ACTIVITY FUNDAMENTALS OF NURSING EXAM Q & A/2023.Qualified Virginia State University, Exams of Nursing

Download ACTIVITY FUNDAMENTALS OF NURSING EXAM Q & A/2023.Qualified Virginia State University and more Exams Nursing in PDF only on Docsity! ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University Endocrine System Function and Assessment 1) The nurse is reviewing information with a patient about the normal anatomy and physiology of the endocrine system. Which factor is inaccurate? 1. All endocrine glands are anatomically separate in location. 2. All endocrine glands function independently of each other. 3. Most hormone levels are regulated by a negative feedback system. 4. Each hormone is secreted in response to a specific stimulus. ANS: 2 Chapter: Chapter 38. Endocrine System Function and Assessment Objective: Identify the glands of the endocrine system. Pages: 773–778 Heading: Normal Endocrine System Anatomy and Physiology Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Physiological Integrity—Physiological Adaptation Cognitive Level: Application (Applying) Concept: Patient-Centered Care Difficulty: Moderate Feedback 1 Unlike other organ systems, all endocrine glands are anatomically separate in location. 2 Endocrine glands may function separately, but some hormones are secreted in response to hormones secreted by other endocrine glands. 3 Most hormone levels are regulated by a negative feedback system, as when hormone levels are low or body functions are not normal. ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University 4 Each specific hormone is secreted in response to a specific stimulus and affects target cells for that specific hormone. PTS: 1 CON: Patient-Centered Care 2) The nurse is researching information for a patient newly diagnosed with diabetes mellitus. The nurse wants to present the responses by hormones other than insulin. Which information does the nurse avoid? 1. Growth hormones (GHs) secreted by the anterior pituitary play a part in glucose regulation. 2. Growth hormone-releasing hormone (GHRH) is secreted during hypoglycemia or when there is a high blood level of amino acids. 3. GH and growth hormone-inhibiting hormone (GHIH) are secreted to maintain blood glucose levels and metabolism rates are normal. 4. GHIH is secreted during hyperglycemia when carbohydrates are available for energy production. ANS: 3 Chapter: Chapter 38. Endocrine System Function and Assessment ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University continues to function adequately in old age. 2 Most of the endocrine glands decrease their secretions with age, but normal aging usually does not lead to serious hormone deficiencies or illness. Unless specific pathological conditions develop, the endocrine system usually continues to function adequately in old age. 3 Decreases in thyroid-stimulating hormone (TSH) and thyroid hormone cause a decrease in the basal metabolic rate and may result in decreased energy. The decrease in secretion is normal with aging. 4 Low parathyroid hormone is not a common cause of tiredness. PTS: 1 CON: Patient-Centered Care 4) After reviewing the patient’s medical record, the nurse plans to perform a physical examination. Which finding will change the usual process of physical examination? 1. The patient had surgery for a goiter. 2. The patient is being treated for diabetes mellitus. 3. The patient has elevated thyroid hormones. 4. The patient is diagnosed with a posterior pituitary tumor ANS: 3 Chapter: Chapter 38. Endocrine System Function and Assessment Objective: List data to collect when caring for a patient with a disorder of the endocrine system. Page: 796 Heading: Thyroid Gland Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Physical Integrity—Reduction of Risk Potential Cognitive Level: Analysis (Analyzing) Concept: Patient-Centered Care ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University Difficulty: Moderate Feedback 1 The finding that the patient had surgery for a goiter will not alone change the nurse’s process of physical examination. 2 The finding that the patient is being treated for diabetes mellitus will not change the nurse’s process of physical examination. 3 Elevated thyroid hormones are indicative of a hyperactive thyroid gland. The nurse will not assist the health care provider (HCP) during thyroid examination. The HCP will avoid palpating the thyroid to avoid stimulation. 4 Because the nurse would be unable to perform a physical examination on the posterior pituitary gland, this finding alone is not going to change the nurse’s process of physical examination. PTS: 1 CON: Patient-Centered Care 5. The HCP prescribes a 24-hour urine specimen for cortisol. The patient is incontinent. Which method will the nurse use to collect the specimen? 1. Place the patient on a bedpan every half hour during the test. 2. Obtain an order for an indwelling catheter for the duration of the test. ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University 3. Review the use of the nurse call light and have the patient indicate a need to void. 4. Place a bedside commode in a position to enable the patient to make a safe transfer. ANS: 2 Chapter: Chapter 38. Endocrine System Function and Assessment Objective: Plan nursing care for patients undergoing testing for an endocrine disorder. Page: 780 Heading: Adrenal Cortex Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Safe and Effective Care Environment—Safety and Infection Control Cognitive Level: Application (Applying) Concept: Patient-Centered Care Difficulty: Moderate Feedback 1 Placing the patient on a bedpan every half hour is not going assure that all urine is collected; the patient may have continuous incontinence. 2 If the patient is incontinent or otherwise unable to participate in the test, a catheter may need to be inserted. If the patient already has an indwelling catheter, a new bag and tubing should be attached before the start of the test. 3 Reviewing the use of the call light may not be effective. The patient may or may not be able to determine the need to void or may not be able to wait for help without voiding. 4 There is not enough information to determine if the patient is able to use a bedside commode safely. Functional incontinence would not support this method of collection. PTS: 1 CON: Patient-Centered Care 6. The nurse is providing care for a patient diagnosed with posterior pituitary tumor resulting ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University Feedback 1 Pancreatic alpha cells will stimulate the release of glucagon to raise glucose blood levels in response to hypoglycemia. Alpha cells do not inhibit the release of insulin. 2 Hyperglycemia stimulates pancreatic beta cells to release insulin; the beta cells do not move glucose from the cells and into the blood in the event of hypoglycemia. 3 Pancreatic alpha cells will stimulate the release of glucagon in response to hypoglycemia. Glucagon raises blood glucose levels and makes it available to body cells. 4 Pancreatic beta cells are stimulated to increase the secretion of insulin with hyperglycemia. The beta cells do not have a role with hypoglycemia. PTS: 1 CON: Metabolism 8. The nurse is assisting with care to a patient who underwent surgery for removal of the thyroid gland. Which symptom contradicts a possible complication of the surgery? 1. Decreased calcium in blood ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University 2. Prolonged clotting time 3. Decreased calcitonin levels 4. Hyperactive bowel sounds ANS: 4 Chapter: Chapter 38. Endocrine System Function and Assessment Objective: Explain the function of each of the hormones in the endocrine system. Page: 800 Heading: Parathyroid Glands Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Physiological Integrity—Reduction of Risk Potential Cognitive Level: Analysis (Analyzing) Concept: Metabolism Difficulty: Moderate Feedback 1 A possible complication related to removal of the thyroid is accidental removal or damage to the parathyroid glands, which secrete parathyroid hormone (PTH). A complication of thyroid surgery is hypocalcemia, or a decrease in calcium in the blood. 2 Parathyroid hormone (PTH) is necessary to assist in blood clotting. With the accidental removal or damage to the parathyroid glands, blood clotting will be prolonged. 3 Calcitonin is an antagonist to parathyroid hormone (PTH). If the secretion of PTH is decreased by the accidental removal or damage to the parathyroid glands, the level of calcitonin is also decreased. 4 The delivery of calcium ions is essential for normal excitability of neurons and muscle cells and blood clotting. A decrease or lack of parathyroid hormone (PTH) will affect bone, the small intestine, and kidneys. Hyperactive bowels sound are a contraindication. ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University PTS: 1 CON: Metabolism 9. The licensed practical nurse/licensed vocational nurse (LPN/LVN) is assisting with the physical examination of a patient in the HCP’s office. Which physical examination does the LPN/LVN perform? 1. Observe for abnormal physical characteristics. 2. Palpation of the flank for adrenal gland disorders. 3. Gently palpate the thyroid gland for enlargement. 4. Percuss the abdomen to validate normal pancreas size. ANS: 1 Chapter: Chapter 38. Endocrine System Function and Assessment Objective: List data to collect when caring for a patient with a disorder of the endocrine system. Page: 790 Heading: Nursing Assessment of the Endocrine System Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Physiological Integrity—Reduction of Risk Potential Cognitive Level: Application (Applying) ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University 3. The test will need to be restarted if a urine sample is missed. 4. Urine samples are collected immediately after voiding. ANS: 2 Chapter: Chapter 38. Endocrine System Function and Assessment Objective: Plan nursing care for patients undergoing testing for an endocrine disorder. Page: 780 Heading: Urine Tests Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Safe and Effective Care Environment—Coordinated Care Cognitive Level: Application (Applying) Concept: Patient-Centered Care Difficulty: Moderate Feedback 1 The test is complete when the last voiding is collected at the end of the 24-hour period. The nurse needs to ask the patient to void at the time the test ends. 2 The first morning sample of urine is discarded because it is a product of a time period before the test began. 3 The urine collection is a continuous collection during a designated 24-hour period. If a sample is missed, the test is restarted. 4 Urine samples for a 24-hour urine collection should be collected immediately to prevent deterioration of the sample. Most collections are refrigerated and may have added preservatives. PTS: 1 CON: Patient-Centered Care 12. The nurse is preparing a patient to undergo a suppression test to verify adrenal cortex dysfunction. Which reply will the nurse make when the client asks about the expected test procedure? 1. “You will be injected with an adrenal stimulant to see how the adrenal ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University glands work.” 2. “You will be injected with a steroid hormone that should suppress cortisol release.” 3. “A failure of adrenal cortex function is indicated by a low blood cortisol level.” 4. “You will be injected with epinephrine to stimulate your metabolic functions.” ANS: 2 Chapter: Chapter 38. Endocrine System Function and Assessment Objective: Plan nursing care for patients undergoing testing for an endocrine disorder. Page: 807 Heading: Suppression Tests Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Physiological Integrity—Physiological Integrity Cognitive Level: Analysis (Analyzing) Concept: Patient-Centered Care Difficulty: Moderate Feedback ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University 1 A suppression test does not stimulate organ activity; this would result from a stimulation test. 2 A suppression test for adrenal cortex function incudes the injection of a steroid hormone, which should result in a suppression of cortisol release. If the cortisol level is not suppressed, it is indicative of adrenal cortex dysfunction and verifies the patient’s diagnosis. 3 The indicator of adrenal cortex dysfunction is a high blood cortisol level even after the administration of a suppressor. 4 The patient will not be injected with epinephrine as part of a suppression test. Epinephrine is a metabolic stimulant. PTS: 1 CON: Patient-Centered Care 13. The nurse is preparing a patient for a thyroid scan to rule out thyroid cancer. Which instruction does the nurse give the patient prior to the testing? 1. Do not leave the area after the radioactive material is injected. 2. Collect all urine for 4 hours so it can be evaluated for radiation. 3. Use the bathroom before the scanning part of the test is performed. 4. Multiple series of x-rays will be taken over a period of 2 hours. ANS: 3 Chapter: Chapter 38. Endocrine System Function and Assessment Objective: Plan nursing care for patients undergoing testing for an endocrine disorder. Page: 800 Heading: Thyroid Scan Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Physiological Integrity—Reduction of Risk Potential Cognitive Level: Analysis (Analyzing) Concept: Patient-Centered Care Difficulty: Moderate ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University 15. A patient has returned to the unit after a needle biopsy of the thyroid gland to rule out cancer. Which observation is expected by the nurse following the procedure? 1. Pain level of 2 on a 0-to-10 scale 2. Moderate amount of bleeding on the bandage 3. Inability to swallow or speak clearly 4. An oxygen saturation level of 90 percent ANS: 1 Chapter: Chapter 38. Endocrine System Function and Assessment Objective: Plan nursing care for patients undergoing testing for an endocrine disorder. Page: 803 Heading: Biopsy Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Physiological Integrity—Reduction of Risk Potential Cognitive Level: Analysis (Analyzing) Concept: Patient-Centered Care Difficulty: Difficult ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University Feedback 1 After a needle biopsy of the thyroid, the patient may express a low level of pain; this observation is expected. 2 It is unlikely that a needle biopsy will produce a moderate amount of bleeding on the bandage used to cover the puncture site. This is an unexpected observation. 3 The inability to swallow or speak after a thyroid needle biopsy is unexpected. The throat is not involved in the procedure. 4 An oxygen saturation level of 90 percent is unexpected after a needle biopsy of the thyroid. The procedure is not likely to interfere with the patient’s airway. PTS: 1 CON: Patient-Centered Care 16. The nurse is aware that a 12-year-old male client is at the fifth percentile on the growth chart for height. Which medical intervention does the nurse expect the HCP to prescribe? 1. Surgery to lengthen the long bones and increase height 2. Administration of GH therapy for added height 3. Maintaining a wait-and-see approach until the patient is age 18 4. Diagnostic testing to identify any adrenal gland dysfunction ANS: 2 Chapter: Chapter 38. Endocrine System Function and Assessment Objective: Explain the function of each of the hormones in the endocrine system. Page: 794 Heading: Anterior Pituitary Gland Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Physiological Integrity—Physiological Adaptation Cognitive Level: Analysis (Analyzing) Concept: Patient-Centered Care Difficulty: Difficult ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University Feedback 1 Surgery to lengthen the long bones and increase height is a long and painful process, which is usually not performed on adolescent clients when growth can be promoted in less invasive ways. 2 It is expected for an adolescent to experience notable increases in height. When height lags behind, the patient may be treated with GH to stimulate height increase. 3 By the age of 18 years, the most responsive time for growth stimulation may have passed. 4 Growth hormones are secreted by the hypothalamus; testing of the adrenal glands is not needed. PTS: 1 CON: Patient-Centered Care 17. The nurse is aware that the pancreas is the only gland that is both endocrine and exocrine. Which secretion is related to the endocrine function of the pancreas? 1. Insulin 2. Bile ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University glucocorticoids. PTS: 1 CON: Patient-Centered Care MULTIPLE RESPONSE 1. A patient is prescribed a dose of epinephrine. Which effects does the nurse expect the patient to exhibit after receiving this medication? (Select all that apply.) 1. Decreases peristalsis 2. Constricts bronchioles 3. Increases heart rate and force of contraction 4. Stimulates the liver to convert glycogen to glucose 5. Stimulates vasoconstriction in skin and most viscera ANS: 1, 3, 4, 5 Chapter: Chapter 38. Endocrine System Function and Assessment Objective: Explain the function of each of the hormones in the endocrine system. Page: 819 Heading: Adrenal Medulla Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Physiological Integrity—Physiological Adaptation Cognitive Level: Analysis (Analyzing) Concept: Patient-Centered Care Difficulty: Difficult Feedback 1. Epinephrine increases the heart rate and force of contraction, stimulates vasoconstriction in skin and most viscera and vasodilation in skeletal muscles, dilates the bronchioles, decreases peristalsis, stimulates the liver to convert glycogen to glucose, increases the use of fats for energy, and ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University increases the rate of cell respiration. 2. Epinephrine does not constrict the bronchioles. 3. Epinephrine increases the heart rate and force of contraction, stimulates vasoconstriction in skin and most viscera and vasodilation in skeletal muscles, dilates the bronchioles, decreases peristalsis, stimulates the liver to convert glycogen to glucose, increases the use of fats for energy, and increases the rate of cell respiration. 4. Epinephrine increases the heart rate and force of contraction, stimulates vasoconstriction in skin and most viscera and vasodilation in skeletal muscles, dilates the bronchioles, decreases peristalsis, stimulates the liver to convert glycogen to glucose, increases the use of fats for energy, and increases the rate of cell respiration. 5. Epinephrine increases the heart rate and force of contraction, stimulates vasoconstriction in skin and most viscera and vasodilation in skeletal muscles, dilates the bronchioles, decreases peristalsis, stimulates the liver to convert glycogen to glucose, increases the use of fats for energy, and increases the rate of cell respiration. ENDOCRINE SYSTEM FUNCTION AND ASSESSMENT EXAM Q & AWITH REFERENCES /2023.Qualified Virginia State University PTS: 1 CON: Patient-Centered Care 2. A patient is experiencing an increased level of corticotropin-releasing hormone (CRH). What should the nurse consider is occurring with this patient? (Select all that apply.) 1. Body stressed 2. Low blood volume 3. Presence of an injury 4. Low blood glucose level 5. Elevated blood glucose level ANS: 1, 3, 4 Chapter: Chapter 38. Endocrine System Function and Assessment Objective: Explain the function of each of the hormones in the endocrine system. Page: 781 Heading: Adrenal Cortex Integrated Process: Clinical Problem-Solving Process (Nursing Process) Client Need: Physiological Integrity—Physiological Adaptation Cognitive Level: Analysis (Analyzing) Concept: Patient-Centered Care Difficulty: Difficult Feedback 1. CRH is produced during any type of stress such as injury, disease, exercise, or hypoglycemia. 2. Antidiuretic hormone is released in response to low blood volume. 3. CRH is produced during any type of stress such as injury, disease, exercise, or hypoglycemia. 4. CRH is produced during any type of stress such as injury, disease, exercise, or hypoglycemia. 5. Growth hormone–inhibiting hormone is secreted during hyperglycemia.