Chapter 43: Drug Therapy for Pituitary and Hypothalamic Dysfunction

A patient is to receive pegvisomant. The nurse would expect to administer this agent by which route? a. Subcutaneous b. Oral c. Intramuscular d. Intravenous

a. Subcutaneous Pegvisomant is administered by subcutaneous injection.

A female client is diagnosed with a pituitary hormone deficiency. She reports that her drug dosages are modified frequently. The nurse explains that the dosage of all pituitary hormones must be individualized. The nurse knows that what factor determines the dosage? a. The responsiveness of affected tissues, which varies b. The age of the client c. The weight of the client d. The responsiveness of affected tissues, which is static

a. The responsiveness of affected tissues, which varies Dosage of all pituitary hormones must be individualized because the responsiveness of affected tissues varies.

What is the duration of action of water-soluble, protein-derived hormones compared to that of lipid-soluble steroid and thyroid hormones? a. The water-soluble hormones have a shorter duration of action. b. The water-soluble hormones have a longer duration of action. c. The water-soluble hormones have the same duration of action. d. No comparison can be made regarding the duration of action.

a. The water-soluble hormones have a shorter duration of action. The lipid-soluble steroid and thyroid hormones have a longer duration of action than water-soluble, protein-derived hormones, because the former are bound to plasma proteins.

Which hormones are controlled by a negative feedback mechanism? (Select all that apply.) a. Thyroid hormone b, Follicle stimulating hormone c. Adrenocorticotropic hormone d. Prolactin e. Growth hormone

a. Thyroid hormone b, Follicle stimulating hormone c. Adrenocorticotropic hormone Thyroid hormone is controlled by the negative feedback system. Follicle stimulating hormone is controlled by the negative feedback system. Adrenocorticotropic hormone is controlled by the negative feedback system. Prolactin is not controlled by the negative feedback system. Growth hormone is not controlled by the negative feedback system.

Which of the following drugs is most commonly used in the treatment of bleeding esophageal varices? a. Vasopressin b. Pitocin c. Thyrogen d. Somavert

a. Vasopressin Pitocin functions in childbirth and lactation. Somavert is a GH receptor antagonist used in the treatment of acromegaly in adults who are unable to tolerate or are resistant to other management strategies. Thyrogen is a synthetic formulation of TSH used as a diagnostic adjunct for serum thyroglobulin (Tg) testing in individuals with well-differentiated thyroid cancer. Vasopressin is used as a vasoconstrictor for bleeding varices.

During physical examination of a client with a suspected endocrine disorder, the nurse assesses the body structures. The nurse gathers this data based on the understanding that it is an important aid in: a. detecting evidence of hormone hypersecretion. b. detecting information about possible tumor growth. c. determining the presence or absence of testosterone levels. d. determining the size of the organs and location.

a. detecting evidence of hormone hypersecretion. The evaluation of body structures helps the nurse detect evidence of hypersecretion or hyposecretion of hormones. This helps in the assessment of findings that are unique to specific endocrine glands. Radiographs of the chest or abdomen are taken to detect tumors. Radiographs also determine the size of the organ and its location. Antidiuretic hormone (ADH) levels determine the presence or absence of ADH and testosterone levels.

A client is receiving prednisone. When reviewing electrolyte level results, which would the nurse identify as an adverse reaction related to drug therapy? Select all that apply. a. hypokalemia b. hypernatremia c. hypocalcemia d. hyperkalemia e. hyponatremia

a. hypokalemia b. hypernatremia c. hypocalcemia Electrolyte disturbances associated with glucocorticoids such as prednisone include sodium retention (hypernatremia), potassium loss (hypokalemia), and hypocalcemia. The major cause of hyperkalemia is kidney dysfunction. Common causes of hyponatremia include diuretic use, diarrhea, heart failure, liver disease, renal disease, and the syndrome of inappropriate ADH secretion (SIADH).

Hypothalamic hormones must be given by what route to avoid destruction? Select all that apply. a. injection b. topically c. vaginally d. sublingually e. nasal inhalation

a. injection e. nasal inhalation Because the hormones are proteins, they must be given by injection or nasal inhalation (nafarelin). If taken orally, the hormones would be destroyed by the proteolytic enzymes in the gastrointestinal (GI) tract.

What hormones does the pancreas produce and release that help moderate the body's varying blood glucose levels? Select all that apply. a. insulin b. antidiuretic hormone (ADH) c. glucagon d. somatostatin e. amylase

a. insulin c. glucagon d. somatostatin The pancreas produces and releases insulin, glucagon, and somatostatin from different cells in response to varying blood glucose levels. ADH does not respond to blood glucose levels but controls sodium and potassium levels. Amylase is an enzyme released by the pancreas.

What effect do growth hormones (GH) have on homeostasis? Select all that apply. a. regulation of cell division b. regulation of protein synthesis c. programming of cell apoptosis d. stimulation of triglyceride synthesis e. sex determination during fetal development

a. regulation of cell division b. regulation of protein synthesis d. stimulation of triglyceride synthesis GH, also called somatotropin, stimulates growth of body tissues. It regulates cell division and protein synthesis required for normal growth and promotes an increase in cell size and number, including growth of muscle cells and lengthening of bone. GH enhances fat utilization by stimulating triglyceride breakdown and oxidation in fat-storing cells. GH does not influence apoptosis or sex determination.

A critically ill client is being treated with desmopressin. When reviewing the diagnostic and laboratory findings of a client prescribed desmopressin, the nurse should prioritize what values? Select all that apply. a. sodium (Na) b. potassium (K) c. hemoglobin (Hgb) d. leukocytes (WBC) e. partial thromboplastin time (PTT)

a. sodium (Na) b. potassium (K) Because of the profound changes in fluid balance that exist before and after treatment with desmopressin, it is important to assess the serum electrolytes, particularly the sodium and potassium levels. This takes precedence over coagulation factors, red blood cell indices, and white cell levels.

The nurse is assessing a child who is receiving growth hormone therapy. What would the nurse identify as suggesting glucose intolerance? a. Injection site pain b. Fatigue c. Thirst d. Cold intolerance

c. Thirst Signs of glucose intolerance include thirst, hunger, and voiding pattern changes. Injection site pain is an adverse effect of the therapy. Fatigue and cold intolerance suggest thyroid dysfunction.

A child is receiving growth hormone therapy. The nurse suspects possible thyroid dysfunction based on which assessment? a. Cold intolerance b. Thirst c. Hunger d. Increased urination

a. Cold intolerance Intolerance to cold is associated with thyroid dysfunction. Thirst is associated with glucose intolerance. Hunger would reflect glucose intolerance. Increased urination would reflect glucose intolerance.

A child with von Willebrand's disease requires an intravenous injection of 0.3 mcg/kg of desmopressin in 50 mL of sterile saline. The child weighs 15 kg. How much desmopressin should be administered? a. 4.5 mcg b. 0.02 mcg c. 50 mcg d. 45 mcg

a. 4.5 mcg 15 kg × 0.3 mcg/kg = 4.5 mcg.

Somatropin would be prescribed for which of these patients? a. A 5-year-old with short stature and Turner syndrome b. A 5-year-old with short stature and history of open heart surgery in the past month c. A 7-year-old with short stature and recently involved in an ATV rollover d. A 12-year-old with short stature and closure of the growth plates

a. A 5-year-old with short stature and Turner syndrome Somatropin is used as long-term replacement therapy for children who have a growth failure secondary to inadequate endogenous GH secretion and those with short stature caused by Turner syndrome. Somatropin stimulates linear growth in such patients, resulting in an increase in skeletal growth. Therefore, it is given for short stature only when the epiphyses are not closed. Somatropin is not indicated for patients with acute critical illness due to complications following open heart or abdominal surgery, multiple accidental trauma, or acute respiratory failure because of an increased risk of mortality with these conditions.

Damage to which lobe of the pituitary gland would result in problems related to the function of stimulating hormones? a. Anterior b. Posterior c. Intermediate d. Lateral

a. Anterior The pituitary is made up of three lobes: Anterior, posterior, and intermediate. The anterior lobe produces stimulating hormones in response to hypothalamic stimulation.

A client is to undergo fertility treatment and is to receive an agent that induces ovulation because her ovaries are functioning. Which agent would this most likely be? a. Chorionic gonadotropin b. Corticotropin c. Cosyntropin d. Thyrotropin alfa

a. Chorionic gonadotropin Chorionic gonadotropin would be used to induce ovulation in females with functioning ovaries. Corticotropin and cosyntropin are used to diagnose adrenal function. Thyrotropin alfa is used as adjunctive treatment for radioiodine ablation of thyroid tissue for thyroid cancer.

After teaching a group of students about growth hormone agonists and antagonists, the instructor determines that additional teaching is needed when the students identify which agent as a growth hormone antagonist? a. Somatropin b. Bromocriptine c. Octreotide d. Pegvisomant

a. Somatropin Somatropin is a growth hormone agonist.

The primary function of the thyroid gland includes: a. Control of cellular metabolic activity b. Facilitation of milk ejection c. Reabsorption of water d. Reduction of plasma level of calcium

a. Control of cellular metabolic activity The primary function of the thyroid hormone is to control cellular metabolic activity. Oxytocin facilitates milk ejection during lactation and increases the force of uterine contraction during labor and delivery. Antidiuretic hormone (ADH) release results in reabsorption of water into the bloodstream rather than excretion by the kidneys. Calcitonin reduces the plasma level of calcium by increasing its deposition in bone.

Which would be used to diagnose adrenal function? a. Corticotropin b. Chorionic gonadotropin c. Thyrotropin alfa d. Menotropins

a. Corticotropin Cosyntropin, a synthetic form of corticotropin, is used to diagnose adrenal function. Chorionic gonadotropin would be used to induce ovulation in females with functioning ovaries. Thyrotropin alfa is used as adjunctive treatment for radioiodine ablation of thyroid tissue for thyroid cancer. Menotropins are used as a fertility drug to stimulate ovulation and spermatogenesis.

After administering desmopressin to a client with diabetes insipidus, which would the nurse identify as indicating drug effectiveness? a. Decreased reports of thirst b. Elevated blood glucose levels c. Increased urination d.Decreased skin turgor

a. Decreased reports of thirst Thirst is associated with diabetes insipidus. A decrease in the symptom would indicate that the drug is working. Diabetes insipidus causes elevated blood glucose levels. Diabetes insipidus causes polyuria. Decreased skin turgor would suggest dehydration, which is a sign of diabetes insipidus.

A client diagnosed with diabetes insipidus is taking vasopressin (Desmopressin). What outcome would indicate to the nurse that the desmopressin is producing a therapeutic effect? a. Decreased urine output b. Decreased water reabsorption c. Increased plasma osmolarity d. Decreased blood volume

a. Decreased urine output Vasopressin causes the cortical and medullary parts of the collecting duct to become permeable to water, increasing water reabsorption and decreasing urine output. This process produces decreased plasma osmolarity and increases blood volume.

Which is released in response to decreased oxygenated blood flowing through the kidneys? a. Erythropoietin b. Glucagon c. Calcitonin d. Aldosterone

a. Erythropoietin Erythropoietin is released in response to a decrease in oxygenated blood flowing through the kidneys. Glucagon is released based on blood glucose levels. Calcitonin is released in response to serum calcium levels. Aldosterone is released in response to ACTH and to high potassium levels.

Which of the following should be included in the nurse's pre-administration assessment of a client about to receive somatropin ? Select all that apply: a. Height b. Weight c. Blood pressure d. Pulse e. Respiratory rate

a. Height b. Weight c. Blood pressure d. Pulse e. Respiratory rate Blood pressure, pulse, respiratory rate, temperature, height and weight should be included in the nurse's pre-administration assessment of a client about to receive somatropin (Nutropin).

The anatomy and physiology instructor is discussing hormones with the pre-nursing class. Which gland would the instructor tell the students controls secretions of the pituitary gland? a. Hypothalamus b. Pineal c. Thyroid d. Adrenal cortex

a. Hypothalamus The hypothalamus uses a number of hormones or factors to either stimulate or inhibit the release of hormones from the anterior pituitary. These factors are not secreted by the pineal, the thyroid, and the adrenal cortex.

A client is experiencing an increase in blood glucose levels. The nurse understands that which hormone would be important in lowering the client's blood glucose level? a. Insulin b. Parathormone c. Melatonin d. Calcitonin

a. Insulin Insulin is a hormone released by the beta islet cells that lowers the level of blood glucose when it rises above normal limits. Parathormone increases the level of calcium in the blood when a decrease in serum calcium levels occurs. Melatonin aids in regulating sleep cycles and mood. Calcitonin is a thyroid hormone that inhibits the release of calcium from the bone into the extracellular fluid.

What qualifies the hypothalamus to be called the master gland? a. It regulates the nervous and endocrine responses to stimuli. b. It stimulates the pituitary gland to control the endocrine system. c. It combines the nervous and endocrine system to work together. d. It produces all of the releasing hormones in the body.

a. It regulates the nervous and endocrine responses to stimuli. The hypothalamus gland is called the master gland of the neuroendocrine system because it regulates both nervous and endocrine responses to internal and external stimuli. There is more to the hypothalamus than just its stimulation of the pituitary gland or its production of releasing hormones that leads it to be considered the master gland. The neuroendocrine system combines the nervous and endocrine systems to work closely together to maintain regulatory control and homeostasis in the body.

After reviewing the hormonal secretion of the pituitary gland, the students demonstrate understanding when they identify which hormone as being released by the posterior lobe? a. Oxytocin b. Endorphins c. Thyrotropin d. Growth hormone

a. Oxytocin Oxytocin is released by the posterior pituitary gland. Endorphins are released by the intermediate lobe of the pituitary gland. Thyrotropin or thyroid releasing hormone is released from the anterior pituitary gland. Growth hormone is released by the anterior pituitary gland.

Which hormone is important for milk production in a lactating woman? a. Prolactin b. Oxytocin c. Luteinizing hormone d. Estrogen

a. Prolactin Prolactin is responsible for milk production in lactating women. Oxytocin is responsible for uterine contraction and the let down reflex. Luteinizing hormone is important in regulating the secretion of estrogen and progesterone in the menstrual cycle and in regulating the secretion of testosterone in males. Estrogen is responsible for the development of secondary sex characteristics in the female.

Which event would mark the beginning of diurnal rhythm? a. Secretion of corticotropin releasing factor b. Peaking of adrenocortical response c. Falling levels of melanocyte stimulating hormone d. Release of follicle stimulating hormone

a. Secretion of corticotropin releasing factor Secretion of corticotropin releasing factor is the beginning event of diurnal rhythm. This event occurs usually early in the morning of the diurnal rhythm. Melanocyte stimulating hormone does not play a role in diurnal rhythm. Follicle stimulating hormone plays a role in the menstrual cycle.

Which hormones are responsible for the growth of the body during childhood, especially the growth of muscles and bones? a. somatotropin b. vasopressin c. gonadotropin d. adrenocorticotropic hormone (ACTH)

a. somatotropin Somatropin is the hormone responsible for the growth of the body during childhood, especially the growth of muscles and bones. Vasopressin is the hormone responsible for the regulation of reabsorption of water by the kidneys. The gonadotropins (FSH and LH) influence the secretion of sex hormones, the development of secondary sex characteristics, and the reproductive cycle in both men and women. ACTH stimulates the adrenal cortex to secrete the corticosteroids in response to biologic stress.

What is the main purpose of the hormones secreted by the hypothalamus? a. stimulating or inhibiting release of hormones from the pituitary b. stimulating organs within the body to secrete hormones c. allowing the secretion of hormones from the hypothalamus d. stimulating other glands to release hormones

a. stimulating or inhibiting release of hormones from the pituitary The hypothalamus uses various hormones or factors to either stimulate or inhibit the release of hormones from the anterior pituitary. These do not stimulate other organs, the hypothalamus, or other glands to release hormones.

Diabetes insipidus is treated with replacement of which hormones? a. vasopressin b. gonadotropin c. somatropin d. adrenocorticotropic hormone (ACTH)

a. vasopressin Diabetes insipidus is treated with replacement of vasopressin. Gonadotropins are used to induce ovulation and pregnancy in anovulatory women (women whose bodies fail to produce an ovum or fail to ovulate). Of recombinant DNA origin, somatropin is identical to human GH and produces skeletal growth in children. This drug is administered to children who have not grown because of a deficiency of pituitary GH; it must be used before closure of the child's bone epiphyses. Bone epiphyses are the ends of bones. ACTH is produced by the anterior pituitary and stimulates the adrenal cortex to secrete the corticosteroids in response to biologic stress.

A group of nursing students are reviewing information about hormones secreted by the posterior pituitary gland. The students demonstrate understanding when they identify which hormone? a. vasopressin b. gonadotropin c. growth hormone d. adrenocorticotropic hormone (ACTH)

a. vasopressin Vasopressin is a hormone secreted by the posterior pituitary gland. Gonadotropin, growth hormones, and adrenocorticotropic hormones are secreted by the anterior pituitary gland.

Which hormones are responsible for the regulation of reabsorption of water by the kidneys? a. vasopressin b. gonadotropin c. somatotropin d. adrenocorticotropic hormone (ACTH)

a. vasopressin Vasopressin is the hormone responsible for the regulation of reabsorption of water by the kidneys. The gonadotropins (FSH and LH) influence the secretion of sex hormones, the development of secondary sex characteristics, and the reproductive cycle in both men and women. GH, also called somatotropic hormone, is secreted by the anterior pituitary. This hormone regulates the growth of the individual until approximately early adulthood or the time when the person no longer gains height. ACTH stimulates the adrenal cortex to secrete the corticosteroids in response to biologic stress.

Deficiency of which hormone causes excessive and frequent urination and excessive thirst? a. Prolactin deficiency b. ADH deficiency c. TSH deficiency d. ACTH deficiency

b. ADH deficiency Antidiuretic hormone (ADH), also called vasopressin, functions to regulate water balance. When ADH is secreted, it makes renal tubules more permeable to water. This allows water in renal tubules to be reabsorbed into the plasma and so conserves body water. In the absence of ADH, little water is reabsorbed, and large amounts are lost in the urine.

The pharmacology instructor is discussing hormones with the nursing students. What hormone, important in the digestive process, is secreted by the gastrointestinal mucosa? a. Liothyronine b. Cholecystokinin c. Tetraiodothyronine d. Prolactin

b. Cholecystokinin Gastrointestinal mucosa produces hormones that are important in the digestive process (i.e., gastrin, enterogastrone, secretin, and cholecystokinin).

The nurse would contact the health care provider prior to administering desmopressin to a client with a history of what condition? a. Allergy to bananas b. Heart attack c. Detached retina d. Gout

b. Heart attack Desmopressin is contraindicated in clients with a history of cardiovascular disorders because a black box warning stipulates that changes in fluid volume status may result in cardiac arrest in clients with known cardiovascular disease.

The nursing students in pharmacology class are learning about menotropin. What would they learn this drug is used to treat? a. Promote development of secondary sex characteristics b. Induce ovulation c. Promote bone growth d. Treat diabetes insipidus

b. Induce ovulation Menotropin is used as fertility drug to stimulate ovulation and spermatogenesis. is not used to promote the development of secondary sex hormones, promote bone growth, or treat diabetes insipidus.

Hypothalamic hormones must be given by which route to avoid destruction? a. Topically or vaginal suppository b. Injection or nasal inhalation c. Sublingually or nasal inhalation d. Injection or sublingually

b. Injection or nasal inhalation Because the hormones are proteins, they must be given by injection or nasal inhalation. If taken orally, the hormones would be destroyed by the proteolytic enzymes in the GI tract.

A client is to receive nafarelin. The nurse would instruct the client in administering this drug by which route? a. Oral b. Intranasal c. Intramuscular d. Subcutaneous

b. Intranasal Nafarelin is given in nasal form.

The pharmacology instructor is discussing the endocrine system with a class of pre-nursing students. What would the instructor tell the students is considered to be a hormone? a. Acetylcholine b. Norepinephrine c. Nucleic acid d. Serotonin

b. Norepinephrine A hormone is secreted directly into the blood stream and travels from the site of production to react with specific receptor sites to cause an action. Norepinephrine, which is a neurotransmitter, is a hormone when it is produced in the adrenal medulla, secreted into circulation, and travels to norepinephrine receptor sites to cause an effect. Acetylcholine and serotonin are neurotransmitters, but are not hormones. Nucleic acid is used to build DNA and RNA.

The nurse is preparing to administer octreotide. The nurse expects to administer this drug by which route? a. Oral b. Subcutaneous c. Intramuscular d. Intranasal

b. Subcutaneous Octreotide must be administered subcutaneously.

Which hormone is released in the presence of low blood volume? a. growth hormone (GH) b. antidiuretic hormone (ADH) c. adrenocorticotropic hormone (ACTH) d. thyroid-stimulating hormone (TSH)

b. antidiuretic hormone (ADH) Secretion of ADH (vasopressin) occurs when body fluids become concentrated (high amounts of electrolytes in proportion to the amount of water) and when blood volume is low. None of the other hormones are secreted in cases of low blood volume.

A nurse is caring for a 70-year-old client who is taking desmopressin (DDAVP). The client has a history of cardiovascular disease. The nurse will prioritize the assessment of: a. weight. b. electrolyte levels. c. dehydration. d. body temperature.

b. electrolyte levels. Desmopressin should be used with caution in clients with conditions associated with fluid and electrolyte imbalance, such as cystic fibrosis or renal or cardiovascular diseases, because these clients are especially prone to hyponatremia. When administered to either pediatric or geriatric individuals, fluid intake should be adjusted downward to limit the risk of hyponatremia and water intoxication. The drug has no effect on the weight or the temperature of the client. There is no risk for dehydration.

A client is diagnosed with diabetes insipidus. The health care provider orders desmopressin, which the nurse knows is the synthetic equivalent of what hormone? a. PTH b. ACTH c. ADH d. PTCH

c. ADH Desmopressin (DDAVP, Stimate) and vasopressin (Pitressin) are synthetic equivalents of ADH. A major clinical use is the treatment of neurogenic diabetes insipidus, a disorder characterized by a deficiency of ADH and the excretion of large amounts of dilute urine.

The release of FSH and LH are stimulated by what hormone? a. Thyrotropin-releasing hormone b. Prolactin-releasing factor c. Gonadotropin-releasing factor d. Melanocyte-stimulating hormone

c. Gonadotropin-releasing factor Factors that stimulate the release of hormones are growth hormone-releasing hormone (GHRH), thyrotropin-releasing hormone (TRH), gonadotropin-releasing hormone (GnRH), corticotropin-releasing hormone (CRH), and prolactin-releasing hormone (PRH).

A 45-year-old client is receiving somatropin for treatment of a growth hormone deficiency. The nurse educates the client that regular laboratory tests will be needed to monitor the client for which adverse effect? a. Leukocytosis b. Renal dysfunction c. Hyperglycemia d. Hyponatremia

c. Hyperglycemia Middle-aged and older adults who use GH for treatment of a growth hormone deficiency are at high risk for the development of hyperglycemia.

Which hormone would be responsible for the letdown reflex in lactating women? a. Prolactin b. Follicle-stimulating hormone c. Oxytocin d. Luteinizing hormone

c. Oxytocin Oxytocin stimulates uterine smooth muscle contraction in late pregnancy and also causes the milk release or letdown reflex in lactating women. Prolactin is the hormone responsible for milk production. Follicle-stimulating hormone and luteinizing hormone are responsible for the initial events of the menstrual cycle.

An instructor is preparing a teaching plan for a class on the various pituitary hormones. Which hormone would the instructor include as being released by the posterior pituitary gland? a. Somatotropin b. Prolactin c. Oxytocin d. Adrenocorticotropic hormone

c. Oxytocin The posterior pituitary gland releases oxytocin and antidiuretic hormone. Somatotropin, prolactin, and adrenocorticotropic hormone are released by the anterior pituitary gland.

The client, prescribed posterior pituitary hormone therapy, demonstrates the technique used to deliver the medication nasally. Which action requires immediate review of the technique by the nurse? a. Sits upright in a chair b. Inserts tip of bottle into nostril 1/2 inch c. The head is tilted back d. Presses finger against one nostril to occlude it

c. The head is tilted back Instruct the patient to sit upright and press a finger over one nostril to close it. Then, with the spray bottle held upright, have the patient place the tip of the bottle about 1.5 cm (1/2 in.) into the open nostril. A firm squeeze should deliver the drug to the desired mucosal area for absorption. Caution the patient not to use excessive force and not to tip the head back because these actions could result in ineffective administration.

Which of the following hypothalamic hormones causes the release of TSH in response to stress, such as exposure to cold? a. Growth hormone-releasing hormone (GHRH) b. Gonadotropin-releasing hormone (GnRH) c. Thyrotropin-releasing hormone (TRH) d. Prolactin-inhibitory factor (PIF)

c. Thyrotropin-releasing hormone (TRH) In response to stress, the hypothalamus releases TRH, which stimulates the pituitary to produce TSH (thyrotropin).

Your client, an 18-year-old bodybuilder, indicates that he is considering using growth hormones to increase his muscle mass. When discussing this, you would advise him about all of the following EXCEPT: a. Possible adverse effects include acromegaly and diabetes. b. Possible adverse effects include hypertension and increased risk of cardiovascular disease. c. Using growth hormone in moderate amounts can make the heart function more efficiently. d. Using growth hormones is potentially dangerous because the long-term effects are unknown.

c. Using growth hormone in moderate amounts can make the heart function more efficiently. Inappropriate use of GH is an increasing concern. Young athletes may use the drug for bodybuilding and to enhance athletic performance. If so, they are likely to use relatively high doses. In addition, the highest levels of physiologic hormone are secreted during adolescence. The combination of high pharmacologic and high physiologic amounts increases the risks of health problems from excessive hormone. Also, there is little evidence that hormone use increases muscle mass or strength beyond that achieved with exercise alone.

The process in which hormone secretion is stimulated when hormones are needed and inhibited when they are not needed is known as: a. cyclic patterns. b. a positive feedback system. c. a negative feedback system. d. releasing and inhibitory factors.

c. a negative feedback system. A negative feedback system is one in which hormone secretion is stimulated when hormones are needed and inhibited when they are not needed. The hypothalamic-pituitary-thyroid axis also functions by a negative feedback mechanism.

After administering somatropin to an 11-year-old client with growth failure, what outcome would indicate that the drug should be stopped? a. early sexual development b. thyroid over activity c. closure of the epiphyses in long bones d. gynecomastia

c. closure of the epiphyses in long bones Closure of the epiphyses is a sign that the drug should be stopped. Early sexual development, thyroid overactivity, and gynecomastia would not be associated with this drug.

The hypothalamus is the gland that helps regulate the CNS and ANS and the endocrine system. By regulating these systems, the hypothalamus works to maintain the: a. negative feedback system. b. diurnal rhythm. c. homeostasis. d. prolactin-inhibiting factor (PIF).

c. homeostasis. The hypothalamus works to help maintain homeostasis or a balance between the endocrine system and the CNS and ANS. The negative feedback system is how the homeostasis is maintained. When the hypothalamus senses a need for a certain hormone, it secretes a releasing factor directly into an area such as the anterior pituitary. This causes the area to produce a hormone. When the hypothalamus senses a rising level of the hormone, it stops secreting the releasing factor, which decreases the hormone production. When this occurs, the hypothalamus senses the falling hormone level and the releasing factor is secreted again. This process is how the hormone level is maintained. Diurnal rhythm refers to the release of hormones at various times of the day. PIF produced by the hypothalamus acts as a regulator to shut off production of hormones when levels become too high.

What is the regulatory function of vasopressin? a. growth b. lactation c. water balance d. corticosteroid production

c. water balance Antidiuretic hormone (ADH), also called vasopressin, functions to regulate water balance. Corticotropin stimulates corticosteroid production. Oxytocin is involved in lactation. Growth hormone stimulates growth of body tissues.

Some hormones are secreted in cyclic patterns. How long is the time pattern related to secretion of estrogen and progesterone? a. 24 hours b. 5 weeks c. 7 days d. 28 days

d. 28 days Estrogen and progesterone secretion is related to the menstrual cycle, which is typically 28 days long.

When the release of a hormone is not influenced by the HPA, what is their release in response to? a. Indirect local stimulation b. Direct delayed stimulation c. Indirect delayed stimulation d. Direct local stimulation

d. Direct local stimulation Some hormones are not influenced by the HPA and are released in response to direct, local stimulation.

Growth hormones cause all of the following EXCEPT: a. Stimulation and growth of body tissues. b. Regulation of cell division and protein synthesis. c. Promotion of an increase in cell size and number. d. Suppression of triglyceride synthesis.

d. Suppression of triglyceride synthesis. GH, also called somatotropin, stimulates growth of body tissues. It regulates cell division and protein synthesis required for normal growth and promotes an increase in cell size and number, including growth of muscle cells and lengthening of bone. These effects occur mainly via altered metabolism of carbohydrate, protein, and fat by direct and indirect effects. GH is often considered an insulin antagonist because it suppresses the abilities of insulin to stimulate uptake of glucose in peripheral tissues and enhance glucose synthesis in the liver.

A nurse is organizing the care of a child who takes somatropin. The desired outcome the nurse should prioritize in the planning of this child's care is that the client will: a. experience a normal progression of secondary sex characteristics. b. not demonstrate the signs and symptoms of water intoxication. c. deny feelings of anxiety. d. demonstrate an increase in linear growth.

d. demonstrate an increase in linear growth. The primary indication for the use of somatotropin is GH deficiency leading to short stature. Anxiety, water intoxication, and lack of sex characteristics are not associated with GH deficiency and are not addressed through the therapeutic use of somatropin.

A 65-year-old client was involved in a motor vehicle accident and sustained a closed head injury. He is diagnosed with diabetes insipidus and is prescribed vasopressin for the management of this condition. Which condition would pose a risk for this client as a vasopressin recipient? a. gender would be a risk factor b. if the client has abused alcohol in the past c. has a history of chronic obstructive pulmonary disease d. has a history of left ventricular enlargement

d. has a history of left ventricular enlargement Vasopressin should be used with caution in patients with coronary artery insufficiency or those who are hypertensive. Vasopressin is used cautiously in patients with a history of seizures, migraine headaches, asthma, heart failure (HF), or vascular disease (because the substance may precipitate angina or myocardial infarction) and in those with perioperative polyuria.

What organs function to control most of the body's metabolic functions and maintain homeostasis? Select all that apply. a. gonads b. thyroid c. adrenal gland d. hypothalamus e. pituitary gland

d. hypothalamus e. pituitary gland The hypothalamus of the brain and the pituitary gland interact to control most metabolic functions of the body and to maintain homeostasis. The hypothalamus controls secretions of the pituitary gland. The pituitary gland, in turn, regulates secretions or functions of other body tissues, called target tissues. The functions of the other glands are more limited in scope.