patho endocrine

Which pregnant woman likely faces the greatest risk of developing gestational diabetes? A client who:

is morbidly obese (defined as greater than 100 pounds over ideal weight).

A client's low serum T4 level has led to a diagnosis of hypothyroidism. When planning this client's care, the nurse should:

teach the client about the safe and effective use of synthetic thyroid hormones.

A nurse educator is conducting a course for newly diagnosed diabetes clients. Which statement by a participant should the nurse follow up first?

"I've had a little sore on the sole of my foot for a few days, but I'm sure it will eventually heal."

A nurse is evaluating clients for the risk of developing type 2 diabetes. Which client has the highest risk for developing this metabolic disorder?

A middle aged obese adult with a sedentary lifestyle

When providing nutrition education to the client with diabetes, the nurse should include which statement regarding fat intake?

"If you have diabetes, avoiding saturated fats is important."

The mother of a 2-year-old newly diagnosed with type 1 diabetes asks why insulin has to be given by injection. The best response by the nurse is:

"Insulin is destroyed by the stomach contents and has to be administered by injection."

Which factor contributes to an infant developing macrosomia (large body size)?

Maternal diabetes

A client with Graves disease has ophthalmopathy and asks the nurse if the eyes will stay like this forever. What is the best response by the nurse?

"With treatment of the hyperthyroid state, the ophthalmopathy usually tends to stabilize."

Following an oral glucose tolerance, a 36-year-old mother of 4 has been diagnosed with gestational diabetes mellitus (GDM), a problem that was not present in any of her previous pregnancies. What should her primary care provider tell her about this new health problem?

"Your baby could become too large or have low blood sugars if we're not vigilant about controlling your sugars."

Loss of pituitary function can result in deficiencies (or loss) of secretions of which hormones? Select all that apply.

Growth hormone Luteinizing hormone Follicle stimulating hormone Prolactin

The nurse is performing an assessment for a client who has hyperthyroidism that is untreated. When obtaining vital signs, what is the expected finding?

Heart rate 110 and bounding

The nurse is caring for a client with diabetes. Which of these findings is cause for concern, leading the nurse to initiate client education?

Hemoglobin A1C level is 8.7%.

A 30-year-old client who manages type 2 diabetes with glyburide presents at the emergency room reporting headache, confusion, and tachycardia. The client has come from a party at which the client drank two beers to celebrate running a half-marathon. Which is likely to be the cause of this client's?

Hypoglycemia

The diagnosis of type 1 diabetes would be confirmed by which principle?

Insulin is not available for use by the body.

Which metabolic abnormality can lead to the development of type 2 diabetes?

Insulin resistance

A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?

Random blood glucose 85 mg/dL (4.72 mmol/L)

The nurse is assessing a female client with a diagnosis of primary adrenal cortical insufficiency. Which manifestation should the nurse anticipate?

Sparse axillary and pubic hair

Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as a thyroid storm. What are the manifestations of a thyroid storm? Select all that apply.

Tachycardia Delirium Very high fever

The nurse is educating a newly diagnosed client with Hashimoto thyroiditis who is to be discharged from the acute care facility. What should the nurse be sure to include in the education to prevent complications?

The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.

The nurse is taking a health history from a client with acromegaly. The client informs the nurse that he is waking up several times a night and has been told he has sleep apnea. What does the nurse inform the client is the rationale for this syndrome?

There is an increase in pharyngeal soft tissue accumulation.

A client with type 1 diabetes mellitus wishes to stop taking insulin injections. What option is appropriate?

Using an insulin infusion pump

The nurse is caring for a client with diabetes who has developed gastroparesis. Which symptom does the nurse expect the client to report?

Vomiting after eating

An obese adult has recently been diagnosed with type 2 diabetes. The nurse knows that the most likely treatment plan for this client will include which topics?

Weight loss, glucose monitoring, and oral antihyperglycemic medications

The nurse screening for diabetes mellitus at a health fair obtains these results. Which client should be referred to a primary health care provider for further evaluation?

random blood glucose 195 mg/dl (10.8 mmol/l)

Select the most common symptoms of diabetes. Select all that apply.

Polydipsia Polyuria Polyphagia

When educating a client with possible glucocorticoid dysfunction, the nurse will explain that the CRH controls the release of ACTH. The best time to perform the blood test to measure peak ACTH levels would be:

06:00 to 08:00 AM

After receiving change-of-shift report about the following four clients, which client should the nurse assess first?

70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and an elevated temperature of 103.2°F (39.6°C)

Which pediatric assessment finding would the nurse recognize as an example of precocious puberty?

A 7-year-old female with early menarche

Which client would be considered to be exhibiting manifestations of "prediabetes"?

A middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL (10.49 mmol/L).

Impaired and delayed healing in a person with diabetes is caused by long-term complications that include:

Chronic neuropathies

One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisol-releasing hormone (CRH) and:

ACTH

The critical care nurse has just admitted a client with diabetic ketoacidosis (DKA) whose blood glucose level is 877 mg/dL (48.67 mmol/L). The client's breath has a fruity odor and the client is confused. Which of these does the nurse set as the priority at this time?

Administration of intravenous fluids

When educating a client about type 1 diabetes, the nurse will mention that this type is caused by which mechanism?

Autoimmune destruction of pancreatic beta cells

The results of a 44-year-old obese man's recent diagnostic workup have culminated in a new diagnosis of type 2 diabetes. Which pathophysiologic process underlies the client's new diagnosis?

Beta cell exhaustion due to long-standing insulin resistance

The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?

Beta cells

Which complication of acromegaly can be life threatening?

Cardiac structures increase in size

The nurse is caring for an adult client with growth hormone deficiency. When performing an assessment of this client, which system should the nurse be sure to assess for complications related to this disorder?

Cardiovascular system

A hospitalized client with diabetes mellitus has sudden onset of slurred speech; lack of coordination; and cool, clammy skin. What will the nurse do first?

Check blood glucose.

The parents of a child who is diagnosed with short stature ask what may have caused the abnormality. Which response by the nurse is most accurate? Select all that apply.

Chromosomal abnormalities GH deficiency Protein-calorie malnutrition Malabsorption syndromes

The newborn nursery nurse is obtaining a blood sample to determine if a newborn has congenital hypothyroidism. What long-term complication is the nurse aware can occur if this test is not performed and the infant has congenital hypothyroidism?

Cretinism

The nurse is caring for a client with prolonged growth hormone excess who is exhibiting syncope. What laboratory finding does the nurse recognize as consistent with this diagnosis?

Elevated blood glucose levels

Management of hyperthyroidism would include which interventions? Select all that apply.

Eradication of the gland with radioactive iodine Surgical removal of part of the gland or the entire gland Drug therapy directed toward decreasing the gland's function

A newly diagnosed adolescent with type 1 diabetes read online that diabetes is the leading cause of blindness among Americans. Which statement would be the most accurate information to share with the client along with preventive measures?

Explain that almost all people with diabetes do experience some degree of vision loss.

A 15-year-old child with type 1 diabetes asks nurse about the potential to "lose sight." Which response would be the most appropriate?

Explain that many people with diabetes experience some complications like retinopathy, but these are best prevented with tight control of glucose levels.

A nurse is teaching a client with newly diagnosed type 1 diabetes about the importance of blood glucose control to decrease the risk of which potential chronic complications of diabetes? Select all that apply.

Gastroparesis Nephropathy Retinopathy Neuropathy

Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur?

Genetic predisposition environmental triggering event T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen

The nurse is caring for a client who received regular insulin at 7 am. Four hours later the nurse finds the client diaphoretic, cool, and clammy. Which of these interventions is the priority?

Give the client a concentrated carbohydrate.

The family of a client in the hospital with diabetes mellitus that is out of control asks the nurse to explain the client's recent weight loss while eating more than usual. How will the nurse respond?

Glucose is unused without insulin, so body fats are used for energy.

A client with diabetes will be undergoing an evaluation of the fluctuation of blood glucose over the previous 120-day span. Which test will this client undergo?

Glycosylated hemoglobin

Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:

Graves disease

A nurse is assessing a client who is experiencing hypoglycemia caused by an insulin reaction. The client is conscious and can follow directions. Which intervention is most appropriate at this time?

Immediately administer a rapidly absorbed form of glucose (preferably via oral route if the client is alert enough to swallow).

When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptom does the client report that the nurse would find associated with this disorder?

Increase in appetite

A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing?

Increased levels of ACTH

An overweight, 14-year-old boy feels tired all the time. He sleeps 12 to 14 hours a day and has a voracious appetite but no energy to burn off the calories. He has been diagnosed with hypothyroidism brought about by the accumulation of a nonpitting mucosal edema. For which life-threatening condition should his care team be prepared?

Myxedema coma

The most common cause of thyrotoxicosis is Graves disease. When assessing this client, the nurse should put priority on which sign/symptom?

Ophthalmopathy

The newborn nursery nurse is preparing to perform a required neonatal screening for congenital hypothyroidism. What should the nurse do to obtain the necessary sample?

Perform a heel stick to obtain a drop of blood for a T4 and TSH.

Which individual is experiencing the effects of a primary endocrine disorder?

Person who has low calcium levels because of the loss of the parathyroid gland

The nurse knows that the client with which complication of diabetes has the greatest risk for the development of foot ulcers?

Sensory neuropathy

Precocious puberty is a disorder that occurs in both boys and girls. Which condition may occur in adults due to precocious puberty?

Short stature in adults

A parent arrives in the endocrinology clinic with her 8-year-old son, concerned about his rapid development and tall stature. What significant assessment finding does the nurse recognize is important to report to the physician related to the development of precocious puberty?

Significant genital enlargement

Which clinical manifestations following thyroidectomy would alert the nurse that the client is going into a life-threatening thyroid storm? Select all that apply.

Temperature of 104.2°F (40.1°C) Telemetry showing heart rate of 184 Extremely agitated

The nurse is teaching a client with diabetes about the signs and symptoms of hypoglycemia. The client asks, "Why will I get headache, disturbed behavior, coma, and seizures if it's my pancreas that's impaired?" Which response is the best explanation?

The brain relies on blood glucose as its main energy source.

A child is born with dwarfism to normal-sized parents. The nurse is explaining how growth hormone (GH) plays a central role in the increase in stature that characterizes childhood and adolescence. What is the first step in the growth hormone chain of events?

The hypothalamus secretes GH-releasing hormone.

A newborn is screened for congenital hypothyroidism and is found to have the disorder. When educating the mother about the importance of the infant taking thyroid hormone supplement, what should be included in the education?

The infant will have dosage levels adjusted as he grows.

A client with long-standing type 2 diabetes is surprised to see high blood sugar readings while recovering from an emergency surgery. Which factor may have contributed to the client's inordinately elevated blood glucose levels?

The stress of the event caused the release of adrenal cortical hormones.

The hallmark manifestations of Cushing syndrome are a moon face, a "buffalo hump" between the shoulder blades, and a protruding abdomen. What other manifestations of Cushing syndrome occur?

Thin extremities and muscle weakness

A client who has just undergone a thyroidectomy is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these findings as manifestations of which complication?

Thyroid storm

The obstetrical nurse is caring for a client who has been treated for gestational diabetes. When teaching the client about the causes of gestational diabetes, the nurse should include which risk factor in the teaching?

Woman with a family history of diabetes

Which individual displays the precursors to acromegaly?

An adult with an excess of growth hormone due to an adenoma

Diabetic ketoacidosis (DKA) in a client with type 1 diabetes occurs when the lack of insulin leads to the release of which physiologic product?

Fatty acids