Adult health - Endocrine

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which findings support this diagnosis? Select all that apply.

Comatose state 3. Deep, rapid breathing Elevated blood glucose level

A nurse is assessing a client who has had cranial surgery and is at risk for development of diabetes insipidus. The nurse would assess for which signs or symptoms that could indicate development of this complication?

Polydipsia

The nurse has provided home care measures to the client with diabetes mellitus regarding exercise and insulin administration. Which statement by the client indicates a need for further instruction?

"I should perform my exercise at peak insulin time."

The nurse is taking a health history for a client with hyperparathyroidism. Which question would elicit information about this client's condition?

"Are you experiencing pain in your joints?"

The nurse has provided instructions to the client with hyperparathyroidism regarding home care measures to manage the symptoms of the disease. Which statement by the client indicates a need for further instruction?

"I need to avoid doing any exercise at all."

The home care nurse visits a client with a diagnosis of hyperparathyroidism who is taking furosemide and provides dietary instructions to the client. Which statement by the client indicates a need for additional instruction?

"I need to increase my intake of dietary items that are high in calcium."

A client with suspected Cushing's syndrome is scheduled for adrenal venography. A nurse has provided instructions to the client regarding the test. Which statement by the client indicates a need for further instruction?

"I will be placed in a high-sitting position for the test."

The nurse is caring for a client with Addison's disease. The client asks the nurse about the risks associated with this disease, specifically about addisonian crisis. Regarding prevention of this complication, how should the nurse inform the client?

"You need to increase salt in your diet, particularly during stressful situations."

The home care nurse is visiting a client newly diagnosed with diabetes mellitus. The client tells the nurse that he is planning to eat dinner at a local restaurant this week. The client asks the nurse if eating at a restaurant will affect diabetic control and if this is allowed. Which nursing response is most appropriate?

"You should order a half-portion meal and have fresh fruit for dessert."

The nurse is caring for a client with a serum phosphorus level of 5.0 mg/dL (1.61 mmol/L). What other laboratory value might the nurse expect to note in the medical record?

Calcium level of 8 mg/dL (2.0 mmol/L)

A 33-year-old female client is admitted to the hospital with a tentative diagnosis of Graves' disease. Which symptom related to the menstrual cycle would the client be most likely to report during the initial assessment?

Amenorrhea

The nurse is assessing a client who has a diagnosis of goiter. Which should the nurse expect to note during the assessment of the client?

An enlarged thyroid gland

A client has been hospitalized for impaired function of the posterior pituitary gland. The nurse plans to monitor for signs and symptoms of which hormone imbalance?

Antidiuretic hormone (ADH)

A client has a tumor that is interfering with the function of the hypothalamus. The nurse should monitor for signs and symptoms related to which imbalance?

Antidiuretic hormone (ADH) excess or deficit

The nurse is reviewing the postoperative prescriptions for a client who had a transsphenoidal hypophysectomy. Which health care provider's (HCP's) prescriptions, if noted on the record, would indicate the need for clarification?

Apply a loose dressing if any clear drainage is noted.

After hypophysectomy, a client complains of being thirsty and having to urinate frequently. What is the initial nursing action?

Assess urine specific gravity.

A client received 5 units of insulin aspart subcutaneously just before eating lunch at 12:00 p.m. The nurse should assess the client for a hypoglycemic reaction at which times?

Between 1:00 and 3:00 p.m.

The nurse is developing a plan of care for a client who is scheduled for a thyroidectomy. The nurse focuses on psychosocial needs, knowing that which is likely to occur in the client?

Body image changes

The nurse is performing an assessment on a client with a diagnosis of myxedema (hypothyroidism). Which assessment finding should the nurse expect to note in this client?

Dry skin

The nurse is monitoring a client with diabetes mellitus for signs of hypoglycemia. Which manifestations are associated with this complication?

Elevated pulse; shakiness; cool, clammy skin

A client arrives in the hospital emergency department in an unconscious state. As reported by the spouse, the client has diabetes mellitus and began to show symptoms of hypoglycemia. A blood glucose level is obtained for the client, and the result is 40 mg/dL (2.28 mmol/L). Which medication should the nurse anticipate will be prescribed for the client?

Glucagon

A client with a diagnosis of Addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional health care team focus on? Select all that apply.

Hypotension Hyperkalemia

A nurse is reviewing the assessment findings and laboratory data for a client with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The nurse understands that which symptoms are associated characteristics of this disorder? Select all that apply.

High urine osmolality 4. Low serum osmolality 5. Hypotonicity of body fluids 6. Continued release of antidiuretic hormone (ADH)

The emergency department nurse is preparing a plan for initial care of a client with a diagnosis of hyperosmolar hyperglycemic syndrome (HHS). The nurse recognizes that the hyperglycemia associated with this disorder results from which occurrence?

Increased production of glucose

The nurse is providing instructions to a client newly diagnosed with diabetes mellitus. The nurse gives the client a list of the signs of hyperglycemia. Which specific sign of this complication should be included on the list?

Increased thirst

A client has abnormal amounts of circulating thyronine (T3) and thyroxine (T4). While obtaining the health history, the nurse asks the client about dietary intake. Lack of which dietary element is most likely the cause?

Iodine

A nurse is assisting a client with diabetes mellitus who is recovering from diabetic ketoacidosis (DKA) to develop a plan to prevent a recurrence. Which is most important to include in the plan of care?

Monitor blood glucose levels frequently.

The nurse is developing a plan of care for a client with Cushing's syndrome. The nurse documents a client problem of excess fluid volume. Which nursing actions should be included in the care plan for this client? Select all that apply.

Monitor daily weight. 2. Monitor intake and output. 3. Assess extremities for edema.

A client has overactivity of the thyroid gland. The nurse should expect which finding?

Nutritional deficiencies

A nurse is assessing the glycemic status of a client with diabetes mellitus. Which sign or symptom would indicate that the client is developing hyperglycemia?

Polyuria

The nurse is caring for a client with a diagnosis of diabetic ketoacidosis (DKA). Which assessment findings are consistent with this diagnosis? Select all that apply.

Polyuria 2. Polydipsia 3. Polyphagia 4. Dry mouth 5. Flushed, dry skin

The nurse is monitoring a diabetic client with a blood glucose level of 400 mg/dL (22.2 mmol/L). Which clinical manifestation would indicate diabetic ketoacidosis (DKA)?

Rapid, deep respirations

A client's serum blood glucose level is 48 mg/dL (2.74 mmol/L). The nurse would expect to note which as an additional finding when assessing this client?

Slurred speech

The nurse is caring for a client after hypophysectomy and notes clear nasal drainage from the client's nostril. The nurse should take which initial action?

Test the drainage for glucose.

A client is admitted to an emergency department, and a diagnosis of myxedema coma is made. Which action should the nurse prepare to carry out initially?

Maintain a patent airway.

A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety?

Convey empathy, trust, and respect toward the client.

A client with diabetes mellitus has a blood glucose level of 50 mg/dL (2.85 mmol/L) and reports feeling hungry and shaky. Which should the nurse provide the client?

4 oz of apple juice

The nurse is reviewing the laboratory test results for a client with a diagnosis of Cushing's syndrome. Which laboratory finding would the nurse expect to note in this client?

A potassium (K+) level of 3.0 mEq/L (3.0 mmol/L)

The nurse should include which interventions in the plan of care for a client with hyperthyroidism? Select all that apply.

A thyroid-releasing inhibitor will be prescribed. 4. Encourage the client to consume a well-balanced diet.

A client with type 1 diabetes mellitus is to begin an exercise program, and the nurse is providing instructions regarding the program. Which instruction should the nurse include in the teaching plan?

Take a blood glucose test before exercising.

The nurse is preparing for a client's postoperative return to the unit after a parathyroidectomy procedure. The nurse should ensure that which piece of medical equipment is at the client's bedside?

Tracheotomy set

A nurse is assigned to care for a client with type 1 diabetes mellitus. During the shift, the nurse should monitor for which manifestation as a sign of hypoglycemia?

Tremors

The nurse caring for a client who underwent intracranial surgery is suspected of having diabetes insipidus. Which finding noted by the nurse is consistent with this complication of surgery?`

Complaints of excessive thirst

A client visits the health care provider's office for a routine physical examination and reports a new onset of intolerance to cold. Since hypothyroidism is suspected, which additional information would be noted during the client's assessment?

Complaints of weakness and lethargy

A nurse needs to maintain food and fluid intake to minimize the risk of dehydration in a client with diabetes mellitus who has gastroenteritis. Which is the appropriate nursing intervention?

Encourage the client to take 8 to 12 oz of fluid every hour while awake.

The nurse is admitting a client diagnosed with pheochromocytoma. The client is complaining of a pounding headache and palpitations and the blood pressure is 170/90 mm Hg. The nurse is aware that which substance is responsible for these clinical manifestations?

Epinephrine

The nurse is developing a plan of care for a client with Addison's disease. The nurse has identified a problem of risk for deficient fluid volume and identifies nursing interventions that will prevent this occurrence. Which nursing interventions should the nurse include in the plan of care? Select all that apply.

Monitor for changes in mentation. Encourage fluid intake of at least 3000 mL per day. 5. Monitor vital signs, skin turgor, and intake and output.

A nurse is reviewing the health care provider's prescriptions for a client diagnosed with hypothyroidism. Which medication prescription should the nurse question and verify?

Morphine sulfate

A client with suspected primary hyperparathyroidism is undergoing diagnostic testing. The nurse would assess for which as a manifestation of this disorder?

Polyuria

The nurse has provided dietary instructions to a client with a diagnosis of hypoparathyroidism. The nurse should instruct the client that it is acceptable to include which item in the diet?

Vegetables

The nurse is instructing a client with Cushing's syndrome on follow-up care. Which of these client statements would indicate a need for further instruction?

"I need to avoid foods high in potassium."

A nurse is caring for a client who had a thyroidectomy 1 day ago. Which client laboratory data should the nurse identify as a possible complication of thyroid surgery?

Decreased serum calcium level

The nurse is caring for a client who is scheduled to have a thyroidectomy and provides instructions to the client about the surgical procedure. Which client statement indicates an understanding of the nurse's instructions?

"I need to place my hands behind my neck when I have to cough or change positions."

A nurse has provided dietary instructions to a client with Addison's disease. Which statement made by the client indicates that the client understands instructions?

"I will maintain a normal sodium intake in my diet."

A hospitalized client is experiencing an episode of hypoglycemia. The client is lethargic and has no available intravenous (IV) access. Which medication should the nurse anticipate administering?

Glucagon

The nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118 mmol/L). Which health care provider prescriptions should the nurse anticipate receiving? Select all that apply.

Initiate an infusion of 3% NaCl. Restrict fluids to 800 mL over 24 hours. Administer a vasopressin antagonist as prescribed.

The nurse is providing instructions regarding insulin administration for a client newly diagnosed with diabetes mellitus. The health care provider has prescribed a mixture of NPH insulin and regular insulin. The nurse should instruct the client that which is the first step in this procedure?

Inject air equal to the amount of NPH insulin prescribed into the vial of NPH insulin.

A client is hospitalized with a diagnosis of adrenal insufficiency. Which findings does the nurse identify as supportive of this diagnosis? Select all that apply.

Irritability 2. Complaints of nausea 3. Sodium level of 128 mEq/L (128 mmol/L) Blood pressure lying 138/70 mm Hg and standing 110/58 mm Hg

The nurse is performing an assessment on a client with pheochromocytoma. Which assessment data would indicate a potential complication associated with this disorder?

A heart rate that is 90 beats/minute and irregular

The nurse is performing an assessment on a client with a diagnosis of Cushing's syndrome. Which should the nurse expect to note on assessment of the client?

A rounded "moonlike" appearance to the face

The nurse is monitoring a client diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy and is recovering in the intensive care unit. Which findings should alert the nurse to the presence of a possible postoperative complication? Select all that apply.

Leukocytosis Urinary output of 800 mL/hour Clear drainage on nasal dripper pad

A nurse is preparing a teaching plan for a client with diabetes mellitus regarding proper foot care. Which instruction should be included in the plan?

Apply a moisturizing lotion to dry feet but not between the toes.

A client is admitted with suspected diabetic ketoacidosis (DKA). Which clinical manifestations best support a diagnosis of DKA?

Blood glucose 350 mg/dL (19.4 mmol/L); arterial blood gases: pH 7.28, PaCo2 30, HCO3- 14.

A client is admitted to the hospital with a diagnosis of pheochromocytoma. The nurse would check which item to detect the primary manifestation of this disorder?

Blood pressure

The nurse is performing an assessment on a client with a diagnosis of hyperthyroidism. Which assessment finding should the nurse expect to note in this client?

Bulging eyeballs

A client has returned to the nursing unit after a thyroidectomy. The nurse notes that the client is complaining of tingling sensations around the mouth, fingers, and toes. On the basis of these findings, the nurse should next assess the results of which serum laboratory study?

Calcium

A client is diagnosed with Cushing's syndrome. When reviewing the recent laboratory results, the nurse should expect an excess of which substance?

Cortisol

The nurse provides dietary instructions to a client with diabetes mellitus regarding the prescribed diet. Which statement, if made by the client, indicates a need for further teaching?

"I need to purchase special dietetic foods."

The nurse is teaching a client with hyperparathyroidism how to manage the condition at home. Which response by the client indicates the need for additional teaching?

"I should limit my fluids to 1 liter per day."

The nurse is interviewing a client with type 2 diabetes mellitus who is taking a sulfonylurea. Which statement by the client indicates an understanding of this treatment for this disorder?

"The medications I'm taking help release the insulin I already make."

A client with Cushing's syndrome verbalizes concern to the nurse regarding the appearance of the buffalo hump that has developed. Which statement should the nurse make to the client?

"Usually these physical changes slowly improve following treatment."

The client with pheochromocytoma is scheduled for surgery and says to the nurse, "I'm not sure that surgery is the best thing to do." Which statement is the appropriate response by the nurse?

"You have concerns about the surgical treatment for your condition?"

A client with medullary carcinoma of the thyroid has an excess function of the C cells of the thyroid gland. When reviewing the most recent laboratory results, the nurse should expect which electrolyte abnormality?

Calcium

A home health nurse is visiting a client with type 1 diabetes mellitus. The client tells the nurse that he is not feeling well and has had a "respiratory infection" for the past week, which seems to be getting worse. After interviewing the client, what should be the initial nursing action?

Check the client's blood glucose.

The nurse has documented the problem of body image distortion for a client with a diagnosis of Cushing's syndrome. The nurse identifies nursing interventions related to this problem and includes these interventions in the plan of care. Which nursing intervention is inappropriate?

Encourage the client to recognize that the body changes need to be dealt with.

The nurse should include which interventions in the plan of care for a client with hypothyroidism? Select all that apply.

Instruct the client about thyroid replacement therapy. 4. Encourage the client to consume fluids and high-fiber foods in the diet. Instruct the client to contact the health care provider (HCP) if episodes of chest pain occur.

A health care provider has prescribed propylthiouracil for a client with hyperthyroidism. The nurse recalls that first-line treatment calls for methimazole for medication therapy. The nurse should question the client about her past medical history, specifically regarding which condition?

Pregnancy

A client with a history of diabetes mellitus has a fingerstick blood glucose level of 460 mg/dL. The home care nurse anticipates that which additional finding would be present with further testing if the client is experiencing diabetic ketoacidosis (DKA)?

Presence of ketone bodies

The nurse is monitoring a client who was diagnosed with type 1 diabetes mellitus and is being treated with NPH and regular insulin. Which manifestations would alert the nurse to the presence of a possible hypoglycemic reaction? Select all that apply.

Tremors irritability nervousness

A preoperative client is scheduled for adrenalectomy to remove a pheochromocytoma. The nurse would most closely monitor which item in the preoperative period?

Vital signs

The nurse is completing an assessment on a client who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which client complaint would be characteristic of this disorder? Select all that apply.

Polyuria Bone pain

A test to measure long-term control of diabetes mellitus has been prescribed for a client. In instructing the client about the test, the nurse explains that long-term control can be measured because chronic high blood glucose levels lead to irreversible glucose binding onto what?

Red blood cells (RBCs)

The nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose level of 120 mg/dL (6.8 mmol/L), temperature of 101°F (38.3°C), pulse of 102 beats/minute, respirations of 22 breaths/minute, and blood pressure of 142/72 mm Hg. Which finding would be the priority concern to the nurse?

Temperature

A client with an endocrine disorder has experienced recent weight loss and exhibits tachycardia. Based on the clinical manifestations, the nurse should suspect dysfunction of which endocrine gland?

Thyroid

The nurse is caring for a client with pheochromocytoma who is scheduled for adrenalectomy. In the preoperative period, what should the nurse monitor as the priority?

Vital signs

A client with hypovolemia experiences activation of the renin-angiotensin system to maintain blood pressure. The registered nurse determines that the new nurse understands that what substance is secreted if which statement is made?

"Aldosterone will be secreted."

A client with diabetes mellitus who takes insulin is seen in the health care clinic. The client tells the clinic nurse that after the insulin injection, the insulin seems to leak through the skin. The nurse would appropriately determine the problem by asking the client which question?

"Are you rotating the injection site?"

The health care provider prescribes a 24-hour urine collection for vanillylmandelic acid (VMA). The community health nurse visits the client at home and instructs the client in the procedure for the collection of the urine. Which statement, if made by the client, would indicate a need for further instruction?

"I can take medication if I need to during the collection."

The nurse is providing discharge instructions to a client who has Cushing's syndrome. Which client statement indicates that instructions related to dietary management are understood?

"I should eat foods that have a lot of potassium in them."

The nurse has provided instructions for measuring blood glucose levels to a client newly diagnosed with diabetes mellitus who will be taking insulin. The client demonstrates understanding of the instructions by identifying which method as the best method for monitoring blood glucose levels?

"I will check my blood glucose level before each meal and at bedtime."

A nurse is providing home care instructions to a client with a diagnosis of Addison's disease. Which statement by the client indicates a need for further instruction?

"I will need to take daily medications until my symptoms decrease."

The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client makes which statement?

"I will notify my health care provider (HCP) if my blood glucose level is higher than 250 mg/dL (14.2 mmol/L)."

The nurse is caring for a client who had a transsphenoidal hypophysectomy. Which statements should the nurse include in the discharge teaching instructions? Select all that apply.

"Include adequate fiber and fluids in your diet." 2. "Wear slip-on shoes rather than those that need to be tied." "Brushing your teeth will not be permitted for at least 2 weeks after surgery." 5. "Contact your health care provider immediately if you develop any headache, fever, or neck stiffness."

The nurse is caring for a client diagnosed with type 1 diabetes mellitus experiencing the Somogyi effect. Which blood glucose results and treatment would the nurse expect?

0300 blood glucose 68 mg/dL (3.8 mmol/L) and 0700 blood glucose 200 mg/dL (11.1 mmol/L). Instruct to decrease amount of evening insulin.

A client has undergone a 2-hour oral glucose tolerance test (OGTT). Which of the listed glucose levels is compatible with diabetes mellitus at the conclusion of the test?

160 mg/dL (9.14 mmol/L)

The nurse is preparing to care for a client after parathyroidectomy. The nurse should plan for which action for this client?

Administer a continuous mist of room air or oxygen.

The nurse is caring for a client admitted to the emergency department with diabetic ketoacidosis (DKA). In the acute phase, the nurse plans for which priority intervention?

Administer short-duration insulin intravenously.

The nurse is providing instructions regarding home care measures to a client with diabetes mellitus and instructs the client about the causes of hypoglycemia. The nurse determines that additional instruction is needed if the client identifies which as a cause of hypoglycemia?

Decreased daily insulin dosage

A young man with type 1 diabetes mellitus tells the nurse that he might lose his job because he has been having frequent hypoglycemic reactions. His boss thinks that he is drunk during these episodes and that he has been drinking on the job. Which action by the nurse would best assist this client to meet his needs?

Examine factors with the client that may be causing frequent hypoglycemic episodes.

The nurse is preparing a client with a new diagnosis of hypothyroidism for discharge. The nurse determines that the client understands discharge instructions if the client states that which signs and symptoms are associated with this diagnosis? Select all that apply.

Feeling cold 4. Loss of body hair 5. Persistent lethargy 6. Puffiness of the face

A client has been diagnosed with hyperthyroidism. The nurse monitors for which signs and symptoms indicating a complication of this disorder? Select all that apply.

Fever 2. Nausea tremors confusion

The nurse is monitoring a client with Graves' disease for signs of thyrotoxic crisis (thyroid storm). Which signs or symptoms, if noted in the client, will alert the nurse to the presence of this crisis?

Fever and tachycardia

A client with diabetes mellitus is being tested to determine long-term diabetic control. Which result should the nurse expect to see if the client's long-term control is within acceptable limits?

Glycosylated hemoglobin of <6%

A nurse is caring for a client with pheochromocytoma. The client asks for a snack and something warm to drink. Which items would be the most appropriate choice for this client to meet nutritional needs?

Graham crackers and warm milk

The clinic nurse is providing instructions to a client with diabetes mellitus about the signs and symptoms of hypoglycemia. The nurse should tell the client that which would be noted in a hypoglycemic reaction?

Hunger

A client with type 2 diabetes mellitus has a blood glucose level greater than 600 mg/dL (34.3 mmol/L) and is complaining of polydipsia, polyuria, weight loss, and weakness. The nurse reviews the health care provider's documentation and expects to note which diagnosis?

Hyperosmolar hyperglycemic syndrome (HHS)

A client with type 2 diabetes mellitus is complaining of polydipsia, polyuria, weight loss, and weakness. Laboratory results indicate a blood glucose level of 800 mg/dL (45.7 mmol/L) and nonketosis. The nurse reviews the health care provider's documentation and expects to note which diagnosis?

Hyperosmolar hyperglycemic syndrome (HHS)

A nurse is caring for a client with a dysfunctional thyroid gland and is concerned that the client will exhibit a sign of thyroid storm. Which is an early indicator of this complication?

Hyperreflexia

A client has been diagnosed with pheochromocytoma. Which clinical manifestation is most indicative of this condition?

Hypertension

A nurse is caring for a client with thyrotoxicosis who is at risk for the development of thyroid storm. To detect this complication, the nurse should assess for which sign or symptom?

Hypertension

The nurse is reviewing the record of a client admitted to the hospital with a diagnosis of pheochromocytoma. The nurse reads the assessment findings and expects to note documentation of which major symptom associated with this condition?

Hypertension

A client is admitted to the hospital with a diagnosis of Addison's disease. The nurse would assess for which problem as a manifestation of this disorder?

Hypotension

The nurse is caring for a client who has had an adrenalectomy and is monitoring the client for signs of adrenal insufficiency. Which signs and symptoms indicate adrenal insufficiency in this client?

Hypotension and fever

A client has begun medication therapy with propylthiouracil. The nurse should assess the client for which condition as an adverse effect of this medication?

Hypothyroidism

A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240 mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication?

IV fluids containing dextrose

The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The nurse places priority on which client problem?

Inadequate fluid volume

A client's serum blood glucose level is 389 mg/dL (22.2 mmol/L). The nurse would expect to note which as an additional finding when assessing this client?

Increased thirst

A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperosmolar hyperglycemic syndrome is made. The nurse would immediately prepare to initiate which anticipated health care provider's prescription?

Intravenous infusion of normal saline

An external insulin pump is prescribed for a client with diabetes mellitus. When the client asks the nurse about the functioning of the pump, the nurse bases the response on which information about the pump?

It administers a small continuous dose of short-duration insulin subcutaneously. The client can self-administer an additional bolus dose from the pump before each meal.

The nurse is caring for a client after thyroidectomy. The client expresses concern about the postoperative voice hoarseness she is experiencing and asks if the hoarseness will subside. The nurse should provide the client with which information?

It is normal during this time and will subside.

A client with diabetes mellitus is at risk for a serious metabolic disorder from the breakdown of fats for conversion to glucose. The nurse should anticipate that which substance will be elevated?

Ketones

A nurse is assessing the status of a client who returned to the surgical nursing unit after a parathyroidectomy procedure. The nurse would place highest priority on which assessment finding?

Laryngeal stridor

The nurse is caring for a client with a diagnosis of Cushing's syndrome. Which expected signs and symptoms should the nurse monitor for? Select all that apply.

Moon face 5. Hypertension 6. Truncal obesity

During physical examination of a client, which finding is characteristic of hypothyroidism?

Periorbital edema

The nurse is caring for a client with a new diagnosis of hypothyroidism. Which clinical manifestations might the nurse expect to note on examination of this client? Select all that apply.

Periorbital edema 3. Coarse, brittle hair 4. Slow or slurred speech 5. Abdominal distention

The nurse is caring for a client admitted to the hospital with uncontrolled type 1 diabetes mellitus. In the event that diabetic ketoacidosis (DKA) does occur, the nurse anticipates that which medication would most likely be prescribed?

Regular insulin

A client arrives in the hospital emergency department complaining of severe thirst and polyuria. The client tells the nurse that she has a history of diabetes mellitus. A blood glucose level is drawn, and the result is 685 mg/dL (39.1 mmol/L). Which intervention should the nurse anticipate to be prescribed initially for the client?

Regular insulin via the intravenous (IV) route

A nurse notes that a client with type 1 diabetes mellitus has lipodystrophy on both upper thighs. The nurse should ask the client if which measure is taken?

Rotating sites for injection

A client with type 1 diabetes mellitus is admitted to the emergency department with suspected diabetic ketoacidosis (DKA). Which laboratory result would be expected with this diagnosis?

Serum potassium is 6.8 mEq/L (6.8 mmol/L).

During health history taking, the client complains of weight loss and diarrhea and says that he can "feel my heart beating in my chest." The nurse anticipates that which diagnostic test will most likely be prescribed by the health care provider (HCP) in order to determine the underlying condition leading to the client's signs and symptoms?

Serum thyroid-stimulating hormone (TSH)

The nurse is caring for a client with a diagnosis of Addison's disease and is monitoring the client for signs of addisonian crisis. The nurse should assess the client for which manifestation that would be associated with this crisis?

Severe abdominal pain

The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptom or symptoms develop? Select all that apply.

Shakiness 3. Palpitations Lightheadedness

The nurse is caring for a postoperative client who has had an adrenalectomy. What should the nurse check for during the client's focused assessment?

Signs and symptoms of hypovolemia

A nurse is performing an admission assessment on a client with a diagnosis of pheochromocytoma. The nurse should assess for the major sign associated with pheochromocytoma by performing which action?

Taking the client's blood pressure

The nurse is caring for a client after thyroidectomy. The nurse notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed for which purpose?

To treat hypocalcemic tetany

A nurse is caring for a client after a thyroidectomy. Which specific emergency equipment should the nurse have available as it relates to this procedure?

Tracheostomy tray

A client has been diagnosed with Cushing's syndrome. The nurse should assess the client for which expected manifestations of this disorder?

Truncal obesity

A client newly diagnosed with diabetes mellitus is started on a 2-dose insulin protocol combination of short- and intermediate-acting insulin injected twice daily. What portion of the total dose is given before breakfast, and what portion is given before the evening meal?

Two thirds before breakfast and one third before the evening meal

During routine nursing assessment after hypophysectomy, a client complains of thirst and frequent urination. Knowing the expected complications of this surgery, what should the nurse assess next?

Urine specific gravity

Which findings should raise suspicion to the nurse that a head-injured client may be experiencing diabetes insipidus? Select all that apply.

Urine specific gravity is 1.001. Serum osmolality is 320 mOsm/kg (320 mmol/kg) of water. Urine output has increased from 1000 mL in 24 hours to 4000 mL in 24 hours.

A multidisciplinary health care team is developing a plan of care for a client with hyperparathyroidism. The nurse should include which priority intervention in the plan of care?

Walk down the hall for 15 minutes 3 times a day.

The nurse teaches a class on foot care for clients diagnosed with diabetes mellitus. Which instructions should the nurse include in the class? Select all that apply.

Wear closed-toe shoes. Cut toenails straight across and file the edges. 5. Pat feet dry gently, especially between the toes.

After client education about the importance of sunscreen use and active vitamin production via the skin, the nurse determines that the client understands the teaching when which statement is made?

`"Vitamin D is activated in the epidermis from ultraviolet light, such as sunlight."

The nurse is caring for a client scheduled for a transsphenoidal hypophysectomy. The preoperative teaching instructions should include which statement?

"Brushing your teeth needs to be avoided for at least 2 weeks after surgery."

The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client relates a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching?

"I need to stop my insulin."

A client has been hospitalized for an endocrine system dysfunction of the pancreas. The registered nurse asks the new orientee nurse what kind of problem a client hospitalized for endocrine dysfunction of the pancreas would expect. The new orientee nurse demonstrates understanding if which statement is made?

"Insulin production will be decreased."

A client with type 1 diabetes mellitus is having trouble remembering the types, duration, and onset of the action of insulin. The client tells the nurse that family members have not been supportive. Which response by the nurse is best?

"Let me go over the types of insulins with you again."

The nurse is providing education to a client with type 2 diabetes mellitus. The nurse explains in layperson's language the physiological mechanism behind hypoglycemia. Which response by the client determines that teaching has been successful?

"My body increases glucagon production to fight low blood sugars."

A client with diabetes mellitus has been instructed in the dietary exchange system. The client asks the nurse if bacon is allowed in the diet. Which nursing response is most appropriate?

"One strip of bacon may be eaten if you eliminate 1 teaspoon of butter."

A client with type 1 diabetes mellitus calls the nurse to report recurrent episodes of hypoglycemia with exercising. Which statement by the client indicates an adequate understanding of the peak action of NPH insulin and exercise?

"The best time for me to exercise is after breakfast."

The family of a bedridden client with type 2 diabetes mellitus and chronic kidney disease calls the nurse to report symptoms of headache, polydipsia, and increased lethargy. Which most important question should the nurse ask the family to determine a possible problem?

"What is the client's capillary blood glucose level?"

The nursing instructor asks a nursing student to identify the risk factors associated with the development of thyrotoxicosis. The student demonstrates understanding of the risk factors by identifying an increased risk for thyrotoxicosis in which client?

A client with Graves' disease who is having surgery

The nurse is reviewing the health care provider's (HCP's) prescriptions for a client with a diagnosis of diabetes mellitus who has been hospitalized for treatment of an infected foot ulcer. The nurse expects to note which finding in the HCP's prescriptions?

An increased amount of NPH insulin daily insulin

A nursing instructor is teaching the class about Addison's disease. The instructor determines that the class understands the disease process if they indicate which are affected in this disease? Select all that apply.

Androgens Glucocorticoids 5. Mineralocorticoids

The emergency department nurse is reviewing the laboratory test results for a client suspected of having diabetic ketoacidosis (DKA). Which laboratory result should the nurse expect to note in this disorder?

Blood glucose level of 500 mg/dL (28.5 mmol/L)

A client who visits the health care provider's office for a routine physical examination reports new onset of intolerance to cold. Knowing that this is a frequent complaint associated with hypothyroidism, the nurse should check for which manifestations?

Complaints of weakness and lethargy

The nurse is providing dietary instructions to help with diabetes control for a client newly diagnosed with diabetes mellitus who will be taking insulin. The nurse should provide the client with which best instruction?

Eat meals at approximately the same time each day.

The nurse caring for a male client newly admitted to the hospital with a diagnosis of pneumonia suspects that the client is also at risk for metabolic syndrome if which characteristics have been identified in this client? Select all that apply.

Hemoglobin A1C of 6.5% Triglycerides 160 mg/dL (1.81 mmol/L) Serial fasting glucose levels of 120 mg/dL (6.85 mmol/L), 132 mg/dL (7.54 mmol/L), and 128 mg/dL (7.31 mmol/L)

A client is admitted with a serum glucose level of 650 mg/dL (37.14 mmol/L) and diabetic ketoacidosis (DKA) is suspected. Which additional laboratory result does the nurse identify as being supportive of DKA?

Ketones in urine

The nurse has developed a postoperative plan of care for a client who had a thyroidectomy and documents that the client is at risk for developing an ineffective breathing pattern. Which nursing intervention should the nurse include in the plan of care?

Monitor neck circumference every 4 hours.

The nurse is caring for a client who is 2 days postoperative from abdominal hysterectomy. The client has a history of diabetes mellitus and has been receiving regular insulin based on capillary blood glucose testing 4 times a day. A carbohydrate-controlled diet has been prescribed, but the client has not been eating. On entering the client's room, the nurse finds the client to be pale and diaphoretic. Which action is appropriate at this time?

Obtain a capillary blood glucose level and quickly perform a focused assessment.

A client with Graves' disease has exophthalmos and is experiencing photophobia. Which nursing action would best assist the client with these manifestations?

Obtain dark glasses for the client.

A client's laboratory results indicate the serum calcium is 12 mg/dL (3 mmol/L) and the serum phosphorous is 2.1 mg/dL (0.697 mmol/L). Based on these findings, the nurse suspects imbalance of which hormone?

Parathyroid hormone

The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which sign or symptom, if exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if the blood glucose is not adequately managed?

Polyuria

A nurse is reviewing the assessment findings for a client who was admitted to the hospital with a diagnosis of diabetes insipidus. The nurse understands that which manifestations are associated with this disorder? Select all that apply.

Polyuria 2. Polydipsia Complaints of excessive thirst 5. Specific gravity lower than 1.005

The nurse caring for a client with a diagnosis of hypoparathyroidism reviews the laboratory results of blood tests for this client and notes that the calcium level is extremely low. The nurse should expect to note which finding on assessment of the client?

Positive Trousseau's sign

The nurse in a health care clinic is reviewing the record of a client with diabetes mellitus who was just seen by the health care provider (HCP). The nurse notes that the HCP has prescribed acarbose. Which preexisting disorder, if noted in the client's record, would indicate a contraindication to the use of this medication?

Renal insufficiency

A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client?

Respiratory distress

A client newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. A nurse prepares a discharge teaching plan regarding the insulin and plans to reinforce which concept?

Systematically rotate insulin injections within 1 anatomical site.

The nurse is assessing the learning readiness of a client newly diagnosed with diabetes mellitus. Which behavior indicates to the nurse that the client is not ready to learn?

The client complains of fatigue whenever the nurse plans a teaching session.

A client with diabetes mellitus is being discharged following treatment for hyperosmolar hyperglycemic syndrome (HHS) precipitated by acute illness. The client tells the nurse, "I will call the health care provider (HCP) the next time I can't eat for more than a day or so." Which statement reflects the most appropriate analysis of this client's level of knowledge?

The client needs immediate education before discharge.

The nurse is providing home care instructions to the client with a diagnosis of Cushing's syndrome and prepares a list of instructions for the client. Which instructions should be included on the list? Select all that apply.

The signs and symptoms of hypoadrenalism 2. The signs and symptoms of hyperadrenalism 3. Instructions to take the medications exactly as prescribed 4. The importance of maintaining regular outpatient follow-up care

The nurse is monitoring a client for signs of hypocalcemia after thyroidectomy. Which sign or symptom, if noted in the client, would most likely indicate the presence of hypocalcemia?

Tingling around the mouth

A hospitalized client is diagnosed with type 1 diabetes mellitus. The nurse plans care for the client, understanding that which factors are likely causes of the beta cell destruction that accompanies this disorder? Select all that apply.

Viruses 2. Genetic factors 3. Autoimmune factors 4. Human leukocyte antigen (HLA)