Evolve Endocrine NCLEX-PN 2 - flashcardbook.com · preparing a teaching plan for the client with...

Evolve Endocrine NCLEX-PN 2The nurse caring for a

client scheduled for a

transsphenoidal

hypophysectomy to

remove a tumor in the

pituitary gland assists in

developing a plan of care

for the client. The nurse

suggests including which

specific information in the

preoperative teaching

plan?

Toothbrushing will not be permitted for at least 2 weeks following

surgery.

The nurse has provided

diabetic teaching with the

family of a client newly

diagnosed with diabetes.

The nurse determines that

the family understands the

reason for having

glucagon on hand for

emergency home use if

the family indicates that

the purpose of the

medication is to treat

which condition?

Hypoglycemia frominsulin overdose

A comatose client with an

admitting diagnosis of

diabetic ketoacidosis

(DKA) has a blood glucose

value of 368 mg/dL,

arterial pH of 7.2, arterial

Fruity breath order

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bicarbonate of 14 mEq/L,

and is positive for serum

ketones. The diagnosis is

supported by which noted

data?

After receiving furosemide

(Lasix) 40 mg slow

intravenous push for chest

pain related to shortness

of breath and generalized

edema, the client responds

poorly. The client has no

relief of the chest pain,

shortness of breath, or

edema and only minimal

urine output (less than 40

mL of urine). The health

care provider is notified,

and after reviewing the

chart, suspects the client

has syndrome of

inappropriate antidiuretic

hormone (SIADH). Which

findings would lead to this

specific diagnosis? Refer

to chart.

Minimal responsiveness to furosemide (Lasix) and small cell lung

cancer

The nurse is discussing

foot care with a diabetic

client and the spouse. The

nurse includes which

instruction during this

informational session?

The toenails should be cut straight across

The nurse has collected Temperature


data on a client with

diabetes mellitus. Findings

include a fasting blood

glucose of 130 mg/dL,

temperature 101° F, pulse

of 88 beats per minute,

respirations of 22 breaths

per minute, and a blood

pressure of 118/78 mm

Hg. Which finding would

be of concern to the

nurse?

The nurse is collecting

data on a client with

hyperparathyroidism.

Which question would elicit

accurate information about

this condition from the

client?

"Are you experiencing pain in your joints?"


data from a client who is

being admitted to the

hospital for a diagnostic

workup for primary

hyperparathyroidism. The

nurse understands that

which client complaint

would be characteristic of

this disorder?

Polyuria

When the nurse is

reinforcing instructions to a

client who has been newly

diagnosed with type 1

"I will notify my health care provider if my blood glucose level is

consistently greater than 250 mg/dL


diabetes mellitus, which

statement by the client

would indicate that

teaching has been

effective?

The nurse is assisting with

preparing a teaching plan

for the client with diabetes

mellitus regarding proper

foot care. Which

instruction should be

included in the plan of

care?

Apply a moisturizing lotion to dry feet, but n to between the toes.

The nurse is caring for a

client with type 1 diabetes

mellitus who is

hyperglycemic. Which

problem should the nurse

consider first, when

planning care for this

client?

Signs of dehydration

The nurse reinforces

teaching with a client with

diabetes mellitus regarding

differentiating between

hypoglycemia and

ketoacidosis. The client

demonstrates an

understanding of the

teaching by stating that

glucose will be taken if

which symptom develops?

Shakiness

A client with diabetes "Are you rotating the injection site?"


mellitus who takes insulin

is seen in the health care

clinic. The client tells the

nurse that after giving the

injection, the insulin seems

to leak through the skin.

The nurse can

appropriately determine

the problem by asking the

client which?

The nurse is monitoring a

client with Graves' disease

for signs of thyrotoxic crisis

(thyroid storm). Which

signs and symptoms noted

in the client should alert

the nurse to the presence

of this crisis? Select all

that apply.

Fever, Sweating, Agitation

A hospitalized client is

newly diagnosed with

diabetes mellitus. The

client must take both NPH

and Regular insulin for

glucose control. The nurse

develops a teaching plan

to help the client meet

which outcome as a first

step in managing the

disease?

Adjust insulin according to capillary blood glucose levels.

Which client is at risk for

developing thyrotoxicosis?

A client with Graves' disease who is having surgery

The wife of a client with Check his blood glucose level.


diabetes mellitus who

takes insulin calls the

nurse in a health care

provider's office about her

husband. She states that

her husband is sleepy and

that his skin is warm and

flushed. She adds that his

breathing is faster than

normal and his pulse rate

seems fast. Which action

should the nurse tell the

wife to do first

A client with type 2

diabetes mellitus has a

blood glucose of more

than 600 mg/dL and is

complaining of polydipsia,

polyuria, weight loss, and

weakness. The nurse

reviews the health care

provider's documentation

and would expect to note

which diagnosis?

Hyperglycemic hyperosmolar state (HHS)

Which signs/symptoms

should the nurse expect to

note when collecting data

on a client with Addison's

disease?

Hypotension and vomiting

The nurse participating in

a free health screening at

the local mall obtains a

random blood glucose

Call the health care provider to have the value rechecked as soon as

possible.


level of 200 mg/dL on an

otherwise healthy client.

The nurse tells the client to

do which as a next step?

The nurse notes that a

client with type 1 diabetes

mellitus has lipodystrophy

on both upper thighs.

Which further information

should the nurse obtain

from the client during data

collection?

Plan for injection rotation

Which measure should the

nurse anticipate being

included in the plan of care

for a client who has been

diagnosed with Graves'

disease?

A restful environment


data on a client admitted to

the hospital with a

diagnosis of myxedema.

Which data collection

technique would provide

data necessary to support

the admitting diagnosis?

Inspection of facial features

A client recently diagnosed

with diabetes mellitus

requiring insulin tells the

clinic nurse that he is

traveling by air throughout

the next week. The client

asks the nurse for any

Keep snacks in carry-on luggage to prevent hypoglycemia during the

flight.


suggestions about

managing the disorder

while traveling. Which

action should the nurse tell

the client to do?

A client who is managing

diabetes mellitus with

insulin injections asks the

nurse for information about

any necessary changes in

her diet to avoid

hyperinsulinism. Which

diet would be appropriate

for the client?

Small frequent meals with protein, fat, and carbohydrates at each

meal


postoperative

parathyroidectomy client.

Which would require the

nurse's immediate

attention?

Laryngeal stridor

A client with myxedema

has changes in intellectual

function such as impaired

memory, decreased

attention span, and

lethargy. The client's

husband is upset and

shares his concerns with

the nurse. Which

statement by the nurse is

helpful to the client's

husband?

"It's seems that you are concerned about your wife's conditions, but

the symptoms may improve with continued therapy."

A client scheduled for a Fear about impending surgery


thyroidectomy says to the

nurse, "I am so scared to

get cut in my neck." Based

on the client's statement,

the nurse determines that

the client is experiencing

which problem?


data regarding a client

after a thyroidectomy and

notes that the client has

developed hoarseness and

a weak voice. Which

nursing action is

appropriate?

Reassure the client that this is usually a temporary condition.


client with a diagnosis of

hypoparathyroidism. The

nurse reviews the client's

laboratory results and

notes that the calcium

level is extremely low. The

nurse should expect to

note which sign/symptom

on data collection?

Positive Trousseau's sign

A client is admitted with a

diagnosis of

pheochromocytoma. The

nurse should monitor

which parameter to detect

the most common sign of

pheochromocytoma?

Blood pressure elevation

Following Check the urine specific gravity


hypophysectomy, a client

complains of being very

thirsty and having to

urinate frequently. Which

is the initial nursing action?

The nurse provides dietary

instructions to a client with


the prescribed diabetic

diet. Which statement

made by the client

indicates the need for

further teaching

" I need to buy special dietetic foods."

During data collection on a

postoperative client who

has undergone

hypophysectomy, the

client complains of thirst

and frequent urination.

Knowing the expected

complication of this

surgery, the nurse should

check which parameter

next

Urine specific gravity


client with Addison's

disease. The nurse checks

the client's vital signs and

determines that the client

has orthostatic

hypotension. The nurse

determines that this finding

relates to which factor?

A decreased secretion of aldosterone


A client newly diagnosed

with diabetes mellitus is

having difficulty learning

the technique of blood

glucose measurement.

The nurse should teach

the client to do which

action to perform the

procedure properly?

Let the arm hang dependently and milk the digit

The nurse is preparing to

reinforce instructions to a


disease regarding diet

therapy. The nurse

understands that which

diet should be prescribed

for this client?

High-sodium, high-carbohydrate diet

The nurse has just

supervised a newly

diagnosed diabetes

mellitus client self-inject

NPH insulin at 7:30 .

The nurse reviews the time

frames for peak insulin

action with the client,

telling the client to be

especially watchful for a

hypoglycemic reaction

between which time

frame?

1:30pm and 7:30pm

The nurse educator is

asking the nursing student

to recall the

Dry skin, constipation, cold intolerance


signs/symptoms of

hypothyroidism. The nurse

educator determines that

the student understands

this disorder if which are

included in the student's

response? Select all that

apply.


child with a diagnosis of

diabetes insipidus. The

nurse anticipates that the

health care provider will

prescribe which

medications?

Desmopressin Acetate (DDAVP)


diabetes mellitus takes

NPH insulin every morning

and checks the blood

glucose level four times

per day. The client tells the

nurse that yesterday the

late afternoon blood

glucose was 60 mg/dL and

that she "felt funny." Which


indicates an understanding

of this occurrence?

"I forgot to take my usual mid afternoon snack yesterday."

The nurse is reinforcing

discharge teaching with a

client who has Cushing's

syndrome. Which


"I can eat foods that contain potassium"


indicates that the

instructions related to

dietary management were

understood?

A health care provider has

prescribed propylthiouracil

(PTU) for a client with

hyperthyroidism, and the

nurse assists in developing

a plan of care for the

client. Which nursing

measure would be

included in the plan

regarding this medication?

Signs and symptoms of hypothroidism


client experiencing thyroid

storm. Which should be a

priority concern for this

client?

Potential for cardiac disturbances

The nurse is reinforcing

discharge instructions to a

client who had a unilateral

adrenalectomy. Which

information should be a

component of the

instructions?

Instructions about early signs of a wound infection


data from a client newly

diagnosed with diabetes

mellitus regarding the

client's learning readiness.

Which client behavior

indicates to the nurse that

The client complains of fatigue whenever the nurse plans a teaching

session.


the client is not ready to

learn?

The nurse in an outpatient

diabetes clinic is assisting

in caring for a client on

insulin pump therapy.

Which statement by the

client indicates that a need

for teaching regarding

insulin pump therapy?

"Now that I have this pump, I don't have to worry about insulin

reactions or ketoacidosis occurring again."

A client is brought to the

emergency department in

an unresponsive state, and

a diagnosis of

hyperglycemic

hyperosmolar state (HHS)

is made. The nurse who is

assisting with care for the

client obtains which item in

preparation for the

treatment of this

syndrome?

Intravenous (IV) infusion of normal saline

The nurse is instructing a


disease about a newly

prescribed medication,

fludrocortisone acetate

(Florinef). Which statement

by the client indicates a

need for further teaching?

"I will be glad to gain weight."

An older client with a

history of

hyperparathyroidism and

The possibility of injury


severe osteoporosis is

hospitalized. The nurse

caring for the client plans

to address which problem

first

The nurse has reinforced

instructions about

measuring blood glucose

levels to a client newly

diagnosed with diabetes

mellitus. The nurse


understands the procedure

when making which most

accurate statement?

"I should check my blood glucose level before eating each meal,

regardless of how much I eat."

The nurse is reviewing a

health care provider's

prescriptions for a client

with newly diagnosed,

untreated hypothyroidism.

Which medication

prescribed for the client

should the nurse question

and verify?

Morphine sulfate

A client is admitted to the

hospital with a diagnosis of


(DKA). The initial serum

glucose level was 950

mg/dL. Intravenous (IV)

insulin was started along

with rehydration with IV

normal saline. The serum

IV infusion containing 5% dextrose


glucose level is now 240

mg/dL. The nurse who is

assisting in caring for the

client obtains which item,

anticipating a health care

provider's prescription?


client with


client is scheduled for an

adrenalectomy. During the

preoperative period, the

priority nursing action

should be to monitor which

criterion?

Vital signs


instructions to the client

with hyperparathyroidism

regarding home care

measures related to

exercise. Which statement

by the client indicates a

need for further teaching?

Select all that apply.

" I need to limit playing football to only the weekends."

"I should exercise in the evening to encourage a good sleep pattern."


data on a client with a

diagnosis of

hypothyroidism. Which of

these behaviors, if present

in the client's history,

should the nurse

determine as being likely

related to the symptoms of

Depression


this disorder?


client diagnosed with

hyperparathyroidism who

is prescribed furosemide

(Lasix). The nurse

reinforces dietary

instructions to the client.

Which is an appropriate

instruction?

Drink at least 2 to 3 L of fluid daily.

Glucagon hydrochloride

injection would most likely

be prescribed for which

disorder?

Type 1 diabetes mellitus

A client with diabetes

mellitus is scheduled to

have a fasting blood

glucose level determined

in the morning. The nurse

tells the client not to eat or

drink after midnight. When

the client asks for further

information, the nurse

clarifies by stating that

which should be

acceptable to take before

the test?

Water

The nurse is reviewing the

postoperative prescriptions

for a client who had a

transsphenoidal

hypophysectomy. Which

health care provider's

Apply a loose dressing if any clear drainage is noted


prescription noted on the

record indicates the need

for clarification?

The nurse caring for a

client who has had a

subtotal thyroidectomy

reviews the plan of care

and determines which

problem is the priority for

this client in the immediate

postoperative period?

Bleeding


client newly diagnosed

with diabetes mellitus. The

client asks the nurse

whether eating at a

restaurant will affect the

diabetic control and

whether this is allowed.

Which nursing response is

appropriate?

"You should order a half-portion meal and have fresh fruit for

dessert."

(AKA stop being a fat a** and put the pie down)

The nurse enters the room

of a client with type 1

diabetes mellitus and finds

the client difficult to

arouse. The client's skin is

warm and flushed, and the

pulse and respiratory rate

are elevated from the

client's baseline. Which

action should the nurse

implement?

Check the client's capillary blood glucose

A client with type 1 "I should not exercise in the later afternoon."


diabetes mellitus calls the

nurse to report recurrent

episodes of hypoglycemia.

Which statement by the

client indicates a correct

understanding of Humulin

N insulin and exercise?

The nurse is assigned to

assist in caring for a client

admitted to the emergency

department with diabetic

ketoacidosis (DKA). Which

is the priority nursing

action for this client who is

in the acute phase?

Administer IV regular insulin

When caring for a client

diagnosed with

pheochromocytoma, which

information should the

nurse know when assisting

with planning care?

Excessive catecholamines are released.


diabetes mellitus is to

begin an exercise

program, and the nurse is

reinforcing instructions to

the client regarding the

program. Which should the

nurse include in the

instructions?

Take a blood glucose test before exercising.

The nurse working on an

endocrine nursing unit

understands that which

Clients who have hyperparathyroidism should be protected against

falls.


correct concept is used in

planning care?

The nurse is planning to

instruct a client with

diabetes mellitus who has

hypertension about "sick

day management." Which

beverage does the nurse

avoid putting on a list of

easily consumed

carbohydrate-containing

beverages for use when

the client cannot tolerate

food orally?

Mineral water

A client with a pituitary

tumor will undergo

transsphenoidal

hypophysectomy. The

nurse reinforces which

information in the

preoperative teaching plan

for the client?

Blowing the nose following surgery is prohibited.


client with

pheochromocytoma.

Which data are indicative

of a potential complication

associated with this

disorder?

Congestion heard on auscultation of the lungs

The nurse should expect

to note which interventions

in the plan of care for a

client with hypothyroidism?

Instruct the client about thyroid replacement therapy.

Encourage the client to consume fluids and high-fiber foods in the

diet

Instruct the client to contact the health care provider if episodes of


Select all that apply. chest pain occur.

The nurse is preparing to

discharge a client who has

had a parathyroidectomy.

When reinforcing

instructions to the client

about the prescribed oral

calcium supplement, which


nurse include?

Take the calcium 30 to 60 minutes following a meal


postoperative

adrenalectomy client.

Which finding does the

nurse specifically monitor

for in this client?

Signs and symptoms of hypovolemia


mellitus is being

discharged following

treatment for

hyperglycemic

hyperosmolar state (HHS)

precipitated by acute

illness. The client states to

the nurse, "I will call the

doctor next time I can't eat

for more than a day or so."

The nurse plans care,

understanding that which

statement accurately

reflects this client's level of

knowledge?

The client needs immediate education before discharge

The nurse is caring for a Graham crackers and warm milk


client with


client asks for a snack and

something warm to drink.

Which is the appropriate

choice for this client to

meet nutritional needs?

A client has just been

admitted with a diagnosis

of myxedema coma. If all

of the following

interventions were

prescribed, the nurse

should place highest

priority on completing

which action first?

Administering oxygen

The nursing instructor asks

a student to describe the

pathophysiology that

occurs in Cushing's

disease. Which statement

by the student indicates an

accurate understanding of

this disorder?

"Cushing's disease is characterized by an over secretion of

glucocorticoid hormones."


dietary instructions to a

client with a diagnosis of

hypoparathyroidism. The

nurse instructs the client to

include which item in the

diet?

Vegetables


mellitus visits the health

Prednisone


care clinic. The client

previously had been well

controlled with glyburide

(DiaBeta), but recently, the

fasting blood glucose has

been running 180 to 200

mg/dL. Which medication,

if added to the client's

regimen, may be

contributing to the

hyperglycemia?

Which nursing action

would be appropriate to

implement when a client

has a diagnosis of

pheochromocytoma?

Monitor the client's blood pressure


home care measures to a

client diagnosed with


exercise and insulin

administration. Which


indicates a need for further

teaching?"

"I should perform my exercise at peak insulin time."

A client with a diagnosis of


(DKA) is being treated in

the emergency

department. Which finding

should the nurse expect to

note as confirming this

diagnosis?

Elevated blood glucose and low plasma bicarbonate


A client has an endocrine

system dysfunction of the

pancreas. The nurse

anticipates that the client

will exhibit impaired

secretion of which

substance?

Insulin

While collecting data on a

client being prepared for

an adrenalectomy, the

nurse obtains a

temperature reading of

100.8° F. The nurse

analyzes this temperature

reading as which?

A finding that meeds to be reported immediately


client with hypothyroidism

who is overweight. Which

food items should the

nurse suggest to include in

the plan?

Skim milk, apples, whole-grain bread, and cereal

The nurse is assigned to

care for a client at home

who has a diagnosis of

type 1 diabetes mellitus.

When the nurse arrives to

care for the client, the

client tells the nurse that

she has been vomiting and

has diarrhea. Which

additional statement by the

client indicates a need for

further teaching?

"I need to stop my insulin."


Which nursing measure

would be effective in

preventing complications

in a client with Addison's

disease?

Monitoring the blood glucose

The anticipated intended

effect of fludrocortisone

acetate (Florinef) for the

treatment of Addison's

disease is which?

Promote electrolyte balance

A client has a blood

glucose level drawn for

suspected hyperglycemia.

After interviewing the

client, the nurse


ate lunch approximately 2

hours before the blood

specimen was drawn. The

laboratory reports the

blood glucose to be 180

mg/dL, and the nurse

analyzes this result as

indicative of which

interpretation?

Elevated from the normal value

In planning nutrition for the

client with

hypoparathyroidism, which

diet would be appropriate?

High in calcium and low phosphorous

The nurse is assisting in

preparing a care plan for a

client with diabetes

mellitus who has

Dehydration


hyperglycemia. The nurse

should focus on which

potential problem for this

client?

A client with Graves'

disease has exophthalmos

and is experiencing

photophobia. Which

intervention would best

assist the client with this

problem?

Obtaining dark glasses for the client

The nurse is providing

instructions to a client


diabetes mellitus. The

nurse gives the client a list

of the signs of

hyperglycemia. Which

specific signs of this

complication should be

included on the list?

Increased thirst

Which client complaint

should alert the nurse to a

possible hypoglycemic

reaction?

Tremors and double vision

A preoperative client is

scheduled for

adrenalectomy to remove

a pheochromocytoma. The

nurse should most closely

monitor which assessment

in the preoperative period?

Vital signs

A client who has been Rotate the insulin injections sites systematically.



diabetes mellitus has been

stabilized with daily insulin

injections. Which teaching


nurse reinforce upon

discharge?

A client who returned to

the nursing unit 8 hours

ago after hypophysectomy

has clear drainage

saturating the nasal

dressing. The nurse

should take which action?

Test the drainage for glucose


emergency department

with suspected diabetic


finding should the nurse

note as being consistent

with this diagnosis?

H

High serum glucose level and low serum bicarbonate level.


client after a thyroidectomy

and monitoring for signs of

thyroid storm. The nurse

determines that which

sign/symptom is indicative

that a thyroid storm may

be occurring?

Blood pressure of 80/60 mmHg

A client who returned to

the nursing unit 8 hours

ago after hypophysectomy

Test the drainage for glucose


has clear drainage

saturating the nasal

dressing. The nurse

should take which action?


emergency department

with suspected diabetic


finding should the nurse

note as being consistent

with this diagnosis?

High serum glucose level and low serum bicarbonate level


client after a thyroidectomy

and monitoring for signs of

thyroid storm. The nurse

determines that which

sign/symptom is indicative

that a thyroid storm may

be occurring?

Blood pressure of 80/60 mmHg


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