Nokea
The nurse is teaching a patient how to prepare for an oral glucose tolerance test (OGTT). Which of the following patient response indicates that the teaching has been effective?
- A. Fast 12 hours before the procedure
- B. Clear fluid diet 12 hours prior to the test
- C. Drink only full fluids 6 hours before the test
- D. No fluid or food restrictions prior to the test
Correct Answer: A
Rationale: Fasting for 12 hours before the procedure demonstrates that teaching has been effective. The patient is to be NPO 12 hours prior to the test. A clear fluid diet 12 hours pretest is not indicated. A full fluid diet 6 hours pretest is not indicated.
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The nurse is obtaining the health history from a patient. Which of the following statements by the patient indicates further assessment of thyroid function may be necessary?
- A. I notice my breasts are tender lately.
- B. I am so thirsty that I drink all day long.
- C. I get up several times at night to urinate.
- D. I feel a lump in my throat when I swallow.
Correct Answer: D
Rationale: Difficulty in swallowing can occur with a goitre. Nocturia is associated with diseases such as diabetes mellitus, diabetes insipidus, or persistent kidney disease. Breast tenderness would occur with excessive gonadal hormone levels. Thirst is a sign of disease such as diabetes.
The nurse is evaluating the laboratory results for a patient who has increased secretion of the anterior pituitary hormones. Which of the following findings should the nurse anticipate when reviewing the laboratory findings?
- A. Decreased serum thyroxine levels
- B. Elevated serum aldosterone levels
- C. An increase in urinary free cortisol
- D. Low urinary excretion of catecholamines
Correct Answer: C
Rationale: Increased secretion of adrenocorticotropic hormone (ACTH) by the anterior pituitary gland will lead to an increase in serum and urinary cortisol levels. An increase, rather than a decrease, in thyroxine level would be expected with increased secretion of thyroid-stimulating hormone (TSH) by the anterior pituitary. Aldosterone and catecholamine levels are not controlled by the anterior pituitary.
The nurse is caring for a patient who is preparing for a growth hormone stimulation test. Which of the following adverse effects should the nurse monitor for during the test?
- A. Bradycardia
- B. Hypotension
- C. Hyperglycemia
- D. Tachypnea
Correct Answer: B
Rationale: During a growth hormone stimulation test, the nurse should continually assess for hypoglycemia and hypotension. There is no indication to monitor for bradycardia or tachypnea.
Which of the following information about a patient who is scheduled for an oral glucose tolerance test should be reported to the health care provider before starting the test?
- A. Occasional orthostatic dizziness
- B. A 5 kg weight gain in the last month
- C. Intake of 1 L of water an hour previously
- D. Oral corticosteroid use for rheumatoid arthritis
Correct Answer: D
Rationale: Corticosteroids can affect blood glucose results. The other information will be provided to the provider but will not affect the test results.
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.