Chapter 40: Mechanisms of Endocrine Control

Which statements are correct about hormone transport? Select all that apply.

Insulin is unbound. Glucocorticoids are bound. Prolactin is unbound.

What 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 male client has been diagnosed with a low sperm count. Which endocrine imbalances could contribute to this condition? Select all that apply.

Lack of follicle-stimulating hormone (FSH) Insufficient androgens

Which body function is regulated by several hormones?

Lipolysis

While teaching a science class, the instructor mentions that both autocrine and paracrine hormonal actions occur without entering the bloodstream. A student aks, "What cells do paracrine actions affect?" Which response is correct?

Local

Which organ system is matched with the preferred type of imaging?

Magnetic resonance imaging (MRI) of the pituitary gland

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

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

Hormones that cause the subsequent stimulation or release of another hormone, such as thyroid-stimulating hormone, typically belong to which structural classification?

Peptide proteins and glycoproteins

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

Which hormone is secreted based on a cyclic rather than a diurnal manner?

Follicle-stimulating hormone (FSH)

Release and synthesis of anterior pituitary hormones are mainly regulated by which part of the body?

Hypothalamus

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

Hypothalamus

Select the most appropriate statement that describes the function of hormones.

Hormones function as modulators of cellular and systematic responses.

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."

How long is the half-life of the hormone aldosterone, which is only 15% protein bound?

25 minutes

A client comes to a scheduled appointment in the endocrine clinic. The primary care physician referred the client, suspecting acromegaly. Knowing the usual testing involved, the nurse should educate the client about which lab/diagnostic procedure?

A suppression test

Hormones exert their action by interacting with which type of receptors?

Affinity

Hormones are usually divided into categories according to their structure. The release of epinephrine would be classified as:

Amines and amino acids

Select the category of hormones that include norepinephrine and epinephrine.

Amines and amino acids

The release of insulin from the pancreatic beta cells can inhibit further release of insulin from the same cells. This is an example of which type of hormone action?

Autocrine

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

If glucagon binds to surface receptors on liver cells to send an intracellular message for glycogen breakdown, this process is known as which mechanism of action?

Cell surface receptors

The nurse is reviewing the test results of a client who was given thyrotropin-releasing hormone (TRH) to evaluate the function of the pituitary gland. The nurse would recognize pituitary dysfunction as:

Decreased TSH levels

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)

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

Which type of imaging is preferred to evaluate the bone density of a client with hyperparathyroidism?

Dual energy x-ray absorptiometry (DXA) scan

When caring for a client who is being screened for osteoporosis, the nurse plans to evaluate the results of which diagnostic test?

Dual-energy x-ray absorptiometry (DXA)

An adult client with a possible growth hormone (GH)-secreting tumor is undergoing testing. If a glucose load is given, which response by the body would confirm the client has a GH-secreting tumor?

Elevated GH level after a glucose load

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

Elevated atrial natriuretic hormone

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

Which statements concerning endocrinology laboratory testing are true? Select all that apply.

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

The endocrine system is closely linked with the nervous system. What neurotransmitter can also act as a hormone?

Epinephrine

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

Epinephrine Norepinephrine

Which of the following is an example of a positive feedback system?

Estradiol and follicle-stimulating hormone (FSH)

When sensors detect a change in a hormone level, the hormonal response is regulated by which mechanism that will return the level to within normal range?

Feedback

What 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.

Which physiologic process allows hormones to exert influence upon some cells and not others?

Hormone receptors

Which statement best explains the function of hormone receptors?

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

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

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

Which complications could occur when an adult client has an anterior hypophysectomy? Select all that apply.

Hypothyroidism Addison disease

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

Increased GH secretion

The nurse is discussing positive feedback mechanisms. Which example best explains this mechanism?

Increased estradiol production causes increased follicle-stimulating hormone (FSH) production.

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

An adult client with suspected hypothyroidism is scheduled for a thyrotropin-releasing hormone (TRH) stimulation test to evaluate pituitary response. Which test results would confirm secondary hypothyroidism?

No increase in TSH

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 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

Select the most accurate statement regarding measurements of urinary hormone.

Provide a better measure of hormone levels during a designated period.

Many hormones are measured for diagnostic reasons by using the plasma levels of the hormones. What is used today to measure plasma hormone levels?

Radioimmunoassay methods

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 who is receiving exogenous corticosteroids for rheumatoid arthritis. Recognizing that hormone levels are regulated by negative feedback, which laboratory test result does the nurse anticipate uncovering when reviewing the medical record?

Reduction in ACTH

A client has received an injection containing thyrotropin-releasing hormone (TRH) and is now being assessed for serum levels of thyroid-stimulating hormone (TSH). Which type of diagnostic testing is this client undergoing?

Stimulation testing

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

Stimulation tests

The nurse cares for a client with severe chronic obstructive pulmonary disease who has been taking oral steroids for several years. Which response in the client's endocrine control will the nurse expect?

Suppression of the client's 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

Which statement about immunoradiometric assay (IRMA) testing for measuring plasma hormone levels is most accurate?

These tests are very specific since they utilize two antibodies instead of one.

Imaging has proven useful in both the diagnosis and follow-up of endocrine disorders. Two types of imaging studies are useful when dealing with endocrine disorders: Isotopic imaging and nonisotopic imaging. What is an example of isotopic imaging?

Thyroid scan

Sometimes the measurement of hormones is done through a urine sample. What is an advantage of measuring hormone levels through a urine sample rather than a blood sample?

Urine samples are easily obtained.

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.

Which statement describes how water-soluble peptides, such as parathyroid hormone or glucagon, exert their effect on cells?

they bind as receptors

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.

During a near-miss accident while cycling, a client marvels at how fast he was able to react. He attributes this to his "fight or flight" response but then wonders why it lasts for only a short period. The client had a short burst of catecholamine activity because catecholamines are:

rapidly degraded by enzymes in circulation and at the tissue.

In major athletic competition, athletes are required to submit to liquid chromatography testing looking for:

use of performance-enhancing agents to increase the chances of winning.

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 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 comparing the endocrine and nervous system functions, the nurse knows that the endocrine system:

releases hormones into the blood that is transported throughout the body. glands are widely scattered throughout the body. takes longer to respond to innervations but has prolonged actions when they arrive.

Which hormone requires a carrier protein for transport through the blood?

Cortisol

A client with many nonspecific complaints has been ordered a positron emission tomography (PET) scanning for evaluation of:

tumors located on the endocrine glands.

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.

A teen with newly diagnosed pituitary dwarfism asks the nurse why growth hormone must be taken as an injection rather than a pill like the steroids used for arthritis. Which response best answers the client's question?

Peptide proteins will be digested instead of entering the bloodstream.

The kidney produces 1,25-dihydroxyvitamin D. This form of vitamin D is responsible for which action in the body?

Stimulates calcium absorption from the intestine

Which type of characteristic do thyroid and steroid hormones exert on target cells by way of nuclear receptors?

The ability to cross the cell membrane of target cells

Paracrine action involves which characteristic?

Action locally on cells other than those that produce the hormone

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

The nurse is assessing a client with thyrotoxicosis and the nurse is explaining how the thyroid gland is stimulated to release thyroid hormones. The nurse should describe what process?

Action of releasing hormones from hypothalamus

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 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.

After having a very stressful day in pathophysiology class, the student knows that which hormone (secreted by the adrenal cortex) will help decrease the effects of stress?

Cortisol, a glucocorticoid

Which hormone is produced by the anterior pituitary gland?

Growth hormone (GH)

A client experiences an increase in cortisol as a result of Cushing disease. Which hormonal responses demonstrate the negative feedback mechanism?

Decreased adrenocorticotropic hormone (ACTH)

A nurse caring for a client who has undergone an antithyroid peroxidase (anti-TPO) antibody test with elevated results should be prepared to educate the client about which disease process?

Hashimoto thyroiditis

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

Hypothalamus

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

Which manifestation would a nurse expect when assessing a child with insufficient growth hormone (GH) secretion?

Rank below 10% on the growth chart

The nurse is caring for a client with decreased serum protein levels secondary to liver failure. When administering medications that are highly protein bound, the nurse anticipates the resulting drug level will respond in which of these ways?

The drug level will be elevated as lack of protein allows more free drug to circulate.

Which physiologic process best exemplifies a positive feedback mechanism?

The increase in prolactin secretion that occurs with more frequent breast-feeding

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.