Endocrine system questions
The nurse is caring for an adult who has a secreting tumor of the pituitary. Which is the patient most likely to report?
a. Very slow heart rate
b. Increased shoe size
c. Increased height
d. Rapid weight fluctuations
b. Increased shoe size
Secreting tumor of the pituitary gland puts out excessive amounts of the hormones normally secreted by the pituitary. Too much Growth hormone or somatotropic hormone would cause feet, hands, nose and jaw to grow.
A nurse in a mental health practitioner's office is communicating with a client. The client states, "I can't sleep. I stay up all night." The nurse responds, "You are having difficulty sleeping?" Which of the following therapeutic communication techniques is the nurse demonstrating?
A. Offering general leads
B. Summarizing
C. Focusing
D. Restating
D. Restating
Restating allows the nurse to repeat the main idea expressed.
An adult is admitted in Addisonian crisis. Which should the nurse expect to include in the care immediately after admission?
1. Administer hygienic care
2. Monitor vital signs
3. Encourage range of motion exercises
4. Restrict fluid intake
2. Monitor vital signs
The nurse should monitor vital signs frequently. The patient in Addisonian crisis is at risk for hypotension and hypovolemic shock.
A nurse is assisting with planning cognitive reframing techniques for a client who has an anxiety disorder. which of the following techniques should the nurse recommend to include in the plan of care? (select all that apply)
a. Priority restructuring
b. Monitoring thoughts
c. Diaphragmatic breathing
d. journal keeping
e. meditation
a. Priority restructuring
b. Monitoring thoughts
d. journal keeping
1. The nurse is caring for an older patient with type 1 diabetes and diabetic retinopathy. What is the nurse's priority concern for assessing this patient?
1. Assess ability to measure and inject insulin and to monitor blood glucose levels.
2. Assess for damage to motor fibers, which can result in muscle weakness.
3. Assess which modifiable risk factors can be reduced.
4. Assess for albuminuria, which may indicate kidney disease
1. Assess ability to measure and inject insulin and to monitor blood glucose levels.
The older patient with diabetic retinopathy also has general age related vision changes, and the ability to perform self-care may be seriously affected. He or she may have blurred vision, distorted central vision, fluctuating vision, loss of color perception, and mobility problems resulting from loss of depth perception. When a patient has visual changes, it is especially important to assess his or her ability to measure and inject insulin and to monitor blood glucose levels to determine if adaptive devices are needed to assist in self-management. The other options are important but are not specific to diabetic retinopathy. Focus: Prioritization.
A person who had a hypophysectomy has clear drainage on the dressing. What test is the nurse likely to be asked to do to help determine the source of the drainage?
1. a hematest
2. test for acetones
3. glucose test
4. test for pH
3. glucose test
Clear drainage from a head wound may be cerebrospinal fluid, which will test positive for glucose
A nurse is caring for a client who has anorexia nervosa. Which of the following examples demonstrates the nurse's use of interpersonal communication?
a. The nurse discusses the client's weight loss during a health care team meeting.
b. The nurse examines their own personal feelings about clients who have anorexia nervosa.
c. The nurse asks the client about personal body image perception.
d. The nurse presents an educational session about anorexia nervosa to a large group of adolescents.
c. The nurse asks the client about personal body image perception.
The nurse's one-on-one communication with the client is an example of interpersonal communication.
The patient has Addison's disease and is being treated with several medications, including prednisone. The nurse is teaching the patient about taking prednisone. Which teaching is essential?
1. Take prednisone on an empty stomach
2. Take prednisone with milk or crackers
3. Stop the prednisone if edema or acne develops
4. Take the medication until it is gone even if you feel better.
2. Take prednisone with milk or crackers
Prednisone can cause gastric irritation. Taking it with milk or crackers reduces gastric irritation and the chances of developing an ulcer.
A nurse is collecting data from a client following an ECT procedure. Which of the following findings should the nurse expect? (select all that apply)
a. Hypotension
b. Paralytic ileus
c. Memory loss
d. Polyuria
e. Confusion
c. Memory loss
e. Confusion
2. An older patient with type 2 diabetes has cardiovascular autonomic neuropathy (CAN). Which instruction would the nurse provide for the unlicensed assistive personnel (UAP) assisting the patient with morning care?
1. Provide a complete bed bath for this patient.
2. Sit the patient up slowly on the side of the bed before standing.
3. Only let the patient wash his or her face and brush his or her teeth.
4. Be sure to provide rest periods between activities.
2. Sit the patient up slowly on the side of the bed before standing.
CAN affects sympathetic and parasympathetic nerves of the heart and blood vessels. It may lead to orthostatic (postural) hypotension and syncope (brief loss of consciousness on standing) caused by failure of the heart and arteries to respond to position changes by increasing heart rate and vascular tone. The nurse should be sure to instruct the UAP to have the patient change positions slowly when moving from lying to sitting and standing. Focus: Supervision, Delegation.
The nurse is caring for a patient who had a transphenoidal hypophysectomy and will be discharged today. Which statement by the patient indicates a need for further instruction?
1. "I will take all these new pills until they are gone."
2. "I will ask someone to pick things up off the floor if I drop something."
3. "I won't brush my teeth until I see the doctor to have my stitches out."
4. "My wife said she'll feed the dog for a few days, even though that is my job."
1. "I will take all these new pills until they are gone."
The patient will be taking a lot of medications for the rest of their life. The only medication they will take until they are gone is the antibiotic. Hormone replacement medications will be taken for the rest of his life. Client does not understand the teaching.
A nurse is caring for a client who smokes and has lung cancer. The client reports, "I'm coughing because I have that cold that everyone has been getting." The nurse should identify that the client is using which of the following defense mechanisms?
a. Reaction formation
b. Denial
c. Displacement
d. Sublimation
b. Denial
Pretending the truth is not reality to manage the anxiety of acknowledging what is real.
The nurse is caring for a person who had a bilateral adrenalectomy. Which comment by the person indicates the client understands the medication regimen?
1. "If I develop fat cheeks or swollen ankles, I will immediately stope taking the drug."
2. "I will gradually taper the drugs if I want to stop taking them."
3. "If my grandchildren have colds, I will tell them not to come and see me."
4. "I will take all the new pills until I feel better."
3. "If my grandchildren have colds, I will tell them not to come and see me."
These drugs are taken for life. Corticosteroids cause immunosuppression. The person should avoid those who are sick. This response indicates understanding of the medication regimen.
A nurse observes a client who has OCD repeatedly applying, removing, and then reapplying makeup. The nurse identifies that repetitive behavior in a client who has OCD is due to which of the following underlying reasons?
a. Narcissistic behavior
b. Fear of rejection from staff
c. Attempt to reduce anxiety
d. Adverse effect of antidepressant medication
c. Attempt to reduce anxiety
Attempt to suppress persistent thoughts or urges that cause anxiety. pg .60
7. The plan of care for a patient with diabetes includes all of these interventions. Which intervention should the nurse delegate to unlicensed assistive personnel (UAP)?
1. Reminding the patient to put on well-fitting shoes before ambulating
2. Discussing community resources for diabetic outpatient care
3. Teaching the patient to perform daily foot inspection
4. Assessing the patient's technique for drawing insulin into a syringe
1. Reminding the patient to put on well-fitting shoes before ambulating
Reminding the patient to put on well-fitting shoes (after the nurse has taught the patient about the importance of this action) is part of assisting with activities of daily living and is within the education and scope of practice of the UAP. It is a safety measure that can prevent injury. Discussing community resources, teaching, and assessing require a higher level of education and are appropriate to the scope of practice of licensed nurses.
The nurse is caring for a patient who had a transphenoidal hypophysectomy today. The patient has returned to their room following an uneventful PACU stay. How should the nurse position the patient?
1. semi-reclining
2. fully upright
3. supine
4. prone
1. semi-reclining
Patient is at risk for intercranial pressure and should be positioned in low fowlers or semi-reclining position.
a nurse is reinforcing preoperative teaching with a client who was informed of the need for emergency surgery. The client has a RR 30/ min, and says, "This is difficult to comprehend. I feel shaky and nervous." The nurse should identify that the client is experiencing which of the following levels of anxiety?
a. Mild
b. Moderate
c. Severe
d. Panic
b. Moderate
Moderate anxiety decreases problem-solving and my hamper the client's ability to understand information. Vital signs may increase somewhat, and the client is visibly anxious. PG23
The patient has regular insulin at 11:30am. When is he most apt to get a hypoglycemic reaction?
1. 2pm-3pm
2. 12:00-12:30pm
3. 4pm-5pm
4. 8pm-9pm
1. 2pm-3pm
Regular insulin peaks two to four hours after injection. Peak action time is when the risk of hypoglycemia is greatest. Regular insulin administered at 11:30am peaks about 2 or 3pm in the afternoon.
A nurse is caring for a client who has borderline personality disorder. The client says, "The nurse on the evening shift is always nice! You are the meanest nurse ever!" The nurse should recognize the client's statement is an example of which of the following defense mechanisms?
a. Regression
b. Splitting
c. Undoing
d. Identification
b. Splitting
Unable to see positive/negative qualities at the same time. BPD sees only all good or all bad.
In the care of a patient with type 2 diabetes, which actions should the nurse delegate to an unlicensed assistive personnel (UAP)? Select all that apply.
1. Providing the patient with extra packets of artificial sweetener for coffee
2. Assessing how well the patient's shoes fit
3. Recording the liquid intake from the patient's breakfast tray
4. Teaching the patient what to do if dizziness or lightheadedness occurs
5. Checking and recording the patient's blood pressure
6. Assisting the patient to ambulate to the bathroom
1. Providing the patient with extra packets of artificial sweetener for coffee
3. Recording the liquid intake from the patient's breakfast tray
5. Checking and recording the patient's blood pressure
6. Assisting the patient to ambulate to the bathroom
Ans: 1, 3, 5, 6 Giving the patient extra sweetener, recording oral intake, assisting with ambulation, and checking blood pressure are all within the scope of practice of the UAP. Assessing shoe fit and patient teaching are within the professional nurse's scope of practice. Focus: Assignment.
An adult who is being treated for a tumor of the adrenal cortex says t the nurse, "I hate the way I look. Will I always look this bad?" What information should the nurse include wen answering the patient?
1. Once the tumor is removed, then cosmetic surgery can be done to restore your appearance.
2. Makeup and being careful about clothing styles will help the patient's appearance.
3. Counseling or psychotherapy is often recommended for patients with adrenal cortex tumors as they adapt to changes in their appearance.
4. After the tumor is removed, the patient's appearance should become more normal.
4. After the tumor is removed, the patient's appearance should become more normal.
Once the tumor is removed and the hormone levels are regulated, the patient's appearance should become more normal. This may take some time.
A nurse is contributing to the plan of care for a client during the termination phase of the nurse-client relationship. Which of the following interventions should the nurse include?
a. Discussing ways to use new behaviors
b. Practicing new problem-solving skills
c. Developing goals
d. Establishing boundaries
a. Discussing ways to use new behaviors
An adult who has just been diagnosed as having insulin dependent diabetes tells the nurse that he usually goes jogging several days a week. What should the nurse include when teaching the patient?
1. Vigorous exercise such as jogging is not appropriate for persons who have insulin dependent DM.
2. A person who takes insulin should eat a snack before exercising.
3. An insulin dependent diabetic should increase insulin when exercising.
4. Additional fluids when exercising should help to regulate the blood sugar.
2. A person who takes insulin should eat a snack before exercising.
Vigorous exercise uses up sugar and can cause an insulin dependent diabetic to have an insulin reaction. The diabetic who takes insulin should eat a snack before exercising.
A nurse is collecting data on a client 4 hours after receiving an initial dose of fluoxetine (Prozac). Which of the following findings should the nurse report to the RN and provider as indications of serotonin syndrome? (select all that apply)
a. hypothermia
b. hallucinations
c. muscular flaccidity
d. diaphoresis
e. agitation
b. hallucinations
d. diaphoresis
e. agitation
Pg. 119
18. Which task can be delegated to a medical-surgical unlicensed assistive personnel (UAP) who has been temporarily floated to the acute psychiatric unit to help?
1. Performing one-to-one observation of a patient who is suicidal
2. Assisting the occupational therapist to conduct a craft class
3. Accompanying an older adult patient who wanders on a walk outside
4. Assisting the medication nurse who is having problems with a patient
3. Accompanying an older adult patient who wanders on a walk outside
Medical-surgical UAPs assist patients to ambulate, and they frequently care for older confused patients. Performing one-to-one suicide watch requires experience because the observer may have to immediately intervene while calling out for help. Assisting the occupational therapist or medication nurse may be possible, but the medical-surgical UAP is unlikely to be familiar with the behavioral interventions required in these situations.