Question 1

Evaluation of an adult client reveals oversecretion of growth hormone. Which of the following would the nurse expect to find?
A) Excessive urine output
B) Weight loss
C) Bulging forehead
D) Constant thirst

Accepted Answer

Oversecretion of growth hormone can cause acromegaly, which involves enlargement of bones in the face, hands, and feet, leading to a bulging forehead. Excessive urine output, weight loss, and constant thirst are more typically associated with diabetes and/or hyperthyroidism.

Question 2

The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as which of the following?
A) Gigantism
B) Dwarfism
C) Acromegaly
D) Simmonds' disease

Accepted Answer

An oversecretion of growth hormone (GH) that occurs before puberty can cause gigantism. Gigantism results in excessive growth of bones, often leading to abnormally tall stature.

Question 3

A client with diabetes insipidus is extremely dehydrated and is unable to take oral fluids. Fluid therapy is prescribed. Which intervention would be most important for the client?
A) Measuring the urine output every 30 minutes.
B) Monitoring the rate of IV infusions.
C) Measuring the fluid intake.
D) Weighing the client daily.

Accepted Answer

A

Question 4

Which of the following precautions would be most appropriate when caring for a client being treated with RAI for a thyroid tumor?
A) Administer prescribed corticosteroids carefully.
B) Handle body fluids carefully.
C) Monitor the respiratory status.
D) Administer the prescribed medications at the same time each day.

Accepted Answer

When a client is being treated with RAI, their body fluids (including urine and saliva) can be radioactive for a period of time after receiving the treatment. This can pose a risk of radiation exposure to healthcare providers and others who come into contact with the client's fluids. Therefore, it is important to handle their body fluids carefully by using appropriate personal protective equipment and following radiation safety protocols. While monitoring respiratory status and administering medications at the same time each day may also be important aspects of care for this client, they are not the most appropriate precautions specifically related to RAI treatment. Administering corticosteroids would not typically be indicated for RAI treatment of a thyroid tumor.

Question 5

After teaching a group of students about Simmonds' disease, the instructor determines that additional instruction is necessary when the students identify which hormone as being involved?
A) Growth hormone
B) Luteinizing hormone
C) Adrenocorticotropic hormone
D) Oxytocin

Accepted Answer

Simmonds' disease is a condition characterized by the absence or deficiency of all pituitary hormones. Oxytocin is not a pituitary hormone and is not involved in Simmonds' disease. The other three hormones listed are pituitary hormones and could be involved in Simmonds' disease.

Question 6

The nurse is assisting with the preparation of teaching plan for a client who is to receive methimazole (Tapazole). Which of the following would be most appropriate to include in this plan?
A) Telling the client to dilute the drug with fruit juice.
B) Advising the client to use a straw when taking the drug.
C) Urging the client to report any fever or sore throat.
D) Telling the client to take largest dose of the drug in the morning.

Accepted Answer

Methimazole (Tapazole) is an antithyroid drug that is used to treat hyperthyroidism. One of the adverse effects of this medication is agranulocytosis, which is a reduction in white blood cells that can lead to an increased risk of infections. Therefore, it is essential to urge the client to report any fever or sore throat, which could indicate a serious condition. Diluting the drug with fruit juice or using a straw when taking the drug are not necessary. There is no evidence to suggest that taking the largest dose in the morning is more effective than dividing the dose throughout the day.

Question 7

The nurse is reviewing the laboratory and diagnostic test findings of a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following would the nurse expect to find?
A) Elevated serum sodium levels
B) Decreased serum osmolarity
C) Decreased urine sodium levels
D) Elevated urine calcium levels

Accepted Answer

SIADH is characterized by excessive secretion of antidiuretic hormone (ADH), which leads to retention of water in the body, resulting in hyponatremia and decreased serum osmolarity. Urine sodium levels are typically elevated in SIADH due to the increased reabsorption of water in the kidneys. Urine calcium levels are not typically affected by SIADH.

Question 8

A client with pheochromocytoma is scheduled for an adrenalectomy. Which of the following would the nurse perform preoperatively?
A) Begin administering prescribed corticosteroid.
B) Initiate intravenous access for fluid therapy.
C) Monitor blood pressure (BP) frequently.
D) Check for the signs of adrenal insufficiency.

Accepted Answer

Pheochromocytoma causes episodes of high blood pressure due to excess catecholamine release. Monitoring BP frequently is crucial to manage and stabilize the patient preoperatively.

Question 9

When providing teaching to a client with hyperthyroidism that is prescribed radioactive iodine (RAI) to destroy thyroid tissue, which of the following would the nurse include?
A) Radioactive iodine (RAI) has no adverse effects.
B) Its effect is not apparent until the gland has secreted excess thyroid hormone.
C) RAI does not seriously affect other tissues.
D) The process may take several weeks or more.

Accepted Answer

D  Radioactive iodine (RAI) primarily targets thyroid tissue and does not significantly affect other tissues. The therapeutic effects of RAI can take several weeks or more to become apparent as the thyroid tissue is gradually destroyed.

Question 10

After teaching a client diagnosed with primary adrenal insufficiency about his condition, the nurse determines that additional teaching is necessary when the client states which of the following?
A) "I need to drink at least 2 quarts of fluid each day."
B) "I will need to decrease my drug dosage if I develop an infection."
C) "I will have to take the replacement hormone for the rest of my life."
D) "I should eat 5 to 6 small meals per day and snacks rather than 3 big meals."

Accepted Answer

Clients with primary adrenal insufficiency (Addison's disease) require lifelong replacement hormone therapy (choice C is correct). They also need to consume a high-sodium diet and drink plenty of fluids to avoid dehydration (choice A is correct). Clients with primary adrenal insufficiency also need to increase their dosage of replacement hormones during stressful events, including infection, rather than decrease it (choice B is incorrect). Eating 5 to 6 small meals per day and snacks rather than 3 big meals is also recommended for clients with primary adrenal insufficiency to avoid hypoglycemia (choice D is correct).

Question 11

While assessing a client with hypoparathyroidism, the nurse taps the client's facial nerve and observes twitching of the mouth and tightening of the jaw. The nurse would document this finding as which of the following?
A) Positive Trousseau's sign
B) Positive Chvostek's sign
C) Hyperactive deep tendon reflex
D) Tetany

Accepted Answer

The twitching of the mouth and tightening of the jaw in response to facial nerve tapping is a positive Chvostek's sign, which is an indication of hypocalcemia commonly seen in clients with hypoparathyroidism. Positive Trousseau's sign is demonstrated by carpal spasm elicited by inflating a blood pressure cuff above systolic pressure and is also indicative of hypocalcemia. Hyperactive deep tendon reflex and tetany may also be seen in clients with hypoparathyroidism, but they are not specific to this condition and can occur in other neurological or neuromuscular disorders.

Question 12

After teaching a client who is to receive lypression nasal spray as treatment for neurogenic diabetes insipidus about administration, which client statement indicates the need for additional teaching?
A) "I'll inhale fully after spraying the drug."
B) "If my nose gets irritated, I'll call my physician."
C) "I should hold the spray container upright."
D) "While sitting up, I'll place the nozzle in my nostril."

Accepted Answer

The drug is administered via the nasal route, therefore it should not be inhaled fully but sprayed into the nostril. This indicates that the client needs additional teaching. The other statements are correct and indicate adequate understanding of the administration technique.

Question 13

The nurse is reviewing the history and physical examination of a client diagnosed with hyperthyroidism. Which of the following would the nurse expect to find?
A) Complaints of sleepiness
B) Thick hard nails
C) Inability to tolerate cold
D) Reports of increased appetite

Accepted Answer

Clients with hyperthyroidism often have an increased appetite as their metabolism is increased. Complaints of sleepiness are more commonly associated with hypothyroidism, while thick hard nails and inability to tolerate cold are not typical findings in hyperthyroidism.

Question 14

Which of the following nursing action would the nurse include when caring for a client with endemic goiter and experiencing respiratory symptoms?
A) Avoiding physical exertion.
B) Providing proper air circulation in the room.
C) Providing a diet high in iodine.
D) Elevating the head of the bed.

Accepted Answer

Elevating the head of the bed can help improve breathing by allowing the client to breathe more easily. Avoiding physical exertion and providing proper air circulation can also be helpful, but they are not specific to respiratory symptoms in a client with endemic goiter. Providing a diet high in iodine may actually be contraindicated if the goiter is due to iodine excess, rather than deficiency.

Question 15

Which of the following would the nurse expect the physician to order for a client with hypothyroidism?
A) Levothyroxine sodium
B) Methimazole
C) Propranolol
D) Propylthiouracil

Accepted Answer

Levothyroxine sodium is a synthetic thyroid hormone replacement medication commonly used to treat hypothyroidism. Methimazole and propylthiouracil are medications used to treat hyperthyroidism. Propranolol is a beta-blocker used to treat symptoms associated with hyperthyroidism, but it does not address the underlying hypothyroidism. Therefore, the best choice for a client with hypothyroidism would be levothyroxine sodium.

Question 16

Which of the following would the nurse expect to find in a client with severe hyperthyroidism?
A) Tetany
B) Exophthalmos
C) Buffalo hump
D) Striae

Accepted Answer

Exophthalmos, or protruding eyes, is a classic sign of severe hyperthyroidism. Tetany is associated with hypocalcemia and may be seen in hypoparathyroidism. Buffalo hump and striae are associated with Cushing's syndrome, which is caused by excess cortisol production.

Question 17

A client with Addison's disease has a blood glucose level above 80 mg/dL thirty minutes after receiving 15 grams of carbohydrates for symptoms of hypoglycemia. Which of the following would the nurse do now?
A) Inform the physician immediately.
B) Give the client milk and graham crackers.
C) Instruct the client to remain in bed.
D) Check the client's blood glucose level before each meal.

Accepted Answer

DFor a client with Addison's disease experiencing hypoglycemia, after administering carbohydrates and seeing an improvement in blood glucose levels (above 80 mg/dL), the next steps include providing a more sustainable source of energy, such as milk and graham crackers (B), and monitoring the client's blood glucose levels regularly, especially before meals (D), to prevent future episodes of hypoglycemia. Immediate physician notification (A) isn't necessary if the client's condition is stabilizing, and instructing the client to remain in bed (C) isn't directly related to managing blood glucose levels.

Question 18

Which suggestion would the nurse include for a client who has had a thyroidectomy to reduce tension on the suture line?
A) Use the hands to support the head when rising to a sitting position.
B) Keep ambulatory activities to minimum.
C) Maintain complete bed rest for 2 days postoperatively.
D) Take the prescribed analgesics before any strenuous activity.

Accepted Answer

Supporting the head when rising to a sitting position helps to reduce tension on the neck area, including the suture line, by minimizing strain.

Question 19

A nurse is assisting a client diagnosed with hypoparathyroidism about appropriate dietary measures suggested by the dietician. Which of the following would the nurse caution the client to avoid?
A) Milk
B) Green leafy vegetables
C) Carbonated beverages
D) Fortified orange juice

Accepted Answer

Carbonated beverages often contain phosphates, which can bind with calcium and make it harder for the body to absorb. This is particularly problematic for someone with hypoparathyroidism, a condition characterized by insufficient production of parathyroid hormone, leading to low levels of calcium in the blood. The nurse would caution against consuming foods or beverages that could further decrease calcium absorption.

Question 20

Which group of clients should not receive potassium iodide?
A) Those who are allergic to corticosteroids
B) Those who are pregnant
C) Those taking medications such as cough medicines
D) Those who are allergic to seafood

Accepted Answer

Potassium iodide can cause adverse reactions in individuals who are allergic to iodine or shellfish, as these allergies indicate a potential sensitivity to iodine, which is a key component of potassium iodide. Other options listed do not inherently contraindicate the use of potassium iodide.

Quiz 50: Caring for Clients With Disorders of the Endocrine System

Evaluation of an adult client reveals oversecretion of growth hormone. Which of the following would the nurse expect to find?

The nurse is reviewing a client's history which reveals that the client has had an oversecretion of growth hormone (GH) that occurred before puberty. The nurse interprets this as which of the following?

A client with diabetes insipidus is extremely dehydrated and is unable to take oral fluids. Fluid therapy is prescribed. Which intervention would be most important for the client?

Which of the following precautions would be most appropriate when caring for a client being treated with RAI for a thyroid tumor?

After teaching a group of students about Simmonds' disease, the instructor determines that additional instruction is necessary when the students identify which hormone as being involved?

The nurse is assisting with the preparation of teaching plan for a client who is to receive methimazole (Tapazole) . Which of the following would be most appropriate to include in this plan?

The nurse is reviewing the laboratory and diagnostic test findings of a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) . Which of the following would the nurse expect to find?

A client with pheochromocytoma is scheduled for an adrenalectomy. Which of the following would the nurse perform preoperatively?

When providing teaching to a client with hyperthyroidism that is prescribed radioactive iodine (RAI) to destroy thyroid tissue, which of the following would the nurse include?

After teaching a client diagnosed with primary adrenal insufficiency about his condition, the nurse determines that additional teaching is necessary when the client states which of the following?

While assessing a client with hypoparathyroidism, the nurse taps the client's facial nerve and observes twitching of the mouth and tightening of the jaw. The nurse would document this finding as which of the following?

After teaching a client who is to receive lypression nasal spray as treatment for neurogenic diabetes insipidus about administration, which client statement indicates the need for additional teaching?

The nurse is reviewing the history and physical examination of a client diagnosed with hyperthyroidism. Which of the following would the nurse expect to find?

Which of the following nursing action would the nurse include when caring for a client with endemic goiter and experiencing respiratory symptoms?

Which of the following would the nurse expect the physician to order for a client with hypothyroidism?

Which of the following would the nurse expect to find in a client with severe hyperthyroidism?

A client with Addison's disease has a blood glucose level above 80 mg/dL thirty minutes after receiving 15 grams of carbohydrates for symptoms of hypoglycemia. Which of the following would the nurse do now?

Which suggestion would the nurse include for a client who has had a thyroidectomy to reduce tension on the suture line?

A nurse is assisting a client diagnosed with hypoparathyroidism about appropriate dietary measures suggested by the dietician. Which of the following would the nurse caution the client to avoid?

Which group of clients should not receive potassium iodide?