Deck 47: Assessment of Endocrine System

Question 1

Which information about a patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test?

A)The patient reports having occasional orthostatic dizziness.
B)The patient takes oral corticosteroids for rheumatoid arthritis.
C)The patient has had a 10-lb weight gain in the last month.
D)The patient drank several glasses of water an hour previously.

Answer 1

The patient takes oral corticosteroids for rheumatoid arthritis.

Question 2

A 61-yr-old female patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L). The nurse will anticipate the need to teach the patient about testing for _____ levels.

A)calcitonin
B)catecholamine
C)thyroid hormone
D)parathyroid hormone

Answer 2

parathyroid hormone

Question 3

The nurse reviews a patient's glycosylated hemoglobin (A1C)results to evaluate

A)fasting preprandial glucose levels.
B)glucose levels 2 hours after a meal.
C)glucose control over the past 90 days.
D)hypoglycemic episodes in the past 3 months.

Answer 3

glucose control over the past 90 days.

Question 4

A patient will be scheduled in the outpatient clinic for blood cortisol testing. Which instruction will the nurse provide?

A)"Avoid adding any salt to your foods for 24 hours before the test."
B)"You will need to lie down for 30 minutes before the blood is drawn."
C)"Come to the laboratory to have the blood drawn early in the morning."
D)"Do not have anything to eat or drink before the blood test is obtained."

Question 5

Which statement by a 50-yr-old female patient indicates to the nurse that further assessment of thyroid function may be necessary?

A)"I notice my breasts are tender lately."
B)"I am so thirsty that I drink all day long."
C)"I get up several times at night to urinate."
D)"I feel a lump in my throat when I swallow."

Question 6

A registered nurse (RN)is caring for a patient with a goiter and possible hyperthyroidism. Which action by the RN indicates that the charge nurse needs to provide the RN with additional teaching?

A)The RN checks the blood pressure in both arms.
B)The RN palpates the neck to assess thyroid size.
C)The RN orders saline eye drops to lubricate the patient's bulging eyes.
D)The RN lowers the thermostat to decrease the temperature in the room.

Question 7

A patient is taking spironolactone (Aldactone),a drug that blocks the action of aldosterone on the kidney,for hypertension. The nurse will monitor for

A)increased serum sodium.
B)decreased urinary output.
C)elevated serum potassium.
D)evidence of fluid overload.

Question 8

A young adult patient is being seen in the clinic with increased secretion of the anterior pituitary hormones. The nurse would expect the laboratory test results to show

A)increased urinary cortisol.
B)decreased serum thyroxine.
C)elevated serum aldosterone levels.
D)low urinary catecholamines excretion.

Question 9

A patient seen in the emergency department for severe headache and acute confusion has a serum sodium level of 118 mEq/L. The nurse will anticipate the need for which diagnostic test?

A)Urinary 17-ketosteroids
B)Antidiuretic hormone level
C)Growth hormone stimulation test
D)Adrenocorticotropic hormone level

Question 10

Which additional information will the nurse need to consider when reviewing the laboratory results for a patient's total calcium level?

A)The blood glucose
B)The serum albumin
C)The phosphate level
D)The magnesium level

Question 11

Which laboratory value should the nurse review to determine whether a patient's hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland?

A)Thyroxine (T4) level
B)Triiodothyronine (T3) level
C)Thyroid-stimulating hormone (TSH) level
D)Thyrotropin-releasing hormone (TRH) level

Question 12

A patient is admitted with tetany. Which laboratory value should the nurse plan to monitor?

A)Total protein
B)Blood glucose
C)Ionized calcium
D)Serum phosphate

Question 13

The nurse will teach a patient who is scheduled to complete a 24-hour urine collection for 17-ketosteroids to

A)insert and maintain a retention catheter.
B)keep the specimen refrigerated or on ice.
C)drink at least 3 L of fluid during the 24 hours.
D)void and save that specimen to start the collection.

Question 14

An 18-yr-old male patient with small stature is scheduled for a growth hormone stimulation test. In preparation for the test,the nurse will obtain

A)ice in a basin.
B)glargine insulin.
C)a cardiac monitor.
D)50% dextrose solution.

Question 15

Which question from a nurse during a patient interview will provide focused information about a possible thyroid disorder?

A)"What methods do you use to help cope with stress?"
B)"Have you experienced any blurring or double vision?"
C)"Have you had a recent unplanned weight gain or loss?"
D)"Do you have to get up at night to empty your bladder?"

Question 16

The nurse will plan to teach a patient to minimize physical and emotional stress while the patient is undergoing

A)a water deprivation test.
B)testing for serum T3 and T4 levels.
C)a 24-hour urine test for free cortisol.
D)a radioactive iodine (I-131) uptake test.

Question 17

The nurse is caring for a 45-yr-old male patient during a water deprivation test. Which finding is most important for the nurse to communicate to the health care provider?

A)The patient complains of intense thirst.
B)The patient has a 5-lb (2.3-kg) weight loss.
C)The patient's urine osmolality does not increase.
D)The patient feels dizzy when sitting on the edge of the bed.

Question 18

During the nurse's physical examination of a young adult,the patient's thyroid gland cannot be felt. The most appropriate action by the nurse is to

A)palpate the patient's neck more deeply.
B)document that the thyroid was nonpalpable.
C)notify the health care provider immediately.
D)teach the patient about thyroid hormone testing.

Question 19

A patient with a possible pituitary adenoma is scheduled for a computed tomography (CT)scan with contrast media. Which patient information is important for the nurse to communicate to the health care provider before the test?

A)Bilateral poor peripheral vision
B)Allergies to iodine and shellfish
C)Recent weight loss of 20 lb
D)Complaint of ongoing headaches

Question 20

A patient has been newly diagnosed with type 2 diabetes mellitus. Which information about the patient will be most useful to the nurse who is helping the patient develop strategies for successful adaptation to this disease?

A)Ideal weight
B)Value system
C)Activity level
D)Visual changes

Question 21

The nurse is caring for a 63-yr-old with a possible pituitary tumor who is scheduled for a computed tomography scan with contrast. Which information about the patient is important to discuss with the health care provider before the test?

A)History of renal insufficiency
B)Complains of chronic headache
C)Recent bilateral visual field loss
D)Blood glucose level of 134 mg/dL

Question 22

Which statements will the nurse include when teaching a patient who is scheduled for oral glucose tolerance testing in the outpatient clinic ?

A)"You will need to avoid smoking before the test."
B)"Exercise should be avoided until the testing is complete."
C)"Several blood samples will be obtained during the testing."
D)"You should follow a low-calorie diet the day before the test."
E)"The test requires that you fast for at least 8 hours before testing."