NUR 344 Adult Health Exit HESI Study Guide Complete
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Vak
NUR 344
Instelling
NUR 344
ENDOCRINE DISORDERS
1. Nurse Ronn is assessing a client with possible Cushing’s syndrome. In a client with Cushing’s syndrome, the nurse would expect to find: a. Hypotension.
b. Thick, coarse skin.
c. Deposits of adipose tissue in the trunk and dorsocervical area.
d. Weight gain in arms and...
deposits of adipose tissue in the trunk and dorsocervical area
hypertension is caused by fluid retention skin becomes thin and bruises easily because of
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Voorbeeld van de inhoud
ENDOCRINE DISORDERS
1. Nurse Ronn is assessing a client with a. Hypotension. 1. Answer C. Because of changes in fat distribution,
possible Cushing’s syndrome. In a client b. Thick, coarse skin. adipose tissue accumulates in the trunk, face
with Cushing’s syndrome, the nurse would c. Deposits of adipose tissue in the trunk (moonface), and dorsocervical areas (buffalo hump).
expect to find: and dorsocervical area. Hypertension is caused by fluid retention. Skin
d. Weight gain in arms and legs. becomes thin and bruises easily because of a loss of
collagen. Muscle wasting causes muscle atrophy and
thin extremities.
2. A male client with primary diabetes a. “Administer desmopressin while the 2. Answer C. Desmopressin may not be absorbed
insipidus is ready for discharge on suspension is cold.” if the intranasal route is compromised. Although
desmopressin (DDAVP). Which instruction b. “Your condition isn’t chronic, so you diabetes insipidus is treatable, the client should wear
should nurse Lina provide? won’t need to wear a medical identification medical identification and carry medication at all
bracelet.” times to alert medical personnel in an emergency and
c. “You may not be able to use ensure proper treatment. The client must continue to
desmopressin nasally if you have nasal monitor fluid intake and output and receive adequate
discharge or blockage.” fluid replacement.
d. “You won’t need to monitor your
fluid intake and output after you start
taking desmopressin.”
3. Nurse Wayne is aware that a positive a. Hypocalcemia 3. Answer A. Chvostek’s sign is elicited by tapping
Chvostek’s sign indicate? b. Hyponatremia the client’s face lightly over the facial nerve, just
a. Hypocalcemia c. Hypokalemia below the temple. If the client’s facial muscles
b. Hyponatremia d. Hypermagnesemia twitch, it indicates hypocalcemia. Hyponatremia is
c. Hypokalemia indicated by weight loss, abdominal cramping,
d. Hypermagnesemia muscle weakness, headache, and postural
hypotension. Hypokalemia causes paralytic ileus and
muscle weakness. Clients with hypermagnesemia
exhibit a loss of deep tendon reflexes, coma, or
cardiac arrest.
4. In a 29-year-old female client who a. Serum glucose level. 4. Answer A. Hyperglycemia, which develops
is being successfully treated for b. Hair loss. from glucocorticoid excess, is a manifestation of
Cushing’s syndrome, nurse Lyzette c. Bone mineralization. Cushing’s syndrome. With successful treatment of
would expect a decline in: d. Menstrual flow. the disorder, serum glucose levels decline. Hirsutism
a. Serum glucose level. is common in Cushing’s syndrome; therefore, with
b. Hair loss. successful treatment, abnormal hair growth also
c. Bone mineralization. declines. Osteoporosis occurs in Cushing’s
d. Menstrual flow. syndrome; therefore, with successful treatment, bone
, mineralization increases. Amenorrhea develops in
Cushing’s syndrome. With successful treatment, the
client experiences a return of menstrual flow, not a
decline in it.
5. A male client has recently undergone a. It decreases cyclic adenosine 5. Answer C. Corticotropin interacts with plasma
surgical removal of a pituitary tumor. Dr. monophosphate (cAMP) production and membrane receptors to produce enzymatic actions
Wong prescribes corticotropin (Acthar), 20 affects the metabolic rate of target organs. that affect protein, fat, and carbohydrate metabolism.
units I.M. q.i.d. as a replacement therapy. b. It interacts with plasma It doesn’t decrease cAMP production. The posterior
What is the mechanism of action of membrane receptors to inhibit pituitary hormone, antidiuretic hormone, regulates
corticotropin? enzymatic actions. the threshold for water resorption in the kidneys.
c. It interacts with plasma membrane
receptors to produce enzymatic actions
that affect protein, fat, and carbohydrate
metabolism.
d. It regulates the threshold for
water resorption in the kidneys.
6. Capillary glucose monitoring is being a. Onset to be at 2 p.m. and its peak to be at 6. Answer C. Regular insulin, which is a short-
performed every 4 hours for a female client 3 p.m. acting insulin, has an onset of 15 to 30 minutes and a
diagnosed with diabetic ketoacidosis. Insulin b. Onset to be at 2:15 p.m. and its peak to peak of 2 to 4 hours. Because the nurse gave the
is administered using a scale of regular be at 3 p.m. insulin at 2 p.m., the expected onset would be from
insulin according to glucose results. At 2 c. Onset to be at 2:30 p.m. and its peak to 2:15 p.m. to 2:30 p.m. and the peak from 4 p.m. to 6
p.m., the client has a capillary glucose level be at 4 p.m. p.m.
of 250 mg/dl for which he receives 8 U of d. Onset to be at 4 p.m. and its peak to be at
regular 6 p.m.
insulin. Nurse Vince should expect the dose’s:
7. A female client with Cushing’s syndrome a. Depression 7. Answer A. Agitation, irritability, poor memory,
is admitted to the medical-surgical unit. b. Neuropathy loss of appetite, and neglect of one’s appearance may
During the admission assessment, nurse Tyzz c. Hypoglycemia signal depression, which is common in clients with
notes that the client is agitated and irritable, d. Hyperthyroidism Cushing’s syndrome. Neuropathy affects clients with
has poor memory, reports loss of appetite, and diabetes mellitus — not Cushing’s syndrome.
appears disheveled. These findings are Although hypoglycemia can cause irritability, it also
consistent with which problem? produces increased appetite, rather than loss of
appetite. Hyperthyroidism typically causes such
signs as goiter, nervousness, heat intolerance, and
weight loss despite increased appetite.
8. Nurse Ruth is assessing a client after a a. Tetany 8. Answer A. Tetany may result if the parathyroid
thyroidectomy. The assessment reveals b. Hemorrhage glands are excised or damaged during thyroid
,muscle twitching and tingling, along with c. Thyroid storm surgery. Hemorrhage is a potential complication
numbness in the fingers, toes, and mouth area. d. Laryngeal nerve damage after thyroid surgery but is characterized by
The nurse should suspect which tachycardia, hypotension, frequent swallowing,
complication? feelings of fullness at the incision site, choking, and
bleeding. Thyroid storm is another term for severe
hyperthyroidism — not a complication of
thyroidectomy. Laryngeal nerve damage may occur
postoperatively, but its signs include a hoarse voice
and, possibly, acute airway obstruction.
9. After undergoing a subtotal a. Primary hypothyroidism 9. Answer A. Levothyroxine is the preferred agent
thyroidectomy, a female client develops b. Graves’ disease to treat primary hypothyroidism and cretinism,
hypothyroidism. Dr. Smith prescribes c. Thyrotoxicosis although it also may be used to treat secondary
levothyroxine (Levothroid), 25 mcg P.O. d. Euthyroidism hypothyroidism. It is contraindicated in Graves’
daily. For which condition is levothyroxine disease and thyrotoxicosis because these conditions
the preferred agent? are forms of hyperthyroidism. Euthyroidism, a term
used to describe normal thyroid function, wouldn’t
require any thyroid preparation.
10. Which of these signs suggests that a a. Tetanic contractions 10. Answer B. SIADH secretion causes antidiuretic
male client with the syndrome of b. Neck vein distention hormone overproduction, which leads to fluid
inappropriate antidiuretic hormone (SIADH) c. Weight loss retention. Severe SIADH can cause such
secretion is experiencing complications? d. Polyuria complications as vascular fluid overload, signaled by
neck vein distention. This syndrome isn’t associated
with tetanic contractions. It may cause weight gain
and fluid retention (secondary to oliguria).
11. A female client with a history of a. phentolamine (Regitine). 11. Answer A. Pheochromocytoma causes
pheochromocytoma is admitted to the hospital b. methyldopa (Aldomet). excessive production of epinephrine and
in an acute hypertensive crisis. To reverse c. mannitol (Osmitrol). norepinephrine, natural catecholamines that raise the
hypertensive crisis caused by d. felodipine (Plendil). blood pressure. Phentolamine, an alpha-adrenergic
pheochromocytoma, nurse Lyka expects to blocking agent given by I.V. bolus or drip,
administer: antagonizes the body’s response to circulating
epinephrine and norepinephrine, reducing blood
pressure quickly and effectively. Although
methyldopa is an antihypertensive agent available in
parenteral form, it isn’t effective in treating
hypertensive emergencies. Mannitol, a diuretic, isn’t
used to treat hypertensive emergencies. Felodipine,
, an antihypertensive agent, is available only in
extended-release tablets and therefore doesn’t reduce
blood pressure quickly enough to
correct hypertensive crisis.
12. A male client with a history of a. Adrenal cortex 12. Answer A. Excessive secretion of aldosterone
hypertension is diagnosed with primary b. Pancreas in the adrenal cortex is responsible for the client’s
hyperaldosteronism. This diagnosis indicates c. Adrenal medulla hypertension. This hormone acts on the renal tubule,
that the client’s hypertension is caused by d. Parathyroid where it promotes reabsorption of sodium and
excessive hormone secretion from which of excretion of potassium and hydrogen ions. The
the following glands? pancreas mainly secretes hormones involved in fuel
metabolism. The adrenal medulla secretes the
catecholamines — epinephrine and norepinephrine.
The parathyroids secrete parathyroid hormone.
13. Nurse Troy is aware that the most a. Risk for infection 13. Answer A. Addison’s disease decreases the
appropriate for a client with Addison’s b. Excessive fluid volume production of all adrenal hormones, compromising
disease? c. Urinary retention the body’s normal stress response and increasing the
d. Hypothermia risk of infection. Other appropriate nursing
diagnoses for a client with Addison’s disease include
Deficient fluid volume and Hyperthermia. Urinary
retention isn’t appropriate because Addison’s disease
causes polyuria.
14. Acarbose (Precose), an alpha- a. “If I have hypoglycemia, I should eat 14. Answer A. Acarbose delays glucose
glucosidase inhibitor, is prescribed for a some sugar, not dextrose.” absorption, so the client should take an oral form of
female client with type 2 diabetes mellitus. b. “The drug makes my pancreas release dextrose rather than a product containing table sugar
During discharge planning, nurse Pauleen more insulin.” when treating hypoglycemia. The alpha-glucosidase
would be aware of the client’s need for c. “I should never take insulin while inhibitors work by delaying the carbohydrate
additional teaching when the client states: I’m taking this drug.” digestion and glucose absorption. It’s safe to be on a
d. “It’s best if I take the drug with the regimen that includes insulin and an alpha-
first bite of a meal.” glucosidase inhibitor. The client should take the drug
at the start of a meal, not 30 minutes to an hour
before.
15. A female client whose physical a. “You must lie flat for 24 hours after 15. Answer B. After a transsphenoidal
findings suggest a hyperpituitary condition surgery.” hypophysectomy, the client must refrain from
undergoes an extensive diagnostic workup. b. “You must avoid coughing, sneezing, coughing, sneezing, and blowing the nose for
Test results reveal a pituitary tumor, which and blowing your nose.” several days to avoid disturbing the surgical graft
necessitates a c. “You must restrict your fluid intake.” used to
transphenoidal hypophysectomy. The evening close the wound. The head of the bed must be
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