CH 39 NIH III Worksheet PDF

Chapter 39. Nursing Care of Patients With Endocrine Disorders Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. A patient is scheduled for diagnostic tests for hypothyroidism. Which symptoms does the nurse expect to observe in a patient w...

Chapter 39. Nursing Care of Patients With Endocrine Disorders Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. A patient is scheduled for diagnostic tests for hypothyroidism. Which symptoms does the nurse expect to observe in a patient with this disorder? 1. Tremor and oily skin 2. Anxiety and tachycardia 3. Dry skin and slowed heart rate 4. Increase in appetite and diarrhea ____ 2. The nurse is monitoring a patient admitted for testing of diabetes insipidus. Which observation by the nurse is unexpected? 1. Low specific gravity of urine 2. Expressions of extreme thirst 3. Elevated blood glucose levels 4. Large amounts of clear urine ____ 3. A patient who is 1 day postoperative thyroidectomy reports feeling numb around the mouth and is experiencing random muscle twitches. Which IV medication does the nurse anticipate being prescribed by the health care provider (HCP)? 1. Iodine 2. Calcium gluconate 3. Potassium chloride 4. Sodium bicarbonate ____ 4. The nurse is providing care for a patient with syndrome of inappropriate antidiuretic hormone (SIADH). Which additional diagnosis does the nurse need to identify as a contributor to the patient’s disorder? 1. Diabetes insipidus 2. History of renal calculi 3. Ulcerative colitis 4. Mental health disorder ____ 5. The nurse is monitoring a patient 6 hours after a thyroidectomy for cancer. Vital signs are temperature 104°F, pulse 144 beats/min, respirations 24/min, and blood pressure 184/108 mm Hg. Which prescription does the nurse anticipate from the HCP? 1. Aspirin and bedrest 2. Beta blockers and a cooling blanket 3. Epinephrine and compression dressings 4. Diphenhydramine and Fowler’s position ____ 6. The nurse is gathering information from a patient in a HCP’s office. The patient reports difficulty speaking and swallowing and, recently, frequent headaches. Which additional manifestation does the nurse observe that indicates a possible glandular dysfunction? 1. Large fleshy hands 2. Sleep apnea 3. Visual disturbances 4. Carbohydrate intolerance ____ 7. The nurse is contributing to the plan of care for an adult patient diagnosed with growth hormone (GH) deficiency. Which nursing intervention is appropriate for this patient? 1. Teach the importance of weight reduction. 2. Monitor and report blood cholesterol levels. 3. Reassess for cardio- and cerebrovascular changes. 4. Promote a caring, supportive relationship. ____ 8. The nurse determines that treatment has been effective for a patient with diabetes insipidus. Which laboratory value did the nurse use to come to this conclusion? 1. Urine ketones 2. Serum potassium 3. Fasting blood glucose 4. Urine specific gravity ____ 9. The nurse is providing care for a patient who is postoperative for a transsphenoidal surgery for the removal of a pituitary tumor. Which nursing care is inappropriate in the postsurgi- cal period? 1. Promote use of spirometer and deep breathing. 2. Change nasal packing and moustache dressing. 3. Obtain and report results of urine specific gravity. 4. Monitor for signs of cerebrospinal fluid drainage. ____ 10. A patient arrives at the emergency department and states, “I was outside shoveling snow and suddenly started to feel really bad.” The patient’s medical history indicates treatment for hypothyroidism for the past 10 years. Which possible condition causes the nurse the greatest concern? 1. Cardiac failure 2. Myxedema coma 3. Thyrotoxic crisis 4. Respiratory failure ____ 11. A patient enters the emergency department in adrenal crisis. The patient is lethargic and vital signs are blood pressure 85/52 mm Hg and pulse 88 beats/min. Which event in the patient’s week most likely precipitated this crisis? 1. Eating a high-fat diet 2. Being laid off from a job 3. Taking Tylenol for a headache  4. Nightly walking exercise ____ 12. The nurse is reinforcing teaching to a patient who is diagnosed with genetically related hypoparathyroidism. Which comment by the patient indicates that patient teaching is successful? 1. “I will immediately report numbness and tingling of the fingers, tongue, and lips.” 2. “I understand that muscle spasms and twitching mean I need more calcium in my diet.” 3. “If I make funny noises when I breathe, I will drink more fluids and get a humidifier.” 4. “I will switch to whole milk instead of skim milk and increase my intake of cheese.” ____ 13. The licensed practical nurse/licensed vocational nurse (LPN/LVN) is assisting in the care of a 51-year-old patient recovering from a hypophysectomy. Which observation should the nurse identify as needing immediate intervention? 1. Urine specific gravity of 1.19 2. Hemoglobin level of 13.2 g/dL 3. Urinary output of 800 mL in 4 hours 4. Complaints of pain at a 5 on a scale of 0 to 10 ____ 14. The nurse is providing care for a patient scheduled to receive radioactive iodine as treatment for thyroid cancer. Which care intervention for this patient is inappropriate? 1. All urine, vomitus, and body secretions are handled as contaminated. 2. Hospital policy and the radiation safety officer are consulted for instructions. 3. Pregnant caretakers will wear a lead apron during patient contact. 4. The toilet is flushed twice after disposing of contaminated body products. ____ 15. The LPN/LVN is monitoring a patient with a goiter who is scheduled for surgery. Physical inspection reveals only slight swelling in the anterior base of the neck. Which manifesta- tion will prompt the LPN/LVN to notify the registered nurse (RN)? 1. Patient expresses difficulty with swallowing. 2. Patient reports sensation of heaviness in the neck. 3. Patient expresses a fear of choking on food. 4. A whistling sound is heard with breathing. ____ 16. The nurse is assigned to provide care for a patient diagnosed with diabetes insipidus. While reviewing the nursing care planned for the patient, which intervention will the nurse recognize as being least important? 1. Monitoring daily weight, intake and output, vital signs, and urine specific gravity 2. Providing free access of the patient to oral fluids as desired 3. Reporting a significant drop in blood pressure and increase in pulse 4. Determining the patient’s understanding of her condition ____ 17. The nurse is monitoring the effects of a water deprivation test on a patient suspected of diabetes insipidus related to pituitary dysfunction. Which test result supports the diagnosis? 1. Body weight and urine osmolality remains unchanged. 2. The patient is unable to void after 6 hours of deprivation. 3. Urine continues to be diluted with a high specific gravity. 4. Weight loss occurs due to the large amount of urine voided. ____ 18. The nurse is providing care for a patient diagnosed with complications related to Cushing syndrome. Which situation indicates a need for a change in nursing intervention? 1. Insulin for high blood glucose is administered by the nurse. 2. The patient’s skin has remained intact during hospitalization. 3. Complications of fluid overload are recognized and treated early. 4. The patient is receptive to and appreciative of help with personal care. ____ 19. The nurse is gathering data from a patient who voices concerns about feeling dizzy upon standing, fatigue, and recent weight loss. Which additional information will most likely cause the nurse to suspect a problem with adrenal insufficiency? 1. Periods of tachycardia 2. Bronzed skin coloration 3. Low blood pressure reading 4. Indications of dehydration ____ 20. The nurse is reviewing information with a patient about endocrine gland disorders. The patient asks, “I have pituitary insufficiency, what is happening?” Which information from the nurse is incorrect? 1. “You may have an ectopic growth on the pituitary secreting hormones.” 2. “There are a variety of tests that will help distinguish the cause.” 3. “Too little hormone is secreted when a gland does not work properly.” 4. “Target tissue insensitivity results in too little hormone activity.” ____ 21. The nurse is attending to patients in an assisted-living facility. For which reason is the nurse aware that the recognition of hyperthyroidism is difficult in older patients? 1. The manic and psychotic behavior mimics dementia. 2. The presenting symptoms tend to mimic cardiac concerns. 3. Nervousness and tremor are common in this population. 4. This age category has difficulty describing signs and symptoms. ____ 22. The nurse is assisting with discharge of a patient with Addison disease following an adrenal crisis. Which instruction is most important for the nurse to reinforce? 1. The need for a well-balanced diet 2. How to monitor blood glucose levels 3. The importance of 30 minutes of exercise each day 4. The importance of taking steroid replacements as prescribed Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 23. A patient is being discharged with prescribed treatment for long-term hypoparathy- roidism. Which does the nurse include in discharge teaching? (Select all that apply.) 1. Eat a diet high in calcium. 2. Limit dietary phosphates. 3. Have regular eye examinations. 4. Add iron-rich foods to your diet. 5. Follow up with regular laboratory tests. ____ 24. A patient with suspected hyperthyroidism is scheduled for a radioactive iodine uptake test. Which symptoms of hyperthyroidism does the nurse note on the medical record? (Select all that apply.) 1. Fatigue 2. Tremor 3. Weight loss 4. Constipation 5. Buffalo hump ____ 25. A patient diagnosed with SIADH is scheduled for surgery in a few days. Which does the nurse expect to be prescribed for this patient to help manage the symptoms until surgery? (Select all that apply.) 1. Salt restriction 2. Fluid restriction 3. Furosemide 4. Conivaptan 5. Hypertonic saline infusion Chapter 39. Nursing Care of Patients With Endocrine Disorders Answer Section MULTIPLE CHOICE 1. ANS: 3 Chapter: Chapter 39. Nursing Care of Patients With Endocrine Disorders Objective: Describe the etiologies, signs, and symptoms of each of the endocrine orders. Page: 795 Heading: Hypothyroidism Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Physiological Integrity—Physiological Adaptation Cognitive Level: Application (Applying) Concept: Metabolism Difficulty: Moderate  Feedback 1 Tremor and oily skin are not related to hypothyroidism. 2 Anxiety and tachycardia are not related to hypothyroidism. 3 Symptoms of hypothyroidism are related to the reduced metabolic rate and include fatigue, weight gain, bradycardia, constipation, mental dullness, feeling cold, shortness of breath, decreased sweating, and dry skin and hair. 4 Increase in appetite and diarrhea are not related to hypothyroidism. PTS: 1 CON: Metabolism 2. ANS: 3 Chapter: Chapter 39. Nursing Care of Patients With Endocrine Disorders Objective: Describe the etiologies, signs, and symptoms of each of the endocrine orders. Page: 790 Heading: Disorders Related to Antidiuretic Hormone Imbalance Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Physiological Integrity—Physiological Adaptation Cognitive Level: Analysis (Analyzing) Concept: Metabolism Difficulty: Moderate Feedback 1 Low specific gravity of urine (