Module 7: Endocrine
Euthyroid
Normal thyroid production
Which of the following insulins are used for basal dosage? Select all that apply A. Glargine (Lantus) B. NPH (Humulin N) C. Lispro (Humalog) D. Aspart (Novolog)
A
The main function of ________ is hormone synthesis A. Thyroid hormone B. TSH C. Iodine D. Calcitonin
C
This condition is characterized by bone decalcification and the development of renal calculi (kidney stones) containing calcium A. Hyperthyroidism B. Hypothyroidism C. Hyperparathyroidism D. Hypoparathyroidism
C
_____________ thyroid stimulating hormone (TSH) level indicates hyperthyroidism A. Increased B. Decreased
B
A client is receiving insulin lispro at 7:30 AM. The nurse ensures that the client has breakfast by which time? A. 7:45 AM B. 8:00 AM C. 8:15 AM D. 8:30 AM
A (Insulin lispro has an onset of 5 to 15 minutes)
A decreased level of circulating thyroid hormones indicates hypothyroidism A. True B. False
A
Graves' disease is associated with this condition A. Hyperthyroidism B. Hypothyroidism C. Hyperparathyroidism D. Hypoparathyroidism
A
Patients with hyperthyroidism are characteristically: A. Sensitive to heat B. Apathetic and anorexic C. Emotionally stable D. Calm
A
What electrolyte disturbance most commonly follows thyroid surgery? A. Hypocalcemia B. Hyponatremia C. Hyperkalemia D. Hypermagnesemia
A
Which statement by the patient on the medication Levothyroxine may require further teaching? A. My PCP will start me on 100-400 mg per day B. Taking this medication before breakfast helps prevent insomnia C. CP may be signs of toxicity D. My thyroid function levels will be checked periodically and my medication dose will be adjusted if needed
A (Levels should be started at 25-50mg and adjusted gradually)
Propranolol falls into which classifications (s) A. Beta blocker B. Glucocorticoid C. NSIAD D. Hormone
A (Propranolol may be used to control HTN, tachycardia, and arrhythmias caused by hyperthyroidism)
For patients with hypothyroidism you will often see _____ TSH levels and _____ T3 and T4 levels A. High B. Low C. Absent
AB
Which of the following are examples of medications that can alter thyroid test results? A. Valium B. heparin C. furosemide (Lasix) D. Acetaminophen E. Ceftriaxone
ABC
Which of the following patients are at risk of developing type 2 DM? Select all that apply A. 32 y.o. F who delivered a 9.5-lb infant B. 44 y.o. Native American who has a BMI of 32 C. 12 y.o. who is overweight D. 55 y.o. Asian who has HTN and 2 siblings with type 2 DM
ABCD
Which of the following are S/S of hypoparathyroidism? A. Tetany B. Laryngospasm C. Cardiac dysrhythmias D. Skeletal pain E. Chvostek's sign
ABE
Which of the following are potential treatments for hyperthyroidism? Select all that apply A. Radioactive iodine B. Levothroid C. methimazole D. Surgery E. cimetidine
ACD
Which of the following may lead to HYPOthyroidism? Select all that apply A. Thyroidectomy B. Graves' disease C. Low dietary iodine D. Pituitary tumor
ACD
Which of the following are S/S of HYPOthyroidism? Select all that apply A. bradycardia B. tachycardia C. cold intolerance D. exophthalmos E. alopecia F. Dry skin
ACEF (think: low and slow)
Hypothyroidism occurs in women belonging to which age group? A. 30-50 years B. 30-60 years C. 50-70 years
B
Levothyroxine may cause which of the following? A. Bradycardia B. Tachycardia C. Low urine output D. Hypokalemia
B
Ms. Coffee is a 35 y.o. female who presents to her PCP w/ extreme fatigue, recent thinning hair, dry skin, voice changes, menstrual changes, and complaints of being cold all the time. She is not under any increased stress at home or work. What disorder will the PCP most likely diagnose Ms. Coffee with? A. Euthyroid B. Hypothyroidism C. Hyperthyroidism D. Thyrotoxicosis
B
The nurse understands that a client with diabetes mellitus is at greater risk for developing which of the following complications? A. Elevated triglycerides B. Urinary tract infections C. Low blood pressure D. Lifelong obesity
B
Which action is most effective when a nurse is assessing the client suspected of developing diabetes insipidus? A. Taking vitals every 2 hours B. Measuring urine output hourly C. Checking blood glucose levels D. Checking HbA1c
B
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? A. Cardiac monitor B. Tracheostomy set C. Indwelling urinary catheter kit D. Humidifier
B (After a subtotal thyroidectomy, swelling of the surgical site may obstruct the airway. Therefore, the nurse should keep a trach set at the bedside in case of a respiratory emergency)
The nurse is caring for a patient with hyperthyroidism who suddenly develops symptoms related to thyroid storm. What symptoms does the nurse recognize that are indicative of this emergency? Select all that apply A. Heart rate of 99 B. Temperature of 102ºF C. Blood pressure 90/58 mm Hg D. Abdominal pain E. Seizure
BDE
Which of the following are well-known causes of hypoparathyroidism? Select all that apply A. Thyroiditis B. Destruction of the parathyroid glands C. Grave's disease D. Vitamin B deficiency E. Vitamin D deficiency
BE
Which of the following are S/S of HYPERthyroidism? Select all that apply A. constipation B. exophthalmos C. goiter D. hypertension E. hypotension F. weight gain
BCD (think high and fast)
Dexamethasone falls into which classifications (s) A. Beta blocker B. Glucocorticoid C. NSIAD D. Hormone
BD
Which of the following could potentially contribute to hypothyroidism? Select all that apply A. Excessive hypovolemia B. Hashimoto thyroiditis C. Toxic goiter D. Radiation of head or neck,
BD
Which of the following may lead to HYPERthyroidism? Select all that apply A. Low dietary iodine B. Excess levothyroxine C. Hashimoto's thyroiditis D. Graves' disease
BD
A nurse is teaching a client about insulin therapy. The client may need additional teaching when they state that insulin may interact with... A. Hormonal contraceptives B. Aspirin C. Metoprolol D. Hydrochlorothiazide
C
A pt w/ hypothyroidism has started taking thyroid hormone replacement therapy and asks the RN about the reason for feeling sad/depressed. The RN should tell the pt: "the feelings of sadness and depression are caused by..." A. Having a chronic illness and are normal B. A condition unrelated to hypothyroidism and will require follow-up C. Low thyroid hormone levels and will improve with replacement therapy D. The side effects of thyroid hormone replacement therapy and will diminish over time
C
Which glands regulate calcium and phosphorous metabolism? A. Pituitary B. Adrenal C. Parathyroid D. Thyroid
C
A client newly diagnosed with diabetes mellitus asks why he needs ketone testing when the disease affects his blood glucose levels. How should the nurse respond? A. Ketones can damage your kidneys and eyes B. The spleen releases ketones when your body can't use glucose C. Ketones help the physician determine how serious your diabetes is D. Ketones will tell us if your body is using other tissues for energy
D
A nurse explains to a pt w/ thyroid disease that the thyroid gland normally produces A. Iodine and thyroid-stimulating hormone (TSH) B. thyrotropin-releasing hormone (TRH) and TSH C. TSH, triiodothyronine (T3), and calcitonin D. T3, thyroxine (T4), and calcitonin
D
Undiagnosed hypothyroidism may lead to this life-threatening condition A. thyroid storm B. sepsis C. A-fib D. myxedema
D
For a client with hyperthyroidism, treatment is most likely to include: A. emollient lotions B. a synthetic thyroid hormone C. thyroid extract D. a thyroid hormone antagonist
D (block thyroid hormone synthesis & combat increased production of thyroid hormone)
S/S of hyperparathyroidism may include all of the following except: A. Trousseau's sign B. Hypertension C. Fatigue D. N/V E. Diarrhea
E
High T3 & T4 and low TSH indicate...
HYPERthyroidism
Low T3 & T4 and high TSH indicate...
HYPOthyroidism
Levothyroxine is a medication given for....
HYPOthyroidism (lifelong med, taken early in the morning before food)
What is the main function of thyroid hormone?
To control cellular metabolic activity