Endocrine
A patient is instructed to ingest 75 g of glucose orally as a part of an oral glucose tolerance test. In addition, growth hormone measurements are taken consecutively at 30, 60, 90, and 120 minutes. Glucose levels and growth hormone levels are found to be constant during the test. What does the nurse infer from these findings? A. Acromegaly B. Hepatomegaly C.Splenomegaly D. Dactylomegaly
A. Acromegaly
The registered nurse is preparing to teach a group of nursing students about the pathophysiologic events associated with syndrome of inappropriate antidiuretic hormone (SIADH). Which events should the nurse include in the teaching plan? Select all that apply. A. Decreased serum osmolality B. Occurrence of hypernatremia C. Increased water reabsorption D. Decreased water reabsorption E. Occurrence of dilutional hyponatremia
A. Decreased serum osmolality C. Increased water reabsorption E. Occurrence of dilutional hyponatremia
Which interventions does the nurse use when caring for a patient recovering from a transsphenoidal hypophysectomy? Select all that apply. Select all that apply A. Elevate the head of the bed 30 degrees B. Monitor for and report clear nasal drainage C. Encourage hourly coughing and deep breathing D. Perform routine pin cares according to agency policy E. Monitor for and report increased urinary output
A. Elevate the head of the bed 30 degrees B. Monitor for and report clear nasal drainage E. Monitor for and report increased urinary output
While assessing a patient with suspected Cushing's syndrome, of what most prominent clinical manifestation is the nurse aware? A. Dehydration and hypotension B. "Bulking up" of skeletal muscle C. Hypoglycemia with intense hunger D. Weight gain, including truncal obesity
D. Weight gain, including truncal obesity
The nurse recalls that excessive secretion of the hormone vasopressin characterizes: A. Thyrotoxicosis B. Diabetes insipidus C. Hyperosmolar hyperglycemic nonketotic syndrome D. Syndrome of inappropriate antidiuretic hormone secretion
D. Syndrome of inappropriate antidiuretic hormone secretion
The endocrine system involves a number of organs and glands that secrete hormones. The posterior pituitary gland is responsible for secreting antidiuretic hormone (ADH). When the posterior pituitary gland overproduces ADH, a condition called the syndrome of inappropriate antidiuretic hormone (SIADH) develops. Which characteristics best describe SIADH? A. Polyuria, serum hypoosmolality, dilutional hyponatremia, and concentrated urine with normal intravascular volume B. Polyuria, serum hyperosmolality, dilutional hyponatremia, and concentrated urine with normal intravascular volume C. Fluid retention, serum hyperosmolality, dilutional hypernatremia, and concentrated urine with normal intravascular volume D. Fluid retention, serum hypoosmolality, dilutional hyponatremia, and concentrated urine with normal intravascular volume
D. Fluid retention, serum hypoosmolality, dilutional hyponatremia, and concentrated urine with normal intravascular volume
The nurse is caring for a patient who has cerebral edema associated with syndrome of inappropriate antidiuretic hormone (SIADH). What clinical manifestation of severe serum sodium level decline does the nurse assess? Select all that apply. Select all that apply A. Coma B. Lethargy C. Confusion D. Headache E. Tachycardia F. Hypovolemic shock
A. Coma B. Lethargy C. Confusion D. Headache
A nurse is caring for 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? A. Compensation for decreased cortisol levels B. Inhibition of glucose metabolism C. Diuretic action to maintain urine output D. Decreased susceptibility to infection
A. Compensation for decreased cortisol levels
Which is a sign of syndrome inappropriate antidiuretic hormone (SIADH)? A. Decreased ADH B. Excessive urine output C. Increased serum osmolality D. Increased intravascular volume
D. Increased intravascular volume
The nurse is performing a shift assessment of a patient with aldosteronism. What assessments should the nurse include? Select all that apply. A) Urine output B) Signs or symptoms of venous thromboembolism C) Peripheral pulses D) Blood pressure E) Skin integrity
A) Urine output D) Blood pressure
The nurse is teaching a patient with Addison's disease about corticosteroid therapy. The nurse should prioritize which of these teaching points? A."Plan a high-carbohydrate diet." B. "Increase your daily intake of sodium." C. "Decrease your daily intake of calcium." D. "Do not stop taking the medication abruptly."
D. "Do not stop taking the medication abruptly."
The nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone (SIADH) who has muscle twitching, vomiting, severe abdominal cramps, and begins to have seizures. The nurse assesses a serum sodium level of 116 mEq/L. What is the priority nursing action for this patient? A. Administer lorazepam IV slowly. B. Administer carbamazepine by mouth. C. Administer furosemide 40 mg IV push. D. Administer hypertonic saline solution slowly.
D. Administer hypertonic saline solution slowly.
A patient who is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) has the serum sodium levels below 120 mEq/L and presents with neurologic manifestations such as seizures. What would be the most appropriate nursing intervention? A. Fluid restriction of 1000 mL/day B. Administration of vasopressin receptor antagonists C. Administration of loop diuretics such as furosemide D. Administration of intravenous hypertonic saline solution
D. Administration of intravenous hypertonic saline solution
Which hormone deficiency may lead to a life-threatening condition? A. Prolactin B. Oxytocin C. Follicle-stimulating hormone (FSH) D. Adrenocorticotropic hormone (ACTH)
D. Adrenocorticotropic hormone (ACTH)
The nurse determines that additional instruction is needed for a 60-year-old patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) when the patient says which of the following? a. I need to shop for foods low in sodium and avoid adding salt to food. b. I should weigh myself daily and report any sudden weight loss or gain. c. I need to limit my fluid intake to no more than 1 quart of liquids a day. d. I will eat foods high in potassium because diuretics cause potassium loss.
a. I need to shop for foods low in sodium and avoid adding salt to food.
Which nursing intervention is a priority for a patient recovering from removal of a pituitary gland tumor? A. Maintaining patent IV access B. Monitoring the patient for increased temperature C. Offering the bedpan or urinal at least every two to three hours D. Assessing for signs of increased intracranial pressure (ICP)
D. Assessing for signs of increased intracranial pressure (ICP)
A 42-year-old female patient is scheduled for transsphenoidal hypophysectomy to treat a pituitary adenoma. During preoperative teaching, the nurse instructs the patient about the need to a. cough and deep breathe every 2 hours postoperatively. b. remain on bed rest for the first 48 hours after the surgery. c. avoid brushing teeth for at least 10 days after the surgery. d. be positioned flat with sandbags at the head postoperatively.
c. avoid brushing teeth for at least 10 days after the surgery
A patient with hypofunction of the adrenal cortex has been admitted to the medical unit. What would the nurse most likely find when assessing this patient? A) Increased body temperature B) Jaundice C) Copious urine output D) Decreased BP
D) Decreased BP
The home care nurse is conducting patient teaching with a patient on corticosteroid therapy. To achieve consistency with the bodys natural secretion of cortisol, when would the home care nurse instruct the patient to take his or her corticosteroids? A) In the evening between 4 PM and 6 PM B) Prior to going to sleep at night C) At noon every day D) In the morning between 7 AM and 8 AM
D) In the morning between 7 AM and 8 AM
A nurse has just received a report from the emergency department on a patient admitted with a closed head injury after falling down a flight of stairs. The nurse is reviewing the lab results in the patient's electronic record and discovers a sodium level of 128 mEq/L, serum osmolality of 271 mOsm/kg, and a urine specific gravity of 1.030. After reviewing these results, about which disorder is the nurse most concerned? A. Diabetes insipidus B. Cushing syndrome C. Primary hyperparathyroidism D. Syndrome of inappropriate antidiuretic hormone (SIADH)
D. Syndrome of inappropriate antidiuretic hormone (SIADH)
The nurse is caring for an older adult who sustained a closed head injury and notes that the patient has not urinated in the past four hours despite drinking 500 mL of fluid and receiving IV fluids at a rate of 150 mL/hr. Which condition should the nurse suspect in this patient? A. Acromegaly B. Hypopituitarism C. Diabetes insipidus D.Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
D.Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
The nurse is monitoring a patient recovering from the removal of a brain tumor. The nurse notes that the patient has an increase in urinary output to 450 mL of very light urine in the past hour. Which condition should the nurse suspect in this patient? A. Acromegaly B. Hypopituitarism C. Diabetes insipidus D.Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
C. Diabetes insipidus
The nurse is caring for a patient following an adrenalectomy. The highest priority in the immediate postoperative period is to a. protect the patients skin. b. monitor for signs of infection. c. balance fluids and electrolytes. d. prevent emotional disturbances.
c. balance fluids and electrolytes.
An expected nursing diagnosis for a 30-year-old patient admitted to the hospital with symptoms of diabetes insipidus is a. excess fluid volume related to intake greater than output. b. impaired gas exchange related to fluid retention in lungs. c. sleep pattern disturbance related to frequent waking to void. d. risk for impaired skin integrity related to generalized edema.
c. sleep pattern disturbance related to frequent waking to void.
A patient with pituitary adenoma underwent transsphenoidal hypophysectomy. What nursing actions are most effective for prevention of complications? Select all that apply. Select all that apply A. Monitoring the pupillary response B. Elevating the head of the patient's bed C. Observing the patient for any signs of bleeding D. Advising the patient to brush his or her teeth twice daily E. Monitoring extremity strength to detect neurologic complications
A. Monitoring the pupillary response B. Elevating the head of the patient's bed C. Observing the patient for any signs of bleeding E. Monitoring extremity strength to detect neurologic complications
A patient is admitted to the intensive care unit because of low urine output, increased body weight, lethargy, and confusion. Serum sodium level is <120 mEq/L. What should the nurse do first?
Administer 3% sodium chloride intravenously at a slow rate
A 70-year-old man was admitted to an inpatient unit for a closed head injury after falling down a flight of stairs. The patient has been calling for the nurse every half hour requesting more water to drink and to use the urinal. The unlicensed assistive person (UAP) recorded urine output every hour for the past five hours as 500, 400, 600, 250, and 300 mL. Along with the urine output, the urinalysis revealed a specific gravity of 1.000 on each specimen. Because the patient had a head injury, the primary healthcare provider determines that the patient has central diabetes insipidus (DI). What does the nurse expect the primary healthcare provider will order for the patient? A. Indomethacin B. Thiazide diuretics C. Desmopressin acetate (DDAVP) D. Fluid restrictions, oral and intravenous
C. Desmopressin acetate (DDAVP)
A nurse is assessing a patient with suspected hypopituitarism. Which findings would suggest that the patient may have a deficiency of adrenocorticotropic hormone (ACTH)? A. Constipation and lethargy B. Truncal obesity and weakness C. Fasting hypoglycemia and headache D. Decreased facial hair and muscle mass
C. Fasting hypoglycemia and headache
Which intervention will the nurse include in the plan of care for a 52-year-old male patient with syndrome of inappropriate antidiuretic hormone (SIADH)? a. Monitor for peripheral edema. b. Offer patient hard candies to suck on. c. Encourage fluids to 2 to 3 liters per day. d. Keep head of bed elevated to 30 degrees.
. Offer patient hard candies to suck on.
A patient has a serum sodium level of 134 mEq/L, an osmolality less than 280 mOsm/kg, and the urine specific gravity is greater than 1.025. Which medication is most beneficial for this patient? A. Tolvaptan B. Propranolol C. Methimazole D. Desmopressin
A. Tolvaptan
The nurse receives primary care provider orders for a patient with syndrome of inappropriate antidiuretic hormone (SIADH). Which medication order should the nurse question? A. Vinblastine B. Cabergoline C. Bromocriptine D. Lysine vasopressin
A. Vinblastine
Which factors should the nurse assess in a patient who is on desmopressin acetate (DDAVP)? Select all that apply. Select all that apply A. Weight B. Skin turgor C. Mental status D. Sodium levels E. Mucus membranes
A. Weight C. Mental status D. Sodium levels
A nurse is monitoring a client who has SIADH. Which of the following findings should the nurse expect? A. Polyuria B. Dehydration C. Hyponatremia D. Hyperthermia
C. Hyponatremia
The nurse is caring for a patient who is diagnosed with the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention would promote a reduction in the release of antidiuretic hormone (ADH)? A. Positioning the head of the bed flat B. Encouraging the patient to ambulate C. Changing the patient position frequently D. Instructing the patient to perform range-of-motion exercises
A. Positioning the head of the bed flat
A patient with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) is being cared for on the critical care unit. The priority nursing diagnosis for a patient with this condition is what? A) Risk for peripheral neurovascular dysfunction B) Excess fluid volume C) Hypothermia D) Ineffective airway clearance
B) Excess fluid volume
A nurse on an inpatient unit is caring for a patient who underwent a hypophysectomy. While performing the adult ongoing assessment at the beginning of the shift, the nurse notices the moustache dressing is saturated with clear drainage. After notifying the primary healthcare provider, the nurse sends a specimen to the laboratory to assess for a cerebrospinal fluid (CSF) leak. The glucose level is 50 mg/dL. Considering this result, for which complication is the patient most at risk? A. Diabetes B. Meningitis C.Hypoglycemia D. Visual deterioration
B. Meningitis
The nurse is administering intravenous glucose solution to a patient who is suffering from diabetes insipidus. What parameters would the nurse monitor for the management of osmotic diuresis? A. Blood pressure B. Serum glucose levels C. Fluid and electrolytes D. Specific gravity of the urine
B. Serum glucose levels
A patient has undergone surgery for acromegaly. After surgery, the patient is experiencing severe headache. What action should be taken to provide relief from the headache? A. The bed should be placed parallel to the floor. B. The head of the bed should be elevated to 30-degree angle. C. The glucose level of the patient should be maintained. D. The patient should be told to avoid coughing and sneezing.
B. The head of the bed should be elevated to 30-degree angle.
The nurse is preparing a patient for a water deprivation test for central diabetes insipidus in the hospital. What intervention is required for this patient? A. Deprive the patient of water for six hours. B. Administer intravenous hypotonic saline or dextrose 5% in water. C. Administer desmopressin acetate (DDAVP) subcutaneously. D. Provide the patient with a diluted solution of sodium.
C. Administer desmopressin acetate (DDAVP) subcutaneously.
The nurse is teaching the patient with adrenocortical insufficiency and the caregiver about management of corticosteroid therapy. What should the nurse tell the patient and the caregiver? A. Assess for cataracts every two years. B. Decrease the dose of corticosteroids when stressed. C. Recognize edema and ways to restrict sodium intake. D. Plan a diet high in concentrated simple carbohydrates.
C. Recognize edema and ways to restrict sodium intake.
A patient with a pituitary tumor has developed excessive height, and increased hat size and shoe size. Which hormone does the nurse determine is secreting excessively? A. Cortisol B. Thyroxine C. Somatotropin D. Triiodothyronine
C. Somatotropin
A nurse is assessing a client who has manifestations of Acromegaly. Which of the following findings should the nurse expect? A. Thinning of skeletal bone B. Concave Chest C. High- pitched voice D. Increased head size
D. Increased head size
Which finding indicates to the nurse that the current therapies are effective for a patient with acute adrenal insufficiency? a. Increasing serum sodium levels b. Decreasing blood glucose levels c. Decreasing serum chloride levels d. Increasing serum potassium levels
a. Increasing serum sodium levels
The nurse will plan to monitor a patient diagnosed with a pheochromocytoma for a. flushing. b. headache. c. bradycardia. d. hypoglycemia.
b. headache.
A patient is undergoing transsphenoidal hypophysectomy. The nurse is aware that the procedure involves surgical resection of what gland? A. Thyroid B. Adrenal C. Pituitary D. Parathyroid
C. Pituitary
A nurse is caring for a client who has Diabetes Insipidus. For which of the following should the nurse monitor for? A. Proteinuria B. Oliguria C. Polyuria D. Glycosuria
C. Polyuria
The nurse is caring for a patient at risk for an addisonian crisis. For what associated signs and symptoms should the nurse monitor the patient? Select all that apply. A) Epistaxis B) Pallor C) Rapid respiratory rate D) Bounding pulse E) Hypotension
B) Pallor C) Rapid respiratory rate E) Hypotension
The nurse is caring for a patient with Addisons disease who is scheduled for discharge. When teaching the patient about hormone replacement therapy, the nurse should address what topic? A) The possibility of precipitous weight gain B) The need for lifelong steroid replacement C) The need to match the daily steroid dose to immediate symptoms D) The importance of monitoring liver function
B) The need for lifelong steroid replacement
A patient with Cushing syndrome as a result of a pituitary tumor has been admitted for a transsphenoidal hypophysectomy. What would be most important for the nurse to monitor before, during, and after surgery? A) Blood glucose B) Assessment of urine for blood C) Weight D) Oral temperature
A) Blood glucose
The nurse providing care for a patient with Cushing syndrome has identified the nursing diagnosis of risk for injury related to weakness. How should the nurse best reduce this risk? A) Establish falls prevention measures. B) Encourage bed rest whenever possible. C) Encourage the use of assistive devices. D) Provide constant supervision.
A) Establish falls prevention measures.
A nurse is caring for a client with Addison's disease who has been admitted with muscle weakness, dehydration, and nausea and vomiting for the past 2 days. Which of the following prescribed medications should the nurse plan to administer? A. Rifampin B. Loperamide C. Hydrocortisone D. Spirinolactone
C. Hydrocortisone
A patient is suspected of having acromegaly. When gathering a health history, what questions would be important for the nurse to ask? Select all that apply. A. Do you snore? B. Do you crave salty foods? C. Have you experienced a recent weight loss? D. Have you noticed an increase in your shoe size? E. Have you experienced unusual thirst or excessive urination? F. Have you experienced numbness or tingling in your fingers or hands?
A. Do you snore? D. Have you noticed an increase in your shoe size? E. Have you experienced unusual thirst or excessive urination? F. Have you experienced numbness or tingling in your fingers or hands?
The nurse is reviewing a patient's laboratory reports that show increased levels of plasma insulin-like growth factor 1. What does this finding indicate about growth hormone levels? A. Growth hormone levels are elevated. B. Growth hormone levels are decreased. C. Growth hormone production has stopped. D. Growth hormone levels are unchanged.
A. Growth hormone levels are elevated.
The nurse informs a patient that has had a hypophysectomy for removal of a pituitary tumor to avoid vigorous coughing and sneezing. What explanation does the nurse give the patient for these instructions? A. To avoid seizures B. To avoid headache C. To prevent cerebrospinal fluid leakage D. To monitor pupillary and speech responses
C. To prevent cerebrospinal fluid leakage
A nurse is providing teaching to 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? A.Sliced bananas B. Baked potato C. Turkey and cheese sandwich D. Plain yogurt with peaches
C. Turkey and cheese sandwich
Which test is more reliable to diagnose pheochromocytoma? A. Urinary cortisol B. Urine osmolality C. Urinary creatinine D. Urinary aldosterone
C. Urinary creatinine
The nurse is caring for a patient who underwent transsphenoidal hypophysectomy to treat acromegaly. Which is the best nursing action to prevent leakage of cerebrospinal fluid? A. Having the patient lie down in the supine position B. Ensuring oral hygiene in the patient by regular brushing C. Informing the primary health care provider about nasal drainage D. Instructing the patient to avoid vigorous coughing, sneezing, and straining at stool
D. Instructing the patient to avoid vigorous coughing, sneezing, and straining at stool
The nurse is planning postoperative care for a patient who is being admitted to the surgical unit form the recovery room after transsphenoidal resection of a pituitary tumor. Which nursing action should be included? a. Palpate extremities for edema. b. Measure urine volume every hour. c. Check hematocrit every 2 hours for 8 hours. d. Monitor continuous pulse oximetry for 24 hours. ANS: B
b. Measure urine volume every hour.
The nurse is caring for a patient admitted with diabetes insipidus (DI). Which information is most important to report to the health care provider? a. The patient is confused and lethargic. b. The patient reports a recent head injury. c. The patient has a urine output of 400 mL/hr. d. The patients urine specific gravity is 1.003.
a. The patient is confused and lethargic.
A 56-year-old female patient has an adrenocortical adenoma, causing hyperaldosteronism. The nurse providing care should a. monitor the blood pressure every 4 hours. b. elevate the patients legs to relieve edema. c. monitor blood glucose level every 4 hours. d. order the patient a potassium-restricted diet.
a. monitor the blood pressure every 4 hours.
38-year-old male patient is admitted to the hospital in Addisonian crisis. Which patient statement supports a nursing diagnosis of ineffective self-health management related to lack of knowledge about management of Addisons disease? a. I frequently eat at restaurants, and my food has a lot of added salt. b. I had the stomach flu earlier this week, so I couldnt take the hydrocortisone. c. I always double my dose of hydrocortisone on the days that I go for a long run. d. I take twice as much hydrocortisone in the morning dose as I do in the afternoon.
b. I had the stomach flu earlier this week, so I couldnt take the hydrocortisone.
A 56-year-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with possible syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would expect the initial laboratory results to include a(n) a. elevated hematocrit. b. decreased serum sodium. c. low urine specific gravity. d. increased serum chloride.
b. decreased serum sodium.
6. The nurse determines that demeclocycline (Declomycin) is effective for a patient with syndrome of inappropriate antidiuretic hormone (SIADH) based on finding that the patients a. weight has increased. b. urinary output is increased. c. peripheral edema is decreased. d. urine specific gravity is increased.
b. urinary output is increased.
After obtaining the information shown in the accompanying figure regarding a patient with Addisons disease, which prescribed action will the nurse take first? a. Give 4 oz of fruit juice orally. b. Recheck the blood glucose level. c. Infuse 5% dextrose and 0.9% saline. d. Administer oxygen therapy as needed.
c. Infuse 5% dextrose and 0.9% saline.
Which information obtained by the nurse in the endocrine clinic about a patient who has been taking prednisone (Deltasone) 40 mg daily for 3 weeks is most important to report to the health care provider? a. Patients blood pressure is 148/94 mm Hg. b. Patient has bilateral 2+ pitting ankle edema. c. Patient stopped taking the medication 2 days ago. d. Patient has not been taking the prescribed vitamin D.
c. Patient stopped taking the medication 2 days ago.
A 37-year-old patient is being admitted with a diagnosis of Cushing syndrome. Which findings will the nurse expect during the assessment? a. Chronically low blood pressure b. Bronzed appearance of the skin c. Purplish streaks on the abdomen d. Decreased axillary and pubic hair
c. Purplish streaks on the abdomen
36. Which assessment finding of a 42-year-old patient who had a bilateral adrenalectomy requires the most rapid action by the nurse? a. The blood glucose is 176 mg/dL. b. The lungs have bibasilar crackles. c. The blood pressure (BP) is 88/50 mm Hg. d. The patient reports 5/10 incisional pain.
c. The blood pressure (BP) is 88/50 mm Hg.
A 29-year-old woman with systemic lupus erythematosus has been prescribed 2 weeks of high-dose prednisone therapy. Which information about the prednisone is most important for the nurse to include? a. Weigh yourself daily to monitor for weight gain caused by increased appetite. b. A weight-bearing exercise program will help minimize the risk for osteoporosis. c. The prednisone dose should be decreased gradually rather than stopped suddenly. d. Call the health care provider if you experience mood alterations with the prednisone.
c. The prednisone dose should be decreased gradually rather than stopped suddenly.
. A 23-year-old patient is admitted with diabetes insipidus. Which action will be most appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)? a. Titrate the infusion of 5% dextrose in water. b. Teach the patient how to use desmopressin (DDAVP) nasal spray. c. Assess the patients hydration status every 8 hours. d. Administer subcutaneous DDAVP.
d. Administer subcutaneous DDAVP.
A nurse is caring for a client who has been diagnosed with Addisonian crisis and has a blood pressure of 74/42 mmHg. Which of the following prescriptions should the nurse anticipate? A. Desmopression B.Hydrocortisone C. Dopamine D. Furosemide
B.Hydrocortisone
A patient with Cushing syndrome has been hospitalized after a fall. The dietician consulted works with the patient to improve the patients nutritional intake. What foods should a patient with Cushing syndrome eat to optimize health? Select all that apply. A) Foods high in vitamin D B) Foods high in calories C) Foods high in protein D) Foods high in calcium E) Foods high in sodium
A) Foods high in vitamin D C) Foods high in protein D) Foods high in calcium
Which signs and symptoms would the nurse expect to assess in a patient who is diagnosed with acromegaly? Select all that apply. A. Fragile skin B. Increased shoe size C. Elevated blood glucose D. Complaint of headaches E. Increased height and weight
B. Increased shoe size C. Elevated blood glucose D. Complaint of headaches
The patient with systemic lupus erythematosus has been diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). What should the nurse expect to include in this patient's plan of care? Select all that apply. A. Obtain weekly weights B. Limit fluids to 1000 mL per day C. Monitor for signs of hypernatremia D. Minimize turning and range of motion E. Keep the head of the bed at 10 degrees or less elevation
B. Limit fluids to 1000 mL per day E. Keep the head of the bed at 10 degrees or less elevation
The nurse is caring for a patient with central diabetes insipidus (DI). What does the nurse recognize is a priority focus of care? A. Pacing activities and minimizing fatigue B. Preventing treatment-related hypoglycemia C. Avoiding dehydration and fluid volume deficit D. Decreasing renal responsiveness to antidiuretic hormone (ADH)
C. Avoiding dehydration and fluid volume deficit
A nurse is assessing a client who has Addison's disease. Which of the following findings should. the nurse expect? A. Hypotension B. Weight gain C. Sugar craving D. Pale skin tone
A. Hypotension
A patient presents at the walk-in clinic complaining of diarrhea and vomiting. The patient has a documented history of adrenal insufficiency. Considering the patients history and current symptoms, the nurse should anticipate that the patient will be instructed to do which of the following? A) Increase his intake of sodium until the GI symptoms improve. B) Increase his intake of potassium until the GI symptoms improve. C) Increase his intake of glucose until the GI symptoms improve. D) Increase his intake of calcium until the GI symptoms improve.
A) Increase his intake of sodium until the GI symptoms improve.
You are developing a care plan for a patient with Cushing syndrome. What nursing diagnosis would have the highest priority in this care plan? A) Risk for injury related to weakness B) Ineffective breathing pattern related to muscle weakness C) Risk for loneliness related to disturbed body image D) Autonomic dysreflexia related to neurologic changes
A) Risk for injury related to weakness
While assisting with the surgical removal of an adrenal tumor, the OR nurse is aware that the patients vital signs may change upon manipulation of the tumor. What vital sign changes would the nurse expect to see? A) Hyperthermia and tachypnea B) Hypertension and heart rate changes C) Hypotension and hypothermia D) Hyperthermia and bradycardia
B) Hypertension and heart rate changes
A nurse is planning care for a client who has Cushing's Syndrome due to chronic corticosteroid use. Which of the following actions should the nurse include in plan of care? A. Check the client's blood glucose for hypoglycemia B. Check the client's urine specific gravity C. Weight the client weekly D. Insert an indwelling catheter
B. Check the client's urine specific gravity
The nurse caring for a patient with Cushing syndrome is describing the dexamethasone suppression test scheduled for tomorrow. What does the nurse explain that this test will involve? A) Administration of dexamethasone orally, followed by a plasma cortisol level every hour for 3 hours B) Administration of dexamethasone IV, followed by an x-ray of the adrenal glands C) Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8 AM the next morning D) Administration of dexamethasone intravenously, followed by a plasma cortisol level 3 hours after the drug is administered
C) Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8 AM the next morning
A 30 year-old female patient has been diagnosed with Cushing syndrome. What psychosocial nursing diagnosis should the nurse most likely prioritize when planning the patients care? A) Decisional conflict related to treatment options B) Spiritual distress related to changes in cognitive function C) Disturbed body image related to changes in physical appearance D) Powerlessness related to disease progression Ans:
C) Disturbed body image related to changes in physical
A nurse caring for a patient with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding? A) Glucose in the urine B) Albumin in the urine C) Highly dilute urine D) Leukocytes in the urine
C) Highly dilute urine
The nurse is caring for a patient with a diagnosis of Addisons disease. What sign or symptom is most closely associated with this health problem? A) Truncal obesity B) Hypertension C) Muscle weakness D) Moon face
C) Muscle weakness
A patient has been assessed for aldosteronism and has recently begun treatment. What are priority areas for assessment that the nurse should frequently address? Select all that apply. A) Pupillary response B) Creatinine and BUN levels C) Potassium level D) Peripheral pulses E) BP
C) Potassium level E) BP
The patient with small cell lung cancer experiences a sudden 5-pound weight gain without edema and a decreased urinary output. Serum sodium is 128 mEq/L. Which strategy does the nurse anticipate will be prescribed for the patient? A. Low-sodium diet B. Elevate head of bed 30 degrees C. 1000 mL per day fluid restriction D. Administration of desmopressin acetate nasal spray
C. 1000 mL per day fluid restriction
patient who underwent surgery for acromegaly complains of postoperative headache and running nose. What action should the nurse take to resolve the problems within 72 hours? Select all that apply. Select all that apply A. Prepare the patient for spinal tap B. Monitor the vital parameters regularly C. Check for glucose levels in nasal discharge D. Encourage bed rest with the head elevated Check for growth hormone (GH) levels in the blood
C. Check for glucose levels in nasal discharge D. Encourage bed rest with the head elevated
The nurse should monitor for increases in which laboratory value in a patient being treated with dexamethasone? A. Sodium B. Calcium C. Potassium D. Blood glucose
D. Blood glucose
A nurse is planning care for a client who has SIADH with mild manifestations. The nurse should expect the provider to prescribe which of the following medications? A. Chlorpropamide B. Tolvaptan C. Vasopressin D. Desmopression
B. Tolvaptan
A patient has been diagnosed with acromegaly and is suspected of having developed diabetes mellitus as a result of the increased growth hormone (GH). What clinical manifestations does the nurse document that correlate with the development of diabetes mellitus? Select all that apply. A. Increased thirst B. Dysrhythmias C. Constipation D. Increased urination E. Tingling sensation of the hands
A. Increased thirst D. Increased urination
Following an addisonian crisis, a patients adrenal function has been gradually regained. The nurse should ensure that the patient knows about the need for supplementary glucocorticoid therapy in which of the following circumstances? A) Episodes of high psychosocial stress B) Periods of dehydration C) Episodes of physical exertion D) Administration of a vaccine
A) Episodes of high psychosocial stress
A patient with suspected adrenal insufficiency has been ordered an adrenocorticotropic hormone (ACTH) stimulation test. Administration of ACTH caused a marked increase in cortisol levels. How should the nurse interpret this finding? A) The patients pituitary function is compromised. B) The patients adrenal insufficiency is not treatable. C) The patient has insufficient hypothalamic function. D) The patient would benefit from surgery.
A) The patients pituitary function is compromised.
The nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone secretion in the acute care setting. What nursing interventions are important for this patient? Select all that apply. A. Restrict fluid intake to no more than 1000 mL/day. B. Elevate the head of the bed to an angle of 30 degrees. C. Avoid frequent repositioning of the patient. D. Implement seizure precautions and set the bed alarm. E. Provide the patient with ice chips to decrease thirst.
A. Restrict fluid intake to no more than 1000 mL/day. D. Implement seizure precautions and set the bed alarm. E. Provide the patient with ice chips to decrease thirst.
The nurse is obtaining a history and physical on a patient with acromegaly who reports visual changes. What should the nurse assess in this patient? A. The function of cranial nerve II B. The function of cranial nerve III C. The function of cranial nerve IV D. The function of cranial nerve VI
A. The function of cranial nerve II
A patient is diagnosed with central diabetes insipidus and states not knowing how the illness was acquired. What does the nurse recognize as a possible cause of this disorder? A. The presence of a brain tumor B. Renal damage from long-standing hypertension C. Drug therapy with lithium for bipolar disorder D. Structural lesion in the thirst center
A. The presence of a brain tumor
What should the nurse teach a patient on corticosteroid therapy in order to reduce the patients risk of adrenal insufficiency? A) Take the medication late in the day to mimic the bodys natural rhythms. B) Always have enough medication on hand to avoid running out. C) Skip up to 2 doses in cases of illness involving nausea. D) Take up to 1 extra dose per day during times of stress.
B) Always have enough medication on hand to avoid running out.
A patient undergoes a physical examination and several diagnostic tests, upon which the patient is diagnosed with acromegaly. Which findings in the patient would require the nurse to prepare the patient for surgery? Select all that apply. Select all that apply A. Dry skin B. Atrophy of vocal chords C. Appearance of pituitary tumors D. Decreased pressure on optic nerves E. Increase in growth hormone (GH) concentration after oral glucose tolerance test
C. Appearance of pituitary tumors E. Increase in growth hormone (GH) concentration after oral glucose tolerance test
A patient has recently undergone transsphenoidal hypophysectomy and reports a severe supraorbital headache. The nurse maintains the patient's head in an elevated position and requests the patient stay on bed rest for four days. Which finding in the laboratory report is the reason for this nursing action? A. Glucose level 15 mg/dL in the urine sample B. Glucose level 70 mg/dL in the blood sample C. Glucose level 40 mg/dL in the nasal drainage D. Glucose level 60 mg/dL in the cerebrospinal fluid
C. Glucose level 40 mg/dL in the nasal drainage
A patient diagnosed with acromegaly is to receive medication to block the hepatic production of insulin-like growth factor-1. What medication will the nurse prepare to administer to the patient? A. Lanreotide B. Cabergoline C. Pegvisomant D. Bromocriptine
C. Pegvisomant
A nurse is assessing a client who has Addison's disease. Which of the following skin manifestations should the nurse expect to find? A. Purple striae on chest and abdomen B.Butterfly rash across the bridge of nose C.Bronze pigmentation of the skin D.Jaundice of the face and sclera
C.Bronze pigmentation of the skin
The nurse is assessing a female patient that has developed fat pads on the back of the neck, an increased abdominal girth, facial hair growth, and a "moon" face. What disorder does this assessment data indicate? A. Acromegaly B. Conn's disease C. Graves' disease D. Cushing syndrome
D. Cushing syndrome
A patient with pheochromocytoma has been admitted for an adrenalectomy to be performed the following day. To prevent complications, the nurse should anticipate preoperative administration of which of the following? A) IV antibiotics B) Oral antihypertensives C) Parenteral nutrition D) IV corticosteroids
D) IV corticosteroids
Adrenocortical insufficiency develops secondary to inadequate secretion of which pituitary hormone? A. Antidiuretic hormone (ADH) B. Follicle-stimulating hormone (FSH) C. Thyroid-stimulating hormone (TSH) D. Adrenocorticotropic hormone (ACTH
D. Adrenocorticotropic hormone (ACTH
A nurse in the emergency department is caring for a client with Addison's disease, reports. nausea and vomiting, diarrhea and abdominal pain. To prevent an Addisonian crisis , the nurse should administer which of the following medications? A. Calcium B. Potassium C. Iodine D. Hydrocortisone
D. Hydrocortisone
After a 22-year-old female patient with a pituitary adenoma has had a hypophysectomy, the nurse will teach about the need for a. sodium restriction to prevent fluid retention. b. insulin to maintain normal blood glucose levels. c. oral corticosteroids to replace endogenous cortisol. d. chemotherapy to prevent malignant tumor recurrence.
c. oral corticosteroids to replace endogenous cortisol.
A 44-year-old female patient with Cushing syndrome is admitted for adrenalectomy. Which intervention by the nurse will be most helpful for a nursing diagnosis of disturbed body image related to changes in appearance? a. Reassure the patient that the physical changes are very common in patients with Cushing syndrome. b. Discuss the use of diet and exercise in controlling the weight gain associated with Cushing syndrome. c. Teach the patient that the metabolic impact of Cushing syndrome is of more importance than appearance. d. Remind the patient that most of the physical changes caused by Cushing syndrome will resolve after surgery.
d. Remind the patient that most of the physical changes caused by Cushing syndrome will resolve after surgery.
Which information is most important for the nurse to communicate rapidly to the health care provider about a patient admitted with possible syndrome of inappropriate antidiuretic hormone (SIADH)? a. The patient has a recent weight gain of 9 lb. b. The patient complains of dyspnea with activity. c. The patient has a urine specific gravity of 1.025. d. The patient has a serum sodium level of 118 mEq/L.
d. The patient has a serum sodium level of 118 mEq/L.
A patient is undergoing testing for suspected adrenocortical insufficiency. The care team should ensure that the patient has been assessed for the most common cause of adrenocortical insufficiency. What is the most common cause of this health problem? A) Therapeutic use of corticosteroids B) Pheochromocytoma C) Inadequate secretion of ACTH D) Adrenal tumor
A) Therapeutic use of corticosteroids
A patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) has a serum sodium level of 130mEq/L and complains of a severe backache. What are the mostappropriate nursing interventions? Select all that apply. Select all that apply A. Assessing the patient's weight B. Positioning the head of the bed flat C. Restricting fluid intake to 900 mL/day D. Administering opioid analgesics for the management of pain E. Administering intravenous hypertonic solution for the management of sodium levels
A. Assessing the patient's weight B. Positioning the head of the bed flat C. Restricting fluid intake to 900 mL/day
A patient who has been taking corticosteroids for several months has been experiencing muscle wasting. The patient has asked the nurse for suggestions to address this adverse effect. What should the nurse recommend? A) Activity limitation to conserve energy B) Consumption of a high-protein diet C) Use of OTC vitamin D and calcium supplements D) Passive range-of-motion exercises
B) Consumption of a high-protein diet
The physician has ordered a fluid deprivation test for a patient suspected of having diabetes insipidus. During the test, the nurse should prioritize what assessments? A) Temperature and oxygen saturation B) Heart rate and BP C) Breath sounds and bowel sounds D) Color, warmth, movement, and sensation of extremities
B) Heart rate and BP
The nurse is providing discharge instructions to a patient with diabetes insipidus. Which instructions regarding desmopressin acetate would be most appropriate? A. The patient can expect to experience weight loss resulting from increased diuresis. B. The patient should alternate nostrils during administration to prevent nasal irritation. C. The patient should monitor for symptoms of hypernatremia as a side effect of this drug. D. The patient should report any decrease in urinary elimination to the health care provider.
B. The patient should alternate nostrils during administration to prevent nasal irritation.
A nurse is preparing a 24hr urine specimen for a client who is suspected to have Pheocromocytoma. Which of the following laboratory testsform the 24hr urine specimen should the nurse use to determine this client's condition? A. Creatinine clearance B. Vanillylmandelic Acid (VMA) C. 17- hydroxycorticosteroids D. Protein
B. Vanillylmandelic Acid (VMA)
A 35-year-woman who has undergone hypophysectomy develops deficiency of follicle-stimulating hormone and luteinizing hormone. What consequence of this complication should the nurse monitor in the patient? A. Slowed speech B. Impaired memory C. Increase in weight D. Decreased fertility rate
D. Decreased fertility rate
A patient is scheduled for a bilateral adrenalectomy. What does the nurse include in the discharge teaching for this patient? A. No replacement therapy will be needed. B. Weekly adrenocorticotropic hormone (ACTH) injections will be needed. C. Cortisol will be required if the patient has stress. D. Lifelong replacement of corticosteroids will be required.
D. Lifelong replacement of corticosteroids will be required.
