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ATI Endocrine system questions and well detailed answers A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect? a. Moon-shaped face b. Weight gain c. Calcium 12.8 mg/dL d. Sodium 150 mEq/L - c. Calcium 12.8 mg/dL A client who has adrenal insufficiency will have a calcium level above the expected reference range of 4.5 to 5.6 mg/dL. Moon-shaped face A rounded face, or a moon-shaped face, is a finding of Cushing's disease. Weight gain Weight loss is a finding of adrenal insufficiency. Sodium 150 mEq/L A client who has adrenal insufficiency will have a sodium level below the expected reference range of 136 to 145 mEq/L.. A nurse is caring for a client who has diabetes mellitus and developed peripheral neuropathy. Which of the following measures should the nurse recommend to prevent injuries to his feet? a. Examine the skin of the feet weekly for alterations in skin integrity. b. Monitor the temperature of bath water with a thermometer. c. Shop for shoes early in the day. d. Round the edges of toenails when trimming them. - b. Monitor the temperature of bath water with a thermometer.-Peripheral neuropathy makes it difficult to determine if bath water is too hot. Therefore, to prevent injury, the client should use a bath thermometer to ensure a water temperature below 43.3° C (110° F). Examine the skin of the feet feet weekly for alterations in skin integrity. The client should examine the skin of the feet daily. Shop for shoes early in the day.
To make sure they fit, the client should shop for shoes later in the day when the feet are likely to have slight swelling. Round the edges of toenails when trimming them. The client should trim toenails straight across and smooth the edges with an emery board. A nurse is providing teaching for a client who has diabetes mellitus. Which of the following findings associated with diabetic ketoacidosis (DKA) should the nurse include? a.Decreased urine output b.Weight gain of 0.45 kg (1 lb) in 24 hr c.Rapid, shallow respirations d.Blood glucose levels above 300 mg/dL - d.Blood glucose levels above 300 mg/dL-Blood glucose levels above 300 mg/dL are an expected finding of DKA. Levels above 600 mg/dL are an expected finding in a client who is in a hyperglycemic-hyperosmolar state. Decreased urine outputIncreased urine output is an expected finding of DKA. Weight gain of 0.45 kg (1 lb) in 24 hrWeight loss is an expected finding of DKA. Rapid, shallow respirationsDeep, labored breathing, known as Kussmaul respirations, is an expected of DKA. A nurse is preparing to administer propranolol by IV bolus to a client experiencing a thyroid storm. Which of the following findings indicates the client is having a therapeutic response? a.Reduction of the effects of thyroid hormone on the heart b.Blockage of the release of thyroid hormone from the thyroid gland c.Increase in the heart's sensitivity to thyroid hormone d.Increase in the uptake of thyroid hormone by the thyroid gland - Reduction of the effects of thyroid hormone on the heart-Propranolol is a beta2-adrenergic blocking agent that decreases the rapid heart rate caused by excessive thyroid stimulation. Blockage of the release of thyroid hormone from the thyroid gland Propranolol does not affect thyroid hormone release. Increase in the heart's sensitivity to thyroid hormone
d."Restrict coffee intake 2 to 3 days prior to the test." - "Restrict coffee intake 2 to 3 days prior to the test."-The client should avoid coffee and tea, even if they are decaffeinated, bananas, chocolate, and vanilla for 2 to 3 days prior to the test. "Start fasting at midnight prior to the day of the test."The client does not have to fast prior to the test, but there are foods the client should avoid, such as bananas and citrus fruits. "Begin the 24-hour urine collection with the first morning urination."The client should discard the first morning urine, and then collect all urine after that for 24 hr. "Take low-dose aspirin for pain during the testing period."The client should avoid aspirin because it can affect test results. A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the following statements by the client indicates an understanding of the information about this test? a."This test's result is a good indicator of my average blood glucose levels." b."I need to fast after midnight the night before the test." c."A level of 8 to 10 percent suggests adequate blood glucose control." d."I will use my hemoglobin A1c level to adjust my daily insulin doses." - "This test's result is a good indicator of my average blood glucose levels."-HbA1c reflects the client's glucose levels over a 120-day period, which is the life span of RBCs. "I need to fast after midnight the night before the test." The client does not need to fast before blood sampling for HbA1c. What the client eats the day before has no effect on the results of this test. "A level of 8 to 10 percent suggests adequate blood glucose control."The expected reference range for HbA1c is 4-6% for adults. A result greater than 6.5% can indicate diabetes. "I will use my hemoglobin A1c level to adjust my daily insulin doses."The client should use capillary blood glucose levels to adjust daily insulin doses with the provider's approval. A nurse is providing teaching for a client who has type 1 diabetes mellitus about how to prevent complications during illness. Which of the following statements indicates that the client understands the teaching? a."I should stop taking my insulin if I feel nauseous."
b."I will test my urine for protein when I start to feel ill." c."I will call my doctor if my blood sugar is more than 250." d."I should check my blood sugar level every 8 hours." - "I will call my doctor if my blood sugar is more than 250." The client should call the provider if their blood glucose levels exceed 250 mg/dL during illness. "I should stop taking my insulin if I feel nauseous." The client should continue taking the usual dose of insulin even when not feeling well. "I will test my urine for protein when I start to feel ill." The client should check their urine for ketones when blood glucose levels are greater than 240 mg/dL. "I should check my blood sugar level every 8 hours." The client should check their blood glucose level every 4 hr during illness. A nurse is caring for a client who has type 2 diabetes mellitus and is admitted with hyperglycemic-hyperosmolar state (HHS). Which of the following laboratory findings should the nurse expect? a.Serum pH 7. b.Blood glucose 250 mg/dL c.Blood glucose 425 mg/dL d.Serum pH 7.45 - Serum pH 7. A client who is experiencing HHS produces enough insulin to prevent ketosis but not enough to prevent hyperglycemia. Therefore, the serum pH is within the expected reference range. Glucose levels will be above 600 mg/dL. Serum pH 7. This laboratory value indicates the client has diabetic ketoacidosis. Clients who are experiencing HHS will have a pH greater than 7.40, Blood glucose 250 mg/dL
c.Hirsutism d.Increased skin thickness - Hirsutism Increased hair growth, or hirsutism, is an expected finding of Cushing's disease due to increased androgen production. Decreased blood pressure Elevated blood pressure is an expected finding of Cushing's disease. Weight loss Weight gain is an expected finding of Cushing's disease. Increased skin thickness Thinning of the skin is an expected finding of Cushing's disease. A nurse is planning dietary teaching for a client who has type 1 diabetes mellitus. Which of the following information should the nurse include regarding alcohol consumption? a.Consume no more than three servings of alcohol per day. b.Ingest food with alcohol to reduce alcohol-induced hypoglycemia. c.Increase insulin dosage before planned exercise. d.Rest for 3 days between periods of vigorous exercise. - Ingest food with alcohol to reduce alcohol-induced hypoglycemia. Alcohol inhibits the liver's production of glucose. Consuming carbohydrates while drinking alcoholic beverages helps prevent hypoglycemia. Consume no more than three servings of alcohol per day. The nurse should recommend that male clients drink no more than two servings of alcohol per day, and female clients drink no more than one serving of alcohol per day. Increase insulin dosage before planned exercise. The nurse should instruct the client to reduce insulin dosage before planned exercise to prevent hypoglycemia.
Rest for 3 days between periods of vigorous exercise. The nurse should instruct the client to exercise at least three times per week and have no more than 2 consecutive days without exercise. A nurse is preparing to give a client information about an adrenocorticotropic hormone (ACTH) stimulation test. The nurse should explain that the purpose of the test is to assess for which of the following disorders? a.Diabetes insipidus b.Hyperthyroidism c.Pheochromocytoma d.Addison's disease - Addison's disease- The nurse should instruct the client that the ACTH stimulation test is the standard test for Addison's disease. It measures the cortisol response to ACTH. The response is absent or very decreased in clients who have primary adrenal insufficiency. Diabetes insipidus A 24-hr measurement of I&O, a urine specific gravity test, and a test of urine osmolarity are used to diagnose diabetes insipidus. Hyperthyroidism A thyroid scan and a thyroid-stimulating hormone test are used to diagnose hyperthyroidism. Pheochromocytoma A 24-hr urine collection can detect catecholamines and other substances that can indicate pheochromocytoma. A nurse is performing an assessment on a client who has syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following assessment data should the nurse report? a.Sodium 110 mEq/L b.2+ deep-tendon reflexes c.Potassium 3.7 mEq/L d.Urine specific gravity 1.025 - Sodium 110 mEq/L
A nurse is caring for a client who has a pheochromocytoma. Which of the following actions should the nurse take? a.Elevate the head of the client's bed. b.Palpate the client's abdomen. c.Monitor the client for hypotension. d.Check the client's urine specific gravity. - Elevate the head of the client's bed. The nurse should elevate the head of the client's bed to reduce blood pressure and abdominal pressure. Palpate the client's abdomen. The nurse should not palpate the abdomen of a client who has a pheochromocytoma, because this can cause release of catecholamines and increase blood pressure. Monitor the client for hypotension.The nurse should monitor a client who has a pheochromocytoma for hypertension. Check the client's urine specific gravity.The nurse should monitor the urine specific gravity of a client who has diabetes insipidus. A nurse is caring for a client following a thyroidectomy. The nurse should assess for which of the following findings as an indication of hypocalcemia? a.Strong, bounding pulse b.Decreased bowel sounds c.Tingling and numbness of the hands and feet d.Diminished deep-tendon reflexes - Tingling and numbness of the hands and feet Hypocalcemia causes paresthesia, which usually starts in the hands and feet. Strong, bounding pulse Hypocalcemia causes a weak, thready pulse. Decreased bowel sounds Hypocalcemia increases gastrointestinal motility.
Diminished deep-tendon reflexes Hypocalcemia causes hyperactive deep-tendon reflexes. A nurse is caring for a client undergoing screening for primary Cushing's disease. The nurse should expect an elevation in which of the following laboratory findings? a.Lymphocyte count b.Potassium c.Calcium d.Glucose - Glucose Blood glucose is elevated in a client who has Cushing's disease. Lymphocyte count The lymphocyte count is below the expected reference range in a client who has Cushing's disease. Potassium Potassium is below the expected reference range in a client who has Cushing's disease. Calcium Calcium is below the expected reference range in a client who has Cushing's disease. A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a thyroid hormone replacement. Which of the following instructions should the nurse plan to include? a."Take this medication on an empty stomach." b."Take this medication with an antacid." c."Change position slowly while taking this medication." d."Limit your fluid intake while taking this medication." - "Take this medication on an empty stomach."
b."Blow your nose gently prior to using the nasal spray." c."Administer the nasal spray while in a side-lying position." d."Notify the provider if you develop numbness or tingling around the mouth." - "Blow your nose gently prior to using the nasal spray." The nurse should instruct the client to blow his nose gently prior to using the spray. This action prevents dilution of the medication with nasal secretions. "Depress the pump once before using the nasal spray for the first time." The nurse should instruct the client to prime the nasal spray pump by pressing down four times before the initial use. "Administer the nasal spray while in a side-lying position."The nurse should instruct the client to sit upright with their head tilted forward slightly when administering the spray. This upright position prevents the spray from going down the client's throat. "Notify the provider if you develop numbness or tingling around the mouth."Numbness or tingling around the mouth is a manifestation of hypocalcemia. Desmopressin can result in the adverse effect of hyponatremia. A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot care. Which of the following statements by the client indicates an understanding of the teaching? a."I will let my feet air dry after washing." b."I will wear sandals to allow air to circulate around my feet." c."I will buy over-the-counter medicine to treat the calluses on my feet." d."I will apply lotion to the dry areas of my feet but not between my toes." - "I will apply lotion to the dry areas of my feet but not between my toes." Lotion can be used for dry areas of the feet, but the client should avoid applying lotion between the toes, as this area is prone to bacterial growth. "I will let my feet air dry after washing."The client should dry their feet thoroughly after washing to prevent bacterial growth between the toes.
"I will wear sandals to allow air to circulate around my feet."The client should wear closed- toe shoes to prevent injury to their feet. "I will buy over-the-counter medicine to treat the calluses on my feet."Topical over-the- counter medications can impair skin integrity and lead to further injury. A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse should expect which of the following findings? a.Cold intolerance b.Lethargy c.Tremors d.Sunken eyes - Tremors Findings of hyperthyroidism include tremors, diaphoresis, and insomnia. Cold intolerance A client who has hyperthyroidism can experience heat intolerance. Lethargy A client who has hyperthyroidism can be restless and irritable. Sunken eyes A client who has hyperthyroidism can have exophthalmos, which causes a wide-eyed or startled appearance. A nurse is assessing a client who has diabetes mellitus and reports feeling anxious. Which of the following findings should the nurse expect if the client is hypoglycemic? a.Rapid, deep respirations b.Cool, clammy skin c.Abdominal cramping d.Orthostatic hypotension - Cool, clammy skin
a.Decreased heart rate b.Increased hematocrit c.High urine specific gravity d.Low BUN level - Increased hematocrit Increased hematocrit is an expected finding of diabetes insipidus due to dehydration. Decreased heart rate Tachycardia is an expected finding of diabetes insipidus. High urine specific gravity Increased urine output leads to diluted urine and a low urine specific gravity. Low BUN level An increased BUN level is an expected finding of diabetes insipidus due to dehydration. A nurse is caring for a client who is taking propylthiouracil (PTU). The nurse should recognize that the client has met the treatment goals when she reports an increase in which of the following effects? a.Increased ability to sweat b.Increased bowel movements c.Increased body weight d.Increased libido - Increased body weight Propylthiouracil suppresses the production of thyroid hormones and allows for weight gain. However, excessive weight gain could indicate that the dose of propylthiouracil is too high. Increased ability to sweat Diaphoresis is a manifestation of hyperthyroidism. Propylthiouracil is an antithyroid agent that is expected to decrease diaphoresis. Increased bowel movements
Increased bowel movements is a manifestation of hyperthyroidism. Propylthiouracil is an antithyroid agent that is expected to decrease bowel movements. Increased libido Increased libido is a manifestation of hyperthyroidism. Propylthiouracil is an antithyroid agent that is expected to decrease libido. A nurse is teaching a client who has diabetes mellitus about insulin injections. The client's prescription includes evening doses of insulin glargine and regular insulin. Which of the following instructions should the nurse include? a.Inject the insulins intramuscularly. b.Shake the insulins vigorously prior to administration. c.Draw up the insulins into separate syringes. d.Expect the insulins to appear cloudy. - Draw up the insulins into separate syringes. The nurse should instruct the client to draw up the insulins into separate syringes because insulin glargine is not compatible with other insulins. Inject the insulins intramuscularly.The nurse should instruct the client to inject the insulins into the subcutaneous tissue to promote proper absorption. Shake the insulins vigorously prior to administration.The nurse should instruct the client to gently mix the insulin vials prior to administration to prevent altering the chemistry of the medication. Expect the insulins to appear cloudy. The nurse should instruct the client to expect both insulins to appear clear and to discard any that appear cloudy. A home health nurse is assessing a client who is on lifelong hormone replacement therapy for treatment of hypothyroidism. The client has not been taking his medication regularly. Which of the following findings should the nurse expect? a.Increased urine output b.Persistent diarrhea c.Tachycardia
A weight gain or loss of 0.45 kg (1 lb) per week is not enough to suggest overhydration or dehydration.
