Pancreas
A client taking metformin is schedule to have a CT abdomen with contrast. What instructions should the nurse include regarding metformin administration?
A. Continue taking metformin as scheduled.
B. Decrease fluid intake prior to the CT and continue taking metformin
C. Hold metformin for 3 days before and after the CT
D. Hold the metformin for 2-3 days after the CT
A nurse is performing an admission assessment on a client admitted with a diagnosis of pheochromocytoma. The nurse assesses for the major symptom associated with pheochromocytoma when the nurse:
A. Tests the client's urine for glucose
B. Obtains the client's weight
C. Palpates the skin for temperature
D. Takes the client's blood pressure
D. Take the client's blood pressure.
An increased amount of catecholamines are released from the tumor associated with pheochromocytoma, thus increasing the SNS (increased HR & BP).
A client is admitted to an emergency room, and a diagnosis of myxedema coma is made. Which action would the nurse prepare to carry out initially?
A. Warm the client
B. Administer fluid replacement
C. Maintain airway
D. Administer thyroid hormone
C. Maintain airway
The initial nursing intervention would be to maintain a patent airway. Oxygen would be administered, followed by fluid replacement, keeping the client warm, monitoring vital signs, and administering thyroid hormones by the IV route.
A nurse is completing an assessment on an elderly client who is being admitted for a diagnostic workup for primary hyperparathyroidsm. Which client complaint would be characteristic of this disorder?
A. Diarrhea
B. Polyuria
C. Polyphagia
D. Weight gain
A nurse is monitoring a client with diabetes insipidus. Desmopressin (DDAVP) has been prescribed for the client. Which of the following outcomes reflects a therapeutic effect of this medication?
A. Serum osmolality greater than 320 mOsm/kg
B. Increased blood pressure
C. Decreased urine output
D. Urine osmolality less than 100 mOsm/kg
C. Decreased urine output
DDAVP is a synthetic form of anidiuretic hormone. It causes increased reabsorption of water with a resultant decrease in urine output. There would be a decrease in serum osmolality, because more fluid is being retained, and an increase in urine osmolality, because less fluid is being excreted. Increased blood pressure is a side effect rather than a therapeutic effect of the medication.
A client with uncontrolled glucose is at risk for which electrolyte imbalance?
A. Hypokalemia
B. Hyponatremia
C. Hyperkalemia
D. Hypernatremia
Clients with uncontrolled glucose that lack insulin to carry glucose inside of the cell for energy are at risk for hyperkalemia.
A community health nurse visits a client at home. Prednisone 10 mg PO daily has been prescribed for the patient. The nurse teaches the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary?
A. "I need to take the medication every day at the same time."
B. "I can take aspirin or my antihistamine if I need it."
C. "If I gain more than 5 pounds a week, I will call my doctor."
D. "I need to avoid coffee, tea, cola, and chocolate in my diet."
B. I can take aspirin or my antihistamine if I need it.
ASA and other OTC medication should not be taken unless the client consults with the MD. A is correct. A small amount of weight gain is expected with steroid administration due to increase appetite (> 5lbs needs to be called to the MD). Avoiding foods/fluids in C can decrease the risk of steroid ulcer development.
A physician has prescribed propylthiouracil (PTU) for a client with hyperthyroidism. A nurse develops a plan of care for the client. What priority nursing assessment will the nurse include in the plan of care regarding this medication?
A. Signs & symptoms of hypothyroidism
B. Signs & symptoms of hypoglycemia
C. Relief of pain
D. Signs of renal toxicity
A. Signs & symptoms of hypothyroidism.
PTU treats hyperthyroidism. Excessive dosing with PTU may convert the client from a hyperthyroid state to a hypothyroid state. If this occurs, the dosing must be reduced and may require temporary administration of thyroid hormones. The other answers are incorrect.
The nurse develops a plan of care for a client with hyperparathyroidism who is receiving calcitonin salmon (Calcimar). Which of the following outcome criteria has the highest priority regarding this medication?
A. Absence of side effects
B. Achievement of normal serum calcium levels
C. Relief of pain
D. Verbalization of appropriate medication knowledge
B. Achievement of normal serum calcium levels.
Calcitonin helps to reduce calcium release from the bones, thus lowering the calcium levels.
After a hypophysectomy, a client complains of being very thirsty and having to urinate frequently. The initial nursing action is to:
A. Document the complaints
B. Increase fluid intake
C. Assess urine specific gravity
D. Assess for urinary glucose
C. Assess urine specific gravity
After hypophysectomy, diabetes insipidus can occur temporarily because of antidiuretic hormone deficiency. This deficiency is related to surgical manipulation. The nurse should assess specific gravity and notify the physician if the results are less than 1.006.
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level was 950 mg/dL. A continuous IV infusion of regular insulin is initiated along with rehydration with IV normal saline. The serum glucose is now 240 mg/dL. The nurse would next prepare to administer which of the following?
A. IV fluids containing 5% dextrose
B. NPH insulin subcutaneously
C. An ampule of 50% dextrose
D. Phenytoin (Dilantin) for the prevention of seizures
A. IV fluids containing 5% dextrose. Once the glucose reaches < 250 mg/dL, IV fluids will be swapped from NS to D5W. This continuous infusion of a smaller concentration of glucose allows the acidosis & electrolyte issues to resolve without dropping the glucose. (Remember anion gap)
A nurse is preparing to provide instructions to a client with Addison's disease regarding diet therapy. The nurse knows that which of the following diets would most likely be prescribed for this client?
A. Low sodium
B. High sodium
C. Low protein
D. Low carbohydrate
B. A high sodium, high complex-carbohydrate, and high protein diet will be prescribed for client's with Addison's disease. To prevent excess fluid and sodium loss, the client is instructed to maintain an adequate salt intake daily and to increase salt intake during hot weather, before strenuous activity, and in response to fever, vomiting, or diarrhea.
A patient is recovering from a thyroidectomy. The patient starts to complain of tingling and numbness in the face, toes, and fingers. Which of the following findings below warrants attention?
A. Ca+ of 6 mg/dL
B. Na+ of 145 mg/dL
C. K+ of 3/5 mg/dL
D. Phosphorus of 4.3 mg/dL
A. Ca+ of 6 mg/dL
Numbness & tingling of the face, toes, and fingers is associated with hypocalcemia. The client has had a thyroidectomy with possible removal of the parathyroid tissue leaving the body unable to regulate calcium.
This medication is used to treat hyperparathyroidism in patients with chronic renal failure. It works by mimicking the role of calcium in the blood and tricks the parathyroid gland into stop secreting PTH (parathyroid hormone). Which of the following medications does this describe below?
A. Calcitonin (Miacalcin)
B. Fosamax (alendronate)
C. Lasix (Furosemide)
D. Sensipar (Cinacalet)
D. Sensipar
It binds to ca+ receptors of PT tissue, reduces PTH.
A. Continue to observe the drainage.
B. Test the drainage for glucose
C. Lower the head of the bed.
D. Obtain a culture of the drainage.
B. Test the drainage for glucose.
After hypophysectomy, the client should be monitored for rhinorrhea, which could indicate a cerebrospinal fluid (CSF) leak. If this occurs, the drainage should be collected and tested for the presence of CSF. The head of bed should not be lowered, to prevent increased ICP. Clear nasal drainage would not indicate the need for a culture. Continuing to observe the drainage without taking action could result in a serious complication,
A home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client relates a history of vomiting and diarrhea and tells the nurse that no food or medication has been consumed for 36 hours. Which additional statement by the client indicates a need for further teaching?
A. "I need to stop my insulin"
B. "I need to increase my fluid intake."
C. "I need to call the physician because of these symptoms."
D. "I need to monitor my blood glucose every 3 to 4 hours."
A. "I need to stop my insulin."
Clients should continue to take insulin during sickness and check glucose levels more frequently. Glucose can increase during sickness.
A nursing instructor asks a student to describe the pathophysiology that occurs in Cushing's disease. Which statement by the student indicates an accurate understanding of this disorder?
A. It is characterized by an oversecretion of glucocorticoid hormones.
B. It is characterized by an undersecretion of glucocorticoid hormones.
C. It is characterized by an oversecretion of insulin.
D. It is characterized by an undersecretion of corticotropic hormones.
Cushings is too much cortisol. Addison's is not enough. C & D not accurate with Cushings.
A patient has an extremely high T3 and T4 level. Which of the following signs and symptoms DO NOT present with this condition?
A. Weight loss
B. Intolerance to heat
C. Anxiety
D. Hair loss
D: Hair loss
High T3 & T4 levels are associated with hyperthyroidism. Everything is heightened during this time due.
A patient is diagnosed with hyperparathyroidism. Which of the following signs and symptoms are not expected findings? Select all that apply.
A. Calcium level 6 mg/dL
B. Bone fracture
C. Positive Trousseau's sign
D. Tingling and numbness of lips and fingers
E. Calcium level of 15 mg/dL
F. Phosphate level of 1.2 mg/dL
G. Renal calculi
A, C, D
A patient with SIADH is undergoing IV treatment of a hypertonic IV solution of 3% saline and IV Lasix. Which of the following nursing findings requires intervention?
A. Sodium level of 136.
B. Patient reports urinating more frequently.
C. Potassium level of 5.0.
D. Assessment finding of crackles throughout the lung fields.
D. Assessment findings of crackles throughout the lung fields.
A client is diagnosed with Type 1 diabetes mellitus. The nurse would follow up with which statement made by the client?
A. "I will need to obtain a sharps container."
B. "I will order a pill box to organize my medication."
C. "I will try to keep my blood glucose around 100"
D. "I will get an annual physical each year."
B. "I will order a pill box to organize my medication."
Type I diabetes mellitus is treated by insulin injection only due to the lack of insulin production by the pancreas.
To prevent Addisonian crisis, the nurse would teach the patient to increase cortisol and aldosterone intake during which "events"? Select all that apply.
A. Exercise
B. During a divorce
C. + COVID test
D. Traveling long distances
E. Laparoscopic appendectomy
Stress, sickness, and surgery can precede Addisonian crisis in clients with Addisonian disease if not properly treated. These patients require an increase amount of hormones to help counteract the supply and demand of the body.
The thyroid hormones, T3 and T4, play many roles in the human body. Which of the following functions are performed by T3 and T4? Select all that apply
A. Storing calories
B. Increasing the Heart Rate
C. Stimulating the Sympathetic Nervous System
D. Decreasing the body’s temperature
E. Regulating TSH produced by the anterior pituitary gland
The answers are B, C, and E.
T3 and T4 burn calories (not store them) and increases body temperature (not decrease).
A patient is 6 hours post-opt from thyroid surgery. The patient’s calcium level is 5 and phosphate level is 4.2. What physical signs and symptoms would NOT present with these findings? Select-all-that-apply.
A. Bronchospasm
B. Constipation
C. Numbness and tingling in the face
D. Positive Chvostek’s Sign
E. Absent Trousseau’s Sign
F. Hypertension
B, E, F
The anti-diuretic hormone is __________ in Diabetes Insipidus and _________ in SIADH.
A. high, low
B. absent, absent
C. low, high
D. low, low
C. Low, high
ADH is low in DI, thus the patient is not able to retain fluid and diuresis a large amount of urine each day. ADH is high in SIADH, thus the patient retains fluid and has minimal urine output.