Hormone Havoc
A nurse is caring for a client with hypothyroidism that was started on levothyroxine. Which assessment finding indicates effective therapy?
A. Slowed Metabolism and dry skin
B. Decreased blood pressure and pulse
C. Increased energy and heart rate
D. Cold intolerance and weight gain
C. Increased energy and heart rate
Which insulin has the fastest onset?
A. Regular
B. Lispro
C. NPH
D. Glargine
B. Lispro
Which finding is expected in Cushing’s syndrome?
A. Hypoglycemia
B. Hypotension
C. Truncal obesity
D. Weight loss
C. Truncal obesity
Which finding suggests neutropenic precautions are required?
A. WBC 3,000/mm³
B. ANC > 700/mm³
C. Platelets 90,000/mm³
D. Hgb 10 g/dL
A. WBC 3,000/mm³
Which medication is commonly used to treat rheumatoid arthritis?
A. Adalimumab
B. Furosemide
C. Atorvastatin
D. Metoprolol
A. Adalimumab
The nurse prepares to administer IV calcium gluconate. This medication is used for which endocrine emergency?
A. Addisonian crisis
B. Thyroid storm
C. Tetany after thyroidectomy
D. DKA
C. Tetany after thyroidectomy
Which symptom best differentiates DKA from HHS?
A. Kussmaul respirations
B. Severe dehydration
C. Blood glucose >600
D. Absence of ketones
D. Absence of ketones
A client in Addisonian crisis is most at risk for which complication?
A. Hypertension
B. Hypokalemia
C. Hypovolemic shock
D. Metabolic alkalosis
Answer: C. Hypovolemic shock
A client receiving methrotrexate reports a fever of 100.6°F (38.1°C). The nurse’s priority action is:
A. Give acetaminophenand recheck in 1 hour
B. Notify provider immediately
C. Encourage fluids and rest
D. Advise the patient to wear a mask
B. Notify provider immediately
The nurse gives discharge teaching for a patient on methotrexate. Which statement requires intervention?
A. “I’ll avoid crowds.”
B. “I’ll take it with folic acid.”
C. “I should limit my alcohol consumption.”
D. “I’ll report mouth sores.”
C. “I should limit my alcohol consumption.”
A nurse is caring for a patient with a suspected pituitary tumor. Which clinical finding supports this?
A. Polyuria and polydipsia
B. Hypertension and truncal obesity
C. Growth changes and large hands
D. Cold intolerance and hypotension
C. Growth changes and large hands
The nurse provides education on metformin. Which statement requires intervention?
A. “I will take this with meals.”
B. “I can drink alcohol occasionally.”
C. “I’ll report muscle pain or fatigue.”
D. “It can cause diarrhea initially.”
B. “I can drink alcohol occasionally.”
The nurse is teaching about prednisone. Which teaching point is essential?
A. Take with food
B. Stop abruptly if edema develops
C. Avoid potassium-rich foods
D. Take double dose if you miss one
Answer: A. Take with food
The nurse is preparing to administer a live attenuated vaccine. Which patient condition would contraindicate this immunization?
A. Type 2 diabetes mellitus
B. HIV with CD4 count of 150 cells/mm³
C. History of mild allergic rhinitis
D. Pregnancy in the second trimester
Answer: B. HIV with CD4 count of 150 cells/mm³
A patient with type 1 diabetes presents with a blood sugar of 650mg/DM and deep, rapid respirations, fruity breath, and abdominal pain. Which is the nurse’s priority action?
A. Administer sodium bicarbonate
B. Provide an oral glucose supplement
C. Start an IV insulin infusion
D. Apply oxygen via nasal cannula
C. Start an IV insulin infusion
In evaluating treatment for diabetes insipidus, which finding best indicates improvement?
A. Urine output 200 mL/hr
B. Serum sodium 135 mEq/L
C. Elevated Urine Osmolarity
D. Weight loss of 5 lb/day
B. Serum sodium 135 mEq/L
The nurse is teaching sick-day management for type 1 DM. Which instruction is most important?
A. Adjust insulin if not eating
B. Check blood sugar every 2–4 hours
C. Double insulin dose if glucose >250
D. Limit fluid intake
B. Check blood sugar every 2–4 hours
A client with Addison’s disease suddenly collapses. BP 80/50, BG 52 mg/dL, Na 122 mEq/L. The nurse anticipates which IV medication?
A. Dextrose 5% only
B. Insulin and glucose
C. Hydrocortisone sodium succinate
D. Potassium chloride
C. Hydrocortisone sodium succinate
A nurse is monitoring a patient receiving IV antibiotics for a possible allergic reaction. Which early manifestation of anaphylaxis should the nurse recognize first?
A. Hypotension
B.Diarrhea
C. Urticaria
D. Stridor
C. Urticaria
A patient with Grave’s disease is being treated with radioactive iodine. Which discharge instruction is most important?
A. Expect rapid symptom relief
B. Avoid close contact with children and pregnant women
C. Take with calcium supplements
D. Avoid low-iodine foods
B. Avoid close contact with children and pregnant women
Which lab result is expected in SIADH?
A. Hyponatremia and low serum osmolality
B. Hypernatremia and high serum osmolality
C. Hypokalemia and metabolic alkalosis
D. Hypercalcemia and low urine sodium
A. Hyponatremia and low serum osmolality
A patient with DKA has potassium of 2.8 mEq/L before insulin administration. What is the priority action?
A. Give insulin IV as ordered
B. Administer potassium replacement
C. Increase IV fluids
D. Recheck glucose
B. Administer potassium replacement
A patient with Cushing’s syndrome is scheduled for bilateral adrenalectomy. Which postoperative nursing intervention has the highest priority during the first 24 hours?
A. Encourage early ambulation to prevent DVT
B. Monitor blood glucose and electrolytes closely
C. Teach lifelong corticosteroid replacement
D. Provide emotional support for body image changes
B. Monitor blood glucose and electrolytes closely
A nurse is caring for a patient who received a kidney transplant 2 weeks ago and is now presenting with fever, tenderness over the graft site, and elevated creatinine levels. The nurse expects which of the following conditions?
A. Urinary tract obstruction
B. Acute Kidney rejection
C. Chronic Kidney rejection
D. Infection at the incision site
B. Acute Kidney rejection
A patient newly diagnosed with AIDS is prescribed sulfamethoxazole/trimethoprim prophylactically. The nurse understands this is to prevent:
A. Cytomegalovirus retinitis
B. Pneumocystis jirovecii pneumonia
C. Vaginal Candidiasis
D. Kaposi sarcoma
B. Pneumocystis jirovecii pneumonia