Question 1

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?

Accepted Answer

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 C

Question 2

The nurse is caring for a patient at risk for an addisonian crisis. For what associated signs and symptoms should the nurse monitor the patient? Select all that apply.

Accepted Answer

A)   Epistaxis
B)   Pallor
C)   Rapid respiratory rate
D)   Bounding pulse
E)   Hypotension B, C, E

Question 3

A patient with Cushing syndrome has been hospitalized after a fall. The dietician consulted works with the patient to improve the patients nutritional intake. What foods should a patient with Cushing syndrome eat to optimize health? Select all that apply.

Accepted Answer

A)   Foods high in vitamin D
B)   Foods high in calories
C)   Foods high in protein
D)   Foods high in calcium
E)   Foods high in sodium A, C, D

Question 4

A patient with Cushing syndrome as a result of a pituitary tumor has been admitted for a transsphenoidal hypophysectomy. What would be most important for the nurse to monitor before, during, and after surgery?

Accepted Answer

A)   Blood glucose
B)   Assessment of urine for blood
C)   Weight
D)   Oral temperature

Question 5

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?

Accepted Answer

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

Question 6

A nurse caring for a patient with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding?

Accepted Answer

A)   Glucose in the urine
B)   Albumin in the urine
C)   Highly dilute urine
D)   Leukocytes in the urine

Question 7

A patient has been taking prednisone for several weeks after experiencing a hypersensitivity reaction. To prevent adrenal insufficiency, the nurse should ensure that the patient knows to do which of the following?

Accepted Answer

A)   Take the drug concurrent with levothyroxine (Synthroid) .
B)   Take each dose of prednisone with a dose of calcium chloride.
C)   Gradually replace the prednisone with an OTC alternative.
D)   Slowly taper down the dose of prednisone, as ordered.

Question 8

A patient is undergoing testing for suspected adrenocortical insufficiency. The care team should ensure that the patient has been assessed for the most common cause of adrenocortical insufficiency. What is the most common cause of this health problem?

Accepted Answer

A)   Therapeutic use of corticosteroids
B)   Pheochromocytoma
C)   Inadequate secretion of ACTH
D)   Adrenal tumor

Question 9

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?

Accepted Answer

A)   Eggs
B)   Shellfish
C)   Table salt
D)   Red meat

Question 10

A patient on corticosteroid therapy needs to be taught that a course of corticosteroids of 2 weeks duration can suppress the adrenal cortex for how long?

Accepted Answer

A)   Up to 4 weeks
B)   Up to 3 months
C)   Up to 9 months
D)   Up to 1 year

Question 11

A patient presents at the walk-in clinic complaining of diarrhea and vomiting. The patient has a documented history of adrenal insufficiency. Considering the patients history and current symptoms, the nurse should anticipate that the patient will be instructed to do which of the following?

Accepted Answer

A)   Increase his intake of sodium until the GI symptoms improve.
B)   Increase his intake of potassium until the GI symptoms improve.
C)   Increase his intake of glucose until the GI symptoms improve.
D)   Increase his intake of calcium until the GI symptoms improve.

Question 12

The nurses assessment of a patient with thyroidectomy suggests tetany and a review of the most recent blood work corroborate this finding. The nurse should prepare to administer what intervention?

Accepted Answer

A)   Oral calcium chloride and vitamin D
B)   IV calcium gluconate
C)   STAT levothyroxine
D)   Administration of parathyroid hormone (PTH)

Question 13

The home care nurse is conducting patient teaching with a patient on corticosteroid therapy. To achieve consistency with the bodys natural secretion of cortisol, when would the home care nurse instruct the patient to take his or her corticosteroids?

Accepted Answer

A)   In the evening between 4 PM and 6 PM
B)   Prior to going to sleep at night
C)   At noon every day
D)   In the morning between  7AM7 \mathrm{AM}7AM  and  8AM8 \mathrm{AM}8AM

Question 14

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?

Accepted Answer

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.

Question 15

A patient has returned to the floor after having a thyroidectomy for thyroid cancer. The nurse knows that sometimes during thyroid surgery the parathyroid glands can be injured or removed. What laboratory finding may be an early indication of parathyroid gland injury or removal?

Accepted Answer

A)   Hyponatremia
B)   Hypophosphatemia
C)   Hypocalcemia
D)   Hypokalemia

Question 16

A patient who has been taking corticosteroids for several months has been experiencing muscle wasting. The patient has asked the nurse for suggestions to address this adverse effect. What should the nurse recommend?

Accepted Answer

A)   Activity limitation to conserve energy
B)   Consumption of a high-protein diet
C)   Use of OTC vitamin D and calcium supplements
D)   Passive range-of-motion exercises

Question 17

A patient has been assessed for aldosteronism and has recently begun treatment. What are priority areas for assessment that the nurse should frequently address? Select all that apply.

Accepted Answer

A)   Pupillary response
B)   Creatinine and BUN levels
C)   Potassium level
D)   Peripheral pulses
E)   BP

Question 18

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?

Accepted Answer

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?

Question 19

The nurse is assessing a patient diagnosed with Graves disease. What physical characteristics of Graves disease would the nurse expect to find?

Accepted Answer

A)   Hair loss
B)   Moon face
C)   Bulging eyes
D)   Fatigue

Question 20

Following an addisonian crisis, a patients adrenal function has been gradually regained. The nurse should ensure that the patient knows about the need for supplementary glucocorticoid therapy in which of the following circumstances?

Accepted Answer

A)   Episodes of high psychosocial stress
B)   Periods of dehydration
C)   Episodes of physical exertion
D)   Administration of a vaccine

Exam 51: Assessment and Management of Patients With Endocrine Disorders