Nokea
The nurse is reviewing endocrine disorders with a group of students. It would be correct for the nurse to identify which manifestation is associated with hyperthyroidism?
- A. Injected (red) conjunctiva
- B. Insomnia
- C. Increased systolic blood pressure
- D. Diaphoresis
- E. Confusion
Correct Answer: B, C, D
Rationale: Hyperthyroidism increases metabolism, causing insomnia, elevated systolic BP, and sweating (diaphoresis). Red conjunctiva and confusion are not typical features of this condition.
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A nurse is caring for a client receiving metformin. Which of the following laboratory data should be reported to the provider?
- A. Decreased blood urea nitrogen (BUN) level
- B. Decreased glomerular filtration rate (GFR)
- C. Decreased fasting plasma glucose
- D. Decreased hemoglobin A1C
Correct Answer: B
Rationale: A decreased GFR indicates renal impairment, increasing the risk of metformin-associated lactic acidosis, requiring immediate reporting. Decreased BUN, glucose, and HbA1c are expected or less urgent.
The nurse is caring for a client who is receiving newly prescribed prednisone. Which of the following medications should the client avoid while receiving this medication?
- A. valsartan
- B. naproxen
- C. omeprazole
- D. acetaminophen
Correct Answer: B
Rationale: Naproxen, an NSAID, should be avoided with prednisone due to increased risk of gastrointestinal bleeding and ulceration. Valsartan, omeprazole, and acetaminophen are generally safe with prednisone, though monitoring is needed.
The nurse is performing a physical assessment on a client with Cushing's disease. Which assessment findings should the nurse expect?
- A. Hypotension
- B. Acne
- C. Hirsutism
- D. Buffalo hump
- E. Truncal obesity
Correct Answer: B, C, D, E
Rationale: Cushing's disease from excess cortisol causes acne, hirsutism (excess hair), buffalo hump, and truncal obesity due to fat redistribution. Hypertension, not hypotension, is typical.
The following scenario applies to the next 1 items
The nurse in the emergency department cares for a 45-year-old female
Nurses’ Note
The client reports significant fatigue that has worsened over the past eight weeks. Additionally, the client reports constipation, hair loss, and a 3-kilogram (6.6 pounds) weight gain. She reports missing work because of difficulty concentrating and persistent fatigue.
The client is alert and fully oriented. She appears fatigued and reports dizziness when she moves quickly. Periorbital edema, various bruises, and facial swelling were noted on assessment. Peripheral pulses were intact and weak. The client denies any pain.
Vital Signs
Oral temperature 97 F (36.1o C); Pulse 51/minute; Respirations 15/minute.
BP 93/61 mm Hg; Oxygen saturation 95% on room air.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two (2) actions the nurse should take to address that condition, and two (2) parameters the nurse should monitor to assess the client's progress.
- A. Obtain a prescription for levothyroxine, Obtain a prescription for methimazole, Have the client complete a blood transfusion consent, Obtain an order for a urine cortisol level, Initiate fall precautions.
- B. Vital Signs, Serum TSH/T3/T4 levels, Intake and Output, Cortisol Level, BUN and Creatinine.
- C. Graves' disease, Cushing's syndrome, Hypothyroidism, Systemic Lupus Erythematosus, Adrenal Insufficiency.
Correct Answer: C, A, E, B
Rationale: Fatigue, weight gain, and bradycardia suggest hypothyroidism. Levothyroxine treats it, fall precautions address dizziness, and TSH/T3/T4 and vital signs monitor progress.
The nurse is planning a staff education program about conditions that increase cortisol levels. Which of the following conditions should the nurse include?
- A. Addison's disease
- B. Congestive heart failure (CHF)
- C. Renal failure
- D. Cushing's disease
Correct Answer: D
Rationale: Cushing's disease increases cortisol due to excess ACTH. Addison's reduces cortisol, and CHF and renal failure do not directly elevate cortisol levels.