Endocrine Disorders

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? A) "I will increase my fluid and calcium intake." B) "I'll schedule a follow-up visit with my physician as soon as I get home." C) "I will take my pain medications according to the schedule we developed." D) "I'll call my physician if I notice tingling around my lips."

A) "I will increase my fluid and calcium intake."

The nurse instructs a client about insulin self-administration. It is MOST important for the nurse to make which statement? A) "You should rotate the injection sites." B) "Wipe the needle with alcohol prior to the injection." C) "Insert the needle at a 90* angle." D) "Cool the insulin prior to injecting it."

A) "You should rotate the injection sites."

The nurse provides care for a client immediately after a thyroidectomy. It is MOST important for the nurse to contact the health care provider for which observation? A) Change in quality or respirations B) Nausea and vomiting C) Poor intake of solid foods D) Dysphagia

A) Change in quality or respirations

A middle-aged female client complains of anxiety, insomnia, weight loss, the inability to concentrate, and eyes feeling "gritty." Thyroid function tests reveal the following: thyroid-stimulating hormone (TSH) 0.02 U/ml, thyroxine 20 g/dl, and triiodothyronine 253 ng/dl. A 6-hour radioactive iodine uptake test showed a diffuse uptake of 85%. Based on these assessment findings, the nurse should suspect: A) Graves' disease B) Multinodular goiter C) Thyroiditis D) Hashimoto's thyroiditis

A) Graves' disease

Which of the following would the nurse need to be alert for in a client with severe hypothyroidism? A) Myxedemic coma B) Addison's disease C) Acromegaly D) Thyroid storm

A) Myxedemic coma

A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the nurse do? A) Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes. B) Observe for swelling of the neck, tracheal deviation, and severe pain. C) Monitor laboratory values daily for elevated thyroid-stimulating hormone. D) Evaluate the quality of the client's voice postoperatively, noting any drastic changes.

A) Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.

When teaching a client with Addison disease about dietary needs, the nurse should emphasize the importance of consuming which nutrient? A) Potassium B) Sodium C) Magnesium D) Chloride

B) Sodium

Parathyroid hormone (PTH) has which effects on the kidney? A) Increased absorption of vitamin D and excretion of vitamin E B) Increased absorption of vitamin E and excretion of vitamin D C) Stimulation of phosphate reabsorption and calcium excretion D) Stimulation of calcium reabsorption and phosphate excretion

D) Stimulation of calcium reabsorption and phosphate excretion

A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect? A) Diaphoresis, fever, and decreased sweating B) Weight gain, constipation, and lethargy C) Exophthalmos, diarrhea, and cold intolerance D) Weight loss, nervousness, and tachycardia

D) Weight loss, nervousness, and tachycardia

The nurse is aware that the best time of day for the total large corticosteroid dose is between: A) 0400-0500 B) 2000-2100 C) 1600-1800 D) 0700-0800

D) 0700-0800

The major action of the _____ is controlling the release of pituitary hormones.

Hypothalamus

T or F: Acute hypercalcemic crisis occurs with extreme elevation of serum calcium levels and can be life threatening.

True

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? A) Temperature of 102*F B) HR of 62 bpm C) BP 90/58 mmHg D) O2 sat of 96%

A) Temperature of 102*F

_____ disease occurs when the adrenal cortex function is inadequate to meet the patient's need for cortical hormones.

Addison

The nurse provides for a client with Addison disease. The nurse assesses for which of the following conditions? A) Urinary retention B) Dysrhythmias C) Glycosuria D) Water intoxication

B) Dysrhythmias

A client with hyperthyroidism reports feeling irritable to the nurse. The nurse understands which about this symptom? A) Irritability is usually the result of temporary mental confusion. B) Irritability is commonly observed in clients with hyperthyroidism. C) Irritability is typical when a client thinks an illness is irreversible. D) Irritability is frequently associated with decreasing serum thyroxine level.

B) Irritability is commonly observed in clients with hyperthyroidism.

A client is recvering from a subtotal thyroidectomy.The nurse identifies which symptom indicates damage to the parathyroid gland? A) Muscle faccidity B) Numbness in the fingers C) Hoarseness D) High fever

B) Numbness in the fingers

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? A) Adrenal gland B) Parathyroid gland C) Thymus gland D) Thyroid gland

B) Parathyroid gland

The nurse assesses a patient who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease? A) Glucose of 100 mg/dL B) Potassium of 6.0 mEq/L C) Sodium of 140 mEq/L D) A BP reading of 135/90 mmHg

B) Potassium of 6.0 mEq/L

The nurse provides care for a client receiving levothyroxine sodium. Which indicates a nursing consideration for this medication? A) Side effects include weight gain and tachycardia B) Provide medication at the sae time daily C) Assess for a decreased pulse rate D) Medication is given over a 10 day period

B) Provide medication at the sae time daily

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? A) The client's blood sugar level. B) The functioning of endocrine glands. C) Details about the size of the organ and its location. D) The concentration of a substance in plasma.

B) The functioning of endocrine glands.

On the day of discharge, a client newly diagnosed with type 1 diabetes says to the nurse, "What should I do if I develop a fever?" Which response by the nurse is best? A) "Increase your caloric inake and decrease you insulin dosage." B) "Discontinue taing insulin until after your febrile state has passed." C) "Continue taking insulin as prescribed." D) "Go to the emergency department if your fever lasts more than 12 hr."

C) "Continue taking insulin as prescribed."

Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany? A) Tapazole B) Synthroid C) Calcium gluconate D) Propylthiouracil (PTU)

C) Calcium gluconate

The actions of parathyroid hormone (PTH) are increased in the presence of which vitamin? A) B B) C C) D D) E

C) D

Which medication is the treatment of choice for pregnant women diagnosed with hyperthyroidism? A) Methimazole B) SSKI C) PTU D) Potassium iodide

C) PTU

The nurse on the telemetry floor is caring for a patient with long-standing hypothyroidism who has been taking synthetic thyroid hormone replacement sporadically. What is a priority that the nurse monitors for in this patient? A) Symptoms of PNA B) Heat intolerance C) Symptoms of acute coronary syndrome D) Dietary intake of foods with saturated fats

C) Symptoms of acute coronary syndrome

The home care nurse monitors a client 7 days after a transsphenoidal hypophysectomy. The nurse intervenes if which observation is made? A) The client bends at the knees to pick up shoes. B) The client eats a diet high in fiber and fluids. C) The client brushes teeth morning and night. D) The client is using a room humidifier.

C) The client brushes teeth morning and night.

Oversecretion of the anterior pituitary gland most commonly involves ACTH or growth hormone and results in _____ syndrome or acromegaly.

Cushing

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? A) Hypopituitarism B) Panhypopituitarism C) Panhyperpituitarism D) Hyperpituitiarism

D) Hyperpituitiarism

A client is receiving long-term treatment with high-dose corticosteroids. Which of the following would the nurse expect the client to exhibit? A) Pale, thick skin B) Weight loss C) Hypotension D) Moon face

D) Moon face

Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome? A) Monitor bowel patterns B) Observe urine output C) Monitor vital signs every 4 hr D) Observe the color of stool

D) Observe the color of stool

Which glands regulate calcium and phosphorous metabolism? A) Thyroid B) Pituitary C) Adrenal D) Parathyroid

D) Parathyroid

The nurse teaches a client diagnosed with Graves' disease about diet. The nurse determines furhter teaching is required when the client selects which food? A) Non-iodized salt B) Poultry, such as chicken or turkey C) Calcium fortified cereals D) Seafood

D) Seafood

A client visits the physician's office complaining of agitation, restlessness, and weight loss. The physical examination reveals exophthalmos, a classic sign of Graves' disease. Based on history and physical findings, the nurse suspects hyperthyroidism. Exophthalmos is characterized by: A) more than 10 beats/minute difference between the apical and radial pulse rates. B) a wide, staggering gait. C) dry, waxy swelling and abnormal mucin deposits in the skin. D) protruding eyes and a fixed stare

D) protruding eyes and a fixed stare

T or F: Extreme fatigue, hair loss, brittle nails, and dry skin are common clinical manifestations or hyperthyroidism.

False

Following thyroid surgery, the patient should be monitored closely for signs of _____, an indicator of a disturbance in calcium metabolism due to injury or removal of the parathyroid gland.

Tetany

Which of the following endocrine disorder causes the patient to have dilutional hyponatremia? A) Hyperthyroidism B) Diabetes insipidus (DI) C) Syndrome of inappropriate antidiuretic hormone secretion (SIADH) D) Hypothyroidism

C) Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

The home care nurse instructs a client diagnosed with Addisno disease about precautions to take to avoid an Addisonian crisis. Which client statement indicates the teaching is successful? A) "I should increase my salt intake during very hot weather or excessive perspiration." B) "I should decrease my caloric inake if I gain weight." C) "I should decrease my medication prior to going to the dentist." D) "I should rest if I have problems with weakness."

A) "I should increase my salt intake during very hot weather or excessive perspiration."

The nurse provides care for a client diagnosed with Addison disease. How does the nurse expect the client's skin to appear? A) Abnormally dark and pigmented B) Ruddy and oily C) Puffy D) Pale, dry, and scaly

A) Abnormally dark and pigmented

Which diagnostic test is done to determine a suspected pituitary tumor? A) CT B) Radioimmunoassay C) Radiography of the ABD D) Measuring blood hormone levels

A) CT

A client diagnosed with type 2 diabetes asks the nurse, "Are the pills I am taking to control my blood sugar a form of insulin?" Which statement BEST describes te action of oral hypoglycemia agents? A) Oral hypoglycemic agents stimulate beta cells in the pancreas to release endogenous insulin. B) Oral hypoglycemic agents supply exogenous insulin, which enhances the transfer of glucose into cells. C) Oral hypoglycemic agents increase the release of insulin in the liver, which restores efficient glucose and fat utilization. D) Oral hypoglycemic agents stimulate adipose tissue to release endogenous insulin.

A) Oral hypoglycemic agents stimulate beta cells in the pancreas to release endogenous insulin.

A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder? A) Pituitary disorder B) Adrenal disorder C) Parathyroid disorder D) Thyroid disorder

A) Pituitary disorder

The nurse instructs a client about the correct way to administer insulin. Which statement, by the client, requires follow-up teaching? A) "I will use my abdomen for the morning injection." B) "I will inject insulin into my left arm prior to weight training." C) "I will inject insulin into the subcutaneous tissue." D) "I will dispose the used needle into the puncture resistant contained."

B) "I will inject insulin into my left arm prior to weight training."

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? A) "Rest as much as possible." B) "Maintain a moderate exercise program." C) "Lose weight." D) "Jog at least 2 miles per day."

B) "Maintain a moderate exercise program."

In preparation for discharge, the nurse reviews the diabetic exchange list with a client diagnosed with type 1 diabetes. Which information is MOST important for the nurse to provide? A) The exchange list is developed to eliminate the need to measure portions of food eaten. B) Each measured serving of food on an exchange list has about the same amount of carbohydrate, protein, fat, and caloriesas the other foods on the list. C) All items on the bread/starch exchange are breads, grains, or pasta. D) Using the exchange list correctly will allow the client to decrease the amount of insulin needed each day.

B) Each measured serving of food on an exchange list has about the same amount of carbohydrate, protein, fat, and caloriesas the other foods on the list.

A client with acromegaly has been given the option of a surgical approach or a medical approach. The client decides to have a surgical procedure to remove the pituitary gland. What does the nurse understand this surgical procedure is called? A) Ablation B) Hypophysectomy C) Hysteroscopy D) Thyroidectomy

B) Hypophysectomy

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? A) Laryngeal nerve damage B) Tetany C) Hemorrhage D) Thyroid storm

B) Tetany

The nurse provides care for a client diagnosed with syndrome or inappropriate antidiuretic hormone (SIADH). Which observation causes the nurse the MOST concern? A) The client's serum sodium level is 137 mEq/L (137 mmol/L). B) The client is eating ice chips. C) The client is oriented to person, place, and time. D) The client has a urine output of 100 mL/hr.

B) The client is eating ice chips.

A clietn diagnosed with type 1 diabetes reports waking in the mornings with elevated blood glucose levels. Which information is MOST important for the nurse to obtain to assist the client with this occurence? A) How many calories is the client consuming during the day? B) How many times a day does the client self monitor the blood glucose? C) What is the client's blood glucose level in the middle of the night? D) Is the client compliant with the prescribed insulin regimen?

C) What is the client's blood glucose level in the middle of the night?

The nurse provides dietary teaching to a client diagnosed with type 2 diabetes who has been placed on a 1500 calorie ADA diet. The client states, "I don't think I am going to be able to do this." Which response by the nurse is MOST appropriate? A) "This diet will help you maintain a normal blood glucose." B) "You will do fine if you just give it some time." C) "If you don't follow the diet, you will have complications." D) "Tell me what concerns you have about following this diet plan."

D) "Tell me what concerns you have about following this diet plan."

Which of the following hormones controls secretion of adrenal androgens? A) Calcitonin B) Parathormone C) Thyroid-stimulating hormone (TSH) D) Adrenocorticotropic hormone (ACTH)

D) Adrenocorticotropic hormone (ACTH)

_____ disease, an autoimmune disorder, is the most common cause of hyperthyroidism.

Graves

T or F: Iodine is essential to the thyroid gland for the synthesis of its hormones.

True

T or F: The major function of the parathyroid hormone is the regulation of serum calcium.

True

T or F: Thyroidectomy is the treatment of choice for thyroid cancer.

True

During a client education session, the nurse describes the mechanism of hormone level maintenance. What causes most hormones to be secreted? A) Decrease in hormonal levels B) Hormonal underproduction C) Increase in hormonal levels D) Hormonal overproduction

A) Decrease in hormonal levels

A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority? A) Decreased cardiac output B) Impaired physical mobility C) Imbalanced nutrition: Less than body requirements D) Risk for infection

A) Decreased cardiac output

The nurse recognizes which symptoms are characteristic of impending diabetic ketoacidosis? A) Hyperreflexia, Babinski reflex, numbness B) Hot, dry, flushed skin, excessive thirst, rapid pulse C) Hot flashes, severe hunger, bradycardia D) Profuse diaphoresis, headache, bradycardia

B) Hot, dry, flushed skin, excessive thirst, rapid pulse

The nurse in the outpatient clinic provides care for a client with the diagnosis of Cushing disease. The nurse expects to observe which symptom? A) Weight loss B) Thin legs and arms C) Hypoglycemia D) Hypotension

B) Thin legs and arms

A client is evaluated in the outpatient clinic for hypothyroidism. The nurse expects the client to exhibit which symptom? A) Joint pain B) Urinary frequency C) Increasing fatigue D) Muscular twitchings

C) Increasing fatigue

Trousseau sign is elicited: A) by tapping sharply over the facial nerve just in front of the parotid gland and anterior to the ear, causing spasm or twitching of the mouth, nose, and eye. B) when the foot is dorsiflexed and there is pain in the calf. C) by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff. D) after making a clenched fist and opening the hand; the palm remains blanched when pressure is placed over the radial artery.

C) by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.

The nurse monitors a client diagnosed with type 1 diabetes. The client tells the nurse, "I jog 30 minutes every day but today after my jog I felt nervous, hungry, and had tremors." Which statement by the nurse is BEST? A) "You should walk rather than jog." B) "How do you feel before you begin exercising." C) "What do you think is causing these feelings?" D) "You should eat cheese and crackers prior to jogging."

D) "You should eat cheese and crackers prior to jogging."

A client with severe hypoparathyroidism is experiencing tetany. What medication, prescribed by the physician for emergency use, will the nurse administer to correct the deficit? A) Fludrocortisone B) Methylprednisolone C) Sodium bicarbonate D) Calcium gluconate

D) Calcium gluconate

What interventions can the nurse encourage the client with diabetes insipidus to do in order to control thirst and compensate for urine loss? A) Limit the fluid intake at night B) Weigh daily C) Consume adequate amounts of fluid D) Come to the clinic for IV fluid therapy daily

C) Consume adequate amounts of fluid

The nurse understands that glucosteroids provide a source of energy during a stressful situation. Which statement BEST describes the action of glucosteroids? A) Prepare for "fight or flight" mechanism B) Regulate calcium metabolism C) Convert protein and fat into glucose D) Enhance musculoskeletal capacity

C) Convert protein and fat into glucose

A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate? A) Diabetes insipidus B) Syndrome on inappropriate antidiuretic hormone (SIADH) C) Myxedema coma D) Thyroid storm

C) Myxedema coma

A client sustained a head injury when falling off of a ladder. While in the hospital, the client begins voiding large amounts of clear urine and states he is very thirsty. The client states that he feels weak, and he has had an 8-lb weight loss since admission. What should the client be tested for? A) Hypothyroidism B) Pituitary tumor C) Diabetes insipidus (DI) D) Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

C) Diabetes insipidus (DI)

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? A) Dwarfism B) Acromegaly C) Gigantism D) Simmond's disease

C) Gigantism

The nurse provides care for a couscious client with severe ketoaciosis. The nurse anticipates which treatment modality? A) Orange juice B) Glucose tablets C) Insulin D) Exercise

C) Insulin

The nurse knows that a blood glucose level of 40 mg/dL indiciates which condition? A) Ketoacidosis B) Normal serum blood glucose C) Insulin reaction D) Glycosuria

C) Insulin reaction

The nurse counsels a client about preparation for a subtotal thyroidectomy. The client asks the nurse why the client was prescribed an iodine solution to take prior to surgery. Which response by the nurse is BEST? A) "The medication will increase the release of thyroid hormone." B) "This medication will increase your basal metabolic rate (BMP)." C) "This medication will prevent postoperative hemorrhage." D) "This medication will prevent nervousness and anxiety."

C) "This medication will prevent postoperative hemorrhage."

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? A) Glucose B) Potassium C) Calcium D) Sodium

C) Calcium

A nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse expects to find: A) Deposits of adipose tissue in the trunk and dorsocervical area. B) Weight gain in arms and legs. C) Hypotension. D) Tick, coarse skin.

A) Deposits of adipose tissue in the trunk and dorsocervical area.

A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? (Select all that apply.) A) Hypoventilation B) Hypotension C) Hypothermia D) Hyperventilation E) Hypertension

A) Hypoventilation B) Hypotension C) Hypothermia

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? A) Kidneys B) Liver C) Brain D) Cardiac atria

A) Kidneys

The nurse is reviewing the history and physical examination of a client diagnosed with hyperthyroidism. Which of the following would the nurse expect to find? A) Reports of increased appetite B) Thick, hard nails C) Inability to tolerate cold D) Complaints of sleepiness

A) Reports of increased appetite

The nurse recognizes that which of the following agents suppress release of thyroid hormones? (Select all that apply.) A) Sodium iodide B) Potassium iodide C) Propylthiouracil (PTU) D) Saturated solution of potassium iodide (SSKI) E) Methimazole

A) Sodium iodide B) Potassium iodide D) Saturated solution of potassium iodide (SSKI)

The nurse understands which type of insulin has the longest duration of action? A) Regular B) Glargine C) Isophane D) Lispo

B) Glargine

Following a client's treatment for Addison disease, the nurse plans for the client's discharge. Teh client aska the nurse how long the steroid medication must be continued. Which response is correct? A) "You will take the medications for approximately 6 months." B) "You will need to continue hormone replacemet for approximately 1 year." C) "You will continue to take the medications until the lab values are within normal limits." D) "You will need to continue hormone replacement therapy for the rest of your life."

D) "You will need to continue hormone replacement therapy for the rest of your life."

Hypophysectomy is the treatment of choice for which endocrine disorder? A) Pheochromocytoma B) Hyperthyroidism C) Acromegaly D) Cushing syndrome

D) Cushing syndrome

Which hormone would be responsible for increasing blood glucose levels by stimulating glycogenolysis? A) Insulin B) Cholecystokinin C) Somatostatin D) Glucagon

D) Glucagon

Which instruction should be included in the discharge teaching plan for a client after thyroidectomy for Graves' disease? A) Exercise to improve cardiovascular fitness B) Use nasal desmopressin acetate (DDAVP) C) Keep an accurate record of intake and output D) Have regular follow-up care

D) Have regular follow-up care

The nurse provides care for a client diagnosed with diabetes insipidus. The client is prescribed desmopressin. The nurse determines that the medication is effective if which observation is made? A) The client's 24-hr urinary output is 5000 mL. B) The client's weight decreases by 4 lb in a week. C) The client reports thirst. D) The client's specific gravity is 1.015.

D) The client's specific gravity is 1.015.

When describing the difference between endocrine and exocrine glands, which of the following would the instructor include as characteristic of endocrine glands? A) The glands contain ducts that produce the hormones. B) The secreted hormones act like target cells. C) The glands play a minor role in maintaining homeostasis. D) The secretions are released directly into the blood stream.

D) The secretions are released directly into the blood stream.

A client diagnosed with type 1 diabetes is placed on a 1,800 calorie/day diet. The nurse understands which is the goal of the diabetic diet for this client? A) To ensure the client is compliant with treatment B) To eliminate the possibility of complications C) To decrease the body mass index (BMI) D) To maintain blood glucose within normal range

D) To maintain blood glucose within normal range