med surg 44-46 endo

The nurse assigned to care for a patient with diabetic ketoacidosis (DKA) is aware that this is a life-threatening condition that results in: a. Inability of carbohydrates, fats, and proteins to be metabolized b. Storage of glycogen, resulting in a severe shortage of glucose in the bloodstream c. Dangerously elevated pH and bicarbonate levels in the blood d. Severe hypoglycemia, which can result in coma and convulsions

a. Inability of carbohydrates, fats, and proteins to be metabolized

The nurse caring for a patient with Addison disease suspects adrenal crisis when the patient exhibits: a. Hypertension and abdominal pain b. Confusion and tachycardia c. Bradycardia and nausea d. Widening pulse pressure and shortness of breath

b. Confusion and tachycardia

Two days after a hypophysectomy the patient complains of a headache and nuchal rigidity. Based on these assessments the nurse should: a. Medicate with the prescribed analgesic. b. Report suspected meningitis to the head nurse. c. Closely monitor the patient's blood pressure, d. Elevate the head of the bed to 45 degrees

b. Report suspected meningitis to the head nurse.

Excessive output of dilute urine from an antidiuretic hormone (ADH) abnormality is characteristic of __________. a. hyperthyroidism b. diabetes insipidus c. diabetes mellitus d. adrenal insufficiency

b. diabetes insipidus

Excessive glucose in the bloodstream increases its osmolality, which initially causes the patient to experience __________. a. polyphagia b. polyuria c. hypoglycemia d. Polydipsia

d. Polydipsia

On returning from surgery after undergoing a thyroidectomy, the patient is alarmed about the large tracheostomy tray on the bedside table. When she asks why it is there, the nurse's most reassuring response would be: a. "We have it there as a precautionary measure in the unlikely event that you have difficulty breathing." b. "If you start bleeding, we'll be able to take care of it right here at the bedside." c. "We have to keep it there in case of an emergency and the physician needs it." d. "It's hospital policy to have it available for persons who are likely to have respiratory arrest."

a. "We have it there as a precautionary measure in the unlikely event that you have difficulty breathing."

The nurse recommends the use of salt that is iodized because iodized salt: a. Can prevent the development of goiter in adults and cretinism in infants. b. Can help prevent hypothyroidism. c. Is instrumental in preventing tumors of the parathyroid gland. d. Works as an important component of thyroid replacement therapy.

a. Can prevent the development of goiter in adults and cretinism in infants.

When the 18-year-old girl is diagnosed with adenoma of the anterior pituitary gland, the nurse assesses for the classic signs of this diagnosis, which are: (Select all that apply.) a. Cessation of menses b. Milk production c. Changing facial features d. Excessive urine output e. Weight gain

a. Cessation of menses b. Milk production c. Changing facial features e. Weight gain

The nurse explains to the patient that the presurgical protocol of antithyroid drugs is given to: (Select all that apply.) a. Decrease the level of hormone in the blood before surgery. b. Help reduce the risk of hemorrhage during surgery. c. Decrease the threat of a thyroid storm. d. Reduce exophthalmia. e. Increase weight.

a. Decrease the level of hormone in the blood before surgery. b. Help reduce the risk of hemorrhage during surgery. c. Decrease the threat of a thyroid storm. d. Reduce exophthalmia.

On an intake physical examination, the nurse questions the patient with diabetes insipidus (DI) about the classic symptoms of that disease, which are: a. Diuresis, tachycardia, and weakness b. Dizziness, hypertension, and excitability c. Stress incontinence, vomiting, and edema d. Bradycardia, insomnia, and muscle cramps

a. Diuresis, tachycardia, and weakness

The nurse tells a patient that the functional causes of hypoglycemia include:(Select all that apply.) a. Dumping syndrome b. Overdose of insulin c. Addison disease d. Prolonged muscular exercise e. Chronic alcoholism

a. Dumping syndrome c. Addison disease d. Prolonged muscular exercise

When assessing the patient with a diagnosis of SIADH during an intake interview, the nurse expects that the patient will complain of: (Select all that apply.) a. Headache b. Hypotension c. Weight gain d. Muscle cramps e. Weakness

a. Headache c. Weight gain d. Muscle cramps e. Weakness

The nurse suspects that the patient with type 1 diabetes may be experiencing the Somogyi phenomenon when the patient exhibits: a. Headache on awakening and enuresis b. 6 AM blood sugar of 58 and nausea c. Abdominal pain and elevated blood pressure d. Drowsiness and disorientation after eating

a. Headache on awakening and enuresis

If a patient has hypothyroidism, what would the thyroid-stimulating hormone level be? a. Increased b. Decreased c. Normal d. Not used to evaluate hypothyroidism

a. Increased

The home health care nurse is aware that hypothyroidism is frequently overlooked in older adults because: (Select all that apply.) a. Signs and symptoms are subtle. b. Signs and symptoms are discounted as age-related changes. c. Weight changes in the older adult are not pronounced. d. Older adults are not susceptible to thyroid disorders. e. Decrease in mental function is attributed to dementia.

a. Signs and symptoms are subtle. b. Signs and symptoms are discounted as age-related changes. c. Weight changes in the older adult are not pronounced. e. Decrease in mental function is attributed to dementia.

When the patient starts taking a saturated solution of potassium iodide (SSKI), the nurse should instruct the patient to: a. Sip medication through a straw to prevent tooth staining. b. Double the dose if a dose is missed. c. Expect excessive salivation. d. Take before meals.

a. Sip medication through a straw to prevent tooth staining.

Food such as soybeans, turnips and rutabagas can have an effect on persons with a thyroid disorder by: a. Suppressing thyroid hormone b. Decreasing the hypothermia of the person with hypothyroidism c. Supplementing the diet of a person with hypothyroidism d. Counteracting the effect of iodide therapy

a. Suppressing thyroid hormone

The patient with long-term asthma develops Cushing syndrome. The nurse explains that this condition is probably the result of: a. Taking corticosteroids for many years b. Abruptly withdrawing cortisone therapy c. Lack of ACTH, related to the pituitary gland d. Poorly functioning adrenal glands

a. Taking corticosteroids for many years

Two hormones produced by the posterior pituitary gland (neurohypophysis) are __________. a. antidiuretic hormone (ADH) and oxytocin b. growth hormone (GH) and adrenocorticotropic hormone (ACTH) c. thyroid-stimulating hormone (TSH) and growth hormone (GH) d. follicle-stimulating hormone (FSH) and luteinizing hormone (LH)

a. antidiuretic hormone (ADH) and oxytocin

The nurse clarifies the pathophysiologic changes of Graves disease by saying: a. "Your thyroid gland is not producing enough hormones; consequently, you will need replacement therapy." b. "Your thyroid gland is overactive, but there are ways to treat it—through medicine or surgery." c. "It's an autoimmune disorder that has no satisfactory treatment." d. "Graves disease is a temporary disorder that will gradually subside."

b. "Your thyroid gland is overactive, but there are ways to treat it—through medicine or surgery."

An older patient with hypothyroidism asks why her daily dose of thyroid hormone, which she has taken for 15 years, has been reduced. The nurse's best response would be that the decreased dose is related to: a. Improved efficacy of the thyroid preparation b. Age-related reduction in metabolic rate c. Drug-related hypertrophy of the thyroid d. Changes in your diet and activity level

b. Age-related reduction in metabolic rate

A 42-year-old woman reports excessive weight gain in the abdomen and shoulders, excessive hair growth on her face, and an intermittent menses. The reported signs are associated with __________. a. Addison disease b. Cushing syndrome c. gigantism d. diabetes insipidus

b. Cushing syndrome

The patient being treated for hyperparathyroidism is to receive calcitonin (Calcimar). Before administering this drug, the patient should be: a. Assessed for hydration status b. Evaluated for cardiac dysrhythmia c. Tested for sensitivity d. X-rayed for the presence of urinary calculi

b. Evaluated for cardiac dysrhythmia

The nurse would anticipate that the patient with hyperparathyroidism would exhibit a history of: a. Fatigue, hyperactive reflexes, muscle cramps, and twitching b. Poor muscle tone, bone pain, urinary calculi, and fractures c. Hunger, thirst, and urinary retention d. Tachycardia, air hunger, and nervousness

b. Poor muscle tone, bone pain, urinary calculi, and fractures

The patient with Addison disease asks why she must take hydrocortisone. The nurse clarifies that the drug will: a. Increase cardiac output. b. Regulate the excretion of potassium and sodium. c. Decrease the level of cortisol. d. Lower the blood sugar level.

b. Regulate the excretion of potassium and sodium.

The patient has been admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Her blood glucose level is very high (880 mg/dl) on admission. The physician believes that her condition is the result of large amounts of glucose solutions administered intravenously (IV) during kidney dialysis. The nurse anticipates that the patient would exhibit: Tg

b. Severe dehydration and hypernatremia caused by the hyperglycemia

Bromocriptine (Parlodel) is a pituitary hormone suppressant that acts to __________. a. inhibit the production of clotting factor VIII from the posterior pituitary gland b. inhibit the release of prolactin from the anterior pituitary gland c. suppress the release of growth hormone from the anterior pituitary gland d. suppress the release of antidiuretic hormone from the anterior pituitary gland

b. inhibit the release of prolactin from the anterior pituitary gland

Facial edema that is associated with long-term untreated hypothyroidism is called __________. a. cretinism b. myxedema c. tetany d. thyroiditis

b. myxedema

The patient, newly diagnosed with hypothyroidism, is anxious to begin her drug regimen. The nurse's instructions relative to hormone replacement include: a. "Be certain that no dose is skipped." b. "Be sure and take these drugs just before bedtime." c. "Know the signs and symptoms of hyperthyroidism." d. "You will be able to notice the benefits of thyroid replacement therapy right away."

c. "Know the signs and symptoms of hyperthyroidism."

The patient asks about his laboratory test, which showed a high level of thyroid-stimulating hormone (TSH) and a low level of T4. You explain that: a. "It means that you have an inconsistency in your thyroid tests, and you will need more testing." b. "I am sorry. You will have to ask your physician about your laboratory results. We are not allowed to discuss them." c. "The TSH is sending a message to your thyroid gland to increase production, but your thyroid isn't producing enough hormone." d. "That means that you will have to go on hormone therapy for the rest of your life."

c. "The TSH is sending a message to your thyroid gland to increase production, but your thyroid isn't producing enough hormone."

The nurse assessing a patient 1 day after a subtotal thyroidectomy notes that the patient's color is poor, the pulse and respirations are rapid, and she feels warm to the touch. The patient says that she feels frightened. The nurse's initial implementation should be to: a. Tell her that there is nothing to be afraid of, and to stay to calm her. b. Ask her if she would like pain medication. c. Call the charge nurse; these are signs of a thyroid storm. d. Get a tracheostomy set at the bedside.

c. Call the charge nurse; these are signs of a thyroid storm.

he nurse explains that type 1 diabetes mellitus is a disease in which the body does not produce enough insulin; consequently, the blood glucose is elevated because of the: a. Prolonged elevation of stress hormone (cortisol, epinephrine, glucagon, growth hormone) levels. b. Malfunction of the glycogen-storing capabilities of the liver. c. Destruction of the beta cells in the pancreas. d. Insulin resistance of the receptor cells in the muscle tissue.

c. Destruction of the beta cells in the pancreas.

The patient states that he is confused because the physician told him that his DI is nephrogenic. The nurse explains that nephrogenic DI differs from neurogenic DI in that nephrogenic DI: a. Will eventually resolve without medication. b. Requires the nasal spray lypressin. c. Does not respond to ADH. d. Will require dialysis.

c. Does not respond to ADH.

The hallmark findings expected when assessing a patient with Cushing syndrome are: a. Edema of the trunk, extremities, and face b. Wasting of the abdomen with thick, calloused skin c. Excess adipose tissue in the trunk, slender extremities, and moon face d. High levels of potassium and low levels of sodium, weakness, and wasting

c. Excess adipose tissue in the trunk, slender extremities, and moon face

What is the function of the parathyroid glands? a. Regulate potassium levels b. Regulate sodium levels c. Regulate serum calcium levels d. Regulate the thyroid gland

c. Regulate serum calcium levels

The patient with exophthalmos is distressed about her appearance and asks when it will go away. The nurse's best and most informative response would be based on the knowledge that exophthalmos: a. Is not reversible. b. Can be disguised with sunglasses and makeup. c. Usually subsides after medication for hyperthyroidism is started. d. Can be minimized with plastic surgery to the eyelids.

c. Usually subsides after medication for hyperthyroidism is started.

In drawing up a teaching plan for a patient with Addison disease, the nurse will include: a. Discontinuing hormonal replacement therapy if the patient becomes nauseated or has diarrhea. b. Decreasing medication if the patient is under stress or is being treated for an infection. c. Wearing a medical alert tag and carrying emergency dexamethasone. d. Beginning a vigorous exercise program to overcome weakness and muscle wasting.

c. Wearing a medical alert tag and carrying emergency dexamethasone.

A pituitary adenoma is most commonly found in patients with __________. a. Addison disease b. hypopituitarism c. hyperpituitarism d. Cushing disease

c. hyperpituitarism

Maintenance of extracellular fluid volume is controlled by __________. a. prolactin b. glucocorticoids c. mineralocorticoids d. thyroid-stimulating hormone

c. mineralocorticoids

most visible sign of Graves disease is __________. a. swelling of the neck b. exophthalmus c. weight loss d. irritability

c. weight loss

Thyroid storm is prevented by administering what medications before a thyroidectomy? a. Thyroid replacement hormones b. Thyroid-stimulating drugs c. Can't be prevented d. Antithyroid drugs

d. Antithyroid drugs

The nurse assessing a patient with Simmonds cachexia anticipates that the patient will exhibit: a. High body temperature b. Ruddy complexion c. Silky body hair d. Muscle wasting

d. Muscle wasting

The nurse clarifies that the drug, octreotide (Sandostatin), is a treatment for acromegaly and will: a. Reverse the effects of acromegaly. b. Be given on a daily basis by injection. c. Increase insulin secretion causing hypoglycemia. d. Suppress the growth hormone.

d. Suppress the growth hormone.

The patient has been admitted to the hospital with the diagnosis of DKA. The nurse anticipates that the patient will exhibit vital signs of: a. Temperature, 99° F; pulse, 62 beats/min; respirations, 16 breaths/min and shallow b. Temperature, 98.6° F; pulse, 76 beats/min; respirations, 16 breaths/min and deep c. Temperature, 98° F; pulse, 84 beats/min; respirations, 18 breaths/min and shallow d. Temperature, 97.4° F; pulse, 100 beats/min; respirations, 20 breaths/min and deep

d. Temperature, 97.4° F; pulse, 100 beats/min; respirations, 20 breaths/min and deep

Why are vital signs important in assessing thyroid function? a. It's good practice. b. Vital signs are part of the assessment. c. The patient expects it. d. Vital signs reflect the metabolic rate

d. Vital signs reflect the metabolic rate

The most reliable test for acromegaly is the __________. a. parathyroid hormone b. cortisol level c. thyroid-stimulating hormone level d. glucose tolerance test

d. glucose tolerance test

The nurse is aware that the cardinal indication of a pheochromocytoma is: a. Significant hypertension b. Extreme nausea c. Abdominal pain d. Edema in the legs

a. Significant hypertension

common electrolyte imbalance found in patients with syndrome of inappropriate antidiuretic hormone is __________. a. hyponatremia b. hyperkalemia c. hyperglycemia d. hypochloremi

a. hyponatremia