NCLEX Review Questions (Wagner) - Chapter (31)

Chapter 31: Metabolic Responses to Stress NCLEX® Review This activity contains 10 questions. A nurse providing care to a patient with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis would assess for changes associated with which hormones? Select all that apply. Corticotropin-releasing hormone (CRH) Glucagon Cortisol Adrenocorticotropic hormone (ACTH) Luteinizing hormone (LH) A nurse working with critically injured patients would expect to see the "fight-or-flight" response at which point of hospitalization? On admission to the Emergency Department About a week after discharge from the hospital Just before discharge After several days of hospitalization A patient is at risk for development of adrenal insufficiency. The nurse will monitor for the development of which finding? Bradycardia Hypothermia Nausea and vomiting Brisk reflexes A patient's levothyroxine (T4) and triiodothyronine (T3) levels are low. Which change would the nurse expect to see if the patient's endocrine system were functioning normally? Rapid increase in thyroglobin Increased thyrotropin-regulating hormone (TRH) Rapid decrease in growth hormone (GH) Decreased thyroid-stimulating hormone (TSH) A patient has been prescribed methimazole (Tapazole) for treatment of hyperthyroidism. Which discharge instructions should the nurse provide? Select all that apply. "Report any weight gain to your health care provider." "Take your pills at the same time each day." "Watch for increasing fatigue." "While you are taking this medication, you should avoid drinking milk." "You may notice a discoloration in your urine while taking this medication." The patient with thyroid deficiency is at risk for dilution of the blood by increased free water. Which laboratory value would the nurse monitor to assess for this complication? Magnesium Potassium level Phosphorus Sodium A patient has developed non-thyroid illness syndrome (NTIS). Which finding would the nurse evaluate as indicating the patient has a poor prognosis? Rapid increase in T3 with normal TSH Increased T3 with decreased TSH level Decreased T3 with normal T4 Decreased T3 and significant T4 decrease A patient with pre-existing insulin-dependent diabetes mellitus has been hospitalized for treatment of a severe infection. The patient is febrile and vomiting. How does the nurse expect to manage this patient's insulin requirements? Insulin dose will be decreased until the patient is able to eat. Insulin dose will not change. Insulin dose will likely be increased. Insulin will be given intravenously rather than subcutaneously. A nurse is providing care to a patient with pre-existing diabetes who had surgery to correct a dissecting abdominal aneurysm. Which blood glucose levels would the nurse evaluate as indicating additional intervention is required? Select all that apply. 180 mg/dL 220 mg/dL 115 mg/dL 140 mg/dL 89 mg/dL A nurse is working on a committee that is designing standard protocols for management of acutely ill patients with pre-existing diabetes mellitus being managed with insulin drips. The nurse would advocate for serum glucose measurements via venipuncture at least how often in these patients? Every 12 hours Every 2 hours Every 24 hours Every 6 hours