Metabolism

After administering desmopressin to a client with diabetes insipidus, which would the nurse identify as indicating drug effectiveness?

Decreased reports of thirst

A client with Parkinson's disease is hospitalized on a medical unit. The nurse would be correct in identifying which neurotransmitter decreased in this disease?

Dopamine

Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes melitus. Which of the following explains the cause of this secondary diabetes?

Dysfunction of the pancreatic islet cells

A group of students is reviewing material about endocrine system function. The students demonstrate understanding of the information when they identify which of the following as secreted by the adrenal medulla?

Epinephrine

Which of the following would the nurse expect to find in a client with severe hyperthyroidism?

Exophthalmos

A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which symptom when caring for this client?

Hypoglycemia

A patient with diabetes is prescribed propranolol (Inderal). For what should the patient be assessed?

Hypoglycemia

Which of the following is inconsistent as a condition related to metabolic syndrome?

Hypotension

The circular layer of smooth muscle that lies between the stomach and the small intestine is called:

Pyloric sphincter

A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?

Random blood glucose 85 mg/dL (4.72 mmol/L)

Which is a gastrointestinal route for administration of analgesics?

Rectal

A group of students is reviewing for a test on hormones. The students demonstrate understanding of the material when they state which of the following as being secreted by the kidneys?

Renin

A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to:

immature liver and kidney function in infants and children.

An infant's antiseizure medication has been prescribed after careful consideration of the unique pharmacokinetics among this population. What characteristic of neonates has the greatest bearing on drug metabolism?

immaturity of the infant's liver

Penicillin causes bacterial cell death without disrupting normal human cell functioning. This is an example of:

selective toxicity.

A 2-year-old client and the parents are at the office for a follow-up visit. The client has had excessive hormone levels in the recent blood work, and the parents question why this was not found sooner. Which response by the nurse would be most appropriate?

"As endocrine functions become more stable throughout childhood, alterations become more apparent."

A client is diagnosed with Addison disease. What statement by the client indicates an understanding of the discharge instructions by the nurse?

"I will have to take my medication for the rest of my life."

A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement by the client indicates the need for additional discharge teaching?

"I will increase my fluid and calcium intake."

A nurse is teaching a client recovering from diabetic ketoacidosis (DKA) about management of "sick days." The client asks the nurse why it is important to monitor the urine for ketones. Which statement is the nurse's best response?

"Ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. Ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy."

A 70-year-old male client asks why he is receiving a lower dose of zaleplon than his son. As part of the nurse's teaching plan, which explanation will the nurse give this client?

"Older adults metabolize the drug more slowly, and half-lives are longer than in younger adults."

The parents of a client with cystic fibrosis ask the nurse why supplemental pancreatic enzymes are needed. What is the best response by the nurse?

"Pancreatic enzymes promote absorption of nutrients and fat."

The parents of a male child who has been exposed to chronic stress are concerned about the long-term effects that may develop. The best response by the nurse would be:

"Prolonged stress may lead to suppression of growth hormone."

During prenatal education classes, a woman asks the nurse if she can continue her exercise program of going to the gym 3 to 5 times a week for cardio and a yoga class 1 to 2 times a week. Which information might the educator provide in terms of keeping blood sugar level adequate throughout the workout?

"Try to eat a protein and complex carb like cheese on wheat crackers before exercise."

A patient who is 6 months' pregnant was evaluated for gestational diabetes mellitus. The doctor considered prescribing insulin based on the serum glucose result of:

138 mg/dL, 2 hours postprandial.

Which pediatric assessment finding would the nurse recognize as an example of precocious puberty?

A 7-year-old female with early menarche

A group of students are reviewing material in preparation for a test on the male and female breasts. The students demonstrate understanding of the material when they identify which of the following?

A primary function of the female breast is to produce milk.

The mother of 6-year-old male and female fraternal twins has brought her son to see a pediatrician because he is nearly 4 inches shorter than his sister. Which phenomenon would the physician most likely suspect as contributing factor to the boy's short stature?

A shortage of hypothalamic GHRH production

An individual is considered obese when their BMI is what value?

30-39

A client has been prescribed a protein intake of 0.6 g/kg of body weight. The client weighs 154 pounds. The nurse calculates the daily protein intake to be how many grams? Enter the correct number ONLY.

42

The nurse is working in a pediatric clinic. Which child would the nurse recognize as having isosexual precocious puberty?

A 5-year-old black female with developing breasts and pubic hair

A client with multiple pain-related injuries to the back, knees, and hips is admitted with acute liver failure. Upon procuring a medication list, the nurse notes that the client is taking several over-the-counter medications that contain a preparation known to be the drug that most commonly causes liver failure. Which drug is this?

Acetaminophen

The nurse is assessing a male client and finds abnormally large hands and feet, a bulbous nose, and a broad face with a protruding jaw. Based on these findings, which endocrine abnormality is most likely the cause for these physical changes?

Acromegaly

A primary health care provider has prescribed levothyroxine to a client with hypothyroidism. Which information would the nurse include in the teaching plan to promote an optimal response to the drug therapy?

Administer the drug early in the morning before breakfast.

A client with type 1 diabetes presents with a decreased level of consciousness and a fingerstick glucose level of 39 mg/dl. His family reports that he has been skipping meals in an effort to lose weight. Which nursing intervention is most appropriate?

Administering 1 ampule of 50% dextrose solution, per physician's order

Which of the following describes a total absence of pigment melanin?

Albinism

A patient is suspected of having a pheochromocytoma and is having diagnostic tests done in the hospital. What symptoms does the nurse recognize as most significant for a patient with this disorder?

Blood pressure varying between 120/86 and 240/130 mm Hg

The nurse has completed an assessment on a 1-day-old newborn. Which finding should the nurse prioritize?

Blood sugar 42 mg/dL

Surgical removal of the thyroid gland is the treatment of choice for thyroid cancer. During the immediate postoperative period, the nurse knows to evaluate serum levels of __________ to assess for a serious and primary postoperative complication of thyroidectomy.

Calcium

Which statement is true concerning the digestion of carbohydrates?

Carbohydrates are broken down into monosaccharides before being absorbed.

A 70-year-old female client comes to the clinic with back pain. An x-ray reveals vertebral fractures and she is diagnosed with osteoporosis. Which factor most likely contributed to her condition?

Decreased estrogen levels

A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority?

Decreased cardiac output

More patients experience hyperthyroidism than hypothyroidism.

False

Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur?

Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen

The nurse is appraising the laboratory results of a pregnant client who is in her second trimester and notes the following: TSH slightly elevated, glucose in the urine, complete blood count low normal, and normal electrolytes. The nurse prioritizes further testing to rule out which condition?

Gestational diabetes

The nurse is caring for a client who received regular insulin at 7 am. Four hours later the nurse finds the client diaphoretic, cool, and clammy. Which of these interventions is the priority?

Give the client a concentrated carbohydrate.

A nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. To reverse hypoglycemia, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand?

Glucagon

A nursing student is reviewing for an upcoming anatomy and physiology examination. Which of the following would the student correctly identify as a function of the liver? Select all that apply.

Glucose metabolism Ammonia conversion Protein metabolis

A patient is diagnosed with Addison's disease, a condition that results in insufficient production of cortisol. Which of the following is the most important function of cortisol that the nurse needs to consider when caring for a patient with Addison's disease?

Helps the body adjust to stress

A type 2 diabetic is ordered metformin (Glucophage) as part of the management regime. Which is the best nursing explanation for the action of this drug in controlling glucose levels?

Helps tissues use insulin more efficiently

When caring for the client with acute pancreatitis, which alterations does the nurse recognize is consistent with the disease?

Hyperglycemia

You are admitting an insulin-dependent patient to the same-day surgical suite for carpal tunnel surgery. You know that this patient may be at risk for which metabolic disorder?

Hyperglycemia

A client has returned to the floor after having a thyroidectomy for thyroid cancer. The nurse knows that sometimes during thyroid surgery the parathyroid glands can be injured or removed. What laboratory finding may be an early indication of parathyroid gland injury or removal?

Hypocalcemia

A student nurse is preparing a plan of care for a client with chronic pancreatitis. What nursing diagnosis related to the care of a client with chronic pancreatitis is the priority?

Impaired nutrition: less than body requirements

The client with chronic kidney disease asks the nurse why he must take active vitamin D (calcitriol) as a medication. What is the most appropriate response by the nurse?

In renal disease, vitamin D is unable to be transformed to its active form.

Which condition is a sympathetic-adrenal medullary response to stress?

Increased heart rate

When caring for a client with hepatitis B, the nurse should monitor closely for the development of which finding associated with a decrease in hepatic function?

Irritability and drowsiness

Which statement is correct regarding glargine insulin?

It cannot be mixed with any other type of insulin.

The liver has many jobs. One of the most important functions of the liver is to cleanse the portal blood of old and defective blood cells, bacteria in the bloodstream, and any foreign material. Which cells in the liver are capable of removing bacteria and foreign material from the portal blood?

Kupffer cells

The two major classifications of diabetes are type 1 and type 2. What is a distinguishing characteristic of type 1 diabetes?

Lifelong exogenous insulin is required.

A client has monthly laboratory tests done. The nurse notes a decrease in the albumin level. What condition in the client's history could alter the albumin level?

Liver disease

A nurse is assessing a patient's urinary output as an indicator of diabetes insipidus. The nurse knows that an hourly output of what volume over 2 hours may be a positive indicator?

More than 200 mL/h

A patient who is diagnosed with type 1 diabetes would be expected to:

Need exogenous insulin.

What is the most common mechanism of hormone control?

Negative feedback

The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body?

Negative feedback loop

When thyroxine (T4) in the thyroid is low, it triggers the pituitary to increase thyroid stimulating hormone (TSH), which then increases T4 secretion. This is an example of which of the following?

Negative feedback mechanism

A client has a fever that was induced by damage to the hypothalamus due to intercranial bleeding. The nurse plans care for which type of fever?

Neurogenic

The nurse is learning about mitochondrial DNA mutations. She learns that they generally affect which tissues and organs?

Neuromuscular

A nurse, working in a health clinic, treats a variety of conditions on a daily basis. One disorder that is rapidly increasing and is the leading cause of secondary morbidity is:

Obesity

Which action would be appropriate when evaluating a client's neck for thyroid enlargement?

Palpate the thyroid gland gently.

Which gland is often referred to as the master gland because it secretes many hormones?

Pituitary

A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?

Serum glucose level of 52 mg/dl

Select the screening procedure performed on newborns to decrease the risk of intellectual disability and compromised neurological development.

Serum phenylalanine test

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

Stimulation of calcium reabsorption and phosphate excretion

A client is receiving a thyroid hormone to treat hypothyroidism. Which would indicate to the nurse that the client needs a reduced dosage of the drug?

Tachycardia

The nurse is caring for a patient with hyperthyroidism who suddenly develops symptoms related to thyroid storm. What symptoms does the nurse recognize that are indicative of this emergency?

Temperature of 102ºF

With the aging male, many changes are measurable. The measurable changes in the reproductive system of the older male are particularly attributable to which hormone?

Testosterone hormone

When a client asks why some body fat is good, the nurse responds based on what fact?

The body stores energy in adipose tissue.

A client is managing diabetes with exercise and diet. The health care provider reviews the client's most recent laboratory results: fasting blood glucose level at 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (0.05). Select the response that best identifies the client.

The client is achieving normal glycemic control.

The nurse is educating a newly diagnosed client with Hashimoto thyroiditis who is to be discharged from the acute care facility. What should the nurse be sure to include in the education to prevent complications?

The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.

A client is scheduled for a diagnostic test to measure blood hormone levels. The nurse expects that this test will determine which of the following?

The functioning of endocrine glands

A 51-year-old male has been diagnosed with alcohol-induced liver disease. He admits to the nurse he does not understand what the liver does in the body. Which of these statements bestexplains the liver's function?

The liver metabolizes most components of food and also cleans the blood of bacteria and drugs.

The nurse auscultates a bruit over the thyroid glands. What does the nurse understand is the significance of this finding?

The patient may have hyperthyroidism.

Which assessment finding within the first 24 hours of birth requires immediate health care provider notification?

The skin is jaundiced.

The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which statement about the role of the thyroid gland is most accurate?

The thyroid gland is responsible for increasing the metabolic rate.

A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason?

Underlying problem of insulin resistance

A client with type 1 diabetes mellitus wishes to stop taking insulin injections. What option is appropriate?

Using an insulin infusion pump

A client is admitted to the hospital for control of diabetes mellitus. When does the nurse understand the nursing process begins?

When the client enters the healthcare system

The nurse is reviewing a client's daily labs. Which lab report would concern the nurse related to the client's risk for skin breakdown?

albumin

During a crime scene investigation, the coroner confirms that rigor mortis has set in. This helps to confirm an approximate time of death. The forensic nurse can explain this process (rigor mortis) to a group of students based on the fact that:

at death, the body is unable to complete the actin/myosin cycle and release the coupling between the myosin and actin, creating a state of muscular contraction.

A nurse is assessing a newborn for jaundice. The nurse would first notice jaundice at which area?

face

When educating a client about glargine, the nurse should explain that this medication:

has a prolonged absorption rate and provides a relatively constant concentration for 12-24 hours.

A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. What are classic symptoms associated with diabetes?

increased thirst, hunger, and urination

The nurse measures a newborn's temperature immediately after birth and finds it to be 99°F (37.2°C). An hour later, it has dropped several degrees. The nurse understands that this heat loss can be explained in part by which factor in the newborn?

lack of subcutaneous fat

A nurse is reviewing home medications for a client recently admitted to a long-term psychiatric unit. The charge nurse asks why this client has frequent blood draws over the next few weeks. The nurse would be correct to state which home medication dosages vary according to the blood levels of the drug?

lithium carbonate

The nurse is reviewing the admission assessment of a client admitted with jaundice and abdominal pain. The client tells the nurse that he injured his back about 6 weeks ago and has been taking 750 mg of acetaminophen every 4 hours each day for pain relief. The nurse recognizes that client may have sustained damage of the:

liver.

A nurse performs a fingerstick glucose-monitoring test for a client. The results are 49 mg/dL (2.7 mmol/L). Which clinical manifestations does the nurse assess for?

nervousness, diaphoresis, and confusion

When caring for a neonate receiving phototherapy, the nurse should remember to:

reposition the neonate frequently.

A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect?

weight loss, nervousness, and tachycardia