EAQ - Endocrine

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While caring for a client receiving hydrocortisone therapy, the nurse anticipates a dose adjustment in the client's prescription. Which observation in the client supports this anticipation?

Sudden weight gain of 8 kg

A client with hyperthyroidism is treated with radioactive iodine to ablate thyroid tissue. What should the nurse instruct the client to do after the procedure?

Avoid holding an infant.

A nurse teaches a client with type 1 diabetes how to best treat hypoglycemia If the teaching is effective, which foods does the client identify to manage hypoglycemia?

Cheese sandwich and sugar

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

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

Glucose level

After surgical clipping of a ruptured cerebral aneurysm, a client develops the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). What manifestations are exhibited with excessive levels of antidiuretic hormone?

Hyponatremia and decreased urine output

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

Prolactin-inhibiting hormone Corticotropin-releasing hormone

Which parameter monitoring should be the nurse's priority while caring for a client with hypothyroidism?

Respiratory rate

A client has had a resection of an aldosterone-secreting tumor of an adrenal gland. The client says to the nurse, "It will be good for me to return to work soon." Based on an understanding of the problem, what is the nurse's response?

Tell the client that returning to work is possible if the client takes prescribed hormone supplements.

A client is diagnosed with hyperthyroidism and is treated with 131I. Before discharge the nurse teaches the client to observe for signs and symptoms of therapy-induced hypothyroidism. Which signs and symptoms should be included in the teaching? Select all that apply.

Fatigue Dry skin Progressive weight gain

A client diagnosed with adrenal gland hypofunction is receiving fludrocortisone therapy. Which nursing intervention would help the client reduce the risk of complications?

Instruct the client to regularly monitor blood pressure

A nurse is reviewing a client's history and finds images showing progressive development of facial changes due to acromegaly. Which diagnostic study would have confirmed this diagnosis?

Insulin-like growth factor 1 (IGF-1)

The nurse caring for a client with diabetic ketoacidosis (DKA) can expect to implement which intervention?

Intravenous administration of regular insulin

In order to ensure a quality specimen and an accurate test result, which instruction should the nurse give a client who is scheduled to undergo urine endocrine testing?

"Store the urine specimen in a cooler with ice."

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

Which hormone does the nurse state is formed from cholesterol?

Cortisol

A client with a tentative diagnosis of Cushing syndrome has an increased cortisol level. What response should the nurse assess this client for?

Hypernatremia

A client with diabetes states, "I cannot eat big meals; I prefer to snack throughout the day." What information should the nurse include in response to this client's statement?

Regulated food intake is basic to control.

After recording the blood pressure of a client, the primary health care provider confirms a diagnosis of pheochromocytoma. What blood pressure may have helped confirm the diagnosis?

190/90 mmHg

While caring for a client receiving fludrocortisone, the nurse suspects that the drug has caused a negative side effect. Which finding supports the nurse's conclusion?

Blood pressure of 150/90 mm Hg

A client is admitted with a diagnosis of chronic adrenal insufficiency. Which roommate should be avoided when assigning a room for this client?

A young adult client with pneumonia

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

Aldosterone

Two clients with polydipsia and polyuria arrived at the hospital. Both were having similar symptoms but were diagnosed with different types of diabetes insipidus. Which assessment finding helped to differentiate the diagnosis?

Urine osmolarity

The nurse is teaching a client with decreased ovarian production of estrogen due to menopause about self-management and prevention of complications. Which actions performed by the client would help to reduce the complications? Select all that apply

Walking for 30 minutes per day Performing weight-bearing activities Urinating immediately after sexual intercourse

After a teaching session, the nurse evaluates the client's understanding of hypoparathyroidism. Which statement made by the client indicates the need for further education?

"I should include yogurt in my diet."

While assessing a postpartum client who is suspected of having a thyroid disorder, the nurse suspects that the client has autoimmune thyroiditis. Which diagnostic studies are most suitable for confirming the diagnosis?

Radioactive iodine uptake

A nurse plans to set up emergency equipment at the bedside of a client in the immediate postoperative period after a thyroidectomy. What should the nurse include in the bedside setup?

Tracheostomy set and oxygen

The primary healthcare provider prescribed carbamazepine to a client with central diabetes insipidus. The serum osmolarity is 600 mOsm (mmol)/kg. Which will be an effective outcome of the drug?

Decreased thirst

A client reports enlargement of the hands and feet, thickened lips, and joint pains. The client's blood glucose is 250 mg/dL (13.89 mmol/L) and x-ray reports reveal increased size of the lungs. Which hormonal change does the nurse suspect in the client?

Growth hormone

A primary healthcare provider prescribes propylthiouracil (PTU) for a client with hyperthyroidism. Two months after being started on the antithyroid medication, the client calls the nurse and complains of feeling tired and looking pale. What should the nurse do?

Schedule the client for an appointment.

A client reports backache and abnormal increase in shoe size. The primary healthcare provider prescribes 100 g of oral glucose and blood and urine samples are collected for testing. Which finding in the client indicates an abnormality?

Growth hormone level is 7 ng/mL

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?

Hyperplasia of the adrenal cortex

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?

"Dress warmly in cold weather"

Which statement does the nurse know is true regarding the effects of parathyroid hormone on bones for the maintenance of calcium balance?

Increases net release of calcium into extracellular fluid

A client with Cushing syndrome asks why a low-sodium, high-potassium diet has been prescribed. What is the best response by the nurse?

"Excessive aldosterone and cortisone cause the retention of sodium and loss of potassium."

The nurse teaches a client with exophthalmos how to reduce discomfort and prevent corneal ulceration. Which statement by the client indicates that teaching was effective?

"I should avoid using a sleeping mask at night."

A nurse teaches a client with type 2 diabetes how to provide self-care to prevent infections of the feet. Which statement made by the client shows that teaching was effective?

"I should control my blood glucose with diet, exercise, and medication."

Which statement made by a diabetic client shows that dietary teaching by the nurse was effective?

"My diet can be planned around a wide variety of commonly used foods."

On the first postoperative day following a thyroidectomy, a client tolerates a full-fluid diet. This is changed to a soft diet on the second postoperative day. The client reports a sore throat when swallowing. What should the nurse do first?

Administer analgesics as prescribed before meals.

A nurse is caring for a client who has a 20-year history of type 2 diabetes. The nurse should assess for what physiologic changes associated with a long history of diabetes?

Blurry, spotty, or hazy vision

A client has been on a hunger strike for 5 days. Which hormones are providing glucose as energy through catabolism? Select all that apply.

Cortisol Glucagon

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

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?

Hyperthyroidism

A client is admitted to the hospital with a potential diagnosis of excess antidiuretic hormone. Which clinical indicator should the nurse identify when assessing this client?

Hyponatremia

Which clinical feature is indicative when a client has hypercortisolism?

Increased pigmentation

A nurse provides post-operative care to a client who has undergone a hypophysectomy. Which action should the nurse take if there is a yellowish discharge at the dressing site?

Inform the primary healthcare provider

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

A nurse is caring for a client after radioactive iodine is administered for Graves disease. What information about the client's condition after therapy should the nurse consider when providing care?

Mildly radioactive but should be treated with routine safety precautions

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

Muscle spasms

Which hormone is released from the posterior pituitary gland?

Oxytocin

A nurse is caring for an adult client with acromegaly. What clinical manifestation does the nurse expect the client to exhibit?

Prominent jaw

Upon assessing a female client, the nurse discovers an abnormal endocrine finding. Which finding in the client supports the nurse's conclusion?

Protruding eyes

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

Seizures

Which electrolyte concentration has the potential to precipitate dysrhythmias and cardiac arrest in a client?

Serum potassium of 7.2 mEq/L (7.2 mmol/L)

A 24-hour urine test is prescribed for a client who has a tentative diagnosis of pheochromocytoma. What should the nurse do first?

Start the time of the test after discarding the first voiding.

A client is scheduled to have a thyroidectomy for thyroid cancer. What specific instruction about postoperative care should the nurse provide the client during preoperative teaching?

Support the head with the hands when changing position.

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

What symptoms will the nurse identify when assessing a client with Graves disease?

Weight loss, exophthalmos, and restlessness

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 Lethargy Sensitivity to cold

Which carcinoma is the most common type of thyroid cancer and is most often found in younger women?

Papillary carcinoma

The nurse provides a list of appropriate food choices to a client with newly diagnosed diabetes. The client reviews the list and says, "I do not like and refuse to eat asparagus, broccoli, and mushrooms." In response, the nurse teaches the client about the food exchange list. The nurse evaluates that teaching was effective when the client states, "Instead of asparagus, broccoli, and mushrooms, I will eat which foods?"

String beans, beets, or carrots.

A client who has just had an adrenalectomy is told about a death in the family and becomes very upset. What concern about the client requires the nurse to notify the primary healthcare provider?

There is a decreased ability to handle stress despite steroid therapy.

A client with diabetes asks the nurse whether the new forearm stick glucose monitor gives the same results as a finger stick. What is the nurse's best response to this question?

"There is no difference between readings."

A registered nurse is teaching the student nurse about drugs used to treat hyponatremia in hospitalized clients. Which statement made by the student nurse indicates an effective learning?

"Tolvaptan used for more than 30 days causes liver failure."

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?

Hypocalcemia

A nurse is caring for an older client who had non-insulin dependent diabetes for 15 years that progressed to insulin-dependent diabetes 2 years ago. What common complications of diabetes should the nurse assess for when examining this client? Select all that apply.

Leg ulcers Loss of visual acuity Prolonged capillary refill in the toes Decreased sensation in the lower extremities

A nurse is caring for a client with myxedema who has undergone abdominal surgery. What should the nurse consider when administering opioids to this client?

One-third to one-half the usual dose should be prescribed

A client with a parathyroid disorder reports nausea, vomiting, weight loss, and epigastric pain. Which electrolyte disturbance would be responsible for the client's clinical manifestations?

Hypercalcemia

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? Select all that apply.

Changes in chest shape Changes in lip thickness Changes in length of hands

Which laboratory finding is a characteristic feature in a client with hypercortisolism?

Serum sodium of 150 mEq/L (150 mmol/L)


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