Endocrine Challenge Questions

A nurse is assessing a client who is admitted to the hospital with a tentative diagnosis of pituitary tumor. What signs of Cushing syndrome does the nurse identify? A. Retention of sodium and water B. Hypotension and a rapid, thready pulse C. Increased fatty deposition in the extremities D. Hypoglycemic episodes early in the morning

A. Retention of sodium and water

A client with the diagnosis of Cushing syndrome has the following laboratory results: Na (sodium) 149 mEq/L; K (potassium) 3.2 mEq/L; Hb (hemoglobin) 17 g/dL; and glucose 90 mg/dL. What should the nurse teach the client? Select all that apply. A. Avoid foods high in salt B. Restrict your fluid intake C. Eat foods high in potassium D. Limit your carbohydrate intake E. Continue you regular diet as before

A. Avoid foods high in salt C. Eat foods high in potassium

A client has a history of hypothyroidism. Which skin condition should the nurse expect when performing a physical assessment? A. Dry B. Moist C. Flushed D. Smooth

A. Dry

A 24 hour urine test is prescribed for a client who has a tentative diagnosis of pheochromocytoma. What should the nurse do? A. Start the time of the test after discarding the first voiding B. Discard the last voiding in the 24 hour time period for the test C. Insert a urinary retention catheter to promotor the collection of urine D. Strain the urine following each voiding before adding the urine to the container

A. Start the time of the test after discarding the first voiding

A client is admitted with a diagnosis of chronic adrenal insufficiency. When assigning a room, which roommate should be avoided because of the newly admitted client's diagnosis? A. Young adult client with pneumonia B. Adolescent client with a fractured leg C. Older adult client who has a brain attack D. Middle aged client who had cholecystitis

A. Young adult client with pneumonia

Name the Disorder: High IGF-1 High Blood glucose High cholesterol High Lipids

Acromegaly

ACTH stimulation

Addison's

A client with hyperthyroidism is treated with radioactive iodine to ablate thyroid tissue. What should the nurse instruct the client to do after the procedure? A. Remain in the house B. Avoid holding an infant C. Save urine in a lead-lined container D. Refrain from using a bathroom used by others

B. Avoid holding an infant

Postoperatively a client who had a thyroidectomy complains of tingling and numbness of the fingers and toes, and the nurse observes muscle twitching. Which complications does the nurse suspect the client is experiencing? A. Hypokalemia B. Hypocalcemia C. Thyrotoxic crisis D. Hypovolemic shock

B. Hypocalcemia

A client's parathyroid glands are removed. What clinical manifestation is indicative of the fluid and electrolyte imbalance associated with this surgery? A. Constipation B. Muscle spasms C. Hypoactive reflexes D. Increased specific gravity

B. Muscle Spasms

What should a nurse teach the client to do to avoid lipodystrophy when self-administering insulin therapy? A. Exercise regularly B. Rotate injection sites C. Use the Z track technique D. Avoid massaging the injection site

B. Rotate injection sites

ACTH suppression

Cushing's

Name the Disorder: High Na Low K Low serum osmolarity High pH Low Ca High glucose

Cushing's

A nurse is assessing a client and suspects diabetic ketoacidosis (DKA). What clinical findings support this conclusion? A. Nervousness and tachycardia B. Erythema toxicum rash and pruritus C. Diaphoresis and altered mental state D. Deep respirations and fruity odor to the breath

D. Deep respirations and fruity odor to the breath

A client with Cushing syndrome asks why a low-sodium, high-potassium diet has been prescribed. The nurse explains that: A. The client will gain excessive weight if sodium is not limited B. An inadequate intake of potassium contributed to the disease C. This type of diet increases emotional stability D. Excessive aldosterone and cortisone cause the retention of sodium and loss of potassium

D. Excessive aldosterone and cortisone cause the retention of sodium and loss of potassium

The nurse is providing immediate post operative care to a client who had a thyroidectomy. The nurse should monitor the client for which clinical manifestation? A. Urinary retention B. Signs of restlessness C. Decreased blood pressure D. Signs of respiratory obstruction

D. Signs of respiratory obstruction

Name the Disorder: High Serum Osmolality Low urine Osmolarity High Na

Diabetes Insipidus

Name the Disorder: Treated with Biphosphonates, IV Fluids, Lasix

Hyperparathyroidism

Why would a patient with Cushing's have metabolic alkalosis?

Increased excretion of potassium causes and increase in pH

What should you teach a diabetic who is wanting to start an exercise program?

Start slowly after you are medically cleared Monitor blood glucose before and after because glucose lowering effects last up to 48 hours Do not exercise if your blood glucose level is above 300 and you have ketones in the urine

Name the Disorder: Low TSH Low T3 Low T4

Secondary Hypothyroidism

A nurse is caring for a client with type 1 diabetes, and the healthcare provider prescribes one tube of glucose gel. What is the primary reason for the administration of glucose gel to this client? A. Diabetic Acidosis B. Hyperinsulin secretion C. Insulin-induced hypoglycemia D. Idiosyncratic reactions to insulin

C. Insulin-induced hypoglycemia

A client with type 1 diabetes is transported via ambulance to the emergency department of the hospital. The client has dry, hot, flushed skin and a fruity odor to the breath and is having Kussmaul respirations. Which complication does the nurse suspect the client is experiencing? A. Ketoacidosis B. Somogyi Phenomenon C. Hypoglycemic reaction D. Hyperosmolar nonketotic coma

A. Ketoacidosis

A nurse is caring for an older client who had non-insulin dependent diabetes for 15 years that progressed to insulin dependent diabetes 2 years ago. What common complications of diabetes should the nurse assess for when examining this client? Select all that apply? A. Leg ulcers B. Loss of visual acuity C. Increased creatinine clearance D. Prolonged capillary refill in the toes E. Decreased sensation in the lower extremities

A. Leg ulcers B. Loss of visual acuity D. Prolonged capillary refill in the toes E. Decreased sensation in the lower extremities

The nurse provides education about signs and symptoms of hypoglycemia to a client with newly diagnosed type 1 diabetes. The nurse concludes that the teaching was effective when the client states, "I will drink orange juice and eat a slice of bread when I feel: A. Nervous and weak" B. Flushed and short of breath" C. Thirsty and have a headache" D. Nauseated and have abdominal cramps

A. Nervous and Weak

A client with type 1 diabetes is diagnosed with diabetic ketoacidosis and initially treated with intravenous (IV) fluids followed by an IV bolus of regular insulin. The nurse anticipates that the health care provider will prescribe a continuous infusion of: A. Novolin L insulin B. Novolin R insulin C. Novolin N insulin D. Novolin U insulin

B. Novolin R insulin

When assessing a client with Graves Disease, the nurse expects to identify: A. constipation, dry skin, and weight gain B. lethargy, weight gain, and forgetfulness C. Weight loss, exophthalmos, and restlessness D. Weight loss, protruding eyeballs, and lethargy

C. Weight loss, exophthalmos, and restlessness

A client has a tentative diagnosis of Cushing syndrome. The nurse's physical assessment of this client is likely to reveal the presence of: A. Fever and tachycardia B. Lethargy and constipation C. Hypertension and moon face D. Hyperactivity and exophthalmos

C. Hypertension and moon face

After surgical clipping of a rupture cerebral aneurysm, a client develops the syndrome of inappropriate antidiuretic hormone (SIADH). The nurse expects that manifestations of excessive levels of antidiuretic hormone are: A. Increased blood urea nitrogen (BUN) and hypotension B. Hyperkalemia and poor skin turgor C. Hyponatremia and decreased urine output D. Polyuria and increased specific gravity of urine

C. Hyponatremia and decreased urine output

The nurse provides a list of appropriate food choices to a client with newly diagnoses diabetes. The client reviews the list and says, "I do not like and refuse to eat asparagus, broccoli, and mushrooms." In response, the nurse teaches the client about the food exchange list. The nurse evaluates that the teaching is understood when the client states, "Instead of asparagus, broccoli, and mushrooms, I can eat: A. String beans, beets, or carrots" B. Corn, lima beans, or dried pasta" C. Baked beans, potatoes, or parsnips" D. Corn muffins, corn ships, or pretzels."

A. String beans, beets, or carrots"

Hydrocortisone (Cortef) is prescribed for a client with Addison disease. Before discharge, the nurse teaches the client about this medication. What did the nurse include as a therapeutic effect of the drug? A. Supports a better response to stress B. Promotes a decrease in blood pressure C. Decreases episodes of shortness of breath D. Controls an excessive loss of potassium from the body

A. Supports a better response to stress

One week after beginning antithyroid medication for the treatment of hyperthyroidism, a client reports diarrhea, abdominal pain, and a fever. The client is admitted with a diagnosis of thyrotoxic crisis. The nurse determines that the most important intervention for this client is: A. Limiting fluid intake B. Reducing body temperature and heart rate C. Observing for an exaggerated response to sedatives D. Treating the associated hyperglycemia and ketoacidosis

B. Reducing body temperature and heart rate

A client, visiting the health center, reports feeling nervous, irritable, and extremely tired. The client says to the nurse, "Although I eat a lot of food, I have frequent bouts of diarrhea and am losing weight." The nurse observes a fine hand tremor, an exaggerated reaction to external stimuli, and a wide-eyed expression. What laboratory tests may be prescribed to determine the cause of these signs and symptoms? A. Partial thromboplastin time (PTT) and prothrombin time (PT) B. T3, T4, and thyroid stimulating hormone (TSH) C. Venereal disease research laboratory (VDRL) test and complete blood count D. Adernocorticotropic hormone (ACTH), Antidiuretic hormone (ADH), and corticotropin-releasing hormone (CRH)

B. T3, T4, and thyroid stimulating hormone (TSH)

A client with hyperthyroidism asks the nurse about the tests that will be prescribed. Which diagnostic tests should the nurse include in a discussion with this client? A. Thyroxine (T4) and xray films B. Thyroid stimulating hormone (TSH) assay and triiodothyronine (T3) C. Thyroglobulin level and PO2 D. Protein-bound iodine and sequential multichannel autoanalyzer (SMA)

B. Thyroid stimulating hormone (TSH) assay and triiodothyronine (T3)

At 4:30 PM, a client who is receiving human insulin (Humalin N) every morning states, "I feel very nervous." The nurse observes that the client's skin is moist and cool. What is the nurse's most accurate interpretation of what the client is likely experiencing? A. Polydipsia B. Ketoacidosis C. Glycogenolysis D. Hypoglycemia

D. Hypoglycemia

While a nurse is teaching a client with diabetes about food choices, the client states, "I do not like broccoli." The nurse suggests that a food that can be substituted for the broccoli is: A. Peas B. Corn C. Green beans D. Mashed potatoes

C. Green beans

A nurse is caring for a patient who has a 20 year history of type 2 diabetes. The nurse should assess for what physiological changes that are associated with a long history of diabetes? A. Blurry, spotty, or hazy vision B. Arthritic changes in the hands C. Hyperactive knee and ankle jerk reflexes D. Dependent pallor of the feet and lower legs

A. Blurry, spotty, or hazy vision

A nurse is caring for a client with uncontrolled diabetes, suspects that a client is experiencing hypoglycemia in response to insulin administration. What clinical manifestations lead the nurse to this conclusion? Select all that apply. A. Headache B. Confusion C. Extreme thirst D. Profuse sweating E. Increased urination

A. Headache B. Confusion D. Profuse sweating

A client with diabetes asks how exercise will affect insulin and dietary needs. The nurse should respond, "Exercise: A. increases the need for carbohydrates and decreases the need for insulin." B. increases the need for insulin and increases the need for carbohydrates." C. Decreases the need for insulin and decreases the need for carbohydrates." D. Decreases the need for carbohydrates but does not affect the need for insulin."

A. Increases the need for carbohydrates and decreases the need for insulin."

A nurse is caring for an adult with acromegaly. What clinical manifestation does the nurse expect the client to exhibit? A. Prominent jaw B. Decreased Pulse C. Increased Height D. Increases Sodium

A. Prominent jaw

A nurse working in the diabetic clinic is evaluating a client's success with managing the medical regimen. Which is the best indication that a client with type 1 diabetes is successfully managing the disease? A. Reduction in excess body weight B. Stabilization of the serum glucose C. Demonstrated knowledge of the disease D. Adherence to the prescription for insulin

B. Stabilization of the serum glucose

A 40 year old male is prescribed Metformin XL (Glucophage) to control his type 2 diabetes mellitus. Which statement made by this client indicates the need for further education? A. "I will take this drug with food" B. "I must swallow my medication whole and not crush or chew it." C. "I will stop taking Metformin for 24 hours before and after having a test involving dye." D. "I will notify my doctor if I develop muscular or abdominal discomfort."

C. "I will stop taking Metformin for 24 hours before and after having a test involving dye"

A client with adrenal insufficiency reports feeling weak and dizzy, especially in the morning. What should the nurse determine is the most probable cause of these symptoms? A. A lack of potassium B. Postural hypertension C. A hypoglycemic reaction D. Increased extracellular fluid volume

C. A hypoglycemic reaction

A client with type 1 diabetes is placed on an insulin pump. The most appropriate short term goal when teaching this client to control the diabetes is: "The client will: A. Adhere to the medical regimen" B. Remain normoglycemic for three weeks" C. Demonstrate the correct use of the administration equipment" D. List three self care activities that are necessary to control the diabetes"

C. Demonstrate the correct use of the administration equipment"

A client with type 2 diabetes is admitted for elective surgery. The health care provider prescribes regular insulin even though oral antidiabetics were adequate before the client's hospitalization. The nurse concludes that regular insulin is needed because the: A. Client will need a higher serum glucose level while on bed rest B. Possibility of acidosis is greater when a client is on oral hypoglycemics C. Dosage can be adjusted to changing needs during recovery from surgery D. Stress of surgery may precipitate uncontrollable periods of hypoglycemia

C. Dosage can be adjusted to changing needs during recovery from surgery

Name the Disorder: Treated with Tapazole, PTU, Beta Blockers, Radioactive Iodine

Hyperthyroidism