NCLEX Review: Practice Questions and Rationales

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Endocrinei NCLEXi Practicei Questionsi

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1. Which of the following assessment findings characterize thyroid storm?
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a) increasedi bodyi temperature,i decreasedi pulse,i andi increasedi bloodi pres-i surei


b) increased body temperature, increased pulse, and increased blood pres- sure
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c) increasedi bodyi temperature,i decreasedi pulse,i andi decreasedi bloodi pres-i surei


d) increased body temperature, increased pulse, and decreased blood pres- sure: b) increased body temperature, increased pulse,
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andi increasedi bloodi pres-i surei



Thyroidi stormi isi characterizedi byi SNSi activation.i Thyroidi hormonesi potentiatei effectsi ofi cathecolaminesi


(epinephrine/norepinephrine).i Therefore,i alli vitali signsi willi bei increased.i



2. The nurse is planning care for a client with hyperthyroidism. Which of the following nursing interventions are appropriate? Select
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alli thati applyi




a) instilli isotonici eyei dropsi asi necessaryi


b) provide several, small, well-balanced meals
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, c) providei resti periodsi


d) keep environment warm
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e) encouragei frequenti visitorsi andi conversationi


f) weighi thei clienti daily:i a,i b,i c,i andi fi



(a)i Thei clienti withi hyperthyroidismi mayi experiencei exopthalmos.i Thisi requiresi instillationi ofi eyei dropsi toi preventi drynessi andi


ulcerationi ofi thei cornea.i



(bi andi f)i Thei clienti experiencesi weighti lossi becausei ofi hypermetabolism.i Several,i small,i well-balancedi mealsi arei giveni toi


improvei nutritionali statusi ofi thei clienti andi dailyi weightsi shouldi bei monitored.i Weighti isi thei mosti objectivei indicatori ofi


nutritionali status.i



(c)i Thei clienti isi usuallyi exhaustedi duei toi restlessnessi andi agitation.i Frequenti resti periodsi helpi thei clienti regaini energy.i



3. After thyroidectomy, which of the following is the priority assessment to observe laryngeal nerve damage?
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a) hoarseness of voice
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b) difficulty in swallowing i i i




c) tetanyi


d) fever: a) hoarseness of voice
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Laryngeali nervei damagei isi manifestedi byi severei hoarsenessi ofi voicei ofi "whisperyi voice".i


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4. When caring for a male client with diabetes insipidus, nurse Juliet expects to administer:
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a. vasopressin (Pitressin Synthetic)
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b. furosemide (Lasix). i i




c. regular insulin. i i




d. 10% dextrose.: a. vasopressin (Pitressin Synthetic)
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Becausei diabetesi insipidusi resultsi fromi decreasedi antidiuretici hormonei (vaso-i pressin)i production,i thei nursei shouldi expecti toi


administeri synthetici vasopressini fori hormonei replacementi therapy.i Furosemide,i ai diuretic,i isi contraindicatedi becausei ai clienti withi


diabetesi insipidusi experiencesi polyuria.i Insulini andi dextrosei arei usedi toi treati diabetesi mellitusi andi itsi complications,i noti diabetesi


insipidus.i



5. Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect
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toi find:i



a. Hypotension. i




b. Thick, coarse skin.
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c. Deposits of adipose tissue in the trunk and dorsocervical area.
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d. Weight gain in arms and legs.: c. Deposits of adipose tissue in the trunk and dorsocervical area
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, Becausei ofi changesi ini fati distribution,i adiposei tissuei accumulatesi ini thei trunk,i facei (moonface),i andi dorsocervicali areasi (buffaloi


hump).i Hypertensioni isi causedi byi fluidi retention.i Skini becomesi thini andi bruisesi easilyi becausei ofi ai lossi ofi collagen.i Musclei wastingi


causesi musclei atrophyi andi thini extremities.i



6. i Fori thei firsti 72i hoursi afteri thyroidectomyi surgery,i nursei Jamiei wouldi as-i sessi thei femalei clienti fori Chvostek'si signi andi


Trousseau'si signi becausei theyi indicatei whichi ofi thei following?i



a. Hypocalcemia i




b. Hypercalcemia i




c. Hypokalemia i




d. Hyperkalemia: a. Hypocalcemia i i i




Thei clienti whoi hasi undergonei ai thyroidectomyi isi ati riski fori developingi hypocal-i cemiai fromi inadvertenti removali ori damagei toi thei


parathyroidi gland.i Thei clienti withi




hypocalcemiai willi exhibiti ai positivei Chvostek'si signi (faciali musclei contractioni wheni thei faciali nervei ini fronti ofi thei eari isi tapped)i andi


ai positivei Trousseau'si signi (carpali spasmi wheni ai bloodi pressurei cuffi isi inflatedi fori ai fewi minutes).i Thesei signsi aren'ti presenti withi


hypercalcemia,i hypokalemia,i ori hyperkalemia.i



7. An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad.
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Physicali andi laboratoryi find-i ingsi reveali hypothermia,i hypoventilation,i respiratoryi acidosis,i bradycardia,i hypotension,i andi




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