NCLEX Endocrine
A client with hyperthyroidism has been given methimazole. Which nursing considerations are associated with this medication? Select all that apply a. administer methimazole with food b. place the client on a low calorie, low protein diet c. assess the client for unexplained bruising or bleeding d. instruct the client to report aide and adverse effects such as sore throat, fever, or headaches e. use special radioactive precautions when handling the client's urine for the first 24 hours following initial administration
a. administer methimazole with food c. assess the client for unexplained bruising or bleeding d. instruct the client to report aide and adverse effects such as sore throat, fever, or headaches
The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide and metformin. The nurse should provide which instructions to the client? Select all that apply a. diarrhea may occur secondary to the metformin b. the repaglinide is not taken if a meal is skipped c. the repaglinide is taken 30 minutes before eating d. a simple sugar food item is carried and used to treat mild hypoglycemia episodes e. muscle pain is an expected effect of metformin and may be treated with acetaminophen f. metformin increases hepatic glucose production to prevent hypoglycemia associated with repaglinide
a. diarrhea may occur secondary to the metformin b. the repaglinide is not taken if a meal is skipped c. the repaglinide is taken 30 minutes before eating d. a simple sugar food item is carried and used to treat mild hypoglycemia episodes
A client has been diagnosed with hyperthyroidism. The nurse monitors for which signs and symptoms indicating a complication of this disorder? select all that apply a. fever b. nausea c. lethargy d. tremors e. confusion f. bradycardia
a. fever b. nausea d. tremors e. confusion
A client is taking Humulin NPH insulin and regular insulin every morning. The nurse should provide which instructions to the client? Select all that apply a. hypoglycemia may be experienced before dinnertime b. the insulin dose should be decreased if illness occurs c. the insulin should be administered at room temperature d. the insulin vial need to be shaken vigorously to break up the precipitates e. the NPH insulin should be drawn into the syringe first, then the regular insulin
a. hypoglycemia may be experienced before dinnertime c. the insulin should be administered at room temperature
A client with a diagnosis of addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional health care team focus on? Select all that apply a. hypotension b. leukocytosis c. hyperkalemia d. hypercalcemia e. hypernatremia
a. hypotension c. hyperkalemia
The nurse is admitting a client who is diagnose with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has sodium of 118. Which health care provider prescriptions should the nurse anticipate receiving? Select all that apply: a. initiate an infusion of 3% NaCl b. administer intravenous furosemide c. restrict fluids to 800 mL over 24 hrs d. elevate the head of the bed to high fowler's e. administer a vasopressin antagonist as prescribed
a. initiate an infusion of 3% NaCl c. restrict fluids to 800 mL over 24 hrs e. administer a vasopressin antagonist as prescribed
The nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply a. insomnia b. weight loss c. bradycardia d. constipation e. mild heat intolerance
a. insomnia b. weight loss e. mild heat intolerance
The nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications. Which sign or symptom, if exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if the blood glucose is not adequately managed? a. polyuria b. diaphoresis c. pedal edema d. decreased respiratory rate
a. polyuria
The nurse is completing an assessment on a client who is being admitted for a diagnostic workup for primary hyperparathyroidism. Which client complaint would be characteristic of this disorder? select all that apply a. polyuria b. headache c. bonepain d. nervousness e. weight gain
a. polyuria c. bonepain
A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide daily, but recently the fasting blood glucose level has been 180 to 200 mg. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia? a. prednisone b. atenolol c. phenelzine d. allopurinol
a. prednisone
The nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching? a. withdraws the NPH insulin first b. withdraws the regular insulin first c. injects air into NPH insulin vial first d. injects an amount of air equal to the desired dose of insulin into each vial
a. withdraws the NPH insulin first
The HCP prescribes exenatide for a client with type 1 diabetes mellitus who takes insulin. The nurse should plan to take which most appropriated intervention? a. withhold the medication and call the HCP, questioning the prescription for the client b. administer the medication within 60 minutes before the morning and evening meal c. monitor the client for gastrointestinal side effects after administering the medication d. withdraw the insulin from the prefilled pen into an insulin syringe to prepare for administration
a. withhold the medication and call the HCP, questioning the prescription for the client
The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The nurse places priority on which client problem? a. lack of knowledge b. inadequate fluid volume c. compromise family coping d. inadequate consumption of nutrients
b. inadequate fluid volume
The nurse is monitoring a client diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy and is recovering in the ICU. Which findings should alert the nurse to the presence of a possible postoperative complication? Select all that apply a. anxiety b. leukocytosis c. Chvostek's sign d. urinary output of 800 ml e. clear drainage on nasal dripper pad
b. leukocytosis d. urinary output of 800 ml e. clear drainage on nasal dripper pad
A client is admitted to an emergency department, and a diagnosis of myxedema coma is made. Which action should the nurse prepare to carry out initially? a. warm the client b. maintain a patent airway c. administer thyroid hormone d. administer fluid replacement
b. maintain a patent airway
Glimepiride is prescribed for a client with diabetes mellitus. The nurse instructs the client that which food items are most acceptable to consume while taking this medication? Select all that apply a. alcohol b. red meats c. whole grain cereals d. low calorie desserts e. carbonated beverages
b. red meats c. whole grain cereals e. carbonated beverages
The home care nurse visits a client recently diagnosed with diabetes mellitus who is taking humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse should tell the client to take which action? a. freeze the insulin b. refrigerator the insulin c. store the insulin in a dark, dry place d. keep the insulin at room temperature
b. refrigerator the insulin
The nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. The client demonstrates an understanding of the teaching by stating that a form of glucose should be taken if which symptom or symptoms develop? Select all that apply a.polyuria b. shakiness c. palpitations d. blurred vision e. lightheadedness f. fruity breath odor
b. shakiness c. palpitations e. lightheadedness
The nurse is caring for a client after hypophysectomy and notes clear nasal drainage from the client's nostril. The nurse should take which initial action? a. lower the head of the bed b. test the drainage for glucose c. obtain a culture of the drainage d. continue to observe the drainage
b. test the drainage for glucose
The nurse should tell the client, who is taking levothyroxine, to notify the health care provider is which problem occurs a. fatigue b. tremors c. cold intolerance d. excessively dry skin
b. tremors
A client with a diagnosis of diabetic ketoacidosis is being treated in the emergency department. Which findings support this diagnosis? Select all that apply a. increase in PH b. comatose state c. deep, rapid breathing d. decreased urine output e. elevated blood glucose level
b. comatose state c. deep, rapid breathing e. elevated blood glucose level
A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety a. administer a sedative b. convey empathy, trust, and respect toward the client c. Ignore the signs and symptoms of anxiety, anticipating that they will soon disappear d. make sure that the client is familiar with the correct medical terms to promote understanding of what is happening
b. convey empathy, trust, and respect toward the client
The nurse is caring for a client admitted to the emergency department with diabetic ketoacidosis. In the acute phase, the nurse plans for which priority intervention? a. correct the acidosis b. administer 5% dextrose intravenously c. apply a monitor for an electrocardiogram d. administer short-duration insulin intravenously
d. administer short-duration insulin intravenously
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis. The initial blood glucose level is 950 mg. A continuous IV infusion of short-acting insulin is initiates, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240 mg. The nurse would next prepare to administer which medication? a. an ampule of 50% dextrose b. NPH insulin subcutaneously c. IV fluids containing dextrose d. phenytoin for the prevention of seizures
c. IV fluids containing dextrose
A daily dose of prednisone is prescribed for a client. The nurse provides instructions to the client regarding administration of the medication and should instruct the client that which time is best to take this medication? a. at noon b. at bedtime c. early morning d. any time, at the same time, each day
c. early morning
The nurse is preparing a client with a new diagnosis of hypothyoidism for discharge. The nurse determines that the client understands discharge instructions if the client states that which signs and symptoms are associated with this diagnosis? Select all that apply a. Tremors b. weight loss c. feeling cold d. loss of body hair e. persistent lethargy f. puffiness of the face
c. feeling cold d. loss of body hair e. persistent lethargy f. puffiness of the face
A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperosmolar hyperglycemic syndrome is made. The nurse would immediately prepare to initiate which anticipated HCP prescription a. endotracheal intubation b. 100 units of NPH insulin c. intravenous infusion of normal saline d. intravenous infusion of sodium bicarbonate
c. intravenous infusion of normal saline
The nurse provides instructions to a client who is taking levothyroxine. The nurse should tell the client to take the medication in which way? a. with food b. at lunchtime c. on an empty stomach d. at bedtime with a snack
c. on an empty stomach
A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client? a. hypoglycemia b. level of hoarseness c. respiratory distress d. edema at the surgical site
c. respiratory distress
The nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose level of 120 mg, temperature of 101F, pulse of 102, respirations of 22, & BP of 142/72. Which finding would be the priority concern to the nurse? a. pulse b. respiration c. temperature d. BP
c. temperature
The client with hyperparathyroidism is taking alendronate. Which statements by the client indicate understanding of the proper way to take this medication? Select all that apply a. "I should take this medication with food" b. "I should take this medication at bedtime" c. "I Should sit up for at least 30 minutes after taking this medication" d. "I should take this medication first thing in the morning on an empty stomach" e. "I can pick a time to take this medication that best fits my lifestyle as long as I take it at the same time each day"
c. "I Should sit up for at least 30 minutes after taking this medication" d. "I should take this medication first thing in the morning on an empty stomach"
The nurse is teaching the client about his prescribed prednisone. Which statement, if made by the client, indicated that further teaching is necessary? a. "I can take aspirin or my antihistamine if I need it" b. "I need to take the medication every day at the same time" c. "I need to avoid coffee, tea, cola, and chocolate in my diet" d. "If I gain more than 5lb a week, I will call my HCP"
a. "I can take aspirin or my antihistamine if I need it"
The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client relates of history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching? a. "I need to stop my insulin" b. "I need to increase my fluid intake" c. "I need to monitor my blood glucose every 3 to 4 hours" d. "I need to call the health care provider (HCP) because of these symptoms"
a. "I need to stop my insulin"
The nurse is teaching a client with hyperparathyroidism how to manage the condition at home. Which response by the client indicates the need for additional teaching? a. "I should limit my fluids to 1 liter per day" b. "I should use my treadmill or go for walks daily" c. "I should follow a moderate-calcium, high fiber diet" d. "my alendronate helps to keep calcium from coming out of my bones"
a. "I should limit my fluids to 1 liter per day"
The nurse is monitoring a client who was diagnosed with type 1 diabetes mellitus and is being treated with NPH and regular insulin. Which manifestations would alert the nurse to the presence of a possible hypoglycemia reaction? Select all that apply a. tremors b. anorexia c. irritability d. nervousness e. hot, dry skin f. muscle cramps
a. tremors c. irritability d. nervousness
the nurse is providing discharge teaching for a client newly diagnosed with type 2 diabetes mellitus who has been prescribed metformin. Which client statement indicated the need for further teaching? a. "it is okay if I skip meals now and then" b. "I need to constantly watch for signs of low blood sugar" c. "I need to let my health care prover know if I get unusually tired" d. "I will be sure to not drink alcohol excessively while on this medication"
b. "I need to constantly watch for signs of low blood sugar"
The nurse teaches the client, who is newly diagnosed with diabete insipidus, about the prescribed intranasal desmopressin. Which statements by the client indicate understanding? Select all that apply a. "this medication will turn my urine orange" b. "I should decrease my oral fluids when I start this medication" c. "the amount of urine I make should increase if this medicine is working" d. "I need to follow a low-fat diet to avoid pancreatitis when taking this medicine" e. "I should report headache and drowsiness to my health care provider since these symptoms could be related to my desmopressin"
b. "I should decrease my oral fluids when I start this medication" e. "I should report headache and drowsiness to my health care provider since these symptoms could be related to my desmopressin"
The nurse is providing instructions to the client newly diagnosed with diabetes mellitus who has been prescribed pramlintide. Which instruction should the nurse include in the discharge teaching? a. "inject the pramlintide at the same time you take your other medications" b. "take your prescribed pills 1 hour before or 2 hours after the injection" c. "be sure to take the pramlintide with food so you don't upset your stomach" d. "make sure you take your pramlintide immediately after you eat so you don't experience a low blood sugar"
b. "take your prescribed pills 1 hour before or 2 hours after the injection"
A client with type 1 diabetes mellitus calls the nurse to report recurrent episodes of hypoglycemia with exercising. Which statement by the client indicates and adequate understanding of the peak action of NPH insulin and exercise a. "I should not exercise since I am taking insulin" b. "the best time for me to exercise is after breakfast" c. "the best time for me to exercise is mid to late afternoon" d. "NPH is a basal insulin, so I should exercise in the evening"
b. "the best time for me to exercise is after breakfast"
The nurse is performing an assessment on a client with pheochromocytoma. Which assessment data would indicate a potential complication associated with this disorder? a. a urinary output of 50 mL b. a coagulant time of 5 minutes c. a heart rate that is 90 beats/minute and irregular d. a blood urea nitrogen level of 20 mg
c. a heart rate that is 90 beats/minute and irregular
The nurse provides instructions to a client newly diagnosed with type 1 diabetes mellitus. The nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis when the client makes which statement? a. "I will stop taking my insulin if I'm too sick" b. "I will decrease my insulin dose during times of illness" c. "I will adjust my insulin dose according to the level of glucose in my urine" d. "I will notify my health care provider (HCP) if my blood glucose level is higher than 250 mg"
d. "I will notify my health care provider (HCP) if my blood glucose level is higher than 250 mg"
An external insulin pump is prescribed for a client with diabetes mellitus. When the client asks the nurse about the functioning pump, the nurse bases the response on which information about the pump? a. it is timed to release programmed doses of either short-duration or NPH insulin into the blood stream at specific intervals b. it continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels c. it is surgically attached to the pancreas and infuses regular insulin into the pancreas. This releases insulin into the bloodstream d. it administers a small continuous dose of short duration insulin subcutaneously. The client can self-administer an additional bolus dose from the pump before each meal
d. it administers a small continuous dose of short duration insulin subcutaneously. The client can self-administer an additional bolus dose from the pump before each meal
