path prepU ch 41

Research has identified a cycle of insulin-induced posthypoglycemic episodes. What is this phenomenon called? sunset effect joslin phenomenon somogyi effect dawn phenomenon

somogyi effect

When educating a client with possible glucocorticoid dysfunction, the nurse will explain that the CRH controls the release of ACTH. The best time to perform the blood test to measure peak ACTH levels would be: 4-6pm 10am-12pm 6-8am 9-11pm

6-8 am

One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisol-releasing hormone (CRH) and: DHEA GH ACTH PSH

ACTH

Which client would be considered to be exhibiting manifestations of "prediabetes"? a school-aged child who has a blood glucose level of 115 following lunch a retired female registered nurse with a fasting plasma glucose level of 92 mg/dL (5.00 mmol/L) an older adult client who got "light-headed" when he skipped his lunch. blood glucose level was 60 mg/dL (3.33 mmol/L) at this time a middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL (10.49 mmol/L)

a middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL (10.49 mmol/L)

Which individual displays the precursors to acromegaly? an adult with an excess of growth hormone due to an adenoma a girl who has been diagnosed with precocious puberty an adult who has a diagnosis of cushing syndrome a client who has recently developed primary adrenal carcinoma

an adult with an excess of growth hormone due to adenoma

The nurse is caring for a client who is in a severe hypothyroid state. Which medications should be avoided related to the inability to metabolize these drugs? Select all that apply. calcium channel blockers analgesics anesthetics nonsteroidal anti-inflammatories sedatives

analgesics anesthetics sedatives

Which medication order should the nurse question for a client with hyperthyroidism who is experiencing signs of impending thyroid storm? aspirin prednisone propranolol propylthiouracil

aspirin

When educating a client about type 1 diabetes, the nurse will mention that this type is caused by which mechanism? genetic predisposition autoimmune destruction of pancreatic beta cells idiopathic, abnormally large pancreatic cells overuse of steroids, making pancreatic cells resistance to glucose

autoimmune destruction of pancreatic beta cells

A client is to have a serum thyroxine and thyroid stimulating laboratory test performed to assess the baseline status of the hypothalamic-pituitary target cell hormones. When educating the client about the laboratory tests, when would the nurse inform him the test should be obtained? prior to midnight after 0900 before 0800 at noon

before 0800

The results of a 44-year-old obese man's recent diagnostic workup have culminated in a new diagnosis of type 2 diabetes. Which pathophysiologic process underlies the client's new diagnosis? beta cell exhaustion due to long-standing insulin resistance destruction of beta cells that is not attributable to autoimmunity actions of insulin autoantibodies (IAAs) and islet cell autoantibodies (ICAs) T-lymphocyte-mediated hypersensitivity reactions

beta cell exhaustion due to long-standing insulin resistance

A diabetic client presents to the clinic. He is concerned his lower legs are "feeling funny." Which assessment findings lead the health care provider to suspect the client may have developed somatic neuropathy? Select all that apply. both legs appear to be the same as far as numbness is involved bilateral cool ankles and feet right foot has a diminished perception of vibration; left foot is normal with eyes closed, the client cannot identify where the health care provider is touching his feet one leg has a reddened area in the calf and has a positive homan sign

both legs appear to be the same as far as numbness is involved bilateral cool ankles and feet with eyes closed, the client cannot idenfity wher the health acre provider is touching his feet

When caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which organ does the nurse recognize is reliant on glucose as the major energy source? heart brain spleen lungs

brain

Which criterion about insulin would prompt a diagnosis of type 1 diabetes? small amounts of insulin secreted complete failure of insulin secretion insulin not efficiently used large amounts of insulin secreted

complete failure of insulin secretion

Which sign of congenital hypothyroidism in a neonate is one of the first signs the nurse would pick up on? prolonged period of physiologic jaundice no passage of meconium within the first 72 hours after birth palpable mass in the neck region full, bounding fontanels

prolonged period of physiologic jaundice

Which pathophysiologic phenomenon may result in a diagnosis of Cushing disease? autoimmune destruction of the adrenal cortex hypopituitarism excess ACTH production by a pituitary tumor malfunction of the HPA system

excess ACTH production by a pituitary tumor

Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur? diabetogenic gene from both parents, physiologic triggering event, and an allergic reaction to pancreatic delta cells genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen genetic predisposition, physiologic triggering event, allergic reaction to pancreatic alpha cells diabetogenic gene from both parents, environmental triggering event, and a B-lymphocyte reaction to alpha cell antigens

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

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? place the client in the supine position bathe the client with tepid water give the client a concentrated carbohydrate repeat the dose of insulin

give the client a concentrated carbohydrate

The family of a client in the hospital with diabetes mellitus that is out of control asks the nurse to explain the client's recent weight loss while eating more than usual. How will the nurse respond? surplus glucose is stored as glycogen in the liver fatty acids enter the glycolytic pathway to release energy lack of insulin raises circulating blood glucose levels glucose is unused without insulin, so body fats are used for energy

glucose is unused without insulin, so body fats are used for energy

A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis? hyponatremia hyperglycemia hypoglycemia hypernatremia

hypoglycemia

When providing nutrition education to the client with diabetes, the nurse should include which statement regarding fat intake? when diabetes is present, 40% of calories may be from fat people with diabetes should not consume fats individuals with type 2 diabetes may consume more fat calories than those with type 1 diabetes if you have diabetes avoiding saturated fats is important

if you have diabetes, avoiding saturated fats is important

When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptom does the client report that the nurse would find associated with this disorder? fatigue increase in appetite weight gain constipation

increase in appetite

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? 1% ketones present in urine gained 5lbs in one week random blood glucose 85 mg/dL (4.72mmol/L) glycosylated hemoglobin 7.2% (0.7)

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

Which metabolic abnormality can lead to the development of type 2 diabetes? chronic overeating acute pancreatitis insulin resistance recurrent hypoglycemia

insulin resistance

In an acute adrenal crisis with Addison disease, the onset of symptoms are sudden and can be precipitated by exposure to a minor illness or stress. What are the manifestations of acute adrenal crisis? Select all that apply. muscle weakness dehydration altered mental status hypertension vascular collapse

muscle weakness dehydration altered mental status vascular collapse

A diabetic client presents to a clinic for a routine visit. Blood work reveals an HbA1C of 11.0% (high). Which response by the client may account for this abnormal lab result? to tell you the truth, my blood glucose has been pretty normal for me I've had more periods of hypoglycemia than usual over the past few months I've been doing great. I haven't needed much insulin coverage before meals my meter broke so i have not been checking my blood glucose levels for a while

my mete broke so i have not been checking my blood glucose levels for a while

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 the client should not participate in any exercise activity that could utilize more thyroid hormone the client should skip a dose of the thyroid supplement if he has symptoms of fever or restlessness the client should be informed that if he observes an increase in fatigue, an extra dose of his thyroid medication should be taken

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

A client with long-standing type 2 diabetes is surprised to see high blood sugar readings while recovering from an emergency surgery. Which factor may have contributed to the client's inordinately elevated blood glucose levels? the stress of the event caused the release of adrenal cortical hormones sleep disruption in the hospital precipitated the dawn effect illness inhibited the release and uptake of glucagon the tissue trauma of surgery resulted in gluconeogenesis

the stress of the event caused the release of adrenal cortical hormones

A young child develops type 1A diabetes. The parents ask, "They tell us this is genetic. Does that mean our other children will get diabetes?" The best response by the health care provider would be: "Probably not. since genetically your other children have a different cellular makeup, they just might not become diabetic." "we don't know what causes diabetes, so we will just have to wait and see." "this autoimmune disorder causes destruction fo the beta cells, placing your children at high risk of developing diabetes." "if you put all your children on a low-carbohydrate diet, maybe they won't get diabetes."

this autoimmune disorder causes destruction of the beta cells, placing your children at high risk for developing diabetes