Download Edapt: Altered Hormonal Regulation – NR507 Chamberlain University – 2024/2025 – Questions and more Exams Medicine in PDF only on Docsity!
EDAPT: ALTERED HORMONAL REGULATION
QUESTIONS WITH 100% ACCURATE ANSWERS
The nurse is caring for a client with fluid volume deficit. Which hormone is most likely affecting fluid balance? - Accurate answers Antidiuretic hormone (ADH) The nurse is caring for a client with extreme tachycardia, diarrhea, weight loss, hypertension, and intolerance to heat. Which hormone is most likely affecting the client's metabolic rate? - Accurate answers Triiodothyronine (T3) Primary causes of altered hormonal regulation originate __________. Secondary causes of altered hormonal regulation originate __________. - Accurate answers Within the gland in question From another organ dysfunction For each endocrine disorder, specify its likely manifestations. - Accurate answers Cushing's Disease: Delayed wound healing Hypertension Diabetes Insipidus: Polyuria Polydipsia Hypothyroidism: Brittle hair and nails Constipation The nurse is caring for a client who is prescribed an MRI with contrast to evaluate the pituitary gland. Which lab value must the nurse review before testing can occur? - Accurate answers Creatinine level The nurse suspects alterations of which hormones? Select all that apply. - Accurate answers Thyroxine Thyroid-stimulating hormone (TSH)
Further exploration of Jodie's history reveals that she had a total thyroidectomy 3 months ago and is taking levothyroxine. Which serum electrolyte should be monitored closely following total thyroidectomy? - Accurate answers Calcium Which prescriptions should the nurse anticipate in Jodie's treatment plan? Select all that apply. - Accurate answers Increasing levothyroxine dosage. Initiating fall prevention strategies. Closely monitoring the thyroid-stimulating hormone level. Select the cues that are suspicious of endocrine dysfunction. Jack Jermaine (pronouns: he/him/his), age 68, presents to the emergency department (ED) via ambulance with weakness, excessive urination, weight loss, and insatiable thirst. He appears confused about the date and time but is oriented to location. - Accurate answers Weakness Excessive urination Insatiable thirst Confused Based on Mr. Jermaine's symptoms, the nurse should focus on assessing for an alteration of which hormone? - Accurate answers Antidiuretic hormone (ADH) Antidiuretic hormone is likely __________, resulting in placing the client at significant risk for __________. __________ is the priority client need. - Accurate answers Decreased Diabetes insipidus Hypovolemia Fluid volume replacement For each prescription, select if the nurse anticipates or does not anticipate it being included in the healthcare provider's care for Jack. - Accurate answers Anticipated:
- Administer desmopressin
- Monitor for signs of water intoxication once treatment begins
- Head MRI with contrast Not Anticipated:
- Administer albuterol via inhaler
The client was recently diagnosed with thyroid cancer and has a history of migraines, diverticulitis, and infertility. Vital signs are T 99.9 °F (37.7 °C), P 110, BP 152/98, RR 30, and oxygen saturation 93% on room air. - Accurate answers Thyroid cancer The client has __________ hyperthyroidism and is at risk for developing __________ due to __________. - Accurate answers Primary Respiratory alkalosis Hyperventilation Simone's highest priority is __________ followed by __________. - Accurate answers Ineffective breathing Risk for unstable blood pressure The healthcare provider prescribes methimazole, and the nurse prepares discharge teaching. Which statements made by the client indicate an understanding of teaching? Select all that apply. - Accurate answers "If I have a sore throat or fever, I will contact my healthcare provider right away." "I should start to feel better in about a week or two." "I should use caution around sharp objects and use an electric razor to shave my legs." The nurse is caring for a client admitted to the intensive care unit with thyroid storm following a thyroidectomy. For each nursing action, identify if the action is essential, nonessential, or contraindicated. - Accurate answers Essential:
- Monitor the temperature closely as an increase indicates a worsening condition.
- Use cooled saline and ice packs to lower temperature. Nonessential:
- Guide the client through a meditation session to slow breathing. Contraindicated:
- Prepare to administer levothyroxine intravenously.
- Restrain the client during seizure activity to prevent injury. Select the two assessment findings that require immediate follow-up by the nurse.
Simone presents to the emergency department (ED) with shortness of breath, severe anxiety and agitation, nausea, and extreme fatigue. Yesterday, Simone fell and sprained her left ankle, but she cannot recall any details about the accident and seems confused. She recently lost her insurance coverage and has been taking methimazole every other day to make the prescription last longer. Vital signs are T 104.5 - Accurate answers BP 168/ Oxygen saturation 88% The client is at risk for __________ due to __________. - Accurate answers Acute thyrotoxicosis Uncontrolled hyperthyroidism Which complications is the client at risk for developing due to acute thyrotoxicosis? Select all that apply.
- Accurate answers Stroke High-output heart failure Seizures Cardiogenic shock For each potential healthcare provider prescription, specify whether the prescription is anticipated, nonessential, or contraindicated for the care of this client. - Accurate answers Anticipated:
- Administer propylthiouracil intravenously 1 mg over 10 minutes; repeat every few hours based on vital signs.
- Administer propranolol 2 mg slow intravenous push. Nonessential:
- Refer to a social worker for assistance with insurance coverage. Contraindicated:
- Administer Lugol's solution 150 mg oral solution by mouth now. For each body system, select the nursing action that would be appropriate for the care of this client. - Accurate answers Cardiovascular system - Apply monitoring leads to assess for dysrhythmias. Respiratory system - Place the client in a high-Fowler's position. Integumentary system - Apply cooling blanket. Nervous system - Teach breathing techniques.
Fatigue and weakness Constipation Forgetfulness In the case study below, select the primary cause of the client's symptoms. The client has a history of ulcerative colitis, diabetes mellitus type 1, and throat cancer requiring external beam radiation and chemotherapy but is now in remission. Vital signs are T 97.4 °F (36.3 °C), P 55, BP 92/62, RR 14, and oxygen saturation 92% on room air. - Accurate answers External beam radiation The client has __________ hypothyroidism and is at risk for developing respiratory __________ due to __________. - Accurate answers Primary Acidosis Hypoventilation Nevaeh's highest priority is __________ followed by __________. - Accurate answers Risk for impaired gas exchange Hypothermia The healthcare provider prescribes levothyroxine, and the nurse prepares discharge teaching. Which statements made by the client indicate a need for further teaching? Select all that apply. - Accurate answers "I should start to feel better in about 24 hours." "I will need to decrease my dosage of insulin while taking this medication." "I will be so happy when this is all behind me and I no longer have to take medication." The nurse is caring for a client admitted to the intensive care unit with myxedema coma. For each nursing action, identify if the action is essential, nonessential, or contraindicated. - Accurate answers Essential:
- Apply telemetry leads and closely monitor for cardiac dysrhythmias.
- Observe the client for signs of infection. Nonessential:
- Administer stool softeners and encourage increased oral intake. Contraindicated:
- Provide the client with an electric blanket for warmth.
- Verify apical heart rate before administering propranolol. Select two assessment findings that require immediate follow up by the nurse. Today, Nevaeh presents to the clinic with significant weight loss over the past two months and chronic headaches. Further assessment reveals they have stopped menstruating and have trouble sleeping. Vital signs are T 101.8 °F (38.7 °C), P 110, BP 162/98, RR 27, and oxygen saturation 95% on room air. Peripheral pulses are 3+ bilaterally and tremors are noted. Nevaeh is very anxious stating, "I hope my cance - Accurate answers T 101.8 °F (38.7 °C) BP 162/ The client is likely experiencing __________ due to __________. - Accurate answers Hyperthyroidism Medication increase Based on the client's symptoms, which laboratory results does the nurse anticipate? Select all that apply. - Accurate answers Total T3 300 ng/dL TSH 0.2 ng/dL Total T4 13.7 mcg/dL The healthcare provider admits Nevaeh to the hospital for medication management and symptom control. For each nursing action, indicate if the admitting nurse should anticipate or not anticipate performing the action in the care of this client. - Accurate answers Anticipated:
- Provide a low-stimulation environment. Not Anticipated:
- Increase the temperature in the room and provide warm blankets.
- Hold atenolol if the heart rate is less than 80 beats per minute.
- Administer liotrix 1 tablet by mouth once daily. After several days of treatment, Nevaeh is ready for discharge. Until laboratory values return to normal, the client is instructed to eat a diet low in iodine. Which foods should the nurse teach Nevaeh to avoid until the next follow-up appointment? - Accurate answers Greek yogurt with strawberries Three weeks later, Nevaeh returns to the clinic for follow-up. Which laboratory values indicate Nevaeh's condition is improving? - Accurate answers TSH 2.2 ng/dL
To confirm a diagnosis of Cushing's syndrome, the healthcare provider prescribes a dexamethasone suppression test for Monday. Place the steps of this procedure in the correct order, from first to last. - Accurate answers 1. Hold medications that may affect the test.
- Take oral dexamethasone as prescribed.
- Draw blood for plasma cortisol levels.
- Review the results. Sam's plasma cortisol levels are expected to __________ in response to the administration of dexamethasone if she has Cushing's syndrome. - Accurate answers Increase Identify the assessment findings that indicate Sam is experiencing fluid volume overload and hyperaldosteronism. - Accurate answers Weight gain of 10 pounds in the past month Swelling in her legs P 110, BP 152/ Sodium 150 mEq/L Hemoglobin 10 g/dL Hematocrit 30% Without treatment, the client is at risk for __________ due to circulatory overload caused by fluid and __________ retention. - Accurate answers Pulmonary edema Sodium In addition to fluid and electrolyte imbalances, which complications is the client at risk of developing? Select all that apply. - Accurate answers Kidney stones Sepsis Coronary artery disease Depression For each potential healthcare provider prescription, select whether the prescription is anticipated, nonessential, or contraindicated for the care of this client. - Accurate answers Anticipated:
- Slowly taper prednisone dosage by administering one tablet every other day.
- Initiate fluid restriction 1500 mL per day. Nonessential:
- Refer to psychologist for disturbed body image. Contraindicated:
- Administer 0.9% sodium chloride at 125 mL/hour.
For each body system, select the nursing action that would be appropriate for the care of this client. - Accurate answers Cardiovascular system - Educate on low-fat, low-cholesterol diet. Immune system - Educate on avoiding large crowds and people who are sick. Integumentary system - Reposition the client frequently. Musculoskeletal system - Use a gait belt to assist with ambulation. Which assessment findings in the nurses' note indicate that the client is progressing as expected? Select all that apply. - Accurate answers Peripheral edema Electrolyte values Lung sounds and respiratory rate Hemoglobin and hematocrit Blood pressure Which is the nurse's priority at this time? - Accurate answers Fluid and electrolyte balance Two hours later, the nurse notes that the incisional dressing is saturated with blood. Vital signs are T 98.2 oF (36.7 oC), P 110, BP 98/62, RR 26, and oxygen saturation 95% on room air. The nurse should first __________ and then __________. - Accurate answers Apply a pressure dressing to the incision Call the healthcare provider
