Adult Health- All Endocrine

A client with a recent history of total thyroidectomy has developed iatrogenic hypoparathyroidism. Which observed findings does the nurse determine are associated with the hypoparathyroidism? Select all that apply. 1.Laryngospasm 2.Nephrolithiasis 3.Muscle weakness 4.Positive Chvostek's sign 5.Positive Trousseau's sign

1.Laryngospasm 4.Positive Chvostek's sign 5.Positive Trousseau's sign

A nurse is performing an admission assessment on a client with a diagnosis of pheochromocytoma. The nurse should assess for the major sign associated with pheochromocytoma by performing which action? 1.Obtaining the client's weight 2.Taking the client's blood pressure 3.Testing the client's urine for glucose 4.Palpating the skin for its temperature

2.Taking the client's blood pressure

The nurse is instructing a client with Cushing's syndrome on follow-up care. Which of these client statements would indicate a need for further instruction? 1."I should avoid contact sports." 2."I should check my ankles for swelling." 3."I need to avoid foods high in potassium." 4."I need to check my blood glucose regularly."

3."I need to avoid foods high in potassium."

A client has been hospitalized for impaired function of the posterior pituitary gland. The nurse plans to monitor for signs and symptoms of which hormone imbalance? 1.Growth hormone (GH) 2.Luteinizing hormone (LH) 3.Antidiuretic hormone (ADH) 4.Follicle-stimulating hormone (FSH)

3.Antidiuretic hormone (ADH)

A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client? 1.Hoarseness 2.Hypocalcemia 3.Audible stridor 4.Edema at the surgical site

3.Audible stridor

A client's serum blood glucose level is 389 mg/dL (22.2 mmol/L). The nurse would expect to note which as an additional finding when assessing this client? 1.Unsteady gait 2.Slurred speech 3.Increased thirst 4.Cold, clammy skin

3.Increased thirst

The nurse is reviewing the primary health care provider's (PHCP's) prescriptions for a client with a diagnosis of diabetes mellitus who has been hospitalized for treatment of an infected foot ulcer. The nurse expects to note which finding in the PHCP's prescriptions? 1.A decreased-calorie diet 2.An increased-calorie diet 3.A decreased amount of NPH insulin daily insulin 4.An increased amount of NPH insulin daily insulin

4.An increased amount of NPH insulin daily insulin

The nurse is reviewing the record of a client admitted to the hospital with a diagnosis of pheochromocytoma. The nurse reads the assessment findings and expects to note documentation of which major symptom associated with this condition? 1.Glycosuria 2.Diaphoresis 3.Weight loss 4.Hypertension

4.Hypertension

The nurse is caring for a client with a diagnosis of Addison's disease and is monitoring the client for signs of Addisonian crisis. The nurse should assess the client for which manifestation that would be associated with this crisis? 1.Agitation 2.Diaphoresis 3.Restlessness 4.Severe abdominal pain

4.Severe abdominal pain

A 33-year-old female client is admitted to the hospital with a tentative diagnosis of Graves' disease. Which symptom related to the menstrual cycle would the client be most likely to report during the initial assessment? 1.Amenorrhea 2.Menorrhagia 3.Metrorrhagia 4.Dysmenorrhea

1.Amenorrhea

The nurse is performing an assessment on a client with a diagnosis of myxedema (hypothyroidism). Which assessment finding should the nurse expect to note in this client? 1.Dry skin 2.Thin, silky hair 3.Bulging eyeballs 4.Fine muscle tremors

1. Dry skin

During physical examination of a client, which finding is characteristic of hypothyroidism? 1. Periorbital edema 2.Flushed, warm skin 3.Hyperactive bowel sounds 4.Heart rate of 120 beats/min

1. Periorbital edema

A client's serum blood glucose level is 48 mg/dL (2.74 mmol/L). The nurse would expect to note which as an additional finding when assessing this client? 1.Slurred speech 2.Increased thirst 3.Increased appetite 4.Increased urination

1.Slurred speech

The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client relates a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching? 1."I need to stop my insulin." 2."I need to increase my fluid intake." 3."I need to monitor my blood glucose every 3 to 4 hours." 4."I need to call the primary health care provider (PHCP) because of these symptoms."

1."I need to stop my insulin."

The nurse is teaching a client with hyperparathyroidism how to manage the condition at home. Which response by the client indicates the need for additional teaching? 1."I should consume less than 1 liter of fluid per day." 2."I should use my treadmill or go for walks daily." 3."I should follow a moderate-calcium, high-fiber diet." 4."My alendronate helps keep calcium from coming out of my bones."

1."I should consume less than 1 liter of fluid per day."

The nurse is performing an assessment on a client with a diagnosis of hyperthyroidism. Which assessment finding should the nurse expect to note in this client? 1.Dry skin 2.Bulging eyeballs 3.Periorbital edema 4.Coarse facial features

2. Bulging eyeballs

A client with medullary carcinoma of the thyroid has an excess function of the C cells of the thyroid gland. When reviewing the most recent laboratory results, the nurse should expect which electrolyte abnormality? 1.Sodium 2.Calcium 3.Potassium 4.Magnesium

2. Calcium

The nurse is taking a health history for a client with hyperparathyroidism. Which question would elicit information about this client's condition? 1."Do you have tremors in your hands?" 2."Are you experiencing pain in your joints?" 3."Do you notice swelling in your legs at night?" 4."Have you had problems with diarrhea lately?"

2."Are you experiencing pain in your joints?"

The nurse has provided instructions to the client with hyperparathyroidism regarding home care measures to manage the symptoms of the disease. Which statement by the client indicates a need for further instruction? 1."I should avoid bed rest." 2."I need to avoid doing any exercise at all." 3."I need to space activity throughout the day." 4."I should gauge my activity level by my energy level."

2."I need to avoid doing any exercise at all."

The nurse is providing discharge instructions to a client who has Cushing's syndrome. Which client statement indicates that instructions related to dietary management are understood? 1."I will need to limit the amount of protein in my diet." 2."I should eat foods that have a lot of potassium in them." 3."I am fortunate that I can eat all of the salty foods I enjoy." 4."I am fortunate that I do not need to follow any special diet."

2."I should eat foods that have a lot of potassium in them."

The clinic nurse is providing instructions to a client with diabetes mellitus about the signs and symptoms of hypoglycemia. The nurse should tell the client that which would be noted in a hypoglycemic reaction? 1.Thirst 2.Hunger 3.Polydipsia 4.Increased urine output

2.Hunger

A nurse needs to maintain food and fluid intake to minimize the risk of dehydration in a client with diabetes mellitus who has gastroenteritis. Which is the appropriate nursing intervention? 1.Offer water only until the client is able to tolerate solid foods. 2.Withhold all fluids until vomiting has ceased for at least 4 hours. 3.Encourage the client to take 8 to 12 oz of fluid every hour while awake. 4.Maintain a clear liquid diet for at least 5 days before advancing to solids.

3.Encourage the client to take 8 to 12 oz of fluid every hour while awake.

A client has been diagnosed with pheochromocytoma. Which clinical manifestation is most indicative of this condition? 1.Water loss 2.Bradycardia 3.Hypertension 4.Decreased cardiac output

3.Hypertension

A client is admitted with suspected diabetic ketoacidosis (DKA). Which clinical manifestations best support a diagnosis of DKA? 1.Blood glucose 500 mg/dL (27.8 mmol/L); arterial blood gases: pH 7.30, Paco2 50, HCO3- 26. 2.Blood glucose 400 mg/dL (22.2 mmol/L); arterial blood gases: pH 7.38, Paco2 40, HCO3- 22. 3.Blood glucose 450 mg/dL (25.0 mmol/L); arterial blood gases: pH 7.48, Paco2 39, HCO3- 29. 4.Blood glucose 350 mg/dL (19.4 mmol/L); arterial blood gases: pH 7.28, Paco2 30, HCO3- 14.

4.Blood glucose 350 mg/dL (19.4 mmol/L); arterial blood gases: pH 7.28, Paco2 30, HCO3- 14.

After hypophysectomy, a client complains of being thirsty and having to urinate frequently. What is the initial nursing action? 1.Increase fluid intake. 2.Document the complaints. 3.Assess for urinary glucose. 4.Assess urine specific gravity.

4.Assess urine specific gravity.

The emergency department nurse is reviewing the laboratory test results for a client suspected of having diabetic ketoacidosis (DKA). Which laboratory result should the nurse expect to note in this disorder? 1.Serum pH of 9.0 2.Absent ketones in the urine 3.Serum bicarbonate of 22 mEq/L (22 mmol/L) 4.Blood glucose level of 500 mg/dL (28.5 mmol/L)

4.Blood glucose level of 500 mg/dL (28.5 mmol/L)

The nurse caring for a client who underwent intracranial surgery is suspected of having diabetes insipidus. Which finding noted by the nurse is consistent with this complication of surgery? 1.Complaints of excessive thirst 2.Urine specific gravity of 1.030 3.Urine output of 10 to 15 mL/hour 4.Systolic blood pressures running consistently over 150 mm Hg

1.Complaints of excessive thirst

A client has been diagnosed with hyperthyroidism. The nurse monitors for which signs and symptoms indicating a complication of this disorder? Select all that apply. 1.Fever 2.Nausea 3.Lethargy 4.Tremors 5.Confusion 6.Bradycardia

1.Fever 2.Nausea 4.Tremors 5.Confusion

A client is admitted with a serum glucose level of 650 mg/dL (37.14 mmol/L), and diabetic ketoacidosis (DKA) is suspected. Which additional laboratory result does the nurse identify as being supportive of DKA? 1.Ketones in urine 2.Lactic dehydrogenase (LDH) of 200 U/L 3.pH of 7.52 on arterial blood gas (ABG) analysis 4.Blood urea nitrogen (BUN) of 10 mg/dL (3.6 mmol/L)

1.Ketones in urine

The nurse is developing a plan of care for a client with Cushing's syndrome. The nurse documents a client problem of excess fluid volume. Which nursing actions should be included in the care plan for this client? Select all that apply. 1.Monitor daily weight. 2.Monitor intake and output. 3.Assess extremities for edema. 4.Maintain a high-sodium diet. 5.Maintain a low-potassium diet.

1.Monitor daily weight. 2.Monitor intake and output. 3.Assess extremities for edema.

A client who visits the primary health care provider's office for a routine physical examination reports new onset of intolerance to cold. Knowing that this is a frequent complaint associated with hypothyroidism, the nurse should check for which manifestations? 1.Weight loss and thinning skin 2.Complaints of weakness and lethargy 3.Diaphoresis and increased hair growth 4.Increased heart rate and respiratory rate

2.Complaints of weakness and lethargy

A client is admitted to an emergency department, and a diagnosis of myxedema coma is made. Which action should the nurse prepare to carry out initially? 1.Warm the client. 2.Maintain a patent airway. 3.Administer thyroid hormone. 4.Administer fluid replacement.

2.Maintain a patent airway.

The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptom or symptoms develop? Select all that apply. 1.Polyuria 2.Shakiness 3.Palpitations 4.Blurred vision 5.Lightheadedness 6.Fruity breath odor

2.Shakiness 3.Palpitations 5.Lightheadedness

The nurse is caring for a client after hypophysectomy and notes clear nasal drainage from the client's nostril. The nurse should take which initial action? 1.Lower the head of the bed. 2.Test the drainage for glucose. 3.Obtain a culture of the drainage. 4.Continue to observe the drainage.

2.Test the drainage for glucose.

The nurse is preparing for a client's postoperative return to the unit after a parathyroidectomy procedure. The nurse should ensure that which piece of medical equipment is at the client's bedside? 1.Cardiac monitor 2.Tracheotomy set 3.Intermittent gastric suction device 4.Underwater seal chest drainage system

2.Tracheotomy set

The home care nurse visits a client with a diagnosis of hyperparathyroidism who is taking furosemide and provides dietary instructions to the client. Which statement by the client indicates a need for additional instruction? 1."I need to eat foods high in potassium." 2."I need to drink at least 2 to 3 L of fluid daily." 3."I need to eat small, frequent meals and snacks if nauseated." 4."I need to increase my intake of dietary items that are high in calcium."

4."I need to increase my intake of dietary items that are high in calcium."

The nurse has provided instructions for measuring blood glucose levels to a client newly diagnosed with diabetes mellitus who will be taking insulin. The client demonstrates understanding of the instructions by identifying which method as the best method for monitoring blood glucose levels? 1."I will check my blood glucose level every day at 5:00 p.m." 2."I will check my blood glucose level 1 hour after each meal." 3."I will check my blood glucose level 2 hours after each meal." 4."I will check my blood glucose level before each meal and at bedtime."

4."I will check my blood glucose level before each meal and at bedtime."

The nurse is providing education to a client with type 2 diabetes mellitus. The nurse explains in layperson's language the physiological mechanism behind hypoglycemia. Which response by the client determines that teaching has been successful? 1."My body cannot make insulin." 2."My body has decreased epinephrine levels." 3."My body decreases release of cortisol, which is a stress hormone." 4."My body increases glucagon production to fight low blood sugars."

4."My body increases glucagon production to fight low blood sugars."

A client has a tumor that is interfering with the function of the hypothalamus. The nurse should monitor for signs and symptoms related to which imbalance? 1.Melatonin excess or deficit 2.Glucocorticoid excess or deficit 3.Mineralocorticoid excess or deficit 4.Antidiuretic hormone (ADH) excess or deficit

4.Antidiuretic hormone (ADH) excess or deficit

The nurse teaches a class on foot care for clients diagnosed with diabetes mellitus. Which instructions should the nurse include in the class? Select all that apply. 1.Wear closed-toe shoes. 2.Soak feet in hot water twice a day. 3.Massage lanolin lotion between the toes. 4.Cut toenails straight across and file the edges. 5.Pat feet dry gently, especially between the toes.

1.Wear closed-toe shoes. 4.Cut toenails straight across and file the edges. 5.Pat feet dry gently, especially between the toes.

The nurse is providing instructions to a client newly diagnosed with diabetes mellitus. The nurse gives the client a list of the signs of hyperglycemia. Which specific sign of this complication should be included on the list? 1.Shakiness 2.Increased thirst 3.Profuse sweating 4.Decreased urine output

2.Increased thirst

The nurse is monitoring a client diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy and is recovering in the intensive care unit. Which findings should alert the nurse to the presence of a possible postoperative complication? Select all that apply. 1.Anxiety 2.Leukocytosis 3.Chvostek's sign 4.Urinary output of 800 mL/hr 5.Clear drainage on nasal dripper pad

2.Leukocytosis 4.Urinary output of 800 mL/hr 5.Clear drainage on nasal dripper pad

A client newly diagnosed with diabetes mellitus is started on a 2-dose insulin protocol combination of short- and intermediate-acting insulin injected twice daily. What portion of the total dose is given before breakfast, and what portion is given before the evening meal? 1.Half before breakfast and half before the evening meal 2.Two thirds before breakfast and one third before the evening meal 3.One third before breakfast and two thirds before the evening meal 4.Three fourths before breakfast and one fourth before the evening meal

2.Two thirds before breakfast and one third before the evening meal

A client has been hospitalized for an endocrine system dysfunction of the pancreas. The registered nurse asks the new orientee nurse what kind of problem a client hospitalized for endocrine dysfunction of the pancreas would expect. The new orientee nurse demonstrates understanding if which statement is made? 1."Lipase levels will decrease." 2."Insulin production will be decreased." 3."There will be overproduction of trypsin." 4."Amylase will be secreted in excess amounts."

2."Insulin production will be decreased."

A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety? 1.Administer a sedative. 2.Convey empathy, trust, and respect toward the client. 3.Ignore the signs and symptoms of anxiety, anticipating that they will soon disappear. 4.Make sure that the client is familiar with the correct medical terms to promote understanding of what is happening.

2.Convey empathy, trust, and respect toward the client.

The nurse is preparing a client with a new diagnosis of hypothyroidism for discharge. The nurse determines that the client understands discharge instructions if the client states that which signs and symptoms are associated with this diagnosis? Select all that apply. 1.Tremors 2.Weight loss 3.Feeling cold 4.Loss of body hair 5.Persistent lethargy 6.Puffiness of the face

3.Feeling cold 4.Loss of body hair 5.Persistent lethargy 6.Puffiness of the face

A nurse is caring for a client with a dysfunctional thyroid gland and is concerned that the client will exhibit a sign of thyroid storm. Which is an early indicator of this complication? 1.Bradycardia 2.Constipation 3.Hyperreflexia 4.Low-grade temperature

3.Hyperreflexia

The nurse is caring for a client diagnosed with type 1 diabetes mellitus experiencing the Somogyi effect. Which blood glucose results and treatment would the nurse expect? 1.0300 blood glucose 68 mg/dL (3.8 mmol/L) and 0700 blood glucose 200 mg/dL (11.1 mmol/L). Instruct to decrease amount of evening insulin. 2.0300 blood glucose 68 mg/dL (3.8 mmol/L) and 0700 blood glucose 200 mg/dL (11.1 mmol/L). Instruct to increase amount of evening insulin. 3.0300 blood glucose 190 mg/dL (10.6 mmol/L) and 0700 blood glucose 240 mg/dL (13.3 mmol/L). Instruct to decrease amount of evening insulin. 4.0300 blood glucose 190 mg/dL (10.6 mmol/L) and 0700 blood glucose 240 mg/dL (13.3 mmol/L). Instruct to increase amount of evening insulin.

1.0300 blood glucose 68 mg/dL (3.8 mmol/L) and 0700 blood glucose 200 mg/dL (11.1 mmol/L). Instruct to decrease amount of evening insulin.

A nursing instructor is teaching the class about Addison's disease. The instructor determines that the class understands the disease process if they indicate which are affected in this disease? Select all that apply. 1.Androgens 2.Bicarbonate 3.Electrolytes 4.Glucocorticoids 5.Mineralocorticoids

1.Androgens 4.Glucocorticoids 5.Mineralocorticoids

A client arrives in the hospital emergency department in an unconscious state. As reported by the spouse, the client has diabetes mellitus and began to show symptoms of hypoglycemia. A blood glucose level is obtained for the client, and the result is 40 mg/dL (2.28 mmol/L). Which medication should the nurse anticipate will be prescribed for the client? 1.Glucagon 2.Glyburide 3.Metformin 4.Regular insulin

1.Glucagon

The nurse caring for a male client newly admitted to the hospital with a diagnosis of pneumonia suspects that the client is also at risk for metabolic syndrome if which characteristics have been identified in this client? Select all that apply. 1.Hemoglobin A1C of 6.5% 2.Waist circumference of 36 inches 3.Triglycerides 160 mg/dL (1.81 mmol/L) 4.Consistent systolic blood pressures <130 mm Hg 5.Serial fasting glucose levels of 120 mg/dL (6.85 mmol/L), 132 mg/dL (7.54 mmol/L), and 128 mg/dL (7.31 mmol/L)

1.Hemoglobin A1C of 6.5% 3.Triglycerides 160 mg/dL (1.81 mmol/L) 5.Serial fasting glucose levels of 120 mg/dL (6.85 mmol/L), 132 mg/dL (7.54 mmol/L), and 128 mg/dL (7.31 mmol/L)

The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which prescriptions should the nurse anticipate receiving? Select all that apply. 1.Initiate an infusion of 3% NaCl. 2.Administer intravenous furosemide. 3.Restrict fluids to 800 mL over 24 hours. 4.Elevate the head of the bed to high-Fowler's. 5.Administer a vasopressin antagonist as prescribed.

1.Initiate an infusion of 3% NaCl. 3.Restrict fluids to 800 mL over 24 hours. 5.Administer a vasopressin antagonist as prescribed.

The nurse is developing a plan of care for a client with Addison's disease. The nurse has identified a problem of risk for deficient fluid volume and identifies nursing interventions that will prevent this occurrence. Which nursing interventions should the nurse include in the plan of care? Select all that apply. 1.Monitor for changes in mentation. 2.Encourage an intake of low-protein foods. 3.Encourage an intake of low-sodium foods. 4.Encourage fluid intake of at least 3000 mL per day. 5.Monitor vital signs, skin turgor, and intake and output.

1.Monitor for changes in mentation. 4.Encourage fluid intake of at least 3000 mL per day. 5.Monitor vital signs, skin turgor, and intake and output.

A nurse is assessing the glycemic status of a client with diabetes mellitus. Which sign or symptom would indicate that the client is developing hyperglycemia? 1.Polyuria 2.Diaphoresis 3.Hypertension 4.Increased pulse rate

1.Polyuria

The nurse is completing an assessment on a client who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which client complaints would be characteristic of this disorder? Select all that apply. 1.Polyuria 2.Headache 3.Bone pain 4.Nervousness 5.Weight gain

1.Polyuria 3.Bone pain

A nurse notes that a client with type 1 diabetes mellitus has lipodystrophy on both upper thighs. The nurse should ask the client if which measure is taken? 1.Rotating sites for injection 2.Administering the insulin at a 45-degree angle 3.Cleaning the skin with alcohol before each injection 4.Aspirating for blood before injection into the subcutaneous tissue

1.Rotating sites for injection

What information stated by a nursing student about the 15/15 rule for treating a hypoglycemic reaction indicates a need for further teaching? Select all that apply. 1.Since my client is diabetic, I will check the blood glucose every 15 minutes during the shift. 2.If my client's blood glucose is over 70 mg/dL (3.9 mmol/L), I will give 15 g of juice every 15 minutes. 3.Since my client is diabetic, I will order 15 g of sugar and 15 g of simple carbohydrates to arrive on the lunch tray. 4.If my client's blood glucose is below 70 mg/dL (3.9 mmol/L), I will give 15 g of juice and recheck blood glucose in 15 minutes.

1.Since my client is diabetic, I will check the blood glucose every 15 minutes during the shift. 2.If my client's blood glucose is over 70 mg/dL (3.9 mmol/L), I will give 15 g of juice every 15 minutes. 3.Since my client is diabetic, I will order 15 g of sugar and 15 g of simple carbohydrates to arrive on the lunch tray.

A client with diabetes mellitus is being discharged following treatment for hyperosmolar hyperglycemic syndrome (HHS) precipitated by acute illness. The client tells the nurse, "I will call the primary health care provider (PHCP) the next time I can't eat for more than a day or so." Which statement reflects the most appropriate analysis of this client's level of knowledge? 1.The client needs immediate education before discharge. 2.The client requires follow-up teaching regarding the administration of oral antidiabetics. 3.The client's statement is inaccurate, and he or she should be scheduled for outpatient diabetic counseling. 4.The client's statement is inaccurate, and he or she should be scheduled for educational home health visits.

1.The client needs immediate education before discharge.

The nurse is providing home care instructions to the client with a diagnosis of Cushing's syndrome and prepares a list of instructions for the client. Which instructions should be included on the list? Select all that apply. 1.The signs and symptoms of hypoadrenalism 2.The signs and symptoms of hyperadrenalism 3.Instructions to take the medications exactly as prescribed 4.The importance of maintaining regular outpatient follow-up care 5.A reminder to read the labels on over-the-counter medications before purchase

1.The signs and symptoms of hypoadrenalism 2.The signs and symptoms of hyperadrenalism 3.Instructions to take the medications exactly as prescribed 4.The importance of maintaining regular outpatient follow-up care

The nurse is monitoring a client who was diagnosed with type 1 diabetes mellitus and is being treated with NPH and regular insulin. Which manifestations would alert the nurse to the presence of a possible hypoglycemic reaction? Select all that apply. 1.Tremors 2.Anorexia 3.Irritability 4.Nervousness 5.Hot, dry skin 6.Muscle cramps

1.Tremors 3.Irritability 4.Nervousness

A hospitalized client is diagnosed with type 1 diabetes mellitus. The nurse plans care for the client, understanding that which factors are likely causes of the beta cell destruction that accompanies this disorder? Select all that apply. 1.Viruses 2.Genetic factors 3.Autoimmune factors 4.Human leukocyte antigen (HLA) 5.Primary failure of glucagon secretion

1.Viruses 2.Genetic factors 3.Autoimmune factors 4.Human leukocyte antigen (HLA)

A client with type 1 diabetes mellitus who takes NPH daily in the morning calls the nurse to report recurrent episodes of hypoglycemia with exercising. Which statement by the client indicates an adequate understanding of the peak action of NPH insulin and exercise? 1."I should not exercise since I am taking insulin." 2."The best time for me to exercise is after breakfast." 3."The best time for me to exercise is mid- to late-afternoon." 4."NPH is a basal insulin, so I should exercise in the evening."

2."The best time for me to exercise is after breakfast." Rationale:Exercise is an important part of diabetes management. It promotes weight loss, decreases insulin resistance, and helps control blood glucose levels. A hypoglycemic reaction may occur in response to increased exercise, so clients should exercise either an hour after mealtime or after consuming a 10- to 15-g carbohydrate snack, and they should check their blood glucose level before exercising. Option 1 is incorrect because clients with diabetes should exercise, though they should check with their primary health care provider before starting a new exercise program. Option 3 in incorrect; clients should avoid exercise during the peak time of insulin. NPH insulin peaks at 4 to 12 hours; therefore, afternoon exercise takes place during the peak of the medication. Option 4 is incorrect; NPH insulin is an intermediate-acting insulin, not a basal insulin.

The nursing instructor asks a nursing student to identify the risk factors associated with the development of thyrotoxicosis. The student demonstrates understanding of the risk factors by identifying an increased risk for thyrotoxicosis in which client? 1.A client with hypothyroidism 2.A client with Graves' disease who is having surgery 3.A client with diabetes mellitus scheduled for a diagnostic test 4.A client with diabetes mellitus scheduled for debridement of a foot ulcer

2.A client with Graves' disease who is having surgery

A client has returned to the nursing unit after a thyroidectomy. The nurse notes that the client is complaining of tingling sensations around the mouth, fingers, and toes. On the basis of these findings, the nurse should next assess the results of which serum laboratory study? 1.Sodium 2.Calcium 3.Potassium 4.Magnesium

2.Calcium

The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The nurse places priority on which client problem? 1.Lack of knowledge 2.Inadequate fluid volume 3.Compromised family coping 4.Inadequate consumption of nutrients

2.Inadequate fluid volume

The nurse is caring for a client who is 2 days postoperative from abdominal hysterectomy. The client has a history of diabetes mellitus and has been receiving regular insulin based on capillary blood glucose testing 4 times a day. A carbohydrate-controlled diet has been prescribed, but the client has not been eating. On entering the client's room, the nurse finds the client to be pale and diaphoretic. Which action is appropriate at this time? 1.Call a code to obtain needed assistance immediately. 2.Obtain a capillary blood glucose level and quickly perform a focused assessment. 3.Ask the assistive personnel (AP) to stay with the client while obtaining a carbohydrate snack for the client to eat. 4.Stay with the client and ask the AP to call the primary health care provider (PHCP) for a prescription for intravenous 50% dextrose.

2.Obtain a capillary blood glucose level and quickly perform a focused assessment.

A client's laboratory results indicate the serum calcium is 12 mg/dL (3 mmol/L) and the serum phosphorous is 2.1 mg/dL (0.697 mmol/L). Based on these findings, the nurse suspects imbalance of which hormone? 1.Thyroid hormone 2.Parathyroid hormone 3.Follicle-stimulating hormone 4.Adrenocorticotropic hormone

2.Parathyroid hormone

A client with type 1 diabetes mellitus is admitted to the emergency department with suspected diabetic ketoacidosis (DKA). Which laboratory result would be expected with this diagnosis? 1.Urine is negative for ketones. 2.Serum potassium is 6.8 mEq/L (6.8 mmol/L). 3.Serum osmolality is 260 mOsm/kg (260 mmol/kg) H2O. 4.Arterial blood gas values are pH 7.52, PCO2 44 mm Hg, HCO3- 30 mEq/L (30 mmol/L).

2.Serum potassium is 6.8 mEq/L (6.8 mmol/L).

A client with suspected Cushing's syndrome is scheduled for adrenal venography. A nurse has provided instructions to the client regarding the test. Which statement by the client indicates a need for further instruction? 1."I need to sign an informed consent." 2."The insertion site will be locally anesthetized." 3."I will be placed in a high-sitting position for the test." 4."I may feel a burning sensation after the dye is injected."

3."I will be placed in a high-sitting position for the test."

A client newly diagnosed with diabetes mellitus is instructed by the primary health care provider to obtain glucagon for emergency home use. The client asks a home care nurse about the purpose of the medication. What is the nurse's best response to the client's question? 1."It will boost the cells in your pancreas if you have insufficient insulin." 2."It will help promote insulin absorption when your glucose levels are high." 3."It is for the times when your blood glucose is too low from too much insulin." 4."It will help prevent lipoatrophy from the multiple insulin injections over the years."

3."It is for the times when your blood glucose is too low from too much insulin."

The nurse is performing an assessment on a client with pheochromocytoma. Which assessment data would indicate a potential complication associated with this disorder? 1.A urinary output of 50 mL/hour 2.A coagulation time of 5 minutes 3.A heart rate that is 90 beats/minute and irregular 4.A blood urea nitrogen level of 20 mg/dL (7.1 mmol/L)

3.A heart rate that is 90 beats/minute and irregular

The nurse is reviewing the laboratory test results for a client with a diagnosis of Cushing's syndrome. Which laboratory finding would the nurse expect to note in this client? 1.A platelet count of 200,000 mm3 (200 × 109/L) 2.A blood glucose level of 110 mg/dL (6.28 mmol/L) 3.A potassium (K+) level of 5.5 mEq/L (5.5 mmol/L) 4.A white blood cell (WBC) count of 6000 mm3 (6 × 109/L)

3.A potassium (K+) level of 5.5 mEq/L (5.5 mmol/L)

The nurse is reviewing the postoperative prescriptions for a client who had a transsphenoidal hypophysectomy. Which prescription, if noted on the record, would indicate the need for clarification? 1.Assess vital signs and neurological status. 2.Instruct the client to avoid blowing his nose. 3.Apply a loose dressing if any clear drainage is noted. 4.Instruct the client about the need for a MedicAlert bracelet.

3.Apply a loose dressing if any clear drainage is noted.

A client is admitted to the hospital with a diagnosis of pheochromocytoma. The nurse would check which item to detect the primary manifestation of this disorder? 1.Weight 2.Urine ketones 3.Blood pressure 4.Skin temperature

3.Blood pressure

The nurse is providing instructions regarding home care measures to a client with diabetes mellitus and instructs the client about the causes of hypoglycemia. The nurse determines that additional instruction is needed if the client identifies which as a cause of hypoglycemia? 1.Omitted meals 2.Increased intensity of activity 3.Decreased daily insulin dosage 4.Inadequate amount of fluid intake

3.Decreased daily insulin dosage

A nurse is reviewing the assessment findings and laboratory data for a client with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The nurse understands that which symptoms are associated characteristics of this disorder? Select all that apply. 1.Hypernatremia 2.Signs of water deficit 3.High urine osmolality 4.Low serum osmolality 5.Hypotonicity of body fluids 6.Continued release of antidiuretic hormone (ADH)

3.High urine osmolality 4.Low serum osmolality 5.Hypotonicity of body fluids 6.Continued release of antidiuretic hormone (ADH)

A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level is 950 mg/dL (52.9 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240 mg/dL (13.3 mmol/L). The nurse would next prepare to administer which medication? 1.An ampule of 50% dextrose 2.NPH insulin subcutaneously 3.IV fluids containing dextrose 4.Phenytoin for the prevention of seizures

3.IV fluids containing dextrose

The nurse should include which interventions in the plan of care for a client with hypothyroidism? Select all that apply. 1.Provide a cool environment for the client. 2.Instruct the client to consume a high-fat diet. 3.Instruct the client about thyroid replacement therapy. 4.Encourage the client to consume fluids and high-fiber foods in the diet. 5.Inform the client that iodine preparations will be prescribed to treat the disorder. 6.Instruct the client to contact the primary health care provider (PHCP) if episodes of chest pain occur.

3.Instruct the client about thyroid replacement therapy. 4.Encourage the client to consume fluids and high-fiber foods in the diet. 6.Instruct the client to contact the primary health care provider (PHCP) if episodes of chest pain occur.

The nurse is caring for a client after thyroidectomy. The client expresses concern about the postoperative voice hoarseness she is experiencing and asks if the hoarseness will subside. The nurse should provide the client with which information? 1.It indicates nerve damage. 2.The hoarseness is permanent. 3.It is normal during this time and will subside. 4.It will worsen before it subsides, which may take 6 months.

3.It is normal during this time and will subside.

A client with type 1 diabetes mellitus is to begin an exercise program, and the nurse is providing instructions regarding the program. Which instruction should the nurse include in the teaching plan? 1.Try to exercise before mealtimes. 2.Administer insulin after exercising. 3.Take a blood glucose test before exercising. 4.Exercise is best performed during peak times of insulin.

3.Take a blood glucose test before exercising.

The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client makes which statement? 1."I will stop taking my insulin if I'm too sick to eat." 2."I will decrease my insulin dose during times of illness." 3."I will adjust my insulin dose according to the level of glucose in my urine." 4."I will notify my primary doctor if my blood glucose level is higher than 250."

4."I will notify my primary doctor if my blood glucose level is higher than 250."

After client education about the importance of sunscreen use and active vitamin production via the skin, the nurse determines that the client understands the teaching when which statement is made? 1."Vitamin B is activated in the outer layer of the skin by the sun." 2."Vitamin E deficiency occurs from lack of exposure to sunlight." 3."Vitamin K can be depleted if exposed to excess ultraviolet light." 4."Vitamin D is activated in the epidermis from ultraviolet light, such as sunlight."

4."Vitamin D is activated in the epidermis from ultraviolet light, such as sunlight."

The nurse is caring for a client admitted to the emergency department with diabetic ketoacidosis (DKA). In the acute phase, the nurse plans for which priority intervention? 1.Correct the acidosis. 2.Administer 5% dextrose intravenously. 3.Apply a monitor for an electrocardiogram. 4.Administer short-duration insulin intravenously.

4.Administer short-duration insulin intravenously.

A client arrives in the hospital emergency department complaining of severe thirst and polyuria. The client tells the nurse that she has a history of diabetes mellitus. A blood glucose level is drawn, and the result is 685 mg/dL (39.1 mmol/L). Which intervention should the nurse anticipate to be prescribed initially for the client? 1.Glyburide via the oral route 2.Glucagon via the subcutaneous route 3.Insulin aspart via the subcutaneous route 4.Regular insulin via the intravenous (IV) route

4.Regular insulin via the intravenous (IV) route

During health history taking, the client complains of weight loss and diarrhea and says that he can "feel my heart beating in my chest." The nurse anticipates that which diagnostic test will most likely be prescribed by the primary health care provider (PHCP) in order to determine the underlying condition leading to the client's signs and symptoms? 1.Endoscopy 2.Electrocardiogram 3.Stool for occult blood 4.Serum thyroid-stimulating hormone (TSH)

4.Serum thyroid-stimulating hormone (TSH)

A client with type 1 diabetes mellitus is admitted to the hospital with diabetic ketoacidosis and a serum glucose level of 789 mg/dL (45 mmol/L). The primary health care provider (PHCP) prescribes 10 units of regular insulin by intravenous (IV) bolus, followed by a continuous insulin infusion at a rate of 5 units/hr. The pharmacy sends 500 mL of normal saline solution containing 50 units of regular insulin. After administering the IV bolus of 10 units of regular insulin, the nurse sets the infusion pump flow rate of the normal saline solution containing 50 units of regular insulin to infuse at how many milliliters per hour to deliver 5 units/hr? Fill in the blank.

50 mL/hr

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which findings support this diagnosis? Select all that apply. 1.Increase in pH 2.Comatose state 3.Deep, rapid breathing 4.Decreased urine output 5.Elevated blood glucose level

2.Comatose state 3.Deep, rapid breathing 5.Elevated blood glucose level

The nurse is monitoring a client with Graves' disease for signs of thyrotoxic crisis (thyroid storm). Which signs or symptoms, if noted in the client, will alert the nurse to the presence of this crisis? 1.Fever and tachycardia 2.Pallor and tachycardia 3.Agitation and bradycardia 4.Restlessness and bradycardia

1.Fever and tachycardia

A client with suspected primary hyperparathyroidism is undergoing diagnostic testing. The nurse would assess for which as a manifestation of this disorder? 1.Polyuria 2.Diarrhea 3.Polyphagia 4.Weight gain

1.Polyuria

The client with pheochromocytoma is scheduled for surgery and says to the nurse, "I'm not sure that surgery is the best thing to do." Which statement is the appropriate response by the nurse? 1."There is no reason to worry. Your surgeon is wonderful." 2."I think you are making the right decision to have the surgery." 3."You are very ill. Your surgeon has made the correct decision." 4."You have concerns about the surgical treatment for your condition?"

4."You have concerns about the surgical treatment for your condition?"

The nurse is caring for a client with a diagnosis of Cushing's syndrome. Which expected signs and symptoms should the nurse monitor for? Select all that apply. 1.Anorexia 2.Dizziness 3.Weight loss 4.Moon face 5.Hypertension 6.Truncal obesity

4.Moon face 5.Hypertension 6.Truncal obesity

A test to measure long-term control of diabetes mellitus has been prescribed for a client. In instructing the client about the test, the nurse explains that long-term control can be measured because chronic high blood glucose levels lead to irreversible glucose binding onto what? 1.Platelets 2.Muscle tissue 3.Adipose tissue 4.Red blood cells (RBCs)

4.Red blood cells (RBCs)

The nurse is assessing the learning readiness of a client newly diagnosed with diabetes mellitus. Which behavior indicates to the nurse that the client is not ready to learn? 1.The client asks if the spouse may attend the teaching session. 2.The client asks appropriate questions about what will be taught. 3.The client asks for written materials about diabetes mellitus before class. 4.The client complains of fatigue whenever the nurse plans a teaching session.

4.The client complains of fatigue whenever the nurse plans a teaching session.

During routine nursing assessment after hypophysectomy, a client complains of thirst and frequent urination. Knowing the expected complications of this surgery, what should the nurse assess next? 1.Serum glucose 2.Blood pressure 3.Respiratory rate 4.Urine specific gravity

4.Urine specific gravity