Hepatic/Endocrine

Question 1

Spider __________ are lesions with a red center and numerous extensions that spread out like a spider web are an _______finding for a client who has cirrhosis. ______ colored stools, and dark colored, foamy urine are also expected findings for a client who has cirrhosis.

Answer 1

angiomas, expected, clay

Question 2

Frequent nosebleeds are a manifestation of cirrhosis since __________ defects are a common complication of cirrhosis.

Answer 2

coagulation

Question 3

With end-stage cirrhosis of the liver, ammonia levels ____ and can cause encephalopathy. Lactulose is used to promote excretion of ammonia from the body through the ______. Lactulose should not be suspended due to diarrhea since ammonia levels will _______. Lactulose, a disaccharide, is a sugar that works as an ________diuretic. It prevents absorption of _______ in the colon. Accumulation of ________ in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma.

Answer 3

rise, stool, increase, osmotic, ammonia, ammonia

Question 4

With hepatitis B, _________ activity is usually recommended until the symptoms of hepatitis have subsided. The nurse should recommend the client rest frequently throughout the day to reduce the metabolic demands upon the liver and __________ energy demands.

Answer 4

limiting, decrease

Question 5

Effective _______ _________—along with immunization, sewer sanitation, and a safe water supply—are the most effective strategies for preventing the transmission of hepatitis A. The hepatitis A virus can be left on food from unclean hands of food handlers. The client can help prevent transmission to others by performing careful ________ after toileting and by thoroughly washing the food. Isolation is not ___________.

Answer 5

hand hygiene, handwashing, required

Question 6

Hepatitis C is a blood-borne pathogen that is commonly spread by ______ _____ injury, sharing of IV drug paraphernalia and sexual contact. The nurse should implement _________ precautions when in contact with blood, body fluids (except sweat), broken skin, and mucous membranes.
The nurse should wear additional personal protective equipment if there is possible _____ contact or a risk for splashes or sprays of _____or body fluids.

Answer 6

needle-stick, standard, blood, blood

Question 7

Prolonged ________ of the common bile duct is the most common cause of biliary cirrhosis.

Answer 7

obstruction

Question 8

A manifestation of advanced cirrhosis is petechiae due to impaired ________ from a dysfunctional liver.

Answer 8

coagulation

Question 9

Addison’s disease is an endocrine disorder that occurs when the adrenal glands do not produce enough of the hormone __________, and in some cases, the hormone aldosterone. The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and hyperpigmentation (__________) of the skin in both exposed and non-exposed parts of the body.

Answer 9

cortisol, browning/darkening

Question 10

With the syndrome of inappropriate antidiuretic hormone (SIADH), nurses can expect _______natremia, significant _________ in urine output, weight _____, and loss of thirst.

Answer 10

hyper-, decrease, gain

Question 11

Some of the treatment options for small cell lung cancer can cause __________ of antidiuretic hormone. This results in the body _________ water and can cause the syndrome of inappropriate antidiuretic hormone (SIADH).

Answer 11

secretion, retaining

Question 12

The TSH test helps determine __________ status (whether it is overactive, underactive, or normal and helps monitor the effectiveness and dosage of thyroid hormone replacement therapy.

Answer 12

thyroid

Question 13

In hypothyroidism, the nonfunctioning thyroid gland is unable to respond to the TSH, and no endogenous thyroid hormones are __________. This results in an ________ of the TSH level as the anterior pituitary continues to release the TSH to stimulate the thyroid gland. Administration of exogenous thyroid hormones, such as levothyroxine, turns off this feedback loop, which results in a _________ level of TSH.

Answer 13

released, increase, decreased

Question 14

When using the airway, breathing, circulation approach to client care for a client post thyroidectomy, the nurse should determine it is the priority to monitor the client’s _________. Nerve damage, hypocalcemia induced tetany, and edema can all impair the _______ following thyroidectomy.

Answer 14

airway, airway

Question 15

The nurse should expect a TSH level _______ the expected reference range in a client who has Graves’ disease.

Answer 15

below

Question 16

The client who has an acute _________ of levothyroxine will exhibit heat intolerance, _________, and hyperthermia. These manifestations are indications of excessive levels of thyroid hormone that could lead to death.

Answer 16

overdose, sweating

Question 17

When caring for a client with Diabetes Insipidus, the nurse should check the client’s urine specific gravity to monitor _______ concentration and ________ fluids. A client who has diabetes insipidus has a urine specific gravity of _____than 1.005, _______ peripheral pulses, tachycardia, and ____ mucous membranes due to dehydration.

Answer 17

urine, increased, less, weak, dry

Question 18

The major manifestations of diabetes insipidus are _________ urination and extreme thirst. Vasopressin is used to control frequent urination, increased thirst, and loss of water associated with diabetes insipidus. A _________ urine output is the desired response.

Answer 18

excessive, decreased

Question 19

Common manifestations of Cushing’s Syndrome include alopecia, ____ face, purple _________, and __________ hump.

Answer 19

moon, striae, buffalo

Question 20

Clients with Cushing’s disease can take Calcium and vitamin D supplements that will help to reduce the ____ of pathological fractures.

Answer 20

risk

Question 21

Addison’s disease is an endocrine disorder that causes weight ____, muscle weakness, fatigue, ___ blood pressure, and hyperpigmentation (darkening) of the skin. Obtaining the client’s daily _________ will alert the nurse that dehydration is developing, which could indicate an impending crisis.
weight will alert the nurse that dehydration is developing, which could indicate an impending crisis.

Answer 21

loss, low, weight

Question 22

Addison’s disease is caused by a ____ of production of the adrenocorticotropic hormones (cortisol and aldosterone) by the adrenal gland.

Answer 22

decreased/lack

Question 23

Clients who have SIADH have an increased amount of antidiuretic hormones, which results in ________ fluid volume. This excess fluid dilutes the sodium level in the blood, causing dilutional hyponatremia. Oral fluids are ________ to restore the fluid balance and the sodium level in the blood. The nurse should offer this client _______ oral care to prevent discomfort and breakdown of the oral mucosa.

Answer 23

increased, restricted, frequent

Question 24

A water deprivation test measures the ability of the kidneys to concentrate _________ in the environment of high plasma osmolality and low ADH.

Answer 24

urine

Question 25

An overnight dexamethasone _________ test is used to diagnosis pituitary and adrenal causes of Cushing syndrome.

Answer 25

depression

Question 26

The nurse should place the client with myxedema coma on _________ precautions because the client can have __________ mental status and is at risk for laryngeal edema and tongue thickening.

Answer 26

aspiration, altered/decreased

Question 27

The nurse should measure the amount of unabsorbed __________ from the previous enteral feeding to identify delayed gastric emptying. If it is delayed, the nurse should avoid overfeeding the client and causing gastric distention.

Answer 27

formula

Question 28

The nurse should flush the NG feeding tube with 15 to 60 mL of water following each medication administration to ensure the feeding tube is cleared of the ___________.

Answer 28

medications

Question 29

TPN contains high concentrations of dextrose and ________. To avoid __________, the nurse should infuse dextrose 10% or 20% in water until the next container of TPN solution arrives.

Answer 29

proteins, hypoglycemia

Question 30

The greatest risk to the safety of a client who has a pulmonary embolism is ________ with respiratory distress and cyanosis. _______ therapy should be applied by the nurse using a nasal cannula or mask. Pulse oximetry should be initiated to monitor _______ ________.

Answer 30

hypoxemia, oxygen, oxygen saturation

Question 31

When caring for a client who has accidentally removed their ET tube, The first action the nurse should take using the nursing process is to _______ the client’s airway for obstruction, listen to the client’s lungs for air movement, and provide mechanical ventilation with a ___-___ ____ device to reduce the risk for hypoxia.

Answer 31

assess, bag-valve mask