Saunders NCLEX Endocrine
A 33-year-old female client is admitted to the hospital with a tentative diagnosis of
Graves' disease. Which symptom related to the menstrual cycle would the client be
most likely to report during the initial assessment?
1.
Amenorrhea
2.
Menorrhagia
3.
Metrorrhagia
4.
Dysmenorrhea - ANS-Amenorrhea
Amenorrhea or a decreased menstrual flow occurs in the client with Graves' disease.
Menorrhagia, metrorrhagia, and dysmenorrhea are also disorders related to the
female reproductive system; however, they are not typical manifestations of Graves'
disease.
\A client arrives in the hospital emergency department complaining of severe thirst
and polyuria. The client tells the nurse that she has a history of diabetes mellitus. A
blood glucose level is drawn, and the result is 685 mg/dL (39.1 mmol/L). Which
intervention should the nurse anticipate to be prescribed initially for the client?
1.
Glyburide via the oral route
2.
Glucagon via the subcutaneous route
3.
Insulin aspart via the subcutaneous route
4.
Regular insulin via the intravenous (IV) route - ANS-Regular insulin via the
intravenous (IV) route
The client is most likely in diabetic ketoacidosis (DKA). Regular insulin via the IV
route is the preferred treatment for DKA. Regular insulin is a short-acting insulin and
can be given intravenously; it is titrated to the client's high blood glucose levels.
Glucagon is used to treat hypoglycemia, and glyburide is an oral hypoglycemic agent
used to treat type 2 diabetes mellitus. Insulin aspart is a short-acting insulin and is
not appropriate for the emergency treatment of DKA.
,\A client arrives in the hospital emergency department in an unconscious state. As
reported by the spouse, the client has diabetes mellitus and began to show
symptoms of hypoglycemia. A blood glucose level is obtained for the client, and the
result is 40 mg/dL (2.28 mmol/L). Which medication should the nurse anticipate will
be prescribed for the client?
1.
Glucagon
2.
Glyburide
3.
Metformin
4.
Regular insulin - ANS-Glucagon
A blood glucose level lower than 50 mg/dL (2.85 mmol/L) is considered to be
critically low. Glucagon is used to treat hypoglycemia because it increases blood
glucose levels. Insulin would lower the client's blood glucose and would not be an
appropriate treatment for hypoglycemia. Glyburide and metformin are oral
hypoglycemic agents used to treat type 2 diabetes mellitus and would not be given to
a client with hypoglycemia. In addition, an oral medication would not be administered
to an unconscious client.
\A client has a tumor that is interfering with the function of the hypothalamus. The
nurse should monitor for signs and symptoms related to which imbalance?
1.
Melatonin excess or deficit
2.
Glucocorticoid excess or deficit
3.
Mineralocorticoid excess or deficit
4.
Antidiuretic hormone (ADH) excess or deficit - ANS-Antidiuretic hormone (ADH)
excess or deficit
The hypothalamus exerts an influence on both the anterior and the posterior pituitary
gland. Abnormalities can result in excess or deficit of substances normally mediated
by the pituitary. ADH could be affected by disease of the hypothalamus because the
hypothalamus produces ADH and stores it in the posterior pituitary gland. The pineal
gland is responsible for melatonin production. The adrenal cortex is responsible for
the production of glucocorticoids and mineralocorticoids
,\A client has abnormal amounts of circulating thyronine (T3) and thyroxine (T4).
While obtaining the health history, the nurse asks the client about dietary intake.
Lack of which dietary element is most likely the cause?
1.
Iodine
2.
Calcium
3.
Phosphorus
4.
Magnesium - ANS-Iodine
\A client has been diagnosed with Cushing's syndrome. The nurse should assess the
client for which expected manifestations of this disorder?
1.
Dizziness
2.
Weight loss
3.
Hypoglycemia
4.
Truncal obesity - ANS-Truncal obesity
The client with Cushing's syndrome may exhibit a number of different manifestations.
These may include moon face, truncal obesity, and a "buffalo hump" fat pad. Other
signs include hyperglycemia, hypernatremia, hypocalcemia, peripheral edema,
hypertension, increased appetite, and weight gain. Dizziness is not part of the clinical
picture for this disorder.
\A client has been diagnosed with hyperthyroidism. The nurse monitors for which
signs and symptoms indicating a complication of this disorder? Select all that apply.
1.
Fever
2.
Nausea
3.
Lethargy
4.
Tremors
5.
Confusion
, 6.
Bradycardia - ANS-1.
Fever
2.
Nausea
4.
Tremors
5.
Confusion
Thyroid storm is an acute and life-threatening complication that occurs in a client
with uncontrollable hyperthyroidism. Signs and symptoms of thyroid storm include
elevated temperature (fever), nausea, and tremors. In addition, as the condition
progresses, the client becomes confused. The client is restless and anxious and
experiences tachycardia.
\A client has been diagnosed with pheochromocytoma. Which clinical manifestation
is most indicative of this condition?
1.
Water loss
2.
Bradycardia
3.
Hypertension
4.
Decreased cardiac output - ANS-Hypertension
The client with pheochromocytoma has a benign or malignant tumor in the adrenal
medulla. Because the medulla secretes epinephrine and norepinephrine, the client
will exhibit signs related to excesses of these catecholamines, including tachycardia,
increased cardiac output, and increased blood pressure. Vasoconstriction of the
renal arteries triggers the renin-angiotensin system, resulting in water reabsorption
and retention.
\A client has been hospitalized for an endocrine system dysfunction of the pancreas.
The registered nurse asks the new orientee nurse what kind of problem a client
hospitalized for endocrine dysfunction of the pancreas would expect. The new
orientee nurse demonstrates understanding if which statement is made?
1.
"Lipase levels will decrease."
2.
"Insulin production will be decreased."
3.
A 33-year-old female client is admitted to the hospital with a tentative diagnosis of
Graves' disease. Which symptom related to the menstrual cycle would the client be
most likely to report during the initial assessment?
1.
Amenorrhea
2.
Menorrhagia
3.
Metrorrhagia
4.
Dysmenorrhea - ANS-Amenorrhea
Amenorrhea or a decreased menstrual flow occurs in the client with Graves' disease.
Menorrhagia, metrorrhagia, and dysmenorrhea are also disorders related to the
female reproductive system; however, they are not typical manifestations of Graves'
disease.
\A client arrives in the hospital emergency department complaining of severe thirst
and polyuria. The client tells the nurse that she has a history of diabetes mellitus. A
blood glucose level is drawn, and the result is 685 mg/dL (39.1 mmol/L). Which
intervention should the nurse anticipate to be prescribed initially for the client?
1.
Glyburide via the oral route
2.
Glucagon via the subcutaneous route
3.
Insulin aspart via the subcutaneous route
4.
Regular insulin via the intravenous (IV) route - ANS-Regular insulin via the
intravenous (IV) route
The client is most likely in diabetic ketoacidosis (DKA). Regular insulin via the IV
route is the preferred treatment for DKA. Regular insulin is a short-acting insulin and
can be given intravenously; it is titrated to the client's high blood glucose levels.
Glucagon is used to treat hypoglycemia, and glyburide is an oral hypoglycemic agent
used to treat type 2 diabetes mellitus. Insulin aspart is a short-acting insulin and is
not appropriate for the emergency treatment of DKA.
,\A client arrives in the hospital emergency department in an unconscious state. As
reported by the spouse, the client has diabetes mellitus and began to show
symptoms of hypoglycemia. A blood glucose level is obtained for the client, and the
result is 40 mg/dL (2.28 mmol/L). Which medication should the nurse anticipate will
be prescribed for the client?
1.
Glucagon
2.
Glyburide
3.
Metformin
4.
Regular insulin - ANS-Glucagon
A blood glucose level lower than 50 mg/dL (2.85 mmol/L) is considered to be
critically low. Glucagon is used to treat hypoglycemia because it increases blood
glucose levels. Insulin would lower the client's blood glucose and would not be an
appropriate treatment for hypoglycemia. Glyburide and metformin are oral
hypoglycemic agents used to treat type 2 diabetes mellitus and would not be given to
a client with hypoglycemia. In addition, an oral medication would not be administered
to an unconscious client.
\A client has a tumor that is interfering with the function of the hypothalamus. The
nurse should monitor for signs and symptoms related to which imbalance?
1.
Melatonin excess or deficit
2.
Glucocorticoid excess or deficit
3.
Mineralocorticoid excess or deficit
4.
Antidiuretic hormone (ADH) excess or deficit - ANS-Antidiuretic hormone (ADH)
excess or deficit
The hypothalamus exerts an influence on both the anterior and the posterior pituitary
gland. Abnormalities can result in excess or deficit of substances normally mediated
by the pituitary. ADH could be affected by disease of the hypothalamus because the
hypothalamus produces ADH and stores it in the posterior pituitary gland. The pineal
gland is responsible for melatonin production. The adrenal cortex is responsible for
the production of glucocorticoids and mineralocorticoids
,\A client has abnormal amounts of circulating thyronine (T3) and thyroxine (T4).
While obtaining the health history, the nurse asks the client about dietary intake.
Lack of which dietary element is most likely the cause?
1.
Iodine
2.
Calcium
3.
Phosphorus
4.
Magnesium - ANS-Iodine
\A client has been diagnosed with Cushing's syndrome. The nurse should assess the
client for which expected manifestations of this disorder?
1.
Dizziness
2.
Weight loss
3.
Hypoglycemia
4.
Truncal obesity - ANS-Truncal obesity
The client with Cushing's syndrome may exhibit a number of different manifestations.
These may include moon face, truncal obesity, and a "buffalo hump" fat pad. Other
signs include hyperglycemia, hypernatremia, hypocalcemia, peripheral edema,
hypertension, increased appetite, and weight gain. Dizziness is not part of the clinical
picture for this disorder.
\A client has been diagnosed with hyperthyroidism. The nurse monitors for which
signs and symptoms indicating a complication of this disorder? Select all that apply.
1.
Fever
2.
Nausea
3.
Lethargy
4.
Tremors
5.
Confusion
, 6.
Bradycardia - ANS-1.
Fever
2.
Nausea
4.
Tremors
5.
Confusion
Thyroid storm is an acute and life-threatening complication that occurs in a client
with uncontrollable hyperthyroidism. Signs and symptoms of thyroid storm include
elevated temperature (fever), nausea, and tremors. In addition, as the condition
progresses, the client becomes confused. The client is restless and anxious and
experiences tachycardia.
\A client has been diagnosed with pheochromocytoma. Which clinical manifestation
is most indicative of this condition?
1.
Water loss
2.
Bradycardia
3.
Hypertension
4.
Decreased cardiac output - ANS-Hypertension
The client with pheochromocytoma has a benign or malignant tumor in the adrenal
medulla. Because the medulla secretes epinephrine and norepinephrine, the client
will exhibit signs related to excesses of these catecholamines, including tachycardia,
increased cardiac output, and increased blood pressure. Vasoconstriction of the
renal arteries triggers the renin-angiotensin system, resulting in water reabsorption
and retention.
\A client has been hospitalized for an endocrine system dysfunction of the pancreas.
The registered nurse asks the new orientee nurse what kind of problem a client
hospitalized for endocrine dysfunction of the pancreas would expect. The new
orientee nurse demonstrates understanding if which statement is made?
1.
"Lipase levels will decrease."
2.
"Insulin production will be decreased."
3.
