C HAPTER 23: E NDOCRINE D ISORDERS AND
T HERAPEUTIC M ANAGEMENT
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. The nurse is caring for a patient with t ype 1 diabetes who was admitte d
with complaints of increased lethargy. Serum laboratory values validate
the diagnosis of diabetic ketoacidosis (DKA). Which medical
intervention would the nurse expect to be ordered for this patient?
a. Extensive hydration
b. Oral hypogl ycemic agents
c. Large doses of IV insulin
d. Limiting food and fluids
ANS: A
Rapid IV fluid replacement requires the use of a volumetric pump.
Insulin is administered intravenousl y to patients who are severel y
dehydrated or have poor peripheral perfusion to ensure effective
absorption. Patients with DKA are kept on NPO (nothing by mouth)
status until the hypergl ycemia is under control. Critical care nurses are
responsible for monitoring the rate of plasma glucose decline in
response to insulin.
PTS: 1 DIF: Cognitive Lev el: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Endocrine
, Disorders and Therapeutic Management MSC: NC LEX:
Physiological Integrity: Physiological Adaptation
2. Which pathophysiologic mechanism occurs in the patient with type 2
diabetes?
a. Lack of insulin production and excessive glucose intake
b. Decreased insulin secretion and insulin resistance
c. Overproduction of glucose and decreased metabolism
d. Increased uptake and decreased release of glucose in the cells
ANS: B
Type 2 diabetes is identifi ed by decreased insulin secretion and insulin
resistance, with a relative, versus absolute, insulin deficiency.
PTS: 1 DIF: Cognitive Level: Understanding OBJ: Nursing
Process Step: Diagnosis TOP: Endocrine Disorders and
Therapeutic Management MSC: NC LEX:
Physiological Integrity: Physiological Adaptation
3. A patient with a history of t ype 2 diabetes was admitted after aneurysm
repair. The patient’s serum glucose levels have been elevated for the
past 2 days and the patient is concerned about b ecoming dependent on
insulin. Which statement is the nurse’s best response to the patient’s
concerns?
a. “This surgery may have damaged your pancreas. We will have to
do more evaluation.”
b. “Perhaps your diabetes was more serious from the beginning.”
c. “You will need to discuss this with your physician.”
T HERAPEUTIC M ANAGEMENT
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. The nurse is caring for a patient with t ype 1 diabetes who was admitte d
with complaints of increased lethargy. Serum laboratory values validate
the diagnosis of diabetic ketoacidosis (DKA). Which medical
intervention would the nurse expect to be ordered for this patient?
a. Extensive hydration
b. Oral hypogl ycemic agents
c. Large doses of IV insulin
d. Limiting food and fluids
ANS: A
Rapid IV fluid replacement requires the use of a volumetric pump.
Insulin is administered intravenousl y to patients who are severel y
dehydrated or have poor peripheral perfusion to ensure effective
absorption. Patients with DKA are kept on NPO (nothing by mouth)
status until the hypergl ycemia is under control. Critical care nurses are
responsible for monitoring the rate of plasma glucose decline in
response to insulin.
PTS: 1 DIF: Cognitive Lev el: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Endocrine
, Disorders and Therapeutic Management MSC: NC LEX:
Physiological Integrity: Physiological Adaptation
2. Which pathophysiologic mechanism occurs in the patient with type 2
diabetes?
a. Lack of insulin production and excessive glucose intake
b. Decreased insulin secretion and insulin resistance
c. Overproduction of glucose and decreased metabolism
d. Increased uptake and decreased release of glucose in the cells
ANS: B
Type 2 diabetes is identifi ed by decreased insulin secretion and insulin
resistance, with a relative, versus absolute, insulin deficiency.
PTS: 1 DIF: Cognitive Level: Understanding OBJ: Nursing
Process Step: Diagnosis TOP: Endocrine Disorders and
Therapeutic Management MSC: NC LEX:
Physiological Integrity: Physiological Adaptation
3. A patient with a history of t ype 2 diabetes was admitted after aneurysm
repair. The patient’s serum glucose levels have been elevated for the
past 2 days and the patient is concerned about b ecoming dependent on
insulin. Which statement is the nurse’s best response to the patient’s
concerns?
a. “This surgery may have damaged your pancreas. We will have to
do more evaluation.”
b. “Perhaps your diabetes was more serious from the beginning.”
c. “You will need to discuss this with your physician.”
