Question 1

The nurse is planning care for a client diagnosed with Graves' disease. Which of the following nursing interventions would be appropriate for this client's care?

Accepted Answer

Graves' disease is a hyperthyroid condition that results in increased metabolism and weight loss. Providing frequent meals can help the client maintain adequate caloric intake and prevent further weight loss. Administering a stool softener may not be specific to the client's diagnosis. Providing extra blankets may be unnecessary and may not address the client's primary need. Restricting caloric intake would be inappropriate for a client with hyperthyroidism who is already experiencing weight loss.

Question 2

A client, complaining of weight gain, has thin extremities, a "buffalo hump," and a protruding abdomen. The nurse realizes that this client is most likely to be diagnosed with which disease process?

Accepted Answer

The presence of a "buffalo hump," thin extremities, and a protruding abdomen are characteristic signs of Cushing's syndrome, which is caused by chronic exposure to excessive levels of cortisol. Weight gain, especially in the abdomen, is a common symptom of Cushing's syndrome, along with muscle weakness, fatigue, and increased blood pressure. Addison's disease involves a deficiency of cortisol and aldosterone, leading to weight loss, weakness, and low blood pressure. Cretinism is a congenital condition resulting in hypothyroidism and stunted physical and mental development. While obesity can also cause weight gain, it is not typically associated with the specific physical signs seen in this client.

Question 3

A client is diagnosed with primary adrenal insufficiency. The nurse realizes that this disorder affects which of the following glands?

Accepted Answer

Primary adrenal insufficiency, also known as Addison's disease, affects the adrenal cortex - the outer layer of the adrenal glands that produce hormones such as cortisol and aldosterone.

Question 4

The nurse is planning care for a client diagnosed with hypercalcemia caused by hyperparathyroidism. Which of the following should the nurse add as interventions to this client's care plan? (Select all that apply.)

Accepted Answer

Administering high volume intravenous fluids helps to dilute the calcium in the blood and promote renal excretion. Calculating sodium chloride intake to achieve 400 mEq each day helps increase calcium excretion in the urine.

Question 5

The nurse suspects a client is experiencing the early signs of myxedema coma when which of the following is assessed? (Select all that apply.)

Accepted Answer

The answer of The nurse suspects a client is experiencing...

Question 6

A client has been instructed regarding a prolactin level to be drawn the next day. Which of the following statements indicate that the client will need further instruction?

Accepted Answer

Prolactin levels are best measured in the morning because they naturally rise during sleep and peak in the early morning hours. An afternoon appointment could result in inaccurately low levels.

Question 7

Which of the following symptoms would suggest to the nurse that a client is experiencing symptoms of pheochromocytoma? (Select all that apply.)

Accepted Answer

Pheochromocytoma is a tumor of the adrenal gland that causes excessive release of catecholamines, which results in symptoms such as severe headache, palpitations, and profuse sweating. Decreased urine output, diarrhea, and weight gain are not typical symptoms of pheochromocytoma.

Question 8

An adult client is complaining of vision changes and difficulty speaking because the tongue is larger. The client also states that his shoes no longer fit. Based on these symptoms, the client is most likely to be diagnosed with:

Accepted Answer

The symptoms described are all characteristic of acromegaly, which is caused by excess growth hormone secretion in adults. This leads to overgrowth of bones and tissues, including the tongue, hands, and feet. The vision changes may be due to pressure on the optic nerve. Cretinism is a form of hypothyroidism that occurs in infants and leads to stunted growth and developmental delays. Gigantism is a similar disorder to acromegaly, but it occurs in children and leads to excessive growth and height. Graves' disease is a type of hyperthyroidism that can cause symptoms such as weight loss and anxiety, but it does not typically present with the specific symptoms described in this scenario.

Question 9

A client is diagnosed with chronic lymphocytic thyroiditis. The nurse should instruct the client regarding signs and symptoms of which of the following?

Accepted Answer

Chronic lymphocytic thyroiditis, also known as Hashimoto's thyroiditis, is an autoimmune disorder that can lead to hypothyroidism. Therefore, the nurse should instruct the client regarding signs and symptoms of hypothyroidism, such as fatigue, weight gain, cold intolerance, constipation, and depression. Type 2 diabetes mellitus, heart failure, and renal failure are not typically associated with chronic lymphocytic thyroiditis.

Question 10

The nurse is assessing a client diagnosed with hyperaldosteronism. Which of the following would take the least priority during this period?

Accepted Answer

While all of the options are important, assistance with ADLs would be the least priority during the assessment of hyperaldosteronism. The focus of the assessment would be on evaluating the effects of the disorder on the body, which would include monitoring breath sounds, cardiac function, and electrolyte levels. While assistance with ADLs may be necessary for the client, it would not be the highest priority during this particular assessment.

Question 11

A client tells the nurse that he is "so thirsty" that he has already consumed four pitchers of water. The client's urine output is 3500 mL in an 8-hour period. The client is recovering from surgery on the pituitary gland. What endocrine disorder is the client most likely experiencing?

Accepted Answer

Excessive thirst and polydipsia, along with large volumes of dilute urine output, suggest diabetes insipidus, which is caused by an insufficient production or secretion of antidiuretic hormone (ADH) and can be related to pituitary gland surgery. Diabetes mellitus can cause increased thirst and urine output, but the urine output is not as large or dilute as in diabetes insipidus. Myxedema is a condition associated with hypothyroidism, which can cause decreased metabolism and a decrease in fluid and electrolyte balance. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) causes excessive water retention and can lead to hyponatremia, but urine output is decreased and not increased as in diabetes insipidus.

Question 12

A male client is diagnosed with hyperprolactinemia. The nurse realizes that which of the following clinical manifestations occurs less frequently in men?

Accepted Answer

Gynecomastia, the development of breast tissue, is less common in males with hyperprolactinemia compared to females. The other manifestations (decrease in testosterone, erectile dysfunction, and infertility) can occur in both males and females with hyperprolactinemia.

Question 13

A client is receiving diagnostic tests to determine the presence of a malignant thyroid lesion. Which of the following are symptoms that are usually associated with a malignant thyroid? (Select all that apply.)

Accepted Answer

The answer of A client is receiving diagnostic tests to...

Question 14

A client is prescribed medication after recovering from surgery to treat acromegaly. Which of the following medications would the nurse expect to see prescribed?

Accepted Answer

Octreotide is a medication used to treat acromegaly by decreasing the levels of growth hormone. It can be given IM every 4 weeks. The other options are not indicated for the treatment of acromegaly.

Question 15

A pregnant client is receiving treatment for hyperthyroidism. Which of the following medications would the nurse expect to see?

Accepted Answer

Propylthiouracil (PTU) is the preferred medication for treating hyperthyroidism in pregnant clients, as it has less risk of causing birth defects compared to methimazole. Levothyroxine is used to treat hypothyroidism, not hyperthyroidism. Radioactive iodine is contraindicated in pregnancy due to potential harm to the developing fetus.

Question 16

The nurse is providing instructions to a client receiving treatment for Cushing's syndrome. Which of the following instructions would not be appropriate for this client?

Accepted Answer

Volunteering at the hospital is not a necessary or appropriate instruction for a client receiving treatment for Cushing's syndrome. The other options are important instructions for managing the syndrome and its associated risks.

Question 17

A female client is admitted with hyperprolactinemia. Which of the following would not be a clinical manifestation of the disorder in this client?

Accepted Answer

Excessive estrogen is not a clinical manifestation of hyperprolactinemia. Hyperprolactinemia typically leads to decreased levels of estrogen in females due to the inhibitory effect of prolactin on gonadotropin-releasing hormone (GnRH), which in turn reduces the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), leading to decreased estrogen production.

Question 18

A client is hospitalized with an ongoing fever. The nurse learns that the client has had a recent infection. Currently the client is restless, diaphoretic, and agitated with the following vital signs: temperature 106°F, pulse 114, blood pressure 180/80 mmHg. Which of the following disorders is the client most likely experiencing?

Accepted Answer

The client is exhibiting symptoms of a thyroid crisis, also known as a thyroid storm, which is a rare but life-threatening complication of an overactive thyroid. The fever, restlessness, and agitation are all symptoms of a thyroid crisis, along with sweating, tachycardia, and high blood pressure. Addisonian crisis is a complication of adrenal insufficiency, goiter is an enlargement of the thyroid gland, and myxedema is a complication of untreated hypothyroidism, none of which fit the symptoms described for this client.

Quiz 56: Endocrine Dysfunction: Nursing Management