Chapter 52: Assessment and Management of Patient with Endocrine Disorders Prep U

A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the nurse do? Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes. Observe for swelling of the neck, tracheal deviation, and severe pain. Evaluate the quality of the client's voice postoperatively, noting any drastic changes. Monitor laboratory values daily for elevated thyroid-stimulating hormone.

Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.

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. excessive thirst. acute gastritis. severe hypotension.

profound neuromuscular irritability.

Which assessment would a nurse perform on a client with Cushing's syndrome who is at high risk of developing a peptic ulcer? Monitor vital signs every 4 hours. Monitor bowel patterns. Observe urine output. Observe stool color.

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. Monitor vital signs every 4 hours. Observe urine output. Monitor bowel patterns.

Observe the color of stool.

An instructor is preparing a teaching plan for a class on the various pituitary hormones. Which hormone would the instructor include as being released by the posterior pituitary gland? Prolactin Adrenocorticotropic hormone Oxytocin Somatotropin

Oxytocin

Which glands regulate calcium and phosphorous metabolism? Thyroid Parathyroid Adrenal Pituitary

Parathyroid

A client with hyperparathyroidism declines surgery and is to receive hormone replacement therapy with estrogen and progesterone. Which instruction is most important for the nurse to include in the client's teaching plan? "Rest as much as possible." "Maintain a moderate exercise program." "Jog at least 2 miles per day." "Lose weight."

"Maintain a moderate exercise program."

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 appetite A decrease in blood pressure A decrease in blood glucose levels A decrease in urine output

A decrease in urine output

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? Administer IV calcium gluconate as ordered. Administer an oral calcium supplement as ordered. Start administering oxygen at 2 L/min via a cannula. Administer a sedative as ordered.

Administer IV calcium gluconate as ordered.

A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately? An irregular apical pulse Frequent urination Dry mucous membranes Pitting edema of the legs

An irregular apical pulse

A patient is suspected of having a pheochromocytoma and is having diagnostic tests done in the hospital. What symptoms does the nurse recognize as most significant for a patient with this disorder? Shivering Heart rate of 56-64 bpm Blood pressure varying between 120/86 and 240/130 mm Hg Complaints of nausea

Blood pressure varying between 120/86 and 240/130 mm Hg

The actions of parathyroid hormone (PTH) are increased in the presence of which vitamin? B C E D

D

A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority? Decreased cardiac output Imbalanced nutrition: Less than body requirements Risk for infection Impaired physical mobility

Decreased cardiac output

A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority? Imbalanced nutrition: Less than body requirements Impaired physical mobility Risk for infection Decreased cardiac output

Decreased cardiac output

Which of the following medications is used in the treatment of diabetes insipidus to control fluid balance? Diabinese Desmopressin (DDAVP) Ibuprofen Thiazide diuretics

Desmopressin (DDAVP)

During physical examination of a client with a suspected endocrine disorder, the nurse assesses the body structures. The nurse gathers this data based on the understanding that it is an important aid in which of the following? Detecting information about possible tumor growth Detecting evidence of hormone hypersecretion Determining the presence or absence of testosterone levels Determining the size of the organs and location

Detecting evidence of hormone hypersecretion

Which is a clinical manifestation of diabetes insipidus? Excessive activities Low urine output Excessive thirst Weight gain

Excessive thirst

Which outcome indicates that treatment of a client with diabetes insipidus has been effective? Urine output measures more than 200 ml/hour. Blood pressure is 90/50 mm Hg. Heart rate is 126 beats/minute. Fluid intake is less than 2,500 ml/day.

Fluid intake is less than 2,500 ml/day.

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. thyroiditis. Hashimoto's thyroiditis. multinodular goiter.

Graves' disease.

Which feature(s) indicates a carpopedal spasm in a client with hypoparathyroidism? Moon face and buffalo hump Hand flexing inward Bulging forehead Cardiac dysrhythmia

Hand flexing inward

Which condition should a nurse expect to find in a client diagnosed with hyperparathyroidism? Hyperphosphatemia Hypocalcemia Hypercalcemia Hypophosphaturia

Hypercalcemia

The nurse is aware that the clinical symptoms of a patient with hypoparathyroidism are the result of the initial physiologic response of: Increased serum levels of phosphate. Decreased levels of vitamin D. Hypocalcemia. Cardiac arrhythmias.

Hypocalcemia

A client with acromegaly has been given the option of a surgical approach or a medical approach. The client decides to have a surgical procedure to remove the pituitary gland. What does the nurse understand this surgical procedure is called? Hypophysectomy Thyroidectomy Ablation Hysteroscopy

Hypophysectomy

Which is a complication of hyperthyroidism? Myxedema coma Addisonian crisis Acromegaly Hypothyroidism

Hypothyroidism

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? Thyroxine Calcitonin Thyrotropin Iodine

Iodine

Which nursing diagnosis takes highest priority for a client with hyperthyroidism? Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing Disturbed body image related to weight gain and edema Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

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 Increase in serum calcium Lowered blood phosphate Increase in the renal excretion of phosphate

Inadequate secretion of parathormone

The nurse knows to assess a patient with hyperthyroidism for the primary indicator of: Intolerance to heat Constipation Weight gain Fatigue

Intolerance to heat

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? Calcitonin Thyrotropin Iodine Thyroxine

Iodine

Which of the following would the nurse expect the physician to order for a client with hypothyroidism? Methimazole Levothyroxine sodium Propylthiouracil Propranolol

Levothyroxine sodium

Which intervention is the most critical for a client with myxedema coma? Maintaining a patent airway Administering an oral dose of levothyroxine (Synthroid) Warming the client with a warming blanket Measuring and recording accurate intake and output

Maintaining a patent airway

A client is receiving long-term treatment with high-dose corticosteroids. Which of the following would the nurse expect the client to exhibit? Moon face Pale thick skin Hypotension Weight loss

Moon face

When preparing teaching plan for a client with an endocrine disorder, the nurse includes information about hormone regulation. Which of the following would the nurse include? The gland becomes enlarged leading to a deficiency of the hormone. The gland slows hormone secretion when the hormone level decreases. Hormone secretion occurs as a straight-line continuous process. Most disorders result from over- or underproduction of the hormone.

Most disorders result from over- or underproduction of the hormone.

Hypocalcemia is associated with which of the following manifestations?

Muscle twitching

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? Syndrome of inappropriate antidiuretic hormone (SIADH) Thyroid storm Myxedema coma Diabetes insipidus

Myxedema coma

Which of the following would the nurse need to be alert for in a client with severe hypothyroidism? Addison's disease Myxedemic coma Thyroid storm Acromegaly

Myxedemic 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? Blood glucose level of 90 mg/dl Blood urea nitrogen (BUN) level of 12 mg/dl Serum potassium level of 5.8 mEq/L Serum sodium level of 134 mEq/L

Serum potassium level of 5.8 mEq/L

Which of the following glands is considered the master gland? Parathyroid Adrenal Thyroid Pituitary

Pituitary

The nurse is reviewing the history and physical examination of a client diagnosed with hyperthyroidism. Which of the following would the nurse expect to find? Inability to tolerate cold Reports of increased appetite Thick hard nails Complaints of sleepiness

Reports of increased appetite

A client has a decreased level of thyroid hormone being excreted. What will the feedback loop do to maintain the level of thyroid hormone required to maintain homeostatic stability? The feedback loop will be unable to perform in response to low levels of thyroid hormone. Produce a new hormone to try and regulate the thyroid function Stimulate more hormones using the positive feedback system Stimulate more hormones using the negative feedback system

Stimulate more hormones using the negative feedback system

Beta-blockers are used in the treatment of hyperthyroidism to counteract which of the following effects? Parasympathetic Sympathetic Respiratory effects Gastrointestinal effects

Sympathetic

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 pneumonia Dietary intake of foods with saturated fats Symptoms of acute coronary syndrome Heat intolerance

Symptoms of acute coronary syndrome

Which of the following endocrine disorder causes the patient to have dilutional hyponatremia? Hypothyroidism Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Hyperthyroidism Diabetes insipidus (DI)

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

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? Dysuria Leg cramps Blurred vision Tachycardia

Tachycardia

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? The client's blood sugar level Details about the size of the organ and its location The functioning of endocrine glands The concentration of a substance in plasma

The functioning of endocrine glands

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 dose of the medication must be too high and should be lowered. Those symptoms are not related to the corticosteroid therapy. The symptoms are permanent side effects of the corticosteroid therapy.

The moon face and acne will resolve when the medication is tapered off.

A client is returned to his room after a subtotal thyroidectomy. Which piece of equipment is most important for the nurse to keep at the client's bedside? Humidifier Cardiac monitor Tracheostomy set Indwelling urinary catheter kit

Tracheostomy set

A nurse is aware that several laboratory results are present in a patient diagnosed with diabetes insipidus. Select all that apply. Serum ADH level of 2.3 pg/mL Urine specific gravity of 1.001 Serum sodium level of 149 mEq/L Serum osmolality of 310 mOsm/kg Urine osmolality of 800 mOsm/kg

Urine specific gravity of 1.001 Serum osmolality of 310 mOsm/kg Serum sodium level of 149 mEq/L

The nurse practitioner who assesses a patient with hyperthyroidism would expect the patient to report which of the following conditions? Weight loss Hair loss Fatigue Dyspnea

Weight loss

A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect? Diaphoresis, fever, and decreased sweating Weight gain, constipation, and lethargy Weight loss, nervousness, and tachycardia Exophthalmos, diarrhea, and cold intolerance

Weight loss, nervousness, and tachycardia

When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect: a blood pressure of 176/88 mm Hg. bradycardia. a blood pressure of 130/70 mm Hg. a blood glucose level of 130 mg/dl.

a blood pressure of 176/88 mm Hg.

For a client with hyperthyroidism, treatment is most likely to include: thyroid extract. a synthetic thyroid hormone. a thyroid hormone antagonist. emollient lotions.

a thyroid hormone antagonist.

Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client (who now has nausea) and records a temperature of 105°F (40.5°C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? Hypoglycemia Tetany Diabetic ketoacidosis Thyroid crisis

Thyroid crisis

Trousseau sign is elicited after making a clenched fist and opening the hand; the palm remains blanched when pressure is placed over the radial artery. by tapping sharply over the facial nerve just in front of the parotid gland and anterior to the ear, causing spasm or twitching of the mouth, nose, and eye. when the foot is dorsiflexed and there is pain in the calf. by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.

by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.

Cardiac effects of hyperthyroidism include palpitations. decreased pulse pressure. decreased systolic blood pressure. bradycardia.

palpitations.