ATI NURSING EXAMS : ENGAGE ADULT MEDICAL SURGICAL RNRN Critical Endocrine Dysfunction Assessment (retake)
Question 1 of 29
Question 2 of 29
A nurse is providing care for a dehydrated client who has hyperglycaemia related to diabetic
ketoacidosis. Which of the following findings explains dehydration?
A. High osmolality Of the blood due to hyperglycaemia
B. Hypotension due to polyuria
C. Polyphagia due to lack of insulin
D. Decreased cellular tissue perfusion due to hypovolemia
Answer: A. High osmolality Of the blood due to hyperglycaemia
Question 3 of 29
The nurse is providing care for several clients on a medical surgical unit. Which client is at
high risk for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?
A. Client who has myocardial infarction
B. Client who has meningitis
C. Client who has diabetes mellitus
D. Client who has a fractured femur
Answer: B. Client who has meningitis
Question 4 of 29
A nurse is presenting on the topic of hypernatremia to a group of newly licensed nurses.
Identify the correct sequence of the body's physiological responses to elevated sodium levels.
(Move the responses into the box on the right, placing them in the order of occurrence. use all
the steps.)
Answer:
Osmoreceptors sense increased osmolality of the blood.
Antidiuretic hormone (ADH) is released from the posterior pituitary
Antidiuretic hormone(ADH) stimulates the kidney to retain water.
Increased fluid in vascular system decrease osmolity of the blood.
Rental tubules release less water.
Incorrect:
Osmoreceptors regulate ADH. An increase in osmolality stimulates the osmoreceptors,
resulting in release of ADH. Decreased osmolality will prevent the release of ADH. ADH is
stored in the posterior pituitary and is released when stimulated by the osmoreceptors. ADH
travels via the bloodstream to the kidneys when it is released, where it acts on the renal
tubules. The renal tubules and collecting ducts release less water (antidiuresis). When the
kidneys retain more water, the blood osmolarity decreases and stabilizes.
Question 5 of 29
A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which of the following
circumstances put a client at greater risk for developing DKA? (Select all that apply)
A. Clients receiving care at home
B. Infection
C. Excessive alcohol use
D. High protein diet
E. Corticosteroid use
Answer: B. Infection
C. Excessive alcohol use
E. Corticosteroid use
Question 6 of 29
A nurse is providing care for a client who has diabetes insipidus. The nurse should monitor
the client for which of the following cardiovascular effects?
A. Ataxia
B. Hyperosmolality
C. Poor skin turgor
D. Diluted urine
Answer: B. Hyperosmolality
Question 7 of 29
A nurse is providing discharge education for a client who has hyperosmolar hyperglycaemic
syndrome (HHS). Which of the following events should the nurse advise the client to report?
A. An episode of glucose 100 mg/dL
B. An episode of severe pain
C. An episode of decreased appetite
D. An episode of dizziness
Answer: D. An episode of dizziness
Question 8 of 29
A nurse is educating a client who has type 1 diabetes mellitus. Which Of the following
statements indicates the client understands the teaching?
A. "Bicarbonate is elevated with diabetes."
B. I have enough insulin in my body to allow glucose to enter my cells."
C. "When I don't have enough insulin in my body, glucagon will be released,"
D. “My sodium level will not be affected by my diabetes.”
Answer: C. "When I don't have enough insulin in my body, glucagon will be released,"
Question 9 of 29
A nurse is providing care for a client who has recently had a stroke. Which of the following
laboratory findings requires immediate intervention?
A. Serum sodium 125 mEq/L
B. Serum potassium 3.2 mEq/L
C. Serum blood urea nitrogen (BIJN) 22 mg/dL
D. Fasting blood glucose (FBS) 1 10 mg/dL
Answer: A. Serum sodium 125 mEq/L
Question 10 of 29
A nurse is providing instructions for a client who has syndrome of inappropriate antidiuretic
hormone (SIADH) regarding the side effects of conivaptan. Which of the following
symptoms should the nurse teach the client to report? (Select all that apply.)
A. Dizziness
B. Urinary frequency
C. Pain at the IV site
D. Dry mouth
E. Excess thirst
Answer: A. Dizziness
C. Pain at the IV site
D. Dry mouth
E. Excess thirst
Question 11 of 29
A nurse is providing discharge instructions to a client who has hyperosmolar hyperglycaemic
syndrome (HHS). Which of the following statements indicates the client has understood the
teaching?
A. "l will drink at least eight 8 oz glasses of water every day."
B. "1 will check and write down my blood sugar every week."
C. "l will check my urine for ketones if I don't feel well."
D. "l will go to the emergency room if I develop athlete's foot."
Answer: A. "l will drink at least eight 8 oz glasses of water every day."
Question 12 of 29
A nurse is providing care for a client who has type 2 diabetes mellitus. Which of the
following medications would put the client at an increased risk for developing hyperosmolar
hyperglycaemic syndrome (HHS)?
A. Potassium chloride
B. Alendronic acid
C. Enalopril
D. Metolazone
Answer: D. Metolazone
Question 13 of 29
A nurse is providing care for a client who has diabetic ketoacidosis (DKA). The nurse should
monitor the client for which of the following neurological manifestations of DKA? (Select all
that apply.)
A. Tachypnoea
B. Vomiting
C. Headache
D. Blurred vision
E. Lethargy
F. Dry mucous membrane
Answer: C. Headache
D. Blurred vision
E. Lethargy
Question 14 of 29
A nurse is caring for a client who has diabetic ketoacidosis and is manifesting polyuria.
Which of the following findings contributes to the alteration that is causing polyuria?
A. Dehydration
B. Hyperglycaemia
C. Lipolysis
D. Hyponatremia
Answer: B. Hyperglycaemia
Question 15 of 29
A nurse is providing care for a client who has syndrome of inappropriate antidiuretic
hormone secretion (SIADH). Which of the following conditions is the most likely cause for
SIADH?
A. Heart failure
B. Small cell lung cancer
C. Kidney stones
D. Hyponatremia
Answer: B. Small cell lung cancer
Question 16 of 29
A nurse is providing care for a client who has hyperosmolar hyperglycaemic
syndrome(HHS). Which of the following findings should the nurse expect?( Select all that
apply)
A. Ketosis
B. Hyperglycaemia
C. Dehydration
D. Acidosis
E. Kussmaul respirations
F. Insulin resistance
Answer: B. Hyperglycaemia
C. Dehydration
F. Insulin resistance
Question 17 of 29
A nurse is providing discharge instructions to a client who has syndrome of inappropriate
antidiuretic hormone (SIADH) with a prescription for tolvaptan. Which of the following
items should the nurse reinforce to the client to avoid while taking this medication?
A. Acetaminophen
B. Spinach
C. Dairy products
D. Grapefruit
Answer: D. Grapefruit
Question 18 of 29
A nurse is providing care to a client who has syndrome Of inappropriate antidiuretic hormone
(SIADH) and a serum sodium of 118 mEq/L. The client is receiving an intravenous (IV)
solution of 3% saline. Which of the following interventions should the nurse expect to be
prescribed? (Select all that apply.)
A. Fluid restriction
B. Weekly client weight-ins
C. Urine specific gravity monitoring
D. A low sodium diet
E. Daily urine ketone monitoring
F. Mental status assessing every 2 hr
Answer: A. Fluid restriction
C. Urine specific gravity monitoring
F. Mental status assessing every 2 hr
Question 19 of 29
A nurse is providing care for a client who is 2 days postoperative following the removal of a
pituitary tumour. Which of the following manifestations requires intervention?
A. The client has a urine specific gravity of 1.010.
B. The client has a urine output of 1,650 mL and intake of 1,800 me
C. The client has 4 cm of dark red drainage on the surgical site dressing.
D. The client is reporting nausea and vomiting,
Answer: D. The client is reporting nausea and vomiting,
Question 20 of 29
A nurse is providing care for a client who has diabetic ketoacidosis (DKA). Which of the
following manifestations indicates a respiratory effect of DKA?
A. Pneumothorax
B. Apnea
C. Atelectasis
D. Acidosis
Answer: D. Acidosis
Question 21 of 29
A nurse is providing care for a client who has hyperosmolar hyperglycaemic syndrome
(HHS). Which of the following lab values is consistent with a diagnosis Of HHS rather than
diabetic ketoacidosis (DKA)?
A. Sodium bicarbonate 14 mEq/L
B. Arterial pH 7.0
C. Serum osmolality greater than 320 mOsm/kg
D. Anion gap greater than 1 0 mEq/L
Answer: C. Serum osmolality greater than 320 mOsm/kg
Question 22 of 29
A nurse is providing care for a client who has syndrome of inappropriate antidiuretic
hormone secretion (SIADH). Which of the following intravenous (IV) fluids should the nurse
anticipate administering?
A. 0.9% sodium chloride
B. Dextrose 5% in water
C. Dextrose 10% in water
D. Lactated Ringers
Answer: A. 0.9% sodium chloride
Question 23 of 29
A nurse is providing care for a client who has diabetes insipidus (DI). Which of the following
manifestation indicate that the client is experiencing water intoxication as a result of
DI?(select all that apply).
A. Acetone breath
B. Ataxia
C. Acidosis
D. Seizures
E. Vomiting
F. Delirium
Answer: B. Ataxia
D. Seizures
E. Vomiting
F. Delirium
Question 24 of 29
A nurse is explaining the process of acute kidney injury (AK') in clients who have diabetic
ketoacidosis (DKA) to a newly licensed nurse. Put the following pathophysiological events in
order of occurrence. (Move the Steps into the box on the right, placing them in the Order of
occurrence. Use all the steps.)
Answer:
Hyperglycaemia
Osmotic diuresis
Hypovolemia
Decreased perfusion to kidney
Acute kidney injury (AKI)
Explanation:
Hyperglycaemia is one of the main three characteristics of DKA. Hyperglycaemia in DKA is
characterized by a blood glucose level of greater than 250 mg/dL. During the process of
osmotic diuresis, the client experiences polyuria which leads to electrolyte loss, dehydration
and hypovolemia, hyperosmolarity, and acidosis. The resulting hypovolemia eventually leads
to decreased perfusion to the kidneys that can lead to AKI.
Question 25 of 29
A nurse is providing care for a client who has acquired nephrogenic diabetes insipidus.
Which of the following is the most likely cause?
A. Pregnancy
B. Antibiotics
C. Lithium
D. Gene mutation
Answer: A. Pregnancy
Question 26 of 29
A nurse is providing care for a client who has diabetic ketoacidosis (DKA). The client states
"l manage my diabetes very carefully. I don't understand why this happened." Which of the
following statements should the nurse make?
A. "You likely have DKA due to taking an extra dose of insulin,"
B. "DKA probably occurred because you did not check for urine ketones."
C. "DKA was likely caused by the respiratory infection you had last Week."
D. "Your recent increase in exercise could have caused DKA”
Answer: C. "DKA was likely caused by the respiratory infection you had last Week."
Question 27 of 29
A nurse is preparing to administer an intravenous (IV) solution of 3% saline to a client who
has syndrome of inappropriate antidiuretic hormone (SIADH). The prescription is for 100 mL
of 3% saline solution to be infused over 4 hr. What is the flow rate for the IV? (Round the
answer to the nearest whole number. use a leading zero if it applies. Do not use a trailing
zero.)
Answer: 25 mL/hr
STEP 1: What is the unit of measurement the nurse should calculate? ml./hr
STEP 2: What is the volume the nurse should infuse? 100 ml
STEP 3: What is the total infusion time?4 hr
STEP 4: set up an equation and solve for X
Volume (mL)/Time (hr) = X mL/hr
100 mL/4 hr = X mL/hr
X = 25 mL/hr
Question 28 of 29
Question 29 of 29
