chapter 8 endocrine management
which client would most benefit from acupressure, a traditional chinese medicine, which is considered complementary alternative medication?
-the client diagnosed with thyroid cancer who has chemotherapy-induced nausea.
which client is the priority to be assigned to a case manager in the outpatient clinic so that care can be achieved?
-the client diagnosed with type 2 diabetes and CAD
which task is most appropriate for the RN staff nurse to delegate or assign when caring for clients on a surgical unit?
-ask another nurse to administer an IVP pain medication to a postoperative client in severe pain.
the night nurse enters the client's room and finds the client crying. the client asks the nurse, "Am i dying? I think something is terribly wrong with me, but no one is telling me." the nurse knows the client has pancreatic cancer and has less than 6 months to live. which response is an example of the ethical principle of veracity?
-"your diagnosis is pancreatic cancer"
the nurse is hanging 1000 mL of IV fluids to run for 8 hours. the IV tubing is a microdrip. At how many gtt/min should the IV rate be set?
-125 ggt/min
the client diagnosed with type 1 diabetes is receiving regular insulin by sliding scale. the client's glucometer reading is 249. the order reads blood glucose level. how much insulin should the nurse administer?
-8 units
the clinical nurse manager on the endocrine unit overhears the staff nurses who are upset and arguing over how the clients are being assigned by the charge nurse. which statement indicates a democratic leadership style by the clinical nurse manager?
-I will schedule a meeting and we will all sit down and discuss the situation.
the critical care nurse has received the am shift report on a client diagnosed with heart failure and who has pre-existing type 2 diabetes. after reviewing the client's medication administration record, which medication should the nurse administer first?
-administer 70/30 insulin subcutaneously
the client is admitted to the endocrinology unit newly diagnosed with an acute exacerbation of central diabetes insipidus. Which intervention is the priority nursing intervention?
-administer intravenous hypotonic saline.
the hospice nurse caring for a client diagnosed with diabetes mellitus type 2 observes the client eating a bowl of ice cream. which intervention should the nurse implement first?
-allow the client to enjoy the ice cream
the hospice nurse is writing a care plan for a client diagnosed with type 2 diabetes mellitus who has peripheral neuropathy. which client problem has priority for the client?
-alteration in comfort
the clinic nurse is caring for a 10-year-old client diagnosed with type 2 diabetes mellitus. which client problem is the priority?
-altered nutritoin, excessive intake
the RN staff nurse and UAP are caring for clients on an endocrinology unit. which tasks should the RN delegate to the UAP? Select all that apply.
-ambulate the client who had a unilateral adrenalectomy -change the linens on the client diagnosed with acute thyrotoxicosis who is diaphoretic -bring ice cold water to the client diagnosed with DI -deliver the lunch tray to the client receiving regular insulin on a sliding scale.
the rehabilitation nurse is caring for a client diagnosed with type 2 diabetes who is 1 week postoperative for left carotid endarterectomy. the client's 11:30 am bedside glucose reading is 408 mg/dL. based on the medication administration record (MAR), which intervention should the nurse implement first?
-recheck the bedside glucometer reading.
the home health director of nurses hears a nurse and the occupational therapist loudly disagreeing about the care of a newly admitted client while they are sitting in an area that is accessible to anyone coming into the office. which action should the director of nurses implement first?
-request both individuals to come into the director's office.
which task is most appropriate for the RN staff nurse to delegate to the UAP?
-request the UAP to take the diabetic client's HS snack to the client.
the RN clinic nurse in the outpatient clinic is working with an UAP. which tasks are most appropriate for the nurse to delegate to the UAP? select all that apply.
-take the client to the examination room and take the vital signs -weigh the client and document the weight in the client's EHR. -prepare the examination room for the next client.
the nurse is working in an outpatient clinic triaging phone calls. which client warrants notifying the health-care provider?
-the client diagnosed with type one diabetes who had a kidney transplant and reports decreased urine output and flu-like symptoms.
the home health agency chief nursing officer is making assignments for the nurse. which client should be assigned to the new graduate nurse who just completed orientation?
-the client reporting pain who is diagnosed with diabetic neuropathy
the nurse is working on an endocrinology unit. which client should the nurse assess first?
-the client who 1-day postoperative thyroidectomy who has neck edema.
the unit manager of an endocrinology unit is overbudget for the year and must transfer one staff member to another unit. which option is the best action for the unit manager to take before deciding which staff member to transfer?
-assess each staff member's abilities
the nurse is preparing to administer morning medications. which medication should the nurse administer first?
-the insulin isophane to a client diagnosed with type 2 diabetes
which statement is an example of community-oriented, population-focused nursing?
-the nurse develops an educational program for the type 2 diabetics in the local area.
the UAP has just taken the blood pressure of a client who had a thyroidectomy. the UAP tells the RN primary nurse that the client's hand turned into a claw when the blood pressure was taken. which intervention should the nurse implement first?
-assess the client for signs or symptoms of hypoparathyroidism.
the UAP tells the nurse the client who had a thyroidectomy has a T 104, P 128, RR 26, BP 164/88. Which intervention should the nurse implement first?
-assess the client's vital signs and surgical dressing
the overhead page has just announced a code red, actual fire, on a unit two floors below the unit where the RN staff nurse is working. which action should the nurse implement first?
-close all of the doors to the clients' rooms.
which activities are examples of home health care nurse responsibilities when caring for clients diagnosed with endocrine disorders? select all that apply.
-complete nutritional counseling and teaching for a client on a high-fiber diet -manage oxygen therapy for a client diagnosed with chronic obstructive pulmonary disease (COPD) -teach the client and family about administration and side effects of medications -draw blood for studies related to monitoring disease processes and therapy.
the client diagnosed with Addison's disease is being prepared for emergency surgery and is asking to complete an advance directive. which type of advance directive should the nurse recommend the client complete at this time?
-durable power of attorney for health care
the female client diagnosed with the type 2 diabetes and urinary tract infection (UTI) describes frequent UTIs. which intervention should the nurse implement? Select all that apply.
-encourage the client to empty her bladder regularly and completely -instruct the client to drink 8 ounces of cranberry or lingonberry juice a day. -explain the importance of taking oral hypoglycemic medications -discuss the importance of taking all the antibiotics.
which interventions should the RN primary nurse implement for the client diagnosed with hyperthyroidism? select all that apply.
-establish a supportive and trusting relationship to help the client cope -assist with exercises involving large muscle groups -place the client in a cool room away from high-traffic areas.
at 1000, the client diagnosed with type 1 diabetes is reporting being jittery, having a headache, and feeling dizzy. which intervention should the nurse implement first?
-give the client glucose tablets.
which laboratory data should the nurse monitor for the client receiving intravenous methylprednisolone?
-glucose level
the UAP tells the RN staff nurse the client diagnosed with thyroid cancer who is terminally ill is having deep-rapid breathing, but then doesn't breathe for about a minute. which intervention should the nurse implement first?
-go to the client's room immediately and assess the client.
which priority intervention should the nurse implement when teaching the client diagnosed with type 2 diabetes about glucometer testing?
-have the client demonstrate how to correctly perform the blood sugar test
the nurse is preparing to administer medications for clients on a medical unit. the client diagnosed with hypothyroidism is describing being hot all the time, feeling palpitations, and being jittery. which intervention should the nurse implement first?
-hold the client's thyroid medication
which statement by the client experiencing exophthalmos indicates the client needs more teaching by the endocrinology nurse?
-i should not move my eyes unless absolutely necessary
the RN nurse supervisor in the home health office is assigning tasks for the day. which task is most appropriate for the nurse supervisor to assign to the LPN?
-instruct the LPN to visit the client diagnosed with type 2 diabetes who is stable and needs a hospital bed.
which priority intervention should the nurse implement for the client diagnosed with syndrome of inappropriate antidiuretic hormone?
-maintain the prescribed daily fluid restriction
which nursing intervention is the priority for the intensive care nurse to implement when caring for a client diagnosed with diabetic ketoacidosis (DKA)?
-maintain the regular insulin IV rate on an infusion pump
the UAP tells the RN primary nurse that a client is crying and upset because she has been told her husband has just died. which intervention should the nurse implement?
-make a referral for the chaplain to see the client.
an elderly client diagnosed with thyroid cancer frequently makes statements that are inappropriate for the situation, and is not oriented to place, time, or date. the HCP has ordered a MRI scan of the client's brain. Which intervention should the nurse implement?
-make sure the client does not have pacemaker
after receiving the shift report, the 7:00 pm to 7:00 am nurse is reviewing the medication administration record (MAR) of the client diagnosed with type 2 diabetes. which intervention should the nurse implement?
-make sure the client receives a snack at bedtime
the nurse is providing complementary alternative medicine by teaching the client diagnosed with hyperthyroidism to focus attention, increase self-awareness, and increase concentration on an object. which type of mind-body intervention is the nurse teaching?
-meditation
the nurse on the medical unit is preparing to administer 0900 medications. which medication should the nurse question administering?
-metformin to the type 2 diabetic who just had a CT scan with dye
the nurse is working in a primary health-care clinic reviewing laboratory data. which laboratory data should the nurse report to the HCP first?
-mr. F.G., who has seen for his annual physical examination.
the RN staff nurse on the endocrinology unit is caring for clients, assisted by an UAP. which task is most appropriate to delegate to the UAP?
-obtain a urine specimen for the client diagnosed with diabetes insipidus
the nurse is administering medications on an endocrinology unit. which medication should the nurse question administering?
-the propanolol to the client diagnosed with hypothyroidism.
the client diagnosed with type 2 diabetes mellitus has a hemoglobin A1C of 11 mg/dL. which intervention should the nurse implement first?
-teach the client about the effects of uncontrolled hyperglycemia.
which task is most appropriate for the RN charge nurse to assign to the LPN?
-tell the LPN to change the client's sublavian dressing
the RN charge nurse on the endocrine surgical unit is making assignments. which task should be deleted or assigned to the team members?
-tell the LPN to perform an intermittent urinary catheterization for the client diagnosed with acromegaly.
which task should the RN ambulatory care nurse delegate to the UAP?
-tell the UAP to take the glucometer reading on the client about to go to surgery
the new graduate nurse on the endocrine unit is having difficulty completing the workload in a timely manner. which suggestion could the RN preceptor make to help the new graduate become more organized?
-tell the new nurse to start the shift with a work organization sheet for the assigned clients.
the RN charge nurse on a busy 20-bed endocrinology unit must send on staff member to the nursery. which staff member is most appropriate to send to the nursery?
-the LPN who has worked in a newborn nursery at another facility
the RN staff nurse is caring for the client who is 1-day postoperative transsphenoidal hypophysectomy. which action by the UAP warrants intervention by the nurse?
-the UAP is helping the client splint the incision.
which action by the UAP warrants intervention by the RN primary nurse caring for the client diagnosed with type 2 diabetes and chronic renal disease who is on hemodialysis?
-the UAP ties a sheet around the client sitting in the chair.
for which client's laboratory data should the charge nurse notify the HCP?
-the blood glucose level of 543 mg/dL in a client diagnosed with uncontrolled diabetes mellitus type 1
the nurse in an outpatient clinic is triaging telephone calls. Rank in order of priority.
-the call from a husband who states his wife started on an antidepressant and now will not wake up. -the client diagnosed with hypothyroidism who is reporting feeling hot, having hand tremors, and having diarrhea -the call from the pharmacist wanting an authorization to change a medication from a brand name to a generic name drug. -the call from a client who states the medication that was prescribed for her type 2 diabetes mellitus is too expensive -the call from the client who had a MRI scan 2 days ago and has not received the results.
which client is most appropriate for the parish nurse to care for?
-the catholic client ho is confined to the home because of severe arthritis.
the nurse is working in an endocrinology unit. which client warrants immediate intervention by the nurse?
-the client diagnosed diagnosed with pheochromocytoma who has a severe pounding headache and chest pain.
the charge nurse is reviewing the morning laboratory results for the clients. which laboratory results require notifying the client's health care provider?
-the client diagnosed with hyperthyroidism who has an increased TSH level.
the clinic nurse is caring for clients using complementary alternative medicine. which intervention is an example of CAM? select all that apply.
-the client diagnosed with hypothyroidism who takes centella asiatica -the client diagnosed with type 2 diabetes who takes cinnamon daily -the client who uses acupuncture to help quit smoking cigarettes -the client who uses hypnosis to improve memory function
which client should the nurse on the endocinology unit assess first?
-the client diagnosed with hypthyroidism whose vital sings are T 94.2, AP 48, RR 14, BP 90/68.
which client should the charge nurse on a medical unit assign to a nurse who is 5 months pregnant?
-the client who completed chemotherapy treatment and who is immunosuppressed.
the nurse is caring for clients in the post-anesthesia care unit (PACU). which client requires immediate intervention by the PACU nurse?
-the client who had a bilateral adrenalectomy who is exhibiting masseter rigidity
the charge nurse of a surgical unit has been notified of an external disaster with multiple casualties. which client should the charge nurse request to be discharged from the hospital to make room for clients from the disaster?
-the client who had a total abdominal hysterectomy 2 days ago and PCA machine has been discontinued
which client should the endocrinology nurse assess first after receiving the shift report?
-the client who is 1-day postoperative transsphenoidal hypophysectomy who has clear drainage from the nose.
the client diagnosed with hypothyroidism and a diagnosis of myxedema coma is admitted to the critical care unit. which assessment data warrants immediate intervention by the nurse?
-the client's ABG values are pH, 7.33; PaO2, 78; PaCO2, 48; HcO3, 25.
an elderly female client is admitted from the long-term care facility diagnosed with hyperglycemic hyperosmolar nonketotic coma. the client does not have any family or friends present. which resources should the admission nurse utilize to obtain information about the client?
-the transfer form from the nurse home and old hospital records
the nurse administering medications to clients on a medical unit discovers the wrong medication was administered to a client, Mrs Jones. Mrs. Jones had replied she was Mrs. Smith when the nurse asked her name from the MAR. which step in medication administration did the nurse violate when administering the medication?
-verifying the client's armband with the MAR
the client diagnosed with type 2 diabetes who has chronic renal disease asks the nurse, "how can i qualify for home health care when I go home?" which statement is the nurse's best response?
-you must be homebound to receive home health care