Question 1

The nurse is interviewing a client with a suspected endocrine disorder. Which question by the nurse would BEST obtain subjective data related to this client's possible diagnosis?
A)"I noticed that your blood pressure is 97/76 today. Was it this low the last time your blood pressure was measured?"
B)"Can you tell me more about the tingling you are experiencing in your feet?"
C)"Your skin appears very tanned. Did you recently go to the beach?"
D)"Does your face twitch when you touch your cheek?

Accepted Answer

A client's description of a tingling feeling is subjective data.

Question 2

Place in correct order the steps for obtaining capillary blood glucose sampling.
A)Cleanse the side of the client's finger.
B)Apply the blood to the test strip.
C)Pierce the skin with a lancet.
D)Calibrate the blood glucose meter.
E)Apply clean gloves.
F)Wipe away the first drop of blood.

Accepted Answer

A)Cleansing the site is completed after the glucometer is calibrated.
B)Application of blood to the test strip is the last step in capillary blood glucose sampling.
C)Piercing the skin with a lancet is completed after putting on clean gloves.
D)Calibrating the glucometer is the first step in the process to ensure the result is correct.
E)Clean gloves are applied immediately before piercing the skin.
F)The first drop of blood is wiped away before applying the blood to the test strip.

Question 3

The nurse is caring for a client with a large abdomen. Which assessment technique would assist the nurse in determining whether the client is experiencing ascites or the large abdomen is related to obesity?
A)Weigh the client weekly.
B)Check the client's feet for pedal edema.
C)Measure the client's abdomen daily.
D)Measure the amount of food the client eats with each meal.

Accepted Answer

Frequent measurement of abdominal girth allows the nurse to see if the abdomen is growing quickly, which is seen in ascites but not in obesity.

Question 4

The client tells the nurse that he doesn't check his blood sugar as often as he should because his fingers are so sore from pricking them. How can the nurse assist this client to be more compliant with his blood sugar monitoring?
A)Push the injector as far into the finger as possible to ensure that an adequate drop is obtained with the first prick.
B)Hang the hand to be used below the waist for a minute to make sure the site that is chosen will have adequate blood supply for the test.
C)For best results, choose the pad of the finger for the test.
D)Allow two or three drops of blood to fall, wipe them away, and then place the next drop of blood on the test strip.

Accepted Answer

Hanging the hand below the waist will increase blood supply to the finger chosen for the blood sample and will make obtaining the correct size blood sample easier for the client.

Question 5

A nurse is shopping and notes an individual who is acting oddly. The nurse notes that the person is sweating and appears confused. The nurse approaches the individual, helps him find a seat, and takes the pulse, which is increased. The person complains of a headache. Which is this nurse's first action in assisting this individual?
A)Ask for someone in the store to call for emergency assistance.
B)Ask the individual if he has any hard candy in his pocket.
C)Lie the individual on the floor and raise the individual's feet above the heart.
D)Determine if the store has an automated external defibrillator (AED).

Accepted Answer

By asking the person if hard candy is in the pocket, the nurse can immediately give the person a quick source of glucose and begin raising the blood sugar.

Question 6

The nurse is discussing issues related to childbearing with a woman who has a low prolactin level and knows that this woman may experience difficulty related to which childbearing activity?
A)Becoming pregnant
B)Staying pregnant
C)Giving birth
D)Breastfeeding

Accepted Answer

Prolactin is released by the anterior pituitary and enables the client to breastfeed.

Question 7

The nurse is discussing glucose control with a client who reports consistently elevated capillary blood glucose levels. The client appears unconcerned and says, "I don't see why this is a problem. I feel fine." Which is the nurse's BEST response to this client?
A)"That's good. I'm glad that nothing has happened to you yet."
B)"Most people with diabetes never develop complications."
C)"I know you say you that you feel fine but you don't know just how sick you are."
D)"While you may feel good right now, complications usually appear after many years of poor glucose control."

Accepted Answer

Informing the client that complications will occur years from now is important to help the client understand why glucose control must be established now.

Question 8

The client calls the clinic complaining of an unusual problem. Which client statement to the nurse is most suggestive of a subjective symptom related to an endocrine problem?
A)"I don't have as much energy as I used to. I get out of breath going up stairs."
B)"Recently I have noticed little purple spots on my legs."
C)"All I want to eat are salty things and I'm adding salt to everything I eat."
D)"My belly seems to be growing bigger every day and it's hard to breathe."

Accepted Answer

Salt cravings is suggestive of Addison disease, an endocrine disorder.

Question 9

The nurse is observing a client obtain a capillary blood specimen for glucose and notes that the client actively squeezes the finger after piercing it with a lancet and then places a drop of blood on the test strip. The meter shows the blood glucose as 126 mg/dl. How does the nurse interpret these results?
A)The blood sugar is within normal limits for a client with diabetes mellitus.
B)The blood sugar result may be incorrect. The milking of the finger caused the test to read lower than it should.
C)The client should be treated for hypoglycemia because the milking of the finger caused the test to read higher than it should.
D)The client should be instructed to apply pressure to the fingertip when obtaining a capillary blood glucose instead of squeezing the finger.

Accepted Answer

The blood sugar reading may be lower than the actual result because of the squeezing or milking of the finger that the client performed after piercing the skin with the lancet.

Question 10

The nurse is working with a client who has just been diagnosed with diabetes mellitus and informs the client to adhere to which principles that will be most helpful at preventing complications of this disease? Select all that apply.
A)Monitor your blood glucose levels at least once each week.
B)Make sure to take your oral antidiabetic medications as ordered.
C)Exercise at least an hour a day.
D)Make sure that meals and snacks are eaten at regular times.
E)See your healthcare provider (HCP)regularly even if you don't feel ill.

Accepted Answer

Oral antidiabetic drugs or insulin need to be taken as prescribed to prevent complications.
Food intake should be regulated so that it matches the insulin or oral antidiabetic medications that are taken.
It is important for the client to see the HCP regularly to ensure that complications are not developing or to catch early signs of complications.

Question 11

The nurse is caring for a client who has just been diagnosed with diabetes mellitus. The client tells the nurse that she went to the doctor with symptoms of a urinary tract infection and ended up being admitted with diabetes mellitus. She then tells the nurse that her father had diabetes and he ended up dying with kidney failure. The client says, "It looks like that's what is going to happen to me. My kidneys are already messed up." Which is the nurse's BEST response to this client's statement?
A)"It does appear that your disease is progressing quite quickly. Do you have anyone in your family who would donate a kidney for you?"
B)"I wouldn't worry about that right now. Your first job is to get used to having diabetes."
C)"Have you had any other symptoms of kidney failure such as edema or high blood pressure?"
D)"Your current infection was caused by the diabetes, but watching your blood sugar in the future will help prevent complications."

Accepted Answer

The nurse is correct to help the client see the connection between good blood sugar control and prevention of complications.

Question 12

The client diagnosed with diabetes mellitus calls the nurse to complain about dizziness that occurs upon standing. The nurse informs the client that this may be caused by which initial complication related to diabetes mellitus?
A)Hypertension
B)Impaired peripheral circulation
C)Diabetic autonomic neuropathy
D)Diabetic nephropathy

Accepted Answer

Neuropathy caused by diabetes leads to postural hypotension, which causes the client to have dizziness when standing.

Question 13

The nurse is conducting an initial assessment of a client diagnosed with an endocrine disorder and identifies which signs and symptoms as subjective, as opposed to objective symptoms? Select all that apply.
A)There is 2+ edema present in both hands and feet.
B)The client complains of feeling tired most of the time.
C)The client states that he can't see as well as before.
D)The client's vision measured as 20/200.
E)The client reports very dry skin.

Accepted Answer

A complaint of feeling tired is subjective.
Complaining of decreased visual acuity is a subjective symptom.
Client report of dry skin is a subjective symptom.

Question 14

A client calls the clinic and asks to speak to the nurse. The client states, "I don't understand why you keep telling me that my thyroid is overactive when my TSH level is so low." How does the nurse BEST explain this to the client?
A)"You are correct. We should have said that your thyroid was underactive, not overactive."
B)"I will recheck your lab reports to make sure that they are correct."
C)"Well, that's just the way it works. You just have to know what the number means."
D)"TSH stands for thyroid stimulating hormone, so if it is low it means that your thyroid is working hard and producing more hormone than it needs to."

Accepted Answer

Explaining to the client the relationship between TSH and thyroid function is the best response to the client who asks about a lab test.

Question 15

The charge nurse is discussing the endocrine system and the new nurse correctly identifies which organ as the one that influences the release of hormones into the portal circulation?
A)Hypothalamus
B)Pituitary gland
C)Pancreas
D)Adrenal gland

Accepted Answer

The hypothalamus is responsible for releasing hormones in the portal circulation.

Question 16

A client diagnosed with acromegaly is scheduled for a growth hormone test. When the client arrives for the test, the nurse notes that the client appears to have been crying. The nurse shares with the client this observation and the client begins to cry again and tells the nurse about some serious family problems. Which should the nurse do at this time in relation to the client's growth hormone test?
A)After the client's growth hormone test has been completed, discuss with the client possible resources available to assist with the family problems that the client is experiencing.
B)Explain to the client that the growth hormone test will not be accurate if performed when the client is emotionally upset, so the test needs to be rescheduled.
C)Wait until the client calms down to have the test performed.
D)Report to the healthcare provider that the client's emotional state must be taken into account when interpreting the growth hormone test.

Accepted Answer

The growth hormone test should be rescheduled because the result will be inaccurate if the client is not fasting or well rested, or is physical or emotionally stressed.

Question 17

The nurse in the clinic receives a call from a client diagnosed with diabetes mellitus who states his blood sugar is 275 mg/dl and he doesn't feel well. Which is the first thing the nurse should tell the client to do?
A)Obtain a urine specimen and check it for ketones.
B)Immediately go to the emergency department to be admitted.
C)Drink a large beverage that has sugar and electrolytes and recheck the blood sugar.
D)Ask the client if he has a headache or irritability.

Accepted Answer

The client has developed hyperglycemia and also states he doesn't feel well, so the nurse should first have the client check his urine for ketones to see if he is developing diabetic ketoacidosis.

Question 18

The nurse is caring for a client who just had 1,500 mL of fluid removed during a paracentesis. The client asks the nurse why his belly still feels so big even though that large amount of fluid was removed. Which is the nurse's BEST answer to this client?
A)"The skin of your belly stretched while you had fluid in your abdomen and it will take a while for your belly to return to its normal size."
B)"Only a certain amount of fluid can be removed from our abdomen at a time to prevent your body from going into shock."
C)"Removing that much fluid helps to get rid of the excess fluid. Now the rest of the fluid will drain into your lymphatic system."
D)"It was important to limit the amount of fluid that was removed to prevent infection from occurring."

Accepted Answer

Draining very large amounts of fluid can cause hypovolemia, which could then lead to shock so the amount of fluid drained during a paracentesis is limited to 1,500 mL.

Question 19

The nurse is caring for a client who is experiencing both decreased appetite and shortness of breath related to ascites. A paracentesis has been scheduled for this client. Immediately prior to the procedure, the nurse accompanies the client to the bathroom so the client can void. Which would be the nurse's BEST action when the client reports an inability to void?
A)Request that the healthcare provider (HCP)postpone the procedure until the client can void.
B)Explain to the healthcare provider that extra caution must be taken during the paracentesis because the client couldn't void before the procedure.
C)Ask the healthcare provider for a one-time order of an in-and-out catheterization.
D)Ask the client to try the void again because the paracentesis cannot be performed until the client's bladder is empty.

Accepted Answer

Requesting that the HCP order a one-time bladder catheterization allows the nurse to empty the client's bladder and the paracentesis to be performed.

Question 20

The healthcare provider has ordered a radioactive iodine (RA)uptake exam for a client who has complained of constipation, fatigue, and weight gain. The client asks the nurse to explain again why this test has been ordered in relation to these symptoms. Which is the nurse's BEST response to this client?
A)"This test is used to check all of the endocrine glands that could cause you to have these symptoms."
B)"Your symptoms are related to possible problems with your adrenal gland, so this test will evaluate if this is the problem."
C)"Your symptoms are suggestive of a thyroid problem. Iodine is taken up exclusively by the thyroid gland, so it is used to evaluate if this gland is responsible for your problems."
D)"The pituitary gland puts out iodine that is taken up by the thyroid, so this test will tell if your thyroid is producing enough of this."

Accepted Answer

Iodine is taken up by the thyroid, so the RA uptake test is done to see if the thyroid is functioning properly.

Quiz 59: Metabolism

The nurse is interviewing a client with a suspected endocrine disorder. Which question by the nurse would BEST obtain subjective data related to this client's possible diagnosis?

Place in correct order the steps for obtaining capillary blood glucose sampling.

The nurse is caring for a client with a large abdomen. Which assessment technique would assist the nurse in determining whether the client is experiencing ascites or the large abdomen is related to obesity?

The client tells the nurse that he doesn't check his blood sugar as often as he should because his fingers are so sore from pricking them. How can the nurse assist this client to be more compliant with his blood sugar monitoring?

The nurse is discussing issues related to childbearing with a woman who has a low prolactin level and knows that this woman may experience difficulty related to which childbearing activity?

The nurse is discussing glucose control with a client who reports consistently elevated capillary blood glucose levels. The client appears unconcerned and says, "I don't see why this is a problem. I feel fine." Which is the nurse's BEST response to this client?

The client calls the clinic complaining of an unusual problem. Which client statement to the nurse is most suggestive of a subjective symptom related to an endocrine problem?

The nurse is working with a client who has just been diagnosed with diabetes mellitus and informs the client to adhere to which principles that will be most helpful at preventing complications of this disease? Select all that apply.

The client diagnosed with diabetes mellitus calls the nurse to complain about dizziness that occurs upon standing. The nurse informs the client that this may be caused by which initial complication related to diabetes mellitus?

The nurse is conducting an initial assessment of a client diagnosed with an endocrine disorder and identifies which signs and symptoms as subjective, as opposed to objective symptoms? Select all that apply.

A client calls the clinic and asks to speak to the nurse. The client states, "I don't understand why you keep telling me that my thyroid is overactive when my TSH level is so low." How does the nurse BEST explain this to the client?

The charge nurse is discussing the endocrine system and the new nurse correctly identifies which organ as the one that influences the release of hormones into the portal circulation?

The nurse in the clinic receives a call from a client diagnosed with diabetes mellitus who states his blood sugar is 275 mg/dl and he doesn't feel well. Which is the first thing the nurse should tell the client to do?

The nurse is caring for a client who just had 1,500 mL of fluid removed during a paracentesis. The client asks the nurse why his belly still feels so big even though that large amount of fluid was removed. Which is the nurse's BEST answer to this client?