Evolve Endocrine

A patient is admitted with dehydration and polyuria. The nurse knows that the patient might be experiencing an alteration in which hormone? 1 Antidiuretic hormone (ADH) 2 Follicle-stimulating hormone (FSH) 3 Thyroid-stimulating hormone (TSH) 4 Adrenocorticotropic hormone (ACTH)

1 ADH 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. FSH functions in ovum and sperm formation. TSH stimulates thyroid function. ACTH stimulates adrenal function. Text Reference - p. 1139

A patient is admitted to the hospital with severe burns. Which hormone level does the nurse expect to be elevated in the patient's laboratory reports? 1 Cortisol 2 Oxytocin 3 Aldosterone 4 Antidiuretic hormone

1 Cortisol is a glucocorticoid that protects the body from stress; it is also called as stress hormone. Cortisol helps to maintain vascular integrity and fluid volume; cortisol levels are increased in patients with burns, infections, fevers, and acute anxiety. The level of oxytocin, aldosterone, and antidiuretic hormone does not increase in response to stress. Text Reference - p. 1140

The nurse reviews a patient's medical record and notes assessment findings. Which endocrine hormone level does the nurse expect to be increased in the patient? 1 Cortisol 2 Aldosterone 3 Androstenedione 4 Dehydroepiandrosterone

1 Cortisol level increases if a patient has fever, stress, burns, infection, acute anxiety, or hypoglycemia. A body temperature of 104o F indicates that the patient has fever. The normal white blood cell count is 4500 to 10,000/microliter. A white blood cell count of 14,000/microliter indicates that the patient may have an infection. The normal fasting blood glucose levels of a patient are 70 to 100 mg/dL. Blood glucose levels of 65 mg/dL indicate that the patient has hypoglycemia. Therefore, the nurse expects to find high levels of cortisol in the patient. Fever, infection, and hypoglycemia may not enhance the secretion of aldosterone. Androstenedione and dehydroepiandrosterone are adrenal hormones. They are not elevated because of fever, infection, or hypoglycemia. Text Reference - p. 1140

An adult patient is experiencing menopause-related symptoms. Which hormone decline results in an increased risk of atherosclerosis and osteoporosis? 1 Estrogen 2 Epinephrine 3 Progesterone 4 Norepinephrine

1 Estrogen is secreted from the woman's ovaries and stimulates the development of secondary sex characteristics. It prepares the uterus for fertilization and stimulates bone growth. Decreased estrogen secretion increases the risk for atherosclerosis and osteoporosis. Progesterone maintains the lining of the uterus for successful pregnancy. Epinephrine and norepinephrine increase in response to stress and enhance the effects of the sympathetic nervous system. Test-Taking Tip: You have at least a 25 percent chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses. Text Reference - p. 1136

A patient has sought care because of a loss of 25 lb over the past six months during which the patient states that he or she has made no significant dietary changes. For what potential problem should the nurse assess the patient? 1 Thyroid disorders 2 Diabetes insipidus 3 Pituitary dysfunction 4 Parathyroid dysfunction

1 Hyperthyroidism is associated with weight loss. Alterations in pituitary function, such as diabetes insipidus, and parathyroid dysfunction commonly are not associated with this phenomenon. Text Reference - p. 1143

A nurse is assessing a patient who has thick, dry skin, weight gain, and cold insensitivity. What possible cause does the nurse suspect? 1 Hypothyroidism 2 Hyperthyroidism 3 Addison's disease 4 Cushing syndrome

1 Hypothyroidism is a condition in which the body lacks sufficient thyroid hormone. Low thyroid hormone levels cause low metabolism and result in weight gain. Hyperthyroidism is associated with an increase in thyroid hormone levels. A patient with hyperthyroidism has increased metabolism and weight loss. Addison's disease is caused by low cortisol levels. The physical symptoms of Addison's disease include hyperpigmentation of the skin. Cushing syndrome is a hormonal disorder associated with high levels of cortisol. The main symptom of Cushing syndrome is the presence of striae on the skin surface. Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer. Text Reference - p. 1146

The nurse suspects that a patient has hypothyroidism based on which total thyroxine (T4) and free thyroxine (FT4) levels? 1 50 nmol/L; 5 pmol/L 2 60 nmol/L; 20 pmol/L 3 70 nmol/L; 30 pmol/L 4 80 nmol/L; 35 pmol/L

1 Hypothyroidism refers to a condition in which the patient will have low levels of total thyroxine (T4) and free thyroxine (FT4) in blood. The normal levels of total thyroxine (T4) and free thyroxine (FT4) are 59 to 142 nmol/L and 10 to 35 pmol/L respectively. Therefore, T4 and FT4 levels of 50 nmol/L and 5 pmol/L indicate hypothyroidism. T4 and FT4 levels of 60 nmol/L and 20 pmol/L are normal findings. T4 and FT4 levels of 70 nmol/L and 30 pmol/L do not indicate hypothyroidism, because these values fall within the range of normal levels. T4 and FT4 levels of 80 nmol/L and 35 pmol/L do not indicate hypothyroidism, because these values are within the normal range. Text Reference - p. 1148

Which structure indicated in the image helps regulate circadian rhythm? 1. A 2. B 3. C 4. D

1 Label A indicates the pineal gland, which regulates the circadian rhythm and reproductive system during the onset of puberty. Label B represents the parathyroid gland, which regulates the blood levels of calcium. Label C represents the thyroid gland, which secretes hormones involved in oxygen consumption; carbohydrate and lipid metabolism; and brain function, growth and development. Label D represents the pancreas, which secretes hormones that regulate glucose metabolism. Text Reference - p. 1135

The nurse finds that a postpartum patient does not have sufficient milk secretion. Which hormonal deficiency does the nurse suspect in this patient? 1 Oxytocin 2 Calcitonin 3 Vasopressin 4 Parathormone

1 Oxytocin is released by the posterior pituitary gland, and stimulates milk secretion. An oxytocin deficiency can result in reduced milk secretion during the postpartum period. Calcitonin regulates blood levels of calcium and phosphorus. Vasopressin promotes water reabsorption and vasoconstriction. Parathormone promotes bone demineralization and intestinal calcium absorption. Text Reference - p. 1136

The patient has been feeling tired lately and has gained weight, reports thickened, dry skin, and increased cold sensitivity even though it is now summer. Which endocrine diagnostic test should be done first? 1 Free thyroxine (FT4) 2 Serum growth hormone (GH) 3 Follicle stimulating hormone (FSH) 4 Magnetic resonance imaging (MRI) of the head

1 The manifestations the patient is experiencing could be related to hypothyroidism. Free thyroxine (FT4) is considered a better indicator of thyroid function than total T4 and could be done to evaluate the patient for hypothyroidism. Growth hormone excess could cause thick, leathery, oily skin, but does not demonstrate the other manifestations. FSH is manifested with menstrual irregularity and would be useful in distinguishing primary gonadal problems from pituitary insufficiency. MRI is the examination of choice for radiologic evaluation of the pituitary gland and the hypothalamus, but would not be the first diagnostic study to further explore the basis of these manifestations. Text Reference - p. 1143

The nurse working in an endocrine clinic knows that Trousseau's sign is an important diagnostic tool. Which statement best describes how to conduct the test for Trousseau's sign? 1 Inflate a blood pressure cuff above the antecubital space 2 Tap two fingers anterior to the front of the patient's ear 3 Depress the skin over the sternum for one minute 4 Observe for circumoral twitches following speaking

1 Trousseau's sign is a diagnostic tool that is used to assess for tetany, a sign of hypocalcemia. This is an important assessment when the nurse is dealing with patients in an endocrine clinic, especially those that may have hypoparathyroidism. Trousseau's sign is performed by inflating a blood pressure cuff above the antecubital space for three to five minutes. Tapping a finger in front of the ear describes testing for Chvostek's sign. Depressing the skin over the sternum and observing for circumoral twitches are not techniques associated with Trousseau's sign. Text Reference - p. 1145

Which hormones produced in a patient's body have an antagonistic effect on each other? Select all that apply. 1 Insulin 2 Prolactin 3 Growth hormone 4 Thyroid-stimulating hormone 5 Adrenocorticotropic hormone

1, 3 Insulin and growth hormone (GH) function as antagonists in the human body. Insulin is produced from the pancreas and has a hypoglycemic effect, because it promotes the entry of glucose into the cells. Growth hormone (GH) indirectly inhibits glucose metabolism and increases the blood glucose levels. Increased levels of GH cause an increase in glucose levels, which suppress insulin production. Prolactin is a lactogenic hormone that stimulates and promotes the secretion of milk in nursing mothers. Thyroid-stimulating hormone (TSH) promotes and maintains the development of the thyroid gland. Adrenocorticotropic hormone (ACTH) promotes and maintains the development of the cortex of the adrenal gland. Prolactin, TSH, and ACTH do not have antagonistic effects. Test Reference - p. 1137

A patient's x-ray reveals hypercalcification of bones. The nurse notes that the patient's serum calcium level is normal. Which endocrine dysfunctions does the nurse expect to find in the patient? Select all that apply. 1 Thyroid dysfunction 2 Pancreatic dysfunction 3 Parathyroid dysfunction 4 Adrenal cortex dysfunction 5 Adrenal medulla dysfunction

1, 3 The C cells of the thyroid gland produce calcitonin, which inhibits the release of calcium from the bone into the blood if the serum calcium levels are high. The parathyroid gland secretes parathormone, which stimulates the release of calcium from the bone into the blood and inhibits bone formation in the body. Therefore, the presence of hypercalcification, or more than normal calcium in the bones, and normal serum calcium levels indicate that the patient has thyroid and parathyroid dysfunction in the body. The pancreas does not have any role in regulating calcium levels. Therefore, its dysfunction should not result in hypercalcification of the bones. Adrenal hormones such as cortisol and aldosterone do not regulate calcium levels in the body. Therefore, adrenal hormone dysfunction will not result in hypercalcification of bones. Test-Taking Tip: Be alert for details about what you are being asked to do. In this question type, you are asked to select all options that apply to a given situation or patient. All options likely relate to the situation, but only some of the options may relate directly to the situation. Text Reference - p. 1139

A patient is referred for an insulin tolerance test. What care must the nurse take when preparing the patient for the test? Select all that apply. 1 Ensure the patient is fasting after midnight. 2 Ask the patient to avoid water on the morning of the test. 3 Establish IV access for frequent sampling. 4 Keep ready 50% dextrose and 5% dextrose IV solution. 5 Obtain a baseline weight.

1, 3, 4 The nurse should ensure that the patient is fasting after midnight; however, water may be permitted on the morning of the test. The nurse must establish IV access for administration of medication and frequent blood sampling. The nurse should assess the patient for hypoglycemia and hypotension and keep ready 50% dextrose and 5% dextrose IV solution at the bedside in case severe hypoglycemia occurs. The nurse does not need a baseline weight. Text Reference - p. 1150

The nurse working in an endocrine clinic knows that Chvostek's sign is a diagnostic tool that is used to assess for which electrolyte disturbance? 1 Hypokalemia 2 Hypocalcemia 3 Hyperkalemia 4 Hypercalcemia

2 Chvostek's sign is a diagnostic tool that is used to assess for tetany, a sign of hypocalcemia. This is an important assessment when the nurse is dealing with patients in an endocrine clinic, especially those that may have hypoparathyroidism. A positive Chvostek's sign is specific to hypocalcemic tetany, and therefore would not indicate a state of hypercalcemia, hypokalemia, or hyperkalemia. Text Reference - p. 1146

A patient presents at the outpatient unit for a cortisol (total) blood test. Which intervention should the nurse perform? 1 Instruct the patient to restrict food, fluid, or medication before test. 2 Mark the time of blood draw on the slip. 3 Keep the sample on ice. 4 Use a plastic heparinized tube.

2 Cortisol has diurnal variation; levels are higher in the morning than in evening. The nurse should mark the time of the blood draw on the slip. A fasting blood sample is collected and kept on ice for parathyroid hormone blood studies but is not necessary for cortisol tests. The test measures the amount of cortisol in serum; hence heparinized tubes are not required to collect a blood sample. Text Reference - p. 1149

Which statement is true about cortisol? 1 It does not regulate fluid volume. 2 Its levels are increased during hypoglycemia. 3 It increases the inflammatory response. 4 Its control is through a positive feedback mechanism.

2 Cortisol level increases when a person experiences hypoglycemia and stimulates gluconeogenesis process. Cortisol maintains fluid volume by acting on mineralocorticoid receptors. This chemical decreases the inflammatory response by reducing the effects of proteolytic enzymes on surrounding tissue. Cortisol works via negative feedback mechanism. Text Reference - p. 1140

The nurse is caring for a female patient with abnormal development of breasts. What does the nurse expect to find in the patient's diagnostic reports? 1 Low levels of insulin 2 Low levels of estrogen 3 Low levels of testosterone 4 Low levels of corticosteroids

2 Estrogen helps in developing secondary sexual characteristics, such as breast development, in females. Therefore, low levels of estrogen may lead to abnormal development of breasts in the female patient. Low levels of insulin may lead to decreased glucose levels in the blood. Low levels of testosterone may lead to decreased spermatogenesis (in men). Low levels of corticosteroids may lead to decreased lipid metabolism. Test-Taking Tip: Avoid looking for an answer pattern or code. There may be times when four or five consecutive questions have the same letter or number for the correct answer. Text Reference - p. 1136

The nurse suspects that a patient has hyperthyroidism. Which finding supports the nurse's suspicion? 1 Moon face 2 Exophthalmos 3 Striae on skin 4 Thick, dry skin

2 Exophthalmos is a condition in which the eyeballs protrude from the orbits. Exophthalmos occurs in hyperthyroidism due to accumulation of fluid in the eye and the retroorbital tissue. Moon face is periorbital edema and facial fullness, which is associated with Cushing syndrome due to an increase in cortisol secretion. Striae are purplish-red marks below the skin surface also associated with Cushing syndrome. Thick, dry skin is not a clinical manifestation of hyperthyroidism; the patient with hyperthyroidism has warm, smooth skin due to increased metabolism. Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer. Text Reference - p. 1146

A patient reports weight loss, increased appetite, chest pain, and hair loss. Assessment findings include large and protruding eyes, skin that is warm, smooth, and moist, an elevated blood pressure, and an increased heart rate. The nurse suspects that the patient has which condition? 1 Goiter 2 Hyperthyroidism 3 Addison's disease 4 Hypoparathyroidism

2 Hyperthyroidism occurs due to the hypersecretion of thyroid hormone, resulting in an increased basal metabolic rate. Signs and symptoms that include weight loss, large and protruding eyes, warm, smooth, moist skin, hair loss, chest pain indicate hyperthyroidism. Increased heart rate indicates tachycardia. Elevated blood pressure and tachycardia also occur due to hyperthyroidism. Increased metabolism, a result of hyperthyroidism, may lead to weight loss. A goiter is characterized by the enlargement of the thyroid gland, and may occur due to iodine deficiency and an imbalance of thyroid hormones. Addison's disease is characterized by darkening of the skin in skinfolds, weakness, irritability, and decreased cold tolerance. Hypoparathyroidism is characterized by tetany, tachycardia, hyperreflexia, and increased phosphate levels. Text Reference - p. 1144

A patient complains about symptoms that include unexplained weight gain, a puffy face, dry skin, and heavy, irregular menstrual periods. Which abnormal assessment would help guide the patient's treatment? 1 Abnormal insulin levels 2 Abnormal thyroxine levels 3 Abnormal calcitonin levels 4 Abnormal melatonin levels

2 Hypothyroidism refers to an abnormal decrease in the levels of thyroxine associated with signs such as unexplained weight gain, a puffy face, dry skin, and heavy, irregular menstrual periods. Abnormal insulin levels cause changes in the blood sugar levels, associated with polydipsia and polyuria. Abnormal calcitonin and melatonin levels do not cause any weight gain or signs such as dry skin or a puffy face. Text Reference - p. 1197

The nurse determines that an older adult patient's luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are within normal ranges. The determination is based on which laboratory results? 1 LH 55 U/L; FSH 7 mU/mL 2 LH 50 U/L; FSH 95 mU/mL 3 LH 1.24 U/L; FSH 15.4 mU/mL 4 LH 1.70 U/L; FSH 1.37 mU/mL

2 The normal ranges of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in postmenopausal women are 14.2 to 52.3 IU/L and 19.3 to 100.6 mU/mL, respectively. Therefore, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) values of 50 U/L and 95 mU/mL may be observed in a 60-year-old patient. The normal LH and FSH values for a patient in an ovulatory phase are 21.9 to 56.6 IU/L and 6.17 to 17.2 mU/mL, respectively. Therefore, values of 55 U/L and 7 mU/mL indicate LH and FSH values of a patient in an ovulatory phase. Generally, LH and FSH values for men are 1.24 to 7.8 IU/L and 1.42 to 15.4 mU/mL, respectively. The normal range for LH is 1.68 to 15 IU/L and for FSH is 6.17 to 17.2 mU/mL. Therefore, values of 1.70 U/L and 1.37 mU/mL may be observed in a patient during a follicular phase. Text Reference - p. 1147

Which hormone acts on all of the body tissues? 1 Parathormone 2 Thyroid hormone 3 Luteinizing hormone 4 Antidiuretic hormone

2 Thyroid hormone is produced by the thyroid gland; it acts on all of the body tissues. Parathormone acts on the bones, intestines, and kidneys. Luteinizing hormone acts on the reproductive organs. Antidiuretic hormone acts on the renal tubules and vascular smooth muscles. Text Reference - p. 1136

When caring for the patient with a traumatic brain injury (TBI), the nurse knows that damage to which endocrine gland can affect the hormone secretion from some of the other endocrine glands? 1. 1 2. 2 3. 3 4. 4

2 With a TBI, the anterior pituitary is likely to be damaged. The anterior pituitary gland secretes tropic hormones that control the secretion of hormones by other endocrine glands (the thyroid, adrenal cortex, and reproductive organs). The parathyroids secrete parathyroid hormone, which regulates serum calcium level by acting on bone, the kidneys, and, indirectly, the gastrointestinal tract. The pineal gland secretes melatonin, which helps regulate circadian rhythm and reproduction. The thyroid glands secrete thyroxine (T4) and triiodothyronine (T3), which regulate the cell processes of cell growth and tissue differentiation, and calcitonin, which affects bone tissue to regulate serum calcium and phosphorus levels. Text Reference - p. 1136

Which cells of the islets of Langerhans produce and secrete insulin and amylin? 1 α cells 2 β cells 3 F cells 4 Delta cells

2 β cells are responsible for producing and secreting insulin and amylin. α cells produce and secrete glucagon. F cells are responsible for producing and secreting pancreatic polypeptides. Delta cells are responsible for producing and secreting somatostatin. Text Reference - p. 1140

When reviewing a patient's laboratory reports, the nurse notes increased aldosterone levels. Which conditions may be the cause of this finding? Select all that apply. 1 Hypokalemia 2 Hyponatremia 3 Hyperkalemia 4 Hypernatremia 5 Hypercalcemia

2, 3 Aldosterone is a mineralocorticoid that maintains extracellular fluid volume. Hyperkalemia and hyponatremia result in the synthesis and secretion of aldosterone from the adrenal cortex. Hypokalemia inhibits synthesis and release of aldosterone. Hypernatremia and hypercalcemia have no effect on aldosterone synthesis and secretion. Text Reference - p. 1140

The nurse is assessing a patient with Cushing syndrome. What might the nurse observe in the patient? Select all that apply. 1 Eyeball protrusion from orbits 2 Excessive facial hair 3 Periorbital edema 4 Facial fullness 5 Masklike effect

2, 3, 4 Cushing syndrome is caused by increased cortisol secretion. Excessive facial hair, periorbital edema, and facial fullness are noted in the patient with Cushing syndrome. Eyeball protrusion from orbits occurs in hyperthyroidism as a result of fluid accumulation in eye and retroorbital tissue. A masklike effect is found in patients with hypothyroidism. Text Reference - p. 1146

The nurse is assessing a patient with impaired adrenal cortex functioning. Which hormone levels does the nurse monitor in this patient? Select all that apply. 1 Oxytocin 2 Androgens 3 Epinephrine 4 Glucocorticoids 5 Mineralocorticoids

2, 4, 5 Androgens, glucocorticoids, and mineralocorticoids are secreted by the adrenal cortex and should be monitored for in this patient. Oxytocin is secreted by the posterior pituitary gland and is involved in stimulating uterine contractility. Epinephrine is the hormone of the adrenal medulla that enhances and prolongs the effects of the sympathetic nervous system. Test-Taking Tip: Be alert for details about what you are being asked to do. In this question type, you are asked to select all options that apply to a given situation or patient. All options likely relate to the situation, but only some of the options may relate directly to the situation. Text Reference - p. 1151

A patient is referred for a magnetic resonance imaging (MRI) scan for radiologic evaluation of the pituitary gland. Which interventions should the nurse perform for the patient? Select all that apply. 1 Assess renal function before the test. 2 Inform the patient of the need to lie still during the procedure. 3 Ensure the patient is fasting. 4 Explain that the test is noninvasive. 5 Assure the patient that the test is painless.

2, 4, 5 The nurse should inform the patient to lie as still as possible. The patient should be assured that the test is noninvasive and painless. Renal function is assessed in the patient preparing for computed tomography (CT) scan. The patient does not need to fast for an MRI test. Test-Taking Tip: Look for answers that focus on the client or are directed toward feelings. Text Reference - p. 1148

Which gland releases its secretions directly into the bloodstream? 1 Salivary gland 2 Lacrimal gland 3 Pituitary gland 4 Mammary gland

3 The pituitary gland is an endocrine gland located in the brain that releases its secretions into the blood. The salivary, lacrimal, and mammary glands are exocrine glands that release their secretions through ducts into a body cavity or onto the surface. Text Reference - p. 1134

When instructing a patient regarding a urine study for free cortisol, what is most important for the nurse to tell the patient? 1 Save the first voided urine in the morning 2 Maintain a high-sodium diet three days before collection 3 Try to avoid stressful situations during the collection period 4 Complete at least 30 minutes of exercise before collecting the urine sample

3 A urine study for free cortisol requires a 24-hour urine collection. The patient should maintain a low-sodium diet before and during the urine collection period. The patient should be instructed to avoid stressful situations and excessive physical exercise, which could unduly increase cortisol levels. Text Reference - p. 1150

Which hormone regulates fluid volume in the renal tubules? 1 Oxytocin 2 Growth hormone (GH) 3 Antidiuretic hormone (ADH) 4 Adrenocorticotropic hormone (ACTH)

3 Antidiuretic hormone (ADH) secretion is stimulated by plasma osmolarity; it plays a major role in regulating fluid volume and stimulates reabsorption of water in the renal tubules. Oxytocin stimulates the ejection of milk into the mammary ducts during lactation. Growth hormone (GH) affects the growth and development of body tissues. Adrenocorticotropic hormones stimulate the adrenal cortex to secrete corticosteroids. Text Reference - p. 1138

The laboratory reports of a patient reveal reduced parafollicular cells of the thyroid gland. Which hormonal deficiency does the nurse recognize through this finding? 1 Prolactin 2 Oxytocin 3 Calcitonin 4 Parathormone

3 Calcitonin is produced by the C-cells (parafollicular cells) of the thyroid gland in response to high circulating calcium levels. Therefore, reduced parafollicular cells can result in calcitonin deficiency. Prolactin is a protein that enables female mammals to produce milk. Oxytocin stimulates the ejection of milk. Parathormone is secreted by the parathyroid hormone; it regulates serum calcium concentrations. Text Reference - p. 1139

A patient reports excessive thirst, increased urine output, and weight loss. Upon reviewing the laboratory reports of the patient, the nurse finds increased blood glucose levels. The nurse suspects that the patient has which condition? 1 Acromegaly 2 Addison's disease 3 Diabetes mellitus 4 Cushing syndrome

3 Diabetes mellitus (DM) is characterized by polyuria (increased urine output), polydipsia (excessive thirst), and polyphagia (excessive hunger). Other signs and symptoms of DM include weakness, fatigue, hyperglycemia, irritability, and weight loss. Acromegaly occurs due to hypersecretion of growth hormone and is characterized by the elongation of facial bones and extremities. Addison's disease is caused by hyposecretion of adrenal gland hormones and is characterized by hyperpigmentation of the skin, weakness, and irritability. Cushing syndrome results from hypersecretion of cortisol and is characterized by periorbital edema, easy bruising, moon face, and elevated blood pressure. Text Reference - p. 1146

The nurse is assessing a patient diagnosed with Addison's disease. What would the nurse expect to find in this patient? 1 Patchy areas of light skin 2 Warm, smooth, moist skin 3 Darkened skin on the knuckles, elbows, and palmar creases 4 Purplish red marks on the abdomen

3 Hyperpigmentation, or "bronzing" of the skin, particularly on the knuckles, elbows, knees, genitalia, and palmar creases, is found in Addison's disease. Patchy areas of light skin may indicate autoimmune endocrine disorders. Warm, smooth, moist skin may indicate hyperthyroidism. Purplish red marks on the abdomen are seen in patients with Cushing syndrome. Text Reference - p. 1146

A patient's serum potassium level is 3 mEq/L and serum sodium level is 145 mEq/L. Which hormone synthesis does the nurse understand is inhibited by these conditions? 1 Oxytocin 2 Thyroxine 3 Aldosterone 4 Progesterone

3 Mineralocorticoids are essential maintaining fluid and electrolyte balance. Conditions such as low levels of potassium and high levels of calcium inhibit the synthesis of aldosterone, which leads to fluid and electrolyte imbalance. Oxytocin peptide is synthesized as an inactive precursor protein from an OXT gene and the synthesis of oxytocin is affected by low levels of vitamin C. Thyroxine and progesterone synthesis are not inhibited by low levels of potassium and high levels of sodium in the blood stream. Text Reference - p. 1140

Acts on renal tubules and vascular smooth muscles. Promotes reabsorption of water and vasoconstriction. Decreases urine production by causing the renal tubules to reabsorb water from the urine and return it to the circulating blood. A patient demonstrating excessive urination might indicate an alteration in this hormone.

Antidiuretic Hormone

Acts on renal tubules and vascular smooth muscles. Promotes reabsorption of water and vasoconstriction. Decreases urine production by causing renal tubules to reabsorb water from urine and return it to circulating blood.

Antidiuretic hormone

What change in the aging process helps the nurse determine that a geriatric patient is at an increased risk for diabetes mellitus? 1 Decreased secretion of estrogen 2 Increased secretion of parathyroid hormone 3 Decreased β-adrenergic response to norepinephrine 4 Increased fibrosis and fatty acid deposits in the pancreas

4 Increased fibrosis and fatty acid deposits in the pancreas may lead to an increased risk for diabetes mellitus in geriatric patients. Decreased secretion of estrogen leads to symptoms associated with menopause in women, which increases the risk for atherosclerosis and osteoporosis. A decreased β-adrenergic response to norepinephrine leads to an increased risk for hypertension. An increased secretion of parathyroid hormone leads to an increased calcium reabsorption from the bone, which causes hypercalcemia. Text Reference - p. 1141

The laboratory findings of a patient indicate decreased urine output. What condition does the nurse suspect? 1 Hypothyroidism 2 Diabetes mellitus 3 Addison's disease 4 Syndrome of inappropriate antidiuretic hormone

4 Syndrome of inappropriate antidiuretic hormone is associated with a decrease in antidiuretic hormone, resulting in reduced reabsorption of water from the kidney tubules and low urine output. Hypothyroidism is associated with reduced metabolic process, which leads to cold insensitivity. Diabetes mellitus is a metabolic disorder associated with excessive urine output. Addison's disease is a chronic renal insufficiency in which the patient has excessive thirst and high urine output. Test-Taking Tip: Avoid looking for an answer pattern or code. There may be times when four or five consecutive questions have the same letter or number for the correct answer. Text Reference - p. 1147

The hypothalamus secretes releasing hormones and inhibiting hormones. What is the target tissue of these releasing hormones and inhibiting hormones? 1 Pineal 2 Adrenal cortex 3 Posterior pituitary 4 Anterior pituitary

4 The anterior pituitary is the target tissue of the releasing hormones (corticotropin releasing hormone, thyrotropin releasing hormone, growth hormone releasing factor, gonadotropin releasing hormone, and prolactin releasing factor) and the inhibiting hormones (somatostatin, prolactin inhibiting factor). These hormones release or inhibit other hormones that affect the thyroid, adrenal cortex, pancreas, reproductive organs, and all body cells. The pineal gland is not affected directly by the releasing and inhibiting hormones from the hypothalamus. The posterior pituitary releases antidiuretic hormone (ADH) in response to plasma osmolality changes that are not affected directly by the hypothalamus hormones. Text Reference - p. 1137

Which feature of a hormone influences its interaction with target cells? 1 Target tissues 2 Cell membranes 3 Chemical structure 4 Solubility differences

4 The differences in solubility are important in understanding how a hormone interacts with its target cells. Target tissues play an important role in the "lock-and-key" mechanism. Cell membranes are helpful for simple diffusion of small molecules. The chemical structure of a hormone is useful in classifying the hormone as lipid-soluble or water-soluble. Text Reference - p. 1135

The nurse is educating a patient about an ultrasound of the thyroid gland to observe for any nodules. What should the nurse teach the patient? 1 Instruct the patient to fast. 2 Inform the patient that sedation may be required. 3 Inform the patient that the test will last approximately 30 minutes. 4 Inform the patient that a gel and transducer will be used over the neck.

4 The nurse preparing the patient for an ultrasound to evaluate thyroid nodules should inform the patient that a gel and transducer will be used over the neck. The patient is not required to fast, and sedation is not required. The test will last 15 minutes. Test-Taking Tip: Many times the correct answer is the longest alternative given, but do not count on it. NCLEX item writers (those who write the questions) are also aware of this and attempt to avoid offering you such "helpful hints." Text Reference - p. 1148

What is the order of events associated with the body's response to increased plasma osmolality? 1. Increase in plasma volume 2. Decrease in plasma osmolality 3. Inhibition of antidiuretic hormone 4. Reabsorption of water in the kidney tubules 5. Antidiuretic hormone release by posterior pituitary gland

5, 4, 1, 2, 3 An increase in plasma osmolality stimulates the posterior pituitary gland to release antidiuretic hormone. This antidiuretic hormone regulates urine concentration by reabsorbing the water into the kidney tubules. Due to this, there will be an increase in the plasma volume. This again results in decreased plasma osmolality, and the release of antidiuretic hormone is inhibited. Text Reference - p. 1139

A teenaged female patient reports disturbances in her menstrual cycle. Which gland does the nurse suspect to cause the disturbances caused by improper functioning? A. Pineal gland B. Adrenal gland C. Anterior pituitary gland D. Posterior pituitary gland

A

Secretes glucocorticoids, mineral corticoids, and androgens. Maintains the body's fluid and electrolyte balance.

Adrenal cortex

Produced by the anterior pituitary. Fosters the growth of the adrenal cortex and stimulates the secretion of corticosteroids.

Adrenocorticotropic hormone (ACTH)

Potent mineralocorticoid that maintains extracellular fluid volume. Acts on the renal tubule to promote renal reabsorption of sodium and excretion of potassium and hydrogen ions = major role in fluid and electrolyte balance.

Aldosterone

Produce and secrete glucagon.

Alpha cells

Secretes tropic hormones that control the secretion of hormones by other endocrine glands (thyroid, adrenal cortex, reproductive organs). Likely to be injured in traumatic brain injury.

Anterior pituitary

Produce and secrete insulin and amylin.

Beta cells

Affects bone tissue to regulate serum calcium and phosphorus levels. Produced by C cells (parafollicular cells) of the thyroid gland in response to high circulating calcium levels.

Calcitonin

Epinephrine, norepinephrine, and dopamine secreted by the medulla. An essential part of the body's "fight or flight" response to stress. Break down stored complexes in the fasting state to provide glucose as a fuel for energy.

Catecholamines

A glucocorticoid that protects the body from stress; it is also called as stress hormone. Helps to maintain vascular integrity and fluid volume by acting on mineralocorticoid receptors; levels are increased in patients with burns, infections, fevers, and acute anxiety. Levels increase during hypoglycemia. This chemical decreases the inflammatory response by reducing the effects of proteolytic enzymes on surrounding tissue. Works via negative feedback mechanism.

Cortisol

Which hormone is associated with fostering growth of the ADRENAL CORTEX? A. Oxytocin B. Somatostatin C. Growth hormone D. Adrenocorticotropic hormone (ACTH)

D

Which hormone participates in catabolism during the fasting state? A. Insulin B. Aldosterone C. Somatostatin D. Catecholamines

D

Produce and secrete somatostatin.

Delta cells

Hormone that helps enhance and prolong the sympathetic nervous system effects. Increases in response to stress.

Epinephrine

A hormone produced in the kidneys and secreted in response to hypoxia and decreased renal blood flow. Stimulates RBC production in the bone marrow. A deficiency occurs in kidney failure, leading to anemia.

Erythropoietin

Produce and secrete pancreatic polypeptides.

F Cells

Functions in ovum and sperm formation.

Follicle-stimulating hormone

Stimulates glycogenolysis and gluconeogenesis.

Glucagon

Promotes protein anabolism(growth and tissue repair). Indirectly inhibits glucose metabolism and increases the blood glucose levels. Increases cause increases in glucose levels which suppress insulin production.

Growth hormone (GH)

Secretes atrial natriuretic peptide which helps homeostatic control of body water, sodium, potassium, and fat.

Heart

Produced from the pancreas. Responsible for anabolism, has a hypoglycemic effect because it promotes the entry of glucose into the cells. Helps with glucose regulation in the body.

Insulin

Acts on the reproductive organs to stimulate sex hormone secretion, reproductive organ growth, and reproductive processes.

Luteinizing hormone

Produces insulin, glucagon, pancreatic polypeptide, and somatotropin. It secretes hormones responsible for regulating the level of glucose in blood.

Pancreas

Secreted by the parathyroid. Helps maintain calcium and phosphorous levels in the body. Promotes bone demineralization and increases intestinal absorption of Ca2+. Acts on bones, kidneys, and intestines.

Parathormone

Secrete parathyroid hormone which regulates serum calcium level by acting on bone, kidneys, and indirectly on the GI tract.

Parathyroid

Composed of photo receptive cells. Secretes melatonin, which helps regulate circadian rhythm and reproduction. Abnormalities may lead to disturbances in the menstrual cycle.

Pineal gland

Lactogenic hormone that stimulates and promotes the secretion of milk in nursing mothers.

Prolactin

Produced by the pancreas. Inhibits other hormones such as insulin and glucagon secretion. Low levels may lead to decrease in protein anabolism which leads to growth suppression.

Somatostatin

This gland produces triiodothyronine (T3), thyroxine (T4), and calcitonin. T3 and T4 regulate cell processes of cell growth and tissue differentiation. It secretes hormones that affect metabolic rate, oxygen consumption, and carbohydrate and lipid metabolism.

Thyroid

Stimulates synthesis and release of thyroid hormones; promotes growth and maintains the function of the thyroid gland.

Thyroid stimulating hormone