Deck 23: Endocrine Clinical Assessment and Diagnostic Procedures

Question 1

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

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

Answer 1

diagnostic of diabetes, but it should be re-evaluated for accuracy.

Question 2

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

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

Answer 2

hyperglycemia.

Question 3

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

A) Insulin level of 25 m/mL
B) Absence of ketones in the urine
C) Presence of ketones in the blood
D) Serum osmolality of 270 mOsm/kg H2O

Answer 3

Presence of ketones in the blood

Question 4

A normal HbA₁c level for a normal person is

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

Question 5

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

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

Question 6

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

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

Question 7

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

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

Question 8

Glycosylated hemoglobin levels provide information about

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

Question 9

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

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

Question 10

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

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

Question 11

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

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

Question 12

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

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

Question 13

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

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

Question 14

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

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

Question 15

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

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

Question 16

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

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