Question 1

A patient is scheduled for a growth hormone stimulation test. In preparation for the test, the nurse will obtain a&#10;A) vial of 50% dextrose solution.&#10;B) vial of glargine insulin.&#10;C) cardiac monitor.&#10;D) basin of ice.

Accepted Answer

Hypoglycemia is induced during the growth hormone stimulation test, and the nurse should be ready to administer 50% dextrose immediately. Regular insulin is used to induce hypoglycemia (glargine is never given intravenously). The patient does not require cardiac monitoring during the test. Although blood samples for some tests must be kept on ice, this is not true for the growth hormone stimulation test.

Question 2

A patient is scheduled for a 24-hour urine collection for 17-ketosteroids. The nurse will plan to&#10;A) insert a retention catheter.&#10;B) keep the specimen on ice.&#10;C) have the patient void and save that specimen to start the collection.&#10;D) encourage the patient to drink 2 to 3 L of fluid during the 24 hours.

Accepted Answer

The specimen must be kept on ice or refrigerated until the collection is finished. Voided or catheterized specimens are acceptable for the test. The initial voided specimen is discarded. There is no fluid intake requirement for the 24-hour collection.

Question 3

When the nurse is describing the effects of insulin on the body to a patient newly diagnosed with diabetes mellitus, the best explanation is,&#10;A) &#34;Insulin helps keep your blood sugar levels from dropping too low.&#34;&#10;B) &#34;Insulin promotes the cellular transport and storage of foods you eat.&#34;&#10;C) &#34;Insulin breaks down foods into simple sugars you can use for energy.&#34;&#10;D) &#34;Insulin is used inside the cells to transform fats and proteins into sugar.&#34;

Accepted Answer

Insulin is an anabolic hormone that assists with the transport of nutrients into cells and their synthesis into glycogen, triglycerides, and proteins. Insulin decreases blood glucose and can lead to hypoglycemia. Insulin transports glucose and enhances the conversion of glucose to storage forms such as glycogen. Insulin assists in the synthesis of fats and proteins.

Question 4

When caring for a patient having a water deprivation test, which assessment obtained by the nurse will be of most concern?&#10;A) The patient complains of intense thirst.&#10;B) The patient has a 5-lb weight loss.&#10;C) The patient feels dizzy when sitting up on the edge of the bed.&#10;D) The patient's urine osmolality does not change after ADH is given.

Accepted Answer

A drop in the weight of more than 2 kg indicates severe dehydration, and the test should be discontinued. The other assessment data are not unusual with this test.

Question 5

When a patient is taking spironolactone (Aldactone), a drug that blocks the action of aldosterone on the kidney, the nurse will monitor for&#10;A) decreased urinary output.&#10;B) increased serum sodium levels.&#10;C) evidence of fluid overload.&#10;D) elevated serum potassium levels.

Accepted Answer

Because aldosterone increases the excretion of potassium, a medication that blocks aldosterone will tend to cause hyperkalemia. Aldosterone also promotes the reabsorption of sodium and water in the renal tubules, so spironolactone will tend to cause increased urine output, decreased or normal serum sodium level, and signs of dehydration.

Question 6

When evaluating the laboratory findings of a patient with increased secretion of the anterior pituitary hormones, the nurse would expect to find&#10;A) an increase in urinary free cortisol.&#10;B) decreased serum thyroxine levels.&#10;C) elevated serum aldosterone levels.&#10;D) low urinary excretion of catecholamines.

Accepted Answer

Increased secretion of ACTH by the anterior pituitary gland will lead to an increase in serum and urinary cortisol levels. An increase, rather than a decrease, in thyroxine level would be expected with increased secretion of TSH by the anterior pituitary. Aldosterone and catecholamine levels are not controlled by the anterior pituitary.

Question 7

When working with a patient who has diabetes mellitus, the nurse reviews the results of testing for glycosylated hemoglobin (Hb A1C) to evaluate for&#10;A) glucose levels 2 hours after a meal.&#10;B) glucose control over the past 3 months.&#10;C) circulating, nonfasting glucose levels.&#10;D) hypoglycemic episodes in the past 90 days.

Accepted Answer

Glycosylated hemoglobin testing measures glucose control over the last 3 months. Glucose testing after a meal or random testing may reveal impaired glucose tolerance and indicate prediabetes, but it is not done on patients who already have a diagnosis of diabetes. There is no test to evaluate for hypoglycemic episodes in the past.

Question 8

When caring for a patient who has just had a parathyroidectomy, the nurse will plan to monitor the patient for&#10;A) low serum calcium level.&#10;B) low magnesium level.&#10;C) increased levels of active vitamin D.&#10;D) increased levels of calcitonin.

Accepted Answer

Serum calcium levels are likely to fall after a parathyroidectomy, and it will be important to monitor the calcium level to avoid tetany. Magnesium and vitamin D levels impact parathyroid function, but these will not be relevant after a parathyroidectomy. Calcitonin is secreted by the thyroid gland.

Question 9

Which action taken by a nursing student when caring for patient with thyroiditis and a goiter requires that the nurse intervene immediately?&#10;A) The student checks the blood pressure on both arms.&#10;B) The student lowers the thermostat to decrease the temperature in the room.&#10;C) The student palpates the neck to check thyroid size.&#10;D) The student orders nonmedicated eye drops to lubricate the patient's eyes.

Accepted Answer

Palpation can cause the release of thyroid hormones in a patient with an enlarged thyroid and should be avoided. The other actions by the student are appropriate when caring for a patient with an enlarged thyroid.

Question 10

When reviewing the laboratory results for a patient's total calcium level, which information will the nurse need to consider?&#10;A) The serum albumin level is low.&#10;B) The phosphate level is normal.&#10;C) The blood glucose is elevated.&#10;D) The total protein is decreased.

Accepted Answer

Part of the total calcium is bound to albumin, so hypoalbuminemia can lead to misinterpretation of calcium levels. The other laboratory values will not impact on total calcium interpretation.

Question 11

A patient has been diagnosed with diabetes mellitus. During assessment of the patient's functional health patterns, the nurse recognizes that an ability to manage the many lifestyle changes associated with diabetes is best reflected by the patient's responses to questions related to

A) activity-exercise.
B) role-relationship.
C) nutritional-metabolic.
D) value-belief.

Accepted Answer

The answer of A patient has been diagnosed with diabetes...

Question 12

The nurse will plan patient care that will decrease the patient's physical and emotional stress when the patient is undergoing&#10;A) a water deprivation test.&#10;B) testing for serum T3 and T4 levels.&#10;C) a 24-hour urine test for free cortisol.&#10;D) a radioactive iodine (I-131) uptake test.

Accepted Answer

The answer of The nurse will plan patient care that...

Question 13

During assessment of a patient's functional health patterns, a question by the nurse that addresses thyroid function is,&#10;A) &#34;Do you have to get up at night to empty your bladder?&#34;&#10;B) &#34;Have you experienced any blurring or double vision?&#34;&#10;C) &#34;Do you experience fatigue even if you have slept a long time?&#34;&#10;D) &#34;Can you describe the amount of stress you have at home and work?&#34;

Accepted Answer

The answer of During assessment of a patient's functional health...

Question 14

During a physical examination, the nurse finds that a patient's thyroid gland cannot be palpated. The most appropriate action by the nurse is to&#10;A) document that the thyroid was nonpalpable.&#10;B) notify the health care provider about the finding.&#10;C) teach the patient about the purpose of thyroid-stimulating hormone (TSH) testing.&#10;D) palpate the patient's neck more deeply.

Accepted Answer

The answer of During a physical examination, the nurse finds...

Question 15

A patient has clinical manifestations of hypothyroidism. To determine whether the low thyroid level is caused by a problem with the anterior pituitary gland or with the thyroid gland, which value will the nurse check in the patient's chart?

A) Thyroxine (T₄) level
B) Triiodothyronine (T₃) level
C) Thyrotropin-releasing hormone (TRH) level
D) TSH level

Accepted Answer

The answer of A patient has clinical manifestations of hypothyroidism....

Question 16

The health care provider has ordered a serum cortisol level to rule out adrenal dysfunction in a patient who works at night from 11:00 PM to 7:00 AM and normally sleeps from 8:00 AM to 4:00 PM. To ensure the most reliable test results, the nurse arranges the blood specimen to be drawn

A) in the early morning.
B) in the late afternoon.
C) at 3:00 AM.
D) at 11:00 PM.

Accepted Answer

The answer of The health care provider has ordered a...

Question 17

When obtaining the health history, which statement by a patient indicates that the nurse should assess further for a possible problem with the thyroid gland?&#10;A) &#34;I have noticed difficulty in swallowing.&#34;&#10;B) &#34;I get up several times at night to urinate.&#34;&#10;C) &#34;I notice my breasts are tender lately.&#34;&#10;D) &#34;I drink about a gallon of water a day.&#34;

Accepted Answer

The answer of When obtaining the health history, which statement...

Question 18

A patient has a total serum calcium level of 13.3 mg/dl (6.7 mEq/L, 3.3 mmol/L). The nurse understands that this level of calcium normally&#10;A) indicates hypothyroidism.&#10;B) stimulates the secretion of calcitonin.&#10;C) occurs when the parathyroid gland is surgically removed.&#10;D) results from oversecretion of calcitonin from the thyroid gland.

Accepted Answer

The answer of A patient has a total serum calcium...

Question 19

When a patient eats a bag of potato chips, the nurse recognizes that hypernatremia is likely to occur if the patient is experiencing a decreased production of&#10;A) cortisol.&#10;B) aldosterone.&#10;C) pancreatic somatostatin.&#10;D) antidiuretic hormone (ADH).

Accepted Answer

The answer of When a patient eats a bag of...

Deck 48: Nursing Assessment: Endocrine System