Chapter 11: Care of the Patient with an Endocrine Disorder

Chapter 11: Care of the Patient with an Endocrine Disorder


MULTIPLE CHOICE

1. The nurse explains that the negative feedback system controls hormone release by
communication between:
a.the pituitary and the target organ.
b.the thymus and the blood stream.
c.lymphatic system and the target organ.
d.central nervous system and the blood stream.
ANS: A
The amount of hormone released is controlled by a negative feedback system. When the level
of the particular hormone is appropriate, the target organ signals the pituitary to stop the
stimulation of the target organ.

DIF: Cognitive Level: Implementation REF: Page 500 OBJ: 2
TOP: Anatomy KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

2. Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the
previous 8 to 12 weeks?
a. Fasting blood sugar (FBS)
b. Oral glucose tolerance test (OGT)
c. Glycosylated hemoglobin (HbA1c)
d. Postprandial glucose test (PPBG)
ANS: C
Glycosylated hemoglobin (HbA1c)—This blood test measures the amount of glucose that has
become incorporated into the hemoglobin within an erythrocyte. Because glycosylation occurs
constantly during the 120-day life span of the erythrocyte, this test reveals the effectiveness of
diabetes therapy for the preceding 8 to 12 weeks.

DIF: Cognitive Level: Knowledge REF: Page 539, Box 11-2
OBJ: 8 TOP: Glucose monitoring
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

3. Which test will furnish immediate feedback for a newly diagnosed diabetic who is not yet
under control?
a. Fasting blood sugar (FBS)
b. Glycosylated hemoglobin (HgbA1c)
c. Oral glucose tolerance test (OGTT)
d. Clinitest
ANS: A
Diabetics should do a fingerstick blood glucose level test before each meal and at bedtime
each day until their disease is under control. The HgbA1c serum test reveals the effectiveness
of diabetes therapy for the preceding 8 to 12 weeks.

DIF: Cognitive Level: Comprehension REF: Page 539, Box 11-2
OBJ: 9 TOP: Diabetes mellitus

, KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

4. To which diet should a patient with Cushing syndrome adhere?
a. Less sodium
b. More calories
c. Less potassium
d. More carbohydrates
ANS: A
The diet should be lower in sodium to help decrease edema.

DIF: Cognitive Level: Analysis REF: Page 524, Table 11-3
OBJ: 5 TOP: Cushing syndrome
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

5. The patient is a 20-year-old college student who has type 1 diabetes and normally walks each
evening as part of an exercise regimen. The patient plans to enroll in a swimming class.
Which adjustment should be made based on this information?
a. Time the morning insulin injection so that the peak action will occur during
swimming class.
b. Delete normal walks on swimming class days.
c. Delay the meal before the swimming class until the session is over.
d. Monitor glucose level before, during, and after swimming to determine the need
for alterations in food or insulin.
ANS: D
Exercise can reduce insulin resistance and increase glucose uptake for as long as 72 hours, as
well as reducing blood pressure and lipid levels. However, exercise can carry some risks for
patients with diabetes, including hypoglycemia.

DIF: Cognitive Level: Analysis REF: Page 530 OBJ: 11
TOP: Diabetes mellitus KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity

6. What is a long-term complication of diabetes mellitus?
a. Diverticulitis
b. Renal failure
c. Hypothyroidism
d. Hyperglycemia
ANS: B
Long-term complications of diabetes include blindness, cardiovascular problems, and renal
failure.

DIF: Cognitive Level: Analysis REF: Page 538 OBJ: 15
TOP: Diabetes mellitus KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

7. A patient has returned to his room after a thyroidectomy with signs of thyroid crisis. During
thyroid crisis, exaggerated hyperthyroid manifestations may lead to the development of the
potentially lethal complication of:
a. severe nausea and vomiting.

, b. bradycardia.
c. delirium with restlessness.
d. congestive heart failure.
ANS: D
In thyroid crisis, all the signs and symptoms of hyperthyroidism are exaggerated. The patient
may develop congestive heart failure and die.

DIF: Cognitive Level: Analysis REF: Page 513 OBJ: 7
TOP: Thyroidectomy KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

8. In diabetes insipidus, a deficiency of which hormone causes clinical manifestations?
a. antidiuretic hormone (ADH)
b. follicle-stimulating hormone (FSH)
c. thyroid-stimulating hormone (TSH)
d. adrenocorticotropic hormone (ACTH)
ANS: A
Diabetes insipidus is a transient or permanent metabolic disorder of the posterior pituitary in
which ADH is deficient.

DIF: Cognitive Level: Knowledge REF: Page 507 OBJ: 5
TOP: Diabetes insipidus KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

9. What is an appropriate nursing diagnosis for a patient who has recently been diagnosed with
acromegaly?
a. Ineffective coping
b. Activity intolerance
c. Risk for trauma
d. Chronic low self-esteem
ANS: C
Nursing interventions are mainly supportive. The presence of muscle weakness, joint pain, or
stiffness warrants assessment of the ability to perform activities of daily living (ADLs).

DIF: Cognitive Level: Analysis REF: Page 503 OBJ: 5
TOP: Acromegaly KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment

10. The purpose of the use of radioactive iodine in the treatment of hyperthyroidism is to:
a. stimulate the thyroid gland.
b. depress the pituitary.
c. destroy some of the thyroid tissue.
d. alter the stimulus from the pituitary.
ANS: C
Radioactive iodine 131 destroys some of the hyperactive thyroid gland to produce a more
normally functioning gland.

DIF: Cognitive Level: Application REF: Page 511, Box 11-1
OBJ: 5 TOP: Radioactive iodine 131