ATI: #4 Targeted Medical-Surgical 2013: Endocrine Flashcards

1
Q

A nurse in an outpatient clinic is teaching a pt with a diabetic foot ulcer about foot care. Which demonstrates an understanding?
A. I will let my feet air dry
B. I will wear sandals to let air circulate around my feet
C. I will buy OTC medicine to treat the calluses on my feet
D. I will apply lotion to the dry areas of my feet, avoiding application btwn my toes

A

D. I will apply lotion to the dry areas of my feet, avoiding application btwn my toes

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2
Q
A nurse is assessing a pt with DM who reports feeling anxious. Which of the following findings should the nurse expect if the pt is hypoglycemic? 
A. Rapid, deep respirations
B. Cool, clammy skin
C. Abdominal cramping
D. Orthostatic hypotension
A

B. Cool, clammy skin

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3
Q

A nurse is caring for a pt with T2DM and is admitted with hyperglycemic-hyperosmolar state (HHS). Which lab results should the nurse expect?
A. Blood glucose of 496 mg/dL and serum pH of 7.32
B. Blood glucose of 550 mg/dL and serum pH of 7.02
C. Blood glucose of 702 mg/dL and serum pH of 6.11
D. Blood glucose of 846 mg/dL and serum pH of 7.40

A

D. Blood glucose of 846 mg/dL and serum pH of 7.40

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4
Q

A nurse is preparing insulin for a pt who has DM. The pt is to receive evening doses of insulin glargine and regular insulin. Which of thee following actions should the nurse take to administer these two meds safely?
A. Draw up the glargine into the syringe first, and then draw up the regular insulin
B. Draw up the regular first, and then the glargine
C. Draw up glargine and the regular in separate syringes
D. Draw up either insulins first because they’re both clear

A

C. Draw up glargine and the regular in separate syringes

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5
Q
A nurse is monitoring a pt's status 24hr post total thyroidectomy. Which of the following findings should the nurse report to the provider?
A. Laryngeal stridor
B. Productive cough
C. Pain with hyperextension of the neck
D. Hoarse, weak voice
A

A. Laryngeal stridor

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6
Q

A nurse is caring for a pt who has DM and developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to the feet?
A. Examine the skin & feet weekly for alterations in skin integrity
B. Monitor the temperature of bath water with a thermometer
C. Shop for shoes early in the day
D. Round the edges of toenails when trimming

A

B. Monitor the temperature of bath water with a thermometer

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7
Q
A nurse is planning preoperative care for a pt who has pheochromocytoma. Which of the following interventions should the nurse anticipate as being the priority?
A. Use same arm for BP measurement
B. Avoid palpating the abdomen
C. Manage headaches w/ analgesics
D. Provide a private, darkened room
A

B. Avoid palpating the abdomen

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8
Q

A nurse is caring for a pt following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia?
A. Strong, bounding pulse
B. Decreased bowel sounds
C. Tingling and numbness of the hands and feet
D. Diminished deep-tendon reflexes

A

C. Tingling and numbness of the hands and feet

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9
Q

A nurse is preparing to administer propranolol by IV bolus to a pt experiencing thyroid storm. Which of the following findings indicates the pt is having a therapeutic response?
A. Reduction of the effects of the thyroid hormone on the heart
B. Blockage of the release of the thyroid hormone from the thyroid gland
C. Increase of the heart’s sensitivity to thyroid hormone
D. Increase of the uptake of thyroid hormone by the thyroid gland

A

A. Reduction of the effects of the thyroid hormone on the heart

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10
Q

A nurse is providing teaching for a pt who has DM. Which of the following findings associated with DKA should the nurse include?
A. Decreased urine output
B. Weight gain of 0.45kg (1lb) in 24hr
C. Rapid, shallow respirations
D. Blood glucose levels greater than 300mg/dL

A

D. Blood glucose levels greater than 300mg/dL

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11
Q
A nurse is assessing a pt who has adrenal insufficiency. Which of the following findings should the nurse expect?
A. Moon face
B. Weight gain
C. Serum calcium 12.8mg/dL
D. Serum sodium 150 mEq/L
A

C. Serum calcium 12.8mg/dL

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12
Q

A nurse is managing the care of a pt who is postop and experiencing acute adrenal insufficiency. Which of the following actions should the nurse take?
A. Administer IV hydrocortisone sodium succinate
B. Give oral spironolactone
C. Infuse 1 unit of platelets
D. Restrict daily fluid intake

A

A. Administer IV hydrocortisone sodium succinate

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13
Q
A nurse is assessing a client who has a new dx of Cushing's disease. Which of the following findings should the nurse expect?
A. Decreased BP
B. Weight loss
C. Hirsutism
D. Increased skin thickness
A

C. Hirsutism

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14
Q
A nurse is admitting a pt who has hyperthyroidism. When assessing the pt, the nurse should expect which of the following findings?
A. Cold intolerance
B. Lethargy
C. Tremors
D. Sunken eyes
A

C. Tremors

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15
Q

A nurse is providing teaching for a pt who has T1DM about how to prevent complications during illness. Which of the following statements indicates that the pt understands the teaching?
A. I should stop taking my insulin if I feel nauseous
B. I will test my urine for protein when I start to feel ill
C. I will call my doctor if my blood sugar is more than 250mg/dL
D. I should check my blood glucose level Q8hr

A

C. I will call my doctor if my blood sugar is more than 250mg/dL

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16
Q
A nurse is assessing a pt on lifelong hormone replacement therapy for hypothyroidism. The pt has not been taking his medication regularly. Which of the following findings should the nurse expect?
A. Significant weight loss
B. Persistent diarrhea
C. Tachycardia
D. Hypotension
A

D. Hypotension

17
Q
A nurse is caring for a pt undergoing screening for primary Cushing's disease. The nurse should expect which of the following lab findings to be elevated?
A. Lymphocyte count
B. Serum potassium
C. Serum calcium
D. Blood glucose
A

D. Blood glucose

18
Q

A nurse is developing a teaching plan for a pt who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include?
A. Take this medication on an empty stomach
B. Take this medication with an antacid
C. Change position slowly while taking this medication
D. Limit your fluid intake while taking this medication

A

A. Take this medication on an empty stomach before breakfast daily

19
Q

A nurse is providing discharge teaching for a pt who has Diabetes Insipidus and has a new prescription for desmopressin nasal spray. Which of the following instructions should the nurse include in the teaching?
A. Breath deeply while using the nasal spray
B. Blow nose gently prior to using the nasal spray
C. Administer the nasal spray while in side-lying position
D. Instill the medication QID

A

B. Blow nose gently prior to using the nasal spray

20
Q

A nurse is teaching a pt about glycosylated hemoglobin (HbA1c) testing. Which of the following statements by the pt indicates an understanding?
A. I need to fast after midnight the night before the test
B. This test is a good indicator of my average blood glucose levels
C. A level of 8-10% suggest adequate blood glucose control
D. I will use my HbA1c level to adjust my daily insulin doses

A

B. This test is a good indicator of my average blood glucose levels

21
Q
A nurse is performing an assessment on a pt who has SIADH. Which of the following assessment data should the nurse report?
A. Serum sodium 110 mEq/L
B. 2+ deep-tendon reflexes
C. Serum potassium 3.7 mEq/L
D. Urine specific gravity 1.025
A

A. Serum sodium 110 mEq/L

22
Q

A nurse is preparing a teaching plan for a pt who has diabetes insipidus and is receiving intranasal desmopressin. Which of the following information should the nurse include?
A. Daily fluid intake should be at least 3L
B. Obtain weight weekly while wearing similar clothing at the same time of the day
C. Notify the provider if a weight loss of 0.45kg (1lb) or more per week is noted
D. Occurrence of nocturia indicates the need for a dosage adjustment (start with bedtime dose, and when nocturia is controlled, doses are given twice daily)

A

D. Occurrence of nocturia indicates the need for a dosage adjustment

23
Q
A nurse is preparing to give a pt info about an ACTH stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders?
A. Cushing's Syndrome
B. Hyperthyriodism
C. Pheochromocytoma
D. Addison's Disease
A

D. Addison’s Disease

24
Q

A nurse is planning dietary teaching for a pt who has T1DM. Which of the following info should the nurse include regarding EtOH?
A. Substitute 2 carb exchanges for every 1 EtOH beverage
B. Ingest EtOH w/ meals to reduce hypoglycemia
C. Cosuming EtOH decreases blood triglyceride levels
D. Expect to increase insulin dosage when consuming EtOH

A

B. Ingest EtOH w/ meals to reduce hypoglycemia

25
Q

A nurse is monitoring the lab values of a pt with DM and who is taking insulin. Which of the following results indicates a therapeutic outcome?
A. Fasting blood glucose of 96mg/dL
B. Postprandial blood glucose of 196mg/dL
C. Casual blood glucose of 210mg/dL
D. Preprandial blood glucose 60mg/dL

A

A. Fasting blood glucose of 96mg/dL

26
Q
A nurse is teaching a pt who has an autoimmune disease about the adverse effects of long-term corticosteroid therapy. Which of the following effects should the nurse include? SELECT ALL THAT APPLY
A. Osteoporosis
B. Moon-shaped face
C. Increased risk of infection
D. Hearing loss
E. Weight loss
A

A. Osteoporosis
B. Moon-shaped face
C. Increased risk of infection

27
Q
A nurse is caring for a pt taking propylthiouracil (PTU). The nurse should recognize that the pt has met the treatment goals when she reports an increase in which of the following?
A. sweating
B. stools
C. weight
D. appetite
A

C. weight

28
Q

To screen for pheochromocytoma, a nurse schedules a vanillylmandelic acid test. When teaching the pt about it, which of the following info should the nurse include?
A. Start fasting at midnight
B. Begin the 24hr urine collection with the first morning urination
C. Take low-dose aspirin for pain during the test
D. Restrict coffee intake 2-3 days prior to the test

A

D. Restrict coffee intake 2-3 days prior to the test

29
Q
A nurse is assessing a pt who has diabetes insipidus. The nurse should expect which of the following findings?
A. Decreased heart rate
B. Increased Hct
C. High urine specific gravity
D. Decreased BUN
A

B. Increased Hct

30
Q

A nurse is reviewing the lab values for a pt who has DKA. Which of the following results should the nurse expect?
A. pH 7.32 – PaCO2 36mmHg – HCO3 14mEq/L
B. pH 7.38 – PaCO2 55mmHg – HCO3 22mEq/L
C. pH 7.44 – PaCO2 40mmHg – HCO3 24mEq/L
D. pH 7.50 – PaCO2 42mmHg – HCO3 30mEq/L

A

A. pH 7.32 – PaCO2 36mmHg – HCO3 14mEq/L