Chapter 24-Pituitary and Thyroid Disorders (Davis QUIZ)

A patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following would support this diagnosis? Select all that apply. -Increased plasma osmolarity -Increased plasma ADH levels -Increased urine concentration -Dehydration and fluid volume deficit -Dilutional hyponatremia

-Increased plasma ADH levels -Increased urine concentration -Dilutional hyponatremia Rationale: SIADH indicates higher than needed ADH levels. Rationale: Urine will become more concentrated, as fluid is retained. Rationale: Dilutional hyponatremia may occur as excess fluid is retained.

A nursing student is reviewing signs and symptoms of hyperthyroidism. Which of the following should she include on her list? Select all that apply. -Weight loss -Tachycardia -Lethargy -Tremors -Cold intolerance

-Weight loss -Tachycardia -Tremors Rationale: Hyperthyroidism stimulates metabolism, causing weight loss. Rationale: Hyperthyroidism stimulates the heart rate. Rationale: Hyperthyroidism can stimulate the nervous system, causing tremors.

Please place the following sequences in order to describe how iodine deficiency may lead to a goiter.

1. Decreased iodine in diet 2. Decreased thyroid hormone synthesis 3. Decreased negative feedback on anterior pituitary 4. Increased thyroid-stimulating hormone (TSH) secretion 5. Increased thyroid growth Rationale: Decreased iodine results in reduced ability to synthesize thyroid hormones. Reduced thyroid hormones cause decreased negative feedback on the anterior pituitary. Anterior pituitary secretion of TSH increases, which causes the thyroid gland to grow.

A patient needs a screening of anterior pituitary hormone functioning. Which hormone should not be included in the evaluation? -Antidiuretic hormone -Thyroid stimulating hormone (TSH) -Growth hormone -Follicle-stimulating hormone

Antidiuretic hormone Rationale: Antidiuretic hormone is produced by the posterior pituitary.

Please indicate on the figure the step in which elevated T4 levels would decrease further stimulatory signals from the pituitary gland.

Arrows pointing towards the hypothalamus. Rationale: On the image, thyroid hormone would be released from the endocrine gland. This signal would cause negative feedback to the anterior pituitary.

A patient with a traumatic brain tumor suffered a pituitary apoplexy. Which of the following does the nurse expect to encounter? -Patient with limited signs and symptoms -Blood laboratory values revealing elevated growth hormone-releasing hormone (GHRH), thyrotropic releasing hormone (TRH) and corticotropin-releasing factor (CRF) -Hyperfunctioning of thyroid and adrenal gland -Increased adrenocorticotropic hormone (ACTH) and thyroid-stimulating hormone (TSH) blood levels

Blood laboratory values revealing elevated growth hormone-releasing hormone (GHRH), thyrotropic releasing hormone (TRH) and corticotropin-releasing factor (CRF) Rationale: A pituitary apoplexy results in pituitary dysfunction. Hypothalamic hormones would increase in an attempt to stimulate the pituitary gland.

A patient suffering for diabetes insipidus is given antidiuretic hormone (ADH). The result is increased fluid retention and decreased urine output. Which of the following conditions does the patient have? -Nephrogenic diabetes insipidus -Central diabetes insipidus -Diabetes mellitus -Syndrome of inappropriate diabetes insipidus (SIADH)

Central diabetes insipidus Rationale: In central diabetes insipidus, the kidneys can respond to ADH. Giving ADH and seeing fluid retention shows that the kidney can respond to ADH when it is present. The problem is a lack of ADH.

Question 9 of 15 Which of the following is shown in this image? -Exophthalmos -Periorbital edema -Bell's palsy -Enophthalmos

Exophthalmos Rationale: Exophthalmos is the protrusion of the eyeballs. This can occur with hyperthyroidism.

A patient suffering from severe stress and anorexia has the following laboratory values, which are all low: gonadotropin-releasing hormone (GnRH), growth hormone-releasing hormone (GHRH), and corticotropin-releasing factor (CRF). Which tissue is likely dysfunctional? -Adrenal cortex -Hypothalamus -Posterior pituitary -Anterior pituitary

Hypothalamus Rationale: All the values indicated are from the hypothalamus, so this tissue is likely disrupted by the patient's condition.

A patient with Hashimoto's thyroiditis is being given levothyroxine. The patient wants to know how the medication works. Which of the following responses is correct for the nurse to make? -Levothyroxine blocks excess thyroid hormones. -Levothyroxine stimulates thyroid receptors. -Levothyroxine blocks the antibodies that cause Hashimoto's thyroiditis. -Levothyroxine replaces missing thyroid hormone.

Levothyroxine replaces missing thyroid hormone Rationale: Levothyroxine is a medication that compensates for lacking thyroid hormones.

A patient presents with hyperthyroidism. Which of the following values enables the clinician to rule out secondary hyperthyroidism? -Low thyroid-stimulating hormone (TSH) -Elevated thyroxine -Low thyrotropic releasing hormone (TRH) -Elevated T3 levels

Low thyroid-stimulating hormone (TSH) Rationale: If the hyperthyroidism were secondary, then TSH levels would be high, indicating a problem with the anterior pituitary.

Reviewing a patient's chart, a nurse notes the presence of acromegaly. Which of the following is likely to be present when the nurse assesses the patient? -Increased stature -Cold intolerance -Overgrowth of jaw, hands -Galactorrhea

Overgrowth of jaw, hands Rationale: Acromegaly is increased GH in adulthood.

Which of the following individuals would a nurse be most concerned about with respect to the development of Sheehan's syndrome? -15-year-old male -Postpartum woman -Young child with growth delay -Postmenopausal woman

Postpartum woman Rationale: Sheehan's syndrome, which results from disruption of blood flow to the pituitary gland, most commonly happens after childbirth.

Hyperpituitarism is most commonly caused by which of the following? -Prolactinoma -Autoimmune disorder -Congenital defect -Sheehan syndrome

Prolactinoma Rationale: A prolactinoma is the most common cause of elevated pituitary activity.

A nursing student notices elevated thyroid stimulating hormone (TSH) on laboratory values, along with low thyroxine levels. What is the proper interpretation of the results? -The patient has secondary hypothyroidism. -The patient has primary hypothyroidism. -The patient has hyperfunctioning of the anterior pituitary. -The patient has Grave's disease.

The patient has primary hypothyroidism. Rationale: TSH levels are elevated, but the thyroid gland is not responding with additional thyroid hormone.