NUR 4125: Chapter 40
Hormones are usually divided into categories according to their structure. The release of epinephrine would be classified as: Amines and amino acids Proteins Steroids Peptides and polypeptides
a
A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of: Somatostatin and prolactin Antidiuretic hormone (ADH) and oxytocin Growth hormone-releasing hormone (GHRH) and dopamine Adrenocorticotropic hormone (ACTH) and vasopressin
b
A client receives steroids for several months to treat an inflammatory condition. Which action by the primary health care provider indicates an understanding of the negative feedback mechanism when the client no longer needs the medication? Instructing the client to stop taking the medication Prescribing a tapering dose of the medication over weeks Measuring urine catecholamine levels before stopping the drug Scheduling a positron emission tomography scan a week after stopping the drug
b
A client with newly diagnosed diabetes mellitus asks the nurse why insulin is not available in a pill like thyroid hormone is. Which response best answers the client's question? Hormones that are cholesterol derived are unaffected by digestion. Peptide proteins will be digested instead of entering the bloodstream. Thyroid hormone is an amino acid that directly enters the bloodstream from the gastrointestinal tract. Autocrine effects of hormones influence the cells that produce them.
b
Which hormones cross cell membranes to connect to nuclear receptors? Select all that apply. Parathyroid hormone Thyroid hormones Vitamin D Glucagon Glucocorticoids
b c e
A client undergoing an evaluation of hormone levels asks, "What regulates the hormone levels?" Which response by the nurse would be considered most accurate? The hypophysial portal system The positive feedback loop The hypothalamic-pituitary-target cell system Exogenous forms of hormones
c
A health care provider is assessing a client for a potential endocrine disorder. Assessment findings identify abnormalities with emotion, pain, and body temperature. Which mechanism of endocrine control will require further laboratory/diagnostic assessment? Anterior pituitary Cerebellum Hypothalamus Cerebral cortex
c
Cyclic adenosine monophosphate (cAMP) performs which role in the functioning of the endocrine system? Acting as a high-affinity receptor on the surface of target cells Inactivating hormones to prevent excess accumulation Acting as a second messenger to mediate hormone action on target cells Mediating hormone synthesis by non-vesicle-mediated pathways
c
Several hormones, including growth hormone (GH) and thyrotropin-releasing hormone (TRH), are bound to and carried by which substance? Target cells Cholesterol Proteins Prohormones
c
The nurse is discussing positive feedback mechanisms. Which example best explains this mechanism? Increased glucose levels in the blood decreases growth hormone (GH) levels. Decreased cortisone levels increase blood levels of adrenocorticotropic hormone (ACTH). Increased estradiol production causes increased follicle-stimulating hormone (FSH) production. Decreased thyroid hormone (TH) increases thyroid-stimulating hormone (TSH) levels.
c
The release of insulin from the pancreatic beta cells can inhibit further release of insulin from the same cells. This is an example of which type of hormone action? Juxtaposed Arachidonic Autocrine Retinoid
c
When describing to a client newly diagnosed with diabetes how insulin is regulated, the nurse will draw upon her knowledge of which hormonal regulation mechanism? The angiotensin I to angiotensin II to aldosterone system Basal metabolic rate The hypothalamic-pituitary-target cell system The cytokine-interleukin regulatory mechanism
c
A nurse examines the laboratory values of a client in heart failure. Which value indicates a compensatory hormone mechanism? Elevated serum pH Decreased red blood cell count Decreased hematocrit Elevated atrial natriuretic hormone
d
A nurse who works in the office of an endocrinologist is orienting a new staff member. Which teaching point should the nurse include in the orientation? "It's uncommon for production of hormones to be far removed from the tissue where they ultimately exert their effect." "Sometimes hormones act locally on the area where they were produced, as in the case of endocrine actions." "The regulation of homeostasis requires that hormones be absent from the body when their effect is not needed." "A single hormone can act on not only one process or organ but often on several different locations or processes."
d
Which physiologic process best exemplifies a positive feedback mechanism? The release of antidiuretic hormone when sodium levels are higher than normal The regulation of blood glucose levels by insulin The release of parathyroid hormone in response to decreased serum calcium levels The increase in prolactin secretion that occurs with more frequent breast-feeding
d
While teaching a science class, the instructor mentions that both autocrine and paracrine hormonal actions occur without entering the bloodstream. A student aks, "What cells do paracrine actions affect?" Which response is correct? Self Target Stored Local
d
Which gland is often referred to as the master gland because it secretes many hormones? Pancreas Thyroid Pituitary Hypothalamus
d
A client experiences an increase in thyroid hormone as a result of a thyroid tumor. Which hormonal response demonstrates the negative feedback mechanism? Decreased thyroid-stimulating hormone (TSH) Decreased adrenocorticotropic hormone (ACTH) Increased thyrotropin-releasing hormone (TRH) Increased follicle-stimulating hormone (FSH)
a
A client has received an injection containing thyrotropin-releasing hormone (TRH) and is now being assessed for serum levels of thyroid-stimulating hormone (TSH). Which type of diagnostic testing is this client undergoing? Stimulation testing Autoantibody testing Suppression testing Radioimmunoassay (RIA)
a
A client with a history of brain tumors that resulted in partial removal of the pituitary gland years ago expresses concern to the health care provider about whether she will be able to breast-feed her infant. Which physiologic function of the pituitary gland facilitates breast milk production? Prolactin Oxytocin Corticotropin-releasing hormone (CRH) Growth hormone (GH)
a
A middle-aged female client has been diagnosed with a thyroid condition. The nurse educates the client about the prescription and needed follow-up lab work, which will help regulate the dosage. The client asks, "Why do I not return to the clinic for weeks, since I am starting the medication tomorrow morning?" The nurse bases the answer on the knowledge that thyroid hormones: may take days for the full effect to occur, based on the mechanism of action. can cause weight loss, so the clinic wants to see how much weight the client loses at the return visit. cause many side effects, and the clinic wants the client to be on the medication for several weeks so that all the effects can be reported. will begin working right away, and the clinic wants to see how the body is responding to the drug.
a
Release and synthesis of anterior pituitary hormones are mainly regulated by which part of the body? Hypothalamus Adrenal gland Thymus gland Cell receptors
a
The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which statement about the role of the thyroid gland is most accurate? The thyroid gland is responsible for increasing the metabolic rate. The thyroid gland is responsible for regulating serum calcium levels. The thyroid gland releases neurotransmitters when the "flight or flight" mechanism is stimulated. The thyroid gland promotes development of secondary sex characteristics.
a
When hormones act locally rather than being secreted into the bloodstream, their actions are termed: Autocrine and paracrine Autocratic and paracratic Localized and influential Preventers and inhibitors
a
Which gland acts as a signal-relaying bridge between multiple body systems and the pituitary gland? Hypothalamus Parathyroid Thyroid Posterior pituitary
a
Which hormone is produced by the anterior pituitary gland? Growth hormone (GH) Corticotropin-releasing hormone (CRH) Norepinephrine Oxytocin
a
Which statement best explains the function of hormone receptors? Hormone receptors recognize a specific hormone and translate the hormonal signal into a cellular response. Hormone receptors respond to decreasing hormone levels by producing a decrease in receptor numbers. Hormone receptors produce antibodies to block certain hormones from entering the cell. Hormone receptors are located within the red blood cells and carry hormones to the target cells.
a
The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body? Sensory feedback loop Negative feedback loop Regulated feedback loop Positive feedback loop
b
The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function. Suppression tests Stimulation tests Genetic testing Imaging studies
b
What is the most common mechanism of hormone control? Positive feedback Negative feedback Hypothalamic-pituitary-adrenal axis Hypothalamic-pituitary-target cell feedback
b
Which manifestation would a nurse expect when assessing a child with insufficient growth hormone (GH) secretion? Mental sluggishness Rank below 10% on the growth chart Increased susceptibility to infection Lower blood calcium levels
b
The vesicle-mediated pathway has a role in synthesis and release of which hormones? Select all that apply. Aldosterone Follicle-stimulating hormone Antidiuretic hormone Dopamine Testosterone
b c d
A nursing instructor is teaching a group of students about the action of hormones. The instructor determined that teaching was effective when the students recognize the local action of hormones as: Hormonal Autocrine Pancreatic Paracrine
d
After having a very stressful day in pathophysiology class, the student knows that which hormone (secreted by the adrenal cortex) will help decrease the effects of stress? Androstenedione, an adrenal androgen Aldosterone, a mineralocorticosteroid Dehydroepiandrosterone, an adrenal androgen Cortisol, a glucocorticoid
d
As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated? Free receptor sites Stimulate production Absorb metabolic waste Prevent accumulation
d
Hormones can be synthesized by both vesicle-mediated pathways and non-vesicle-mediated pathways. What hormones are synthesized by non-vesicle-mediated pathways? Neurotransmitters that are also hormones Renin and angiotensin Pepsin and ghrelin Androgens and estrogens
d
How will cell receptors change in the absence of a particular hormone? Cell antibodies destroy receptors. Receptors will lose sensitivity. Cells develop fewer receptors. Receptors in each cell will increase.
d
When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of: Posterior adrenal cortex Pancreas Thyroid gland Anterior pituitary gland
d