Medsurg CAQ assignment #2

A nurse observes that a client’s urine has a sweet fruity odor. Which information is most important to evaluate when performing a further client assessment?
1
Vital signs
2
Fluid balance
3
Serum glucose level
4
Dietary calorie count

3

While a nurse is teaching a client with diabetes about food choices, the client states, "I do not like broccoli." Which food should the nurse suggest to substitute for broccoli?
1
Peas
2
Corn
3
Green beans
4
Mashed potato

3

Which glands secrete hormones that regulate metabolism of carbohydrates, proteins, and fats? Select all that apply.
1
Pancreas
2
Thyroid gland
3
Adrenal cortex
4
Adrenal medulla
5
Parathyroid gland

1, 2, 3

Which hormonal deficiency reduces the growth of axillae and pubic hair in female clients?
1
Growth hormone
2
Antidiuretic hormone
3
Thyroid-stimulating hormone
4
Adrenocorticotropic hormone

4

Which type of hormonal imbalance does the nurse infer through this image?
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1
Acromegaly
2
Exophthalmos
3
Addison’s disease
4
Cushing’s syndrome

1

Which term should the nurse use in a report to describe the absence of menstrual periods in a 35-year-old non-pregnant client?
1
Rhinorrhea
2
Menopause
3
Amenorrhea
4
Dyspareunia

3

Which hormone does the nurse state binds to the receptor site on the surface of a target cell?
1
Estrogen
2
Adrenaline
3
Aldosterone
4
Hydrocortisone

4

A client with malignant hot nodules of the thyroid gland has a thyroidectomy. What is the nurse’s priority action immediately postoperative?
1
Place in semi-Fowler’s position to limit edema of the neck
2
Monitor intake and output strictly to assess for fluid overload
3
Encourage coughing and deep breathing to prevent atelectasis
4
Assess level of consciousness to determine recovery from anesthesia

1

Which hormone does the nurse state has both inhibiting and releasing action?
1
Prolactin
2
Somatostatin
3
Somatotropin
4
Gonadotropin

1

Which gland does the nurse state is an exocrine gland?
1
Thyroid gland
2
Salivary gland
3
Pituitary gland
4
Parathyroid gland

2

Which hormone synthesis does the nurse state is inhibited by hypokalemia?
1
Aldosterone
2
Somatostatin
3
Norepinephrine
4
Androstenedione

1 (Hypokalemia inhibits synthesis of aldosterone hormone. Somatostatin inhibits the synthesis of insulin. Norepinephrine also inhibits the synthesis of insulin. Androstenedione secretion may not be inhibited by hypokalemia.)

Which hormone secretion does the nurse state is an example of a positive feedback mechanism?
1
Insulin
2
Estradiol
3
Parathormone
4
Catecholamines

2

Which cells does the nurse identify as producing thyrocalcitonin hormone?
1
Islet cells
2
Adrenal cells
3
Pituitary cells
4
Parafollicular cells

4

Which catecholamine receptor is responsible for increased heart rate?
1
Beta1 receptor
2
Beta2 receptor
3
Alpha1 receptor
4
Alpha2 receptor

1

When assessing the laboratory values of a client with type 2 diabetes, what would the nurse expect the results to reveal?
1
Ketones in the blood but not in the urine
2
Glucose in the urine but not in the blood
3
Urine and blood positive for glucose and ketones
4
Urine negative for ketones and positive glucose in the blood

4

What is a clinical manifestation in a client with hyposecretion of growth hormone?
1
Lethargy
2
Weight gain
3
Decreased libido
4
Reduced bone density

4

A nurse is teaching a client with type 1 diabetes about assessing for signs and symptoms of hypoglycemia as a result of excessive insulin. What response should the nurse instruct the client to monitor in addition to nervousness and hunger?
1
Thirst
2
Nausea
3
Anorexia
4
Sweating

4 When serum glucose decreases, the sympathetic nervous system is stimulated, resulting in a surge of epinephrine and norepinephrine; this response causes sweating, tremors, tachycardia, palpitations, nervousness, and hunger. Increased thirst (polydipsia) occurs in response to the osmotic diuresis associated with hyperglycemia. The ketosis and acidosis of diabetic ketoacidosis lead to gastrointestinal problems such as nausea, anorexia, vomiting, and abdominal cramping.

What intervention should the nurse implement when caring for a client 24 hours postthyroidectomy?
1
Check the back and sides of the operative site.
2
Support the head during mild range-of-motion (ROM) exercises.
3
Encourage the client to ventilate feelings about the surgery.
4
Advise the client that regular activities can be resumed immediately.

1

In order to ensure a quality specimen and an accurate test result, which instruction should the nurse give a client who is scheduled to undergo urine endocrine testing?
1
"Start the urine collection when the bladder is full."
2
"Store the urine specimen in a cooler with ice."
3
"Store the urine specimen in a home refrigerator."
4
"Save the urine specimen that begins the collection."

2

A nurse is providing postoperative care for a client one hour after an adrenalectomy. Maintenance steroid therapy has not begun yet. The nurse should monitor the client for which complication?
1
Hypotension
2
Hyperglycemia
3
Sodium retention
4
Potassium excretion

1

A client has a history of hypothyroidism. Which skin condition should the nurse expect when performing a physical assessment?
1
Dry
2
Moist
3
Flushed
4
Smooth

1

While obtaining the client’s health history, which factor does the nurse identify that predisposes the client to type 2 diabetes?
1
Having diabetes insipidus
2
Eating low-cholesterol foods
3
Being 20 pounds (9 kilograms) overweight
4
Drinking a daily alcoholic beverage

3

The registered nurse instructs the new nurse in orientation regarding the physiologic processes of the endocrine system prior to client assessment. Which statement made by the new nurse indicates effective learning?
1
"The endocrine system comprises glands with narrow ducts."
2
"The endocrine system comprises salivary and lacrimal glands."
3
"The hormones of the endocrine system exert their action by ‘lock and key’ mechanism."
4
"The hormones secreted by endocrine system exert their action on all tissues they contact."

3

A primary healthcare provider prescribes a low-sodium, high-potassium diet for a client with Cushing syndrome. Which explanation should the nurse provide to the client about the need to follow this diet?
1
"The use of salt probably contributed to the disease."
2
"Excess weight will be gained if sodium is not limited."
3
"The loss of excess sodium and potassium in the urine requires less renal stimulation."
4
"Excessive aldosterone and cortisone cause retention of sodium and loss of potassium."

4

The nurse is assessing a client suspected of having hypercortisolism. Which questions should the nurse ask to help confirm the diagnosis? Select all that apply.
1
"Did you lose any weight unintentionally?"
2
"Did you notice your extremities to be thin?"
3
"Did you notice any roughness of your skin?"
4
"Did you notice any skin darkening recently?"
5
"Did the hair on your body become thicker?"

2, 5

A client is diagnosed with Cushing syndrome. Which clinical manifestation does the nurse expect to increase in a client with Cushing syndrome?
1
Urine output
2
Glucose level
3
Serum potassium
4
Immune response

2

When assessing a client with Graves disease (hyperthyroidism), what would the nurse expect to find in the client’s history?
1
Diaphoresis
2
Menorrhagia
3
Dry, brittle hair
4
Sensitivity to cold
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1

The primary healthcare provider prescribed a diagnostic study with contrast medium for an older adult who has an endocrine disorder. Which assessment result should the nurse check before the study?
1
Urinary pH
2
Serum creatinine
3
Urinary creatinine
4
Creatinine clearance

2

Which electrolyte concentration has the potential to precipitate dysrhythmias and cardiac arrest in a client?
1
Serum sodium of 139 mEq/L (139 mmol/L)
2
Serum chloride of 100 mEq/L (100 mmol/L)
3
Serum calcium of 10.2 mg/dL (2.55 mmol/L)
4
Serum potassium of 7.2 mEq/L (7.2 mmol/L)

4 Hyperkalemia causes dysrhythmias and cardiac arrest. The normal serum potassium concentration ranges between 3.5 and 5.0 mEq/L (3.5-5.0 mmol/L). A concentration of 7.2 mEq/L (7.2 mmol/L) indicates hyperkalemia. The normal concentration of sodium in the serum ranges between 135 and 145 mEq/L (135-145 mmol/L). The normal chloride concentration ranges between 96 and 106 mEq/L (96-106 mmol/L). The normal serum calcium level ranges between 9 and 10.5 mg/dL (2.25-2.625 mmol/L).

While caring for a client receiving fludrocortisone, the nurse suspects that the drug has caused a negative side effect. Which finding supports the nurse’s conclusion?
1
Body temperature of 37˚C (98.6˚F)
2
Blood glucose of 100 mg/dL (5.5 mmol/L)
3
Serum sodium of 137 mEq/L (137 mmol/L)
4
Blood pressure of 150/90 mm Hg

4

Which condition does the nurse identify in the image?
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1
Goiter
2
Myxedema
3
Exophthalmos
4
Pheochromocytoma

3

Which client has Cushing’s syndrome?
1
Client A
2
Client B
3
Client C
4
Client D

4

A nurse is caring for a newly admitted client with a diagnosis of Graves disease. In preparing a teaching plan, the nurse anticipates which diet will be prescribed for this client?
1
High-calorie diet
2
Low-sodium diet
3
High-roughage diet
4
Mechanical-soft diet

1

A client diagnosed with adrenal gland hypofunction is receiving fludrocortisone therapy. Which nursing intervention would help the client reduce the risk of complications?
1
Instruct the client to report severe diarrhea
2
Instruct the client to report fever and vomiting
3
Instruct the client to take the drug with meals or snacks
4
Instruct the client to regularly monitor blood pressure

4

A client is admitted to the hospital with a potential diagnosis of excess antidiuretic hormone. Which clinical indicator should the nurse identify when assessing this client?
1
Polyuria
2
Dehydration
3
Hyponatremia
4
Hyperglycemia

3

Which clinical findings should the nurse assess when caring for a client with hyperthyroidism? Select all that apply.
1
Lethargy
2
Tachycardia
3
Weight gain
4
Constipation
5
Exophthalmos

2, 5