CHAPTER 50

Question 1

1. The nurse is evaluating the laboratory results for a client who has increased secretion of
   the anterior pituitary hormones. Which of the following findings should the nurse
   anticipate when reviewing the laboratory findings?
   a. Decreased serum thyroxine levels
   b. Elevated serum aldosterone levels
   c. An increase in urinary free cortisol
   d. Low urinary excretion of catecholamines

Answer 1

C

Question 2

2. The nurse is obtaining the health history from a client. Which of the following statements
   by the client indicates further assessment of thyroid function may be necessary?
   a. “I notice my breasts are tender lately.”
   b. “I am so thirsty that I drink all day long.”
   c. “I get up several times at night to urinate.”
   d. “I feel a lump in my throat when I swallow.”

Answer 2

D

Question 3

3. The nurse is caring for a client who is preparing for a growth hormone stimulation test.
   Which of the following adverse effects should the nurse monitor for during the test?
   a. Bradycardia
   b. Hypotension
   c. Hyperglycemia

Answer 3

B

Question 4

4. The nurse is interviewing a client who has a possible thyroid disorder. Which of the
   following questions will provide the most useful information?
   a. “What methods do you use to help cope with stress?”
   b. “Have you experienced any blurring or double vision?”
   c. “Do you have to get up at night to empty your bladder?”
   d. “Have you had any recent unplanned weight gain or loss?”

Answer 4

D

Question 5

5. The nurse is caring for a client in the outpatient clinic who has a prescription for blood
   cortisol testing. Which of the following instructions should the nurse provide for the
   client?
   a. “Avoid adding any salt to your foods for 24 hours before the test.”
   b. “You will need to lie down for 30 minutes before the blood is drawn.”
   c. “Come to the laboratory to have the blood drawn early in the morning.”
   d. “Do not have anything to eat or drink before the blood test is obtained.”

Answer 5

C

Question 6

6. A client has a total serum calcium level of 3.3 mmol/L. Which of the following laboratory
   results should the nurse assess next?
   a. Calcitonin
   b. Catecholamine
   c. Thyroid hormone
   d. Parathyroid hormone

Answer 6

D

Question 7

7. During a physical examination, the nurse finds that a client’s thyroid gland cannot be
   palpated. Which of the following is the best action for the nurse to take?
   a. Palpate the client’s neck more deeply
   b. Document that the thyroid was nonpalpable
   c. Notify the health care provider immediately
   d. Teach the client about thyroid hormone testing

Answer 7

B

Question 8

8. The nurse is caring for a client who has clinical manifestations of hypothyroidism. Which
   of the following laboratory tests is most accurate to evaluate thyroid function?
   a. Thyroxine (T4) level
   b. Triiodothyronine (T3) level
   c. Thyroid-stimulating hormone (TSH) level
   d. Thyrotropin-releasing hormone (TRH) level

Answer 8

C

Question 9

9. A client who has diabetes mellitus asks the nurse what the glycosylated hemoglobin
   (HbA1C) test measures. Which of the following explanations should be the basis of the
   nurse’s response?
   a. Glucose levels 2 hours after a meal
   b. Circulating, non-fasting glucose levels
   c. Glucose control over the past 3 months
   d. Hypoglycemic episodes in the past 90 days

Answer 9

C

Question 10

10. The nurse is caring for a client who is taking spironolactone. Which of the following
    parameters should the nurse monitor?
    a. Decreased urinary output
    b. Evidence of fluid overload.
    c. Increased serum sodium levels.
    d. Elevated serum potassium levels.

Answer 10

D

Question 11

11. The nurse is teaching a client how to prepare for an oral glucose tolerance test (OGTT).
    Which of the following client response indicates that the teaching has been effective?
    a. Fast 12 hours before the procedure
    b. Clear fluid diet 12 hours prior to the test
    c. Drink only full fluids 6 hours before the test
    d. No fluid or food restrictions prior to the test

Answer 11

D

Question 12

12. A client is scheduled for a growth hormone stimulation test. Which of the following items should the nurse obtain in preparation for the test?
    a. Basin of ice
    b. Cardiac monitor
    c. Vial of glargine insulin
    d. Intravenous dextrose solution

Answer 12

D

Question 13

13. The regulation of oxytocin during childbirth is an example of which of the following
    mechanisms?
    a. Physiological rhythm
    b. Secondary input
    c. Loop regulation
    d. Positive feedback

Answer 13

D

Question 14

14. The nurse is caring for a client who is scheduled for a 24-hour urine collection for
    17-ketosteroids. Which of the following actions should the nurse implement?
    a. Keep the specimen on ice
    b. Insert a retention catheter
    c. Have the client void and save that specimen to start the collection
    d. Encourage the client to drink 2–3 L of fluid during the 24 hours

Answer 14

A

Question 15

15. When reviewing the laboratory results for a client’s total calcium level, which of the
    following information should the nurse consider?
    a. The blood glucose is elevated.
    b. The phosphate level is normal.
    c. The serum albumin level is low.
    d. The magnesium level is normal.

Answer 15

C

Question 16

16. The nurse is caring for a client who was admitted with tetany. Which of the following
    laboratory values should the nurse monitor?
    a. Total protein
    b. Blood glucose
    c. Ionized calcium
    d. Serum phosphate

Answer 16

C

Question 17

17. Which of the following information about a client who is scheduled for an oral glucose
    tolerance test should be reported to the health care provider before starting the test?
    a. Occasional orthostatic dizziness.
    b. A 5-kg weight gain in the last month.
    c. Intake of 1 L of water an hour previously.
    d. Oral corticosteroid use for rheumatoid arthritis.

Answer 17

D

Question 18

18. The student nurse is caring for a client with goitre and possible hyperthyroidism. Which of the following actions by the student nurse should cause the nursing instructor to intervene?
    a. Palpates the neck to check thyroid size.
    b. Checks the blood pressure on both arms.
    c. Administers nonmedicated eye drops to the client’s eyes.
    d. Lowers the thermostat to decrease the temperature in the room.

Answer 18

A

Question 19

19. The nurse is caring for a client who is undergoing a water deprivation test. Which of the
    following findings is most important for the nurse to communicate to the health care
    provider?
    a. Intense thirst
    b. 2.3 kg weight loss
    c. Orthostatic hypotension
    d. No change in urine osmolality

Answer 19

B

Question 20

20. A client with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which of the following client information is most important for the nurse to communicate to the health care provider before the test?
    a. Bilateral poor peripheral vision
    b. Allergies to iodine and shellfish
    c. Recent weight loss of 8.5 kg
    d. History of ongoing headaches

Answer 20

B