Assessment and Management of Patients With Endocrine Disorders (PrepU)
Which of the following would the nurse expect the physician to order for a client with hypothyroidism? A. Levothyroxine sodium B. Methimazole C. Propranolol D. Propylthiouracil
A
The nurse practitioner who assesses a patient with hyperthyroidism would expect the patient to report which of the following conditions? A. Fatigue B. Dyspnea C. Weight loss D. Hair loss
C
Which assessment would a nurse perform on a client with Cushing's syndrome who is at high risk of developing a peptic ulcer? A. Observe stool color. B. Monitor bowel patterns. C. Monitor vital signs every 4 hours. D. Observe urine output.
A
Which of the following would the nurse expect to find in a client with severe hyperthyroidism? A. Tetany B. Exophthalmos C. Buffalo hump D. Striae
B
A client is having chronic pain from arthritis. What type of hormone is released in response to the stress of this pain that suppresses inflammation and helps the body withstand stress? A. Testosterone B. Mineralocorticoids C. Glucocorticoids D. Estrogen
C
Which of the following agents suppress release of thyroid hormones? Select all that apply. A. Sodium iodide B. Potassium iodide C. Dexamethasone D. Saturated solution of potassium iodide (SSKI) E. Methimazole
A, B, C, D
A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply. A. Hypothermia B. Hypertension C. Hypotension D. Hypoventilation E. Hyperventilation
A, C, D
A client is receiving long-term treatment with high-dose corticosteroids. Which of the following would the nurse expect the client to exhibit? A. Weight loss B. Pale thick skin C. Moon face D. Hypotension
C
Which instruction should be included in the discharge teaching plan for a client after thyroidectomy for Graves' disease? A. Keep an accurate record of intake and output. B. Use nasal desmopressin acetate (DDAVP). C. Have regular follow-up care. D. Exercise to improve cardiovascular fitness.
C
Which of the following hormones would the nurse identify as being secreted by the thyroid gland? A. Parathormone B. Thymosin C. Thyroxine D. Somatotropin
C
Which symptom of thyroid disease is seen in older adults? A. Restlessness B. Hyperactivity C. Atrial fibrillation D. Weight gain
C
A client is scheduled for a diagnostic test to measure blood hormone levels. The nurse expects that this test will determine which of the following? A. The concentration of a substance in plasma B. Details about the size of the organ and its location C. The functioning of endocrine glands D. The client's blood sugar level
C
A nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse expects to find: A. hypotension. B. thick, coarse skin. C. deposits of adipose tissue in the trunk and dorsocervical area. D. weight gain in arms and legs.
C
A nurse should perform which intervention for a client with Cushing's syndrome? A. Offer clothing or bedding that's cool and comfortable. B. Suggest a high-carbohydrate, low-protein diet. C. Explain that the client's physical changes are a result of excessive corticosteroids. D. Explain the rationale for increasing salt and fluid intake in times of illness, increased stress, and very hot weather.
C
During an assessment of a client's functional health pattern, which question by the nurse directly addresses the client's thyroid function? A. "Do you have to get up at night to empty your bladder?" B. "Have you experienced any headaches or sinus problems?" C. "Do you experience fatigue even if you have slept a long time?" D. "Can you describe the amount of stress in your life?"
C
When caring for a client who's being treated for hyperthyroidism, the nurse should: A. provide extra blankets and clothing to keep the client warm. B. monitor the client for signs of restlessness, sweating, and excessive weight loss during thyroid replacement therapy. C. balance the client's periods of activity and rest. D. encourage the client to be active to prevent constipation.
C
Although not designated as endocrine glands, several organs within the body secrete hormones as part of their normal function. Which organ secretes hormones involved in increasing blood pressure and volume and maturation of red blood cells? A. kidneys B. cardiac atria C. brain D. liver
A
For a client with hyperthyroidism, treatment is most likely to include: A. a thyroid hormone antagonist. B. thyroid extract. C. a synthetic thyroid hormone. D. emollient lotions.
A
The nurse is aware that the best time of day for the total large corticosteroid dose is between: A. 7:00 AM and 8:00 AM B. 8:00 PM and 9:00 PM C. 4:00 AM and 5:00 AM D. 4:00 PM and 6:00 PM
A
Trousseau's sign is elicited by which of the following? A. Carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff. B. A sharp tapping over the facial nerve just in front of the parotid gland and anterior to the ear causes spasm or twitching of the mouth, nose, and eye. C. After making a clenched fist, the palm remains blanched when pressure is placed over the radial artery. D. The patient complains of pain in the calf when his foot is dorsiflexed.
A
Which of the following glands is considered the master gland? A. Pituitary B. Thyroid C. Parathyroid D. Adrenal
A
A client has been experiencing a decrease in serum calcium. After diagnostics, the physician proposes the calcium level fluctuation is due to altered parathyroid function. What is the typical number of parathyroid glands? A. four B. three C. two D. one
A
Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany? A. Calcium gluconate B. Synthroid C. Propylthiouracil (PTU) D. Tapazole
A
A health care provider suspects that a thyroid nodule may be malignant. The nurse knows to prepare information for the patient based on the usual test that will be ordered to establish a diagnosis. What is that test? A. Serum immunoassay for TSH B. Fine-needle biopsy of the thyroid gland C. Free T4 analysis D. Ultrasound of the thyroid gland
B
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: A. thyroiditis. B. Graves' disease. C. Hashimoto's thyroiditis. D. multinodular goiter.
B
A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect? A. Weight gain, constipation, and lethargy B. Weight loss, nervousness, and tachycardia C. Exophthalmos, diarrhea, and cold intolerance D. Diaphoresis, fever, and decreased sweating
B
A nurse is collecting data from a client who is suspected of having an endocrine disorder and is scheduled for diagnostic testing that involves the use of a contrast medium. The nurse would inform the physician if the client stated which of the following? A. "My father had diabetes when he got older." B. "I have an allergy to shrimp and shellfish." C. "I take a multivitamin every day." D. "Years ago, I took a steroid for my asthma."
B
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 condition should the nurse expect the health care provider to diagnose? A. Diabetes mellitus B. Goiter C. Diabetes insipidus D. Cushing's syndrome
B
After a thyroidectomy, the client develops a carpopedal spasm while the nurse is taking a BP reading on the left arm. Which action by the nurse is appropriate? A. Administer a sedative as ordered. B. Administer IV calcium gluconate as ordered. C. Start administering oxygen at 2 L/min via a cannula. D. Administer an oral calcium supplement as ordered.
B
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. A. Sodium B. Calcium C. Potassium D. Magnesium
B
Which medication is the treatment of choice for pregnant women diagnosed with hyperthyroidism? A. Methimazole B. PTU C. Potassium iodide D. SSKI
B
Which of the following would the nurse need to be alert for in a client with severe hypothyroidism? A. Thyroid storm B. Myxedemic coma C. Addison's disease D. Acromegaly
B
A nurse explains to a client with thyroid disease that the thyroid gland normally produces: A. iodine and thyroid-stimulating hormone (TSH). B. thyrotropin-releasing hormone (TRH) and TSH. C. TSH, triiodothyronine (T3), and calcitonin. D. T3, thyroxine (T4), and calcitonin.
D
A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the nurse do? A. Monitor laboratory values daily for elevated thyroid-stimulating hormone. B. Observe for swelling of the neck, tracheal deviation, and severe pain. C. Evaluate the quality of the client's voice postoperatively, noting any drastic changes. D. Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.
D
Cardiac effects of hyperthyroidism include A. decreased pulse pressure. B. decreased systolic BP. C. bradycardia. D. palpitations.
D
Patients with hyperthyroidism are characteristically: A. Apathetic and anorexic B. Calm C. Emotionally stable D. Sensitive to heat
D
The nurse knows to assess a patient with hyperthyroidism for the primary indicator of: A. Fatigue B. Weight gain C. Constipation D. Intolerance to heat
D
Which group of clients should not receive potassium iodide? A. Those who are allergic to corticosteroids B. Those who are pregnant C. Those taking medications such as cough medicines D. Those who are allergic to seafood
D
