Test Bank for Principles of
Information Systems, 15th
Edition
The nurse is caring for a group of older patients in a long-term care setting. Which physical changes
in the patients should the nurse investigate as signs of possible endocrine dysfunction?
A. Absent reflexes, diarrhea, and hearing loss
B. Hypoglycemia, delirium, and incontinence
C. Fatigue, constipation, and mental impairment
D. Hypotension, heat intolerance, and bradycardia - ANSWERSC.
Changes of aging often mimic clinical manifestations of endocrine disorders. Clinical manifestations
of endocrine dysfunction such as fatigue, constipation, or mental impairment in the older adult are
often missed because they are attributed solely to aging.
The nurse interviews a 50-year-old man with a history of type 2 diabetes mellitus, chronic bronchitis,
and osteoarthritis who has a fasting blood glucose of 154 mg/dL. Which medications, if taken by the
patient, may raise blood glucose levels?
A. Glargine (Lantus)
B. Prednisone (Deltasone)
C. Metformin (Glucophage)
D. Acetaminophen (Tylenol) - ANSWERSB.
Prednisone is a corticosteroid that may cause glucose intolerance in susceptible patients by
increasing gluconeogenesis and insulin resistance. Insulin (e.g., glargine) and metformin (an oral
hypoglycemic agent) decrease blood glucose levels. Acetaminophen has a glucose-lowering effect.
The nurse is caring for a 36-year-old woman with possible hypoparathyroidism after a
thyroidectomy. It is most appropriate for the nurse to assess for which clinical manifestations?
A. Polyuria, polydipsia, and weight loss
B. Cardiac dysrhythmias and hypertension
C. Muscle spasms and hyperactive deep tendon reflexes
D. Hyperpigmentation, skin ulcers, and peripheral edema - ANSWERSC.
Common assessment abnormalities associated with hypoparathyroidism include tetany (muscle
spasms) and increased deep tendon reflexes. Hyperpigmentation is associated with Addison's
disease. Skin ulcers occur in patient with diabetes. Edema is associated with hypothyroidism.
,Polyuria and polydipsia occur in patients with diabetes mellitus or diabetes insipidus. Weight loss
occurs in hyperthyroidism or diabetic ketoacidosis. Hypertension and cardiac dysrhythmias may be
caused by hyperthyroidism, hyperparathyroidism, or pheochromocytoma.
An 18-year-old male patient is undergoing a growth hormone stimulation test. The nurse should
monitor the patient for
A. hypothermia.
B. hypertension.
C. hyperreflexia.
D. hypoglycemia. - ANSWERSD.
Insulin or arginine (agent that stimulates insulin secretion) is administered for a growth hormone
stimulation test. The nurse should monitor the patient closely for hypoglycemia. Hypothermia and
hypertension are not expected in response to insulin or arginine. Hyperreflexia is an autonomic
complication of spinal cord injury.
A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant.
Based on initial assessment findings, the nurse 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 - ANSWERSA.
Poorly controlled hyperparathyroidism may cause an elevated serum calcium level. This, in turn, may
diminish calcium stores in the bone, causing bone demineralization and setting the stage for
pathologic fractures and a risk for injury. Hyperparathyroidism doesn't accelerate the metabolic rate.
A decreased thyroid hormone level, not an increased parathyroid hormone level, may cause edema
and dry skin secondary to fluid infiltration into the interstitial spaces. Hyperparathyroidism causes
hypercalcemia, not hypocalcemia; therefore, it isn't associated with tetany.
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 - ANSWERSB.
,Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight gain. Signs and
symptoms of hyperthyroidism (Graves' disease) include an increased appetite, weight loss,
nervousness, tremors, and thyroid gland enlargement (goiter).
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 - ANSWERSC.
Levothyroxine, a synthetic thyroid hormone, is given to a client with hypothyroidism to simulate the
effects of thyroxine. Adverse effects of this agent include tachycardia. The other options aren't
associated with levothyroxine.
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 - ANSWERSD.
Hyperparathyroidism is most common in older women and is characterized by bone pain and
weakness from excess parathyroid hormone (PTH). Clients also exhibit hypercaliuria-causing
polyuria. While clients with diabetes mellitus and diabetes insipidus also have polyuria, they don't
have bone pain and increased sleeping. Hypoparathyroidism is characterized by urinary frequency
rather than polyuria.
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. - ANSWERSA.
Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin) production,
the nurse should expect to administer synthetic vasopressin for hormone replacement therapy.
Furosemide, a diuretic, is contraindicated because a client with diabetes insipidus experiences
, polyuria. Insulin and dextrose are used to treat diabetes mellitus and its complications, not diabetes
insipidus.
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 - ANSWERSD.
An autonomous aldosterone-producing adenoma is the most common cause of hyperaldosteronism.
Hyperplasia is the second most frequent cause. Aldosterone secretion is independent of sodium and
potassium intake as well as of pituitary stimulation.
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 - ANSWERSA.
Muscle weakness, bradycardia, nausea, diarrhea, and paresthesia of the hands, feet, tongue, and
face are findings associated with hyperkalemia, which is transient and occurs from transient
hypoaldosteronism when the adenoma is removed. Tremors, diaphoresis, and constipation aren't
seen in hyperkalemia.
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). - ANSWERSA.
ADH is the hormone clients with diabetes insipidus lack. The client's TSH, FSH, and LH levels won't be
affected.
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?
Information Systems, 15th
Edition
The nurse is caring for a group of older patients in a long-term care setting. Which physical changes
in the patients should the nurse investigate as signs of possible endocrine dysfunction?
A. Absent reflexes, diarrhea, and hearing loss
B. Hypoglycemia, delirium, and incontinence
C. Fatigue, constipation, and mental impairment
D. Hypotension, heat intolerance, and bradycardia - ANSWERSC.
Changes of aging often mimic clinical manifestations of endocrine disorders. Clinical manifestations
of endocrine dysfunction such as fatigue, constipation, or mental impairment in the older adult are
often missed because they are attributed solely to aging.
The nurse interviews a 50-year-old man with a history of type 2 diabetes mellitus, chronic bronchitis,
and osteoarthritis who has a fasting blood glucose of 154 mg/dL. Which medications, if taken by the
patient, may raise blood glucose levels?
A. Glargine (Lantus)
B. Prednisone (Deltasone)
C. Metformin (Glucophage)
D. Acetaminophen (Tylenol) - ANSWERSB.
Prednisone is a corticosteroid that may cause glucose intolerance in susceptible patients by
increasing gluconeogenesis and insulin resistance. Insulin (e.g., glargine) and metformin (an oral
hypoglycemic agent) decrease blood glucose levels. Acetaminophen has a glucose-lowering effect.
The nurse is caring for a 36-year-old woman with possible hypoparathyroidism after a
thyroidectomy. It is most appropriate for the nurse to assess for which clinical manifestations?
A. Polyuria, polydipsia, and weight loss
B. Cardiac dysrhythmias and hypertension
C. Muscle spasms and hyperactive deep tendon reflexes
D. Hyperpigmentation, skin ulcers, and peripheral edema - ANSWERSC.
Common assessment abnormalities associated with hypoparathyroidism include tetany (muscle
spasms) and increased deep tendon reflexes. Hyperpigmentation is associated with Addison's
disease. Skin ulcers occur in patient with diabetes. Edema is associated with hypothyroidism.
,Polyuria and polydipsia occur in patients with diabetes mellitus or diabetes insipidus. Weight loss
occurs in hyperthyroidism or diabetic ketoacidosis. Hypertension and cardiac dysrhythmias may be
caused by hyperthyroidism, hyperparathyroidism, or pheochromocytoma.
An 18-year-old male patient is undergoing a growth hormone stimulation test. The nurse should
monitor the patient for
A. hypothermia.
B. hypertension.
C. hyperreflexia.
D. hypoglycemia. - ANSWERSD.
Insulin or arginine (agent that stimulates insulin secretion) is administered for a growth hormone
stimulation test. The nurse should monitor the patient closely for hypoglycemia. Hypothermia and
hypertension are not expected in response to insulin or arginine. Hyperreflexia is an autonomic
complication of spinal cord injury.
A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant.
Based on initial assessment findings, the nurse 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 - ANSWERSA.
Poorly controlled hyperparathyroidism may cause an elevated serum calcium level. This, in turn, may
diminish calcium stores in the bone, causing bone demineralization and setting the stage for
pathologic fractures and a risk for injury. Hyperparathyroidism doesn't accelerate the metabolic rate.
A decreased thyroid hormone level, not an increased parathyroid hormone level, may cause edema
and dry skin secondary to fluid infiltration into the interstitial spaces. Hyperparathyroidism causes
hypercalcemia, not hypocalcemia; therefore, it isn't associated with tetany.
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 - ANSWERSB.
,Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight gain. Signs and
symptoms of hyperthyroidism (Graves' disease) include an increased appetite, weight loss,
nervousness, tremors, and thyroid gland enlargement (goiter).
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 - ANSWERSC.
Levothyroxine, a synthetic thyroid hormone, is given to a client with hypothyroidism to simulate the
effects of thyroxine. Adverse effects of this agent include tachycardia. The other options aren't
associated with levothyroxine.
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 - ANSWERSD.
Hyperparathyroidism is most common in older women and is characterized by bone pain and
weakness from excess parathyroid hormone (PTH). Clients also exhibit hypercaliuria-causing
polyuria. While clients with diabetes mellitus and diabetes insipidus also have polyuria, they don't
have bone pain and increased sleeping. Hypoparathyroidism is characterized by urinary frequency
rather than polyuria.
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. - ANSWERSA.
Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin) production,
the nurse should expect to administer synthetic vasopressin for hormone replacement therapy.
Furosemide, a diuretic, is contraindicated because a client with diabetes insipidus experiences
, polyuria. Insulin and dextrose are used to treat diabetes mellitus and its complications, not diabetes
insipidus.
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 - ANSWERSD.
An autonomous aldosterone-producing adenoma is the most common cause of hyperaldosteronism.
Hyperplasia is the second most frequent cause. Aldosterone secretion is independent of sodium and
potassium intake as well as of pituitary stimulation.
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 - ANSWERSA.
Muscle weakness, bradycardia, nausea, diarrhea, and paresthesia of the hands, feet, tongue, and
face are findings associated with hyperkalemia, which is transient and occurs from transient
hypoaldosteronism when the adenoma is removed. Tremors, diaphoresis, and constipation aren't
seen in hyperkalemia.
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). - ANSWERSA.
ADH is the hormone clients with diabetes insipidus lack. The client's TSH, FSH, and LH levels won't be
affected.
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?
