Endocrine - PrepU

A client with hyperparathyroidism declines surgery and is to receive hormone replacement therapy with estrogen and progesterone. Which instruction would be most important to include in the client's teaching plan?

Maintain a moderate exercise program.

The nurse explains to a client with thyroid disease that the thyroid gland normally produces:

T3, T4, and calcitonin.

After reinforcing education to a client on how to correctly self-administer daily maintenance dose of 3 units of regular insulin and 4 units of NPH insulin, which client statement demonstrates that the education has been successful?

"After taking my insulin out of the refrigerator, I'll draw up the clear insulin first to the line for 3 units and then cloudy insulin until there's a total of 7 units in the syringe."

After reinforcing teaching for a client receiving glipizide about the medication, the nurse asks the client to discuss potential side effects of the medication. Which statements about glipizide, if reported by the client, indicates to the nurse that the client has a good understanding of what to expect when taking this medication? Select all that apply.

"My skin may have a reaction to sunlight." "I may have some skin reactions, such as rash and itchiness."

The nurse is reinforcing education about home care with the parents of a child diagnosed with type 1 diabetes. The nurse determines the education has been successful when the parent makes which of the following statements? Select all that apply.

"We can dispose of used lancets and insulin syringes in a puncture-proof container such as a bleach bottle." "I will be sure my child wears a Medic Alert bracelet." "My child should receive immunizations for influenza and pneumonia."

A client who is diagnosed with hyperthyroidism is admitted to the hospital. The nurse anticipates that the client's treatment is most likely to include which medication?

A thyroid hormone antagonist

A female client who weighs 210 lb (95 kg) and has been diagnosed with hyperglycemia tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client's hyperglycemia?

Acromegaly

A client's laboratory findings indicating a deficiency of cortical hormones would correlate with which disease?

Addison's disease

The nurse is developing a teaching plan for a client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?

Antidiuretic Hormone ADH

During preoperative teaching for a client who will undergo a subtotal thyroidectomy, the nurse should include which statement?

Avoid hyperextending your neck after surgery.

The nurse is collecting data on a client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine. During the physical assessment, the nurse is most likely to detect which vital sign or symptom?

Blood pressure of 176/88 mm Hg

The nurse is caring for a client with hypoparathyroidism. During data collection, the nurse taps the client's face 2 cm anterior to the earlobe. The nurse is attempting to elicit which of the following?

Chvostek's sign

A client with a history of gout is admitted to the medical-surgical unit. The nurse should expect to administer which medication to a client with gout?

Colchicine

A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms?

Coma, anxiety, confusion, headache, and cool, moist skin

A child has experienced symptoms of hypoglycemia and has eaten sugar cubes. The nurse expects to follow this rapid-releasing sugar with which food?

Complex carbohydrates and protein

The nurse is caring for a client with a history of hypothyroidism. Which clinical manifestations would indicate to the nurse the progression to myxedemic crisis? Select all that apply.

Hypothermia Hypoglycemia Hypotension Hypoventilation

The nurse and a client have just discussed the client's recent diagnosis of hypothyroidism and its causes and effects. Which statement indicates that the client needs further instruction?

I just eat too much. That's why I'm depressed and overweight.

A client has been diagnosed with hyperthyroidism. In assisting with the plan of care, the nurse should give priority to which goals? Select all that apply.

Increase the client's calorie intake. Provide adequate rest and sleep. Provide a cool environment.

A client with hyperparathyroidism develops renal calculi. The nurse should expect to see which electrolyte levels?

Increased calcium levels

For a client with hyperglycemia, which data collection finding best supports a nursing diagnosis of Deficient fluid volume?

Increased urine osmolarity

The nurse is caring for a client who developed ketoacidosis. Which prescribed treatment does the nurse anticipate administering?

Insulin and IV fluids

A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse would be most accurate in stating:

It tells us about your sugar control over the last 3 months.

A nurse is caring for a postoperative thyroidectomy client at risk for hypocalcemia. What intervention should the nurse implement in this client's care?

Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.

A client with type 1 diabetes takes 15 units of isophane insulin suspension before breakfast and 8 units before dinner. During a follow-up visit, the nurse reevaluates the client's knowledge about insulin therapy and self-administration skills and learns that the client is unaware that certain over-the-counter (OTC) preparations and other medications may interact with insulin. The nurse should advise the client to avoid which OTC preparations?

Preparations containing salicylates

A nonpregnant client tells the nurse that two recent, fasting blood glucose results were 132 mg/dL (7.3 mmol/L) and 146 mg/dL (8.1 mmol/L). The nurse should expect which actions to occur?

These results indicate diabetes; further follow-up is needed.

A client is admitted with Graves' disease. Which laboratory test should the nurse expect to be ordered?

Thyroid panel

A client has a serum calcium level of 7.2 mg/dl. During the physical examination, the nurse expects to assess:

Trousseau's sign.

A health care provider prescribes diet, exercise, and oral antidiabetic agents for a client with diabetes. Which type of diabetes will the nurse reinforce educating the client about?

Type 2 diabetes

The nurse is instructing a client with newly diagnosed hypoparathyroidism about the regimen used to treat this disorder. The nurse should state that the physician probably will prescribe daily supplements of calcium and:

Vitamin D

A child is diagnosed with diabetes insipidus. Which characteristics will the nurse recognize in the health history?

abrupt onset of polyuria, nocturia, and polydipsia

The nurse is explaining the action of insulin to a client newly diagnosed with diabetes mellitus. During the teaching, the nurse reviews the process of insulin secretion in the body. The nurse is correct when stating that insulin is secreted from the:

beta cells of the pancreas

The nurse is caring for a client with possible Cushing's syndrome undergoing diagnostic testing. The health care provider orders lab work and a dexamethasone suppression test. Which parameter is measured with the dexamethasone suppression test?

cortisol levels before and after the system is challenged with a synthetic steroid

After falling off a ladder and suffering a brain injury, a client develops syndrome of inappropriate antidiuretic hormone (SIADH). Which findings indicate to the nurse the effectiveness of the treatment the client is receiving? Select all that apply.

decrease in body weight increased urine output decreased urine osmolarity

A client with Cushing syndrome is admitted to the medical-surgical unit. When gathering data, the nurse notes that the client is agitated and irritable, has poor memory, reports loss of appetite, and is disheveled. The nurse recognizes that these signs and symptoms are associated with which condition?

depression

A client experiences polydipsia and voiding large amounts of waterlike urine with a specific gravity of 1.003. What do these clinical manifestations indicate to the nurse?

diabetes insipidus

The nurse is caring for a client with type I diabetes who does not adhere to an insulin regimen regularly. The nurse identifies that the client is at risk for which complication?

diabetic ketoacidosis

The nurse is caring for a client with hypothyroidism. Which client data would the nurse expect to collect?

fatigue, cold intolerance, weight gain, and constipation

The nurse is caring for a client suspected of experiencing hyperglycemia. Which symptoms would correlate with this suspicion?

polydipsia, polyuria, and polyphagia

A nurse is evaluating a client for signs of hypoxemia. Which diagnostic procedure would the nurse expect to perform first to monitor the client's respiratory status?

pulse oximetry

A client with diabetes is being taught about possible complications. The nurse should include which conditions in the discussion with the client?

retinopathy, neuropathy, and coronary artery disease

A client with diabetes insipidus has had limited fluid intake over the past 12 hours. For which complications should the nurse monitor the client?

severe dehydration and hypernatremia

A client was recently admitted with a diagnosis of diabetes. The nurse observes that the client has acetone breath, a weak and rapid pulse, and Kussmaul's respirations. The nurse recognizes that interventions should be provided for what condition?

Diabetic ketoacidosis

Observation of a client reveals thin extremities, but an obese truncal area and a "buffalo hump" at the shoulder area with reports of weakness and disturbed sleep. The nurse interprets this data as indicating which disorder?

Cushing syndrome

The nurse is planning care for a 52-year-old male client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority?

Decreased cardiac output

When plotting height and weight on a growth chart, which observation by the nurse would indicate that a 4-year-old child has a growth hormone deficiency?

Downward shift of 2% or more

The newly diagnosed diabetes mellitus client is to receive his first insulin dose. The nurse administers the insulin into his abdomen. How does absorption at the abdominal site compare to absorption at other sites?

Insulin is absorbed more rapidly at abdominal injection sites than at other sites.

A nurse is reviewing data in the progress notes entry of a client with adrenocortical insufficiency (Addison's disease). The client reports difficulties in the work environment and a recent upper respiratory infection. The nurse identifies the client as at risk for which condition?

adrenal crisis

After a client is admitted with an adrenal malfunction, the nurse demonstrates an understanding of the function of the adrenal gland by identifying which hormones as being released by the adrenal medulla?

epinephrine and norepinephrine

The nurse is reinforcing education with parents of a child with growth hormone deficiency. What sport should the nurse encourage?

gymnastics

The nurse is caring for a client with suspected parathyroid dysfunction. Which laboratory results support a diagnosis of primary hyperparathyroidism?

high parathyroid hormone and high calcium levels

The physician diagnoses type 1 diabetes in a client who has classic manifestations of the disease and a random blood glucose level of 350 mg/dl. In addition to dietary modifications, the physician prescribes insulin. Initially, most clients receive the least antigenic form of insulin. Therefore, the nurse expects the physician to prescribe:

human insulin

On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. 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?

hypocalcemia

A client presents to the emergency department with weight gain, lethargy, and goiter. When reviewing laboratory values, in which major mineral would the nurse anticipate this client to be deficient?

iodine

A nurse is preparing to administer regular insulin 4 units subcutaneously to a client with type 1 diabetes. Which equipment does the nurse need to perform the injection? Select all that apply.

medication administration record 27-gauge, 1/2-inch needle insulin syringe

A client with diabetes mellitus has just been prescribed insulin. When teaching the client about hypoglycemia, the nurse should mention that this reaction may cause:

nervousness, diaphoresis, and confusion.

The client with Addison's disease is admitted to a medical-surgical unit. The nurse educator is discussing with the student why this client at risk for development of hypoglycemia and asks the following question: "The decreased adrenal cortical function of which substances leads to decreased glucose availability?"

Glucocorticoids

A client tells the nurse that she has been working hard for the past 3 months to control her type 2 diabetes with diet and exercise. To determine the effectiveness of the client's efforts, the nurse is preparing to draw laboratory values. Which laboratory test should the nurse perform?

Glycosylated hemoglobin level

A middle-age female complains of anxiety, insomnia, weight loss, the inability to concentrate, and her eyes feeling "gritty." Thyroid function tests reveal the following: a thyroid-stimulating hormone (TSH) level of 0.02 units/ml, a thyroxine level of 20 g/dl, and a triiodothyronine level of 253 ng/dl. A 6-hour radioactive iodine uptake test showed a diffuse uptake of 85%. Based on these findings, the nurse would suspect:

Grave's disease

A client with hyperthyroidism develops high fever, extreme tachycardia, and altered mental status. Which condition does the nurse suspect is developing?

thyroid storm

A client is diagnosed with diabetes insipidus. The nurse assists with the development of a care plan based on the understanding that which hormone is deficient?

vasopressin

When reinforcing education with the parents about signs that indicate levothyroxine overdose, which comment by a parent indicates the need for further education?

I shouldn't worry if my baby doesn't sleep very much.

A client whose physical findings suggest a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal hypophysectomy. The evening before the surgery, the nurse reviews preoperative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize?

You must avoid coughing, sneezing and blowing your nose.

A client, age 23, is diagnosed with type 1 diabetes. The physician prescribes 15 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. The nurse checks the medication order, assembles the appropriate equipment, washes her hands, rotates the NPH insulin vial, puts on disposable gloves, and cleans the stoppers. To draw the two insulin doses into the single U-100 insulin syringe, which sequence should the nurse use?

Inject 35 units of air into the NPH vial; inject 15 units of air into the regular insulin vial and withdraw 15 units of regular insulin; and withdraw 35 units of NPH.