Quiz 1 Endocrine
Which assessment finding in a client with diagnosis of diabetes insipidus (DI) indicates to the nurse that desmopressin therapy is effective? A. Urine output of 30 to 50 mL/hr B. Blood glucose level of 110 mg/dL (6.1 mmol/L) C. Respiratory rate of 20 breaths/min D. Potassium level of 3.9 mEq/L (mmol/L)
A. Urine output of 30 to 50 mL/hr
Which signs and symptoms in a client who has hyperthyroidism indicate to the nurse possible progression to a thyroid storm? (Select all that apply.) Select all that apply. A. Elevated temperature B. Tachycardia C. Somnolence D. Elevated systolic blood pressure E. Abdominal pain and nausea F. Slow respiratory rate
A. Elevated temperature B. Tachycardia D. Elevated systolic blood pressure E. Abdominal pain and nausea
A patient is being educated on how to take their anti-thyroid medication. Which of the following statements are INCORRECT? A. "I will continue taking aspirin daily." B. "I will take this medication at the same time every day." C. "It may take a while before I notice that the medication is helping my condition." D. "I will avoid foods containing high levels of iodine."
A. "I will continue taking aspirin daily."
You are performing discharge teaching with a patient who is going home on Synthroid. Which statement by the patient causes you to re-educate the patient about this medication? A. "I will take this medication at bedtime with a snack." B. "I will never stop taking the medication abruptly." C. "If I have palpitations, chest pain, intolerance to heat, or feel restless, I will notify the doctor." D. "I will not take this medication at the same time I take my Carafate."
A. "I will take this medication at bedtime with a snack."
Which statement made by a client about thyroid hormone replacement therapy (HRT) indicates to the nurse that further teaching is needed? A. "If I continue to lose weight, I may need an increased dose." B. "I will have more energy with this medication." C. "If I often am constipated and feel tired, I may need an increased dose." D. "I will take the medication every morning."
A. "If I continue to lose weight, I may need an increased dose."
A 30-year-old male client having an annual health physical reports that all of the following changes have developed during the past year. Which ones alert the nurse to possible pituitary hyperfunction? Select all that apply. A. 15 lb weight gain B. Decreased libido C. Four sinus infections D. Frequent constipation E. Increased foot callus formation F. Occasional dripping of clear fluid from both breasts G. Severely sprained ankle from a volley ball injury
A. 15 lb weight gain B. Decreased libido F. Occasional dripping of clear fluid from both breasts
Which patient is most at risk for developing Syndrome of Inappropriate Anti-diuretic Hormone (SIADH)? A. A patient diagnosed with small cell lung cancer. B. A patient whose kidney tubules are failing to reabsorb water. C. A patient with a tumor on the anterior pituitary gland. D. A patient taking Declomycin.
A. A patient diagnosed with small cell lung cancer.
A patient is admitted to the ER. The patient is unconscious on arrival. However, the patient's family is with the patient and reports that before the patient became unconscious she was complaining of severe pain in the abdomen, legs, and back, and has been experiencing worsening confusion. In addition, they also report the patient has not been taking any medications. The patient was recently discharged from the hospital for treatment of low cortisol and aldosterone levels. On assessment, you note the patient's blood pressure is 70/45. What disorder is this patient most likely experiencing? A. Addisonian Crisis B. Cushing Syndrome C. Thyroid crisis D. Hashimoto thyroiditis
A. Addisonian Crisis
Which of the following side effects are possible for a patient taking an anti-thyroid medication? A. Agranulocytosis and aplastic anemia B. Tachycardia C. Skin discoloration D. Joint pain and eczema
A. Agranulocytosis and aplastic anemia
Which of the following are the priority precautions the nurse will teach the client who remains at continuing risk for adrenal hypofunction and is taking hormone replacement therapy to prevent harm related to the disorder? Select all that apply. A. Avoid crowds and people who are ill B. Check your heart rate for irregular or skipped beats twice daily C. Do not choose low sodium versions of prepared foods D. Get up slowly from sitting or lying positions E. Keep a source of glucose, such as candy, with you at all times F. Never skip your hormone replacement drugs
A. Avoid crowds and people who are ill B. Check your heart rate for irregular or skipped beats twice daily C. Do not choose low sodium versions of prepared foods D. Get up slowly from sitting or lying positions E. Keep a source of glucose, such as candy, with you at all times F. Never skip your hormone replacement drugs
Which trends in serum electrolyte values will the nurse expect to find in a client who has untreated hypoparathyroidism? A. Below normal calcium levels; above normal phosphorus levels B. Below normal calcium levels; below normal phosphorus levels C. Above normal calcium levels; above normal phosphorus levels D. Above normal calcium levels; below normal phosphorus levels
A. Below normal calcium levels; above normal phosphorus levels
Which action immediately after a hypophysectomy will the nurse instruct a client to avoid to prevent harm? (Select all that apply.) Select all that apply. A. Bending at the waist B. Talking C. Deep breathing D. Coughing E. Wearing makeup F. Using dental floss
A. Bending at the waist D. Coughing
For which symptoms will the nurse instruct the family and client who is being treated for diabetes insipidus (DI) to call 911 or go to the nearest emergency department? (Select all that apply.) Select all that apply. A. Decreased urine output B. Hypotension C. Weigh gain of more than 2.2 lb (1 kg) in 24 hours D. Persistent headache E. Hyperglycemia F. Acute confusion
A. Decreased urine output C. Weigh gain of more than 2.2 lb (1 kg) in 24 hours D. Persistent headache F. Acute confusion
For which change reported by a client taking bromocriptine therapy to manage hyperpituitarism will the nurse notify the primary health care provider immediately to prevent harm? A. Chest pain B. Constipation C. Headache D. Increased sleepiness
A. Chest pain
What is the nurse's best action when noticing that the phlebotomist, who plans to draw blood from the client with severe hypercortisolism, displays symptoms of a cold? A. Ensuring the phlebotomist wears a facemask while in the client's room B. Asking the phlebotomist to delay the blood draw C. Monitoring the client closely for cold-like symptoms D. Placing a facemask on the client
A. Ensuring the phlebotomist wears a facemask while in the client's room
Which assessment has the highest priority for the nurse to perform for a client with syndrome of inappropriate antidiuretic hormone (SIADH) receiving tolvaptan therapy for 24 hours? A. Evaluating serum sodium levels B. Evaluating serum potassium levels C. Examining the skin and sclera for jaundice D. Examining the IV site for indications of phlebitis
A. Evaluating serum sodium levels
A patient with hypothyroidism is having pain 6 on 1-10 scale in the right hip due to recent hip surgery. Which of the following medications are NOT appropriate for this patient? Select all that apply: A. Fentanyl B. Tylenol C. Morphine D. Dilaudid
A. Fentanyl C. Morphine D. Dilaudid
You are developing a care plan for a patient with SIADH. Which of the following would be a potential nursing diagnosis for this patient? A. Fluid volume overload B. Fluid volume deficient C. Acute pain D. Impaired skin integrity
A. Fluid volume overload
A patient with Cushing's syndrome will be undergoing an adrenalectomy. Which of the following will be included in the patient's discharge teaching after the procedure? A. Glucocorticoid replacement therapy B. Avoiding avocadoes and pears C. Declomycin therapy D. Signs and symptoms of Grave's Disease
A. Glucocorticoid replacement therapy
Which of the following signs and symptoms causes concern and requires nursing intervention for a patient who recently had a thyroidectomy? A. Heart rate of 120, blood pressure 220/102, temperature 103.2 'F B. Heart rate of 35, blood pressure 60/43, temperature 95.3 'F C. Soft hair, irritable, diarrhea D. Constipation, drowsiness, goiter
A. Heart rate of 120, blood pressure 220/102, temperature 103.2 'F
Which of the following is not a typical sign and symptom of Cushing's Syndrome? A. Hyperpigmentation of the skin B. Hirsutism C. Purplish striae D. Moon Face
A. Hyperpigmentation of the skin
In the scenario above, what medication do you expect the patient to be started on? A. IV Solu-Cortef B. PO Prednisone C. PO Declomycin D. IV Insulin
A. IV Solu-Cortef
In Cushing's Disease and Syndrome there are: A. Increased cortisol production B. Low potassium and glucose levels C. Increased production of aldosterone and cortisol D. Decreased production of cortisol and aldosterone
A. Increased cortisol production
Performance of which assessment is a priority for the nurse before giving a client the first oral dose of hormone replacement for hypothyroidism? A. Measuring heart rate and rhythm B. Checking core body temperature C. Asking about previous allergic drug reactions D. Listening to bowel sounds in all four abdominal quadrants
A. Measuring heart rate and rhythm
A patient who is in her first trimester of pregnancy is diagnosed with hyperthyroidism. Which medication do you suspect the patient will be started on? A. Propylthiouracil (PTU) B. Radioactive Iodine C. Tapazole D. Synthroid
A. Propylthiouracil (PTU)
Which change in serum electrolyte values in the past 12 hours for a client with syndrome of inappropriate antidiuretic hormone (SIADH) being treated with tolvaptan will the nurse report immediately to the health care provider? A. Serum sodium increases from 122 mEq/L to 140 mEq/L. B. Serum potassium decreases from 4.2 mEq/L to 3.8 mEq/L. C. Serum chloride decreases from 109 mEq/L to 99 mEq/L. D. Serum calcium increases from 9.5 mg/dL to 10.2 mg/dL.
A. Serum sodium increases from 122 mEq/L to 140 mEq/L.
A patient with a mild case of diabetes insipidus is started on Diabinese. What would you include in your patient teaching with this patient? A. Signs and symptoms of hypoglycemia B. Restricting foods containing caffeine C. Taking the medication on an empty stomach D. Drinking 16 oz of water when taking the medication
A. Signs and symptoms of hypoglycemia
A patient is receiving radioactive iodine treatment for hyperthyroidism. What will you include in your patient education to this patient about this type of treatment? A. Taste changes and swollen salivary glands B. Constipation C. Excessive thirst D. Sun protection
A. Taste changes and swollen salivary glands.
Which assessment finding of a client 8 hours after a subtotal thyroidectomy does the nurse consider most relevant as an indication of a possible complication? A. The client's hand spasms during blood pressure measurement. B. The respiratory rate has dropped from 18 to 14 breaths per minute. C. The dressing has a moderate amount of serosanguinous drainage. D. The client responds to questions correctly but does not open the eyes while talking.
A. The client's hand spasms during blood pressure measurement.
Which of the following are treatment options for hyperthyroidism? Please select all that apply: A. Thyroidectomy B. Methimazole C. Liothyronine Sodium "Cytomel" D. Radioactive Iodine
A. Thyroidectomy B. Methimazole D. Radioactive Iodine
A patient arrives to the ER and is unable to give you a health history due to altered mental status. The family reports the patient has gained over 10 lbs in 1 week and says it is mainly "water" weight. In addition, they report the patient hasn't been able to urinate or eat within the past week as well and was recently diagnosed with small cell lung cancer. On assessment, you note the patient's HR is 115 and BP 180/92. Patient sodium level is 90. Which of the following conditions do you suspect the patient is most likely presenting with? A. SIADH B. Diabetes Insipidus C. Addison's Disease D. Fluid Volume Deficient
A: SIADH
Which statement made by the client alerts the nurse to the possibility of hypothyroidism? A. "I seem to feel the heat more than other people." B. "I am always tired, even when I get 10 or 12 hours of sleep." C. "Food just doesn't taste good without a lot of salt." D. "My grandmother had thyroid problems."
B. "I am always tired, even when I get 10 or 12 hours of sleep."
Which statement made by the client who is going home after a transsphenoidal hypophysectomy indicates to the nurse correct understanding of actions to prevent complications from this treatment? A. "While I am awake, I will be sure to cough and deep breathe at least every 2 hours." B. "I will keep the cat food bowl on my counter so that I do not have to bend over." C. "Whenever I am out-of-doors in the sunshine, I will wear dark glasses." D. "If the dressing gets wet, I will wash the incision line and redress it immediately."
B. "I will keep the cat food bowl on my counter so that I do not have to bend over."
A patient with Addison's Disease is being discharged home on Prednisone. Which of the following statements by the patient warrants you to re-educate the patient? A. "I will notify the doctor if I become sick or experience extra stress." B. "I will take this medication as needed when symptoms present." C. "I will take this medication at the same time every day." D. "My daughter has bought me a Medic-Alert bracelet."
B. "I will take this medication as needed when symptoms present."
What is the nurse's best response when a client, who has been taking high-dose corticosteroid therapy for a month for a problem that has now resolved, asks you why she needs to continue taking the corticosteroid? A. "Corticosteroids are a type of hormone, and once you have been started on a replacement hormone, you must continue the hormone replacement therapy for the rest of your life." B. "The drug suppressed your own adrenal gland secretion of corticosteroids. Slowly decreasing the dose over time allows your adrenal glands to start adequate secretion again." C. "It is possible for your health problem to recur when corticosteroid therapy is halted suddenly." D. "The drug suppressed your immune system while you were taking it. Slowly decreasing the dose over time prevents your immune system from starting up too quickly and causing allergic reactions."
B. "The drug suppressed your own adrenal gland secretion of corticosteroids. Slowly decreasing the dose over time allows your adrenal glands to start adequate secretion again."
What is the nurse's best response when a client with Cushing syndrome screams at her husband, bursts into tears, throws her water pitcher against the wall, and then says "I feel like I am going crazy"? A. "You must learn to control your behavior. Because you are disturbing others, I am going to keep the door to your room closed and restrict your visitors." B. "You feel this way because of your high hormone levels. Your health care provider can prescribe an antianxiety drug for you." C. "I will tell your primary health care provider order a psychiatric consult for you." D. "You are probably feeling this way because you are frightened about having a chronic disease. Would you like some information about a support group?"
B. "You feel this way because of your high hormone levels. Your health care provider can prescribe an antianxiety drug for you."
With which client will the nurse be aware of an increased risk for hypoparathyroidism? A. A 28-year-old woman with pregnancy-induced hypertension B. A 35-year-old woman who had radiation therapy for Graves disease C. A 50-year-old man starting on insulin therapy for type 2 diabetes mellitus D. A 55-year-old man with moderate heart failure after myocardial infarction
B. A 35-year-old woman who had radiation therapy for Graves disease
For which client will the nurse question the prescription for long-term androgen therapy? A. A 40 year old who also has syndrome of inappropriate antidiuretic hormone (SIADH). B. A 52 year old with a history of prostate cancer treatment. C. A 30 year old who is taking antiviral therapy for HIV disease. D. A 66 year old with impotence that is resistant to standard erectile dysfunction therapy.
B. A 52 year old with a history of prostate cancer treatment.
Which of the following patients are at risk for developing Cushing's Syndrome? A. A patient with a tumor on the pituitary gland, which is causing too much ACTH to be secreted. B. A patient taking glucocorticoids for several weeks. C. A patient with a tuberculosis infection. D. A patient who is post-opt from an adrenalectomy
B. A patient taking glucocorticoids for several weeks.
Clients who have deficiencies of which hormones will the nurse assess for increased risk of life-threatening consequences? A. Prolactin and prolactin inhibiting hormone (PIH) B. Adrenocorticotrophicn hormone (ACTH) and thyroid-stimulating hormone (TSH) C. Growth hormone (GH) and melanocyte-stimulating hormone (MSH) D. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
B. Adrenocorticotrophicn hormone (ACTH) and thyroid-stimulating hormone (TSH)
Which assessment findings in a client with hyperthyroidism indicates to the nurse that the client is in danger of thyroid storm? Select all that apply. A. Increased salivation B. Client report of increased palmar sweating C. Decreased pulse pressure from 40 mm Hg to 36 mm Hg D. Diminished bowel sounds in all four abdominal quadrants E. An increase in temperature from 99.5o F (37.5o C) to 101.3o F (38.5o C) F. Serum sodium level increase from 136 mEq/L (mmol/L) to 139 mEq/L (mmol/L) G. Increase in premature ventricular heart contractions from 4 per minute to 28 per minute
B. Client report of increased palmar sweating E. An increase in temperature from 99.5o F (37.5o C) to 101.3o F (38.5o C) G. Increase in premature ventricular heart contractions from 4 per minute to 28 per minute
Which assessment finding in a client with hyperaldosteronism indicates to the nurse that the condition is becoming more severe? A. Urine output for the past 24 hours has increased. B. Client reports numbness and tingling around the mouth. C. Temperature is now elevated. D. pH is now 7.43.
B. Client reports numbness and tingling around the mouth.
Which signs, symptoms, or behaviors will the nurse expect to find when assessing a client who has just been diagnosed with hypothyroidism? (Select all that apply.) Select all that apply. A. Goiter B. Nonpitting edema of hands and feet C. Warm, moist skin D. Decreased deep tendon reflexes E. Agitation and inability to sleep F. Pulse rate below 60 beats/min
B. Nonpitting edema of hands and feet D. Decreased deep tendon reflexes F. Pulse rate below 60 beats/min
Fill in the blank regarding the negative feedback loop for thyroid hormone production: The ______________ produces TRH (Thyrotropin-Releasing Hormone) which causes the anterior pituitary gland to produce _______________ which in turn causes the thyroid gland to release _______ and _______. A. Thalamus, CRH (Corticotropin-releasing hormone) TSH (thyroid-stimulating hormone) and T4 B. Hypothalamus, TSH (thyroid-stimulating hormone), T3 and T4 C. Posterior pituitary gland, TSH (thyroid-stimulating hormone), T3 and T4 D. Hypothalamus, CRH (Corticotropin-releasing hormone), TSH (thyroid-stimulating hormone), T3 and TSH
B. Hypothalamus, TSH (thyroid-stimulating hormone), T3 and T4
The thyroid hormones, T3 and T4, play many roles in the human body. Which of the following functions are performed by T3 and T4? Note: Select all that apply A. Storing calories B. Increasing the Heart Rate C. Stimulating the Sympathetic Nervous System D. Decreasing the body's temperature E. Regulating TSH produced by the anterior pituitary gland
B. Increasing the Heart Rate C. Stimulating the Sympathetic Nervous System E. Regulating TSH produced by the anterior pituitary gland
Which statements regarding hyperthyroidism are accurate? (Select all that apply.) Select all that apply. A. Has a sudden onset of symptoms. B. Is much more common among women than among men. C. Produces symptoms of a hypermetabolic state. D. Most common form is Graves disease. E. Can be diagnosed by the presence of a goiter. F. Often occurs weeks after exposure to ionizing radiation.
B. Is much more common among women than among men. C. Produces symptoms of a hypermetabolic state. D. Most common form is Graves disease.
In collaboration with the registered dietitian nutritionist, which dietary alterations will the nurse instruct a client with Cushing disease to make? A. High carbohydrate, low potassium, and fluid restriction B. Low carbohydrate, high calorie, and low sodium C. Low protein, high carbohydrate, and low calcium D. High protein, high carbohydrate, and low potassium
B. Low carbohydrate, high calorie, and low sodium
A patient was recently discharged home for treatment of hypothyroidism and was ordered to take Synthroid for treatment. The patient is re-admitted with signs and symptoms of the following: heart rate 42, blood pressure 70/56, blood glucose 55, and body temperature of 96.8 'F. The patient is very fatigued and drowsy. The family reports the patient has not been taking Synthroid since being discharged home from the hospital. Which of the following conditions is this patient most likely experiencing? A. Thryoid Storm B. Myxedema Coma C. Iodism D. Toxic Nodular Goiter
B. Myxedema Coma
In Cushing's disease, the _______is secreting too much ACTH (Adrenocorticotropic hormone) which is causing an increase in cortisol production. A. Adrenal cortex B. Pituitary gland C. Thyroid gland D. Hypothalamus
B. Pituitary gland
Which electrolyte laboratory values indicate to the nurse monitoring a client with adrenal insufficiency undergoing IV therapy with hydrocotisone that the client is responding positively to this drug therapy? A. Serum sodium 147 mEq/L (mmol/L); serum potassium 7.1 mEq/L (mmol/L) B. Serum sodium 137 mEq/L (mmol/L); serum potassium 4.9 mEq/L (mmol/L) C. Serum sodium 127 mEq/L (mmol/L); serum potassium 2.8 mEq/L (mmol/L) D. Serum sodium 119 mEq/L ((mmol/L); serum potassium 6.2 mEq/L (mmol/L)
B. Serum sodium 137 mEq/L (mmol/L); serum potassium 4.9 mEq/L (mmol/L)
In the scenario above what drug do you anticipate the patient will be started on per doctor's order? A. Desmopressin (DDAVP) IV B. Declomycin C. Diabinese D. Stimate
B: Declomycin
Why is a goiter often present in clients who have Graves disease? A. The low circulating levels of thyroid hormones stimulates the feedback system and triggers the anterior pituitary gland to secrete more thyroid-stimulating hormone, which increases the numbers and size of glandular cells in the thyroid gland. B. The excessive autoantibodies bind to the thyroid-stimulating hormone receptor sites, which increases the number and size of glandular cells in the thyroid gland. C. The autoantibodies stimulate blood vessel growth and blood storage within the thyroid gland, increasing its overall size. D. The autoantibodies stimulate the inflammatory and immune responses to increase the number of white blood cells circulating in the thyroid gland, which increases tissue size without increasing the number of glandular cells.
B. The excessive autoantibodies bind to the thyroid-stimulating hormone receptor sites, which increases the number and size of glandular cells in the thyroid gland.
Which precaution will the nurse include when providing instructions to the female client with hypothyroidism who is prescribed to take thyroid hormone replacement therapy (HRT)? A. "Increase the amount of fiber in your diet to prevent the side effect of constipation." B. "Stop this drug immediately if you discover you are pregnant." C. "Avoid over-the-counter medications unless prescribed by your primary health care provider." D. "If you miss a dose, double your next day's dose."
C. "Avoid over-the-counter medications unless prescribed by your primary health care provider."
Which precaution is most important for the nurse to teach a female client to prevent harm while undergoing drug therapy with estrogen and progesterone for hypopituitarism? A. "Use a barrier method of contraception to prevent an unplanned pregnancy." B. "Wear a hat with a brim and use sunscreen when outdoors." C. "Do not smoke or use nicotine in any form." D. "Avoid drinking caffeinated beverages."
C. "Do not smoke or use nicotine in any form."
Which statement made by a client who is undergoing therapy with radioactive iodine (RAI) for Graves disease indicates a lack of understanding about the disorder and its treatment? A. "Luckily, I have my own bathroom, so I won't be exposing the rest of my family to radiation. B. "If this treatment works, maybe I will stop sweating all the time. C. "It will be great to lose my "bug-eyed" appearance. D. "I hope I don't gain too much weight when my thyroid function is normal.
C. "It will be great to lose my "bug-eyed" appearance.
A client at continuing risk for hyperparathyroidism is prescribed to take furosemide 40 mg and to drink at least 3 to 4 L of fluid daily. He tells the nurse he believes taking a "water pill" and then drinking so much seems wrong. How will the nurse respond? A. "This combination of a water pill and drinking more ensures protects you from buildup of excess sodium in the kidney." B. "The furosemide makes you lose water and you need to increase your intake to keep from becoming dehydrated." C. "The drug helps you to get rid of calcium and drinking more helps dilute your blood calcium so the level doesn't get too high." D. "You are correct. I will check with your primary health care provider to determine whether you should restrict your fluid intake."
C. "The drug helps you to get rid of calcium and drinking more helps dilute your blood calcium so the level doesn't get too high."
Which assessment finding in a client who had a parathyroidectomy yesterday indicates to the nurse that immediate action is needed? A. Hypoactive bowel sounds B. Apical pulse of 92 beats/min C. Bilateral leg muscle twitching D. Dry mouth
C. Bilateral leg muscle twitching
Which items are most important for the nurse to ensure are in the room when a client returns from having a thyroidectomy? (Select all that apply.) Select all that apply. A. Hypertonic saline B. Furosemide C. Calcium gluconate D. Oxygen E. Suction F. Emergency tracheotomy kit
C. Calcium gluconate D. Oxygen E. Suction F. Emergency tracheotomy kit
The nurse reviewing the laboratory values of a client with hypoparathyroidism finds a serum calcium level of 7.9 mg/dL (1.76 mmol/L). Which parameter is most important for the nurse to assess to prevent harm? A. Temperature B. Heart rate and rhythm C. Deep tendon reflexes D. Level of consciousness
C. Deep tendon reflexes
Which type of drug therapy will the nurse prepare to teach about to a client who has mild hyperparathyroidism? A. Antipyretics B. Opioid analgesics C. Furosemide diuretics D. Calcium supplements
C. Furosemide diuretics
A patient is admitted with complaints of palpations, excessive sweating, and unable to tolerate heat. In addition, the patient voices concern about how her appearance has changed over the past year. The patient presents with protruding eyeballs and pretibial myxedema on the legs and feet. Which of the following is the likely cause of the patient's signs and symptoms? A. Thyroiditis B. Deficiency of iodine consumption C. Grave's Disease D. Hypothyroidism
C. Grave's Disease
___________ is an autoimmune disorder where the body attacks the thyroid gland that causes it to stop releasing T3 and T4. The patient is likely to have the typical signs/symptoms of hypothyroidism, however, they may present with what other sign as well? A. Myxedema coma; joint pain B. Thyroid storm; memory loss C. Hashimoto's Thyroiditis; goiter D. Toxic nodular goiter (TNG); goiter
C. Hashimoto's Thyroiditis; goiter
A patient with Addison's Disease should consume which of the following diets? A. High fat and fiber B. Low potassium and high protein C. High protein, carbs, and adequate sodium D. Low carbs, high protein, and increased sodium
C. High protein, carbs, and adequate sodium
A. Checking body temperature B. Testing deep tendon reflex responses C. Measuring oxygen saturation by pulse oximetry D. Checking blood pressure, heart rate, and rhythm E. Determining level of consciousness and cognition F. Identifying presence or absence of the swallowing reflex G. Examining feet and ankles for indications of peripheral edema
C. Measuring oxygen saturation by pulse oximetry D. Checking blood pressure, heart rate, and rhythm
Where is the anti-diuretic hormone PRODUCED in the body? A. Anterior pituitary gland B. Posterior pituitary gland C. Hypothalamus D. Medulla
C. Hypothalamus
Which client symptom appearing after a head injury suffered in a car crash is most relevant for the nurse to consider the possibility of diabetes insipidus (DI)? A. New-onset hypertension. B. The client reports extreme salt craving. C. No change in urine output with minimal fluid intake. D. The client's headache is gradually increasing in intensity.
C. No change in urine output with minimal fluid intake.
A patient is being discharged home for treatment of hypothyroidism. Which medication is most commonly prescribed for this condition? A. Tapazole B. PTU (Propylthiouracil) C. Synthroid D. Inderal
C. Synthroid
Where is the anti-diuretic hormone SECRETED in the body? A. Hypothalamus B. Thyroid C. Posterior Pituitary gland D. Anterior pituitary gland
C. Posterior Pituitary gland
Which urine characteristics indicate to the nurse that the client being managed for diabetes insipidus is responding appropriately 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 decreased; urine specific gravity decreased
C. Urine output volume decreased; urine specific gravity increased
A nurse caring for a client with Cushing's syndrome who must remain on continued corticosteroid therapy for another health problem will use which of the following actions to prevent harm? A. Urging the client to salt his or her food. B. Testing voided urine for the present of glucose. C. Using non-adhesive methods to secure an IV access. D. Ensuring that the prescribed corticosteroid drug is given on an empty stomach.
C. Using non-adhesive methods to secure an IV access.
The anti-diuretic hormone is __________ in Diabetes Insipidus and _________ in SIADH. A. high, low B. absent, absent C. low, high D. low, low
C. low, high
Which of the following signs and symptoms is NOT expected with Diabetes Insipidus? A. Polyuria B. Polydipsia C. Polyphagia D. Extreme thirst
C: Polyphagia
Which action is most important for the nurse to take first after finding a client who has severe hypothyroidism to be unresponsive to attempts to waken her and have a heart rate of 46 beats/min? A. Increasing the IV infusion rate B. Initiating the Rapid Response Team C. Assessing temperature D. Applying oxygen by mask
D. Applying oxygen by mask
Which question is most relevant to ask a male client suspected to have a gonadotropin deficiency? A. "Are you experiencing any pain during sexual intercourse?" B. "Do you work with or have hobbies that involve exposure to chemicals?" C. "Have you gained or lost any weight recently?" D. "How often do you need to shave your face?"
D. "How often do you need to shave your face?"
Which question asked by a 48-year-old client with sleep apnea whose blood glucose level is elevated suggests to the nurse the possibility of a growth hormone excess? A. "Do you think if I lost weight my sleep apnea would improve?" B. "Why do I feel thirsty all the time?" C. "How can I make my skin less itchy?" D. "Does everyone's feet get bigger during menopause?"
D. "Does everyone's feet get bigger during menopause?"
What is the nurse's best response when family members of a client with hyperthyroidism express concern about the client's frequent mood swings? A. "Do the client's mood swings make you feel angry?" B. "The medications will make the mood swings disappear completely." C. "Your family member is sick. You must be patient." D. "Mood swings are common should diminish with treatment."
D. "Mood swings are common should diminish with treatment."
A client preparing for surgery to remove a cortisol-secreting tumor from the adrenal gland asks the nurse whether the physical changes from the excessive cortisol will go away as a result of the surgery so she can look like herself again. What is the nurse's best response? A. "The surgery is to remove the tumor, not reconstructive surgery." B. "You will notice a great difference in your appearance starting within a week after surgery." C. "All the changes will resolve but may take a year or longer to completely disappear." D. "The fatty changes and and acne will resolve with time but the stretch marks only fade."
D. "The fatty changes and and acne will resolve with time but the stretch marks only fade."
The nurse has just received report on a group of clients. Which client is the nurse's first priority? A. A 42 year old with diabetes insipidus who has a dose of desmopressin due. B. A 35 year old with hyperaldosteronism who has a serum potassium of 3.0 mEq/L (3.0 mmol/L). C. A 50 year old with pituitary adenoma who is reporting a severe headache. D. A 28 year old with acute adrenal insufficiency who has a blood glucose of 36 mg/dL (2.0 mmol/L).
D. A 28 year old with acute adrenal insufficiency who has a blood glucose of 36 mg/dL (2.0 mmol/L).
The nurse reviews the vital signs of a client diagnosed with Graves disease and notes that the client's temperature is 99.6° F (37.6° C). After notifying the primary health care provider, what is the nurse's best next action? A. Administering acetaminophen B. Observing for the presence of chills C. Initiating the Rapid Response Team D. Assessing cardiac status
D. Assessing cardiac status
A patient with SIADH is undergoing IV treatment of a hypertonic IV solution of 3% saline and IV Lasix. Which of the following nursing findings requires intervention? A. Sodium level of 136. B. Patient reports urinating more frequently. C. Potassium level of 5.0. D. Assessment finding of crackles throughout the lung fields.
D. Assessment finding of crackles throughout the lung fields.
For which assessment finding in a client who had a transsphenoidal hypophysectomy yesterday will the nurse notify the primary health care provider immediately? A. Dry lips and oral mucosa on examination B. Nasal drainage that tests negative for glucose C. Urine specific gravity of 1.016 D. Client report of a headache and stiff neck
D. Client report of a headache and stiff neck
Addison's Disease is: A. Increased secretion of cortisol B. Increased secretion of aldosterone and cortisol C. Decreased secretion of cortisol D. Decreased secretion of aldosterone and cortisol
D. Decreased secretion of aldosterone and cortisol
A patient has an extremely high T3 and T4 level. Which of the following signs and symptoms DO NOT present with this condition? A. Weight loss B. Intolerance to heat C. Smooth skin D. Hair loss
D. Hair loss
For which new-onset symptom or behavior will the nurse teach a client taking thyroid hormone replacement therapy (HRT) to report immediately to the primary health care provider? A. Calf muscle cramping B. Runny nose C. Anorexia D. Hand tremors
D. Hand tremors
A patient reports they do not eat enough iodine in their diet. What condition are they most susceptible to? A. Pheochromocytoma B. Hyperthyroidism C. Thyroid Storm D. Hypothyroidism
D. Hypothyroidism
Which primary health care provider order will the nurse perform first for a client with syndrome of inappropriate antidiuretic hormone (SIADH) who has a serum sodium level of 105 mEq/L (105 mmol/L)? A. Administering an infusion of 150 mL hypertonic saline over the next 3 hours B. Drawing blood for hemoglobin and hematocrit levels C. Measuring serial weights at the same daily with the client wearing the same amount of clothing D. Inserting an indwelling catheter and monitoring urine output
D. Inserting an indwelling catheter and monitoring urine output
Which action does the postanesthesia care unit (PACU) nurse perform first when caring for a client who has just arrived after a total thyroidectomy? A. Administering morphine for pain B. Assessing the wound dressing for bleeding C. Hyperextending the neck D. Monitoring oxygen saturation
D. Monitoring oxygen saturation
Which changing trends in a client's serum laboratory values indicate to the nurse that thyroid hormone replacement therapy for hypothyroidism is effective? A. Declining thyroglobulin (Tg) levels; rising thyrotropin receptor antibody (TRAb) levels B. Declining thyroid hormone (TH) levels; rising thyroid-stimulating hormone (TSH) levels C. Rising thyroglobulin (Tg) levels; declining thyrotropin receptor antibody (TRAb) levels D. Rising thyroid hormone (TH) levels; declining thyroid-stimulating hormone (TSH) levels
D. Rising thyroid hormone (TH) levels; declining thyroid-stimulating hormone (TSH) levels
A patient is 6 hours post-opt from a thyroidectomy. The surgical site is clean, dry and intact with no excessive swelling noted. What position is best for this patient to be in? A. Fowler's B. Prone C. Trendelenburg D. Semi-Fowler's
D. Semi-Fowler's
Which client report of changes in appearance indicates to the nurse that a client's adrenal insufficiency is related to direct malfunction of the adrenal glands? A. 5-lb weight loss B. Dry, cracked lips C. Thinning pubic hair D. Skin darkening
D. Skin darkening
