Module 9 TTC (Hormonal/Glucose Regulation B)00

The nurse is teaching a client diagnosed with Addison disease about the importance of lifetime oral replacement therapy. Which pharmacologic agent would be the drug of choice and included in this teaching plan? Potassium supplements Hydrocortisone Insulin Ketoconazole

Hydrocortisone

A client is diagnosed with Addison disease. What statement by the client indicates an understanding of the discharge instructions by the nurse? "I will have to take my medication for the rest of my life." "I should be able to control my condition with diet and exercise." "If I have surgery, it will cure me." "Once the symptoms go away, I will be able to stop taking my medication."

"I will have to take my medication for the rest of my life."

The nurse has just completed teaching a client, newly diagnosed with type 1 diabetes, about the treatment options. Which response by the client leads the nurse to conclude that additional teaching is needed? "An exercise plan will be helpful for prevention of long-term complications." "So I can stop my insulin if I start an exercise program." "If I forget my insulin in the morning, I should take it as soon as I can to prevent hyperglycemia." "If I work on losing some weight, that might help prevent complications later."

"So I can stop my insulin if I start an exercise program."

A 3-year-old girl has just been diagnosed with type 1A diabetes. Her parents are currently receiving education from the diabetes education nurse. How can the nurse best explain to the parents the etiology (cause) of their daughter's diabetes? "It's not known exactly why your daughter has completely stopped making insulin, and treatment will consist of your rigidly controlling her diet." "The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin." "This tendency to produce insufficient amounts of insulin is likely something that she inherited." "Environmental and lifestyle factors are known to play a part in the fact that her pancreas secretes and withholds insulin at the wrong times."

"The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin."

A young child develops type 1A diabetes. The parents ask, "They tell us this is genetic. Does that mean our other children will get diabetes?" The best response by the health care provider would be: "Probably not. Since genetically your other children have a different cellular makeup, they just might not become diabetic." "We don't know what causes diabetes, so we will just have to wait and see." "If you put all your children on a low-carbohydrate diet, maybe they won't get diabetes." "This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes."

"This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes."

Which manifestation indicates a client is at risk for developing diabetes mellitus? Serum potassium 4.2 mEq/L (4.2 mmol/L) Fasting blood glucose level 75 mg/dL (4.16 mmol/L) Hemoglobin A1 5.0% (.05) 2 hour oral GTT 175 mg/dL (9.7 mmol/L)

2 hour oral GTT 175 mg/dL (9.7 mmol/L)

The nurse is reviewing assessment data and determines which client is at highest risk for developing type 2 diabetes? A 10-year-old male whose grandmother has type 2 diabetes A 60-year-old female with a history of gestational diabetes A 40-year-old male who has liver disease due to hepatitis A 45-year-old obese female with a sedentary lifestyle

A 45-year-old obese female with a sedentary lifestyle

Which pediatric assessment finding would the nurse recognize as an example of precocious puberty? A 16-year-old male with genital enlargement and pubic hair growth A 7-year-old female with early menarche A 13-year-old female with menarche and a recent growth spurt A 12-year-old male with advanced growth

A 7-year-old female with early menarche

The mother of 6-year-old male and female fraternal twins has brought her son to see a pediatrician because he is nearly 4 inches shorter than his sister. Which phenomenon would the physician most likely suspect as contributing factor to the boy's short stature? A shortage of hypothalamic GHRH production Genetic short stature Excess insulin production resulting in chronically low blood glucose levels Lack of IGF receptors in epiphyseal long bones

A shortage of hypothalamic GHRH production

The nurse is assessing a male client and finds abnormally large hands and feet, a bulbous nose, and a broad face with a protruding jaw. Based on these findings, which endocrine abnormality is most likely the cause for these physical changes? Myxedema Cushing syndrome Acromegaly Hyperthyroidism

Acromegaly

The signs and symptoms of abrupt cessation of pharmacologic glucocorticoids closely resemble those of which disease process? Addison disease Cushing syndrome Cushing disease Graves disease

Addison disease

A 60 year-old man has long managed his type 1 diabetes effectively with a combination of vigilant blood sugar monitoring, subcutaneous insulin administration, and conscientious eating habits. This morning, however, his wife has noted that he appears pale and clammy and appears to be in a stupor, though he is responsive. She suspects that he has made an error in his insulin administration and that he is experiencing a hypoglycemic episode. Which action should be the wife's first choice? IV infusion of 50% dextrose and water solution. Administration of 15 to 20 g of glucose in a concentrated carbohydrate source. Careful monitoring for level of consciousness and resolution of hypoglycemia. Administration of subcutaneous glucagon.

Administration of 15 to 20 g of glucose in a concentrated carbohydrate source.

A client is to have a serum thyroxine and thyroid stimulating laboratory test performed to assess the baseline status of the hypothalamic-pituitary target cell hormones. When educating the client about the laboratory tests, when would the nurse inform him the test should be obtained? At noon After 0900 Prior to midnight Before 0800

Before 0800

Which classification of medication does the nurse prepare to administer to the client with hyperthyroidism that will block the effects of the hyperthyroid state on sympathetic nervous system function? Angiotensin-converting enzyme (ACE) inhibitor Angiotensin receptor blocking agent Calcium channel blocking agent Beta-adrenergic blocking agent (beta-blocker)

Beta-adrenergic blocking agent (beta-blocker)

When caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which organ does the nurse recognize is reliant on glucose as the major energy source? Lungs Spleen Brain Heart

Brain

Which criterion about insulin would prompt a diagnosis of type 1 diabetes? Complete failure of insulin secretion Small amounts of insulin secreted Insulin not efficiently used Large amounts of insulin secreted

Complete failure of insulin secretion

Which effect of thyroid hormone deficit alters the function of all major organs in the body? Causes vitamin deficiencies Increases protein synthesis Decreases metabolism Enhances absorption of glucose

Decreases metabolism

A client with pancreatitis is admitted with weight loss, nausea, and vomiting. To maintain nutrition, the physician orders parenteral nutrition to be started. Knowing that a major side effect of parenteral nutrition is a hyperosmolar hyperglycemic state, the nurse should assess the client for which clinical manifestations? Fever, chills, elevated BP of 170/101. Dry lips, excess urine output, and seizures. Irritability, bradycardia, wheezing noted on inspiration. Facial tics, shuffling gait, stiff joints.

Dry lips, excess urine output, and seizures.

A 23-year-old man is admitted to the hospital. He is experiencing polyphagia, polyuria, and polydipsia. He states that the condition has come on very suddenly. This client is likely to require what treatment? Meglitinides Exogenous insulin injections Biguanides Sulfonylureas

Exogenous insulin injections

A newly diagnosed adolescent with type 1 diabetes read online that diabetes is the leading cause of blindness among Americans. Which statement would be the most accurate information to share with the client along with preventive measures? Explain that almost all people with diabetes do experience some degree of vision loss. Tell her there is about a 50 percent chance that she will suffer some diabetes-related sight loss by the time she is 50. Tell her to expect that she will begin to lose her eyesight by the time she is 25. Reassure her that only type 2 diabetes is a risk factor for blindness.

Explain that almost all people with diabetes do experience some degree of vision loss.

A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves disease. Which assessments should the nurse prioritize? Eye health and visual acuity Signs and symptoms of decreased bone density Cognition and judgment Skin integrity and distribution of adipose tissue

Eye health and visual acuity

Which test can the nurse prepare the client for to determine the differentiation between a benign and malignant thyroid disease? MRI Ultrasonography Fine-needle aspiration biopsy CT scan

Fine-needle aspiration biopsy

Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur? Diabetogenic gene from both parents, environmental triggering event, and a B-lymphocyte reaction to alpha cell antigens Diabetogenic gene from both parents, physiologic triggering event, and an allergic reaction to pancreatic delta cells Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen Genetic predisposition, physiologic triggering event, allergic reaction to pancreatic alpha cells

Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen

The family of a client in the hospital with diabetes mellitus that is out of control asks the nurse to explain the client's recent weight loss while eating more than usual. How will the nurse respond? Surplus glucose is stored as glycogen in the liver. Lack of insulin raises circulating blood glucose levels. Glucose is unused without insulin, so body fats are used for energy. Fatty acids enter the glycolytic pathway to release energy.

Glucose is unused without insulin, so body fats are used for energy.

A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes. The best diagnostic indicator that would support the client's response would be: Capillary blood glucose sample Fasting blood glucose level Glycosylated hemoglobin, hemoglobin A1C (HbA1C) Urine test

Glycosylated hemoglobin, hemoglobin A1C (HbA1C)

Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of: Cushing disease Cushing syndrome Graves disease Addison disease

Graves disease

A 62-year-old man who is overweight has just been diagnosed with type 2 diabetes. The nurse educator is instructing him in the ways his diabetes can be controlled. The nurse should initially prioritize which action? Assisting the client with the appropriate choice of oral antihyperglycemics. Educating the client about the risks and management of hypoglycemia. Helping the client make meaningful changes to his diet and activity level. Teaching the client about the action and safe administration of insulin.

Helping the client make meaningful changes to his diet and activity level.

The nurse is caring for a client with diabetes. Which of these findings is cause for concern, leading the nurse to initiate client education? Glucose level is 80 mg/dL (4.44 mmol/L). The client states insulin is produced in the pancreas. The client is dependent on insulin. Hemoglobin A1C level is 8.7%.

Hemoglobin A1C level is 8.7%.

The nurse is caring for a client with diabetes. Which of these findings is cause for concern, leading the nurse to initiate client education? The client states insulin is produced in the pancreas. Glucose level is 80 mg/dL (4.44 mmol/L). Hemoglobin A1C level is 8.7%. The client is dependent on insulin.

Hemoglobin A1C level is 8.7%.

During periods of fasting and starvation, the glucocorticoid and other corticosteroid hormones are critical for survival because of their stimulation of gluconeogenesis by the liver. When the glucocorticoid hormones remain elevated for extended periods of time, what can occur? Adrenal hyperplasia Hyperglycemia Portal hypertension Hepatomegaly

Hyperglycemia

A 30-year-old man who manages his type 1 diabetes with glyburide presents at the emergency room reporting headache, confusion, and tachycardia. He has come from a party at which he drank two beers to celebrate running his first half marathon. Which phenomenon is likely to be the cause of his symptoms? Somogyi effect Diabetic ketoacidosis Hypoglycemia Hyperosmolar hyperglycemic state

Hypoglycemia

An extremely lethargic client arrives by ambulance at the emergency department. His blood glucose level is 32 mg/dL (1.78 mmol/L). The nurse will anticipate that this client will be diagnosed with: Hypoglycemia Dawn phenomenon Autonomic neuropathy Diabetic ketoacidosis

Hypoglycemia

A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing? Increased levels of ACTH Positive C-reactive protein Increase in sedimentation rate Elevated WBC count

Increased levels of ACTH

A client with diabetes asks the nurse for advice in controlling between-meal blood glucose levels. Which of these might the nurse suggest as a long-acting insulin to provide a consistent basal level? Regular insulin Insulin aspart Insulin glulisine Insulin glargine

Insulin glargine

A client with diabetic retinopathy develops a retinal bleed and asks the nurse, "How can I prevent this from happening again?" What response provides the most effective information? Visit your eye health professional for annual examinations. Wear glasses when reading and limit computer time. Control stress and monitor vision changes. Maintain healthy blood pressure and blood sugar levels.

Maintain healthy blood pressure and blood sugar levels.

The nurse is caring for a client with cirrhosis of the liver. Which medications prescribed by the physician should the nurse question since they may affect the binding of thyroid hormone to normal concentrations of binding proteins? Select all that apply. Lisinopril Aspirin Metoprolol Diazepam Phenytoin

Phenytoin Aspirin Diazepam

A client with diabetes carries insulin with him at all times. At 11:35, he obtains a blood glucose reading of 218 mg/dL (12.1 mmol/L) and self-administers a dose of insulin in anticipation of eating lunch at noon. What type of insulin did he most likely inject? Premixed Long acting Short acting Intermediate acting

Short acting

A client with severe hypothyroidism is presently experiencing hypothermia. What nursing intervention is a priority in the care of this client? Slow rewarming of the client to prevent vasodilation and vascular collapse Placing the client on a hyperthermia blanket and using heated saline in order to induce vasodilation Keeping the client in a hypothermic state in order to prevent renal failure Active rewarming of the client to increase body temperature rapidly

Slow rewarming of the client to prevent vasodilation and vascular collapse

A client is managing diabetes with exercise and diet. The health care provider reviews the client's most recent laboratory results: fasting blood glucose level at 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (0.05). Select the response that best identifies the client. The client is at risk for an insulin reaction. The client needs to modify the diet related to the low readings. The client is at risk for developing hyperglycemia. The client is achieving normal glycemic control.

The client is achieving normal glycemic control.

The nurse is providing discharge instructions for a client with Graves disease who has ophthalmopathy. What should the nurse be sure to include in the instructions to decrease exacerbation of this clinical manifestation? The client should be informed that he should not be in contact with other people during the acute phase. The client should be strongly encouraged not to drink any alcohol. The client should be strongly urged not to smoke. The client should be informed that if he begins to feel symptoms getting worse, he should take an extra dose of medication.

The client should be strongly urged not to smoke.

The nurse is caring for an older adult client who is being treated for primary hypothyroidism. The medication therapy includes a "go low and go slow" regimen. What is the importance of this medication regimen for this client? The older adult client is at increased risk for thyroid storm. There is a risk of renal failure in the older adult client if a more rapid correction of thyroid levels is used. There is a risk of inducing acute coronary syndromes in the older adult client if a more rapid correction of thyroid levels is used. There is a risk to the older client of developing hyperthyroidism.

There is a risk of inducing acute coronary syndromes in the older adult client if a more rapid correction of thyroid levels is used.

The nurse is teaching a newly diagnosed client with diabetes about fingerstick blood glucose testing. When the client obtains a premeal fingerstick reading of 206 mg/dL (11.43 mmol/L), which teaching by the nurse is most appropriate? Blood glucose levels of 206 (11.4 mmol/L) are acceptable when you are ill. This reading is within normal range - continue your regimen. This is an elevated reading - let's talk about adherence to insulin and diet. This is a normal reading for after meals.

This is an elevated reading - let's talk about adherence to insulin and diet.

A client with severe hypoglycemia is unconscious. Which method of providing glucose should not be used for this client? orange juice orally dextrose IV glucose gel in the buccal pocket glucagon IM

orange juice orally

Which factor contributes to an infant developing macrosomia (large body size)? Maternal nutrition Fetal chromosome disorder Maternal diabetes Fetal gene disorder

Maternal diabetes

A client with Graves disease has ophthalmopathy and asks the nurse if the eyes will stay like this forever. What is the best response by the nurse? "With treatment of the hyperthyroid state, the ophthalmopathy usually tends to stabilize." "Once we treat your Graves disease, your eyes will go back to their normal state." "The protrusion of the eyes will get worse before they get better." "Your eyes will be like this but there are things we can do to reduce visual loss."

"With treatment of the hyperthyroid state, the ophthalmopathy usually tends to stabilize."

A client with small cell carcinoma lung cancer may secrete an excess of which hormone, causing an ectopic form of Cushing syndrome due to a nonpituitary tumor? DHEA TSH GH ACTH

ACTH

A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to begin replacement therapy. Regarding which type of replacement will the nurse educate the client? Growth hormone replacement therapy Replacement therapy with synthetic thyroid hormone Replacement therapy with prolactin Cortisol replacement therapy

Cortisol replacement therapy

The newborn nursery nurse is obtaining a blood sample to determine if a newborn has congenital hypothyroidism. What long-term complication is the nurse aware can occur if this test is not performed and the infant has congenital hypothyroidism? Cretinism Dehydration from diarrhea Irritability and restlessness Accelerated growth

Cretinism

Which treatment regimen is most likely to result in stable blood glucose levels for a client with a diagnosis of type 1 diabetes? Wait until after eating the first meal of the day before checking blood glucose and then calculate insulin dose Perform a daily moderate exercise routine prior to insulin administration Initially try to control blood glucose levels with diet and exercise routines along with weight reduction Monitor blood glucose levels throughout the day and administer exogenous insulin replacement as needed

Monitor blood glucose levels throughout the day and administer exogenous insulin replacement as needed