Endocrine Disorders PrepU
A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority?
Decreased cardiac output
A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication?
Myxedema coma
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
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.
Dilutional hyponatremia occurs in which disorder?
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Which of the following endocrine disorder causes the patient to have dilutional hyponatremia?
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
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
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."
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.
A patient has been diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following manifestations would be expected in this patient?
Concentrated urine
A group of students is reviewing material about endocrine system function. The students demonstrate understanding of the information when they identify which of the following as secreted by the adrenal medulla?
Epinephrine
A client is being seen in the clinic to receive the results of the lab work to determine thyroid levels. The nurse observes the client's eyes appear to be bulging, and there is swelling around the eyes. What does the nurse know that the correct documentation of this finding is?
Exophthalmos
A nurse should perform which intervention for a client with Cushing's syndrome?
Explain that the client's physical changes are a result of excessive corticosteroids.
Which outcome indicates that treatment of a client with diabetes insipidus has been effective?
Fluid intake is less than 2,500 ml/day.
Which feature(s) indicates a carpopedal spasm in a client with hypoparathyroidism?
Hand flexing inward
A client with a history of Addison's disease and flu-like symptoms accompanied by nausea and vomiting over the past week is brought to the facility. His wife reports that he acted confused and was extremely weak when he awoke that morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. What should the nurse expect to administer by IV infusion?
Hydrocortisone
A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply.
Hypothermia Hypotension Hypoventilation
Which nursing diagnosis takes highest priority for a client with hyperthyroidism?
Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
The thymus gland secretes thymosin and thymopoietin, which aid in developing T lymphocytes, a type of white blood cell involved in immunity. Which of the following best identifies the location of this gland?
In the upper part of the chest above or near the heart
A nurse is assigned to support a patient while a cast is being applied to treat a greenstick fracture. The nurse documents that this fracture is classified as what type of fracture?
Incomplete
The nurse is teaching a client that the body needs iodine for the thyroid to function. What food would be the best source of iodine for the body?
Iodized table salt
Which intervention is the most critical for a client with myxedema coma?
Maintaining a patent airway
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?
Most disorders result from over or underproduction of the hormone.
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?
Oxytocin
Which medication is the treatment of choice for pregnant women diagnosed with hyperthyroidism?
PTU
Vision and visual fields are altered in disorders of which of the following endocrine glands?
Pituitary
A client with acromegaly is admitted to the hospital with complaints of partial blindness that began suddenly. What does the nurse suspect is occurring with this client?
Pressure on the optic nerve
A client with hyperthyroidism is concerned about changes in appearance. How can the nurse convey an understanding of the client's concern and promote effective coping strategies?
Reassure the client that their emotional reactions are a result of the disorder and symptoms can be controlled with effective treatment.
Patients with hyperthyroidism are characteristically:
Sensitive to heat
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?
Serum potassium level of 5.8 mEq/L
A nurse is caring for a client in acute addisonian crisis. Which test result does the nurse expect to see?
Serum potassium level of 6.8 mEq/L
Beta-blockers are used in the treatment of hyperthyroidism to counteract which of the following effects?
Sympathetic
A nurse is caring for a female client with hypothyroidism. The client is extremely upset about her altered physical appearance. She doesn't want to take her medication because she doesn't believe it's doing any good. What should the nurse do?
Tell the client she'll soon experience improvement in her looks as the medication corrects her hormone deficiency.
The nurse is caring for a patient with hyperthyroidism who suddenly develops symptoms related to thyroid storm. What symptoms does the nurse recognize that are indicative of this emergency?
Temperature of 102ºF
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 functioning of endocrine glands
A client with thyroiditis has undergone surgery and is concerned about the barely visible scar. Which suggestion should the nurse give the client to cope with the condition?
Wear clothing that covers the neck
A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect?
Weight loss, nervousness, and tachycardia
Trousseau sign is elicited
by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.
A client with hypofunction of the adrenal cortex has been admitted to the medical unit. What would the nurse most likely find when assessing this client?
decreased blood pressure
A client has been experiencing a decrease in serum calcium. After diagnostics, the physician proposes the calcium level fluctuation is due to altered parathyroid function. What is the typical number of parathyroid glands?
four
When teaching a client with Cushing's syndrome about dietary changes, the nurse should instruct the client to increase intake of:
fresh fruits
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?
iodine
A client is undergoing diagnostics for an alteration in thyroid function. What physiologic function is affected by altered thyroid function?
metabolic rate
Hypocalcemia is associated with which of the following manifestations?
muscle twitching
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
Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany?
Calcium gluconate
Trousseau's sign is elicited by which of the following?
Carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.
A client sustained a head injury when falling from a ladder. While in the hospital, the client begins voiding large amounts of clear urine and reports being very thirsty. The client states feeling weak and having experienced an 8-pound weight loss since admission. What condition does the nurse expect the client to be tested for?
Diabetes insipidus
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
A patient has been placed on corticosteroid therapy for an Addison's disease. The nurse should be aware of which of the following side effects with this type of therapy? Select all that apply.
Hypertension Alterations in glucose metabolism Poor wound healing
The nurse auscultates a bruit over the thyroid glands. What does the nurse understand is the significance of this finding?
The patient may have hyperthyroidism.
Which diagnostic test is done to determine suspected pituitary tumor?
computed tomography scan
Cardiac effects of hyperthyroidism include
palpitations.
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.
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:
sodium and potassium abnormalities
When caring for a client with diabetes insipidus, the nurse expects to administer:
vasopressin
During an assessment of a client's functional health pattern, which question by the nurse directly addresses the client's thyroid function?
"Do you experience fatigue even if you have slept a long time?"
A nurse is completing an assessment of a client with suspected acromegaly. To assist in making the diagnosis, which question should the nurse ask?
"Has your shoe size increased recently?"
A nurse is caring for a client with Cushing's syndrome. Which interventions would the nurse include in the client's plan of care? Select all that apply.
-Report systolic BP greater than 139 mm Hg or diastolic -BP greater than 89 mm Hg. -Examine extremities for pitting edema. -Administer prescribed diuretics. -Monitor weight.
A patient is diagnosed with overactivity of the adrenal medulla. What epinephrine value does the nurse recognize is a positive diagnostic indicator for overactivity of the adrenal medulla?
450 pg/mL
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
During the first 24 hours after a client is diagnosed with addisonian crisis, which intervention should the nurse perform frequently?
Assess vital signs
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?
Blood pressure varying between 120/86 and 240/130 mm Hg
The nurse is assessing a client diagnosed with Graves disease. What physical characteristics of Graves disease would the nurse expect to find?
Bulging eyes
Evaluation of an adult client reveals oversecretion of growth hormone. Which of the following would the nurse expect to find?
Bulging forehead
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?
Parathyroid gland
The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as which of the following?
gigantism
A client presents with a huge lower jaw, bulging forehead, large hands and feet, and frequent headaches. What could be causing this client's symptoms?
hyperpituitarism
The nurse is aware that the clinical symptoms of a patient with hypoparathyroidism are the result of the initial physiologic response of:
hypocalcemia
A client has been experiencing a decrease in serum calcium. After diagnostics, the physician believes the calcium level fluctuation is due to altered parathyroid function. What is the role of parathormone?
increase serum calcium level
The most common type of goiter is caused by lack of which of the following?
iodine
