ATI RN
Exam Questions on Endocrine System Questions
Question 1 of 5
During care of the patient with SIADH, what should the nurse do?
Correct Answer: A
Rationale: Rationale: The correct answer is A) Monitor neurologic status at least every 2 hours. In Syndrome of Inappropriate Antidiuretic Hormone (SIADH), there is an excess of ADH leading to water retention and dilutional hyponatremia. Monitoring neurologic status is crucial as hyponatremia can lead to neurological complications such as confusion, seizures, and coma. Checking neurologic status every 2 hours allows for early detection of any neurological changes, ensuring prompt intervention. Option B) is incorrect because in SIADH, where there is water retention, restricting sodium intake can further worsen hyponatremia. Option C) is incorrect as keeping the head of the bed elevated does not prevent ADH release. Option D) is incorrect as notifying the healthcare provider about a decrease in blood pressure is not directly related to managing SIADH. Educationally, understanding the rationale behind monitoring neurologic status in SIADH reinforces the importance of frequent assessment to prevent serious complications associated with electrolyte imbalances. Nurses need to be vigilant in assessing and monitoring patients with endocrine disorders like SIADH to provide safe and effective care.
Question 2 of 5
When caring for a patient with primary hyperaldosteronism, the nurse would question a health care provider's prescription for which drug?
Correct Answer: A
Rationale: In the case of a patient with primary hyperaldosteronism, the correct answer to question the healthcare provider's prescription would be A) Furosemide (Lasix). This is because primary hyperaldosteronism results in excessive aldosterone production, leading to sodium and water retention, potassium excretion, and hypertension. Furosemide, a loop diuretic, would exacerbate potassium loss, which is already a concern in these patients due to aldosterone's effects on potassium excretion. Option B) Spironolactone (Aldactone) is actually a preferred treatment for primary hyperaldosteronism as it is a potassium-sparing diuretic and an aldosterone receptor antagonist, helping to counteract the effects of excess aldosterone. Option C) Amiloride (Midamor) is another potassium-sparing diuretic and could also be considered appropriate in this scenario. Option D) Aminoglutethimide (Cytadren) is not typically used in the treatment of primary hyperaldosteronism. Aminoglutethimide is an adrenal steroid inhibitor primarily used in the management of Cushing's syndrome. In an educational context, understanding the rationale behind drug choices in specific endocrine disorders is crucial for nursing practice. This knowledge ensures safe and effective patient care by being able to identify appropriate medications and question prescriptions that may be contraindicated or potentially harmful in certain conditions like primary hyperaldosteronism.
Question 3 of 5
Mr. Weber, an insulin-dependent diabetic, states that in the afternoon he has occasional severe reactions during which he becomes unconscious. In planning his care, which of the following nursing actions is most appropriate?
Correct Answer: A
Rationale: In the case of an insulin-dependent diabetic like Mr. Weber experiencing occasional severe reactions leading to unconsciousness in the afternoon, the most appropriate nursing action is to place a tube of commercially prepared glucose paste at his bedside (Option A). This is because severe hypoglycemia can lead to unconsciousness, and administering glucose quickly is crucial to raise blood sugar levels rapidly and reverse the hypoglycemic state. Option B, administering regular insulin, is incorrect as it would further lower Mr. Weber's blood sugar levels, worsening his condition. Option C, checking his level of consciousness every hour, is not as effective as providing immediate intervention with glucose paste. Option D, keeping a supply of orange juice in the refrigerator, is less concentrated than glucose paste and may not act quickly enough to address severe hypoglycemia. Educationally, this question highlights the importance of rapid response in managing hypoglycemic emergencies in diabetic patients. It emphasizes the critical role of glucose administration in quickly reversing the effects of low blood sugar to prevent serious complications like unconsciousness. This scenario also underscores the significance of preparedness and having appropriate supplies readily available to address medical emergencies effectively.
Question 4 of 5
While awaiting surgery for removal of an adrenal tumor that has produced Cushing syndrome, Mrs. A. has been placed on a strict diet to help manage her symptoms. The nurse's evaluation that the diet has been helpful includes observations that Mrs. A.
Correct Answer: C
Rationale: The correct answer is C) maintains blood pressure within normal limits. Rationale: 1. The adrenal gland plays a crucial role in regulating blood pressure through the secretion of aldosterone and cortisol. In Cushing syndrome, excessive cortisol production can lead to high blood pressure. By managing the symptoms through a strict diet, Mrs. A's blood pressure can be kept within normal limits. 2. Option A) has gained 5 lb: Weight gain is a common symptom of Cushing syndrome due to cortisol's role in metabolism. Weight gain would not indicate that the diet is helping manage the symptoms. 3. Option B) has consistently low blood sugar values: While cortisol can influence blood sugar levels, low blood sugar values would not be an expected outcome of managing Cushing syndrome symptoms through diet alone. 4. Option D) becomes more moody: Mood changes are also common in Cushing syndrome due to the impact of excess cortisol on the brain. However, mood changes alone would not be a reliable indicator of the effectiveness of the diet in managing symptoms. Educational Context: Understanding the effects of adrenal tumors and Cushing syndrome on the body is essential for healthcare professionals caring for patients with endocrine disorders. Monitoring blood pressure is a critical aspect of managing these patients, and recognizing the effects of diet on symptom management is crucial for providing comprehensive care. This question assesses the test-taker's knowledge of the physiological effects of Cushing syndrome and the role of diet in symptom management.
Question 5 of 5
Adam has just been diagnosed with diabetes insipidus. The most common presenting sign is:
Correct Answer: D
Rationale: In the case of Adam being diagnosed with diabetes insipidus, the most common presenting sign being an increase in urination (Option D) is the correct answer. This condition is characterized by the inability of the kidneys to conserve water, leading to excessive urination and extreme thirst. Option A, Body wasting, is not typically associated with diabetes insipidus. Hyperglycemia (Option B) is a symptom of diabetes mellitus, not diabetes insipidus. Hypoglycemia (Option C) is also not a common presenting sign of diabetes insipidus. Educationally, understanding the specific signs and symptoms of different endocrine disorders is crucial for healthcare professionals to make accurate diagnoses and provide appropriate treatment. Recognizing the key features of diabetes insipidus, such as polyuria and polydipsia, helps in distinguishing it from other conditions with similar symptoms. This knowledge is essential in clinical practice to ensure proper management and improve patient outcomes.