ENDOCRINE

A client with hyperthyroidism is taking potassium iodide (SSKI) prior to having a thyroidectomy. The nurse instructs the client to do which of the following? A Discontinue all other medications. B Take on an empty stomach. C Take with water. D Take with milk.

D Take with milk.

The nurse is caring for a client who is scheduled for an adrenalectomy. The nurse plans to administer which medication in the preoperative period to prevent Addison's crisis? a) prednisone (deltasone)orally b) fludrocortisone (Florinef) subcutaneously c) spironolactone (Aldactone) intramuscularly d) methiprednisolone sodium succinate (Solu-Medrol) intravenously

D

A client with Addison disease is hospitalized for an acute crisis. During the crisis, which of the following nursing diagnoses is a priority? A Deficit fluid volume. B Activity intolerance. C Anxiety. D Risk for injury.

A Deficit fluid volume.

When teaching a patient diagnosed with hypothyroidism regarding medical intervention, which of the following is important to communicate? Choose one of the following A TH may decrease blood glucose levels. B TH may increase the effect of digitalis preparation. C The normal dosages of sedative agents are prescribed. D Increased resorption occurs with TH

B TH may increase the effect of digitalis preparation

You assess a patient with Cushing's disease. For which finding will you notify the physician immediately?

Crackles bilaterally in lower lobes of lungs

BEFORE UNDERGOING A SUBTOTAL THYROIDECTOMY, A CLIENT RECEIVES POTASSIUM IODIDE(LUGOL'S SOLUTION) & PROPYLTHIOURACIL(PTU). THE NURSE WOULD EXPECT THE CLIENT'S SYMPTOMS TO SUBSIDE WHEN?

1-2 WEEKS (REACHES MAX EFFECT)

A client with Grave's disease has exopthalmos and is experiencing photophobia. Which of the following nursing interventions would best assist the client with this problem? a) obtain dark glasses for the client b) lubricate the eyes with tap water every 2 to 4 hours c) administer methimazole (Tapazole) every 8 hours around the clock d) instruct the client to avoid straining or heavy lifting because this can increase eye pressure

A

The nurse is admitting a client with a diagnosis of myxedema to the hospital. The nurse performs which of the following that will provide data related to this diagnosis? a) inspects facial features b) auscultates lung sounds c) percusses the thyroid gland d) palpates the adrenal glands

A

Which of the following disorders is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex? Choose one of the following A Cushing's syndrome B Addison's disease C Graves' disease D Hashimoto's disease

A Cushing's syndrome

Which statement by the patient demonstrates an understanding of discharge instructions on the use of levothyroxine (Synthroid)? A."I will take this medication in the morning so as not to interfere with sleep." B."I will double my dose if I gain more than 1 pound per day." C."I will stop the medication immediately if I lose more than 2 pounds in a week." D."I can expect to see relief of my symptoms within 1 week."

A."I will take this medication in the morning so as not to interfere with sleep."

When assessing for potential toxicity to PTU, the nurse will monitor the patient for changes in which laboratory test? A.CBC B.BNP C.Serum electrolytes D.Renal function tests

A.CBC

BEFORE DISCHARGE WHAT SHOULD A CLIENT WITH ADDISION'S DISEASE BE INSTRUCTED TO DO WHEN EXPOSED TO PERIODS OF STRESS?

ADMIN. HYDROCORTISONE I.M.

A client with a diagnosis of Cushing's syndrome is undergoing a dexamethasone suppression test. The nurse plans to implement which steps during this test? a ) collect a 24-hour urine specimen to measure serum cortisol levels b) administer 1 mg of dexamethasone orally at night and obtain serum cortisol levels the next morning c) draw blood samples before and after exercise to evaluate the effect of exercise on serum cortisol levels d) administer an injection of adrenocorticotropic hormone (ACTH) 30 minutes before drawing blood to measure serum cortisol levels

B

The nurse is preparing to care for a client returning from the operating room following a subtotal thyroidectomy. The nurse anticipates the need for which of the following items to be placed at the bedside? a) hypothermia blanket b) emergency tracheostomy kit c) magnesium sulfate in a ready-to-inject vial d) ampule of saturated solution of potassium iodide (SSKI)

B

A hypophysectomy is the treatment of choice for which endocrine disorder? Choose one of the following A Acromegaly B Cushing's syndrome C Hyperthyroidism D Pheochromocytoma

B Cushing's syndrome

Antithyroid medications are not generally recommended for elderly patients because of which of the following? Choose one of the following A Mental confusion B Granulocytopenia C Weight loss D Fatigue

B Granulocytopenia

Which of the following is a complication of hyperthyroidism? Choose one of the following A Myxedema coma B Hypothyroidism C Addisonian crisis D Acromegaly

B Hypothyroidism

A client with Cushing disease had a bilateral adrenalectomy 24 hr ago. The nurse should monitor the client closely for which of the following? Choose one of the following A Neurogenic shock. B Hypovolemic shock. C Cardiogenic shock. D Anaphylactic shock

B Hypovolemic shock

A patient receiving propylthiouracil (PTU) asks the nurse how this medication will help relieve his symptoms. What is the nurse's best response? A."Propylthiouracil inactivates any circulating thyroid hormone, thus decreasing signs and symptoms of hyperthyroidism." B."Propylthiouracil inhibits the formation of new thyroid hormone, thus gradually returning your metabolism to normal." C."Propylthiouracil helps your thyroid gland use iodine and synthesize hormones better." D."Propylthiouracil stimulates the pituitary gland to secrete thyroid-stimulating hormone (TSH), which inhibits the production of hormones by the thyroid gland."

B."Propylthiouracil inhibits the formation of new thyroid hormone, thus gradually returning your metabolism to normal."

Which patient statement demonstrates understanding of radioactive iodine (I-131) therapy? A."I will have to isolate myself from my family for 1 week so as not to expose them to radiation." B."This drug will be taken up by the thyroid gland and destroy the cells to reduce my hyperthyroidism." C."This drug will help decrease my cold intolerance and weight gain." D."I will need to take this drug on a daily basis for at least 1 year."

B."This drug will be taken up by the thyroid gland and destroy the cells to reduce my hyperthyroidism."

Patients taking levothyroxine (Synthroid) and warfarin (Coumadin) concurrently would be monitored for which adverse effect? A.Cardiac arrhythmias B.Increased risk of bleeding C.Excessive weight loss D.Increased risk of deep vein thrombosis

B.Increased risk of bleeding

A nurse is preparing postoperative discharge instructions for a client who had one adrenal gland removed. The nurse includes which of the following in the instructions? a) the reason for maintaining a diabetic diet b) teaching proper application of an ostomy pouch c) instructions about early signs of a wound infection d) the need for lifelong replacement of all adrenal hormones

C

The nurse is preparing a client with Graves' disease to receive radioactive iodine therapy. The nurse tells the client which of the following about the therapy? a) following the initial dose, subsequent treatments must continue lifelong b) the radioactive iodine is designed to destroy the entire thyroid gland with just one dose c) it takes 6 to 8 weeks after treatment to experience relief from the symptoms of the disease d) the high levels of radioactivity prohibit contact with family for 4 weeks after initial treatment

C

Which of the following symptoms of thyroid disease is seen in older adults? Choose one of the following A Restlessness B Hyperactivity C Atrial fibrillation D Weight gain

C Atrial fibrillation

A client with hyperthyroidism is hospitalized to have a thyroidectomy. The physician has prescribed propranolol (Inderal). In reviewing the client's history, the nurse notes that the client has asthma. The nurse should next:

C Contact the physician; question the order for propranolol (Inderal) with the client's asthma history.

A client who takes levothyroxine (Synthroid) had a cholecystectomy yesterday. Laboratory results indicate a normal T4 level and a decreased thyroid-stimulating hormone (TSH) level. The nurse should: A Hold the medication and notify the physician of the lab results. B Explain to the client that the medication is not needed after surgery. C Schedule the medication for early each morning to mimic normal thyroid release. D Teach the client about the manifestations of hyperparathyroidism following surgery.

C Schedule the medication for early each morning to mimic normal thyroid release.

The nurse is teaching the patient taking an antithyroid medication to avoid foods high in iodine. Which food will the nurse advise the patient against? A.Milk B.Eggs C.Seafood D.Chicken

C.Seafood

A NURSE SHOULD EXPECT TO ADMINISTER WHICH MED TO A CLIENT WITH GOUT?

COLCHICINE

You are providing care for a patient who underwent thyroidectomy 2 days ago. Which laboratory value requires close monitoring?

Calcium

The nurse would suspect excessive thyroid replacement in a patient taking levothyroxine (Synthroid) when the patient is exhibiting which adverse effect? A.Depression B.Intolerance to cold C.Weight gain D.Irritability

D.Irritability

A patient is admitted to the medical unit with possible Graves' disease (hyperthyroidism). Which assessment finding supports this diagnosis?

Exophthalmos (abnormal protrusion of the eye) is characteristic of patients with hyperthyroidism due to Graves' disease.

WHEN TEACHING A CLIENT WITH CUSHING'S SYNDROME ABOUT DIETARY CHANGES THE NURSE SHOULD INSTRUCT THE CLIENT TO INCREASE INTAKE OF?

FRESH FRUITS(POTASSIUM RICH FOODS) CUSHING'S SYNDROME CAUSES SODIUM RETENTION WHICH INCREASES URINARY POTASSIUM LOSS

Is the following statement True or False? Oversecretion of adrencorticotropic hormone (ACTH) or the growth hormone results in Graves' disease.

False

HYPERTHYROIDISM IS CAUSED BY INCREASED LEVELS OF THYROXINE IN BLOOD PLASMA. A CLIENT WITH THIS ENDOCRINE DYSFUNCTION WOULD EXPERIENCE?

HEAT INTOLERANCE & SYSTOLIC HYPERTENSION

CLIENT PRESENTS WITH TACHYCARDIA, HYPOTENSION, FREQ. SWALLOWING, FEELINGS OF FULLNESS AT THE INCISION SITE, CHOKING & BLEEDING POSTOP FOR A THYROIDECTOMY. WHAT SHOULD THE NURSE SUSPECT?

HEMORRHAGE

Is the following statement True or False? The patient in acute hypercalcemic crisis requires close monitoring for life-threatening complications and prompt treatment to reduce serum calcium levels.

True

A CLIENT HAS RECENTLY UNDERGONE SURGICAL REMOVAL OF A PITUITARY TUMOR. THE MD PRESCRIBES CORTICOTROPIN(ACTHAR) 20 UNITS I.M. Q.I.D AS A REPLACEMENT THERAPY. WHAT IS THE MOA OF CORTICOTROPIN?

IT INTERACTS WITH PLASMA MEMBRANE RECEPTORS TO PRODUCE ENZYMATIC ACTIONS THAT AFFECT PROTEIN, FAT, & CARB METABOLISM

Which change in vital signs would you instruct a nursing assistant to report immediately for a patient with hyperthyroidism?

Increased and rapid heart rate

A CLIENT WITH HYPERPARATHYROIDISM DECLINES SURGERY & IS TO RECEIVE HORMONE REPLACEMENT THERAPY WITH ESTROGEN & PROGESTERONE. WHICH INSTRUCTION WOULD BE MOST IMPORTANT TO INCLUDE IN THE CLIENT'S TEACHING PLAN?

MAINTAIN A MODERATE EXERCISE PROGRAM

A CLIENT WITH HYPERTHYROIDISM IS ABOUT TO RECEIVE RADIOACTIVE IODINE AS AN OUTPATIENT. WHAT SAFETY MEASURES SHOULD THE NURSE TEACH THE CLIENT TO PROTECT HIS FAMILY WHILE HE UNDERGOES TREATMENT?

USE OF DISPOSABLE EATING UTENSILS, AVOID KISSING, AVOID SEX, & HOLDING BABIES

Which medication blocks synthesis of thyroid hormone? Dexamethasone Methimazole Potassium iodide Sodium iodide

Methimazole blocks synthesis of thyroid hormone. Dexamethasone, potassium iodide, and sodium iodide suppress release of thyroid hormone.

THE NURSING COORDINATOR CALLS THE ICU TO INFORM THEM THAT A CLIENT WITH SUSPECTED PHEOCHROMOCYTOMA WILL BE ADMITTED FROM THE ER. THE NURSE SHOULD PREPARE TO ADMINISTER WHICH DRUG TO THE CLIENT?

NITROPRUSSIDE(CONTROLS HYPERTENSION)

For the patient with pheochromocytoma, what physical assessment technique should you instruct the LPN/LVN to avoid?

Palpating the abdomen can cause sudden release of catecholamines and severe hypertension

WHICH NURSING DIAGNOSIS IS MOST APPROPRIATE FOR A CLIENT WITH ADDISON'S DISEASE?

RISK FOR INFECTION

A patient is hospitalized with adrenocortical insufficiency. Which nursing activity should you delegate to the nursing assistant?

Remind patient to change positions slowly

The patient with adrenal insufficiency is to be discharged taking prednisone 10 mg orally each day. What will you be sure to teach the patient?

Report excessive weigh gain or swelling to the physician

IN A 28 YR OLD FEMALE CLIENT WHO IS BEING SUCCESSFULLY TREATED FOR CUSHING'S SYNDROME THE NURSE WOULD EXPECT A DECLINE IN?

SERUM GLUCOSE LEVEL

THE NURSE EXPLAINS TO A CLIENT WITH THYROID DISEASE THAT THE THYROID GLAND NORMALLY PRODUCES?

T3, T4, & CALCITONIN

A CLIENT WITH HYPOTHRYOIDISM(MYXEDEMA) IS RECEIVING LEVOTHYROXINE(SYNTHROID) 25 MCG P.O. DAILY. WHICH FINDING SHOULD THE NURSE RECOGNIZE AS AN ADVERSE REACTION TO THE DRUG?

TACHYCARDIA

WHICH IMPORTANT INSTRUCTION CONCERNING THE ADMINISTRATION OF LEVOTHYROXINE(SYNTHROID) SHOULD THE NURSE TEACH A CLIENT?

TAKE THE DRUG ON A EMPTY STOMACH

A 56 YR OLD FEMALE CLIENT IS BEING DISCHARGED AFTER UNDERGOING A THYROIDECTOMY. WHICH DISCHARGE INSTRUCTIONS WOULD BE APPROPRIATE FOR THIS CLIENT?

TAKE THYROID MEDS AS ORDERED WATCH FOR CHANGES IN BODY FUNCTIONING SUCH AS LETHARGY, RESTLESSNESS, SENSITIVITY TO COLD, & DRY SKIN-NOTIFY MD

THE NURSE IS ASSESSING A CLIENT AFTER A THYROIDECTOMY. THE ASSESSMENT REVEALS MUSCLE TWITCHING & TINGLING, ALONG WITH NUMBNESS IN THE FINGERS, TOES & MOUTH AREA. THE NURSE SHOULD SUSPECT WHICH COMPLICATION?

TETANY

A CLIENT HAS A SERUM CALCIUM OF 7.2 MG/DL. DURING PHYSICAL EXAM THE NURSE EXPECTS TO ASSESS?

TROUSSEAU'S SIGN