Chapter 51

Question 1

The nurse explains that the negative feedback inhibition controls hormone release by
communication between which two anatomical areas?
a. the pituitary and the target organ.
b. the thymus and the bloodstream.
c. lymphatic system and the target organ.
d. central nervous system and the bloodstream.

Answer 1

a. the pituitary and the target organ.

Question 2

Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the
previous 8 to 12 weeks?
a. Fasting blood sugar (FBS)
b. Oral glucose tolerance test (OGT)
c. Glycosylated hemoglobin (HbA1c)
d. Postprandial glucose test (PPBG)

Answer 2

c. Glycosylated hemoglobin (HbA1c)

Question 3

Which test will furnish immediate feedback for a newly diagnosed diabetic who is not yet
under control?
a. Fasting blood sugar (FBS)
b. Glycosylated hemoglobin (HbA1c)
c. Oral glucose tolerance test (OGTT)
d. Clinitest

Answer 3

a. Fasting blood sugar (FBS)

Question 4

To which diet should a patient with Cushing syndrome adhere?
a. Less sodium
b. More calories
c. Less potassium
d. More carbohydrates

Answer 4

a. Less sodium

Question 5

The patient is a 20-year-old college student who has type 1 diabetes and normally walks
each evening as part of an exercise regimen. The patient plans to enroll in a swimming class.
Which adjustment will the nurse suggest to the patient based on thisinformation?
a. Time the morning insulin injection so that the peak action will occur during
swimming class.
b. Delete normal walks on swimming class days.
c. Delay the meal before the swimming class until the session is over.
d. Monitor glucose level before, during, and after swimming to determine the need
for alterations in food or insulin.

Answer 5

d. Monitor glucose level before, during, and after swimming to determine the need
for alterations in food or insulin.

Question 6

Which disorder is a long-term complication of diabetes mellitus?
a. Diverticulitis
b. Renal failure
c. Hypothyroidism
d. Hyperglycemia

Answer 6

b. Renal failure

Question 7

A patient has returned to his room after a thyroidectomy with signs of thyroid crisis. During
thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of
which potentially lethal complication?
a. severe nausea and vomiting.
b. bradycardia.
c. delirium with restlessness.
d. congestive heart failure.

Answer 7

d. congestive heart failure.

Question 8

In diabetes insipidus, a deficiency of which hormone causes clinical manifestations?
a. Antidiuretic hormone (ADH)
b. Follicle-stimulating hormone (FSH)
c. Thyroid-stimulating hormone (TSH)
d. Adrenocorticotropic hormone (ACTH)

Answer 8

a. Antidiuretic hormone (ADH)

Question 9

The nurse expects to see which intervention in the plan of care for a patient who has recently
been diagnosed with acromegaly?
a. Encourage fluids
b. Maintain leg joints in flexion
c. Assist with activities of daily living
d. Monitor for episodes of bleeding into the joints

Answer 9

c. Assist with activities of daily living

Question 10

The use of radioactive iodine in the treatment of hyperthyroidism is for which purpose?
a. stimulate the thyroid gland.
b. depress the pituitary.
c. destroy some of the thyroid tissue.
d. alter the stimulus from the pituitary.

Answer 10

c. destroy some of the thyroid tissue.

Question 11

Which precaution(s) will the nurse take when caring for a patient who is being treated with
radioactive iodine 131 (RAIU)?
a. Initiate radioactive safety precautions.
b. Avoid assigning any young woman to the patient.
c. Wait 3 days after dose before assigning a pregnant nurse to care for this patient.
d. Advise visitors to sit at least 10 ft away from the patient.

Answer 11

c. Wait 3 days after dose before assigning a pregnant nurse to care for this patient.

Question 12

For which reason would a patient with hyperthyroidism be prescribed the drug
methimazole?
a. To limit the effect of the pituitary on the thyroid.
b. To destroy part of the hyperactive thyroid tissue.
c. To stimulate the pineal gland.
d. To block the production of thyroid hormones.

Answer 12

d. To block the production of thyroid hormones.

Question 13

The nurse will place the patient who has had a thyroidectomy in which position
postoperatively?
a. Prone
b. Semi-Fowler
c. Side-lying
d. Supine

Answer 13

b. Semi-Fowler

Question 14

Which extra equipment will the nurse provide at the bedside of a patient who has returned to
the nursing unit after a thyroidectomy three hours ago?
a. Large bandage scissors
b. Tracheotomy tray
c. Ventilator
d. Water-sealed drainage system

Answer 14

b. Tracheotomy tray

Question 15

As the nurse is shaving a patient who is 2 days postoperative from a thyroidectomy, the
patient has a spasm of the facial muscles. The nurse will recognize this as whichsign?
a. Chvostek sign
b. Montgomery sign
c. Trousseau sign
d. Homans’ sign

Answer 15

a. Chvostek sign

Question 16

Lispro has an onset of action within how many minutes?
a. 90
b. 60
c. 15
d. 45

Answer 16

c. 15

Question 17

Which information will the nurse provide a patient with type I diabetes regarding excessive
exercise?
a. It can increase the need for insulin and may result inhyperglycemia.
b. It can decrease the need for insulin and may result inhypoglycemia.
c. It can increase muscle bulk and may result in malabsorption of insulin.
d. It can decrease metabolic demand and may result in metabolic acidosis.

Answer 17

b. It can decrease the need for insulin and may result inhypoglycemia.

Question 18

Which condition does the Chvostek sign and the Trousseau sign indicate?
a. Low levels of serum calcium
b. High levels of blood sugar
c. Low levels of serum sodium
d. High levels of serum aldosterone

Answer 18

a. Low levels of serum calcium

Question 19

A patient has undergone tests that indicate a deficiency of the parathyroid hormone
secretion. The nurse will inform the patient of which potential complication?
a. Osteoporosis
b. Lethargy
c. Laryngeal spasms
d. Kidney stones

Answer 19

c. Laryngeal spasms

Question 20

The nurse caring for a 75-year-old man who has developed diabetes insipidus following a
head injury expects to see which aspect emphasized in the plan of care?
a. limiting fluids to 1500 mL a day.
b. encouraging physical exercise.
c. protecting patient from injury.
d. discouraging daytime naps.

Answer 20

c. protecting patient from injury.

Question 21

The health care provider orders an 1800-calorie diabetic diet and 40 units of NPH insulin
subcutaneously daily for a patient with diabetes mellitus. For which reason will a
mid-afternoon snack of milk and crackers be given?
a. To improve nutrition.
b. To improve carbohydrate metabolism.
c. To prevent hypoglycemia
d. To prevent diabetic coma.

Answer 21

c. To prevent hypoglycemia

Question 22

The nurse teaching a patient with type 1 diabetes mellitus (IDDM) will include which
information about early signs of hypoglycemia?
a. abdominal pain and nausea.
b. dyspnea and pallor.
c. flushing of the skin and headache.
d. hunger and a trembling sensation.

Answer 22

d. hunger and a trembling sensation.

Question 23

The nurse discovers a patient with type I diabetes drowsy and tremulous, the skin is cool
and moist, and the respirations are 32 and shallow. The nurse recognizes the patient is
having which type of reaction and quickly provides which intervention?
a. hypoglycemic reaction; give 6 oz of orange juice.
b. hyperglycemic reaction; give ordered regular insulin.
c. hyperglycemic hyperosmolar nonketotic reaction; squeeze glucagon gel in buccal
cavity.
d. hypoglycemic reaction; give ordered insulin.

Answer 23

a. hypoglycemic reaction; give 6 oz of orange juice.

Question 24

A patient has come to the clinic because of enlarged hands and feet, amenorrhea, and
increased hair growth. These symptoms most likely indicate problems with which endocrine
gland?
a. pituitary gland.
b. adrenal glands.
c. thyroid gland.
d. pancreas.

Answer 24

a. pituitary gland.

Question 25

Which instructions will the nurse provide to a patient with diabetes to prevent injury to the
feet?
a. Soak feet in warm water every day.
b. Avoid going barefoot and always wear shoes with soles.
c. Use of commercial keratolytic agents to remove corns and calluses are preferred to
cutting off corns and calluses.
d. Use a heating pad to warm feet when they feel cool to the touch.

Answer 25

b. Avoid going barefoot and always wear shoes with soles.

Question 26

The health care provider prescribes glyburide for a patient, when diet and exercise have not
been able to control type 2 diabetes. Which information will the nurse reinforce in the
teaching plan about this medication?
a. It is a substitute for insulin and acts by directly stimulating glucose uptake into the
cell.
b. It does not cause the hypoglycemic reactions that may occur with insulin use.
c. It is thought to stimulate insulin production and increase sensitivity to insulin at receptor sites.
d. It lowers blood sugar by inhibiting glucagon release from the liver, preventing
gluconeogenesis.

Answer 26

c. It is thought to stimulate insulin production and increase sensitivity to insulin at receptor sites.

Question 27

A 27-year-old patient with hypothyroidism is referred to the dietitian for dietary
consultation. The nurse will reinforce instructions for which nutritionalinterventions?
a. Frequent small meals high in carbohydrates
b. Calorie-restricted meals
c. Caffeine-rich beverages
d. Fluid restrictions

Answer 27

b. Calorie-restricted meals

Question 28

Which instructions will the nurse reinforce in the discharge instructions for a 47-year-old
patient with hypothyroidism?
a. Taking medication whenever symptoms cause discomfort
b. Decreasing fluid and fiber intake
c. Consuming foods rich in iron
d. Seeing the health care provider regularly for follow-up care

Answer 28

d. Seeing the health care provider regularly for follow-up care

Question 29

In which manner will the nurse administer insulin to prevent lipohypertrophy?
a. At room temperature
b. At body temperature
c. Straight from the refrigerator
d. After rolling bottle between hands to warm

Answer 29

a. At room temperature

Question 30

A patient with a history of Graves’ disease is admitted to the unit with shortness of breath.
The nurse notes the patient’s vital signs: T 103°F, P 160, R 24, BP 160/80. The nurse also
notes distended neck veins. Which disorder does the patient most likely have?
a. Pulmonary embolism
b. Hypertensive crisis
c. Thyroid storm
d. Cushing crisis

Answer 30

c. Thyroid storm

Question 31

Which gland is the master gland of the endocrine system?
a. Thyroid
b. Parathyroid
c. Pancreas
d. Pituitary

Answer 31

d. Pituitary

Question 32

Which information should be obtained from the patient before treatment with iodine-131?
a. Presence of metal in the body
b. Allergy to sulfa drugs
c. Status of possible pregnancy
d. Use of prescription drugs for hypertension

Answer 32

c. Status of possible pregnancy

Question 33

The patient being treated for hypothyroidism has been instructed to eat well-balanced meals
including intake of iodine. The nurse will reinforce instructions to eat which food containing
iodine?
a. Eggs
b. Pork
c. White bread
d. Skinless chicken

Answer 33

a. Eggs

Question 34

The nurse is caring for a patient who is receiving calcium gluconate for treatment of
hypoparathyroid tetany. Which assessment would indicate an adverse reaction to thedrug?
a. Increase in heart rate
b. Flushing of face and neck
c. Drop in blood pressure
d. Urticaria

Answer 34

c. Drop in blood pressure

Question 35

The nurse cautions the patient who is being instructed on self-medication with insulin to be aware that there are 25-, 30-, 50-, and 100-unit syringes. How is the 100-unit syringe marked?
a. 1-unit increments
b. 2-unit increments
c. 4-unit increments
d. 5-unit increments

Answer 35

b. 2-unit increments