Ms(T5-Endocrine2)

Front 1

The patient has been feeling tired lately and has gained weight, reports thickened, dry skin, and increased cold sensitivity even though it is now summer. Which endocrine diagnostic test should be done first?

Back 1

Free thyroxine (FT4)

The manifestations the patient is experiencing could be related to hypothyroidism.

Front 2

Hyperpigmentation, or "bronzing" of the skin, particularly on the knuckles, elbows, knees, genitalia, and palmar creases, is found in ____

Back 2

Addison's disease.

Front 3

Warm, smooth, moist skin may indicate ____. Purplish red marks on the abdomen are seen in patients with ____.

Back 3

hyperthyroidism

Cushing's syndrome

Front 4

A patient with low levels of parathormone in the blood is experiencing frequent muscle spasms in the extremities. Which diet should the nurse suggest to this patient?

Back 4

Calcium-rich diet

Hypoparathyroidism, or low levels of parathormone, may lead to tetany in the patient.

Front 5

Which assessment parameter is of highest priority when caring for a patient undergoing a water deprivation test?

Back 5

Patient weight

Front 6

____ targets the mammary glands in postpartum patients and stimulates milk secretion. It also initiates uterine contractility.

Back 6

Oxytocin

Front 7

The nurse working in an endocrine clinic knows that Trousseau's sign is an important diagnostic tool. Which statement best describes how to conduct the test for Trousseau's sign?

Back 7

Inflate a blood pressure cuff above the antecubital space.

Front 8

_____ is another diagnostic tool that is used to assess for tetany, a sign of hypocalcemia.

Back 8

Chvostek's sign

Front 9

_____ is associated with weight loss.

Back 9

Hyperthyroidism

Front 10

_____ helps in developing secondary sexual characteristics, such as breast development, in females.

Back 10

Estrogen

Front 11

Which hormone helps maintain water balance in a patient’s body?

Back 11

Antidiuretic hormone

Front 12

When assessing a patient with hypothyroidism, which finding does the nurse anticipate?

Back 12

A goiter

It is a common clinical manifestation of hypothyroidism, caused by the thyroid's compensatory enlargement to try to produce and secrete more thyroid hormone.

Front 13

An elderly patient is seen in the endocrine clinic. Upon assessment, the nurse notes a palpable thyroid gland. What does this finding indicate?

Back 13

This is a normal finding in the elderly

Front 14

growth hormone (GH) and adrenocorticotropic hormone (ACTH) are secreted by:

Back 14

the anterior pituitary

Front 15

Which hormones act on a patient’s mammary glands? Select all that apply. 2

Back 15

Oxytocin

Prolactin

Front 16

A patient reports excessive thirst, increased urine output, and weight loss. Upon reviewing the laboratory reports of the patient, the nurse finds increased blood glucose levels. The nurse suspects that the patient has which condition?

Back 16

Diabetes mellitus

Front 17

A patient's recent medical history is indicative of diabetes insipidus. The nurse would perform patient teaching related to which diagnostic test?

Back 17

Water deprivation test

Front 18

When the nurse assesses the patient who has pancreatitis, what function may be altered related to the endocrine function of the pancreas?

Back 18

Blood glucose regulation

Front 19

The health care provider was unable to save a patient's parathyroid gland during a radical thyroidectomy. The nurse should consequently pay particular attention to which laboratory value?

Back 19

Calcium levels

Front 20

A patient is referred for a magnetic resonance imaging (MRI) scan for radiologic evaluation of the pituitary gland. Which interventions should the nurse perform for the patient? Select all that apply.

Back 20

Inform the patient of the need to lie still during the procedure.

Assure the patient that the test is painless.

Explain that the test is noninvasive.

Front 21

The nurse has been teaching a patient with diabetes mellitus how to perform self-monitoring of blood glucose (SMBG). During evaluation of the patient's technique, the nurse identifies a need for additional teaching when the patient does what?

Back 21

Chooses a puncture site in the center of the finger pad

The patient should select a site on the sides of the fingertips, not on the center of the finger pad as this area contains many nerve endings and would be unnecessarily painful.

Front 22

The nurse is assigned to care for a 76-year-old patient with type 2 diabetes. To encourage the patient to become an active participant in his or her care, the nurse must first:

Back 22

Assess the patient's understanding of the disease

Front 23

The nurse is teaching the caregiver about the manifestations of hypoglycemia in the diabetic patient. What should the caregiver identify as a manifestation of hypoglycemia?

Back 23

Nervousness and tremors

Front 24

After a teaching session with the registered nurse, the newly diagnosed patient with Type 1 diabetes mellitus is correct when he or she makes which statement?

Back 24

"I will need to be medicated with insulin for the rest of my life."

Front 25

_____ is caused by destruction of pancreatic β-cells, which causes permanent insulin insufficiency and eventual absence.

Back 25

Type 1 diabetes

Front 26

The nurse is evaluating the teaching session on nutrition for the newly diagnosed diabetic patient. Which statement indicates an understanding of the teaching?

Back 26

"When my blood sugar is less than 70mg/dL, I will take 15 grams of a fast-acting carbohydrate, such as orange juice, and re-check in 15 minutes."

Front 27

The nurse has taught a patient who was admitted with diabetes, cellulitus, and osteomyelitis about the principles of foot care. The nurse determines that teaching is effective when the patient makes which statement?

Back 27

Patients with diabetes mellitus should inspect the feet daily for broken areas that are at risk for delayed wound healing, avoid walking barefoot, and have a podiatrist for foot care.

Front 28

The nurse is teaching a patient with type 2 diabetes about exercise as a method to control blood glucose levels. The nurse knows the patient understands when the patient elicits which exercise plan?

Back 28

"I will take a brisk 30-minute walk five days per week and do resistance training three times a week."

The best exercise plan for the person with type 2 diabetes is for 30 minutes of moderate activity five days per week and resistance training three times a week. Brisk walking is moderate activity

Front 29

A 51-year-old patient with diabetes mellitus is scheduled for a fasting blood glucose level at 8:00 am. The nurse instructs the patient to only drink water after what time?

Back 29

Midnight before the test

Front 30

The nurse provides dietary instructions to a patient with type 1 (insulin-dependent) diabetes mellitus. Which statement made by the patient indicates a need for further teaching?

Back 30

"If I go over my calories, I can just increase my insulin."

Front 31

A patient, who is admitted with diabetes mellitus, has a glucose level of 380 mg/dL and a moderate level of ketones in the urine. As the nurse assesses for signs of ketoacidosis, which respiratory pattern would the nurse expect to find?

Back 31

Kussmaul respirations, which are deep and nonlabored

Front 32

A type 2 (non–insulin-dependent) diabetic patient who takes oral hypoglycemics is admitted to the hospital with a urinary tract infection (UTI). The patient asks why insulin injections have been prescribed. What explanation should the nurse provide?

Back 32

The infection increases the glucose level, resulting in a need for more insulin.

Front 33

A patient who was recently diagnosed with Type 2 diabetes mellitus completed a teaching session about disease management. Which statement by the patient indicates understanding of Type 2 diabetes mellitus?

Back 33

"If I become ill, I will need to check my blood sugar more frequently."

Front 34

The nurse is assisting a patient with newly diagnosed type 2 diabetes to learn dietary planning as part of the initial management of diabetes. The nurse would encourage the patient to limit intake of which foods to help reduce the percent of fat in the diet?

Back 34

Cheese

Front 35

Which laboratory test is the best indicator of glucose control and long-term diabetes management in the patient with type 2 diabetes mellitus?

Back 35

A glycoslated hemoglobin level

When the glucose level is increased, glucose molecules attach to hemoglobin in the red blood cells (RBCs). This attachment lasts for the life of the RBC, 2 to 3 months.

Front 36

The nurse is caring for a patient in an outpatient diabetes clinic. Which statement by the patient indicates an understanding of the teaching?

Back 36

"I will be sure to measure my finger stick blood glucose level four times a day, and more frequently when I am ill."

Front 37

Laboratory results have been obtained for a 50-year-old patient with a 15-year history of type 2 diabetes. Which result reflects the expected pattern accompanying macrovascular disease as a complication of diabetes?

Back 37

Increased triglyceride levels

Front 38

A 54-year-old patient admitted with type 2 diabetes asks the nurse what "type 2" means. What is the most appropriate response by the nurse?

Back 38

"With type 2 diabetes, insulin secretion is decreased and insulin resistance is increased."

Front 39

The nurse observes a return demonstration by a patient who is learning how to mix regular insulin and NPH insulin in the same syringe. Which action by the patient indicates the need for further teaching?

Back 39

Withdrawing the NPH insulin first

Regular insulin is always withdrawn first so it will not become contaminated with the NPH insulin.

Front 40

The unlicensed assistive personnel (UAP) reports to the nurse a patient with a known history of diabetes is slow to respond, pale, and diaphoretic. What is the nurse's priority intervention?

Back 40

Obtain a bedside glucose reading.

Front 41

An 18-year-old patient, admitted with type 1 diabetes, asks the nurse what "type 1" means. What is the nurse's best response?

Back 41

"The body produces autoantibodies that destroy beta cells in the pancreas."

Front 42

The nurse provides dietary instructions to a patient with type 1 (insulin-dependent) diabetes mellitus. Which statement made by the patient indicates adequate teaching?

Back 42

"I'll need a bedtime snack, because I take an evening dose of NPH insulin.

I can have an occasional low-calorie dessert as long as I include it in my meal plan."

I should eat meals at the scheduled times, even if I'm not hungry, to prevent hypoglycemia."

Front 43

A diabetic patient experiences hypoglycemia. The nurse recalls that one possible cause of the condition is:

Back 43

Exercise without a carbohydrate-based snack

Front 44

mild illness, insufficient insulin dosage, and overeating are situations that would cause ____, or an increased blood glucose level.

Back 44

hyperglycemia

Front 45

A college student is newly diagnosed with type 1 diabetes. The patient now has a headache, changes in vision, and is anxious, but does not have the portable blood glucose monitor with him or her. Which action should the campus nurse advise the patient to take?

Back 45

Eat 15 g of simple carbohydrates

When the patient with type 1 diabetes is unsure about the meaning of the symptoms he or she is experiencing, the patient should treat him- or herself for hypoglycemia to prevent seizures and coma from occurring.

Front 46

The nurse is evaluating a 45-year-old patient diagnosed with type 2 diabetes mellitus. Which symptom reported by the patient is considered one of the classic clinical manifestations of diabetes?

Back 46

Excessive thirst

The classic symptoms of diabetes are polydipsia (excessive thirst), polyuria, (excessive urine output), and polyphagia (increased hunger).

Front 47

Weight gain, fatigue, and blurred vision may all occur with ____

Back 47

type 2 diabetes ,

Front 48

A patient with diabetes mellitus is scheduled for a fasting blood glucose level at 8 AM. The nurse instructs the patient to fast for what period of time?

Back 48

At least eight hours

Front 49

The nurse provides education to a patient with newly diagnosed type 1 (insulin-dependent) diabetes mellitus. Which statement made by the patient indicates a need for further instruction?

Back 49

"If I skip breakfast, I can hold my insulin until noon."

Front 50

"If I have to urinate a lot, feel thirsty all of the time, or have blurred vision, my____might be high."

Back 50

blood sugar

Front 51

A patient with type 2 diabetes who takes metformin daily to manage blood sugar is scheduled for an intravenous pyelogram (IVP). Which question by the nurse is most important to ask the patient when preparing for the procedure?

Back 51

"When was the last time you took your metformin?"

To reduce risk of kidney injury, metformin should be discontinued a day or two before the procedure and for 48 hours following the procedure.

Front 52

Which symptom reported by a 50-year-old patient would lead the nurse to suspect early undiagnosed type 2 diabetes?

Back 52

A wound that will not heal

Front 53

Type 2 diabetes presents with vague complaints including: fatigue, frequent infections, and delayed wound healing. Blurred vision is a late symptom of uncontrolled diabetes.

Back 53

Nursing

Front 54

The nurse is reviewing diabetic self-care management with a patient newly diagnosed with diabetes. The patient is in need of further education when stating to the nurse:

Back 54

"To toughen my skin so I do not get pressure sores, I should rub my feet down with rubbing alcohol after my bath."

Front 55

Patients with ____ are at great risk for skin breakdown because of peripheral vascular problems and peripheral neuropathy.

Back 55

diabetes

Front 56

The best way to prevent foot ulcers is prevention and early detection. Inspecting the feet every day for cuts, abrasions, pressure areas, or sores is a good practice. Toenails should be cut with the rounded contour of the nail and not cut down the corners of the nail. Another complication of diabetes is retinopathy. Patients with a history of diabetes should have an eye examintion annually by an ophthalmologist.

Back 56

nursing

Front 57

A patient is scheduled for a total thyroidectomy. What information does the nurse include when teaching this patient about recovery after the procedure?

Back 57

Life-long hormone replacement will be needed.

levothyroxine (Synthroid)

Front 58

A patient has just begun long-term corticosteroid therapy. The nurse determines that the patient requires further education when making which statement?

Back 58

"If I begin to gain weight I should stop taking my medication."

Corticosteroids should be gradually tapered and not stopped suddenly to avoid life-threatening adrenal insufficiency.

Front 59

The nurse, providing care to a patient with Cushing's syndrome, understands that the disorder is primarily related to:

Back 59

Excessive secretion of adrenocorticosteroid hormones

Front 60

The nurse is caring for a patient who is postoperative following a thyroidectomy. A priority of the patient's nursing care includes which action?

Back 60

A positive Cvostek's sign is a sign of life-threatening tetany, which could be caused by hypocalcemia because of accidental removal of the parathyroid glands. Hoarseness for three to four weeks postoperatively is an expected outcome of a thyroidectomy

Front 61

Adrenocortical insufficiency develops secondary to inadequate secretion of which pituitary hormone?

Back 61

Adrenocorticotropic hormone (ACTH)

Adrenocortical insufficiency occurs as a result of an inadequate amount of serum cortisol, which occurs as a result of undersecretion of ACTH by the anterior pituitary.

Front 62

A nurse, creating a plan of care for a patient with Addison's disease, expects that primary treatment will include:

Back 62

Adrenocorticosteroid replacement therapy

Front 63

Because ____ results from a deficiency of adrenocorticosteroid hormones, steroid therapy is the primary treatment

Back 63

Addison's disease

Front 64

Which condition can result if hypersecretion of growth hormone (GH) occurs after epiphyseal plate closure?

Back 64

Acromegaly

Front 65

The health care provider was unable to spare a patient's parathyroid gland during a thyroidectomy. Which assessments should the nurse prioritize when providing postoperative care for this patient?

Back 65

Monitoring the patient's serum calcium levels and assessing for signs of hypocalcemia

Front 66

Which parameter would indicate the optimal intended effect of therapy with levothyroxine (Synthroid)?

Back 66

Thyroid-stimulating hormone (TSH) of 1.5 mIU/L

Front 67

A normal TSH level (between____mIU/L) indicates optimal intended effects of the medication.

Back 67

0.4 to 4

Front 68

A patient diagnosed with hyperthyroidism received radioactive iodine (RAI) one week ago. The patient tells the nurse, "I don't think the medication is working, I don't feel any different." Identify the best nursing response.

Back 68

"It may take several weeks to see the full benefits of the treatment."

Front 69

A nurse completes an assessment and notes that a patient's thyroid gland is enlarged. With which condition is this finding consistent?

Back 69

Goiter

Front 70

Thyroid abnormalities consist of three basic forms:

Back 70

goiter (enlarged thyroid gland), hypothyroidism, and hyperthyroidism.

Goiter may be present in hyper- or hypofunction of the gland.

Front 71

Which nursing intervention is most important for a patient with diabetes insipidus?

Back 71

Monitoring fluid intake and output

Front 72

The nurse is caring for a patient who underwent removal of the thyroid gland (thyroidectomy) 3 days ago. The patient's serum chemistries reveal calcium of 3.2 mg/dL, potassium of 3.9 mEq/L, and phosphorus of 4.0 mg/dL. What condition do these findings indicate?

Back 72

Hypocalcemia

Front 73

The normal serum calcium level ranges from ____. Potassium ranges (____), and phosphorus ranges (_____).

Back 73

9.0 to 11.5 mg/dL

3.5 to 5 mEq/L

2.8 to 4.5 mg/dL

Front 74

While assessing a patient with suspected Cushing's syndrome, of what most prominent clinical manifestation is the nurse aware?

Back 74

Weight gain, including truncal obesity

also a characteristic rounded "moon face" and fat deposits in the neck and upper back, also known as a "buffalo hump."

Front 75

A patient is prescribed levothyroxine (Synthroid). To promote optimal absorption, the nurse should instruct the patient to take the medication at which time?

Back 75

0600

Front 76

A patient is scheduled for a bilateral adrenalectomy. What does the nurse include in the discharge teaching for this patient?

Back 76

Lifelong replacement of corticosteroids will be required.

Front 77

ACTH

Back 77

adrenocorticotropic hormone

Front 78

A patient is just returning to the surgical floor from the recovery room after undergoing a thyroidectomy. Identify the priority nursing intervention.

Back 78

Have a tracheostomy tray at the bedside.

Postoperative complications for a patient following a thyroidectomy include injury to the recurrent or superior laryngeal nerve, which can lead to vocal cord paralysis. If both cords are paralyzed, spastic airway obstruction will occur, requiring an immediate tracheostomy.

Front 79

What is a nursing priority in the care of a patient with a diagnosis of hypothyroidism?

Back 79

Patient teaching related to levothyroxine (Synthroid)

Front 80

The priority focus of care in the patient with central diabetes insipidus (DI) is on:

Back 80

Avoiding dehydration and fluid volume deficit