Which of the following would the nurse expect to find in a client with severe hyperthyroidism?

Detailed Answer Key

Endocrine 3

1.A nurse is reinforcing teaching about exercise with a client who has type 1 diabetes mellitus. Which of the following

statements by the client indicates an understanding of the teaching?

A. "I will carry a complex carbohydrate snack with me when I exercise."

Rationale:The nurse should reinforce that the client should carry a simple carbohydrate such as hard

candy or glucose tablets for use during exercise if the client becomes hypoglycemic.

B. "I should exercise first thing in the morning before eating breakfast."

Rationale:The nurse should reinforce that exercise should follow a meal. Exercising first thing in the

morning on an empty stomach places the client at risk for hypoglycemia.

C. "I should avoid injecting insulin into my thigh if I am going to go running."

Rationale:The nurse should reinforce that the client should avoid injecting insulin into an area that will soon

be exercised to avoid increasing the absorption rate of the insulin.

D. "I will increase the intensity of my exercise routine if my urine is positive for ketones."

Rationale:The nurse should reinforce that exercise should be avoided if ketones are present in the urine as

this indicates an elevated blood glucose level or ketoacidosis.

2.A nurse is caring for a client who has Cushing's syndrome. Which of the following clinical manifestations should the

nurse expect to observe? (Select all that apply.)

A. Buffalo hump

B. Purple striations

C. Moon face

D. Tremors

E. Obese extremities

Rationale:Buffalo hump is correct. Cushing's syndrome is a disease caused by an increased production of

cortisol or by excessive use of corticosteroids. Buffalo hump, a collection of fat between the

shoulders, is a common manifestation of Cushing's syndrome.

Purple striations is correct. Purple striations on the skin of the abdomen, thighs, and breasts are

a common manifestation of Cushing's syndrome. This is due to the collection of body fat in these

areas.

Moon face is correct. Moon face is a common manifestation of Cushing's syndrome. Clients who

have this manifestation present with a round, red, full face.

Tremors is incorrect. Tremors are not a common finding of Cushing's syndrome.

Obese extremities is incorrect. Clients who have Cushing's syndrome have truncal obesity, a

protuberant abdomen, with thin extremities, which is due to an alteration in protein metabolism.

Created on:03/31/2021Page 1

Detailed Answer Key

ATI Complex Endocrine Practice

1.A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a

tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should

the nurse assess the client?

A. Chvostek's sign

Rationale:The nurse should suspect that the client has hypocalcemia, a possible complication following

subtotal thyroidectomy. Manifestations of hypocalcemia include numbness and tingling in the

hands, the soles of the feet, and around the lips, typically appearing between 24 and 48 hr after

surgery. To elicit Chvostek's sign, the nurse should tap the client's face at a point just below and

in front of the ear. A positive response would be twitching of the ipsilateral (same side only)

facial muscles, suggesting neuromuscular excitability due to hypocalcemia.

B. Babinski's sign

Rationale:Babinski's sign is a diagnostic test for brain damage or upper motor neuron damage. It is

positive if the toes flare up when the nurse strokes the plantar aspect of the foot.

C. Brudzinski's sign

Rationale:Brudzinski's sign is an indication of meningeal irritation, such as in clients who have meningitis.

With the client supine, the nurse should place one hand behind his head and places her other

hand on his chest. The nurse then raises the client's head with her hand behind his head, while

the hand on his chest restrains him and prevents him from rising. Flexion of the client's lower

extremities constitutes a positive sign.

D. Kernig's sign

Rationale:Kernig's sign is an indication of meningeal irritation, such as in clients who have meningitis. The

nurse performs the maneuver with the client supine with his hips and knees in flexion. The

inability to extend the client's knees fully without causing pain constitutes a positive test.

2.A nurse is caring for an adolescent client who has a long history of diabetes mellitus and is being admitted to the

emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is

suspected. The nurse should anticipate using which of the following types of insulin to treat this client?

A. NPH insulin

Rationale:Isophane NPH insulin is intermediate-acting. It has an onset of action of 1 to 3 hr and is not

appropriate for emergency treatment of ketoacidosis.

B. Insulin glargine

Rationale:Insulin glargine is a long-acting insulin, with an onset of 2 to 4 hr. It is not appropriate for

emergency treatment of ketoacidosis.

C. Insulin detemir

Rationale:Insulin detemir is an intermediate-acting insulin. It has an onset of action of 1 hr and is not

appropriate for emergency treatment of ketoacidosis.

D. Regular insulin

Rationale:

Created on:08/13/2018Page 1

Which condition should a nurse expect to find in a client diagnosed with hyperparathyroidism?

Which medication would the nurse expect the physician to order for a client with hypothyroidism?

What dietary modifications should be recommended to a client with hyperthyroidism?

Which of the following hormones would the nurse identify as being secreted by the thyroid gland?