hurst endocrine post test

Which clinical manifestation does the nurse expect to see in a client diagnosed with Addison's disease? Select All That Apply 1. Confusion 2. Hypertension 3. Vitiligo 5. Hypernatremia 6. Weight gain

1. Confusion 3. Vitiligo 4. Hyperkalemia rationale: 1., 3., & 4. Correct: Clients with Addison's disease may present with nonspecific symptoms of confusion. As the continual reduced functioning of the adrenal medulla and adrenal cortex occurs, the client will present with cognitive impairment, delusions, and hallucinations. The reduced blood cortisol increases the adrenocorticotropic hormones (ACTH) and the melanocyte-stimulating activity. The feedback mechanism results in the hyperpigmentation of skin. A deficiency of mineralocorticoids will result in the decreased excretion of potassium which results in hyperkalemia.

Which selection by the client indicates to the nurse that the client understands food allowed during a vanillylmandelic acid (VMA) test? Select All That Apply 1. Milk 2. Caffeine 3. Citrus fruit 4. Chicken 5. Vanilla ice cream

1. Milk 4. Chicken rationale 1., & 4. Correct: Milk intake will not alter the production of epinephrine or norepinephrine. The client can drink milk prior to a VMA test. The period prior to a VMA test which measures the amount of production of epinephrine and norepinephrine would not require the client to eliminate chicken. Eating chicken would not alter the production of epinephrine or norepinephrine.

Which laboratory test should be assessed by the nurse prior to administering radioactive iodine (RAI) to a female client? 1. Thyroid Scan 2. Serum calcium 3. Pregnancy test 4. Metanephrine test

#. pregnancy test rationale: 3. Correct: RAI crosses the placenta and will affect the development of the fetus. If RAI is administered to a client who is pregnant, the fetus can experience mental retardation, hypothyroidism, and develop increased cancer risk. It is imperative that a pregnancy test should be prescribed prior to administering RAI. RAI should not be administered to a client who has a positive pregnancy test.

The nurse is reviewing the primary healthcare provider's (PHP) initial prescriptions for a client diagnosed with diabetic ketoacidosis (DKA)? Which prescription from the PHP would the nurse question? Select All That Apply 1. Arterial blood gases 2. 500 ml D5W at 100 mL per hour 3. Serum glucose levels every hour 4. Hourly adjustment of Regular insulin IV according to serum glucose level protocol 5. 100 mL O.45% sodium chloride (NaCL) with potassium chloride KCL 10mEq IV

2. 500 ml D5W at 100 mL per hour 5. 100 mL O.45% sodium chloride (NaCL) with potassium chloride KCL 10mEq IV Rationale 2. & 5. Correct: The clinical manifestation of DKA is a serum glucose level of greater than 300mg/dL. The goal of the treatment for DKA is to reduce the serum glucose level. Prescribing D5W will increase the client's serum glucose level which is already elevated. The prescription should begin with 0.9% NaCL. to compensate for the effects of polyuria, IV normal saline, an isotonic solution. An isotonic solution is composed of equal concentrations of solutes and water which will increase vascular volume. Initially the potassium is normal or high and can decrease when treatment begins. This prescription should be questioned. 1. Incorrect: The normal range for BUN is 10-20 mg/dl (3.6-7.1 mmol/L). The client's BUN level is 12 mg/dL (4.28 mmol/L). 3. Incorrect: The normal range for sodium is 135 - 145 mEq/L (135-145 mmol/L). The client's sodium level is 140 mEq/dL (140 mmol/L). 5. Incorrect: The normal range for potassium is 3.5 -5.0 mEq/L (3.5-5.0 mmol/L). The client's potassium level is 3.5 mEq/dL (3.5 mmol/L).

A nurse is caring for a client with a possible diagnosis hyperparathyroidism. Which serum laboratory value would validate this diagnosis? SATA 1. BUN 12 mg/dL (4.28 mmol/L) 2. Calcium 12 mg/dL (3 mmol/L) 3. Sodium 140 mg/dL (140 mmol/L) 4. Phosphate 2.8 mg/dL (0.9 mmol/L5. Potassium 3.5 mEq/L (3.5 mmol/L)

2. Calcium 12 mg/dL (3 mmol/L) 4. Phosphate 2.8 mg/dL (0.9 mmol/L rationale: 2., & 4 Correct: Normal calcium range is 9.0 -10.5 mg/dl (2.25-2.62 mmol/L). The client's calcium level is 12 mg/dL (3 mmol/L) which is above normal range. Parathyroids secrete parathormone (PTH) for remodeling of the bones. PTH stimulates transfer calcium from the bone to the blood. Parathyroidism, an excess of PTH production by the parathyroids, will result in an increase in calcium movement from the bone to the blood. The normal range for phosphate is 3.0 - 4.5 mg/dL (0.97-1.45 mmol/L). The client's phosphate level is 2.8 mg/dL (0.9 mmol/L) which is below normal range. Parathyroidism, an excess of PTH production by the parathyroids, reduces the reabsorption of phosphorus in the kidneys. The result is that there is an increase in the excretion of phosphorus in the urine resulting in a decreased serum phosphorus level.

A nurse is caring for a client with a possible diagnosis hyperparathyroidism. Which serum laboratory value would validate this diagnosis? Select All That Apply 1. BUN 12 mg/dL (4.28 mmol/L) 2. Calcium 12 mg/dL (3 mmol/L) 3. Sodium 140 mg/dL (140 mmol/L) 4. Phosphate 2.8 mg/dL (0.9 mmol/L) 5. Potassium 3.5 mEq/L (3.5 mmol/L)

2. Calcium 12 mg/dL (3 mmol/L) 4. Phosphate 2.8 mg/dL (0.9 mmol/L) Rationale 2., & 4 Correct: Normal calcium range is 9.0 -10.5 mg/dl (2.25-2.62 mmol/L). The client's calcium level is 12 mg/dL (3 mmol/L) which is above normal range. Parathyroids secrete parathormone (PTH) for remodeling of the bones. PTH stimulates transfer calcium from the bone to the blood. Parathyroidism, an excess of PTH production by the parathyroids, will result in an increase in calcium movement from the bone to the blood. The normal range for phosphate is 3.0 - 4.5 mg/dL (0.97-1.45 mmol/L). The client's phosphate level is 2.8 mg/dL (0.9 mmol/L) which is below normal range. Parathyroidism, an excess of PTH production by the parathyroids, reduces the reabsorption of phosphorus in the kidneys. The result is that there is an increase in the excretion of phosphorus in the urine resulting in a decreased serum phosphorus level.

The nurse is initiating a client assessment. What signs and symptoms would validate the client's diagnosis of Cushing's disease? SATA 1. Hypoglycemia 2. Mood alterations 3. Lipolysis 4. Truncal obesity 5. Hirsutism 6. Hyperkalemia

2. Mood alterations 3. Lipolysis 4. Truncal obesity 5. Hirsutism rationale: 2., 3., 4., & 5. Correct: The client will experience mood swings. Several of the clinical manifestations of Cushing's are related to significant physical changes which can result in periods of depression for the client. Another clinical manifestation is lipolysis which is the breakdown of adipose tissue and the thinning of the extremities. Truncal obesity (apple-shaped obesity) is the distribution of adipose tissue located in the abdominal area. Hirsutism is when a female develops male characteristics such as increased hair on the face. When the adrenal cortex is stimulated there is an increase production of adrenal androgen. This results in the increased production of testosterone, a sex hormone.

The nurse is providing dietary instructions to a client newly diagnosed with type 2 diabetes. Which food examples should make up the highest percentage of this client's recommended diet? 1. Pecans, eggs, pork chop 2. Wheat bread, dried beans, brown rice 3. Lean hamburger, fish, skinless chicken 4. Whole milk, cheese, dark chocolate

2. Wheat bread, dried beans, brown rice Rationale 2. Correct: A calorie is the unit of energy needed to raise the temperature of 1 kilogram of water 1 degree of Celsius. Wheat bread, dried beans, and brown rice are complex carbohydrates. The breakdown of complex carbohydrates occurs at a slower rate which decreases the possibility of increases and decreases in the serum glucose level. The recommended percentage of calories from carbohydrates is 45% of the daily diet.

A nurse on a surgical unit is assigned a client who had a total thyroidectomy 3 days ago. As the nurse enters the room which nursing assessment is the priority for this client? 1. Eating a soft diet. 2. Positioned at 15 degrees in bed. 3. States hands are tingling. 4. Expresses frontal neck pain level of 5 out of 10.

3. States hands are tingling. rationale: 3. Correct: Hypocalcemia is a severe complication of a thyroidectomy due to damage to the parathyroid. The negative feedback of a low parathyroid hormone (PTH) results in a decrease in serum calcium. PTH regulates the amount of calcium levels in the blood. Symptoms of hypocalcemia include numbness, and tingling on the extremities and face. As the calcium levels decrease the client may present with tetany and spasm of the larynx.

During a clinic visit 3 months following a client's diagnosis of type 2 diabetes, the client reports following a 1200 calorie diet and did not bring their glucose-monitoring record. The nurse will anticipate the prescription of which laboratory test? 1. Fasting blood glucose test 2. Urine glucose test 3. Glucose tolerance test (GTT) 4. Glycosylated hemoglobin level (HbA1C)

4. Glycosylated hemoglobin level (HbA1C) Rationale 4. Correct: The glycosylated hemoglobin (Hb A1C) test identifies the average serum glucose attached to hemoglobin over 90 days. The 90 days is correlated with 90 day life of hemoglobin. This test is reflective of how well the client's diabetes is controlled. The client has no restrictions prior to the test

The client has been prescribed 0.6 units of insulin/kg /day. The client weighs 214 pounds (97 kg). What is the amount of insulin the client can receive in a day? (Round to the nearest whole number)

58 Rationale Answer: 58 units per day 97 kg x 0.6 units = 58.2 units = 58 units The average adult dose of insulin is 0.4-1.0 units/kg/day. Rounding Rules for Whole Units: 0.1 -0.4 = round down to whole unit 0.5-0.9 = round up to whole unit