Exam 8 Adult Health Chapter 49, 50, 51
During a routine medical evaluation, a client is found to have a random blood glucose level of 210 mg/dL. Which client statement(s) made by the client are concerning to the nurse? Select all that apply. "At times my vision is blurry." "I have to void nearly every hour." "I cannot seem to quench my thirst." "I sleep at least 8 hours each night." "I have lost 10 pounds without even trying."
"At times my vision is blurry." "I have to void nearly every hour." "I cannot seem to quench my thirst." "I have lost 10 pounds without even trying." 51
The nurse is providing information about foot care to a client with diabetes. Which of the following would the nurse include? "Wash your feet in hot water every day." "Use a razor to remove corns or calluses." "Be sure to apply a moisturizer to feet daily." "Wear well-fitting comfortable rubber shoes."
"Be sure to apply a moisturizer to feet daily." 51
A newly admitted client with a diagnosis of type 1 diabetes asks the nurse what caused their diabetes. When the nurse is explaining to the client the etiology of type 1 diabetes, what process should the nurse describe? "The tissues in your body are resistant to the action of insulin, making the glucose levels in your blood increase." "Damage to your pancreas causes an increase in the amount of glucose that it releases, and there is not enough insulin to control it." "The amount of glucose that your body makes overwhelms your pancreas and decreases your production of insulin." "Destruction of special cells in the pancreas causes a decrease in insulin production. Glucose levels rise because insulin normally breaks it down."
"Destruction of special cells in the pancreas causes a decrease in insulin production. Glucose levels rise because insulin normally breaks it down." 51
During an assessment of a client's functional health pattern, which question by the nurse directly addresses the client's thyroid function? "Do you have to get up at night to empty your bladder?" "Have you experienced any headaches or sinus problems?" "Do you experience fatigue even if you have slept a long time?" "Can you describe the amount of stress in your life?"
"Do you experience fatigue even if you have slept a long time?" 49
A patient who is diagnosed with type 1 diabetes would be expected to: Be restricted to an American Diabetic Association diet. Have no damage to the islet cells of the pancreas. Need exogenous insulin. Receive daily doses of a hypoglycemic agent.
Need exogenous insulin. Type 1 diabetes is characterized by the destruction of pancreatic beta cells that require exogenous insulin. 51
Which is a characteristic of type 2 diabetes? insulin resistance presence of islet antibodies little or no insulin ketosis-prone when insulin absent
insulin resistance 51
A client with a history of type 1 diabetes is demonstrating fast, deep, labored breathing and has fruity odored breath. What could be the cause of the client's current serious condition? ketoacidosis hyperosmolar hyperglycemic nonketotic syndrome hepatic disorder All options are correct.
ketoacidosis 51
A nurse should expect a client with hypothyroidism to report: increased appetite and weight loss. puffiness of the face and hands. nervousness and tremors. thyroid gland swelling.
puffiness of the face and hands. 50
A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of: calcium and phosphorus abnormalities. chloride and magnesium abnormalities. sodium and chloride abnormalities. sodium and potassium abnormalities.
sodium and potassium abnormalities. In Addison's disease, a form of adrenocortical hypofunction, aldosterone secretion is reduced. Aldosterone promotes sodium conservation and potassium excretion. Therefore, aldosterone deficiency increases sodium excretion, predisposing the client to hyponatremia, and inhibits potassium excretion, predisposing the client to hyperkalemia. Because aldosterone doesn't regulate calcium, phosphorus, chloride, or magnesium, an aldosterone deficiency doesn't affect levels of these electrolytes directly. 50
An adult client has gained 55 lbs in the last 3 years. During client education, the nurse should educate the client about: the risk of type 2 diabetes. the risk of type 1 diabetes. insulin resistance. the benefits of a low-sugar diet.
the risk of type 2 diabetes. 51
A client with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the client should prioritize what question when addressing potential complications? "Do you feel any muscle twitches or spasms?" "Do you feel flushed or sweaty?" "Are you experiencing any dizziness or lightheadedness?" "Are you having any pain that seems to be radiating from your bones?"
"Do you feel any muscle twitches or spasms?" As the blood calcium level falls, hyperirritability of the nerves occurs, with spasms of the hands and feet and muscle twitching. This is characteristic of hypoparathyroidism. 49
A nurse is preparing to administer insulin to a child who's just been diagnosed with type 1 diabetes. When the child's mother stops the nurse in the hall, she's crying and anxious to talk about her son's condition. The nurse's best response is: "I can't talk now. I have to give your son his insulin as soon as possible." "If you'll wait in your son's room, the physician will talk with you as soon as he's free." "Everything will be just fine. I'll be back in a minute and then we can talk." "I'm going to give your son some insulin. Then I'll be happy to talk with you."
"I'm going to give your son some insulin. Then I'll be happy to talk with you." 51
A client newly diagnosed with diabetes mellitus asks why he needs ketone testing when the disease affects his blood glucose levels. How should the nurse respond? "The spleen releases ketones when your body can't use glucose." "Ketones will tell us if your body is using other tissues for energy." "Ketones can damage your kidneys and eyes." "Ketones help the physician determine how serious your diabetes is."
"Ketones will tell us if your body is using other tissues for energy." 51
A client has just been diagnosed with type 1 diabetes. When teaching the client and family how diet and exercise affect insulin requirements, the nurse should include which guideline? "You'll need more insulin when you exercise or increase your food intake." "You'll need less insulin when you exercise or reduce your food intake." "You'll need less insulin when you increase your food intake." "You'll need more insulin when you exercise or decrease your food intake."
"You'll need less insulin when you exercise or reduce your food intake." 51
A 16-year-old client newly diagnosed with type 1 diabetes has a very low body weight despite eating regular meals. The client is upset because friends frequently state, "You look anorexic." Which statement by the nurse would be the best response to help this client understand the cause of weight loss due to this condition? "I will refer you to a dietician who can help you with your weight." "You may be having undiagnosed infections, causing you to lose extra weight." "Your body is using protein and fat for energy instead of glucose." "Don't worry about what your friends think; the carbohydrates you eat are being quickly digested, increasing your metabolism."
"Your body is using protein and fat for energy instead of glucose." 51
What should the nurse teach a client on corticosteroid therapy in order to reduce the client's risk of acute adrenal insufficiency? Take the medication late in the day to mimic the body's natural rhythms. Always have enough medication on hand to avoid running out. Skip up to 2 doses in cases of illness involving nausea. Take up to 1 extra dose per day during times of stress.
Always have enough medication on hand to avoid running out. 50
A client with diabetes mellitus has a blood glucose level of 40 mg/dL. Which rapidly absorbed carbohydrate would be most effective? 1/2 cup fruit juice or regular soft drink 4 oz of skim milk 1/2 tbsp honey or syrup three to five LifeSavers candies
1/2 cup fruit juice or regular soft drink 51
An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting: 2 to 5 g of a simple carbohydrate. 10 to 15 g of a simple carbohydrate. 18 to 20 g of a simple carbohydrate. 25 to 30 g of a simple carbohydrate.
10 to 15 g of a simple carbohydrate. 51
Once digested, what percentage of carbohydrates is converted to glucose? 70 80 90 100
100 51
A nurse is caring for a client with type 1 diabetes. The client's medication administration record includes the administration of regular insulin three times daily. Knowing that the client's lunch tray will arrive at 11:45 AM, when should the nurse administer the client's insulin? 10:45 AM 11:15 AM 11:45 AM 11:50 AM
11:15 AM 51
A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness, and aberrant behavior. The client is conscious. The nurse should first administer: I.M. or subcutaneous glucagon. I.V. bolus of dextrose 50%. 15 to 20 g of a fast-acting carbohydrate such as orange juice. 10 units of fast-acting insulin.
15 to 20 g of a fast-acting carbohydrate such as orange juice. 51
A nurse knows to assess a patient with type 1 diabetes for postprandial hyperglycemia. The nurse knows that glycosuria is present when the serum glucose level exceeds: 120 mg/dL 140 mg/dL 160 mg/dL 180 mg/dL
180 mg/dL 51
Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis? Hypokalemia and hypoglycemia Hypocalcemia and hyperkalemia Hyperkalemia and hyperglycemia Hypernatremia and hypercalcemia
Hypokalemia and hypoglycemia 51
A client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should the nurse recognize as an adverse reaction to the drug? Dysuria Leg cramps Tachycardia Blurred vision
Tachycardia 50
Glycosylated hemoglobin reflects blood glucose concentrations over which period of time? 1 month 3 months 6 months 9 months
3 months 51
A patient is diagnosed with overactivity of the adrenal medulla. What epinephrine value does the nurse recognize is a positive diagnostic indicator for overactivity of the adrenal medulla? 50 pg/mL 100 pg/mL 100 to 300 pg/mL 450 pg/mL
450 pg/mL 50
Which of the following clients diagnosed with type 1 diabetes is most likely to meet the therapeutic goal of adequate glucose control? A client who skips breakfast when the glucose reading is greater than 220 mg/dL (12.3 mmol/L) A client who never deviates from the prescribed dose of insulin A client who adheres closely to a meal plan and meal schedule A client who eliminates carbohydrates from the daily intake
A client who adheres closely to a meal plan and meal schedule 51
The nurse is assessing mental and emotional status in a client about to begin therapy for an endocrine disorder. Which of the following would the nurse test to assess the client's mental and emotional status? Ability to respond to questions Motor function Sleep and awake cycles Facial expression
Ability to respond to questions 49
A female client with hyperglycemia who weighs 210 lb (95 kg) tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that the client has large hands and a hoarse voice. Which disorder would the nurse suspect as a possible cause of the client's hyperglycemia? Acromegaly Type 1 diabetes mellitus Hypothyroidism Deficient growth hormone
Acromegaly 50
After a thyroidectomy, the client develops a carpopedal spasm while the nurse is taking a BP reading on the left arm. Which action by the nurse is appropriate? Administer a sedative as ordered. Administer IV calcium gluconate as ordered. Start administering oxygen at 2 L/min via a cannula. Administer an oral calcium supplement as ordered.
Administer IV calcium gluconate as ordered. 50
Before discharge, what should a nurse instruct a client with Addison's disease to do when exposed to periods of stress? Administer hydrocortisone I.M. Drink 8 oz of fluids. Perform capillary blood glucose monitoring four times daily. Continue to take his usual dose of hydrocortisone.
Administer hydrocortisone I.M. 50
A nurse is working for the summer at a camp for adolescents with diabetes. When providing information on the prevention and management of hypoglycemia, what action should the nurse promote? Always carry a form of fast-acting sugar. Perform exercise prior to eating whenever possible. Eat a meal or snack every 8 hours. Check blood sugar at least every 24 hours.
Always carry a form of fast-acting sugar. 51
Which would be included in the teaching plan for a client diagnosed with diabetes mellitus? An elevated blood glucose concentration contributes to complications of diabetes, such as diminished vision. Sugar is found only in dessert foods. The only diet change needed in the treatment of diabetes is to stop eating sugar. Once insulin injections are started in the treatment of type 2 diabetes, they can never be discontinued.
An elevated blood glucose concentration contributes to complications of diabetes, such as diminished vision. 51
The nurse is preparing a client with mild cognitive impairment for upcoming diagnostics. Which action is most important for the nurse to take at this time? Ask the client's family to confirm the medications the client is using. Reassure the family members that radioactive substances used for the tests are safe. Reassure the client by including the family members in the process. Determine the etiology of the client's symptoms.
Ask the client's family to confirm the medications the client is using. 49
A nurse is caring for a client suspected of having a pituitary tumor that is causing panhypopituitarism. During assessment of the client, which clinical manifestation would the nurse expect to find? Atrophy of the gonads Carpopedal spasm Hypertension Tachycardia
Atrophy of the gonads Undersecretion (hyposecretion) commonly involves all of the anterior pituitary hormones and is termed panhypopituitarism. In this condition, the thyroid gland, the adrenal cortex, and the gonads atrophy (shrink) because of loss of tropic-stimulating hormones. 49
A patient is suspected of having a pheochromocytoma and is having diagnostic tests done in the hospital. What symptoms does the nurse recognize as most significant for a patient with this disorder? Blood pressure varying between 120/86 and 240/130 mm Hg Heart rate of 56-64 bpm Shivering Complaints of nausea
Blood pressure varying between 120/86 and 240/130 mm Hg 50
The nurse is preparing an educational session about foot care for clients with diabetes. Which information will the nurse include in the education? Select all that apply. Wear binding compression socks daily. Shave any calluses with a disposable razor. Apply lotion between the toes after bathing. Check the inside of shoes before putting them on. Check the bottom of the feet with a mirror every day.
Check the inside of shoes before putting them on. Check the bottom of the feet with a mirror every day. 51
A client has been experiencing a decrease in serum calcium. After diagnostics, the physician proposes the calcium level fluctuation is due to altered parathyroid function. What is the typical number of parathyroid glands? four three two one
four 49
Which hormone would the nurse identify as important in decreasing serum calcium levels? Calcitonin Melatonin Gastrin Thyroid hormone
Calcitonin 49
Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany? Calcium gluconate Synthroid Propylthiouracil (PTU) Tapazole
Calcium gluconate 50
Which factors will cause hypoglycemia in a client with diabetes? Select all that apply. Client has not consumed food and continues to take insulin or oral antidiabetic medications. Client has not consumed sufficient calories. Client has been exercising more than usual. Client has been sleeping excessively. Client is experiencing effects of the aging process.
Client has not consumed food and continues to take insulin or oral antidiabetic medications. Client has not consumed sufficient calories. Client has been exercising more than usual. 51
A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms? Coma, anxiety, confusion, headache, and cool, moist skin Kussmaul respirations, dry skin, hypotension, and bradycardia Polyuria, polydipsia, hypotension, and hypernatremia Polyuria, polydipsia, polyphagia, and weight loss
Coma, anxiety, confusion, headache, and cool, moist skin other s/x of hypoglycemia: anxiety, restlessness, headache, irritability, confusion, diaphoresis, cool skin, tremors, coma, and seizures. 51
A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which condition when caring for this client? Polyuria Hypoglycemia Blurred vision Polydipsia
Hypoglycemia 51
Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex? Cushing syndrome Addison disease Graves disease Hashimoto disease
Cushing syndrome The client with Cushing syndrome demonstrates truncal obesity, moon face, acne, abdominal striae, and hypertension. Regardless of the cause, the normal feedback mechanisms that control the function of the adrenal cortex become ineffective, and the usual diurnal pattern of cortisol is lost. The signs and symptoms of Cushing syndrome are primarily a result of the oversecretion of glucocorticoids and androgens, although mineralocorticoid secretion also may be affected. 49
A client with hypofunction of the adrenal cortex has been admitted to the medical unit. What would the nurse most likely find when assessing this client? Increased body temperature Jaundice Copious urine output Decreased blood pressure
Decreased BP 49
A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority? Risk for infection Decreased cardiac output Impaired physical mobility Imbalanced nutrition: Less than body requirements
Decreased cardiac output 50
A client with a serum glucose level of 618 mg/dl is admitted to the facility. He's awake and oriented, has hot dry skin, and has the following vital signs: temperature of 100.6° F (38.1° C), heart rate of 116 beats/minute, and blood pressure of 108/70 mm Hg. Based on these assessment findings, which nursing diagnosis takes highest priority? Deficient fluid volume related to osmotic diuresis Decreased cardiac output related to elevated heart rate Imbalanced nutrition: Less than body requirements related to insulin deficiency Ineffective thermoregulation related to dehydration
Deficient fluid volume related to osmotic diuresis A serum glucose level of 618 mg/dl indicates hyperglycemia, which causes polyuria and fluid volume deficit, making Deficient fluid volume related to osmotic diuresis the highest priority 51
Which information should be included in the teaching plan for a client receiving glargine, a "peakless" basal insulin? Administer the total daily dosage in two doses. Draw up the drug first, then add regular insulin. It is rapidly absorbed and has a fast onset of action. Do not mix with other insulins.
Do not mix with other insulins. 51
Which of the following is a characteristic of diabetic ketoacidosis (DKA)? Select all that apply. Elevated blood urea nitrogen (BUN) and creatinine Rapid onset More common in type 1 diabetes Absent ketones Normal arterial pH level
Elevated blood urea nitrogen (BUN) and creatinine Rapid onset More common in type 1 diabetes 51
A nurse is caring for a client with suspected diabetes insipidus. Which test does the nurse anticipate the physician will order to confirm the diagnosis? Capillary blood glucose test Fluid deprivation test Serum ketone test Urine glucose test
Fluid deprivation test 50
During a follow-up visit 3 months after a new diagnosis of type 2 diabetes, a client reports exercising and following a reduced-calorie diet. Assessment reveals that the client has only lost 1 pound and did not bring the glucose-monitoring record. Which value should the nurse measure? Fasting blood glucose level Glucose via a urine dipstick test Glycosylated hemoglobin level Glucose via an oral glucose tolerance test
Glycosylated hemoglobin level 51
An older adult female 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, the nurse should suspect which disorder? Diabetes mellitus Diabetes insipidus Hypoparathyroidism Hyperparathyroidism
Hyperparathyroidism Hyperparathyroidism is most common in older women and is characterized by bone pain and weakness from excess parathyroid hormone. Clients also exhibit hypercalciuria-causing polyuria. 50
When the nurse is caring for a patient with type 1 diabetes, what clinical manifestation would be a priority to closely monitor? Hypoglycemia Hyponatremia Ketonuria Polyphagia
Hypoglycemia The therapeutic goal for diabetes management is to achieve normal blood glucose levels (euglycemia) without hypoglycemia while maintaining a high quality of life. 51
The typical triad of manifestations seen in a client diagnosed with pheochromocytoma does not include which of the following? Headache Hypotension Diaphoresis Palpitations
Hypotension The typical triad of symptoms seen in clients diagnosed with pheochromocytoma comprises headache, diaphoresis, and palpitations. 49
The pharmacology instructor is diagramming the nervous and endocrine systems. What organ would the instructor diagram as the connector between the nervous and endocrine systems? Hypothalamus Pituitary gland Thyroid gland Pineal gland
Hypothalamus 49
A client has been brought to the emergency department by paramedics after being found unconscious. The client's MedicAlert bracelet indicates that the client has type 1 diabetes and the client's blood glucose is 22 mg/dL (1.2 mmol/L). The nurse should anticipate what intervention? IV administration of 50% dextrose in water Subcutaneous administration of 10 units of Humalog Subcutaneous administration of 12 to 15 units of regular insulin IV bolus of 5% dextrose in 0.45% NaCl
IV administration of 50% dextrose in water 51
The nurse's assessment of a client post thyroidectomy suggests tetany and a review of the most recent blood work corroborate this finding. The nurse should prepare to administer what intervention? Oral calcium chloride and vitamin D IV calcium gluconate STAT levothyroxine Administration of parathyroid hormone (PTH)
IV calcium gluconate 49
A 60-year-old client comes to the ED reporting weakness, vision problems, increased thirst, increased urination, and frequent infections that do not seem to heal easily. The physician suspects that the client has diabetes. Which classic symptom should the nurse watch for to confirm the diagnosis of diabetes? Numbness Increased hunger Fatigue Dizziness
Increased hunger The classic symptoms of diabetes are the three Ps: polyuria (increased urination), polydipsia (increased thirst), and polyphagia (increased hunger) 51
A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia? Cheyne-Stokes respirations Increased urine output Decreased appetite Diaphoresis
Increased urine output 51
A patient is diagnosed with a deficiency in vasopressin, a posterior pituitary hormone. Therefore, a primary nursing responsibility is to assess for: Indicators of dehydration. Glycosuria Serum calcium levels. Indicators of hyponatremia.
Indicators of dehydration. 50
A nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare with absorption at other sites? Insulin is absorbed more slowly at abdominal injection sites than at other sites. Insulin is absorbed rapidly regardless of the injection site. Insulin is absorbed more rapidly at abdominal injection sites than at other sites. Insulin is absorbed unpredictably at all injection sites.
Insulin is absorbed more rapidly at abdominal injection sites than at other sites. 51
The nurse assesses a patient who has an obvious goiter. What type of deficiency does the nurse recognize is most likely the cause of this? Thyrotropin Iodine Thyroxine Calcitonin
Iodine 50
Which is a by-product of fat breakdown in the absence of insulin and accumulates in the blood and urine? Ketones Creatinine Hemoglobin Cholesterol
Ketones 51
A patient is diagnosed with type 1 diabetes. What clinical characteristics does the nurse expect to see in this patient? Select all that apply. Ketosis-prone Little or no endogenous insulin Obesity at diagnoses Younger than 30 years of age Older than 65 years of age
Ketosis-prone Little or no endogenous insulin Younger than 30 years of age 51
One of the most frequently occurring complications (55% occurrence) of primary hyperparathyroidism is: Kidney stones. Pancreatitis. Pathologic fractures. Peptic ulcer.
Kidney stones. Kidney stones occur in 55% of patients with primary hyperparathyroidism. They are caused by renal damage from the precipitation of calcium phosphate in the renal pelvis and parenchyma. 50
Which type of insulin acts most quickly? Regular NPH Lispro Glargine
Lispro The onset of action of rapid-acting lispro is within 10 to 15 minutes 51
A medical nurse is aware of the need to screen specific clients for their risk of hyperglycemic hyperosmolar syndrome (HHS). In what client population does this syndrome most often occur? Clients who are obese and who have no known history of diabetes Clients with type 1 diabetes and poor dietary control Adolescents with type 2 diabetes and sporadic use of antihyperglycemics Middle-aged or older people with either type 2 diabetes or no known history of diabetes
Middle-aged or older people with either type 2 diabetes or no known history of diabetes HHS occurs most often in older clients (50 to 70 years of age) who have no known history of diabetes or who have type 2 diabetes. HHS is a serious metabolic disorder resulting from a relative insulin deficiency initiated by an illness that raises the demand for insulin. 51
The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer? NPH Iletin II Lispro (Humalog) Glargine (Lantus)
NPH 51
A hospitalized, insulin-dependent patient with diabetes has been experiencing morning hyperglycemia. The patient will be awakened once or twice during the night to test blood glucose levels. The health care provider suspects that the cause is related to the Somogyi effect. Which of the following indicators support this diagnosis? Select all that apply. Normal bedtime blood glucose Rise in blood glucose about 11:00 AM Increase in blood glucose from 3:00 AM until breakfast Decrease in blood sugar to a hypoglycemic level between 2:00 to 3:00 AM Elevated blood glucose at bedtime
Normal bedtime blood glucose Increase in blood glucose from 3:00 AM until breakfast Decrease in blood sugar to a hypoglycemic level between 2:00 to 3:00 AM 51
A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the nurse do? Monitor laboratory values daily for elevated thyroid-stimulating hormone. Observe for swelling of the neck, tracheal deviation, and severe pain. Evaluate the quality of the client's voice postoperatively, noting any drastic changes. Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.
Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes 50
A nurse is caring for a client with type 1 diabetes who is being discharged home tomorrow. What is the best way to assess the client's ability to prepare and self-administer insulin? Ask the client to describe the process in detail. Observe the client drawing up and administering the insulin. Provide a health education session reviewing the main points of insulin delivery. Review the client's first hemoglobin A1C result after discharge.
Observe the client drawing up and administering the insulin. 51
A client presents to the clinic reporting an increase in thirst and urinating large amounts frequently. Which is/are the priority action(s) by the nurse? Select all that apply. Obtain a random plasma glucose level as ordered. Obtain an A1c level as ordered. Administer glucagon IV as prescribed. Assess for risk factors of diabetes. Schedule for an oral glucose tolerance test.
Obtain a random plasma glucose level as ordered. Obtain an A1c level as ordered. Assess for risk factors of diabetes. Criteria for the diagnosis of diabetes include symptoms of diabetes plus random plasma glucose greater than or equal to 200 mg/dL, a fasting plasma glucose greater than or equal to 126 mg/dL, or an A1c level of 6.5% or higher. 51
A client has been living with type 2 diabetes for several years, and the nurse realizes that the client is likely to have minimal contact with the health care system. To ensure that the client maintains adequate blood sugar control over the long term, the nurse should recommend which of the following? Participation in a support group for persons with diabetes Regular consultation of websites that address diabetes management Weekly telephone "check-ins" with an endocrinologist Participation in clinical trials relating to antihyperglycemics
Participation in a support group for persons with diabetes 51
A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder? pituitary disorder thyroid disorder parathyroid disorder adrenal disorder
Pituitary disorder Pituitary disorders usually result from excessive or deficient production and secretion of a specific hormone. Dwarfism occurs when secretion of growth hormone is insufficient during childhood. 50
A nurse is teaching a diabetic support group about the causes of type 1 diabetes. The teaching is determined to be effective when the group is able to attribute which factor as a cause of type 1 diabetes? Presence of autoantibodies against islet cells Obesity Rare ketosis Altered glucose metabolism
Presence of autoantibodies against islet cells 51
A nurse is teaching basic "survival skills" to a client newly diagnosed with type 1 diabetes. What topic should the nurse address? Signs and symptoms of diabetic nephropathy Management of diabetic ketoacidosis Effects of surgery and pregnancy on blood sugar levels Recognition of hypoglycemia and hyperglycemia
Recognition of hypoglycemia and hyperglycemia 51
The nurse is administering an insulin drip to a patient in ketoacidosis. What insulin does the nurse know is the only one that can be used intravenously? NPH Regular Lispro Lantus
Regular 51
A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms? Serum glucose level of 450 mg/dl Serum glucose level of 52 mg/dl Serum calcium level of 8.9 mg/dl Serum calcium level of 10.2 mg/dl
Serum glucose level of 52 mg/dl Headache, sweating, tremor, pallor, and nervousness typically result from hypoglycemia, an insulin reaction in which serum glucose level drops below 70 mg/dl. 51
Laboratory studies indicate a client's blood glucose level is 185 mg/dl. Two hours have passed since the client ate breakfast. Which test would yield the most conclusive diagnostic information about the client's glucose use? Fasting blood glucose test 6-hour glucose tolerance test Serum glycosylated hemoglobin (Hb A1c) Urine ketones
Serum glycosylated hemoglobin (Hb A1c) 51
A client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes that is being controlled with an oral diabetic agent, tolazamide. Which laboratory test is the most important for confirming this disorder? Serum potassium level Serum sodium level Arterial blood gas (ABG) values Serum osmolarity
Serum osmolarity A client with HHNS typically has a serum osmolarity of more than 350 mOsm/L. 51
After being sick for 3 days, a client with a history of diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should evaluate which diagnostic test results to prevent dysrhythmias? Serum potassium level Serum calcium level Serum sodium level Serum chloride level
Serum potassium level 51
A client diagnosed with type 2 diabetes achieves adequate glycemic control through diet and exercise. Upon being admitted to the hospital for a cholecystectomy, however, the client has required insulin injections on two occasions. The nurse would identify what as the likely cause for this short-term change in treatment? Alterations in bile metabolism and release have likely caused hyperglycemia. Stress has likely caused an increase in the client's blood sugar levels. The client has likely overestimated their ability to control the diabetes using nonpharmacologic measures. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars.
Stress has likely caused an increase in the client's blood sugar levels 51
A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia? Sweating, tremors, and tachycardia Dry skin, bradycardia, and somnolence Bradycardia, thirst, and anxiety Polyuria, polydipsia, and polyphagia
Sweating, tremors, and tachycardia 51
x The nurse is caring for a patient with hyperthyroidism who suddenly develops symptoms related to thyroid storm. What symptoms does the nurse recognize that are indicative of this emergency? Heart rate of 62 Blood pressure 90/58 mm Hg Oxygen saturation of 96% Temperature of 102ºF
Temperature of 102ºF Thyroid storm is characterized by the following: 1) high fever (hyperpyrexia), >38.5°C (>101.3°F); 2) extreme tachycardia (>130 bpm); 3) exaggerated symptoms of hyperthyroidism with disturbances of a major system—for example, gastrointestinal (weight loss, diarrhea, abdominal pain) or cardiovascular (edema, chest pain, dyspnea, palpitations); and 4) altered neurologic or mental state, which frequently appears as delirium psychosis, somnolence, or coma. 50
A pregnant client has been diagnosed with gestational diabetes. The client is shocked by the diagnosis, stating that they are conscientious about their health, and asks the nurse what causes gestational diabetes. The nurse should explain that gestational diabetes is a result of what etiologic factor? Increased caloric intake during the first trimester Changes in osmolality and fluid balance The effects of hormonal changes during pregnancy Overconsumption of carbohydrates during the first two trimesters
The effects of hormonal changes during pregnancy 51
A nurse educator been invited to local seniors center to discuss health-maintaining strategies for older adults. The nurse addresses the subject of diabetes mellitus, its symptoms, and consequences. What should the educator teach the participants about type 1 diabetes? The participants are unlikely to develop a new onset of type 1 diabetes. New cases of diabetes are highly uncommon in older adults. New cases of diabetes will be split roughly evenly between type 1 and type 2. Type 1 diabetes always develops before the age of 20.
The participants are unlikely to develop a new onset of type 1 diabetes. 51
The nurse auscultates a bruit over the thyroid glands. What does the nurse understand is the significance of this finding? The patient may have hypothyroidism. The patient may have thyroiditis. The patient may have hyperthyroidism. The patient may have Cushing disease.
The patient may have hypothyroidism. 50
A nurse is preparing to administer two types of insulin to a client with diabetes mellitus. What is the correct procedure for preparing this medication? The short-acting insulin is withdrawn before the intermediate-acting insulin. The intermediate-acting insulin is withdrawn before the short-acting insulin. Different types of insulin are not to be mixed in the same syringe. If administered immediately, there is no requirement for withdrawing one type of insulin before another.
The short-acting insulin is withdrawn before the intermediate-acting insulin. 51
Hormones are chemicals produced in the body to perform specific functions. What is a characteristic of a hormone? They are produced in very large amounts They go through a very lengthy process to be broken down They are secreted indirectly into the blood stream They travel through the blood to specific receptor sites throughout the body
They travel through the blood to specific receptor sites throughout the body Hormones are chemicals that are produced in the body and meet specific criteria. Hormones are produced in very small amounts and are secreted directly into the blood stream. They do travel through the blood to specific receptor sites throughout the body and are immediately broken down. 49
A client receives a daily injection of glargine insulin at 7:00 a.m. When should the nurse monitor this client for a hypoglycemic reaction? Between 8:00 and 10:00 a.m. Between 4:00 and 6:00 p.m. Between 7:00 and 9:00 p.m. This insulin has no peak action and does not cause a hypoglycemic reaction.
This insulin has no peak action and does not cause a hypoglycemic reaction. 51
Which intervention is essential when performing dressing changes on a client with a diabetic foot ulcer? Applying a heating pad Debriding the wound three times per day Using sterile technique during the dressing change Cleaning the wound with a povidone-iodine solution
Using sterile technique during the dressing change 51
Which hormone is secreted by the posterior pituitary? Vasopressin Calcitonin Corticosteroids Somatostatin
Vasopressin 49
A client is having problems with parathyroid hormone. What vitamin would the nurse suspect as potentially contributing to the client's problem? Vitamin A Vitamin C Vitamin D Vitamin K
Vitamin D 49
Which findings should a nurse expect to assess in client with Hashimoto's thyroiditis? Weight loss, increased appetite, and hyperdefecation Weight loss, increased urination, and increased thirst Weight gain, decreased appetite, and constipation Weight gain, increased urination, and purplish-red striae
Weight gain, decreased appetite, and constipation Signs and symptoms include weight gain, decreased appetite; constipation; lethargy; dry cool skin; brittle nails; coarse hair; muscle cramps; weakness; and sleep apnea. 50
A nurse is observing a newly diagnosed client with diabetes mellitus administer an insulin injection. Which site will the nurse advise the client to predominantly use? abdomen upper arms thighs buttocks
abdomen 51
When a client's gallbladder has decreased ability to release bile when he is having a high fat content meal, what hormone is not released to stimulate contractions of the gallbladder? Gastrin Erythropoietin Angiotensin Cholecystokinin
cholecystokinin 49 -chole (bile) -cysto (sac) -kinin (move)
A visiting nurse is setting up an insulin schedule for an older adult who has diabetes mellitus. What should the nurse consider when determining the dosing time? client's eating and sleeping habits client's ability to self-administer insulin cognitive problems client's history
client's eating and sleeping habits 51
During a client education session, the nurse describes the mechanism of hormone level maintenance. What causes most hormones to be secreted? decrease in hormonal levels increase in hormonal levels hormonal overproduction hormonal underproduction
decrease in hormone levels 49 (Study Guide 49:2 --> Feedback loop)
When instructing a client diagnosed with hyperparathyroidism about diet, the nurse should stress the importance of: restricting fluids. restricting sodium. encouraging fluids. restricting potassium.
encouraging fluids. The nurse should encourage fluid intake to prevent renal calculi formation. 50
A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect? Weight gain, constipation, and lethargy Weight loss, nervousness, and tachycardia Exophthalmos, diarrhea, and cold intolerance Diaphoresis, fever, and decreased sweating
Weight loss, nervousness, and tachycardia 50
A nurse explains the role of the ovaries. Which hormones would be included in that discussion? estrogen and progesterone estrogen and progestin testosterone and progesterone estrogen and testosterone
estrogen and progesterone 49
ADH is secreted by which gland? Anterior pituitary Posterior pituitary Adrenal Thyroid
Posterior pituitary 49
Patients with hyperthyroidism are characteristically: Apathetic and anorexic Calm Emotionally stable Sensitive to heat
Sensitive to heat 50
A nurse is completing an assessment of a client with suspected acromegaly. To assist in making the diagnosis, which question should the nurse ask? "Have you had a recent head injury?" "Has your shoe size increased recently?" "Do you experience skin breakouts?" "Is there any family history of acromegaly?"
"Has your shoe size increased recently?" 49
A nurse is teaching a client with adrenal insufficiency about corticosteroids. Which statement by the client indicates a need for additional teaching? "I will avoid friends and family members who are sick." "I will eat lots of chicken and dairy products." "I may stop taking this medication when I feel better." "I will see my ophthalmologist regularly for a check-up."
"I may stop taking this medication when I feel better." 50
A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement by the client indicates the need for additional discharge teaching? "I will take my pain medications according to the schedule we developed." "I will increase my fluid and calcium intake." "I'll schedule a follow-up visit with my physician as soon as I get home." "I'll call my physician if I notice tingling around my lips."
"I will increase my fluid and calcium intake The client requires additional teaching if he states that he will increase his calcium intake. Hyperparathyroidism causes extreme increases in serum calcium levels. The client should increase his fluid intake, but he should limit his calcium and vitamin D intake. 50
Which of the following can be performed to determine a client's general status and rule out disorders? A complete blood count A complete blood count and chemistry profile Chemistry profile Radiographs of the chest or abdomen
A complete blood count and chemistry profile 49
A patient is ordered desmopressin (DDAVP) for the treatment of diabetes insipidus. What therapeutic response does the nurse anticipate the patient will experience? A decrease in blood pressure A decrease in blood glucose levels A decrease in urine output A decrease in appetite
A decrease in urine output 50
The nurse is preparing a client for a thyroid test. Which medications that the client is taking should be documented on the laboratory slip as possibly affecting the thyroid test? SATA Phenytoin Metoclopramide Lisinopril Furosemide Amphetamine
Phenytoin Metoclopramide Furosemide Amphetamine 49
The nurse is caring for a patient with hyperparathyroidism and observes a calcium level of 16.2 mg/dL. What interventions does the nurse prepare to provide to reduce the calcium level? Select all that apply. Administration of calcitonin Administration of calcium carbonate Intravenous isotonic saline solution in large quantities Monitoring the patient for fluid overload Administration of a bronchodilator
Administration of calcitonin Intravenous isotonic saline solution in large quantities Monitoring the patient for fluid overload 50
What is the most common cause of hyperaldosteronism? Excessive sodium intake A pituitary adenoma Deficient potassium intake An adrenal adenoma
An adrenal adenoma An autonomous aldosterone-producing adenoma is the most common cause of hyperaldosteronism. 50
Which diagnostic test is done to determine a suspected pituitary tumor? Radiography of the abdomen Computed tomography Measuring blood hormone levels Radioimmunoassay
Computed tomography 49
What dietary modifications should be recommended to a client with hyperthyroidism? Consume a high-protein diet. Restrict calorie intake. Increase calorie intake by 70%. Limit intake of nutritionally dense foods such as milk products, eggs, and cheese.
Consume a high-protein diet. 50
The primary function of the thyroid gland includes which of the following? Control of cellular metabolic activity Facilitation of milk ejection Reabsorption of water Reduction of plasma level of calcium
Control of cellular metabolic activity 49
The nurse assesses a patient who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease? Potassium of 6.0 mEq/L Sodium of 140 mEq/L Glucose of 100 mg/dL A blood pressure reading of 135/90 mm Hg
Potassium of 6.0 mEq/L Addison's disease is characterized by hypotension, low blood glucose, low serum sodium, and high serum potassium levels. The normal serum potassium level is 3.5 to 5 mEq/L. 50
A nurse is preparing to palpate a client's thyroid gland. Which action by the nurse is appropriate? Have the client flex his neck onto his chest and cough while she palpates the anterior neck with her fingertips. Place her hands around the client's neck, with the thumbs in the front of the neck, and gently massage the anterior neck. Encircle the client's neck with both hands, have the client slightly extend his neck, and ask him to swallow. Have the client hyperextend his neck and take slow, deep inhalations while she palpates his neck with her fingertips.
Encircle the client's neck with both hands, have the client slightly extend his neck, and ask him to swallow. 49
Following an Addisonian crisis, a client's adrenal function has been gradually regained. The nurse should ensure that the client knows about the need for supplementary glucocorticoid therapy in which of the following circumstances? Episodes of high psychosocial stress Periods of dehydration Episodes of physical exertion Administration of a vaccine
Episodes of high psychosocial stress 49
A patient is noted to be anemic. Which hormone will affect the development of red blood cells in this patient? Insulin Secretin Erythropoietin Epinephrine
Erythropoietin 49
Which is a clinical manifestation of diabetes insipidus? Low urine output Excessive thirst Weight gain Excessive activities
Excessive thirst 50
A nurse should perform which intervention for a client with Cushing's syndrome? Offer clothing or bedding that's cool and comfortable. Suggest a high-carbohydrate, low-protein diet. Explain that the client's physical changes are a result of excessive corticosteroids. Explain the rationale for increasing salt and fluid intake in times of illness, increased stress, and very hot weather.
Explain that the client's physical changes are a result of excessive corticosteroids. 50
A health care provider suspects that a thyroid nodule may be malignant. The nurse knows to prepare information for the patient based on the usual test that will be ordered to establish a diagnosis. What is that test? Serum immunoassay for TSH Fine-needle biopsy of the thyroid gland Free T4 analysis Ultrasound of the thyroid gland
Fine-needle biopsy of the thyroid gland 50
A woman with a progressively enlarging neck comes into the clinic. She mentions that she has been in a foreign country for the previous 3 months and that she didn't eat much while she was there because she didn't like the food. She also mentions that she becomes dizzy when lifting her arms to do normal household chores or when dressing. What endocrine condition should the nurse expect the health care provider to diagnose? Diabetes mellitus Goiter Diabetes insipidus Cushing's syndrome
Goiter A goiter can result from inadequate dietary intake of iodine associated with changes in foods or malnutrition. It's caused by insufficient thyroid gland production and depletion of glandular iodine. Signs and symptoms of goiter include an enlarged thyroid gland, dizziness when raising the arms above the head, dysphagia, and respiratory distress 50
A middle-aged female client complains of anxiety, insomnia, weight loss, the inability to concentrate, and eyes feeling "gritty." Thyroid function tests reveal the following: thyroid-stimulating hormone (TSH) 0.02 U/ml, thyroxine 20 g/dl, and triiodothyronine 253 ng/dl. A 6-hour radioactive iodine uptake test showed a diffuse uptake of 85%. Based on these assessment findings, the nurse should suspect: thyroiditis. Graves' disease. Hashimoto's thyroiditis. multinodular goiter.
Graves' disease. Graves' disease, an autoimmune disease causing hyperthyroidism, is most prevalent in middle-aged females. 50
The primary care provider (PCP) has ordered a fluid deprivation test for a client suspected of having diabetes insipidus. During the test, the nurse should prioritize what assessments? Temperature and oxygen saturation Heart rate and blood pressure Breath sounds and bowel sounds Color, warmth, movement, and sensation of extremities
Heart rate and blood pressure 50
A nurse caring for a client with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding? Glucose in the urine Albumin in the urine Highly dilute urine Leukocytes in the urine
Highly Dilute Urine 49
Which condition should a nurse expect to find in a client diagnosed with hyperparathyroidism? Hypocalcemia Hypercalcemia Hyperphosphatemia Hypophosphaturia
Hypercalcemia 50
On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance most commonly follows thyroid surgery? Hypocalcemia Hyponatremia Hyperkalemia Hypermagnesemia
Hypocalcemia Hypocalcemia may follow thyroid surgery if the parathyroid glands were removed accidentally. Signs and symptoms of hypocalcemia may be delayed for up to 7 days after surgery. 50
A client with a 20-year history of hypothyroidism who has not been compliant with taking thyroid replacement therapy is brought into the ED with a diagnosis of myxedema coma. What client symptoms are consistent with this life-threatening event? Select all that apply. Tachycardia Hypothermia Hypotension Hypoventilation Hyperactivity
Hypothermia Hypotension Hypoventilation 50
A client diagnosed with Addisonian crisis has been admitted for an adrenalectomy to be performed the following day. To prevent complications, the nurse should anticipate preoperative administration of which of the following? IV antibiotics Oral antihypertensives Parenteral nutrition IV corticosteroids
IV corticosteroids 50
The home care nurse is conducting client teaching with a client on corticosteroid therapy. To achieve consistency with the body's natural secretion of cortisol, when should the home care nurse instruct the client to take the corticosteroids? In the evening between 4 PM and 6 PM Prior to going to sleep at night At noon every day In the morning between 7 AM and 8 AM
In the morning between 7 AM and 8 AM 50
The nurse is teaching a client that the body needs iodine for the thyroid to function. What food would be the best source of iodine for the body? Eggs Soy products Iodized table salt Red meat
Iodized table salt 49
A client newly diagnosed with diabetes is discussing the disease with the nurse. The client asks about the hormones that might affect diabetes. Which is considered client teaching information about somatostatin? It releases cortisol to help with stress. It stimulates the release of a hormone. It inhibits the release of insulin. It stimulates the breakdown of fats and proteins.
It inhibits the release of insulin. 49
Which intervention is the most critical for a client with myxedema coma? Administering an oral dose of levothyroxine (Synthroid) Warming the client with a warming blanket Measuring and recording accurate intake and output Maintaining a patent airway
Maintaining a patent airway Because respirations are depressed in myxedema coma, maintaining a patent airway is the most critical nursing intervention. Ventilatory support is usually needed. 50
For a client with Graves' disease, which nursing intervention promotes comfort? Restricting intake of oral fluids Placing extra blankets on the client's bed Limiting intake of high-carbohydrate foods Maintaining room temperature in the low-normal range
Maintaining room temperature in the low-normal range Graves' disease causes signs and symptoms of hypermetabolism, such as heat intolerance, diaphoresis, excessive thirst and appetite, and weight loss. To reduce heat intolerance and diaphoresis, the nurse should keep the client's room temperature in the low-normal range. 50
A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication? Exophthalmos Thyroid storm Myxedema coma Tibial myxedema
Myxedema coma Myxedema coma, severe hypothyroidism, is a life-threatening condition that may develop if thyroid replacement medication isn't taken. 50
The pharmacology instructor is discussing the endocrine system with a class of pre-nursing students. What would the instructor tell the students is considered to be a hormone? Norepinephrine Acetylcholine Nucleic acid Serotonin
Norepinephrine A hormone is secreted directly into the blood stream and travels from the site of production to react with specific receptor sites to cause an action. Norepinephrine, which is a neurotransmitter, is a hormone when it is produced in the adrenal medulla, secreted into circulation, and travels to norepinephrine receptor sites to cause an effect. Acetylcholine and serotonin are neurotransmitters, but are not hormones. Nucleic acid is used to build DNA and RNA. 49
Which assessment would a nurse perform on a client with Cushing syndrome who is at high risk of developing a peptic ulcer? Observe stool color. Monitor bowel patterns. Monitor vital signs every 4 hours. Observe urine output.
Observe stool color. 50
Which organ is both an exocrine and an endocrine gland? pancreas ovaries pineal gland thymus gland
Pancreas The pancreas lies behind the stomach, with the head of the gland close to the duodenum. It is both an exocrine and an endocrine gland. 49
A client is undergoing a diagnostic workup for suspected thyroid cancer. What is the most common form of thyroid cancer in adults? Follicular carcinoma Medullary carcinoma Anaplastic carcinoma Papillary carcinoma
Papillary carcinoma 50
A client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse 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? Related to bone demineralization resulting in pathologic fractures Related to exhaustion secondary to an accelerated metabolic rate Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces Related to tetany secondary to a decreased serum calcium level
Related to bone demineralization resulting in pathologic fractures 50
A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? Infusing IV fluids rapidly as ordered Encouraging increased oral intake Restricting fluids Administering glucose-containing I.V. fluids as ordered
Restricting fluids 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. 50
A client is transferred to a rehabilitation center after being treated in the hospital for a stroke. Because the client has a history of Cushing's syndrome (hypercortisolism) and chronic obstructive pulmonary disease, the nurse formulates a nursing diagnosis of: Risk for imbalanced fluid volume related to excessive sodium loss. Risk for impaired skin integrity related to tissue catabolism secondary to cortisol hypersecretion. Ineffective health maintenance related to frequent hypoglycemic episodes secondary to Cushing's syndrome. Decreased cardiac output related to hypotension secondary to Cushing's syndrome.
Risk for impaired skin integrity related to tissue catabolism secondary to cortisol hypersecretion. Cushing's syndrome causes tissue catabolism, resulting in thinning skin and connective tissue loss; along with immobility related to stroke, 50
A nurse is caring for a client in acute addisonian crisis. Which test result does the nurse expect to see? Serum potassium level of 6.8 mEq/L Blood urea nitrogen (BUN) level of 2.3 mg/dl Serum sodium level of 156 mEq/L Serum glucose level of 236 mg/dl
Serum potassium level of 6.8 mEq/L 50
The nurse is planning the care of a client with hyperthyroidism. What should the nurse specify in the client's meal plan? A reduced calorie diet, high in nutrients Small, frequent meals, high in protein and calories Three large, bland meals a day A diet high in fiber and plant-sourced fat
Small, frequent meals, high in protein and calories A client with hyperthyroidism has an increased appetite. The client should be counseled to consume several small, well-balanced meals. High-calorie, high-protein foods are encouraged. A clear liquid diet would not satisfy the client's caloric or hunger needs. A diet rich in fiber and fat should be avoided because these foods may lead to GI upset or increase peristalsis. 49
Dilutional hyponatremia occurs in which disorder? Diabetes insipidus (DI) Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Pheochromocytoma Addison disease
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Clients diagnosed with SIADH exhibit dilutional hyponatremia. They retain fluids and develop a sodium deficiency. 50
The nurse is teaching a client that the body needs iodine for the thyroid to function. What is the function of iodine? Maintaining body metabolism in a steady state Maintaining effective oxygen consumption Synthesis of thyroid hormones Altering the responsiveness of body tissue to other hormones
Synthesis of thyroid hormones 49
A nurse explains to a client with thyroid disease that the thyroid gland normally produces: iodine and thyroid-stimulating hormone (TSH). thyrotropin-releasing hormone (TRH) and TSH. TSH, triiodothyronine (T3), and calcitonin. T3, thyroxine (T4), and calcitonin.
T3, thyroxine (T4), and calcitonin. The thyroid gland normally produces thyroid hormone (T3 and T4) and calcitonin. The pituitary gland produces TSH to regulate the thyroid gland. The hypothalamus gland produces TRH to regulate the pituitary gland. 49
A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication? Tetany Hemorrhage Thyroid storm Laryngeal nerve damage
Tetany 50
A client is prescribed corticosteroid therapy. What would be priority information for the nurse to give the client who is prescribed long-term corticosteroid therapy? The client's diet should be low protein with ample fat. The client may experience short-term changes in cognition. The client is at an increased risk for developing infection. The client is at a decreased risk for development of thrombophlebitis and thromboembolism.
The client is at an increased risk for developing infection. 49
A patient with thyroiditis has undergone surgery and is concerned about the barely visible scar. Which of the following suggestions should the nurse give the patient to cope with the condition? Wear clothing that covers the neck. Undergo a skin graft. Apply medicines to remove scar. Consider cosmetic surgery.
Wear clothing that covers the neck 50
The nurse provides care for a client, with a history of atherosclerosis, who is hospitalized for the initiation of pharmacotherapy for the treatment of hypothyroidism. Complete the following sentence by choosing from the lists of options. The client is at highest risk for developing____________ Hypothermia Skin Changes Cardiac Dysfunction as evidenced by _______________________ Myxedema coma An accumulation of mucopolysaccharides in the subcutaneous tissues Angina .
The client is at highest risk for developing CARDIAC DYSFUNCTION as evidenced by ANGINA Prevention of cardiac dysfunction is a priority when providing care to a client who requires the initiation of pharmacotherapy in the clinical setting. When thyroid hormone is given to a client who is diagnosed with hypothyroidism, the oxygen demand increases, but oxygen delivery cannot be increased unless, or until, the preexisting atherosclerosis improves. The occurrence of angina and acute coronary syndrome is the signal that the oxygen needs of the myocardium exceed its blood supply and is the result of thyroid hormones enhancing the cardiovascular effects of catecholamines. Although skin changes due to the accumulation of mucopolysaccharides in the client's subcutaneous tissues do occur with hypothyroidism, this is not caused by the initiation of pharmacotherapy but by the disease process. Hypothermia is caused by myxedema coma but the client's risk for this decreases, not increases, with the initiation of pharmacotherapy for the treatment of hypothyroidism. 50
A patient taking corticosteroids for exacerbation of Crohn's disease comes to the clinic and informs the nurse that he wants to stop taking them because of the increase in acne and moon face. What can the nurse educate the patient regarding these symptoms? The symptoms are permanent side effects of the corticosteroid therapy. The moon face and acne will resolve when the medication is tapered off. Those symptoms are not related to the corticosteroid therapy. The dose of the medication must be too high and should be lowered.
The moon face and acne will resolve when the medication is tapered off. 50
The nurse is caring for a client with Addison disease who is scheduled for discharge. When teaching the client about hormone replacement therapy, the nurse should address what topic? The possibility of precipitous weight gain The need for lifelong steroid replacement The need to match the daily steroid dose to immediate symptoms The importance of monitoring liver function
The need for lifelong steroid replacement 49
A group of nursing students are doing a presentation on hormones. What hormone would the presentation show regulates the metabolic rate and influences the growth and development of the body? PTH or parathormone Thyroid hormone Cortisol Insulin
Thyroid hormone 49
When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect: a blood pressure of 130/70 mm Hg. a blood glucose level of 130 mg/dl. bradycardia. a blood pressure of 176/88 mm Hg.
a blood pressure of 176/88 mm Hg. Pheochromocytoma causes hypertension, tachycardia, hyperglycemia, hypermetabolism, and weight loss. 50
A nurse is reviewing the laboratory order for a client suspected of having an endocrine disorder. The lab slip includes obtaining cortisol levels. What is being tested? adrenal function thyroid function thymus function parathyroid function
adrenal function The adrenal cortex manufactures and secretes glucocorticoids, such as cortisol, which affect body metabolism, suppress inflammation, and help the body withstand stress. 49
A nurse is reviewing the laboratory order for a client suspected of having an endocrine disorder. The lab slip includes obtaining cortisol levels. What is being tested? adrenal function thyroid function thymus function parathyroid function
adrenal function 49
A nurse working in the ED at a level 1 trauma center is notified that casualties from a multivehicle car accident are currently in transit. The nurse's heart is pounding and mouth is dry. What gland is responsible for this nurse's physiologic response? adrenal medulla thyroid gland adrenal cortex pineal gland
adrenal medulla 49
A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for: exophthalmos and conjunctival redness. flushed, warm, moist skin. systolic murmur at the left sternal border. decreased body temperature and cold intolerance.
decreased body temperature and cold intolerance. Hypothyroidism markedly decreases the metabolic rate, causing a reduced body temperature and cold intolerance. Other signs and symptoms include dyspnea, hypoventilation, bradycardia, hypotension, anorexia, constipation, decreased intellectual function, and depression. 50
A nurse is caring for a client with hypoparathyroidism. During assessment, the nurse elicits a positive Trousseau sign. What does the nurse observe to verify this finding? hand flexing inward cardiac dysrhythmia moon face and buffalo hump bulging forehead
hand flexing inward 50
A client has been experiencing a decrease in serum calcium. After diagnostics, the physician believes the calcium level fluctuation is due to altered parathyroid function. What is the role of parathormone? increase serum calcium level inhibit release of calcium into extracellular fluid decrease serum calcium level promote urinary secretion of calcium
increase serum calcium level 49
Although not designated as endocrine glands, several organs within the body secrete hormones as part of their normal function. Which organ secretes hormones involved in increasing blood pressure and volume and maturation of red blood cells? kidneys cardiac atria brain liver
kidneys 49
The nurse is completing discharge teaching with a client with hyperthyroidism who has been treated with radioactive iodine at an outpatient clinic. The nurse instructs the client to discontinue all antithyroid medications. monitor for symptoms of hypothyroidism. watch for symptoms of hyperthyroidism to disappear within 1 week. continue radioactive precautions with all body secretions.
monitor for symptoms of hypothyroidism. 50
An incoherent 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 periorbital area. Knowing that these findings suggest severe hypothyroidism, the nurse prepares to take emergency action to prevent the potential complication of: thyroid storm. cretinism. myxedema coma. Hashimoto's thyroiditis.
myxedema coma. 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 50
Cardiac effects of hyperthyroidism include decreased pulse pressure. decreased systolic BP. bradycardia. palpitations.
palpitations Cardiac effects may include sinus tachycardia, increased pulse pressure, and palpitations. Systolic BP is elevated. 49
Cardiac effects of hyperthyroidism include decreased pulse pressure. decreased systolic blood pressure. bradycardia. palpitations.
palpitations. 50
During a follow-up visit to the physician, a client with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and: sodium. potassium. magnesium. phosphorus.
phosphorus. 49
A client is admitted to an acute care facility with a tentative diagnosis of hypoparathyroidism. The nurse should monitor the client closely for the related problem of: severe hypotension. excessive thirst. profound neuromuscular irritability. acute gastritis.
profound neuromuscular irritability. 50
A client has had an alteration in the production of T lymphocytes and is undergoing diagnostics. What gland aids in the development of T lymphocytes? thymus pineal parathyroid thyroid
thymus 49
A nurse is caring for a client with diabetes insipidus. The nurse should anticipate administering: insulin. furosemide. potassium chloride. vasopressin.
vasopressin. 50
