Endocrine study exam

a nurse is providing teaching to a client who has a new diagnosis of diabetes insipidus. Which of the following client statements indicates an understanding of the teaching?

"I might experience confusion"

A patient with Graves' disease asks the nurse what caused the disorder. What is the best response by the nurse?

"In genetically susceptible persons, antibodies are formed that cause excessive thyroid hormone secretion"

which statement made by the pt makes the nurse suspect the pt is experiencing hyperthyroidism?

- "i have noticed all my collars are getting tighter" rationale: the thyroid gland (in the neck) enlarges as a result of the increased need for thyroid hormone production; an enlarged gland is called a goiter

During care of the patient with SIADH, what should the nurse do?

- monitor neurologic status at least every 2 hrs rationale: pt with SIADH has marked dilutional hyponatremia and should be monitored for decreased neurologic function and seizure every 2 hrs

An IV hydrocortisone infusion is started before a patient is taken to surgery for a bilateral adrenalectomy. Which explanation, if given by the nurse is most appropraite

-"This medicine is given to help your body respond to stress after removal of adrenal glands" rationale: hydrocortisone is administered IV during and after a bilateral adrenalectomy to ensure adequate responses to the stress of the procedure

a nurse is caring for a client who has syndrome of inappropraite antidiuretic hormone (SIADH). Which of the following findings should the nurse expect?

-Decreased blood sodium -blood osmolarity 230 mOsm/L

A nurse is reviewing the health record of a client who has SIADH. Which of the following lab findings should the nurse expect?

-Low sodium: SIADH results in water retention, causing a low sodium level -Increased urine osmolality: SIADH results in an increased urine osmolality due to decreased urine volume -High urine sodium: SIADH results in water retention, causing a high urine sodium level -Increased urine specific gravity: water retention causes an increase in urine specific gravity

The client has developed acute kidney injury and has a low urine output, hyperkalemia and confused. What are the appropriate nursing actions?

-Monitor urine output -administer sodium polystyrene -administer potassium chloride IV infusion -put client close to the nurse station -monitor LOC

A nurse is caring for a client who has primary adrenal insufficiency and is preparing to undergo an ACTH stimulation test. Which of the following findings should the nurse expect after an IV injection of cosyntropin?

-No change in plasma cortisol indicates primary adrenal insufficiency (addison's disease or hypocortisolism) after an IV injection of cosyntropin during an ACTH stimulation test due to an inadequate production of cortisol

A patient with hypoparathyroidism from surgical treatment of hyperparathyroidism is preparing for discharge. What should the nurse teach the patient?

-calcium supplements with vitamin D can effectively maintain calcium balance rationale: hypocalcemia results from PTH deficiency is controlled with calcium and vitamin D supplementation and possible oral phosphate binders.

the pt is diagnosed with hypothyroidism. Which signs/symptoms should the nurse expect the pt to exhibit

-complaints of extreme fatigue and hair loss rationale: a decrease in thyroid hormone causes decreased metabolism which leads to fatigue and hair loss

The patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What manifestations should the nurse expect to find?

-decreased urinary output rationale: in SIADH, decreased urine output of concentrated urine with increased urine osmolality and specific gravity occur

a nurse is reinforcing teaching with a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following info should the nurse include?

-do not discontinue med without the advice of the provider -have follow-up serum TSH levels performed -take med on an empty stomach

a nurse is reinforcing discharge teaching with a pt who had a transsphenodial hypophysectomy. Which of the following instructions should the nurse include?

-eat high fiber diet -notify provider of any sweet tasting drainage (glucose)

a pt diagnosed with hyperthyroidism is being treated with radio active iodine therapy. Which interventions should the nurse discuss with the pt

-explain it will take up to a month for symptoms of hyperthyroidism to subside rationale: radioactive iodine therapy is used to destroy the overactive thyroid cells. After treatment, the pt is followed closely for 3-4 wks until the euthyroid state is reached

the nurse is preparing a pt with a new diagnosis of hypothyroidism for discharge. The nurse determines that the client understands discharge instructions if the pt states that which symptoms are associated with this diagnosis.

-feeling cold -loss of body hair -persistent lethargy -puffiness of face

a nurse is reviewing manifestations of hyperthyroidism. Which of the following findings should the nurse include

-heat intolerance -constipation -palpitations -weight loss

A nurse is reviewing the assessment findings and lab data for a client with the syndrome of inappropriate hormone secretion (SIADH). The nurse understands that which symptoms are associated characteristics of this disorder? select all

-high urine osmolality -low serum osmolality -hypotonicity of body fluids -continued release of ADH

a patient has a serum calcium level of 13.4 mg/dL. Which disorder would the nurse suspect?

-hyperparathyroidism

A patient is admitted to the hospital with a diagnosis of Cushing syndrome. On physical assessment of the patient, what should the nurse expect to find?

-hypertension, moon face, and purple striations

A client with a dx of addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional healthcare team focus on? select all

-hypotension -hyperkalemia

The nurse is caring for a client who has had an adrenalectomy and is monitoring the client for signs of adrenal insufficiency in this client?

-hypotension and fever

What is an appropriate nursing intervention for the patient with hyperparathyroidism?

-increase fluid intake to 3000 to 4000 mL daily

A patient is admitted to the hospital with acute thyrotoxicosis. On physical assessment of the patient, what should the nurse expect to find?

-increased temp and signs of heart failure rationale: a thyroid storm results in marked manifestations of hyperthyroidism. Severe tachycardia, heart failure, shock, hyperthermia, agitation, delirium, seizures, abdominal pain, vomiting, diarrhea, and coma occurs.

`The nurse should include which interventions in the plan of care for a client with hypothyroidism? select all.

-instruct the pt about thyroid replacement therapy -encourage the pt to consume fluids and high fiber foods in diet -instruct the pt to contact the PCP if episodes of chest pain occur

a nurse is collecting an admission history from a female client who has hypothyroidism. Which of the following findings should the nurse expect?

-menorrhagia -dry skin -hoarseness

a nurse is assisting in planning care for a pt who has myxedema coma. Which of following actions should the nurse include

-monitor daily weights -observe for evidence of urinary tract infection -record input and output -initiate aspiration precautions

the nurse is teaching the pt diagnosed with hyperthyroidism. Which info should be taught to the pt?

-notify HCP if a 3 pound wt loss occurs in 2 days -discuss ways to cope with emotional lability -notify the HCP if taking over-the-counter med rationale: wt loss indicates med may not be effective and need to be increased. the pt needs to know emotional highs and lows are secondary to hyperthyroidism. Any over the counter meds may negatively affect the pts hyperthyroidism or meds being used for treatment.

a nurse is reinforcing teaching with a pt who has addison's disease and is taking hydrocortisone. Which of the following instructions should the nurse include

-notify provider of any illness or stress -report any manifestations of weakness or dizziness -do not discontinue that med suddenly

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

-polyuria -polydipsia -complaints of excessive thirst -specific gravity lower than 1.005

which nursing intervention should be included in the plan of care for the pt diagnosed with hyperthyrodism

-provide 6 small, well-balance meals a day rationale: the pt with hyperthyroidism has an increased appetite, therefore, well-balanced meals served several times throughout the day will help with the pts constant hunger

the nurse givens corticosteroids to a patient with acute adrenal insufficiency. The nurse determines that treatment is effective if what is observed?

-the patient is alert and oriented

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 hypocalcemic tetany

a nurse is reviewing the lab findings for a client who might have hyperthyroidism. The nurse should identify an elevation of which of the following substances as an indication that the client has this disorder?

-triiodothyronine (T3) -increased triiodothyronine (T3) indicates hyperthyroidism

During assessment of the patient with acromegaly, what should the nurse expect the patient to report?

-undesirable changes in appearance rationale: the increased production of GH in acromegaly causes an increase in thickness and width of bones and enlargement of soft tissues, resulting in marked changes in facial features, feet and head; oily and coarse skin; and speech difficulties

a nurse is planning to reinforce teaching with a client who is being evaluated for addison's disease about the ACTH stimulation test. The nurse instruct the client on which of the following information

ACTH is a hormone produced by the pituitary gland

a nurse is caring for a client who has diabetes insipidus. Which of the following urinalysis lab findings should the nurse expect?

Decreased specific gravity

A patient with Addison's disease comes to the ED with reports of nausea, vomiting, diarrhea, and fever. What interprofessional care should the nurse expect?

IV administration of hydrocortisone

a nurse is planning care for a client who has acromegaly and is postoperative following a transsphenodial hypophysectomy. Which of the following interventions should the nurse include in the plan?

Observe dressing drainage for the presence of glucose rationale: transsphenoidal hypophysectomy: the pituitary gland is taken out through your nose via the sphenoid sinus, a cavity near the back of your nose

a patient has signs of hypothyroidism. Which diagnostic test will the nurse expect to be done first?

Thyroid-stimulating hormone (TSH)

The nurse is reviewing the lab test results for a client with a diagnosis of Cushings syndrome. Which lab finding would the nurse expect to note in this client?

a K+ level of 5.5 mEq/L

a nurse is caring for a pt who is taking methimazole. For which of the following adverse effects of this med should the nurse monitor

bradycardia

a nurse is caring for a pt who is taking somatropin to stimulate growth. The nurse should plan to monitor the pts urine for which of the following

calcium

Which statement accurately describes Graves' disease?

exophthalmos occurs in graves disease

The nurse is monitoring a client with Grave's disease for signs of thyroid storm. Which s/s if noted in the client, will alert the nurse to the presence of this crisis?

fever and tachycardia

a nurse in a providers office is collecting data from a client who has hypothyroidism and recently began treatment with thyroid replacement therapy. Which of the following findings indicate that the client might need a decrease in the dosage of the med?

hand tremors

a nurse is collecting data for a pt who takes desmopressin for diabetes insipidus. For which of the following adverse effects should the nurse monitor

headache

A patient suspected of having acromegaly has an increased plasma growth hormone (GH) level. In acromegaly, what would the nurse expect the patient's diagnostic results to show?

increased levels of plasma insulin- like growth factor-1 (IGF-1)

a pt is admitted to an ED and a diagnosis of myxedema coma is made. Which action would the nurse prepare to carry out initially

maintain a patent airway

A nurse is assessing a client during a water deprivation test. For which of the following complications should the nurse monitor the client?

orthostatic hypotension

a nurse is reinforcing teaching to a pt who has graves disease about her prescribed meds. Which of the following statements by the pt indicates an understanding of the use of propranolol in the treatment of graves disease

propranolol will decrease my tremors and fast heart beat

The patient with diabetes insipidus is brought to the emergency department (ED) with confusion and dehydration after excretion of a large volume of urine today even though several liters of fluid were consumed. What is a diagnostic test that the nurse should expect to be done first to help make a diagnosis?

water deprivation test