NCLEX Questions: Endocrine

"Which instruction about insulin administration should the nurse give to a client?

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

A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, nurse Sharmaine would be most accurate in stating:

"It tells us about your sugar control for the last 3 months"

A male client with primary diabetes insipidus is ready for discharge on desmopressin (DDVAP). Which instruction should nurse Lina provide?

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

A male client has just been diagnosed with types 1 diabetes mellitus. When teaching the client and family how diet and exercise affect insulin requirements, Nurse Joy should include which guideline?

"You'll need less insulin when you exercise or reduce you food intake"

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:

15 to 20 g of a fast-acting carbohydrate such as orange juice

The nurse is aware that the following is the most common cause of hyperaldosteronism?

An Adrenal adenoma

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? D. Every day

At least three times a week.

Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:

Consuming a low-carbohydrate, high protein diet and avoiding fasting

Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find:

Deposits of adipose tissue in the trunk and dorsocervical area

A female client with 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 with which problem?

Depression

"Which outcome indicates that treatment of a client with diabetes insipidus has been effective?

Fluid intake less than 2,500 ml/day.

Which nursing diagnosis is of highest priority for a female client with hyperthyroidism?

Imbalanced nutrition: less than body requirements related to thyroid hormone excess.

For a male client with hyperglycemia, which assessment finding best supports a nursing diagnosis of deficient fluid volume?

Increased urine osmolarity

Following a unilateral adrenalectomy, a nurse should assess for hyperkalemia as indicated by:

Muscle Weakness

Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications?

Neck vein distention

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?

Oral anticoagulants

After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr. Smith prescribes levothyroxine (Levothroid), 25 mug PO daily. For which condition is levothyroxine is the preferred agent?

Primary hypothyroidism

Nurse Oliver should expect a client with hypothyroidism to report which health concerns?

Puffiness of the face and hands

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?

Related to bone demineralization resulting in pathologic fractures Poorly controlled hyperparathyroidism may cause and elevated serum calcium level.

In a 29-year-old female client whois being successfully treated for Cushing's Syndrome, nurse Lynette would expect a decline in:

Serum glucose level

A male client with a tentative diagnosis of hyperosmolar hyperglycemia nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide (Tolinase). Which of the following is the most important laboratory test for confirming this disorder?

Serum osmolarity

Nurse Joey is assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview, the client reports that he's impotent nd says he's concerned about its effects on his marriage. In planning this client's care, the most appropriate intervention would be:

Suggest referral to a sex counselor or other appropriate professional.

When caring for a female client with a history go hypoglycemia, nurse Ruby should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description:

Sulfisoxazole (Gastrisin)

After taking glipizide (Glucotrol) for 9 months, a client experiences secondary failure. What should the nurse expect the physician to do?

Switch the client to a different oral anti-diabetic agent

A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect?

Tachycardia

Nurse Ruth 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 expect which complication?

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?

They debride the wound and promote healing by secondary intention.

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?

Thyroid crisis

A female client has a serum calcium level of 7.2 mg/dl. During the physical examination, nurse Noah expects to assess:

Trousseau's sign

When caring for a male client with diabetes insipidus, nurse Juliet expects to administer:

Vasopressin (Pitressin Synthetic)

"During preoperative teaching for a female client who will undergo a subtotal thyroidectomy, the nurse should include which statement?

You must avoid hyperextending your neck after surgery

A female client with 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:

phentolamine (Regitine)

A female client whose physical findings suggest hyper pituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal hypophysectomy. The evening before the surgery, nurse Jacob evils preoperative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize?

"You must avoid coughing, sneezing, and blowing your nose"

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?

Antidiuretic hormone (ADH).

Nurse Troy is aware that the most appropriate for a client with Addison's disease?

Risk for infection

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?

"Be sure to take glipizide 30 minutes before meals."

Acarbose (Precose), an alpha glucosidase inhibitor, is prescribed for a female client with type 2 diabetes mellitus. During discharge planning, nurse Pauline would be aware of the client's need for additional teaching when the client states:

"If I have hypoglycemia, I should eat some sugar, not dextrose."

An agitated, confused female 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:

10 to 15 g of a simple carbohydrate. To reverse hypoglycemia, the American Diabetes Associated recommends ingesting 10 to 15 g of simple carbohydrates, such ss three to five pieces of hard candy, two to three packs of sugar or 4 oz of fruit juice

When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, nurse April is most likely to detect:

A blood pressure of 176/88 mm Hg

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?

Acromegaly

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

Adrenal cortex

When instructing the female client diagnosed with hyperparathyroidism about diet, nurse Gina should stress the importance of which of the following?

Forcing Fluids

A male client with types 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. Nurse jack explains that these medication are only effective if the client:

Has type 2 diabetes

A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, nurse Richard would expect which of the following disorders?

Hyperparathyroidism

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?

Hypocalcemia

Nurse Wayne is aware that a positive Chvostek's sign indicate?

Hypocalcemia

A male client has recently undergone surgical removal of a pituitary tumore. Dr. Wong prescribes corticotropin (Acthar), 20 units I.M q.i.d. as a replacement therapy. What is the mechanism of action of corticotropin?

It interacts with plasma membrane receptors to promote enzymatic actions that affect portent, fact, and carbohydrate metabolism.

"An incoherent 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, the nurse prepares to take emergency action to prevent the potential complication of:

Myxedema coma

"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:

Onset to be at 2:30 pm and its peak to be at 4 pm

A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

Restricting Fluids