Hesi Cox Endocrine
Which term should the nurse use in a report to describe the absence of menstrual periods in a 35-year-old non-pregnant client? Rhinorrhea Menopause Amenorrhea Dyspareunia
Amenorrhea The absence of menstrual periods in a non-pregnant client less than 55 years old is called amenorrhea. Rhinorrhea is an allergic state that is manifested by a runny nose. Menopause is cessation of menstruation after 55 years of age. Dyspareunia is pain during sexual intercourse.
Which catecholamine receptor is responsible for increased heart rate? Beta 1 receptor Beta 2 receptor Alpha 1 receptor Alpha 2 receptor
Beta 1 receptor Beta 1 receptors are responsible for increased heart rate. Beta 2 receptors, alpha 1 receptors, and alpha 2 receptors are not present in the heart; therefore, they are not responsible for increasing the heart rate. Beta 2 receptors are present in such organs as blood vessels, kidneys, bronchioles, and bladder. Alpha receptors are present in such organs as eyes, skin, and liver.
What therapeutic effect does the nurse expect to identify when mannitol is administered parenterally to a client with cerebral edema? Improved renal blood flow Decreased intracranial pressure Maintenance of circulatory volume Prevention of the development of thrombi
Decreased intracranial pressure As an osmotic diuretic, mannitol helps reduce cerebral edema. Although there may be a transient increase in blood volume as a result of an increased osmotic pressure, which increases renal perfusion, this is not the therapeutic effect. Prevention of the development of thrombi is not the reason for giving this drug.
What is the priority goal for a client with asthma who is being discharged from the hospital with prescriptions for inhaled bronchodilators? Is able to obtain pulse oximeter readings Demonstrates use of a metered-dose inhaler Knows the healthcare provider's office hours Can identify the foods that may cause wheezing
Demonstrates use of a metered-dose inhaler Clients with asthma use metered-dose inhalers to administer medications prophylactically or during times of an asthma attack; this is an important skill to have before discharge. Pulse oximetry is rarely conducted in the home; home management usually includes self-monitoring of the peak expiratory flow rate. Although knowing the healthcare provider's office hours is important, it is not the priority; during a persistent asthma attack that does not respond to planned interventions, the client should go to the emergency department of the local hospital or call 911 for assistance. Not all asthma is associated with food allergies.
A nurse is caring for a client with Addison disease. Which information should the nurse include in a teaching plan to encourage this client to modify dietary intake? Increased amounts of potassium are needed to replace renal losses. Increased protein is needed to heal the adrenal tissue and thus cure the disease. Supplemental vitamins are needed to supply energy and assist in regaining the lost weight. Extra salt is needed to replace the amount being lost caused by lack of sufficient aldosterone to conserve sodium.
Extra salt is needed to replace the amount being lost caused by lack of sufficient aldosterone to conserve sodium Lack of mineralocorticoids ( aldosterone) leads to loss of sodium ions in the urine and subsequent hyponatremia. Potassium intake is not encouraged; hyperkalemia is a problem because of insufficient mineralocorticoids. Increasing protein is needed to heal the adrenal tissue and thus cure the disease caused by idiopathic atrophy of the adrenal cortex; tissue repair of the gland is not possible. Vitamins are not directly energy-producing; nor will they help the client gain weight.
Four hours after surgery, the blood glucose level of a client who has type 1 diabetes is elevated. What intervention should the nurse implement? Administer an oral hypoglycemic Institute urine glucose monitoring Give supplemental doses of regular insulin Decrease the rate of the intravenous infusion
Give supplemental doses of regular insulin The blood glucose level needs to be reduced; regular insulin begins to act in 30 to 60 minutes. The client has type 1, not type 2, diabetes, and an oral hypoglycemic will not be effective. Blood glucose levels are far more accurate than urine glucose levels. The rate may be increased because polyuria often accompanies hyperglycemia.
A client is admitted with a head injury. The nurse identifies that the client's urinary catheter is draining large amounts of clear, colorless urine. What does the nurse identify as the most likely cause? Increased serum glucose Deficient renal perfusion Inadequate antidiuretic hormone (ADH) secretion Excess amounts of intravenous (IV) fluid
Inadequate antidiuretic hormone (ADH) secretion Deficient ADH from the posterior pituitary results in diabetes insipidus. This can be caused by head trauma; water is not conserved by the body, and excess amounts of urine are produced. Although increased serum glucose may cause polyuria, it is associated with diabetes mellitus, not diabetes insipidus. Ineffective renal perfusion will cause decreased urine production. While excess amounts of IV fluids may cause dilute urine, it is unlikely that a client with head trauma will be receiving excess fluid because of the danger of increased intracranial pressure.
A client with hyperthyroidism is to receive methimazole. What instructions does the nurse provide? Initial improvement will take several weeks. There are few side effects associated with this drug. This medication may be taken at any time during the day. Large doses are used to quickly correct the functions of the thyroid.
Initial improvement will take several weeks. Methimazole blocks thyroid hormone synthesis; it takes several weeks of medication therapy before the hormones stored in the thyroid gland are released and the excessive level of thyroid hormone in the circulation is metabolized. There are many common side effects that include nausea, vomiting, diarrhea, rash, urticaria, pruritus, alopecia, hyperpigmentation, drowsiness, headache, vertigo, and fever. Methimazole should be spaced at regular intervals because blood levels are reduced in approximately 8 hours. Large doses cause toxic side effects that can be life threatening, including nephritis, hepatitis, agranulocytosis, leukopenia, thrombocytopenia, hypothrombinemia, and lymphadenopathy.
A client who had a subtotal thyroidectomy asks how hypothyroidism may develop when the problem was hyperthyroidism. What should the nurse consider when formulating a response? Hypothyroidism is a gradual slowing of the body's function. A decrease in pituitary thyroid-stimulating hormone (TSH) will occur. Less thyroid tissue is available to supply thyroid hormone after surgery. Atrophy of tissue remaining after surgery reduces secretion of thyroid hormones.
Less thyroid tissue is available to supply thyroid hormone after surgery After a thyroidectomy, thyroxine output usually is inadequate to maintain an appropriate metabolic rate. Hypothyroidism is decreased thyroid functioning, not a slowing of functions of the entire body. With hypothyroidism, the level of TSH from the pituitary usually is increased. Thyroid tissue remaining after surgery does not atrophy.
A client is receiving combination chemotherapy for treatment of metastatic carcinoma. For which systemic side effect should the nurse monitor the client? Ascites Nystagmus Leukopenia Polycythemia
Leukopenia Leukopenia, a reduction in white blood cells, is a systemic effect of chemotherapy as a result of myelosuppression. Ascites is not a side effect of chemotherapy. Chemotherapy does not affect the eyes; nystagmus is an involuntary, rapid rhythmic movement of the eyeballs. Also, nystagmus is a local, not a systemic, response. The red blood cells will be decreased, not increased.
A healthcare provider prescribes furosemide for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in what part of the renal system? Distal tubule Collecting duct Glomerulus of the nephron Loop of Henle
Loop of Henle Furosemide acts in the ascending limb of the loop of Henle in the kidney. Thiazides act in the distal tubule in the kidney. Potassium-sparing diuretics act in the collecting duct in the kidney. Plasma expanders, not diuretics, act in the glomerulus of the nephron in the kidney.
Which hormone regulates blood levels of calcium? Parathormone Luteinizing hormone Thyroid stimulating hormone Adrenocorticotropic hormone
Parathormone Parathyroid hormone (PTH), or parathormone, regulates the blood levels of calcium and phosphorus. Luteinizing hormone (LH) stimulates the production of sex hormones, promotes the growth of reproductive organs, and also stimulates reproductive processes. Thyroid stimulating hormone (TSH) stimulates the release of thyroid hormones and the growth and functioning of the thyroid gland. Adrenocorticotropic hormone (ACTH) promotes the growth of the adrenal cortex and stimulates the release of corticosteroids.
A client is scheduled for an adrenalectomy. What does the nurse expect that the plan of care will include? Low-protein diet Parenteral corticosteroids Preoperative 24-hour urine specimen Withholding all medications 48 hours before surgery
Parenteral corticosteroids Steroid therapy usually is given intravenously or intramuscularly preoperatively and continued intraoperatively to prepare for the acute adrenal insufficiency that follows surgery. The diet must supply ample protein and potassium. A 24-hour urine specimen is unnecessary. Corticosteroids must be administered preoperatively to prevent adrenal insufficiency during surgery, so withholding all medications for 48 hours before surgery is contraindicated.
Which gland secretes melatonin? Pineal gland Thyroid gland Adrenal gland Parathyroid gland
Pineal gland The pineal gland secretes the hormone melatonin, which regulates the circadian rhythm and reproductive system at the onset of puberty. The thyroid gland secretes thyroid hormones. The adrenal gland secretes androgens, corticosteroids, and catecholamines. The parathyroid gland secretes the hormone calcitonin.
A client is receiving oxycodone postoperatively for pain. The healthcare provider's prescription indicates that the dose should be administered every 3 hours for eight doses. What should the nurse assess before administering each dose of oxycodone? Respiratory rate and level of consciousness Color, character, and amount of urine output Intravenous site and patency of the intravenous catheter Amount and character of drainage in the portable drainage system
Respiratory rate and level of consciousness Oxycodone is an opioid that depresses the central nervous system, resulting in a decreased level of consciousness and depressed respirations. The medication should be administered, delayed, or held, depending on the client's status. Although urinary output of postoperative clients should be assessed, urinary output is not related directly to the administration of opioid medications. Oxycodone is administered via tablets, not intravenously. Wound drainage is unrelated to the administration of oxycodone.
Which gland does the nurse state is an exocrine gland? Thyroid gland Salivary gland Pituitary gland Parathyroid gland
Salivary gland Exocrine glands are glands with ducts that produce enzymes but not hormones. These glands secrete enzymes into ducts. The salivary gland secreting saliva is an example of an exocrine gland. Endocrine glands are ductless glands that produce hormones that are secreted into the blood. Thyroid, pituitary, and parathyroid glands are examples of endocrine glands.
Which hormone is released from the pancreas? Oxytocin Prolactin Calcitonin Somatostatin
Somatostatin Somatostatin is a hormone produced by the pancreas that inhibits the release of insulin and glucagon. Oxytocin is a hormone produced by the posterior pituitary gland that acts on the uterus and mammary glands. Prolactin is a hormone produced by the anterior pituitary gland that targets the ovaries and mammary glands in women and testes in men. Calcitonin is a hormone produced by the thyroid gland that interacts with bone tissue.
A client newly diagnosed with type 1 diabetes is taught to exercise on a regular basis. What is the primary reason for instruction on exercise? To decrease insulin sensitivity To stimulate glucagon production To improve the cellular uptake of glucose To reduce metabolic requirements for glucose
To improve the cellular uptake of glucose Exercise increases the metabolic rate, and glucose is needed for cellular metabolism; therefore, excess glucose is consumed during exercise. Regular vigorous exercise increases cell sensitivity to insulin. Glucagon action raises blood glucose but does not affect cell uptake or use of glucose. Cellular requirements for glucose increase with exercise.
A nurse concludes that the simvastatin being administered to a client is effective. A decrease in what clinical finding supports this conclusion? Heart rate Triglycerides Blood pressure International normalized ratio (INR)
Triglycerides Therapeutic effects of simvastatin include decreased levels of serum triglycerides, low-density lipoprotein (LDL), and cholesterol. INR is not related to simvastatin; it is a measure used to evaluate blood coagulation. Heart rate and blood pressure are not related to simvastatin.
When preparing a client for discharge after a thyroidectomy, the nurse teaches the signs of hypothyroidism. When teaching when to call the primary healthcare provider, what statement made by the client shows that teaching was effective? "I should call the primary healthcare provider for dry hair and an intolerance to cold." "I should call the primary healthcare provider for muscle cramping and sluggishness." "I should call the primary healthcare provider for fatigue and an increased pulse rate." "I should call the primary healthcare provider for tachycardia and an increase in weight."
"I should call the primary healthcare provider for dry hair and an intolerance to cold" Dry, sparse hair and cold intolerance are characteristic responses to low serum thyroxine. Muscle cramping is associated with hypocalcemia. Low thyroxine levels reduce the metabolic rate, resulting in fatigue, but do not increase the pulse rate. Low thyroxine levels reduce the metabolic rate, resulting in weight gain and bradycardia, not tachycardia.
Which is the target tissue for the parathyroid hormone? Intestines All body cells Mammary glands Sympathetic effectors
Intestines The target tissue of the parathyroid hormone is the intestines. Growth hormone acts on all body cells. The mammary gland is the target tissue of oxytocin. Epinephrine and non-epinephrine acts on the sympathetic effectors.
A nurse teaches a client who has had a thyroidectomy for thyroid cancer to observe for signs of surgically induced hypothyroidism. What should be included in the teaching plan? Select all that apply. Select all that apply Dry skin Lethargy Insomnia Tachycardia Sensitivity to cold
Dry Skin/Lethargy/Sensitivity to cold Dry skin is a response to hypothyroidism that is related to the associated decreased metabolic rate. Lethargy and sensitivity to cold are symptoms related to hypothyroidism that are associated with a decreased metabolic rate. Insomnia and tachycardia are related to hyperthyroidism, not hypothyroidism.
What will the nurse expect diagnostic studies of a client with Cushing syndrome to indicate? Moderately increased serum potassium levels Increased numbers of eosinophils in the blood High levels of 17-ketosteroids in a 24-hour urine test Normal to low levels of adrenocorticotropic hormone (ACTH)
High levels of 17-ketosteroids in a 24-hour urine test High levels of 17-ketosteroids in a 24-hour urine test is a urinary metabolite of steroid hormones that are excreted in large amounts in hyperaldosteronism. With aldosterone hypersecretion, sodium is retained and potassium is excreted, resulting in hypernatremia and hypokalemia. With Cushing syndrome, the eosinophil count is decreased, not increased. ACTH levels usually are high in Cushing syndrome.
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 that the client is experiencing? Ketoacidosis Somogyi phenomenon Hypoglycemic reaction Hyperosmolar nonketotic coma
Ketoacidosis Ketoacidosis occurs when insulin is lacking and carbohydrates cannot be used for energy; this increases the breakdown of protein and fat, causing deep, rapid respirations (Kussmaul respirations), decreased alertness, decreased circulatory volume, metabolic acidosis, and an acetone breath. The Somogyi phenomenon is a rebound hyperglycemia induced by severe hypoglycemia; there are not enough data to determine whether this occurred. Hypoglycemia is manifested by cool, moist skin, not hot, dry skin; Kussmaul respirations do not occur with hypoglycemia. Hyperosmolar nonketotic coma usually occurs in clients with type 2 diabetes because available insulin prevents the breakdown of fat.
Which clinical manifestation is found in a client with a deficiency of adrenocorticotropic hormone? Anovulation Dehydration Malaise and lethargy Menstrual abnormalities
Malaise and lethargy Malaise is a general feeling of discomfort or illness and lethargy is a lack of energy. A client with deficiency of adrenocorticotropic hormone may experience malaise and lethargy. Adrenocorticotropic hormone deficiency is not associated with anovulation, dehydration, and menstrual abnormalities. Anovulation (ovaries do not release an oocyte during the menstrual cycle) occurs due to deficiency of gonadotropins. Dehydration is a result of deficiency of antidiuretic hormone. The deficiency of thyroid-stimulating hormone may result in menstrual abnormalities.
A client with type 1 diabetes is admitted to the hospital for major surgery. Before surgery, the client's insulin requirements are elevated but well controlled. What insulin requirements will the nurse anticipate for this client postoperatively? Decrease Fluctuate Increase sharply Remain elevated
Remain elevated Emotional and physical stress may cause insulin requirements to remain elevated in the postoperative period. Insulin requirements will remain elevated rather than decrease. Fluctuating insulin requirements usually are associated with noncompliance, not surgery. A sharp increase in the client's insulin requirements may indicate sepsis, but this is not expected.
Which diagnostic test does the nurse consider to help in identifying the abnormalities of the sella turcica in hyperpituitarism? Skull x-ray Angiography Computer tomography Magnetic resonance image
skull x-ray An imaging assessment such as skull x-ray imaging is helpful in the identification of problems related to the sella turcica. Angiography would be helpful in ruling out any aneurysms or vascular abnormalities. Computer tomography and magnetic resonance image are helpful in defining soft tissue lesions.
A client who is receiving chemotherapy for lung cancer has nausea and vomiting because of the therapy. The client wants to know if it is true that smoking marijuana will help. What is the nurse's best response? "Smoking marijuana is not legal in any state." "Marijuana is effective for nausea and vomiting if it is injected." "Marijuana is not proven to be effective in preventing chemotherapy-induced nausea and vomiting." "There are some tetrahydrocannabinol (THC)-based medications that contain marijuana that control chemotherapy-induced nausea and vomiting in some people."
"There are some tetrahydrocannabinol (THC)-based medications that contain marijuana that control chemotherapy-induced nausea and vomiting in some people." THC, an ingredient in marijuana, acts as an antiemetic in some people and can be absorbed through the gastrointestinal tract or inhaled. THC-based medications, dronabinol (Marinol) and nabilone (Cesamet), are available by prescription to control nausea and vomiting resulting from cancer chemotherapy. The statement, "Smoking marijuana is not legal in any state," does not answer the client's question and is inaccurate. Marijuana is not injected. THC is an effective antiemetic for some clients.
A client with a stage IV pressure ulcer is to receive 0.22 g of zinc sulfate by mouth. Each tablet contains 110 mg. How many tablets should the nurse administer? Record your answer using a whole number. tablets
2 The prescribed dose is 0.22 g. The available medication is 110 mg/tablet. First, convert the prescribed dose in grams to the available medication in milligrams. Then, use the dimensional analysis and ratio and proportion methods to determine the appropriate number of tablets to be administered.