COMPREHENSIVE EVALUATED QUESTIONS & ANSWERS FOR THE ASSESSMENT AND MANAGEMENT OF PATIENTS WITH ENDOCRINE DISORDERS – VERIFIED STUDY GUIDE

EVALUATEDQUESTIONSANDANSWERS kj kj kj




FOR ASSESSMENTANDMANAGEMENT O kj kj kj kj




F PATIENTS WITH ENDOCRINE DISORDER
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A nurse is instructing a client with newly diagnosed hypoparathyroidism about the regimen used to treat t
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his disorder. The nurse should state that the physician probably will order daily supplements of calcium an
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d:



A. iron.



B. potassium.



C. folic acid. kj




D. vitamin D. - CORRECT ANSWER -D. vitamin D. kj kj kj kj kj kj kj




Typically, clients with hypoparathyroidism are ordered daily supplements of vitamin D along with calcium
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because calcium absorption from the small intestine depends on vitamin D. Hypoparathyroidism doesn't c
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ause a deficiency of folic acid, potassium, or iron. Therefore, the client doesn't require daily supplements
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of these substances to maintain a normal serum calcium level.
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During preoperative teaching for a client who will undergo subtotal thyroidectomy, the nurse should inclu
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de which statement?
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A. "You must avoid hyperextending your neck after surgery."
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,B. "The head of your bed must remain flat for 24 hours after surgery."
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C. "You should avoid deep breathing and coughing after surgery."
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D. "You won't be able to swallow for the first day or two." - CORRECT ANSWER -
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A. "You must avoid hyperextending your neck after surgery."
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To prevent undue pressure on the surgical incision after subtotal thyroidectomy, the nurse should advise
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the client to avoid hyperextending the neck. The client may elevate the head of the bed as desired and s
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hould perform deep breathing and coughing to help prevent pneumonia. Subtotal thyroidectomy doesn'
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t affect swallowing.
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Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client
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(who now has nausea) and records a temperature of 105°F (40.5°C), tachycardia, and extreme restlessness. W
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hat is the most likely cause of these signs?
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A. Tetany



B. Thyroid crisis kj




C. Diabetic ketoacidosis kj




D. Hypoglycemia - CORRECT ANSWER -B. Thyroid crisis kj kj kj kj kj kj




Thyroid crisis usually occurs in the first 12 hours after thyroidectomy and causes exaggerated signs of hyp
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erthyroidism, such as high fever, tachycardia, and extreme restlessness. Diabetic ketoacidosis is more like
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ly to produce polyuria, polydipsia, and polyphagia. Hypoglycemia is likely to produce weakness,
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,tremors, profuse perspiration, and hunger. Tetany typically causes uncontrollable muscle spasms, stridor,
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cyanosis, and possibly asphyxia.
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For the first 72 hours after thyroidectomy surgery, a nurse should assess a client for Chvostek's sign and Trouss
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eau's sign because they indicate:
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A. hypocalcemia



B. hypokalemia.



C. hypercalcemia.



D. hyperkalemia. - CORRECT ANSWER -A. hypocalcemia kj kj kj kj kj




A client who has undergone a thyroidectomy is at risk for developing hypocalcemia from inadvertent rem
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oval of or damage to the parathyroid gland. The client with hypocalcemia will exhibit a positive Chvostek's
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sign (facial muscle contraction when the facial nerve in front of the ear is tapped) and a positive Troussea
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u's sign (carpal spasm when a blood pressure cuff is inflated for a few minutes). These signs aren't present
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with hypercalcemia, hypokalemia, or hyperkalemia.
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Parathyroid hormone (PTH) has which effects on the kidney? kj kj kj kj kj kj kj kj




A. Stimulation of calcium reabsorption and phosphate excretion kj kj kj kj kj kj




B. Stimulation of calcium reabsorption and phosphate excretion kj kj kj kj kj kj




C. Increased absorption of vitamin D and excretion of vitamin E kj kj kj kj kj kj kj kj kj

, D. Increased absorption of vitamin E and excretion of vitamin D - CORRECT ANSWER -
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A. Stimulation of calcium reabsorption and phosphate excretion
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PTH stimulates the kidneys to reabsorb calcium and excrete phosphate and converts vitamin D to its active
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form, 1,25-dihydroxyvitamin D. PTH doesn't have a role in the metabolism of vitamin E.
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Evaluation of an adult client reveals oversecretion of growth hormone. Which of the following would the nurse
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expect to find?
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A. Excessive urine output kj kj




B, Constant thirst
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C. Weight loss kj




D. Bulging forehead - CORRECT ANSWER -D. Bulging forehead
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Oversecretion of growth hormone in an adult results in acromegaly, manifested by coarse features, a hug
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e lower jaw, thick lips, thickened tongue, a bulging forehead, bulbous nose, and large hands and feet. Exc
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essive urine output, weight loss, and constant thirst are associated with diabetes insipidus.
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A nurse is providing care to a client with primary hyperparathyroidism. Which interventions would be inclu
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ded in the client's care plan? Select all that apply.
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A. Monitor gait, balance, and fatigue level with ambulation.
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B. Encourage intake of dairy products, seafood, nuts, broccoli, and spinach.
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