ATI Medical-Surgical: Endocrine

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about the pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching? "My cells are resistant to the effects of insulin" "My body breaks down sugars too efficiently" "My pancreas does not produce insulin" "My body produces antibodies against pancreatic beta cells"

A "My cells are resistant to the effects of insulin" The client who has type 2 diabetes mellitus will have resistance to insulin and a decrease in the secretion of insulin by the pancreatic beta cells

A nurse is reviewing the laboratory values for a client who has hyperglycemic hyperosmolar nonketotic syndrome. The nurse should expect that which of the following laboratory values is consistent with hyperglycemic hyperosmolar nonketotic syndrome? Blood glucose 320 mg/dL Positive urine ketones Blood pH 7.34 Blood osmolality greater than 350 mOsm/kg

A Blood glucose 320 mg/dL The client who has hyperglycemic hyperosmolar nonketotic syndrome should have a blood glucose level greater than 250 mg/dL which will cause spilling of ketones in the urine and development of metabolic acidosis

A nurse is caring for a client who is postoperative following a bilateral adrenalectomy. The nurse should expect to administer glucocorticoids following the procedure to enhance which of the following therapeutic effects? Compensate for decrease in cortisol levels Inhibit glucose metabolism Act as a diuretic to maintain urine output Decrease susceptibility to infection

A Compensate for decrease in cortisol levels The client who has an adrenalectomy requires glucocorticoids before, during, and after surgery to prevent an adrenal crisis caused by a sudden drop in cortisol levels. On of the hormones produced by the adrenal glands is cortisol, a glucocorticoid. Loos of glucocorticoid secretion leads to a state of altered metabolism and an inability to deal with stressors which if untreated, is fatal.

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus about hypoglycemia. Which of the following manifestations should the nurse include in the teaching? Irritability Urinary frequency Dry mucous membranes Excess thirst

A Irritability The client has has irritability is displaying an early manifestation of hypoglycemia for type 1 diabetes mellitus. Other early manifestations include fatigue, headache, difficulty thinking, sweating, and nausea

A nurse is collecting data from a client who has Cushing's syndrome. Which of the following skin manifestations should the nurse expect to find? Purple straie on the chest and abdomen Butterfly rash across the bridge of the nose Bronze pigmentation of skin Jaundice of the face and sclera

A Purple straie on the chest and abdomen The client who has Cushing's disease should have purple straie (streaks or stripes) on the chest and abdomen because cortisol destroys collagen under the skin

A nurse is preparing a 24-hour urine specimen for a client who is suspected to have pheochromocytoma. Which of the following laboratory tests from the 24-hour urine specimen should the nurse use to determine the client's condition? Creatinine clearance Catecholamine metablolites 17-hydroxycorticosteroids (17-OHCS) Protein

B Catecholamine metabolites The nurse should expect 24-hr urine specimen to test for Catecholamine metabolites. The test is used to determine if the client has pheochromocytoma, which measures the level of catecholamines (epinephrine and norepinephrine) secretion in a 24-hr urine sample. Pheochromocytoma is a tumor of the adrenal gland that causes excess release of the catecholamines ( epinephrine and norepinephrine), which are hormones that regulate blood pressure and heart rate.

A nurse is assisting with the plan of care for a community health screening for a group of clients who are at risk for type 2 diabetes mellitus. Which of the following clients should the nurse include in the screening? Men who smoke Men and Women who are obese Women who have hepatitis Men and women who consume high-protein and low-carbohydrate foods

B Men and Women who are obese There is a high correlation between obesity and type 2 diabetes mellitus. Obesity plays a major role in the development of type 2 diabetes mellitus by decreasing the number of available insulin receptors in skeletal muscles and fat cells. This is referred to as peripheral insulin resistance. A reduced-calorie diet for obese clients tends to reverse the phenomenon of peripheral insulin resistance

A nurse is reinforcing with a client who has type 1 diabetes mellitus about exercise. Which of the following statements should the nurse include in the teaching? "You should exercise during a peak insulin time" "Wear a medical alert identification tag when you exercise" "Exercise can decrease the effects of insulin and cause the blood glucose levels to increase" "You will get the most benefit from exercise when your glucose levels are higher than normal"

B. "Wear a medical alert identification tag when you exercise"

A nurse is assisting with the plan of care who has Cushing's syndrome due to chronic corticosteroid use. Which of the following actions should the nurse include in the plan of care? Check the client's blood glucose for hypoglycemia Check for hypertension Weigh the client weekly Insert an indwelling urinary catheter for the client

B. Check for hypertension The nurse should check the client for hypertension, which can indicate fluid volume overload

A nurse is caring for a client who has type 2 diabetes mellitus and is displaying manifestations of hyperglycemia. Which of the following findings should indicate to the nurse that the client has hyperglycemia? Hunger Increased urination Cold, clammy skin Tremors

B. Increased urination Increased urination, or polyuria, is a manifestation of hyperglycemia due to a deficiency of insulin, which can lead to osmotic diuresis.

A nurse is collecting data from a client who has Graves' disease. Which of the following findings should the nurse expect to display? Constipation Cold intolerance Difficulty sleeping Anorexia

C Difficulty sleeping The client who has Graves' disease can have difficulty sleeping and anxiety due to overproduction of thyroid hormone

A nurse is checking laboratory values to determine if a client who has diabetes mellitus is adhering to the treatment plan. Which of the following tests should the nurse use to make the determination? Glucose tolerance test Urine sugar and acetone Glycosylated hemoglobin levels Fasting serum glucose

C Glycosylated hemoglobin levels Checking glycosylated hemoglobin levels, or HbA1c, is an accurate method to determine if the client is routinely compliant. Glycosylated hemoglobin refers to hemoglobin that is connected to glucose. Since the life span of a RBC is 4 months, this value will not be affected by recent changes in the client's diet or medication

A nurse is monitoring a client who has syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings should the nurse expect? Polyuria Dehydration Hyponatremia Hyperthermia

C Hyponatremia The client who has SIADH will have hyponatremia caused by the excessive release of an antidiuretic hormone (ADH). As a result of the excess ADH, the client retains water that causes dilutional hyponatremia

A nurse is caring for a client who has diabetes insipidus. For which of the following findings should the nurse monitor? Proteinuria Oliguria Polyuria Glycosuria

C Polyuria Diabetes insipidus is characterized by increased thirst (polydipsia) and increased urination (polyuria). The client who has diabetes insipidus will excrete large quantities of urine with a very low specific gravity

A nurse is reinforcing teaching with a client who has Addison's disease about healthy snack foods. Which of the following food choices by the client indicates an understanding of the teaching? Sliced bananas Baked potatoes Turkey and cheese sandwich Plain yogurt and peaches

C Turkey and cheese sandwich A turkey and cheese sandwich is high in protein, carbohydrates, and sodium. The client who has Addison's disease requires a diet low in potassium and high in sodium, carbohydrates, and protein

A nurse is caring for a client who is postoperative following a parathyroidectomy to treat hyperparathyroidism. Which of the following laboratory values should the nurse expect to decrease as a therapeutic effect of the procedure? Phosphorous Sodium Potassium Calcium

D Calcium The parathyroid hormone regulates calcium, phosphorus, and magnesium balance within the client's blood and bone by maintaining a balance between the mineral levels in the blood and the bone. Hyperparathyroidism is associated with hypercalcemia; therefore, a decrease in the calcium level indicates an improvement in the client's condition

A nurse is checking a client who has Graves' disease for a development of thyroid storm. The nurse should report which of the following findings to the provider? Constipation Headache Bradycardia Fever

D Fever The client who is experiencing a thyroid storm will have an exaggerated condition of hyperthyroidism associated with the development of a sudden extreme elevation in body temperature, hypertension, abdominal pain, and tachycardia

A nurse is collecting data from a client who has manifestations of acromegaly. Which of the following findings should the nurse expect? Thinning of skeletal bone structure Concave chest wall High-pitched voice Increased head size

D Increased head size The client who has acromegaly will manifest an enlarged head size due to excessive production of growth hormones after closing of the epiphyses (the "growth plate" at the ends of the long bones) by the pituitary gland. It results in the gradual enlargement of the client's body tissues, such as the bones of the face, jaw, hands, feet, and skull

A nurse is assisting with the plan of care for a client who is experiencing the Somogyi effect and takes intermittent-acting insulin. Which of the following actions should the nurse include in the plan? Move the evening intermediate-acting insulin dose to 90 min before dinner Increase the client's morning caloric intake Omit the client's evening snack Monitor the client's nighttime blood glucose levels

D Monitor the client's nighttime blood glucose levels The Somogyi effect is a swing of a high blood glucose level in the morning after an extremely low blood level during the night. The swing is caused by the release of stress hormones to counter low glucose levels. Monitoring the client's nighttime blood glucose levels over time can provide an accurate diagnosis of the Somogyi effect

A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism caused by an adenoma. Which of the following findings should the nurse report to the provider? (Select all that apply) Tachycardia and hypertension Respiratory rate 16/min Negative Chvostek's sign Laryngeal stridor and hoarseness Positive Trousseau's sign

Tachycardia and hypertension Laryngeal stridor and hoarseness Positive Trousseau's sign