Deck 50: Caring for Clients With Disorders of the Endocrine System

Question 1

Evaluation of an adult client reveals oversecretion of growth hormone. Which of the following would the nurse expect to find?

A) Excessive urine output
B) Weight loss
C) Bulging forehead
D) Constant thirst

Answer 1

Bulging forehead

Question 2

The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as which of the following?

A) Gigantism
B) Dwarfism
C) Acromegaly
D) Simmonds' disease

Answer 2

Gigantism

Question 3

A client with diabetes insipidus is extremely dehydrated and is unable to take oral fluids. Fluid therapy is prescribed. Which intervention would be most important for the client?

A) Measuring the urine output every 30 minutes.
B) Monitoring the rate of IV infusions.
C) Measuring the fluid intake.
D) Weighing the client daily.

Answer 3

Measuring the urine output every 30 minutes.

Question 4

Which of the following precautions would be most appropriate when caring for a client being treated with RAI for a thyroid tumor?

A) Administer prescribed corticosteroids carefully.
B) Handle body fluids carefully.
C) Monitor the respiratory status.
D) Administer the prescribed medications at the same time each day.

Question 5

After teaching a group of students about Simmonds' disease, the instructor determines that additional instruction is necessary when the students identify which hormone as being involved?

A) Growth hormone
B) Luteinizing hormone
C) Adrenocorticotropic hormone
D) Oxytocin

Question 6

The nurse is assisting with the preparation of teaching plan for a client who is to receive methimazole (Tapazole). Which of the following would be most appropriate to include in this plan?

A) Telling the client to dilute the drug with fruit juice.
B) Advising the client to use a straw when taking the drug.
C) Urging the client to report any fever or sore throat.
D) Telling the client to take largest dose of the drug in the morning.

Question 7

The nurse is reviewing the laboratory and diagnostic test findings of a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following would the nurse expect to find?

A) Elevated serum sodium levels
B) Decreased serum osmolarity
C) Decreased urine sodium levels
D) Elevated urine calcium levels

Question 8

A client with pheochromocytoma is scheduled for an adrenalectomy. Which of the following would the nurse perform preoperatively?

A) Begin administering prescribed corticosteroid.
B) Initiate intravenous access for fluid therapy.
C) Monitor blood pressure (BP) frequently.
D) Check for the signs of adrenal insufficiency.

Question 9

When providing teaching to a client with hyperthyroidism that is prescribed radioactive iodine (RAI) to destroy thyroid tissue, which of the following would the nurse include?

A) Radioactive iodine (RAI) has no adverse effects.
B) Its effect is not apparent until the gland has secreted excess thyroid hormone.
C) RAI does not seriously affect other tissues.
D) The process may take several weeks or more.

Question 10

After teaching a client diagnosed with primary adrenal insufficiency about his condition, the nurse determines that additional teaching is necessary when the client states which of the following?

A) "I need to drink at least 2 quarts of fluid each day."
B) "I will need to decrease my drug dosage if I develop an infection."
C) "I will have to take the replacement hormone for the rest of my life."
D) "I should eat 5 to 6 small meals per day and snacks rather than 3 big meals."

Question 11

While assessing a client with hypoparathyroidism, the nurse taps the client's facial nerve and observes twitching of the mouth and tightening of the jaw. The nurse would document this finding as which of the following?

A) Positive Trousseau's sign
B) Positive Chvostek's sign
C) Hyperactive deep tendon reflex
D) Tetany

Question 12

After teaching a client who is to receive lypression nasal spray as treatment for neurogenic diabetes insipidus about administration, which client statement indicates the need for additional teaching?

A) "I'll inhale fully after spraying the drug."
B) "If my nose gets irritated, I'll call my physician."
C) "I should hold the spray container upright."
D) "While sitting up, I'll place the nozzle in my nostril."

Question 13

The nurse is reviewing the history and physical examination of a client diagnosed with hyperthyroidism. Which of the following would the nurse expect to find?

A) Complaints of sleepiness
B) Thick hard nails
C) Inability to tolerate cold
D) Reports of increased appetite

Question 14

Which of the following nursing action would the nurse include when caring for a client with endemic goiter and experiencing respiratory symptoms?

A) Avoiding physical exertion.
B) Providing proper air circulation in the room.
C) Providing a diet high in iodine.
D) Elevating the head of the bed.

Question 15

Which of the following would the nurse expect the physician to order for a client with hypothyroidism?

A) Levothyroxine sodium
B) Methimazole
C) Propranolol
D) Propylthiouracil

Question 16

Which of the following would the nurse expect to find in a client with severe hyperthyroidism?

A) Tetany
B) Exophthalmos
C) Buffalo hump
D) Striae

Question 17

A client with Addison's disease has a blood glucose level above 80 mg/dL thirty minutes after receiving 15 grams of carbohydrates for symptoms of hypoglycemia. Which of the following would the nurse do now?

A) Inform the physician immediately.
B) Give the client milk and graham crackers.
C) Instruct the client to remain in bed.
D) Check the client's blood glucose level before each meal.

Question 18

Which suggestion would the nurse include for a client who has had a thyroidectomy to reduce tension on the suture line?

A) Use the hands to support the head when rising to a sitting position.
B) Keep ambulatory activities to minimum.
C) Maintain complete bed rest for 2 days postoperatively.
D) Take the prescribed analgesics before any strenuous activity.

Question 19

A nurse is assisting a client diagnosed with hypoparathyroidism about appropriate dietary measures suggested by the dietician. Which of the following would the nurse caution the client to avoid?

A) Milk
B) Green leafy vegetables
C) Carbonated beverages
D) Fortified orange juice

Question 20

Which group of clients should not receive potassium iodide?

A) Those who are allergic to corticosteroids
B) Those who are pregnant
C) Those taking medications such as cough medicines
D) Those who are allergic to seafood

Question 21

A client is receiving long-term treatment with high-dose corticosteroids. Which of the following would the nurse expect the client to exhibit?

A) Weight loss
B) Pale thick skin
C) Moon face
D) Hypotension

Question 22

Which of the following would the nurse need to be alert for in a client with severe hypothyroidism?

A) Thyroid storm
B) Myxedemic coma
C) Addison's disease
D) Acromegaly

Question 23

The nurse is monitoring the status of client who has had an unilateral adrenalectomy. The nurse is closely monitoring the client's respiratory status for which reason?

A) The remaining adrenal gland is not producing sufficient hormone to meet the client's needs.
B) The client is at risk for atelectasis and pneumothorax due to the location of the adrenal glands.
C) The client is receiving a prescribed corticosteroid which can affect the client's recovery from anesthesia.
D) One of the primary clinical manifestations of acute adrenal crisis is respiratory distress.

Question 24

A client is diagnosed with simple goiter. Information related to which of the following would be important for the nurse to obtain?

A) Use of corticosteroid agents
B) Iodine content of diet
C) History of antibiotic use
D) Ingestion of soybeans

Question 25

A client has had a thyroidectomy. Which of the following would lead the nurse to suspect that the client is developing thyrotoxic crisis?

A) Bradycardia
B) Hoarseness
C) Hyperthermia
D) Tetany