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RN4 endocrine
| Question | Answer |
|---|---|
| The nurse is providing care for an older adult patient whose current medication regimen levothyroxine (Synthroid). As a result, the nurse should be aware of the heightened risk of adverse effects when administering an IV dose of what medication? | D) A benzodiazepine;s.Even in small IV doses, hypnotic and sedative agents may induce profound somnolence, lasting far longer than anticipated and leading to narcosis (stupor like condition). Furthermore, they are likely to cause respiratory depression, |
| 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? | B) Consumption of a high-protein diet; Consumption of a high-protein diet;Muscle wasting can be partly addressed through increased protein intake. Passive ROM |
| 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. | C) Potassium level E) BP |
| 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. | B) Pallor C) Rapid respiratory rate E) Hypotension The patient at risk is monitored for signs and symptoms indicative of addisonian crisis, which can include shock; hypotension; rapid, weak pulse; rapid respiratory rate; pallor; and extreme weakness. |
| What should the nurse teach a patient on corticosteroid therapy in order to reduce the patients risk of adrenal insufficiency? | B) Always have enough medication on hand to avoid running out.The patient and family should be informed that acute adrenal insufficiency and underlying symptoms will recur if corticosteroid therapy is stopped abruptly without medical supervision. |
| 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? | Blood glucose;Before, during, and after this surgery, blood glucose monitoring and assessment of stools for blood are carried out. The patients blood sugar is more likely to be volatile than body weight or temperature. |
| 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? | D) Up to 1 year;Suppression of the adrenal cortex may persist up to 1 year after a course of corticosteroids of only 2 weeks duration. |
| A patient with Cushing syndrome has been hospitalized after a fall. The dietician consulted works withthe patient to improve the patients nutritional intake. What foods should a patient with Cushingsyndrome eat to optimize health? Select all that apply. | A) Foods high in vitamin D;C) Foods high in protein;D) Foods high in calcium;Foods high in vitamin D, protein, and calcium are recommended to minimize muscle wasting and osteoporosis. |
| 32. The nurse providing care for a patient with Cushing syndrome has identified the nursing diagnosis of risk for injury related to weakness. How should the nurse best reduce this risk? | A) Establish falls prevention measures.; |
| 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? | A) Therapeutic use of corticosteroids;Therapeutic use of corticosteroids is the most common cause of adrenocortical insufficiency. The other options also cause adrenocortical insufficiency, but they are not the most common causes. |
| A patient with pheochromocytoma has been admitted for an adrenalectomy to be performed the following day. To prevent complications, the nurse should anticipate preoperative administration of which of the following? | D) IV corticosteroids;IV administration of corticosteroids (methylprednisolone sodium succinate [Solu-Medrol]) may begin onthe evening before surgery and continue during the early postoperative period to prevent adrenalinsufficiency. |
| A 30 year-old female patient has been diagnosed with Cushing syndrome. What psychosocial nursing diagnosis should the nurse most likely prioritize when planning the patients care? | C) Disturbed body image related to changes in physical appearance;Cushing syndrome causes characteristic physical changes that are likely to result in disturbed body image. |
| 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? | A) Episodes of high psychosocial stress |
| 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? | D) Slowly taper down the dose of prednisone, as ordered. |
| 26. 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? | B) IV calcium gluconate;When hypocalcemia and tetany occur after a thyroidectomy, the immediate treatment is administration of IV calcium gluconate. This has a much faster therapeutic effect than PO calcium or vitamin D supplements. |
| 25. A patient has been admitted to the critical care unit with a diagnosis of thyroid storm. What interventions should the nurse include in this patients immediate care? Select all that apply. | B) Administering beta blockers to reduce heart rate D) Applying interventions to reduce the patients temperature;Thyroid storm necessitates interventions to reduce heart rate and temperature. |
| 24. A patient with a recent diagnosis of hypothyroidism is being treated for an unrelated injury. When administering medications to the patient, the nurse should know that the patients diminished thyroid function may have what effect | D) Prolonged duration of effect;In all patients with hypothyroidism, the effects of analgesic agents, sedatives, and anesthetic agents are prolonged. |
| 23. A nurse works in a walk-in clinic. The nurse recognizes that certain patients are at higher risk for different disorders than other patients. What patient is at a greater risk for the development of hypothyroidism? | A) A 75-year-old female patient with osteoporosis; |
| 22. The physician has ordered a fluid deprivation test for a patient suspected of having diabetes insipidus. During the test, the nurse should prioritize what assessments? | B) Heart rate and BP;The fluid deprivation test is carried out by withholding fluids for 8 to 12 hours or until 3% to 5% of the body weight is lost. The patients condition needs to be monitored frequently during the test, and the testis terminated itachy |
| 21. A patient with suspected adrenal insufficiency has been ordered an adrenocorticotropic hormone (ACTH) stimulation test. Administration of ACTH caused a marked increase in cortisol levels. How should the nurse interpret this finding? | A) The patients pituitary function is compromised;An adrenal response to the administration of a stimulating hormone suggests inadequate production ofthe stimulating hormone. In this case, ACTH is produced by the pituitary and, consequently, pituitaryhypo |
| 20. The nurse is assessing a patient diagnosed with Graves disease. What physical characteristics of Graves disease would the nurse expect to find? | C) Bulging eyes |
| 19. A patient with hypofunction of the adrenal cortex has been admitted to the medical unit. What would the nurse most likely find when assessing this patient? | D) Decreased BP;Decreased BP may occur with hypofunction of the adrenal cortex. Decreased function of the adrenal cortex does not affect the patients body temperature, urine output, or skin tone. |
| 18. A patient with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) is being cared for on the critical care unit. The priority nursing diagnosis for a patient with this condition is what? | B) Excess fluid volume;The priority nursing diagnosis for a patient with SIADH is excess fluid volume, as the patient retains fluids and develops a sodium deficiency. Restricting fluid intake is a typical intervention for managing this syndrome. |
| 17. The nurse is planning the care of a patient with hyperthyroidism. What should the nurse specify in the patients meal plan? | B) Small, frequent meals, high in protein and calories |
| 16. A patient has returned after having a thyroidectomy for thyroid cancer. The nurse knows thatsometimes during thyroid surgery the parathyroid glands can be injured or removed. What laboratoryfinding may be an early indication of parathyroid gland injur | C) Hypocalcemia;Injury or removal of the parathyroid glands may produce a disturbance in calcium metabolism and result in a decline of calcium levels (hypocalcemia). As the blood calcium levels fall, hyperirritability of thenerves occurs, with spasms of |
| 15. While assisting with the surgical removal of an adrenal tumor, the OR nurse is aware that the patients vital signs may change upon manipulation of the tumor. What vital sign changes would the nurse expect to see? | B) Hypertension and heart rate changes |
| 14. The nurse is caring for a patient with hyperparathyroidism. What level of activity would the nurse expect to promote? | D) Ambulation and activity as tolerated |
| 13. A patient presents at the walk-in clinic complaining of diarrhea and vomiting. The patient has ahistory of adrenal insufficiency. Considering the patients history and symptoms, thenurse should anticipate that the patient will be instructed to do which | A) Increase his intake of sodium until the GI symptoms improve. |
| 12. The home care nurse is conducting patient teaching with a patient on corticosteroid therapy. To achieveconsistency with the bodys natural secretion of cortisol, when would the home care nurse instruct thepatient to take his or her corticosteroids? | D) In the morning between 7 AM and 8 AM |
| 11. The nurse is performing a shift assessment of a patient with aldosteronism. What assessments should the nurse include? Select all that apply | A) Urine output D) Blood pressure |
| 10. You are developing a care plan for a patient with Cushing syndrome. What nursing diagnosis would have the highest priority in this care plan? | A) Risk for injury related to weakness |
| 9. 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? | C) Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8 AM the next morning |
| 8. A nurse caring for a patient with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding? | C) Highly dilute urine |
| 7. 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? | C) The patient is at an increased risk for developing infection. |
| 6. 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? | C) Table salt |
| 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? | B) The need for lifelong steroid replacement |
| 4. 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? | C) Muscle weakness |
| 3. 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 addressingpotential complications? | A) Do you feel any muscle twitches or spasms? |
| 2. 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? | C) Semi-Fowlers with the head supported on two pillows |
| What are the two parts of the pituitary gland? | anterior and posterior |
| Name the 8 major endocrine glands: | pituitary, thyroid, parathyroid, adrenal, pancreas, thymus, pineal, gonads |
| What regulates the release of anterior pituitary hormones? | hypothalamus |
| Name the 6 major hormones produced by the pituitary gland | GH (growth hormone), TSH ( thyroid stimulating hormone) , ACTH 9adrenocorticotropic hormone), FSH, LH, Prolactin |
| What hormones are produced and released by the thyroid? | T3, T4, Thyrocalcitonin |
| What is the purpose of T3 and T4? | regulate metabolism |
| What role does the pituitary play in metabolism? | production and release of TSH when stimulated by the hypothalamus. |
| What pharmacologic therapy does the nurse anticipate administering when the patient is experiencing thyroid storm? (Select all that apply.) | Propylthiouracil Acetaminophen Iodine |
| A patient has been taking tricyclic antidepressants for many years for the treatment of depression. The patient has developed SIADH and has been admitted to the acute care facility. What should the nurse carefully monitor when caring for this patient? | Strict intake and output Urine and blood chemistry Neurologic function |
| Which is a complication of hyperthyroidism? | Hypothyroidism |
| A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply. | Hypotension Hypoventilation Hypothermia |
| Thyroid storm is a severe form of hyperthyroidism that can be fatal if not treated. Medical management includes pharmacotherapy. Which of the following drugs have proved helpful? Select all that apply. | Hydrocortisone Methimazole Acetaminophen Iodine |
| The nurse recognizes that which of the following agents suppress release of thyroid hormones? Select all that apply. | Sodium iodide Potassium iodide Saturated solution of potassium iodide (SSKI) |
| A physician orders laboratory tests to confirm hyperthyroidism in a client with classic signs and symptoms of this disorder. Which test result would confirm the diagnosis? | No increase in the thyroid-stimulating hormone (TSH) level after 30 minutes during the TSH stimulation test |
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hobart3809