Deck 31: Endocrine Clinical Assessment and Diagnostic Procedures

Question 1

A patient is reporting a headache,fatigue,abdominal pain,and blurred vision.The nurse knows that these signs may indicate the patient has what problem?

A) Hypothyroidism
B) Pituitary tumor
C) Cushing syndrome
D) Hyperglycemia

Answer 1

Hyperglycemia

Question 2

A patient has been admitted with abdominal pain.The nurse notes that the patient's fasting blood glucose is 120 mg/dL.Which statement regarding this finding is accurate?

A) This is a normal finding in critically ill patients.
B) This finding is indicative of prediabetes, but another test should be done to confirm.
C) This finding is lower than what the nurse would expect in a patient receiving intravenous fluids.
D) This finding is indicative of diabetic ketoacidosis.

Answer 2

This finding is indicative of prediabetes, but another test should be done to confirm.

Question 3

A patient is admitted with diabetic ketoacidosis.The nurse requests the practitioner order a glycosylated hemoglobin (HbA₁C).What information does this test provide to the health care team?

A) It is an indicator of the patient's average blood glucose level over the previous 3 to 4 months.
B) It compares blood glucose levels with serum hemoglobin over the previous 3 to 4 weeks.
C) It is an indicator of the patient's highest blood ketone level over the past month.
D) It associates the serum and urine glucose levels and is an indicator of kidney involvement.

Answer 3

It is an indicator of the patient's average blood glucose level over the previous 3 to 4 months.

Question 4

A patient is admitted with hypernatremia secondary to neurogenic diabetes insipidus.The nurse notes that the patient's serum osmolality is 350 mOsm/kg.What does this finding indicate?

A) The patient is overhydrated.
B) The patient's serum osmolality is normal.
C) The patient is dehydrated.
D) The patient is hypothyroid.

Question 5

The nurse is caring for a patient with a traumatic brain injury.Yesterday the patient weighed 62 kg and today the patient weighs 60 kg.How much fluid loss does this change in weight reflect?

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

Question 6

A patient has been admitted with a brain mass.The practitioner suspects it might be a pituitary tumor and orders a computed tomography (CT)scan.What area of brain should be scanned to confirm this diagnosis?

A) Frontal lobe
B) Base of the skull
C) Temporal lobe
D) Anterior fossa

Question 7

A patient is admitted with hypernatremia secondary to diabetes insipidus (DI).The practitioner suspects the patient has neurogenic DI.Which finding would confirm that diagnosis?

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 8

A patient has been admitted with uncontrolled atrial fibrillation and muscle wasting.The practitioner suspects the patient may have a thyroid disorder.The nurse auscultates a bruit over the thyroid.What does this finding indicate?

A) Normal function
B) Enlargement of the thyroid
C) Hypoplasia of the thyroid
D) Tumor of the thyroid

Question 9

A patient reports losing weight even though she eats "everything in sight." She also reports tremors and diarrhea.The nurse suspects the patient may have what problem?

A) Hypothyroidism
B) Diabetes mellitus
C) Hyperthyroidism
D) Pituitary tumor

Question 10

A nurse is teaching a patient with diabetes mellitus.The patient asks the nurse what is an acceptable HbA₁c level for him.What should the nurse tell the patient?

A) An acceptable level is less than 5.4%.
B) An acceptable level is less than 6.5%.
C) An acceptable level is determined by your practitioner.
D) It is dependent on your age.

Question 11

A patient is being evaluated for thyroid dysfunction.The patient's medications include aspirin,digoxin,chlorothiazide,and insulin.The nurse knows that the laboratory work may be affected by which of these medications?

A) Aspirin
B) Digoxin
C) Insulin
D) Chlorothiazide

Question 12

The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes.Which laboratory results would the nurse note confirming this diagnosis?

A) Hemoglobin A₁C of 3%
B) Absence of ketones in the urine
C) Presence of ketones in the blood
D) Fasting glucose of 105 mg/dL

Question 13

The nurse is caring for a patient with a traumatic brain injury.The nurse suspects the patient is developing diabetes insipidus.Which test or procedure would confirm this diagnosis?

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

Question 14

The nurse is caring for a patient who has been newly diagnosed with type 1 diabetes.The nurse notes that the patient is extremely dehydrated.To make this assessment,what did the nurse evaluate?

A) Skin turgor
B) Nail bed color
C) Capillary refill
D) Skin temperature

Question 15

A patient is admitted with severe hyperglycemia due to new-onset type 1 diabetes mellitus.The nurse notes a sweet-smelling odor on the patient's exhaled breath.What causes this phenomenon?

A) Metabolic alkalosis
B) Ketoacidosis
C) Glycosylation
D) Dehydration

Question 16

A patient is admitted with severe hyperglycemia due to new-onset type 1 diabetes mellitus.Which 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 17

A patient has been admitted who is suspected of having thyrotoxicosis.Which laboratory findings would confirm this diagnosis?

A) Very low thyroid-stimulating hormone (TSH)
B) Decreased T₃ uptake ratio
C) Increased serum osmolality
D) Decreased urine osmolality

Question 18

A patient is admitted with hypernatremia secondary to diabetes insipidus (DI).Which test would help the practitioner differentiate between central and nephrogenic DI?

A) Water deprivation test
B) Serum osmolality
C) Serum antidiuretic hormone level
D) Antidiuretic hormone (ADH) test

Question 19

A patient is admitted with hyponatremia.The practitioner suspects the patient may have syndrome of inappropriate secretion of antidiuretic hormone (SIADH)and orders a serum ADH level for the next morning.Which medications must be stopped or withheld at least 8 hours prior to the test?

A) Insulin and furosemide
B) Morphine and carbamazepine
C) Digoxin and potassium
D) Heparin and lopressor

Question 20

A patient has been admitted who is suspected of having thyrotoxicosis.Which symptom would support this diagnosis?

A) Lethargy despite adequate sleep
B) Bradycardia not related to medications
C) Constipation despite laxatives
D) Weight loss despite increased appetite

Question 21

A patient is diagnosed with a pheochromocytoma.What signs or symptoms might the nurse expect to see in this patient?

A) Hypertension and tachycardia
B) Weight gain and acne
C) Diarrhea and facial swelling
D) Blurred vision and poor skin turgor

Question 22

A patient has been admitted with uncontrolled atrial fibrillation and muscle wasting.The practitioner suspects the patient may have a thyroid disorder.The nurse anticipates the practitioner will initially order which diagnostic procedure to visualize the thyroid?

A) Magnetic resonance imaging (MRI)
B) Ultrasound
C) Biopsy
D) Computed tomography (CT)

Question 23

A patient was admitted with asthma who has been on steroids for a long time.The nurse knows that this patient is at risk of developing secondary Cushing syndrome.What would be the cause of this condition?

A) Pharmacologic glucocorticoids
B) Pharmacologic mineralocorticoids
C) Cortisol
D) Aldosterone

Question 24

A patient with thyrotoxicosis is admitted.Which laboratory tests would the nurse expect to be ordered for this patient?

A) Total serum triiodothyronine (TT₃)
B) Total serum thyroxine (TT₄)
C) Free urine thyroid stimulating hormone
D) Total urine thyroxine
E) Thyroglobulin (Tg)
F) Free thyroxine (T₄)

Question 25

A patient has been admitted with multiple trauma due to a motor vehicle accident several weeks ago.Given the prolonged critical illness,the nurse knows the patient may no longer secrete adequate amounts of what hormone?

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

Question 26

A patient is admitted with Cushing syndrome.Which findings would the nurse expect to note as confirming this diagnosis?

A) Hirsutism
B) Rounded face
C) Hypotension
D) Decreased libido
E) Scleroderma
F) Fatigue and weakness

Question 27

A patient is admitted with critical hypotension,hyperkalemia,hyponatremia,and hypoglycemia.The nurse knows that these symptoms are highly suggestive of which disorder?

A) Myxedema
B) Diabetes insipidus
C) Addisonian crisis
D) Cushing syndrome

Question 28

The nurse is managing a patient with hyperglycemia.Which findings would the nurse expect to note to support this diagnosis?

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

Question 29

A patient is being evaluated for thyroid dysfunction.The laboratory findings include a decreased serum free thyroxine (T₄)level and an elevated thyroid-stimulating hormone (TSH)level.These findings confirm which diagnosis?

A) Cushing syndrome
B) Addison disease
C) Thyrotoxicosis
D) Hypothyroidism

Question 30

A nurse is initiating a patient teaching plan for a patient with hypothyroidism.The patient is currently taking salicylates,lithium,and sulfonamides.It is important that the nurse tell the patient that these medications influence thyroid levels.How are thyroid levels affected by these medications?

A) They increase T₃
B) They increasing T₄
C) They decrease T₃
D) They decrease T₄