The Endocrine System

A nurse is caring for a client who has recurring kidney stones and a history of diabetes mellitus the client is scheduled for an IVP (dye test) the nurse should collect additional data about which of the following statements made by the client? A. I skipped my metformin this morning B. I took my metformin before breakfast C. I took an aspirin this morning for my headache D. I used my inhaler this morning

"I took my metformin before breakfast." The nurse should identify clients taking metformin are at risk for lactic acidosis when receiving contrast media.

A nurse is reinforcing teaching with a client who has diabetes mellitus about the manifestations of hypoglycemia which of the following statements by the client indicates an understanding of the teaching? A. "I can experience excessive sweating" B. "I may experience a slowing heart rate" C. "It is common to lose your appetite" D. "I can eat whatever I want"

A. "I can experience excessive sweating" Diaphoresis is a common manifestation of hypoglycemia. Along with tachycardia, tremors, fatigue, and excessive hunger.

a nurse working in a long term care facility is assigned care of four clients following the 0700 morning change of shift report. which of the following clients should the nurse attend to first? A. A client who has diabetes, and had an 0600 blood glucose level of 60 mg/dL. B. A client who has diabetes, and did not sleep all night. C. A client with diabetes, who did not experience dawn phenomenon. D. A client with diabetes, who had a 0600 blood glucose level of 90mg/dL

A. A client who has diabetes, and had an 0600 blood glucose level of 60 mg/dL.

A nurse is assisting with the admission of a client for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. Which of the following actions is the nurse's priority? A. Administering a supplemental dose of hydrocortisone B. Instructing the client about coughing and deep breathing C. Collecting additional information about the clients history of Addison's disease D. Inserting an indwelling catheter

A. Admistering a supplemental dose of hydrocortisone

A nurse is caring for a client who is 32 weeks gestation who has hyperthyroidism. For which of the following clinical findings should the nurse report to the provider? A. Excessive sweating & hunger, fever, vomiting, tachycardia, restlessness, weight loss, and tremors. B. Bradycardia, high energy levels, and delirium. C. Extrapyramidal symptoms, excessive urination, and increase blood pressure. D. Wondering, confusion, nausea, vomiting, constipation, and catatonic schizophrenia symptoms.

A. Excessive sweating & hunger, fever, vomiting, tachycardia, restlessness, weight loss, and tremors.

You are caring for a client who is taking levothyroxine (Synthroid) to treat hypothyroidism. The client reports palpitations, weight loss, and diarrhea. You suspect which of the following adverse effects of this drug? A. Hyperthyroidism B. Addison's disease C. Myxedema D. Hyperglycemia

A. Hyperthyroidism

A client is about to start taking hydrocortisone (Cortef) to treat adrenocortical insufficiency. You should instruct the client to do which of the following to reduce the risk of adverse effects of this drug? (Select all that apply) A. Increase her calcium and vitamin D intake B. Take the drug with food C. Record weight regularly D. Urinate every 4 hours E. Report increased stress

A. Increase her calcium and vitamin D intake B. Take the drug with food C. Record weight regularly E. Report increased stress

A nurse is reinforcing teaching for a client who has type 2 diabetes mellitus who is taking glipizide. The client should be taught that Glipizide works in the following ways? A. It stimulates the release of insulin from the islet cells of the pancreas B. Promotes cellular uptake and use of insulin C. It raises blood glucose levels through glucogenesis D. It reduces insulin resistant tissue

A. It stimulates the release of insulin from the islet cells of the pancreas *The client must have a functioning pancreas. Not for type one diabetics*

When talking with a 30-year-old woman who will receive radioactive iodine-131 (Iodotope) to treat Grave's disease, you should include which of the following instructions? (Select all that apply) A. Report weight gain and edema B. Use effective contraceptives C. Allow 2-3 months for full effects D. Expect periodic blood sampling E. Obtain regular eye examinations

A. Report weight gain and edema B. Use effective contraceptives C. Allow 2-3 months for full effects D. Expect periodic blood sampling

A nurse is caring for a client who is taking metformin to treat type 2 diabetes mellitus and reports muscle pain. Which of the following adverse reactions should the nurse suspect? A. lactic acidosis B. anticholinergic effects C. extrapyramidal effects D. hypophosphatemia

A. lactic acidosis

A nurse in the emergency department is assisting with the care of a client who is comatose. The provider suspects ketoacidiosis. Which of the following findings should the nurse expect?

Acetone odor to the breath

Drug-drug interactions for levothyroxine

Antacids, antiseizure, insulin, and catecholamines

a nurse is assisting with the plan of care for a client who has hypothyroidism and myxedema. which of the following interventions should the nurse include in the plan of care

Apply warm blankets

Which lab value indicates antidiabetic therapy is effective? a. TSH b. HbA1C c. Potassium d. Creatinine clearance

B - HbA1C

A nurse is preparing to administer insulin lispro to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse plan to take? a. Check the client for hypoglycemia 4 hr after the insulin lispro injection. b. Inject insulin lispro 15 min before a meal. c. Monitor the client for polyuria after the insulin lispro injection. d. Administer insulin lispro in the same syringe as a short-acting insulin.

B - Inject 15 min prior to meal

A nurse is preparing to administer subcutaneous regular insulin to a client before he eats breakfast at 0800. Which of the following actions should the nurse take? A. Give the medication at 0900 B. Give the medication at 0730 C. Give the medication at 0800 D. Give the medication at 1000

B. Give the medication at 0730. 30 minutes before breakfast. The onset of regular insulin is 30 minutes to 1 hour.

The nurse is reinforcing teaching for a client who has Diabetes Mellitus and has a prescription for insulin levemir(detemir) injection every day. Which of the following statements by the client indicates an understanding of the teaching? A. I can take levemir with regular insulin B. I can inject my insulin levemir in the evening before bedtime C. Levemir should be taken TID D. When taking levemir I should expect to see results within 15 minutes.

B. I can inject my insulin detemir in the evening before bedtime When prescribed once daily, insulin detemir is injected in the evening, either with the evening meal or at bedtime.

a nurse is collecting data from a client who has diabetes mellitus which of the following findings indicate that the client is experiencing DKA? A. Excessive hunger and dizziness B. Increased thirst and frequent urination C. Increased sweating and dizziness D. Tachycardia and confusion

B. Increased thirst and frequent urination Polydipsia, or increased thirst, is a manifestation of DKA.

A nurse is monitoring client for findings related to diabetes Insipidus following a surgery. Which of the following findings should indicate a manifestation of this condition to the nurse? A. Decreased urine output B. Increased urine output C. Decrease thirst and hunger D. Increased thirst and hunger

B. Increased urine output

A client is about to start taking sustained release glipizide to treat type 2 diabetes mellitus. Which of the following instructions should you include when talking to the client about taking this drug? A. Chew tablet completely before swallowing B. Take it once a day, 30 minutes before breakfast C. Take it in the evening before bedtime D. Drink 16oz of water before taking it

B. Take it once a day, 30 minutes before breakfast

A nurse is caring for a client who is about to begin taking pioglitazone to treat type 2 diabetes mellitus. The nurse should explain to the client about the need to monitor which of the following laboratory values? (select all that apply) A. Thyroid-stimulating hormone (TSH) B. Alanine aminotransferase (ALT) C. LDL D. CBC E. Creatinine clearance

B. alanine aminotransferase (ALT) C. LDL

When considering replacement therapy options for a client who has chronic adrenocortical insufficiency, a nurse should recognize that the provider will choose which of the following drugs? A. somatropin B. hydrocortisone C. glucagon D. desmopressin

B. hydrocortisone

A nurse is caring for a client who is taking desmopressin. The nurse should make which of the following assessments to evaluate the drug's effectiveness? A. peripheral pulses B. urine output C. skin integrity D. blood glucose

B. urine output

A nurse is caring for a client who is taking pioglitazone to treat type 2 diabetes mellitus. The nurse should monitor for which of the following findings? A. joint pain B. weight gain C. dilated pupils D. constipation

B. weight gain

A nurse is reinforcing teaching for a client who has diabetes mellitus and has a prescription for Levemir injections once daily. Which of the following statements by the client indicates an understanding of the teaching? a. "If my blood sugar is high, I can mix a dose of regular insulin with my Levemir." b. "I should inject by Levemir 30 min before a meal to lower my blood sugar." c. "I can inject my Levemir in the evening before bedtime." d. "I don't have to worry about hypoglycemia while taking Levemir."

C - "I can inject my Levemir in the evening before bedtime."

A nurse is collecting data from a client who takes metformin for type 2 diabetes. Which of the following medications is contraindicated for this client due its effect on blood glucose levels? a. Cimetidine b. Cephalexin c. Prednisone d. Levothyroxine

C - Prednisone

A nurse is reinforcing teaching with clients about the use of insulin to treat type 1 diabetes. For which of the following types of insulin should the nurse tell the cients to expect a peak effect 1 to 5 hr after administration? a. Insulin glargine b. NPH insulin c. Regular insulin d. Insulin lispro

C - Regular

A nurse is reinforcing teaching to a client who has diabetes mellitus and is to start taking chlorpropamide. The nurse should teach the client to avoid consumption of which of the following while taking this medication? a. Grapefruit b. ​Milk c. ​Alcohol d. ​Shellfish

C - alcohol Also avoid alcohol with glipizide

A nurse is preparing to administer levothyroxine 100 mcg PO to a client who has hypothyroidism. Available is levothyroxine 50 mcg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) A. 1 tablet B. 1/2 tablet C. 2 tablets D. 3 tablets

C. 2 tablets

A nurse is preparing to administer a prescribed dose of 10 units of regular insulin and 20 units of NPH insulin to a client who has diabetes. How many units of insulin should be given to this patient? A. 10 units B. 20 units C. 30 units D. 15 units

C. 30 units 10 of regular + 20 of NPH = 30 units:)

A nurse is collecting data on a client who has hyperthyroidism. Which of the following manifestations should the nurse expect the client to report? A. Cold intolerance, dizziness, slow heart rate, weight gain. B. Confusion, dizziness, drowsiness, and agitation. C. Heat intolerance, tremors, palpitations, anxiety, and weight loss. D. Constipation, drowsiness, GI upset, and bradycardia.

C. Heat intolerance, tremor, palpitations, anxiety, and weight loss.

A client is about to start taking somatropin (Genotropin). You plan to evaluate the effectiveness of this drug therapy with which of the following assessments? A. Level of consciousness B. ECG C. Height and weight D. Breath sounds and respiratory rate

C. Height and weight Somatropin is the growth hormome

A nurse in a clinic is caring for a client who has a new diagnosis of hypothyroidism. Which of the following findings should the nurse expect? A. Edema B. Weight loss C. Weight gain D. Cramping

C. Weight gain

A nurse is caring for a client who is taking metformin and is scheduled to undergo angiography using iodine-containing contrast dye. The nurse should identify that an interaction between metformin and the IV contrast dye increases the client's risk for which of the following conditions? A. hypokalemia B. hyperglycemia C. acute renal failure D. acute pancreatitis

C. acute renal failure

A nurse is caring for a client who is about to begin insulin glargine therapy. The nurse should identify the need for additional precautions because the client also takes which of the following types of drugs? A. oral contraceptives B. calcium supplements C. beta blockers D. iron supplements

C. beta blockers

A nurse is providing teaching to a client who is about to begin levothyroxine therapy to treat hypothyroidism. Which of the following instructions should the nurse include? A. take levothyroxine with food to increase absorption B. take levothyroxine with an antacid to reduce gastrointestinal effects C. expect life-long therapy with the drug D. carry a carbohydrate snack at all times

C. expect life-long therapy with the drug

A nurse is caring for a client who is about to begin taking somatropin. The nurse should explain the need to monitor which of the following laboratory values? (select all that apply) A. Blood amylase B. Creatinine clearance C. Urine calcium D. Blood glucose E. CBC

C. urine calcium D. blood glucose

A nurse is caring for a client who has type 1 diabetes mellitus the nurse misread the client's morning blood glucose level of 210 mg per dL, instead of 120 mg per dL, and administered the wrong dose of insulin and which of the following actions should the nurse identify as a priority.

Check the client's blood glucose level.

A nurse is reinforcing teaching with a client who is to self-administer regular insulin and NPH insulin from the same syringe. Which of the following instructions should the nurse provide? a. Draw up the NPH insulin into the syringe first. b. Inject air into the regular insulin first. c. Shake the NPH insulin until it is well-mixed. d. Discard regular insulin if it appears cloudy.

D - Discard cloudy regular insulin

A nurse is preparing to administer subcutaneous regular insulin to a client before he eats breakfast at 0800. Which of the following actions should the nurse take? a. Give the insulin at 0700. b. Give the insulin when the breakfast tray arrives. c. Give the insulin 30 min after breakfast with other routine medicines. d. Give the insulin at 30 min before breakfast.

D - Give insulin 30min prior to breakfast

A nurse is collecting data from a client who has been taking methimazole for hyperthyroidism. For which of the following findings should the nurse monitor to identify that the medication is effective? a. Weight loss b. Decreased heart rate c. Increased urine output d. Elevated temperature

D - decreased heart rate

While caring for a client taking somatropin to stimulate growth, which of the following adverse effects should the nurse monitor for? a. Increased heart rate b. Hyperthyroidism c. Sweating d. Hyperglycemia

D - hyperglycemia

A nurse is caring for a client who has been taking acarbose for type 2 diabetes. Which of the following lab tests should the nurse plan to monitor? a. WBC b. Amylase c. Platelet count d. Liver functions

D - liver functions

A nurse is planning to administer a clients Intermediate-acting (NPH) insulin at 0730. The nurse should expect this type of insulin to peak within which of the following time frames after administration? A. 1-4 hours B. 1-5 hours C. 6-10 hours D. 6-14 hours

D. 6 to 14 hours

A nurse is reviewing the medical record of a client who takes desmopressin for diabetes insipidus. The nurse should identify that which of the following findings can be an adverse effect of desmopressin? A. Hypovolemia B. Hypercalcemia C. Agitation D. Headache

D. Headache

A nurse is caring for a client who is taking somatropin to stimulate growth. The nurse should plan to monitor for which of the following as an adverse effect of this medication? A. Increase heart rate B. Hyperthyroidism C. Sweating D. Hyperglycemia

D. Hyperglycemia

A nurse at a provider's office is assessing a client who has been taking hydrocortisone for adrenal insufficiency. The client reports fatigue and feeling overwhelmed by personal responsibilities. Which of the following findings should the nurse identify as an indication the provider might need to increase the client's dosage? A. hyperglycemia B. weight gain C. fat redistribution D. hypotension

D. hypotension

A nurse is teaching a client about self-administering regular insulin. The nurse should instruct the client to rotate injection sites to prevent which of the following? A. rapid absorption B. intradermal injection C. injection pain D. lipohypertrophy

D. lipohypertrophy

A nurse is assessing a client who has a new prescription for levothyroxine. The nurse should identify which of the following findings as a contraindication for this drug? A. bacterial skin infections B. diabetes insipidus C. immunosuppression D. recent myocardial infarction

D. recent myocardial infarction

a nurse is reinforcing teaching to a client who is to self administer regular insulin and nph insulin from the same syringe. which of the following instructions should the nurse provide

Discard regular insulin if it appears cloudy

Client education with oral antidiabetics

Exercise daily Follow dietary guidelines Maintain glucose logs Monitor for hypoglycemia & report

Adverse effects of desmopressin

Fluid retention and hyponatremia

Identify the glands of the endocrine system and their hormones.

Hypothalamus: CRH, GHRH, TRH, GnRH, ADH, oxytocin Pituitary: anterior- ACTH, GH, TSH, FSH/LH Pituitary: posterior- ADH, oxytocin Thyroid: TRH -> TSH-> T3, T4 Pancreas: amylin, insulin Adrenal cortex: cortisol, aldosterone, androgens, estrogen Medulla: epinephrine, norepinephrine

Adverse effects of propylthiouracil/methimazole (PTU)

Hypothyroidism Agranulocytosis (sore throat, fever) Liver injury, hepatitis (jaundice, dark urine)

A nurse is reinforcing teaching with a client who has Diabetes mellitus type 1 about sick day management which of the following is the priority to recommend to the client?

Monitor blood glucose levels more frequently. Glucose levels rise when a client is sick.

a nurse is collecting data from a client who takes metformin for type 2 diabetes. which of the following medications is contraindicated for this client due to its effects on blood glucose?

Prednisone

Nurse is collecting data for a client who has diabetes mellitus. The client is confused, flushed, and has acetone odor in his breath. The nurse should anticipate rx for which of the following type of insulin?

Regular. Regular insulin is used for DKA and is usually given IV if unresponsive. This is the only insulin that can be given IV.

Nurse is reinforcing teaching with a pt who is scheduled for a blood test to measure her thyroid stimulating hormone (TSH) levels. Which of the following statements should the nurse give?

The test determines whether your thyroid gland is overactive, appropriately active, or underactive.

A nurse is reviewing the medical record of a client who has hyperthyroidism (Graves' disease). Which of the following serum laboratory findings should the nurse expect to be below the expected reference range? A. TSH levels B. T3 levels C. T4 levels D. CBC levels

Thyroid-stimulating hormone (TSH) level Hyperthyroidism = Graves' disease

Examples of sulfonylureas

chlorpropamide, glipizide, tolazamide, glimepiride

Examples of biguanides and their action

metformin (glucophage) - decreases absorption of glucose by intestines, decreases synthesis of glucose by the liver, and increases sensitivity of insulin receptors in tissues.

Examples of meglitinides

tepaglinide, nateglinide

A nurse finds a client who has type 1 diabetes mellitus lying in bed, sweating, tachycardic, and reporting feeling lightheaded and shaky. which of the following complications should the nurse expect? A. Hyperglycemic B. Hypothyroidism C. Hyperthyroidism D. Hypoglycemic

​D. Hypoglycemic