Endocrine
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)?
"Avoid over-the-counter medication unless prescribed by your primary health care provider"
What is the nurse's best first response when a client with a suspected endocrine disorder says, "I can't, you know, satisfy my wife anymore."?
"Can you please tell me more?"
Which precaution is most important for the nurse to teach a client who has cardiovascular autonomic neuropathy (CAN) from diabetes to prevent harm?
"Change positions slowly when moving from sitting to standing."
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?
"Does everyone's feet get bigger during menopause?"
Which question is most relevant to ask a male client suspected to have a gonadotropin deficiency?
"How often do you need to shave your face?"
Which statement made by the client alerts the nurse to the possibility of hypothyroidism?
"I am always tired, even when I get 10 or 12 hours of sleep"
Which statement by a client indicates to the nurse correct understanding of what to do when the sensations of hunger and shakiness occur?
"I will eat three graham crackers"
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?
"I will keep the cat food bowl on my counter so that I do not have to bend over"
After instructing a client about the correct procedure for a 24-hour urine test, which client statement indicates to the nurse a need for further teaching?
"I will not eat any fatty foods when I am collecting urine for this test."
What is the nurse's best response to a client newly diagnosed with type 1 diabetes who asks why insulin is only given by injection and not as an oral drug?
"Insulin is a small protein that is destroyed in by stomach acids and intestinal enzymes."
What is the nurse's best response to a client with type 2 diabetes controlled with metformin who asks why now that he is recovering from surgery, is he prescribed to receive insulin therapy for a few days?
"You just need insulin temporarily because the stress of surgery causes increased blood glucose levels for a day or two."
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?
"It will be great to lose my "bug-eyed" appearance.
A client expresses fear and anxiety over the life changes associated with diabetes, stating, "I am scared that I can't do it all and will get so sick that I will be a burden on my family." What is the nurse's best response?
"Let's tackle it piece by piece. what is most scary to you?"
What is the nurse's best response when family members of a client with hyperthyroidism express concern about the client's frequent mood swings?
"Mood swings are common should diminish with treatment"
Which specific action is a priority for the nurse to teach a client with diabetes who has peripheral neuropathy to prevent harm?
"Never go barefoot."
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?
"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 to a client newly diagnosed with diabetes who asks why he is always so thirsty?
"The extra glucose in the blood makes the blood thicker, which then triggers thirst so that the water you drink will dilute the blood glucose level."
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"?
"You feel this way because of your high hormone levels. Your health care provider can prescribe an antianxiety drug for you."
Which statement made by a client about thyroid hormone replacement therapy (HRT) indicates to the nurse that further teaching is needed?
"if I continue to lose weight, I may need an increased dose."
what action will the nurse advise to prevent harm for a client with diabetes who has a 3-cm callus on the ball of the right foot?
"make an appointment with your podiatrist as soon as possible"
Which statement made by a client who is learning about self-injection of insulin indicates to the nurse that clarification is needed about injection site selection and rotation?
"the abdominal site is best because it is closest to the pancreas."
How will the nurse reply when a client with type 2 diabetes tells the nurse that he would like to have a 12-ounce glass of beer with supper but believes that is now impossible?
"you can have a beer with a meal if you test yourself for hypoglycemia an hour later"
Which new-onset symptoms will the nurse instruct a client with diabetes who is prescribed to take the sodium-glucose cotransport inhibitor, empagliflozin, to report to the diabetes health care provider to prevent harm? (Select all that apply.)
-muscle weakness and dizziness on standing -redness and tenderness of the perineum -sensations of hunger, tremor, sweating, and confusion -pain and burning on urination
A client newly diagnosed with type 1 diabetes says she is not ready to learn everything about diabetes control right now. Which information has the greatest priority for the nurse to teach this client and her family for now to prevent harm? (Select all that apply.)
-what to do when ill? -symptoms and treatment of hypoglycemia -insulin administration
When (at which time) will the nurse plan to monitor for hypoglycemia in a client with type 1 diabetes received regular insulin at 7:00 a.m.?
11:00 am
The nurse has just received report on a group of clients. Which client is the nurse's first priority?
A 26 year old with type 1 diabetes whose insulin pump is beeping "occlusion."
The nurse has just received report on a group of clients. Which client is the nurse's first priority?
A 28 year old with acute adrenal insufficiency who has a blood glucose of 36 mg/dL (2.0 mmol/L).
For which client will the nurse question the prescription for long-term androgen therapy?
A 52 year old with a history of prostate cancer treatment.
Which factor or condition does the nurse expect to result in an increase in a client's production of thyroid hormones (TH)?
Cold environmental temperatures
Clients who have deficiencies of which hormones will the nurse assess for increased risk of life-threatening consequences?
Adrenocorticotrophicn hormone (ACTH) and thyroid-stimulating hormone (TSH)
Which action in the plan of care for a client who is hospitalized for pituitary function testing would be most appropriate for the nurse to delegate to an experienced assistive personnel (AP)?
Checking the client's blood glucose levels every 4 hours
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?
Ensuring the phlebotomist wears a facemask while in the client's room
Which type of drug therapy will the nurse prepare to teach about to a client who has mild hyperparathyroidism?
Furosemide diuretics
Which laboratory findings will the nurse use to validate the statement of a client with diabetes that therapy instructions for glucose control "have been followed to the letter" for the past 2 months?
Glycosylated hemoglobin (HbA )
What is the nurse's best response when a client with diabetes who is being treated for hypoglycemic asks why people without diabetes don't become severely hypoglycemic even after fasting for 8 hours?
In a person without diabetes, the secretion of glucagon prevents hypoglycemia by promoting glucose release from liver storage sites (glycogenolysis).
Which client assessment finding indicates to the nurse the need to assess further for a possible endocrine problem?
Increased facial hair and absent menses in a 28-year-old nonpregnant woman
What effect on circulating levels of sodium and glucose does the nurse expect in a client who has been taking an oral cortisol preparation for 2 years because of a respiratory problem?
Increased sodium, increased glucose
Which changing trends in a client's serum laboratory values indicate to the nurse that thyroid hormone replacement therapy for hypothyroidism is effective?
Rising thyroid hormone (TH) levels; declining thyroid-stimulating hormone (TSH) levels
Which action will the nurse recommend to a client with type 1 diabetes on insulin therapy who has been having a morning fasting blood glucose (FBG) level of 160 mg/dL (8.9 mmol/L) and is diagnosed with "dawn phenomenon" to achieve better control?
Take your evening insulin dose right before going to bed instead of at supper time."
How will the nurse evaluate the level of glycemic control for a client with diabetes whose laboratory values include a fasting blood glucose level of 82 mg/dL (mmol/L) and an A1c of 5.9%?
The values indicate that the client has managed his or her disease well.
Which assessment finding in a client with diagnosis of diabetes insipidus (DI) indicates to the nurse that desmopressin therapy is effective?
Urine output of 30 to 50 mL/hr
With which client will the nurse be aware of an increased risk for hypoparathyroidism?
a 35-year-old woman who had radiation therapy for Graves disease
The nurse has just received report on a group of clients. Which client is the nurse's first priority?
a 45 year old taking metformin who has abdominal cramps
Which client does the nurse caution to avoid self-monitoring of blood glucose (SMBG) at alternate sites?
a 75-year-old client whose blood glucose levels show little variation
Which signs and symptoms in a client who has hyperthyroidism indicate to the nurse possible progression to a thyroid storm? (Select all that apply.)
abdominal pain and nausea tachycardia elevated temperature elevated systolic blood pressure
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.)
acute confusion decreased urine output persistent headache weigh gain of more that 2.2 lb (1 kg) in 24 hours
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?
apply oxygen by mask
Which action has the highest priority for the nurse to take when a client with type 1 diabetes arrives in the emergency department breathing deeply and stating, "I can't catch my breath." and has vital signs of: T 98.4° F (36.9° C), P 112 beats/min, R 38 breaths/min, BP 91/54 mm Hg, and O2 saturation 99% on room air?
assessing blood glucose level
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?
assessing cardiac status
Which trends in serum electrolyte values will the nurse expect to find in a client who has untreated hypoparathyroidism?
below normal calcium levels; above normal phosphorus levels
Which assessment finding in a client who had a parathyroidectomy yesterday indicates to the nurse that immediate action is needed?
bilateral leg muscle twitching
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?
chest pain
For which assessment finding in a client who had a transsphenoidal hypophysectomy yesterday will the nurse notify the primary health care provider immediately?
client report of a headache and stiff neck
Which assessment finding in a client with hyperaldosteronism indicates to the nurse that the condition is becoming more severe?
client reports numbness and tingling around the mouth
Which action immediately after a hypophysectomy will the nurse instruct a client to avoid to prevent harm? (Select all that apply.)
coughing bending at the waist
Which factor is most important for the nurse to assess before providing instruction to a client newly diagnosed with diabetes about the disease and its management?
education and literacy levels
Which action is most important for the nurse to perform when caring for an older client decreased antidiuretic hormone (ADH) production?
encouraging fluids every 2 hours
What is the nurse's best action when finding that a client who has had diabetes for 15 years has decreased sensory perception in both feet?
examining both feet for indications of injury
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?
hand temors
Which changes in laboratory values will the nurse expect to see in a client who has tumor causing excess secretion of aldosterone? (Select all that apply.)
hypokalemia hypernatremia
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)?
inserting an indwelling catheter and monitoring urine output
Which client assessment finding indicates to the nurse the possible presence of diabetic autonomic neuropathy?
intermittent constipation
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)?
no change in urine output with minimal fluid intake
In collaboration with the registered dietitian nutritionist, which dietary alterations will the nurse instruct a client with Cushing disease to make?
low carbohydrate, high calorie, and low sodium
Which action does the postanesthesia care unit (PACU) nurse perform first when caring for a client who has just arrived after a total thyroidectomy?
monitoring oxygen saturation
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.)
nonpitting edema of hands and feet decreased deep tendon reflexes pulse rate below 60 beats/min
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.)
oxygen calcium gluconate suction emergency tracheotomy kit
Which action is appropriate for the nurse to delegate to the assistive personnel (AP) when caring for clients with diabetes?
performing a blood glucose check on a client who requires insulin
Which assessment is a priority for the nurse to make when a client with diabetic ketoacidosis (DKA) who is being monitored while receiving an insulin infusion begins to show an irregular heart beat with inverted T-waves?
potassium level
Which statements regarding hyperthyroidism are accurate? (Select all that apply.)
produces symptoms of a hypermetabolic state most common form is a Graves disease is much more common among women than among men
Which assessment finding in a client with diabetes mellitus indicates to the nurse that the disease is damaging the kidneys?
protein in the urine a random urinalysis
Which laboratory finding in a client with a possible pituitary disorder will the nurse report to the health care provider immediately?
serum sodium 110mEq/L (110 mmol/L)
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?
serum sodium increases from 122 mEq/L to 140 mEq/L
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?
skin darkening
Why is a goiter often present in clients who have Graves disease?
the excessive autoantibodies bind to the thyroid-stimulating hormone receptor site, which increases the number and size of glandular cells in the thyroid gland
