Unit 5 EAQ

Which hormone does the nurse state binds to the receptor site on the surface of a target cell?

Water-soluble hormones have receptors on the surface of a target cell. Adrenaline is a water-soluble hormone. Lipid-soluble hormones have receptors inside the target cell. Estrogen, aldosterone, and hydrocortisone are lipid-soluble hormones ADRENALINE

A nurse teaches a client who has had a thyroidectomy for thyroid cancer to observe for signs of surgically induced hypothyroidism. What should be included in the teaching plan? Select all that apply.

Dry skin

A client is admitted for hypertension, and serum electrolyte studies have yielded abnormal results. The scheduled workup includes a scan for an aldosteronoma. What gland is affected in aldosteronoma?

An aldosteronoma is an aldosterone-secreting adenoma of the adrenal cortex. An aldosteronoma is not a tumor of the kidney cortex. An aldosteronoma is not a tumor of the thyroid gland. An aldosteronoma is not a tumor of the pituitary gland. ADRENAL CORTEX

Which clinical findings are observed in a client suffering from an imbalance of adrenocorticotropic hormone? Select all that apply. Anorexia Hyponatremia Slowed cognition Postural hypotension Decreased muscle strength

Anorexia Hyponatremia Postural hypotension

A nurse explains to a client with diabetes that self-monitoring of blood glucose is preferred to urine glucose testing. Why is blood glucose monitoring preferred?

blood glucose is more accurate

Which hormones does the nurse state are released by the hypothalamus? Select all that apply.

Melanocyte-inhibiting hormone (MIH) Correct4 Corticotropin-releasing hormone (CRH) Correct5 Growth hormone-releasing hormone (GHRH)

A client who has had a subtotal thyroidectomy does not understand how hypothyroidism can develop when the problem was initially hyperthyroidism. On what fact should the nurse base her response?

There may not be enough thyroid tissue to supply adequate thyroid hormone.

The nurse is assessing a client suspected of having hypercortisolism. Which questions should the nurse ask to help confirm the diagnosis? Select all that apply. "Did you lose any weight unintentionally?" 2 "Did you notice your extremities to be thin?" 3 "Did you notice any roughness of your skin?" 4 "Did you notice any skin darkening recently?" 5 "Did the hair on your body become thicker?

"Did the hair on your body become thicker "Did you notice your extremities to be thin?"

A client has a tentative diagnosis of Cushing syndrome. The nurse's physical assessment of this client is likely to reveal the presence of:

Hypertension and moon face

What symptoms will the nurse identify when assessing a client with Graves disease? Constipation, dry skin, and weight gain Lethargy, weight gain, and forgetfulness Weight loss, exophthalmos, and restlessness Weight loss, protruding eyeballs, and lethargy

Weight loss, exophthalmos, and restlessness Weight loss and restlessness occur because of an increased basal metabolic rate; exophthalmos occurs because of peribulbar edema. Constipation, dry skin, and weight gain are associated with hypothyroidism because of the decreased metabolic rate. Lethargy and weight gain are associated with hypothyroidism as a result of a decreased metabolic rate; forgetfulness is not related. Although weight loss and exophthalmos occur with hyperthyroidism, the client will be hyperactive, not hypoactive.

What drug can cause diabetes Insipidus

Demeclocycline

While reviewing the client's laboratory reports, the nurse finds that there is an elevation in the client's growth hormone levels. Which key features does the nurse assess to rule out the occurrence of acromegaly Changes in facial shape Changes in body weight Changes in the chest shape Changes in the lip thickness Changes in the length of hands

Changes in the chest shape Correct4 Changes in the lip thickness Correct5 Changes in the length of hands

The nurse is caring for a client newly diagnosed with diabetes. When preparing the teaching plan about the importance of yearly eye examinations, the nurse should instruct the client on which eye problem most associated with diabetes?

Diabetic retinopathy is a leading cause of blindness in diabetics. Glaucoma and cataracts also are associated with diabetes, but retinopathy is the most common eye problem. Astigmatism is not associated with diabetes.

A client is admitted to the hospital with diabetic ketoacidosis. The nurse concludes that the client's elevated ketone level is caused by incomplete oxidation of which nutrient?

Fats Incomplete oxidation of fat results in fatty acids that further break down to ketones. Protein metabolism produces nitrogenous waste, causing elevated blood urea nitrogen (BUN), not ketones. Potassium is not oxidized; potassium is not directly associated with ketones. Carbohydrates do not contain fatty acids that are broken down into ketones.

A nurse is caring for a newly admitted client with a diagnosis of Graves disease. In preparing a teaching plan, the nurse anticipates which diet will be prescribed for this client? High-calorie diet Low-sodium diet High-roughage diet Mechanical-soft die

High-calorie diet Because of the individual's increased metabolic rate, a high-calorie diet is needed to meet the energy demands of the body and prevent weight loss. Sodium is not restricted because clients with hyperthyroidism perspire heavily and lose sodium. Gastrointestinal motility is increased and does not require the additional stimulus of increased roughage. Modification of dietary consistency is unnecessary.

What are the cardiovascular manifestations observed in a client with adrenal insufficiency?

Hyponatremia is a decrease in serum sodium levels, which is the cardiovascular manifestation of adrenal insufficiency. Fatigue is a neuromuscular manifestation observed in clients with adrenal insufficiency, while salt cravings and weight loss are the abdominal manifestations observed in clients with adrenal insufficiency.

A primary healthcare provider writes prescriptions addressing the needs of a client with Addison disease. Which outcome does the nurse conclude is the main focus of treatment for this client Decrease in eosinophils Increase in lymphoid tissue Restoration of electrolyte balance Improvement of carbohydrate metabolism

Lack of mineralocorticoids causes hyponatremia, hypovolemia, and hyperkalemia. Dietary modification and administration of cortical hormones are aimed at correcting these electrolyte imbalances, which can be life threatening. There is no disturbance in the eosinophil count. Lymphoid tissue does not change. Although glucocorticoids are involved in metabolic activities, including carbohydrate metabolism, the primary aim of therapy is to restore electrolyte imbalance.

A client's parathyroid glands are removed. What clinical manifestation is indicative of the fluid and electrolyte imbalance associated with this surgery?

Muscle spasms Removal of the parathyroids causes hypocalcemia and associated neuromuscular irritability. Constipation is a sign of hypercalcemia. Hypoactive reflexes are signs of hypercalcemia. Increased specific gravity is a sign of fluid volume deficit.

Which hormones are secreted by the client's hypothalamus? Select all that apply.

The hormones that are secreted by the hypothalamus include prolactin-inhibiting hormone and corticotropin-releasing hormone. Growth hormone, follicle-stimulating hormone, and melanocyte-stimulating hormone are hormones secreted by the anterior pituitary gland.

Which is the target tissue for the parathyroid hormone?

The target tissue of the parathyroid hormone is the INTESTINES. Growth hormone acts on all body cells. The mammary gland is the target tissue of oxytocin. Epinephrine and non-epinephrine acts on the sympathetic effectors.

Which intervention should the nurse provide while caring for an older adult client who is reported to have decreased estrogen production? se minimal tape on client's skin. Cover the client with warm clothing. Perform blood glucose test for the client Monitor for bradycardia

Use minimal tape on client's skin. Decreased estrogen production associated with aging affects skin texture and makes the skin dry and thin. Therefore the nurse should refrain from using tape on the client's skin to prevent skin injury. Warm clothing and monitoring heart rate are needed for older adult clients with decreased general metabolism or hypothyroidism but are not relevant with estrogen deficiency. A client exhibiting signs of decreased glucose tolerance, such as slow wound healing and recurrent yeast infections, should be tested for blood glucose levels.

After assessing a client, the nurse anticipates that the client has hyperpituitarism. Which questions asked by the nurse helps confirm the diagnosis? Select all that apply. Is there any change in your vision?" Do you experience severe headaches?" Are you suffering with frequent urination?" "Do you eat more than five times a day?" Is there any change in your menstrual cycle?

"Is there any change in your vision?" Correct2 "Do you experience severe headaches? "Is there any change in your menstrual cycle?" Hyperpituitarism manifests with vision disturbances and severe headaches. Due to hypersecretion of prolactin in females, a change in menstrual cycle may also be observed. Frequent urination is observed in a client with diabetes insipidus. Clients with diabetes mellitus experience intense hunger.

Which hormonal deficiency reduces the growth of axillae and pubic hair in female clients

Adrenocorticotropic hormone

A nurse is reviewing the diagnostic blood tests of a client with a diagnosis of type 1 diabetes. Which laboratory results support the nurse's suspicion that the client is experiencing ketoacidosis?

Blood glucose of 300 mg/100 mL (16.7 mmol/L), blood pH of 7.20

What are the neurologic manifestations of hyperthyroidism? Select all that apply. Fatigue Diaphoresis Blurred vision Exophthalmos Shallow respirations

Blurred vision Exophthalmos

The nurse is assisting the primary healthcare provider, who is examining the client's skull radiograph. An abnormality in the endocrine gland situated in a depression of the sphenoid bone is suspected. Which hormone release is most probably affected? Glucagon Cortisol Aldosterone Corticotropin

Corticotropin The pituitary gland is the endocrine gland that is situated in a bony depression of the sphenoid bone. Corticotropin or adrenocorticotropic hormones are secreted by the anterior pituitary and could be affected by an abnormality in the pituitary. Glucagon is a hormone that is secreted by the pancreas. Cortisol and aldosterone are hormones secreted by the adrenal cortex. There is less likelihood that the release of glucagon, cortisol, or aldosterone might be affected by a suspected abnormality in the pituitary gland.

When assessing a client with Graves disease (hyperthyroidism), what would the nurse expect to find in the client's history? Diaphoresis Menorrhagia Dry, brittle hair Sensitivity to cold

Diaphoresis Increased basal metabolic rate, increased circulation, and vasodilation result in warm, moist skin. Menorrhagia, sensitivity to cold, and dry, brittle hair are associated with hypothyroidism.

While assessing a client during a routine examination, a nurse in the clinic identifies signs and symptoms of hyperthyroidism Diaphoresis Weight loss Constipation Protruding eyes Cold intolerance

Diaphoresis, weight loss, protuding eyes

A client reports their lips feel thicker, as well as joint pain and coarse facial features. What should the nurse suspect as the cause of the anterior pituitary hyperfunction?

Excessive secretion of growth hormone

A nurse is caring for a client with Addison disease. Which information should the nurse include in a teaching plan to encourage this client to modify dietary intake?

Extra salt is needed to replace the amount being lost caused by lack of sufficient aldosterone to conserve sodium.

A nurse is assessing a client with a suspected pituitary tumor. Which assessment finding is consistent with a pituitary tumor? Tetany Seizures Lethargy Hyperreflexia

Seizures are common in clients who have pituitary tumors. Tetany is associated with severe hypocalcemia; that condition can be caused by hypoparathyroidism. Lethargy is found in clients with hypothyroidism. Hyperreflexia is observed in clients with hyperthyroidism and hypoparathyroidism.

On reviewing the data of a client with thyroid disorder, the primary healthcare provider prescribed atenolol. Which assessment findings would indicate the need for atenolol therapy? Select all that apply. Tachycardia Correct2 Atrial fibrillation 3 Distant heart sounds Correct4 Systolic hypertension Incorrect5 Decreased cardiac output

Tachycardia Atrial fibrillation Systolic hypertension In hyperthyroidism, atenolol is prescribed to reduce cardiac manifestations. Tachycardia, atrial fibrillation, and systolic hypertension are cardiac manifestations associated with hyperthyroidism. Distant heart sounds are associated with hypothyroidism. The cardiac output is increased in hyperthyroidism.

A nurse is caring for a client who had a thyroidectomy. Which client response should the nurse assess when concerned about an accidental removal of the parathyroid glands during surgery? Tetany Myxedema Hypovolemic shock Adrenocortical stimulation

Tetany Parathyroid removal eliminates the body's source of parathyroid hormone (parathormone), which increases the blood calcium level. The resulting low body fluid calcium affects muscles, including the diaphragm, resulting in dyspnea, asphyxia, and death. Loss of the thyroid gland will upset thyroid hormone balance and may cause myxedema. The parathyroids are not involved in regulating plasma volume; the pituitary and adrenal glands are responsible. The parathyroids do not regulate the adrenal glands.

After a head injury, a client develops a deficiency of antidiuretic hormone (ADH). What should the nurse consider before assessing the patient about the response to secretion of ADH? serum osmolarity increases Urine concentration decreases Glomerular filtration decreases Tubular reabsorption of water increases

Tubular reabsorption of water increases Reabsorption of sodium and water in the kidney tubules decreases urinary output and retains body fluids. There is no effect on filtration with ADH; ADH increases reabsorption in the tubules. The opposite is true of serum osmolarity increase, urine concentration decrease, and tubular reabsorption of water increase.

The nurse caring for a client with diabetic ketoacidosis (DKA) can expect to implement which intervention? Intravenous administration of regular insulin Administer insulin glargine subcutaneously at hour of sleep Maintain nothing prescribed orally (NPO) status Intravenous administration of 10% dextrose

A client admitted with DKA will have a blood glucose value greater than 250 and blood ketones. Intravenous (IV) administration of regular insulin is needed to rid the body of ketones and regulate blood glucose. Administration of insulin glargine is not going to reverse the ketoacidosis. The client will be allowed fluids to maintain hydration. Administration of 10% dextrose IV will increase the client's blood glucose.

A nurse is caring for a client with Cushing syndrome. Which cardiovascular complication should the nurse assess for in this client?

Hypertension Hypertension is a cardiovascular complication found in clients with Cushing syndrome due to increased metabolic demands and catecholamines. Chest pain is seen in clients with hyperthyroidism and hypothyroidism. Tachycardia and atrial fibrillation are manifestations of dysrhythmias, which are associated with hypothyroidism or hyperthyroidism, parathyroidism, and pheochromocytoma.

Postoperatively, a client who had a thyroidectomy complains of tingling and numbness of the fingers and toes, and the nurse observes muscle twitching. Which complication does the nurse suspect the client is experiencing? Hypokalemia Hypocalcemia Thyrotoxic crisis Hypovolemic shock

The signs and symptoms presented in the question indicate hypocalcemia. Injury to the parathyroid glands during a thyroidectomy results in a deficiency of parathormone, which decreases calcium levels in the blood. Hypokalemia is characterized by generalized weakness, a decrease in reflexes, shallow respirations, and cardiac dysrhythmias. Thyrotoxic crisis is characterized by tachycardia, hyperpyrexia, and an exacerbation of hyperthyroid symptoms. Hypovolemic shock is characterized by a weak, thready pulse and hypotension.

A nurse is caring for a client with hypothyroidism. Which clinical manifestations should the nurse anticipate when assessing this client? Select all that apply. Dry skin Brittle hair Weight loss Resting tremors Heat intolerance

brittle skin dry skin Dry skin results from a decrease in the metabolic rate, which is associated with hypothyroidism. Dry, brittle hair results from a decrease in the metabolic rate, which is associated with hypothyroidism. Weight loss is associated with hyperthyroidism because of an increase in body metabolism. Resting tremors are not associated with hypothyroidism; they are associated with Parkinson's disease. Heat intolerance is associated with hyperthyroidism, not hypothyroidism, because of the increase in body metabolism

Which clinical findings should the nurse expect when assessing a client with hyperthyroidism? Select all that apply.

diarrhea weight loss

Which hormone synthesis does the nurse state is inhibited by hypokalemia?

Aldosterone

Which hormonal deficiency causes diabetes insipidus in a client?

ADH deficiency causes diabetes insipidus. Decreased levels of prolactin may cause decreased amounts of milk secretion after birth. Decreased levels of thyrotropin cause hypothyroidism, weight gain, and lethargy. LH deficiency causes menstrual abnormalities, decreased libido, and breast atrophy.

What are the primary causes of adrenal insufficiency? Select all that apply.

Acquired immune deficiency syndrome Tuberculosis Hemorrhage

A client has a glycosylated hemoglobin measurement of 6%. What should the nurse conclude about this client when planning teaching strategies based on the results of this laboratory test? The client is experiencing a rebound hyperglycemia. 2 The client needs the insulin changed to a different type. Correct3 The client has followed the treatment plan as prescribed. 4 The client requires further teaching regarding nutritional guidelines

The expected range of glycosylated hemoglobin (HbA1C) is 4.4% to 6.4%. A value of 6% is within the expected range. Glycosylated hemoglobin measures the average blood glucose level for the 90- to 120-day period before the blood sample is collected; thus, it is a reliable way to measure adherence to a therapy plan of insulin, diet, and exercise. A glycosylated hemoglobin measurement does not measure rebound hyperglycemia (Somogyi effect). The HbA1C fraction of hemoglobin is measured, and its value is not affected by short-term infractions of diet or the type of insulin the client takes. The client does not require further teaching regarding nutritional guidelines because the laboratory result is within the expected range, indicating adherence to a therapy plan of insulin, diet, and exercise.

The nurse is caring for a client with hypothyroidism. Which instruction is most important to provide to the client to help in managing their condition? "Take medication on time" "Perform regular exercises" "Dress warmly in cold weather" "Take more proteins in your diet"

Thyroxin levels decrease during cold temperatures, thus hypothyroidism causes the client to become very sensitive to cold. Clients are advised to dress warmly in cold weather to prevent worsening the situation. A client with any disease condition should be instructed to take the medication on time. Hypothyroidism may cause the client to gain weight due to poor metabolic activity. Therefore, the client should be instructed to perform regular exercises and increase proteins in the diet to meet nutritional requirements.

When obtaining a health history from a client recently diagnosed with type 1 diabetes, the nurse expects the client to report what clinical manifestations?

Excessive thirst (polydipsia), excessive hunger (polyphagia), and frequent urination (polyuria) are caused by the body's inability to metabolize glucose adequately. Although polydipsia and polyuria occur with type 1 diabetes, lethargy occurs because of a lack of metabolized glucose for energy. Although polydipsia and weight loss occur with type 1 diabetes, frequent urination occurs throughout a 24-hour period because glucose in the urine pulls fluid with it. Although polyphagia and polyuria occur with type 1 diabetes, diaphoresis occurs with severe hypoglycemia, not hyperglycemia.

A client with untreated type 1 diabetes mellitus may lapse into a coma because of acidosis. Which component is increased in the blood and a direct cause of acidosis? Ketones Glucose Lactic acid Glutamic acid

The ketones produced excessively in diabetes are a by-product of the breakdown of body fats and proteins for energy; this occurs when insulin is not secreted or is unable to be used to transport glucose across the cell membrane into the cells. The major ketone, acetoacetic acid, is an alpha-ketoacid that lowers the blood pH, resulting in acidosis. Glucose does not change the pH. Lactic acid is produced as a result of muscle contraction; it is not unique to diabetes. Glutamic acid is a product of protein metabolism.

Which hormonal deficiency causes breast atrophy in female clients?

A luteinizing hormone deficiency causes atrophy of the breasts. A growth hormone deficiency causes decreased bone density and pathologic fractures. A thyroid-stimulating hormone deficiency results in hirsutism, weight gain, and menstrual abnormalities. An adrenocorticotropic hormone deficiency causes postural hypotension, hypoglycemia, and anorexia.

Which disease is caused by the deficiency of antidiuretic hormone?

Diabetes insipidus

The nurse is performing an assessment and notes that the client has exophthalmos and complains of double vision. These assessment findings are found with which condition? Glaucoma 2 Hypertension Correct3 Hyperthyroidism 4 Sinus infection

Visual changes such as blurring or double vision, as well as tiring of the eyes, may be among the earliest problems for a client with hyperthyroidism. Exophthalmos, or protruding eyes, is also seen with hyperthyroidism. Glaucoma, hypertension, and sinus infection are not characteristic of the other conditions listed.

Which clinical manifestation is found in a client with a deficiency of adrenocorticotropic hormone?

MALIASE AND LATHARGY

The registered nurse instructs the new nurse in orientation regarding the physiologic processes of the endocrine system prior to client assessment. Which statement made by the new nurse indicates effective learning?

"The hormones of the endocrine system exert their action by 'lock and key' mechanism

The nurse is caring for a client who is diagnosed with hyperpituitarism due to a prolactin-secreting tumor. Which clinical manifestation can help confirm the diagnosis? Hypertrophy of skin Enlargement of liver Hypertrophy of the heart Absence of menstruation

Absence of menstruation A prolactin-secreting tumor is a common type of pituitary adenoma that results from excessive secretion of prolactin. Therefore, ultimately, there are associated clinical symptoms, such as absence of galactorrhea and menstruation and infertility. Excessive production of growth hormone is manifested by clinical symptoms, such as skin hypertrophy and enlargement of organs (e.g., liver and heart).

A nurse is caring for a client with hypoglycemia. Which nursing intervention would be appropriate in managing the client's condition? Select all that apply. Administering insulin Administering glucagon Administering IV glucose Administering oral hydrocortisone Administering somatostatin

Administering glucagon Administering IV glucose Administering oral hydrocortisone A client with hypoglycemia suffers with weakness and vision disturbances due to low glucose levels. Glucagon is the hormone secreted by the pancreas that helps with increasing the blood glucose levels. Administering IV glucose would immediately improve the blood glucose levels. Hydrocortisone is a glucocorticoid that prevents hypoglycemia by increasing liver gluconeogenesis and inhibiting peripheral glucose use. Insulin is administered when glucose levels are high as it increases the glucose reuptake, thereby reducing blood glucose levels. Somatostatin is a hormone released by delta cells of the pancreas that inhibits insulin and glucagon.

The nurse is caring for a client immediately after a subtotal thyroidectomy. How will the nurse assess for unilateral injury of the laryngeal nerve? Checking the throat for edema 2 Asking the client to say what the current time is 3 Eliciting spasms of the facial muscles 4 Palpating the neck for seepage of blood

Asking the client to say what the current time is If the laryngeal nerve is damaged during surgery, the client will be hoarse and have difficulty speaking. Checking the throat for edema does not indicate injury to the laryngeal nerve; this is part of the assessment for a compromised airway. Eliciting the Chvostek sign assesses for hypocalcemia resulting from inadvertent removal of the parathyroid glands. Palpating the neck for seepage of blood assesses for bleeding and possible hemorrhage, not laryngeal nerve injury.

A urine specimen is needed to test for the presence of ketones in a diabetic client. What should the nurse do when collecting this specimen from a urinary catheter?

Clamp the catheter, cleanse the port, and use a sterile syringe to remove urine The urinary catheter and drainage bag should always remain a closed, sterile system; urine should be drawn only from the catheter port, not the collection bag. Cleaning the drainage valve and removing the urine from the catheter bag will not yield a fresh specimen indicating present acetone levels. The system should remain closed so that fewer microorganisms enter the urinary tract.

Which hormone levels peak during the client's sleep? Select all that apply. Cortisol Calcitonin Thyrotropin Progesterone Growth hormone

Cortisol Thyrotropin Growth hormone Cortisol, thyrotropin, and growth hormone levels peak during sleep. Calcitonin and progesterone hormone levels are not altered during sleep.

While assessing the health of a female client, the nurse suspects endocrine dysfunction. Which findings support the nurse's suspicion? Select all that apply. Diminished pubic hair Yellow-colored urine Pulse of 74 beats/min Protrusion of eyeballs Blood pressure of 172/80 mm Hg

Diminished pubic hair Protrusion of eyeballs Blood pressure of 172/80 mm Hg Diminished axillary and pubic hair, protruding eyeballs, and elevated blood pressure are signs of endocrine dysfunction. Yellow urine is a normal finding. The normal pulse rate ranges from 60 to 100 beats/min.

A client is diagnosed with Cushing syndrome. Which clinical manifestation does the nurse expect to increase in a client with Cushing syndrome?

Glucose level As a result of increased cortisol levels, glucose metabolism is altered, which may contribute to an increase in blood glucose levels. Increased mineralocorticoids will decrease urine output. Sodium is retained by the kidneys, but potassium is excreted. The immune response is suppressed.

A nurse is caring for a client with a diagnosis of Cushing syndrome. What is the most common cause of Cushing syndrome that the nurse should consider before assessing this client for physiologic responses? Pituitary hypoplasia Hyperplasia of the adrenal cortex Deprivation of adrenocortical hormones Insufficient adrenocorticotropic hormone (ACTH) production

Hyperplasia of the adrenal cortex Hyperplasia of the adrenal cortex leads to increased secretion of cortical hormones, which causes signs of Cushing syndrome. Pituitary hypoplasia is a malfunction of the pituitary that will result in Simmonds disease (panhypopituitarism), which has clinical manifestations similar to those for Addison disease. Cushing syndrome results from excessive cortical hormones. ACTH stimulates production of adrenal hormones. Inadequate ACTH will result in Addisonian signs and symptoms.

What is the effect of parathyroid hormone on bones? Select all that apply. Increased bone breakdown Increased serum calcium levels Increased sodium and phosphorus excretion Increased absorption of calcium and phosphorus Increased net release of calcium and phosphorus

Increased bone breakdown Increased serum calcium levels Increased net release of calcium and phosphorus Parathyroid hormone increases bone breakdown, which increases serum calcium levels. Parathyroid hormone increases net release of calcium and phosphorus from bone into the extracellular fluid. It increases sodium and phosphorus excretion by the kidneys, not in the bone and increases absorption of calcium and phosphorus in the gastrointestinal tract by using activated vitamin D. However, this increased absorption of calcium and phosphorus is not related to the bone.

Which clinical feature is indicative when a client has hypercortisolism? Loss of weight Thickening of skin Enhanced density of bones Increased pigmentation

Increased pigmentation Hypercortisolism causes such skin manifestations as increased pigmentation. Weight gain is a characteristic finding in hypercortisolism. The skin becomes thin due to increased fragility of the blood vessels. Loss of bone density is seen in clients with hypercortisolism.

A client feeling increasingly tired seeks medical care. Type 1 diabetes is diagnosed. What causes increased fatigue with type 1 diabetes? Increased metabolism at the cellular level Increased glucose absorption from the intestine Decreased production of insulin by the pancreas Decreased glucose secretion into the renal tubules

Insulin facilitates transport of glucose across the cell membrane to meet metabolic needs and prevent fatigue. With diabetes there is decreased cellular metabolism because of the decrease in glucose entering the cells. Glucose is not absorbed from the intestinal tract by the cells; fatigue is caused by decreased, not increased, cellular levels of glucose. Filtration and excretion of glucose by the kidneys do not regulate energy levels; if insulin production is adequate, glucose does not spill into the urine.

A client who is 60 pounds (27.2 kilograms) more than the ideal body weight is admitted to the hospital with a diagnosis of type 1 diabetes. Which concept should the nurse include in teaching about diabetes when discussing strategies to lose weight

Obesity leads to insulin resistance.

Which catecholamine receptor is responsible for increased heart rate?

beta 1 Beta1 receptors are responsible for increased heart rate. Beta2 receptors, alpha1 receptors, and alpha2 receptors are not present in the heart; therefore, they are not responsible for increasing the heart rate. Beta2 receptors are present in such organs as blood vessels, kidneys, bronchioles, and bladder. Alpha receptors are present in such organs as eyes, skin, and liver.

The nurse is assessing a client with a suspected thyroid disorder. Which diagnostic studies will be most appropriate to confirm that the thyroid disorder is autoimmune in origin? Select all that apply. Thyroglobulin antibody Thyroid peroxidase antibody Thyroid-stimulating antibody

Thyroglobulin antibody Thyroid peroxidase antibody Thyroid-stimulating antibody Thyroglobulin, thyroid peroxidase, and thyroid-stimulating antibodies are assessed in a thyroid antibody test. This test helps to differentiate other forms of thyroiditis from autoimmune thyroid disease. An active component of total T4 is measured by free thyroxine but cannot differentiate the origin. Thyroid-stimulating hormone levels are used to evaluate a thyroid dysfunction but cannot differentiate the origin.

The nurse is providing instructions about foot care for a client with diabetes mellitus. What should the nurse include in the instructions? Select all that apply. Wear shoes when out of bed. Soak the feet in warm water daily. Dry between the toes after bathing. Remove corns as soon as they appear.

Wearing shoes protects the feet from trauma; they should fit well and should be worn over clean socks. Drying between the toes after bathing prevents maceration and skin breakdown, thus maintaining skin integrity. Soaking the feet is contraindicated because it can cause macerations and skin breakdown, which allow a portal of entry for pathogenic organisms. Clients should not self-treat corns, calluses, warts, or ingrown toenails because of the potential for trauma and skin breakdown; these conditions should be treated by a podiatrist. Use of a heating pad, hot water bottle, or hot water is contraindicated because of the potential for burns; diabetic neuropathy, if present, does not allow the client to accurately evaluate the extremes of temperature.

A nurse is caring for a client with type 1 diabetes who developed ketoacidosis. Which laboratory value supports the presence of diabetic ketoacidosis? Decreased serum glucose levels Decreased serum calcium levels Increased blood urea nitrogen levels Increased serum bicarbonate levels

With diabetic ketoacidosis blood urea nitrogen level generally is increased because of dehydration. With diabetic ketoacidosis, the serum glucose levels are generally above 300 mg/dL (16.7 mmol/L). The calcium level is unrelated to diabetic ketoacidosis. Serum bicarbonate levels are below 15 mEq/L (15 mmol/L).

Which clinical findings should the nurse expect when assessing a client with hyperthyroidism? Select all that apply. Diarrhea Listlessness Weight loss Bradycardia Decreased appetite

diarrhea weight loss Excessive thyroid hormones increase the metabolic rate, causing an increase in intestinal peristalsis. Excessive thyroid hormones increase the metabolic rate, causing weight loss. Listlessness occurs with hypothyroidism because of a decreased metabolic rate. A slow pulse rate accompanies hypothyroidism, not hyperthyroidism, because of a decreased metabolic rate. Appetite increases (polyphagia) with hyperthyroidism in an effort to meet metabolic needs.