Endocrine

Question 1

The nurse performs discharge teaching for a client diagnosed with Addison’s disease. It is MOST important for the nurse to instruct the client about which of the following?

1. Signs and symptoms of infection.
2. Fluid and electrolyte balance.
3. Seizure precautions.
4. Steroid replacement.

Answer 1

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Strategy: Determine the outcome of each answer choice. Is it desired?

(1) not most important
(2) not most important
(3) not most important
(4) correct—steroid replacement is the most important information the client needs to know

Question 2

A patient is returned to the room after a subtotal thyroidectomy for treatment of hyperthyroidism. Which of the following, if found by the nurse at the patient’s bedside, is nonessential?

1. Potassium chloride for IV administration.
2. Calcium gluconate for IV administration.
3. Tracheostomy setup.
4. Suction equipment.

Answer 2

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Strategy: Answers are all implementations. Determine the outcome of each answer choice. Is it desired?

(1) correct—hypokalemia is not expected after this surgery
(2) used to treat tetany resulting from possible damage to parathyroid glands
(3) essential equipment to provide for airway
(4) needed to maintain a patent airway

Question 3

The nurse knows that the client diagnosed with drug-induced Cushing’s syndrome should FIRST be instructed about which of the following?

1. Compression fractures from increased calcium excretion.
2. Decreased resistance to stress.
3. The schedule for gradual withdrawal of the drug.
4. Changes in secondary sex characteristics.

Answer 3

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Strategy: Think about each answer choice.

(1) problems associated with Cushing’s syndrome but are not the first priority
(2) problems associated with Cushing’s syndrome but are not the first priority
(3) correct—if steroids are withdrawn suddenly, the client may die of acute adrenal insufficiency
(4) not seen with this medication

Question 4

The client exhibits symptoms of myxedema. The nursing assessment should reveal which of the following?

1. Increased pulse rate.
2. Decreased temperature.
3. Fine tremors.
4. Increased radioactive iodine uptake level.

Answer 4

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Strategy: Determine how each answer choice relates to myxedema.

(1) pulse will decrease
(2) correct—with myxedema there is a slowing of all body functions
(3) associated with hyperthyroidism
(4) associated with hyperthyroidism

Question 5

The nurse cares for a client diagnosed with Cushing’s syndrome. Which of the following nursing actions is the priority?

1. Implement measures to prevent skin breakdown.
2. Plan measures to prevent infections.
3. Teach the client signs and symptoms of hyperglycemia.
4. Instigate measures to prevent fluid overload.

Answer 5

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Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired?

(1) clients are susceptible to skin breakdown and infections
(2) clients are susceptible to skin breakdown and infections
(3) impaired glucose tolerance often leads to hyperglycemia, but is not highest priority
(4) correct—respirations are the first priority; clients with Cushing’s syndrome are prone to fluid overload and CHF due to sodium and water retention

Question 6

A client diagnosed with Addison’s disease is admitted with pneumonia. The nurse suggests salted broth for lunch. The appropriateness of this decision is based on which of the following statements about Addison’s disease?

1. The client requires increased sodium intake to prevent hypotension.
2. A decrease in sodium intake may lead to seizures.
3. Steroid replacement causes rapid loss of sodium.
4. Sodium intake should be increased during periods of stress.

Answer 6

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Strategy: Think about each answer choice.

(1) not as important as answer choice 4
(2) not a correct statement for this condition
(3) steroid replacement increases sodium retention
(4) correct—with decrease in aldosterone, there is an increased excretion of sodium; sodium intake should be increased

Question 7

The nurse obtains a history on a client with hyperthyroidism. The nurse should report which of the following assessments to the physician?

1. Anxiety with extreme nervousness.
2. Slow, sluggish pulse.
3. Cool, clammy skin.
4. Husky, slow speech.

Answer 7

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Strategy: Determine how each answer choice relates to hyperthyroidism.

(1) correct—signs and symptoms of hyperthyroidism are related to an increased metabolic rate
(2) related to a decreased metabolic rate
(3) related to a decreased metabolic rate
(4) related to a decreased metabolic rate

Question 8

A client is scheduled to have a parathyroidectomy. The nurse is MOST concerned if the client is observed eating quantities of food from which of the following food groups?

1. Milk products.
2. Green vegetables.
3. Seafood.
4. Poultry products.

Answer 8

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Strategy: Determine the outcome of each answer choice.

(1) correct—low-calcium diet is recommended preoperatively
(2) diet should be high in phosphorus and low in calcium
(3) diet should be high in phosphorus and low in calcium
(4) poultry is allowed in the diet