Quiz 7: Adrenal & Pituitary and Thyroid and Parathyroid

62. Which are causes of secondary adrenal insufficiency? SATA A. Tuberculosis B. Pituitary Tumors C. Adrenalectomy D. Hypophysectomy E. Metastatic Cancer F. High-dose pituitary radiation

B. Pituitary Tumors D. Hypophysectomy F. High-dose pituitary radiation

What is the hallmark of thyroid cancer? A. aggressive tumors b. Elevated serum thyroglobulin level c. Metastasis to other organs d. Invasion of blood vessels

bb. Elevated serum thyroglobulin level

The nurse is providing instructions to a patient who is taking the antithyroid medication propylthiouracil (PTU). The nurse instructs the patient to notify the health care provider immediately if which sign/symptom occurs? A. Weight gain b. Dark-colored urine c. Cold intolerance d. Headache

b b. Dark-colored urine

Production of which hormones causes lower levels of calcium? A. Calcitonin b. PTH c. T4 d. TSH

aA. Calcitonin

365. Fludrocortisone (Florinef) is prescribed for a client with adrenal insufficiency. Which reponses to the medication should the nurse teach the client to report? SATA 1. Edema 2. Rapid weight gain 3. Fatigue in the afternoon 4. Unpredictable changes in mood 5. Increased frequency of urination

1. Edema 2. Rapid weight gain

337. A nurse is assessing a client with a diagnosis of diabetes insipidus. For which signs indicative of diabetes insipidus should the nurse assess the client? SATA 1. Excessive thirst 2. Increased blood glucose 3. Dry mucous membranes 4. Increased blood pressure 5. Decreased serum osmolarity 6. Decreased urine specific gravity

1. Excessive thirst 3. Dry mucous membranes 6. Decreased urine specific gravity 1. As excessive fluid is lost through urination, dehydration triggers the thirst response. 2. Diabetes insipidus is not a disorder of glucose metabolism; blood glucose levels are not affected. Diabetes mellitus affects cglucose metabolism 3. As excessive fluid is lost through urination, dehydration occurs, resulting in dry mucous membranes and poor skin turgot. 4. Loss of fluid may decrease the blood pressure because fluid is lost from the intravascular compartment. 5. As fluid is lost from the intravascular compartment, serum osmolarity increases, not decreases. 6. Because water is not being reabsorbed urine is dilute, resulting in a low specific gravity (less than 1.005)

415. A nurse is assessing a client for possible laryngeal nerve injury following a thryoidectomy. Which action should the nurse implement on an hourly basis? 1. ask the client to speak 2. instruct the client to swallow 3. have the client hum a familiar tune 4. swab the clients throat to test the gag reflex

1. ask the client to speak

28. Which actions should the nurse assign to the experienced LPN for the care of a patient with hypothyroidism? SATA 1. assessing and recording the rate and depth of respirations 2. auscultating lung sounds every 4 hours 3. creating an individualized nursing care plan for the patient 4. administering sedation medications every 6 hours 5. Checking BP, HR, respirations every 4 hours 6. reminding the patient to report any episodes of chest pain or discomfort

1. assessing and recording the rate and depth of respirations 2. auscultating lung sounds every 4 hours 5. Checking BP, HR, respirations every 4 hours 6. reminding the patient to report any episodes of chest pain or discomfort

420. When taking the blood pressure of a client who had a thyroidectomy, the nurse identifies that the client is pale and has spasms of the hand. The nurse notifies the HCP. Which should the nurse expect the HCP to prescribe? 1. calcium 2. magnesium 3. bicarbonate 4. potassium chloride

1. calcium

15. The nurse is providing care for a patient who underwent thyroidectomy 2 days ago. Which lab value requires close monitoring by the nurse? 1. calcium level 2. sodium level 3. potassium level 4. WBC count

1. calcium level

20. When providing care for a patient with addison disease, the nurse should be alert for which lab value change? 1. decreased hematocrit 2. increased sodium level 3. decreased potassium level 4. decreased calcium level

1. decreased hematocrit

412. Which clinical findings should have the nurse expect when assessing a client with hyperthyroidism? SATA 1. diarrhea 2. listlessness 3. weight loss 4. bradycardia 5. decreased appetite

1. diarrhea 3. weight loss

423. A nurse is assessing a client with a diagnosis of hypothyroidism. Which clinical manifestations should the nurse expect when assessing the client? SATA 1. dry skin 2. brittle hair 3. weight loss 4. resting tremors 5. heat intolerance

1. dry skin 2. brittle hair

427. A nurse is caring for a client who is admitted to the hospital with the diagnosis of primary hyperparathyroidism. Which action should be included in the client's plan of care? 1. ensuring a large fluid intake 2. providing a high-calcium diet 3. instituting seizure precautions 4. encouraging complete bed rest

1. ensuring a large fluid intake

12. A patient with adrenal insufficiency is to be discharged and will take prednisone 10 mg orally each day. Which instruction would the nurse be sure to teach the patient? 1. excessive weight gain or swelling should be reported to the HCP 2. changing positions rapidly may cause hypotension and dizziness 3. a diet with food low in sodium may be beneficial to prevent side effects 4. signs of hypoglycemia may occur while taking this drug

1. excessive weight gain or swelling should be reported to the HCP

13. The nurse is caring for a patient who has just undergone hypophysectomy for hyperpituitarism. Which postoperative finding requires immediate intervention? 1. presence of glucose in the nasal drainage 2. presence of nasal packing in the nares 3. urine output of 40-50 mL/hr 4. patient reports of thirst

1. presence of glucose in the nasal drainage

4. Which changes in vital signs would the nurse instruct the UAP to report immediately for a patient with hyperthyroidism? 1. rapid heart rate 2. decreased systolic blood pressure 3. increased respiratory rate 4. decreased oral temperature

1. rapid heart rate

7. A patient is hospitalized with adrenocorticol insufficiency. Which nursing activity should the nurse delegate to UAP? 1. reminding the patient to change position slowly 2. assessing the patient for muscle weakness 3. teaching the patient how to collect a 24-hour sample 4. revising the patient's nursing care plan

1. reminding the patient to change position slowly

9. The nurse is preparing to discharge a patient with hyperpituitarism caused by a benign pituitary tumor, who is prescribed the drug bromocriptine. Which key points would the nurse teach the patient about this drug? SATA 1. take the drug with a meal or snack to avoid GI symptoms 2. side effects of bromocriptine include severe fatigue and reflux after meals 3. seek medical care if you experience chest pain or dizziness when taking this drug 4. if the drug causes headaches, you can take over-the-counter acetaminophen 5. treatment starts with a high dose, which is gradually lowered 6. the purpose of bromocriptine is to shrink your pituitary to normal size

1. take the drug with a meal or snack to avoid GI symptoms 3. seek medical care if you experience chest pain or dizziness when taking this drug 4. if the drug causes headaches, you can take over-the-counter acetaminophen 6. the purpose of bromocriptine is to shrink your pituitary to normal size

29. The nurse is caring for a patient with hyperthyroidism who had a partial thyroidectomy yesterday. Which change in assessment would the nurse report to the HCP immediately? 1. temperature elevation to 101.2F 2. HR increases from 64 to 76 3. respiratory rate decreases from 26 to 16 4. pulse ox reading of 92%

1. temperature elevation to 101.2F

25. Which action prescribed by the HCP for the patient with Addison disease should the nurse delegate to the experienced UAP? SATA 1. weigh the patient every morning 2. obtain finger stick glucose before each meal and at bedtime 3. check vital signs every 2 hours 4. monitor for cardiac dysrhythmias 5. administer oral prednisone every morning 6. record intake and output

1. weigh the patient every morning 2. obtain finger stick glucose before each meal and at bedtime 3. check vital signs every 2 hours 6. record intake and output

5. For a patient with hyperthyroidism, which task should the nurse delegate to an experienced UAP? 1. instructing the patient to report any occurrence of palpitations, dyspnea, vertigo, or chest pain 2. monitoring the apical pulse, BP, and temperature every 4 hours 3. drawing blood to measure levels of TSH, triiodothyronine, and thyroxine 4. teaching the patient about side effects of the drug proplythiouracil

2. monitoring the apical pulse, BP, and temperature every 4 hours

410. Propylthiouracil (PTU) is prescribed for a client diagnosed with with hyperthyroidism. The client asks the nurse, "why do I have to take this medication if I am going to get the atomic cocktail?" The nurse explains that the medication is being prescribed because it decreases the: 1. vascularity of the thyroid gland 2. production of thyroid hormones 3. need for thyroid iodine supplements 4. amount of already formed thyroid hormones

2. production of thyroid hormones

341. A client who has acromegaly and insulin-dependent diabetes undergoes a hypophysectomy. the nurse identifies that further teaching about the hypophysectomy is necessary when the client state, "I know I will: 1. be sterile for the rest of my life." 2. require larger doses of insulin than I did preoperatively." 3. have to take cortisone or a similar drug for the rest of my life." 4. have to take thyroxine or a similar medication of the rest of my life."

2. require larger doses of insulin than I did preoperatively."

27. The patient with hyperparathyroidism who is not a candidate for surgery asks the nurse why she is receiving IV normal saline and IV furosemide. What is the nurse's best response? 1. "this therapy is to protect your kidney function" 2. "You are receiving these therapies to prevent edema formation" 3. "diuretic and hydration therapies are used to reduce your serum calcium; 4. "these therapies may help to improve your candidacy for surgery"

3. "diuretic and hydration therapies are used to reduce your serum calcium;

24. The nurse is caring for the following patients with endocrine disorders. Which patient must the nurse assess first? 1. 21-year-old patient with DI whose urine output overnight was 2000mL 2. 55-year-old with SIADH who is demanding that the UAP refills his water pitcher 3. 65-year-old with addison disease whose morning potassium level is 6.2 4. 48-year-old with cushing disease with a weight gain of 1.5 lbs over the past 4 days

3. 65-year-old with addison disease whose morning potassium level is 6.2

346. A nurse is caring for a newly admitted client with a diagnosis of Cushing syndrome. Why should the nurse monitor this client for clinical indicators of diabetes mellitus? 1. Cortical hormones stimulate rapid weight loss. 2. Tissue catabolism results in a negative nitrogen balance. 3. Glucocorticoids accelerate the process of gluconeogenesis. 4. Excessive adrenocorticotropic hormone secretion damage pancreatic tissue.

3. Glucocorticoids accelerate the process of gluconeogenesis.

338. A client is admitted with a head injury. The nurse identifies that the client's urinary retention catheter is draining large amounts of clear, colorless urine. What does the nurse identify as the most likely cause? 1. Increased serum glucose 2. Deficient renal perfusion 3. Inadequate ADH secretion 4.Excess amounts of IV fluid

3. Inadequate ADH secretion

361. A client is admitted to a medical unit with a diagnosis of Addison disease. The client is emaciated and reports muscular weakness and fatigue. Which disturbed body process does the nurse determine is the root cause of the client's clinical manifestations? 1. Fluid balance 2. Electrolyte levels 3. Protein anabolism 4. Masculinizing hormones

3. Protein anabolism

363. A health care provider writes orders addressing the needs of a client with Addison disease. Which outcome does the nurse conclude is the main focus of treatment for the client? 1. Decrease in eosinophils 2. Increase in lymphoid tissue 3. Restoration of electrolyte balance 4. Improvement of carbohydrate metabolism

3. Restoration of electrolyte balance

422. On the first postoperative day following a thyroidectomy, a client tolerates a full-fluid diet. This is changed to a soft diet on the second postoperative day. The client reports having a sore throat when swallowing. What should the nurse do first? 1. reorder the full fluid diet 2. notify HCP 3. administer analgesics as prescribed before meals 4. provide saline gargles to moisten the mucus membranes

3. administer analgesics as prescribed before meals

344. A nurse is caring for two clients newly diagnosed with diabetes. One client has type 1 diabetes and the other client has type 2 diabetes. The nurse determines that the main difference between newly diagnosed type 1 and type 2 diabetes is that in type 1 diabetes: 1. onset of the disease is slow 2. excessive weight is a contributing factor. 3. complications are not present at the time of diagnosis 4. treatment involves diet, exercise and oral medications.

3. complications are not present at the time of diagnosis

3. A patient is admitted to the medical unit with possible graves disease (hyperthyroidism). Which assessment finding by the nurse supports this diagnosis? 1. periorbital edema 2. bradycardia 3. exophthalmos 4. hoarse voice

3. exophthalmos

414. A client is scheduled to have a thyroidectomy. Which medication does the nurse anticipate the health care provider will prescribe to decrease the size and vascularity of the thyroid gland before surgery? 1. vasopressin (pitressin) 2. propylthiouracil (PTU) 3. potassium iodine (SSKI) 4. levothyroxine (synthroid)

3. potassium iodine (SSKI)

32. Which prescribed order for a patient with DI would the nurse be sure to question? 1. monitor and record accurate intake and output 2.. check urine specific gravity 3. restrict fluids for 6 hours 4. weigh the patient every morning

3. restrict fluids for 6 hours

411. A nurse is caring for a client with an underactive thyroid gland. Which responses should the nurse expect the client to exhibit as a result of decreased levels of triiodothyronine (T3) and T4? SATA 1. irritability 2. tachycardia 3. weight gain 4. cold intolerance 5. profuse diaphoresis

3. weight gain 4. cold intolerance

358. A health care provider orders a low-sodium, high-potassium diet for a client with Cushing syndrome. Which explanation should the nurse provide as to why the client needs to follow this diet? 1. "The use of salt probably contributed to the disease." 2. "Excess weight will be gained if sodium is not limited." 3. " The loss of excess sodium and potassium in the urine requires less renal stimulation." 4. "Excessive aldosterone and cortisone cause retention of sodium and loss of potassium."

4. "Excessive aldosterone and cortisone cause retention of sodium and loss of potassium."

16. A 24-year-old patient with DI makes all of these statements when the nurse is preparing the patient for discharge from the hospital. Which statement indicates to the nurse that the patient needs additional teaching? 1. "i will drink fluids equal to the amount of my urine output" 2. "i will weigh myself every day using the same scale" 3. "i will wear my medical alert bracelet at all times" 4. "i will gradually wean myself off the vasopressin"

4. "i will gradually wean myself off the vasopressin"

353. A client is scheduled for bilateral adrenalectomy. Before surgery, steroids are administered to the client. What does the nurse determine is the reason for the steroids? 1. Foster accumulation of glycogen in the liver 2. Increase the inflammatory action to promote scar formation 3. Facilitate urinary excretion of salt and water following surgery. 4. Compensate for sudden lack of these hormones

4. Compensate for sudden lack of these hormones

8. Assessment findings for a patient with cushing disease include all of the following. For which finding would the nurse notify the HCP immediately? 1. purple striae present on abdomen and thighs 2. weight gain of 1 lbs since the previous day 3. dependent edema rated as +1 in the ankles and calves 4. Crackles bilaterally in the lower lobes of the lungs

4. Crackles bilaterally in the lower lobes of the lungs

364. A nurse is caring for a client with Addison disease. Which information should the nurse include in a teaching plan as a means of encouraging this client to modify dietary intake? 1. Increased amounts of potassium are needed to replace renal losses. 2. Increased protein is needed to heal the adrenal tissue and thus cure the disease. 3. Supplemental vitamins are needed to supply energy and assist in regaining the lost weight. 4. Extra salt is needed to replace the amount being lost due to lack of sufficient aldosterone to conserve sodium.

4. Extra salt is needed to replace the amount being lost due to lack of sufficient aldosterone to conserve sodium.

22. The nurse is instructing a senior nursing student on the techniques for palpation of the thyroid gland. What precaution would the nurse be sure to include when instructing the student about thyroid palpation? 1. always stand to the side of the patient 2. instruct the patient not to swallow 3. palpate using one hand and then the other 4. always palpate the thyroid gland gently

4. always palpate the thyroid gland gently

428. A client's lab values demonstrate an increased serum calcium level, and further diagnostic tests reveal hyperparathyroidism. For which clinical manifestations should the nurse assess the client? SATA 1. muscle tremors 2. abdominal cramps 3. increased peristalsis 4. cardiac dysrhythmias 5. hypoactive bowel sounds

4. cardiac dysrhythmias 5. hypoactive bowel sounds

10. A patient with pheocromocytoma underwent surgery to remove his adrenal glands. Which nursing intervention should the nurse delegate to an UAP? 1. revising the nursing care plan to include strategies to provide a calm and restful environment postoperatively 2. instructing the patient to avoid smoking and drinking caffeine-containing beverages 3. assessing the patient's skin and MM for signs of adequate hydration 4. monitoring lying and standing BP every 4 hours with a cuff placed on the same arm

4. monitoring lying and standing BP every 4 hours with a cuff placed on the same arm

Discharge planning for a patient with chronic hypoparathyroidism includes which instructions? (SATA) a. Prescribed medications must be taken for the patient entire life b. Eat foods low in vitamin D and high in phosphorous c. Eat foods high in calcium, but low in phosphorous d. After several weeks, medications can be discontinued e. Kidney stones are no longer a risk to the patient

ac a. Prescribed medications must be taken for the patient entire life c. Eat foods high in calcium, but low in phosphorous

424. Levothyroxine (Synthroid) 0.125 mg by mouth is prescribed for a client with hypothyroidism. The only tablets available contain 25mcg per tablet. How many tablets should the nurse administer? (round to whole number)

5 tablets

347. A nurse is caring for a client with a diagnosis of Cushing syndrome. What is the most common cause of Cushing syndrome that the nurse should consider before assessing this client for physiological responses? 1. Pituitary hypoplasia. 2. Hyperplasia of the adrenal cortex. 3. Deprivation of adrenocortical hormones. 4. Insufficient adrenocorticotropic hormone production

2. Hyperplasia of the adrenal cortex.

356. A client who has just had an adrenalectomy is told about a death in the family and becomes very upset. What concern about the client requires the nurse to notify the health care provider? 1. Analgesia and mild sedation will be required to ensure rest. 2. Steroid replacement medication therapy will have to be reduced. 3. The is a decreased ability to handle stress despite steroid therapy. 4. Feelings of exhaustion and lethargy may result from the emotional stress.

3. The is a decreased ability to handle stress despite steroid therapy.

426. For which client response should the nurse monitor when assessing for complications of hyperparathyroidism? 1. tetany 2. seizures 3. bone pain 4. graves disease

3. bone pain

The UAP is providing a bath for a patient with hyperparathyroidism. What essential teaching must the nurse provide to the UAP? A. Handle the patient carefully and use a lift sheet for repositioning

A

28. Which medication is used to treat diabetes insipidus (DI)? A. Desmopressin Acetate B. Lithium C. Vasopressin D. Demeclocycline

A. Desmopressin Acetate

A patient with exophthalmos from hyperthyroidism reports dry eyes, especially in the morning. The nurse teaches the patient to perform which intervention to help correct this problem? A. Wear sunglasses at all times when outside in the bright sun b. Use cool compresses to the eye four times a day c. Tape the eyes closed with nonallergenic tape d. There is nothing that can be done to relieve this problem.

Cc. Tape the eyes closed with nonallergenic tape

The nurse is caring for a young female patient with papillary carcinoma of the thyroid gland. Which treatment is most likely to be prescribed to this patient? D. Thyroidectomy

D

Which laboratory result is consistent with a diagnosis of hyperthyroidism? A. Decreased serum T3 and T4 levels b. Elevated serum TRH level c. Decreased radioactive iodine uptake d. Increased serum T3 and T4

D d. Increased serum T3 and T4

The nurse assessing a patient palpates enlargement of the thyroid gland, along with noticeable swelling of the neck. How does the nurse interpret this finding? A. globe lag b. Myxedema c. Exophthalmos d. Goiter

d d. Goiter

The nurse is performing a physical examination of a patient's thyroid gland. Precautions are takin in performing the correct technique because palpation can result in which occurrence? A. Damage to the esophagus causing gastric reflux b. Obstruction of the carotid arteries causing a stroke c. Pressure on the trachea and laryngeal nerve causing hoarseness d. Exacerbation of symptoms by releasing additional thyroid hormone

dd. Exacerbation of symptoms by releasing additional thyroid hormone

Laboratory findings of elevated T3 and T4, decreased TSH, and high thyrotropin receptor antibody titer indicate which condition? A. Multinodular goiter b. Hyperthyroidism related to overmedication c. Pituitary tumor suppressing TSH d. Graves' disease

dd. Graves' disease

What is the most common cause of death from myxedema coma? A myocardial infarction b. Acute kidney failure c. High serum level of iodide d. Respiratory failure

dd. Respiratory failure

44. When diagnosed with Cushing's syndrome, the patient's manifestations are most likely related to an excess production of which hormone? A. Insulin from the pancreas B. ADH from posterior pituitary gland C. PRL from anterior pituitary gland D. Cortisol from the adrenal cortex

D. Cortisol from the adrenal cortex

42. Which diuretic is ordered by the health care provider to treat hyperaldosteronism> A. Furosemide B. Ethacrynic Acid C. Bumetanide D. Spironolactone

D. Spironolactone

52. The nurse is teaching a patient being discharged after bilateral adrenalectomy. What medication information does the nurse emphasize in the teaching plan? A. The dosage of steroid replacement drugs will be consistent throughout the patient's lifetime. B. The steroid drugs should be taken in the evening so as not to interfere with sleep. C. The patient should take the drugs on an empty stomach. D. The patient should learn how to give himself an intramuscular injection of hydrocortisone.

D. The patient should learn how to give himself an intramuscular injection of hydrocortisone.

417. A nurse is caring for a newly admitted client with a diagnosis of graves disease. In preparing a teaching plan, the nurse anticipates which diet will be ordered for this client? 1. high-calorie 2. low-sodium 3. high-roughage 4. mechanical-soft

1. high-calorie

352. What should the nurse do when collecting a 24-hour urine specimen? 1. Check to verify if a preservative is needed. 2. Weigh the client before starting the collection. 3. Discard the last voided specimen of the 24-hour specimen. 4. Assess the client's intake and output for the previous 24-hours.

1. Check to verify if a preservative is needed.

348. A nurse is assessing a female client with Cushing syndrome. Which clinical findings can the nurse expect to identify? SATA 1. Hirsutism 2. Menorrhagia 3. Buffalo hump 4. dependent edema 5. Migraine headaches

1. Hirsutism 3. Buffalo hump

355. A nurse is caring for a client who had an adrenalectomy. For what clinical response should the nurse monitor while steroid therapy is being regulated? 1. Hypotension 2. Hyperglycemia 3. Sodium retention 4. Potassium excretion

1. Hypotension

349. Which clinical indicators can the nurse expect when assessing a client with Cushing syndrome? SATA 1. Liability of mood 2. Slow wound healing 3. A decrease in the growth of hair 4. Ectomorphism with a moon face 5. An increased resistance to bruising

1. Liability of mood 2. Slow wound healing

409. A nurse is caring for a client who is experiencing an underproduction of thyroxine . Which client response is associated with an underproduction of thyroxine (T4)? 1. Myxedema 2. Acromegaly 3. Graves Disease 4. Cushing Disease

1. Myxedema

343. Which information from the client's history does the nurse identify as a risk factor for developing osteoporosis? 1. Receives long-term steroid therapy 2. Has a history of hypopatathyroidism 3. Engages in strenuous physical activity 4. Consumes high doses of the hormone estrogen

1. Receives long-term steroid therapy

360. A nurse is monitoring for clinical manifestations of infection in a client with a diagnosis of Addison disease. Which body mechanism related to infectious processes does the nurse conclude is impaired as a result of this disease? 1. Stress response 2. Electrolyte balance 3. Metabolic processes 4. Respiratory function

1. Stress response

345. A client is scheduled for an adrenalectomy. Which nursing intervention should the nurse anticipate will be ordered for this client? 1. administer IV steroids. 2. Provide a high-protein diet. 3. Collect a 24-hour urine specimen. 4. Withhold all medications for 48 hours.

1. administer IV steroids.

31. The nurse is orienting a new graduate RN who is providing care for a postoperative patient after a thyroidectomy. The new graduate assess the patient and notes laryngeal stridor with a pulse ox measure of 89%. What is the priority action for the nurse and new grad? 1. immediately notify RRT 2. apply oxygen by face mask 3. prepare to suction the patient 4. assess for numbness and tingling around the mouth

1. immediately notify RRT

18. The nurse is caring for a patient with SIADH. Which patient care actions should the nurse delegate to the experienced UAP? SATA 1. monitor and record strict intake and output 2. provide the patient with ice chips when requested 3. remind the patient about his fluid restriction 4. weigh the patient every morning using the same scale 5. report weight gain of 2.2 lbs to the nurse 6. provide mouth care allowing the patent to swallow and rinses

1. monitor and record strict intake and output 3. remind the patient about his fluid restriction 4. weigh the patient every morning using the same scale 5. report weight gain of 2.2 lbs to the nurse

21. A female patient is admitted with a diagnosis of primary hypofunction of the adrenal glands. Which nursing assessment finding supports this diagnosis? 1. patchy areas of pigment loss over the face 2. decreased muscle strength 3. greatly increased urine output 4. scalp alopecia

1. patchy areas of pigment loss over the face

26. The LPN who is assigned to care for a patient with Cushing disease asks the RN why the patient has bruising and petechiae across her abdomen. What is the RN's best response? 1. "patients with Cushing disease often have bleeding disorders" 2. "patients with Cushing disease have very fragile capillaries" 3. "please ask the patient if she slipped and fell during the night" 4. "thin and delicate skin can result in development of bruising"

2. "patients with Cushing disease have very fragile capillaries"

351. A client is diagnosed with Cushing syndrome. Which clinical manifestation does the nurse expect to increase in a client with Cushing syndrome? 1. Urine output 2. Glucose level 3. Serum potassium 4. Immune response

2. Glucose level

350. A nurse is caring for a male client with a diagnosis of Cushing syndrome. Which clinical manifestations does the nurse expect to identify? SATA 1. Polyuria 2. Obese trunk 3. Hypotension 4. Sleep disturbance. 5. Thin arms and legs

2. Obese trunk 4. Sleep disturbance. 5. Thin arms and legs

362. Which is an important intervention that the nurse should include in the plan of care that is specific for a client with Addison disease? 1. Encouraging the client to exercise 2. Protecting the client from exertion 3. Restricting the client's fluid intake 4. Monitoring the client for hypokalemia

2. Protecting the client from exertion

416. A client with hyperthyroidism asks the nurse about the tests that will be ordered. Which diagnostic test should the nurse include in a discussion with this client? 1. T4 and x-ray films 2. TSH assay and T3 3. thyroglobulin level and Po2 4. Protein-bound iodine and SMA

2. TSH assay and T3

340. After surgical clipping of a cerebral aneurysm, the client develops the syndrome of inappropriate secretion of antidiuretic hormone. For which manifestations of excessive levels of antidiuretic hormone (ADH) should the nurse assess the client? SATA 1. Polyuria 2. Weight gain 3. Hypotension 4. Hyponatremia 5. Decreased specific gravity

2. Weight gain 4. Hyponatremia

1. The nurse is caring for a 25-year-old patient admitted to the acute care unit with an extra strong thirst, and dilute, excessive straw-colored urine output (up to 15L/day). What does the nurse suspect? 1. type 2 diabetes 2. diabetes insipidus (DI) 3. cushing disease 4. addison disease

2. diabetes insipidus (DI)

30. The nurse admits a new patient whose assessment reveals prominent brow ridge, large hands and feet, and large lips and nose. Which pituitary hormone does the nurse suspect is elevated? 1. thyroid-stimulating hormone 2. growth hormone 3. adrenocorticotropic hormone 4. vasopressin anti-diuretic hormone

2. growth hormone

33. The nurse assesses a newly admitted patient with a diagnosis of hyperthyroidism (see figure, pg. 127). How would the nurse best document the findings in the patient? 1. bilateral exophthalmos 2. large visible goiter 3. myxedema 4. moon face

2. large visible goiter

6. As the shift begins, the nurse is assigned to care for the following patients. Which patient should the nurse assess first? 1. a 38-year-old patient with graves disease and a HR of 94 2. a 63-year-old patient with type 2 diabetes and fingerstick glucose level of 137 mg/dL 3. a 58-year-old patient with hypothyroidism and a HR of 48 4. a 49-year-old patient with cushing disease and dependent edema rated as +1

3. a 58-year-old patient with hypothyroidism and a HR of 48

354. A nurse is caring for a client who is scheduled for a bilateral adrenalectomy. Which medication should the nurse expect to be prescribed for this client on the day of surgery and in the immediate postoperative period? 1. Methimazole (Tapazole) 2. Pituitary Extract (Pituitrin) 3. Regular insulin (Novolin R) 4. Hydrocortisone succinate (Solu-Cortef)

4. Hydrocortisone succinate (Solu-Cortef)

357. A client with a tentative diagnosis of Cushing syndrome has an increased cortisol level. For what response should the nurse assess this client? 1. Hypovolemia 2. Hyperkalemia 3. Hypoglycemia 4. Hypernatremia

4. Hypernatremia

342. A nurse is caring for a client who had a hypophysectomy. For which complication specific to this surgery should the nurse assess the client for early clinical manifestations? 1. Urinary retention 2. Respiratory distress 3. Bleeding at the suture line 4. Increased intracranial pressure

4. Increased intracranial pressure

359. A nurse is caring for a client with the clinical manifestation of hypotension associated with a diagnosis of Addison disease. Which hormone is impaired in its production as a result of this disease? 1. Estrogens 2. Androgens 3. Glucocorticoids 4. Mineralcorticoids

4. Mineralcorticoids

339. After a head injury a client develops a deficiency of antidiuretic hormone (ADH). What should the nurse consider about the response to secretion of ADH before assessing this client? 1. Serum osmolarity increases 2. Urine concentration decreases 3. Glomerular filtration dcreases 4. Tubular reabsorption of water increases

4. Tubular reabsorption of water increases

418. A nurse in the PACU is caring for a client who just had a thyroidectomy. For which client response is it most important for the nurse to monitor? 1. urinary retention 2. signs of restlessness 3. decreased BP 4. signs of respiratory obstruction

4. signs of respiratory obstruction

18. After a hypophysectomy, focused assessment and monitoring by the nurse include which factors? SATA A. Cognition and mental status B. Maintaining bedrest with bedside commode C. Possible leakage of cerebrospinal fluid (CSF) D. 24-hour intake of fluids and urine output E. 24-hour diet recall F. Headaches or visual disturbances

A. Cognition and mental status C. Possible leakage of cerebrospinal fluid (CSF) D. 24-hour intake of fluids and urine output F. Headaches or visual disturbances

36. In addition to IV fluids, a patient with SIADH is on a fluid restriction as low as 500 to 600 mL/24 hours. Which serum and urine results demonstrate effectiveness of this treatment? SATA A. Decreased urine specific gravity B. Decreased Serum sodium C. Increased urine output D. Increased urine specific gravity E. Increased serum sodium F. Decreased urine output

A. Decreased urine specific gravity D. Increased urine specific gravity

60. The nurse should instruct a patient who is taking hydrocortisone to report which symptoms to the health care provider for possible dosage adjustment? SATA A. Rapid weight gain B. Changes in blood pressure C. Fluid Retention D. Gastrointestinal irritation E. Urinary incontinence F. Round face

A. Rapid weight gain C. Fluid Retention F. Round face

12. Which statements about the etiology of hypopituitarism are correct? SATA A. Dysfunction can result from radiation treatment to the head or brain. B. Dysfunction can result from infection or a brain tumor. C. Infarction following systemic shock can result in hypopituitarism. D. Severe malnutrition and body fat depletion can depress pituitary glad function. E. There is always an underlying cause of hypopituitarism. F. Pituitary tumors are the most common cause of hypopituitarism.

A. Dysfunction can result from radiation treatment to the head or brain. B. Dysfunction can result from infection or a brain tumor. C. Infarction following systemic shock can result in hypopituitarism. D. Severe malnutrition and body fat depletion can depress pituitary glad function.

26. A hospitalized patient is prescribed desmoprssin acetate metered dose spray as a replacement hormone for vasopressin (ADH) which is an indication for another dose? SATA A. Excessive urination B. Specific gravity of 1.003 C. Dark, concentrated urine D. Edema in the legs E. Decreased urination F. Shortness of breath

A. Excessive urination B. Specific gravity of 1.003

6. A 30-year-old female patient is prescribed bromocriptine. Which information does the nurse teach the patient? SATA A. Get up slowly from a lying position. B. Take medication on an empty stomach. C. Take daily for purposes of raising GH levels to reduce symptoms of acromegaly. D. Begin therapy with a maintenance level dose. E. Report watery nasal discharge to the health care provider immediately. F. If pregnancy occurs the drug is stopped immediately.

A. Get up slowly from a lying position. E. Report watery nasal discharge to the health care provider immediately. F. If pregnancy occurs the drug is stopped immediately.

56. Which interventions are necessary for a patient with acute adrenal insufficiency (addisonian crisis)? SATA A. IV infusion of normal saline B. IV infusion of 3% saline C. Hourly glucose monitoring D. Insulin administration E. IV potassium therapy F. Administer IV hydrocortisone sodium

A. IV infusion of normal saline C. Hourly glucose monitoring D. Insulin administration F. Administer IV hydrocortisone sodium

32. In SIADH, as result of water retention from excess ADH, which laboratory values does the nurse expect to find? SATA A. Increased sodium in urine B. Elevated serum sodium level C. Increased urine specific gravity D. Decreased serum osmolarity E. Decreased urine specific gravity F. Decreased serum sodium level

A. Increased sodium in urine C. Increased urine specific gravity D. Decreased serum osmolarity F. Decreased serum sodium level

48. The female patient with Cushing's syndrome expresses concern about the changes in her general appearance. What is the expected outcome for this patient? A. To verbalize an understanding that that treatment will reverse many of the problems B. To ventilate about the frustration of these lifelong physical changes. C. To verbalize ways to cope with the changes such as joining a support group or changing style of dress D. To achieve a personal desired level of sexual functioning

A. To verbalize an understanding that that treatment will reverse many of the problems

64. Which patient care tasks could the nurse delegate to the unlicensed assistive personnel (UAP) in the care of a patient with acute adrenal insufficiency that is immobile? SATA A. Turn the patient every 1-2 hours B. Apply skin lubricants. C. Assess lung sounds every 2-4 hours D. Provide mouth care every 2 hours while awake. E. Record accurate intake and output F. Teach the patient to cough and deep breathe.

A. Turn the patient every 1-2 hours B. Apply skin lubricants. D. Provide mouth care every 2 hours while awake. E. Record accurate intake and output

Which factor is a main assessment finding that signifies hypothyroidism? A. Irritability b. Cold intolerance c. Diarrhea d. Fatigue

B b. Cold intolerance

50. Which drug decreases cortisol production? A. Mitotane B. Aminoglutethimide C. Cyproheptadine D. Hydrocortisone

B. Aminoglutethimide

14. A female patient has been prescribed hormone replacement therapy. What does the nurse instruct the patient to do regarding this therapy? SATA A. Report any recurrence of symptoms, such as decreased libido, between injections. B. Avoid smoking because of the increased risk for cardiovascular complications. C. Treat leg pain, especially in the calves, with gentle muscle stretching. D. Take measures to reduce risk for hypertension and thrombosis. E. Monitor blood pressure at least weekly for potential hypotension. F. Regular follow-up visits with the health care provider are essential.

B. Avoid smoking because of the increased risk for cardiovascular complications. D. Take measures to reduce risk for hypertension and thrombosis. F. Regular follow-up visits with the health care provider are essential.

20. While caring for a postoperative patient following a transsphenoidal hypophysectomy, the nurse observes nasal drainage that is clear with yellow color at the edge. This "halo sign" is indicative of which condition? A. Worsening neurologic status of the patient B. Drainage of CSF from the patient's nose C. Onset of postoperative infection D. An expected finding following this surgery.

B. Drainage of CSF from the patient's nose

40. Which intervention applies to a patient with pheochromocyoma? A. Assist to sit in a chair for blood pressure monitoring. B. Instruct not to smoke, drink coffee, or change positions suddenly. C. Encourage to maintain an active exercise schedule including activity such as running. D. Encourage one glass of red wine nightly to promote rest.

B. Instruct not to smoke, drink coffee, or change positions suddenly.

38. A patient in the emergency department is diagnosed with possible pheochromocytoma. What is priority nursing intervention for this patient? A. Monitor the patient's intake and output and urine specific gravity. B. Monitor blood pressure for severe hypertension C. Monitor blood pressure for severe hypotension D. Administer medication to increase cardiac output.

B. Monitor blood pressure for severe hypertension

8. The nurse is performing an assessment of an adult patient with new onset acromegaly. What does the nurse expect to find? A. Extremely long arms and legs B. Thickened lips C. Changes in menses with infertility D. Rough, extremely dry skin

B. Thickened lips

30. Which statement about the pathophysiology of SIADH is correct? A. ADH secretion is inhibited in the presence of low plasma osmolality. B. Water retention results in dilutional hyponatrmia and expanded extracellular fluid (ECF) volume. C. The glomerulus is unable to increase its filtration rate to reduce the excess plasma volume. D. Renin and aldosterone are released and help decrease the loss of urinary sodium.

B. Water retention results in dilutional hyponatrmia and expanded extracellular fluid (ECF) volume.

34. Which type of IV fluid does the nurse use to treat a patient with SIADH when the serum sodium level is very low? A. D5 1/2 normal saline B. D5W C. 3% normal saline D. normal saline

C. 3% normal saline

2. A malfunctioning posterior pituitary gland can result in which disorders? SATA A. Hypothyroidism B. Altered Sexual Function C. Diabetes Insipidus D. Growth retardation E. Syndrome of inappropriate antidiuretic hormone (SIADH) F. Virilization

C. Diabetes insipidus E. Syndrome of inappropriate antidiuretic hormone (SIADH)

22. The action of antidiuretic hormone (ADH) influences normal kidney funtion by stimulation which mechanism? A. Glomerulus to control the filtration rate B. Proximal nephron tubules to reabsorb water C. Distal Nephron Tubules and collecting ducts to reabsorb water D. Constriction of glomerular capillaries to prevent loss of protein in urine.

C. Distal Nephron Tubules and collecting ducts to reabsorb water

The clinical manifestations of hyperthyroidism are known as which condition? A thyrotoxicosis. B. Euthyroid function c. Graves' disease d. Hypermetabolism

a A thyrotoxicosis.

Which statements about hyperthyroidism are accurate? (SATA) a. It is most commonly caused by Graves' disease b. It can be caused by overuse of thyroid replacement medication c. It occurs more often in med between the ages of 20-40 d. Weight gain is a common manifestation e. Serum T3 and T4 results will be elevated

a, b, e a. It is most commonly caused by Graves' disease b. It can be caused by overuse of thyroid replacement medication e. Serum T3 and T4 results will be elevated

A patient who has been diagnosed with Graves' disease is going to receive radioactive iodine (RAI) in the oral form of 131I. what does the nurse teach the patient about how this drug works? A. It destroys the hormones T3 and T4 b. It destroys the tissue that produces thyroid hormones c. IT blocks thyroid hormone production d. It prevents T4 from being converted to T3

b b. It destroys the tissue that produces thyroid hormones

After a visit to the health care provider's office, a patient is diagnosed with general thyroid enlargement and elevate thyroid hormone level. Which condition do these findings indicate? A. Hyperthyroidism and goiter b. Hypothyroidism and goiter c. Nodules on the parathyroid gland d. Thyroid or parathyroid cancer

a. Hyperthyroidism and goiter

Which assessment finings of hypocalcemia? (SATA) a. Numbness and tingling around the mouth b. muscle cramping c. Bone fractures d. fever e. Tachycardia

ab a. Numbness and tingling around the mouth b. muscle cramping

Which disorders/conditions can cause hyperparathyroidism? (SATA) a. Chronic kidney diseases b. Neck trauma c. Thyroidectomy d. Vitamin D deficiency e. Parathyroidectomy

abd a. Chronic kidney diseases b. Neck trauma d. Vitamin D deficiency

Which statement about thyroiditis are accurate? (SATA) a. It is an inflammation of the thyroid gland b. Hashimoto's disease is the most common type c. IT always resolves with antibiotic therapy d. There are three types: acute, subacute, and chronic. E. The patient must take thyroid hormones

abde a. It is an inflammation of the thyroid gland b. Hashimoto's disease is the most common type d. There are three types: acute, subacute, and chronic. E. The patient must take thyroid hormones

Which statements about hypothyroidism are accurate? (SATA) a. It occurs more often in women b. It can be caused by iodine deficiency c. Weight loss is a common manifestation d. It can be caused by autoimmune thyroid destruction e. Myxedema coma is a rare but serious complication

abde a. It occurs more often in women b. It can be caused by iodine deficiency d. It can be caused by autoimmune thyroid destruction e. Myxedema coma is a rare but serious complication

Which signs and symptoms are assessment findings indicative of thyroid storm? (SATA) a. Abdominal pain and nausea b. Hypothermia c. Elevated temperature d. Tachycardia e. Elevated systolic blood pressure f. Bradycardia

acde a. Abdominal pain and nausea c. Elevated temperature d. Tachycardia e. Elevated systolic blood pressure

Which are preoperative instructions for a patient having thyroid surgery? (SATA) a. Teach postoperative restrictions such as no coughing and deep-breathing exercises to prevent strain on the suture line b. Teach the moving and turning technique of manually supporting the head and avoiding neck extension to minimize strain on the suture line c. Inform the patient that hoarseness for a few days after surgery is usually the result of a breathing tube (endotracheal tube) used during surgery d. Humidification of air may be helpful to promote expectoration of secretions. Suctioning may also be used e. Clarify any questions regarding placement of incision, complications, and postoperative care f. A supine position and lying flat will be maintained postoperatively to avoid strain on suture line

bcde b. Teach the moving and turning technique of manually supporting the head and avoiding neck extension to minimize strain on the suture line c. Inform the patient that hoarseness for a few days after surgery is usually the result of a breathing tube (endotracheal tube) used during surgery d. Humidification of air may be helpful to promote expectoration of secretions. Suctioning may also be used e. Clarify any questions regarding placement of incision, complications, and postoperative care

Which foods will the nurse instruct a patient with hypoparathyroidism to avoid? (SATA) a. Canned vegetables b. yogurt c. Fresh fruit d. Red meat e. Milk f. Processed cheese

bef b. yogurt e. Milk f. Processed cheese

The nurse is assessing a patient after thyroid surgery and discovers harsh, high-pitched respiratory sounds. What is the nurses best first action? A. Administer oxygen at 5L via nasal cannula b. Administer IV calcium chloride c. Notify the Rapid Response Team D. Suction the patient for oral secretions

cc. Notify the Rapid Response Team

In addition to regulation of calcium levels, PTH and calcitonin regulate the circulating blood levels of which substance? A. Potassium b. Sodium c. Phosphate d. Chloride

cc. Phosphate

Which statement best describes globe lag in a patient with hyperthyroidism? A. Abnormal protrusion of the eyes b. Upper eyelid fails to descend when the patient gazes downward c. Upper eyelid pulls back faster than the eyeball when the patient gazes upward d. Inability of both eyes to focus on an object simultaneously

cc. Upper eyelid pulls back faster than the eyeball when the patient gazes upward

After a thyroidectomy, a patient reports tingling around the mouth and muscle twitching. Which complication do these assessment findings indicate to the nurse? A. hemorrhage b. Respiratory distress c. Thyroid storm d. hypocalcemia

dd. hypocalcemia

419. A nurse is caring for a client who just had a thyroidectomy. For which client response should the nurse assess the client when concerned about an accidental removal of the parathyroid glands during surgery? 1. tetany 2. myxedema 3. hypovolemic shock 4. adrenocortical stimulation

1. tetany

425. A client is diagnosed with hyperthyroidism and is experiencing exophthalmia. Which measures should the nurse include when teaching this client how to manage the discomfort associated with exophthalmia? SATA 1. use tinted glasses 2. use warm, moist compresses 3. elevate the head of bed 45 degress 4. tape eyelids shut at night if they do not close 5. apply a petroleum-based jelly along the lower lid

1. use tinted glasses 3. elevate the head of bed 45 degress 4. tape eyelids shut at night if they do not close

19. The nurse is preparing a care plan for a patient with cushings disease. Which abnormal lab values would the nurse expect? SATA 1. increased serum calcium 2. increased salivary cortisol 3. increased urinary cortisol 4. decreased serum glucose 5. decreased sodium level 6. increased serum cortisol level

2. increased salivary cortisol 3. increased urinary cortisol 6. increased serum cortisol level

413. A nurse is caring for a client after radioactive iodine is administered for graves disease. What information about the client's condition after this therapy should the nurse consider when providing care? 1. not radioactive and can be handled as any other individual 2. highly radioactive and should be isolated as mush as possible 3. mildly radioactive but should be treated with routine safety precautions 4. not radioactive but may still transmit some dangerous radiations and must be treated with precautions

3. mildly radioactive but should be treated with routine safety precautions

421. What should a nurse do immediately when a client returns from the PACU following a subtotal thyroidectomy? 1. inspect the incision 2. instruct the client not to speak 3. place a tracheostomy set at the bedside 4. place in the supine position for 24 hours

3. place a tracheostomy set at the bedside

46. Which are physical findings of Cushing's Disease? SATA A. "Moon-faced" appearance. B. Decreased amount of body hair C. Truncal obesity D. Coarse facial features E. Thin, easily damaged skin F. Extremity muscle wasting

A. "Moon-faced" appearance. C. Truncal obesity E. Thin, easily damaged skin F. Extremity muscle wasting

16. A patient is recovering from a transsphenoidal hypophysectomy. What postoperative nursing interventions apply to this patient? SATA A. Encouraging the patient to perform deep-breathing exercises B. Vigorous coughing and deep-breathing exercises. C. Instructing on the use of a soft-bristled toothbrush for brushing the teeth. D. Strict monitoring of fluid balance E. Hourly neurologic checks for first 24 hours F. Instructing the patient to alert the nurse regarding postnasal drip

A. Encouraging the patient to perform deep-breathing exercises D. Strict monitoring of fluid balance E. Hourly neurologic checks for first 24 hours F. Instructing the patient to alert the nurse regarding postnasal drip

24. Which statements about diabetes insipidus (DI) are accurate? SATA A. It is caused by ADH deficiency. B. It is characterized by a decrease in urination. C. Urine output of greater than 4 L/24 hours is the first diagnostic indication. D. The water loss increases plasma osmolarity E. Nephrogenic DI can be caused by lithium (Eskalith). F. Increased thirst is a mechanism of the body to attempt maintaining fluid balance.

A. It is caused by ADH deficiency. C. Urine output of greater than 4 L/24 hours is the first diagnostic indication. D. The water loss increases plasma osmolarity F. Increased thirst is a mechanism of the body to attempt maintaining fluid balance.

10. In caring for a patient with hyperpituitarism, which symptoms does the nurse expect the patient to report? SATA A. Joint pain B. Visual disturbances C. Changes in menstruation D. Increased libido E. Headache F. Fatigue

A. Joint pain B. Visual disturbances C. Changes in menstruation E. Headache F. Fatigue

54. Which patient is at risk for developing secondary adrenal insufficiency? A. patient who suddenly stops taking high-dose steroid therapy B. Patient who tapers the dosages of steroid therapy C. Patient deficient in ADH D. Patient with an adrenal tumor causing excessive secretion of ACTH

A. patient who suddenly stops taking high-dose steroid therapy

A patient has the following assessment findings: elevated TSH level, low T3 and T4 levels, difficulty with memory, lethargy, and muscle stiffness. There are clinical manifestations of which disorder? A. Hypothyroidism b. Hyperthyroidism c. Hypoparathyroidism d. Hyperparathyroidism

AA. Hypothyroidism

The nurse assesses a patient in the ED and finds the following; constipation, fatigue with increased sleeping time impaired memory, facial puffiness, and weight gain. Which deficiency does the nurse recognize? A. Hyperthyroidism b. Hypothyroidism c. Hyperparathyroidism d. Hypoparathyroidism

B b. Hypothyroidism

4. The assessment findings of a male patient with an anterior pituitary tumor include reports of changes in secondary sex characteristics, such as episodes of impotence and decreased libido. The nurse explains to the patient that these findings are a result of overproduction of which hormone? A. Gonadotropins inhibiting prolactin (PRL) B. Thyroid hormone inhibiting prolactin (PRL) C. Prolactin (PRL) inhibiting secretion of gonadotropins D. Steroids inhibiting production of sex hormones

C. Prolactin (PRL) inhibiting secretion of gonadotropins

66. The patient with hypercortisolism asks the nurse why she is prescribed the drug ranitidine. What is the nurse's best response? A. This drug inhibits the gastric proton pump an prevents the formation of hydrochloric acid in your stomach. B. Gastrointestinal bleeding is common complication in patients with hypercortisolism. C. Ranitidine blocks the H2-receptor site to decrease formation of hydrochloric acid and prevent GI bleeding. D. This drug buffers stomach acids and protects the gastrointestinal mucosa.

C. Ranitidine blocks the H2-receptor site to decrease formation of hydrochloric acid and prevent GI bleeding.