NCLEX Endocrine Disorders

"Which instruction about insulin administration should nurse Kate give to a client? A. "Always follow the same order when drawing the different insulins into the syringe." B. "Shake the vials before withdrawing the insulin." C. "Store unopened vials of insulin in the freezer at temps well below freezing." D. "discard the intermediate-acting insulin if it appears cloudy."

"Always follow the same order when drawing the different insulins into the syringe."

Dr. Kennedy prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a male client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide? A. "Be sure to take glipizide 30 minutes before meals." B. "Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly." C. "You won't need to check your blood glucose level after you start taking glipizide." D. "Take glipizide after a meal to prevent heartburn."

"Be sure to take glipizide 30 minutes before meals." Take twice a day, 30 min before a meal bc food decreases its absorption.

Acarbose (Precose), an alpha-glucosidase inhibitor, is prescribed for a female client w type 2 DM. During discharge planning, nurse Pauleen would be aware of the client's need for additional teaching when the client states: A. "If I have hypoglycemia, I should eat some sugar, not dextrose." B. "The drug makes my pancreas release more insulin." C. "I should never take insulin while I'm taking this drug." D. " It's best if I take the drug w the first bite of a meal."

"If I have hypoglycemia, I should eat some sugar, not dextrose." Acarbose delays glucose absorption, so the client should take an oral form of dex rather than a product containing table sugar when treating hypoglycemia. The alpha-glucosidase inhibitors work by delaying the CHO digestion and glucose absorption. It's safe to be on a regiment that includes insulin and an alpha-glucosidase inhibitor. The client should take the drug at the start of a meal, not 30 mins to an hour before.

A male client w type 1 DM has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result w the client, nurse Charmaine would be most accurate in stating: A. "The test needs to be repeated following a 12hr fast." B. "It looks like you aren't following the prescribed diabetic diet." C. "It tells us about your sugar control for the last 3 months." D. "Your insulin regimen needs to be altered significantly."

"It tells us about your sugar control for the last 3 months." The glycosylated Hb test provides an objective measure of glycemic control over 3 months. The test helps identify trends or practices that impair glycemic control, and it doesn't require a fasting period before blood is drawn. The nurse can't conclude that the result occurs from poor dietary mngmt or inadequate insulin coverage.

A male client w primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should nurse Lina provide? A. "Administer desmopressin while the suspension is cold." B. "Your condition isn't chronic, so you won't need to wear a medical ID bracelet." C. "You may not be able to use desmopressin nasally if you have nasal discharge or blockage." D. "You won't need to monitor your fluid intake and output after you start taking desmopression."

"You may not be able to use desmopressin nasally if you have nasal discharge or blockage."

A female client whose physical findings suggest a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal hypophysectomy. The evening before the surgery, nurse Jacob reviews preoperative and postoperative instructions given to the client earlier. Which postop instruction should the nurse emphasize? A. "You must lie felt for 24 hrs after surgery." B. "You must avoid coughing, sneezing, and blowing your nose." C. "You must restrict your fluid intake." D. "You must report ringing in your ears immediately."

"You must avoid coughing, sneezing, and blowing your nose." After a transsphenoidal hypophysectomy, the client must refrain form coughing, sneezing, and blowing the nose for 7 days to avoid disturbing the surgical graft used to close the wound. The HOB must be elevated, not kept flat, to prevent tension or pressure on the suture line. Within 24 hrs after a hypophysectomy, transient diabetes insipidus commonly occurs; this calls for increased, not restricted, fluid intake. Visual, not auditory, changes are a potential complication of hypophysectomy.

During preoperative teaching for a client who will undergo a subtotal thyroidectomy, the nurse should include which statement? A. "The head of your bed must remain flat for 24 hours after surgery." B. "Your would avoid deep breathing and coughing after surgery." C. "You won't be able to swallow for the firs day or two." D. "You must avoid hyperextending your neck after surgery."

"You must avoid hyperextending your neck after surgery." To prevent undue pressure on the surgical incision after subtotal thyroidectomy, the nurse should advise the client to avoid hyperextending the neck. The client may elevate the HOB as desired and should cough and deep breathe to prevent pneumonia.

A male client has just been diagnosed w type 1 DM. When teaching the client and family how diet and exercise affect insulin requirements, Nurse Joy should include which guideline? A. "You'll need more insulin when your exercise or increase your food intake." B. "You'll need less insulin when you exercise or reduce your food intake." C. "You'll need less insulin when you increase your food intake." D. "You'll need more insulin when you exercise or decrease your food intake."

"You'll need less insulin when you exercise or reduce your food intake." Exercise, reduced food intake, hypothyroidism, and certain meds decrease the insulin reqs. Growth, reg, greater food intake, stress, surgery, infection, illness, increased insulin antibodies, and certain meds increase the insulin reqs.

An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting: A. 2 to 5 g of a simple carbohydrate B. 10 to 15 g of a simple carbohydrate C. 18 to 20 g of a simple carbohydrate D. 25 to 30 g of a simple carbohydrate

10 to 15 g of a simple carbohydrate To reverse hypoglycemia, the American Diabetes Assoc recommends ingesting 10 to 15 g, such a s 3-5 pieces of hard candy, 2-3 packets of sugar (4-6 tsp), or 4 oz of fruit juice. If necessary, this trtmnt can be repeated in 15 mins. Ingesting only 2-5 g of a simple CHO may not raise the blood glucose level sufficiently. Ingesting more than 15 g may raise it above normal, causing hyperglycemia.

Nurse Perry is caring for a female client with type 1 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer: A. I.M. or subcutaneous glucagon. B. I.V. bolus of dextrose 50%. C. 15 to 20 g of a fast-acting carbohydrate such as orange juice. D. 10 U of fast-acting insulin.

15 to 20 g of a fast-acting carbohydrate such as orange juice. This client is having a hypoglycemic episode. Because the client is conscious, the nurse should first administer the fast-acting CHO, such as OJ, hard candy, or honey. If the client has lost consciousness, the nurse should admin either IM or subQ glucagon or an IV bolus of dex 50%. The nurse shouldn't admin insulin to a client who's hypoglycemic; this action will further compromise the client's condition.

Jemma, who weighs 210 lb (95 kg) and has been diagnosed with hyperglycemia tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client's hyperglycemia? A. Acromegaly B. Type 1 diabetes mellitus C. Hypothyroidism D. Deficient growth hormone

Acromegaly Caused by a pituitary tumor that releases excessive growth hormone, assoc w hyperglycemia, HTN, diaphoresis, peripheral neuropathy, and joint pain. Enlarged hands and feet are related to lateral bone growth, which is seen in adults w this disorder. The accompanying soft tissues swelling causes hoarseness and often sleep apnea. Type 1 diabetes is usually seen in children, and newly diagnosed persons are usually very ill and thin. Hypothyroidism isn't assoc w hyperglycemia, nor is growth hormone deficiency.

A male client w a history of HTN is diagnosed w primary hyperaldosteronism. This diagnosis indicates that the client's HTN is caused by excessive hormone secretion from which of the following glands? A. Adrenal cortex B. Pancreas C. Adrenal medulla D. Parathyroid

Adrenal cortex Excessive secretion of aldosterone in the adrenal cortex is responsibly for the client's HTN. This hormone acts on the renal tubule, where it promotes reabsorption of Na and excretion of K and H ions. The pancreas mainly recreates hormones involved in fuel metabolism. The adrenal medulla secretes the catecholamines--epi and norepinephrine. The parathyroids secrete parathyroid hormone.

The nurse is aware that the following is the most common cause of hyperaldosteronism? A. Excessive Na intake B. A pituitary adenoma C. Deficient K intake D. An adrenal adenoma

An adrenal adenoma An autonomous aldosterone-producing adenoma is the most common cause of hyperaldosteronism. Hyperplasia is the 2nd most frequent cause. Aldosterone secretion is independent of Na and K intake as well as of pituitary stimulation.

During a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise? A. At least once a week B. At least three times a week C. At least five times a week D. Every day

At least three times a week Goals of planned exercise include: lowering the bg level, reducing or maintaining the proper weight, increasing the serum high-density lipoprotein level, decreasing serum triglyceride levels, reducing BP, minimizing stress.

Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend: A. Increasing saturated fat intake and fasting in the afternoon. B. Increasing intake of vitamins B and D and taking iron supplements. C. Eating a candy bar if lightheadedness occurs. D. Consuming a low-carbohydrate, high protein diet and avoiding fasting

Consuming a low-carbohydrate, high protein diet and avoiding fasting To control hypoglycemic episodes, the nurse should instruct the client to consume a low-CHO, high-protein, avoid fasting, and avoid simple sugars. Increasing saturated fat intake and increasing vitamin supplementation wouldn't help control hypoglycemia.

Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find: a. Hypotension. b. Thick, coarse skin. c. Deposits of adipose tissue in the trunk and dorsocervical area. d. Weight gain in arms and legs.

Deposits of adipose tissue in the trunk and dorsocervical area. Bc of changes in fat distribution, adipose tissue accumulates in the trunk, face (moonfaced), and doroscervical areas (buffalo hump). Hypertension is caused by fluid retention. Skin becomes thin and bruises easily because of a loss of collagen. Muscle wasting causes muscle atrophy and thin extremities.

A female client w Cushing's syndrome is admitted to the medical-surgical unit. During the admission assessment, nurse Tyzz notes that the client is agitated and irritable, has poor memory, reports loss of appetite, and appears disheveled. These findings are consistent w which problem? A. Depression B. Neuropathy C. Hypoglycemia D. Hyperthyroidism

Depression

For a male client with hyperglycemia, which assessment finding best supports a nursing diagnosis of deficient fluid volume? A. Cool, clammy skin B. Distended neck veins C. Increased urine osmolarity D. Decreased serum Na level

Increased urine osmolarity In hyperglycemia, urine osmolarity (the measurement of dissolved particles in the urine) increases as glucose particles move into the urine. The client experiences glycosuria and polyuria, losing body fluids and experiencing fluid vol deficit.

Which outcome indicates that treatment of a male client w diabetes insipidus has been effective? A. Fluid intake is less than 2.500ml/day B. Urine output measures more than 200 ml/hr. C. BP is 90/50 mmHg D. The HR is 126 beats/min

Fluid intake is less than 2.500ml/day DI is characterized by polyuria (up to 8 L/day), constant thirst, and an unusually high oral intake of fluids. Trtmnt w the appropriate drug should decrease both oral fluid intake and urine output. A urine output of 200ml/hr indicates continuing polyuria. A BP of 90/50 mmHg and a HR of 126 beats/min indicate compensation for the continued fluid deficit, suggesting that trtmnt hasn't been effective.

When instructing the female client diagnosed w hyperparathyroid about diet, nurse Gina should stress the importance of which of the following? A. Restricting fluids B. Restricting Na C. Forcing fluids D. Restricting K

Forcing fluids To prevent the formation of renal calculi. Na should be encouraged to replace losses in urine. Restricting K isn't necessary in hyperparathyroidism.

A 67yo male client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes w her going outdoors. Based on these assessment findings, Nurse Richard would suspect which of the following disorders? A. DM B. Diabetes insipidus C. Hypoparathyroidism D. Hyperparathyroidism

Hyperparathyroidism Most common in older women and is characterized by bone pain and weakness from excess parathyroid hormone (PTH). Clients also exhibit hypercaliuria-causing polyuria. While clients w diabetes mellitus and diabetes insidious also have polyuria, they don't have bone pain and increased sleeping. Hypoparathyroidism is characterized by urinary frequency rather than polyuria.

For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek's sign and Trousseau's sign because they indicate which of the following? a. Hypocalcemia b. Hypercalcemia c. Hypokalemia d. Hyperkalemia

Hypocalcemia

Nurse Wayne is aware that a positive Chvostek's sign indicate? A. Hypocalcemia B. Hyponatremia C. Hypokalemia D. Hypermagnesemia

Hypocalcemia Elicited by taping the client's face lightly over the facial nerve, just below the temple. If the client's facial muscles twitch, it indicates hypocalcemia. Hyponatremia is indicated yb weight loss, ab cramping, muscle weakness, headache, and postural hypotension. Hypokalemia causes paralytic ileum and muscle weakness. Clients w hypermagnesemia exhibit a loss of deep tendon reflexes, coma, or cardiac arrest.

Which nursing diagnosis takes highest priority for a female client w hyperthyroidism? A. Risk for imbalanced nutrition: more than body requirements related to thyroid hormone excess B. Risk for impaired skin integrity related to deem, skin fragility, and poor wound healing C. Body image disturbance related to weight gain and edema D. Imbalanced nutrition: less than body requirements related to thyroid hormone excess

Imbalanced nutrition: less than body requirements related to thyroid hormone excess In the client w hyperthyroidism, excessive thyroid hormone production leads to hypermetabolism and increased nutrient metabolism. These conditions may result in a negative nitrogen balance, increased protein synthesis and breakdown, decreased glucose tolerance, and fat mobilization and depletion. This puts the client at risk for marked nutrient and calorie deficiency, making imbalance nutrition: less than body reqs the most important.

A male client has recently undergone surgical removal of a pituitary tumor. Dr. Wong prescribes corticotropin (Acthar), 20 units IM q.i.d. as a replacement therapy. What is the mechanism of action of corticotropin? A. It decrease cyclic adenosine monophosphate (cAMP) production and affects the metabolic rate of target organs. B. It interacts w plasma membrane receptors to inhibit enzymatic actions. C. It interacts w plasma membrane receptors to produce enzymatic actions that affect protein, fat, and CHO metabolism. D. It regulates the threshold for water reabsorption in the kidneys.

It interacts w plasma membrane receptors to produce enzymatic actions that affect protein, fat, and CHO metabolism.

Following a unilateral adrenalectomy, nurse Betty would assess for hyperkalemia shown by which of the following? A. Muscle weakness B. Tremors C. Diaphoresis D. Constipation

Muscle weakness Muscle weakness, bradycardia, nausea, diarrhea, and paresthesia of the hands, feet, tongue, and face are findings assoc w hyperkalemia, which is transient and occurs from transit hypoaldosteronism when the adenoma is removed. Tremors, diaphoresis, and constipation aren't seen in hyperkalemia.

An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of: a. Thyroid storm. b. Cretinism. c. Myxedema coma. d. Hashimoto's thyroiditis.

Myxedema coma Severe hypothyroidism may result in myxedema coma, in which a drastic drop in the metabolic rate causes decreased vital signs, hypoventilation (possibly leading to respiratory acidosis), and nonpittinmg edema. Thyroid storm is an acute complication of hyperthyroidism. Cretinism is a form of hypothyroidism that occurs in infants. Hashimoto's thyroiditis is a common chronic inflammatory disease of the thyroid gland in which autoimmune factors play a prominent role.

Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications? a. Tetanic contractions b. Neck vein distention c. Weight loss d. Polyuria

Neck vein distention SIADH secretion causes antidiuretic hormone overproduction, which leads to fluid retention. Severe SIADH can cause such complications as vascular fluid overload, signaled by neck vein distention. This syndrome isn't assoc w tetanic contractions. It may cause weight gain and field retention (second to oliguria).

"Capillary glucose monitoring is being performed every 4 hours for a client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he receives 8 units of regular insulin. The nurse should expect the dose's: A. Onset to be at 2 pm and its peak to be at 3 pm B. Onset to be at 2:15 pm and its peak to be at 3 pm C. Onset to be at 2:30 pm and its peak to be at 4 pm D. Onset to be at 4 pm and its peak to be at 6 pm

Onset to be at 2:30 pm and its peak to be at 4 pm Reg insulin, which is short-acting, has an onset of 15-20 mins and a peak of 2-4 hrs.

Nurse Noemi administers glucagon to her diabetic client, then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon? A. Oral anticoagulants B. Anabolic steroids C. Beta-adrenergic blockers D. Thiazide diuretics

Oral anticoagulants As a normal body protein, glucagon only interacts adversely w oral anticoagulants, increasing the anticoagulant effects.

A female client w a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer: A. Phentolamine (Regitine) B. Methydopa (Aldomet) C. Mannitol (Osmitrol) D. Felodipine (Plendil)

Phentolamine (Regitine) Pheochromocytoma causes excessive production of epinephrine and norepinephrine, natural catecholamines that raise the BP. Phentolamine, an alpha-adrenergic blocking agent given by IV bolus or drip, antagonizes the body's response to circulating epinephrine and norepinephrine, reducing BP quickly and effectively. Although methyldopa is an antihypertensive agent available in parenteral form, it isn't effective in treating hypertensive emergencies. Mannitol, a diuretic, isn't used to treat hypertensive emergencies. Felodipine, an antihypertensive agent, is available only in extended-release tablets and therefore doesn't reduce BP quickly enough to correct hypertensive crisis.

After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr. Smith prescribes levothyroxine (Levothroid), 25 mcg PO daily. For which condition is levothyroxine the preferred agent? A. Primary hypothyroidism B. Graves' disease C. Thyrotoxicosis D. Euthyroidism

Primary hypothyroidism

Nurse Oliver should expect a client with hypothyroidism to report which health concerns? a. Increased appetite and weight loss b. Puffiness of the face and hands c. Nervousness and tremors d. Thyroid gland swelling

Puffiness of the face and hands Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight gain. S&S of hyperthyroidism (Graves' disease) include an increased appetite, weight loss, nervousness, tremors, and thyroid gland enlargement (goiter).

A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which "related-to" phrase should the nurse add? A. Related to bone demineralization resulting in pathologic fractures B. Related to exhaustion secondary to an accelerated metabolic rate C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces D. Related to tetany secondary to a decreased serum calcium level

Related to bone demineralization resulting in pathologic fractures Poorly controlled hyperparathyroidism may cause an elevated serum Ca level. This, in turn, may diminish Ca stores in the bone, causing bone demineralization and setting the stage for pathologic fractures and a risk for injury. Hyperparathyroidism doesn't accelerate the metabolic rate. A decreased thyroid hormone level, not an increased parathyroid hormone level, may cause deem and dry skin 2ndary to fluid infiltration into the interstitial spaces. Hyperparathyroidism causes hyperCa, not hypoCa; therefore it isn't assoc w tetany

A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? A. Infusing IV fluids rapidly as ordered B. Encouraging increased oral intake C. Restricting fluids D. Administering glucose-containing IV fluids as ordered

Restricting fluids To reduce water retention, restrict fluid--admin of fluids by any route would further increase the client's already heightened fluid load.

Nurse Troy is aware that the most appropriate for a client with Addison's disease? a. Risk for infection b. Excessive fluid volume c. Urinary retention d. Hypothermia

Risk for infection Addison's disease decreases the production of all adrenal hormones, compromising the body's normal stress response and increasing the risk of infection. Other appropriate nursing diagnoses for a client w Addison's disease include deficient fluid volume and hyperthermia. Urinary retention isn't appropriate bc Addison's disease causes polyuria.

In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse Lyzette would expect a decline in: A. Serum glucose level B. Hair loss C. Bone mineralization D. Menstrual flow

Serum glucose level Hyperglycemia, which develops from glucocorticoid excess, is a manifestation of Cushing's syndrome. W successful trtmnt of the disorder, serum glucose levels decline.

A male client w a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled w an oral diabetic agent, tolazamide (Tolinase). Which of the following is the most important lab test for confirming this disorder? A. Serum K level B. Serum Na level C. Arterial blood gas (ABG) values D. Serum osmolarity

Serum osmolarity

Nurse Joey is assigned to care for a postop male client who has DM. During the assessment interview, the client reports that he's impotent and says he's concerned about its effect on his marriage. In planning this client's care, the most appropriate intervention would be to: A. Encourage the client to ask qs about personal sexuality B. Provide time for privacy C. Provide support for the spouse or sig other D. Suggest referral to a sex counselor or other appropriate professional

Suggest referral to a sex counselor or other appropriate professional

After taking glypizide (Glucotrol) for 9 months, a male client experiences secondary failure. Which of the following would the nurse expect the physician to do? A. instate insulin therapy B. Switch the client to a different oral anti diabetic agent. C. Prescribe an additional oral anti diabetic agent. Restrict carbohydrate intake to less than 30% of the total caloric intake.

Switch the client to a different oral anti diabetic agent May clients (25-60%) w secondary failure respond to a different oral anti diabetic agent. Therefore, it wouldn't be appropriate to initiate insulin therapy at this time. However, if a new oral anti diabetic agent is unsuccessful in keeping glucose levels at an acceptable level, insulin may be used in addition to the anti diabetic agent.

A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg PO daily. Which finding should nurse Hans recognize as an adverse drug effect? A. Dysuria B. Leg cramps C. Tachycardia D. Blurred vision

Tachycardia Levothyroxine is given to a client w hypothyroidism to stimulate the effects o thyroxine. Ad effects include tachycardia.

Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication? A. Tetany B. Hemorrhage C. Thyroid storm D. Laryngeal nerve damage

Tetany

For a diabetic male client with a foot ulcer, the physician orders bed rest, a wet-to-dry dressing change every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used for this client? A. They contain exudate and provide a moist wound environment. B. They protect the wound from mechanical trauma and promote healing. C. They debride the wound and promote healing by secondary intention. D. They prevent the entrance of microorganisms and minimize wound discomfort.

They debride the wound and promote healing by secondary intention. For this client, wet-to-dry dressings are most appropriate bc they clean the foot ulcer by deriding exudate and necrotic tissue, thus promoting healing by secondary intention. Moist transparent dressings contain exudate and provide a moist wound environment. Hydrocolloid dressings prevent the entrance of microorganisms and minimize wound discomfort. Dry sterile dressings protect the wound form mechanical trauma and promote healing.

Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? a. Diabetic ketoacidosis b. Thyroid crisis c. Hypoglycemia d. Tetany

Thyroid crisis Usually occurs in the first 12 hrs after thyroidectomy and causes exaggerated signs of hyperthyroidism, such as high fever, tachycardia, and extreme restlessness. DKA is more likely to produce polyuria, polydipsia, and polyphagia; hypoglycemia, to produce weakness, tremors, profuse perspiration, and hunger. Tetany typically causes uncontrollable muscle spasms, stridor, cyanosis, and possibly asphyxia.

A female client has a serum Ca level of 7.2 mg/dl. During the physical exam, nurse Noah expects to assess: A. Trousseau's sign B. Homans' sign C. Hega's sign D. Goodell's sign

Trousseau's sign Trousseau's sign: Carpopedal spasm induced by inflating the BP cuff above systolic pressure. Homans' sign: pain on dorsiflexion of the food (DVT). Hegar's sign: softening fo the uterine isthmus (pregnancy). Goodell's sign: cervial softening (pregnancy).

When caring for a female client with a history of hypoglycemia, nurse Ruby should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description? A. sulfisoxazole (Gantrisin) B. mexiletine (Mexitil) C. prednisone (Orasone) D. lithium carbonate (Lithobid)

sulfisoxazole (Gantrisin) Sulfisoxazole and other sulfonamides are chemically related to oral anti diabetic agents and may precipitate hypoglycemia. Mexiletine- anti arrhythmic used to treat refractory ventricular arrhythmias, does not cause hyperglycemia. Prednisone- corticosteroid assoc w hyperglycemia. Lithium may cause transient hyperglycemia, not hypo.

When caring for a male client w diabetes insipidus, nurse Juliet expects to administer: A. Vasopressin (Pitressin Synthetic) B. Furosemide (Lasix) C. Regular insulin D. 10% Dextrose

Vasopressin (Pitressin Synthetic) Bc diabetes insipidus results from decreased antidiuretic hormone (vasopressin) production, the nurse should expect to admin synthetic vasopressin for hormone replacement therapy. Furosemide is contraindicated because client experiences polyuria. Insulin and dex treat DM not DI.

When assessing a male client w pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, nurse April is most likely to detect: A. a BP of 130/70 mmHg B. a blood glucose level of 130 mg/dl C. bradycardia D. a BP of 176/88 mmHg

a BP of 176/88 mmHg Pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, causes hypertension, tachycardia, hyperglycemia, hyper metabolism, and weight loss.

Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus? a. antidiuretic hormone (ADH). b. thyroid-stimulating hormone (TSH). c. follicle-stimulating hormone (FSH). d. luteinizing hormone (LH).

antidiuretic hormone (ADH)

A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. Nurse Jack explains that these medications are only effective if the client: A. prefers to take insulin orally B. has type 2 diabetes C. has type 1 diabetes D. is pregnant and has type 2 diabetes

has type 2 diabetes