Endocrine ATI

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 sensitvity to thyroid hormone D. Increase in the uptake of thyroid hormone by the thyroid gland

A

A nurse is monitoring the laboratory values of a client who has diabetes mellitus & is taking insulin. Which of the following results indicates a therapeutic outcome of insuline 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. Fasting blood glucose 96 mg/dL This is within the expected reference range of 70 to 110 mg/dL for a fasting BGL & indicates that insulin therapy is effective

A nurse is assessing a client who has 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. correct --> dilutional hyponatremia B. incorrect --> this is an expected response, clients have hyperactive deep tendon reflexes of 3+ & 4+ C. incorrect --> within normal range D. incorrect --> within normal range (1.005 to 1.030)

A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following client statements indicates an understanding of the teaching? 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. correct --> reflects the glucose levels over a 120-day period A. incorrect --> no fasting needed C. incorrect --> 4-6% for adults, a greater than 6.5% can indicated DM D. incorrect --> capillary blood glucose levels to adjust daily insulin doses

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. correct --> findings include tremors, diaphoresis, & insomnia A. incorrect --> heat intolerance is expected B. incorrect --> restless & irritable is expected D. incorrect --> wide-eyed or startled appearance is expected

A nurse is monitoring a client who is 24 hours postoperative 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. correct --> preserve the airway B. incorrect --> expected after general anesthesia due to a buildup of secretions caused by intubation C. incorrect --> expected D. incorrect --> expected after intubation

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. correct --> reduce blood pressure & abdominal pressure B. incorrect --> this can release catecholamines & increase blood pressure C. incorrect --> the nurse should monitor for hypretension D. incorrect --> this is for a patient with diabetes insipidus

A nurse managing the care of a client who is postoperative & 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. correct --> replace the cortisol deficiency that occurs B. incorrect --> administering a potassium-sparing diuretic will further increase the client's potassium level C. incorrect --> not appropriate D. incorrect --> adrenal insufficiency causes hypovolemia, which is an indication for rapid fluid replacement

A nurse is planning teaching for a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse plan to 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. correct --> alcohol inhibits the liver's production of glucose A. incorrect --> males no more than 2 servings, females no more than one serving per day C. incorrect --> reduce insuline before exercise to prevent hypoglycemia D. incorrect --> exercise at least 3 times per week & have no more than 2 consecutive days without exercise

A nurse is assessing a client who has DM & 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. correct --> as well as tachycardia, nervousness & confusion

A nurse is reviewing the lab results of a client undergoing screening for primary Cushing's disease. The nurse should expect an elevation in which of the following lab findings? A. Lymphocyte count B. Potassium C. Calcium D. Glucose

D. correct A. incorrect --> expected to be below B. incorrect --> expected to be below C. incorrect --> expected to be below

A nurse is caring for a client who has type 2 diabetes mellitus & is experiencing HHS. Which of the following laboratory findings should the nurse expect? A. Serum pH of 7.32 B. BGL 250 mg/dL C. BGL 425 mg/dL D. Serum pH of 7.45

D. correct --> HHS produces enough insulin to prevent ketosis but not enough to prevent hyperglycemia. Therefore, the serum pH is within expected range & glucose will be above 600 mg/dL

A nurse is caring for a client who has diabetes mellitus & 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 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 to toenails when trimming them

B. correct --> neuropathy makes it difficult to determine temperature A. incorrect --> examine feet daily C. incorrect --> shop for shoes later in the day when feet are likely to have slight swelling D. incorrect --> trim toenails straigt across & smooth the edges with an emery board

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 & numbness of the hands & feet D. Diminished deep-tendon reflexes

C. Tingling & numbness of the hands & feet Hypocalcemia causes parestesia, which usually starts in the hands & feet

A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings shoud the nurse expect? A. Decreased blood pressure B. Weight loss C. Hirsutism D. Increased skn thickness

C. correct --> due to increased androgen production A. incorrect --> elevated BP is expected B. incorrect --> weight gain is expected D. incorrect --> thinning of the skin is expected

A nurse is teaching a client who is scheduled for a vanillylmandelic acid test to screen for pheochromocytoma. Which of the following statements should the nurse include in the teaching? 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. correct A. incorrect --> no fasting needing, but avoid foods such as bananas & citrus fruits B. incorrect --> discard the first morning urine then begin to collect C. incorrect --> avoid aspirin, it can affect test results

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. correct --> due to dehydration A. incorrect --> tachycardia is expected C. incorrect --> diluted urine & low specific gravity is expected D. incorrect --> an increased BUN is expected due to dehydration

A nurse is providing discharge teaching to a client who has diabetes insipidus & 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. correct --> prevents dilution of the medication with nasal secretions A. incorrect --> prime the nasal spray pump by pressing down four times C. incorrect --> sit upright with their head tilted forward slightly D. incorrect --> this is a manifestation of hypocalcemia. Desmopressin can result in the adverse effect of hyponatremia

A nurse is teaching a client who has type 1 diabetes mellitus about how to prevent complications during illness. Which of the following statements by the client indicates an understanding of 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. correct A. incorrect --> continue taking insulin even when not feeling well B. incorrect --> check urine for ketones when BGL is >240 mg/dL D. incorrect --> every 4 hours during illness

A nurse is assessing a client who is taking propylthiouracil. The nurse should identify which of the following as an indication that the medication has been effective? A. Increased ability to sweat B. Increased bowel movements C. Increased body weight D. Increased libido

C. correct --> Propylthiouracil suppresses the production of thyroid hormones & allows for weight gain. A. incorrect --> diaphoresis is a manifestation of hyperthyroidism. Diaphoresis is expected to decrease B. incorrect --> this is a manifestation of hyperthyroidism & expected to decrease D. incorrect --> this is a manifestation of hyperthyroidism & is expected to decrease with medication

A nurse is teaching a client who has diabetes mellitus about insulin injections. The client's prescription includes evening doses of insulin glargine & regular insulin. Which of the following instrucrions should the nurse include? A. Inject the insulins intramuscularly B. Shake the insulins vigorously prior to administration C. Draw up the insulins into seperate syringes D. Expect the insulin to appear cloudy

C. correct --> glargine is not compatible with other insulins A. incorrect --> subcutaneous tissue B. incorrect --> gently mix D. incorrect --> both should be clear & discard if any appear cloudy

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/d: D. Sodium 150 mEq/L

C. correct --> usual to be above expected range A. incorrect --> finding of cushing's disease B. incorrect --> weight loss is expected D. incorrect --> low sodium is expected

A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements by the client indicates an understanding of 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 calluses on my feet." D. "I will apply lotion to the dry areas of my feet but not between my toes."

D. correct --> between toes is prone to bacterial growth A. incorrect --> dry thoroughly after washing B. incorrect --> wear closed toe to prevent injury C. incorrect --> topical OTC medications can impair skin integrity & lead to further injury

A nurse is preparing a teaching plan for a client who has diabetes insipidus & requires intranasal desmopressin. Which of the following information should the nurse include? 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. correct --> take initial dose in the evening