Module 10 Questions

Which of the following problems arises from primary hyperaldosteronism? Hyponatremia Hypertension Hyperkalemia Hyperglycemia

Hypertension Sodium and water retention from elevated aldosterone levels results in volume overload and hypertension.

Growth hormone is secreted into the bloodstream by the: thymus. anterior pituitary. posterior pituitary hypothalamus.

anterior pituitary. Growth hormone from the anterior pituitary regulates metabolic processes related to cellular growth.

Alterations in lipid and protein metabolism lead to chronic complications of DM through which of the following processes? Induction of the polyol pathway Glycosylation Activation of protein kinase C All of the above

All of the above Hyperglycemia activates protein kinase C, induction of the polyol pathway, and glycosylation.

Chronic complications of DM include which of the following? All of the above Coronary artery disease End-stage renal disease Peripheral neuropathies

All of the above Microvascular and macrovascular disease can lead to peripheral neuropathies, end-stage renal disease (nephropathy), and coronary artery disease.

Which cells in the pancreas secrete insulin? Delta Alpha Beta Acinar

Beta Beta cells secrete insulin. Delta cells secrete somatostatin. Alpha cells secrete glucagon. Acinar cells secrete pancreatic digestive enzymes.

Prolactinomas (pituitary tumors that secrete prolactin) cause which of the following problems in women? Hair loss Breast milk production without pregnancy Dysmenorrhea Heavy menstrual periods

Breast milk production without pregnancy Elevated prolactin in women causes galactorrhea, which is the discharge of milk from the breast.

Which of the following disorders can cause secondary hyperparathyroidism? A pituitary tumor Graves disease Chronic renal failure Primary hyperparathyroidism

Chronic renal failure In chronic renal failure, the kidney cannot activate vitamin D and cannot adequately reabsorb calcium from the tubules. Persistent hypocalcemia results in increased parathyroid hormone secretion.

Which of the following is a steroid hormone? Thyroxine (T4) Cortisol Insulin Growth hormone

Cortisol Cortisol is one example of a steroid hormone.

What is the cause of exophthalmos in Graves disease? Optic nerve damage High levels of TSH causing retinal toxicity Decreased blood flow to the eye Degenerative changes in the muscle and orbital edema

Degenerative changes in the muscle and orbital edema Increased secretion of hyaluronic acid, orbital fat accumulation, inflammation, and edema of the orbital contents result in exophthalmos, a classic sign of Graves disease.

The development of an acute metabolic acidosis from insulin deficiency is due to which of the following processes? Protein catabolism with ammonia release Renal failure Fatty acid metabolism with ketone production Anaerobic metabolism of glucose

Fatty acid metabolism with ketone production An insulin deficiency will increase the release and utilization of fatty acids as fuel. Metabolizing fatty acids liberates acidic molecules called ketones.

Which hormone functions in a manner opposite to that of insulin? Somatostatin Glucagon Amylin Aldosterone

Glucagon Glucagon increases blood sugar levels by stimulating glycogenolysis and gluconeogenesis.

Which of the following nutrients is essential for thyroid hormone synthesis? Iodine Phosphate Calcium Iron

Iodine An essential ingredient for thyroid hormone synthesis is iodine.

Which of the following is a serious complication of SIADH? Myocardial infarction Panhypopituitarism Renal failure Permanent neurological damage

Permanent neurological damage Hyponatremia in SIADH can lead to severe, irreversible neurological damage.

Which of the following thyroid disorders can be caused by exposure of the thyroid gland to ionizing radiation? Thyroid cancer Subacute thyroiditis Graves disease Hashimoto thyroiditis

Thyroid cancer Ionizing radiation, often from treatment of a prior cancer, is a risk factor for thyroid cancer.

What effect does the presence of advanced glycosylation end products (AGEs) have in diabetes? Tissue injury microvascular/macrovascular disease. Reduction of chronic complications Dawn phenomenon Increased ketone formation

Tissue injury AGEs cause tissue injury through a variety of mechanisms, including the production of free radicals and the induction of

Which of the following alterations would you expect to find in a patient with untreated Cushing disease or syndrome? Pale skin Truncal obesity Peripheral edema Weight loss

Truncal obesity Truncal obesity secondary to central fat deposition is a common physical manifestation of hypercortisolism.

A clinician would suspect thyrotoxicosis if a patient presented with which of the following symptoms? Weight loss and enlarged thyroid gland Slow tendon reflexes and muscle stiffness Confusion and gait disturbances Peripheral edema and dry skin

Weight loss and enlarged thyroid gland Weight loss and enlarged thyroid gland are common signs of hyperthyroidism in thyrotoxicosis.

In adults, the most serious consequence of panhypopituitarism is the loss of: luteinizing hormone (LH). adrenocorticotropic hormone (ACTH). growth hormone. thyroid-stimulating hormone (TSH).

adrenocorticotropic hormone (ACTH). Loss of ACTH secretion leads to decreased cortisol production, resulting in life-threatening hypoglycemia.

In Graves disease, accumulation of edema in the orbit can lead to: all of the above. eye muscle palsies. exophthalmos. optic nerve damage.

all of the above. Accumulation of edema behind the eyeball can lead to compression of the optic nerve, strain on the extraocular eye muscles resulting in palsies, and eyeball protrusion that is known as exophthalmos.

The pathophysiology of type 1 diabetes mellitus (DM) involves: all of the above. autoimmune destruction of pancreatic beta cells. type IV hypersensitivity against pancreatic islet cells. production of antibodies against insulin.

all of the above. The insulin deficiency that results in type 1 DM is caused by three factors: (1) the production of antibodies that destroy the beta cells in the pancreatic islets of Langerhans, (2) the production of antibodies against insulin, and (3) cell-mediated destruction of the islet cells.

Adrenocorticotropic hormone (ACTH) is synthesized and released in the: adrenal cortex. anterior pituitary. adrenal medulla. posterior pituitary.

anterior pituitary. ACTH is synthesized and released by the anterior pituitary gland in response to stimulation from the hypothalamus.

The most common cause of Addison disease is: bacterial infection of the adrenal medulla. viral infection of the pituitary gland. adrenal cancer. autoimmune injury to the adrenal cortex.

autoimmune injury to the adrenal cortex. In idiopathic Addison disease, antibodies against the adrenal cortex cause immunologic damage to the gland, resulting in hypocortisolism and hypoaldosteronism.

The most common cause of primary hypothyroidism in adults is: viral infection of the thyroid gland. autoimmune thyroiditis. bacterial infection of the thyroid gland. congenital hypothyroidism

autoimmune thyroiditis. Autoimmune thyroiditis (Hashimoto) is the most common cause of primary hypothyroidism in adults.

Calcitonin and parathyroid hormone strictly regulate serum levels of: potassium. magnesium. iron. calcium.

calcium. Together, calcitonin and parathyroid hormone regulate calcium levels in the blood.

Increased thyroid hormone levels in the blood result in: increased secretion of thyrotropin-releasing hormone from the hypothalamus. decreased release of thyroid-stimulating hormone from the anterior pituitary. inhibition of parathyroid hormone release from the parathyroid glands. further stimulus to produce thyroid hormone.

decreased release of thyroid-stimulating hormone from the anterior pituitary. Increased thyroid hormone levels provide negative feedback to the hypothalamus and anterior pituitary to shut off production of thyrotropin-releasing hormone and thyroid-stimulating hormone, respectively.

Neurological symptoms of SIADH are related to: hypokalemia. increased serum osmolarity. decreased serum sodium concentrations. hypotension and cellular dehydration.

decreased serum sodium concentrations. ADH secretion in SIADH causes a dilutional hyponatremia and decreased serum osmolarity.

Signs and symptoms of hypothyroidism include all of the following except: lethargy. myxedema. diarrhea. weight gain.

diarrhea. Decreased bowel activity in hypothyroidism generally leads to constipation. Diarrhea is a symptom of hyperthyroidism.

Signs and symptoms that a person with type 1 diabetes has administered too much insulin include: dizziness and confusion. pain at the site of injection. Kussmaul respirations and acetone breath. abdominal cramping and nausea.

dizziness and confusion. Dizziness and confusion, combined with tachycardia, palpations, and visual disturbances are signs of hypoglycemia related to over administration of insulin.

To adapt to high hormone concentrations, many target cells have the capacity for: positive feedback. down-regulation. up-regulation. negative feedback.

down-regulation. To adapt to high levels of hormones, some cells have the capacity to decrease the number of receptors for that hormone through the process of down-regulation.

Gestational diabetes can occur: during pregnancy. in early childhood. in older adults. during fetal development.

during pregnancy. Gestational diabetes is the development of glucose intolerance in women during pregnancy.

Cushing disease may be caused by: excessive production of aldosterone from a tumor in the adrenal cortex. ectopic production of ACTH from a lung tumor. autoimmune destruction of the adrenal cortex. excessive production of cortisol from a tumor in the adrenal cortex.

ectopic production of ACTH from a lung tumor. Cushing disease is excessive ACTH production most commonly caused by an adrenal adenoma or a non-pituitary adenoma as is often seen with lung cancer.

Graves disease is characterized by: excessive production of circulating thyroid-stimulating immunoglobulin. autoimmune destruction of the thyroid gland. injury to the pituitary, resulting in decreased thyroid-stimulating hormone secretion. ectopic secretion of thyroid hormone by a tumor.

excessive production of circulating thyroid-stimulating immunoglobulin. Graves disease is caused by the production of antibodies to the TSH receptor called thyroid-stimulating immunoglobulins (TSIs). These antibodies stimulate the production of high levels of thyroid hormone.

A new diagnosis of type 1 DM is based on: fasting plasma glucose levels and glycosylated hemoglobin (A1c). the presence of symptoms only. random serum glucose levels genetic testing.

fasting plasma glucose levels and glycosylated hemoglobin (A1c). The suspicion of diabetes-based clinical manifestations can be confirmed by evaluating fasting plasma glucose levels and glycosylated hemoglobin (A1c).

The physiologic stress of illness or surgery can induce a severe response in individuals who have unrecognized and untreated thyrotoxicosis.The pathophysiology of thyroid storm, also known as thyrotoxic crisis, involves: fever and tachycardia leading to high-output heart failure. pulmonary edema and bronchoconstriction leading to respiratory arrest. hypercoagulability and formation of deep vein thromboses leading to pulmonary emboli. hypotension and bradycardia leading to shock.

fever and tachycardia leading to high-output heart failure. High levels of thyroid hormone in conjunction with high levels of stress hormones lead to fever, tachycardia, and eventually high-output heart failure if the condition is not treated.

Acromegaly is caused by increased secretion of: growth hormone. glucocorticoids. prolactin. insulin.

growth hormone. Acromegaly from increased growth hormone secretion results in gigantism as well as other structural and physiological problems.

When evaluating the kidney function of an individual with diabetes insipidus (DI), the nurse would observe: blood in the urine. protein in the urine. high volume urine output. high urine osmolarity.

high volume urine output. In DI, the kidneys are unable to conserve water in the distal and collecting tubules, resulting in the production of large volumes of dilute urine.

Metabolic abnormalities in Addison disease include all of the following except: hyperkalemia. hyponatremia. hypercalcemia. hypoglycemia.

hypercalcemia. Serum calcium levels are not directly affected by cortisol.

Classic symptoms of diabetes insipidus (DI) include all of the following except: dehydration. thirst. hypertension. low urine osmolarity.

hypertension. Absence of ADH secretion in DI leads to increased urine output, volume depletion, and hypotension.

Mental status changes in people with Addison disease are caused by: insulin resistance. CNS ischemia. encephalopathy. hypoglycemia.

hypoglycemia. Mental status changes in people with Addison disease are caused by hypoglycemia from low cortisol levels.

High levels of glucocorticoids such as cortisol can result in: all of the above. weight loss. hypoglycemia. immunosuppression.

immunosuppression. High levels of glucocorticoids can inhibit the immune and inflammatory responses by suppressing the activity of white blood cells, lymphokines, and inflammatory mediators. High levels of glucocorticoids tend to cause weight gain because of fat deposition and fluid retention. High levels of cortisol cause hyperglycemia by decreasing glucose use in muscle tissue and promoting

The symptom of polyuria in diabetes mellitus (DM) is caused by: the production of ketones. the loss of protein across the glomerular membrane. increased glucose in the urine. a reduced AHD response caused by insulin deficiency.

increased glucose in the urine. When glucose levels in the blood are greater than 300 mg/dL, glucose is excreted in the urine. The presence of glucose in the urine filtrate draws water into the tubules, causing an "osmotic diuresis."

Hyperglycemia and lipid abnormalities in type 2 DM are a result of: insulin resistance. glucagon deficiency. production of inactive insulin. glycogen excess.

insulin resistance. Type 2 DM is caused by cellular resistance to the physiologic effects of insulin.

Target cells for aldosterone are located in the: kidneys. adrenal cortex. adrenal medulla. liver.

kidneys. Aldosterone stimulates sodium reabsorption by the kidneys.

The level of thyroid-stimulating hormone (TSH) in Graves disease is: high. normal. variable. low.

low. In Graves disease, the presence of TSI mimics the activity of TSH at the thyroid receptor. The result is increased thyroid hormone production that suppresses TSH production from the anterior pituitary.

If left untreated, congenital hypothyroidism results in: increased risk of childhood thyroid cancer. mental retardation and stunted growth. hyperactivity and attention deficit disorder. liver, kidney, and pancreas failure.

mental retardation and stunted growth. Thyroid hormone is necessary for nervous system development and skeletal growth in fetuses and children.

The main function of thyroid hormone (T3 and T4) is control of: gastric secretions. synaptic activity. insulin secretion. metabolic rate.

metabolic rate. Increased secretion of thyroid hormone results in increased metabolic rate of all cells

The purpose of monitoring glycosylated hemoglobin levels in persons with diabetes is to: measure fasting glucose levels. check for hyperlipidemia. detect acute complications of diabetes. monitor long-term serum glucose control.

monitor long-term serum glucose control. Monitoring hemoglobin A1c levels in a person with diabetes provides a measure of glucose control during the life span of the red blood cells being evaluated.

One problem associated with untreated hypoparathyroidism is: osteoporosis. insulin resistance. metabolic acidosis. muscle spasms.

muscle spasms. Hypocalcemia in untreated hypoparathyroidism can cause muscle spasms, including laryngeal spasms that can cause airway obstruction.

Regulation of the release of T3 and T4 from the thyroid gland is controlled by: neural feedback. negative feedback. positive feedback. all of the above.

negative feedback. Thyroid hormone, like most other hormones, is regulated through negative feedback.

Damage to the posterior pituitary caused by a cerebrovascular accident (stroke) results in _____ diabetes insipidus (DI). nephrogenic neurogenic vascular psychogenic

neurogenic When DI develops from injury to the CNS, it is called "neurogenic" DI.

The most common cause of hypoparathyroidism is: pituitary hyposecretion. parathyroid adenoma. parathyroid gland injury or removal. hypothalamic inactivity.

parathyroid gland injury or removal. Parathyroid gland injury or surgical removal of the gland is the most common cause of hypoparathyroidism.

An endocrinologist orders a series of lab tests to assess thyroid function. Low levels of thyroid hormone (T3 and T4) and high levels ofthyroid-stimulating hormone (TSH) are indicative of: primary hypothyroidism. secondary hypothyroidism. secondary hyperthyroidism. primary hyperthyroidism.

primary hypothyroidism. Low levels of T3 and T4 production caused by the destruction or removal of the thyroid gland (primary hypothyroidism) stimulate the anterior pituitary to increase the production of TSH.

The primary physiologic effect of insulin is to: promote glucose uptake into cells. decrease basal metabolic rate. raise blood glucose levels. stimulate nutrient absorption from the digestive tract.

promote glucose uptake into cells. The presence of insulin stimulates the transport of glucose into cells to be stored or used as a substrate for metabolism.

Syndrome of inappropriate diuretic hormone (SIADH) results in excessive: renal retention of water without sodium retention. renal retention of sodium without water retention. renal excretion of water without sodium retention. renal retention of sodium and water.

renal retention of water without sodium retention. Elevated ADH secretion in SIADH stimulates increased water reabsorption in the distal and collecting tubules which dilutes serum electrolyte levels.

Thyroid carcinoma usually presents with the following thyroid tissue changes: thyroid gland atrophy. elevated T3 and T4. large, diffuse goiter. small nodules.

small nodules. Thyroid carcinoma usually presents with small thyroid nodules.

Hypersecretion of androgens from an adrenal tumor in female children causes virilization, which is: the development of male sex characteristics. the early development of female sex characteristics. a form of hypercortisolism. sterility.

the development of male sex characteristics. Androgens are male sex hormones that stimulate the development of male sex characteristics in females.

Graves disease is an example of a: type I hypersensitivity. type III hypersensitivity. type II hypersensitivity. type IV hypersensitivity.

type II hypersensitivity. Graves disease is an example of a tissue-specific (type II)

Causes of myxedema coma include: a reaction to abnormally high levels of thyroid autoantibodies. subclinical hyperthyroidism. untreated hypothyroidism. thyroid storm.

untreated hypothyroidism. Myxedema coma is caused by severe hypothyroidism. Symptoms include hypothermia, hypotension, and hypoglycemia.

The primary effect of antidiuretic hormone (ADH) in the kidneys is to stimulate: acid secretion. sodium and water excretion. water reabsorption. sodium reabsorption.

water reabsorption.The presence of ADH makes the renal tubules more permeable to water, which enhances water reabsorption.

Signs and symptoms common to both type 1 and type 2 diabetes mellitus (DM) include all of the following except: polydipsia. weight loss. polyuria. polyphagia.

weight loss. Weight loss is a symptom of type 1 DM. Typically, individuals with type 2 DM are overweight.

Chronic hyperparathyroidism will lead to all of the following conditions except: pathologic bone fractures. renal calculi (stones). osteopenia. weight loss.

weight loss. Weight loss is not associated with hyperparathyroidism.