Prep U questions Med Surg exam 3
What foods should the nurse suggest that the patient consume less of in order to reduce nitrate intake because of the possibility of carcinogenic action?
Ham and bacon
Which instruction should be included in the discharge teaching plan for a client after thyroidectomy for graves disease?
Have regular follow up care
A client with a history of addisons disease and flu like symptoms accompanied by nausea and vomiting over the past week is brought to the facility. His wife reports that he acted confused and was extremely weak when he awoke that morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101f. A diagnosis of acute adrenal insufficiency is made. What should the nurse expect to administer by IV infusion?
Hydrocortisone
The nurse is aware that the clinical symptoms of a patient with hypoparathyroidism are the result of the initial physiologic response of:
Hypocalcemia
The client has finished the first round of chemotherapy. Which statement made by the client indicates a need for further teaching by the nurse ?
I can continue taking my vitamins and herbs because they make me feel better
A nurse practitioner is aware of the high incidence and prevalence of hypothyroidism and regularly encourages many patients to undergo screening of their thyroid secreting hormone levels. Which of the following individuals likely faces the greatest risk of developing hypothyroidism?
a 55 year old woman who complains of fatigue
The adrenal cortex is responsible for producing which substances?
Glucocorticoids and androgens
A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately?
An irregular apical pulse
A nurse is administering daunorubicin through a peripheral IV line when the client complains of burning at the insertion site. The nurse notes no blood return from the catheter and redness at the IV site. The client is most likely experiencing which complication?
Extravasation
A nurse is teaching a client with bone marrow suppression about the time frame when bone suppression will be noticeable after administration of floxuridine. What is the time frame the nurse should include with client teaching?
7 to 14 days
The oncology nurse is giving chemotherapy to a client in a short stay area. The client confides that they are very depressed. The nurse recognizes depression as what?
A normal reaction to the diagnosis of cancer
A nurse is reviewing a clients lab studies and determines that the client has an elevated calcium level. What does the nurse know will occur as a result of the rise in the serum calcium level?
A rise in serum calcium stimulates the release of calcitonin from the thyroid gland
After a thyroidectomy the client develops a carpopedal spasm while the nurse is taking a BP reading on the left arm. Which action by the nurse is appropriate?
Administer IV calcium gluconate as ordered
A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the clients hypertension is caused by excessive hormone secretion from which gland?
Adrenal cortex
A client receiving external radiation to the left thorax to treat lung cancer has a nursing diagnosis of risk for impaired skin integrity. Which intervention should be part of the client's care plan?
Avoiding using soap on the irradiated areas.
When is the best time to take corticosteroid medication?
Between 7 and 8am
Mrs. Unger is a 53-year-old woman who was diagnosed with breast cancer following a process that began with abnormal screen mammography results. Mrs. Unger, her oncologist, and surgeon have agreed on a mastectomy as treatment and have discussed the importance of rigorously assessing whether her cancer has metastasized. What action will best detect possible metastasis of Mrs. Unger's breast cancer?
Biopsy of the axillary lymph nodes
When high levels of plasma calcium occur, the nurse is aware that the following hormone will be secreted:
Calcitonin
Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany?
Calcium gluconate
What factor has the greatest impact on the development of all cancers?
Chemical agents
A nurse is performing a home visit for a client who received chemotherapy within the past 24 hours. The nurse observes a small child playing in the bathroom, where the toilet lid has been left up. Based on these observations, the nurse modifies the client's teaching plan to include...
Chemotherapy exposure and risk factors
What screening test should be done every 10 years?
Colonoscopy
During physical examination of a client with a suspected endocrine disorder, the nurse assesses the body structures. The nurse gathers this data based on the understanding that it is an important aid in what?
Detecting evidence of hormone hypersecretion
A side effect of chemotherapy is renal damage. To prevent this, the nurse should...
Encourage fluid intake to dilute the urine
A patient with a diagnosis of prostate cancer is receiving radiation therapy, a treatment that has resulted in stomatitis. To best manage this patient's stomatitis, the nurse should:
Encourage the patient to use an oral swab rather than a regular toothbrush
A nurse is assessing a client experiencing a severe anxiety attack. The nurse understands that the client's physiologic response to the unknown fear involves secretion of which hormone?
Epinephrine
A nurse has agreed to draft a medication teaching plan for a patient who is taking the hormonal agent, Aromasin, an aromatase inhibitor for postmenopausal women with breast cancer. The nurse knows that a major teaching point is to tell the patient to:
Increase her intake of calcium-rich foods.
Chemotherapeutic agents have which effect associated with the renal system?
Increased uric acid excretion
The nurse knows to assess a pt with hyperthyroidism for the primary indicator of:
Intolerance to heat
Although nor designated as endocrine glands, several organs within the body secrete hormone as part of their normal function. Which organ secretes hormones involved in increasing blood pressure and volume and maturation of red blood cells
Kidneys
What is one of the most common metastasis sites for cancer cells?
Liver
A number of pharmacologic agents are used to treat hyperthyroidism. Which of the following drugs is one of the most commonly prescribed and acts by blocking synthesis of the thyroid hormones?
Methimazole
Which assessment would a nurse perform on a client with Cushing's syndrome who is at high risk of developing a peptic ulcer?
Observe stool color
Which glands regulate calcium and phosphorus metabolism?
Parathyroid gland
A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder?
Pituitary disorder
An adult patient has admitted to his primary care provider that he has been experiencing an unprecedented loss of libido in recent months. This complaint should prompt the clinician to assess the patient for dysfunction of what endocrine gland?
Pituitary gland
The nurse is reviewing the plan of care for a client with a disorder of the thyroid gland. Which diagnostic test would the nurse expect the physician to order to evaluate thyroid hormone?
Radioimmunoassay
A client with hyperthyroidism is concerned about changes in appearance. How can the nurse convey an understanding of the clients concern and promote effective coping strategies?
Reassure the client that their emotional reactions are a result of the disorder and symptoms can be controlled with effective treatment
PTH has what affect on the kidneys?
Stimulation of calcium reabsorption and phosphate excretion
The thyroid normally produces...
T3, T4, and calcitonin
A nurse 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?
Tetany
A 66-year old man is receiving radiation therapy and chemotherapy for the treatment of small cell lung cancer. The nurse has assessed him many times since he was admitted to the hospital. This morning, he admits that his greatest challenge he is currently facing is his overwhelming fatigue. How should the nurse respond to this patient's statement?
That must be incredibly difficult for you. How would you rate your fatigue on a number from 1 to 10.
A nurse is assessing a clients thyroid gland. The nurse asks the client to swallow. Which response would the nurse document as a normal finding?
The client's thyroid rises
A patient who is currently in the hospital recovering from orthopedic surgery has always considered herself to be a "borderline diabetic" who prides herself on maintaining acceptable blood glucose levels through diet and lifestyle modifications. Consequently, she is surprised that her primary care provider has ordered a sliding scale of insulin while she is in the hospital. Why might this patient require insulin at this particular time?
The stress of hospitalization and surgery may cause increased release of glucocorticoids
A patient is scheduled for cryoablation for cervical cancer and tells the nurse "I am not exactly sure what the surgeon is going to do". What is the best response by the nurse?
The surgeon is going to use liquid nitrogen to freeze the area
a client is receiving radiation therapy and asks the nurse about oral hygiene. What teaching specific to the client's situation should the nurse include?
Use a soft toothbrush and allow it to air dry before storing.
What is the best way for the nurse to assess the nutritional status of a patient with cancer?
Weigh the patient daily
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 secreting by the adrenal medulla?
epinephrine
An adult patient is experiencing a temporary decrease in serum levels of T3 and T4. What physiological response is this state likely to result in
increased release of Tsh