Endocrine And Metabolic Disorders (Part 2)

102 Questions | Total Attempts: 161

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Endocrine And Metabolic Disorders (Part 2)

Endocrine and metabolic diseases span a vast range of conditions. Together, they affect many millions of Americans and can profoundly decrease the quality of life. The disorders can result in hormone overproduction or underproduction. At the end of studying part two, take the quiz below to test what you have understood so far. All the best!


Questions and Answers
  • 1. 
    A client with type 1 diabetesmust undergo bowel resection in the morning. How should the nurse proceed while caring for him on the morning of surgery?
    • A. 

      Administer half of the client's typical morning insulin dose as ordered.

    • B. 

      Administer an oral antidiabetic agent as ordered.

    • C. 

      Administer an I.V. insulin infusion as ordered.

    • D. 

      Administer the client's normal daily dose of insulin as ordered.

  • 2. 
    • A. 

      Initiate insulin therapy.

    • B. 

      Switch the client to a different oral antidiabetic agent.

    • C. 

      Order an additional oral antidiabetic agent.

    • D. 

      Restrict carbohydrate intake to less than 30% of the total caloric intake.

  • 3. 
    Laboratory studies indicate a client's blood glucose level is 185 mg/dl. Two hours have passed since the client ate breakfast. Which test would yield the most conclusive diagnostic information about the client's glucose use?
    • A. 

      Fasting blood glucose test

    • B. 

      6-hour glucose tolerance test

    • C. 

      Serum glycosylated hemoglobin (Hb A1c)

    • D. 

      Urine ketones

  • 4. 
    Diet and exercise have failed to control a client's blood glucose level. The physician orders glipizide (Glucotrol). After oral administration, the onset of action is:
    • A. 

      15 to 30 minutes.

    • B. 

      30 to 60 minutes.

    • C. 

      1 to 1½ hours.

    • D. 

      2 to 3 hours.

  • 5. 
    A nurse administered neutral protamine Hagedorn (NPH) insulin to a client with diabetes mellitusat 7 a.m. At what time should the nurse expect the client to be most at risk forhypoglycemia?
    • A. 

      10 a.m.

    • B. 

      Noon

    • C. 

      4 p.m.

    • D. 

      10 p.m.

  • 6. 
    A nurse is teaching a client with diabetes mellitusabout self-management of his condition. The nurse should instruct the client to administer 1 unit of insulin for every:
    • A. 

      10 g of carbohydrates.

    • B. 

      15 g of carbohydrates.

    • C. 

      20 g of carbohydrates.

    • D. 

      25 g of carbohydrates.

  • 7. 
    A nurse is preparing the daily care plan for a client with newly diagnosed diabetes mellitus. The priority nursing concern for this client should be:
    • A. 

      Monitoring blood glucose every 4 hours and as needed.

    • B. 

      Checking for the presence of ketones with each void.

    • C. 

      Providing client education at every opportunity.

    • D. 

      Administering insulin routinely and as needed via a sliding scale.

  • 8. 
    • A. 

      "If I have hypoglycemia, I should eat some sugar, not dextrose."

    • B. 

      "The drug makes my pancreas release more insulin."

    • C. 

      "I can take insulin while I'm taking this drug."

    • D. 

      "It's best if I take the drug with the first bite of a meal."

  • 9. 
    A client with type 1 diabetestakes 15 units of Humulin N insulin before breakfast and 8 units before dinner. During a follow-up visit, the nurse reevaluates the client's knowledge about insulin therapy and self-administration skills. The nurse realizes the client requires additional teaching when she discovers the client takes which over-the-counter preparations?
    • A. 

      Antacids

    • B. 

      Salicylate-containing preparations

    • C. 

      Vitamins with iron

    • D. 

      Acetaminophen-containing preparations

  • 10. 
    Before undergoing a subtotal thyroidectomy, a client receives potassium iodide (Lugol's solution) and propylthiouracil (PTU). The nurse should expect the client's symptoms to subside:
    • A. 

      In a few days.

    • B. 

      In 3 to 4 months.

    • C. 

      Immediately.

    • D. 

      In 1 to 2 weeks.

  • 11. 
    A nurse has been caring for a client newly diagnosed with diabetes mellitus. The client is overwhelmed by what he's facing and not sure he can handle giving himself insulin. This client has been discharged and the charge nurse is insisting the nurse hurry because she needs the space for clients being admitted. How should the nurse handle the situation?
    • A. 

      Suggest the client find a supportive friend or family member to assist in his care.

    • B. 

      Ask the physician to delay the discharge because the client requires further teaching.

    • C. 

      Tell the charge nurse she doesn't believe this client will be safe and refuse to rush.

    • D. 

      Ask the physician for a referral for a diabetes nurse-educator to see the client before discharge.

  • 12. 
    • A. 

      Onset to be at 2 p.m. and its peak to be at 3 p.m.

    • B. 

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

    • C. 

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

    • D. 

      Onset to be at 4 p.m. and its peak to be at 6 p.m.

  • 13. 
    A nursing coordinator calls the intensive care unit (ICU) to inform the department that a client with a suspected pheochromocytomawill be admitted from the emergency department. The ICU nurse should prepare to administer which drug to the client?
    • A. 

      Nitroprusside

    • B. 

      Dopamine (Inotropin)

    • C. 

      Insulin

    • D. 

      Lidocaine

  • 14. 
    A physician orders laboratory tests to confirm hyperthyroidismin a client with classic signs and symptoms of this disorder. Which test result would confirm the diagnosis?
    • A. 

      No increase in the thyroid-stimulating hormone (TSH) level after 30 minutes during the TSH stimulation test

    • B. 

      A decreased TSH level

    • C. 

      An increase in the TSH level after 30 minutes during the TSH stimulation test

    • D. 

      Below-normal levels of serum triiodothyronine (T3) and serum thyroxine (T4) as detected by radioimmunoassay

  • 15. 
    Which condition may contribute to hyperparathyroidism?
    • A. 

      Chronic renal failure

    • B. 

      Thyroidectomy

    • C. 

      Elevated serum calcium level

    • D. 

      Steroid use

  • 16. 
    A nurse is teaching a client about glipizide (Glucotrol) therapy. The nurse warns the client that glipizide commonly causes hypoglycemiawhen combined with which over-the-counter preparation?
    • A. 

      Acetaminophen (Tylenol)

    • B. 

      Aspirin

    • C. 

      St. John's wort

    • D. 

      Multivitamins

  • 17. 
    • A. 

      Thyroxine (T4), 22 μg/dl; triiodothyronine (T3), 320 ng/dl; thyroid-stimulating hormone (TSH) undetectable

    • B. 

      T4, 22 μg/dl; T3, 200 ng/dl; TSH 0.1 μIU/ml

    • C. 

      T4, 2 μg/dl; T3, 200 ng/dl; TSH 5.9 μIU/ml

    • D. 

      T4, 2 μg/dl; T3, 35 ng/dl; TSH 45 μIU/ml

  • 18. 
    An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement aboutdiabetes mellitusis true?
    • A. 

      Nearly two-thirds of clients with diabetes mellitus are older than age 60.

    • B. 

      Diabetes mellitus is more common in Hispanics and Blacks than in Whites.

    • C. 

      Type 2 diabetes mellitus is less common than type 1 diabetes mellitus.

    • D. 

      Approximately one-half of the clients diagnosed with type 2 diabetes are obese.

  • 19. 
    Nursing care for a client in addisonian crisisshould include which intervention?
    • A. 

      Encouraging independence with activities of daily living (ADLs)

    • B. 

      Allowing ambulation as tolerated

    • C. 

      Offering extra blankets and raising the heat in the room to keep the client warm

    • D. 

      Placing the client in a private room

  • 20. 
    A client has recently undergone surgical removal of a pituitary tumor. The physician orders corticotropin (Acthar), 20 units I.M. q.i.d., as a replacement therapy. What is the mechanism of action of corticotropin?
    • A. 

      It decreases cyclic adenosine monophosphate (cAMP) production and affects the metabolic rate of target organs.

    • B. 

      It interacts with plasma membrane receptors to inhibit enzymatic actions.

    • C. 

      It interacts with plasma membrane receptors to produce enzymatic actions that affect protein, fat, and carbohydrate metabolism.

    • D. 

      It regulates the threshold for water resorption in the kidneys.

  • 21. 
    A nurse explains to a client that she will administer his first insulin dose in his abdomen. How does absorption at the abdominal site compare with absorption at other sites?
    • A. 

      Insulin is absorbed more slowly at abdominal injection sites than at other sites.

    • B. 

      Insulin is absorbed rapidly regardless of the injection site.

    • C. 

      Insulin is absorbed more rapidly at abdominal injection sites than at other sites.

    • D. 

      Insulin is absorbed unpredictably at all injection sites.

  • 22. 
    A client with type 1 diabeteshas been on a regimen of multiple daily injection therapy. He's being converted to continuous subcutaneous insulin therapy. While teaching the client about continuous subcutaneous insulin therapy, the nurse should tell him that the regimen includes the use of:
    • A. 

      Intermediate- and long-acting insulins.

    • B. 

      Short- and long-acting insulins.

    • C. 

      Short-acting insulin only.

    • D. 

      Short- and intermediate-acting insulins.

  • 23. 
    A nurse is caring for a client in acute addisonian crisis. Which test result does the nurse expect to see?
    • A. 

      Serum potassium level of 6.8 mEq/L

    • B. 

      Blood urea nitrogen (BUN) level of 2.3 mg/dl

    • C. 

      Serum sodium level of 156 mEq/L

    • D. 

      Serum glucose level of 236 mg/dl

  • 24. 
    A client with type 1 diabetesis admitted to an acute care facility withdiabetic ketoacidosis. To correct this acute diabetic emergency, which measure should the health care team take first?
    • A. 

      Initiate fluid replacement therapy.

    • B. 

      Administer insulin.

    • C. 

      Correct diabetic ketoacidosis.

    • D. 

      Determine the cause of diabetic ketoacidosis.

  • 25. 
    A client with status asthmaticusrequiresendotracheal intubationand mechanical ventilation. Twenty-four hours after intubation, the client is started on the insulin infusion protocol. The nurse must monitor the client's blood glucose levels hourly and watch for which early signs and symptoms associated withhypoglycemia?
    • A. 

      Sweating, tremors, and tachycardia

    • B. 

      Dry skin, bradycardia, and somnolence

    • C. 

      Bradycardia, thirst, and anxiety

    • D. 

      Polyuria, polydipsia, and polyphagia