-counter medication. 4. Carry a medical identification card or bracelet. 5. Teach how to take thyroid medications correctly.

1. Weight loss indicates the medication may not be effective and will probably need to be increased. 2. The client needs to know emotional highs and lows are secondary to hyperthyroidism. With treatment, this emotional lability will subside. 3. Any over-the-counter medications (for example, alcohol-based medications) may negatively affect the client's hyperthyroidism or medications being used for treatment. 4. This will help any HCP immediately know of the client's condition, especially if the client is unable to tell the HCP. 5. The client with hyperthyroidism will be on antithyroid medications, not thyroid medications.

1. What is the thyroid gland's function? a. Maintain metabolic rate and growth and development of all tissues b. Stimulates the heart, constricts blood vessels, inhibits visceral muscles, dilates bronchioles c. Maintains serum calcium levels by stimulating bone resorption and kidney resorption of calcium d. Promotes reabsorption of sodium and water in the kidney tubule.

The client is admitted to the medical department with a diagnosis of rule-out (R/O) acute pancreatitis. Which laboratory values should the nurse monitor to confirm this diagnosis? 1. Creatinine and (BUN). 2. Troponin and (CK-MB). 3. Serum amylase and lipase. 4. Serum bilirubin and calcium.

1.These laboratory values are monitored for clients in kidney failure. 2. These laboratory values are elevated in clients with a myocardial infarction. 3. Serum amylase increases within two (2) to 12 hours of the onset of acute pancreatitis to two (2) to three (3) times normal and returns to normal in three (3) to four (4) days; lipase elevates and remains elevated for seven (7) to 14 days. 4. Bilirubin may be elevated as a result of compression of the common duct, and hypocalcemia develops in up to 25% of clients with acute pancreatitis, but these laboratory values do not confirm the diagnosis.

A 25-year-old patient was exposed to the Hepatitis A virus at a local restaurant one week ago. What education is important to provide to this patient?* ○ A. Inform the patient to notify the physician when signs and symptoms of viral Hepatitis start to appear. ○ B. Reassure the patient the chance of acquiring the virus is very low. ○ C. Inform the patient it is very important to obtain the Hepatitis A vaccine immediately to prevent infection. ○ D. Inform the patient to promptly go to the local health department to receive immune globulin.

A 33-year-old female client is admitted to the hospital with a tentative diagnosis of Graves' disease. Which symptom related to the menstrual cycle would the client be most likely to report during the initial assessment? a. Amenorrhea b. Menorrhagia c. Metrorrhagia d. Dysmenorrhea

A 36-year-old patient's lab work show anti-HAV and IgG present in the blood. As the nurse you would interpret this blood work as?* ○ A. The patient has an active infection of Hepatitis A. ○ B. The patient has recovered from a previous Hepatitis A infection and is now immune to it. ○ C. The patient is in the preicetric phase of viral Hepatitis. ○ D. The patient is in the icteric phase of viral Hepatitis.

A 45 year old male has cirrhosis. The patient reports concern about the development of enlarged breast tissue. You explain to the patient that this is happening because?* ○ A. The liver cells are removing too much estrogen from the body which causes the testicles to produce excessive amounts of estrogen, and this leads to gynecomastia. ○ B. The liver is producing too much estrogen due to the damage to the liver cells, which causes the level to increase in the body, and this leads to gynecomastia. ○ C. The liver cells are failing to recycle estrogen into testosterone, which leads to gynecomastia. ○ D. The liver cells are failing to remove the hormone estrogen properly from the body, which causes the level to increase in the body, and this leads to gynecomastia.

A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? Select all that apply. a. Diarrhea b. Black, tarry stools c. Hyperactive bowel sounds d. Gray-blue color ar the flank e. Abdominal guarding and tenderness f. Left upper quadrant pain with radiation

A client arrives at the clinic complaining of fatigue, lack of energy, constipation, and depression. Hypothyroidism is diagnosed, and levothyroxine is prescribed. What is an expected outcome of the medication? a. Alleviate depression b. Increase energy levels c. Increase blood glucose levels d. Achieve normal thyroid hormone levels

A client diagnosed with hypothyroidism is taking levothyroxine. The client returns to the clinic 1 week after beginning the medication and tells the nurse that the medication has not helped. What is the appropriate nursing response to the client? a. A higher dosage is required. b. The medication may need to be changed. c. Full therapeutic effect may take 1 to 3 weeks. d. Full therapeutic effect may take up to 4 months.

A client has abnormal amounts of circulating thyronine (T3) and thyroxine (T4). While obtaining the health history, the nurse asks the client about dietary intake. Lack of which dietary element is most likely the cause? a. Iodine b. Calcium c. Phosphorus d. Magnesium

A client has been diagnosed with Cushing's syndrome. The nurse should assess the client for which expected manifestations of this disorder? a. Dizziness b. Weight loss c. Hypoglycemia d. Truncal obesity

A client has been diagnosed with hyperthyroidism. The nurse monitors for which signs and symptoms indicating a complication of this disorder? Select all that apply. a. Fever b. Nausea c. Lethargy d. Tremors e. Confusion f. Bradycardia

A client has been diagnosed with pheochromocytoma. Which clinical manifestation is most indicative of this condition? a. Water loss b. Bradycardia c. Hypertension d. Decreased cardiac output

A client has been hospitalized for impaired function of the posterior pituitary gland. The nurse plans to monitor for signs and symptoms of which hormone imbalance? a. Growth hormone (GH) b. Luteinizing hormone (LH) c. Antidiuretic hormone (ADH) d. Follicle-stimulating hormone (FSH)

A client has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? a. Weight loss b. Relief of heart burn c. Reduction of steatorrhea d. Absence of abdominal pain

A client has begun medication therapy with propylthiouracil. The nurse should assess the client for which condition as an adverse effect of this medication? a. Joint pain b. Renal toxicity c. Hyperglycemia d. Hypothyroidism

A client has developed hepatitis A after eating contaminated oysters. The nurse assesses the client for which expected assessment finding? a. Malaise b. Dark stools c. Weight gain d. Left upper quadrant discomfort

A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client? a. Hoarseness b. Hypocalcemia c. Audible stridor d. Edema at the surgical site

A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client? a. Hypoglycemia b. Level of hoarseness c. Respiratory distress d. Edema at the surgical site

A client has overactivity of the thyroid gland. The nurse should expect which finding? a. Weight gain b. Nutritional deficiencies c. Low blood glucose levels d. Increased body fat stores

A client has returned to the nursing unit after a thyroidectomy. The nurse notes that the client is complaining of tingling sensations around the mouth, fingers, and toes. On the basis of these findings, the nurse should next assess the results of which serum laboratory study? a. Sodium b. Calcium c. Potassium d. Magnesium

A client is admitted to an emergency department, and a diagnosis of myxedema coma is made. Which action should the nurse prepare to carry out initially? a. Warm the client b. Maintain a patent airway c. Administer thyroid hormone d. Administer fluid replacement

A client is admitted to the hospital with a diagnosis of Addison's disease. The nurse would assess for which problem as a manifestation of this disorder? a. Edema b. Obesity c. Hirsutism d. Hypotension

A client is admitted to the hospital with a diagnosis of pheochromocytoma. The nurse would check which item to detect the primarymanifestation of this disorder? a. Weight b. Urine ketones c. Blood pressure d. Skin temperature

A client is admitted to the hospital with acute viral hepatitis. Which sign or symptom should the nurse expect to note based on this diagnosis? a. Fatigue b. Pale urine c. Weight gain d. Spider angiomas

A client is diagnosed with Cushing's syndrome. When reviewing the recent laboratory results, the nurse should expect an excess of which substance? a. Calcium b. Cortisol c. Epinephrine d. Norepinephrine

A client is diagnosed with viral hepatitis, complaining of "no appetite" and "losing my taste for food." What instruction should the nurse give the client to provide adequate nutrition? a. Select foods high in fat. b. Increase intake of fluids, including juices. c. Eat a good supper when anorexia is not as severe. d. Eat less often, preferably only 3 large meals daily.

A client is hospitalized with a diagnosis of adrenal insufficiency. Which findings does the nurse identify as supportive of this diagnosis? Select all that apply. a. Irritability b. Complaints of nausea c. Sodium level of 128 mEq/L d. Potassium level of 3.2 mEq/L e. Blood pressure lying 138/70 mm Hg and standing 110/58 mmHg

A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. After diagnostic studies, diabetes insipidus is diagnosed. Desmopressin is prescribed. The client asks why this medication was prescribed. Which is a correct statement by the nurse? a. "It relieves the headaches." b. "It increases water reabsorption." c. "It stimulates the production of aldosterone." d. "It decreases the production of the antidiuretic hormone."

A client seen in the ambulatory care clinic has ascites and slight jaundice. The nurse should assess the client for a history of chronic use of which medication? a. Ibuprofen b. Ranitidine c. Acetaminophen d. Acetylsalicylic acid

A client visits the primary health care provider's office for a routine physical examination and reports a new onset of intolerance to cold. Since hypothyroidism is suspected, which additional information would be noted during the client's assessment? a. Weight loss and tachycardia b. Complaints of weakness and lethargy c. Diaphoresis and increased hair growth d. Increased heart rate and respiratory rate

A client with Cushing's syndrome verbalizes concern to the nurse regarding the appearance of the buffalo hump that has developed. Which statement should the nurse make to the client? a. "Don't be concerned; this problem can be covered with clothing." b. "Usually these physical changes slowly improve following treatment." c. "This is permanent, but looks are deceiving and are not that important." d. "Try not to worry about it; there are other things to be concerned about."

A client with Graves' disease has exophthalmos and is experiencing photophobia. Which nursing action would best assist the client with these manifestations? a. Obtain dark glasses for the client b. Lubricate the eyes with tap water every 2 to 4 hours c. Administer methimazole every 8 hours around the clock d. Instruct the client to avoid straining or heavy lifting because this effort can increase eye pressure

A client with a diagnosis of addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional health care team focus on? Select all that apply. a. Hypotension b. Leukocytosis c. Hyperkalemia d. Hypercalcemia e. Hypernatramia

A client with acute pancreatitis is experiencing severe pain from the disorder. The nurse determines that education about positioning to reduce pain was effective if the client avoids which action? a. Sitting up b. Lying flat c. Leaning forward d. Drawing the legs to the chest

A client with an endocrine disorder has experienced recent weight loss and exhibits tachycardia. Based on the clinical manifestations, the nurse should suspect dysfunction of which endocrine gland a. Thyroid b. Pituitary c. Parathyroid d. Adrenal cortex

A client with chronic pancreatitis needs information on dietary modification to manage the health problem. Which item in the diet should the nurse teach the client to limit? a. Fat b. Protein c. Carbohydrate d. Water-soluble vitamins

A client with diabetes insipidus asks the nurse about the purpose of a new medication, vasopressin. The nurse provides teaching about the medication. Which statement by the client indicates successful teaching? a. "It causes muscle contractions." b. "It opens up my blood vessels." c. "It prevents me from 'peeing' so much." d. "It decreases stomach and colon motility."

A client with hyperthyroidism has been given methimazole. Which nursing considerations are associated with this medication? Select all that apply. a. Administer methimazole with food. b. Place the client on a low-calorie, low-protein diet c. Assess the client for unexplained bruising or bleeding d. Instruct the client to report side and adverse effects such as sore throat, fever, or headaches. e. Use special radioactive precautions when handling the client's urine for the first 24 hours following initial administration.

A client with medullary carcinoma of the thyroid has an excess function of the C cells of the thyroid gland. When reviewing the most recent laboratory results, the nurse should expect which electrolyte abnormality? a. Sodium b. Calcium c. Potassium d. Magnesium

A client with suspected Cushing's syndrome is scheduled for adrenal venography. A nurse has provided instructions to the client regarding the test. Which statement by the client indicates a need for further instruction? a. "I need to sign an informed consent." b. "The insertion site will be locally anesthetized." c. "I will be placed in a high-sitting position for the test." d. "I may feel a burning sensation after the dye is injected."

A client with suspected primary hyperparathyroidism is undergoing diagnostic testing. The nurse would assess for which as a manifestation of this disorder? a. Polyuria b. Diarrhea c. Polyphagia d. Weight gain

A client with viral hepatitis has no appetite, and food makes the client nauseated. Which nursing intervention is appropriate? a. Encourage foods that are high in protein. b. Monitor for fluid and electrolyte imbalance. c. Explain that high-fat diets usually are better tolerated. d. Explain that most daily calories need to be consumed in the evening hours.

A client with viral hepatitis is discussing with the nurse the need to avoid alcohol and states, "I'm not sure I can avoid alcohol." What is the most appropriate nursing response? a. "I don't believe that." b. "Everything will be all right." c. "I'm not sure that I understand. Would you please explain?" d. "I think you should talk more with the primary health care provider about this."

A client with viral hepatitis states, "I am so yellow." What is the most appropriate nursing action? a. Assist the client in expressing feelings. b. Restrict visitors until the jaundice subsides. c. Perform most of the activities of daily living for the client. d. Provide information to the client only when he or she requests it.

A client's laboratory results indicate the serum calcium is 12 mg/dL (3 mmol/L) and the serum phosphorus is 2.1 mg/dL (0.697 mmol/L). Based on these findings, the nurse suspects imbalance of which hormone? a. Thyroid hormone b. Parathyroid hormone c. Follicle-stimulating hormone d. Adrenocorticotropic hormone

A community health nurse is planning an educational program about hepatitis A. When preparing the materials, the nurse should identify which of the following groups is most at risk for developing hepatitis A? a. Children b. Older adults c. Women who are pregnant d. Middle-age men

A female patient with Cushing syndrome is distressed because of the appearance of abdominal stretch marks. What should the nurse explain to the patient about this skin change? a. Excessive mineralocorticoids reduce the absorption of calcium b. Excessive glucocorticoids affect normal carbohydrate metabolism c. Excessive glucocorticoids cause a loss of collagen and connective tissue Excessive cortisol results in changes in protein metabolism and protein catabolism

A multidisciplinary health care team is developing a plan of care for a client with hyperparathyroidism. The nurse should include which priority intervention in the plan of care? a. Describe the use of loperamide b. Restrict fluids to 1000 mL per day c. Walk down the hall for 15 minutes 3 times a day d. Describe the administration of aluminum hydroxide gel.

A nurse has provided dietary instructions to a client with Addison's disease. Which statement made by the client indicates that the client understands the instructions? a. "I will decrease my carbohydrate intake." b. "High fat intake is essential with this disease." c. "I will maintain a normal sodium intake in my diet." d. "I will need to restrict the amount of protein in my diet."

A nurse if assessing a client who has Addison's disease. Which of the following skin manifestations should the nurse expect to find? a. Purple striae on the chest and abdomen b. Butterfly rash across the bridge of the nose c. Bronze pigmentation of skin d. Jaundice of the face and sclera

A nurse in a provider's office is assessing a client who recently began taking levothyroxine to treat hypothyroidism. Which of the following findings should indicate to the nurse that the client might need a decrease in the dosage of the medication? a. Hand tremors b. Bradycardia c. Pallor d. Slow speech

A nurse in a provider's office is planning care for a client who has a new diagnoses of Graves' disease. And a new prescription for methimazole. Which of the following interventions should the nurse include in the plan of care? Select All That Apply. a. Monitor CBC b. Monitor triifothyronine (T3) c. Instruct the client to increase consumption of shellfish d. Advise the client to take the medication at the time every day. e. Inform the client that an adverse effect of this medication is iodine toxicity.

A nurse in a provider's office is reviewing laboratory results of a client who is being evaluated for secondary hypothyroidism. Which of the following laboratory findings is expected? a. Elevated T4 b. Decrease T3 c. Elevated thyroid stimulating hormone d. Decrease cholesterol

A nurse in a provider's office is reviewing the health record of a client who is being evaluated for Grave's disease. The nurse should identify which of the following laboratory results is an expected finding? a. Decreased thyrotropin receptor antibodies b. Decreased thyroid-stimulating hormone (TSH) c. Decreased free thyroxine index d. Decreased triiofothyronine

A nurse in the emergency department is assessing a client who has pancreatitis. In which of the following laboratory results should the nurse expect to see an elevation? a. Amylase b. Potassium c. Calcium d. Hematocrit

A nurse in the emergency department is caring for a client who has Addison's disease and reports nausea, vomiting, diarrhea, and abdominal pain. To prevent Addisonian crisis, the nurse should prepare to administer which of the following medications? a. Calcium b. Potassium c. Iodine d. Hydrocortisone

A nurse in the emergency department is caring for a client who has bleeding esophageal varices. The nurse should anticipate a prescription for which of the following manifestations? a. Famotidine b. Esomeprazole c. Vasopressin d. Omeprazole

A nurse is accepting a transfer from the postanesthesia care unit (PACU) of a client who has had a subtotal thyroidectomy. Which of the following pieces of equipment should the nurse have available at the bedside for this client? a. Cardiac monitor b. Defibrillator c. Thoracotomy tray d. Tracheostomy tray

A nurse is admitting a client who has acute adrenal insufficiency. Which of the following prescriptions should the nurse expect? Select All That Apply. a. IV therapy with 0.45% sodium chloride b. Regular insulin c. Hydrocortisone sodium succinate d. Sodium polystyrene sulfonate e. Furosemide

A nurse is admitting a client who has cirrhosis. Which of the following prescriptions should the nurse anticipate? Select All That Apply. a. Obtain the client's PT and INR measurements b. Administer lactulose 30 mL PO 4 times daily c. Obtain daily weight and abdominal girth measurements d. Administer a daily multivitamin e. Place the client on a low-protein diet

A nurse is assessing a client during a water deprivation test. For which of the following complications should the nurse monitor for the client? a. Bradycardia b. Orthostatic hypotension c. Neck vein distention d. Crackles in the lungs

A nurse is assessing a client who has Addison's disease. Which of the following findings should the nurse expect? a. Hypotension b. Weight gain c. Sugar craving d. Pale skin tone

A nurse is assessing a client who has Grave's disease. Which of the following findings should the nurse expect the client to display? a. Constipation b. Cold intolerance c. Difficulty sleeping d. Anorexia

A nurse is assessing a client who has Graves disease. Which of the following should the nurse expect the client to display? a. Constipation b. Cold intolerance c. Difficulty sleeping d. Anorexia

A nurse is assessing a client who has had cranial surgery and is at risk for development of diabetes insipidus. The nurse would assess for which signs or symptoms that could indicate development of this complication? a. Diarrhea b. Infection c. Polydipsia d. Weight gain

A nurse is assessing a client who has manifestations of acromegaly. Which of the following findings should the nurse expect? a. Thinning of skeletal bone structure b. Concave chest wall c. High-pitched voice d. Increased head size

A nurse is assessing a client who is 12 hr postoperative following a thyroidectomy. Which of the following findings is indicative of thyroid crisis? Select All That Apply. a. Bradycardia b. Hypothermia c. Dyspnea d. Abdominal pain e. Mental confusion

A nurse is assessing a client who is in the early stages of hepatitis A. Which of the following manifestations should the nurse expect? a. Jaundice b. Anorexia c. Dark urine d. Pale feces

A nurse is assessing a client who is recovering from a thyroidectomy and has a harsh, high-pitched respiratory sound. Which of the following actions should the nurse take? a. Hyperextend the client's neck b. Prepare for a tracheostomy c. Lower the head of the bed d. Administer morphine

A nurse is assessing the status of a client who returned to the surgical nursing unit after a parathyroidectomy procedure. The nurse would place highest priority on which assessment finding? a. Laryngeal stridor b. Difficulty voiding c. Mild incisional pain d. Absence of bowel sounds

A nurse is assisting a provider with performing a paracentesis on a client. Which of the following actions should the nurse take? a. Ask the client to empty his bladder before the procedure b. Place the client leaning forward over the bedside table for the procedure c. Inform the client he will be sedated during the procedure d. Instruct the client to fast for 6 hr prior to the procedure

A nurse is beginning a shift, a nurse is assessing a client who has Cushing's disease. Which of the following findings is the priority? a. Weight gain b. Fatigue c. Fragile skin d. Joint pain

A nurse is caring for a client who had a thyroidectomy 1 day ago. Which client laboratory data should the nurse identify as a possible complication of thyroid surgery? a. Increased serum sodium level b. Increased serum glucose level c. Decreased serum calcium level d. Decreased serum albumin level

A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism caused by adenoma. Which of the following findings should the nurse report to the provider? (select all that apply.) a. Tachycardia and hypertension b. Respiratory rate 16/min c. Negative Chvostek's sign d. Laryngeal stridor and hoarseness e. Positive Trousseau's sign

A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism caused by an adenoma. Which of the following findings should the nurse report to the provider? Select All That Apply. a. Tachycardia and hypertension b. Respiratory rate 16/min c. Negative Chvostek's sign d. Laryngeal stridor and hoarseness e. Positive Trousseau's sign

A nurse is caring for a client who had diabetes insipidus. For which of the following findings should the nurse monitor? a. Proteinuria b. Oliguria c. Polyuria d. Glycosuria

A nurse is caring for a client who has abdominal pain and possible pancreatitis. Which of the following laboratory results should the nurse identify as an indication of pancreatitis? a. Decreased white blood cell count b. Increased albumin level c. Increased serum lipase level d. Decreased blood glucose level

A nurse is caring for a client who has acute pancreatitis. Which of the following serum laboratory values should return to the expected reference range within 72 hours of treatment beginning? a. Aldolase b. Lipase c. Amylase

A nurse is caring for a client who has been diagnosed with an Addisonian crisis and has a blood pressure of 74/42 mmHg. Which of the following prescriptions should the nurse anticipate? a. Desmopressin b. Hydrocortisone c. Dopamine d. Furosemide

A nurse is caring for a client who has diabetes insipidus. For which of the following findings should the nurse monitor? a. Proteinuria b. Oliguria c. Polyuria d. Glycosuria Proteinuria

A nurse is caring for a client who has diabetes insipidus. Which of the following urinalysis laboratory findings should the nurse expect? a. Presence of glucose b. Decreased specific gravity c. Presence of ketones d. Presence of red blood cells

A nurse is caring for a client who has fulminant hepatic failure. Which of the following procedures should the nurse anticipate for this client? a. Endoscopic sclerotherapy b. Liver lobectomy c. Liver transplant d. Transjugular intrahepatic portal-systemic shunt placement

A nurse is caring for a client who has primary adrenal insufficiency and is preparing to undergo an ACTH stimulation test. Which of the following findings should the nurse expect after an IV injection of cosyntropin? a. No change in plasma cortisol b. Elevated fasting blood glucose c. Decrease in sodium d. Increase in urinary output

A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following findings should the nurse expect? Select All That Apply. a. Decreased blood sodium b. Urine specific gravity 1.001 c. Blood osmolarity 230 mOsm/L d. Polyuria e. Increased thirst

A nurse is caring for a client who is 6 hr postoperative following a transsphenoidal hypophysectomy. The nurse should test the client's nasal drainage for the presence of which of the following? a. RBCs b. Ketones c. Glucose d. Streptococci

A nurse is caring for a client who is postoperative following a bilateral adrenalectomy. The nurse should expect to administer glucocorticoids following the procedure to enhance which of the following therapeutic effects? a. Compensation for decreased cortisol levels b. Inhibition of glucose metabolism c. Diuretic action to maintain urine output d. Decreased susceptibility to infection

A nurse is caring for a client who is postoperative following a bilateral adrenalectomy. The nurse should expect to administer glucocortioids following the procedure to enhance which of the therapeutic effects? a. Compensate for decrease in cortisol levels b. Inhibit glucose metabolism c. Act as a diuretic to maintain urine output d. Decrease susceptibility to infection

A nurse is caring for a client who is postoperative following a parathyroidectomy to treat hyperparathyroidism. Which of the following laboratory values should the nurse expect to decrease as the therapeutic effect of the procedure? a. Calcium b. Sodium c. Potassium d. Phosphorous

A nurse is caring for a client who is postoperative following a parathyroidectomy to treat hypoparathyroidism. Which of the following laboratory values should the nurse expect to decrease as a therapeutic effect of the procedure? a. Calcium b. Sodium c. Potassium d. Phosphorus

A nurse is caring for a client who is scheduled to undergo a liver biopsy for a suspected malignancy. Which of the following laboratory findings should the nurse monitor prior to the procedure? a. Prothrombin time b. Serum lipase c. Bilirubin d. Calcium

A nurse is caring for a client with Addison's disease who has been admitted with muscle weakness, dehydration, and nausea and vomiting for the past 2 days. Which of the following prescribed medications should the nurse plan to administer? a. Rifampin b. Loperamide c. Hydrocortisone d. Spironolactone

A nurse is caring for a client with a diagnosis of hyperthyroidism. Laboratory studies are performed, and the serum calcium level is 12.0 mg/dL (3 mmol/L). Which medication should the nurse anticipate to be prescribed for the client? a. Calcitonin b. Calcium chloride c. Calcium gluconate d. Large doses of vitamin D

A nurse is caring for a client with a dysfunctional thyroid gland and is concerned that the client will exhibit a sign of thyroid storm. Which is an early indicator of this complication? a. Bradycardia b. Constipation c. Hyperreflexia d. Low-grade temperature

A nurse is caring for a client with a history of cirrhosis who has been admitted with manifestations of hepatic encephalopathy. The nurse should anticipate a prescription for which of the following tests to determine the possibility of recent excessive alcohol use? a. Gamma-glutamyl transferase (GGT) b. Alkaline phosphatase (ALP) c. Serum bilirubin d. Alanine aminotransferase (ALT)

A nurse is caring for a client with pheochromocytoma. The client asks for a snack and something warm to drink. Which items would be the most appropriate choice for this client to meet nutritional needs? a. Crackers with cheese and tea b. Graham crackers and warm milk c. Toast with peanut butter and cocoa d. Vanilla wafers and coffee with cream and sugar

A nurse is caring for a client with thyrotoxicosis who is at risk for the development of thyroid storm. To detect this complication, the nurse should assess for which sign or symptom? a. Bradycardia b. Constipation c. Hypertension d. Low-grade temperature

A nurse is checking laboratory values to determine if a client who has diabetes mellitus is adhering to the treatment plan. Which of the following tests should the nurse use to make this determination? a. Glycosylated hemoglobin levels b. Urine sugar and acetone c. Glucose tolerance test d. Fasting serum glucose

A nurse is collecting an admission history form a client who has hypothyroidism. Which of the following findings should the nurse expect? Select All That Apply. a. Diarrhea b. Menorrhagia c. Dry skin d. Increased libido e. Hoarseness

A nurse is completing a history and physical assessment for a client who has chronic pancreatitis. Which of the following findings should the nurse identify as a likely cause of the client's condition? a. High-calorie diet b. Prior gastrointestinal illnesses c. Tobacco use d. Alcohol use

A nurse is completing the admission assessment of a client who has acute pancreatitis. Which of the following findings is the priority to be reported to the provider? a. History of cholelithiasis b. Serum amylase levels three times greater than the expected value c. Client report of severe pain radiating to the back that is rated at and 8 d. Hand spasms present when blood pressure is checked

A nurse is completing the admission assessment of a client who has acute pancreatitis. Which of the following findings is the priority to be reported to the provider? a. History of cholelithiasis b. Serum amylase levels three times greater than the expected value c. Client report of severe pain radiating to the back that is rated at and 8 d. Hand spasms present when blood pressure is checked - trousseau sign - tells us a significant electrolyte imbalance

A nurse is monitoring a client following a thyroidectomy for the presence of hypoparathyroidism. Which of the following findings should the nurse expect? a. Elevated blood pressure b. Involuntary muscle spasms c. Cold intolerance d. Weight loss

A nurse is monitoring a client who has Graves' disease for the development of thyroid storm. The nurse should report which of the following findings to the provider? a. Constipation b. Headache c. Bradycardia d. Hypertension

A nurse is monitoring a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings should the nurse expect? a. Polyuria b. Dehydration c. Hyponatremia d. Hyperthermia

A nurse is monitoring a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following signs should the nurse expect? a. Polyuria b. Dehydration c. Hyponatremia d. Hyperthermia

A nurse is monitoring the laboratory results of a client who has end-stage liver failure. Which of the following results should the nurse expect? a. Decreased lactate dehydrogenase b. Increased serum c. Decreased serum ammonia d. Increased prothrombin time

A nurse is performing a gastrointestinal assessment of a client who has liver cirrhosis with abdominal distention. Which of the following actions should the nurse take to assess for changes in the client's abdominal distention? a. Percuss the abdomen for tympanic sounds b. Inspect the contour of the abdominal wall c. Instruct the client to report increased abdominal discomfort d. Take serial measurements of the abdomen with a tape a measure

A nurse is planning a community health screening for a group of clients who are at risk for type 2 diabetes mellitus. Which of the following clients should the nurse include in this screening? a. Men who smoke b. Men and women who are obese c. Women who have hepatitis d. Men and women who consume high-protein and low-carbohydrate foods

A nurse is planning care for a client who has Cushing's disease. The nurse should identify that clients who have Cushing's disease are at risk for which of the following? Select All That Apply. a. Infection b. Gastric ulcer c. Renal calculi d. Bone fractures e. Dysphagia

A nurse is planning care for a client who has Cushing's syndrome due to chronic corticosteroid use. Which of the following actions should the nurse include in the plan of care? a. Check the client's blood b. glucose for hypoglycemia. b. Check the client's urine specific gravity. c. Weigh the client weekly. d. Insert an indwelling urinary catheter for the client.

A nurse is planning care for a client who has Cushing's syndrome due to chronic corticosteroid use. Which of the following actions should the nurse include in the plan of care? a. Check the client's blood glucose for hypoglycemia b. Check the client's urine specific gravity c. Weight the client weekly d. Insert an indwelling urinary catheter for the client

A nurse is planning care for a client who has acromegaly and is postoperative following a transsphenoidal hypophysectomy. Which of the following interventions should the nurse include in the plan? a. Maintain the client in a low-fowler's position b. Encourage deep breathing and coughing c. Encourage the client to brush their teeth when awake and alert d. Observe dressing drainage for the presence of glucose

A nurse is preparing a community education program about hepatitis B. Which of the following statements should the nurse include in the teaching? a. "A hepatitis B immunization is recommended for those who travel, especially military personnel." b. "Hepatitis B immunization is given to infants and children." c. "Hepatitis B is acquired by eating foods that are contaminated during handling." d. "Hepatitis B can be prevented by using good personal hygiene habits and proper sanitation."

A nurse is preparing to administer pancrelipase (Viokase) to a client who has pancreatitis. Which of the following is an appropriate nursing action? a. Administer medication 30 min after a snack b. Offer a glass of water following medication administration c. Administer medication 30 min before meals d. Sprinkle the contents on peanut butter

A nurse is preparing to receive a client from the PACU who is postoperative following a thyroidectomy. The nurse should ensure that which of the following equipment is available? Select All That Apply. a. Suction equipment b. Humidified oxygen c. Flashlight d. Tracheostomy tray e. Chest tube tray

A nurse is providing dietary teaching to a client who has dumping syndrome following gastric surgery 4 days ago. Which of the following recommendations should the nurse include in the teaching? a. Avoid foods containing protein b. Drink liquids during each meal c. Eat foods that contain simple sugars d. Maintain a supine position after meals

A nurse is providing discharge teaching for a client who had a transsphenoidal hypophysectomy. Which of the following instructions should the nurse include? Select All That Apply. a. Brush teeth after every meal or snack b. Avoid bending at the knees c. Eat a high-fiber diet d. Notify the provider of increased swallowing e. Notify the provider of a diminished sense of smell

A nurse is providing discharge teaching to the partner of a client who has a new diagnosis of hepatitis A. Which of the following instructions should the nurse include in the teaching? a. "During this illness, she may take acetaminophen" b. "Encourage her to eat foods that are high in carbohydrates." c. "The provider will prescribe a medication to help her liver heal faster." d. "Have her perform moderate exercise to restore her strength more quickly."

A nurse is providing home care instructions to a client with a diagnosis of Addison's disease. Which statement by the client indicates a need for further instruction? a. "I need to wear a MedicAlert bracelet." b. "I need to purchase a travel kit that contains cortisone." c. "I will need to take daily medications until my symptoms decrease." d. "I need an increased dose of glucocorticoid medication during stressful minor illnesses."

A nurse is providing instructions to a client who has Graves' disease and has a new prescription for propranolol. Which of the following information should the nurse include? a. "An adverse effect of this medication is jaundice." b. "Take your pulse before each dose." c. "The purpose of this medication is to decrease production of thyroid hormone." d. "You should stop taking this medication if you have a sore throat."

A nurse is providing medication teaching for a client who has Addison's disease and is taking hydrocortisone. Which of the following instructions should the nurse include? Select All That Apply. a. Take the medication on an empty stomach b. Notify the provider of any illness or stress c. Report any manifestations of weakness or dizziness d. Don't discontinue the medication suddenly e. Eat a low-sodium diet

A nurse is providing postoperative teaching about the management of dumping syndrome to a client who had a partial gastrectomy. Which of the following instructions should the nurse include in the teaching? a. "Consume at least 4 oz of fluid with meals" b. "Take a short walk after each meal" c. "Use honey to flavor foods such as cereal" d. "Eat protein with each meal"

A nurse is providing teaching to a client who has Addison's disease about healthy snack foods. Which of the following food choices by the client indicates an understanding of the teaching? a. Sliced bananas b. Baked potatoes c. Turkey and cheese sandwich d. Plain yogurt with peaches

A nurse is providing teaching to a client who has a new diagnosis of diabetes insipidus. Which of the following client statements indicates an understanding of the teaching? a. "I can drink up to 2 quarts of fluid a day." b. "I will need to use insulin to control my blood glucose levels." c. "I should expect to gain weight during the illness." d. "I should experience confusion or balance problems

A nurse is providing teaching to a client who has diabetes mellitus about hypoglycemia. Which of the following manifestations should the nurse include in the teaching? a. Shakiness b. urinary frequency c. dry mucous membranes d. excess thirst

A nurse is providing teaching to a client who has type 1 diabetes mellitus about exercise. Which of the following statements should the nurse include in the teaching? a. "You should exercise during a peak insulin time." b. "Wear a medical alert identification tag when you exercise." c. "Exercise can decrease the effects of insulin and cause the blood glucose levels to increase." d. d. "You will get the most benefit from exercise when your glucose levels are higher than normal."

A nurse is providing teaching to a client who has type 2 diabetes mellitus about the pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching? a. "My cells are resistant to the effects of insulin." b. "My body breaks down sugars too efficiently." c. "My pancreas does not produce insulin." d. "My body produces antibodies against pancreatic beta cells."

A nurse is reinforcing teaching with a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following information should the nurse include in the teaching? Select All That Apply. a. Weight gain is expected while taking this medication b. Medication should not be discontinued without the advice of the provider c. Follow-up blood TSH levels should be obtained d. Take the medication on an empty stomach e. Use fiber laxatives for constipation

A nurse is reviewing laboratory results for a client who has Addison's disease. Which of the following laboratory results should the nurse expect for this client? Select All That Apply. a. Sodium 130 mEq/L b. Potassium 6.1 mEq/L c. Calcium 11.6 mg/dL d. Blood urea nitrogen (BUN) 28 mg/dL e. Fasting blood glucose 148 mg/dL

A nurse is reviewing the assessment findings and laboratory data for a client with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The nurse understands that which symptoms are associated characteristics of this disorder? Select all that apply. a. Hypernatremia b. Signs of water deficit c. High urine osmolality d. Low serum osmolality e. Hypotonicity of body fluids f. Continued release of antidiuretic hormone

A nurse is reviewing the assessment findings for a client who was admitted to the hospital with a diagnosis of diabetes insipidus. The nurse understands that which manifestations are associated with this disorder? Select all that apply. a. Polyuria b. Polydipsia c. Concentrated urine d. Complaints of excessive thirst e. Specific gravity lower than 1.005

A nurse is reviewing the health record of a client who has pancreatitis. The physical exam report by the provider indicates the presence of Cullen's sign. Which of the following is an appropriate action by the nurse to identify this finding? a. Tap lightly at the costovertebral margin on the client's back b. Palpate the client's right lower quadrant c. Inspect the skin around the umbilicus d. Auscultate the area below the client's scapula

A nurse is reviewing the health record of a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following laboratory findings should the nurse expect? Select All That Apply. a. Low sodium b. High potassium c. Increased urine osmolality d. High urine sodium e. Increased urine specific gravity

A nurse is reviewing the laboratory findings for a client who might have hyperthyroidism. The nurse should identify an elevation of which of the following substances as an indication that the client has this disorder? a. Triiodothyronine b. Plasma-free metanephrine c. Urine cortisol d. Urine osmolality

A nurse is reviewing the laboratory reports of a client and notes an elevated thyroid-stimulating hormone (TSH) level. Which of the following findings should the nurse expect? a. Bradycardia b. Tremors c. Low-grade fever d. Diaphoresis

A nurse is reviewing the laboratory values of a client who has diabetic ketoacidosis. The nurse should understand that which of the following laboratory values is consistent with diabetic ketoacidosis? a. Blood glucose 30 mg/dL b. Negative urine ketones c. Blood pH 7.38 d. Bicarbonate level 12 mEq/L

A nurse is reviewing the manifestations of hyperthyroidism with a client. Which of the following findings should the nurse include? Select All That Apply. a. Anorexia b. Heat intolerance c. Constipation d. Palpitations e. Weight loss f. Bradycardia

A nurse is reviewing the primary health care provider's prescriptions for a client diagnosed with hypothyroidism. Which medication prescription should the nurse question and verify? a. Acetaminophen b. Docusate sodium c. Morphine sulfate d. Levothyroxine sodium

A nurse is teaching a client who has cirrhosis of the liver and a history of alcohol consumption. The nurse should explain that alcohol can cause liver cirrhosis through which of the following actions? a. Increasing the workload of the liver by releasing stored glycogen b. Causing ulceration of liver tissue that can lead to bleeding c. Dilating veins in the portal circulation d. Destroying liver cells that are later replaced with scar tissue.

A nurse is teaching a client who has hyperthyroidism about managing this disorder. Which of the following recommendations should the nurse include? a. Reduce total hours of sleep b. Keep the immediate environment warm c. Increase caloric intake with meals d. Gradually increase activity

A nurse is teaching a group of clients about the function of the liver and gallbladder. Which of the following should the nurse include in the teaching as the purpose of bile? a. Digesting fats b. Producing chyme c. Stimulating gastric acid secretion d. Providing energy

A nurse is teaching a newly licensed nurse about caring for a client who is scheduled for an esophagogastric balloon tamponade tube to treat bleeding esophageal varices. Which of the following pieces of information should the nurse include in the teaching? a. The client will be placed on mechanical ventilation prior to this procedure b. The tube will be inserted into the client's trachea c. The client will receive a bowel preparation with cathartics prior to this procedure d. The tube allows the application of a ligation band to the bleeding varices.

A nurse is teaching dietary-modification strategies to a client who has been newly diagnosed with cirrhosis. Which of the following foods should the nurse recommend? a. Grilled chicken b. Potato soup c. Fish sticks d. Baked ham

A nurse is updating the plan of care for a client who had dumping syndrome. Which of the following instructions should the nurse include? a. Consume beverages with meals b. Eat 3 large meals per day c. Include high-fiber foods in the diet d. Eat a source of protein with each meal

A nursing instructor is teaching the class about Addison's disease. The instructor determines that the class understands the disease process if they indicate which are affected in this disease? Select all that apply. a. Androgens b. Bicarbonate c. Electrolytes d. Glucocorticoids e. Mineralcorticoids

A patient arrives to the ER and is unable to give you a health history due to altered mental status. The family reports the patient has gained over 10 lbs in 1 week and says it is mainly "water" weight. In addition, they report the patient hasn't been able to urinate or eat within the past week as well and was recently diagnosed with small cell lung cancer. On assessment, you note the patient's HR is 115 and BP 180/92. Patient sodium level is 90. Which of the following conditions do you suspect the patient is most likely presenting with?* ○ A. SIADH ○ B. Diabetes Insipidus ○ C. Addison's Disease ○ D. Fluid Volume Deficient In the scenario above what drug do you anticipate the patient will be started on per doctor's order?* ○ A. Desmopressin (DDAVP) IV ○ B. Declomycin ○ C. Diabinese ○ D. Stimate

A patient comes to the clinic after having bariatric surgery and says, "After I eat, I feel really funny. My heart races, I feel nauseated, and my abdomen cramps up." What does the nurse suspect is happening with this patient? a. Hyperglycemia b. Intestinal obstruction c. Peritonitis d. Dumping Syndrome

A patient has an extremely high T3 and T4 level. Which of the following signs and symptoms DO NOT present with this condition?* ○ A. Weight loss ○ B. Intolerance to heat ○ C. Smooth skin ○ D. Hair loss

A patient has lab work drawn and it shows a positive HBsAg. What education will you provide to the patient?* ○ A. Avoid sexual intercourse or intimacy such as kissing until blood work is negative. ○ B. The patient is now recovered from a previous Hepatitis B infection and is now immune. ○ C. The patient is not a candidate from antiviral or interferon medications. ○ D. The patient is less likely to develop a chronic infection.

. A patient hospitalized with hypoparathyroidism is about to order lunch. Which food selection is best for this patient based on their dietary needs at this time?* ○ A. Baked chicken, green beans, and boiled potatoes ○ B. Broccoli salad, cottage cheese, and peaches ○ C. Roast beef, carrots, and pinto beans ○ D. Hamburger, fries, and sorbet

A patient hospitalized with hypoparathyroidism is about to order lunch. Which food selection is best for this patient based on their dietary needs at this time?* ○ A. Baked chicken, green beans, and boiled potatoes ○ B. Broccoli salad, cottage cheese, and peaches ○ C. Roast beef, carrots, and pinto beans ○ D. Hamburger, fries, and sorbet

A patient is 6 hours post-opt from a thyroidectomy. The surgical site is clean, dry and intact with no excessive swelling noted. What position is best for this patient to be in? Trendelenburg Fowler's Prone Semi-Fowler's

A patient is 6 hours post-opt from a thyroidectomy. The surgical site is clean, dry and intact with no excessive swelling noted. What position is best for this patient to be in?* ○ A. Fowler's ○ B. Prone ○ C. Trendelenburg ○ D. Semi-Fowler's

A patient is 6 hours post-opt from thyroid surgery. The patient's calcium level is 5 and phosphate level is 4.2. What physical signs and symptoms would NOT present with these findings? (Select-all-that-apply)* ○ A. Bronchospasm ○ B. Constipation ○ C. Numbness and tingling in the face ○ D. Positive Chvostek's Sign ○ E. Absent Trousseau's Sign ○ F. Hypertension

A patient is admitted to the ER with the following signs and symptoms: very painful mid-epigastric pain felt in the back, elevated glucose, fever, and vomiting. During the head-to-toe assessment, you notice bluish discoloration around the belly button. As the nurse, you know this is called? Grey-Turner's sign Cullen's sign Homan's Sign McBurney's sign

A patient is admitted to the ER with the following signs and symptoms: very painful mid-epigastric pain felt in the back, elevated glucose, fever, and vomiting. During the head-to-toe assessment, you notice bluish discoloration around the belly button. As the nurse, you know this is called?* ○ A. Grey-Turner's Sign ○ B. McBurney's Sign ○ C. Homan's Sign ○ D. Cullen's Sign

A patient is admitted to the ER. The patient is unconscious on arrival. However, the patient's family is with the patient and reports that before the patient became unconscious she was complaining of severe pain in the abdomen, legs, and back, and has been experiencing worsening confusion. In addition, they also report the patient has not been taking any medications. The patient was recently discharged from the hospital for treatment of low cortisol and aldosterone levels. On assessment, you note the patient's blood pressure is 70/45. What disorder is this patient most likely experiencing?* ○ A. Addisonian Crisis ○ B. Cushing Syndrome ○ C. Thyroid crisis ○ D. Hashimoto thyroiditis

A patient is admitted to the ER. The patient is unconscious on arrival. However, the patient's family is with the patient and reports that before the patient became unconscious she was complaining of severe pain in the abdomen, legs, and back, and has been experiencing worsening confusion. In addition, they also report the patient has not been taking any medications. The patient was recently discharged from the hospital for treatment of low cortisol and aldosterone levels. On assessment, you note the patient's blood pressure is 70/45. Which of the following disorders is this patient most likely experiencing? and what medication do you anticipate starting? Hashimoto thyroiditis and IV insulin Thyroid crisis and declomycin Addisonian Crisis and IV Solu-cortef Cushing's Syndrome and PO prednisone

A patient is admitted with hepatic encephalopathy secondary to cirrhosis. Which meal option selection below should be avoided with this patient?* ○ A. Beef tips and broccoli rabe ○ B. Pasta noodles and bread ○ C. Cucumber sandwich with a side of grapes ○ D. Fresh salad with chopped water chestnuts

A patient is being discharged home for treatment of hypothyroidism. Which medication is most commonly prescribed for this condition?* ○ A. Tapazole ○ B. PTU (Propylthiouracil) ○ C. Synthroid ○ D. Inderal

A patient is being treated for a condition where the pituitary gland is producing an increased amount of antidiuretic hormone. What finding would the nurse most likely assess in this patient? a. Increased output of urine b. Decreased output of urine c. Decreased production of testosterone d. Increased facial hair growth in women

A patient is diagnosed with Hepatitis A. The patient asks how a person can become infected with this condition. You know the most common route of transmission is?* ○ A. Blood ○ B. Percutaneous ○ C. Mucosal ○ D. Fecal-oral

A patient is diagnosed with Hepatitis D. What statement is true about this type of viral Hepatitis? Select all that apply:* ○ A. The patient will also have the Hepatitis B virus. ○ B. Hepatitis D is most common in Southern and Eastern Europe, Mediterranean, and Middle East. ○ C. Prevention of Hepatitis D includes handwashing and the Hepatitis D vaccine. ○ D. Hepatitis D is most commonly transmitted via the fecal-oral route.

A patient is diagnosed with hyperparathyroidism. Which of the following signs and symptoms would you NOT find in this patient? Select all that apply:* ○ A. Calcium level 6 mg/dL ○ B. Bone fracture ○ C. Positive Trousseau's Sign ○ D. Tingling and numbness of lips and fingers ○ E. Calcium level of 15 mg/dL ○ F. Phosphate level 1.2 ○ G. Renal calculi

A patient is having abdominal paracentesis as an outpatient procedure. The nurse will provide which instruction? #7 a. Empty bladder before procedure b. Report excess flatus after the procedure to the physician c. Scrub the abdomen with antiseptic soap before procedure d. Avoid eating or drinking fluid for 6 hours after procedure

A patient is prescribed Fosamax (Alendronate). The patient is about to be discharged and you observe the patient taking the medication. Which of the following findings requires you to re-educate the patient on how to take this medication?* ○ A. The patient takes the medication on an empty stomach. ○ B. The patient takes the medication with water. ○ C. The patient sits up for 10 minutes after taking the medication. D. The patient waits 30 minutes after taking Fosamax before taking the prescribed vitamins and antacids

A patient is receiving radioactive iodine treatment for hyperthyroidism. What will you include in your patient education to this patient about this type of treatment? Taste changes and swollen lymph nodes Excessive thirst and urination Sun protection including sunglasses Constipation and stomach pains

A patient is receiving radioactive iodine treatment for hyperthyroidism. What will you include in your patient education to this patient about this type of treatment?* ○ A. Taste changes and swollen salivary glands ○ B. Constipation ○ C. Excessive thirst ○ D. Sun protection

A patient is recovering from a thyroidectomy. The patient starts to complain of tingling and numbness in the face, toes, and fingers. Which of the following findings below warrants attention? Phosphate level: 4.3 mg/dL Ca+ level: 6 mg/dL K+ level: 3.5 mg/dL Na+ level: 145 mg/dL

A patient is recovering from a thyroidectomy. The patient starts to complain of tingling and numbness in the face, toes, and fingers. Which of the following findings below warrants attention?* ○ A. Ca+ level: 6 mg/dL ○ B. Na+ level: 145 mg/dL ○ C. K+ level: 3.5 mg/dL ○ D. Phosphate level: 4.3 mg/dL

. A patient is recovery from a parathyroidectomy. Which of the following findings causes concern and requires nursing intervention? The patient is in Semi-Fowler's position The patient's voice is hoarse The patient's calcium level is 8.9 mg/dL The patient is drowsy but arouses to name

A patient is recovery from a parathyroidectomy. Which of the following findings causes concern and requires nursing intervention? The patient is in Semi-Fowler's position The patient's voice is hoarse The patient's calcium level is 8.9 mg/dL The patient is drowsy but arouses to name

A patient is surprised to be diagnosed with acute pancreatitis because the patient reports no history of alcohol intake. How will the nurse respond to this patient? #9 a. "Was there a time in your life that you did drink heavily?" b. "It is also prevalent in smokers; do you smoke cigarettes?" c. "Gallstones are also a risk factor. We'll evaluate for them" d. "Intravenous drug use is a risk factor. Do you use drugs by injection?"

A patient on a reduced-calorie diet asks the nurse what she can do to lose weight faster because most weeks she loses no more than 0.5 lb. "At this rate, it will take me years to get to my goal!" How should the nurse respond to this patient? a. "Let's reevaluate your long-term goal. Perhaps it was set too low for you." b. "You sound frustrated. Would you like to take some time off from your diet and exercise plan?" c. "Perhaps we should look into a diet supplement since you are unable to stick with your prescribed diet plan." d. "A pound of body fat equals 3500 calories. Let's reevaluate your diet and exercise plan for calorie intake and expenditure."

A patient recovering from a thyroidectomy is experiencing tingling around the mouth and fingertips. The nurse would assess findings associated with which condition? a. Addisonian crisis b. Hypoparathyroidism c. Cushing syndrome d. Hyperparathyroidism

A patient reports they do not eat enough iodine in their diet. What condition are they most susceptible to?* ○ A. Pheochromocytoma ○ B. Hyperthyroidism ○ C. Thyroid Storm ○ D. Hypothyroidism

A patient taking steroids for an autoimmune disorder asks when the weight loss in the legs is going to stop. What should the nurse realize the patient is experiencing? a. Muscle wasting b. Poor wound healing c. Risk for compression fractures d. Increased susceptibility to infections

A patient was exposed to Hepatitis B recently. Postexposure precautions include vaccination and administration of HBIg (Hepatitis B Immune globulin). HBIg needs to be given as soon as possible, preferably ___________ after exposure to be effective.* ○ A. 2 weeks ○ B. 24 hours ○ C. 1 month ○ D. 7 days

A patient was recently discharged home for treatment of hypothyroidism and was ordered to take Synthroid for treatment. The patient is re-admitted with signs and symptoms of the following: heart rate 42, blood pressure 70/56, blood glucose 55, and body temperature of 96.8 'F. The patient is very fatigued and drowsy. The family reports the patient has not been taking Synthroid since being discharged home from the hospital. Which of the following conditions is this patient most likely experiencing? Thyroid Storm Myexedema Coma Thyroiditis Toxic Nodular Goiter

A patient was recently discharged home for treatment of hypothyroidism and was ordered to take Synthroid for treatment. The patient is re-admitted with signs and symptoms of the following: heart rate 42, blood pressure 70/56, blood glucose 55, and body temperature of 96.8 'F. The patient is very fatigued and drowsy. The family reports the patient has not been taking Synthroid since being discharged home from the hospital. Which of the following conditions is this patient most likely experiencing?* ○ A. Thryoid Storm ○ B. Myxedema Coma ○ C. Iodism ○ D. Toxic Nodular Goiter

A patient who is in her first trimester of pregnancy is diagnosed with hyperthyroidism. Which medication do you suspect the patient will be started on?* ○ A. Propylthiouracil (PTU) ○ B. Radioactive Iodine ○ C. Tapazole ○ D. Synthroid

A patient who received treatment for pancreatitis is being discharged home. You're providing diet teaching to the patient. Which statement by the patient requires immediate re-education about the diet restrictions?* ○ A. "It will be hard but I will eat a diet low in fat and avoid greasy foods." ○ B. "It is very important I limit my alcohol intake to no more than 2-3 glasses of wine a week." ○ C. "I will concentrate on eating complex carbohydrates rather than refined carbohydrates." ○ D. "I will purchase foods that are high in protein."

A patient whose thyroid gland produces an insufficient amount of thyroid hormone is concerned about an elevated cholesterol level. What should the nurse explain to this patient? a. "The thyroid gland malfunction can affect your cholesterol level." b. "Maybe you dont realize how much fat is in the foods you eat." c. "Elevated cholesterol is a normal part of aging." d. "Describe your typical bedtime snack."

A patient with Addison's Disease is being discharged home on Prednisone. Which of the following statements by the patient warrants you to re-educate the patient?* ○ A. "I will notify the doctor if I become sick or experience extra stress." ○ B. "I will take this medication as needed when symptoms present." ○ C. "I will take this medication at the same time every day." ○ D. "My daughter has bought me a Medic-Alert bracelet."

A patient with Addison's Disease should consume which of the following diets?* ○ A. High fat and fiber ○ B. Low potassium and high protein ○ C. High protein, carbs, and adequate sodium ○ D. Low carbs, high protein, and increased sodium

A patient with Cushing's syndrome will be undergoing an adrenalectomy. Which of the following will be included in the patient's discharge teaching after the procedure? Glucocorticoid replacement therapy Declomycin therapy Signs and symptoms of Grave's Disease Avoiding avocadoes and pears

A patient with Hepatitis A asks you about the treatment options for this condition. Your response is?* ○ A. Antiviral medications ○ B. Interferon ○ C. Supportive care ○ D. Hepatitis A vaccine

A patient with Hepatitis is extremely confused. The patient is diagnosed with Hepatic Encephalopathy. What lab result would correlate with this mental status change?* ○ A. Ammonia 100 mcg/dL ○ B. Bilirubin 7 mg/dL ○ C. ALT 56 U/L ○ D. AST 10 U/L

A patient with SIADH is undergoing IV treatment of a hypertonic IV solution of 3% saline and IV Lasix. Which of the following nursing findings requires intervention?* ○ A. Sodium level of 136. ○ B. Patient reports urinating more frequently. ○ C. Potassium level of 5.0. ○ D. Assessment finding of crackles throughout the lung fields.

A patient with a mild case of diabetes insipidus is started on Diabinese. What would you include in your patient teaching with this patient?* ○ A. Signs and symptoms of hypoglycemia ○ B. Restricting foods containing caffeine ○ C. Taking the medication on an empty stomach ○ D. Drinking 16 oz of water when taking the medication

A patient with acute pancreatitis is reporting excessive thirst, excessive voiding, and blurred vision. As the nurse, it is priority you?* ○ A. Reassure the patient this is normal with pancreatitis ○ B. Check the patient's blood glucose ○ C. Assist the patient with drinking a simple sugar drink like orange juice ○ D. Provide a dark and calm environment

A patient with adrenal cortex dysfunction is experiencing an increased amount of glucocorticoids being released into the general circulation. For which physiologic response should the nurse plan care for this patient? a. Delayed onset of puberty b. Decreased metabolic rate c. Inhibited immune response d. Increased response to glucagon

A patient with cirrhosis and esophageal varices vomits 200mL of bright red blood. What should the nurse do first? #6 a. Insert a nasogastric tube b. Lower the head of the bed c. Check stool for occult blood d. Prepare for central line insertion

A patient with cirrhosis and severe ascites develops a fever and confusion. What action will the nurse take? #8 a. Inquire about headache and check for nuchal rigidity b. Measure abdominal girth and percuss for shifting dullness c. Observe for neck vein distention and auscultate lung sounds d. Auscultate breath sounds and measure diaphragmatic excursion

A patient with hyperthyroidism is scheduled to receive radioactive iodine. What should the nurse explain about the use of radioactive iodine in hyperthyroidism? a. The thyroid gland takes up iodine in any form. b. Radioactive iodine reduces the vascularity of the thyroid gland c. Irradiation of the thyroid gland decreases the risk for hypothyroidism d. Doses of radioactive iodine are too small to be hazardous to other body parts.

A patient is being educated on how to take their anti-thyroid medication. Which of the following statements are INCORRECT?* ○ A. "I will continue taking aspirin daily." ○ B. "I will take this medication at the same time every day." ○ C. "It may take a while before I notice that the medication is helping my condition." ○ D. "I will avoid foods containing high levels of iodine."

A patient with hypothyroidism is having pain 6 on 1-10 scale in the right hip due to recent hip surgery. Which of the following medications are NOT appropriate for this patient? Select all that apply:* ○ A. Fentanyl ○ B. Tylenol ○ C. Morphine ○ D. Dilaudid

A patient with late-stage cirrhosis develops portal hypertension. Which of the following options below are complications that can develop from this condition? Select all that apply:* ○ A. Increase albumin levels ○ B. Ascites ○ C. Splenomegaly ○ D. Fluid volume deficient ○ E. Esophageal varices

A physician orders Calcium Gluconate IV as treatment for a patient with hypoparathyroidism. The patient's calcium level is 5 mg/dL. Which of the following finding causes you to question this order?* ○ A. The patient is taking Digoxin. ○ B. The patient complains of muscle cramping and numbness in the face. ○ C. The patient is taking Aluminum Carbonate. ○ D. The patient's phosphate level is 7 mg/dL.

A preoperative client is scheduled for adrenalectomy to remove a pheochromocytoma. The nurse would most closely monitor which item in the preoperative period? a. Vital signs b. Fluid balance c. Anxiety levels d. Creatinine levels

A primary health care provider has prescribed propylthiouracil for a client with hyperthyroidism. The nurse recalls that first-line treatment calls for methimazole for medication therapy. The nurse should question the client about her past medical history, specifically regarding which condition? a. Pregnancy b. Renal failure c. Prolonged QT interval d. Adverse reaction to levothyroxine

A registered nurse (RN) who is working with a nursing student assigns the student to care for a client with a diagnosis of Cushing's syndrome. The RN asks the student questions about this disorder. Which statement made by the student indicates understanding of Cushing's syndrome? a. "Cushing's syndrome is caused by excessive amounts of cortisol." b. "Cushing's syndrome is caused by decreased amounts of aldosterone." c. "Cushing's syndrome is caused by excessive amounts of antidiuretic hormone." d. "Cushing's syndrome is caused by decreased amounts of parathyroid hormone."

A sexually active young adult client has developed viral hepatitis. Which client statement indicates the need for further teaching? a. "I should avoid drinking alcohol." b. "I can go back to work right away." c. "My partner should get the vaccine." d. "A condom should be used for sexual intercourse."

Addison's Disease is:* ○ A. Increased secretion of cortisol ○ B. Increased secretion of aldosterone and cortisol ○ C. Decreased secretion of cortisol ○ D. Decreased secretion of aldosterone and cortisol

A patient has a low cortisol level. With which health problem is this finding associated? 1. Addison disease 2. Hyperthyroidism 3. Cushing syndrome 4. Diabetes mellitus

Answer: 1 Explanation: 1. A cortisol level is a serum test done to measure the amount of total cortisol in the serum and evaluate adrenal cortex function. Decreased levels are associated with Addison disease. 2. A cortisol level is a serum test done to measure the amount of total cortisol in the serum and evaluate adrenal cortex function. Decreased levels do not indicate hyperthyroidism. 3. Cushing syndrome would cause an elevated cortisol level. 4. A cortisol level is a serum test done to measure the amount of total cortisol in the serum and evaluate adrenal cortex function. Decreased levels are not associated with diabetes mellitus.

The nurse is completing an endocrine-focused health assessment interview with an older adult. What finding should the nurse suspect is related to an age-related change in the patient's thyroid function? 1. Inability to tolerate heat and cold 2. Indigestion and intolerance of fatty foods 3. Increased facial hair 4. Enlarged nose, hands, and feet

Answer: 1 Explanation: 1. A lowered basal metabolic rate due to decreased thyroid activity in the aging patient may cause intolerance to heat and cold. 2. Decreased production of the pancreatic enzyme lipase results in indigestion and intolerance of fatty foods. 3. Increased facial hair occurs with decreased pituitary function. 4. Enlargement of nose, hands, and feet occurs with decreased pituitary function.

A patient has a positive Trousseau sign. For which health problem should the nurse plan care for this patient? 1. Pain 2. Excessive fluid 3. Difficulty breathing 4. Reduced blood flow

Answer: 1 Explanation: 1. A positive Trousseau sign causes painful carpal spasms due to decreased calcium. The patient will be experiencing pain. 2. A positive Trousseau sign is not associated with fluid volume. 3. A positive Trousseau sign is not associated with respiratory function. 4. A positive Trousseau sign is not associated with perfusion or blood flow.

An older adult patient reports ingesting a fat-soluble vitamin every day to boost the endocrine system. For what age-related change does the nurse recognize the patient is addressing by taking this vitamin? 1. The ability to absorb fat-soluble vitamins declines with aging. 2. Lipase production is increased and results in fat intolerance. 3. Older patients have increased resistance to insulin. 4. Indigestion increases with aging due to decreased lipase production.

Answer: 1 Explanation: 1. Absorption of fat-soluble vitamins declines with age. 2. Lipase production decreases in the older adult patient, causing reduced fat absorption. 3. Older patients have increased resistance to insulin, but this has no effect on absorption of fat-soluble vitamins. 4. Lipase production decreases in the older adult patient, causing reduced fat absorption. This may result in intolerance to fatty foods and indigestion.

A patient with an adrenal gland alteration asks why the skin appears tan when no time is spent outdoors in the sun. What should the nurse do to address the patient's concern? 1. Ask if the patient is still taking steroids prescribed for another illness. 2. Ask the patient what time of day he is outdoors. 3. Auscultate the patient's lung sounds. 4. Palpate the patient's thyroid gland.

Answer: 1 Explanation: 1. Addison disease could develop if a patient abruptly stops taking steroids for a chronic health condition. 2. The patient has already reported that no time is spent outdoors in the sun. 3. Auscultation of lung sounds would not help in determining the cause of this skin change. 4. Palpation of the thyroid gland would not help in determining the cause of this skin change.

The nurse is planning a teaching session for a patient with a new diagnosis of adrenoleukodystrophy. What topic should the nurse include? 1. Why genetic counseling is included in the plan of care 2. The role of autoimmunity in the development of the disorder 3. The role of anticoagulants in the development of the disorder 4. The surgical site for transsphenoidal entry, using a diagram

Answer: 1 Explanation: 1. Adrenoleukodystrophy is an X-linked disorder characterized by an accumulation of very long chain fatty acids in the adrenal cortex, testes, brain, and spinal cord. 2. Adrenoleukodystrophy is not an autoimmune disorder. 3. Adrenoleukodystrophy is not caused by anticoagulant therapy. 4. Adrenoleukodystrophy is not treated with surgery.

A patient is pleased to learn that an oral glucose tolerance test is not needed after having a fasting blood glucose level drawn. What should the nurse explain as the reason for the oral glucose tolerance test to be cancelled? 1. Consistently high fasting blood glucose levels 2. No evidence of type 1 diabetes mellitus 3. Normal renal functioning 4. Normal liver functioning

Answer: 1 Explanation: 1. An oral glucose tolerance test is done to diagnose diabetes mellitus if prior fasting blood sugar levels are inconsistent. However, the test will not be done if the patient's fasting blood sugars are consistently high or greater than 200 mg/dL. 2. Cancellation of the test does not indicate absence of evidence of type 1 diabetes. 3. Cancellation of the test does not indicate normal liver function. 4. Cancellation of the test does not indicate normal renal function.

A patient is demonstrating symptoms of dehydration and excessive urination. Which hormone should the nurse suspect is causing this patient's symptoms? 1. Antidiuretic hormone (ADH) 2. Adrenocorticotropic hormone (ACTH) 3. Follicle-stimulating hormone (FSH) 4. Thyroid-stimulating hormone (TSH)

Answer: 1 Explanation: 1. Antidiuretic hormone decreases urine production by causing the renal tubules to reabsorb water from the urine and return it to the circulating blood. This patient is demonstrating excessive urination, which might indicate an alteration in this hormone. 2. Adrenocorticotropic hormone stimulates adrenal function. 3. Follicle-stimulating hormone functions in ovum and sperm formation. 4. Thyroid-stimulating hormone stimulates thyroid function.

The nurse is assessing a patient who is experiencing hepatocellular failure. Which finding best indicates that the patient is developing ascites? 1. Accumulation of fluid in the abdomen 2. Jaundiced skin 3. Ecchymosis 4. Upper-right-quadrant pain

Answer: 1 Explanation: 1. Ascites is the accumulation of the fluid in the abdomen and is a result of hepatocellular failure. 2. Jaundice is manifested as yellow-tinged skin and is the result of hepatic disorders. 3. The patient experiencing hepatic problems might have bleeding and bruising due to inadequate vitamin K. 4. Obstructed biliary flow could be the cause of upper-right-quadrant pain.

A patient with hyperparathyroidism secondary to renal failure is prescribed calcimimetic. What should the nurse instruct the patient about this medication? 1. It increases the sensitivity of the calcium-sensing receptors of the parathyroid gland to serum calcium. 2. It blocks calcium receptors in the nervous and musculoskeletal systems. 3. It decreases resorption of calcium in the distal renal tubule. 4. It binds calcium to bile salts that are then excreted through the GI tract.

Answer: 1 Explanation: 1. Calcimimetic increases the sensitivity of the calcium-sensing receptors of the parathyroid gland to serum calcium. The effect is decreased secretion of PTH and reduced serum calcium and phosphorus. 2. Calcimimetic does not block calcium receptors in the nervous and musculoskeletal systems. 3. Calcimimetic does not decrease the resorption of calcium in the distal renal tubule. 4. Calcimimetic does not bind calcium to bile salts to excrete through the GI tract.

A 35-year-old female patient taking oral contraceptives is prescribed steroid therapy. What is a priority teaching point for this patient? 1. "Consider adding another form of contraception while using both medications." 2. "These medications do not interact. No changes need to be made." 3. "Measure your weight daily." 4. "Avoid the use of salt."

Answer: 1 Explanation: 1. Corticosteroids may impair the effectiveness of oral contraceptives. 2. Corticosteroids may impair the effectiveness of oral contraceptives. 3. Daily weights have nothing to do with the interaction of oral contraceptives and steroids. 4. Limiting salt has nothing to do with the interaction of oral contraceptives and steroids.

The nurse is assessing an older patient with type 2 diabetes mellitus. What age-related endocrine change should the nurse expect in this patient? 1. Decreased sensitivity to insulin 2. More rapid insulin release 3. Intolerance of fatty foods 4. Lower and prolonged blood glucose levels

Answer: 1 Explanation: 1. Decreased sensitivity to insulin and delayed and decreased insulin release are seen in the older patient diagnosed with type 2 diabetes. 2. Delayed and decreased insulin release are seen in the older patient diagnosed with type 2 diabetes. 3. Intolerance of fatty foods occurs in older adults but is not specific to the older patient with type 2 diabetes. 4. Blood glucose levels are higher and prolonged in the older patient with diabetes.

A patient whose thyroid gland produces an insufficient amount of thyroid hormone is concerned about an elevated cholesterol level. What should the nurse explain to this patient? 1. "The thyroid gland malfunction can affect your cholesterol level." 2. "Maybe you don't realize how much fat is in the foods you eat." 3. "Elevated cholesterol is a normal part of aging." 4. "Describe your typical bedtime snack."

Answer: 1 Explanation: 1. Deficient amounts of thyroid hormone can cause abnormalities in lipid metabolism, with elevated serum cholesterol and triglyceride levels. As a result, the patient is at increased risk for atherosclerosis and cardiac disorders. 2. The nurse should not make assumptions about the patient's dietary intake. 3. Comments about aging are not therapeutic. 4. Comments about eating at bedtime are not therapeutic.

A patient recovering from a closed head injury has a urine specific gravity of 1.010 g/mL. The previous intake and output totals were 1200 mL intake and 10,000 mL output. Which prescription from the healthcare provider should the nurse question for this patient? 1. Desmopressin (Minirin) 0.2 mg by mouth daily 2. Oral fluid restriction of 800 mL per day 3. 3% normal saline at 100 mL per hour 4. Computed tomography scan of head

Answer: 1 Explanation: 1. Desmopressin is administered intranasally or parenterally and is the treatment of choice for SIADH that cannot be treated by correcting the underlying cause. 2. Strategies for correcting the underlying cause of SIADH include treating the hyponatremia and replacing fluid based on a calculation that adds fluid losses from the prior hour to an hourly base rate of fluid. 3. Strategies for correcting the underlying cause of SIADH include treating the hyponatremia with intravenous hypertonic saline. 4. A CT scan is an appropriate diagnostic tool.

The nurse is reviewing data collected during a patient's health history. What information would indicate a disorder of the pituitary gland? 1. Dwarfism 2. Carpal spasms 3. Enlarged thyroid nodule 4. Hyperpigmentation of the skin

Answer: 1 Explanation: 1. Dwarfism results from insufficient growth hormone produced by the pituitary gland. 2. Carpal spasms can indicate a parathyroid gland disorder. 3. An enlarged thyroid nodule could be associated with a thyroid malignancy. 4. Hyperpigmentation of the skin might be associated with an adrenal disorder such as Addison disease or Cushing syndrome.

The nurse suspects that a patient with chronic hyperfunction of the adrenal cortex has an infection. What did the nurse assess to come to this conclusion? 1. General feeling of malaise 2. Recent weight loss 3. Muscular tremors 4. Sense of nervous energy

Answer: 1 Explanation: 1. Elevated cortisol levels impair the immune response and put the patient with Cushing syndrome at risk for infection. A generalized feeling of malaise may be the primary manifestation of infection. 2. A weight change is not a manifestation of infection in a patient with chronic hyperfunction of the adrenal cortex. 3. Muscle tremors are not a manifestation of infection in a patient with chronic hyperfunction of the adrenal cortex. Patients typically experience muscle weakness and fatigue rather than tremors. 4. Nervous energy is not a manifestation of infection in a patient with chronic hyperfunction of the adrenal cortex. Patients typically experience muscle weakness and fatigue rather than increased energy.

A patient is demonstrating signs of exophthalmos. What additional finding should the nurse expect to assess in this patient? 1. Enlarged thyroid gland 2. Dry, thick nails 3. Dry skin 4. Decreased reflexes

Answer: 1 Explanation: 1. Exophthalmos is a clinical manifestation associated with hyperthyroidism. 2. Dry, thick nails are associated with hypothyroidism. 3. Dry skin is associated with hypothyroidism. 4. Decreased reflexes are associated with hypothyroidism.

During an assessment, the nurse notes that the patient's eyes are extremely wide open and bulging. With which health problem is this finding associated? 1. Hyperthyroidism 2. Diabetes mellitus 3. Hypofunction of the adrenal glands 4. Hypofunction of the anterior pituitary gland

Answer: 1 Explanation: 1. Exophthalmos, or protruding eyes, may be seen in hyperthyroidism. 2. This is not a finding that is associated with diabetes mellitus. 3. This is not a finding that is associated with hypofunction of the adrenal glands. 4. This is not a finding that is associated with hypofunction of the pituitary gland.

The nurse is assessing a patient. What health problem should the nurse suspect is caused by abnormally high levels of growth hormone in a patient? 1. Acromegaly 2. Dwarfism 3. Hirsutism 4. Gynecomastia

Answer: 1 Explanation: 1. Extremely large bones may indicate acromegaly, which is caused by excessive growth hormone. 2. Extremely short stature may indicate dwarfism, which is caused by insufficient growth hormone. 3. Hirsutism, or abnormal hair growth, is associated with adrenal hormone access. 4. Gynecomastia, or development of breast tissue in men, is frequently associated with androgen therapy.

During a focused endocrine assessment, a patient states that a brother has fragile X syndrome. What should the nurse recall about this health problem? 1. It is an endocrine disorder having a genetic basis. 2. It is not a relevant issue since the patient is female. 3. It is a health condition separate from the endocrine system. 4. It is a blood disorder.

Answer: 1 Explanation: 1. Fragile X syndrome involves a gene mutation causing learning disabilities and mental retardation and is considered an endocrine disorder. 2. Males are more severely affected than females, and both sexes can be carriers of the disorder. 3. Fragile X syndrome is considered an endocrine disorder. 4. Fragile X syndrome is not a blood disorder.

The nurse prepares teaching material for a patient with Cushing syndrome. Which statement about the risk for infection should the nurse alter before teaching? 1. "Epidermal hypertrophy restricts macrophage activity." 2. "Cortisol affects protein synthesis." 3. "Cortisol inhibits collagen synthesis." 4. "The resulting edema impairs blood flow to tissues."

Answer: 1 Explanation: 1. Glucocorticoid excess inhibits fibroblasts, resulting in loss of collagen and connective tissue. Thinning of skin, poor wound healing, and frequent skin infections result. Macrophage activity is not a related action. 2. Increased cortisol affects protein synthesis, causing delayed wound healing and further inhibiting resistance to infection. 3. Increased cortisol inhibits collagen formation, which results in epidermal atrophy, further inhibiting resistance to infection. 4. Impaired blood flow to edematous tissue results in altered cellular nutrition, which increases the potential for infection.

The nurse is assessing a patient with liver failure and jaundice. Which question should the nurse ask to determine if the cause of the jaundice is hemolytic? 1. "Have you been diagnosed with a disorder of red blood cell destruction?" 2. "What color is your urine?" 3. "What color are your stools?" 4. "Do you have any gallbladder problems?"

Answer: 1 Explanation: 1. Hemolytic jaundice develops when excess RBC destruction releases more bilirubin into circulation than the liver is able to process. 2. Darkened urine is more commonly associated with hepatic or obstructive jaundice. 3. Light or clay-colored stools are more commonly associated with hepatic or obstructive jaundice. 4. Patients with gallbladder disorders are also at risk for jaundice; however, this patient's liver failure is a given.

A patient with hyperparathyroidism is taking digoxin (Lanoxin). For what should the nurse assess this patient? 1. Toxic effects of digoxin (Lanoxin) 2. Evidence the medication dose needs to be increased 3. Onset of polyuria 4. Muscle weakness and atrophy

Answer: 1 Explanation: 1. Hyperparathyroidism increases sensitivity to cardiotonic glycosides such as digoxin. The patient should be assessed for toxic effects of this medication. 2. The medication dose will unlikely need to be increased. 3. Polyuria is a manifestation of hyperparathyroidism. 4. Muscle weakness and atrophy are manifestations of hyperparathyroidism.

The nurse is caring for a patient with elevated serum T3 and T4 levels who receives a new prescription for methimazole (Tapazole). Which patient statement indicates that additional teaching is needed about this medication? 1. "This medication will increase my metabolism." 2. "I must contact my physician if I plan to become pregnant." 3. "It may take several weeks for this medication to take effect." 4. "I may take a beta-blocker along with this medication."

Answer: 1 Explanation: 1. Hyperthyroidism is treated by administering methimazole or PTU, medications that reduce TH production, thereby decreasing metabolism. 2. Methimazole crosses the placenta and cannot be taken during pregnancy. 3. Antithyroid medications inhibit thyroid hormone production but have no effect on already-produced and circulating thyroid hormone. It can take several weeks for the patient to experience the effects. 4. To rapidly reduce the cardiovascular symptoms associated with hyperthyroidism, propranolol (Inderal) or esmolol, a rapid-acting parenteral beta-blocker, may be used along with methimazole.

The nurse is assessing a patient with Cushing syndrome. Which finding should the nurse report for immediate follow-up? 1. Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg 2. Serum sodium 145 mEq/L and reports of muscle weakness 3. Serum calcium 11 mg/dL and reports of feelings of depression 4. Serum phosphorus 3 mg/dL and hirsutism

Answer: 1 Explanation: 1. Hypokalemia and hypertension occur with Cushing syndrome as potassium is lost and sodium is retained. 2. These findings do not need to be reported for immediate follow-up. 3. These findings do not need to be reported for immediate follow-up. 4. These findings do not need to be reported for immediate follow-up.

The nurse is providing preoperative teaching to a patient scheduled for a subtotal thyroidectomy. What should the nurse include in these instructions? 1. Report sensations of tingling in toes, fingers, or lips. 2. Report signs of constipation. 3. Report the improvement of hoarseness. 4. Take aspirin before the surgery.

Answer: 1 Explanation: 1. Hypoparathyroidism may result from manipulation of the parathyroid glands during a subtotal thyroidectomy. The lack of circulating parathyroid hormone (PTH) causes hypocalcemia. Neuromuscular manifestations that result from hypocalcemia include numbness and tingling around the mouth and in the fingertips. 2. Hypoparathyroidism may result from manipulation of the parathyroid glands during a subtotal thyroidectomy. The lack of circulating PTH causes hypocalcemia. Constipation is associated with hypercalcemia, not hypocalcemia. 3. The improvement of hoarseness would be desired. 4. Antiplatelet agents, such as aspirin, should be withheld prior to surgery.

A patient with suspected Cushing syndrome is prescribed a 24-hour urine collection. What should the nurse explain to the patient about the reason for this urine collection? 1. It measures the amount of cortisol in the urine over 24 hours. 2. At least 2000 mL of urine is required to perform the test. 3. It identifies urine specific gravity changes over a 24-hour period. 4. The 24-hour timeline reduces unwanted effects of medications excreted in the urine.

Answer: 1 Explanation: 1. If the dexamethasone test is positive, a test for urinary free cortisol is made. This measures the amount of cortisol in the urine over 24 hours. 2. The 24-hour urine collection is not performed because 2 L of urine is needed. 3. The 24-hour urine collection does not measure urine specific gravity changes. 4. The 24-hour urine collection is not performed to ensure medication excretion in the urine.

The nurse is assessing a patient with a pituitary disorder. Which finding should the nurse expect to assess in this patient? 1. Enlargement of the hands and feet 2. Thin, soft hair 3. Excessive growth of facial hair 4. Purple striae over the trunk

Answer: 1 Explanation: 1. In a patient experiencing a pituitary disorder such as acromegaly, enlargement of the hands and feet may be observed. 2. Thin, soft hair occurs in hyperthyroidism. 3. Hirsutism is associated with Cushing disease, an adrenal disorder. 4. Purple striae are associated with Cushing disease, an adrenal disorder.

The nurse is instructing a patient with low levels of circulating thyroid hormone. Food containing which nutrient should the nurse encourage the patient to increase the consumption? 1. Iodine 2. Calcium 3. Phosphorus 4. Vitamin D

Answer: 1 Explanation: 1. Iodine is necessary for adequate thyroid hormone secretion. 2. Calcium does not affect thyroid hormone secretion. 3. Phosphorus does not affect thyroid hormone secretion. 4. Vitamin D does not affect thyroid hormone secretion.

A patient taking steroids for an autoimmune disorder asks when the weight loss in the legs is going to stop. What should the nurse realize the patient is experiencing? 1. Muscle wasting 2. Poor wound healing 3. Risk for compression fractures 4. Increased susceptibility to infections

Answer: 1 Explanation: 1. Long-term use of steroids can place a patient at risk for developing Cushing syndrome. One characteristic of this syndrome is muscle weakness and wasting, particularly in the extremities. 2. Poor wound healing is common in patients who are being treated with steroids. However, this would not manifest as weight loss in the limbs. 3. Risk for compression fractures is common in patients who are being treated with steroids. However, this would not manifest as weight loss in the limbs. 4. Increased susceptibility to infections is common in patients who are being treated with steroids. However, this problem would not manifest as weight loss in the limbs.

An older patient who is seen in the clinic has a palpable thyroid gland. What should the nurse realize this finding indicates? 1. Normal finding in the older patient 2. Onset of hypertension 3. Onset of diabetes mellitus 4. Explanation for a reduced urine output

Answer: 1 Explanation: 1. Older patients' thyroid glands can be more fibrotic and nodular as a normal finding. 2. Without other assessments or supporting data, a palpable thyroid gland does not explain the onset of hypertension. 3. Without other assessments or supporting data, a palpable thyroid gland does not explain the onset of diabetes mellitus. 4. Without other assessments or supporting data, a palpable thyroid gland does not explain the onset of reduction in urine output.

A patient who has three school-age children has jaundice and is diagnosed with hepatitis A after taking a trip to Central America. Which patient statement should the nurse address with the patient? 1. "I can't go home and expose my children to this." 2. "We cared for several very ill people on our trip." 3. "I plan to get a lot of rest in the next few days." 4. "I am likely to recover fully eventually."

Answer: 1 Explanation: 1. Once jaundice develops, the amount of virus in the stool and the risk of spreading the disease decrease significantly. The nurse should teach that the patient was likely more contagious in the last 2 weeks than at the current time. 2. This disease is spread through the fecal-oral route. It is likely the patient contracted the illness on the trip. 3. Rest is recommended for the patient with hepatitis A. 4. Full recovery is the typical scenario with this illness.

The nurse teaches a patient about portal hypertension. Which patient statement indicates teaching was effective? 1. "In portal hypertension, blood backs up in the liver. It causes enlarged blood vessels in my esophagus." 2. "In portal hypertension, blood leaks from my liver. It causes me to feel hungry frequently." 3. "Portal hypertension means fast-spreading high blood pressure. It causes red veins on my arms." 4. "Portal hypertension means high blood pressure throughout my abdomen. It causes me to feel confused."

Answer: 1 Explanation: 1. Portal hypertension, increased pressure in the portal system, has several effects when it is prolonged, including dilation of veins in the gastrointestinal tract and the abdominal wall. 2. Portal hypertension does not mean blood is leaking from the liver. Portal hypertension tends to suppress (not increase) the appetite. 3. Portal hypertension is not fast-spreading hypertension, and it is not defined as high blood pressure throughout the abdomen. In advanced liver failure, superficial varices may develop around the umbilicus (not on the arms), a feature known as caput medusae. 4. Portal systemic encephalopathy (or hepatic encephalopathy), impaired consciousness and mental status, results from the accumulation of toxic waste products in the blood (ammonia in particular) as blood bypasses the congested liver. This is not caused by high abdominal blood pressure.

The nurse is reviewing the laboratory results for a group of patients. Which set of results should the nurse identify as being consistent with primary hypothyroidism? 1. Elevated TSH, depressed T3 and T4 2. Elevated TSH, elevated T3 and T4 3. Depressed TSH, elevated T3 and T4 4. Depressed TSH, depressed T3 and T4

Answer: 1 Explanation: 1. Primary hypothyroidism emanates from the thyroid gland itself. Laboratory analysis will indicate an elevated TSH, as the pituitary attempts to stimulate the thyroid gland to produce thyroid hormone, and the thyroid hormone levels T3 and T4 will be low. 2. Laboratory analysis will indicate an elevated TSH, as the pituitary attempts to stimulate the thyroid gland to produce thyroid hormone. Thyroid hormone levels T3 and T4 will not be elevated. 3. TSH is depressed in hyperthyroidism. 4. TSH is depressed in hyperthyroidism.

The nurse is providing care to a patient recovering from a bilateral adrenalectomy. What should the nurse do to assess for the onset of adrenal insufficiency? 1. Monitor strict intake and output. 2. Change the dressing using clean technique. 3. Question the order for cortisol administration. 4. Place the patient on fluid restriction.

Answer: 1 Explanation: 1. Removal of an adrenal gland, especially a bilateral adrenalectomy, results in adrenal insufficiency. Addisonian crisis and hypovolemic shock may occur. The nurse should monitor intake and output. 2. While care should be taken during dressing changes to avoid infection, this will not prevent adrenal insufficiency. 3. Cortisol is often given on the day of surgery and in the postoperative period to replenish inadequate hormone levels. 4. Intravenous fluids are administered postoperatively.

The nurse is reviewing the relationship between thyroid hormone and iodine. Which information should the nurse identify that is least likely to cause iodine deficiency and hypothyroidism? 1. Eating large amounts of shellfish 2. Using prescribed lithium carbonate 3. Eating large amounts of turnips or rutabagas 4. Living in an area where iodine is deficient in the soil

Answer: 1 Explanation: 1. Shellfish contains iodine. 2. Drugs such as lithium carbonate interfere with thyroid hormone synthesis. 3. Foods such as turnips and rutabagas interfere with thyroid hormone synthesis. 4. Living in an area where iodine is deficient in the soil may lead to thyroid deficiency and hypothyroidism.

A patient is having a 17-keosteroid test performed. What statement by the patient indicates that teaching about this test has been effective? 1. "I will store the specimen container in the refrigerator." 2. "I shouldn't eat or drink anything before this test." 3. "I know this test will be helpful in diagnosing my thyroid problem." 4. "I will arrive early to have my blood drawn."

Answer: 1 Explanation: 1. The 17-ketosteroid test is a 24-hour collection of urine to evaluate adrenal cortex function. The patient is instructed to collect urine in a container in preservative and store it in the refrigerator. 2. There are no food or fluid restrictions. 3. The 17-ketosteroid test is a 24-hour collection of urine to evaluate adrenal cortex function. 4. The test does not include having blood drawn.

A patient who is scheduled to have a hemoglobin A1C level drawn asks about the purpose of the test. How should the nurse respond to this patient? 1. "It's to check for pancreas functioning." 2. "It's a blood test to check for kidney functioning." 3. "It's to check for thyroid functions." 4. "It's a blood test to check for menopausal symptoms."

Answer: 1 Explanation: 1. The diagnostic tests of the pancreas are primarily to identify, confirm, and monitor glucose levels in patients with diabetes mellitus. The hemoglobin A1C is one of these tests. 2. Hemoglobin A1C does not measure kidney function. 3. Hemoglobin A1C does not measure thyroid function. 4. Hemoglobin A1C does not measure menopausal symptoms.

A patient has been experiencing fatigue and prolonged symptoms of a cold that started after beginning a new job and a family member moved in. Which reaction should the nurse suspect is occurring in this patient? 1. An increase in glucocorticoid secretion 2. An increase in epinephrine secretion 3. A drop in mineralocorticoid secretion 4. A reduction in norepinephrine secretion

Answer: 1 Explanation: 1. The glucocorticoids include cortisol and cortisone. These hormones affect carbohydrate metabolism and are released in times of stress. An excess of glucocorticoids in the body depresses the inflammatory response and inhibits the effectiveness of the immune system. 2. Alteration in epinephrine would have an influence on cardiovascular function and fluid and electrolyte balance, but would not influence immune response as much as an increase in glucocorticoid secretion. 3. Alteration in mineralocorticoids would have an influence on cardiovascular function and fluid and electrolyte balance, but would not influence immune response as much as an increase in glucocorticoid secretion. 4. Alteration in norepinephrine would have an influence on cardiovascular function and fluid and electrolyte balance, but would not influence immune response as much as an increase in glucocorticoid secretion.

A patient is experiencing manifestations of Addisonian crisis. What should the nurse expect to provide to this patient? 1. Intravenous fluids 2. Warm blankets 3. Thyroid replacement hormone 4. Blood transfusion

Answer: 1 Explanation: 1. The manifestations of Addisonian crisis are high fever, weakness, abdominal pain, severe hypotension, circulatory collapse, shock, and coma. The crisis is treated with rapid intravenous replacement of fluids. 2. The patient in Addisonian crisis may have a high fever, so warm blankets would not promote comfort or therapeutic action. 3. There is no thyroid hormone insufficiency. 4. There are no indications the patient is in need of a blood transfusion.

The nurse is screening a group of patients for risk factors related to thyroid cancer. Which patient should the nurse recognize as having the highest risk for developing thyroid cancer? 1. A 75-year-old patient with a history of sinus infections in childhood 2. A 70-year-old patient who refinishes furniture as a hobby 3. An 80-year-old patient whose diet consists largely of red meat 4. An 85-year-old patient who works outdoors without sunscreen

Answer: 1 Explanation: 1. The most consistent risk factor for thyroid cancer is exposure to ionizing radiation to the head and neck during childhood. For example, many adults in their 60s, 70s, and 80s received x-ray treatments for colds, tonsillitis, acne, and sinus infections during childhood. 2. Exposure to products used in refinishing furniture is not a risk factor for thyroid cancer. 3. A diet of red meat is not a risk factor for thyroid cancer. 4. Failing to use sunscreen when working outdoors is not a risk factor for thyroid cancer.

The nurse is reviewing postoperative care for a patient scheduled for a thyroidectomy. What information should the nurse include in this teaching? 1. "Avoid the use of iodized salt after your procedure." 2. "Plastic surgery may be required to conceal the surgical scar." 3. "Use iodized salt when preparing foods." 4. "Perform neck flexion and extension exercises twice daily for several weeks postoperatively."

Answer: 1 Explanation: 1. The nurse anticipates that the patient who has a thyroidectomy will require a lifelong prescription for a thyroid preparation. Iodized salt and iodine preparations should not be taken with thyroid preparations. 2. Typically the scar fades to a small line, so plastic surgery is not needed. 3. Iodized salt and iodine preparations should not be taken with thyroid preparations. 4. The patient is instructed to support the neck by placing both hands behind the neck when sitting up in bed, while moving about, and while coughing. Neck extension would place stress on the suture line.

A patient is demonstrating symptoms of hypocalcemic tetany. What assessment should the nurse conduct to determine the patient's health problem? 1. Tap a finger in front of the patient's ear at the angle of the jaw. 2. Place a tuning fork over one of the patient's fingers. 3. Measure the patient's blood pressure. 4. Measure capillary blood.

Answer: 1 Explanation: 1. The nurse should assess the patient for Chvostek sign by tapping a finger in front of the patient's ear at the angle of the jaw. Decreased calcium levels will cause the patient's lateral facial muscles to contract. This demonstrates tetany. 2. Placing a tuning fork over the patient's finger evaluates the patient's ability to perceive vibrations, but it does not evaluate the muscle response of tetany. 3. Blood pressure measurement may give the nurse valuable information about the patient's fluid and electrolyte status, but it does not evaluate tetany. 4. A capillary blood level for serum calcium would give a measurement, but it does not assess for the clinical symptoms of tetany.

The nurse is planning to assess a patient's endocrine system. What should the nurse expect to perform on this patient? 1. Palpation of the thyroid gland 2. Palpation of the pancreas 3. Percussion of the adrenal glands 4. Palpation of the parathyroid glands

Answer: 1 Explanation: 1. The only endocrine organ that can be palpated is the thyroid gland. 2. The anatomical location of the pancreas prohibits direct examination by palpation or percussion. 3. The anatomical location of the adrenal glands prohibits direct examination by palpation or percussion. 4. The anatomical location of the parathyroid glands prohibits direct examination by palpation or percussion

While instructing a patient on pain relief, the nurse uses the example of endorphins as endocrine hormones, which act locally at the site of injury. What route of hormone transport is the nurse explaining? 1. Paracrine method 2. Direct release into the bloodstream 3. Neuroendocrine route 4. Nerve cell extension into the posterior pituitary

Answer: 1 Explanation: 1. The paracrine method involves diffusion of hormones through interstitial fluids to act locally. Endorphins produce pain relief in this manner. 2. This method does not release hormones directly into the bloodstream. 3. This method is not the neuroendocrine route. 4. This method is not accomplished through nerve cell extension into the posterior pituitary.

1) The nurse is assessing a patient diagnosed with hypothyroidism. Which health assessment interview question should the nurse ask this patient? 1. "Is your skin feeling rough and dry?" 2. "Is your skin smooth or flushed?" 3. "Does your skin feel clammy?" 4. "Do you have brown, shiny patches on the lower extremities?"

Answer: 1 Explanation: 1. The patient experiencing hypothyroidism has rough, dry skin. 2. Smooth, flushed skin is associated with hyperthyroidism. 3. Cool, clammy skin is found in patients with low blood sugar. 4. Brown, shiny patches on the lower extremities are associated with poor circulation.

The nurse is conducting a health interview with a female patient. What should the nurse ask that focuses on the endocrine system? 1. "Is your menstrual cycle regular?" 2. "Do you have children?" 3. "Are you able to provide for your children?" 4. "How old were you when your menses first began?"

Answer: 1 Explanation: 1. The patient who has a change in the menstrual cycle might be experiencing an endocrine disorder such as increased androgen production or decreased estrogen levels. 2. Having children is not a function of the endocrine system. 3. Asking how the patient is able to provide for children provides psychosocial information. 4. Asking when menses first began might provide information about cancer risk but not about endocrine function.

The nurse is reviewing health history information for a group of patients. Which patient should the nurse identify as being at the lowest risk of developing Cushing syndrome? 1. The patient who received radioactive iodine treatment for hyperthyroidism 2. The patient receiving treatment for rheumatoid arthritis 3. The patient who has had an organ transplant 4. The patient receiving chemotherapy to treat a brain tumor

Answer: 1 Explanation: 1. The patient who received radioactive iodine treatment for hyperthyroidism is not at increased risk for Cushing syndrome. 2. Patients receiving treatment for rheumatoid arthritis are frequently prescribed corticosteroids, which are a primary risk factor for Cushing syndrome. 3. Patients with organ transplants are frequently prescribed corticosteroids, which are a primary risk factor for Cushing syndrome. 4. Patients receiving chemotherapy are frequently prescribed corticosteroids, which are a primary risk factor for Cushing syndrome.

A patient with Cushing syndrome is concerned about having a head cold every few weeks. What should the nurse do to address this patient's concern? 1. Assess for protein and vitamin intake. 2. Plan for frequent rest periods. 3. Encourage daily weights. 4. Review coping strategies.

Answer: 1 Explanation: 1. The patient with Cushing syndrome is at risk for infection due to the overproduction of glucocorticoids. The nurse should assess for protein and vitamins C and A intake which are all needed to support and repair body tissues. 2. Rest periods are recommended in the care of a patient with Cushing but would not address the problem of frequent infections. 3. Daily weights are recommended in the care of a patient with Cushing but would not address the problem of frequent infections. 4. There is no indication of a need to review or change coping strategies.

A patient is experiencing severe hypertension. Which endocrine gland should the nurse suspect is causing this patient's health problem? 1. Adrenal 2. Thyroid 3. Parathyroid 4. Gonads

Answer: 1 Explanation: 1. The patient with hypertension could be experiencing an adrenal disorder, as the adrenal gland regulates epinephrine and norepinephrine, both of which can influence blood pressure. The adrenal gland also regulates blood pressure by secreting mineralocorticoids and aldosterone. 2. The thyroid regulates metabolism. 3. The parathyroid gland regulates calcium. 4. The gonads secrete the hormones of sexuality.

While assessing a patient with an alteration in thyroid function, the nurse notes smooth, fine hair and warm, dry skin. Which question should the nurse ask this patient? 1. "Have you experienced any recent weight loss?" 2. "Have you been feeling constipated?" 3. "Have you noticed increased bruising?" 4. "Have you noticed a change in your skin color?"

Answer: 1 Explanation: 1. The patient with hyperthyroidism can present with dry, warm skin, and the hair may become fine. Weight loss is another symptom of hyperthyroidism. 2. Constipation is a symptom of hypothyroidism or hyperparathyroidism. Dry, warm skin and hair that becomes fine are associated with another disorder. 3. Increased bruising is a sign of Cushing syndrome. Dry, warm skin and hair that becomes fine are associated with another disorder. 4. A change in skin color is a sign of Addison disease. Dry, warm skin and hair that becomes fine are associated with another disorder.

The nurse notes that a patient who has hypoparathyroidism has a serum calcium level of 6.8 mg/dL. What would be a priority problem when planning care for this patient? 1. Potential for injury 2. Safety concerns because of confusion 3. Changes in renal function 4. Problems with oxygenation

Answer: 1 Explanation: 1. The patient with hypocalcemia has a potential for injury because of the effects of the low calcium level on bone structure. Calcium is also needed for muscle and nerve function. 2. Confusion is not a manifestation of hypoparathyroidism and low calcium level. 3. Renal function changes are not a manifestation of hypoparathyroidism and low calcium level. 4. Problems with oxygenation are not a manifestation of hypoparathyroidism and low calcium level.

The family of an older patient with hypothyroidism is concerned about the open wounds on the patient's legs and arms. How should the nurse respond to the family's questions about bathing? 1. "Use warm water to bathe the patient." 2. "Make sure bathing occurs daily." 3. "Use firm, consistent strokes when bathing." 4. "Follow the bath with a rubbing-alcohol massage."

Answer: 1 Explanation: 1. The patient with hypothyroidism has dry skin and edema, which increase the risk of skin breakdown. Hot water, rough massage, and the use of alcohol-based products increase skin dryness. The patient should only bathe when necessary, with warm, not hot, water. 2. The patient should bathe only when necessary. 3. Gentle motions should be used. 4. Alcohol-free oils and lotions should be used.

The nurse is conducting a physical assessment with a patient. Which assessment technique should the nurse use to assess the patient's thyroid gland? 1. Stand behind the patient and palpate the thyroid. 2. Stand in front of the patient and palpate the thyroid. 3. Place the patient supine and palpate one side of the neck at a time. 4. Have the patient flex the neck forward and palpate the thyroid.

Answer: 1 Explanation: 1. The thyroid is palpated by standing behind the patient and placing the fingers on each side of the trachea below the thyroid, and asking the patient to swallow to palpate the right lobe. Repeat the procedure, tilting the neck to the left. 2. The thyroid gland is not palpated by standing in front of the patient. 3. Placing the patient supine would not permit the nurse to have full access to the neck. 4. Flexing the neck forward could occlude the airway if a mass were present.

A patient being treated with medication for a seizure disorder is scheduled for a serum T3 and T4 level. What results should the nurse expect for these levels? 1. Falsely reduced 2. Falsely elevated 3. Normal 4. Pending parathyroid hormone disease

Answer: 1 Explanation: 1. The value of T3 and T4 blood levels might be decreased by certain medications including phenytoin (Dilantin), which is a medication commonly prescribed for seizure disorders. 2. Medication for a seizure disorder will not falsely elevate T3 and T4 blood levels. 3. T3 and T4 levels will not be normal when a patient is taking an antiseizure medication. 4. Measurement of T3 and T4 levels is not indicative of parathyroid disease.

The nurse is caring for a patient with Graves disease. On which laboratory value should the nurse focus for this patient? 1. Thyroid antibodies 2. Urine-specific gravity 3. Cortisol 4. Calcium

Answer: 1 Explanation: 1. Thyroid antibodies (TA) is a blood test that is used to identify thyroid immune disease such as Graves disease. 2. Urine-specific gravity would be measured to provide information about the posterior pituitary. 3. The adrenal gland produces cortisol. 4. The parathyroid gland regulates calcium and phosphorous.

When measuring the blood pressure of a patient with hypoparathyroidism, the nurse notes spasms of the patient's hand. How should the nurse document this finding? 1. Trousseau sign 2. Chvostek sign 3. Turner sign 4. Cullen sign

Answer: 1 Explanation: 1. Trousseau sign is elicited by placing a blood pressure cuff on the patient's arm; when the cuff is inflated, the patient experiences carpal spasms of the hand. 2. Chvostek sign is elicited by tapping on the face in front of the ear and observing for contractions of the facial muscle. 3. Turner sign is observed on a patient's abdomen and flank and associated with intra- or retroperitoneal bleeding. 4. Cullen signs is observed on a patient's abdomen and flank and associated with intra- or retroperitoneal bleeding

A patient with a non-ACTH-producing adrenal cortex tumor is scheduled for a surgical procedure to remove the tumor. Which statement by the patient indicates that teaching about the procedure has been effective? 1. "The adrenal gland with the tumor will be removed." 2. "I will need to take adrenal hormones for the rest of my life." 3. "The tumor will be removed by the transsphenoidal route." 4. "I will receive IV cortisol in preparation for the surgery."

Answer: 1 Explanation: 1. When Cushing syndrome is caused by a non-ACTH-producing adrenal cortex tumor, an adrenalectomy may be performed to remove the tumor and the affected adrenal gland. 2. Only one adrenal gland is usually involved. As there is a remaining adrenal gland, patients do not need lifetime adrenal hormone replacement. 3. Adrenal glands are not removed via the transsphenoidal route. 4. The patient with Cushing syndrome is already experiencing elevated cortisol levels; IV cortisol is not indicated prior to adrenalectomy.

The nurse suspects that a patient is experiencing a response to stress. By which route should the nurse expect hormone transport to be conducted in this stress response? 1. Neuroendocrine 2. Paracrine 3. Portal 4. Nerve cell extension

Answer: 1 Explanation: 1. When a patient is undergoing a stress response, epinephrine is released into the bloodstream by the adrenal medulla, which is an example of the neuroendocrine route of hormone transport. 2. The paracrine route involves endorphins being released into interstitial fluids to act locally in response to inflammation. 3. The portal route involves most endocrine hormones being released into the bloodstream to act on target organs, such as occurs with thyroid hormone and insulin. 4. The hypothalamus releases its hormones directly to target cells in the posterior pituitary by nerve cell extension.

The nurse notes new areas of ecchymosis on the arms and legs of a patient with liver cirrhosis. Which laboratory test result should the nurse monitor because of this finding? Select all that apply. 1. Complete blood count with platelets 2. Coagulation studies 3. Serum albumin 4. Serum ammonia levels 5. Serum hepatitis antibodies

Answer: 1, 2 Explanation: 1. A CBC with platelets should be monitored. A low RBC count, hemoglobin, and hematocrit indicate anemia related to bone marrow suppression, increased RBC destruction, bleeding, and deficiencies of folic acid and vitamin B12. Platelets are low, related to increased destruction by the spleen. Leukopenia (low WBC count) also relates to splenomegaly. 2. Coagulation studies reveal the patient's tendency to bleed and the ability of the blood to clot and should be monitored. These studies show a prolonged prothrombin time due to impaired production of coagulation proteins and lack of vitamin K. 3. Albumin levels reflect liver impairment and/or nutritional status and are not related to risk for bleeding. 4. Serum ammonia levels elevate during liver failure due to the liver's inability to convert ammonia to urea for renal excretion. This test does not provide information regarding bleeding risk. 5. Testing for the presence of hepatitis antibodies in the blood does not provide information regarding coagulation.

The nurse is teaching a patient who has a diagnosis of hypothyroidism about the importance of dietary fiber. Which statement by the patient indicates that teaching has been effective? Select all that apply. 1. "I will drink a full glass of water with my fiber pill each morning." 2. "I will snack on fruit rather than potato chips." 3. "I will take an over-the-counter fiber pill each morning with my levothyroxine." 4. "I will increase my intake of protein sources such as meat and eggs." 5. "I will read the nutrition labels and choose foods with high carbohydrate content."

Answer: 1, 2 Explanation: 1. A full glass of water should be taken with fiber tablets to reduce the risk of intestinal blockage. 2. Fruit is a high-fiber food and an appropriate choice for a patient who needs a high-fiber diet. 3. The patient should not ingest a high-fiber source at the same time as thyroid replacement medications, as the fiber will interfere with absorption of the medication. 4. Meat and eggs are not good sources of fiber. 5. This patient should look for fiber content rather than carbohydrate content on labels.

A patient with Addison disease is experiencing weakness and abdominal pain and has an oral temperature of 102°F and blood pressure of 70/35 mmHg. Which patient information should the nurse identify as potentially causing these manifestations? Select all that apply. 1. "I had my tonsils out last week." 2. "I have a pressure ulcer from sleeping in my recliner." 3. "I have been using a tanning bed." 4. "I take my prednisone (Deltasone) every day." 5. "I have been increasing my intake of calcium-rich foods."

Answer: 1, 2 Explanation: 1. Addisonian crisis is a life-threatening response to acute adrenal insufficiency. Surgery is one trigger. 2. Addisonian crisis is a life-threatening response to acute adrenal insufficiency. One trigger is acute systemic illness such as sepsis from a pressure ulcer. 3. The use of tanning beds is not associated with Addisonian crisis. 4. Patients are prescribed prednisone or related glucocorticoids to treat Addison disease; this is not a cause of Addisonian crisis. 5. Intake of calcium-rich foods is not associated with Addisonian crisis.

The nurse is assessing a patient who has an abnormally high level of parathyroid hormone. Which assessment finding would be consistent with this diagnosis? Select all that apply. 1. Muscle atrophy 2. Muscle weakness 3. Diarrhea 4. Weight gain 5. Hypotension

Answer: 1, 2 Explanation: 1. Manifestations of hyperparathyroidism are related to hypercalcemia. Elevated calcium levels alter neural and muscular activity, leading to muscle atrophy. 2. Manifestations of hyperparathyroidism are related to hypercalcemia. Elevated calcium levels alter neural and muscular activity, leading to muscle weakness. 3. Diarrhea is not a manifestation of hyperparathyroidism. 4. Weight gain is not a manifestation of hyperparathyroidism. 5. Hypotension is not a manifestation of hyperparathyroidism.

The nurse is describing the manifestations of myxedema coma to a patient with hypothyroidism. What should the nurse identify as precipitating factors for this health problem? Select all that apply. 1. Stroke 2. Pneumonia 3. Excessive use of thyroid replacement medications 4. Excessive use of central nervous system stimulants 5. Exposure to excessive heat and humidity

Answer: 1, 2 Explanation: 1. Myxedema coma may be precipitated by a stroke. 2. Myxedema coma may be precipitated by an infection such as pneumonia. 3. Excessive use of thyroid replacement medications would not precipitate myxedema coma. 4. Excessive use of central nervous system stimulants would not precipitate myxedema coma. 5. Exposure to heat and humidity would not precipitate myxedema coma.

The nurse is caring for a patient with untreated hypothyroidism. For which health problem should the nurse assess this patient? Select all that apply. 1. Elevated serum cholesterol 2. Anemia 3. Hyperglycemia 4. Hypernatremia 5. Decreased serum LDL

Answer: 1, 2 Explanation: 1. Untreated hypothyroidism increases the risk for abnormalities in lipid metabolism. 2. Anemia is common in untreated hypothyroidism. 3. Hyperglycemia is not associated with untreated hypothyroidism. 4. Hypernatremia is not associated with untreated hypothyroidism. 5. Untreated hypothyroidism increases the risk for abnormal lipid metabolism.

The nurse is assessing an older patient for genetic influences on the endocrine system. What should the nurse ask this patient during the assessment? Select all that apply. 1. "Do you have any family members with diabetes mellitus?" 2. "Is there a pattern of obesity in your family?" 3. "Has anyone in your family been diagnosed with Hashimoto disease?" 4. "How do you cope with stress?" 5. "Have you noticed any changes in coloration of your skin?"

Answer: 1, 2, 3 Explanation: 1. A family history of diabetes mellitus has a genetic influence on the endocrine system. 2. Obesity has a genetic influence on the endocrine system. 3. Hashimoto disease has a genetic influence on the endocrine system. 4. Questions about the patient's ability to cope with stress are asked to identify possible disorders of endocrine gland function. 5. Questions about changes in skin color are asked to identify possible disorders of endocrine gland function.

During an endocrine assessment, the nurse asks a patient about changes in weight. For which organ is the nurse assessing function in the patient? Select all that apply. 1. Adrenal 2. Thyroid 3. Pituitary 4. Parathyroid 5. Gonads

Answer: 1, 2, 3 Explanation: 1. Disorders of the adrenal glands can result in weight changes by altering fluid balance. 2. Disorders of the thyroid gland can result in weight changes in patients with disorders of these glands. The patient might gain weight with hypothyroidism and lose weight with hyperthyroidism. 3. Disorders of the pituitary gland can result in weight changes in patients with disorders of these glands. The patient might gain weight as the pituitary gland controls antidiuretic hormone, which influences the renal tubules to absorb water. 4. The parathyroid gland regulates calcium and phosphorous. 5. The gonads influence estrogen and androgens.

The nurse is instructing a patient about the symptoms of hyperparathyroidism. Which symptom should the nurse include in this discussion? Select all that apply. 1. Abdominal pain 2. Dysrhythmias 3. Hypertension 4. Diarrhea 5. Reduced urine output

Answer: 1, 2, 3 Explanation: 1. Hyperparathyroidism can cause abdominal pain. 2. Hyperparathyroidism can cause dysrhythmias. 3. Hyperparathyroidism can cause hypertension. 4. Diarrhea is not associated with hyperparathyroidism. 5. Reduced urine output is not associated with hyperparathyroidism.

The nurse is reviewing orders for a patient in myxedema coma. Which prescription should the nurse question before administering to this patient? Select all that apply. 1. Regular insulin IV at 5 units per hour 2. Cooling blanket 3. Methimazole (Tapazole) 15 mg PO daily 4. Pulse oximetry and vital signs hourly 5. Serum TSH level daily

Answer: 1, 2, 3 Explanation: 1. Myxedema coma is characterized by hypoglycemia. There is no evidence that IV insulin is indicated, and administering it would likely be harmful to an already hypoglycemic patient. 2. Patients with myxedema are often hypothermic, and a cooling blanket would be harmful. 3. Methimazole (Tapazole) interferes with thyroid hormone and would be contraindicated for a patient in myxedema coma. 4. Hourly vital signs with oximetry are appropriate for this patient. 5. Daily serum TSH monitoring is appropriate for this patient.

The nurse is preparing material to present during a community health fair. Which information about type 2 diabetes mellitus should the nurse include? Select all that apply. 1. Control weight. 2. Choose healthy family meals. 3. Increase amount of exercise. 4. Engage in a walking program. 5. Reduce the intake of saturated fats.

Answer: 1, 2, 3 Explanation: 1. One health promotion activity for type 2 diabetes mellitus is to control weight. 2. One health promotion activity for type 2 diabetes mellitus is to choose healthy family meals. 3. One health promotion activity for type 2 diabetes mellitus is to increase the amount of exercise. 4. A walking program would be beneficial for the patient with osteoporosis. 5. Reducing the intake of saturated fats would be appropriate for the patient with hypertension or cardiovascular disease.

The nurse is conducting an interview with an adult female patient. Which question should the nurse ask that focuses on genetic factors that influence the endocrine system? Select all that apply. 1. Did you have any difficulties with your pregnancies? 2. What was the pattern and characteristics of your menstrual cycle? 3. Did you have any problems related to menopause? 4. Have you noticed any changes in your breasts? 5. Have you noticed any changes in the color of your urine or feces?

Answer: 1, 2, 3 Explanation: 1. Questions for the female patient that could identify genetic factors affecting the patient would include problems with pregnancy. 2. Questions for the female patient that could identify genetic factors affecting the patient would include problems with menstruation. 3. Questions for the female patient which could identify genetic factors affecting the patient would include problems with menopause. 4. This question does not focus on possible genetic influences on endocrine function. 5. This question does not focus on possible genetic influences on endocrine function.

A patient is prescribed prednisone (Dexasone) for a chronic health problem. Which sign of Cushing syndrome should the nurse instruct this patient to report to the healthcare provider? Select all that apply. 1. Fat deposits in the abdominal and clavicle regions 2. Muscle weakness and wasting in the extremities 3. Delayed wound healing 4. Development of varicose leg veins 5. Hypotension

Answer: 1, 2, 3 Explanation: 1. Symptoms of Cushing syndrome include obesity and a redistribution of body fat to the abdominal region (central obesity), the upper back, and under the clavicle. 2. Changes in protein metabolism cause muscle weakness and wasting, especially in the extremities. 3. Poor wound healing is common. 4. Varicose veins are not a manifestation of Cushing syndrome. 5. Hypotension is not a manifestation of Cushing syndrome.

The nurse is assessing a patient with liver cirrhosis. Which findings should the nurse relate to the patient's failed liver function? Select all that apply. 1. The patient had two episodes of epistaxis. 2. The patient had toxic levels of a prescribed medication. 3. The patient is oriented to person and place but not to time. 4. The patient's urinary output has decreased. 5. The patient has cholelithiasis.

Answer: 1, 2, 3 Explanation: 1. The liver produces clotting factors. Two episodes of epistaxis are likely related to the patient's liver failure. 2. The liver metabolizes medications. Toxic levels of prescribed medication in the absence of other factors are likely related to liver failure. 3. The patient who is disoriented may be experiencing high serum ammonia levels, an effect of liver failure. 4. Decreased urinary output is not associated with liver failure, but with kidney failure. 5. Cholelithiasis is not caused by liver failure.

The nurse is developing a plan of care for a patient with hyperparathyroidism and a serum calcium level of 12.0 mg/dL. What should be included in the plan? Select all that apply. 1. Promoting ambulation and mobility 2. Discussing a change from ordered thiazide diuretics to another type of diuretic with healthcare provider 3. Teaching to increase daily oral intake of fluids 4. Encouraging supplementation of fat-soluble vitamins 5. Encouraging use of calcium-based antacids for indigestion

Answer: 1, 2, 3 Explanation: 1. Treatment of hyperparathyroidism focuses on reducing elevated serum calcium levels. Patients with mild hypercalcemia are urged to keep active and avoid immobilization. 2. Patients with mild hypercalcemia are urged to avoid thiazide diuretics. 3. Patients with mild hypercalcemia are urged to increase fluid intake. 4. Patients with mild hypercalcemia are urged to avoid large doses of vitamins A and D. 5. Patients with mild hypercalcemia are urged to avoid antacids containing calcium.

The nurse is providing care to a patient with a low level of serum parathyroid hormone. What should the nurse expect to assess in this patient? Select all that apply. 1. Brittle nails 2. Abdominal cramps 3. Hair loss 4. Dysrhythmias 5. Smooth, soft skin

Answer: 1, 2, 3, 4 Explanation: 1. Brittle nails is an integumentary manifestation of hypoparathyroidism. 2. Abdominal cramps are a gastrointestinal manifestation of hypoparathyroidism. 3. Hair loss is an integumentary manifestation of hypoparathyroidism. 4. Dysrhythmias are a cardiovascular manifestation of hypoparathyroidism. 5. Smooth, soft skin is not a common finding in the patient with hypoparathyroidism.

The nurse is conducting a health assessment interview with a patient. What should the nurse include when assessing the patient's endocrine system? Select all that apply. 1. Occupation 2. Use of alcohol, drugs, and tobacco 3. Lifestyle 4. Exercise and sleep patterns 5. Alterations in bowel habits

Answer: 1, 2, 3, 4 Explanation: 1. During assessment of the endocrine system, the nurse should ascertain data about occupation. 2. During assessment of the endocrine system, the nurse should ascertain data about substance use. 3. During assessment of the endocrine system, the nurse should ascertain data about lifestyle and personal relationships. 4. During assessment of the endocrine system, the nurse should ascertain data about exercise and sleep patterns. 5. Bowel habits are not influenced by the endocrine system.

The nurse is reviewing the manifestations of hyperparathyroidism with a patient. Which statement by the patient indicates that teaching has been effective? Select all that apply. 1. "Hyperparathyroidism can cause the kidneys to keep calcium and excrete phosphorus." 2. "Calcium and phosphorus leave the bones and make them weak." 3. "Calcium is deposited in soft tissues." 4. "Kidney stones can develop." 5. "The kidneys work to raise blood pH and retain potassium."

Answer: 1, 2, 3, 4 Explanation: 1. Hyperparathyroidism is characterized by increased resorption of calcium and excretion of phosphate by the kidneys, which increases the risk of hypercalcemia and hypophosphatemia. 2. Hyperparathyroidism increases the release of calcium and phosphorus by the bones, with resultant bone decalcification. 3. The increase in PTH affects the kidneys and bones, leading to the deposit of calcium in soft tissues. 4. Renal calculi can form. 5. Hyperparathyroidism causes the kidneys to lower blood pH and excrete potassium.

A patient is scheduled for surgery to remove a tumor of the anterior pituitary. Which hormone should the nurse expect to be affected by this surgery? Select all that apply. 1. Adrenocorticotropic hormone (ACTH) 2. Thyroid stimulating hormone (TSH) 3. Gonadotropin hormones 4. Prolactin 5. Oxytocin

Answer: 1, 2, 3, 4 Explanation: 1. The anterior pituitary produces adrenocorticotropic hormone. 2. The anterior pituitary produces thyroid-stimulating hormone. 3. The anterior pituitary produces the gonadotropin hormones, one of which is follicle-stimulating. 4. The anterior pituitary produces the gonadotropin hormones, one of which is prolactin. 5. Oxytocin is produced in the posterior pituitary.

The nurse is preparing to assess a patient with Cushing syndrome. Which finding should the nurse expect to assess in this patient? Select all that apply. 1. Weight gain 2. Auscultatory lung crackles 3. Jugular vein distention 4. Peripheral edema 5. Hypotension

Answer: 1, 2, 3, 4 Explanation: 1. The excess cortisol secretion associated with Cushing syndrome results in sodium and water resorption, causing symptoms of fluid volume excess such as weight gain. 2. The nurse may note crackles and wheezes on lung auscultation. 3. The nurse may note jugular vein distention. 4. The excess cortisol secretion associated with Cushing syndrome results in sodium and water resorption, causing symptoms of fluid volume excess and edema. 5. Hypotension is not an expected assessment finding in the patient with Cushing syndrome.

The nurse is beginning the assessment of a patient with an endocrine disorder. What should the nurse include in this assessment? Select all that apply. 1. Height and weight 2. Skin, hair, and nails 3. Deep tendon reflexes 4. Musculoskeletal system 5. Respiratory system

Answer: 1, 2, 3, 4 Explanation: 1. When assessing a patient's endocrine system, the nurse should include measuring height and weight. 2. When assessing a patient's endocrine system, the nurse should include evaluating skin, hair, and nails. 3. When assessing a patient's endocrine system, the nurse should include evaluating reflexes. 4. When assessing a patient's endocrine system, the nurse should include evaluating the musculoskeletal system. 5. The respiratory system does not influence the endocrine system.

The nurse suspects that a patient is experiencing a response caused by the hormones of the adrenal medulla. What did the nurse assess to come to this conclusion? Select all that apply. 1. Heart rate 112 beats per minute 2. Cold extremities 3. Respiratory rate 24 breaths per minute 4. Urine output 10 mL/hr 5. Blood glucose level 142 mg/dL

Answer: 1, 2, 3, 5 Explanation: 1. Hormones secreted by the adrenal medulla stimulate the heart. 2. Hormones secreted by the adrenal medulla constrict blood vessels, which could cause cold extremities. 3. Hormones secreted by the adrenal medulla can increase respirations. 4. Hormones secreted by the adrenal medulla do not affect urine output. 5. Hormones secreted by the adrenal medulla increase blood glucose.

A patient with hyperthyroidism is experiencing vision changes. What teaching should the nurse provide to preserve this patient's sight? Select all that apply. 1. Apply eye shields. 2. Instill artificial tears. 3. Wear eyeglasses with tinted lenses. 4. Apply warm compresses to the eyes every 4 hours. 5. Notify the healthcare provider about vision changes.

Answer: 1, 2, 3, 5 Explanation: 1. Measures to protect the eyes from injury and maintain visual acuity include applying eye shields. 2. Measures to protect the eyes from injury and maintain visual acuity include instilling artificial tears to moisten the eyes. 3. Measures to protect the eyes from injury and maintain visual acuity include using tinted glasses. 4. The application of warm compresses would not help preserve this patient's visual acuity. 5. Measures to protect the eyes from injury and maintain visual acuity include notifying the healthcare provider about vision changes.

The nurse is caring for a patient with hypoparathyroidism. What action should the nurse expect to perform to help this patient with a low calcium level? Select all that apply. 1. Administering calcium tablets as prescribed 2. Arranging for a dietary consult regarding foods high in calcium 3. Restricting fluids 4. Administering intravenous IV calcium gluconate 5. Administering calcimimetic

Answer: 1, 2, 4 Explanation: 1. Treatment of hypoparathyroidism focuses on increasing calcium levels. Long-term therapy includes supplemental calcium. 2. Treatment of hypoparathyroidism focuses on increasing calcium levels. Long-term therapy includes increased dietary calcium. 3. Fluids are not restricted in the treatment of hypoparathyroidism. 4. Treatment of hypoparathyroidism focuses on increasing calcium levels. Intravenous calcium gluconate is given immediately to reduce tetany. 5. Treatment of hypoparathyroidism focuses on increasing calcium levels. Calcimimetic would reduce the amount of calcium in the body.

The nurse is teaching a patient about the effects of liver failure. Which patient statement about manifestations indicates that teaching was effective? Select all that apply. 1. "My abdomen is becoming very large." 2. "My blood sugar is sometimes too high and sometimes too low." 3. "My left lower leg is red and swollen." 4. "My menstrual cycle has become very irregular." 5. "My skin appears yellow."

Answer: 1, 2, 4, 5 Explanation: 1. Ascites occurs during liver failure due to low oncotic pressure related to a deficiency of serum albumin. 2. The liver's ability to use glycogen is impaired by liver failure, leading to difficulty controlling hypoglycemia and/or hyperglycemia. 3. The patient is describing symptoms of a blood clot. This is not associated with liver failure. Excessive bleeding is associated with liver failure. 4. Impaired metabolism of steroid hormones interferes with the menstrual cycle. 5. Impaired ability to metabolize and excrete bilirubin leads to a buildup of bilirubin in skin, causing a jaundiced appearance.

During a health assessment the nurse becomes concerned that a patient is at high risk for pancreatic cancer. What assessment finding caused this concern? Select all that apply. 1. The patient smokes cigarettes. 2. The patient has a body mass index of 32.5. 3. The patient has been treated for osteoarthritis. 4. The patient's uncle died from pancreatic cancer. 5. The patient has been diagnosed with chronic pancreatitis.

Answer: 1, 2, 4, 5 Explanation: 1. Risk factors for pancreatic cancer include cigarette smoking. 2. Risk factors for pancreatic cancer include obesity. 3. Osteoarthritis is not a risk factor for pancreatic cancer. 4. Risk factors for pancreatic cancer include a genetic predisposition. 5. Risk factors for pancreatic cancer include chronic pancreatitis.

A patient with Addison disease is experiencing problems with fluid balance. What actions should the nurse take to help this patient? Select all that apply. 1. Teach to sit and stand slowly. 2. Monitor cardiac monitor rhythm. 3. Turn and reposition every 2 hours while awake. 4. Weigh the patient daily at the same time and in the same clothing. 5. Encourage oral fluid intake of 3000 mL/day and increased salt intake

Answer: 1, 2, 4, 5 Explanation: 1. The nurse should teach the patient to sit and stand slowly, and provide assistance as necessary. Extracellular fluid volume deficit causes orthostatic hypotension, dizziness, and possible loss of consciousness. These manifestations increase the risk of injury from falls. 2. A drop in aldosterone levels can reduce renal excretion of potassium, leading to increased blood levels and the potential for cardiac dysrhythmias. 3. Turning and repositioning would be beneficial to maintain skin integrity, not to address a fluid imbalance. 4. The nurse should weigh the patient daily at the same time and in the same clothing because dehydration is manifested by weight loss. 5. The nurse should encourage an oral fluid intake of 3000 mL/day and an increased salt intake. Cortisol deficiency increases fluid loss, leading to extracellular fluid volume depletion. Oral fluid replacement is necessary to balance this loss. An increase in dietary sodium can reduce the hyponatremia characteristic of adrenal insufficiency.

A public health report was published that identified high exposure to bisphenol A (BPA) in a community. On what should the nurse focus when sharing this information during a community town hall meeting? Select all that apply. 1. Identify food containers with BPA. 2. Avoid using food containers with BPA. 3. Receive a vaccination to prevent BPA toxicity. 4. Have laboratory studies to measure BPA levels. 5. Avoid purchasing food items in containers with BPA.

Answer: 1, 2, 5 Explanation: 1. Actions to reduce BPA exposure include identifying food containers with the chemical. 2. Actions to reduce BPA exposure include avoiding the use of food containers with BPA. 3. There is no vaccination to prevent BPA toxicity. 4. Laboratory studies to measure BPA levels are not identified as an appropriate action. 5. Actions to reduce BPA exposure include avoiding the purchase of food items in containers with BPA.

During a physical assessment the nurse suspects a patient is experiencing hypothyroidism. What skin assessment finding did the nurse use to make this assumption? Select all that apply. 1. Rough, dry skin 2. Smooth, flushed skin 3. Yellowish cast to the skin 4. Areas of hyperpigmentation 5. Purple striae over the abdomen

Answer: 1, 3 Explanation: 1. Rough, dry skin is often seen in patients with hypothyroidism. 2. Smooth, flushed skin can be a sign of hyperthyroidism. 3. A yellowish cast to the skin might indicate hypothyroidism. 4. Areas of hyperpigmentation may be seen in patients with Addison disease or Cushing syndrome. 5. Purple striae over the abdomen may be present in patients with Cushing syndrome.

A patient recovering from a head injury is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which should the nurse expect to be prescribed for this patient? Select all that apply. 1. Restrict fluids. 2. Increase oral fluids. 3. Provide a loop diuretic. 4. Administer Conivaptan. 5. Administer demeclocycline.

Answer: 1, 3, 4, 5 Explanation: 1. Fluid intake is restricted to gradually reduce total body water. 2. Increasing fluids will exacerbate hyponatremia in SIADH. 3. Loop diuretics such as furosemide are used to decrease fluid volume. 4. Vasopressin receptor antagonist, such as Conivaptan, is used to correct hyponatremia. 5. Demeclocycline is a tetracycline antibiotic that suppresses ADH activity, resulting in increased urine production.

A patient with hypothyroidism is prescribed levothyroxine sodium (Synthroid). What dietary adjustment should the nurse instruct the patient to make? Select all that apply. 1. Avoid eating walnuts. 2. Avoid all grapefruit or citrus fruits. 3. Restrict the intake of foods high in fiber. 4. Reduce the intake of green leafy vegetables. 5. Take the medication 30 minutes before eating breakfast in the morning.

Answer: 1, 3, 5 Explanation: 1. The patient should be instructed to avoid excessive intake of foods that are known to inhibit thyroid hormone utilization, such as walnuts. 2. There is no reason for the patient to avoid grapefruit or other citrus fruits. 3. The patient should be instructed to avoid excessive intake of foods that are known to inhibit thyroid hormone utilization, such as high-fiber foods. 4. There is no reason for the patient to limit the intake of green leafy vegetables. 5. The patient should be instructed to take the thyroid preparation in the morning 30 minutes before eating to reduce the possibility of insomnia.

A patient with chronic pancreatitis is prescribed pancrelipase (Lipancreatin). What should the nurse instruct the patient about this medication? Select all that apply. 1. Take the medication with meals or snacks. 2. Take the medication with milk or ice cream. 3. Stop taking the medication if bowel movements increase. 4. Do not crush enteric coated doses of the medication. 5. Take this medication until advised otherwise by the healthcare provider.

Answer: 1, 4, 5 Explanation: 1. Pancrelipase enhances the digestion of starches and fats in the gastrointestinal tract by supplying an exogenous source of the enzymes protease, amylase, and lipase. The drug promotes nutrition and decreases the number of bowel movements. This medication should be taken with meals or snacks. 2. This medication should not be taken with alkaline foods such as milk or ice cream. 3. This medication should be taken as directed by the healthcare provider. 4. Pancrelipase enhances the digestion of starches and fats in the gastrointestinal tract by supplying an exogenous source of the enzymes protease, amylase, and lipase. The drug promotes nutrition and decreases the number of bowel movements. Enteric coated doses of this medication should not be crushed. 5. Pancrelipase enhances the digestion of starches and fats in the gastrointestinal tract by supplying an exogenous source of the enzymes protease, amylase, and lipase. The drug promotes nutrition and decreases the number of bowel movements. This medication should be taken until advised otherwise by the healthcare provider.

The nurse is caring for a patient with chronic pancreatitis and a serum amylase level of 180 units/L. Which eating plan should the nurse instruct the patient to follow? 1. Low residue, no alcohol 2. Low fat, no alcohol 3. Low fat, no fiber 4. Mechanical soft

Answer: 2 Explanation: 1. A low-residue diet is prescribed for patients experiencing bowel disorders. 2. After the serum amylase level returns to normal, the patient experiencing pancreatitis should be instructed to consume a diet low in fat with no alcohol. 3. Almost all patients should consume a low-fat diet, but most patients need increased fiber. 4. A mechanical soft diet is reserved for the patient who needs to conserve energy or has a mouth or dentition disorder.

The nurse is caring for a patient with hepatitis C who is treating the illness with licorice root. Which statement by the patient requires follow-up regarding this medication? 1. "I feel so tired all the time." 2. "My fingers feel numb and tingly." 3. "I have a dull ache in my abdomen." 4. "I have antibodies for hepatitis C in my blood."

Answer: 2 Explanation: 1. Feeling tired is expected in a patient with hepatitis C. 2. Herbalists may use licorice root to treat hepatitis. It has both antiviral and anti-inflammatory effects. Long-term use of licorice root, however, can lead to hypertension and affect fluid and electrolyte balance. Reports of numbness and tingling in the fingers may be a sign of electrolyte imbalance. 3. A dull ache in the abdomen is often seen in patients with hepatitis. 4. It is expected that this patient would have antibodies to hepatitis C in the blood.

A patient with hepatitis is receiving interferon alpha. Which manifestation indicates that the patient is experiencing an untoward effect of this medication? 1. Jaundice 2. Flulike syndrome 3. Gallbladder pain 4. Clay-colored stools

Answer: 2 Explanation: 1. Jaundice is characterized by yellow-tinged skin as a result of hepatitis. 2. The patient who is receiving interferon alpha may experience flulike symptoms such as fever, fatigue, body aches, headache, and chills. 3. Gallbladder pain is the result of stones in the gallbladder. 4. Clay-colored stools are associated with liver or biliary disease.

A patient with pancreatitis asks why the stools are frothy and have a foul odor. Which response should the nurse make? 1. "This is a sign of malnutrition." 2. "This indicates your stools have more fat in them." 3. "This is a sign of peptic ulcer disease." 4. "You may be developing diabetes mellitus."

Answer: 2 Explanation: 1. Pancreatitis can lead to malnutrition, but steatorrhea is not a sign of malnutrition. This statement is inaccurate. 2. Steatorrhea is fatty, frothy, smelly stools associated with pancreatitis. It is caused by a decrease in pancreatic enzyme secretion; fat in the GI tract is not absorbed properly and a greater than normal amount of fat is excreted in the stool, causing the symptoms of steatorrhea. 3. Peptic ulcer disease can be related to pancreatitis, but it is not related to steatorrhea. 4. Diabetes mellitus causes increased urine production and could be the result of pancreatitis, but it does not affect stool characteristics.

The patient in the icteric phase of hepatitis asks why stools are no longer brown. How should the nurse respond? 1. "Your liver isn't making any of the substance that makes stools brown." 2. "The pigment is backing up into your blood and turning your skin yellow." 3. "It is being released into your bloodstream and turning your blood darker red." 4. "The answer is not known. More research is needed regarding this question."

Answer: 2 Explanation: 1. The liver continues to make bilirubin, even during hepatitis. 2. The icteric (jaundiced) phase usually begins 5 to 10 days after the onset of symptoms. It is heralded by jaundice of the sclera, skin, and mucous membranes. Inflammation of the liver and bile ducts prevents bilirubin from being excreted into the small intestine. As a result, the serum bilirubin levels are elevated, causing yellowing of the skin and mucous membranes. The stools are light brown or clay colored because bile pigment is not excreted through the normal fecal pathway. 3. The blood does not become darker when bilirubin levels are elevated. 4. The cause of this phenomenon is known.

A patient with a liver abscess is experiencing nausea and vomiting. Which problem should the nurse identify as a priority for this patient? 1. Too much fluid 2. Not enough fluid 3. Problem breathing 4. Altered self-image

Answer: 2 Explanation: 1. The patient with a liver abscess is at risk for developing dehydration due to fever, nausea, and vomiting as a result of the infection. The patient is likely not experiencing a problem with too much fluid. 2. The patient with a liver abscess is at risk for developing dehydration due to fever, nausea, and vomiting as a result of the infection. It is important that the nurse assess for signs of dehydration. 3. The patient with a liver abscess is not usually in respiratory distress. 4. There should be no problems with self-image, as the infection is in the liver.

A patient with liver failure is taking lactulose (Chronulac). Which laboratory data indicates that the medication is having the desired effect? 1. Increased serum ammonia level 2. Decreased serum ammonia level 3. Increased serum ALT level 4. Decreased serum ALT level

Answer: 2 Explanation: 1. This medication does not increase the serum ammonia level. 2. Ammonia, a toxic by-product of protein metabolism, is converted to urea in the liver for elimination by the kidneys. Lactulose works by acidifying the contents of the bowel, which has the effect of keeping ammonia in the bowel, where it is excreted from the body in the stools, rather than being reabsorbed into the circulation. 3. This medication does not affect the ALT level. 4. This medication does not affect the ALT level.

The nurse is reviewing the function of the pancreas with a patient who is newly diagnosed with diabetes mellitus. When discussing this organ's function, on which cell type should the nurse focus? Select all that apply. 1. F cells 2. Beta cells 3. Delta cells 4. Alpha cells 5. Omega cells

Answer: 2, 3, 4 Explanation: 1. F cells secrete pancreatic polypeptide, which is believed to inhibit the exocrine activity of the pancreas and has no impact on the regulation of blood glucose. 2. Beta cells produce insulin, which facilitates the uptake and use of glucose by muscle, liver, and fat cells and prevents an excessive breakdown of glycogen in the liver and muscle. 3. Delta cells secrete somatostatin, which inhibits the secretion of glucagon and insulin by the alpha and beta cells. 4. Alpha cells produce glucagon, which decreases glucose oxidation and promotes an increase in the blood glucose level by signaling the liver to release glucose from glycogen stores. 5. The pancreas does not have omega cells.

A patient is scheduled for a water deprivation test. What should the nurse instruct the patient to prepare for this test? Select all that apply. 1. Expect this test to take 16 hours to complete. 2. Abstain from smoking as directed by the healthcare provider. 3. A sedative will be provided prior to the beginning of the test. 4. Do not eat or drink anything as directed by the healthcare provider. 5. Blood and urine samples will be collected every hour during the test.

Answer: 2, 4, 5 Explanation: 1. The water deprivation test takes up to 8 hours to complete. 2. For the water deprivation test, the patient should be instructed to not smoke as directed by the healthcare provider. 3. For the water deprivation test, a sedative is not needed. 4. For the water deprivation test, the patient should be instructed not to eat or drink as directed by the healthcare provider. 5. For the water deprivation test, blood samples for osmolality are taken when urine samples are collected each hour.

The nurse is caring for a patient with a Sengstaken-Blakemore tube. Which assessment finding should the nurse immediately report for follow-up? 1. Left lower leg swollen and reddened 2. Absent bowel sounds to lower-left quadrant 3. Decreased level of consciousness 4. 3 cm darkened area on left heel

Answer: 3 Explanation: 1. A swollen and reddened lower leg may indicate a venous thrombus. While this is a potentially serious problem, the possibility of another problem is the priority for follow-up. 2. Absent bowel sounds may indicate ileus. While this is a potentially serious problem, the possibility of another problem is the priority for follow-up. 3. The Sengstaken-Blakemore tube has two balloons, which are used to tamponade the esophageal bleeding. One balloon is in the stomach and the other is in the esophagus, and if the tube migrates, the airway can be obstructed. Decreased level of consciousness may indicate hypoxia and is the priority for follow-up. 4. A darkened area on the left heel may indicate a pressure ulcer. While this is a potentially serious problem, the possibility of another problem is the priority for follow-up.

A patient with a distant history of injection substance use is diagnosed with hepatitis. For which type of hepatitis should the nurse plan care for this patient? 1. Hepatitis A 2. Hepatitis B 3. Hepatitis C 4. Hepatitis D

Answer: 3 Explanation: 1. Hepatitis A usually resolves completely and rarely results in a carrier state. 2. Patients with hepatitis B are typically very ill following the preicteric phase, which is not consistent with this patient's history. 3. Hepatitis C is the primary worldwide cause of chronic hepatitis, cirrhosis, and liver cancer. It is transmitted through infected blood and body fluids. Injection drug use is the primary risk factor for HCV infection, accounting for nearly half of all new infections. Acute hepatitis C usually is asymptomatic; if symptoms do develop, they often are mild and nonspecific. The disease often is recognized long after exposure occurred, when secondary effects of the disease (such as chronic hepatitis or cirrhosis) develop. Few acute infections completely resolve; most progress to chronic active hepatitis. 4. Hepatitis D infects only people already infected with hepatitis B.

A patient with cirrhosis is experiencing hypertension, edema, and shortness of breath. What should the nurse identify as the patient's priority problem? 1. Insufficient fluid level 2. Problem with tissue perfusion 3. Too much bodily fluid 4. Problem with integumentary status

Answer: 3 Explanation: 1. Hypotension and dry mucous membranes are associated with a fluid volume deficit. 2. There is no evidence that the patient is having problems with tissue perfusion. 3. The patient with shortness of breath, edema, and hypertension is experiencing an excess amount of fluid. 4. Edema can cause an alteration in skin integrity, but there is no evidence of such problems in this patient.

The nurse is planning care for a patient scheduled for paracentesis to treat ascites. Which outcome should the nurse use for this patient's plan of care? 1. The patient will have normal bilateral breath sounds. 2. The patient's spleen will not rupture. 3. The patient's respiratory effort will be lessened. 4. The patient will not manifest symptoms of hepatomegaly.

Answer: 3 Explanation: 1. Paracentesis does not alter breath sounds. 2. A ruptured spleen is not a complication of paracentesis. 3. The goal of paracentesis is to relieve respiratory distress caused by excess fluid in the abdomen. 4. Paracentesis does not cause an enlarged liver.

A patient has abdominal pain and a serum conjugated bilirubin level of 1.2 mg/dL. What should the nurse suspect is occurring with this patient? 1. A disease that requires phototherapy 2. A disorder that causes large amounts of red blood cell death 3. A disorder of the biliary system 4. A small bowel obstruction

Answer: 3 Explanation: 1. Phototherapy is used in the care of a newborn. 2. The laboratory finding does not provide information to identify red blood cell death. 3. Elevated direct (conjugated) bilirubin may indicate obstructed bile flow in the biliary duct system. 4. The laboratory finding does not provide information to identify small bowel obstruction.

A patient with epigastric pain has a serum amylase level of 369 units/L. What should the nurse do? 1. Continue to monitor the patient. 2. Refer the patient to a dietician. 3. Contact the primary healthcare provider. 4. Question the patient regarding alcohol use patterns.

Answer: 3 Explanation: 1. The patient could develop shock. 2. A dietitian is not needed at this time. 3. A normal level for serum amylase is between 0 and 130 units/L. In pancreatitis, the serum amylase increases to two to three times the normal level and remains elevated for 3 to 4 days. The primary healthcare provider should be notified of the patient's symptoms and the laboratory findings. 4. The nurse can assess the patient's alcohol intake at a later t

The nurse in the postanesthesia care area is concerned that a patient recovering from a subtotal thyroidectomy is experiencing postoperative complications. What finding led the nurse to come to this conclusion? Select all that apply. 1. Hoarse voice 2. Restlessness and irritability 3. Blood pressure 92/56 mmHg 4. Heart rate 116 beats per minute 5. High-pitched, squeaky sound with breathing

Answer: 3, 4, 5 Explanation: 1. Hoarseness is expected immediately after a subtotal thyroidectomy. It is too soon to suspect laryngeal nerve damage in this patient. 2. Restlessness and irritability are vague symptoms that could result from the anesthesia, the surgical procedure, or recovery. This is not considered a postoperative complication. 3. A postoperative complication is hemorrhage, which can manifest as a dropping blood pressure. 4. A postoperative complication is hemorrhage, which can manifest as a rapid heart rate. 5. Stridor, a high-pitched, squeaky sound, is heard in acute airway obstructions.

The nurse is teaching a patient about strategies for reducing the risk of hepatitis B transmission. Which patient statement indicates teaching has been effective? Select all that apply. 1. "I will wash my hands frequently to prevent fecal-oral transmission." 2. "I will avoid alcohol." 3. "I will avoid contact with blood and body fluids." 4. "I will avoid contaminated food and water." 5. "I will use safe sex techniques."

Answer: 3, 5 Explanation: 1. Hepatitis A virus, not hepatitis B virus, is spread by fecal-oral transmission. 2. Cirrhosis is related to alcohol consumption and to chronic hepatitis B or C. 3. Hepatitis B is contracted through contaminated blood and body fluids. Strategies that reduce exposure to the blood and body fluids of others reduce the risk of hepatitis B transmission. 4. Hepatitis A virus, not hepatitis B virus, is spread through contaminated food and water. 5. Hepatitis B is contracted through contaminated blood and body fluids. Using safe sex techniques reduces the risk of hepatitis B transmission.

A patient has ascites caused by liver failure. Which finding should the nurse report for immediate follow-up? 1. Asterixis 2. Jaundice 3. Increased abdominal girth 4. Dyspnea

Answer: 4 Explanation: 1. Asterixis or liver flap is a muscle tremor that interferes with the ability to maintain a fixed position of the extremities, causes involuntary jerking movements, and is an early sign of portal systemic encephalopathy. 2. Jaundice is a chronic problem with liver failure and does not present an immediate threat to the patient. 3. Increased abdominal girth is likely the result of ascites and may be contributing to the patient's shortness of breath. 4. Dyspnea is the immediate priority for this patient.

A patient who has portal systemic encephalopathy is receiving Neomycin (neomycin sulfate). Which manifestation should indicate to the nurse that the patient's condition is improving? 1. Increase in potassium level 2. Asterixis 3. Relief of jaundice 4. Increased level of consciousness

Answer: 4 Explanation: 1. Neomycin (neomycin sulfate) causes diarrhea, which decreases rather than increases potassium. 2. Asterixis, the downward flapping of the hands, is a sign of portal systemic encephalopathy and should improve with administration of Neomycin (neomycin sulfate). 3. Neomycin does not improve jaundice. 4. Portal systemic encephalopathy is characterized by impaired judgment, confusion, disorientation, and incoherence related to high level of ammonia in the blood. Administering Neomycin (neomycin sulfate) should reduce ammonia levels by decreasing the number of bacteria-producing microorganisms in the bowel.

The nurse is instructing a patient recovering from a liver transplant. What should the nurse include in this teaching? 1. Eat a high-protein diet. 2. Reduce scheduled antirejection drugs to every other day if nausea occurs. 3. Take acetaminophen (Tylenol) if fever develops. 4. Report sore throats to the healthcare provider.

Answer: 4 Explanation: 1. The patient should be instructed to eat a low-to-moderate-protein diet to reduce the workload of the liver in terms of protein metabolism. 2. The patient must adhere to the prescribed medication schedule unless otherwise instructed by the healthcare provider. 3. Acetaminophen (Tylenol) should not be taken, as it is liver-toxic. 4. The patient who has undergone a liver transplant should be instructed to report any signs of infection, such as a sore throat, as the medications prescribed to prevent organ rejection increase the risk of contracting infectious diseases.

The nurse is assessing a patient for Trousseau sign. In which order should the nurse conduct this assessment? Place in order the steps of the process. Choice 1. Inflate the cuff. Choice 2. Wait 2‒5 minutes. Choice 3. Note a point greater than systolic blood pressure. Choice 4. Place a blood pressure cuff above the antecubital space. Choice 5. Observe for carpal spasms in the patient's hands and fingers.

Answer: 4, 1, 3, 2, 5 Explanation: Trousseau sign is a test for hypocalcemia with resulting tetany (tonic muscle spasms). It is assessed by placing a blood pressure cuff above the antecubital space, inflating the cuff to a point greater than systolic blood pressure and waiting for 2‒5 minutes to observe for carpal spasms in the patient's hands and fingers.

A patient has Pheochromocytoma you would plan to administer this type of medication?

Beta blocker

It's a synthetic vasopressin that be given to treat DI

Desmopressin

During a home health visit, you are assessing how a patient takes the prescribed pancreatic enzyme. The patient is unable to swallow the capsule whole, so they open the capsule and mix the beads inside the capsule with food/drink. Which food or drink is safe for the patient to mix the beads with?* ○ A. Pudding ○ B. Ice cream ○ C. Milk ○ D. Applesauce

During an assessment, the nurse decides to assess a patient's calcium level. Which action will the nurse take to identify a low calcium level? a. Palpate turgor of skin b. Observe color of skin c. Conduct a trousseau sign test d. Save urine to measure 17-ketosteroids

During physical examination, the nurse assesses a patient with hypothyroidism as having a goiter. The nurse teaches the patient that which physiologic process caused the thyroid gland to enlarge? a. An increased dietary iodine intake b. A compensatory effort to produce more TH c. An excess of TH that stimulated thyroid follicles d. Tissue hypertrophy in response to increased TH

During the posticteric phase of Hepatitis the nurse would expect to find? Select all that apply:* ○ A. Increased ALT and AST levels along with an increased bilirubin level ○ B. Decreased liver enzymes and bilirubin level ○ C. Flu-like symptoms ○ D. Resolved jaundice and dark urine

During your morning assessment of a patient with cirrhosis, you note the patient is disoriented to person and place. In addition while assessing the upper extremities, the patient's hands demonstrate a flapping motion. What lab result would explain these abnormal assessment findings?* ○ A. Decreased magnesium level ○ B. Increased calcium level ○ C. Increased ammonia level ○ D. Increased creatinine level

What causes, s/s, Tx of hyperthyroidism?

Elevated T3 and T4 levels s/s= tremors, flushing, tachycardia, increased systolic BP, weight loss, muscle wasting, TX = potassium iodide, PTU, propranolol surgery.

A nurse is reviewing the laboratory findings of a client who has Cushing's disease. Which of the following findings should the nurse expect for this client? Select All That Apply. a. Sodium 150 mEq/L b. Potassium 3.3 mEq/L c. Calcium 8.0 mg/dL d. Lymphocyte count 35% e. Fasting glucose 145 mg/dL

Fasting glucose 145 mg/dL

Fill in the blank regarding the negative feedback loop for thyroid hormone production: The ______________ produces TRH (Thyrotropin-Releasing Hormone) which causes the anterior pituitary gland to produce _______________ which in turn causes the thyroid gland to release _______ and _______.* ○ A. Thalamus, CRH (Corticotropin-releasing hormone) TSH (thyroid-stimulating hormone) and T4 ○ B. Hypothalamus, TSH (thyroid-stimulating hormone), T3 and T4 ○ C. Posterior pituitary gland, TSH (thyroid-stimulating hormone), T3 and T4 ○ D. Hypothalamus, CRH (Corticotropin-releasing hormone), TSH (thyroid-stimulating hormone), T3 and TSH

In Cushing's Disease and Syndrome there are:* ○ A. Increased cortisol production ○ B. Low potassium and glucose levels ○ C. Increased production of aldosterone and cortisol ○ D. Decreased production of cortisol and aldosterone

In Cushing's disease, the _______ is secreting too much ACTH (Adrenocorticotropic hormone) which is causing an increase in cortisol production.* ○ A. Adrenal cortex ○ B. Pituitary gland ○ C. Thyroid gland ○ D. Hypothalamus

Inside the pancreas are special cells that secrete digestive enzymes and hormones. The cells that secrete digestive enzymes are known as ______________ cells.* ○ A. Islet of Langerhans ○ B. Protease ○ C. Acinar ○ D. Amylase

Lactulose is prescribed for a hospitalized client with a diagnosis of hepatic encephalopathy. Which assessment finding indicates that the client is responding to this medication therapy as anticipated? a. Vomiting occurs b. The fecal pH is acidic c. The client experiences diarrhea d. The client is able to tolerate a full diet

What are the s/s of hypothyroidism?

Lethargy muscle aches and weakness, costipation, intolerance to cold, facial/ eyelid edema weight gain and hair loss

Levothyroxine is prescribed for a client diagnosed with hypothyroidism. Upon review of the client's record, the nurse notes that the client is taking warfarin. Which modification to the plan of care should the nurse review with the client's primary health care provider? a. A decreased dosage of levothyroxine b. An increased dosage of levothyroxine c. A decreased dosage of warfarin sodium d. An increased dosage of warfarin sodium

Octreotide acetate is prescribed for a client with acromegaly. The nurse monitors the client, knowing that which side or adverse effect is associated with the administration of this medication? a. Polyuria b. Hypotension c. Constipation d. Abdominal pain

What causes, S/s, chronic pancreatitis?

Re-current condition commonly caused by ETOH abuse, s/s= recurrent pain, nausea, constipation, steatorrhea (takes pancrelipase for), advised to avoid alcohol, caffeine, tobacco smoking, and eat small, low fat meals

Select all the signs and symptoms associated with Hepatitis?* ○ A. Arthralgia ○ B. Bilirubin 1 mg/dL ○ C. Ammonia 15 mcg/dL ○ D. Dark urine ○ E. Vision changes ○ F. Yellowing of the sclera ○ G. Fever ○ H. Loss of appetite

Select all the types of viral Hepatitis that have preventive vaccines available in the United States?* ○ A. Hepatitis A ○ B. Hepatitis B ○ C. Hepatitis C ○ D. Hepatitis D ○ E. Hepatitis E

Select all the ways a person can become infected with Hepatitis B:* ○ A. Contaminated food/water ○ B. During the birth process ○ C. IV drug use ○ D. Undercooked pork or wild game ○ E. Hemodialysis ○ F. Sexual intercourse

Somatropin, a growth hormone, is prescribed for a client. The nurse reviews the assessment data in the client's health record, knowing that the medication would be contraindicated for which client? a. A child with growth failure b. A child with pituitary dwarfism c. A 20-year-old with growth failure d. A child with growth hormone deficiency

What s/s of acute pancreatitis?

Sudden onset of nausea, vomiting, and left upper quadrant abdominal pain.

TRUE or FALSE: A patient with Hepatitis A is contagious about 2 weeks before signs and symptoms appear and 1-3 weeks after the symptoms appear.* ○ True ○ False

. Fill in the blank regarding the negative feedback loop for thyroid hormone production: The _________ produces TRH (Thyrotropin-Releasing Hormone) which causes the anterior pituitary gland to produce _______________ which in turn causes the thyroid gland to release _______ and _______. Thalamus, CRH (Corticotropin-releasing hormone) TSH (thyroid-stimulating hormone) and T4 Posterior pituitary gland, TSH (thyroid-stimulating hormone), T3 and T4 Hypothalamus, CRH (Corticotropin-releasing hormone), TSH (thyroid-stimulating hormone), T3 and TSH Hypothalamus, TSH (thyroid-stimulating hormone), T3 and T4

Thalamus, CRH (Corticotropin-releasing hormone) TSH (thyroid-stimulating hormone) and T4 Posterior pituitary gland, TSH (thyroid-stimulating hormone), T3 and T4 Hypothalamus, CRH (Corticotropin-releasing hormone), TSH (thyroid-stimulating hormone), T3 and TSH Hypothalamus, TSH (thyroid-stimulating hormone), T3 and T4

The anti-diuretic hormone is __________ in Diabetes Insipidus and _________ in SIADH.* ○ A. high, low ○ B. absent, absent ○ C. low, high ○ D. low, low

The client with hyperparathyroidism is taking alendronate. Which statements by the client indicate understanding of the proper way to take this medication? Select all that apply. a. "I should take this medication with food." b. "I should take this medication at bedtime." c. "I should sit up for at least 30 minutes after taking this medication." d. "I should take this medication first thing in the morning on an empty stomach." e. "I can pick a time to take this medication that best fits my lifestyle as long as I take it at the same time each day."

The client with pheochromocytoma is scheduled for surgery and says to the nurse, "I'm not sure that surgery is the best thing to do." Which statement is the appropriate response by the nurse? a. "There is no reason to worry. Your surgeon is wonderful." b. "I think you are making the right decision to have the surgery." c. "You are very ill. Your surgeon has made the correct decision." d. "You have concerns about the surgical treatment for your condition?"

The community health nurse has been asked to provide teaching to employees of a local restaurant about ways to reduce the incidence of hepatitis A after an outbreak of the disease was traced back to the restaurant. What should the nurse teach these employees to eliminate future outbreaks of the disease? #3 a. Test all new employees for hepatitis A antigen b. Use gloves for handling food if any cuts or scrapes are on hands c. Wash hands thoroughly before handling food and after using the bathroom d. Emphasize the need for all food handlers to be immunized against hepatitis A

The family of an older patient with hypothyroidism is concerned about the open wounds on the patient's legs and arms. How should the nurse respond to the family's questions about bathing? a. "Use warm water to bathe the patient." b. "Make sure bathing occurs daily." c. "Use firm, consistent strokes when bathing." d. "Follow the bath with a rubbing-alcohol massage."

The home care nurse visits a client with a diagnosis of hyperparathyroidism who is taking furosemide and provides dietary instructions to the client. Which statement by the client indicates a need for additional instruction? a. "I need to eat foods high in potassium." b. "I need to drink at least 2 to 3 L of fluid daily." c. "I need to eat small, frequent meals and snacks if nauseated." d. "I need to increase my intake of dietary items that are high in calcium."

The home health nurse is planning care for patient with hyperparathyroidism and osteoporosis. Which patient problem is the priority in this situation? a. The patient is fearful b. The patient is at risk for falls and other injury c. The patient does not want to go out in public d. The patient has low self-esteem

The liver receives blood from two sources. The _____________ is responsible for pumping blood rich in nutrients to the liver.* ○ A. hepatic artery ○ B. hepatic portal vein ○ C. mesenteric artery ○ D. hepatic iliac vein

The liver receives it blood supply from two sources. One of these sources is called the _________________, which is a vessel network that delivers blood _____________ in nutrients but ________ in oxygen.* ○ A. hepatic artery, low, high ○ B. hepatic portal vein, high, low ○ C. hepatic lobule, high, low ○ D. hepatic vein, low, high

The nurse assists a primary health care provider in performing a liver biopsy. After the procedure, the nurse should place the client in which position? a. Prone b. Supine c. Left side d. Right side

The nurse caring for a client with a diagnosis of hypoparathyroidism reviews the laboratory results of blood tests for this client and notes that the calcium level is extremely low. The nurse should expect to note which finding on assessment of the client? a. Unresponsive pupils b. Positive trousseau's signs c. Negative chvostek's signs

The nurse has been caring for a client who required a Sengstaken-Blakemore tube because other treatment measures for esophageal varices were unsuccessful. The primary health care provider (PHCP) arrives on the nursing unit and deflates the esophageal balloon. Which assessment finding by the nurse is the most important and should be reported to the PHCP immediately? a. Hematemesis b. Bloody diarrhea c. Swelling of the abdomen d. An elevated temperature and a rise in blood pressure

The nurse has developed a postoperative plan of care for a client who had a thyroidectomy and documents that the client is at risk for developing an ineffective breathing pattern. Which nursing intervention should the nurse include in the plan of care? a. Maintain a supine position b. Monitor neck circumference every 4 hours c. Maintain a pressure dressing on the operative sire d. Encourage deep-breathing exercises and vigorous coughing exercises.

The nurse has documented the problem of body image distortion for a client with a diagnosis of Cushing's syndrome. The nurse identifies nursing interventions related to this problem and includes these interventions in the plan of care. Which nursing intervention is inappropriate? a. Encourage the client's expression of feelings. b. Assess the client's understanding of the disease process c. Encourage family members to share their feelings about the disease process. d. Encourage the client to recognize that the body changes need to be dealt with.

The nurse has provided dietary instructions to a client with a diagnosis of hypoparathyroidism. The nurse should instruct the client that it is acceptable to include which item in the diet? a. Fish b. Cereals c. Vegetables d. Meat and poultry

The nurse has provided home care instructions to a client who had a subtotal gastrectomy. The nurse instructs the client on the signs and symptoms associated with dumping syndrome. Which client statement indicates that teaching was effective? a. "It will cause diaphoresis and diarrhea." b. "I have to monitor for hiccups and diarrhea." c. "It will be associated with constipation and fever." d. "I have to monitor for fatigue and abdominal pain."

The nurse has provided instructions to the client with hyperparathyroidism regarding home care measures to manage the symptoms of the disease. Which statement by the client indicates a need for further instruction? a. "I should avoid bed rest." b. "I need to avoid doing any exercise at all." c. "I need to space activity throughout the day. d. "I should gauge my activity level by my energy level."

The nurse instructs a patient with chronic hepatitis C about the disease process. Which patient statement indicates that teaching has been effective? #4 a. "I will avoid donating blood and will use barrier protection during sex" b. "I will reduce my alcohol intake and use only acetaminophen for pain relief" c. "Even though no treatment is available for this disease, I plan to live a long life" d. "I understand that I must return to the doctor every year for a follow-up liver biopsy"

The nurse is admitting a client diagnosed with pheochromocytoma. The client is complaining of a pounding headache and palpitations and the blood pressure is 170/90 mm Hg. The nurse is aware that which substance is responsible for these clinical manifestations? a. Cortisol b. Androgens c. Aldosterone d. Epinephrine

The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which primary health care provider prescriptions should the nurse anticipate receiving? Select all that apply. a. Initiate an infusion of 3% NaCl. b. Administer intravenous furosemide. c. Restrict fluids to 800 mL over 24 hours d. Elevate the head of the bed to high-Fowler's. e. Administer a vasopressin antagonist as prescribed.

The nurse is assessing a client who has a diagnosis of goiter. Which should the nurse expect to note during the assessment of the client? a. An enlarged thyroid gland b. The presence of heart damage c. Client complaints of chronic fatigue d. Client complaints of slow wound healing

The nurse is assessing a patient who has an abnormally high level of parathyroid hormone. Which assessment finding would be consistent with this diagnosis? Select All That Apply. a. Muscle atrophy b. Muscle weakness c. Diarrhea d. Weight gain e. Hypotension

The nurse is assessing a patient's deep tendon reflexes. For which endocrine disorder is this nurse assessing? a. Tetany b. Acromegaly c. Hyperthyroidism d. Cushing syndrome

The nurse is assessing the endocrine system of an older female patient. Which finding would the nurse attribute to aging? a. S1/S2 heart tones b. Decreased facial hair c. Thyroid nodules present d. Pituitary enlarged and firm

The nurse is assigned to care for a client with a Sengstaken-Blakemore tube. Which laboratory result is most focused on evaluating the effectiveness of this tube? a. Sodium b. Creatinine c. Hemoglobin d. Ammonia

The nurse is caring for a client admitted to the hospital with a suspected diagnosis of acute appendicitis. Which laboratory result should the nurse expect to note if the client does have appendicitis? a. Leukopenia with a shift to the left b. Leukocytosis with a shift to the left c. Leukopenia with a shift to the right d. Leukocytosis with a shift to the right

The nurse is caring for a client after thyroidectomy. The client expresses concern about the postoperative voice hoarseness she is experiencing and asks if the hoarseness will subside. The nurse should provide the client with which information? a. It indicates nerve damage b. The hoarseness is permanent c. It is normal during this time and will subside d. It will worsen before it subsides, which may take 6 months.

The nurse is caring for a client after thyroidectomy. The nurse notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed for which purpose? a. To treat thyroid storm b. To prevent cardiac irritability c. To treat hypocalcemic tetany d. To stimulate release of parathyroid hormone

The nurse is caring for a client who had a subtotal gastrectomy. The nurse should assess the client for which signs and symptoms of dumping syndrome? a. Diarrhea, chills, and hiccups b. Weakness, diaphoresis, and diarrhea c. Fever, constipation, and rectal bleeding d. Abdominal pain, elevated temperature, and weakness

The nurse is caring for a client who had intracranial surgery and is now suspected of having developed diabetes insipidus (DI). What initial prescription should the nurse expect from the primary health care provider (PHCP)? a. Serum electrolytes b. Urine specific gravity c. 24-hour fluid intake and output without restricting food or fluid intake d. Postoperative magnetic resonance imaging to detect any damage to the hypothalamus or pituitary gland

The nurse is caring for a client who has had an adrenalectomy and is monitoring the client for signs of adrenal insufficiency. Which signs and symptoms indicate adrenal insufficiency in this client? a. Hypotension and fever b. Mental status changes and hypertension c. Subnormal temperature and hypotension d. Complaints of weakness and hypertension

The nurse is caring for a client who is scheduled to have a thyroidectomy and provides instructions to the client about the surgical procedure. Which client statement indicates an understanding of the nurse's instructions? a. "I expect to experience some tingling of my toes, fingers, and lips after surgery." b. "I will definitely have to continue taking antithyroid medications after this surgery." c. "I need to place my hands behind my neck when I have to cough or change positions." d. "I need to turn my head and neck front, back, and laterally every hour for the first 12 hours after surgery."

The nurse is caring for a client with Addison's disease. The client asks the nurse about the risks associated with this disease, specifically about addisonian crisis. Regarding prevention of this complication, how should the nurse inform the client? a. "You can take either hydrocortisone or fludrocortisone for replacement." b. "You need to take your fludrocortisone 3 times a day to prevent a crisis." c. "You need to increase salt in your diet, particularly during stressful situations." d. "You need to decrease your dosages of glucocorticoids and mineralocorticoids during stressful situations."

The nurse is caring for a client with a diagnosis of Addison's disease and is monitoring the client for signs of Addisonian crisis. The nurse should assess the client for which manifestation that would be associated with this crisis? a. Agitation b. Diaphoresis c. Restlessness d. Severe abdominal pain

The nurse is caring for a client with a diagnosis of Cushing's syndrome. Which expected signs and symptoms should the nurse monitor for? Select all that apply. a. Anorexia b. Dizziness c. Weight loss d. Moon face e. Hypertension f. Truncal obesity

The nurse is caring for a client with a low thrombin level as a result of liver dysfunction. Based on this finding it is most important for the nurse to monitor the client for signs and symptoms of which potential complication? a. Bleeding b. Infection c. Dehydration d. Malnutrition

The nurse is caring for a client with a new diagnosis of hypothyroidism. Which clinical manifestations might the nurse expect to note on examination of this client? Select all that apply. a. Irritability b. Periorbital edema c. Coarse, brittle hair d. Slow or slurred speech e. Abdominal distension f. Soft, silky, thinning hair

The nurse is caring for a client with acute pancreatitis. Which medications should the nurse expect to be prescribed for treatment of this problem? Select all that apply. a. Insulin b. Morphine c. Dicyclomine d. Pancrelipase e. Pantoprazole f. acetazolamide

The nurse is caring for a client with altered protein metabolism as a result of liver dysfunction. Which finding should the nurse expect to note when reviewing the client's laboratory results? a. Increased lactase level b. Decreased albumin level c. Increased ammonia level d. Decreased lactic acid level

The nurse is caring for a client with cirrhosis of the liver. To minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the dietary measures to follow if the client states an intention to increase the intake of which food? a. Milk b. Chicken c. Broccoli d. Legumes

The nurse is caring for a client with cirrhosis. As part of dietary teaching to minimize the effects of the disorder, the nurse teaches the client about foods that are high in thiamine. The nurse determines that the client has the best understanding of the material if the client states to increase intake of which food? a. Pork b. Milk c. Chicken d. Broccoli

The nurse is caring for a patient after bariatric surgery. What is the nurse's priority for this patient? a. Nutritional intake b. Pain management c. Prevention of infection d. Airway management

The nurse is caring for a patient with elevated serum T3 and T4 levels who receives a new prescription for methimazole (Tapazole). Which patient statement indicates that additional teaching is needed about this medication? a. "This medication will increase my metabolism." b. "I must contact my physician if I plan to become pregnant." c. "It may take several weeks for this medication to take effect." d. "I may take a beta-blocker along with this medication."

The nurse is caring for a patient with elevated serum thyroid hormones and new-onset proptosis. Which problem would be a priority for this patient? a. Change in appearance b. Altered immunity c. Weight gain d. Fluid retention

The nurse is caring for a patient with newly diagnosed hypothyroidism. What should the nurse expect when assessing this patient's skin? a. Rough, dry skin b. Smooth, flushed skin c. Increased hair growth d. Cold and clammy skin

The nurse is caring for a postoperative client who has had an adrenalectomy. What should the nurse check for during the client's focused assessment? a. Peripheral edema b. Bilateral exophthalmos c. Signs and symptoms of hypovolemia d. Signs and symptoms of hypocalcemia

The nurse is completing an assessment on a client who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which client complaints would be characteristic of this disorder? Select all that apply. a. Polyuria b. Headache c. Bone pain d. Nervousness e. Weight gain

The nurse is conducting a health history with a patient that focuses on the endocrine system. Which questions should the nurse include in this assessment? Select All That Apply. a. "How did you get this scar on your leg?" b. "Have you noticed a change in your thirst?" c. "Do your children have problems with urination?" d. "When did you first notice the pain in your abdomen?" e. "Have you noticed that your rings feel tight?"

The nurse is developing a plan of care for a client who is scheduled for a thyroidectomy. The nurse focuses on psychosocial needs, knowing that which is likely to occur in the client? a. Infertility b. Gynecomastia c. Sexual dysfunction d. Body image changes

The nurse is developing a plan of care for a client with Addison's disease. The nurse has identified a problem of risk for deficient fluid volume and identifies nursing interventions that will prevent this occurrence. Which nursing interventions should the nurse include in the plan of care? Select all that apply. a. Monitor for changes in mentation. b. Encourage an intake of low-protein c. Encourage an intake of low-sodium foods. d. Encourage fluid intake of at least 3000 mL per day. e. Monitor vital signs, skin turgor, and intake and output.

The nurse is developing a plan of care for a client with Cushing's syndrome. The nurse documents a client problem of excess fluid volume. Which nursing actions should be included in the care plan for this client? Select all that apply. a. Monitor daily weight b. Monitor intake and output c. Assess extremities for edema d. Maintain a high-sodium diet e. Maintain a low-potassium diet

The nurse is developing a teaching plan for a client with viral hepatitis. The nurse should plan to include which information in the teaching session? a. The diet should be low in calories. b. Meals should be large to conserve energy. c. Activity should be limited to prevent fatigue. d. Alcohol intake should be limited to 2 ounces per day.

The nurse is explaining the process of bariatric surgery to a severely obese client who has attended a medically supervised weight loss program for approximately 6 months. The client is considering this procedure. What are some conditions that may interfere with a client's commitment to lifelong behavioral changes and that may lead to poor surgical outcomes? Select all that apply. a. Anxiety b. Untreated depression c. Binge eating disorders d. Drug and alcohol abuse e. Lack of family resources f. Inability to comply with nutritional recommendations

The nurse is identifying actual and potential problems for patients with obesity. Which problem is the priority for a patient with a BMI of 30.4 and a waist-to-hip ratio of 1:1? #6 a. Difficulty coping b. Insufficient knowledge regarding healthy diet choices c. Prior difficulty achieving weight loss goals d. Cardiac complications associated with obesity

The nurse is instructing a client with Cushing's syndrome on follow-up care. Which of these client statements would indicate a need for further instruction? a. "I should avoid contact sports." b. "I should check my ankles for swelling." c. "I need to avoid foods high in potassium." d. "I need to check my blood glucose regularly."

The nurse is interviewing a patient with hepatitis A. The nurse will ask assessment questions about which priority concerns? Select All That Apply. #5 a. Immunization status b. Sexual partners c. Close household contacts d. Food preparation activities e. Presence of blood in feces

The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which findings indicate this occurrence? a. Sweating and pallor b. Bradycardia and indigestion c. Double vision and chest pain d. Abdominal cramping and pain

The nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply. a. Insomnia b. Weight loss c. Bradycardia d. Constipation e. Mild heat intolerance

The nurse is monitoring a client with Graves' disease for signs of thyrotoxic crisis (thyroid storm). Which signs or symptoms, if noted in the client, will alert the nurse to the presence of this crisis? a. Fever and tachycardia b. Pallor and tachycardia c. Agitation and bradycardia d. Restlessness and bradycardia

The nurse is monitoring a client with cirrhosis of the liver for signs of hepatic encephalopathy. Which assessment finding would the nurse note as an early sign of hepatic encephalopathy? a. Restlessness b. Presence of asterixis c. Complaints of fatigue d. Decreased serum ammonia levels

The nurse is obtaining a health history for a client with chronic pancreatitis. The health history is most likely to include which as a mostcommon causative factor in this client's disorder? a. Weight gain b. Use of alcohol c. Exposure to occupational chemicals d. Abdominal pain relieved with food or antacids

The nurse is performing an assessment on a client with a diagnosis of Cushing's syndrome. Which should the nurse expect to note on assessment of the client? a. Skin atrophy b. The presence of sunken eyes c. Drooping on 1 side of the face d. A rounded "moonlike" appearance to the face

The nurse is performing an assessment on a client with a diagnosis of hyperthyroidism. Which assessment finding should the nurse expect to note in this client? a. Dry skin b. Bulging eyeballs c. Periorbital edema d. Coarse facial features

The nurse is performing an assessment on a client with a diagnosis of myxedema (hypothyroidism). Which assessment finding should the nurse expect to note in this client? a. Dry skin b. Thin, silky hair c. Bulging eyeballs d. Fine muscle tremors

The nurse is performing an assessment on a client with acute pancreatitis who was admitted to the hospital. Which assessment question would most specifically elicit information regarding the pain that is associated with acute pancreatitis? a. "Does the pain in your stomach radiate to your back?" b. "Does the pain in your lower abdomen radiate to your hip?" c. "Does the pain in your lower abdomen radiate to your groin?" d. "Does the pain in your stomach radiate to your lower middle abdomen?"

The nurse is performing an assessment on a client with pheochromocytoma. Which assessment data would indicate a potential complication associated with this disorder? a. A urinary output of 50 mL/hr b. A coagulation time of 5 minutes c. A heart rate that is 90 beats per minute d. A blood urea nitrogen level of 20 mg/dL

The nurse is performing an assessment on a client with suspected acute pancreatitis. Which complaint made by the client supports the diagnosis? a. "I have epigastric pain radiating to my neck." b. "I have severe abdominal pain that is relieved after vomiting." c. "My temperature has been running between 96º F (35.5º C) and 97º F (36.1º C)." d. "I've been experiencing constant, severe abdominal pain that is unrelieved by vomiting."

The nurse is performing discharge teaching for a client with chronic pancreatitis. Which information should the nurse include? a. Alcohol should be consumed in moderation. b. Avoid caffeine because it may aggravate symptoms. c. Diet should be high in carbohydrates, fats, and proteins. d. Frothy, fatty stools indicate that enzyme replacement is working.

The nurse is planning care for a patient scheduled for bariatric surgery. Which interventions should the nurse expect to be part of the patient's post-operative care? Select All That Apply. #4 a. Use of a continuous positive airway pressure (CPAP) device throughout the postoperative period. b. Need to monitor effects of anesthesia for a shorter period of time than with patients of normal weight c. Continuation of cardiac monitor into the postoperative period d. Reduction of normal amounts of postoperative analgesics to reduce change of respiratory depression e. Use of strict aseptic technique in all wound care activities

The nurse is preparing a client with a new diagnosis of hypothyroidism for discharge. The nurse determines that the client understands discharge instructions if the client states that which signs and symptoms are associated with this diagnosis? Select all that apply. a. Tremors b. Weight loss c. Feeling cold d. Loss of body hair e. Persistent lethargy f. Puffiness of the face

The nurse is preparing for a client's postoperative return to the unit after a parathyroidectomy procedure. The nurse should ensure that which piece of medical equipment is at the client's bedside? a. Cardiac monitor b. Tracheotomy set c. Intermittent gastric suction device d. Underwater seal chest drainage system

The nurse is preparing teaching for a patient diagnosed with Graves disease. What should the nurse explain about the etiology of this help problem? a. It is a genetic disorder b. It is caused by an allergy c. It occurs in response to an infection d. It develops as an autoimmune response

The nurse is preparing to assess a patient's thyroid gland. For which criteria is the nurse assessing this gland? a. Pain and pulse rate b. Size and consistency c. Character and texture d. Edema and movement

The nurse is preparing to care for a client after parathyroidectomy. The nurse should plan for which action for this client? a. Maintain an endotracheal tube for 24 hours. b. Administer a continuous mist of room air or oxygen. c. Place the client in a flat position with the head and neck immobilized. d. Use only a rectal thermometer for temperature measurement.

The nurse is preparing to discharge a client who has had a parathyroidectomy. The discharge instructions include medication administration of oral calcium supplements that the client will need daily. Which statement by the nurse would be most appropriateregarding the oral calcium supplement therapy? a. Take the tablets following a meal. b. Store the tablets in the refrigerator to maintain potency. c. Avoid sunlight because the medication can cause skin color changes. d. Check the pulse daily; if it is less than 60 beats/minute, do not take the tablets.

The nurse is providing care to a patient with a low level of serum parathyroid hormone. What should the nurse expect to assess in this patient? Select All That Apply. a. Brittle nails b. Abdominal cramps c. Hair loss d. Dysrhythmias e. Smooth, soft skin

The nurse is providing dietary instructions to a client hospitalized for pancreatitis. Which food should the nurse instruct the client to avoid? a. Chili b. Bagel c. Lentil soup d. Watermelon

The nurse is providing discharge instructions to a patient recovering from bariatric surgery. Which patient statements indicate diet teaching has been effective? Select All That Apply. #7 a. "I should drink fluids with meals to aid with digestion." b. "I should drink caffeinated carbonated liquids to aid with weight loss." c. ""I can eat anything that I want because weight loss will occur regardless of food intake." d. "I should eat four to six small meals each day that are low in fat, high in complex carbohydrates, and high in protein." e. "I should avoid foods that are high in simple carbohydrates."

The nurse is providing home care instructions to the client with a diagnosis of Cushing's syndrome and prepares a list of instructions for the client. Which instructions should be included on the list? Select all that apply. a. The signs and symptoms of hypoadrenalism b. The signs and symptoms of hyperadrenalism c. Instructions to take the medications exactly as prescribed d. The importance of maintaining regular outpatient follow-up care e. A reminder to read the labels on over-the-counter medications before purchase

The nurse is providing instructions to a client regarding measures to minimize the risk of dumping syndrome. The nurse should make which suggestion to the client? a. Maintain a high-carbohydrate diet b. Increase fluid intake, particularly at mealtime c. Maintain a low-fowler's position while eating d. Ambulate for at least 30 minutes following each meal

The nurse is providing instructions to a client with a diagnosis of Addison's disease regarding the administration of prescribed glucocorticoids. The nurse should provide which instruction to the client? a. To stop the medication if side effects occur b. To avoid taking the medication if nausea occurs c. That minimal side effects will occur with use of this medication d. That an increased dose of medication may be needed during times of stress

The nurse is providing preoperative teaching to a patient scheduled for a subtotal thyroidectomy. What should the nurse include in these instructions? a. Report sensations of tingling in toes, fingers, or lips. b. Report signs of constipation. c. Report the improvement of hoarseness. d. Take aspirin before the surgery.

The nurse is reviewing postoperative care for a patient scheduled for a thyroidectomy. What information should the nurse include in this teaching? a. "Avoid the use of iodized salt after your procedure." b. "Plastic surgery may be required to conceal the surgical scar." c. "Use iodized salt when preparing foods." d. "Perform neck flexion and extension exercises twice daily for several weeks postoperatively."

The nurse is reviewing the laboratory results for a client with cirrhosis and notes that the ammonia level is 85 mcg/dL (51 mcmol/L). Which dietary selection does the nurse suggest to the client? a. Roast pork b. Cheese omelet c. Pasta with sauce d. Tuna fish sandwich

The nurse is reviewing the laboratory test results for a client and notes that the albumin level is 3.0 g/dL (30 g/L). The nurse understands that this laboratory value would be noted in which condition? a. Diarrhea b. Dehydration c. Multiple myeloma d. Cirrhosis of the liver

The nurse is reviewing the laboratory test results for a client with a diagnosis of Cushing's syndrome. Which laboratory finding would the nurse expect to note in this client? a. A platelet count of 200,000 mm3 (200 × 109/L) b. A blood glucose level of 99 mg/dL (5.5 mmol/L) c. A potassium (K+) level of 3.0 mEq/L (3.0 mmol/L) d. A white blood cell (WBC) count of 6000 mm3 (6 × 109/L)

The nurse is reviewing the prescription for a client admitted to the hospital with a diagnosis of acute pancreatitis. Which interventions would the nurse expect to be prescribed for the client? Select all that apply. a. Maintain NPO (nothing by mouth) status b. Encourage coughing and deep breathing c. Give small, frequent high-calorie feedings d. Maintain the client in a supine and flat position e. Give hydromorphone intravenously as prescribed for pain f. Maintain intravenous fluids at 10 mL/hr to keep the vein open.

The nurse is reviewing the primary health care provider's prescriptions written for a client admitted to the hospital with acute pancreatitis. Which prescription requires follow-up by the nurse? a. Full liquid diet b. Morphine sulfate for pain c. Nasogastric tube insertion d. An anticholinergic medication

The nurse is reviewing the record of a client admitted to the hospital with a diagnosis of pheochromocytoma. The nurse reads the assessment findings and expects to note documentation of which major symptom associated with this condition? a. Glycosuria b. Diaphoresis c. Weight loss d. Hypertension

The nurse is reviewing the record of a client admitted to the nursing unit and notes that the client has a history of Laënnec's cirrhosis. Which question related to the client's history would be most important to ask? a. "Do you abuse alcohol?" b. "Do you have any known cardiac disease?" c. "Does your type of employment cause you to have exposure to chemicals?" d. "Have you ever been told that you have had obstruction to your biliary ducts?"

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for its presence? a. Dorsiflex the client's foot b. Measure the abdominal girth c. Ask the client to extend the arms d. Instruct the client to lean forward

The nurse is reviewing the results of serum laboratory studies for a client admitted for suspected hepatitis. Which laboratory finding is most associated with hepatitis, requiring the nurse to contact the primary health care provider? a. Elevated serum bilirubin level b. Below normal hemoglobin concentration c. Elevated BUN level d. Elevated erythrocyte sedimentation rate

The nurse is taking a health history for a client with hyperparathyroidism. Which question would elicit information about this client's condition? a. "Do you have tremors in your hands? b. "Are you experiencing pain in your joints?" c. "Do you notice swelling in your legs at night?" d. "Have you had problems with diarrhea lately?"

The nurse is teaching a client with hyperparathyroidism how to manage the condition at home. Which response by the client indicates the need for additional teaching? a. "I should consume less than 1 liter of fluid per day." b. "I should use my treadmill or go for walks daily." c. "I should follow a moderate-calcium, high-fiber diet." d. "My alendronate helps keep calcium from coming out of my bones."

The nurse is teaching a patient with Addison disease about the disease process. Which statement illustrates that the patient understands the teaching? a. "I wonder why I look tan all the time" b. "I know I should never alter my dose of medications." c. "I have purchased an emergency kit and keep it with me all the time." d. "I will be sure to stop taking my medications when I have an infection."

The nurse is teaching the client with viral hepatitis about the stages of the disease. The nurse should explain to the client that the second stage of this disease is characterized by which specific assessment findings? Select all that apply. a. Jaundice b. Flu-like symptoms c. Clay-colored stools d. Elevated bilirubin levels e. Dark or tea-colored urine

The nurse is teaching the patient with cirrhosis about lactulose therapy. Which statement by the patient indicates the teaching has been effective? a. "This therapy will promote the removal of ammonia in my stool" b. "Constipation is a frequent side effect of this medication." c. "I will know the therapy is working when I am less itchy." d. "The drug tastes bitter and is watery."

The nurse manager is providing an educational session to nursing staff members about the phases of viral hepatitis. The nurse manager tells the staff that which clinical manifestation(s) are primary characteristics of the preicteric phase? a. Pruritus b. Right upper quadrant pain c. Fatigue, anorexia, and nausea d. Jaundice, dark-colored urine, and clay-colored stools

The nurse notes that a patient has a low calcium level and plans to assess for Chvostek sign. How will the nurse conduct this assessment? Select All That Apply. a. Depress the skin over the shin b. Pinch a fold of skin over the sternum c. Tap a finger in front of the patient's ear d. Inflate a blood pressure cuff above the antecubital space e. Observe for facial grimacing

The nurse provides education to the client with hyperthyroidism about potassium iodide before medication administration. The client is scheduled for a subtotal thyroidectomy. Which response by the client indicates understanding? a. "It replaces thyroid hormone." b. "It prevents iodine absorption." c. "It increases thyroid hormone." d. "It suppresses thyroid hormone."

The nurse provides instructions to a client who is taking levothyroxine. The nurse should tell the client to take the medication in which way? a. With food b. At lunchtime c. On an empty stomach d. At bedtime with a snack

The nurse reviews the laboratory tests prescribed for a patient. Changes in which laboratory value would indicate a change in the patient's thyroid gland? a. GH b. TSH c. FBS d. Aldosterone

The nurse should include which interventions in the plan of care for a client with hyperthyroidism? Select all that apply. a. Provide a warm environment for the client. b. Instruct the client to consume a low-fat diet. c. A thyroid-releasing inhibitor will be prescribed. d. Encourage the client to consume a well-balanced diet. e. Instruct the client that thyroid replacement therapy will be needed. f. Instruct the client that episodes of chest pain are expected to occur.

The nurse should include which interventions in the plan of care for a client with hypothyroidism? Select all that apply. a. Provide a cool environment for the client. b. Instruct the client to consume a high-fat diet. c. Instruct the client about thyroid replacement therapy d. Encourage the client to consume fluids and high-fiber foods in the diet. e. Inform the client that iodine preparations will be prescribed to treat the disorder f. Instruct the client to contact the primary health care provider (PHCP) if episodes of chest pain occur

The nurse should incorporate which in the dietary plan to ensure optimal nutrition for the client during the acute phase of hepatitis? Select all that apply. a. Select foods high in protein content. b. Consume multiple small meals throughout the day. c. Select foods low in carbohydrates to prevent nausea. d. Allow the client to select foods that are most appealing. e. Eliminate fatty foods from the meal trays until nausea subsides. f. Eat a nutritious dinner because it is typically the best tolerated meal of the day.

The nurse should tell the client who is taking levothyroxine to notify the primary health care provider (PHCP) if which problem occurs? a. Fatigue b. Tremors c. Cold intolerance d. Excessively dry skin

The nurse suspects that a patient with syndrome of inappropriate antidiuretic hormone secretion is experiencing hyponatremia. Which manifestation of hyponatremia did the nurse most likely assess? Select All That Apply. a. Irritability b. Weight loss c. Constipation d. Hyperkalemia e. Lethargy

The nurse teaches the client who is newly diagnosed with diabetes insipidus about the prescribed intranasal desmopressin. Which statements by the client indicate understanding? Select all that apply. a. "This medication will turn my urine orange." b. "I should decrease my oral fluids when I start this medication c. "The amount of urine I make should increase if this medicine is working." d. "I need to follow a low-fat diet to avoid pancreatitis when taking this medicine." e. "I should report headache and drowsiness to my doctor since these symptoms could be related to my desmopressin."

The nurse who is caring for a client with a diagnosis of cirrhosis is monitoring the client for signs of portal hypertension. Which finding should the nurse interpret as a sign or symptom of portal hypertension? a. Flat neck veins b. Abdominal distention c. Hemoglobin of 14.2 g/dL d. Platelet count of 600,000 mm3

The nursing instructor asks a nursing student to identify the risk factors associated with the development of thyrotoxicosis. The student demonstrates understanding of the risk factors by identifying an increased risk for thyrotoxicosis in which client? a. A client with hypothyroidism b. A client with Grave's disease who is having surgery c. A client with diabetes mellitus scheduled for a diagnostic test d. A client with diabetes mellitus scheduled for debridement of a foot ulcer.

The physician orders Lactulose 30 mL by mouth per day for a patient with cirrhosis. What findings below demonstrates the medication is working effectively? Select all that apply:* ○ A. Decrease albumin levels ○ B. Decrease in Fetor Hepaticus ○ C. Patient is stuporous. ○ D. Decreased ammonia blood level ○ E. Presence of asterixis

The physician orders a patient with pancreatitis to take a pancreatic enzyme. What assessment finding demonstrates the pancreatic enzymes are working properly? Abdominal girth is decreased, Blood glucose is 250, Skin turgor is less than 2 seconds, Stools appear formed and solid

The physician orders a patient with pancreatitis to take a pancreatic enzyme. What assessment finding demonstrates the pancreatic enzymes are working properly?* ○ A. Abdominal girth is decreased ○ B. Skin turgor is less than 2 seconds ○ C. Blood glucose is 250 ○ D. Stools appear formed and solid

The primary health care provider has determined that a client has contracted hepatitis A based on flu-like symptoms and jaundice. Which statement made by the client supports this medical diagnosis? a. "I have had unprotected sex with multiple partners." b. "I ate shellfish about 2 weeks ago at a local restaurant." c. "I was an intravenous drug abuser in the past and shared needles." d. "I had a blood transfusion 30 years ago after major abdominal surgery."

The thyroid hormones, T3 and T4, play many roles in the human body. Which of the following functions are performed by T3 and T4? Note: Select all that apply* ○ A. Storing calories ○ B. Increasing the Heart Rate ○ C. Stimulating the Sympathetic Nervous System ○ D. Decreasing the body's temperature ○ E. Regulating TSH produced by the anterior pituitary gland

This medication is used to treat hyperparathyroidism in patients with chronic renal failure. It works by mimicking the role of calcium in the blood and tricks the parathyroid gland into stop secreting PTH (parathyroid hormone). Which of the following medications does this describe below?* ○ A. Calcitonin ○ B. Fosamax ○ C. Lasix ○ D. Sensipar

Three days after gastric bypass surgery, a patient complains of increasing abdominal pain. Bowel sounds are absent and the abdomen is firm and very tender. What should the nurse do first? #10 a. Discuss the findings with the surgeon b. Evaluate the effectiveness of analgesia c. Ambulate the patient to promote peristalsis d. Chart assessment data and continue to monitor

What is the BEST preventive measure to take to help prevent ALL types of viral Hepatitis?* ○ A. Vaccination ○ B. Proper disposal of needles ○ C. Hand hygiene ○ D. Blood and organ donation screening

What is the MOST common transmission route of Hepatitis C?* ○ A. Blood transfusion ○ B. Sharps injury ○ C. Long-term dialysis ○ D. IV drug use

When admitting a patient with cirrhosis, the nurse assesses for which conditions as possible complications of the disease? Select All That Apply. a. Ascites b. Bleeding esophageal varices c. Hepatrorenal syndrome d. Coagulation defects e. Portal hypertensive gastropathy

When teaching the client with adrenal insufficiency about cortisone, the nurse should include which items? Select all that apply. a. Increase intake of sodium. b. Take the medication with food. c. Increase intake of potassium-rich foods. d. Stay away from people with active infections. e. Discontinue the medication when symptoms subside. f. Notify the primary health care provider if illness occurs or surgery is anticipated.

Where is the anti-diuretic hormone PRODUCED in the body?* ○ A. Anterior pituitary gland ○ B. Posterior pituitary gland ○ C. Hypothalamus ○ D. Medulla

Where is the anti-diuretic hormone SECRETED in the body?* ○ A. Hypothalamus ○ B. Thyroid ○ C. Posterior Pituitary gland ○ D. Anterior pituitary gland

Which condition is NOT a known cause of cirrhosis?* ○ A. Obesity ○ B. Alcohol consumption ○ C. Blockage of the bile duct ○ D. Hepatitis C ○ E. All are known causes of cirrhosis

Which findings should raise suspicion to the nurse that a head-injured client may be experiencing diabetes insipidus? Select all that apply. a. Urine specific gravity is 1.001 b. Ketones are present in the urine c. Jugular venous distention is observed d. Serum osmolality is 320 mOsm/kg e. Blood glucose levels are greater than 200mg/dL f. Urine output has increased from 1000mL in 24 hours to 4000 mL in 24 hours

Which of the following are treatment options for hyperthyroidism? Please select all that apply:* ○ A. Thyroidectomy ○ B. Methimazole ○ C. Liothyronine Sodium "Cytomel" ○ D. Radioactive Iodine

Which of the following is NOT a common source of transmission for Hepatitis A? Select all that apply:* ○ A. Water ○ B. Food ○ C. Semen ○ D. Blood

Which of the following is not a typical sign and symptom of Cushing's Syndrome?* ○ A. Hyperpigmentation of the skin ○ B. Hirsutism ○ C. Purplish striae ○ D. Moon Face

Which of the following signs and symptoms causes concern and requires nursing intervention for a patient who recently had a thyroidectomy?* ○ A. Heart rate of 120, blood pressure 220/102, temperature 103.2 'F ○ B. Heart rate of 35, blood pressure 60/43, temperature 95.3 'F ○ C. Soft hair, irritable, diarrhea ○ D. Constipation, drowsiness, goiter

Which of the following signs and symptoms is NOT expected with Diabetes Insipidus?* ○ A. Polyuria ○ B. Polydipsia ○ C. Polyphagia ○ D. Extreme thirst

Which patient below is at MOST risk for CHRONIC pancreatitis?* ○ A. A 25 year old female with a family history of gallstones. ○ B. A 35 year old male who reports social drinking of alcohol. ○ C. A 15 year old female with cystic fibrosis. ○ D. A 66 year old female with stomach cancer.

Which patient below is at MOST risk for developing a complication related to a Hepatitis E infection?* ○ A. A 45-year-old male with diabetes. ○ B. A 26-year-old female in the 3rd trimester of pregnancy. ○ C. A 12-year-old female with a ventricle septal defect. ○ D. A 63-year-old male with cardiovascular disease.

Which patient is most at risk for developing Syndrome of Inappropriate Anti-diuretic Hormone (SIADH)?* ○ A. A patient diagnosed with small cell lung cancer. ○ B. A patient whose kidney tubules are failing to reabsorb water. ○ C. A patient with a tumor on the anterior pituitary gland. ○ D. A patient taking Declomycin.

Which patient is most likely to experience secondary hyperparathyroidism? A 56 year-old male with a magnesium level of 0.5 mg/dL A 69 year-old female with an adenoma on the parathyroid gland A 58 year-old male with chronic renal failure A 7 year-old with diabetes type 1

Which patients below are at risk for developing complications related to a chronic hepatitis infection, such as cirrhosis, liver cancer, and liver failure? Select all that apply:* ○ A. A 55-year-old male with Hepatitis A. ○ B. An infant who contracted Hepatitis B at birth. ○ C. A 32-year-old female with Hepatitis C who reports using IV drugs. ○ D. A 50-year-old male with alcoholism and Hepatitis D. ○ E. A 30-year-old who contracted Hepatitis E.

Which people are in need of immunization against hepatitis B (HBV)? Select All That Apply. a. People who have unprotected sex with more than one partner b. People with any chronic liver disease c. Firefighters and police officers d. Healthcare professionals

Which statements are INCORRECT regarding the anatomy and physiology of the liver? Select all that apply:* ○ A. The liver has 3 lobes and 8 segments. ○ B. The liver produces bile which is released into the small intestine to help digest fats. ○ C. The liver turns urea, a by-product of protein breakdown, into ammonia. ○ D. The liver plays an important role in the coagulation process.

While assessing a patient with an alteration in thyroid function, the nurse notes smooth, fine hair and warm, dry skin. Which question should the nurse ask this patient? a. "Have you experienced any recent weight loss?" b. "Have you been feeling constipated?" c. "Have you noticed increased bruising?" d.. "Have you noticed a change in your skin color?"

While assisting a patient with chronic pancreatitis to the bathroom, you note the patient's stool to be oily/greasy in appearance. In your documentation you note this as:* ○ A. Steatorrhea ○ B. Melena ○ C. Currant ○ D. Hematochezia

While providing mouth care to a patient with late-stage cirrhosis, you note a pungent, sweet, musty smell to the breath. This is known as:* ○ A. Metallic Hepatico ○ B. Fetor Hepaticus ○ C. Hepaticoacidosis ○ D. Asterixis

While reviewing a medication list, the nurse learns that a new patient has taken cortisone as treatment for rheumatoid arthritis for several years. The nurse increases assessment for which endocrine disorder? a. Acromegaly b. Hypothyroidism c. Hyperthyroidism d. Cushing syndrome

While reviewing the medical history, the nurse determines a patient at risk for obesity. Which findings contribute to the nurse's assessment? Select All That Apply. a. The patient's identical twin has a BMI of 27.8 b. The patient lists computer gaming as a major source of enjoyment c. The patient takes medication for depression d. The patient eaats most meals at home e. The patient rarely watches television

You are developing a care plan for a patient with SIADH. Which of the following would be a potential nursing diagnosis for this patient?* ○ A. Fluid volume overload ○ B. Fluid volume deficient ○ C. Acute pain ○ D. Impaired skin integrity

You are performing discharge teaching with a patient who is going home on Synthroid. Which statement by the patient causes you to re-educate the patient about this medication?* ○ A. "I will take this medication at bedtime with a snack." ○ B. "I will never stop taking the medication abruptly." ○ C. "If I have palpitations, chest pain, intolerance to heat, or feel restless, I will notify the doctor." ○ D. "I will not take this medication at the same time I take my Carafate."

You are providing discharge teaching to a patient who is prescribed calcium supplements with vitamin D for treatment of hypoparathyroidism. Which of the following statements by the patient warrants you to re-educate the patient on how they should take this medication?* ○ A. "I will also make sure I eat foods rich in calcium, such as dairy and green leafy vegetables while I'm taking this medication." ○ B. "A side effect of this medication is constipation. Therefore, I should drink plenty of fluids." ○ C. "I will take my calcium supplements in the morning when I take my Synthroid." ○ D. All the statements above are correctly stated by the patient.

You are receiving shift report on a patient with cirrhosis. The nurse tells you the patient's bilirubin levels are very high. Based on this, what assessment findings may you expect to find during your head-to-toe assessment? (Select all that apply) Frothy light-colored urine Dark brown urine Dark brown stool Yellowing of the sclera Jaundice of the skin

You are receiving shift report on a patient with cirrhosis. The nurse tells you the patient's bilirubin levels are very high. Based on this, what assessment findings may you expect to find during your head-to-toe assessment? Select all that apply:* ○ A. Frothy light-colored urine ○ B. Dark brown urine ○ C. Yellowing of the sclera ○ D. Dark brown stool ○ E. Jaundice of the skin ○ F. Bluish mucous membranes

You're caring for a 45 year old patient who is admitted with suspected acute pancreatitis. The patient reports having extreme mid-epigastric pain that radiates to the back. The patient states the pain started last night after eating fast food. As the nurse, you know the two most common causes of acute pancreatitis are:* ○ A. High cholesterol and alcohol abuse ○ B. History of diabetes and smoking ○ C. Pancreatic cancer and obesity ○ D. Gallstones and alcohol abuse

You're caring for a 45 year old patient who is admitted with suspected acute pancreatitis. The patient reports having extreme mid-epigastric pain that radiates to the back. The patient states the pain started last night after eating fast food. What are the two most common causes of acute pancreatitis? Gallstones and alcohol abuse High cholesterol and alcohol abuse History of diabetes and smoking Pancreatic cancer and obesity

You're providing an in-service to new nurse graduates about esophageal varices in patients with cirrhosis. You ask the graduates to list activities that should be avoided by a patient with this condition. Which activities listed are correct: Select all that apply* ○ A. Excessive coughing ○ B. Sleeping on the back ○ C. Drinking juice ○ D. Alcohol consumption ○ E. Straining during a bowel movement ○ F. Vomiting

You're providing education to a patient with an active Hepatitis B infection. What will you include in their discharge instructions? Select all that apply:* ○ A. "Take acetaminophen as needed for pain." ○ B. "Eat large meals that are spread out through the day." ○ C. "Follow a diet low in fat and high in carbs." ○ D. "Do not share toothbrushes, razors, utensils, drinking cups, or any other type of personal hygiene product." ○ E. "Perform aerobic exercises daily to maintain strength."

Your patient with acute pancreatitis is scheduled for a test that will use a scope to assess the pancreas, bile ducts, and gallbladder. The patient asks you, "What is the name of the test I'm going for later today?" You tell the patient it is called:* ○ A. MRCP ○ B. ERCP ○ C. CT scan of the abdomen ○ D. EGD

Your patient with cirrhosis has severe splenomegaly. As the nurse you will make it priority to monitor the patient for signs and symptoms of? Select all that apply:* ○ A. Thrombocytopenia ○ B. Vision changes ○ C. Increased PT/INR ○ D. Leukopenia

What is hyperpituitarism?

gigantism abnormally tall acromegaly bones of the hands and feet grow rapidly enlarged forehead and irregular menses

Following a transsphenoidal hypophysectomy nurse notices leakage from the patient's nose, what is the called

halo sign

What are s/s of thyroid storm?

hyperthermia, tachycardia, agitation, restlessness, tremors, seizures, abdominal pain, n/v

the nurse is caring for a hospitalized client with pancreatitis. Which findings should the nurse look for and expect to note when reviewing the laboratory results? Select all that apply. a. Elevated lipase level b. Elevated lactase level c. Elevated trypsin level d. Elevated amylase level e. Elevated sucrase level

exam 6

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