Pathopharmacology Endocrine Practice Questions

A client is taking humulin NPH insulin and regular insulin every morning. The nurse should provide which instructions to the client? Select all that apply. 1.hypoglycemia may be experienced before dinner time. 2.the insulin dose should be decreased if illness occurs. 3.the insulin should be administered at room temperature. 4.the insulin vial needs to be shaken vigorously to break up the precipitates.

1 & 3 Humulin NPH is an intermediate acting insulin. The onset of action is 1.5 hours, it peaks in 4 to 12 hours, and it's duration of action is 24 hours. Regular insulin is a short acting insulin. Depending on the type, the onset of action is 0.5 hours, it peaks in 2 to 5.5 hours, and it's duration is 5 to 8 hours. Hypoglycemic reactions most likely occur during peak time. Insulin should be at room temperature when administered. Clients may need their insulin dosages increased during times of illness. Insulin vials should never be shaken vigorously. Regular insulin is always drawn up before NPH.

The nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe. Which action is performed by the client, indicates a need for further teaching? 1.withdraws the NPH insulin first 2.withdraws the regular insulin first 3.injects air into NPH insulin vial first 4.injects an amount of air equal to the desired dose of insulin into each vial.

1. When preparing a mixture of short acting insulin such as regular insulin with another insulin preparation, the short acting insulin is drawn into the syringe first. This sequence will avoid contaminating the vial of short acting insulin with insulin of another type.

The nurse is monitoring a client newly diagnosed with DM for signs of complications. Which sign, if exhibited in the client, would indicate hyperglycemia? 1.polyuria 2.diaphoresis 3.hypertension 4.increased pulse rate

1. Classic symptoms of hyperglycemia include polydipsia, polyuria, and polyphagia.

A young woman makes an appointment to see a physician at the clinic. She complains of tiredness, weight gain, muscle aches and pains, and constipation. The physician will likely order: 1. T3 and T4 serum level laboratory tests. 2. glucose tolerance test. 3. cerebral computed tomography (CT) scan. 4. adrenocortical stimulating test.

1. T3 and T4 serum level laboratory tests. These complaints are strongly suggestive of thyroid disorder; T3 and T4 laboratory tests are the most useful diagnostic tests.

The nurse is preparing a plan of care for a client with DM who has hyperglycemia. The nurse places highest priority on which client problem? 1.lack of knowledge 2.inadequate fluid volume 3.compromised family coping 4.in adequate consumption of nutrients

2. And increased BG level will cause the kidneys to excrete the glucose in the urine. This glucose is accompanied by fluids and electrolytes, causing an osmotic diuresis since leading to dehydration. This fluid loss must be replaced when it becomes severe.

The nurse is preparing a client with a new diagnosis of hypothyroidism for discharge. The nurse determines that the client understands discharge instructions as the client states that which symptoms are associated with this diagnosis? Select all that apply. 1.tremors 2.weight loss 3.feeling cold 4.loss of body hair 5.persistent lethargy 6.puffiness of the face

3, 4, 5, 6 Feeling cold, hair loss, lethargy, and facial puffiness are signs of hypothyroidism. Tremors and weight loss are signs of hyperthyroidism.

The client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client? 1.hypoglycemia 2.level of hoarseness 3.respiratory distress 4.edema at the surgical site

3.

After several diagnostic tests, a client is diagnosed with diabetes insipidus (DI). The nurse performs an assessment on the client, knowing that which symptom is most indicative of this disorder? 1.fatigue 2.diarrhea 3.polydipsia 4.weight gain

3. DI is characterized by hyposecretion of antidiuretic hormone, and the kidney tubules fail to reabsorb water. Polydipsia and polyuria are classic symptoms of DI. The urine is pale, and the specific gravity is low. Anorexia and weight loss occur.

The nursing instructor asks the student to describe the pathophysiology that occurs in Cushing's disease. Which statement by the student indicates an accurate understanding of this disorder? 1.Cushing's disease results from an oversecretion of insulin. 2.Cushing's disease results from an undersecretion of corticotropic hormones. 3.Cushing's disease results from an undersecretion of mineralocorticoid hormones. 4.Cushing's disease results from an increased pituitary secretion of adrenocorticotropic hormone.

4. Cushing's disease is a metabolic disorder characterized by abnormally increased secretion (endogenous) of cortisol, caused by increased amounts of adrenocorticotropic hormone (ACTH) secreted by the pituitary gland. Addison's disease is characterized by the hyposecretion of adrenal cortex hormones (glucocorticoid and mineralocorticoid) from the adrenal gland, resulting in deficiency of the corticosteroid hormones.

A patient is scheduled to start taking insulin glargine (Lantus). On the care plan a nurse should include which of these outcomes related to the therapeutic effects of the medication? A) Blood glucose control for 24 hours B) Mealtime coverage of blood glucose C) Less frequent blood glucose monitoring D) Peak effect achieved in 2 to 4 hours

A) Blood glucose control for 24 hours Insulin glargine is administered as a once-daily subcutaneous injection for patients who have type 1 diabetes. It is used for basal insulin coverage, not mealtime coverage. It has a prolonged duration up to 24 hours with no peaks. Blood glucose monitoring is still an essential component to achieve tight glycemic control.

A patient who has type 2 diabetes has a glycated hemoglobin (HbA1c) result of 10%. A nurse should make which of these changes to the nursing care plan? A) Refer to a diabetic educator, there is poor glycemic control. B) Glycemic control is adequate, no changes are needed. C) Hypoglycemia is a risk, teach the patient the symptoms. D) Instruct the patient to limit activity and weekly exercise.

A) Refer to a diabetic educator, there is poor glycemic control.

In the administration of a drug such as levothyroxine (Synthroid), the nurse should teach the client: A) That therapy typically lasts about 6 months. B) That weekly laboratory tests for T4 levels will be required. C) To report weight loss, anxiety, insomnia, and palpitations. D) That the drug may be taken every other day if diarrhea occurs.

C) To report weight loss, anxiety, insomnia, and palpitations.

A patient with hyperthyroidism is taking propylthiouracil (PTU). The nurse will monitor the patient for: A) gingival hyperplasia and lycopenemia. B) dyspnea and a dry cough. C) blurred vision and nystagmus. D) fever and sore throat.

D) fever and sore throat.

A physician prescribes levothyroxine sodium (Synthroid), 0.15 mg orally daily, for a client with hypothyroidism. The nurse will prepare to administer this medication: a) in the morning to prevent insomnia b) only when the client complains of fatigue and cold intolerance c) at various times during the day to prevent tolerance from occurring d) three times daily in equal doses of 0.5 mg each to ensure consistent serum drug levels

a) in the morning to prevent insomnia Levothyroxine (Synthroid) is a synthetic thyroid hormone that increases cellular metabolism. Levothyroxine should be given in the morning in a single dose to prevent insomnia and should be given at the same time each day to maintain an adequate drug level. Therefore, options B, C, and D are incorrect.

A patient with Grave's dz asks the nurse what caused the disorder. The best response by the nurse is a. "The cause of Grave's disease is not known, although it is thought to be genetic." b. "It is usually associated with goiter formation from an iodine deficiency over a long period of time." c. "Antibodies develop against thyroid tissue and destroy it, causing a deficiency of thyroid hormones" d. "In genetically susceptible persons antibodies form that attack thyroid tissue and stimulate overproduction of thyroid hormones."

d. "In genetically susceptible persons antibodies form that attack thyroid tissue and stimulate overproduction of thyroid hormones." (rationale- The antibodies present in Graves' disease that attack thyroid tissue cause hyperplasia of the gland and stimulate TSH receptors on the thyroid and activate the production of thyroid hormones, creating hyperthyroidism. The disease is not directly genetic, but individuals appear to have a genetic susceptibility to become sensitized to develop autoimmune antibodies. Goiter formation from insufficient iodine intake is usually associated with hypothyroidism.)