Endocrine NCLEX prep

A client with type 1 diabetes mellitus calls the nurse to report recurrent episodes of hypoglycemia with exercising. Which statement by the client indicates an adequate understanding of the peak action of NPH insulin and exercise? "I should not exercise since I am taking insulin." "The best time for me to exercise is after breakfast." "The best time for me to exercise is mid- to late afternoon." "NPH is a basal insulin, so I should exercise in the evening."

The best time for me to exercise is after breakfast

The nurse has provided instructions to the client with hyperparathyroidism regarding home care measures to manage the symptoms of the disease. Which statement by the client indicates a need for further instruction? "I should avoid bed rest." "I need to avoid doing any exercise at all." "I need to space activity throughout the day." "I should gauge my activity level by my energy level."

I need to avoid doing any exercise at all

A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client? Hoarseness Hypocalcemia Audible stridor Edema at the surgical site

Audible stridor

A client with type 2 diabetes mellitus is complaining of polydipsia, polyuria, weight loss, and weakness. Laboratory results indicate a blood glucose level of 800 mg/dL (45.7 mmol/L) and nonketosis. The nurse reviews the primary health care provider's documentation and expects to note which diagnosis? Hypoglycemia Pheochromocytoma Diabetic ketoacidosis (DKA) Hyperosmolar hyperglycemic syndrome (HHS)

Hyperosmolar hyperglycemic syndrome (HHS)

A client with diabetes mellitus has a blood glucose level of 50 mg/dL (2.85 mmol/L) and reports feeling hungry and shaky. Which should the nurse provide the client? 3 oz of 2% milk 4 oz of apple juice 2 oz of orange juice A teaspoon of granulated sugar

4 oz of apple juice

A nursing instructor is teaching the class about Addison's disease. The instructor determines that the class understands the disease process if they indicate which are affected in this disease? Select all that apply. Androgens Bicarbonate Electrolytes Glucocorticoids Mineralocorticoids

Androgens Glucocorticoids Mineralcorticoids

The nurse is developing a plan of care for a client with Cushing's syndrome. The nurse documents a client problem of excess fluid volume. Which nursing actions should be included in the care plan for this client? Select all that apply. Monitor daily weight. Monitor intake and output. Assess extremities for edema. Maintain a high-sodium diet. Maintain a low-potassium diet.

Monitor daily weight Monitor intake and output Assess extremities for edema

The nurse is caring for a client with a diagnosis of Addison's disease and is monitoring the client for signs of Addisonian crisis. The nurse should assess the client for which manifestation that would be associated with this crisis? Agitation Diaphoresis Restlessness Severe abdominal pain

Severe abdominal pain

The nurse has provided dietary instructions to a client with a diagnosis of hypoparathyroidism. The nurse should instruct the client that it is acceptable to include which item in the diet? Fish Cereals Vegetables Meat and poultry

Vegetables

A hospitalized client is diagnosed with type 1 diabetes mellitus. The nurse plans care for the client, understanding that which factors are likely causes of the beta cell destruction that accompanies this disorder? Select all that apply. Viruses Genetic factors Autoimmune factors Human leukocyte antigen (HLA) Primary failure of glucagon secretion

Viruses Genetic factors Autoimmune factors Human leukocyte antigen (HLA)

A multidisciplinary health care team is developing a plan of care for a client with hyperparathyroidism. The nurse should include which priority intervention in the plan of care? Describe the use of loperamide. Restrict fluids to 1000 mL per day. Walk down the hall for 15 minutes 3 times a day. Describe the administration of aluminum hydroxide gel.

Walk down the hall for 15 minutes 3 times a day

The nurse teaches a class on foot care for clients diagnosed with diabetes mellitus. Which instructions should the nurse include in the class? Select all that apply. Wear closed-toe shoes. Soak feet in hot water twice a day. Massage lanolin lotion between the toes. Cut toenails straight across and file the edges. Pat feet dry gently, especially between the toes.

Wear closed-toe shoes Cut toenails straight across and file the edges Pat feet dry gently, especially between the toes

The 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 statement is the appropriate response by the nurse? "There is no reason to worry. Your surgeon is wonderful." "I think you are making the right decision to have the surgery." "You are very ill. Your surgeon has made the correct decision." "You have concerns about the surgical treatment for your condition?"

You have concerns about the surgical treatment for your condition?

A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety? Administer a sedative. Convey empathy, trust, and respect toward the client. Ignore the signs and symptoms of anxiety, anticipating that they will soon disappear. Make sure that the client is familiar with the correct medical terms to promote understanding of what is happening.

Convey empathy, trust, and respect toward the client

A client has been diagnosed with hyperthyroidism. The nurse monitors for which signs and symptoms indicating a complication of this disorder? Select all that apply. Fever Nausea Lethargy Tremors Confusion Bradycardia

Fever Nausea Tremors Confusion

The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client reports a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching? "I need to stop my insulin." "I need to increase my fluid intake." "I need to monitor my blood glucose every 3 to 4 hours." "I need to call my primary health care provider (PHCP) because of these symptoms."

I need to stop my insulin

A nurse has provided dietary instructions to a client with Addison's disease. Which statement made by the client indicates that the client understands the instructions? "I will decrease my carbohydrate intake." "High fat intake is essential with this disease." "I will maintain a normal sodium intake in my diet." "I will need to restrict the amount of protein in my diet."

I will maintain a normal sodium intake in my diet

The emergency department nurse is preparing a plan for initial care of a client with a diagnosis of hyperosmolar hyperglycemic syndrome (HHS). The nurse recognizes that the hyperglycemia associated with this disorder results from which occurrence? Increased use of glucose Overproduction of insulin Increased production of glucose Increased osmotic movement of water

Increased production of glucose

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 sign of this complication should be included on the list? Shakiness Increased thirst Profuse sweating Decreased urine output

Increased thirst

A nurse is assessing the status of a client who returned to the surgical nursing unit after a parathyroidectomy procedure. The nurse would place highest priority on which assessment finding? Laryngeal stridor Difficulty voiding Mild incisional pain Absence of bowel sounds

Laryngeal stridor

The nurse has developed a postoperative plan of care for a client who had a thyroidectomy and documents that the client is at risk for developing an ineffective breathing pattern. Which nursing intervention should the nurse include in the plan of care? Maintain a supine position. Monitor neck circumference every 4 hours. Maintain a pressure dressing on the operative site. Encourage deep-breathing exercises and vigorous coughing exercises.

Monitor neck circumference every 4 hours

The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptom or symptoms develop? Select all that apply. Polyuria Shakiness Palpitations Blurred vision Lightheadedness Fruity breath odor

Shakiness Palpitations Lightheadedness

A client's serum blood glucose level is 48 mg/dL (2.74 mmol/L). The nurse would expect to note which as an additional finding when assessing this client? Slurred speech Increased thirst Increased appetite Increased urination

Slurred speech

The nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose level of 70 mg/dL (3.9 mmol/L). Which finding would be the priority concern to the nurse? Pulse Respiration Temperature Blood pressure

Temperature

The nurse is caring for a client after thyroidectomy. The nurse notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed for which purpose? To treat thyroid storm To prevent cardiac irritability To treat hypocalcemic tetany To stimulate release of parathyroid hormone

To treat hypocalcemic tetany

A client with Cushing's syndrome verbalizes concern to the nurse regarding the appearance of the buffalo hump that has developed. Which statement should the nurse make to the client? "Don't be concerned; this problem can be covered with clothing." "Usually these physical changes slowly improve following treatment." "This is permanent, but looks are deceiving and are not that important." "Try not to worry about it; there are other things to be concerned about."

Usually these physical changes slowly improve following treatment

The family of a bedridden client with type 2 diabetes mellitus and chronic kidney disease calls the nurse to report symptoms of headache, polydipsia, and increased lethargy. Which most important question should the nurse ask the family to determine a possible problem? "What is the client's urine output?" "What is the client's capillary blood glucose level?" "Has there been any change in the dietary intake?" "Have you increased the amount of fluids provided?"

What is the client's capillary blood glucose level?

The nurse is caring for a client diagnosed with type 1 diabetes mellitus experiencing the Somogyi effect. Which blood glucose results and treatment would the nurse expect? 0300 blood glucose 68 mg/dL (3.8 mmol/L) and 0700 blood glucose 200 mg/dL (11.1 mmol/L). Instruct to decrease amount of evening insulin. 0300 blood glucose 68 mg/dL (3.8 mmol/L) and 0700 blood glucose 200 mg/dL (11.1 mmol/L). Instruct to increase amount of evening insulin. 0300 blood glucose 190 mg/dL (10.6 mmol/L) and 0700 blood glucose 240 mg/dL (13.3 mmol/L). Instruct to decrease amount of evening insulin. 0300 blood glucose 190 mg/dL (10.6 mmol/L) and 0700 blood glucose 240 mg/dL (13.3 mmol/L). Instruct to increase amount of evening insulin.

0300 blood glucose 68 mg/dL (3.8 mmol/L) and 0700 blood glucose 200 mg/dL (11.1 mmol/L). Instruct to decrease amount of evening insulin.

A client has undergone a 2-hour oral glucose tolerance test (OGTT). Which of the listed glucose levels is compatible with diabetes mellitus at the conclusion of the test? 80 mg/dL (4.57 mmol/L) 110 mg/dL (6.0 mmol/L) 130 mg/dL (7.42 mmol/L) 160 mg/dL (9.14 mmol/L)

160 mg/dL

The nurse is caring for a client with a diagnosis of diabetic ketoacidosis (DKA). Which assessment findings are consistent with this diagnosis? Select all that apply. Polyuria Polydipsia Polyphagia Dry mouth Flushed, dry skin Moist mucous membranes

Polyuria Polydipsia Polyphagia Dry mouth flushed, dry skin

The nurse is performing an assessment on a client with pheochromocytoma. Which assessment data would indicate a potential complication associated with this disorder? A urinary output of 50 mL/hr A coagulation time of 5 minutes A heart rate that is 90 beats per minute and irregular A blood urea nitrogen level of 20 mg/dL (7.1 mmol/L)

A heart rate that is 90 beats per minute and irregular

A client with hypovolemia experiences activation of the renin-angiotensin system to maintain blood pressure. The registered nurse determines that the new nurse understands that what substance is secreted if which statement is made? "Cortisol will be secreted." "Aldosterone will be secreted." "Additional glucagon will be produced." "Adrenocorticotropic hormone production will increase."

Aldosterone will be secreted

A 33-year-old female client is admitted to the hospital with a tentative diagnosis of Graves' disease. Which symptom related to the menstrual cycle would the client be most likely to report during the initial assessment? Amenorrhea Menorrhagia Metrorrhagia Dysmenorrhea

Amenorrhea

The nurse is assessing a client who has a diagnosis of goiter. Which should the nurse expect to note during the assessment of the client? An enlarged thyroid gland The presence of heart damage Client complaints of chronic fatigue Client complaints of slow wound healing

An enlarged thyroid gland

The nurse is reviewing the postoperative prescriptions for a client who had a transsphenoidal hypophysectomy. Which prescription, if noted on the record, would indicate the need for clarification? Assess vital signs and neurological status. Instruct the client to avoid blowing his nose. Apply a loose dressing if any clear drainage is noted. Instruct the client about the need for a MedicAlert bracelet.

Apply a loose dressing if any clear drainage is noted

A client with diabetes mellitus who takes insulin is seen in the health care clinic. The client tells the clinic nurse that after the insulin injection, the insulin seems to leak through the skin. The nurse would appropriately determine the problem by asking the client which question? "Are you rotating the injection site?" "Are you aspirating before you inject the insulin?" "Are you using a 1-inch needle to give the injection?" "Are you placing an air bubble in the syringe before injection?"

Are you rotating the injection site?

After hypophysectomy, a client complains of being thirsty and having to urinate frequently. What is the initial nursing action? Increase fluid intake. Document the complaints. Assess for urinary glucose. Assess urine specific gravity.

Assess urine specific gravity

A client received 5 units of insulin aspart subcutaneously just before eating lunch at 12:00 p.m. The nurse should assess the client for a hypoglycemic reaction at which times? Between 1:00 and 3:00 p.m. 10 minutes after administration Between 4:00 p.m. and 12:00 a.m. Between 8:00 and 10:00 p.m.

Between 1:00 and 3:00 p.m.

The emergency department nurse is reviewing the laboratory test results for a client suspected of having diabetic ketoacidosis (DKA). Which laboratory result should the nurse expect to note in this disorder? Serum pH of 9.0 Absent ketones in the urine Serum bicarbonate of 22 mEq/L (22 mmol/L) Blood glucose level of 500 mg/dL (28.5 mmol/L)

Blood glucose level of 500 mg/dL

A client is admitted to the hospital with a diagnosis of pheochromocytoma. The nurse would check which item to detect the primary manifestation of this disorder? Weight Urine ketones Blood pressure Skin temperature

Blood pressure

The nurse is caring for a client scheduled for a transsphenoidal hypophysectomy. The preoperative teaching instructions should include which statement? "Your hair will need to be shaved." "You will receive spinal anesthesia." "You will need to ambulate after surgery." "Brushing your teeth needs to be avoided for at least 2 weeks after surgery."

Brushing your teeth needs to be avoided for at least 2 weeks after surgery

The nurse is performing an assessment on a client with a diagnosis of hyperthyroidism. Which assessment finding should the nurse expect to note in this client? Dry skin Bulging eyeballs Periorbital edema Coarse facial features

Bulging eyeballs

The nurse caring for a client who underwent intracranial surgery is suspected of having diabetes insipidus. Which finding noted by the nurse is consistent with this complication of surgery? Complaints of excessive thirst Urine specific gravity of 1.030 Urine output of 10 to 15 mL/hour Systolic blood pressures running consistently over 150 mm Hg

Complaints of excessive thirst

A client who visits the primary health care provider's office for a routine physical examination reports new onset of intolerance to cold. Knowing that this is a frequent complaint associated with hypothyroidism, the nurse should check for which manifestations? Weight loss and thinning skin Complaints of weakness and lethargy Diaphoresis and increased hair growth Increased heart rate and respiratory rate

Complaints of weakness and lethargy

The nurse is providing instructions regarding home care measures to a client with diabetes mellitus and instructs the client about the causes of hypoglycemia. The nurse determines that additional instruction is needed if the client identifies which as a cause of hypoglycemia? Omitted meals Increased intensity of activity Decreased daily insulin dosage Inadequate amount of fluid intake

Decreased daily insulin dosage

A nurse is caring for a client who had a thyroidectomy 1 day ago. Which client laboratory data should the nurse identify as a possible complication of thyroid surgery? Increased serum sodium level Increased serum glucose level Decreased serum calcium level Decreased serum albumin level

Decreased serum calcium level

The nurse is providing dietary instructions to help with diabetes control for a client newly diagnosed with diabetes mellitus who will be taking insulin. The nurse should provide the client with which best instruction? Eat meals at approximately the same time each day. Adjust mealtimes depending on blood glucose levels. Vary mealtimes if insulin is not administered at the same time every day. Avoid being concerned about the time of meals as long as snacks are taken on time.

Eat meals at approximately the same time each day

The nurse has documented the problem of body image distortion for a client with a diagnosis of Cushing's syndrome. The nurse identifies nursing interventions related to this problem and includes these interventions in the plan of care. Which nursing intervention is inappropriate? Encourage the client's expression of feelings. Assess the client's understanding of the disease process. Encourage family members to share their feelings about the disease process. Encourage the client to recognize that the body changes need to be dealt with.

Encourage the client to recognize that the body changes need to be dealt with

The nurse is admitting a client diagnosed with pheochromocytoma. The client is complaining of a pounding headache and palpitations and the blood pressure is 170/90 mm Hg. The nurse is aware that which substance is responsible for these clinical manifestations? Cortisol Androgens Aldosterone Epinephrine

Epinephrine

A young man with type 1 diabetes mellitus tells the nurse that he might lose his job because he has been having frequent hypoglycemic reactions. His boss thinks that he is drunk during these episodes and that he has been drinking on the job. Which action by the nurse would best assist this client to meet his needs? Ask the client if he indeed has been drinking at work. Ask the client what he does to treat his hypoglycemia. Contact the local employment office to help him find another job. Examine factors with the client that may be causing frequent hypoglycemic episodes.

Examine factors with the client that may be causing frequent hypoglycemic episodes

A client arrives in the hospital emergency department in an unconscious state. As reported by the spouse, the client has diabetes mellitus and began to show symptoms of hypoglycemia. A blood glucose level is obtained for the client, and the result is 40 mg/dL (2.28 mmol/L). Which medication should the nurse anticipate will be prescribed for the client? Glucagon Glyburide Metformin Regular insulin

Glucagon

A nurse is caring for a client with a dysfunctional thyroid gland and is concerned that the client will exhibit a sign of thyroid storm. Which is an early indicator of this complication? Bradycardia Constipation Hyperreflexia Low-grade temperature

Hyperreflexia

A client has been diagnosed with pheochromocytoma. Which clinical manifestation is most indicative of this condition? Water loss Bradycardia Hypertension Decreased cardiac output

Hypertension

A client with a diagnosis of addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional health care team focus on? Select all that apply. Hypotension Leukocytosis Hyperkalemia Hypercalcemia Hypernatremia

Hypotension Hyperkalemia

A client has begun medication therapy with propylthiouracil. The nurse should assess the client for which condition as an adverse effect of this medication? Joint pain Renal toxicity Hyperglycemia Hypothyroidism

Hypothyroidism

A client's serum blood glucose level is 389 mg/dL (22.2 mmol/L). The nurse would expect to note which as an additional finding when assessing this client? Unsteady gait Slurred speech Increased thirst Cold, clammy skin

Increased thirst

The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which prescriptions should the nurse anticipate receiving? Select all that apply. Initiate an infusion of 3% NaCl. Administer intravenous furosemide. Restrict fluids to 800 mL over 24 hours. Elevate the head of the bed to high-Fowler's. Administer a vasopressin antagonist as prescribed.

Initiate an infusion of 3% NaCl Restrict fluids to 800 mL over 24 hours Administer a vasopressin antagonist as prescribed

The nurse should include which interventions in the plan of care for a client with hypothyroidism? Select all that apply. Provide a cool environment for the client. Instruct the client to consume a high-fat diet. Instruct the client about thyroid replacement therapy. Encourage the client to consume fluids and high-fiber foods in the diet. Inform the client that iodine preparations will be prescribed to treat the disorder. Instruct the client to contact the primary health care provider (PHCP) if episodes of chest pain occur.

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

A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperosmolar hyperglycemic syndrome is made. The nurse would immediately prepare to initiate which anticipated primary health care provider's prescription? Endotracheal intubation 100 units of NPH insulin Intravenous infusion of normal saline Intravenous infusion of sodium bicarbonate

Intravenous infusion of normal saline

A client with a recent history of total thyroidectomy has developed iatrogenic hypoparathyroidism. Which observed findings does the nurse determine are associated with the hypoparathyroidism? Select all that apply. Laryngospasm Nephrolithiasis Muscle weakness Positive Chvostek's sign Positive Trousseau's sign

Laryngospasm Positive Chvostek's sign Positive Trousseau's sign

The nurse is monitoring a client diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy and is recovering in the intensive care unit. Which findings should alert the nurse to the presence of a possible postoperative complication? Select all that apply. Anxiety Leukocytosis Chvostek's sign Urinary output of 800 mL/hr Clear drainage on nasal dripper pad

Leukocytosis Urinary output of 800 mL/hr Clear drainage on nasal dripper pad

A client is admitted to an emergency department, and a diagnosis of myxedema coma is made. Which action should the nurse prepare to carry out initially? Warm the client. Maintain a patent airway. Administer thyroid hormone. Administer fluid replacement.

Maintain a patent airway

The nurse is caring for a client with a diagnosis of Cushing's syndrome. Which expected signs and symptoms should the nurse monitor for? Select all that apply. Anorexia Dizziness Weight loss Moon face Hypertension Truncal obesity

Moon face Hypertension Truncal obesity

The nurse is providing education to a client with type 2 diabetes mellitus. The nurse explains in layperson's language the physiological mechanism behind hypoglycemia. Which response by the client determines that teaching has been successful? "My body cannot make insulin." "My body has decreased epinephrine levels." "My body decreases release of cortisol, which is a stress hormone." "My body increases glucagon production to fight low blood sugars."

My body increases glucagon production to fight low blood sugars

A client with Graves' disease has exophthalmos and is experiencing photophobia. Which nursing action would best assist the client with these manifestations? Obtain dark glasses for the client. Lubricate the eyes with tap water every 2 to 4 hours. Administer methimazole every 8 hours around the clock. Instruct the client to avoid straining or heavy lifting because this effort can increase eye pressure.

Obtain dark glasses for the client

The nurse caring for a client with a diagnosis of hypoparathyroidism reviews the laboratory results of blood tests for this client and notes that the calcium level is extremely low. The nurse should expect to note which finding on assessment of the client? Unresponsive pupils Positive Trousseau's sign Negative Chvostek's sign Hyperactive bowel sounds

Positive Trousseau's sign

A client with diabetes mellitus has been instructed in the dietary exchange system. The client asks the nurse if bacon is allowed in the diet. Which nursing response is most appropriate? "Bacon is not allowed." "Bacon is much too high in fat." "Bacon may be eaten if you eliminate 1 meat item from your diet." "One strip of bacon may be eaten if you eliminate 1 teaspoon of butter."

One strip of bacon may be eaten if you eliminate 1 teaspoon of butter

A client's laboratory results indicate the serum calcium is 12 mg/dL (3 mmol/L) and the serum phosphorous is 2.1 mg/dL (0.697 mmol/L). Based on these findings, the nurse suspects imbalance of which hormone? Thyroid hormone Parathyroid hormone Follicle-stimulating hormone Adrenocorticotropic hormone

Parathyroid hormone

A nurse is assessing the glycemic status of a client with diabetes mellitus. Which sign or symptom would indicate that the client is developing hyperglycemia? Polyuria Diaphoresis Hypertension Increased pulse rate

Polyuria

The nurse is completing an assessment on a client who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which client complaint would be characteristic of this disorder? Select all that apply. Polyuria Headache Bone pain Nervousness Weight gain

Polyuria Bone Pain

The nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose level of 120 mg/dL (6.8 mmol/L), temperature of 101º F (38.3º C), pulse of 102 beats/minute, respirations of 22 breaths/minute, and blood pressure of 142/72 mm Hg. Which finding would be the priority concern to the nurse? Pulse Respiration Temperature Blood pressure

Temperature

The nurse is caring for a client admitted to the hospital with uncontrolled type 1 diabetes mellitus. In the event that diabetic ketoacidosis (DKA) does occur, the nurse anticipates that which medication would most likely be prescribed? Glucagon Glyburide Regular insulin Neutral protamine Hagedorn (NPH) insulin

Regular insulin

A client with type 1 diabetes mellitus is to begin an exercise program, and the nurse is providing instructions regarding the program. Which instruction should the nurse include in the teaching plan? Try to exercise before mealtimes. Administer insulin after exercising. Take a blood glucose test before exercising. Exercise is best performed during peak times of insulin.

Take a blood glucose test before exercising

A client with diabetes mellitus is being discharged following treatment for hyperosmolar hyperglycemic syndrome (HHS) precipitated by acute illness. The client tells the nurse, "I will call the primary health care provider (PHCP) the next time I can't eat for more than a day or so." Which statement reflects the most appropriate analysis of this client's level of knowledge? The client needs immediate education before discharge. The client requires follow-up teaching regarding the administration of oral antidiabetics. The client's statement is inaccurate, and he or she should be scheduled for outpatient diabetic counseling. The client's statement is inaccurate, and he or she should be scheduled for educational home health visits.

The client needs immediate education before discharge

The nurse is interviewing a client with type 2 diabetes mellitus who is taking a sulfonylurea. Which statement by the client indicates an understanding of this treatment for this disorder? "I take oral insulin instead of shots." "By taking this medication, I am able to eat more." "When I become ill, I need to increase the number of pills I take." "The medications I'm taking help release the insulin I already make."

The medications I'm taking help release the insulin I already make

The nurse is preparing to care for a client after parathyroidectomy. The nurse should plan for which action for this client? Maintain an endotracheal tube for 24 hours. Administer a continuous mist of room air or oxygen. Place the client in a flat position with the head and neck immobilized. Use only a rectal thermometer for temperature measurement.

Administer a continuous mist of room air or oxygen

A client has returned to the nursing unit after a thyroidectomy. The nurse notes that the client is complaining of tingling sensations around the mouth, fingers, and toes. On the basis of these findings, the nurse should next assess the results of which serum laboratory study? Sodium Calcium Potassium Magnesium

Calcium

The nurse is preparing a client with a new diagnosis of hypothyroidism for discharge. The nurse determines that the client understands discharge instructions if the client states that which signs and symptoms are associated with this diagnosis? Select all that apply. Tremors Weight loss Feeling cold Loss of body hair Persistent lethargy Puffiness of the face

Feeling cold Loss of body hair Persistent lethargy Puffiness of the face

The clinic nurse is providing instructions to a client with diabetes mellitus about the signs and symptoms of hypoglycemia. The nurse should tell the client that which would be noted in a hypoglycemic reaction? Thirst Hunger Polydipsia Increased urine output

Hunger

The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The nurse places priority on which client problem? Lack of knowledge Inadequate fluid volume Compromised family coping Inadequate consumption of nutrients

Inadequate fluid volume

The nurse is providing instructions regarding insulin administration for a client newly diagnosed with diabetes mellitus. The primary health care provider has prescribed a mixture of NPH insulin and regular insulin. The nurse should instruct the client that which is the first step in this procedure? Draw up the correct dosage of NPH insulin into the syringe. Draw up the correct dosage of regular insulin into the syringe. Inject air equal to the amount of NPH insulin prescribed into the vial of NPH insulin. Inject air equal to the amount of regular insulin prescribed into the vial of regular insulin.

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

A client has abnormal amounts of circulating thyronine (T3) and thyroxine (T4). While obtaining the health history, the nurse asks the client about dietary intake. Lack of which dietary element is most likely the cause? Iodine Calcium Phosphorus Magnesium

Iodine

A client newly diagnosed with diabetes mellitus is instructed by the primary health care provider to obtain glucagon for emergency home use. The client asks a home care nurse about the purpose of the medication. What is the nurse's best response to the client's question? "It will boost the cells in your pancreas if you have insufficient insulin." "It will help to promote insulin absorption when your glucose levels are high." "It is for the times when your blood glucose is too low from too much insulin." "It will help to prevent lipoatrophy from the multiple insulin injections over the years."

It is for the times when your blood glucose is too low from too much insulin

A nurse is reviewing the assessment findings for a client who was admitted to the hospital with a diagnosis of diabetes insipidus. The nurse understands that which manifestations are associated with this disorder? Select all that apply. Polyuria Polydipsia Concentrated urine Complaints of excessive thirst Specific gravity lower than 1.005

Polyuria Polydipsia Complaints of excessive thirst Specific gravity lower than 1.005

A client newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. A nurse prepares a discharge teaching plan regarding the insulin and plans to reinforce which concept? Always keep insulin vials refrigerated. Ketones in the urine signify a need for less insulin. Increase the amount of insulin before excessive exercise. Systematically rotate insulin injections within 1 anatomical site.

Systematically rotate insulin injections within 1 anatomical site

A nurse is performing an admission assessment on a client with a diagnosis of pheochromocytoma. The nurse should assess for the major sign associated with pheochromocytoma by performing which action? Obtaining the client's weight Taking the client's blood pressure Testing the client's urine for glucose Palpating the skin for its temperature

Taking the client's blood pressure

The nurse is caring for a client after hypophysectomy and notes clear nasal drainage from the client's nostril. The nurse should take which initial action? Lower the head of the bed. Test the drainage for glucose. Obtain a culture of the drainage. Continue to observe the drainage.

Test the drainage for glucose

The nurse is providing home care instructions to the client with a diagnosis of Cushing's syndrome and prepares a list of instructions for the client. Which instructions should be included on the list? Select all that apply. The signs and symptoms of hypoadrenalism The signs and symptoms of hyperadrenalism Instructions to take the medications exactly as prescribed The importance of maintaining regular outpatient follow-up care A reminder to read the labels on over-the-counter medications before purchase

The signs and symptoms of hypoadrenalism The signs and symptoms of hyperadrenalism Instructions to take the medications exactly as prescribed The importance of maintaining regular outpatient follow-up care

A client with type 2 diabetes mellitus has a blood glucose level greater than 600 mg/dL (34.3 mmol/L) and is complaining of polydipsia, polyuria, weight loss, and weakness. The nurse reviews the primary health care provider's documentation and expects to note which diagnosis? Hypoglycemia Pheochromocytoma Diabetic ketoacidosis (DKA) Hyperosmolar hyperglycemic syndrome (HHS)

Hyperosmolar hyperglycemic syndrome (HHS)

The primary health care provider prescribes a 24-hour urine collection for vanillylmandelic acid (VMA). The community health nurse visits the client at home and instructs the client in the procedure for the collection of the urine. Which statement, if made by the client, would indicate a need for further instruction? "I can take medication if I need to during the collection." "When I start the collection, I will urinate and discard that specimen." "I will pour the urine in the collection bottle each time I urinate and refrigerate the urine." "I will start the collection in 2 days. Starting now, I cannot eat or drink any tea, chocolate, vanilla, or fruit until the test is completed."

I can take medication if I need to during the collection

The nurse has provided home care measures to the client with diabetes mellitus regarding exercise and insulin administration. Which statement by the client indicates a need for further instruction? "I should always wear a MedicAlert bracelet." "I should perform my exercise at peak insulin time." "I should always carry a quick-acting carbohydrate when I exercise." "I should avoid exercising at times when a hypoglycemic reaction is likely to occur."

I should perform my exercises at peak insulin time

Which findings should raise suspicion to the nurse that a head-injured client may be experiencing diabetes insipidus? Select all that apply. Urine specific gravity is 1.001. Ketones are present in the urine. Jugular venous distention is observed. Serum osmolality is 320 mOsm/kg (320 mmol/kg) of water. Blood glucose levels are greater than 200 mg/dL (11.4 mmol/L). Urine output has increased from 1000 mL in 24 hours to 4000 mL in 24 hours.

Urine specific gravity is 1.001 Serum osmolality is 320 mOsm/kg of water Urine output has increased from 1000 mL in 24 hours to 4000 mL in 24 hours.

The nurse is caring for a client with Addison's disease. The client asks the nurse about the risks associated with this disease, specifically about addisonian crisis. Regarding prevention of this complication, how should the nurse inform the client? "You can take either hydrocortisone or fludrocortisone for replacement." "You need to take your fludrocortisone 3 times a day to prevent a crisis." "You need to increase salt in your diet, particularly during stressful situations." "You need to decrease your dosages of glucocorticoids and mineralocorticoids during stressful situations."

You need to increase salt in your diet, particularly during stressful situations

The nurse provides dietary instructions to a client with diabetes mellitus regarding the prescribed diet. Which statement, if made by the client, indicates a need for further teaching? "I'll eat a balanced meal plan." "I need to drink diet soft drinks." "I'll snack on fruit instead of cake." "I need to purchase special dietetic foods."

I need to purchase special dietetic foods

The nurse caring for a male client newly admitted to the hospital with a diagnosis of pneumonia suspects that the client is also at risk for metabolic syndrome if which characteristics have been identified in this client? Select all that apply. Hemoglobin A1C of 6.5% Waist circumference of 36 inches Triglycerides 160 mg/dL (1.81 mmol/L) Consistent systolic blood pressures <130 mm Hg Serial fasting glucose levels of 120 mg/dL (6.85 mmol/L), 132 mg/dL (7.54 mmol/L), and 128 mg/dL (7.31 mmol/L)

Hemoglobin A1C of 6.5% Triglycerides 160 mg/dL Serial fasting glucose levels of 120 mg/dL, 132 mg/dL, and 128 mg/dL

A nurse is reviewing the assessment findings and laboratory data for a client with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The nurse understands that which symptoms are associated characteristics of this disorder? Select all that apply. Hypernatremia Signs of water deficit High urine osmolality Low serum osmolality Hypotonicity of body fluids Continued release of antidiuretic hormone (ADH)

High urine osmolality Low serum osmolality Hypotonicity of body fluids Continued release of antidiuretic hormone (ADH)

The home care nurse visits a client with a diagnosis of hyperparathyroidism who is taking furosemide and provides dietary instructions to the client. Which statement by the client indicates a need for additional instruction? "I need to eat foods high in potassium." "I need to drink at least 2 to 3 L of fluid daily." "I need to eat small, frequent meals and snacks if nauseated." "I need to increase my intake of dietary items that are high in calcium."

I need to increase my intake of dietary items that are high in calcium

The nurse is providing discharge instructions to a client who has Cushing's syndrome. Which client statement indicates that instructions related to dietary management are understood? "I will need to limit the amount of protein in my diet." "I should eat foods that have a lot of potassium in them." "I am fortunate that I can eat all of the salty foods I enjoy." "I am fortunate that I do not need to follow any special diet."

I should eat foods that have a lot of potassium in them

A nurse is providing home care instructions to a client with a diagnosis of Addison's disease. Which statement by the client indicates a need for further instruction? "I need to wear a MedicAlert bracelet." "I need to purchase a travel kit that contains cortisone." "I will need to take daily medications until my symptoms decrease." "I need an increased dose of glucocorticoid medication during stressful minor illnesses."

I will need to take daily medications until my symptoms decrease

The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client makes which statement? "I will stop taking my insulin if I'm too sick to eat." "I will decrease my insulin dose during times of illness." "I will adjust my insulin dose according to the level of glucose in my urine." "I will notify my primary health care provider (PHCP) if my blood glucose level is higher than 250 mmol/L."

I will notify my primary health care provider (PHCP) if my blood glucose level is higher than 250 mmol/L

A client arrives in the hospital emergency department complaining of severe thirst and polyuria. The client tells the nurse that she has a history of diabetes mellitus. A blood glucose level is drawn, and the result is 685 mg/dL (39.1 mmol/L). Which intervention should the nurse anticipate to be prescribed initially for the client? Glyburide via the oral route Glucagon via the subcutaneous route Insulin aspart via the subcutaneous route Regular insulin via the intravenous (IV) route

Regular insulin via the intravenous route

The nurse is preparing for a client's postoperative return to the unit after a parathyroidectomy procedure. The nurse should ensure that which piece of medical equipment is at the client's bedside? Cardiac monitor Tracheotomy set Intermittent gastric suction device Underwater seal chest drainage system

Tracheotomy set

A nurse is assigned to care for a client with type 1 diabetes mellitus. During the shift, the nurse should monitor for which manifestation as a sign of hypoglycemia? Tremors Anorexia Hot, dry skin Muscle cramps

Tremors

The nurse is caring for a client after thyroidectomy. The client expresses concern about the postoperative voice hoarseness she is experiencing and asks if the hoarseness will subside. The nurse should provide the client with which information? It indicates nerve damage. The hoarseness is permanent. It is normal during this time and will subside. It will worsen before it subsides, which may take 6 months.

It is normal during this time and will subside

The home care nurse is visiting a client newly diagnosed with diabetes mellitus. The client tells the nurse that he is planning to eat dinner at a local restaurant this week. The client asks the nurse if eating at a restaurant will affect diabetic control and if this is allowed. Which nursing response is most appropriate? "You are not allowed to eat in restaurants." "You should order a half-portion meal and have fresh fruit for dessert." "If you plan to eat in a restaurant, you need to skip the lunchtime meal." "You should increase your daily dose of insulin by half on the day that you plan to eat in the restaurant."

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

The nurse in a health care clinic is reviewing the record of a client with diabetes mellitus who was just seen by the primary health care provider (PHCP). The nurse notes that the PHCP has prescribed acarbose. Which preexisting disorder, if noted in the client's record, would indicate a contraindication to the use of this medication? Hypothyroidism Renal insufficiency Arterial insufficiency Coronary artery disease

Renal insufficiency

The nurse is assessing the learning readiness of a client newly diagnosed with diabetes mellitus. Which behavior indicates to the nurse that the client is not ready to learn? The client asks if the spouse may attend the teaching session. The client asks appropriate questions about what will be taught. The client asks for written materials about diabetes mellitus before class. The client complains of fatigue whenever the nurse plans a teaching session.

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