Chapter 51 Answers Endo Evolve Quiz.pdf

Questions 1. 1.ID: 20005141241 The nurse explains that the negative feedback inhibition controls hormone release by communication between: A. the pituitary and the target organ. Correct The amount of hormone released is controlled b...

Questions 1. 1.ID: 20005141241 The nurse explains that the negative feedback inhibition controls hormone release by communication between: A. the pituitary and the target organ. Correct The amount of hormone released is controlled by negative feedback inhibition. The negative feedback inhibition process is when a gland releases a primary hormone, which stimulates target cells to release a secondary hormone; the gland slows the release of the primary hormone as it senses the rise of the secondary hormone. Information is constantly being exchanged via the bloodstream between target organs and endocrine glands. B. the thymus and the bloodstream. C. lymphatic system and the target organ. D. central nervous system and the bloodstream. Awarded 0.0 points out of 1.0 possible points. 2. 2.ID: 20005141261 Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the previous 8 to 12 weeks? A. Fasting blood sugar (FBS) B. Oral glucose tolerance test (OGT) C. Glycosylated hemoglobin (HbA1c) Correct Glycosylated hemoglobin (HbA1c)—This blood test measures the amount of glucose that has become incorporated into the hemoglobin within an erythrocyte. Because glycosylation occurs constantly during the 120-day lifespan of the erythrocyte, this test reveals the effectiveness of diabetes therapy for the preceding 8 to 12 weeks. D. Postprandial glucose test (PPBG) Awarded 1.0 points out of 1.0 possible points. 3. 3.ID: 20005141255 Which test will furnish immediate feedback for a newly diagnosed diabetic who is not yet under control? A. Fasting blood sugar (FBS) Correct Diabetics should do a finger-stick blood glucose level test before each meal and at bedtime each day until their disease is under control. The HbA1c serum test reveals the effectiveness of diabetes therapy for the preceding 8 to 12 weeks. B. Glycosylated hemoglobin (HbA1c) C. Oral glucose tolerance test (OGTT) D. Clinitest Incorrect Awarded 0.0 points out of 1.0 possible points. 4. 4.ID: 20005140977 To which diet should a patient with Cushing syndrome adhere? A. Less sodium Correct The diet should be lower in sodium to help decrease edema. B. More calories C. Less potassium D. More carbohydrates Awarded 0.0 points out of 1.0 possible points. 5. 5.ID: 20005141257 The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of an exercise regimen. The patient plans to enroll in a swimming class. Which adjustment should be made based on this information? A. Time the morning insulin injection so that the peak action will occur during swimming class. B. Delete normal walks on swimming class days. C. Delay the meal before the swimming class until the session is over. D. Monitor glucose level before, during, and after swimming to determine the need for alterations in food or insulin. Correct Exercise can reduce insulin resistance and increase glucose uptake for as long as 72 hours, as well as reducing blood pressure and lipid levels. However, exercise can carry some risks for patients with diabetes, including hypoglycemia. Awarded 0.0 points out of 1.0 possible points. 6. 6.ID: 20005141223 What is a long-term complication of diabetes mellitus? A. Diverticulitis B. Renal failure Correct Long-term complications of diabetes include blindness, cardiovascular problems, and renal failure. C. Hypothyroidism D. Hyperglycemia Awarded 0.0 points out of 1.0 possible points. 7. 7.ID: 20005141247 A patient has returned to his room after a thyroidectomy with signs of thyroid crisis. During thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of the potentially lethal complication of: A. severe nausea and vomiting. B. bradycardia. C. delirium with restlessness. D. congestive heart failure. Correct  In thyroid crisis, all the signs and symptoms of hyperthyroidism are exaggerated. The patient may develop congestive heart failure and die. Awarded 0.0 points out of 1.0 possible points. 8. 8.ID: 20005141201 In diabetes insipidus, a deficiency of which hormone causes clinical manifestations? A. Antidiuretic hormone (ADH) Correct Diabetes insipidus develops when there is a decrease in production of ADH from the posterior pituitary or the action of ADH is diminished. B. Follicle-stimulating hormone (FSH) C. Thyroid-stimulating hormone (TSH) D. Adrenocorticotropic hormone (ACTH) Awarded 0.0 points out of 1.0 possible points. 9. 9.ID: 20005141235 What is an appropriate patient problem for a patient who has recently been diagnosed with acromegaly? A. Ineffective coping B. Activity intolerance C. Risk for trauma Correct Nursing interventions are mainly supportive. The presence of muscle weakness, joint pain, or stiffness warrants assessment of the ability to perform activities of daily living (ADLs). D. Chronic low self-esteem Awarded 0.0 points out of 1.0 possible points. 10. 10.ID: 20005141213 The purpose of the use of radioactive iodine in the treatment of hyperthyroidism is to: A. stimulate the thyroid gland. B. depress the pituitary. C. destroy some of the thyroid tissue. Correct Radioactive iodine 131 destroys some of the hyperactive thyroid gland to produce a more normally functioning gland. D. alter the stimulus from the pituitary. Awarded 0.0 points out of 1.0 possible points. 11. 11.ID: 20005141259 Which precaution(s) should the nurse take when caring for a patient who is being treated with radioactive iodine 131 (RAIU)? A. Initiate radioactive safety precautions. B. Avoid assigning any young woman to the patient. C. Wait 3 days after dose before assigning a pregnant nurse to care for this patient. Correct  The dose is patient specific and at a very low level. No radioactive safety precautions are necessary and pregnant nurses can be assigned 3 days after the dose. RAIU is not harmful to nonpregnant women. D. Advise visitors to sit at least 10 ft away from the patient. Awarded 0.0 points out of 1.0 possible points. 12. 12.ID: 20005140999 Why would a patient with hyperthyroidism be prescribed the drug methimazole (Tapa- zole)? A. To limit the effect of the pituitary on the thyroid. B. To destroy part of the hyperactive thyroid tissue. C. To stimulate the pineal gland. D. To block the production of thyroid hormones. Correct Medical management for hyperthyroidism may include administration of drugs that block the production of thyroid hormones, such as propylthiouracil or methimazole. Awarded 0.0 points out of 1.0 possible points. 13. 13.ID: 20005140971 What is the postoperative position for a person who has had a thyroidectomy? A. Prone B. Semi-Fowler Correct Postoperative management of this patient includes keeping the bed in a semi-Fowler’s position, with pillows supporting the head and shoulders. There should be a suction apparatus and tracheotomy tray available for emergency use. C. Side-lying D. Supine Awarded 0.0 points out of 1.0 possible points. 14. 14.ID: 20005140975 What extra equipment should the nurse provide at the bedside of a new postoperative thyroidectomy patient? A. Large bandage scissors B. Tracheotomy tray Correct There should be a suction apparatus and tracheotomy tray available for emergency use. C. Ventilator D. Water-sealed drainage system Awarded 0.0 points out of 1.0 possible points. 15. 15.ID: 20005140973 As the nurse is shaving a patient who is 2 days postoperative from a thyroidectomy, the patient has a spasm of the facial muscles. What should the nurse recognize this as?  A. Chvostek sign Correct The spasm of facial muscles when stimulated is the Chvostek sign, an indication of hypocalcemic tetany. B. Montgomery sign C. Trousseau sign D. Homans’ sign Awarded 0.0 points out of 1.0 possible points. 16. 16.ID: 20005141249 The human insulin whose onset of action occurs within ____ minutes is lispro (Humalog). A. 30 B. 60 C. 15 Correct Humalog begins to take effect in less than half the time of regular, fast- acting insulin. The new formula can be injected 15 minutes before a meal. D. 45 Awarded 0.0 points out of 1.0 possible points. 17. 17.ID: 20005141207 What should the nurse caution a type I diabetic about excessive exercise? A. It can increase the need for insulin and may result in hyperglycemia. B. It can decrease the need for insulin and may result in hypoglycemia. Correct The patient with diabetes should exercise regularly. Exercise can reduce insulin resistance and increase glucose uptake for as long as 72 hours, as well as reducing blood pressure and lipid levels. However, exercise can carry some risks for patients with diabetes, including hypoglycemia. C. It can increase muscle bulk and may result in malabsorption of insulin. D. It can decrease metabolic demand and may result in metabolic acidosis. Awarded 0.0 points out of 1.0 possible points. 18. 18.ID: 20005141215 What do the Chvostek sign and the Trousseau sign indicate? A. Low levels of serum calcium Correct Low levels of blood calcium may cause the Chvostek sign and Trousseau sign. B. High levels of blood sugar C. Low levels of serum sodium D. High levels of serum aldosterone Awarded 0.0 points out of 1.0 possible points. 19. 19.ID: 20005141253 A patient has undergone tests that indicate a deficiency of the parathyroid hormone secretion. She should be informed of which potential complication?  A. Osteoporosis B. Lethargy C. Laryngeal spasms Correct Decreased parathyroid hormone levels in the bloodstream cause a decreased calcium level. Severe hypocalcemia may result in laryngeal spasm, stridor, cyanosis, and increased possibility of asphyxia. D. Kidney stones Awarded 0.0 points out of 1.0 possible points. 20. 20.ID: 20005141219 The nurse caring for a 75-year-old man who has developed diabetes insipidus following a head injury will include in the plan of care provisions for: A. limiting fluids to 1500 mL a day. B. encouraging physical exercise. C. protecting patient from injury. Correct The patients need protection from injury because they are often exhausted from sleep deprivation and having to get up frequently at night. Fluids should not be limited and their energy should be preserved. D. discouraging daytime naps. Awarded 0.0 points out of 1.0 possible points. 21. 21.ID: 20005141205 The health care provider orders an 1800-calorie diabetic diet and 40 units of (Humulin N) insulin U-100 subcutaneously daily for a patient with diabetes mellitus. Why would a mid-afternoon snack of milk and crackers be given? A. To improve nutrition. B. To improve carbohydrate metabolism. C. To prevent an insulin reaction. Correct Humulin N insulin starts to peak in 4 hours. The nurse should be alert for signs of hypoglycemia (low blood glucose) at the peak of action of whatever type of insulin the patient is receiving. D. To prevent diabetic coma. Awarded 0.0 points out of 1.0 possible points. 22. 22.ID: 20005140969 The nurse teaching a patient with type 1 diabetes mellitus (IDDM) about early signs of insulin reaction would include information about: A. abdominal pain and nausea. B. dyspnea and pallor. C. flushing of the skin and headache. D. hunger and a trembling sensation. Correct The patient should be instructed to notify a member of the nursing staff if any signs of hypoglycemic (low insulin) reaction occur: excessive perspiration or trembling.  Awarded 0.0 points out of 1.0 possible points. 23. 23.ID: 20005141217 The nurse discovers the type 1 diabetic (IDDM) patient drowsy and tremulous, the skin is cool and moist, and the respirations are 32 and shallow. These are signs of: A. hypoglycemic reaction; give 6 oz of orange juice. Correct Hypoglycemic reaction is due to not enough food for the insulin. Quick acting carbohydrates—such as orange juice or longer acting foods such as milk, crackers, and cheese—are beneficial. B. hyperglycemic reaction; give ordered regular insulin. C. hyperglycemic hyperosmolar nonketotic reaction; squeeze glucagon gel in buccal cavity. D. hypoglycemic reaction; give ordered insulin. Awarded 0.0 points out of 1.0 possible points. 24. 24.ID: 20005140979 A patient has come to the clinic because of enlarged hands and feet, amenorrhea, and increased hair growth. These symptoms most likely indicate problems with the: A. pituitary gland. Correct The pituitary gland may produce an overabundance of growth hormone. This overproduction of hormones may cause changes throughout the patient’s body, including enlargement of the pituitary gland and hands and feet. Female patients may develop a deepened voice, increased facial hair growth, and amenorrhea. B. adrenal glands. C. thyroid gland. D. pancreas. Awarded 0.0 points out of 1.0 possible points. 25. 25.ID: 20005141251 What instructions should a nurse give to a diabetic patient to prevent injury to the feet? A. Soak feet in warm water every day. B. Avoid going barefoot and always wear shoes with soles. Correct Sturdy, properly fitting shoes should be worn. Use of corn removers and heating pads is not beneficial to preserve the health of a diabetic’s feet. C. Use of commercial keratolytic agents to remove corns and calluses are preferred to cutting off corns and calluses. D. Use a heating pad to warm feet when they feel cool to the touch. Awarded 0.0 points out of 1.0 possible points. 26. 26.ID: 20005141243 The health care provider prescribes glyburide (Micronase, DiaBeta, Glynase) for a patient, age 57, when diet and exercise have not been able to control type 2 diabetes. What should the nurse include in the teaching plan about this medication?  A. It is a substitute for insulin and acts by directly stimulating glucose uptake into the cell. B. It does not cause the hypoglycemic reactions that may occur with insulin use. C. It is thought to stimulate insulin production and increase sensitivity to insulin at receptor sites. Correct Oral hypoglycemics are compounds that stimulate the β cells in the pancreas to increase insulin release. D. It lowers blood sugar by inhibiting glucagon release from the liver, preventing gluconeogenesis. Awarded 0.0 points out of 1.0 possible points. 27. 27.ID: 20005141239 A 27-year-old patient with hypothyroidism is referred to the dietitian for dietary consultation. What should nutritional interventions include? A. Frequent small meals high in carbohydrates B. Calorie-restricted meals Correct A high-protein, high-fiber, lower calorie diet is given. C. Caffeine-rich beverages D. Fluid restrictions Awarded 0.0 points out of 1.0 possible points. 28. 28.ID: 20005141221 What instructions should be included in the discharge instructions for a 47-year-old patient with hypothyroidism? A. Taking medication whenever symptoms cause discomfort B. Decreasing fluid and fiber intake C. Consuming foods rich in iron D. Seeing the health care provider regularly for follow-up care Correct Regular checkups are essential, because drug dosage may have to be adjusted from time to time. Awarded 0.0 points out of 1.0 possible points. 29. 29.ID: 20005140983 How should the nurse administer insulin to prevent lipohypertrophy? A. At room temperature Correct In fact, it is now believed that insulin should be administered at room temperature, not straight from the refrigerator, to help prevent insulin lipohypertrophy. B. At body temperature C. Straight from the refrigerator D. After rolling bottle between hands to warm Awarded 0.0 points out of 1.0 possible points. 30. 30.ID: 20005141245  A patient with a history of Graves disease is admitted to the unit with shortness of breath. The nurse notes the patient’s vital signs: T 103°F, P 160, R 24, BP 160/80. The nurse also notes distended neck veins. What does the patient most likely have? A. Pulmonary embolism B. Hypertensive crisis C. Thyroid storm Correct In a thyroid crisis, all the signs and symptoms of hyperthyroidism are exaggerated. Additionally, the patient may develop nausea, vomiting, severe tachycardia, severe hypertension, and occasionally hyperthermia up to 41°C (106°F). Extreme restlessness, cardiac arrhythmia, and delirium may also occur. The patient may develop heart failure and may die. D. Cushing crisis Awarded 0.0 points out of 1.0 possible points. 31. 31.ID: 20005141203 What is the master gland of the endocrine system? A. Thyroid B. Parathyroid C. Pancreas D. Pituitary Correct The pituitary gland, located in the brain, is the master gland of the endocrine system. It has been called the “master gland” because through the negative feedback inhibition, it exerts its control over the other endocrine glands. Awarded 0.0 points out of 1.0 possible points. 32. 32.ID: 20005140981 What information should be obtained from the patient before an iodine-131 test? A. Presence of metal in the body B. Allergy to sulfa drugs C. Status of possible pregnancy Correct Iodine-131 is not a radiation hazard to the nonpregnant patient but is absolutely contraindicated during pregnancy. Pregnant nurses should not care for this patient for several days. D. Use of prescription drugs for hypertension Awarded 0.0 points out of 1.0 possible points. 33. 33.ID: 20005141233 The patient being treated for hypothyroidism should be instructed to eat well-balanced meals including intake of iodine. Which of the following foods contains iodine? A. Eggs Correct The hypothyroid diet should be adequate in intake of iodine, in foods such as saltwater fish, milk, and eggs; fluids should be increased to help prevent constipation.  B. Pork C. White bread D. Skinless chicken Awarded 0.0 points out of 1.0 possible points. 34. 34.ID: 20005140993 The nurse is caring for a patient who is receiving calcium gluconate for treatment of hypoparathyroid tetany. Which assessment would indicate an adverse reaction to the drug? A. Increase in heart rate B. Flushing of face and neck C. Drop in blood pressure Correct Indications of an adverse effect of calcium gluconate are dyspnea, bradycardia, and hypotension. D. Urticaria Awarded 0.0 points out of 1.0 possible points. 35. 35.ID: 20005140987 The nurse cautions the patient who is being instructed on self-medication with insulin to be aware that there are 25-, 30-, 50-, and 100-unit syringes. How is the 100-unit syringe marked? A. 1-unit increments B. 2-unit increments Correct The 100-unit syringe is marked in 2-unit increments while the smaller syringes are marked in 1-unit increments. C. 4-unit increments D. 5-unit increments Awarded 0.0 points out of 1.0 possible points. 36. 36.ID: 20005140965 Which of the following are signs and symptoms of hypoglycemia? (Select all that apply.) A. Irritability Correct B. Dry mouth C. Tremors Correct D. Diaphoresis Correct E. Fruity breath F. Deep respirations Hypoglycemic reaction: rapid shallow respirations, irritability, tremors, excessive perspiration, and possibly loss of consciousness. Awarded 0.0 points out of 3.0 possible points. 37. 37.ID: 20005141237 What are the three major life-threatening complications postoperatively of a thyroidectomy? (Select all that apply.)  A. Hemorrhaging Correct B. Seizures C. Tetany Correct D. Hypoglycemia E. Thyroid crisis (storm) Correct F. SIADH The nurse must be alert for signs of internal or external bleeding. In addition to hemorrhage, two significant postoperative complications exist after thyroidectomy. The first is tetany. The second is thyroid crisis. Manipulation of the thyroid during surgery may cause the release of large amounts of thyroid hormones into the bloodstream, creating a thyroid crisis (storm). Awarded 0.0 points out of 3.0 possible points. 38. 38.ID: 20005140967 The adrenal cortex secretes glucocorticoids. The most important is cortisol. What is it involved in? (Select all that apply.) A. Glucose metabolism Correct B. Releasing androgens and estrogens C. Providing extra reserve energy during stress Correct D. Decreasing the level of potassium in the bloodstream E. Increasing retention of sodium in the bloodstream Cortisol is involved in glucose metabolism and provides extra reserve energy in times of stress. Awarded 0.0 points out of 2.0 possible points. 39. 39.ID: 20005140985 What should the nurse include in provisions for the postoperative care of the patient who had a thyroidectomy? (Select all that apply.) A. Assessing ability to speak by asking him or her to recite name and address every hour B. Maintaining anatomic position of the head when moving a patient Correct C. Assisting a patient to hyperextend the head to assess for muscle damage D. Doing voice check every 2 hours Correct E. Turning, coughing every hour F. Checking for bleeding at the sides and the back of the head Correct The nurse should hold the head in an anatomic position when moving the patient to prevent tension on the suture line, do a voice check every 2 to 4 hours by asking the patient to say “ah”; the patient is not turned nor is coughing recommended immediately after a thyroidectomy. Awarded 0.0 points out of 3.0 possible points. 40. 40.ID: 20005140963  The nurse would instruct a patient with hyperthyroidism (Graves disease) to select which of the following nutritious foods because of the increased metabolism related to the disease? (Select all that apply.) A. Coffee with cream B. Lean meat Correct C. White bread D. Leafy green vegetables Correct E. Supplemental vitamin D Correct Nutritious food sources, such as food high in protein (e.g., lean meat), sources of vitamin B (e.g., leafy green vegetables), and vitamin D supplements are helpful to meet the metabolic needs of the patient with hyperthyroidism. Awarded 0.0 points out of 3.0 possible points. 41. 41.ID: 20005141263 The nurse would instruct a patient who is hypocalcemic from hypoparathyroidism about a diet that should include: (Select all that apply) A. high phosphorus foods. B. canned fish with the bones. Correct C. cucumbers. Correct D. tofu. Correct E. bananas. F. vitamin D supplements. Correct The hypocalcemic patient should eat a high-calcium, low-phosphorus diet that includes canned fish, cucumbers, tofu, and vitamin D supplements as an aid to the absorption of the calcium. Awarded 0.0 points out of 4.0 possible points. 42. 42.ID: 20005141209 The nurse is administering long-acting insulin once a day, which provides insulin coverage for 24 hours. This insulin is _________________. Correct Responses 1. Lantus Awarded 0.0 points out of 1.0 possible points. 43. 43.ID: 20005141225 Another term for hyperglycemic reaction is diabetic ______________. Correct Responses 1. ketoacidosis Awarded 0.0 points out of 1.0 possible points. 44. 44.ID: 20005140959  Only ________insulin can be administered intravenously. Correct Responses 1. regular Awarded 0.0 points out of 1.0 possible points. 45. 45.ID: 20005140995 A condition with a deficiency in growth hormone is called ________________ dwarfism. Correct Responses 1. hypopituitary Awarded 0.0 points out of 1.0 possible points. 46. 46.ID: 20005141229 ________________is the term that describes a condition of normal thyroid function. Correct Responses 1. Euthyroid Awarded 0.0 points out of 1.0 possible points. 47. 47.ID: 20005140989 When the nurse inflates the sphygmomanometer cuff exceeding the systolic blood pressure and observes a carpal spasm, this is a(n) __________ sign. Correct Responses 1. Trousseau