NCLEX endocrine system
A client with severe diabetes insipidus is receiving desmopressin acetate, which is administered intranasally in a metered spray. During the follow-up visits, the client reports chest tightness to the primary healthcare provider. Which intervention would effectively reduce complications in the client? Select all that apply. A. Administration of desmopressin acetate orally B. Administration of lithium carbonate intranasally C. Administration of antidiuretic hormone intravenously D. Administration of antidiuretic hormone intramuscularly E. Administration of desmopressin acetate subcutaneously
A. Administration of desmopressin acetate orally E. Administration of desmopressin acetate subcutaneously
The physical examination of a client reveals moon face, buffalo hump, and truncal obesity. The laboratory report reveals salivary cortisol level of 3.0 ng/mL (9.54 nmol/L). Which other manifestations would be present in the client? Select all that apply. A. Edema B. Osteoporosis C. Hypogonadism D. Muscle atrophy E. Barrel-shaped chest
A. Edema B. Osteoporosis D. Muscle atrophy
A nurse is caring for a client admitted to the hospital with primary hyperparathyroidism. Which action should be included in this client's plan of care? A. Ensuring a large fluid intake B. Providing a high-calcium diet C. Instituting seizure precautions D. Encouraging complete bed rest
A. Ensuring a large fluid intake
A client with a brain tumor develops a urine output of 300 mL/hr, dry skin, and dry mucous membranes. Which nursing intervention is the most appropriate to perform for this client? A. Evaluate urine specific gravity. B. Implement fluid restrictions. C. Provide emollients to the skin to prevent breakdown. D. Slow down the intravenous (IV) fluids and notify the primary healthcare provider.
A. Evaluate urine specific gravity.
A nurse, caring for a client with uncontrolled diabetes, suspects that a client is experiencing hypoglycemia in response to insulin administration. What clinical manifestations lead the nurse to this conclusion? Select all that apply. A. Headache B. Confusion C. Extreme thirst D. Profuse sweating E. Increased urination
A. Headache B. Confusion D. Profuse sweating
The laboratory reports of a client with adrenal adenoma show high urine aldosterone levels and a low specific gravity of urine. The serum potassium is found to be 2.8 mEq/L (2.8 mmol/L). Which other findings will be present upon assessment? Select all that apply. A. Hypernatremia B. Hypertension C. Hypoglycemia D. Hypercalcemia E. Metabolic alkalosis
A. Hypernatremia B. Hypertension E. Metabolic alkalosis
You administered 5 units of Humalog at 0800. What is the ONSET and DURATION of this medication? A. Onset: 15 minutes, Duration: 3 hours B. Onset: 2 hours, Duration: 16 hours C. Onset: 30 minutes, Duration: 1 hour D. Onset: 2 hours, Duration: 24 hours
A. Onset: 15 minutes, Duration: 3 hours
A patient newly diagnosed with diabetes is about to be discharged home. You are watching the patient administer insulin. Which of the following actions causes you to re-educate them? A. They massaged the site after administering the insulin. B. They injected into the fat of their thighs. C. They used an opposite side for injection compared to the last insulin injection. D. They engaged the safety after administering the medication.
A. They massaged the site after administering the insulin.
Type 1 diabetics typically have the following clinical characteristics: A. Thin, young with ketones present in the urine B. Overweight, young with no ketones present in the urine C. Thin, older adult with glycosuria D. Overweight, adult-aged with ketones present in the urine
A. Thin, young with ketones present in the urine
A registered nurse is teaching the student nurse the precautions to follow when blood samples are collected. Which statement made by the student nurse indicates effective learning? A. "I can place the specimen with other samples." B. "I can use a single-lumen line to obtain samples." C. "I should not reveal the test procedure to the client." D. "I should not place the blood samples collected for adrenaline on ice."
B. "I can use a single-lumen line to obtain samples."
The nurse evaluates the statements of a client after teaching about hydrocortisone therapy. Which statement made by the client indicates effective learning? A. "I should report if I experience two to three episodes of vomiting." B. "I should report if there is swelling in the hands or legs." C. "I should immediately report if my body temperature crosses 37°C (98.6 °F)." D. "I should immediately report if I experience diarrhea."
B. "I should report if there is swelling in the hands or legs."
A patient with Type 2 Diabetes is started on the medication Glyburide. Which of the following statements by the patient causes concern? A. "I will monitor my blood glucose regularly because I know this medication can cause a low blood sugar." B. "I will consume no more than 8 oz. of alcohol per week." C. "I will continue monitoring my diet and participating in exercise while taking this medication." D. "This medication works by stimulating the beta cells in the pancreas to make insulin."
B. "I will consume no more than 8 oz. of alcohol per week."
A patient is scheduled to take 5 units of Humulin R and 10 units of NPH. What is the proper way of mixing these insulins? A. These insulins cannot be mixed, therefore, should be drawn up in different syringes. B. Draw-up the Humulin R insulin first and then the NPH insulin. C. Draw-up 2.5 units of NPH, then 10 units of Humulin R, and then finish drawing up 2.5 units of NPH. D. Draw-up the NPH insulin first and then the Humulin R insulin.
B. Draw-up the Humulin R insulin first and then the NPH insulin.
A patient is scheduled to take a morning dose of Metformin. The patient is scheduled for surgery tomorrow. Which of the following nursing interventions are correct? A. Administer the medication as ordered. B. Hold the dose and notify the doctor for further orders. C. Administer the medication as ordered but hold the next day's dose. D. Check the patient's blood glucose prior to administering the medication.
B. Hold the dose and notify the doctor for further orders.
A client who had a subtotal thyroidectomy returns to the unit from the postanesthesia care unit. What is the priority nursing action at this time? A. Monitor for hypoglycemia. B. Observe for signs of tetany. C. Place a sandbag under the neck. D. Teach the need to support the head.
B. Observe for signs of tetany.
The nurse is teaching a nursing student how to care for a client who underwent stereotactic radiosurgery for a pituitary adenoma. Which statement made by the student indicates effective learning? A. "I will assess for bleeding." B. "I will monitor cardiac output." C. "I will monitor serum osmolarity." D. "I will assess for glucose levels in nasal discharge."
C. "I will monitor serum osmolarity."
Which treatment intervention should be provided to a client diagnosed with Cushing's disease? A. Increase cortisol levels B. Increase sodium levels C. Decrease blood glucose levels D. Decrease serum calcium levels
C. Decrease blood glucose levels
The laboratory reports of a client reveal selective hypopituitarism related to growth hormone (GH). What other findings does the nurse anticipate in the client? Select all that apply. A. Decreased body hair B. Decreased serum cortisol C. Decreased muscle strength D. Increased serum cholesterol E. Decreased tolerance to cold
C. Decreased muscle strength D. Increased serum cholesterol
A client with addisonian crisis exhibits severe manifestations of glucocorticoid and mineralocorticoid deficiencies. Which responses should the nurse expect the client to exhibit? Select all that apply. A. Bradycardia B. Hypertension C. Hyperkalemia D. Hyponatremia E. Postural hypotension
C. Hyperkalemia D. Hyponatremia E. Postural hypotension
The nurse is teaching a diabetic client about the advantages of using an insulin pump. What information should the nurse include? Select all that apply. A. It prevents ketoacidosis. B. It helps cause weight loss. C. It can improve A1C levels. D. An insulin pump costs less than subcutaneous injections. E. Clients may be able to exercise without eating more carbohydrates.
C. It can improve A1C levels. E. Clients may be able to exercise without eating more carbohydrates.
Which of the following insulins has no peak but a duration of 24 hours? A. NPH B. Novolog C. Lantus D. Humulin N
C. Lantus
What is the most important test the nurse should check to determine whether a transplanted kidney is functioning? A. White blood cell (WBC) cell count B. Renal ultrasound C. Serum creatinine level D. 24-hour urinary output
C. Serum creatinine level
A patient with diabetes asks you about what type of exercise they should perform throughout the week. The best response is: A. Lifting weights B. Sprinting C. Swimming D. Jumping
C. Swimming
A patient taking the medication Precose asks when it is the best time to take this medication. Your response is: A. 1 hour prior to eating B. 1 hour after eating C. With the first bite of food D. At bedtime
C. With the first bite of food
A client has been diagnosed with hyperthyroidism. The nurse expects the client to exhibit which clinical manifestations? Select all that apply. A. Dry skin B. Slow pulse C. Weight gain D. Nervousness E. Increased appetite
D. Nervousness E. Increased appetite
A nurse is preparing to assess the client's thyroid gland. Arrange the procedure for posterior palpation of the thyroid gland in sequence. 1. Place both thumbs on the nape of the client's neck. 2. Stand behind the client. 3. Ask the client to swallow water so that the thyroid will move up. 4. Use the index and middle fingers of both hands to feel the thyroid isthmus. 5. Ask the client to flex the neck slightly forward and to the right. 6. Palpate the sternocleidomastoid muscle with the index and middle fingers.
2. Stand behind the client. 1. Place both thumbs on the nape of the client's neck. 4. Use the index and middle fingers of both hands to feel the thyroid isthmus. 5. Ask the client to flex the neck slightly forward and to the right. 6. Palpate the sternocleidomastoid muscle with the index and middle fingers. 3. Ask the client to swallow water so that the thyroid will move up.
A patient who has diabetes is nothing by mouth as prep for surgery. The patient states they feel like their blood sugar is low. You check the glucose and find it to be 52. The next nursing intervention would be to: A. Notify the doctor for further orders regarding the blood sugar B. Continue to monitor the glucose C. Give the patient 3 graham crackers to eat D. None, this is a normal blood glucose reading
A. Notify the doctor for further orders regarding the blood sugar
The nurse is caring for an older client admitted to the hospital with type 2 diabetes. What is important for the nurse to remember about older adults and type 2 diabetes? A. Older adults seldom develop ketoacidosis. B. Older adults secrete no endogenous insulin. C. Older adults have a lower risk of complications. D. Older adults develop a sudden onset of symptoms.
A. Older adults seldom develop ketoacidosis.
After assessing a client's condition, the nurse suspects that the client has diabetes mellitus. Which statement made by the client would be most appropriate in helping the nurse reach this conclusion? Select all that apply. A. "I am 55 years old." B. "I quite often feel thirsty." C. "I eat food every 2 hours." D. "I have excessive sweating." E. "I sometimes experience shortness of breath."
A. "I am 55 years old." B. "I quite often feel thirsty." C. "I eat food every 2 hours."
Which statement by a client with type 2 diabetes indicates to the nurse that additional dietary teaching is needed? A. "I can eat as much dietetic fruit as I want." B. "I can have a lettuce salad whenever I want it." C. "I know that half of my diet should be carbohydrates." D. "I need to reduce the amounts of saturated fats in my diet."
A. "I can eat as much dietetic fruit as I want."
A patient is scheduled to take 10 units of Humulin N at 1100. When is the patient most susceptible for hypoglycemia? A. 1900 B. 1300 C. 1130 D. 1500
A. 1900
A 36 year old male is newly diagnosed with Type 2 diabetes. Which of the following treatments do you expect the patient to be started on initially? A. Diet and exercise regimen B. Metformin BID by mouth C. Regular insulin subcutaneous D. None, monitoring at this time is sufficient enough
A. Diet and exercise regimen
What is the cause of Sheehan's syndrome? A. Thinner bones B. Intolerance to cold C. Severe hypotension D. Postpartum hemorrhage
D. Postpartum hemorrhage
A Type 2 diabetic may have all the following signs or symptoms EXCEPT: A. Blurry vision B. Ketones present in the urine C. Glycosuria D. Poor wound healing
B. Ketones present in the urine
Which of the following patient statements about the diabetic diet regimen is correct? A. "I'll try to consume about 20% carbs and 40% fats on a daily basis." B. "Foods that are high in mono and poly fats are avocados, olives, and nuts." C. "Meats increase the glycemic index; therefore, I should only consume 5% of them on a daily basis." D. "I should completely avoid starchy vegetables like potatoes and corn."
B. "Foods that are high in mono and poly fats are avocados, olives, and nuts."
A nurse is monitoring a client's fasting plasma glucose (FPG) level. At which FPG level should the nurse identify that the client has prediabetes? A. 70 mg/dL (3.9 mmol/L) B. 100 mg/dL (5.6 mmol/L) C. 130 mg/dL (7.2 mmol/L) D. 160 mg/dL (8.9 mmol/L)
B. 100 mg/dL (5.6 mmol/L)
A nurse is caring for a client with myxedema who has undergone abdominal surgery. What should the nurse consider when administering opioids to this client? A. Tolerance to the drug develops readily. B. One-third to one-half the usual dose should be prescribed. C. Opioids may interfere with the secretion of thyroid hormones. D. Sedation will have a paradoxical effect, causing hyperactivity.
B. One-third to one-half the usual dose should be prescribed.
When is a patient most susceptible to hypoglycemic symptoms after the administration of insulin? A. Onset B. Peak C. Duration D. Duration & Peak
B. Peak
A patient with diabetes is experiencing a blood glucose of 275 when waking. What is a typical treatment for this phenomenon? A. None, this is a normal blood glucose reading. B. The patient may need a night time dose of an intermediate-acting insulin to counteract the morning hyperglycemia. C. A bedtime snack may prevent this phenomenon. D. This is known as the Somogyi effect and requires decreasing the bedtime dose of insulin.
B. The patient may need a night time dose of an intermediate-acting insulin to counteract the morning hyperglycemia.
A client is admitted with a diagnosis of Cushing syndrome. Which clinical manifestations should the nurse expect the client to exhibit? Select all that apply. A. Emaciation B. Weakness C. Hypertension D. Truncal obesity E. Intermittent tonic spasms
B. Weakness C. Hypertension D. Truncal obesity
A patient has a blood glucose of 400. Which of the following medications could be the cause of this? A. Glyburide B. Atenolol C. Bactrim D. Prednisone
D. Prednisone
The nurse is assessing a client who reports frequent urination. Which inquiry made by the nurse will help determine diabetes insipidus? A. "Do you have history of cancer?" B. "Are you on fluoroquinolone therapy?" C. "Are you on lithium carbonate therapy?" D. "Do you have a history of lymphoma?"
C. "Are you on lithium carbonate therapy?"
A patient is scheduled to take 7 units of Humulin R at 0830. You administer Humulin R at 0900 in the right thigh. When do you expect this medication to peak? A. 1300 B. 0930 C. 1100 D. 1700
C. 1100
A nurse is caring for a client admitted to the hospital for diabetic ketoacidosis. Which clinical findings related to this event should the nurse document in the client's clinical record? Select all that apply. A. Diaphoresis B. Retinopathy C. Acetone breath D. Increased arterial bicarbonate level E. Decreased arterial carbon dioxide level
C. Acetone breath E. Decreased arterial carbon dioxide level
A client with type 2 diabetes travels frequently and asks how to plan meals during trips. What is the nurse's best response? A. "You can order diabetic foods on most airlines and in restaurants." B. "Plan your food ahead and carry it with you from home." C. "Monitor your blood glucose level frequently and eat accordingly." D. "Choose the foods you normally do and follow your food plan wherever you are."
D. "Choose the foods you normally do and follow your food plan wherever you are."
A nurse is developing a discharge plan for a client hospitalized with severe cirrhosis of the liver. What should be included in this plan? A. The need for a high-protein diet B. The use of a sedative for relaxation C. The need to increase fluids D. The importance of reporting personality changes to the primary healthcare provider
D. The importance of reporting personality changes to the primary healthcare provider
What statement or statements are INCORRECT regarding Diabetic Ketoacidosis? A. DKA occurs mainly in Type 1 diabetics. B. Ketones are present in the urine in DKA. C. Cheyne-stokes breathing can present in DKA. D. Severe hypoglycemia is a hallmark sign in DKA. E. Options C & D
E. Options C & D
True or False: The Somogyi effect causes the patient to experience an increase in their blood glucose during the hours of 2-3 am.
False: decrease
Which of the following symptoms do NOT present in hyperglycemia? A. Extreme thirst B. Hunger C. Blood glucose <60 mg/dL D. Glycosuria
C. Blood glucose <60 mg/dL
Which of the following insulins can be administered intravenously? A. NPH B. Lantus C. Humulin R D. Novolog
C. Humulin R
The nurse teaches a client with exophthalmos how to reduce discomfort and prevent corneal ulceration. Which statement by the client indicates that teaching was effective? A. "I should eliminate excessive blinking." B. "I should not move my extraocular muscles." C. "I should elevate the head of my bed at night." D. "I should avoid using a sleeping mask at night."
D. "I should avoid using a sleeping mask at night."
The _____ ______ secrete insulin which are located in the _______. A. Alpha cells, liver B. Alpha cells, pancreas C. Beta cells, liver D. Beta cells, pancreas
D. Beta cells, pancreas
A client's blood gases reflect diabetic ketoacidosis. Which clinical indicator should the nurse identify when monitoring this client's laboratory values? A. Increased pH B. Decreased PO2 C. Increased PCO2 D. Decreased HCO3
D. Decreased HCO3
A patient has a blood glucose of 45 and is sweating, cold, and clammy. The patient is conscious. What is your next nursing intervention? A. Recheck the blood glucose in 5 minutes. B. Call the doctor for further orders. C. No intervention is needed because this is a normal blood glucose. D. Give the patient 3 graham crackers to eat.
D. Give the patient 3 graham crackers to eat.
A client is learning alternate site testing (AST) for glucose monitoring. Which client statement indicates to the nurse that additional teaching is necessary? A. "I need to rub my forearm vigorously until warm before testing at this site." B. "The fingertip is preferred for glucose monitoring if hyperglycemia is suspected." C. "Alternate site testing is unsafe if I am experiencing a rapid change in glucose levels." D. "I have to make sure that my current glucose monitor can be used at an alternative site."
B. "The fingertip is preferred for glucose monitoring if hyperglycemia is suspected."
What interventions should the nurse implement in caring for a client with diabetes insipidus (DI) following a head injury? Select all that apply. A. Providing adequate fluids within easy reach B. Reporting an increasing urine specific gravity C. Administering prescribed erythromycin D. Assessing for and reporting changes in neurological status E. Monitoring for constipation, weight loss, hypotension, and tachycardia
A. Providing adequate fluids within easy reach D. Assessing for and reporting changes in neurological status E. Monitoring for constipation, weight loss, hypotension, and tachycardia
Which of the following statements are INCORRECT about exercise management for the diabetic patient? A. "I will check my blood glucose prior to exercise. If it is less than 200 I will eat a complex carb snack prior to exercising." B. "I plan on exercising for an extended period. So I will check my blood glucose prior, during, and after exercising." C. "My blood glucose is 268 and I have ketones in my urine. Therefore, I will avoid exercising today." D. All of the options are correct statements.
A. "I will check my blood glucose prior to exercise. If it is less than 200 I will eat a complex carb snack prior to exercising."
Which of the following patients is at most risk for Type 2 diabetes? A. A 6 year old girl recovering from a viral infection with a family history of diabetes. B. A 28 year old male with a BMI of 49. C. A 76 year old female with a history of cardiac disease. D. None of the options provided.
B. A 28 year old male with a BMI of 49.
A patient with diabetes has a morning glucose of 50. The patient is sweaty, cold, and clammy. Which of the following nursing interventions is MOST important? A. Recheck the glucose level B. Give the patient ½ cup (4 oz) of fruit juice C. Call the doctor D. Keep the patient nothing by mouth
B. Give the patient ½ cup (4 oz) of fruit juice
A client with hyperthyroidism refuses radioactive iodine therapy and a subtotal thyroidectomy is scheduled. The nurse reviews the preoperative plan of care and questions which prescription? A. High-protein, high-carbohydrate diet B. Dietary consult C. Antithyroid drugs D. Drugs to increase the blood pressure
D. Drugs to increase the blood pressure
A nurse is caring for a client after a thyroidectomy. Which symptoms indicating thyroid storm should the nurse monitor the client for? Select all that apply. A. Increased heart rate B. Increased temperature C. Decreased respirations D. Increased pulse deficit E. Decreased blood pressure
A. Increased heart rate B. Increased temperature
Which of the following statements are true regarding Type 2 diabetes treatment? A. Insulin and oral diabetic medications are administered routinely in the treatment of Type 2 diabetes. B. Insulin may be needed during times of surgery or illness. C. Insulin is never taken by the Type 2 diabetic. D. Oral medications are the first line of treatment for newly diagnosed Type 2 diabetics.
B. Insulin may be needed during times of surgery or illness.