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Endocrine CH 52

Terms in this set (40)

A patient with hypofunction of the adrenal cortex has been admitted to the medical unit. What would the nurse most likely find when assessing this patient?
A) Increased body temperature
B) Jaundice
C) Copious urine output
D) Decreased BP
D) Decreased BP
The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimoto's thyroiditis. When assessing this patient, what sign or symptom would the nurse expect?
A) Fatigue
B) Bulging eyes
C) Palpitations
D) Flushed skin
A) Fatigue
A patient has been admitted to the post-surgical unit following a thyroidectomy. To promote comfort and safety, how should the nurse best position the patient?
A) Side-lying (lateral) with one pillow under the head
B) Head of the bed elevated 30 degrees and no pillows placed under the head
C) Semi-Fowler's with the head supported on two pillows
D) Supine, with a small roll supporting the neck
C) Semi-Fowler's with the head supported on two pillows
A patient with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the patient should prioritize what question when addressing potential complications?
A) "Do you feel any muscle twitches or spasms?"
B) "Do you feel flushed or sweaty?"
C) "Are you experiencing any dizziness or lightheadedness?"
D) "Are you having any pain that seems to be radiating from your bones?"
A) "Do you feel any muscle twitches or spasms?"
The nurse is caring for a patient with a diagnosis of Addison's disease. What sign or symptom is most closely associated with this health problem?
A) Truncal obesity
B) Hypertension
C) Muscle weakness
D) Moon face
C) Muscle weakness
The nurse is caring for a patient with Addison's disease who is scheduled for discharge. When teaching the patient about hormone replacement therapy, the nurse should address what topic?
A) The possibility of precipitous weight gain
B) The need for lifelong steroid replacement
C) The need to match the daily steroid dose to immediate symptoms
D) The importance of monitoring liver function
B) The need for lifelong steroid replacement
The nurse is teaching a patient that the body needs iodine for the thyroid to function. What food would be the best source of iodine for the body?
A) Eggs
B) Shellfish
C) Table salt
D) Red meat
C) Table salt
A patient is prescribed corticosteriod therapy. What would be priority information for the nurse to give the patient who is prescribed long-term corticosteroid therapy?
A) The patient's diet should be low protein with ample fat.
B) The patient may experience short-term changes in cognition.
C) The patient is at an increased risk for developing infection.
D) The patient is at a decreased risk for development of thrombophelbitis and thromboembolism.
C) The patient is at an increased risk for developing infection.
A nurse caring for a patient with diabetes insipidus is reviewing laboratory results. What is an expected uninalysis finding?
A) Glucose in the urine
B) Albumin in the urine
C) Highly dilute urine
D) Leukocytes in the urine
C) Highly dilute urine
The nurse caring for a patient with Cushing's syndrome is describing the dexamethasone suppression test scheduled for tomorrow. What does the nurse explain that this test will involve?
A) Administration of dexamethasone orally, followed by a plasma cortisol level every hour for 3 hours
B) Administration of dexamethasone IV, followed by an x-ray of the adrenal glands
C) Administration of dexamethasone orally at 11PM, and a plasma cortisol level at 8AM the next morning
D) Administration of dexamethasone intravenously, followed by a plasma cortisol level 3 hours after the drug is administered
C) Administration of dexamethasone orally at 11PM, and a plasma cortisol level at 8AM the next morning
You are developing a care plan for a patient with Cushing's syndrome. What nursing diagnosis would have the highest priority in this care plan?
A) Risk for injury r/t weakness
B) Ineffective breathing pattern r/t muscle weakneess
C) Risk for loneliness r/t disturbed body image
D) Autonomic dysreflexia r/t neurologic changes
A) Risk for injury r/t weakness
The nurse is performing a shift assessment of a patient with aldosteronism. What assessments should the nurse include? Select all that apply.
A) Urine output
B) Signs or symptoms of venous thromoembolism
C) Peripheral pulses
D) Blood pressure
E) Skin integrity
A) Urine output
D) Blood pressure
The home care nurse is conducting patient teaching with a patient on corticosteroid therapy. To achieve consistency with the body's natural secretion of cortisol, when would the home care nurse instruct the patient to take his or her corticosteroids?
A) Un the evening between 4PM and 6PM
B) Prior to going to sleep at night
C) At noon every day
D) In the morning between 7AM and 8AM
D) In the morning between 7AM and 8AM
A patient presents at the walk-in clinic complaining of diarrhea and vomiting. The patient has a documented history of adrenal insufficiency. Considering the patient's history and current symptoms, the nurse should anticipate that the patient will be instructed to do which of the following?
A) Increase his intake of sodium until the GI symptoms improve.
B) Increase his intake of potassium until the GI symptoms improve.
C) Increase his intake of glucose until the GI symptoms improve.
D) Increase his intake of calcium until the GI symptoms improve.
A) Increase his intake of sodium until the GI symptoms improve.
The nurse is caring for a patient with hyperparathyroidism. What level of activity would the nurse expect to promote?
A) Complete bed rest
B) Bed rest with bathroom privileges
C) Out of bed (OOB) to the chair twice a day
D) Ambulation and activity as tolerated
D) Ambulation and activity as tolerated
While assisting with the surgical removal of an adrenal tumor, the OR nurse is aware that the patient's vital signs may change upon manipulation of the tumor. What vital sign changes would the nurse expect to see?
A) Hyperthermia and tachypnea
B) Hypertension and heart rate changes
C) Hypotension and hypothermia
D) Hyperthermia and bradycardia
B) Hypertension and heart rate changes
A patient has returned to the floor after having a thyroidectomy for thyroid cancer. The nurse knows that sometimes during the surgery the parathyroid glands can be injured or removed. What laboratory finding may be an early indication of parathyroid gland injury or removal?
A) Hyponatremia
B) Hypophosphatemia
C) Hypocalcemia
D) Hypokalemia
C) Hypocalcemia
The nurse is planning the care of a patient with hyperthyroidism. What should the nurse specify in the patient's meal plan?
A) A clear thin liquid diet, high in nutrients
B) Small frequent meals, high in protein and calories
C) Three large, bland meals a day
D) A diet high in fiber and plant-sourced fat
B) Small frequent meals, high in protein and calories
A patient with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) is being cared for on the critical care unit. The priority nursing diagnosis for a patient with this condition is what?
A) Risk for peripheral neurovascular dysfunction
B) Excess fluid volume
C) Hypothermia
D) Ineffective airway clearance
B) Excess fluid volume
Urinary anti-infectives are used only to treat urinary tract infections (UTIs). What causes urinary anti-infectives to be so effective in treating UTIs?
A) They sterilize feces
B) They act specifically within the urinary tract
C) They reach high plasma levels in short period of time
D) They are excreted through the liver
B) They act specifically with the urinary tract
The nurse is assessing a patient diagnosed with Grave's disease. What physical characteristics of Grave's disease would the nurse expect to find?
A) Hair loss
B) Moon face
C) Bulging eyes
D) Fatigue
C) Bulging eyes
A patient with suspected adrenal insufficiency has been ordered an adrenocorticotropic hormone (ACTH) stimulation test. Administration of ACTH caused a marked increase in cortisol levels. How should the nurse interpret this finding?
A) The patient's pituitary function is compromised
B) The patient's adrenal insufficiency is not treatable
C) The patient has insufficient hypothalamic function
D) The patient would benefit from surgery
A) The patient's pituitary function is comprimised
The physician has ordered a fluid deprivation test for a patient suspected of having diabetes insipidus. During the test, the nurse should prioritize what assessments?
A) Temperature and oxygen saturation
B) Heart rate and BP
C) Breath sounds and bowel sounds
D) Color, warmth, movement, and sensation of extremities
B) Heart rate and BP
A nurse works in a walk-in clinic. The nurse recognizes that certain patients are at higher risk for different disorders than other patients. What patient is at a greater risk for the development of hypothyroidism?
A) A 75-year-old female patient with osteoporosis
B) A 50-year-old male patient who is obese
C) A 45-year-old female patient who used oral contraceptives
D) A 25-year-old male patient who uses recreational drugs
A) A 75-year-old female patient with osteoporosis
A patient with a recent diagnosis of hypothyroidism is being treated for an unrelated injury. When administering medications to the patient, the nurse should know that the patient's diminished thyroid function may have what effect?
A) Anaphylaxis
B) Nausea and vomiting
C) Increased risk of drug interactions
D) Prolonged duration of effect
D) Prolonged duration of effect
A patient has been admitted to the critical care unit with a diagnosis of thyroid storm. What interventions should the nurse include in this patient's immediate care? Select all that apply.
A) Administering diuretics to prevent fluid overload
B) Administering beta blockers to reduce heart rate
C) Administering insulin to reduce blood glucose levels
D) Applying interventions to reduce the patient's temperature
E) Administering corticosteroids
B) Administering beta blockers to reduce heart rate
D) Applying interventions to reduce the patient's temperature
The nurse's assessment of a patient with thyroidectomy suggests tetany and a review of the most recent blood work corroborate this finding. The nurse should prepare to administer what intervention?
A) Oral calcium chloride and vitamin D
B) IV calcium gluconate
C) STAT levothyroxine
D) Administration of parathyroid hormone(PTH)
B) IV calcium gluconate
A patient has been taking prednisone for several weeks after experiencing a hypersensitivity reaction. To prevent adrenal insufficiency, the nurse should ensure that the patient knows to do which of the following?
A) Take the drug concurrent with levothyroxine (Synthroid)
B) Take each dose of prednisone with a dose of calcium
C) Gradually replace the prednisone with an OTC alternative
D) Slowly taper down the dose of prednisone, as ordered
D) Slowly taper down the dose of prednisone, as ordered
Following an addisonian crisis, a patient's adrenal function has been gradually regained. The nurse should ensure that the patient knows about the need for supplementary glucocorticoid therapy in which of the following circumstances?
A) Episodes of high psychosocial stress
B) Periods of dehydration
C) Episodes of physical exertion
D) Administration of a vaccine
A) Episodes of high psychosocial stress
A 30-year-old female patient has been diagnosed with Cushing's syndrome. What psychosocial nursing diagnosis should the nurse most likely prioritize when planning the patient's care?
A) Decisional conflict r/t treatment options
B) Spiritual distress r/t changes in cognitive function
C) Disturbed body image r/t changes in physical appearance
D) Powerlessness r/t disease progression
C) Disturbed body image r/t changes in cognitive function
A patient with pheochromocytoma has been admitted for an adrenalectomy to be performed the following day. To prevent complications, the nurse should anticipate preoperative administration of which of the following?
A) IV antibiotics
B) Oral antihypertensives
C) Parenteral nutrition
D) IV corticosteroids
D) IV corticosteroids
A patient is undergoing testing for suspected adrenocortical insufficiency. The care team should ensure that the patient has been assessed for the most common cause of adrenocortical insufficiency. What is the most common cause of this health problem?
A) Therapeutic use of corticosteroids
B) Pheochromocytoma
C) Inadequate secretion of ACTH
D) Adrenal tumor
A) Therapeutic use of corticosteroids
The nurse is providing care for a patient with Chushing's syndrome has identified the nursing diagnosis of risk for injury r/t weakness. How should the nurse best reduce this risk?
A) Establish falls prevention
B) Encourage bed rest whenever possible
C) Encourage the use of assistive devices
D) Provide constant supervision
A) Establish falls prevention
A patient with Cushing's syndrome has been hospitalized after a fall. The dietitian consulted works with the patient to improve the patient's nutritional intake. What foods should a patient with Cushing's syndrome eat to optimize health? Select all that apply.
A) Foods high in vitamin D
B) Foods high in calories
C) Foods high in proteins
D) Foods high in calcium
E) Foods high in sodium
A) Foods high in vitamin D
C) Foods high in proteins
D) Foods high in calcium
A patient on corticosteroid therapy needs to be taught that a course of corticosteroids of 2 weeks' duration can suppress the adrenal cortex for how long?
A) Up to 4 weeks
B) Up to 3 months
C) Up to 9 months
D) Up to 1 year
D) Up to 1 year
A patient with Cushing's syndrome as a result of a pituitary tumor has been admitted for a transsphenoidal hypophysectomy. What would be most important for the nurse to monitor before, during, and after surgery?
A) Blood glucose
B) Assessment of urine for blood
C) Weight
D) Oral temperature
A) Blood glucose
The nurse is caring for a patient at risk for an addisonian cirisis. For what associated signs and symptoms should the nurse monitor the patient? Select all that apply.
A) Epitaxis
B) Pallor
C) Rapid respiratory rate
D) Bounding pulse
E) Hypotension
B) Pallor
C) Rapid respiratory rate
E) Hypotension
A patient has been assessed for aldosteronism and has recently begun treatment. What are priority areas for assessment that the nurse should frequently address? Select all that apply.
A) Pupillary response
B) Creatine and BUN levels
C) Potassium level
D) Peripheral pulses
E) BP
C) Creatine and BUN levels
E) BP
A patient who has been taking corticosteroids for several months has been experiencing muscle wasting. The patient has asked the nurse for suggestions to address this adverse effect. What should the nurse recommend?
A) Activity limitation to conserve energy
B) Consumption of a high-protein diet
C) Use of OTC vitamin D and calcium
D) Passive range-of-motion exercises
B) Consumption of a high-protein diet
The nurse is providing care for an older adult patient whose current medication regimen includes levothyroxine (Synthroid). As a result, the nurse should be aware of the heightened risk of adverse effects when administering an IV dose of what medication?
A) A fluroquinalone antibiotic
B) A loop diuretic
C) A proton pump inhibitor (PPI)
D) A benzodiazepine
D) A benzodiazepine
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