NUR 439: Quiz #8

Which actions should the nurse assign to the experienced LPN/LVN for the care of a patient with hypothyroidism? Select all that apply.

- Assessing and recording the rate and depth of respirations - Auscultating lung sounds every 4 hours - Checking blood pressure, heart rate, and respirations every 4 hours - Reminding the patient to report any episodes of chest pain or discomfort

The nurse is providing care for a male patient with hypogonadotropin who is receiving sex steroid replacement therapy with testosterone. Which changes indicate to the nurse that therapy is successful? Select all that apply.

- Increased libido - Increased muscle mass - Increased axillary hair growth

The nurse is preparing a care plan for a patient with Cushing disease. Which abnormal laboratory values would the nurse expect? Select all that apply.

- Increased salivary cortisol level - Increased urinary cortisol level - Increased serum cortisol level

The nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone secretion. Which patient care actions should the nurse delegate to the experienced assistive personnel? Select all that apply.

- Monitor and record strict intake and output. - Remind the patient about his or her fluid restriction. - Weigh the patient every morning using the same scale. - Report a weight gain of 2.2 lb (1 kg) to the nurse.

The nurse is preparing to discharge a patient with hyperpituitarism caused by a benign pituitary tumor. The patient has been prescribed the drug bromocriptine. Which key points would the nurse teach the patient about this drug? Select all that apply.

- Take this drug with a meal or snack to avoid gastrointestinal (GI) symptoms. - Seek medical care if you experience chest pain or dizziness while taking this drug. - If the drug causes headaches, you can take over-the-counter acetaminophen. - the purpose of bromocriptine is to shrink your pituitary gland to normal size.

Which actions prescribed by the health care provider for the patient with Addison disease should the nurse delegate to the experienced assistive personnel (AP)? Select all that apply.

- Weigh the patient every morning. - Obtain fingerstick glucose before each meal and at bedtime. - Check vital signs every 2 hours. - Record intake and output.

The nurse is providing care for a patient who underwent a thyroidectomy 2 days ago. Which laboratory value requires close monitoring by the nurse?

Calcium level

A patient with pheochromocytoma underwent surgery to remove his adrenal glands. Which nursing intervention should the nurse delegate to an assistive personnel (AP)?

Checking lying and standing blood pressure every 4 hours with a cuff placed on the same arm

Assessment findings for a patient with Cushing disease include all of the following. For which finding would the nurse notify the health care provider immediately?

Crackles bilaterally in the lower lobes of the lungs

The nurse is caring for a 25-year-old patient admitted to the acute care unit with an intense thirst and dilute, excessive straw-colored urine output (up to 15 L/day). What does the nurse suspect?

Diabetes insipidus (DI)

Two assistive personnel (AP) are assisting a patient with Cushing disease to move up in bed. Which action by the APs requires the nurse's immediate intervention?

Grasping under the patient's arms to pull him up in bed

The nurse admits a patient whose assessment reveals prominent brow ridge, large hands and feet, and large lips and nose. Which pituitary hormone does the nurse suspect is elevated?

Growth hormone

The nurse is orienting a newly graduated RN who is providing care for a postoperative patient after a thyroidectomy. The new RN assesses the patient and notes laryngeal stridor with a pulse oximetry measure of 89%. What is the priority action for the nurse and new RN?

Immediately notify the rapid response team (RRT).

The nurse is instructing a senior nursing student on the techniques for palpation of the thyroid gland. What instruction would the nurse be sure to include when instructing the student about thyroid palpation?

Palpate the thyroid gland for size, symmetry, shape, and presence of nodules.

The LPN/LVN is assigned to provide care for a patient with pheochromocytoma. Which physical assessment technique would the RN instruct the LPN/ LVN to avoid?

Palpating the abdomen in all four quadrants

A female patient is admitted with a diagnosis of primary hypofunction of the adrenal glands. Which nursing assessment finding supports this diagnosis?

Patchy areas of pigment loss over the face

The nurse is caring for a patient who has just undergone a hypophysectomy for hyperpituitarism. Which postoperative finding requires immediate intervention?

Presence of glucose in the nasal drainage

Which change in vital signs for a patient with hyperthyroidism would the nurse instruct the assistive personnel (AP) to report immediately?

Rapid heart rate

A patient is hospitalized with adrenocortical insufficiency. Which nursing activity should the nurse delegate to assistive personnel (AP)?

Reminding the patient to change positions slowly

The RN is serving as preceptor for a senior nursing student who is assessing an endocrine patient. For which action must the nurse intervene immediately?

Student nurse vigorously palpates patient's thyroid while standing behind him.

The nurse is caring for a patient with hyperthyroidism who had a partial thyroidectomy yesterday. Which change in assessment would the nurse report to the health care provider immediately?

Temperature elevation to 100.2°F (37.9°C)

The nurse assesses a newly admitted patient with a diagnosis of hyperthyroidism (see the figure). How would the nurse best document the finding in this patient?

Large visible goiter

For a patient with hyperthyroidism, which task should the nurse delegate to an experienced assistive personnel (AP)?

Monitoring the apical pulse, blood pressure, and temperature every 4 hours

The nurse is caring for the following patients with endocrine disorders. Which patient must the nurse assess first?

A 65-year-old patient with Addison disease whose morning potassium level is 6.2 mEq/L (6.2 mmol/L)

The patient with hyperparathyroidism who is not a candidate for surgery asks the nurse why she is receiving IV normal saline and IV furosemide. What is the nurse's best response?

"Diuretic and hydration therapies are used to reduce your serum calcium."

A 24-year-old patient with diabetes insipidus (DI) makes all of these statements when the nurse is pre-paring the patient for discharge from the hospital. Which statement indicates to the nurse that the patient needs additional teaching?

"I will gradually wean myself off the vasopressin."

The LPN/LVN who is assigned to care for a patient with Cushing disease asks the RN why the patient has bruising and petechiae across her abdomen. What is the RN's best response?

"Patients with Cushing disease have very fragile capillaries."

As the shift begins, the nurse is assigned to care for the following patients. Which patient should the nurse assess first?

A 58-year-old patient with hypothyroidism and a heart rate of 48 beats/min

Which patient should the charge nurse assign to the care of an LPN/LVN under the supervision of the RN team leader?

An 83-year-old patient with type 2 diabetes and chronic obstructive pulmonary disease

When providing care for a patient with Addison disease, the nurse should be alert for which laboratory value change?

Decreased hematocrit

The RN is supervising a senior student nurse who is caring for a fresh postoperative patient who had a hypophysectomy. The RN observes the student nurse perform all of these actions. For which action must the RN intervene?

Encourage the patient to cough vigorously.

A patient with adrenal insufficiency is to be discharged and will take prednisone 10 mg orally each day. Which instruction would the nurse be sure to teach the patient?

Excessive weight gain or swelling should be reported to the health care provider.

A patient is admitted to the medical unit with possible Graves disease (hyperthyroidism). Which assessment finding by the nurse supports this diagnosis?

Exophthalmos

Which prescribed order for a patient with diabetes insipidus (DI) would the nurse be sure to question?

Restrict fluids for 6 hours.