Endocrine System
When obtaining subjective data from a pt during an assessment of the endocrine system, the nurse should ask questions regarding which of the following? A. Energy level B. Intake of Vit C C. Employment hx D. Frequency of sexual intercourse
A. Energy level
To control the side effects of corticosteroid therapy, the nurse should include which of the following interventions? A. Increase calcium intake to 1500 mg daily B. Perform glucose monitoring for hypoglycemia C. Obtain immunizations due to high risk of infections D. Avoid abrupt position changes because of orthostatic hypotension
A. Increase calcium intake to 1500 mg daily
A patient with Addison's disease is hospitalized for an acute crisis. During the crisis, which of the following nursing diagnosis is a priority? A. Deficient fluid volume B. Activity intolerance C. Anxiety D. Risk for injury
A. deficient fluid volume
Following a hypophysectomy for a pituitary tumor, the nurse suspects that the pt has developed DI upon finding which of the following? A. urine specific gravity of 1.003 B. a consistent rise in BP C. Fluid retention w/ dependent edema D. serum sodium of 130 mEq/L
A. urine specific gravity of 1.003
A pt seeks care at the clinic because of increasing speech difficulties & hoarseness, telling the nurse his tongue has gotten so big that he can hardly talk. The NP suspects acromegaly. During the nursing hx, the nurse would ask which of the following? A. A recent head injury B. Increase in shoe size C. Family hx of endocrine problems D. symptoms of hypoglycemia such as hunger and nervousness
B. An increase in shoe size
When sympathetic blocking agents are used to decrease the BP prior to removal of an adrenal tumor, the nurse should instruct the patient for which of the following? A. Continue current prescriptions B. Change positions cautiously C. Walk 30 mins daily D. Place furniture for support
B. Change positions cautiously
Which of these signs suggests that a male patient with SIADH secretion is experiencing complications? A. Tetanic contractions B. Neck distention C. Weight loss D. Polyuria
B. Neck vein distention
A pheochromocytoma is an adrenal medulla tumor that causes arterial HTN by increasing circulating level of which of the following? A. Catecholamines B. Enzymes C. Hormones D. Glucocorticoids
A. Catecholamines
The pt scheduled for an adrenalectomy is ordered IV meds to prevent adrenal insufficiency in a pt. Which med would the nurse expect to be included in the order? A. Corticosteroids B. Diuretics C. Antibiotics D. Insulin
A. Corticosteroids
A patient with Addison's disease is taking corticosteroid replacement therapy. The nurse should instruct the patient about which of the following effects of corticosteroids? (SATA) A. Hyperkalemia B. Skeletal muscle weakness C. Mood changes D. Hypocalcemia E. Increased susceptibility to infection F. Hypotension
B. Skeletal muscle weakness C. Mood changes D. Hypocalcemia E. Increased susceptibility to infection
The RN caring for a postoperative patient after a transphenoidal hypophysectomy will be most concerned with which of the following? A. Facial mooning B. Blood glucose C. WBCs in urine D. Weight gain
B. blood glucose
Which teaching is appropriate for a pt who is taking an inhaled glucocorticoid for asthma? A. "Exhale while pushing in on the canister of the inhaler." B. "Blow your nose after taking the med" C. "Rinse your mouth thoroughly after taking the med" D. "Do not eat immediately after taking the med"
C. "Rinse your mouth thoroughly after taking the med"
For which client does the nurse question the prescription of androgen replacement therapy? A. 35 yo man who has had a vasectomy B. 48 yo man who takes prednisone for severe asthma C. 62 yo man who has a hx of prostate cancer D. 70 yo man who has HTN & DM 2
C. 62 yo man who has a hx of prostate cancer *Androgens cause prostate cancer to grow*
A patient is admitted to the unit with a diagnosis of SIADH. For which electrolyte abnormality will you be sure to monitor? A. Hypokalemia B. Hyperkalemia C. Hyponatremia D. Hypernatremia
C. Hyponatremia
The nurse assessing a patient with SIADH would expect to find lab values of which of the following? A. Serum Na of 120 mEq/L & high urine osmolality B. Serum K of 5 mEq/L & low urine osmolality C. Serum Na of 150 mEq/L & high osmolality D. Serum K of 3 mEq/L & low osmolality
Serum Na of 120 mEq/L & high urine osmolality
Following the pt's adrenalectomy, the nurse is going to assess for which of the following complications? (SATA) A. Hypoglycemia B. Abdominal striae C. Hypotension D. Dependent edema E. Magnesium levels
A. Hypoglycemia C. Hypotension
Which of the following statements about the endocrine system are true? (SATA) A. Overproduction of the adrenal cortex may cause masculinization in women B. Epinephrine & norepinephrine are considered hormones when they are secreted by the adrenal medulla and are considered neurotransmitters when they are secreted by nerve cells C. In a person who normally works a night shift from 2300-0700 & sleeps from 0800-1500, serum analysis of cortisol taken at 0730 would reveal a false high cortisol level D. Hormones that act on the anterior pituitary glad to stimulate tropic hormone secretion are known as releasing hormones E. Androgens secreted by the adrenal cortex are responsible for sex drive in women
A. Overproduction of the adrenal cortex may cause masculinization in women B. Epinephrine & norepinephrine are considered hormones when they are secreted by the adrenal medulla and are considered neurotransmitters when they are secreted by nerve cells D. Hormones that act on the anterior pituitary gland to stimulate tropic hormone secretion are known as releasing hormones E. Androgens secreted by the adrenal cortex are responsible for sex drive in women
Which hormones are secreted by the anterior pituitary gland? SATA A. Prolactin B. Gonadotropin C. Oxytocin D. Adenosine
A. Prolactin B. Gonadotropin
The nurse is reviewing labs for a pt in Addisonian crisis. Which findings would the nurse expect to see? A. Serum potassium 6.7 mEq/L B. Blood sugar 183 mg/dL C. Serum sodium 188 mEq/: D. BUN 7.9 mg/dL
A. Serum potassium 6.7 mEq/L
Endocrine disorders often go unrecognized in older adults because of which of the following? A. Symptoms are often attributed to age B. Older adults rarely have identifiable symptoms C. Endocrine disorders are relatively rare in older adults D. Older adults usually have subclinical endocrine disorders that minimize symptoms
A. Symptoms are often attributed to age
After a hypophysectomy for acromegaly, the nurse should focus on which of the following postoperatively? A. frequent monitoring of serum & urine osmolarity B. parenteral admin of a GH-receptor antagonist C. Keeping the pt in a recumbent position at all times D. Pt teaching regarding the need for lifelong hormone therapy
A. frequent monitoring of serum and urine osmolarity
Which hormones are secreted by the adrenal gland ? SATA A. glucocorticoids B. ACTH C. growth hormone D. insulin E. mineralocorticoids
A. glucocorticoids E. mineralocorticoids
A pt has a serum sodium level of 152 mEq/L. Which of the following is the normal hormonal response to this stimulation? A. release of ADH B. release of ACTH C. secretion of aldosterone D. secretion of corticotropin-releasing hormone
A. release of ADH
The normal response to increased serum osmolality is release of which of the following? A. Aldosterone from the adrenal cortex, which stimulates sodium excretion by the kidney B. ADH from the posterior gland, which stimulates the kidney to reabsorb water C. Mineralocorticoids from the adrenal gland, which stimulate the kidney to excrete potassium D. Calcitonin from the thyroid gland, which increases bone resorption and decreases serum calcium levels
ADH from the posterior pituitary gland, which stimulates the kidney to reabsorb water
The nurse should teach a patient taking an oral corticosteroid to take the med at what time? A. 8:00 am B. 12 noon C. 5:00 pm D. 8:00 pm
A. 8:00 am
Which hormones are secreted by the posterior pituitary lobe? SATA A. Antidiuretic hormone (ADH) B. Growth hormone (GH) C. Oxytocin D. Prolactin E. Desmopressin
A. Antidiuretic hormone C. Oxytocin
The nurse is preparing an IV antihypertensive med to prevent adrenal insufficiency in a patient scheduled for an adrenalectomy. Which assessment would be most important prior to administering the med? A. BP B. Respirations C. Temperature D. Urine output
A. BP
What are 2 effects of hypokalemia on the endocrine system? A. Decreased insulin & aldosterone release B. Decreased glucagon & increased cortisol release C. Decreased release of atrial natriuretic factor & increased ADH release D. Decreased release of parathyroid hormone and increased calcitonin release
A. Decreased insulin and aldosterone release
A patient with Addison's disease is hospitalized for an acute crisis. During the crisis, which of the following nursing diagnosis is a priority? A. Deficient fluid volume B. Activity Intolerance C. Anxiety D. Risk for injury
A. Deficient fluid volume
Which of the following should the nurse include when teaching a patient about glucocorticoid therapy? A. Do not abruptly stop taking the drug B. Take the med on an empty stomach C. Avoid use of antiulcer meds when taking glucocorticoids D. When used long-term, alternate day dosing of glucocorticoids will help minimize thyroid suppression
A. Do not abruptly stop taking the drug
Which info is important to teach a pt who is taking corticosteroids? (SATA) A. Do not suddenly stop taking the med B. Avoid exposure to crowds C. Wound healing may be delayed D. Avoid operating heavy equipment for 6 hrs E. Take before bed
A. Do not suddenly stop taking the med B. Avoid exposure to crowds C. Wound healing may be delayed
The RN is assessing the lab data of a patient diagnosed with Cushing's syndrome. The RN would expect to note which lab values prior to initiation of drug therapy? (SATA) A. Elevated plasma cortisol level. B. Decreased blood glucose level. C. Increased WBC count. D. Increased sodium level. E. Increased potassium level.
A. Elevated plasma cortisol level C. Increased WBC count D. Increased sodium level
A pt w/ a head injury develops SIADH. Manifestations the nurse would expect to find include which of the following? A. hypernatremia & HTN B. muscle spasticity & HTN C. low urine output & hyponatremia D. weight gain & decreased GFR
C. low urine output & hyponatremia
A pt with adenoma of the adrenal zona glomerulosa causing hyperaldosteronism and is scheduled for surgery to remove the affected gland. During care prior to the surgery, the nurse should do which of the following. A. limit fluids to 1,000 mL/day B. provide a potassium restricted diet C. monitor BP every 4 hrs D. elevate pt's extremities to relieve edema
C. monitor BP every 4 hrs
A pt w/ Cushing's syndrome returns to the surgical unit following an adrenalectomy. During the initial post-op period, the nurse gives the highest priority to which of the following? A. monitoring for infection B. protecting pt's skin C. monitoring fluid & electrolyte status D. preventing severe emotional disturbances
C. monitoring fluid & electrolyte status
A pt with an ADH-secreting small cell cancer of the lung is treated with demeclocycline to control the symptoms of SIADH. The nurse determines that the med is effective upon finding which of the following? A. pt's weight is stable B. urine specific gravity is increased C. pt's urinary output is increased D. reduction in pt's edema
C. urinary output increased
Which of the following are common nonspecific manifestations that may alert the nurse to an endocrine dysfunction? A. Goiter and alopecia B. Exopthalmos and tremors C. weight loss, fatigue, depression D. Poluria, polydipsia, polyphagia
C. weight loss, fatigue, depression
The patient is admitted to the acute medical care unit for a work up for Cushing's disease. When she is assessed, she is found sitting at the bedside crying. She states, "I just don't know what to do. I feel so confused & down in the dumps." What is the nurse's best response? A. "Would you like to speak with a pastor or priest?" B. "Have you experienced this kind of confusion before?" C. "It's going to be fine. We'll find out what's wrong and take care of you." D. "Have you noticed if your mood goes quickly from happy to sad?"
D. "Have you noticed if your mood goes quickly from happy to sad?"
The nurse is providing discharge teaching to a patient prescribed corticosteroid therapy. Which statement by the patient would most concern the nurse? A. "I will weigh myself daily at the same time every day" B. "I will take walks every day to increase my strength" C. "I will avoid fried foods & foods high in fat" D. "I will be staying with my son who has pneumonia"
D. "I will be staying with my son who has pneumonia"
A pt with Cushing's syndrome is admitted to the hospital in preparation for surgery for an adrenal tumor. During the admission assessment, the pt tells the nurse that she just looks so awful, she does not want anyone to be around her. Which of the following is the best response by the nurse? A. "Let me show you how to dress so that the changes are not so noticeable" B. "I do not think you look bad. Your appearance is just altered by your disease" C. "You should not worry about how you look in the hospital. We see many worse things" D. "Most of the physical and mental changes caused by the disease will gradually improve after surgery"
D. "Most of the physical and mental changes caused by the disease will gradually improve after surgery"
The physician has ordered a serum cortisol level to rule out adrenal dysfunction in a pt who is a night security guard who works 2300-0700 and normally sleeps from 0800-1600. To ensure the most reliable test results, the nurse arranges the blood specimen to be drawn at which time? A. 0300 B. 2300 C. 0930 D. 1630
D. 1630
The nurse knows which patient with Cushing's disease is at greatest risk for developing heart failure? A. 60 y.o. with pneumonia B. 59 y.o. with hx HTN C. 32 y.o. w/ hx Hep B infection D. 42 y.o. w/ serum creatinine level of 3.7 mg/dL
D. 42 y.o. w/ serum creatinine level of 3.7 mg/dL
When a pt eats a bag of potato chips, the nurse recognizes that hypernatremia is likely to occur if the pt is experiencing a decreased production of which of the following? A. Cortisol B. Aldosterone C. Pancreatic somatostatin D. Antidiuretic hormone
D. Antidiuretic hormone
A patient with a pituitary tumor had a transphenoidal hypophysectomy. Following surgery, the nurse places the head of the bed in which of the following positions? A. Flat B. Lowered 20* C. Elevated 90* D. Elevated 30*
D. Elevated 30*
A patient with acute adrenal insufficiency (Adrenal crisis) is admitted to the hospital. The RN monitors for resolution of which manifestations to determine that drug therapy with cortisone has been effective? A. Hyper-excitability and restlessness B. Decreased appetite and weight loss C. Vitiligo and hyperpigmentation D. HTN & Hypernatremia E. Episodes of angina & hypotension
D. HTN & Hypernatremia
A pt with Addison's disease is brought into the ER. Which of the following is priority intervention? A. Admin IV fluid fluids for fluid replacement B. Assess pt for potential abuse C. Evaluate pt for mood changes D. Insert an IV catheter
D. Insert an IV catheter
A pt with DI has a nursing diagnosis of fluid volume deficit related to excessive urination. Which of the following is an appropriate pt goal? A. Pt drinks 500 mL of fluids every 24 hrs B. Pt understands need for increased fluid intake C. Pt demonstrates decreased urination D. Pt urine specific gravity is between 1.005-1.020
D. Pt urine specific gravity is between 1.005-1.020
When administering fludrocortisone, the nurse understands which of the following concepts about this med? A. The entire daily dose should all be given in the morning 1/2 hr before eating B. The entire daily dose should all be given at bedtime with a simple carb snack C. The daily dose should be split into smaller doses with morning dose being smaller D. The daily dose should be split into smaller doses with evening dose being smaller
D. The daily dose should be split into smaller doses with the evening dose being smaller
The nursing student taking an exam comes to a problem that they don't remember studying. The student becomes anxious and can feel their heart pounding. Which of the following is happening in this scenario? A. This is a physiologic response by the parathyroid B. This is a physiologic response by the adrenal cortex C. This is a physiologic response by the temporal lobe D. This is a physiologic response by the adrenal medulla
D. This is a physiologic response by the adrenal medulla
Which of the following is associated with a positive diagnosis of Cushing's Syndrome? A. The disappearance of lymphoid tissue B. A reduction in circulating eosinophils C. An elevated cortisol level D. All of the above
D. all of the above
A pt is hospitalized with acute adrenal insufficiency. The nurse determines that the pt responding favorably to treatment upon finding which of the following? A. decreasing blood glucose B. increasing urinary output C. decreasing serum sodium D. decreasing serum potassium
D. decreasing serum potassium
Which of the following results would the nurse expect in a pt taking spironolactone, a drug that blocks the action of aldosterone on the kidney? A. decreased urinary output B. increased serum sodium levels C. increased vascular fluid volume D. increased serum potassium levels
D. increased serum potassium levels
What is the rationale for admin of IV hydrocortisone infusion to be started prior to surgery for a pt having a bilateral adrenalectomy? A. prevent sodium & water retention following surgery B. stimulate the inflammatory response to promote surgical wound healing C. prevent thromboembolic episodes during the post-op recovery period D. promote response to the stress of surgery after removal of adrenal glands
D. promote response to the stress after removal of adrenal glands
A pt with a possible pheochromocytoma is admitted tot he hospital for evaluation and diagnostic testing. During an attack, the nurse would expect the pt to experience which of the following? A. persistent hypoglycemia B. severe bradycardia refractory to drug therapy C. severe hypotension with sympathoadrenal blockade D. severe pounding headache, tachycardia, and profuse sweating
D. severe pounding headache, tachycardia, and profuse sweating
A nursing student caring for a pt with pheochromocytoma is discussing their pt with the nursing instructor. Which statement by the student would be most alarming to the nursing instructor? A. "The pt's BP has decreased from 188/90 to 142/82" B. "The pt complained of no pain when I palpated the abdomen" C. "The pt's lung sounds are clear throughout anteriorly & posteriorly" D. "The pt has a temp of 99.9 & states they are tired"
B "The pt complained of no pain when I palpated the abdomen"
A pt is admitted to the hospital in Addisonian crisis one month following a diagnosis of Addison's disease. The nurse identifies ineffective management of therapeutic regimen related to lack of knowledge of management of the condition when the pt states which of the following? A. "I double my dose of hydrocortisone if I am experiencing moderate stress as instructed" B. "If I take too much of my med I have vomiting and diarrhea, so I reduce the dosage a little" C. "I measure & record my BP daily and notify my Dr if it is out of the range specified" D. "I have learned to control some major stresses in my life & use relaxation techniques on a daily basis"
B. " If I take too much of my med I have vomiting & diarrhea, so I reduce the dosage a little"
A nurse is providing education for a pt that has been ordered a glucocorticoid med. Which of the following statements by the pt indicates understanding? A. "I need to call my dr if I do not have a BM in 3 days" B. "I need to call my dr if I have weight gain of 2 lbs or more in a day" C. "I need to increase the amount of sodium in my diet while taking this med" D. "I need to decrease the amount of insulin I take while taking this med"
B. "I need to call my Dr. if I have a weight fain of 2 lbs or more in a day"
A nurse is providing education to a patient that is ordered a 24-hour urine collection that is suspected of having pheochromocytoma. Which statement by the patient indicates the need for further education? A. "I will collect all urine during the 24-hr period." B. "I will start in the morning with my first urination" C. "I will keep the urine container in a container of ice." D. "I will report any missed urine samples that I forget to keep"
B. "I will start in the morning with my first urination."
A pt who is taking corticosteroids says, "My face is getting rounder. Will this go away?" What is your best response? A. "This is a normal side effect of corticosteroids, but try to lose weight." B. "This is a common side effect & will begin to go away when therapy stops." C. "You must be having an allergic reaction to the drug. Stop taking it & notify your provider." D. "As soon as you finish the therapy, your face will look normal again."
B. "This is a common side effects & will begin to go away when the therapy stops."
Which of the following matches are correct with the adrenal hormones? A. Aldosterone stimulates decreased BP B. ADH stimulates increased serum sodium C. Aldosterone inhibits decreased serum cortisol D. ADH inhibits decreased serum glucode
B. ADH stimulates increased serum sodium
Discharge teaching for a pt receiving glucocorticoids would include the preferred use of which med for pain management? A. Aspirin B. Acetaminophen C. Ibuprofen D. Naproxen
B. Acetaminophen
When monitoring for a therapeutic response to aminoglutethimide, the nurse will look for which potential outcomes? A. Increase in Cushing's syndrome characteristics B. Decrease in Cushing's syndrome characteristics C. Increased lymphocyte levels D. Growth suppression
B. Decrease in Cushing's syndrome characteristics
A patient had a bilateral adrenalectomy to treat Cushing's disease yesterday. The patient now has a temperature of 99.4. Which is priority nursing intervention? A. Admin IV fluids B. Encourage coughing & deep breathing every 1-2 hrs C. Assuming wound infection & notify physician D. Obtain a urine sample for culture
B. Encourage coughing & deep breathing every 1-2 hrs
Which of the following are abnormal findings during assessment of the endocrine system? SATA A. BP 100/70 mm Hg B. Excessive facial hair on a woman C. Soft, formed stool every other day D. 3-lb weight gain over the last 6 mos E. Hyperpigmented coloration in lower legs
B. Excessive facial hair on a woman E. Hyperpigmented coloration in lower legs
The student nurse is creating a care plan for the patient with Cushing's disease. Which priority problems should be the focus of the care plan? (SATA) A. Fatigue B. Fluid overload C. Sleep deprivation D. Potential for infection E. Predisposition to injury
B. Fluid overload D. Potential for infection E. Predisposition to injury
A 56-year old woman is admitted to the ED with a BP of 168/92 & reports of fatigue & muscle weakness. She has bruising on her arms & 2+ swelling in her ankles. Her weight has gone from 150 lbs to 185 lbs over the past 6 mos. Assessment reveals that she has truncal obesity & thin extremities. Which diagnosis does the nurse suspect? A. Hyperpituitarism (Acromegaly) B. Hypercortisolism (Cushing's Disease) C. Hyperaldosteronism (Conn's Syndrome) D. Adrenal insufficiency (Addison's disease)
B. Hypercortisolism (Cushing's disease)
A patient with Cushing's disease had a bilateral adrenalectomy 24 hrs ago. The nurse should monitor the patient closely for which of the following? A. Neurogenic shock B. Hypovolemic shock C. Cardiogenic shock D. Anaphylactic shock
B. Hypovolemic shock
Hormones of one gland influence the function of hormones of another gland. This is demonstrated by which of the following facts? A. Increased insulin levels inhibit the release of glucagon B. Increased cortisol levels inhibit secretion of insulin C. Increased testosterone levels inhibit the release of estrogen D. Decreased aldosterone levels stimulate the release of atrial natriuretic factor
B. Increased cortisol levels inhibit the secretion of insulin
A patient newly diagnosed with adrenal insufficiency is going to begin therapy with fludrocortisone. What therapeutic effect of this med should the nurse explain to the patient? A. Decreased resorption of sodium by decreasing hydrogen & potassium excretion in distal tubule B. Increased resorption of sodium by increasing hydrogen & potassium excretion in distal tubule C. Decreases inflammation by suppressing migration of leukocytes & eliminating the body's immune response to certain stimuli D. Increases inflammation by stimulating the production of leukocytes & enhancing the body's immune response to many stimuli
B. Increased resorption of sodium by increasing hydrogen & potassium excretion in the distal tubule
Which of the following is a characteristic common to all hormones? A. Circulate in the blood bound to plasma proteins B. Influence cellular activity of specific target tissues C. Accelerate the metabolic processes of all body cells D. Enter a cell to alter the cell's metabolism or gene expression
B. Influence cellular activity of specific target tissues
Important nursing interventions when caring for a pt w/ Cushing's syndrome include which of the following? SATA A. Restricting protein intake B. Monitoring blood glucose levels C. Admin med in equal doses D. observing for signs of hypotension E. Protecting pt from exposure to infection
B. Monitoring blood glucose levels E. Protecting pt from exposure to infection
A patient who has received metyrapone experiences an adrenal crisis. The nurse considers that which of the following most likely predisposed the patient to this occurrence? A. Pt has hyperaldosteronism B. Pt has adrenal insufficiency C. Pt has pheochromocytoma D. Pt has type 1 DM
B. Pt has adrenal insufficiency
During pre-op teaching for a pt schedule for a transphenoidal microsurgery for treatment of a pituitary adenoma, the nurse is going to include which of the following? A. The pt will have to take replacement growth hormone the rest of her life B. The pt will not be able to brush her teeth for several days after surgery C. The pt will be expected to cough & deep breathe every 2 hrs post-op D. The pt will be positioned flat w/ sandbags at her head to prevent head movement
B. The pt will not be able to brush her teeth for several days after surgery
Why should corticosteroids be taken in the morning? A. To prevent nocturnal diuresis B. To mimic the action of the adrenal gland C. To stimulate cortisol release D. To keep to a consistent routine
B. To mimic the action of the adrenal gland
Which urine properties indicate to the RN that the client with SIADH antidiuretic hormone is responding to interventions? A. Urine output volume increased, urine specific gravity increased. B. Urine output volume increased, urine specific gravity decreased. C. Urine output volume decreased, urine specific gravity increased. D. Urine output volume increased, urine specific gravity decreased.
B. Urine output volume increased, urine specific gravity decreased.
The nurse observes the clinical manifestation on a female pt in the pic below and appropriately documents which of the following medical terms as a clinical manifestation that the pt is experiencing? A. striae B. hirsutism c. vitiligo D. exophthalmos
B. hirsutism
During long-term corticosteroid therapy, the nurse will monitor the pt for Cushing's syndrome. Which is manifested by which of the following? A. weight loss B. moon face C. hypotension D. thickened hair growth
B. moon face
A patient with Addison's disease is scheduled for discharge after being hospitalized for an adrenal crisis. Which statements by the patient would indicate that the teaching has been effective? (SATA) A. "I have to take my steroids for 10 days" B. "I need to weigh myself daily to be sure I don't eat too many calories" C. "I need to call my Dr. to discuss my steroid needs before I have dental work." D. "I will call the Dr. if I suddenly feel very weak or dizzy" E. "If I feel like I have the flu, I'll carry on as usual because this is an expected response" F. "I need to obtain & wear a medic alert bracelet"
C. "I need to call my Dr to discuss my steroid needs before I have dental work" D. "I will call the Dr if I suddenly feel very weak or dizzy" F. "I need to obtain & wear a medic alert bracelet"
The nurse is educating a patient how to collect a 24 hr urine sample. Which statement by the pt indicates understanding? A. "I need to collect my urine from when I wake up until I go to bed" B. "I need to keep my urine in a warmer to stay in a specific temp range" C. "I will discard the first sample in the morning before starting to collect" D. "I will avoid eating foods that are bladder irritants while collecting my urine"
C. "I will discard the first urine sample in the morning before I start to collect"
A pt beginning treatment for Cushing's disease tells the nurse they are uncomfortable because they laugh or cry at inappropriate moments. What response by the nurse is most appropriate? A. "You need to learn how to control your emotions better" B. "Perhaps you should be tested for Tourette's" C. "Inappropriate laughing can be a symptom of Cushing's disease" D. "Let's get you an appt with a therapist to work through these issues"
C. "Inappropriate laughing can be a symptom of Cushing's disease"
A nurse instructor is asking a group of students studying the endocrine system about U/A results. Which statement by the student indicates an understanding of DI? A. "Low specific gravity (<1.005) of the urine is a characteristic of pheochromocytoma B. "DI, starvation, and dehydration causes formation of ketone bodies." C. "The U/A will demonstrate a high dilute to the urine with DI." D. "Systemic diseases that may cause proteinuria include DI, lupus erythematosus, and febrile illnesses
C. "The U/A will demonstrate high dilute to the urine with DI"
The next day, a student nurse is caring for the patient, who is scheduled for an MRI of the head. The student nurse asks why a patient with Cushing's disease needs this test. What is the nurse's best response? A. "They are looking for brain cancer which may have caused the disease." B. "The patient may have had headaches & they are looking for the cause." C. "The most common cause of Cushing's is a pituitary tumor called an adenoma." D. "A tumor of the adrenal gland can cause about 15% of Cushing's disease cases."
C. "The most common cause of Cushing's is a pituitary tumor called an adenoma"
The oncoming nurse receives 0700 report on the following pts. Which of the following pts should the nurse see first? A. a pt w/ DI w/ a urine specific gravity of 1.012 B. a pt w/ SIADH that is scheduled to receive conivaptan at 0800 C. a pt that is post-op for a hypophysectomy that can be heard coughing D. a pt that is collecting urine for a 24 hr urine collection that turns on their call light to go to the bathroom
C. A pt that is post-op for a hypophysectomy that can be heard coughing
An important pre-op nursing intervention before an adrenalectomy for hyperaldosteronism is which of the following? A. Monitor blood glucose levels B. Restrict fluid & sodium intake C. Admin potassium-sparing diuretics D. Advise pt to make postural changes slowly
C. Admin potassium-sparing diuretics
What are the effects of aging on the endocrine system? (SATA) A. Increased function of pituitary hormones B. Increased function of gonad tissues C. Decreased function of thyroid D. Decreased function of kidneys E. Decreased function of the islet cells of the pancreas
C. Decreased function of the thyroid E. Decreased function of the islet cells of the pancreas
The nurse manager overhears a nurse delegating tasks to an unlicensed assistive personnel for a patient diagnosed with Cushing's Disease. Which task would cause the nurse manager to intervene? A. Taking the patient their food tray B. Ambulating the patient to the bathroom C. Encouraging fluid intake D. Getting the patient's vital signs
C. Encouraging fluid intake
Clinical manifestations suggestive of Addison's disease include all of the following, except which? A. relative lymphocytosis B. hyperkalemia & hyponatremia C. HTN D. hypoglycemia
C. HTN
In a pt with an elevated serum cortisol level, the nurse would expect other lab findings to reveal which of the following? A. Hyponatremia B. Hyperkalemia C. Hyperglycemia D. Decreased serum triglycerides
C. Hyperglycemia
When assessing for potential side effects of fludrocortisone the nurse monitors for s/sx of which adverse effect? A. Hyponatremia B. Hypercalcemia C. Hypokalemia D. Hypovolemia
C. Hypokalemia
Which nursing intervention is most appropriate for a patient admitted with SIADH? A. Infusing IV Vasopressin as ordered B. Encouraging increased oral intake C. Infusing hypertonic IV fluids as ordered D. Admin glucose containing IV fluids as ordered
C. Infusing hypertonic IV fluids as ordered
When administering aminoglutethimide to a patient, it is most important for the nurse to monitor which of the following? A. Serum electrolytes B. Cardiac enzymes C. Liver enzymes D. Arterial blood gases
C. Liver enzymes
The nurse teaches the pt that the best time to take corticosteroids for replacement purposes is which of the following? A. Once a day at bedtime B. Every other day on awakening C. On arising & late afternoon D. At consistent intervals every 6-8 hrs
C. On arising & late afternoon
The patient is in the midst of an Addisonian crisis. Which of the following is priority? A. Assessing for HTN B. Preventing Infection C. Preventing hypotension D. Increasing urine output
C. Preventing hypotension
A nurse assessment of a pt with Cushing's syndrome reveals that the pt has truncal obesity & thin arms & legs. Additional manifestation of Cushing's syndrome that the nurse would expect to find includes which of the following? A. Hypotension B. decreased axillary & pubic hair C. purplish red striae on the abdomen D. Bronzed hyperpigmentation of skin
C. Purplish red striae on the abdomen
Which nursing intervention is most appropriate for a patient admitted with SIADH? A. Infusing normal saline as ordered B. Encouraging increased oral intake C. Restrict fluids D. Reposition every 2 hrs
C. Restrict fluids
While caring for a pt with a pituitary disorder, the nurse understands that all hormones of the anterior pituitary gland are released in response to which of the following? A. effects of somatostatin on the hypothalamus B. Neural stimulation of the anterior pituitary by the hypothalamus C. Stimulation of the anterior pituitary by releasing hormones secreted by the hypothalamus D. Decreased levels of hormones in the blood as they circulate through the anterior pituitary gland
C. Stimulation of the anterior pituitary by releasing hormones secreted by the hypothalamus
When evaluating the lab findings of a pt with decreased function of the anterior pituitary gland, the nurse would expect to find which of the following diagnostic values? A. normal serum cortisol B. normal serum calcium C. increased serum thyroxin D. decreased serum aldosterone
normal serum calcium
Which of the following patient is most at risk for acute adrenal insufficiency? A. Patient with hyperaldosteronism that forgot to take their insulin B. Patient with Conn's syndrome taking acetaminophen for joint pain C. Patient with Cushing's syndrome from glucocorticoid drug therapy D. Patient with pheochromocytoma scheduled for surgical removal of adrenal glands
Patient with Cushing's syndrome from glucocorticoid drug therapy
When teaching a pt with chronic SIADH about long-term management of the disorder, the nurse determines that additional instruction is needed when the pt states which of the following? A. "I need to maintain a sodium-restricted diet at home." B. "I should weigh myself daily & report a sudden loss or gain." C. "I need to limit my fluid intake to no more than 1 quart of liquids a day." D. "I will eat foods high in potassium since the diuretics cause potassium loss.:
A. "I need to maintain a sodium-restricted diet at home."
The client who is about to have a unilateral adrenalectomy for an adenoma that is causing hypercortisolism asks the RN if she will have to continue the severe sodium restriction after surgery. What is the nurse's best response? A. "No, once the tumor has been removed and your cortisol levels have normalized, you will not retain excess sodium anymore." B. "No, after surgery you will have to take oral cortisol, which can easily be controlled so that your sodium levels do not rise." C. "Yes, the fact that you are retaining sodium and have high BP is related to your age and lifestyle, not the tumor." D. "Yes, sodium is very bad for people and everyone needs to eliminate sodium completely from their diets for the rest of their lives."
A. "No, once the tumor has been removed and your cortisol levels have normalized, you will not retain excess sodium anymore."
