Question 1

The neuroendocrine stress response produces which of the following?

Accepted Answer

A)  Elevated blood pressure 
B)  Decreased gastric motility 
C)  Tachycardia 
D)  Heightened pain awareness 
E)  Increased glucose 
A)  Elevated blood pressure 
B)  Decreased gastric motility 
C)  Tachycardia 
D)  Heightened pain awareness 
E)  Increased glucose

Question 2

A patient was admitted to the critical care unit with diabetic ketoacidosis (DKA).Glucose is 349 mg/dL, K+ is 3.7 mEq/L, and pH is 7.10.Which of the following interventions would you expect?

Accepted Answer

A)  NS 1.5 L IV fluid bolus 
B)  Insulin infusion at 5 units/hr 
C)  Sodium bicarbonate 50 mmol IV push 
D)  Vasopressin 10 units IM every 3 hr 
E)  Potassium 20 mEq/L of IV fluid 
A)  NS 1.5 L IV fluid bolus 
B)  Insulin infusion at 5 units/hr 
C)  Sodium bicarbonate 50 mmol IV push 
D)  Vasopressin 10 units IM every 3 hr 
E)  Potassium 20 mEq/L of IV fluid

Question 3

After a patient has been diagnosed with SIADH, the nurse would expect the first line of treatment to include

Accepted Answer

A)  fluid restriction. 
B)  hypotonic intravenous fluid. 
C)  D5W. 
D)  fluid bolus. 
A)  fluid restriction. 
B)  hypotonic intravenous fluid. 
C)  D5W. 
D)  fluid bolus.

Question 4

A patient is admitted with a long history of mental illness.Her husband states she has been drinking up to 10 gallons of water each day for the past 2 days and refuses to eat.The patient is severely dehydrated and soaked with urine.The nurse suspects

Accepted Answer

A)  central diabetes insipidus (DI). 
B)  nephrogenic DI. 
C)  psychogenic (dipsogenic) DI. 
D)  iatrogenic DI. 
A)  central diabetes insipidus (DI). 
B)  nephrogenic DI. 
C)  psychogenic (dipsogenic) DI. 
D)  iatrogenic DI.

Question 5

The most common problem in the patient with type 2 diabetes is a(n)

Accepted Answer

A)  lack of insulin production. 
B)  imbalance between insulin production and use. 
C)  overproduction of glucose. 
D)  increased uptake of glucose in the cells. 
A)  lack of insulin production. 
B)  imbalance between insulin production and use. 
C)  overproduction of glucose. 
D)  increased uptake of glucose in the cells.

Question 6

A patient was admitted with diabetic ketoacidosis 1 hour ago and is on an insulin drip.Suddenly, the nurse notices frequent premature ventricular contractions (PVCs)on the electrocardiogram.The expected intervention would be to

Accepted Answer

A)  administer a lidocaine bolus. 
B)  administer a lidocaine drip. 
C)  synchronize cardioversion. 
D)  evaluate electrolytes. 
A)  administer a lidocaine bolus. 
B)  administer a lidocaine drip. 
C)  synchronize cardioversion. 
D)  evaluate electrolytes.

Question 7

A patient presenting with diabetes insipidus (DI)exhibits

Accepted Answer

A)  hyperosmolality and hypernatremia. 
B)  hyperosmolality and hyponatremia. 
C)  hypo-osmolality and hypernatremia. 
D)  hypo-osmolality and hyponatremia. 
A)  hyperosmolality and hypernatremia. 
B)  hyperosmolality and hyponatremia. 
C)  hypo-osmolality and hypernatremia. 
D)  hypo-osmolality and hyponatremia.

Question 8

The patient admitted in diabetic ketoacidosis has dry, cracked lips and is begging for something to drink.The nurse's best response would be to

Accepted Answer

A)  keep the patient NPO. 
B)  allow the patient a cup of coffee. 
C)  allow the patient water. 
D)  allow the patient to drink anything he chooses. 
A)  keep the patient NPO. 
B)  allow the patient a cup of coffee. 
C)  allow the patient water. 
D)  allow the patient to drink anything he chooses.

Question 9

The nurse knows that the dehydration associated with diabetic ketoacidosis results from

Accepted Answer

A)  increased serum osmolality and urea. 
B)  decreased serum osmolality and hyperglycemia. 
C)  ketones and potassium shifts. 
D)  acute renal failure. 
A)  increased serum osmolality and urea. 
B)  decreased serum osmolality and hyperglycemia. 
C)  ketones and potassium shifts. 
D)  acute renal failure.

Question 10

A patient is admitted to the unit with extreme fatigue, vomiting, and headache.This patient has type 1 diabetes but has been on an insulin pump for 6 months.He states, "I know it could not be my diabetes because my pump gives me 24-hour control." The nurse's best response would be

Accepted Answer

A)  "You know a lot about your pump, and you are correct." 
B)  "You're right. This is probably a virus." 
C)  "We'll get an abdominal CT and see if your pancreas is inflamed." 
D)  "We'll check your serum blood glucose and ketones." 
A)  "You know a lot about your pump, and you are correct." 
B)  "You're right. This is probably a virus." 
C)  "We'll get an abdominal CT and see if your pancreas is inflamed." 
D)  "We'll check your serum blood glucose and ketones."

Question 11

A patient with bronchogenic oat cell carcinoma has a drop in urine output.The laboratory reports a serum sodium level of 120 mEq/L, a serum osmolality level of 220 mOsm/kg, and urine specific gravity of 1.035.The nurse would suspect

Accepted Answer

A)  diuresis. 
B)  DI. 
C)  SIADH. 
D)  hyperaldosteronism. 
A)  diuresis. 
B)  DI. 
C)  SIADH. 
D)  hyperaldosteronism.

Question 12

The onset of seizures in the patient with DI indicates

Accepted Answer

A)  increased potassium levels. 
B)  hyperosmolality. 
C)  severe dehydration. 
D)  toxic ammonia levels. 
A)  increased potassium levels. 
B)  hyperosmolality. 
C)  severe dehydration. 
D)  toxic ammonia levels.

Question 13

While a patient with SIADH is receiving hypertonic saline, the nurse assesses for signs that the saline must be stopped.These signs would include

Accepted Answer

A)  decreased CVP and decreased PAP. 
B)  bradycardia and thirst. 
C)  hypotension and wheezing. 
D)  hypertension and lung crackles. 
A)  decreased CVP and decreased PAP. 
B)  bradycardia and thirst. 
C)  hypotension and wheezing. 
D)  hypertension and lung crackles.

Question 14

A patient weighs 140 kg and is 60 in.tall.The patient's blood sugar is being controlled by glipizide.As the nurse discusses discharge instructions, the primary treatment goal with this type 2 diabetes patient would be

Accepted Answer

A)  signs of hypoglycemia. 
B)  proper injection technique. 
C)  weight loss. 
D)  increased caloric intake. 
A)  signs of hypoglycemia. 
B)  proper injection technique. 
C)  weight loss. 
D)  increased caloric intake.

Question 15

A patient in diabetic ketoacidosis has the following arterial blood gasses: pH 7.25; pCO2 30 mm Hg; HCO3- 16.The patient has rapid, regular respirations.The nurse's best response would be to

Accepted Answer

A)  ask the patient to breathe into a paper bag to retain CO2. 
B)  administer sodium bicarbonate. 
C)  administer insulin and fluids intravenously. 
D)  prepare for intubation. 
A)  ask the patient to breathe into a paper bag to retain CO2. 
B)  administer sodium bicarbonate. 
C)  administer insulin and fluids intravenously. 
D)  prepare for intubation.

Question 16

A patient with type 2 diabetes is admitted.He is very lethargic and hypotensive.A diagnosis of hyperglycemic hyperosmolar syndrome (HHS)is made based on laboratory values of

Accepted Answer

A)  decreased serum glucose and increased serum ketones. 
B)  increased urine ketones and decreased serum osmolality. 
C)  increased serum osmolality and increased serum potassium. 
D)  increased serum osmolality and increased serum glucose. 
A)  decreased serum glucose and increased serum ketones. 
B)  increased urine ketones and decreased serum osmolality. 
C)  increased serum osmolality and increased serum potassium. 
D)  increased serum osmolality and increased serum glucose.

Question 17

The major electrolyte disturbances that result from diuresis are

Accepted Answer

A)  low calcium and high phosphorus levels. 
B)  low potassium and low sodium levels. 
C)  high sodium and low phosphorus levels. 
D)  low calcium and low potassium levels. 
A)  low calcium and high phosphorus levels. 
B)  low potassium and low sodium levels. 
C)  high sodium and low phosphorus levels. 
D)  low calcium and low potassium levels.

Question 18

A patient who has type 2 diabetes is on the unit after aneurysm repair.His serum glucose levels have been elevated for the past 2 days.He is concerned that he is becoming dependent on insulin.The best response for the nurse would be

Accepted Answer

A)  "This surgery may have damaged your pancreas. We will have to do more evaluation." 
B)  "Perhaps your diabetes was more serious from the beginning." 
C)  "You will need to discuss this with your physician." 
D)  "The stress on your body has temporarily increased your blood sugar levels." 
A)  "This surgery may have damaged your pancreas. We will have to do more evaluation." 
B)  "Perhaps your diabetes was more serious from the beginning." 
C)  "You will need to discuss this with your physician." 
D)  "The stress on your body has temporarily increased your blood sugar levels."

Question 19

The primary intervention for hyperglycemic hyperosmolar syndrome (HHS)is

Accepted Answer

A)  rapid rehydration. 
B)  monitoring vital signs. 
C)  high-dose intravenous (IV) insulin. 
D)  hourly urine sugar and acetone testing. 
A)  rapid rehydration. 
B)  monitoring vital signs. 
C)  high-dose intravenous (IV) insulin. 
D)  hourly urine sugar and acetone testing.

Question 20

The diagnosis of SIADH is made when which of the following conditions is present?

Accepted Answer

A)  Decreased ADH level and hyperkalemia 
B)  Decreased ADH level and hypernatremia 
C)  Increased ADH level and serum ketones 
D)  Increased ADH level and low serum osmolality 
A)  Decreased ADH level and hyperkalemia 
B)  Decreased ADH level and hypernatremia 
C)  Increased ADH level and serum ketones 
D)  Increased ADH level and low serum osmolality

Exam 24: Endocrine Disorders and Therapeutic Management

The neuroendocrine stress response produces which of the following?

A patient was admitted to the critical care unit with diabetic ketoacidosis (DKA).Glucose is 349 mg/dL, K+ is 3.7 mEq/L, and pH is 7.10.Which of the following interventions would you expect?

After a patient has been diagnosed with SIADH, the nurse would expect the first line of treatment to include

A patient is admitted with a long history of mental illness.Her husband states she has been drinking up to 10 gallons of water each day for the past 2 days and refuses to eat.The patient is severely dehydrated and soaked with urine.The nurse suspects

The most common problem in the patient with type 2 diabetes is a(n)

A patient was admitted with diabetic ketoacidosis 1 hour ago and is on an insulin drip.Suddenly, the nurse notices frequent premature ventricular contractions (PVCs)on the electrocardiogram.The expected intervention would be to

A patient presenting with diabetes insipidus (DI)exhibits

The patient admitted in diabetic ketoacidosis has dry, cracked lips and is begging for something to drink.The nurse's best response would be to

The nurse knows that the dehydration associated with diabetic ketoacidosis results from

A patient is admitted to the unit with extreme fatigue, vomiting, and headache.This patient has type 1 diabetes but has been on an insulin pump for 6 months.He states, "I know it could not be my diabetes because my pump gives me 24-hour control." The nurse's best response would be

A patient with bronchogenic oat cell carcinoma has a drop in urine output.The laboratory reports a serum sodium level of 120 mEq/L, a serum osmolality level of 220 mOsm/kg, and urine specific gravity of 1.035.The nurse would suspect

The onset of seizures in the patient with DI indicates

While a patient with SIADH is receiving hypertonic saline, the nurse assesses for signs that the saline must be stopped.These signs would include

A patient weighs 140 kg and is 60 in.tall.The patient's blood sugar is being controlled by glipizide.As the nurse discusses discharge instructions, the primary treatment goal with this type 2 diabetes patient would be

A patient in diabetic ketoacidosis has the following arterial blood gasses: pH 7.25; pCO2 30 mm Hg; HCO3- 16.The patient has rapid, regular respirations.The nurse's best response would be to

A patient with type 2 diabetes is admitted.He is very lethargic and hypotensive.A diagnosis of hyperglycemic hyperosmolar syndrome (HHS)is made based on laboratory values of

The major electrolyte disturbances that result from diuresis are

A patient who has type 2 diabetes is on the unit after aneurysm repair.His serum glucose levels have been elevated for the past 2 days.He is concerned that he is becoming dependent on insulin.The best response for the nurse would be

The primary intervention for hyperglycemic hyperosmolar syndrome (HHS)is

The diagnosis of SIADH is made when which of the following conditions is present?

Caring for the Critically Ill Patient

Ethical and Legal Issues

Patient and Family Education

Psychosocial and Spiritual Alterations and Management

Sleep Alterations

Nutritional Alterations

Gerontological Alterations

Pain and Pain Management

Sedation, Agitation and Delirium Management

End of Life Care

Cardiovascular Clinical Assessment and Diagnostic Procedures

Cardiovascular Disorders

Cardiovascular Therapeutic Management

Pulmonary Clinical Assessment and Diagnostic Procedures

Pulmonary Disorders

Pulmonary Therapeutic Management

Neurologic Clinical Assessment and Diagnostic Procedures

Neurologic Disorders and Therapeutic Management

Kidney Clinical Assessment and Diagnostic Procedures

Kidney Disorders and Therapeutic Management

Gastrointestinal Clinical Assessment and Diagnostic Procedures

Gastrointestinal Disorders and Therapeutic Management

Endocrine Clinical Assessment and Diagnostic Procedures

Trauma

Shock, Sepsis, and Multiple Organ Dysfunction Syndrome

Hematologic Disorders and Oncologic Emergencies

Filters

A patient was admitted to the critical care unit with diabetic ketoacidosis (DKA).Glucose is 349 mg/dL, K⁺ is 3.7 mEq/L, and pH is 7.10.Which of the following interventions would you expect?

A patient in diabetic ketoacidosis has the following arterial blood gasses: pH 7.25; pCO₂ 30 mm Hg; HCO₃^- 16.The patient has rapid, regular respirations.The nurse's best response would be to