Endocrine Questions

A common electrolyte imbalance found in patients with syndrome of inappropriate antidiuretic hormone is __________. a. hyponatremia. c. hyperglycemia. b. hyperkalemia. d. hypochloremia.

a. hyponatremia

Why are vital signs important in assessing thyroid function? a. It's good practice. b. Vital signs are part of the assessment. c. The patient expects it. d. Vital signs reflect the metabolic rate.

d. Vital signs reflect the metabolic rate.

The patient is preparing to go home. What important teaching points should the nurse include? (Select all that apply.) A. "Report any difficulty with orientation to time, place, or person." B. "Note how many hours you sleep in a 24-hr period." C. "Be sure that you take your medication every day at the same time." D. "Your diet should be low-fiber, but with plenty of fluids." E. "Call the provider if you develop an unsteady gait or tremors in your hands."

A. "Report any difficulty with orientation to time, place, or person." B. "Note how many hours you sleep in a 24-hr period." C. "Be sure that you take your medication every day at the same time." E. "Call the provider if you develop an unsteady gait or tremors in your hands." Patients should not take OTC drugs because thyroid hormone preparations interact with many drugs. The patient should always consult the provider before taking any OTC preparations. The diet should include fiber to prevent constipation. When the patient becomes constipated, the dose of replacement thyroid hormone may need to be increased. When the patient has difficulty getting to sleep and has more bowel movements than normal, the dose may need to be decreased.

If a patient has hypothyroidism, what would the thyroid-stimulating hormone level be? a. Increased b. Decreased c. Normal d. Not used to evaluate hypothyroidism

A. increased

Which of the following is the primary hormone for the long-term regulation of sodium balance? a) Aldosterone b) Thyroxin c) Calcitonin d) Antidiuretic hormone (ADH)

Aldosterone

Facial edema that is associated with long-term untreated hypothyroidism is called __________. a. cretinism b. myxedema c. tetany d. thyroiditis

B. myxedema

The provider orders laboratory work that includes thyroid function tests. Which results does the nurse expect to see? A. Increased T3 and T4 levels B. Decreased TSH level C. Decreased T3 and T4 levels D. Normal T3 and T4 levels

C. Decreased T3 and T4 levels Laboratory findings for hypothyroidism include decreased T3 and T4 levels, and increased TSH levels with primary hypothyroidism. With secondary hypothyroidism, the TSH level can be close to normal.

The most visible sign of Graves' disease is __________. a. swelling of the neck b. exophthalmus c. weight loss d. irritability

C. weight loss

Which statement by the patient indicates the need for additional teaching about her condition? A. "When I go home I should check my heart rate and BP every day." B. "I will call my provider if I notice any change in level of consciousness." C. "I will be sure to include fiber in my diet and drink plenty of water." D. "When I am feeling better in a few months I will no longer need to take the Synthroid pills."

D. "When I am feeling better in a few months I will no longer need to take the Synthroid pills." The most important educational need for the patient with hypothyroidism is about hormone replacement therapy and its side effects. The need to take these drugs is life-long.

The most reliable test for acromegaly is the __________. a. parathyroid hormone. b. cortisol level. c. thyroid-stimulating hormone level. d. glucose tolerance test.

d. glucose tolerance test.

A 45-year-old woman who is seeing her health care provider states that she is tired all the time and has muscle aches and pains. Assessment reveals a heart rate of 56/min and a BP of 96/58. She has non-pitting edema of her face, especially around her eyes, and in her hands and feet. Her health history includes radioactive iodine (RAI) for hyperthyroidism. What diagnosis does the nurse expect for this patient?

Rule out hypothyroidism - most cases of hypothyroidism in the U.S. occur as a result of thyroid surgery and radioactive iodine treatment of hyperthyroidism. Supporting data: hr, non pitting edema, BP, tx for hyperthyroidism

A tumor of the adrenal medulla causing excessive secretion of catecholamines and resulting in hypertension is a __________. a. leiomyoma. c. pituitary tumor. b. sarcoma. d. pheochromocytoma.

d. pheochromocytoma.

Two hormones produced by the posterior pituitary gland (neurohypophysis) are __________. a. antidiuretic hormone (ADH) and oxytocin. b. growth hormone (GH) and adrenocorticotropic hormone (ACTH). c. thyroid-stimulating hormone (TSH) and growth hormone (GH). d. follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

a. antidiuretic hormone (ADH) and oxytocin.

A group of students are reviewing information about the relationship of the hypothalamus and the pituitary gland. The students demonstrate the need for additional study when they state which of the following? a) "The pituitary gland, as the master gland, controls the secretion of hormones by the hypothalamus." b) "The hypothalamus, a portion of the brain between the cerebrum and brain stem, creates a pathway for neurohormones." c) "The hypothalamus secretes releasing hormones that stimulate or inhibit pituitary gland secretions." d) "Corticotropin-releasing hormone from the hypothalamus triggers ACTH secretion by the pituitary gland."

a) "The pituitary gland, as the master gland, controls the secretion of hormones by the hypothalamus."

Before discharge, what should a nurse instruct a client with Addison's disease to do when exposed to periods of stress? a) Administer hydrocortisone I.M. b) Perform capillary blood glucose monitoring four times daily. c) Continue to take his usual dose of hydrocortisone. d) Drink 8 oz of fluids.

a) Administer hydrocortisone I.M.

The adrenal cortex is responsible for producing which substances? a) Glucocorticoids and androgens b) Mineralocorticoids and catecholamines c) Norepinephrine and epinephrine d) Catecholamines and epinephrine

a) Glucocorticoids and androgens

A patient who has had a total parathyroidectomy has returned to the unit from PACU. The nurse caring for the patient knows to assess for what complication following this surgery? a) Muscle twitching b) Hypercalcemia c) Fatigue d) Hemorrhage

a) Muscle twitching

A patient has been diagnosed with Cushing's syndrome. The nurse would expect which of the following features to be present upon physical examination? a) Purple striae b) Truncal obesity c) "Moon face" d) "Buffalo hump" e) Thin extremities

a) Purple striae b) Truncal obesity c) "Moon face" d) "Buffalo hump" e) Thin extremities

When caring for a client who's being treated for hyperthyroidism, the nurse should: a) balance the client's periods of activity and rest. b) provide extra blankets and clothing to keep the client warm. c) encourage the client to be active to prevent constipation. d) monitor the client for signs of restlessness, sweating, and excessive weight loss during thyroid replacement therapy.

a) balance the client's periods of activity and rest.

The most common cause of hyperparathyroidism is __________. a. an adenoma. b. Wilson's disease c. accidental removal or damage of the parathyroid glands d. hypothyroidism

a. an adenoma

Which of the following agents suppress release of thyroid hormones? Select all that apply. a) Methimazole b) Dexamethasone c) Potassium iodide d) Sodium iodide e) Saturated solution of potassium iodide (SSKI)

b) Dexamethasone c) Potassium iodide d) Sodium iodide e) Saturated solution of potassium iodide (SSKI)

A patient presents at the walk-in clinic complaining of diarrhea and vomiting. The patient has a history of adrenal insufficiency. Considering the patient's history and current symptoms, what would the nurse instruct the patient? a) Increase his intake of potassium until the gastrointestinal symptoms improve b) Increase his intake of sodium until the gastrointestinal symptoms improve c) Increase his intake of calcium until the gastrointestinal symptoms improve d) Increase his intake of glucose until the gastrointestinal symptoms improve

b) Increase his intake of sodium until the gastrointestinal symptoms improve

A patient has undergone a cerebral angiogram and the arterial access catheter has been removed. The nurse should apply pressure to the arterial puncture site for __________. a. 5 minutes. c. 25 minutes. b. 15 minutes. d. 30 minutes.

b. 15 minutes

A 42-year-old woman reports excessive weight gain in the abdomen and shoulders, excessive hair growth on her face, and an intermittent menses. The reported signs are associated with __________. a. Addison's disease. b. Cushing's syndrome. c. gigantism. d. diabetes insipidus.

b. Cushing's syndrome.

Of the following information obtained during a health history, what would indicate a possible thyroid problem? a. Eats three well-balanced meals a day b. Has gained 15 pounds in the past 3 months c. Sleeps 8 hours a night d. Reports a regular menstrual cycle

b. Has gained 15 pounds in the past 3 months

Excessive output of dilute urine from an antidiuretic hormone (ADH) abnormality is characteristic of __________. a. hyperthyroidism. b. diabetes insipidus. c. diabetes mellitus. d. adrenal insufficiency.

b. diabetes insipidus.

Bromocriptine (Parlodel) is a pituitary hormone suppressant that acts to __________. a. inhibit the production of clotting factor VIII from the posterior pituitary gland. b. inhibit the release of prolactin from the anterior pituitary gland. c. suppress the release of growth hormone from the anterior pituitary gland. d. suppress the release of antidiuretic hormone from the anterior pituitary gland.

b. inhibit the release of prolactin from the anterior pituitary gland.

A nurse understands that for the parathyroid hormone to exert its effect, what must be present? a) Decreased phosphate level b) Functioning thyroid gland c) Adequate vitamin D level d) Increased calcium level

c) Adequate vitamin D level

The nurse caring for a patient with Cushing's syndrome is teaching the patient about the dexamethasone suppression test scheduled for tomorrow. What does the nurse explain that this test will involve? a) Administration of dexamethasone intravenously, followed by an X-ray of the adrenal glands b) Administration of dexamethasone intravenously, followed by a plasma cortisol level 3 hours after the drug is administered c) Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8 AM the next morning d) Administration of dexamethasone orally, followed by a plasma cortisol level every hour for 3 hours

c) Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8 AM the next morning

Undersecretion of thyroid hormone during fetal and neonatal development can cause which of the following? a) Myxedema b) Hypothyroidism c) Cretinism d) Diabetes insipidus

c) Cretinism

The nurse is caring for a patient with Addison's disease. The patient is scheduled for discharge in the morning. When teaching the patient about hormone replacement, the nurse instructs that too low a dose may be indicated by what? a) Headache b) Weight gain c) Dizziness d) Increase in systolic blood pressure

c) Dizziness

Urinalysis has been ordered as part of a patient's diagnostic workup, and the nurse has obtained and submitted a sample. Assessment of this patient's urine osmolality may be undertaken to diagnose dysfunction of the patient's: a) Thyroid gland b) Adrenal medulla c) Posterior pituitary d) Adrenal cortex

c) Posterior pituitary

When providing teaching to a client with hyperthyroidism that is prescribed radioactive iodine (RAI) to destroy thyroid tissue, which of the following would the nurse include? a) The process may take several weeks or more. b) Its effect is not apparent until the gland has secreted excess thyroid hormone. c) RAI does not seriously affect other tissues. d) Radioactive iodine (RAI) has no adverse effects.

c) RAI does not seriously affect other tissues.

The nurse is developing a care plan for a patient with hypersecretion of the adrenal cortex (Cushing's syndrome). What nursing diagnosis would have the highest priority in this care plan? a) Risk for loneliness related to disturbed body image b) Disturbed body image related to changes in physical appearance c) Risk for injury related to weakness d) Fatigue related to sleep disturbances

c) Risk for injury related to weakness

What is the function of the parathyroid glands? a. Regulate potassium levels b. Regulate sodium levels c. Regulate serum calcium levels d. Regulate the thyroid gland

c. Regulate serum calcium levels

1. The thyroid gland is located in the __________. a. apex of the lung b. brain c. anterior neck d. abdomen

c. anterior neck

Enlargement of the thyroid gland is called __________. a. hypothyroidism b. Graves' disease c. goiter d. myxedema

c. goiter

A pituitary adenoma is most commonly found in patients with __________. a. Addison's disease. b. hypopituitarism. c. hyperpituitarism. d. Cushing's disease.

c. hyperpituitarism.

Maintenance of extracellular fluid volume is controlled by __________. a. prolactin. b. glucocorticoids. c. mineralocorticoids. d. thyroid-stimulating hormone.

c. mineralocorticoids.

Which of the following statements by patients should prompt the nurse to assess for potential failure of the adrenal cortex? a) "Lately, I find that I'm more irritable and impatient than normal." b) "My thirst is almost insatiable these days, and my mouth always feels dry." c) "The last little while I get numbness and tingling in my lips and fingers a lot." d) "I'm always exhausted these days, and I never really feel like eating."

d) "I'm always exhausted these days, and I never really feel like eating."

A 59-year-old patient is being assessed for hypoparathyroidism. The nurse should anticipate that this patient is likely to require what diagnostic test? a) Cardiac stress testing b) 24-hour urine c) CT of the abdomen d) Bone density testing

d) Bone density testing

Nursing care for a client in addisonian crisis should include which intervention? a) Offering extra blankets and raising the heat in the room to keep the client warm b) Encouraging independence with activities of daily living (ADLs) c) Allowing ambulation as tolerated d) Placing the client in a private room

d) Placing the client in a private room

Which nursing diagnosis is most appropriate for a client with Addison's disease? a) Hypothermia b) Excessive fluid volume c) Urinary retention d) Risk for infection

d) Risk for infection

Thyroid storm is prevented by administering what medications before a thyroidectomy? a. Thyroid replacement hormones c. Can't be prevented b. Thyroid-stimulating drugs d. Antithyroid drugs

d. Antithyroid drugs