Endocrine

The parathyroid glands play a major role in regulating which substances? A. Calcium and Phosphorus B. Cholride and potassium C. Potassium and calcium D. Sodium and potassium

A. Calcium and Phosphorus

Cushing Syndrome causes the anterior pituitary gland to secret an excess amount of which hormone? A. CRH B. cortisol C. ACTH D. GH

C. ACTH

An appropriate nursing intervention for the patient with hyperparathyroidism is to a. pad side rails as a seizure precaution b. increase fluid intake to 3000 to 4000ml/day c. maintain bed rest to prevent pathologic fractures d. monitor the patient for Trousseau's phenomenon or Chvostek's sign

b. increase fluid intake to 3000 to 4000ml/day

The nurse is teaching diet restrictions for a client with Addison's disease. The client would indicate an understanding of the diet by stating A. "I will increase sodium and fluids and restrict potassium." B. "I will increase potassium and sodium and restrict fluids." C. "I will increase sodium, potassium and fluids." D. "I will increase fluids and restrict sodium and potassium."

A. "I will increase sodium and fluids and restrict potassium."

Which of the following is the most common cause of Cushing's syndrome? A. ACTH- secreting pituitary tumor B. Ectopic tumors C. Prolonged administration of corticosteroids (prednisone) D. Cortisol-secreting neoplasm within the adrenal cortex

A. ACTH- secreting pituitary tumor

Trousseau's sign can be elicited in the hypocalcemic patient by: A. Applying a BP cuff to upper arm, inflating it, and observing for carpopedal spasm. B. Tapping a finger on the supramandibular portion of the parotid cland and observing for twitching of the upper lip on the side opposite to the stimulation. C. Tapping a finger on the supramandibular portion of the parotid gland and observing for twitching of the upper lip on the same side as stimulation. D. Having the patient hyperventilate (more than 30 breaths/minute) to produce carpopedal spasm resulting from respiratory acidosis.

A. Applying a BP cuff to upper arm, inflating it, and observing for carpopedal spasm.

The patient admitted with hypothyroid crisis (myxedema coma) would most likely have which of the following electrolyte abnormalities? A. Hyponatremia B. Hypernatremia C. Hyperglycemia D. Hypocalcemia

A. Hyponatremia

Following a unilateral adrenalectomy, nurse Betty would assess for hyperkalemia shown by which of the following? A. Muscle weakness B. Tremors C. Diaphoresis D. Constipation

A. Muscle weakness

A male client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which of the following glands? a. Adrenal cortex b. Pancreas c. Adrenal medulla d. Parathyroid

a. Adrenal cortex

A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, nurse Julia formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which "related-to" phrase should the nurse add? A. Related to bone demineralization resulting in pathologic fractures B. Related to exhaustion secondary to an accelerated metabolic rate C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces D. Related to tetany secondary to a decreased serum calcium level

A. Related to bone demineralization resulting in pathologic fractures Rationale: Poorly controlled hyperparathyroidism may cause an elevated serum calcium level. This, in turn, may diminish calcium stores in the bone, causing bone demineralization and setting the stage for pathologic fractures and a risk for injury. Hyperparathyroidism doesn't accelerate the metabolic rate. A decreased thyroid hormone level, not an increased parathyroid hormone level, may cause edema and dry skin secondary to fluid infiltration into the interstitial spaces. Hyperparathyroidism causes hypercalcemia, not hypocalcemia; therefore, it isn't associated with tetany.

Which of the following is not a complication experienced with Cushing's Syndrome? A. Unexplained hyperkalemia B. Muscle weakness C. Kidney Stones D. Subsequent pathologic fractures

A. Unexplained hyperkalemia

8. Hashimoto's disease is: a. Chronic inflammation of the thyroid gland b. Diagnosed most frequently in Asian-Americans and Pacific Islanders c. A form of hyperthyroidism d. A rare form of hypothyroidism

a. Chronic inflammation of the thyroid gland common cause of hypothyroidism

Nurse Troy is aware that the most appropriate for a client with Addison's disease? a. Risk for infection b. Excessive fluid volume c. Urinary retention d. Hypothermia

a. Risk for infection

An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, nurse Lily teaches the client to treat hypoglycemia by ingesting: A. 2 to 5 g of a simple carbohydrate. B. 10 to 15 g of a simple carbohydrate. C. 18 to 20 g of a simple carbohydrate. D. 25 to 30 g of a simple carbohydrate

B. 10 to 15 g of a simple carbohydrate.

Which of the following complications are related to hyperthyroidism? A. Poor eyesight B. Brittle bones C. Nephritis D. Weight gain

B. Brittle bones

Nurse Oliver should expect a client with hypothyroidism to report which health concerns? A. Increased appetite and weight loss B. Puffiness of the face and hands C. Nervousness and tremors D. Thyroid gland swelling

B. Puffiness of the face and hands s/sx of myxedema

The nurse is caring for a patient admitted with suspected hyperparathyroidism. Because of the potential effects of this disease on electrolyte balance, the nurse should assess this patient for which of the following manifestations? A) Neurologic irritability B) Declining urine output C) Lethargy and weakness D) Hyperactive bowel sounds

C) Lethargy and weakness

Which nursing intervention would you not implement with a patient who is Diagnosed with Cushing's Syndrome? A. Minimize stress in the environment B. Monitor vital signs; observe for hypertension, edema C. Tell patient to increase caloric intake to maintain body weight. D. Protect client from exposure to infection

C. Tell patient to increase caloric intake to maintain body weight.

A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect? A. Dysuria B. Leg cramps C. Tachycardia D. Blurred vision

C.Tachycardia

The nurse is aware that the following is the most common cause of hyperaldosteronism? A. Excessive sodium intake (Your Answer) B. A pituitary adenoma C. Deficient potassium intake D. An adrenal adenoma

D. An adrenal adenoma

A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, nurse Richard would suspect which of the following disorders? A. Diabetes mellitus B. Diabetes insipidus C. Hypoparathyroidism D. Hyperparathyroidism

D. Hyperparathyroidism

A female client whose physical findings suggest a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transphenoidal hypophysectomy. The evening before the surgery, nurse Jacob reviews preoperative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize? a. "You must lie flat for 24 hours after surgery." b. "You must avoid coughing, sneezing, and blowing your nose." c. "You must restrict your fluid intake." d. "You must report ringing in your ears immediately."

b. "You must avoid coughing, sneezing, and blowing your nose."

What's the difference between primary and secondary hyperthyroidism?

Primary hyperthyroidism: T3 T4 Increase TSH decrease Secondary hyperthyroidism: T3 T4 Increase TSH increase

A nurse is preparing to perform an assessment on a client being admitted to the hospital with a diagnosis of Cushing's syndrome. When performing the assessment, the nurse checks for which significant manifestation of the disorder? a) fluid retention b) stretch marks c) goiter d) melanosis

a) fluid retention

A patient with hypothyroidism is treated with Synthroid. When teaching the patient about the therapy, the nurse a. explains that caloric intake must be reduced when drug therapy is started b. provides written instruction for all information related to the medication therapy c. assures the patient that a return to normal function will occur with replacement therapy d. informs the patient that medications must be taken until hormone balance is reestablished

b. provides written instruction for all information related to the medication therapy

When caring for a patient with nephrogenic DI, the nurse would expect treatment to include a. fluid restriction b. thiazide diuretics c. a high-sodium diet d. chlorpropamide (DIabinese)

b. thiazide diuretics

When instructing the female client diagnosed with hyperparathyroidism about diet, nurse Gina should stress the importance of which of the following? a. Restricting fluids b. Restricting sodium c. Forcing fluids d. Restricting potassium

c. Forcing fluids

A patient with Addison's disease comes to the emergency department with complaints of N/V/D, and fever. The nurse would expect collaborative care to include a. parenteral injections of ACTH b. IV administration of vasopressors c. IV administration of hydrocortisone d. IV administration of D5W with 20mEq of KCl

c. IV administration of hydrocortisone

What is the treatment for hyperparathyroidism? a. Synthetic thyroid hormone b. Desiccated thyroid hormone c. Surgical removal of the glands d. Calcium and phosphate

c. Surgical removal of the glands

To prevent complications in the patient with Cushing syndrome, the nurse monitors the patient for a. hypotension b. hypoglycemia c. cardiac arrhythmias d. decreased cardiac output

c. cardiac arrhythmias

A nurse is caring for a client with Addison's disease. Which of the following mursing considerations shoul dbe employed when caring for this client? a. avoid sodium in the clients diet b. monitor and protect skin integrity c. document the specific gravity of urine d. monitor increases in blood pressure

c. document the specific gravity of urine

A patient is admitted to the hospital in thyrotoxic crisis. On physical assessment of the patient, the nurse would expect to find a. hoarseness and laryngeal stridor b. bulging eyeballs and arrhythmias c. elevated temperature and signs of heart failure d. lethargy progressing suddenly to impairment of consciousness

c. elevated temperature and signs of heart failure

A patient is scheduled for bilateral adrenalectomy. During the postoperative period, the nurse would expect administration of corticosteroids to be a. reduced to promote wound healing b. withheld until symptoms of hypocortisolism appear c. increased to promote an adequate response to the stress of surgery d. reduced because excessive hormones are released during surgical manipulation of the glands

c. increased to promote an adequate response to the stress of surgery

A home care nurse is teaching an adolescent with type I diabetes mellitus about insulin administration and rotation sites. Which statement, if made by the adolescent, would indicate effective teaching? a) I need to use a different site for each insulin injection b) I should use only my stomach and my thighs for injections c) I need to use the same site for 1 month before rotating to another d) I need to use one major site for 2 to 3 weeks before changing major sites

d) I need to use one major site for 2 to 3 weeks before changing major sites

19. Which nursing diagnosis takes highest priority for a female client with hyperthyroidism? a. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess b. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing c. Body image disturbance related to weight gain and edema d. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

d. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

Physical changes of hypothyroidism that must be monitored when replacement therapy is started include a. achlorhydria and constipation b. slowed mental processes and lethargy c. anemia and increased capillary fragility d. decreased cardiac contractility and coronary atherosclerosis

d. decreased cardiac contractility and coronary atherosclerosis