endocrine

A nurse is planning to administer a clients daily dose of insulin at 0730. The nurse should expect this type of insulin to peak within which of the following time frames after administration?

4 to 14 hr NPH insulin, an intermediate-acting insulin, peaks at 4 to 14 hr following administration.

a nurse is reinforcing teaching with a client who has diabetes mellitus about the manifestations of hypoglycemia which of the following statements by the client indicates an understanding of the teaching?

Diaphoresis Diaphoresis is a manifestation of hypoglycemia.

Nurse is caring for pt who is post op and has hx of addison's disease. What manifestation should the nurse monitor?

Hypotension The client who has Addison's disease is at risk for developing Addisonian crisis following a major physiological stressor such as surgery. Manifestations such as hypotension and tachycardia, extreme weakness and a decrease in mental status are noted. Untreated, Addisonian crisis may result in death.

a nurse is reviewing data for a client who had a head injury. which of the following findings should indicate to the nurse that the client might have diabetes insipidus

Urine output 650 mL/hr Diabetes insipidus is an endocrine disorder of the anterior pituitary gland. A decrease in antidiuretic hormone results in an increasingly high output of very dilute urine.

A nurse is reviewing nutrition therapy with a client who has cushings disease. which of the following dietary modifications should the nurse include in the discussion?

Decrease sodium intake. Clients who have Cushing's disease experience the impaired breakdown of nutrients resulting in hypernatremia, hyperglycemia, and hypokalemia. Therefore, the nurse should instruct the client to decrease sodium intake.

A nurse is assisting with a client's Plan of care for a client who had a subtotal thyroidectomy and which of the following position should the nurse place the patient ?

Fowler's position The nurse should position the client in the Fowler's position, to reduce the swelling of the operative area as well as facilitate breathing. The nurse may use sandbags to support the head to relieve tension on the sutures.

A nurse is reinforcing teaching about manifestations of hypoglycemia with an adolescent who has type 1 diabetes mellitus. which of the following manifestations should the nurse include in the teaching?

Headache A headache is a manifestation of hypoglycemia. Other manifestations of hypoglycemia include nervousness, dizziness, tachycardia, and sweating.

Nurse is monitoring pt for finding related to Diabetes Insipidus following craniotomy. Which of the following findings should indicate a manifestation of this condition to the nurse?

Increased urine output Diabetes insipidus is a water metabolism disorder caused by a deficiency of antidiuretic hormone (ADH). This deficiency results in the excretion of large amounts of dilute urine. Dehydration and shock may ensue, resulting in a life-threatening situation for the client.

a nurse is assisting with the plan of care for a client who has hypothyroidism and myxedema. which of the following interventions should the nurse include in the plan of care

Apply warm blankets The nurse should apply warm blankets to the client because he may have cold intolerance related to hypothyroidism.

A nurse is assisting a client of care for a client who is 4 hour postoperative from a subtotal thyroidectomy which of the following implementations should the nurse recommend?

Check for bleeding on the dressing at the back of the client's neck. The client is at risk for hemorrhage due to the vascularity of the surrounding tissue. The nurse should check the dressing on the back of the client's neck for evidence of hemorrhage

A nurse is caring for a client who has type 1 diabetes mellitus the nurse misread the client's morning blood glucose level of 210 mg per dL, instead of 120 mg per dL, and administered the wrong dose of insulin and which of the following actions should the nurse identify as a priority.

Check the client's blood glucose level. The first action the nurse should take using the nursing process is to assess or collect data from the client. The nurse should immediately check the client's blood glucose level, expecting it to be low because of the unnecessary dose of insulin. If it is within the expected reference range, the nurse should continue to monitor the client for hypoglycemia.

A nurse is preparing to administer subcutaneous regular insulin to a client before he eats breakfast at 0800. which of the following actions should the nurse take?

Give the insulin at 30 min before breakfast. The nurse should administer regular insulin 30 min before meals.

A nurse is reinforcing teaching for a pt who has type 2 DM who is taking glipizide. The pt should be taught that Glipizide works in the following ways?

Glipizide stimulates the pancreas to release adequate insulin. Glipizide is a sulfonylurea agent. It helps lower blood glucose levels by increasing insulin secretion from the beta cells of the pancreas.

A nurse is reviewing the medical record of a client who has hyperthyroidism (Graves' disease). Which of the following serum laboratory findings should the nurse expect to be below the expected reference range?

Thyroid stimulating hormone (TSH) level Graves' disease is a form of primary hyperthyroidism resulting from impaired function of the thyroid gland. The nurse should expect the TSH level to be below the expected reference range, due to increased thyroid hormone levels.

A nurse is reinforcing teaching with a client who has diabetes about which dietary source should provide the greatest percentage of her calories. Which of the following client statements indicates an understanding of the teaching?

"I should eat more calories from complex carbohydrates than anything else." The client who has diabetes should consume 45% of the total calories per day from complex carbohydrates, such as whole grains, fruits, and vegetables for better glycemic control.

a nurse is reinforcing teaching with a client who has diabetes mellitus about the manifestations of hypoglycemia which of the following statements by the client indicates an understanding of the teaching?

"I will feel shaky." This statement by the client indicates an understanding of the teaching as feeling shaky is a manifestation of hypoglycemia.

A nurse is caring for a client who has diabetes insipidus. Which of the following findings should the nurse expect?

Decreased urine specific gravity The nurse should expect a client who has diabetes insipidus to experience dilute urine as a result of excessive urinary output (about 15 L daily). Therefore, the nurse should expect a client who has diabetes insipidus to have a urine specific gravity below the expected reference range of 1.005 to 1.030.

a nurse is reinforcing teaching to a client who is to self administer regular insulin and nph insulin from the same syringe. which of the following instructions should the nurse provide

Discard regular insulin if it appears cloudy. The nurse should teach the client to discard regular insulin that appears cloudy. All insulin preparations except NPH should be clear. NPH insulin has a cloudy appearance.

a nurse is assisting with meal planning with a client who has hypothyroidism the nurse should reinforce with the client that she should increase her daily intake of which of the following nutrients

Fiber Constipation is a classic manifestation of hypothyroidism; therefore, this client should increase her fiber and fluid intake to help prevent constipation.

A nurse is collecting data on a client who has hyperthyroidism. Which of the following manifestations should the nurse expect the client to report

Frequent mood changes Hyperthyroidism develops when the thyroid gland produces an excess of the thyroid hormones that regulate the metabolic rate. Nervousness and frequent mood changes; hand tremors; a rapid, pounding, irregular heartbeat are common manifestations of hyperthyroidism.

Nurse is collecting data for a client who has diabetes mellitus. The client is confused, flushed, and has acetone odor in his breath. The nurse should anticipate rx for which of the following type of insulin?

Regular Regular insulin is the type of insulin used in the emergency treatment of diabetic ketoacidosis to reduce hyperglycemia and acidosis. It is the only insulin that can be given by IV and it has an onset of action as rapid as 30 min.

A nurse is collecting data from a client who has hypocalcemia. which of the following findings should the nurse expect?

Tingling of the lips Tingling and twitching in the extremities and face (lips, nose, and ears) are consistent with hypocalcemia, a deficiency in the serum calcium level. Intervention is required to prevent tetany, a life-threatening event.

a nurse is contributing to the plan of care for a client who has a new diagnosis of type 2 diabetes mellitus which of the following interventions should the nurse include? SATA

assist the client to develop an individualized meal plan offer the client 240 ml (8 oz) of skim milk if the clients skin becomes cool and clammy check the clients blood glucose levels before meals and at bedtime A client who has a new diagnosis of type 2 diabetes mellitus will need assistance to develop a meal plan that will help him achieve his weight goals, maintain his lifestyle, and meet his food preferences.Cool, clammy skin, pallor, irritability, and shakiness can indicate the client's blood glucose is below the expected reference range and that the client is having hypoglycemia. The nurse should offer the client a snack of 15 to 20 g of carbohydrate, such as 8 oz of skim milk, 1 small box of raisins, or 4 oz of juice.The nurse should check the client's blood glucose level at least before each meal and at bedtime to monitor glucose control and identify the need for medication.

A nurse administers NPH insulin at 0700 to a child who has diabetes. t which of the following times should the nurse observe for hypoglycemia caused by the onset of this medication?

0900 NPH insulin is an intermediate-acting insulin, and has an expected onset of 1½ to 4 hr with a peak of 4 to 12 hours. Therefore, the nurse should observe for hypoglycemia caused by the onset of the medication beginning at 0900.

a nurse working in a long term care facility is assigned care of four clients following the 0700 morning change of shift report. which of the following clients should the nurse attend to first?

A client who has diabetes, and had an 0600 blood glucose level of 60 mg/dL. When using the acute vs chronic approach to client care, the nurse should first collect data from the client who has diabetes and a blood glucose level below the expected reference range to prevent injury; therefore, the nurse should attend to this client first.

A nurse is reinforcing teaching to a client who has dm and is to start taking chlorpropamide. the nurse should teach the client to avoid consumption of which of the following while taking this medication?

​Alcohol Chlorpropamide is first generation sulfonylurea that can interact with alcohol to cause a disulfiram-like reaction. This can lead to flushing, palpitations, and nausea. In addition, alcohol can promote the hypoglycemic effect of chlorpropamide, causing the client's blood glucose level to decrease and cause injury.

A nurse finds a client who has type 1 diabetes mellitus lying in bed, sweating, tachycardic, and reporting feeling lightheaded and shaky. which of the following complications should the nurse expect?

​Hypoglycemia The client who has hypoglycemia manifests sweating, tachycardia, tremors, palpitations, hunger, and lightheadedness.

The nurse is reinforcing teaching for a client who has Diabetes Mellitus and has a prescription for insulin levemir(detemir) injection every day. Which of the following statements by the client indicates Understanding of the teaching?

"I can inject my insulin detemir in the evening before bedtime." When prescribed once daily, insulin detemir is injected in the evening, either with the evening meal or at bedtime.

A nurse is teaching a newly licensed nurse about insulin storage. Which of the following statements by the newly licensed nurse indicates and understanding of the teaching?

"I can keep the current vial of insulin in use stored at room temperature." The nurse can store the current vial of insulin at room temperature for up to 1 month.

a nurse is caring for a client who has recurring kidney stones and a history of diabetes mellitus the client is scheduled for an IVP (dye test) the nurse should collect additional data about which of the following statements made by the client?

"I took my metformin before breakfast." The nurse should identify clients taking metformin are at risk for lactic acidosis when receiving contrast media. Additional data should be collected about this statement.

A nurse is reinforcing teaching with a client who has diabetes mellitus and self administers insulin. The client reports drinking the occasional glass of wine. which of the following is an appropriate response by the nurse?

"It is best for you to drink an occasional glass of wine with a meal." Ingesting alcohol with a meal helps reduce the risk of nighttime hypoglycemia for clients who receive insulin therapy.

A nurse is reinforcing teaching with a client who has Diabetes mellitus type 1 about sick day management which of the following is the priority to recommend to the client

"Monitor blood glucose levels every 4 hours." The greatest risk to the client is the development of diabetic ketoacidosis, which results from an absence of insulin and manifests as elevated blood glucose levels. Therefore, the most important action for the client to take is to monitor the blood glucose level frequently.

a nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription for lispro and lantus insulins. which of the following statements by the client indicates an understanding of the teaching?

"Unopened vials of insulin should be kept in my refrigerator." MY ANSWER Prior to opening vials of insulin, they should be stored in the refrigerator. After opening, insulin can be stored in a cool place for up to 4 weeks.

A nurse is caring for a client who has gestational diabetes and reports feeling shaky, sweaty, and having blurred vision. The clients blood glucose level is 48mg/dl. which of the following foods should the nurse give to the client

120 mL of unsweetened fruit juice. 1 tbsp honey. 5 hard candies It is appropriate for the nurse to give 120 mL of unsweetened fruit juice, which contains 10 to 15 g of simple carbohydrate, to the client to treat hypoglycemia. It is appropriate for the nurse to give 1 tbsp of honey, which contains 10 to 15 g of simple carbohydrates, to the client to treat hypoglycemia. Five to six hard candies contain 10 to 15 g of simple carbohydrates and are appropriate for the nurse to give to the client to treat hypoglycemia.

A nurse in the emergency department is assisting with the care of a client who is comatose. The provider suspects ketoacidiosis. Which of the following findings should the nurse expect?

Acetone odor to breath Acetone odor to breath is an expected finding for ketoacidosis.

A nurse is reinforcing teaching to a client who has type 2 DM. The nurse determines that the teaching has been effective when the client identifies which of the following manifestations of hypoglycemia

Blurry vision, Tachycardia, sweating Manifestations of hypoglycemia include blurry vision, tremors, anxiety, irritability, headache, and hypotension.

a nurse in a providers office is collecting data from a client who has hypothyroidism. which of the findings should the nurse expect

Bradycardia Reduced thyroid hormone levels (hypothyroidism) reduce the body's metabolic rate and thus slow down various body functions. Bradycardia reflects slowed cardiovascular function.

A nurse is caring for a client who has type 1 diabetes mellitus. Which of the following recommendations should the nurse make to the client for a sweetener?

C. Nonnutritive sugar substitute The client who has type 1 diabetes mellitus should limit carbohydrate intake. Nonnutritive sugar substitutes allow the client to sweeten the taste of foods without increasing carbohydrate intake.

a nurse is collecting data from a client who has diabetes mellitus which of the following findings indicate that the client is experiencing DKA?

Polydipsia Polydipsia, or increased thirst, is a manifestation of DKA.

A nurse is preparing to administer a prescribed dose of 10 units of regular insulin and 20 units of NPH insulin to a client who has diabetes. Identify the steps the nurse should take when preparing two insulin's.

Using evidence-based practice, the first action the nurse should take is to draw up 20 units of air into the syringe, inject 20 units of air into the NPH insulin vial, and then withdraw the needle, which will facilitate drawing up the insulin. Next the nurse should draw up 10 units of air into the syringe and then inject 10 units of air into the regular insulin vial. The nurse should next withdraw 10 units of regular insulin into the syringe and withdraw the needle. The nurse should then reinsert the needle into the NPH insulin vial and withdraw 20 units of NPH, which will minimize mixing any of the NPH insulin with the regular insulin.

A nurse in a clinic is caring for a client who has a new diagnosis of hypothyroidism. Which of the following findings should the nurse expect?

Weight gain The nurse should expect the client to experience weight gain caused by a decreased metabolic rate. The client may report anorexia and decreased dietary intake.

a nurse is reinforcing teaching about exercise with a client who has type 1 diabetes mellitus which of the following statements by the client indicates an understanding of the teaching?

"I should avoid injecting insulin into my thigh if I am going to go running." The nurse should reinforce that the client should avoid injecting insulin into an area that will soon be exercised to avoid increasing the absorption rate of the insulin.

A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize which of the following as manifestations of Cushing's syndrome? (Select all that apply.)

Cushing's syndrome have hirsutism, excessive body hair, rather than alopecia, hair loss.Tremors are not a common finding in Cushing's syndrome.*Moon face is correct. Moon face, manifested by a round, red, full face, is common in Cushing's syndrome.*Purple striations is correct. Purple striations on the skin of the abdomen, thighs, and breasts are a common manifestation in Cushing's syndrome.Obese extremities is incorrect. Clients who have Cushing's syndrome have truncal obesity (a protuberant abdomen) with thin extremities.*Buffalo hump is correct. Buffalo hump, a collection of fat between the shoulder blades, is a common manifestation in Cushing's syndrome.

A nurse is caring for a client who is 32 weeks gestation who has hyperthyroidism. For which of the following clinical findings should the nurse report to the provider

Fever, tachycardia, vomiting , restlessness Fever is a clinical manifestation of thyroid storm, a complication of hyperthyroidism, which can occur in response to stresses such as birth, surgery, or infection. The nurse should report this finding to the provider.Tachycardia is a clinical manifestation of thyroid storm, a complication of hyperthyroidism, which can occur in response to stresses such as birth, surgery, or infection. The nurse should report this finding to the provider.Vomiting is a clinical manifestation of thyroid storm, a complication of hyperthyroidism, which can occur in response to stresses such as birth, surgery, or infection. The nurse should report this finding to the provider.Restlessness is a clinical manifestation of thyroid storm, a complication of hyperthyroidism, which can occur in response to stresses such as birth, surgery, or infection. The nurse should report this finding.

a nurse is collecting data from a client who takes metformin for type 2 diabetes. which of the following medications is contraindicated for this client due to its effects on blood glucose?

Prednisone Medications that increase plasma glucose levels are contraindicated for this client. Corticosteroids, such as prednisone, increase plasma levels of glucose levels and cause hyperglycemia and glycosuria.

Nurse is reinforcing teaching with a pt who is scheduled for a blood test to measure her thyroid stimulating hormone (TSH) levels. Which of the following statements should the nurse give?

The test determines whether your thyroid gland is overactive, appropriately active, or underactive." This statement describes this test, which helps determine thyroid status and helps monitor the effectiveness and dosage of thyroid hormone replacement therapy.

A nurse is caring for a client who is postoperative following a thyroidectomy. Which of the following is a priority for the nurse to monitor during the first 24hr of care?

​Airway patency When using the airway, breathing, circulation approach to client care, the nurse determines that the priority to monitor is airway patency. A thyroidectomy can result in edema or bleeding that can obstruct the airway. Provide humidification and elevate the client's head of bed to reduce swelling.