Endocrine Test
C)IV infusion of normal saline
A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperosmolar hyperglycemic syndrome is made. The nurse would immediately prepare to initiate which anticipated primary health care provider's prescription? A)Endotracheal intubation B)100 units of NPH insulin C)IV infusion of normal saline D)IV infusion of sodium bicarbonate
D)Consuming a low-carbohydrate, high-protein diet and avoiding fasting
A male patient has hypoglycemia. To control hypoglycemic episodes, the nurse should recommend which of the following? A)Increasing saturated fat intake and fasting in the afternoon. B)Increasing intake of vitamins B and D and taking iron supplements C)Eating a candy bar if light-headedness occurs D)Consuming a low-carbohydrate, high-protein diet and avoiding fasting
B. Document that the thyroid was nonpalpable. Rationale: The thyroid is frequently nonpalpable. The nurse should simply document the finding. There is no need to notify the health care provider immediately about a normal finding. There is no indication for thyroid-stimulating hormone (TSH) testing unless there is evidence of thyroid dysfunction. Deep palpation of the neck is not appropriate.
During the physical examination of a 36-year-old female, the nurse finds that the patient's thyroid gland cannot be palpated. The most appropriate action by the nurse is to A. Palpate the patient's neck more deeply. B. Document that the thyroid was nonpalpable. C. Notify the health care provider immediately. D. Teach the patient about thyroid hormone testing.
A)"I need to stop my insulin."
The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client reports a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching? A)"I need to stop my insulin." B)"I need to increase my fluid intake." C)"I need to monitor my blood glucose every 3 to 4 hours." D)"I need to call my PHCP because of these symptoms."
A) Polyuria
The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which sign or symptom, if frequently exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if the blood glucose is not adequately managed? A)Polyuria B)Diaphoresis C)Pedal edema D)Decreased respiratory rate
C)temperature
The nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose level of 70 mg/dL, temperature of 101 *F, pulse of 82 BPM, respirations of 20 breaths per minute, and blood pressure of 118/68 mm Hg. Which finding would be the priority concern to the nurse? A)Pulse B)Respiration C)Temperature D)Blood pressure
D)pituitary gland
What is the master gland of the body? A)thyroid gland B)adrenal gland C)pineal gland D)pituitary gland
A. Increased urinary cortisol. Rationale: Increased secretion of adrenocorticotropic hormone (ACTH) by the anterior pituitary gland will lead to an increase in serum and urinary cortisol levels. An increase, rather than a decrease, in thyroxine level would be expected with increased secretion of thyroid stimulating hormone (TSH) by the anterior pituitary. Aldosterone and catecholamine levels are not controlled by the anterior pituitary.
A 22-year-old patient is being seen in the clinic with increased secretion of the anterior pituitary hormones. The nurse would expect the laboratory results to show? A. Increased urinary cortisol. B. Decreased serum thyroxine. C. Elevated serum aldosterone levels. D. Low urinary catecholamines excretion.
C. "Come to the laboratory to have the blood drawn early in the morning." Rationale: Cortisol levels are usually drawn in the morning, when levels are highest. The other instructions would be given to patients who were having other endocrine testing.
A 29-year-old patient in the outpatient clinic will be scheduled for blood cortisol testing. Which instruction will the nurse provide? A. "Avoid adding any salt to your foods for 24 hours before the test." B. "You will need to lie down for 30 minutes before the blood is drawn." C. "Come to the laboratory to have the blood drawn early in the morning." D. "Do not have anything to eat or drink before the blood test is obtained."
B. Antidiuretic hormone level Rationale: Elevated levels of antidiuretic hormone will cause water retention and decrease serum sodium levels. The other tests would not be helpful in determining possible causes of the patient's hyponatremia.
A 30-year-old patient seen in the emergency department for severe headache and acute confusion is found to have a serum sodium level of 118 mEq/L. The nurse will anticipate the need for which diagnostic test? A. Urinary 17-ketosteroids B. Antidiuretic hormone level C. Growth hormone stimulation test D. Adrenocorticotropic hormone level
B. Value system Rationale: When dealing with a patient with a chronic condition such as diabetes, identification of the patient's values and beliefs can assist the health care team in choosing strategies for successful lifestyle change. The other information also will be useful, but is not as important in developing an individualized plan for the necessary lifestyle changes.
A 40-year-old male patient has been newly diagnosed with type 2 diabetes mellitus. Which information about the patient will be most useful to the nurse who is helping the patient develop strategies for successful adaptation to this disease? A. Ideal weight B. Value system C. Activity level D. Visual changes
C - Tetany is associated with hypocalcemia. The other values would not be useful for this patient.
A 44-year-old patient is admitted with tetany. Which laboratory value should the nurse monitor? A. Total protein B. Blood glucose C. Ionized calcium D. Serum phosphate
C. Elevated serum potassium.
A 60-year-old patient is taking spironolactone (Aldactone), a drug that blocks the action of aldosterone on the kidney, for hypertension. The nurse will monitor for A. Increased serum sodium. B. Decreased urinary output. C. Elevated serum potassium. D. Evidence of fluid overload.
D. Parathyroid hormone Rationale: Parathyroid hormone is the major controller of blood calcium levels. Although calcitonin secretion is a countermechanism to parathyroid hormone, it does not play a major role in calcium balance. Catecholamine and thyroid hormone levels do not affect serum calcium level.
A 61-year-old female patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L). The nurse will anticipate the need to teach the patient about testing for _____ levels A. Calcitonin B. Catecholamine C. Thyroid hormone D. Parathyroid hormone
A)fever B)nausea D)tremors E)confusion
A client has been diagnosed with hyperthyroidism. The nurse monitors for which signs and symptoms indicating a complication of this disorder? SATA A)fever B)nausea C)lethargy D)tremors E)confusion F)bradycardia
C)Audible stridor
A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client? A)Hoarseness B)Hypocalcemia C)Audible stridor D)Edema at the surgical site
C)IV fluids containing dextrose
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level is 950 mg/dL (52.9 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240 mg/dL (13.3 mmol/L). The nurse would next prepare to administer which medication? A)An ampule of 50% dextrose B)NPH insulin subcutaneously C)IV fluids containing dextrose D)Phenytoin for the prevention of seizures
B)Maintain a patent airway.
A client is admitted to an ED and a diagnosis of myxedema coma is made. Which action should the nurse prepare to carry out initially? A)Warm the client B)Maintain a patent airway. C)Administer thyroid hormone D)Administer fluid replacement
D) the pituitary gland
A client reports symptoms of accelerated growth, agitation, and sleep disturbances following head trauma which occured three years ago in a serious motor vehicle accient. The health care provider prescribes a radioimmunoassay to measure levels of hormones in the blood. The LPN believes this is a disorder of which gland? A)The adrenal glands B)The thymus gland C)The thyroid gland D)The pituitary gland
A) Hypotension C) Hyperkalemia
A client with a diagnosis of Addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional health care team focus on? SATA A)Hypotension B)Leukocytosis C)Hyperkalemia D)Hypercalcemia E)Hypernatremia
B)Comatose state C)Deep, rapid breathing E)Elevated blood glucose level
A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which findings support this diagnosis? SATA A)Increase in PH B)Comatose state C)Deep, rapid breathing D)decreased urine output E)Elevated blood glucose level
B)Convey empathy, trust, and respect toward the client
A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety? A)Administer a sedative B)Convey empathy, trust, and respect toward the client. C)Ignore the signs and symptoms of anxiety, anticipating that they will son disappear. D)Make sure that the client is familiar with the correct medical terms to promote understanding of what is happening.
B)"The best time for me to exercise is after breakfast."
A client with type 1 diabetes mellitus who takes NPH daily in the morning calls the nurse to report recurrent episodes of hypoglycemia with exercising. Which statement by the client indicates an adequate understanding of the peak action of NPH insulin and exercise? A)"I should not exercise since I am taking insulin." B)"The best time for me to exercise is after breakfast." C)'The best time for me to exercise is mid- to late afternoon." D)"NPH is a basal insulin, so I should exercise in the evening."
B. Keep the specimen refrigerated or on ice. Rationale: The specimen must be kept on ice or refrigerated until the collection is finished. Voided or catheterized specimens are acceptable for the test. The initial voided specimen is discarded. There is no fluid intake requirement for the 24-hour collection.
A nurse will teach a patient who is scheduled to complete a 24-hour urine collection for 17-ketosteroids to A. Insert and maintain a retention catheter. B. Keep the specimen refrigerated or on ice. C. Drink at least 3 L of fluid during the 24 hours. D. Void and save that specimen to start the collection.
A)Rx:(Vasopressor)DDAVP 2.0mcg BID IV Intervention: strict I's and O's, vitals signs q 4 hours, neuro assessment q 8 hours, no fluid restrictions, skin turgor and daily weight's daily, educate patient on what to expect, and no caffeine
A patient has been admitted with a diagnosis and treatment plan for diabetes insipidus. What can the nurse expect to see in this patients orders? A)Rx:(Vasopressor)DDAVP 2.0mcg BID IV Intervention: strict I's and O's, vitals signs q 4 hours, neuro assessment q 8 hours, no fluid restrictions, skin turgor and daily weight's daily, educate patient on what to expect, and no caffeine B)Rx:DDAVP 2.0mcg BID IV Intervention: strict I's and O's, fluid restrictions, no fall precautions necessary C)Rx: D5LR-1,000 mL KVO Intervention: no fluid restrictions, educate patient on what to expect, watch for dehydration status, no diet restrictions
B)Diabetes insipidus
A patient is brought in complaining of polyuria, feeling very weak all over, and intense polydipsia. Her heart rate is 124 and blood pressure is 104/68. Labs have come in and the urine specific gravity is 1.005. What condition might the nurse expect the patient to have? A)Diabetes mellitus B)Diabetes insipidus C)SIADH D)acromegaly
D. 50% dextrose solution.
An 18-year-old male patient with a small stature is scheduled for a growth hormone stimulation test. In preparation for the test, the nurse will obtain A. Ice in a basin. B. Glargine insulin. C. A cardiac monitor. D. 50% dextrose solution.
D) It administers a small continuous dose of short-duration insulin subcutaneously. The client can self-administer an additional bolus dose from the pump before each meal.
An external insulin pump is prescribed for a client with diabetes mellitius. When the client asks the nurse about the functioning of the pump, the nurse bases the response on which information about the pump? A)It is timed to release programmed doses of either short-duration on NPH insulin into the blood-stream at specific intervals. B)It continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels. C)It is surgically attached to the pancreas and infuses regular insulin into the pancreas. This releases insulin into the bloodstream. D)It administers a small continuous dose of short-duration insulin subcutaneously. The client can self-administer an additional bolus dose from the pump before each meal.
D) 1600
At 0800, the LPN administers 25 units of 70/30 insulin to the client with diabetes mellitus. At what time is the client at risk for developing hypoglycemia? A)1800 B)1230 C)0830 D)1600
B)thyroid crisis
Early in the day, a patient had a subtotal thyroidectomy. During evening rounds, you assess the patient, who now has nausea, a temperature of 105*F (45*C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? A)Diabetic ketoacidosis B)Thyroid crisis C)Hypoglycemia D)Tetany
A)Too much antidiuretic hormone
In the syndrome of inappropriate antidiuretic hormone (SIADH), what best describes the body's secretions? A)Too much antidiuretic hormone B)Too little antidiuretic hormone C)Too much diuretic hormone D)Too little diuretic hormone
Acromegaly
Over production of the growth hormone aka somatotropin.
C)diabetes insipidus;polyuria;intense polydypsia;patient craves cold ice water and may drink large amounts yet still be dehydrated severely and have increased Na levels in the blood
Patients who have small celled lung cancer can often have the same signs and symptoms as: A)acromegaly increased GH;excessive growth of hands, feet, jaw, and internal organs; muscle weakness; amenorrhea B)hyperthyroidism;dysphagia;may be hoarse; insomnia;increased HR and BP;heat intolerance C)diabetes insipidus;polyuria;intense polydypsia;patient craves cold ice water and may drink large amounts yet still be dehydrated severely and have increased Na levels in the blood D) pheochromocytoma;HTN;h/a;papitations;diaphoresis;hyperglycemia;anxiety
C)Use the room intercom to tell the unit secretary that the RN is needed in the room immediately, ask the unit secretary to put in a call to the health care provider, stay with the client.
The LPN cares for a client dx w/ Crohn disease and type 1 diabetes. The LPN performs a blood glucose check and the results is 500 mg/dL. Which priority actions should the LPN perform? A)Go to the rooms nearby to see if the RN can be located. If the RN is not found, give the client the highest amount on the sliding scale insulin plus 10 units more. B)Look out in the hall to see if any RNs are there. If any health care providers are seen, ask them how much insulin to give the client. C)Use the room intercom to tell the unit secretary that the RN is needed in the room immediately, ask the unit secretary to put in a call to the health care provider, stay with the client. D)Go to the nursing station to look for the RN, tell the UAP to go and stay in the room with the client, and call the client's family.
B)crohns disease
The LPN cares for the client diagnosed with Addison's disease. The LPN recognizes that the pathophysiological basis of Addison's disease is adrenal hyposecretion. Which disease is characterized by adrenal hypersecretion? A)hyperpituitarism B)crushing's syndrome C)crohn's disease D)blepharitis
A)Sudden marked decrease in adrenal hormones
The LPN cares for the client diagnosed with Addison's disease. The LPN recognizes which as the physiological basis for acute adrenal crisis (Addisonian crisis)? A)Sudden marked decrease in adrenal hormones B)Abnormally high secretion of thyroid hormone C)Sudden decrease in the amount of parathyroid hormone (PTH) D)Development of ketoacidosis
C)Gives the client 3-4 teaspoons of sugar
The LPN cares for the client recovering from a cholecystectomy. The client has a history of type 1 diabetes and hypertension. While talking with the client, the LPN notes the client becomes shaky, diaphoretic, and drowsy. Based on the client's history and current symptoms, the LPN should take which action? A)Give the client 4-6 ounces juice with 2 packets of sugar added. B)Gives the client 4-6 ounces of a diet soft drink. C)Gives the client 3-4 teaspons of sugar D)Gives the client 2 cookies
A)polyphagia, weight loss, and polydipsia
The LPN expects to find which cardinal signs and symptoms in the history of the client with type 1 diabetes? A)polyphagia, weight loss, polydipsia B)polycythemia, polyphagia, polyuria C)Polyuria, fatigue, irritability D)Polydipsia, polyuria, hypoglycemia
C)Diarrhea
The LPN expects to find which condition in the history of the client with Graves' disease? A)Fatigue B)Bradycardia C)Diarrhea D)Weight gain
A)Tell the client to wear another pair of shoes until an appointment can be made with the HCP
The LPN makes a home visit to the client diagnosed with type 2 diabetes. She immediately notices that there are tow reddened areas on the clients foot. The skin is broken on one of the areas, and a blister has formed on the second. The client says, "I just noticed them yesterday. I never felt any soreness. I did get a new pair of shoes about a week ago and I have worn them every day since then. "Which action by the nurse is best? A)Tell the client to wear another pair of shoes until an appointment can be made with the HCP B)Tell the client to call the LPN if the reddened areas are not better within a week. C)Suggest that the client soak the feet in warm water and magnesium sulfate for 20 minutes 3 times a day. D)Apply sterile bandages over the two reddened sites and tell the client to change these every day.
C)iatrogenic result of treating rheumatoid arthritis.
The LPN recalls which explanation as the most common cause of the client having Cushing's syndrome? A)excessive production of adrenocorticotropic hormone B)adrenal adenoma C)iatrogenic result of treating rheumatoid arthritis. D)Insufficient secretion of steroid hormones.
C)"I will need to take my medication for the rest of my life."
The LPN recognizes that the reinforced client education about hypothyroidism is effective if the client makes which statement? A)"I might become hypertensive in later years." B)"I might have problems with my eyes bulging." C)"I will need to take my medication for the rest of my life." D)"I will need to move to a drier climate to aid my breathing."
A)dry skin D)fatigue E)depression F)constipation
The LPN reinforces teaching of the client diagnosed with hypothyroidism. The LPN recognizes that the teaching is effective if the client identifies which of these as symptoms? A)dry skin B)tachycardia C)weight loss D)fatigue E)depression F)constipation
A)Initiate and infusion of 3% NaCl C)Restrict fluids to 800 mL over 24 hours E)Administer a vasopressin antagonist as prescribed
The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has a serum sodium of 118 mEq/L. Which primary health care provider prescriptions should the nurse anticipate receiving? SATA A)Initiate an infusion of 3% NaCl. B)Administer iv furosemide C)Restrict fluids to 800 mL over 24 hours D)Elevate the head of the bed to high-Fowler's. E)Administer a vasopressin antagonist as prescribed.
D)The patient is becoming increasingly hoarse.343
The nurse is assessing a postoperative thyroidectomy patient for damage to the laryngeal nerve. Which is most likely to suggest that damage may have occurred? A)The patient complains of a slight sore throat. B)The patient's voice tone has changed slightly. C)The patient is unable to swallow fluids. D)The patient is becoming increasingly hoarse.
A)Peripheral edema B)Hyponatremia C)Water retention D)Brain cells becoming edematous
The nurse is aware that SIADH is characterized by which clinical characteristics? SATA A)Peripheral edema B)Hyponatremia C)Water retention D)Brain cells becoming edematous E)Intake equal to output
B)Fluid shifts resulting from the osmotic effect of hyperglycemia
The nurse is aware that the polydipsia and polyuria experienced by a patient with poorly controlled diabetes are caused primarily by which of the following? A)The release of ketones from cells during fat metabolism B)Fluid shifts resulting from the osmotic effect of hyperglycemia C)Damage to the kidneys from exposure to high levels of glucose D)Changes in RBC's resulting from attachment of excessive glucose to hemoglobin
D)administer short-duration insulin intravenously
The nurse is caring for a client admitted to the emergency department with diabetic ketoacidosis (DKA). In the acute phase, the nurse plans for which priority intervention? A)Correct the acidosis B)Administer 5% dextrose intravenously. C)Apply a monitor for an electrocardiogram D)Administer short-duration insulin intravenously
B)Test the drainage for glucose. Rationale: The drainage should be tested for glucose because this could be cerebrospinal fluid leakage and if it is then glucose will be present. This is very important and should always be monitored. Do not lower the head of the bed as it will increase intracranial pressure. Because the drainage is clear no culture is required.
The nurse is caring for a client after hypophysectomy and notes clear nasal drainage from the client's nostril. The nurse should take which initial action? A)Lower the head of the bed. B)Test the drainage for glucose. C)Obtain a culture of the drainage. D)Continue to observe the drainage.
A)Potential for infection
The nurse is caring for a patient diagnosed with Addison's disease (adrenal hypofunction). The nurse's assessment reveals postural hypotension, fatigue, nausea, vomiting, and poor skin turgor. Which of these patient problems is of greatest priority at this time? A)Potential for infection B)Potential for Inability to Regulate Body Temperature C)Pain D)Potential for Inadequate Fluid Volume
D)calcium gluconate IV
The nurse is caring for a patient recovering from a total thyroidectomy. The first night the patient experiences signs and symptoms of postoperative tetany. Which medication should the nurse anticipate will be ordered by the health care provider? A)Sodium iodide PO B)Potassium chloride IV C)Magnesium sulfate IM D)Calcium gluconate IV
A)Potential for Inadequate Fluid Volume, related to excessive loss via the urinary system
The nurse is caring for a patient who had cranial surgery to remove a pituitary tumor 3 days ago, leaving the patient with partial left hemiparesis and diabetes insipidus. Which patient problem is of the greatest priority postoperatively? A)Potential for Inadequate Fluid Volume, related to excessive loss via the urinary system B)Despair, related to development of chronic illness (hemiparesis and diabetes insipidus) C)Potential for Compromised Oral Mucous Membranes, related to dehydration D)Potential for Impaired Family Coping, related to chronic illness
B)Lispro (Humalog), aspart (Novolog)
The nurse is caring for a patient who states the health care provider is prescribing an insulin that "takes effect in less than half the time of regular (short-acting) insulin." The nurse is aware that this patient has been prescribed which type of insulin? A)Humulin R, Novolin R B)Lispro (humalong), aspart (NovoLog) C)Humulin N, Novolin N D)Humulin 70/30, Novolin 70/30
A)Polyuria C)Bone pain
The nurse is completing an assessment on a client who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which client complaints would be characteristic of this disorder? SATA A)Polyuria B)Headache C)Bone pain D)Nervousness E)Weight gain
A)Regular insulin (Humulin R) has an onset of action of 30 minutes to 1 hour B)Lispro (Humalog) has an onset of action of 15 minutes
The nurse is conducting a class for patients with diabetes in the community. What information should the nurse include in the educational plan? SATA A)Regular insulin (Humulin R) has an onset of action of 30 minutes to 1 hour B)Lispro (Humalog) has an onset of action of 15 minutes C)NPH (Humulin N) has an onset of action of 2 hours D)Glargine (Lantus) has an onset of action of 6 to 10 hours. E)Lantus has a peak of 8 to 10 hours
A)Tremors C)Irritability D)Nervousness
The nurse is monitering a client who was diagnosed with type 1 diabetes mellitus and is being treated with NPH and regular insulin. Which manifestations would alert the nurse to the presence of a possible hypoglycemic reaction? SATA A)Tremors B)Anorexia C)Irritability D)Nervousness E)Hot, dry skin F)Muscle cramps
B)Leukocytosis D)Urinary output of 800 mL/hr E)Clear drainage on nasal dripper pad
The nurse is monitoring a client diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy and is recovering in the intensive care unit. Which findings should alert the nurse to presence of a possible postoperative complication? SATA A)Anxiety B)Leukocytosis C)Chvostek's sign D)Urinary output of 800 mL/hr E)Clear drainage on nasal dripper pad
C)A heart rate that is 90 beats per minute and irregular
The nurse is performing an assessment on a client with pheochromocytoma. Which assessment data would indicate a potential complication associated with this disorder? A)A urinary output of 50 mL/hr B)A coagulation time of 5 minutes C)A heart rate that is 90 beats per minute and irregular D)A blood urea nitrogen level of 20 mg/dL
D)May have sufficient endogenous insulin to prevent ketosis but is at risk for
The nurse is planning care for an elderly patient with type 2 diabetes admitted to the hospital with pneumonia. What should the nurse understand about this patient? A)Must receive insulin therapy to prevent the development of ketoacidosis B)Has islet cell antibodies that have destroyed the ability of the pancreas to produce insulin C)Has minimal or absent endogenous insulin injections D)May have sufficient endogenous insulin to prevent ketosis but is at risk for development of hyperosmolar coma.
C)feeling cold D)loss of body hair E)persistent lethargy F)puffiness of the face
The nurse is preparing a client with a new diagnosis of hypothyroidism for discharge. The nurse determines that the client understands the discharge instructions if the client states that which signs and symptoms are associated with this diagnosis? SATA A)tremors B)weight loss C)feeling cold D)loss of body hair E)persistent lethargy F)puffiness of the face
B)Inadequate fluid volume
The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The nurse places priority on which client problem? A)Lack of knowledge B)Inadequate fluid volume C)Compromised family coping D)Inadequate consumption of nutrients
B)Fluid restriction to 800 to 1000 mL/day
The nurse is providing care to a patient with SIADH. What can most likely be anticipated to be included in the health care provider's orders? A)Increased fluid intake to 3000 mL/day B)Fluid restriction to 800 to 1000 mL/day C)Discontinue the ordered diuretics D)Antiemetics for complaints of nausea
A)"If I want to lose weight, all I have to do is increase my dose of insulin."
The nurse is reviewing the plan of care for a patient who has had type 1 diabetes for the past year. Which statement demonstrates his need for additional teaching? A)"If I want to lose weight, all I have to do is increase my dose of insulin." B)"I can have an occasional beer if it's calculated into my diet." C)"I will maintain better control of my blood sugar if I eat regular meals." D)"It is important that I eat properly, exercise regularly, and take my insulin injections."
A)Daily weight B) I & O C)Fluid restriction
The nurse is reviewing the plan of care for a patient with syndrome of inappropriate antidiuretic hormone (SIADH). What would nurse would include in the interventions? SATA A)Daily weight B) I & O C)Fluid restriction D)Foods high in sodium E)Assessment for abdominal sounds
A) "I should consume less than 1 liter of fluid per day."
The nurse is teaching a client with hyperparathyroidism how to manage the condition at home. Which response by the client indicates the need for additional teaching? A)"I should consume less than 1 liter of fluid per day." B)"I should use my treadmill or go for walks daily." C)"I should follow a moderate-calcium, high-fiber diet." D)"MY alendronate helps keep calcium from coming out of my bones."
A)Exercise leads to a decreased need for insulin.
The nurse is teaching a diabetic education class in the community. What information should the nurse include in the educational plan? A)Exercise leads to a decreased need for insulin. B)Insulin should be adjusted on the basis of the amount of protein ingested at each meal. C)During illness, the patient should avoid all insulin injections. D)Slow-healing wounds are expected and do not have to be reported to the health care provider.
D) "I will notify my primary health care provider (PHCP) if my blood glucose level is higher than 250 mg/dL (13.9 mmol/L)."
The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client makes which statement? A)"I will stop taking my insulin if I'm too sick to eat." B)"I will decrease my insulin dose during times of illness." C)"I will adjust my insulin dose according to the level of glucose in my urine." D)"I will notify my primary health care provider (PHCP) if my blood glucose level is higher than 250 mg/dL (13.9 mmo/L)."
C. Glucose control over the past 90 days.
The nurse reviews a patient's glycosylated hemoglobin (Hb A1C) results to evaluate A. Fasting preprandial glucose levels. B. Glucose levels 2 hours after a meal. C. Glucose control over the past 90 days. D. Hypoglycemic episodes in the past 3 months.
B)Shakiness C)Palpitations E)Lightheadedness
The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptoms develop? SATA A)Polyuria B)Shakiness C)Palpitations D)Blurred vision E)Lightheadedness F)Fruity breath odor
A)Obtain blood glucose immediately.
What is an appropriate nursing intervention for a patient admitted into the hospital with signs and symptoms of diabetic ketoacidosis? A)Obtain blood glucose immediately. B)Administer NPH insulin intravenously. C)Give intravenous glucagon. D)Take vital signs every 4 hours.
C/The serum albumin level is low.D. Rationale: Part of the total calcium is bound to albumin so hypoalbuminemia can lead to misinterpretation of calcium levels. The other laboratory values will not affect total calcium interpretation.
Which additional information will the nurse need to consider when reviewing the laboratory results for a patient's total calcium level? A. The blood glucose is elevated. B. The phosphate level is normal.C. C/The serum albumin level is low.D. D.The magnesium level is normal.
C)epinephrine and norepinephrine
Which hormones are responsible for "fight or flight"? A)Estrogen and testosterone B)FSH and LH C)Epinephrine and norepinephrine D)Calcitonin and parathyroid hormone
A)calcitonin and parathyroid hormone
Which hormones are responsible for blood calcium levels? A)calcitonin and parathyroid hormone B)estrogen and progesterone C)melatonin and follicle-stimulating hormone (FSH) D)Thyroxine and parathyroid hormone
Corticosteroids can affect blood glucose results. The other information will be provided to the health care provider but will not affect the test results.
Which information about a 30-year-old patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test? A. The patient reports having occasional orthostatic dizziness. B. The patient takes oral corticosteroids for rheumatoid arthritis. C. The patient has had a 10-pound weight gain in the last month. D. The patient drank several glasses of water an hour previously.
C)Severe hypertension
Which is a principal clinical manifestation in the patient with pheochromocytoma? A)Darkly pigmented skin and mucous membranes. B)Moonface and buffalo hump C)Severe hypertension D)Carpopedal spasms
C)Inspect all surfaces of the feet daily.
Which is an appropriate instruction for the patient with diabetes related to care of the feet? A)Use heat to increase blood supply B)Avoid softening lotions and creams C)Inspect all surfaces of the feet daily. D)Use iodine to disinfect cuts and abrasions
C. Thyroid-stimulating hormone (TSH) level Rationale: A low TSH level indicates that the patient's hypothyroidism is caused by decreased anterior pituitary secretion of TSH. Low T3 and T4 levels are not diagnostic of the primary cause of the hypothyroidism. TRH levels indicate the function of the hypothalamus.
Which laboratory value should the nurse review to determine whether a patient's hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland? A. Thyroxine (T4) level B. Triiodothyronine (T3) level C. Thyroid-stimulating hormone (TSH) level D. Thyrotropin-releasing hormone (TRH) level
C. "Have you had a recent unplanned weight gain or loss?" Rationale: Because thyroid function affects metabolic rate, changes in weight may indicate hyperfunction or hypofunction of the thyroid gland. Nocturia, visual difficulty, and changes in stress level are associated with other endocrine disorders.
Which question will provide the most useful information to a nurse who is interviewing a patient about a possible thyroid disorder? A. "What methods do you use to help cope with stress?" B. "Have you experienced any blurring or double vision?" C. "Have you had a recent unplanned weight gain or loss?" D. "Do you have to get up at night to empty your bladder?"
D. "I feel a lump in my throat when I swallow." Rationale: Difficulty in swallowing can occur with a goiter. Nocturia is associated with diseases such as diabetes mellitus, diabetes insipidus, or chronic kidney disease. Breast tenderness would occur with excessive gonadal hormone levels. Thirst is a sign of disease such as diabetes.
Which statement by a 50-year-old female patient indicates to the nurse that further assessment of thyroid function may be necessary? A. "I notice my breasts are tender lately." B. "I am so thirsty that I drink all day long." C. "I get up several times at night to urinate." D. "I feel a lump in my throat when I swallow."
B)because muscle weakness, joint pain, and stiffness are all s/s of this disorder thus can cause the patient to be at higher risk
Why would the nurse need to instruct on decreasing the risk for injury with a patient who has been diagnosed or there is a suspicion of acromegaly? A)because acromegaly is found in the brain and that can effect mobilization B)because muscle weakness, joint pain, and stiffness are all s/s of this disorder thus can cause the patient to be at higher risk C)because the patient will have increased seizure activity and fall precautions are standard D)because the patient will develop brittle bones and should be prepared for deterioration causing falls
