Chapter 11 Care of the Patient with an Endocrine Disorder

Chapter 11  Care of the Patient with an Endocrine Disorder

MULTIPLE CHOICE

1. The amount of hormone released by any gland is controlled by

1. a negative feedback system.
2. a positive feedback system.
3. exogenous stimuli.
4. the nervous system.

ANS: A
The amount of hormone released is controlled by a negative feedback system.

DIF: Cognitive Level: Knowledge REF: Page 485 OBJ: 2 TOP: Anatomy KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

2. Which diagnostic test for diabetes mellitus provides a measure of glucose levels for the previous 8 to 12 weeks?

1. Fasting blood sugar (FBS)
2. Oral glucose tolerance test
3. Glycosylated hemoglobin (HbA1c)
4. Postprandial glucose test

ANS: C
Glycosylated hemoglobin (HbA1c)—This blood test measures the amount of glucose that has become incorporated into the hemoglobin within an erythrocyte. Because glycosylation occurs constantly during the 120-day life span of the erythrocyte, this test reveals the effectiveness of diabetes therapy for the preceding 8 to 12 weeks.

DIF: Cognitive Level: Knowledge REF: Page 512, Box 11-2
OBJ: 12 TOP: Glucose monitoring
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

3. The patient is a newly diagnosed diabetic. Until he has his diabetes under control, which test will furnish valuable immediate feedback information?
a. BS
b. HgbA1c

c. OGTT d. Clinitest

ANS: A
Diabetics should do a fingerstick blood glucose level test before each meal and at bedtime each day until their disease is under control. HgbA1c serum test reveals the effectiveness of diabetes therapy for preceding 8-12 weeks.

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 11-2

DIF: Cognitive Level: Analysis REF: Page 511, Box 11-2 OBJ: 12 TOP: Diabetes mellitus

KEY: Nursing Process Step: Planning MSC:

NCLEX: Physiological Integrity

4. A 63-year-old patient on the medical floor has a diagnosis of adrenal hyperfunction (Cushing’s syndrome). She will probably have to adhere to a diet that contains

1. less sodium.
2. more calories.
3. less potassium.
4. more carbohydrates.

ANS: A
The diet should be lower in sodium to help decrease edema.

DIF: Cognitive Level: Analysis REF: Page 505
TOP: Cushing’s syndrome KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

5. The patient is a 20-year-old college student who has type 1 diabetes and normally walks each evening as part of her exercise regimen. She now plans to enroll in a swimming class to meet her physical education requirement. Which adjustment in her treatment plan will the nurse help this patient make?

1. Time her morning insulin injection so that the peak action will occur during her swimming class.
2. Delete her normal walks on days she has swimming class.
3. Delay the meal before the swimming class until the session is over.
4. Monitor her glucose level before, during, and after swimming to determine the

   need for alterations in food or insulin.

ANS: D
Exercise can reduce insulin resistance and increase glucose uptake for as long as 72 hours as well as reducing blood pressure and lipid levels. However, exercise can carry some risks for patients with diabetes, including hypoglycemia.

DIF: Cognitive Level: Analysis REF: Page 512 OBJ: 14
TOP: Diabetes mellitus KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

6. A long-term complication of diabetes mellitus is a. Cushing’s disease.
b. renal failure.
c. hypothyroidism.

d. hyperglycemia.

ANS: B
Long-term complications of diabetes include blindness, cardiovascular problems, and renal failure.

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

OBJ: 6

Test Bank 11-3

DIF: Cognitive Level: Analysis
TOP: Diabetes mellitus
Assessment
MSC: NCLEX: Physiological Integrity

REF: Page 526 OBJ: 20 KEY: Nursing Process Step: