Deck 39: Nursing Care of Patients With Endocrine Disorders

Question 1

The nurse is preparing a patient for a thyroidectomy to treat hyperthyroidism.What patient statement 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 probably need thyroid replacement medication after surgery."
C) "I will avoid taking any thyroid or antithyroid drugs before surgery."
D) "I will need to increase my calorie intake after surgery to avoid weight loss."

Answer 1

"I will probably need thyroid replacement medication after surgery."

Question 2

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

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

Answer 2

Question the neighbor about symptoms of hypothyroidism or hyperthyroidism.

Question 3

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

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

Answer 3

Heart rate 112 beats/min

Question 4

The nurse is planning care for a patient with diabetes insipidus.What data should the nurse to monitor this patient?

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

Question 5

A patient who is one day postoperative thyroidectomy reports feeling numb around the mouth and is experiencing random muscle twitches.Which intravenous (IV)medication should the nurse anticipate that the physician will prescribe?

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

Question 6

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

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

Question 7

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

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

Question 8

A patient recovering from a thyroidectomy is being assessed for tetany.What is the most likely cause of tetany after this surgery?

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

Question 9

A patient scheduled for diagnostic tests for hypothyroidism.Which symptoms should the nurse expect to observe in a patient with this disorder?

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

Question 10

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) An accepting attitude and lubricating eyedrops
D) Reassurance that the symptoms will resolve when the Graves' disease is under control

Question 11

A patient is newly diagnosed with acromegaly.Which nursing diagnosis should the nurse identify as being appropriate for this patient?

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

Question 12

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

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

Question 13

A patient is prescribed levothyroxine (Synthroid)for hypothyroidism.Which statement should the nurse include when teaching the patient about this medication?

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

Question 14

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

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

Question 15

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

Question 16

The nurse is caring for a patient following a thyroidectomy.Which postoperative assessment activity is most important to detect the development of thyrotoxic crisis?

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

Question 17

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

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

Question 18

A patient 6 hours after a thyroidectomy has a temperature of 104°F,pulse 144 beats per minute,respirations 24 per minute,and blood pressure 184/108 mm Hg.Which orders should the nurse anticipate being prescribed for this patient?

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

Question 19

The nurse determines that treatment has been effective for a patient with diabetes insipidus.Which laboratory value did the nurse use to come to this conclusion?

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

Question 20

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

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

Question 21

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

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

Question 22

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

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

Question 23

A patient with chronic obstructive pulmonary disease prescribed corticosteroid therapy asks what the medication does.What should the nurse respond to the patient?

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

Question 24

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

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

Question 25

The LPN admits a well-known patient to the clinic and notes that the patient's face and features seem broader and coarser.Which laboratory test should the nurse expect to be prescribed for this patient?

A) Cortisol
B) Growth hormone
C) Glucose tolerance test
D) Vanillylmandelic acid (VMA)

Question 26

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

A) Isotonic
B) Hypotonic
C) Hypertonic
D) Parenteral nutrition

Question 27

A patient is diagnosed with hyperthyroidism.What should the nurse realize as being the most common cause of this disorder?

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

Question 28

The LPN is assisting in the care of a 51-year-old patient recovering from a hypophysectomy.Which observation should the nurse identify as needing immediate intervention?

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

Question 29

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

Question 30

A patient is prescribed to ingest a high-calcium diet.What foods should the nurse instruct the patient to ingest? (Select all that apply.)

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

Question 31

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

Question 32

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

Question 33

The nurse is reviewing discharge instructions with a patient recovering from a hypophysectomy.What should the nurse emphasize with this 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) "Visual changes you experienced before surgery will begin to reverse within 6 months."
D) "Be sure to take the thyroid hormone, corticosteroids, and sex hormones that have been prescribed for you."

Question 34

A patient with an adrenal disorder is prescribed fludrocortisone.What is important for the nurse to monitor in this patient?

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

Question 35

After a thyroid scan,a patient is diagnosed with a hot nodule.What should this finding suggest to the nurse?

A) The nodule is malignant and a thyroidectomy is necessary.
B) The nodule is benign and may need a biopsy to confirm the diagnosis.
C) The nodule is malignant and chemotherapy must be started immediately.
D) The nodule is benign but will be treated with chemotherapy and radiation.

Question 36

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) Ankle circumference will be measured for edema daily.
C) Patient's fluid volume will decrease as evidenced by discontinuing steroids.
D) Patient will have improved fluid balance as evidenced by weight returning to baseline.

Question 37

A patient is demonstrating manifestations of a pheochromocytoma.Which intervention is the most important for the nurse to implement?

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

Question 38

After collecting data the nurse determines that a patient is at risk for compression fractures.What health problem caused the nurse to come to this conclusion?

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

Question 39

A patient is suspected of having dilutional hyponatremia.What manifestations of this disorder should the nurse expect to observe in this patient? (Select all that apply.)

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

Question 40

The nurse is caring for patients in a primary care physician office.Which patient should the nurse recognize as being the highest risk for iodine deficiency?

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

Question 41

A patient diagnosed with syndrome of inappropriate antidiuretic hormone is scheduled for surgery in a few days.What should the nurse expect to be prescribed for this patient to help manage the symptoms until surgery? (Select all that apply.)

A) Salt restriction
B) Fluid restriction
C) Furosemide (Lasix)
D) Conivaptan (Vaprisol)
E) Hypertonic saline infusion

Question 42

The nurse is assisting in the preparation of a patient for a hypophysectomy.What should the nurse emphasize when teaching this patient? (Select all that apply.)

A) Blow the nose twice a day
B) Use an incentive spirometer.
C) Avoid bending from the waist.
D) Cough using the huff technique.
E) Perform deep breathing exercises.

Question 43

Planning is underway to determine the best course of treatment for a patient with hyperparathyroidism.What should the nurse expect to observe when collecting data from this patient? (Select all that apply.)

A) Fatigue
B) Nausea
C) Confusion
D) Depression
E) Hypertension

Question 44

While collecting data the nurse suspects a patient is experiencing manifestations of Addison's disease.What observations did the nurse make to come to this conclusion? (Select all that apply.)

A) Ankle edema
B) Bronzing of the skin
C) Blood pressure 90/55 mm Hg
D) Bruises over the upper chest and arms
E) Weight loss 10 lbs from last examination

Question 45

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

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