Endocrine Disorders

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

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 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 homecare nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse should provide which information?

Refrigerate the insulin

A client has been prescribed acarbose for treatment of diabetes mellitus. Client teaching regarding this medication should include which instructions? Select all that apply

Abdominal cramping is common. Side effects include excessive flatulence The medication should be taken with each meal

When discussing the rationale for levothyroxine with a client with hypothyroidism, the nurse should emphasize that the client can anticipate which primary expected outcome?

Achieving normal thyroid hormone levels

A hospitalized client is newly diagnosed with diabetes mellitus. The client must take both NPH and regular insulin for glucose control. The nurse develops a teaching plan to help the client meet which outcome as a first step in managing the disease?

Adjust insulin according to capillary blood glucose levels.

The nurse is collecting data on a client with hyperparathyroidism. Which question would elicit accurate information about this condition from the client?

Are you experiencing pain in your joints?

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 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

A client is admitted with a diagnosis of pheochromocytoma. The nurse should monitor which parameter to detect the most common sign of pheochromocytoma?

Blood pressure elevation

The nurse is collecting data from a client receiving pioglitazone 30 mg orally daily. Which finding indicates that the client is experiencing the expected result of the action of this medication?

Decreased fasting blood glucose and reduced hemoglobin A1c (HbA1c)

The nurse is collecting data on a client with a diagnosis of hypothyroidism. Which of these behaviors, if present in the client's history, should the nurse determine as being likely related to the symptoms of this disorder?

Depression

The nurse is caring for a child with a diagnosis of diabetes insipidus. The nurse anticipates that the primary health care provider will prescribe which medications?

Desmopressin acetate

A client who has sustained an eye injury has been prescribed corticosteroid eye drops. The nurse should most carefully monitor for side effects of this medication if the client has which health problem listed on the medical record?

Diabetes mellitus

A glucocorticoid is prescribed for a client with adrenal insufficiency, and the nurse reinforces medication instructions to the client. The nurse determines that the client needs further teaching if the client states which action is necessary?

Discontinue the medication when symptoms subside.

A client scheduled for a thyroidectomy says to the nurse, "I am so scared to get cut in my neck." Based on the client's statement, the nurse determines that the client is experiencing which problem?

Fear about impending surgery

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

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

Fever Weakness Hypotension Mental status changes

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? Select all that apply.

Fruity breath odor Rapid, deep breathing Dry mucous membranes

The nurse is reinforcing instructions to a client newly diagnosed with diabetes mellitus regarding insulin administration. The primary 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 reinforcing discharge instructions to a client who had a unilateral adrenalectomy. Which information should be a component of the instructions?

Instructions about early signs of a wound infection

The nurse is reinforcing instructions to a client regarding the administration of lypressin. The nurse instructs the client that the medication will be taken by which routes?

Intranasal

A client diagnosed with diabetes insipidus is beginning medication therapy with lypressin. The nurse realizes the client understands instructions if the client comments the medicine will be taken in which manner?

Intranasally to promote water reabsorption

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

A client with newly diagnosed Cushing's syndrome expresses concern about personal appearance, specifically about the "buffalo hump" that has developed at the base of the neck. When counseling the client about this symptom, the nurse should incorporate which knowledge?

It may slowly improve with treatment of the disorder

A client with myxedema has changes in intellectual function such as impaired memory, decreased attention span, and lethargy. The client's husband is upset and shares his concerns with the nurse. Which statement by the nurse is helpful to the client's husband?

It's seems that you are concerned about your wife's condition, but the symptoms may improve with continued therapy

A client recently diagnosed with diabetes mellitus requiring insulin tells the clinic nurse that he is traveling by air throughout the next week. The client asks the nurse for any suggestions about managing the disorder while traveling. Which action should the nurse tell the client to do?

Keep snacks in carry-on luggage to prevent hypoglycemia during the flight

A client newly diagnosed with diabetes mellitus is having difficulty learning the technique of blood glucose measurement. The nurse should teach the client to do which action to perform the procedure properly?

Let the arm hang dependently and milk the digit.

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

Monitor vital signs and neurological status.

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

Insulin glargine is prescribed for a client with diabetes mellitus. The nurse tells the client that which is the best time to take the insulin?

Once daily at the same time each day

Lispro insulin is prescribed for a child with type 1 diabetes mellitus. The nurse is reinforcing a teaching session with the child and mother about the onset, peak, and duration times of the insulin. The nurse provides which information about this type of insulin?

Onset of 15 to 30 minutes from injection time, peak of 2 to 4 hours later, and duration time of 4 to 8 hours

The nurse is caring for a client with a diagnosis of myasthenia gravis. The primary health care provider plans to perform an edrophonium test on the client to determine the presence of cholinergic crisis. In addition to planning care for the client during this testing, which equipment will the nurse ensure is at the bedside?

Oxygen equipment

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 newly diagnosed with type 1 diabetes mellitus. In reviewing the medical record the nurse should note which signs and symptoms? Select all that apply.

Polyphagia Extreme thirst Rapid weight loss

The nurse is collecting data from a client who is being admitted to the hospital for a diagnostic workup for primary hyperparathyroidism. The nurse understands that which client complaint would be characteristic of this disorder?

Polyuria

A client is newly diagnosed with hypothyroidism. Levothyroxine is prescribed. The nurse should reinforce to the client which instructions about the medication?

Take on an empty stomach.

The nurse is preparing to discharge a client who has had a parathyroidectomy. When reinforcing instructions to the client about the prescribed oral calcium supplement, which information should the nurse include?

Take the calcium 30 to 60 minutes following a meal

The nurse reinforces instructions to a client who is taking levothyroxine. Which instruction should the nurse give the client?

Take the medication on an empty stomach.

Which instruction should the nurse reinforce to the client with diabetes mellitus receiving acarbose? Select all that apply.

Take the medication with each meal Side effects include abdominal bloating and flatus Take some form of glucose if hypoglycemia occurs Report symptoms such as shortness of breath or tiredness

A client who returned to the nursing unit 8 hours ago after hypophysectomy has clear drainage saturating the nasal dressing. The nurse should take which action?

Test the drainage for glucose

An older client with a history of hyperparathyroidism and severe osteoporosis is hospitalized. The nurse caring for the client plans to address which problem first?

Urinary retention

During data collection on a postoperative client who has undergone hypophysectomy, the client complains of thirst and frequent urination. Knowing the expected complication of this surgery, the nurse should check which parameter next?

Urine specific gravity

A client with Cushing's syndrome verbalizes concern to the nurse regarding the appearance of the buffalo hump that has developed. Which response by the nurse is appropriate?

Usually, these physical changes slowly improve following treatment

The nurse has reinforced dietary instructions to a client with a diagnosis of hypoparathyroidism. The nurse instructs the client to include which item in the diet?

Vegetables

A preoperative client is scheduled for adrenalectomy to remove a pheochromocytoma. The nurse should most closely monitor which assessment in the preoperative period?

Vital signs

A client with diabetes mellitus is scheduled to have a fasting blood glucose level determined in the morning. The nurse tells the client not to eat or drink after midnight. When the client asks for further information, the nurse clarifies by stating that which should be acceptable to take before the test?

Water

The nurse is caring for a client with Addison's disease. The diagnosis is supported by which noted data? Select all that apply.

Weight loss Skin hyperpigmentation Orthostatic hypotension

Cortisone acetate is prescribed for a client with adrenal insufficiency, and the nurse reinforces instructions to the client regarding the medication. Which statement by the client would indicate a need for further teaching?

I will stop the medication when I feel better

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

A client with myasthenia gravis verbalizes complaints of feeling much weaker than normal. The primary health care provider plans to implement a diagnostic test to determine if the client is experiencing a myasthenic crisis and administers edrophonium. Which data would indicate that the client is experiencing a myasthenic crisis?

A temporary improvement in the condition

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

A client has a fasting blood glucose of 268 mg/dL at 7:30 am. The sliding scale prescriptions are blood glucose 151 to 200 mg/dL, administer 3 units Humalog insulin; 201 to 250, administer 6 units Humalog insulin; 251 to 300 mg/dL, administer 9 units Humalog insulin; over 300 mg/dL contact the primary health care provider. Therefore, at 7:30 am, how many units of Humalog should be administered?

Humalog 9 units

A client newly diagnosed with diabetes mellitus is instructed by the primary health care provider to obtain glucagon hydrochloride for emergency home use. The client asks the nurse about the purpose of the medication. The nurse tells the client that the purpose of the medication is to treat which aspect of diabetes?

Hypoglycemia from insulin overdose

An adult client with hypothyroidism is admitted to the hospital. When reviewing the client's health record, the nurse notes that the client is taking a maintenance dose of levothyroxine. The nurse is also reviewing instructions concerning taking levothyroxine with the client. There is a need for further teaching when the client makes which statement?

I will take the pill with milk to keep from upsetting my stomach

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 collecting data regarding a client after a thyroidectomy and notes the development of a hoarse and weak voice. Which nursing action is appropriate?

Reassure the client that this is usually a temporary condition.

The nurse preparing a client for surgery reviews the client's medication record. The client is to receive nothing by mouth (NPO) after midnight. Which medication noted on the client's record should the nurse question?

Prednisone

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 primary health care provider's prescription?

IV infusion containing 5% dextrose

Glimepiride is prescribed for a client with diabetes mellitus. The nurse reinforces instructions for the client and tells the client to avoid which while taking this medication?

Alcohol

A client received 20 units of NPH insulin subcutaneously at 8:00 am. The nurse should check the client for a potential hypoglycemic reaction at which time?

5:00 pm

A client with a pituitary tumor will undergo transsphenoidal hypophysectomy. The nurse reinforces which information in the preoperative teaching plan for the client?

Blowing the nose following surgery is prohibited

A client with diabetes mellitus calls the clinic and tells the nurse that she has been nauseated during the night. The client asks the nurse if the morning insulin should be administered. Which is the appropriate nursing response?

Administer the full dose as prescribed

A client has just been admitted with a diagnosis of myxedema coma. If all of the following interventions were prescribed, the nurse should place highest priority on completing which action first?

Administering oxygen

A client receiving desmopressin begins to complain of a headache. The nurse notes that the client is listless and falls asleep easily. The nurse interprets that the client is most likelyexperiencing which reaction?

Adverse medication effects

The client plans to give his lispro insulin injection at 0800 right before eating breakfast. The nurse knows that the client understood the education provided when the client states which time presents the greatest risk for hypoglycemia?

0930

A client received a dose of regular insulin this morning at 7:00 am. At which time should the nurse likely anticipate the potential for a hypoglycemic reaction to occur?

10:00 am

A client has self-administered his first injection of regular insulin at 7:30 am, before breakfast. This client should be instructed to closely monitor for signs of hypoglycemia at which time?

11:00 am

The nurse has just supervised a client who has newly diagnosed diabetes mellitus self-inject NPH insulin at 7:30 am. The nurse reviews the time frames for peak insulin action with the client, telling the client to be especially watchful for a hypoglycemic reaction during which time frame?

1:30 pm and 7:30 pm

The nurse is asked to prefill syringes containing NPH and regular insulin for a diabetic client who lives at home alone and has difficulty with seeing and accurately preparing dosages. Considering the stability of insulin, which number of prefilled syringes should the nurse prepare for the client?

A 7-day supply

Potassium iodide is prescribed for a client. The nurse reinforces instructions to the client that the primary health care provider should be notified if the client experiences which symptom? Select all that apply.

A burning in the mouth A brassy taste in the mouth Soreness of the gums and teeth

Which client is at risk for developing thyrotoxicosis?

A client with Graves' disease who is having surgery

While collecting data on a client being prepared for an adrenalectomy, the nurse obtains a temperature reading of 100.8° F. The nurse analyzes this temperature reading as which?

A finding that needs to be reported immediately

The nurse is monitoring a client receiving glipizide. Which outcome indicates an ineffective response from the medication?

A glycosylated hemoglobin level of 12%

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

A restful environment

A client is suspected of having myasthenia gravis, and the primary health care provider administers edrophonium to determine the diagnosis. After administration of this medication, which sign/symptom would indicate the presence of myasthenia gravis?

An increase in muscle strength

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

An increased amount of NPH daily insulin

Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which prescription change does the nurse anticipate during therapy with the prednisone?

An increased amount of daily Humulin NPH insulin

Prednisone is prescribed for a client with diabetes mellitus who is taking NPH insulin daily. Which prescription should the nurse anticipate during therapy with the prednisone?

An increased amount of daily NPH insulin

A client with an exacerbation of chronic obstructive pulmonary disease (COPD) has been on oral glucocorticoids and is being weaned to triamcinolone by inhalation. The nurse determines that the client understands the potential adverse effects to watch for during this medication change when the client states to monitor for which?

Anorexia nausea weakness fatigue

The nurse is caring for a client with Paget's disease who has an elevated serum calcium level of 12.3 mEq/L. The nurse should expect the primary health care provider to prescribe which? Select all that apply.

Calcitonin Furosemide Assist to ambulate PRN

The nurse participating in a free health screening at the local mall obtains a random blood glucose level of 200 mg/dL on an otherwise healthy client. The nurse tells the client to do which as a nextstep?

Call the primary health care provider to have the value rechecked as soon as possible

The wife of a client with diabetes mellitus who takes insulin calls the nurse in a primary health care provider's office about her husband. She states that her husband is sleepy and that his skin is warm and flushed. She adds that his breathing is faster than normal and his pulse rate seems fast. Which action should the nurse tell the wife to do first?

Check his blood glucose level

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 working on an endocrine nursing unit understands that which correct concepts are used in planning care? Select all that apply

Clients with Cushing's syndrome are likely to experience hypertension. Clients who have hyperparathyroidism should be protected against falls Clients who have pheochromocytoma should be monitored for signs of orthostatic hypotension.

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

A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. Which intervention would be appropriate to decrease the client's anxiety?

Convey empathy, trust, and respect toward the client

A client is admitted with chest pain related to atrial fibrillation. Based on her blood glucose reading, metformin is prescribed for the client. As the nurse reviews the client's chart and prescriptions, which finding would require the nurse to verify the metformin prescription?

Creatinine result

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

Cushing's syndrome is characterized by an oversecretion of glucocorticoid hormones

A client is diagnosed with hypothyroidism, and levothyroxine is prescribed. The nurse notes that the client is presently taking warfarin sodium and anticipates that the primary health care provider will alter which medication dosage?

Decrease the dosage of warfarin sodium

A licensed practical nurse (LPN) is assisting in the care of a client who is receiving oxytocin to induce labor. The LPN plans to notify the registered nurse immediately if which signs and symptoms are noted? Select all that apply.

Decreased blood pressure, increased pulse Contractions greater than 1 minute in duration

Desmopressin acetate is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?

Decreased urinary output

The home care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client, prescribed repaglinide and metformin, asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select all that apply.

Diarrhea can occur secondary to metformin The repaglinide is not taken if a meal is skipped. The repaglinide is taken 30 minutes before eating Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes

The nurse is preparing to administer an injection of regular insulin. The vial of the regular insulin has been refrigerated. On inspection of the vial, the nurse finds that the medication is frozen. Which action should the nurse take?

Discard the insulin and obtain another vial.

The nurse is caring for a client diagnosed with hyperparathyroidism who is prescribed furosemide. The nurse reinforces dietary instructions to the client. Which are appropriate instructions? Select all that apply.

Drink at least 2 to 3 L of fluid daily Increase dietary intake of potassium

The nurse is monitoring a client receiving desmopressin acetate for adverse effects to the medication. Which sign/symptom indicates the presence of an adverse effect?

Drowsiness

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 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

A nursing student notes in the medical record that a client with Cushing's syndrome is experiencing body image disturbances. A need for further teaching 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

A client diagnosed with hypothyroidism is taking levothyroxine. The client returns to the clinic 1 week after beginning the medication and tells the nurse that the medication has not helped. The appropriate nursing response to the client is based on which information?

Full therapeutic effect may take 1 to 3 weeks

Metformin is prescribed for a client with type 2 diabetes mellitus. Which should the nurse tell the client is a common side effect of the medication?

Gastrointestinal (GI) disturbances

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 performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of which disorder?

Graves' disease

In planning nutrition for the client with hypoparathyroidism, which diet would be appropriate?

High in calcium and low phosphorous

A client is brought to the emergency department with suspected diabetic ketoacidosis (DKA). Which finding should the nurse note as being consistent with this diagnosis?

High serum glucose level and low serum bicarbonate level

A client with diabetes mellitus decides to exercise an extra 30 minutes. The client is now experiencing hypoglycemia. Hypoglycemia is supported by which noted data? Select all that apply.

Hunger Shakiness Cool, clammy skin

A client newly diagnosed with diabetes mellitus takes NPH insulin every day at 7:00 am. The nurse has taught the client how to recognize the signs of hypoglycemia. The nurse determines that the client understands the information presented if the client watches for which signs and symptoms in the late afternoon?

Hunger; shakiness; and cool, clammy skin

The nurse has provided diabetic teaching with the family of a client newly diagnosed with diabetes. The nurse determines that the family understands the reason for having glucagon on hand for emergency home use if the family indicates that the purpose of the medication is to treat which condition?

Hypoglycemia from insulin overdose

The client with Cushing's syndrome had bilateral adrenalectomies and is now on corticosteroid therapy. The client also has a history of seizures. The nurse giving discharge instructions concerning corticosteroid therapy realizes there is a need for further teaching when the client makes which statement?

I know my doctor can now decrease my dosage of phenytoin

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 I should exercise in the evening to encourage a good sleep pattern

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 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

The nurse has reinforced home care measures to a client diagnosed with diabetes mellitus regarding exercise and insulin administration. Which statement by the client indicates a need for further teaching?

I should perform my exercise at peak insulin time

The nurse realizes that the client taking metformin needs further teaching when the client makes which statement?

I should treat hypoglycemic episodes due to metformin with glucose tablets only

The nurse is instructing a client with Addison's disease about a newly prescribed medication, fludrocortisone acetate. Which statement by the client indicates a need for further teaching?

I will be glad to gain weight

The nurse is reinforcing instructions to the client about insulin glargine. The nurse determines that the client understands the action of the medication if the client makes which statement?

I will give myself this medication subcutaneously once each night before bed

Lispro insulin is prescribed three times a day, with the amount based on blood glucose levels. The nurse determines that the client understands teaching regarding lispro insulin if which statement is made?

I will take the lispro 10 to 15 minutes before I eat breakfast, lunch, and dinner

A client is diagnosed with hyperparathyroidism. The nurse teaching the client about dietary alterations to manage the disorder tells the client to limit which food in the diet?

Ice cream

Levothyroxine sodium is prescribed for a client with hypothyroidism. When should the nurse encourage the client to take the medication?

In the morning

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

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

The nurse is teaching a client, newly diagnosed with diabetes mellitus, to mix 24 units NPH and 12 units regular insulin in the same syringe. Which instructions should the nurse give to the client to take after wiping the vials with an alcohol wipe?

Inject 24 units of air into the NPH insulin vial

The nurse needs to mix Regular insulin (clear) and NPH insulin (cloudy) in the same syringe.

Inject air into the NPH insulin vial Inject air into the regular insulin vial Draw up the regular insulin into the syringe. Draw up the NPH insulin into the syringe.

The nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply

Insomnia Weight loss Bradycardia Mild heat intolerance

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 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 Instruct the client to contact the primary health care provider (PHCP) if episodes of chest pain occur

An oral hypoglycemic medication, a sulfonylurea, is prescribed for a client with type 2 diabetes mellitus. The nurse is reviewing the medical record and needs to contact the primary health care provider if there is a history of which condition?

Liver disease

A client has been diagnosed with hypoparathyroidism. Which food groups should be included in the diet?

Low in phosphorus and high in calcium

A client with hypoparathyroidism has hypocalcemia. The nurse avoids giving the client the prescribed vitamin and calcium supplement with which liquid?

Milk

The nurse is planning to instruct a client with diabetes mellitus who has hypertension about "sick day management." Which beverage does the nurse avoid putting on a list of easily consumed carbohydrate-containing beverages for use when the client cannot tolerate food orally?

Mineral water

After receiving furosemide 40 mg slow intravenous push for chest pain related to shortness of breath and generalized edema, the client responds poorly. The client has no relief of the chest pain, shortness of breath, or edema and only minimal urine output (less than 40 mL of urine). The primary health care provider is notified, and after reviewing the chart, suspects the client has syndrome of inappropriate antidiuretic hormone (SIADH). Which findings would lead to this specific diagnosis?

Minimal responsiveness to furosemide and small cell lung cancer

The nurse is reinforcing instructions to 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 level 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

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 interventions are appropriate components 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

Which nursing measure would be effective in preventing complications in a client with Addison's disease?

Monitoring the blood glucose

The nurse is reviewing a primary 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

The nurse is monitoring a client following a thyroidectomy for signs/symptoms of hypocalcemia. Which signs/symptoms noted in the client indicates the presence of hypocalcemia? Select all that apply.

Muscle spasms Positive Trousseau's sign Tingling around the mouth

Potassium iodide is prescribed for a client. The client calls the nurse at the clinic and complains of a brassy taste and burning sensations in the mouth. How should the nurse respond?

Notify the primary health care provider

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

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

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

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

The nurse is monitoring the results of periodic serum laboratory studies drawn on a client with diabetic ketoacidosis (DKA) receiving an insulin infusion. The nurse determines that which value needs to be reported?

Potassium 3.1 mEq/L

The nurse is caring for a client experiencing thyroid storm. Which should be a priorityconcern for this client?

Potential for cardiac disturbances

A client with diabetes mellitus visits a healthcare clinic. The client's diabetes mellitus previously had been well controlled with glyburide daily, but recently the fasting blood glucose level has been 180 mg/dL to 200 mg/dL (10.2 mmol/L to 11.4 mmol/L). Which medication, added to the client's regimen, may have contributed to the hyperglycemia?

Prednisone

A client with diabetes mellitus visits the health care clinic. The client previously had been well controlled with glyburide, 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

What is included in the treatment of Addison's disease? Select all that apply.

Prednisone Fludrocortisone

The nurse assists with creating a plan of care for a client with hyperparathyroidism receiving calcitonin-human. Which outcome has the highest priority regarding this medication?

Reaching normal serum calcium levels

A client is in metabolic acidosis caused by diabetic ketoacidosis (DKA). The nurse prepares for the administration of which medication as a primarytreatment for this problem?

Regular insulin

When caring for a client diagnosed with pheochromocytoma, which signs and symptoms should the nurse note? Select all that apply.

Severe headache Profuse diaphoresis Severe hypertension

The nurse reinforces teaching to 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

A primary health care provider has prescribed propylthiouracil 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 and symptoms of hypothyroidism

The nurse is caring for a postoperative adrenalectomy client. Which finding does the nurse specifically monitor for in this client?

Signs and symptoms of hypovolemia

The nurse is caring for a client with type 1 diabetes mellitus who is hyperglycemic. Which problem should the nurse consider first when planning care for this client?

Signs of dehydration

The nurse is caring for a client with hypothyroidism who is overweight. Which food items should the nurse suggest to include in the plan?

Skim milk apples whole-grain bread cereal

A client who is managing diabetes mellitus with insulin injections asks the nurse for information about any necessary changes in her diet to avoid hyperinsulinism. Which diet would be appropriate for the client?

Small frequent meals with protein, fat, and carbohydrates at each meal

A client diagnosed with hyperthyroidism will be taking propylthiouracil. The nurse reinforces medication instructions and determines that the client understands the information if the client states that it is most important to report which symptoms to the primary health care provider?

Sore throat

A client is scheduled for subtotal thyroidectomy. Potassium iodide is prescribed. The nurse understands that which outcome is the therapeutic effect of this medication?

Suppress thyroid hormone production

The nurse is preparing to perform an abdominal assessment on a client. The nurse places the client in which best position to perform the assessment?

The dorsal recumbent position

A client who exhibits fatigue, lack of energy, constipation, and depression is diagnosed with hypothyroidism. The primary health care provider prescribes levothyroxine. To increase the likelihood of medication compliance in the early course of treatment, the nurse plans to reinforce which information?

The full therapeutic effect may take 1 to 3 weeks

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 regarding the hoarseness should the nurse make?

The hoarseness is normal and will gradually subside.

The nurse is collecting data from a client with type 2 diabetes mellitus. Which statement by the client indicates an understanding of the medication regimen?

The medication that I am taking helps release the insulin I already make

Thyroid replacement therapy is prescribed for a client diagnosed with hypothyroidism. The client asks the nurse when the medication will no longer be needed. Which response by the nurse would be accurate?

The medication will need to be continued for life

The nurse reviews the nursing care plan of an older client with diabetic neuropathy of the lower extremities as a result of type 2 diabetes mellitus. The nurse plans care knowing that which problem has the highest priority for this client?

The possibility of injury as a result of decreased sensation in the legs and feet

The nurse is discussing foot care with a diabetic client and the spouse. The nurse includes which instruction during this informational session?

The toenails should be cut straight across

Somatrem is administered to a client with pituitary dwarfism. Which is the expected therapeutic effect of this medication?

To stimulate linear growth

Glucagon hydrochloride injection would most likely be prescribed for which disorder?

Type 1 diabetes mellitus

The nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which action performed by the client indicates the need for further teaching?

Withdraws the NPH insulin first

A client who will undergo thyroidectomy at a later date has been started on medication therapy with potassium iodide As the licensed practical nurse (LPN) prepares to administer a scheduled dose, the client states that there is a burning sensation and a brassy taste in the mouth. Which action should the LPN take?

Withhold the medication and notify the RN.

A client with pheochromocytoma is scheduled for surgery and says to the nurse, "I'm not sure that surgery is the best thing to do." Which response by the nurse is appropriate?

You have concerns about the surgical treatment for your condition?

The nurse is caring for a client newly diagnosed with diabetes mellitus. The client asks the nurse whether eating at a restaurant will affect the diabetic control and whether this is allowed. Which nursing response is appropriate?

You should order a half-portion meal and have fresh fruit for dessert

A client with a partial right adrenalectomy is placed on corticosteroid replacement therapy. Which data would indicate that the client is experiencing an adverse effect related to the pharmacological treatment?

Tarry stools

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 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 primary health care provider (PHCP) notification?

I am urinating a lot

The nurse is reinforcing discharge teaching to 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

Prednisone 10 mg orally daily has been prescribed for a client. The nurse provides instructions to the client regarding the medication. Which statement by the client indicates that further teaching is needed?

I can take acetylsalicylic acid (aspirin) or my antihistamine if I need it

The home care nurse visits a client at home who has been prescribed prednisone 5 mg orally daily. The nurse reinforces teaching for the client about the medication. Which statement made by the client indicates a need for further teaching?

I can take aspirin or my antihistamine if I need it

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 instruction should the nurse include?

Take a blood glucose test before exercising

A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions to the client and should tell the client that which is the most likely time for a hypoglycemic reaction to occur?

6 to 14 hours after administration

A client informs the nurse that she has been taking acarbose as prescribed. The nurse determines that a therapeutic effect of the medication has occurred if which laboratory value is noted?

A 2-hour postprandial serum glucose of 120 mg/dL

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 hospitalized client with severe seborrheic dermatitis is receiving treatments of topical glucocorticoid applications followed by the application of an occlusive dressing. The nurse monitors the client for which systemic effect that can occur as a result of this treatment?

Adrenal suppression

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 mm Hg

A daily dose of prednisone is prescribed for a client. The nurse reinforces instructions to the client regarding administration of the medication and instructs the client to take this medication at which time?

Early morning

Fludrocortisone is prescribed for a client with Addison's disease. The primary health care provider needs to be notified if the client experiences which conditions? Select all that apply.

Edema Chest pain Muscle cramps

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

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

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

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

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 reinforces medication instructions to a client who is taking levothyroxine. The nurse instructs the client to notify the primary health care provider (PHCP) if which sign/symptom occurs?

Tremors

The nurse is reinforcing instructions to a client regarding intranasal desmopressin acetate. The nurse should tell the client that the medication has which side effect?

Runny nose

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 primary health care provider's documentation and would expect to note which diagnosis?

Hyperglycemic hyperosmolar state (HHS)

A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. Following diagnostic studies, diabetes insipidus is diagnosed. Desmopressin acetate is prescribed for the client. What would the nurse explain to the client as the purpose of the medication?

To increase water reabsorption

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 caring for a client after a thyroidectomy and notes that calcium gluconate is prescribed. The nurse determines that this medication has been prescribed for which reason?

Treat hypocalcemic tetany

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

Tremors and double vision

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

Which statement indicates that a client with Addison's disease knows how to safely manage a medication regimen that consists of daily doses of glucocorticoids?

I will need to call my doctor for an increase in medication dose when I'm experiencing a lot of stress

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 primary health care provider if my blood glucose level is consistently greater than 250

The nurse reinforces instructions to a client with myxedema about the dosage, method of administration, and side effects of levothyroxine sodium. Which statement by the client indicates an understanding of the nurse's instructions?

I will report any episodes of palpitations, chest pain, or dyspnea

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

The nurse is assisting in reinforcing a teaching plan for a client given a prescription for pioglitazone. The nurse plans to reinforce instructions to the client about which information related to this medication?

Signs of hypoglycemia

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 primary health care provider (PHCP) prescribes exenatide for a client with type 1 diabetes mellitus who takes insulin. The nurse knows that which is the most appropriateintervention?

The medication is withheld and the PHCP is called to question the prescription for the client

The nurse is collecting data from a client seen in the health care clinic for the first time. When the nurse asks the client about current prescribed medications, the client tells the nurse that metformin is taken daily. Based on this finding, the nurse elicits data from the client regarding the presence of which condition?

Diabetes mellitus

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

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

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

Laryngeal stridor