A patient arrives to the ER and is unable to give A patient with a mild case of diabetes insipidus is Where is the anti-diuretic
etic hormone PRODUCED
you a health history due to altered mental
status. The family reports the patient has gained
over 10 lbs in 1 week and says it is mainly
"water" weight. In addition, they report the
patient hasn't been able to urinate or eat within
the past week as well and was recently
diagnosed with small cell lung cancer. On
assessment, you note the patient's HR is 115 and
BP 180/92. Patient sodium level is 90. Which of
the following conditions do you suspect the
patient is most likely presenting with?*
A. SIADH
B. Diabetes Insipidus
C. Addison's Disease
D. Fluid Volume Deficient
In the scenario above what drug do you
anticipate the patient will be started on per
doctor's order?*
A. Desmopressin (DDAVP) IV
B. Declomycin
C. Diabinese
D. Stimate
Which of the following signs and symptoms is
NOT expected with Diabetes Insipidus?*
A. Polyuria
B. Polydipsia
C. Polyphagia
D. Extreme thirst
You are developing a care plan for a patient with
SIADH. Which of the following would be a
potential nursing diagnosis for this patient?*
A. Fluid volume overload
B. Fluid volume deficient
C. Acute pain
D. Impaired skin integrity
started on Diabinese. What would you include in
your patient teaching with this patient?*
A. Signs and symptoms of hypoglycemia
B. Restricting foods containing caffeine
C. Taking the medication on an empty stomach
D. Drinking 16 oz of water when taking the
medication
Which patient is most at risk for developing
Syndrome of Inappropriate Anti-diuretic
Hormone (SIADH)?*
A. A patient diagnosed with small cell lung
cancer.
B. A patient whose kidney tubules are failing to
reabsorb water.
C. A patient with a tumor on the anterior
pituitary gland.
D. A patient taking Declomycin.
A patient with SIADH is undergoing IV treatment
of a hypertonic IV solution of 3% saline and IV
Lasix. Which of the following nursing findings
requires intervention?*
A. Sodium level of 136.
B. Patient reports urinating more frequently.
C. Potassium level of 5.0.
D. Assessment finding of crackles throughout
the lung fields.
The anti-diuretic hormone is __________ in
Diabetes Insipidus and _________ in SIADH.*
A. high, low
B. absent, absent
C. low, high
D. low, low
in the body?*
A. Anterior pituitary gland
B. Posterior pituitary gland
C. Hypothalamus
D. Medulla
Where is the anti-diuretic hormone SECRETED in
the body?*
A. Hypothalamus
B. Thyroid
C. Posterior Pituitary gland
D. Anterior pituitary gland
A client with primary diabetes insipidus is
prescribed desmopressin (DDAVP). Which
instruction should the nurse provide before the
client is discharged?
1. "Administer desmopressin while the
suspension is cold."
2. "Your condition isn't chronic, so you won't
need to wear a medical identification bracelet."
3. "You may not be able to use desmopressin
nasally if you have nasal discharge or
blockage."
4. "You won't need to monitor your fluid intake
and output after you start taking desmopressin."
Which of the following would indicate that a
client has developed water intoxication
secondary to treatment for diabetes insipidus?
1. Confusion and seizures
2. Sunken eyeballs and spasticity
3. Flaccidity and thirst
4. Tetany and increased blood urea nitrogen
(BUN) levels.
A client is admitted for treatment of the
syndrome of inappropriate antidiuretic hormone
(SIADH). Which nursing intervention is
appropriate?
1. Infusing I.V. fluids rapidly as ordered
2. Encouraging increased oral intake
3. Restricting fluids
4. Administering glucose-containing I.V. fluids as
ordered
The nurse is developing a teaching plan for a
client diagnosed with diabetes insipidus. The
nurse should include information about which
hormone lacking in clients with diabetes
insipidus?
1. Antidiuretic hormone (ADH)
2. Thyroid-stimulating hormone (TSH)
3. Follicle-stimulating hormone (FSH)
4. Luteinizing hormone (LH)
When caring for a client with diabetes insipidus,
the nurse expects to administer:
1. vasopressin (Pitressin Synthetic).
2. furosemide (Lasix).
3. regular insulin.
4. 10% dextrose.
Which sign suggests that a client with the
syndrome of inappropriate antidiuretic hormone
(SIADH) secretion is experiencing complications?
1. Tetanic contractions
2. Neck vein distention
3. Weight loss
4. Polyuria

After falling off a ladder and suffering a brain
injury, a client develops syndrome of
inappropriate antidiuretic hormone (SIADH).
Which findings indicate that the treatment he's
receiving is effective?Select all that apply:
1. Decrease in body weight
2. Rise in blood pressure and drop in heart rate
3. Absence of wheezes in his lungs
4. Increased urine output
5. Decreased urine osmolarity
A client is diagnosed with syndrome of
inappropriate antidiuretic hormone (SIADH). The
nurse informs the client that the physician will
prescribe diuretic therapy and restrict fluid and
sodium intake to treat the disorder. If the client
doesn't comply with the recommended
treatment, which complication may arise?
1. Cerebral edema
2. Hypovolemic shock
3. Severe hyperkalemia
4. Tetany
When caring for a male client with diabetes
insipidus, nurse Juliet expects to administer:
A. vasopressin (Pitressin Synthetic)
B. furosemide (Lasix).
C. regular insulin.
D. 10% dextrose.
Nurse Louie is developing a teaching plan for a
male client diagnosed with diabetes insipidus.
The nurse should include information about
which hormone lacking in clients with diabetes
insipidus?
A. antidiuretic hormone (ADH).
B. thyroid-stimulating hormone (TSH).
C. follicle-stimulating hormone (FSH).
D. luteinizing hormone (LH).
A male client is admitted for treatment of the
syndrome of inappropriate antidiuretic hormone
(SIADH). Which nursing intervention is
appropriate?
A. Infusing I.V. fluids rapidly as ordered
B. Encouraging increased oral intake
C. Restricting fluids
D. Administering glucose-containing I.V. fluids as
ordered
Which outcome indicates that treatment of a
male client with diabetes insipidus has been
effective?
A. Fluid intake is less than 2,500 ml/day.
B. Urine output measures more than 200
ml/hour.
C. Blood pressure is 90/50 mm Hg.
D. The heart rate is 126 beats/minute.
A patient with SIADH is treated with water
restriction and administration of IV fluids. The
nurses evaluates that treatment has been
effective when the patient experiences
A. Increased urine output, decreased serum
sodium, and increased urine specific gravity
B. Increased urine output, increased serum
sodium, and decreased urine specific gravity
C. Decreased urine output, increased serum
sodium, and decreased urine specific gravity
D. Decreased urine output, decreased serum
sodium, and increased urine specific gravity
The client diagnosed with a pituitary tumor
developed syndrome of inappropriate
antidiuretic hormone (SIADH). Which
interventions should the nurse implement?
1. Assess for dehydration and monitor blood
glucose levels.
2. Assess for nausea and vomiting and weigh
daily.
3. Monitor potassium levels and encourage fluid
intake.
4. Administer vasopressin IV and conduct a fluid
deprivation test.
Which laboratory value should be monitored by
the nurse for the client diagnosed with diabetes
insipidus?
1. Serum sodium.
2. Serum calcium
3. Urine glucose.
4. Urine white blood cells.
The nurse is discharging a client diagnosed with
diabetes insipidus. Which statement made by
the client warrants further intervention?
1. "I will keep a list of my medications in my
wallet and wear a Medic Alert bracelet."
2. "I should take my medication in the morning
and leave it refrigerated at home."
3. "I should weigh myself every morning and
record any weight gain."
4. "If I develop a tightness in my chest, I will call
my health-care provider."
The client is admitted to the medical unit with a
diagnosis of rule-out diabetes insipidus (DI).
Which instructions should the nurse teach
regarding a fluid deprivation test?
1. The client will be asked to drink 100 mL of
fluid as rapidly as possible and then will not be
allowed fluid for 24 hours.
2. The client will be administered an injection of
antidiuretic hormone, and urine output will be
measured for four (4) to six (6) hours.
3. The client will be NPO, and vital signs and
weights will be done hourly until the end of the
test.
4. An IV will be started with normal saline, and
the client will be asked to try to hold the urine in
the bladder until a sonogram can be done.
The nurse is planning the care of a client
diagnosed with syndrome of inappropriate
antidiuretic hormone (SIADH). Which
interventions should be implemented? Select all
that apply.
1. Restrict fluids per health-care provider order.
2. Assess level of consciousness every two (2)
hours.
3. Provide an atmosphere of stimulation.
4. Monitor urine and serum osmolality.
5. Weigh the client every three (3) day
The nurse is caring for a client diagnosed with
diabetes insipidus (DI). Which intervention
should be implemented?
1. Administer sliding-scale insulin as ordered.
2. Restrict caffeinated beverages.
3. Check urine ketones if blood glucose is >250.
4. Assess tissue turgor every four (4) hours.
The unlicensed assistive personnel (UAP)
complains to the nurse she has filled the water
pitcher four (4) times during the shift for a client
diagnosed with a closed head injury and the
client has asked for the pitcher to be filled again.
Which intervention should the nurse implement
first?
1. Tell the UAP to fill the pitcher with ice cold
water.
2. Instruct the UAP to start measuring the
client's I & O.
3. Assess the client for polyuria and polydipsia.
4. Check the client's BUN and creatinine levels.
The nurse is admitting a client diagnosed with
syndrome of inappropriate antidiuretic hormone
(SIADH). Which clinical manifestations should be
reported to the health-care provider?
1. Serum sodium of 112 mEq/L and a headache.
2. Serum potassium of 5.0 mEq/L and a
heightened awareness.
3. Serum calcium of 10 mg/dL and tented tissue
turgor.
4. Serum magnesium of 1.2 mg/dL and large
urinary output.
The male client diagnosed with syndrome of
inappropriate antidiuretic hormone (SIADH)
secondary to cancer of the lung tells the nurse
he wants to discontinue the fluid restriction and
does not care if he dies. Which action by the
nurse is an example of the ethical principle of
autonomy?
1. Discuss the information the client told the
nurse with the health-care provider and
significant other.
2. Explain it is possible the client could have a
seizure if he drank fluid beyond the restrictions.
3. Notify the health-care provider of the client's
wishes and give the client fluids as desired.
4. Allow the client an extra drink of water and
explain the nurse could get into trouble if the
client tells the health-care provider.
The nurse determines that demeclocycline
(Declomycin) is effective for a patient with
syndrome of inappropriate antidiuretic hormone
(SIADH) based on finding that the patient's
A. weight has increased.
B. urinary output is increased.
C. peripheral edema is decreased.
D. urine specific gravity is increased.
The nurse determines that additional instruction
is needed for a 60-year-old patient with chronic
syndrome of inappropriate antidiuretic hormone
(SIADH) when the patient says which of the
following?
A. "I need to shop for foods low in sodium and
avoid adding salt to food."
B. "I should weigh myself daily and report any
sudden weight loss or gain."
C. "I need to limit my fluid intake to no more
than 1 quart of liquids a day."
D. "I will eat foods high in potassium because
diuretics cause potassium loss."
A 56-year-old patient who is disoriented and
reports a headache and muscle cramps is
hospitalized with possible syndrome of
inappropriate antidiuretic hormone (SIADH). The
nurse would expect the initial laboratory results
to include a(n)
A. elevated hematocrit.
B. decreased serum sodium.
C. low urine specific gravity.
D. increased serum chloride.
An expected nursing diagnosis for a 30-year-old
patient admitted to the hospital with symptoms
of diabetes insipidus is
A. excess fluid volume related to intake greater
than output.
B. impaired gas exchange related to fluid
retention in lungs.
C. sleep pattern disturbance related to frequent
waking to void.
D. risk for impaired skin integrity related to
generalized edema.
Which intervention will the nurse include in the
plan of care for a 52-year-old male patient with
syndrome of inappropriate antidiuretic hormone
(SIADH)?
A. Monitor for peripheral edema.
B. Offer patient hard candies to suck on.
C. Encourage fluids to 2 to 3 liters per day.
D. Keep head of bed elevated to 30 degrees.
The nurse is caring for a patient admitted with
diabetes insipidus (DI). Which information is
most important to report to the health care
provider?
A. The patient is confused and lethargic.
B. The patient reports a recent head injury.
C. The patient has a urine output of 400 mL/hr.
D. The patient's urine specific gravity is 1.003.
A 23-year-old patient is admitted with diabetes
insipidus. Which action will be most appropriate
for the registered nurse (RN) to delegate to an
experienced licensed practical/vocational nurse
(LPN/LVN)?
A. Titrate the infusion of 5% dextrose in water.
B. Teach the patient how to use desmopressin
(DDAVP) nasal spray.
C. Assess the patient's hydration status every 8
hours.
D. Administer subcutaneous DDAVP.
Which information is most important for the
nurse to communicate rapidly to the health care
provider about a patient admitted with possible
syndrome of inappropriate antidiuretic hormone
(SIADH)?
A. The patient has a recent weight gain of 9 lb.
B. The patient complains of dyspnea with
activity.
C. The patient has a urine specific gravity of
1.025.
D. The patient has a serum sodium level of 118
mEq/L.
1. A patient arrives to the ER and is unable to
give you a health history due to altered mental
status. The family reports the patient has gained
over 10 lbs in 1 week and says it is mainly
“water” weight. In addition, they report the
patient hasn’t been able to urinate or eat within
the past week as well and was recently
diagnosed with small cell lung cancer. On
assessment, you note the patient’s HR is 115 and
BP 180/92. Patient sodium level is 90. Which of
the following conditions do you suspect the
patient is most likely presenting with?
A. SIADH
B. Diabetes Insipidus
C. Addison's Disease
D. Fluid Volume Deficient
2. In the scenario above what drug do you
anticipate the patient will be started on per
doctor’s order?
A. Desmopressin (DDAVP) IV
B. Declomycin
C. Diabinese
D. Stimate
3. Which of the following signs and symptoms is
NOT expected with Diabetes Insipidus?
A. Polyuria
B. Polydipsia
C. Polyphagia
D. Extreme thirst
4. You are developing a care plan for a patient
with SIADH. Which of the following would be a
potential nursing diagnosis for this patient?
A. Fluid volume overload
B. Fluid volume deficient
C. Acute pain
D. Impaired skin integrity
5. A patient with a mild case of diabetes
insipidus is started on Diabinese. What would
you include in your patient teaching with this
patient?
A. Signs and symptoms of hypoglycemia
B. Restricting foods containing caffeine
C. Taking the medication on an empty stomach
D. Drinking 16 oz of water when taking the
medication
6. Which patient is most at risk for developing
Syndrome of Inappropriate Anti-diuretic
Hormone (SIADH)?
A. A patient diagnosed with small cell lung
cancer.
B. A patient whose kidney tubules are failing to
reabsorb water.
C. A patient with a tumor on the anterior
pituitary gland.
D. A patient taking Declomycin.
7. A patient with SIADH is undergoing IV
treatment of a hypertonic IV solution of 3%
saline and IV Lasix. Which of the following
nursing findings requires intervention?
A. Sodium level of 136.
B. Patient reports urinating more frequently.
C. Potassium level of 5.0.
D. Assessment finding of crackles throughout
the lung fields.
8. The anti-diuretic hormone is __________ in
Diabetes Insipidus and _________ in SIADH.
A. high, low
B. absent, absent
C. low, high
D. low, low
9. Where is the anti-diuretic hormone
PRODUCED in the body?
A. Anterior pituitary gland
B. Posterior pituitary gland
C. Hypothalamus
D. Medulla
10. Where is the anti-diuretic hormone
SECRETED in the body?
A. Hypothalamus
B. Thyroid
C. Posterior Pituitary gland
D. Anterior pituitary gland
The client diagnosed with a pituitary tumor
developed syndrome of inappropriate
antidiuretic hormone (SIADH). Which
interventions should the nurse implement?
1. Assess for dehydration and monitor blood
glucose levels.
2. Assess for nausea and vomiting and weigh
daily.
3. Monitor potassium levels and encourage fluid
intake.
4. Administer vasopressin IV and conduct a fluid
deprivation test.
The nurse is admitting a client to the
neurological intensive care unit who is
postoperative transsphenoidal hypophysectomy.
Which data warrant immediate intervention?
1. The client is alert to name but is unable to tell
the nurse the location.
2. The client has an output of 2,500 mL since
surgery and an intake of 1,000 mL.
3. The client's vital signs are T 97.6ºF, P 88, R 20,
and BP 130/80.
4. The client has a 3-cm amount of dark-red
drainage on the turban dressing.
Which laboratory value should be monitored by
the nurse for the client diagnosed with diabetes
insipidus?
1. Serum sodium.
2. Serum calcium
3. Urine glucose.
4. Urine white blood cells.
The nurse is discharging a client diagnosed with
diabetes insipidus. Which statement made by
the client warrants further intervention?
1. "I will keep a list of my medications in my
wallet and wear a Medic Alert bracelet."
2. "I should take my medication in the morning
and leave it refrigerated at home."
3. "I should weigh myself every morning and
record any weight gain."
4. "If I develop a tightness in my chest, I will call
my health-care provider."
The client is admitted to the medical unit with a
diagnosis of rule-out diabetes insipidus (DI).
Which instructions should the nurse teach
regarding a fluid deprivation test?
1. The client will be asked to drink 100 mL of
fluid as rapidly as possible and then will not be
allowed fluid for 24 hours.
2. The client will be administered an injection of
antidiuretic hormone, and urine output will be
measured for four (4) to six (6) hours.
3. The client will be NPO, and vital signs and
weights will be done hourly until the end of the
test.
4. An IV will be started with normal saline, and
the client will be asked to try to hold the urine in
the bladder until a sonogram can be done.
1. The client is not allowed to drink during the
The nurse is caring for clients on a medical floor.
Which client should be assessed first?
1. The client diagnosed with syndrome of
inappropriate antidiuretic hormone (SIADH) who
has a weight gain of 1.5 pounds since yesterday.
2. The client diagnosed with a pituitary tumor
who has developed diabetes insipidus (DI) and
has an intake of 1,500 mL and an output of 1,600
mL in the last 8 hours.
3. The client diagnosed with syndrome of
inappropriate antidiuretic hormone (SIADH)
who is having muscle twitching.
4. The client diagnosed with diabetes insipidus
(DI) who is complaining of feeling tired after
having to get up at night.
The nurse is planning the care of a client
diagnosed with syndrome of inappropriate
antidiuretic hormone (SIADH). Which
interventions should be implemented? Select all
that apply.
1. Restrict fluids per health-care provider order.
2. Assess level of consciousness every two (2)
hours.
3. Provide an atmosphere of stimulation.
4. Monitor urine and serum osmolality.
5. Weigh the client every three (3) day
ANS: 1, 2, 4
The nurse is caring for a client diagnosed with
diabetes insipidus (DI). Which intervention
should be implemented?
1. Administer sliding-scale insulin as ordered.
2. Restrict caffeinated beverages.
3. Check urine ketones if blood glucose is >250.
4. Assess tissue turgor every four (4) hours.
The unlicensed assistive personnel (UAP)
complains to the nurse she has filled the water
pitcher four (4) times during the shift for a client
diagnosed with a closed head injury and the
client has asked for the pitcher to be filled again.
Which intervention should the nurse implement
first?
1. Tell the UAP to fill the pitcher with ice cold
water.
2. Instruct the UAP to start measuring the
client's I & O.
3. Assess the client for polyuria and polydipsia.
4. Check the client's BUN and creatinine levels.
The nurse is admitting a client diagnosed with
syndrome of inappropriate antidiuretic hormone
(SIADH). Which clinical manifestations should be
reported to the health-care provider?
1. Serum sodium of 112 mEq/L and a headache.
2. Serum potassium of 5.0 mEq/L and a
heightened awareness.
3. Serum calcium of 10 mg/dL and tented tissue
turgor.
4. Serum magnesium of 1.2 mg/dL and large
urinary output.
The male client diagnosed with syndrome of
inappropriate antidiuretic hormone (SIADH)
secondary to cancer of the lung tells the nurse
he wants to discontinue the fluid restriction and
does not care if he dies. Which action by the
nurse is an example of the ethical principle of
autonomy?
1. Discuss the information the client told the
nurse with the health-care provider and
significant other.
2. Explain it is possible the client could have a
seizure if he drank fluid beyond the restrictions.
3. Notify the health-care provider of the client's
wishes and give the client fluids as desired.
4. Allow the client an extra drink of water and
explain the nurse could get into trouble if the
client tells the health-care provider.
Question 1: Which of the following is a
characteristic of Syndrome of Inappropriate
Antidiuretic Hormone (SIADH)?
A. High urine output
B. Low serum sodium levels
C. Hyperkalemia
D. Increased serum osmolality
Question 2: Which of the following is a A client with DI is prescribed desmopressin
characteristic of Diabetes Insipidus? (DDAVP). Which of the following statements by
the client indicates a need for further education
A. Low urine output about the medication?
B. High serum sodium levels A. "I need to drink plenty of water while taking
C. Hypokalemia this medication."
D. Decreased serum osmolality B. "I should take this medication at the same
time every day."
Question 3: Which of the following is a potential C. "I should avoid drinking alcohol while taking
cause of SIADH? this medication."
D. "I should monitor my blood glucose levels
A. Head injury while taking this medication."
B. Hypothyroidism
C. Nephrotic syndrome A client with SIADH is at risk for developing
D. Addison's disease which of the following complications?
A. Hypovolemic shock
Question 4: Which of the following is a potential B. Hypernatremia
cause of Diabetes Insipidus? C. Cerebral edema
D. Metabolic acidosis
A. Hyperthyroidism Answer: C. Cerebral edema
Explanation: In SIADH, the body retains too much water,
B. Chronic kidney disease
which can lead to cerebral edema (swelling of the brain).
C. Pituitary tumor Hypovolemic shock, hypernatremia, and metabolic acidosis
D. Cushing's syndrome are not typically associated with SIADH.
Question 5: Which of the following medications A client is admitted to the hospital with
can be used to treat SIADH? symptoms of DI. Which of the following
assessment findings would the nurse expect to
A. Furosemide observe?
B. Vasopressin A. Increased urine output
C. Desmopressin B. Decreased serum sodium levels
D. Spironolactone C. Weight gain
D. Elevated blood glucose levels
A client is admitted to the hospital with a Answer: A. Increased urine output
Explanation: DI is characterized by a decrease in the body's
diagnosis of SIADH. The nurse should expect
ability to concentrate urine, which leads to increased urine
which of the following laboratory findings? output. Serum sodium levels may be elevated as a result of
A. Increased serum sodium levels dehydration caused by excessive urine output. Weight loss,
B. Decreased serum osmolality not weight gain, may be observed as a result of fluid loss.
Elevated blood glucose levels are not typically associated
C. Decreased urine output
with DI.
D. Decreased urine sodium levels

A client with SIADH is prescribed a loop diuretic.
The nurse should monitor the client for which of
the following adverse effects?
A. Hypokalemia
B. Hyperglycemia
C. Hypertension
D. Tachycardia
Answer: A. Hypokalemia
Explanation: Loop diuretics such as furosemide (Lasix) are
used to treat fluid retention in clients with SIADH by
increasing urine output. However, these medications can
also cause hypokalemia (low potassium levels) as a result of
increased potassium excretion in the urine. Hyperglycemia,
hypertension, and tachycardia are not typically associated
with loop diuretics.
A patient arrives to the ER and is unable to give
you a health history due to altered mental
status. The family reports the patient has gained
over 10 lbs in 1 week and says it is mainly
“water” weight. In addition, they report the
patient hasn’t been able to urinate or eat within
the past week as well and was recently
diagnosed with small cell lung cancer. On
assessment, you note the patient’s HR is 115 and
BP 180/92. Patient sodium level is 90. Which of
the following conditions do you suspect the
patient is most likely presenting with?
A. SIADH
B. Diabetes Insipidus
C. Addison’s Disease
D. Fluid Volume Deficient
The answer is A: SIADH
2. In the scenario above what drug do you
anticipate the patient will be started on per
doctor’s order?
A. Desmopressin (DDAVP) IV
B. Declomycin
C. Diabinese
D. Stimate
3. Which of the following signs and symptoms is
NOT expected with Diabetes Insipidus?
A. Polyuria
B. Polydipsia
C. Polyphagia
D. Extreme thirst
4. You are developing a care plan for a patient
with SIADH. Which of the following would be a
potential nursing diagnosis for this patient?
A. Fluid volume overload
B. Fluid volume deficient
C. Acute pain
D. Impaired skin integrity
5. A patient with a mild case of diabetes
insipidus is started on Diabinese. What would
you include in your patient teaching with this
patient?
A. Signs and symptoms of hypoglycemia
B. Restricting foods containing caffeine
C. Taking the medication on an empty stomach
D. Drinking 16 oz of water when taking the
medication
6. Which patient is most at risk for developing
Syndrome of Inappropriate Anti-diuretic
Hormone (SIADH)?
A. A patient diagnosed with small cell lung
cancer.
B. A patient whose kidney tubules are failing to
reabsorb water.
C. A patient with a tumor on the anterior
pituitary gland.
D. A patient taking Declomycin.
7. A patient with SIADH is undergoing IV
treatment of a hypertonic IV solution of 3%
saline and IV Lasix. Which of the following
nursing findings requires intervention?
A. Sodium level of 136.
B. Patient reports urinating more frequently.
C. Potassium level of 5.0.
D. Assessment finding of crackles throughout
the lung fields.
The answer is D: Assessment finding of crackles throughout
the lung fields. Remember that when administering a
hypertonic solution you have to do this very slowly and
watch for volume overload. Hypertonic solutions pull fluid
from the cell (which is already water intoxicated) and place it
back into the vascular system…therefore, crackles in the
lungs are a sign there is too much fluid in the body and the
heart can not compensate so the fluid is backing up into the
lungs. This would require intervention.
8. The anti-diuretic hormone is __________ in
Diabetes Insipidus and _________ in SIADH.
A. high, low
B. absent, absent
C. low, high
D. low, low
9. Where is the anti-diuretic hormone
PRODUCED in the body?
A. Anterior pituitary gland
B. Posterior pituitary gland
C. Hypothalamus
D. Medulla
10. Where is the anti-diuretic hormone
SECRETED in the body?
A. Hypothalamus
B. Thyroid
C. Posterior Pituitary gland
D. Anterior pituitary gland
/////////////////////////////////////////
HYPERTHYROIDISM AND HYPOTHYROIDISM
Fill in the blank regarding the negative feedback
loop for thyroid hormone production: The
______________ produces TRH (Thyrotropin-
Releasing Hormone) which causes the anterior
pituitary gland to produce _______________
which in turn causes the thyroid gland to release
_______ and _______.*
A. Thalamus, CRH (Corticotropin-releasing
hormone) TSH (thyroid-stimulating hormone)
and T4
B. Hypothalamus, TSH (thyroid-stimulating
hormone), T3 and T4
C. Posterior pituitary gland, TSH (thyroid-
stimulating hormone), T3 and T4
D. Hypothalamus, CRH (Corticotropin-releasing
hormone), TSH (thyroid-stimulating hormone),
T3 and TSH
A patient reports they do not eat enough iodine
in their diet. What condition are they most
susceptible to?*
A. Pheochromocytoma
B. Hyperthyroidism
C. Thyroid Storm
D. Hypothyroidism
A patient has an extremely high T3 and T4 level.
Which of the following signs and symptoms DO
NOT present with this condition?*
A. Weight loss
B. Intolerance to heat
C. Smooth skin
D. Hair loss
A patient is being discharged home for
treatment of hypothyroidism. Which medication
is most commonly prescribed for this condition?
*
A. Tapazole
B. PTU (Propylthiouracil)
C. Synthroid
D. Inderal
You are performing discharge teaching with a
patient who is going home on Synthroid. Which
statement by the patient causes you to re-
educate the patient about this medication?*
A. "I will take this medication at bedtime with a
snack."
B. "I will never stop taking the medication
abruptly."
C. "If I have palpitations, chest pain, intolerance
to heat, or feel restless, I will notify the doctor."
D. "I will not take this medication at the same
time I take my Carafate."
The thyroid hormones, T3 and T4, play many
roles in the human body. Which of the following
functions are performed by T3 and T4? Note:
Select all that apply*
A. Storing calories
B. Increasing the Heart Rate
C. Stimulating the Sympathetic Nervous System
D. Decreasing the body's temperature
E. Regulating TSH produced by the anterior
pituitary gland
A patient is admitted with complaints of
palpations, excessive sweating, and unable to
tolerate heat. In addition, the patient voices
concern about how her appearance has changed
over the past year. The patient presents with
protruding eyeballs and pretibial myxedema on
the legs and feet. Which of the following is the
likely cause of the patient's signs and symptoms?
* surgery. Which of the following medications are
A. Thyroiditis
B. Deficiency of iodine consumption
C. Grave's Disease
D. Hypothyroidism
A patient who is in her first trimester of
pregnancy is diagnosed with hyperthyroidism.
Which medication do you suspect the patient
will be started on?*
A. Propylthiouracil (PTU)
B. Radioactive Iodine
C. Tapazole
D. Synthroid
Which of the following are treatment options for
hyperthyroidism? Please select all that apply:*
A. Thyroidectomy
B. Methimazole
C. Liothyronine Sodium "Cytomel"
D. Radioactive Iodine
A patient was recently discharged home for
treatment of hypothyroidism and was ordered to
take Synthroid for treatment. The patient is re-
admitted with signs and symptoms of the
following: heart rate 42, blood pressure 70/56,
blood glucose 55, and body temperature of 96.8
'F. The patient is very fatigued and drowsy. The
family reports the patient has not been taking
Synthroid since being discharged home from the
hospital. Which of the following conditions is this
patient most likely experiencing?*
A. Thryoid Storm
B. Myxedema Coma
C. Iodism
D. Toxic Nodular Goiter
A patient with hypothyroidism is having pain 6
on 1-10 scale in the right hip due to recent hip
NOT appropriate for this patient? Select all that
apply:*
A. Fentanyl
B. Tylenol
C. Morphine
D. Dilaudid
A,D,E
A patient is being educated on how to take their
anti-thyroid medication. Which of the following
statements are INCORRECT?*
A. "I will continue taking aspirin daily."
B. "I will take this medication at the same time
every day."
C. "It may take a while before I notice that the
medication is helping my condition."
D. "I will avoid foods containing high levels of
iodine.
The client is diagnosed with hypothyroidism.
Which signs/symptoms should the nurse expect
the client to exhibit?
1. Complaints of extreme fatigue and hair loss
2. Exophthalmos and complaints of nervousness
3. Complaints of profuse sweating and flushed
skin
4. Treaty and complaints of stiffness of the hands
The nurse identifies the client problem "risk for
imbalanced body temperature" for the client
diagnosed with hypothyroidism. Which
intervention should be included in the plan of
care?
1. Discourage the use of an electric blanket
2. Assess the client's temperature every two (2)
hours
3. Keep the room temperature cool
4. Space activities to promote rest
Which statement made by the client makes the
nurse suspect the client is experiencing
hyperthyroidism?
1. "I just don't seem to have any appetite
anymore"
2. "I have a bowel movement about every 3 to 4
days"
3. "My skin is really becoming dry and coarse"
4. "I have noticed all my collars are getting
tighter"
4. "I have noticed all my collars are getting
tighter"
i have noticed all my collars are getting tighter:
the thyroid gland (in the neck) enlarges as a
result of the increased need for thyroid hormone
production; an enlarged gland is called a goiter.
1. decreased appetite is a symptom of
hypothyroidism, not hyperthyroidism. 2.
constipation is a symptom of hypothyroidism. 3.
dry, coarse skin is a sign of hypothyroidism.
The 68-year-old client diagnosed with
hyperthyroidism is being treated with
radioactive iodine therapy. Which interventions
should the nurse discuss with the client?
1. Explain it will take up to a month for
symptoms of hyperthyroidism to subside
2. Teach the iodine therapy will have to be
tapered slowly over one (1) week
3. Discuss the client will have to be hospitalized
during the radioactive therapy
4. Inform the client after therapy the client will
not have to take any medication
1. Explain it will take up to a month for symptoms of
hyperthyroidism to subside
xplain it will take up to a month for symptoms of
hyperthyroidism to subside:radioactive idodine therapy is
used to destroy the overactive thyroid cells.
The nurse is teaching the client diagnosed with
hyperthyroidism. Which information should be
taught to the client? Select all that apply.
1. Notify the HCP if a three (3)-pound weight
loss occurs in two (2) days
2. Discuss ways to cope with the emotional
lability
3. Notify the HCP if taking over-the-counter
medication
4. Carry a medical identification card or bracelet
5. Teach how to take thyroid medications
correctly
The nurse is providing an in-service on thyroid
disorders. One of the attendees asks the nurse,
"Why don't the people in the United States get
goiters as often?" Which statement by the nurse
is the best response?
1. "It is because of the screening techniques
used in the United States"
2. "It is a genetic predisposition rare in North
Americans"
3. "The medications available in the United
States decrease goiters"
4. Iodized salt helps prevent the development
of goiters in the United States"
The nurse is preparing to administer the
following medications. Which medication should
the nurse question administering?
1. The thyroid hormone to the client who does
not have a T3, T4 level
2. The regular insulin to the client with a blood
glucose level of 210 mg/dL
3. The loop diuretic to the client with a
potassium level of 3.3 mEq/L
4. The cardiac glycoside to the client who has a
digoxin level of 1.4 mg/dL
3 with what other sign as well?
Which signs/symptoms should make the nurse
suspect the client is experiencing a thyroid
storm?
1. Constipation and hyperactive bowel syndrome
2. Hyperpyrexia and extreme tachycardia
3. Hypotension and bradycardia
4. Decreased respirations and hypoxia
A patient is being discharged home for
treatment of hypothyroidism. Which medication
is most commonly prescribed for this condition?]
A. Tapazole
B. PTU (Propylthiouracil)
C. Synthroid
D. Inderal
The answer is C: Synthroid is the only medication
listed that treats hypothyroidism. All the other
medications are used for hyperthyroidism.
You are performing discharge teaching with a
patient who is going home on Synthroid. Which
statement by the patient causes you to re-
educate the patient about this medication?
A. "I will take this medication at bedtime with a
snack."
B. "I will never stop taking the medication
abruptly."
C. "If I have palpitations, chest pain, intolerance
to heat, or feel restless, I will notify the doctor."
D. "I will not take this medication at the same
time I take my Carafate."
The answer is A: Synthroid is best taken in the MORNING on
an empty stomach. All the other statements are correct
about taking Synthroid.
A patient with hypothyroidism is having pain 6
on 1-10 scale in the right hip due to recent hip
surgery. Which of the following medications are
NOT appropriate for this patient? Select all that
apply:
A. Fentanyl
B. Tylenol
C. Morphine
D. Dilaudid
The answers are A, C, and D. Patients who have
hypothyroidism are very sensitive to narcotics and should
take NON-NARCOTICS for pain relief. Fentanyl, Morphine,
and Dilaudid are all narcotics, whereas, Tylenol is not.
A patient is 6 hours post-opt from a
thyroidectomy. The surgical site is clean, dry and
intact with no excessive swelling noted. What
position is best for this patient to be in?
A. Fowler's
B. Prone
C. Trendelenburg
D. Semi-Fowler's
Which of the following signs and symptoms
causes concern and requires nursing
intervention for a patient who recently had a
thyroidectomy?
A. Heart rate of 120, blood pressure 220/102,
temperature 103.2 'F
B. Heart rate of 35, blood pressure 60/43,
temperature 95.3 'F
C. Soft hair, irritable, diarrhea
D. Constipation, drowsiness, goiter
. ___________ is an autoimmune disorder where
the body attacks the thyroid gland that causes it
to stop releasing T3 and T4. The patient is likely
to have the typical signs/symptoms of
hypothyroidism, however, they may present
A. Myxedema coma; joint pain
B. Thyroid storm; memory loss
C. Hashimoto's Thyroiditis; goiter
D. Toxic nodular goiter (TNG); goiter
Which of the following side effects are possible
for a patient taking an anti-thyroid medication?
A. Agranulocytosis and aplastic anemia
B. Tachycardia
C. Skin discoloration
D. Joint pain and eczem
A patient is receiving radioactive iodine
treatment for hyperthyroidism. What will you
include in your patient education to this patient
about this type of treatment?
A. Taste changes and swollen salivary glands
B. Constipation
C. Excessive thirst
D. Sun protection
//////////////////////////////////////////////
HYPERPARATHYROIDISM AND
HYPOPARATHYROIDISM
A patient is recovering from a thyroidectomy.
The patient starts to complain of tingling and
numbness in the face, toes, and fingers. Which of
the following findings below warrants attention?
*
A. Ca+ level: 6 mg/dL
B. Na+ level: 145 mg/dL
C. K+ level: 3.5 mg/dL
D. Phosphate level: 4.3 mg/dL
Explanation: A normal calcium level is 8.6 to 10.0 mg/dL.
Therefore, due to the patient's signs and symptoms and low
calcium level of 6 mg/dL this warrants a nursing intervention.
Which of the following patients are MOST at risk
for hypoparathyroidism?*
A. A 75 year-old female who is diabetic and takes
Os-Cal daily.
B. A 59 year-old male with a Mg+ level of 0.9
mg/dL.
C. A 85 year-old female complaining of flank pain
and constipation.
D. A 19 year-old male with a Ca+ level of 8.9
mg/dL.
B. This patient is experiencing HYPOmagnesemia which is a
cause of HYPOparathyroidism and is most at risk for
developing this condition.
A patient hospitalized with hypoparathyroidism
is about to order lunch. Which food selection is
best for this patient based on their dietary needs
at this time?*
A. Baked chicken, green beans, and boiled
potatoes
B. Broccoli salad, cottage cheese, and peaches
C. Roast beef, carrots, and pinto beans
D. Hamburger, fries, and sorbet
A patient is 6 hours post-opt from thyroid
surgery. The patient's calcium level is 5 and
phosphate level is 4.2. What physical signs and
symptoms would NOT present with these
findings? (Select-all-that-apply)*
A. Bronchospasm
B. Constipation
C. Numbness and tingling in the face
D. Positive Chvostek's Sign
E. Absent Trousseau's Sign
F. Hypertension
B, E, and F.
A physician orders Calcium Gluconate IV as
treatment for a patient with
hypoparathyroidism. The patient's calcium level
is 5 mg/dL. Which of the following finding causes
you to question this order?*
A. The patient is taking Digoxin.
B. The patient complains of muscle cramping and
numbness in the face.
C. The patient is taking Aluminum Carbonate.
D. The patient's phosphate level is 7 mg/dL.
You are providing discharge teaching to a patient
who is prescribed calcium supplements with
vitamin D for treatment of hypoparathyroidism.
Which of the following statements by the patient
warrants you to re-educate the patient on how
they should take this medication?*
A. "I will also make sure I eat foods rich in
calcium, such as dairy and green leafy vegetables
while I'm taking this medication."
B. "A side effect of this medication is
constipation. Therefore, I should drink plenty of
fluids."
C. "I will take my calcium supplements in the
morning when I take my Synthroid."
D. All the statements above are correctly stated
by the patient.
C D. Tingling and numbness of lips and fingers
Calcium supplements should NOT be taken at
the same time as iron or thyroid hormones
(Synthroid) because it affects absorption.
Therefore, this medications should be taken at
separate times.
A patient is recovery from a parathyroidectomy.
Which of the following findings causes concern
and requires nursing intervention?*
A. The patient is in Semi-Fowler's position.
B. The patient's calcium level is 8.9 mg/dL.
C. The patient's voice is hoarse.
D. The patient is drowsy but arouses to name.
A patient is prescribed Fosamax (Alendronate).
The patient is about to be discharged and you
observe the patient taking the medication.
Which of the following findings requires you to
re-educate the patient on how to take this
medication?*
A. The patient takes the medication on an empty
stomach.
B. The patient takes the medication with water.
C. The patient sits up for 10 minutes after
taking the medication.
D. The patient waits 30 minutes after taking
Fosamax before taking the prescribed vitamins
and antacids.
C. Fosamax can cause serious throat and stomach ulcers and
taking it with a full glass of water and sitting-up afterwards
helps prevents this.
A patient is diagnosed with
hyperparathyroidism. Which of the following
signs and symptoms would you NOT find in this
patient? Select all that apply:*
A. Calcium level 6 mg/dL
B. Bone fracture
C. Positive Trousseau's Sign
E. Calcium level of 15 mg/dL
F. Phosphate level 1.2
G. Renal calculi
This medication is used to treat
hyperparathyroidism in patients with chronic
renal failure. It works by mimicking the role of
calcium in the blood and tricks the parathyroid
gland into stop secreting PTH (parathyroid
hormone). Which of the following medications
does this describe below?*
A. Calcitonin
B. Fosamax
C. Lasix
D. Sensipar
After several diagnostic tests, a client is
diagnosed with diabetes insipidus. The nurse
performs an assessment on the client, knowing
that which symptom is most indicative of this
disorder?
1.Fatigue
2.Diarrhea
3.Polydipsia
4.Weight gain
A client is admitted to an emergency
department, and a diagnosis of myxedema coma
is made. Which action would the nurse prepare
to carry out initially?
1.Warm the client.
2.Maintain a patent airway.
3.Administer thyroid hormone.
4.Administer fluid replacement
The nurse is providing discharge instructions to a
client who has Cushing's syndrome. Which client
statement indicates that instructions related to
dietary management are understood?
1"I will need to limit the amount of protein in my
diet."
2."I should eat foods that have a lot of
potassium in them."
3."I am fortunate that I can eat all the salty foods
I enjoy."
4."I am fortunate that I do not need to follow
any special diet."
The nurse is preparing a client with a new
diagnosis of hypothyroidism for discharge. The
nurse determines that the client understands
discharge instructions if the client states that
which symptoms are associated with this
diagnosis? Select all that apply.
1.Tremors
2.Weight loss
3.Feeling cold
4.Loss of body hair
5.Persistent lethargy
6.puffiness of the face
A client has just been admitted to the nursing
unit following thyroidectomy. Which assessment
is the priority for this client?
1Hypoglycemia
2.Level of hoarseness
3.Respiratory distress
4.Edema at the surgical site
A client has been diagnosed with
hyperthyroidism. Which signs and symptoms
may indicate thyroid storm, a complication of
this disorder? Select all that apply
1. Fever
2.Nausea
3.Lethargy
4.Tremors
5.Confusion
6.Bradycardia
The nurse should include which interventions in
the plan of care for a client with
hypothyroidism? Select all that apply.
1.Provide a cool environment for the client.
2.Instruct the client to consume a high-fat diet.
3.Instruct the client about thyroid replacement
therapy.
4.Encourage the client to consume fluids and
high-fiber foods in the diet.
5.Inform the client that iodine preparations will
be prescribed to treat the disorder.
6.Instruct the client to contact the health care
provider (HCP) if episodes of chest pain occur.
The nurse is caring for a client after
thyroidectomy. The nurse notes that calcium
gluconate is prescribed for the client. The nurse
determines that this medication has been
prescribed for which purpose?
1.To treat thyroid storm
2.To prevent cardiac irritability
3.To treat hypocalcemic tetany
4.To stimulate release of parathyroid hormone
The nurse is reviewing the laboratory test results
for a client with a diagnosis of Cushing's
syndrome. Which laboratory finding would the
nurse expect to note in this client
1.A platelet count of 200,000 cells/mm3
2.A blood glucose level of 110 mg/dL
3.A potassium (K+) level of 5.5 mEq/L
4.A white blood cell (WBC) count of 6000
cells/mm3
The nurse caring for a client with a diagnosis of
hypoparathyroidism reviews the laboratory
results of blood tests for this client and notes t
1Unresponsive pupils
2.Positive Trousseau's sign
3.Negative Chvostek's sign
4.Hyperactive bowel soundshat the calcium level
is extremely low. The nurse should expect to
note which on assessment of the client?
The nurse is caring for a client with a diagnosis of
Addison's disease. The nurse is monitoring the
client for signs of Addisonian crisis. The nurse
should assess the client for which manifestation
that would be associated with this crisis?
1.Agitation
2.Diaphoresis
3.Restlessness
4.Severe abdominal pain
The nurse is performing an assessment on a
client with a diagnosis of Cushing's syndrome.
Which should the nurse expect to note on
assessment of the client?
1.Skin atrophy
2.The presence of sunken eyes
3.Drooping on one side of the face
4.A rounded "moon-like" appearance to the
face
The nurse is performing an assessment on a
client with a diagnosis of myxedema
(hypothyroidism). Which assessment finding
should the nurse expect to note in this client
1. Dry skin
2.Thin, silky hair
3.Bulging eyeballs
4.Fine muscle tremors
The nurse is performing an assessment on a
client with a diagnosis of hyperthyroidism.
Which assessment finding should the nurse
expect to note in this client?
1Dry skin
2.Bulging eyeballs
3. Periorbital edema
4.Coarse facial features
The nurse is developing a plan of care for a client
with Cushing's syndrome. The nurse documents
a client problem of excess fluid volume. Which
nursing actions should be included in the care
plan for this client? Select all that apply.
1. Monitor daily weight.
2.Monitor intake and output.
3.Assess extremities for edema.
4.Maintain a high-sodium diet.
5.Maintain a low-potassium diet.
The nurse is caring for a client who has had an
adrenalectomy and is monitoring the client for
signs of adrenal insufficiency. Which signs and
symptoms indicate adrenal insufficiency in this
client?
1.Hypotension and fever
2.Mental status changes and hypertension
3.Subnormal temperature and hypotension
4.Complaints of weakness and hypertension
The nurse is providing home care instructions to
the client with a diagnosis of Cushing's syndrome
and prepares a list of instructions for the client.
Which instructions should be included on the
list? Select all that apply.
1.The signs and symptoms of hypoadrenalism
2.The signs and symptoms of hyperadrenalism
3.Instructions to take the medications exactly
as prescribed
4.The importance of maintaining regular
outpatient follow-up care
5.A reminder to read the labels on over-the-
counter medications before purchase
. A patient suspected of having acromegaly has
an elevated plasma growth hormone (GH) level.
In acromegaly, what would the nurse also expect
the patient's diagnostic results to indicate?
a. Hyperinsulinemia
b. Plasma glucose of <70 mg/dL (3.9 mmol/L)
c. Decreased GH levels with an oral glucose
challenge test
d. Elevated levels of plasma insulin-like growth
factor-1 (IGF--1)
During assessment of the patient with
acromegaly, what should the nurse expect the
patient to report?
a. Infertility
c. Undesirable changes in appearance
b. Dry, irritated skin
d. An increase in height of 2 to 3 inches a year
A patient with acromegaly is treated with a
transsphenoidal hypophysectomy. What should
the nurse do postoperatively?
a. Ensure that any clear nasal drainage is tested
for glucose
b. Maintain the patient flat in bed to prevent
cerebrospinal fluid (CSF) leakage.
c. Assist the patient with toothbrushing every 4
hours to keep the surgical area clean.
d. Encourage deep breathing, coughing, and
turning to prevent respiratory complications.
The patient is diagnosed with syndrome of
inappropriate antidiuretic hormone (SIADH).
What manifestation should the nurse expect to
find?
a. Decreased body weight
c. Increased plasma osmolality
b. Decreased urinary output
d. Increased serum sodium levels
During care of the patient with SIADH, what
should the nurse do?
a. Monitor neurologic status at least every 2
hours.
b. Teach the patient receiving treatment with
diuretics to restrict sodium intake.
c. Keep the head of the bed elevated to prevent
antidiuretic hormone (ADH) release.
d. Notify the health care provider if the patient's
blood pressure decreases more than 20 mm Hg
from baseline.
A patient with SIADH is treated with water
restriction. What does the patient experience
when the nurse determines that treatment has
been effective?
a. Increased urine output, decreased serum
sodium, and increased urine specific gravity
b. Increased urine output, increased serum
sodium, and decreased urine specific gravity
c. Decreased urine output, increased serum
sodium, and decreased urine specific gravity
d. Decreased urine output, decreased serum
sodium, and increased urine specific gravity
The patient with diabetes insipidus is brought to
the emergency department with confusion and
dehydration after excretion of a large volume of
urine today even though several liters of fluid
were drunk. What is a diagnostic test that the
nurse should expect to be done to help make a
diagnosis?
a. Blood glucose
c. Urine specific gravity
b. Serum sodium level
d. Computed tomography (CT) of the head
In a patient with central diabetes insipidus, what
will the administration of ADH during a water
deprivation test result in?
a. Decrease in body weight
c. Decrease in blood pressure
b. Increase in urinary output
d. Increase in urine osmolality
A patient with diabetes insipidus is treated with
nasal desmopressin acetate (DDAVP). The nurse
determines that the
drug is not having an adequate therapeutic
effect when the patient experiences
a. headache and weight gain.
c. a urine specific gravity of 1.002.
b. nasal irritation and nausea.
d. an oral intake greater than urinary output
When caring for a patient with nephrogenic
diabetes insipidus, what should the nurse expect
the treatment to
include?
a. Fluid restriction
c. A high-sodium diet
b. Thiazide diuretics
d. Chlorpropamide (Diabinese)
Which statement accurately describes Graves'
disease?
a. Exophthalmos occurs in Graves' disease.
b. It is an uncommon form of hyperthyroidism.
c. Manifestations of hyperthyroidism occur from
tissue desensitization to the sympathetic
nervous system.
d. Diagnostic testing in the patient with Graves'
disease will reveal an increased thyroid-
stimulating hormone
(TSH) level.
A patient with Graves' disease asks the nurse
what caused the disorder. What is the best
response by the nurse?
a. "The cause of Graves' disease is not known,
although it is thought to be genetic."
b. "It is usually associated with goiter formation
from an iodine deficiency over a long period of
time."
c. "Antibodies develop against thyroid tissue and
destroy it, causing a deficiency of thyroid
hormones."
d. "In genetically susceptible persons,
antibodies are formed that cause excessive
thyroid hormone secretion."
A patient is admitted to the hospital with
thyrotoxicosis. On physical assessment of the
patient, what should the nurse expect to find?
a. Hoarseness and laryngeal stridor
b. Bulging eyeballs and dysrhythmias
c. Elevated temperature and signs of heart
failure
d. Lethargy progressing suddenly to impairment
of consciousness
What medication is used with thyrotoxicosis to
block the effects of the sympathetic nervous
stimulation of the thyroid hormones?
a. Potassium iodide
c. Propylthiouracil (PTU)
b. Atenolol (Tenormin)
d. Radioactive iodine (RAI)
What preoperative instruction should the nurse
give to the patient scheduled for a subtotal
thyroidectomy?
a. How to support the head with the hands
when turning in bed
b. Coughing should be avoided to prevent
pressure on the incision
c. Head and neck will need to remain immobile
until the incision heals
d. Any tingling around the lips or in the fingers
As a precaution for vocal cord paralysis from
damage to the recurrent laryngeal nerve during
thyroidectomy surgery,
what equipment should be in the room in case it
is needed for this emergency situation?
a. Tracheostomy tray
c. IV calcium gluconate
b. Oxygen equipment
d. Paper and pencil for communication
When providing discharge instructions to a
patient who had a subtotal thyroidectomy for
hyperthyroidism, what should the nurse teach
the patient?
a. Never miss a daily dose of thyroid
replacement therapy.
b. Avoid regular exercise until thyroid function is
normalized.
c. Use warm saltwater gargles several times a
day to relieve throat pain.
d. Substantially reduce caloric intake compared
What is a cause of primary hypothyroidism in
adults?
a. Malignant or benign thyroid nodules
b. Surgical removal or failure of the pituitary
gland
c. Surgical removal or radiation of the thyroid
gland
d. Autoimmune-induced atrophy of the thyroid
gland
When replacement therapy is started for a
patient with long-standing hypothyroidism, what
is most important for the nurse to monitor the
patient for?
a. Insomnia
c. Nervousness
b. Weight loss
d. Dysrhythmias
A patient with hypothyroidism is treated with
levothyroxine (Synthroid). What should the
nurse include when teaching the patient about
this therapy?
a. Explain that alternate-day dosage may be used
if side effects occur.
b. Provide written instruction for all
information related to the drug therapy.
c. Assure the patient that a return to normal
function will occur with replacement therapy.
d. Inform the patient that the drug must be
taken until the hormone balance is reestablished
A patient who recently had a calcium oxalate
renal stone had a bone density study, which
showed a decrease in her
bone density. What endocrine problem could
this patient have?
a. SIADH
c. Cushing syndrome
b. Hypothyroidism
d. Hyperparathyroidism
What is an appropriate nursing intervention for
the patient with hyperparathyroidism?
a. Pad side rails as a seizure precaution.
b. Increase fluid intake to 3000 to 4000 mL
daily.
c. Maintain bed rest to prevent pathologic
fractures.
d. Monitor the patient for Trousseau's and
Chvostek's signs
A patient has been diagnosed with
hypoparathyroidism. What manifestations
should the nurse expect to observe
(select all that apply)?
a. Skeletal pain
d. Abdominal cramping
b. Dry, scaly skin
e. Cardiac dysrhythmias
c. Personality changes
f. Muscle spasms and stiffness
When the patient with parathyroid disease
experiences symptoms of hypocalcemia, what is
a measure that can be
used to temporarily raise serum calcium levels?
a. Administer IV normal saline. c. Administer
furosemide (Lasix) as ordered.
b. Have patient rebreathe in a paper bag.
d. Administer oral phosphorus supplements.
A patient with hypoparathyroidism resulting
from surgical treatment of hyperparathyroidism
is preparing for discharge. What should the
nurse teach the patient?
a. Milk and milk products should be increased in
the diet.
b. Parenteral replacement of parathyroid
hormone will be required for life.
c. Calcium supplements with vitamin D can
effectively maintain calcium balance.
d. Bran and whole-grain foods should be used to
prevent GI effects of replacement therapy
A patient is admitted to the hospital with a
diagnosis of Cushing syndrome. On physical
assessment of the patient, what should the
nurse expect to find?
a. Hypertension, peripheral edema, and
petechiae
b. Weight loss, buffalo hump, and moon face
with acne
c. Abdominal and buttock striae, truncal obesity,
and hypotension
d. Anorexia, signs of dehydration, and
hyperpigmentation of the skin
A patient is scheduled for a bilateral
adrenalectomy. During the postoperative period,
what should the nurse expect related to the
administration of corticosteroids?
a. Reduced to promote wound healing
b. Withheld until symptoms of hypocortisolism
appear
c. Increased to promote an adequate response
to the stress of surgery
d. Reduced because excessive hormones are
released during surgical manipulation of adrenal
glands
c. Although the patient with Cushing syndrome
A patient with Addison's disease comes to the
emergency department with complaints of
nausea, vomiting, diarrhea, and fever. What
collaborative care should the nurse expect?
a. IV administration of vasopressors
b. IV administration of hydrocortisone
c. IV administration of D5W with 20 mEq KCl
d. Parenteral injections of adrenocorticotropic
hormone (ACTH)
During discharge teaching for the patient with
Addison's disease, which statement by the
patient indicates that the nurse needs to do
additional teaching?
a. "I should always call the doctor if I develop
vomiting or diarrhea."
b. "If my weight goes down, my dosage of
steroid is probably too high."
c. "I should double or triple my steroid dose if I
undergo rigorous physical exercise."
d. "I need to carry an emergency kit with
injectable hydrocortisone in case I can't take my
medication by mouth."
A patient who is on corticosteroid therapy for
treatment of an autoimmune disorder has the
following additional drugs ordered. Which one is
used to prevent corticosteroid-induced
osteoporosis?
a. Potassium
c. Alendronate (Fosamax)
b. Furosemide (Lasix)
d. Pantoprazole (Protonix)
A patient with mild iatrogenic Cushing syndrome
is on an alternate-day regimen of corticosteroid
therapy. What does the nurse explain to the
patient about this regimen?
a. It maintains normal adrenal hormone balance.
b. It prevents ACTH release from the pituitary
gland.
c. It minimizes hypothalamic-pituitary-adrenal
suppression.
d. It provides a more effective therapeutic effect
of the drug

When caring for a patient with primary

hyperaldosteronism, the nurse would question a
health care provider's
prescription for which drug?
a. Furosemide (Lasix)
c. Spironolactone (Aldactone)
b. Amiloride (Midamor)
d. Aminoglutethimide (Cytadren)

What is the priority nursing intervention during

the management of the patient with
pheochromocytoma?
a. Administering IV fluids
c. Administering β-adrenergic blockers
b. Monitoring blood pressure
d. Monitoring intake and output and daily
weights

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disorder-nclex-flash-cards/