HEHI ATI Quiz: Week 1 - Adult Endocrine System

A nurse is assessing a client who is admitted for elective surgery and has a h/o Addison's disease. Which of the following findings should the nurse expect? a) Hyperpigmentation b) Intention tremors c) Hirsutism d) Purple striations

a) Hyperpigmentation Addison's disease is an endocrine disorder that occurs when the adrenal glands do not produce enough of the hormone cortisol, and in some cases, the hormone aldosterone. The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and hyperpigmentation (darkening) of the skin in both exposed and non-exposed parts of the body.

A nurse is caring for a client who is being evaluated for acromegaly. Which of the following manifestations should the nurse expect to find during the assessment? SATA a) Loss of color discrimination. b) Coarse facial features c) Enlarged distal extremities d) Hepatomegaly e) Moon face

a) Loss of color discrimination Acromegaly is a chronic metabolic disorder caused by an excess of growth hormone (hyperpituitarism) during adulthood, after normal growth of the skeleton and other organs is complete. Often rising from an adenoma, the tumor compresses the optic nerve and causes visual changes such as loss of color discrimination, narrowed perceptual field, or blindness.

A nurse is caring for a child who has Addison's disease. Which of the following actions should the nurse take? a) Teach the parents about cortisol replacement therapy. b) Place the child on a low-sodium diet. c) Monitor the child for fluid volume excess. d) Discuss the manifestations of hyperglycemia with the parents.

a) Teach the parents about cortisol replacement therapy. The nurse should plan to teach the child's parents about cortisol replacement therapy. Administration of glucocorticoids and mineralocorticoids is necessary because inadequate supplies or a sudden cessation of the medications can cause acute adrenal crisis.

A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect? a) Urine specific gravity 1.002 b) Bounding peripheral pulses c) Bradycardia d) Moist mucous membranes

a) Urine specific gravity 1.002 The nurse should expect a client who has diabetes insipidus to have diluted urine with a specific gravity less than 1.005.

A staff nurse is teaching a client who has Addison's disease about the disease process. The client asks the nurse what causes Addison's disease. Which of the following responses should the nurse make? a) "It is caused by the lack of production of insulin by the pancreas.." b) "It is caused by the lack of production of aldosterone by the adrenal gland." c) "It is caused by the overproduction of growth hormone by the pituitary gland." d) "It is caused by the overproduction of parathormone by the parathyroid gland."

b) "It is caused by the lack of production of aldosterone by the adrenal gland." Addison's disease is caused by a lack of production of the adrenocorticotropic hormones (cortisol and aldosterone) by the adrenal gland.

A nurse is teaching about levothyroxine with a client who has primary hypothyroidism. Which of the following statements should the nurse use when teaching the client? a) "Take this medication until your symptoms are gone and then discontinue." b) "Tremors, nervousness, and insomnia may indicate your dose is too high." c) "Symptoms improve immediately after starting the medication." d) "The medication decreases the overproduction of the thyroid hormone thyroxine."

b) "Tremors, nervousness, and insomnia may indicate your dose is too high." The nurse should teach that tremors, nervousness, and insomnia may indicate an overdose of the medication and to notify the provider.

A nurse is providing teaching to a client who has a new dx of hypothyroidism. On which of the following medications should the nurse prepare to instruct the client? a) Radioactive iodine b) Levothyroxine c) Sumatriptan d) Levofloxacin

b) Levothyroxine Levothyroxine is a synthetic thyroid hormone that is chemically identical to thyroxine (T4). It is used in the treatment of hypothyroidism. The nurse should prepare to instruct the client on the use of this medication.

A nurse is assessing a client who had a craniotomy and has developed syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following manifestations should the nurse anticipate? a) Hypernatremia b) Oliguria c) Weight loss d) Increased thirst

b) Oliguria The nurse should expect a client who has developed SIADH following a craniotomy to manifest oliguria. The decrease in urine output can be dramatic with output less than 20 mL/hr.

A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123mEq/L. Which of the following rx should the nurse anticipate? a) Maintain an IV of 0.45% sodium chloride. b) Restrict fluid intake to 1,000 mL per day. c) Provide a diet containing 2 g of sodium per day. d) Administer desmopressin acetate 0.2 mg orally.

b) Restrict fluid intake to 1,000 mL per day. Clients who have SIADH have an increased amount of antidiuretic hormone, which results in excess fluid volume. This excess fluid dilutes the sodium level in the blood, causing dilutional hyponatremia. Oral fluids are restricted in an attempt to restore the fluid balance and the sodium level in the blood. The nurse should offer this client frequent oral care to prevent discomfort and breakdown of the oral mucosa.

A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective? a) A decrease in blood sugar b) A decrease in blood pressure c) A decrease in urine output d) A decrease in specific gravity

c) A decrease in urine output The major manifestations of diabetes insipidus are excessive urination and extreme thirst. Vasopressin is used to control frequent urination, increased thirst, and loss of water associated with diabetes insipidus. A decreased urine output is the desired response.

A nurse is caring for a client who is 1 day post op following a transsphenoidal hypophysectomy. While assessing the client, the nurse notes a large area of clear drainage seeping from the nasal packing. Which of the following should the nurse's initial action? a) Document the amount of drainage. b) Obtain a culture of the drainage. c) Check the drainage for glucose. d) Notify the client's provider.

c) Check the drainage for glucose. A potential complication of hypophysectomy is cerebral spinal fluid (CSF) leakage. Fluid leakage from the nose is a sign that this complication has occurred. The first action the nurse should take using the nursing process is to assess the drainage for the presence of glucose, which would indicate that the drainage is CSF.

A nurse is assessing a client who is receiving liothyroninefor treatment of hypothyroidism. The nurse should recognize which of the following findings is a therapeutic response to this medication? a) Decrease in appetite b) Increase in weight c) Increase in energy d) Decrease in body temperature

c) Increase in energy An increase in energy is a therapeutic response to liothyronine. Depression, lethargy, and fatigue are manifestations of hypothyroidism and effective treatment will improve these manifestations.

A nurse is teaching a client who has a new dx of hyperparathyroidism. The nurse should include in the teaching that the client is at risk for which of the following complications? a) Impaired skin integrity b) Fluid retention c) Pathologic fractures d) Dysphagia

c) Pathologic fractures A client who has hyperparathyroidism is at risk for pathological fractures due to the release of calcium and phosphate into the blood, which reduces bone density and places the client at risk for pathologic fractures.

A nurse administers desmopressin to a client who has a dxx of diabetes insipidus. The nurse recognizes that which of the following laboratory findings indicate a therapeutic effect of the medication? a) Serum sodium 146 mEq/L b) Blood glucose 80 mg/dL c) Urine specific gravity 1.015 d) Blood urea nitrogen (BUN) 15 mg/dL

c) Urine specific gravity 1.015 A therapeutic effect of the medication would be urine specific gravity within the expected reference range, which is 1.010-1.025.

A nurse is talking with a client whose thyroid-stimulating hormone (TSH) level will be measured. Which of the following statements by the nurse explains the purpose of this test? a) "This test measures the amount of thyroid hormone that attaches to a protein in your blood." b) "This test detects antithyroid antibodies in your blood." c) "This test measures the absorption of iodine and how it relates to the thyroid gland." d) "This test determines whether your thyroid gland is overactive, appropriately active, or underactive."

d) "This test determines whether your thyroid gland is overactive, appropriately active, or underactive." This describes the TSH test, which helps determine thyroid status and helps monitor the effectiveness and dosage of thyroid hormone replacement therapy.

A nurse is reviewing the lab results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism? a) A client who has a vitamin D of 25 ng/mL b) A client who has a magnesium of 1.8 mEq/L c) A client who has a calcium of 9.8 mg/dL d) A client who has a phosphate of 5.7 mg/dL

d) A client who has a phosphate of 5.7 mg/dL This level is above the expected reference range of 3.0 to 4.5 mg/dL. Phosphorus levels are increased in a client who has hypoparathyroidism.