Targeted Practice Endocrine
A nurse is caring for a client who has a pheochromocytoma. Which of the following actions should the nurse take? a. Elevate the head of the client's bed. b. Palpate the client's abdomen. c. Monitor the client for hypotension. d. Check the client's urine specific gravity.
A
A nurse has administered propranolol by IV bolus to a client who is having a thyroid storm. Which of the following findings indicates that the client is having a therapeutic response? a. Reduction of the effects of thyroid hormone on the heart b. Blockage of the release of thyroid hormone from the thyroid gland c. Increase in the heart's sensitivity to thyroid hormone d. Increase in the uptake of thyroid hormone by the thyroid gland
A
A nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following findings should the nurse report to the provider? a. Sodium 110 mEq/L b. 2+ deep-tendon reflexes c. Potassium 3.7 mEq/L d. Urine specific gravity 1.025
A
A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include? a. "Take this medication on an empty stomach." b. "Take this medication with an antacid." c. "Change position slowly while taking this medication." d. "Limit your fluid intake while taking this medication."
A
A nurse is managing the care of a client who is postoperative and has acute adrenal insufficiency. Which of the following actions should the nurse take? a. Administer IV hydrocortisone sodium. b. Give oral spironolactone. c. Infuse 1 unit of platelets. d. Restrict daily fluid intake.
A
A nurse is monitoring a client's status 24 hours after a total thyroidectomy. Which of the following findings should the nurse report to the provider? a. Laryngeal stridor b. Productive cough c. Pain with hyperextension of the neck d. Hoarse, weak voice
A
A nurse is monitoring the laboratory values of a client who has diabetes mellitus and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy? a. Fasting blood glucose 96 mg/dL b. Postprandial blood glucose 195 mg/dL c. Random blood glucose 210 mg/dL d. Preprandial blood glucose 60 mg/dL
A
A nurse is reviewing laboratory values for a client who has diabetic ketoacidosis (DKA). Which of the following results should the nurse expect? a. pH 7.32, PaCO2 36 mm Hg, HCO3- 14 mEq/L b. pH 7.38, PaCO2 55 mm Hg, HCO3- 22 mEq/L c. pH 7.44, PaCO2 40 mm Hg, HCO3- 24 mEq/L d. pH 7.50, PaCO2 42 mm Hg, HCO3- 30 mEq/L
A
A nurse is teaching a client who has an autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following effects should the nurse include? (select all that apply) a. Osteoporosis b. Moon-shaped face c. Increased risk of infection d. Hearing loss e. Weight loss
A, B, C
A nurse is assessing a client who has diabetes insipidus. The nurse should expect which of the following findings? a. Decreased heart rate b. Increased hematocrit c. High urine specific gravity d. Low BUN level
B
A nurse is assessing a client who has diabetes mellitus and reports feeling anxious. Which of the following findings should the nurse expect if the client is hypoglycemic? a. Rapid, deep respirations b. Cool, clammy skin c. Abdominal cramping d. Orthostatic hypotension
B
A nurse is caring for a client who has diabetes mellitus and has developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to the client's feet? a. Examine the skin of the feet feet weekly for alterations in skin integrity. b. Monitor the temperature of bath water with a thermometer. c. Shop for shoes early in the day. d. Round the edges of toenails when trimming them.
B
A nurse is planning teaching for a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include? a. Consume no more than three servings of alcohol per day. b. Ingest food with alcohol to reduce alcohol-induced hypoglycemia. c. Increase insulin dosage before planned exercise. d. Rest for 3 days between periods of vigorous exercise.
B
A nurse is providing discharge teaching for a client who has diabetes insipidus and has a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching? a. "Depress the pump once before using the nasal spray for the first time." b. "Blow your nose gently prior to using the nasal spray." c. "Administer the nasal spray while in a side-lying position." d. "Notify the provider if you develop numbness or tingling around the mouth."
B
A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following statements should the nurse identify as an indication that the client understands the information about this test? a. "I need to fast after midnight the night before the test." b. "This test's result is a good indicator of my average blood glucose levels." c. "A level of 8 to 10 percent suggests adequate blood glucose control." d. "I will use my hemoglobin A1c level to adjust my daily insulin doses."
B
A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings? a. Cold intolerance b. Lethargy c. Tremors d. Sunken eyes
C
A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect? a. Decreased blood pressure b. Weight loss c. Hirsutism d. Increased skin thickness
C
A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect? a. Moon-shaped face b. Weight gain c. Calcium 12.8 mg/dL d. Sodium 150 mEq/L
C
A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia? a. Strong, bounding pulse b. Decreased bowel sounds c. Tingling and numbness of the hands and feet d. Diminished deep-tendon reflexes
C
A nurse is caring for a client who is taking propylthiouracil. The nurse should identify that the client has met the treatment goals when she reports an increase in which of the following manifestations? a. Increased ability to sweat b. Increased bowel movements c. Increased body weight d. Increased libido
C
A nurse is teaching a client who has diabetes mellitus about insulin injections. The client's prescription includes evening doses of insulin glargine and regular insulin. Which of the following instructions should the nurse include? a. Inject the insulins intramuscularly. b. Shake the insulins vigorously prior to administration. c. Draw up the insulins into separate syringes. d. Expect the insulins to appear cloudy.
C
A nurse is teaching a client who has type 1 diabetes mellitus about how to prevent complications during illness. Which of the following statements should the nurse identify as an indication that the client understands the teaching? a. "I should stop taking my insulin if I feel nauseous." b. "I will test my urine for protein when I start to feel ill. "c. "I will call my doctor if my blood sugar is more than 250." d. "I should check my blood sugar level every 8 hours."
C
A home health nurse is assessing a client who requires lifelong hormone replacement therapy for the treatment of hypothyroidism. The client has not been taking his medication regularly. Which of the following findings should the nurse expect? a. Increased urine output b. Persistent diarrhea c. Tachycardia d. Hypotension
D
A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements should the nurse identify as an indication that the client understands the teaching? a. "I will let my feet air dry after washing." b. "I will wear sandals to allow air to circulate around my feet." c. "I will buy over-the-counter medicine to treat the calluses on my feet." d. "I will apply lotion to the dry areas of my feet but not between my toes."
D
A nurse is caring for a client undergoing screening for primary Cushing's disease. The nurse should expect an elevation in which of the following laboratory findings? a. Lymphocyte count b. Potassium c. Calcium d. Glucose
D
A nurse is caring for a client who has type 2 diabetes mellitus and has hyperglycemic-hyperosmolar state (HHS). Which of the following laboratory findings should the nurse expect? a. Serum pH 7.32 b. Blood glucose 250 mg/dL c. Blood glucose 425 mg/dL d. Serum pH 7.45
D
A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires intranasal desmopressin. Which of the following information should the nurse include in the teaching plan? a. "Drink at least 3 liters of fluid per day." b. "Weigh yourself weekly while wearing similar clothing at the same time of day." c. "Notify the provider of a weight loss of 1 pound or more per week." d. "Report nocturia because it requires a dosage adjustment."
D
A nurse is teaching a client about the adrenocorticotropic hormone (ACTH) stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders? a. Diabetes insipidus b. Hyperthyroidism c. Pheochromocytoma d. Addison's disease
D
A nurse is teaching a client who has diabetes mellitus. Which of the following should the nurse include as an expected finding of diabetic ketoacidosis (DKA)? a. Decreased urine output b. Weight gain of 0.45 kg (1 lb) in 24 hr c. Rapid, shallow respirations d. Blood glucose levels above 300 mg/dL
D
To screen a client for pheochromocytoma, a nurse schedules a vanillylmandelic acid test. When teaching the client about this test, which of the following instructions should the nurse include? a. "Start fasting at midnight prior to the day of the test." b. "Begin the 24-hour urine collection with the first morning urination." c. "Take low-dose aspirin for pain during the testing period." d. "Restrict coffee intake 2 to 3 days prior to the test."
D
