Download TESTBANK Chapter Title: The History and Interviewing Process

TESTBANK Chapter Title: Endocrine Clinical Assessment and Diagnostic Procedures
Chapter #: Chapter 35
1. Which of the following laboratory results is found in the patient with hyperglycemia?
1. Insulin level of 25 µU/ml
2. Absence of ketones in the blood
3. Presence of ketones in the urine
4. Serum osmolality of 270 mOsm/Kg H2O
2. A hydration assessment consists of checking a variety of parameters, including:
1. skin turgor.
2. serum potassium.
3. capillary refill.
4. serum protein.
3. Glycosylated hemoglobin levels provide information about:
1. the average blood glucose over the previous 3 to 4 months.
2. blood glucose levels in comparison to serum hemoglobin.
3. serial glucose readings after ingestion of a concentrated glucose solution.
4. the difference between serum and urine glucose levels.
4. The diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH) is made when which of the following conditions are
present?
1. Decreased antidiuretic hormone (ADH) level and hyperkalemia
2. Decreased ADH level and hypernatremia
3. Increased ADH level and serum ketones
4. Increased ADH level and low serum osmolality
5. Decreased urine osmolality is a sign of:
1. hyperglycemia.
2. diabetes insipidus.
3. thyroid crisis.
4. SIADH.
6. Which of the following laboratory studies or diagnostic procedures is most useful in identifying nephrogenic or neurogenic
diabetes insipidus?
1. Skull x-rays
2. Serum glucose
3. Water deprivation test
4. Vasopressin stimulation test
7. The patient with thyrotoxicosis may exhibit which of the following signs or symptoms?
1. Lethargy
2. Bradycardia
3. Constipation
4. Increased appetite
8. Which of the following laboratory findings is indicative of thyrotoxicosis?
1. Increased T3 level
2. Decreased T3 uptake ratio
3. Increased serum osmolality
4. Decreased urine osmolality
Copyright © 2003, Elsevier Science (USA). All rights reserved.
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Questions 9-10 refer to the following situation.
Ms. K. is a 16-year-old woman admitted to the critical care unit with severe hyperglycemia secondary to new onset type I diabetes
mellitus.
9. Which of the following signs and symptoms obtained as part of Ms. K.’s history might indicate the presence of hyperglycemia?
1. Recent episodes of tachycardia and missed heart beats
2. Decreased urine output accompanied by peripheral edema
3. Periods of hyperactivity with weight gain
4. Increased thirst and increased urinary output
10. The nurse assesses a sweet-smelling odor on Ms. K.’s exhaled breath. This is a result of:
1. compensation for metabolic alkalosis.
2. the body attempting to decrease accumulated acids.
3. prior ingestion of high-calorie foods.
4. decreased serum osmolality.
11. The nurse knows that which of the following signs may indicate diabetes?
1. Kidney stones
2. Indigestion and diarrhea
3. Loss of appetite
4. Blurred vision and memory loss
12. The patient has a fasting glucose level of 150 mg/dl. The nurse knows this value is:
1. normal.
2. elevated but may be the result of the stress of hospitalization.
3. lower than what the nurse would expect in a patient with IV fluids.
4. elevated and indicates DKA.
13. Which of the following would be used to evaluate the patient’s blood sugar levels over the past 3 months?
1. Glycosylated hemoglobin levels
2. Insulin levels
3. Serum glucose levels
4. Serum ketones
14. The patient weighed 62 kilograms on admission yesterday. Today, the patient weighs 60 kilograms. The nurse knows this
reflects a fluid loss of:
1. 1 liter.
2. 2 liters.
3. 4 liters.
4. 10 liters.
15. When preparing the patient for a serum ADH level, the nurse must withhold:
1. insulin and furosemide.
2. phenytoin and glucocorticoids.
3. Lanoxin and potassium.
4. heparin and beta-blockers.
16. The nurse knows that a serum osmolality of 378 mOsm/kg indicates a patient who is:
1. overhydrated.
2. normal.
3. dehydrated.
4. hypokalemic.
Copyright © 2003, Elsevier Science (USA). All rights reserved.
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17. The nurse knows that the best test to differentiate between central and nephrogenic diabetes insipidus is:
1. the water deprivation test.
2. serum osmolality.
3. CT Scan.
4. the vasopressin stimulation test.
18. The nurse knows that an abnormal response to a vasopressin stimulation test would be:
1. a slight increase in urine osmolality.
2. a decrease in urine output.
3. a decrease in serum osmolality.
4. no change in urine osmolality.
19. When evaluating the patient for a pituitary tumor, attention on the CT scan should be focused on the:
1. frontal lobe.
2. sella turcica.
3. temporal lobe.
4. anterior fossa.
20. A patient complains of losing weight even though she “eats everything in sight.” She also complains of tremors and diarrhea.
The nurse would suspect:
1. hypothyroidism.
2. diabetes mellitus.
3. hyperthyroidism.
4. pancreatic tumor.
21. The nurse auscultates a bruit over the thyroid and knows that this indicates:
1. normal function.
2. enlargement of the thyroid.
3. hypoplasia of the thyroid.
4. tumor of the thyroid.
22. A patient is being evaluated for thyroid dysfunction. His daily regular medications include 1 ASA, Lanoxin, and insulin. The
nurse knows that the laboratory work may be affected by:
1. the ASA.
2. the Lanoxin.
3. the insulin.
4. none of the medications.
23. A patient is admitted with an acute myocardial infarction and a history of thyroid dysfunction. The nurse knows that:
1. no cardiac medications will affect the thyroid hormone levels.
2. heparin may decrease TSH.
3. dopamine may increase TSH.
4. morphine may decrease TSH.
24. A patient with a decreased T4 level but an elevated thyroid stimulating hormone level has:
1. primary hyperthyroidism.
2. secondary hypothyroidism.
3. secondary hyperthyroidism.
4. primary hypothyroidism.
Copyright © 2003, Elsevier Science (USA). All rights reserved.
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25. The insulin deficiency in the patient with Type I, IDDM, results in:
1. serum hypoosmolality and water overload.
2. serum hypoosmolality and dehydration.
3. serum hyperosmolality and water overload.
4. serum hyperosmolality and dehydration.
Copyright © 2003, Elsevier Science (USA). All rights reserved.