Question 1

A patient has been admitted with diabetic ketoacidosis,and treatment has been initiated.Which findings would lead the nurse to suspect the patient is dehydrated?

Accepted Answer

A)   Poor skin turgor and flat neck veins
B)   Dyspnea and crackles
C)   Presence of Chvostek and Trousseau signs
D)   Extra heart sounds and 3+ edema A

Question 2

A patient has been admitted with diabetic ketoacidosis (DKA).The nurse knows that the top priority in the initial treatment of DKA is which intervention?

Accepted Answer

A)   Lowering the blood sugar as quickly as possible
B)   Administering intravenous fluids
C)   Administering sodium bicarbonate
D)   Determining the precipitating cause B

Question 3

The nurse is caring for a patient with a head injury who has developed diabetes insipidus (DI).What medication would the nurse expect to be prescribed for the patient?

Accepted Answer

A)   Vasopressin
B)   Insulin
C)   Glucagon
D)   Propylthiouracil A

Question 4

A patient is admitted with diabetic ketoacidosis (DKA).The nurse knows that the dehydration associated with DKA results from which pathophysiologic mechanism?

Accepted Answer

A)   Increased serum osmolality and urea
B)   Decreased serum osmolality and hyperglycemia
C)   Ketones and potassium shifts
D)   Acute renal failure

Question 5

The nurse is caring for a critically ill patient with type 1 diabetes.The nurse understands that the patient is at risk for developing diabetic ketoacidosis (DKA)secondary to what etiology?

Accepted Answer

A)   Excess insulin administration
B)   Inadequate food intake
C)   Physiologic and psychologic stress
D)   Increased release of antidiuretic hormone (ADH)

Question 6

A patient was admitted with diabetic ketoacidosis (DKA)an hour ago and is on an insulin drip.Suddenly,the nurse notices frequent premature ventricular contractions (PVCs)on the electrocardiogram.The nurse notifies the practitioner.The nurse would anticipate an order for which intervention?

Accepted Answer

A)   A lidocaine bolus
B)   Stopping the insulin drip
C)   Synchronizing cardioversion
D)   Obtaining serum electrolytes

Question 7

The nurse has admitted a patient with hyperglycemic hyperosmolar state (HHS).Which medical intervention would the nurse expect to see ordered for this patient?

Accepted Answer

A)   Rapid rehydration with intravenous fluids
B)   Insertion of a pulmonary artery catheter
C)   Administration of high-dose intravenous insulin
D)   Hourly monitoring of urine glucose and ketone levels

Question 8

The nurse has admitted a patient with hyperglycemic hyperosmolar state (HHS).Which findings would the nurse expect to observe in this patient?

Accepted Answer

A)   Hyperglycemia with low serum osmolality
B)   Severe hyperglycemia with minimal or absent ketosis
C)   Little or no ketosis in serum with rapidly escalating ketonuria
D)   Hyperglycemia and ketosis

Question 9

Which pathophysiologic mechanism occurs in the patient with type 2 diabetes?

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

Question 10

A patient presents with ketoacidosis and a blood glucose level of 125 mg/dL.Diabetic ketoacidosis has been ruled out.The nurse knows that ketoacidosis can occur in which condition?

Accepted Answer

A)   Acute pancreatitis
B)   Drug overdose
C)   Hyperglycemic hyperosmolar state
D)   Hyperaldosteronism

Question 11

A patient is admitted with syndrome of inappropriate secretion of antidiuretic hormone (SIADH).The nurse understands that the hyponatremia associated with this disorder is the result of which mechanism?

Accepted Answer

A)   Increased cortisol release
B)   Excessive water reabsorption
C)   Excessive sodium excretion
D)   Decreased glucagon release

Question 12

A patient with hyperglycemic hyperosmolar state (HHS)has a serum glucose level of 400 mg/dL and a serum sodium level of 138 mEq/L.What is the intravenous fluid of choice?

Accepted Answer

A)   D5W
B)   0.45% NS
C)   0.9% NS
D)   D5/NS

Question 13

Which nursing intervention should be initiated on all patients with the syndrome of inappropriate antidiuretic hormone (SIADH)?

Accepted Answer

A)   Placing the patient on an air mattress
B)   Forcing fluids
C)   Initiating seizure precautions
D)   Applying soft restraints

Question 14

A patient has been admitted with hyperosmolar hyperglycemic state (HHS).The nurse knows that intravenous insulin is usually administered at what dosage?

Accepted Answer

A)   0.1 U/kg/h
B)   1.0 U/kg/h
C)   2.0 U/kg/h
D)   5.0 U/kg/h

Question 15

Decreased urine osmolality is a sign of which disorder?

Accepted Answer

A)   Hyperglycemia
B)   Diabetes insipidus
C)   Thyroid crisis
D)   Syndrome of inappropriate secretion of antidiuretic hormone

Question 16

The nurse is caring for a patient with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH).Which findings would confirm this diagnosis?

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

Question 17

As a patient with diabetic ketoacidosis (DKA)receives insulin and fluids,the nurse knows careful assessment must be given to which electrolyte?

Accepted Answer

A)   Potassium
B)   Sodium
C)   Phosphorus
D)   Calcium

Question 18

The nurse is caring for a patient with type 1 diabetes who was admitted with complaints of increased lethargy.Serum laboratory values validate the diagnosis of diabetic ketoacidosis (DKA).Which medical intervention would the nurse expect to be ordered for this patient?

Accepted Answer

A)   Extensive hydration
B)   Oral hypoglycemic agents
C)   Large doses of intravenous (IV)  insulin
D)   Limiting food and fluids

Question 19

A patient is admitted with diabetic ketoacidosis (DKA)and is experiencing polyuria.Which electrolyte disturbances would the nurse expect to see at this phase of DKA?

Accepted Answer

A)   Decreased calcium and increased phosphorus levels
B)   Decreased potassium and sodium levels.
C)   Increased sodium and decreased phosphorus levels
D)   Decreased calcium and potassium levels.

Question 20

Which finding is expected in the patient with hypothyroidism?

Accepted Answer

A)   Increased T₄
B)   Anemia
C)   Decreased thyroid stimulating hormone
D)   Hyperglycemia

Exam 32: Endocrine Disorders and Therapeutic Management

A patient has been admitted with diabetic ketoacidosis,and treatment has been initiated.Which findings would lead the nurse to suspect the patient is dehydrated?

A patient has been admitted with diabetic ketoacidosis (DKA) .The nurse knows that the top priority in the initial treatment of DKA is which intervention?

The nurse is caring for a patient with a head injury who has developed diabetes insipidus (DI) .What medication would the nurse expect to be prescribed for the patient?

A patient is admitted with diabetic ketoacidosis (DKA) .The nurse knows that the dehydration associated with DKA results from which pathophysiologic mechanism?

The nurse is caring for a critically ill patient with type 1 diabetes.The nurse understands that the patient is at risk for developing diabetic ketoacidosis (DKA) secondary to what etiology?

A patient was admitted with diabetic ketoacidosis (DKA) an hour ago and is on an insulin drip.Suddenly,the nurse notices frequent premature ventricular contractions (PVCs) on the electrocardiogram.The nurse notifies the practitioner.The nurse would anticipate an order for which intervention?

The nurse has admitted a patient with hyperglycemic hyperosmolar state (HHS) .Which medical intervention would the nurse expect to see ordered for this patient?

The nurse has admitted a patient with hyperglycemic hyperosmolar state (HHS) .Which findings would the nurse expect to observe in this patient?

Which pathophysiologic mechanism occurs in the patient with type 2 diabetes?

A patient presents with ketoacidosis and a blood glucose level of 125 mg/dL.Diabetic ketoacidosis has been ruled out.The nurse knows that ketoacidosis can occur in which condition?

A patient is admitted with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) .The nurse understands that the hyponatremia associated with this disorder is the result of which mechanism?

A patient with hyperglycemic hyperosmolar state (HHS) has a serum glucose level of 400 mg/dL and a serum sodium level of 138 mEq/L.What is the intravenous fluid of choice?

Which nursing intervention should be initiated on all patients with the syndrome of inappropriate antidiuretic hormone (SIADH) ?

A patient has been admitted with hyperosmolar hyperglycemic state (HHS) .The nurse knows that intravenous insulin is usually administered at what dosage?

Decreased urine osmolality is a sign of which disorder?

The nurse is caring for a patient with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) .Which findings would confirm this diagnosis?

As a patient with diabetic ketoacidosis (DKA) receives insulin and fluids,the nurse knows careful assessment must be given to which electrolyte?

The nurse is caring for a patient with type 1 diabetes who was admitted with complaints of increased lethargy.Serum laboratory values validate the diagnosis of diabetic ketoacidosis (DKA) .Which medical intervention would the nurse expect to be ordered for this patient?

A patient is admitted with diabetic ketoacidosis (DKA) and is experiencing polyuria.Which electrolyte disturbances would the nurse expect to see at this phase of DKA?

Which finding is expected in the patient with hypothyroidism?