Endocrine System
A nurse prepares to administer metformin (Glucophage XR) to an older adult who has asked that it be crushed because it is difficult to swallow. The nurse explains that this drug cannot be crushed because it: 1.Is released slowly. 2.Is difficult to crush. 3.Irritates mucosal tissue. 4.Has an unpleasant taste if crushed
1.Is released slowly.
A client is receiving total parenteral nutrition. The nurse assesses for which client response that indicates hyperglycemia? 1.Polyuria 2.Paralytic ileus 3.Respiratory rate below 16 4.Serum glucose of 105 mg/100 mL
1.Polyuria
A client with type 1 diabetes has an above-the-knee amputation because of severe lower extremity arterial disease. What is the nurse's primary responsibility two days after surgery when preparing the client to eat dinner? 1.Checking the client's serum glucose level 2.Assisting the client out of bed into a chair 3.Placing the client in the high-Fowler position 4.Ensuring the client's residual limb is elevated
1.Checking the client's serum glucose level
A client is admitted to the hospital with diabetic ketoacidosis. The nurse concludes that the client's elevated ketone level is caused by incomplete oxidation of which nutrient? 1.Fats 2.Protein 3.Potassium 4.Carbohydrates
1.Fats
A client is admitted to the hospital with diabetic ketoacidosis. The nurse identifies that the elevated ketone level present with this disorder is caused by the incomplete oxidation of: 1.Fats 2.Protein 3.Potassium 4.Carbohydrates
1.Fats
A client with history of multiple chronic illnesses comes to the emergency department (ED) complaining of a small progressive weight loss over the last month and feeling lethargic and thirsty all the time. The client's fasting blood glucose is 180 mg/dL and vital signs are blood pressure (BP) 118/78 mm Hg, oral temperature 99.6º F, pulse 72 beats per minute and regular, and respirations 22 breaths per minute and irregular. The nurse reviews the assessment findings and the client's medical record. What condition does the nurse conclude the client is experiencing? 1.Hypervolemia 2.Hyperglycemia 3.Infectious process 4.Respiratory distress
2.Hyperglycemia
A nurse plans to set up emergency equipment at the bedside of a client in the immediate postoperative period after a thyroidectomy. What should the nurse include in the bedside setup? 1.Crash cart with bed board 2.Tracheostomy set and oxygen 3.Ampule of sodium bicarbonate 4.Airway and nonrebreather mask
2.Tracheostomy set and oxygen
Four hours after surgery the blood glucose level of a client who has type 1 diabetes is elevated. The nurse can expect to: 1.Administer an oral hypoglycemic 2.Institute urine glucose monitoring 3.Give supplemental doses of regular insulin 4.Decrease the rate of the intravenous infusion
3.Give supplemental doses of regular insulin
A client with type 2 diabetes, who is taking an oral hypoglycemic agent, is to have a serum glucose test early in the morning. The client asks the nurse, "What do I have to do to prepare for this test?" Which statement by the nurse reflects accurate information? 1."Eat your usual breakfast." 2."Have clear liquids for breakfast." 3."Take your medication before the test." 4."Do not ingest anything before the test."
4."Do not ingest anything before the test."
Which statement made by a 28-year-old client recently diagnosed with type 1 diabetes indicates that further education is necessary regarding the teaching plan? 1."I will need to have my eyes and vision examined once a year." 2."I will need to check my blood sugar at home to evaluate my response to my treatment plan." 3."I can improve metabolic and cardiac risk factors of this disease if I follow a low-calorie diet and lose weight." 4."Once I reach my target weight there is a good chance that I will be able to switch from insulin to an oral medication to control my blood sugar."
4."Once I reach my target weight there is a good chance that I will be able to switch from insulin to an oral medication to control my blood sugar."
A female client receiving cortisone therapy for adrenal insufficiency expresses concern about why she is developing facial hair. How should the nurse respond? 1."It is just another sign of the illness." 2."Do not worry because it will disappear with therapy." 3."This is not important as long as you are feeling better," 4."The drug contains a hormone that causes male characteristics."
4."The drug contains a hormone that causes male characteristics."
A client who was diagnosed recently with type 1 diabetes states, "I feel bad. I don't think I even want to go home. My spouse doesn't care about my diabetes." What is the most appropriate nursing response? 1."What can I do to make you feel better?" 2."It seems that you don't get along with your spouse." 3."It's probably temporary. Your spouse needs more time to adjust." 4."You are unhappy. Have you tried to talk with your spouse?"
4."You are unhappy. Have you tried to talk with your spouse?"
At 4:30 PM, a client who is receiving human insulin (Humulin N) every morning states, "I feel very nervous." The nurse observes that the client's skin is moist and cool. What is the nurse's most accurate interpretation of what the client is likely experiencing? 1.Polydipsia 2.Ketoacidosis 3.Glycogenesis 4.Hypoglycemia
4.Hypoglycemia
The nurse provides education about signs and symptoms of hypoglycemia to a client with newly diagnosed type 1 diabetes. The nurse concludes that the teaching was effective when the client states, "I will drink orange juice and eat a slice of bread when I feel: 1.Nervous and weak." 2.Flushed and short of breath." 3.Thirsty and have a headache." 4.Nauseated and have abdominal cramps."
1.Nervous and weak."
After assessing a client, a nurse concludes that the client may be experiencing hyperglycemia. Which clinical findings commonly associated with hyperglycemia support the nurse's conclusion? (Select all that apply.) 1.Polyuria 2.Polydipsia 3.Polyphagia 4.Polyphrasia 5.Polydysplasia
1.Polyuria 2.Polydipsia 3.Polyphagia
Levothyroxine (Synthroid) 12.5 mcg orally each day is prescribed for a client with hypothyroidism. Six weeks later, the health care provider increases the client's dose to 25 mcg daily and gives the client a prescription to be filled at the pharmacy. The client asks the nurse whether the original pill prescription can be completed before starting the new dose. How many of the original pills should the nurse instruct the client to take daily? Record your answer using a whole number. __________ tablets
2 tablets
A nurse is caring for a client with a diagnosis of type 1 diabetes who has developed diabetic coma. Which element excessively accumulates in the blood to precipitate the signs and symptoms associated with this condition? 1.Sodium bicarbonate, causing alkalosis 2.Ketones as a result of rapid fat breakdown, causing acidosis 3.Nitrogen from protein catabolism, causing ammonia intoxication 4.Glucose from rapid carbohydrate metabolism, causing drowsiness
2.Ketones as a result of rapid fat breakdown, causing acidosis
A client with hyperthyroidism asks the nurse about the tests that will be prescribed. Which diagnostic tests should the nurse include in a discussion with this client? 1.Thyroxine (T4) and x-ray films 2.Thyroid stimulating hormone (TSH) assay and triiodothyronine (T3) 3.Thyroglobulin level and PO2 4.Protein-bound iodine and sequential multichannel autoanalyzer (SMA)
2.Thyroid stimulating hormone (TSH) assay and triiodothyronine (T3)
A nurse is caring for a newly admitted client with a diagnosis of Cushing syndrome. Why should the nurse monitor this client for clinical indicators of diabetes mellitus? 1.Cortical hormones stimulate rapid weight loss. 2.Tissue catabolism results in a negative nitrogen balance. 3.Glucocorticoids accelerate the process of gluco-neogenesis. 4.Excessive adrenocorticotropic hormone (ACTH) secretion damages pancreatic tissue
3.Glucocorticoids accelerate the process of gluco-neogenesis.
A client has a tentative diagnosis of Cushing syndrome. The nurse's physical assessment of this client is likely to reveal the presence of: 1.Fever and tachycardia 2.Lethargy and constipation 3.Hypertension and moon face 4.Hyperactivity and exophthalmos
3.Hypertension and moon face
A client with diabetes is being taught to self-administer a subcutaneous injection of insulin. Identify the preferred site for the self-administration of this drug. 1.upper arm 2.buttocks 3.abdomen 4.thigh
3.abdomen
Metformin (Glucophage) 2 g by mouth is prescribed for a client with type 2 diabetes. Each tablet contains 500 mg. How many tablets should the nurse administer? Record your answer using a whole number. _____ tablets
4 tablets
A client with type 1 diabetes receives 30 units of Humulin N insulin at 7 am. At 3:30 pm the client becomes diaphoretic, weak, and pale. The nurse determines that these physiological responses are associated with: 1.Diabetic coma 2.Somogyi effect 3.Diabetic ketoacidosis 4.Hypoglycemic reaction
4.Hypoglycemic reaction
A nurse administers a tube of glucose gel to a client who is hypoglycemic. What should the nurse consider about this reversal of hypoglycemia? 1.It liberates glucose from hepatic stores of glycogen. 2.Insulin action is blocked as it competes for tissue sites. 3.Glycogen is supplied to the brain as well as other vital organs. 4.It provides a glucose substitute for rapid replacement of deficits
4.It provides a glucose substitute for rapid replacement of deficits
A client is admitted to the hospital for a thyroidectomy. In which position should the nurse maintain the client after this surgery? 1.Prone 2.Supine 3.Left Sims 4.Semi-Fowler
4.Semi-Fowler
A nurse in the post-anesthesia care unit is caring for a client who just had a thyroidectomy. For which client response is it most important for the nurse to monitor? 1.Urinary retention 2.Signs of restlessness 3.Decreased blood pressure 4.Signs of respiratory obstruction
4.Signs of respiratory obstruction
A nurse is monitoring a client's laboratory results for a fasting plasma glucose level. Within which range of a fasting plasma glucose level does the nurse conclude that a client is considered to be diabetic? 1.40 and 60 mg/dL 2.80 and 99 mg/dL 3.100 and 125 mg/dL 4.126 and 140 mg/dL
4.126 and 140 mg/dL
A client, visiting the health center, reports feeling nervous, irritable, and extremely tired. The client says to the nurse, "Although I eat a lot of food, I have frequent bouts of diarrhea and am losing weight." The nurse observes a fine hand tremor, an exaggerated reaction to external stimuli, and a wide-eyed expression. What laboratory tests may be prescribed to determine the cause of these signs and symptoms? 1.Partial thromboplastin time (PTT) and prothrombin time (PT) 2.T3, T4, and thyroid-stimulating hormone (TSH) 3.Venereal disease research laboratory (VDRL) test and complete blood count (CBC) 4.Adrenocorticotropic hormone (ACTH), antidiuretic hormone ADH, and corticotropin-releasing factor (CRF)
2.T3, T4, and thyroid-stimulating hormone (TSH)
A nurse is caring for a client newly diagnosed with type 1 diabetes. When the health care provider tries to regulate this client's insulin regimen, the client experiences episodes of hypoglycemia and hyperglycemia, and 15 g of a simple sugar is prescribed. What is the reason this is administered when a client experiences hypoglycemia? 1.Inhibits glycogenesis 2.Stimulates release of insulin 3.Increases blood glucose levels 4.Provides more storage of glucose
3.Increases blood glucose levels
A male client who is receiving prolonged steroid therapy complains of always being thirsty and urinating frequently. What is the nurse's best initial action? 1.Have the client assessed for an enlarged prostate. 2.Obtain a urine specimen from the client to test for ketonuria. 3.Perform a finger stick to test the client's blood glucose level. 4.Assess the client's lower extremities for the presence of pitting edema
3.Perform a finger stick to test the client's blood glucose level.
