Deck 39: Nursing Care of Patients With Endocrine Disorders

Question 1

A patient is newly diagnosed with diabetes insipidus. Which of the following medications should the nurse anticipate for long-term patient management?

A)Inderal (propranolol)
B)Calcium and vitamin D
C)Desmopressin acetate
D)Mithramycin

Answer 1

Desmopressin acetate

Question 2

The nurse is caring for a patient with a history of asthma who is newly diagnosed with hyperthyroidism. What assessment finding should the LPN report to the RN immediately?

A)Heart rate 112 beats/min
B)Respiratory rate 20 breaths/min
C)Blood pressure 112/73 mm Hg
D)Temperature 97.2°F (36.2°C)

Answer 2

Heart rate 112 beats/min

Question 3

The nurse is doing volunteer health screenings at a local mall. A patient with a large growth on the neck approaches. What finding should alert the nurse to send the patient to the physician immediately?

A)The growth is difficult to conceal with clothing.
B)The patient makes a funny high-pitched sound with each breath.
C)The patient complains of being very tired lately.
D)The patient seems depressed.

Answer 3

The patient makes a funny high-pitched sound with each breath.

Question 4

The nurse is preparing a patient for a thyroidectomy to treat hyperthyroidism. What statement by the patient indicates to the nurse that the patient understands the preoperative instructions?

A)"I know that I should avoid turning my head after surgery."
B)"I will need to increase my calorie intake after surgery to avoid weight loss."
C)"I will probably need thyroid replacement medication after surgery."
D)"I will avoid taking any thyroid or antithyroid drugs before surgery."

Question 5

A patient develops hyperparathyroidism related to a benign tumor. What laboratory result should the nurse expect to see?

A)Decreased serum potassium
B)Elevated serum potassium
C)Decreased serum calcium
D)Elevated serum calcium

Question 6

What is the most likely cause of tetany after thyroidectomy?

A)Excess circulating thyroid hormone released during manipulation of the gland during surgery
B)Swelling of the incisional area
C)Overdose of preoperative antithyroid medication
D)Accidental removal of the parathyroids during surgery

Question 7

While caring for a patient with diabetes insipidus, the nurse recognizes that treatment is effective when normal results are noted for which of the following laboratory values?

A)Fasting blood glucose
B)Serum potassium
C)Urine specific gravity
D)Urine ketones

Question 8

The nurse is caring for a patient following a thyroidectomy. Which postoperative assessment activity is most important in detecting thyrotoxic crisis?

A)Monitor the surgical dressing.
B)Monitor vital signs.
C)Assess hand grips and foot presses.
D)Assess for confusion and delirium.

Question 9

The nurse is caring for a patient with lung cancer who develops syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Which assessment findings does the nurse expect?

A)Weight gain and concentrated urine
B)Poor skin turgor and polyuria
C)Truncal obesity and thin extremities
D)Fatigue and weakness

Question 10

A patient is prescribed levothyroxine (Synthroid) for hypothyroidism. Which of the following statements should the nurse include when teaching the patient?

A)"Worsening hypothyroidism can result in a condition called myxedema coma, so it is important to take this medication."
B)"If you do not take your medication, you will retain water and begin to see swelling in your feet and legs."
C)"Thyrotoxicosis results from too little thyroid hormone, so you should monitor your temperature every day."
D)"Cushing's syndrome is a complication of severe hypothyroidism, so you need to take this medication regularly."

Question 11

The nurse is caring for a patient following a thyroidectomy. What item is most important to have at the bedside?

A)Hemostats
B)Tracheostomy set
C)Gauze dressings
D)Suture removal kit

Question 12

For which nursing diagnosis should the nurse assess in a patient with newly diagnosed acromegaly?

A)Imbalanced Nutrition
B)Ineffective Airway Clearance
C)Body Image Disturbance
D)Risk for Complications related to fluid imbalance

Question 13

A nurse is approached by a neighbor who has a neck growth that appears to be a goiter. What should the nurse do?

A)Palpate the neighbor's thyroid gland for enlargement or nodules.
B)Advise the neighbor to switch to iodized salt when cooking.
C)Question the neighbor about symptoms of hypothyroidism or hyperthyroidism.
D)Ask if the neighbor has numbness or tingling in the hands or lips.

Question 14

What data would best help the nurse to monitor a patient with diabetes insipidus?

A)Bowel sounds and abdominal girth
B)Intake and output and daily weight
C)Blood glucose before meals and at bedtime
D)Pupil responses and hand grasps

Question 15

The nurse is caring for a patient who underwent thyroid surgery the day before. The patient reports feeling numb around the mouth and experiencing random muscle twitches. The nurse anticipates the physician will order which of the following intravenous medications?

A)Sodium bicarbonate
B)Potassium chloride
C)Iodine
D)Calcium gluconate

Question 16

The nurse is caring for a patient who is newly diagnosed with acromegaly. Which treatment does the nurse anticipate?

A)Adrenalectomy
B)Administration of intravenous beta blockers
C)Irradiation or removal of the pituitary gland
D)Irradiation of the thyroid gland

Question 17

Which of the following symptoms would the nurse expect to observe in a patient diagnosed with hypothyroidism?

A)Anxiety and tachycardia
B)Dry skin and slowed heart rate
C)Increase in appetite and diarrhea
D)Tremor and oily skin

Question 18

The nurse is caring for a patient 6 hours after a thyroidectomy and notes the patient's temperature is 104°F, pulse is 144 beats per minute, respirations are 24 per minute, and blood pressure is 184/108 mm Hg. Which of the following orders does the nurse anticipate?

A)Beta blockers and a cooling blanket
B)Epinephrine and compression dressings
C)Aspirin and bedrest
D)Diphenhydramine (Benadryl) and Fowler's position

Question 19

The nurse is caring for a patient with exophthalmos secondary to Graves' disease. What nursing interventions are appropriate for this patient?

A)Myotic eyedrops and privacy
B)Television and other diversionary activities
C)Reassurance that the symptoms will resolve when the Graves' disease is under control
D)An accepting attitude and lubricating eyedrops

Question 20

A patient with hyperparathyroidism asks why ambulation three times per day is necessary because it is so difficult to do so. Which response by the nurse is best?

A)"Walking is important for preventing cardiovascular disease."
B)"Walking is good for you; I walk three times a day."
C)"Walking will keep the calcium where it belongs-in your bones."
D)"Walking is important to maintaining adequate serum calcium levels."

Question 21

A patient is admitted to the hospital with new-onset diabetes insipidus. Which of the following nursing diagnoses should the nurse include in the plan of care? (Select all that apply.?

A)Risk for Injury related to hypertension
B)Risk for Injury related to fractures
C)Risk for Deficient Fluid Volume
D)Impaired Gas Exchange related to decreased oxygenation
E)Knowledge Deficit related to disease process

Question 22

The LPN is caring for a patient with suspected hyperthyroidism who is scheduled for a radioactive iodine uptake test. What are symptoms of hyperthyroidism that the nurse should note on the medical record? (Select all that apply.?

A)Weight loss
B)Fatigue
C)Cold intolerance
D)Constipation
E)Tremor
F)Buffalo hump

Question 23

What are signs/symptoms of dilutional hyponatremia? (Select all that apply.?

A)Weak, slow pulse
B)Muscle weakness
C)Nausea
D)Constipation
E)Headache
F)Elevated blood pressure

Question 24

The nurse working in a primary care physician office recognizes which of the following individuals is at highest risk for iodine deficiency?

A)A 52-year-old vegan with dietary sodium restrictions
B)A 44-year-old lacto-vegetarian with a 40 pack-year smoking history
C)A 49-year-old with celiac disease who takes digoxin (Lanoxin)
D)A 28-year-old with lactose intolerance and a history of Graves' disease

Question 25

The nurse is assisting with discharge of a patient with Addison's disease following an addisonian crisis. Which instruction is most important for the nurse to reinforce?

A)The importance of taking steroid replacements as prescribed
B)How to monitor blood glucose levels
C)The need for a well-balanced diet
D)The importance of 30 minutes of exercise each day

Question 26

What is the most common cause of hyperthyroidism?

A)Multinodular goiter
B)Radiation exposure
C)Graves' disease
D)Excess thyrotropin-releasing hormone (TRH) from the hypothalamus

Question 27

The nurse is caring for a patient with diabetes insipidus. What type of intravenous fluid would the nurse expect to be ordered for fluid replacement?

A)Isotonic
B)Hypotonic
C)Hypertonic

Question 28

What disorder places the patient at risk for compression fractures?

A)Hyperparathyroidism
B)Hypoparathyroidism
C)Hyperthyroidism
D)Hypothyroidism

Question 29

Which intervention by the nurse is most important for a patient with symptoms of a pheochromocytoma?

A)Offer distraction such as television or music.
B)Encourage frequent intake of fluids.
C)Provide a calm, quiet environment.
D)Assist with ambulation at least three times a day.

Question 30

The LPN is assisting in the care of a 51-year-old woman recovering from a hypophysectomy. Which of the following, if noted by the nurse, would require immediate intervention?

A)Complaints of pain at a 5 on a scale of 0 to 10
B)Urinary output of 800 mL in 4 hours
C)Hemoglobin level of 13.2 g/dL
D)Urine specific gravity of 1.19

Question 31

A patient enters the emergency department in an addisonian crisis. Vital signs are blood pressure 85/52 mm Hg and pulse 88 beats/min. The patient is lethargic. Which event in the patient's week most likely precipitated this crisis?

A)Taking Tylenol for a headache
B)Maintaining usual exercise of walking each night
C)Eating a high-fat diet
D)Being laid off from a job

Question 32

What are good sources of calcium that should be included in dietary instruction for the patient who needs to follow a high-calcium diet? (Select all that apply.?

A)Milk, cheese, and yogurt
B)Beef and pork
C)Chicken
D)Sardines, salmon
E)Potatoes
F)Whole grain breads and cereals

Question 33

A patient with chronic obstructive pulmonary disease who is placed on corticosteroid therapy asks the nurse what the medication does. Which of the following responses by the nurse is best?

A)"The medication causes your airways to dilate."
B)"The medication is an expectorant that helps you cough up secretions."
C)"It is an anti-infective and helps kill bacteria."
D)"It is an anti-inflammatory agent that reduces the swelling in your airways."

Question 34

In addition to monitoring vital signs, which physical or laboratory result assessment is important for the nurse to monitor for a patient being given fludrocortisone for an adrenal disorder?

A)Serum calcium levels
B)Serum potassium levels
C)Serum magnesium levels
D)Thyroid hormone levels

Question 35

The LPN admits a well-known patient to the clinic and notes that the patient's face and features seem broader and more coarse. Which of the following laboratory tests would the nurse expect to be ordered?

A)Cortisol
B)Vanillylmandelic acid (VMA)
C)Growth hormone
D)Glucose tolerance test
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 36

The LPN is caring for a patient with diabetes insipidus and obtains a urine specific gravity reading of 1.002. Which response by the LPN is most important?

A)Document the results
B)Report the reading to the RN because therapy is ineffective
C)Report the reading to the RN because the patient may be receiving too much medication
D)Advise the patient to drink less water

Question 37

A patient is being discharged after a hypophysectomy, which was performed because of a tumor that resulted in acromegaly. What is important for the nurse to include in discharge teaching?

A)"Be sure to take your prescribed bromocriptine (Parlodel) every day."
B)"You must learn to accept the enlargement of soft tissues that occurred before surgery."
C)"Be sure to take the thyroid hormone, corticosteroids, and sex hormones that have been prescribed for you."
D)"Visual changes you experienced before surgery will begin to reverse within 6 months."

Question 38

A patient is being discharged with treatment for long-term hypoparathyroidism. What should the nurse include in discharge teaching? (Select all that apply.?

A)Eat a diet high in calcium.
B)Have regular eye examinations.
C)Eat a diet high in phosphates.
D)Follow up with regular laboratory tests.
E)Take oral calcium and vitamin D supplements as prescribed.
F)Add iron-rich foods to your diet.

Question 39

A patient with chronic obstructive pulmonary disease develops Cushing's syndrome related to long-term steroid use. The physician writes an order to discontinue the steroids. Which action by the nurse is most appropriate?

A)Monitor the patient's blood glucose level.
B)Monitor the patient's weight daily.
C)Instruct the patient to report worsening respiratory symptoms.
D)Question the order.

Question 40

The nurse develops a nursing diagnosis of "fluid volume excess related to sodium retention secondary to steroid therapy as evidenced by weight gain of 12 pounds in 2 weeks and edema of lower extremities." Which goal is most appropriate?

A)Patient will verbalize importance of low-sodium diet.
B)Patient will have improved fluid balance as evidenced by weight returning to baseline.
C)Patient's fluid volume will decrease as evidenced by discontinuing steroids.
D)Ankle circumference will be measured for edema daily.