Deck 50: Care of the Patient with an Endocrine Disorder

Question 1

Why would a patient with hyperthyroidism be prescribed the drug methimazole (Tapa-zole)?

A) To limit the effect of the pituitary on the thyroid
B) To destroy part of the hyperactive thyroid tissue
C) To stimulate the pineal gland
D) To block the production of thyroid hormones

Answer 1

To block the production of thyroid hormones

Question 2

What is the postoperative position for a person who has had a thyroidectomy?

A) Prone
B) Semi-Fowler
C) Side-lying
D) Supine

Answer 2

Semi-Fowler

Question 3

Which test will furnish immediate feedback for a newly diagnosed diabetic who is not yet under control?

A) Fasting blood sugar (FBS)
B) Glycosylated hemoglobin (HgbA1c)
C) Oral glucose tolerance test (OGTT)
D) Clinitest

Answer 3

Fasting blood sugar (FBS)

Question 4

What should the nurse caution a type I diabetic about excessive exercise?

A) It can increase the need for insulin and may result in hyperglycemia.
B) It can decrease the need for insulin and may result in hypoglycemia.
C) It can increase muscle bulk and may result in malabsorption of insulin.
D) It can decrease metabolic demand and may result in metabolic acidosis.

Question 5

The nurse caring for a 75-year-old man who has developed diabetes insipidus following a head injury will include in the plan of care provisions for:

A) limiting fluids to 1500 mL a day.
B) encouraging physical exercise.
C) protecting patient from injury.
D) discouraging daytime naps.

Question 6

What extra equipment should the nurse provide at the bedside of a new postoperative thyroidectomy patient?

A) Large bandage scissors
B) Tracheotomy tray
C) Ventilator
D) Water-sealed drainage system

Question 7

The nurse explains that the negative feedback system controls hormone release by communication between:

A) the pituitary and the target organ.
B) the thymus and the blood stream.
C) lymphatic system and the target organ.
D) central nervous system and the blood stream.

Question 8

The human insulin whose onset of action occurs within ____ minutes is lispro (Humalog).

A) 30
B) 60
C) 15
D) 45

Question 9

To which diet should a patient with Cushing syndrome adhere?

A) Less sodium
B) More calories
C) Less potassium
D) More carbohydrates

Question 10

Which precaution(s) should the nurse take when caring for a patient who is being treated with radioactive iodine 131 (RAIU)?

A) Initiate radioactive safety precautions
B) Avoid assigning any young woman to the patient
C) Wait three days after dose before assigning a pregnant nurse to care for this patient
D) Advise visitors to sit at least 10 feet away from the patient

Question 11

What is an appropriate nursing diagnosis for a patient who has recently been diagnosed with acromegaly?

A) Ineffective coping
B) Activity intolerance
C) Risk for trauma
D) Chronic low self-esteem

Question 12

Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the previous 8 to 12 weeks?

A) Fasting blood sugar (FBS)
B) Oral glucose tolerance test (OGT)
C) Glycosylated hemoglobin (HbA1c)
D) Postprandial glucose test (PPBG)

Question 13

The purpose of the use of radioactive iodine in the treatment of hyperthyroidism is to:

A) stimulate the thyroid gland.
B) depress the pituitary.
C) destroy some of the thyroid tissue.
D) alter the stimulus from the pituitary.

Question 14

What is a long-term complication of diabetes mellitus?

A) Diverticulitis
B) Renal failure
C) Hypothyroidism
D) Hyperglycemia

Question 15

The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of an exercise regimen. The patient plans to enroll in a swimming class. Which adjustment should be made based on this information?

A) Time the morning insulin injection so that the peak action will occur during swimming class.
B) Delete normal walks on swimming class days.
C) Delay the meal before the swimming class until the session is over.
D) Monitor glucose level before, during, and after swimming to determine the need for alterations in food or insulin.

Question 16

A patient has undergone tests that indicate a deficiency of the parathyroid hormone secretion. She should be informed of which potential complication?

A) Osteoporosis
B) Lethargy
C) Laryngeal spasms
D) Kidney stones

Question 17

As the nurse is shaving a patient who is 2 days postoperative from a thyroidectomy, the patient has a spasm of the facial muscles. What should the nurse recognize this as?

A) Chvostek sign
B) Montgomery sign
C) Trousseau sign
D) Homans sign

Question 18

A patient has returned to his room after a thyroidectomy with signs of thyroid crisis. During thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of the potentially lethal complication of:

A) severe nausea and vomiting.
B) bradycardia.
C) delirium with restlessness.
D) congestive heart failure.

Question 19

What do the Chvostek sign and the Trousseau sign indicate?

A) Low levels of serum calcium
B) High levels of blood sugar
C) Low levels of serum sodium
D) High levels of serum aldosterone

Question 20

In diabetes insipidus, a deficiency of which hormone causes clinical manifestations?

A) antidiuretic hormone (ADH)
B) follicle-stimulating hormone (FSH)
C) thyroid-stimulating hormone (TSH)
D) adrenocorticotropic hormone (ACTH)

Question 21

What instructions should be included in the discharge instructions for a 47-year-old patient with hypothyroidism?

A) Taking medication whenever symptoms cause discomfort
B) Decreasing fluid and fiber intake
C) Consuming foods rich in iron
D) Seeing the physician regularly for follow-up care

Question 22

The nurse cautions the patient who is being instructed on self-medication with insulin to be aware that there are 25-, 30-, 50-, and 100-unit syringes. How is the 100-unit syringe marked?

A) 1-unit increments
B) 2-unitt increments
C) 4-unit increments
D) 5-unit increments

Question 23

The physician orders an 1800-calorie diabetic diet and 40 units of (Humulin N) insulin U-100 subcutaneously daily for a patient with diabetes mellitus. Why would a mid-afternoon snack of milk and crackers be given?

A) To improve nutrition
B) To improve carbohydrate metabolism
C) To prevent an insulin reaction
D) To prevent diabetic coma

Question 24

The nurse is caring for a patient who is receiving calcium gluconate for treatment of hypoparathyroid tetany. Which assessment would indicate an adverse reaction to the drug?

A) Increase in heart rate
B) Flushing of face and neck
C) Drop in blood pressure
D) Urticaria

Question 25

What is the master gland of the endocrine system?

A) Thyroid
B) Parathyroid
C) Pancreas
D) Pituitary

Question 26

A patient with a history of Graves disease is admitted to the unit with shortness of breath. The nurse notes the patient's vital signs: T 103° F, P 160, R 24, BP 160/80. The nurse also notes distended neck veins. What does the patient most likely have?

A) Pulmonary embolism
B) Hypertensive crisis
C) Thyroid storm
D) Cushing crisis

Question 27

A patient has come to the clinic because of enlarged hands and feet, amenorrhea, and increased hair growth. These symptoms most likely indicate problems with the:

A) pituitary gland.
B) adrenal glands.
C) thyroid gland.
D) pancreas.

Question 28

What information should be obtained from the patient before an iodine-131 test?

A) Presence of metal in the body
B) Allergy to sulfa drugs
C) Status of possible pregnancy
D) Use of prescription drugs for hypertension

Question 29

A 27-year-old patient with hypothyroidism is referred to the dietitian for dietary consultation. What should nutritional interventions include?

A) Frequent small meals high in carbohydrates
B) Calorie-restricted meals
C) Caffeine-rich beverages
D) Fluid restrictions

Question 30

The patient being treated for hypothyroidism should be instructed to eat well-balanced meals including intake of iodine. Which of the following foods contains iodine?

A) Eggs
B) Pork
C) White bread
D) Skinless chicken

Question 31

What should the nurse include in provisions for the postoperative care of the patient who had a thyroidectomy? (Select all that apply.)

A) Assessing ability to speak by asking him or her to recite name and address every hour
B) Maintaining anatomic position of the head when moving a patient
C) Assisting a patient to hyperextend the head to assess for muscle damage
D) Doing voice check every 2 hours
E) Turning, coughing every hour
F) Checking for bleeding at the sides and the back of the head

Question 32

Which of the following are signs and symptoms of hypoglycemia? (Select all that apply.)

A) Irritability
B) Dry mouth
C) Tremors
D) Diaphoresis
E) Fruity breath

Question 33

The nurse discovers the type 1 diabetic (IDDM) patient drowsy and tremulous, the skin is cool and moist, and the respirations are 32 and shallow. These are signs of:

A) hypoglycemic reaction; give 6 oz of orange juice.
B) hyperglycemic reaction; give ordered regular insulin.
C) hyperglycemic hyperosmolar nonketotic reaction; squeeze glucagon gel in buccal cavity.
D) hypoglycemic reaction; give ordered insulin.

Question 34

The physician prescribes glyburide (Micronase, DiaBeta, Glynase) for a patient, age 57, when diet and exercise have not been able to control type 2 diabetes. What should the nurse include in the teaching plan about this medication?

A) It is a substitute for insulin and acts by directly stimulating glucose uptake into the cell.
B) It does not cause the hypoglycemic reactions that may occur with insulin use.
C) It is thought to stimulate insulin production and increase sensitivity to insulin at receptor sites.
D) It lowers blood sugar by inhibiting glucagon release from the liver, preventing gluconeogenesis.

Question 35

How should the nurse administer insulin to prevent lipohypertrophy?

A) At room temperature
B) At body temperature
C) Straight from the refrigerator
D) After rolling bottle between hands to warm

Question 36

What are the three major life-threatening complications postoperatively of a thyroidectomy? (Select all that apply.)

A) Hemorrhaging
B) Seizures
C) Tetany
D) Hypoglycemia
E) Thyroid crisis (storm)
F) SIADH

Question 37

The adrenal cortex secretes glucocorticoids. The most important is cortisol. What is it involved in? (Select all that apply.)

A) Glucose metabolism
B) Releasing androgens and estrogens
C) Providing extra reserve energy during stress
D) Decreasing the level of potassium in the blood stream
E) Increasing retention of sodium in the blood stream

Question 38

What instructions should a nurse give to a diabetic patient to prevent injury to the feet?

A) Soak feet in warm water every day.
B) Avoid going barefoot and always wear shoes with soles.
C) Use of commercial keratolytic agents to remove corns and calluses are preferred to cutting off corns and calluses.
D) Use a heating pad to warm feet when they feel cool to the touch.

Question 39

The nurse would instruct a patient with hyperthyroidism (Graves disease) to select which of the following nutritious foods because of the increased metabolism related to the disease. (Select all that apply.)

A) Coffee with cream
B) Lean meat
C) White bread
D) Leafy green vegetables
E) Supplemental vitamin D

Question 40

The nurse teaching a patient with type 1 diabetes mellitus (IDDM) about early signs of
Insulin reaction would include information about:

A) abdominal pain and nausea.
B) dyspnea and pallor.
C) flushing of the skin and headache.
D) hunger and a trembling sensation.

Question 41

Another term for hyperglycemic reaction is ____________ ______________.

Question 42

When the nurse inflates the sphygmomanometer cuff exceeding the systolic blood pressure and observes a carpal spasm, this is a(n) __________ ____________.

Question 43

Only ________insulin can be administered intravenously.

Question 44

________________is the term that describes a condition of normal thyroid function.

Question 45

Arrange the steps of drawing up a short-acting and a long-acting insulin in the same syringe. (Separate letters by a comma and space as follows: A, B, C, D)

A) Draw up amount of shorter-acting insulin
B) Check insulin dose with a second licensed nurse
C) Inject the desired amount of air into the long-acting insulin
D) Clean rubber stopper of both vials with alcohol
E) Draw up desired amount of longer-acting insulin
F) Inject the desired amount of air into the short-acting insulin

Question 46

The nurse is administering long-acting insulin once a day, which provides insulin coverage for 24 hours. This insulin is _________________.

Question 47

The nurse would instruct a patient who is hypocalcemic from hypoparathyroidism about a diet that should include (select all that apply):

A) High phosphorus foods
B) Canned fish with the bones
C) Cucumbers
D) Tofu
E) Bananas
F) Vitamin D supplements

Question 48

A condition with a deficiency in growth hormone is called ________________.

Question 49

Arrange the steps of the negative feedback system in the control of blood glucose in chronologic order. (Separate letters by a comma and space as follows: A, B, C, D):

A) Elevation of blood glucose
B) Decrease in blood glucose
C) Beta cells repressed
D) Beta cells of pancreas stimulated to excrete insulin
E) Intake of nutrients