Endocrine

What cells are responsible for secreting catecholamines?* A. Chromaffin B. Langerhans C. Enkephalin D. Parietal

A. Chromaffin

17. A female client has a serum calcium level of 7.2 mg/dl. During the physical examination, nurse Noah expects to assess: A. Trousseau's sign. B. Homans' sign. C. Hegar's sign. D. Goodell's sign.

Answer A. This client's serum calcium level indicates hypocalcemia, an electrolyte imbalance that causes Trousseau's sign (carpopedal spasm induced by inflating the blood pressure cuff above systolic pressure). Homans' sign (pain on dorsiflexion of the foot) indicates deep vein thrombosis. Hegar's sign (softening of the uterine isthmus) and Goodell's sign (cervical softening) are probable signs of pregnancy.

3. A physician orders a patient in thyroid storm to be started on Inderal. What in the patient's health history causes the nurse to question the doctor's order?* A. History of mental illness B. History of asthma C. History of tachycardia D. History of cancer

B. History of asthma

6. The thyroid hormones, T3 and T4, play many roles in the human body. Which of the following functions are performed by T3 and T4? Note: Select all that apply* A. Storing calories B. Increasing the Heart Rate C. Stimulating the Sympathetic Nervous System D. Decreasing the body's temperature E. Regulating TSH produced by the anterior pituitary gland

B. Increasing the Heart Rate C. Stimulating the Sympathetic Nervous System E. Regulating TSH produced by the anterior pituitary gland

3. A patient hospitalized with hypoparathyroidism is about to order lunch. Which food selection is best for this patient based on their dietary needs at this time?* A. Baked chicken, green beans, and boiled potatoes B. Spinach salad, cottage cheese, and peaches C. Roast beef, carrots, and pinto beans D. Hamburger, fries, and sorbet

B. Spinach salad, cottage cheese, and peaches

15. When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, nurse April is most likely to detect: A. a blood pressure of 130/70 mm Hg. B. a blood glucose level of 130 mg/dl. C. bradycardia. D. a blood pressure of 176/88 mm Hg.

Answer D. Pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, causes hypertension, tachycardia, hyperglycemia, hypermetabolism, and weight loss. It isn't associated with the other options.

Where is the anti-diuretic hormone PRODUCED in the body?* A. Medulla B. Anterior pituitary gland C. Hypothalamus D. Posterior pituitary gland

C. Hypothalamus

7. Lugol's solution helps block ________ of thyroid hormones in thyroid storm. Which of the following are a common side effect of this medication?* A. synthesis; oral sores B. excretion; swollen lymph nodes C. secretion; taste changes D. movement; hypocalcemia

C. secretion; taste changes

4. Signs and Symptoms of myxedema coma include all of the following EXCEPT? Select all that apply:* A. Fever B. Bradycardia C. Sodium level less than 135 D. Blood glucose level greater than 350 E. Hypothermia

A. Fever D. Blood glucose level greater than 350 E. Hypothermia

8. A patient who is in her first trimester of pregnancy is diagnosed with hyperthyroidism. Which medication do you suspect the patient will be started on?* A. Propylthiouracil (PTU) B. Radioactive Iodine C. Tapazole D. Synthroid

A. Propylthiouracil (PTU)

11. Following a unilateral adrenalectomy, nurse Betty would assess for hyperkalemia shown by which of the following? A. Muscle weakness B. Tremors C. Diaphoresis D. Constipation

Answer A. Muscle weakness, bradycardia, nausea, diarrhea, and paresthesia of the hands, feet, tongue, and face are findings associated with hyperkalemia, which is transient and occurs from transient hypoaldosteronism when the adenoma is removed. Tremors, diaphoresis, and constipation aren't seen in hyperkalemia.

6. Which of the following are not a treatment for Thyroid Storm?* A. Propylthiouracil (PTU) B. Synthroid C. Inderal D. Glucocorticoids

B. Synthroid

Where is the anti-diuretic hormone SECRETED in the body? A. Hypothalamus B. Posterior Pituitary gland C. Anterior pituitary gland D. Thyroid

C. Anterior pituitary gland

4. A patient is being discharged home for treatment of hypothyroidism. Which medication is most commonly prescribed for this condition?* A. Tapazole B. PTU (Propylthiouracil) C. Synthroid D. Inderal

C. Synthroid

7. A patient is recovery from a parathyroidectomy. Which of the following findings causes concern and requires nursing intervention?* A. The patient is in Semi-Fowler's position. B. The patient's calcium level is 8.9 mg/dL. C. The patient's voice is hoarse. D. The patient is drowsy but arouses to name.

C. The patient's voice is hoarse.

The anti-diuretic hormone is __________ in Diabetes Insipidus and _________ in SIADH.* A. absent, absent B. low, high C. low, low D. high, low

D. high, low

12. A patient is being educated on how to take their anti-thyroid medication. Which of the following statements are INCORRECT?* A. "I will continue taking aspirin daily." B. "I will take this medication at the same time every day." C. "It may take a while before I notice that the medication is helping my condition." D. "I will avoid foods containing high levels of iodine."

A. "I will continue taking aspirin daily."

5. You are performing discharge teaching with a patient who is going home on Synthroid. Which statement by the patient causes you to re-educate the patient about this medication?* A. "I will take this medication at bedtime with a snack." B. "I will never stop taking the medication abruptly." C. "If I have palpitations, chest pain, intolerance to heat, or feel restless, I will notify the doctor." D. "I will not take this medication at the same time I take my Carafate."

A. "I will take this medication at bedtime with a snack."

You are developing a care plan for a patient with SIADH. Which of the following would be a potential nursing diagnosis for this patient?* A. Acute pain B. Fluid volume overload C. Fluid volume deficient D. Impaired skin integrity

A. Acute pain

4. A patient is admitted to the ER. The patient is unconscious on arrival. However, the patient's family is with the patient and reports that before the patient became unconscious she was complaining of severe pain in the abdomen, legs, and back, and has been experiencing worsening confusion. In addition, they also report the patient has not been taking any medications. The patient was recently discharged from the hospital for treatment of low cortisol and aldosterone levels. On assessment, you note the patient's blood pressure is 70/45. What disorder is this patient most likely experiencing?* A. Addisonian Crisis B. Cushing Syndrome C. Thyroid crisis D. Hashimoto thyroiditis

A. Addisonian Crisis

16. Which of the following side effects are possible for a patient taking an anti-thyroid medication?* A. Agranulocytosis and aplastic anemia B. Tachycardia C. Skin discoloration D. Joint pain and eczema

A. Agranulocytosis and aplastic anemia

4. A patient taking Tapazole reports feeling dizzy, intolerant to cold, and tired. On assessment, you note the patient's heart rate is 45 and blood pressure is 70/30. What is the most likely cause?* A. Antithyroid toxicity B. Agranulocytosis C. Thyroid storm D. Bronchospasm

A. Antithyroid toxicity

1. A patient is recovering from a thyroidectomy. The patient starts to complain of tingling and numbness in the face, toes, and fingers. Which of the following findings below warrants attention?* A. Ca+ level: 6 mg/dL B. Na+ level: 145 mg/dL C. K+ level: 3.5 mg/dL D. Phosphate level: 4.3 mg/dL

A. Ca+ level: 6 mg/dL

9. A patient is diagnosed with hyperparathyroidism. Which of the following signs and symptoms would you NOT find in this patient? Select all that apply:* A. Calcium level 6 mg/dL B. Bone fracture C. Positive Trousseau's Sign D. Tingling and numbness of lips and fingers E. Calcium level of 15 mg/dL F. Phosphate level 1.2 G. Renal calculi

A. Calcium level 6 mg/dL C. Positive Trousseau's Sign D. Tingling and numbness of lips and fingers

A patient with a mild case of diabetes insipidus is started on Diabinese. What would you include in your patient teaching with this patient?* A. Drinking 16 oz of water when taking the medication B. Restricting foods containing caffeine C. Taking the medication on an empty stomach D. Signs and symptoms of hypoglycemia

A. Drinking 16 oz of water when taking the medication

A patient arrives to the ER and is unable to give you a health history due to altered mental status. The family reports the patient has gained over 10 lbs in 1 week and says it is mainly "water" weight. In addition, they report the patient hasn't been able to urinate or eat within the past week as well and was recently diagnosed with small cell lung cancer. On assessment, you note the patient's HR is 115 and BP 180/92. Patient sodium level is 90. Which of the following conditions do you suspect the patient is most likely presenting with?* A. Fluid Volume Deficient B. Diabetes Insipidus C.Addison's Disease D. SIADH

A. Fluid Volume Deficient

8. A patient with Cushing's syndrome will be undergoing an adrenalectomy. Which of the following will be included in the patient's discharge teaching after the procedure?* A. Glucocorticoid replacement therapy B. Avoiding avocadoes and pears C. Declomycin therapy D. Signs and symptoms of Grave's Disease

A. Glucocorticoid replacement therapy

14. Which of the following signs and symptoms causes concern and requires nursing intervention for a patient who recently had a thyroidectomy?* A. Heart rate of 120, blood pressure 220/102, temperature 103.2 'F B. Heart rate of 35, blood pressure 60/43, temperature 95.3 'F C. Soft hair, irritable, diarrhea D. Constipation, drowsiness, goiter

A. Heart rate of 120, blood pressure 220/102, temperature 103.2 'F

6. Select all that apply: Which of the following are signs and symptoms of Grave's Disease:* A. Heat Intolerance B. Weight gain C. Bradycardia D. Goiter E. Pretibial Myxedema F. Cold intolerance G. Ophthalmopathy changes H. Fast Heart Rate

A. Heat Intolerance D. Goiter E. Pretibial Myxedema G. Ophthalmopathy changes H. Fast Heart Rate

9. Which of the following is not a typical sign and symptom of Cushing's Syndrome?* A. Hyperpigmentation of the skin B. Hirsutism C. Purplish striae D. Moon Face

A. Hyperpigmentation of the skin

5. In the scenario above, A patient is admitted to the ER. The patient is unconscious on arrival. However, the patient's family is with the patient and reports that before the patient became unconscious she was complaining of severe pain in the abdomen, legs, and back, and has been experiencing worsening confusion. In addition, they also report the patient has not been taking any medications. The patient was recently discharged from the hospital for treatment of low cortisol and aldosterone levels. On assessment, you note the patient's blood pressure is 70/45 What medication do you expect the patient to be started on?* A. IV Solu-Cortef B. PO Prednisone C. PO Declomycin D. IV Insulin

A. IV Solu-Cortef

7. In Cushing's Disease and Syndrome there are:* A. Increased cortisol production B. Low potassium and glucose levels C. Increased production of aldosterone and cortisol D. Decreased production of cortisol and aldosterone

A. Increased cortisol production

4. A patient is receiving radioactive iodine as treatment for Grave's Disease. Which of the following are common side effects of the treatment? Select all that apply:* A. Nausea B. Taste changes C. Excessive saliva D. Swollen salivary glands

A. Nausea B. Taste changes D. Swollen salivary glands

A patient with SIADH is undergoing IV treatment of a hypertonic IV solution of 3% saline and IV Lasix. Which of the following nursing findings requires intervention?* A. Potassium level of 5.0. B. Sodium level of 136. C. Patient reports urinating more frequently. D. Assessment finding of crackles throughout the lung fields.

A. Potassium level of 5.0.

5. Which of the following foods below should a patient experiencing a thyroid storm avoid? Select all that apply:* A. Shrimp B. Milk C. Hard boiled eggs D. Seaweed (Kelp) E. Broccoli F. Peas

A. Shrimp B. Milk C. Hard boiled eggs D. Seaweed (Kelp)

17. A patient is receiving radioactive iodine treatment for hyperthyroidism. What will you include in your patient education to this patient about this type of treatment?* A. Taste changes and swollen salivary glands B. Constipation C. Excessive thirst D. Sun protection

A. Taste changes and swollen salivary glands

5. A physician orders Calcium Gluconate IV as treatment for a patient with hypoparathyroidism. The patient's calcium level is 5 mg/dL. Which of the following finding causes you to question this order?* A. The patient is taking Digoxin. B. The patient complains of muscle cramping and numbness in the face. C. The patient is taking Aluminum Carbonate. D. The patient's phosphate level is 7 mg/dL.

A. The patient is taking Digoxin.

Which statement is incorrect about pheochromocytoma?* A. This condition can be trigger by eating foods high in Tyramine such as hamburger meat and spinach. B. Monoamine oxidase inhibitors can trigger signs and symptoms of pheochromocytoma. C. An adrenalectomy is the only surgical treatment for pheochromocytoma. D. Patients with pheochromocytoma are at risk for hypertensive crisis.

A. This condition can be trigger by eating foods high in Tyramine such as hamburger meat and spinach.

9. Which of the following are treatment options for hyperthyroidism? Please select all that apply:* A. Thyroidectomy B. Methimazole C. Liothyronine Sodium "Cytomel" D. Radioactive Iodine

A. Thyroidectomy B. Methimazole D. Radioactive Iodine

12. Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus? A. antidiuretic hormone (ADH). B. thyroid-stimulating hormone (TSH). C. follicle-stimulating hormone (FSH). D. luteinizing hormone (LH).

Answer A. ADH is the hormone clients with diabetes insipidus lack. The client's TSH, FSH, and LH levels won't be affected.

8. When caring for a male client with diabetes insipidus, nurse Juliet expects to administer: A. vasopressin (Pitressin Synthetic). B. furosemide (Lasix). C. regular insulin. D. 10% dextrose

Answer A. Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin) production, the nurse should expect to administer synthetic vasopressin for hormone replacement therapy. Furosemide, a diuretic, is contraindicated because a client with diabetes insipidus experiences polyuria. Insulin and dextrose are used to treat diabetes mellitus and its complications, not diabetes insipidus.

18. Which outcome indicates that treatment of a male client with diabetes insipidus has been effective? A. Fluid intake is less than 2,500 ml/day. B. Urine output measures more than 200 ml/hour. C. Blood pressure is 90/50 mm Hg. D. The heart rate is 126 beats/minute.

Answer A. Diabetes insipidus is characterized by polyuria (up to 8 L/day), constant thirst, and an unusually high oral intake of fluids. Treatment with the appropriate drug should decrease both oral fluid intake and urine output. A urine output of 200 ml/hour indicates continuing polyuria. A blood pressure of 90/50 mm Hg and a heart rate of 126 beats/minute indicate compensation for the continued fluid deficit, suggesting that treatment hasn't been effective.

2. A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, nurse Julia formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which "related-to" phrase should the nurse add? A. Related to bone demineralization resulting in pathologic fractures B. Related to exhaustion secondary to an accelerated metabolic rate C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces D. Related to tetany secondary to a decreased serum calcium level

Answer A. Poorly controlled hyperparathyroidism may cause an elevated serum calcium level. This, in turn, may diminish calcium stores in the bone, causing bone demineralization and setting the stage for pathologic fractures and a risk for injury. Hyperparathyroidism doesn't accelerate the metabolic rate. A decreased thyroid hormone level, not an increased parathyroid hormone level, may cause edema and dry skin secondary to fluid infiltration into the interstitial spaces. Hyperparathyroidism causes hypercalcemia, not hypocalcemia; therefore, it isn't associated with tetany.

5. Nurse Oliver should expect a client with hypothyroidism to report which health concerns? A. Increased appetite and weight loss B.Puffiness of the face and hands C.Nervousness and tremors D. Thyroid gland swelling

Answer B. Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight gain. Signs and symptoms of hyperthyroidism (Graves' disease) include an increased appetite, weight loss, nervousness, tremors, and thyroid gland enlargement (goiter).

13. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? A. Diabetic ketoacidosis B. Thyroid crisis C. Hypoglycemia D. Tetany

Answer B. Thyroid crisis usually occurs in the first 12 hours after thyroidectomy and causes exaggerated signs of hyperthyroidism, such as high fever, tachycardia, and extreme restlessness. Diabetic ketoacidosis is more likely to produce polyuria, polydipsia, and polyphagia; hypoglycemia, to produce weakness, tremors, profuse perspiration, and hunger. Tetany typically causes uncontrollable muscle spasms, stridor, cyanosis, and possibly asphyxia.

6. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect? A. Dysuria B. Leg cramps C. Tachycardia D. Blurred vision

Answer C. Levothyroxine, a synthetic thyroid hormone, is given to a client with hypothyroidism to simulate the effects of thyroxine. Adverse effects of this agent include tachycardia. The other options aren't associated with levothyroxine.

21. An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of: A. Thyroid storm. B. Cretinism. C. myxedema coma. D. Hashimoto's thyroiditis.

Answer C. Severe hypothyroidism may result in myxedema coma, in which a drastic drop in the metabolic rate causes decreased vital signs, hypoventilation (possibly leading to respiratory acidosis), and nonpitting edema. Thyroid storm is an acute complication of hyperthyroidism. Cretinism is a form of hypothyroidism that occurs in infants. Hashimoto's thyroiditis is a common chronic inflammatory disease of the thyroid gland in which autoimmune factors play a prominent role.

16. A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? A. Infusing I.V. fluids rapidly as ordered B. Encouraging increased oral intake C. Restricting fluids D. Administering glucose-containing I.V. fluids as ordered

Answer C. To reduce water retention in a client with the SIADH, the nurse should restrict fluids. Administering fluids by any route would further increase the client's already heightened fluid load.

9. The nurse is aware that the following is the most common cause of hyperaldosteronism? A. Excessive sodium intake B. A pituitary adenoma C. Deficient potassium intake D. An adrenal adenoma

Answer D. An autonomous aldosterone-producing adenoma is the most common cause of hyperaldosteronism. Hyperplasia is the second most frequent cause. Aldosterone secretion is independent of sodium and potassium intake as well as of pituitary stimulation.

7. A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, nurse Richard would suspect which of the following disorders? A. Diabetes mellitus B. Diabetes insipidus C. Hypoparathyroidism D. Hyperparathyroidism

Answer D. Hyperparathyroidism is most common in older women and is characterized by bone pain and weakness from excess parathyroid hormone (PTH). Clients also exhibit hypercaliuria-causing polyuria. While clients with diabetes mellitus and diabetes insipidus also have polyuria, they don't have bone pain and increased sleeping. Hypoparathyroidism is characterized by urinary frequency rather than polyuria.

25. During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the nurse should include which statement? A. "The head of your bed must remain flat for 24 hours after surgery." B. "You should avoid deep breathing and coughing after surgery." C. "You won't be able to swallow for the first day or two." D. "You must avoid hyperextending your neck after surgery."

Answer D. To prevent undue pressure on the surgical incision after subtotal thyroidectomy, the nurse should advise the client to avoid hyperextending the neck. The client may elevate the head of the bed as desired and should perform deep breathing and coughing to help prevent pneumonia. Subtotal thyroidectomy doesn't affect swallowing.

2. As the nurse educating the patient about Grave's Disease, which of the following statements by the patient ensures the patient understood the education about their condition?* A. "I could experience myxedema coma, which is life-threatening, if I abruptly stop taking my antithyroid medication." B. "Grave's disease is due to an excessive amount of thyroid hormone in the body." C. "I will be sure to eat a lot of kelp because it helps with decreasing thyroid hormone levels." D. "If I have pain I will only take aspirin."

B. "Grave's disease is due to an excessive amount of thyroid hormone in the body."

7. A patient is started on Tapazole (Methimazole) for treatment of Grave's Disease. Which statement by the patient indicates they understood your teaching about this medication?* A. "If I experience fast heart, excessive sweating, or fever, I will notify the doctor immediately because I may be experiencing toxicity of the medication." B. "I know it may take a while before I feel relief of symptoms, therefore, I will never abruptly stop taking my medication." C. "This medication can cause high blood glucose." D. "I will make sure my diet is rich in foods containing iodine." SUBMIT

B. "I know it may take a while before I feel relief of symptoms, therefore, I will never abruptly stop taking my medication."

3. A patient with Addison's Disease is being discharged home on Prednisone. Which of the following statements by the patient warrants you to re-educate the patient?* A. "I will notify the doctor if I become sick or experience extra stress." B. "I will take this medication as needed when symptoms present." C. "I will take this medication at the same time every day." D. "My daughter has bought me a Medic-Alert bracelet."

B. "I will take this medication as needed when symptoms present."

1. Which patient is most at risk for Thyroid Storm?* A. A 60 year old female who reports not taking Synthroid regularly. B. A 45 year old male who has not been taking Tapazole as ordered and is experiencing diabetic ketoacidosis. C. A 6 year old with an allergy to iodine. D. A 25 year old female who is pregnant with her 4th child and is experiencing eczema.

B. A 45 year old male who has not been taking Tapazole as ordered and is experiencing diabetic ketoacidosis.

2. Which of the following patients are MOST at risk for hypoparathyroidism?* A. A 75 year-old female who is diabetic and takes Os-Cal daily. B. A 59 year-old male with a Mg+ level of 0.9 mg/dL. C. A 85 year-old female complaining of flank pain and constipation. D. A 19 year-old male with a Ca+ level of 8.9 mg/dL.

B. A 59 year-old male with a Mg+ level of 0.9 mg/dL.

1. Which of the following patients are MOST at risk for developing myxedema coma?* A. A 28 year old female who is prescribed Methimazole. B. A 75 year old female who is taking Lithium and reports missing several doses of Synthroid. C. A 69 year old male experiencing nausea and vomiting for 4 days. D. A 55 year old male with a history of diabetes and is insulin dependent.

B. A 75 year old female who is taking Lithium and reports missing several doses of Synthroid.

8. Which of the following medication orders should a nurse question if ordered on a patient with thyroid storm?* A. Propylthiouracil "PTU" for a 25 year old who is 8 weeks pregnant B. Aspirin as needed for a fever greater than 102.2 'F C. Inderal for a patient who reports having insomnia D. Tapazole for a 30 year old having complaints of a headache SUBMIT

B. Aspirin as needed for a fever greater than 102.2 'F

4. A patient is 6 hours post-opt from thyroid surgery. The patient's calcium level is 5 and phosphate level is 4.2. What physical signs and symptoms would NOT present with these findings? (Select-all-that-apply)* A. Bronchospasm B. Constipation C. Numbness and tingling in the face D. Positive Chvostek's Sign E. Absent Trousseau's Sign F. Hypertension

B. Constipation E. Absent Trousseau's Sign F. Hypertension

1. Fill in the blank regarding the negative feedback loop for thyroid hormone production: The ______________ produces TRH (Thyrotropin-Releasing Hormone) which causes the anterior pituitary gland to produce _______________ which in turn causes the thyroid gland to release _______ and _______.* A. Thalamus, CRH (Corticotropin-releasing hormone) TSH (thyroid-stimulating hormone) and T4 B. Hypothalamus, TSH (thyroid-stimulating hormone), T3 and T4 C. Posterior pituitary gland, TSH (thyroid-stimulating hormone), T3 and T4 D. Hypothalamus, CRH (Corticotropin-releasing hormone), TSH (thyroid-stimulating hormone), T3 and TSH

B. Hypothalamus, TSH (thyroid-stimulating hormone), T3 and T4

10. A patient was recently discharged home for treatment of hypothyroidism and was ordered to take Synthroid for treatment. The patient is re-admitted with signs and symptoms of the following: heart rate 42, blood pressure 70/56, blood glucose 55, and body temperature of 96.8 'F. The patient is very fatigued and drowsy. The family reports the patient has not been taking Synthroid since being discharged home from the hospital. Which of the following conditions is this patient most likely experiencing?* A. Thryoid Storm B. Myxedema Coma C. Iodism D. Toxic Nodular Goiter

B. Myxedema Coma

10. In Cushing's disease, the _______ is secreting too much ACTH (Adrenocorticotropic hormone) which is causing an increase in cortisol production.* A. Adrenal cortex B. Pituitary gland C. Thyroid gland D. Hypothalamus

B. Pituitary gland

10. In Cushing's disease, the _______ is secreting too much ACTH (Adrenocorticotropic hormone) which is causing an increase in cortisol production.* A. Adrenal cortex B. Pituitary gland C. Thyroid gland D. Hypothalamus C. A patient with a tuberculosis infection. D. A patient who is post-opt from an adrenalectomy.

B. Pituitary gland

3. A patient is post-opt from a thyroidectomy for treatment of Grave's Disease. When you walk into the patient's room to perform an assessment, which of the following findings causes the MOST concern and needs nursing intervention?* A. The patient complains of a pain rating of 4 on 1-10 at the surgical site. B. The patient is positioned in supine position. C. The patient's Foley catheter is draining 50 cc of urine per hour. D. The patient is splinting the neck while coughing and deep breathing.

B. The patient is positioned in supine position.

5. A patient taking IV Synthroid starts to complain of feeling hot and chest pain. On assessment, you find that the heart rate is 125 bpm and blood pressure is 200/103. You immediately notify the physician of the patient's condition and receive orders for lab work. Based on the patient's signs and symptoms, what is the MOST important lab result at this time to determine the cause of the patient's symptoms?* A. Potassium level B. Thyroid levels C. Calcium level D. Sodium level

B. Thyroid levels

6. You are providing discharge teaching to a patient who is prescribed calcium supplements with vitamin D for treatment of hypoparathyroidism. Which of the following statements by the patient warrants you to re-educate the patient on how they should take this medication?* A. "I will also make sure I eat foods rich in calcium, such as dairy and green leafy vegetables while I'm taking this medication." B. "A side effect of this medication is constipation. Therefore, I should drink plenty of fluids." C. "I will take my calcium supplements in the morning when I take my Synthroid." D. All the statements above are correctly stated by the patient.

C. "I will take my calcium supplements in the morning when I take my Synthroid."

A patient is admitted with uncontrolled hypertension and the doctor suspects pheochromoctyoma. On assessment, you note the blood pressure to be 196/120 and HR 130. The patient reports feeling very anxious, sweaty, and having palpations. What do you expect the doctor will order to confirm a diagnosis of pheochromocytoma?* A. Urinalysis B. Urine culture C. 24-hour urine D. 8-hour urine

C. 24-hour urine

Which patient is most at risk for developing Syndrome of Inappropriate Anti-diuretic Hormone (SIADH)?* A. A patient diagnosed with small cell lung cancer. B. A patient with a tumor on the anterior pituitary gland. C. A patient taking Declomycin. D. A patient whose kidney tubules are failing to reabsorb water.

C. A patient taking Declomycin.

3. A patient is receiving treatment for myxedema coma with IV Synthroid. Which of the following findings would require nursing intervention for this patient?* A. Blood glucose 75 B. Sodium level of 138 C. A physician's order for Fentanyl 0.25 mcg every 2 hours for pain D. Temperature 98.9 'F

C. A physician's order for Fentanyl 0.25 mcg every 2 hours for pain

1. A patient is diagnosed with pheochromocytoma. From your nursing knowledge, you know that the patient will present with hypertension, sweating, and palpations due to excessive catecholamine production from the? A. Adrenal Cortex B. Adrenal Zona Fasciculata C. Adrenal Medulla D. Adrenal Glomerulosa

C. Adrenal Medulla

7. A patient is admitted with complaints of palpations, excessive sweating, and unable to tolerate heat. In addition, the patient voices concern about how her appearance has changed over the past year. The patient presents with protruding eyeballs and pretibial myxedema on the legs and feet. Which of the following is the likely cause of the patient's signs and symptoms?* A. Thyroiditis B. Deficiency of iodine consumption C. Grave's Disease D. Hypothyroidism

C. Grave's Disease

1. Which of the following statements are CORRECT about Grave's Disease?* A. Grave's Disease is caused by independently functioning nodular goiters producing excessive amounts of T3 and T4. B. Grave's Disease is a complication of untreated hypothyroidism. C. Grave's Disease is caused by an autoimmune condition where the body produces an antibody called TSI (which acts like TSH on the body). D. Grave's Disease patients do not present with protruding eyes or a goiter, as in Toxic Nodular Goiter (TNG).

C. Grave's Disease is caused by an autoimmune condition where the body produces an antibody called TSI (which acts like TSH on the body).

15. ___________ is an autoimmune disorder where the body attacks the thyroid gland that causes it to stop releasing T3 and T4. The patient is likely to have the typical signs/symptoms of hypothyroidism, however, they may present with what other sign as well?* A. Myxedema coma; joint pain B. Thyroid storm; memory loss C. Hashimoto's Thyroiditis; goiter D. Toxic nodular goiter (TNG); goiter

C. Hashimoto's Thyroiditis; goiter

6. A patient with Addison's Disease should consume which of the following diets?* A. High fat and fiber B. Low potassium and high protein C. High protein, carbs, and adequate sodium D. Low carbs, high protein, and increased sodium

C. High protein, carbs, and adequate sodium

A patient has excessive catecholamines in the urine. Which of the following signs and symptoms would the patient NOT exhibit? SELECT-ALL-THAT-APPLY:* A. Tachycardia B. Anxiety C. Hypoglycemia D. Thermogenesis E. Decreased Basal Metabolic Rate

C. Hypoglycemia E. Decreased Basal Metabolic Rate

2. All of the following are treatments for myxedema coma EXCEPT?* A. Corticosteroids B. IV glucose C. Hypotonic IV solutions D. IV Synthroid

C. Hypotonic IV solutions

7. Which of the following are NOT a cause of myxedema coma?* A. Illness B. Sedatives C. Iodine Toxicity D. Thyroidectomy

C. Iodine Toxicity

5. A patient is being treated for Grave's Disease. They have a health history of type 1 diabetes, breast cancer, eczema, and hypertension. The physician orders Inderal. What important information will you include in their discharge teaching about this medication?* A. Importance of taking the medication only as needed for symptoms. B. Avoid aged cheeses and wines while taking this medication. C. Monitor blood glucose levels closely because this medication can mask the signs and symptoms of hypoglycemia. D. Monitor heart rate regularly because this medication will increase the heart rate.

C. Monitor blood glucose levels closely because this medication can mask the signs and symptoms of hypoglycemia.

Which of the following signs and symptoms is NOT expected with Diabetes Insipidus?* A. Polyuria B. Polydipsia C. Polyphagia D. Extreme thirst

C. Polyphagia

A patient is scheduled for a bilateral adrenalectomy. Preoperatively, the patient is ordered by the doctor to take an alpha-adrenergic blocker. After administering a dose of this medication, what type of side effect will you monitor the patient for?* A. Bradypnea B. Hyperglycemia C. Reflex tachycardia D. Hypertension

C. Reflex tachycardia

8. A patient is prescribed Fosamax (Alendronate). The patient is about to be discharged and you observe the patient taking the medication. Which of the following findings requires you to re-educate the patient on how to take this medication?* A. The patient takes the medication on an empty stomach. B. The patient takes the medication with water. C. The patient sits up for 10 minutes after taking the medication. D. The patient waits 30 minutes after taking Fosamax before taking the prescribed vitamins and antacids.

C. The patient sits up for 10 minutes after taking the medication.

In regards to question 6, you are also educating the patient about the post-opt care for a bilateral adrenalectomy. Which statement by the patient indicates they understood your instructions?* A. "I will have to take mineralocorticoids daily for 2 years." B. "I will have to take glucocorticoids and mineralocorticoids daily for 2 years." C. "When I experience signs of stress I will have to take mineralocorticoids as needed." D. "I will have to take glucocorticoids and mineralocorticoids daily for life."

D. "I will have to take glucocorticoids and mineralocorticoids daily for life."

2. Addison's Disease is:* A. Increased secretion of cortisol B. Increased secretion of aldosterone and cortisol C. Decreased secretion of cortisol D. Decreased secretion of aldosterone and cortisol

D. Decreased secretion of aldosterone and cortisol

3. A patient has an extremely high T3 and T4 level. Which of the following signs and symptoms DO NOT present with this condition?* A. Weight loss B. Intolerance to heat C. Smooth skin D. Hair loss

D. Hair loss

2. A patient is admitted with thyroid storm. Which sign and symptoms are NOT present with this condition-SELECT ALL THAT APPLY?* A. Temperature of 104.9'F B. Heart rate of 125 bpm C. Respirations of 42 D. Heart rate of 20 bpm E. Intolerance to cold F. Restless

D. Heart rate of 20 bpm E. Intolerance to cold

A patient is receiving treatment for pheochromocytoma. What type of diet is best for this patient?* A. Low sodium and high potassium diet B. 2 L fluid restriction diet C. Low calorie and high fiber diet D. High calorie diet

D. High calorie diet

2. A patient reports they do not eat enough iodine in their diet. What condition are they most susceptible to?* A. Pheochromocytoma B. Hyperthyroidism C. Thyroid Storm D. Hypothyroidism

D. Hypothyroidism

6. A patient is recovering from myxedema coma and will be discharged tomorrow. What will you include in their discharge teaching?* A. Avoiding green leafy vegetables. B. Importance of taking Tapazole exactly as prescribed at the same time every day. C. Limiting foods with Iodine such as kelp, dairy, and eggs. D. Importance of taking Synthroid in the morning without any food.

D. Importance of taking Synthroid in the morning without any food.

13. A patient is 6 hours post-opt from a thyroidectomy. The surgical site is clean, dry and intact with no excessive swelling noted. What position is best for this patient to be in?* A. Fowler's B. Prone C. Trendelenburg D. Semi-Fowler's

D. Semi-Fowler's

11. This medication is used to treat hyperparathyroidism in patients with chronic renal failure. It works by mimicking the role of calcium in the blood and tricks the parathyroid gland into stop secreting PTH (parathyroid hormone). Which of the following medications does this describe below?* A. Calcitonin B. Fosamax C. Lasix D. Sensipar

D. Sensipar

In the scenario above, A patient arrives to the ER and is unable to give you a health history due to altered mental status. The family reports the patient has gained over 10 lbs in 1 week and says it is mainly "water" weight. In addition, they report the patient hasn't been able to urinate or eat within the past week as well and was recently diagnosed with small cell lung cancer. On assessment, you note the patient's HR is 115 and BP 180/92. Patient sodium level is 90. Which drug do you anticipate the patient will be started on per doctor's order?* A. Declomycin B. Desmopressin (DDAVP) IV C. Diabinese D. Stimate

D. Stimate