Evolve: Endocrine

A 40-year-old male is prescribed Metformin XL (Glucophage) to control his type 2 diabetes mellitus. Which statement made by this client indicates the need for further education?

"I will stop taking Metformin for 24 hours before and after having a test involving dye."

During a teaching session about insulin injections, a client asks the nurse, "Why can't I take the insulin in pills instead of taking shots?" What is the nurse's best response?

"Insulin is destroyed by gastric juices, rendering it ineffective."

A client experiencing thyrotoxic crisis tells the nurse, "I know I'm going to die. I'm very sick." Which is the best response by the nurse?

"You must feel very sick and frightened."

A nurse is assessing a client for possible laryngeal nerve injury following a thyroidectomy. Which action should the nurse implement on an hourly basis?

Ask the client to speak

A client with type 1 diabetes self-administers Novolin N insulin every morning at 8 AM. The nurse evaluates that the client understands the action of the insulin when the client says, "I should be alert for signs of hypoglycemia between:

2 PM and 8 PM."

The parents of a young man suspected of having Cushing syndrome expresses anxiety about their son's condition. What should the nurse tell the parents to help them better understand the illness?

He may have mood swings or depression as a result of his illness.

A client with adrenal insufficiency reports feeling weak and dizzy, especially in the morning. What should the nurse determine is the most probable cause of these symptoms?

A hypoglycemic reaction

A client is admitted to the hospital for medical management of acute pancreatitis. Which nursing action is most likely to reduce the pancreatic and gastric secretions of a client with pancreatitis?

Administering prescribed anticholinergic medication.

A client's problem with ineffective control of type 1 diabetes is pinpointed as a sudden decrease in blood glucose level followed by rebound hyperglycemia. What should the nurse do when this event occurs?

Collaborate with the health care provider to alter the insulin prescription.

A client's blood gases reflect diabetic ketoacidosis. Which clinical indicator should the nurse expect to identify when monitoring this client's laboratory values?

Decreased HCO3

A nurse is formulating a teaching plan for a client recently diagnosed with type 2 diabetes. What interventions should the nurse include that will decrease the risk of complications? Select all that apply.

Examining the feet daily Wearing well-fitting shoes Performing regular exercise

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

Glucose level

Late in the postoperative period after resection of an aldosterone-secreting adenoma, the nurse expects the client's blood pressure to:

Gradually return to near normal levels

A nurse is caring for a client who is scheduled for a bilateral adrenalectomy. Which medication should the nurse expect to be prescribed for this client on the day of surgery and in the immediate postoperative period?

Hydrocortisone succinate (Solu-Cortef)

Which insulin should the nurse prepare for the emergency treatment of ketoacidosis?

Insulin aspart (NovoLog)

During the progressive stage of shock, anaerobic metabolism occurs. For which complication should the nurse assess the client?

Metabolic acidosis

A nurse is caring for a client who is experiencing an underproduction of thyroxine (T4). Which client response is associated with an underproduction of thyroxine?

Myxedema

A client with a diagnosis of Graves disease refuses to have radioactive iodine (RAI) therapy, and a subtotal thyroidectomy is performed. What should the nurse do postoperatively to reduce the risk of thyroid storm?

Prevent infection at the surgical site.

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

Prominent jaw

A nurse is caring for a client after a thyroidectomy. Because of concerns about potential nerve injury associated with this type of surgery, the nurse should assess for which functional ability?

Speaking

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 health care provider?

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

A nurse is assessing a client who is admitted to the hospital with a tentative diagnosis of a pituitary tumor. What signs of Cushing syndrome does the nurse identify?

Retention of sodium and water

A female client who is scheduled for a thyroidectomy is concerned that the surgery will interfere with her ability to become pregnant. The nurse should base a response on the understanding that:

As long as medication is continued, ovulation will occur

The nurse is providing instructions about foot care for a client with diabetes mellitus. What should the nurse include in the instructions? Select all that apply.

Wear shoes when out of bed. Dry between the toes after bathing.

A client who is feeling increasingly tired seeks medical care. Type 1 diabetes is diagnosed. The nurse explains that the increased fatigue is the result of:

Decreased production of insulin by the pancreas

A client is admitted to the hospital with a possible diagnosis of Addison disease. What is an important nursing responsibility during a 24-hour urine collection for this client?

Keeping the client quiet and reducing stress

A client has been diagnosed with hyperthyroidism. The nurse expects the client to exhibit which clinical manifestations? Select all that apply.

Nervousness Increased appetite