pathophys chapter 41
A client diagnosed with type 2 diabetes has been instructed about managing his condition with diet. Which statements by the client indicate a need for additional education? Select all that apply. A) "I need to carefully limit my protein consumption." B) "I can drink 8 to 10 glasses of water daily without concern for calories." C) "I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads." D) "I need to limit the amount of foods that I eat that contain trans fats." E) "I need to avoid adding salt to my foods."
A) "I need to carefully limit my protein consumption." C) "I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads."
The nurse is working in a pediatric clinic. Which child would the nurse recognize as having isosexual precocious puberty? A) A 5-year-old black female with developing breasts and pubic hair B) A 9-year-old white female who has small breast buds C) A 14-year old white female who has not yet developed secondary sex characteristics D) A 10-year-old black female who has begun menstruating
A) A 5-year-old black female with developing breasts and pubic hair
A 48-year-old male client diagnosed with type 2 diabetes presents with the following: • Blood glucose level of 46 mg/dL (2.55 mmol/L) • Very lethargic • Has cool, clammy skin. Select the most appropriate intervention. A) Administer injectable glucagon B) Administer scheduled dose of insulin C) Encourage the client to sit up and drink 12 ounces of orange juice D) Place sugared breath mints in the client's mouth
A) Administer injectable glucagon
Which manifestations regarding hypothyroidism are accurate? Select all that apply. A) Anorexia B) Diarrhea C) Oily skin D) Onset of symptoms is gradual E) Weight gain
A) Anorexia D) Onset of symptoms is gradual E) Weight gain
A 25-year-old female client exhibits exophthalmos of both eyes. The health care provider recognizes this as a manifestation of: A) Graves disease B) Hashimoto thyroiditis C) Acquired hypothyroidism D) Myxedema
A) Graves disease
Which interventions would be included in the plan of care for a client experiencing myxedema coma? Select all that apply. A) Initiation of thyroid replacement therapy B) Reversal of hypoglycemia C) Oxygen therapy to support ineffective respirations D) Frequent monitoring of cardiac functions E) Rewarming to manage hypothermia
A) Initiation of thyroid replacement therapy B) Reversal of hypoglycemia C) Oxygen therapy to support ineffective respirations D) Frequent monitoring of cardiac functions
The diagnosis of type 1 diabetes would be confirmed by which principle? A) Insulin is not available for use by the body. B) Small amounts of insulin are produced daily. C) Insulin is produced but unavailable for use in the body. D) Insulin is present in large amounts for use by the body.
A) Insulin is not available for use by the body.
Management of hyperthyroidism would include which interventions? Select all that apply. A) Surgical removal of part of the gland or the entire gland B) Eradication of the gland with radioactive iodine C) Drug therapy directed toward decreasing the gland's function D) Lifelong glucocorticoid and mineralocorticoid therapies E) Excision of the existing cancerous tumor
A) Surgical removal of part of the gland or the entire gland B) Eradication of the gland with radioactive iodine C) Drug therapy directed toward decreasing the gland's function
A client is managing his type 2 diabetes with exercise and diet. He has a fasting blood sugar level (FBS) of 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (.05). Based on these findings, which of the following can the nurse assume? A) The client is achieving normal glycemic control. B) The client needs to modify his diet related to the low readings. C) The client is at risk for an insulin reaction. D) The client is at risk for developing hyperglycemia.
A) The client is achieving normal glycemic control.
Which statement best describes a secondary disorder of endocrine function? A) The disorder occurs when the target organ is normal, but stimulating hormones alter its function. B) The disorder occurs from hypothalamic dysfunction resulting in understimulation of the target organ. C) The disorder occurs in the target gland responsible for producing the hormone. D)The disorder occurs when the target organ becomes dysfunctional.
A) The disorder occurs when the target organ is normal, but stimulating hormones alter its function.
The health care provider is teaching a client about the metabolic effect of cortisol. The most appropriate information to provide would be: A) Suppression of the immune response to invasive pathogens B) Breakdown of proteins and fats C) Regulation of anti-inflammatory reactions D) Regulation of behavior and emotion
B) Breakdown of proteins and fats
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: A) "Insulin needs to go directly into the vein to work best." B) "Insulin is destroyed by the stomach contents and has to be administered by injection." C) "When your child gets old enough, you will not have to administer injections." D) "Your child is not old enough to swallow the pills needed to treat her diabetes."
B) "Insulin is destroyed by the stomach contents and has to be administered by injection."
The health care provider is reviewing diurnal variation pattern in adrenocorticotropic (ACTH) levels. Select the typical diurnal variation pattern in adrenocorticotropic (ACTH) levels. A) ACTH peaks in correspondence with food intake. B) ACTH peaks in the morning and declines throughout the day. C) ACTH increases in the morning and peaks again in the evening hours. D) ACTH maintains a consistent level regardless of the time of day.
B) ACTH peaks in the morning and declines throughout the day.
A client with a suspected diagnosis of primary hypothyroidism would most likely demonstrate which serum laboratory value? A) Decreased thyroid-stimulating hormone (TSH) and thyroxine (T4), and low T3 B) Elevated thyroid-stimulating hormone (TSH) and decreased thyroxine (T4) C) Decreased thyroid-stimulating hormone (TSH) related to poor thyroid function D) Elevated thyroid-stimulating hormone (TSH), thyroxine (T4), and T3
B) Elevated thyroid-stimulating hormone (TSH) and decreased thyroxine (T4)
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. A) Anxiety disorder B) Neuropathy C) Gastroparesis D) Nephropathy E) Retinopathy
B) Neuropathy C) Gastroparesis D) Nephropathy E) Retinopathy
The nurse is assessing a female client with a diagnosis of primary adrenal cortical insufficiency. Which manifestation should the nurse anticipate? A) Weight gain and fluid retention B) Sparse axillary and pubic hair C) Anorexia and increased excitability D) Pale skin and increased hunger
B) Sparse axillary and pubic hair
Which complication of acromegaly can be life threatening? A) Splayed teeth result in impaired chewing B) Vertebral changes result in kyphosis C) Cardiac structures increase in size D) Bone overgrowth causes arthralgias
C) Cardiac structures increase in size
Which disorder is a result of excess cortisol? A) Marfan syndrome B) Hashimoto disease C) Turner syndrome D) Cushing syndrome
D) Cushing syndrome
Select the most appropriate intervention for the nurse to teach a client diagnosed with distal symmetric neuropathy related to diabetes. A) Wear comfortable, open-toed shoes B) Decrease daily walking activity C) Rotate insulin injection sites once a week D) Inspect the feet for blisters daily
D) Inspect the feet for blisters daily
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? A) The client should not participate in any exercise activity that could utilize more thyroid hormone. B) The client should be informed that if he observes an increase in fatigue, an extra dose of his thyroid medication should be taken. C) The client should skip a dose of the thyroid supplement if he has symptoms of fever or restlessness. D) The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.
D) The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.