Med-Surge Endocrine Level 3 Questions

While assessing a client during a routine examination, a nurse in the clinic identifies signs and symptoms of hyperthyroidism. Which signs are characteristic of hyperthyroidism? Select all that apply. 1 Diaphoresis 2 Weight loss 3 Constipation 4 Protruding eyes 5 Cold intolerance

Diaphoresis occurs with hyperthyroidism because of increased metabolism, resulting in hyperthermia. Weight loss occurs with hyperthyroidism because of increased metabolism. Bulging eyes occur with hyperthyroidism and are thought to be related to an autoimmune response of the retro-orbital tissue, which causes the eyeballs to enlarge and push forward. Diarrhea occurs because of increased body processes, specifically increased gastrointestinal peristalsis. Heat intolerance occurs because of the increased metabolism associated with hyperthyroidism.

A client understands that an increase in vitamin E and beta-carotene is important for healthier skin. The nurse teaches the client that excellent food sources of both of these are 1 Spinach and mangoes 2 Fish and peanut butter 3 Oranges and grapefruits 4 Carrots and sweet potatoes

The antioxidants vitamin E and beta-carotene, which help inhibit oxidation and therefore tissue breakdown, are found in spinach and mangoes. Fish and peanut butter are excellent sources of vitamin E, not beta-carotene. Oranges and grapefruits are excellent sources of vitamin C, not vitamin E and beta-carotene. Carrots and sweet potatoes are excellent sources of beta-carotene, not vitamin E.

A client who is scheduled to have surgery to remove an aldosterone-secreting adenoma asks the nurse what will happen if surgery is not performed. On what information should the nurse base a response? 1 The tumor must be removed to prevent heart and kidney damage. 2 Surgery will prevent the tumor from metastasizing to other organs. 3 Radiation therapy can be just as effective as surgery if the tumor is small. 4 Chemotherapy is as reliable as surgery for the treatment of adenomas of this type in some people.

Renal and cardiac complications will occur if hypertension caused by the tumor is not arrested. Aldosteronomas are benign tumors; metastasis is not possible. Radiation is not used to treat this type of adenoma. Chemotherapy is not recommended treatment for this particular adenoma.

A client with type 2 diabetes is admitted to the ambulatory surgery unit for elective cataract surgery. Before surgery the client asks the nurse, "How will my diabetes be managed while I am here?" The best response by the nurse is: 1 "What did your surgeon tell you?" 2 "Has the anesthesiologist talked to you yet?" 3 "Your surgeon will write your postoperative prescriptions." 4 I'm not quite certain I understand what you are asking."

The nurse needs to know specifically what the client is asking; this response permits clarification. Asking what the surgeon has said collects more information, but it will not clarify what the client wants to know. Asking what the anesthesiologist has said does not relate to what the client wants to know. The nurse is making an assumption about medical management.

A nurse is caring for a client who had a hypophysectomy. For which complication specific to this surgery should the nurse assess the client for early clinical manifestations? 1 Urinary retention 2 Respiratory distress 3 Bleeding at the suture line 4 Increased intracranial pressure

Because the pituitary gland is located in the brain, edema after surgery may result in increased intracranial pressure. Early signs include decreased visual acuity, papilledema, and unilateral pupillary dilation. Urinary retention may follow any surgery because of the effects of anesthesia and is not a specific occurrence following cranial surgery. Respiratory distress is a later, not early, sign of increased intracranial pressure. This is a decompensated response indicated by altered respiratory pattern, decreased respiratory rate, and, finally, respiratory arrest. This occurs because of increasing pressure on the medulla. Bleeding at the suture line may occur with any surgery, not just a hypophysectomy.

The nurse is assessing a client with hyperthyroidism. Which clinical indicators are consistent with this diagnosis? Select all that apply. 1 Emotional lability 2 Dyspnea on exertion 3 Abdominal distension 4 Decreased bowel sounds 5 Hyperactive deep tendon reflexes

Lability of mood is a psychological/emotional manifestation related to excess thyroid hormones. Dyspnea with or without exertion can occur as the body attempts to meet oxygen demands related to the increased metabolic rate associated with hyperthyroidism. Hyperactive reflexes are a neurologic manifestation related to excessive production of thyroid hormones. Abdominal distension is associated with hypothyroidism; it is related to constipation and weight gain. Bowel sounds increase, not decrease, as a result of hyperperistalsis associated with the elevated metabolic rate. Hypoactive bowel sounds are related to hypothyroidism.

Because of multiple physical injuries and emotional concerns, a hospitalized client is at high risk to develop a stress ulcer (Curling's). The nurse recalls that stress ulcers usually are evidenced by: 1 Unexplained shock 2 Melena for several days 3 A sudden massive hemorrhage 4 A gradual drop in the hematocrit value

Stress ulcers are asymptomatic until they produce massive hematemesis and rectal bleeding. Shock is the outcome of massive hemorrhage; it is not unexplained because the sudden gastrointestinal bleeding will be identified. Sudden massive bleeding occurs, not the slow oozing that causes melena. A gradual drop in the hematocrit value indicates slow blood loss.

A client with type 1 diabetes self-administers Novolin N insulin every morning at 8 AM. The nurse evaluates that the client understands the action of the insulin when the client says, "I should be alert for signs of hypoglycemia between: 1 9 AM and 10 AM." 2 10 AM and 11 AM." 3 2 PM and 8 PM." 4 8 PM and 12 NOON."

The action of intermediate-acting insulins peak in 6 to 12 hours. Nine to 10 AM and 10 AM to 11 AM are too soon for Novolin N to produce a hypoglycemic response. Novolin N will have produced a hypoglycemic response before 8 pm and 12 pm. A hypoglycemic response that occurs in 45 to 60 minutes after administration is associated with rapid-acting insulins.

In addition to clients who are receiving insulin for type 1 diabetes, the nurse should assess for signs and symptoms of hypoglycemia in clients who are diagnosed with: 1 Liver disease 2 Type 2 diabetes 3 Hyperthyroidism 4 Stage 3 hypertension

The client with liver disease is at risk for hypoglycemia. This client is limited in mobilizing carbohydrates because of a decreased ability to form glycogen (glycogenesis) and to form glucose from glycogen (glycogenolysis). Clients with type 2 diabetes do not depend on exogenous insulin, nor are they prone to ketosis when they experience hyperglycemia. Hyperthyroidism is not related to a decreased serum glucose level. Hypertension is not related to a decreased serum glucose level.

Preparation of a client for a subtotal thyroidectomy may include the administration of potassium iodide solution. The client refuses to take the medication. What explanation should the nurse give as to why this medication should be taken? 1 The metabolic rate of the body will increase. 2 It will reduce the risk of hemorrhage during surgery. 3 It will maintain the functioning of the parathyroid glands. 4 The amount of thyroid hormones being secreted will decrease.

Potassium iodide, which aids in decreasing vascularity of the thyroid gland, decreases the risk for hemorrhage. Thyroid hormone antagonists help decrease the body's metabolism. Potassium iodide does not regulate parathyroid function. Thyroid hormone antagonists help decrease the amount of thyroid hormones being secreted.