Exam (elaborations) NUR 265 Exam 3 Endocrine Questions

Exam (elaborations) NUR 265 Exam 3 Endocrine Questions 1) A client is admitted to the ICU with diagnosis of a brain tumor complicated by transient diabetes insipidus. Which client data related to this complication should the nurse expect? Select all that apply. 1. Dark, amber urine with sediment 2. High serum osmolality 3. Low urine specific gravity 4. Recent weight gain 5. Reports of excessive thirst 2) A hospitalized patient is diagnosed with a pheochromocytoma, a tumor of the adrenal medulla. Which clinical manifestation should the nurse expect to observe? 1. Elevated H&H 2. Hypertension 3. Hypoglycemia 4. Weight gain. 3) The nurse is assessing a patient with hypoparathyroidism for electrolyte imbalances. The nurse notes a positive Chvostek’s sign, indicating: 1. Hypercalcemia 2. Hyperphosphatemia 3. Hypocalcemia 4. Hypophosphatemia 4) A patient is seen in the ER after abruptly discontinuing her thyroid medication. She is hypotensive ve, hypoglycemic, and is unresponsive. This clinical picture is most common with: 1. Hypertensive crisis 2. Myxedema coma 3. Thyroid cancer 4. Thyroid storm 5) The nurse is assessing a patient admitted with SIADH. Which assessment finding suggests this condition? 1. Hypotension 2. Increased urine output 3. Jugular vein distension (JVD) 4. Weight loss 6) The nurse is performing her routine physical assessment on a patient with Cushing’s syndrome. Which of the following assessment findings is the nurse most likely to discover? 1. Adipose deposits in the face and back 2. Cardiac arrhythmias from hyperkalemia 3. Dizziness from hypotension 4. Shakiness and sweating from hypoglycemia 7) The nurse reviews a patient’s lab results, noting a blood glucose level of 895 mg/dl. The patient is most likely experiencing which acid-base imbalance? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis NUR 265 Exam 3 Endocrine Questions 8) The nurse is caring for a patient scheduled for a radioactive iodine uptake test. Which of the following statements should be included in the patient instructions? 1. “A small dose of IV radioactive iodine will be administered after the test.” 2. “Minimize contact with others to avoid radioactive contamination.” 3. “Take special precautions when urinating, such as flushing the toilet at least twice.” 4. “The procedure tests the rate of iodine excretion.” 9) The nurse is treating a patient suffering from an Addisonian crisis. The nurse should avoid the administration of: 1. Dextrose 2. Hydrocortisone 3. Potassium Chloride 4. Vasopressor 10) The nurse caring for a critical patient with hypoparathyroidism. Which of the following complications should the nurse be alert for in a patient with severe hyposecretion of the parathyroid hormone? 1. Encephalopathy 2. Hypertensive crisis 3. Renal failure 4. Seizures 11) The nurse is assigned to care for a client who had a thyroidectomy 24 hours ago. On initial assessment which finding requires the most immediate action by the nurse? 1. Calcium 8.8 mg/dL 2. Heart rate 100/minute 3. Laryngeal stridor 4. Pain rated 8 out of 10. 12) The nurse in ICU cares for a client with adrenocortical insufficiency (Addison’s) disease. The client reports nausea and abdominal pain. The blood pressure suddenly drops from 120/74 to 88/48, HR increases from 80 to 100/min and the client appears confused. Which action should the nurse take first? 1. Administer as-needed dose of hydrocortisone IVP 2. Complete a head-to-toe assessment to identify any sources of infection. 3. Document the findings in the clients electronic medical record 4. Take blood pressure sitting and standing to assess orthostatic hypotension. 13) The nurse cares for a client with Addison’s disease who was involved in a motor vehicle accident and hospitalized for a fracture of the right femur. Which client information is most important to report to the PCP? 1. B/P change from 128/80 mm Hg to 90/50 mm Hg 2. Development of first degree atrioventricular block on electrocardiogram (ECG) 3. Report of right femur pain of 7 out of 10 4. Vesicular breath sounds auscultated over the lung tissue 14) The nurse is caring for a client with a closed traumatic brain injury and suspects that the client is developing diabetes insipidus (DI). Which of the following findings would be consistent with this diagnosis? A. An increase in the blood glucose level from 89 mg/dL to 187 mg/dL B. An increase in blood pressure from 98/66 mm Hg to 126/78 mm Hg. C. A decrease in deep tendon reflexes from 3+ to 2+. D. A decrease in specific gravity from 1.010 to 1.001. 15) The nurse is reviewing newly prescribed medications for assigned clients. Which of the following prescribed medications should the nurse question? A. Methimazole for a client who has developed thyroid storm. B. Furosemide for a client who has hyperparathyroidism. C. Desmopressin IV for a client who has SIADH. D. Hydrocortisone sodium succinate IV for a client who has developed Addisonian crisis. 16) The nurse is caring for a client who has lung cancer and has developed syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which of the following would be an expected finding? A. Serum sodium level of 118 mEq/L. B. Hematocrit level of 54%. C. Report by the client of increased thirst. D. Blood urea nitrogen (BUN) level of 31 mg/dL. 17) The nurse is caring for a client who has developed SIADH. It would be necessary for the nurse to immediately notify the primary health care provider (PHCP) if the client A. Has 2+ pitting edema of the lower extremities B. Gained 1.5 pounds in the past 24 hours C. Drank 500 mL of water at lunch. D. Developed crackles in the bases of the lungs. 18) The nurse is caring for a client who has adrenal insufficiency. Which of the following medications should the nurse expect to be prescribed for the client? A. Spironolactone. B. Furosemide. C. Vasopressin. D. Prednisone. 19) The nurse is caring for a client who has adrenal insufficiency and is experiencing an exacerbation. Which of the following nursing actions should the nurse incorporate into the client’s plan of care? A. Assist the client to stand up slowly. B. Keep the lights in the client’s room dim. C. Maintain the client on a low sodium diet. D. Monitor the client’s blood glucose for hyperglycemia. 20) The nurse is assessing clients for their risk of developing Cushing’s syndrome. The nurse should identify at greatest risk, the client who is a A. 44-year-old female and has been taking corticosteroids for 10 years to treat rheumatoid arthritis. B. 55-year-old male and was recently diagnosed with a pheochromocytoma. C. 33-year-old female, has a goiter, and is receiving supplemental iodine (SSKI). D. 22-year-old male, and recently had an adrenalectomy. 21) The nurse is caring for a client who was admitted with a pheochromocytoma. Which of the following nursing actions would be a priority? A. Continuous monitoring of the client’s oxygen saturation. B. Encourage the client to use the incentive spirometer every hour. C. Maintaining a strict record of the client’s intake and output. D. Frequent monitoring of the client’s blood pressure. 22) The nurse is instructing a client who has suspected Graves’ disease and is scheduled to have a radioactive iodine uptake (RAIU) test. Which of the following client statements would indicate a correct understanding about this test? A. “This test is being performed to destroy some of the cells that produce thyroid hormone. B. “I will need to use a separate bathroom for two weeks after this test is performed.” C. “This test is being performed to determine how well my thyroid gland functions.” D. “I will need to stay away from my grandchild for 48 hours after this test is performed.” 23) The nurse is assessing a client who has hyperthyroidism and is at risk for developing thyroid storm. It would be necessary for the nurse to notify the primary health care provider (PHCP) if the client A. reports having a sensitivity to light. B. has an increase in temperature from 98.6⁰ F to 100.8⁰ F. C. Voided 500 mL in the past four hours. D. has had a blood pressure of 118/62 mm Hg for the past four hours. 24) The nurse has instructed a client who has hyperthyroidism and been prescribed propylthiouracil. Which of the following client statements would indicate a correct understanding of the teaching? A. “I will need to use an electric razor because this medication will cause me to bleed much easier." B. “I need to observe my urine and notify my doctor if I notice that it is becoming dark in color. C. “I will need to have my blood sugar monitored while taking this medication.” D. “I should increase my foods containing iron while taking this medication.” 25) The nurse is caring for a client who has undergone a subtotal thyroidectomy. Which of the following should the nurse include in the client’s plan of care? A. Encourage the client to avoid coughing for 72 hours following surgery. B. Instruct the client to rest in bed with the neck slightly extended. C. Keep a tracheotomy set at the client’s bedside. D. Monitor the client for evidence of an elevated calcium level. 26) The nurse is assessing a client who has suspected hypothyroidism. Which of the following findings is consistent with this diagnosis? A. Impaired memory. B. Diaphoresis C. Exophthalmos. D. Low-grade fever. 27) The home health nurse is visiting a client who has hypothyroidism and was recently started on levothyroxine. It would be a priority for the nurse to assess the client’s A. skin turgor and oral temperature. B. neurological status and activity level. C. bowel sounds and last reported bowel movement. D. heart rate and blood pressure. 28) The nurse has become aware of the following client situations. It would be a priority for the nurse to follow up with the client who A. has SIADH and continues to have a sodium level of 119 mEq/L. B. had a subtotal thyroidectomy 12 hours ago and is reporting that the dressing now feels tight. C. is newly diagnosed with hyperthyroidism and has an apical heart rate of 110 beats per minute. D. has diabetes insipidus (DI) and received the first dose of prescribed vasopressin thirty minutes ago. 29) The nurse is caring for a client with suspected hypoparathryoidism. Which of the following would be an expected finding? A. Muscle weakness B. Hypermagnesemia C. Constipation D. Hypocalcemia. 30) The nurse working on a surgical unit has been made aware of the following client situations. The nurse should first see the client who had a A. thyroidectomy 24 hours ago and has a serum calcium level of 8.5 mg/dL. B. thyroidectomy six hours ago and has not voided since surgery. C. transsphenoidal hypophysectomy 12 hours ago and is asking for a tissue in order to blow their nose. D. transsphenoidal hypophysectomy 8 hours ago and has been performing deep breathing exercises without coughing 31) The nurse is providing care to a client who has hypoparathyroidism and has developed a positive Trousseau’s sign and reports tingling of the hands and lips. Which of the following actions should the nurse be prepared to take? A. Implement seizure precautions for the client. B. Encourage the client to increase the intake of milk and yogurt. C. Monitor the client’s serum potassium levels. D. Continuously monitor the client’s oxygen saturation level. 32) The nurse is caring for a client who is receiving treatment for DKA. Which of the following laboratory values would indicate that the client’s DKA is resolving? A. A glycosylated hemoglobin (HgbA1C) level of 6.0%. B. A urine specific gravity of 1.000. C. A blood glucose level of 190 mg/dL and a HCO3- of 21 mEq/L. D. A blood pH of 7.30 and a serum potassium level of 4.9 mEq/L 33) The nurse is providing discharge teaching to a client with type 1 diabetes mellitus about ‘sick day’ rules, and ways to prevent the development of diabetic ketoacidosis (DKA). It would indicate a correct understanding of the teaching if the client states A. “I will test my urine ketones if my blood sugar becomes greater than 240 mg/dL.” B. “I will change my eating pattern to eat six small meals throughout the day.” C. “I will monitor my blood glucose level two times a day when I am sick.” D. “I will not take my insulin if I am unable to eat due to nausea or vomiting.” 34) The nurse is developing a plan of care for a client with type 1 diabetes mellitus who is being admitted with DKA and influenza. Which of the following should the nurse recognize as the priority intervention? A. Monitoring the client’s urine glucose level. B. Determining the client’s knowledge about ‘sick day’ rules. C. Obtaining a prescription for sodium bicarbonate to correct the acid-base imbalance D. Decreasing the client’s blood glucose level 50-75 mg/dL/hr. 35) The nurse is admitting a client who has hyperglycemic-hyperosmolar state (HHS). Which of the following assessment findings is consistent with this diagnosis? A. Positive ketones in the urine. B. A blood sugar of 820 mg/dL. C. A serum pH of 7.29 D. Kussmaul respirations. 36) The nurse is caring for a client who requires treatment for hyperglycemic-hyperosmolar