Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find:

1. Hypotension.
2. Thick, coarse skin.
3. Deposits of adipose tissue in the trunk and dorsocervical area.
4. Weight gain in arms and legs.

C. Deposits of adipose tissue in the trunk and dorsocervical area

For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek's sign and Trousseau's sign because they indicate which of the following?

1. Hypocalcemia
2. Hypercalcemia
3. Hypokalemia
4. Hyperkalemia

A. Hypocalcemia

An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of:

1. Thyroid storm.
2. Cretinism.
3. Myxedema coma.
4. Hashimoto's thyroiditis.

C. Myexedema coma.

In a 29-year-old female client who is being successfully treated for Cushing's syndrome, nurse Lyzette would expect a decline in:

1. Serum glucose level.
2. Hair loss.
3. Bone mineralization.
4. Menstrual flow.

A. Serum glucose level.

Nurse Oliver should expect a client with hypothyroidism to report which health concerns?

1. Increased appetite and weight loss
2. Puffiness of the face and hands
3. Nervousness and tremors
4. Thyroid gland swelling

B. Puffiness of the face and hands

Which nursing diagnosis takes highest priority for a female client with hyperthyroidism?

1. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess
2. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing
3. Body image disturbance related to weight gain and edema
4. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess

Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, nurse Tina assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?

1. Diabetic ketoacidosis
2. Thyroid crisis
3. Hypoglycemia
4. Tetany

B. Thyroid crisis

Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?

1. antidiuretic hormone (ADH)
2. thyroid-stimulating hormone (TSH)
3. follicle-stimulating hormone (FSH)
4. luteinizing hormone (LH)

A. antidiuretic hormone (ADH).

A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

1. Infusing I.V. fluids rapidly as ordered
2. Encouraging increased oral intake
3. Restricting fluids
4. Administering glucose-containing I.V. fluids as ordered

C. Restricting fluids

Nurse Troy is aware that the most appropriate for a client with Addison's disease?

1. Risk for infection
2. Excessive fluid volume
3. Urinary retention
4. Hypothermia

A. Risk for infection

A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect?

1. Dysuria
2. Leg cramps
3. Tachycardia
4. Blurred vision

C. Tachycardia

A female client with Cushing's syndrome is admitted to the medical-surgical unit. During the admission assessment, nurse Tyzz notes that the client is agitated and irritable, has poor memory, reports loss of appetite, and appears disheveled. These findings are consistent with which problem?

1. Depression
2. Neuropathy
3. Hypoglycemia
4. Hyperthyroidism

A. Depression

Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications?

1. Tetanic contractions
2. Neck vein distention
3. Weight loss
4. Polyuria

B. Neck vein distention

Which outcome indicates that treatment of a male client with diabetes insipidus has been effective?

1. Fluid intake is less than 2,500 ml/day.
2. Urine output measures more than 200 ml/hour.
3. Blood pressure is 90/50 mm Hg.
4. The heart rate is 126 beats/minute.

A. Fluid intake is less than 2,500 ml/day

In the administration of a drug such as levothyroxine (Synthroid), the nurse should teach the client:

1. That therapy typically lasts about 6 months.
2. That weekly laboratory tests for T4 levels will be required.
3. To report weight loss, anxiety, insomnia, and palpitations.
4. That the drug may be taken every other day if diarrhea occurs.

C. To report weight loss, anxiety, insomnia, and palpitations.

A patient with hyperthyroidism is taking propylthiouracil (PTU). The nurse will monitor the patient for:

1. gingival hyperplasia and lycopenemia.
2. dyspnea and a dry cough.
3. blurred vision and nystagmus.
4. fever and sore throat.

D. fever and sore throat.

A physician has prescribed propylthiouracil (PTU) for a client with hyperthyroidism and the nurse develops a plan of care for the client. A priority nursing assessment to be included in the plan regarding this medication is to assess for:

1. relief of pain
2. signs of renal toxicity
3. signs and symptoms of hyperglycemia
4. signs and symptoms of hypothyroidism

D. signs and symptoms of hypothyroidism

A physician prescribes levothyroxine sodium (Synthroid), 0.15 mg orally daily, for a client with hypothyroidism. The nurse will prepare to administer this medication:

1. in the morning to prevent insomnia
2. only when the client complains of fatigue and cold intolerance
3. at various times during the day to prevent tolerance from occurring
4. three times daily in equal doses of 0.5 mg each to ensure consistent serum drug levels

A. in the morning to prevent insomnia

Of what precautions should a client receiving radioactive iodine-131 be made aware?

1. Drink plenty of fluids, especially those high in calcium.
2. Avoid close contact with children or pregnant women for one week after administration of drug.
3. Be aware of the symptoms of tachycardia, increased metabolic rate, and anxiety.
4. Wear a mask if around children or pregnant women.

B. Avoid close contact with children or pregnant women for one week after administration of drug.

A client presents to the emergency room with a history of Graves' disease. The client reports having symptoms for a few days, but has not previously sought or received any additional treatment. The client also reports having had a cold a few days back. Which of the following interventions would be appropriate to implement for this client, based on the history and current symptoms? Select all that apply.

1. Administer aspirin
2. Replace intravenous fluids
3. Induce shivering
4. Relieve respiratory distress
5. Administer a cooling blanket

B. Replace intravenous fluids

C. Induce shivering

D. Relieve respiratory distress

E. Administer a cooling blanket

A nursing student is studying for a test on care of the client with endocrine disorders. Which of the following statements demonstrates an understanding of the difference between hyperthyroidism and hypothyroidism?

1. "Deficient amounts of TH cause abnormalities in lipid metabolism, with decreased serum cholesterol and triglyceride levels."
2. "Graves' disease is the most common cause of hypothyroidism."
3. "Decreased renal blood flow and glomerular filtration rate reduces the kidney's ability to excrete water, which may cause hyponatremia."
4. "Increased amounts of TH cause a decrease in cardiac output and peripheral blood flow."

C. "Decreased renal blood flow and glomerular filtration rate reduces the kidney's ability to excrete water, which may cause hyponatremia."

A nurse on a general medical-surgical unit is caring for a client with Cushing's syndrome. Which of the following statements is correct about the medication regimen for Cushing's syndrome?

1. Mitotane is used to treat metastatic adrenal cancer.
2. Aminogluthimide may be administered to clients with ectopic ACTH-secreting tumors before surgery is performed.
3. Ketoconazole increases cortisol synthesis by the adrenal cortex.
4. Somatostatin analog increases ACTH secretion in some clients.

A. Mitotane is used to treat metastatic adrenal cancer.

Which of the following nursing implications is most important in a client being medicated for Addison's disease?

1. Administer oral forms of the drug with food to minimize its ulcerogenic effect.
2. Monitor capillary blood glucose for hypoglycemia in the diabetic client.
3. Instruct the client to never abruptly discontinue the medication.
4. Teach the client to consume a diet that is high in potassium, low in sodium, and high in protein.

C. Instruct the client to never abruptly discontinue the medication.

The nurse is caring for a client who is about to undergo an adrenalectomy. Which of the following Preoperative interventions is most appropriate for this client?

1. Maintain careful use of medical and surgical asepsis when providing care and treatments.
2. Teach the client about a diet high in sodium to correct any potential sodium imbalances preoperatively.
3. Explain to the client that electrolytes and glucose levels will be measured postoperatively.
4. Teach the client how to effectively cough and deep breathe once surgery is complete.

A. Maintain careful use of medical and surgical asepsis when providing care and treatments.

A client newly diagnosed with Addison's disease is giving a return explanation of teaching done by the primary nurse. Which of the following statements indicates that further teaching is necessary?

1. "I need to increase how much I drink each day."
2. "I need to weigh myself if I think I am losing or gaining weight."
3. "I need to maintain a diet high in sodium and low in potassium."
4. "I need to take my medications each day."

B. "I need to weigh myself if I think that I am losing or gaining weight."

A patient with SIADH is treated with water restriction and administration of IV fluids. The nurses evaluates that treatment has been effective when the patient experiences

1. increased urine output, decreased serum sodium, and increased urine specific gravity
2. increased urine output, increased serum sodium, and decreased urine specific gravity
3. decreased urine output, increased serum sodium, and decreased urine specific gravity
4. decreased urine output, decreased serum sodium, and increased urine specific gravity

B. increased urine output, increased serum sodium, and decreased urine specific gravity

Causes of primary hypothyroidism in adults include

1. malignant or benign thyroid nodules
2. surgical removal or failure of the pituitary gland
3. surgical removal or radiation of thyroid gland
4. autoimmune-induced atrophy of the gland

D. autoimmune-induced atrophy of the gland

A patient with hypothyroidism is treated with Synthroid. When teaching the patient about the therapy, the nurse

1. explains that caloric intake must be reduced when drug therapy is started
2. provides written instruction for all information related to the medication therapy
3. assures the patient that a return to normal function will occur with replacement therapy
4. informs the patient that medications must be taken until hormone balance is reestablished

B. provides written instruction for all information related to the medication therapy

A patient is admitted to the hospital with a diagnosis of Cushing syndrome. On physical assessment of the patient, the nurse would expect to find

1. HTN, peripheral edema, and petechiae
2. weight loss, buffalo hump, and moon face with acne
3. abdominal and buttock striae, truncal obesity, and hypotension
4. anorexia, signs of dehydration, and hyper pigmentation of the skin

A. HTN, peripheral edema, and petechiae