Endocrine
The nurse is caring for a patient undergoing the fluid deprivation test. This test is designed to confirm which condition?
a. Diabetes mellitus
b. Hypothyroidism
c. Hyperparathyroidism
d. Diabetes insipidus
d. Diabetes insipidus
Which precaution(s) should the nurse take when caring for a patient who is being treated with radioactive iodine 131 (RAIU)?
a. Initiate radioactive safety precautions.
b. Advise visitors to sit at least 10 ft away from the patient.
c. Wait 3 days after dose before assigning a pregnant nurse to care for this patient.
d. Avoid assigning any young woman to the patient.
c. Wait 3 days after dose before assigning a pregnant nurse to care for this patient.
What is the master gland of the endocrine system?
a. Pancreas
b. Pituitary
c. Parathyroid
d. Thyroid
b. Pituitary
As the nurse is shaving a patient who is 2 days postoperative from a thyroidectomy, the patient has a spasm of the facial muscles. What should the nurse recognize this as?
a. Homans' sign
b. Trousseau sign
c. Montgomery sign
d. Chvostek sign
d. Chvostek sign
The nurse is preparing a client for an MRI for a suspected tumor of the pituitary gland. The nurse will report which finding to the physician?
a. pin inserted into the hip
b. a metal watch
c. removable metal earrings
d. a belt with a metal buckle
a. pin inserted into the hip
Which assessment finding for a 33-year-old female patient admitted with Graves’ disease requires the most rapid intervention by the nurse?
a. Blood pressure 166/100 mmHg.
b. Heart rate of 112 beats/minute.
c. Bilateral exophthalmos.
d. Temperature 104.8F.
d. Temperature 104.8F.
In caring for the postoperative thyroidectomy patient, what extra equipment should the nurse have readily available at the bedside?
a. Suction machine
b. Tracheostomy tray.
c. Water sealed drainage system.
d. Ventilator.
b. Tracheostomy tray.
Which assessment technique is most appropriate when checking for laryngeal nerve damage in the patient who has had a thyroidectomy?
a. Observing the patient swallow.
b. Turning the patient’s head from side to side.
c. Asking the patient to say “Ah.”
d. Looking for tracheal deviation.
c. Asking the patient to say “Ah.”
Which information obtained by the nurse working in the endocrine clinic about a patient who has been taking prednisone 40 mg daily for 3 weeks is most important to report to the healthcare provider?
a. A self-report by the patient saying the client has increased their dose of vitamin D.
b. A self report that the client feels fatigued
c. A self-report by the patient saying the patient stopped taking the medication 4 days ago.
d. Presence of bilateral 1+ pitting ankle edema.
c. A self-report by the patient saying the patient stopped taking the medication 4 days ago.
What instructions should be included in the discharge instructions for a 47-year-old patient with hypothyroidism?
a. Taking medication whenever symptoms cause discomfort
b. Decreasing fluid and fiber intake
c. Consuming foods rich in iron
d. Seeing the health care provider regularly for follow-up care
d. Seeing the health care provider regularly for follow-up care
Which statement by a 50-year-old female patient indicates to the nurse that further assessment of thyroid function may be necessary?
a. “I feel a lump in my throat when I swallow.”
b. “I get up several times at night to urinate.”
c. “I notice my breasts are tender lately.”
d. “I am so hungry that I eat all through the day.”
a. “I feel a lump in my throat when I swallow.”
A 42-year-old female patient is scheduled for transsphenoidal hypophysectomy to treat a pituitary adenoma. During preoperative teaching, the nurse instructs the patient about the need to?
a. Cough and deep breath every 2 hours postoperatively.
b. Be positioned semi-fowlers postoperatively.
c. Avoid brushing teeth for at least 10 days after surgery.
d. Remain on bedrest for the first 48-72 hours after the surgery.
c. Avoid brushing teeth for at least 10 days after surgery.
After teaching a client who is recovering from a complete thyroidectomy, the nurse assesses the clients understanding. Which statement made by the client indicates a need for additional instruction?
a. I can receive pain medication if I feel that I need it.
b. I’ll need to take thyroid hormones for the rest of my life.
c. After surgery, I won’t need to take thyroid medication.
d. I may need calcium replacement after surgery.
c. After surgery, I won’t need to take thyroid medication.
A 35-year old presented to the clinic with an outward pouch on the side of the neck. It is neither painful nor tender. The client does not have difficulty breathing. The physician concludes that the client has a goiter and prescribes?
a. Iodine
b. Dexamethasone
c. Iron
d. PTU
a. Iodine
The nurse understands that patient’s with Cushing syndrome should adhere to which diet?
a. High carbohydrate
b. High calories.
c. Low potassium.
d. Low sodium.
d. Low sodium.
a. The patient’s urine specific gravity is 1.003.
b. The patient is confused and lethargic.
c. The patient has a urine output of 400 milliliters/hour.
d. The patient reports a recent head injury
b. The patient is confused and lethargic.
The nurse caring for a patient with hyperthyroidism is aware that the purpose of radioactive iodine treatment is to?
a. Alter the stimulus from the pituitary.
b. Depress the pituitary.
c. Stimulate the thyroid gland.
d. Destroy some of the thyroid tissue.
d. Destroy some of the thyroid tissue.
A patient who was admitted with myxedema coma and diagnosed with hypothyroidism is improving and expected to be discharged in 1 day. Which teaching strategy is best for the nurse to use?
a. Provide written reminders of self-care information.
b. Ensure that all of the patient’s medications are completely refilled.
c. Delay teaching until patient discharge date is confirmed.
d. Offer multiple options for management of therapies.
a. Provide written reminders of self-care information.
Which nursing assessment of a 69-year-old patient is most important to make during initiation of thyroid replacement with Synthroid?
a. Fluid balance.
b. Orientation and alertness.
c. Nutritional intake.
d. Apical heart rate.
d. Apical heart rate.
A 37-year-old patient is being admitted with a diagnosis of Cushing syndrome. Which findings should the nurse expect during initial assessment?
a. Chronically low blood pressure.
b. Bronzed appearance of the skin.
c. Purplish streaks on the abdomen.
d. Decreased axillary and pubic hair.
c. Purplish streaks on the abdomen.
After receiving change of shift report about the following four patients, which patient should the nurse assess first?
a. A 78-year-old female taking Synthroid who has an irregular pulse of 144 and temperature of 102.8F.
b. A 22-year-old male admitted with SIADH who has a serum sodium level of 130 mEq/L.
c. A 31-year-old female with Cushing syndrome and a blood glucose level of 244 mg.
d. A 53-year-old male who has Addison’s disease and is due for a scheduled dose of Solu-Cortef.
a. A 78-year-old female taking Synthroid who has an irregular pulse of 144 and temperature of 102.8F.
Which findings indicates to the nurse that the current therapies are effective for a patient with acute adrenal insufficiency?
a. Decreasing blood glucose levels.
b. Increasing serum sodium levels.
c. Increasing serum potassium levels.
d. Decreasing serum chloride levels.
b. Increasing serum sodium levels.
A 30-year-old patient seen in the emergency department for a severe headache and acute confusion is found to have a serum sodium level of 118 mEq/L. The patient is severely dehydrated. The nurse should anticipate the need for which diagnostic test?
a. Growth hormone stimulation test.
b. Antidiuretic hormone level.
c. Adrenocorticotropic hormone level.
d. Urinary 17-ketosteroids.
b. Antidiuretic hormone level.
A patient has returned to his room after a thyroidectomy with signs of thyroid crisis. During thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of the potential lethal complication of?
a. Delirium and restlessness.
b. Bradycardia.
c. Severe nausea and vomiting.
d. Congestive heart failure.
d. Congestive heart failure.
Why would a patient with hyperthyroidism be prescribed the drug methimazole (Tapa-zole)?
a. To limit the effect of the pituitary on the thyroid.
b. To block the production of thyroid hormones.
c. To destroy part of the hyperactive thyroid tissue.
d. To stimulate the pineal gland.
b. To block the production of thyroid hormones.