Nursing Assessment: Endocrine System
- 1.When evaluating the laboratory results for a patient with increased secretion of the anterior pituitary hormones, the nurse would expect to find
- A.
Decreased serum thyroxine levels.
- B.
Elevated serum aldosterone levels.
- C.
An increase in urinary free cortisol.
- D.
Low urinary excretion of catecholamines.
- 2.When the nurse is obtaining the health history, which statement by a patient indicates further assessment of thyroid function may be necessary?
- A.
“I notice my breasts are tender lately.”
- B.
“I am so thirsty that I drink all day long.”
- C.
“I get up several times at night to urinate.”
- D.
“I feel a lump in my throat when I swallow.”
- 3.A patient is admitted with a serum sodium level of 118 mEq/L. The nurse will anticipate the need for which diagnostic test?
- A.
Urinary 17-ketosteroids
- B.
Antidiuretic hormone level
- C.
Growth hormone stimulation test
- D.
Adrenocorticotropic hormone level
- 4.The nurse is interviewing a patient who has a possible thyroid disorder. Which question will provide the most useful information?
- A.
“What methods do you use to help cope with stress?”
- B.
“Have you experienced any blurring or double vision?”
- C.
“Do you have to get up at night to empty your bladder?”
- D.
“Have you had any recent unplanned weight gain or loss?”
- 5.When a patient in the outpatient clinic has an order for blood cortisol testing, which instruction will the nurse provide for the patient?
- A.
“Avoid adding any salt to your foods for 24 hours before the test.”
- B.
“You will need to lie down for 30 minutes before the blood is drawn.”
- C.
“Come to the laboratory to have the blood drawn early in the morning.”
- D.
“Do not have anything to eat or drink before the blood test is obtained.”
- 6.A patient has a total serum calcium level of 13.3 mg/dL (3.3 mmol/L). The nurse will anticipate the need to teach the patient about testing for
- A.
Calcitonin levels.
- B.
Catecholamine levels.
- C.
Thyroid hormone levels.
- D.
Parathyroid hormone levels.
- 7.During a physical examination, the nurse finds that a patient’s thyroid gland cannot be palpated. The most appropriate action by the nurse is to
- A.
Palpate the patient’s neck more deeply.
- B.
Document that the thyroid was nonpalpable.
- C.
Notify the health care provider immediately.
- D.
Teach the patient about thyroid hormone testing.
- 8.When a patient has clinical manifestations of hypothyroidism, which laboratory value should the nurse review to determine whether the hypothyroidism is caused by a problem with the anterior pituitary gland or with the thyroid gland?
- A.
Thyroxine (T4) level
- B.
Triiodothyronine (T3) level
- C.
Thyroid-stimulating hormone (TSH) level
- D.
Thyrotropin-releasing hormone (TRH) level
- 9.When working with a patient who has diabetes mellitus, the nurse reviews the results of testing for glycosylated hemoglobin (HbA1C) to evaluate for
- A.
Glucose levels 2 hours after a meal.
- B.
Circulating, nonfasting glucose levels.
- C.
Glucose control over the past 3 months.
- D.
Hypoglycemic episodes in the past 90 days.
- 10.When a patient is taking spironolactone (Aldactone), a drug that blocks the action of aldosterone on the kidney, the nurse will monitor for
- A.
Decreased urinary output.
- B.
Evidence of fluid overload.
- C.
Increased serum sodium levels.
- D.
Elevated serum potassium levels.
- 11.Which information about a patient with newly diagnosed diabetes mellitus will be most useful to the nurse in developing strategies for successful adaptation to this disease?
- A.
Ideal weight
- B.
Value system
- C.
Activity level
- D.
Visual changes
- 12.The nurse will plan patient care that will decrease the patient’s physical and emotional stress when the patient is undergoing
- A.
A water deprivation test.
- B.
Testing for serum T3 and T4 levels.
- C.
A 24-hour urine test for free cortisol. .
- D.
A radioactive iodine (I-131) uptake test
- 13.A patient is scheduled for a growth hormone stimulation test. In preparation for the test, the nurse will obtain a
- A.
Basin of ice.
- B.
Cardiac monitor.
- C.
Vial of glargine insulin. .
- D.
Vial of 50% dextrose solution
- 14.A patient is scheduled for a 24-hour urine collection for 17-ketosteroids. The nurse will need to
- A.
Keep the specimen on ice.
- B.
Insert a retention catheter.
- C.
Have the patient void and save that specimen to start the collection.
- D.
Encourage the patient to drink 2 to 3 L of fluid during the 24 hours.
- 15.When reviewing the laboratory results for a patient’s total calcium level, which information will the nurse need to consider?
- A.
The blood glucose is elevated.
- B.
The phosphate level is normal.
- C.
The serum albumin level is low.
- D.
The magnesium level is normal.
- 16.When the nurse is caring for a patient who was admitted with tetany, which laboratory value should be monitored?
- A.
Total protein
- B.
Blood glucose
- C.
Ionized calcium
- D.
Serum phosphate
- 17.Which information about a patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test?
- A.
The patient reports having occasional orthostatic dizziness.
- B.
The patient has had a 10-pound weight gain in the last month.
- C.
The patient drank several glasses of water an hour previously.
- D.
The patient takes oral corticosteroids for rheumatoid arthritis.
- 18.After the nurse manager at the endocrine clinic has completed the orientation of a new RN, which action by the new RN who is caring for a patient with a goiter and possible hyperthyroidism indicates the charge nurse needs to do more teaching?
- A.
The RN palpates the neck to check thyroid size.
- B.
The RN checks the blood pressure on both arms.
- C.
The RN orders nonmedicated eye drops to lubricate the patient’s eyes.
- D.
The RN lowers the thermostat to decrease the temperature in the room.
- 19.When caring for a patient having a water deprivation test, which finding is most important for the nurse to communicate to the health care provider?
- A.
The patient complains of intense thirst.
- B.
The patient has a 5-lb (2.3 kg) weight loss.
- C.
The patient feels dizzy when sitting up on the edge of the bed.
- D.
The patient’s urine osmolality does not change after antidiuretic hormone (ADH) is given.
- 20.A patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which patient information is most important for the nurse to communicate to the health care provider before the test?
- A.
Bilateral poor peripheral vision
- B.
Allergies to iodine and shellfish
- C.
Recent weight loss of 20 pounds
- D.
Complaints of ongoing headaches
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