Endocrine Med surg III
A nurse is caring for a client who has Cushing's. Which of the following interventions should the nurse expect to perform? (SATA) A) Assess blood glucose levels B) Assess for neck vein distention C) Monitor for an irregular heart rate D) Monitor for postural hypotension E) Weight the client daily.
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A nurse is caring for a client who is being evaluated for acromegaly. Which of the following manifestations should the nurse expect during the assessment? (SATA) A) loss of color discrimination B) Coarse facial features C) Enlarged distal extremities D) hepatomegaly E) moon face
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A nurse has administered propranolol by IV bolus to a client who is having a thyroid storm. Which of the following findings indicates that the client is having a therapeutic response? A) Reduction of the effects of thyroid hormone on the heart B) Blockage of the release of thyroid hormone from the thyroid gland C) Increase in the hearts sensitivity to thyroid hormone D) Increase in the uptake of thyroid hormone by the thyroid gland
A) Reduction of the effects of thyroid hormone on the heart Propranolol is a beta blocker that decreases the rapid heart rate caused by excessive thyroid stimulation
A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective? A) A decrease in blood sugar B) A decrease in blood pressure C) A decrease in urine output D) A decrease in specific gravity
C) A decrease in urine output
A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride. The nurse should teach the client to avoid which of the following drinks while taking this medication? A) Grapefruit juice B) Milk C) Alcohol D) Coffee
C) Alcohol
A nurse is assessing a client who has a new diagnosis of Cushing's disease. Which of the following findings should the nurse expect? A) Decreased blood pressure B) Weight loss C) Hirsutism D) Increased skin thickness
C) Hirsutism Increased hair growth, or hirsutism, is an expected finding of Cushing's disease due to increased androgen production
A nurse is managing the care of a client who is post op and has acute adrenal insufficiency. Which of the following actions should the nurse take? A) Administer IV Hydrocortisone sodium B) Give oral spironolactone C) Infuse 1 unit of platelets D) Restrict daily fluid intake
A) Administer IV Hydrocortisone sodium Hydrocortisone sodium is necessary to replace the cortisol deficiency that occurs with adrenal insufficiency
A nurse is caring for a client who is 1 day post of following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client? A) Chvosteks sign B) Babinski sign C) Brudzinskis sign D) Kernigs sign
A) Chvosteks sign The nurse should suspect that the client has hypocalcemia, a possible complication following subtotal thyroidectomy. Manifestations of hypocalcemia include numbness and tingling in the hands, soles of the feet, and around the lips, typically appearing between 24-48 hours after surgery.
A nurse is caring for a client who has pheochromocytoma. Which of the following actions should the nurse take? A) Elevate the head of the bed B) Palpate the clients abdomen C) Monitor the client for hypotension D) Check the clients urine specific gravity
A) Elevate the head of the bed The nurse should elevate the head of the clients bed to reduce blood pressure and abdominal pressure
A nurse is monitoring the lab values of a client who has DM and is taking insulin. Which of the following results indicated a therapeutic outcome to insulin therapy? A) Fasting blood sugar of 96 B) Postprandial blood sugar 195 C) random blood sugar 210 D) Pre-prandial blood sugar 60
A) Fasting blood sugar of 96 This is within the expected reference range of 70-110 for a fasting blood glucose level and indicates that insulin therapy is effective.
A nurse is monitoring a client who is 24 hour postop after a total thyroidectomy. Which of the following findings should the nurse report to the provider? A) Laryngeal stridor B) Productive cough C) Pain with hyperextension of the neck D) Hoarse, weak voice
A) Laryngeal stridor Laryngeal stridor is a harsh, high pitched sound with inspiration that indicates respiratory obstruction. The nurse should take immediate action to preserve the clients airway
A nurse is teaching a client who has an autoimmune disease about the ASE of long term corticosteroid therapy. Which of the following ASE should the nurse include (SATA) A) Osteoporosis B) Moon Shaped face C) Increased risk of infection D) Hearing loss E) weight loss
A) Osteoporosis B) Moon Shaped face C) Increased risk of infection Osteoporosis is an ASE due to suppression of bone formation and the acceleration of bone reabsorption that corticosteroid therapy can cause.
A nurse is reviewing lab values for a client who has DKA. Which of the following results should the nurse expect. A) Ph 7.32, PaCO2 36, HCO3 14 B)Ph 7.38, PaCO2 55, HCO3 22 C) Ph 7.44, PaCO2 40, HCO3 24 D) Ph 7.50, PaCO2 42, HCO3 30
A) Ph 7.32, PaCO2 36, HCO3 14 Metabolic acidosis is a common manifestation of DKA, with a low pH, carbon dioxide within expected reference range, and a low bicarbonate.
A nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone. Which of the following findings should the nurse report to the provider? A) Sodium 110 B) 2+ Deep tendon reflexes C) Potassium 3.7 D) Urine specific gravity 1.025
A) Sodium 110 A client with SIADH retains fluids, which causes dilutional hyponatremia
A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include? A) Take this medicine on an empty stomach B) Take with medicine with an antacid C) change position slowly while taking this medicine D) Limit your fluid intake while taking this medicine
A) Take this medicine on an empty stomach To promote proper absorption, the client should take the medication on an empty stomach and not eat or drink anything for 30 - 60 min after.
A nurse is providing discharge teaching to a client who has diabetes insipidus and a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching? A) Depress the pump once before using the nasal spray for the first time B) Blow your nose gently prior to using the nasal spray C) Administer the nasal spray while in a side lying position D) notify the provider if you develop numbness or tingling around the mouth
B) Blow your nose gently prior to using the nasal spray The nurse should instruct the client to blow his nose gently prior to using the spray. This action prevents dilution of the medication with nasal secretions.
A nurse is assessing a client who has DM and reports feeling anxious. Which of the following findings should the nurse expect if the client is hypoglycemic? A) Rapid, deep respirations B) Cool, Clammy skin C) Abdominal cramping D) Orthostatic hypotension
B) Cool, Clammy skin Hypoglycemia causes cool, clammy skin in addition to anxiety, nervousness, tachycardia, and confusion.
A nurse is planning teaching for a client who has type 1 DM. Which of the following instructions should the nurse plan to make? A) Consume no more than 3 servings of alcohol per day B) Ingest food with alcohol to reduce alcohol induce hypoglycemia C) Increase insulin dosage before planned exercise D) Rest for 3 days between periods of vigorous exercise
B) Ingest food with alcohol to reduce alcohol induce hypoglycemia Alcohol inhibit the livers production of glucose. Consuming carbs while drinking alcohol will help prevent hypoglycemia
A nurse is caring for a client who has DM and has developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to the clients feet? A) Examine the skin of the feet weekly for alterations in skin integrity B) Monitor the temperature of bath water with a thermometer C) Shop for shoes early in the day D) Round the edges of toenails when trimming them
B) Monitor the temperature of bath water with a thermometer Peripheral neuropathy makes it difficult to determine if bath water is too hot. Therefore, to prevent injury, the client should use a bath thermometer to ensure a water temperature below 110F
A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following statements indicates an understanding of the teaching? A) I need to fast after midnight the night before the test B) This tests result in a good indicator of my average blood glucose levels C) a level of 8-10% suggests adequate blood glucose control D) I will use my hemoglobin A1c level to adjust my daily insulin doses
B) This tests result in a good indicator of my average blood glucose levels HbA1c reflects the clients glucose levels over 120 days which is the life span of RBCs
A Nurse is assessing a client who has diabetes insipidus. The nurse should expect which of the following findings? A) Decreased heart rate B) increased hematocrit C) High urine specific gravity D)Low BUN level
B) increased hematocrit Increased hematocrit is an expected finding of diabetes insipidus due to dehydration.
A nurse is collecting the medical history from a client who has manifestations of SIADH. The nurse should ask the client if he has a history of which of the following conditions that can cause SIADH? A) Osteoarthritis B) lung cancer C) liver cirrhosis D) Dyspepsia
B) lung cancer The nurse should ask the client if they have a HX of lung cancer because some of the treatment options for small cell lung cancer can cause secretion of antidiuretic hormone. This results in the body retaining water and can cause the SIADH.
A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect? A) Mood shaped face B) Weight gain C) Calcium 12.8 D) Sodium 150
C) Calcium 12.8. A client who has adrenal insufficient will have a calcium level above the expected reference range of 4.5-5.6
A nurse is caring for a client who is 1 day post of following a transsphenoidal hypophysectomy. While assessing the client, the nurse notes a large area of clear drainage seeping from the nasal packing. Which of the following should be the nurses initial action? A) Document the amount of drainage B) Obtain a culture of the drainage C) Check the drainage for glucose D) Notify the clients provider
C) Check the drainage for glucose
A nurse is teaching a client who has DM about insulin injections. The clients prescription includes evening doses of insulin glargine and regular insulin. Which of the following instructions should the nurse include? A) Inject the insulins intramuscularly B) Shake the insulins vigorously prior to administration C) Draw up the insulins into separate syringes D) Expect the insulins to appear cloudy
C) Draw up the insulins into separate syringes The nurse should instruct the client to draw up the insulins into separate syringes because insulin glargine is not compatible with other insulins.
A nurse is teaching a client who has type 1 DM about how to prevent complications during illness. Which of the following statements by the client indicates an understanding of the teaching? A) I should stop taking my insulin if i feel nauseous B) I will test my urine for protein when i start to feel ill C) I will call my doctor is my blood sugar is more than 250 D) I should check my blood sugar level every 8 hours
C) I will call my doctor is my blood sugar is more than 250
A nurse is assessing a client who is receiving liothyronine for treatment of hypothyroidism. The nurse should recognize which of the following findings is a therapeutic response to this medication? A) Decrease in appetite B) Increase in weight C) Increase in energy D) Decrease in body temp
C) Increase in energy An increase in energy is a therapeutic response to liothyronine. Depression, lethargy, and fatigue are manifestations of hypothyroidism and effective treatment will improve these manifestations.
A nurse is caring for a client who has Cushing's syndrome. The nurse should recognize that which of the following are manifestations of Cushings syndrome? (SATA) A) alopecia B) Tremors C) Moon Face D) Purple striations E) Buffalo Hump
C) Moon Face D) Purple striations E) Buffalo Hump
A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia? A) Strong, bounding pulse B) Decreased bowel sounds C) Tingling and numbness of the hands and feet D) Diminished deep- tendon reflexes
C) Tingling and numbness of the hands and feet Hypocalcemia causes paresthesia, which usually starts in the hands and feet
A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings? A) Cold intolerance B) Lethargy C) Tremors D) Sunken eyes
C) Tremors Findings of hyperthyroidism include tremors, diaphoresis, and insomnia.
A nurse is assessing a client who is taking propylthiouracil. The nurse should identify which of the following findings as an indication that the medication has been effective? A) Increased ability to sweat B) Increased bowel movements C) Increased body weight D) Increased libido
C) increased body weight Propylthiouracil suppressed the production of thyroid hormones and allows for weight gain. However, excessive weight gain could indicate that the dose of propylthiouracil is too high.
A nurse is teaching a client about the adrenocorticotropic hormone (ACTH) stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders? A) Diabetes Insipidus B) Hyperthyroidism C) Pheochromocytoma D) Addison's disease
D) Addison's disease The nurse should instruct the client that the ACTH simulation test is the standard test for Addison's disease. IT measures the cortisol response to ACTH. The response is absent or very decreased in clients who have primary adrenal insufficiency.
A nurse is teaching a client who has DM. Which of the following should the nurse include as an expected finding of DKA? A) Decreased urine output B) Weight gain of 1lb in 24 hours C) Rapid, shallow respirations D) Blood glucose above 300
D) Blood glucose above 300 Blood glucose above 300 are an expected finding of DKA. Levels above 600 are an expected finding of a client who is in a hyperglycemic-hyperosmolar state
nurse is reviewing the laboratory results of a client undergoing screening for primary Cushing's disease. The nurse should expect an elevation in which of the following lab findings? A) Lymphocyte count B) potassium C) Calcium D) Glucose
D) Glucose Blood glucose is elevated in a client who has Cushing's disease
A home health nurse is assessing a client who requires lifelong hormone replacement therapy for the treatment of hypothyroidism. The client has not been taking the medication regularly. Which of the following findings should the nurse expect? A) Increased urine output B) persistent diarrhea C) tachycardia D) Hypotension
D) Hypotension Hypotension is an expected finding of hypothyroidism, along with bradypnea, dysrhythmias, and cold intolerance, cool, dry skin.
A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements by the client indicates an understanding of the teaching? A) I will let my feet air dry after washing B) I will wear sandals to allow air to circulate around my feet C) I will buy over the counter medication to treat the calluses on my feet D) I will apply lotion to the dry areas of my feet but not between my toes
D) I will apply lotion to the dry areas of my feet but not between my toes Lotion can be used for dry areas of the feet, but the client should avoid applying lotion between the toes, as this area is prone to bacterial growth.
A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires intranasal desmopressin. Which of the following information should the nurse include? A) Drink at least 3 liters of fluid per day B) Weight yourself weekly while wearing similar clothing at the same time of day C) Notify the provider of a weight loss of 1 pound or more per week D) Report nocturia because it requires a dosage adjustment.
D) Report nocturia because it requires a dosage adjustment. The client should take the initial dose of desmopressin in the evening. The provider will increase the dosage until the client no longer has nocturia.
A nurse is teaching a client who is scheduled for a vanillylmandelic acid test to screen for pheochromocytoma. Which of the following statements should the nurse include in the teaching? A) Start fasting at midnight prior to the day of the test B) Begin the 24 hour urine collection with the first morning urination C) take low dose aspirin for pain during the testing period D) Restrict coffee intake 2-3 days prior to the test.
D) Restrict coffee intake 2-3 days prior to the test. The client should avoid coffee and tea, even if they are decaffeinated, bananas, chocolate, and vanilla for 2-3 days prior to test
A nurse is caring for a client who has type 2 DM and is experiencing hyperglycemic-hyperosmolar state (HHS). which of the following lab findings should the nurse expect? A) pH 7.32 B) Blood sugar 250 C) Blood sugar 425 D) pH 7.45
D) pH 7.45 A client who is experiencing HHS produces enough insulin to prevent ketosis but not enough to prevent hyperglycemia. Therefore, the serum pH is within the expected reference range. Glucose levels will be above 600mg/dl
