Endocrine

Question 1

The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimotos thyroiditis. When assessing this patient, what sign or symptom would the nurse expect?

Answer 1

Fatigue

Question 2

A patient has been admitted to the post-surgical unit following a thyroidectomy. To promote comfort and safety, how should the nurse best position the patient?

Answer 2

Semi-Fowlers with the head supported on two pillows

Question 3

A patient with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has been removed. The nurse caring for the patient should prioritize what question when addressing potential complications?

Answer 3

Do you feel any muscle twitches or spasms?

Question 4

The nurse is caring for a patient with a diagnosis of Addisons disease. What sign or symptom is most closely associated with this health problem?

Answer 4

Muscle weakness

Question 5

The nurse is caring for a patient with Addisons disease who is scheduled for discharge. When teaching the patient about hormone replacement therapy, the nurse should address what topic?

Answer 5

The need for lifelong steroid replacement

Question 6

The nurse is teaching a patient that the body needs iodine for the thyroid to function. What food would be the best source of iodine for the body?

Answer 6

Table salt

Question 7

A patient is prescribed corticosteroid therapy. What would be priority information for the nurse to give the patient who is prescribed long-term corticosteroid therapy?

Answer 7

The patient is at an increased risk for developing infection

Question 8

A nurse caring for a patient with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding?

Answer 8

Highly dilute urine

Question 9

The nurse caring for a patient with Cushing syndrome is describing the dexamethasone suppression test scheduled for tomorrow. What does the nurse explain that this test will involve?

Answer 9

Administration of dexamethasone orally at 11pm, and a plasma cortisol level at 8am the next morning

Question 10

You are developing a care plan for a patient with Cushing syndrome. What nursing diagnosis would have the highest priority in this care plan?

Answer 10

Risk for injury related to weakness

Question 11

The nurse is performing a shift assessment of a patient with aldosteronism. What assessments should the nurse include? Select all that apply.

Answer 11

Urine output

Blood pressure

Question 12

The home care nurse is conducting patient teaching with a patient on corticosteroid therapy. To achieve consistency with the bodys natural secretion of cortisol, when would the home care nurse instruct the patient to take his or her corticosteroids?

Answer 12

In the morning between 7am and 8am

Question 13

A patient presents at the walk-in clinic complaining of diarrhea and vomiting. The patient has a documented history of adrenal insufficiency. Considering the patients history and current symptoms, the nurse should anticipate that the patient will be instructed to do which of the following?

Answer 13

Increase his intake of sodium until the GI symptoms improve

Question 14

The nurse is caring for a patient with hyperparathyroidism. What level of activity would the nurse expect to promote?

Answer 14

Ambulation and activity as tolerated

Question 15

While assisting with the surgical removal of an adrenal tumor, the OR nurse is aware that the patients vital signs may change upon manipulation of the tumor. What vital sign changes would the nurse expect to see?

Answer 15

Hypertension and heart rate changes

Question 16

A patient has returned to the floor after having a thyroidectomy for thyroid cancer. The nurse knows that sometimes during thyroid surgery the parathyroid glands can be injured or removed. What laboratory finding may be an early indication of parathyroid gland injury or removal?

Answer 16

Hypocalcemia

Question 17

The nurse is planning the care of a patient with hyperthyroidism. What should the nurse specify in the patients meal plan?

Answer 17

Small, frequent meals, high in protein and calories

Question 18

A patient with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) is being cared for on the critical care unit. The priority nursing diagnosis for a patient with this condition is what?

Answer 18

Excess fluid volume

Question 19

A patient with hypofunction of the adrenal cortex has been admitted to the medical unit. What would the nurse most likely find when assessing this patient?

Answer 19

Decreased BP

Question 20

The nurse is assessing a patient diagnosed with Graves disease. What physical characteristics of Graves disease would the nurse expect to find?

Answer 20

Bulging eyes

Question 21

A patient with suspected adrenal insufficiency has been ordered an adrenocorticotropic hormone (ACTH) stimulation test. Administration of ACTH caused a marked increase in cortisol levels. How should the nurse interpret this finding?

Answer 21

The patient’s pituitary function is compromised

Question 22

The physician has ordered a fluid deprivation test for a patient suspected of having diabetes insipidus. During the test, the nurse should prioritize what assessments?

Answer 22

Heart rate and blood pressure

Question 23

A nurse works in a walk-in clinic. The nurse recognizes that certain patients are at higher risk for different disorders than other patients. What patient is at a greater risk for the development of hypothyroidism?

Answer 23

A 75-year-old female with osteoporosis

Question 24

A patient with a recent diagnosis of hypothyroidism is being treated for an unrelated injury. When administering medications to the patient, the nurse should know that the patients diminished thyroid function may have what effect?

Answer 24

Prolonged duration of effect

Question 25

A patient has been admitted to the critical care unit with a diagnosis of thyroid storm. What interventions should the nurse include in this patients immediate care? Select all that apply.

Answer 25

Administering beta blockers to reduce heart rate

Applying interventions to reduce the patient’s temperature

Question 26

The nurses assessment of a patient with thyroidectomy suggests tetany and a review of the most recent blood work corroborate this finding. The nurse should prepare to administer what intervention?

Answer 26

IV calcium gluconate

Question 27

A patient has been taking prednisone for several weeks after experiencing a hypersensitivity reaction. To prevent adrenal insufficiency, the nurse should ensure that the patient knows to do which of the following?

Answer 27

Slowly taper down the dose of prednisone, as ordered

Question 28

Following an addisonian crisis, a patients adrenal function has been gradually regained. The nurse should ensure that the patient knows about the need for supplementary glucocorticoid therapy in which of the following circumstances?

Answer 28

Episodes of high psychosocial stress

Question 29

A 30 year-old female patient has been diagnosed with Cushing syndrome. What psychosocial nursing diagnosis should the nurse most likely prioritize when planning the patients care?

Answer 29

Disturbed body image related to changes in physical appearance

Question 30

A patient with pheochromocytoma has been admitted for an adrenalectomy to be performed the following day. To prevent complications, the nurse should anticipate preoperative administration of which of the following?

Answer 30

IV corticosteroids

Question 31

A patient is undergoing testing for suspected adrenocortical insufficiency. The care team should ensure that the patient has been assessed for the most common cause of adrenocortical insufficiency. What is the most common cause of this health problem?

Answer 31

Therapeutic use of corticosteroids

Question 32

The nurse providing care for a patient with Cushing syndrome has identified the nursing diagnosis of risk for injury related to weakness. How should the nurse best reduce this risk?

Answer 32

Establish falls prevention measures

Question 33

A patient with Cushing syndrome has been hospitalized after a fall. The dietician consulted works with the patient to improve the patients nutritional intake. What foods should a patient with Cushing syndrome eat to optimize health? Select all that apply.

Answer 33

Foods high in vitamin D

Foods high in protein

Foods high in calcium

Question 34

A patient on corticosteroid therapy needs to be taught that a course of corticosteroids of 2 weeks duration can suppress the adrenal cortex for how long?

Answer 34

Up to 1 year

Question 35

A patient with Cushing syndrome as a result of a pituitary tumor has been admitted for a transsphenoidal hypophysectomy. What would be most important for the nurse to monitor before, during, and after surgery?

Answer 35

Blood glucose

Question 36

What should the nurse teach a patient on corticosteroid therapy in order to reduce the patients risk of adrenal insufficiency?

Answer 36

Always have enough medication on hand to avoid running out

Question 37

The nurse is caring for a patient at risk for an addisonian crisis. For what associated signs and symptoms should the nurse monitor the patient? Select all that apply.

Answer 37

Pallor

Rapid respiratory rate

Hypotension

Question 38

A patient has been assessed for aldosteronism and has recently begun treatment. What are priority areas for assessment that the nurse should frequently address? Select all that apply.

Answer 38

Potassium level

Blood pressure

Question 39

A patient who has been taking corticosteroids for several months has been experiencing muscle wasting. The patient has asked the nurse for suggestions to address this adverse effect. What should the nurse recommend?

Answer 39

Consumption of a high protein diet

Question 40

The nurse is providing care for an older adult patient whose current medication regimen includes levothyroxine (Synthroid). As a result, the nurse should be aware of the heightened risk of adverse effects when administering an IV dose of what medication?

Answer 40

A benzodiazepine