endocrine NCLEX Questions

endocrine NCLEX Questions 5.0 (3 reviews) Students also studied Terms in this set (45) Science MedicineNursing Save Endocrine NCLEX questions 121 terms awebstePreview Endocrine Disorder NCLEX Questio...24 terms AnnaLawrence23 Preview Endocrine NCLEX Questions 17 terms s646680Preview Evolve 103 term iam A nurse is collecting data regarding a client after a thyroidectomy and notes that the client has developed hoarseness and a weak voice. Which nursing action is appropriate?

• Check for signs of bleeding.
• Administer calcium gluconate.
• Notify the registered nurse immediately.
• Reassure the client that this is usually a temporary

condition.

• Check for signs of bleeding.
• Administer calcium gluconate.
• Notify the registered nurse immediately.
• Reassure the client that this is usually a temporary condition.

rationale Weakness and hoarseness of the voice can occur as a result of trauma of the laryngeal nerve. If this develops, the client should be reassured that the problem will subside in a few days. Unnecessary talking should be discouraged. It is not necessary to notify the registered nurse immediately. These signs do not indicate bleeding or the need to administer calcium gluconate.A nurse is reviewing discharge teaching with a client who has Cushing's syndrome. Which statement by the client indicates that the instructions related to dietary management were understood?

• "I can eat foods that contain potassium."
• "I will need to limit the amount of protein in my diet."
• "I am fortunate that I can eat all the salty foods I enjoy."
• "I am fortunate that I do not need to follow any special

diet."

• "I can eat foods that contain potassium."
• "I will need to limit the amount of protein in my diet."
• "I am fortunate that I can eat all the salty foods I enjoy."
• "I am fortunate that I do not need to follow any special diet."

rationale A diet that is low in calories, carbohydrates, and sodium but ample in protein and potassium content is encouraged for a client with Cushing's syndrome. Such a diet promotes weight loss, the reduction of edema and hypertension, the control of hypokalemia, and the rebuilding of wasted tissue.

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?

• "Cushing's disease is characterized by an oversecretion

of insulin."

• "Cushing's disease is characterized by an oversecretion

of glucocorticoid hormones."

• "Cushing's disease is characterized by an

undersecretion of corticotropic hormones."

• "Cushing's disease is characterized by an

undersecretion of glucocorticoid hormones."

• "Cushing's disease is characterized by an oversecretion of insulin."
• "Cushing's disease is characterized by an oversecretion of glucocorticoid

hormones."

• "Cushing's disease is characterized by an undersecretion of corticotropic

hormones."

• "Cushing's disease is characterized by an undersecretion of glucocorticoid

hormones." rationale Cushing's syndrome is characterized by an oversecretion of glucocorticoid hormones. Addison's disease is characterized by the failure of the adrenal cortex to produce and secrete adrenocortical hormones. Options 1 and 4 are inaccurate regarding Cushing's syndrome.A nurse would expect to note which interventions in the plan of care for a client with hypothyroidism? Select all that apply.

• Provide a cool environment for the client.
• Instruct the client to consume a high-fat diet.
• Instruct the client about thyroid replacement therapy.
• Encourage the client to consume fluids and high-fiber

foods in the diet.

• Instruct the client to contact the health care provider if

episodes of chest pain occur.

• Inform the client that iodine preparations will be

prescribed to treat the disorder.

• Provide a cool environment for the client.
• Instruct the client to consume a high-fat diet.
• Instruct the client about thyroid replacement therapy.
• Encourage the client to consume fluids and high-fiber foods in the diet.
• Instruct the client to contact the health care provider if episodes of chest

pain occur.

• Inform the client that iodine preparations will be prescribed to treat the

disorder.rationale The clinical manifestations of hypothyroidism are the result of decreased metabolism from low levels of thyroid hormone. Interventions are aimed at replacement of the hormones and providing measures to support the signs and symptoms related to a decreased metabolism. The nurse encourages the client to consume a well-balanced diet that is low in fat for weight reduction and high in fluids and high-fiber foods to prevent constipation. The client often has cold intolerance and requires a warm environment. The client would notify the health care provider if chest pain occurs since it could be an indication of overreplacement of thyroid hormone. Iodine preparations are used to treat hyperthyroidism. These medications decrease blood flow through the thyroid gland and reduce the production and release of thyroid hormone.Which nursing action would be appropriate to implement when a client has a diagnosis of pheochromocytoma?

• Weigh the client.
• Test the client's urine for glucose.
• Monitor the client's blood pressure.
• Palpate the client's skin to determine warmth.
• Weigh the client.
• Test the client's urine for glucose.
• Monitor the client's blood pressure.
• Palpate the client's skin to determine warmth.

rationale Hypertension is the major symptom that is associated with pheochromocytoma. The blood pressure status is monitored by taking the client's blood pressure. Glycosuria, weight loss, and diaphoresis are also clinical manifestations of pheochromocytoma, but hypertension is the major symptom.A nurse is caring for a client with pheochromocytoma.The client is scheduled for an adrenalectomy. During the preoperative period, the priority nursing action would be

to monitor the:

• Vital signs
• Intake and output
• Blood urea nitrogen (BUN) level
• Urine for glucose and acetone
• Vital signs
• Intake and output
• Blood urea nitrogen (BUN) level
• Urine for glucose and acetone

rationale Hypertension is the hallmark of pheochromocytoma. Severe hypertension can precipitate a brain attack (stroke) or sudden blindness. Although all of the options are accurate nursing interventions for the client with pheochromocytoma, the priority nursing action is to monitor the vital signs, particularly the blood pressure.

A nurse is caring for a client with pheochromocytoma.The client asks for a snack and something warm to drink.The appropriate choice for this client to meet nutritional needs would be which of the following?

• Crackers with cheese and tea
• Graham crackers and warm milk
• Toast with peanut butter and cocoa
• Vanilla wafers and coffee with cream and sugar
• Crackers with cheese and tea
• Graham crackers and warm milk
• Toast with peanut butter and cocoa
• Vanilla wafers and coffee with cream and sugar

rationale The client with pheochromocytoma needs to be provided with a diet that is high in vitamins, minerals, and calories. Of particular importance is that food or beverages that contain caffeine (e.g., chocolate, coffee, tea, and cola) are prohibited.A nurse is caring for a client with pheochromocytoma.Which data would indicate a potential complication associated with this disorder?

• A urinary output of 50 mL/hr
• A coagulation time of 5 minutes
• Congestion heard on auscultation of the lungs
• A blood urea nitrogen (BUN) level of 20 mg/dL
• A urinary output of 50 mL/hr
• A coagulation time of 5 minutes
• Congestion heard on auscultation of the lungs
• A blood urea nitrogen (BUN) level of 20 mg/dL

rationale The complications associated with pheochromocytoma include hypertensive retinopathy and nephropathy, myocarditis, congestive heart failure (CHF), increased platelet aggregation, and stroke. Death can occur from shock, stroke, renal failure, dysrhythmias, or dissecting aortic aneurysm. Congestion heard on auscultation of the lungs is indicative of CHF. A urinary output of 50 mL/hr is an appropriate output; the nurse would become concerned if the output were less than 30 mL/hr. A coagulation time of 5 minutes is normal. A BUN level of 20 mg/dL is a normal finding.A nurse is caring for a client after thyroidectomy and monitoring for signs of thyroid storm. The nurse understands that which of the following is a manifestation associated with this disorder?

• Bradycardia
• Hypotension
• Constipation
• Hypothermia
• Bradycardia
• Hypotension
• Constipation
• Hypothermia

rationale Clinical manifestations associated with thyroid storm include a fever as high as 106° F (41.1° C), severe tachycardia, profuse diarrhea, extreme vasodilation, hypotension, atrial fibrillation, hyperreflexia, abdominal pain, diarrhea, and dehydration. With this disorder, the client's condition can rapidly progress to coma and cardiovascular collapse.When caring for a client who is having clear drainage from his nares after transsphenoidal hypophysectomy, which action by the nurse is appropriate?

• Lower the head of the bed.
• Test the drainage for glucose.
• Obtain a culture of the drainage.
• Continue to observe the drainage.
• Lower the head of the bed.
• Test the drainage for glucose.
• Obtain a culture of the drainage.
• Continue to observe the drainage.

rationale 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 glucose, indicating the presence of CSF. The head of the bed should not be lowered to prevent increased intracranial pressure.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.Which clinical manifestation should the nurse expect to note when assessing a client with Addison's disease?

• Edema
• Obesity
• Hirsutism
• Hypotension
• Edema
• Obesity
• Hirsutism
• Hypotension

rationale Common manifestations of Addison's disease include postural hypotension from fluid loss, syncope, muscle weakness, anorexia, nausea, vomiting, abdominal cramps, weight loss, depression, and irritability. The manifestations in options 1, 2, and 3 are not associated with Addison's disease.

What would the nurse anticipate being included in the plan of care for a client who has been diagnosed with Graves' disease?

• Provide a high-fiber diet.
• Provide a restful environment.
• Provide three small meals per day.
• Provide the client with extra blankets.
• Provide a high-fiber diet.
• Provide a restful environment.
• Provide three small meals per day.
• Provide the client with extra blankets.

rationale Because of the hypermetabolic state, the client with Graves' disease needs to be provided with an environment that is restful both physically and mentally. Six full meals a day that are well balanced and high in calories are required, because of the accelerated metabolic rate. Foods that increase peristalsis (e.g., high-fiber foods) need to be avoided. These clients suffer from heat intolerance and require a cool environment.Which statement by the client would cause the nurse to suspect that the thyroid test results drawn on the client this morning may be inaccurate?

• "I had a radionuclide test done 3 days ago."
• "When I exercise I sweat more than normal."
• "I drank some water before the blood was drawn."
• "That hamburger I ate before the test sure tasted

good."

• "I had a radionuclide test done 3 days ago."
• "When I exercise I sweat more than normal."
• "I drank some water before the blood was drawn."
• "That hamburger I ate before the test sure tasted good."

rationale Option 1 indicates that a recent radionuclide scan had been performed.Recent radionuclide scans performed before the test can affect thyroid laboratory results. No food, fluid, or activity restrictions are required for this test, so options 2, 3, and 4 are incorrect.A nurse is preparing to provide instructions to a client with Addison's disease regarding diet therapy. The nurse understands that which of the following diets would likely be prescribed for this client?

• Low-protein diet
• Low-sodium diet
• High-sodium diet
• Low-carbohydrate diet
• Low-protein diet
• Low-sodium diet
• High-sodium diet
• Low-carbohydrate diet

rationale A high-sodium, high-complex carbohydrate, and high-protein diet will be prescribed for the client with Addison's disease. To prevent excess fluid and sodium loss, the client is instructed to maintain an adequate salt intake of up to 8 g of sodium daily and to increase salt intake during hot weather, before strenuous exercise, and in response to fever, vomiting, or diarrhea.A nurse caring for a client scheduled for a transsphenoidal hypophysectomy to remove a tumor in the pituitary gland assists to develop a plan of care for the client. The nurse suggests including which specific information in the preoperative teaching plan?

• Hair will need to be shaved.
• Deep breathing and coughing will be needed after

surgery.

• Toothbrushing will not be permitted for at least 2

weeks following surgery.

• Spinal anesthesia is used.
• Hair will need to be shaved.
• Deep breathing and coughing will be needed after surgery.
• Toothbrushing will not be permitted for at least 2 weeks following surgery.
• Spinal anesthesia is used.

rationale Based on the location of the surgical procedure, spinal anesthesia would not be used. In addition, the hair would not be shaved. Although coughing and deep breathing are important, specific to this procedure is avoiding toothbrushing to prevent disruption of the surgical site. Also, coughing may disrupt the surgical site.A health care provider has prescribed propylthiouracil (PTU) for a client with hyperthyroidism, and the nurse assists in developing a plan of care for the client. A priority nursing measure to be included in the plan

regarding this medication is to monitor the client for:

• Signs and symptoms of hypothyroidism
• Signs and symptoms of hyperglycemia
• Relief of pain
• Signs of renal toxicity
• Signs and symptoms of hypothyroidism
• Signs and symptoms of hyperglycemia
• Relief of pain
• Signs of renal toxicity

rationale Excessive dosing with propylthiouracil may convert the client from a hyperthyroid state to a hypothyroid state. If this occurs, the dosage should be reduced. Temporary administration of thyroid hormone may be required.Propylthiouracil is not used for pain and does not cause hyperglycemia or renal toxicity.