Sat, March 5, 2011 9:10:15 PM

endocrine nclex
From: Tiffany <thatcuteballerina@yahoo.com>
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To: thatcuteballerina@yahoo.com

1. For a client with hyperglycemia, which data collection finding best supports a nursing
diagnosis of Deficient fluid volume? Increased urine osmolarity

2. During the first 24 hours after a client is diagnosed with addisonian crisis, which task should
the nurse perform frequently? Assess vital signs.

3. A client is ordered to receive 20 units of isophane insulin suspension (Humulin N) and 5 units
of regular insulin (Humulin R) by subcutaneous injection. Place in chronological order the steps
to take when mixing different types of insulin in a syringe. 2,4,5,1,3,6

4. The nurse administered isophane insulin suspension (NPH) to a diabetic client at 7 a.m. At
what time would the nurse expect the client to be most at risk for a hypoglycemic reaction? 4pm

5. Following a transsphenoidal hypophysectomy, the nurse should assess the client carefully
for: hypocortisolism

6. Before undergoing a subtotal thyroidectomy, a client receives potassium iodide (Lugol's

solution) and propylthiouracil (PTU). The nurse would expect the client's symptoms to subside:
1-2 weeks

7. The nurse explains to a client that she will administer his first insulin dose in his abdomen.
How does absorption at the abdominal site compare to absorption at other sites?
Isulin is absorbed more rapidly at abdominal injection sites than at other
sites.

8. A client with type 1 diabetes must learn how to self-administer insulin. The physician has
prescribed 10 units of U-100 regular insulin and 35 units of U-100 isophane insulin suspension
(NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin
injection sites, the nurse should provide which instruction? "Rotate injection sites within the
same anatomic region, not among different regions."

9. iddle-age female complains of anxiety, insomnia, weight loss, the inability to concentrate, and
her eyes feeling "gritty." Thyroid function tests reveal the following: a thyroid-stimulating
hormone (TSH) level of 0.02 units/ml, a thyroxine level of 20 g/dl, and a triiodothyronine level of
253 ng/dl. A 6-hour radioactive iodine uptake test showed a diffuse uptake of 85%. Based on
these findings, the nurse would suspect: GRAVES DISEASE

10. A client with a tentative diagnosis of hyperosmolar hyperglycemic nonketotic syndrome

(HHNS) has a history of type 2 diabetes, which is controlled by tolazamide (Tolinase). What is
the most important laboratory test for confirming HHNS? Serum osmolarity

11. A client is transferred to a rehabilitation center after being treated in the hospital for a stroke.
Because the client has a history of Cushing's syndrome (hypercortisolism) and chronic
obstructive pulmonary disease (COPD), the nurse helps formulate a nursing diagnosis of: Risk
for impaired skin integrity related to tissue catabolism secondary to cortisol hypersecretion.

12. A client with type 1 diabetes is admitted to an acute care facility with diabetic ketoacidosis.
To correct this acute diabetic emergency, which measure should the health care team take
first? Initiate fluid replacement therapy.

13. A client is admitted to an acute care facility with a tentative diagnosis of hypoparathyroidism.
The nurse should monitor the client closely for the related problem of:
profound neuromuscular irritability.

14. A client visiting the clinic is scheduled for an outpatient thyroid scan in 2 weeks. Which
instructions should the nurse include in her client teaching to ensure that this client is prepared
for the test? 1,2,4

15. client with type 1 diabetes takes 15 units of isophane insulin suspension (Humulin N)
before breakfast and 8 units before dinner. During a follow-up visit, the nurse reevaluates the
client's knowledge about insulin therapy and self-administration skills and learns that the client
is unaware that certain over-the-counter (OTC) preparations and other medications may interact
with insulin. The nurse should advise the client to avoid which OTC preparations? Preparations
containing salicylates

16.
The nurse is instructing a client with newly diagnosed hypoparathyroidism about the regimen
used to treat this disorder. The nurse should state that the physician probably will prescribe
daily supplements of calcium and: vit D

17.
In a 28-year-old female client who is being successfully treated for Cushing's syndrome, the
nurse would expect a decline in: serum glucose level.
18.
Which outcome indicates that treatment of a client with diabetes insipidus has been effective?
Fluid intake is less than 2,500
ml/day.

19.
When collecting data on a client with pheochromocytoma, a tumor of the adrenal medulla that
secretes excessive catecholamine, the nurse is most likely to detect:
a blood pressure of 176/88 mm Hg.

20. thyroid hormone antagonist

For a client with hyperthyroidism, treatment is most likely to include:

21.
A client is evaluated for type 1 diabetes. Which client comment correlates best with this
disorder? I'm thirsty all the time. I just can't get enough to drink."

22.
A client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on
initial data collection findings, the nurse realizes the client's risk for injury is related to: bone
demineralization resulting in pathologic fractures.

23.
A client with hyperparathyroidism declines surgery and is to receive hormone replacement
therapy with estrogen and progesterone. Which instruction would be most important to include
in the client's teaching plan? Maintain a moderate exercise program.

24.
When administering spironolactone (Aldactone) to a client who has had a unilateral
adrenalectomy, the nurse should instruct the client about which possible adverse effect of the
drug? Menstrual irregularities

25. client is seen in the clinic with suspected parathormone (PTH) deficiency. Part of the
diagnosis of this condition includes the analysis of serum electrolyte levels. Which electrolyte
levels would the nurse expect to be abnormal in a client with PTH deficiency? 3,6

26.
A client with type 1 diabetes has a prescription for 5 units of U-100 regular insulin and 25 units
of U-100 isophane insulin suspension (NPH) to be taken before breakfast. At about 4:30 p.m.,
the client experiences headache, sweating, tremor, pallor, and nervousness. What is the most
probable cause of these signs and symptoms? Hypoglycemia

27.
Capillary glucose monitoring is being performed every 4 hours for a client diagnosed with
diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to
glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he
receives 8 units of regular insulin. The nurse should expect the dose's:
onset to be at 2:30 p.m. and its peak to be at 4
p.m.

28.
A client whose physical findings suggest a hyperpituitary condition undergoes an extensive
diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal
hypophysectomy. The evening before the surgery, the nurse reviews preoperative and
postoperative instructions given to the client earlier. Which postoperative instruction should the
nurse emphasize? You must avoid coughing, sneezing, and blowing your nose

29.
A client with long-standing type 1 diabetes is admitted to the hospital with unstable angina
pectoris. After the client's condition stabilizes, the nurse evaluates the diabetes management
regimen. The nurse learns that the client sees the physician every 4 weeks, injects insulin after
breakfast and dinner, and measures blood glucose before breakfast and at bedtime.
Consequently, the nurse should help formulate a nursing diagnosis of: Deficient knowledge.

30.
Which statement about fluid replacement is accurate for a client with hyperosmolar
hyperglycemic nonketotic syndrome (HHNS)? Administer 2 to 3 L of I.V. fluid over 2 to 3 hours

31..
Which of the following is an adverse reaction to glipizide (Glucotrol)?
Photosensitivit
y

32.
A client is scheduled for a transsphenoidal hypophysectomy to remove a pituitary tumor.
Preoperatively, the nurse should assess for potential complications by:
performing capillary glucose testing
frequently.

33. of the following would the nurse expect to assess in an elderly client with Hashimoto's
thyroiditis? Weight gain, decreased appetite, and constipation

34.
The nurse expects to note an elevated serum glucose level in a client with hyperosmolar
hyperglycemic nonketotic syndrome (HHNS). Which other laboratory finding should the nurse
anticipate?
Below-normal serum potassium
level

35. A 45-year-old female client is admitted to the hospital with Cushing's syndrome. Which
nursing interventions are appropriate for this client? 1,3,5

36.
A client with Cushing's syndrome is admitted to the medical-surgical unit. While collecting data,
the nurse notes that the client is agitated and irritable, has poor memory, reports loss of
appetite, and appears disheveled. These findings are consistent with which problem?
depression

37.
The nursing care for the client in addisonian crisis should perform which intervention?
Place the client in a private
room.

38.
When caring for a client who's being treated for hyperthyroidism, the nurse should:
balance the client's periods of activity and
rest.

39.
Which of the following would the nurse expect to find in a client diagnosed with
hyperparathyroidism? hypercalcemia

40.
A client is prescribed prednisone (Deltasone) daily. Which statement best explains why the
nurse should instruct the client to take this drug in the morning? Morning administration of
prednisone mimics the body's natural corticosteroid secretion pattern.

41. A 56-year-old female client is being discharged after having a thyroidectomy. Which
discharge instructions are appropriate for this client? 2,3

42.
The nurse is teaching a client with type 1 diabetes how to treat adverse reactions to insulin. To
reverse a hypoglycemic reaction, the client ideally should ingest an oral carbohydrate. However,
this treatment isn't always possible or safe. Therefore, the nurse should advise the client to
keep which alternate treatment on hand? glucagon

43.
A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone
(SIADH). Which nursing intervention is appropriate? Restricting fluids

44.
The nurse is caring for a client in acute addisonian crisis. Which laboratory data would the
nurse expect to find?
Hyperkalemia

45.
Parathyroid hormone (PTH) has which effect on the kidneys? Stimulation of calcium
reabsorption and phosphate excretion

46.
The nurse is caring for a client with type 1 diabetes who exhibits confusion, light-headedness,
and aberrant behavior. The client is still conscious. The nurse should first administer: 15 to 20 g
of a fast-acting carbohydrate such as orange juice

47. client with a serum glucose level of 618 mg/dl is admitted to the facility. He's awake and
oriented. He has hot, dry skin and the following vital signs: a temperature of 100.6° F (38.1° C),
a heart rate of 116 beats/minute, and a blood pressure of 108/70 mm Hg. Based on these
findings, which nursing diagnosis takes highest priority? def. fluid volume

48.
A client's blood glucose level is 45 mg/dl. The nurse should be alert for which signs and
symptoms? Coma, anxiety, confusion, headache, and cool, moist skin

49.
The client is being evaluated for hypothyroidism. The nurse should stay alert for:
decreased body temperature and cold
intolerance.

50.
A client with Addison's disease comes to the clinic for a follow-up visit. When collecting data on
this client, the nurse should stay alert for signs and symptoms of: NA, K abnormalities

51. A client is admitted to the hospital with signs and symptoms of diabetes mellitus. Which of
the following findings is the nurse most likely to observe in this client? 1,4,6

52.
A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-
surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl.
Which finding is most likely to accompany this blood glucose level? Rapid, thready pulse

53.
The nurse is developing a teaching plan for a client diagnosed with diabetes insipidus. The
nurse should include information about which hormone lacking in clients with diabetes
insipidus? Antidiuretic hormone (ADH)

54.
A client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O.
daily. Which finding should the nurse recognize as an adverse drug effect? tachycardia

55. instruction concerning the administration of levothyroxine (Synthroid) should the nurse
teach a client? take on empty stomach

56.
The nurse explains to a client with thyroid disease that the thyroid gland normally produces: T3,
T4, and calcitonin.

57.
A client has just been diagnosed with type 1 diabetes. When teaching the client and family how
diet and exercise affect insulin requirements, the nurse should include which guideline? You'll
need less insulin when you exercise or reduce your food intake."

58. After falling off a ladder and suffering a brain injury, a client develops syndrome of
inappropriate antidiuretic hormone (SIADH). Which findings indicate that the treatment he's
receiving is effective? 1,4,5

59.
An incoherent client with a history of hypothyroidism is brought to the emergency department by
the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation,
respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial
area. Knowing that these findings suggest severe hypothyroidism, the nurse prepares to take
emergency action to prevent the potential complication of: m. coma

60.
A client with type 1 diabetes asks the nurse about taking an oral antidiabetic agent. The nurse
explains that these medications are only effective if the client: has type 2 dm

61.
For a client with Graves' disease, which nursing intervention promotes comfort? Maintaining
room temperature in the low-normal range

62. owing a unilateral adrenalectomy, the nurse would assess for hyperkalemia shown by which
of the following? muscle weakness

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hypothermia