Elsevier Adaptive Quizzing Endocrine Quiz

A client is diagnosed with parathyroid dysfunction. Which serum calcium concentration in the client would support the diagnosis? 7.8 mg/dL 8.9 mg/dL 9.7 mg/dL 10.2 mg/dL

7.8 mg/dL Rationale The normal serum calcium concentration ranges from 8.6 to 10.2 mg/dL. A serum calcium concentration below 8.6 mg/dL indicates hypocalcemia and a serum calcium concentration above 10.2 mg/dL indicates hypercalcemia. Parathyroid hormone maintains calcium balance in the body. Hypocalcemia reflects hypoparathyroidism and hypercalcemia suggests hyperparathyroidism. The serum calcium concentration of 7.8 mg/dL is below the normal range and indicates hypocalcemia. Therefore, the client may have hypoparathyroidism, which is a parathyroid dysfunction. Serum calcium concentrations of 8.9 mg/dL, 9.7 mg/dL, and 10.2 mg/dL are all normal findings.

Which condition does the nurse identify in the image?

Exophthalmos Rationale Exophthalmos is a condition in which the eyeballs are protruded. The wide-eyed look is caused by edema in the extraocular muscles and increased fatty tissue behind the eyes. This condition is common in clients with Graves' disease. Goiter is the enlargement of the thyroid gland near the neck. Clients with myxedema have dry, waxy, swelling skin that is accompanied by nonpitting edema. This condition is associated with primary hypothyroidism. Pheochromocytoma is a tumor of the adrenal medulla, which can cause excessive secretion of catecholamines.

A nurse is caring for a client admitted to the hospital with a diagnosis of Addison disease. The nurse should assess the client for what signs related to this disorder? Diarrhea and pyrexia Edema and hypertension Moon face and hirsutism Hypoglycemia and hypotension

Hypoglycemia and hypotension Rationale Adrenocortical insufficiency causes decreased glucocorticoids, resulting in hypoglycemia; also, it causes decreased aldosterone, resulting in fluid excretion that leads to hypotension. Although diarrhea can occur initially with steroid replacement, it should subside; pyrexia will occur only if there is a concomitant infection. Edema and hypertension are not related to Addison disease; they are associated with Cushing disease, because of excessive cortisol and aldosterone, resulting in fluid and sodium retention. Moon face and hirsutism are related to Cushing disease, not Addison disease; moon facies is caused by adipose tissue deposition, and hirsutism is caused by excessive androgen secretion.

Which hormones are secreted by the client's hypothalamus? Select all that apply Growth hormone Follicle-stimulating hormone Prolactin-inhibiting hormone Corticotropin-releasing hormone Melanocyte-stimulating hormone

Prolactin-inhibiting hormone Corticotropin-releasing hormone Rationale The hormones that are secreted by the hypothalamus include prolactin-inhibiting hormone and corticotropin-releasing hormone. Growth hormone, follicle-stimulating hormone, and melanocyte-stimulating hormone are hormones secreted by the anterior pituitary gland.

A client is being discharged after having a total thyroidectomy. Which instruction is most important for the nurse to include? Take thyroid replacement medications as prescribed. Be aware of signs and symptoms of dehydration. Avoid all over-the-counter medications. Report signs of hypoglycemia.

Take thyroid replacement medications as prescribed. Rationale Long-term thyroid replacement is prescribed after surgery to replace the thyroid's natural function. Although teaching signs and symptoms of dehydration is a health promotion strategy, it is not the priority. Clients should not be encouraged to avoid all over-the-counter medications, but they should be instructed to discuss contraindications with their primary healthcare provider or pharmacy. Low blood glucose is not attributed to this procedure.

A client with a primary brain tumor has developed syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The nurse will expect to see which clinical findings upon assessment? Select all that apply . Nausea and vomiting Hyperthermia Bradycardia Increased weight Decreased serum sodium Decreased level of consciousness

Nausea and vomiting Increased weight Decreased serum sodium Decreased level of consciousness Rationale Water retention and decreased urinary output occur because of excess secretion of antidiuretic hormone (ADH). Early manifestations are related to water retention and may include gastrointestinal (GI) disturbances such as loss of appetite, nausea, and vomiting. Weight gain occurs because of the water retention. Serum sodium levels are decreased because of fluid retention and sodium loss. Central nervous system changes include headaches, lethargy, and decreased level of consciousness, progressing to coma and seizures. Hypothermia also occurs because of central nervous system disturbance. The pulse is full and bounding because of the increased fluid volume.

A nurse plans to set up emergency equipment at the bedside of a client in the immediate postoperative period after a thyroidectomy. What should the nurse include in the bedside setup? Crash cart with bed board Tracheostomy set and oxygen Ampule of sodium bicarbonate Airway and nonrebreather mask

Tracheostomy set and oxygen Rationale A tracheostomy set and oxygen are necessary if the client experiences an acute respiratory obstruction as a result of postoperative edema, nerve damage, or tetany. A cardiac arrest is not an expected response after thyroid surgery. Acidosis requiring sodium bicarbonate and cardiac arrest are not expected responses after a thyroidectomy. If the airway is obstructed by postoperative edema, the use of a mechanical airway will be ineffective because it will not reach beyond the point of the obstruction. A nonrebreather mask is designed to deliver high concentrations of oxygen. In the event of an airway obstruction, the client's need is to circumvent the obstruction, not deliver high concentrations of oxygen.

What symptoms will the nurse identify when assessing a client with Graves disease? Constipation, dry skin, and weight gain Lethargy, weight gain, and forgetfulness Weight loss, exophthalmos, and restlessness Weight loss, protruding eyeballs, and lethargy

Weight loss, exophthalmos, and restlessness Rationale Weight loss and restlessness occur because of an increased basal metabolic rate; exophthalmos occurs because of peribulbar edema. Constipation, dry skin, and weight gain are associated with hypothyroidism because of the decreased metabolic rate. Lethargy and weight gain are associated with hypothyroidism as a result of a decreased metabolic rate; forgetfulness is not related. Although weight loss and exophthalmos occur with hyperthyroidism, the client will be hyperactive, not hypoactive.