NCLEX : Endocrine Condition Follow-Up
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Example Questions
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.
Example Question #2 : Endocrine Condition Follow Up
The home health nurse assesses the home of a elderly diabetic patient with peripheral neuropathy who lives alone. Which of the following observations most concerns the nurse?
The patient uses the bath without testing the temperature of the water.
The patient wears slippers when walking around the house.
The patient does not exercise when her blood sugar is high.
The patient has a full-length mirror to assess feet daily.
The patient cuts toenails straight across.
The patient uses the bath without testing the temperature of the water.
Peripheral neuropathy is a common condition among elderly diabetic patients. Due to the loss of sensation in fingers, arms, legs, and toes, these patients must be aware of their surroundings, use proper foot care, inspect feet daily (with a mirror if the patient is elderly or has decreased joint mobility), wear well-fitting shoes, avoid heating pads on feet, avoid walking barefoot, and cut toenails straight across without rounding corners. It is also important for the patient to avoid exercise when their condition is poorly controlled due to the increased demand for glucose. This patient must be sure to check the temperature of baths before using them, as the potential for burns is high in those with decreased sensation and neuropathy.
Example Question #3 : Endocrine Condition Follow Up
The bedside nurse cares for a patient newly diagnosed with cystic fibrosis and educates the patient on new diet modifications. The nurse is concerned when the patient makes which of the following statements?
“A good meal for me to eat would have fruits, vegetables, and lean meats.”
“I will increase the amount of calories I consume when I am sick.”
“I will avoid soda, junk food, bacon, and butter.”
“I will cut all protein from my diet because I do not absorb proteins well.”
“I will make sure to take my medications for enzyme replacement before or with my meals.”
“I will cut all protein from my diet because I do not absorb proteins well.”
Cystic fibrosis is a disorder that mainly affects the lungs, but also alters fat metabolism from a lack of pancreatic enzymes. The disorder is treated with pancreatic enzyme replacement, which is best absorbed when taken before meals or with food. The best diet for cystic fibrosis is low-fat and cholesterol-restricted with good sources of protein, such as fruit, vegetables, lean meats, and cereals. These patients must avoid fatty, marbled meats such as bacon, fatty foods such as avocado, egg yolks, and butter. During illness, patients with cystic fibrosis have higher calorie and protein demands.
Example Question #4 : Endocrine Condition Follow Up
The nurse provides education to a patient newly diagnosed with Addison’s disease. The patient wants to learn about lifestyle modifications such as nutrition and diet changes. Which of the following statements by the nurse would be inappropriate?
“Make sure to eat enough calories for your height and weight.”
“Try a low-sodium diet by cutting out additional salts.”
“A diet high in protein is best for you.”
“You can increase your intake of fiber and whole grains.”
“Have a glass of water for every non-water drink you consume (i.e. soda, coffee, alcohol).”
“Try a low-sodium diet by cutting out additional salts.”
Patients with Addison’s disease are more susceptible to becoming dehydrated and may lose salts more quickly than others. Because of this, it is important to make sure these patients have a well-rounded diet with an emphasis on fluids. Protein, whole grains, and fibers are routinely recommended in a healthy, balanced diet, but it is not recommended to have a sodium-restricted diet.
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