N-clex Pass-point For Endocrine

After a 3-month trial of dietary therapy, a client with type 2 diabetes still has blood glucose levels above 180 mg/dl. The physician adds glyburide, 2.5 mg P.O. daily, to the treatment regimen. The nurse should instruct the client to take glyburide:

30 minutes before breakfast.

A client is admitted with Graves' disease. Which laboratory test should the nurse expect to be ordered?

thyroid panel

A client with hyperthyroidism develops high fever, extreme tachycardia, and altered mental status. Which condition does the nurse suspect is developing?

thyroid storm

When preparing a client scheduled for a thyroid function test, the nurse questions the client about medications. Which medications contain iodine and could alter the results?

topical antiseptics and multivitamins

A client is diagnosed with diabetes insipidus. The nurse assists with the development of a care plan based on the understanding that which hormone is deficient?

vasopressin

A client is receiving oral calcium supplements. Which additional vitamin would the nurse encourage the client to consume to enhance absorption of calcium from the gastrointestinal (GI) tract?

vitamin D

A client who has had type 2 diabetes for 20 years tells the nurse that sometimes she has diarrhea and other times constipation. In addition, she sometimes feels "full" after eating small amounts. Which of the following would be an appropriate response for the nurse to make?

"Sometimes people with diabetes have problems with their digestion. Did you tell your physician about this?"

After reinforcing education to a client on how to correctly self-administer daily maintenance dose of 3 units of regular insulin and 4 units of NPH insulin, which client statement demonstrates that the education has been successful?

"After taking my insulin out of the refrigerator, I'll draw up the clear insulin first to the line for 3 units and then cloudy insulin until there's a total of 7 units in the syringe."

The nurse reinforces disease management instructions for a client newly diagnosed with type 1 diabetes. Which statement indicates to the nurse that the client has understood the information?

"Checking my blood sugar before meals and at bedtime will help me manage my blood sugar."

A client with type 2 diabetes tells a nurse that he stopped walking at the mall because of his "bad leg pain." How should the nurse respond to this client?

"Did you notify your physician when you started to have the leg pains?"

When teaching a client about insulin administration, the nurse should include which instruction?

"Draw up clear insulin first when mixing two types of insulin in one syringe."

During a class on exercise for clients with diabetes mellitus, a client asks the nurse how often he should exercise. Which answer by the nurse is appropriate?

"Follow a regular, individualized exercise plan."

The nurse is collecting data from an older adult client being screened for hypothyroidism. Which statement by the nurse demonstrates understanding the effects of aging?

"Hypothyroidism can be difficult to diagnose in older adults because symptoms may resemble normal aging."

A client with cystic fibrosis is being discharged with a high-frequency chest wall oscillating vest. Which statement by the client indicates an understanding of how to use the vest?

"I can be in any position to use the vest."

A client has received dietary instructions as part of the treatment plan for diabetes type 1. Which statement by the client should alert the nurse that the client needs additional instructions?

"I can eat whatever I want as long as I cover the calories with sufficient insulin."

A client with a family history of diabetes asks the nurse which measures can be practiced to decrease the chance of developing the disease. Which statement would be the nurse's best response?

"Start a moderate exercise program."

A client diagnosed with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is stabilized and prepared for discharge. When preparing the client for discharge and home management, which statement indicates that the client understands her condition and how to control it?

"I should avoid becoming dehydrated and pay attention to my need to urinate, drink, or eat more than usual."

An older adult client who has recently been diagnosed with hypothyroidism lives independently in an apartment in a community development designed for older adults. The client asks the nurse assigned to the complex for advice about managing this condition. What is the best response by the nurse?

"Increase fiber and fluids in your diet."

While reinforcing education with the parents of a child of short stature, the nurse discusses familial short stature. Which statement by the nurse about this condition is most accurate?

"It occurs in children who have ancestors with adult height in the lower percentiles and whose height during childhood is appropriate."

Which statement made by the nurse to the client and parents about diabetic ketoacidosis is most accurate?

"It's a life-threatening situation."

While reviewing the food diary of a client with type 2 diabetes, a nurse notices that the client typically skips breakfast. Which instruction by the nurse would be helpful for this client.

"It's important to maintain a stable blood sugar throughout the day. Can I help you devise a plan so you can eat breakfast each day?"

The nurse is caring for an adolescent with type 1 diabetes who controls blood glucose levels well with twice-daily doses of insulin. The adolescent asks the nurse about participating in swimming after school without adversely affecting the blood glucose. What is the best response by the nurse?

"Make sure you have a snack before swimming."

A client with type 1 diabetes must learn how to self-administer insulin. The physician has prescribed 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?

"Rotate injection sites within the same anatomic region, not among different regions."

A client with primary diabetes insipidus is prescribed desmopressin. Which instruction should the nurse provide before the client is discharged?

"You may not be able to use desmopressin nasally if you have nasal discharge or blockage."

A client with diabetes who had a stroke has right-sided paralysis and incontinence and is in the rehabilitation center. Which action should be the nurse's priority in caring for the client?

Wash the client's skin with soap and water, gently patting it dry.

A client with adrenocortical hyperfunction has returned to the nursing unit after bilateral adrenalectomy. What are the nurse's priorities when caring for this client? Select all that apply.

Administer prescribed corticosteroids as ordered. Observe closely for signs and symptoms of acute adrenal crisis. Maintain strict aseptic technique during dressing changes.

The nurse is teaching the client about risk factors for diabetes mellitus. Which risk factor for diabetes mellitus is nonmodifiable?

Advanced age

The nurse is developing a teaching plan for a client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?

Antidiuretic hormone (ADH)

A client brings her food journal containing her dietary intake for the past 3 days to the diabetic clinic. A nurse notes that despite dietary teaching about carbohydrate intake, the client consumed 3 servings of bread each day. What should the nurse do with this information?

Ask the diabetes educator to review with the client ways to decrease carbohydrate intake.

A client with a history of diabetes has serum ketones and a serum glucose level above 300 mg/dL. Which condition does the nurse expect is the cause?

diabetic ketoacidosis

The nurse is caring for a client with type I diabetes who does not adhere to an insulin regimen regularly. The nurse identifies that the client is at risk for which complication?

diabetic ketoacidosis

The nurse is caring for a client with hypoparathyroidism. During data collection, the nurse taps the client's face 2 cm anterior to the earlobe. The nurse is attempting to elicit which of the following?

Chvostek's sign

A client with diabetes insipidus has had limited fluid intake over the past 12 hours. For which complications should the nurse monitor the client?

severe dehydration and hypernatremia

A nurse is teaching a group of certified nursing assistants (CNAs) about blood glucose monitoring. Which finding indicates that the CNA understands how to use a blood glucose meter?

Demonstrating correct technique

A client becomes upset when the physician diagnoses diabetes mellitus as the cause of his signs and symptoms. The client tells the nurse, "This must be a mistake. No one in my family has ever had diabetes." Based on this statement, the nurse suspects the client is using which coping mechanism?

Denial

The nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. To reverse a hypoglycemic reaction, the client ideally should ingest an oral carbohydrate. However, this treatment isn't always possible or safe. Therefore, the nurse should advise the client to keep which alternate treatment on hand?

Glucagon

A client with newly diagnosed type 2 diabetes mellitus is admitted to the metabolic unit. The primary goal for this admission is education. Which of the following goals should the nurse incorporate into her teaching plan?

Exercise and a weight reduction diet

A client with type 1 diabetes has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension to be taken before breakfast. At about 4:30 p.m. (1630), the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?

Hypoglycemia

A client has been diagnosed with hyperthyroidism. In assisting with the plan of care, the nurse should give priority to which goals? Select all that apply.

Increase the client's calorie intake. Provide adequate rest and sleep. Provide a cool environment.

A client has diabetic ketoacidosis secondary to infection. As the condition progresses, which signs and symptoms might the nurse see?

Kussmaul respirations and a fruity odor on the breath

Which intervention is the most critical for a client with myxedema coma?

Maintaining a patent airway

A client with type 2 diabetes hasn't received insulin coverage for his afternoon blood glucose levels for 2 days. After further investigation, a nurse discovers that the afternoon blood glucose levels were phoned in from the laboratory but weren't documented in the client's medical record. What should the nurse do with this information?

Notify the physician and complete an incident report.

A nurse is caring for a client with syndrome of inappropriate antidiuretic hormone secretion (SIADH). The client becomes confused and develops crackles and dyspnea. What is the priority action of the nurse?

Notify the health care provider.

A nurse is caring for a postoperative thyroidectomy client at risk for hypocalcemia. What intervention should the nurse implement in this client's care?

Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.

After undergoing a subtotal thyroidectomy, a client develops hypothyroidism. The physician prescribes levothyroxine, 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent?

Primary hypothyroidism

A client with type 1 diabetes has been on a regimen of multiple daily injection therapy. He's being converted to continuous subcutaneous insulin therapy. While teaching the client about continuous subcutaneous insulin therapy, the nurse would be accurate in telling him the regimen includes the use of:

short-acting insulin only.

A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

Restricting fluids

A client with type 2 diabetes was diagnosed with retinopathy. While a nurse reviews the client's medication dosage, the client states, "I can't read the names on the medicine bottles, so I hope I'm taking the right pills at the right time." What should the nurse do with this information?

Teach the client how to tell the difference between the medicine bottles.

Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the nurse obtains data from the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?

Thyroid crisis

A client has type 1 diabetes. Her husband finds her unconscious at home and administers glucagon, 0.5 mg subcutaneous (SC). She awakens in 5 minutes. Why should her husband offer a complex carbohydrate snack to her as soon as possible?

To restore liver glycogen and prevent secondary hypoglycemia

A client is being returned to his room after a subtotal thyroidectomy. Which piece of equipment is most important for the nurse to keep at the client's bedside?

Tracheostomy set

A client has a serum calcium level of 7.2 mg/dl. During the physical examination, the nurse expects to assess:

Trousseau's sign.

A nurse administers bromocriptine to a client diagnosed with acromegaly. After administering the medication, the nurse realizes that she gave the medication to the wrong client. What could have been done to prevent this error?

Verifying the client's identity on the identification band and medication administration record before providing the medication

A client with a history of type 1 diabetes mellitus recently had an amputation and is in the rehabilitation unit. When the nurse enters the room to administer the client's daily insulin, the client is diaphoretic, reports having a headache, and has slurred speech. What should the nurse do next?

Withhold the client's insulin, check the blood glucose level, bring a glass of orange juice, and report the findings to the charge nurse.

The nurse is participating in a discharge planning conference for a school-age child with newly diagnosed diabetes mellitus. The parents express concern about the accommodations needed when the child returns to school. Which recommendations does the nurse expect the team to make? Select all that apply.

a schedule for blood glucose testing with target ranges and interventions a written plan for the school to follow regarding insulin administration education for appropriate school staff about care that will be rendered

A client with a diagnosis of diabetes insipidus is being treated with desmopressin acetate. The client asks, "What is this medication?" What is the best response by the nurse?

a synthetic vasopressin

A child is diagnosed with diabetes insipidus. Which characteristics will the nurse recognize in the health history?

abrupt onset of polyuria, nocturia, and polydipsia

A client with alcoholism is hospitalized with cirrhosis of the liver. The nurse notes hand tremors, irritability, and anxiety developing 24 hours after admission. What complication does the nurse suspect the client is developing?

acute alcohol withdrawal

A client has been admitted after reporting acute abdominal pain in the midepigastric region, back tenderness, nausea, and vomiting. The nurse recognizes these findings to be associated with which condition?

acute pancreatitis

A nurse is reviewing data in the progress notes entry of a client with adrenocortical insufficiency (Addison's disease). The client reports difficulties in the work environment and a recent upper respiratory infection. The nurse identifies the client as at risk for which condition?

adrenal crisis

The nurse is explaining the action of insulin to a client newly diagnosed with diabetes mellitus. During the teaching, the nurse reviews the process of insulin secretion in the body. The nurse is correct when stating that insulin is secreted from the:

beta cells of the pancreas.

After undergoing a thyroidectomy, a client develops hypocalcemia and tetany. Which medication should the nurse anticipate administering?

calcium gluconate

The client is being evaluated for hypothyroidism. The nurse should stay alert for:

decreased body temperature and cold intolerance.

The nurse is participating in a care planning conference for an adolescent client recently diagnosed with diabetes mellitus type 1. Which characteristics of adolescents does the nurse identify that should be taken into consideration when planning client education and care? Select all that apply.

desire to be like peers desire to become independent of parents

A client was recently admitted with a diagnosis of diabetes. The nurse observes that the client has acetone breath, a weak and rapid pulse, and Kussmaul's respirations. The nurse recognizes that interventions should be provided for what condition?

diabetic ketoacidosis

When plotting height and weight on a growth chart, which observation by the nurse would indicate that a 4-year-old child has a growth hormone deficiency?

downward shift of 2 percentiles or more

Which condition could possibly cause hypoglycemia?

excessive exercise without a carbohydrate snack

A client is diagnosed with pituitary gigantism. The nurse reviews the laboratory findings of which hormone value?

growth hormone (GH)

The nurse is reinforcing education with parents of a child with growth hormone deficiency. What sport should the nurse encourage?

gymnastics

A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are only effective if the client:

has type 2 diabetes.

The nurse is caring for a client with suspected parathyroid dysfunction. Which laboratory results support a diagnosis of primary hyperparathyroidism?

high parathyroid hormone and high calcium levels

The physician diagnoses type 1 diabetes in a client who has classic manifestations of the disease and a random blood glucose level of 350 mg/dl. In addition to dietary modifications, the physician prescribes insulin. Initially, most clients receive the least antigenic form of insulin. Therefore, the nurse expects the physician to prescribe:

human insulin.

A client has flushed skin, bulging eyes, and perspiration, and states he or she has been "irritable" and having palpitations. Which interpretation of these findings might the nurse suspect?

hyperthyroidism

A nurse reviews the laboratory data of a client. The data reveals increased blood and urine levels of triiodothyronine (T3) and thyroxine (T4). The nurse determines these values are associated with which condition?

hyperthyroidism

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

hypokalemia and hypoglycemia

A client reports weight gain and fatigue. The nurse obtains data that reveal the following: blood pressure 120/74 mm Hg, pulse rate 52 beats/minute, respiratory rate 20 breaths/minute, and temperature 98° F. Laboratory results show low thyroxine (T4) and triiodothyronine (T3) levels. The nurse determines these symptoms are associated with which condition?

hypothyroidism

A client with hyperparathyroidism develops renal calculi. The nurse should expect to see which electrolyte levels?

increased calcium levels

Which criteria would the nurse use to measure good metabolic control in a child with diabetes?

infrequent occurrences of mild hypoglycemic reactions

A client has elevated levels of triiodothyronine (T3), thyroxine (T4), and calcitonin. The nurse is aware that these hormones are produced by which gland?

thyroid gland

A client presents with a "buffalo hump" at the shoulder area and an obese truncal area with thin extremities. Which test should the nurse anticipate?

low-dose dexamethasone suppression test

A client with diabetes mellitus has just been prescribed insulin. When teaching the client about hypoglycemia, the nurse should mention that this reaction may cause:

nervousness, diaphoresis, and confusion.

A client recently diagnosed with pre-diabetes asks the nurse about the risk factors for developing diabetes. The nurse identifies which factor as the client's greatest risk for developing diabetes mellitus?

obesity

Capillary glucose monitoring is being performed every 4 hours for a client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he receives 8 units of regular insulin. The nurse should expect the dose's:

onset to be at 2:30 p.m. and its peak to be at 4 p.m.

The nurse is caring for a client diagnosed with hyperthyroidism. Which nursing intervention should be the priority to decrease the client's anxiety?

providing a calm, restful environment

A nurse is evaluating a client for signs of hypoxemia. Which diagnostic procedure would the nurse expect to perform first to monitor the client's respiratory status?

pulse oximetry

A nurse is interviewing the parent of a 7-year-old child. Which symptom reported by the parent would most lead the nurse to suspect that the child has type 1 diabetes?

recent bed-wetting

A client with diabetes is being taught about possible complications. The nurse should include which conditions in the discussion with the client?

retinopathy, neuropathy, and coronary artery disease