Sat, March 5, 2011 9:10:15 PM endocrine nclex From: Tiffany <firstname.lastname@example.org> View Contact To: email@example.com 1.
For a client with hyperglycemia, which data collection finding best supports a nursing diagnosis of Deficient fluid volume? Increased urine osmolarity 2. During the first 24 hours after a client is diagnosed with addisonian crisis, which task should the nurse perform frequently? Assess vital signs. 3. A client is ordered to receive 20 units of isophane insulin suspension (Humulin N) and 5 units of regular insulin (Humulin R) by subcutaneous injection. Place in chronological order the steps to take when mixing different types of insulin in a syringe. 2,4,5,1,3,6 4. The nurse administered isophane insulin suspension (NPH) to a diabetic client at 7 a.m. At what time would the nurse expect the client to be most at risk for a hypoglycemic reaction? 4pm 5. Following a transsphenoidal hypophysectomy, the nurse should assess the client carefully for: hypocortisolism 6. Before undergoing a subtotal thyroidectomy, a client receives potassium iodide (Lugol's solution) and propylthiouracil (PTU). The nurse would expect the client's symptoms to subside: 1-2 weeks 7. The nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare to absorption at other sites? Isulin is absorbed more rapidly at abdominal injection sites than at other sites. 8. A client with type 1 diabetes must learn how to self-administer insulin. The physician has prescribed 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction? "Rotate injection sites within the same anatomic region, not among different regions." 9. iddle-age female complains of anxiety, insomnia, weight loss, the inability to concentrate, and her eyes feeling "gritty." Thyroid function tests reveal the following: a thyroid-stimulating hormone (TSH) level of 0.02 units/ml, a thyroxine level of 20 g/dl, and a triiodothyronine level of
13.2. the nurse would suspect: GRAVES DISEASE 10. which is controlled by tolazamide (Tolinase). A client visiting the clinic is scheduled for an outpatient thyroid scan in 2 weeks. During a follow-up visit. A client is admitted to an acute care facility with a tentative diagnosis of hypoparathyroidism. A client with type 1 diabetes is admitted to an acute care facility with diabetic ketoacidosis. To correct this acute diabetic emergency. client with type 1 diabetes takes 15 units of isophane insulin suspension (Humulin N) before breakfast and 8 units before dinner. A 6-hour radioactive iodine uptake test showed a diffuse uptake of 85%. The nurse should monitor the client closely for the related problem of: profound neuromuscular irritability. Which instructions should the nurse include in her client teaching to ensure that this client is prepared for the test? 1. 14. which measure should the health care team take first? Initiate fluid replacement therapy. What is the most important laboratory test for confirming HHNS? Serum osmolarity 11.
. The nurse is instructing a client with newly diagnosed hypoparathyroidism about the regimen used to treat this disorder. 12. A client is transferred to a rehabilitation center after being treated in the hospital for a stroke. the nurse reevaluates the client's knowledge about insulin therapy and self-administration skills and learns that the client is unaware that certain over-the-counter (OTC) preparations and other medications may interact with insulin. the nurse helps formulate a nursing diagnosis of: Risk for impaired skin integrity related to tissue catabolism secondary to cortisol hypersecretion. the nurse would expect a decline in: serum glucose level. In a 28-year-old female client who is being successfully treated for Cushing's syndrome. Based on these findings. A client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNS) has a history of type 2 diabetes.4 15.253 ng/dl. The nurse should state that the physician probably will prescribe daily supplements of calcium and: vit D 17. Because the client has a history of Cushing's syndrome (hypercortisolism) and chronic obstructive pulmonary disease (COPD). The nurse should advise the client to avoid which OTC preparations? Preparations containing salicylates 16.
the nurse should instruct the client about which possible adverse effect of the drug? Menstrual irregularities 25. thyroid hormone antagonist For a client with hyperthyroidism.
. treatment is most likely to include: 21. A client is evaluated for type 1 diabetes. a tumor of the adrenal medulla that secretes excessive catecholamine. I just can't get enough to drink. Part of the diagnosis of this condition includes the analysis of serum electrolyte levels." 22. Based on initial data collection findings. Which client comment correlates best with this disorder? I'm thirsty all the time. When collecting data on a client with pheochromocytoma.18. 20. A client with hyperparathyroidism declines surgery and is to receive hormone replacement therapy with estrogen and progesterone. the nurse realizes the client's risk for injury is related to: bone demineralization resulting in pathologic fractures. When administering spironolactone (Aldactone) to a client who has had a unilateral adrenalectomy. A client with a history of chronic hyperparathyroidism admits to being noncompliant. Which instruction would be most important to include in the client's teaching plan? Maintain a moderate exercise program. Which outcome indicates that treatment of a client with diabetes insipidus has been effective? Fluid intake is less than 2.6 26. 23. 24. 19. Which electrolyte levels would the nurse expect to be abnormal in a client with PTH deficiency? 3. the nurse is most likely to detect: a blood pressure of 176/88 mm Hg.500 ml/day. client is seen in the clinic with suspected parathormone (PTH) deficiency.
Consequently. and nervousness. and blowing your nose 29. At 2 p.V. A client is scheduled for a transsphenoidal hypophysectomy to remove a pituitary tumor. 30. 28. The evening before the surgery. sweating. Which statement about fluid replacement is accurate for a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS)? Administer 2 to 3 L of I. Capillary glucose monitoring is being performed every 4 hours for a client diagnosed with diabetic ketoacidosis.. Test results reveal a pituitary tumor. the nurse evaluates the diabetes management regimen. and measures blood glucose before breakfast and at bedtime. At about 4:30 p.m.m. the nurse should help formulate a nursing diagnosis of: Deficient knowledge. sneezing.A client with type 1 diabetes has a prescription for 5 units of U-100 regular insulin and 25 units of U-100 isophane insulin suspension (NPH) to be taken before breakfast. the nurse should assess for potential complications by:
. Which of the following is an adverse reaction to glipizide (Glucotrol)? Photosensitivit y 32. The nurse should expect the dose's: onset to be at 2:30 p.. Preoperatively. After the client's condition stabilizes.m. which necessitates a transsphenoidal hypophysectomy.. A client whose physical findings suggest a hyperpituitary condition undergoes an extensive diagnostic workup. the client experiences headache. the client has a capillary glucose level of 250 mg/dl for which he receives 8 units of regular insulin. Which postoperative instruction should the nurse emphasize? You must avoid coughing.m. and its peak to be at 4 p. tremor. the nurse reviews preoperative and postoperative instructions given to the client earlier. The nurse learns that the client sees the physician every 4 weeks. Insulin is administered using a scale of regular insulin according to glucose results. pallor. injects insulin after breakfast and dinner. A client with long-standing type 1 diabetes is admitted to the hospital with unstable angina pectoris. What is the most probable cause of these signs and symptoms? Hypoglycemia 27. fluid over 2 to 3 hours 31.
and appears disheveled. has poor memory. Which of the following would the nurse expect to find in a client diagnosed with hyperparathyroidism? hypercalcemia 40. reports loss of appetite.
. decreased appetite. and constipation 34. 33. While collecting data. of the following would the nurse expect to assess in an elderly client with Hashimoto's thyroiditis? Weight gain.performing capillary glucose testing frequently. Which other laboratory finding should the nurse anticipate? Below-normal serum potassium level 35. the nurse notes that the client is agitated and irritable. 38.5 36. These findings are consistent with which problem? depression 37. When caring for a client who's being treated for hyperthyroidism. A client with Cushing's syndrome is admitted to the medical-surgical unit. The nurse expects to note an elevated serum glucose level in a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS). 39. the nurse should: balance the client's periods of activity and rest. Which nursing interventions are appropriate for this client? 1. The nursing care for the client in addisonian crisis should perform which intervention? Place the client in a private room. A 45-year-old female client is admitted to the hospital with Cushing's syndrome.3.
and a blood pressure of 108/70 mm Hg. this treatment isn't always possible or safe. fluid volume 48.A client is prescribed prednisone (Deltasone) daily. The nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. Which statement best explains why the nurse should instruct the client to take this drug in the morning? Morning administration of prednisone mimics the body's natural corticosteroid secretion pattern. light-headedness. client with a serum glucose level of 618 mg/dl is admitted to the facility. He's awake and oriented. He has hot. the client ideally should ingest an oral carbohydrate. Parathyroid hormone (PTH) has which effect on the kidneys? Stimulation of calcium reabsorption and phosphate excretion 46. The nurse is caring for a client with type 1 diabetes who exhibits confusion. a heart rate of 116 beats/minute. Which discharge instructions are appropriate for this client? 2. However. Based on these findings. The client is still conscious.
. To reverse a hypoglycemic reaction. Which nursing intervention is appropriate? Restricting fluids 44.6° F (38.1° C). Therefore. and aberrant behavior. 41. which nursing diagnosis takes highest priority? def. The nurse should first administer: 15 to 20 g of a fast-acting carbohydrate such as orange juice 47. A 56-year-old female client is being discharged after having a thyroidectomy. Which laboratory data would the nurse expect to find? Hyperkalemia 45.3 42. dry skin and the following vital signs: a temperature of 100. A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). the nurse should advise the client to keep which alternate treatment on hand? glucagon 43. The nurse is caring for a client in acute addisonian crisis.
A client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid). thready pulse 53. The nurse should be alert for which signs and symptoms? Coma. 50. Which finding is most likely to accompany this blood glucose level? Rapid. Which of the following findings is the nurse most likely to observe in this client? 1. the nurse should stay alert for signs and symptoms of: NA. headache.4. K abnormalities 51. The nurse is developing a teaching plan for a client diagnosed with diabetes insipidus. anxiety. the client's blood glucose level is 470 mg/dl. The nurse should include information about which hormone lacking in clients with diabetes insipidus? Antidiuretic hormone (ADH) 54. A client with Addison's disease comes to the clinic for a follow-up visit. The nurse should stay alert for: decreased body temperature and cold intolerance. and calcitonin.O. daily. 25 mcg P. Which finding should the nurse recognize as an adverse drug effect? tachycardia 55.6 52. When collecting data on this client. On admission. instruction concerning the administration of levothyroxine (Synthroid) should the nurse teach a client? take on empty stomach 56. T4. The nurse explains to a client with thyroid disease that the thyroid gland normally produces: T3.
. confusion. and cool. The client is being evaluated for hypothyroidism. A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medicalsurgical unit with abdominal pain. 57.A client's blood glucose level is 45 mg/dl. moist skin 49. A client is admitted to the hospital with signs and symptoms of diabetes mellitus.
coma 60. After falling off a ladder and suffering a brain injury. Knowing that these findings suggest severe hypothyroidism. the nurse prepares to take emergency action to prevent the potential complication of: m. the nurse should include which guideline? You'll need less insulin when you exercise or reduce your food intake. When teaching the client and family how diet and exercise affect insulin requirements. bradycardia.5 59. hypoventilation." 58. Which findings indicate that the treatment he's receiving is effective? 1. the nurse would assess for hyperkalemia shown by which of the following? muscle weakness
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. For a client with Graves' disease. hypotension. The nurse explains that these medications are only effective if the client: has type 2 dm 61.A client has just been diagnosed with type 1 diabetes. owing a unilateral adrenalectomy. respiratory acidosis. Physical and laboratory findings reveal hypothermia. which nursing intervention promotes comfort? Maintaining room temperature in the low-normal range 62.4. An incoherent client with a history of hypothyroidism is brought to the emergency department by the rescue squad. A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. and nonpitting edema of the face and pretibial area. a client develops syndrome of inappropriate antidiuretic hormone (SIADH).
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