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EDAPT: Nursing Care: Complex
Gastrointestinal and Endocrine Alterations
Questions and Answers Latest Update
The nurse is caring for a client with a small gastrointestinal (GI) bleed from
a peptic ulcer. The nurse should anticipate which stool characteristic? Ans:
Melena
A client with hypothyroidism after a thyroidectomy is seen in the emergency
department after stopping levothyroxine therapy last year. Which
assessment finding could the nurse anticipate? Ans: Decreased level of
consciousness progressing to coma.
A nurse is admitting a client with a history of Addison's disease who is to
undergo a total hip arthroplasty. Which action is most likely to prevent
acute adrenal insufficiency? Ans: Administer a supplemental dose of
intravenous (IV) hydrocortisone before surgery.
A client is seen in the emergency department with bright red, profuse
hematemesis. Which action is the nurse's initial priority? Ans: Perform a
focused nursing assessment of the client's status.
After initial treatment of the client with profuse bright-red hematemesis,
which laboratory finding indicates that management has been effective?
Ans: Blood urea nitrogen (BUN) decreased from 40 to 25 mg/dL
Match each disease process to the appropriate treatment. Ans: Esophageal
varices - Balloon tamponade is used to place direct pressure on the site of
bleeding.
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, 2 | Page
Gastric ulcer - Pantoprazole is used to reduce acid secretions in the
prevention of this stress-related complication.
Mallory-Weiss syndrome - Surgical intervention is required to repair this
arterial tear.
The nurse is caring for a client admitted to the intensive care unit in
Addisonian crisis. Which laboratory assessment findings are anticipated?
Select all that apply. Ans: Potassium 6.1 mEq/L
Sodium 130 mEq/L
Glucose 50 mg/dL
Tachycardia
pH 7.28
Bicarbonate (HCO3-) 18 mEq/L
A nurse is caring for a client who was diagnosed with thyroid cancer and
underwent a thyroidectomy 12 hours ago. Which findings are indicative of
acute thyrotoxicosis? Select all that apply. Ans: Hyperthermia
Mental confusion
Dyspnea
Linda Shapiro (pronouns: they/them/theirs), a 32-year-old client, was
recently diagnosed with Addison's disease after seeking care for increasing
weakness, fatigue, and weight loss.
Which assessment findings are consistent with the client's diagnosis? Select
all that apply. Ans: Hyponatremia
Tachycardia
© 2025 All rights reserved
, 3 | Page
Hyperpigmentation of the skin
Hypoglycemia
Today, the nurse attempted to reach Linda for a follow-up call regarding
their recent diagnosis. The nurse was informed that Linda was in the
emergency department after a syncopal episode this morning. The nurse
recognizes which is the greatest threat to the client with adrenal
insufficiency? Ans: Blood pressure 72/50
Linda's vital signs are BP 98/60 (lying), BP 80/58 (standing), P 115, T 99 °F
(37.2 °C), RR 26. Distal pulses are +1 bilaterally and the extremities are cool.
The client reports extreme dizziness when standing, excessive thirst, and
fatigue. The diagnosis is acute adrenal insufficiency. Which is the priority
concern for this client? Ans: Hypovolemic shock and decreased cardiac
output.
After assessment, the nurse begins to plan care for the client. Which
prescriptions are anticipated in the initial management of an adrenal crisis?
Select all that apply. Ans: Dextrose 5% in normal saline
Intravenous hydrocortisone
Intravenous regular insulin
Clients with Addison's disease are continually at risk for acute adrenal
insufficiency (adrenal crisis). Which teaching is required prior to discharge
to prevent future problems? Select all that apply. Ans: Abruptly
discontinuing hormone therapy can trigger an adrenal crisis.
Lifelong replacement therapy of adrenal hormones is required.
Nausea and vomiting are indications of an adrenal crisis.
After initial management of the adrenal crisis, which laboratory values
indicate that the client is responding to treatment? Select if the laboratory
© 2025 All rights reserved
EDAPT: Nursing Care: Complex
Gastrointestinal and Endocrine Alterations
Questions and Answers Latest Update
The nurse is caring for a client with a small gastrointestinal (GI) bleed from
a peptic ulcer. The nurse should anticipate which stool characteristic? Ans:
Melena
A client with hypothyroidism after a thyroidectomy is seen in the emergency
department after stopping levothyroxine therapy last year. Which
assessment finding could the nurse anticipate? Ans: Decreased level of
consciousness progressing to coma.
A nurse is admitting a client with a history of Addison's disease who is to
undergo a total hip arthroplasty. Which action is most likely to prevent
acute adrenal insufficiency? Ans: Administer a supplemental dose of
intravenous (IV) hydrocortisone before surgery.
A client is seen in the emergency department with bright red, profuse
hematemesis. Which action is the nurse's initial priority? Ans: Perform a
focused nursing assessment of the client's status.
After initial treatment of the client with profuse bright-red hematemesis,
which laboratory finding indicates that management has been effective?
Ans: Blood urea nitrogen (BUN) decreased from 40 to 25 mg/dL
Match each disease process to the appropriate treatment. Ans: Esophageal
varices - Balloon tamponade is used to place direct pressure on the site of
bleeding.
© 2025 All rights reserved
, 2 | Page
Gastric ulcer - Pantoprazole is used to reduce acid secretions in the
prevention of this stress-related complication.
Mallory-Weiss syndrome - Surgical intervention is required to repair this
arterial tear.
The nurse is caring for a client admitted to the intensive care unit in
Addisonian crisis. Which laboratory assessment findings are anticipated?
Select all that apply. Ans: Potassium 6.1 mEq/L
Sodium 130 mEq/L
Glucose 50 mg/dL
Tachycardia
pH 7.28
Bicarbonate (HCO3-) 18 mEq/L
A nurse is caring for a client who was diagnosed with thyroid cancer and
underwent a thyroidectomy 12 hours ago. Which findings are indicative of
acute thyrotoxicosis? Select all that apply. Ans: Hyperthermia
Mental confusion
Dyspnea
Linda Shapiro (pronouns: they/them/theirs), a 32-year-old client, was
recently diagnosed with Addison's disease after seeking care for increasing
weakness, fatigue, and weight loss.
Which assessment findings are consistent with the client's diagnosis? Select
all that apply. Ans: Hyponatremia
Tachycardia
© 2025 All rights reserved
, 3 | Page
Hyperpigmentation of the skin
Hypoglycemia
Today, the nurse attempted to reach Linda for a follow-up call regarding
their recent diagnosis. The nurse was informed that Linda was in the
emergency department after a syncopal episode this morning. The nurse
recognizes which is the greatest threat to the client with adrenal
insufficiency? Ans: Blood pressure 72/50
Linda's vital signs are BP 98/60 (lying), BP 80/58 (standing), P 115, T 99 °F
(37.2 °C), RR 26. Distal pulses are +1 bilaterally and the extremities are cool.
The client reports extreme dizziness when standing, excessive thirst, and
fatigue. The diagnosis is acute adrenal insufficiency. Which is the priority
concern for this client? Ans: Hypovolemic shock and decreased cardiac
output.
After assessment, the nurse begins to plan care for the client. Which
prescriptions are anticipated in the initial management of an adrenal crisis?
Select all that apply. Ans: Dextrose 5% in normal saline
Intravenous hydrocortisone
Intravenous regular insulin
Clients with Addison's disease are continually at risk for acute adrenal
insufficiency (adrenal crisis). Which teaching is required prior to discharge
to prevent future problems? Select all that apply. Ans: Abruptly
discontinuing hormone therapy can trigger an adrenal crisis.
Lifelong replacement therapy of adrenal hormones is required.
Nausea and vomiting are indications of an adrenal crisis.
After initial management of the adrenal crisis, which laboratory values
indicate that the client is responding to treatment? Select if the laboratory
© 2025 All rights reserved
