Endocrine Flashcards
A nurse is caring for a client who is postoperative following a bilateral adrenalectomy. The nurse should expect to administer glucocorticoids following the procedure to enhance which of the following therapeutic effects?
A. compensate for decrease in cortisol levels
B. inhibit glucose metabolism
C. Act as a diuretic to maintain urine output
D. Decrease susceptibility to infection
A. compensate for decrease in cortisol levels
A client who has an adrenalectomy requires glucocorticoids before, during, and after surgery to prevent an _____ caused by a sudden drop in cortisol levels.
adrenal crisis
The client who has an adrenalectomy has increased ________ levels due to the increase in production of glucocorticoids. Glucocoricoids stimulate gluconeogenesis and are not given to inhibit glucose metabolism.
blood glucose
The client who has an adrenalectomy has an increased risk for infection due to the increase in production of glucocorticoids. Glucocorticoids have potent anti-inflammatory and _________ properties and increase the client’s susceptibility to infection.
v
A nurse is planning a community health screening for a group of clients who are at risk for type 2 diabetes mellitus. Which of the following clients should the nurse include in the screening?
A. men who smoke
B. Men and women who are obese
C. Women who have hepatitis
D. Men and women who consume high protein and low carb foods.
B. Men and women who are obese
There is a high correlation between ______ and type 2 diabetes.
obesity
A nurse is providing teaching to a client who has type 1 diabetes mellitus about hypoglycemia. Which of the following manifestations should the nurse include in the teaching?
A. Shakiness
B. Urinary frequency
C. Dry mucous membranes
D. Excess thirst
A. shakiness
The client who has hypoglycemia can experience early manifestations of shakiness. Other early manifestations include fatigue, headache, difficulty thinking, ______, and nausea.
sweating
The client who has hyperglycemia will have manifestations of increased _______ called polyuria.
urination
The client who has _______ will have manifestations of excess thirst called polydipsia.
hyperglycemia
The client who has hyperglycemia will have manifestations of dehydration, such as dry mucous membranes and ______.
sunken eyeballs
A nurse is caring for a client who has type 2 diabetes mellitus and is displaying manifestations of hyperglycemia. Which of the following findings should indicate to the nurse that the client has hyperglycemia?
A. Hunger
B. Increased urination
C. Cold, clammy skin
D. Tremors
B. Increased urination
Increased hunger is a manifestation of _____ due to a cholinergic response from central glucose deprivation.
hypoglycemia
Cold, clammy skin is a manifestation of _____ due to a cholinergic response from central glucose deprivation.
hypoglycemia
Tremulousness is a manisfestation of _____ due to an adrenergic response from central glucose deprivation.
hypoglycemia
A nurse is reviewing the lab values of a client who has diabetic ketoacidosis. The nurse should understand that which of the following lab values is consistent with diabetic ketoacidosis?
A. Blood glucose 30 mg/dL
B. Negative urine ketones
C. Blood pH 7.28
D. BIcarbonate level 12 mEq/L
D. BIcarbonate level 12 mEq/L
The client who has diabetic ketoacidosis should have a bicarbonate level less than ______ b/c the client has an increased production of counter-regulatory hormones that lead to metabolic acidosis.
15 mEq/L
The client who has diabetic ketoacidosis should have a pH level less than ______ because the client has an increased production of counter-regulatory hormones that lead to metabolic acidosis.
7.3
The client who has diabetic ketoacidosis should have ________ ketones because of the increased production of counter-regulatory hormones that lead to the production of ketoacids.
positive urine ketones
The client who has diabetic ketoacidosis should have a blood glucose level greater than ______ mg/dL, which will cause spilling of ketones in the urine and development of metabolic acidosis.
250 mg/dL
A nurse is preparing a 24-hour urine specimen for a client who is suspected to have pheochromocytoma. Which of the following lab tests from the 24-hour urine specimen should the nurse use to determine the client’s condition?
A. creatinine clearance
B. Vanillymandelic acid (VMA)
C. 17-hydroxycorticosteroids (17-OHCS)
D. Protein
Vanilylmandelic acid (VMA) - measures the level of catecholamine metabolites in a 24 hour urine sample
A 24 hour urine specimen for creatinine clearance is used to evaluate the client’s ______ function by calculating the glomerular filtration rate of the kidneys.
renal
A 24 hour urine specimen for 17-OHCS is used to determine if the client is producing an adequate amount of ______. An increase of ______ in the 24 hour urine specimen can indicate the client has Cushing’s disease.
cortisol
cortisol
A 24 hour urine specimen for protein is used to evaluate the client’s _____ function.
renal
A nurse is providing teaching to a client who has type 1 diabetes mellitus about exercise. Which of the following statements should the nurse include in the teaching?
A. you should exercise during a peak insulin time
B. wear a medical alert identification tag when you exercise
C. exercise can decrease the effects of insulin and cause the blood glucose levels to increase.
D. You will get the most benefit from exercise when your glucose levels are higher than normal.
B. wear a medical alert identification tag when you exercise
The nurse should avoid exercising within _____ of receiving the insulin, or at the peak time of insulin, because exercise can increase the absorption of the insulin at the injection site and cause the client to have a marked drop in blood sugar at the insulin peak time.
1 hour
The client who exercises can potentiate the effects of insulin and cause the blood glucose levels to ____.
decrease
The client who has poorly controlled insulin dependent diabetes mellitus is taught not to exercise when blood glucose levels are greater than ______, or if ketones are noted in the urine.
250 mg/dL
A nurse is caring for a client who is postoperative following a parathyroidism. Which of the following lab values should the nurse expect to decrease as a therapeutic effect of the procedure?
A. calcium
B> sodium
C. Potassium
D. Phosphorous
A. Calcium
The _______ hormone regulates calcium, phosphorous, and magnesium balance within the client’s blood and bone by maintaining a balance between the mineral levels in the blood and the bone.
parathyroid
hyperparathyroidism is associated with _______, therefore, a decrease in the calcium level indicates an improvement in the client’s condition.
hypercalcemia
Hyperparathyrodism is associated with hypophosphatemia; therefore, an increase in the phosphorous level indicates an _____ in the client’s condition.
improvement
A nurse is caring for a client who had a thyroidectomy to treat hyperthyroidism caused by an adenoma. Which of the following findings should the nurse report to the provider? (select all that apply.)
A. Tachycardia and Hypertension
B. Respiratory rate 16/min
C> Negative Chvostek’s sign
D. Laryngeal stridor and hoarseness
E. Positive Trousseau’s sign
A. Tachycardia and hypertension
D. Laryngeal stridor and hoarseness
E. Positive Trousseau’s sgin
A nurse is planning care for a client who is experiencing the Somogyi effect and takes intermittent-acting insulin. Which of the following actions should the nurse include in the plan?
A. move the evening intermediate acting insulin dose to 90 min before dinner.
B. Increase the client’s morning caloric intake.
C. Omit the client’s evening snack
D. Monitor the client’s nighttime blood glucose levels
D. Monitor the client’s nighttime blood glucose levels
The Somogyi effect is a swing of a high blood glucose level in the ___________ level during the night. The swing is caused by the release of stress hormones to counter low glucose levels. Monitoring the client’s nighttime blood glucose levels time can provide an accurate diagnosis of the Somogyi effect.
morning after an extremely low blood glucose
The nurse should evaluate the client’s evening caloric intake based on the insulin dose and exercise programs during the day to avoid conditions that can lead to the _______.
Somogyi effect
The nurse should plan to administer a smaller dose of intermediate-acting insulin at bedtime, or increase the client’s bedtime ______ to avoid conditions that can lead to the Somogyi effect.
snacks,
A nurse is assessing a client who has Graves’ disease. Which of the following findings should the nurse expect the client to display?
Constipation
Cold intolerance
Difficulty sleeping
Anorexia
Difficulty sleeping
The client who has Grave’s disease should have an increase in ________ and still experience weight loss because of the overproduction of thyroid hormone.
appetite
The client who has Grave’s disease can experience ______ due to the overproduction of thyroid hormone.
heat intolerance
A nurse is monitoring a client who has syndrome inappropriate antidiuretic hormone secretion (SIADH). Which of the following findings should the nurse expect?
Polyuria
Dehydration
Hyponatremia
Hyperthermia
Hyponatremia
The client who has SIADH will ____ free water in the circulatory system, which is due to excess antidiuretic hormone.
retain
A nurse is planning care for a client who has Cushing’s syndrome due to chronic corticosteroid use. Which of the following actions should the nurse include in the plan of care?
Check the client’s blood glucose for hypoglycemia
Check the client’s urine specific gravity
Weight the client weekly
Insert an indwelling urinary catheter for the client
Check the client’s urine specific gravity
The nurse should check the Cushing’s client’s urine specific gravity to assess for _______.
fluid volume overload
A nurse is caring for a client who has diabetes insipidus. For which of the following findings should the nurse monitor?
Proteinuria
Oliguria
Polyuria
Glycosuria
Polyuria (increased urination)
Diabetes insipidus is characterized by polydipsia, which is ______.
increased thirst
Protein in the urine is a manifestation of ________.
kidney disease (proteinuria)
_______ in the urine is a manifestation of type 1 diabetes mellitus.
Glucose
A nurse is providing teaching to a client who has type 2 diabetes mellitus about the pathophysiology of the disease. Which of the following statements by the client indicates an understanding of the teaching?
A. my cells are resistant to the effects of insulin
B. my body breaks down sugars too efficiently
C. My pancreas does not produce insulin
D. my body produces antibodies against pancreatic beta cells
A. my cells are resistant to the effects of insulin
The client who has type 2 diabetes mellitus will have resistance to insulin and a decrease in the secretion of insulin by the _____.
pancreatic beta cells
