455 Endocrine (6)

C. Urine specific gravity 1.015 Feedback: A therapeutic effect of the medication would be urine specific gravity within the expected reference range, which is 1.010-1.025.

A nurse administers desmopressin to a client who has a diagnosis of diabetes insipidus. The nurse recognizes that which the following laboratory findings indicate a therapeutic effect of the medication? A. Serum sodium 146 mEq/L B. Blood glucose 80 mg/dL C. Urine specific gravity 1.015Feedback: A therapeutic effect of the medication would be urine specific gravity within the expected reference range, which is 1.010-1.025. D. Blood urea nitrogen (BUN) 15 mg/dL

D. Thyroid stimulating hormone (TSH) Feedback: The nurse should anticipate that TSH will be elevated.

A nurse in a clinic is reviewing the laboratory values of a client who has primary hypothyroidism. The nurse should anticipate an elevation of which of the following laboratory values? A. Serum T3 B. Serum T4 C. Free T4 D. Thyroid stimulating hormone (TSH)

B. Oliguria Feedback: The nurse should expect a client who has developed SIADH following a craniotomy to manifest oliguria. The decrease in urine output can be dramatic with output less than 20 mL/hr. The nurse should expect hyponatremia, due to the development SIADH. The nurse should expect weight gain, due to water retention from SIADH. The nurse should expect a loss of thirst, due to the development of SIADH.

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

D. Urine specific gravity 1.002 Feedback: The nurse should expect a client who has diabetes insipidus to have diluted urine with a specific gravity less than 1.005.

A nurse is assessing a client who has diabetes insipidus. Which of the following findings should the nurse expect? A. Bradycardia B. Moist mucous membranes C. Bounding peripheral pulses D. Urine specific gravity 1.002

C. Frequent mood changes Feedback: Hyperthyroidism develops when the thyroid gland produces an excess of the thyroid hormones that regulate the metabolic rate. Clients experience emotional lability that fluctuates between emotional hyperexcitability and irritability. They often cannot sit quietly.

A nurse is assessing a client who has hyperthyroidism. The nurse should expect the client to report which of the following manifestations? A. Sensitivity to cold B. Constipation C. Frequent mood changes D. Weight gain of 4.5 kg (10 lb) in 3 weeks

D. Hypertension Feedback: The patient in a thyroid storm has an exaggerated case of hyperthyroidism caused by overproduction or oversecretion of thyroid hormones. This causes hypertension, tachycardia and fever

A nurse is assessing a client who has myxedema. Which of the following findings should the nurse NOT expect? A. Constipation B. Impaired memory C. Bradycardia D. HypertensionFeedback: The patient in a thyroid storm has an exaggerated case of hyperthyroidism caused by overproduction or oversecretion of thyroid hormones. This causes hypertension, tachycardia and fever

A. Chvostek's sign Feedback: The nurse should suspect that the client has hypocalcemia, a possible complication following subtotal thyroidectomy. Manifestations of hypocalcemia include numbness and tingling in the hands, the soles of the feet, and around the lips, typically appearing between 24 and 48 hr after surgery. To elicit Chvostek's sign, the nurse should tap the client's face at a point just below and in front of the ear. A positive response would be twitching of the ipsilateral (same side only) facial muscles, suggesting neuromuscular excitability due to hypocalcemia

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. For which of the following findings should the nurse assess the client? A. Chvostek's signFeedback: The nurse should suspect that the client has hypocalcemia, a possible complication following subtotal thyroidectomy. Manifestations of hypocalcemia include numbness and tingling in the hands, the soles of the feet, and around the lips, typically appearing between 24 and 48 hr after surgery. To elicit Chvostek's sign, the nurse should tap the client's face at a point just below and in front of the ear. A positive response would be twitching of the ipsilateral (same side only) facial muscles, suggesting neuromuscular excitability due to hypocalcemia B. Babinski's sign C. Brudzinski's sign D. Kernig's sign

B. Verify the most recent calcium level. Feedback: A client who has had a thyroidectomy is at risk of hypocalcemia due to the possible disruption of the parathyroid gland during surgery. The parathyroid glands are four small glands located inside the thyroid gland that are responsible for calcium regulation. If they are damaged during a thyroidectomy, there is a risk of hypocalcemia. Low calcium levels can be manifested as numbness and tingling of the fingers and around the mouth, muscle spasms (particularly of the hands and feet), and hyperactive reflexes. If a client develops any of these manifestations following a thyroidectomy, the nurse should check the client's latest calcium level. The expected reference range for calcium is 8.5 to 10.5 mg/dL. If the calcium level is low, the provider should be notified, and oral or intravenous calcium replacement should be administered.

A nurse is caring for a client who is 1 day postoperative following a thyroidectomy and reports severe muscle spasms of the lower extremities. Which of the following actions should the nurse take? A. Check the pedal pulses. B. Verify the most recent calcium level. C. Request prescription for a relaxant. D. Administer an oral potassium supplement.

B. Lung cancer Feedback: The nurse should ask the client if he has a history of lung cancer because some of the treatment options for small cell lung cancer can cause secretion of antidiuretic hormone. This results in the body retaining water and can cause the syndrome of inappropriate antidiuretic hormone (SIADH).

A nurse is collecting the medical history from a client who has manifestations of syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should ask the client if he has a history of which of the following conditions that can cause SIADH? A. Osteoarthritis B. Lung cancer C. Liver cirrhosis D. Dyspepsia

B. Restrict sodium intake. Feedback: The nurse should recommend the client to restrict sodium intake to control fluid volume. This restriction can range from "no-added-salt" to table foods to a restriction of 2 g/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 intake of potassium-rich foods. B. Restrict sodium intake. C. Increase carbohydrate intake. D. Decrease protein intake.