Endocrine

Question 1

Trousseau sign is to determine presence of

Answer 1

Assessment to determine for hypocalcemia before
and after thyroidectomy.

Question 2

Symptoms of hepatic coma (Select all apply)

Answer 2

Impaired memory, attention, oncentration
hallucination, and dapcing tremor upon dorsiflexion of
hand.

Question 3

Signs of Laennec’s cirrhosis due to alcohol abuse

Answer 3

Abdominal distention, protruding umbilicus, icteric
sclera

Question 4

Esophageal varices (food to avoid)

Answer 4

Eating raw vegetables and food must be chewed well
and to eat slowly, No alcohol ingestion.

Question 5

For liver biopsy which is significant assessment to the site,

Answer 5

Ecchymosis - bruising

Question 6

A common complaints of patient who had laparoscopic
cholecystectomy

Answer 6

Right shoulder pain (due to irritation to the diaphragm
after carbon dioxide insufflation)

Question 7

Hepatic Encephalopathy - On Lactulose to decrease
ammonia level so expect for diarrhea

Answer 7

On Lactulose (Duphalac) to decrease ammonia level
so expect for diarrhea.

Question 8

Sengstaken Blakemore tube, nurse to keep at the bedside

Answer 8

A pair of scissors

Question 9

Trousseau bedside application before surgery as baseline
after to determine?

Answer 9

Check serum level of Calcium (hypocalcemia)

Question 10

Positive sign for hypocalcemia?

Answer 10

(+) Trousseau and Chvostek’s signs

Question 11

Positive sign for hypomagnesemia?

Answer 11

(+) Trousseau and Chvostek’s signs

Question 12

Predisposing factor associated with Type 2diabetes

Answer 12

Obesity

Question 13

What would be the effect to a diabetic client of taking
alcohol when on Sulfonylurea

Answer 13

Disulfiram (Antabuse) like symptoms
(flushing, vertigo, tachycardia, and palpitations)

Question 14

Insulin glargine (Lantus) is administered at what time?

Answer 14

At bedtime and is indicated for Type Il diabetes
mellitus.

Question 15

Lispro (Humalog) insulin teaching when to start eating?

Answer 15

Eat within 5-15 minutes of Lispro administration

Question 16

Signs and symptoms of hypoglycemia.

Answer 16

Cold clammy skin, diaphoresis, tremors, tachycardia
palpitation, and lethargy.

Question 17

What to administer to reverse acidosis in Diabetic
Ketoacidosis (DKA)?

Answer 17

potassium shift back into intracellular compartments.
Nurse alert: oral hypoglycemic medication is
contraindicated in Diabetic Ketoacidosis.

Question 18

Normal value of Glycosylated hemoglobin HbA1c

Answer 18

Less than 7% for diabetic
Less than 6% for non-diabetic *
Greater than 8% is considered poorly controlled

Question 19

Effect of insulin and alcohol, may cause fast reaction in

Answer 19

Hypoglycemia

Question 20

In DKA, potassium level is initially high or low?

Answer 20

High
Hyperkalemia

Question 21

Client teaching on client with DKA when activity is being
planned.

Answer 21

Avoid exercise, rest and take plenty of fluids.

Question 22

When a ketone is check?

Answer 22

When blood sugar is 250mg/dl or when acetone
breath is present.

Question 23

Nursing intervention when the bedside glucose monitoring
is read as critically high or critically low.

Answer 23

Obtain a stat venous blood draw. Most agencies
May have a protocol order in this case.

Question 24

Nursing alert for Protamine Zinc

Answer 24

Long acting, check insulin reaction early in the
morning, and give milk or carbohydrate foods at
bedtime

Question 25

Denver shunt is inserted to client with cases of

Answer 25

Cirrhosis - to divert ascetic fluid from the abdomen into the jugular vein or to the vena cava

Question 26

Chronic idiopathic jaundice with pigments in the liver

Answer 26

Dubin-Johnson syndrome

Question 27

Amount of ascitic fluid drawn during paracentesis

Answer 27

Slow removal of 2 to 3 liters to relieve acute symptoms.

Question 28

Electrolyte imbalance resulting in patient with DKA

Answer 28

Hyperkalemia

Question 29

Medication used to sterilize the bowel by reducing the number of bacteria in the GIT (as in cirrhosis of the liver)

Answer 29

Neomycin

Question 30

It lowers the pH and traps ammonia in the colon; diarrhea is a common side effect. It is also used for constipation.

Answer 30

Lactulose (is a synthetic sugar), used as a cathartic.

Question 31

Used to reduce ammonia level (hepatic encephalopathy).

Answer 31

Lactulose (a laxative-osmotic effect).

Question 32

Drug of choice for pancreatic, gallbladder pain

Answer 32

Demerol (meperidine)

Question 33

Reason for taking Neomycin among clients with cirrhosis of the liver.

Answer 33

To reduce ammonia level by enteric bacteria.

Question 34

Nursing intervention when pt is eating with a T tube post cholecystectomy

Answer 34

Clamp the tube during meal hours to assist in fat digestion.

Question 35

An autoimmune disorder where body's own antibodies attack the cells of the body. Most common cause of hypothyroidism.

Answer 35

Hashimoto's thyroiditis

Question 36

Thyroid Storm or Thyroid Crisis

Answer 36

Extreme form of hyperthyroidism, fever spikes to 106.

Question 37

How to administer SSK1 (Saturated Solution of Potassium lodide)

Answer 37

Dilute well with milk, water, carbonated drinks or water to disguise the bitter taste. KKSl is taken with a straw to avoid staining to the teeth.

Question 38

It helps to control the amount of calcium in the blood. Normal calcium levels help maintains muscle control and the blood's ability to clot.

Answer 38

Parathyroid gland

Question 39

Patient teaching undergoing parathyroidectomy avoid:

Answer 39

Milk, seafood, green fruits, green leafy vegetable, turkey or chicken. Answer: Milk or milk products.

Question 40

Signs of Addisonian “crisis” What is the Diagnostic test for Addison crisis?

Answer 40

Decreased urine output, hypotension, dry skin, dry mucous membrane, altered LOC. ACTH stimulation test .

Question 41

SIADH is defined as.

Answer 41

Excessive release of antidiuretic hormone or vasopressin from posterior pituitary gland.

Question 42

Signs and symptoms of SIADH

Answer 42

1. Hyponatremia, fluid overload (not causing edema and hypertension) 2. Fluid retention 3. Decreased urinary output 4. Decreased LOC (due to cerebral edema and increased intracranial pressure) 5. Normal or increased plasma volume

Question 43

Treatment for SIADH

Answer 43

Fluid restriction Diuretic (Lasix-furosemide), a loop diuretic Sodium replacement

Question 44

What is diabetes Insipidus?

Answer 44

Profound deficiency of an antidiuretic hormone (ADH), causing excessive diuresis,

Question 45

Treatment for Diabetes insipidus

Answer 45

Desmopressin

Question 46

Treatment for nephrogenic diabetis insipidus

Answer 46

Thiazides ( diuretics) for paradoxical effect

Question 47

What do you seen on Anterior and Posterior gland?

Answer 47

Anterior Pituitary gland: ACTH FSH, LH, prolactin Growth hormones TSH Posterior gland: Vasopressin (ADH) Oxytocin

Question 48

The endocrine system is made of glands, hormones, & organs. Billary-Tree _______ is the largest gland/ internal organ. It produces two (2) pints of bile (digestive enzyme) daily. _____ stores and concentrates bile. _______releases pancreatic juices, enzymes, and secretes insulin.

Answer 48

Liver Gall bladder Pancreas

Question 49

Ammonia

Answer 49

Question 50

Cirrhosis of the liver what electrolyte imbalance Hypo or hyper? Natremia What do you reduced? Complications?

Answer 50

Cirrhosis. at the Uver is a chronic liver disease secondary to destruction of hepatic cells from chronic alcoholism but It is only one of the causes. May progress to liver failure and obstruction of portal circulation, Signs and symptoms: Early symptoms: fatigue, anorexia, and weight loss, to edema, elevated liver enzymes, electrolyte imbalance primarily hyponatremia. Reduced albumin causing edema and ascites, Complications: fluid retention, esophageal varices, and upper Gl bleeding.

Question 51

Paracentesis: Nursing alert : May require “ albumin”

Answer 51

Question 52

Paracentesis

Answer 52

What

Question 53

Liver biopsy Patient Teaching Pre liver biopsy

Answer 53

Question 54

Post liver biopsy care

Answer 54

Question 55

Pancreas

Answer 55

Question 56

Gland hormone action

Answer 56

Question 57

Pancreatitis Signs Cullen and Grey turner

Answer 57

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3216450/

Question 58

Gall bladder - stores and concentrates bile to digest fast and oils. Chole - Gall bladder ____ is inflammation of the gallbladder (acute or chronic). Primarily affecting obese female. ______ is the presence of one or more calculi (gallstones) in the gallbladder. _____ cholecystitis is a sudden inflammation of the galibladder that causes severe abdominal pain. _____ cholecystitis is long-standing swelling and irritation of the gallbladder.

Answer 58

Question 59

Diagnostic procedures for Chole cyctography

Answer 59

Question 60

Cholesintigraphy or HIDA (Hydroxy. Imino Diacetic Acid).-

Answer 60

is a study of gallbladder through imaging to detect: Biliary obstruction (gallbladder stone or cancer)., HIDA Scan determines any blockage If there is an obstruction, the radioactive tracer will not be able to reach the gallbladder coming from the liver. Preparation: NP0 after midnight lor the procedure and resume to low fat meal.

Question 61

Question 62

____ is a useful tool in establishing the diagnosis of cholecystitis, Confirmation of the diagnosis depends on a combination of physical findings by palpation and ultrasound,

Answer 62

Murphy’s sign

Question 63

Client complaint after laparoscopic cholecystectomy:

Answer 63

irritate the diaphragm and cause referred shoulder pain. Pain last for 24-48 hours or may take several days.

Question 64

Diabetes Mellitus

Answer 64

Question 65

Type 1 and Type 2

Answer 65

Question 66

Hyper glycemic Vs Hypo glycemia

Answer 66

Question 67

Optic click insulin Pen Lantus is for?what type of diatebetes? How many times a day? What is levemir for?

Answer 67

Question 68

Question 69

_____ Normal or elevate blood glucose at bedtime, a decrease of glucose level between “2-3 am” to hypoglycemic levels, and a subsequent rise of the sugar due to the production of counter- regulatory hormones,

Answer 69

Somogyi effect Nursing teaching: Decrease evening dose (pre-dinner or bedtime) of intermediate-acting insulin or increased bed time snack,

Question 70

Injection

Answer 70

Question 71

DKA vs HHNK

Answer 71

Question 72

____ an uncommon initial manifestation in patients with diabetic ketoacidosis. Aggressive potassium repletion to correct other metabolic abnormalities, including hyperglycemia and hyperosmolality.

Answer 72

Profound hypokalemia ( DKA) Initial

Question 73

Potassium loss is caused by a shift of ____ from the _______ to the extra cellular space exchange with hydrogen ions that accumulate extracellularly in acidosis. Much of the shifted extracellular potassium is lost in urine because of osmotic diuresis.

Answer 73

Potassium Intracellular

Question 74

What is hemoconcentration? What is hemodilution? BUN? Creatinine?

Answer 74

Question 75

Peripheral Neuropathy

Answer 75

Question 76

Mixing insulins

Answer 76

Question 77

D/S x Q

Answer 77

Question 78

Metformin : Side Effects Metallic taste, abdominal discomfort, diarrhea, anorexia, nausea or vomiting. Monitor for : Hypo or Hypperglycemia? Contraindicated? When lasix and metformin? Whats gonna happen?

Answer 78

Question 79

/Oral Drug Combinations to treat Type 2 Diabetes & Non-insulin injections

Answer 79

Question 80

Glucagon - used for hypoglycemia and administered IM, IV, subcutaneous. Usual dose 1-2 mg. Do not administer anything orally when patient is lethargic or ALOC.. > Diagnostic test for Pheochromocytoma (will induce increased BP) but contraindicated in known Pheochromocytoma.

Answer 80

Question 81

Hemoglobin A1c Diabetic Foot care

Answer 81

Question 82

Insulin onset test:

Answer 82

Question 83

DI VS SIADH

Answer 83

Question 84

DI and SIADH treatment and Nursing alert

Answer 84

Question 85

Addison and Cushing Syndrome

Answer 85

Question 86

Addison and Cushing Syndrome

Answer 86

Question 87

Addisonian Crisis (Adrenal Crisis)

Answer 87

Question 88

Pheochromocytoma

Answer 88

Question 89

Side Effects of Steroids

Answer 89

Question 90

Thyroid Gland

Answer 90

Question 91

Thyroid Diagnostic Test Thyroid Ultrasound Thyroid Scan Serum Thyroid Panel

Answer 91

Question 92

Hyperthyroidism and Hypothyroidism

Answer 92

Question 93

Hyperthyroidism/Hypothyroidism Treatment Nursing Action

Answer 93

Question 94

Chvostek's Sign and Trousseau Signs (+*) for hypocalcemia and hypomagnesemia

Answer 94

Question 95

Thyroid Levels Interpretation T3 T4 Low TSH High - Hypothyroidism T3 T4 High TSH Low - Hyperthyroidism

Answer 95

Question 96

Hyperthyroidism also known as ________.

Answer 96

Grave’s Disease ( toxic goiter)

Question 97

Radioactive Iodine Teaching And Administration:

Answer 97

Question 98

Thyroidectomy Available at the bedside prior to receiving client from PACU: Thyroidectomy set, suction machine Oxygen inhalation, Calcium chloride IV

Answer 98

Post thyroidectomy Care : Semi-Fowler'$ position or 2-3 pillows. Avoid hyperextending the neck, head in neutral position. No Aspirin or NSAIDs within 10 days, No lifting 20 pounds within 10 days after surgery. Follow up with the surgeon after a week,

Question 99

Para thyroid gland

Answer 99

Question 100

Hypo para thyroidism and Hyper parathyroidism Treatment See pictures:

Answer 100

Question 101

Hypo physectomy - Removal of pituitary gland to treat Cushing Syndrome or tumor.

Answer 101

Question 102

Client Teaching to decrease Addisonian crisis: Most important is “ Steriod in Addison crisis”

Answer 102

Question 103

Acgromegaly Treatment : Sando”statin”

Answer 103

Question 104

Hepa B - Vertical Transmission When is the vaccine treatment?

Answer 104

0,1 and 6 months

Question 105

Hepatitis D (Delta Hepatitis) Transmission?

Answer 105

Bloody fluids, excretion of infected person or maybe acquired from infected HBV.

Question 106

AIDS and HIV

Answer 106

Question 107

Hepatitis A Post Exposure: Gamma globulin injection _______ - Presence of a virus in the bloodstream

Answer 107

Viremia