Chapter 40: Mechanisms of Endocrine Control

What is the most common mechanism of hormone control? Positive feedback Hypothalamic-pituitary-target cell feedback Hypothalamic-pituitary-adrenal axis Negative feedback

Negative feedback

Which manifestation would a nurse expect when assessing a child with insufficient growth hormone (GH) secretion? Rank below 10% on the growth chart Lower blood calcium levels Mental sluggishness Increased susceptibility to infection

Rank below 10% on the growth chart

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 releases neurotransmitters when the "flight or flight" mechanism is stimulated. The thyroid gland is responsible for increasing the metabolic rate. The thyroid gland is responsible for regulating serum calcium levels. The thyroid gland promotes development of secondary sex characteristics.

The thyroid gland is responsible for increasing the metabolic rate.

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? "It's uncommon for production of hormones to be far removed from the tissue where they ultimately exert their effect." "The regulation of homeostasis requires that hormones be absent from the body when their effect is not needed." "A single hormone can act on not only one process or organ but often on several different locations or processes." "Sometimes hormones act locally on the area where they were produced, as in the case of endocrine actions."

"A single hormone can act on not only one process or organ but often on several different locations or processes."

During a thyroid crisis, which medication may increase dissociation of free hormone from the binding proteins, resulting in a worsening effect on the client? Glucophage, a biguanide Acetylsalicylic acid, a nonsteroidal anti-inflammatory drug (NSAID) Atorvastatin, a statin drug Lisinopril, an ACE-inhibitor

Acetylsalicylic acid, a nonsteroidal anti-inflammatory drug (NSAID)

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 Growth hormone-releasing hormone (GHRH) and dopamine Somatostatin and prolactin Adrenocorticotropic hormone (ACTH) and vasopressin

Antidiuretic hormone (ADH) and oxytocin

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 Arachidonic Retinoid Juxtaposed

Autocrine

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. Client has hypothyroidism. Client has anemia. Client has diabetes.

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? Aldosterone, a mineralocorticoid Androstenedione, an adrenal androgen Dehydroepiandrosterone, an adrenal androgen Cortisol, a glucocorticoid

Cortisol, a glucocorticoid

A client experiences an increase in thyroid hormone as a result of a thyroid tumor. Which hormonal response demonstrates the negative feedback mechanism? Increased thyrotropin-releasing hormone (TRH) Increased follicle-stimulating hormone (FSH) Decreased thyroid-stimulating hormone (TSH) Decreased adrenocorticotropic hormone (ACTH)

Decreased thyroid-stimulating hormone (TSH)

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) Increased follicle-stimulating hormone (FSH) Decreased thyroid-stimulating hormone (TSH) Increased thyrotropin-releasing hormone (TRH)

Decreased adrenocorticotropic hormone (ACTH)

Which hormone is produced by the anterior pituitary gland? Oxytocin Norepinephrine Growth hormone (GH) Corticotropin-releasing hormone (CRH)

Growth hormone (GH)

Which statement best explains the function of hormone receptors? Hormone receptors are located within the red blood cells and carry hormones to the target cells. Hormone receptors respond to decreasing hormone levels by producing a decrease in receptor numbers. Hormone receptors produce antibodies to block certain hormones from entering the cell. Hormone receptors recognize a specific hormone and translate the hormonal signal into a cellular response.

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? Agglutination Antibody binding 24-hour urine Hormone stimulation

Hormone stimulation

Following a stroke that disrupts blood flow to the pituitary gland, a client develops signs of hypopituitarism. Which manifestations are unexpected findings? Increased volume of dilute urine Bradycardia and hypotension Hyperkalemia and fluid deficit Weakness and fatigue

Increased volume of dilute urine The hypothalamus produces a number of hormones that stimulate the anterior pituitary. It also produces antidiuretic hormone and oxytocin, the hormones that are stored and released in the posterior pituitary. If the pituitary is damaged or removed, expected manifestations correspond to lack of thyroid-adrenocorticotropic hormone. These signs and symptoms include bradycardia, hypotension, cessation of menstruation, fluid volume deficit, and hyperkalemia. Because the posterior pituitary hormones are manufactured in the hypothalamus and would be unaffected by the tissue damage, the nurse would not expect symptoms of a lack of antidiuretic hormone, indicating the presence of diabetes insipidus.

Which body function is regulated by several hormones? Lipolysis Vitamin D manufacture Natriuresis Erythropoiesis

Lipolysis

The nurse is caring for a client who has decreased secretion of arginine vasopressin from the posterior pituitary gland. When evaluating the client's fluid and electrolyte status, which alteration does the nurse anticipate will be present? Hyperkalemia Decreased serum osmolarity Polyuria Hyponatremia

Polyuria

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? Measuring urine catecholamine levels before stopping the drug Instructing the client to stop taking the medication Prescribing a tapering dose of the medication over weeks Scheduling a positron emission tomography scan a week after stopping the drug

Prescribing a tapering dose of the medication over weeks

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? Oxytocin Prolactin Corticotropin-releasing hormone (CRH) Growth hormone (GH)

Prolactin The anterior pituitary gland or adenohypophysis contains five cell types: (1) thyrotrophs, which produce thyrotropin, also called MTSH; (2) corticotrophs, which produce corticotropin, also called ACTH; (3) gonadotrophs, which produce the gonadotropins, LH, and FSH; (4) somatotrophs, which produce GH; and (5) lactotrophs, which produce prolactin that is involved with breast growth and milk production.

Which statements are correct about hormone transport? Select all that apply. Prolactin is unbound. Thyroid hormone is unbound. Adrenocorticotropic hormone (ACTH) is bound. Insulin is unbound. Glucocorticoids are bound.

Prolactin is unbound. Insulin is unbound. Glucocorticoids are bound

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 non-isotopic imaging. What is an example of isotopic imaging? MRI PET scan Renal angiography Thyroid scan

Thyroid scan Isotopic imaging includes radioactive scanning of the thyroid.

A client reports multiple nonspecific concerns, and the health care provider has ordered a positron emission tomography (PET). For which is the client being evaluated? bone density tumors located on the endocrine glands radioactivity of the thyroid gland the pancreas response to an insulin injection

tumors located on the endocrine glandsrs located on the endocrine glands

A nurse examines the laboratory values of a client in heart failure. Which value indicates a compensatory hormone mechanism? Decreased hematocrit Decreased red blood cell count Elevated atrial natriuretic hormone Elevated serum pH

Elevated atrial natriuretic hormone

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? Cerebral cortex Cerebellum Anterior pituitary Hypothalamus

Hypothalamus

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

Hypothalamus

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: cause many side effects, and the clinic wants the client to be on the medication for several weeks so that all the effects can be reported. will begin working right away, and the clinic wants to see how the body is responding to the drug. may take days for the full effect to occur, based on the mechanism of action. can cause weight loss, so the clinic wants to see how much weight the client loses at the return visit.

may take days for the full effect to occur, based on the mechanism of action.

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 Pancreas Thyroid gland Posterior adrenal cortex

Anterior pituitary gland

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 No change in blood level after the glucose load Suppression of the GH level Development of gigantism

Elevated GH level after a glucose load

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? When a person's body pH is decreasing, the stomach lining becomes more acidic to offset this. Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas. When a female is thinking about getting pregnant, the body knows to release female sex hormones in greater proportion than usual. In children, the body knows to release growth hormones while they are sleeping instead of when they are awake and running around.

Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.

As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated? Prevent accumulation Absorb metabolic waste Stimulate production Free receptor sites

Prevent accumulation