COMPREHENSIVE REVIEW FOR THE NCLEX-RN EXAM MED-SURG ENDOCRINE WITH VERIFIED SOLUTIONS

1. What diagnostic test is used to determine thyroid activity? 1. T3, T4 2. What condition results from all txs for hyperthyroidism? 2. Hypothyroidism, requiring thyroid replacement. 3. Stat 3 symptoms of hyperthyroidism and 3 symptoms of hypothyroidism. 3. Hyperthyroidism: weight loss, heat intolerance, diarrhea. Hypothyroidism: fatigue, cold intolerance, weight gain. 4. List 5 important teaching aspects for clients who are beginning corticosteroid therapy. 4. Continue medication until weaning plan is begun by physician, monitor serm K, glucose, and Na frequently; weigh daily, and report gain of >5lb/wk; monitor BP and pulse closely; teach symptoms of Cushing's syndrome. 5. Describe the physical appearance of clients who are Cushinoid. 5. Moon fae, obesity in trunk, buffalo hump in back, muscle atrophy, and thin skin. 6. Which type of diabetic always requires insulin replacement? 6. Type I, Insulin-dependent diabetes mellitus (IDDM). 7. what type of diabetic sometimes requires no medication? 7. Type II, Non-insulin-dependent diabetes mellitus (NIDDM) 8. List 5 symptoms of hyperglycemia. 8. Polydipsia, polyuria, polyphagia, weakness, weight loss 9. List 5 symptoms of hypoglycemia. 9. Hunger, lethargy, confusion, tremors or shakes, sweating 10. Name the necessary elements to include in teaching the new diabetic. 10. Teach the underlying pathophysiology of the disease, its management/tx regime, meal planning, exercise program, insulin administration, sick-day management, symptoms of hyperglycemia (not enough insulin), symptoms of hypoglycemia (too much insulin, too much exercise; not enough food) 11. In less then 10 steps, describe the method for drawing up a mixed dose of insulin (regular with NPH). 11. identify the prescribed dose/type of insulin per physician order; Store unopened insulin in refrigerator. If opened, may be kept at room temperature for up to 3 months. Draw up regular insulin FIRST; Rotate injection sites; May re-use syringe by recapping and storing in refrigerator. 12. Identify the peak action times of the following types of insulin: rapid-acting, regular insulin, intermediate-acting, long-acting. 12. Rapid-acting regular insulin: 2 to 4 hrs. Immediate-acting: 6 to 12 hrs. Long-acting 14 to 20 hrs. 13. Wen preparing the diabetic for discharge, the nurse teaches the client the relationship b/w stress, exercise, bedtime snacking, and glucose balance. State the relationship b/w each of these. 13. Stress and stress hormones usually increase glucose production and increase insulin need; exercise can increase the change for an insulin reaction, therefore, the client should always have a sugar snack available when exercising (to treat hypoglycemia); bedtime snacking can prevent insulin reactions while waiting for long-acting insulin to peak. 14. When making rounds at night, the nurse notes than an insulin-dependent client is complaining of H/A, slight nausea, and minimal trembling. The client's hand is cool and moist. What is the client most likely experiencing? 14. Hypoglycemia/insulin reaction. 15. Identify 5 foot-care intervention that should be taught to the diabetic client. 15. Check feet daily and report any breaks, sores or blisters to HCP, wear well-fitting shoes; never go barefoot or wear sandals; never personally remove corns or calluses; cut or file nails straight