Adult. Endocrine disorders Exam

Lily, a 32-year-old woman, presents to the clinic with complaints of irregular menstrual cycles, occasional galactorrhea (milky nipple discharge), and persistent headaches. She reports that she has not been pregnant recently and is not on any form of contraception.
Lily also complains of decreased libido. Her vital signs are within normal limits. The healthcare provider orders blood work, which reveals elevated prolactin levels.
Which statement by Lily during the nurse’s education about managing hyperprolactinemia requires intervention?

Angela, a 52-year-old woman, underwent a total thyroidectomy two days ago due to a large multinodular goiter. Since surgery, she has been recovering on the post-surgical unit with stable vital signs.
However, this morning she reports feeling numbness around her mouth and tingling in her fingertips and toes.
She also complains of muscle cramps in her legs.
Upon physical examination, she shows a positive Chvostek's and Trousseau's sign.
Which of the following is the most likely cause of Angela's symptoms?

David, a 45-year-old man with Type 2 diabetes, is visiting the clinic for a follow-up appointment. His most recent HbA1c is 8.5%, indicating poor glycemic control.
During the visit, the nurse provides education on dietary management to help David better control his blood sugar levels.
David shares his current understanding of how he plans to manage his diet moving forward.

During the conversation, David makes several statements about his diet.

Which of David’s statements would require the nurse to intervene?

Paul, a 60-year-old man with Type 2 diabetes, is visiting the clinic for a routine follow-up. He has a history of poor glycemic control, and his most recent HbA1c was 9.0%. Paul mentions that he’s been noticing some numbness and tingling in his feet.
During the exam, the nurse notes a small ulcer on the bottom of Paul’s left foot, which Paul says he didn’t even realize was there.
The nurse educates Paul on diabetic foot care to prevent further complications.

During the conversation, Paul makes several statements about foot care.

Which of Paul’s statements would require the nurse to intervene?

A female client is being worked up for an endocrine disorder. The client reports feeling tired and lethargic, increasing constipation, bruising easily, gaining weight despite dieting, and having shortness of breath.
For each client finding, click to specify if the finding is consistent with the disease process of hyperthyroidism, thyroid storm, or hypothyroidism. Each finding may support more than one disease process.

Jack, a 45-year-old man with Type 1 diabetes, visits the clinic reporting frequent morning hyperglycemia. He takes long-acting insulin at night and adheres to his prescribed regimen. His bedtime glucose levels are typically within the normal range, but by the morning, his glucose levels are elevated.
Jack denies experiencing any symptoms of nocturnal hypoglycemia, such as sweating or confusion.
The nurse suspects Jack may be experiencing the Somogyi phenomenon.

Which intervention should the nurse consider for Jack?

Anna, a 50-year-old post-menopausal woman, visits her healthcare provider with concerns about osteoporosis. She's witnessed her mother's struggles with the condition and wants to take preventive steps.
Osteoporosis is characterized by

Among the most important preventive measures are

Maria, a 40-year-old woman, is admitted to the hospital for evaluation of weight gain, muscle weakness, and frequent infections. On physical examination, she presents with a "moon face," central obesity, and purple striae on her abdomen.
Her blood pressure is elevated at 160/95 mmHg.
She has been diagnosed with Cushing syndrome, confirmed by laboratory tests showing elevated cortisol, elevated ACTH, and a blood glucose level of 180 mg/dL.

During the nurse’s discussion about managing Cushing syndrome, Maria makes several statements about her understanding of the condition and self-management strategies.

Which of Maria’s statements would require the nurse to intervene?

A 46-year-old client was admitted to the hospital after reporting increased thirst, increased hunger, and increased urination for the last 7 days. On admission, the client’s blood glucose level was significantly elevated, and the client was treated for DKA. After being stabilized, the client was discharged to home with a diagnosis of new-onset DM. The home care nurse is visiting the client and is providing teaching on self-management and measures to prevent hospitalization. The client tells the home care nurse about often feeling hungry, irritable, shaky, weak, and having a headache.

Based on the client’s reported symptoms, which 5 measures would the home care nurse plan to teach this client to implement when these symptoms occur?

Alex, a 46-year-old male, arrives at the emergency department with complaints of severe abdominal pain, dizziness, and confusion. His family reports that he has been progressively worsening over the past two days, exhibiting increased fatigue, nausea, and vomiting. He appears pale, diaphoretic, and disoriented on examination.
His blood pressure is critically low at 80/50 mmHg, and his heart rate is elevated at 110 beats per minute.
Upon further questioning, it is revealed that Alex has a known history of Addison's disease but has not taken his prescribed corticosteroid medication for the past week due to an issue with obtaining his prescription.
He has lost 10 pounds over the past week and has become increasingly weak, struggling to perform basic daily activities. His skin shows areas of hyperpigmentation, particularly in the creases of his hands and around his elbows.
Given Alex's clinical presentation and history of Addison's disease, among the following symptoms which is best correlates with an Addisonian crisis?

Samantha, a 40-year-old preschool teacher, is about to receive Radioactive iodine (RAI I131) therapy for her hyperthyroidism. The nurse is providing instructions regarding precautions she should take post-treatment.
Which of the following precautions is essential for Samantha post RAI I131 therapy?

Marie, a 65-year-old female, is brought to the intensive care unit by emergency medical services. Her family reports that she has a long-standing history of hypothyroidism, for which she has not been taking her prescribed medications for several months.
Over the past week, Marie has become progressively more lethargic, confused, and unresponsive. 
The clinical team suspects myxedema coma.

Which of the following is the most crucial nursing intervention for Marie in the initial management of her condition?

Michael, a 52-year-old male with a 15-year history of Type 1 diabetes, has just returned to the surgical floor after undergoing a left hip replacement. The procedure lasted 3 hours, and he is now 2 hours post-op. Michael reports a pain level of 5/10 in his left hip and is receiving IV fluids.
Michael mentions feeling tired but otherwise well.
His glucose level has just been checked, reading 310 mg/dL.
His prescribed medications include a sliding scale of regular insulin, IV fluids, pain management, and antibiotics.
After obtaining the client's glucose level of 310 mg/dL, what should the nurse do first?

The nurse is beginning the morning shift in a medical-surgical unit. After receiving a handoff from the night shift nurse, there are several patients with urgent needs.

Which client should the nurse prioritize and see first?

Laura, a 50-year-old woman with Type 1 diabetes, reports persistent morning hyperglycemia despite taking long-acting insulin at night and following her prescribed regimen. She mentions that her bedtime glucose levels are within the normal range and denies any symptoms of hypoglycemia during the night. The nurse suspects the dawn phenomenon as the cause of Laura’s morning hyperglycemia.

What intervention should the nurse consider for Laura to address the dawn phenomenon?

Rebecca, a 36-year-old woman, has been diagnosed with Addison's disease for the past two years. During her routine check-up at the endocrinology clinic, she expresses concern about the noticeable bronze coloration of her skin, especially as it draws attention and questions from her peers.
What should the nurse explain to Rebecca as the primary cause of the bronze skin coloration associated with Addison's disease?

Jennifer, a 45-year-old woman, underwent a total thyroidectomy three days ago due to a large goiter causing compressive symptoms.
She is currently recovering in the surgical ward.
This morning, she complained of numbness and tingling around her mouth and in her fingertips.
Upon physical examination, she exhibits facial muscle twitching when the facial nerve is tapped at the angle of the jaw, and her hand and fingers contract in a characteristic position when a blood pressure cuff is inflated on her upper arm and maintained for 3 minutes.
Which nursing intervention is most appropriate for Jennifer given her symptoms post-thyroidectomy?

Elaine, a 16-year-old girl, is brought to the pediatric clinic by her mother due to a lack of menstruation. 
Which of the following causes is the most likely explanation for Elaine's primary amenorrhea?

Michael, a 28-year-old man with a 10-year history of Type 1 diabetes mellitus, is admitted to the ICU with diabetic ketoacidosis (DKA). He presents with a three-day history of nausea, vomiting, abdominal pain, and increased thirst and urination.
His family reports that he has had flu-like symptoms and reduced his insulin dose because he wasn't eating well.
In managing Michael's condition, which of the following three interventions are the priority for the nursing team in this moment? 

Eduardo, a 36-year-old man, is rushed to the ER with symptoms of palpitations, profuse sweating, and extreme anxiety.  Eduardo has a history of hyperthyroidism but has been non-compliant with his medication regimen. In the hospital, immediately provide  him with supplemental oxygen, and ventilatory support.
Laboratory tests are pending, but his clinical presentation is highly suggestive of a thyroid storm.

Which of the following physician’s orders would the nurse anticipate? Select all that apply.

The nurse begins her morning shift in the endocrine ward, she is assigned six different patients 
Which patient requires immediate nursing attention based on current clinical status?

The nurse on a medical-surgical unit is beginning her shift and has been assigned to care for seven patients. She must prioritize who to attend to first.

1. Mr. Johnson, 55, has a fasting blood glucose of 145 mg/dL and reports feeling slightly more thirsty than usual.

2. Ms. Roberts, 42, is jittery with mild palpitations but stable vital signs.

3. Mr. Baker, 70, is fatigued, has lost weight, and feels dizzy when standing.

4. Ms. Thompson, 62, is recovering from surgery and reports muscle cramps and tingling in her hands.

5. Mr. Stevens, 48, has gained weight recently, has a rounded face, and is complaining of a headache.

6. Ms. Wright, 30, reports frequent urination and excessive thirst but has normal lab results this morning.

7. Mr. Lewis, 65, has a heart rate of 45 bpm, is lethargic, and feels cold despite being in a warm room.

Jeremy, a 42-year-old man, presents to an endocrinology clinic for evaluation of his increasing hand and foot size over the past five years. He also mentions having developed coarser facial features and sleep apnea. After a series of tests, he is diagnosed with acromegaly. Jeremy asks about possible complications of his condition.
Which of the following complications is commonly associated with acromegaly?

John, a 45-year-old male, presents to the clinic with complaints of fatigue, weight gain, constipation, and feeling cold all the time. His vital signs show a heart rate of 58 bpm, blood pressure of 110/70 mmHg, and respiratory rate of 12 breaths per minute.
He has dry skin and slow speech.
Blood work reveals a TSH level of 10.5 mIU/L (elevated) and free T4 of 0.5 ng/dL (low).

Which nursing intervention is most appropriate for John’s condition?

Patient Profile:
Name: John Doe Age: 58 Sex: Male
Presenting to: Emergency Department

Chief Complaint:
Intense thirst and excessive urination. 
Reports an intake of up to 8 liters of water daily for the past few weeks.
No family history of diabetes mellitus.
Denies recent head injury or surgeries.
No known allergies.
Not on any regular medications.
Complete the diagram below by dragging from the choice below what condition the client is most likely experiencing, 2 actions the nurse would take to address that condition, and 2 parameters the nurse would monitor to assess the condition.

A 65-year-old client has a 10-year history of Type 2 diabetes mellitus, hypertension, impaired renal function, and hypercholesteremia. The client was a 30-pack-year smoker and has not smoked for 2 years. The client has had recent stress and underwent surgery for a stent insertion 8 months ago.
Initial admission assessment and laboratory findings include:
Which of the following assessment findings require follow-up by the nurse?

Emily, a 45-year-old woman, presents to the endocrinology clinic with concerns about weight gain, particularly in her abdomen and face, over the past year. She has noticed an increase in fat around her neck and a rounding of her face.
Additionally, she reports developing purple stretch marks on her abdomen and upper thighs, and she bruises easily with minimal trauma.
Emily also complains of muscle weakness, particularly in her legs, making it difficult for her to climb stairs or get up from a seated position. She has a history of hypertension and was diagnosed with type 2 diabetes mellitus six months ago.
Her current medications include lisinopril for hypertension, metformin for diabetes, and calcium supplements.
Based on Emily's presentation and laboratory results, which of the following interventions should the nurse prioritize in her care plan? Select all that apply.

The nurse is caring for a client who began showing signs of diabetes insipidus 4 hours ago and was treated with IV fluids and one dose of nasal desmopressin.
Which assessment finding demonstrates to the nurse that the treatment has been effective? Select all that apply.

Rachel, a 28-year-old woman with a 10-year history of type 1 diabetes, is admitted to the hospital for recurrent early morning hyperglycemia. Over the past month, she has been experiencing high blood glucose readings consistently in the early mornings, despite her usual insulin regimen.
She reports feeling fatigued and sometimes waking up with a headache. Rachel adheres to her prescribed insulin routine, which includes a long-acting insulin at bedtime and rapid-acting insulin before meals. She has a well-balanced diet and engages in regular evening exercise.
Despite these measures, her fasting blood glucose levels range from 180-220 mg/dL (10-12.2 mmol/L).
On questioning, she denies any recent changes in her diet, activity level, or stress. A continuous glucose monitor (CGM) reveals episodes of nocturnal hypoglycemia around 2-3 AM, followed by a rebound hyperglycemia in the early morning hours, suggesting the Somogyi effect.

Which of the following nursing interventions would be appropriate to prevent this effect in Rachel? Select all that apply.

The nurse is conducting a teaching session for a group of nursing students about diabetes mellitus. She presents two case studies for comparison.
Which of the following statements is correct regarding the differences between Jake's and Linda's conditions?