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A patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which of the following patient information is most important for the nurse to communicate to the health care provider before the test?
- A. Bilateral poor peripheral vision
- B. Allergies to iodine and shellfish
- C. Recent weight loss of 8.5 kg
- D. History of ongoing headaches
Correct Answer: B
Rationale: Since the usual contrast media is iodine-based, the health care provider will need to know about the allergy before the CT scan. The other findings are common with any mass in the brain such as a pituitary adenoma.
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A patient is scheduled for a growth hormone stimulation test. Which of the following items should the nurse obtain in preparation for the test?
- A. Basin of ice
- B. Cardiac monitor
- C. Vial of glargine insulin
- D. Intravenous dextrose solution
Correct Answer: D
Rationale: Hypoglycemia is induced during the growth hormone stimulation test, and the nurse should be prepared to administer glucose IV immediately or have a sweet snack available for the patient immediately following the test. Regular insulin is used to induce hypoglycemia (glargine is never given intravenously). The patient does not require cardiac monitoring during the test. Although blood samples for some tests must be kept on ice, this is not true for the growth hormone stimulation test.
The nurse is interviewing a patient who has a possible thyroid disorder. Which of the following questions will provide the most useful information?
- A. What methods do you use to help cope with stress?
- B. Have you experienced any blurring or double vision?
- C. Do you have to get up at night to empty your bladder?
- D. Have you had any recent unplanned weight gain or loss?
Correct Answer: D
Rationale: Because thyroid function affects metabolic rate, changes in weight may indicate hyper- or hypofunction of the thyroid gland. Nocturia, visual difficulty, and changes in stress level are associated with other endocrine disorders.
During a physical examination, the nurse finds that a patient's thyroid gland cannot be palpated. Which of the following is the best action for the nurse to take?
- A. Palpate the patient's neck more deeply.
- B. Document that the thyroid was nonpalpable.
- C. Notify the health care provider immediately.
- D. Teach the patient about thyroid hormone testing.
Correct Answer: B
Rationale: The thyroid is frequently nonpalpable. The nurse should simply document the finding. There is no need to notify the health care provider immediately about a normal finding. There is no indication for TSH testing unless there is evidence of thyroid dysfunction. Deep palpation of the neck is not appropriate.
The nurse is caring for a patient who was admitted with tetany. Which of the following laboratory values should the nurse monitor?
- A. Total protein
- B. Blood glucose
- C. Ionized calcium
- D. Serum phosphate
Correct Answer: C
Rationale: Tetany is associated with hypocalcemia. The other values would not be useful for this patient in relation to tetany.
A patient who has diabetes mellitus asks the nurse what the glycosylated hemoglobin (HbA1c) test measures. Which of the following explanations should be the basis of the nurse's response?
- A. Glucose levels 2 hours after a meal
- B. Circulating, non-fasting glucose levels
- C. Glucose control over the past 3 months
- D. Hypoglycemic episodes in the past 90 days
Correct Answer: C
Rationale: Glycosylated hemoglobin testing measures glucose control over the last 3 months. Glucose testing after a meal or random testing may reveal impaired glucose tolerance and indicate prediabetes, but it is not done on patients who already have a diagnosis of diabetes. There is no test to evaluate for hypoglycemic episodes in the past.