Endocrine NCLEX Questions (71-75)

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71. A client undergoes a thyroidectomy and the nurse monitors the client for signs of damage to the parathyroid glands postoperatively. Which of the following findings would indicate damage to the parathyroid glands?

a) neck pain
b) hoarseness
c) respiratory distress
d) tingling around the mouth

72. A nurse is conducting a health history on a client with hyperparathyroidism. Which of the following questions asked of the client would elicit information about this condition?

a) do you have tremors in your hands?
b) are you experiencing pain in your joints?
c) have you had problems with diarrhea lately?
d) do you notice any swelling in your legs at night?

73. A client is admitted to the hospital in metabolic acidosis caused by diabetic ketoacidosis (DKA). The nurse prepares to administer which of the following medications as a primary initial treatment for this problem?

a) potassium
b) regular insulin
c) calcium gluconate
d) sodium bicarbonate

74. A client with Cushing's syndrome is being instructed by the nurse on follow-up care. Which statement by the client would indicate a need for further instructions?

a) I should avoid contact sports
b) I should check my ankles for swelling
c) I need to avoid foods high in potassium
d) I need to check my blood glucose regularly

75. A client with hyperaldosteronism is being treated with spironolactone (Aldactone)> Which of the following indicates to the nurse that the medication is effective?

a) a decrease in blood pressure
b) a decrease in sodium excretion
c) a decrease in body metabolism
d) a decrease in plasma potassium





Endocrine NCLEX Questions
Answers and Rationale

71) D

- The parathyroid glands can be damaged or their blood supply impaired during thyroid surgery. Hypocalcemia and tetany result when parathyroid hormone (PTH) levels decrease. The nurse monitors for complaints of tingling around the mouth or of the toes or fingers and muscular twitching because these are signs of calcium deficiency. Additional later signs of hypocalcemia are positive Chvostek's and Trousseau's signs. Hoarseness and neck pain are expected findings postoperatively. Respiratory distress indicates a complication but is not a sign of damage to the parathyroid glands.

72) B

- Hyperparathyroidism causes an oversecretion of parathyroid hormone (PTH), which causes excessive osteoblast growth and activity within the bones. When bone reabsorption is increased, calcium is released from the bones into the blood, causing hypercalcemia. The bones suffer demineralization as a result of calcium loss, leading to bone and joint pain, and pathological fractures. Options A and C relate to assessment of hypoparathyroidism. Option D is unrelated to hyperparathyroidism.

73) B

- The primary treatment for any acid-base imbalance is the treatment of the underlying disorder that caused the problem. In this case, the underlying cause of the metabolic acidosis is anaerobic metabolism caused by the lack of the ability by the body to use circulating glucose. The administration of insulin corrects this problem. Potassium may be added to the treatment regimen if serum potassium levels indicate it is necessary. Options C and D would not be used in the treatment of this disorder.

74) C

- Hypokalemia is a common characteristic of Cushing's syndrome, and the client is instructed to consume foods high in potassium. Clients also experience activity intolerance, osteoporosis, and frequent bruising. Excess fluid volume results from water and sodium retention. Hyperglycemia is caused by an increased cortisol secretion.

75) A

- Aldactone antagonizes the effect of aldosterone and decreases circulating volume by inhibiting tubular reabsorption of sodium and water. Thus, it produces a decrease in blood pressure. It increases the excretion of sodium and water and increases potassium retention. It has no effect on body metabolism.


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Endocrine NCLEX Questions (1-7)

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Endocrine NCLEX Questions (76-80)