Study sets, textbooks, questions
Upgrade to remove ads
Diabetes, Hyperthyroidism, and Hypothyroidism Quiz
Terms in this set (15)
Which statement by a nurse to a patient newly diagnosed with type 2 diabetes is accurate?
1 Complications of type 2 diabetes are less serious than those of type 1 diabetes.
2 Insulin is not used to control blood glucose in patients with type 2 diabetes.
3 Type 2 diabetes is usually diagnosed when a patient is admitted in hyperglycemic coma.
4 Changes in diet and exercise may control blood glucose levels in type 2 diabetes
4. For some patients w/ type 2 diabetes, changes in lifestyle are sufficient to achieve blood glucose control.
A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?
1 Glycosylated hemoglobin
2 Fasting blood glucose
3 Oral glucose tolerance test
4 Urine dipstick for glucose and ketones
1. The glycosylated hemoglobin (A1C) test shows the overall control of glucose over 90 to 120 days.
2. A fasting blood level indicates only the glucose level at one time.
4. Urine glucose testing is not an accurate reflection of blood glucose level and does not reflect the glucose over a prolonged time.
3. Oral glucose tolerance testing is done to diagnose diabetes but is not used for monitoring glucose control after diabetes has been diagnosed
A patient receives aspart (NovoLog) insulin at 8:00 AM. At which time would the nurse anticipate the highest risk for hypoglycemia?
1 12:00 AM
2 4:00 PM
3 2:00 PM
4 10:00 AM
4. 10:00 AM
The rapid-acting insulins peak in 1 to 3 hours. The patient is not at high risk for hypoglycemia at the other listed times, although hypoglycemia may occur.
Which information will the nurse include when teaching a patient who has type 2 diabetes about glyburide?
1 Glyburide should be taken even if the morning blood glucose level is low.
2 Glyburide decreases glucagon secretion from the pancreas.
3 Glyburide should not be used for 48 hours after receiving IV contrast media.
4 Glyburide stimulates insulin production and release from the pancreas.
4. The sulfonylureas stimulate the production and release of insulin from the pancreas.
1. If the glucose level is low, the patient should contact the health care provider before taking the glyburide, because hypoglycemia can occur with this class of medication.
3. Metformin should be held for 48 hours after administration of IV contrast media, but this is not necessary for glyburide.
2. Glucagon secretion is not affected by glyburide.
An unresponsive patient who has type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemia syndrome (HHS). What should the nurse anticipate doing?
1 Administering glargine (Lantus) insulin
2 Initiating O2 by nasal cannula
3 Inserting an IV catheter
4 Giving 50% dextrose
3. insert a large-bore IV catheter. HHS is initially treated with large volumes of IV fluids to correct hypovolemia.
1. Regular insulin is administered, not long-acting insulin.
2. There is no indication that the patient requires oxygen.
4. Dextrose solutions will increase the patients blood glucose and would be contraindicated.
A 30-yr-old patient has a new diagnosis of type 2 diabetes. When should the nurse recommend the patient schedule a dilated eye examination?
1 As soon as available
2 Every 6 months
3 At the age of 39 years
4 Every 2 years
1. Because many patients have some diabetic retinopathy when they are first diagnosed with type 2 diabetes, a dilated eye examination is recommended at the time of diagnosis and annually thereafter.
Patients with type 1 diabetes should have dilated eye examinations starting 5 years after they are diagnosed and then annually.
After change-of-shift report, which patient will the nurse assess first?
1 A 68-yr-old patient with type 2 diabetes who has severe peripheral neuropathy and reports burning foot pain
2 A 60-yr-old patient with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
3 A 35-yr-old patient with type 1 diabetes whose most recent blood glucose reading was 130 mg/dL
4 A 19-yr-old patient with type 1 diabetes who was admitted with dawn phenomenon
2. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa. The patients diagnosis of HHS and signs of dehydration indicate that the nurse should rapidly assess for signs of shock and determine whether increased fluid infusion is needed.
1.3.4. The other patients also need assessment and intervention but do not have life-threatening complications.
A patient who has hyperthyroidism is treated with radioactive iodine (RAI). What information should the nurse include in discharge teaching?
a. Take radioactive precautions with all body secretions.
b. Symptoms of hyperthyroidism should be relieved in about a week.
c. Symptoms of hypothyroidism will occur as the RAI therapy takes effect.
d. Discontinue the antithyroid medications that were taken before the RAI therapy.
C. There is a high incidence of post-radiation hypothyroidism after RAI, and the patient should be monitored for symptoms of hypothyroidism.
B. D. RAI has a delayed response, with the maximum effect not seen for 2 to 3 months, and the patient will continue to take antithyroid medications during this time.
A. The therapeutic dose of radioactive iodine is low enough that no radiation safety precautions are needed.
A patient who was admitted with myxedema coma and diagnosed with hypothyroidism is improving. Discharge is expected to occur in 2 days. Which teaching strategy is likely to result in effective patient self-management at home?
1 Ensure privacy for teaching by asking the family to leave.
2 Provide teaching closer to admission date.
3 Provide written reminders of information taught.
4 Offer family options for management of therapies.
3. Written instructions will be helpful to the patient because initially the hypothyroid patient maybe unable to remember to take medications and other aspects of self-care.
2. Because the treatment regimen is somewhat complex, teaching should be initiated well before discharge.
1. Family members or friends should be included in teaching because the hypothyroid patient is likely to forget some aspects of the treatment plan.
4. A simpler regimen will be easier to understand until the patient is euthyroid.
A patient has just arrived on the unit after a thyroidectomy. Which action should the nurse take first?
1 Assess the patient's respiratory effort.
2 Check the blood pressure and pulse.
3 Support the patient's head with pillows.
4 Observe the dressing for bleeding.
1. Airway obstruction is a possible complication after thyroidectomy because of swelling or bleeding at the site or tetany.
The priority nursing action is to assess the airway.
2.3.4. The other actions are also part of the standard nursing care post thyroidectomy but are not as high of a priority.
Which assessment finding for an adult admitted with Graves' disease requires the most rapid intervention by the nurse?
1 Severe bilateral exophthalmos
2 Heart rate 136 beats/min
3 Blood pressure 166/100 mm Hg
4 Temperature 103.8° F (40.4° C)
4. The patient's temperature indicates that the patient may have a thyrotoxic crisis and that interventions to lower the temperature are needed immediately.
1.2.3. The other findings also require intervention but do not indicate potentially life-threatening complications
A patient has just arrived in the postanesthesia recovery unit (PACU) after a thyroidectomy. Which information about the patient is most important to communicate to the surgeon?
1 Difficult to awaken.
2 Cardiac rate 112 beats/min.
3 Reports 7/10 incisional pain.
4 Increasing neck swelling.
4. The neck swelling may lead to respiratory difficulty, and rapid intervention is needed to prevent airway obstruction.
3. The incisional pain should be treated but is not unusual after surgery.
2. A heartrate of 112 beats/min is not unusual in a patient who has been hyperthyroid and has just arrived in the PACU from surgery.
1. Sleepiness in the immediate postoperative period is expected.
When teaching about hypoglycemia, the nurse will make sure that the patient is aware of the early signs of hypoglycemia, including:
1 fruity, acetone odor to the breath.
2 hypothermia and seizures.
3 nausea and diarrhea.
4 confusion and sweating.
4. Early symptoms of hypoglycemia include the central nervous system manifestations of confusion, irritability, tremor, and sweating.
2. Hypothermia and seizures are later symptoms of hypoglycemia.
1.3. The other options are incorrect.
Which action is most appropriate regarding the nurse's administration of a rapid-acting insulin to a hospitalized patient?
1 Administer it with a snack before bedtime.
2 Give it within 15 minutes of mealtime.
3 Give it after the meal has been completed.
4 Administer it once daily at the time of the midday meal.
2. Rapid-acting insulins, such as insulin lispro and insulin aspart, are able to mimic closely the body's natural rapid insulin output after eating a meal; for this reason, both insulins are usually administered within 15 minutes of the patient's mealtime.
1.3.4. The other options are incorrect.
A patient with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes has been treated for pneumonia for the past week. The patient has been receiving intravenous corticosteroids as well as antibiotics as part of his therapy. At this time, the pneumonia has resolved, but when monitoring the blood glucose levels, the nurse notices that the level is still elevated. What is the best explanation for this elevation?
1 The hypoxia caused by the COPD causes an increased need for insulin.
2 His type 2 diabetes has converted to type 1.
3 The corticosteroids may cause an increase in glucose levels.
4 The antibiotics may cause an increase in glucose levels.
3. Corticosteroids can antagonize the hypoglycemic effects of insulin, resulting in elevated blood glucose levels.
1.2.4. The other options are incorrect.
Sets found in the same folder
Electrocardiography a better way
Other sets by this creator
AQ: Disorders of the Biliary Tract
AQ: Disorders of the Pancreas
AQ: Disorders of the Liver
Other Quizlet sets
Social Media Marketing ROI Quiz
Marketing (Chapter 5 - Lesson Quiz)
Ch 17 quiz