Patho Davis - Chapter 24 Endocrine

Which of the following hormones are not altered in a pheochromocytoma? Cortisol Aldosterone Epinephrine Norepinephrine Adrenal androgens

**A pheochromocytoma is a tumor of the adrenal medulla** *pheochromocytoma effects Epinephrine and Norepinephrine Cortisol Made by the adrenal cortex Aldosterone made by the adrenal cortex Adrenal androgens made by the adrenal cortex

The nurse finds decreased T3 and T4 hormone levels in the laboratory report of a patient diagnosed with an endocrine disorder. What specific characteristics does the nurse expect to find? Select all that apply. Fatigue Weight loss Feeling hot Decreased heart rate Weight gain

Fatigue Decreased heart rate Weight gain

Which of the following conditions do you also suspect Mary may experience? Weight gain Hypotension Diabetes mellitus Insulin resistance

Hypotension Both aldosterone and cortisol, which are low in Mary, help maintain blood pressure. Without adequate levels of these hormones, a patient may experience hypotension. Aldosterone stimulates sodium and water reabsorption, maintaining blood volume and blood pressure. Cortisol is a vasoconstrictor, which also helps maintain blood pressure.

A patient suffering from severe stress and anorexia has the following laboratory values, which are all low: gonadotropin-releasing hormone (GnRH), growth hormone-releasing hormone (GHRH), and corticotropin-releasing factor (CRF). Which tissue is likely dysfunctional? Adrenal cortex Hypothalamus Posterior pituitary Anterior pituitary

Hypothalamus

Corticotropin-releasing factor is produced by which tissues? Hypothalamus Ovaries Anterior pituitary Adrenal glands

Hypothalamus

A patient with central diabetes insipidus _________________. will drink less water than normal. will have a higher than normal metabolism. will likely have edema. will have increased urine output.

will have increased urine output.

Reviewing a patient's chart, a nurse notes the presence of acromegaly. Which of the following is likely to be present when the nurse assesses the patient? Increased stature Cold intolerance Overgrowth of jaw, hands Galactorrhea

Overgrowth of jaw, hands It is increased GH in adulthood.

A patient has a tumor that compresses the posterior pituitary. Which hormones are likely affected? Select all that apply. Adrenocorticotropic hormone (ACTH) Growth hormone (GH) Oxytocin Thyroid stimulating hormone (TSH) Antidiuretic hormone (ADH)

Oxytocin Oxytocin is released from the posterior pituitary Antidiuretic hormone (ADH) ADH is released from the posterior pituitary.

A 24-hour urine collection reveals very elevated catecholamine levels. What may account for these results? Parathyroid gland tumor Anterior pituitary tumor Adrenal cortex tumor Pheochromocytoma

Pheochromocytoma

A patient presents with a strange complaint of "I am more tan than ever. I am seldom out in the sun, but I look so tan." Which laboratory values may be evaluated? Parathyroid hormone (PTH) adrenocorticotropic hormone (ACTH) Growth hormone (GH) Epinephrine

adrenocorticotropic hormone (ACTH)

Hyperfunction of the ________________ that results in excess growth hormone may cause ___________. posterior pituitary; acromegaly anterior pituitary; acromegaly hypothalamus; acromegaly anterior pituitary; Graves' disease

anterior pituitary; acromegaly

Secondary hyperparathyroidism may result from _______________. suppressed parathyroid hormone secretion. a tumor of the parathyroid gland. a tumor of the anterior pituitary gland. any disorder that causes hypocalcemia.

any disorder that causes hypocalcemia.

Please indicate on the figure the step in which elevated T4 levels would decrease further stimulatory signals from the pituitary gland.

arrow part that splits into fork pointing towards enlarged picture of hypothalamus

The hypothalamic-pituitary-end organ progression of hormones is best represented by _____________. corticotropin-releasing factor - adrenocorticotropic hormone - cortisol cortisol - corticotropin-releasing factor - adrenocorticotropic hormone cortisol - adrenocorticotropic hormone - corticotropin-releasing factor corticotropin-releasing factor - cortisol - adrenocorticotropic hormone

corticotropin-releasing factor - adrenocorticotropic hormone - cortisol

Primary hyperparathyroidism is most commonly caused by ______________. a tumor of the anterior pituitary a tumor of the parathyroid glands excess adrenocorticotropic hormone secretion elevated serum calcium levels

a tumor of the parathyroid glands

A patient needs a screening of anterior pituitary hormone functioning. Which hormone should not be included in the evaluation? Antidiuretic hormone Thyroid stimulating hormone (TSH) Growth hormone Follicle-stimulating hormone

Antidiuretic hormone Produced by the posterior pituitary

The following image shows a man who experienced excess growth hormone (GH) in adulthood. Which term should the nurse use in the patient's file? Giantism Cushing's syndrome Acromegaly Hyperthyroidism

Acromegaly This results from excess GH in adulthood causing enlargement of facial features, hands, fingers, feet.

Which of the following conditions may present with low cortisol and elevated adrenocorticotropic hormone (ACTH) serum values? Addison's disease Cushing's syndrome Pheochromocytoma Hyperparathyroidism

Addison's disease

What is another name for Mary's condition? Addison's disease Cushing's disease Cushing's syndrome Pheochromocytoma Check Answer

Addison's disease Addison's disease is a form of primary adrenal insufficiency. Remember, in Addison's disease, more adrenal hormones need to be "added." Cushing's disease and Cushing's syndrome are adrenal excess diseases. Pheochromocytoma is a tumor of the adrenal medulla that can lead to hypertensive crisis.

Mary presents in your office with the unusual complaint of being "more tan" than expected based on her self-report sun exposure. Follow up questions reveal that Mary has been experiencing severe fatigue, dizziness upon standing, and an overall feeling that "something is wrong." You examine Mary and order blood tests. The test results show the following abnormalities: low cortisol, low aldosterone, elevated ACTH, low blood glucose, low serum sodium, elevated serum potassium, normal calcium, normal PTH. Mary takes no medications. Which of the following conditions is most likely based on Mary's laboratory results? Primary hyperparathyroidism Adrenal excess Secondary hyperparathyroidism Adrenal insufficiency

Adrenal insufficiency Mary's laboratory results indicate normal PTH and calcium levels, so issues with the parathyroid gland can be ruled out. Low cortisol and elevated ACTH levels are associated with adrenal insufficiency. Elevated cortisol is a sign of adrenal excess.

A patient has very low cortisol levels. Which of the following tests may be appropriate? Dexamethasone suppression test Adrenocorticotropic hormone (ACTH) stimulation test Parathyroid hormone (PTH) stimulation test Dexamethasone activation test

Adrenocorticotropic hormone (ACTH) stimulation test

A patient's laboratory results reveal elevated adrenocorticotropic hormone (ACTH) and cortisol with lower-than-normal corticotropic releasing factor (CRF). Which tissue is likely the cause of the patient's endocrine disorder? Hypothalamus Adrenal cortex Posterior pituitary Anterior pituitary

Anterior pituitary Elevated ACTH and cortisol, with reduced CF, would indicate a problem in the anterior pituitary.

Which of the following is the number one cause of adrenal insufficiency? Corticosteroid usage Radiation therapy Pituitary tumor Autoimmune destruction of the adrenal gland

Autoimmune destruction of the adrenal gland

A patient with a traumatic brain tumor suffered a pituitary apoplexy. Which of the following does the nurse expect to encounter? Patient with limited signs and symptoms Blood laboratory values revealing elevated growth hormone-releasing hormone (GHRH), thyrotropic releasing hormone (TRH) and corticotropin-releasing factor (CRF) Hyperfunctioning of thyroid and adrenal gland Increased adrenocorticotropic hormone (ACTH) and thyroid-stimulating hormone (TSH) blood levels

Blood laboratory values revealing elevated growth hormone-releasing hormone (GHRH), thyrotropic releasing hormone (TRH) and corticotropin-releasing factor (CRF)

A patient has a parathyroid gland disorder. Which supplement may be needed? Potassium Sodium Calcium Iron

Calcium

A patient suffering for diabetes insipidus is given antidiuretic hormone (ADH). The result is increased fluid retention and decreased urine output. Which of the following conditions does the patient have? Nephrogenic diabetes insipidus Central diabetes insipidus Diabetes mellitus Syndrome of inappropriate diabetes insipidus (SIADH)

Central diabetes insipidus In central DI, the kidneys can respond to ADH. Giving ADH and seeing fluid retention increase shows that the kidneys can respond to ADH when it is present. The problem is lack of ADH.

A patient's parathyroid glands were damaged. What signs and symptoms does the nurse expect? Select all that apply. Tetany Chvostek's sign Trousseau's sign Low serum calcium Tingling sensation

Chvostek's sign Trousseau's sign Low serum calcium Tingling sensation

Mary reports that she takes no medications. Which medications may cause adrenal insufficiency? NSAID's Corticosteroids Anti-histamines Diuretics

Corticosteroids Corticosteroid usage, especially for longer periods, can suppress normal cortisol production by the adrenal glands. In this case, ACTH levels are also reduced due to the negative feedback by the corticosteroids. The other medications listed do not affect adrenal gland synthesis of cortisol.

Which hormones are from the adrenal cortex? Select all that apply. Corticosteroids Adrenocorticotropic hormone Mineralocorticoids Thyroxine Androgens

Corticosteroids Androgens

A patient has a hyperfunctioning tumor of the parathyroid gland. Which of the following conditions may the patient be most at risk for? Coronary event Osteoporosis Severe weight loss Acromegaly

Osteoporosis

An order for a 24-hour urine collection has appeared. Which hormone is most likely being assessed? Oxytocin Thyroid stimulating hormone Cortisol Thyroxine

Cortisol Cortisol levels can be assessed with a 24-hour urine collection.

A patient is given an adrenocorticotropic hormone (ACTH)-stimulation test. Which of the following results will confirm hypofunctioning of the adrenal gland? Elevated ACTH Suppressed corticotropin releasing factor Cortisol levels less than expected Suppressed thyroid hormone levels

Cortisol levels less than expected ACTH should increase cortisol levels. If cortisol does not increase with ACTH administration, then the adrenal glands are underperforming.

A dexamethasone suppression test is performed on a patient. The diagnosis is Cushing's syndrome. What was the result of the dexamethasone test? Cortisol levels were suppressed. Catecholamine levels remained elevated. Cortisol remained elevated. Catecholamine levels were suppressed.

Cortisol remained elevated.

A disorder of the anterior pituitary resulting in elevated adrenocorticotropic hormone is known as ____________. acromegaly Cushing's disease Cushing's syndrome Addison's disease

Cushing's disease

A female patient appears at the clinic complaining that she "looks different." She states that her face is more rounded than normal, she has abnormal hair growth, and she feels like she gained fat around her back. What condition does the clinician suspect? Pheochromocytoma Hyperthyroidism Cushing's syndrome Addison's disease

Cushing's syndrome

Which of the following conditions are due to a hormone excess? Select all that apply. Cushing's syndrome Grave's disease Addison's disease Giantism Hashimoto's thyroiditis

Cushing's syndrome Due to excess adrenal cortex hormones Grave's disease due to excess thyroid hormone release Giantism due to an excess of GH

Please place the following sequences in order to describe how iodine deficiency may lead to a goiter. Decreased thyroid hormone synthesis Increased thyroid-stimulating hormone (TSH) secretion Decreased iodine in diet Increased thyroid growth Decreased negative feedback on anterior pituitary

Decreased iodine in diet Decreased thyroid hormone synthesis Decreased negative feedback on anterior pituitary Increased thyroid-stimulating hormone (TSH) secretion Increased thyroid growth

A nursing student asks whether there is a difference between Cushing's disease versus Cushing's syndrome. Which laboratory value can help differentiate Cushing's disease from Cushing's syndrome? Elevated adrenocorticotropic hormone (ACTH) Elevated cortisol Decreased cortisol Elevated epinephrine

Elevated adrenocorticotropic hormone (ACTH)

Which of the following laboratory values may lead you to believe a patient has Cushing's syndrome? Select all that apply. Elevated cortisol Elevated norepinephrine Reduced blood glucose levels Reduced cortisol Reduced adrenocorticotropic hormone

Elevated cortisol Reduced adrenocorticotropic hormone

A patient with diabetes insipidus will likely have which of the following laboratory values? Elevated blood glucose Elevated plasma osmolarity Elevated urine osmolarity Elevated urine retention

Elevated plasma osmolarity In DI, fluid loss in the urine is increased. This, in return, raises plasma osmolarity.

You note slight tremors in Janelle's hands, and an area in her neck appears to be enlarged compared with its appearance in previous visits. Janelle lists further complaints, including hair loss, diarrhea, and "feeling hot all the time." Which of the following is true? Parathyroid gland enlargement normally appears in the anterior neck area. You should manually palpate Janelle's neck with moderate force to assess the size of the tissue. Enlargement of the thyroid gland can make the neck area appear "fuller" than normal. Any enlargement of the thyroid gland indicates the presence of thyroid cancer, which is likely Janelle's diagnosis.

Enlargement of the thyroid gland can make the neck area appear "fuller" than normal. When the thyroid gland enlarges, changes in the appearance of the neck may be noticeable. Janelle's neck should not be palpated with force as this can cause further damage to the thyroid gland. The parathyroid glands are located behind the thyroid, not on the anterior neck. An enlarged thyroid gland can occur for many reasons, not necessarily cancer.

Which of the following is shown in this image? Exophthalmos Periorbital edema Bell's palsy Enophthalmos

Exophthalmos

Which signs or symptoms would result from syndrome of inappropriate antidiuretic hormone? Select all that apply. Concentrated plasma Thirst Fluid retention Hypervolemia Dehydration

Fluid retention Dehydration

An antibody test is ordered for an endocrine disorder. Which of the following conditions is commonly diagnosed by antibody test results? Multiple endocrine neoplasia Grave's disease Pheochromocytoma Cushing's syndrome

Grave's disease Grave's disease is an autoimmune disorder of the thyroid gland and can be detected with antibody testing.

Further screening reveals elevated thyroid-stimulating antibodies. What condition is Janelle experiencing? Hashimoto's thyroiditis Cushing's syndrome Graves' disease SIADH

Graves' disease Elevated thyroid hormone levels can occur for a variety of reasons. Determining the underlying etiology of the elevated hormones is key for treatment. In this case, Janelle is experiencing an autoimmune disease known as Graves' disease. In Graves' disease, there are excess levels of T3 and T4 because of thyroid-stimulating autoantibodies, which bind to and activate thyrotropin receptors within the thyroid gland, causing the gland to enlarge and continually synthesize thyroid hormones. Graves' disease is the most common cause of hyperthyroidism.

The most common cause of thyroid hyperfunction is ______________. elevated TSH. Hashimoto's thyroiditis. Graves' disease. a tumor of the pituitary.

Graves' disease.

Hypofunction of an endocrine gland is associated with which of the following? Select all that apply. Hashimoto's thyroiditis Graves' disease Central diabetes insipidus Syndrome of inappropriate antidiuretic hormone Acromegaly

Hashimoto's thyroiditis Central diabetes insipidus

Which of the following describe possible endocrine dysfunction? Select all that apply. Hormone resistance Hormone balance Hormone excess Hormone juggling Hormone deficiency

Hormone resistance Hormone excess Hormone deficiency

In the image, the person on the left has increased height, while the person on the right is a normal size. Which of the following apply to the person on the left? Hypofunctioning of posterior pituitary Hyperfunctioning of posterior pituitary Hypofunctioning of anterior pituitary Hyperfunctioning of anterior pituitary

Hyperfunctioning of anterior pituitary The person on the left has excess GH, which is hyper functioning of the anterior pituitary.

If the parathyroid gland is damaged during thyroid surgery, which condition will the physician be most concerned about Janelle developing? Hypernatremia Hypocalcemia Hypokalemia Diuresis

Hypocalcemia The parathyroid glands release parathyroid hormone in response to low serum calcium. If the parathyroid glands are damaged and cannot release parathyroid hormone, serum calcium levels may fall.

Which of the following would you expect to see in a patient suffering from Addison's disease? Elevated cortisol Hypoglycemia Elevated norepinephrine Elevated serum calcium

Hypoglycemia

A patient with Addison's disease is at increased risk for an adrenal crisis. Which of the following does the nurse need to be aware of the patient developing? Select all that apply. Hyponatremia Hyperkalemia Hyperglycemia Polycythemia Elevated stress response

Hyponatremia Hyperkalemia

A patient is treated for central diabetes insipidus. Which statement by the patient indicates that the treatment is working? I am going to the bathroom more now than ever. I don't feel as thirsty, and I am not drinking as much. I drink 1 L of water several times and day, and still it is not enough. I feel dehydrated all the time.

I don't feel as thirsty, and I am not drinking as much. Central DI causes too much water to be lost in urine. Correcting the issue should result in more fluid retention and less thirst.

In a patient suspected of having an endocrine disorder, which of the following diagnostic options may be considered first? Immunoassay of blood hormone levels Computed tomography (CT) scan Magnetic resonance imaging (MRI) Antibody testing

Immunoassay of blood hormone levels A Immunoassay of blood hormone levels is usually the first step in endocrine assessment.

What explains Mary's "tan" appearance? Reduced blood glucose activates melanocytes Increased ACTH leads to increased melanocyte-stimulating hormone (MSH) Cortisol damages melanocytes Cancer of the melanocytes

Increased ACTH leads to increased melanocyte-stimulating hormone (MSH) In Mary's case, reduced cortisol causes an elevation in ACTH. As precursor molecule for ACTH also contains melanocyte-stimulating hormone (MSH). As more ACTH is formed, so is more MSH, which in turn activates melanocytes leading to a tanned appearance.

A patient was recently admitted with primary hyperparathyroidism. Which of the following laboratory values would you expect to see? Select all that apply. Decreased parathyroid hormone Increased serum phosphate Increased parathyroid hormone Decreased serum calcium Increased serum calcium

Increased parathyroid hormone Increased serum calcium

A patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following would support this diagnosis? Select all that apply. Increased plasma osmolarity Increased plasma ADH levels Increased urine concentration Dehydration and fluid volume deficit Dilutional hyponatremia

Increased plasma ADH levels Increased urine concentration Dilutional hyponatremia

The physician informs Janelle that if her thyroid gland was removed, she would need to take medication to replace the hormones normally synthesized by this gland. Which medication will Janelle likely be prescribed? Naproxen Amantadine Herceptin Levothyroxine

Levothyroxine Once the thyroid gland is removed, Janelle must take a replacement thyroid hormone such as levothyroxine for the rest of her life. She will work closely with her physician to determine the proper dosage to meet her metabolic needs.

A patient with Hashimoto's thyroiditis is being given levothyroxine. The patient wants to know how the medication works. Which of the following responses is correct for the nurse to make? Levothyroxine blocks excess thyroid hormones. Levothyroxine stimulates thyroid receptors. Levothyroxine blocks the antibodies that cause Hashimoto's thyroiditis. Levothyroxine replaces missing thyroid hormone.

Levothyroxine replaces missing thyroid hormone. Levothyroxine is an medication that compensates for lacking thyroid hormones.

After checking the thyroid hormone levels in the laboratory report of a patient suspected to have an endocrine disorder, the nurse concludes that the patient has secondary hypothyroidism. Which findings support the nurse's conclusion? Select all that apply. High thyroid-stimulating hormone levels Normal T3, low T4 levels Normal T3, T4 levels Low T4 levels Low thyroid-stimulating hormone levels

Low T4 levels Low thyroid-stimulating hormone levels

Which of the following most likely causes Mary's low blood glucose?' Reduced aldosterone Elevated ACTH Low serum sodium Low cortisol

Low cortisol Cortisol is a glucose-sparing hormone, meaning it works to keep blood glucose levels elevated. With inadequate cortisol, blood glucose levels may fall. Neither aldosterone nor ACTH directly affect blood glucose levels.

A patient presents with hyperthyroidism. Which of the following values enables the clinician to rule out secondary hyperthyroidism? Low thyroid-stimulating hormone (TSH) Elevated thyroxine Low thyrotropic releasing hormone (TRH) Elevated T3 levels

Low thyroid-stimulating hormone (TSH) In the hyperthyroidism were secondary, then TSH levels would be high, indicating a problem with the anterior pituitary.

Which of the following laboratory values indicates a primary disorder of the thyroid gland? Low thyrotropin-releasing hormone, low thyroid-stimulating hormone, high thyroid hormone High thyrotropin-releasing hormone, high thyroid-stimulating hormone, high thyroid hormone Low thyrotropin-releasing hormone, low thyroid-stimulating hormone, low thyroid hormone Normal thyrotropin-releasing hormone, normal thyroid-stimulating hormone, normal thyroid hormone

Low thyrotropin-releasing hormone, low thyroid-stimulating hormone, high thyroid hormone

A patient had to have surgery to remove a parathyroid gland tumor. What location of the body should the nurse help prepare for surgery? Superior abdomen Neck Mediastinum Near adrenal glands

Neck

To determine if a patient is suffering from pheochromocytoma, which laboratory value would you examine? Aldosterone Norepinephrine Cortisol Adrenocorticotropic hormone

Norepinephrine

Mr. Ruiz is experiencing reduced adrenocorticotropic hormone (ACTH) from the anterior pituitary and elevated cortisol from the adrenal cortex. PRIMARY SECONDARY TERTIARY

PRIMARY A primary disorder occurs when the problem is in the end organ. In this example, the adrenal cortex is not receiving a signal to produce cortisol, as shown by reduced ACTH from the anterior pituitary. However, the adrenal cortex is continuing to produce cortisol despite a lack of signal.

Ms. Lee is experiencing elevated thyroid-stimulating hormone (TSH) from the anterior pituitary and reduced thyroid hormone levels. PRIMARY SECONDARY TERTIARY

PRIMARY When TSH is elevated, but thyroid hormone levels remain low, this is a primary disorder. The thyroid glands are the problem. They are receiving a signal to produce thyroid hormone, but are unable to respond.

Mr. Thompson's adrenal problem originates in the adrenal cortex. PRIMARY SECONDARY TERTIARY

PRIMARY When the hormonal abnormality originates in the organ itself, it is considered a primary disorder.

The physician states that Janelle may need surgery to remove her thyroid gland. What other endocrine tissues are located near the thyroid glands? Adrenal glands Parathyroid glands Pituitary gland Pineal gland

Parathyroid glands The parathyroid glands are small glands, normally four in number, located on the posterior thyroid. Procedures on the thyroid gland may result in incidental parathyroid injury.

A patient is displaying signs and symptoms of an endocrine disorder. The patient also complains of headaches and visual disturbances. Which of the following tissues will likely require further evaluation? Parathyroid Thyroid Pituitary Adrenal cortex

Pituitary pituitary tumors can cause headaches and disturbances in vision, due to the location of the pituitary gland.

Which of the following individuals would a nurse be most concerned about with respect to the development of Sheehan's syndrome? 15-year-old male Postpartum woman Young child with growth delay Postmenopausal woman

Postpartum woman Sheehan's syndrome, which results from disruption of blood flow to the pituitary gland, most commonly happens after childbirth.

Based on Mary's laboratory results, which form of adrenal insufficiency does Mary have? Primary adrenal insufficiency Secondary adrenal insufficiency Tertiary adrenal insufficiency Pheochromocytoma

Primary adrenal insufficiency Mary's condition is a result of a problem in the adrenal glands not being able to produce cortisol. The adrenal glands are receiving a signal from the anterior pituitary, shown by the elevated ACTH; however, the glands are incapable of responding to this signal. A tertiary condition is a problem in the hypothalamus, and Mary's problem is located within the adrenal glands. A pheochromocytoma is a disorder of the adrenal medulla that would present with elevated epinephrine and norepinephrine levels.

Laboratory values for a patient reveal elevated parathyroid hormone (PTH) and elevated serum calcium levels. What condition is most likely? Primary hypoparathyroidism Primary hyperparathyroidism Secondary hyperparathyroidism Primary hyperthyroidism

Primary hyperparathyroidism

Based on your assessment, the physician decides to have several blood tests completed. All results are normal except the following: significantly elevated thyroid hormone levels (free T3 and free T4) and undetectable TSH and TRH. What endocrine disorder does Janelle most likely have? Primary thyroid hypofunction Secondary thyroid hyperfunction Tertiary thyroid hyperfunction Primary thyroid hyperfunction

Primary thyroid hyperfunction Janelle's condition is hyperthyroidism as indicated by the elevated thyroid hormone levels. The condition is primary, a problem in the thyroid gland, because TSH levels (the signal from the anterior pituitary that stimulates the thyroid gland) are low.

Hyperpituitarism is most commonly caused by which of the following? Prolactinoma Autoimmune disorder Congenital defect Sheehan syndrome

Prolactinoma A Prolactinoma is the most common cause of elevated pituitary activity.

What factor is likely playing a role in Mary's abnormal serum sodium and potassium levels? Elevated ACTH Reduced cortisol Reduced aldosterone Normal PTH

Reduced aldosterone Aldosterone is released from the adrenal cortex and targets the kidneys. Aldosterone stimulates sodium reabsorption and potassium secretion by the kidneys. Without adequate aldosterone, sodium is excreted in the urine, while potassium is reabsorbed.

A patient has been diagnosed with syndrome of inappropriate anti-diuretic hormone (SIADH). Which of the following is the correct approach by the nurse? Frequently encourage the patient to drink water. Restrict fluid intake. Wait to see whether the patient stabilizes before any interventions. Plan to administer an IV for fluid restoration.

Restrict fluid intake. SIADH causes fluid retention so restriction of fluids may be necessary.

Ms. Wallace's adrenal problem originates in the pituitary gland. PRIMARY SECONDARY TERTIARY

SECONDARY A secondary condition arises when the hormonal signaling problem occurs in the pituitary gland.

Mr. Wilson is experiencing elevated adrenocorticotropic hormone (ACTH) from the anterior pituitary and elevated cortisol from the adrenal cortex. PRIMARY SECONDARY TERTIARY

SECONDARY A secondary disorder arises from improper signaling from the anterior pituitary. Normally, elevated cortisol levels should suppress further secretion of ACTH by the anterior pituitary. In a secondary disorder, the anterior pituitary no longer responds appropriately to this signal.

Ms. Ang is experiencing low corticotropin releasing factor (CRF) from the hypothalamus, elevated adrenocorticotropic hormone (ACTH) from the anterior pituitary, and elevated cortisol from the adrenal gland. PRIMARY SECONDARY TERTIARY

SECONDARY Problems in the anterior pituitary result in secondary disorders. In this case, the anterior pituitary is not responding correctly to signals from other glands. Elevated cortisol normally negatively feedbacks and reduces ACTH. Low CRF indicates the anterior pituitary is not being signaled to produce more ACTH. Despite this, the anterior pituitary is continuing to produce elevated ACTH levels, which in turn cause elevated cortisol levels.

Excess antidiuretic hormone is associated with which of the following conditions? Central diabetes insipidus Graves' disease SIADH Hashimoto's thyroiditis

SIADH

Endocrine laboratory values reveal your patient has a tumor of the anterior pituitary. This tumor secretes excess adrenocorticotropic hormone, which stimulates cortisol secretion by the adrenal gland. What type of endocrine dysfunction does your patient have? Primary Secondary Tertiary No hormone dysfunction

Secondary

Which of the following may also result in a "tanned" appearance? Primary adrenal excess Secondary adrenal excess Hypothyroidism Hyperparathyroidism

Secondary adrenal excess Secondary adrenal excess refers to a problem in the anterior pituitary, the organ that synthesizes ACTH. In secondary adrenal excess, ACTH is elevated, along with its precursor molecule, which contains melanocyte-stimulating hormone.

A patient has a hyperfunctioning adrenal cortex tumor. Which of the following will the nurse expect to observe? Hypotension Suppressed adrenocorticotropic hormone (ACTH) levels Suppressed cortisol levels Weight loss

Suppressed adrenocorticotropic hormone (ACTH) levels

Mrs. Smith is experiencing elevated thyrotropic-releasing hormone (TRH) from the hypothalamus, elevated thyroid-stimulating hormone (TSH) from the anterior pituitary, and elevated thyroid hormones. PRIMARY SECONDARY TERTIARY

TERTIARY A tertiary disorder is a signaling problem from the hypothalamus. In this case, the hypothalamus is overproducing TRH, which stimulates TSH, which in turn stimulates the thyroid gland. In a normal response, elevated thyroid hormones would suppress TRH from the hypothalamus through negative feedback.

Mrs. Jacobi's adrenal problem originates in the hypothalamus. PRIMARY SECONDARY TERTIARY

TERTIARY Endocrine disorders originating in the hypothalamus are tertiary disorders.

A nursing student notices elevated thyroid stimulating hormone (TSH) on laboratory values, along with low thyroxine levels. What is the proper interpretation of the results? The patient has secondary hypothyroidism. The patient has primary hypothyroidism. The patient has hyperfunctioning of the anterior pituitary. The patient has Grave's disease.

The patient has primary hypothyroidism.****

You examine Janelle and notes her resting heart rate is 84 beats per minute and blood pressure is 144/88 mm Hg. Which hormone may increase resting heart rate and blood pressure? Oxytocin Growth hormone Thyroid hormone Antidiuretic hormone

Thyroid hormone Thyroid hormones have a stimulatory effect on cardiac tissue. Thyroid hormone increase would be the most likely to account for the increase in heart rate and blood pressure.

Janelle, a 30-year-old woman, presents at her primary care office complaining of feeling nervous and anxious. She states that she even feels as if her heart is racing because she is "so stressed out." Janelle would like to be prescribed antianxiety medication. Janelle's height and weight measurements reveal she has lost 15 pounds in the last 6 months. She attributes her weight loss to stress. What hormone disorder may lead to weight loss? Thyroid hyperfunction Thyroid hypofunction Central diabetes insipidus Posterior pituitary hyperfunction Check Answer

Thyroid hyperfunction Thyroid hormone hyperfunction is commonly associated with weigh loss as thyroid hormones regulate body metabolism. Hyperthyroidism causes an elevation in the basal metabolic rate, which may result in significant weight loss.

A patient presents with secondary hyperthyroidism. Which of the following values does the nurse expect to see reduced on the chart? Thyroid stimulating hormone (TSH) Thyroxine Thyrotropin releasing hormone (TRH) Triiodothyronine

Thyrotropin releasing hormone (TRH) TRH would be reduced by the elevated TSH levels in secondary hyperthyroidism.

Which of the following would demonstrate hypofunction of the posterior pituitary? Select all that apply. Too little aldosterone Too little oxytocin Too little PRL Too little ADH Too little ACTH

Too little PRL Too little ADH Too little ACTH

A nursing student is reviewing signs and symptoms of hyperthyroidism. Which of the following should she include on her list? Select all that apply. Weight loss Tachycardia Lethargy Tremors Cold intolerance

Weight loss Tachycardia Tremors

Acromegaly is caused by __________________. excess growth hormone excess cortisol excess antidiuretic hormone excess thyroid hormone

excess growth hormone

In Cushing's syndrome, a ____________ adrenal gland causes elevated levels of _____________. hypoactive; cortisol hyperactive; adrenocorticotropic hormone hypoactive; adrenocorticotropic hormone hyperactive; cortisol

hyperactive; cortisol

If thyrotropin-releasing hormone, from the hypothalamus, and thyroid-stimulating hormone, from the anterior pituitary, are both lower than normal and thyroid hormone levels are elevated, the thyroid gland is demonstrating ___________________. hypofunction hyperfunction normal function reduced function

hyperfunction

Pheochromocytoma __________________. Select all that apply. results in elevated cortisol levels. is a disorder of the adrenal medulla. results in reduced norepinephrine levels. may cause elevated heart rate and blood pressure. mimics Addison's disease.

is a disorder of the adrenal medulla. may cause elevated heart rate and blood pressure.

Graves' disease ________________. Select all that apply. is an autoimmune condition of the posterior pituitary. is a form of hyperthyroidism. is a neurogenic disorder. causes weight gain, bradycardia, and fatigue. results in elevated thyroid hormones.

is a form of hyperthyroidism.

Destruction or removal of the parathyroid glands will cause _________________. secondary hypoparathyroidism primary hyperparathyroidism primary hypoparathyroidism pheochromocytoma

primary hypoparathyroidism

Central diabetes insipidus _________________. Select all that apply. results in increased plasma osmolarity. results in excess water secretion. causes increased blood glucose. is another form of diabetes mellitus. is caused by oversecretion of ADH.

results in excess water secretion.

Increasing cortisol levels will _____________________. stimulate adrenocorticotropic hormone production stimulate corticotropic-releasing factor production suppress adrenocorticotropic hormone secretion suppress posterior pituitary activity

stimulate corticotropic-releasing factor production