Endocrine PrepU

A client has been newly diagnosed with acute pancreatitis and admitted to the acute medical unit. How should the nurse explain the pathophysiology of this client's health problem?

"The enzymes that your pancreas produces have damaged the pancreas itself."

A client seeks medical attention for new onset of weight loss and heat intolerance. Which additional statements indicate to the nurse that the client is experiencing hyperthyroidism? Select all that apply.

"I switched from knitting to glue projects since I have developed tremors in my hands." "Even sitting still, sometimes it feels like my heart is racing." "My children tell me that my eyes appear to be bigger, almost buldging, particularly when I tell them to do the dishes."

The nurse instructs the client with diabetes on self-care during days of illness. Which client statement indicates that teaching has been effective? Select all that apply.

"I will increase my intake of fluids." "I will test my blood sugar level every 3 to 4 hours." "I will call the doctor if I have vomiting or diarrhea." "I will eat soft foods if I cannot tolerate regular food."

Which of the following is considered a late symptom of hypothyroidism?

Cold intolerance

A client is admitted with diabetic ketoacidosis (DKA). Which order from the physician should the nurse implement first?

Infuse 0.9% normal saline solution 1 L/hr for 2 hours.

A client has ascites. Which of the following interventions would the nurse prepare to assist with implementing to help the client control this condition? Select all that apply.

Instructing the client to remove salty and salted foods from the diet Administering prescribed spironolactone (Aldactone) Assisting with placement of a transjugular intrahepatic portosystemic shunt

A nurse cares for a client with a disorder of the endocrine function of the pancreas. Which hormones or enzymes may be impacted by this disorder? Select all that apply.

Insulin Glucagon Somatostatin

When caring for a client with hepatitis B, the nurse should monitor closely for the development of which finding associated with a decrease in hepatic function?

Irritability and drowsiness

A client recovering from a cholecystectomy has decreased breath sounds bilaterally in the lower lobes. Which action(s) will the nurse take to improve the client's respiratory function? Select all that apply.

Splint the affected area. Raise the head of the bed. Assist to ambulate as prescribed. Deep breathe and cough every hour. Use the incentive spirometer as instructed.

The nurse is planning care for a client with Cushing syndrome. Which complications will the nurse monitor for in this client? Select all that apply.

Fluid balance Sodium intake Risk for infection Potential for injury Body image changes

Increased appetite and thirst may indicate that a client with chronic pancreatitis has developed diabetes mellitus. Which of the following explains the cause of this secondary diabetes?

Dysfunction of the pancreatic islet cells

A client with severe acute pancreatitis has been on nothing by mouth status for two days. Which nutrition will the nurse expect to be prescribed for this client?

Enteral feedings

A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

Tetany

A client has a decreased level of thyroid hormone being excreted. What will the feedback loop do to maintain the level of thyroid hormone required to maintain homeostatic stability?

Stimulate more hormones using the negative feedback system

Which of the following factors would a nurse identify as a most likely cause of diabetic ketoacidosis (DKA) in a client with diabetes?

The client has eaten and has not taken or received insulin.

Which of the following insulins are used for basal dosage?

Glargine (Lantus)

A nurse should expect a client with hypothyroidism to report:

puffiness of the face and hands.

A client with cholelithiasis has a gallstone lodged in the common bile duct. When assessing this client, the nurse expects to note:

yellow sclerae.

A patient has been diagnosed with Cushing's syndrome. The nurse would expect which of the following features to be present upon physical examination? Select all that apply.

"Buffalo hump" Thin extremities "Moon face" Truncal obesity Purple striae

What pharmacologic therapy does the nurse anticipate administering when the patient is experiencing thyroid storm? (Select all that apply.)

Acetaminophen Iodine Propylthiouracil Dexamethasone (Decadron)

Which of the following hormones controls secretion of adrenal androgens?

Adrenocorticotropic hormone (ACTH)

A patient has been placed on corticosteroid therapy for an Addison's disease. The nurse should be aware of which of the following side effects with this type of therapy? Select all that apply.

Hypertension Alterations in glucose metabolism Poor wound healing

Which of the following is a risk factor for the development of diabetes mellitus? Select all that apply.

Hypertension Obesity Family history Age greater than 45 years or older History of gestational diabetes

Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis?

Hypokalemia and hypoglycemia

A patient is admitted to the hospital with possible cholelithiasis. What diagnostic test of choice will the nurse prepare the patient for?

Ultrasonography

Following diagnostic testing, a patient requires a cholecystectomy. This surgical procedure would be categorized as which of the following?

Urgent

The nurse understands that a client with diabetes mellitus is at greater risk for developing which of the following complications?

Urinary tract infections

What does the nurse recognize as clinical manifestations consistent with ascites? Select all that apply.

increased abdominal girth rapid weight gain visible distended veins stretch marks

A client with Cushing syndrome is admitted to the hospital. During the initial assessment, the client tells the nurse, "The worst thing about this disease is how awful I look. I want to cry every time I look in the mirror." Which statements by the nurse is the best response?

"If treated successfully, the major physical changes will disappear with time."

A nurse prepares teaching for a client with newly-diagnosed diabetes. Which statements about the role of insulin will the nurse include in the teaching? Select all that apply.

"Insulin permits entry of glucose into the cells of the body." "Insulin promotes synthesis of proteins in various body tissues." "Insulin promotes the storage of fat in adipose tissue."

Which type of cell secretes glucagon and promotes gluconeogenesis?

Alpha

What concepts does the nurse understand about gerontologic considerations related to acute pancreatitis? Select all that apply.

As the client ages, there is an increased mortality rate for acute pancreatitis. As the client ages, there is an increased risk for the development of multiple organ dysfunction syndrome. As the client ages, the pattern of complications related to acute pancreatitis changes.

Hypophysectomy is the treatment of choice for which endocrine disorder?

Cushing syndrome

The nurse is caring for a client suspected of having stones that have collected in the common bile duct. What test should the nurse prepare the client for that will locate these stones?

Endoscopic retrograde cholangiopancreatography (ERCP)

A client is given a diagnosis of hepatic cirrhosis. The client asks the nurse what findings led to this determination. Which of the following clinical manifestations would the nurse correctly identify? Select all that apply.

Enlarged liver size Ascites Hemorrhoids

The nurse is caring for a client who has ascites as a result of hepatic dysfunction. What intervention can the nurse provide to determine if the ascites is increasing? Select all that apply.

Measure urine output every 8 hours. Measure abdominal girth daily. Perform daily weights.

A client with diabetes is attending a class on the prevention of associated diseases. What action should the nurse teach the client to reduce the risk of osteomyelitis?

Monitor and control blood glucose levels.

A client is admitted to the hospital with acute hemorrhage from esophageal varices. What medication should the nurse anticipate administering that will reduce pressure in the portal venous system and control esophageal bleeding?

Octreotide

The nurse is caring for a client at risk for an Addisonian crisis. For what associated signs and symptoms should the nurse monitor the client? Select all that apply.

Pallor Rapid respiratory rate Hypotension

On assessment of a patient with early-stage hypothyroidism, the nurse practitioner assesses for a vague yet significant sign which is:

Paresthesia

A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level?

Rapid, thready pulse

A medical-surgical nurse is teaching a client about the health implications of the client's recently diagnosed type 2 diabetes. The nurse should teach the client to be proactive with glycemic control to reduce the risk of what health problem?

Renal failure

Which nursing diagnosis is most appropriate for a client with Addison's disease?

Risk for infection

A client telephones the medical clinic to ask for help with pruritus and a change in stool color. Which additional symptom(s) indicates to the nurse that the client is experiencing gallbladder stones? Select all that apply.

Yellow sclera Dark-colored urine Right shoulder pain

A nurse is preparing a client for endoscopic retrograde cholangiopancreatography (ERCP). The client asks what this test is used for. Which statements by the nurse explains how ERCP can determine the difference between pancreatitis and other biliary disorders? Select all that apply.

"It can evaluate the presence and location of ductal stones and aid in stone removal." "It can assess the anatomy of the pancreas and the pancreatic and biliary ducts." "It can detect unhealthy tissues in the pancreas and assess for abscesses and pseudocysts."

A nurse cares for an older adult client and teaches the client about age-related changes of the biliary tract. What statements will the nurse include when discussing age-related changes that occur in the pancreas of the older adult? Select all that apply.

"The pancreas develops fibrous material with age." "The pancreas develops fatty deposits with age." "The pancreas decreases secretion of enzymes with age." "The pancreas decreases bicarbonate secretion with age."

A client discharged after a laparoscopic cholecystectomy calls the surgeon's office reporting severe right shoulder pain 24 hours after surgery. Which statement is the correct information for the nurse to provide to this client?

"This pain is caused from the gas used to inflate your abdominal area during surgery. Sitting upright in a chair, walking, or using a heating pad may ease the discomfort."

Alcohol, which is toxic to the liver, is a common cause of hepatic disorders. As part of health teaching, the nurse advises a group of women that the amount of daily alcohol use should generally be limited to the equivalent of:

1 drink

Which finding(s) support a diagnosis of ascites?

"swollen belly" distended abdominal veins shortness of breath

A client seeks medical attention for a new onset of mid-back pain that is worse at night when lying supine. Which additional symptom(s) may the nurse use to determine if the client has pancreatic cancer? Select all that apply.

Ascites Jaundice Weight loss Epigastric pain

Which intervention should be included in the plan of care for a client who has undergone a cholecystectomy?

Assessing the color of the sclera every shift

The most common cause of hypothyroidism is which of the following?

Autoimmune thyroiditis

The nurse is preparing an educational session about foot care for clients with diabetes. Which information will the nurse include in the education? Select all that apply.

Check the inside of shoes before putting them on. Check the bottom of the feet with a mirror every day.

A very ill client with acute cholecystitis is scheduled for surgery. The surgeon plans to create an incision in the common bile duct to remove stones. The nurse correctly documents this surgery in the electronic medical record using which term?

Choledochostomy

A patient is having diagnostic testing for suspected hyperthyroidism. Which of the following diagnostics correlate with this endocrine disorder? Select all that apply.

Decrease in serum thyroid-stimulating hormone (TSH) Increased T3 Increased T4 Increase in radioactive iodine uptake

A 25-year-old client comes to the emergency department with excessive bleeding from a cut sustained when cleaning a knife. Blood work shows a prolonged prothrombin time (PT), but a vitamin K deficiency is ruled out. When assessing the client, areas of ecchymosis are noted on other areas of the body. Which of the following is the most plausible cause of the client's signs and symptoms?

Hepatic dysfunction

A client has an elevated serum ammonia concentration and is exhibiting changes in mental status. The nurse should suspect which condition?

Hepatic encephalopathy

A client is brought to the emergency department. The client is a type 2 diabetic and is experiencing hyperglycemic hyperosmolar syndrome (HHS). The nurse should identify what components of HHS? Select all that apply.

Glycosuria Dehydration Hyperglycemia

The nurse is taking a nursing history on a client who has come to the clinic with complaints of fatigue, weight gain, and constipation. The client states, "I'm just depressed." The nurse knows that before the health care provider institutes therapy, the client will receive a full physical assessment for what reason?

Physical conditions such as hypothyroidism can mimic the symptoms of depression.

Nursing care for a client in addisonian crisis should include which intervention?

Placing the client in a private room