MLQ Ch. 52
A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? A. Restricting fluids B. Administering glucose-containing I.V. fluids as ordered C. Infusing IV fluids rapidly as ordered D. Encouraging increased oral intake
A
A client with hyperparathyroidism declines surgery and is to receive hormone replacement therapy with estrogen and progesterone. Which instruction is most important for the nurse to include in the client's teaching plan? A. "Maintain a moderate exercise program." B. "Jog at least 2 miles per day." C. "Rest as much as possible." D. "Lose weight."
A
A nurse is caring for a female client with hypothyroidism. The client is extremely upset about her altered physical appearance. She doesn't want to take her medication because she doesn't believe it's doing any good. What should the nurse do? A. Tell the client she'll soon experience improvement in her looks as the medication corrects her hormone deficiency. B. Tell the client that she looks fine and offer to help her with makeup. C. Tell the client she needs to learn to accept herself as she is and be compliant during treatment. D. Tell the client she'll feel better if she consistently takes the thyroid replacement medication.
A
A patient has been diagnosed with thyroidal hypothyroidism. The nurse knows that this diagnosis in consistent with which of the following? A. Dysfunction of the thyroid gland itself B. Failure of the pituitary gland C. Disorder of the hypothalamus D. Inadequate secretion of TSH
A
During a client education session, the nurse describes the mechanism of hormone level maintenance. What causes most hormones to be secreted? A. decrease in hormonal levels B. hormonal overproduction C. hormonal underproduction D. increase in hormonal levels
A
During the first 24 hours after a client is diagnosed with addisonian crisis, which intervention should the nurse perform frequently? A. Assess vital signs. B. Administer oral hydrocortisone. C. Weigh the client. D. Test urine for ketones.
A
The following clients are scheduled for thyroid testing. Which client would be at greatest risk for inaccurate results? A. A client who was given salicylates last month B. A client who received corticosteroids 4 months ago C. A client who avoids kelp D. A client diagnosed with low blood sugar
A
The nurse is assessing a client in the clinic who appears restless, excitable, and agitated. The nurse observes that the client has exophthalmos and neck swelling. What diagnosis do these clinical manifestations correlate with? A. Hyperthyroidism B. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) C. Hypothyroidism D. Diabetes insipidus (DI)
A
A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply. A. Hypoventilation B. Hypertension C. Hypothermia D. Hyperventilation E. Hypotension
A, C, E
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? A. three B. four C. one D. two
B
A client with hypothyroidism is afraid of needles and doesn't want to have his blood drawn. What should the nurse say to help alleviate his concerns? A. "When your thyroid levels are stable, we won't have to draw your blood as often." B. "I'll stay here with you while the technician draws your blood." C. "The physician has ordered this test so you can get better sooner." D. "It's only a little stick. It'll be over before you know it."
B
A nurse is assigned to care for a patient with increased parathormone secretion. Which of the following serum levels should the nurse monitor for this patient? A. Sodium B. Calcium C. Potassium D. Glucose
B
A nurse is caring for a client with diabetes insipidus. The nurse should anticipate administering: A. insulin. B. vasopressin. C. potassium chloride. D. furosemide.
B
A nurse is performing a physical examination on client suspected of having an endocrine disorder. Which assessment finding might be indicative of a problem with the thyroid gland? A. Dilated pupils B. Cold intolerance C. Sudden weight loss without dieting D. Diarrhea
B
A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority? A. Impaired physical mobility B. Decreased cardiac output C. Risk for infection D. Imbalanced nutrition: Less than body requirements
B
A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate? A. Diabetes insipidus B. Myxedema coma C. Syndrome of inappropriate antidiuretic hormone (SIADH) D. Thyroid storm
B
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? A. Start administering oxygen at 2 L/min via a cannula. B. Administer IV calcium gluconate as ordered. C. Administer an oral calcium supplement as ordered. D. Administer a sedative as ordered.
B
During physical examination of a client with a suspected endocrine disorder, the nurse assesses the body structures. The nurse gathers this data based on the understanding that it is an important aid in which of the following? A. Detecting information about possible tumor growth. B. Detecting evidence of hormone hypersecretion. C. Determining the presence or absence of testosterone levels. D. Determining the size of the organs and location.
B
Hypocalcemia is associated with which of the following manifestations? A. Polyuria B. Muscle twitching C. Fatigue D. Bowel hypomotility
B
The most common type of goiter is caused by lack of which of the following? A. Sodium B. Iodine C. Potassium D. Calcium
B
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? A. Oxygen saturation of 96% B. Temperature of 102ºF C. Heart rate of 62 D. Blood pressure 90/58 mm Hg
B
Which findings should a nurse expect to assess in client with Hashimoto's thyroiditis? A. Weight loss, increased urination, and increased thirst B. Weight gain, decreased appetite, and constipation C. Weight loss, increased appetite, and hyperdefecation D. Weight gain, increased urination, and purplish-red striae
B
Which of the following glands is considered the master gland? A.Parathyroid B. Pituitary C. Thyroid D. Adrenal
B
Which of the following hormones controls secretion of adrenal androgens? A. Calcitonin B. Adrenocorticotropic hormone (ACTH) C. Parathormone D. Thyroid-stimulating hormone (TSH)
B
Which symptom of thyroid disease is seen in older adults? A. Weight gain B. Atrial fibrillation C. Restlessness D. Hyperactivity
B
A nurse is caring for a client in addisonian crisis. Which medication order should the nurse question? A. Hydrocortisone (Cortef) B. Fludrocortisone (Florinef) C. Potassium chloride D. Normal saline solution
C
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? A. "I'll call my physician if I notice tingling around my lips." B. "I'll schedule a follow-up visit with my physician as soon as I get home." C. "I will increase my fluid and calcium intake." D. "I will take my pain medications according to the schedule we developed."
C
A nursing student asks the instructor why the pituitary gland is called the "master gland." What is the best response by the instructor? A. "It is the gland that is responsible for regulating the hypothalamus." B. "It regulates metabolism." C. "It regulates the function of other endocrine glands." D. "The gland does not have any other function other than to cause secretion of the growth hormones."
C
A postpartum client is receiving intravenous oxytocin (Pitocin) after birth. Why will this medication be used for this client after the birth of her child? A. Decreases the postpartum cramping B. Helps treat nausea C. Stimulates the contraction of the uterus and prevents bleeding D. Will prevent lactation for a woman who is bottle feeding her newborn
C
An instructor is preparing a teaching plan for a class on the various pituitary hormones. Which hormone would the instructor include as being released by the posterior pituitary gland? A. Prolactin B. Somatotropin C. Oxytocin D. Adrenocorticotropic hormone
C
Parathyroid hormone (PTH) has which effects on the kidney? A. Stimulation of phosphate reabsorption and calcium excretion B. Increased absorption of vitamin D and excretion of vitamin E C. Stimulation of calcium reabsorption and phosphate excretion D. Increased absorption of vitamin E and excretion of vitamin D
C
The nurse assesses a patient who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease? A. Sodium of 140 mEq/L B. A blood pressure reading of 135/90 mm Hg C. Potassium of 6.0 mEq/L D. Glucose of 100 mg/dL
C
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 A. discontinue all antithyroid medications. B. watch for symptoms of hyperthyroidism to disappear within 1 week. C. monitor for symptoms of hypothyroidism. D. continue radioactive precautions with all body secretions.
C
The nurse is reviewing the history and physical examination of a client diagnosed with hyperthyroidism. Which of the following would the nurse expect to find? A. Inability to tolerate cold B. Complaints of sleepiness C. Reports of increased appetite D. Thick hard nails
C
The nurse practitioner who assesses a patient with hyperthyroidism would expect the patient to report which of the following conditions? A. Dyspnea B. Fatigue C. Weight loss D. Hair loss
C
Which of the following precautions would be most appropriate when caring for a client being treated with radioactive iodine (RAI) for a thyroid tumor? A. Administer prescribed corticosteroids carefully. B. Administer the prescribed medications at the same time each day. C. Handle body fluids carefully. D. Monitor the respiratory status.
C
A client is receiving long-term treatment with high-dose corticosteroids. Which of the following would the nurse expect the client to exhibit? A. Weight loss B. Pale thick skin C. Hypotension D. Moon face
D
A client is suspected to have a pituitary tumor due to signs of diabetes insipidus. What initial test does the nurse help to prepare the client for? A. Radioimmunoassay B. A nuclear scan C. Radioactive iodine uptake test D. Magnetic resonance imaging (MRI)
D
A client with acromegaly has been given the option of a surgical approach or a medical approach. The client decides to have a surgical procedure to remove the pituitary gland. What does the nurse understand this surgical procedure is called? A. Thyroidectomy B. Ablation C. Hysteroscopy D. Hypophysectomy
D
A client with hyperthyroidism is concerned about changes in appearance. How can the nurse convey an understanding of the client's concern and promote effective coping strategies? A. Refer the client to professional counseling. B. Encourage the client to participate in outside activities to boost coping strategies. C. Suggest that the client wear cosmetics to cover any changes in appearance. D. Reassure the client that their emotional reactions are a result of the disorder and symptoms can be controlled with effective treatment.
D
A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the nurse do? A. Evaluate the quality of the client's voice postoperatively, noting any drastic changes. B. Observe for swelling of the neck, tracheal deviation, and severe pain. C. Monitor laboratory values daily for elevated thyroid-stimulating hormone. D. Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.
D
A nursing coordinator calls the intensive care unit (ICU) to inform the department that a client with a suspected pheochromocytoma will be admitted from the emergency department. The ICU nurse should prepare to administer which drug to the client? A. Insulin B. Dopamine (Inotropin) C. Lidocaine D. Nitroprusside
D
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? A. 50 pg/mL B. 100 to 300 pg/mL C. 100 pg/mL D. 450 pg/mL
D
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? A. brain B. liver C. cardiac atria D. kidneys
D
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: A. magnesium. B. sodium. C. potassium. D. phosphorus.
D
The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as which of the following? A. Dwarfism B. Acromegaly C. Simmonds' disease D. Gigantism
D
The typical triad of manifestations seen in a client diagnosed with pheochromocytoma does not include which of the following? A. Palpitations B. Headache C. Diaphoresis D. Hypotension
D
What is the most common cause of hyperaldosteronism? A. Excessive sodium intake B. A pituitary adenoma C. Deficient potassium intake D. An adrenal adenoma
D
Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome? A. Monitor bowel patterns. B. Monitor vital signs every 4 hours. C. Observe urine output. D. Observe the color of stool.
D
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? A. inhibit release of calcium into extracellular fluid B. promote urinary secretion of calcium C. decrease serum calcium level D. increase serum calcium level
d