Nursing 101 Exam Help

When caring for a client diagnosed with pheochromocytoma, which information should the nurse know when assisting with planning care? The nurse is reviewing a plan of care for a client with Addison's disease. The nur ...

When caring for a client diagnosed with pheochromocytoma, which information should the nurse know when assisting with planning care? The nurse is reviewing a plan of care for a client with Addison's disease. The nurse notes that the client is at risk for dehydration and suggests nursing interventions that will prevent this occurrence. Which nursing intervention is an appropriate component of the plan of care? Select all that apply. The nursing instructor asks a student to describe the pathophysiology that occurs in Cushing's disease. Which statement by the student indicates an accurate understanding of this disorder? The nurse working on an endocrine nursing unit understands that which correct concept is used in planning care? After several diagnostic tests, a client is diagnosed with diabetes insipidus. The nurse understands that which signs/symptoms are indicative of this disorder? Which signs/symptoms should the nurse expect to note when collecting data on a client with Addison's disease? While collecting data on a client being prepared for an adrenalectomy, the nurse obtains a temperature reading of 100.8° F. The nurse analyzes this temperature reading as which? A client is admitted with a diagnosis of pheochromocytoma. The nurse should monitor which parameter to detect the most common sign of pheochromocytoma? A client with hypoparathyroidism has hypocalcemia. The nurse avoids giving the client the prescribed vitamin and calcium supplement with which liquid? The nurse is caring for a client diagnosed with hyperparathyroidism who is prescribed furosemide (Lasix). The nurse reinforces dietary instructions to the client. Which is an appropriate instruction? The nurse has reinforced dietary instructions to a client with a diagnosis of hypoparathyroidism. The nurse instructs the client to include which item in the diet? A client with a pituitary tumor will undergo transsphenoidal hypophysectomy. The nurse reinforces which information in the preoperative teaching plan for the client? An older client with a history of hyperparathyroidism and severe osteoporosis is hospitalized. The nurse caring for the client plans to address which problem first? The nurse is collecting data on a client with a diagnosis of hypothyroidism. Which of these behaviors, if present in the client's history, should the nurse determine as being likely related to the symptoms of this disorder? The nurse is caring for a child with a diagnosis of diabetes insipidus. The nurse anticipates that the health care provider will prescribe which medications? The nurse is collecting data on a client admitted to the hospital with a diagnosis of myxedema. Which data collection technique would provide data necessary to support the admitting diagnosis? The nurse reviews a plan of care for a postoperative client following a thyroidectomy and notes that the client is at risk for breathing difficulty. Which nursing intervention should the nurse include in the plan of care? A client has an endocrine system dysfunction of the pancreas. The nurse anticipates that the client will exhibit impaired secretion of which substance? The nurse is monitoring a client following a thyroidectomy for signs/symptoms of hypocalcemia. Which sign/symptom noted in the client indicates the presence of hypocalcemia? The nurse has reinforced instructions to the client with hyperparathyroidism regarding home care measures related to exercise. Which statement by the client indicates a need for further teaching? Select all that apply. The nurse is reviewing the postoperative prescriptions for a client who had a transsphenoidal hypophysectomy. Which health care provider's prescription noted on the record indicates the need for clarification? The nurse is collecting data from a client who is being admitted to the hospital for a diagnostic workup for primary hyperparathyroidism. The nurse understands that which client complaint would be characteristic of this disorder? A preoperative client is scheduled for adrenalectomy to remove a pheochromocytoma. The nurse should most closely monitor which assessment in the preoperative period? A client has been diagnosed with hypoparathyroidism. Which food groups should be included in the diet? The nurse is caring for a client with pheochromocytoma. The client asks for a snack and something warm to drink. Which is the appropriate choice for this client to meet nutritional needs? After receiving furosemide (Lasix) 40 mg slow intravenous push for chest pain related to shortness of breath and generalized edema, the client responds poorly. The client has no relief of the chest pain, shortness of breath, or edema and only minimal urine output (less than 40 mL of urine). The health care provider is notified, and after reviewing the chart, suspects the client has syndrome of inappropriate antidiuretic hormone (SIADH). Which findings would lead to this specific diagnosis? Refer to chart. The nurse is caring for a client with hypothyroidism who is overweight. Which food items should the nurse suggest to include in the plan? The nurse is reinforcing home care instructions to a client with a diagnosis of Cushing's syndrome. Which client statement reflects a need for further teaching? The nurse is instructing a client with Addison's disease about a newly prescribed medication, fludrocortisone acetate (Florinef). Which statement by the client indicates a need for further teaching? The nurse is monitoring a client with Graves' disease for signs of thyrotoxic crisis (thyroid storm). Which signs and symptoms noted in the client should alert the nurse to the presence of this crisis? Select all that apply. The nurse is caring for a client following a thyroidectomy. The client tells the nurse that she is concerned because of voice hoarseness. The client asks the nurse whether the hoarseness will subside. Which statement by the nurse regarding the hoarseness is accurate? The nurse caring for a client scheduled for a transsphenoidal hypophysectomy to remove a tumor in the pituitary gland assists in developing a plan of care for the client. The nurse suggests including which specific information in the preoperative teaching plan? A client is diagnosed with hyperparathyroidism. The nurse teaching the client about dietary alterations to manage the disorder tells the client to limit which food in the diet? A client with pheochromocytoma is scheduled for surgery and says to the nurse, "I'm not sure that surgery is the best thing to do." Which response by the nurse is appropriate? Following hypophysectomy, a client complains of being very thirsty and having to urinate frequently. Which is the initial nursing action? The nurse should expect to note which interventions in the plan of care for a client with hypothyroidism? Select all that apply. The nurse is preparing to reinforce instructions to a client with Addison's disease regarding diet therapy. The nurse understands that which diet should be prescribed for this client? The nurse is caring for a client with a diagnosis of hypoparathyroidism. The nurse reviews the client's laboratory results and notes that the calcium level is extremely low. The nurse should expect to note which sign/symptom on data collection? The nurse is caring for a client with Addison's disease. The nurse checks the client's vital signs and determines that the client has orthostatic hypotension. The nurse determines that this finding relates to which factor? The nurse is caring for a client after a thyroidectomy and monitoring for signs of thyroid storm. The nurse determines that which sign/symptom is indicative that a thyroid storm may be occurring? The nurse is caring for a client following an adrenalectomy and is monitoring for signs of adrenal insufficiency. Which are signs and symptoms related to adrenal insufficiency? Select all that apply. The nurse is reinforcing discharge teaching with a client who has Cushing's syndrome. Which statement by the client indicates that the instructions related to dietary management were understood? A health care provider has prescribed propylthiouracil (PTU) for a client with hyperthyroidism, and the nurse assists in developing a plan of care for the client. Which nursing measure would be included in the plan regarding this medication? The nurse is collecting data regarding a client after a thyroidectomy and notes that the client has developed hoarseness and a weak voice. Which nursing action is appropriate? The nurse is caring for a postoperative parathyroidectomy client. Which would require the nurse's immediate attention? A client has just been admitted with a diagnosis of myxedema coma. If all of the following interventions were prescribed, the nurse should place highest priority on completing which action first? The nurse is reinforcing discharge instructions to a client who had a unilateral adrenalectomy. Which information should be a component of the instructions? The nurse educator is asking the nursing student to recall the signs/symptoms of hypothyroidism. The nurse educator determines that the student understands this disorder if which are included in the student's response? Select all that apply Which client is at risk for developing thyrotoxicosis? 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. 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." 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? a. Urinary 17-ketosteroids b. Antidiuretic hormone level c. Growth hormone stimulation test d. Adrenocorticotropic hormone level 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?" 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." 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 During the physical examination of a 36-year-old female, the nurse finds that the patient's thyroid gland cannot be palpated. The most appropriate action by the nurse is to a. palpate the patient's neck more deeply. b. document that the thyroid was nonpalpable. c. notify the health care provider immediately. d. teach the patient about thyroid hormone testing. Which laboratory value should the nurse review to determine whether a patient's 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 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. 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. 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. A nurse will teach a patient who is scheduled to complete a 24-hour urine collection for 17- ketosteroids to a. insert and maintain a retention catheter. b. keep the specimen refrigerated or on ice. c. drink at least 3 L of fluid during the 24 hours. d. void and save that specimen to start the collection. Which additional information will the nurse need to consider when reviewing the laboratory results for a patient's 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. 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 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 patient's bulging eyes. 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 patient's urine osmolality does not increase. d. The patient feels dizzy when sitting on the edge of the bed. 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 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 The nurse is teaching the patient with hyperthyroidism the importance of stress management. She is teaching how to do deep breathing exercises and listens to the patient's thoughts on coping mechanism and spirituality. The nurse knows this is an important part of this patients plan because: a) Knowing how to cope with stress will help this patient be able to work through some of the difficult treatments of this disease b) Every patient needs to know how to cope with stress c) Extra stress with the patient with hyperthyroidism can lead to life threatening complications d) Listening to the patients thoughts instead of imposing one's own thoughts encourages the patient to become self-reliant You are the nursing student and you are taking care of the patient recently diagnosed with hyperthyroidism. You can visibly see the thryroid gland enlarged. What is the next thing you should assess? A) Assess for a bruit or a thrill B) Listen to respiratory rate and look at SpO2 C) Check for peripheral pulses D) Poke the neck to see if it is soft or hard The patient diagnosed with SIADH (Syndrome of inappropriate antidiuretic hormone) has a sodium level of 129 mEq/L. He is receiving IV 3% saline at 100 mL/hr. Which of the following is the nurse most concerned about? A) The patient complains of cramps in his hands B) There is trace edema in the lower extremities C) HR 110 D) The patient is suddenly states "Who are you?" Which of the following would the nurse monitor for as signs of thyroid storm? SATA: A) T 101.5 B) HR 59 C) Constipation D) Edema E) Chest pain The nurse is providing preoperative teaching to the patient about to undergo a thyroidectomy. Which statement, if made by the patient, indicates the need for further teaching? A) I need to eat super healthy before the surgery and should limit my calories to a healthy amount B) Before the surgery I should practice raising my elbows and placing both hands behind my neck to provide support C) Well, I will have to quit drinking my coffee and alcohol for now D) I will be sure increase my intake of protein and carbohydrates The nurse is counseling the patient with hypoparathyroidism about nutrition choices r/t her disease process. Which of the following trays demonstrates correct understanding of the teaching? A) Yogurt, cream of chicken soup, and apple sauce with sweet tea B) Fried salmon, green beans, and a white wheat bread roll C) Sausage and egg sandwich with whole wheat bread and coffee with creamer D) Turkey sandwich with lettuce, tomato, fruit cup and a glass of milk Uh oh, the patient records got scrambled up. You need to go in and see each of the patients in the clinic to see which problem they have. Which of the following patients does the nurse suspect to be the patient with hyperparathyroidism? A) The patient with shakiness in his hands and c/o numbness and tingling in fingers and toes B) The patient c/o back pain and abdominal cramping with nausea C) The patient with a BP of 167/87 and HR 110 with profuse sweating D) The patient c/o of fatigue and depression with bronze skin pigmentation You the nurse are taking care of the patient with hypoparathyroidism. Based on your knowledge of the disease process. Which of the following do you expect to be your priority in planning care for this patient? A) Acute Pain B) Fluid Volume Deficit C) Ineffective Airway Maintenance D) Impaired Cerebral Perfusion Which of the following would the nurse most expect to find in the patient with hypoparathyroidism? A) Hypertension and cramps in extremities B) Dysphagia and stiffness in hands or feet C) Positive Trousseau's sign and profuse sweating D) Increased Phosphorous levels and tremors The doctor walks into the patient room and says. "You have pheochromocytoma" and leaves. The patient begins to cry and says, "What does that mean?" What is the best response by the nurse? A) It is a tumor in your pituitary gland. You are probably going to die. B) You seem upset. Tell me how you are feeling. C) Pheochromocytoma is a disorder of the adrenal glands where too little steroids are released into the blood stream D) This is a caused by a benign tumor in certain glands in your body located above your kidneys Which of the following symptoms are expected in the patient with pheochromocytoma? Select all that Apply (SATA): A) Hypertension B) HA C) Hypoglycemia D) Hypermetabolism E) Dry skin The patient with Addison's disease presents to the clinic saying "I've gained five pounds in the past week!" You note some edema in both lower extremities. What does the nurse suspect to be the problem? A) Precipitation of Addisonian Crisis B) Heart Failure d/t end stage Addison's disease C) Excessive hormone replacement dose D) Adrenocarcinoma development You are providing discharge teaching to the client with primary Addison's disease. Which statement, if made by the patient, indicates the need for further teaching? A) I will have to take my Florinef and prednisone for the rest of my life B) During hot weather I will be sure to eat lots of salty foods C) I should continue to monitor my blood pressure for any drops D) Because I can't tolerate the heat I will cancel my trip to the Bahamas but I can still go skiing A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, nurse Julia formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which "related-to" phrase should the nurse add? a. Related to bone demineralization resulting in pathologic fractures b. Related to exhaustion secondary to an accelerated metabolic rate c. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces d. Related to tetany secondary to a decreased serum calcium level 5. Nurse Oliver should expect a client with hypothyroidism to report which health concerns? a. Increased appetite and weight loss b. Puffiness of the face and hands c. Nervousness and tremors d. Thyroid gland swelling 6. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect? a. Dysuria b. Leg cramps c. Tachycardia d. Blurred vision 7. A 67-year-old male client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, nurse Richard would suspect which of the following disorders? a. Diabetes mellitus b. Diabetes insipidus c. Hypoparathyroidism d. Hyperparathyroidism 8. When caring for a male client with diabetes insipidus, nurse Juliet expects to administer: a. vasopressin (Pitressin Synthetic). b. furosemide (Lasix). c. regular insulin. d. 10% dextrose. 9. The nurse is aware that the following is the most common cause of hyperaldosteronism? a. Excessive sodium intake b. A pituitary adenoma c. Deficient potassium intake d. An adrenal adenoma 11. Following a unilateral adrenalectomy, nurse Betty would assess for hyperkalemia shown by which of the following? a. Muscle weakness b. Tremors c. Diaphoresis d. Constipation 12. Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus? a. antidiuretic hormone (ADH). b. thyroid-stimulating hormone (TSH). c. follicle-stimulating hormone (FSH). d. luteinizing hormone (LH). 13. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? a. Diabetic ketoacidosis b. Thyroid crisis c. Hypoglycemia d. Tetany 15. When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, nurse April is most likely to detect: a. a blood pressure of 130/70 mm Hg. b. a blood glucose level of 130 mg/dl. c. bradycardia. d. a blood pressure of 176/88 mm Hg. 16. A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? a. Infusing I.V. fluids rapidly as ordered b. Encouraging increased oral intake c. Restricting fluids d. Administering glucose-containing I.V. fluids as ordered 17. A female client has a serum calcium level of 7.2 mg/dl. During the physical examination, nurse Noah expects to assess: a. Trousseau's sign. b. Homans' sign. c. Hegar's sign. d. Goodell's sign. 18. Which outcome indicates that treatment of a male client with diabetes insipidus has been effective? a. Fluid intake is less than 2,500 ml/day. b. Urine output measures more than 200 ml/hour. c. Blood pressure is 90/50 mm Hg. d. The heart rate is 126 beats/minute. 19. Jemma, who weighs 210 lb (95 kg) and has been diagnosed with hyperglycemia tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client's hyperglycemia? a. Acromegaly b. Type 1 diabetes mellitus c. Hypothyroidism d. Deficient growth hormone 21. An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of: a. Thyroid storm. b. Cretinism. c. myxedema coma. d. Hashimoto's thyroiditis. 25. During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the nurse should include which statement? a. "The head of your bed must remain flat for 24 hours after surgery." b. "You should avoid deep breathing and coughing after surgery." c. "You won't be able to swallow for the first day or two." d. "You must avoid hyperextending your neck after surgery." What is a hormone secreted from the posterior lobe of the pituitary gland? Answers: A. LH B. MSH C. ADH D. GnRH An indication of Chvostek' sign is: Answers: A. Twitching of the lips after tapping the face B. Elevated blood sugar after glucose infusion C. Inability to hold one's arms straight D. Spasms of the hand after blood circulation is cut off A 26 year old female client presents with the symptom of unwanted facial hair. What of the following conditions is most likely? Answers: A. Graves' disease B. PCOS C. Hyperthyroidism D. Addison's disease In explaining the condition to a client, a nurse would say that Cushing's syndrome is caused primarily by: Answers: A. Low levels of glucocorticoids B. Excess secretion of sodium C. Autoimmunity in the pancreas D. Elevated levels of cortisol Which of the following symptoms is not typical of Cushing's syndrome? Answers: A. Osteoporosis B. Weight loss C. Diabetes D. Mood instability Which of the following would be an indication of Androgen Insensitivity Syndrome? Answers: A. A 33 year old woman with a karyotype of XY B. A 16 year old male with reduced kidney function C. Failure to respond to cortisol therapy D. Several pregnancies all of which ended in miscarriages A client presents with hypocalcemia, hyperphosphatemia, muscle cramps, and positive Trosseau's sign. What diagnosis does this support? Answers: A. Diabetes insipidus B. Conn's syndrome C. Hypoparathyroidism D. Acromegaly A client with Graves' disease experiences a thyroid storm and has tachycardia and hypertension. What medication is most likely to be used? Answers: A. Levofloxcin B. Chlorothiazide C. Percocet D. Propylthiouracil In educating a client, the nurse is likely to explain the following is the cause of Hashimoto's disease: Answers: A. Antibodies attacking the thyroid gland B. Inflammation in the kidneys C. An adenocarcinoma in the brain D. Overactivation of the pituitary gland 2. Grave's disease is: a. The most common cause of hypothyroidism b. The most common cause of hyperparathyroidism c. The most common cause of hyperthyroidism d. The most common cause of adrenal insufficiency 3. Symptoms of Grave's ophthalmopathy include all of the following except: a. Bulging eyeballs b. Dry, irritated eyes and puffy eyelids c. Cataracts d. Light sensitivity 4. An ACTH stimulation test is commonly used to diagnose: a. Grave's disease b. Adrenal insufficiency and Addison's disease c. Cystic fibrosis d. Hashimoto's disease 5. All of the following are symptoms of Cushing's syndrome except: a. Severe fatigue and weakness b. Hypertension and elevated blood glucose c. A protruding hump between the shoulders d. Hair loss 6. Which of the following conditions is caused by long-term exposure to high levels of cortisol? a. Addison's disease b. Crohn's disease c. Adrenal insufficiency d. Cushing's syndrome 11. The most common benign tumor of the pituitary gland is a: a. Glioma b Prolactinoma c. Carcinoid tumor d. Islet cell tumor 14. All of the following organs may be affected by multiple endocrine neoplasia type 1 except: a. Parathyroid glands b. Kidneys c. Pancreas and Duodenum d. Pituitary gland 15. What is the treatment for hyperparathyroidism? a. Synthetic thyroid hormone b. Desiccated thyroid hormone c. Surgical removal of the glands d. Calcium and phosphate The parathyroid glands play a major role in regulating which substances? A. Calcium and Phosphorus B. Cholride and potassium C. Potassium and calcium D. Sodium and potassium A client is admitted to the hospital with a medical DX of hyperthyroidism. When taking a history which information would be most significant? A. edema, intolerance to cold, lethargy b. peri-orbital edema, lethargy mask like face c. weight loss, intolerance to cold, muscle wasting d. weight loss, intolerance to heat, exophthalmos Which of the following would be a nursing priority for a client just DX with Addison's disease? a. avioding unnecessary activity b. encouraging client to wear a med alert tag c. ensuring the client is adequatly hydrated d. explaining that the client will need life long hormone therapy A nurse is caring for a client with Addison's disease. Which of the following nursing considerations should be employed when caring for this client? a. avoid sodium in the clients diet b. monitor and protect skin integrity c. document the specific gravity of urine d. monitor increases in blood pressure A nurse is preparing a diet plan for a 50 yr old with simple goiter. Which of the following should be included in the clients diet to decrease the enlargement of he thyroid gland? a. iodine b. sodium c. potassium d. calcium A nurse is caring for a 60 yr old client affected with hypoparathyroidism. When checking the lab report, the nurse finds that the clients calcium level was very low. Which of the following vitamins regulates the calcium level in the body? a. A b. D c. E d. K A client presents to the emergency room with a history of Graves' disease. The client reports having symptoms for a few days, but has not previously sought or received any additional treatment. The client also reports having had a cold a few days back. Which of the following interventions would be appropriate to implement for this client, based on the history and current symptoms? Select all that apply. a. Administer aspirin b. Replace intravenous fluids c. Induce shivering d. Relieve respiratory distress e. Administer a cooling blanket A nursing student is studying for a test on care of the client with endocrine disorders. Which of the following statements demonstrates an understanding of the difference between hyperthyroidism and hypothyroidism? a. "Deficient amounts of TH cause abnormalities in lipid metabolism, with decreased serum cholesterol and triglyceride levels." b. "Graves' disease is the most common cause of hypothyroidism." c. "Decreased renal blood flow and glomerular filtration rate reduces the kidney's ability to excrete water, which may cause hyponatremia." d. "Increased amounts of TH cause a decrease in cardiac output and peripheral blood flow." A Clinical Instructor is questioning a student nurse about disorders of the parathyroid glands. Which statement by the nursing student, would indicate the need for further teaching? a. "Hyperparathyroidism results in an increased release of calcium and phosphorus by bones, with resultant bone decalcification." b. "Hyperparathyroidism results in deposits in soft tissues and the formation of renal calculi." c. "Hypoparathyroidism results in impaired renal tubular regulation of calcium and phosphate." d. "Hypoparathyroidism results in decreased activation of vitamin D which then results in decreased absorption of calcium by the pancreas." A nurse on a general medical-surgical unit is caring for a client with Cushing's syndrome. Which of the following statements is correct about the medication regimen for Cushing's syndrome? a. Mitotane is used to treat metastatic adrenal cancer. b. Aminogluthimide may be administered to clients with ectopic ACTHsecreting tumors before surgery is performed. c. Ketoconazole increases cortisol synthesis by the adrenal cortex. d. Somatostatin analog increases ACTH secretion in some clients. Which of the following nursing implications is most important in a client being medicated for Addison's disease? a. Administer oral forms of the drug with food to minimize its ulcerogenic effect. b. Monitor capillary blood glucose for hypoglycemia in the diabetic client. c. Instruct the client to never abruptly discontinue the medication. d. Teach the client to consume a diet that is high in potassium, low in sodium, and high in protein. A nurse on a surgical floor is caring for a post-operative client who has just had a subtotal thyroidectomy. Which of the following assessments should be completed first on the client? a. Assess for signs of tetany by checking for Chvostek's and Trousseau's signs b. Assess dressing (if present) and the area under the client's neck and shoulders for drainage. c. Administer analgesic pain medications as ordered, and monitor their effectiveness. d. Assess respiratory rate, rhythm, depth, and effort. The nurse is caring for a client who is about to undergo an adrenalectomy. Which of the following Preoperative interventions is most appropriate for this client? a. Maintain careful use of medical and surgical asepsis when providing care and treatments. b. Teach the client about a diet high in sodium to correct any potential sodium imbalances preoperatively. c. Explain to the client that electrolytes and glucose levels will be measured postoperatively. d. Teach the client how to effectively cough and deep breathe once surgery is complete. The nurse is caring for a client with pheochromocytoma. Which of the following must be included in planning the nursing care for this client ? a. Monitor blood pressure frequently, assessing for hypertension. b. Assess only for physical stressors present. c. Collect a random urine sample. d. Prepare the client for chemotherapy to shrink the tumor. A client newly diagnosed with Addison's disease is giving a return explanation of teaching done by the primary nurse. Which of the following statements indicates that further teaching is necessary? a. "I need to increase how much I drink each day." b. "I need to weigh myself if I think I am losing or gaining weight." c. "I need to maintain a diet high in sodium and low in potassium." d. "I need to take my medications each day." . The nurse assessing a female client with Cushing's syndrome would expect to note which of the following? a) hirsutism b) hypotension c) hypoglycemia d) pallor 2. A nurse is admitting a client with a diagnosis of Addison's disease to the hospital. On assessment, the nurse would expect to note which finding that is a manifestation of this disorder? a) peripheral edema b) excessive facial hair c) lower than normal blood glucose level d) high blood pressure 3. A nurse is preparing to perform an assessment on a client being admitted to the hospital with a diagnosis of Cushing's syndrome. When performing the assessment, the nurse checks for which significant manifestation of the disorder? a) fluid retention b) stretch marks c) goiter d) melanosis 4. A clinic nurse is performing an assessment on a client who has hypothyroidism. The nurse would expect to note which clinical manifestation? a) complaints of difficulty sleeping b) complaints of diarrhea c) significant weight loss since the last clinic visit d) complaints of intolerance to cold weather . A client has been diagnosed with goiter. The nurse looks for documentation of which of the following in the client's medical record? a) decreased wound healing b) chronic fatigue c) enlarged thyroid gland d) heart damage 8. A nurse is caring for a client following thyroidectomy and is monitoring for complications. Which of the following if noted in the client, would indicate a need for physician notification? a) surgical pain in the neck area b) voice hoarseness c) numbness and tingling around the mouth d) weakness of the voice 9. A nurse is monitoring a client for complications following thyroidectomy. The nurse notes that the client's voice is very hoarse, and the client is concerned about the hoarseness and asks the nurse about it. The nurse makes which response to alleviate the client's concern? a) hoarseness and weak voice indicate permanent damage to the nerves b) this complication is expected c) this problem is temporary and will probably subside in a few days d) it is best that you not talk at all until the problem is further evaluated 10. A nurse provides dietary instructions to a client with a diagnosis of hyperparathyroidism. Which statement by the client indicates the need for further instructions? a) I need to drink 3000 ml of fluid per day b) I should drink cranberry juice daily c) I should eat foods high in calcium d) I should eat foods high in fiber 16. A nurse is caring for a client with hyperthyroidism and is instructing the client about dietary measures. The nurse tells the client that it is important to eat foods that are: a) high in bulk and fiber b) low in calories c) low in carbohydrates and fats d) high in calories 20. A husband of a client with graves' disease expresses concern regarding his wife's health because during the past 3 months she has been experiencing nervousness, inability to concentrate even on trivial tasks, and outbursts of temper. On the basis of this information, which nursing diagnosis would the nurse identify as appropriate for the client? a) ineffective coping b) disturbed sensory perception c) social isolation d) grieving 21. A nurse is caring for a client with hypoparathyroidism. In planning for discharge from the hospital, the nurse identifies which of the following as a potential psychosocial nursing diagnosis? a) impaired comfort related to cold intolerance secondary to decreased metabolic rate b) constipation related to decreased peristaltic action secondary to decreased metabolic rate c) high risk for impaired skin integrity related to edema d) anxiety related to the need for lifelong dietary interventions to control the disease 27. A nurse provides instructions to a client who is scheduled for a radioactive iodine uptake test. Which statement by the client indicates a need for further instructions? a) the test measures the rate of iodine uptake by my thyroid gland b) I will need to drink a small dose of radioactive iodine before the test c) a 24 hour urine specimen will need to be collected to measure iodine excretion d) I need to minimize close contact with others in my family for a period of 48 hours after the test because of the radioactivity in my system 29. A nurse is caring for a client with Cushing's syndrome who demonstrates withdrawn behavior. The nurse recognizes that this client's behavior is likely related to which nursing diagnosis? a) deficient diversional activity b) powerlessness c) hopelessness d) disturbed body image 30. A client with Addison's disease makes all of the following statements. Which one does the nurse analyze as requiring further discussion? a) I wear a Medic-Alert bracelet at all times b) I need to weigh myself daily and record it c) It is important that I drink enough fluids and increase my salt intake d) my medication doses will not need to be adjusted for any reason A client is admitted for removal of a goiter. Which nursing intervention should receive priority during the post-operative period? A. Maintaining fluid and electrolyte balance B. Assessing the client's airway C. Providing needed nutrition and fluids D. Providing pain relief with narcotic analgesics A client is admitted for treatment of hypoparathyroidism. Based on the client's diagnosis, the nurse would anticipate an order for: A. Potassium B. Magnesium C. Calcium D. Iron A client with Addison's disease will most likely exhibit which symptom? A. Hypertension B. Bronze pigmentation C. Hirsutism D. Purple striae A client with Cushing's syndrome should be instructed to: A. Avoid alcoholic beverages B. Limit the sodium in her diet C. Increase servings of dark green vegetables D. Limit the amount of protein in her diet The client with a suspected pituitary tumor will most likely exhibit symptoms of: A. Alteration in visual acuity B. Frequent diarrhea C. Alterations in blood glucose D. Urticaria Which item should be kept at the bedside of a client who has just returned from having a thyroidectomy? A. A padded tongue B. An endotracheal tube C. An airway D. A tracheostomy set Which vitamin is directly involved in the metabolism of the hormones secreted by the parathyroid? A. Vitamin C B. Vitamin D C. Vitamin K D. Vitamin B9 A client with acromegaly will most likely experience which symptom? A. Bone pain B. Frequent infections C. Fatigue D. Weight loss Acromegaly is most frequently diagnosed in: a. Middle-aged adults b. Newborns c. Children ages 2 to 5 d. Adults age 65 and older 8. Hashimoto's disease is: a. Chronic inflammation of the thyroid gland b. Diagnosed most frequently in AsianAmericans and Pacific Islanders c. A form of hyperthyroidism d. A rare form of hypothyroidism 9. Persons at increased risk of developing Hashimoto's disease include all of the following except: a. Persons with vitiligo b. Asian-Americans c. Persons with rheumatoid arthritis d. Persons with Addison's disease 10. All of the following statements about Hashimoto's disease are true except: a. Many patients are entirely asymptomatic b. Not all patients become hypothyroid c. Most cases of obesity are attributable to Hashimoto's disease d. Hypothyroidism may be subclinical 17. Untreated hyperthyroidism during pregnancy may result in all of the following except: a. Premature birth and miscarriage b. Low birthweight c. Autism d. Preeclampsia 19. Endocrine disorders may be triggered by all of the following except: a. Stress b. Infection c. Chemicals in the food chain and environment d. Cell phone use A nurses caring for a client after a thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medicine has been prescribed to A nurse is collecting data regarding a client after a thyroidectomy and notes that the client has developed hoarseness and a week voice. What nursing action is appropriate A client is admitted to the emergency department and they diagnose of myxedema coma is made. What nursing action with the nurse prepared to carry out initially A nurse is reviewing discharge teaching with a client you has Cushing's syndrome. Which statement made by the client indicates that the instructions related to dietary management were understood A nurses caring for a postoperative parathyroidectomy client. Which of the following would require the nurses immediate attention sildenafil (Viagra) is prescribed for a client to treat erectile dysfunction. A nurse reviews the clients medical record and would question the prescription if which of the following is noted in the clients history A community health nurse visit a client at home. Prednisone 10 mg orally daily has been prescribed for a client and the nurse reinforces teaching for the client about the medication. What statement made by the client indicates that further teaching is necessary demopressin acetate (DDVAP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response A nurse is collecting data regarding a client after a thyroidectomy and notes that the client has developed hoarseness and a weak voice. Which nursing action is appropriate? 1. Check for signs of bleeding. 2. Administer calcium gluconate. 3. Notify the registered nurse immediately. 4. Reassure the client that this is usually a temporary condition. A nurse is reviewing discharge teaching with a client who has Cushing's syndrome. Which statement by the client indicates that the instructions related to dietary management were understood? 1. "I can eat foods that contain potassium." 2. "I will need to limit the amount of protein in my diet." 3. "I am fortunate that I can eat all the salty foods I enjoy." 4. "I am fortunate that I do not need to follow any special diet." A nurse is caring for a postoperative parathyroidectomy client. Which of the following would require the nurse's immediate attention? 1. Incisional pain 2. Laryngeal stridor 3. Difficulty voiding 4. Abdominal cramps A nurse assists in developing a plan of care for a client with hyperparathyroidism receiving calcitonin-human (Cibacalcin). Which outcome has the highest priority regarding this medication? 1. Relief of pain 2. Absence of side effects 3. Reaching normal serum calcium levels 4. Verbalization of appropriate medication knowledge A nursing instructor asks a student to describe the pathophysiology that occurs in Cushing's disease. Which statement by the student indicates an accurate understanding of this disorder? 1. "Cushing's disease is characterized by an oversecretion of insulin." 2. "Cushing's disease is characterized by an oversecretion of glucocorticoid hormones." 3. "Cushing's disease is characterized by an undersecretion of corticotropic hormones." 4. "Cushing's disease is characterized by an undersecretion of glucocorticoid hormones." A nurse would expect to note which interventions in the plan of care for a client with hypothyroidism? Select all that apply. 1. Provide a cool environment for the client. 2. Instruct the client to consume a high-fat diet. 3. Instruct the client about thyroid replacement therapy. 4. Encourage the client to consume fluids and high-fiber foods in the diet. 5. Instruct the client to contact the health care provider if episodes of chest pain occur. 6. Inform the client that iodine preparations will be prescribed to treat the disorder. Which nursing action would be appropriate to implement when a client has a diagnosis of pheochromocytoma? 1. Weigh the client. 2. Test the client's urine for glucose. 3. Monitor the client's blood pressure. 4. Palpate the client's skin to determine warmth. A nurse is caring for a client with pheochromocytoma. The client is scheduled for an adrenalectomy. During the preoperative period, the priority nursing action would be to monitor the: 1. Vital signs 2. Intake and output 3. Blood urea nitrogen (BUN) level 4. Urine for glucose and acetone A nurse is caring for a client with pheochromocytoma. The client asks for a snack and something warm to drink. The appropriate choice for this client to meet nutritional needs would be which of the following? 1. Crackers with cheese and tea 2. Graham crackers and warm milk 3. Toast with peanut butter and cocoa 4. Vanilla wafers and coffee with cream and sugar A nurse is caring for a client with pheochromocytoma. Which data would indicate a potential complication associated with this disorder? 1. A urinary output of 50 mL/hr 2. A coagulation time of 5 minutes 3. Congestion heard on auscultation of the lungs 4. A blood urea nitrogen (BUN) level of 20 mg/dL A nurse is caring for a client after thyroidectomy and monitoring for signs of thyroid storm. The nurse understands that which of the following is a manifestation associated with this disorder? 1. Bradycardia 2. Hypotension 3. Constipation 4. Hypothermia When caring for a client who is having clear drainage from his nares after transsphenoidal hypophysectomy, which action by the nurse is appropriate? 1. Lower the head of the bed. 2. Test the drainage for glucose. 3. Obtain a culture of the drainage. 4. Continue to observe the drainage. After several diagnostic tests, a client is diagnosed with diabetes insipidus. The nurse understands that which symptom is indicative of this disorder? 1. Diarrhea 2. Polydipsia 3. Weight gain 4. Blurred vision Which clinical manifestation should the nurse expect to note when assessing a client with Addison's disease? 1. Edema 2. Obesity 3. Hirsutism 4. Hypotension What would the nurse anticipate being included in the plan of care for a client who has been diagnosed with Graves' disease? 1. Provide a high-fiber diet. 2. Provide a restful environment. 3. Provide three small meals per day. 4. Provide the client with extra blankets. Which statement by the client would cause the nurse to suspect that the thyroid test results drawn on the client this morning may be inaccurate? 1. "I had a radionuclide test done 3 days ago." 2. "When I exercise I sweat more than normal." 3. "I drank some water before the blood was drawn." 4. "That hamburger I ate before the test sure tasted good." . A nurse is preparing to provide instructions to a client with Addison's disease regarding diet therapy. The nurse understands that which of the following diets would likely be prescribed for this client? 1. Low-protein diet 2. Low-sodium diet 3. High-sodium diet 4. Low-carbohydrate diet A nurse is caring for a client with a diagnosis of hypoparathyroidism. The nurse reviews the laboratory results drawn on the client and notes that the calcium level is extremely low. The nurse would expect to note which of the following on data collection of the client? 1. Positive Trousseau's sign 2. Negative Chvostek's sign 3. Unresponsive pupils 4. Hyperactive bowel sounds A nurse caring for a client scheduled for a transsphenoidal hypophysectomy to remove a tumor in the pituitary gland assists to develop a plan of care for the client. The nurse suggests including which specific information in the preoperative teaching plan? 1. Hair will need to be shaved. 2. Deep breathing and coughing will be needed after surgery. 3. Toothbrushing will not be permitted for at least 2 weeks following surgery. 4. Spinal anesthesia is used. Following hypophysectomy, a client complains of being very thirsty and having to urinate frequently. The initial nursing action is to: 1. Document the complaints. 2. Increase fluid intake. 3. Check the urine specific gravity. 4. Check for urinary glucose. A client is brought to the emergency department in an unresponsive state, and a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is made. The nurse who is assisting to care for the client obtains which of the following immediately in preparation for the treatment of this syndrome? 1. NPH insulin 2. A nasal cannula 3. Intravenous (IV) infusion of sodium bicarbonate 4. IV infusion of normal saline A health care provider has prescribed propylthiouracil (PTU) for a client with hyperthyroidism, and the nurse assists in developing a plan of care for the client. A priority nursing measure to be included in the plan regarding this medication is to monitor the client for: 1. Signs and symptoms of hypothyroidism 2. Signs and symptoms of hyperglycemia 3. Relief of pain 4. Signs of renal toxicity A health care provider prescribes a 24-hour urine collection for vanillylmandelic acid (VMA). The nurse instructs the client in the procedure for the collection of the urine. Which statement by the client would indicate a need for further instruction? 1. "I will start the collection in 2 days. I cannot eat or drink any tea, chocolate, vanilla, or fruit until the test is completed." 2. "When I start the collection, I will urinate and discard that specimen." 3. "I will pour the urine into the collection bottle each time I urinate and refrigerate the urine." 4. "I can take any medications if I need to before the collection." A client with Graves' disease has exophthalmos and is experiencing photophobia. Which intervention would best assist the client with this problem? 1. Administering methimazole (Tapazole) every 8 hours 2. Lubricating the eyes with tap water every 2 to 4 hours 3. Instructing the client to avoid straining or heavy lifting 4. Obtaining dark glasses for the client The nurse caring for a client who has had a subtotal thyroidectomy reviews the plan of care and determines which problem is the priority for this client in the immediate postoperative period? 1. Dehydration 2. Infection 3. Urinary retention 4. Bleeding A nurse is collecting data on a client admitted to the hospital with a diagnosis of myxedema. Which data collection technique will provide data necessary to support the admitting diagnosis? 1. Auscultation of lung sounds 2. Inspection of facial features 3. Percussion of the thyroid gland 4. Palpation of the adrenal glands A client with Cushing's disease is being admitted to the hospital after a stab wound to the abdomen. The nurse plans care and places highest priority on which potential problem? 1. Nervousness 2. Infection 3. Concern about appearance 4. Inability to care for self A nurse notes in the medical record that a client with Cushing's syndrome is experiencing fluid overload. Which interventions should be included in the plan of care? Select all that apply. 1. Monitoring daily weight 2. Monitoring intake and output 3. Maintaining a low-potassium diet 4. Monitoring extremities for edema 5. Maintaining a low-sodium diet A nursing student notes in the medical record that a client with Cushing's syndrome is experiencing body image disturbances. The need for additional education regarding this problem is identified when the nursing student suggests which nursing intervention? 1. Encouraging the client's expression of feelings 2. Evaluating the client's understanding of the disease process 3. Encouraging family members to share their feelings about the disease process 4. Evaluating the client's understanding that the body changes need to be dealt with A nurse is caring for a client following an adrenalectomy and is monitoring for signs of adrenal insufficiency. Which of the following, if noted in the client, indicates signs and symptoms related to adrenal insufficiency? Select all that apply. 1. Double vision 2. Hypotension 3. Mental status changes 4. Weakness 5. Fever A nurse is reinforcing home care instructions to a client with a diagnosis of Cushing's syndrome. Which statement reflects a need for further client education? 1. "Taking my medications exactly as prescribed is essential." 2. "I need to read the labels on any over-the-counter medications I purchase." 3. "My family needs to be familiar with the signs and symptoms of hypoadrenalism." 4. "I could experience the signs and symptoms of hyperadrenalism because of Cushing's." A nurse is reviewing a plan of care for a client with Addison's disease. The nurse notes that the client is at risk for dehydration and suggests nursing interventions that will prevent this occurrence. Which nursing intervention is an appropriate component of the plan of care? Select all that apply. 1. Encouraging fluid intake of at least 3000 mL/day 2. Encouraging an intake of low-protein foods 3. Monitoring for changes in mental status 4. Monitoring intake and output 5. Maintaining a low-sodium diet A nurse is reviewing the postoperative prescriptions for a client who had a transsphenoidal hypophysectomy. Which health care provider's prescription, if noted on the record, indicates the need for clarification? 1. Instruct the client about the need for a Medic-Alert bracelet. 2. Apply a loose dressing if any clear drainage is noted. 3. Monitor vital signs and neurological status. 4. Instruct the client to avoid blowing the nose. A nurse reviews a plan of care for a postoperative client following a thyroidectomy and notes that the client is at risk for breathing difficulty. Which of the following nursing interventions will the nurse suggest to include in the plan of care? 1. Maintain a supine position. 2. Encourage coughing and deep breathing exercises. 3. Monitor neck circumference frequently. 4. Maintain a pressure dressing on the operative site. A nurse is monitoring a client following a thyroidectomy for signs of hypocalcemia. Which of the following signs, if noted in the client, likely indicates the presence of hypocalcemia? 1. Tingling around the mouth 2. Negative Chvostek's sign 3. Flaccid paralysis 4. Bradycardia A nurse is caring for a client following a thyroidectomy. The client tells the nurse that she is concerned because of voice hoarseness. The client asks the nurse whether the hoarseness will subside. The nurse appropriately tells the client that the hoarseness: 1. Indicates nerve damage 2. Is harmless but permanent 3. Will worsen before it subsides 4. Is normal and will gradually subside A nurse is monitoring a client with Graves' disease for signs of thyrotoxic crisis (thyroid storm). Which of the following signs and symptoms, if noted in the client, will alert the nurse to the presence of this crisis? Select all that apply. 1. Bradycardia 2. Fever 3. Sweating 4. Agitation 5. Pallor Which of the following clients is at risk for developing thyrotoxicosis? 1. A client with hypothyroidism 2. A client with Graves' disease who is having surgery 3. A client with diabetes mellitus scheduled for debridement of a foot ulcer 4. A client with diabetes insipidus scheduled for an invasive diagnostic test A nurse is caring for a client diagnosed with hyperparathyroidism who is prescribed furosemide (Lasix). The nurse reinforces dietary instructions to the client. Which of the following is an appropriate instruction? 1. Increase dietary intake of calcium. 2. Drink at least 2 to 3 L of fluid daily. 3. Eat sparely when experiencing nausea. 4. Decrease dietary intake of potassium. A nurse has reinforced instructions to the client with hyperparathyroidism regarding home care measures related to exercise. Which statement by the client indicates a need for further instruction? Select all that apply. 1. "I enjoy exercising but I need to be careful." 2. "I need to pace my activities throughout the day." 3. "I need to limit playing football to only the weekends." 4. "I should gauge my activity level by my energy level." 5. "I should exercise in the evening to encourage a good sleep pattern." A nurse has reinforced dietary instructions to a client with a diagnosis of hypoparathyroidism. The nurse instructs the client to include which of the following items in the diet? 1. Vegetables 2. Meat 3. Fish 4. Cereals A client has an endocrine system dysfunction of the pancreas. The nurse anticipates that the client will exhibit impaired secretion of which of the following substances? 1. Amylase 2. Lipase 3. Trypsin 4. Insulin A nurse is providing discharge instructions to a client who had a unilateral adrenalectomy. Which of the following will be a component of the instructions? 1. The reason for maintaining a diabetic diet 2. Instructions about early signs of a wound infection 3. Teaching regarding proper application of an ostomy pouch 4. The need for lifelong replacement of all adrenal hormones A nurse is caring for a client experiencing thyroid storm. Which of the following would be a priority concern for this client? 1. Inability to cope with the treatment plan 2. Lack of sexual drive 3. Self-consciousness about body appearance 4. Potential for cardiac disturbances A nurse is collecting data on a client with hyperparathyroidism. Which of the following questions would elicit the accurate information about this condition from the client? 1. "Do you have tremors in your hands?" 2. "Are you experiencing pain in your joints?" 3. "Have you had problems with diarrhea lately?" 4. "Do you notice swelling in your legs at night?" A nurse is caring for a postoperative adrenalectomy client. Which of the following does the nurse specifically monitor for in this client? 1. Peripheral edema 2. Bilateral exophthalmos 3. Signs and symptoms of hypocalcemia 4. Signs and symptoms of hypovolemia A client with myxedema has changes in intellectual function such as impaired memory, decreased attention span, and lethargy. The client's husband is upset and shares his concerns with the nurse. Which statement by the nurse is helpful to the client's husband? 1. "Would you like me to ask the health care provider for a prescription for a stimulant?" 2. "Give it time. I've seen dozens of clients with this problem that fully recover." 3. "I don't blame you for being frustrated, because the symptoms will only get worse." 4. "It's obvious that you are concerned about your wife's condition, but the symptoms may improve with continued therapy." A client with hypoparathyroidism has hypocalcemia. The nurse avoids giving the client the prescribed vitamin and calcium supplement with which of the following liquids? 1. Milk 2. Water 3. Iced tea 4. Fruit juice A client is diagnosed with hyperparathyroidism. The nurse teaching the client about dietary alterations to manage the disorder tells the client to limit which of the following foods in the diet? 1. Bananas 2. Oatmeal 3. Ice cream 4. Chicken breast A client with Addison's disease asks the nurse how a newly prescribed medication, fludrocortisone acetate (Florinef), will improve the condition. When formulating a response, the nurse should incorporate that a key action of this medication is to: 1. Help restore electrolyte balance. 2. Make the body produce more cortisol. 3. Replace insufficient circulating estrogens. 4. Alter the body's immune system functioning. An older client with a history of hyperparathyroidism and severe osteoporosis is hospitalized. The nurse caring for the client plans first to address which problem? 1. The possibility of injury 2. Constipation 3. Urinary retention 4. Need for teaching about the disorder A client has been diagnosed with hypoparathyroidism. The nurse teaches the client to include foods in the diet that are: 1. High in phosphorus and low in calcium 2. Low in phosphorus and low in calcium 3. Low in phosphorus and high in calcium 4. High in phosphorus and high in calcium A client scheduled for a thyroidectomy says to the nurse, "I am so scared to get cut in my neck." Based on the client's statement, the nurse determines that the client is experiencing which problem? 1. Inadequate knowledge about the surgical procedure 2. Fear about impending surgery 3. Embarrassment about the changes in personal appearance 4. Lack of support related to the surgical procedure A nurse is caring for a client with Addison's disease. The nurse checks the vital signs and determines that the client has orthostatic hypotension. The nurse determines that this finding relates to which of the following? 1. A decrease in cortisol release 2. A decreased secretion of aldosterone 3. An increase in epinephrine secretion 4. Increased levels of androgens Which nursing measure would be effective in preventing complications in a client with Addison's disease? 1. Restricting fluid intake 2. Offering foods high in potassium 3. Checking family support systems 4. Monitoring the blood glucose A nurse is collecting data on a client with a diagnosis of hypothyroidism. Which of these behaviors, if present in the client's history, would the nurse determine as being likely related to the manifestations of this disorder? 1. Depression 2. Nervousness 3. Irritability 4. Anxiety While collecting data on a client being prepared for an adrenalectomy, the nurse obtains a temperature reading of 100.8° F. The nurse analyzes this temperature reading as: 1. Within normal limits 2. A finding that needs to be reported immediately 3. An expected finding caused by the operative stress response 4. Slightly abnormal but an insignificant finding The anticipated intended effect of fludrocortisone acetate (Florinef) for the treatment of Addison's disease is to: 1. Stimulate the immune response. 2. Promote electrolyte balance. 3. Stimulate thyroid production. 4. Stimulate thyrotropin production. A nurse is caring for a client with hypothyroidism who is overweight. Which food items would the nurse suggest to include in the plan? 1. Peanut butter, avocado, and red meat 2. Skim milk, apples, whole-grain bread, and cereal 3. Organ meat, carrots, and skim milk 4. Seafood, spinach, and cream cheese In planning nutrition for the client with hypoparathyroidism, which diet would be appropriate? 1. High in calcium and low phosphorous 2. Low in vitamins A, D, E, and K 3. High in sodium with no fluid restriction 4. Low in water and insoluble fiber A preoperative client is scheduled for adrenalectomy to remove a pheochromocytoma. The nurse would most closely monitor which of the following items in the preoperative period? 1. Intake and output 2. Blood urea nitrogen (BUN) 3. Vital signs 4. Urine glucose and ketones A nurse working on an endocrine nursing unit understands that which correct concept is used in planning care? 1. Clients with Cushing's syndrome are likely to experience episodic hypotension. 2. Clients with hyperthyroidism must be monitored for weight gain. 3. Clients who have diabetes insipidus should be assessed for fluid excess. 4. Clients who have hyperparathyroidism should be protected against falls. When caring for a client diagnosed with pheochromocytoma, what information should the nurse know when assisting with planning care? 1. Profound hypotension may occur. 2. Excessive catecholamines are released. 3. The condition is not curable and is treated symptomatically. 4. Hypoglycemia is the primary presenting symptom. A client with pheochromocytoma is scheduled for surgery and says to the nurse, "I'm not sure that surgery is the best thing to do." What response by the nurse is appropriate? 1. "I think you are making the right decision to have the surgery." 2. "You are very ill. Your health care provider has made the correct decision." 3. "There is no reason to worry. Your health care provider is a wonderful surgeon." 4. "You have concerns about the surgical treatment for your condition." A client with Cushing's syndrome verbalizes concern to the nurse regarding the appearance of the buffalo hump that has developed. Which response by the nurse is appropriate? 1. "Don't be concerned, this problem can be covered with clothing." 2. "This is permanent, but looks are deceiving and not that important." 3. "Usually, these physical changes slowly improve following treatment." 4. "Try not to worry about it. There are other things to be concerned about." A nurse is collecting data from a client who is being admitted to the hospital for a diagnostic workup for primary hyperparathyroidism. The nurse understands that which client complaint would be characteristic of this disorder? 1. Diarrhea 2. Polyuria 3. Polyphagia 4. Weight gain A nurse is preparing to discharge a client who has had a parathyroidectomy. When teaching the client about the prescribed oral calcium supplement, what information should the nurse include? 1. Take the calcium 30 to 60 minutes following a meal. 2. Avoid sunlight because it can cause skin color change. 3. Store the calcium in the refrigerator to maintain potency. 4. Check the pulse daily and hold the dosage if it is below 60 beats per minute. A client is admitted with a diagnosis of pheochromocytoma. The nurse would monitor which of the following to detect the most common sign of pheochromocytoma? 1. Skin temperature 2. Blood pressure 3. Urine ketones 4. Weight During routine postoperative assessment of a client who has undergone hypophysectomy, the client complains of thirst and frequent urination. Knowing the expected complications of this surgery, the nurse would next check the: 1. Urine specific gravity 2. Serum glucose 3. Respiratory rate 4. Blood pressure A client with a pituitary tumor will undergo transsphenoidal hypophysectomy. The nurse includes which priority item in the preoperative teaching plan for the client? 1. Brushing the teeth vigorously and frequently is important to minimize bacteria in the mouth. 2. Blowing the nose following surgery is prohibited. 3. A small area will be shaved at the base of the neck. 4. It will be necessary to cough and deep breathe following the surgery. A client who returned to the nursing unit 8 hours ago after hypophysectomy has clear drainage saturating the nasal dressing. The nurse should take which action first? 1. Continue to observe for further drainage. 2. Test the drainage for glucose.* 3. Put the head of the bed flat. 4. Test the drainage for occult blood. A client with newly diagnosed Cushing's syndrome expresses concern about personal appearance, specifically about the "buffalo hump" that has developed at the base of the neck. When counseling the client about this manifestation, the nurse should incorporate the knowledge that: 1. This is a permanent feature. 2. It can be minimized by wearing tight clothing. 3. It may slowly improve with treatment of the disorder. 4. It will quickly disappear once medication therapy is started. A client has just been admitted with a diagnosis of myxedema coma. If all of the following interventions were prescribed, the nurse would place highest priority on completing which of the following first? 1. Administering oxygen 2. Administering thyroid hormone 3. Warming the client 4. Giving fluid replacement A nurse has just supervised a newly diagnosed diabetes mellitus client self-inject NPH insulin at 7:30 ᴀᴍ. The nurse reviews the time frames for peak insulin action with the client, telling the client to be especially watchful for a hypoglycemic reaction between: 1. 7:30 ᴀᴍ and 9:30 ᴀᴍ 2. 1:30 ᴘᴍ and 7:30 ᴘᴍ 3. 8:30 ᴘᴍ and 12:00 ᴀᴍ 4. 2:30 ᴀᴍ and 4:30 ᴀᴍ an indication of hypocalcemia following a thyroidectomy adverse effects of long term corticosteroid therapy include expected finding in patient with adrenal insufficiency in HHS the patient produces enough insulin to prevent ketosis but not enough to prevent ACTH adrenocorticotropic hormone measures ACTH stimulation test is to assess for Addison's disease (primary insufficiency) of the adrenal gland results from In patients with primary adrenal insufficiency will have this result from ACTH stimulation test expected finding for a patient with primary cushing's disease how propanolol is used in treatment of thyroid storm hyperthyroid expected findings expected finding in new diagnosis of cushing's disease for a patient taking desmopressin in the treatment of diabetes insipidus, adjustment is needed in the medication dosage for acute adrenal insufficiency requires treatment with for patient using a thermometer to test bathwater due to diabetic neuropathy, the temp should be test used to screen for pheochromocytoma pheochromocytoma is a patient teaching to prepare for vanillylmandellic acid test expected finding for patient with diabetes insipidus in patient with pheochromocytoma avoid pheochromocytoma symptoms are in patients with pheochromocytoma there is a release of purpose of 24 hour urine collection in patient with pheochromocytoma Aldosterone is produced by the function of aldosterone is to s/s of addison's disease include SIADH is caused by result of excessive secretion of ADH thyroid storm s/s chvostek's sign & trousseau sign are both expected findings of when is calcium likely to be impaired trousseau sign is seen with chvosteks sigh is seen with thyroid storm usually follows thyroid storm can quickly cause graves disease is also known as parathyroid gland regulates hyperparathyroidism is associated with diet requirements for Addison's patient Graves' disease - an autoimmune disorder that leads to Myxedema coma Hypoparathyroidism Hypopituitarism Cushing syndrome Acromegaly is NOT the result of excess growth hormone secretion in children, IT IS IN ADULTS Central diabetes insipidus may be caused by damage to the ). The water deprivation test is used to diagnose The water deprivation test DETERMINES With SIADH, hypersecretion of ADH causes hyponatremia, as serum sodium drops hyperosmolar hyperglycemic state (HHS) Management of mild hyperparathyroidism includes increasing oral fluid intake to prevent Extra PTH results in hypercalcemia. There is also increased calcium in the Clients should take levothyroxine (Synthroid)