Endocrine System Disorders | NCLEX Quiz 94

2.

Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling. along with numbness in the fingers. toes. and mouth area. The nurse should suspect which complication?

Tetany
Hemorrhage
Thyroid storm
Laryngeal nerve damage

Correct Answer

A. Tetany

Explanation

Tetany may result if the parathyroid glands are excised or damaged during thyroid surgery. Hemorrhage is a potential complication after thyroid surgery but is characterized by tachycardia. hypotension. frequent swallowing. feelings of fullness at the incision site. choking. and bleeding. Thyroid storm is another term for severe hyperthyroidism — not a complication of thyroidectomy. Laryngeal nerve damage may occur postoperatively. but its signs include a hoarse voice and. possibly. acute airway obstruction.

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3.

After undergoing a subtotal thyroidectomy. a female client develops hypothyroidism. Dr. Smith prescribes levothyroxine (Levothroid). 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent?

Primary hypothyroidism
Graves’ disease
Thyrotoxicosis
Euthyroidism

Correct Answer

A. Primary hypothyroidism

Explanation

Levothyroxine is the preferred agent to treat primary hypothyroidism and cretinism. although it also may be used to treat secondary hypothyroidism. It is contraindicated in Graves’ disease and thyrotoxicosis because these conditions are forms of hyperthyroidism. Euthyroidism. a term used to describe normal thyroid function. wouldn’t require any thyroid preparation.

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4.

A female client whose physical findings suggest a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor. which necessitates a transsphenoidal hypophysectomy. The evening before the surgery. nurse Jacob reviews preoperative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize?

“You must lie flat for 24 hours after surgery.”
“You must avoid coughing. sneezing. and blowing your nose.”
“You must restrict your fluid intake.”
“You must report ringing in your ears immediately.”

Correct Answer

A. “You must avoid coughing. sneezing. and blowing your nose.”

Explanation

After a transsphenoidal hypophysectomy. the client must refrain from coughing. sneezing. and blowing the nose for several days to avoid disturbing the surgical graft used to close the wound. The head of the bed must be elevated. not kept flat. to prevent tension or pressure on the suture line. Within 24 hours after a hypophysectomy. transient diabetes insipidus commonly occurs; this calls for increased. not restricted. fluid intake. Visual. not auditory. changes are a potential complication of hypophysectomy.

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1

5.

Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m.. the client has a capillary glucose level of 250 mg/dl for which he receives 8 U of regular insulin. Nurse Vince should expect the dose’s:

Onset to be at 2 p.m. and its peak to be at 3 p.m.
Onset to be at 2:15 p.m. and its peak to be at 3 p.m.
Onset to be at 2:30 p.m. and its peak to be at 4 p.m.
Onset to be at 4 p.m. and its peak to be at 6 p.m.

Correct Answer

A. Onset to be at 2:30 p.m. and its peak to be at 4 p.m.

Explanation

Regular insulin. which is a short-acting insulin. has an onset of 15 to 30 minutes and a peak of 2 to 4 hours. Because the nurse gave the insulin at 2 p.m.. the expected onset would be from 2:15 p.m. to 2:30 p.m. and the peak from 4 p.m. to 6 p.m.

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6.

Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications?

Tetanic contractions
Neck vein distention
Weight loss
Polyuria

Correct Answer

A. Neck vein distention

Explanation

SIADH secretion causes antidiuretic hormone overproduction. which leads to fluid retention. Severe SIADH can cause such complications as vascular fluid overload. signaled by neck vein distention. This syndrome isn’t associated with tetanic contractions. It may cause weight gain and fluid retention (secondary to oliguria).

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7.

Nurse Troy is aware that the most appropriate for a client with Addison’s disease?

Risk for infection
Excessive fluid volume
Urinary retention
Hypothermia

Correct Answer

A. Risk for infection

Explanation

Addison’s disease decreases the production of all adrenal hormones. compromising the body’s normal stress response and increasing the risk of infection. Other appropriate nursing diagnoses for a client with Addison’s disease include Deficient fluid volume and Hyperthermia. Urinary retention isn’t appropriate because Addison’s disease causes polyuria.

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1

8.

A female client with Cushing’s syndrome is admitted to the medical-surgical unit. During the admission assessment. nurse Tyzz notes that the client is agitated and irritable. has poor memory. reports loss of appetite. and appears disheveled. These findings are consistent with which problem?

Depression
Neuropathy
Hypoglycemia
Hyperthyroidism

Correct Answer

A. Depression

Explanation

Agitation. irritability. poor memory. loss of appetite. and neglect of one’s appearance may signal depression. which is common in clients with Cushing’s syndrome. Neuropathy affects clients with diabetes mellitus — not Cushing’s syndrome. Although hypoglycemia can cause irritability. it also produces increased appetite. rather than loss of appetite. Hyperthyroidism typically causes such signs as goiter. nervousness. heat intolerance. and weight loss despite increased appetite.

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9.

Acarbose (Precose). an alpha-glucosidase inhibitor. is prescribed for a female client with type 2 diabetes mellitus. During discharge planning. nurse Pauleen would be aware of the client’s need for additional teaching when the client states:

“If I have hypoglycemia. I should eat some sugar. not dextrose.”
“The drug makes my pancreas release more insulin.”
“I should never take insulin while I’m taking this drug.”
“It’s best if I take the drug with the first bite of a meal.”

Correct Answer

A. “If I have hypoglycemia. I should eat some sugar. not dextrose.”

Explanation

Acarbose delays glucose absorption. so the client should take an oral form of dextrose rather than a product containing table sugar when treating hypoglycemia. The alpha-glucosidase inhibitors work by delaying the carbohydrate digestion and glucose absorption. It’s safe to be on a regimen that includes insulin and an alpha-glucosidase inhibitor. The client should take the drug at the start of a meal. not 30 minutes to an hour before.

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2

10.

A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma. nurse Lyka expects to administer:

Phentolamine (Regitine).
Methyldopa (Aldomet).
Mannitol (Osmitrol).
Felodipine (Plendil).

Correct Answer

A. Phentolamine (Regitine).

Explanation

Pheochromocytoma causes excessive production of epinephrine and norepinephrine. natural catecholamines that raise the blood pressure. Phentolamine. an alpha-adrenergic blocking agent given by I.V. bolus or drip. antagonizes the body’s response to circulating epinephrine and norepinephrine. reducing blood pressure quickly and effectively. Although methyldopa is an antihypertensive agent available in parenteral form. it isn’t effective in treating hypertensive emergencies. Mannitol. a diuretic. isn’t used to treat hypertensive emergencies. Felodipine. an antihypertensive agent. is available only in extended-release tablets and therefore doesn’t reduce blood pressure quickly enough to correct hypertensive crisis.

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Endocrine System Disorders | NCLEX Quiz 94

A male client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client’s hypertension is caused by excessive hormone secretion from which of the following glands?

Quiz Preview

Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling. along with numbness in the fingers. toes. and mouth area. The nurse should suspect which complication?

After undergoing a subtotal thyroidectomy. a female client develops hypothyroidism. Dr. Smith prescribes levothyroxine (Levothroid). 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent?

Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications?

Nurse Troy is aware that the most appropriate for a client with Addison’s disease?

A female client with Cushing’s syndrome is admitted to the medical-surgical unit. During the admission assessment. nurse Tyzz notes that the client is agitated and irritable. has poor memory. reports loss of appetite. and appears disheveled. These findings are consistent with which problem?

Acarbose (Precose). an alpha-glucosidase inhibitor. is prescribed for a female client with type 2 diabetes mellitus. During discharge planning. nurse Pauleen would be aware of the client’s need for additional teaching when the client states:

A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma. nurse Lyka expects to administer: