Endocrine PrepU
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?" "Do you experience skin breakouts?" "Have you had a recent head injury?" "Is there any family history of acromegaly?"
"Have you increased your shoe size recently?"
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? Somatotropin Adrenocorticotropic hormone Oxytocin Prolactin
oxytocin
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: excessive thirst. profound neuromuscular irritability. severe hypotension. acute gastritis.
profound neuromuscular irritability.
Trousseau sign is elicited
by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.
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? 100 to 300 pg/mL 100 pg/mL 450 pg/mL 50 pg/mL
450 pg/mL
The following clients are scheduled for thyroid testing. Which client would be at greatest risk for inaccurate results? A client who received corticosteroids 4 months ago A client who was given salicylates last month A client who avoids kelp A client diagnosed with low blood sugar
A client who was given salicylates last month
A patient is ordered desmopressin (DDAVP) for the treatment of diabetes insipidus. What therapeutic response does the nurse anticipate the patient will experience? A decrease in blood glucose levels A decrease in blood pressure A decrease in appetite A decrease in urine output
A decrease in urine output
A client with acromegaly is complaining of severe headaches. What does the nurse suspect is the cause of the headaches that is related to the acromegaly? A pituitary tumor An increase in cerebral edema A decrease in release in the growth hormone A decrease in the glucose level
A pituitary tumor
Which of the following is a clinical manifestation of hypothyroidism? An elevated systolic blood pressure. Exophthalmos A pulse rate below 60 beats/minute. Systolic murmurs
A pulse rate below 60
The nurse is reviewing a client's laboratory studies and determines that the client has an elevated calcium level. What does the nurse know will occur as a result of the rise in the serum calcium level? A rise in serum calcium stimulates the release of T lymphocytes. A rise in serum calcium stimulates the release of calcitonin from the thyroid gland. A rise in serum calcium inhibits the release of calcitonin. A rise in serum calcium stimulates the release of erythropoietin.
A rise in serum calcium stimulates the release of calcitonin from the thyroid gland.
A female client with hyperglycemia who weighs 210 lb (95 kg) tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that the client has large hands and a hoarse voice. Which disorder would the nurse suspect as a possible cause of the client's hyperglycemia? Deficient growth hormone Acromegaly Hypothyroidism Type 1 diabetes mellitus
Acromegaly
A nurse understands that for the parathyroid hormone to exert its effect, what must be present? Functioning thyroid gland Decreased phosphate level Increased calcium level Adequate vitamin D level
Adequate vitamin D level
The nurse is reviewing the laboratory and diagnostic test findings of a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following would the nurse expect to find? Elevated serum sodium levels Decreased serum osmolarity Decreased urine sodium levels Elevated urine calcium levels
Decreased serum osmolarity
Which of the following medications is used in the treatment of diabetes insipidus to control fluid balance?Desmopressin (DDAVP) Thiazide diuretics Ibuprofen Diabinese
Desmopressin (DDAVP)
A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which gland? Adrenal medulla Parathyroid Adrenal cortex Pancreas
Adrenal cortex
Which assessment would a nurse perform on a client with Cushing's syndrome who is at high risk of developing a peptic ulcer? Monitor bowel patterns. Observe stool color. Monitor vital signs every 4 hours. Observe urine output.
Observe stool color.
The nurse knows to assess a patient with hyperthyroidism for the primary indicator of: A. Fatigue B. Intolerance to heat C. Constipation D. Weight gain
B. Intolerance to heat
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 Complaints of nausea Heart rate of 56-64 bpm Shivering
Blood pressure varying between 120/86 and 240/130 mm Hg
When high levels of plasma calcium occur, the nurse is aware that the following hormone will be secreted: Thyroxine Calcitonin Phosphorus Parathyroid
Calcitonin
Trousseau's sign is elicited by which of the following? After making a clenched fist, the palm remains blanched when pressure is placed over the radial artery. The patient complains of pain in the calf when his foot is dorsiflexed. A sharp tapping over the facial nerve just in front of the parotid gland and anterior to the ear causes spasm or twitching of the mouth, nose, and eye. Carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.
Carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.
Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex? Hashimoto disease Addison disease Graves disease Cushing syndrome
Cushing syndrome
During physical examination of a client with a suspected endocrine disorder, the nurse assesses the body structures. The nurse gathers this data based on the understanding that it is an important aid in which of the following? Determining the presence or absence of testosterone levels. Detecting evidence of hormone hypersecretion. Detecting information about possible tumor growth. Determining the size of the organs and location.
Detecting evidence of hormone hypersecretion.
A client sustained a head injury when falling off of a ladder. While in the hospital, the client begins voiding large amounts of clear urine and states he is very thirsty. The client states that he feels weak, and he has had an 8-lb weight loss since admission. What should the client be tested for? Diabetes insipidus (DI) Syndrome of inappropriate antidiuretic hormone secretion (SIADH) Pituitary tumor Hypothyroidism
Diabetes insipidus (DI)
The nurse obtains a complete family history of a client with a suspected endocrine disorder based on which rationale? Endocrine disorders can be inherited. An allergy to iodine is inherited. It helps determine the client's general status. Diet and drug histories are related to the family history.
Endocrine disorders can be inherited.
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? Bulging eyes Retinal detachment Periorbital swelling Exophthalmos
Exophthalmos
Which of the following would the nurse expect to find in a client with severe hyperthyroidism? Buffalo hump Tetany Exophthalmos Striae
Exophthalmos
A health care provider suspects that a thyroid nodule may be malignant. The nurse knows to prepare information for the patient based on the usual test that will be ordered to establish a diagnosis. What is that test? Serum immunoassay for TSH Free T4 analysis Ultrasound of the thyroid gland Fine-needle biopsy of the thyroid gland
Fine-needle biopsy of the thyroid gland
Which outcome indicates that treatment of a client with diabetes insipidus has been effective? Heart rate is 126 beats/minute. Fluid intake is less than 2,500 ml/day. Blood pressure is 90/50 mm Hg. Urine output measures more than 200 ml/hour.
Fluid intake is less than 2,500 ml/day.
The nurse is caring for a client with diabetes who developed hypoglycemia. What can the nurse administer to the client to raise the blood sugar level? Cortisone Estrogen Glucagon Insulin
Glucagon
A woman with a progressively enlarging neck comes into the clinic. She mentions that she has been in a foreign country for the previous 3 months and that she didn't eat much while she was there because she didn't like the food. She also mentions that she becomes dizzy when lifting her arms to do normal household chores or when dressing. What endocrine condition should the nurse expect the health care provider to diagnose? Goiter Diabetes mellitus Diabetes insipidus Cushing's syndrome
Goiter
Which feature(s) indicates a carpopedal spasm in a client with hypoparathyroidism? Moon face and buffalo hump Bulging forehead Hand flexing inward Cardiac dysrhythmia
Hand flexing inward
Which of the following precautions would be most appropriate when caring for a client being treated with radioactive iodine (RAI) for a thyroid tumor? Administer prescribed corticosteroids carefully. Administer the prescribed medications at the same time each day. Handle body fluids carefully. Monitor the respiratory status.
Handle body fluids carefully.
Which instruction should be included in the discharge teaching plan for a client after thyroidectomy for Graves' disease? Have regular follow-up care. Exercise to improve cardiovascular fitness. Use nasal desmopressin acetate (DDAVP). Keep an accurate record of intake and output.
Have regular follow-up care.
On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance most commonly follows thyroid surgery? Hyponatremia Hypocalcemia Hyperkalemia Hypermagnesemia
Hypocalcemia
The typical triad of manifestations seen in a client diagnosed with pheochromocytoma does not include which of the following? Diaphoresis Hypotension Palpitations Headache
Hypotension
A client with a 20-year history of hypothyroidism who has not been compliant with taking thyroid replacement therapy is brought into the ED with a diagnosis of myxedema coma. What client symptoms are consistent with this life-threatening event? Select all that apply.
Hypothermia Hypoventilation Hypotension
When reviewing laboratory results for a patient with a possible diagnosis of hypoparathyroidism, the nurse knows that this condition is characterized by which of the following? Inadequate secretion of parathormone Increase in serum calcium Increase in the renal excretion of phosphate Lowered blood phosphate
Inadequate secretion of parathormone
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? Thyrotropin Iodine Calcitonin Thyroxine
Iodine
The preferred preparation for treating hypothyroidism includes which of the following? Radioactive iodine Methimazole (Tapazole) Propylthiouracil (PTU) Levothyroxine (Synthroid)
Levothyroxine (Synthroid)
The nurse is teaching a client about the dietary restrictions related to his diagnosis of hyperparathyroidism. What foods should the nurse encourage the client to avoid? Chicken livers Milk Hamburger Bananas
Milk
A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate? Syndrome of inappropriate antidiuretic hormone (SIADH) Thyroid storm Myxedema coma Diabetes insipidus
Myxedema coma
Which of the following would the nurse need to be alert for in a client with severe hypothyroidism? Thyroid storm Addison's disease Myxedemic coma Acromegaly
Myxedemic coma
The nurse assesses a patient who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease? Sodium of 140 mEq/L A blood pressure reading of 135/90 mm Hg Potassium of 6.0 mEq/L Glucose of 100 mg/dL
Potassium of 6.0 mEq/L
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? Corneal abrasions Pressure on the optic nerve Retinal detachment Glaucoma
Pressure on the optic nerve
The nurse is reviewing the history and physical examination of a client diagnosed with hyperthyroidism. Which of the following would the nurse expect to find? Complaints of sleepiness Thick hard nails Inability to tolerate cold Reports of increased appetite
Reports of increased appetite
A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? Encouraging increased oral intake Administering glucose-containing I.V. fluids as ordered Infusing IV fluids rapidly as ordered Restricting fluids
Restricting fluids
Patients with hyperthyroidism are characteristically: Emotionally stable Calm Sensitive to heat Apathetic and anorexic
Sensitive to heat
A postpartum client is receiving intravenous oxytocin (Pitocin) after birth. Why will this medication be used for this client after the birth of her child? Helps treat nausea Stimulates the contraction of the uterus and prevents bleeding Will prevent lactation for a woman who is bottle feeding her newborn Decreases the postpartum cramping
Stimulates the contraction of the uterus and prevents bleeding
Parathyroid hormone (PTH) has which effects on the kidney? Stimulation of phosphate reabsorption and calcium excretion Increased absorption of vitamin D and excretion of vitamin E Stimulation of calcium reabsorption and phosphate excretion Increased absorption of vitamin E and excretion of vitamin D
Stimulation of calcium reabsorption and phosphate excretion
The nurse on the telemetry floor is caring for a patient with long-standing hypothyroidism who has been taking synthetic thyroid hormone replacement sporadically. What is a priority that the nurse monitors for in this patient? Dietary intake of foods with saturated fats Symptoms of acute coronary syndrome Heat intolerance Symptoms of pneumonia
Symptoms of acute coronary syndrome
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 feel better if she consistently takes the thyroid replacement medication. Tell the client she'll soon experience improvement in her looks as the medication corrects her hormone deficiency. Tell the client that she looks fine and offer to help her with makeup. Tell the client she needs to learn to accept herself as she is and be compliant during treatment.
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? Blood pressure 90/58 mm Hg Heart rate of 62 Oxygen saturation of 96% Temperature of 102ºF
Temperature of 102ºF
Which hormones are secreted by the posterior lobe of the pituitary gland? Select all that apply. Oxytocin Luteinizing hormone (LH) Vasopressin Follicle-stimulating hormone (FSH) Thyroid-stimulating hormone (TSH)
Vasopressin Oxytocin
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? Apply medicines to remove the scar Consider cosmetic surgery Undergo a skin graft Wear clothing that covers the neck
Wear clothing that covers the neck
A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect? Weight gain, constipation, and lethargy Exophthalmos, diarrhea, and cold intolerance Diaphoresis, fever, and decreased sweating Weight loss, nervousness, and tachycardia
Weight loss, nervousness, and tachycardia
A 35-year-old female client who complains of weight gain, facial hair, absent menstruation, frequent bruising, and acne is diagnosed with Cushing's syndrome. Cushing's syndrome is most likely caused by: an inborn error of metabolism. an ectopic corticotropin-secreting tumor. a corticotropin-secreting pituitary adenoma. adrenal carcinoma.
a corticotropin-secreting pituitary adenoma.
A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for: exophthalmos and conjunctival redness. flushed, warm, moist skin. systolic murmur at the left sternal border. decreased body temperature and cold intolerance.
decreased body temperature and cold intolerance.
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:
grave's disease
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. Hyperventilation Hypotension Hypoventilation Hypertension Hypothermia
hypothermia hypotension hypoventilation
Before undergoing a subtotal thyroidectomy, a client receives potassium iodide (Lugol's solution) and propylthiouracil (PTU). The nurse should expect the client's symptoms to subside: immediately. in 3 to 4 months. in 1 to 2 weeks. in a few days.
in 1 to 2 weeks.
Although not designated as endocrine glands, several organs within the body secrete hormones as part of their normal function. Which organ secretes hormones involved in increasing blood pressure and volume and maturation of red blood cells? cardiac atria kidneys brain liver
kidneys
A nurse is caring for a client with diabetes insipidus. The nurse should anticipate administering: vasopressin. potassium chloride. furosemide. insulin.
vasopressin.