NCLEX endocrine questions

a patient is admitted to the hospital with a diagnosis of cushing syndrome. On physical assessment of the pt, the nurse would expect to find

-HTN, peripheral edema and petechiae

A nurse on a general medical-surgical unit is caring for a client with Cushing's syndrome. Which of the following statements is correct about the medication regimen for Cushing's syndrome? a. Mitotane is used to treat metastatic adrenal cancer. b. Aminogluthimide may be administered to clients with ectopic ACTH-secreting tumors before surgery is performed. c. Ketoconazole increases cortisol synthesis by the adrenal cortex. d. Somatostatin analog increases ACTH secretion in some clients.

-a mitotane is used to treat metastatic adrenal cancer

a patient with SIADH is treated with water restriction and administration of IV fluids. The nurses evaluate that treatment has been effective when the pt experiences

-increased urine output, increased serum sodium, and decreased urine specific gravity

The nurse is teaching a patient with hyperparathyroidism how to manage the condition at home. Which response by the patient indicates the need for additional teaching? A. "I should limit my fluids to 1 liter 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 to keep calcium from coming out of my bones."

A. "I should limit my fluids to 1 liter per day" rationale: 1 to 2 liters daily should be encouraged to protect kidneys and decrease risk of nephrolithiasis

The nurse is completing an assessment on a patient who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which patient complaint would be characteristic of this disorder? Select all that apply. A. Polyuria B. Headache C. Bone pain D. Nervousness E. Weight gain

A. polyuira C. bone pain rationale: in hyperparathyroidism, PTH is high and caused resorption of calcium that is pulled from bones. Elevated serum calcium levels produce osmotic diuresis and thus polyuria.

The nurse is admitting a patient who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which health care provider prescriptions should the nurse anticipate receiving? Select all that apply. A. Initiate an infusion of 3% NaCl. B. Administer intravenous 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.

A.- initiate an infusion of 3% NaCl C. restrict fluids to 800 mL over 24 hrs E. Administer a vasopressin antagonist as prescribed

A patient with thyrotoxicosis says to the nurse, "I am so irritable. I am having problems at work because I lose my temper very easily." Which of the following responses by the nurse would give the patient the most accurate explanation of her behavior? A. "Your behavior is caused by temporary confusion brought on by your illness." B. "Your behavior is caused by the excess thyroid hormone in your system." C. "Your behavior is caused by your worrying about the seriousness of your illness." D. "Your behavior is caused by the stress of trying to manage a career and cope with illness."

B. "Your behavior is caused by the excess thyroid hormone in your system."

The nurse is monitoring a patient diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy and is recovering in the intensive care unit. Which findings should alert the nurse to the presence of a possible postoperative complication? Select all that apply. A. Anxiety B. Leukocytosis C. Chvostek's sign D. Urinary output of 800 mL/hour E. Clear drainage on nasal dripper pad

B. Leukocytosis D. urinary output of 800 mL/hr E. clear drainage on nasal dripper pad rationale: leukocytosis may indicate infection. DI may be a complication of surgery

While assessing a patient with hypoparathyroidism, the nurse taps the patient's facial nerve and observes twitching of the mouth and tightening of the jaw. The nurse would document this finding as to which of the following? A. Positive Trousseau's sign B. Positive Chvostek's sign C. Tetany D. Hyperactive deep tendon reflex

B. Positive Chvostek's sign

A patient is admitted to an emergency department, and a diagnosis of myxedema coma is made. Which action should the nurse prepare to carry out initially? A. Warm the patient. B. Maintain a patent airway. C. Administer thyroid hormone. D. Administer fluid replacement.

B. maintain a patent airway

The most important nursing intervention during the medical and surgical treatment of the patient with a pheochromocytoma is A. administering IV fluids B. monitoring blood pressure C. monitoring I&O and daily weights D. administering B-adrenergic blocking agents

B. monitoring blood pressure

During a follow-up visit to the physician, a patient with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and: A. magnesium B. phosphorus C. sodium D. potassium

B. phosphorus

Nurse Oliver should expect a client with hypothyroidism to report which health concerns? a. Increased appetite and weight loss b. Puffiness of the face and hands c. Nervousness and tremors d. Thyroid gland swelling

B. puffiness of face and hands

The patient with Cushing's disease needs to modify dietary intake to control symptoms. In addition to increasing protein, which strategy would be most appropriate? A. Increase calories. B. Restrict sodium. C. Restrict potassium. D. Reduce fat to 10%.

B. restrict sodium rationale: a primary dietary interventions is to restrict sodium, thereby reducing fluid retention

the nurse is caring for a patient after hypophysectomy and notes clear nasal drainage from the patients 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.

B. test the drainage for glucose

The nurse is providing discharge instructions to a patient with diabetes insipidus. Which of the following instructions regarding desmopressin acetate (DDAVP) would be most appropriate? A. The patient can expect to experience weight loss resulting from increased diuresis. B. The patient should alternate nostrils during administration to prevent nasal irritation. C. The patient should monitor for symptoms of hypernatremia as a side effect of this drug. D. The patient should report any decrease in urinary elimination to the health careprovider.

B. the pt should alternate nostrils during administration to prevent nasal irritation rationale: DDAVP can cause nasal irritation, HA, nausea

A patient with Addison's disease comes to the emergency department with complaints of nausea, vomiting, diarrhea, and fever. The nurse would expect collaborative care to Include A. parenteral injections of ACTH B. IV administration of vasopressors C. IV administration of hydrocortisone D. IV administration of D5W with 20mEq of KCl

C. IV administration of hydrocortisone

The nurse is caring for a patient admitted with suspected hyperparathyroidism. Because of the potential effects of this disease on electrolyte balance, the nurse should assess this patient for which of the following manifestations? A. Neurologic irritability B. Declining urine output C. Lethargy and weakness D. Hyperactive bowel sounds

C. Lethargy and weakness

Before discharge, what should a nurse instruct a patient with Addison's disease to do when exposed to periods of stress? A. Perform capillary blood glucose monitoring four times daily. B. Drink 8 oz of fluids. C. Administer hydrocortisone I.M. D. Continue to take his usual dose of hydrocortisone

C. administer hydrocortisone IM

When providing discharge instructions to a patient following a subtotal thyroidectomy, the nurse advises the patient to A. never miss a daily dose of thyroid replacement therapy B. avoid regular exercise until thyroid function is normalized C. avoid eating foods such as soybeans, turnips, and rutabagas D. use warm salt water gargles several times a day to relieve throat pain

C. avoid eating foods such as soybeans, turnips and rutabagas rationale: avoid foods that inhibit thyroid.

A patient with Addison's disease is admitted to the medical unit. The nurse diagnoses the patient with Deficient fluid volume related to inadequate fluid intake and to fluid loss secondary to inadequate adrenal hormone secretion. As the patient's oral intake increases, which of the following fluids would be most appropriate? A. Milk and diet soda. B. Water and eggnog. C. Bouillon and juice. D. Coffee and milkshakes.

C. bouillon and jucie rationale: salted bouillon and fruit juices provide glucose and sodium to replenish electrolyte imbalances

The nurse is educating a couple who has had difficulty with conception. The patient asks about the hormone, which is responsible for the production of eggs. The nurse answers that this hormone is called: A. Melanocyte-stimulating hormone B. Luteinizing hormone (LH) C. Follicle-stimulating hormone (FSH) D. Interstitial cell-stimulating hormone (ICSH)

C. follicle - stimulating hormone (FSH) rationale: FSh stimulates growth and secretion of ovarian follicles in women and production of sperm in med

A patient has been taking oral prednisone for the past several weeks after having a severe reaction to poison ivy. The nurse has explained the procedure for gradual reduction rather than sudden cessation of the drug. What is the rationale for this approach to drug administration? A. Prevention of hypothyroidism B. Prevention of diabetes insipidus C. Prevention of adrenal insufficiency D. Prevention of cardiovascular complications

C. preventions of adrenal insufficiency rationale: sudden cessation of corticosteroid therapy can precipitate life-threatening adrenal insufficiency

A patient with Graves' disease is treated with radioactive iodine (RAI) in the form of sodium iodide 131I. Which of the following statements by the nurse will explain to the patient how the drug works? A. "The radioactive iodine stabilizes the thyroid hormone levels before a thyroidectomy. "B. "The radioactive iodine reduces uptake of thyroxine and thereby improves your condition." C. "The radioactive iodine lowers the levels of thyroid hormones by slowing your body's production of them." D. "The radioactive iodine destroys thyroid tissue so that thyroid hormones are no longer produced."

D. "The radioactive iodine destroys thyroid tissue so that thyroid hormones are no longer produced." rationale: sodium iodine destroys the thyroid follicular cells, and thyroid hormones are no longer produced

The patient with pheochromocytoma is scheduled for surgical resection of the tumor in the adrenal medulla. The nurse should monitor the patient postoperatively for which of the following potential complications? A. Orthostatic hypotension. B. Hemorrhage. C. Hypoglycemia. D. Hypertensive crisis

D. hypertensive crisis

In a patient with central diabetes insipidus, administration of aqueous vasopressin during a water deprivation test will result in a A. decrease in body weight B. increase in urinary output C. decrease in blood pressure D. increase in urine osmolality

D. increase in urine osmolality

causes of primary hypothyroidism in adults inculde

autoimmune induced atrophy of the gland

of what precautions should a client receiving radioactive iodine-131 be made aware of

avoid close contact with children or pregnant women for one week after administration of drug

a female client with cushing's syndrome is admitted to the medical surgical unit. During the admission assessment, the nurse notes that the client is agitated and irritable, has poor memory, and reports loss of appetite, and appears disheveled. The findings are consistent with which problem?

depression

a patient with hyperthyroidism is taking propylthiouracil (PTU). The nurse will monitor the pt for

fever and sore throat

which nursing diagnosis takes highest priority for a female client with hyperthyroidism

imbalanced nutrition: less than body requirements related to thyroid hormone excess

the nurse is caring for a client who is about to undergo an adrenalectomy. Which of the following preoperative interventions is most appropriate for this client?

maintain careful use of medical and surgical asepsis when providing care and treatments

in the administration of a drug such as levothyroxine (synthroid), the nurse should teach the client

to report wt loss, anxiety, insomnia, and palpitations