Deck 6: Pharmacology of Alterations in the Endo-crine System

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Question
The nurse is caring for a client who had been receiving supplemental cortisone. The client developed a bleeding ulcer, and the steroid was discontinued. The bleeding has stopped but the blood pressure remains unstable. The nurse recognizes that the unstable blood pressure is related to:
1) down-regulation of corticosteroid receptors.
2) up-regulation of epinephrine.
3) up-regulation of corticosteroid receptors.
4) down-regulation of epinephrine.
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Question
A client with hyperthyroidism has been reading about PTU on the internet. The client asks the nurse, "How do anti-hormones work to help my condition?" Which is the nurse's best response?
1) "Your body has been affected by too much thyroid hormone. PTU is a drug that can block your body's response to thyroid hormone."
2) "Anti-hormones oppose the action of estrogen, which allows thyroid to regain its effectiveness."
3) "PTU regenerates your thyroid gland and causes normal tissue to regrow, so the effects of too much thyroid will disappear."
4) "PTU replaces your abnormal thyroid hormone with normal thyroid hormone."
Question
The nurse notes that several clients prescribed supplemental thyroid hormone are all receiving different doses of the same drug. The nurse recognizes that this variation is mostly driven by:
1) the client's age and ethnicity.
2) the client's psychological status and acceptance of hormone therapy.
3) the number and sensitivity of the individual client's tissue receptors.
4) the client's height and weight.
Question
A client with an exacerbation of COPD is receiving steroid therapy in tapering doses. The nurse recognizes that this approach is medically appropriate because it applies what principle of up-regulation?
1) Up-regulation decreases the sensitivity of the cell-wall hormone receptors.
2) Up-regulation decreases the number of receptors on the cell-wall surface.
3) Up-regulation requires time for regrowth of cell-wall hormone receptors.
4) Up-regulation changes the configuration of cell-wall hormone receptors to allow them to bind better.
Question
A nurse is instructing an adolescent on the reproductive system. Which of the following hormones does the nurse explain is responsible for maturation of ovarian follicles ant the production of estrogen? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Follicle-stimulating hormone
2) Gonadotropin-releasing hormone
3) Adrenocorticotropic hormone
4) Antidiuretic hormone
5) Growth hormone
Question
The nurse is evaluating a client who is receiving a thyroid hormone supplement. The client's TSH level has gone down, and the T3 and T4 levels have increased. How does the nurse interpret these results?
1) The TSH, T3, and T4 all should have increased.
2) A decrease in the TSH is undesirable.
3) An increase in the T3 and T4 is undesirable.
4) A decrease in the TSH is desirable.
Question
A client with a pituitary defect is being treated for Addison disease with supplemental corticosteroids. The client develops signs and symptoms of Cushing syndrome. Which of the following is the mechanism responsible for this syndrome?
1) chemical messengers.
2) feedback mechanisms.
3) receptor sensitivity.
4) ACTH formation.
Question
The nurse in an endocrinology practice is seeing a client with low growth hormone levels. The client's history reveals extensive pituitary damage secondary to a large adenoma. The nurse recognizes that the client's small stature results from:
1) negative feedback from GH receptors.
2) an inability to respond to GH.
3) lack of tissue receptors for GH.
4) high levels of ACTH.
Question
The nurse is caring for a client with hyperglycemia. When choosing nursing interventions, the nurse is aware that a high serum blood sugar produces changes in the client's pancreas that are consistent with a:
1) hormonal stimulus.
2) humoral stimulus.
3) exocrine gland stimulus.
4) neuronal stimulus.
Question
The nurse is checking lab work on a client's record. The client's FSH and LH levels are low. What health problem related to these deficiencies does the nurse suspect?
1) growth and development.
2) nutrition and metabolism.
3) the reproductive system.
4) the renal system.
Question
A client with hypothyroidism is told by the health care provider that the thyroid-stimulating hormone level is elevated. The client says to the nurse, "I don't understand why my TSH is high. I thought I had low thyroid levels." The most appropriate response by the nurse is:
1) "You probably misunderstood your health care provider."
2) "TSH is a hormone released by the pituitary that signals your thyroid to make hormones."
3) "TSH is not thyroid hormone. When thyroid values are low, other lab tests are performed to assess how you tolerate the low levels."
4) "TSH is an incomplete thyroid hormone. Because it cannot bind to tissues, it builds up in the bloodstream."
Question
The nurse is assisting a postpartum client who is new to breastfeeding. Which hormonal mechanism is responsible for the production of breast milk?
1) Follicular-stimulating hormone binding to cells in the ovaries
2) Epinephrine binding to alpha receptors in the blood vessels of the chest wall
3) Luteinizing hormone binding to cells in the ovaries
4) Prolactin binding to receptors in the breast secretory cells
Question
The nurse is administering hormones to several clients. Which of the following represents an exaggerated response therapy?
1) Insulin to a client with diabetes mellitus
2) Vasopressin to a client with diabetes insipidus
3) Thyroid hormone to a client with a history of Graves disease
4) Corticosteroid to a client with lupus
Question
A child who is small-for-age is to receive supplemental injections of growth hormone. The mother of the client asks, "Why does my child have to take these shots? I read in the paper that hormones are dangerous." Which response by the nurse is most appropriate?
1) "There are some hormones that are dangerous, but given under medical supervision the medication may be beneficial."
2) "Are you worried that your child will get hooked on drugs?"
3) "Your child's pituitary gland is not making enough growth hormone. This hormone makes bones and muscles grow to normal size. The shots are safe."
4) "Your child's parathyroid glands are not making enough of a hormone called GH. The injection is very safe."
Question
The nurse is administering testosterone to a client with breast cancer. How does this treatment work?
1) Testosterone has a high affinity for rapidly dividing cancer cells.
2) Testosterone decreases the inflammation associated with rapid tumour growth.
3) Testosterone replicates the action of antineoplastic drugs without nausea.
4) Testosterone blocks the growth of estrogen-sensitive cancers.
Question
The nurse is caring for a client with hypocalcemia. In planning to meet the client's needs, the nurse would expect which alteration?
1) An increased level of parathyroid hormone
2) An increased level of corticotropin releasing hormone
3) A decreased level of parathyroid hormone
4) A decreased level of T3 and/or T4
Question
A client is diagnosed with a disorder of the pituitary gland. When reviewing this client's medical history, the nurse will identify which health problems as potential results of the pituitary disorder? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Diabetes insipidus
2) Acromegaly
3) Breast-feeding abnormalities
4) Graves disease
5) Addison disease
Question
When a client's blood sugar drops too low, the pancreas refrains from releasing insulin. The nurse caring for the client recognizes that the drop in insulin production is a result of:
1) positive feedback.
2) negative feedback.
3) up-regulation.
4) down-regulation.
Question
A client who is acutely ill is having difficulty maintaining a steady blood pressure. What hormonal mechanism takes immediate action when the client's blood pressure drops?
1) Aldosterone, released by the adrenal cortex to conserve water.
2) Cortisol, released by the adrenal cortex to raise blood sugar.
3) Insulin, released by the pancreas to increase energy production.
4) Epinephrine, released by the adrenal medulla to trigger vasoconstriction.
Question
While reviewing a medical record, the nurse notes that a client's ACTH levels are low. Which of the following levels will this deficit impact?
1) thyroxine.
2) insulin.
3) corticosteroids.
4) epinephrine.
Question
A nurse is giving a presentation on steroid abuse to a group of adolescents. One of the students comments that growth hormone is safe because it is a natural product. What is the best response of the nurse?
1) Growth hormone is more likely to be a drug of abuse among older individuals, because adolescents have sufficient growth hormone already present.
2) Adolescents rarely abuse growth hormone because it is not as readily available as anabolic steroids.
3) Adolescents might abuse growth hormone to improve their athletic performance or to impress others with their enhanced appearance.
4) Growth hormone is safe for adolescents to use but should not be used by anyone whose bone ends are fused.
Question
The nurse is assessing a client who is newly prescribed to receive supplemental growth hormone therapy. Which parameters should the nurse assess?
1) Bowel sounds, vitamin B12 level, and history of gallbladder disease
2) Height and weight, head circumference, and EKG
3) Blood sugar, blood pressure, height, and weight
4) Urine specific gravity, serum osmolality, and serum electrolytes
Question
A nurse is administering desmopressin to a client recovering from a head injury that increased pressure on the posterior pituitary gland. What assessment data will this drug impact?
1) Peripheral nervous system function, including reflexes
2) Cardiac function, including the conduction system
3) Urine output and blood pressure
4) The Glasgow coma scale
Question
The nurse is preparing to administer somatropin (Humatrope). In the process of planning care, the nurse is aware that the client is likely to experience what minor adverse effects?
1) Headache and joint ache
2) Nausea and vomiting
3) Diarrhea and increased flatus
4) Nasal congestion and flushing
Question
The nurse is teaching a client about the need for supplemental thyroid hormone following a hypophysectomy because of an anterior pituitary adenoma. The client says, "I thought thyroid hormone came from a gland in my neck." Which follow-up statement by the nurse is most appropriate?
1) "Your thyroid gland no longer gets messages from the pituitary."
2) "You will only need to take thyroid hormone until healing occurs."
3) "You need this hormone because your TSH is too high since surgery."
4) "Your thyroid gland was damaged because of the long surgical procedure."
Question
A nurse is assessing a client with the diagnosis of SIADH., a syndrome that results in an excessive production of ADH. How is this syndrome manifested in clients?
1) Severe overhydration.
2) Acute renal failure.
3) Severe dehydration.
4) A shock state.
Question
A nurse is explaining the need to track blood glucose levels to a client who will be receiving growth hormone injections. What effects will the growth hormone produce?
1) Increase insulin resistance.
2) Decrease blood glucose levels.
3) Promote very rapid growth.
4) Trigger type I diabetes mellitus.
Question
A client with SIADH, a syndrome where the pituitary produces an excess of ADH, is upset about being prescribed a fluid restriction. Which explanation by the nurse is most appropriate?
1) "Your IV fluids are providing you with the liquids you need. You should not be thirsty."
2) "Your body is retaining too much water. Decreasing your intake, along with the drugs will help correct the problem."
3) "Rinse your mouth with salt water. It will help to decrease your thirst."
4) "Your kidney is not working as it should. Decreasing your fluid intake allows your kidney to rest."
Question
The nurse is planning the discharge of a client with a known long-term deficit of ADH. What teaching is required about AHD supplements?
1) Self-administration of an every-third-day intramuscular preparation.
2) Self-administration of a weekly intravenous preparation.
3) Self-administration of an oral or intranasal preparation.
4) Self-administration of a daily subcutaneous preparation.
Question
The nurse is reviewing the pathophysiology of Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
1) Cells in the pancreas sense the level of glucose in the blood.
2) Depending on the level of glucose in the blood, the pancreas will either secrete insulin or stop the secretion of insulin.
3) Nerve impulses to the pancreas stimulate the release of insulin.
4) The pancreas reacts to other hormone levels in the blood.
5) Insulin is secreted in response to hormone levels within other digestive system organs.
Question
A client's hormone replacement therapy for a health problem has been discontinued. The nurse should instruct the client about which effects because the therapy has been stopped? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Body cells will need time to adjust to the new hormone level.
2) Target cells are desensitized and are less responsive to the effects of the hormone.
3) Body cells will create more receptors on the plasma membrane to capture hormone molecules.
4) Body cells will send signals that hormone action is needed.
5) Body cells will secrete more hormone.
Question
The nurse is caring for a client who had deep brain surgery that resulted in damage to the hypothalamus. Which of the following identifies the correct location of the hypothalamus?
1) Just anterior to the occipital lobe of the brain.
2) In the diencephalon, just above the brainstem.
3) Deep within the brainstem.
4) Within the parietal lobe of the brain.
Question
An adolescent client is prescribed nasal desmopressin for treatment of diabetes insipidus (DI). What signs and symptoms are important for the nurse to include when teaching client and family?
1) Acute renal failure.
2) Hypoglycemic reaction.
3) Liver failure.
4) Water intoxication.
Question
A client tells the nurse that because a hormone replacement medication "was not working," the client started taking double the prescribed dose. How should the nurse respond to this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) "The health care provider will need to be notified, because hormonal balance falls within a narrow range."
2) "It may take several days or longer to produce the desired effect."
3) "That was not a very wise thing to do."
4) "The wrong hormone replacement was prescribed."
5) "The health care provider would have probably made the same decision."
Question
A nurse is administering Lasix to a client with SIADH, a syndrome where the pituitary produces an excess of ADH. What is the desired outcome?
1) a decrease in serum potassium.
2) an increase in blood pressure.
3) a decrease in serum osmolality.
4) an increase in urine output.
Question
The nurse is reviewing the process of ovulation with nursing students at a fertility clinic. What will the nurse include in her teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Gonadotropin-releasing hormone stimulates the luteinizing hormone to stimulate ovulation.
2) Gonadotropin-releasing hormone stimulates luteinizing hormone to produce estrogen.
3) The presence of estrogen stops gonadotropin-releasing hormone from secreting more hormone.
4) The presence of estrogen signals the ovaries to continue releasing gonadotropin-releasing hormone.
5) Luteinizing hormone stimulates estrogen to release gonadotropin-releasing hormone for ovulation to occur.
Question
A client receiving hormone replacement therapy tells the nurse that the medication is "not working." How should the nurse respond to this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) "Hormones affect all body cells."
2) "It may take several days or longer to achieve optimum results."
3) "The medication should work immediately."
4) "The medication will be changed to one that works faster."
5) "The wrong hormone is being replaced."
Question
A client being treated for breast cancer is prescribed tamoxifen. What should the nurse instruct the client about this medication's mechanism of action? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) This medication is an anti-hormone.
2) This medication blocks the action of estrogen.
3) This medication replaces a hormone in the body.
4) This medication will shrink the breast tumour.
5) This medication will cause the breast cancer to become more aggressive.
Question
A preschool-age client is well nourished but is in the fourth percentile for height according to age. The nurse recognizes this client needs to be referred promptly because:
1) There is evidence the client has inadequate GH levels.
2) There is evidence the client has inadequate ACTH levels.
3) There is evidence the child has inadequate TSH levels.
4) There is evidence the child has inadequate FSH and LH levels.
Question
A client with metastatic abdominal cancer has become debilitated secondary to bowel-related signs and symptoms. The nurse is preparing to administer octreotide (Sandostatin). The nurse would anticipate:
1) A decrease in gastric reflux signs and symptoms.
2) A decrease in nausea and vomiting episodes.
3) Severe constipation and possible ileus.
4) aAdecrease in the number of diarrheal stools.
Question
When caring for a client with diabetes, what serum laboratory finding indicates that the client is breaking down fatty acids for energy?
1) Leukocytes
2) Protein
3) Glucose
4) Ketones
Question
What is the primary factor contributing to the development of type 2 diabetes?
1) age.
2) ethnicity.
3) a sedentary lifestyle.
4) obesity.
Question
A client is prescribed insulin via the intravenous (IV) route. Which insulin will the nurse administer to this client?
1) Glulisine
2) Humulin R
3) Aspart
4) Lispro
Question
When teaching a class on health promotion to a group of seniors, what does the nurse describe as risk factors for developing Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
1) Ethnicity
2) Age below 45
3) Obesity
4) Race
5) Family history
Question
Which drug would alter a client's ability to recognize the symptoms of hypoglycaemia?
1) Beta blockers
2) Antibiotics
3) Diuretics
4) Oral hypoglycaemic agents
Question
Which of the following allergies would be reported to the health care provider who has ordered Glyburide for a client?
1) Seafood
2) Milk products.
3) Eggs.
4) Sulfa drugs.
Question
The normal range for fasting serum glucose is between 4-7 mmol/L/, the body usually tightly regulates this level to:
1) 5-11 mmol/L.
2) 5-8 mmol/L.
3) 4- 9 mmolL.
4) 4-8 mmolL.
Question
The nurse realizes that a client with a growth hormone deficiency is not a candidate to receive somatropin (Humatrope) because of which health problems? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Sleep apnea
2) Morbid obesity
3) Chronic renal failure
4) Type 2 diabetes mellitus
5) Foot wound
Question
The nurse is concerned that a client prescribed octreotide (Sandostatin) is at risk for drug interactions because the client is currently prescribed which medications? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Antidiabetic agent
2) Beta blocker
3) Calcium channel blocker
4) Antidiarrheal
5) Antibiotics
Question
The nurse is instructing a client on the effects of insulin. What will the nurse include as the primary adverse effect?
1) Somogyi phenomenon
2) Swollen lymph glands
3) Hypoglycaemia
4) Urticaria
Question
An adult client is receiving treatment for a growth hormone deficiency. What effects of treatment will the nurse expect to assess in the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Increased lean body mass
2) Decreased fat mass
3) Increased bone mineral density
4) Decreased lipid levels
5) Decreased insulin resistance
Question
A client is prescribed the insulin with the slowest onset. Which insulin will the nurse administer to this client?
1) Glulisine
2) Regular
3) Aspart
4) Glargine
Question
What health teaching should the nurse provide a client who is diagnosed with diabetes? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Have eye examinations every 2 to 3 years.
2) Monitor blood pressure regularly.
3) Check feet daily for signs of irritation.
4) Maintain glucose control.
5) Quit smoking.
Question
An adult client diagnosed with a malfunctioning hypothalamus is experiencing hormone deficiencies. Which hormones will the nurse expect to be prescribed for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Thyroid hormone
2) Corticosteroids
3) Estrogen
4) Progesterone
5) Gonadotropin-releasing hormone
Question
A client is scheduled for a hemoglobin A1C laboratory test. The nurse explains to the client that this test monitors:
1) The percentage of glucagon in the blood.
2) The level of hemoglobin over time.
3) The percentage of glucose present in the blood.
4) The level of glucose over time.
Question
A nurse is instructing clients in a diabetes education class about glucose balance. What comment by the client indicates an understanding of how excess glucose taken in during meals is stored?
1) "Glucose that is not needed immediately is stored in the pancreas."
2) "Glucose not immediately needed is stored in the liver as glycogen."
3) "Glucose not needed is stored as fat."
4) "Glucose not immediately needed is stored as glucagon."
Question
A client with diabetes is experiencing polyuria. The nurse explains that polyuria is caused by:
1) inflammation of the glomerulus.
2) excessive fluid intake.
3) lack of albumin.
4) osmotic diuresis.
Question
When teaching a client about a prescribed second-generation sulfonylurea for blood glucose control, what does the nurse explain is the advantage of this over first generation sulfonylureas?
1) Exhibits fewer drug-drug interactions.
2) Does not cause hypoglycemia.
3) Can be administered in smaller doses.
4) Causes fewer adverse effects.
Question
A client is acutely confused, sweating, and complaining of a headache. The nurse suspects hypoglycaemia. How should the nurse respond?
1) Draw a serum blood glucose.
2) Prepare client for a glucose tolerance test.
3) Draw serum electrolytes.
4) Complete a capillary blood glucose level.
Question
The nurse is evaluating outcomes after administering desmopressin therapy. Which assessment finding is considered a desired outcome in an adult male client?
1) Urine output of 3,500 mL/day
2) Urine specific gravity of 1.015
3) Edema of lower extremities absent
4) Serum sodium 156 mmol/L
Question
Which of the following is considered the strongest stimuli responsible for a client's elevated thyroid hormone?
1) Hunger.
2) Exposure to cold.
3) Ongoing infection.
4) Hypocalcemia.
Question
How would the nurse explain the pathophysiologic etiology of cretinism to a client's family?
1) Lack of iodine replacement
2) Hypercalcemia from thyroid hyperplasia
3) Congenital hypofunction of the thyroid gland
4) Hypersecretion of the thyroid in the first six months of life
Question
The nurse is reviewing the results of a client's laboratory studies. Which of the following must be available to assist in the synthesis of thyroid hormones?
1) Cortisol.
2) Iodide.
3) Calcitonin.
4) Iodine.
Question
When administering insulin to a client, the nurse will rotate injection sites primarily to prevent:
1) Systemic absorption of insulin.
2) Lipodystrophy.
3) Abscess development.
4) Ineffective dosing.
Question
Which of the following medications may require an adjustment of insulin by the health care provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Beta blocker
2) Monoamine oxidase inhibitor
3) Angiotensin-converting enzyme inhibitor
4) Cardiac glycoside
5) Nonsteroidal anti-inflammatory agents
Question
Which statements indicate that instruction provided to a client with Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
1) "I should start any new exercise regimen slowly."
2) "I should exercise an hour after a meal."
3) "I should have a snack of 10 to 15 grams of carbohydrate before exercising."
4) "I should take 10- to 15-gram carbohydrate snacks with me to the gym if I plan to exercise longer than 30 minutes."
5) "I should withhold my routine insulin dose if I plan to exercise that day."
Question
The nurse is instructing a client on the role of the pancreas in controlling blood glucose levels. When does the pancreas excrete glucagon to maintain an adequate amount of glucose in the blood? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) During periods of fasting
2) During exercise
3) When drinking alcohol
4) After eating a large meal
5) When fighting an infection
Question
What should the nurse include when teaching a newly diagnosed client about insulin? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Rotate injection sites.
2) Recognize the signs of hypoglycaemia.
3) Store insulin in the freezer.
4) Carry a readily available supply of sugar.
5) Wear a medic alert bracelet that explains the client has diabetes.
Question
What dietary instructions should the nurse provide a client who is prescribed glyburide (DiaBeta)? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Avoid the intake of St John's Wort.
2) Avoid using garlic.
3) Drink decaffeinated beverages only.
4) Avoid green leafy vegetables.
5) Avoid the intake of ginseng.
Question
The student nurse administers a dose of lispro insulin to a client before breakfast at 0730. At 0735, the porter comes to take the client for a chest x-ray (CXR), the client will be off the floor for about 15 minutes. What is the best action of the student?
1) Cancel the CXR for today.
2) Give the client glucagon tabs and send for the CXR
3) Have the breakfast ready to give the client at 0800
4) Have the CXR delayed till after breakfast.
Question
Which laboratory value will the nurse monitor to determine the progression of a thyroid disease in a client?
1) TSH
2) T3
3) Iodine
4) T4
Question
The nurse decides to withhold a prescribed dose of metformin to a client after reviewing the medical record. For which conditions is this medication contraindicated or used with caution? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Impaired renal function
2) Recent alcohol intake
3) Hyperthyroidism
4) Septicemia
5) Sleep apnea
Question
Which diagnostic test would the nurse prepare a client for to detect malignancy of a thyroid nodule, the nurse would prepare the client for:
1) Thyroid scanning.
2) Ultrasound.
3) Needle biopsy.
4) X-ray.
Question
In which of the following conditions would the nurse expect to find elevated levels of T3 and T4?
1) Client with leukopenia.
2) Client with thrombocytopenia.
3) Client with hypo-albuminemia.
4) Client with hemolytic anemia.
Question
After an assessment, the nurse suspects that a client is experiencing signs of Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
1) Excessive urination
2) Excessive thirst
3) Blurred vision
4) Tingling of the fingers and toes
5) Itchy skin rash
Question
MCSA A nurse is conducting a class on diabetes to a group of newly diagnosed clients with Diabetes Type
1) The beta cells in my pancreas have been destroyed
2) I may eventually require insulin along with the pills I take now.
2) What statement by a client indicates more teaching is necessary?
3) More people have Type 2 diabetes than Type 1
4) Type 2 diabetes includes insulin resistance.
Question
What should the nurse teach a client with diabetes about how to reduce the risk of cardiovascular complications from the disorder? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Stop smoking.
2) Follow a low-fat diet.
3) Take blood pressure medication as prescribed.
4) Keep blood glucose levels within normal limits.
5) Prevent constipation.
Question
Which client statements indicate to the nurse that instruction about Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
1) "Exercise will improve insulin resistance."
2) "Eating a healthy diet will reverse insulin resistance."
3) "Exercise will cure type 2 diabetes mellitus."
4) "Eating a healthy diet will cure type 2 diabetes mellitus."
5) "I can eat anything I want as long as I take my medication exercise afterwards."
Question
Which symptom would the nurse anticipate the client with hypothyroidism to exhibit?
1) Constipation
2) Heat intolerance
3) Weight loss
4) Hypertension
Question
A client has low levels of T3 and T
1) Thyroid-stimulating hormone.
2) Tri-iodothyronine.
3) Thyrotropin-releasing hormone.
4) The nurse realizes that in response to these levels, the anterior pituitary will secrete:
4) Thyroxine.
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Deck 6: Pharmacology of Alterations in the Endo-crine System
1
The nurse is caring for a client who had been receiving supplemental cortisone. The client developed a bleeding ulcer, and the steroid was discontinued. The bleeding has stopped but the blood pressure remains unstable. The nurse recognizes that the unstable blood pressure is related to:
1) down-regulation of corticosteroid receptors.
2) up-regulation of epinephrine.
3) up-regulation of corticosteroid receptors.
4) down-regulation of epinephrine.
1
2
A client with hyperthyroidism has been reading about PTU on the internet. The client asks the nurse, "How do anti-hormones work to help my condition?" Which is the nurse's best response?
1) "Your body has been affected by too much thyroid hormone. PTU is a drug that can block your body's response to thyroid hormone."
2) "Anti-hormones oppose the action of estrogen, which allows thyroid to regain its effectiveness."
3) "PTU regenerates your thyroid gland and causes normal tissue to regrow, so the effects of too much thyroid will disappear."
4) "PTU replaces your abnormal thyroid hormone with normal thyroid hormone."
1
3
The nurse notes that several clients prescribed supplemental thyroid hormone are all receiving different doses of the same drug. The nurse recognizes that this variation is mostly driven by:
1) the client's age and ethnicity.
2) the client's psychological status and acceptance of hormone therapy.
3) the number and sensitivity of the individual client's tissue receptors.
4) the client's height and weight.
3
4
A client with an exacerbation of COPD is receiving steroid therapy in tapering doses. The nurse recognizes that this approach is medically appropriate because it applies what principle of up-regulation?
1) Up-regulation decreases the sensitivity of the cell-wall hormone receptors.
2) Up-regulation decreases the number of receptors on the cell-wall surface.
3) Up-regulation requires time for regrowth of cell-wall hormone receptors.
4) Up-regulation changes the configuration of cell-wall hormone receptors to allow them to bind better.
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5
A nurse is instructing an adolescent on the reproductive system. Which of the following hormones does the nurse explain is responsible for maturation of ovarian follicles ant the production of estrogen? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Follicle-stimulating hormone
2) Gonadotropin-releasing hormone
3) Adrenocorticotropic hormone
4) Antidiuretic hormone
5) Growth hormone
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6
The nurse is evaluating a client who is receiving a thyroid hormone supplement. The client's TSH level has gone down, and the T3 and T4 levels have increased. How does the nurse interpret these results?
1) The TSH, T3, and T4 all should have increased.
2) A decrease in the TSH is undesirable.
3) An increase in the T3 and T4 is undesirable.
4) A decrease in the TSH is desirable.
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7
A client with a pituitary defect is being treated for Addison disease with supplemental corticosteroids. The client develops signs and symptoms of Cushing syndrome. Which of the following is the mechanism responsible for this syndrome?
1) chemical messengers.
2) feedback mechanisms.
3) receptor sensitivity.
4) ACTH formation.
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8
The nurse in an endocrinology practice is seeing a client with low growth hormone levels. The client's history reveals extensive pituitary damage secondary to a large adenoma. The nurse recognizes that the client's small stature results from:
1) negative feedback from GH receptors.
2) an inability to respond to GH.
3) lack of tissue receptors for GH.
4) high levels of ACTH.
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9
The nurse is caring for a client with hyperglycemia. When choosing nursing interventions, the nurse is aware that a high serum blood sugar produces changes in the client's pancreas that are consistent with a:
1) hormonal stimulus.
2) humoral stimulus.
3) exocrine gland stimulus.
4) neuronal stimulus.
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10
The nurse is checking lab work on a client's record. The client's FSH and LH levels are low. What health problem related to these deficiencies does the nurse suspect?
1) growth and development.
2) nutrition and metabolism.
3) the reproductive system.
4) the renal system.
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11
A client with hypothyroidism is told by the health care provider that the thyroid-stimulating hormone level is elevated. The client says to the nurse, "I don't understand why my TSH is high. I thought I had low thyroid levels." The most appropriate response by the nurse is:
1) "You probably misunderstood your health care provider."
2) "TSH is a hormone released by the pituitary that signals your thyroid to make hormones."
3) "TSH is not thyroid hormone. When thyroid values are low, other lab tests are performed to assess how you tolerate the low levels."
4) "TSH is an incomplete thyroid hormone. Because it cannot bind to tissues, it builds up in the bloodstream."
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12
The nurse is assisting a postpartum client who is new to breastfeeding. Which hormonal mechanism is responsible for the production of breast milk?
1) Follicular-stimulating hormone binding to cells in the ovaries
2) Epinephrine binding to alpha receptors in the blood vessels of the chest wall
3) Luteinizing hormone binding to cells in the ovaries
4) Prolactin binding to receptors in the breast secretory cells
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13
The nurse is administering hormones to several clients. Which of the following represents an exaggerated response therapy?
1) Insulin to a client with diabetes mellitus
2) Vasopressin to a client with diabetes insipidus
3) Thyroid hormone to a client with a history of Graves disease
4) Corticosteroid to a client with lupus
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14
A child who is small-for-age is to receive supplemental injections of growth hormone. The mother of the client asks, "Why does my child have to take these shots? I read in the paper that hormones are dangerous." Which response by the nurse is most appropriate?
1) "There are some hormones that are dangerous, but given under medical supervision the medication may be beneficial."
2) "Are you worried that your child will get hooked on drugs?"
3) "Your child's pituitary gland is not making enough growth hormone. This hormone makes bones and muscles grow to normal size. The shots are safe."
4) "Your child's parathyroid glands are not making enough of a hormone called GH. The injection is very safe."
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15
The nurse is administering testosterone to a client with breast cancer. How does this treatment work?
1) Testosterone has a high affinity for rapidly dividing cancer cells.
2) Testosterone decreases the inflammation associated with rapid tumour growth.
3) Testosterone replicates the action of antineoplastic drugs without nausea.
4) Testosterone blocks the growth of estrogen-sensitive cancers.
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16
The nurse is caring for a client with hypocalcemia. In planning to meet the client's needs, the nurse would expect which alteration?
1) An increased level of parathyroid hormone
2) An increased level of corticotropin releasing hormone
3) A decreased level of parathyroid hormone
4) A decreased level of T3 and/or T4
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17
A client is diagnosed with a disorder of the pituitary gland. When reviewing this client's medical history, the nurse will identify which health problems as potential results of the pituitary disorder? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Diabetes insipidus
2) Acromegaly
3) Breast-feeding abnormalities
4) Graves disease
5) Addison disease
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18
When a client's blood sugar drops too low, the pancreas refrains from releasing insulin. The nurse caring for the client recognizes that the drop in insulin production is a result of:
1) positive feedback.
2) negative feedback.
3) up-regulation.
4) down-regulation.
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19
A client who is acutely ill is having difficulty maintaining a steady blood pressure. What hormonal mechanism takes immediate action when the client's blood pressure drops?
1) Aldosterone, released by the adrenal cortex to conserve water.
2) Cortisol, released by the adrenal cortex to raise blood sugar.
3) Insulin, released by the pancreas to increase energy production.
4) Epinephrine, released by the adrenal medulla to trigger vasoconstriction.
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20
While reviewing a medical record, the nurse notes that a client's ACTH levels are low. Which of the following levels will this deficit impact?
1) thyroxine.
2) insulin.
3) corticosteroids.
4) epinephrine.
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21
A nurse is giving a presentation on steroid abuse to a group of adolescents. One of the students comments that growth hormone is safe because it is a natural product. What is the best response of the nurse?
1) Growth hormone is more likely to be a drug of abuse among older individuals, because adolescents have sufficient growth hormone already present.
2) Adolescents rarely abuse growth hormone because it is not as readily available as anabolic steroids.
3) Adolescents might abuse growth hormone to improve their athletic performance or to impress others with their enhanced appearance.
4) Growth hormone is safe for adolescents to use but should not be used by anyone whose bone ends are fused.
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22
The nurse is assessing a client who is newly prescribed to receive supplemental growth hormone therapy. Which parameters should the nurse assess?
1) Bowel sounds, vitamin B12 level, and history of gallbladder disease
2) Height and weight, head circumference, and EKG
3) Blood sugar, blood pressure, height, and weight
4) Urine specific gravity, serum osmolality, and serum electrolytes
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23
A nurse is administering desmopressin to a client recovering from a head injury that increased pressure on the posterior pituitary gland. What assessment data will this drug impact?
1) Peripheral nervous system function, including reflexes
2) Cardiac function, including the conduction system
3) Urine output and blood pressure
4) The Glasgow coma scale
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24
The nurse is preparing to administer somatropin (Humatrope). In the process of planning care, the nurse is aware that the client is likely to experience what minor adverse effects?
1) Headache and joint ache
2) Nausea and vomiting
3) Diarrhea and increased flatus
4) Nasal congestion and flushing
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25
The nurse is teaching a client about the need for supplemental thyroid hormone following a hypophysectomy because of an anterior pituitary adenoma. The client says, "I thought thyroid hormone came from a gland in my neck." Which follow-up statement by the nurse is most appropriate?
1) "Your thyroid gland no longer gets messages from the pituitary."
2) "You will only need to take thyroid hormone until healing occurs."
3) "You need this hormone because your TSH is too high since surgery."
4) "Your thyroid gland was damaged because of the long surgical procedure."
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26
A nurse is assessing a client with the diagnosis of SIADH., a syndrome that results in an excessive production of ADH. How is this syndrome manifested in clients?
1) Severe overhydration.
2) Acute renal failure.
3) Severe dehydration.
4) A shock state.
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27
A nurse is explaining the need to track blood glucose levels to a client who will be receiving growth hormone injections. What effects will the growth hormone produce?
1) Increase insulin resistance.
2) Decrease blood glucose levels.
3) Promote very rapid growth.
4) Trigger type I diabetes mellitus.
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28
A client with SIADH, a syndrome where the pituitary produces an excess of ADH, is upset about being prescribed a fluid restriction. Which explanation by the nurse is most appropriate?
1) "Your IV fluids are providing you with the liquids you need. You should not be thirsty."
2) "Your body is retaining too much water. Decreasing your intake, along with the drugs will help correct the problem."
3) "Rinse your mouth with salt water. It will help to decrease your thirst."
4) "Your kidney is not working as it should. Decreasing your fluid intake allows your kidney to rest."
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29
The nurse is planning the discharge of a client with a known long-term deficit of ADH. What teaching is required about AHD supplements?
1) Self-administration of an every-third-day intramuscular preparation.
2) Self-administration of a weekly intravenous preparation.
3) Self-administration of an oral or intranasal preparation.
4) Self-administration of a daily subcutaneous preparation.
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30
The nurse is reviewing the pathophysiology of Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
1) Cells in the pancreas sense the level of glucose in the blood.
2) Depending on the level of glucose in the blood, the pancreas will either secrete insulin or stop the secretion of insulin.
3) Nerve impulses to the pancreas stimulate the release of insulin.
4) The pancreas reacts to other hormone levels in the blood.
5) Insulin is secreted in response to hormone levels within other digestive system organs.
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31
A client's hormone replacement therapy for a health problem has been discontinued. The nurse should instruct the client about which effects because the therapy has been stopped? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Body cells will need time to adjust to the new hormone level.
2) Target cells are desensitized and are less responsive to the effects of the hormone.
3) Body cells will create more receptors on the plasma membrane to capture hormone molecules.
4) Body cells will send signals that hormone action is needed.
5) Body cells will secrete more hormone.
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32
The nurse is caring for a client who had deep brain surgery that resulted in damage to the hypothalamus. Which of the following identifies the correct location of the hypothalamus?
1) Just anterior to the occipital lobe of the brain.
2) In the diencephalon, just above the brainstem.
3) Deep within the brainstem.
4) Within the parietal lobe of the brain.
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33
An adolescent client is prescribed nasal desmopressin for treatment of diabetes insipidus (DI). What signs and symptoms are important for the nurse to include when teaching client and family?
1) Acute renal failure.
2) Hypoglycemic reaction.
3) Liver failure.
4) Water intoxication.
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34
A client tells the nurse that because a hormone replacement medication "was not working," the client started taking double the prescribed dose. How should the nurse respond to this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) "The health care provider will need to be notified, because hormonal balance falls within a narrow range."
2) "It may take several days or longer to produce the desired effect."
3) "That was not a very wise thing to do."
4) "The wrong hormone replacement was prescribed."
5) "The health care provider would have probably made the same decision."
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35
A nurse is administering Lasix to a client with SIADH, a syndrome where the pituitary produces an excess of ADH. What is the desired outcome?
1) a decrease in serum potassium.
2) an increase in blood pressure.
3) a decrease in serum osmolality.
4) an increase in urine output.
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36
The nurse is reviewing the process of ovulation with nursing students at a fertility clinic. What will the nurse include in her teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Gonadotropin-releasing hormone stimulates the luteinizing hormone to stimulate ovulation.
2) Gonadotropin-releasing hormone stimulates luteinizing hormone to produce estrogen.
3) The presence of estrogen stops gonadotropin-releasing hormone from secreting more hormone.
4) The presence of estrogen signals the ovaries to continue releasing gonadotropin-releasing hormone.
5) Luteinizing hormone stimulates estrogen to release gonadotropin-releasing hormone for ovulation to occur.
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37
A client receiving hormone replacement therapy tells the nurse that the medication is "not working." How should the nurse respond to this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) "Hormones affect all body cells."
2) "It may take several days or longer to achieve optimum results."
3) "The medication should work immediately."
4) "The medication will be changed to one that works faster."
5) "The wrong hormone is being replaced."
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38
A client being treated for breast cancer is prescribed tamoxifen. What should the nurse instruct the client about this medication's mechanism of action? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) This medication is an anti-hormone.
2) This medication blocks the action of estrogen.
3) This medication replaces a hormone in the body.
4) This medication will shrink the breast tumour.
5) This medication will cause the breast cancer to become more aggressive.
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39
A preschool-age client is well nourished but is in the fourth percentile for height according to age. The nurse recognizes this client needs to be referred promptly because:
1) There is evidence the client has inadequate GH levels.
2) There is evidence the client has inadequate ACTH levels.
3) There is evidence the child has inadequate TSH levels.
4) There is evidence the child has inadequate FSH and LH levels.
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40
A client with metastatic abdominal cancer has become debilitated secondary to bowel-related signs and symptoms. The nurse is preparing to administer octreotide (Sandostatin). The nurse would anticipate:
1) A decrease in gastric reflux signs and symptoms.
2) A decrease in nausea and vomiting episodes.
3) Severe constipation and possible ileus.
4) aAdecrease in the number of diarrheal stools.
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41
When caring for a client with diabetes, what serum laboratory finding indicates that the client is breaking down fatty acids for energy?
1) Leukocytes
2) Protein
3) Glucose
4) Ketones
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42
What is the primary factor contributing to the development of type 2 diabetes?
1) age.
2) ethnicity.
3) a sedentary lifestyle.
4) obesity.
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43
A client is prescribed insulin via the intravenous (IV) route. Which insulin will the nurse administer to this client?
1) Glulisine
2) Humulin R
3) Aspart
4) Lispro
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44
When teaching a class on health promotion to a group of seniors, what does the nurse describe as risk factors for developing Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
1) Ethnicity
2) Age below 45
3) Obesity
4) Race
5) Family history
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45
Which drug would alter a client's ability to recognize the symptoms of hypoglycaemia?
1) Beta blockers
2) Antibiotics
3) Diuretics
4) Oral hypoglycaemic agents
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46
Which of the following allergies would be reported to the health care provider who has ordered Glyburide for a client?
1) Seafood
2) Milk products.
3) Eggs.
4) Sulfa drugs.
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47
The normal range for fasting serum glucose is between 4-7 mmol/L/, the body usually tightly regulates this level to:
1) 5-11 mmol/L.
2) 5-8 mmol/L.
3) 4- 9 mmolL.
4) 4-8 mmolL.
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48
The nurse realizes that a client with a growth hormone deficiency is not a candidate to receive somatropin (Humatrope) because of which health problems? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Sleep apnea
2) Morbid obesity
3) Chronic renal failure
4) Type 2 diabetes mellitus
5) Foot wound
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49
The nurse is concerned that a client prescribed octreotide (Sandostatin) is at risk for drug interactions because the client is currently prescribed which medications? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Antidiabetic agent
2) Beta blocker
3) Calcium channel blocker
4) Antidiarrheal
5) Antibiotics
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50
The nurse is instructing a client on the effects of insulin. What will the nurse include as the primary adverse effect?
1) Somogyi phenomenon
2) Swollen lymph glands
3) Hypoglycaemia
4) Urticaria
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51
An adult client is receiving treatment for a growth hormone deficiency. What effects of treatment will the nurse expect to assess in the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Increased lean body mass
2) Decreased fat mass
3) Increased bone mineral density
4) Decreased lipid levels
5) Decreased insulin resistance
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52
A client is prescribed the insulin with the slowest onset. Which insulin will the nurse administer to this client?
1) Glulisine
2) Regular
3) Aspart
4) Glargine
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53
What health teaching should the nurse provide a client who is diagnosed with diabetes? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Have eye examinations every 2 to 3 years.
2) Monitor blood pressure regularly.
3) Check feet daily for signs of irritation.
4) Maintain glucose control.
5) Quit smoking.
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54
An adult client diagnosed with a malfunctioning hypothalamus is experiencing hormone deficiencies. Which hormones will the nurse expect to be prescribed for this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Thyroid hormone
2) Corticosteroids
3) Estrogen
4) Progesterone
5) Gonadotropin-releasing hormone
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55
A client is scheduled for a hemoglobin A1C laboratory test. The nurse explains to the client that this test monitors:
1) The percentage of glucagon in the blood.
2) The level of hemoglobin over time.
3) The percentage of glucose present in the blood.
4) The level of glucose over time.
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56
A nurse is instructing clients in a diabetes education class about glucose balance. What comment by the client indicates an understanding of how excess glucose taken in during meals is stored?
1) "Glucose that is not needed immediately is stored in the pancreas."
2) "Glucose not immediately needed is stored in the liver as glycogen."
3) "Glucose not needed is stored as fat."
4) "Glucose not immediately needed is stored as glucagon."
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57
A client with diabetes is experiencing polyuria. The nurse explains that polyuria is caused by:
1) inflammation of the glomerulus.
2) excessive fluid intake.
3) lack of albumin.
4) osmotic diuresis.
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58
When teaching a client about a prescribed second-generation sulfonylurea for blood glucose control, what does the nurse explain is the advantage of this over first generation sulfonylureas?
1) Exhibits fewer drug-drug interactions.
2) Does not cause hypoglycemia.
3) Can be administered in smaller doses.
4) Causes fewer adverse effects.
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59
A client is acutely confused, sweating, and complaining of a headache. The nurse suspects hypoglycaemia. How should the nurse respond?
1) Draw a serum blood glucose.
2) Prepare client for a glucose tolerance test.
3) Draw serum electrolytes.
4) Complete a capillary blood glucose level.
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60
The nurse is evaluating outcomes after administering desmopressin therapy. Which assessment finding is considered a desired outcome in an adult male client?
1) Urine output of 3,500 mL/day
2) Urine specific gravity of 1.015
3) Edema of lower extremities absent
4) Serum sodium 156 mmol/L
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61
Which of the following is considered the strongest stimuli responsible for a client's elevated thyroid hormone?
1) Hunger.
2) Exposure to cold.
3) Ongoing infection.
4) Hypocalcemia.
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62
How would the nurse explain the pathophysiologic etiology of cretinism to a client's family?
1) Lack of iodine replacement
2) Hypercalcemia from thyroid hyperplasia
3) Congenital hypofunction of the thyroid gland
4) Hypersecretion of the thyroid in the first six months of life
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63
The nurse is reviewing the results of a client's laboratory studies. Which of the following must be available to assist in the synthesis of thyroid hormones?
1) Cortisol.
2) Iodide.
3) Calcitonin.
4) Iodine.
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64
When administering insulin to a client, the nurse will rotate injection sites primarily to prevent:
1) Systemic absorption of insulin.
2) Lipodystrophy.
3) Abscess development.
4) Ineffective dosing.
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65
Which of the following medications may require an adjustment of insulin by the health care provider? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Beta blocker
2) Monoamine oxidase inhibitor
3) Angiotensin-converting enzyme inhibitor
4) Cardiac glycoside
5) Nonsteroidal anti-inflammatory agents
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66
Which statements indicate that instruction provided to a client with Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
1) "I should start any new exercise regimen slowly."
2) "I should exercise an hour after a meal."
3) "I should have a snack of 10 to 15 grams of carbohydrate before exercising."
4) "I should take 10- to 15-gram carbohydrate snacks with me to the gym if I plan to exercise longer than 30 minutes."
5) "I should withhold my routine insulin dose if I plan to exercise that day."
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67
The nurse is instructing a client on the role of the pancreas in controlling blood glucose levels. When does the pancreas excrete glucagon to maintain an adequate amount of glucose in the blood? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) During periods of fasting
2) During exercise
3) When drinking alcohol
4) After eating a large meal
5) When fighting an infection
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68
What should the nurse include when teaching a newly diagnosed client about insulin? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Rotate injection sites.
2) Recognize the signs of hypoglycaemia.
3) Store insulin in the freezer.
4) Carry a readily available supply of sugar.
5) Wear a medic alert bracelet that explains the client has diabetes.
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69
What dietary instructions should the nurse provide a client who is prescribed glyburide (DiaBeta)? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Avoid the intake of St John's Wort.
2) Avoid using garlic.
3) Drink decaffeinated beverages only.
4) Avoid green leafy vegetables.
5) Avoid the intake of ginseng.
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70
The student nurse administers a dose of lispro insulin to a client before breakfast at 0730. At 0735, the porter comes to take the client for a chest x-ray (CXR), the client will be off the floor for about 15 minutes. What is the best action of the student?
1) Cancel the CXR for today.
2) Give the client glucagon tabs and send for the CXR
3) Have the breakfast ready to give the client at 0800
4) Have the CXR delayed till after breakfast.
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71
Which laboratory value will the nurse monitor to determine the progression of a thyroid disease in a client?
1) TSH
2) T3
3) Iodine
4) T4
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72
The nurse decides to withhold a prescribed dose of metformin to a client after reviewing the medical record. For which conditions is this medication contraindicated or used with caution? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Impaired renal function
2) Recent alcohol intake
3) Hyperthyroidism
4) Septicemia
5) Sleep apnea
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73
Which diagnostic test would the nurse prepare a client for to detect malignancy of a thyroid nodule, the nurse would prepare the client for:
1) Thyroid scanning.
2) Ultrasound.
3) Needle biopsy.
4) X-ray.
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74
In which of the following conditions would the nurse expect to find elevated levels of T3 and T4?
1) Client with leukopenia.
2) Client with thrombocytopenia.
3) Client with hypo-albuminemia.
4) Client with hemolytic anemia.
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75
After an assessment, the nurse suspects that a client is experiencing signs of Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
1) Excessive urination
2) Excessive thirst
3) Blurred vision
4) Tingling of the fingers and toes
5) Itchy skin rash
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76
MCSA A nurse is conducting a class on diabetes to a group of newly diagnosed clients with Diabetes Type
1) The beta cells in my pancreas have been destroyed
2) I may eventually require insulin along with the pills I take now.
2) What statement by a client indicates more teaching is necessary?
3) More people have Type 2 diabetes than Type 1
4) Type 2 diabetes includes insulin resistance.
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77
What should the nurse teach a client with diabetes about how to reduce the risk of cardiovascular complications from the disorder? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Stop smoking.
2) Follow a low-fat diet.
3) Take blood pressure medication as prescribed.
4) Keep blood glucose levels within normal limits.
5) Prevent constipation.
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78
Which client statements indicate to the nurse that instruction about Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
1) "Exercise will improve insulin resistance."
2) "Eating a healthy diet will reverse insulin resistance."
3) "Exercise will cure type 2 diabetes mellitus."
4) "Eating a healthy diet will cure type 2 diabetes mellitus."
5) "I can eat anything I want as long as I take my medication exercise afterwards."
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79
Which symptom would the nurse anticipate the client with hypothyroidism to exhibit?
1) Constipation
2) Heat intolerance
3) Weight loss
4) Hypertension
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80
A client has low levels of T3 and T
1) Thyroid-stimulating hormone.
2) Tri-iodothyronine.
3) Thyrotropin-releasing hormone.
4) The nurse realizes that in response to these levels, the anterior pituitary will secrete:
4) Thyroxine.
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Unlock Deck
Unlock for access to all 196 flashcards in this deck.