Prep U unit 11
A nursing student asks the instructor why the pituitary gland is called the "master gland." What is the best response by the instructor?
"It regulates the function of other endocrine glands."
A client with diabetes mellitus must learn how to self-administer insulin. The physician has ordered 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?
"Rotate injection sites within the same anatomic region, not among different regions."
A client is scheduled for a Roux-en-Y bariatric surgery. When teaching the client about the surgical procedure, which statement will the nurse use?
"The stomach is stapled to create a very small pouch and part of the small intestine is rerouted."
A nurse caring for adults with obesity recognizes that obesity is classified based on BMI. Which BMI does the nurse recognize as Class II obesity?
35 kg/m2
After a thyroidectomy, the client develops a carpopedal spasm while the nurse is taking a BP reading on the left arm. Which action by the nurse is appropriate?
Administer IV calcium gluconate as ordered.
A nurse researcher is reviewing data obtained from a developing nation on nutrition and metabolism issues facing that country. What is the nurse's understanding of the "double-burden" many developing nations now face?
Both undernutrition and obesity
Which of the following precautions would be most appropriate when caring for a client being treated with radioactive iodine (RAI) for a thyroid tumor?
Handle body fluids carefully
Which type of jaundice seen in adults is the result of increased destruction of red blood cells?
Hemolytic
A nurse is teaching a client with adrenal insufficiency about corticosteroids. Which statement by the client indicates a need for additional teaching?
"I may stop taking this medication when I feel better."
After teaching a client with type 1 diabetes who is scheduled to undergo an islet cell transplant, which client statement indicates successful teaching?
"I might need insulin later on but probably not as much or as often."
A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says:
"I should become involved in a weight loss program."
Which statement best indicates that a client understands how to administer his own insulin injections?
"I wrote down the steps in case I forget what to do
A nurse cares for a client who is obese. The health care provider prescribes orlistat in an effort to help client lose weight, along with diet and exercise. When teaching the client about this medication, what will the nurse include?
"It binds with enzymes to help prevent digestion of fat."
A client with type 1 diabetes has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, the nurse is most accurate in stating:
"It tells us about your sugar control for the last 3 months."
A nurse is reviewing the medical records of several patients and their risk for health problems. The nurse determines that the patient with which body mass index (BMI) would have the lowest risk?
23
A client weighs 215 lbs and is 5' 8" tall. The nurse calculate this client's body mass index (BMI) as what?
32.7
The nurse is aware that the best time of day for the total large corticosteroid dose is between:
7:00 AM and 8:00 AM
The nurse is assisting the physician with a procedure to remove ascitic fluid from a client with cirrhosis. What procedure does the nurse ensure the client understands will be performed?
Abdominal paracentesis
When administering insulin to a client with type 1 diabetes, which of the following would be most important for the nurse to keep in mind?
Accuracy of the dosage
Evaluation of an adult client reveals oversecretion of growth hormone. Which of the following would the nurse expect to find?
Bulging forehead
A nurse cares for a client with obesity who is also diagnosed with depression. Which medication does the nurse expect the health care provider will prescribe, which also aids in weight loss?
Bupropion
Surgical removal of the thyroid gland is the treatment of choice for thyroid cancer. During the immediate postoperative period, the nurse knows to evaluate serum levels of __________ to assess for a serious and primary postoperative complication of thyroidectomy
Calcium
The nurse is working with a client who has difficulty controlling her blood sugar. The overweight client does not adhere to a low-calorie diet and forgets to take medications and check her blood glucose level. The client's glycohemoglobin is 8.5%. When establishing a goal for the client, the nurse first
Collaborates with the client to establish an agreed-upon goal
A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and symptoms?
Coma, anxiety, confusion, headache, and cool, moist skin
A nurse is providing discharge instruction for a client who is postoperative bariatric surgery. What statement will the nurse include when providing teaching aimed at decreasing the risk of gastric ulcers?
"Avoid taking non-steroidal anti-inflammatory drugs."
A nurse cares for an obese client taking phentermine for weight loss. What client teaching will the nurse include when discussing precautions about the medication?
"Do not drink alcohol while taking this medication."
A nurse is educating a client who has been treated for hepatic encephalopathy about dietary restrictions to prevent ammonia accumulation. What should the nurse include in the dietary teaching?
The amount of protein is not restricted in the diet
A nurse is caring for a client with cirrhosis. The nurse assesses the client at noon and discovers that the client is difficult to arouse and has an elevated serum ammonia level. The nurse should suspect which situation?
The client's hepatic function is decreasing.
Ammonia, the major etiologic factor in the development of encephalopathy, inhibits neurotransmission. Increased levels of ammonia are damaging to the body. The largest source of ammonia is from:
The digestion of dietary and blood proteins
A client is scheduled for a diagnostic test to measure blood hormone levels. The nurse expects that this test will determine which of the following?
The functioning of endocrine glands
Which group of clients should not receive potassium iodide?
Those who are allergic to seafood
An important message for any nurse to communicate is that drug-induced hepatitis is a major cause of acute liver failure. The medication that is the leading cause is:
acetaminophen
A female client with hyperglycemia who weighs 210 lb (95 kg) tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that the client has large hands and a hoarse voice. Which disorder would the nurse suspect as a possible cause of the client's hyperglycemia?
acromegaly
A nurse is reviewing the laboratory order for a client suspected of having an endocrine disorder. The lab slip includes obtaining cortisol levels. What is being tested?
adrenal function
A client with advanced cirrhosis has a prothrombin time (PT) of 15 seconds, compared with a control time of 11 seconds. The nurse expects to administer:
phytonadione (Mephyton).
Which of the following glands is considered the master gland?
pituitary
A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder?
pituitary disorder
A nurse is teaching a client recovering from diabetic ketoacidosis (DKA) about management of "sick days." The client asks the nurse why it is important to monitor the urine for ketones. Which statement is the nurse's best response?
Ketones accumulate in the blood and urine when fat breaks down in the absence of insulin. Ketones signal an insulin deficiency that will cause the body to start breaking down stored fat for energy."
The nurse is administering medications to a client that has elevated ammonia due to cirrhosis of the liver. What medication will the nurse give to detoxify ammonium and to act as an osmotic agent?
Lactulose
Which of the following would the nurse expect the physician to order for a client with hypothyroidism?
Levothyroxine sodium
A physician orders spironolactone (Aldactone), 50 mg by mouth four times daily, for a client with fluid retention caused by cirrhosis. Which finding indicates that the drug is producing a therapeutic effect?
Loss of 2.2 lb (1 kg) in 24 hours
The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order?
Reflects the amount of glucose stored in hemoglobin over past several months.
A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously?
Regular
A nurse researcher investigates why clients with obesity who have lost weight often regain the weight. The nurse looks at the relationship of leptin and its role in weight gain. What does the nurse determine is true regarding leptin and weight gain? Select all that apply.
Drops in leptin level increases hunger. Leptin signals satiety in the hypothalamus.
A nurse researcher studies the pathophysiology and etiology of obesity. What does the nurse discover is true regarding the "thrifty gene" theory of obesity?
Over time, we have become efficient in food storage and deposition of fat stores.
A nurse cares for a client who has secondary obesity. Which condition is the most likely to result in secondary obesity?
Cushing's syndrome
A nurse cares for a client who is post op bariatric surgery and the nurse offers the client a sugar-free beverage. What is the primary purpose of offering a sugar-free beverage?
These are less likely to cause dumping syndrome.
A client presents with a huge lower jaw, bulging forehead, large hands and feet, and frequent headaches. What could be causing this client's symptoms?
hyperpituitarism
The mode of transmission of hepatitis A virus (HAV) includes which of the following?
fecal-oral
Which type of deficiency results in macrocytic anemia?
folic acid
A nurse cares for a client with obesity. Which medication that the client takes may be contributing to the client's obesity?
gabapentin
A client tells the nurse that she has been working hard for the past 3 months to control her type 2 diabetes with diet and exercise. To determine the effectiveness of the client's efforts, the nurse should check:
glycosylated hemoglobin level.
The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?
has weight gain of 5 lb
Cardiac effects of hyperthyroidism include
palpitations
A nurse prepares community teaching on healthy lifestyle modifications to a group of older adults. When discussing obesity rates of older adults in comparison with the rest of the population, what will the nurse include?
"Older adults have a slightly higher prevalence of obesity in comparison to the general population."
A client with obesity is prescribed orlistat for weight loss. The client asks the nurse, "I understand the medication prevents digestion of fat, but what happens if I eat fat?" What is the nurse's best response?
"The fat is passed in your stools."
A client with diabetes mellitus has a blood glucose level of 40 mg/dL. Which rapidly absorbed carbohydrate would be most effective?
1/2 cup fruit juice or regular soft drink
A public health nurse plans teaching on the neurological morbid diseases and conditions associated with obesity. Which diseases or conditions will the nurse identify in the teaching? Select all that apply.
Alzheimer disease Anxiety Depression Stroke
Which would be included in the teaching plan for a client diagnosed with diabetes mellitus?
An elevated blood glucose concentration contributes to complications of diabetes, such as diminished vision.
A nurse is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse expects to find:
deposits of adipose tissue in the trunk and dorsocervical area.
A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The medical reports indicate a history of type 1 diabetes. The nurse suspects the client's symptoms to be those of diabetic ketoacidosis (DKA). Which action will help the nurse confirm the diagnosis?
Assess the client's breath odor
The nurse is caring for a patient with cirrhosis of the liver and observes that the patient is having hand-flapping tremors. What does the nurse document this finding as?
Asterixis
Which of the following would the nurse expect to assess in a client with hepatic encephalopathy?
Asterixis
Which clinical characteristic is associated with type 2 diabetes (previously referred to as non-insulin-dependent diabetes mellitus)?
Blood glucose can be controlled through diet and exercise
A patient is suspected of having a pheochromocytoma and is having diagnostic tests done in the hospital. What symptoms does the nurse recognize as most significant for a patient with this disorder?
Blood pressure varying between 120/86 and 240/130 mm Hg
A nurse explains the role of the ovaries. Which hormones would be included in that discussion?
estrogen and progesterone
What test should the nurse prepare the client for that will locate stones that have collected in the common bile duct?
Endoscopic retrograde cholangiopancreatography (ERCP)
A client is being seen in the clinic to receive the results of the lab work to determine thyroid levels. The nurse observes the client's eyes appear to be bulging, and there is swelling around the eyes. What does the nurse know that the correct documentation of this finding is?
Exophthalmos
Which of the following would the nurse expect to find in a client with severe hyperthyroidism?
Exophthalmos
A nurse should perform which intervention for a client with Cushing's syndrome?
Explain that the client's physical changes are a result of excessive corticosteroids.
A client is having chronic pain from arthritis. What type of hormone is released in response to the stress of this pain that suppresses inflammation and helps the body withstand stress?
Glucocorticoids
Which feature(s) indicates a carpopedal spasm in a client with hypoparathyroidism?
Hand flexing inward
A client has a blockage of the passage of bile from a stone in the common bile duct. What type of jaundice does the nurse suspect this client has?
Obstructive jaundice
Which glands regulate calcium and phosphorous metabolism?
Parathyroid
The nurse is reviewing the history and physical examination of a client diagnosed with hyperthyroidism. Which of the following would the nurse expect to find?
Reports of increased appetite
The nurse is providing care to a patient with gross ascites who is maintaining a position of comfort in the high semi-Fowler's position. What is the nurse's priority assessment of this patient?
Respiratory assessment related to increased thoracic pressure
In what location would the nurse palpate for the liver?
Right upper quadrant
Which of the following medications used for obesity improves cardiovascular disease risk factors in obese patients with metabolic syndrome?
Rimonabant (Acomplia)
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?
Tracheostomy set
A client with type 2 diabetes asks the nurse why he can't have a pancreatic transplant. Which of the following would the nurse include as a possible reason?
Underlying problem of insulin resistance
The nurse is caring for a patient with ascites due to cirrhosis of the liver. What position does the nurse understand will activate the renin-angiotensin aldosterone and sympathetic nervous system and decrease responsiveness to diuretic therapy?
Upright
Which of the following is the most effective strategy to prevent hepatitis B infection?
Vaccine
Which medication is used to decrease portal pressure, halting bleeding of esophageal varices?
Vasopressin
A nurse is instructing a client with newly diagnosed hypoparathyroidism about the regimen used to treat this disorder. The nurse should state that the physician probably will order daily supplements of calcium and:
Vitamin D
A nurse cares for clients with obesity. Which clinical measurements use quantified measurements to diagnose obesity? Select all that apply.
Waist circumference BMI Weight
Which condition indicates an overdose of lactulose?
Watery diarrhea
A client is being evaluated for hypothyroidism. During assessment, the nurse should stay alert for:
decreased body temperature and cold intolerance.
A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply.
Hypothermia Hypotension Hypoventilation
A client with type 2 diabetes has recently been prescribed acarbose, and the nurse is explaining how to take this medication. The teaching is determined to be effective based on which statement by the client?
I will take this medication in the morning, with my first bite of breakfast."
Which of the following dietary guidelines should be followed following bariatric surgery? Select all that apply.
Include two protein snacks per day. Eat slowly. Eat three meals per day.
When performing a physical examination on a client with cirrhosis, a nurse notices that the client's abdomen is enlarged. Which of the following interventions should the nurse consider?
Measure abdominal girth according to a set routine.
While assessing a client with hypoparathyroidism, the nurse taps the client's facial nerve and observes twitching of the mouth and tightening of the jaw. The nurse would document this finding as which of the following?
Positive Chvostek's sign
Which clinical characteristic is associated with type 1 diabetes (previously referred to as insulin-dependent diabetes mellitus)?
Presence of islet cell antibodies
Which information should be included in the teaching plan for a client receiving glargine, which is "peakless" basal insulin?
Do not mix with other insulins.
Which intervention is the most critical for a client with myxedema coma?
Maintaining a patent airway
The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which of the following would the nurse include as associated with type 2 diabetes?
Insufficient insulin production
A nurse explains to a client with thyroid disease that the thyroid gland normally produces:
T3, thyroxine (T4), and calcitonin.
A client with obesity is prescribed lorcaserin for weight loss. The client reports dry mouth. What is the nurse's best response?
"This is an expected finding with this medication."
A nurse cares for a client with a BMI of 36 kg/m2 and nonalcoholic fatty liver disease. The client asks the nurse if he is a candidate for bariatric surgery. How should the nurse respond to the client?
"Yes, your BMI and chronic condition meets the criteria for bariatric surgery."
A student accepted into a nursing program must begin receiving the hepatitis B series of injections. The student asks when the next two injections should be administered. What is the best response by the instructor?
"You must have the second one in 1 month and the third in 6 months."
A nurse cares for a female client of childbearing age who will undergo bariatric surgery. When teaching the client about precautions after surgery, which teaching will the nurse include that is specific to this population?
"You should avoid pregnancy for at least 18 months after surgery."
Alcohol, which is toxic to the liver, is a common cause of hepatic disorders. As part of health teaching, the nurse advises a group of women that the amount of daily alcohol use should generally be limited to the equivalent of:
1 drink
An agitated, confused client arrives in the emergency department. The client's history includes type 1 diabetes, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting:
10 to 15 g of a simple carbohydrate.
The nurse is administering lispro insulin. Based on the onset of action, how long before breakfast should the nurse administer the injection?
10 to 15 minutes
A patient who is 6 months' pregnant was evaluated for gestational diabetes mellitus. The doctor considered prescribing insulin based on the serum glucose result of:
138 mg/dL, 2 hours postprandial.
What statement best describes a client with severe or extreme obesity?
A BMI >40 kg/m2
A nurse cares for a client who is 5 feet 11 inches tall and weighs 225 pounds. What statement describes the client's BMI?
Class I obesity
A client sustained a head injury when falling off of a ladder. While in the hospital, the client begins voiding large amounts of clear urine and states he is very thirsty. The client states that he feels weak, and he has had an 8-lb weight loss since admission. What should the client be tested for?
Diabetes insipidus (DI)
A client with severe hypoparathyroidism is experiencing tetany. What medication, prescribed by the physician for emergency use, will the nurse administer to correct the deficit?
Calcium gluconate
Accidental removal of one or both parathyroid glands can occur during a thyroidectomy. Which of the following is used to treat tetany?
Calcium gluconate
A nurse is caring for a client with cholelithiasis. Which sign indicates obstructive jaundice?
Clay-colored stools
Which diagnostic test is done to determine a suspected pituitary tumor?
Computed tomography
A patient has been diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following manifestations would be expected in this patient?
Concentrated urine
What interventions can the nurse encourage the client with diabetes insipidus to do in order to control thirst and compensate for urine loss?
Consume adequate amounts of fluid.
The primary function of the thyroid gland includes which of the following?
Control of cellular metabolic activity
A health care provider suspects that a thyroid nodule may be malignant. The nurse knows to prepare information for the patient based on the usual test that will be ordered to establish a diagnosis. What is that test?
Fine-needle biopsy of the thyroid gland
A nurse is preparing a presentation for a local community group about hepatitis. Which of the following would the nurse include?
Hepatitis C increases a person's risk for liver cancer.
An older adult patient is in the hospital being treated for sepsis related to a urinary tract infection. The patient has started to have an altered sense of awareness, profound dehydration, and hypotension. What does the nurse suspect the patient is experiencing?
Hyperglycemic hyperosmolar syndrome
What does a positive Chvostek's sign indicate?
Hypocalcemia
Which combination of adverse effects should a nurse monitor for when administering IV insulin to a client with diabetic ketoacidosis?
Hypokalemia and hypoglycemia
The client who is managing diabetes through diet and insulin control asks the nurse why exercise is important. Which is the best response by the nurse to support adding exercise to the daily routine?
Increases ability for glucose to get into the cell and lowers blood sugar
A nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare with absorption at other sites?
Insulin is absorbed more rapidly at abdominal injection sites than at other sites.
The nurse assesses a patient who has an obvious goiter. What type of deficiency does the nurse recognize is most likely the cause of this?
Iodine
A nurse works in a community clinic that treats clients with obesity. The nurse understands that obesity is considered a disease based on what characteristics? Select all that apply
It impairs normal body function It has characteristic signs and symptoms It causes morbidity
A nurse cares for a client who is post op bariatric surgery. Which position will the nurse place the client in order to best promote comfort?
Low Fowler's
A client with cirrhosis has a massive hemorrhage from esophageal varices. Balloon tamponade is used temporarily to control hemorrhage and stabilize the client. In planning care, the nurse gives the highest priority to which goal?
Maintaining the airway
A nurse is planning care for a client who will be arriving to the unit postoperatively from bariatric surgery. In an effort to decrease the risk of venous thromboembolism (VTE), which health care provider orders does the nurse anticipate?
Mechanical compression and prophylactic anticoagulation
A client with diabetes is receiving an oral anti diabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?
Metformin
A client with obesity is diagnosed with type 2 diabetes. In order to promote weight loss in the client and aid in glucose management, which medication will the nurse anticipate the health care provider ordering?
Metformin
A client with pheochromocytoma is scheduled for an adrenalectomy. Which of the following would the nurse perform preoperatively?
Monitor blood pressure (BP) frequently.
Hypocalcemia is associated with which of the following manifestations?
Muscle twitching
A nurse is educating a community group about coronary artery disease. One member asks about how to avoid coronary artery disease. Which of the following items are considered modifiable risk factors for coronary artery disease? Choose all that apply.
Obesity Tobacco use Hyperlipidemia
A nurse is preparing a presentation for a local community group addressing the influences on health care delivery. Which of the following would the nurse include in presentation when describing disease patterns?
Obesity along with conditions associated with it has become a major health concern.
A client is actively bleeding from esophageal varices. Which medication would the nurse most expect to be administered to this client?
Octreotide
A client with obesity reports pain in the joints. Which musculoskeletal condition related to obesity does the nurse suspect the client has?
Osteoarthritis
A client has a dysfunction in one of his glands that is causing a decrease in the level of calcium in the blood. What gland should be evaluated for dysfunction?
Parathyroid gland
Which is the most common cause of esophageal varices?
Portal hypertension
The nurse is caring for a client with hypoparathyroidism. When the nurse taps the client's facial nerve, the client's mouth twitches and the jaw tightens. What is this response documented as related to the low calcium levels?
Positive Chvostek's sign
Which liver function study is used to show the size of the liver and hepatic blood flow and obstruction?
Radioisotope liver scan
Lispro (Humalog) is an example of which type of insulin?
Rapid-acting
A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide?
Reduce fluid accumulation and venous pressure.
A client is suspected of having cirrhosis of the liver. What diagnostic procedure will the nurse prepare the client for in order to obtain a confirmed diagnosis?
a liver biopsy
Clients with chronic liver dysfunction have problems with insufficient vitamin intake. Which may occur as a result of vitamin C deficiency?
Scurvy
Patients with hyperthyroidism are characteristically:
Sensitive to heat
The diabetic client asks the nurse why shoes and socks are removed at each office visit. Which assessment finding is most significant in determining the protocol for inspection of feet?
Sensory neuropathy
For a client with hyperthyroidism, treatment is most likely to include:
a thyroid hormone antagonist.
A client with diabetes mellitus has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m., the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most probable cause of these signs and symptoms?
Serum glucose level of 52 mg/dl
Gynecomastia is a common side effect of which of the following diuretics?
Spironolactone
A nurse cares for a client who is post op from bariatric surgery. Once able, the nurse encourages oral intake for what primary purpose?
Stimulate GI peristalsis
Parathyroid hormone (PTH) has which effects on the kidney?
Stimulation of calcium reabsorption and phosphate excretion
Which category of oral antidiabetic agents exerts the primary action by directly stimulating the pancreas to secrete insulin?
Sulfonylureas
A client with status asthmaticus requires endotracheal intubation and mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated with hypoglycemia?
Sweating, tremors, and tachycardia
Which laboratory test results should a nurse expect to find in a client diagnosed with Hashimoto's thyroiditis?
T4, 2 µg/dl; T3, 35 ng/dl; TSH 45 mIU/ml
A nurse is caring for a female client with hypothyroidism. The client is extremely upset about her altered physical appearance. She doesn't want to take her medication because she doesn't believe it's doing any good. What should the nurse do?
Tell the client she'll soon experience improvement in her looks as the medication corrects her hormone deficiency.
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?
Temperature of 102ºF
The nurse observes that a client's medical report indicates that the client has Cushing syndrome. During inspection, the nurse notes that the client's BMI is 31, waist circumference is 40 inches, and localized fat pads exist around the neck and upper part of the back. Which of the following must the nurse keep in mind while planning the client's care?
The nurse recognizes that the client's obesity may be specifically related to the endocrine disorder. The nurse performs a thorough nutritional assessment.
A client is admitted for suspected GI disease. Assessment data reveal muscle wasting, a decrease in chest and axillary hair, and increased bleeding tendency. The nurse suspects the client has:
cirrhosis.
A nurse epidemiologist examines the overall decrease in life expectancy related to obesity. What finding is true?
There is a 6-20 year decrease in overall life expectancy for those with obesity.
A nurse practitioner treating a patient who is diagnosed with hepatitis A should provide health care information. Which of the following statements are correct for this disorder? Select all that apply.
There is a 70% chance that jaundice will occur. Transmission of the virus is possible with oral-anal contact during sex. Typically there is a spontaneous recovery.
A nurse examines the socioeconomic impact of obesity among Americans. Which statements does the nurse understand is true? Select all that apply.
Those with less education are impacted at a greater prevalence of disease. Those with less income are impacted at a greater prevalence of disease.
A nurse is assessing a client with hyperthyroidism. What findings should the nurse expect?
Weight loss, nervousness, and tachycardia
A nurse is caring for a client with obesity and diabetes after abdominal surgery. What is the client at increased risk for?
Wound dehiscence
When assessing a client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, the nurse is most likely to detect:
a blood pressure of 176/88 mm Hg.
Which type of cell secretes glucagon and promotes gluconeogenesis?
alpha
A client has just been diagnosed with hepatitis A. On assessment, the nurse expects to note:
anorexia, nausea, and vomiting.
During a class on exercise for clients with diabetes mellitus, a client asks the nurse educator how often to exercise. To meet the goals of planned exercise, the nurse educator should advise the client to exercise:
at least three times per week.
Trousseau sign is elicited
by occluding the blood flow to the arm for 3 minutes with the use of a blood pressure cuff.
When assessing a client with cirrhosis of the liver, which of the following stool characteristics is the client likely to report?
clay-colored or white
Which diagnostic test is done to determine suspected pituitary tumor?
computed tomography scan
A preoperative client scheduled to have an open cholecystectomy says to the nurse, "The doctor said that after surgery, I will have a tube in my nose that goes into my stomach. Why do I need that?" What most common reason for a client having a nasogastric tube in place after abdominal surgery should the nurse include in a response?
decompression
During a client education session, the nurse describes the mechanism of hormone level maintenance. What causes most hormones to be secreted?
decrease in hormonal levels
A middle-aged female client complains of anxiety, insomnia, weight loss, the inability to concentrate, and eyes feeling "gritty." Thyroid function tests reveal the following: thyroid-stimulating hormone (TSH) 0.02 U/ml, thyroxine 20 g/dl, and triiodothyronine 253 ng/dl. A 6-hour radioactive iodine uptake test showed a diffuse uptake of 85%. Based on these assessment findings, the nurse should suspect:
graves disease
The nurse identifies which type of jaundice in an adult experiencing a transfusion reaction?
hemolytic
A client with diabetes mellitus is receiving an oral antidiabetic agent. The nurse observes for which symptom when caring for this client?
hypoglycemia
A client with diabetes mellitus is receiving an oral antidiabetic agent. When caring for this client, the nurse should observe for signs of:
hypoglycemia
Clients diagnosed with esophageal varices are at risk for hemorrhagic shock. Which is a sign of potential hypovolemia?
hypotension
A nurse educator is providing an in-service to a group of nurses working on a medical floor that specializes in liver disorders. What is an important education topic regarding ingestion of medications?
metabolism of medications
Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome?
observe color of stool
A client has been recently diagnosed with type 2 diabetes, and reports continued weight loss despite increased hunger and food consumption. This condition is called:
polyphagia
A nurse in the surgical ICU just received a client from recovery following a Whipple procedure. Which nursing diagnoses should the nurse consider when caring for this acutely ill client? Select all that apply.
potential for infection acute pain and discomfort alterations in respiratory function
Which symptoms will a nurse observe most commonly in clients with pancreatitis?
severe, radiating abdominal pain
A client with acute liver failure exhibits confusion, a declining level of consciousness, and slowed respirations. The nurse finds him very difficult to arouse. The diagnostic information which best explains the client's behavior is:
subnormal serum glucose and elevated serum ammonia levels.
A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?
tetany
A client with severe and chronic liver disease is showing manifestations related to inadequate vitamin intake and metabolism. He reports difficulty driving at night because he cannot see well. Which of the following vitamins is most likely deficient for this client?
vitamin A
A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery?
vitamin K
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:
15 to 20 g of a fast-acting carbohydrate such as orange juice.
A nurse working in a bariatric clinic assesses various clients with obesity. Which clients will the nurse recognize as meeting the selection criteria for bariatric surgery? Select all that apply.
48-year-old female with BMI 36 k/m2 and uncontrolled type 2 diabetes. 34-year-old male with BMI 30 k/m2 and metabolic syndrome with hypertension.
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?
6.5%
A health care provider prescribes short-acting insulin for a patient, instructing the patient to take the insulin 20 to 30 minutes before a meal. The nurse explains to the patient that Humulin-R taken at 6:30 AM will reach peak effectiveness by:
8:30 AM
Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex?
Cushing syndrome
The actions of parathyroid hormone (PTH) are increased in the presence of which vitamin?
D
What initial measure can the nurse implement to reduce risk of injury for a client with liver disease?
Pad the side rails on the bed
Which is an age-related change of the hepatobiliary system?
Decreased blood flow
A client comes to the emergency department complaining of pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder?
Degenerative joint disease
Which of the following factors may contribute to rapid and shallow respirations in a postoperative client? Select all that apply.
Pain Constricting dressings Abdominal distention Obesity
A nurse caring for clients with obesity understands these clients are at increased risk for developing pressure ulcers. What does the nurse recognize increases the client's risk for developing pressure ulcers? Select all that apply.
Increased adipose tissue decreases the supply of blood, oxygen, and nutrients to peripheral tissue. Skin folds are associated with more moisture and friction.
Which are correct statements about the relationship between the hypothalamus and the pituitary gland? Select all that apply.
Many endocrine glands respond to stimulation from the pituitary gland, which is connected by a stalk to the hypothalamus in the brain. Under the influence of the hypothalamus, the lobes of the pituitary gland secrete various hormones.
A client with type 1 diabetes is experiencing polyphagia. The nurse knows to assess for which additional clinical manifestation(s) associated with this classic symptom?
Muscle wasting and tissue loss
A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication?
Myxedema coma
The nurse is preparing to administer intermediate-acting insulin to a patient with diabetes. Which insulin will the nurse administer?
NPH
A patient who is diagnosed with type 1 diabetes would be expected to:
Need exogenous insulin.
A client with acromegaly is admitted to the hospital with complaints of partial blindness that began suddenly. What does the nurse suspect is occurring with this client?
Pressure on the optic nerve
Total parental nutrition (TPN) should be used cautiously in clients with pancreatitis because such clients:
cannot tolerate high-glucose concentration.
A nurse is providing education to a client who is newly diagnosed with diabetes mellitus. What are classic symptoms associated with diabetes?
increased thirst, hunger, and urination
The most common type of goiter is caused by lack of which of the following?
iodine
Although not designated as endocrine glands, several organs within the body secrete hormones as part of their normal function. Which organ secretes hormones involved in increasing blood pressure and volume and maturation of red blood cells?
kidneys
A nurse is caring for a client with a BMI of 35 kg/m2 who is wanting to lose weight. What is the initial recommendation the nurse will expect from the client's health care provider?
lifestyle modifications
A client with a lengthy history of alcohol addiction is being seen for jaundice. The appearance of jaundice would most likely indicate:
liver disorder.
A client is undergoing diagnostics for an alteration in thyroid function. What physiologic function is affected by altered thyroid function?
metabolic rate
