Passpoint - Endocrine and Metabolic Disorders

The nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. To reverse a hypoglycemic reaction, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand?

Glucagon

A client with hyperparathyroidism declines surgery and is to receive hormone replacement therapy with estrogen and progesterone. Which instruction would be most important to include in the client's teaching plan?

Maintain a moderate exercise program.

After reinforcing education to a client on how to correctly self-administer daily maintenance dose of 3 units of regular insulin and 4 units of NPH insulin, which client statement demonstrates that the education has been successful?

"After taking my insulin out of the refrigerator, I'll draw up the clear insulin first to the line for 3 units and then cloudy insulin until there's a total of 7 units in the syringe."

The nurse reinforces disease management instructions for a client newly diagnosed with type 1 diabetes. Which statement indicates to the nurse that the client has understood the information?

"Checking my blood sugar before meals and at bedtime will help me manage my blood sugar."

When teaching a client about insulin administration, the nurse should include which instruction?

"Draw up clear insulin first when mixing two types of insulin in one syringe."

A client has received dietary instructions as part of the treatment plan for diabetes type 1. Which statement by the client should alert the nurse that the client needs additional instructions?

"I can eat whatever I want as long as I cover the calories with sufficient insulin."

A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse would be most accurate in stating:

"It tells us about your sugar control for the last 3 months."

A client with a family history of diabetes asks the nurse which measures can be practiced to decrease the chance of developing the disease. Which statement would be the nurse's best response?

"Start a moderate exercise program."

A client with primary diabetes insipidus is prescribed desmopressin. Which instruction should the nurse provide before the client is discharged?

"You may not be able to use desmopressin nasally if you have nasal discharge or blockage."

A female client who weighs 210 lb (95 kg) and has been diagnosed with hyperglycemia tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client's hyperglycemia?

Acromegaly

The nurse is teaching the client about risk factors for diabetes mellitus. Which risk factor for diabetes mellitus is nonmodifiable?

Advanced age

The nurse is developing a teaching plan for a client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?

Antidiuretic hormone (ADH)

The nursing staff has just been trained how to use and care for a new blood glucose monitor. Which nursing intervention demonstrates proper use of a blood glucose monitor?

Calibrate the machine after installing a new battery.

While administering morning medications, a nurse enters the room of a client who recently had a thyroidectomy. She observes that the client is sitting up in bed but appears unresponsive. After confirming unresponsiveness, what should the nurse do next?

Call for help.

A client presents with diaphoresis, palpitations, jitters, and tachycardia approximately 4 hours after taking the prescribed usual morning insulin. What is the nurse's priority action?

Check blood glucose level, and administer carbohydrates.

A client with type 1 diabetes has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension to be taken before breakfast. At about 4:30 p.m. (1630), the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?

Hypoglycemia

A client with type 2 diabetes hasn't received insulin coverage for his afternoon blood glucose levels for 2 days. After further investigation, a nurse discovers that the afternoon blood glucose levels were phoned in from the laboratory but weren't documented in the client's medical record. What should the nurse do with this information?

Notify the physician and complete an incident report.

A client with type 2 diabetes was diagnosed with retinopathy. While a nurse reviews the client's medication dosage, the client states, "I can't read the names on the medicine bottles, so I hope I'm taking the right pills at the right time." What should the nurse do with this information?

Teach the client how to tell the difference between the medicine bottles.

Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the nurse obtains data from the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?

Thyroid crisis

A client has a serum calcium level of 7.2 mg/dl. During the physical examination, the nurse expects to assess:

Trousseau's sign.

A nurse administers bromocriptine to a client diagnosed with acromegaly. After administering the medication, the nurse realizes that she gave the medication to the wrong client. What could have been done to prevent this error?

Verifying the client's identity on the identification band and medication administration record before providing the medication

A client has been admitted after reporting acute abdominal pain in the midepigastric region, back tenderness, nausea, and vomiting. The nurse recognizes these findings to be associated with which condition?

acute pancreatitis

The nurse is explaining the action of insulin to a client newly diagnosed with diabetes mellitus. During the teaching, the nurse reviews the process of insulin secretion in the body. The nurse is correct when stating that insulin is secreted from the:

beta cells of the pancreas.

After undergoing a thyroidectomy, a client develops hypocalcemia and tetany. Which medication should the nurse anticipate administering?

calcium gluconate

The client is being evaluated for hypothyroidism. The nurse should stay alert for:

decreased body temperature and cold intolerance.

The nurse is collecting data on a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find:

deposits of adipose tissue in the trunk and dorsocervical area.

The nurse is gathering data from a child with juvenile hypothyroidism. Which common clinical finding would the nurse most likely observe? Select all that apply.

dry skin fatigue

The nurse is caring for a client with hypothyroidism. Which client data would the nurse expect to collect?

fatigue, cold intolerance, weight gain, and constipation

A client is diagnosed with pituitary gigantism. The nurse reviews the laboratory findings of which hormone value?

growth hormone (GH)

The physician diagnoses type 1 diabetes in a client who has classic manifestations of the disease and a random blood glucose level of 350 mg/dl. In addition to dietary modifications, the physician prescribes insulin. Initially, most clients receive the least antigenic form of insulin. Therefore, the nurse expects the physician to prescribe:

human insulin.

The nurse is caring for a client who developed ketoacidosis. Which prescribed treatment does the nurse anticipate administering?

insulin and IV fluids

When collecting data on an infant, which condition would alert the nurse to a subtle sign of hypothyroidism? Select all that apply.

lethargy poor feeding

The nurse is caring for a client with hypothyroidism. For which medication will the nurse reinforce instructions?

levothyroxine

The nurse is reviewing laboratory data for a child with diabetes insipidus. What characteristics of the urine would the nurse anticipate observing?

pale; specific gravity less than 1.006

A client with diabetes insipidus has had limited fluid intake over the past 12 hours. For which complications should the nurse monitor the client?

severe dehydration and hypernatremia

A client with hyperthyroidism develops high fever, extreme tachycardia, and altered mental status. Which condition does the nurse suspect is developing?

thyroid storm

A health care provider prescribes diet, exercise, and oral antidiabetic agents for a client with diabetes. Which type of diabetes will the nurse reinforce educating the client about?

type 2 diabetes

A nurse is evaluating a client with hyperthyroidism. Which findings should the nurse anticipate that correlate with the diagnosis?

weight loss, nervousness, and tachycardia

The nurse is caring for a diabetic adolescent who admits to consuming many simple sugars and carbohydrates at a graduation party. The parents brought the client to the emergency room with unusual behavior. The serum glucose level was 375 mg/dL. The health care provider provided a coverage schedule: 150 to 200 mg/dL—2 units of Humulin R. 201 to 250 mg/dL—4 units of Humulin R. 251 to 300 mg/dL—6 units of Humulin R. 301 to 350 mg/dL—8 units of Humulin R. 351 to 399 mg/dL—10 units of Humulin R. Over 400 mg/dL—call the health care provider. Mark the amount of insulin the nurse should draw into the low-dose insulin syringe.

10 units

The nurse is reinforcing education with parents of a child with growth hormone deficiency. What sport should the nurse encourage?

gymnastics