Deck 43: Endocrine System

Question 1

What is the MOST common chronic complication of diabetes mellitus?

A)blindness
B)renal failure
C)morbid obesity
D)neuropathy

Answer 1

neuropathy

Question 2

In caring for a client who is taking oral hypoglycemic agents,the nurse recognizes these medications are used in the treatment of which type of diabetes?

A)gestational,requiring therapy for a very short time
B)type 1,not stable with insulin administration only
C)type 2,not controlled with diet and exercise
D)type 1 and type 2,not controlled by diet and exercise

Answer 2

type 2,not controlled with diet and exercise

Question 3

A client who has diabetes begins to experience nausea,vomiting,weakness,fatigue,and blurred vision.The nurse observes the client's skin is warm and flushed and notes a fruity odor to the client's breath.The nurse should anticipate the client will be treated for:

A)hypoglycemia
B)diabetic ketoacidosis
C)hyperosmolar hyperglycemic nonketotic syndrome
D)insulin resistance

Answer 3

diabetic ketoacidosis

Question 4

In which situation would a client possibly require glucose management by sliding scale insulin?

A)clients with type 1 diabetes mellitus experiencing illness,stress,or surgery
B)clients with type 1 or type 2 diabetes mellitus experiencing illness,stress,or surgery
C)clients newly diagnosed with type 2 diabetes mellitus
D)clients participating in a rigorous sport or activity

Question 5

The major goal of medical nutrition therapy for clients with diabetes mellitus is to:

A)reduce serum lipid levels
B)improve health through optimal nutrition
C)maintain as near-normal a blood glucose level as possible
D)wean insulin-dependent clients with diabetes from insulin through diet control

Question 6

Which nursing intervention would minimize a client's risk of developing lipodystrophies?

A)administering insulin intramuscularly
B)rotating sites of administration
C)using human insulin
D)using insulin at room temperature

Question 7

Which person would be MOST likely to develop type 2 diabetes?

A)a 20-year-old white athlete with a family history of diabetes
B)a 30-year-old black athlete with a family history of diabetes
C)a 40-year-old black female who is 50 pounds overweight
D)a 50-year-old white male who is 10 pounds overweight

Question 8

Symptoms of glycosuria,polyuria,polydipsia,and ketoacidosis are indicative of which of these conditions?

A)gestational diabetes mellitus
B)idiopathic diabetes mellitus
C)impaired glucose tolerance
D)non-insulin-dependent diabetes mellitus

Question 9

A client tells the nurse about experiencing symptoms of a hypoglycemic insulin reaction.Which action should the nurse take FIRST?

A)Assess the blood glucose level,and administer glucose in the most appropriate form.
B)Call the health care provider.
C)Give the client juice or hard candy immediately.
D)Have the client lie down and see if symptoms subside.

Question 10

What is the cornerstone of treatment for the person who has type 2 diabetes?

A)blood glucose monitoring
B)medication with oral hypoglycemic agents
C)nutritional therapy
D)weight loss

Question 11

When mixing two different types of insulin in the same syringe,which type is always drawn up first?

A)lente,intermediate acting
B)NPH,intermediate acting
C)regular,short acting
D)ultra lente,long acting

Question 12

When a client's glucose level drops below 70 mg/dL,often before meals or when insulin action is peaking,the client is experiencing:

A)diabetic ketoacidosis
B)diabetic neuropathy
C)hyperosmolar hyperglycemic nonketotic syndrome
D)hypoglycemia

Question 13

Which complication of insulin therapy is characterized by a rapid decrease in serum glucose,usually at night,causing the release of glucose-elevating hormones and an elevated glucose level in the morning,which may be inadvertently treated with an increased insulin dose?

A)dawn phenomenon
B)insulin resistance
C)lipodystrophy
D)Somogyi phenomenon

Question 14

What is the advantage of giving metformin,a biguanide,to a client requiring oral hypoglycemic agents?

A)It can be administered on a more flexible schedule.
B)It does not have the major side effects of nausea,abdominal discomfort,and diarrhea.
C)It does not increase insulin release or produce hypoglycemic episodes.
D)It does not tend to react with other medications.

Question 15

The nurse should instruct clients with diabetes about "sick day management" of their disease by emphasizing which action?

A)Report blood glucose lower than 100 mg/dL to the health care provider.
B)Continue taking the scheduled insulin or oral hypoglycemic agent.
C)Use sliding scale insulin to manage hypoglycemia.
D)Increase intake of carbohydrates for the duration of the illness.

Question 16

What is the primary function of insulin?

A)to stimulate active transport of glucose into muscle and adipose tissue cells
B)to convert glycogen to glucose
C)to stimulate breakdown of adipose tissue
D)to increase breakdown of protein into amino acids

Question 17

Which forms of type 1 diabetes are characterized by an absolute insulin deficiency requiring management with insulin injections?

A)gestational diabetes mellitus
B)impaired glucose tolerance
C)immune-mediated or idiopathic diabetes mellitus
D)chemical-induced diabetes mellitus

Question 18

Subcutaneous insulin absorption occurs MOST quickly when injected into which area?

A)abdomen
B)arms
C)hips
D)thighs

Question 19

The nurse is caring for a client who has a family history of diabetes,is obese,and is aging.Which type of diabetes would the nurse suspect this client has?

A)gestational diabetes mellitus
B)immune-mediated diabetes mellitus
C)type 1 diabetes mellitus
D)type 2 diabetes mellitus

Question 20

When the body produces an excess amount of insulin,the nurse should monitor for signs and symptoms of:

A)diabetes insipidus
B)diabetes mellitus
C)hyperglycemia
D)hypoglycemia

Question 21

Which nursing intervention is indicated for a client who has myxedema?

A)Take frequent baths or showers.
B)Encourage an increasingly vigorous exercise program.
C)Teach the client to monitor intake and output.
D)Provide a high-fiber diet.

Question 22

After surgical removal of a pituitary tumor,the client will require which of these therapies?

A)corrective lenses
B)hormone replacement
C)optic nerve evaluation
D)strict bed rest

Question 23

For a client who has a subtotal thyroidectomy,which nursing intervention is essential?

A)monitoring potassium and sodium levels
B)encouraging voice rest for 48 hours
C)placing the client in reverse Trendelenburg position
D)placing a tracheotomy tray at the client's bedside

Question 24

Which nursing diagnosis is MOST appropriate for a client who has hyperthyroidism?

A)Anxiety related to complications of hyperthyroidism
B)Risk for injury related to potential for hypertensive crisis
C)Imbalanced nutrition,less than body requirements
D)Impaired swallowing related to goiter

Question 25

The client is experiencing an increased thyroid hormone production.The nurse would monitor for which effect on a client's metabolic rate and subsequent symptoms?

A)rate decrease with weight gain and decreased appetite
B)rate decrease with weight loss and increased appetite
C)rate increase with weight loss and increased appetite
D)rate increase with weight gain and decreased appetite

Question 26

When caring for a client,which assessment would the nurse use to correlate with a diagnosis of hypoparathyroidism?

A)Chvostek's sign
B)Homans' sign
C)tetany
D)Trousseau's sign

Question 27

A client is receiving radioactive iodine for the treatment of hyperthyroidism.Which precaution should the nurse initiate?

A)Avoid close contact with the adult family members.
B)Use disposable eating utensils.
C)Restrict fluids for the 2 days before and after administration.
D)Institute airborne precautions.

Question 28

Which symptom would be present in the client who has syndrome of inappropriate antidiuretic hormone (SIADH)?

A)dilute urine
B)hypernatremia
C)weight gain
D)hyperreflexia

Question 29

The nurse is caring for a client with an autoimmune disease characterized by the production of antibodies that destroy essential enzymes needed for the production of T 3 and T 4.This nurse is aware that this client is experiencing:

A)Hashimoto's thyroiditis
B)hyperthyroidism
C)hypothyroidism
D)cretinism

Question 30

Which nursing intervention is essential for the client who has Cushing's syndrome?

A)providing a private room with reverse or protective isolation as indicated
B)encouraging discussion about changed body image
C)instructing the client how to reduce stress
D)teaching the client about low-protein,high-carbohydrate foods

Question 31

What is the MOST common cause of hypopituitarism?

A)congenital defect
B)metabolic disorder
C)trauma causing damage to the pituitary gland
D)tumor

Question 32

The client receiving propylthiouracil should be taught to report signs and symptoms of infection immediately because of which of the following?

A)Depression of thyroid function increases risk of infection.
B)Hyperthyroidism predisposes the client to immune system breakdown.
C)Iodine preparations inhibit blood clotting.
D)Propylthiouracil can cause agranulocytosis.

Question 33

A client newly diagnosed with type 2 diabetes mellitus has a nursing diagnosis of Knowledge deficit: diabetes,medical regimen,diet,exercise,and self-care management skills.Which nursing goal is appropriate for this client?

A)to maintain current weight
B)to maintain vital signs within normal limits
C)to use the food pyramid for meal planning
D)to relate the importance of an exercise program

Question 34

Which nursing intervention would be included in the care of a client who has hyperparathyroidism?

A)Encourage the client to alternate rest and activity periods.
B)Place the client in a room with reverse ventilation.
C)Encourage the client to increase ambulation each day.
D)Encourage the family to seek hospice care for the client.

Question 35

The MOST appropriate nursing goal for a client with hypoparathyroidism would be:

A)to prevent infections
B)to maintain adequate calcium intake
C)to monitor fluid intake
D)to verbalize feelings about changed appearance

Question 36

A client has a pituitary tumor that is placing pressure on the optic nerve and causing altered vision.Which nursing intervention is MOST important?

A)encouraging bed rest
B)insisting that a family member remain in the room with the client at all times
C)providing a safe,clutter-free environment.
D)keeping the room well-lit at all times

Question 37

A client is to start thyroid replacement therapy.The nurse should include which instructions for the client?

A)Eat plenty of shellfish,saltwater fish,and iodized salt.
B)Avoid drinking coffee or tea with meals.
C)Store the medication in a cool,dark place.
D)Take the prescribed medication in the morning.

Question 38

The nurse is caring for a client experiencing an excess secretion of growth hormone.The nurse is aware that this is characterized in which condition?

A)acromegaly
B)Addison's disease
C)Cushing's syndrome
D)Hashimoto's disease

Question 39

The nurse should teach the client to monitor for which complication of diabetic neuropathy?

A)arthrosclerosis
B)diabetic retinopathy
C)injury and undetected foot injury
D)kidney failure

Question 40

Which nursing diagnosis would be MOST appropriate for the client with diabetes insipidus?

A)Body image disturbance related to physical changes
B)Fluid volume deficit related to polyuria
C)Risk for infection related to chronic steroid therapy
D)Altered nutrition,less than body requirements,related to imbalance between insulin,diet,and activity

Question 41

The client is receiving calcium gluconate for hypocalcemia.The nurse will monitor for which of the following complications? (Select all that apply. )

A)decreased heart rate
B)hypercalcemia
C)seizures
D)laryngeal spasms
E)dry mouth

Question 42

A teenaged client appears to have developed hybrid diabetes.The nurse is aware that this type of diabetes causes the client to have which of the following? (Select all that apply. )

A)insulin resistance associated type 1 diabetes
B)antibodies against pancreatic islet cells associated with autoimmunity
C)antibodies against pancreatic islet cells associated with type 1 diabetes
D)insulin resistance associated with obesity
E)insulin resistance associated type 2 diabetes

Question 43

The nurse is caring for a client with the condition characterized by paroxysmal or sustained hypertension.The nurse suspects this client is experiencing:

A)Addison's disease
B)Cushing's syndrome
C)pheochromocytoma
D)Simmonds' disease

Question 44

The nurse is reviewing a client's medical history.Which factors would indicate that client is at risk for the development of diabetes? (Select all that apply. )

A)triglyceride level of 199 mg/dL
B)first child weighed 9 lbs 3 oz
C)body mass index of 32
D)blood pressure of 138/78
E)taking antihypertensive medications

Question 45

The nurse caring for a client monitors for the classic clinical manifestation of Addison's disease,which include:

A)a bronze coloration of the skin resembling a deep suntan
B)moon-shaped face and buffalo hump
C)hoarseness and vocal stridor
D)tetany

Question 46

The diet of the client with Addison's disease should emphasize which aspect?

A)avoiding canned and other prepared foods
B)choosing foods high in sodium and low in potassium with adequate calories
C)restricting caloric intake
D)restricting sodium and increasing fluid intake