Unit 4 Exam- Endocrine System

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- decrease in blood sugar B-decrease in BP C-decrease in urine output D-decrease in specific gravity

A- decrease in urine output

You are performing discharge teaching with a patient who is going home on Synthroid. Which statement by the patient causes you to re-educate the patient about this medication? A. "I will take this medication at bedtime with a snack." B. "I will never stop taking the medication abruptly." C. "If I have palpitations, chest pain, intolerance to heat, or feel restless, I will notify the doctor." D. "I will not take this medication at the same time I take my Carafate."

A. "I will take this medication at bedtime with a snack." Synthroid is best taken in the MORNING on an empty stomach. All the other statements are correct about taking Synthroid.

A patient with Cushing's syndrome will be undergoing an adrenalectomy. Which of the following will be included in the patient's discharge teaching after the procedure? A. Glucocorticoid replacement therapy B. Avoiding avocadoes and pears C. Declomycin therapy D. Signs and symptoms of Grave's Disease

A. Glucocorticoid replacement therapy

In Cushing's Disease and Syndrome there are: A. Increased cortisol production B. Low potassium and glucose levels C. Increased production of aldosterone and cortisol D. Decreased production of cortisol and aldosterone

A. Increased cortisol production

A patient who is in her first trimester of pregnancy is diagnosed with hyperthyroidism. Which medication do you suspect the patient will be started on? A. Propylthiouracil (PTU) B. Radioactive Iodine C. Tapazole D. Synthroid

A. PTU Propylthiouracil (PTU) is the only anti-thyroid medication that can be used during the 1st trimester of pregnancy.

A patient is receiving radioactive iodine treatment for hyperthyroidism. What will you include in your patient education to this patient about this type of treatment? A. Taste changes and swollen salivary glands B. Constipation C. Excessive thirst D. Sun protection

A. Taste changes and swollen salivary glands

Which of the following is not a typical sign and symptom of Cushing's Syndrome? A. Hyperpigmentation of the skin B. Hirsutism C. Purplish striae D. Moon Face

A. hyperpigmentation of the skin

Which of the following side effects are possible for a patient taking an anti-thyroid medication? A. Agranulocytosis and aplastic anemia B. Tachycardia C. Skin discoloration D. Joint pain and eczema

A: Agranulocytosis and aplastic anemia

A patient is being educated on how to take their anti-thyroid medication. Which of the following statements are INCORRECT? A. "I will continue taking aspirin daily." B. "I will take this medication at the same time every day." C. "It may take a while before I notice that the medication is helping my condition." D. "I will avoid foods containing high levels of iodine."

A: The patient needs to be instructed NOT to take aspirin because it increases thyroid hormones. All the other statements are correct.

The thyroid hormones, T3 and T4, play many roles in the human body. Which of the following functions are performed by T3 and T4? Note: Select all that apply A. Storing calories B. Increasing the Heart Rate C. Stimulating the Sympathetic Nervous System D. Decreasing the body's temperature E. Regulating TSH produced by the anterior pituitary gland

B, C, and E. T3 and T4 burn calories (not store them) and increases body temperature (not decrease).

In Cushing's disease, the _______ is secreting too much ACTH (Adrenocorticotropic hormone) which is causing an increase in cortisol production. A. Adrenal cortex B. Pituitary gland C. Thyroid gland D. Hypothalamus

B. Pituitary gland

A patient was recently discharged home for treatment of hypothyroidism and was ordered to take Synthroid for treatment. The patient is re-admitted with signs and symptoms of the following: heart rate 42, blood pressure 70/56, blood glucose 55, and body temperature of 96.8 'F. The patient is very fatigued and drowsy. The family reports the patient has not been taking Synthroid since being discharged home from the hospital. Which of the following conditions is this patient most likely experiencing? A. Thryoid Storm B. Myxedema Coma C. Iodism D. Toxic Nodular Goiter

B: Myxedema Coma... The red flags in this question are the patient's signs/symptoms and the report from the family the patient hasn't been taking the prescribed Synthroid. The patient is showing signs and symptoms of extreme hypothyroidism known as Myxedema coma (which is life-threatening if not treated).

. ___________ is an autoimmune disorder where the body attacks the thyroid gland that causes it to stop releasing T3 and T4. The patient is likely to have the typical signs/symptoms of hypothyroidism, however, they may present with what other sign as well? A. Myxedema coma; joint pain B. Thyroid storm; memory loss C. Hashimoto's Thyroiditis; goiter D. Toxic nodular goiter (TNG); goiter

C. Hashimoto's Thyroiditis; goiter

A patient is admitted with complaints of palpations, excessive sweating, and unable to tolerate heat. In addition, the patient voices concern about how her appearance has changed over the past year. The patient presents with protruding eyeballs and pretibial myxedema on the legs and feet. Which of the following is the likely cause of the patient's signs and symptoms? A. Thyroiditis B. Deficiency of iodine consumption C. Grave's Disease D. Hypothyroidism

C. graves disease

A patient is being discharged home for treatment of hypothyroidism. Which medication is most commonly prescribed for this condition? A. Tapazole B. PTU (Propylthiouracil) C. Synthroid D. Inderal

C. synthroid Synthroid is the only medication listed that treats hypothyroidism. All the other medications are used for hyperthyroidism

A patient reports they do not eat enough iodine in their diet. What condition are they most susceptible to? A. Pheochromocytoma B. Hyperthyroidism C. Thyroid Storm D. Hypothyroidism

D. Hypothyroidism Iodine helps make T3 and T4....if a person does not consume enough iodine they are at risk for developing HYPOTHYROIDISM

A patient is 6 hours post-opt from a thyroidectomy. The surgical site is clean, dry and intact with no excessive swelling noted. What position is best for this patient to be in? A. Fowler's B. Prone C. Trendelenburg D. Semi-Fowler's

D. Semi-Fowler's

Which of the following are treatment options for hyperthyroidism? Please select all that apply: A. Thyroidectomy B. Methimazole C. Liothyronine Sodium "Cytomel" D. Radioactive Iodine

The answers are A, B,and D. Liothyronine Sodium "Cytomel" is a treatment for hypothyroidism. All the other options are for hyperthyroidism.

A patient with hypothyroidism is having pain 6 on 1-10 scale in the right hip due to recent hip surgery. Which of the following medications are NOT appropriate for this patient? Select all that apply: A. Fentanyl B. Tylenol C. Morphine D. Dilaudid

The answers are A, C, and D. Patients who have hypothyroidism are very sensitive to narcotics and should take NON-NARCOTICS for pain relief. Fentanyl, Morphine, and Dilaudid are all narcotics, whereas, Tylenol is not.

Which of the following signs and symptoms causes concern and requires nursing intervention for a patient who recently had a thyroidectomy? A. Heart rate of 120, blood pressure 220/102, temperature 103.2 'F B. Heart rate of 35, blood pressure 60/43, temperature 95.3 'F C. Soft hair, irritable, diarrhea D. Constipation, drowsiness, goiter

a A patient is at risk for experiencing thyroid storm after a thyroidectomy because of manipulation of the thryroid gland that could cause excessive T3 and T4 to enter into the bloodstream during removal of the gland. Therefore, heart rate of 120, blood pressure 220/102, temperature 103.2 'F are classic signs of thyroid storm and this requires nursing intervention.

What medication is given for addisonian crisis? a. IV solu-cortef b. PO prednisone C. PO declomycin D. IV insulin

a. IV solu-cortef

A patient is admitted to the ER. The patient is unconscious on arrival. However, the patient's family is with the patient and reports that before the patient became unconscious she was complaining of severe pain in the abdomen, legs, and back, and has been experiencing worsening confusion. In addition, they also report the patient has not been taking any medications. The patient was recently discharged from the hospital for treatment of low cortisol and aldosterone levels. On assessment, you note the patient's blood pressure is 70/45. What disorder is this patient most likely experiencing? a. addisonian crisis b. cushing syndrome c. thyroid crysis d. hashimoto thyroiditis

a. addisonian crisis

A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? Select all that apply. a. assess blood glucose level b. assess for neck vein distention c. monitor for an irregular HR d. monitor for postural hypotension e. weigh the pt daily

a. assess blood glucose level b. assess for neck vein distention e. weigh pt daily

A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. Which of the following findings should the nurse assess the client for next? a. chvostek's sign b. babinski's sign c. brudzinski's sign d. kernig's sign

a. chvostek's sign

A nurse is assessing a client who is admitted with hyperthyroidism. The client reports a weight loss of 5.4 kg in the last 2 months, increased appetite, increased perspiration, fatigue, menstrual irregularity, and restlessness. Which of the following actions should the nurse take to prevent a thyroid crisis? a. provide a quiet, low-stimulus environment b. admin aspirin as prescribed for any sign of hyperthermia c. keep pt NPO d. observe pt carefully for signs of hypocalcemia

a. provide a quiet, low-stimulus environment thyroid crisis can occur in response to a stressor Aspirin can cause increased amount of thyroid hormones in blood

A nurse is caring for a client who has Addison's disease. Which of the following actions should the nurse take? a. teach the pt about cortisol replacement therapy b. place pt on a low-sodium diet c. monitor the pt for fluid volume excess d. discuss the manifestations of hypoglycemia with the pt

a. teach the pt about cortisol replacement therapy

Which of the following patients are at risk for developing Cushing's Syndrome? a. a pt with a tumor on the pituitary gland, causing too much ACTH to be secreted b. a pt taking glucocorticoids for several weeks c. a pt with a TB infection d. a pt who is post-op from an adrenalectomy

b. a pt taking glucocorticoids for several weeks

A nurse is planning care for a client who is postoperative following a thyroidectomy. Which of the following interventions should the nurse include in the plan? a. instruct pt to deep breathe Q4H b. check pts voice Q2H c. place the HOB flat d. hyperextend the pts neck

b. check pts voice Q2H

A patient with Addison's Disease is being discharged home on Prednisone. Which of the following statements by the patient warrants you to re-educate the patient? a. I will notify the dr if I become sick or experience extra stress b. i will take this med as needed when symptoms are present c. I will take this med at the same time everyday d. my daughter has bought me a Medic-Alert bracelet

b. i will take this med as needed when symptoms are present

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

A nurse is assessing a client who has hypoparathyroidism. Which of the following findings should the nurse expect? a. flaccid muscles b. pt report of numbness in their hands c. negative chvostek's sign d. pt report of anorexia

b. pt report of numbness in their hands

A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone and a sodium level of 123 mEq/L. Which of the following prescriptions should the nurse anticipate? a. maintain an IV of 0.45% sodium chloride b. restrict fluid intake to 1000mL/day c. provide a diet containing 2gm of sodium/day d. administer desmopressin acetate 0.2mg PO

b. restrict fluid intake to 1000mL/day

A nursing is providing dietary teaching for a client who has Cushing's disease. Which of the following recommendations should nurse include in the teaching? a. limit the intake of calcium-rich foods b. restrict sodium intake c. increase carb intake d. decrease protein intake

b. restrict sodium intake

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 med until your symptoms are gone + then discontinue b. tremors, nervousness + insomnia may indicate your dosage is too high c. symptoms will improve immediately after starting the medication d. the med decreases the overproduction of the thyroid hormone thyroxine

b. tremors, nervousness + insomnia may indicate your dose is too high

A pt with Addisons disease should consume which of the following diets? a. high fat + fiber b. low potassium + high protein c. high protein, carbs + adequate sodium d. low carbs, high protein, increased sodium

c. high protein, carbs + adequate sodium

A nurse is assessing a client who is receiving levothyroxine for 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

A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize that which of the following are manifestations of Cushing's syndrome? Select all that apply. a. alopecia b. tremors c. moonface d. purple striations e. buffalo hump

c. moonface d. purple striations e. buffalo hump

A nurse is teaching a client who has a new diagnosis 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. pathological fractures d. dysphagia

c. pathological fractures due to the release of calcium + phos into the blood --> reducing bone density

A nurse is assessing a client who has diabetes insipidus. Which of the following findings is a manifestation of this diagnosis? A-HTN B-Bounding peripheral pulses C- tachycardia D- hyperglycemia

c. tachycardia

A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take? a. provide a low-carbohydrate diet b. weigh the pt daily c. administer oral corticosteroids d. restrict fluid intake

c. weigh the pt daily

Addison's disease is: a. increased secretion of cortisol b. increased secretion of aldosterone + cortisol c. decreased secretion of cortisol d. decreased secretion of aldosterone + cortisol

d. decreased secretion of aldosterone + cortisol

A patient has an extremely high T3 and T4 level. Which of the following signs and symptoms DO NOT present with this condition? A. Weight loss B. Intolerance to heat C. Smooth skin D. Hair loss

d. hair loss

A nurse is caring for a client who is 8 hr postoperative following a subtotal thyroidectomy. In which of the following positions should the nurse keep the client? a. high-fowlers with the neck extended b. high fowlers with the neck in a neutral position c. semi fowlers with neck extended d. semi fowlers with the neck in a neutral position

d. semi fowlers with the neck in a neutral position