The effects of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion include which solute?
Sodium and water retention
Sodium retention and water loss
c. Sodium dilution and water retention
Sodium dilution and water loss
Which patient would the healthcare professional assess for elevated levels of antidiuretic hormone (ADH) secretion?
Being treated for small cell carcinoma of the stomach
Taking high dose acetaminophen (Tylenol) for arthritis
Had a hip replacement operation 14 days ago
Has long-standing kidney disease from diabetes
Which laboratory value would the nurse expect to find if a person is experiencing syndrome of inappropriate antidiuretic hormone (SIADH)?
Hypernatremia and urine hypoosmolality
. Serum potassium (K+) level of 5 mEq/L and urine hyperosmolality compared to serum
Serum sodium (Na+) level of 120 mEq/L and serum osmolality 260 mOsm/kg
Serum potassium (K+) of 2.8 mEq/L and serum hyperosmolality
What is diabetes insipidus a result of?
Antidiuretic hormone hyposecretion
Antidiuretic hormone hypersecretion
Insulin hyposecretion
Insulin hypersecretion
A patient who is diagnosed with a closed head injury has a urine output of 6 to 8 L/day. Electrolytes are within normal limits, but the antidiuretic hormone (ADH) level is low. Although the patient has had no intake for 4 hours, no change in the polyuria level has occurred. What treatment or diagnostic testing does the healthcare professional prepare the patient for?
Administration of desmopressin
Serum copeptin testing
Insulin administration
Renal angiogram
A patient is having a water deprivation test. The patient’s initial weight was 220 pounds (100 kg). The next weight is 209 pounds (95 kg). What action by the healthcare professional is most appropriate?
Stop the water deprivation test.
Administer salt tablets.
Continue with the test as planned.
Take the patient’s blood glucose.
A healthcare professional is caring for four patients. Which patient does the professional assess for neurogenic diabetes insipidus (DI)?
Anterior pituitary tumor
Thalamus hypofunction
Posterior pituitary trauma
Renal tubule disease
Which form of diabetic insipidus (DI) will result if the target cells for antidiuretic hormone (ADH) in the renal collecting tubules demonstrate insensitivity?
Neurogenic
Nephrogenic
Psychogenic
Ischemic
Which laboratory value is consistent with diabetes insipidus (DI)?
Low urine-specific gravity
Low serum sodium
Low urine protein
High serum total protein
A patient has nephrogenic diabetes insipidus (DI). What treatment does the healthcare professional anticipate for this patient?
Exogenous ADH replacement
Intranasal desmopressin
Water and sodium restriction
Loop diuretic administration
Which condition may result from pressure exerted by a pituitary tumor?
Hypothyroidism
Hypercortisolism
Diabetes insipidus
A healthcare professional reads a chart that notes the patient has panhypopituitarism. What does the professional understand that term to mean?
The patient has a lack of all hormones associated with the anterior pituitary gland.
The patient has a lack of all hormones associated with the lateral pituitary gland.
The patient has total adrenocorticoptropic hormone deficiency.
The patient has a dysfunction of the posterior pituitary gland due to a tumor.
Visual disturbances are a result of a pituitary adenoma because of what?
Liberation of anterior pituitary hormones into the optic chiasm
Pituitary hormones clouding the lens of the eyes
Pressure of the tumor on the optic chiasm
Pressure of the tumor on the optic and oculomotor cranial nerves
A patient has an enlarged tongue, body odor, rough skin, and coarse hair. Which laboratory result does the healthcare professional associate with this presentation?
Decreased blood glucose
Increased growth hormone
Decreased ACTH
Increased TSH
A patient has acromegaly. What assessment by the healthcare professional would be most important?
Skin condition
Sleep patterns
Bowel function
Range of motion
Why does giantism occur only in children and adolescents?
Their growth hormones are still diminished.
Their epiphyseal plates have not yet closed.
Their skeletal muscles are not yet fully developed.
Their metabolic rates are higher than in adulthood.
A patient chart notes the patient has amenorrhea, galactorrhea, hirsutism, and osteoporosis. What diagnostic test would the healthcare professional prepare the patient for?
Water deprivation test
Hemoglobin A1C
CT scan of the head
Ovarian biopsy
What does Graves’ disease develop from?
A viral infection of the thyroid gland that causes overproduction of thyroid hormone
An autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue
A thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones
An ingestion of goitrogens that inhibits the synthesis of the thyroid hormones, causing a goiter
Which patient would the healthcare professional assess for other signs of thyrotoxic crisis?
Constipation with gastric distention
Bradycardia and bradypnea
Hyperthermia and tachycardia
Constipation and lethargy
Which pathologic changes are associated with Graves’ disease?
High levels of circulating thyroid-stimulating immunoglobulins
Diminished levels of thyrotropin-releasing hormone
High levels of thyroid-stimulating hormone
Diminished levels of thyroid-binding globulin
A healthcare professional is palpating the neck of a person diagnosed with Graves’ disease. What finding would the professional associate with this disorder?
Parathyroids left of midline
Thyroid small with discrete nodules
Parathyroids normal in size
Thyroid diffusely enlarged
A person has hypothyroidism. What chemical does the healthcare professional advise the person to include in the diet?
Iron
Iodine
Zinc
Magnesium
A patient has a suspected thyroid carcinoma. What diagnostic test does the healthcare professional prepare the patient for?
Measurement of serum thyroid levels
Radioisotope scanning
Ultrasonography
Fine-needle aspiration biopsy
Renal failure is the most common cause of which type of hyperparathyroidism?
Primary
Secondary
Exogenous
Inflammatory
A patient had a thyroidectomy and now reports tingling around the mouth and has a positive Chvostek sign. What laboratory finding would be most helpful to the healthcare professional?
TSH and T4
Serum sodium
Serum calcium
Urine osmolality
A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500 mg/dL; positive urine glucose and ketones; serum potassium (K+) 2 mEq/L; serum sodium (Na+) 130 mEq/L. The patient reports that he has been sick with the “flu” for 1 week. What relationship do these values have to his insulin deficiency?
Increased glucose use causes the shift of fluid from the intravascular to the intracellular space.
Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis.
Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis.
Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss
Why does polyuria occur with diabetes mellitus?
Formation of ketones
Chronic insulin resistance
Elevation in serum glucose
Increase in antidiuretic hormone
A student asks the professor to differentiate Type 2 diabetes mellitus from Type 1. The professors’ response would be that Type 2 is best described as what?
Resistance to insulin by insulin-sensitive tissues
Need for lifelong insulin injections
Increase of glucagon secretion from beta cells of the pancreas
Presence of insulin autoantibodies that destroy beta cells in the pancreas
A person diagnosed with type 1 diabetes experienced an episode of hunger, lightheadedness, tachycardia, pallor, headache, and confusion. The healthcare professional teaches the person that what is the most probable cause of these symptoms?
Hyperglycemia caused by incorrect insulin administration
Dawn phenomenon from eating a snack before bedtime
Hypoglycemia caused by increased exercise
Somogyi effect from insulin sensitivity
Which serum glucose level would indicate hypoglycemia in a newborn?
28 mg/dL
40 mg/dL
60 mg/dL
80 mg/dL
When comparing the clinical manifestations of both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS), which condition is associated with only DKA?
Fluid loss
Weight loss
Increased serum glucose
Kussmaul respirations
Hypoglycemia, followed by rebound hyperglycemia, is observed in those with what?
The Somogyi effect
The dawn phenomenon
Diabetic ketoacidosis
Hyperosmolar hyperglycemic nonketotic syndrome
A patient has diabetes mellitus. A recent urinalysis showed increased amounts of protein. What therapy does the healthcare provider educate the patient that is specific to this disorder?
More frequent blood glucose monitoring
Moderate dietary sodium restriction
Treatment with an ACE inhibitor
Home blood pressure monitoring
Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake?
Biguanide (metformin)
Sulfonylureas (glyburide)
Meglitinides (glinides)
α-Glycosidase inhibitor (miglitol)
What causes the microvascular complications in patients with diabetes mellitus?
The capillaries contain plaques of lipids that obstruct blood flow.
Pressure in capillaries increases as a result of the elevated glucose attracting water.
The capillary basement membranes thicken, and cell hyperplasia develops.
Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries.
A healthcare professional advises a person with diabetes mellitus to have an annual eye exam. When the person asks why this is necessary, the professional states that retinopathy develops in patients with diabetes mellitus because of what reason?
Plaques of lipids develop in the retinal vessels.
Pressure in the retinal vessels increase as a result of increased osmotic pressure.
Ketones cause microaneurysms in the retinal vessels.
Retinal ischemia and red blood cell aggregation occur.
A person has acne, easy bruising, thin extremities, and truncal obesity. The healthcare professional assesses the person for which of these?
Previous thyroid surgery
Serum electrolytes
Use of glucocorticoids
A person may experience which complications as a result of a reduction in parathyroid hormone (PTH)? (Select all that apply.)
Muscle spasms
Tonic-clonic seizures
Laryngeal spasms
Hyporeflexia
Asphyxiation
A chronic complication of diabetes mellitus is likely to result in microvascular complications in which areas? (Select all that apply.)
Eyes
Coronary arteries
Renal system
Peripheral vascular system
Nerves
What are clinical manifestations of hypothyroidism? (Select all that apply.)
Intolerance to heat
Restlessness
Constipation
Bradycardia
Lethargy
