Chapter 45 Prep U

A patient is diagnosed with overactivity of the adrenal medulla. What epinephrine value does the nurse recognize is a positive diagnostic indicator for overactivity of the adrenal medulla? 450 pg/mL 50 pg/mL 100 to 300 pg/mL 100 pg/mL

450 pg/mL

A client with acromegaly is complaining of severe headaches. What does the nurse suspect is the cause of the headaches that is related to the acromegaly? A pituitary tumor An increase in cerebral edema A decrease in the glucose level A decrease in release in the growth hormone

A pituitary tumor

A nurse is caring for a client recovering from a hypophysectomy. What would be included in the client's care plan? Select all that apply. Assess for neurologic changes. Encourage deep breathing and coughing. Offer the client a straw when drinking liquids. Closely monitor nasal packing and postnasal drainage.

Assess for neurologic changes. Closely monitor nasal packing and postnasal drainage.

During physical examination of a client with a suspected endocrine disorder, the nurse assesses the body structures. The nurse gathers this data based on the understanding that it is an important aid in which of the following? Determining the size of the organs and location. Determining the presence or absence of testosterone levels. Detecting evidence of hormone hypersecretion. Detecting information about possible tumor growth.

Detecting evidence of hormone hypersecretion.

A patient has been diagnosed with thyroidal hypothyroidism. The nurse knows that this diagnosis is consistent with which of the following? Inadequate secretion of TSH Dysfunction of the thyroid gland itself Failure of the pituitary gland Disorder of the hypothalamus

Dysfunction of the thyroid gland itself

The typical triad of manifestations seen in a client diagnosed with pheochromocytoma does not include which of the following? Palpitations Hypotension Diaphoresis Headache

Hypotension

For a client with Graves' disease, which nursing intervention promotes comfort? Restricting intake of oral fluids Maintaining room temperature in the low-normal range Limiting intake of high-carbohydrate foods Placing extra blankets on the client's bed

Maintaining room temperature in the low-normal range

The nurse is teaching a client about the dietary restrictions related to his diagnosis of hyperparathyroidism. What foods should the nurse encourage the client to avoid? Bananas Milk Chicken livers Hamburger

Milk

When preparing teaching plan for a client with an endocrine disorder, the nurse includes information about hormone regulation. Which of the following would the nurse include? The gland becomes enlarged leading to a deficiency of the hormone. Hormone secretion occurs as a straight-line continuous process. Most disorders result from over- or underproduction of the hormone. The gland slows hormone secretion when the hormone level decreases.

Most disorders result from over- or underproduction of the hormone.

A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication? Myxedema coma Exophthalmos Tibial myxedema Thyroid storm

Myxedema coma

An instructor is preparing a teaching plan for a class on the various pituitary hormones. Which hormone would the instructor include as being released by the posterior pituitary gland? Adrenocorticotropic hormone Somatotropin Oxytocin Prolactin

Oxytocin

Which glands regulate calcium and phosphorous metabolism? Adrenal Thyroid Pituitary Parathyroid

Parathyroid

The nurse assesses a patient who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease? A blood pressure reading of 135/90 mm Hg Potassium of 6.0 mEq/L Sodium of 140 mEq/L Glucose of 100 mg/dL

Potassium of 6.0 mEq/L

Patients with hyperthyroidism are characteristically: Apathetic and anorexic Calm Emotionally stable Sensitive to heat

Sensitive to heat

A client is admitted to the health care facility for evaluation for Addison's disease. Which laboratory test result best supports a diagnosis of Addison's disease? Blood urea nitrogen (BUN) level of 12 mg/dl Serum sodium level of 134 mEq/L Blood glucose level of 90 mg/dl Serum potassium level of 5.8 mEq/L

Serum potassium level of 5.8 mEq/L

A nurse is caring for a female client with hypothyroidism. The client is extremely upset about her altered physical appearance. She doesn't want to take her medication because she doesn't believe it's doing any good. What should the nurse do? Tell the client she needs to learn to accept herself as she is and be compliant during treatment. Tell the client that she looks fine and offer to help her with makeup. Tell the client she'll soon experience improvement in her looks as the medication corrects her hormone deficiency. Tell the client she'll feel better if she consistently takes the thyroid replacement medication.

Tell the client she'll soon experience improvement in her looks as the medication corrects her hormone deficiency.

When caring for a client with diabetes insipidus, the nurse expects to administer: vasopressin. furosemide. 10% dextrose. regular insulin.

vasopressin

What is the most common cause of hyperaldosteronism? Excessive sodium intake An adrenal adenoma Deficient potassium intake A pituitary adenoma

A pituitary adenoma

A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which gland? Pancreas Parathyroid Adrenal medulla Adrenal cortex

Adrenal cortex

A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which gland? Parathyroid Adrenal medulla Pancreas Adrenal cortex

Adrenal cortex

A nurse is performing a physical examination on client suspected of having an endocrine disorder. Which assessment finding might be indicative of a problem with the thyroid gland? Sudden weight loss without dieting Dilated pupils Diarrhea Cold intolerance

Cold intolerance

A group of students is reviewing material about endocrine system function. The students demonstrate understanding of the information when they identify which of the following as secreted by the adrenal medulla? Glucocorticoids Glucagon Epinephrine Mineralocorticoids

Epinephrine

Which of the following would the nurse expect to find in a client with severe hyperthyroidism? Tetany Buffalo hump Striae Exophthalmos

Exophthalmos

A health care provider suspects that a thyroid nodule may be malignant. The nurse knows to prepare information for the patient based on the usual test that will be ordered to establish a diagnosis. What is that test? Ultrasound of the thyroid gland Serum immunoassay for TSH Fine-needle biopsy of the thyroid gland Free T4 analysis

Fine-needle biopsy of the thyroid gland

Which of the following precautions would be most appropriate when caring for a client being treated with radioactive iodine (RAI) for a thyroid tumor? Administer prescribed corticosteroids carefully. Monitor the respiratory status. Handle body fluids carefully. Administer the prescribed medications at the same time each day.

Handle body fluids carefully.

A number of pharmacologic agents are used to treat hyperthyroidism. Which of the following drugs is one of the most commonly prescribed and acts by blocking synthesis of the thyroid hormones? Propranolol Dexamethasone Potassium Iodide Methimazole

Methimazole

The nurse is reviewing the history and physical examination of a client diagnosed with hyperthyroidism. Which of the following would the nurse expect to find? Inability to tolerate cold Reports of increased appetite Complaints of sleepiness Thick hard nails

Reports of increased appetite

A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication? Tibial myxedema Myxedema coma Thyroid storm Exophthalmos

Thyroid storm

Which hormone is secreted by the posterior pituitary? Vasopressin Corticosteroids Calcitonin Somatostatin

Vasopressin

A client has been experiencing a decrease in serum calcium. After diagnostics, the physician proposes the calcium level fluctuation is due to altered parathyroid function. What is the typical number of parathyroid glands? one three two four

four

A nurse is assigned to support a patient while a cast is being applied to treat a greenstick fracture. The nurse documents that this fracture is classified as what type of fracture? Closed Compression Incomplete Stress

incomplete

A nurse is completing an assessment of a client with suspected acromegaly. To assist in making the diagnosis, which question should the nurse ask? "Has your shoe size increased recently?" "Is there any family history of acromegaly?" "Have you had a recent head injury?" "Do you experience skin breakouts?"

"Has your shoe size increased recently?"

A patient is ordered desmopressin (DDAVP) for the treatment of diabetes insipidus. What therapeutic response does the nurse anticipate the patient will experience? A decrease in blood pressure A decrease in appetite A decrease in urine output A decrease in blood glucose levels

A decrease in urine output

The nurse is reviewing a client's laboratory studies and determines that the client has an elevated calcium level. What does the nurse know will occur as a result of the rise in the serum calcium level? A rise in serum calcium inhibits the release of calcitonin. A rise in serum calcium stimulates the release of T lymphocytes. A rise in serum calcium stimulates the release of calcitonin from the thyroid gland. A rise in serum calcium stimulates the release of erythropoietin.

A rise in serum calcium stimulates the release of calcitonin from the thyroid gland.

Before discharge, what should a nurse instruct a client with Addison's disease to do when exposed to periods of stress? Perform capillary blood glucose monitoring four times daily. Drink 8 oz of fluids. Continue to take his usual dose of hydrocortisone. Administer hydrocortisone I.M.

Administer hydrocortisone I.M.

A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately? Pitting edema of the legs Frequent urination Dry mucous membranes An irregular apical pulse

An irregular apical pulse

When high levels of plasma calcium occur, the nurse is aware that the following hormone will be secreted: Calcitonin Phosphorus Parathyroid Thyroxine

Calcitonin

Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany? Calcium gluconate Tapazole Propylthiouracil (PTU) Synthroid

Calcium gluconate

Which diagnostic test is done to determine a suspected pituitary tumor? Measuring blood hormone levels Computed tomography Radioimmunoassay Radiography of the abdomen

Computed tomography

Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex? Hashimoto disease Graves disease Cushing syndrome Addison disease

Cushing syndrome

A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority? Impaired physical mobility Imbalanced nutrition: Less than body requirements Decreased Cardiac output Risk for infection

Decreased Cardiac output

A client with a traumatic brain injury is producing an abnormally large volume of dilute urine. Which alteration to a hormone secreted by the posterior pituitary would the nurse expect to find? Increased antidiuretic hormone Increased oxytocin Deficient production of vasopressin A deficient amount of somatostatin

Deficient production of vasopressin

A client sustained a head injury when falling off of a ladder. While in the hospital, the client begins voiding large amounts of clear urine and states he is very thirsty. The client states that he feels weak, and he has had an 8-lb weight loss since admission. What should the client be tested for? Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Pituitary tumor Diabetes insipidus (DI) Hypothyroidism

Diabetes insipidus (DI)

A patient is being evaluated for a diagnosis of pheochromocytoma. He is scheduled for epinephrine and norepinephrine laboratory tests. Which of the following plasma levels is a positive value that is diagnostic for pheochromocytoma? Norepinephrine @ 550 pg/mL Epinephrine @ 100 pg/mL Epinephrine @ 450 pg/mL Norepinephrine @ 200 pg/mL

Epinephrine @ 450 pg/mL

Which outcome indicates that treatment of a client with diabetes insipidus has been effective? Fluid intake is less than 2,500 ml/day. Heart rate is 126 beats/minute. Blood pressure is 90/50 mm Hg. Urine output measures more than 200 ml/hour.

Fluid intake is less than 2,500 ml/day.

The adrenal cortex is responsible for producing which substances? Catecholamines and epinephrine Glucocorticoids and androgens Mineralocorticoids and catecholamines Norepinephrine and epinephrine

Glucocorticoids and androgens

Which instruction should be included in the discharge teaching plan for a client after thyroidectomy for Graves' disease? Keep an accurate record of intake and output. Exercise to improve cardiovascular fitness. Use nasal desmopressin acetate (DDAVP). Have regular follow-up care.

Have regular follow-up care.

The nurse is aware that the clinical symptoms of a patient with hypoparathyroidism are the result of the initial physiologic response of: Increased serum levels of phosphate. Hypocalcemia. Decreased levels of vitamin D. Cardiac arrhythmias.

Hypocalcemia.

A client with a 20-year history of hypothyroidism who has not been compliant with taking thyroid replacement therapy is brought into the ED with a diagnosis of myxedema coma. What client symptoms are consistent with this life-threatening event? Select all that apply. Hyperactivity Hypotension Hypoventilation Hypothermia Tachycardia

Hypotension Hypoventilation Hypothermia

Which nursing diagnosis takes highest priority for a client with hyperthyroidism? Disturbed body image related to weight gain and edema Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

The thymus gland secretes thymosin and thymopoietin, which aid in developing T lymphocytes, a type of white blood cell involved in immunity. Which of the following best identifies the location of this gland? Positioned above the kidneys Attached to the thalamus in the brain In the upper part of the chest above or near the heart Connected by a stalk to the hypothalamus in the brain

In the upper part of the chest above or near the heart

A patient is diagnosed with a deficiency in vasopressin, a posterior pituitary hormone. Therefore, a primary nursing responsibility is to assess for: Indicators of hyponatremia. Indicators of dehydration. Glycosuria Serum calcium levels.

Indicators of dehydration.

One of the most frequently occurring complications (55% occurrence) of primary hyperparathyroidism is: Peptic ulcer. Pathologic fractures. Kidney stones. Pancreatitis.

Kidney stones.

After teaching a class about the endocrine system, the instructor determines that the students need additional instruction when they identify which of the following as an endocrine gland? Kidneys Adrenal gland Pancreas Testes

Kidneys

A nurse teaches a client with newly diagnosed hypothyroidism about the need for thyroid hormone replacement therapy to restore normal thyroid function. Which thyroid preparation is the agent of choice for thyroid hormone replacement therapy? Thyroid USP desiccated (Thyroid USP Enseals) Levothyroxine (Synthroid) Methimazole (Tapazole) Liothyronine (Cytomel)

Levothyroxine (Synthroid)

The nurse visits the home of a client recovering from a thyroidectomy. Which finding(s) indicates to the nurse that the client is developing hypocalcemia? Select all that apply. New onset of dysphagia +3 pitting edema of the lower extremities Report of stiff hands and feet Numbness and tingling of the hands Hypoactive bowel sounds

New onset of dysphagia Report of stiff hands and feet Numbness and tingling of the hands

On assessment of a patient with early-stage hypothyroidism, the nurse practitioner assesses for a vague yet significant sign which is: Hypothermia Bradypnea Paresthesia Hypotension

Paresthesia

Vision and visual fields are altered in disorders of which of the following endocrine glands? Pituitary Parathyroid Pancreas Thyroid

Pituitary

A client with hyperthyroidism is concerned about changes in appearance. How can the nurse convey an understanding of the client's concern and promote effective coping strategies? Refer the client to professional counseling. Encourage the client to participate in outside activities to boost coping strategies. Reassure the client that their emotional reactions are a result of the disorder and symptoms can be controlled with effective treatment. Suggest that the client wear cosmetics to cover any changes in appearance.

Reassure the client that their emotional reactions are a result of the disorder and symptoms can be controlled with effective treatment.

A client has a decreased level of thyroid hormone being excreted. What will the feedback loop do to maintain the level of thyroid hormone required to maintain homeostatic stability? Stimulate more hormones using the negative feedback system The feedback loop will be unable to perform in response to low levels of thyroid hormone. Stimulate more hormones using the positive feedback system Produce a new hormone to try and regulate the thyroid function

Stimulate more hormones using the negative feedback system

Beta-blockers are used in the treatment of hyperthyroidism to counteract which of the following effects? Gastrointestinal effects Sympathetic Respiratory effects Parasympathetic

Sympathetic

The nurse on the telemetry floor is caring for a patient with long-standing hypothyroidism who has been taking synthetic thyroid hormone replacement sporadically. What is a priority that the nurse monitors for in this patient? Heat intolerance Dietary intake of foods with saturated fats Symptoms of acute coronary syndrome Symptoms of pneumonia

Symptoms of acute coronary syndrome

Dilutional hyponatremia occurs in which disorder? Diabetes insipidus (DI) Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Addison disease Pheochromocytoma

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication? Thyroid storm Hemorrhage Laryngeal nerve damage Tetany

Tetany

A client who is frightened of needles has been told that he will have to have an intravenous (IV) line inserted. The client's blood pressure and pulse rate increase, and the nurse observes the pupils dilating. What does the nurse recognize has occurred with this client? The client is showing the fight-or-flight response. The client is in a hypertensive crisis. The client is developing an infection. The client is having a response to dehydration.

The client is showing the fight-or-flight response.

The nurse auscultates a bruit over the thyroid glands. What does the nurse understand is the significance of this finding? The patient may have thyroiditis. The patient may have hyperthyroidism. The patient may have hypothyroidism. The patient may have Cushing disease.

The patient may have hyperthyroidism.

Which group of clients should not receive potassium iodide? Those taking medications such as cough medicines Those who are allergic to corticosteroids Those who are allergic to seafood Those who are pregnant

Those who are allergic to seafood

What life-threatening outcome should the nurse monitor for in a client who is not compliant with taking the prescribed antithyroid medication? Myxedema coma Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Diabetes insipidus Thyrotoxic crisis

Thyrotoxic crisis

Which hormones are secreted by the posterior lobe of the pituitary gland? Select all that apply. Luteinizing hormone (LH) Oxytocin Follicle-stimulating hormone (FSH) Vasopressin Thyroid-stimulating hormone (TSH)

Vasopressin Oxytocin

A client with thyroiditis has undergone surgery and is concerned about the barely visible scar. Which suggestion should the nurse give the client to cope with the condition? Consider cosmetic surgery Undergo a skin graft Apply medicines to remove the scar Wear clothing that covers the neck

Wear clothing that covers the neck

which findings should a nurse expect to assess in client with Hashimoto's thyroiditis? Weight loss, increased urination, and increased thirst Weight gain, increased urination, and purplish-red striae Weight loss, increased appetite, and hyperdefecation Weight gain, decreased appetite, and constipation

Weight gain, decreased appetite, and constipation

A 35-year-old female client who complains of weight gain, facial hair, absent menstruation, frequent bruising, and acne is diagnosed with Cushing's syndrome. Cushing's syndrome is most likely caused by: a corticotropin-secreting pituitary adenoma. an inborn error of metabolism. adrenal carcinoma. an ectopic corticotropin-secreting tumor.

a corticotropin-secreting pituitary adenoma.

Trousseau sign is elicited when the foot is dorsiflexed and there is pain in the calf. by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff. after making a clenched fist and opening the hand; the palm remains blanched when pressure is placed over the radial artery. by tapping sharply over the facial nerve just in front of the parotid gland and anterior to the ear, causing spasm or twitching of the mouth, nose, and eye.

by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.

Because there is no one cause for Graves' disease, treatment is relegated to the management of symptoms, or in severe cases, surgery to remove the thyroid gland. Which is not a symptom of Graves' disease? constipation fine hand tremors blurred vision increased appetite

constipation

The nurse is completing discharge teaching with a client with hyperthyroidism who has been treated with radioactive iodine at an outpatient clinic. The nurse instructs the client to continue radioactive precautions with all body secretions. discontinue all antithyroid medications. watch for symptoms of hyperthyroidism to disappear within 1 week. monitor for symptoms of hypothyroidism.

continue radioactive precautions with all body secretions.

A nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse expects to find deposits of adipose tissue in the trunk and dorsocervical area. weight gain in arms and legs. hypotension. thick, coarse skin.

deposits of adipose tissue in the trunk and dorsocervical area.

A client with Cushing's syndrome is admitted to the medical-surgical unit. During the admission assessment, the nurse notes that the client is agitated and irritable, has poor memory, reports loss of appetite, and appears disheveled. These findings are consistent with: neuropathy. depression. hypoglycemia. hyperthyroidism.

depression

When teaching a client with Cushing's syndrome about dietary changes, the nurse should instruct the client to increase intake of: fresh fruits. cereals and grains. processed meats. dairy products.

fresh fruits.

Hyperthyroidism is caused by increased levels of thyroxine in blood plasma. A client with this endocrine dysfunction experiences: anorexia and hyperexcitability. weight gain and heat intolerance. heat intolerance and systolic hypertension. diastolic hypertension and widened pulse pressure.

heat intolerance and systolic hypertension.

A client presents with a huge lower jaw, bulging forehead, large hands and feet, and frequent headaches. What could be causing this client's symptoms? panhypopituitarism hyperpituitarism panhyperpituitarism hypopituitarism

hyperpituitarism

A client has been experiencing a decrease in serum calcium. After diagnostics, the physician believes the calcium level fluctuation is due to altered parathyroid function. What is the role of parathormone? promote urinary secretion of calcium increase serum calcium level inhibit release of calcium into extracellular fluid decrease serum calcium level

increase serum calcium level

A client has been experiencing a decrease in serum calcium. After diagnostics, the physician believes the calcium level fluctuation is due to altered parathyroid function. What is the role of parathormone? promote urinary secretion of calcium inhibit release of calcium into extracellular fluid increase serum calcium level decrease serum calcium level

increase serum calcium level

A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder? parathyroid disorder adrenal disorder thyroid disorder pituitary disorder

pituitary disorder

A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder? pituitary disorder parathyroid disorder thyroid disorder adrenal disorder

pituitary disorder

A client is admitted to an acute care facility with a tentative diagnosis of hypoparathyroidism. The nurse should monitor the client closely for the related problem of: acute gastritis. profound neuromuscular irritability. excessive thirst. severe hypotension.

profound neuromuscular irritability.

A nurse should expect a client with hypothyroidism to report: increased appetite and weight loss. nervousness and tremors. thyroid gland swelling. puffiness of the face and hands.

puffiness of the face and hands.

A female client is being successfully treated for Cushing's syndrome. The nurse should expect a decline in: bone mineralization. hair loss. serum glucose level. menstrual flow.

serum glucose level.

A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of: sodium and chloride abnormalities. calcium and phosphorus abnormalities. chloride and magnesium abnormalities. sodium and potassium abnormalities.

sodium and potassium abnormalities.

A nurse is caring for a client with diabetes insipidus. The nurse should anticipate administering: vasopressin. furosemide. potassium chloride. insulin.

vasopressin.

A nurse is instructing a client with newly diagnosed hypoparathyroidism about the regimen used to treat this disorder. The nurse should state that the physician probably will order daily supplements of calcium and: potassium. vitamin D. iron. folic acid.

vitamin D