Lewis’s Medical-Surgical - Chapter 52: Assessment: Endocrine System

A young adult patient who is being seen in the clinic has excessive secretion of the anterior pituitary hormones. Which laboratory test result would the nurse expect?

a. Increased urinary cortisol

b. Decreased serum thyroxine

c. Elevated serum aldosterone

d. Low urinary catecholamines

a. Increased urinary cortisol

Which statement made by a 50-yr-old female patient indicates to the nurse that further assessment of thyroid function may be needed?

a. "I am so thirsty that I drink all day long."

b. "I get up several times at night to urinate."

c. "I feel a lump in my throat when I swallow."

d. "I notice my breasts are always tender lately."

c. "I feel a lump in my throat when I swallow."

A patient seen in the emergency department for severe headache and acute confusion has a serum sodium level of 118 mEq/L. The nurse would anticipate the need for which diagnostic test?

a. Urinary 17-ketosteroids

b. Antidiuretic hormone level

c. Growth hormone stimulation test

d. Adrenocorticotropic hormone level

b. Antidiuretic hormone level

Which question from the nurse during a patient interview would provide focused information about a possible thyroid disorder?

a. "What methods do you use to help cope with stress?"

b. "Have you experienced any blurring or double vision?"

c. "Have you had a recent unplanned weight gain or loss?"

d. "Do you have to get up at night to empty your bladder?"

c. "Have you had a recent unplanned weight gain or loss?"

A patient is scheduled in the outpatient clinic for blood cortisol testing. Which instruction would the nurse provide?

a. "Avoid adding any salt to your foods for 24 hours before the test."

b. "You will need to lie down for 30 minutes before the blood is drawn."

c. "Come to the laboratory to have the blood drawn early in the morning."

d. "Do not have anything to eat or drink before the blood test is obtained."

c. "Come to the laboratory to have the blood drawn early in the morning."

A patient admitted with pneumonia has a total serum calcium level of 13.3 mg/dL. Which serum level would the nurse anticipate will be tested next?

a. Calcitonin

b. Catecholamine

c. Thyroid hormone

d. Parathyroid hormone

d. Parathyroid hormone

During the physical examination, the nurse cannot feel the patient's thyroid gland. Which

action would the nurse 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.

b. Document that the thyroid was nonpalpable.

Which laboratory value would the nurse review to determine whether a patient's hypothyroidism is caused by a problem with the anterior pituitary gland?

a. Thyroxine (T4) level

b. Triiodothyronine (T3) level

c. Thyroid-stimulating hormone (TSH) level

d. Thyrotropin-releasing hormone (TRH) level

c. Thyroid-stimulating hormone (TSH) level

Which information will a patient's glycosylated hemoglobin (A1C) result provide to the nurse?

a. Fasting preprandial glucose levels

b. Glucose levels 2 hours after a meal

c. Glucose control over the past 90 days

d. Hypoglycemic episodes in the past 3 months

c. Glucose control over the past 90 days

A patient is taking a drug that blocks the action of aldosterone. Which additional effect of the

medication would the nurse monitor?

a. Increased serum sodium

b. Decreased urinary output

c. Elevated serum potassium

d. Evidence of fluid overload

c. Elevated serum potassium

A patient has been newly diagnosed with type 2 diabetes. Which information about the patient will be most useful to the nurse who is helping the patient develop strategies for successful adaptation to this disease?

a. Ideal weight

b. Value system

c. Activity level

d. Visual changes

b. Value system

An 18-yr-old male patient with small stature is scheduled for a growth hormone stimulation test. Which item would the nurse obtain in preparation for the test?

a. Ice in a basin

b. Glargine insulin

c. A cardiac monitor

d. 50% dextrose solution

d. 50% dextrose solution

In preparation for which test would the nurse teach the patient to minimize physical and emotional stress?

a. A water deprivation test

b. A test for serum T3 and T4 levels

c. A 24-hour urine test for free cortisol

d. A radioactive iodine (I-131) uptake test

c. A 24-hour urine test for free cortisol

Which instruction would the nurse give to a patient who is scheduled to complete a 24-hour urine collection for 17-ketosteroids?

a. Insert and maintain a retention catheter.

b. Keep the specimen refrigerated or on ice.

c. Drink at least 3 L of fluid during the 24 hours.

d. Void and save the specimen to start the collection.

b. Keep the specimen refrigerated or on ice.

Which additional information would the nurse consider when reviewing the laboratory results for a patient's total calcium level?

a. The blood glucose

b. The serum albumin

c. The phosphate level

d. The magnesium level

b. The serum albumin

A patient is admitted with tetany. Which laboratory value would the nurse plan to monitor?

a. Total protein

b. Blood glucose

c. Ionized calcium

d. Serum phosphate

c. Ionized calcium

Which information about a patient who is scheduled for an oral glucose tolerance test would the nurse consider in interpreting the test results?

a. The patient reports having occasional orthostatic dizziness.

b. The patient takes oral corticosteroids for rheumatoid arthritis.

c. The patient has had a 10 pound weight gain in the last month.

d. The patient drank several glasses of water an hour previously.

b. The patient takes oral corticosteroids for rheumatoid arthritis.

A nurse is caring for a patient with a goiter and possible hyperthyroidism. Which action by the nurse has the potential for patient harm?

a. The nurse checks the blood pressure in both arms.

b. The nurse palpates the neck to assess thyroid size.

c. The nurse orders saline eye drops to lubricate the patient's bulging eyes.

d. The nurse lowers the thermostat to decrease the temperature in the room.

b. The nurse palpates the neck to assess thyroid size.

The nurse is caring for a patient during a water deprivation test. Which finding is most important for the nurse to communicate to the health care provider?

a. The patient reports intense thirst.

b. The patient has a 5-lb (2.3-kg) weight loss.

c. The patient feels dizzy when sitting on the bed.

d. The patient's urine osmolality does not increase.

b. The patient has a 5-lb (2.3-kg) weight loss.

A patient with a possible pituitary adenoma is scheduled for a computed tomography (CT) scan with contrast media. Which patient information is 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 20 pounds

d. Patient reports ongoing headaches

b. Allergies to iodine and shellfish

The nurse is caring for a patient with a possible pituitary tumor who is scheduled for a computed tomography scan with contrast. Which information about the patient is important

to discuss with the health care provider before the test?

a. Report of chronic headache

b. History of renal insufficiency

c. Recent bilateral visual field loss

d. Blood glucose level of 134 mg/dL

b. History of renal insufficiency

Which instructions would the nurse include when teaching a patient who is scheduled for oral glucose tolerance testing in the outpatient clinic? (Select all that apply.)

a. "You will need to avoid smoking before the test."

b. "Exercise should be avoided until the testing is complete."

c. "Several blood samples will be obtained during the testing."

d. "You should follow a low-calorie diet the day before the test."

e. "The test requires that you fast for at least 8 hours before testing."

a. "You will need to avoid smoking before the test."

c. "Several blood samples will be obtained during the testing."

e. "The test requires that you fast for at least 8 hours before testing."