Chapter 52: Assessment and Management of Patients With Endocrine Disorders
A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which gland? Adrenal cortex Pancreas Adrenal medulla Parathyroid
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A nurse explains the role of the ovaries. Which hormones would be included in that discussion? estrogen and progesterone estrogen and progestin testosterone and progesterone estrogen and testosterone
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Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex? Cushing syndrome Addison disease Graves disease Hashimoto disease
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Which of the following endocrine disorder causes the patient to have dilutional hyponatremia? Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Diabetes insipidus (DI) Hypothyroidism Hyperthyroidism
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Which of the following medications is used in the treatment of diabetes insipidus to control fluid balance? Desmopressin (DDAVP) Thiazide diuretics Ibuprofen Diabinese
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A client has a dysfunction in one of his glands that is causing a decrease in the level of calcium in the blood. What gland should be evaluated for dysfunction? Thyroid gland Parathyroid gland Thymus gland Adrenal gland
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A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately? Pitting edema of the legs An irregular apical pulse Dry mucous membranes Frequent urination
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A nurse is caring for a client who was recently diagnosed with hyperparathyroidism. Which statement by the client indicates the need for additional discharge teaching? "I will take my pain medications according to the schedule we developed." "I will increase my fluid and calcium intake." "I'll schedule a follow-up visit with my physician as soon as I get home." "I'll call my physician if I notice tingling around my lips."
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The nurse is reviewing the laboratory and diagnostic test findings of a client diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following would the nurse expect to find? Elevated serum sodium levels Decreased serum osmolarity Decreased urine sodium levels Elevated urine calcium levels
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The nurse is reviewing the plan of care for a client with a disorder of the thyroid gland. Which diagnostic test would the nurse expect the physician to order to evaluate thyroid hormones? Magnetic resonance imaging Radioimmunoassay Computed tomography (CT) Cortisol level determination
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Which is a clinical manifestation of diabetes insipidus? Low urine output Excessive thirst Weight gain Excessive activities
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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 concentration of a substance in plasma Details about the size of the organ and its location The functioning of endocrine glands The client's blood sugar level
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A client visits the clinic to seek treatment for disturbed sleep cycles and depressed mood. Which glands and hormones help to regulate sleep cycles and mood? Thymus gland, thymosin Parathyroid glands, parathormone Pineal gland, melatonin Adrenal cortex, corticosteroids
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A nurse is teaching a client with adrenal insufficiency about corticosteroids. Which statement by the client indicates a need for additional teaching? "I will avoid friends and family members who are sick." "I will eat lots of chicken and dairy products." "I may stop taking this medication when I feel better." "I will see my ophthalmologist regularly for a check-up."
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A nurse should perform which intervention for a client with Cushing's syndrome? Offer clothing or bedding that's cool and comfortable. Suggest a high-carbohydrate, low-protein diet. Explain that the client's physical changes are a result of excessive corticosteroids. Explain the rationale for increasing salt and fluid intake in times of illness, increased stress, and very hot weather.
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An incoherent client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and periorbital area. Knowing that these findings suggest severe hypothyroidism, the nurse prepares to take emergency action to prevent the potential complication of: thyroid storm. cretinism. myxedema coma. Hashimoto's thyroiditis.
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Evaluation of an adult client reveals oversecretion of growth hormone. Which of the following would the nurse expect to find? Excessive urine output Weight loss Bulging forehead Constant thirst
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The nurse practitioner who assesses a patient with hyperthyroidism would expect the patient to report which of the following conditions? Fatigue Dyspnea Weight loss Hair loss
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Which instruction should be included in the discharge teaching plan for a client after thyroidectomy for Graves' disease? Keep an accurate record of intake and output. Use nasal desmopressin acetate (DDAVP). Have regular follow-up care. Exercise to improve cardiovascular fitness.
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A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of: calcium and phosphorus abnormalities. chloride and magnesium abnormalities. sodium and chloride abnormalities. sodium and potassium abnormalities.
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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 Hysteroscopy Thyroidectomy Ablation
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A client with adrenal insufficiency is gravely ill and presents with nausea, vomiting, diarrhea, abdominal pain, profound weakness, and headache. The client's family reports that the client has been doing strenuous yard work all day and was sweating profusely. Nursing management of this client would include observation for signs of: hyponatremia and hyperkalemia. hyponatremia and hypokalemia. hypernatremia and hyperkalemia. hypernatremia and hypokalemia.
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A client with symptoms of Cushing syndrome is admitted to the hospital for evaluation and treatment. The nurse is creating a plan of care for the client. Which is an appropriate nursing diagnosis? Self-care deficit related to weakness, fatigue, muscle wasting, and altered sleep patterns Insomnia related to increased nighttime voiding Impaired nutrition: more than body requirements related to polyphagia Activity intolerance related to muscle cramps, cardiac dysrhythmias, and weakness
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A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder? pituitary disorder thyroid disorder parathyroid disorder adrenal disorder
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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? kidneys cardiac atria brain liver
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Beta-blockers are used in the treatment of hyperthyroidism to counteract which of the following effects? Sympathetic Parasympathetic Gastrointestinal effects Respiratory effects
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For the first 72 hours after thyroidectomy surgery, a nurse should assess a client for Chvostek's sign and Trousseau's sign because they indicate: hypocalcemia. hypercalcemia. hypokalemia. hyperkalemia.
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Trousseau sign is elicited by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff. 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. after making a clenched fist and opening the hand; the palm remains blanched when pressure is placed over the radial artery. when the foot is dorsiflexed and there is pain in the calf.1
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When describing the difference between endocrine and exocrine glands, which of the following would the instructor include as characteristic of endocrine glands? The secretions are released directly into the blood stream. The glands contain ducts that produce the hormones. The secreted hormones act like target cells. The glands play a minor role in maintaining homeostasis.
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Which assessment would a nurse perform on a client with Cushing's syndrome who is at high risk of developing a peptic ulcer? Observe stool color. Monitor bowel patterns. Monitor vital signs every 4 hours. Observe urine output.
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A client with a 20-year history of hypothyroidism who has not been compliant with taking thyroid replacement therapy is brought into the ED with a diagnosis of myxedema coma. What client symptoms are consistent with this life-threatening event? Select all that apply. Tachycardia Hypothermia Hypotension Hypoventilation Hyperactivity
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Which glands regulate calcium and phosphorous metabolism? Parathyroid Thyroid Adrenal Pituitary
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The nurse is aware that the clinical symptoms of a patient with hypoparathyroidism are the result of the initial physiologic response of: Hypocalcemia. Decreased levels of vitamin D. Increased serum levels of phosphate. Cardiac arrhythmias.
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The nurse obtains a complete family history of a client with a suspected endocrine disorder based on which rationale? An allergy to iodine is inherited. Endocrine disorders can be inherited. It helps determine the client's general status. Diet and drug histories are related to the family history.
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Which condition should a nurse expect to find in a client diagnosed with hyperparathyroidism? Hypocalcemia Hypercalcemia Hyperphosphatemia Hypophosphaturia
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During a follow-up visit to the physician, a client with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and: sodium. potassium. magnesium. phosphorus.
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The nurse knows to assess a patient with hyperthyroidism for the primary indicator of: Fatigue Weight gain Constipation Intolerance to heat
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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 130/70 mm Hg. a blood glucose level of 130 mg/dl. bradycardia. a blood pressure of 176/88 mm Hg.
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Which group of clients should not receive potassium iodide? Those who are allergic to corticosteroids Those who are pregnant Those taking medications such as cough medicines Those who are allergic to seafood
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The adrenal cortex is responsible for producing which substances? Glucocorticoids and androgens Catecholamines and epinephrine Mineralocorticoids and catecholamines Norepinephrine and epinephrine
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The nurse assesses a patient who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease? Potassium of 6.0 mEq/L Sodium of 140 mEq/L Glucose of 100 mg/dL A blood pressure reading of 135/90 mm Hg
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The nurse is aware that the best time of day for the total large corticosteroid dose is between: 7:00 AM and 8:00 AM 8:00 PM and 9:00 PM 4:00 AM and 5:00 AM 4:00 PM and 6:00 PM
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A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication? Tetany Hemorrhage Thyroid storm Laryngeal nerve damage
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A nursing student asks the instructor why the pituitary gland is called the "master gland." What is the best response by the instructor? "It regulates the function of other endocrine glands." "It is the gland that is responsible for regulating the hypothalamus." "The gland does not have any other function other than to cause secretion of the growth hormones." "It regulates metabolism."
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A client is suspected to have a pituitary tumor due to signs of diabetes insipidus. What initial test does the nurse help to prepare the client for? Magnetic resonance imaging (MRI) Radioactive iodine uptake test Radioimmunoassay A nuclear scan
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A client is undergoing diagnostics for an alteration in thyroid function. What physiologic function is affected by altered thyroid function? metabolic rate growth fluid/electrolyte balance sleep/wake cycles
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A client is receiving long-term treatment with high-dose corticosteroids. Which of the following would the nurse expect the client to exhibit? Weight loss Pale thick skin Moon face Hypotension
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Which nursing diagnosis takes highest priority for a client with hyperthyroidism? Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing Disturbed body image related to weight gain and edema Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
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On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance most commonly follows thyroid surgery? Hypocalcemia Hyponatremia Hyperkalemia Hypermagnesemia
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Cardiac effects of hyperthyroidism include decreased pulse pressure. decreased systolic BP. bradycardia. palpitations.
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