MCA II: Endocrine and Diabetes

Which nursing action will be included in the plan of care for a 55-year-old patient with Graves disease who has exophthalmos?

Place cold packs is INCORRECT

A patient receives aspart (Novolog) insulin at 8am. Which time will it be most important for the nurse to monitor for symptoms of hypoglycemia?

10am

The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL. Fifteen minutes later the blood glucose is 67 mg/dL. Which action should the nurse take next?

Give the patient 4-6 oz more orange juice

a 63-year-old patient with primary hyperparathyroidism has a serum phosphorus level of 1.7 mg/dL and calcium of 14 mg/dL. Which nursing action should be included in the plan of care?

Assess for positive Chvostek's sign is INCORRECT

Which finding for a patient who has hypothyroidism and hypertension indicates that the nurse should contact the health care provider before administering levothyroxine (Synthroid)?

Blood pressure 112/62 is INCORRECT

Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is correct?

Changes in diet and exercise may control blood glucose levels in type 2 diabetes.

Which information is most important for the nurse to report to the health care provider before a patient with type 2 diabetes is prepared for a coronary angiogram with intravenous contrast medium?

The patient took the prescribed metformin (Glucophage) today.

The following is consistent with a diagnosis of diabetes insipidus (DI)

specific gravity < 1.005

a few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the health care provider?

GFR is decreased

A patient had a subtotal thyroidectomy and the parathyroid may have been nicked. The patient develops a cramp in the right hand while taking the blood pressure. Which action will the nurse anticipate next?

Administer IV calcium gluconate

Truncal obesity, "moon face", red striae on the abdomen, and a buffalo hump are consistent with which disorder?

Cushing's syndrome

In order to assist an older diabetic patient to engage in moderate daily exercise which action is most important for the nurse to take?

Determine what type of activities the patient enjoys.

Which information will the nurse include when teaching a 50-year-old patient who has type 2 diabetes about Sulfonylurea medication such as glyburide (Micronase, Diabeta, Glynase)?

Glyburide stimulates insulin production and release from the pancreas.

A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?

Glycosylated hemoglobin level (A1C or HbA1C)

The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes. Which question is most appropriate for the nurse to ask?

Have you lost weight lately?

Which lab information should the nurse expect on a patient with Addison's disease

Hypokalemia is INCORRECT

The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following?

I can choose any foods, as long as I use enough insulin to cover the calories.

which statement by a 50-year-old patient indicates to the nurse that further assessment of thyroid function may be necessary

I feel a lump in my throat when I swallow

The nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone (SIADH). What interventions should be included in the care? (select all that apply)

Obtain daily weights Restrict fluid intake to 1000 mL/day Position head of bed at 10 degrees Implement seizure precautions

Which nursing assessment of a 69-year-old patient is most important to make during initiation of thyroid replacement with levothyroxine (Synthroid)?

Orientation and alertness is INCORRECT

Which patient action indicates good understanding of the nurse's teaching about administration of as part (Novolog) insulin?

Patient cleans the skin with soap and water before insulin administration

a patient develops anxiety with an increased respiratory rate, following a parathyroidectomy. Which action should the nurse take first?

Start PRN oxygen at 2L/min per cannula Place patient on rebreather mask?

Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP) who are working in the diabetes clinic?

Take the patient's vital signs

A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?

The patent skips a meal when exercising.

A 55-year-old female patient with type 2 diabetes has a nursing diagnosis of imbalanced nutrition: more than body requirements. Which goal is most important for this patient?

The patient will follow a diet and exercise plan that results in weight loss.

a 23-year-old patient is admitted with diabetes insipidus (DI). Which action will be most appropriate for the RN to delegate to an unlicensed assistive personnel (UAP)?

assist the patient to the bathroom

an expected nursing diagnosis for a 30-year-old patient admitted to the hospital with symptoms of diabetes insipidus (DI) is what?

sleep pattern disturbance related to frequent waking to void

A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1pm. The clinic nurse will plan to teach the patient to do what?

check glucose level before, during, and after swimming to determine needs for diet changes during exercise

which assessment finding for a 53-year-old female patient admitted with hyperaldosteronism (Conn's) disease is most concerning?

hyperglycemia is INCORRECT

A 56-year-old patient who is disoriented and has muscle cramps is hospitalized with possible syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would expect the initial lab results to include:

hyponatremia

A 48-year-old male patient screened for diabetes at a clinic has a fasting glucose level of 120 mg/dL. The nurse will plan to teach the patient about:

lifestyle changes to lower blood glucose.

What symptoms should the nurse monitor when caring for a patient with diabetes insipidus (DI)?

nausea, vomiting, and muscle cramps

Which lab value reported to the nurse by the unlicensed assistive personnel (UAP) indicates the most urgent need for the nurse's assessment of the patient?

noon blood glucose level of 42 mg/dL

What symptoms should the nurse plan to monitor for while caring for a patient diagnosed with pheochromocytoma?

profuse sweating severe hypertension tachycardia

a 37-year-old patient is being admitted with a diagnosis of Cushing syndrome. Which findings will the nurse expect during the assessment)

purplish streaks on the abdomen

A hospitalized diabetic patient received 38 U of NPH insulin at 7am. At 1pm the patient has been away from the nursing unit for 2 hours, missing the lunch delivery while awaiting a chest X-ray. To prevent hypoglycemia, the best action by the nurse is to do what?

request that if testing is further delayed, the patient be returned to the unit to eat

In which order will the nurse take these steps to prepare NPH 20 units and regular insulin 2 units using the same syringe?

rotate NPH vial inject 20 units of air into NPH vial inject 2 units of air into regular insulin vial withdraw regular insulin withdraw 20 units NPH

to monitor for complications in a patient with type 2 diabetes which tests will the nurse in the diabetes clinic schedule at least annually (select all that apply).

serum creatinine complete blood count (CBC) monofilament testing of the foot MORE??

a 62-year-old patient with hyperthyroidism is to be treated with radioactive iodine (RAI). The nurse instructs the patient:

that symptoms of hypothyroidism may occur as the RAI therapy takes effect

Which action by a patient indicates that the home health nurse's teaching about glargine (Lantus) and regular insulin has been successful?

the patient prepares glargine (Lantus) and the regular insulin in separate syringes