Patho final part 1
Which test can the nurse prepare the client for to determine the differentiation between a benign and malignant thyroid disease?
Fine-needle aspiration biopsy
What is the role of glucagon in initiating the breakdown of glycogen?
First messenger
When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of:
Anterior pituitary gland
A male client is admitted with a spinal injury that has damaged his sacral plexus. The nurse understands that this type of injury could affect the impulse stimulation for initiating the sexual act through which organ?
Glans penis
Select the most accurate statement regarding measurements of urinary hormone.
Provide a better measure of hormone levels during a designated period.
A 52-year-old male diagnosed with erectile dysfunction (ED) asks the nurse what will be implemented as a first option for treatment. The best response would be:
Psychosexual counseling and PDE-5 inhibitor medications
How will cell receptors change in the absence of a particular hormone?
Receptors in each cell will increase.
The nurse is caring for a client with acute superficial balanoposthitis. The nurse assesses for which of these signs or symptoms consistent with the diagnosis?
Redness of the glans penis and malodorous discharge
Hormones are chemical messengers that provide which function in the body?
Regulate body functions
A client with diabetes carries insulin with him at all times. At 11:35, he obtains a blood glucose reading of 218 mg/dL (12.1 mmol/L) and self-administers a dose of insulin in anticipation of eating lunch at noon. What type of insulin did he most likely inject?
Short acting
A female client experiencing hot flashes during perimenopause asks the nurse about hormone therapy (HT). What is the appropriate response by the nurse?
Short term HT can be used to reduce symptoms.
Which physiologic process best exemplifies a positive feedback mechanism?
The increase in prolactin secretion that occurs with more frequent breast-feeding
The pediactric nurse is teaching the mother of a newborn with hypospadias about this disorder. Which of these does the nurse convey?
The opening of the urethra is found on the underside of the penis.
A client with hyperthyroidism is being treated with medication that blocks the activity of thyroid-stimulating hormone. Her care team has determined that she has been overproducing TSH. This client will have lost her ability to:
have negative feedback regulation.
During periods of fasting and starvation, the glucocorticoid and other corticosteroid hormones are critical for survival because of their stimulation of gluconeogenesis by the liver. When the glucocorticoid hormones remain elevated for extended periods of time, what can occur?
hyperglycemia
Which pregnant woman likely faces the greatest risk of developing gestational diabetes? A client who:
is morbidly obese (defined as greater than 100 pounds over ideal weight).
What are the small bumps or projections on the areolar surface called?
Montgomery tubercles or glands
Which of these complications does the nurse recognize may occur after illness with parotitis (mumps) in young men?
Orchitis with residual sterility
The nurse on the urology unit teaches the nursing student that which test assists in detecting a recurrence of prostate cancer after prostatectomy?
PSA level
Which clinical manifestations are characteristic for clients with Peyronie disease? Select all that apply.
Painful erection Presence of a hard mass on the tunica albuginea of the penis
The perimetrium reflects over the bladder wall and forms what?
The pouch of Douglas
Which hormone is secreted based on a cyclic rather than a diurnal manner?
Follicle-stimulating hormone (FSH)
A client with small cell carcinoma lung cancer may secrete an excess of which hormone, causing an ectopic form of Cushing syndrome due to a nonpituitary tumor?
ACTH
A client with type 2 diabetes experiences unexplained elevations of fasting blood glucose in the early morning hours. Which conditions can account for this effect?
Dawn phenomenon
Where is the final site for sperm maturation?
Epididymis
Which hormone is produced by the anterior pituitary gland?
Growth hormone (GH)
Following a meal, a client's blood glucose level has increased. In addition, the client's pancreas has increased the amount of insulin produced and released. Which phenomenon has occurred?
Increased hormone level according to a negative feedback mechanism
If not treated urgently, testicular torsion can result in which complication?
Loss of testicular perfusion
Which hormone is responsible for breast development and the increase in body temperature that occurs with ovulation?
Progesterone
Hormones exert their action by interacting with which type of receptors?
Affinity
Select the structure primarily responsible for the secretions of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin.
Anterior pituitary gland
Which statement best explains the function of hormone receptors?
Hormone receptors recognize a specific hormone and translate the hormonal signal into a cellular response.
A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis?
Hypoglycemia
A couple is undergoing initial testing to determine why they are unable to conceive. One of the tests shows that the man has a testosterone level of 198.8 ng/dL (6.9 nmol/L). The man reports being tired all the time. The woman is completely healthy. Which problem is most likely?
Hypogonadism
Release and synthesis of anterior pituitary hormones are mainly regulated by which part of the body?
Hypothalamus
The nurse is caring for a client with significant benign prostatic hyperplasia (BPH) and hydronephrosis who is fearful of having corrective surgery. Which information is important for the nurse to convey?
The obstruction is causing urine to flow backward and cause kidney dysfunction.
Which gland acts as a signal-relaying bridge between multiple body systems and the pituitary gland?
Hypothalamus
The nurse is caring for a client who has inflammation of the vagina. The nurse is aware that which bodily disturbance may change the vaginal ecology? Select all that apply.
Oral contraceptive use Diabetes Systemic antibiotic use
The mother requests that a circumcision be performed on a newborn with hypospadias. Which information related to treatment of hypospadias should the nurse convey?
Circumcision is avoided as the foreskin will be used to repair the urinary opening.
The nurse is planning to collect a 24-hour urine sample for hormone assay. In which situation does the nurse collaborate with the health care provider to find an alternate type of testing?
Client has anuria.
An older adult female client had an oophorectomy before menopause. Which current symptoms could result from early loss of estrogen? Select all that apply.
Cognitive decline Hyperlipidemia
A 22-year-old male client presents with an enlarged firm testis and scrotal edema and is suspected to have orchitis. The nurse includes what actions in the plan of care? Select all that apply.
Collection of urethral cultures Application of cold packs Elevation of the scrotum Restriction of client's activity
Which criterion about insulin would prompt a diagnosis of type 1 diabetes?
Complete failure of insulin secretion
A client arrives in the emergency department complaining of severe pain in the left testicular area with nausea and vomiting for 2 hours. The left testicle is large and tender to palpation and radiating to the inguinal area. Which of the following reflexes can the nurse assess the absence of in order to indicate testicular torsion?
Cremasteric reflex
The environment of the vagina is moist with a pH 4.0 to 4.5. The major purpose of the acidic environment is:
Bacteriostatic
A 60-year-old male client is informed by the health care provider that he has an overgrowth of mucosal glands of the prostate. Based solely on this finding, what diagnosis will the provider likely document in the health record?
Benign prostatic hyperplasia (BPH)
The nurse in the urology office recognizes screening men at risk for prostate cancer includes which diagnostic measures?
Blood level of prostate-specific antigen (PSA) and digital rectal exam
When caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which organ does the nurse recognize is reliant on glucose as the major energy source?
Brain
An adult with acromegaly presents with a very distinctive appearance. What is the distinctive feature in a person with acromegaly?
Broad, bulbous nose and a protruding lower jaw
A client asks, "What gland is responsible for urethral lubrication during male sexual stimulation?" Which response by the health care provider would be the best reply?
Bulbourethral glands
Which complication of acromegaly can be life threatening?
Cardiac structures increase in size
Which physiologic changes result in menopause?
Cessation of ovarian function and decreased estrogen levels
A client with diabetes mellitus has sudden onset of slurred speech, incoordination, and cool, clammy skin. What will the nurse do first?
Check blood glucose
Ovaries are responsible for ovulation and hormone production.
!!
A nurse who works in the office of an endocrinologist is orienting a new staff member. Which teaching point should the nurse include in the orientation?
"A single hormone can act on not only one process or organ but often on several different locations or processes."
A nurse suspects an older adult client is experiencing benign prostatic hyperplasia (BPH). Which question should the nurse ask this client?
"Has the force of your urinary stream decreased?"
The nurse has just completed teaching a client, newly diagnosed with type 1 diabetes, about the treatment options. Which response by the client leads the nurse to conclude that addidtional teaching is needed?
"So I can stop my insulin if I start an exercise program."
The parents of a baby born with hypospadias ask the nurse if the baby can be circumcised. Which response by the nurse is most accurate?
"The circumcision will not be done now; the foreskin is needed for surgical repair."
A male client is diagnosed with an inguinal hernia. Which statement by the client indicates that the nurse's teaching about the hernia has been effective?
"The hernia is a loop of bowel protruding through a weak spot in my abdominal muscles."
The nurse is teaching a female client who has been prescribed hormone therapy. The client asks, "What does this medication do?" Which statement is an appropriate response by the nurse?
"This medication will help relieve hot flashes and other adverse symptoms of menopause."
A 70-year-old male tells the health care provider he is now in a relationship with a younger woman who is capable of reproduction. The client asks if he may still be fertile. The best response would be:
"Yes; some 80- and 90-year-old men have been known to father children."
When educating a client with possible glucocorticoid dysfunction, the nurse will explain that the CRH controls the release of ACTH. The best time to perform the blood test to measure peak ACTH levels would be:
06:00 to 08:00 AM
breasts leak post feeding
3mo-1yr
Menipause
48-55
The nurse is caring for several clients who are taking growth hormone replacement therapy. Which client does the nurse recognize is most at risk for side effects?
A 45-year-old obese client with an elevated serum IGF-1 concentration
A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to?
A hypermetabolic state
An 18-month-old boy is diagnosed with cryptorchidism. Based on this diagnosis, what does the nurse expect to observe during the physical assessment?
Absence of the testis in the scrotum bilaterally
Cyclic adenosine monophosphate (cAMP) performs which role in the functioning of the endocrine system?
Acting as a second messenger to mediate hormone action on target cells
What should the nurse do when a woman who stopped breast-feeding her infant 3 months ago complains of occasional milk leakage from her breasts?
Advise the woman that this is a normal occurrence after stopping breast-feeding
The non-vesicle-mediated pathway has a role in synthesis and release of which hormones? Select all that apply.
Aldosterone Testosterone
A female client with anorexia nervosa tells the nurse that she has been experiencing amenorrhea. The nurse is aware that this is a result of:
Alteration of critical body fat-to-muscle ratio needed for menses to occur
Hormones can be synthesized by both vesicle-mediated pathways and non-vesicle-mediated pathways. What hormones are synthesized by non-vesicle-mediated pathways?
Androgens and estrogens
The nurse is administering a phenothiazine derivative with the understanding that this medication puts the client at risk for hyperprolactinemia, which may produce which manifestations? Select all that apply.
Anovulation Amenorrhea Oligomenorrhea
The nurse is explaining ovulation to a female client. The nurse explains that follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are important hormones needed to ovulate and are secreted by which gland?
Anterior pituitary
A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of:
Antidiuretic hormone (ADH) and oxytocin
A female client's assessment identifies symptoms of dyspareunia and burning. The nurse is aware that the client may have developed:
Atrophic vaginitis
When educating a client about type 1 diabetes, the nurse will mention that this type is caused by which mechanism?
Autoimmune destruction of pancreatic beta cells
A client experiences an increase in thyroid hormone as a result of a thyroid tumor. Which hormonal response demonstrates the negative feedback mechanism?
Decreased thyroid-stimulating hormone (TSH)
Erectile dysfunction is the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse. The nurse knows that there may be many causes of erectile dysfunction, and a psychogenic cause would include which of the following?
Depression
An adult client presents to the emergency department after an episode of syncope. Blood pressure is low and the pulse is thready and rapid. The client frequently voids large amounts of pale, clear urine. Lung sounds are clear and skin turgor is inelastic. Which endocrine disorder is the likely cause of these manifestations?
Diabetes insipidus
What can cause erectile dysfunction?
Dysfunction of pudendal nerves
A nurse examines the laboratory values of a client in heart failure. Which value indicates a compensatory hormone mechanism?
Elevated atrial natriuretic hormone
The nurse is caring for a client with primary hypothyroidism who is being monitored for the complication of myxedema coma while thyroid-level therapy is started. What does the nurse understand are the three major aspects of myxedema coma? Select three that apply.
Elevated carbon dioxide levels and decreased oxygen saturation Fluid and electrolyte imbalance Hypothermia
Which manifestation would the nurse observe when assessing a client diagnosed with a benign secreting tumor of the adrenal medulla?
Elevated catecholamine levels and tachycardia
In the complex interaction of the sexual act in males, the nurse is aware that there are four stages involved. Which stage involves shunting of blood into the corpus cavernosum?
Erection
A 23-year-old man is admitted to the hospital. He is experiencing polyphagia, polyuria, and polydipsia. He states that the condition has come on very suddenly. This client is likely to require what treatment?
Exogenous insulin injections
A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves disease. Which assessments should the nurse prioritize?
Eye health and visual acuity
The endocrine system is highly involved in the female reproductive system. Which hormones are used to stimulate the primordial follicles?
FSH and LH
A nurse educator is explaining the process of sexual intercourse, fertilization, and fetal development to a high school biology class. What process should the nurse describe?
Fertilization in the outer portion of the fallopian tube
While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best?
Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.
Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur?
Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen
A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes. The best diagnostic indicator that would support the client's response would be:
Glycosylated hemoglobin, hemoglobin A1C (HbA1C)
Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:
Graves disease
A client comes to the clinic and informs the nurse that he was playing soccer and was kicked in the scrotal area on the right side. The nurse observes that the scrotal skin on the right side is dark red. What should the nurse suspect this client may have?
Hematocele
When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response?
Hormone stimulation
An extremely lethargic client arrives by ambulance at the emergency department. His blood glucose level is 32 mg/dL (1.78 mmol/L). The nurse will anticipate that this client will be diagnosed with:
Hypoglycemia
The hypophysis is a unit formed by the pituitary and the hypothalamus. These two glands are connected by the blood flow in what system?
Hypophyseal portal system
A health care provider is assessing a client for a potential endocrine disorder. Assessment findings identify abnormalities with emotion, pain, and body temperature. Which mechanism of endocrine control will require further laboratory/diagnostic assessment?
Hypothalamus
Which gland acts as a signal relaying bridge between multiple body systems and the pituitary gland?
Hypothalamus
An infant whose mother had myxedema during the pregnancy has failed to meet standards for growth and is developmentally delayed. Which hormonal imbalance is this child exhibiting?
Hypothyroidism
A client has developed priapism. For which outcome is this client at risk?
Impotence
What is one function of progesterone in the body?
Increases body temperature at ovulation
A male client reports sudden pain and a bulging in the scrotal sac after lifting a heavy object. The swelling does not reduce when the client is supine and he begins to sweat profusely. What condition is the likely cause of these manifestations?
Inguinal hernia
Which metabolic abnormality can lead to the development of type 2 diabetes?
Insulin resistance
A 12-year-old girl is experiencing an increase in her FSH and LH levels. This rise in hormone levels will have which effect on her reproductive system?
Maturation of her follicles
Which treatment regimen is most likely to result in stable blood glucose levels for a client with a diagnosis of type 1 diabetes?
Monitor blood glucose levels throughout the day and administer exogenous insulin replacement as needed
A 20-year-old female has come to the clinic complaining of severe menstrual cramps. The clinic nurse practitioner knows that dysmenorrhea occurs when which muscle group contracts?
Myometrium
What is the most common mechanism of hormone control?
Negative feedback
The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body?
Negative feedback loop
The prostate gland functions in the elimination of urine. The nurse knows that the prostate gland if enlarged can cause which dysfunction of the urinary system?
Obstruction
A client is complaining to the health care provider about several vague signs/symptoms. Which sign/symptom raises a "red flag" indicating the client may have developed endometrial cancer?
Painless abnormal bleeding
A nursing instructor is teaching a group of students about the action of hormones. The instructor determined that teaching was effective when the students recognize the local action of hormones as:
Paracrine
Which gland is often referred to as the master gland because it secretes many hormones?
Pituitary
Which structure controls the functions of the greatest number of target glands and cells?
Pituitary gland
Select the most common symptoms of diabetes. Select all that apply.
Polydipsia Polyuria Polyphagia
A client receives steroids for several months to treat an inflammatory condition. Which action by the primary health care provider indicates an understanding of the negative feedback mechanism when the client no longer needs the medication?
Prescribing a tapering dose of the medication over weeks
As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated?
Prevent accumulation
The nurse is caring for a pregnant client who is experiencing morning sickness. The nurse understands that which of the following is responsible for many of the common discomforts of pregnancy?
Progesterone
A client with a history of brain tumors that resulted in partial removal of the pituitary gland years ago expresses concern to the health care provider about whether she will be able to breast-feed her infant. Which physiologic function of the pituitary gland facilitates breast milk production?
Prolactin
Several hormones, including growth hormone (GH) and thyrotropin-releasing hormone (TRH), are bound to and carried by which substance?
Proteins
When trying to explain hypothyroidism to a newly diagnosed client, the nurse stresses the fact that the thyroid hormone is transported in blood by specific:
Proteins
A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?
Random blood glucose 85 mg/dL (4.72 mmol/L)
Which manifestation would a nurse expect when assessing a child with insufficient growth hormone (GH) secretion?
Rank below 10% on the growth chart
A parent arrives in the endocrinology clinic with her 8-year-old son, concerned about his rapid development and tall stature. What significant assessment finding does the nurse recognize is important to report to the physician related to the development of precocious puberty?
Significant genital enlargement
The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function.
Stimulation tests
Which clinical manifestations following thyroidectomy would alert the nurse that the client is going into a life-threatening thyroid storm? Select all that apply.
Temperature of 104.2°F (40.1°C) Telemetry showing heart rate of 184 Extremely agitated
An obstetrician is explaining the differentiation of embryonic tissue into a fetus to an aspiring class of nursing students. Which hormone is primarily responsible for the development of male sex characteristics?
Testosterone
The nurse is teaching a client with diabetes about the signs and symptoms of hypoglycemia. The client asks, "Why will I get headache, disturbed behavior, coma, and seizures if it's my pancreas that's impaired?" Which response is the best explanation?
The brain relies on blood glucose as its main energy source.
A client is managing his type 2 diabetes with exercise and diet. He has a fasting blood sugar level (FBS) of 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (.05). Based on these findings, which of the following can the nurse assume?
The client is achieving normal glycemic control.
The nurse is providing discharge instructions for a client with Graves disease who has ophthalmopathy. What should the nurse be sure to include in the instructions to decrease exacerbation of this clinical manifestation?
The client should be strongly urged not to smoke.
A client undergoing an evaluation of hormone levels asks, "What regulates the hormone levels?" Which response by the nurse would be considered most accurate?
The hypothalamic-pituitary-target cell system
When describing to a client newly diagnosed with diabetes how insulin is regulated, the nurse will draw upon her knowledge of which hormonal regulation mechanism?
The hypothalamic-pituitary-target cell system
A newborn is screened for congenital hypothyroidism and is found to have the disorder. When educating the mother about the importance of the infant taking thyroid hormone supplement, what should be included in the education?
The infant will have dosage levels adjusted as he grows.
A male client is being prepared for a physical examination of his prostate gland. How will the nurse explain the location of the prostate gland?
The prostate gland is located in the pelvis, inferior to the bladder.
A nurse is inspecting the scrotum and testes of a 43-year-old male client. Which finding requires additional evaluation?
The skin on the scrotum is hard, taut, and shiny.
The nurse is discussing ovulation with a female client and notes an indication of ovulation is spinnbarkeit. What is an accurate description of spinnbarkeit?
The stretchy consistency of cervical mucus during ovulation
The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which statement about the role of the thyroid gland is most accurate?
The thyroid gland is responsible for increasing the metabolic rate.
A female client is taking antibiotics to treat a skin infection and informs the nurse that she does not think the antibiotics are working because now she thinks she has a vaginal infection. What does the nurse believe has occurred due to the antibiotic use?
The use of the antibiotics decreases the number of lactobacilli in the vagina, which can result in a vaginal infection.
Which statement describes how water-soluble peptides, such as parathyroid hormone or glucagon, exert their effect on cells?
They bind to receptors.
A client who has just undergone a thyroidectomy is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these findings as manifestations of which complication?
Thyroid storm
The client presents with symptoms consistent with hypogonadism. For a diagnosis of hypogonadism, the nurse expects which diagnostic test to be ordered?
Total testosterone levels
The nursing student who is studying pathophysiology of the male genitourinary system correctly identifies which of these as functions of the penis? Select all that apply.
Urine elimination Sexual function
An obese adult has recently been diagnosed with type 2 diabetes. The nurse knows that the most likely treatment plan for this client will include which topics?
Weight loss, glucose monitoring, and oral antihyperglycemic medications
A client is admitted with a prolonged and painful erection that has lasted longer than 4 hours. The nurse knows that this is a true urologic emergency, and that the cause is:
impaired blood flow in the corpora cavernosa of the penis.
The nurse is explaining the process of conception to a group of middle-school students and points out that fertilization occurs:
in the middle to outer portion of the fallopian tube.
A middle-aged female client has been diagnosed with a thyroid condition. The nurse educates the client about the prescription and needed follow-up lab work, which will help regulate the dosage. The client asks, "Why do I not return to the clinic for weeks, since I am starting the medication tomorrow morning?" The nurse bases the answer on the knowledge that thyroid hormones:
may take days for the full effect to occur, based on the mechanism of action.
Which type of imaging is preferred to differentiate cystic from solid thyroid nodules?
u/s
