Chapter 48: Nursing Assessment: Endocrine System Lewis: Medical-Surgical Nursing, 8th Edition

After the nurse manager at the endocrine clinic has completed the orientation of a new RN, which action by the new RN who is caring for a patient with a goiter and possible hyperthyroidism indicates the charge nurse needs to do more teaching? a. The RN palpates the neck to check thyroid size. b. The RN checks the blood pressure on both arms. c. The RN orders nonmedicated eye drops to lubricate the patients eyes. d. The RN lowers the thermostat to decrease the temperature in the room.

a. The RN palpates the neck to check thyroid size.

A patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which patient information is most important for the nurse to communicate to the health care provider before the test? a. Bilateral poor peripheral vision b. Allergies to iodine and shellfish c. Recent weight loss of 20 pounds d. Complaints of ongoing headaches

b. Allergies to iodine and shellfish

A patient is admitted with a serum sodium level of 118 mEq/L. The nurse will anticipate the need for which diagnostic test? a. Urinary 17-ketosteroids b. Antidiuretic hormone level c. Growth hormone stimulation test d. Adrenocorticotropic hormone level

b. Antidiuretic hormone level

Which information about a patient with newly diagnosed diabetes mellitus will be most useful to the nurse in developing strategies for successful adaptation to this disease? a. Ideal weight b. Value system c. Activity level d. Visual changes

b. Value system

When caring for a patient having a water deprivation test, which finding is most important for the nurse to communicate to the health care provider? a. The patient complains of intense thirst. b. The patient has a 5-lb (2.3 kg) weight loss. c. The patient feels dizzy when sitting up on the edge of the bed. d. The patients urine osmolality does not change after antidiuretic hormone (ADH) is given.

b. The patient has a 5-lb (2.3 kg) weight loss.

During a physical examination, the nurse finds that a patient's thyroid gland cannot be palpated. The most appropriate action by the nurse is to a. palpate the patient's neck more deeply. b. document that the thyroid was nonpalpable. c. notify the health care provider immediately. d. teach the patient about thyroid hormone testing.

b. document that the thyroid was nonpalpable.

A patient is scheduled for a 24-hour urine collection for 17-ketosteroids. The nurse will need to a. keep the specimen on ice. b. insert a retention catheter. c. have the patient void and save that specimen to start the collection. d. encourage the patient to drink 2 to 3 L of fluid during the 24 hours.

b. insert a retention catheter.

When a patient in the outpatient clinic has an order for blood cortisol testing, which instruction will the nurse provide for the patient? a. Avoid adding any salt to your foods for 24 hours before the test. b. You will need to lie down for 30 minutes before the blood is drawn. c. Come to the laboratory to have the blood drawn early in the morning. d. Do not have anything to eat or drink before the blood test is obtained.

c. Come to the laboratory to have the blood drawn early in the morning.

When the nurse is caring for a patient who was admitted with tetany, which laboratory value should be monitored? a. Total protein b. Blood glucose c. Ionized calcium d. Serum phosphate

c. Ionized calcium

When reviewing the laboratory results for a patient's total calcium level, which information will the nurse need to consider? a. The blood glucose is elevated. b. The phosphate level is normal. c. The serum albumin level is low. d. The magnesium level is normal.

c. The serum albumin level is low.

When a patient has clinical manifestations of hypothyroidism, which laboratory value should the nurse review to determine whether the hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland? a. Thyroxine (T4) level b. Triiodothyronine (T3) level c. Thyroid-stimulating hormone (TSH) level d. Thyrotropin-releasing hormone (TRH) level

c. Thyroid-stimulating hormone (TSH) level

When working with a patient who has diabetes mellitus, the nurse reviews the results of testing for glycosylated hemoglobin (HbA1C) to evaluate for a. glucose levels 2 hours after a meal. b. circulating, nonfasting glucose levels. c. glucose control over the past 3 months. d. hypoglycemic episodes in the past 90 days.

c. glucose control over the past 3 months.

The nurse will plan patient care that will decrease the patient's physical and emotional stress when the patient is undergoing a. a water deprivation test. b. testing for serum T3 and T4 levels. c. a 24-hour urine test for free cortisol. d. a radioactive iodine (I-131) uptake test.

c. a 24-hour urine test for free cortisol.

When evaluating the laboratory results for a patient with increased secretion of the anterior pituitary hormones, the nurse would expect to find a. decreased serum thyroxine levels. b. elevated serum aldosterone levels. c. an increase in urinary free cortisol. d. low urinary excretion of catecholamines.

c. an increase in urinary free cortisol.

The nurse is interviewing a patient who has a possible thyroid disorder. Which question will provide the most useful information? a. What methods do you use to help cope with stress? b. Have you experienced any blurring or double vision? c. Do you have to get up at night to empty your bladder? d. Have you had any recent unplanned weight gain or loss?

d. Have you had any recent unplanned weight gain or loss?

When the nurse is obtaining the health history, which statement by a patient indicates further assessment of thyroid function may be necessary? a. I notice my breasts are tender lately. b. I am so thirsty that I drink all day long. c. I get up several times at night to urinate. d. I feel a lump in my throat when I swallow.

d. I feel a lump in my throat when I swallow.

Which information about a patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test? a. The patient reports having occasional orthostatic dizziness. b. The patient has had a 10-pound weight gain in the last month. c. The patient drank several glasses of water an hour previously. d. The patient takes oral corticosteroids for rheumatoid arthritis.

d. The patient takes oral corticosteroids for rheumatoid arthritis.

When a patient is taking spironolactone (Aldactone), a drug that blocks the action of aldosterone on the kidney, the nurse will monitor for a. decreased urinary output. b. evidence of fluid overload. c. increased serum sodium levels. d. elevated serum potassium levels.

d. elevated serum potassium levels.

A patient has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L). The nurse will anticipate the need to teach the patient about testing for a. calcitonin levels. b. catecholamine levels. c. thyroid hormone levels. d. parathyroid hormone levels.

d. parathyroid hormone levels.

A patient is scheduled for a growth hormone stimulation test. In preparation for the test, the nurse will obtain a a. basin of ice. b. cardiac monitor. c. vial of glargine insulin. d. vial of 50% dextrose solution.

d. vial of 50% dextrose solution.