Module 8 - Edge Questions

A clinician is working with a patient with type 2 diabetes mellitus, and the clinician wants to evaluate the patient's insulin production. What test can be used? A1c C-peptide test Islet antibody test Oral glucose tolerance test

C-peptide test

A patient arrives in a state of diabetic ketoacidosis. Which of the following are primary management strategies? Select all that apply. IV administration of insulin Carbohydrate ingestion Fluid replacement Potassium administration Diuretic

IV administration of insulin Fluid replacement Potassium administration

A patient with type 1 diabetes mellitus is going to begin an exercise program. Which of the following advice from the nurse is appropriate for the patient to avoid hypoglycemia? Make sure to take your insulin right before you begin to exercise. Restrict carbohydrates before and during exercise. If possible, work out with a partner who can recognize the signs of hypoglycemia. If your workout is over an hour, be prepared to give yourself insulin half-way through the workout.

If possible, work out with a partner who can recognize the signs of hypoglycemia.

In a patient suspected of having an endocrine disorder, which of the following diagnostic options may be considered first? Immunoassay of blood hormone levels Computed tomography (CT) scan Magnetic resonance imaging (MRI) Antibody testing

Immunoassay of blood hormone levels

Laboratory values for a patient reveal elevated parathyroid hormone (PTH) and elevated serum calcium levels. What condition is most likely? Primary hypoparathyroidism Primary hyperparathyroidism Secondary hyperparathyroidism Primary hyperthyroidism

Primary hyperparathyroidism

Hyperpituitarism is most commonly caused by which of the following? Prolactinoma Autoimmune disorder Congenital defect Sheehan syndrome

Prolactinoma

A patient has been diagnosed with syndrome of inappropriate anti-diuretic hormone (SIADH). Which of the following is the correct approach by the nurse? Frequently encourage the patient to drink water. Restrict fluid intake. Wait to see whether the patient stabilizes before any interventions. Plan to administer an IV for fluid restoration.

Restrict fluid intake.

Please place the following sequences in order to describe how iodine deficiency may lead to a goiter. Decreased iodine in diet Decreased thyroid hormone synthesis Increased thyroid-stimulating hormone (TSH) secretion Increased thyroid growth Decreased negative feedback on anterior pituitary

1. Decreased iodine in diet 2. Decreased thyroid hormone synthesis 3. Decreased negative feedback on anterior pituitary 4. Increased thyroid-stimulating hormone (TSH) secretion 5. Increased thyroid growth

A nurse is explaining to a patient how uncontrolled diabetes mellitus may eventually lead to amputation. What is the proper sequence of steps leading to this development? Nerve damage Decreased sensation Poor wound healing and increased infection Increased risk for wounds Hyperglycemia

1. Hyperglycemia 2. Nerve damage 3. Decreased sensation 4. Increased risk for wounds 5. Poor wound healing and increased infection

A patient has appeared in the emergency department with diabetic ketoacidosis. What are the steps that the nurse should explain, in the proper sequence, as to why the patient's respiration is now increased? Decrease in blood pH Inability to use carbohydrates for metabolism Increased ventilation Acidosis detected by chemoreceptors Ketone formation

1. Inability to use carbohydrates for metabolism 2. Ketone formation 3. Decrease in blood pH 4. Acidosis detected by chemoreceptors 5. Increased ventilation

A nurse is explaining how uncontrolled diabetes mellitus (DM) may lead to dehydration. Please place the following steps in the proper sequence to explain this development. Increased plasma blood glucose Osmotic diuresis by glucose in urine Transport maximum of kidney exceeded Fluid loss in urine Glucose enters urine

1. Increased plasma blood glucose 2. Transport maximum of kidney exceeded 3. Glucose enters urine 4. Osmotic diuresis by glucose in urine 5. Fluid loss in urine

A nurse is evaluating the need for patient education. Which of the following patients does the nurse consider most at risk for hypoglycemia? A person with type 1 diabetes mellitus (DM) who has not taken his inulin. A patient with type 2 DM on a single medication. A patient who is a cross-country runner with type 1 DM. A patient with type 2 DM who is managing the condition with diet and exercise changes.

A patient who is a cross-country runner with type 1 DM.

A mother is wondering how her child, who was recently diagnosed with type 1 diabetes mellitus, developed the disease. The nurse explains that which of the following is the number one cause of type 1 diabetes mellitus? Genetic defect Autoimmune disorder Obesity and sedentary lifestyle 95% of cases are of unknown origin

Autoimmune disorder

A patient insists that his blood glucose control has been excellent. Which of the following laboratory results would support this conclusion? A1c of 4.9% C-peptide results are normal No glucose in urine Patient's self-reported postprandial blood glucose results

A1c of 4.9%

A patient with diabetes states that he feels fine. A fasting blood glucose level reveals a slightly higher-than-normal value. The clinician wants to evaluate glycemic control over the preceding months. Which test will be most helpful? Oral glucose tolerance test Islet cell antibody test C-peptide test A1c test

A1c test

A nurse is assessing a patient for skin changes that can occur with diabetes mellitus (DM). Which of the following will the nurse note that is likely associated with diabetes mellitus? Red rash on chest Acanthosis nigricans Petechiae Purpura

Acanthosis nigricans

Which of the following conditions may present with low cortisol and elevated adrenocorticotropic hormone (ACTH) serum values? Addison's disease Cushing's syndrome Pheochromocytoma Hyperparathyroidism

Addison's disease

A patient presents with a strange complaint of "I am more tan than ever. I am seldom out in the sun, but I look so tan." Which laboratory values may be evaluated? Parathyroid hormone (PTH) Adrenocorticotropic hormone (ACTH) Growth hormone (GH) Epinephrine

Adrenocorticotropic hormone (ACTH)

A patient has very low cortisol levels. Which of the following tests may be appropriate? Dexamethasone suppression test Adrenocorticotropic hormone (ACTH) stimulation test Parathyroid hormone (PTH) stimulation test Dexamethasone activation test

Adrenocorticotropic hormone (ACTH) stimulation test

A patient is experiencing the Somogyi effect. Which of the following is the correct interpretation by the clinician? Increase bedtime insulin dosage. Encourage nighttime snacking. Restrict all insulin after noon. Alter insulin so peak does not occur during sleep.

Alter insulin so peak does not occur during sleep.

A patient with type 1 diabetes mellitus has glycated hemoglobin levels of 7.8%. The patient states his blood glucose levels have been perfect over the past several weeks. Which of the following is an appropriate response by the nurse? I don't think you are telling the truth about your blood glucose levels. All of your blood glucose values appear to be excellent. Although you may feel your blood glucose levels have been perfect, these additional test results reveal glycemic control needs to be improved. Your insulin regimen is apparently not working.

Although you may feel your blood glucose levels have been perfect, these additional test results reveal glycemic control needs to be improved.

A college athlete with diabetes is speaking about his upcoming training season. Which of the following recommendations may the clinician make to the athlete? When training, always have a high-fat snack available. Always have on hand an easily absorbable, high-glucose source. Ask your coach to monitor your blood sugar and insulin dosages during the training season. Increase your protein intake immediately before and during training.

Always have on hand an easily absorbable, high-glucose source.

A nurse is explaining to a patient that, although he feels "fine," glycemic control is important as chronic hyperglycemia has been associated with increased risk for which of the following? Osteoporosis Amputation Thyroid gland suppression Liver failure

Amputation

A patient's laboratory results reveal elevated adrenocorticotropic hormone (ACTH) and cortisol with lower-than-normal corticotropic releasing factor (CRF). Which tissue is likely the cause of the patient's endocrine disorder? Hypothalamus Adrenal cortex Posterior pituitary Anterior pituitary

Anterior pituitary

A patient needs a screening of anterior pituitary hormone functioning. Which hormone should not be included in the evaluation? Antidiuretic hormone Thyroid stimulating hormone (TSH) Growth hormone Follicle-stimulating hormone

Antidiuretic hormone

A patient states to a nurse that he is experiencing changes in the skin and tissue in the location he uses for his insulin injection. What is an appropriate response by the nurse? Ask the patient if he is rotating injection sites. Suggest that the patient is having an allergic reaction. Suggest that the patient switch insulin types. Ask the patient to refrain from insulin injections until the site heals.

Ask the patient if he is rotating injection sites.

Which of the following is the number one cause of adrenal insufficiency? Corticosteroid usage Radiation therapy Pituitary tumor Autoimmune destruction of the adrenal gland

Autoimmune destruction of the adrenal gland

A patient has recently been diagnosed with type 2 diabetes mellitus. He wants to know whether his disease can lead to any long-term problems. Which of the following may the nurse share as a long-term complication of diabetes mellitus? Hypoglycemia Blindness Diabetic ketoacidosis Dawn syndrome

Blindness

A patient with a traumatic brain tumor suffered a pituitary apoplexy. Which of the following does the nurse expect to encounter? Patient with limited signs and symptoms Blood laboratory values revealing elevated growth hormone-releasing hormone (GHRH), thyrotropic releasing hormone (TRH) and corticotropin-releasing factor (CRF) Hyperfunctioning of thyroid and adrenal gland Increased adrenocorticotropic hormone (ACTH) and thyroid-stimulating hormone (TSH) blood levels

Blood laboratory values revealing elevated growth hormone-releasing hormone (GHRH), thyrotropic releasing hormone (TRH) and corticotropin-releasing factor (CRF)

A patient is diagnosed with hyperglycemia hyperosmolar syndrome (HHS). Which of the following support this diagnosis? Select all that apply. Blood glucose < 70 mg/dL Blood osmolarity of 340 mOsm/L Arterial pH of 7.21 Tachycardia Hypotension

Blood osmolarity of 340 mOsm/L Tachycardia Hypotension

A patient has a parathyroid gland disorder. Which supplement may be needed? Potassium Sodium Calcium Iron

Calcium

Individuals with diabetes mellitus (DM) are at an increased risk for chronic infections with which of the following infectious agents? Clostridium difficile Escherichia coli Candia albicans Neisseria meningitidis

Candia albicans

A patient suffering for diabetes insipidus is given antidiuretic hormone (ADH). The result is increased fluid retention and decreased urine output. Which of the following conditions does the patient have? Nephrogenic diabetes insipidus Central diabetes insipidus Diabetes mellitus Syndrome of inappropriate diabetes insipidus (SIADH)

Central diabetes insipidus

A patient's parathyroid glands were damaged. What signs and symptoms does the nurse expect? Select all that apply. Tetany Chvostek's sign Trousseau's sign Low serum calcium Tingling sensation

Chvostek's sign Trousseau's sign Low serum calcium Tingling sensation

An order for a 24-hour urine collection has appeared. Which hormone is most likely being assessed? Oxytocin Thyroid stimulating hormone Cortisol Thyroxine

Cortisol

Which of the following hormones are not altered in a pheochromocytoma? Cortisol Aldosterone Epinephrine Norepinephrine Adrenal androgens

Cortisol Aldosterone Adrenal androgens

A patient is given an adrenocorticotropic hormone (ACTH)-stimulation test. Which of the following results will confirm hypofunctioning of the adrenal gland? Elevated ACTH Suppressed corticotropin releasing factor Cortisol levels less than expected Suppressed thyroid hormone levels

Cortisol levels less than expected

A dexamethasone suppression test is performed on a patient. The diagnosis is Cushing's syndrome. What was the result of the dexamethasone test? Cortisol levels were suppressed. Catecholamine levels remained elevated. Cortisol remained elevated. Catecholamine levels were suppressed.

Cortisol remained elevated.

A female patient appears at the clinic complaining that she "looks different." She states that her face is more rounded than normal, she has abnormal hair growth, and she feels like she gained fat around her back. What condition does the clinician suspect? Pheochromocytoma Hyperthyroidism Cushing's syndrome Addison's disease

Cushing's syndrome

Which of the following conditions are due to a hormone excess? Select all that apply. Cushing's syndrome Grave's disease Addison's disease Giantism Hashimoto's thyroiditis

Cushing's syndrome Grave's disease Giantism

Which of the following individuals would a nurse be most concerned about with respect to the development of Sheehan's syndrome? 15-year-old male Postpartum woman Young child with growth delay Postmenopausal woman

Postpartum woman

On a fundoscopic examination of a patient with diabetes mellitus (DM), proliferative retinopathy is noted. Which of the following is the correct interpretation? Positive sign of retinal recovery Loss of retinal blood vessels Occurrence of retinal detachment Damage to microvasculature of the retina

Damage to microvasculature of the retina

A nurse learns that a patient has presented with hypoglycemia. Which signs and symptoms does the nurse expect to observe? Select all that apply. Dizziness Hunger Sweating "Fruity" smelling breath Kussmaul's respirations

Dizziness Hunger Sweating

A nursing student asks whether there is a difference between Cushing's disease versus Cushing's syndrome. Which laboratory value can help differentiate Cushing's disease from Cushing's syndrome? Elevated adrenocorticotropic hormone (ACTH) Elevated cortisol Decreased cortisol Elevated epinephrine

Elevated adrenocorticotropic hormone (ACTH)

A patient with diabetes insipidus will likely have which of the following laboratory values? Elevated blood glucose Elevated plasma osmolarity Elevated urine osmolarity Elevated urine retention

Elevated plasma osmolarity

Because diabetes mellitus can damage the autonomic nervous system, the nurse wants to explain some signs and symptoms that the patient may experience. Which should she include on her list for a patient with disrupted autonomic nervous system functioning? Erectile dysfunction Skin appearance changes Sense of sustained muscle contraction Loss of sensation from the extremities

Erectile dysfunction

Because diabetes mellitus (DM) is associated with long-term complications, which of the following common follow-up care examinations are recommended? Select all that apply. Feet examinations Fundoscopic examinations Liver function analysis Skin examinations Tests for peptic ulcer disease

Feet examinations Fundoscopic examinations Skin examinations

A nurse is concerned about the poor glycemic control of a patient and the complaints of blurred vision by the patient. Which of the following is recommended? Fundoscopic examination Change in corrective eye wear LASIK surgery Cataract surgery

Fundoscopic examination

Insulin helps move glucose into cells. Which other hormones are counter-regulatory to insulin and work to raise blood glucose? Select all that apply. Glucagon Antidiuretic hormone (ADH) Thyroxine Cortisol Epinephrine

Glucagon Cortisol Epinephrine

An antibody test is ordered for an endocrine disorder. Which of the following conditions is commonly diagnosed by antibody test results? Multiple endocrine neoplasia Grave's disease Pheochromocytoma Cushing's syndrome

Grave's disease

Excess GH is caused by... Hypofunctioning of posterior pituitary. Hyperfunctioning of posterior pituitary. Hypofunctioning of anterior pituitary. Hyperfunctioning of anterior pituitary.

Hyperfunctioning of anterior pituitary.

A nurse sates that a patient has type 2 diabetes mellitus rather than type 1 diabetes mellitus (DM). Which laboratory value led her to this conclusion? Elevated A1c Glucose in urine Hyperinsulinemia High fasting blood glucose levels

Hyperinsulinemia

A patient with Addison's disease is at increased risk for an adrenal crisis. Which of the following does the nurse need to be aware of the patient developing? Select all that apply. Hyponatremia Hyperkalemia Hyperglycemia Polycythemia Elevated stress response

Hyponatremia Hyperkalemia

A patient suffering from severe stress and anorexia has the following laboratory values, which are all low: gonadotropin-releasing hormone (GnRH), growth hormone-releasing hormone (GHRH), and corticotropin-releasing factor (CRF). Which tissue is likely dysfunctional? Adrenal cortex Hypothalamus Posterior pituitary Anterior pituitary

Hypothalamus

A patient is treated for central diabetes insipidus. Which statement by the patient indicates that the treatment is working? I am going to the bathroom more now than ever. I don't feel as thirsty, and I am not drinking as much. I drink 1 L of water several times and day, and still it is not enough. I feel dehydrated all the time.

I don't feel as thirsty, and I am not drinking as much.

A patient presents in the emergency department with diabetic ketoacidosis. Which of the following treatments will be administered first? Fluid restriction IV administration of insulin Bicarbonate to correct acidosis Beta blockers

IV administration of insulin

A patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following would support this diagnosis? Select all that apply. Increased plasma osmolarity Increased plasma ADH levels Increased urine concentration Dehydration and fluid volume deficit Dilutional hyponatremia

Increased plasma ADH levels Increased urine concentration Dilutional hyponatremia

A pregnant woman wants to know why she needs to be concerned about gestational diabetes. What of the following are possible developments the nurse could share with the patient? Gestational diabetes can lead to newborns presenting with signs and symptoms similar to fetal alcohol syndrome. If you have gestational diabetes, you will be at a decreased risk for developing diabetes while not pregnant. Infants of mothers with gestational diabetes may develop macrosomia. Infants of mothers with gestational diabetes are more likely to develop vision problems.

Infants of mothers with gestational diabetes may develop macrosomia.

A man with type 1 diabetes mellitus is complaining of hunger, dizziness, and agitation. He thinks that he may be suffering from hypoglycemia. He has been counseled as to how to counteract hypoglycemia. Which of the following recommendations should he follow? Ingest 1 gram of fast-acting carbohydrates. Inject rapid-acting insulin. Ingest 15 grams of simple carbohydrates. Ingest 30 to 35 grams of simple carbohydrates.

Ingest 15 grams of simple carbohydrates.

Which of the following results is more indicative of type 1 rather than type 2 diabetes mellitus? Hyperglycemia Polyuria Ketones in urine Glucose in urine

Ketones in urine

Which of the following would indicate to a nurse that a patient has type 1 diabetes mellitus (DM) rather than type 2 DM? Glucose in urine Ketones in urine Blood in urine Albumin in urine

Ketones in urine

A patient with Hashimoto's thyroiditis is being given levothyroxine. The patient wants to know how the medication works. Which of the following responses is correct for the nurse to make? Levothyroxine blocks excess thyroid hormones. Levothyroxine stimulates thyroid receptors. Levothyroxine blocks the antibodies that cause Hashimoto's thyroiditis. Levothyroxine replaces missing thyroid hormone.

Levothyroxine replaces missing thyroid hormone.

A patient presents with hyperthyroidism. Which of the following values enables the clinician to rule out secondary hyperthyroidism? Low thyroid-stimulating hormone (TSH) Elevated thyroxine Low thyrotropic releasing hormone (TRH) Elevated T3 levels

Low thyroid-stimulating hormone (TSH)

A patient had to have surgery to remove a parathyroid gland tumor. What location of the body should the nurse help prepare for surgery? Superior abdomen Neck Mediastinum Near adrenal glands

Neck

A patient has a hyperfunctioning tumor of the parathyroid gland. Which of the following conditions may the patient be most at risk for? Coronary event Osteoporosis Severe weight loss Acromegaly

Osteoporosis

Reviewing a patient's chart, a nurse notes the presence of acromegaly. Which of the following is likely to be present when the nurse assesses the patient? Increased stature Cold intolerance Overgrowth of jaw, hands Galactorrhea

Overgrowth of jaw, hands

A patient has a tumor that compresses the posterior pituitary. Which hormones are likely affected? Select all that apply. Adrenocorticotropic hormone (ACTH) Growth hormone (GH) Oxytocin Thyroid stimulating hormone (TSH) Antidiuretic hormone (ADH)

Oxytocin Antidiuretic hormone (ADH)

A nurse is working with a patient who has had type 2 diabetes mellitus (DM) for several years. The nurse will need to keep in mind which of the following psychological aspects? Patients should be encouraged to refrain from getting emotional about having DM. So that patients with DM do not become discouraged, long-term complications of the disease should not be discussed. Schizophrenia may develop in those with DM for 10 or more years. People with DM are twice as likely to suffer depression.

People with DM are twice as likely to suffer depression.

A 24-hour urine collection reveals very elevated catecholamine levels. What may account for these results? Parathyroid gland tumor Anterior pituitary tumor Adrenal cortex tumor Pheochromocytoma

Pheochromocytoma

A patient is displaying signs and symptoms of an endocrine disorder. The patient also complains of headaches and visual disturbances. Which of the following tissues will likely require further evaluation? Parathyroid Thyroid Pituitary Adrenal cortex

Pituitary

A patient has a hyperfunctioning adrenal cortex tumor. Which of the following will the nurse expect to observe? Hypotension Suppressed adrenocorticotropic hormone (ACTH) levels Suppressed cortisol levels Weight loss

Suppressed adrenocorticotropic hormone (ACTH) levels

A patient's blood glucose levels are 90 mg/dL after an eight-hour fast. Which of the following is the correct assessment of these results? The blood glucose levels are normal. The blood glucose levels indicate prediabetes. The blood glucose levels indicate diabetes. The blood glucose levels indicate hypoglycemia.

The blood glucose levels are normal.

A nurse is educating a patient about hyperglycemia hyperosmolar syndrome (HHS). Which of the following points is correct information for patient to receive? HHS is a condition of low blood glucose. Make certain to always have a carbohydrate with you. The onset of HHS can occur slowly over time. Watch for elevating blood glucose levels. Because you have type 1 diabetes mellitus (DM), you are most at risk for HHS. HHS is not a serious condition. Many patients experience several bouts.

The onset of HHS can occur slowly over time. Watch for elevating blood glucose levels.

A nursing student notices elevated thyroid stimulating hormone (TSH) on laboratory values, along with low thyroxine levels. What is the proper interpretation of the results? The patient has secondary hypothyroidism. The patient has primary hypothyroidism. The patient has hyperfunctioning of the anterior pituitary. The patient has Grave's disease.

The patient has primary hypothyroidism.

A nurse is working with a patient who is performing "insulin purging." What is the correct association for the nurse to make? The patient is taking all her insulin in one shot per day. The patient is restricting insulin usage to promote weight loss. The patient is taking extra insulin to stimulate her metabolic rate. The patient is using only one site for her insulin injections.

The patient is restricting insulin usage to promote weight loss.

A patient with type 2 diabetes mellitus (DM) receives urinalysis results that are positive for albumin. What does the nurse suspect? The patient is dehydrated. The patient has entered renal failure. The patient may be developing diabetic nephropathy. The patient has a kidney stone.

The patient may be developing diabetic nephropathy.

A patient with type 2 diabetes mellitus, who is not on insulin, is experiencing morning hyperglycemia. Which of the following should be considered? The patient is obviously eating too many carbohydrates in the evening. The patient is developing early signs of type 1 diabetes mellitus. The patient's blood glucose falls overnight, and compensatory hormones elevate blood glucose in the morning. The patient should be on insulin.

The patient's blood glucose falls overnight, and compensatory hormones elevate blood glucose in the morning.

A nursing educator is working with students. Which of the following indicate correct understanding by the students in regards to hyperglycemia hyperosmolar syndrome (HHS)? Ketones will be elevated. The condition will have a sudden, rapid onset. The patient will likely present with dizziness and hypoglycemia. The risk of developing this condition increases with infection or severe stress.

The risk of developing this condition increases with infection or severe stress.

A mother comes the clinic wanting her child to be evaluated for diabetes mellitus, as she feels the child has some of the signs and symptoms. Which of the following would be signs and symptoms the child may display with diabetes mellitus? Hyperactivity and a lack of focus on activities Thirsty all the time, weight loss, and getting up in the night to urinate Lack of interest in activities, lethargy, and weight gain Nauseated, stomach bloating, and constipation

Thirsty all the time, weight loss, and getting up in the night to urinate

A patient presents with secondary hyperthyroidism. Which of the following values does the nurse expect to see reduced on the chart? Thyroid stimulating hormone (TSH) Thyroxine Thyrotropin releasing hormone (TRH) Triiodothyronine

Thyrotropin releasing hormone (TRH)

A patient is working towards better glycemic control. She has become frustrated though, saying how variable her measurements are. The nurse decides to review all the factors that influence her blood glucose levels. Which of the following should be included? Select all that apply. Timing and type of nutrient intake Physical activity Lipoprotein levels Status of insulin resistance Illness and stressors

Timing and type of nutrient intake Physical activity Status of insulin resistance Illness and stressors

A nursing student is reviewing signs and symptoms of hyperthyroidism. Which of the following should she include on her list? Select all that apply. Weight loss Tachycardia Lethargy Tremors Cold intolerance

Weight loss Tachycardia Tremors

A clinician is reviewing laboratory values, signs, and symptoms. Which of the following is more indicative of hyperglycemia hyperosmolar syndrome (HHS) rather than diabetic ketoacidosis (DKA)? Hyperglycemia Polydipsia pH> 7.3 Increased plasma osmolarity

pH> 7.3