Adult-Endocrine

Question 1

A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperosmolar hyperglycemic syndrome (A serious complication of diabetes mellitus) is made. the nurse would immediately prepare to initiate which anticipated primary health care providers prescription?

Answer 1

intravenous infusion of normal saline

Question 2

an external insulin pump is prescribed for a client with diabetes mellitus. when the client ask the nurse about the functioning of the pump, the nurse bases the response on which information about the pump?

Answer 2

it administers a small continuous dose of short duration insulin subcutaneously. the client can self administer an additional bolus dose from the pump before each meal.

Question 3

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. which findings support this diagnosis? select all that apply.

Answer 3

Comatose state
deep, rapid breathing
elevated blood glucose level

Question 4

the nurse teaches a client with diabetes mellitus about differentiating between hypoglycemia and ketoacidosis. the client demonstrate an understanding of the teaching by stating that a form of glucose should be taken if which symptom develop? select all that apply.

Answer 4

shakiness
palpitations
lightheadedness

Question 5

a client with diabetes mellitus demonstrate acute anxiety when admitted to the hospital for the treatment of hyperglycemia (high blood glucose, body has too little insulin). what is the appropriate intervention to decrease the clients anxiety?

Answer 5

convey empathy, trust, and respect toward the client.

Question 6

the nurse provides instructions to a client newly diagnosed with type 1 mellitus. the nurse recognizes accurate understanding of measures to prevent diabetic ketoacidosis (DKA is a serious complication of diabetes that can be life threatening) when the client makes which statement.

Answer 6

“i will notify my primary health care provider (PHCP) if my blood glucose level is higher than 250mg/dL (13.9mmol/L)

Question 7

A client admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level is 950mg/dL (52.9mmol/L). a continuous intravenous (IV) infusion of short -acting insulin is initiated, along with IV rehydration with normal saline. the serum glucose level is no decreased to 240mg/dL (13.3mmol/L). The nurse will next prepare to administer which medication?

Answer 7

IV fluids containing dextrose

Question 8

the nurse is monitoring a client newly diagnosed with diabetes mellitus for signs of complications. which sign or symptom, if frequently exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if the blood glucose is not adequately managed?

Answer 8

polyuria (excessive urination)

Question 9

the home health nurse visits a client with diagnosis of type one diabetes mellitus. the client reports a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24hrs. which additional statement by the client indicates a need for further teaching?

Answer 9

” i need to stop my insulin”

Question 10

the nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. the nurse places priority on which clients problem?

Answer 10

inadequate fluid volume

Question 11

maslows hierarchy of needs theory

Answer 11

Physiological Needs. Food, water, clothing, sleep, and shelter are the bare necessities for anyone’s survival. …
Safety and Security. Once a person’s basic needs are satisfied, the want for order and predictability sets in. …
Love and Belonging. …
Esteem. …
Self-Actualization.

Question 12

the nurse is caring for a client after hypophysectomy (surgery done to remove the pituitary gland) and notes clear nasal drainage from the clients nostril. the nurse should take which initial action?

Answer 12

test the drainage for glucose.

Question 13

the nurse is admitting a client who is diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and has serum sodium of 118 mEq/L (118mmol/L). which primary health care provider prescriptions should the nurse anticipate receiving? select all that apply.

Answer 13

initiate an infusion of 3% NaCl.
restrict fluids to 800mL over 24hr.
administer a vasopressin antagonist as prescribed.

Question 14

a client admitted to an emergency department , and a diagnosis of myxedema coma is made. which action should the nurse prepare to carry out initially?

Answer 14

maintain a patent airway.

Question 15

the nurse is caring for a client admitted to the emergency department with diabetic ketoacidosis (DKA). in the acute phase, the nurse plans for which priority intervention?

Answer 15

administer short duration insulin intravenously.

Question 16

a client with type 1 diabetes mellitus who takes NPH daily in the morning calls the nurse to report recurrent episode of hypoglycemia with exercising. which statement by the client indicates an adequate understanding of the peak action of NPH insulin and exercise?

Answer 16

“the best time for me to exercise is after breakfast.”

Question 17

The nurse is completing an assessment on a client who is being admitted for a diagnostic workup for primary hyperparathyroidism. which client complains would be characteristic of this disorder?

Answer 17

polyuria

bone pain

Question 18

the nurse is teaching a client with hyperparathyroidism how to manage the condition at home. which response by the client indicates the need for additional teaching?

Answer 18

“i should consume less than one liter of fluid per day.”

Question 19

a client with diagnosis of Addisonian crisis (a life threatening situation that results in low blood pressure, low blood levels of sugar and high blood levels of potassium.)is being admitted to the intensive care unit. which findings will be inter-professional health care team focus on? select all that apply

Answer 19

hypotension (bp under 90/60mm/hg)

hyperkalemia (potassium level in your blood thats higher than normal)

Question 20

the nurse in monitoring a client who was diagnosed with type 1 diabetes mellitus and is being treated with NPH and regular insulin. which manifestations would alert the nurse to the presence of a possible hypoglycemic reaction (blood sugar drops too low)

Answer 20

tremors
irritability
nervousness

Question 21

the nurse is performing an assessment on a client with pheochromocytoma (a type of neuro endocrine tumor that grows from cells called chromaffin cells). which assessment data would indicate potential complication associated with this disorder?

Answer 21

a heart rate that is 90 beats per minute and irregular

Question 22

the nurse is monitoring a client diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy (an effective surgical technique for removing pituitary) and is recovering in the intensive care unit. which finding should alert the nurse to a presence of a possible postoperative complication? select all that apply

Answer 22

leukocytosis
urinary output of 800mL/hr
clear drainage on nasal dripper pad

Question 23

the nurse performs a physical assessment on a client with type 2 diabetes mellitus. finding include a fasting blood glucose level of 70mg/dL (3.9 mmol/L), temperature of 101 F (38.3 C), pulse of 82 beats per minute, respirations of 20 breaths per minute, and blood pressure of 118/68mm Hg. which finding would be the priority concern to the nurse?

Answer 23

temperature (in the client with type 2 diabetes mellitus an elevated temperature may indicate infection. infection is a leading cause of hyperosmolar hyperglycemic syndrome (BLOOD GLUCOSE LEVELS ARE TOO HIGH FOR A LONG PERIOD, LEADING TO DEHYDRATION AND CONFUSION))

Question 24

The nurse is preparing a client with a new diagnoses of hypothyroidism (thyroid doesnt create and release enough thyroid hormone into your blood stream) for discharge. the nurse determines that the client understands discharge instructions if the client states that which signs and symptoms are associated with this diagnosis?

Answer 24

feeling cold
loss of body hair
persistent lethargy
puffiness of the face

Question 25

a client has just been admitted to the nursing unit following thyroidectomy (surgical removal of all or part of the thyroid gland). which assessment is the priority for this client?

Answer 25

audible stridor (it is very important to monitor airway status as any swelling to the surgical site could cause respiratory distress)

Question 26

a client has been diagnosed with hyperthyroidism. the nurse monitors for which signs and symptoms indicating a complication of this disorder? select all that apply.

Answer 26

fever
nausea
tremors
confusion

Question 27

the nurse is teaching a client with diabetes mellitus how to fix regular insulin and NPH insulin in the same syringe. which action, if performed by the client , indicates the need for further teaching?

Answer 27

withdraws the NPH insulin first (when preparing a mixture of short acting insulin, such as regular insulin, with another insulin preparation, the short acting insulin is drawn into the syringe first. this sequence will avoid contaminating the vial of short acting insulin of another type)

Question 28

the home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. the client asks the nurse how to store the unopened vials of insulin. the nurse should tell the client to take which action?

Answer 28

refrigerate the insulin

Question 29

Glimepiride (used to treat high blood sugar levels caused by type 2 diabetes) is prescribed for a client with diabetes mellitus. the nurse instructs the client that which food item are most acceptable to consume while taking this medication? select all that apply.

Answer 29

Red meats
whole grain cereal
carbonated beverages

Question 30

the nurse is providing discharge teaching for a client newly diagnosed with type 2 diabetes mellitus who has been prescribed metformin ( is used to treat high blood sugar levels that are caused by a type of diabetes mellitus or sugar diabetes called type 2 diabetes). which client statement indicates the need for further teaching?

Answer 30

“i need to constantly watch for signs of blood sugar”

Question 31

the primary health care provider (PHCP) prescribes exenatide (an injectable diabetes medicine that helps control blood sugar levels, type 2 diabetes) for a client with type 1 diabetes mellitus who takes insulin . the nurse should plan to take which most appropriate intervention?

Answer 31

withhold the medication and call the PHCP, questioning the prescription for the client.

Question 32

a client with diabetes mellitus is taking Humulin NPH insulin and regular insulin every morning. The nurse should provide which instructions to the client? Select all that apply

Answer 32

hypoglycemia may be experienced before dinner time.

the insulin should be administer at room temperature.

Question 33

the home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. the client is prescribed repaglinide and metformin. the nurse should provide which instructions to the client? select all that apply.

Answer 33

Diarrhea may occur secondary to the metformin.
the repaglinide is not taken if a meal is skipped.
the repaglinide is taken 30minutes before eating .
a simple sugar food item is carried and used to treat mild hypoglycemia episodes.

Question 34

the nurse is teaching the client about his prescribed prednisone. which statement if made by the client, indicates that further teaching is necessary?

Answer 34

“i can take aspirin or my antihistamine if i need it.”

Question 35

A client with hyperthyroidism has been given methimazole. which nursing considerations are associated with this medication? select all that apply

Answer 35

administer methimazole with food
assess the client for unexplained bruising or bleeding.
instruct the client to report side and adverse effects such as sore throat , fever, or headaches.

Question 36

the nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. which findings indicate the presence of a side effect associated with this medication? select all that apply

Answer 36

insomnia
weight loss
mild heat intolerance

Question 37

the nurse provides instructions to a client who is taking levothyroxine. the nurse should tell the client to take the medication in which way?

Answer 37

on an empty stomach

Question 38

the nurse should tell the client who is taking levothyroxine to notify the primary health care provider (PHCP) if which problem occurs?

Answer 38

tremors

Question 39

the nurse is providing instructions to the client newly diagnosed with diabetes mellitus who has been prescribed pramlintide. which instruction should the nurse include in the discharge teaching?

Answer 39

” take your prescribed pills 1 hour before or 2 hours after the injection.”

Question 40

the nurse teaching the client who is newly diagnosed with diabetes insipidus about the prescribed intranasal desmopressin. which statement by the client indicate understanding? select all that apply.

Answer 40

i should decrease my oral fluids when i start this medication.
i should report headache and drowsiness to my doctor since these symptoms could be related to my desmopressin.

Question 41

a daily dose of prednisone is prescribed for a client. the nurse provides instructions to the client regarding administration of the medication and should instruct the client that which time is best to take this medication?

Answer 41

early morning

Question 42

the client with hyperparathyroidism is taking alendronate. which statement by the client indicate understanding of the proper way to take his medication? select all that apply

Answer 42

” i should sit up for at least 30 minutes after taking this medication.”

” i should take this medication first thing in the morning on an empty stomach.”

Question 43

a client with diabetes mellitus visits a health care clinic. the clients diabetes mellitus previously had been well controlled with glyburide daily, but recently the fasting blood glucose level has been 180 to 200mg/dL (10 to 11.1 mmol/L). which medication, if added to the clients regimen, may have contributed to the hyperglycemia?

Answer 43

prednisone