Endocrine practice

Question 1

A characteristic common to all hormones is that they
a. circulate in the blood bound to plasma proteins
b. influence cellular activity of specific target tissues
c. accelerate the metabolic processes of all body cells
d. enter a cell and change the cell’s metabolism or gene expression

Answer 1

b

Question 2

A pt is receiving radiation therapy for cancer of the kidney. The nurse monitors the pt for s/s of damage to the
a. pancreas
b. thyroid gland
c. adrenal gland
d. posterior pituitary gland

Answer 2

c

Question 3

A pt has a serum sodium levels of 152mEq/L. The normal hormonal response to the situation is

a. release of ADH
b. release of ACTH
c. secretion of aldosterone
d. section of corticotropin-releasing horomee

Answer 3

a

Question 4

All cells in the body are believed to have intracellular receptors for

a. insulin
b. glucagon
c. growth hormone
d. thyroid horome

Answer 4

d

Question 5

**When obtaining subjective data from a pt during the assessment of the endocrine system, the nurse asks specifically about
**
a. energy level
b. intake of vitamin C
c. employment history
d. frequency of sexual internourse

Answer 5

a

Question 6

An appropriate technique to use during physical assesment of the thyroid gland is
a. asking a pt to hyperextend the neck during palpation
b. percussion the neck for dullness to define the size of the thyroid
c. having the pt swallow water during inspection and palpation if the gland
d. using deep palpation to determine the extent of a visibly enlarged thyroid gland

Answer 6

c

Question 7

Endocrine disorder often go underrecognized in the older adult because

a. symptoms are often attributed to aging
b. older adults rarely have identifiable symptoms
c. endocrine disorders are relatively rare in older adults
d. older adults usually have subclinical endocrine disorder that minimize symptoms

Answer 7

a

Question 8

Abnormal findings during an endocrine assessment include SATA

a. excess facial hair on a woman
b. blood pressure of 100/70 mm Hg
c. soft, formed stool every other day
d. 3-lb weight gain over last 6 months
e. hyperpigmented coloration in lower legs

Answer 8

a,e

Question 9

A pt has a total serum calcium level of 3mg/dL. If these findings reflect hypoparathyroidism, the nurse would expect further diagnostic testing to reveal
a. decreased serum PTH
b. increase serum ACTH
c. increase serum glucose
d. decrease serum cortisol level

Answer 9

a

Question 10

After hypophysectomy for acromegaly, immediate postoperative nursing care should focus on
a. frequent monitoring of serum and urine osmolarity
b. parenteral administration of a GH-receptor antagonist
c. keeping the patient in a recumbent position at all times
d. patient teaching about the need for lifelong hormone therapy

Answer 10

a

Question 11

A pt with a head injury develops SIADH. Manifestations the nurse would expect
a. hypernatremia and edema
b. muscle spasticity and hypertension
c. low urine output and hyponatremia
d. weight gain and decreased glomerular filtration

Answer 11

c
SIADH=a condition in which the body makes too much antidiuretic hormone (ADH)

Question 12

The health care provider prescribes levothyroxine for a pt with hypothyrpodosim. After teaching about this drug, the nurse determines that further instruction is needed when the pt says
a. I can expect the medication dose may need to be adjusted
b. I only need to take this drug until my symptoms are improved
c. I can expect to return to normal function with the use of this drug
d. I will report any chest pain or difficulty breathing to the provider

Answer 12

b

Question 13

After thyroid surgery, the nurse suspects damage or removal of the parathyroid glands when the pt develops
a. muscle weakness and weight loss
b. hyperthermia and severe tachycardia
c. hypertension and difficulty swallowing
d. laryngospasm as ane tingling in the hands and feet

Answer 13

d
laryngospasm= a transient and reversible spasm of the vocal cords that temporarily makes it difficult to speak or breathe

Question 14

Important nursing interventions when caring for a pt with Cushing syndrome include SATA

a. restricting protein intake
b. monitoring blood glucose level
c. observing for signs of hypotension
d. administering medication in equal dosage
e. protecting py form exposure to infection

Answer 14

b,e

Question 15

An important preoperative nursing intervention before adrenalectomy for hyperaldosteronism is to
a. monitor blood glucose levels
b. restrict fluid and sodium intake
c. administer potassium-sparing diuretics
d. advise the pt to make postural changes slowly

Answer 15

c

Question 16

To control the side effects of corticosteroid therapy, the nurse teaches the pt sh is taking corticosteroids to
a. increase calcium intake to 1500mg/day
b. perform glucose monitoring for hypoglycemia
c. obtain immunizations due to high risk for infections
d. avoid abrupt position change because if orthostatic hypotension

Answer 16

a

Question 17

A nurse is caring for a pt who has a blood glucose 52mg/dL. the pt is lethargic but arousable. Which of the following actions should the nurse perform first?
a) Recheck blood glucose in 15min
b) Provide a carbohydrate and protein food
c) Provide 15g of simple carbohydrate
d) Report findings to the provider

Answer 17

c
a-after 15g snack
b-if the next meal more than 1hr away
after IF glucose return to normal

Question 18

A nurse is preparing to administer a morning dose of insulin aspart to a pt who has type 1 DM. Which of the following actions should the nurse take?

a) Check bllod glucose immediately after breakfast
b) Administer insulin when breakfast arrives
c) Hold breakfast for 1 hr after insulin administration
d) Clarify the prescription because insulin should not be administered at this time

Answer 18

b
a-should check before
c-should eat within 5-15 min after insulin to prevent hypoglycimea
d-insuloin aspart must administer at mealtime

Question 19

A nurse is presenting information to a group of pts about nutrition habits that prevent type 2 DM. Which of the following should the nurse include in the information? SATA

a) Eat at regular intervals
b) Decrease intake of saturated fat
c) Increase daily fiber intake
c) Limit saturated fat intake to 15% of daily intake
d) Include omega-3 fatty acids in the diet

Answer 19

a,b,c,e
d-n more than 7%

Question 20

A nurse is teaching foot care to a pt who has DM. Which of the following information should the nurse include in the teaching? SATA
a) Remove calluses using OTC remedies
b) Apply lotion beteweem toes
c) Test water temp with the fingers before bathing
d) Trim toenails straight across
e) Wear closed-toe shoes

Answer 20

d,e
c- no finger, finger might not be sensitive

Question 21

A nurse is reviewing the health history of a pt who has DM type 2. Which og the following are risk factres fr hyperglycemic hyperosmolar state (HHS)? SATA
a) Evidence of recent MI
b) BUN 35mg/dL
c) Takes a CCB
d) Age 77 years
e) Daily insulin injections

Answer 21

a,b,c,d

Question 22

A nurse is assessing a pt who has DKA and ketones in the urine. The nurse should expect which of the following findings? SATA
a) Weight gain
b) Fruiry odor of the breath
c) Abdominal pain
d) Kussmaul respirations
e) Metabolic acidosis

Answer 22

b,c,d,e

Question 23

A nurse is reviewing the lab reports of a pt who has HHS. Which of the following findings should the nurse expect?
a) Blood pH 7.2
b) Blood osmolarity 350 mOsm/L
c) Blood potassoium 3.8mg/dL
d) Blood creatinine 0.8mg/dL

Answer 23

b
a- DKA
c-should decrease
d-shuld grater then 1.5

Question 24

A nurse is reviewing the medical record for a pt who is to begin therapy for DKA. Which of the following prescriptions should the nurse expect?
a) Administer an IV infusion of regular insulin at 0.3 unit/kg/hr
b) Administer a slow IV infusion of 3% sodium chloride
c) Rapidly administer an IV infusion of 0.9% sodium chloride
d) Add glucose to the IV infusion when blood glucose is 350mg/dL

Answer 24

c
a- insulin 0.1 unit for prevent cebral edema
b-for hyponatrimia
d- when glucose is 250,not 350

Question 25

A nurse is providing discharge teaching to a pt who had DKA. Which of the following information should nurse include about preventing DKA? SATA
a) Drink 2L daily
b) Monitor blood sugar every 4 hr when ill
c) Administer insulin as prescribed when ill
d) Notify the provider when blood glucose is 200mg/dL
e) Report ketones in the urine after 24hr of illness

Answer 25

a,b,c,e
d- notify the provider remian 250 after the treatment

Question 26

Which manifestations should a nurse investigate first when monitoring a patient who is taking levothyroxine (Synthroid)?
A) Tachycardia
B) Tremors
C) Insomnia
D) Irritability

Answer 26

A
Tachycardia is the priority assessment, because it can lead to severe cardiac dysfunction. Tremors, insomnia, and irritability are other symptoms

Question 27

A client who is taking levothyroxine (Synthroid) begins to develop weight loss, diarrhea, and intolerance. The nurse should be aware that this might be an indication of what hormonal condition?
a.) Addison’s disease
b.) Hyperthyroidism
c.) Cushing’s syndrome
d.) Development of acromegaly

Answer 27

b

Question 28

The client who underwent thyroidectomy is
experiencing tingling around the mouth. What
action by the nurse best demonstrates the
nurse’s knowledge of thyroidectomy?
a. Having calcium gluconate available
b. Assessing for frequent swallowing
c. Monitoring for hoarseness
d. Assessing peripheral circulation

Answer 28

a
used to manage hypocalcemia, cardiac arrest

Question 29

a) Hoarseness?
b) laryngeal stridor?

Answer 29

a) is an anormality of voiced sounds due to disorganized movment of the vocal coeds
b) is a loud, harsh, high-piched sounds produced by turbulent airflow through a partially abstracted airway

Question 30

A patient has just arrived on the unit after a thyroidectomy. Which action should the nurse take first?
a. Observe the dressing for bleeding.
b. Check the blood pressure and pulse.
c. Assess the patients respiratory effort.
d. Support the patients head with pillows.

Answer 30

c
Airway obstruction is a possible complication after thyroidectomy because of swelling or bleeding at the site

Question 31

A nurse assesses a client who is recovering from a total thyroidectomy and notes the development of stridor. Which action should the nurse take first?
a. Reassure the client that the voice change is temporary.
b. Document the finding and assess the client hourly.
c. Place the client in high-Fowler’s position and apply oxygen.
d. Contact the provider and prepare for intubation.

Answer 31

D.
Stridor on exhalation is a hallmark of respiratory distress, usually caused by obstruction resulting from edema. The nurse should prepare to assist with emergency intubation or tracheostomy while notifying the provider or the Rapid Response Team.

Question 32

A client just returned from surgery for a thyroid disorder and complains that his/her mouth has an odd sensation. Which medication should the nurse anticipate administering?
a. Calcium gluconate
b. Epinephrine
c. Potassium chloride
d. Rectal aspirin

Answer 32

A.
Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed during surgery.
If the client develops positive Chvosteks or Trousseaus sign, numbness and tingling around the mouth or in the fingertips or toes, muscle spasms, or twitching, the nurse should call the physician immediately and anticipate giving calcium gluconate.