Question 1

Which of the following actions should the nurse take first when caring for a client who has just arrived on the unit after a thyroidectomy?

Accepted Answer

A)  Check the dressing for bleeding.
B)  Assess respiratory rate and effort.
C)  Take the blood pressure and pulse.
D)  Support the client's head with pillows. B

Question 2

Which of the following information should the nurse include when teaching a client who has been newly diagnosed with Graves' disease?

Accepted Answer

A)  Exercise is contraindicated to avoid increasing metabolic rate.
B)  Restriction of iodine intake is needed to reduce thyroid activity.
C)  Surgery will eventually be required to remove the thyroid gland.
D)  Antithyroid medications may take several weeks to have an effect. D

Question 3

A few hours after returning to the surgical nursing unit, a client who has undergone a subtotal thyroidectomy develops laryngeal stridor and a cramp in the right hand. Which of the following actions should the nurse anticipate implementing first?

Accepted Answer

A)  Infuse IV calcium gluconate.
B)  Suction the client's airway.
C)  Prepare for endotracheal intubation.
D)  Assist with emergency tracheostomy. A

Question 4

The nurse is caring for a client with acute adrenal insufficiency. Which of the following findings indicate that the prescribed therapies are effective?

Accepted Answer

A)  Increasing serum sodium levels
B)  Decreasing blood glucose levels
C)  Decreasing serum chloride levels
D)  Increasing serum potassium levels

Question 5

The nurse is caring for a client who has an adrenocortical adenoma and hyperaldosteronism. Which of the following actions should the nurse implement?

Accepted Answer

A)  Provide a potassium-restricted diet
B)  Monitor the blood pressure every 4 hours
C)  Evaluate blood glucose level every 4 hours
D)  Maintain extremities in an elevated position

Question 6

The nurse is admitting a client with Graves' disease to the emergency department in thyrotoxic crisis. Which of these prescribed medications should the nurse administer first?

Accepted Answer

A)  propranolol
B)  propylthiouracil
C)  methimazole
D)  iodine

Question 7

The nurse is caring for a client with Graves' disease who has exophthalmos. Which of the following actions shouldbe included in the plan of care?

Accepted Answer

A)  Apply eye patches to protect the cornea from irritation.
B)  Place cold packs on the eyes to relieve pain and swelling.
C)  Elevate the head of the client's bed to reduce periorbital fluid.
D)  Teach the client to blink every few seconds to lubricate the cornea.

Question 8

Aclient is being treated with a medication to block the effect of antidiuretic hormone to control the symptoms of syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following findings indicates that the medication is effective?

Accepted Answer

A)  Decreased peripheral edema
B)  Increased weight
C)  Increased urine specific gravity
D)  Increased urinary output

Question 9

The nurse is teaching a client with chronic syndrome of inappropriate antidiuretic hormone (SIADH) about long-term management. Which of the following client statements indicate that additional instruction is needed?

Accepted Answer

A)  "I should weigh myself daily and report any sudden weight loss or gain."
B)  "I need to limit my fluid intake to no more than 1 L of liquids a day."
C)  "I will eat foods high in potassium because the diuretics cause potassium loss."
D)  "I need to shop for foods that are low in sodium and avoid adding salt to foods."

Question 10

The nurse is caring for a client with hypothyroidism who is receiving a hypertonic saline IV solution to counteract hyponatremia. The nurse will expect the saline solution to be administered until the client's serum sodium reaches which of the followinglevels?

Accepted Answer

A)  112 mmol/L
B)  120 mmol/L
C)  132 mmol/L
D)  168 mmol/L

Question 11

The nurse is caring for a client with hyperthyroidism who is being treated with radioactive iodine (RAI) at the clinic. Which of the following information should the nurse provide to the client prior to discharge?

Accepted Answer

A)  Symptoms of hyperthyroidism should be relieved in about a week.
B)  Hypothyroidism may occur as the RAI therapy takes effect.
C)  Discontinue the antithyroid medications taken before the radioactive therapy.
D)  Teach radioactive precautions to use with urine, stool, and other body secretions.

Question 12

The nurse is caring for a client with symptoms of diabetes insipidus who has been admitted to the hospital for evaluation and treatment. Which of the following nursing diagnoses is best for this client?

Accepted Answer

A)  Insomnia related to frequent waking at night to void
B)  Impaired gas exchange related to fluid retention in lungs
C)  Excess fluid volume related to intake greater than output
D)  Risk for impaired skin integrity related to generalized edema

Question 13

The nurse is caring for a client who has had a transsphenoidal resection of a pituitary tumour. Which of the following nursing actions should be included in the postoperative plan of care?

Accepted Answer

A)  Monitor urine output every hour.
B)  Palpate extremities for dependent edema.
C)  Check hematocrit hourly for first 12 hours.
D)  Obtain continuous pulse oximetry for 24 hours.

Question 14

When developing a plan of care for a client with syndrome of inappropriate antidiuretic hormone (SIADH), which of the following interventions should the nurse include?

Accepted Answer

A)  Encourage fluids to 2 000 mL/day.
B)  Offer client ice chips to suck on.
C)  Monitor for increased peripheral edema.
D)  Keep head of bed elevated to 30 degrees.

Question 15

The nurse is caring for a client with possible syndrome of inappropriate antidiuretic hormone (SIADH). The client is confused and reports a headache, muscle cramps, and twitching. Which of the following initial laboratory results should the nurse anticipate?

Accepted Answer

A)  Elevated hematocrit
B)  Decreased serum sodium
C)  Increased serum chloride
D)  Low urine specific gravity

Question 16

The nurse is admitting a client with possible syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following information obtained by the nurse is most important to communicate rapidly to the health care provider?

Accepted Answer

A)  The client complains of dyspnea with activity.
B)  The client has a urine specific gravity of 1.025.
C)  The client has a recent weight gain of 3.6 kg.
D)  The client has a serum sodium level of 119 mmol/L.

Question 17

The nurse is caring for a client following a parathyroidectomy who develops tingling of the lips and a positive Trousseau's sign. Which of the following actions should the nurse take first?

Accepted Answer

A)  Administer the ordered muscle relaxant.
B)  Give the ordered oral calcium supplement.
C)  Start the PRN oxygen at 2 L/minute per cannula.
D)  Have the client rebreathe using a paper bag.

Question 18

After receiving change-of-shift report, which of the following four clients should the nurse assess first?

Accepted Answer

A)  A 31-year-old with Cushing's syndrome and a blood glucose level of 13.7 mmol/L
B)  A 22-year-old admitted with syndrome of inappropriate antidiuretic hormone (SIADH)  who has a serum sodium level of 130 mmol/L
C)  A 70-year-old who recently started taking levothyroxine and has an irregular pulse of 134
D)  A 53-year-old who has Addison's disease and is due for a scheduled dose of hydrocortisone.

Question 19

The nurse is planning teaching for a client who was admitted with myxedema coma and diagnosed with hypothyroidism. Which of the following strategies isbest for the nurse to use?

Accepted Answer

A)  Delay teaching until client discharge.
B)  Ensure privacy by asking visitors to leave.
C)  Provide written handouts of all information.
D)  Offer multiple options for management of therapies.

Question 20

The nurse is providing preoperative teaching for a client scheduled for a hypophysectomy for treatment of a pituitary adenoma. Which of the following instructions should the nurse include in client teaching?

Accepted Answer

A)  Cough and deep breathe every 2 hours postoperatively
B)  Bed rest for the first 24 hours after the surgery
C)  Be positioned flat with sandbags at the head postoperatively
D)  Have a NG tube after the surgery

Exam 51: Nursing Management Endocrine Problems