Study questions

The nurse is completing a health assessment of a 42 yo female with suspected Graves disease. The nurse should assess the client for: A. Anorexia B. Tachycardia C. Weight gain D. Cold skin

B. Tachycardia

The nurse is caring for a patient admitted with suspected hyperparathyroidism. Which signs and symptoms would represent the expected electrolyte imbalance (select all that apply.)? Select all that apply. A. Nausea and vomiting B. Neurologic irritability C. Lethargy and weakness D. Increasing urine output E. Hyperactive bowel sounds

A, C, D Hyperparathyroidism can cause hypercalcemia. Signs of hypercalcemia include muscle weakness, polyuria, constipation, nausea and vomiting, lethargy, and memory impairment. Neurologic irritability and hyperactive bowel sounds do not occur with hypercalcemia.

What is a nursing priority in the care of a patient with hypothyroidism? A. Patient teaching related to levothyroxine B. Providing a dark, low-stimulation environment C. Closely monitoring the patient's intake and output D. Initiating precautions related to radioactive iodine therapy

A. Patient teaching related to levothyroxine A euthyroid state is most often achieved in patients with hypothyroidism by the administration of levothyroxine. It is not necessary to closely monitor intake and output. Low stimulation and radioactive iodine therapy are used to treat hyperthyroidism.

A 60 year old female is diagnosed with hypothyroidism. The nurse should assess the client for which of the following? A Tachycardia B Weight gain C Diarrhea D Nausea

B Weight gain

After treatment with radioactive iodine in the form of sodium iodide, the nurse teaches the client to A. Monitor for signs and symptoms of hyperthyroidism B. Rest for 1 week to prevent complications of the medication C. Take thyroxine replacement for the remainder of the clients life D. Assess for hypertension and tachycardia resulting from altered thyroid activity

C. Take thyroxine replacement for the remainder of the clients life

How many hormones are created by the anterior pituitary? A. 4 B. 3 C. 5 D. 6

D. 6

PTU is prescribed for a client with Graves disease. The nurse should teach the client to immediately report which of the following? A Sore throat B. Painful, excessive menstruation C. Constipation D. Increased urine output

A Sore throat

Which assessment finding would the nurse expect in a patient who has been taking oral prednisone several weeks and is experiencing sudden withdrawal (select all that apply.)? Select all that apply. A. BP 80/50 B. Heart rate 54 C. Glucose 63 mg/dL D. Sodium 148 mEq/L E. Potassium 6.3 mEq/L F. Temperature 101.1° F

A, C, E, F Sudden cessation of corticosteroid therapy can precipitate life-threatening adrenal insufficiency. During acute adrenal insufficiency, the patient exhibits severe manifestations of glucocorticoid and mineralocorticoid deficiencies, including hypotension, tachycardia, dehydration, hyponatremia, hyperkalemia, hypoglycemia, fever, weakness, and confusion.

The nurse is teaching a patient with acromegaly from an unresectable benign pituitary tumor about octreotide therapy. The nurse should provide further teaching if the patient makes which statement? A. "The provider will infuse this medication through an IV." B. "I will inject the medication in the subcutaneous layer of the skin." C. "The medication should decrease the growth hormone production to normal." D. "I will have my growth hormone level measured every 2 weeks for several weeks."

A. "The provider will infuse this medication through an IV." Drug therapy is an option for patients whose tumors are not surgically resectable. The primary drug used is octreotide, a somatostatin analog. It reduces growth hormone (GH) levels to normal in many patients. Octreotide is given by subcutaneous injection three times a week. GH levels are measured every 2 weeks to guide drug dosing, and then every 6 months until the desired response is obtained.

The nurse performs a physical assessment on patient with possible endocrine dysfunction. The patient's weight was 142 lb 6 months ago compared with a current weight of 125 lb. What percent weight change will the nurse document in the patient's health record? A. 12% weight loss B. 17% weight loss C. 25% weight loss D. 74% weight loss

A. 12% weight loss 142 lb - 125 lb = 17 lb; (17/142) × 100 = 12%. Weight change (%) is calculated by dividing the current body weight change by the usual body weight and multiplying the result by 100. Weight change greater than 5% in 1 month, 7.5% in 3 months, or 10% in 6 months is considered severe.

Addison's disease is an abnormal condition of which gland? A. Adrenal gland B. Parathyroid gland C. Thyroid D. Pancreas

A. Adrenal gland

The nurse is providing discharge instructions to a patient with diabetes insipidus. Which instruction regarding desmopressin acetate would be most appropriate? A. Expect to experience some nasal irritation while using this drug. B. Monitor for symptoms of hypernatremia as a side effect of this drug. C. Drink at least 3000 mL of water per day while taking this medication. D. Report any decrease in urinary elimination to the health care provider.

A. Expect to experience some nasal irritation while using this drug. Desmopressin acetate is used to treat diabetes insipidus by replacing the antidiuretic hormone that the patient is lacking. Diuresis will be decreased and is expected. Inhaled desmopressin can cause nasal irritation, headache, nausea, and other signs of hyponatremia, not hypernatremia. Drinking too much water or other fluids increases the risk of hyponatremia. The patient should follow the provider's directions for limiting fluids and be taught to seek medical attention they experience severe nausea; vomiting; severe headache; muscle weakness, spasms, or cramps; sudden weight gain; unusual tiredness; mental/mood changes; seizures; and slow or shallow breathing.

The nurse is caring for a patient after a parathyroidectomy. The nurse would prepare to administer IV calcium gluconate if the patient exhibits which clinical manifestations? A. Facial muscle spasms and laryngospasms B. Tingling in the hands and around the mouth C. Decreased muscle tone and muscle weakness D. Shortened QT interval on the electrocardiogram

A. Facial muscle spasms and laryngospasms Nursing care for a patient after a parathyroidectomy includes monitoring for a sudden decrease in serum calcium levels causing tetany, a condition of neuromuscular hyperexcitability. If tetany is severe (e.g., muscular spasms or laryngospasms develop), IV calcium gluconate should be administered. Mild tetany, characterized by unpleasant tingling of the hands and around the mouth, may be present but should decrease over time without treatment. Decreased muscle tone, muscle weakness, and shortened QT interval are clinical manifestations of hyperparathyroidism.

The patient reports feeling tired, gaining weight, and increasing cold sensitivity even though it is now summer. Which endocrine diagnostic test should be completed first? A. Free thyroxine (FT4) B. Serum growth hormone (GH) C. Follicle-stimulating hormone (FSH) D. Magnetic resonance imaging (MRI) of the head

A. Free thyroxine (FT4) The manifestations the patient is experiencing could be related to hypothyroidism. FT4 is a better indicator of thyroid function than total T4 and should be done to evaluate the patient for hypothyroidism. GH excess could cause thick, leathery, oily skin but does not demonstrate the other manifestations. FSH is manifest with menstrual irregularity and would be useful in distinguishing primary gonadal problems from pituitary insufficiency. MRI is the examination of choice for radiologic evaluation of the pituitary gland and the hypothalamus but would not be the first diagnostic study done to explore the basis of these manifestations.

The nurse is caring for a patient receiving high-dose oral corticosteroid therapy after a kidney transplant. Which potential side effect presents the greatest risk? A. Infection B. Low blood pressure C. Increased urine output D. Decreased blood glucose

A. Infection Side effects of corticosteroid therapy include increased susceptibility to infection, edema related to sodium and water retention (decreasing urine output), hypertension, and hyperglycemia.

Which assessment parameter has highest priority when caring for a patient undergoing a water deprivation test? A. Patient weight B. Oral temperature C. Arterial blood gases D. Serum glucose levels

A. Patient weight A patient is at risk for severe dehydration during a water deprivation test. The test should be discontinued and the patient rehydrated if the patient's weight drops more than 2 kg at any time. The other assessment parameters do not assess fluid balance.

A patient is seeking care because of a loss of 25 lb over the past 6 months during which the patient claims to have made no significant dietary changes. What potential problem should the nurse assess the patient for? A Thyroid disorders B Diabetes insipidus C Pituitary dysfunction D Parathyroid dysfunction

A. Thyroid disorders Hyperthyroidism is associated with weight loss. Alterations in pituitary function, such as diabetes insipidus, and parathyroid dysfunction are not commonly associated with unexplained weight loss.

Hormones are frequently called what? A. chemical messengers B. senders C. message carriers D. feelings

A. chemical messengers

What is the pineal gland? A. small structure attached to the roof of the brain B. temporary gland produced during pregnancy C. mass located in upper part of the chest D. there is no pineal gland

A. small structure attached to the roof of the brain

The patient with systemic lupus erythematosus is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What should be included in the plan of care (select all that apply.)? Select all that apply. A. Obtain weekly weights. B. Limit fluids to 1000 mL/day. C. Monitor for signs of hypernatremia. D. Administration of diuretics as ordered. E. Minimize turning and range of motion. F. Keep the head of the bed at 10 degrees or less elevation.

B, D, F The care for the patient with SIADH will include limiting fluids to 1000 mL/day or less to decrease weight, increase osmolality, and improve symptoms and keeping the head of the bed elevated at 10 degrees or less to enhance venous return to the heart and increase left atrial filling pressure, thereby reducing the release of ADH. Measure weights daily and maintain accurate intake and output. Monitor for signs of hyponatremia. Frequent turning, positioning, and range-of-motion exercises are important to maintain skin integrity and joint mobility.

A client with thyrotoxicosis says to the nurse, "I am so irritable. I am having problems at work because I lose my temper very easily." Which of the following responses by the nurse would give the client the most accurate explanation of her behavior? A. "Your behavior is caused by temporary confusion brought on by your illness" B. "Your behavior is caused by the excess thyroid hormone in your system" C. Your behavior is caused by your worrying about the seriousness of your illness" D. "Your behavior is caused by the stress of trying to manage a career and cope with illness

B. "Your behavior is caused by the excess thyroid hormone in your system"

Which of the following medications should be available to provide emergency treatment if a client develops tetany after a subtotal thyroidectomy? A. Sodium phosphate B. Calcium gluconate C. Echothophate iodide D. Sodium bicarbinate

B. Calcium gluconate

The surgeon was unable to preserve the parathyroid glands during a radical thyroidectomy. Which laboratory value should the nurse diligently monitor? A. Sodium levels B. Calcium levels C. Potassium levels D. Blood glucose levels

B. Calcium levels The parathyroid gland plays a key role in maintaining calcium levels. The loss of the parathyroid gland does not directly influence potassium, sodium, and glucose.

The nurse is caring for a patient recently started on levothyroxine for hypothyroidism. What information reported by the patient requires immediate action? A. Weight gain or weight loss B. Chest pain and palpitations C. Muscle weakness and fatigue D. Decreased appetite and constipation

B. Chest pain and palpitations Levothyroxine is used to treat hypothyroidism. With replacement, the patient can be overmedicated, causing hyperthyroidism. Any chest pain, heart palpitations, or heart rate greater than 100 beats/min experienced by a patient starting thyroid replacement should be reported immediately, and electrocardiography and serum cardiac enzyme tests should be performed.

A 24 YO female is diagnosed with hypothroidism. The nurse should assess the client for which of the following? SATA A. Rapid Pulse B. Decreased energy and fatigue C. Weight gain of 10 lb D. Fine, thin hair with hair loss E. Constipation F. Menorrhagia

B. Decreased energy and fatigue C. Weight gain of 10 lb E. Constipation F. Menorrhagia

The nurse is evaluating a client with hyperthyroidism who is taking PTU 100mg/day in three divided doses for maintenance therapy. Which of the following statements from the client indicates the desired outcome of the drug? A. I have excess energy throughout the day B. I am able to sleep and rest at night C. I have lost weight since taking this medication D. I do perspire throughout the entire day

B. I am able to sleep and rest at night

The patient in the emergency department after a car accident is wearing medical identification listing Addison's disease. What should the nurse expect to be included in the care of this patient? A. Low-sodium diet B. Increased glucocorticoid replacement C. Limiting IV fluid replacement therapy D. Withholding mineralocorticoid replacement

B. Increased glucocorticoid replacement The patient with Addison's disease needs lifelong glucocorticoid and mineralocorticoid replacement and has an increased need with illness, injury, or stress, as this patient is experiencing. The patient with Addison's may need large volumes of IV fluid replacement and a high-sodium diet. Withholding mineralocorticoid replacement cannot be done for patients with Addison's disease.

One day following a subtotal thyroidectomy, a client begins to have tingling in the fingers and toes. The nurse should first: A. Encourage the client to flex and extend the fingers and toes B. Notify the physician C. Assess client for thrombophlebitis D. Ask the client to speak

B. Notify the physician

The nurse interviews a patient with a history of type 2 diabetes mellitus, chronic bronchitis, and osteoarthritis who has a fasting blood glucose of 154 mg/dL. Which patient medication may be responsible for the elevated blood glucose level? A. Metformin B. Prednisone C. Insulin glargine D. Acetaminophen

B. Prednisone Prednisone is a corticosteroid that may cause glucose intolerance in susceptible patients by increasing gluconeogenesis and insulin resistance. Insulin (e.g., glargine) and metformin (an oral hypoglycemic agent) decrease blood glucose levels. Acetaminophen has a glucose-lowering effect.

A client with a large goiter is scheduled for a subtotal thyroidectomy to treat thyrotoxicosis. Saturated solution of potassium iodide (SSKI) is prescribed preoperatively for the client. The expected outcome of using this drug is that it helps: A. Slow progression of exophthalmos B. Reduce the vascularity of the thyroid gland C. Decrease the bodys ability to store thyroxine D. Increase the bodys ability to excrete thyroxine

B. Reduce the vascularity of the thyroid gland

The surgeon was unable to spare a patient's parathyroid gland during a thyroidectomy. Which assessments should the nurse prioritize when providing postoperative care for this patient? A. White blood cell levels and signs of infection B. Serum calcium levels and signs of hypocalcemia C. Hemoglobin, hematocrit, and red blood cell levels D. Level of consciousness and signs of acute delirium

B. Serum calcium levels and signs of hypocalcemia Loss of the parathyroid gland is associated with hypocalcemia. Whereas infection and anemia are not associated with loss of the parathyroid gland, cognitive changes are less pronounced than the signs and symptoms of hypocalcemia.

The nurse is caring for a group of older patients in a long-term care setting. Which physical assessment findings would indicate possible endocrine dysfunction? A. Hypoglycemia, delirium, and incontinence B. Impaired reflexes, diarrhea, and hearing loss C. Fatigue, constipation, and mental impairment D. Hypotension, heat intolerance, and bradycardia

C Fatigue, constipation, and mental impairment Changes of aging often mimic clinical manifestations of endocrine disorders. Clinical manifestations of endocrine dysfunction such as fatigue, constipation, or mental impairment in the older adult are often missed because they are attributed solely to aging.

The nurse is teaching a patient who is scheduled for an oral glucose tolerance test. Which statement indicates further teaching is required? A. "I will fast for at least 8 hours before the test." B. "Ingesting caffeine and smoking may alter the test results." C. "The results of this test will indicate my blood sugar control over the last 3 months." D. "Blood samples will be taken at intervals after I drink a sample of glucose solution."

C. "The results of this test will indicate my blood sugar control over the last 3 months." Glycosylated hemoglobin measures the amount of glucose bound to hemoglobin over the past 3 months, not an oral glucose tolerance test. An oral glucose tolerance test requires nothing by mouth for 8 to12 hours. Caffeine and smoking may influence test results. After ingesting the oral glucose sample, blood is drawn after 30-, 60-, and 120-minute intervals.

The hypothalamus secretes releasing hormones and inhibiting hormones. What is the target tissue of these releasing hormones and inhibiting hormones? A. Pineal B. Adrenal cortex C. Anterior pituitary D. Posterior pituitary

C. Anterior pituitary The anterior pituitary is the target tissue of the releasing hormones (corticotropin-releasing hormone, thyrotropin-releasing hormone, growth hormone releasing factor, gonadotropin-releasing hormone, prolactin-releasing factor) and the inhibiting hormones (somatostatin, prolactin-inhibiting factor). These hormones release or inhibit other hormones that affect the thyroid, adrenal cortex, pancreas, reproductive organs, and all body cells. The pineal gland is not directly affected by the hormones from the hypothalamus. The posterior pituitary releases antidiuretic hormone in response to plasma osmolality changes and is not directly affected by the hypothalamus hormones.

What should be included in the interprofessional plan of care for a patient with Cushing disease? A. Lab monitoring for hyperkalemia B. Vital sign monitoring for hypotension C. Counseling related to body image changes D. Diet consultation to determine low protein choices

C. Counseling related to body image changes Elevated corticosteroid levels can cause body changes, including truncal obesity, moon face, and hirsutism in women and gynecomastia in men. Counseling and support should be offered because of the changes in body image. Hypokalemia and hypertension are consistent with Cushing disease. Sodium restriction and potassium supplementation are indicated. High protein choices are necessary to counteract catabolic processes and assist with wound healing

The nurse is administering a saturated solution of potassium iodide (SSKI). The nurse should: A. Pour the solution over ice chips B. Mix the solution with an antacid C. Dilute the solution with water, milk, fruit juice, and have the client drink it with a straw D. Disguise the solution in pureed fruit or vegetable

C. Dilute the solution with water, milk, fruit juice, and have the client drink it with a straw

Following a subtotal thyroidectomy, the nurse asks the client to speak immediately upon regaining consciousness. The nurse does this to monitor for signs of which of the following? A. Internal hemorrhage B. Decreasing level of consciousness C. Laryngeal nerve damage D. Upper airway obstruction

C. Laryngeal nerve damage

The nurse is caring for a patient after a thyroidectomy. Which assessment findings would indicate the presence of possible hypoparathyroidism? A. Polyuria, polydipsia, and weight loss B. Cardiac dysrhythmias and hypertension C. Muscle spasms and hyperactive deep tendon reflexes D. Hyperpigmentation, skin ulcers, and peripheral edema

C. Muscle spasms and hyperactive deep tendon reflexes Common assessment abnormalities associated with hypoparathyroidism include tetany (muscle spasms) and increased deep tendon reflexes. Hyperpigmentation is associated with Addison's disease. Skin ulcers occur in patients with diabetes. Edema is associated with hypothyroidism. Polyuria and polydipsia occur in patients with diabetes mellitus or diabetes insipidus. Weight loss occurs in hyperthyroidism or diabetic ketoacidosis. Hypertension and cardiac dysrhythmias may result from hyperthyroidism, hyperparathyroidism, or pheochromocytoma.

When conducting a health history with a female client with thyrotoxicosis, the nurse should ask about which of the following changes in the menstrual cycle? A. Dysmenorrhea B. Metorrhagia C. Oligomenorrhea D. Menorrhagia

C. Oligomenorrhea

A patient who smokes reports having significant stress and is experiencing eye problems. On assessment, the nurse notes exophthalmos. What additional abnormal findings should the nurse assess for? A. Muscle weakness and slow movements B. Puffy face, decreased sweating, and dry hair C. Systolic hypertension and increased heart rate D. Decreased appetite, increased thirst, and pallor

C. Systolic hypertension and increased heart rate The patient's manifestations are consistent with Graves' disease or hyperthyroidism. Systolic hypertension, increased heart rate, and increased thirst are associated with hyperthyroidism. Cigarette smoking places the patient at increased risk of developing Graves' disease. The inhaled cigarette toxins may absorb via the eye orbits, causing exophthalmos. A puffy face; decreased sweating; dry, coarse hair; muscle weakness and slow movements; decreased appetite; and pallor are all manifestations of hypothyroidism.

When teaching a patient about a urine study for free cortisol, what is most important for the nurse to tell the patient? A. Save the first voided urine in the morning. B. Maintain a high-sodium diet 3 days before collection. C. Try to avoid stressful situations during the collection period. D. Complete at least 30 minutes of exercise before collecting the urine sample.

C. Try to avoid stressful situations during the collection period. A urine study for free cortisol requires a 24-hour urine collection. Instruct the patient to avoid stressful situations and excessive physical exercise because these could unduly increase cortisol levels. The patient should maintain a low-sodium diet before and during the urine collection period.

The nurse should teach the client with Graves disease to prevent corneal irritation from mild exophthalmos by: A. Massaging the eyes at regular intervals B. Instilling an ophthalmic anesthetic as prescribed C. Wearing dark-colored glasses D. Covering both eyes with moistened gauze

C. Wearing dark-colored glasses

What disease results from an oversecretion of somatotropin in an adult? A. giantism B. diabetes insipidus C. acromegaly D. dwarfism

C. acromegaly

What is a goiter? A. overactive thyroid gland B. underactive thyroid C. enlargement of thyroid D. has nothing to do with the thyroid

C. enlargement of thyroid

What gland is often called the "master gland"? A. thyroid gland B. Adrenal gland C. pituitary gland D. parathyroid gland

C. pituitary gland

A patient with a severe pounding headache has been diagnosed with hypertension. However, the hypertension is not responding to traditional treatment. What should the nurse expect as the next step in determining a diagnosis for this patient? A. Administration of β-blocker medications B. Abdominal palpation to search for a tumor C. Administration of potassium-sparing diuretics D. A 24-hour urine collection for fractionated metanephrines

D. A 24-hour urine collection for fractionated metanephrines Pheochromocytoma should be suspected when hypertension does not respond to traditional treatment. The 24-hour urine collection for fractionated metanephrines is simple and reliable with elevated values in 95% of people with pheochromocytoma. In a patient with pheochromocytoma, an α-adrenergic receptor blocker is used preoperatively to reduce blood pressure. Abdominal palpation is avoided to avoid a sudden release of catecholamines and severe hypertension. Potassium-sparing diuretics are not needed. Most likely they would be used for hyperaldosteronism, which is another cause of hypertension.

Which hormone level would the nurse expect to be elevated in response to a low serum cortisol level? A. Growth hormone (GH) B. Follicle-stimulating hormone (FSH) C. Thyroid-stimulating hormone (TSH) D. Adrenocorticotropic hormone (ACTH)

D. Adrenocorticotropic hormone (ACTH) A negative feedback mechanism controls cortisol secretion. The release of corticotropin-releasing hormone from the hypothalamus stimulates the secretion of ACTH by the anterior pituitary. ACTH stimulates the adrenal cortex to secrete corticosteroids.

Which complication should the nurse monitor for in a patient undergoing a growth hormone stimulation test? A. Hypothermia B. Hypertension C. Hyperreflexia D. Hypoglycemia

D. Hypoglycemia A growth hormone stimulation test involves the administration of insulin or arginine (agent that stimulates insulin secretion). Therefore, the nurse should monitor the patient closely for hypoglycemia. Hypothermia and hypertension are not expected in response to insulin or arginine. Hyperreflexia is an autonomic complication of spinal cord injury.

Which hormone stimulates production of melanin pigment? A. LTH-prolactin B. GH-somatrophic C. LH-leutinizing hormone D. MSH-melanocyte stimulating

D. MSH-melanocyte stimulating

A client who has undergone a subtotal thyroidectomy is subject to complications in the first 48 hours after surgery. The nurse should obtain and keep at the bedside equipment to: A. Begin total parenteral nutrition B Start a cutdown infusion C. Administer tube feedings D. Perform a tracheotomy

D. Perform a tracheotomy

The patient with an adrenal hyperplasia is returning from surgery after an adrenalectomy. The nurse should monitor the patient for what immediate postoperative complication? A. Vomiting B. Infection C. Thromboembolism D. Rapid blood pressure changes

D. Rapid blood pressure changes The risk of hemorrhage is increased with surgery on the adrenal glands as well as large amounts of hormones being released in the circulation, which may produce hypertension and cause fluid and electrolyte imbalances to occur for the first 24 to 48 hours after surgery. Vomiting, infection, and thromboembolism may occur postoperatively with any surgery.

A client with Graves disease is treated with radioactive iodine in the form of sodium iodide. Which of the following statements by the nurse will explain to the client how the drug works? A. The RAI stabilizes the thyroid hormone levels before a thyroidectomy B. The RAI reduces uptake of thyroxine and thereby improves your condition C. The RAI lowers the levels of thyroid hormones by slowing your bodies production of them D. The RAI destroys thyroid tissue so that thyroid hormones are no longer produced

D. The RAI destroys thyroid tissue so that thyroid hormones are no longer produced

A patient's recent medical history is indicative of diabetes insipidus. The nurse would anticipate teaching the patient about which diagnostic test? A. Thyroid scan B. Fasting glucose test C. Oral glucose tolerance D. Water deprivation test

D. Water deprivation test A water deprivation test is used to diagnosis if polyuria is related to diabetes insipidus. Glucose tests and thyroid tests are not directly related to the diagnosis of diabetes insipidus.

What hormones do the thyroid produce? A. parathyroid B. melatonin C. insulin D. thyroxine

D. thyroxine