Question 1

A patient was admitted with diabetic ketoacidosis (DKA).Glucose is 349 mg/dL,K⁺ is 3.7 mEq/L,and pH is 7.10.Which of the following interventions would you expect?

Accepted Answer

Dehydration is a common presenting issue in diabetic ketoacidosis (DKA),so the administration of fluids and insulin will help correct the hyperglycemia and acidosis.Sodium bicarbonate is not recommended unless the pH is less than 6.9.As dehydration is reversed,potassium moves back into the cells,and hypokalemia can result,so administration of replacement potassium is necessary.

Question 2

Patients who have sustained head trauma or have undergone resection of a pituitary tumor have an increased risk of developing which disorder?

Accepted Answer

Any patient who has head trauma or resection of a pituitary tumor has an increased risk of developing diabetes insipidus.

Question 3

In caring for a patient with a thyrotoxicosis,the nurse would expect to observe which neurologic symptom?

Accepted Answer

Agitation and the inability to rest are often found in a patient with thyrotoxic crisis.

Question 4

A patient has been diagnosed with syndrome of inappropriate secretion of antidiuretic hormone (SIADH).The nurse would expect the first line treatment to include which intervention?

Accepted Answer

Reduction in fluid intake is one component of the treatment plan for syndrome of inappropriate secretion of antidiuretic hormone (SIADH).

Question 5

A patient is admitted with syndrome of inappropriate secretion of antidiuretic hormone (SIADH).The nurse understands that the hyponatremia associated with this disorder is the result of which mechanism?

Accepted Answer

The patient with syndrome of inappropriate secretion of antidiuretic hormone (SIADH)has an excess of ADH secreted into the bloodstream,more than the amount needed to maintain normal blood volume and serum osmolality.Excessive water is resorbed at the kidney tubule,leading to dilutional hyponatremia.

Question 6

The neuroendocrine stress response produces which findings?

Accepted Answer

The fight-or-flight response,or sympathetic nervous response,releases catecholamine that causes an increased heart rate and blood pressure.Blood is shunted from nonessential organs such as the stomach,glucose is made available to the brain cells,and pain awareness is decreased.

Question 7

Patients discharged with antithyroid medications should be alerted to which potential side effect?

Accepted Answer

Patients discharged with antithyroid medications are alerted to the potential side effect of agranulocytosis.Symptoms of agranulocytosis include sudden cough,fever,rash,and inflammation.

Question 8

A patient has thyroid storm.The nurse is providing medication instruction for home.The patient asks,"If I have a fever,should I take Tylenol or aspirin?" Which response would be the most appropriate?

Accepted Answer

For management or elevated temperature,patients are instructed to use acetaminophen rather than salicylates because salicylates increase the amount of free thyroid hormone in circulation.

Question 9

Which finding is expected in the patient with hypothyroidism?

Accepted Answer

Anemia is a common problem that is present in 25% to 50% of patients with hypothyroidism.Symptoms of fatigue and depression are associated.Erythropoiesis (red blood cell production)is impaired and inadequate.Coagulation abnormalities may coexist.

Question 10

Decreased urine osmolality is a sign of which disorder?

Accepted Answer

Decreased urine osmolality is a sign of diabetes insipidus.

Question 11

The nurse is caring for a patient with myxedema coma.The patient's temperature is 93° F.Which intervention would the nurse include in the plan of care for this patient?

Accepted Answer

Hypothermia will gradually improve as the patient is treated with thyroid hormone.Several warm blankets comfortably wrapped around the patient (with mild hypothermia)may be sufficient to help raise the body temperature to normal.Active warming devices are also used.Continuous assessments are important to avoid too-rapid heating and vasodilation.

Question 12

A patient has been diagnosed with syndrome of inappropriate secretion of antidiuretic hormone (SIADH).The nurse is administering hypertonic saline.The nurse knows that the serum sodium should not be raised more than how many milliequivalents per day?

Accepted Answer

Serum sodium levels must be evaluated at least every 4 hours during the acute phase of sodium replacement.The serum sodium should not be raised more than 10 mEq/L in 24 hours.

Question 13

The nurse is caring for a patient with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH).Which findings would confirm this diagnosis?

Accepted Answer

Secretion of antidiuretic hormone (SIADH)occurs when there are increased levels of ADH in the blood compared with a low serum osmolality.

Question 14

Which medication can place a patient at risk for developing syndrome of inappropriate secretion of antidiuretic hormone (SIADH)?

Accepted Answer

Acetaminophen increases the release of antidiuretic hormone.

Quiz 32: Endocrine Disorders and Therapeutic Management

A patient was admitted with diabetic ketoacidosis (DKA) .Glucose is 349 mg/dL,K⁺ is 3.7 mEq/L,and pH is 7.10.Which of the following interventions would you expect?

Patients who have sustained head trauma or have undergone resection of a pituitary tumor have an increased risk of developing which disorder?

In caring for a patient with a thyrotoxicosis,the nurse would expect to observe which neurologic symptom?

A patient has been diagnosed with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) .The nurse would expect the first line treatment to include which intervention?

A patient is admitted with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) .The nurse understands that the hyponatremia associated with this disorder is the result of which mechanism?

The neuroendocrine stress response produces which findings?

Patients discharged with antithyroid medications should be alerted to which potential side effect?

A patient has thyroid storm.The nurse is providing medication instruction for home.The patient asks,"If I have a fever,should I take Tylenol or aspirin?" Which response would be the most appropriate?

Which finding is expected in the patient with hypothyroidism?

Decreased urine osmolality is a sign of which disorder?

The nurse is caring for a patient with myxedema coma.The patient's temperature is 93° F.Which intervention would the nurse include in the plan of care for this patient?

A patient has been diagnosed with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) .The nurse is administering hypertonic saline.The nurse knows that the serum sodium should not be raised more than how many milliequivalents per day?

The nurse is caring for a patient with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) .Which findings would confirm this diagnosis?

Which medication can place a patient at risk for developing syndrome of inappropriate secretion of antidiuretic hormone (SIADH) ?