Adaptive Question Endocrine

Which nutrient causes elevated ketones in diabetic acidosis by incomplete oxidation? 1 Fats 2 Protein 3 Potassium 4 Carbohydrates

1 Fats

In preparing a teaching plan, the nurse anticipates which diet will be prescribed for this client? 1 High-calorie diet 2 Low-sodium diet 3 High-roughage diet 4 Mechanical-soft diet

1 High-calorie diet

Which situation associated with the physiological finding of ketones in the blood and urine would be the nurse's focus when collecting additional data about a client? 1 Starvation 2 Alcoholism 3 Bone healing 4 Positive nitrogen balance

1

While assessing a postpartum client who is suspected of having a thyroid disorder, the nurse suspects that the client has autoimmune thyroiditis. Which diagnostic studies are most suitable for confirming this diagnosis? 1 Radioactive iodine uptake 2 Computed tomography scan 3 Magnetic resonance imaging 4 Thyroid-stimulating hormone

1

Which dietary instruction would be beneficial to a client who has undergone a hypophysectomy and has difficulty passing stools? 1 "Drink plenty of water." 2 "Eat foods rich in protein." 3 "Drink a glass of milk daily." 4 "Eat foods rich in carbohydrates."

1 "Drink plenty of water."

Which physiological changes would the nurse expect to find in a client with a 20-year history of type 2 diabetes? 1 Blurry, spotty, or hazy vision 2 Arthritic changes in the hands 3 Hyperactive knee and ankle jerk reflexes 4 Dependent pallor of the feet and lower legs

1 Blurry, spotty, or hazy vision

The nurse is teaching a client who had a thyroidectomy to observe for symptoms of surgically induced hypothyroidism. Which symptoms would be included in the teaching plan? Select all that apply. One, some, or all responses may be correct. 1 Dry skin 2 Lethargy 3 Insomnia 4 Tachycardia 5 Sensitivity to cold

1 Dry skin 2 Lethargy 5 Sensitivity to cold

During preoperative teaching for a thyroidectomy, which specific instruction about postoperative care would the nurse provide the client? 1 Cough and deep breathe every hour. 2 Perform range-of-motion exercises of the head and neck. 3 Support the head with the hands when changing position. 4 Apply gentle pressure against the incision when swallowing.

3

Which clinical manifestation is found in a client with a deficiency of adrenocorticotropic hormone? 1 Anovulation 2 Dehydration 3 Malaise 4 Menstrual abnormalities

3

Which eye problem is the leading cause of blindness in clients with diabetes? 1 Cataracts 2 Glaucoma 3 Retinopathy 4 Astigmatism

3

While the nurse is teaching a client with diabetes about food choices, the client states, "I do not like broccoli." Which food would the nurse suggest to substitute for broccoli? 1 Peas 2 Corn 3 Green beans 4 Mashed potatoes

3

The nurse provides postoperative care to a client who has undergone a hypophysectomy. Which action would the nurse take if there is a yellowish discharge at the dressing site? 1 Change the dressing. 2 Remove the discharge with alcohol swabs. 3 Inform the primary health care provider. 4 Reinforce the dressing to prevent leakage.

3 Inform the primary health care provider.

The nurse is planning care for a client with hyperparathyroidism and subsequent hypocalcemia and low bone density. Which information would the nurse provide the unlicensed assistive personnel (UAP) to prevent injury? 1 Record urinary output. 2 Document respirations. 3 Initiate cardiac monitoring. 4 Use a lift sheet for transfers.

4

Which condition is a primary cause of Sheehan syndrome? 1 Thin bones 2 Intolerance to cold 3 Severe hypotension 4 Postpartum hemorrhage

4

Which arterial blood gas report is indicative of diabetic ketoacidosis? 1 Pco2: 49, HCO3: 32, pH: 7.50 2 Pco2: 26, HCO3: 20, pH: 7.52 3 Pco2: 54, HCO3: 28, pH: 7.30 4 Pco2: 28, HCO3: 18, pH: 7.28

4 Pco2: 28, HCO3: 18, pH: 7.28

A client who is 60 pounds (27.2 kg) more than the ideal body weight is admitted to the hospital with a diagnosis of type 1 diabetes. Which concept would the nurse include in teaching about diabetes when discussing strategies to lose weight? 1 Obesity leads to insulin resistance. 2 Surplus fat causes excretion of insulin. 3 Fat cells absorb insulin and prevent its circulation to other cells. 4 Lipids accumulate in the pancreas and interfere with insulin production.

1

A female client who is scheduled for a thyroidectomy is concerned that the surgery will interfere with her ability to become pregnant. Which response by the nurse is appropriate? 1 "As long as medication is continued, ovulation will occur." 2 "Hyperthyroidism can cause abortions and fetal anomalies." 3 "Pregnancy is not advisable for the client with a thyroidectomy." 4 "Pregnancy affects metabolism and will require decreased thyroid hormone."

1

The nurse is caring for a client after transsphenoidal hypophysectomy and observes clear drainage from the nares. Which statement is accurate in explaining the cause of this drainage? 1 Cerebral spinal fluid could be leaking from an opening to the brain. 2 It is a normal occurrence for this client's procedure. 3 The client is developing an infection. 4 The client may have had a cold preoperatively, and the nurse will continue to monitor.

1

Which signs of Cushing syndrome would the nurse identify in a client with a pituitary tumor? 1 Retention of sodium and water 2 Hypotension and a rapid, thready pulse 3 Increased fatty deposition in the extremities 4 Hypoglycemic episodes in the early morning

1

Which initial intervention would the nurse expect the primary health care provider to order for a client admitted to the hospital with a diagnosis of diabetic ketoacidosis? 1 Intravenous (IV) fluids 2 Potassium 3 NPH insulin (Novolin N) 4 Sodium polystyrene sulfonate (Kayexalate)

1 Intravenous (IV) fluids

Which is a nursing responsibility during a 24-hour urine collection for a client with the diagnosis of Addison disease? 1 Keep the client quiet and reduce stress 2 Assess the client for signs and symptoms of edema 3 Monitor the client for an elevation in blood pressure 4 Restrict the client's fluid intake during the day of the test

1 Keep the client quiet and reduce stress

Which assessment finding indicates hypersecretion of adrenocorticotrophic hormone? 1 Moon face 2 Lower jaw protrusion 3 Heat intolerance 4 Barrel-shaped chest

1 Moon face

Which assessment findings would indicate the need for atenolol in a client diagnosed with hyperthyroidism? Select all that apply. One, some, or all responses may be correct. 1 Tachycardia 2 Atrial fibrillation 3 Distant heart sounds 4 Systolic hypertension 5 Decreased cardiac output

1 Tachycardia 2 Atrial fibrillation 4 Systolic hypertension

Which intervention would the nurse provide while caring for an older adult client who is reported to have decreased estrogen production? 1 Use minimal tape on client's skin 2 Cover the client with warm clothing 3 Perform blood glucose test for the client 4 Monitor for bradycardia

1 Use minimal tape on client's skin

The nurse is providing instructions about foot care for a client with diabetes mellitus. Which would the nurse include in the instructions? Select all that apply. One, some, or all responses may be correct. 1 Wear shoes when out of bed. 2 Soak the feet in warm water daily. 3 Dry between the toes after bathing. 4 Remove corns as soon as they appear. 5 Use a heating pad when the feet feel cold.

1 3

The nurse is educating the client newly diagnosed with type 2 diabetes on oral antidiabetic medications. Which instruction would the nurse include in the teaching plan? Select all that apply. One, some, or all responses may be correct. 1 The client should obtain a finger-stick blood glucose reading before each meal. 2 The client does not need to follow a specific diet until insulin is required. 3 The teaching plan should include signs and symptoms of hypoglycemia. 4 The teaching plan should include how to administer regular insulin. 5 The teaching plan should include sick day rules.

1 3 5

Which clinical finding would the nurse expect to increase in a client with Cushing syndrome? 1 Urine output 2 Glucose level 3 Serum potassium 4 Fever

2

A client is hospitalized with a tentative diagnosis of pancreatic cancer. On admission the client asks the nurse, "Do you think I have anything serious, like cancer?" Which response by the nurse is most appropriate? 1 "What makes you think you have cancer?" 2 "I don't know if you do; let's talk about it." 3 "Why don't you discuss this with your primary health care provider?" 4 "You needn't worry now; we won't know the answer for a few days."

2 "I don't know if you do; let's talk about it."

Which action is appropriate to include in the plan of care for a client who just had a subtotal thyroidectomy? 1 Monitor for hypoglycemia. 2 Observe for signs of tetany. 3 Place a sandbag under the neck. 4 Teach the need to support the head.

2 Observe for signs of tetany.

Which laboratory value may indicate hyperfunction of the adrenal gland in a client? 1 Sodium: 143 mEq/L 2 Potassium: 2.9 mEq/L 3 Bicarbonate: 25 mEq/L 4 Total calcium: 10 mg/dL

2 Potassium: 2.9 mEq/L

Which common cause of diabetic ketoacidosis would the nurse consider when caring for a postoperative client with diabetes? 1 Emotional stress 2 Presence of infection 3 Increased insulin dose 4 Inadequate food intake

2 Presence of infection

The nurse reviews the medical record of a client with a suspected pituitary tumor and expects which assessment finding? 1 Tetany 2 Seizures 3 Lethargy 4 Hyperreflexia

2 Seizures

An older adult who has an endocrine disorder is scheduled for a diagnostic study with contrast medium. The nurse identifies that it is essential for which laboratory test to be performed before the procedure? 1 Urine pH 2 Serum creatinine 3 Serum albumin 4 Creatinine clearance

2 Serum creatinine

A client is newly diagnosed with diabetes. The nurse would instruct the client to monitor for which indication of hypoglycemia? 1 Kussmaul respirations 2 Tachycardia 3 Confusion 4 Anorexia

3 Confusion

A client is being treated for pituitary Cushing syndrome. The nurse anticipates that which medication will be prescribed? 1 Mitotane 2 Cabergoline 3 Cyproheptadine 4 Bromocriptine mesylate

3 Cyproheptadine

Which situation in a client with hyperthyroidism may precipitate thyroid crisis (thyroid storm)? 1 Increased iodine in the blood 2 Removal of the parathyroid glands 3 High levels of the hormone triiodothyronine 4 Rebound increase in metabolism after anesthesia

3 High levels of the hormone triiodothyronine

A client is admitted with a head injury and has large amounts of clear, colorless urine draining from the urinary catheter. Which physiological response is possibly causing the increased urine output? 1 Increased serum glucose 2 Deficient renal perfusion 3 Inadequate antidiuretic hormone (ADH) secretion 4 Excess amounts of intravenous (IV) fluid

3 Inadequate antidiuretic hormone (ADH) secretion

Which information about a client's condition would the nurse consider when providing care to a client who just received radioactive iodine for Graves disease? 1 Not radioactive and can be handled as any other individual 2 Highly radioactive and should be isolated as much as possible 3 Mildly radioactive and should be treated with routine safety precautions 4 Not radioactive but may still transmit some dangerous radiations and must be treated with precautions

3 Mildly radioactive and should be treated with routine safety precautions

Which hormones are secreted by the client's hypothalamus? Select all that apply. One, some, or all responses may be correct. 1 Growth hormone 2 Follicle-stimulating hormone 3 Prolactin-inhibiting hormone 4 Corticotropin-releasing hormone 5 Melanocyte-stimulating hormone

3 Prolactin-inhibiting hormone 4 Corticotropin-releasing hormone

A client had a resection of an aldosterone-secreting tumor of an adrenal gland and says to the nurse, "It will be good for me to return to work soon." Based on an understanding of the problem, how would the nurse respond? 1 Caution the client about high expectations because the prognosis is variable; the outcome depends on many factors. 2 Advise the client to prepare to apply for permanent disability. 3 Advise the client to investigate other occupational alternatives if the client wishes to stay in the workforce. 4 Tell the client that returning to work is possible if the client takes prescribed hormone supplements.

4

A client's fasting plasma glucose levels are being evaluated. The nurse identifies that the client is considered to be diabetic if the results are within which range? 1 40 to 60 mg/dL (2.2-3.3 mmol/L) 2 80 to 99 mg/dL (4.5-5.5 mmol/L) 3 100 to 125 mg/dL (5.6-6.9 mmol/L) 4 126 to 140 mg/dL (7.0-7.8 mmol/L)

4

A client with Cushing syndrome asks why a low-sodium, high-potassium diet has been prescribed. Which response by the nurse is accurate? 1 "The client will gain excessive weight if sodium is limited." 2 "An inadequate intake of potassium contributed to the disease." 3 "This type of diet increases emotional stability." 4 "Excessive aldosterone and cortisone cause the retention of sodium and loss of potassium."

4 "Excessive aldosterone and cortisone cause the retention of sodium and loss of potassium."

A client with diabetes is given instructions about foot care. Which statement made by the client shows effective learning? 1 "I will trim my toenails before bathing." 2 "I will soak my feet daily for 1 hour." 3 "I will examine my feet using a mirror at least once a week." 4 "I will break in my new shoes over the course of several weeks."

4 "I will break in my new shoes over the course of several weeks."

A client suspected to have hyperpituitarism is sent by the primary health care provider to undergo a suppression test. Which laboratory value would indicate a positive result? 1 3 ng/mL 2 4 ng/mL 3 5 ng/mL 4 6 ng/mL

4 6 ng/mL

The nurse is caring for a client with type 2 diabetes mellitus and renal insufficiency. The client is scheduled for a computerized tomography (CT) scan with contrast. Which medication would the nurse withhold to prevent lactic acidosis? 1 Pioglitazone 2 Insulin 3 Glyburide 4 Metformin

4 Metformin

Which instruction would the nurse emphasize when preparing a client for an emergency splenectomy? 1 The poor prognosis associated with a splenectomy 2 The expectation that postoperative bleeding will occur 3 The high risk associated with the procedure in light of the client's other injuries 4 The presence of abdominal drains for several days after the surgery

4 The presence of abdominal drains for several days after the surgery

A client receiving calcitonin therapy reports a stinging sensation in the hands and feet. Which finding will the nurse observe in the client's laboratory results if the client is experiencing a side effect of calcitonin therapy? 1 Serum sodium of 139 mEq/L (mmol/L) 2 Serum creatinine of 0.4 mg/dL (35.36 µmol/L) 3 Blood urea nitrogen of 17 mg/dL (6.07 mmol/L) 4 Total serum calcium of 8 mg/dL (2 mmol/L)

4 Total serum calcium of 8 mg/dL (2 mmol/L)

Which client is at risk for developing type 2 diabetes mellitus (DM)? Select all that apply. One, some, or all responses may be correct. 1 15-year-old male who plays video games 6 hours per day 2 36-year-old female with a history of gestational diabetes 3 47-year-old male who weighs 250 pounds and is 5' 9" tall 4 28-year-old female with polycystic ovarian syndrome (POS) 5 60-year-old male of Native American descent who abuses alcohol

ALL