Targeted Medical-Surgical: Endocrine

A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements by the client indicates an understanding of the teaching?

"I will apply lotion to the dry areas of my feet, avoiding application between my toes." Lotion is appropriate for dry areas of the feet, but the client should avoid applying lotion between the toes, as this area is prone to bacterial growth

A nurse is providing teaching for a client who has type 1 diabetes mellitus about how to prevent complications during illness. Which of the following statements indicates that the client understands the teaching?

"I will call my doctor if my blood sugar is more than 250 mg/dL The client should call the provider if blood glucose levels exceed 250 mg/dL during illness.

A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following statements by the client indicates an understanding of the information about this test?

"This test is a good indicator of my average blood glucose levels." HbA1c reflects the client's glucose levels over a 120-day period, which is the life span of RBCs.

A nurse is monitoring the laboratory values of a client who has DM and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy?

Fasting blood glucose 96 mg/dL This is within the expected reference range for a fasting blood glucose level and indicates insulin therapy is effective

A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect?

Hirsutism Increased hair growth, or hirsutism, is an expected finding of Cushing's disease due to increased androgen production.

A home health nurse is assessing a client who is on lifelong hormone replacement therapy for treatment of hypothyroidism. The client has not been taking his medication regularly. Which of the following findings should the nurse expect?

Hypotension Hypotension is an expected finding of hypothyroidism.

A nurse is caring for a client who has DM and developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to his feet?

Monitor the temperature of bath water with a thermometer Peripheral neuropathy makes it difficult to determine if bath water is too hot. Therefore, to prevent injury, the client should use a bath thermometer to ensure the water temperature is less than 43.3 C (110 F)

A nurse is preparing a teaching plan for a client who has diabetes insipidus and is receiving receiving intranasal desmopressin. Which of the following information should the nurse include in the teaching plan?

Occurrence of nocturia indicates the need for a dosage-adjustment. The initial dose of desmopressin is administered in the evening; the provide will increase the dosage until the client no longer experiences nocturia.

A nurse is preparing to administer propranolol by by IV bolus to a client experiencing a thyroid storm. Which of the following findings indicates the client is having a therapeutic response?

Reduction of the effects of thyroid hormone of the heart Propranolol is a beta 2-adrenergic blocking agent that decreases the rapid heart rate caused by excessive thyroid stimulation

To screen a client for pheochromocytoma, a nurse schedules a vanillylmandelic acid test. When teaching the clients about this test, which of the following instructions should the nurse include

Restrict coffee intake 2 to 3 days prior to the test The client should avoid coffee and tea (even if they are decaffeinated), bananas, chocolate, and vanilla for 2 to 3 days prior to the test.

A nurse is assessing a client who has adrenal insufficiency. Which of the findings should the nurse expect?

Serum calcium 12.8 mg/dL A client who has adrenal insufficiency has a serum calcium level above the expected reference range.

A nurse is performing an assessment on a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following assessment data should the nurse report?

Serum sodium 110 mEq/L A client who has SIADH retains fluids, which causes dilutional hyponatremia

A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia?

Tingling and numbness of the hands and feet Hypocalcemia causes paresthesias, usually starting in the hands and feet

A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings?

Tremors Findings of hyperthyroidism include tremors, diaphoresis, and insomnia

A nurse is preparing to give a client information about an adrenocorticotropic hormone (ACTH) stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorder?

Addison's disease The ACTH stimulation test is the standard test for Addison's disease. It measures the cortisol response to ACTH. The response is absent or very decreased in clients who have primary adrenal insufficiency.

A nurse is providing discharge teaching for a client who has diabetes insipidus and has new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching?

Blow nose gently prior to using nasal spray By blowing the nose gently prior to use of the spray, the client avoids dilution of the medication by nasal secretions or improper absorption of the medication due to nasal blockage.

A nurse is assessing a client who has diabetes mellitus and reports feeling anxious. Which of the following findings should the nurse expect if the client is hypoglycemic

Cool, Clammy skin Hypoglycemia causes cool clammy skin, in addition to anxiety, nervousness, tachycardia, and confusion.

A nurse is preparing insulin for a client who has DM. The client is to receive evening doses of insulin glargine and regular insulin. Which of the following actions should the nurse take to administer these two medications safely?

Draw up the insulin glargine and the regular insulin into separate syringes. The nurse should not mix insulin glargine with any other insulin in the same syringe due to the low pH of its diluent.

A nurse is assessing a client who has diabetes insipidus. The nurse should expect which of the following findings?

Increased hematocrit An increased hematocrit level is an expected finding related to dehydration.

A nurse is planning dietary teaching for a client who has type 1 DM. Which of the following information should the nurse include regarding alcohol consumption?

Ingest alcohol with meals to reduce alcohol-induced hyperglycemia Alcohol prevents liver production of glucose. Consuming carbohydrates while drinking alcoholic beverages helps prevent hypoglycemia.

A nurse is monitoring a client's status 24 hr after a total thyroidectomy. Which of the following findings should the nurse report to the provider?

Laryngeal stridor Laryngeal stridor is a harsh, high-pitched sound upon inspiration that indicates respiratory obstruction. The nurse should take immediate action to preserve the client's airway

A nurse is caring for a client who is taking propylthiouracil (PTU). The nurse should recognize that the client has met the treatment goals when she reports an increase in which of the following effects?

Weight PTU suppresses the production of thyroid hormone and, therefore, allows for weight gain.

A nurse caring for a client undergoing screening for primary Cushing's disease. The nurse should expect that which of the following laboratory findings to be elevated?

Blood Glucose Blood glucose is elevated with Cushing's disease.

A nurse is providing teaching for a client who has diabetes mellitus. Which of the following findings associated with diabetic ketoacidosis (DKA) should the nurse include?

Blood glucose levels greater than 300 mg/dL Blood glucose levels above 300 mg/dL are an expected finding of DKA.

A nurse is caring for a client who has type 2 DM and is admitted with hyperglycemic-hyperosmolar state (HHS). Which of the following laboratory findings should the nurse expect?

Blood glucose of 846 mg/dL and serum pH 7.40 With HHS, the client produces enough insulin to prevent ketosis, but not enough to prevent hyperglycemia. Therefore, the serum pH is within the expected reference range, but the blood glucose is greater than 600 mg/dL

A nurse is teaching a client who has an autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following effects should the nurse include? (Select all that apply.)

1. Osteoporosis is an adverser effect of long-term corticosteroid therapy due to the suppression of bone formation and the acceleration of bone resorption that corticosteroid therapy can cause 2. Moon-shaped face Long-term corticosteroid therapy causes characteristics of the iatrogenic syndrome characterized by a moon-shaped face, a potbelly, and buffalo hump. 3. Increased risk of infection is an adverse effect of long-term corticosteroid therapy due to decrease it causes in the number of circulating lymphocytes.

A nurse is managing the care of a client who is postoperative and experiencing acute adrenal insufficiency. Which of the following actions should the nurse take?

Administer IV hydrocortisone sodium succinate Hydrocortisone sodium succinate necessary to replace the cortisol deficiency that occurs with adrenal insufficiency.

A nurse is planning preoperative care for a client who has pheochromocytoma. Which of the following interventions should the nurse anticipate as being the priority?

Avoiding palpating the abdomen. The greatest risk to this client is injury from hypertensive crisis. Therefore, the priority intervention is to avoid palpating the abdomen, which can cause a sudden release of catecholamines, causing a hypertensive crisis.

A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include?

Take this medication on an empty stomach To promote absorption, the client should take the medication on an empty stomach and not eat or drink anything for 30 to 60 min after taking it.

A nurse is reviewing laboratory values for a client who has diabetic ketoacidosis (DKA). Which of the following results should the nurse expect?

pH 7.32, PaCO2 36 mm Hg HCO3 14 mEq/L With DKA, the pH is low, carbon dioxide is within the expected reference range, bicarbonate is low.