Deck 32: Endocrine Clinical Assessment and Diagnostic Procedures

Question 1

A patient is being evaluated for thyroid dysfunction.His daily regular medications include aspirin,Lanoxin,and insulin.The nurse knows that the laboratory work may be affected by

A) the aspirin.
B) the Lanoxin.
C) the insulin.
D) none of the medications.

Answer 1

the aspirin.

Question 2

A 16-year-old young woman is admitted to the critical care unit with severe hyperglycemia caused by new-onset type 1 diabetes mellitus.The patient is complaining of headache and blurred vision.The nurse knows that these are signs that may indicate

A) kidney stones.
B) diabetes insipidus.
C) hypoglycemia.
D) hyperglycemia.

Answer 2

hyperglycemia.

Question 3

When evaluating the patient for a pituitary tumor,attention on the computed tomography scan should be focused on the

A) frontal lobe.
B) sella turcica.
C) temporal lobe.
D) anterior fossa.

Answer 3

sella turcica.

Question 4

Which of the following laboratory studies or diagnostic procedures is most useful in identifying central diabetes insipidus (DI)?

A) Skull radiographs
B) Serum glucose level
C) Water deprivation test
D) Antidiuretic hormone (ADH) stimulation test

Question 5

A nurse auscultates a bruit over the thyroid and knows that this indicates

A) normal function.
B) enlargement of the thyroid.
C) hypoplasia of the thyroid.
D) tumor of the thyroid.

Question 6

A 16-year-old young woman is admitted to the critical care unit with severe hyperglycemia caused by new-onset type 1 diabetes mellitus.The nurse notes a sweet-smelling odor on the patient's exhaled breath.This is a result of

A) compensation for metabolic alkalosis.
B) ketoacidosis.
C) prior ingestion of high-calorie foods.
D) decreased serum osmolality.

Question 7

Which of the following laboratory results is found in a patient with hyperglycemia?

A) Insulin level of 25 ?/mL
B) Absence of ketones in the urine
C) Presence of ketones in the blood
D) Serum osmolality of 270 mOsm/kg H?O

Question 8

Which of the following laboratory findings is indicative of thyrotoxicosis?

A) Very low thyroid-stimulating hormone (TSH)
B) Decreased T? uptake ratio
C) Increased serum osmolality
D) Decreased urine osmolality

Question 9

The patient weighed 62 kg on admission yesterday.Today the patient weighs 60 kg.The nurse knows this reflects a fluid loss of

A) 1 L.
B) 2 L.
C) 4 L.
D) 10 L.

Question 10

A patient with thyrotoxicosis may exhibit which of the following signs or symptoms?

A) Lethargy
B) Bradycardia
C) Constipation
D) Weight loss despite increased appetite

Question 11

Glycosylated hemoglobin levels provide information about

A) the average blood glucose level over the previous 3 to 4 months.
B) blood glucose levels in comparison with serum hemoglobin.
C) serial glucose readings after ingestion of a concentrated glucose solution.
D) the difference between serum and urine glucose levels.

Question 12

A normal HbA?c level for a normal person is

A) less than 5.4%.
B) less than 6.5%.
C) between 5.4% and 6.5%.
D) between 3% and 5.4%.

Question 13

A 16-year-old young woman is admitted to the critical care unit with severe hyperglycemia caused by new-onset type 1 diabetes mellitus.Which of the following signs and symptoms obtained as part of the patient's history might indicate the presence of hyperglycemia?

A) Recent episodes of tachycardia and missed heart beats
B) Decreased urine output accompanied by peripheral edema
C) Periods of hyperactivity with weight gain
D) Increased thirst and increased urinary output

Question 14

The nurse knows that a serum osmolality of 378 mOsm/kg indicates a patient who is

A) overhydrated.
B) normal.
C) dehydrated.
D) hypokalemic.

Question 15

A patient reports losing weight even though she eats "everything in sight." She also reports tremors and diarrhea.The nurse would suspect

A) hypothyroidism.
B) diabetes mellitus.
C) hyperthyroidism.
D) pancreatic tumor.

Question 16

A hydration assessment consists of checking a variety of parameters,including

A) skin turgor.
B) serum potassium level.
C) capillary refill.
D) serum protein level.

Question 17

The nurse knows that the best test to differentiate between central and nephrogenic DI is

A) the water deprivation test.
B) serum osmolality.
C) computed tomography scan.
D) the ADH test.

Question 18

The nurse knows that an abnormal response to the ADH test would be

A) a slight increase in urine osmolality.
B) a decrease in urine output.
C) a decrease in serum osmolality.
D) no change in urine osmolality.

Question 19

The patient has a fasting glucose level of 150 mg/dL.The nurse knows this value is

A) normal.
B) diagnostic of diabetes, but it should be re-evaluated for accuracy.
C) lower than what the nurse would expect in a patient receiving intravenous fluids.
D) elevated, indicating diabetic ketoacidosis.

Question 20

When preparing the patient for a serum ADH level,the nurse must withhold

A) insulin and furosemide.
B) morphine and carbamazepine.
C) Lanoxin and potassium.
D) heparin and beta-blockers.

Question 21

A patient with a decreased T? level but an elevated TSH level has

A) primary Cushing syndrome.
B) Addison disease.
C) thyrotoxicosis.
D) myxedema.

Question 22

Patients who are transplant recipients or who have chronic obstructive pulmonary disease or chronic inflammatory conditions may develop secondary Cushing syndrome because of

A) pharmacologic glucocorticoids.
B) pharmacologic mineralocorticoids.
C) cortisol.
D) aldosterone.

Question 23

Which hormone is secreted in response to physiologic stress as the result of infection or trauma?

A) Aldosterone
B) Adrenocorticotropic hormone (ACTH)
C) Cortisol
D) Antidiuretic hormone (ADH)

Question 24

Medications such as salicylates,lithium,and sulfonamides can influence thyroid levels by

A) increasing T?.
B) increasing T? .
C) decreasing T?.
D) decreasing T? .

Question 25

Which of the following laboratory tests will measure thyroid function?

A) Total serum triiodothyronine
B) Total serum thyroxine
C) Free urine TSH
D) Total urine thyroxine
E) Thyroglobulin
F) Free thyroxine

Question 26

A patient is admitted to the critical care unit with critical hypotension,hyperkalemia,hyponatremia,and hypoglycemia.The most likely cause of this is

A) myxedema.
B) diabetes insipidus.
C) addisonian crisis.
D) Cushing syndrome.

Question 27

Which of the following findings would you expect to see in the patient with hyperglycemia?

A) Anorexia
B) Abdominal pain
C) Bradycardia
D) Fluid overload
E) Change in level of consciousness
F) Kussmaul respirations

Question 28

A patient is admitted with an acute myocardial infarction and a history of thyroid dysfunction.The nurse knows that

A) no cardiac medications will affect the thyroid hormone levels.
B) heparin may decrease TSH.
C) dopamine may increase TSH.
D) morphine may decrease TSH.

Question 29

A patient is considered to have adrenal insufficiency

A) if the cortisol baseline value is below 10 mcg/dL.
B) if the rise from baseline cortisol level is less than 9 mcg/dL.
C) if the baseline cortisol value is between 10 and 15 mcg/dL.
D) if the rise from baseline cortisol value is between 10 and 15 mcg/dL.

Question 30

Clinical signs and symptoms of Cushing syndrome include

A) hirsutism.
B) rounded face.
C) hypotension.
D) decreased libido.
E) scleroderma.
F) fatigue and weakness.