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Example Questions
Example Question #21 : Endocrine Conditions
A 50-year-old female client is seen in the clinic for her recent diagnosis of hypothyroidism. Which of the following instructions should be included in the nurse's teaching plan?
High fiber, low calorie diet, and 5-6 small meals per day
The use of antiglycemic medications
High protein, low carbohydrate diet and replacement hydrocortisone
Explain the outcomes expected with removal of the thyroid gland
Obtain a hemoglobin A1C test
High fiber, low calorie diet, and 5-6 small meals per day
Hypothyroidism usually involves weight gain so a lower calorie diet with frequent small meals are recommended. High fiber, low calorie diets and stool softeners will help to alleviate these symptoms. Antiglycemics and hemoglobin A1C tests are indicated for diabetics.
Example Question #22 : Endocrine Conditions
A middle-aged female client has just underwent a thyroidectomy for treatment of Graves' disease. The nurse caring for this client is aware she may need to monitor the client for what possible complication?
Bone pain
Tetany
Goiter
Oliguria
Tetanus
Tetany
Tetany is a complication due to hypocalcemia which can occur if the parathyroid glands which control calcium balance are accidentaly injured during thyroidectomy. Tetany is associated with nerve excitability and sustained muscle contractions, or spasms. Tetanus, bone pain, and oliguria are not associated with complications of a thyroidectomy. Goiter is a manifestation of an overactive thyroid.
Example Question #23 : Endocrine Conditions
A 45-year-old female client with Addison's disease has presented to the client for instruction on her medication regiment The nurse understands that the patient may require lifelong corticosteroid replacement. It will be necessary to educate the client about possible side effects of this type of therapy.
Which of the following should a nurse include in his/her teaching plan about corticosteroid therapy?
Monitor glucose with finger sticks to check for hypoglycemia.
The medications should be taken on a empty stomach in the morning to avoid nausea if taken with food.
Increase calcium intake to at least with vitamin D, to help to prevent steroid induced osteoporosis.
Incease intake of folic acid and B12 to prevent neurological side effects such as paresthesias of the hands and feet.
Increase sodium intake to prevent hypotension due to edema.
Increase calcium intake to at least with vitamin D, to help to prevent steroid induced osteoporosis.
Corticosteroids may lead to bone loss, especially after long term treatment (over 3 months). Calcium and vitamin D supplementation can help prevent these side effects. The client should also be advised to start a low impact exercise regimine if possible, and if necessary take a bisphosphonate drug.
Example Question #432 : Conditions And Treatments
You are caring for a patient who is started on clindamycin, ketorolac, prednisone, lisinopril, and simvastatin. After receiving multiple doses of each of these medications, you notice that the patient's blood glucose is . Which of these medications is known to cause hyperglycemia?
Ketorolac
Simvastatin
Prednisone
Lisinopril
Clindamycin
Prednisone
The correct answer is prednisone. Of all the medications listed, prednisone is the only medication that is known to cause hyperglycemia.
Prednisone has a number of side effects including hyperglycemia, acne, headache, restlessness, insomnia, nausea, vomiting, and weight gain, among others.
Clindamycin's side effects include diarrhea (including Clostridium difficile), and less commonly nausea, vomiting, and abdominal pain, among others, but not hyperglycemia.
Ketorolac's side effects include renal toxicity, tinnitus, heartburn, diarrhea, and abdominal pain, among others, but not hyperglycemia.
Lisinopril's side effects include hypotension, lightheadedness, angioedema, and barky cough, among others, but not hyperglycemia.
Simvastatin's side effects include muscle pains/aches, muscle weakness, and less frequently confusion, and electrolyte disturbances, but not hyperglycemia.
Example Question #432 : Conditions And Treatments
You are the nurse taking care of a patient with type two diabetes mellitus. The patient is hospitalized for pneumonia and switched from his home medication, metformin, to sliding-scale insulin, while inpatient. You explain to the patient that the specific reason is which of the following?
To prevent depression while hospitalized
To prevent stroke while hospitalized
To prevent lactic acidosis while hospitalized
To prevent headache while hospitalized
To prevent myocardial infarction while hospitalized
To prevent lactic acidosis while hospitalized
The correct answer is "to prevent lactic acidosis while hospitalized." This is the correct answer because a known side effect of metformin use is development of lactic acidosis (a form of metabolic acidosis). Patients who are hospitalized, especially if hospitalized for infections, like pneumonia, are independently at an elevated risk of developing a lactic acidosis. As such, to minimize the risk of lactic acidosis, a modifiable risk factor, metformin use, is frequently temporarily discontinued while inpatient. Patients on metformin are frequently switched to sliding-scale insulin as inpatients, as this allows for adequate glycemic monitoring, titration, and control. Once they are stable for discharge and the cause of their hospitalization is addressed and treated, most can be safely discharged home on metformin without issue.
While numerous measures are carried out while patients are hospitalized to prevent myocardial infarction, stroke, headache, and depression, the switching of metformin to sliding-scale insulin is not performed specifically for any of those reasons.
Example Question #24 : Endocrine Conditions
Which of the following is true of type I diabetes?
Patients typically present in diabetic ketoacidosis
Patients are typically overweight adults
Patients develop insulin resistance
Patients do not require treatment with insulin
Patients typically present in diabetic ketoacidosis
Type I diabetes is an autoimmune process that typically presents in young children in the form of DKA (diabetic ketoacidosis). This potentially life threatening condition is treated with IV insulin. Type II diabetes is insulin resistance, and is found in older adults (typically those who are overweight).
Example Question #1 : Symptoms And Tests For Endocrine Conditions
The nurse is caring for a patient who is to receive a fasting blood glucose test. The nurse does all of the following to prepare the patient except __________.
Stops the patient's D5 0.45 IV maintenance fluid
Instructs the patient to refrain from the use of hard candy
Instructs the patient not to use any gum or breath mints
Marks the patient NPO 2 hours before the test
Restricts meals 4-8 hours before the test
Marks the patient NPO 2 hours before the test
The patient should refrain from ingesting any material that may contain sugar prior to a fasting blood glucose. However, is not necessary for a patient to be labeled NPO as they are still able to ingest water. All other preparations should be made.
Example Question #1241 : Nclex
The nurse cares for a patient newly diagnosed with systemic lupus erythematosus (SLE). Which of the following is a characteristic sign of SLE?
Lesions on extremities
Blood in urine
Arthritis and joint swelling
Butterfly rash across bridge of nose and cheeks
Pain during exposure to cold
Butterfly rash across bridge of nose and cheeks
The most characteristic sign of SLE is a butterfly rash across the bridge of nose and cheeks. The others listed are also signs and symptoms of SLE, but the most well-known sign that is specific to SLE is the butterfly rash. Arthritis and joint swelling, hematuria, lesions on extremities, and pain during exposure to cold (Raynaud’s phenomenon) may be signs of other diseases
Example Question #2 : Symptoms And Tests For Endocrine Conditions
The nurse reviews lab results for a patient with hyperparathyroidism. Which of the following changes in lab findings would the nurse expect?
Low vitamin D level
Low serum calcium level
High serum calcium level
Normal vitamin D level
Low parathyroid hormone level
High serum calcium level
The nurse should know the parathyroid glands regulate serum calcium levels; in hyperparathyroidism, serum calcium levels are elevated. Parathyroid hormones are not low in hyperparathyroidism due to the overactivity of the parathyroid glands. Urine calcium may be elevated due to spilling of the high serum calcium level into the urine. Vitamin D levels should be low, as the body will increase vitamin D in the blood to lower the calcium level.
Example Question #1 : Endocrine Condition Follow Up
What type of thyroid cancer has the worst prognosis?
Medullary carcinoma
Anaplastic carcinoma
Follicular carcinoma
Papillary carcinoma
Anaplastic carcinoma
The 5 year survival rate for aplastic carcinoma of the thyroid is 7-14%. The 5 year survival rates of papillary, medullary, and follicular thyroid carcinomas are close to 100% for stage I cancers. Survival rates decrease to approximately 50% for stage IV papillary and follicular carcinomas and 28% for stage IV medullary carcinoma.
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