Ati lpn med surg endocrine exam
Total Questions : 44
Showing 25 questions, Sign in for moreA nurse is reinforcing teaching about preventing long-term complications of retinopathy and neuropathy with an older adult client who has diabetes mellitus. Which of the following actions is the most important for the nurse to include in the teaching?
Explanation
Rationale:
A. Wearing closed-toed shoes daily is important for foot protection but does not address the root cause of diabetic complications.
B. Annual eye examinations are essential, but they are part of a broader strategy for monitoring and preventing complications rather than the most critical preventive measure.
C. Examining feet daily can help detect injuries or complications early, but it does not prevent the underlying issues associated with diabetes.
D. Maintaining stable blood glucose levels is the most important action because it directly impacts the risk of developing complications such as retinopathy and neuropathy. Good glycemic control helps prevent the progression of these conditions.
A nurse is collecting data on a client who has hyperthyroidism. Which of the following manifestations should the nurse expect the client to report?
Explanation
Rationale:
A. Weight gain is typically associated with hypothyroidism; clients with hyperthyroidism often experience weight loss due to increased metabolism.
B. Frequent mood changes, including anxiety and irritability, are common in hyperthyroidism as a result of increased thyroid hormone levels affecting mood regulation.
C. Sensitivity to cold is associated with hypothyroidism; hyperthyroid clients usually have an increased sensitivity to heat.
D. Constipation is more characteristic of hypothyroidism; hyperthyroidism often causes increased bowel movements or diarrhea.
A nurse is reviewing the medical record of a client who has hyperthyroidism (Graves' disease). Which of the following serum laboratory findings should the nurse expect to be below the expected reference range?
Explanation
Rationale:
A. Glucose levels are not directly affected by hyperthyroidism and are typically within the normal range unless the client has diabetes or another condition.
B. Triiodothyronine (T3) levels are elevated in hyperthyroidism due to excessive thyroid hormone production.
C. Thyroxine (T4) levels are also elevated in hyperthyroidism.
D. Thyroid stimulating hormone (TSH) is suppressed in hyperthyroidism because the thyroid gland produces excessive hormones, causing a negative feedback loop that reduces TSH levels.
A nurse is reinforcing teaching about exercise with a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?
Explanation
Rationale:
A. Carrying a simple carbohydrate snack (not a complex one) is recommended during exercise to prevent hypoglycemia, but this is not the correct statement.
B. Exercising first thing in the morning before eating can cause hypoglycemia due to low glucose levels after fasting.
C. Injecting insulin into the thigh before running can increase absorption rates, leading to hypoglycemia. Rotating injection sites and avoiding muscle groups that will be heavily exercised is recommended.
D. Exercise should be avoided if ketones are present in the urine, as it can indicate inadequate insulin and the risk of diabetic ketoacidosis.
Which findings are expected when assessing a patient with Cushing syndrome?
Explanation
Rationale:
A. Cushing syndrome is characterized by central obesity (excess adipose tissue in the trunk), slender extremities, a moon-shaped face, and other features like a buffalo hump. This is due to prolonged exposure to elevated cortisol levels.
B. High levels of potassium and low levels of sodium are not associated with Cushing syndrome, which typically presents with hypokalemia and hypernatremia.
C. Wasting of the abdomen is not a feature of Cushing syndrome. The skin may become fragile, but it is not typically calloused.
D. Edema is not a primary feature; rather, fat redistribution to the trunk and face is more common.
A nurse is reviewing the laboratory report of a client who has hypoparathyroidism. The nurse should expect which of the following values?
Explanation
Rationale:
A. Vitamin D levels may be normal or low in hypoparathyroidism, but this value is within the expected range.
B. Calcium levels are expected to be low in hypoparathyroidism. A calcium level of 9.8 mg/dL is within the normal range (8.5 to 10.5 mg/dL), which is not consistent with hypoparathyroidism.
C. Magnesium levels are often normal or low in hypoparathyroidism, but this value is within the normal range.
D. Hypoparathyroidism results in hypocalcemia and hyperphosphatemia due to insufficient parathyroid hormone (PTH) secretion. A phosphate level of 5.7 mg/dL is elevated, which is consistent with this condition.
A nurse is reinforcing teaching for a client who has type 1 diabetes mellitus about foot care. Which of the following client statements should indicate to the nurse an understanding of the instructions?
Explanation
Rationale:
A. Soaking feet is not recommended for clients with diabetes as it can cause skin maceration and increase the risk of infection.
B. Wearing sandals exposes the feet to injury and is not recommended for clients with diabetes. Closed-toed shoes are better for protecting the feet.
C. Daily foot inspection for sores, cuts, or bruises is essential for clients with diabetes to prevent infections and complications like diabetic ulcers.
D. Lotion should not be applied between the toes because it can promote excess moisture and fungal infections.
A nurse is caring for a client who is prescribed 15 units of NPH insulin to be administered at 0700. At which of the following times of day is most appropriate for the nurse to plan to offer a snack?
Explanation
Rationale:
A. NPH insulin is an intermediate-acting insulin that peaks 6-8 hours after administration. Offering a snack at 1500 helps prevent hypoglycemia during the peak action of the insulin.
B. 0730 is too soon after the insulin administration, and the peak effect has not occurred yet.
C. 0900 is still early in the insulin's action, and hypoglycemia is unlikely at this time.
D. 1230 is during the early stages of NPH insulin's action, but hypoglycemia typically does not occur until the peak time later in the day.
A nurse is caring for a client who has type 1 diabetes mellitus and observes mild hand tremors. Which of the following snacks should the nurse offer the client after obtaining a glucometer reading of 60 mg/dL?
Explanation
Rationale:
A. Regular soda provides a fast-acting source of glucose, which is essential for quickly raising blood sugar levels in a hypoglycemic event.
B. While oral glucose tablets are a good option, they may not act as quickly as soda in this case, especially if not immediately available.
C. Milk contains lactose, which takes longer to convert into glucose and is not ideal for rapidly raising blood glucose levels.
D. Hard candy can work, but soda is often faster in delivering glucose.
A nurse is caring for a client who has diabetes insipidus. Which of the following findings should the nurse expect?
Explanation
Rationale:
A. Diabetes insipidus typically causes dehydration, which leads to weak rather than bounding pulses.
B. Clients with diabetes insipidus often have dry mucous membranes due to excessive fluid loss.
C. Bradycardia is not associated with diabetes insipidus. Tachycardia is more likely due to dehydration.
D. Diabetes insipidus leads to excessive urination, resulting in diluted urine with decreased specific gravity.
A patient has been admitted to the hospital with the diagnosis of DKA. What vital signs should a nurse anticipate that the patient will exhibit?
Explanation
Rationale:
A. Normal pulse and respiratory rates do not indicate the expected tachycardia or Kussmaul respirations in DKA.
B. This option shows a slower heart rate, which is not typical of DKA where tachycardia is expected.
C. In diabetic ketoacidosis (DKA), clients typically exhibit tachycardia due to dehydration and deep, rapid Kussmaul respirations as the body attempts to correct the acidosis.
D. The vital signs in this option do not reflect the expected findings of DKA, such as tachycardia and deep respirations.
A nurse is assisting with the plan of care for a client who has hypothyroidism with myxedema. Which of the following interventions should the nurse include in the plan of care?
Explanation
Rationale:
A. Weight gain, rather than weight loss, is associated with hypothyroidism and myxedema.
B. High-fiber foods are encouraged in hypothyroidism to manage constipation, not limited.
C. Clients with myxedema experience cold intolerance and need warmth, making the application of warm blankets an appropriate intervention.
D. While clients may experience fatigue, bedrest is not a primary intervention; maintaining activity as tolerated is encouraged.
A nurse finds a client who has type 1 diabetes mellitus lying in bed, sweating, tachycardic, and reporting feeling lightheaded and shaky. Which of the following complications should the nurse suspect?
Explanation
Rationale:
A. Hyperglycemia typically presents with polyuria, thirst, and blurred vision, rather than sweating and shakiness.
B. Diabetic ketoacidosis presents with symptoms like deep breathing (Kussmaul respirations), fruity breath, and confusion, not sweating and tachycardia.
C. Nephropathy does not cause these acute symptoms; it is a long-term complication involving kidney damage.
D. Hypoglycemia presents with symptoms such as sweating, tachycardia, shakiness, and lightheadedness, which match the client's presentation.
A nurse is discussing the care of a client who has type 1 diabetes mellitus with an assistive personnel (AP). Which of the following situations should the nurse instruct the AP to report immediately?
Explanation
Rationale:
A. Toenail trimming should be performed by a professional to prevent injury, but it does not require immediate reporting.
B. Dark yellow urine can indicate dehydration, but it is not an urgent concern in this context.
C. Dizziness when standing is a concern, but it does not take priority over the refusal of breakfast, which may lead to hypoglycemia.
D. A refusal to eat can lead to hypoglycemia in clients with type 1 diabetes, and this situation should be reported immediately to prevent a dangerous drop in blood glucose levels.
The nurse is administering sulfonylurea drugs to four different patients diagnosed with type 2 diabetes. Which patient should not receive the medication as ordered?
Explanation
Rationale:
A. Hypertension does not contraindicate the use of sulfonylureas.
B. A blood glucose level of 140 mg/dL is a common finding in type 2 diabetes, and sulfonylureas are used to control such levels.
C. Shingles (herpes zoster) does not directly contraindicate the use of sulfonylureas.
D. Sulfonylureas should not be given to patients with a sulfa allergy because these medications contain sulfa compounds, which could cause an allergic reaction.
A home health care nurse is assessing a patient with type 1 diabetes who has been controlled for 6 months. The nurse is surprised and concerned about a blood glucose reading of 52 mg/dL. What action by this patient most likely caused this episode of hypoglycemia?
Explanation
Rationale:
A. An insufficient dose of insulin would likely cause hyperglycemia, not hypoglycemia.
B. Sugar substitutes do not affect blood glucose levels significantly and would not lead to hypoglycemia.
C. Birth control pills generally do not cause hypoglycemia.
D. Prolonged exercise increases insulin sensitivity and glucose uptake, which can lead to hypoglycemia if insulin or food intake is not adjusted accordingly. The 2-hour exercise session is the most likely cause of the hypoglycemic episode.
A nurse is assisting with the plan of care for a client who had a subtotal thyroidectomy. In which of the following positions should the nurse plan to place the client?
Explanation
Rationale:
A. Dorsal recumbent is not an ideal position after a thyroidectomy due to the risk of airway obstruction.
B. Supine position does not provide optimal airway protection post-surgery.
C. Sims' position is not recommended for clients recovering from a thyroidectomy as it could affect breathing and circulation.
D. Fowler’s position (head of the bed elevated 45 to 90 degrees) is the best position post-thyroidectomy to reduce tension on the suture line and to facilitate breathing by decreasing swelling around the surgical site.
A nurse is collecting data from a client who has Cushing's syndrome. Which of the following findings should the nurse expect?
Explanation
Rationale:
A. Cushing’s syndrome usually causes hypertension, not hypotension, due to increased cortisol levels.
B. Weight gain, not weight loss, is a common finding in Cushing's syndrome due to fat redistribution (truncal obesity).
C. Hyperpigmentation is more associated with Addison's disease, not Cushing’s syndrome.
D. Diaphoresis (excessive sweating) can be a symptom of Cushing’s syndrome, caused by hormonal imbalances.
A nurse is reinforcing teaching about the manifestations of hyperglycemia with a client who has diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?
Explanation
Rationale:
A. Fruity breath is a sign of ketoacidosis, a more severe complication of hyperglycemia.
B. Increased thirst (polydipsia) is a common symptom of hyperglycemia due to dehydration caused by high blood glucose levels.
C. Blurry vision may also occur with hyperglycemia, as high blood sugar can affect fluid levels in the eyes.
D. Hyperglycemia is more likely to cause an increased appetite (polyphagia), rather than a decreased one.
As part of a teaching plan in preparation for discharge, a patient with type 1 diabetes needs guidelines for exercise. Which guideline should be included?
Explanation
Rationale:
A. Insulin should not be injected into a limb that will be actively exercised, as it can alter absorption rates and lead to hypoglycemia.
B. Regular, moderate exercise is recommended to improve glucose control, not minimizing it.
C. Exercise consistency helps to maintain stable blood glucose levels and prevent fluctuations.
D. Exercising at the peak action of insulin increases the risk of hypoglycemia. It is safer to avoid high-intensity exercise during this time.
A nurse in a clinic is caring for a client who has a new diagnosis of hypothyroidism. Which of the following findings should the nurse expect?
Explanation
Rationale:
A. Weight gain is common in hypothyroidism due to a slowed metabolism.
B. Diaphoresis is more associated with hyperthyroidism, not hypothyroidism.
C. Palpitations are a symptom of hyperthyroidism.
D. Protruding eyeballs (exophthalmos) is associated with Graves' disease, a form of hyperthyroidism.
A nurse is checking the laboratory results of a client who is at risk for diabetes mellitus. Which of the following laboratory results indicates to the nurse that the client is at risk for diabetes mellitus?
Explanation
Rationale:
A. A 2-hour blood glucose of 132 mg/dL is within normal limits, as levels under 140 mg/dL are considered normal after an oral glucose tolerance test.
B. A fasting blood glucose level of 155 mg/dL is above the normal threshold (greater than 126 mg/dL indicates diabetes).
C. A casual blood glucose of 178 mg/dL suggests hyperglycemia but does not meet the diagnostic criteria for diabetes unless associated with symptoms.
D. An HbA1c of 5.2% is well within the normal range (below 5.7%).
A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus. The nurse determines that teaching has been effective when the client identifies which of the following manifestations of hypoglycemia? (Select all that apply.)
Explanation
Rationale:
A. Sweating is a classic sign of hypoglycemia due to the activation of the sympathetic nervous system in response to low blood glucose levels.
B. Polydipsia (excessive thirst) is a symptom of hyperglycemia, not hypoglycemia.
C. Tachycardia is a common symptom of hypoglycemia as the body responds to low glucose with increased adrenaline release.
D. Blurry vision can occur during hypoglycemia due to the effects of low glucose on the brain and eye function.
E. Polyuria (excessive urination) is associated with hyperglycemia, not hypoglycemia.
A nurse is reinforcing teaching with a client who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following statements by the client indicates an understanding of the teaching?
Explanation
Rationale:
A. Shakiness is a common symptom of hypoglycemia, often caused by the body's release of adrenaline in response to low blood glucose levels.
B. Hypoglycemia typically causes an increase in hunger, not a decreased appetite, as the body attempts to correct low glucose levels.
C. Cool, clammy skin is associated with hypoglycemia due to the body's stress response, not warm, moist skin.
D. Increased thirst (polydipsia) is a symptom of hyperglycemia, not hypoglycemia.
A nurse is assisting with meal planning for a client who has hypothyroidism. The nurse should reinforce with the client that she should increase her daily intake of which of the following nutrients?
Explanation
Rationale:
A. Protein intake should be increased in hypothyroidism to support muscle mass and metabolism, which may slow due to reduced thyroid hormone levels.
B. Fiber is important for digestion, but it is not directly related to managing hypothyroidism. Excess fiber may also interfere with thyroid medication absorption.
C. Polyunsaturated fats are beneficial for overall health but do not specifically target the needs of clients with hypothyroidism.
D. Monounsaturated fats are also healthy, but they are not directly linked to the metabolic changes in hypothyroidism.
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