Endocrine (Q & A)

The nurse is admitting a client with a diagnosis of Addison's disease. On assessment, the nurse should expect to note which manifestation of this disorder? 1. Peripheral edema 2. High blood pressure 3. Excessive facial hair 4. A low blood glucose level

4. A low blood glucose level

The nurse creates a plan of care for an older client diagnosed with diabetes mellitus. It is important that the nurse plans to complete which action first? 1. Structure menus for adherence to diet. 2. Teach with videotapes showing insulin administration to ensure competence. 3. Encourage dependence on others to prepare the client for the chronicity of the disease. 4. Assess the client's ability to read label markings on syringes and blood glucose monitoring equipment.

4. Assess the client's ability to read label markings on syringes and blood glucose monitoring equipment.

The clinic nurse instructs a client diagnosed with diabetes mellitus about preventing diabetic ketoacidosis on days when the client is feeling ill. Which statement by the client indicates the need for further teaching? 1. "I need to stop my insulin if I am vomiting." 2. "I need to call my doctor if I am ill for more than 24 hours." 3. "I need to eat 10 to 15 g of carbohydrates every 1 to 2 hours." 4. "I need to drink small quantities of fluid every 15 to 30 minutes."

1. "I need to stop my insulin if I am vomiting."

The nurse caring for a client diagnosed with diabetes insipidus should identify which assessment findings as being specifically related to this disorder? 1. Hypotension, decreased pulse pressure, and tachycardia 2. Bounding peripheral pulses, hemodilution, and hypertension 3. Decreased sense of thirst, increased cognition, and hypotension 4. Decreased urine output, poor skin turgor, and moist mucous membranes

1. Hypotension, decreased pulse pressure, and tachycardia

A client is scheduled for an adrenalectomy to remove a pheochromocytoma. What should the nurse most closely monitor in the preoperative period? 1. Vital signs 2. Intake and output 3. Urine glucose and ketones 4. Blood urea nitrogen (BUN)

1. Vital signs

The nurse creates a postoperative plan of care for a client scheduled for a hypophysectomy. Which interventions should be included in the plan of care? Select all that apply. 1. Obtain daily weights. 2. Monitor intake and output. 3. Elevate the head of the bed. 4. Use a soft toothbrush for mouth care. 5. Encourage coughing and deep breathing.

1. Obtain daily weights. 2. Monitor intake and output. 3. Elevate the head of the bed.

The nurse caring for a client diagnosed with diabetic ketoacidosis (DKA) monitors the client for which gastrointestinal signs and symptom(s) that are frequently caused by acidosis? Select all that apply. 1. Melena 2. Diarrhea 3. Constipation 4. Nausea and vomiting 5. Absolute true borborygmi

2. Diarrhea 4. Nausea and vomiting

The nurse planning care for the client diagnosed with aldosteronism should plan to monitor the client for which related complication? 1. Hypoglycemia 2. Fluid overload 3. Urinary retention 4. Gastrointestinal bleeding

2. Fluid overload

The nurse is gathering data from a client newly diagnosed with diabetes mellitus concerning events leading to the client's seeking medical attention. What should the nurse identify as the major signs/symptoms of diabetes mellitus? 1. Dyspepsia, polyuria, and polyphagia 2. Polydipsia, polyuria, and polyphagia 3. Hypoglycemia, polyuria, and dysphagia 4. Hypoglycemia, polyuria, and dysphasia

2. Polydipsia, polyuria, and polyphagia

The nurse is monitoring a client diagnosed with acute hypoparathyroidism for signs of hypocalcemia. Which finding should the nurse note if hypocalcemia is present? 1. Brudzinski's sign 2. Positive Trousseau's sign 3. Negative Chvostek's sign 4. Hypoactive deep tendon reflexes

2. Positive Trousseau's sign

The nurse should plan care for the client diagnosed with diabetes mellitus with consideration for which overall goals? Select all that apply. 1. To reverse the disease entirely 2. To be an active participant in management of the disease 3. To adjust the lifestyle to accommodate the diabetes regimen 4. To experience few or no episodes of hypoglycemic reactions 5. To prevent, minimize, or delay the occurrence of complications

2. To be an active participant in management of the disease 3. To adjust the lifestyle to accommodate the diabetes regimen 4. To experience few or no episodes of hypoglycemic reactions 5. To prevent, minimize, or delay the occurrence of complications

The nurse is performing an assessment of a client with a diagnosis of hypothyroidism. Which of these behaviors, if present in the client's history, would the nurse determine as being likely related to the manifestations of this disorder? 1. Anxiety 2. Irritability 3. Depression 4. Nervousness

3. Depression

A client has a blood glucose level drawn for suspected hyperglycemia. After interviewing the client, the nurse determines that the client ate lunch approximately 2 hours before the blood specimen was drawn. The laboratory reports that the blood glucose is 180 mg/dL (10.2 mmol/L). How should the nurse analyze this result? 1. Normal 2. Lower than the normal value 3. Elevated from the normal value 4. A dangerously high value requiring immediate health care provider notification

3. Elevated from the normal value

The nurse has taught a client diagnosed with hyperaldosteronism about dietary changes needed to manage the condition. The nurse determines that the information presented was understood when the client states that she should decrease which type of foods? 1. Oranges 2. Red meats 3. Salty snacks 4. Whole-grain breads

3. Salty snacks

A client newly diagnosed with diabetes mellitus is admitted to the hospital for evaluation and control of the disease. When analyzing the client's assessment data, what condition should the nurse likely expect to find? 1. Hematuria 2. Weight gain 3. Hypoglycemia 4. Hyperglycemia

4. Hyperglycemia

When planning care for a client diagnosed with myxedema coma, which complication of this disease most commonly results in death? 1. Kidney failure 2. Hepatic failure 3. Pancreatic failure 4. Respiratory failure

4. Respiratory failure

The nurse caring for a client diagnosed with hypoparathyroidism is planning for the client's discharge from the hospital. The nurse should identify which option as a potential psychosocial problem? 1. Potential for skin breakdown due to edema 2. Discomfort due to cold intolerance because of decreased metabolic rate 3. Anxiety due to the need for lifelong dietary interventions to control the disease 4. Constipation due to decreased peristaltic action resulting from a decreased metabolic rate

3. Anxiety due to the need for lifelong dietary interventions to control the disease

A client is admitted to the hospital with a diagnosis of Cushing's syndrome. The nurse monitors the client for which problem that is likely to occur with this diagnosis? 1. Hypovolemia 2. Hypoglycemia 3. Mood disturbances 4. Deficient fluid volume

3. Mood disturbances

The nurse monitors a client diagnosed with uncontrolled diabetes mellitus for hyperglycemia by monitoring for which sign/symptom? Select all that apply. 1. Anuria 2. Tremors 3. Polyuria 4. Polydipsia 5. Diaphoresis

3. Polyuria 4. Polydipsia

A client is diagnosed with diabetes insipidus. The nurse should plan interventions to address which manifestations of this disorder? Select all that apply. 1. Bradycardia 2. Hypertension 3. Poor skin turgor 4. Increased urinary output 5. Dry mucous membranes 6. Decreased pulse pressure

3. Poor skin turgor 4. Increased urinary output 5. Dry mucous membranes 6. Decreased pulse pressure

The nurse should assess the results of which laboratory study to detect an adverse effect associated with a bilateral adrenalectomy? 1. Calcium 2. Creatinine 3. Magnesium 4. Blood glucose

4. Blood glucose

The nurse working on an endocrine unit understands that safety-focused client care is based on which concept? 1. Clients diagnosed with hyperthyroidism should be monitored for weight gain. 2. Clients diagnosed with Cushing's syndrome experience episodic hypotension. 3. Clients diagnosed with diabetes insipidus should be assessed for fluid excess. 4. Clients diagnosed with hyperparathyroidism should be protected against falls.

4. Clients diagnosed with hyperparathyroidism should be protected against falls.

The new nurse assigned to care for a client with Graves' disease is asked to identify the clinical manifestations associated with this disease. Which manifestation, if noted by the new nurse, indicates a need for further teaching? 1. Goiter 2. Exophthalmos 3. Pretibial edema 4. Decreased libido

4. Decreased libido

The nurse is developing a nursing care plan for an older client diagnosed with diabetic neuropathy of the lower extremities due to type 2 diabetes mellitus. The nurse understands that which problem is the priority for this client? 1. Impaired ability to walk 2. Perceived loss of abilities 3. Pain and intermittent claudication 4. Decreased sensation in legs and feet

4. Decreased sensation in legs and feet

Which the laboratory results should the nurse expect to note when reviewing the medical record of a client diagnosed with primary hypothyroidism? Select all that apply. 1. Increased T3 resin uptake levels 2. Decreased thyroid antibody titers 3. Increased thyroxine (T4) serum levels 4. Decreased triiodothyronine (T3) serum levels 5. Increased thyroid-stimulating hormone (TSH) levels

4. Decreased triiodothyronine (T3) serum levels 5. Increased thyroid-stimulating hormone (TSH) levels

The nurse notes that an assigned client has been diagnosed with hyperthyroidism as a result of excessive use of thyroid replacement hormones. The nurse interprets this as which medical diagnosis? 1. Thyroid crisis 2. Thyroid storm 3. Toxic multinodular goiter 4. Exogenous hyperthyroidism

4. Exogenous hyperthyroidism

A client with syndrome of inappropriate antidiuretic hormone (SIADH) experiencing generalized edema is reporting chest pain related to severe shortness of breath. The health care provider prescribed furosemide 40 mg by intravenous push (IVP) STAT. After administration of the medication, there is less than 40 mL of urinary output. The nurse reviews the chart and calls the health care provider to discuss administration of demeclocycline. What triggered the nurse to anticipate the need for the demeclocycline? Refer to chart. 1. Hypertension and weight gain 2. Generalize edema and pulse of 110 beats per minute 3. Seizure disorder and a serum sodium level of 118 mEq/L (118 mmol/L) 4. Minimal responsiveness to furosemide and history of syndrome of inappropriate antidiuretic hormone (SIADH)

4. Minimal responsiveness to furosemide and history of syndrome of inappropriate antidiuretic hormone (SIADH)

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? 1. Elevate the hand before puncturing. 2. Wash the hands first, using cold water. 3. Puncture the finger as deeply as possible. 4. Puncture finger near the sides rather than the center.

4. Puncture finger near the sides rather than the center.

A client diagnosed with diabetes mellitus has been controlled with daily NPH insulin. The client has been prescribed atenolol to control angina pectoris. Because of the effects of the atenolol, the nurse determines that which finding is the most reliable indicator of hypoglycemia? 1. Sweating 2. Tachycardia 3. Feelings of anxiety 4. Low capillary glucose level

4. Low capillary glucose level

After undergoing a thyroidectomy, a client is monitored for signs of damage to the parathyroid glands postoperatively. The nurse would determine which finding suggests damage to the parathyroid glands? 1. Fever 2. Neck pain 3. Hoarseness 4. Tingling around the mouth

4. Tingling around the mouth

A client diagnosed with type 1 diabetes mellitus tells the nurse, "I often begin to feel sick late in the afternoon. Is there something wrong with me?" Which statement is an appropriate response by the nurse? 1. "Let me know if that happens today." 2. "Most people feel tired late in the afternoon." 3. "Can you describe what you mean by 'feeling sick'?" 4. "Don't worry about that. Most diabetics feel that way."

3. "Can you describe what you mean by 'feeling sick'?"

The nurse is conducting a health history on a client diagnosed with hyperparathyroidism. Which question asked of the client would elicit information about this condition? 1. "Do you have tremors in your hands?" 2. "Are you experiencing pain in your joints?" 3. "Have you had problems with diarrhea lately?" 4. "Do you notice any swelling in your legs at night?"

2. "Are you experiencing pain in your joints?"

The nurse has taught a client about the manifestations and treatment of hyperglycemia. Which statement by the client reflects an accurate understanding? 1. "I may become diaphoretic and faint." 2. "I may notice that I have dry skin and increased urination and thirst." 3. "I should restrict my fluid intake if my blood glucose level is more than 250. 4. "I need to take an extra diabetic pill if my blood glucose level is more than 300."

2. "I may notice that I have dry skin and increased urination and thirst."

A client is admitted to the hospital with a diagnosis of aldosteronism. When providing care, which nursing action is appropriate based on the client's medical condition? 1. Prevent hypoglycemia. 2. Record intake and output. 3. Monitor color of the stools. 4. Restrict foods high in potassium.

2. Record intake and output.

A new nurse has been assigned to care for a client diagnosed with Cushing's disease. Which statement made by the new nurse indicates a need for further teaching regarding the description of this disease? 1. "This disease is characterized by acute adrenal insufficiency." 2. "In this disease, nitrogen, carbohydrate, and mineral metabolism are altered." 3. "This disease is characterized by the excessive secretion of cortisol from the adrenal cortex." 4. "This disease can lead to issues with the adrenal cortex, the anterior pituitary gland, and the hypothalamus."

1. "This disease is characterized by acute adrenal insufficiency."

Which finding should the nurse expect to note in the client with a suspected diagnosis of hypothyroidism? 1. Bradycardia 2. Hyperactivity 3. Exophthalmos 4. Profuse diaphoresis

1. Bradycardia

The nurse is assessing a client newly diagnosed with hypothyroidism. Which assessment findings should the nurse anticipate to note in this client? Select all that apply. 1. Constipation 2. Dry, brittle hair 3. Periorbital edema 4. Shallow respirations 5. Restlessness and irritability 6. Heart rate greater than 100 beats per minute

1. Constipation 2. Dry, brittle hair 3. Periorbital edema 4. Shallow respirations

A client diagnosed with hypothyroidism asks why it is necessary to take levothyroxine sodium. Which response by the nurse accurately indicates the function of this medication? 1. Increases energy level 2. Promotes weight gain 3. Inhibits acid production 4. Decreases body temperature

1. Increases energy level

The nurse is providing information to the client about the causes of Addisonian crisis. Which causes of this acute state should be included? Select all that apply. 1. Infection 2. Adrenal surgery 3. Circulatory collapse 4. Increased consumption of fat 5. Sudden discontinuation of corticosteroids

1. Infection 2. Adrenal surgery 3. Circulatory collapse 5. Sudden discontinuation of corticosteroids

The nurse is admitting a client with a diagnosis of hypothyroidism. What assessment should the nurse perform to obtain data related to this diagnosis? 1. Inspect facial features. 2. Auscultate lung sounds. 3. Percuss the thyroid gland. 4. Inspect ability to ambulate safely.

1. Inspect facial features.

The nurse is caring for a client diagnosed with type 1 diabetes mellitus. Because the client is at risk for hypoglycemia, which instructions should the nurse teach the client to follow? 1. Keep glucose tablets. 2. Monitor the urine for acetone. 3. Report any feelings of drowsiness. 4. Omit the evening dose of NPH insulin if the client has been exercising.

1. Keep glucose tablets.

A client diagnosed with Cushing's disease is being admitted to the hospital after a stab wound to the abdomen. The nurse should place highest priority on which client problem?

1. Negative body image 2. Risk of low fluid volume 3. Poor health maintenance 4. Risk of possible infection

A client is admitted to the hospital with the diagnosis of Cushing's disease. The nurse should monitor the client's laboratory studies for which associated disorder? 1. Hypokalemia 2. Hyperglycemia 3. Decreased plasma cortisol levels 4. Low white blood cell (WBC) count

2. Hyperglycemia

A client diagnosed with myxedema reports having experienced a lack of energy, cold intolerance, and puffiness around the eyes and face. The nurse plans care knowing that these clinical manifestations are caused by a lack of production of which hormones? Select all that apply. 1. Thyroxine (T4) 2. Prolactin (PRL) 3. Triiodothyronine (T3) 4. Growth hormone (GH) 5. Luteinizing hormone (LH) 6. Adrenocorticotropic hormone (ACTH)

1. Thyroxine (T4) 3. Triiodothyronine (T3)

The nurse is caring for a hospitalized client with dual diagnoses of dehydration and diabetes mellitus. The client is alert but disoriented, pale, and slightly diaphoretic. The nurse suspects that the client is hypoglycemic. What should be the initial nursing intervention? 1. Administer oral glucose. 2. Obtain a finger-stick blood specimen and test the glucose level. 3. Assist the client to bed, putting the side rails up to assure safety. 4. Immediately notify the health care provider of the client's status.

2. Obtain a finger-stick blood specimen and test the glucose level

The nurse creating a nursing care plan for an older client diagnosed with diabetic retinopathy secondary to type 2 diabetes mellitus should give priority to which client concern? 1. Poor daily hygiene related to decreased vision 2. Possible injury related to decreased visual acuity 3. Chronic low self-esteem related to perceived loss of independence 4. Altered body image related to perceived negative effect of visual changes

2. Possible injury related to decreased visual acuity

A client is admitted to the hospital with a diagnosis of metabolic acidosis caused by diabetic ketoacidosis (DKA). The nurse prepares to administer which prescribed medication as a primary initial treatment for this problem? 1. Potassium 2. Regular insulin 3. Calcium gluconate 4. Sodium bicarbonate

2. Regular insulin

The nurse teaches a client about the signs/symptoms of Addisonian crisis. The nurse determines that teaching was effective when the client identifies which event as a sign/symptom of this crisis? 1. Headache 2. Severe agitation 3. Profuse diaphoresis 4. Sudden, profound weakness

4. Sudden, profound weakness

Which action by the client who has received teaching about postoperative parathyroidectomy care indicates that the client understood the instructions? 1. The client speaks frequently to exercise the vocal cords. 2. The client drinks nothing by mouth (NPO) for 24 to 48 hours. 3. The client splints the chest when deep breathing and coughing. 4. The client places the hands at the back of the head when moving the neck.

4. The client places the hands at the back of the head when moving the neck.

The nurse creating a plan of care for a client diagnosed with hypothyroidism identifies which meal as being most appropriate for the client?

Organ meat, carrots, and skim milk 2. Seafood, spinach, and cream cheese 3. Peanut butter, avocado, and red meat 4. Skim milk, apples, whole-grain bread, and cereal

A client newly diagnosed with diabetes mellitus has had several hypoglycemic reactions in the last few days. The client now refuses to take insulin, stating, "I am afraid of that insulin. Every time I take insulin it makes me sick." Which client problem needs to be addressed first? 1. Medication noncompliance 2. Fear of medication regimen 3. Poor personal health maintenance 4. Lack of information about insulin and its complications

2. Fear of medication regimen

The nurse is caring for a client diagnosed with type 1 diabetes mellitus. Which laboratory result would indicate a potential complication associated with this disorder? 1. Positive urinary ketones 2. Potassium: 4.2 mEq (4.2 mmol/L) 3. Blood glucose: 100 mg/dL (5.7 mmol/L) 4. Blood urea nitrogen (BUN): 18 mg/dL (6.48 mmol/L)

1. Positive urinary ketones

The nurse provides dietary instructions to a client with a diagnosis of hyperparathyroidism. Which statement by the client indicates the need for further instructions? 1. "I should eat foods high in fiber." 2. "I should eat foods high in calcium." 3. "I should drink cranberry juice daily." 4. "I need to drink 3000 mL of fluid per day."

2. "I should eat foods high in calcium."

The nurse assessing a client diagnosed with Cushing's syndrome should expect to note which finding? 1. Pallor 2. Hirsutism 3. Hypotension 4. Hypoglycemia

2. Hirsutism

The nurse is caring for a client with type 1 diabetes mellitus who is currently hyperglycemic. Which client problem should the nurse consider first when planning care for this client? 1. Hypouresis 2. Hypovolemia 3. Poor nutrition 4. Lack of understanding

2. Hypovolemia

Which assessment finding should the nurse interpret to be consistent with those commonly observed in clients with a history of hypothyroidism? 1. Palpitations 2. Bounding pulse 3. Decreased pulse rate 4. Systolic hypertension

3. Decreased pulse rate

The nurse requests that a client with a diagnosis of diabetes mellitus ask family members to attend an educational conference about the administration of insulin. The client questions why they need to be included. Which statement is best for the nurse to respond? 1. "Family members are at risk of developing diabetes." 2. "Family members can take you to your appointments." 3. "Nurses will need someone to call and check on a client's progress." 4. "Families often work together towards the successful management of diabetes."

4. "Families often work together towards the successful management of diabetes."

The nurse is admitting a client who recently underwent a bilateral adrenalectomy. Which intervention is essential for the nurse to include in the client's plan of care? 1. Prevent social isolation. 2. Consider occupational therapy. 3. Discuss changes in body image. 4. Avoid stress-producing situations.

4. Avoid stress-producing situations.

A client diagnosed with diabetes mellitus has received instructions about foot care. Which statement by the client would indicate that the client needs further instructions? 1. "I'll trim my nails straight across after my bath." 2. "My feet should be inspected daily using a mirror." 3. "The cuticles of my nails must be cut to prevent overgrowth." 4. "Cotton stockings should be worn to absorb excess moisture.

3. "The cuticles of my nails must be cut to prevent overgrowth.

Which response should the nurse give to a client who asks why a glycosylated hemoglobin (HbA1c) level test is necessary? 1. "It is done as a method of verifying the accuracy of the meter used at home." 2. "This test is done yearly to predict the likelihood of long-term complications." 3. "This test gives an indication of glycemic control over the last 3-month period." 4. "It predicts the risk of developing hypoglycemia with your diet and medication regimen."

3. "This test gives an indication of glycemic control over the last 3-month period."

A client with a diagnosis of hypoparathyroidism is assessed as having a positive Trousseau's sign. Which statement accurately describes this finding? 1. Spasm of the facial muscle when tapped below the temple 2. Pulling up of the knees when the head is bent onto the chest 3. Fanning and spreading of the toes when the sole of the foot is stroked 4. Carpopedal spasm when a blood pressure cuff is inflated on the arm for 3 minutes

4. Carpopedal spasm when a blood pressure cuff is inflated on the arm for 3 minutes

A client diagnosed with diabetes mellitus reports that it is very difficult to adhere to the diabetic treatment plan. The nurse interprets the client's concern and responds appropriately with which response? 1. "Let's check your blood glucose now." 2. "Let's go over your diet again to be sure it contains foods you like." 3. "Do you understand what noncompliance can mean to your future health?" 4. "If you don't take your insulin, you will develop diabetic ketoacidosis (DKA)."

2. "Let's go over your diet again to be sure it contains foods you like."

The nurse is monitoring a client for complications after thyroidectomy. The nurse notes that the client's voice is very hoarse. The client is concerned about the hoarseness and asks the nurse about it. The nurse should make which response to alleviate the client's concern? 1. "This complication is expected; don't worry." 2. "This problem is temporary and will probably subside in a few days." 3. "It is best that you not talk at all until the problem is further evaluated." 4. "Hoarseness may indicate permanent damage to the nerves in your throat."

2. "This problem is temporary and will probably subside in a few days."

A client diagnosed with type 1 diabetes mellitus is undergoing peritoneal dialysis with insulin being added to the dialysate before instillation. The nurse determines that the dose of insulin added to the dialysate is optimal when the client has a random blood glucose level of what value? 1. 70 mg/dL (4 mmol/L) 2. 110 mg/dL (6 mmol/L) 3. 140 mg/dL (8 mmol/L) 4. 200 mg/dL (11.4 mmol/L)

2. 110 mg/dL (6 mmol/L)

A client diagnosed with type 1 diabetes mellitus is prescribed 8 units of regular insulin and 12 units of NPH insulin at 7:00 a.m. At 10:30 a.m., the client reports feeling uneasy and shaky. How should the nurse interpret these symptoms? 1. The action of the NPH insulin is peaking, and the blood glucose level is insufficient. 2. The action of the regular insulin is peaking, and the blood glucose level is insufficient. 3. The client consumed too many calories at breakfast and now has an elevated blood glucose level. 4. The symptoms are unrelated to the insulin or diet, and the client is at risk of a cardiovascular emergency.

2. The action of the regular insulin is peaking, and the blood glucose level is insufficient.

The nurse is preparing the bedside for a postoperative parathyroidectomy client. The nurse should ensure that which specific priority item is at the client's bedside? 1. Cardiac monitor 2. Tracheotomy set 3. Intermittent gastric suction 4. Underwater seal chest drainage system

2. Tracheotomy set

The nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus. The nurse should recognize that which teaching plan component is most important initially? 1. Knowledge of the diabetic diet 2. Understanding of the diagnosis 3. Monitoring of blood glucose levels 4. Correct technique for administering insulin

2. Understanding of the diagnosis

The nurse is caring for a client with a suspected diagnosis of Cushing's syndrome. The nurse reviews the client's medical record and expects to note documentation of which signs/symptoms that are indicative of this condition? 1. Weight loss and polyuria 2. Weight loss and polydipsia 3. Truncal obesity and translucent skin 4. Butterfly rash and peripheral edema

3. Truncal obesity and translucent skin

A client with a new diagnosis of type 1 diabetes mellitus has been seen for 3 consecutive days in the emergency department with hyperglycemia. During the assessment, the client states to the nurse, "I'm sorry to keep bothering you every day, but I just can't give myself those awful shots." Which therapeutic comment is most appropriate for the nurse to respond? 1. "I couldn't give myself a shot either." 2. "You must learn to give yourself the shots." 3. "Let me see if we can change your medication." 4. "Have you had instructions on injecting yourself?"

4. "Have you had instructions on injecting yourself?"

The nurse is caring for a client who is scheduled for an adrenalectomy. The nurse plans to administer which medication in the preoperative period to prevent Addisonian crisis? 1. Prednisone orally 2. Fludrocortisone orally 3. Spironolactone intramuscularly 4. Methylprednisolone sodium succinate intravenously

4. Methylprednisolone sodium succinate intravenously

A client is admitted to the hospital with a suspected diagnosis of Graves' disease. On assessment, which manifestation related to the client's menstrual cycle should the nurse expect the client to report? 1. Amenorrhea 2. Menorrhagia 3. Metrorrhagia 4. Dysmenorrhea

1. Amenorrhea

The nurse advising a client diagnosed with Addison's disease about ways to prevent Addisonian crisis should make which suggestion to the client? 1. Avoid stressful situations whenever possible. 2. Minimize risk by eating a diet low in protein. 3. Minimize risk by eating a diet high in glucose. 4. Stop medication therapy if infection or illness occurs.

1. Avoid stressful situations whenever possible.

A client diagnosed with Addison's disease has been instructed on follow-up care to avoid complications of the disease. In order for the nurse to determine that teaching was effective, what should the client verbalize that he or she will avoid? 1. Eating salty foods 2. Becoming dehydration 3. Taking corticosteroids 4. Snacking between meals

2. Becoming dehydration

A client is diagnosed with hypothyroidism. The nurse performs an assessment on the client, expecting to note which findings? Select all that apply. 1. Weight loss 2. Bradycardia 3. Hypotension 4. Dry, scaly skin 5. Heat intolerance 6. Decreased body temperature

2. Bradycardia 3. Hypotension 4. Dry, scaly skin 6. Decreased body temperature

The nurse is caring for a client newly diagnosed with diabetes mellitus, who has been prescribed NPH insulin at 7:00 a.m. daily. What client instructions concerning self-monitoring for late afternoon signs/symptoms should the nurse stress? 1. Nausea and vomiting and abdominal pain 2. Hunger; shakiness; and cool, clammy skin 3. Drowsiness; red, dry skin; and fruity breath odor 4. Increased urination, thirst, and rapid deep breathing

2. Hunger; shakiness; and cool, clammy skin

A client is admitted to the hospital with a diagnosis of severe hypoparathyroidism. What intervention should the nurse include in the plan of care to do to provide a safe environment for the client? 1. Keep the room slightly cool. 2. Institute seizure precautions. 3. Keep the head of bed lowered. 4. Use a waist restraint continuously.

2. Institute seizure precautions.

Which statement made by a client diagnosed with Addison's disease indicates a need for follow-up by the nurse? 1. "I wear a Medic-Alert bracelet at all times." 2. "I need to weigh myself daily and record it." 3. "My medication doses will not need to be adjusted for any reason." 4. "It's important that I drink enough fluids and increase my salt intake."

3. "My medication doses will not need to be adjusted for any reason."

A client diagnosed with Cushing's syndrome is being instructed by the nurse on follow-up care. Which statement by the client indicates a need for further teaching? 1. "I should avoid contact sports." 2. "I should check my ankles for swelling." 3. "I need to avoid foods high in potassium." 4. "I need to check my blood glucose regularly."

3. "I need to avoid foods high in potassium."

he nurse is assessing a lethargic client who was brought to the emergency department by emergency medical services and notes a fruity odor to the client's breath. The nurse immediately suspects that the client is experiencing what pathological occurrence? A serious drop in serum glucose levels 2. Potential existence of ethanol oxide intoxication 3. A dangerous high buildup of ketones in the extracellular fluid 4. Dehydration related to undiagnosed type 2 diabetes mellitus

3. A dangerous high buildup of ketones in the extracellular fluid

The nurse is assessing a client admitted to the emergency department with a tentative diagnosis of diabetic ketoacidosis. The nurse observes for respirations with what distinctive characteristics? 1. Deep and labored 2. Shallow and labored 3. Deep and nonlabored 4. Shallow and nonlabored

3. Deep and nonlabored

The nurse caring for a client diagnosed with Addison's disease assesses the vital signs and determines the existence of orthostatic hypotension. The nurse suspects that this finding relates to which cause? 1. A decrease in cortisol release 2. Increased levels of androgens 3. An increase in epinephrine secretion 4. A decreased secretion of aldosterone

4. A decreased secretion of aldosterone

While performing a preoperative physical assessment of a client being prepared for an adrenalectomy, the nurse obtains a temperature reading of 100.8° F (38.2° C). How should the nurse interpret this temperature reading? 1. Within normal limits 2. Slightly abnormal but an insignificant finding 3. An expected finding caused by the operative stress response 4. A finding that needs to be reported to the health care provider immediately

4. A finding that needs to be reported to the health care provider immediately

The significant other of a client diagnosed with Graves' disease expresses concern regarding the client's bursts of temper, nervousness, and an inability to concentrate on even trivial tasks. On the basis of this information, the nurse should identify which concern for the client? 1. Grief 2. Socialization issues 3. Issues related to sensory perception 4. Trouble with coping with a disease process

4. Trouble with coping with a disease process

The nurse notes that a client diagnosed with aldosteronism is experiencing a dysrhythmia. Which assessment should the nurse address as a priority? 1. Peripheral pulses 2. Intake and output 3. Superficial reflexes 4. Serum potassium level

4. Serum potassium level

The nurse is monitoring the results of periodic serum laboratory studies drawn on a client diagnosed with diabetic ketoacidosis (DKA) who is receiving an insulin drip. The nurse should alert the health care provider regarding which test result? 1. Calcium 9.2 mg/dL (2.3 mmol/L) 2. Sodium 137 mEq/L (137 mmol/L) 3. Potassium 3.1 mEq/L (3.1 mmol/L) 4. Serum osmolality 288 mOsm/kg (288 mmol/kg)

3. Potassium 3.1 mEq/L (3.1 mmol/L)

The nurse is performing an admission assessment on a client admitted to the hospital with a diagnosis of pheochromocytoma. What action should the nurse prepare to implement to assess for the primary manifestation associated with this disorder? 1. Check the client's pupils. 2. Check the peripheral pulses. 3. Take the client's blood pressure. 4. Assess for the presence of peripheral edema.

3. Take the client's blood pressure.

The nurse discusses strategies for preventing Addisonian crisis with a client. The nurse determines that the teaching goals have been met when the client makes which statement? 1. "I'm going to miss eating pizza every Friday with my friends." 2. "Losing weight is something I should have done years ago." 3. "I'm going to practice my stress reduction techniques daily." 4. "I'll lower my medication dosage when I feel a cold coming on."

3. "I'm going to practice my stress reduction techniques daily."

The nurse is monitoring a client diagnosed with type 1 diabetes mellitus. Today's blood work reveals a glycosylated hemoglobin level of 10%. The nurse creates a teaching plan based on the understanding that this result indicates which finding? 1. A normal value that indicates that the client is managing blood glucose control well 2. A value that does not offer information regarding the client's management of the disease 3. A low value that indicates that the client is not managing blood glucose control very well 4. A high value that indicates that the client is not managing blood glucose control very well

4. A high value that indicates that the client is not managing blood glucose control very well

A client who has just had a parathyroidectomy returns to the unit from the recovery room. The nurse checks the client's blood pressure and notes that it is 90/60 mm Hg and that the client's apical pulse is 102 beats per minute. The nurse's first action should be to perform which activity? 1. Take the vital signs again. 2. Increase the intravenous fluid rate. 3. Check the back of the dressing for bleeding. 4. Place the client in a Trendelenburg's position.

3. Check the back of the dressing for bleeding.

The clinic nurse is performing an assessment on a client who has been diagnosed with hypothyroidism. Which clinical manifestation should the nurse expect to note? 1. Reports of diarrhea 2. Reports of difficulty sleeping 3. Indications of intolerance to cold weather 4. Significant weight loss since the last clinic visit

3. Indications of intolerance to cold weather

The nurse is completing a health history on a client diagnosed with diabetes mellitus who has been taking insulin for many years. At present the client states that he is experiencing periods of hypoglycemia followed by periods of hyperglycemia. What is the most likely cause for this occurrence? 1. Eating snacks between meals 2. Initiating the use of the insulin pump 3. Injecting insulin at a site of lipodystrophy 4. Adjusting insulin according to blood glucose levels

3. Injecting insulin at a site of lipodystrophy

The nurse is preparing a client diagnosed with Graves' disease to receive radioactive iodine therapy. What information should the nurse share with the client about the therapy? 1. After the initial dose, subsequent treatments must continue lifelong. 2. The radioactive iodine is designed to destroy the entire thyroid gland with just one dose. 3. It takes 6 to 8 weeks after treatment to experience relief from the symptoms of the disease. 4. High radioactivity levels prohibit contact with family for 4 weeks after the initial treatment.

3. It takes 6 to 8 weeks after treatment to experience relief from the symptoms of the disease.

A client diagnosed with type 2 diabetes mellitus is being discharged from the hospital after an occurrence of hyperglycemic hyperosmolar state (HHS). The nurse creates a discharge teaching plan for the client and identifies which intervention as a priority? 1. Exercise routines 2. Controlling dietary intake 3. Keeping follow-up appointments 4. Monitoring for signs/symptoms of dehydration

4. Monitoring for signs/symptoms of dehydration

The nurse receives a report that an adult client diagnosed with delirium has a blood glucose level of 33 mg/dL (1.8 mmol/L). What is the best interpretation of this result? 1. A normal reading for this client 2. Insignificant and unrelated to the delirium 3. Higher than normal, indicating a cause of the delirium 4. A lower than normal reading, indicating a cause for the delirium

4. A lower than normal reading, indicating a cause for the delirium

Which statement by the client indicates a need for further teaching regarding insulin pump therapy? 1. "If my blood glucose is elevated, I can bolus myself with additional insulin as prescribed." 2. "I'll need to check my blood glucose before meals in case I need a premeal insulin bolus." 3. "I still need to follow a diet and exercise plan even though I don't inject myself daily anymore." 4. "Now that I have this pump, I don't have to worry about insulin reactions or ketoacidosis ever happening again."

4. "Now that I have this pump, I don't have to worry about insulin reactions or ketoacidosis ever happening again."

The nurse is caring for a client who is being treated for secondary hyperaldosteronism. Which question should the nurse ask to assess the client's ability to manage this disease? 1. "Have you ever smoked cigarettes?" 2. "Did you ever have gastrointestinal disease?" 3. "Tell me what you do when you are under stress." 4. "Tell me how you manage your high blood pressure."

4. "Tell me how you manage your high blood pressure."

The nurse is caring for a client scheduled for a bilateral adrenalectomy for treatment of an adrenal tumor. What information should the nurse give the client about the postsurgical needs? 1. "You will need to undergo chemotherapy after surgery." 2. "You will need to wear an abdominal binder after surgery." 3. "You will not need any special long-term treatment after surgery." 4. "You will need to take daily hormone replacements beginning after the surgery."

4. "You will need to take daily hormone replacements beginning after the surgery."

A client newly diagnosed with diabetes mellitus has been prescribed Humalog insulin on a sliding scale for glucose control. The nurse creates a teaching plan to help the client meet which outcome as a first step in managing the disease? 1. Avoid all strenuous exercise. 2. Lose 40 pounds to achieve ideal body weight. 3. Identify all of the foods in the diabetic exchange diet. 4. Adjust insulin according to capillary blood glucose levels.

4. Adjust insulin according to capillary blood glucose levels.

The nurse has addressed necessary dietary changes with a client diagnosed with hypothyroidism to help manage the disorder. The nurse determines that the client understood the information when the client states that it is permissible to continue eating which foods? 1. Shrimp, green beans, and butter 2. Peanut butter, cheese, and red meat 3. Beef liver, carrots, and fried potatoes 4. Apples, whole-grain breads, and low-fat milk

4. Apples, whole-grain breads, and low-fat milk

What is the anticipated intended effect of fludrocortisone acetate when administered for the treatment of Addison's disease? Select all that apply. 1. Stimulate thyroid production. 2. Stimulate the immune response. 3. Stimulate thyrotropin production. 4. Assist with excretion of potassium. 5. Promote reabsorption of sodium and chloride ions.

4. Assist with excretion of potassium. 5. Promote reabsorption of sodium and chloride ions.