Adult Nursing 5 Test 5

A patient with diabetes rides a bicycle to and from work every day. Which site should the nurse teach the patient to use to administer the morning insulin

abdomen.

Which tissues require insulin to enable movement of glucose into the tissue cells (select all that apply)?

adipose and skeletal muscle

A 30-yr-old patient has a new diagnosis of type 2 diabetes. The nurse will discuss the need to schedule a dilated eye examination

as soon as possible

A patient is scheduled for transsphenoidal hypophysectomy to treat a pituitary adenoma. During preoperative teaching, the nurse instructs the patient about the need to

avoid brushing teeth for at least 10 days after the surgery.

A patient who had radical neck surgery to remove a malignant tumor developed hypoparathyroidism. The nurse should plan to teach the patient about

calcium supplements to normalize serum calcium levels.

A patient who has type 1 diabetes plans to swim laps for an hour daily at 1:00 PM. The clinic nurse will plan to teach the patient to

check glucose level before, during, and after swimming

The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose

chooses a puncture site in the center of the finger pad.

The nurse is assessing a male patient diagnosed with a pituitary tumor causing panhypopituitarism. Assessment findings consistent with panhypopituitarism include

decreased facial hair.

A 56-yr-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with possible syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would expect the initial laboratory results to include a(n)

decreased serum sodium.

An 82-yr-old patient in a long-term care facility is newly diagnosed with hypothyroidism. The nurse will need to consult with the health care provider before administering the prescribed

diazepam (Valium).

During the nurse's physical examination of a young adult, the patient's thyroid gland cannot be felt. The most appropriate action by the nurse is to

document that the thyroid was nonpalpable

Individualized nutrition therapy for patients using conventional, fixed insulin regimens should include teaching the patient to

eat regular meals at regular times

A patient is taking spironolactone (Aldactone), a drug that blocks the action of aldosterone on the kidney, for hypertension. The nurse will monitor for

elevated serum potassium

The nurse reviews a patient's glycosylated hemoglobin (A1C) results to evaluate

glucose control over the past 90 days.

The nurse will plan to monitor a patient diagnosed with a pheochromocytoma for

headache

The nurse determines that a patient with a 2-hour OGTT of 152 mg/dL has

impaired glucose tolerance

A young adult patient is being seen in the clinic with increased secretion of the anterior pituitary hormones. The nurse would expect the laboratory test results to show

increased urinary cortisol

An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

insert an IV catheter.

The nurse will teach a patient who is scheduled to complete a 24-hour urine collection for 17-ketosteroids to

keep the specimen refrigerated or on ice

A patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about

lifestyle changes to lower blood glucose

The home care nurse should intervene to correct a patient whose insulin administration includes

mixing an evening dose of regular insulin with insulin glargine in one syringe for administration.

The nurse providing care for a patient who has an adrenocortical adenoma causing hyperaldosteronism should

monitor the blood pressure every 4 hours.

After a patient with a pituitary adenoma has had a hypophysectomy, the nurse will teach about the need for

oral corticosteroids to replace endogenous cortisol

A 61-yr-old female patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L). The nurse will anticipate the need to teach the patient about testing for _____ levels

parathyroid hormone

A hospitalized diabetic patient received 38 U of NPH insulin at 7:00 AM. At 1:00 PM, the patient has been away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest x-ray. To prevent hypoglycemia, the best action by the nurse is to

request that if testing is further delayed, the patient be returned to the unit to eat

When a patient who takes metformin (Glucophage) to manage type 2 diabetes develops an allergic rash from an unknown cause, the health care provider prescribes prednisone. The nurse will anticipate that the patient may

require administration of insulin while taking prednisone

A 62-yr-old patient with hyperthyroidism is to be treated with radioactive iodine (RAI). The nurse instructs the patient

that symptoms of hypothyroidism may occur as the RAI therapy takes effect

The nurse determines that demeclocycline is effective for a patient with syndrome of inappropriate antidiuretic hormone (SIADH) based on finding that the patient's

urinary output is increased.

Common nonspecific manifestations that may alert the nurse to endocrine dysfunction include

weight loss, fatigue, and depression.

From where is the hormone glucagon secreted?

α-cells of the islets of Langerhans

During routine health screening, a patient is found to have fasting plasma glucose (FPG) of 132 mg/dL (7.33 mmol/L). At a follow-up visit, a diagnosis of diabetes would be made based on which laboratory results (select all that apply)?

-A1C of 7.5% -FPG ≥127 mg/dL (7.0 mmol/L).

To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually (select all that apply)?

-Blood pressure -Serum creatinine -Urine for microalbuminuria -Monofilament testing of the foot

What disorders and diseases are related to macrovascular complications of diabetes (select all that apply)?

-Coronary artery disease -Ulceration and amputation of the lower extremities

An African American woman with a history of breast cancer has panhypopituitarism from radiation therapy for a primary pituitary tumor. Which medications should the nurse teach her about needing for the rest of her life (select all that apply)?

-Cortisol -Vasopressin -Levothyroxine (Synthroid) -Growth hormone (somatropin [Omnitrope])

A patient has been diagnosed with hypoparathyroidism. What manifestations should the nurse expect to observe (select all that apply)?

-Dry, scaly skin -Personality changes -Abdominal cramping -Cardiac dysrhythmias -Muscle spasms and stiffness

The patient with diabetes is brought to the emergency department by his family members, who say that he has had an infection, is not acting like himself, and he is more tired than usual. Number the nursing actions in the order of priority for this patient.

-Ensure patent airway -Check blood glucose -Establish IV access -Administer 0.9% NaCl solution at 1 L/hr. -Begin continuous regular insulin drip. -Establish time of last food and medication(s).

The patient with diabetes has been diagnosed with autonomic neuropathy. What problems should the nurse expect to find in this patient (select all that apply)?

-Erectile dysfunction -Vomiting undigested food -Painless myocardial infarction

The patient with diabetes has a blood glucose level of 248 mg/dL. Which manifestations in the patient would the nurse understand as being related to this blood glucose level (select all that apply)?

-Headache -Abdominal cramps -Increase in urination -Weakness and fatigue

Which abnormal assessment findings are related to thyroid dysfunction (select all that apply)?

-Heat intolerance caused by hyperfunction -Exophthalmos associated with excessive secretion -A goiter with either hyperfunction or hypofunction

The nurse is teaching the patient with prediabetes ways to prevent or delay the development of type 2 diabetes. What information should be included (select all that apply)?

-Maintain a healthy weight -Monitor for polyuria, polyphagia, and polydipsia

Which characteristics most accurately describe the use of RAI (select all that apply)?

-Often causes hypothyroidism over time -Treatment of choice in nonpregnant adults -Decreases thyroid hormone secretion by damaging thyroid gland

In which order will the nurse take these steps to prepare NPH 20 units and regular insulin 2 units using the same syringe

-Rotate NPH vial -Inject 20 units of air into NPH vial. -Inject 2 units of air into regular insulin vial -Withdraw regular insulin. -Withdraw 20 units of NPH.

The patient with type 2 diabetes is being put on acarbose (Precose) and wants to know about taking it. What should the nurse include in this patient's teaching (select all that apply)?

-Take it with the first bite of each meal -Effectiveness is measured by 2-hour postprandial glucose. -It delays glucose absorption from the gastrointestinal (GI) tract

Which statements will the nurse include when teaching a patient who is scheduled for oral glucose tolerance testing in the outpatient clinic (select all that apply

-You will need to avoid smoking before the test -Several blood samples will be obtained during the testing -The test requires that you fast for at least 8 hours before testing

A patient with Addison's disease comes to the ED with complaints of nausea, vomiting, diarrhea, and fever. What interprofessional care should the nurse expect?

IV administration of hydrocortisone

Which information will the nurse include when teaching a 50-yr-old male patient about somatropin (Genotropin)?

Inject the medication subcutaneously every day

A patient with diabetic ketoacidosis is brought to the emergency department. Which prescribed action should the nurse implement first?

Infuse 1 L of normal saline per hour.

A nurse working in an outpatient clinic plans a screening program for diabetes. What recommendations for screening should be included?

FPG for all individuals at age 45 and then every 3 years

A 27-yr-old patient admitted with diabetic ketoacidosis (DKA) has a serum glucose level of 732 mg/dL and serum potassium level of 3.1 mEq/L. Which action prescribed by the health care provider should the nurse take first?

Place the patient on a cardiac monitor.

When caring for a patient with nephrogenic diabetes insipidus, what should the nurse expect the treatment to include

Thiazide diuretics

A 26-yr-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to

monitor blood glucose every 4 hours and notify the clinic if it continues to rise

An expected patient problem for a patient admitted to the hospital with symptoms of diabetes insipidus is

sleep pattern disturbance related to frequent waking to void

A 30-yr-old female patient was brought to the emergency department (ED) after a seizure at work. During the assessment she mentions hair loss and menstrual irregularities. What diagnostic tests would be helpful to determine if endocrine problems are a cause of her problem (select all that apply)?

-Luteinizing hormone (LH) -Follicle-stimulating hormone (FSH) -Magnetic resonance imaging (MRI) of the head

What are manifestations of diabetic ketoacidosis (DKA) (select all that apply)?

-Thirst -Ketonuria -Dehydration -Metabolic acidosis -Kussmaul respirations -Sweet, fruity breath odor

What characterizes type 2 diabetes (select all that apply)?

-β-cell exhaustion -Insulin resistance -Genetic predisposition -Altered production of adipokines -Inherited defect in insulin receptors -Inappropriate glucose production by the liver

A patient is admitted to the hospital with a diagnosis of Cushing syndrome. On physical assessment of the patient, what should the nurse expect to find?

. Hypertension, peripheral edema, and petechiae

The nurse is interviewing a new patient with diabetes who takes rosiglitazone (Avandia). Which information would the nurse anticipate resulting in the health care provider discontinuing the medication

. The patient has chest pressure when walking

The nurse should observe the patient for symptoms of ketoacidosis when

. an insulin deficit causes the body to metabolize large amounts of fatty acids rather than glucose for energy

A patient receives aspart (NovoLog) insulin at 8:00 AM. At which time would the nurse anticipate the highest risk for hypoglycemia?

10:00 AM

An 18-yr-old male patient with small stature is scheduled for a growth hormone stimulation test. In preparation for the test, the nurse will obtain

50% dextrose solution

To ensure accurate results of a fasting blood glucose analysis, the nurse instructs the patient to fast for at least how long?

8 hours

After change-of-shift report, which patient should the nurse assess first

A 23-yr-old patient with type 1 diabetes who has a blood glucose of 40 mg/dL

Which patient should the nurse plan to teach how to prevent or delay the development of diabetes?

A 34-yr-old woman whose parents both have type 2 diabetes

After change-of-shift report, which patient will the nurse assess first

A 60-yr-old patient with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa

After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?

A 70-yr-old female patient taking levothyroxine (Synthroid) who has an irregular pulse of 134

A patient with type 1 diabetes uses 20 U of Novolin 70/30 (NPH/regular) in the morning and at 6:00 PM. When teaching the patient about this regimen, what should the nurse emphasize

A set meal pattern with a bedtime snack is necessary to prevent hypoglycemia.

What is released in the normal response to increased serum osmolality

ADH from the posterior pituitary gland, which stimulates the kidney to reabsorb water

When caring for a patient with metabolic syndrome, the nurse should give the highest priority to teaching the patient about which treatment plan?

Achieving a normal weight

A patient who is on corticosteroid therapy for treatment of an autoimmune disorder has the following additional drugs ordered. Which one is used to prevent corticosteroid-induced osteoporosis?

Alendronate (Fosamax)

A patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which patient information is important for the nurse to communicate to the health care provider before the test?

Allergies to iodine and shellfish

A patient who has diabetes and reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline

Amitriptyline helps prevent transmission of pain impulses to the brain

A patient seen in the emergency department for severe headache and acute confusion has a serum sodium level of 118 mEq/L. The nurse will anticipate the need for which diagnostic test

Antidiuretic hormone level

What is a cause of primary hypothyroidism in adults

Autoimmune-induced atrophy of the thyroid gland

Which class of oral glucose-lowering agents (OA) is most commonly used for people with type 2 diabetes because it reduces hepatic glucose production and enhances tissue uptake of glucose?

Biguanide

An active 32-yr-old male who has type 1 diabetes is being seen in the endocrine clinic. Which finding indicates a need for the nurse to discuss a possible a change in therapy with the health care provider?

Blood pressure of 140/88 mmHg

A patient with hypoparathyroidism resulting from surgical treatment of hyperparathyroidism is preparing for discharge. What should the nurse teach the patient

Calcium supplements with vitamin D can effectively maintain calcium balance

Which statement about the adrenal medulla hormones is accurate

Catecholamines are considered hormones when they are secreted by the adrenal medulla and neurotransmitters when they are secreted by nerve cells.

Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is correct

Changes in diet and exercise may control blood glucose levels in type 2 diabetes

The following interventions are planned for a patient with diabetes. Which intervention can the nurse delegate to UAP?

Check that the bath water is not too hot.

The health care provider suspects the Somogyi effect in a 50-yr-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take

Check the blood glucose during the night

Which information will the nurse include in teaching a female patient who has peripheral arterial disease, type 2 diabetes, and sensory neuropathy of the feet and legs

Choose flat-soled leather shoes.

What characteristic is related to Hashimoto's thyroiditis?

Chronic autoimmune thyroiditis with antibody destruction of thyroid tissue

The nurse assesses the technique of the patient with diabetes for self-monitoring of blood glucose (SMBG) 3 months after initial instruction. Which error in the performance of SMBG noted by the nurse requires intervention

Cleaning the puncture site with alcohol before the puncture

A patient will be scheduled in the outpatient clinic for blood cortisol testing. Which instruction will the nurse provide

Come to the laboratory to have the blood drawn early in the morning

When teaching the patient with diabetes about insulin administration, the nurse should include which instruction for the patient

Consistently use the same size of insulin syringe to avoid dosing errors

What are two effects of hypokalemia on the endocrine system?

Decreased insulin and aldosterone release

. The patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What manifestation should the nurse expect to find?

Decreased urinary output

To assist an older patient with diabetes to engage in moderate daily exercise, which action is most important for the nurse to take

Determine what types of activities the patient enjoys

Which question during the assessment of a patient who has diabetes will help the nurse identify autonomic neuropathy

Do you feel bloated after eating

A 40-yr-old patient with suspected acromegaly is seen at the clinic. To assist in making the diagnosis, which question should the nurse ask?

Do you have to wear larger shoes now

When replacement therapy is started for a patient with long-standing hypothyroidism, what is most important for the nurse to monitor for in the patient

Dysrhythmias

Which nursing action will be included in the plan of care for a patient with Graves' disease who has exophthalmos

Elevate the head of the patient's bed to reduce periorbital fluid

The female patient is admitted with a new diagnosis of Cushing syndrome with elevated serum and urine cortisol levels. Which assessment findings should the nurse expect to see in this patient?

Elevated blood pressure and blood glucose

A patient suspected of having acromegaly has an elevated plasma growth hormone (GH) level. In acromegaly, what would the nurse also expect the patient's diagnostic results to indicate

Elevated levels of plasma insulin-like growth factor-1 (IGF-1)

A patient is admitted to the hospital with acute thyrotoxicosis. On physical assessment of the patient, what should the nurse expect to find

Elevated temperature and signs of heart failure

A patient with primary hyperparathyroidism has a serum phosphorus level of 1.7 mg/dL (0.55 mmol/L) and calcium of 14 mg/dL (3.5 mmol/L). Which nursing action should be included in the plan of care?

Encourage 4000 mL of fluids daily

A patient with acromegaly is treated with a transsphenoidal hypophysectomy. What should the nurse do postoperatively?

Ensure that any clear nasal drainage is tested for glucose and protein.

What manifestations of endocrine problems in the older adult are commonly attributed to the aging process?

Fatigue and mental impairment

When caring for a patient with primary hyperaldosteronism, the nurse would question an HCP's prescription for which drug

Furosemide (Lasix)

The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL. Fifteen minutes later, the blood glucose is 67 mg/dL. Which action should the nurse take next?

Give the patient 4 to 6 oz more orange juice.

Which action should the nurse take after a patient treated with intramuscular glucagon for hypoglycemia regains consciousness

Give the patient a snack of peanut butter and crackers

A few weeks after an 82-yr-old patient with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding should the nurse promptly discuss with the health care provider?

Glomerular filtration rate is decreased.

How do hormones respond following the ingestion of a high-protein, carbohydrate-free meal

Glucagon is released to promote gluconeogenesis, and insulin is released to facilitate movement of amino acids into muscle cells.

The patient with type 2 diabetes has had trouble controlling his blood glucose with several OAs but wants to avoid the risks of insulin. The HCP told him a medication will be prescribed that will increase insulin synthesis and release from the pancreas, inhibit glucagon secretion, and slow gastric emptying. The nurse knows this is which medication that will have to be injected?

Glucagon-like peptide-1 receptor agonist, exenatide extended release (Bydureon)

The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following

I can choose any foods, as long as I use enough insulin to cover the calories

Which statement by a 50-yr-old female patient indicates to the nurse that further assessment of thyroid function may be necessary?

I feel a lump in my throat when I swallow

During discharge teaching for the patient with Addison's disease, which statement by the patient indicates that the nurse needs to do additional teaching?

If my weight goes down, my dosage of steroid is probably too high

A patient with Graves' disease asks the nurse what caused the disorder. What is the best response by the nurse?

In genetically susceptible persons, antibodies are formed that cause excessive thyroid hormone secretion

What is an appropriate nursing intervention for the patient with hyperparathyroidism

Increase fluid intake to 3000 to 4000 mL daily.

In a patient with central diabetes insipidus, the administration of ADH during a water deprivation test will result in what?

Increase in urine osmolality

What accurately demonstrates that hormones of one gland influence the function of hormones of another gland

Increased atrial natriuretic peptide (ANP) levels inhibit the secretion of aldosterone

Which finding for a patient who has hypothyroidism and hypertension indicates that the nurse should contact the health care provider before administering levothyroxine (Synthroid)?

Increased thyroxine (T4) level

A patient is scheduled for a bilateral adrenalectomy. During the postoperative period, what should the nurse expect related to the administration of corticosteroids?

Increased to promote an adequate response to the stress of surgery

A patient with SIADH is treated with water restriction. What does the patient experience when the nurse determines that treatment has been effective?

Increased urine output, increased serum sodium, and decreased urine specific gravity

A patient is admitted with tetany. Which laboratory value should the nurse plan to monitor

Ionized calcium

A 72-year-old woman is diagnosed with diabetes. What does the nurse recognize about the management of diabetes in the older adult

It is more difficult to achieve strict glucose control than in younger patients

A patient with mild iatrogenic Cushing syndrome is on an alternate-day regimen of corticosteroid therapy. What does the nurse explain to the patient about this regimen?

It minimizes hypothalamic-pituitary-adrenal suppression

Which statement best describes atherosclerotic disease affecting the cerebrovascular, cardiovascular, and peripheral vascular systems in patients with diabetes?

It occurs with a higher frequency and earlier onset than in the nondiabetic population

A patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage

Lispro (Humalog)

Which nursing action can the nurse delegate to experienced UAP who are working in the diabetic clinic?

Measure the ankle-brachial index

The nurse is planning postoperative care for a patient who is being admitted to the surgical unit from the recovery room after transsphenoidal resection of a pituitary tumor. Which nursing action should be included?

Measure urine volume every hour

The nurse has identified the nursing diagnosis of fatigue for a patient who is hypothyroid. What should the nurse do while caring for this patient

Monitor for vital signs and cardiac rhythm response to activity

During care of the patient with SIADH, what should the nurse do?

Monitor neurologic status at least every 2 hours

A patient taking insulin has recorded fasting glucose levels above 200 mg/Dl (11.1 mmol/L) on awakening for the last five mornings. What should the nurse advise the patient to do first?

Monitor the glucose level at bedtime, between 2:00 AM and 4:00 AM, and on arising.

What is the priority nursing intervention during the management of the patient with pheochromocytoma

Monitoring blood pressure

The nurse has been teaching a patient with type 2 diabetes about managing blood glucose levels and taking glipizide (Glucotrol). Which patient statement indicates a need for additional teaching?

My diabetes won't cause complications because I don't need insulin

Which finding by the nurse when assessing a patient with a large pituitary adenoma is most important to report to the health care provider

Nausea and projectile vomiting

Which finding by the nurse when assessing a patient with Hashimoto's thyroiditis and a goiter will require the most immediate action?

New-onset changes in the patient's voice

Which laboratory value reported to the nurse by the UAP indicates an urgent need for the nurse's assessment of the patient

Noon blood glucose of 52 mg/dL

What should the goals of nutrition therapy for the patient with type 2 diabetes include

Normal serum glucose and lipid levels

A patient who was admitted with diabetic ketoacidosis secondary to a urinary tract infection has been weaned off an insulin drip 30 minutes ago. The patient reports feeling lightheaded and sweaty. Which action should the nurse take first

Obtain a glucose reading using a finger stick

Which intervention will the nurse include in the plan of care for a patient with syndrome of inappropriate antidiuretic hormone (SIADH)?

Offer the patient hard candies to suck on.

Which information obtained by the nurse in the endocrine clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the health care provider

Patient stopped taking the medication 2 days ago.

To prevent hyperglycemia or hypoglycemia related to exercise, what should the nurse teach the patient using glucose-lowering agents about the best time for exercise?

Plan activity and food intake related to blood glucose levels

In type 1 diabetes there is an osmotic effect of glucose when insulin deficiency prevents the use of glucose for energy. Which classic symptom is caused by the osmotic effect of glucose?

Polydipsia

What medication is used with thyrotoxicosis to block the effects of the sympathetic nervous stimulation of the thyroid hormones?

Propranolol (Inderal)

Which prescribed medication should the nurse expect will have rapid effects on a patient admitted to the emergency department in thyroid storm?

Propranolol (Inderal)

A patient with hypothyroidism is treated with levothyroxine (Synthroid). What should the nurse include when teaching the patient about this therapy

Provide written instruction for all information related to the drug therapy

A patient who was admitted with myxedema coma and diagnosed with hypothyroidism is improving. Discharge is expected to occur in 2 days. Which teaching strategy is likely to result in effective patient self-management at home?

Provide written reminders of information taught

A patient is being admitted with a diagnosis of Cushing syndrome. Which findings will the nurse expect during the assessment?

Purplish streaks on the abdomen

The nurse is taking a health history from a 29-yr-old pregnant patient at the first prenatal visit. The patient reports that she has no personal history of diabetes, but her mother has diabetes. Which action will the nurse plan to take

Schedule the patient for a fasting blood glucose level.

What findings are commonly found in a patient with a prolactinoma?

Signs of increased intracranial pressure, including headache, nausea, and vomiting

Why are the hormones cortisol, glucagon, epinephrine, and growth hormone referred to as counter regulatory hormones

Stimulate glucose output by the liver

When providing discharge instructions to a patient who had a subtotal thyroidectomy for hyperthyroidism, what should the nurse teach the patient

Substantially reduce caloric intake compared to what was eaten before surgery

Which assessment finding for a 33-yr-old female patient admitted with Graves' disease requires the most rapid intervention by the nurse

Temperature 103.8° F (40.4° C)

Two days following a self-managed hypoglycemic episode at home, the patient tells the nurse that his blood glucose levels since the episode have been between 80 and 90 mg/dL. Which is the best response by the nurse?

That is a good range for your glucose levels

An RN is caring for a patient with a goiter and possible hyperthyroidism. Which action by the RN indicates that the charge nurse needs to provide the RN with additional teaching

The RN palpates the neck to assess thyroid size

Which assessment finding of a 42-yr-old patient who had a bilateral adrenalectomy requires the most rapid action by the nurse?

The blood pressure (BP) is 88/50 mm Hg

A patient has a low serum T3 level. The HCP orders measurement of the TSH level. If the TSH level is elevated, what does this indicate?

The cause of the low T3 level is most likely primary hypothyroidism

Which patient action indicates good understanding of the nurse's teaching about administration of aspart (NovoLog) insulin?

The patient cleans the skin with soap and water before insulin administration.

Which action by a patient indicates that the home health nurse's teaching about glargine and regular insulin has been successful

The patient discards the open vials of glargine and regular insulin after 4 weeks

The nurse is caring for a 45-yr-old male patient during a water deprivation test. Which finding is most important for the nurse to communicate to the health care provider

The patient has a 5-lb (2.3-kg) weight loss

Which information is most important for the nurse to communicate rapidly to the health care provider about a patient admitted with possible syndrome of inappropriate antidiuretic hormone (SIADH)?

The patient has a serum sodium level of 118 mEq/L

A 28-yr-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching

The patient increases daily exercise when ketones are present in the urine

The nurse is caring for a patient admitted with diabetes insipidus (DI). Which information is most important to report to the health care provider

The patient is confused and lethargic.

Which patient action indicates a good understanding of the nurse's teaching about the use of an insulin pump?

The patient programs the pump for an insulin bolus after eating

Which information about a patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test

The patient takes oral corticosteroids for rheumatoid arthritis.

A patient who has type 2 diabetes is being prepared for an elective coronary angiogram. Which information would the nurse anticipate might lead to rescheduling the test?

The patient took the prescribed metformin today.

A female patient is scheduled for an oral glucose tolerance test. Which information from the patient's health history is important for the nurse to communicate to the health care provider regarding this test

The patient uses oral contraceptives.

Which finding indicates a need to contact the health care provider before the nurse administers metformin (Glucophage

The patient's blood urea nitrogen (BUN) level is 52 mg/dL

A 29-yr-old woman with systemic lupus erythematosus has been prescribed 2 weeks of high-dose prednisone therapy. Which information about the prednisone is most important for the nurse to include

The prednisone dose should be decreased gradually

Which additional information will the nurse need to consider when reviewing the laboratory results for a patient's total calcium level

The serum albumin

Which laboratory value should the nurse review to determine whether a patient's hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland

Thyroid-stimulating hormone (TSH) level

When teaching the patient with type 1 diabetes, what should the nurse emphasize as the major advantage of using an insulin pump

Tight glycemic control can be maintained.

As a precaution for vocal cord paralysis from damage to the recurrent or superior laryngeal nerve during thyroidectomy surgery, what is the most important equipment to have in the room in case it is needed for this emergency situation?

Tracheostomy tray

During assessment of the patient with acromegaly, what should the nurse expect the patient to report?

Undesirable changes in appearance

A patient has been newly diagnosed with type 2 diabetes mellitus. Which information about the patient will be most useful to the nurse who is helping the patient develop strategies for successful adaptation to this disease

Value system

The patient with diabetes insipidus is brought to the emergency department (ED) with confusion and dehydration after excretion of a large volume of urine today even though several liters of fluid were consumed. What is a diagnostic test that the nurse should expect to be done first to help make a diagnosis?

Water deprivation test

Which question will the nurse in the endocrine clinic ask to help determine a patient's risk factors for goiter?

What medications are you taking

A patient with diabetes is learning to mix regular insulin and NPH insulin in the same syringe. The nurse determines that additional teaching is needed when the patient does what

Withdraws the NPH dose into the syringe first

A patient with diabetes insipidus is treated with nasal desmopressin acetate (DDAVP). The nurse determines that the drug is not having an adequate therapeutic effect when the patient experiences

a urine specific gravity of 1.002.

In a patient with an elevated serum cortisol, what should the nurse expect other laboratory findings to reveal?

Hypokalemia

A patient with newly diagnosed type 2 diabetes has been given a prescription to start an oral hypoglycemic medication. The patient tells the nurse she would rather control her blood sugar with herbal therapy. Which action should the nurse take

Advise the patient to discuss using herbal therapy with her HCP before using it

A patient who had a subtotal thyroidectomy earlier today develops laryngeal stridor and a cramp in the right hand upon returning to the surgical nursing unit. Which collaborative action will the nurse anticipate next

Administer IV calcium gluconate

. A patient with diabetes is found unconscious at home and a family member calls the clinic. After determining that a glucometer is not available, what should the nurse advise the family member to do?

Administer glucagon 1 mg intramuscularly (IM) or subcutaneously.

A patient is admitted with diabetes insipidus. Which action will be appropriate for the RN to delegate to an experienced LPN?

Administer prescribed subcutaneous DDAVP

When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a LPN?

Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.

A patient with diabetes calls the clinic because she is experiencing nausea and flu-like symptoms. Which advice from the nurse will be the best for this patient?

Administer the usual insulin dosage

Which endocrine gland secretes cortisol in a diurnal pattern

Adrenal cortex

Which information will the nurse teach a patient who has been newly diagnosed with Graves' disease?

Antithyroid medications may take several months for full effect

Which nursing assessment of a 70-yr-old patient is most important to make during initiation of thyroid replacement with levothyroxine (Synthroid

Apical pulse rate

The nurse is preparing to teach a 43-yr-old man who is newly diagnosed with type 2 diabetes about home management of the disease. Which action should the nurse take first?

Assess the patient's perception of what it means to have diabetes mellitus.

A patient has just arrived on the unit after a thyroidectomy. Which action should the nurse take first?

Assess the patient's respiratory effort.

Lispro insulin (Humalog) with NPH (Humulin N) insulin is ordered for a patient with newly diagnosed type 1 diabetes. The nurse knows that when lispro insulin is used, when should it be administered?

At mealtime or within 15 minutes of meals

Which information will the nurse include when teaching a patient who has type 2 diabetes about glyburide

Glyburide stimulates insulin production and release from the pancreas

A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient

Glycosylated hemoglobin

The patient with type 1 diabetes mellitus is in the clinic to check his long-term glycemic control. Which test should be used

Glycosylated hemoglobin (A1C)

What describes the primary difference in treatment for diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS)?

HHS requires greater fluid replacement to correct the dehydration.

When the patient with parathyroid disease experiences symptoms of hypocalcemia, what is a measure that can be used to temporarily raise serum calcium levels?

Have patient rebreathe in a paper bag.

A patient develops carpopedal spasms and tingling of the lips following a parathyroidectomy. Which action will provide the patient with rapid relief from the symptoms

Have the patient rebreathe from a paper bag.

Which question from a nurse during a patient interview will provide focused information about a possible thyroid disorder?

Have you had a recent unplanned weight gain or loss

The nurse is assessing a 22-yr-old patient experiencing the onset of symptoms of type 1 diabetes. To which question would the nurse anticipate a positive response

Have you lost weight lately

The nurse is assessing a newly admitted patient with diabetes. Which observation should be addressed as the priority by the nurse

Rapid respirations with deep inspiration

What is a potential adverse effect of palpation of an enlarged thyroid gland

Release of excessive thyroid hormone into circulation

The nurse is caring for a patient following an adrenalectomy. The highest priority in the immediate postoperative period is to

balance fluids and electrolytes.

After the nurse has finished teaching a patient who has a new prescription for exenatide (Byetta), which patient statement indicates that the teaching has been effective

I should take my daily aspirin at least an hour before the Byetta

Following the teaching of foot care to a patient with diabetes, the nurse determines that additional instruction is needed when the patient makes which statement?

I'll know if I have sores or lesions on my feet because they will be painful

Which statement accurately describes Graves' disease?

Exophthalmos occurs in Graves' disease

Which laboratory results would indicate that the patient has prediabetes

Fasting blood glucose result of 120 mg/dL (6.7 mmol/L)

The nurse is caring for a 63-yr-old with a possible pituitary tumor who is scheduled for a computed tomography scan with contrast. Which information about the patient is important to discuss with the health care provider before the test?

History of renal insufficiency

What preoperative instruction should the nurse give to the patient scheduled for a subtotal thyroidectomy

How to support the head with the hands when turning in bed

A patient who recently had a calcium oxalate renal stone had a bone density study, which showed a decrease in her bone density. What endocrine problem could this patient have

Hyperparathyroidism

The nurse admits a patient to the hospital in Addisonian crisis. Which patient statement supports the need to plan additional teaching

I had the flu earlier this week, so I couldn't take the hydrocortisone

Which statement by the patient indicates a need for additional instruction in administering insulin

I need to rotate injection sites among my arms, legs, and abdomen each day

The nurse determines that additional instruction is needed for a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) when the patient makes which statement

I need to shop for foods low in sodium and avoid adding salt to food

In addition to promoting the transport of glucose from the blood into the cell, what does insulin do?

Increases amino acid transport into cells and protein synthesis

A 37-yr-old patient has just arrived in the postanesthesia recovery unit (PACU) after a thyroidectomy. Which information about the patient is most important to communicate to the surgeon

Increasing neck swelling.

Which finding indicates to the nurse that the current therapies are effective for a patient with acute adrenal insufficiency

Increasing serum sodium levels

The cardiac telemetry unit charge nurse receives status reports from other nursing units about four patients who need cardiac monitoring. Which patient should be transferred to the cardiac unit first?

Patient with tetany who has a new order for IV calcium chloride

A 44-yr-old female patient with Cushing syndrome is admitted for adrenalectomy. Which intervention by the nurse will be most helpful for the patient problem of disturbed body image related to changes in appearance

Remind the patient that most of the physical changes caused by Cushing syndrome will resolve after surgery

The nurse is assessing a 55-yr-old female patient with type 2 diabetes who has a body mass index (BMI) of 31 kg/m2.Which goal in the plan of care is most important for this patient?

The patient will reach a glycosylated hemoglobin level of less than 7%.

The nurse will plan to teach a patient to minimize physical and emotional stress while the patient is undergoing

a 24-hour urine test for free cortisol