ATI Endocrine Dynamic Quizzes (45 Qs)
A nurse is checking a client with Graves' disease for the development of thyroid storm. The nurse should report which of the following findings to the provider? A. Constipation B. Headache C. Bradycardia ✔D. Fever
A client who is experiencing a thyroid storm will have an exaggerated condition of hyperthyroidism associated with the sudden development of an extreme elevation in body temperature, hypertension, abdominal pain, and tachycardia. Graves' disease is a common cause of hyperthyroidism, which is an imbalance of metabolism caused by overproduction of thyroid hormone. Incorrect Answers: A. A client who is experiencing a thyroid storm will have diarrhea, abdominal pain, nausea, and vomiting in response to the overproduction of thyroid hormone. B. A client who is experiencing a thyroid storm will demonstrate restlessness, confusion, and possible seizures in response to the overproduction of thyroid hormone. C. A client who is experiencing a thyroid storm will have tachycardia in response to the overproduction of thyroid hormone.
A nurse is assisting with the care of a client who has Addison's disease and comes to the emergency department reporting nausea, vomiting, diarrhea, and abdominal pain. To prevent an Addisonian crisis, the nurse should expect the provider to prescribe which of the following medications? A. Calcium B. Potassium C. Iodine ✔D. Hydrocortisone
Addison's disease causes adrenal gland hypofunction and inadequate production of glucocorticoids. Acute adrenal insufficiency is life-threatening due to severe fluid and electrolyte imbalances. Without treatment, sodium levels fall, and potassium levels increase. Rapid infusion of IV fluids such as 0.9% sodium chloride and IV administration of high-dose corticosteroids such as hydrocortisone are essential to correct the glucocorticoid deficiency. Incorrect Answers: A. IV calcium corrects hypoparathyroidism, not acute adrenal insufficiency. B. Acute adrenal insufficiency causes hyperkalemia, and the client requires a potassium binding and excreting resin, not additional potassium. C. Iodine-containing agents treat thyrotoxicosis, not acute adrenal insufficiency.
A nurse is reviewing the laboratory reports for a client and notes an elevated thyroid-stimulating hormone (TSH) level. When collecting data from the client, which of the following findings should the nurse expect? ✔A. Bradycardia B. Tremors C. Low-grade fever D. Diaphoresis
An elevated TSH level indicates hypothyroidism, which is characterized by weight gain, bradycardia, cold intolerance, paresthesia, hearing loss, depression, and many other manifestations. Incorrect Answers: B. Tremors are a manifestation of Graves' disease, the most common type of hyperthyroidism. C. A low-grade fever is a manifestation of Graves' disease, the most common type of hyperthyroidism. D. Diaphoresis, along with heat intolerance, is a manifestation of Graves' disease, the most common type of hyperthyroidism.
A nurse is collecting data from a client who has Cushing's syndrome. Which of the following skin manifestations should the nurse expect to find? ✔A. Purple striae on the chest and abdomen B. Butterfly rash across the bridge of the nose C. Bronze skin pigmentation D. Jaundice of the face and sclera
Correct Answer: A. Purple striae on the chest and abdomen A client who has Cushing's disease should have purple striae (streaks or stripes) on the chest and abdomen because cortisol destroys collagen under the skin. Incorrect Answers: B. A client who has systemic lupus erythematosus should have a butterfly rash across the bridge of the nose. C. A client who has Addison's disease will have a darkening of the skin in both exposed and unexposed parts of the body due to a hormone deficiency caused by damage to the outer layer of the adrenal gland (adrenal cortex). D. A client who has hepatic, biliary, or gallbladder disease should have jaundice of the face and sclera.
A nurse is reinforcing teaching with a client who has hyperthyroidism about managing this disorder. Which of the following recommendations should the nurse include? A. Reduce her total hours of sleep B. Keep her immediate environment warm ✔C. Increase her caloric intake with meals D. Gradually increase her activity
Correct Answer: C. Increase her caloric intake with meals Clients whose thyroid hormone levels are high have increased protein, lipid, and carbohydrate metabolism, resulting in a loss of protein stores and a negative nitrogen balance. Even with an increased appetite, it is often difficult to meet energy demands, and weight loss is common. Muscle weakness and wasting can develop without adequate caloric and protein intake. Incorrect Answer: A. Clients who have hyperthyroidism often report an inability to sleep. A decreased attention span and mild to severe hyperactivity are common. The nurse should suggest frequent rest periods in a quiet environment. B. Clients who have hyperthyroidism often have a low-grade fever and diaphoresis due to their hypermetabolic state. A cool environment can decrease the discomfort of heat intolerance. D. Clients who have hyperthyroidism are often restless and have an increased systolic blood pressure, tachycardia, and other dysrhythmias. During the acute phase, increased activity is not an appropriate recommendation.
A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about the pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching? ✔A. "My cells are resistant to the effects of insulin." B. "My body breaks down sugars too efficiently." C. "My pancreas does not produce insulin." D. "My body produces antibodies against pancreatic beta cells."
Correct Answer: A. "My cells are resistant to the effects of insulin." This client who has type 2 diabetes mellitus will have resistance to insulin and a decrease in the secretion of insulin by the pancreatic beta cells. Incorrect Answers: B. A client who has type 2 diabetes mellitus does not secrete enough insulin by the pancreatic beta cells to break down enough glucose. C. A client who has type 1 diabetes mellitus does not secrete insulin because of the destruction of beta cells by the body. Although insulin is still produced, it is of insufficient quantity to maintain homeostasis. D. The client who has type 1 diabetes mellitus has destruction of the beta cells because of the body producing blood antibodies. This is not a manifestation of type 2 diabetes mellitus.
A nurse is collecting data from a client who has Addison's disease. Which of the following findings should the nurse expect? ✔A. Hypotension B. Weight gain C. Sugar craving D. Pale skin tone
Correct Answer: A. Hypotension The nurse should expect hypotension in a client who has adrenal insufficiency (Addison's disease). The nurse should monitor the client's blood pressure closely. If an Addisonian crisis occurs, the client's hypotension can become severe due to blood volume depletion caused by the loss of aldosterone. Incorrect Answers: B. The nurse should expect weight loss in a client who has Addison's disease. C. The nurse should expect salt craving in a client who has Addison's disease. D. The nurse should expect increased skin pigmentation in a client who has Addison's disease.
A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about hypoglycemia. Which of the following manifestations should the nurse include in the teaching? ✔A. Irritability (hypoglycemia) B. Urinary frequency (hyperglycemia) C. Dry mucous membranes (hyperglycemia) D. Excess thirst (hyperglycemia)
Correct Answer: A. Irritability A client with irritability is displaying an early manifestation of hypoglycemia for type 1 diabetes mellitus. Other early manifestations include fatigue, a headache, difficulty thinking, sweating, and nausea. Incorrect Answers: B. A client who has hyperglycemia will have manifestations of increased urination called polyuria. C. A client who has hyperglycemia will have manifestations of dehydration such as dry mucous membranes and sunken eyeballs. D. A client who has hyperglycemia will have manifestations of excess thirst called polydipsia.
A nurse is caring for a client who has type 1 diabetes mellitus and a capillary blood glucose reading of 48 mg/dL. Which of the following findings should the nurse expect? A. Kussmaul respirations (hyperglycemia) ✔B. Diaphoresis C. Decreased skin turgor (hyperglycemia) D. Ketonuria (hyperglycemia)
Correct Answer: B. Diaphoresis A nurse should expect a client who has a blood glucose level below 70 mg/dL to exhibit indications of hypoglycemia. Expected findings associated with hypoglycemia include weakness, hunger, diaphoresis, nausea, shakiness, and confusion. Incorrect Answers: A. The nurse should expect Kussmaul respirations in a client who has hyperglycemia. C. The nurse should expect dehydration and decreased skin turgor in a client who has hyperglycemia. D. The nurse should expect ketonuria in a client who has hyperglycemia.
A nurse is monitoring a client following a thyroidectomy. Which of the following findings should the nurse identify as an indication of hypoparathyroidism? A. Elevated blood pressure ✔B. Involuntary muscle spasms C. Cold intolerance D. Weight loss
Correct Answer: B. Involuntary muscle spasms The nurse should identify involuntary muscle spasms as an indication of hypoparathyroidism, which can occur if the parathyroid glands are damaged or removed during a thyroidectomy. Muscle twitching and paresthesias can result due to decreased parathyroid hormone levels and calcium deficiency. Incorrect Answers: A. The nurse should identify hypertension as an indication of thyroid storm, which is a potential complication following a thyroidectomy. C. The nurse should identify cold intolerance as an indication of hypothyroidism. D. The nurse should identify weight loss as an indication of hyperthyroidism.
A nurse is collecting data from a client who has Graves' disease. Which of the following findings should the nurse expect the client to display? A. Constipation B. Cold intolerance ✔C. Difficulty sleeping D. Anorexia
Correct Answer: C. Difficulty sleeping A client who has Graves' disease can have difficulty sleeping and anxiety due to the overproduction of thyroid hormone. Incorrect Answers: A. A client who has Graves' disease should report diarrhea due to the overproduction of thyroid hormone. B. A client who has Graves' disease can experience heat intolerance due to the overproduction of thyroid hormone. D. A client who has Graves' disease should have an increased appetite and still experience weight loss because of the overproduction of thyroid hormone.
A nurse is checking laboratory values to determine if a client who has diabetes mellitus is adhering to the treatment plan. Which of the following tests should the nurse use to make this determination? A. Glucose tolerance test (to Dx DM Type 2 and gestational diabetes) B. Urine sugar and acetone (for the last few hours) ✔C. Glycosylated hemoglobin levels D. Fasting serum glucose (provides info. previous 24 hrs)
Correct Answer: C. Glycosylated hemoglobin levels Checking glycosylated hemoglobin levels (HbA1c) is an accurate method to determine if the client is routinely compliant. Glycosylated hemoglobin refers to hemoglobin that is connected to glucose. Since the lifespan of an RBC is 4 months, this value will not be affected by recent changes in the client's diet or medications. Incorrect Answers: A. A glucose tolerance test is used to diagnose diabetes mellitus and most commonly identifies type 2 and gestational diabetes. B. Urine sugar and acetone reflect how well-controlled the client has been for the last few hours. D. A fasting serum glucose provides information about the client's previous 24 hours.
A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which of the following findings should the nurse expect? A. Urine negative for ketones B. Distended neck veins ✔C. Kussmaul respirations D. Elevated blood pressure
Correct Answer: C. Kussmaul respirations The nurse should expect the client to experience Kussmaul respirations with DKA. These deep and rapid respirations are the body's attempt to exhale carbon dioxide to reverse the metabolic acidosis that occurs with DKA. Incorrect Answers: A. The nurse should expect ketones to be present in the urine and blood of a client who has DKA due to excessive glucose production. B. Distended neck veins are not an expected finding of DKA. Signs of dehydration such as flattened neck veins, hypotension, dry skin, and sunken eyeballs are common. D. A client who has DKA is more likely to have orthostatic hypotension due to the dehydration caused by the excessive blood glucose and osmotic diuresis.
A nurse is reinforcing teaching with a client who has Addison's disease about healthy snacks. Which of the following food choices by the client indicates an understanding of the teaching? A. Sliced bananas B. Baked potato ✔C. Turkey and cheese sandwich D. Plain yogurt with peaches
Correct Answer: C. Turkey and cheese sandwich A turkey and cheese sandwich is high in protein, carbohydrates, and sodium. A client who has Addison's disease requires a diet that is low in potassium and high in sodium, carbohydrates, and protein. Addison's disease is a hormone deficiency caused by damage to the outer layer of the adrenal gland (adrenal cortex). Addison's disease occurs when the adrenal glands do not produce enough cortisol and, in some cases, aldosterone. Incorrect Answers: A. Bananas are high in potassium. A client who has Addison's disease requires a diet low in potassium because this condition causes hyperkalemia. B. Baked potatoes are high in potassium. D. Plain yogurt with peaches is high in potassium.
A nurse is caring for a client who is postoperative following a parathyroidectomy to treat hyperparathyroidism. Which of the following laboratory values should the nurse expect to DECREASE as a therapeutic effect of the procedure? A. Phosphorous (INCREASED DURING THERAPEUTIC EFFECT) B. Sodium (REGAULTED BY KIDNEYS) C. Potassium (REGULATED BY KIDNEYS) ✔D. Calcium
Correct Answer: D. Calcium The parathyroid hormone regulates calcium, phosphorus, and magnesium balance within the client's blood and bone by maintaining a balance between mineral levels in blood and bone. Hyperparathyroidism is associated with hypercalcemia; therefore, a decrease in the calcium level indicates an improvement in the client's condition. Incorrect Answers: A. Hyperparathyroidism is associated with hypophosphatemia; therefore, an increased phosphorous level indicates an improvement in the client's condition. B. Sodium levels are not regulated by the parathyroid gland but rather by the filtration system of the kidneys. C. Potassium levels are not regulated by the parathyroid gland but rather by the filtration system of the kidneys.
A nurse is reviewing laboratory results for a client who has diabetes mellitus. Which of the following results indicates that the client is controlling the diabetes? A. HbA1c 8.5% B. Postprandial blood glucose 190 mg/dL C. Casual blood glucose 205 mg/dL ✔D. Fasting blood glucose 95 mg/dL
Correct Answer: D. Fasting blood glucose 95 mg/dL The nurse should identify that a fasting blood glucose of 95 mg/dL is within the expected reference range of 70 to 110 mg/dL, which indicates that the client has the diabetes under control. Incorrect Answers: A. An HbA1c of 8.5% is above the expected reference of less than 7% and does not indicate that the client is controlling the diabetes. B. A post-prandial blood glucose of 190 mg/dL is above the expected reference range of less than 160 mg/dL and does not indicate that the client is controlling the diabetes. C. A casual blood glucose of 205 mg/dL is above the expected reference of less than 200 mg/dL and does not indicate that the client is controlling the diabetes.
A nurse is assisting with the plan of care for a client who is experiencing the Somogyi effect and takes intermittent-acting insulin. Which of the following actions should the nurse include in the plan? A. Move the client's evening intermediate-acting insulin dose to 90 minutes before dinner B. Increase the client's morning caloric intake C. Omit the client's evening snack ✔D. Monitor the client's nighttime blood glucose levels
Correct Answer: D. Monitor the client's nighttime blood glucose levels The Somogyi effect is a swing of a high blood glucose level in the morning after an extremely low blood glucose level during the night. This swing is caused by the release of stress hormones to counter low glucose levels. Monitoring the client's nighttime blood glucose levels can provide an accurate diagnosis of the Somogyi effect. Incorrect Answers: A. The nurse should plan to administer a smaller dose of intermediate-acting insulin at bedtime or increase the client's bedtime snacks to avoid conditions that can lead to the Somogyi effect. B. The nurse should evaluate the client's evening caloric intake based on the insulin dose and exercise programs during the day to avoid conditions that can lead to the Somogyi effect. C. The nurse should ensure the client receives a bedtime snack to decrease the risk of hypoglycemia during the night.
