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Term 2 > Test 3 ch 51 > Flashcards

Test 3 ch 51 Flashcards

1
Q

The nurse explains that the negative feedback inhibition controls hormone release by communication between which two anatomical areas?
a. the pituitary and the target organ.
b. the thymus and the bloodstream.
c. lymphatic system and the target organ.
d. central nervous system and the bloodstream.

A

a. the pituitary and the target organ.

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2
Q

Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the previous 8 to 12 weeks?
a. Fasting blood sugar (FBS)
b. Oral glucose tolerance test (OGT)
c. Glycosylated hemoglobin (HbA1c)
d. Postprandial glucose test (PPBG)

A

c. Glycosylated hemoglobin (HbA1c)

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3
Q

Which test will furnish immediate feedback for a newly diagnosed diabetic who is not yet under control?
a. Fasting blood sugar (FBS)
b. Glycosylated hemoglobin (HbA1c)
c. Oral glucose tolerance test (OGTT)
d. Clinitest

A

a. Fasting blood sugar (FBS)

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4
Q

To which diet should a patient with Cushing syndrome adhere?
a. Less sodium
b. More calories
c. Less potassium
d. More carbohydrates

A

a. Less sodium

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5
Q

The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of an exercise regimen. The patient plans to enroll in a swimming class. Which adjustment will the nurse suggest to the patient based on this information?
a. Time the morning insulin injection so that the peak action will occur during
swimming class.
b. Delete normal walks on swimming class days.
c. Delay the meal before the swimming class until the session is over.
d. Monitor glucose level before, during, and after swimming to determine the need
for alterations in food or insulin.

A

d. Monitor glucose level before, during, and after swimming to determine the need
for alterations in food or insulin.

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6
Q

Which disorder is a long-term complication of diabetes mellitus?
a. Diverticulitis
b. Renal failure
c. Hypothyroidism
d. Hyperglycemia

A

b. Renal failure

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7
Q

A patient has returned to his room after a thyroidectomy with signs of thyroid crisis. During thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of which potentially lethal complication?
a. severe nausea and vomiting.
b. bradycardia.
c. delirium with restlessness.
d. congestive heart failure.

A

d. congestive heart failure.

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8
Q

In diabetes insipidus, a deficiency of which hormone causes clinical manifestations?
a. Antidiuretic hormone (ADH)
b. Follicle-stimulating hormone (FSH)
c. Thyroid-stimulating hormone (TSH)
d. Adrenocorticotropic hormone (ACTH)

A

a. Antidiuretic hormone (ADH)

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9
Q

The nurse expects to see which intervention in the plan of care for a patient who has recently been diagnosed with acromegaly?
a. Encourage fluids
b. Maintain leg joints in flexion
c. Assist with activities of daily living
d. Monitor for episodes of bleeding into the joints

A

c. Assist with activities of daily living

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10
Q

The use of radioactive iodine in the treatment of hyperthyroidism is for which purpose?
a. stimulate the thyroid gland.
b. depress the pituitary.
c. destroy some of the thyroid tissue.
d. alter the stimulus from the pituitary.

A

c. destroy some of the thyroid tissue.

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11
Q

Which precaution(s) will the nurse take when caring for a patient who is being treated with radioactive iodine 131 (RAIU)?
a. Initiate radioactive safety precautions.
b. Avoid assigning any young woman to the patient.
c. Wait 3 days after dose before assigning a pregnant nurse to care for this patient.
d. Advise visitors to sit at least 10 ft away from the patient.

A

c. Wait 3 days after dose before assigning a pregnant nurse to care for this patient.

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12
Q

For which reason would a patient with hyperthyroidism be prescribed the drug methimazole?
a. To limit the effect of the pituitary on the thyroid.
b. To destroy part of the hyperactive thyroid tissue.
c. To stimulate the pineal gland.
d. To block the production of thyroid hormones.

A

d. To block the production of thyroid hormones.

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13
Q

The nurse will place the patient who has had a thyroidectomy in which position postoperatively?
a. Prone
b. Semi-Fowler
c. Side-lying
d. Supine

A

b. Semi-Fowler

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14
Q

Which extra equipment will the nurse provide at the bedside of a patient who has returned to the nursing unit after a thyroidectomy three hours ago?
a. Large bandage scissors
b. Tracheotomy tray
c. Ventilator
d. Water-sealed drainage system

A

b. Tracheotomy tray

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15
Q

As the nurse is shaving a patient who is 2 days postoperative from a thyroidectomy, the patient has a spasm of the facial muscles. The nurse will recognize this as whichsign?
a. Chvostek sign
b. Montgomery sign
c. Trousseau sign
d. Homans’ sign

A

a. Chvostek sign

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16
Q

Lispro has an onset of action within how many minutes?
a. 90
b. 60
c. 15
d. 45

A

c. 15

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17
Q

Which information will the nurse provide a patient with type I diabetes regarding excessive exercise?
a. It can increase the need for insulin and may result inhyperglycemia.
b. It can decrease the need for insulin and may result inhypoglycemia.
c. It can increase muscle bulk and may result in malabsorption of insulin.
d. It can decrease metabolic demand and may result in metabolic acidosis.
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A

b. It can decrease the need for insulin and may result inhypoglycemia.

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18
Q

Which condition does the Chvostek sign and the Trousseau sign indicate?
a. Low levels of serum calcium
b. High levels of blood sugar
c. Low levels of serum sodium
d. High levels of serum aldosterone

A

a. Low levels of serum calcium

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19
Q

A patient has undergone tests that indicate a deficiency of the parathyroid hormone secretion. The nurse will inform the patient of which potential complication?
a. Osteoporosis
b. Lethargy
c. Laryngeal spasms
d. Kidney stones

A

c. Laryngeal spasms

20
Q

The nurse caring for a 75-year-old man who has developed diabetes insipidus following a head injury expects to see which aspect emphasized in the plan of care?
a. limiting fluids to 1500 mL a day.
b. encouraging physical exercise.
c. protecting patient from injury.
d. discouraging daytime naps.

A

c. protecting patient from injury.

21
Q

The health care provider orders an 1800-calorie diabetic diet and 40 units of NPH insulin subcutaneously daily for a patient with diabetes mellitus. For which reason will a mid-afternoon snack of milk and crackers be given?
a. To improve nutrition.
b. To improve carbohydrate metabolism.
c. To prevent hypoglycemia
d. To prevent diabetic coma.

A

c. To prevent hypoglycemia

22
Q

The nurse teaching a patient with type 1 diabetes mellitus (IDDM) will include which information about early signs of hypoglycemia?
a. abdominal pain and nausea.
b. dyspnea and pallor.
c. flushing of the skin and headache.
d. hunger and a trembling sensation.

A

d. hunger and a trembling sensation.

23
Q

The nurse discovers a patient with type I diabetes drowsy and tremulous, the skin is cool and moist, and the respirations are 32 and shallow. The nurse recognizes the patient is having which type of reaction and quickly provides which intervention?
a. hypoglycemic reaction; give 6 oz of orange juice.
b. hyperglycemic reaction; give ordered regular insulin.
c. hyperglycemic hyperosmolar nonketotic reaction; squeeze glucagon gel in buccal
cavity.
d. hypoglycemic reaction; give ordered insulin.

A

a. hypoglycemic reaction; give 6 oz of orange juice.

24
Q

A patient has come to the clinic because of enlarged hands and feet, amenorrhea, and increased hair growth. These symptoms most likely indicate problems with which endocrine gland?
a. pituitary gland.
b. adrenal glands.
c. thyroid gland.
d. pancreas.

A

a. pituitary gland.

25
Q

Which instructions will the nurse provide to a patient with diabetes to prevent injury to the feet?
a. Soak feet in warm water every day.
b. Avoid going barefoot and always wear shoes with soles.
c. Use of commercial keratolytic agents to remove corns and calluses are preferred to
cutting off corns and calluses.
d. Use a heating pad to warm feet when they feel cool to the touch.

A

b. Avoid going barefoot and always wear shoes with soles.

26
Q

The health care provider prescribes glyburide for a patient, when diet and exercise have not been able to control type 2 diabetes. Which information will the nurse reinforce in the teaching plan about this medication?
a. It is a substitute for insulin and acts by directly stimulating glucose uptake into the
cell.
b. It does not cause the hypoglycemic reactions that may occur with insulin use.
c. It is thought to stimulate insulin production and increase sensitivity to insulin at
receptor sites.
d. It lowers blood sugar by inhibiting glucagon release from the liver, preventing
gluconeogenesis.

A

c. It is thought to stimulate insulin production and increase sensitivity to insulin at
receptor sites.

27
Q

A 27-year-old patient with hypothyroidism is referred to the dietitian for dietary consultation. The nurse will reinforce instructions for which nutritionalinterventions?
a. Frequent small meals high in carbohydrates
b. Calorie-restricted meals
c. Caffeine-rich beverages
d. Fluid restrictions

A

b. Calorie-restricted meals

28
Q

Which instructions will the nurse reinforce in the discharge instructions for a 47-year-old patient with hypothyroidism?
a. Taking medication whenever symptoms cause discomfort
b. Decreasing fluid and fiber intake
c. Consuming foods rich in iron
d. Seeing the health care provider regularly for follow-up care

A

d. Seeing the health care provider regularly for follow-up care

29
Q

In which manner will the nurse administer insulin to prevent lipohypertrophy?
a. At room temperature
b. At body temperature
c. Straight from the refrigerator
d. After rolling bottle between hands to warm

A

a. At room temperature

30
Q

A patient with a history of Graves’ disease is admitted to the unit with shortness of breath. The nurse notes the patient’s vital signs: T 103°F, P 160, R 24, BP 160/80. The nurse also notes distended neck veins. Which disorder does the patient most likely have?
a. Pulmonary embolism
b. Hypertensive crisis
c. Thyroid storm
d. Cushing crisis

A

c. Thyroid storm

31
Q

Which gland is the master gland of the endocrine system?
a. Thyroid
b. Parathyroid
c. Pancreas
d. Pituitary

A

d. Pituitary

32
Q

Which information should be obtained from the patient before treatment with iodine-131?
a. Presence of metal in the body
b. Allergy to sulfa drugs
c. Status of possible pregnancy
d. Use of prescription drugs for hypertension

A

c. Status of possible pregnancy

33
Q

The patient being treated for hypothyroidism has been instructed to eat well-balanced meals including intake of iodine. The nurse will reinforce instructions to eat which food containing iodine?
a. Eggs
b. Pork
c. White bread
d. Skinless chicken

A

a. Eggs

34
Q

The nurse is caring for a patient who is receiving calcium gluconate for treatment of hypoparathyroid tetany. Which assessment would indicate an adverse reaction to thedrug?
a. Increase in heart rate
b. Flushing of face and neck
c. Drop in blood pressure
d. Urticaria

A

c. Drop in blood pressure

35
Q

The nurse cautions the patient who is being instructed on self-medication with insulin to be aware that there are 25-, 30-, 50-, and 100-unit syringes. How is the 100-unit syringe marked?
a. 1-unit increments
b. 2-unit increments
c. 4-unit increments
d. 5-unit increments

A

b. 2-unit increments

36
Q

MULTIPLE RESPONSE
1. Which is a sign or symptom of hypoglycemia? (Select all that apply.)
a. Irritability
b. Dry mouth
c. Tremors
d. Diaphoresis
e. Fruity breath
f. Deep respirations

A

ANS: A, C, D

a. Irritability
c. Tremors
d. Diaphoresis

37
Q

MULTIPLE RESPONSE
The nurse should observe the patient for which major life-threatening complication postoperatively of a thyroidectomy? (Select all that apply.)
a. Hemorrhaging
b. Seizures
c. Tetany
d. Hypoglycemia
e. Thyroid crisis (storm)
f. SIADH

A

ANS: A, C, E

a. Hemorrhaging
c. Tetany
e. Thyroid crisis (storm)

38
Q

MULTIPLE RESPONSE
Which is the role of cortisol? (Select all that apply.)
a. Glucose metabolism
b. Releasing androgens and estrogens
c. Providing extra reserve energy during stress
d. Decreasing the level of potassium in the bloodstream
e. Increasing retention of sodium in the bloodstream

A

ANS: A, C

a. Glucose metabolism
c. Providing extra reserve energy during stress

39
Q

MULTIPLE RESPONSE
Which action will the nurse take for the postoperative care of the patient who had a thyroidectomy? (Select all that apply.)
a. Assessing ability to speak by asking him or her to recite name and address every
hour
b. Maintaining anatomic position of the head when moving a patient
c. Assisting a patient to hyperextend the head to assess for muscle damage
d. Doing voice check every 2 hours
e. Turning, coughing every hour
f. Checking for bleeding at the sides and the back of the head

A

ANS: B, D, F
b. Maintaining anatomic position of the head when moving a patient
d. Doing voice check every 2 hours
f. Checking for bleeding at the sides and the back of the head

40
Q

MULTIPLE RESPONSE
The nurse will reinforce instruction for a patient with hyperthyroidism (Graves disease) to select which nutritious food because of the increased metabolism related to the disease? (Select all that apply.)
a. Coffee with cream
b. Lean meat
c. White bread
d. Leafy green vegetables
e. Supplemental vitamin D

A

ANS: B, D, E

b. Lean meat
d. Leafy green vegetables
e. Supplemental vitamin D

41
Q

MULTIPLE RESPONSE
The nurse would instruct a patient with hypocalcemia from hypoparathyroidism about a diet that should include which item? (Select all that apply.)
a. high phosphorus foods.
b. canned fish with the bones.
c. cucumbers.
d. tofu.
e. bananas.
f. Tomatoes

A

ANS: B, C, D, F

b. canned fish with the bones.
c. cucumbers.
d. tofu.
f. Tomatoes

42
Q

COMPLETION
The nurse is administering long-acting insulin once a day, which provides insulin coverage for 24 hours. This insulin is __________.

ANS: Glargine.

A

Glargine

43
Q

COMPLETION
Another term for hyperglycemic reaction is diabetic _____________ .
ANS: ketoacidosis

A

Ketoacidosis

44
Q

COMPLETION
Only __________ insulin can be administered intravenously.
ANS: regular

A

Regular

45
Q

COMPLETION
A condition with a deficiency in growth hormone is called ____________ dwarfism.
ANS: hypopituitary

A

hypopituitary

46
Q

COMPLETION
___________is the term that describes a condition of normal thyroid function.
ANS: Euthyroid

A

Euthyroid

47
Q

When the nurse inflates the sphygmomanometer cuff exceeding the systolic blood pressure and observes a carpal spasm, this is a(n) _________sign.
ANS: Trousseau

A

Trousseau

Term 2 (20 decks)

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