Chapter 52: Assessment and
Management of Patients with Endocrine
Disorders NCLEX
A
(Symptoms of hypothyroidism include extreme fatigue, hair loss, brittle nails, dry skin, voice
huskiness or hoarseness, menstrual disturbance, and numbness and tingling of the fingers.
Bulging eyes, palpitations, and flushed skin would be signs and symptoms of
hyperthyroidism.) - correct answer-The nurse is caring for a patient diagnosed with
hypothyroidism secondary to Hashimotos thyroiditis. When assessing this patient, what sign
or symptom would the nurse expect?
A)Fatigue
B) Bulging eyes
C) Palpitations
D) Flushed skin
C
(When moving and turning the patient, the nurse carefully supports the patients head and
avoids tension on the sutures. The most comfortable position is the semi-Fowlers position,
with the head elevated and supported by pillows.) - correct answer-A patient has been
admitted to the post-surgical unit following a thyroidectomy. To promote comfort and safety,
how should the nurse best position the patient?
A) Side-lying (lateral) with one pillow under the head
B) Head of the bed elevated 30 degrees and no pillows placed under the head
C) Semi-Fowlers with the head supported on two pillows
D) Supine, with a small roll supporting the neck
A
(As the blood calcium level falls, hyperirritability of the nerves occurs, with spasms of the
hands and feet and muscle twitching. This is characteristic of hypoparathyroidism. Flushing,
diaphoresis, dizziness, and pain are atypical signs of the resulting hypocalcemia.) - correct
answer-A patient with thyroid cancer has undergone surgery and a significant amount of
parathyroid tissue has been removed. The nurse caring for the patient should prioritize what
question when addressing potential complications?
A) Do you feel any muscle twitches or spasms?
B) Do you feel flushed or sweaty?
C) Are you experiencing any dizziness or lightheadedness?
D) Are you having any pain that seems to be radiating from your bones?
,C
(Patients with Addisons disease demonstrate muscular weakness, anorexia, gastrointestinal
symptoms, fatigue, emaciation, dark pigmentation of the skin, and hypotension. Patients with
Cushing syndrome demonstrate truncal obesity, moon face, acne, abdominal striae, and
hypertension.) - correct answer-The nurse is caring for a patient with a diagnosis of
Addisons disease. What sign or symptom is most closely associated with this health
problem?
A) Truncal obesity
B) Hypertension
C) Muscle weakness
D) Moon face
B
(Because of the need for lifelong replacement of adrenal cortex hormones to prevent
addisonian crises, the patient and family members receive explicit education about the
rationale for replacement therapy and proper dosage. Doses are not adjusted on a
short-term basis. Weight gain and hepatotoxicity are not common adverse effects.) - correct
answer-The nurse is caring for a patient with Addisons disease who is scheduled for
discharge. When teaching the patient about hormone replacement therapy, the nurse should
address what topic?
A) The possibility of precipitous weight gain
B) The need for lifelong steroid replacement
C) The need to match the daily steroid dose to immediate symptoms
D) The importance of monitoring liver function
C
(The major use of iodine in the body is by the thyroid. Iodized table salt is the best source of
iodine.) - correct answer-The nurse is teaching a patient that the body needs iodine for the
thyroid to function. What food would be the best source of iodine for the body?
A) Eggs
B) Shellfish
C) Table salt
D) Red meat
C
(The patient is at increased risk of infection and masking of signs of infection. The
cardiovascular effects of corticosteroid therapy may result in development of
thrombophlebitis or thromboembolism. Diet should be high in protein with limited fat.
Changes in appearance usually disappear when therapy is no longer necessary. Cognitive
changes are not common adverse effects.) - correct answer-A patient is prescribed
, corticosteroid therapy. What would be priority information for the nurse to give the patient
who is prescribed long-term corticosteroid therapy?
A) The patients diet should be low protein with ample fat.
B) The patient may experience short-term changes in cognition.
C) The patient is at an increased risk for developing infection.
D) The patient is at a decreased risk for development of thrombophlebitis and
thromboembolism.
C
(Patients with diabetes insipidus produce an enormous daily output of very dilute, water-like
urine with a specific gravity of 1.001 to 1.005. The urine contains no abnormal substances
such as glucose or albumin. Leukocytes in the urine are not related to the condition of
diabetes insipidus, but would indicate a urinary tract infection, if present in the urine.) -
correct answer-A nurse caring for a patient with diabetes insipidus is reviewing laboratory
results. What is an expected urinalysis finding?
A) Glucose in the urine
B) Albumin in the urine
C) Highly dilute urine
D) Leukocytes in the urine
C
(Dexamethasone (1 mg) is administered orally at 11 PM, and a plasma cortisol level is
obtained at 8 AM the next morning. This test can be performed on an outpatient basis and is
the most widely used and sensitive screening test for diagnosis of pituitary and adrenal
causes of Cushing syndrome.) - correct answer-The nurse caring for a patient with Cushing
syndrome is describing the dexamethasone suppression test scheduled for tomorrow. What
does the nurse explain that this test will involve?
A) Administration of dexamethasone orally, followed by a plasma cortisol level every hour for
3 hours
B) Administration of dexamethasone IV, followed by an x-ray of the adrenal glands
C) Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8 AM the
next morning
D) Administration of dexamethasone intravenously, followed by a plasma cortisol level 3
hours after the drug is administered
A
(The nursing priority is to decrease the risk of injury by establishing a protective
environment. The patient who is weak may require assistance from the nurse in ambulating
to prevent falls or bumping corners or furniture. The patients breathing will not be affected
and autonomic dysreflexia is not a plausible risk. Loneliness may or may not be an issue for
the patient, but safety is a priority.) - correct answer-You are developing a care plan for a
Management of Patients with Endocrine
Disorders NCLEX
A
(Symptoms of hypothyroidism include extreme fatigue, hair loss, brittle nails, dry skin, voice
huskiness or hoarseness, menstrual disturbance, and numbness and tingling of the fingers.
Bulging eyes, palpitations, and flushed skin would be signs and symptoms of
hyperthyroidism.) - correct answer-The nurse is caring for a patient diagnosed with
hypothyroidism secondary to Hashimotos thyroiditis. When assessing this patient, what sign
or symptom would the nurse expect?
A)Fatigue
B) Bulging eyes
C) Palpitations
D) Flushed skin
C
(When moving and turning the patient, the nurse carefully supports the patients head and
avoids tension on the sutures. The most comfortable position is the semi-Fowlers position,
with the head elevated and supported by pillows.) - correct answer-A patient has been
admitted to the post-surgical unit following a thyroidectomy. To promote comfort and safety,
how should the nurse best position the patient?
A) Side-lying (lateral) with one pillow under the head
B) Head of the bed elevated 30 degrees and no pillows placed under the head
C) Semi-Fowlers with the head supported on two pillows
D) Supine, with a small roll supporting the neck
A
(As the blood calcium level falls, hyperirritability of the nerves occurs, with spasms of the
hands and feet and muscle twitching. This is characteristic of hypoparathyroidism. Flushing,
diaphoresis, dizziness, and pain are atypical signs of the resulting hypocalcemia.) - correct
answer-A patient with thyroid cancer has undergone surgery and a significant amount of
parathyroid tissue has been removed. The nurse caring for the patient should prioritize what
question when addressing potential complications?
A) Do you feel any muscle twitches or spasms?
B) Do you feel flushed or sweaty?
C) Are you experiencing any dizziness or lightheadedness?
D) Are you having any pain that seems to be radiating from your bones?
,C
(Patients with Addisons disease demonstrate muscular weakness, anorexia, gastrointestinal
symptoms, fatigue, emaciation, dark pigmentation of the skin, and hypotension. Patients with
Cushing syndrome demonstrate truncal obesity, moon face, acne, abdominal striae, and
hypertension.) - correct answer-The nurse is caring for a patient with a diagnosis of
Addisons disease. What sign or symptom is most closely associated with this health
problem?
A) Truncal obesity
B) Hypertension
C) Muscle weakness
D) Moon face
B
(Because of the need for lifelong replacement of adrenal cortex hormones to prevent
addisonian crises, the patient and family members receive explicit education about the
rationale for replacement therapy and proper dosage. Doses are not adjusted on a
short-term basis. Weight gain and hepatotoxicity are not common adverse effects.) - correct
answer-The nurse is caring for a patient with Addisons disease who is scheduled for
discharge. When teaching the patient about hormone replacement therapy, the nurse should
address what topic?
A) The possibility of precipitous weight gain
B) The need for lifelong steroid replacement
C) The need to match the daily steroid dose to immediate symptoms
D) The importance of monitoring liver function
C
(The major use of iodine in the body is by the thyroid. Iodized table salt is the best source of
iodine.) - correct answer-The nurse is teaching a patient that the body needs iodine for the
thyroid to function. What food would be the best source of iodine for the body?
A) Eggs
B) Shellfish
C) Table salt
D) Red meat
C
(The patient is at increased risk of infection and masking of signs of infection. The
cardiovascular effects of corticosteroid therapy may result in development of
thrombophlebitis or thromboembolism. Diet should be high in protein with limited fat.
Changes in appearance usually disappear when therapy is no longer necessary. Cognitive
changes are not common adverse effects.) - correct answer-A patient is prescribed
, corticosteroid therapy. What would be priority information for the nurse to give the patient
who is prescribed long-term corticosteroid therapy?
A) The patients diet should be low protein with ample fat.
B) The patient may experience short-term changes in cognition.
C) The patient is at an increased risk for developing infection.
D) The patient is at a decreased risk for development of thrombophlebitis and
thromboembolism.
C
(Patients with diabetes insipidus produce an enormous daily output of very dilute, water-like
urine with a specific gravity of 1.001 to 1.005. The urine contains no abnormal substances
such as glucose or albumin. Leukocytes in the urine are not related to the condition of
diabetes insipidus, but would indicate a urinary tract infection, if present in the urine.) -
correct answer-A nurse caring for a patient with diabetes insipidus is reviewing laboratory
results. What is an expected urinalysis finding?
A) Glucose in the urine
B) Albumin in the urine
C) Highly dilute urine
D) Leukocytes in the urine
C
(Dexamethasone (1 mg) is administered orally at 11 PM, and a plasma cortisol level is
obtained at 8 AM the next morning. This test can be performed on an outpatient basis and is
the most widely used and sensitive screening test for diagnosis of pituitary and adrenal
causes of Cushing syndrome.) - correct answer-The nurse caring for a patient with Cushing
syndrome is describing the dexamethasone suppression test scheduled for tomorrow. What
does the nurse explain that this test will involve?
A) Administration of dexamethasone orally, followed by a plasma cortisol level every hour for
3 hours
B) Administration of dexamethasone IV, followed by an x-ray of the adrenal glands
C) Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8 AM the
next morning
D) Administration of dexamethasone intravenously, followed by a plasma cortisol level 3
hours after the drug is administered
A
(The nursing priority is to decrease the risk of injury by establishing a protective
environment. The patient who is weak may require assistance from the nurse in ambulating
to prevent falls or bumping corners or furniture. The patients breathing will not be affected
and autonomic dysreflexia is not a plausible risk. Loneliness may or may not be an issue for
the patient, but safety is a priority.) - correct answer-You are developing a care plan for a
