Endocrine Practice 2019

A nurse is teaching a client who has diabetes mellitus. Which of the following should the nurse include as an expected finding of diabetic ketoacidosis (DKA)?

Blood glucose levels above 300 mg/dL. Levels above 300 are an expected finding of DKA

A nurse is caring for a client who has a pheochromocytoma. Which of the following actions should the nurse take?

Elevate the head of the client's bed. This will reduce blood pressure and abdominal pressure, they should NOT palpate the client's abdomen, and monitor for hypertension.

A nurse is monitoring the laboratory values of a client who has diabetes mellitus and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy?

Fast blood glucose 96 mg/dL The normal range is 70 - 110 mg/dL for fastign blood glucose The expected range is lesss than 180 mg/dL for postpradial blood glucose The expected range is less than 200 mg/dL for random blood glucose The normal range is 70 - 130 mg/dL for preprandial blood glucose

A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect?

Hirsutism, or increased hair growth is expected. Clients should also expect elevated blood pressure, weight gain, and thinning of the skin

A home health nurse is assessing a client who requires lifelong hormone replacement therapy for the treatment of hypothyroidism. The client has not been taking the medication regularly. Which of the following findings should the nurse expect?

Hypotension, along with bradycardia, dysrhythmias, cold intolerance, and cool, dry skin

A nurse is an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements by the client indicates an understanding of the teaching?

I will apply lotion to the dry areas of my feet but not in between my toes, as this area is prone to bacterial growth

A nurse is planning teaching for a client who has type 1 diabetes mellitus. Which of the following findings instructions should the nurse plan to include?

Ingest food with alcohol to reduce alcohol-induced hypoglycemia. Men should drink no more than 2 drinks a day, and women no more than 1. Patients should reduce insulin dosage before planned exercise to prevent hypoglycemia, and exercise at least 3 times a week and have no more than 2 consecutive days without exercise.

A nurse is caring for a client who has diabetes mellitus and has developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to the client's feet?

Monitor the temperature of the bath water with a thermometer. Clients have difficulty determining if the water is too hot, so to prevent injury use a bath thermometer.

A nurse is teaching a client who has an autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following adverse effects should the nurse include? (Select all that apply)

Osteoporosis, moon-shaped face, and increased risk of infecrion

A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires intranasal desmopressin. Which of the following information should the nurse include?

Report nocturia because it requires a dosage adjustment, the provider will increase the dosage until the client no longer has nocturia.

A nurse is teaching a client who is scheduled for a vanillylmandelic acid test to screen for pheochromocytoma. Which of the following statements should the nurse include in the teaching?

Restrict coffee intake 2-3 days prior to the test. Clients should avoid coffee, tea, bananas, chocolate, and vanilla prior to the test.

A nurse is caring for a client who has type 2 diabetes mellitus and is experiencing a hyperglycemic-hyperosmolar state (HHS). Which of the following laboratory findings should the nurse expect?

Serum pH 7.45 Client will produce enough insulin to prevent ketosis but not enough to prevent hyperglycemia, having a pH greater than 7.40 and a blood glucose level greater than 600 mg/dL.

A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia.

Tingling and numbness of the hands and feet. Hypocalcemia causes paresthesia, which usually starts in the hands and feet, a weak thready pulse, increases gastrointestinal motility, and hyperactive deep-tendon reflexes

A nurse is teaching a client who has diabetes mellitus about insulin injections. The client's prescription includes evening doses of insulin glargine and regular insulin. Which of the following instructions should the nurse include?

Draw up the insulin into separate syringes because insulin glargine is not compatible with other insulins

A nurse is assessing a client who has diabetes insipidus. The nurse should expect which of the following findings?

Increased hematocrit An increased hematocrit level is an expected finding related to dehydration. Also expect to see tachycardia, diluted urine and a low urine specific gravity, and increase BUN also due to dehydration.

A nurse is teaching a client about glycosylated hemoglobin (HbA1C) testing. Which of the following client statements indicates an understanding of the teaching?

This test's results is a good indicator of my average blood glucose levels, this test reflects glucose levels over a 120 day period.

A nurse is teaching a client about the adrenocorticotropic hormone (ACTH) stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders?

Addison's disease

A nurse is assessing a client who has a diabetes mellitus and reports feeling anxious. Which of the following findings should the nurse expect if the client is hypoglycemic?

Cool, clammy skin, nervousness, tachycardia, and confusion

A nurse is reviewing the laboratory results of a client undergoing screening for primary Cushing's disease. The nurse should expect an elevation of which of the followign laboratory findings?

Glucose should be elevated. Lymphocyte count, potassium, and calcium is below the expected range.

A nurse is monitoring a client who is 24 hour postoperative after a total thyroidectomy. Which of the following findings should the nurse report to the provider?

Laryngeal stridor, a harsh, high-pitched sound with inspiration that indicates respiratory obstructions. Preserve client's airway immediately.

A nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following findings should the nurse report to the provider?

Sodium 110 mEq/L. The client with SIADH retains fluids.

A nurse us developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include?

Take this medication on an empty stomach. The client should not eat 30-60 minutes after taking mediation

A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings?

Tremors, diaphoresis, and insomnia. Clients can experience heat intolerance, restless and irritable, and can have exophthalmos which causes a wide-eyed or startled appearance.

A nurse is managing the care of the client who is postoperative and has acute adrenal insufficiency. Which of the following actions should the nurse first take?

Administer hydrocortisone sodium, which is necessary to replace the cortisol deficiency that occurs. An oral spironolactone will worsen hyperkalemia.

A nurse is providing discharge teaching to a client who has diabetes insipidus and a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching.

Blow your nose gently prior to using the nasal spray

A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect?

Calcium 12.8 mg/dL. Client will have a calcium level about the expected range of 4.5 - 5.6 mg/dL.

A nurse is reviewing laboratory values for a client who has a diabetic ketoacidosis (DKA). Which of the following results should the nurse expect?

pH 7.32, PaCO2 36 mm Hg HCO3 14 mEq/L With DKA, the pH is low, carbon dioxide is within the expected reference range, bicarbonate is low.

A nurse is teaching a client who has type 1 diabetes mellitus about how to prevent complications during illness. Which of the following statements by the client indicates an understanding of teaching?

I will call my doctor if my blood strange is more than 250 during illness. They should continue to take their usual dose even when they feel ill, check their urine for protein when glucose levels are greater than 240 mg/dL, and check their blood glucose levels every 4 hours during an illness.

A nurse is assessing a client who is taking propylthiouracil. The nurse should identify which of the following findings as an indication that the medication has been effective?

Increased body weight. Propylthiouracil suppresses the production of thyroid hormones and allows for weight gain, decreases bowel movements, decreased diaphoresis, and decreased libido.

A nurse has administered propranolol by IV bonus to a client who is having a thyroid storm. Which of the following findings indicates that the client is having a therapeutic response?

Reduction of the effects of thyroid hormone on the heart. Propranolol is a β2-adrenergic blocking's agent that decreases the rapid heart rate caused by excessive thyroid stimulation.