Targeted Medical-Surgical: Endocrine

A nurse is reviewing the health record of a client who has SIADH, Which of the following lab findings should the nurse expect? (select all that apply.)

Low sodium increased urine osmolality high urine sodium increased urine specific gravity

A nurse is providing discharge teaching for a client who has diabetes insipidus and has a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching?

"Blow your nose gently prior to using the nasal spray." The nurse should instruct the client to blow his nose gently prior to use of the spray. This action prevents dilution of the medication with nasal secretions.

A nurse is caring for a client who asks why the provider bases the medication regimen on HbA1c results instead of the log of morning fasting blood glucose results. Which of the following responses should the nurse make?

"HbA1c indicates how well you have regulated your blood glucose over the past 120 days."

A nurse is providing teaching to a client who has a new diagnosis of diabetes insipidus. Which of the following client statements indicates an understanding of the teaching?

"I might experience confusion or balance problems."

A nurse is providing discharge teaching to a client who had a gastrectomy for stomach cancer. Which of the following information should the nurse include in teaching? (select all that apply.)

"you will need a monthly injection of B12 for the rest of your life" "use the nasal spray form of vitamin b12 on a daily basis can be an option"

What lab value is consistent with DKA?

Bicarb level less than 15

A nurse is teaching a client who has diabetes mellitus. Which of the following should the nurse include as an expected finding of diabetic ketoacidosis (DKA)?

Blood glucose levels above 300 mg/dL Blood glucose levels above 300 mg/dL are an expected finding with DKA. Levels above 600 mg/dL are an expected finding with hyperglycemic-hyperosmolar state.

A nurse is reviewing lab reports of a client who has HHS. Which of the following findings should the nurse expect?

Blood osmolarity 350 mOsm/L

What skin manifestation is common in addisons disease?

Bronze hyperpigmentation of skin

A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect?

Calcium 12.8 mg/dL A client who has adrenal insufficiency has a calcium level above the expected reference range.

A nurse is assessing a client who has diabetes mellitus and reports feeling anxious. Which of the following findings should the nurse expect if the client is hypoglycemic?

Cool, clammy skin Hypoglycemia causes cool, clammy skin, in addition to anxiety, nervousness, tachycardia, and confusion.

A nurse is caring for a client who has idiopathic thrombocytopenia purpura. The nurse should notify the provider and report small-vessel clotting when which of the following is assessed?

Cyanotic nail beds

A nurse in a providers office is reviewing lab results of a client who is being evaluated for secondary hypothyroidism. Which of the following lab findings is expected?

Decreased T3

A nurse in a provider's office is reviewing the health record of a client who is being evaluated for Graves' disease. The nurse should identify that which of the following lab results is an expected finding?

Decreased TSH

A nurse is caring for a client who has SIADH. Which of the following findings should the nurse expect? (select all that apply.)

Decreased blood sodium blood osmolarity 230 mosm/L

A nurse is preparing to administer morning doses of insulin glargine and regular insulin to a client who has a blood glucose of 278 mg/dL. Which of the following actions should the nurse take?

Draw up and administer regular and glargine insulin in separate syringes

A nurse is teaching a client who has diabetes mellitus about insulin injections. The client's prescription includes evening doses of insulin glargine and regular insulin. Which of the following instructions should the nurse include?

Draw up the insulins into separate syringes. The nurse should instruct the client to draw up the insulins into separate syringes because insulin glargine is not compatible with other insulins.

A nurse is assessing a client and suspects the client is experiencing DIC. Which of the following physical findings should the nurse expect?

Epistaxis

A home health nurse is assessing a client who requires lifelong hormone replacement therapy for the treatment of hypothyroidism. The client has not been taking his medication regularly. Which of the following findings should the nurse expect?

Hypotension Hypotension is an expected finding with hypothyroidism, along with bradypnea, dysrhythmias, cold intolerance, and cool, dry skin.

A nurse is caring for a client who is receiving warfarin and anticoagulation therapy. Which of the following laboratory tests indicates to the nurse that the client needs to increase in the dosage?

INR 1.1

A nurse is assessing a client who has diabetes insipidus. The nurse should expect which of the following findings?

Increased hematocrit An increased hematocrit is an expected finding resulting from dehydration.

A nurse is planning care for a client who has Cushing's disease. The nurse should identify that clients who have Cushing's disease are at increased risk for which of the following? (Select all that apply).

Infection Gastric Ulcer Bone fractures

What food choice is indicated for a client with addisons disease?

Turkey and cheese sandwich. Addisons disease pt require diets low in potassium and high in carbs, sodium, and protein

A nurse is caring for a client who is taking propylthiouracil. The nurse should identify that the client has met the treatment goals when she reports an increase in which of the following manifestations?

Weight Propylthiouracil suppresses the production of thyroid hormones and, therefore, allows for weight gain. However, excessive weight gain could indicate that the dose of propylthiouracil is too high

At the beginning of a shift, a nurse is assessing a client who has Cushing's disease. Which of the following findings is the priority?

Weight gain

A nurse is reviewing laboratory values for a client who has diabetic ketoacidosis (DKA). Which of the following results should the nurse expect?

pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L Metabolic acidosis is a common manifestation of DKA, with pH characteristically low, carbon dioxide within the expected reference range, and bicarbonate low.

A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements should the nurse identify as an indication that the client understands the teaching?

"I will apply lotion to the dry areas of my feet, but not between my toes." Lotion can be used for dry areas of the feet, but the client should avoid applying lotion between the toes, as this area is prone to bacterial growth.

A nurse is teaching a client who has type 1 diabetes mellitus about how to prevent complications during illness. Which of the following statements should the nurse identify as an indication that the client understands the teaching?

"I will call my doctor if my blood sugar is more than 250 milligrams per deciliter." The client should call the provider if her blood glucose levels exceed 250 mg/dL during illness.

A nurse is providing teaching for a client who is scheduled for a bone marrow biopsy of the iliac crest. Which of the following statements made by the client indicates an understanding of the teaching?

"I will need to stay in bed for about an hour after the test."

To screen a client for pheochromocytoma, a nurse schedules a vanillylmandelic acid test. When teaching the client about this test, which of the following instructions should the nurse include?

"Restrict coffee intake 2 to 3 days prior to the test." The client should avoid coffee and tea (even if they are decaffeinated), bananas, chocolate, and vanilla for 2 to 3 days prior to the test.

A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include?

"Take this medication on an empty stomach." To promote proper absorption, the client should take the medication on an empty stomach and not eat or drink anything for 30 to 60 min after taking it.

A nurse is providing instructions to a client who has Graves' disease and has a new prescription for propanolol. Which of the following information should the nurse include?

"Take your pulse before each dose."

A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following statements should the nurse identify as an indication that the client understands the information about this test?

"This test's result is a good indicator of my average blood glucose levels." HbA1c reflects the client's glucose levels over a 120-day period, which is the life span of RBCs.

A nurse is providing preoperative teaching for. client who requests autologous donation in preparation for a scheduled orthopedic surgical procedure. Which go the following statements should the nurse include in the teaching?

"you can donate blood each week if your hemoglobin is stable."

A nurse is planning to teach a client who is being evaluated for Addison's disease about the ACTH stimulation test. The nurse should base the instructions on which of the following?

ACTH is a hormone produced by the pituitary gland

A nurse is teaching a client about the adrenocorticotropic hormone (ACTH) stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders?

Addison's disease The nurse should instruct the client that the ACTH stimulation test is the standard test for Addison's disease. It measures the cortisol response to ACTH. The response is absent or very decreased in clients who have primary adrenal insufficiency.

A nurse is managing the care of a client who is postoperative and has acute adrenal insufficiency. Which of the following actions should the nurse take?

Administer IV hydrocortisone sodium. Hydrocortisone sodium is necessary to replace the cortisol deficiency that occurs with adrenal insufficiency.

A nurse is preparing to administer a morning dose of insulin aspart to a client who has T1DM. Which of the following actions should the nurse take?

Administer insulin when breakfast arrives

A nurse is preparing to administer packed RBCs to a client who has a Hgb of 8g/dL. Which of the following actions should the nurse plan to take during the first 15 min of the transfusion?

Assess for an acute hemolytic reaction

A nurse is caring for a client who has diabetes insipidus. Which of the following urinalysis lab findings should the nurse expect?

Decreased specific gravity

A nurse is providing discharge teaching to a client who had diabetic ketoacidosis. Which of the following information should the nurse include about preventing DKA? (select all that apply.)

Drink 2L fluids daily Monitor blood glucose 4hr when ill Administer insulin as prescribed when ill report ketones in the urine after 24hr of illness

A nurse is assessing a client who is 12hr postoperative following a thyroidectomy. which of the following findings is indicative of thyroid crisis? (select all that apply).

Dyspnea Abdominal pain mental confusion

A nurse is caring for a client who has a pheochromocytoma. Which of the following actions should the nurse take?

Elevate the head of the client's bed. The nurse should elevate the head of the client's bed to reduce blood pressure and abdominal pressure.

A nurse is reviewing the health history of a client who has T2DM. Which of the following are risk factors for hyperglycemic-hyperosmolar state (HHS)? (select all that apply).

Evidence of recent MI BUN 35mg/dL Takes a calcium channel blocker Age 77yrs

A nurse is caring for a client who has suspected anemia. Which of the following laboratory tests should the nurse expect?

Hgb 10g/dL

A nurse is monitoring the laboratory values of a client who has diabetes mellitus and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy?

Fasting blood glucose 96 mg/dL This is within the expected reference range for a fasting blood glucose level and indicates that insulin therapy is effective.

A nurse is teaching a client who has a new prescription for ferrous sulfate. Which of the following information should the nurse include in teaching?

Foods high in Vitamin. C will promote absorption

A nurse is assessing a client who has diabetic ketoacidosis and ketones in the urine. The nurse should expect which of the following findings? (select all that apply).

Fruity odor of breath abdominal pain kussmaul respirations metabolic acidosis

A nurse is caring for a client who is 6hr post following a transsphenoidal hypophysectomy. The nurse should test the clients nasal drainage for the presence of which of the following?

Glucose

A nurse is caring for a client undergoing screening for primary Cushing's disease. The nurse should expect an elevation in which of the following laboratory findings?

Glucose Blood glucose is elevated in a client who has Cushing's disease.

A nurse in a providers office is assessing a client who recently began taking levothyroxine to treat hypothyroidism. Which of the following findings should indicate to the nurse that the client might need a decrease in dosage of the medication?

Hand tremors

A nurse is monitoring a client who began receiving a unit of packed RBCs 10 min ago. Which of the following actions should the nurse identify as an indication of a febrile. transfusion reaction? (select all that apply).

Heart rate changes from 88/min to 120/min Client appears flushed

A nurse is reviewing the manifestations of hyperthyroidism with a client. Which of the following findings should the nurse include? (select all that apply).

Heat intolerance palpitations weight loss

A nurse is caring for a client who has DIC. Which of the following meds should the nurse anticipate administering?

Heparin

A nurse is teaching a newly licensed nurse about heparin-induced thrombocytopenia. Which of the following risk factors for this disorder should the nurse include in this teaching?

Heparin therapy for DVT

A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect?

Hirsutism Increased hair growth, or hirsutism, is an expected finding of Cushing's disease due to increased androgen production.

A nurse is monitoring a client who has Grave's disease for the development of thyroid storm. the nurse should report what finding to the providor?

Hypertension

A nurse is planning teaching for a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include?

Ingest alcohol with food to reduce alcohol-induced hypoglycemia. Alcohol inhibits the liver from producing glucose. Consuming carbohydrates while drinking alcoholic beverages helps prevent hypoglycemia.

A nurse is monitoring a client's status 24 hours after a total thyroidectomy. Which of the following findings should the nurse report to the provider?

Laryngeal stridor Laryngeal stridor is a harsh, high-pitched sound with inspiration that indicates respiratory obstruction. The nurse should take immediate action to preserve the client's airway.

A nurse is reinforcing teaching with a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following information should the nurse include in the teaching? (select all that apply).

Medication should not be discontinued without the advice of the provider Follow up blood TSH levels should be obtained take the medication on an empty stomach

A nurse is collecting an admission hx from a client who has hypothyroidism. Which of the following findings should the nurse expect? (select all that apply).

Menorrhagia Dry skin hoarseness

A nurse in a providers office is planning care for a client who has a new diagnosis of Graves' disease and a new prescription for methimazole. Which of the following interventions should the nurse include in the plan of care? (Select all that apply).

Monitor CBC Monitor T3 Advise the client to take the medication at the same time everyday

A nurse is caring for a client who has diabetes mellitus and has developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to the client's feet?

Monitor the temperature of bath water with a thermometer. Peripheral neuropathy makes it difficult to determine if bath water is too hot. Therefore, to prevent injury, the client should use a bath thermometer to ensure a water temperature below 43.3° C (110° F).

A nurse is caring for a client who has primary adrenal insufficiency and is preparing to undergo an ACTH stimulation test. Which of the following findings should the nurse expect after an IV injection of cosyntropin?

No change in plasma cortisol

A nurse is providing medication teaching for a client who has Addison's disease and is taking hydrocortisone. Which of the following instructions should the nurse include? (select all that apply).

Notify the provider of any illness or stress Report any manifestations of weakness or dizziness Do not discontinue the medication suddenly

A nurse in an intensive care unit is planning care for a client who has myxedema coma. Which of the following actions should the nurse include? (select all that apply).

Observe cardiac monitor for dysrhythmias observe for evidence of UTI Initiate IV fluids using 0.9% NaCl Administer a levothyroxine bolus

A nurse is planning care for a client who has acromegaly and is post op rolling a transsphenoidal hypophysesctomy. Which of the following interventions should the nurse include in the plan?

Observe the dressing drainage for the presence of glucose

A nurse preceptor is observing a newly licensed nurse on the unit who is preparing to administer a blood transfusion to an older adult client. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure?

Obtains vital signs every 15 min throughout the procedure

A nurse is assisting a client during a water deprivation test. For which of the following complications should the nurse monitor the client?

Orthostatic hypotension

A nurse is teaching a client who has an autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following effects should the nurse include? (select all that apply)

Osteoporosis is correct. Osteoporosis is an adverse effect of long-term corticosteroid therapy due to the suppression of bone formation and the acceleration of bone resorption that corticosteroid therapy can cause. Moon-shaped face is correct. Long-term corticosteroid therapy causes characteristics of iatrogenic Cushing's syndrome, including a moon-shaped face, a potbelly, and a buffalo hump. Increased risk of infection is correct. Increased risk of infection is an adverse effect of long-term corticosteroid therapy due to suppression of the immune system. It reduces the phagocytic actions of macrophages and neutrophils, thus increasing the risk of infection. Hearing loss is incorrect. Long-term corticosteroid therapy can cause cataracts and glaucoma, but it does not cause hearing loss. Weight loss is incorrect. Long-term corticosteroid therapy is more likely to cause weight gain due to the fluid and sodium retention these medications cause.

A nurse is caring for a client who has disseminated intravascular coagulation (DIC). Which of the following lab values indicate that the clients clotting factors are depleted? (select all that apply.)

Platelets 100,000/mm3 Fibrinogen levels 120mg/dL

A nurse is caring for a client who has a blood glucose 52mg/dL. The client is lethargic but arousable. Which of the following actions should the nurse perform first?

Provide 15g of simple carbs

A nurse is planning care for a client who has Hgb 7.5g/dL and Hct 21.5%. Which of the following actions should the nurse include in the plan of care? (Select all that apply.)

Provide assistance w/ ambulation monitor O2 sat Obtain a stool specimen for occult blood schedule daily rest periods

A nurse is reviewing the medical record for a client who is to begin therapy for DKA. Which of the following prescriptions should the nurse expect?

Rapidly administer an IV infusion of 0.9% NaCl

A nurse has administered propranolol by IV bolus to a client who is having a thyroid storm. Which of the following findings indicates that the client is having a therapeutic response?

Reduction of the effects of thyroid hormone on the heart Propranolol is a beta2-adrenergic blocking agent that decreases the rapid heart rate that excessive thyroid stimulation causes.

A nurse is admitting a client who has acute adrenal insufficiency. Which of the following prescriptions should the nurse expect? (select all that apply).

Regular insulin Hydrocortisone sodium succinate Sodium polystyrene sulfonate Furosemide

A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires intranasal desmopressin. Which of the following information should the nurse include in the teaching plan?

Report nocturia because it requires a dosage adjustment. The client should receive the initial dose of desmopressin in the evening; the provider will increase the dosage until the client no longer has nocturia.

A nurse is caring for a client who has type 2 diabetes melliltus and has hyperglycemic-hyperosmolar state (HHS). Which of the following laboratory findings should the nurse expect?

Serum pH of 7.45 A client who has HHS produces enough insulin to prevent ketosis, but not enough to prevent hyperglycemia. Therefore, the serum pH is within the expected reference range. Glucose levels will be above 600 mg/dL.

A nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following findings should the nurse report to the provider?

Sodium 110 mEq/L A client who has SIADH retains fluids, which causes dilutional hyponatremia.

A nurse is reviewing lab results for a client who has Addison's disease. Which of the following lab results should the nurse expect for this client? (select all that apply).

Sodium 130 Potassium 6.1 Calcium 11.6 BUN 28

A nurse is reviewing the lab findings of a client who has Cushing's disease. Which of the following findings should the nurse expect for this client? (select all that apply).

Sodium 150 mEw/L Potassium 3.3 mEq/L Calcium 8.0mg/dL Fasting glucose 145mg/dL

A nurse is completing an integumentary assessment of a client who has anemia. Which of the following findings should the nurse expect?

Spoon shaped nails

A nurse is caring for a client who is receiving a blood transfusion. Which of the following actions should the nurse plan to take if an allergic transfusion reaction is suspected? (Select all that apply.)

Stop the transfusion Maintain an IV infusion with 0.9% sodium chloride Administer diphenhydramine

A nurse is preparing to receive a client from the PACU who is posted following a thyroidectomy. The nurse should ensure that which of the following equipment is available? (Select all that apply).

Suction equipment humidified oxygen tracheostomy tray

A nurse in a clinic receives a phone call from a client seeking information about a new prescription for erythropoietin. Which of the following information should the nurse review for the client?

The client should have their hemoglobin checked twice a week

A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia?

Tingling and numbness of the hands and feet Hypocalcemia causes paresthesias, which usually starts in the hands and feet.

A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings?

Tremors Findings of hyperthyroidism include tremors, diaphoresis, and insomnia.

A nurse is reviewing laboratory findings for a client who might have hyperthyroidism. The nurse should identify an elevation of which of the following substances as an indication that the client has this disorder?

Triiodothyronine

A nurse is teaching foot care to a client who has diabetes mellitus. Which of the following information should the nurse include in the teaching? (select all that apply).

Trim toenails straight across wear closed-toe shoes

A nurse is providing discharge teaching for a client who had a transsphenoidal hypophysectomy. Which of the following instructions should the nurse include? (select all that apply).

eat a high fiber diet notify the provider of increased swallowing

A nurse is presenting information to a group of clients about nutrition habits that prevent T2DM. Which of the following should the nurse include in the information? (select all that apply)

eat at regular intervals decrease intake of saturated fats increase daily fiber intake Include omega-3 fatty acids