endocrine assess

Question 1

A 22-year-old patient is being seen in the clinic with increased secretion of the anterior pituitary hormones. The nurse would expect the laboratory results to show
a. increased urinary cortisol.
b. decreased serum thyroxine.
c. elevated serum aldosterone levels.
d. low urinary catecholamines excretion.

Answer 1

ANS: A
Increased secretion of adrenocorticotropic hormone (ACTH) by the anterior pituitary gland will lead to an
increase in serum and urinary cortisol levels. An increase, rather than a decrease, in thyroxine level would be
expected with increased secretion of thyroid stimulating hormone (TSH) by the anterior pituitary. Aldosterone
and catecholamine levels are not controlled by the anterior pituitary.

Question 2

Which statement by a 50-year-old female patient indicates to the nurse that 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

ANS: D
Difficulty in swallowing can occur with a goiter. Nocturia is associated with diseases such as diabetes mellitus, diabetes insipidus, or chronic kidney disease. Breast tenderness would occur with excessive gonadal hormone
levels. Thirst is a sign of disease such as diabetes.

Question 3

A 30-year-old patient seen in the emergency department for severe headache and acute confusion is found to
have a serum sodium level of 118 mEq/L. The nurse will anticipate the need for which diagnostic test?
Test Bank - Lewis’s Medical Surgical Nursing (11th Edition by Harding) 590
a. Urinary 17-ketosteroids
b. Antidiuretic hormone level
c. Growth hormone stimulation test
d. Adrenocorticotropic hormone level

Answer 3

ANS: B
Elevated levels of antidiuretic hormone will cause water retention and decrease serum sodium levels. The other
tests would not be helpful in determining possible causes of the patients hyponatremia.

Question 4

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

Answer 4

ANS: C
Because thyroid function affects metabolic rate, changes in weight may indicate hyperfunction or hypofunction
of the thyroid gland. Nocturia, visual difficulty, and changes in stress level are associated with other endocrine
disorders

Question 5

5. A 29-year-old patient in the outpatient clinic will be scheduled for blood cortisol testing. Which instruction
   will the nurse provide?
   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

ANS: C
Cortisol levels are usually drawn in the morning, when levels are highest. The other instructions would be
given to patients who were having other endocrine testing.

Question 6

A 61-year-old female patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL (3.3
mmol/L). The nurse will anticipate the need to teach the patient about testing for _____ levels.
a. calcitonin
b. catecholamine
c. thyroid hormone
d. parathyroid hormone

Answer 6

ANS: D
Parathyroid hormone is the major controller of blood calcium levels. Although calcitonin secretion is a
countermechanism to parathyroid hormone, it does not play a major role in calcium balance. Catecholamine
and thyroid hormone levels do not affect serum calcium level.

Question 7

Which laboratory value should the nurse review to determine whether a patients hypothyroidism is caused
by a problem with the anterior pituitary gland or with the thyroid gland?
a. Thyroxine (T4) level
b. Triiodothyronine (T3) level
c. Thyroid-stimulating hormone (TSH) level
d. Thyrotropin-releasing hormone (TRH) level

Answer 7

ANS: C
A low TSH level indicates that the patients hypothyroidism is caused by decreased anterior pituitary secretion
of TSH. Low T3 and T4 levels are not diagnostic of the primary cause of the hypothyroidism. TRH levels indicate the function of the hypothalamus.

Question 8

The nurse reviews a patients glycosylated hemoglobin (Hb A1C) results to evaluate
a. fasting preprandial glucose levels.
b. glucose levels 2 hours after a meal.
c. glucose control over the past 90 days.
d. hypoglycemic episodes in the past 3 months.

Answer 8

ANS: C
Glycosylated hemoglobin testing measures glucose control over the last 3 months. Glucose testing before/after
a meal or random testing may reveal impaired glucose tolerance and indicate prediabetes, but it is not done on
patients who already have a diagnosis of diabetes. There is no test to evaluate for hypoglycemic episodes in the
past.

Question 9

A 60-year-old patient is taking spironolactone (Aldactone), a drug that blocks the action of aldosterone on
the kidney, for hypertension. The nurse will monitor for
a. increased serum sodium.
b. decreased urinary output.
c. elevated serum potassium.
d. evidence of fluid overload.

Answer 9

ANS: C
Because aldosterone increases the excretion of potassium, a medication that blocks aldosterone will tend to
cause hyperkalemia. Aldosterone also promotes the reabsorption of sodium and water in the renal tubules, so
spironolactone will tend to cause increased urine output, a decreased or normal serum sodium level, and signs
of dehydration

Question 10

A 40-year-old male patient has been newly diagnosed with type 2 diabetes mellitus. Which information
about the patient will be most useful to the nurse who is helping the patient develop strategies for successful
adaptation to this disease?
a. Ideal weight
b. Value system
c. Activity level
d. Visual changes

Answer 10

ANS: B
When dealing with a patient with a chronic condition such as diabetes, identification of the patients values and
beliefs can assist the health care team in choosing strategies for successful lifestyle change. The other
information also will be useful, but is not as important in developing an individualized plan for the necessary
lifestyle changes

Question 11

An 18-year-old male patient with a small stature is scheduled for a growth hormone stimulation test. In preparation for the test, the nurse will obtain
a. ice in a basin.
b. glargine insulin.
c. a cardiac monitor.
d. 50% dextrose solution.

Answer 11

ANS: D
Hypoglycemia is induced during the growth hormone stimulation test, and the nurse should be ready to
administer 50% dextrose immediately. Regular insulin is used to induce hypoglycemia (glargine is never given
IV). The patient does not require cardiac monitoring during the test. Although blood samples for some tests
must be kept on ice, this is not true for the growth hormone stimulation test.

Question 12

The nurse will teach a patient to plan to minimize physical and emotional stress while the patient is
undergoing
a. a water deprivation test.
b. testing for serum T3 and T4
levels.
c. a 24-hour urine test for free cortisol.
d. a radioactive iodine (I-131) uptake test.

Answer 12

ANS: C
Physical and emotional stress can affect the results of the free cortisol test. The other tests are not impacted by stress.

Question 13

Which additional information will the nurse need to consider when reviewing the laboratory results for a
patients total calcium level?
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 13

ANS: C
Part of the total calcium is bound to albumin so hypoalbuminemia can lead to misinterpretation of calcium levels. The other laboratory values will not affect total calcium interpretation.

Question 14

A 44-year-old patient is admitted with tetany. Which laboratory value should the nurse monitor?
a. Total protein
b. Blood glucose
c. Ionized calcium
d. Serum phosphate

Answer 14

ANS: C
Tetany is associated with hypocalcemia. The other values would not be useful for this patient.

Question 15

17. Which information about a 30-year-old patient who is scheduled for an oral glucose tolerance test should
    be reported to the health care provider before starting the test?
    a. The patient reports having occasional orthostatic dizziness.
    b. The patient takes oral corticosteroids for rheumatoid arthritis.
    c. The patient has had a 10-pound weight gain in the last month.
    d. The patient drank several glasses of water an hour previously.

Answer 15

ANS: B
Corticosteroids can affect blood glucose results. The other information will be provided to the health care provider but will not affect the test results.

Question 16

Which action by a new registered nurse (RN) caring for a patient with a goiter and possible
hyperthyroidism indicates that the charge nurse needs to do more teaching?
a. The RN checks the blood pressure on both arms.
b. The RN palpates the neck thoroughly to check thyroid size.
c. The RN lowers the thermostat to decrease the temperature in the room.
d. The RN orders nonmedicated eye drops to lubricate the patients bulging eyes.

Answer 16

ANS: B
Palpation can cause the release of thyroid hormones in a patient with an enlarged thyroid and should be
avoided. The other actions by the new RN are appropriate when caring for a patient with an enlarged thyroid.

Question 17

The nurse is caring for a 45-year-old male patient during a water deprivation test. Which finding is most
important for the nurse to communicate to the health care provider?
a. The patient complains of intense thirst.
b. The patient has a 5-lb (2.3 kg) weight loss.
c. The patients urine osmolality does not increase.
d. The patient feels dizzy when sitting on the edge of the bed.

Answer 17

ANS: B
A drop in the weight of more than 2 kg indicates severe dehydration, and the test should be discontinued. The
other assessment data are not unusual with this test.

Question 18

A 35-year-old female patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which patient 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 20 pounds
d. Complaint of ongoing headaches

Answer 18

ANS: B
Because the usual contrast media is iodine-based, the health care provider will need to know about the allergy
before the CT scan. The other findings are common with any mass in the brain such as a pituitary adenoma.

Question 19

The nurse is caring for a 63-year-old with a possible pituitary tumor who is scheduled for a computed tomography (CT) scan with contrast. Which information about the patient is most important to discuss with the health care provider before the test?
a. History of renal insufficiency
b. Complains of chronic headache
c. Recent bilateral visual field loss
d. Blood glucose level of 134 mg/dL

Answer 19

ANS: A
Because contrast media may cause acute kidney injury in patients with poor renal function, the health care
provider will need to prescribe therapies such as IV fluids to prevent this complication. The other findings are
consistent with the patients diagnosis of a pituitary tumor.

Question 20

Which statements will the nurse include when teaching a patient who is scheduled for oral glucose tolerance
testing in the outpatient clinic (select all that apply)?
a. You will need to avoid smoking before the test.
b. Exercise should be avoided until the testing is complete.
c. Several blood samples will be obtained during the testing.
d. You should follow a low-calorie diet the day before the test.
e. The test requires that you fast for at least 8 hours before testing

Answer 20

ANS: A, C, E
Smoking may affect the results of oral glucose tolerance tests. Blood samples are obtained at baseline and at
30, 60, and 120 minutes. Accuracy requires that the patient be fasting before the test. The patient should
consume at least 1500 calories/day for 3 days before the test. The patient should be ambulatory and active for
accurate test results.

Question 21

A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL
(6.7 mmol/L). The nurse will plan to teach the patient about
a. self-monitoring of blood glucose.
b. using low doses of regular insulin.
c. lifestyle changes to lower blood glucose.
d. effects of oral hypoglycemic medications.

Answer 21

ANS: C
The patients impaired fasting glucose indicates prediabetes, and the patient should be counseled about lifestyle
changes to prevent the development of type 2 diabetes. The patient with prediabetes does not require insulin or
oral hypoglycemics for glucose control and does not need to self-monitor blood glucose.

Question 22

A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?
a. The patient always carries hard candies when engaging in exercise.
b. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
c. The patient has a peanut butter sandwich before going for a bicycle ride.
d. The patient increases daily exercise when ketones are present in the urine.

Answer 22

ANS: D
When the patient is ketotic, exercise may result in an increase in blood glucose level. Type 1 diabetic patients
should be taught to avoid exercise when ketosis is present. The other statements are correct.

Question 23

The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes. Which
question is most appropriate for the nurse to ask?
a. Are you anorexic?
b. Is your urine dark colored?
c. Have you lost weight lately?
d. Do you crave sugary drinks?

Answer 23

ANS: C
Weight loss occurs because the body is no longer able to absorb glucose and starts to break down protein and
fat for energy. The patient is thirsty but does not necessarily crave sugar-containing fluids. Increased appetite
is a classic symptom of type 1 diabetes. With the classic symptom of polyuria, urine will be very dilute.

Question 24

A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?
a. Urine dipstick for glucose
b. Oral glucose tolerance test
c. Fasting blood glucose level
d. Glycosylated hemoglobin level

Answer 24

ANS: D
The glycosylated hemoglobin (A1C or HbA1C) test shows the overall control of glucose over 90 to 120 days. A
fasting blood level indicates only the glucose level at one time. Urine glucose testing is not an accurate
reflection of blood glucose level and does not reflect the glucose over a prolonged time. Oral glucose tolerance
testing is done to diagnose diabetes, but is not used for monitoring glucose control once diabetes has been
diagnosed.

Question 25

A 55-year-old female patient with type 2 diabetes has a nursing diagnosis of imbalanced nutrition: more
than body requirements. Which goal is most important for this patient?
a. The patient will reach a glycosylated hemoglobin level of less than 7%.
b. The patient will follow a diet and exercise plan that results in weight loss.
c. The patient will choose a diet that distributes calories throughout the day.
d. The patient will state the reasons for eliminating simple sugars in the diet.

Answer 25

ANS: A
The complications of diabetes are related to elevated blood glucose, and the most important patient outcome is
the reduction of glucose to near-normal levels. The other outcomes also are appropriate but are not as high in
priority

Question 26

A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00PM. The clinic nurse will
plan to teach the patient to
a. check glucose level before, during, and after swimming.
b. delay eating the noon meal until after the swimming class.
c. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
d. time the morning insulin injection so that the peak occurs while swimming.

Answer 26

ANS: A
The change in exercise will affect blood glucose, and the patient will need to monitor glucose carefully to
determine the need for changes in diet and insulin administration. Because exercise tends to decrease blood
glucose, patients are advised to eat before exercising. Increasing the morning NPH or timing the insulin to
peak during exercise may lead to hypoglycemia, especially with the increased exercise.

Question 27

The nurse determines a need for additional instruction when the patient with newly diagnosed type 1
diabetes says which of the following?
a. I can have an occasional alcoholic drink if I include it in my meal plan.
b. I will need a bedtime snack because I take an evening dose of NPH insulin.
c. I can choose any foods, as long as I use enough insulin to cover the calories.
d. I will eat something at meal times to prevent hypoglycemia, even if I am not hungry.

Answer 27

ANS: C
Most patients with type 1 diabetes need to plan diet choices very carefully. Patients who are using intensified
insulin therapy have considerable flexibility in diet choices but still should restrict dietary intake of items such
as fat, protein, and alcohol. The other patient statements are correct and indicate good understanding of the diet
instruction.

Question 28

Which statement by the patient indicates a need for additional instruction in administering insulin?
a. I need to rotate injection sites among my arms, legs, and abdomen each day.
Test Bank - Lewis’s Medical Surgical Nursing (11th Edition by Harding) 603
b. I can buy the 0.5 mL syringes because the line markings will be easier to see.
c. I should draw up the regular insulin first after injecting air into the NPH bottle.
d. I do not need to aspirate the plunger to check for blood before injecting insulin

Answer 28

ANS: A
Rotating sites is no longer recommended because there is more consistent insulin absorption when the same
site is used consistently. The other patient statements are accurate and indicate that no additional instruction is
needed.

Question 29

Which patient action indicates good understanding of the nurses teaching about administration of aspart
(NovoLog) insulin?
a. The patient avoids injecting the insulin into the upper abdominal area.
b. The patient cleans the skin with soap and water before insulin administration.
c. The patient stores the insulin in the freezer after administering the prescribed dose.
d. The patient pushes the plunger down while removing the syringe from the injection site.

Answer 29

ANS: B
Cleaning the skin with soap and water or with alcohol is acceptable. Insulin should not be frozen. The patient
should leave the syringe in place for about 5 seconds after injection to be sure that all the insulin has been
injected. The upper abdominal area is one of the preferred areas for insulin injection

Question 30

A patient receives aspart (NovoLog) insulin at 8:00 AM. Which time will it be most important for the
nurse to monitor for symptoms of hypoglycemia?
a. 10:00 AM
b. 12:00 AM
c. 2:00 PM
d. 4:00

Answer 30

ANS: A
The rapid-acting insulins peak in 1 to 3 hours. The patient is not at a high risk for hypoglycemia at the other
listed times, although hypoglycemia may occur.

Question 31

Which patient action indicates a good understanding of the nurses teaching about the use of an insulin
pump?
a. The patient programs the pump for an insulin bolus after eating.
b. The patient changes the location of the insertion site every week.
c. The patient takes the pump off at bedtime and starts it again each morning.
d. The patient plans for a diet that is less flexible when using the insulin pump.

Answer 31

ANS: A
In addition to the basal rate of insulin infusion, the patient will adjust the pump to administer a bolus after each
meal, with the dosage depending on the oral intake. The insertion site should be changed every 2 or 3 days. There is more flexibility in diet and exercise when an insulin pump is used. The pump will deliver a basal
insulin rate 24 hours a day.

Question 32

The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose
a. washes the puncture site using warm water and soap.
b. chooses a puncture site in the center of the finger pad.
c. hangs the arm down for a minute before puncturing the site.
d. says the result of 120 mg indicates good blood sugar control.

Answer 32

ANS: B
The patient is taught to choose a puncture site at the side of the finger pad because there are fewer nerve
endings along the side of the finger pad. The other patient actions indicate that teaching has been effective.

Question 33

The health care provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood
glucose is 230 mg/dL. Which action will the nurse teach the patient to take?
a. Avoid snacking at bedtime.
b. Increase the rapid-acting insulin dose.
c. Check the blood glucose during the night
d. Administer a larger dose of long-acting insulin.

Answer 33

ANS: C
If the Somogyi effect is causing the patients increased morning glucose level, the patient will experience
hypoglycemia between 2:00 and 4:00 AM. The dose of insulin will be reduced, rather than increased. A
bedtime snack is used to prevent hypoglycemic episodes during the night.

Question 34

Which action should the nurse take after a 36-year-old patient treated with intramuscular glucagon for
hypoglycemia regains consciousness?
a. Assess the patient for symptoms of hyperglycemia.
b. Give the patient a snack of peanut butter and crackers.
c. Have the patient drink a glass of orange juice or nonfat milk.
d. Administer a continuous infusion of 5% dextrose for 24 hours

Answer 34

ANS: B
Rebound hypoglycemia can occur after glucagon administration, but having a meal containing complex
carbohydrates plus protein and fat will help prevent hypoglycemia. Orange juice and nonfat milk will elevate
blood glucose rapidly, but the cheese and crackers will stabilize blood glucose. Administration of IV glucose
might be used in patients who were unable to take in nutrition orally. The patient should be assessed for
symptoms of hypoglycemia after glucagon administration

Question 35

Which question during the assessment of a diabetic patient will help the nurse identify autonomic
neuropathy?
a. Do you feel bloated after eating?
b. Have you seen any skin changes?
c. Do you need to increase your insulin dosage when you are stressed?
d. Have you noticed any painful new ulcerations or sores on your feet?

Answer 35

ANS: A
Autonomic neuropathy can cause delayed gastric emptying, which results in a bloated feeling for the patient. The other questions are also appropriate to ask but would not help in identifying autonomic neuropathy.

Question 36

A 27-year-old patient admitted with diabetic ketoacidosis (DKA) has a serum glucose level of 732 mg/dL
and serum potassium level of 3.1 mEq/L. Which action prescribed by the health care provider should the nurse
takefirst?
a. Place the patient on a cardiac monitor.
b. Administer IV potassium supplements.
c. Obtain urine glucose and ketone levels.
d. Start an insulin infusion at 0.1 units/kg/hr.

Answer 36

ANS: A
Hypokalemia can lead to potentially fatal dysrhythmias such as ventricular tachycardia and ventricular
fibrillation, which would be detected with electrocardiogram (ECG) monitoring. Because potassium must be
infused over at least 1 hour, the nurse should initiate cardiac monitoring before infusion of potassium. Insulin
should not be administered without cardiac monitoring because insulin infusion will further decrease
potassium levels. Urine glucose and ketone levels are not urgently needed to manage the patients care.

Question 37

A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse
implement first?
a. Infuse 1 liter of normal saline per hour.
b. Give sodium bicarbonate 50 mEq IV push.
c. Administer regular insulin 10 U by IV push.
d. Start a regular insulin infusion at 0.1 units/kg/hr.

Answer 37

ANS: A
The most urgent patient problem is the hypovolemia associated with diabetic ketoacidosis (DKA), and the priority is to infuse IV fluids. The other actions can be done after the infusion of normal saline is initiated.

Question 38

. A patient who was admitted with diabetic ketoacidosis secondary to a urinary tract infection has been
weaned off an insulin drip 30 minutes ago. The patient reports feeling lightheaded and sweaty. Which action should the nurse take first?
a. Infuse dextrose 50% by slow IV push.
b. Administer 1 mg glucagon subcutaneously.
c. Obtain a glucose reading using a finger stick.
d. Have the patient drink 4 ounces of orange juice.

Answer 38

ANS: C
The patients clinical manifestations are consistent with hypoglycemia and the initial action should be to check
the patients glucose with a finger stick or order a stat blood glucose. If the glucose is low, the patient should
ingest a rapid-acting carbohydrate, such as orange juice. Glucagon or dextrose 50% might be given if the
patients symptoms become worse or if the patient is unconscious.

Question 39

An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic. Which finding may
indicate the need for a change in therapy?
a. Hemoglobin A1C level 6.2%
b. Blood pressure 146/88 mmHg
c. Heart rate at rest 58 beats/minute
d. High density lipoprotein (HDL) level 65 mg/dL

Answer 39

ANS: B
To decrease the incidence of macrovascular and microvascular problems in patients with diabetes, the goal
blood pressure is usually 130/80. An A1C less than 6.5%, a low resting heart rate (consistent with regular
aerobic exercise in a young adult), and an HDL level of 65 mg/dL all indicate that the patients diabetes and
risk factors for vascular disease are well controlled.

Question 40

The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL. Fifteen minutes later, the blood glucose is 67 mg/dL. Which action should the nurse take next?
a. Give the patient 4 to 6 oz more orange juice.
b. Administer the PRN glucagon (Glucagon) 1 mg IM.
c. Have the patient eat some peanut butter with crackers.
d. Notify the health care provider about the hypoglycemia.

Answer 40

ANS: A
The rule of 15 indicates that administration of quickly acting carbohydrates should be done 2 to 3 times for a
conscious patient whose glucose remains less than 70 mg/dL before notifying the health care provider. More
complex carbohydrates and fats may be used once the glucose has stabilized. Glucagon should be used if the
patients level of consciousness decreases so that oral carbohydrates can no longer be given.

Question 41

After change-of-shift report, which patient will the nurse assessfirst?
a. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
b. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
c. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral
mucosa
d. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning
foot pain

Answer 41

ANS: C
The patients diagnosis of HHS and signs of dehydration indicate that the nurse should rapidly assess for signs
of shock and determine whether increased fluid infusion is needed. The other patients also need assessment and
intervention but do not have life-threatening complications.

Question 42

A 45-year-old male patient with suspected acromegaly is seen at the clinic. To assist in making the
diagnosis, which question should the nurse ask?
a. Have you had a recent head injury?
b. Do you have to wear larger shoes now?
c. Is there a family history of acromegaly?
d. Are you experiencing tremors or anxiety?

Answer 42

ANS: B
Acromegaly causes an enlargement of the hands and feet. Head injury and family history are not risk factors
for acromegaly. Tremors and anxiety are not clinical manifestations of acromegaly

Question 43

The nurse determines that additional instruction is needed for a 60-year-old patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH) when the patient says which of the following?
a. I need to shop for foods low in sodium and avoid adding salt to food.
b. I should weigh myself daily and report any sudden weight loss or gain.
c. I need to limit my fluid intake to no more than 1 quart of liquids a day.
d. I will eat foods high in potassium because diuretics cause potassium lo

Answer 43

ANS: A
Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed. The other patient statements are correct and indicate successful teaching has occurred

Question 44

A 56-year-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with
possible syndrome of inappropriate antidiuretic hormone (SIADH). The nurse would expect the initial
laboratory results to include a(n)
a. elevated hematocrit.
b. decreased serum sodium.
c. low urine specific gravity.
d. increased serum chloride

Answer 44

ANS: B
When water is retained, the serum sodium level will drop below normal, causing the clinical manifestations
reported by the patient. The hematocrit will decrease because of the dilution caused by water retention. Urine
will be more concentrated with a higher specific gravity. The serum chloride level will usually decrease along
with the sodium