ATI ENDOCRINE QUIZ
A nurse is caring for a client who is being evaluated for acromegaly. Which of the following manifestations should the nurse expect to find during assessment? (Select all that apply.)
- Loss of color discrimination. - Coarse facial features - Enlarged distal extremities - Hepatomegaly Rationale: Acromegaly is a chronic metabolic disorder caused by an excess of growth hormone(hyperpituitarism) during adulthood, after normal growth of the skeleton and other organs is complete. Often rising from an adenoma, the tumor compresses the optic nerve and causes visual changes such as loss of color discrimination, narrowed perceptual field, or blindness.3.
A nurse is providing teaching to a client who has a new diagnosis of testicular cancer. Which of the following information should the nurse include in the teaching? (Select all that apply.)
-Close male relatives are at an increased risk of developing testicular cancer. -Testicular cancer typically occurs between ages 15 and 35. Rationale: Close male relatives are at an increased risk of developing testicular cancer is correct.Testicular cancers are more common in clients who have a family history of testicular cancer.Therefore, close male relatives are at increased risk.Testicular cancer typically occurs between ages 15 and 35 is correct. Testicular cancer typically occurs in the productive years and has significant economic, social, and psychological impact clients and their families.Testicular cancer occurs in both testicles equally is incorrect. Testicular cancer is rarely bilateral.Spermare no longer viable after diagnosis is incorrect. Sperm might be absent or low in number but remain viable after diagnosis.An early manifestation is a painful scrotal lump is incorrect. A painless scrotal swelling is an early manifestation.13.
A nurse is caring for a client who is 1 day postoperative following a transurethral resection of the prostate (TURP)and has a continuous bladder irrigation in place. Which of the following actions should the nurse take? (Select all that apply.)
-Use sterile technique when preparing the irrigation solution. -Ensure the drainage tubing is patent and without obstruction. - Notify the surgeon if the urine is bright red in appearance or has large clots. Rationale: Add the amount of bladder irrigation to the total output is incorrect. The irrigation solution that should be used is sterile normal saline, unless otherwise directed by the surgeon. The amount of solution should be subtracted from the total output amount. For example, if the total drainage output is 2,500 mL and the amount of irrigation is 1,000 mL, subtract 1,000 from2,500 and record 1,500 mL as the total urine output.Use sterile technique when preparing the irrigation solution is correct. Using sterile technique decreases the risk of contamination with micro-organisms and reduces the possibility of infection. Many clients who undergo a TURPare older adults who may have other chronic diseases that increase their susceptibility to infection. These clients should also be observed closely for manifestations of infection, such as fever and elevated WBC.Ensure the drainage tubing is patent and without obstruction or kinksis correct. For continuous drainage, the nurse should be sure that the clamp on the drainage tubing is open and check the volume of fluid in the drainage bag. It prevents accumulation of solution in the bladder, which can cause bladder distention and possible injury.Contact the surgeon if the client reports a continual need to void is incorrect. The catheter used following aTURP is large and is pulled taut and secured to the client's leg. This provides traction that holds the catheter balloon against the internal sphincter of the bladder. As a result, the client may experience a continual need to void.Notify the surgeon if the urine is bright red in appearance or has large clots is correct. It is normal to see a few small blood clots and pink tinged drainage, but urine that is bright red, ketchup-like, or has large clots is an indication of bleeding and should be reported to the surgeon.
A client is prescribed 1 g potassium phosphate IV to be infused continuously over 6 hr. Available is 1 g potassium phosphate in 250 mL dextrose 5% water (D5W). The nurse should set the IV pump to run at how many mL/hr?(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
42 mL/hr
A nurse is reviewing the laboratory results for four clients. The nurse should recognize which of the following client shas a manifestation of hypoparathyroidism?
A client who has a phosphate of 5.7 mg/dL Rationale: This level is above the expected reference range of 3.0 to 4.5 mg/dL. Phosphorus levels are increased in a client who has hypoparathyroidism.
A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize that which of the following are manifestations of Cushing's syndrome? (Select all that apply.)
Alopecia, Moon face, Purple striations, Buffalo hump Rationale: Alopecia is correct. Clients who have Cushing's syndrome can develop hirsutism, which is excessive body hair. Women can also develop alopecia, in the form of male pattern baldness.Tremors is incorrect. Tremors are not a common manifestation of Cushing's syndrome.Moon face is correct. Moon face, which is manifested by a round, red, full face, is a common manifestation of Cushing's syndrome.Purple striations is correct. Purple striations on the skin of the abdomen, thighs, and breasts are common manifestations of Cushing's syndrome.Buffalo hump is correct. Buffalo hump, which is a collection of fat between the shoulder blades, is a common manifestation of Cushing's syndrome.
A nurse is caring for a client who is 5 hr postoperative following a transurethral resection of the prostate (TURP).The nurse notes that the client's indwelling urinary catheter has not drained in the past hour. Which of the following actions should the nurse take first?
Check the tubing for kinks.Rationale: When providing client care, the nurse should first use the least restrictive intervention;therefore, the nurse should check the catheter tubing for kinks. The nurse must ensure constant flow of the bladder irrigant into the catheter and outward drainage from the catheter to prevent clotting, which could occlude the catheter lumen.
A nurse is planning care for a client who has a new diagnosis of diabetes insipidus. Which of the following interventions should the nurse include in the plan of care?
Check urine specific gravity. Rationale: The nurse should check the client's urine specific gravity to monitor urine concentration in a client who has diabetes insipidus. A client who has diabetes insipidus has a urine specific gravity of less than 1.005.
A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client?
Chvostek's sign Rationale: The nurse should suspect that the client has hypocalcemia, a possible complication following subtotal thyroidectomy. Manifestations of hypocalcemia include numbness and tingling in the hands, the soles of the feet, and around the lips, typically appearing between 24 and 48 hr after surgery. To elicit Chvostek's sign, the nurse should tap the client's face at a point just below and in front of the ear. A positive response would be twitching of the ipsilateral (same side only)facial muscles, suggesting neuromuscular excitability due to hypocalcemia.B.
A nurse is caring for a client who has benign prostatic hyperplasia (BPH). The nurse should expect which of the following findings?
Difficulty starting the flow of urine Rationale: Hesitancy or difficulty starting the flow of urine is an expected finding of BPH.
A nurse is assessing a client who had a craniotomy and has developed syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following manifestations should the nurse anticipate?
Oliguria Rationale: the nurse should expect a client who has developed SIADH following a craniotomy to manifest oliguria. The
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
The nurse should request a prescription for artificial tears and provide a calm environment for the client because the client is most likely experiencing hyperthyroidism. The nurse should monitor the client's T3 and T4 to identify worsening of the client's hyperthyroidism and check the client's temperature and blood pressure frequently to monitor for manifestations of thyroid storm.15.
A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. The nurse should anticipate an elevation of which of the following laboratory values?
Thyroid stimulating hormone (TSH) Rationale: The nurse should anticipate that TSH will be elevated.
A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect?
Urine specific gravity 1.002 Rationale: The nurse should expect a client who has diabetes insipidus to have diluted urine with a specific gravity less than 1.005.
A nurse is caring for a client who is 1 day postoperative following thyroidectomy and reports severe muscle spasms of the lower extremities. Which of the following actions should the nurse take?
Verify the most recent calcium level. Rationale: A client who has had a thyroidectomy is at risk of hypocalcemia due to the possible disruption of the parathyroid gland during surgery. The parathyroid glands are four small glands located inside the thyroid gland that are responsible for calcium regulation. If they are damaged during a thyroidectomy, there is a risk of hypocalcemia. Low calcium levels can be manifested as numbness and tingling of the fingers and around the mouth, muscle spasms (particularly of the hands and feet), and hyperactive reflexes. If a client develops any of these manifestations following a thyroidectomy, the nurse should check the client's latest calcium level. The expected reference range for calcium is 8.5 to 10.5 mg/dL. If the calcium level is low, the provider should be notified, and oral or intravenous calcium replacement should be administered.
A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take?
Weigh the client daily. Rationale: Addison's disease is an endocrine disorder that causes weight loss, muscle weakness, fatigue,low blood pressure, and hyperpigmentation (darkening) of the skin. Obtaining the client's daily weight will alert the nurse that dehydration is developing, which could indicate an impending crisis.