Ex 4 Practice Questions
What are the biologic functions mineralocorticoids? Select all that apply a.Sodium and water resorption b.Maintenance of potassium and pH levels in the blood c.Anti-inflammatory actions d.Blood pressure control e.Stress effects
a,b,d
in cushing's disease the _________________ is secreting too much ACTH (adrenocorticotropic hormone) which is causing an increase in cortisol production a. adrenal cortex b. pituitary gland c. thyroid gland d. hypothalamus
b
A patient is in pulseless cardiac arrest. Which medication does the nurse anticipate administering? a.Somatropin b.Desmopressin c.Vasopressin d.Cosyntropin
c
The nurse is educating a patient how to collect a 24 hour urine sample. Which statement by the patient indicates understanding? a. "I need to collect my urine from when I wake up to when I go to bed." b. "I need to keep my urine in a warmer to stay in a specific temperature range." c. "I will discard the first urine sample in the morning before starting to collect." d. "I will avoid eating foods that are bladder irritants while collecting my urine."
c
When assessing for potential side effects of fludrocortisone, the nurse monitors for signs and symptoms of which adverse effect? a. Hyponatremia b. Hypercalcemia c. Hypokalemia d. Hypovolemia
c
A female patient is admitted with a diagnosis of primary hypofunction of the adrenal glands. Which nursing assessment finding supports this diagnosis? a.Patchy areas of pigment loss over the face b.Decreased muscle strength c.Greatly increased urine output d.Scalp alopecia
a
A nurse is educating a patient that is scheduled for surgery of the pituitary gland. Which statement by the patient indicates understanding of the pre-surgery education? a."I have a pair of slip on shoes that I will be able to wear after surgery" b."I will need to buy a new toothbrush before my surgery to be prepared" c."I am glad I'll be able to sleep flat on my back like I normally do" d."I need to cough and deep breathe to avoid getting pneumonia"
a
A nurse is providing education for a patient that has been ordered a glucocorticoid medication. Which of the following statements by the patient indicates the need for further teaching?" a. "I will inject this medication in the fat of my stomach." b. "I will take my medicine with food or milk." c. "I will need to watch my blood sugar more closely." d. "I will notify my physician if I develop a fever."
a
A patient is hospitalized with adrenocortical insufficiency. Which nursing activity should the nurse delegate to UAP? a. Reminding the patient to change positions slowly b. Assessing the patient for muscle weakness c. Teaching the patient how to collect a 24-hr urine sample d. Revising the patient's nursing plan of care
a
A patient with adrenal insufficiency is to be discharged and will take prednisone 10 mg orally each day. Which instruction would the nurse be sure to teach the patient? a.Excessive weight gain or swelling should be reported to the health care provider b.Changing positions rapidly may cause hypotension and dizziness c.A diet with foods low in sodium may be beneficial to prevent side effects d.Signs of hypoglycemia may occur while taking this drug
a
The client who is about to have a unilateral adrenalectomy for an adenoma that is causing hypercortisolism asks the nurse if she will have to continue the severe sodium restriction after surgery. What is the nurse's best response? a."No, once the tumor has been removed and your cortisol levels have normalized, you will not retain excess sodium anymore." b. "No, after surgery you will have to take oral cortisol, which can easily be controlled so that your sodium levels do not rise." c. "Yes, the fact that you are retaining sodium and have high blood pressure is related to your age and lifestyle, not the tumor." d. "Yes, sodium is very bad for people and everyone needs to eliminate sodium completely from their diets for the rest of their lives."
a
The nurse is caring for a patient who has just undergone hypophysectomy for hyperpituitarism. Which postoperative finding requires immediate intervention? a. Presence of glucose in the nasal drainage b. Presence of nasal packing in the nares c. Urine output of 40 to 50 mL/hr d. Patient reports of thirst
a
When providing care for a patient with Addison disease, the nurse should be alert for which laboratory value change? a.Decreased hematocrit b.Increased sodium level c.Decreased potassium level d.Decreased calcium level
a
Which does the nurse recognize as a possible outcome for the patient experiencing an age-related decrease in antidiuretic hormone? a.Diluted urine and dehydration b.Yeast infection and polydipsia c.Greater than ideal body weight d.Constipation, lethargy, and dry skin
a
Which of the following statements best describes why exogenous glucocorticoids are tapered before being discontinued? a. When exogenous glucocorticoids are given, endogenous production levels decrease and to resume exogenous levels must be decreased gradually so that hormone output responds to the negative feedback system. b. When exogenous glucocorticoids are given, the feedback loop that is needed for insulin production is blocked and increasing insulin administration will lower blood glucose and slowly decreases the need for glucocorticoids. c. Cortisol levels increase in response to both emotional and physiological stress. Tapering off the medication increase the response of the negative feedback system. d. Cortisol levels increase and has an influence on every body system, making the body dependent on a specific amount of glucocorticoids and unable to be discontinued.
a
Which priority question should the nurse ask a patient with a pituitary tumor? a."Do you have any changes in your visual acuity?" b."Have you noticed a change in your libido?" c."Have you experienced a change in growth of your facial hair?" d."Have you had an unexpected weight loss?"
a
a patient is admitted to the ER. the patient is unconscious on arrival. however, the patient's family is with the patient and reports that before the patient became unconscious she was complaining of severe pain in the abdomen, legs and back and has been experiencing worsening confusion. in addition they also report the patient has not been taking any medications. the patient was recently discharged from the hospital for treatment of low cortisol and aldosterone levels. on assessment you note the patient's BP is 70/45. what disorder is this patient most likely experiencing? a. addisonian crisis b. cushing syndrome c. thyroid crisis d. hashimoto thyroidits
a
a patient with cushings syndrome will be undergoing an adrenalectomy. which of the following will be included in the patient's discharge teaching after the procedure? a. glucocorticoid replacement therapy b. avoiding avocadoes and pears c. declomycin therapy d. signs and symptoms of grave's disease
a
in cushing's disease and syndrome there are: a. increased cortisol production b. low potassium and glucose levels c. increased production of aldosterone and cortisol d. decreased production of aldosterone and cortisol
a
in the scenario above what medication do you expect the patient to b started on? a. IV solu-cortef b. PO prednisone c. PO declomycin d. IV insulin
a
which of the following is not a typical sign and symptom of chushing's syndrome? a. hyperpigmentation of the skin b. hirsutism c. purplish striae d. moon face
a
What are the biologic functions of glucocorticoids? Select all that apply a.Anti-inflammatory actions b.Stress Effects c.Metabolization of carbohydrates, protein, and fat d.Sodium and water resorption e.Maintenance of normal blood pressure
a,b,c,e
Which actions prescribed by the HCP for the patient with Addison disease should the nurse delegate to the experienced UAP? Select all that apply a.Weigh the patient every morning b.Obtain fingerstick glucose before each meal and at bedtime c.Check vital signs every 2 hours d.Monitor for cardiac dysrhythmias e.Administer oral prednisone 10 mg every morning f.Record I&O
a,b,c,f
Which of the following statements about the endocrine system are true? (Select all that apply) a. Overproduction of the adrenal cortex may cause masculinization in women b. Epinephrine and norepinephrine are considered hormones when they are secreted by the adrenal medulla and are considered neurotransmitters when they are secreted by nerve cells c. In a person who normally works a night shift from 2300-0700 and sleeps from 0800 to 1500, a serum analysis of cortisol taken at 0730 would reveal a false high cortisol level d. Hormones that act on the anterior pituitary gland to stimulate tropic hormone secretion are known as releasing hormones e. Androgens secreted by the adrenal cortex are responsible for sex drive in women
a,b,d,e
The nurse is caring for a patient with SIADH secretin. Which patient care actions should the nurse delegate to the experienced UAP? Select all that apply a. Monitor and record strick I&O b. Provide the patient with ice chips when requested c. Remind the patient about their fluid restriction d. Weigh the patient every morning using the same scale e. Report a weight gain of 2.2 lbs to the nurse f. Provide mouth care allowing the patient to swallow the rinse
a,c,d,e
The nurse is preparing to discharge a patient with hyperpituitarism caused by a benign pituitary tumor, who is prescribed the drug bromocriptine. Which key points would the nurse teach the patient about this drug? Select all that apply. a. Take this drug with a meal or snack to avoid gastrointestinal (GI) symptoms b. Side effects of bromocriptine include severe fatigue and reflux after meals c. Seek medical care if you experience chest pain or dizziness while taking this d. If the drug causes headaches, you can take over-the-counter acetaminophen e. Treatment starts with a high dose, which is gradually lowered f. The purpose of bromocriptine is to shrink your pituitary to normal size
a,c,d,f
1.The nurse is caring for a 25 yr old patient admitted to the acute care unit with an extra strong thirst, and dilute, excessive straw-colored urine output (up to 15L/day). What does the nurse suspect? a.Type 2 diabetes b.Diabetes Insipidus (DI) c.Cushing disease d.Addison disease
b
A patient had a bilateral adrenalectomy to treat Cushing's disease yesterday. The patient now has a temperature of 99.4. Which is the priority nursing intervention? a. Administer intravenous fluids b. Encourage coughing and deep breathing every 1 to 2 hours c. Assuming wound infection and notify the physician d. Obtain a urine sample for a urine culture
b
During long-term corticosteroid therapy, the nurse will monitor the patient for Cushing's syndrome, which is manifested by which of the following? a. weight loss. b. moon face. c. hypotension. d. thickened hair growth.
b
The LPN is assigned to provide care for a patient with pheochromocytoma. Which physical assessment technique should the RN instruct the LPN to avoid? a.Listening for abdominal bowel sounds in all 4 quadrants b.Palpating the abdomen in all 4 quadrants c.Checking the blood pressure every hour d.Assessing the mucous membranes for hydration status
b
The LPN who is assigned to care for a patient with Cushing disease asks the RN why the patient has bruising and petechiae across her abdomen. What is the RN's best response? a."Patients with Cushing disease often have bleeding disorders" b."Patients with Cushing disease have very fragile capillaries" c."Please ask the patient if she slipped or fell during the night" d."Thin and delicate skin can result in development of bruising"
b
The nurse admits a patient whose assessment reveals prominent brow ridge, large hands and feet, and large lips and nose. Which pituitary hormone does the nurse suspect is elevated? a.Thyroid-Stimulating hormone b.Growth hormone c.Adrenocorticotropic hormone d.Vasopressin Antidiuretic hormon
b
The nurse is caring for a patient diagnosed with small cell lung cancer. The nurse understands the patient may also present with which endocrine disorder? a a.Adrenal crisis b.Cushing's syndrome c.Diabetes insipidus d.Syndrome of inappropriate antidiuretic hormone (SIADH)
b
Two UAP's are assisting a patient with Cushing disease to move up in bed. Which action by the UAP's requires the nurse's immediate intervention? a.Positioning themselves on opposite sides of the bed b.Grasping under the patient's arms to pull him up c.Lowering the sides rails of the patient's bed before moving him d.Removing the pillow before moving the patient up in bed
b
What is caused by the sudden cessation of long-term high-dose glucocorticoid therapy? a.Cushing Disease b.Addison's Disease c.Diabetes Insipidus d.Hypopituitary Dwarfism
b
What is the major goal of treatment when caring for a patient with hypercortisolism? a. Treat the symptoms b.Protection from infection c.Remove the adrenal glands d.Educate the patient
b
When administering octreotide (sandostatin) to a patient, it is important for the nurse to assess which parameter? a.Urine output b.Blood sugar c.Liver function tests d.Electrocardiogram
b
When monitoring for a therapeutic response to aminoglutethimide, the nurse will look for which potential outcomes? a. Increase in Cushing's syndrome characteristics b. Decrease in Cushing's syndrome characteristics c. Increased lymphocyte levels d. Growth suppression
b
Which of the following finding would the nurse be most concerned about in an adrenal patient that is postoperative and had their adrenal glands removed? a. Patient smokes 52 packs a year b. Blood pressure of 92/76. c. Patient's urine is cloudy. d. Heart rate 86 beats per minute.
b
Which patient should the charge nurse assign to the care of an LPN, under the supervision of the RN team leader? a. A 51 yo who has just undergone a bilateral adrenalectomy b. A 83 yo with type 2 diabetes and COPD c. A 38 yo with myocardial infarction preparing for discharge d. A 72 yo with mental status changes admitted from a long-term care facility
b
Which urine properties indicate to the nurse that the client with syndrome of inappropriate (SIADH) antidiuretic hormone is responding to interventions? a. Urine output volume increased; urine specific gravity increased b. Urine output volume increased; urine specific gravity decreased c. Urine output volume decreased; urine specific gravity increased d. Urine output volume decreased; urine specific gravity decreased
b
a patient with addison's disease is being discharged home on prednisone. which of the following statements by the patient warrants you to re-educate? a. i will notify the doctor if i become sick or experience stress b. i will take this medication as needed when symptoms are present c. i will take this medication at the same time every day d. my daughter has bought me a medic-alert bracelet
b
which of the following patients are at risk for developing Cushing's Syndrome? a. patient with a tumor on the pituitary gland, which is causing too much ACTH to be secreted b. a patient taking glucocorticoids for several weeks c. a patient with a TB infection d. a patient who is post-opt form an adrenalectomy
b
Which of the following would the nurse expect to see from the laboratory results of a patient with Addison's Disease? Select all that apply a.Increased serum cortisol b.Decreased fasting blood glucose c.Increased potassium d.Decreased sodium e.Decreased serum BU
b,c,d
A patient with acute adrenal insufficiency (adrenal crisis) is admitted to the hospital. The nurse monitors for resolution of which manifestation to determine that drug therapy with cortisone has been effective? (Select all that apply) a. Hyper-excitability and restlessness b. Decreased appetite and weight loss c. Vitiligo and hyperpigmentation d. Hypertension and hypernatremia e. Episodes of angina and hypotension
b,c,e
The nurse is preparing a care plan for a patient with Cushing disease. Which abnormal laboratory values would the nurse expect? Select all that apply a.Increased serum calcium level b.Increased salivary cortisol level c.Increased urinary cortisol level d.Decreased serum glucose level e.Decreased sodium level f.Increased serum cortisol level
b,c,f
For which client does the nurse question the prescription of androgen replacement therapy? a. 35-year-old man who has had a vasectomy b. 48-year old man who takes prednisone for severe asthma c. 62-year-old man who has a history of prostate cancer d. 70-year-old man who has hypertension and type 2 diabetes
c
The nurse is caring for the following patients with endocrine disorders. Which patient must the nurse assess first? a.A 21 yo with Diabetes Insipidus whose urine output overnight was 2000 mL b.A 55 yo with SIADH whois demanding that the UAP refill his water pitcher c.A 65 yo with Addison disease whose morning potassium level is 6.2 mEq/L d.A 48 yo with Cushing disease with a weight gain of 1.5 lb over the past 4 days
c
The patient is in the midst of an Addisonian crisis. Which of the following is priority? a. Assessing for hypertension b. Preventing infection c. Preventing hypotension d. Increasing urine output
c
Which finding should alert the nurse to perform a more detailed assessment of the patient's endocrine system? a.Weight gain b.Poor peripheral pulses c.Changes in hair texture and distribution d.Fatigue
c
Which prescribed order for a patient with diabetes insipidus would the nurse be sure to question? a.Monitor and record accurate I&O b.Check urine specific gravity c.Restrict fluids for 6 hrs d.Weigh the patient every morning
c
Which teaching is appropriate for a patient who is taking an inhaled glucocorticoid for asthma? a. "Exhale while pushing in on the canister of the inhaler." b. "Blow your nose after taking the medication." c. "Rinse your mouth thoroughly after taking the medication." d. "Do not eat immediately after taking the medication."
c
a patient with addison's disease should consume which of the following diet? a. high fat and fiber b. low potassium and high protein c. high protein, carbs and adequate sodium d. low carbs, high protein and increased sodium
c
A 24 yo patient with diabetes insipidus makes all of these statements when the nurse is preparing the patient for discharge. Which statement indicates to the nurse that the patient needs additional teaching? a. "I will drink fluids equal to the amount of my urine output" b. "I will weigh myself every day using the same scale" c. "I will wear my medical alert bracelet at all times" d. "I will gradually wean myself off the vasopressin"
d
A nurse is providing education for a patient that has been ordered a glucocorticoid medication. Which of the following statements by the patient indicates understanding?" a. "The medication can be taken whenever I wake up and go to bed." b. "Rinsing my mouth after using my inhaler will keep me from getting pneumonia." c. "I can stop taking this medication as soon as I feel better." d. "I need to avoid anyone that has an infection or symptoms of being sick."
d
A patient with pheochromocytoma underwent surgery to remove his adrenal glands. Which nursing intervention should the nurse delegate to a UAP? a. Revising the nursing care plan to include strategies to provide a calm and restful environment postoperatively b. Instructing the patient to avoid smoking and drinking caffeine-containing beverages c. Assessing the patient's skin and mucous membranes for signs of adequate hydration d. Monitoring lying and standing blood pressure every 4 hours with a cuff placed on the same arm.
d
Assessment findings for a patient with Cushing disease include all of the following. For which finding would the nurse notify the health care provider immediately? a.Purple striae present on the abdomen and thighs b.Weight gain 1 lb since the previous day c.Dependent edema rated as +1 in the ankles and calves d.Crackles bilaterally in the lower lobes of the lungs
d
During evening shift, the patients MRI reveals the presence of a pituitary adenoma. The following day, surgery is performed to remove the tumor. What is the nurse's priority concern for the patient postoperatively? a.Development of transient diabetes mellitus b.Assessing for systemic infection c.Airway management d.Monitoring for neurologic changes
d
The RN is supervising a senior student nurse who is caring for a fresh postoperative patient who had a hypophysectomy. The RN observes the student nurse perform all of these actions. For which action must the RN intervene? a. Assess for changes in vision or mental status b. Keep the head of the bed elevated c. Remind the patient to perform deep breathing every hour while awake d. Encourage the patient to cough vigorously
d
addison's disease is: a. increased secretion of cortisol b. increased secretion of aldosterone and cortisol c. decreased secretion of cortisol d. decreased secretion of aldosternone and cortisol
d