Endocrine ATI 2

Question 1

A nurse is teaching a pt who has type 1 DM about how to prevent complications during illness. Which of the following statements by the pt indicates an understanding of teaching?
a) I should stop taking my insulin if I feel nauseous
b) I will test my urine for protein when I start to feel ill
c) I will call my doctor if my blood sugar is more than 250
d) I should check my blood sugar level every 8hr.

Answer 1

c
a-should take the usual dose
b-should check ketones in urinal
d-every 4 hr

Question 2

A nurse is caring for a pt following a thyroidectomy. The nurse should assess which of the following findings as an indication of hyocalcemea?
a) Strong, bounding pulse
b) Decreased bowel sounds
c) Tingling and numbness of the hands and feet
d) Diminished deep-tendon reflexes

Answer 2

c
a-should weak pulse
b-increase gastrointestinal motility
d-hyperactive deep-tendon reflexes
ハンマーで叩くと、一瞬遅れて筋が不随意に反応する
disminished-減少した

Question 3

A nurse is teaching a pt who has an autoimmune disease about the ADR of long-term corticosteroid therapy. Which of the following ADR should the nurse include? SATA
a) Osteoporosis
b) Moon-shaped face
c) Increased risk of infection
d) Hearing loss
e) Weight loss

Answer 3

a,b,c
a-d/t suppression of bone formation and the acceleration of bone resorption
d-can cause cataracts and glaucoma
e-weight gain

Question 4

A nurse is teaching a pt about glycosylated hemoglobin(HbA1c) testing. Which of the following pt statements indicates an understanding of the teaching?
a) I need to fast after midnight the night before the test
b) This test’s result is a good indicator of my average blood glucose
c) A level of 8 to 10 percent suggests adequate blood glucose control
d) I will use my hemoglobin A1c level to adjust my daily insulin doses

Answer 4

b
c-greater than 6.5% is diabetes
d-should use capillary blood glucose level o adjust

Question 5

A nurse is assessing a pt who has DM and reports feeling anxious. Which of the following findings should the nurse expect if the pt is hypoglycemia?
a) Rapid, deep respirations
b) Cool, clammy skin
c) Abdominal cramping
d) Orthostatic hypotension

Answer 5

b
a-this is for hyperglycemia
c-this is for hyperglycemia
d-hyperglycemia can cause dehydration, resulting orthostatic hypotension

Question 6

A nurse is managing the care of pt who is postoperative and has acute adrenal insufficiency. Which of the following actions should the nurse take?
a) administer IV hydrocortisone sodium
b) GIve oral spironolactone
c) infuse 1 unit of platelets
d) restrict daily fluid intake

Answer 6

a
adrenal insufficiency=Adison’s disease

Question 7

A nurse is in an outpatient clinic teaching a pt who has a DM foot ulcer about foot care. Which of the following statements by the pt indicates an understanding of the teaching?
a) I will let my feet air-dry after washing
b) I will wear sandals to allow air to circulate around my feet
c) I will buy OTC med to treat the calluses on my feet
d) I will apply lotion to the dry areas of my feet but not between my toes

Answer 7

d-lotion can be used in dry areas of the feet, but not between toes
c-OTC med can impair skin integrity and lead to further injury

Question 8

A nurse is caring for a pt who DM and has developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to the pt’s feet?
a) Examine the skin of the feet weekly for alterations in skin integrity
b) Monitor the temp of bath water with a thermometer
c) Shop for shoes in the day
d) Round the edges of toenails when trimming them

Answer 8

b
a- examine daily
Later the day when the feet is swelling to get the right fit shoes
d-straight across

Question 9

A nurse has administered propranolol by IV bolus to a pt who is having a thyroid storm. Which of the following findings indicates that the pt is having a therapeutic response?
a) Reduction of the effects of thyroid hormone on the heart
b) Blockage of the release of thyroid hormone from the thyroid gland
c) Increase in the heart’s sensitivity to thyroid hormone
d) Increase in the uptake of thyroid hormone by the thyroid gland

Answer 9

a
B-blocker will decrease rapid HR caused by excessive thyroid stimulate

Question 10

A nurse is assessing a pt who has adrenal insufficiency. Which of the following findings should the nurse expect?
a) Moon-shaped face
b) Weight gain
c) Calcium 12.8
d) Sodium 150

Answer 10

c
d-sodium level should below 135

Question 11

A nurse is planning to teach a pt who has type 1 DM. Which of the following instructions should the nurse plan to include?
a) consume no more than 3 servings of alcohol per day
b) ingest food with alcohol to reduce alcohol-induced hypoglycemia
c) increase insulin dosage before planned exercise
d) rest for 3 days between periods of vigorous exercise

Answer 11

b
Alcohol inhibits the liver’s production of glucose. Consuming carbohydrates while drinking helps prevent hypoglycemia
a-male no more than 2, and female no more than 1
c-they should reduce insulin dosage before exercise
d-they should exercise at least 3 times per week

Question 12

A nurse is monitoring the lab of a pt who has DM and is taking insulin. Which of the following results indicated a therapeutic outcome of insulin therapy?
a) fasting blood glucose 96
b) postprandial blood glucose 195
c) random blood glucose 210
d) preprandial blood glucose 60

Answer 12

a- normal 70-110
b- normal less than 180
c- normal less than 200
d- normal 70-130

Question 13

a) preprandial plasma glucose?
b)postprandial blood glucose?

Answer 13

a) Before a meal
b) 1-2 hours after beginning of the meal

Question 14

A nurse is monitoring a pt who is 24hr postoperative after a total thyroidectomy, Which of the following findings should the nurse report to the provider?
a) Laryngeal stridor
b) Productive cough
c) Pain with hyperextension of the neck
d) Hoarse, wake voice

Answer 14

a
Laryngeal stridor is a harsh, high-pitched sound with inspiration that indicates respiratory obstruction. The nurse should immediately preserve the pt’s airway
b-this is d/t general anesthesia due to a buildup of secretions caused by endotracheal intubation
c-pain with hyperextension of the neck is normal
d-a hoarse and wake voice is common after anesthesia caused by endotracheal intubation

Question 15

A nurse is reviewing the laboratory results of a pt undergoing primary Cushing’s disease. The nurse should expect an elevation in which of the following lab findings?
a) Lymphocyte count
b) Potassium
c) Calcium
d) Glucose

Answer 15

d
a-should be below
b-should be below
c-should be below

Question 16

A nurse is developing a teaching plan for a pt who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions shuld the nurse plan to include?
a) Take this med on an empty stomach
b) Take this med with an antacid
c) Change position slowly whid taking this med
d) Limit your fluid intake while taking this med

Answer 16

a
c-can increase blood glucose levels in pt who have DM
d-should take the med with a full of glass of water

Question 17

A nurse is admitting a pt has hyperthyroidism. When assessing the pt, the nurse should expect which of the following findings?
a) cold intolerance
b) Lethargy
c) Tremores
d) Sunken eyes

Answer 17

c
a- heat intolerance
b- irritable
d- exophthalmos

Question 18

A nurse is assessing a pt who has DM and reports feeling anxious. Which of the following findings should the nurse expect of the pt is hypoglycemia?
a) rapid, deep respiration
b) cool, clammy skin
c) abdominal cramping
d) orthostatic hypotension

Answer 18

b

Question 19

A nurse is teaching a pt who has DM about insulin injections. The prescription includes evening doses of insulin glargine and regular insulin. Which of the following instructions should the nurse include?
a) inject the insulin intramuscularly
b) shale the insulins vigorously prior to administer
c) draw up the insulin into separate syringes
d) expect the insulin to appear cloudy

Answer 19

c
insulin glargine is not compatible with other insulins
a-subcutaneous
b-gently mix the insulin vails prior to administering
d-should clear,discarded if its cloudy

Question 20

A nurse is teaching a pt about the adrenocorticotropic hormone(ACTH) stimulation test. The nurse should explain the purpose of the test is to assess for which of the following disorders?
a) diabetes insipidus
b) hyperthyroidism
c) pheochromocytoma
d) Addison’s disease

Answer 20

d
it measures the cortisol response to ATH
b-thyroid scan

Question 21

A home health nurse is assessing a pt who requires lifelong hormone replacement therapy for the treatment of hypothyroidism. The pt has not been taking the med regularly. Which of the following findings should the nurse expect?
a) increased urine output
b) Persistent diarrhea
c) Tachycardia
d) hypotension

Answer 21

d

Question 22

The patient reports feeling tired, gaining weight, and increasing cold sensitivity even though it is now summer. Which endocrine diagnostic test should be completed first?
a) Free thyroxine (FT4)
b) Serum growth hormone (GH)
c) Follicle-stimulating hormone (FSH)
d) Magnetic resonance imaging (MRI) of the head

Answer 22

a
The patient’s manifestations could be related to hypothyroidism.

Question 23

Which complication should the nurse monitor for in a patient undergoing a growth hormone stimulation test?
a) Hypothermia
b) Hypertension
c) Hyperreflexia
d) Hypoglycemia

Answer 23

d
A growth hormone stimulation test involves the administration of insulin or arginine

Question 24

The nurse is caring for a group of older patients in a long-term care setting. Which physical assessment findings would indicate a possible endocrine problem?
a) Hypoglycemia, delirium, and incontinence
b) Impaired reflexes, diarrhea, and hearing loss
c) Fatigue, constipation, and mental impairment
d) Hypotension, heat intolerance, and bradycardia

Answer 24

c
Changes of aging often mimic manifestations of endocrine disorders. Manifestations of endocrine problems, such as fatigue, constipation, or mental impairment in the older adult, are often missed because they are attributed solely to aging.

Question 25

The nurse performs a physical assessment on patient with a possible endocrine problem. The patient’s weight was 142 lbs 6 months ago compared with a current weight of 125 lbs. What percent weight change will the nurse document in the patient’s health record?
12% weight loss
17% weight loss
25% weight loss
74% weight loss

Answer 25

a
142 lb - 125 lb = 17 lb; (17/142) × 100 = 12%. Weight change (%)

Question 26

The nurse interviews a patient with a history of type 2 diabetes, chronic bronchitis, and osteoarthritis who has a fasting blood glucose of 154 mg/dL. Which patient medication may be responsible for the elevated blood glucose level?
a) Metformin
b) Prednisone
c) Acetaminophen
d) Insulin glargine

Answer 26

b
Prednisone is a corticosteroid that may cause glucose intolerance in susceptible patients by increasing gluconeogenesis and insulin resistance.

Question 27

The nurse is teaching a patient who is scheduled for an oral glucose tolerance test. Which statement indicates further teaching is required?
a) “I will fast for at least 8 hours before the test.”
b) “Ingesting caffeine and smoking may alter the test results.”
c) “The results of this test will show my blood sugar control over the last 3 months.”
d) “Blood samples will be taken at intervals after I drink a sample of glucose solution.”

Answer 27

c
An oral glucose tolerance test requires nothing by mouth for 8 to12 hours. Caffeine and smoking may influence test results. After ingesting the oral glucose sample, blood is drawn after 30-, 60-, and 120-minute intervals.

Question 28

Which hormone level would the nurse expect to be elevated in response to a low serum cortisol level?
a) Growth hormone (GH)
b) Follicle-stimulating hormone (FSH)
c) Thyroid-stimulating hormone (TSH)
d) Adrenocorticotropic hormone (ACTH)

Answer 28

d