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17 Cards in this Set
- Front
- Back
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The expected serum osmolality for the pt with diabetes insipidus will be:
A. decreased B. increased C. completely normal D. same as the urine osmolality |
B. increased
Increased serum osmolality results from the ensuing dehydration in the absence of adequate ADH. The serum osmolality will decrease in the presence of too musch or ectopic ADH, as is seen with syndrome of inappropriate antidiuretic hormone secretion (SIADH). |
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The normal thyroid gland will have all the following characteristics excpet which one?
A. It is slightly enlarged, enabling easy access for direct assessment. B. It is usually nonpalpable. C. It is easy to visualize when the pt is swallowing D. It is preferable to palpate when located behind the pt. |
A. Positive Hoffman's sign
The healthy thyroid is nonpalpable, without visible nodules or masses. The best way to assess the thyroid is to approach the pt from behind palpating the gland. The best way to visualize the gland is to observe the thyroid while the pt swallows water. |
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Hypocalcemia leading to tetany is assessed by which one of the following parameters?
A. Positive Hoffman's sign B. Positive Turner's sign C. Positive Trousseau's sign D. Positive Povsing's sign |
C. Positive Trousseau's sign
Tetany results in a positive Trousseau's sign (carpedal spasm) when pressure is applied to the pt's arm with a blood pressure cuff for several minutes. Tetany also can result in facial nerve irritation and spasm (Chvostek's sign). |
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According to the American Diabetes Association, the diagnosis of type 2 diabetes is made by which one of the following?
A. Positive results on glycosylated hemoglobin (HbA1C) testing B. Two fasting glucose samples that are greater than 140 mg/dL C. Two fasting glucose samples that are greater than 126 mg/dL D. Any gestational diabetic event |
C. Two fasting glucose samples that are greater than 126 mg/dL.
The American Diabetes Association guidlines include 2 seperate fasting glucose levels greater than 126 mg/dL as diagnostic for type 2 diabetes. The guidlines do not include glycosylated hemoglobin (Hb A1C in the diagnostic criteria. Although the pt with gestational diabetes is at higher risk for future development of type 2 diabetes, the presence of gestational diabetes is still considered a criterion for diagnosis. |
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The proofund neurological signs in a patient with diabetic ketoacidosis (DKA) result from:
A. severe sepsis and fever B. dehydration C. systemic hypokalemia D. neurologic hypoglycemia |
B. dehydration
The pt with diabetic ketoacidosis (DKA) sustains major fluid and electrolyte loss, shifts, or both secondary to the hyperglycemia and resultant dehydration. Not all pts with DKA have sepsis or fever, and hypokalemia usually does not lead to profound neurological symptoms initially. |
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When admitting a patient with a preexisting endocrine condition, it is important for the nurse to assess the patient for a history of:
A. weight gain or loss B. cancer C. smoking D. visual problems |
A. Weight gain or loss
Because disorders of the pituitary that could result in critical care admission affect fluid and electrolyte balance, the nurse inquires about general hydration status. Parameters to be included are weight gain or loss, excessive urination, thirst, edema, and cognitive changes such as slowed mentation, fatigue, or memory impairment. |
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Which of the following is the most likely disease process if the patient's laboratory results indicate an elevated serum ADH and low serum osmolality with an elevated urine osmolality?
A. Central diabetes insipidus B. SIADH C. Diabetes Mellitus D. Myxedema |
B. SIADH
SIADH is indicated by an elevated serum ADH and low serum osmolality with an elevated urine osmolality. |
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An increased urine specific gravity is seen in which disease?
A. central diabetes insipidus B. SIADH C. diabetes mellitus D. B and C |
D. both B and C
SIADH and diabetes mellitus with dehydration both cause increased specific gravity of urine. |
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Urine osmolality is increased in which of the following conditions?
A. SIADH B. Addison's disease C. Renal disease D. All of the above |
D. all of the above
Urine osmolality is increased in SIADH, dehydration, Addison's disease, and renal disease. |
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The thyroid scan and radioactive iodine uptake study are tests used to indicate and provide diagnosis for:
A. hyperthyroidism B. hypothyroidism C. Cancer of the thyroid D. all of the above |
D. all of the above
These nuclear tests indicate areas of increased and decreased function and provide data to diagnose hyperthyroidism, hypothyroidism, nodules, ectopic thyroid tissue, and cancer of the thyroid |
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A classic sign of hypoparathyroidism is:
A. Trousseau's sign B. Chadwick's sign C. Chvostek's sign D A and C |
D. A and C are correct
Trousseau's and Chvostek's signs are indicators of hypokalemia caused by hypoparathyroidism. |
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The patient's fasting blood glucose is 110 mg/dL. Nursing implications for the finding include:
A. assessing a 2 hr post prandial blood sugar for further elevation B. assessing the pt for S/S of hypoglycemia C. nothing; it is a normal blood sugar D. administering 50cc of concentrated juice |
C. nothing; it is a normal blood sugar
The normal value for adults is 65 to 110 mg/dL. |
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Which of the following statements is true about "ketones"?
A. Ketones are normally found in the urine. B. Whenever blood sugar is low, ketones can be found in the urine. C.Ketones are present in the blood before they show up in the urine. D. To test for ketones, a ketone reagent strip is used in a fresh urine sample. |
D. To test for ketones, a ketone reagent sturp is used in a fresh urine sample.
The test is performed by dipping a ketone reagent strip in a fresh sample, as ketones appear in urine before they do in serum. |
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In reviewing the patient's labs, the nurse finds an elevation of adrenocorticotropic hormone (ACTH). This increase may be caused by:
A. Addison's disease B. Cushing's syndrome C. Cirrhosis D. Pituitary hyposecretion |
B. Cushing's syndrome
Adrenal hyperperfusion may be caused by excess secretion of ACTH by the pituitary gland (Cushing's syndrome), high stress, trauma, and surgery. |
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The critically ill patient reports weight loss, anorexia, nausea and vomiting, diarrhea, thirst, and weakness. Physical findings reveal tachycardia, bronze skin color, and postural hypotension. These findings suggest:
A. Cushing's syndrome B. diabetic ketoacidosis C. Syndrome of inappropriate antiduretic hormone (SIADH) D. an adrenal crisis |
D. an adrenal crisis
Adrenal insufficency from autoimmune Addison's disease can lead to an adrenal crisis. The pt becomes lethargic, dehydrated, and unable to mount any stress response to handle acute illness or trauma. |
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The best test to diagnose Cushing's syndrome is:
A. urine vanullylmandelic acid B. cortisol suppression C. corisol stimulation D. urine 17-ketosteroids and 17-hydroxycorticosteroids |
B. Corisol suppression
Cortisol suppression is the test of choice to diagnose Cushing's syndrome |
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A patient with Graves' disease is likely to present with which of the following symptoms?
A. buffalo hump B. edema C. decreased deep tendon reflexes D. exophthalmos |
D. Exophthalmos
Exophthalmos is caused by hyperthyroidism (Grave's disease). |
