Question 1

During a routine physical, a 30-year-old patient remarks, "I had to buy all new shoes because my feet are growing again." How should the nurse reply?

Accepted Answer

The nurse should inquire about changes in the hands because the patient's statement about feet growing could indicate acromegaly, a condition often associated with enlarged hands and feet due to excess growth hormone.

Question 2

The nurse notifies the health care provider that a patient is experiencing signs of myxedema. What assessment parameters has the nurse noted?. Select all that apply.

Accepted Answer

Signs of myxedema include facial swelling (A), macroglossia (C), and bradycardia (E). Anuria (B) and fever (D) are not typically associated with myxedema.

Question 3

The nurse would consider incorporating which nursing diagnoses into the plan of care for a patient with acute adrenal insufficiency?. Select all that apply.

Accepted Answer

Acute adrenal insufficiency can lead to hyponatremia due to low aldosterone levels, risk for injury due to weakness and fatigue, and imbalanced nutrition due to decreased appetite and gastrointestinal symptoms. Risk of ineffective therapeutic regimen management is relevant due to the need for lifelong hormone replacement therapy. Fluid volume excess is not typically associated with adrenal insufficiency; rather, fluid volume deficit is more common.

Question 4

A patient has been admitted for treatment of syndrome of inappropriate antiduretic hormone secretion (SIADH). The nurse expects continued diagnostic tests for which disorder?

Accepted Answer

SIADH is often associated with small cell carcinoma of the lung, so diagnostic tests will likely be focused on diagnosing or ruling out this cancer as the underlying cause of the patient's condition.

Question 5

The nurse is planning to present a community education session on advances in the diagnosis and treatment of endocrine disorders. Which topics should be included in this presentation?. Select all that apply.

Accepted Answer

A) More sensitive technology for hormonal assays: This topic should be included as advances in hormonal assays have allowed for more accurate and precise diagnosis of endocrine disorders.

B) Development of new synthetic hormones: This topic should be included as the development of synthetic hormones has allowed for the treatment of previously untreatable endocrine disorders.

C) Standardized methods to prevent endocrine disorders: While important, this topic may not be directly related to advances in the diagnosis and treatment of endocrine disorders, so it may not be a necessary inclusion in the presentation.

D) New diagnostic imaging technologies: This topic should be included as advances in diagnostic imaging technologies have allowed for improved and more efficient diagnosis of endocrine disorders.

E) Improvements in surgical techniques: This topic should be included as improvements in surgical techniques have allowed for more effective and less invasive treatments for endocrine disorders.

Question 6

A 70-year-old patient is prescribed levothyroxine for treatment of hypothyroidism. The nurse would expect which age-related adjustment in dosage?

Accepted Answer

Older adults are at increased risk for adverse effects from levothyroxine, such as cardiac arrhythmias, due to changes in metabolism and decreased organ function. Therefore, the initial dose is typically lower in older adults and titrated slowly to achieve therapeutic effects. Dosage adjustments may also need to be made based on age-related changes in body weight and coexisting medical conditions.

Question 7

A patient with hypoparathyroidism has a low serum calcium level. How would the nurse test for the clinical manifestation consistent with this laboratory result?. Select all that apply.

Accepted Answer

The nurse can test for Chvostek's sign by tapping over the facial nerve (C) and Trousseau's sign by inflating a blood pressure cuff on the arm (B), both of which are indicative of hypocalcemia.

Question 8

A patient with Graves' disease is brought to the emergency department by her husband. He says that the couple have both had the flu and that she "has not been able to keep anything down for about 3 days." The patient has a temperature of 103ºF, heart rate is 124bpm, respiratory rate 20, and blood pressure 150/88 mmHg. She complains of severe nausea and is very agitated. Which actions should the nurse take?. Select all that apply.

Accepted Answer

The answer of A patient with Graves' disease is brought...

Question 9

When measuring the blood pressure of a patient with hypoparathyroidism, the nurse notes spasms of the patient's hand. How should the nurse document this finding?

Accepted Answer

Spasms of the hand when taking blood pressure may indicate a positive Trousseau's sign, which is a sign of hypoparathyroidism. Chvostek's sign involves facial muscle spasms and is not related to hand spasms. Turner's sign refers to bruising over the flanks and Cullen's sign refers to bruising around the umbilicus, neither of which are relevant in this scenario.

Question 10

A patient has been prescribed the synthetic hormone levothyroxine. What medication instructions should the nurse provide?. Select all that apply.

Accepted Answer

It is important for the patient to take levothyroxine consistently and not switch brands without discussing with their healthcare provider (C). Levothyroxine is typically taken every day for life (D). Taking the medication at least 4 hours before antacids containing calcium is important as calcium can interfere with levothyroxine absorption (E). It is not necessary to take the medication with juice or milk (A) and a stool softener may not be needed for everyone taking levothyroxine (B).

Question 11

Which interventions would the nurse plan to address the nursing diagnosis Risk for Impaired Skin Integrity for a patient with hypothyroidism?. Select all that apply.

Accepted Answer

Hypothyroidism can cause dry skin and poor wound healing, putting the patient at risk for impaired skin integrity. Applying emollient skin lotion twice daily can help moisturize the skin and improve skin resilience. Assessing the need for an alternating air mattress can help prevent pressure ulcers, which may be more difficult to heal in a patient with hypothyroidism. Washing daily with antibacterial soap and using astringent wipes can be too harsh on the skin and may further damage the skin's protective barrier. Cleaning areas between skin folds with alcohol can also be too harsh on the skin and is not recommended.

Question 12

An older adult is diagnosed with apathetic thyrotoxicosis. Which nursing diagnosis would the nurse prioritize in this patient's care plan?

Accepted Answer

Apathetic thyrotoxicosis, especially in older adults, often presents with symptoms like weakness, apathy, and lethargy, which can increase the risk of falls due to decreased strength and balance. Anxiety and depression may be relevant but are not as directly impacted by the condition as the physical risk of injury. Decreased tissue perfusion is not a primary concern with apathetic thyrotoxicosis.

Question 13

Following surgery for hypersecretion of growth hormone, a patient complains of a supraorbital headache. The nurse suspects a possible CSF leak and would take which actions?. Select all that apply.

Accepted Answer

Testing nasal drainage for glucose can help identify CSF leaks. Bed rest and elevating the head of the bed can help reduce CSF pressure and promote healing. Administering antibiotics can prevent infection if a CSF leak is present.

Quiz 46: Caring for the Patient With Glandular and Hormonal Disorders