Ch19 Test Questions & Answers Nursing Care Of Patients With - Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff by LeMone, Burke, Gerene Bauldoff. DOCX document preview.
LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)
Chapter 19 Nursing Care of Patients with Endocrine Disorders
1) While assessing a patient with an alteration in thyroid function, the nurse notes smooth, fine hair and warm, dry skin. Which question should the nurse ask this patient?
1. "Have you experienced any recent weight loss?"
2. "Have you been feeling constipated?"
3. "Have you noticed increased bruising?"
4. "Have you noticed a change in your skin color?"
Page Ref: 566
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with endocrine disorders.
2) The nurse is providing preoperative teaching to a patient scheduled for a subtotal thyroidectomy. What should the nurse include in these instructions?
1. Report sensations of tingling in toes, fingers, or lips.
2. Report signs of constipation.
3. Report the improvement of hoarseness.
4. Take aspirin before the surgery.
Page Ref: 570
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with endocrine disorders.
3) The nurse is caring for a patient with elevated serum T3 and T4 levels who receives a new prescription for methimazole (Tapazole). Which patient statement indicates that additional teaching is needed about this medication?
1. "This medication will increase my metabolism."
2. "I must contact my physician if I plan to become pregnant."
3. "It may take several weeks for this medication to take effect."
4. "I may take a beta-blocker along with this medication."
Page Ref: 569
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
4) The nurse is reviewing postoperative care for a patient scheduled for a thyroidectomy. What information should the nurse include in this teaching?
1. "Avoid the use of iodized salt after your procedure."
2. "Plastic surgery may be required to conceal the surgical scar."
3. "Use iodized salt when preparing foods."
4. "Perform neck flexion and extension exercises twice daily for several weeks postoperatively."
Page Ref: 576
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with endocrine disorders.
5) The nurse is caring for a patient with elevated serum thyroid hormones and new-onset proptosis. Which problem would be a priority for this patient?
1. Change in appearance
2. Altered immunity
3. Weight gain
4. Fluid retention
Page Ref: 566
Cognitive Level: Analyzing
Client Need & Sub: Psychosocial Integrity: Coping Mechanisms
Standards: QSEN Competencies: I.B.3. Provide patient-centered care with sensitivity and respect for the diversity of human experience | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
6) A patient whose thyroid gland produces an insufficient amount of thyroid hormone is concerned about an elevated cholesterol level. What should the nurse explain to this patient?
1. "The thyroid gland malfunction can affect your cholesterol level."
2. "Maybe you don't realize how much fat is in the foods you eat."
3. "Elevated cholesterol is a normal part of aging."
4. "Describe your typical bedtime snack."
Page Ref: 573
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
7) The family of an older patient with hypothyroidism is concerned about the open wounds on the patient's legs and arms. How should the nurse respond to the family's questions about bathing?
1. "Use warm water to bathe the patient."
2. "Make sure bathing occurs daily."
3. "Use firm, consistent strokes when bathing."
4. "Follow the bath with a rubbing-alcohol massage."
Page Ref: 577
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Basic Care and Comfort
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
8) The nurse is assessing a patient who has an abnormally high level of parathyroid hormone. Which assessment finding would be consistent with this diagnosis? Select all that apply.
1. Muscle atrophy
2. Muscle weakness
3. Diarrhea
4. Weight gain
5. Hypotension
Page Ref: 580
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with endocrine disorders.
9) The nurse is providing care to a patient with a low level of serum parathyroid hormone. What should the nurse expect to assess in this patient? Select all that apply.
1. Brittle nails
2. Abdominal cramps
3. Hair loss
4. Dysrhythmias
5. Smooth, soft skin
Page Ref: 580
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with endocrine disorders.
10) A patient taking steroids for an autoimmune disorder asks when the weight loss in the legs is going to stop. What should the nurse realize the patient is experiencing?
1. Muscle wasting
2. Poor wound healing
3. Risk for compression fractures
4. Increased susceptibility to infections
Page Ref: 581
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
11) The nurse is providing care to a patient recovering from a bilateral adrenalectomy. What should the nurse do to assess for the onset of adrenal insufficiency?
1. Monitor strict intake and output.
2. Change the dressing using clean technique.
3. Question the order for cortisol administration.
4. Place the patient on fluid restriction.
Page Ref: 586
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
12) A patient with Cushing syndrome is concerned about having a head cold every few weeks. What should the nurse do to address this patient's concern?
1. Assess for protein and vitamin intake.
2. Plan for frequent rest periods.
3. Encourage daily weights.
4. Review coping strategies.
Page Ref: 583
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
13) A patient with an adrenal gland alteration asks why the skin appears tan when no time is spent outdoors in the sun. What should the nurse do to address the patient's concern?
1. Ask if the patient is still taking steroids prescribed for another illness.
2. Ask the patient what time of day he is outdoors.
3. Auscultate the patient's lung sounds.
4. Palpate the patient's thyroid gland.
Page Ref: 584
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
14) A patient is experiencing manifestations of Addisonian crisis. What should the nurse expect to provide to this patient?
1. Intravenous fluids
2. Warm blankets
3. Thyroid replacement hormone
4. Blood transfusion
Page Ref: 586
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with endocrine disorders.
15) A 35-year-old female patient taking oral contraceptives is prescribed steroid therapy. What is a priority teaching point for this patient?
1. "Consider adding another form of contraception while using both medications."
2. "These medications do not interact. No changes need to be made."
3. "Measure your weight daily."
4. "Avoid the use of salt."
Page Ref: 586
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
16) The nurse is reviewing the relationship between thyroid hormone and iodine. Which information should the nurse identify that is least likely to cause iodine deficiency and hypothyroidism?
1. Eating large amounts of shellfish
2. Using prescribed lithium carbonate
3. Eating large amounts of turnips or rutabagas
4. Living in an area where iodine is deficient in the soil
Page Ref: 575
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with endocrine disorders.
17) The nurse is reviewing orders for a patient in myxedema coma. Which prescription should the nurse question before administering to this patient? Select all that apply.
1. Regular insulin IV at 5 units per hour
2. Cooling blanket
3. Methimazole (Tapazole) 15 mg PO daily
4. Pulse oximetry and vital signs hourly
5. Serum TSH level daily
Page Ref: 576
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with endocrine disorders.
18) The nurse is describing the manifestations of myxedema coma to a patient with hypothyroidism. What should the nurse identify as precipitating factors for this health problem? Select all that apply.
1. Stroke
2. Pneumonia
3. Excessive use of thyroid replacement medications
4. Excessive use of central nervous system stimulants
5. Exposure to excessive heat and humidity
Page Ref: 575
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with endocrine disorders.
19) The nurse is reviewing the laboratory results for a group of patients. Which set of results should the nurse identify as being consistent with primary hypothyroidism?
1. Elevated TSH, depressed T3 and T4
2. Elevated TSH, elevated T3 and T4
3. Depressed TSH, elevated T3 and T4
4. Depressed TSH, depressed T3 and T4
Page Ref: 569
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with endocrine disorders.
20) The nurse is caring for a patient with untreated hypothyroidism. For which health problem should the nurse assess this patient? Select all that apply.
1. Elevated serum cholesterol
2. Anemia
3. Hyperglycemia
4. Hypernatremia
5. Decreased serum LDL
Page Ref: 573
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Practice; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with endocrine disorders.
21) The nurse is teaching a patient who has a diagnosis of hypothyroidism about the importance of dietary fiber. Which statement by the patient indicates that teaching has been effective? Select all that apply.
1. "I will drink a full glass of water with my fiber pill each morning."
2. "I will snack on fruit rather than potato chips."
3. "I will take an over-the-counter fiber pill each morning with my levothyroxine."
4. "I will increase my intake of protein sources such as meat and eggs."
5. "I will read the nutrition labels and choose foods with high carbohydrate content."
Page Ref: 576
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
22) The nurse is screening a group of patients for risk factors related to thyroid cancer. Which patient should the nurse recognize as having the highest risk for developing thyroid cancer?
1. A 75-year-old patient with a history of sinus infections in childhood
2. A 70-year-old patient who refinishes furniture as a hobby
3. An 80-year-old patient whose diet consists largely of red meat
4. An 85-year-old patient who works outdoors without sunscreen
Page Ref: 579
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.2 Describe the pathophysiology and manifestations of disorders of the parathyroid glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with endocrine disorders.
23) The nurse is reviewing the manifestations of hyperparathyroidism with a patient. Which statement by the patient indicates that teaching has been effective? Select all that apply.
1. "Hyperparathyroidism can cause the kidneys to keep calcium and excrete phosphorus."
2. "Calcium and phosphorus leave the bones and make them weak."
3. "Calcium is deposited in soft tissues."
4. "Kidney stones can develop."
5. "The kidneys work to raise blood pH and retain potassium."
Page Ref: 579
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 19.2 Describe the pathophysiology and manifestations of disorders of the parathyroid glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with endocrine disorders.
24) The nurse is instructing a patient about the symptoms of hyperparathyroidism. Which symptom should the nurse include in this discussion? Select all that apply.
1. Abdominal pain
2. Dysrhythmias
3. Hypertension
4. Diarrhea
5. Reduced urine output
Page Ref: 580
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 19.2 Describe the pathophysiology and manifestations of disorders of the parathyroid glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with endocrine disorders.
25) A patient with hyperparathyroidism is taking digoxin (Lanoxin). For what should the nurse assess this patient?
1. Toxic effects of digoxin (Lanoxin)
2. Evidence the medication dose needs to be increased
3. Onset of polyuria
4. Muscle weakness and atrophy
Page Ref: 580
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.2 Describe the pathophysiology and manifestations of disorders of the parathyroid glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
26) The nurse is developing a plan of care for a patient with hyperparathyroidism and a serum calcium level of 12.0 mg/dL. What should be included in the plan? Select all that apply.
1. Promoting ambulation and mobility
2. Discussing a change from ordered thiazide diuretics to another type of diuretic with healthcare provider
3. Teaching to increase daily oral intake of fluids
4. Encouraging supplementation of fat-soluble vitamins
5. Encouraging use of calcium-based antacids for indigestion
Page Ref: 580
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Integrity
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 19.2 Describe the pathophysiology and manifestations of disorders of the parathyroid glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
27) A patient with hyperparathyroidism secondary to renal failure is prescribed calcimimetic. What should the nurse instruct the patient about this medication?
1. It increases the sensitivity of the calcium-sensing receptors of the parathyroid gland to serum calcium.
2. It blocks calcium receptors in the nervous and musculoskeletal systems.
3. It decreases resorption of calcium in the distal renal tubule.
4. It binds calcium to bile salts that are then excreted through the GI tract.
Page Ref: 580
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 19.2 Describe the pathophysiology and manifestations of disorders of the parathyroid glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
28) The nurse notes that a patient who has hypoparathyroidism has a serum calcium level of 6.8 mg/dL. What would be a priority problem when planning care for this patient?
1. Potential for injury
2. Safety concerns because of confusion
3. Changes in renal function
4. Problems with oxygenation
Page Ref: 580
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 19.2 Describe the pathophysiology and manifestations of disorders of the parathyroid glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
29) The nurse is caring for a patient with hypoparathyroidism. What action should the nurse expect to perform to help this patient with a low calcium level? Select all that apply.
1. Administering calcium tablets as prescribed
2. Arranging for a dietary consult regarding foods high in calcium
3. Restricting fluids
4. Administering intravenous IV calcium gluconate
5. Administering calcimimetic
Page Ref: 580
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 19.2 Describe the pathophysiology and manifestations of disorders of the parathyroid glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with endocrine disorders.
30) The nurse suspects that a patient with chronic hyperfunction of the adrenal cortex has an infection. What did the nurse assess to come to this conclusion?
1. General feeling of malaise
2. Recent weight loss
3. Muscular tremors
4. Sense of nervous energy
Page Ref: 583
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
31) The nurse is reviewing health history information for a group of patients. Which patient should the nurse identify as being at the lowest risk of developing Cushing syndrome?
1. The patient who received radioactive iodine treatment for hyperthyroidism
2. The patient receiving treatment for rheumatoid arthritis
3. The patient who has had an organ transplant
4. The patient receiving chemotherapy to treat a brain tumor
Page Ref: 581
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
32) A patient is prescribed prednisone (Dexasone) for a chronic health problem. Which sign of Cushing syndrome should the nurse instruct this patient to report to the healthcare provider? Select all that apply.
1. Fat deposits in the abdominal and clavicle regions
2. Muscle weakness and wasting in the extremities
3. Delayed wound healing
4. Development of varicose leg veins
5. Hypotension
Page Ref: 581
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
33) The nurse is assessing a patient with Cushing syndrome. Which finding should the nurse report for immediate follow-up?
1. Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg
2. Serum sodium 145 mEq/L and reports of muscle weakness
3. Serum calcium 11 mg/dL and reports of feelings of depression
4. Serum phosphorus 3 mg/dL and hirsutism
Page Ref: 582
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with endocrine disorders.
34) A patient with suspected Cushing syndrome is prescribed a 24-hour urine collection. What should the nurse explain to the patient about the reason for this urine collection?
1. It measures the amount of cortisol in the urine over 24 hours.
2. At least 2000 mL of urine is required to perform the test.
3. It identifies urine specific gravity changes over a 24-hour period.
4. The 24-hour timeline reduces unwanted effects of medications excreted in the urine.
Page Ref: 582
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with endocrine disorders.
35) A patient with a non-ACTH-producing adrenal cortex tumor is scheduled for a surgical procedure to remove the tumor. Which statement by the patient indicates that teaching about the procedure has been effective?
1. "The adrenal gland with the tumor will be removed."
2. "I will need to take adrenal hormones for the rest of my life."
3. "The tumor will be removed by the transsphenoidal route."
4. "I will receive IV cortisol in preparation for the surgery."
Page Ref: 582
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
36) The nurse is preparing to assess a patient with Cushing syndrome. Which finding should the nurse expect to assess in this patient? Select all that apply.
1. Weight gain
2. Auscultatory lung crackles
3. Jugular vein distention
4. Peripheral edema
5. Hypotension
Page Ref: 583
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
37) The nurse prepares teaching material for a patient with Cushing syndrome. Which statement about the risk for infection should the nurse alter before teaching?
1. "Epidermal hypertrophy restricts macrophage activity."
2. "Cortisol affects protein synthesis."
3. "Cortisol inhibits collagen synthesis."
4. "The resulting edema impairs blood flow to tissues."
Page Ref: 581
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
38) The nurse is planning a teaching session for a patient with a new diagnosis of adrenoleukodystrophy. What topic should the nurse include?
1. Why genetic counseling is included in the plan of care
2. The role of autoimmunity in the development of the disorder
3. The role of anticoagulants in the development of the disorder
4. The surgical site for transsphenoidal entry, using a diagram
Page Ref: 584
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
39) A patient with Addison disease is experiencing weakness and abdominal pain and has an oral temperature of 102°F and blood pressure of 70/35 mmHg. Which patient information should the nurse identify as potentially causing these manifestations? Select all that apply.
1. "I had my tonsils out last week."
2. "I have a pressure ulcer from sleeping in my recliner."
3. "I have been using a tanning bed."
4. "I take my prednisone (Deltasone) every day."
5. "I have been increasing my intake of calcium-rich foods."
Page Ref: 585
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
40) A patient recovering from a closed head injury has a urine specific gravity of 1.010 g/mL. The previous intake and output totals were 1200 mL intake and 10,000 mL output. Which prescription from the healthcare provider should the nurse question for this patient?
1. Desmopressin (Minirin) 0.2 mg by mouth daily
2. Oral fluid restriction of 800 mL per day
3. 3% normal saline at 100 mL per hour
4. Computed tomography scan of head
Page Ref: 590
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 19.4 Describe the pathophysiology and manifestations of disorders of the pituitary gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with endocrine disorders.
41) A patient with hyperthyroidism is experiencing vision changes. What teaching should the nurse provide to preserve this patient's sight? Select all that apply.
1. Apply eye shields.
2. Instill artificial tears.
3. Wear eyeglasses with tinted lenses.
4. Apply warm compresses to the eyes every 4 hours.
5. Notify the healthcare provider about vision changes.
Page Ref: 571
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
42) The nurse in the postanesthesia care area is concerned that a patient recovering from a subtotal thyroidectomy is experiencing postoperative complications. What finding led the nurse to come to this conclusion? Select all that apply.
1. Hoarse voice
2. Restlessness and irritability
3. Blood pressure 92/56 mmHg
4. Heart rate 116 beats per minute
5. High-pitched, squeaky sound with breathing
Page Ref: 570
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Practice-Know-How; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with endocrine disorders.
43) A patient with Addison disease is experiencing problems with fluid balance. What actions should the nurse take to help this patient? Select all that apply.
1. Teach to sit and stand slowly.
2. Monitor cardiac monitor rhythm.
3. Turn and reposition every 2 hours while awake.
4. Weigh the patient daily at the same time and in the same clothing.
5. Encourage oral fluid intake of 3000 mL/day and increased salt intake.
Page Ref: 586-587
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 19.3 Describe the pathophysiology and manifestations of disorders of the adrenal glands, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
44) A patient with hypothyroidism is prescribed levothyroxine sodium (Synthroid). What dietary adjustment should the nurse instruct the patient to make? Select all that apply.
1. Avoid eating walnuts.
2. Avoid all grapefruit or citrus fruits.
3. Restrict the intake of foods high in fiber.
4. Reduce the intake of green leafy vegetables.
5. Take the medication 30 minutes before eating breakfast in the morning.
Page Ref: 576
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 19.1 Describe the pathophysiology and manifestations of disorders of the thyroid gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with endocrine disorders.
45) A patient recovering from a head injury is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which should the nurse expect to be prescribed for this patient? Select all that apply.
1. Restrict fluids.
2. Increase oral fluids.
3. Provide a loop diuretic.
4. Administer Conivaptan.
5. Administer demeclocycline.
Page Ref: 590
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Practice; Apply evidence to support decision making in situations characterized by ambiguity and uncertainty | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 19.4 Describe the pathophysiology and manifestations of disorders of the pituitary gland, and outline the interprofessional care and nursing care of patients with these disorders.
MNL Learning Outcome: 2. Consider intraprofessional care for patients with endocrine disorders.
Document Information
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