MDC 2 Final Exam NCLEX Style Practice Endocrine D/O(No diabetes included)questions and answers

The nurse is reviewing the laboratory test results for a client with a possible pituitary disorder. Which information requires immediate intervention by the nurse? a.Blood glucose 125 mg/dL (6.9mmol/L) b.Blood urea nitrogen (BUN) 40 mg/dL (14.3 mmol/L) c.Serum potassium 5.0 mEq/L (5.0 mmol/L d.Serum sodium 110 mEq/L (110 mmol/L) d.Serum sodium 110 mEq/L (110 mmol/L) The charge nurse on the medical-surgical unit is making client assignments for the shift. Which client is the most appropriate to assign to an LPN/LVN? a.Client with Cushing's syndrome who requires orthostatic vital signs assessments b.Client with diabetes mellitus who was admitted with a blood glucose of 35 mg/dL (1.9 mmol/L) c.Client with exophthalmos who has many questions about endocrine function d.Client with possible pituitary adenoma who has just arrived on the nursing unit a.Client with Cushing's syndrome who requires orthostatic vital signs assessments A client with an endocrine disorder says, "I can't, you know, satisfy my wife anymore." What is the nurse's best response? a."Can you please tell me more?" b."Don't worry. That is normal." c."How does she feel?" d."Can I make an appointment for you with a counselor?" a."Can you please tell me more?" The nurse is teaching a client about proper nutrition to prevent an endocrine disorder. Which food does the nurse suggest adding to the diet when the client indicates a dislike of fish? a.Iodized salt b.Red meat c.Soy products d.Salt substitute a.Iodized salt A client is hospitalized for pituitary function testing. Which nursing action included in the client's plan of care will be most appropriate for the RN to delegate to the LPN/LVN? a.Assess the client for clinical manifestations of hypopituitarism. b.Administer regular insulin for the growth hormone stimulation test. c.Palpate the thyroid gland for size and firmness. d.Teach the client about the adrenocorticotropic hormone stimulation test. b.Administer regular insulin for the growth hormone stimulation test. When caring for the older adult with decreased antidiuretic hormone (ADH) production, the nurse would include which of these in the plan of care? a.Encourage fluids every 2 hours. b.Plan for weight-bearing activities. c.Inspect the feet and legs for ulcers. d.Increase fiber in the diet. a.Encourage fluids every 2 hours. The nurse is caring for a client who has frequent episodes of hypoglycemia with loss of consciousness. During interdisciplinary rounds, which of these does the nurse suggest the client's family learn to use? a.Norepinephrine b.Calcitonin c.Glucagon d.Insulin c.Glucagon The nurse is instructing a client who will undergo an adrenal suppression test. Which statement by the client indicates that teaching was effective? a."I am being tested to see whether my hormone glands are hyperactive." b."I am being tested to see whether my hormone glands are hypoactive." c."I am being tested to see whether my kidneys work at all." d."I will be given more hormones as a trigger." a."I am being tested to see whether my hormone glands are hyperactive." A client is hospitalized with a possible disorder of the adrenal cortex. Which nursing activity is best for the charge nurse to delegate to an experienced nursing assistant? a.Ask about risk factors for adrenocortical problems. b.Assess the client's response to physiologic stressors. c.Check the client's blood glucose levels every 4 hours. d.Teach the client how to do a 24-hour urine collection. c.Check the client's blood glucose levels every 4 hours. The nurse is teaching a client about the correct procedure for a 24-hour urine test for a hormone level. Which statement by the client indicates a need for further teaching? a."I need to keep the urine container cool in a separate refrigerator or cooler." b."I will not eat any protein when I am collecting urine for this test." c."I won't save the first urine sample of the day." d."To end the collection, I must empty my bladder and add this urine to the collection." b."I will not eat any protein when I am collecting urine for this test." The client tells the visiting nurse his blood glucose values over the last week have been excellent. Which of these resources does the nurse evaluate to verify the client's statement? a.Fasting blood glucose b.Glycosylated hemoglobin (HbA1c) c.Client's blood glucose log d.Postprandial glucose b.Glycosylated hemoglobin (HbA1c) The nurse is caring for a client with a parathyroid dysfunction. Which comment by the client indicates a need for further assessment? a."I am worried about my bones breaking down." b."Lately, I lose my temper more quickly." c."The doctor will need to check my vitamin D levels." d."My weight has been stable these past few years." b."Lately, I lose my temper more quickly." A client with Cushing's disease begins to laugh loudly and inappropriately, causing the family in the room to be uncomfortable. What is the nurse's best response? a."Don't mind this. The disease is causing this." b."I need to check the client's cortisol level." c."The disease can sometimes affect emotional responses." d."Medication is available to help with this." c."The disease can sometimes affect emotional responses." The charge nurse is making client assignments for the medical-surgical unit. Which client will be best to assign to an RN who has floated from the pediatric unit? a.Client who is receiving IV hydrocortisone for an Addisonian crisis b.Client admitted with syndrome of inappropriate antidiuretic hormone (SIADH) secondary to lung cancer c.Client being discharged after a unilateral adrenalectomy to remove a pheochromocytoma d.Client with Cushing's syndrome who requires frequent glucose monitoring and administration of insulin d.Client with Cushing's syndrome who requires frequent glucose monitoring and administration of insulin A client with iatrogenic Cushing's disease is a resident in a long-term care facility. Which nursing action included in the plan of care is most appropriate to delegate to unlicensed assistive personnel (UAP)? a.Assist with personal hygiene and skin care. b.Develop a plan of care to minimize risk for infection. c.Instruct the client on the reasons to avoid overeating. d.Monitor for signs and symptoms of fluid retention. a.Assist with personal hygiene and skin care. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH) admitted with change in mental status. To determine whether fluid restrictions have been effective, for which of these outcomes will the nurse monitor? a.Decreased hematocrit b.Decreased serum osmolality c.Increased serum sodium d.Increased urine specific gravity c.Increased serum sodium A client presents to the emergency department with a history of adrenal insufficiency. The following laboratory values are obtained: Na+ 130 mEq/L (130 mmol/L), K+ 6.6 mEq/L (6.6 mmol/L), and glucose 72 mg/dL (4 mmol/L). Which prescription will the nurse implement first? a.Administer insulin with dextrose in normal saline. b.Give spironolactone (Aldactone) orally. c.Initiate ulcer prophylaxis protocol with a histamine2 (H2) blocker d.Obtain arterial blood gases. a.Administer insulin with dextrose in normal saline. A client is referred to a home health agency after a transsphenoidal hypophysectomy. Which action does the RN case manager delegate to the home health aide who will see the client daily? a.Document symptoms of incisional infection or meningitis. b.Give over-the-counter laxatives if the client is constipated. c.Set up medications as prescribed for the day. d.Test any nasal drainage for the presence of glucose. d.Test any nasal drainage for the presence of glucose. A client with syndrome of inappropriate antidiuretic hormone (SIADH) is admitted with a serum sodium level of 105 mEq/L (105 mmol/L). Which request by the health care provider does the nurse carry out first? a.Administer infusion of 150 mL of 3% NaCl over 3 hours. b.Draw blood for hemoglobin and hematocrit (H&H). c.Insert an indwelling catheter and monitor urine output. d.Weigh the client on admission and daily thereafter. a.Administer infusion of 150 mL of 3% NaCl over 3 hours. A client with Cushing's disease says that she has lost 1 pound (0.5 kg) What does the nurse do next? a.Auscultate the lungs for crackles. b.Check urine for specific gravity. c.Check the blood pressure. d.Weigh the client. d.Weigh the client. The nurse is teaching a client about the expected outcome for treatment of syndrome of inappropriate antidiuretic hormone (SIADH). What does the nurse tell the client to look for? a.Decrease in difficulty in breathing b.Dry mucous membranes c.Increasing heart rate d.Muscle spasms a.Decrease in difficulty in breathing The nurse and nursing student are caring for a client with pheochromocytoma who is admitted for surgery. Which of these statements by the student requires immediate intervention by the nurse? a."I will review the chest x-ray results for pulmonary edema." b."I will initiate a 24-hour urine collection now." c."I have requested the client be placed with a roommate for distraction." d."When performing the gastrointestinal assessment, I need to palpate the client's abdomen." d."When performing the gastrointestinal assessment, I need to palpate the client's abdomen." A client presents to the emergency department with acute adrenal insufficiency and the following vital signs: P 118 beats/min, R 18 breaths/min, BP 84/44 mm Hg, pulse oximetry 98%, and T 98.8°F oral. Which nursing intervention is the highest priority for this client? a.Administering furosemide (Lasix) b.Providing isotonic fluids c.Replacing potassium losses d.Restricting sodium b.Providing isotonic fluids A client with a possible adrenal gland tumor is admitted for testing and treatment. Which nursing action is most appropriate for the charge nurse to delegate to the nursing assistant? a.Assess skin turgor and mucous membranes for hydration status. b.Discuss the dietary restrictions for 24-hour urine testing. c.Plan ways to control the environment that will avoid stimulating the client. d.Remind the client to not order coffee with meals d.Remind the client to not order coffee with meals The client is taking fludrocortisone (Florinef) for adrenal hypofunction. The nurse instructs the client to report which symptom while taking this drug? a.Anxiety b.Headache c.Nausea d.Weight loss b.Headache The nurse is assessing a client who had a transsphenoidal hypophysectomy yesterday. Which finding requires immediate notification to the primary health care provider? a.Dry lips and oral mucosa on examination b.Nasal drainage that tests negative for glucose c.Client report of a headache and stiff neck d.Urine specific gravity of 1.016 c.Client report of a headache and stiff neck A client has been admitted to the medical intensive care unit with a diagnosis of diabetes insipidus (DI) secondary to lithium overdose. The client has a prescription for Desmopressin (DDAVP). Which outcome indicates a positive response to treatment? a.Urine output of 60-80 mL/hour b.Blood glucose level of 110 mg/dL (6.1 mmol/L) c.Ability to sit quietly and read a magazine d.Potassium level within expected range a.Urine output of 60-80 mL/hour