Endocrine NCLEX Practice Questions

Endocrine NCLEX Practice Questions 5.0 (5 reviews) Students also studied Terms in this set (321) George Brown College Nursing Save Endocrine NCLEX questions 121 terms awebstePreview Diabetes Mellitus NCLEX Style Ques...Teacher 36 terms ssandholmPreview Endocrine Disorder NCLEX Questio...24 terms AnnaLawrence23 Preview Neurol 55 terms mar Which of the following assessment findings characterize thyroid storm?

• increased body temperature, decreased pulse, and

increased blood pressure

• increased body temperature, increased pulse, and

increased blood pressure

• increased body temperature, decreased pulse, and

decreased blood pressure

• increased body temperature, increased pulse, and

decreased blood pressure

• increased body temperature, increased pulse, and increased blood pressure

Thyroid storm is characterized by SNS activation. Thyroid hormones potentiate effects of cathecolamines (epinephrine/norepinephrine). Therefore, all vital signs will be increased.The nurse is planning care for a client with hyperthyroidism. Which of the following nursing interventions are appropriate? Select all that apply

• instill isotonic eye drops as necessary
• provide several, small, well-balanced meals
• provide rest periods
• keep environment warm
• encourage frequent visitors and conversation
• weigh the client daily

a, b, c, and f (a) The client with hyperthyroidism may experience exopthalmos. This requires instillation of eye drops to prevent dryness and ulceration of the cornea.(b and f) The client experiences weight loss because of hypermetabolism.Several, small, well-balanced meals are given to improve nutritional status of the client and daily weights should be monitored. Weight is the most objective indicator of nutritional status.(c) The client is usually exhausted due to restlessness and agitation. Frequent rest periods help the client regain energy.

After thyroidectomy, which of the following is the priority assessment to observe laryngeal nerve damage?

• hoarseness of voice
• difficulty in swallowing
• tetany
• fever
• hoarseness of voice

Laryngeal nerve damage is manifested by severe hoarseness of voice of "whispery voice".When caring for a male client with diabetes insipidus,

nurse Juliet expects to administer:

• vasopressin (Pitressin Synthetic)
• furosemide (Lasix).
• regular insulin.
• 10% dextrose.
• vasopressin (Pitressin Synthetic)

Because diabetes insipidus results from decreased antidiuretic hormone (vasopressin) production, the nurse should expect to administer synthetic vasopressin for hormone replacement therapy. Furosemide, a diuretic, is contraindicated because a client with diabetes insipidus experiences polyuria.Insulin and dextrose are used to treat diabetes mellitus and its complications, not diabetes insipidus.Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse

would expect to find:

• Hypotension.
• Thick, coarse skin.
• Deposits of adipose tissue in the trunk and

dorsocervical area.

• Weight gain in arms and legs.
• Deposits of adipose tissue in the trunk and dorsocervical area

Because of changes in fat distribution, adipose tissue accumulates in the trunk, face (moonface), and dorsocervical areas (buffalo hump). Hypertension is caused by fluid retention. Skin becomes thin and bruises easily because of a loss of collagen. Muscle wasting causes muscle atrophy and thin extremities.For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek's sign and Trousseau's sign because they indicate which of the following?

• Hypocalcemia
• Hypercalcemia
• Hypokalemia
• Hyperkalemia
• Hypocalcemia

The client who has undergone a thyroidectomy is at risk for developing hypocalcemia from inadvertent removal or damage to the parathyroid gland. The client with hypocalcemia will exhibit a positive Chvostek's sign (facial muscle contraction when the facial nerve in front of the ear is tapped) and a positive Trousseau's sign (carpal spasm when a blood pressure cuff is inflated for a few minutes). These signs aren't present with hypercalcemia, hypokalemia, or hyperkalemia.An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential

complication of:

• Thyroid storm.
• Cretinism.
• Myxedema coma.
• Hashimoto's thyroiditis.
• Myexedema coma.

Severe hypothyroidism may result in myxedema coma, in which a drastic drop in the metabolic rate causes decreased vital signs, hypoventilation (possibly leading to respiratory acidosis), and nonpitting edema. Thyroid storm is an acute complication of hyperthyroidism. Cretinism is a form of hypothyroidism that occurs in infants. Hashimoto's thyroiditis is a common chronic inflammatory disease of the thyroid gland in which autoimmune factors play a prominent role.

In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse Lyzette would

expect a decline in:

• Serum glucose level.
• Hair loss.
• Bone mineralization.
• Menstrual flow.
• Serum glucose level.

Hyperglycemia, which develops from glucocorticoid excess, is a manifestation of Cushing's syndrome. With successful treatment of the disorder, serum glucose levels decline. Hirsutism is common in Cushing's syndrome; therefore, with successful treatment, abnormal hair growth also declines. Osteoporosis occurs in Cushing's syndrome; therefore, with successful treatment, bone mineralization increases. Amenorrhea develops in Cushing's syndrome. With successful treatment, the client experiences a return of menstrual flow, not a decline in it.Nurse Oliver should expect a client with hypothyroidism to report which health concerns?

• Increased appetite and weight loss
• Puffiness of the face and hands
• Nervousness and tremors
• Thyroid gland swelling
• Puffiness of the face and hands

Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight gain. Signs and symptoms of hyperthyroidism (Graves' disease) include an increased appetite, weight loss, nervousness, tremors, and thyroid gland enlargement (goiter).Which nursing diagnosis takes highest priority for a female client with hyperthyroidism?

a. Risk for imbalanced nutrition: More than body

requirements related to thyroid hormone excess

• Risk for impaired skin integrity related to edema, skin

fragility, and poor wound healing

• Body image disturbance related to weight gain and

edema

d. Imbalanced nutrition: Less than body requirements

related to thyroid hormone excess

d. Imbalanced nutrition: Less than body requirements related to thyroid hormone

excess In the client with hyperthyroidism, excessive thyroid hormone production leads to hypermetabolism and increased nutrient metabolism. These conditions may result in a negative nitrogen balance, increased protein synthesis and breakdown, decreased glucose tolerance, and fat mobilization and depletion. This puts the client at risk for marked nutrient and calorie deficiency, making Imbalanced

nutrition: Less than body requirements the most important nursing diagnosis.

Options B and C may be appropriate for a client with hypothyroidism, which slows the metabolic rate.Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness.What is the most likely cause of these signs?

• Diabetic ketoacidosis
• Thyroid crisis
• Hypoglycemia
• Tetany
• Thyroid crisis

Thyroid crisis usually occurs in the first 12 hours after thyroidectomy and causes exaggerated signs of hyperthyroidism, such as high fever, tachycardia, and extreme restlessness. Diabetic ketoacidosis is more likely to produce polyuria, polydipsia, and polyphagia; hypoglycemia, to produce weakness, tremors, profuse perspiration, and hunger. Tetany typically causes uncontrollable muscle spasms, stridor, cyanosis, and possibly asphyxia.Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?

• antidiuretic hormone (ADH).
• thyroid-stimulating hormone (TSH).
• follicle-stimulating hormone (FSH).
• luteinizing hormone (LH).
• antidiuretic hormone (ADH).

ADH is the hormone clients with diabetes insipidus lack. The client's TSH, FSH, and LH levels won't be affected.

A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

• Infusing I.V. fluids rapidly as ordered
• Encouraging increased oral intake
• Restricting fluids
• Administering glucose-containing I.V. fluids as ordered
• Restricting fluids

To reduce water retention in a client with the SIADH, the nurse should restrict fluids. Administering fluids by any route would further increase the client's already heightened fluid load.Nurse Troy is aware that the most appropriate for a client with Addison's disease?

• Risk for infection
• Excessive fluid volume
• Urinary retention
• Hypothermia
• Risk for infection

Addison's disease decreases the production of all adrenal hormones, compromising the body's normal stress response and increasing the risk of infection. Other appropriate nursing diagnoses for a client with Addison's disease include Deficient fluid volume and Hyperthermia. Urinary retention isn't appropriate because Addison's disease causes polyuria.A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily.Which finding should nurse Hans recognize as an adverse drug effect?

• Dysuria
• Leg cramps
• Tachycardia
• Blurred vision
• Tachycardia

Levothyroxine, a synthetic thyroid hormone, is given to a client with hypothyroidism to simulate the effects of thyroxine. Adverse effects of this agent include tachycardia. The other options aren't associated with levothyroxine.Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications?

• Tetanic contractions
• Neck vein distention
• Weight loss
• Polyuria
• Neck vein distention

SIADH secretion causes antidiuretic hormone overproduction, which leads to fluid retention. Severe SIADH can cause such complications as vascular fluid overload, signaled by neck vein distention. This syndrome isn't associated with tetanic contractions. It may cause weight gain and fluid retention (secondary to oliguria).Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?

• Fluid intake is less than 2,500 ml/day.
• Urine output measures more than 200 ml/hour.
• Blood pressure is 90/50 mm Hg.
• The heart rate is 126 beats/minute.
• Fluid intake is less than 2,500 ml/day

Diabetes insipidus is characterized by polyuria (up to 8 L/day), constant thirst, and an unusually high oral intake of fluids. Treatment with the appropriate drug should decrease both oral fluid intake and urine output. A urine output of 200 ml/hour indicates continuing polyuria. A blood pressure of 90/50 mm Hg and a heart rate of 126 beats/minute indicate compensation for the continued fluid deficit, suggesting that treatment hasn't been effective.