NURSING MISC Endocrine Review CHAPTER 44 AND 45
Question 1
The nursing instructor teaches the student nurses about the endocrine system. The
... [Show More] nursing instructor evaluates that learning has occurred when the student nurses make which statements? Select all that apply.
1. "The hypothalamus secretes releasing hormones."
2. "Hormones released by the endocrine system influence every organ in the body."
3. "The hypothalamus is considered the master gland."
4. "The pituitary gland secretes TSH (thyroid-stimulating hormone)."
5. "The endocrine system is a major controller of homeostasis."
Question 2
The client is very distraught that her 12-year-old son is of very short stature. What is the best plan by the nurse?
1. Tell the client that treatment with growth hormone might result in acromegaly.
2. Tell the client that treatment for short stature is too expensive for many to afford.
3. Tell the client that treatment with growth hormone might help and refer her to an endocrinologist.
4. Tell the client that treatment with growth hormone can add 6 inches of height to her son.
Question 3
A client has diabetes insipidus and receives desmopressin (DDAVP). The nurse completes medication education and evaluates that learning has occurred when the client makes which statement?
1. "This medication is a potent vasodilator; my blood pressure can fall."
2. "This medication promotes diuresis in my body; my blood pressure can fall."
3. "This medication increases water reabsorption in my kidneys."
4. "This medication suppresses hormone secretion from my posterior pituitary gland."
Question 4
The client has been diagnosed with Cushing's syndrome. What will the nurse’s assessment likely reveal?
1. Low blood pressure and hypoglycemia
2. Well-healed scars on the upper body
3. Upper body obesity
4. Thin, gaunt appearance of the face
Question 5
The client has been diagnosed with diabetes insipidus. What will the best plan by the nurse include?
1. Assess for increased urine production.
2. Assess for hyperglycemia.
3. Assess for hyponatremia.
4. Assess for fluid retention.
Question 6
The client has hypothyroidism and is treated with levothyroxine (Synthroid). The nurse plans to do medication education. What will the best plan by the nurse include?
1. Monitor daily temperature
2. Assess for decreased appetite.
3. Assess weekly serum blood levels.
4. Assess for altered sleep patterns.
Question 7
An older adult client has hypothyroidism. Which assessment finding would the nurse report to the physician immediately?
1. Dry skin
2. Generalized weakness
3. Muscle cramps
4. Slurred speech
Question 8
The client receives treatment with radioactive iodine by the nurse reveal?
) therapy. What will the best evaluation
1. The client will only temporarily accomplish the euthyroid state.
2. The client could safely become pregnant while receiving this treatment.
3. The client will most likely require thyroid replacement therapy.
4. The client does not have to distance herself from others.
Question 9
The client has hyperthyroidism. The nurse teaches the client to avoid which food selections?
1. Soy sauce
2. Milk products
3. High-calorie foods
4. Caffeine-free soda
Question 10
The client receives hydrocortisone therapy. The nurse will primarily assess for which electrolyte
disturbance?
1. Hypernatremia and hyperglycemia
2. Hypernatremia and hyperkalemia
3. Hypercalcemia and hyperkalemia
4. Hypoglycemia and hyponatremia
Question 11
The client receives glucocorticoid therapy. The nurse would prioritize assessment for which finding?
1. Hypothermia
2. Hypotension
3. Hypertension
4. Weight loss
Question 12
The nurse teaches the client about glucocorticoid therapy. The nurse evaluates that additional teaching is required when the client makes which statement?
1. "I can take the medication at any time as long as I don't forget it."
2. "I will monitor my blood sugar on a regular basis."
3. "I will eat a diet that is high in protein."
4. "I should take my medication after I have eaten."
Question 13
The nurse plans to administer intranasal desmopressin (DDAVP) to the client. What will the best plan by the nurse include?
1. Instruct the client to blow his nose following administration.
2. Be sure to have fresh water at the bedside.
3. Withhold other medications so absorption of desmopressin (DDAVP) will not be affected.
4. Direct the spray high into the nasal cavity.
Question 14 Type: SEQ
The nurse is reviewing the steps of the negative feedback regulation of thyroid hormone. The nurse would place these steps in which sequence?
1. Blood levels of thyroid hormone rise.
2. Hypothalamus secretes thyroid-releasing hormone (TRH).
3. Secretion of TSH and TRH are suppressed.
4. T3 and T4 are secreted.
5. The anterior pituitary secretes thyroid-stimulating hormone (TSH).
Question 15
Vasopressin is used in the treatment of
1. diabetes insipidus.
2. dehydration.
3. electrolyte imbalances.
4. diabetes mellitus.
Question 16
The function of the thyroid gland is to
1. stimulate growth.
2. control pituitary gland secretion.
3. conserve water in the body.
4. control basal metabolism.
Question 17
Which finding is a sign or symptom of hypothyroidism?
1. Anxiety
2. Bradycardia
3. Tachycardia
4. Weight loss
Question 18
The primary goal of pharmacotherapy in hyperthyroidism (Graves' disease) is to
1. increase metabolism.
2. increase synthesis of corticosteroid.
3. lower the activity of the thyroid hormone.
4. increase the activity of the thyroid hormone.
Question 19
Which finding is a symptom of Cushing's syndrome?
1. Hypoglycemia
2. Vomiting
3. Moon face
4. Diarrhea
Question 20
A client has been prescribed levothyroxine (Levothroid). What medication information should the nurse provide? Select all that apply.
“It may take a few weeks for you to see the full benefits from this drug.”
“Be sure to keep all of your follow-up appointments.”
3. “Take this medication at whatever time you eat your evening meal.”
“Do not start a fiber laxative without first discussing it with your health care team.”
“Take your calcium supplement at least 4 hours after taking this drug.”
Question 21
A client has been prescribed propylthiouracil (PTU). What medication education should the nurse provide? Select all that apply.
“It may take several days or weeks for you to see effects of this drug.” “Take this drug with meals.”
“Do not become pregnant while taking this medication.” “You may experience a rash while taking this drug.”
5. “You may continue to breastfeed while taking this drug.”
Question 22
A client has been taking propylthiouracil (PTU) for several weeks. Which client statements would the nurse interpret as indicating that the drug is having its desired effects? Select all that apply.
1. “I am sleeping so much better.”
2. “I can’t seem to gain any weight no matter how much I eat.”
“I don’t feel as anxious as I once did.”
“My heart doesn’t seem to be racing anymore.”
5. “My skin in not bruising as much.”
Question 23
A client diagnosed with an inoperable tumor of the adrenal gland is prescribed mitotane (Lysodren). The nurse would attribute which assessment finding as indicating an adverse reaction to the drug? Select all that apply.
1. The client reports that food is not appealing.
2. The client reports joint pain.
3. The client reports ringing of the ears.
The client reports increasing depression.
The client reports dizziness.
Question 24
A client will be prescribed an oral corticosteroid for treatment of a rash. The prescriber says, “In order to avoid adverse effects, I am prescribing the smallest amount possible.” What other prescribing regimens could the nurse suggest to achieve this same effect? Select all that apply.
Give the oral medication every other day.
2. Administer a larger dose for a few days and then gradually decrease the dose until the medication is discontinued.
3. Use a topical application instead of an oral product.
4. Start with a small dose and work up to the desired dose.
5. Administer the doses intramuscularly for the first few days of treatment.
Question 25
A client has been taking thyroid hormone replacement for several years. On today’s clinic visit, the nurse remarks that the client has lost 20 pounds. The client states, “I was getting fat, so I started taking an extra
thyroid pill every day or so.” How should the nurse respond? Select all that apply.
1. “Well, it certainly is working for you.”
2. “You should follow the dosage instructions for your thyroid medication exactly as written.”
3. “I’ll ask your physician to increase the number of refills on your prescription.”
4. “That could be dangerous to your health.”
5. “I may ask the doctor to write a prescription for me.”
Question 26
A patient with hyperthyroidism presented with thyroid storm and high temperature. The nurse evaluates that measures to lower the temperature should be changed when which assessment is made?
1. The patient has received a second dose of propylthiouracil.
2. The patient develops crackles in both lung bases.
3. The patient begins to shiver.
4. The patient’s blood glucose increases.
Question 27
A patient has symptoms of adrenocorticoid insufficiency and is having diagnostic testing with
administration of cosyntropin ). The nurse would evaluate that this test shows secondary
adrenocortical insufficiency if which result occurs?
1. The patient’s plasma level of cortisol rises after injection.
2. The patient has carpal spasms following injection.
3. The patient’s urine cortisol fails to rise after injection.
4. The patient flushes after injection.
Question 28
A patient was admitted with Addison’s disease. Assessment now reveals nausea, vomiting, and confusion. The nurse anticipates which urgent intervention?
1. Placement of a nasogastric tube.
2. Administration of intravenous hydrocortisone.
3. Administration of intravenous diuretic.
4. Immediate endotracheal intubation.
Question 29
A patient has been prescribed corticosteroid therapy for the treatment of severe osteoarthritis. The nurse evaluates that teaching about this drug is understood if the patient makes which statement? Select all that apply.
1. “If I get sick and cannot take my medicine for more than 3 days, I will contact my health care provider.”
“I will take my medication at the same time every day.”
“I will take my medication with food or a meal.”
4. “I will avoid dairy products while taking this medication.”
5. “If I notice my vision is changing, I will contact my health care provider.”
Question 30
A patient has been prescribed long-term corticosteroid therapy. Which preventative information does the nurse provide? Select all that apply.
Avoid carbonated beverages.
Participate in regular weight-bearing exercises.
3. Do not take any calcium supplements.
4. Schedule periodic colon studies.
5. Avoid caffeine in the diet.
Question 31
The client has been diagnosed with type 1 diabetes mellitus. He asks the nurse what this means. What is the best response by the nurse? Select all that apply.
1. "The exocrine function of your pancreas is to secrete insulin, and it is not working."
"Without insulin you will develop ketoacidosis (DKA)."
"The endocrine function of your pancreas is to secrete insulin, but it isn’t working."
4. "Your alpha cells should be able to secrete insulin, but cannot."
5. "It means your pancreas cannot secrete insulin."
Question 32
The physician orders insulin lispro (Humalog), 10 units for the client. When will the nurse administer this medication?
1. Thirty minutes before meals
2. Five minutes before a meal
3. When the meal trays arrive on the floor
4. Fifteen minutes after meals
Question 33
The physician writes orders for the client with diabetes mellitus. Which order would the nurse validate with the physician?
1. Lantus insulin 20U BID
2. Administering regular insulin 30 minutes prior to meals
3. 5 units of Humalog/10 units NPH daily
4. Metformin (Glucophage) 1000 mg per day in divided doses
Question 34
A client with diabetes mellitus type 1 is found unresponsive in the clinical setting. Which nursing action is a priority?
1. Call a code.
2. Treat the client for hypoglycemia.
3. Call the physician STAT.
4. Assess the client's vital signs.
Question 35
The nurse makes a home visit to a client with diabetes mellitus. During the visit, the nurse notes that the client's 3-month supply of insulin vials that were delivered a week ago are not refrigerated. What is the best action by the nurse at this time?
1. Instruct the client that the insulin should be stored away from direct sunlight or excessive heat.
2. Have the client discard the vials.
3. Instruct the client to label each vial with the date when opened.
4. Tell the client this is too much insulin to have on hand.
Question 36
The nurse has finished teaching a client with diabetes mellitus how to administer insulin. The nurse evaluates that learning has occurred when the client makes which statement?
1. "I should only use a calibrated insulin syringe for the injections."
2. "I should check my blood sugar immediately prior to the administration."
3. "I should use the abdominal area only for insulin injections."
4. "I should provide direct pressure over the site following the injection."
Question 37
A client with diabetes mellitus is taking oral agents and is scheduled for a diagnostic test that requires him to be NPO (nothing by mouth) and to have contrast dye. What is the best plan by the nurse with regard to giving the client his oral medications?
1. Notify the diagnostic department and request orders.
2. Notify the physician and request orders.
3. Administer the oral agents immediately after the test.
4. Administer the oral agents with a sip of water before the test.
Question 38
The client has type 2 diabetes mellitus. The nurse has taught the client about the illness and evaluates that learning has occurred when the client makes which statement?
1. "My beta cells just cannot produce enough insulin for my cells."
2. "My peripheral cells have increased sensitivity to insulin."
3. "My cells have increased their receptors, but there is not enough insulin."
4. "My cells cannot use the insulin my pancreas makes."
Question 39
The client has type 1 diabetes mellitus and receives insulin. He asks the nurse why he can't just take pills instead. What is the best response by the nurse?
1. "I know it is tough, but you will get used to the shots soon."
2. "Have you talked to your doctor about taking pills instead?"
3. "Insulin can't be in a pill because it is destroyed in stomach acid."
4. "Insulin must be injected because it needs to work quickly."
Question 40
The nurse teaches a class for the public about diabetes mellitus. Which individual does the nurse assess as being at highest risk for developing diabetes?
1. The 38-year-old client who smokes one pack of cigarettes per day
2. The 42-year-old client who is 50 pounds overweight
3. The 50-year-old client who does not get any physical exercise
4. The 56-year-old client who drinks three glasses of wine each evening
Question 41
The client injects his insulin as prescribed but then gets busy and forgets to eat. What is the nurse’s most likely assessment finding?
1. The client will be very thirsty.
2. The client will need to urinate.
3. The client will have moist skin.
4. The client will complain of nausea.
Question 42
The client receives metformin (Glucophage). What will the best plan by the nurse include with regard to patient education with this drug? Select all that apply.
1. It decreases sugar production in the liver.
2. It inhibits absorption of carbohydrates.
3. It stimulates the pancreas to produce more insulin.
4. It reduces insulin resistance.
5. It increases energy use.
Question 43
The client has type 1 diabetes mellitus and receives insulin for glycemic control. The client tells the nurse that she likes to have a glass of wine with dinner. What will the best plan by the nurse for client education include?
1. The alcohol could cause pancreatic disease and decrease insulin production.
2. The alcohol could predispose you to hypoglycemia.
3. The alcohol could cause serious liver disease.
4. The alcohol could predispose you to hyperglycemia.
Question 44
The client has type 1 diabetes mellitus and receives insulin. Which laboratory test will the nurse assess?
1. Potassium
2. Serum amylase
3. AST (aspartate aminotransferase)
4. Sodium
Question 45
The physician orders intravenous (IV) insulin for the client with a blood sugar of 563. The nurse
administers insulin lispro reveal?
1. The nurse used the correct insulin.
intravenously (IV). What does the best evaluation by the nurse
2. The nurse should have contacted the physician prior to administration.
3. The nurse should have used regular insulin (Humulin R).
4. The nurse could have given the insulin subcutaneously.
Question 46
Insulin is released when
1. blood glucose stays the same.
2. blood glucose increases.
3. blood glucose decreases.
4. glucagon increases.
Question 47
What is the primary function of the islets of Langerhans in the pancreas?
1. Secretion of enzymes
2. Acting as exocrine
3. Secretion of glucagon and insulin
4. Absorption of insulin
Question 48
Which sign or symptom is most typical of an untreated client with type 1 diabetes?
1. Increased energy
2. Weight gain
3. Fatigue
4. Decreased hunger
Question 49
The nurse understands that which following drug falls under the classification of biguanides?
1. Metformin HCI (Glucophage)
2. Repaglinide (Prandin)
3. Tolbutamide (Orinase)
4. Acarbose (Precose)
Question 50
The mechanism of action of regular insulin is to
1. stimulate the pancreas to produce insulin.
2. promote entry of glucose into the cells.
3. promote the entry of glucose into the bloodstream.
4. stimulate the pancreas to secrete more insulin.
Question 51
The mother of a 4 boy states, “I can’t believe my son has type 1 diabetes. We eat well and I was
so careful during the pregnancy. What could have caused this?” How should the nurse respond? Select all that apply.
1. “There must have been something you were exposed to during your pregnancy that caused it.”
2. “Are there others in your family who have type 1 diabetes?”
3. “He must have been allowed to eat too much sugar.”
“We are not certain what causes type 1 diabetes.”
“It is thought to be a combination of factors.”
Question 52
A client, newly diagnosed with type 1 diabetes, says, “I have heard this is a bad disease. What could I have?” How should the nurse respond? Select all that apply.
1. “Problems with arteries can occur that may cause such problems as heart disease, stroke, kidney disease, or blindness.”
2. “Let’s not talk about that now, but rather focus on keeping you healthy.”
3. “You could have nerve problems that lead to numbness or tingling in your feet or hands.”
4. “One of the most serious complications is diabetic ketoacidosis.”
5. “You may experience inability to think and difficulty with memory.”
Question 23
A client has been prescribed exenatide (Byetta). What medication education should the nurse provide? Select all that apply.
1. “Drink an 8-ounce glass of water with this pill.”
2. “You should take this medication twice each day.”
3. “You may experience dryness of the mouth while taking this drug.”
4. “You may develop diarrhea while taking this drug.”
5. “This drug will help you secrete more insulin.”
Question 54
A nurse has provided education regarding type 2 diabetes mellitus to a newly diagnosed client. Which statements would the nurse interpret as indicating need for additional education? Select all that apply.
“Well, at least the medications I will be on will help me lose weight.”
“I can take an oral medication and will never have to inject myself.”
3. “I can increase my body’s ability to use the insulin I make by exercising regularly.”
4. “I have several lifestyle changes to make.”
5. “I don’t run the risk of blindness and kidney disease like type 1 diabetics.”
Question 55
A nurse is reviewing the blood work of a client who has recently begun treatment for type 2 diabetes. Which results would indicate that the client is on target with therapy? Select all that apply.
1. HBA1C level is 8.4%.
2. HBA1C level is 6.3%.
3. Fasting blood glucose is 130 g/dL.
4. Fasting blood glucose is 100 g/dL.
5. Fasting blood glucose is 68 g/dL.
Question 56 Type: SEQ
The diabetes educator would teach a patient that different types of insulin have different onsets of action. Arrange these types of insulin in order of the onset starting with the quickest onset.
1. Insulin detemir (Levemir)
2. Insulin glulisine (Apidra)
3. Insulin lispro (Humalog)
4. Regular insulin (Humulin R)
5. Insulin isophane (NPH)
Question 57
A patient who takes insulin states, “My blood glucose has been low the last few mornings.” Which statement would the nurse evaluate as a possible cause of this change?
1. “I have been taking a garlic supplement to prevent colds.”
2. “I have been taking St. John’s wort to help with my memory.”
3. “I have been taking extra vitamin C since so many people have influenza.”
4. “I have been taking vitamin D to help build up my bones.”
Question 58
A patient who has recently been diagnosed with type 1 diabetes mellitus will require insulin therapy. The patient states, “I guess I will have to give up the half bottle of wine I drink at dinner.” Which information should the nurse provide? Select all that apply.
1. “Wine is not permitted on your diet.”
2. “You can drink as much wine as you would like but avoid hard liquor.”
“Limit your wine to a time when you are eating a complete meal.”
“Limit your wine to one glass a day.”
5. “Milk is a better choice for you so substitute it for wine.”
Question 59
A patient was prescribed chlorpropamide (Diabinese) for treatment of type 2 diabetes mellitus. One week after therapy was initiated, the patient comes to the clinic with report of nausea, flushing, and palpitations. The nurse prioritizes which assessment question?
1. “Have you taken your medication as directed?”
2. “Did you eat or drink anything new this week?”
3. “Have you increased the amount of fiber in your diet?”
4. “Did you drink any alcoholic beverages this week?”
Question 30
A patient with type 1 diabetes mellitus is maintained on insulin. The patient has decided to participate in a
sports tournament at work. Which information would the nurse provide regarding diet and insulin?
1. “Do not take your insulin the morning of a game.”
2. “Plan on eating a big meal after your game.”
3. “Take an oral hypoglycemic agent on game days rather than insulin.”
4. “Eat something before the game and drink a sports drink during the game.” [Show Less]