Deck 11: Care of the Patient With an Endocrine Disorder

Question 1

A 69-year-old patient with diabetes mellitus is admitted with cellulitis of the right foot. In applying moist packs to his ulcerated foot, the nurse should use aseptic techniques to

A) destroy bacteria on the skin.
B) inhibit the growth of pathogens.
C) prevent the introduction of additional microorganisms.
D) minimize the risk of spreading infection to others.

Answer 1

prevent the introduction of additional microorganisms.

Question 2

The patient is a newly diagnosed diabetic. Until he has his diabetes under control, which test will furnish valuable immediate feedback information?

A) BS
B) HgbA₁c
C) OGTT
D) Clinitest

Answer 2

BS

Question 3

In diabetes insipidus, clinical manifestations are caused by a deficiency of

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

Answer 3

antidiuretic hormone (ADH).

Question 4

A patient has recently been diagnosed with acromegaly. Using Maslow's hierarchy, which of the nursing diagnoses listed below should be of the highest priority in caring for him?

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

Question 5

A 63-year-old patient on the medical floor has a diagnosis of adrenal hyperfunction (Cushing's syndrome). She will probably have to adhere to a diet that contains

A) less sodium.
B) more calories.
C) less potassium.
D) more carbohydrates.

Question 6

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

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

Question 7

A patient is admitted with a subtotal thyroidectomy. She is returned to the surgical unit after a short stay in the postanesthesia care unit. She is receiving fluids intravenously. When this patient has completely recovered from anesthesia, and her vital signs are stable, which position would be most appropriate for her?

A) Prone
B) Semi-Fowler's
C) Trendelenburg
D) Supine

Question 8

A patient, age 40, is having a diagnostic workup because of a possible disorder of the thyroid gland. The nurse noting the physician's orders recalls that there are several diagnostic tests to determine thyroid disorders. The test that employs radioactive iodine and use of a scintillation camera is called the

A) positron emission tomography (PET).
B) thyroid scan.
C) radioactive iodine uptake test (RAIU).
D) T3.

Question 9

The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of her exercise regimen. She now plans to enroll in a swimming class to meet her physical education requirement. Which adjustment in her treatment plan will the nurse help this patient make?

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

Question 10

Chvostek's sign and Trousseau's sign are tests to determine:

A) low levels of blood calcium.
B) high levels of blood calcium.
C) low levels of blood sodium.
D) high levels of blood sodium.

Question 11

A long-term complication of diabetes mellitus is

A) Cushing's disease.
B) renal failure.
C) hypothyroidism.
D) hyperglycemia.

Question 12

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

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

Question 13

A patient has asked why she needs to exercise. The nurse tells her that if the diabetic patient exercises, then the insulin requirement

A) increases.
B) decreases.
C) remains unchanged.
D) is changed to regular insulin.

Question 14

A patient has returned to his room after a thyroidectomy. He is presenting with signs and symptoms 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 15

What would be most necessary to place postoperatively at the bedside of the patient with a subtotal thyroidectomy?

A) Suction tray
B) Tracheotomy tray
C) Incentive spirometer
D) Water sealed drainage system

Question 16

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
C) Glycosylated hemoglobin (HbA₁c)
D) Postprandial glucose test

Question 17

The amount of hormone released by any gland is controlled by

A) a negative feedback system.
B) a positive feedback system.
C) exogenous stimuli.
D) the nervous system.

Question 18

A patient is diagnosed with hyperthyroidism. In the treatment of hyperthyroidism, which one of these medications is likely to be prescribed to decrease the activity of her thyroid gland?

A) Diazepam (Valium)
B) Liothyronine sodium (Cytomel)
C) Prednisone
D) Propylthiouracil

Question 19

Which nursing diagnosis is appropriate for a patient diagnosed with hypothyroidism as the result of a newly developed goiter?

A) Diarrhea
B) Hyperthermia
C) Disturbed body image
D) Increased cardiac output

Question 20

A patient is depressed about the changes in her personal appearance related to Cushing's disease. She is particularly likely to exhibit which change?

A) Weight gain, moonface, and increased facial hair
B) Hand tremors and nervousness
C) Retracted eyelids and increased skin pigmentation
D) Muscle atrophy, bruising, and weight loss

Question 21

The master gland of the endocrine system is the

A) thyroid.
B) parathyroid.
C) pancreas.
D) pituitary.

Question 22

A patient, age 61, has had type II diabetes for 20 years. He has symmetrical peripheral polyneuropathy of his feet and legs with almost total loss of sensitivity to touch and temperature. He also has peripheral vascular disease evidenced by decreased peripheral pulses and dependent rubor. To prevent injury and infection to this patient's feet and legs, which instruction does the nurse include in teaching?

A) He should soak his feet in warm water every day.
B) He should not go barefoot and should always wear shoes with soles.
C) The use of commercial keratolytic agents to remove corns and calluses is preferred to cutting off corns and calluses.
D) He should use a heating pad to warm his feet when they feel cool to the touch.

Question 23

The physician prescribes glyburide (Micronase, DiaBeta, Glynase) for a patient, age 57, when diet and exercise have not been able to control her type 2 diabetes. Which information does the nurse include when teaching her about the glyburide?

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

Question 24

The primary clinical manifestation of hyperparathyroidism is

A) hypocalcemia.
B) hypercalcemia.
C) hypoglycemia.
D) hyperglycemia.

Question 25

Hypothyroidism is treated with replacement therapy. The patient should be instructed to eat well-balanced meals including intake of iodine. Which food is rich in iodine?

A) Eggs
B) Dairy products
C) Bread and cereal
D) Fruit

Question 26

The three major life-threatening complications postoperatively of a thyroidectomy are: (Select all that apply)

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

Question 27

Common early signs and symptoms of diabetic ketoacidosis include

A) thirst and drowsiness.
B) cold, clammy skin and anxiety.
C) slow pulse and increased blood pressure.
D) bulging of the eyeballs and carpopedal spasms.

Question 28

A patient, age 28, has sought medical attention because her hands and feet have become enlarged. She also has noticed 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 29

Signs and symptoms of hypoglycemia include: (Select all that apply.)

A) irritability.
B) dry mouth.
C) tremors.
D) personality changes.
E) fruity breath.
F) deep respirations.

Question 30

A patient has type 1 diabetes (IDDM). The nurse is teaching her early signs and symptoms of insulin reaction, which include

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

Question 31

To prevent lipodystrophy, the nurse should administer insulin

A) at room temperature.
B) at body temperature.
C) straight from the refrigerator.
D) at any convenient temperature.

Question 32

A 47-year-old patient with hypothyroidism is being given discharge instructions that should include

A) taking his medication whenever symptoms cause discomfort.
B) decreasing fluid and fiber intake.
C) consuming foods rich in iron.
D) seeing his physician regularly for follow-up care.

Question 33

Pregnant women should not be exposed to iodine-131 because of

A) danger to the cardiac system.
B) danger to metabolism.
C) danger to the fetus.
D) danger to the reproductive system.

Question 34

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. The nurse suspects the patient has which medical emergency?

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

Question 35

Another term for hyperglycemic reaction is ____________ ______________.

Question 36

One of the side effects of administering calcium gluconate intravenously is

A) hypocalcemia.
B) hyperglycemia.
C) extravasation at the site.
D) paralysis after infusion.

Question 37

The adrenal cortex secretes glucocorticoids. The most important is cortisol. It is 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

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

A) frequent small meals high in carbohydrates.
B) calorie-restricted meals.
C) caffeine-rich beverages.
D) fluid restrictions.

Question 39

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

Question 40

The physician orders an 1,800-calorie diabetic diet and 40 units of (Humulin N) insulin U-100 subcutaneously daily for a patient with diabetes mellitus. A mid-afternoon snack of milk and crackers is given to

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

Question 41

Only ________insulin can be administered intravenously.

Question 42

A condition with a deficiency in growth hormone is called _____________ ____________.