Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 979
Chapter 52: Assessment and Management of Patients with Endocrine
Disorders
1. The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimotos thyroiditis.
When assessing this patient, what sign or symptom would the nurse expect?
A) Fatigue
B) Bulging eyes
C) Palpitations
D) Flushed skin
Ans: A
Feedback:
Symptoms of hypothyroidism include extreme fatigue, hair loss, brittle nails, dry skin, voice huskiness
or hoarseness, menstrual disturbance, and numbness and tingling of the fingers. Bulging eyes,
palpitations, and flushed skin would be signs and symptoms of hyperthyroidism.
2. A patient has been admitted to the post-surgical unit following a thyroidectomy. To promote comfort and
safety, how should the nurse best position the patient?
A) Side-lying (lateral) with one pillow under the head
B) Head of the bed elevated 30 degrees and no pillows placed under the head
C) Semi-Fowlers with the head supported on two pillows
D) Supine, with a small roll supporting the neck
Ans: C
Feedback:
When moving and turning the patient, the nurse carefully supports the patients head and avoids tension
on the sutures. The most comfortable position is the semi-Fowlers position, with the head elevated and
supported by pillows.
3. A patient with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has
been removed. The nurse caring for the patient should prioritize what question when addressing
,Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 980
potential complications?
A) Do you feel any muscle twitches or spasms?
B) Do you feel flushed or sweaty?
C) Are you experiencing any dizziness or lightheadedness?
D) Are you having any pain that seems to be radiating from your bones?
Ans: A
Feedback:
As the blood calcium level falls, hyperirritability of the nerves occurs, with spasms of the hands and feet
and muscle twitching. This is characteristic of hypoparathyroidism. Flushing, diaphoresis, dizziness, and
pain are atypical signs of the resulting hypocalcemia.
4. The nurse is caring for a patient with a diagnosis of Addisons disease. What sign or symptom is most
closely associated with this health problem?
A) Truncal obesity
B) Hypertension
C) Muscle weakness
D) Moon face
Ans: C
Feedback:
Patients with Addisons disease demonstrate muscular weakness, anorexia, gastrointestinal symptoms,
fatigue, emaciation, dark pigmentation of the skin, and hypotension. Patients with Cushing syndrome
demonstrate truncal obesity, moon face, acne, abdominal striae, and hypertension.
5. The nurse is caring for a patient with Addisons disease who is scheduled for discharge. When teaching
the patient about hormone replacement therapy, the nurse should address what topic?
A) The possibility of precipitous weight gain
B) The need for lifelong steroid replacement
,Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 981
C) The need to match the daily steroid dose to immediate symptoms
D) The importance of monitoring liver function
Ans: B
Feedback:
Because of the need for lifelong replacement of adrenal cortex hormones to prevent addisonian crises,
the patient and family members receive explicit education about the rationale for replacement therapy
and proper dosage. Doses are not adjusted on a short-term basis. Weight gain and hepatotoxicity are not
common adverse effects.
6. The nurse is teaching a patient that the body needs iodine for the thyroid to function. What food would
be the best source of iodine for the body?
A) Eggs
B) Shellfish
C) Table salt
D) Red meat
Ans: C
Feedback:
The major use of iodine in the body is by the thyroid. Iodized table salt is the best source of iodine.
7. A patient is prescribed corticosteroid therapy. What would be priority information for the nurse to give
the patient who is prescribed long-term corticosteroid therapy?
A) The patients diet should be low protein with ample fat.
B) The patient may experience short-term changes in cognition.
C) The patient is at an increased risk for developing infection.
D) The patient is at a decreased risk for development of thrombophlebitis and thromboembolism.
Ans: C
Feedback:
, Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 982
The patient is at increased risk of infection and masking of signs of infection. The cardiovascular effects
of corticosteroid therapy may result in development of thrombophlebitis or thromboembolism. Diet
should be high in protein with limited fat. Changes in appearance usually disappear when therapy is no
longer necessary. Cognitive changes are not common adverse effects.
8. A nurse caring for a patient with diabetes insipidus is reviewing laboratory results. What is an expected
urinalysis finding?
A) Glucose in the urine
B) Albumin in the urine
C) Highly dilute urine
D) Leukocytes in the urine
Ans: C
Feedback:
Patients with diabetes insipidus produce an enormous daily output of very dilute, water-like urine with a
specific gravity of 1.001 to 1.005. The urine contains no abnormal substances such as glucose or
albumin. Leukocytes in the urine are not related to the condition of diabetes insipidus, but would
indicate a urinary tract infection, if present in the urine.
9. The nurse caring for a patient with Cushing syndrome is describing the dexamethasone suppression test
scheduled for tomorrow. What does the nurse explain that this test will involve?
A) Administration of dexamethasone orally, followed by a plasma cortisol level every hour for 3
hours
B) Administration of dexamethasone IV, followed by an x-ray of the adrenal glands
C) Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8 AM the next
morning
D) Administration of dexamethasone intravenously, followed by a plasma cortisol level 3 hours after
the drug is administered
Ans: C
Feedback:
Dexamethasone (1 mg) is administered orally at 11 PM, and a plasma cortisol level is obtained at 8 AM
the next morning. This test can be performed on an outpatient basis and is the most widely used and
sensitive screening test for diagnosis of pituitary and adrenal causes of Cushing syndrome.
Chapter 52: Assessment and Management of Patients with Endocrine
Disorders
1. The nurse is caring for a patient diagnosed with hypothyroidism secondary to Hashimotos thyroiditis.
When assessing this patient, what sign or symptom would the nurse expect?
A) Fatigue
B) Bulging eyes
C) Palpitations
D) Flushed skin
Ans: A
Feedback:
Symptoms of hypothyroidism include extreme fatigue, hair loss, brittle nails, dry skin, voice huskiness
or hoarseness, menstrual disturbance, and numbness and tingling of the fingers. Bulging eyes,
palpitations, and flushed skin would be signs and symptoms of hyperthyroidism.
2. A patient has been admitted to the post-surgical unit following a thyroidectomy. To promote comfort and
safety, how should the nurse best position the patient?
A) Side-lying (lateral) with one pillow under the head
B) Head of the bed elevated 30 degrees and no pillows placed under the head
C) Semi-Fowlers with the head supported on two pillows
D) Supine, with a small roll supporting the neck
Ans: C
Feedback:
When moving and turning the patient, the nurse carefully supports the patients head and avoids tension
on the sutures. The most comfortable position is the semi-Fowlers position, with the head elevated and
supported by pillows.
3. A patient with thyroid cancer has undergone surgery and a significant amount of parathyroid tissue has
been removed. The nurse caring for the patient should prioritize what question when addressing
,Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 980
potential complications?
A) Do you feel any muscle twitches or spasms?
B) Do you feel flushed or sweaty?
C) Are you experiencing any dizziness or lightheadedness?
D) Are you having any pain that seems to be radiating from your bones?
Ans: A
Feedback:
As the blood calcium level falls, hyperirritability of the nerves occurs, with spasms of the hands and feet
and muscle twitching. This is characteristic of hypoparathyroidism. Flushing, diaphoresis, dizziness, and
pain are atypical signs of the resulting hypocalcemia.
4. The nurse is caring for a patient with a diagnosis of Addisons disease. What sign or symptom is most
closely associated with this health problem?
A) Truncal obesity
B) Hypertension
C) Muscle weakness
D) Moon face
Ans: C
Feedback:
Patients with Addisons disease demonstrate muscular weakness, anorexia, gastrointestinal symptoms,
fatigue, emaciation, dark pigmentation of the skin, and hypotension. Patients with Cushing syndrome
demonstrate truncal obesity, moon face, acne, abdominal striae, and hypertension.
5. The nurse is caring for a patient with Addisons disease who is scheduled for discharge. When teaching
the patient about hormone replacement therapy, the nurse should address what topic?
A) The possibility of precipitous weight gain
B) The need for lifelong steroid replacement
,Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 981
C) The need to match the daily steroid dose to immediate symptoms
D) The importance of monitoring liver function
Ans: B
Feedback:
Because of the need for lifelong replacement of adrenal cortex hormones to prevent addisonian crises,
the patient and family members receive explicit education about the rationale for replacement therapy
and proper dosage. Doses are not adjusted on a short-term basis. Weight gain and hepatotoxicity are not
common adverse effects.
6. The nurse is teaching a patient that the body needs iodine for the thyroid to function. What food would
be the best source of iodine for the body?
A) Eggs
B) Shellfish
C) Table salt
D) Red meat
Ans: C
Feedback:
The major use of iodine in the body is by the thyroid. Iodized table salt is the best source of iodine.
7. A patient is prescribed corticosteroid therapy. What would be priority information for the nurse to give
the patient who is prescribed long-term corticosteroid therapy?
A) The patients diet should be low protein with ample fat.
B) The patient may experience short-term changes in cognition.
C) The patient is at an increased risk for developing infection.
D) The patient is at a decreased risk for development of thrombophlebitis and thromboembolism.
Ans: C
Feedback:
, Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 14e (Hinkle 2017) 982
The patient is at increased risk of infection and masking of signs of infection. The cardiovascular effects
of corticosteroid therapy may result in development of thrombophlebitis or thromboembolism. Diet
should be high in protein with limited fat. Changes in appearance usually disappear when therapy is no
longer necessary. Cognitive changes are not common adverse effects.
8. A nurse caring for a patient with diabetes insipidus is reviewing laboratory results. What is an expected
urinalysis finding?
A) Glucose in the urine
B) Albumin in the urine
C) Highly dilute urine
D) Leukocytes in the urine
Ans: C
Feedback:
Patients with diabetes insipidus produce an enormous daily output of very dilute, water-like urine with a
specific gravity of 1.001 to 1.005. The urine contains no abnormal substances such as glucose or
albumin. Leukocytes in the urine are not related to the condition of diabetes insipidus, but would
indicate a urinary tract infection, if present in the urine.
9. The nurse caring for a patient with Cushing syndrome is describing the dexamethasone suppression test
scheduled for tomorrow. What does the nurse explain that this test will involve?
A) Administration of dexamethasone orally, followed by a plasma cortisol level every hour for 3
hours
B) Administration of dexamethasone IV, followed by an x-ray of the adrenal glands
C) Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8 AM the next
morning
D) Administration of dexamethasone intravenously, followed by a plasma cortisol level 3 hours after
the drug is administered
Ans: C
Feedback:
Dexamethasone (1 mg) is administered orally at 11 PM, and a plasma cortisol level is obtained at 8 AM
the next morning. This test can be performed on an outpatient basis and is the most widely used and
sensitive screening test for diagnosis of pituitary and adrenal causes of Cushing syndrome.
