Endocrine

A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include? "Take this medication on an empty stomach." "Take this medication with an antacid." "Change position slowly while taking this medication." "Limit your fluid intake while taking this medication."

"Take this medication on an empty stomach." To promote proper absorption, the client should take the medication on an empty stomach and not eat or drink anything for 30 to 60 min after taking it.

A nurse is managing the care of a client who is postoperative and experiencing acute adrenal insufficiency. Which of the following actions should the nurse take? Administer IV hydrocortisone sodium succinate. Give oral spironolactone. Infuse 1 unit of platelets. Restrict daily fluid intake.

Administer IV hydrocortisone sodium succinate. Hydrocortisone sodium succinate is necessary to replace the cortisol deficiency that occurs with adrenal insufficiency.

A nurse is assessing a client who has diabetes mellitus and reports feeling anxious. Which of the following findings should the nurse expect if the client is hypoglycemic? Rapid, deep respirations Cool, clammy skin Abdominal cramping Orthostatic hypotension

Cool, clammy skin Hypoglycemia causes cool, clammy skin, in addition to anxiety, nervousness, tachycardia, and confusion.

A nurse is assessing a client who has diabetes insipidus. The nurse should expect which of the following findings? Decreased heart rate Increased hematocrit High urine specific gravity Decreased BUN

Increased hematocrit An increased hematocrit level is an expected finding related to dehydration.

A nurse is teaching a client who has an autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following effects should the nurse include? (Select all that apply.) Osteoporosis Moon-shaped face Increased risk of infection Hearing loss Weight loss

Osteoporosis Moon-shaped face Increased risk of infection

A home health nurse is assessing a client who is on lifelong hormone replacement therapy for treatment of hypothyroidism. The client has not been taking his medication regularly. Which of the following findings should the nurse expect? Significant weight loss Persistent diarrhea Tachycardia Hypotension

Hypotension Hypotension is an expected finding of hypothyroidism.

A nurse is reviewing laboratory values for a client who has diabetic ketoacidosis (DKA). Which of the following results should the nurse expect? pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L pH 7.38, PaCO2 55 mm Hg, HCO3- 22 mEq/L pH 7.44, PaCO2 40 mm Hg, HCO3- 24 mEq/L pH 7.50, PaCO2 42 mm Hg, HCO3- 30 mEq/L

pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L With DKA, the pH is low, carbon dioxide is within the expected reference range, and bicarbonate is low.

A nurse is caring for a client undergoing screening for primary Cushing's disease. The nurse should expect that which of the following laboratory findings to be elevated? Lymphocyte count Serum potassium Serum calcium Blood glucose

Blood glucose

A nurse is providing discharge teaching for a client who has diabetes insipidus and has a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching? Breathe deeply while using the nasal spray. Blow nose gently prior to using the nasal spray. Administer the nasal spray while in a side-lying position. Instill the medication four times per day.

Blow nose gently prior to using the nasal spray. By blowing the nose gently prior to use of the spray, the client avoids dilution of the medication by nasal secretions or improper absorption of the medication due to nasal blockage.

A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements by the client indicates an understanding of the teaching? "I will let my feet air dry after washing." "I will wear sandals to allow air to circulate around my feet." "I will buy over-the-counter medicine to treat the calluses on my feet." "I will apply lotion to the dry areas of my feet, avoiding application between my toes."

"I will apply lotion to the dry areas of my feet, avoiding application between my toes." Lotion is appropriate for dry areas of the feet, but the client should avoid applying lotion between the toes, as this area is prone to bacterial growth.

A nurse is providing teaching for a client who has type 1 diabetes mellitus about how to prevent complications during illness. Which of the following statements indicates that the client understands the teaching? "I should stop taking my insulin if I feel nauseous." "I will test my urine for protein when I start to feel ill." "I will call my doctor if my blood sugar is more than 250 mg/dL." "I should check my blood glucose level every 8 hours."

"I will call my doctor if my blood sugar is more than 250 mg/dL." The client should call the provider if blood glucose levels exceed 250 mg/dL during illness.

A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following statements by the client indicates an understanding of the information about this test? "I need to fast after midnight the night before the test." "This test is a good indicator of my average blood glucose levels." "A level of 8% to 10% suggests adequate blood glucose control." "I will use my hemoglobin A1c level to adjust my daily insulin doses."

"This test is a good indicator of my average blood glucose levels." HbA1c reflects the client's glucose levels over a 120-day period, which is the life span of RBCs.

A nurse is preparing to give a client information about an adrenocorticotropic hormone (ACTH) stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders? Cushing's syndrome Hyperthyroidism Pheochromocytoma Addison's disease

Addison's disease The ACTH stimulation test is the standard test for Addison's disease. It measures the cortisol response to ACTH. The response is absent or very decreased in clients who have primary adrenal insufficiency.

A nurse is planning preoperative care for a client who has pheochromocytoma. Which of the following interventions should the nurse anticipate as being the priority? Use same arm for BP measurement. Avoid palpating the abdomen. Manage headaches with analgesics. Provide a private, darkened room.

Avoid palpating the abdomen. The greatest risk to this client is injury from hypertensive crisis. Therefore, the priority intervention is to avoid palpating the abdomen, which can cause a sudden release of catecholamines, causing a hypertensive crisis.

A nurse is providing teaching for a client who has diabetes mellitus. Which of the following findings associated with diabetic ketoacidosis (DKA) should the nurse include? Decreased urine output Weight gain of 0.45 kg (1 lb) in 24 hr Rapid, shallow respirations Blood glucose levels greater than 300 mg/dL

Blood glucose levels greater than 300 mg/dL Blood glucose levels above 300 mg/dL are an expected finding of DKA.

A nurse is caring for a client who has type 2 diabetes mellitus and is admitted with hyperglycemic-hyperosmolar state (HHS). Which of the following laboratory findings should the nurse expect? Blood glucose of 496 mg/dL and serum pH of 7.32 Blood glucose of 550 mg/dL and serum pH of 7.02 Blood glucose of 702 mg/dL and serum pH of 6.11 Blood glucose of 846 mg/dL and serum pH of 7.40

Blood glucose of 846 mg/dL and serum pH of 7.40 With HHS, the client produces enough insulin to prevent ketosis, but not enough to prevent hyperglycemia. Therefore, the serum pH is within the expected reference range, but the blood glucose is greater than 600 mg/dL.

A nurse is preparing insulin for a client who has diabetes mellitus. The client is to receive evening doses of insulin glargine and regular insulin. Which of the following actions should the nurse take to administer these two medications safely? Draw up the insulin glargine into the syringe first, and then draw up the regular insulin. Draw up the regular insulin into the syringe first, and then draw up the insulin glargine. Draw up the insulin glargine and the regular insulin into separate syringes. Draw up either insulin into the syringe first because both insulins are clear.

Draw up the insulin glargine and the regular insulin into separate syringes. The nurse should not mix insulin glargine with any other insulin in the same syringe due to the low pH of its diluent.

A nurse is monitoring the laboratory values of a client who has diabetes mellitus and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy? Fasting blood glucose 96 mg/dL Postprandial blood glucose 195 mg/dL Casual blood glucose 210 mg/dL Preprandial blood glucose 60 mg/dL

Fasting blood glucose 96 mg/dL This is within the expected reference range for a fasting blood glucose level and indicates that insulin therapy is effective.

A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect? Decreased blood pressure Weight loss Hirsutism Increased skin thickness

Hirsutism Increased hair growth, or hirsutism, is an expected finding of Cushing's disease due to increased androgen production.

A nurse is planning dietary teaching for a client who has type 1 diabetes mellitus. Which of the following information should the nurse include regarding alcohol consumption? Substitute two carbohydrate exchanges for every one alcoholic beverage. Ingest alcohol with meals to reduce alcohol-induced hypoglycemia. Consuming alcohol decreases blood triglyceride levels. Expect to increase insulin dosage when consuming alcohol.

Ingest alcohol with meals to reduce alcohol-induced hypoglycemia. Alcohol prevents liver production of glucose. Consuming carbohydrates while drinking alcoholic beverages helps prevent hypoglycemia.

A nurse is monitoring a client's status 24 hr after a total thyroidectomy. Which of the following findings should the nurse report to the provider? Laryngeal stridor Productive cough Pain with hyperextension of the neck Hoarse, weak voice

Laryngeal stridor Laryngeal stridor is a harsh, high-pitched sound upon inspiration that indicates respiratory obstruction. The nurse should take immediate action to preserve the client's airway.

A nurse is caring for a client who has diabetes mellitus and developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to his feet? Examine the skin and feet weekly for alterations in skin integrity. Monitor the temperature of bath water with a thermometer. Shop for shoes early in the day. Round the edges of toenails when trimming.

Monitor the temperature of bath water with a thermometer. Peripheral neuropathy makes it difficult to determine if bath water is too hot. Therefore, to prevent injury, the client should use a bath thermometer to ensure the water temperature is less than 43.3° C (110° F).

A nurse is preparing a teaching plan for a client who has diabetes insipidus and is receiving intranasal desmopressin. Which of the following information should the nurse include in the teaching plan? Daily fluid intake should be at least 3 L. Obtain weight weekly while wearing similar clothing at the same time of day. Notify the provider if a weight loss of 0.45 kg (1 lb) or more per week is noted. Occurrence of nocturia indicates the need for a dosage adjustment.

Occurrence of nocturia indicates the need for a dosage adjustment. The initial dose of desmopressin is administered in the evening; the provider will increase the dosage until the client no longer experiences nocturia.

A nurse is preparing to administer propranolol by IV bolus to a client experiencing a thyroid storm. Which of the following findings indicates the client is having a therapeutic response? Reduction of the effects of thyroid hormone on the heart Blockage of the release of thyroid hormone from the thyroid gland Increase of the heart's sensitivity to thyroid hormone Increase of the uptake of thyroid hormone by the thyroid gland

Reduction of the effects of thyroid hormone on the heart Propranolol is a beta2-adrenergic blocking agent that decreases the rapid heart rate caused by excessive thyroid stimulation.

To screen a client for pheochromocytoma, a nurse schedules a vanillylmandelic acid test. When teaching the client about this test, which of the following instructions should the nurse include? Start fasting at midnight prior to the day of the test. Begin the 24-hr urine collection with the first morning urination. Take low-dose aspirin for pain during the testing period. Restrict coffee intake 2 to 3 days prior to the test.

Restrict coffee intake 2 to 3 days prior to the test. The client should avoid coffee and tea (even if they are decaffeinated), bananas, chocolate, and vanilla for 2 to 3 days prior to the test.

A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect? Moon face Weight gain Serum calcium 12.8 mg/dL Serum sodium 150 mEq/L

Serum calcium 12.8 mg/dL A client who has adrenal insufficiency has a serum calcium level above the expected reference range.

A nurse is performing an assessment on a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following assessment data should the nurse report? Serum sodium 110 mEq/L 2+ deep-tendon reflexes Serum potassium 3.7 mEq/L Urine specific gravity 1.025

Serum sodium 110 mEq/L A client who has SIADH retains fluids, which causes dilutional hyponatremia.

A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia? Strong, bounding pulse Decreased bowel sounds Tingling and numbness of the hands and feet Diminished deep-tendon reflexes

Tingling and numbness of the hands and feet Hypocalcemia causes paresthesias, usually starting in the hands and feet.

A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings? Cold intolerance Lethargy Tremors Sunken eyes

Tremors Findings of hyperthyroidism include tremors, diaphoresis, and insomnia.

A nurse is caring for a client who is taking propylthiouracil (PTU). The nurse should recognize that the client has met the treatment goals when she reports an increase in which of the following effects? Sweating Stools Weight Appetite

Weight