Endocrine questions

A nurse is caring for a postoperative parathyroidectomy client. Which of the following would require the nurse's immediate attention? 1. Incisional pain 2. Laryngeal stridor 3. Difficulty voiding 4. Abdominal cramps

2. Laryngeal stridor is an emergency. It may be caused by compression. This causes respiratory distress. Contact the doctor immediately.

Which clinical manifestation should the nurse expect to note when assessing a client with Addison's disease? 1. Edema 2. Obesity 3. Hirsutism 4. Hypotension

4.

A client with type 1 diabetes mellitus calls the nurse to report recurrent episodes of hypoglycemia. Which statement by the client indicates a correct understanding of NPH insulin and exercise? 1. "I should not exercise after lunch." 2. "I should not exercise after breakfast." 3. "I should not exercise in the late evening." 4. "I should not exercise in the late afternoon.:

4. peak time of NPH is in 6-14 hours after the injection; therefore, late afternoon is the peak hours. Clients should avoid exercising during peak time.

A nurse is collecting data regarding a client after a thyroidectomy and notes that the client has developed hoarseness and a weak voice. Which nursing action is appropriate? 1. Check for signs of bleeding. 2. Administer calcium gluconate. 3. Notify the registered nurse immediately. 4. Reassure the client that this is usually a temporary condition.

4. Also, discourage unnecessary talking.

A client is admitted to the emergency department, and a diagnosis of myxedema coma is made. Which nursing action would the nurse prepare to carry out initially? 1. Warm the client. 2. Maintain a patent airway. 3. Infuse intravenous fluids. 4. Administer thyroid hormone.

2. 1)airway 2)oxygen 3)fluid replacement 4)warm 5)VS 6)hormone thyroid

A nurse is caring for a client after thyroidectomy and monitoring for signs of thyroid storm. The nurse understands that which of the following is a manifestation associated with this disorder? 1. Bradycardia 2. Hypotension 3. Constipation 4. Hypothermia

2. clinical manifestations of thyroid storm: high fever (106 F/411 C), severe tachycardia, profusion, diarrhea, extreme vasodilalion, hypotension, Afib, hyper-refleia, abdominal pain, diarrhea, dehydration.

A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to: 1. Treat thyroid storm. 2. Prevent cardiac irritability. 3. Treat hypocalcemic tetany. 4. Stimulate the release of parathyroid hormone.

3. If parathyroid gland is accidentally removed or injured during thyroidectomy, hypocalcemia develops. The signs and symptoms are numbness and tingling around the mouth, fingertips, or toes or muscle spasms or twitching, the physician is notified immediately. Calcium gluconate should be kept at bedside.

Which nursing action would be appropriate to implement when a client has a diagnosis of pheochromocytoma? 1. Weigh the client. 2. Test the client's urine for glucose. 3. Monitor the client's blood pressure. 4. Palpate the client's skin to determine warmth.

3. pheochromocytoma is tumor of adrenal gland results in release of too much epinephrine and norepinephrine hormones that causes HR, bp, metabolism. hypertension is the major symptom of pheochromocytoma. Other symptoms are minor.

A hospitalized client with type 1 diabetes mellitus received NPH and regular insulin 2 hours ago at 7:30 AM. The client calls the nurse and reports that he is feeling hungry shaky, and weak. The client ate breakfast at 8:00 and is due to eat lunch at noon. List, in order of priority, the actions that the nurse would take. _ Take the client's vital signs. _ Retest the client's blood glucose level. _ Check the client's blood glucose level. _ Give the client half a cup of fruit juice to drink. _ Give the client a small snack of carbohydrate and protein. _ Document the client's complaints, the actions taken,ad the outcome.

3_ Take the client's vital signs. 4_ Retest the client's blood glucose level. 1_ Check the client's blood glucose level. 2_ Give the client half a cup of fruit juice to drink. 5_ Give the client a small snack of carbohydrate and protein. 6_ Document the client's complaints, the actions taken,ad the outcome.

What would the nurse anticipate being included in the plan of care for a client who has been diagnosed with Graves' disease? 1. Provide a high-fiber diet. 2. Provide a restful environment. 3. Provide three small meals per day. 4. Provide the client with extra blanket.

2. Graves' disease is hyperthyroidism. Some of the signs of symptoms are diarrhea, weight loss, heat intolerance, irritability. Therefore, is it appropriate to provide a restful environment. The rest of the options worsens the patient's condition. The patient needs to have a restful (both physically and mentally) environment; Six full meals a day that are well balanced and high in calories due to the accelerated metabolic rate; Avoid foods that increase peristalsis (e.g., high-fiber foods); and have a cool environment.

A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge? 1. Keep insulin vials refrigerated at all times. 2. Rotate the insulin injection sites systematically. 3. Increase the amount of insulin before unusual exercise. 4. Monitor the urine acetone level to determine the insulin dosage.

2. The client should be instructed to give injections in one area, about 1 inch apart, until the whole area has been used and to then change to another site. This prevents dramatic changes in daily insulin absorption. Insulin dosages should not be adjusted or increased before unusual exercise. If acetone is found in the urine, it may possibly indicate the need for additional insulin. To minimize the discomfort associated with insulin injections, the insulin should be administered at room temperature.

A nurse provides instructions to a client with diabetes mellitus regarding the prescribed diabetic diet. Which statement, if made by the client, indicates the need for further teaching? 1. "I'll eat a balanced meal plan." 2. "I need to drink diet soft drinks." 3. "I need to buy special dietetic foods." 4. "I will snack on fruit instead of cake."

3. For a diabetic patient, It is not necessary to buy special dietetic food but rather follow a balanced meal plan. Adhering to nutrition principle and adapt a individual meal plan is very important for diabetic patients.

When a nurse notes that a client with type 1 diabetes mellitus has lipodystrophy on both upper thighs, what information should the nurse obtain from the client? 1. Plan of injection rotation 2. Consistency of aspiration 3. Preparation of the injection site 4. Angle at which the medication is administered

1. lipodystrophy is the hypertrophy of subcutaneous tissue at the injection site.

A nurse is monitoring a client who has been newly diagnosed with diabetes mellitus for signs of complications. Which of the following, if exhibited by the client, would indicate hyperglycemia and thus warrant physician notification? 1. Polyuria 2. Bradycardia 3. Diaphoresis 4. Hypertension

1.

A nurse is reviewing discharge teaching with a client who has Cushing's syndrome. Which statement by the client indicates that the instructions related to dietary management were understood? 1. "I can eat foods that contain potassium." 2. "I will need to limit the amount of protein in my diet." 3. "I am fortunate that I can eat all the salty foods I enjoy." 4. "I am fortunate that I do not need to follow an special diet."

1. patient with Cushing syndrome is recommended to have a diet low in calories, carbohydrates, and sodium but ample in protein and potassium. This promotes weight loss, reduction of edema and hypertension, hypokalemia, and rebuilding wasted tissue.

A nurse is caring for a client with pheochromocytoma. The client is scheduled for an adrenalectomy. During the preoperative period, the priority nursing action would be to monitor: 1. The vital signs 2. The intake and output 3. The blood urea nitrogen level 4. The urine for glucose and acetone

1. priority: monitoring blood pressure excessive blood pressure may cause brain attach and sudden blindness. Other options are minor

A nurse reinforces teaching with a client with diabetes mellitus regarding differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that glucose will be taken if which symptom develops? 1. Polyuria 2. Shakiness 3. Blurred vision 4. Fruity breath odor

2.

After several diagnostic tests, a client is diagnosed with diabetes insipidus. The nurse understands that which symptom is indicative of this disorder? 1. Diarrhea 2. Polydipsia 3. Weight gain 4. Blurred vision

2.

When caring for a client who is having clear drainage from his nares after transsphenoidal hypophysectomy, which action by the nurse is appropriate? 1. Lower the head of the bed. 2. Test the drainage for glucose. 3. Obtain a culture of the drainage. 4. Continue to observe the drainage.

2.

A nurse is caring for a client with pheochromocytoma. The client asks for a snack and something warm to drink. The appropriate choice for this client to meet nutritional needs would be which of the following? 1. Crackers with cheese and tea 2. Graham crackers and warm milk 3. Toast with peanut butter and cocoa 4. Vanilla wafers and coffee with cream and sugar

2. food or beverages contain caffeine are prohibited. patients with pheochromocytoma needs to have a diet that is high in vitamins, minerals, and calories.

A nurse is assisting with preparing a teaching plan for the client with diabetes mellitus regarding proper foot care. Which instruction should be included in the plan of care? 1. Soak the feet in hot water 2. Avoid using soap to wash the feet. 3. Apply a moisturizing lotion to dry feet, but not between the toes. 4. Always have a podiatrist cut your toenails never cut them yourself.

3.

When the nurse is teaching a client who has been newly diagnosed with type 1 diabetes mellitus, which statement by the client would indicate that teaching has been effective? 1. "I will stop taking my insulin if I'm too sick to eat." 2. "I will decrease my insulin dose during times of illness." 3. "I will adjust my insulin dose according to the level of glucose in my urine." 4. "I will notify my physician if my blood glucose level is greater than 250 mg/dL."

4. insulin should never be stopped insulin may be increased during the time of illness insulin should never be adjusted without a doctor's prescription notify the physician if blood glucose level is greater than 250 mg/dl.

Which client complaint would alert the nurse to a possible hypoglycemic reaction? 1. Tremors 2. Anorexia 3. Hot, dry skin 4. Muscle cramps

1. hypoglycemia creates autonomic nervous system symptoms (classic signs): tremor, nervousness, irritability.

A nurse is caring for a client with pheochromocytoma. Which data would indicate a potential complication associated with this disorder? 1. A urinary output of 50ml/hour 2. A coagulation time of 5 minutes 3. Congestion heard on auscultation of the lungs 4. A blood urea nitrogen (BUN) level of 20 mg/dL

3. congestion on auscultation indicates CHF. complications associated with pheochromocytoma include hypertensive retinopathy and nephropathy, myocarditis, congestive heart failure (CHF), increased platelet aggregation, and stoke. Death can occur from shock, stroke, renal failure, dysrhythmias, or dissecting aortic aneurysm. a urinary output of less than 30ml/hour is a concern.

A nurse is reinforcing instructions with a client with diabetes mellitus who is recovering from diabetic ketoacidosis (DKA) regarding measures to prevent a recurrence. Which instruction is important for the nurse to emphasize? 1. Eat six small meals daily. 2. Test the urine ketone levels. 3. Monitor blood glucose levels frequently. 4. Receive appropriate follow-up health care

3. monitor blood glucose 4-5 times per day.