Chapter 31: Mechanisms of Endocrine Control

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 patient exhibiting problems with their thyroid has been scheduled for a radioactive scan. From the following list of patients, which would the nurse question as to whether this would be a safe procedure for this patient

A young female patient who has been trying to get pregnant

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

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

When hormones act locally rather than being secreted into the bloodstream, their actions are termed what

Autocrine and paracrine

To prevent the accumulation of hormones in our bodies, the hormones are constantly being metabolized and excreted. Where are adrenal and gonadal steroid hormones excreted?

Bile and urine

Which of the following options contain a pair of hormones that act to balance each other? Select all that apply

Calcitonin and parathyroid hormone (PTH) Insulin and glucagon

Which hormones illustrate non-vesicle-mediated synthesis? Select all that apply

Cortisol Aldosterone Androgens

A patient experiences an increase in thyroid hormone as a result of a thyroid tumor. Which of the following hormonal responses demonstrates the negative feedback mechanism?

Decreased thyroid-stimulating hormone (TSH)

A nurse examines the laboratory values of a patient in heart failure. Which of the following values indicates a compensatory hormone mechanism?

Elevated atrial natriuretic hormone

Which statements concerning endocrinology laboratory testing are true?

Endocrine tests are generally sensitive to storage requirements. Patient education regarding endocrine testing must include specific test requirements.

A 38-year-old woman takes clomiphene, an infertility drug that works by competing with, and thereby blocking, cellular receptors for estrogen. Which of the following statements is most likely to be true of this client?

Estrogen will continue to pass freely through the cellular membranes

Which of the following is the role of glucagon in initiating the breakdown of glycogen

First messenger

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

A hypernatremic client is researching his condition and learns that aldosterone binds to an intracellular receptor. What do intracellular receptors generally stimulate in a cell?

Gene expression

An adult patient is scheduled for testing of a suspected growth hormone (GH)- secreting tumor. Which of the following results from the glucose suppression test would confirm the condition?

Increased GH secretion

Select the statement that best explains the function of hormone receptors

Hormone receptors recognize a specific hormone and translate the signal into a cellular response

The physician is assessing a client with a preliminary diagnosis of endocrine disorder. Further assessment findings identify abnormalities with emotion, pain, body temperature, and neural input. The physician determines the need to further assess the

Hypothalamus

Which gland acts as a signal relaying bridge between multiple body systems and the pituitary gland?

Hypothalamus

An instructor is teaching the class about positive feedback mechanism. The best example would be:

Increased estradiol production causes increased gonadotropin (FSH) production.

Which of the following is an advantage of assessing hormone levels through collection of a 24-hour urine?

It does not require serum collection for an accurate reading

A patient develops hypocalcemia after thyroid surgery. Which of the following hormonal imbalances caused this complication?

Lack of parathyroid hormone

Which type of hormone is released as soon as they are synthesized?

Lipid-soluble steroid hormones

Which of the following organ systems is matched with the preferred type of imaging

Magnetic resonance imaging (MRI) of the pituitary gland

Neurotransmitters like catecholamines (ex. dopamine and epinephrine) have a reaction time of:

Milliseconds

Which of the following best describes the half-life of a highly protein bound drug such as thyroxine (99% protein bound)? The half-life would be:

Much longer to reduce the concentration of the hormone by one half

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

Which of the following hormones will elicit a more rapid response than the others?

Norepinephrine

Which of the following are examples of amines? Select all that apply.

Norepinephrine Epinephrine

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

A patient receives steroids for several months to treat an inflammatory condition. Which of the following actions by the primary healthcare provider indicates an understanding of the negative feedback mechanism when the patient no longer needs the medication?

Prescribing a tapering dose of the medication over weeks

A client asks the nurse what causes the secretion of growth hormone (GH) and adrenocorticotrophic hormone (ACTH) to fluctuate. The best response by the nurse would be:

Sleep-wake cycles

A 21 year-old female is suspected of having inadequate function of her hypothalamic-pituitary-thyroid system. Her care provider is planning to inject thyrotropin-releasing hormone (TRH) and then measure her levels of TSH. Which of the following diagnostic tests is being performed?

Stimulation test

The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function

Stimulation tests

A client who is referred to the endocrinologist's office for an evaluation of his hormone levels asks what regulates the hormone levels. The best response would be that hormone levels in the body are primarily regulated by

The hypothalamic-pituitary-target cell system

A client is scheduled for a suppression test as part of the diagnostic testing for his suspected endocrine disorder. The results of this test will help the care team determine:

whether the client is producing excessive hormone levels

While reviewing the major actions of follicle-stimulating hormone (FSH), the faculty points out that in males, this hormone is responsible for the

sperm production

A client has developed a tumor of the anterior pituitary gland. The nurse is aware that the client is at risk for alterations of: Select all that apply

Growth and metabolism Function of the thyroid gland Glucocorticoid hormone levels Function of the gonads

While reviewing the concept of nuclear receptors with a group of pathophysiology students, the instructor uses the example of clients with type 2 diabetes mellitus taking pioglitazone, a thiazolidinedione medication. Because of the peroxisome proliferator-activated receptors (PPARs), the drug has which effect on the clients' diabetes? Select the best answer

Promote glucose uptake and increase the synthesis of certain proteins involved in fat metabolism, which reduces levels of certain types of lipids

The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which of these does the nurse explain to the client is the role of the thyroid gland?

The thyroid gland is responsible for increasing the metabolic rate

The nurse administers a glucocorticoid medication to a client with pneumonia. Which of these does the nurse teach the client is the purpose of the medication

To decrease airway inflammation