Question 1

Which question will provide the most useful information to a nurse who is interviewing a patient about a possible thyroid disorder?

Accepted Answer

Because thyroid function affects metabolic rate,changes in weight may indicate hyperfunction or hypofunction of the thyroid gland.Nocturia,visual difficulty,and changes in stress level are associated with other endocrine disorders.

Question 2

Which laboratory value should the nurse review to determine whether a patient's hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland?

Accepted Answer

A low TSH level indicates that the patient's hypothyroidism is caused by decreased anterior pituitary secretion of TSH.Low T₃ and T₄ levels are not diagnostic of the primary cause of the hypothyroidism.TRH levels indicate the function of the hypothalamus.

Question 3

Which action by a new registered nurse (RN)caring for a patient with a goiter and possible hyperthyroidism indicates that the charge nurse needs to do more teaching?

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 new RN are appropriate when caring for a patient with an enlarged thyroid.

Question 4

An 18-year-old male patient with a small stature is scheduled for a growth hormone stimulation test.In preparation for the test,the nurse will obtain

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 IV).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 5

A 35-year-old female patient with a possible pituitary adenoma is scheduled for a computed tomography (CT)scan with contrast media.Which patient information is most important for the nurse to communicate to the health care provider before the test?

Accepted Answer

Because the usual contrast media is iodine-based,the health care provider will need to know about the allergy before the CT scan.The other findings are common with any mass in the brain such as a pituitary adenoma.

Question 6

Which additional information will the nurse need to consider when reviewing the laboratory results for a patient's total calcium level?

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 affect total calcium interpretation.

Question 7

The nurse reviews a patient's glycosylated hemoglobin (Hb A₁C)results to evaluate

Accepted Answer

Glycosylated hemoglobin testing measures glucose control over the last 3 months.Glucose testing before/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

A 61-year-old female patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L).The nurse will anticipate the need to teach the patient about testing for _____ levels.

Accepted Answer

Parathyroid hormone is the major controller of blood calcium levels.Although calcitonin secretion is a countermechanism to parathyroid hormone,it does not play a major role in calcium balance.Catecholamine and thyroid hormone levels do not affect serum calcium level.

Question 9

A 44-year-old patient is admitted with tetany.Which laboratory value should the nurse monitor?

Accepted Answer

Tetany is associated with hypocalcemia.The other values would not be useful for this patient.

Question 10

During the physical examination of a 36-year-old female,the nurse finds that the patient's thyroid gland cannot be palpated.The most appropriate action by the nurse is to

Accepted Answer

The thyroid is frequently nonpalpable.The nurse should simply document the finding.There is no need to notify the health care provider immediately about a normal finding.There is no indication for thyroid-stimulating hormone (TSH)testing unless there is evidence of thyroid dysfunction.Deep palpation of the neck is not appropriate.

Question 11

Which information about a 30-year-old patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test?

Accepted Answer

Corticosteroids can affect blood glucose results.The other information will be provided to the health care provider but will not affect the test results.

Question 12

A nurse will teach a patient who is scheduled to complete a 24-hour urine collection for 17-ketosteroids to

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 13

Which statement by a 50-year-old female patient indicates to the nurse that further assessment of thyroid function may be necessary?

Accepted Answer

Difficulty in swallowing can occur with a goiter.Nocturia is associated with diseases such as diabetes mellitus,diabetes insipidus,or chronic kidney disease.Breast tenderness would occur with excessive gonadal hormone levels.Thirst is a sign of disease such as diabetes.

Question 14

A 40-year-old male patient has been newly diagnosed with type 2 diabetes mellitus.Which information about the patient will be most useful to the nurse who is helping the patient develop strategies for successful adaptation to this disease?

Accepted Answer

When dealing with a patient with a chronic condition such as diabetes,identification of the patient's values and beliefs can assist the health care team in choosing strategies for successful lifestyle change.The other information also will be useful,but is not as important in developing an individualized plan for the necessary lifestyle changes.

Question 15

A 30-year-old patient seen in the emergency department for severe headache and acute confusion is found to have a serum sodium level of 118 mEq/L.The nurse will anticipate the need for which diagnostic test?

Accepted Answer

Elevated levels of antidiuretic hormone will cause water retention and decrease serum sodium levels.The other tests would not be helpful in determining possible causes of the patient's hyponatremia.

Question 16

The nurse will teach a patient to plan to minimize physical and emotional stress while the patient is undergoing

Accepted Answer

Physical and emotional stress can affect the results of the free cortisol test.The other tests are not impacted by stress.

Question 17

A 22-year-old patient is being seen in the clinic with increased secretion of the anterior pituitary hormones.The nurse would expect the laboratory results to show

Accepted Answer

Increased secretion of adrenocorticotropic hormone (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 thyroid stimulating hormone (TSH)by the anterior pituitary.Aldosterone and catecholamine levels are not controlled by the anterior pituitary.

Question 18

A 29-year-old patient in the outpatient clinic will be scheduled for blood cortisol testing.Which instruction will the nurse provide?

Accepted Answer

Cortisol levels are usually drawn in the morning,when levels are highest.The other instructions would be given to patients who were having other endocrine testing.

Question 19

The nurse is caring for a 45-year-old male patient during a water deprivation test.Which finding is most important for the nurse to communicate to the health care provider?

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 20

A 60-year-old patient is taking spironolactone (Aldactone),a drug that blocks the action of aldosterone on the kidney,for hypertension.The nurse will monitor for

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,a decreased or normal serum sodium level,and signs of dehydration.

Quiz 44: Nursing Assessment: Endocrine System

Which question will provide the most useful information to a nurse who is interviewing a patient about a possible thyroid disorder?

Which laboratory value should the nurse review to determine whether a patient's hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland?

Which action by a new registered nurse (RN) caring for a patient with a goiter and possible hyperthyroidism indicates that the charge nurse needs to do more teaching?

An 18-year-old male patient with a small stature is scheduled for a growth hormone stimulation test.In preparation for the test,the nurse will obtain

A 35-year-old female patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media.Which patient information is most important for the nurse to communicate to the health care provider before the test?

Which additional information will the nurse need to consider when reviewing the laboratory results for a patient's total calcium level?

The nurse reviews a patient's glycosylated hemoglobin (Hb A₁C) results to evaluate

A 61-year-old female patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L) .The nurse will anticipate the need to teach the patient about testing for _____ levels.

A 44-year-old patient is admitted with tetany.Which laboratory value should the nurse monitor?

During the physical examination of a 36-year-old female,the nurse finds that the patient's thyroid gland cannot be palpated.The most appropriate action by the nurse is to

Which information about a 30-year-old patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test?

A nurse will teach a patient who is scheduled to complete a 24-hour urine collection for 17-ketosteroids to

Which statement by a 50-year-old female patient indicates to the nurse that further assessment of thyroid function may be necessary?

A 40-year-old male patient has been newly diagnosed with type 2 diabetes mellitus.Which information about the patient will be most useful to the nurse who is helping the patient develop strategies for successful adaptation to this disease?

A 30-year-old patient seen in the emergency department for severe headache and acute confusion is found to have a serum sodium level of 118 mEq/L.The nurse will anticipate the need for which diagnostic test?

The nurse will teach a patient to plan to minimize physical and emotional stress while the patient is undergoing

A 22-year-old patient is being seen in the clinic with increased secretion of the anterior pituitary hormones.The nurse would expect the laboratory results to show

A 29-year-old patient in the outpatient clinic will be scheduled for blood cortisol testing.Which instruction will the nurse provide?

The nurse is caring for a 45-year-old male patient during a water deprivation test.Which finding is most important for the nurse to communicate to the health care provider?

A 60-year-old patient is taking spironolactone (Aldactone) ,a drug that blocks the action of aldosterone on the kidney,for hypertension.The nurse will monitor for

Quiz 44: Nursing Assessment: Endocrine System

Which question will provide the most useful information to a nurse who is interviewing a patient about a possible thyroid disorder?

Which laboratory value should the nurse review to determine whether a patient's hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland?

Which action by a new registered nurse (RN) caring for a patient with a goiter and possible hyperthyroidism indicates that the charge nurse needs to do more teaching?

An 18-year-old male patient with a small stature is scheduled for a growth hormone stimulation test.In preparation for the test,the nurse will obtain

A 35-year-old female patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media.Which patient information is most important for the nurse to communicate to the health care provider before the test?

Which additional information will the nurse need to consider when reviewing the laboratory results for a patient's total calcium level?

The nurse reviews a patient's glycosylated hemoglobin (Hb A1C) results to evaluate

A 61-year-old female patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L) .The nurse will anticipate the need to teach the patient about testing for _____ levels.

A 44-year-old patient is admitted with tetany.Which laboratory value should the nurse monitor?

During the physical examination of a 36-year-old female,the nurse finds that the patient's thyroid gland cannot be palpated.The most appropriate action by the nurse is to

Which information about a 30-year-old patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test?

A nurse will teach a patient who is scheduled to complete a 24-hour urine collection for 17-ketosteroids to

Which statement by a 50-year-old female patient indicates to the nurse that further assessment of thyroid function may be necessary?

A 40-year-old male patient has been newly diagnosed with type 2 diabetes mellitus.Which information about the patient will be most useful to the nurse who is helping the patient develop strategies for successful adaptation to this disease?

A 30-year-old patient seen in the emergency department for severe headache and acute confusion is found to have a serum sodium level of 118 mEq/L.The nurse will anticipate the need for which diagnostic test?

The nurse will teach a patient to plan to minimize physical and emotional stress while the patient is undergoing

A 22-year-old patient is being seen in the clinic with increased secretion of the anterior pituitary hormones.The nurse would expect the laboratory results to show

A 29-year-old patient in the outpatient clinic will be scheduled for blood cortisol testing.Which instruction will the nurse provide?

The nurse is caring for a 45-year-old male patient during a water deprivation test.Which finding is most important for the nurse to communicate to the health care provider?

A 60-year-old patient is taking spironolactone (Aldactone) ,a drug that blocks the action of aldosterone on the kidney,for hypertension.The nurse will monitor for

The nurse reviews a patient's glycosylated hemoglobin (Hb A₁C) results to evaluate