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N326 Quiz -2
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N326 Quiz #2 Q&AA client feeling increasingly tired seeks medical care. Type 1 diabetes is diagnosed.
What causes increased fatigue with type 1 diabetes?
Increased metabolism at the cellular level
Increased glucose absorption from the intestine
Decreased production of insulin by the pancreas
Decreased glucose secretion into the renal tubules - (correct answer)Decreased
production of insulin by the pancreas
*Insulin facilitates transport of glucose across the cell membrane to meet metabolic
needs and prevent fatigue. With diabetes there is decreased cellular metabolism
because of the decrease in glucose entering the cells. Glucose is not absorbed from the
intestinal tract by the cells; fatigue is caused by decreased, not increased, cellular levels
of glucose. Filtration and excretion of glucose by the kidneys do not regulate energy
levels; if insulin production is adequate, glucose does not spill into the urine.
A nurse is collecting information about a client with type 1 diabetes who is being
admitted because of diabetic ketoacidotic coma. Which factors can predispose a client
to this condition?
Taking too much insulin
Getting too much exercise
Excessive emotional stress
,Running a fever with the flu
Eating fewer calories than prescribed - (correct answer)Excessive emotional stress
Running a fever with the flu
* Emotional stress stimulates the sympathetic nervous system, which releases
glucocorticoids, ultimately increasing the blood glucose level. The stress of an infection
increases metabolism and the production of glucocorticoids, resulting in an elevated
blood glucose level. Too much insulin will precipitate insulin coma (hypoglycemia).
Exercise uses glucose for muscle contraction, decreasing the blood glucose level; this
may precipitate insulin coma (hypoglycemia). Not eating enough calories in relation to
the amount of insulin received may precipitate insulin coma (hypoglycemia).
A client with Cushing syndrome asks why a low-sodium, high-potassium diet has been
prescribed. What is the best response by the nurse?
"The client will gain excessive weight if sodium is not limited."
"An inadequate intake of potassium contributed to the disease."
"This type of diet increases emotional stability."
"Excessive aldosterone and cortisone cause the retention of sodium and loss of
potassium." - (correct answer)"Excessive aldosterone and cortisone cause the retention
of sodium and loss of potassium."
*Clients with Cushing syndrome or those receiving cortical hormones must limit their
intake of sodium and increase their intake of potassium, because the kidneys are
retaining sodium and excreting potassium. Although sodium retention causes fluid
retention and weight gain, the need for increased potassium must be considered as
,well. An excessive secretion of adrenocortical hormones in Cushing syndrome, not
inadequate potassium intake, is the problem. This type of diet has no direct effect on the
client's emotional status.
The nurse is caring for a 70-year-old client who presents with dilute urine even when
fluid intake is low. What could be the possible cause of the client's condition?
Decreased glucose tolerance
Decreased general metabolism
Decreased ovarian production of estrogen
Decreased antidiuretic hormone production - (correct answer)Decreased antidiuretic
hormone production
*Dilute urine with decreased fluid intake indicates a decrease in antidiuretic hormone
production. Decreased glucose tolerance causes elevated fasting and random blood
glucose levels. The clinical manifestations of decreased general metabolism are
decreased heart rate and blood pressure, decreased appetite, and decreased tolerance
to cold. Decreased ovarian production of estrogen may result in decreased bone density
and thin and dry skin.
Which type of drug-induced hormonal imbalance is likely to be observed in the client
undergoing treatment with demeclocycline?
Acromegaly
Diabetes mellitus
, Diabetes insipidus
Cushing's syndrome - (correct answer)Diabetes insipidus
* Drug-induced diabetic insipidus is usually caused by demeclocycline, which can
interfere with the response of the kidneys to antidiuretic hormone. Demeclocycline does
not cause endocrine disorders, such as acromegaly, diabetes mellitus, and Cushing's
syndrome.
What is a major nursing concern when caring for a client diagnosed with
hyperthyroidism?
Monitoring for hypoglycemia
Protecting visitors and staff from radiation exposure
Providing foods to increase appetite
Arranging for sufficient rest periods - (correct answer)Arranging for sufficient rest
periods
*Promotion of rest to reduce metabolic demands is a challenging but essential task for a
client who has hyperthyroidism. With hyperthyroidism, glucose tolerance is decreased,
and the client is hyperglycemic. There is no indication that radioactive iodine has been
given; therefore, the client does not emit radiation. The client will have an increased
appetite.
A nurse provides care to a client following a subtotal thyroidectomy. Which interventions
should the nurse implement?
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