SICK VISIT MANAGEMENT OF ENDOCRINE
PRACTICE SOLUTION TESTED QUESTIONS
COMPLETE ANSWER RESOURCE
●● 2. A female adult client with a history of chronic
hyperparathyroidism admits to being noncompliant. Based on initial
assessment findings, nurse Julia formulates the nursing diagnosis of Risk
for injury. To complete the nursing diagnosis statement for this client,
which "related-to" phrase should the nurse add?
a. Related to bone demineralization resulting in pathologic fractures
b. Related to exhaustion secondary to an accelerated metabolic rate
c. Related to edema and dry skin secondary to fluid infiltration into the
interstitial spaces
d. Related to tetany secondary to a decreased serum calcium level
Answer: A.
Poorly controlled hyperparathyroidism may cause an elevated serum
calcium level. This, in turn, may diminish calcium stores in the bone,
causing bone demineralization and setting the stage for pathologic
fractures and a risk for injury. Hyperparathyroidism doesn't accelerate
the metabolic rate. A decreased thyroid hormone level, not an increased
parathyroid hormone level, may cause edema and dry skin secondary to
fluid infiltration into the interstitial spaces. Hyperparathyroidism causes
hypercalcemia, not hypocalcemia; therefore, it isn't associated with
tetany.
,●● 3. Nurse John is assigned to care for a postoperative male client who
has diabetes mellitus. During the assessment interview, the client reports
that he's impotent and says he's concerned about its effect on his
marriage. In planning this client's care, the most appropriate intervention
would be to:
a. Encourage the client to ask questions about personal sexuality.
b. Provide time for privacy.
c. Provide support for the spouse or significant other.
d. Suggest referral to a sex counselor or other appropriate professional.
Answer: D.
The nurse should refer this client to a sex counselor or other
professional. Making appropriate referrals is a valid part of planning the
client's care. The nurse doesn't normally provide sex counseling.
●● 4. During a class on exercise for diabetic clients, a female client asks
the nurse educator how often to exercise. The nurse educator advises the
clients to exercise how often to meet the goals of planned exercise?
a. At least once a week
b. At least three times a week
c. At least five times a week
d. Every day
Answer: B.
Diabetic clients must exercise at least three times a week to meet the
goals of planned exercise — lowering the blood glucose level, reducing
or maintaining the proper weight, increasing the serum high-density
,lipoprotein level, decreasing serum triglyceride levels, reducing blood
pressure, and minimizing stress. Exercising once a week wouldn't
achieve these goals. Exercising more than three times a week, although
beneficial, would exceed the minimum requirement.
●● 5. Nurse Oliver should expect a client with hypothyroidism to report
which health concerns?
a. Increased appetite and weight loss
b. Puffiness of the face and hands
c. Nervousness and tremors
d. Thyroid gland swelling
Answer: B.
Hypothyroidism (myxedema) causes facial puffiness, extremity edema,
and weight gain. Signs and symptoms of hyperthyroidism (Graves'
disease) include an increased appetite, weight loss, nervousness,
tremors, and thyroid gland enlargement (goiter).
●● 6. A female client with hypothyroidism (myxedema) is receiving
levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should
nurse Hans recognize as an adverse drug effect?
a. Dysuria
b. Leg cramps
c. Tachycardia
d. Blurred vision
, Answer: C.
Levothyroxine, a synthetic thyroid hormone, is given to a client with
hypothyroidism to simulate the effects of thyroxine. Adverse effects of
this agent include tachycardia. The other options aren't associated with
levothyroxine.
●● 7. A 67-year-old male client has been complaining of sleeping more,
increased urination, anorexia, weakness, irritability, depression, and
bone pain that interferes with her going outdoors. Based on these
assessment findings, nurse Richard would suspect which of the
following disorders?
a. Diabetes mellitus
b. Diabetes insipidus
c. Hypoparathyroidism
d. Hyperparathyroidism
Answer: D.
Hyperparathyroidism is most common in older women and is
characterized by bone pain and weakness from excess parathyroid
hormone (PTH). Clients also exhibit hypercaliuria-causing polyuria.
While clients with diabetes mellitus and diabetes insipidus also have
polyuria, they don't have bone pain and increased sleeping.
Hypoparathyroidism is characterized by urinary frequency rather than
polyuria.
●● 8. When caring for a male client with diabetes insipidus, nurse Juliet
expects to administer:
PRACTICE SOLUTION TESTED QUESTIONS
COMPLETE ANSWER RESOURCE
●● 2. A female adult client with a history of chronic
hyperparathyroidism admits to being noncompliant. Based on initial
assessment findings, nurse Julia formulates the nursing diagnosis of Risk
for injury. To complete the nursing diagnosis statement for this client,
which "related-to" phrase should the nurse add?
a. Related to bone demineralization resulting in pathologic fractures
b. Related to exhaustion secondary to an accelerated metabolic rate
c. Related to edema and dry skin secondary to fluid infiltration into the
interstitial spaces
d. Related to tetany secondary to a decreased serum calcium level
Answer: A.
Poorly controlled hyperparathyroidism may cause an elevated serum
calcium level. This, in turn, may diminish calcium stores in the bone,
causing bone demineralization and setting the stage for pathologic
fractures and a risk for injury. Hyperparathyroidism doesn't accelerate
the metabolic rate. A decreased thyroid hormone level, not an increased
parathyroid hormone level, may cause edema and dry skin secondary to
fluid infiltration into the interstitial spaces. Hyperparathyroidism causes
hypercalcemia, not hypocalcemia; therefore, it isn't associated with
tetany.
,●● 3. Nurse John is assigned to care for a postoperative male client who
has diabetes mellitus. During the assessment interview, the client reports
that he's impotent and says he's concerned about its effect on his
marriage. In planning this client's care, the most appropriate intervention
would be to:
a. Encourage the client to ask questions about personal sexuality.
b. Provide time for privacy.
c. Provide support for the spouse or significant other.
d. Suggest referral to a sex counselor or other appropriate professional.
Answer: D.
The nurse should refer this client to a sex counselor or other
professional. Making appropriate referrals is a valid part of planning the
client's care. The nurse doesn't normally provide sex counseling.
●● 4. During a class on exercise for diabetic clients, a female client asks
the nurse educator how often to exercise. The nurse educator advises the
clients to exercise how often to meet the goals of planned exercise?
a. At least once a week
b. At least three times a week
c. At least five times a week
d. Every day
Answer: B.
Diabetic clients must exercise at least three times a week to meet the
goals of planned exercise — lowering the blood glucose level, reducing
or maintaining the proper weight, increasing the serum high-density
,lipoprotein level, decreasing serum triglyceride levels, reducing blood
pressure, and minimizing stress. Exercising once a week wouldn't
achieve these goals. Exercising more than three times a week, although
beneficial, would exceed the minimum requirement.
●● 5. Nurse Oliver should expect a client with hypothyroidism to report
which health concerns?
a. Increased appetite and weight loss
b. Puffiness of the face and hands
c. Nervousness and tremors
d. Thyroid gland swelling
Answer: B.
Hypothyroidism (myxedema) causes facial puffiness, extremity edema,
and weight gain. Signs and symptoms of hyperthyroidism (Graves'
disease) include an increased appetite, weight loss, nervousness,
tremors, and thyroid gland enlargement (goiter).
●● 6. A female client with hypothyroidism (myxedema) is receiving
levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should
nurse Hans recognize as an adverse drug effect?
a. Dysuria
b. Leg cramps
c. Tachycardia
d. Blurred vision
, Answer: C.
Levothyroxine, a synthetic thyroid hormone, is given to a client with
hypothyroidism to simulate the effects of thyroxine. Adverse effects of
this agent include tachycardia. The other options aren't associated with
levothyroxine.
●● 7. A 67-year-old male client has been complaining of sleeping more,
increased urination, anorexia, weakness, irritability, depression, and
bone pain that interferes with her going outdoors. Based on these
assessment findings, nurse Richard would suspect which of the
following disorders?
a. Diabetes mellitus
b. Diabetes insipidus
c. Hypoparathyroidism
d. Hyperparathyroidism
Answer: D.
Hyperparathyroidism is most common in older women and is
characterized by bone pain and weakness from excess parathyroid
hormone (PTH). Clients also exhibit hypercaliuria-causing polyuria.
While clients with diabetes mellitus and diabetes insipidus also have
polyuria, they don't have bone pain and increased sleeping.
Hypoparathyroidism is characterized by urinary frequency rather than
polyuria.
●● 8. When caring for a male client with diabetes insipidus, nurse Juliet
expects to administer:
