Endocrine Med/surg

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) A Osteoporosis B Moon-shaped face C Increased risk of infection D Hearing loss E Weight loss

A, B, C

A nurse is teaching a client about HbA1c testing. Which of the following statements by the client indicates an understanding of the information about this test?

B. This test is a good indicator of my avg blood glucose levels.

A nurse is managing the care of a client who is post-op and experiencing acute adrenal insufficiency. Which of the following actions should the nurse take? A. Administer IV hydrocortisone sodium succinate. B. Give oral spironolactone. C. Infuse 1 unit of platelets. D. Restrict daily fluid intake.

A. Administer hydrocortisone sodium succinate . (necessary to replace cortisol deficiency that occurs with adrenal insufficiency) - means the client is hyperkalemic: needs volume replacement to dilute.

A nurse is monitoring the lab values of a client who has DM 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. Casual blood glucose 210 mg/dL D. Preprandial blood glucose 60 mg/dL

A. Fasting blood glucose is 96mg/dL

A nurse is monitoring a client's status 24hr 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. Laryngeal Stridor (indicates respiratory obstruction, nurse should take immediate action to preserve airway)

A nurse is preparing to administer propranolol IV bolus to a client experiencing a thyroid storm. Which of the following findings indicates 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 of the heart's sensitivity to thyroid hormone. D. Increase of the uptake of thyroid hormone by the thyroid glad.

A. Reduction of the effects of thyroid hormone on the heart. (Propranolol [Hemangeol, Inderal] is a beta2-adrenergic blocking agent that decreases the rapid heart rate caused by excessive thyroid stimulation)

A nurse is performing an assessment on a client who has SIADH. Which of the following assessment data should the nurse report? A. Serum sodium 110 mEq/L B. 2+ DTRs C. Serum K+ 3.7 mEq/L D. Urine specific gravity 1.025

A. Serum sodium 110 mEq/L (SIADH retains fluids, causing dilutional hyponatremia)

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 med on an empty stomach B Take this med with an antacid C. Change position slowly while taking this med D. Limit your fluid intake while taking this med

A. Take this medication on an empty stomach (not eat or drink anything for 30 to 60 mins after taking it)

A nurse is reviewing laboratory values for a client who has DKA. Which of the following results should the nurse expect? A. pH 7.32, PaCO2 36, HCO3 14 B. pH 7.38, PaCO2 55, HCO3 22 C. pH 7.44, PaCO2 40, HCO3 24 D. pH 7.50, PaCO2 42, HCO3 30

A. pH 7.32, PaCO2 36, HCO3 14 (DKA: pH is low, CO2 is normal, HCO3 is low)

A nurse is planning preoperative care for a client who has pheochromocytoma. Which of the following interventions should the nurse anticipate as being the priority? A. Use same arm for BP measurement B. Avoid palpating the abdomen C. Manage headaches with analgesics D. Provide a private, darkened room

B. Avoid palpating the abdomen (greatest risk to client is injury from hypertensive crisis. Palpation can can cause a sudden release of catecholamines, causing hypertensive crisis).

A nurse is providing discharge teaching for a client who has DI and has a new scrip for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching? A. Breath deeply while using the nasal spray B, Blow nose gently prior to using the nasal spray. C. Administer the spray while in a side-lying position. D. Instill the med 4x per day.

B. Blow the nose gently prior to using the nasal spray. (avoids dilution of meds by nasal secretions or improper absorption due to blockage)

A nurse is assessing a client who has DM 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. Cool, clammy skin (in addition to anxiety, nervousness, tachycardia, and confusion)

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. Decreased BUN

B. Increased hematocrit (related to dehydration)

A nurse is planning dietary teaching for a client who has type 1 diabetes mellitus. Which of the following information should the nurse include regarding alcohol consumption? A, Substitute two carbohydrate exchanges for every one alcoholic bev. B. Ingest alcohol with meals to reduce alcohol-induced hypoglycemia. C. Consuming alcohol decreases blood triglyceride levels. D. Expect to increase insulin dosage when consuming alcohol.

B. Ingest alcohol with meals to reduce alcohol-induced hypoglycemia. (Alcohol prevents liver production of glucose. Consuming carbs while drinking helps prevent hypoglycemia)

A nurse is caring for a client who has diabetes mellitus and developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to his feet? A. Examine the skin and 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.

B. Monitor the temp of the bath water with a thermometer

A nurse is prepping insulin for a client with DM. He is to receive evening doses of insulin glargine and regular insulin. Which of the following actions should the nurse take to administer these two medications safely? A. Draw up the insulin glargine into the syringe first, then the regular insulin. B. Draw up the regular insulin first, then the insulin glargine C. Draw up the insulin glargine and the regular insulin into two separate syringes. D. Draw up either insulin into the syringe first because both are clear.

C. Draw up the insulin glargine and the regular insulin into separate syringes. (insulin glargine (Lantus - long acting) should not be mixed with any other insulin due the low pH of its diluent).

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. Hirsutism (increased hair growth is an expected finding of Cushing's disease due to increased androgen production.

A nurse is providing teaching for a client who has type 1 DM about to prevent complications during illness. Which of the following statements indicates that the client understands the teaching? A. I should stop taking 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 mg/dL D. I should check my blood glucose level every 8 hours.

C. I will call my doc if my glucose levels exceed 250 mg/dL during illness.

A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect? A. Moon face B. Weight gain C. Serum calcium 12.8 mg/dL D. Serum sodium 150 mEq/L

C. Serum calcium 12.8 mg/dL (adrenal insufficiency will raise calcium levels)

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. Tingling and numbness of the hands and feet. (Hypocalcemia causes paresthesias, usually starting in hands and feet)

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. Tremors (also diaphoresis and insomnia)

A nurse is caring for a client who is taking propylthiouracil (PTU). The nurse should recognize that the client has met the treatment goals when she reports an increase in which of the following effects? A. Sweating B. Stools C. Weight D. Appetite

C. Weight (PTU suppresses the production of thyroid hormones and therefore allows for weight gain

A nurse is preping to give a client information about an ACTH stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders? A. Cushing's syndrome B. Hyperthyroidism C. Pheochromocytoma D. Addison's disease

D. Addison's Disease (ACTH stimulation test is standard test. Measures cortisol response to ACTH. Response is absent or very decreased when there is adrenal insufficiency.

A nurse is caring for a client undergoing screening for primary Cushing's disease. The nurse should expect that which of the following laboratory findings to be elevated? A. Lymphocyte B. Serum Potassium C. Serum Calcium D. Blood Glucose

D. Blood Glucose

A nurse is providing teaching or a client who has DM. Which of the following findings associated with DKA should the nurse include? A. Decreased urine output B. Weight gain of 0.45kg (1lb) in 24 hrs C. Rapid, shallow respirations D. Blood glucose levels greater than 300 mg/dL

D. Blood glucose greater than 300 mg/dL

A nurse is caring for a client who has type 2 DM and is admitted with hyperglycemic-hyperosmolar state (HHS). Which of the following laboratory findings should the nurse expect? A. Blood glucose of 496 mg/dL and serum pH of 7.32 B. Blood glucose of 550 mg/dL and serum pH of 7.02 C. Blood glucose of 702 mg/dL and serum pH of 6.11 D. Blood glucose of 846 mg/dL and serum pH of 7.40

D. Blood glucose of 846 mg/dL and serum pH of 7.40 (Enough insulin to prevent ketosis, but not enough to prevent hyperglycemia -> serum pH is normal, glucose is elevated)

A HH nurse is assessing a client who is on lifelong hormone replacement therapy for tx of hypothyroidism. Client has not been taking meds regularly, Which of the following findings should the nurse expect? A. Significant weight loss B. Persistant diarrhea C. Tachycardia D. Hypotension

D. Hypotension

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 understanding? 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 OTC medicine to tx the calluses on my feet. D. I will apply lotion to the dry areas of my feet, avoiding application between my toes.

D. I will apply lotion to the dry areas of my feet, avoiding application between my toes.

A nurse is preparing a teaching plan for a client who has DI and is receiving intranasal desmopressin. Which of the following should the nurse include in the teaching plan? A.

D. Occurrence of nocturia indicates the need for a dosage adjustment. (Initial dose is admin in the evening, provider increases dosage until client no longer experiences nocturia).

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-hr 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. Restrict coffee intake 2 to 3 days prior to the test. (avoid coffee, tea, bananas, chocolate, and vanilla)