RN Targeted Endocrine
A nurse is reviewing laboratory values for a client who has diabetic ketoacidosis DKA. Which of the following results should The nurse expect?
pH 7.32, PaCO2 36 mm Hg HCO3 14 mEq/L With DKA, the pH is low, carbon dioxide is within the expected reference range, bicarbonate is low Which indicates metabolic acidosis, a common manifestation of DKA.
A nurse is assessing a client who has diabetes mellitus and reports feeling anxious.Which of the following findings should the nurse expect if the client is hypoglycemic?
Cool, clammy skin Rationale: hypoglycemia causes cool, clammy skin, in addition to anxiety, nervousness, tachycardia, and confusion.
A nurse is managing the care of a client who is post operative and has a cute adrenal insufficiency. Which of the following actions should the nurse take
Administer IV HydroCortisone sodium. Rationale: hydrocortisone sodium is necessary to replace the cortisol deficiency that occurs with adrenal insufficiency
A nurse is assessing a client has a new diagnosis of Cushing's disease which of the following findings should the nurse expect?
Hirsutism Rationale: increase hair growth, or hirsutism, is an expected finding of Cushing's disease due to increased androgen production
A nurse is assessing a client who is taking propylthiouracil. The nurse should identify which of the following findings as an indication that the medication has been effective?
Increase in body weight Rationale: propylthiouracil Suppresses the production of thyroid hormones and allows for weight gain. However, excessive weight gain could indicate that the dose Is too high
A nurse is monitoring a client who is 24 hours post operative after a total thyroidectomy. Which of the following findings should the nurse report to the provider?
Laryngeal stridor. Rationale: Laryngeal stridor is a harsh, high pitch sound with inspiration that indicates respiratory obstruction. The nurse should take immediate action to preserve the client airway
A nurse is caring for a client who has diabetes mellitus and has developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to the clients feet?
Monitor the temperature of bathwater with a thermometer. Rationale: peripheral neuropathy makes it difficult to determine if the bathwater is too hot. Therefore, to prevent injury, the client should use a bath thermometer to ensure a Water temperature below 110°F.
A nurse has administered propranolol By IV bolus to a client who has having a thyroid storm. Which of the following findings indicates that the client is having a therapeutic response?
Reduction of the effects of thyroid hormone on the heart. Rationale: propranolol is a beta2-androgenic blocking agent that this creases the rapid heart rate caused by excessive thyroid stimulation.
A nurse is developing a teaching plan for a client who has a thyroid ectomy and takes thyroid hormone replacement. Which of the following instruction should the nurse plan to include?
Take this medication on an empty stomach Rationale: to promote proper absorption, the client should take this medication on an empty stomach and not eat or drink anything for 30 to 60 minutes after. Extra- Aluminum containing an antacid and calcium supplements can reduce the effectiveness. This medication can increase blood glucose levels in clients who have diabetes mellitus. There are no fluid restrictions with this medication therapy and the medication should be taken with a full glass of water.
A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of Hypocalcemia?
Tingling and numbness of hands and feet Rationale: Hypocalcemia causes paresthesia, which usually starts in the hands and feet. Extra- Hypocalcemia causes a weak, thready pulse.It also increases Gastrointestinal motility. It causes hyper active deep tendon reflexes.
A nurse is monitoring the laboratory values of a client who has diabetes Molite us and is taking insulin. Which of the following results indicate a therapeutic outcome of insulin therapy?
A fasting blood glucose of 96 mg/dL. Rationale: the expected reference range is 72 110 mg/dL for a fasting blood glucose levels
A nurse is teaching a client about adrenocorticotropic hormone ACTH stimulation test. The nurse should Explain that the purpose of the test is to assess for which of the following disorders?
Addison's disease Rationale: it measures the cortisol response to ACTH. The response is absent or very decreasing clients who have primary adrenal insufficiency.
A nurse is teaching a client who has diabetes Molite us. Which of the following should the nurse include as an expected finding a diabetic ketoacidosis DKA?
Blood glucose levels above 300 mg/dL. Extra- Deep, labored breathing, known as kussmaul respirations, is an expected finding of DKA. Weight loss is an expected finding of DKA. Increase urine output is an expected finding of DKA.
A nurse is providing discharge teaching to a client who has diabetes insipidus in a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching?
Blow your nose gently prior to using the nasal spray. Rationale: this action prevents dilation of the medication with nasal secretions. Extra- The nurse should instruct the client to prime the nasal spray pump by pressing down four times before the initial use. The nurse should instruct the client to set up right with her head tilted slightly forward when administering the spray, which prevents the spray from going down the clients throat.
A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect?
Calcium 12.8 mg/dL. Rationale: a client who has adrenal insufficiency will have a calcium level above the expected reference range of 4.5 to 5.6 mg/dL. Extra- Sodium level is expected to be below the reference range of 135 to 145MEQ per liter. Weight loss is a finding of adrenal insufficiency.
A nurse is teaching a client who has diabetes Mellitus About insulin injections. The clients prescription includes evening doses of insulin glargine and regular insulin. Which of the following instruction should the nurse include?
Draw up the insulins into separate syringes Rationale: the nurse should instruct the client to draw up the insulins into separate syringes because insulin glargine it's not compatible with other insulin.
A nurse is caring for a client who has pheochromocytoma. Which of the following actions should the nurse take?
Elevate the head of the clients bed. Rationale: elevate the head of the bed to reduce blood pressure and abdominal pressure. Extra- Do not palpate the abdomen because this can cause release of catecholamines and increased blood pressure. Monitor for hypertension.
A nurse is reviewing the laboratory results of a client undergoing screening for Cushing's disease. The nurse should expect an elevation and wish her the following laboratory findings?
Glucose Extra info- Lymphocyte count, potassium, calcium will all be below the expected reference range
A home health nurse is assessing a client who requires lifelong hormone replacement therapy for treatment of hypothyroidism. The client has not been taking the medication regularly. Which of the following findings should the nurse expect?
Hypotension Rationale: hypertension is an expected finding of hypothyroidism, along with Brady piña, dysrhythmias, cold intolerance, and cool, dry skin. Extra- It also causes bradycardia. It is more likely to cause constipation. It is more likely to cause a decrease in urine output.
A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements by the client indicates an understanding of the teaching?
I will apply lotion to the dry areas of my feet but not in between my toes. Rationale: lotion can be used for the dry areas of the feet, but the client should avoid applying lotion between the toes, as this area is prone to bacterial growth.
A nurse is teaching a client who has type one diabetes Molite us about how to prevent complications during illness. Which of the following statements by the client indicates an understanding of the teaching: - "I should stop taking my insulin if I feel nauseous." - " I will test my urine for protein when I start to feel ill." - "I should check my blood sugar level every eight hours." - " I will call my doctor if my blood sugar is more than 250."
I will call my doctor if my blood sugar is more than 250. Rationale: The client should call the provider if their blood glucose levels exceed 250 mg/dL during illness. The client should check their urine for ketones when the blood glucose levels are greater than 240 mg/dL. The client should continue taking the usual dose of insulin even when not feeling well. The client should check their blood glucose level every four hours during illness.
A nurse is Assessing a client who has a diabetes insipidus. The nurse should expect which of the following findings?
Increased hematocrit Rationale: increase in Attica is an expected finding of diabetes insipidus due to dehydration. Extra- Increase your note that leads to diluted urine and a low you're in specific gravity. Tachycardia is an expected finding of diabetes insipidus. An increase value in level is an expected finding a diabetes insipidus due to
A Nurse is planning teaching for a client who has type one diabetes Molite us. Which of the following instruction should the nurse plan to include?
Ingest food with alcohol to reduce alcohol induced hypoglycemia. Rationale: alcohol inhibits the livers production of glucose. Consuming carbohydrates while drinking alcoholic beverages helps prevent hypoglycemia. Extra- The nurse should instruct the client to reduce insulin dosage before planned exercises to prevent hypoglycemia.
A nurse is teaching a client who has an auto immune disease about the adverse effects of long-term corticosteroid therapy. Which of the following adverse effects should the nurse include?
Osteoporosis, moon-shaped face, increase risk of infection. Rationale: osteoporosis is an adverse effect of long-term corticosteroid therapy due to the suppression of the information and the acceleration of boundary resorption that corticosteroid therapy can cause. Long term corticosteroid therapy causes characteristics of iatrogenic Cushing syndrome, including a moon shaped face, a potbelly, and a buffalo hump. Corticosteroid Therapy reduces the phagocytic actions of macrophages and neutrophils, suppressing the moon system
A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires intranasal desmopressin. Which of the following information should the nurse include?
Report nocturia because it requires a dosage adjustment. Rationale: the client should make the initial dose of desmopressin in the evening. The provider will increase the dosage until the client no longer has nocturia.
A nurse is teaching a client who is scheduled for a Vanillylmandelic acid test to screen for pheochromocytoma. Which of the following statements should the nurse include in the teaching?
Restrict coffee and take 2 to 3 days prior to the test. Rationale: the client should avoid coffee and tea, even if they are decaffeinated, bananas, chocolate, and vanilla for 2 to 3 days prior to the test.
A nurse is caring for a client has type two diabetes and is experiencing a hyper glycemic hyper as molar state HHS. Which of the following laboratory findings should the nurse expect
Serum PH 7.45. Rationale: a client who is experiencing HHS produces enough insulin to bring ketosis but not enough to prevent hypoglycemia. Therefore, this year and PH is within the expected reference range. Glucose levels will be above 600 mg/dL.
A nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone SIADH. Which of the following findings should the nurse report to the provider?
Sodium 110 mEq/L. Rationale: a client who has SIADH retains fluid, which causes dilutional hyponatremia. Extra- Client to have SIADH experience hyper active deep tendon reflex is a 3+ or 4+.
A nurse is teaching a client about glycosylated hemoglobin parentheses (HbA1c) testing. Which of the following client statement indicates an understanding of the teaching?
This test's result is a good indicator of my average blood glucose levels. Rationale: HB A1 C reflects the clients glucose levels over 120 day., Which is the lifespan of RBCs.
A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should respect which of the following findings?
Tremors Rationale: findings of hyperthyroidism include tremors, diaphoresis, and insomnia. Extra- They can also experience heat intolerance, they can be restless and irritable, can experience exophthalmos.
