Endocrine

Tel:Snleprometric

Diabetes mellitus:

v classification
• Type 1 diabetes is characterized by destruction of the pancreatic
beta cells.
• Types 2 diabetes involves insulin resistance and impaired insulin
secretion.
• Gestational diabetes mellitus is when a pregnant woman
experiences any degree of glucose intolerance with the onset of
pregnancy.

Signs and symptoms:

1. Poly urea
2. Poly depsia Yet
=

3. Poly phagia

Complications of Diabetes Mellitus:

• Neuropathies
• Retinopathy leading to blindness

year-old diabetes type II patient is in the post-operative care

unit following amputation of the right foot. Post-operatively,
the patient tells the nursE of tingling, coldness and cramping
in the right foot. Which of the following describes best the
type of pain?
A. Visceral
B.Somatic =g☒Wi
C. Ischemic
D.Neuropathic

Nursing Dx :
1. Risk for Unstable Blood Glucose

2. Deficient Knowledge

SNLEPROMETRIC ENDOCRINE


2
Broken fats
Diabetic ketoacidosis (DKA) is a life-threatening emergency caused by
a relative or absolute deficiency of insulin. Main clinical features of DKA

•
&É are hyperglycemia, acidosis, dehydration, and electrolyte losses such as
hypokalemia, hyponatremia.
metabolic
Nursing Dx: Risk for Fluid Volume Deficit

Intervention:
• Monitor hourly intake and output.
• Monitor respirations, e.g., acetone breath Kassmaul breath rabid + shallow
=

• Assess neurological status every two (2) hours.

• Add dextrose to IV fluid when serum blood glucose level is less than 250
mg/dL in DKA or less than 300 mg/dL
• Administer IV potassium and other electrolytes as indicated.

A 16-year-old girl was found unconscious in her home by her mother.

She brought to the hospital by ambulance. The patient has no previously
known medical history. On arrival, the nurse performs an assessment for
Level of consciousness and notes a Glasgow Coma Score of five. The
nurse notes the patient's breathe smells like acetone or fingernail paint
remover. What is the priority therapeutic goal?
A. Increase blood glucose
B. Increase serum osmolarity
C. Increase circulatory volume
D. Decrease intracranial pressure

Diabetes insipidus:
Diabetes insipidus occurs when the body has a lower than normal
amount of antidiuretic hormone (ADH) (ADH is also called
vasopressin)

Vasopressin is made and stored in the hypothalamus. It then travels

through the stalk to the posterior part of the pituitary where it is stored
for release into the bloodstream when needed.

An 11-year-old child has been diagnosis with diabetes insipidus?

A. Posterior pituitary
B. Anterior pituitary
C. Thyroid gland

SNLEPROMETRIC ENDOCRINE

Community health nurse visit diabetic patient. One of family

member complaining about her that patient unmoved. what should
the nurse do? Express >

A. Forced the patient to move Ask

B. Walk with the patient and take round
C. Ask patient express feeling and the cause

A patient took his NPH insulin at 6 AM, when will he be hypoglycemie?

A-7am
B-8am
C-9am
D-10am

is a - ④I

Which type of insulin can never be mixed with another types?

A. Rapid acting
B. Long acting
C. Intermediate
D. Regular

SNLEPROMETRIC ENDOCRINE

Is :@
=

Nurse is aware that a positive Chvostek’ sign indicate?

A. Hypocalcemia

Thyroidectomy:
Major postoperative thyroidectomy complications
include:
Wound infection
Bleeding
Arway obstruction
Ty pet hypocalcemia
Thyroid storm
Voice changes

A 29-year-old man is in the Surgical Ward on his first post-open

thyroidectomy. He appears drowsy but he is able to respiration by
nodding head. He is developing mild restlessness. What is the initial
recommended goal of care?
A. Monitor vital signs of thyroid storm
B. Assess for bilateral vocal fold mobility.
C. Monitor for swelling on the neck.
D. Monitor for vocal cord paralysis

SNLEPROMETRIC ENDOCRINE

Post thyroidectomy patient transferred to ward and developed tetany

the nurse suspected that patient has? Tingling
A. Hypokalemia
B. Hypocalcemia

A patient returned to the Surgical Unit from the thyroidectomy. The

nurse observed that the arousable. Blood pressure 90/60 mmHg Heart
rate 108 /min What immediate action should the nurse take?
A. Recheck pulse and blood pressure
B. Administer intravenous fluids as ordered
C. Place client in modified Trendelenburg's
D. Assess the back of neck surgical dressing for bleeding

The most common complication of thyroidectomy?

A. Distension
B. Bleeding
C. Vocal cord injury

Thyroid Storm: = crisis

It develops in people who have hyperthyroidism but aren’t

receiving appropriate treatment. This condition is marked by
the extreme overproduction of the two hormones produced by
the thyroid gland.

Symptoms of thyroid storm:

• racing heart rate (tachycardia) that exceeds 140 beats per

minute, and atrial fibrillation
• high fever
of
• persistent sweating The remain tissue
• restlessness can cause
• confusion thyroid
• Unconsciousness Thyroid storm

SNLEPROMETRIC ENDOCRINE

A client who has just undergone a thyroidectomy is

experiencing high fever, tachycardia, and extreme
restlessness. The nurse would interpret these manifestations
as?

A. Thyroid crisis/storm .

Cushing syndrome: (metabolic alkalosis)

when your body makes too much of the hormone cortisol over a
long period of time.

Hypokalemia and metabolic alkalosis are more common

Hypocalcemia
*
Moon face

The term Cushing syndrome refers to the manifestations of

hypercortisolism from any cause.

Which disorder is a result of excess cortisol?

A. Cushing syndrome

SNLEPROMETRIC ENDOCRINE

← It metabolic

alkalosis

The nurse is assigned to care for a patient with Cushing's syndrome

who is on adrenal corticoid hormones (see lab result) Test Result
Normal Value ph 7.2 (7.36-7.45)
Which of the following conditions should the nurse expect to
see in this patient?
A.Respiratory alkalosis
B.Respiratory acidosis
C.Metabolic alkalosis
D. Metabolic acidosis

Graves' disease:
Graves' disease is an autoimmune disorder that causes
hyperthyroidism, or overactive thyroid.

Graves disease is a state of hyperthyroidism in which

opthalmopathies, such as exophthalmos It could happen.

SNLEPROMETRIC ENDOCRINE

A 25-year-old female client exhibits exophthalmos of both eyes. The

health care provider recognizes this as a manifestation of?
Graves disease

Female futons
Low in hormone
9

progressive enlargement of a multi-nodular go tracheal compression

including pain at the site of the ear and jaw, difficulty swallowing, change
of pf breath by compressing the oesophagus. There is in otherwise the
patient is at risk. What is the preferred treatment?
A.Iodine treatment⇐ hyperthyroidism
A.Thyroid hormone treatment
C. Radioactive iodine treatment
D.Surgical resection of abnormal thyroid

A Post thyroidectomy patient transferred to ward and developed tetany

the nurse suspected that patient has?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia

SNLEPROMETRIC ENDOCRINE

Gestational diabetes is high blood sugar (diabetes) that starts or is found

during pregnancy. The best time for glucose screening tests during
pregnancy is?
A. 7 – 12 weeks
B.17 – 18 weeks
C.24 – 28 weeks

Patient is being admitted to the Recovery Room following a

thyroidectomy. The back of the neck wound is covered with dressing.
During the first 15 minutes, the patient started working and having
diarrhea . A general assessment is performed with special attention given
for the high risk for haemorrhage . Where would bleeding most likely
occur?
A. Stool
B. Vomitus
C. Dressing
D.Back of neck

A nuclear plant experienced a leakage, and all involved workers were

brought to the Emergency Department for treatment. the medical team
prescribed potassium iodide for the workers to block radioactive iodine to
be absorbed by an organ in the body. Which of the following organs is
the most sensitive to radioactive iodine?
A. Brain
B. Lungs
C. Kidney
D. Thyroid

The nurse care for a 60-year-old woman who history hypertension,

hypothyroidism and elevated cholesterol levels. She takes tablets daily for
each of the health problem. The doctor orders a routine dual- x-ray
absorptiometry test that shows decrease bone density. Which medication
most likely contributed the test result? most common side affect osteoporosis
¥61 Iib
A. Statins any of a group of drugs which act to reduce levels of cholesterol in the blood

stomach
B. Anti-hypertensive
C. Synthetic thyroid hormones should be in empty
SNLEPROMETRIC hevothyro×in@ ENDOCRINE


10

D. Cholesterol absorption inhibitors

A 36-year-old man has undergone a subtotal thyroidectomy ago. he Is

suspected to develop tetany after the surgery. Which of the following
symptoms best indicates tetanus?
A.Tingling in the fingers
B, Pain in hands and feet
C. Tension on the suture lines
D. Bleeding on the back of the dressing I Dm
with type

{
A client diagnosed with type 2 DM is being discharged from the hospital
after an occurrence of hyperglycemic hyperosmolar state (HHS). The
nurse creates a discharge teaching plan for the client and identifies which
intervention as a priority?
A. Exercise routines
B. Controlling dietary intake
C. Keeping follow-up appointments
D. Monitoring signs and symptoms of dehydration

A client presents with Hypocalcemia, hyperphosphatemia, muscle

cramps, and positive Trousseau's sign. What diagnosis does this
support?
A. Diabetes insipidus Primary aldosteronism (also called Conn's syndrome) is a rare condition caused by

:
B. Conn's syndrome overproduction of the hormone aldosterone that controls sodium and potassium in
- .the blood
C. Hypoparathyroidism
D. Acromegaly rare condition where the body produces too much growth hormone, causing body
tissues and bones to grow more quickly

SNLEPROMETRIC ENDOCRINE

 liver = amonia

11
area
kidney :

client with type 1 diabetes mellitus is admitted in which medication if

found by the nurse in the should be clarified with the physician?
A. Humalog (lispro) sliding scale beforemeals
B. Glargine (Lantus) 10 units subcutaneously
C. Metformin (Glucophage) 500 mg per orel
D. Dextrose 50% ampule intravenous push for 50 mg/Dl

Type I Dm
An adolescent with a juvenile diabetes mellitus develops
chronic renal failure. Which of the following diets is suitable?
A. Low fat
B. Low mineral
638' :-.
C. Low protein ±
D. Low carbohydrate

A home health nurse visits a patient who is newly diagnosed

with diabetes. The patient is compliant with taking the
prescribed hypoglycemic medications and eats three meals a
day followed by desserts sweetened with granulated sugar.
The patient also exercises 30 minutes a day, three times a
week. (See lab results) Test Glucose HgbA1c Result Range
from 6.6-8.36.9%
Normal 3.9-5.5mmol/L 4.7-5.6%
Which of the following educational intervention takes
priority?
A. Glucoses Monitoring
B. Dietary requirements
C. Exercise regimen
D. Medication
Getting birth for mother who has gestational diabetes. How
will this affect delivery process?
A. It will be Easy and Mone
Sonia y kills
B. It will be Difficult = Macro
C. It will be fast
D. It will be slow

SNLEPROMETRIC ENDOCRINE


12

A 28-year-old man is recovering from a moderate concussion following a

motor vehicle accident two week ago, when he suddenly develops an
increased thirst , craving cold water , the patient urinated very large
amounts of dilute , water like urine with a specific gravity of 1.001 to
1.005 , Which of the following is the patient most likely developing?
A. Diabetes mellitus
B. Diabetes insipidus
C. Hypothyroidism
D. Thyroid storm

??
Child with type 1 diabetes mellitus. The nurse is instructing mother.
Which of the following signs should be alert?
A. Polyuria
B. Vomiting
C. Dizziness =D KA
D. Thirsty

After subtotal thyroidectomy for patient. He complains

restlessness the nurse is assessing his vital signs.
BP is 150/100
Heart rate is 120.
Temperature 40
The nurse should expect that the cause for his condition is:
A. Hyper-metabolism due to increase in T3&T4
B. Hypo metabolism due to decrease T3&T4
C. Hypo metabolism due to increase in T3&T4
D. Hyper metabolism due to decrease in T3&T4.

Patient will start TPN and should started gradually to avoid

which?
A. Hyperinsulinemia
B. Hyperinsulinemia
C. Hypoglycemia
D. Hyperglycemia

SNLEPROMETRIC ENDOCRINE


13

A client is diagnosed as having secondary Cushing’s syndrome.

The nurse knows that the client has most likely been taking
which medication?
A. Estrogen
B. Penicillin
C. Lovastatin
D. Prednisone
-

Hydrocortisone route of administration?

A. Ear
B. Eye
C. Nose=3 m + oral
D. Under the tongue

2 ? ? Aassessment
nurse cares for a client receiving total parenteral nutrition? Which
parameters does the nurse monitor closely?
? A. Alertness
-

B. Skin turgor
C. Temperature = sepsis
D. Ability to swallow

A 71-year-old woman who resides in a long-term nursing home

fell while walking downstairs. The attending nurse arrives to
find the patient sitting motionless on the stairs. She is alert and
oriented but wishes to rest. While she rests, the nurse reviews
the chart and notes that her medication regimen includes
metformin, loratadine, warfarin and diclofenac. Which
medication is most likely to increase the patient's risk of injury?
A. Metformin
B. Loratadine
C. Warfarin
D. Diclofenac
After thyroidectomy which of the following juice should be offered?
A. Apple juice = dear juice and clear of seeds
B. Tomato juice
C. Orange juice
D. Strawberry

SNLEPROMETRIC ENDOCRINE


14

What is the Position during thyroidectomy?

A. Supine with hyper flexion of neck
B. Supine with hyperextended neck
C. Semi fowler
D. Lateral with slightly flexion neck

What is the Position after thyroidectomy?

A. Lateral flexed
B. Semi fowler with slight neck flexed
C. Prone head extended
D. High Fowler with neck extended

4¥ !
? DM patient at night shift with cold skin, tachycardia,
diaphoresis what you will do first?
A. Check blood glucose.
B. Give him cup of orange juice

Patient diagnosed with septic shock had an upward-trending glucose level

(180-225 mg/dL) requiring control with insulin.The patient's spouse asks
why is insulin needed as the patient does not have DM Which of the
following is the most appropriate nursing response to educate the patient's
spouse?
A. "It is common for critically clients to develop type diabetes. We give
insulin to keep glucose level under control (less than140 mg/dL)
B. " Patient had diabetes before, you just didn't know it. we give insulin
to keep glucose level in the normal range (70-110 mg/dL)
C. " Increase in glucose is a normal response to stress by the body.
We give insulin to keep the level 1t 140-180-mg/dL"
D. " Increase is common in critically ill clients and effects their ability to
fight off infection. We give insulin to keep the glucose level in the normal
range (70-110 mg/dL)"

SNLEPROMETRIC ENDOCRINE


15

Addison disease
Classical signs of adrenal insufficiency?
A. Hyperpigmentation Take
B. Hyponatremia
C. Hypernatremia
years
Position during liver biopsy?
A. Prone
B. Supine right hand below head
C. Right side lying
D. Lateral

SNLEPROMETRIC ENDOCRINE