Med-Surg: Chapter 50 Disorders of the Endocrine System Prep-U Q&A Level 8
A patient is ordered desmopressin (DDAVP) for the treatment of diabetes insipidus. What therapeutic response does the nurse anticipate the patient will experience?
A decrease in urine output
Which of the following disorders results from excessive secretion of somatotropin (growth hormone)?
Acromegaly
A nurse working on a medical-surgical unit is caring for a client with Cushing's syndrome. After receiving report, the nurse reads through the client's nursing diagnoses and prioritizes her interventions. Which of the following would the nurse not include in her plan of care?
Provide a high-sodium diet.
A client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which "related-to" phrase should the nurse add?
Related to bone demineralization resulting in pathologic fractures
A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?
Restricting fluids
Patients with hyperthyroidism are characteristically:
Sensitive to heat
Surgical removal of the thyroid gland is the treatment of choice for thyroid cancer. During the immediate postoperative period, the nurse knows to evaluate serum levels of __________ to assess for a serious and primary postoperative complication of thyroidectomy.
Calcium
Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany?
Calcium gluconate
A client with hyperthyroidism asks the nurse what dietary modifications he should follow. Which of the following would be an appropriate recommendation for a client with this condition?
Consume a high-protein diet.
A nurse is teaching a client with adrenal insufficiency about corticosteroids. Which statement by the client indicates a need for additional teaching
"I may stop taking this medication when I feel better."
Which of the following medications is used in the treatment of diabetes insipidus to control fluid balance?
Desmopressin (DDAVP)
A patient is diagnosed with overactivity of the adrenal medulla. What epinephrine value does the nurse recognize is a positive diagnostic indicator for overactivity of the adrenal medulla?
450 pg/mL
A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which gland?
Adrenal cortex
Anna Brikenwald, a 77-year-old retired chef, is a resident in the long-term care facility where you practice nursing. While she has had a 20-year-history of hypothyroidism, she has progressed into a myxedemic coma and has been admitted to the hospital. What signs and symptoms would have appeared to indicate her worsening condition
All options are correct
What is the most common cause of hyperaldosteronism?
An adrenal adenoma
The most common cause of hypothyroidism is which of the following?
Autoimmune thyroiditis
Which of the following disorders is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex?
Cushing's syndrome
A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority
Decreased cardiac output
A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority?
Decreased cardiac output
A woman with a progressively enlarging neck comes into the clinic. She mentions that she has been in a foreign country for the previous 3 months and that she didn't eat much while she was there because she didn't like the food. She also mentions that she becomes dizzy when lifting her arms to do normal household chores or when dressing. What endocrine disorder should the nurse expect the physician to diagnose?
Goiter
A middle-aged female client complains of anxiety, insomnia, weight loss, the inability to concentrate, and eyes feeling "gritty." Thyroid function tests reveal the following: thyroid-stimulating hormone (TSH) 0.02 U/ml, thyroxine 20 g/dl, and triiodothyronine 253 ng/dl. A 6-hour radioactive iodine uptake test showed a diffuse uptake of 85%. Based on these assessment findings, the nurse should suspect
Graves' disease.
Which condition should a nurse expect to find in a client diagnosed with hyperparathyroidism?
Hypercalcemia
When reviewing laboratory results for a patient with a possible diagnosis of hypoparathyroidism, the nurse knows that this condition is characterized by which of the following?
Inadequate secretion of parathormone
The most common type of goiter is caused by lack of which of the following?
Iodine
The nurse assesses a patient who has an obvious goiter. What type of deficiency does the nurse recognize is most likely the cause of this?
Iodine
One of the most frequently occurring complications (55% occurrence) of primary hyperparathyroidism is:
Kidney stones.
Which intervention is the most critical for a client with myxedema coma?
Maintaining a patent airway
A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication?
Myxedema coma
A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate?
Myxedema coma
A client is admitted to the health care facility for evaluation for Addison's disease. Which laboratory test result best supports a diagnosis of Addison's disease?
Serum potassium level of 5.8 mEq/L
A nurse is caring for a client in acute addisonian crisis. Which test result does the nurse expect to see?
Serum potassium level of 6.8 mEq/L
A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?
Tetany
A patient taking corticosteroids for exacerbation of Crohn's disease comes to the clinic and informs the nurse that he wants to stop taking them because of the increase in acne and moon face. What can the nurse educate the patient regarding these symptoms?
The moon face and acne will resolve when the medication is tapered off.
The actions of parathyroid hormone (PTH) are increased in the presence of which vitamin?
Vitamin D
A patient with thyroiditis has undergone surgery and is concerned about the barely visible scar. Which of the following suggestions should the nurse give the patient to cope with the condition?
Wear clothing that covers the neck.
A 51-year-old client has suffered from several autoimmune disorders over the last 25 years. Lately, she has developed a new set of symptoms and her healthcare provider suspects Addison's disease. Which of the following symptoms would the nurse not expect to see?
Weight gain
Which findings should a nurse expect to assess in client with Hashimoto's thyroiditis?
Weight gain, decreased appetite, and constipation
The nurse practitioner who assesses a patient with hyperthyroidism would expect the patient to report which of the following conditions
Weight loss
A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect?
Weight loss, nervousness, and tachycardia
A nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse expects to find
deposits of adipose tissue in the trunk and dorsocervical area.
A client with Cushing's syndrome is admitted to the medical-surgical unit. During the admission assessment, the nurse notes that the client is agitated and irritable, has poor memory, reports loss of appetite, and appears disheveled. These findings are consistent with:
depression.
The typical triad of manifestations seen in a patient diagnosed with pheochromocytoma includes all of the following except
hypotension.
A client is admitted to an acute care facility with a tentative diagnosis of hypoparathyroidism. The nurse should monitor the client closely for the related problem of:
profound neuromuscular irritability.
A nurse should expect a client with hypothyroidism to report:
puffiness of the face and hands.
A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of:
sodium and potassium abnormalities.
When caring for a client with diabetes insipidus, the nurse expects to administer:
vasopressin (Pitressin).
Cardiac effects of hyperthyroidism include which of the following
Palpitations
A 3-year-old female is being seen by a healthcare provider in the endocrinology group where you practice nursing. She has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of her disorder?
Pituitary disorder
What breakfast items would the nurse recommend when assisting with the breakfast menu for a patient with hyperthyroidism?
Pork sausage and cranberry juice
The nurse on the telemetry floor is caring for a patient with long-standing hypothyroidism who has been taking synthetic thyroid hormone replacement sporadically. What is a priority that the nurse monitors for in this patient?
Symptoms of acute coronary syndrome
Surgical removal of the thyroid gland is the treatment of choice for thyroid cancer. During the immediate postoperative period, the nurse knows to evaluate serum levels of __________ to assess for a serious and primary postoperative complication of thyroidectomy
Calcium
A female client with hyperglycemia who weighs 210 lb (95 kg) tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that the client has large hands and a hoarse voice. Which disorder would the nurse suspect as a possible cause of the client's hyperglycemia?
Acromegaly
A nurse is caring for a client with Simmonds' disease. Which of the following dietary modifications would be most appropriate for this client?
Four to six small meals per day
A nurse is caring for a client with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings would indicate that the client has developed fluid overload?
Dyspnea and hypertension
A client is being seen by a healthcare provider in the primary care group where you practice nursing. He presents with a huge lower jaw, bulging forehead, large hands and feet, and frequent headaches. What could be causing his symptoms?
Hyperpituitarism
Wallace Guterman, a 36-year-old construction manager, is being seen by a physician in the primary care group where you practice nursing. He presents with a huge lower jaw, bulging forehead, large hands and feet and frequent headaches. What could be causing his symptoms?
Hyperpituitarism
A middle-aged female client complains of anxiety, insomnia, weight loss, the inability to concentrate, and eyes feeling "gritty." Thyroid function tests reveal the following: thyroid-stimulating hormone (TSH) 0.02 U/ml, thyroxine 20 g/dl, and triiodothyronine 253 ng/dl. A 6-hour radioactive iodine uptake test showed a diffuse uptake of 85%. Based on these assessment findings, the nurse should suspect:
Graves' disease.
Which of the following aspects is an evidence for carpopedal spasm in a client with hypoparathyroidism
Hand flexing inward
Which of the following is indicative of a carpopedal spasm in a patient with hypoparathyroidism
Hand flexing inward
On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance most commonly follows thyroid surgery?
Hypocalcemia
For a client with Graves' disease, which nursing intervention promotes comfort?
Maintaining room temperature in the low-normal range
Which of the following assessments would a nurse perform on a client with Cushing's syndrome who is at high risk of developing a peptic ulcer?
Observe stool color.
Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome
Observe the color of stool.
When teaching a patient diagnosed with hypothyroidism regarding medical intervention, which of the following is important to communicate?
TH may increase the effect of digitalis preparation.
A client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should the nurse recognize as an adverse reaction to the drug?
Tachycardia
The nurse is caring for a patient with hyperthyroidism who suddenly develops symptoms related to thyroid storm. What symptoms does the nurse recognize that are indicative of this emergency?
Temperature of 102ºF
