NURS MED-SURGICAL NURSING EXAM ENDOCRINE
PROBLEMS QUESTIONS WITH ANSWERS 2023 A+
ASSUARED SUCCESS
Which information will the nurse include when teaching a 50-year-old male patient about somatropin (Genotropin)?
A.The medication will be needed for 3 to 6 months.
B.Inject the medication subcutaneously every day.
C.Blood glucose levels may decrease when taking the medication.
D.Stop taking the medication if swelling of the hands or feet occurs.
ANS: B
Somatropin is injected subcutaneously daily, preferably in the evening. The patient will need to continue on somatropin for life. If swelling or other common adverse effects occur, the health care provider should
be notified. Growth hormone will increase blood glucose levels.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which finding indicates to the nurse that demeclocycline is effective for a patient with syndrome of inappropriate antidiuretic hormone (SIADH)?
A.Weight has increased.
B.Urinary output is increased.
C.Peripheral edema is increased.
D.Urine specific gravity is increased.
ANS: B
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules and increases urine
output. An increase in weight or an increase in urine specific gravity indicates that the SIADH is not corrected. Peripheral edema does not occur with SIADH. A sudden weight gain without edema is a common clinical manifestation of this disorder.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Evaluation MSC: NCLEX:
Physiological Integrity
Which patient statement indicates to the nurse that additional instruction is needed for a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH)?
A.“I should weigh myself daily and report sudden weight loss or gain.”
B.“I need to shop for foods low in sodium and avoid adding salt to food.”
C.“I need to limit my fluid intake to no more than 1 quart of liquids a day.”
D.“I should eat foods high in potassium because diuretics cause potassium loss.”
ANS: B
Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed. The other patient statements are correct and indicate successful teaching has occurred.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Evaluation MSC: NCLEX:
Physiological Integrity
A 56-year-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with syndrome of inappropriate antidiuretic hormone (SIADH). Which initial laboratory result should the NURS MED-SURGICAL NURSING EXAM ENDOCRINE
PROBLEMS QUESTIONS WITH ANSWERS 2023 A+
ASSUARED SUCCESS
nurse expect?
A.Elevated hematocrit
B.Decreased serum sodium
C.Increased serum chloride
D.Low urine specific gravity
ANS: B
When water is retained, the serum sodium level will drop below normal, causing the clinical manifestations reported by the patient. The hematocrit will decrease because of the dilution caused by water retention. Urine will be more concentrated with a higher specific gravity. The serum chloride level will usually decrease along with the sodium level.
DIF: Cognitive Level: Understand (comprehension)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which problem should the nurse anticipate for a patient admitted to the hospital with diabetes insipidus?
A.Generalized edema
B.Fluid volume overload
C.Disturbed sleep pattern
D.Decreased gas exchange
ANS: C
Nocturia occurs because of the polyuria caused by diabetes insipidus. Edema, excess fluid volume, and fluid retention are not expected.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
Which information will the nurse teach a patient who has been newly diagnosed with Graves’ disease?
A.Exercise is contraindicated to avoid increasing metabolic rate.
B.Restriction of iodine intake is needed to reduce thyroid activity.
C.Antithyroid medications may take several months for full effect.
D.Surgery will eventually be required to remove the thyroid gland.
ANS: C
Medications used to block the synthesis of thyroid hormones may take 2 to 3 months before the full effect is seen. Large doses of iodine are used to inhibit the synthesis of thyroid hormones. Exercise using large muscle groups is encouraged to decrease the irritability and hyperactivity associated with high levels of thyroid hormones. Radioactive iodine is the most common treatment for Graves’ disease, although surgery may be used.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
A patient who had a subtotal thyroidectomy earlier today develops laryngeal stridor and a cramp in
the right hand upon returning to the surgical nursing unit. Which collaborative action will the nurse
anticipate next? NURS MED-SURGICAL NURSING EXAM ENDOCRINE
PROBLEMS QUESTIONS WITH ANSWERS 2023 A+
ASSUARED SUCCESS
A.Plan for emergency tracheostomy.
B.Administer IV calcium gluconate.
C.Prepare for endotracheal intubation.
D.Begin thyroid hormone replacement.
ANS: B
The patient’s clinical manifestations of stridor and cramping are consistent with tetany caused by hypocalcemia resulting from damage to the parathyroid glands during surgery. Endotracheal intubation or
tracheostomy may be needed if the calcium does not resolve the stridor. Thyroid hormone replacement may be needed eventually but will not improve the symptoms of hypocalcemia.
DIF: Cognitive Level: Analyze (analysis) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
Which nursing action will be included in the plan of care for a patient with Graves’ disease who has
exophthalmos?
A.Place cold packs on the eyes to relieve pain and swelling.
PROBLEMS QUESTIONS WITH ANSWERS 2023 A+
ASSUARED SUCCESS
Which information will the nurse include when teaching a 50-year-old male patient about somatropin (Genotropin)?
A.The medication will be needed for 3 to 6 months.
B.Inject the medication subcutaneously every day.
C.Blood glucose levels may decrease when taking the medication.
D.Stop taking the medication if swelling of the hands or feet occurs.
ANS: B
Somatropin is injected subcutaneously daily, preferably in the evening. The patient will need to continue on somatropin for life. If swelling or other common adverse effects occur, the health care provider should
be notified. Growth hormone will increase blood glucose levels.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
Which finding indicates to the nurse that demeclocycline is effective for a patient with syndrome of inappropriate antidiuretic hormone (SIADH)?
A.Weight has increased.
B.Urinary output is increased.
C.Peripheral edema is increased.
D.Urine specific gravity is increased.
ANS: B
Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal tubules and increases urine
output. An increase in weight or an increase in urine specific gravity indicates that the SIADH is not corrected. Peripheral edema does not occur with SIADH. A sudden weight gain without edema is a common clinical manifestation of this disorder.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Evaluation MSC: NCLEX:
Physiological Integrity
Which patient statement indicates to the nurse that additional instruction is needed for a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH)?
A.“I should weigh myself daily and report sudden weight loss or gain.”
B.“I need to shop for foods low in sodium and avoid adding salt to food.”
C.“I need to limit my fluid intake to no more than 1 quart of liquids a day.”
D.“I should eat foods high in potassium because diuretics cause potassium loss.”
ANS: B
Patients with SIADH are at risk for hyponatremia, and a sodium supplement may be prescribed. The other patient statements are correct and indicate successful teaching has occurred.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Evaluation MSC: NCLEX:
Physiological Integrity
A 56-year-old patient who is disoriented and reports a headache and muscle cramps is hospitalized with syndrome of inappropriate antidiuretic hormone (SIADH). Which initial laboratory result should the NURS MED-SURGICAL NURSING EXAM ENDOCRINE
PROBLEMS QUESTIONS WITH ANSWERS 2023 A+
ASSUARED SUCCESS
nurse expect?
A.Elevated hematocrit
B.Decreased serum sodium
C.Increased serum chloride
D.Low urine specific gravity
ANS: B
When water is retained, the serum sodium level will drop below normal, causing the clinical manifestations reported by the patient. The hematocrit will decrease because of the dilution caused by water retention. Urine will be more concentrated with a higher specific gravity. The serum chloride level will usually decrease along with the sodium level.
DIF: Cognitive Level: Understand (comprehension)
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
Which problem should the nurse anticipate for a patient admitted to the hospital with diabetes insipidus?
A.Generalized edema
B.Fluid volume overload
C.Disturbed sleep pattern
D.Decreased gas exchange
ANS: C
Nocturia occurs because of the polyuria caused by diabetes insipidus. Edema, excess fluid volume, and fluid retention are not expected.
DIF: Cognitive Level: Apply (application) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
Which information will the nurse teach a patient who has been newly diagnosed with Graves’ disease?
A.Exercise is contraindicated to avoid increasing metabolic rate.
B.Restriction of iodine intake is needed to reduce thyroid activity.
C.Antithyroid medications may take several months for full effect.
D.Surgery will eventually be required to remove the thyroid gland.
ANS: C
Medications used to block the synthesis of thyroid hormones may take 2 to 3 months before the full effect is seen. Large doses of iodine are used to inhibit the synthesis of thyroid hormones. Exercise using large muscle groups is encouraged to decrease the irritability and hyperactivity associated with high levels of thyroid hormones. Radioactive iodine is the most common treatment for Graves’ disease, although surgery may be used.
DIF: Cognitive Level: Apply (application)
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity
A patient who had a subtotal thyroidectomy earlier today develops laryngeal stridor and a cramp in
the right hand upon returning to the surgical nursing unit. Which collaborative action will the nurse
anticipate next? NURS MED-SURGICAL NURSING EXAM ENDOCRINE
PROBLEMS QUESTIONS WITH ANSWERS 2023 A+
ASSUARED SUCCESS
A.Plan for emergency tracheostomy.
B.Administer IV calcium gluconate.
C.Prepare for endotracheal intubation.
D.Begin thyroid hormone replacement.
ANS: B
The patient’s clinical manifestations of stridor and cramping are consistent with tetany caused by hypocalcemia resulting from damage to the parathyroid glands during surgery. Endotracheal intubation or
tracheostomy may be needed if the calcium does not resolve the stridor. Thyroid hormone replacement may be needed eventually but will not improve the symptoms of hypocalcemia.
DIF: Cognitive Level: Analyze (analysis) TOP: Nursing Process: Planning MSC: NCLEX: Physiological Integrity
Which nursing action will be included in the plan of care for a patient with Graves’ disease who has
exophthalmos?
A.Place cold packs on the eyes to relieve pain and swelling.
