EoC Questions - Exam 3
Which precaution will the nurse include when providing instructions to the female client with hypothyroidism who is prescribed to take thyroid hormone replacement therapy (HRT)? "Increase the amount of fiber in your diet to prevent the side effect of constipation." "Stop this drug immediately if you discover you are pregnant." "Avoid over-the-counter medications unless prescribed by your primary health care provider." "If you miss a dose, double your next day's dose."
"Avoid over-the-counter medications unless prescribed by your primary health care provider."
What is the nurse's best first response when a client with a suspected endocrine disorder says, "I can't, you know, satisfy my wife anymore."? "Don't worry. It happens to everyone occasionally." "Do you use any over the counter or recreational drugs?" "Can you please tell me more?" "Would you like to speak with a counselor?"
"Can you please tell me more?"
Which precaution is most important for the nurse to teach a client who has cardiovascular autonomic neuropathy (CAN) from diabetes to prevent harm? "Check your hands and feet weekly for chronic excessive sweating." "Change positions slowly when moving from sitting to standing." "Avoid drinking caffeine or caffeinated beverages." "Be sure to take your blood pressure drug daily."
"Change positions slowly when moving from sitting to standing."
Which question is most relevant to ask a male client suspected to have a gonadotropin deficiency? "Are you experiencing any pain during sexual intercourse?" "Do you work with or have hobbies that involve exposure to chemicals?" "Have you gained or lost any weight recently?" "How often do you need to shave your face?"
"How often do you need to shave your face?"
Which statement made by the client alerts the nurse to the possibility of hypothyroidism? "I seem to feel the heat more than other people." "I am always tired, even when I get 10 or 12 hours of sleep." "Food just doesn't taste good without a lot of salt." "My grandmother had thyroid problems."
"I am always tired, even when I get 10 or 12 hours of sleep."
Which statement by a client indicates to the nurse correct understanding of what to do when the sensations of hunger and shakiness occur? "I will eat three graham crackers." "I will drink a glass of water." "I will sit down and rest." "I will give myself a dose of glucagon."
"I will eat three graham crackers."
Which statement made by the client who is going home after a transsphenoidal hypophysectomy indicates to the nurse correct understanding of actions to prevent complications from this treatment? "While I am awake, I will be sure to cough and deep breathe at least every 2 hours." "I will keep the cat food bowl on my counter so that I do not have to bend over." "Whenever I am out-of-doors in the sunshine, I will wear dark glasses." "If the dressing gets wet, I will wash the incision line and redress it immediately."
"I will keep the cat food bowl on my counter so that I do not have to bend over."
Which statement made by a client about thyroid hormone replacement therapy (HRT) indicates to the nurse that further teaching is needed? "If I continue to lose weight, I may need an increased dose." "I will have more energy with this medication." "If I often am constipated and feel tired, I may need an increased dose." "I will take the medication every morning."
"If I continue to lose weight, I may need an increased dose."
Which statement made by a client who is learning about self-injection of insulin indicates to the nurse that clarification is needed about injection site selection and rotation? "The abdominal site is best because it is closest to the pancreas." "I can reach my thigh best, so I will use different areas of the same thigh." "If I change my injection site from the thigh to an arm, the inulin absorption may be different." "By rotating sites within one area, my chance of having skin changes is less."
"The abdominal site is best because it is closest to the pancreas."
What is the nurse's best response to a client newly diagnosed with type 1 diabetes who asks why insulin is only given by injection and not as an oral drug? "Injected insulin works faster than oral drugs to lower blood glucose levels."' "Oral insulin is so weak that it would require very high dosages to be effective." "Insulin is a small protein that is destroyed in by stomach acids and intestinal enzymes." "Insulin is a "high alert drug" and could more easily be abused if it were available as an oral agent."
"Insulin is a small protein that is destroyed in by stomach acids and intestinal enzymes."
Which statement made by a client who is undergoing therapy with radioactive iodine (RAI) for Graves disease indicates a lack of understanding about the disorder and its treatment? "Luckily, I have my own bathroom, so I won't be exposing the rest of my family to radiation. "If this treatment works, maybe I will stop sweating all the time. "It will be great to lose my "bug-eyed" appearance. "I hope I don't gain too much weight when my thyroid function is normal.
"It will be great to lose my "bug-eyed" appearance.
A client expresses fear and anxiety over the life changes associated with diabetes, stating, "I am scared that I can't do it all and will get so sick that I will be a burden on my family." What is the nurse's best response? "Let's tackle it piece by piece. What is most scary to you?" "It is overwhelming, isn't it?" "Let's see how much you can learn today, so you are less nervous." "Many people live with diabetes and do it just fine."
"Let's tackle it piece by piece. What is most scary to you?"
What action will the nurse advise to prevent harm for a client with diabetes who has a 3-cm callus on the ball of the right foot? "Make an appointment with your podiatrist as soon as possible." "Make an appointment with a pedicurist and have them cut or file off the callus." "Soak your feet nightly in warm water and peel of a little of the callus every day." "Apply an over-the-counter callus-dissolving pad and follow the package directions."
"Make an appointment with your podiatrist as soon as possible."
What is the nurse's best response when family members of a client with hyperthyroidism express concern about the client's frequent mood swings? "Do the client's mood swings make you feel angry?" "The medications will make the mood swings disappear completely." "Your family member is sick. You must be patient." "Mood swings are common and should diminish with treatment."
"Mood swings are common and should diminish with treatment."
Which specific action is a priority for the nurse to teach a client with diabetes who has peripheral neuropathy to prevent harm? "Wear a medical alert bracelet." "Never go barefoot." "Never reuse insulin syringes." "Drink at least 3 L of fluids daily."
"Never go barefoot."
What is the nurse's best response when a client, who has been taking high-dose corticosteroid therapy for a month for a problem that has now resolved, asks you why she needs to continue taking the corticosteroid? "Corticosteroids are a type of hormone, and once you have been started on a replacement hormone, you must continue the hormone replacement therapy for the rest of your life." "The drug suppressed your own adrenal gland secretion of corticosteroids. Slowly decreasing the dose over time allows your adrenal glands to start adequate secretion again." "It is possible for your health problem to recur when corticosteroid therapy is halted suddenly." "The drug suppressed your immune system while you were taking it. Slowly decreasing the dose over time prevents your immune system from starting up too quickly and causing allergic reactions."
"The drug suppressed your own adrenal gland secretion of corticosteroids. Slowly decreasing the dose over time allows your adrenal glands to start adequate secretion again."
What is the nurse's best response to a client newly diagnosed with diabetes who asks why he is always so thirsty? "Without insulin, glucose is excreted rather than used in the cells. The loss of glucose directly triggers thirst, especially for sugared drinks." "The extra glucose in the blood increases the blood sodium level, which increases your sense of thirst." "Without insulin, glucose combines with blood cholesterol, which damages the kidneys, making you feel thirsty even when no water has been lost." "The extra glucose in the blood makes the blood thicker, which then triggers thirst so that the water you drink will dilute the blood glucose level."
"The extra glucose in the blood makes the blood thicker, which then triggers thirst so that the water you drink will dilute the blood glucose level."
How will the nurse reply when a client with type 2 diabetes tells the nurse that he would like to have a 12-ounce glass of beer with supper but believes that is now impossible? "You can have a beer with a meal if you test yourself for hypoglycemia an hour later." "You can have a beer with a meal if you test yourself for hyperglycemia an hour later." "There are non alcoholic beers available that you can substitute for a regular beer." "If you gave up dessert, you can still have one beer."
"You can have a beer with a meal if you test yourself for hypoglycemia an hour later."
What is the nurse's best response when a client with Cushing syndrome screams at her husband, bursts into tears, throws her water pitcher against the wall, and then says "I feel like I am going crazy"? "You must learn to control your behavior. Because you are disturbing others, I am going to keep the door to your room closed and restrict your visitors." "You feel this way because of your high hormone levels. Your health care provider can prescribe an antianxiety drug for you." "I will tell your primary health care provider order a psychiatric consult for you." "You are probably feeling this way because you are frightened about having a chronic disease. Would you like some information about a support group?"
"You feel this way because of your high hormone levels. Your health care provider can prescribe an antianxiety drug for you."
What is the nurse's best response to a client with type 2 diabetes controlled with metformin who asks why now that he is recovering from surgery, is he prescribed to receive insulin therapy for a few days? "Your insurance doesn't permit metformin to be used during hospitalization." "Your presurgical testing indicates that you now have type 1 diabetes and require daily insulin." "You just need insulin temporarily because the stress of surgery causes increased blood glucose levels for a day or two." "You must take insulin from now on because the surgery has aggravated the intensity of your diabetes."
"You just need insulin temporarily because the stress of surgery causes increased blood glucose levels for a day or two."
When (at which time) will the nurse plan to monitor for hypoglycemia in a client with type 1 diabetes received regular insulin at 7:00 a.m.? 7:30 a.m. 7:30 p.m. 11:00 a.m. 2:00 p.m.
11:00 a.m.
Which assessment finding in a client who had a parathyroidectomy yesterday indicates to the nurse that immediate action is needed? Hypoactive bowel sounds Apical pulse of 92 bpm Bilateral leg muscle twitching Dry mouth
Bilateral leg muscle twitching
Which action is most important for the nurse to take first after finding a client who has severe hypothyroidism to be unresponsive to attempts to waken her and have a heart rate of 46 beats/min? Increasing the IV infusion rate Initiating the Rapid Response Team Assessing temperature Applying oxygen by mask
Apply oxygen by mask
The nurse has just received report on a group of clients. Which client is the nurse's first priority? A 26 year old with type 1 diabetes whose insulin pump is beeping "occlusion." A 30 year old with type 1 diabetes who is reporting thirst. A 40 year old with type 2 diabetes who has a blood glucose of 150 mg/dL (8.3 mmol/L). A 50 year old with type 2 diabetes with a blood pressure of 150/90 mm Hg.
A 26 year old with type 1 diabetes whose insulin pump is beeping "occlusion."
The nurse has just received report on a group of clients. Which client is the nurse's first priority? A 42 year old with diabetes insipidus who has a dose of desmopressin due. A 35 year old with hyperaldosteronism who has a serum potassium of 3.0 mEq/L (3.0 mmol/L). A 50 year old with pituitary adenoma who is reporting a severe headache. A 28 year old with acute adrenal insufficiency who has a blood glucose of 36 mg/dL (2.0 mmol/L).
A 28 year old with acute adrenal insufficiency who has a blood glucose of 36 mg/dL (2.0 mmol/L).
With which client will the nurse be aware of an increased risk for hypoparathyroidism? A 28-year-old woman with pregnancy-induced hypertension A 35-year-old woman who had radiation therapy for Graves disease A 50-year-old man starting on insulin therapy for type 2 diabetes mellitus A 55-year-old man with moderate heart failure after myocardial infarction
A 35-year-old woman who had radiation therapy for Graves disease
The nurse has just received report on a group of clients. Which client is the nurse's first priority? A 50 year old taking repaglinide who has nausea and back pain. A 55 year old taking pioglitazone who has bilateral ankle swelling. A 45 year old taking metformin who has abdominal cramps. A 40 year old taking glyburide who is dizzy and sweaty.
A 40 year old taking glyburide who is dizzy and sweaty.
For which client will the nurse question the prescription for long term androgen therapy? A 40 y/o who has SIADH A 52 y/o with a history of prostate cancer treatment A 30 y/o who is taking antiviral therapy for HIV A 66 y/o with impotence resistant to standard erectile dysfunction therapy
A 52 y/o with a history of prostate cancer treatment
Which client does the nurse caution to avoid self-monitoring of blood glucose (SMBG) at alternate sites? A 55-year-old client who has hypoglycemic unawareness An 80-year-old client with type 2 diabetes mellitus A 45-year-old client with type 1 diabetes mellitus A 75-year-old client whose blood glucose levels show little variation
A 55-year-old client who has hypoglycemic unawareness
2. Which assessment has the highest priority for the nurse to perform for a client with syndrome of inappropriate antidiuretic hormone (SIADH) receiving tolvaptan therapy for 24 hours? A. Evaluating serum sodium levels B. Evaluating serum potassium levels C. Examining the skin and sclera for jaundice D. Examining the IV site for indications of phlebitis
A. Evaluating serum sodium levels
1. Which physiological processes directly prevent severe hypoglycemia in a healthy adult without diabetes who is NPO for 12 hours? Select all that apply. A. Gluconeogenesis B. Glycogenesis C. Glycogenolysis D. Ketogenesis E. Lipogenesis F. Lipolysis
A. Gluconeogenesis C. Glycogenolysis
Performance of which assessment is a priority for the nurse before giving a client the first oral dose of hormone replacement for hypothyroidism? A. Measuring heart rate and rhythm B. Checking core body temperature C. Asking about previous allergic drug reactions D. Listening to bowel sounds in all four abdominal quadrants
A. Measuring heart rate and rhythm
Which primary health care provider order will the nurse perform first for a client with syndrome of inappropriate antidiuretic hormone (SIADH) who has a serum sodium level of 105 mEq/L (105 mmol/L)? Administering an infusion of 150 mL hypertonic saline over the next 3 hours Drawing blood for hemoglobin and hematocrit levels Measuring serial weights at the same daily with the client wearing the same amount of clothing Inserting an indwelling catheter and monitoring urine output
Administering an infusion of 150 mL hypertonic saline over the next 3 hours
Clients who have deficiencies of which hormones will the nurse assess for increased risk of life-threatening consequences? Prolactin and prolactin inhibiting hormone (PIH) Adrenocorticotropic hormone (ACTH) and thyroid-stimulating hormone (TSH) Growth hormone (GH) and melanocyte-stimulating hormone (MSH) Follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
Adrenocorticotropic hormone (ACTH) and thyroid-stimulating hormone (TSH)
3. Which of the following are the priority precautions the nurse will teach the client who remains at continuing risk for adrenal hypofunction and is taking hormone replacement therapy to prevent harm related to the disorder? Select all that apply. A. "Avoid crowds and people who are ill B. "Check your heart rate for irregular or skipped beats twice daily." C. "Do not choose low-sodium versions of prepared foods." D. "Get up slowly from sitting or lying positions." E. "Keep a source of glucose, such as candy, with you at all times." F. "Never skip your hormone replacement drugs."
All of the above
Which factor or condition does the nurse expect to result in an increase in a client's production of thyroid hormones (TH)? Getting 8 hours of sleep nightly Chronic constipation Protein-calorie malnutrition Cold environmental temperatures
Cold environmental temperatures
Which action has the highest priority for the nurse to take when a client with type 1 diabetes arrives in the emergency department breathing deeply and stating, "I can't catch my breath." and has vital signs of: T 98.4° F (36.9° C), P 112 beats/min, R 38 breaths/min, BP 91/54 mm Hg, and O2 saturation 99% on room air? Administering oxygen Connecting a cardiac monitor Assessing arterial blood gas (ABG) values Assessing blood glucose level
Assessing blood glucose level
The nurse reviews the vital signs of a client diagnosed with Graves disease and notes that the client's temperature is 99.6° F (37.6° C). After notifying the primary health care provider, what is the nurse's best next action? Administering acetaminophen Observing for the presence of chills Initiating the Rapid Response Team Assessing cardiac status
Assessing cardiac status
3. Which health promotion activity(ies) will the nurse recommend to prevent harm in a client with type 2 diabetes?Select all that apply. A. "Avoid all dietary carbohydrate and fat B. "Have your eyes and vision assessed by an ophthalmologist every year." C. "Reduce your intake of animal fat and increase your intake of plant sterols." D. "Be sure to take your antidiabetes drug right before you engage in any type of exercise. . "Keep your feet warm in cold weather by using either a hot water bottle or a heating pad" F. "Avoid foot damage from shoe-rubbing by going barefoot or wearing flip-flops when you are at home.
B. "Have your eyes and vision assessed by an ophthalmologist every year." C. "Reduce your intake of animal fat and increase your intake of plant sterols."
2. Which instruction/precaution does the nurse teach a client to prevent harm during a 24-hour urine specimen collection? A. Be sure to keep the specimen cool for the entire collection period. B. Avoid splashing urine in the container when a preservative is present. C. Add the preservative to the collection container before adding any urine. D. Discard the first specimen that marks the beginning of the 24-hour test period.
B. Avoid splashing urine in the container when a preservative is present.
2. Which assessment findings in a client with hyperthyroidism indicate to the nurse that the client is in danger of thyroid storm? Select all that apply. A. Increased salivation B. Client report of increased palmar sweating C. Decreased pulse pressure from 40 mm Hg to 36 mm Hg D. Diminished bowel sounds in all four abdominal quadrants E. An increase in temperature from 99.5°F (37.5°C) to 101.3°F (38.5°C) F. Serum sodium level increase from 136 mEg/L (mmol/L) to 139 mEg/L (mmol/L) G. Increase in premature ventricular heart contractions from 4 per minute to 28 per minute
B. Client report of increased palmar sweating E. An increase in temperature from 99.5°F (37.5°C) to 101.3°F (38.5°C) G. Increase in premature ventricular heart contractions from 4 per minute to 28 per minute
5. While making rounds the nurse finds a client with type | diabetes mellitus pale, sweaty, and slightly confused; the client can swallow. The client's blood glucose level check is 48 mg/dL (2.7 mmol/L). What is the nurse's best first action to prevent harm? A. Call the pharmacy and order a STAT does of glucagon. B. Immediately give the client 30 g of glucose orally. C. Start an IV and administer a small amount of a concentrated dextrose solution. D. Recheck the blood glucose level and call the Rapid Response Team.
B. Immediately give the client 30 g of glucose orally.
Which trends in serum electrolyte values will the nurse expect to find in a client who has untreated hypoparathyroidism? Below normal calcium levels; above normal phosphorus levels Below normal calcium levels; below normal phosphorus levels Above normal calcium levels; above normal phosphorus levels Above normal calcium levels; below normal phosphorus levels
Below normal calcium levels; above normal phosphorus levels
Which action immediately after a hypophysectomy will the nurse instruct a client to avoid to prevent harm? (Select all that apply.) Select all that apply. Bending at the waist Talking Deep breathing Coughing Wearing makeup Using dental floss
Bending at the waist Coughing
Which precaution is most important for the nurse to teach a female client to prevent harm while undergoing drug therapy with estrogen and progesterone for hypopituitarism? A. "Use a barrier method of contraception to prevent an unplanned pregnancy." B. "Wear a hat with a brim and use sunscreen when out-doors." C. "Do not smoke or use nicotine in any form." D. "Avoid drinking caffeinated beverages."
C. "Do not smoke or use nicotine in any form."
3. The nurse reviewing the laboratory values of a client with hypoparathyroidism finds a serum calcium level of 7.9 mg/ dL (1.76 mmol/L). Which parameter is most important for the nurse to assess to prevent harm? A. Temperature B. Heart rate and rhythm C. Deep tendon reflexes D. Level of consciousness
C. Deep tendon reflexes
2. Which precaution is a priority for the nurse to teach a client prescribed pramlintide to prevent harm? A. Only take this drug once weekly. B. Do not drink alcohol when taking this drug. C. Do not mix in the same syringe with insulin. D. Report any genital itching to your primary health care provider.
C. Do not mix in the same syringe with insulin.
Which statement regarding trophic (tropic) hormones is true? A. All are categorized as catecholamines. B. Responses are independent of target tissue receptors. C. Their target tissues are always another endocrine gland. D. They represent the final hormone secreted in a complex negative feedback pathway.
C. Their target tissues are always another endocrine gland
Which items are most important for the nurse to ensure are in the room when a client returns from having a thyroidectomy? (Select all that apply.) Hypertonic saline Furosemide Calcium gluconate Oxygen Suction Emergency tracheotomy kit
Calcium gluconate Oxygen Suction Emergency tracheotomy kit
Which action in the plan of care for a client who is hospitalized for pituitary function testing would be most appropriate for the nurse to delegate to an experienced assistive personnel (AP)? Checking the clients blood glucose levels every four hours Monitoring the client response to the IV insulin given during a stimulation test Teaching the client about a hormone suppression test Assessing the client for signs of hypopituitarism
Checking the clients blood glucose levels every four hours
For which assessment finding in a client who had a transsphenoidal hypophysectomy yesterday will the nurse notify the primary health care provider immediately? Dry lips and oral mucosa on examination Nasal drainage that tests negative for glucose Urine specific gravity of 1.016 Client report of a headache and stiff neck
Client report of a headache and stiff neck
Which assessment finding in a client with hyperaldosteronism indicates to the nurse that the condition is becoming more severe? Urine output for the past 24 hours has increased. Client reports numbness and tingling around the mouth. Temperature is now elevated. pH is now 7.43.
Client reports numbness and tingling around the mouth.
4. A client preparing for surgery to remove a cortisol-secreting tumor from the adrenal gland asks the nurse whether the physical changes from the excessive cortisol will go away as a result of the surgery so she can look like herself again. What is the nurse's best response? A. "The surgery is to remove the tumor, not reconstructive surgery." B. "You will notice a great difference in your appearance starting within a week after surgery." C. "All the changes will resolve but may take a year or longer to completely disappear." D. "The fatty changes and acne will resolve with time but the stretch marks only fade."
D. "The fatty changes and acne will resolve with time but the stretch marks only fade."
4. When preparing to administer a prescribed subcutaneous dose of NPH insulin from an open vial taken from a medication drawer to a client with diabetes, the nurse notes the solution is cloudy. What action will the nurse perform to ensure client safety? A. Warm the vial in a bowl of warm water until it reaches normal body temperature. B. Return the vial to the pharmacy and open a fresh vial of NPH insulin. C. Roll the vial between the hands until the insulin is clear. D. Check the expiration date and draw up the insulin dose.
D. Check the expiration date and draw up the insulin dose.
For which symptoms will the nurse instruct the family and client who is being treated for diabetes insipidus (DI) to call 911 or go to the nearest emergency department? (Select all that apply.) Select all that apply. Decreased urine output Hypotension Weigh gain of more than 2.2 lb (1 kg) in 24 hours Persistent headache Hyperglycemia Acute confusion
Decreased urine output Weight gain of more than 2.2 lbs in 24 hrs Persistent headache Acute confusion
Which question asked by a 48-year-old client with sleep apnea whose blood glucose level is elevated suggests to the nurse the possibility of a growth hormone excess? "Do you think if I lost weight my sleep apnea would improve?" "Why do I feel thirsty all the time?" "How can I make my skin less itchy?" "Does everyone's feet get bigger during menopause?"
Does everyone's feet get bigger during menopause?
Which factor is most important for the nurse to assess before providing instruction to a client newly diagnosed with diabetes about the disease and its management? Current energy level and rest patterns Sexual orientation Current lifestyle for diet and exercise Education and literacy levels
Education and literacy levels
Which signs and symptoms in a client who has hyperthyroidism indicate to the nurse possible progression to a thyroid storm? (Select all that apply.) Elevated temperature Tachycardia Somnolence Elevated systolic blood pressure Abdominal pain and nausea Slow respiratory rate
Elevated temperature Tachycardia Elevated SBP Abdominal pain and nausea
Which action is most important for the nurse to perform when caring for an older client decreased antidiuretic hormone (ADH) production? Inspecting feet and legs for ulcers Planning for weight-bearing activities Stressing the importance of fiber in the diet Encouraging fluids, every two hours
Encouraging fluids, every two hours
What is the nurse's best action when noticing that the phlebotomist, who plans to draw blood from the client with severe hypercortisolism, displays symptoms of a cold? Ensuring the phlebotomist wears a facemask while in the client's room Asking the phlebotomist to delay the blood draw Monitoring the client closely for cold-like symptoms Placing a facemask on the client
Ensuring the phlebotomist wears a facemask while in the client's room
What is the nurse's best action when finding that a client who has had diabetes for 15 years has decreased sensory perception in both feet? Testing the sensory perception of the client's hands Examining both feet for indications of injury Explaining to the client that peripheral neuropathy is now present Documenting the finding as the only action
Examining both feet for indications of injury
Which type of drug therapy will the nurse prepare to teach about to a client who has mild hyperparathyroidism? Antipyretics Opioid analgesics Furosemide diuretics Calcium supplements
Furosemide diuretics
Which laboratory findings will the nurse use to validate the statement of a client with diabetes that therapy instructions for glucose control "have been followed to the letter" for the past 2 months? Random blood glucose Glycosylated hemoglobin (HbA1c) Fasting blood insulin level Fasting blood glucose level
Glycosylated hemoglobin (HbA1c)
For which new-onset symptom or behavior will the nurse teach a client taking thyroid hormone replacement therapy (HRT) to report immediately to the primary health care provider? Calf muscle cramping Runny nose Anorexia Hand tremors
Hand tremors
Which changes in laboratory values will the nurse expect to see in a client who has tumor causing excess secretion of aldosterone? (Select all that apply.) Hypoglycemia Hyponatremia Hypokalemia Hypernatremia Hyperglycemia Hyperkalemia
Hypokalemia Hypernatremia
After instructing a client about the correct procedure for a 24-hour urine test, which client statement indicates to the nurse a need for further teaching? I will not eat any fatty foods while I'm collecting urine for this test To end a collection, I must empty my bladder and add this urine to the collection I need to keep the urine container cool and in a separate refrigerator or cooler I won't save the first urine sample of the day
I will not eat any fatty foods while I'm collecting urine for this test
What is the nurse's best response when a client with diabetes who is being treated for hypoglycemic asks why people without diabetes don't become severely hypoglycemic even after fasting for 8 hours? In a person without diabetes, fasting for 8 hours converts proteins into glucose (gluconeogenesis) so that hyperglycemia develops rather than hypoglycemia. In a person without diabetes, the secretion of glucagon prevents hypoglycemia by promoting glucose release from liver storage sites (glycogenolysis). Normal metabolism is so slow when a person without diabetes fasts that blood glucose does not enter cells to be used for energy. As a result, hypoglycemia does not occur. Lipolysis (fat breakdown) in fat stores occurs faster in the nondiabetic person, which converts fatty acids into glucose to maintain blood glucose levels.
In a person without diabetes, the secretion of glucagon prevents hypoglycemia by promoting glucose release from liver storage sites (glycogenolysis).
Which client assessment finding indicates to the nurse the need to assess further for a possible endocrine problem? Increased facial hair and absent menses in a 28-year-old nonpregnant woman Increased appetite in a 40-year-old man who started an aerobic exercise program 1 week ago Male-pattern baldness in a 32-year-old man Dry skin on the shins of a 70-year-old woman
Increased facial hair and absent menses in a 28-year-old nonpregnant woman
What effect on circulating levels of sodium and glucose does the nurse expect in a client who has been taking an oral cortisol preparation for 2 years because of a respiratory problem? Decreased sodium; decreased glucose Increased sodium; increased glucose Increase sodium; decreased glucose Decreased sodium; increased glucose
Increased sodium; increased glucose
Which client assessment finding indicates to the nurse the possible presence of diabetic autonomic neuropathy? Loss of sensation in both feet Hyperglycemia Intermittent constipation Increased thirst
Intermittent constipation
Which statements regarding hyperthyroidism are accurate? (Select all that apply.) Has a sudden onset of symptoms. Is much more common among women than among men. Produces symptoms of a hypermetabolic state. Most common form is Graves disease. Can be diagnosed by the presence of a goiter. Often occurs weeks after exposure to ionizing radiation.
Is much more common among women than among men. Produces symptoms of a hypermetabolic state. Most common form is Graves disease.
In collaboration with the registered dietitian nutritionist, which dietary alterations will the nurse instruct a client with Cushing disease to make? High carbohydrate, low potassium, and fluid restriction Low carbohydrate, high calorie, and low sodium Low protein, high carbohydrate, and low calcium High protein, high carbohydrate, and low potassium
Low carbohydrate, high calorie, and low sodium
Which action does the postanesthesia care unit (PACU) nurse perform first when caring for a client who has just arrived after a total thyroidectomy? Administering morphine for pain Assessing the wound dressing for bleeding Hyperextending the neck Monitoring oxygen saturation
Monitoring oxygen saturation
Which client symptom appearing after a head injury suffered in a car crash is most relevant for the nurse to consider the possibility of diabetes insipidus (DI)? New-onset hypertension. The client reports extreme salt craving. No change in urine output with minimal fluid intake. The client's headache is gradually increasing in intensity.
No change in urine output with minimal fluid intake.
Which signs, symptoms, or behaviors will the nurse expect to find when assessing a client who has just been diagnosed with hypothyroidism? (Select all that apply.) Select all that apply. Goiter Nonpitting edema of hands and feet Warm, moist skin Decreased deep tendon reflexes Agitation and inability to sleep Pulse rate below 60 beats/min
Nonpitting edema of hands and feet Decreased deep tendon reflexes Pulse rate below 60 beats/min
Which action is appropriate for the nurse to delegate to the assistive personnel (AP) when caring for clients with diabetes? Monitoring a client who reports palpitations and anxiety Verifying the infusion rate on a continuous infusion insulin pump Performing a blood glucose check on a client who requires insulin Assessing a client who reports tremors and irritability
Performing a blood glucose check on a client who requires insulin
Which assessment is a priority for the nurse to make when a client with diabetic ketoacidosis (DKA) who is being monitored while receiving an insulin infusion begins to show an irregular heartbeat with inverted T-waves? Rate of IV infusion Urine output Potassium level Breath sounds
Potassium level
Which assessment finding in a client with diabetes mellitus indicates to the nurse that the disease is damaging the kidneys? White blood cells (WBCs) in the urine during a random urinalysis Ketone bodies in the urine during acidosis Glucose in the urine during hyperglycemia Protein in the urine during a random urinalysis
Protein in the urine during a random urinalysis
Which changing trends in a client's serum laboratory values indicate to the nurse that thyroid hormone replacement therapy for hypothyroidism is effective? Declining thyroglobulin (Tg) levels; rising thyrotropin receptor antibody (TRAb) levels Declining thyroid hormone (TH) levels; rising thyroid-stimulating hormone (TSH) levels Rising thyroglobulin (Tg) levels; declining thyrotropin receptor antibody (TRAb) levels Rising thyroid hormone (TH) levels; declining thyroid-stimulating hormone (TSH) levels
Rising thyroid hormone (TH) levels; declining thyroid-stimulating hormone (TSH) levels
Which laboratory finding in a client with a possible pituitary disorder will the nurse report to the health care provider immediately? Blood glucose 148 mg/dL Blood urea nitrogen (BUN) 40 mg/dL Serum sodium 110 mEq/L Serum potassium 3.2 mEq/L
Serum sodium 110 mEq/L
Which change in serum electrolyte values in the past 12 hours for a client with syndrome of inappropriate antidiuretic hormone (SIADH) being treated with tolvaptan will the nurse report immediately to the health care provider? Serum sodium increases from 122 mEq/L to 140 mEq/L. Serum potassium decreases from 4.2 mEq/L to 3.8 mEq/L. Serum chloride decreases from 109 mEq/L to 99 mEq/L. Serum calcium increases from 9.5 mg/dL to 10.2 mg/dL.
Serum sodium increases from 122 mEq/L to 140 mEq/L.
Which action will the nurse recommend to a client with type 1 diabetes on insulin therapy who has been having a morning fasting blood glucose (FBG) level of 160 mg/dL (8.9 mmol/L) and is diagnosed with "dawn phenomenon" to achieve better control? Eat a bedtime snack containing equal amounts of protein and carbohydrates." Avoid eating any carbohydrate with your evening meal." Take your evening insulin dose right before going to bed instead of at supper time."' Inject the insulin into your arm rather than into the abdomen around the navel."
Take your evening insulin dose right before going to bed instead of at supper time."'
*Why is a goiter often present in clients who have Graves disease?* The low circulating levels of thyroid hormones stimulates the feedback system and triggers the anterior pituitary gland to secrete more thyroid-stimulating hormone, which increases the numbers and size of glandular cells in the thyroid gland. The excessive autoantibodies bind to the thyroid-stimulating hormone receptor sites, which increases the number and size of glandular cells in the thyroid gland. The autoantibodies stimulate blood vessel growth and blood storage within the thyroid gland, increasing its overall size. The autoantibodies stimulate the inflammatory and immune responses to increase the number of white blood cells circulating in the thyroid gland, which increases tissue size without increasing the number of glandular cells.
The excessive autoantibodies bind to the thyroid-stimulating hormone receptor sites, which increases the number and size of glandular cells in the thyroid gland.
How will the nurse evaluate the level of glycemic control for a client with diabetes whose laboratory values include a fasting blood glucose level of 82 mg/dL (mmol/L) and an A1c of 5.9%? The values indicate that the client has poorly managed his or her disease. The values indicate that the client has managed his or her disease well. The client's glucose control for the past 24 hours has been good but the overall control is poor. The client's glucose control for the past 24 hours has been poor but the overall control is good.
The values indicate that the client has managed his or her disease well.
Which assessment finding in a client with diagnosis of diabetes insipidus (DI) indicates to the nurse that desmopressin therapy is effective? Urine output of 30 to 50 mL/hr Blood glucose level of 110 mg/dL (6.1 mmol/L) Respiratory rate of 20 breaths/min Potassium level of 3.9 mEq/L (mmol/L)
Urine output of 30 to 50 mL/hr
A client newly diagnosed with type 1 diabetes says she is not ready to learn everything about diabetes control right now. Which information has the greatest priority for the nurse to teach this client and her family for now to prevent harm? (Select all that apply.) Causes of type 1 diabetes What to do when ill? Symptoms and treatment of hypoglycemia Insulin administration Dietary control of blood glucose Importance of regular exercise
What to do when ill Symptoms and treatment of hypoglycemia insulin administration
For which change reported by a client taking bromocriptine therapy to manage hyperpituitarism will the nurse notify the primary health care provider immediately to prevent harm? Chest pain Constipation Headache Increased sleepiness
chest pain
Which new-onset symptoms will the nurse instruct a client with diabetes who is prescribed to take the sodium-glucose cotransport inhibitor, empagliflozin, to report to the diabetes health care provider to prevent harm? (Select all that apply.) Muscle weakness/dizziness on standing Redness and tenderness at injection site Rapid weight gain and shortness of breath Redness and tenderness of the perineum Sensations of hunger, tremors, sweating, and confusion Pain and burning on urination
muscle weakness/dizziness on standing redness and tenderness of the perineum sensations of hunger, tremors, sweating, and confusion pain and burning on urination
Which client report of changes in appearance indicates to the nurse that a client's adrenal insufficiency is related to direct malfunction of the adrenal glands? 5-lb weight loss Dry, cracked lips Thinning pubic hair Skin darkening
skin darkening
