Chapter 23: Endocrine Clinical Assessment and Diagnostic Procedures

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The patient has markedly deep, rapid respirations with a fruity breath odor. Based on the patient’s history, the nurse will:

a.	assess the patient’s mental status for a possible panic attack.
b.	administer a sedative.
c.	perform a blood glucose measurement.
d.	measure serum electrolyte levels.

 

ANS:   C

If ketoacidosis occurs, the patient’s breathing becomes deep and rapid (Kussmaul respiration), and the breath may have a fruity odor. Ketoacidosis is indicative of hyperglycemia and thus the nurse should check the patient’s blood glucose.

 

DIF:    Cognitive Level: Application REF:    472

OBJ:    Nursing Process: Analysis      TOP:    Endocrine Clinical Assessment

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

2. A patient newly diagnosed with diabetes asks about checking her urine for glucose. She remembers that her diabetic cousin had to do this when they were children. The nurse explains:

a.	“Your diabetes is not severe enough to require this assessment.”
b.	“If your blood glucose level is not controlled within the next 6 months, you will have to perform this testing.”
c.	“As long as you are taking oral medicine for your diabetes, you will not have to do this.”
d.	“That is no longer done because it is not an accurate evaluation of diabetes control.”

 

ANS:   D

Testing the urine for glucose is not recommended for diabetic patients because there is too much variation in the renal threshold for glucose when kidney damage secondary to diabetes has occurred.

 

DIF:    Cognitive Level: Comprehension       REF:    474

OBJ:    Nursing Process: Implementation       TOP:    Endocrine Laboratory Studies

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

3. The nurse practitioner is counseling the diabetic patient about follow-up care after discharge. The patient is advised to schedule appointments at what intervals to have blood drawn for glycated hemoglobin studies?

a.	Monthly
b.	Weekly
c.	Quarterly
d.	Annually

 

ANS:   C

The test for glycated hemoglobin (also known as hemoglobin A_1C) provides information about the average amount of glucose that has been present in the patient’s bloodstream over the previous 3 to 4 months.

 

DIF:    Cognitive Level: Application REF:    474

OBJ:    Nursing Process: Implementation       TOP:    Endocrine Laboratory Studies

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

4. The fruity acetone breath of the patient is an indication of:

a.	lack of oxygen.
b.	metabolic acidosis.
c.	respiratory alkalosis.
d.	macrocytic anemia.

 

ANS:   B

Ketones are by-products of fat metabolism. Elevated blood ketone levels (ketonemia) are indicated by a fruity, sweet-smelling odor on the exhaled breath. This odor is the result of the body’s attempt to keep the pH within the normal range. The sweet-smelling breath occurs when the patient exhales in an attempt to decrease the accumulated acids.

 

DIF:    Cognitive Level: Analysis      REF:    474

OBJ:    Nursing Process: Implementation       TOP:    Endocrine Clinical Assessment

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

5. Diabetic patients are advised to check the urine for ketones:

a.	when blood glucose level is higher than 200 mg/dL.
b.	when symptoms of nausea, vomiting, or abdominal pain are present.
c.	daily after meals.
d.	whenever the urine has a fruity acetone odor.

 

ANS:   B

It is recommended that all diabetic patients self-test or have their urine tested for the presence of ketones during any acute illness or stress; when blood glucose level is higher than 300 mg/dl (16.7 mmol/L); when symptoms of nausea, vomiting, or abdominal pain are present; and during pregnancy.

 

DIF:    Cognitive Level: Application REF:    474

OBJ:    Nursing Process: Implementation       TOP:    Endocrine Laboratory Studies

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential