Endocrine - MEDSURG FINAL CH 49 - Endocrine System EXAM
2025 QUESTIONS AND CORRECT ANSWER
The nurse is providing discharge instructions to a client who has Cushing's syndrome. Which
client statement indicates that instructions related to dietary management are understood?
a. i will need to limit the amount of protein in my diet.
b. i should eat foods that have a lot of potassium in them.
c. i am fortunate enough that i can eat all the salty foods i enjoy.
d. i am fortunate that i do not need to follow any special diet. - answer>>>b. i should eat
foods that have a lot of potassium in them.
RATIONALE: a diet low in carbs and sodium but ample in protein and potassium is encouraged
for a client with Cushing's syndrome. Such a diet promotes weight loss, reduction of edema
and hypertension, control of hypokalemia, and rebuilding of wasted tissue.
The nurse is planning postoperative care for a patient who is being admitted to the surgical unit
from the recovery room after transsphenoidal resection of a pituitary tumor. Which nursing
action should be included?
a. Palpate extremities for edema.
b. Measure urine volume every hour.
c. Check hematocrit every 2 hours for 8 hours.
d. Monitor continuous pulse oximetry for 24 hours. - answer>>>b. Measure urine volume
every hour.
RATIONALE: After pituitary surgery, the patient is at risk for diabetes insipidus caused by
cerebral edema. Monitoring of urine output and urine specific gravity is essential.
Hemorrhage is not a common
,problem. There is no need to check the hematocrit hourly. The patient is at risk for
dehydration, not volume overload. The patient is not at high risk for problems with
oxygenation, and continuous pulse oximetry is not needed.
Which information will the nurse include when teaching a 50-yr-old male patient about
somatropin (Genotropin)?
a. The medication will be needed for 3 to 6 months.
b. Inject the medication subcutaneously every day.
c. Blood glucose levels may decrease when taking the medication.
d. Stop taking the medication if swelling of the hands or feet occurs. - answer>>>b. Inject the
medication subcutaneously every day.
RATIONALE: Somatropin is injected subcutaneously on a daily basis, preferably in the evening.
The patient will need to continue on somatropin for life. If swelling or other common adverse
effects occur, the health care provider should be notified. Growth hormone will increase blood
glucose levels.
The nurse determines that additional instruction is needed for a patient with chronic syndrome
of inappropriate antidiuretic hormone (SIADH) when the patient makes which statement?
a. "I need to shop for foods low in sodium and avoid adding salt to food."
b. "I should weigh myself daily and report any sudden weight loss or gain."
c. "I need to limit my fluid intake to no more than 1 quart of liquids a day."
d. "I should eat foods high in potassium because diuretics cause potassium loss." - answer>>>a.
"I need to shop for foods low in sodium and avoid adding salt to food."
,RATIONALE: Patients with SIADH are at risk for hyponatremia, and a sodium supplement may
be prescribed. The other patient statements are correct and indicate successful teaching has
occurred.
The nurse determines that demeclocycline is effective for a patient with syndrome of
inappropriate antidiuretic hormone (SIADH) based on finding that the patient's
a. weight has increased.
b. urinary output is increased.
c. peripheral edema is increased
d. urine specific gravity is increased. - answer>>>b. urinary output is increased.
RATIONALE: Demeclocycline blocks the action of antidiuretic hormone (ADH) on the renal
tubules and increases urine output. An increase in weight or an increase in urine specific gravity
indicates that the SIADH is not corrected. Peripheral edema does not occur with SIADH. A
sudden weight gain without edema is a common clinical manifestation of this disorder.
An expected patient problem for a patient admitted to the hospital with symptoms of diabetes
insipidus is
a. excess fluid volume related to intake greater than output.
b. impaired gas exchange related to fluid retention in lungs.
c. sleep pattern disturbance related to frequent waking to void.
d. risk for impaired skin integrity related to generalized edema. - answer>>>c. sleep pattern
disturbance related to frequent waking to void.
RATIONALE: Nocturia occurs as a result of the polyuria caused by diabetes insipidus. Edema,
excess fluid volume, and fluid retention are not expected.
, Which information will the nurse teach a patient who has been newly diagnosed with Graves'
disease?
a. Exercise is contraindicated to avoid increasing metabolic rate.
b. Restriction of iodine intake is needed to reduce thyroid activity.
c. Antithyroid medications may take several months for full effect.
d. Surgery will eventually be required to remove the thyroid gland. - answer>>>c. Antithyroid
medications may take several months for full effect.
A patient who had a subtotal thyroidectomy earlier today develops laryngeal stridor and a
cramp in the right hand upon returning to the surgical nursing unit. Which collaborative action
will the nurse anticipate next?
a. Suction the patient's airway.
b. Administer IV calcium gluconate.
c. Plan for emergency tracheostomy.
d. Prepare for endotracheal intubation. - answer>>>b. Administer IV calcium gluconate.
RATIONALE: The patient's clinical manifestations of stridor and cramping are consistent with
tetany caused by hypocalcemia resulting from damage to the parathyroid glands during
surgery. Endotracheal intubation or tracheostomy may be needed if the calcium does not
resolve the stridor. Suctioning will not correct the stridor.
A 62-yr-old patient with hyperthyroidism is to be treated with radioactive iodine (RAI). The
nurse instructs the patient
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