Endocrine System (3 of 3)

A controlled type 2 diabetic client states, "The doctor said if my blood sugars remain stable, I may not need to take any medication." Which response by the nurse is most appropriate?

"Diet, exercise, and weight loss can eliminate the need for medication."

An active type 2 diabetic reports recurrent symptoms of weakness and nervousness. Which is the best response from the nurse?

"Exercise and activity can lower glucose levels."

What is the nurse's best response about developing diabetes to the patient whose father has type 1 diabetes mellitus?

"You have a greater susceptibility for development of the disease because of your family history."

Which statement made by a student nurse indicates the need for further teaching about pituitary insufficiency?

"Testosterone supplements may be prescribed for women with gonadotropin deficiency."

When a diabetic patient asks about maintaining adequate blood glucose levels, which of the following statements by the nurse relates most directly to the necessity of maintaining blood glucose levels no lower than about 74 mg/dL?

"The central nervous system cannot store glucose and needs a continuous supply of glucose for fuel."

A recently widowed diabetic comments that blood sugar levels are running higher than usual. Which is the best response from the nurse?

"This must be a stressful time for you."

A child is brought into the emergency department with vomiting, drowsiness, and Kussmaul's respirations. The father reports that the symptoms have been progressing throughout the day. The nurse suspects diabetic ketoacidosis (DKA). Which nursing action is most important in the management of DKA?

Administer prescribed dose of insulin.

Radioactive iodine is indicated for the treatment of hyperthyroidism. The nurse should include which teaching in this patient's plan of care?

An additional dose may be needed

Following a parathyroidectomy, which electrolyte should the nurse most closely monitor?

Calcium

A client reports taking oral medication for control of sugar problems. Which is the best nursing interpretation of this verbal accounting?

Client has type 2 diabetes mellitus.

Which is the primary dietary consideration for a client receiving insulin isophane suspension (NPH) at breakfast?

Encourage midday snack.

A client is admitted with the diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNKS) following steroids therapy. Which of the following symptoms are associated with HHNKS? Select all that apply.

Extreme thirst Poor skin turgor

Which assessment finding is most important in determining nursing care for a client with diabetes mellitus?

Fruity breath

The nurse instructs a patient with type 1 diabetes mellitus to avoid which of the following drugs while taking insulin?

Furosemide (Lasix)

A type 2 diabetic is ordered metformin (Glucophage) as part of the management regime. Which is the best nursing explanation for the action of this drug in controlling glucose levels?

Helps tissues use insulin more efficiently

When the nurse inspects the feet of a diabetic, a tack is found sticking in the sole of one foot. The client denies feeling anything unusual in the foot. Which is the best rationale for this finding?

High blood sugar decreases blood circulation to nerves.

Which is the best nursing explanation for the symptom of polyuria in a client with diabetes mellitus?

High sugar pulls fluid into the bloodstream, which results in more urine production.

The nurse is caring for a patient who has undergone a thyroidectomy. Which patient complaint is highest priority requiring further evaluation?

Hoarseness

A diabetic client maintains glucose control with the use of long-acting and short-acting insulin. Which nursing instruction would be considered a priority teaching issue for this client?

If using Lantus or Levemir, give in separate syringe.

The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine?

Increases ability for glucose to get into the cell and lowers blood sugar

Which factor presents the most likely cause for weight gain in a diabetic client who is controlled with insulin?

Insulin is an anabolic hormone.

The nurse recognizes which patient as having the greatest risk for undiagnosed diabetes mellitus?

Middle-aged Native American woman

The nurse is caring for a patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What is the nurse's best action?

Monitor for changes in level of consciousness

On initial nursing rounds, the diabetic client reports "not feeling well." Later, the nurse finds the client to be diaphoretic and in a stuporous state. Which is the immediate action taken by the nurse?

Obtain a glucometer reading.

The nurse associates which assessment finding in the diabetic patient with decreasing renal function?

Protein in the urine during a random urinalysis

The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order?

Reflects the amount of glucose stored in hemoglobin over past several months.

A patient presents to the emergency room complaining of vomiting with severe back and leg pain. The patient's home medications include daily oral corticosteroids. Vital signs reveal a low blood pressure and there are peaked T waves on the electrocardiogram. What is the nurse's priority intervention?

Start an intravenous line

Which of the following would be included in the assessment of a patient with diabetes mellitus who is experiencing a hypoglycemic reaction? (Select all that apply.)

Tremors Nervousness Profuse perspiration

A client asks why pancreas transplantation is not an option offered to all insulin-dependent diabetics. Which is the best response by the nurse?

Type 1 diabetes can be managed in most clients with insulin.

Which important teaching point should the nurse include in the plan of care for a patient diagnosed with Cushing's disease?

Wash hands frequently

A diabetic client is having difficulty with blood glucose control even though the client claims to be following a strict diet, exercise, and medication regime. Which of the following conditions would the nurse suspect to be the most likely cause of poor control?

emphysema

A client with type 1 diabetes mellitus is receiving short-acting insulin to maintain control of blood glucose levels. In providing glucometer instructions, the nurse would instruct the client to use which site for most accurate findings?

finger

Which of the following assessment findings is most important in determining nursing care for a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)?

hypotension

A diabetic patient is brought into the emergency department unresponsive. The arterial pH is 7.28. Besides the blood pH, which clinical manifestation is seen in uncontrolled diabetes mellitus and ketoacidosis?

increased respiratory rate

Which is the primary reason for encouraging injection site rotation in an insulin-dependent diabetic?

promote absorption

The diabetic client asks the nurse why shoes and socks are removed at each office visit. Which assessment finding is most significant in determining the protocol for inspection of feet?

sensory neuropathy

The nurse understands that a client with diabetes mellitus is at greater risk for developing which of the following complications?

urinary tract infections