Endocrine D2L quiz

When assessing the patient diagnosed with hypothyroidism, the health assessment interview question that provides information would be which of the following? 1) Do you have rough, dry skin? 2) Is your skin smooth or flushed? 3) Does your skin feel clammy? 4) Do you have brown, shiny patches on the lower extremities?

1) Do you have rough, dry skin? Rationale: The patient experiencing hypothyroidism has rough, dry skin. Smooth, flushed skin is associated with hyperthyroidism. Cool, clammy skin is found in patients with low blood sugar. Brown shiny patches on the lower extremities are associated with poor circulation.

A patient is experiencing severe hypertension. The nurse realizes that this finding might indicate a disorder in which endocrine gland? 1) adrenal 2) thyroid 3) parathyroid 4) gonads

1) adrenal Rationale: The patient with hypertension could be experiencing an adrenal disorder, as the adrenal gland regulates epinephrine and norepinephrine, both of which can influence blood pressure. The adrenal gland also regulates blood pressure by secreting mineralocorticoids and aldosterone. The thyroid regulates metabolism. The parathyroid gland regulates calcium. The gonads secrete the hormones of sexuality.

A patient being treated with medication for a seizure disorder is scheduled for a serum T3 and T4 level. The nurse realizes that this patient's results might be which of the following? 1) falsely reduced 2) falsely elevated 3) normal 4) indicative of pending parathyroid hormone disease

1) falsely reduced Rationale: The value of T3 and T4 blood levels might be decreased by certain medications including phenytoin (Dilantin), which is a medication commonly prescribed for seizure disorders. Measurement of T3 and T4 levels is not indicative of parathyroid disease.

When reviewing the patient's record, the nurse sees the results of a recent blood chemistry profile. These results indicate the patient is being evaluated for which of the following? Calcium = 10.2 mg/dL Phosphate = 2.0 mEq/L Vitamin D = WNR 1) hyperparathyroidism 2) Cushing's syndrome 3) thyroiditis 4) hypothyroidism

1) hyperparathyroidism Rationale: Parathyroid hormone (PTH) affects calcium and phosphate metabolism. Normal levels of vitamin D are necessary for PTH to exert its effects. The blood chemistry profile is not indicative of a patient with Cushing's syndrome, thyroiditis or hypothyroidism.

While completing an endocrine focused health assessment interview of an older adult, the nurse recognizes which of the following as an expected change related to thyroid function? 1) inability to tolerate heat and cold 2) indigestion and intolerance of fatty foods 3) increased facial hair 4) enlarged nose, hands and feet

1) inability to tolerate heat and cold Rationale: A lowered basal metabolic rate due to decreased thyroid activity in the aging patient results in inability to tolerate heat and cold. Decreased production of the pancreatic enzyme lipase results in indigestion and intolerance of fatty foods. Increased facial hair and enlarged nose, hands, and feet occur due to decreased pituitary function.

An elderly patient who is seen in the clinic has a palpable thyroid gland. The nurse realizes that this finding indicates which of the following? 1) nothing; this can be normal in the elderly patient 2) the onset of hypertension 3) the onset of diabetes mellitus 4) an explanation for a reduced urine output

1) nothing; this can be normal in the elderly patient Rationale: Elderly patients' thyroid glands could be more fibrotic and nodular as a normal finding. Without other assessments or supporting data, a palpable thyroid gland does not explain the onset of hypertension, diabetes mellitus, or reduction in urine output.

A patient is scheduled for surgery to remove a tumor of the anterior pituitary. The nurse realizes that which of the following hormones will be affected by this surgery? Select all that apply. 1) adrenocorticotropic hormone (ACTH) 2) thyroid stimulating hormone (TSH) 3) gonadotropin hormones 4) prolactin 5) oxytocin

1, 2, 3, 4 Rationale: The anterior pituitary produces adrenocorticotropic hormone, thyroid-stimulating hormone, the gonadotropin hormones which are follicle stimulating hormone and luteinizing hormone, growth hormone, and prolactin. Oxytocin is produced in the posterior pituitary.

Which of the following statements would indicate that discharge instructions to a patient recovering from a total thyroidectomy were not effective? 1) "My doctor will be checking my T3 and T4 levels in the near future." 2) "A blood test for aldosterone will be done in a month." 3) "I know I will be on medication for the rest of my life." 4) "I'll be glad when I get my energy back."

2) "A blood test for aldosterone will be done in a month." Rationale: Aldosterone is a hormone secreted by the adrenal cortex and would not be evaluated in the patient post-thyroidectomy. The other responses are appropriate to the teaching.

Which of the following should the nurse ask a female patient during the assessment of the endocrine system? 1) "Do you have children?" 2) "Is your menstrual cycle regular?" 3) "Are you able to provide for your children?" 4) "How old were you when your menses first began?"

2) "Is your menstrual cycle regular?" Rationale: The patient who has a change in her menstrual cycle might be experiencing an endocrine disorder such as increased androgen production or decreased estrogen levels. Having children is not a function of the endocrine system. Asking how the patient is able to provide for her children provides psychosocial information. Asking when menses first began might provide information about cancer risk but not about endocrine function.

A middle-aged female patient is found to have a decrease in her cortisol level. The nurse realizes that this finding is consistent with which of the following? 1) hyperthyroidism 2) Addison's disease 3) Cushing's syndrome 4) nothing

2) Addison's disease Rationale: A cortisol level is a serum test done to measure the amount of total cortisol in the serum and evaluate adrenal cortex function. Decreased levels are consistent with Addison's disease and hypothyroidism. Cushing's syndrome would reveal an elevated cortisol level.

A patient comes into the clinic demonstrating symptoms of hypocalcemic tetany. Which of the following assessments should the nurse conduct to determine the patient's condition? 1) Place a tuning fork over one of the patient's fingers. 2) Tap a finger in front of the patient's ear at the angle of the jaw. 3) Measure the patient's blood pressure. 4) Measure capillary blood.

2) Tap a finger in front of the patient's ear at the angle of the jaw. Rationale: The nurse should assess the patient for Chvostek's sign by tapping a finger in front of the patient's ear at the angle of the jaw. Decreased calcium levels will cause the patient's lateral facial muscles to contract. This demonstrates tetany. Placing a tuning fork over the patient's finger evaluates the patient's ability to perceive vibrations, but does not evaluate the muscle response of tetany. Blood pressure measurement may give the nurse valuable information about the patient's fluid and electrolyte status, but does not evaluate tetany. A capillary blood level for serum calcium would give a measurement, but does not assess for the clinical symptoms of tetany.

A patient is scheduled for a thyroidectomy. Which of the following should the nurse include when teaching this patient about recovery after the procedure? 1) Exercise will be restricted for up to six months after the surgery. 2) There might be hormone replacement medications needed since the parathyroid glands will most likely also be removed. 3) A low- or no-sodium diet will be prescribed. 4) Physical therapy sessions will need to be continued.

2) There might be hormone replacement medications needed since the parathyroid glands will most likely also be removed. Rationale: The parathyroid glands are embedded on the posterior surface of the lobes of the thyroid gland. They secrete parathyroid hormone in response to dropping levels of calcium in the blood. These glands also participate with phosphorous regulation. This patient will most likely need medication or supplements since these glands will be missing after the surgery. Lengthy exercise restriction or physical therapy is not generally indicated following thyroidectomy. A sodium-restricted diet would not ordinarily be necessary.

When measuring the blood pressure of a patient with hypoparathyroidism, the nurse notes spasms of the patient's hand. The nurse documents this clinical manifestation as which of the following? 1) Chvostek's sign 2) Trousseau's sign 3) Turner's sign 4) Cullen's sign

2) Trousseau's sign Rationale: Trousseau's sign is elicited by placing a blood pressure cuff on the patient's arm; when the cuff is inflated, the patient experiences carpal spasms of the hand. Chvostek's sign is elicited by tapping on the face in front of the ear and observing for contractions of the facial muscle. Turner's and Cullen's signs are observed on a patient's abdomen and flank and are associated with intra- or retroperitoneal bleeding.

The nurse instructs a patient with low levels of circulating thyroid hormone to increase foods in the diet containing which of the following? 1) calcium 2) iodine 3) phosphorus 4) vitamin D

2) iodine Rationale: Iodine is necessary for adequate thyroid hormone secretion. Calcium, phosphorus, and vitamin D do not affect thyroid hormone secretion.

Which of the following statements by the patient would indicate that instruction regarding the 17-ketosteroid test has been effective? 1) "I know this test will be helpful in diagnosing my thyroid problem." 2) "I will arrive early to have my blood drawn." 3) "I will store the specimen container in the refrigerator." 4) "I shouldn't eat or drink anything before this test."

3) "I will store the specimen container in the refrigerator." Rationale: The 17-ketosteroid test is a 24-hour collection of urine to evaluate adrenal cortex function. The patient is instructed to collect urine in a container is preservative and store it in the refrigerator. There are no food or fluid restrictions and the test does not include having blood drawn.

The nurse realizes an alteration in growth hormone can lead to changes in an individual's physical stature. The condition that can occur with abnormally high levels of growth hormone in adults is which of the following? 1) hirsutism 2) gynecomastia 3) acromegaly 4) dwarfism

3) acromegaly Rationale: Extremely large bones may indicate acromegaly, which is caused by excessive growth hormone. Extremely short stature may indicate dwarfism, which is caused by insufficient growth hormone. Hirsutism, or abnormal hair growth, is associated with adrenal hormone access. Gynecomastia, or development of breast tissue in men, is frequently associated with androgen therapy.

A female patient comes into the clinic to be seen for fatigue and a cold that "won't go away," which began when she started a new job and her mother moved in with her family. The nurse realizes that this patient might be experiencing which of the following? 1) a drop in mineralocorticoid secretion 2) a reduction in norepinephrine secretion 3) an increase in glucocorticoid secretion 4) an increase in epinephrine secretion

3) an increase in glucocorticoid secretion Rationale: The glucocorticoids include cortisol and cortisone. These hormones affect carbohydrate metabolism and are released in times of stress. An excess of glucocorticoids in the body depresses the inflammatory response and inhibits the effectiveness of the immune system. Alteration in epinephrine, norepinephrine, or mineralocorticoids would have an influence on cardiovascular function and fluid and electrolyte balance, but would not influence immune response as much as an increase in glucocorticoid secretion.

A patient is demonstrating symptoms of dehydration and excessive urination. The nurse realizes the patient might be experiencing an alteration in which of the following hormones? 1) follicle stimulating hormone (FSH) 2) thyroid stimulating hormone (TSH) 3) antidiuretic hormone (ADH) 4) adrenocorticotropic hormone (ACTH)

3) antidiuretic hormone (ADH) Rationale: Antidiuretic hormone decreases urine production by causing the renal tubules to reabsorb water from the urine and return it to the circulating blood. This patient is demonstrating excessive urination, which might indicate an alteration in this hormone. Follicle-stimulating hormone functions in ovum and sperm formation. Adrenocorticotropic hormone stimulates adrenal function. Thyroid-stimulating hormone stimulates thyroid function. Alteration in these hormones does not have as direct of a relationship to the patient's symptoms as antidiuretic hormone does.

Which of the following assessment findings are most likely to be seen in a patient diagnosed with a pituitary disorder? 1) thin, soft hair 2) excessive growth of facial hair 3) enlargement of the hands and feet 4) purple striae over the trunk

3) enlargement of the hands and feet Rationale: In a patient experiencing a pituitary disorder such as acromegaly, enlargement of the hands and feet may be observed. Thin, soft hair occurs in hyperthyroidism; hirsutism and purple striae are associated with Cushing's disease, an adrenal disorder.

Hormone transport in the body by the __________ route would occur at a time when the patient is undergoing a stress response. 1) paracrine 2) portal 3) neuroendocrine 4) nerve cell extension

3) neuroendocrine Rationale: When a patient is undergoing a stress response, epinephrine is released into the bloodstream by the adrenal medulla which is an example of the neuroendocrine route of hormone transport. The paracrine route involves endorphins being released into interstitial fluids to act locally in response to inflammation. The portal route involves most endocrine hormones being released into the bloodstream to act on target organs, such as occurs with thyroid hormone and insulin. The hypothalamus releases its hormones directly to target cells in the posterior pituitary by nerve cell extension.

Which of the following would the nurse assess in a patient who is demonstrating signs of exophthalmos? 1) dry, thick nails 2) dry skin 3) decreased reflexes 4) enlarged thyroid gland

4) enlarged thyroid gland Rationale: Exophthalmos is a clinical manifestation associated with hyperthyroidism. Dry, thick nails; dry skin; and decreased reflexes are associated with hypothyroidism.

During an assessment the nurse notes that the patient's eyes are extremely wide open and bulging. The nurse realizes that this finding is consistent with which of the following? 1) diabetes mellitus 2) hypofunction of the adrenal glands 3) hypofunction of the anterior pituitary gland 4) hyperthyroidism

4) hyperthyroidism Rationale: Exophthalmos or protruding eyes may be seen in hyperthyroidism. This is not a finding that is associated with diabetes mellitus, hypofunction of the adrenal glands, or hypofunction of the pituitary gland.

The nurse is planning to conduct a physical assessment for a patient's endocrine functioning. Which of the following will the nurse be able to assess on this patient? 1) palpation of the pancreas 2) percussion of the adrenal glands 3) palpation of the parathyroid glands 4) palpation of the thyroid gland

4) palpation of the thyroid gland Rationale: The only endocrine organ that can be palpated is the thyroid gland. The anatomical location of the pancreas, adrenal glands, and the parathyroid glands prohibits direct examination by palpation or percussion.

While instructing a patient on pain relief, the nurse uses the example of endorphins as endocrine hormones, which act locally at the site of injury. The nurse is explaining which route of hormone transport in the body? 1) direct release into the bloodstream 2) neuroendocrine route 3) nerve cell extension into the posterior pituitary 4) paracrine method

4) paracrine method Rationale: The paracrine method involves diffusion of hormones through interstitial fluids to act locally. Endorphins produce pain relief in this manner. The other responses describe the three additional routes of endocrine hormone transport.

Which of the following laboratory values would the nurse assess in the patient diagnosed with Graves' disease? 1) urine-specific gravity 2) cortisol 3) calcium 4) thyroxine

4) thyroxine Rationale: Thyroxine (T4) is the hormone secreted by the thyroid gland. Thyroxine (T4) is converted to triiodothyronine (T3), and both are secreted in response to thyroid-stimulating hormone (TSH). Urine-specific gravity would be measured to provide information about the posterior pituitary. The adrenal gland produces cortisol. The parathyroid gland regulates calcium and phosphorous.