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WorksheetsEndocrine - Adrenal
Total questions: 20
Worksheet time: 15mins
An older adult patient with type 2 diabetes is brought to the emergency department by his daughter. The patient is found to have a blood glucose level of 623 mg/dL. The patient's daughter reports that the patient recently had a gastrointestinal virus and has been confused for the last 3 hours. The diagnosis of hyperglycemic hyperosmolar syndrome (HHS) is made. What nursing action would be a priority?
Administration of antihypertensive medications
Administering sodium bicarbonate intravenously
Reversing acidosis by administering insulin
Fluid and electrolyte replacement
Administration of calcium gluconate
You are developing a care plan for a patient with Cushing syndrome. What nursing diagnosis would have the highest priority in this care plan?
Risk for injury related to weakness
Ineffective breathing pattern related to muscle weakness
Risk for loneliness related to disturbed body image
Autonomic dysreflexia related to neurologic changes
Risk for disturbed sleep related to diurnal secretion of cortisol
The nurse is caring for a patient at risk for an addisonian crisis. For what associated signs and symptoms should the nurse monitor the patient? Select all that apply.
Epistaxis
Pallor
Rapid respiratory rate
Bounding pulse
Hypotension
What is the correct way to administer insulin through an IV infusion set?
(a)
Which if the following is true regarding the administration of fludrocortisone acetate (Florinef) to a patient with adrenocortical insufficiency (Addison’s Disease)? Select all that apply.
Side effects include HTN & pulmonary edema
Can be taken PO daily in the PM or IM every 3 weeks
Cannot be used simultaneously with a diet including increased calcium
Usually needed if patient cannot maintain BP with modified diet
Patient must maintain an increased sodium intake (3 Gm)
A patient with pheochromocytoma has been admitted for an adrenalectomy to be performed the following day. To prevent complications, the nurse should anticipate preoperative administration of which of the following?
IV antibiotics
Oral antihypertensives
Parenteral nutrition
IV corticosteroids
IV fluids
A diabetic educator is discussing sick day rules with a newly diagnosed type 1 diabetic. The educator is aware that the patient will require further teaching when the patient states what? Select all that apply.
I will not take my insulin on the days when I am sick, but I will certainly check my blood sugar every 2 hours.
If I cannot eat a meal, I will eat a soft food such as soup, gelatin, or pudding six to eight times a day.
I will call the doctor if I am not able to keep liquids in my body due to vomiting or diarrhea.
I will call the doctor if my blood sugar is over 300 mg/dL or if I have ketones in my urine.
If my ketones are +3 or higher, I will maintain an intake of liquids every 30 to 60 minutes to prevent dehydration.
The nurse is preparing to administer Regular insulin to a patient with a current diagnosis of HHS. The nurse understands that an IV bolus must be administered at a rate of (a) U/kg/hr.
A patient suspected of pheochromocytoma is receiving education from the nurse on how to prepare for a 24-hour urine collection for diagnosis. The nurse stresses that the patient must abstain from the following for 48-72 hours prior to the collection: (Select all that apply)
Amphetamines
Vanilla
Banana
Aspirin
Bronchodilators
The nurse caring for a patient with Cushing syndrome is describing the dexamethasone suppression test scheduled for tomorrow. What does the nurse explain that this test will involve?
Administration of dexamethasone orally, followed by a plasma cortisol level every hour for 3 hours
Administration of dexamethasone IV, followed by an x-ray of the adrenal glands
Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8 AM the next morning
Administration of dexamethasone intravenously, followed by a plasma cortisol level 3 hours after the drug is administered
While assisting with the surgical removal of an adrenal tumor, the OR nurse is aware that the patient's vital signs may change upon manipulation of the tumor. What vital sign changes would the nurse expect to see?
Hyperthermia and tachypnea
Hypertension and heart rate changes
Hypotension and hypothermia
Hyperthermia and bradycardia
Hyperglycemia and tachypnea
The nurse is taking care of a patient newly diagnosed with pheochromocytoma. When the patient asks what factors could potentially trigger symptoms of pheochromocytoma, how should the nurse respond? Select all that apply.
Tricyclic antidepressants such as amitriptyline
Foods typically found on a charcuterie board
Grilled salmon & fried chicken
Anesthesia & contrast dye
Opiates & stimulants
A nurse is taking care of a patient admitted with DKA. After their blood glucose has reached 300, the nurse then switches the patient to D5NS in order to prevent a rapid decline in blood sugar levels but continues the administration of the Regular insulin drip. The patient asks when they will be taken off of IV insulin & can be switched back to their normal SQ insulin. How should the nurse respond?
(a)
A 32 year-old female patient comes in with the following symptoms: oily skin, loss of libido, cease of menses, stunted growth, HTN, fragile skin, weakness, & thin extremities. What does the nurse suspect the patient is most likely dealing with?
Diabetic ketoacidosis (DKA)
Hyperglycemic hyperosmolar Syndrome (HHS)
Adrenocortical Insufficiency (Addison’s Disease)
Cushing’s Syndrome / Disease
Pheochromocytoma
Following an Addisonian crisis, a patient's adrenal function has been gradually regained. The nurse should ensure that the patient knows about the need for supplementary glucocorticoid therapy in which of the following circumstances? Select all that apply.
Excessive carb intake
Overexertion
Therapeutic use of corticosteroids
Episodes of high psychosocial stress
Administration of a vaccine
You are a nurse caring for a 12-year-old boy admitted to the ER with a blood glucose of 600 mg/dL. After providing fluids, you assess the patient’s potassium levels. You understand that this value will guide your interventions concerning the restoration of electrolytes. What will you do for each of the following scenarios?
1. K+ < 3.5
2. K+ 3.5-5
3. K+ > 5
(a)
A patient is admitted to the ER presenting with signs of Adrenal / Addisonian Crisis. Which of the following does the nurse understand are priority interventions for this patient?
Replacement of missing corticosteroids & mineralocorticoids
Avoidance of high sodium substances
Administration of D5NS
Vasopressors & intropes
Avoidance of further physical & psychological stressors
How can Cushing’s disease lead to Addison’s disease?
(a)
A patient suspected of pheochromocytoma is receiving education from the nurse on how to prepare for a plasma catecholamine blood draw for diagnosis. The nurse stresses that the patient must abstain from the following for 48-72 hours prior to the blood draw: (Select all that apply)
OTC cold medications
Decaffeinated coffee
Chocolate
Tea
Supine 30 minutes prior to draw
What are the 5 H’s to assess with someone diagnosed with pheochromocytoma?
(a)
