Endocrine ATI Assessment (2016)

1. A nurse is managing the care of a client who is postoperative and has acute adrenal
insufficiency. Which of the following actions should the nurse take?
A. Administer IV hydrocortisone sodium
B. Give oral spironolactone
C. Infuse 1 unit of platelets
D. Restrict daily fluid intake

2. A nurse is preparing a teaching plan for a client who has diabetes insipidus and requires
intranasal desmopressin. Which of the following information should the nurse include in the
teaching plan?
A. Drink at least 3 L of fluid per day.
B. Weigh yourself weekly while wearing similar clothing at the same time of day.
C. Notify the provider of a weight loss of 0.45kg (1lb) or more per week.
D. Report nocturia because it requires a dosage adjustment

3. A nurse is teaching a client about the adrenocorticotropic hormone stimulation test. The nurse
should explain that the purpose of the test is to assess or which of the following disorders?
A. Diabetes insipidus
B. Hyperthyroidism
C. Pheochromocytome
D. Addison’s disease

4. A nurse is teaching a client who has an autoimmune disease about the adverse effects of the
long-term corticosteroid therapy. Which of the following effects should the nurse include?
(Select all the apply)
A. Osteoporosis
B. Moon-shaped face
C. Increased risk of infection
D. Hearing loss
E. Weight loss

5. A nurse is caring for a client undergoing screening for primary Cushing’s disease. The nurse
should expect an elevation in which of the following laboratory findings?
A. Lymphocyte count
B. Potassium
C. Calcium
D. Glucose

6. A nurse is assessing a client who has a new diagnosis of Cushing’s disease. Which of the
following findings should the nurse expect?
A. Decreased blood pressure
B. Weight loss
C. Hirsutism
D. Increased skin thickness
7. A nurse is assessing a client who has diabetes mellitus and reports feeling anxious. Which of
the following findings should the nurse expect if the client is hypoglycemic?
A. Rapid, deep respirations
B. Cool clammy skin
C. Abdominal cramping
D. Orthostatic hypotension

8. A nurse is teaching a client who has diabetes mellitus about insulin injections. The clients
prescription includes evening doses of insulin glargine and regular insulin. Which of the
following instructions should the nurse include?
A. Inject the insulins intramuscularly
B. Shake the insulins vigorously prior to administration
C. Draw up the insulins into separate syringes
D. Expect the insulins to appear cloudy

9. A nurse is planning teaching for client who has type 1 diabetes mellitus. Which of the
following instructions should the nurse include?
A. Consume no more than three servings of alcohol per day
B. Ingest alcohol with food to reduce alcohol-induced hypoglycemia
C. Increase insulin dosage before planned exercise
D. Rest for 3 days between periods of vigorous exercise

10. A nurse in an outpatient clinic is teaching a client who has a diabetic foot ulcer about foot
care. Which of the following statements should the nurse identify as an indication that the client
understands the teaching?
A. “I will let my feet air dry after washing”
B. “I will wear sandals to allow air circulate around my feet”
C. “I will buy OTC medicine to treat the calluses on my feet”
D. “I will apply lotion to the dry areas of my feet, but not between my toes”

11. A nurse is monitoring the laboratory values of a client who has diabetes mellitus and is
taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy?
A. Fasting blood glucose 96mg/dL
B. Postprandial blood glucose 195mg/dL
C. casual blood glucose 210 mg/dL
D. Preprandial blood glucose 60 mg/dL

12. A nurse is monitoring a client’s status 24 hr after a total thyroidectomy. Which of the
following findings should the nurse report to the provider?
A. Laryngeal stridor
B. productive cough
C. Pain with hyperextension of the neck
D. Hoarse, weak voice
13. A nurse is caring for a client who is taking propylthiouracil. The nurse should identify that
the client has met the treatment goals when she reports an increase in which of the following
manifestations?
A. Sweating
B. Stools
C. Weight
D. Appetite

14. A home health nurse is assessing a client who requires lifelong hormone replacement therapy
for the treatment of hypothyroidism. The client has not been taking his medication regularity.
Which of the following findings should the nurse expect?
A. Increased urine output
B. Persistent diarrhea
C. tachycardia
D. hypotension

15. A nurse is caring for a client ho has type 2 diabetes mellitus and has hyperglycemic-
hyperosmolar state. Which of the following laboratory findings should the nurse expect?
A. Serum pH of 7.32
B. Blood glucose of 250 mg/dL
C. Blood glucose of 425 mg/dL
D. Serum pH of 7.45

16. A nurse is providing discharge teaching for a client who has diabetes insipidus and has a new
prescription for desmopressin nasal spray. Which of the following instructions should the nurse
include in the teaching?
A. “Depress the pump once before using the nasal spray for the first time”
B. “Blow your nose gently prior to using the nasal spray”
C. “Administer the nasal spray while in a side-lying position”
D. “Instill the medication four times per day”

17. A nurse is teaching a client about glycosylated hemoglobin (HbA1c) testing. Which of the
following statements should the nurse identify as an indication that the client understands the
information about this diet?
A. “I need to fast after midnight the night before the test”
B. “This test’s result is a good indicator of my average blood glucose levels”
C. “A level of eight to ten percent suggests adequate blood glucose control”
D. “I will use my hemoglobin A1c level to adjust my daily insulin doses”

18. A nurse is teaching a client who has type 1 diabetes mellitus about how to prevent
complications during illness. Which of the following statements should the nurse identify as an
indication that the client understands the teaching?
A. “I should stop taking my insulin if I feel nauseous”
B. “I will test my urine for protein when I start to feel ill”
C. “I will call my doctor if my blood sugar is more than 250 milligrams per deciliter”
D. “I should check my blood glucose level every 8 hours”
19. A nurse is assessing a client who has adrenal insufficiency. Which of the following findings
should the nurse expect?
A. Moon face
B. Weight gain
C. Calcium 12.8 mg/dL
D. Sodium 150 mEq/L

20. A nurse is caring for a client who has diabetes mellitus and has developed peripheral
neuropathy. Which of the following measures should the nurse recommend to prevent injuries to
the client’s feet?
A. Examine the skin and feet weekly for alterations in skin integrity
B. Monitor the temperature of bath water with a thermometer
C. Shop for shoes early in the day
D. Round the edges of the toenails when trimming them

21. To screen a client for pheochromocytoma, a nurse schedules a vanillylmandelic acid test.
When teaching the client about this test, which of the following instructions should the nurse
include?
A. “Start fasting at midnight prior to the day of the test”
B. “Begin the 24-hour urine collection with the first morning urination”
C. “Take low-dose aspirin for pain during the testing period”
D. “Restrict coffee intake 2 to 3 days prior to the test”

22. A nurse is teaching a client who has diabetes mellitus. Which of the following should the
nurse include as an expected finding of diabetic ketoacidosis (DKA)?
A. Decreased urine output
B. Weight gain of 0.45 kg (1 lb.) in 24 hr
C. Rapid, shallow respirations
D. Blood glucose levels above 300 mg/dL

23. A nurse is admitting a client who has hyperthyroidism. When assessing the client, the nurse
should expect which of the following findings?
A. Cold intolerance
B. lethargy
C. tremors
D. sunken eyes

24. A nurse is caring for a client who has a pheochromocytoma. Which of the following actions
should the nurse take?
A. Elevate the head of the client’s bed
B. Palpate the client’s abdomen
C. Monitor the client for hypotension
D. Check the client’s urine specific gravity
25. A nurse has administered propranolol by IV bolus to a client who is having a thyroid storm.
Which of the following findings indicates that the client is having a therapeutic response?
A. Reduction of the effects of thyroid hormone on the heart
B. Blockage of the release of thyroid hormone from the thyroid gland
C. Increase in the hearts sensitivity to thyroid hormone
D. Increase in the uptake of thyroid hormone by the thyroid gland

26. A nurse is developing a teaching plan for a client who had a thyroidectomy and takes a
thyroid hormone replacement. Which f the following instructions should the nurse plan to
include?
A. “Take this medication on an empty stomach”
B. “Take this medication with an antacid”
C. “Change positions slowly while taking this medication”
D. “Limit your fluid intake while taking this medication”

27. A nurse is assessing a client who has diabetes insipidus. The nurse should expect which of
the following findings?
A. Decreased heart rate
B. Increased hematocrit
C. High urine specific gravity
D. Low BUN

28. A nurse is caring for a client following a thyroidectomy. The nurse should assess for which
of the following findings as an indication for hypocalcemia?
A. Strong, bounding pulse
B. Decreased bowel sounds
C. Tingling and numbness of the hands and feet
D. Diminished deep-tendon reflexes

29. A nurse is reviewing laboratory values for a client who has diabetic ketoacidosis (DKA).
Which of the following results should the nurse expect?
A. pH 7.32, PaCO2 36 mm Hg, HCO3 14 mEq\L
B. pH 7.38, PaCO2 55 mm Hg, HCO3 22 mEq/L
C. pH 7.44, PaCO2 40 mm Hg, HCO3 24 mEq/L
D. pH 7.50, PaCO2 42 mm Hg, HCO3 30 mEq/L

30. A nurse is assessing a client who has syndrome of inappropriate antidiuretic hormone
(SIADH). Which of the following findings should the nurse report to the provider?
A. Sodium 110 mEq/L
B. 2+ deep tendon reflexes
C. potassium 3.7 mEq/L
D. Urine specific gravity 1.025
1. A
2. D
3. D
4. A, B, C
5. D
6. C
7. B
8. C
9. B
10. D
11. A
12. A
13. C
14. D
15. D
16. B
17. B
18. C
19. C
20. B
21. D
22. D
23. C
24. A
25. A
26. A
27. B
28. C
29. A
30. A