Endocrine quiz

A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? A Infusing I.V. fluids rapidly as ordered B Encouraging increased oral intake C Restricting fluids D Administering glucose-containing I.V. fluids as ordered

C To reduce water retention in a client with the SIADH, the nurse should restrict fluids.

Jemma, 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? A. Acromegaly B Type 1 diabetes mellitus C Hypothyroidism D Deficient growth hormone

A Acromegaly, which is caused by a pituitary tumor that releases excessive growth hormone, is associated with hyperglycemia, hypertension, diaphoresis, peripheral neuropathy, and joint pain. Enlarged hands and feet are related to lateral bone growth, which is seen in adults with this disorder. The accompanying soft tissue swelling causes hoarseness and often sleep apnea.

Nurse Troy is aware that the most appropriate concern for a client with Addison's disease? A Risk for infection B Excessive fluid volume C Urinary retention D Hypothermia

A Addison's disease decreases the production of all adrenal hormones, compromising the body's normal stress response and increasing the risk of infection. Other appropriate nursing diagnoses for a client with Addison's disease include Deficient fluid volume and Hyperthermia. Urinary retention isn't appropriate because Addison's disease causes polyuria.

A female client with Cushing's syndrome is admitted to the medical-surgical unit. During the admission assessment, nurse Tyzz notes that the client is agitated and irritable, has poor memory, reports loss of appetite, and appears disheveled. These findings are consistent with which problem? A Depression B Neuropathy C Hypoglycemia D Hyperthyroidism

A Agitation, irritability, poor memory, loss of appetite, and neglect of one's appearance may signal depression, which is common in clients with Cushing's syndrome. Neuropathy affects clients with diabetes mellitus — not Cushing's syndrome. Although hypoglycemia can cause irritability, it also produces increased appetite, rather than loss of appetite. Hyperthyroidism typically causes such signs as goiter, nervousness, heat intolerance, and weight loss despite increased appetite.

Which outcome indicates that treatment of a male client with diabetes insipidus has been effective? A Fluid intake is less than 2,500 ml/day. B Urine output measures more than 200 ml/hour. C Blood pressure is 90/50 mm Hg. D The heart rate is 126 beats/minute

A Diabetes insipidus is characterized by polyuria (up to 8 L/day), constant thirst, and an unusually high oral intake of fluids. Treatment with the appropriate drug should decrease both oral fluid intake and urine output

A male 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 of the following glands? A Adrenal cortex B Pancreas C Adrenal medulla D Parathyroid

A Excessive secretion of aldosterone in the adrenal cortex is responsible for the client's hypertension. This hormone acts on the renal tubule, where it promotes reabsorption of sodium and excretion of potassium and hydrogen ions. The pancreas mainly secretes hormones involved in fuel metabolism. The adrenal medulla secretes the catecholamines — epinephrine and norepinephrine. The parathyroids secrete parathyroid hormone.

In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse Lyzette would expect a decline in: A Serum glucose level. B Hair loss. C Bone mineralization. D Menstrual flow.

A Hyperglycemia, which develops from glucocorticoid excess, is a manifestation of Cushing's syndrome. With successful treatment of the disorder, serum glucose levels decline. Hirsutism is common in Cushing's syndrome; therefore, with successful treatment, abnormal hair growth also declines. Osteoporosis occurs in Cushing's syndrome; therefore, with successful treatment, bone mineralization increases. Amenorrhea develops in Cushing's syndrome. With successful treatment, the client experiences a return of menstrual flow, not a decline in it.

A male client has just been diagnosed with type 1 diabetes mellitus. When teaching the client and family how diet and exercise affect insulin requirements, Nurse Joy should include which guideline? A "You'll need more insulin when you exercise or increase your food intake." B "You'll need less insulin when you exercise or reduce your food intake." C "You'll need less insulin when you increase your food intake." D "You'll need more insulin when you exercise or decrease your food intake."

B Exercise, reduced food intake, hypothyroidism, and certain medications decrease the insulin requirements. Growth, pregnancy, greater food intake, stress, surgery, infection, illness, increased insulin antibodies, and certain medications increase the insulin requirements.

An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of: A Thyroid storm. B Cretinism. C Myxedema coma. D Hashimoto's thyroiditis

C Severe hypothyroidism may result in myxedema coma, in which a drastic drop in the metabolic rate causes decreased vital signs, hypoventilation (possibly leading to respiratory acidosis), and nonpitting edema

Which nursing diagnosis takes highest priority for a female client with hyperthyroidism? A Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess B Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing C Body image disturbance related to weight gain and edema D Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

D In the client with hyperthyroidism, excessive thyroid hormone production leads to hypermetabolism and increased nutrient metabolism. These conditions may result in a negative nitrogen balance, increased protein synthesis and breakdown, decreased glucose tolerance, and fat mobilization and depletion. This puts the client at risk for marked nutrient and calorie deficiency, making Imbalanced nutrition: Less than body requirements the most important nursing diagnosis. Options B and C may be appropriate for a client with hypothyroidism, which slows the metabolic rate.

When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, nurse April is most likely to detect: A a blood pressure of 130/70 mm Hg. B a blood glucose level of 130 mg/dl. C bradycardia. D a blood pressure of 176/88 mm Hg

D Pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, causes hypertension, tachycardia, hyperglycemia, hypermetabolism, and weight loss

stimulates T3 and T4 production

TSH

Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus? A antidiuretic hormone (ADH). B thyroid-stimulating hormone (TSH). C follicle-stimulating hormone (FSH). D luteinizing hormone (LH)

A

stimulates the adrenal cortex

ACTH

stimulates the kidney tubules to reabsorb water from urine

ADH

Nurse Oliver should expect a client with hypothyroidism to report which health concerns? A Increased appetite and weight loss B Puffiness of the face and hands C Nervousness and tremors D Thyroid gland swelling

B

Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications? A Tetanic contractions B Neck vein distention C Weight loss D Polyuria

B SIADH secretion causes antidiuretic hormone overproduction, which leads to fluid retention. Severe SIADH can cause such complications as vascular fluid overload, signaled by neck vein distention. This syndrome isn't associated with tetanic contractions. It may cause weight gain and fluid retention (secondary to oliguria).

Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find: A Hypotension. B Thick, coarse skin. C Deposits of adipose tissue in the trunk and dorsocervical area. D Weight gain in arms and legs

C Because of changes in fat distribution, adipose tissue accumulates in the trunk, face (moonface), and dorsocervical areas (buffalo hump).

When instructing the female client diagnosed with hyperparathyroidism about diet, nurse Gina should stress the importance of which of the following? A Restricting fluids B Restricting sodium C Forcing fluids D Restricting potassium

C The client should be encouraged to force fluids to prevent renal calculi formation. Sodium should be encouraged to replace losses in urine. Restricting potassium isn't necessary in hyperparathyroidism.

The nurse is aware that the following is the most common cause of hyperaldosteronism? A Excessive sodium intake B A pituitary adenoma C Deficient potassium intake D Adrenal adenoma

D

stimulates development of the follicle in the ovaries

FSH

mobilizes fats, spares glucose, and promotes the protein synthesis necessary for growth

GH

A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, nurse Richard would suspect which of the following disorders?

hyperparathyroidism

decrease in blood Ca2+ levels

parathyroid hormone