Q 5 CH 31-33

The nurse and nursing student are caring for a client undergoing a severe stressor with release of epinephrine into the bloodstream. Which of these effects on blood glucose levels does the nurse teach the student epinephrine will cause?

Blood glucose will elevate.

When caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which of these organs does the nurse recognize is reliant on glucose as the major energy source?

Brain

A client arrives in the clinic and states to the nurse, "I am tired all the time and have gained weight. My hair is so dry it is breaking." The nurse assesses that the client's face is puffy with edematous eyelids and the outer third of the eyebrows are thinning. What lab test will the nurse prepare the client for that is characteristic of this disorder?

T4 and TSH

A client diagnosed with type 2 diabetes has been instructed about managing his condition with diet. The nurse determines further teaching is necessary when the client states:

"I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads."

A client is diagnosed with Addison's disease. What statement by the client indicates an understanding of the discharge instructions by the nurse?

"I will have to take my medication for the rest of my life."

After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?

70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and an elevated temperature of 103.20 F

A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to?

A hypermetabolic state

A nurse is evaluating clients for the risk of developing type 2 diabetes. Which client has the highest risk for developing this metabolic disorder?

A middle aged obese adult with a sedentary lifestyle

A patient exhibiting problems with their thyroid has been scheduled for a radioactive scan. From the following list of patients, which would the nurse question as to whether this would be a safe procedure for this patient?

A young female patient who has been trying to get pregnant.

The nurse assessing a male client finds abnormally large hands and feet, bulbous nose, and a broad face with a protruding jaw. Based on these findings,which endocrine abnormality is most likely the cause for these physical changes?

Acromegaly

The critical care nurse has just admitted a client with diabetic ketoacidosis (DKA) whose blood glucose level is 877 mg/dL. The client's breath has a fruity odor and the client is confused. Which of these does the nurse set as the priority at this time?

Administration of intravenous fluids

A client has been diagnosed with dysfunction of the anterior pituitary gland. The nurse is aware that which hormones will likely be affected? Select all that apply.

Adrenocorticotropic hormone (ACTH) Thyroid-stimulating hormone (TSH) Growth hormone (GH) Luteinizing hormone (LH)

A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of:

Antidiuretic hormone (ADH) and oxytocin

Which complication of acromegaly can be life threatening?

Cardiac structures increase in size

Which of the following criteria about insulin would prompt a diagnosis of type 1 diabetes?

Complete failure of insulin secretion

A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to begin replacement therapy. Regarding which type of replacement will the nurse educate the client?

Cortisol replacement therapy.

Which disorder is a result of excess cortisol?

Cushing syndrome

A client with pancreatitis is admitted with weight loss, nausea, and vomiting. To maintain nutrition, the physician orders parental nutrition to be started. Knowing that a major side effect of parenteral nutrition is a hyperosmolar hyperglycemic state, the nurse should assess the patient for which clinical manifestations (listed below)?

Dry lips, excess urine output, and seizures.

A woman with poorly controlled type 1 diabetes has been admitted to a hospital unit for the treatment of ketoacidosis. Place the following events in the pathophysiology of ketoacidosis in the correct chronological order. Use all the options.

Decrease in pH Breakdown of triglycerides Low serum insulin levels Ketone production by the liver Production of fatty acids and glycerol

A patient experiences an increase in thyroid hormone as a result of a thyroid tumor. Which of the following hormonal responses demonstrates the negative feedback mechanism?

Decreased thyroid-stimulating hormone (TSH)

When caring for a client with anemia and a decrease in red blood cells (RBCs), the nurse recognizes which of these hormones will stimulate the bone marrow to produce additional RBCs?

Erythropoietin

The nurse is caring for a client who received regular insulin at 7 am. Four hours later the nurse finds the client diaphoretic, cool, and clammy. Which of these interventions is the priority?

Give the client a concentrated carbohydrate.

A 25-year-old female client exhibits exophthalmos of both eyes. The health care provider recognizes this as a manifestation of:

Graves disease

The nurse is performing an assessment for a client who has hyperthyroidism that is untreated. When obtaining vital signs, what is the expected finding?

Heart rate 110 and bounding

The nurse is caring for a client with diabetes. Which of these findings is cause for concern leading the nurse to initiate client education?

Hemoglobin A1 C level is 8.7.

Which enzyme has a powerful vasodilator effect on arterioles and increases capillary permeability?

Histamine

Which statement best explains the function of hormone receptors?

Hormone receptors recognize a specific hormone and translate the hormonal signal into a cellular response.

The nurse is teaching a client diagnosed with Addison disease about the importance of lifetime oral replacement therapy. Which pharmacologic agent would be the drug of choice and included in this teaching plan?

Hydrocortisone

A healthcare provider is assessing a client for a potential endocrine disorder. Assessment findings identify abnormalities with emotion, pain, and body temperature. Which mechanism of endocrine control will require further lab/diagnostic assessment?

Hypothalamus

When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptoms does the client report that the nurse would find associated with this disorder?

Increase in appetite

Select the most appropriate intervention for the nurse to teach a client diagnosed with distal symmetric neuropathy related to diabetes.

Inspect the feet for blisters daily

The diagnosis of type 1 diabetes would be confirmed by:

Insulin is not available for use by the body.

A client admitted to the hospital with elevated blood glucose is diagnosed with type 1 diabetes mellitus. What characteristics commonly differentiate type 1 diabetes mellitus from type 2 diabetes mellitus? Select all that apply.

Onset before age 20 Autoimmune beta cell damage Abrupt onset of symptoms

The heart is a four-chambered pump. Which chamber of the heart pumps blood into the systemic circulation?

Left ventricle

The nurse has just completed teaching a client newly diagnosed with type 1 diabetes about rapid-acting insulin. The nurse determines that teaching was effective when the client selects:

Lispro

A client with severe hypoglycemia is unconscious. Which method of providing glucose should be avoided?

Orange juice orally

The heart is a four-chambered pump. What is the function of the right ventricle?

Pumps blood to the lungs

A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?

Random blood glucose 85 mg/dl

The nurse is caring for a client diagnosed with hyperthyroidism. Which clinical manifestations are most likely to be seen in this client? Select all that apply.

Shortness of breath Tachycardia Weight loss Fine muscle tremor

A newborn is screened for congenital hypothyroidism and is found to have the disorder. When educating the mother about the importance of the infant's taking thyroid hormone supplement, what should be included in the education?

The infant will have dosage levels adjusted as he grows.

The nurse is educating a client with hyperthyroidism who has recovered from thyrotoxicosis (thyroid storm) and is preparing for discharge. What can the nurse inform the client that this hypermetabolic state can be caused by in order to decrease exacerbation? Select all that apply.

Stress Physical or emotional trauma Manipulation of the thyroid gland

The nurse is teaching a client with diabetes about the signs and symptoms of hypoglycemia. The client asks, "Why do you get headache, disturbed behavior, coma, and seizures if it's my pancreas that's impaired?" Which response is the best explanation?

The brain relies on blood glucose as its main energy source.

A client is managing their diabetes with exercise and diet. The health care provider reviews the client's most recent lab results: fasting blood sugar level at 80 mg/dL and a hemoglobin A1C of 5%. Select the response that best identifies the client.

The client is achieving normal glycemic control.

The nurse is educating a newly diagnosed client with Hashimoto thyroiditis who is to be discharged from the acute care facility. What should the nurse be sure to include in the education to prevent complications?

The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.

A patient is managing his type 2 diabetes with exercise and diet. He has a fasting blood sugar level (FBS) of 80 mg/dL and a hemoglobin A1C of 5%. Based on these findings, which of the following can the nurse assume?

The patient is achieving normal glycemic control.

The nurse is teaching a new diabetic about fingerstick blood glucose testing. When the client obtains a pre-meal fingerstick reading of 206 mg/dL, which teaching by the nurse is most appropriate?

This is an elevated reading - let's talk about adherence to insulin and diet.

A client who has just undergone a thyroidectomy is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these findings as manifestations of which complication?

Thyroid storm

The nurse explains to a client in labor who has demonstrated ineffective contractions impeding progression of labor that the health care provider has added oxytocin infusion to the orders. Which of these does the nurse teach the client is the purpose of oxytocin?

To stimulate contraction of the uterus

The nurse is caring for a client with diabetes who has developed gastroparesis. Which of these symptoms does the nurse expect the client to report?

Vomiting after eating

The health care provider is teaching a client about the metabolic effect of cortisol. The most appropriate information to provide would be:

Breakdown of proteins and fats