Medsurg2 Final Endocrine
Type 1 diabetes
A 15-year-old child is brought to the emergency department with symptoms of hyperglycemia and is subsequently diagnosed with diabetes. Based on the fact that the child's pancreatic beta cells are being destroyed, the patient would be diagnosed with what type of diabetes?
Disturbed body image related to changes in physical appearance
A 30 year-old female patient has been diagnosed with Cushing syndrome. What psychosocial nursing diagnosis should the nurse most likely prioritize when planning the patient's care?
Polyphagia
A 36-year-old mother of six has been recently diagnosed with type 2 diabetes. She reports increased hunger and food consumption while continuing to lose weight. What is the term used to describe this condition?
Ketoacidosis
A 53-year-old client is brought to the ED, via squad, where you practice nursing. He is demonstrating fast, deep, labored breathing and has a fruity odor to his breath. He has a history of type 1 diabetes. What could be the cause of his current serious condition?
decreased body temperature and cold intolerance.
A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for:
Tracheostomy set
A client is returned to his room after a subtotal thyroidectomy. Which piece of equipment is most important for the nurse to keep at the client's bedside?
sodium and potassium abnormalities.
A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of:
Adrenal cortex
A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which gland?
6.5%
A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well-controlled?
Tachycardia
A client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should the nurse recognize as an adverse reaction to the drug?
has type 2 diabetes.
A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. The nurse explains that these medications are effective only if the client:
Abdomen
A client with type 1 diabetes is to receive a short-acting insulin and an intermediate-acting insulin subcutaneously before breakfast. The nurse would administer the insulin at which site as the preferred site?
Finger
A client with type 1 diabetes mellitus is receiving short-acting insulin to maintain control of blood glucose levels. In providing glucometer instructions, the nurse would instruct the client to use which site for most accurate findings?
"Diet, exercise, and weight loss can eliminate the need for medication."
A controlled type 2 diabetic client states, "The doctor said if my blood sugars remain stable, I may not need to take any medication." Which response by the nurse is most appropriate?
Hold the dose of insulin and consult with the patient's primary care provider.
A hospital patient's medication administration record specifies a dose of NPH insulin to be administered subcutaneously at 8 AM. The nurse has checked the patient's blood glucose level prior to administering the drug and it is 55 mg/dl. How should the nurse respond to this assessment finding?
Administer 50% glucose intravenously.
A hospitalized client is found to be comatose and hypoglycemic with a blood sugar of 50 mg/dL. Which of the following would the nurse do first?
All the above
A nurse diabetes educator is planning an initial visit to a home care patient who was recently diagnosed with diabetes mellitus. Which of the following skills would the nurse teach the patient to accomplish?
Control blood glucose levels.
A nurse educates a group of clients with diabetes mellitus on the prevention of diabetic nephropathy. Which of the following suggestions would be most important?
The presence of a tingling sensation
A nurse is assessing a patient who has diabetes for the presence of peripheral neuropathy. The nurse should question the patient about what sign or symptom that would suggest the possible development of peripheral neuropathy?
Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.
A nurse is caring for a client who had a thyroidectomy and is at risk for hypocalcemia. What should the nurse do?
Four to six small meals per day
A nurse is caring for a client with Simmonds' disease. Which of the following dietary modifications would be most appropriate for this client?
15 to 20 g of a fast-acting carbohydrate such as orange juice.
A nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness, and aberrant behavior. The client is conscious. The nurse should first administer:
Observe the patient drawing up and administering the insulin.
A nurse is caring for a patient with type 1 diabetes who is being discharged home tomorrow. What is the best way to assess the patient's ability to prepare and self-administer insulin?
wash and inspect the feet daily.
A nurse is developing a teaching plan for a client with diabetes mellitus. A client with diabetes mellitus should:
Beta cells of the pancreas
A nurse is explaining the action of insulin to a client with diabetes mellitus. During client teaching, the nurse reviews the process of insulin secretion in the body. The nurse is correct when she states that insulin is secreted from the:
Decreased cardiac output
A nurse is planning care for a client in acute addisonian crisis. Which nursing diagnosis should receive the highest priority?
Increased thirst, increased hunger, and increased urination
A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. Which of the following symptoms would she include when reviewing classic symptoms associated with diabetes?
"I may stop taking this medication when I feel better."
A nurse is teaching a client with adrenal insufficiency about corticosteroids. Which statement by the client indicates a need for additional teaching?
4 tablets
A patient at a healthcare facility has been prescribed 8 mg of rosiglitazone maleate (Avandia) daily to improve glycemic control. On-hand availability of the drug is in the form of 2 mg tablets. How many tablets of the drug should the nurse administer to the patient?
Exogenous insulin is required for life.
A patient is diagnosed with type 1 diabetes. What distinguishing characteristic is associated with type 1 diabetes?
Take the medication on an empty stomach
A patient is started on levothyroxine (Synthroid). What should the patient be instructed on regarding medication administration?
Inhibit production of thyroid hormone
A woman is started on propylthiouracil (PTU). What is the primary mode of action for propylthiouracil?
Calcium gluconate
Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany?
Serum potassium level
After being sick for 3 days, a client with a history of diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). The nurse should evaluate which diagnostic test results to prevent arrhythmias?
"I might need insulin later on but probably not as much or as often."
After teaching a client with type 1 diabetes, who is scheduled to undergo an islet cell transplant, which client statement indicates successful teaching?
"Lately, I drink and drink and can't seem to quench my thirst."
An occupational health nurse is screening a group of workers for diabetes. What statement should the nurse interpret as suggestive of diabetes?
"Insulins have different onsets and durations of action."
During a teaching session on the care of the diabetic patient, a family member asks why her daughter has a different insulin than her best friend. The nurse should make which of the following statements to explain the differences in insulin?
Pineal gland
Joe Taylor, a 15-year-old eighth grade student, has difficulty falling asleep on a nightly basis. He has an appointment with the physician who is part of the primary care group where you practice nursing. The physician suspects a lack of melatonin. What endocrine gland secretes melatonin?
Pituitary disorder
Lydia Kranston, a 3-year-old female, is being seen by a healthcare provider in the endocrinology group where you practice nursing. She has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of her disorder?
Intermediate-acting
NPH is an example of which type of insulin?
Type 2
The greatest percentage of people have which type of diabetes?
Reflects the amount of glucose stored in hemoglobin over past several months.
The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order?
Make sure the client's breakfast is available in the next 5-10 minutes.
The nurse is preparing to administer insulin lispro (Humalog) to a client at 7 AM. What is the nurse's top priority intervention related to this medication?
Gigantism
The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as which of the following?
Hypotension
The typical triad of manifestations seen in a patient diagnosed with pheochromocytoma includes all of the following except
An adrenal adenoma
What is the most common cause of hyperaldosteronism?
Aldosterone
What is the most prevalent mineralocorticoid that regulates fluid balance?
Thyrotoxic crisis
What life-threatening outcome should the nurse monitor for in a client who is not compliant with taking his antithyroid medication?
Vasopressin (Pitressin)
What medication is used to treat diabetes insipidus caused by hypofunction of the posterior pituitary gland?
Excessive hair growth or loss
What skin findings should a nurse pay particular attention to in a client with a history of endocrine problems?
His glucometer readings to be increased
When a diabetic client is taking steroids, he should anticipate
Before epiphyses closure
When growth in a child is impaired by a deficiency of endogenous growth hormone somatropin may be prescribed. When in the period of growth and development must somatropin (Humatrope) be administered to children?
"Diabetes can affect sensation in your feet and you can hurt yourself without realizing it."
When referred to a podiatrist, a client newly diagnosed with diabetes mellitus asks, "Why do you need to check my feet when I'm having a problem with my blood sugar?" The nurse's most helpful response to this statement is:
Those who are allergic to seafood
Which group of clients should not receive potassium iodide?
Calcitonin
Which hormone would the nurse identify as important in decreasing serum calcium levels?
Ketones
Which of the following are byproducts of fat breakdown, which accumulate in the blood and urine?
Cushing's syndrome
Which of the following disorders is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex?
Acromegaly
Which of the following disorders results from excessive secretion of somatotropin (growth hormone)?
Adrenocorticotropic hormone (ACTH)
Which of the following hormones controls secretion of adrenal androgens?
Thyroxine
Which of the following hormones would the nurse identify as being secreted by the thyroid gland?
Excessive thirst
Which of the following is a clinical manifestation of diabetes insipidus?
Insulin lispro (Humalog)
Which of the following is an example of rapid acting insulin? (Choose one)
Humalog
Which of the following is the most rapid acting insulin?
The patient has not consumed food and continues to take insulin or oral antidiabetic medications.
Which of the following may be a potential cause of hypoglycemia in the patient diagnosed with diabetes mellitus?
Handle body fluids carefully.
Which of the following precautions would be most appropriate when caring for a client being treated with radioactive iodine (RAI) for a thyroid tumor?
Less than 7%
Which of the following represent the American Diabetes Association recommended HbA1c goal? (Choose one)
Do not mix with other insulins.
Which of the following should be included in the teaching plan for a patient receiving glargine (Lantus),"peakless" basal insulin?
Use the hands to support the head when rising to a sitting position.
Which suggestion would the nurse include for a client who has had a thyroidectomy to reduce tension on the suture line?
Weakness, sweating, and decreased mentation
You are caring for a client taking insulin. You realize the client is experiencing symptoms of hypoglycemia when he displays the following symptoms:
Regular
Your client is admitted to the intensive care unit with diabetic ketoacidosis. You know that your client will be placed on an intravenous insulin drip. The only type of insulin which can be administered intravenously is:
