Endocrine System Disorders | Diabetes Mellitus | NCLEX Quiz 102

1. Daniel is diagnosed of having hyperthyroidism (Graves' disease). Which of the following is a drug of choice for his condition?

Furosemide (Lasix)

Digoxin (Lanoxin)

Propranolol (Inderal)

Propylthiouracil (PTU)

Propylthiouracil (PTU) initially is given in divided doses. and functions to block thyroid hormone synthesis.

Explanation

Propylthiouracil (PTU) initially is given in divided doses. and functions to block thyroid hormone synthesis.

2. Nurse Gil is caring for a patient with a diagnosis of hypothyroidism. Which nursing diagnosis should the nurse most seriously consider when analyzing the needs of the patient?

High risk for aspiration related to severe vomiting

Diarrhea related to increased peristalsis

Hypothermia related to slowed metabolic rate

Oral mucous membrane. altered related to disease process

Thyroid hormone deficiency results in reduction in the metabolic rate. resulting in hypothermia. and does predispose the older adult to a host of other health-related issues. One-quarter of affected elderly experience constipation.

Explanation

Thyroid hormone deficiency results in reduction in the metabolic rate. resulting in hypothermia. and does predispose the older adult to a host of other health-related issues. One-quarter of affected elderly experience constipation.

3. During a visit in the hospital. the student nurses are asked which of the following persons would most likely be diagnosed with diabetes mellitus. They are correct if they answered a 44-year-old:

Caucasian woman.

Asian woman.

African-American woman.

Hispanic male.

Age-specific prevalence of diagnosed diabetes mellitus (DM) is higher for African-Americans and Hispanics than for Caucasians. Among those younger than 75. black women had the highest incidence.

Explanation

Age-specific prevalence of diagnosed diabetes mellitus (DM) is higher for African-Americans and Hispanics than for Caucasians. Among those younger than 75. black women had the highest incidence.

4. An older woman with diabetes mellitus visits the clinic concerning her condition. Of which of the following symptoms might an older woman with diabetes mellitus complain?

Anorexia

Pain intolerance

Weight loss

Perineal itching

Older women might complain of perineal itching due to vaginal candidiasis.

Explanation

Older women might complain of perineal itching due to vaginal candidiasis.

5. A 50-year-old widower is admitted to the hospital with a diagnosis of diabetes mellitus and complaints of rapid-onset weight loss. elevated blood glucose levels. and polyphagia. the gerontology nurse should anticipate which of the following secondary medical diagnoses?

Impaired glucose tolerance

Gestational diabetes mellitus

Pituitary tumor

Pancreatic tumor

The onset of hyperglycemia in the older adult can occur more slowly. When the older adult reports rapid-onset weight loss. elevated blood glucose levels. and polyphagia. the healthcare provider should consider pancreatic tumor.

Explanation

The onset of hyperglycemia in the older adult can occur more slowly. When the older adult reports rapid-onset weight loss. elevated blood glucose levels. and polyphagia. the healthcare provider should consider pancreatic tumor.

6. An ailing 70-year-old woman with a diagnosis of type 2 diabetes mellitus has been ill with pneumonia. The client's intake has been very poor. and she is admitted to the hospital for observation and management as needed. What is the most likely problem with this patient?

Insulin resistance has developed.

Diabetic ketoacidosis is occurring.

Hypoglycemia unawareness is developing.

Hyperglycemic hyperosmolar non-ketotic coma.

Illness. especially with the frail elderly patient whose appetite is poor. can result in dehydration and HHNC. Insulin resistance usually is indicated by a daily insulin requirement of 200 units or more. Diabetic ketoacidosis. an acute metabolic condition. usually is caused by absent or markedly decreased amounts of insulin.

Explanation

Illness. especially with the frail elderly patient whose appetite is poor. can result in dehydration and HHNC. Insulin resistance usually is indicated by a daily insulin requirement of 200 units or more. Diabetic ketoacidosis. an acute metabolic condition. usually is caused by absent or markedly decreased amounts of insulin.

7. According to the National Diabetes Statistics Report. diabetes remains as one of the leading causes of death in the United States since 2010. Which of the following factors are risks for the development of diabetes mellitus? (Select all that apply.)

Age over 45 years

Overweight with a waist/hip ratio >1

Having a consistent HDL level above 40 mg/dl

Maintaining a sedentary lifestyle

Aging results in reduced ability of beta cells to respond with insulin effectively. Overweight with waist/hip ratio increase is part of the metabolic syndrome of DM II. There is an increase in atherosclerosis with DM due to the metabolic syndrome and sedentary lifestyle.

Explanation

Aging results in reduced ability of beta cells to respond with insulin effectively. Overweight with waist/hip ratio increase is part of the metabolic syndrome of DM II. There is an increase in atherosclerosis with DM due to the metabolic syndrome and sedentary lifestyle.

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8. After visiting the physician. Angela found out that she has a thyroid problem. In line with her condition. which of the following diagnostic studies is done to determine the size and composition of the thyroid gland?

Thyroid scan with RAI 123I

Electrocardiography

Ultrasonography

Venous duplex Doppler study

Although thyroid scans frequently are done to evaluate the thyroid gland. I 123 is used to destroy overactive thyroid cells such as are seen in thyroid cancer. Ultrasonography can be used early in the evaluation process to rule out Graves’ disease. nodular goiter. or other thyroid dysfunction.

Explanation

Although thyroid scans frequently are done to evaluate the thyroid gland. I 123 is used to destroy overactive thyroid cells such as are seen in thyroid cancer. Ultrasonography can be used early in the evaluation process to rule out Graves’ disease. nodular goiter. or other thyroid dysfunction.

9. Gregory is a 52-year-old man identified as high-risk for diabetes mellitus. Which laboratory test should a nurse anticipate a physician would order for him? (Select all that apply.)

Fasting Plasma Glucose (FPG)

Two-hour Oral Glucose Tolerance Test (OGTT)

Glycosylated hemoglobin (HbA1C)

Finger stick glucose three times daily

When an older person is identified as high-risk for diabetes. appropriate testing would include FPG and OGTT. An FPG greater than 140 mg/dL usually indicates diabetes. The OGTT is to determine how the body responds to the ingestion of carbohydrates in a meal. HbA1C evaluates long-term glucose control. A finger stick glucose three times daily spot-checks blood glucose levels.

Explanation

When an older person is identified as high-risk for diabetes. appropriate testing would include FPG and OGTT. An FPG greater than 140 mg/dL usually indicates diabetes. The OGTT is to determine how the body responds to the ingestion of carbohydrates in a meal. HbA1C evaluates long-term glucose control. A finger stick glucose three times daily spot-checks blood glucose levels.

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10. Which of the following medications are most likely to cause hypothyroidism? (Select all that apply.)

Acetylsalicylic acid (aspirin)

Furosemide (Lasix)

Docusate sodium (Colace)

Rifampin (Rifadin)

Acetylsalicylic acid (aspirin). Furosemide (Lasix). and Rifampin (Rifadin) are most likely to cause hypothyroidism.

Explanation

Acetylsalicylic acid (aspirin). Furosemide (Lasix). and Rifampin (Rifadin) are most likely to cause hypothyroidism.

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