Question 1

A patient is admitted to the hospital with new-onset diabetes insipidus. Which of the following nursing diagnoses should the nurse include in the plan of care? (Select all that apply.?

Accepted Answer

Patients with diabetes insipidus are at risk for deficient fluid volume due to excessive urination, so the nurse should include Risk for Deficient Fluid Volume in the plan of care. Additionally, patients may not fully understand the disease process and their treatment options, so Knowledge Deficit related to disease process is also appropriate to include in the plan of care. There is no indication given for hypertension, fractures, or impaired gas exchange, so options A, B, and D are not appropriate.

Question 2

The LPN is caring for a patient with suspected hyperthyroidism who is scheduled for a radioactive iodine uptake test. What are symptoms of hyperthyroidism that the nurse should note on the medical record? (Select all that apply.?

Accepted Answer

The answer of The LPN is caring for a patient...

Question 3

What are signs/symptoms of dilutional hyponatremia? (Select all that apply.?

Accepted Answer

The answer of What are signs/symptoms of dilutional hyponatremia? (Select...

Question 4

The nurse working in a primary care physician office recognizes which of the following individuals is at highest risk for iodine deficiency?

Accepted Answer

A 52-year-old vegan with dietary sodium restrictions is at the highest risk for iodine deficiency because iodine is primarily found in seafood, dairy products, and iodized salt. Vegans do not consume seafood or dairy, and sodium restrictions would likely limit intake of iodized salt, increasing the risk of iodine deficiency.

Question 5

The nurse is assisting with discharge of a patient with Addison's disease following an addisonian crisis. Which instruction is most important for the nurse to reinforce?

Accepted Answer

The most important instruction for the nurse to reinforce for a patient with Addison's disease following an addisonian crisis is the importance of taking steroid replacements as prescribed. Failure to do so can result in a life-threatening adrenal crisis. Monitoring blood glucose levels and maintaining a well-balanced diet are also important, but not as crucial as taking steroid replacements. Exercise can also be beneficial for overall health, but is not the most important instruction in this scenario.

Question 6

What is the most common cause of hyperthyroidism?

Accepted Answer

Graves' disease is the most common cause of hyperthyroidism, accounting for around 85% of cases. It is an autoimmune disorder characterized by the production of antibodies that stimulate the thyroid gland to produce excess thyroid hormone. Multinodular goiter and radiation exposure can also cause hyperthyroidism, but they are less common causes. Excess thyrotropin-releasing hormone (TRH) from the hypothalamus would lead to excess production of thyroid-stimulating hormone (TSH) from the pituitary gland, which would stimulate the thyroid gland to produce more thyroid hormone, but this is not a common cause of hyperthyroidism.

Question 7

The nurse is caring for a patient with diabetes insipidus. What type of intravenous fluid would the nurse expect to be ordered for fluid replacement?

Accepted Answer

Hypotonic solutions are often used in the treatment of diabetes insipidus because they help to rehydrate cells by moving water into the cells, which is beneficial in conditions where there is excessive urination and cellular dehydration, as seen in diabetes insipidus.

Question 8

What disorder places the patient at risk for compression fractures?

Accepted Answer

Hyperparathyroidism can cause increased levels of parathyroid hormone, which can lead to weakened bones and an increased risk for compression fractures.

Question 9

Which intervention by the nurse is most important for a patient with symptoms of a pheochromocytoma?

Accepted Answer

Symptoms of a pheochromocytoma include high blood pressure, palpitations, anxiety, and sweating. Providing a calm, quiet environment can help decrease the stimulation that may exacerbate these symptoms. The other options may be important aspects of nursing care, but providing a calm environment is the most important for managing symptoms of a pheochromocytoma.

Question 10

The LPN is assisting in the care of a 51-year-old woman recovering from a hypophysectomy. Which of the following, if noted by the nurse, would require immediate intervention?

Accepted Answer

Urinary output of 800 mL in 4 hours is significantly high and could indicate diabetes insipidus, a potential complication of hypophysectomy due to a lack of antidiuretic hormone. This requires immediate intervention to prevent dehydration and electrolyte imbalance.

Question 11

A patient enters the emergency department in an addisonian crisis. Vital signs are blood pressure 85/52 mm Hg and pulse 88 beats/min. The patient is lethargic. Which event in the patient's week most likely precipitated this crisis?

Accepted Answer

Being laid off from a job may have caused psychological stress, which can trigger an Addisonian crisis. High-fat diet and exercise routines are not typically known to cause such crises. While taking Tylenol may cause some complications in individuals with adrenal insufficiency, it is unlikely to result in an Addisonian crisis unless there are other precipitating factors present.

Question 12

What are good sources of calcium that should be included in dietary instruction for the patient who needs to follow a high-calcium diet? (Select all that apply.?

Accepted Answer

Milk, cheese, and yogurt are all excellent sources of calcium and should be included in a high-calcium diet. Sardines and salmon are also good sources of calcium for those who choose to eat fish. Beef, pork, chicken, potatoes, and whole grain breads and cereals are not significant sources of calcium and do not need to be emphasized in dietary instruction for a high-calcium diet.

Question 13

A patient with chronic obstructive pulmonary disease who is placed on corticosteroid therapy asks the nurse what the medication does. Which of the following responses by the nurse is best?

Accepted Answer

Corticosteroids are a type of anti-inflammatory medication that can reduce swelling in the airways of patients with asthma or chronic obstructive pulmonary disease (COPD). This can improve breathing and decrease symptoms such as wheezing and shortness of breath. It does not directly dilate the airways, act as an expectorant, or have antibacterial effects.

Question 14

In addition to monitoring vital signs, which physical or laboratory result assessment is important for the nurse to monitor for a patient being given fludrocortisone for an adrenal disorder?

Accepted Answer

Fludrocortisone can cause electrolyte imbalances, specifically hypokalemia, which can lead to muscle weakness, cramping, and cardiac arrhythmias. Therefore, monitoring serum potassium levels is important to allow for timely interventions if needed. Monitoring serum calcium or magnesium levels would not be as relevant for a patient being given fludrocortisone. Additionally, fludrocortisone does not directly affect thyroid hormone levels.

Question 15

The LPN admits a well-known patient to the clinic and notes that the patient's face and features seem broader and more coarse. Which of the following laboratory tests would the nurse expect to be ordered?

Accepted Answer

Broadening of facial features and coarseness can be indicative of acromegaly, which is caused by excess secretion of growth hormone. Therefore, a growth hormone test would be ordered to diagnose acromegaly.

Question 16

The LPN is caring for a patient with diabetes insipidus and obtains a urine specific gravity reading of 1.002. Which response by the LPN is most important?

Accepted Answer

A urine specific gravity of 1.002 is very low, indicating very dilute urine, which is a characteristic finding in diabetes insipidus due to the kidneys' inability to concentrate urine. Reporting this finding to the RN is important because it suggests that the current therapy may not be effective in managing the condition.

Question 17

A patient is being discharged after a hypophysectomy, which was performed because of a tumor that resulted in acromegaly. What is important for the nurse to include in discharge teaching?

Accepted Answer

After a hypophysectomy, the patient will no longer be able to produce certain hormones on their own, and will need to take replacement hormones for the rest of their life. This includes thyroid hormone, corticosteroids, and sex hormones. Option A is incorrect because bromocriptine is used to treat hyperprolactinemia, not acromegaly. Option B is incorrect because after surgery soft tissue enlargement should begin to decrease. Option D is incorrect because while some visual changes may improve after surgery, it is not guaranteed and may take longer than 6 months to notice a difference.

Question 18

A patient is being discharged with treatment for long-term hypoparathyroidism. What should the nurse include in discharge teaching? (Select all that apply.?

Accepted Answer

Patients with hypoparathyroidism should eat a diet high in calcium, have regular eye exams due to potential cataract development, follow up with lab tests to monitor calcium levels, and take prescribed calcium and vitamin D supplements.

Question 19

A patient with chronic obstructive pulmonary disease develops Cushing's syndrome related to long-term steroid use. The physician writes an order to discontinue the steroids. Which action by the nurse is most appropriate?

Accepted Answer

Steroids should be tapered rather than abruptly discontinued, especially after long-term use, to avoid adrenal insufficiency. Abrupt cessation can lead to a life-threatening condition.

Question 20

The nurse develops a nursing diagnosis of "fluid volume excess related to sodium retention secondary to steroid therapy as evidenced by weight gain of 12 pounds in 2 weeks and edema of lower extremities." Which goal is most appropriate?

Accepted Answer

The most appropriate goal in this scenario is for the patient to have improved fluid balance as evidenced by weight returning to baseline. This directly addresses the fluid volume excess related to sodium retention and edema, and is a measurable outcome that can be monitored to assess the effectiveness of interventions. While educating the patient about the importance of a low-sodium diet is important, it does not directly address the current issue of fluid volume excess. Discontinuing steroids may be desirable, but it is not always possible or appropriate depending on the underlying condition being treated. Measuring ankle circumference daily may be a useful intervention, but it is not a specific goal in and of itself.

Quiz 39: Nursing Care of Patients With Endocrine Disorders