ATI Med-Surg Endocrine TEST QUESTIONS WITH 100% CORRECT ANSWERS 2023

A nurse is planning care for a client who is experiencing the Somogyi effect and takes intermittent-acting insulin. Which of the following actions should the nurse include in the plan? A) Move the evening intermediate-acting dose to 90 min. before dinner B) Increase the client's morning caloric intake C) Omit the client's evening snack D) Monitor the client's nighttime blood glucose levels - ANSWER D) Monitor the client's nighttime blood glucose levels The Somogyi effect describes a high blood glucose level in the morning after an extremely low blood glucose level during the night. This swing is caused by the release of stress hormones to counter low glucose levels. Monitoring the client's nighttime blood glucose levels over time can provide an accurate diagnosis of the Somogyi effect. A nurse is caring for a client who is postoperative following a bilateral adrenalectomy. The nurse should expect to administer glucocorticoids following the procedure to enhance which of the following therapeutic effects? A) Compensation for decreased cortisol levels B) Inhibition of glucose metabolism C) Diuretic action to maintain urine output D) Decreased susceptibility to infection - ANSWER A) Compensation for decreased cortisol levels A client who has an adrenalectomy requires glucocorticoids before, during, and after surgery to prevent an adrenal crisis caused by a sudden drop in cortisol levels. The adrenal glands produce several hormones including cortisol, a glucocorticoid. Loss of glucocorticoid secretion leads to a state of altered metabolism and an inability to deal with stressors; if untreated, this can be fatal.