Question 1

Which information obtained by the nurse in the endocrine clinic about a patient who has been taking prednisone (Deltasone)40 mg daily for 3 weeks is most important to report to the health care provider?

Accepted Answer

A)   Patient's blood pressure is 148/94 mm Hg.
B)   Patient has bilateral 2+ pitting ankle edema.
C)   Patient stopped taking the medication 2 days ago.
D)   Patient has not been taking the prescribed vitamin D. C

Question 2

Which finding by the nurse when assessing a patient with Hashimoto's thyroiditis and a goiter will require the most immediate action?

Accepted Answer

A)   New-onset changes in the patient's voice
B)   Apical pulse rate at rest 112 beats/minute
C)   Elevation in the patient's T3 and T4 levels
D)   Bruit audible bilaterally over the thyroid gland A

Question 3

A 37-year-old patient has just arrived in the postanesthesia recovery unit (PACU)after a thyroidectomy.Which information is most important to communicate to the surgeon?

Accepted Answer

A)   The patient reports 7/10 incisional pain.
B)   The patient has increasing neck swelling.
C)   The patient is sleepy and difficult to arouse.
D)   The patient's cardiac rate is 112 beats/minute. B

Question 4

The cardiac telemetry unit charge nurse receives status reports from other nursing units about four patients who need cardiac monitoring.Which patient should be transferred to the cardiac unit first?

Accepted Answer

A)   Patient with Hashimoto's thyroiditis and a heart rate of 102
B)   Patient with tetany who has a new order for IV calcium chloride
C)   Patient with Cushing syndrome and a blood glucose of 140 mg/dL
D)   Patient with Addison's disease who takes hydrocortisone twice daily

Question 5

Which intervention will the nurse include in the plan of care for a 52-year-old male patient with syndrome of inappropriate antidiuretic hormone (SIADH)?

Accepted Answer

A)   Monitor for peripheral edema.
B)   Offer patient hard candies to suck on.
C)   Encourage fluids to 2 to 3 liters per day.
D)   Keep head of bed elevated to 30 degrees.

Question 6

A 42-year-old female patient is scheduled for transsphenoidal hypophysectomy to treat a pituitary adenoma.During preoperative teaching,the nurse instructs the patient about the need to

Accepted Answer

A)   cough and deep breathe every 2 hours postoperatively.
B)   remain on bed rest for the first 48 hours after the surgery.
C)   avoid brushing teeth for at least 10 days after the surgery.
D)   be positioned flat with sandbags at the head postoperatively.

Question 7

The nurse determines that additional instruction is needed for a 60-year-old patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH)when the patient says which of the following?

Accepted Answer

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

Question 8

Which assessment finding for a 33-year-old female patient admitted with Graves' disease requires the most rapid intervention by the nurse?

Accepted Answer

A)   Bilateral exophthalmos
B)   Heart rate 136 beats/minute
C)   Temperature 103.8° F (40.4° 
C)  
D)   Blood pressure 166/100 mm Hg

Question 9

A 56-year-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with possible syndrome of inappropriate antidiuretic hormone (SIADH).The nurse would expect the initial laboratory results to include a(n)

Accepted Answer

A)   elevated hematocrit.
B)   decreased serum sodium.
C)   low urine specific gravity.
D)   increased serum chloride.

Question 10

Which question will the nurse in the endocrine clinic ask to help determine a patient's risk factors for goiter?

Accepted Answer

A)   "How much milk do you drink?"
B)   "What medications are you taking?"
C)   "Are your immunizations up to date?"
D)   "Have you had any recent neck injuries?"

Question 11

A 44-year-old female patient with Cushing syndrome is admitted for adrenalectomy.Which intervention by the nurse will be most helpful for a nursing diagnosis of disturbed body image related to changes in appearance?

Accepted Answer

A)   Reassure the patient that the physical changes are very common in patients with Cushing syndrome.
B)   Discuss the use of diet and exercise in controlling the weight gain associated with Cushing syndrome.
C)   Teach the patient that the metabolic impact of Cushing syndrome is of more importance than appearance.
D)   Remind the patient that most of the physical changes caused by Cushing syndrome will resolve after surgery.

Question 12

A 37-year-old patient is being admitted with a diagnosis of Cushing syndrome.Which findings will the nurse expect during the assessment?

Accepted Answer

A)   Chronically low blood pressure
B)   Bronzed appearance of the skin
C)   Purplish streaks on the abdomen
D)   Decreased axillary and pubic hair

Question 13

Which information will the nurse teach a 48-year-old patient 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)   Antithyroid medications may take several months for full effect.
D)   Surgery will eventually be required to remove the thyroid gland.

Question 14

The nurse is planning postoperative care for a patient who is being admitted to the surgical unit form the recovery room after transsphenoidal resection of a pituitary tumor.Which nursing action should be included?

Accepted Answer

A)   Palpate extremities for edema.
B)   Measure urine volume every hour.
C)   Check hematocrit every 2 hours for 8 hours.
D)   Monitor continuous pulse oximetry for 24 hours.

Question 15

After obtaining the information shown in the accompanying figure regarding a patient with Addison's disease,which prescribed action will the nurse take first?

Accepted Answer

A)   Give 4 oz of fruit juice orally.
B)   Recheck the blood glucose level.
C)   Infuse 5% dextrose and 0.9% saline.
D)   Administer oxygen therapy as needed.

Question 16

Which information will the nurse include when teaching a 50-year-old male patient about somatropin (Genotropin)?

Accepted Answer

A)   The medication will be needed for 3 to 6 months.
B)   Inject the medication subcutaneously every day.
C)   Blood glucose levels may decrease when taking the medication.
D)   Stop taking the medication if swelling of the hands or feet occurs.

Question 17

Which nursing action will be included in the plan of care for a 55-year-old patient with Graves' disease who has exophthalmos?

Accepted Answer

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

Question 18

A patient who had a subtotal thyroidectomy earlier today develops laryngeal stridor and a cramp in the right hand upon returning to the surgical nursing unit.Which collaborative action will the nurse anticipate next?

Accepted Answer

A)   Suction the patient's airway.
B)   Administer IV calcium gluconate.
C)   Plan for emergency tracheostomy.
D)   Prepare for endotracheal intubation.

Question 19

A 29-year-old woman with systemic lupus erythematosus has been prescribed 2 weeks of high-dose prednisone therapy.Which information about the prednisone is most important for the nurse to include?

Accepted Answer

A)   "Weigh yourself daily to monitor for weight gain caused by increased appetite."
B)   "A weight-bearing exercise program will help minimize the risk for osteoporosis."
C)   "The prednisone dose should be decreased gradually rather than stopped suddenly."
D)   "Call the health care provider if you experience mood alterations with the prednisone."

Question 20

The nurse is assessing a 41-year-old African American male patient diagnosed with a pituitary tumor causing panhypopituitarism.Assessment findings consistent with panhypopituitarism include

Accepted Answer

A)   high blood pressure.
B)   decreased facial hair.
C)   elevated blood glucose.
D)   tachycardia and cardiac palpitations.

Exam 46: Nursing Management: Endocrine Problems

Which information obtained by the nurse in the endocrine clinic about a patient who has been taking prednisone (Deltasone) 40 mg daily for 3 weeks is most important to report to the health care provider?