Diabetes & Other Endocrine

333. The nurse will monitor the day to day effectiveness of acarbose (precose) by assessing the patient's: A. 2-hour postprandial blood glucose B. fasting blood glucose C. hemoglobin A1C D. Somogyi effect

A. 2-hour postprandial blood glucose

326. A 30 year old female has been diagnosed with Cushing's syndrome. the nurse knows the patient is MOST LIKELY to exhibit which symptoms? A. HTN & hirsutism B. Hyperkalemia & obesity C. Hypotension & anemia D. Menstrual irregularities & Hypoglycemia

A. HTN & hirsutism

317. Valerie March, age 23, is admitted to the medical unit with ketoacidosis. Serum glucose is 922. Ms. March describes unexplained loss of 10lbs in the preceding 2 weeks, as well as excessive thirst and frequent urination. She is diagnosed with type I DM and intravenous insulin initiated After IN insulin is discontinued, rapid-acting-insulin by subcutaneous injection is ordered for Ms. March. the nurse will administer which of the following medications? A. Lispro (Humalog) B. Glargine (lantus) C. Regular (Novolin R) D. Lente (Humulin L)

A. Lispro (Humalog)

299. The nurse is discussing the patient's insulin regimen with a new graduate. Which statement by the new graduate indicates additional teaching is needed? A. The patient is going for surgery in the morning I will hold the lantus tonight B. The patient is going for surgery in the morning so I will get an order to hold the evening's NPH C. The patient just returned from surgery and will be NPO, so please review the insulin orders with me D. The patient has an order to use his own insulin pump, so i will document in the medical record

A. The patient is going for surgery in the morning I will hold the lantus tonight

313. The nurse is caring for several patients with diabetes. The nurse knows the patient who is MOST likely to develop hyperosmolar hyperglycemic non ketotic syndrome (HHNS) is the one who is taking which long-term medication? A. corticosteroids B. Vitamin K C. Antihypertensives D. Warfarin (Coumadin)

A. corticosteroids

321. Valerie March, age 23, is admitted to the medical unit with ketoacidosis. Serum glucose is 922. Ms. March describes unexplained loss of 10lbs in the preceding 2 weeks, as well as excessive thirst and frequent urination. She is diagnosed with type I DM and intravenous insulin initiated. To assess, Ms. March's long-term maintenance of serum glucose within the target range, the nurse will monitor results of which lab order? A. hemoglobin A1C B. glucose tolerance test C. pancreatic enzyme D. serum insulin

A. hemoglobin A1C

308. The nurse would anticipate which of the following as a possible complication of thyroidectomy? A. hypocalcemia, hemorrhage B. tachycardia, anuria C. hypotension, pleural effusion D. hyperkalemia, hypovolemia

A. hypocalcemia, hemorrhage

332. Glipizide (Glucotrol) has been prescribed for a patient with type II DM. The patient asks the nurse how glipizide helps control her diabetes. The nurse's response is based on knowledge that glipizide: A. increases insulin secretion by the pancreas B. speeds gastric emptying of fatty foods C. slows the absorption of carbs in small intestine D. reduces glucose production by the liver

A. increases insulin secretion by the pancreas

331. As part of the plan of care for a patient with SIADH, the nurse will: A. initiate fluid restriction of 800-100ml/day B. maintain the HOB no more than 30 degrees C. administer IV hypotonic saline D. maintain patient in private room

A. initiate fluid restriction of 800-100ml/day

302. Matthew Kelly, age 48, is admitted to the med-surg unit with a 2 week history of fatigue. Assessment reveals +2 pitting edema to lower extremities, heart rate 116bpm, and bp 210/105. Initial lab results include serum sodium 150mEq/L and serum potassium 2.8mEq/L. Which additional symptoms would the nurse expect to assess in Mr. Kelly? A. pounding headache B. bradycardia C. oliguria D. muscle twitching

A. pounding headache

337. The nurse is providing DC instructions for a patient with Cushings syndrome. The nurse understands instructions for home care must include: A. stress reduction and management strategies B. use of calcium supplementation to avoid tetany C. need for adequate calories due to increased metabolism D. safe handling and administration of propylthiouracil

A. stress reduction and management strategies

296. During the nurse's review of a patient's blood glucose log, the patient's wife states, he has always been a brittle diabetic. To address this comment the nurse FIRST must assess the: A. timing and frequency of the patients meals and snacks B. wife's willingness to use artifical sweetners in cooking and baking C. patient's understanding of the presence of sugar alcohols in food D. glycemic load of the patient's most recent meal or snack

A. timing and frequency of the patients meals and snacks

318. Valerie March, age 23, is admitted to the medical unit with ketoacidosis. Serum glucose is 922. Ms. March describes unexplained loss of 10lbs in the preceding 2 weeks, as well as excessive thirst and frequent urination. She is diagnosed with type I DM and intravenous insulin initiated. The nurse is aware the onset of a rapid acting insulin is 15 minutes and the peak action occurs how long after administration? A. 30-45 minutes B. 60-90 minutes C. 2-3 hours D. 4-6 hours

B. 60-90 minutes

322. A patient with type II DM is to begin taking oral anti-diabetic medication. As part of the medication teaching, the nurse can tell the patient that which of the following medications taken by the patient is least likely to cause low blood glucose? A. Glimepiride (Amaryl) B. Metformin (Glucophage) C. Glipizide (Glucotrol) D. Miconized glyburide (Glynase)

B. Metformin (Glucophage)

328. A patient with acromegaly asks the nurse about the cause of this disorder. The nurse's response is based on knowledge acromegaly develops due to pathology of which gland? A. thyroid B. Pituitary C. Pineal D. Adrenal

B. Pituitary

297. A 16 year old male complains he has "not hit his growth spurt yet". The patient's mother admits, We've been relieved that he's not shown any interest in dating yet". The nurse suspects the patient may have: A. hyposecretion by the posterior pituitary gland B. a secondary disorder of the anterior pituitary gland C. hypersecretion of hormones from the testes D. a tertiary disorder of the adrenal medulla

B. a secondary disorder of the anterior pituitary gland

303. Matthew Kelly, age 48, is admitted to the med-surg unit with a 2 week history of fatigue. Assessment reveals +2 pitting edema to lower extremities, heart rate 116bpm, and bp 210/105. Initial lab results include serum sodium 150mEq/L and serum potassium 2.8mEq/L. The nurse correctly identifies Mr. Kelly's endocrine abnormally as a disorder of which order? A. posterior pituitary B. adrenal medulla C. anterior pituitary D. adrenal cortex

B. adrenal medulla

335. This nurse is providing dietary education for a patient with hyperthyroidism. Which of the following instructions by the nurse is appropriate for this patient? A. chose high fiber food sources to stimulate the GI tract B. avoid caffeine containing liquids to decrease sleep disturbances C. limit carb intake to allow use of stored protein D. plan 3 full mean a day and take mineral supplements

B. avoid caffeine containing liquids to decrease sleep disturbances

312. The nurse is providing instruction on self-monitoring of blood glucose to a patient newly dx with diabetes mellius type I. Which of the following statements by the nurse is correct? A. because you have type 1 DM you should monitor you CBG at least once a day B. be sure to monitor your blood glucose before and after exercise C. when you are sick, you should monitor your blood glucose every 12H D. because you will have an insulin pump, you should monitor your CBG 1-2 times daily

B. be sure to monitor your blood glucose before and after exercise

334. The nurse is caring for a patient with diabetes insipidus (DI). The PCP has ordered IV fluid replacement. The nurse recognizes which of the following as an appropriate solution for this purpose? A. hypertonic saline B. dextrose 5% in water C. 0.9% saline D. dextrose 5% in lactated ringers

B. dextrose 5% in water

325. The nurse recognizes the potential for secondary diabetes in a patient with a diagnosis of: A. Addison's disease B. hyperthyroidism C. hypopituitarism D. Hashimoto's thyroiditis

B. hyperthyroidism

309. A 74 year old patient who underwent thyroidectomy is experiencing a thyroid crisis. When initiating emergency measures for the patient, the nurse will perform which of the following as a FIRST priority? A. monitoring vital signs B. maintaining airway patency C. stabilizing hemodynamic status D. assessing recent output

B. maintaining airway patency

314. A patient with diabetes is unresponsive. lab results reveal serum glucose of 816. The nurse suspects DKA rather than HHNK because of which assessment finding? A. polyuria B. rapid, deep respirations C. petechiae D. peripheral edema

B. rapid, deep respirations

346. The nurse is discussing the difference between Cushing's syndrome and Addison's disease with a new graduate. Which of the following will the nurse identify as characteristic of Addison's disease? A. gynecomastia in men B. salt cravings C. menstrual irregularities in women D. acne

B. salt cravings

316. A patient is diagnosed with insulin resistance syndrome. The nurse recognizes this patient is at greatest risk for which of the following? A. Renal insufficiency B. Pancreatic cancer C. Cardiovascular disease D. Liver failure

C. Cardiovascular disease

304. Gladys Burns, age 54, is admitted to the med-surg unit with a dx of hypoparathyroidism. She was found unresponsive in a homeless shelter. Ms. Burns has a 20 year history of alcoholism. Assessment by the nurse reveals muscle contractions of the fingers and a positive Chvostek's sign The nurse identifies which electrolyte disorder as contributing to the assessment findings for Ms. Burns? A. hypernatremia B. hypomagnesemia C. Hypocalcemia D. Hyperkalemia

C. Hypocalcemia

305. Gladys Burns, age 54, is admitted to the med-surg unit with a dx of hypoparathyroidism. She was found unresponsive in a homeless shelter. Ms. Burns has a 20 year history of alcoholism. Assessment by the nurse reveals muscle contractions of the fingers and a positive Chvostek's sign The nurse identifies which of the following as a possible cause of hypoparathyroidism? A. Neck trauma or radiation B. Chronic renal failure C. Hypomagnesemia D. Parathyroid adenoma

C. Hypomagnesemia

338. Following surgery for thyroid cancer, a patient receives an order for levothyroxine (Synthroid). In providing drug education for this patient, the nurse will include the need to take the medication: A. in the evening when GI motility is greater B. with milk or food to minimize gastric irritation C. In the morning 30 mins before food D. within 1 hour of the mid-day meal

C. In the morning 30 mins before food

339. The nurse is caring for a patient who has received long-term corticosteroid treatment for Addison's disease. The nurse is aware of the patient's risk for injury r/t development of what potential complication r/t this treatment? A. Osteogenesis imperfecta B. Osteosarcoma C. Osteoporosis D. Osteomalacia

C. Osteoporosis

307. What additional equipment should the nurse ensure is present in the room of patient who has had a total thyroidectomy? A. thoractomy tray B. central line insertion tray C. Tracheostomy tray D. chest tube insertion tray

C. Tracheostomy tray

311. The nurse's post-op monitoring for a patient following thyroidectomy is based on recognition of which of the following as the MOST critical potential complication? A. seizures B. neck stiffness C. bleeding D. pain

C. bleeding

327. A 62 year old patient is admitted to the medical unit. When considering the results of physical assessment, the nurse suspects the patient has Graves disease because of the presence of: A. dry eyes B. pigeon chest C. exophthalmos D. hirsutism

C. exophthalmos

345. The nurse knows a patient with severe, long standing hypothyroidism may display which of the following? A. myxedema B. exopthalmos C. goiter D. truncal obesity

C. goiter

323. The nurse is caring for a patient with type II DM who appears confused and irritable. The nurse's assessment reveals the patient is also diaphoretic. The nurse determines the patient is hypoglycemic. What treatment will the nurse initiate? A. administer 1mg glucagon by IM B. provide patient pb and crackers C. have patient drink 8oz of milk D. administer 50ml 50% glucose IV

C. have patient drink 8oz of milk

330. The nurse should assess the patient with SIADH for which of the following? A. sudden weight loss B. increased serum sodium C. high urine specific gravity D. high urine output

C. high urine specific gravity

343. The nurse is providing education at a community center for a group of persons with DM. Which of the following statements by the nurse should be included in the discussion of diabetic diet? A. high protein diets are recommended for weight loss B. saturated fat should equal about 10% of total calories C. include a minimum of 130 grams of carbs daily D. lean red meat is an excellent source of polyunsaturated fat

C. include a minimum of 130 grams of carbs daily

300. the nurse is teaching a patient with diabetes how to read food labels. The nurse notes foods labeled "sugar free" may affect blood glucose because they: A. may contain excess sodium B. are based on 2,000 calorie a day diet C. may contain carbs D. are measured by grams rather than ounces

C. may contain carbs

344. The nurse is providing a self care class for patients with diabetes on the medical unit. What should the nurse tell these patients about "sick day" care for diabetes management? A. continue to check you blood glucose daily if you are sick B. report to the MD if blood glucose is over 110 on two consecutive tests C. patient with type 2 diabetes may need insulin on sick days to prevent hyperglycemia D. immediately discontinue oral agents if you are eating less than normal

C. patient with type 2 diabetes may need insulin on sick days to prevent hyperglycemia

295. The nurse is providing diabetes education for a newly diagnosed patient who is hispanic. During discussion about portion size, the patient comments, "the amounts of rice and beans are so small, and thats not how I like to eat". The nurse's response is based on the knowledge: A. low-carb diets are recommended for people with diabetes B. cultural preferences often cannot be accommodated in the diabetic diet C. serving size that exceed the plate method contribute to hyperglycemia D. beans are considered a protein source for people with diabetes

C. serving size that exceed the plate method contribute to hyperglycemia

320. Valerie March, age 23, is admitted to the medical unit with ketoacidosis. Serum glucose is 922. Ms. March describes unexplained loss of 10lbs in the preceding 2 weeks, as well as excessive thirst and frequent urination. She is diagnosed with type I DM and intravenous insulin initiated. Ms. March experiences itching and erythema around the insulin injection site. The nurse correctly tells the patient: A. this is an allergic reaction. I will call MD about dc the insulin B. you need to clean the site more carefully before injecting C. this reaction is usually a short term response, I will call MD for antihistamine D. you may have a site infection, I will call MD for topical antibiotic order

C. this reaction is usually a short term response, I will call MD for antihistamine

301. Matthew Kelly, age 48, is admitted to the med-surg unit with a 2 week history of fatigue. Assessment reveals +2 pitting edema to lower extremities, heart rate 116bpm, and bp 210/105. Initial lab results include serum sodium 150mEq/L and serum potassium 2.8mEq/L. Mr. Kelly's admitting diagnosis is pheochromocytoma. The nurse knows the patient's HTN is r/t excess secretion of which of the following hormones: A. dopamine & somastostatin B. adrenocorticotropin & epinephrine C. norepinephrine & thyrotropin-releasing hormone D. Epinephrine & norepinephrine

D. Epinephrine & norepinephrine

298. The nurse is caring for a patient with chronic adrenal insufficiency. The nurse would expect this disorder to be treated with which of the following medications? A. Propylthiouracil (PTU) B. Chlorpropamide (Diabinese) C. Desmopressin acetate (DDAVP) D. Hydrocortisone (Cortel)

D. Hydrocortisone (Cortel)

324. The nurse who routinely cares for ethnically diverse patients knows the highest incidence of DM occurs in which of the following groups? A. African Americans B. Hispanics C. Asians D. Native Americans

D. Native Americans

319. Valerie March, age 23, is admitted to the medical unit with ketoacidosis. Serum glucose is 922. Ms. March describes unexplained loss of 10lbs in the preceding 2 weeks, as well as excessive thirst and frequent urination. She is diagnosed with type I DM and intravenous insulin initiated. The nurse is teaching Ms. March about insulin self-injection. The nurse knows which of the following is site of FASTEST absorption? A. upper outer arm B. buttock C. mid-lateral thigh D. abdomen

D. abdomen

329. The nurse is caring for a patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse recognizes electrolytes abnormalities in this patient may present as: A. double vision B. bradycardia C. tachypnea D. abdominal cramps

D. abdominal cramps

340. To help the patient with DM avoid injury to the feet, the nurse will encourage the patient to: A. avoid using wool socks B. use commercial products to promptly remove calluses or corns C. wash feet daily with an antibacterial scrub such as chlorhexadine D. avoid going barefoot

D. avoid going barefoot

310. The nurse knows the older adult who experiences thyroid problems requires additional monitoring because the: A. basal ganglion response decreases with advancing age B. amount of thyroid secretions increases with advancing age C. size of the thyroid gland increases with advancing age D. basal metabolic rate decreases with advancing age

D. basal metabolic rate decreases with advancing age

336. The nurse is caring for patient with newly diagnosed hypothyrpidism. Which of the following is an appropriate nursing dx to include in the plan of care for this patient? A. diarrhea r/t GI hypermotility B. activity intolerance r/t fatigue and heat intolerance C. imbalanced nutrition less than body recquirements r/t inadequate food intake D. impaired memory r/t hypometabloism

D. impaired memory r/t hypometabloism

306. Gladys Burns, age 54, is admitted to the med-surg unit with a dx of hypoparathyroidism. She was found unresponsive in a homeless shelter. Ms. Burns has a 20 year history of alcoholism. Assessment by the nurse reveals muscle contractions of the fingers and a positive Chvostek's sign A nursing plan of care for Ms. Burns would include teaching that patient about which of the following? A. phosphorus supplements B. limited dietary potassium C. restrictions to physical activity D. rebreathing techniques

D. rebreathing techniques

342. The MD has encouraged a patient with long-term type 2 DM to increase his exercise as part of a diabetes management program. In providing additional education for this patient, the nurse includes which of the following statement? A. be sure to drink plenty of fruit juice during exercise B. remember to double insulin dose before exercising C. use new pair of walking shoes for better fit D. remember that exercise will lower your blood glucose

D. remember that exercise will lower your blood glucose

315. The nurse is teaching a patient with a new DX of DM about disease management. Which of th following "survivial skills" should the nurse identify as PRIORITY for this patient. A. weight loss B. limited physical activity C. eliminating sugar from diet D. self-monitoring of blood glucose

D. self-monitoring of blood glucose