Chapter 24: Endocrine Disorders and Therapeutic Management

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The patient with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion will need to have the imbalance of which electrolyte corrected as soon as possible?

a.	Chloride
b.	Potassium
c.	Sodium
d.	Calcium

 

ANS:   C

Excessive levels of ADH dramatically alter the sodium balance in the extracellular vascular compartment. The increased circulating volume causes a dilutional hyponatremia and reduces the sodium concentration to critically low levels.

 

DIF:    Cognitive Level: Comprehension       REF:    502

OBJ:    Nursing Process: Analysis      TOP:    Endocrine Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

2. In response to the fluid volume deficit that occurs in diabetic ketoacidosis (DKA), the nurse anticipates that the patient will develop which of the following as the patient’s body attempts to replenish circulating volume?

a.	Polyuria
b.	Polyphagia
c.	Polydipsia
d.	Polydactyly

 

ANS:   C

Excessive urination (polyuria) and glycosuria (glucose in the urine) occur as a result of the osmotic particle load that occurs in DKA. The excess glucose, filtered at the glomeruli, cannot be reabsorbed at the renal tubule and is then detectable in the urine. The nonreabsorbed solute exerts its own osmotic pull in the renal tubules, and less water is returned to circulation through the collecting ducts. As a result, large volumes of water, along with sodium, potassium, and phosphorus, are excreted in the urine, which causes a fluid volume deficit.

 

DIF:    Cognitive Level: Comprehension       REF:    490

OBJ:    Nursing Process: Analysis      TOP:    Endocrine Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

3. In diabetic ketoacidosis (DKA) polyuria occurs as a result of:

a.	osmotic diuresis due to glycosuria.
b.	excessive oral fluid intake.
c.	hypernatremia.
d.	suppression of ADH.

 

ANS:   A

The osmotic particle load that occurs in DKA leads to excessive urination (polyuria) and glycosuria (glucose in the urine).

 

DIF:    Cognitive Level: Comprehension       REF:    489

OBJ:    Nursing Process: N/A TOP:    Endocrine Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

4. Which of the following conditions occurs when the renal tubules are unable to reabsorb excess glucose?

a.	Glycosuria
b.	Glycolysis
c.	Gluconeogenesis
d.	Glycolization

 

ANS:   A

When excess glucose, filtered at the glomeruli, cannot be reabsorbed at the renal tubules, it is excreted in the urine, producing glycosuria.

 

DIF:    Cognitive Level: Comprehension       REF:    489

OBJ:    Nursing Process: N/A TOP:    Endocrine Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

5. A newly diagnosed diabetic patient is asking why his/her blood glucose level gets too high as he/she strictly monitors his/her diet. The nurse explains:

a.	“There is glucose in your intravenous fluids, and that will raise your blood glucose level.”
b.	“Without insulin, your body cannot use the glucose your cells produce through gluconeogenesis, which is a process that gets energy from alternate sources.”
c.	“Your pancreas is having difficulty metabolizing the insulin that we are giving your.”
d.	“Stored glucose is being broken down and entering your bloodstream by a process known as glycolysis.”

 

ANS:   B

Gluconeogenesis is the process of breaking down fat or protein to make new glucose. The release of glucagon from the liver is stimulated when insulin is ineffective in providing the cells with glucose for energy. Glucagon increases the amount of glucose in the bloodstream by breaking down stored glycogen (glycogenolysis).

 

DIF:    Cognitive Level: Comprehension       REF:    490

OBJ:    Nursing Process: Implementation       TOP:    Endocrine Disorders

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation