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WorksheetsEndocrine System Post Test
Total questions: 50
Worksheet time: 25mins
A 45-year-old woman presents with heat intolerance, weight loss despite increased appetite, tremors, and palpitations. Her TSH is suppressed and free T4 is elevated. Which is the most likely diagnosis?
Subacute thyroiditis
Graves disease
Toxic multinodular goiter
Euthyroid sick syndrome
Which medication is most appropriate to rapidly control sympathetic symptoms such as tachycardia and tremors in severe thyrotoxicosis?
Methimazole
Propranolol
Levothyroxine
Radioactive iodine
A patient with Cushing syndrome has elevated midnight cortisol and a non-suppressible dexamethasone suppression test. ACTH is low. Imaging shows an adrenal mass. Which is true among the following options?
ACTH-dependent Cushing disease from pituitary adenoma
Ectopic ACTH secretion
Primary adrenal Cushing syndrome due to an adrenal adenoma
Factitious Cushing from exogenous steroids
A patient with secondary adrenal insufficiency due to chronic glucocorticoid therapy is most likely to have which laboratory finding?
Hyperkalemia
Hypoglycemia
Increased ACTH
Hyperpigmentation
The assessment of a client that would be most indicative of diabetes insipidus is:
Increased blood glucose
Low urinary specific gravity
Elevation of blood pressure
Decreased serum osmolarity
To understand diabetes insipidus, the nurse must be aware that an antidiuretic substance important for maintaining fluid balance is released by the:
Adrenal cortex
Adrenal medulla
Anterior pituitary
Posterior pituitary
The nurse knows that most of the hormones present in the body at any given time were secreted from the endocrine glands:
24 hours ago
4 to 6 hours
8 to 12 hours ago
More than 72 hours ago
Which of the following would be a priority goal of care for the client with SIADH?
Maintain blood glucose level within normal range
Maintain electrolyte balance
Promote a regular sleep pattern
Prevent fluid volume deficit
Mr. Chang has been receiving glucocorticoid replacement. On what principle should Mr. Chang base his medication administration at home?
Various circumstances increase the need for glucocorticoids, so dosage adjustments will be needed.
The need for glucocorticoids stabilizes and a predetermined dose is taken every third day.
Glucocorticoids are cumulative, so a dose is taken every third day.
Because of the pattern of glucocorticoid secretion, a dose is taken every 6 hours.
All patients taking glucocorticoids should be instructed to take them:
With a full glass of water.
On an empty stomach.
Between meals.
With meals or an antacid.
Which of the following factors would be most important in selecting the length of needle the nurse should use for Mrs. Spencer's subcutaneous injection?
The diameter of the needle.
The circumference of the patient's arm.
The viscosity of the solution to be injected.
The amount of medication to be administered.
Situation: A 32-year-old male professor was complaining of easy fatigability, insomnia, intolerance to heat, palpitation and weight loss. He was diagnosed to be suffering from a certain endocrine disorder that affected his body metabolism and heat production. The primary diagnosis of his condition would most likely be:
Hypothyroidism
Hyperthyroidism
Addison’s Disease
Cushing’s Syndrome
Situation: A 32-year-old male professor was complaining of easy fatigability, insomnia, intolerance to heat, palpitation and weight loss. He was diagnosed to be suffering from a certain endocrine disorder that affected his body metabolism and heat production. Which of these manifestations may be seen among his chief complaints?
Anorexia
Fine hand tremors
Bradycardia
Hypotension
Situation: A 32-year-old male professor was complaining of easy fatigability, insomnia, intolerance to heat, palpitation and weight loss. He was diagnosed to be suffering from a certain endocrine disorder that affected his body metabolism and heat production. Diet recommended for this type of client is:
High calorie, high protein
High fat, high protein
Low fat, low salt
Low salt, high fat
Situation: A 32-year-old male professor was complaining of easy fatigability, insomnia, intolerance to heat, palpitation and weight loss. He was diagnosed to be suffering from a certain endocrine disorder that affected his body metabolism and heat production. This complication of hyperthyroidism is also known as:
Myxedema
Thyrotoxicosis
Goiter
Cretinism
Situation: A 32-year-old male professor was complaining of easy fatigability, insomnia, intolerance to heat, palpitation and weight loss. He was diagnosed to be suffering from a certain endocrine disorder that affected his body metabolism and heat production. Various medications are being administered to clients with hyperthyroidism to treat the said condition. These include all the following, except:
Propylthiouracil (PTU)
Atropine
Digoxin (Lanoxin)
Methimazole (Tapazole)
Diabetes insipidus is a possible complication following pituitary surgery. For which symptom should the nurse observe to aid detection of diabetes insipidus?
Urine specific gravity greater than 1.030
Urine output between 5 and 10 L/day
Blood glucose level above 300 mg/100 ml
Urine negative for glucose and ketones
Which of the following statements if made by the patient would require additional health teaching? “I take potassium iodide…”
With meals
With plain water
With fruit juice
Without meals
A client has just been admitted to the nursing unit following thyroidectomy. Which assessment is the priority for this client?
Hoarseness
Hypocalcemia
Audible stridor
Edema at the surgical site
A 62-year-old female lawyer-legislator is experiencing chronic fatigue syndrome and was suspected to have a certain form of endocrine dysfunction. She was diagnosed to have hypothyroidism. Aside from body weakness, which of these manifestations may be seen among her chief complaints?
Diarrhea
Tachycardia
Fine hand tremors
Weight gain
Which of the following is a life-threatening complication in patients with hyperthyroidism?
Myxedema coma
Thyroid storm
Addisonian crisis
Hypoglycemic coma
Which electrolyte imbalance is expected in hyperparathyroidism?
Hypocalcemia, Hyperphosphatemia
Hypercalcemia, Hypophosphatemia
Hyponatremia, Hyperkalemia
Hypernatremia, Hypokalemia
Nursing management for Cushing’s syndrome includes which diet?
High-sodium, low-potassium
Low-sodium, high-potassium
High-carbohydrate, low-protein
High-fat, high-sodium
A 45-year-old male presents with enlarged hands, deep voice, and prognathism. His glucose tolerance test shows GH levels remain elevated after glucose load. Which treatment is most appropriate?
Somatostatin analogs (Octreotide)
Growth hormone injections
Lugol’s solution
Radioactive iodine
A child presents with short stature, delayed puberty, and cubitus valgus. The physician prescribes somatropin injections. Which nursing instruction is MOST important?
Give the injection once weekly.
Expect height gain within a week.
Administer daily injections for several years.
Stop the treatment when puberty starts.
A client with DI is prescribed vasopressin. The nurse should monitor for which complication?
Hypoglycemia
Hypotension
Water intoxication
Hyperkalemia
A female 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, nurse Jacob reviews the pre-operative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize?
You must lie flat for 24 hours after surgery.
You must avoid coughing, sneezing, and blowing your nose.
You must restrict your fluid intake.
You must report ringing in your ears immediately.
When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamines, nurse April is most likely to detect:
A blood pressure of 130/70 mmHg
A blood glucose level of 130 mg/dl
Bradycardia
A blood pressure of 176/88 mm Hg
Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?
Fluid intake is less than 2,500 ml/day
Urine output measures more than 200 ml/hour
Blood pressure is 90/50 mm Hg
The heart rate is 126 beats/minute
For the first 72 hours after thyroidectomy surgery, nurse Prue would assess the female client for Chvostek’s sign and Trousseau’s sign because they indicate which of the following?
Hypocalcemia
Hypercalcemia
Hypokalemia
Hyperkalemia
Nurse Phoebe is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?
Tetany
Hemorrhage
Thyroid storm
Laryngeal nerve damage
After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr. Paige Matthews prescribes levothyroxine (Levothroid), 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent?
Primary hypothyroidism
Graves’ disease
Thyrotoxicosis
Euthyroidism
A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Patty recognize as an adverse drug effect?
Dysuria
Leg cramps
Tachycardia
Blurred vision
Following a unilateral adrenalectomy, nurse Noreen would assess for hyperkalemia shown by which of the following?
Muscle weakness
Tremors
Diaphoresis
Constipation
Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?
Diabetic ketoacidosis
Thyroid crisis
Hypoglycemia
Tetany
A female client has a serum calcium level of 7.2 mg/dl. During the physical examination, nurse Noah expects to assess:
Trousseau’s sign
Homans’ sign
Hegar’s sign
Goodell’s sign
During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the nurse should include which statement?
The head of your bed must remain flat for 24 hours after surgery.
You should avoid deep breathing and coughing after surgery.
You won’t be able to swallow for the first day or two.
You must avoid hyperextending your neck after surgery.
Capillary glucose monitoring is being performed every 4 hours for a female 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 U of regular insulin. Nurse Vince should expect the dose’s:
Onset to be at 2 p.m. and its peak to be at 3 p.m.
Onset to be at 2:15 p.m. and its peak to be at 3 p.m.
Onset to be at 2:30 p.m. and its peak to be at 4 p.m.
Onset to be at 4 p.m. and its peak to be at 6 p.m.
Dr. Kennedy prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a male client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide?
Be sure to take glipizide 30 minutes before meals.
Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly.
You won’t need to check your blood glucose level after you start taking glipizide.
Take glipizide after a meal to prevent heartburn.
For a diabetic male client with a foot ulcer, the physician orders bed rest, a wet-to-dry dressing change every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used for this client?
They contain exudate and provide a moist wound environment.
They protect the wound from mechanical trauma and promote healing.
They debride the wound and promote healing by secondary intention.
They prevent the entrance of microorganisms and minimize wound discomfort.
Among the following medications, which one is contraindicated in patients with hypothyroidism?
Valium
Inderal
Aspirin
Synthroid
A patient with Addison’s disease presents to the ER with hypotension, vomiting, and hyperkalemia. What is the immediate priority?
Oral hydrocortisone
IV normal saline and IV hydrocortisone
Beta-blockers
Thyroid hormone replacement
Which finding best suggests diabetic ketoacidosis rather than hyperosmolar hyperglycemic state?
Severe hyperglycemia > 600 mg/dL
Serum ketones and metabolic acidosis
Neurologic deficit only
Profound dehydration without acidosis
Which hormone is secreted by the delta cells of the pancreas?
Insulin
Glucagon
Somatostatin
Amylin
A nurse caring for a patient with hypoglycemia administers glucagon. What is the mechanism?
Stimulates insulin release
Promotes glycogenolysis and gluconeogenesis
Blocks gluconeogenesis
Enhances glucose uptake
Which vitamin is required for normal parathyroid hormone function in calcium absorption?
Vitamin A
Vitamin B12
Vitamin D
Vitamin K
A nurse should teach a patient taking corticosteroids to report which symptom immediately?
Mild weight gain
Signs of infection
Increased appetite
Mood swings
The “Somogyi effect” is best prevented by:
Skipping bedtime snacks
Giving a bedtime snack
Reducing morning insulin dose
Administering extra insulin at bedtime
Nurse Noemi administers glucagon to her diabetic client, then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon?
Oral anticoagulants
Anabolic steroids
Beta-adrenergic blockers
Thiazide diuretics
Which instruction about insulin administration should nurse Kate give to a client?
Always follow the same order when drawing the different insulins into the syringe.
Shake the vials before withdrawing the insulin.
Store unopened vials of insulin in the freezer at temperatures well below freezing.
Discard the intermediate-acting insulin if it appears cloudy.
