ENDO

The nurse is caring for a client after a thyroidectomy and monitoring for signs of thyroid storm. The nurse determines that which sign/symptom is indicative that a thyroid storm may be occurring?

Blood pressure of 80/60 mmHg

Which client is at risk for developing thyrotoxicosis?

A client with Graves' disease who is having surgery

The nurse is reviewing the prescriptions of a client diagnosed with diabetes mellitus who was admitted because of an infected foot ulcer. Which health care provider's prescription supports the treatment of this condition?

An increased amount of NPH daily insulin

The nurse is caring for a client with pheochromocytoma. Which data are indicative of a potential complication associated with this disorder?

Congestion heard on auscultation of the lungs

The nurse is assisting in preparing a care plan for a client with diabetes mellitus who has hyperglycemia. The nurse should focus on which potential problem for this client?

Dehydration

The nurse is caring for a client following an adrenalectomy and is monitoring for signs of adrenal insufficiency. Which are signs and symptoms related to adrenal insufficiency? Select all that apply.

Fever Weakness Hypotension Mental status change

The nurse is caring for a client diagnosed with hyperparathyroidism who is prescribed furosemide (Lasix). The nurse reinforces dietary instructions to the client. Which is an appropriate instruction?

Drink at least 2 to 3 L of fluid daily.

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which finding should the nurse expect to note as confirming this diagnosis?

Elevated blood glucose and low plasma bicarbonate

The nurse is assisting in preparing a plan of care for the client with diabetes mellitus and plans to reinforce the client's understanding regarding the signs/symptoms of hypoglycemia. Which signs/symptoms should the nurse review?

Elevated pulse; shakiness; and cool, clammy skin

The nurse is monitoring a client with Graves' disease for signs of thyrotoxic crisis (thyroid storm). Which signs and symptoms noted in the client should alert the nurse to the presence of this crisis? Select all that apply.

Fever Sweating Agitation

A comatose client with an admitting diagnosis of diabetic ketoacidosis (DKA) has a blood glucose value of 368 mg/dL, arterial pH of 7.2, arterial bicarbonate of 14 mEq/L, and is positive for serum ketones. The diagnosis is supported by which noted data?

Fruity breath odor

Which client complaint should alert the nurse to a possible hypoglycemic reaction?

Hot, dry skin and weakness

A client with type 2 diabetes mellitus has a blood glucose of more than 600 mg/dL and is complaining of polydipsia, polyuria, weight loss, and weakness. The nurse reviews the health care provider's documentation and would expect to note which diagnosis?

Hyperglycemic hyperosmolar state (HHS)

The nurse is reinforcing instructions to a client newly diagnosed with diabetes mellitus regarding insulin administration. The health care provider has prescribed a mixture of NPH and regular insulin. The nurse should stress that which is the first step?

Inject air equal to the amount of NPH insulin prescribed into the vial of NPH insulin.

The nurse is collecting data on a client admitted to the hospital with a diagnosis of myxedema. Which data collection technique would provide data necessary to support the admitting diagnosis?

Inspection of facial features

The nurse is reinforcing dietary instructions to a client newly diagnosed with diabetes mellitus. The nurse accurately instructs the client with which statement?

It is best to eat meals at approximately the same time each day.

The nurse is reviewing a plan of care for a client with Addison's disease. The nurse notes that the client is at risk for dehydration and suggests nursing interventions that will prevent this occurrence. Which nursing intervention is an appropriate component of the plan of care? Select all that apply.

Monitoring intake and output Monitoring for changes in mental status Encouraging fluid intake of at least 3000 mL/day

The nurse notes that a client with type 1 diabetes mellitus has lipodystrophy on both upper thighs. Which further information should the nurse obtain from the client during data collection?

Plan for injection rotation

The nurse is caring for a client with a diagnosis of hypoparathyroidism. The nurse reviews the client's laboratory results and notes that the calcium level is extremely low. The nurse should expect to note which sign/symptom on data collection?

Positive Trousseau's sign

A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which teaching information should the nurse reinforce upon discharge?

Rotate the insulin injection sites systematically.

A client with Cushing's disease is being admitted to the hospital after a stab wound to the abdomen. The nurse plans care and places highest priority on which potential problem?

infection

A client with diabetes mellitus who takes insulin is seen in the health care clinic. The client tells the nurse that after giving the injection, the insulin seems to leak through the skin. The nurse can appropriately determine the problem by asking the client which?

"Are you rotating the injection site?"

The nurse in an outpatient diabetes clinic is assisting in caring for a client on insulin pump therapy. Which statement by the client indicates that a need for teaching regarding insulin pump therapy?

"Now that I have this pump, I don't have to worry about insulin reactions or ketoacidosis occurring again."

The nurse reinforces teaching with a client with diabetes mellitus regarding differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that glucose will be taken if which symptom develops?

Shakiness

The nurse is reviewing the postoperative prescriptions for a client who had a transsphenoidal hypophysectomy. Which health care provider's prescription noted on the record indicates the need for clarification?

Apply a loose dressing if any clear drainage is noted.

The nurse enters the room of a client with type 1 diabetes mellitus and finds the client difficult to arouse. The client's skin is warm and flushed, and the pulse and respiratory rate are elevated from the client's baseline. Which action should the nurse implement?

Check the client's capillary blood glucose.

Following hypophysectomy, a client complains of being very thirsty and having to urinate frequently. Which is the initial nursing action?

Check the urine specific gravity.

The nurse caring for a client scheduled for a transsphenoidal hypophysectomy to remove a tumor in the pituitary gland assists in developing a plan of care for the client. The nurse suggests including which specific information in the preoperative teaching plan?

Toothbrushing will not be permitted for at least 2 weeks following surgery.

The nurse is preparing to reinforce instructions to a client with Addison's disease regarding diet therapy. The nurse understands that which diet should be prescribed for this client?

High-sodium, high-carbohydrate diet

Which signs/symptoms should the nurse expect to note when collecting data on a client with Addison's disease?

Hypotension and vomiting

The nurse is caring for a postoperative parathyroidectomy client. Which would require the nurse's immediate attention?

Laryngeal stridor

The nurse has collected data on a client with diabetes mellitus. Findings include a fasting blood glucose of 130 mg/dL, temperature 101° F, pulse of 88 beats per minute, respirations of 22 breaths per minute, and a blood pressure of 118/78 mm Hg. Which finding would be of concern to the nurse?

Temperature

The nurse is monitoring a client following a thyroidectomy for signs/symptoms of hypocalcemia. Which sign/symptom noted in the client indicates the presence of hypocalcemia?

Tingling around the mouth

The nurse is assisting with preparing a teaching plan for the client with diabetes mellitus regarding proper foot care. Which instruction should be included in the plan of care?

Apply a moisturizing lotion to dry feet, but not between the toes.

The nurse is caring for a client with pheochromocytoma. The client asks for a snack and something warm to drink. Which is the appropriate choice for this client to meet nutritional needs?

Graham crackers and warm milk

The nurse is monitoring a client who has been newly diagnosed with diabetes mellitus for signs of complications. Which statement made by the client would indicate hyperglycemia and thus warrant health care provider notification?

"I am urinating a lot."

The nurse is reinforcing discharge teaching with a client who has Cushing's syndrome. Which statement by the client indicates that the instructions related to dietary management were understood?

"I can eat foods that contain potassium."

A client with diabetes mellitus visits the health care clinic. The client previously had been well controlled with glyburide (DiaBeta), but recently, the fasting blood glucose has been running 180 to 200 mg/dL. Which medication, if added to the client's regimen, may be contributing to the hyperglycemia?

Prednisone

The nurse is collecting data regarding a client after a thyroidectomy and notes that the client has developed hoarseness and a weak voice. Which nursing action is appropriate?

Reassure the client that this is usually a temporary condition.

The nurse is collecting data from a client newly diagnosed with diabetes mellitus regarding the client's learning readiness. Which client behavior indicates to the nurse that the client is not ready to learn?

The client complains of fatigue whenever the nurse plans a teaching session.

The nurse caring for a client who has had a subtotal thyroidectomy reviews the plan of care and determines which problem is the priority for this client in the immediate postoperative period?

bleeding

The nurse is providing instructions to a client newly diagnosed with diabetes mellitus. The nurse gives the client a list of the signs of hyperglycemia. Which specific signs of this complication should be included on the list?

increased thirst

The nurse is reinforcing instructions to a client with diabetes mellitus about blood glucose monitoring and monitoring for signs of hypoglycemia. The nurse should teach the client that which result is a sign of hypoglycemia?

less than 50 mg/dl

The nurse is reviewing a health care provider's prescriptions for a client with newly diagnosed, untreated hypothyroidism. Which medication prescribed for the client should the nurse question and verify?

morphine sulfate

Which measure should the nurse anticipate being included in the plan of care for a client who has been diagnosed with Graves' disease?

restful environment

When caring for a client who is having clear drainage from his nares after transsphenoidal hypophysectomy, which action by the nurse is essential?

test the drainage for glucose

A client with type 1 diabetes mellitus is to begin an exercise program, and the nurse is reinforcing instructions to the client regarding the program. Which should the nurse include in the instructions?

Take a blood glucose test before exercising.

A health care provider has prescribed propylthiouracil (PTU) for a client with hyperthyroidism, and the nurse assists in developing a plan of care for the client. Which nursing measure would be included in the plan regarding this medication?

signs of hypothyroid

The nursing instructor asks a student to describe the pathophysiology that occurs in Cushing's disease. Which statement by the student indicates an accurate understanding of this disorder?

"Cushing's disease is characterized by an oversecretion of glucocorticoid hormones."

A client with type 1 diabetes mellitus takes NPH insulin every morning and checks the blood glucose level four times per day. The client tells the nurse that yesterday the late afternoon blood glucose was 60 mg/dL and that she "felt funny." Which statement by the client indicates an understanding of this occurrence?

"I forgot to take my usual mid-afternoon snack yesterday."

The nurse provides dietary instructions to a client with diabetes mellitus regarding the prescribed diabetic diet. Which statement made by the client indicates the need for further teaching?

"I need to buy special dietetic foods."

The nurse has reinforced instructions to the client with hyperparathyroidism regarding home care measures related to exercise. Which statement by the client indicates a need for further teaching? Select all that apply.

"I need to limit playing football to only the weekends."

The nurse is reinforcing home care instructions to a client with a diagnosis of Cushing's syndrome. Which client statement reflects a need for further teaching?

"I need to read the labels on any over-the-counter medications I purchase."

The nurse is assigned to care for a client at home who has a diagnosis of type 1 diabetes mellitus. When the nurse arrives to care for the client, the client tells the nurse that she has been vomiting and has diarrhea. Which additional statement by the client indicates a need for further teaching?

"I need to stop my insulin."

The nurse has reinforced instructions about measuring blood glucose levels to a client newly diagnosed with diabetes mellitus. The nurse determines that the client understands the procedure when making which most accurate statement?

"I should check my blood glucose level before eating each meal, regardless of how much I eat."

A client with type 1 diabetes mellitus calls the nurse to report recurrent episodes of hypoglycemia. Which statement by the client indicates a correct understanding of Humulin N insulin and exercise?

"I should not exercise in the late afternoon."

When the nurse is reinforcing instructions to a client who has been newly diagnosed with type 1 diabetes mellitus, which statement by the client would indicate that teaching has been effective?

"I will notify my health care provider if my blood glucose level is consistently greater than 250 mg/dL."

The nurse should expect to note which interventions in the plan of care for a client with hypothyroidism? Select all that apply.

*Instruct the client about thyroid replacement therapy. *Encourage the client to consume fluids and high-fiber foods in the diet. *Instruct the client to contact the health care provider if episodes of chest pain occur.

The nurse notes in the medical record that a client with Cushing's syndrome is experiencing fluid overload. Which interventions should be included in the plan of care? Select all that apply.

*Monitoring daily weight *Monitoring intake and output *Maintaining a low-sodium diet *Monitoring extremities for edema

The nurse educator is asking the nursing student to recall the signs/symptoms of hypothyroidism. The nurse educator determines that the student understands this disorder if which are included in the student's response? Select all that apply.

*dry skin *constipation *cold intolerance

The nurse is assigned to assist in caring for a client admitted to the emergency department with diabetic ketoacidosis (DKA). Which is the priority nursing action for this client who is in the acute phase?

Administer intravenous (IV) regular insulin.

A nursing student notes in the medical record that a client with Cushing's syndrome is experiencing body image disturbances. The need for additional education regarding this problem is identified when the nursing student suggests which nursing intervention?

Evaluating the client's understanding that the body changes need to be dealt with

After several diagnostic tests, a client is diagnosed with diabetes insipidus. The nurse understands that which signs/symptoms are indicative of this disorder?

Excessive thirst and urine output

A client is admitted to the hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial serum glucose level was 950 mg/dL. Intravenous (IV) insulin was started along with rehydration with IV normal saline. The serum glucose level is now 240 mg/dL. The nurse who is assisting in caring for the client obtains which item, anticipating a health care provider's prescription?

IV infusion containing 5% dextrose

A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar state (HHS) is made. The nurse who is assisting with care for the client obtains which item in preparation for the treatment of this syndrome?

Intravenous (IV) infusion of normal saline

The nurse is reinforcing instructions with a client with diabetes mellitus who is recovering from diabetic ketoacidosis (DKA) regarding measures to prevent a recurrence. Which instruction is important for the nurse to emphasize?

Monitor blood glucose levels frequently.

The nurse reviews a plan of care for a postoperative client following a thyroidectomy and notes that the client is at risk for breathing difficulty. Which nursing intervention should the nurse include in the plan of care?

Monitor neck circumference frequently.

Which nursing action would be appropriate to implement when a client has a diagnosis of pheochromocytoma?

Monitor the client's blood pressure.

A client with Graves' disease has exophthalmos and is experiencing photophobia. Which intervention would best assist the client with this problem?

Obtaining dark glasses for the client

A client with diabetes mellitus is being discharged following treatment for hyperglycemic hyperosmolar state (HHS) precipitated by acute illness. The client states to the nurse, "I will call the doctor next time I can't eat for more than a day or so." The nurse plans care, understanding that which statement accurately reflects this client's level of knowledge?

The client needs immediate education before discharge.

The nurse is caring for a client following a thyroidectomy. The client tells the nurse that she is concerned because of voice hoarseness. The client asks the nurse whether the hoarseness will subside. Which statement by the nurse regarding the hoarseness is accurate?

The hoarseness is normal and will gradually subside.

The nurse is caring for a client with pheochromocytoma. The client is scheduled for an adrenalectomy. During the preoperative period, the priority nursing action should be to monitor which criterion?

Vital signs