Adult Health Exit HESI STUDY GUIDE, WITH QUESTIONS AND ANSWERS.ENDOCRINE DISORDERS
1. Nurse Ronn is assessing a client with
possible Cushing’s
... [Show More] syndrome. In a client with
Cushing’s syndrome, the nurse would expect
to find:
a. Hypotension.
b. Thick, coarse skin.
c. Deposits of adipose tissue in the trunk and
dorsocervical area.
d. Weight gain in arms and legs.
1. Answer C. Because of changes in fat distribution,
adipose tissue accumulates in the trunk, face
(moonface), and dorsocervical areas (buffalo hump).
Hypertension is caused by fluid retention. Skin
becomes thin and bruises easily because of a loss of
collagen. Muscle wasting causes muscle atrophy and
thin extremities.
2. A male client with primary diabetes
insipidus is ready for discharge on
desmopressin (DDAVP). Which instruction
should nurse Lina provide?
a. “Administer desmopressin while the suspension
is cold.”
b. “Your condition isn’t chronic, so you won’t need
to wear a medical identification bracelet.” c.
“You may not be able to use desmopressin
nasally if you have nasal discharge or
blockage.”
d. “You won’t need to monitor your fluid
intake and output after you start taking
desmopressin.”
2. Answer C. Desmopressin may not be absorbed if
the intranasal route is compromised. Although
diabetes insipidus is treatable, the client should wear
medical identification and carry medication at all
times to alert medical personnel in an emergency and
ensure proper treatment. The client must continue to
monitor fluid intake and output and receive adequate
fluid replacement.
3. Nurse Wayne is aware that a positive
Chvostek’s sign indicate? a.
Hypocalcemia
b. Hyponatremia
Hypokalemia
d. Hypermagnesemia
a. Hypocalcemia
b. Hyponatremia
Hypokalemia
d. Hypermagnesemia
3. Answer A. Chvostek’s sign is elicited by tapping
the client’s face lightly over the facial nerve, just
below the temple. If the client’s facial muscles twitch,
it indicates hypocalcemia. Hyponatremia is indicated
by weight loss, abdominal cramping, muscle
weakness, headache, and postural hypotension.
Hypokalemia causes paralytic ileus and muscle
weakness. Clients with hypermagnesemia exhibit a
loss of deep tendon reflexes, coma, or cardiac arrest.
4. In a 29-year-old female client who is
being successfully treated for Cushing’s
syndrome, nurse Lyzette would expect a
decline in:
a. Serum glucose level.
b. Hair loss.
Bone mineralization.
d. Menstrual flow.
a. Serum glucose level.
b. Hair loss.
Bone mineralization.
d. Menstrual flow.
4. Answer A. Hyperglycemia, which develops from
glucocorticoid excess, is a manifestation of
Cushing’s syndrome. With successful treatment of
the disorder, serum glucose levels decline. Hirsutism
is common in Cushing’s syndrome; therefore, with
successful treatment, abnormal hair growth also
declines. Osteoporosis occurs in Cushing’s
syndrome; therefore, with successful treatment, bone
mineralization increases. Amenorrhea develops in
Cushing’s syndrome. With successful treatment, the
client experiences a return of menstrual flow, not a
decline in it.
5. A male client has recently undergone
surgical removal of a pituitary tumor. Dr.
Wong prescribes corticotropin (Acthar), 20
units I.M. q.i.d. as a replacement therapy.
What is the mechanism of action of
corticotropin?
a. It decreases cyclic adenosine monophosphate
(cAMP) production and affects the metabolic
rate of target organs.
b. It interacts with plasma membrane receptors to
inhibit enzymatic actions.
c. It interacts with plasma membrane receptors to
produce enzymatic actions that affect protein,
fat, and carbohydrate metabolism.
d. It regulates the threshold for water resorption in
the kidneys.
5. Answer C. Corticotropin interacts with plasma
membrane receptors to produce enzymatic actions
that affect protein, fat, and carbohydrate metabolism.
It doesn’t decrease cAMP production. The posterior
pituitary hormone, antidiuretic hormone, regulates
the threshold for water resorption in the kidneys. [Show Less]