Ch 52 Endocrine PrepU

Parathyroid hormone (PTH) has which effects on the kidney?

Stimulation of calcium reabsorption and phosphate excretion

Beta-blockers are used in the treatment of hyperthyroidism to counteract which of the following effects?

Sympathetic

A nurse is reviewing the laboratory order for a client suspected of having an endocrine disorder. The lab slip includes obtaining cortisol levels. What is being tested?

adrenal function

The nurse practitioner who assesses a patient with hyperthyroidism would expect the patient to report which of the following conditions?

Weight loss

What does a positive Chvostek's sign indicate?

Hypocalcemia

A number of pharmacologic agents are used to treat hyperthyroidism. Which of the following drugs is one of the most commonly prescribed and acts by blocking synthesis of the thyroid hormones?

Methimazole

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

"Maintain a moderate exercise program."

A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement by the client indicates the need for additional discharge teaching?

"I will increase my fluid and calcium intake.

An 84-year-old client who is experiencing cognitive decline is scheduled for a diagnostic test. Which action by the nurse reflects best practice when recording the client's drug history before the diagnostic test?

Consulting with the client's family or caregiver to confirm the information

The nurse is aware that the best time of day for the total large corticosteroid dose is between:

7:00 AM and 8:00 AM

A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately?

An irregular apical pulse

Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex?

Cushing syndrome

A nurse is assigned to care for a patient with increased parathormone secretion. Which of the following serum levels should the nurse monitor for this patient?

Calcium

Surgical removal of the thyroid gland is the treatment of choice for thyroid cancer. During the immediate postoperative period, the nurse knows to evaluate serum levels of __________ to assess for a serious and primary postoperative complication of thyroidectomy.

Calcium

A patient who is postoperative day 1 following neck dissection surgery has rung his call bell complaining of numb fingers, stiff hands, and a tingling sensation in his lips and around his mouth. The nurse should anticipate that this patient may require the IV administration of:

Calcium gluconate

Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany?

Calcium gluconate

Trousseau's sign is elicited by which of the following?

Carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff

The nurse is reviewing the laboratory and diagnostic test findings of a client diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following would the nurse expect to find?

Decreased serum osmolarity

Which nursing action would the nurse include when caring for a client with endemic goiter and experiencing respiratory symptoms?

Elevating the head of the bed.

A client is being seen in the clinic to receive the results of the lab work to determine thyroid levels. The nurse observes the client's eyes appear to be bulging, and there is swelling around the eyes. What does the nurse know that the correct documentation of this finding is?

Exophthalmos

Which of the following would the nurse expect to find in a client with severe hyperthyroidism?

Exophthalmos

The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as which of the following?

Gigantism

Which hormone would be responsible for increasing blood glucose levels by stimulating glycogenolysis?

Glucagon

A woman with a progressively enlarging neck comes into the clinic. She mentions that she has been in a foreign country for the previous 3 months and that she didn't eat much while she was there because she didn't like the food. She also mentions that she becomes dizzy when lifting her arms to do normal household chores or when dressing. What endocrine disorder should the nurse expect the physician to diagnose?

Goiter

Which condition should a nurse expect to find in a client diagnosed with hyperparathyroidism?

Hypercalcemia

A client is experiencing an increase in blood glucose levels. The nurse understands that which of the following hormones would be important in lowering the client's blood glucose level?

Insulin

The nurse knows to advise the patient with hyperparathyroidism that he or she should be aware of signs of the common complication of:

Kidney Stones

Which of the following would the nurse expect the physician to order for a client with hypothyroidism?

Levothyroxine sodium

A client with pheochromocytoma is scheduled for an adrenalectomy. Which of the following would the nurse perform preoperatively?

Monitor blood pressure (BP) frequently.

A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication?

Myxedema coma

Which assessment would a nurse perform on a client with Cushing's syndrome who is at high risk of developing a peptic ulcer?

Observe stool color.

A client has a dysfunction in one of his glands that is causing a decrease in the level of calcium in the blood. What gland should be evaluated for dysfunction?

Parathyroid gland

While assessing a client with hypoparathyroidism, the nurse taps the client's facial nerve and observes twitching of the mouth and tightening of the jaw. The nurse would document this finding as which of the following?

Positive Chvostek's sign

A client with acromegaly is admitted to the hospital with complaints of partial blindness that began suddenly. What does the nurse suspect is occurring with this client?

Pressure on the optic nerve

Which of the following endocrine disorder causes the patient to have dilutional hyponatremia?

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

The nurse is caring for a patient with hyperthyroidism who suddenly develops symptoms related to thyroid storm. What symptoms does the nurse recognize that are indicative of this emergency?

Temperature of 102ºF

A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

Tetany

A client is scheduled for a diagnostic test to measure blood hormone levels. The nurse expects that this test will determine which of the following?

The functioning of endocrine glands

A patient taking corticosteroids for exacerbation of Crohn's disease comes to the clinic and informs the nurse that he wants to stop taking them because of the increase in acne and moon face. What can the nurse educate the patient regarding these symptoms?

The moon face and acne will resolve when the medication is tapered off.

Which group of clients should not receive potassium iodide?

Those who are allergic to seafood

Which suggestion would the nurse include for a client who has had a thyroidectomy to reduce tension on the suture line?

Use the hands to support the head when rising from a sitting position

When caring for a client who's being treated for hyperthyroidism, the nurse should:

balance the client's periods of activity and rest

Which diagnostic test is done to determine suspected pituitary tumor?

computed tomography scan

During a client education session, the nurse describes the mechanism of hormone level maintenance. What causes most hormones to be secreted?

decrease in hormonal levels

A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for:

decreased body temperature and cold intolerance.

A nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse expects to find:

deposits of adipose tissue in the trunk and dorsocervical area.

A client has been experiencing a decrease in serum calcium. After diagnostics, the physician proposes the calcium level fluctuation is due to altered parathyroid function. What is the typical number of parathyroid glands?

four

A client presents with a huge lower jaw, bulging forehead, large hands and feet, and frequent headaches. What could be causing this client's symptoms?

hyperpituitarism

A client with adrenal insufficiency is gravely ill and presents with nausea, vomiting, diarrhea, abdominal pain, profound weakness, and headache. The client's family reports that the client has been doing strenuous yard work all day and was sweating profusely. Nursing management of this client would include observation for signs of:

hyponatremia and hyperkalemia.

Although not designated as endocrine glands, several organs within the body secrete hormones as part of their normal function. Which organ secretes hormones involved in increasing blood pressure and volume and maturation of red blood cells?

kidneys

The nurse is completing discharge teaching with a client with hyperthyroidism who has been treated with radioactive iodine at an outpatient clinic. The nurse instructs the client to

monitor for symptoms of hypothyroidism.

An incoherent client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and periorbital area. Knowing that these findings suggest severe hypothyroidism, the nurse prepares to take emergency action to prevent the potential complication of:

myxedema coma.

Cardiac effects of hyperthyroidism include

palpitations.

A nurse educator is teaching a chapter on "The Function of the Endocrine System." Which hormone would not be included as one of the six hypothalamic hormones?

prolactin

A nurse is instructing a client with newly diagnosed hypoparathyroidism about the regimen used to treat this disorder. The nurse should state that the physician probably will order daily supplements of calcium and:

vitamin D.