Patho Exam 3 Chapter 31
When hormones act locally rather than being secreted into the bloodstream, their actions are termed what? 1. Autocratic and paracratic 2. Autocrine and paracrine 3.Localized and influential 4. Preventers and inhibitors
Correct response: Autocrine and paracrine Explanation: When hormones act locally on cells other than those that produced the hormone, the action is called paracrine. Hormones also can exert an autocrine action on the cells from which they were produced. The other terms are incorrect.
A patient experiences an increase in cortisol as a result of Cushing's disease. Which of the following hormonal responses demonstrates the negative feedback mechanism? 1. Decreased thyroid-stimulating hormone 2. Increased follicle-stimulating hormone 3. Decreased adrenocorticotropic hormone (ACTH) 4. Increased thyrotropin-releasing hormone
Correct response: Decreased adrenocorticotropic hormone (ACTH) Explanation: Negative feedback occurs when secretion of one hormone causes a reduction in the secretion of the hormone that stimulates production of the first hormone. In this case, ACTH manufactured by the anterior pituitary gland would normally stimulate the release of cortisol, but with the increase of cortisol produced by the secreting tumor, enough cortisol already floods the system that there should be a reduction in the ACTH level.
A patient with osteoporosis is prescribed calcitonin (Miacalcin). Which of the following actions by the patient requires further instruction? 1. Increases calcium with meals 2. Drinks carbonated sodas daily 3. Maintains weight-bearing activity 4. Alternates nostrils for drug inhalation
Correct response: Drinks carbonated sodas daily Explanation: Calcitonin enhances absorption of calcium into the bone. Phosphate, commonly found in carbonated beverages, interferes with calcium absorption in the GI tract. Dietary calcium intake and weight-bearing activity help to maintain bone density and reduce osteoporosis. Clients are encouraged to alternate the nostril into which the medication is administered.
When caring for a client with anemia and a decrease in red blood cells (RBCs), the nurse recognizes which of these hormones will stimulate the bone marrow to produce additional RBCs? 1.Atrial natriuretic peptide 2. Erythropoietin 3. Cortisol 4. Somatostatin
Correct response: Erythropoietin Explanation: Erythropoietin is made in the kidney and stimulates erythropoiesis, production of RBCs in the bone marrow
A client has developed a tumor of the anterior pituitary gland. The nurse is aware that the client is at risk for alterations of: Select all that apply. 1. Growth and metabolism 2. Function of the thyroid gland 3. Glucocorticoid hormone levels 4. Function of the gonads 5. Storage and release of ADH 6. Oxytocin secretion
Correct response: Growth and metabolism Function of the thyroid gland Glucocorticoid hormone levels Function of the gonads Explanation: Hormones produced by the anterior pituitary control body growth and metabolism (GH), function of the thyroid gland (TSH), glucocorticoid hormone levels (ACTH), function of the gonads (FSH and LH), and breast growth and milk production (prolactin). The posterior pituitary gland stores and releases antidiuretic hormone (ADH) and oxytocin.
Which of the following options contain a pair of hormones that act to balance each other? Select all that apply. 1. Insulin and glucagon 2. Calcitonin and parathyroid hormone (PTH) 3.Cortisol and aldosterone 4.Antidiuretic hormone (ADH) and oxytocin 5. Epinephrine and norepinephrine
Correct response: Insulin and glucagon Calcitonin and parathyroid hormone (PTH) Explanation: Insulin lowers blood glucose, whereas glucagon raises blood glucose. Calcitonin stimulates calcium to enter the bones, whereas PTH removes calcium from the bones. Cortisol and aldosterone both come from the adrenal cortex, but they perform similar tasks. ADH and oxytocin both come from the pituitary gland but do not perform opposite tasks. Epinephrine and norepinephrine perform similar tasks as neurotransmitters.
Which of the following is an example of a negative feedback system? Select all that apply. 1. Insulin and glucagon 2. Cortisol and adrenocorticotropic hormone 3. Estradiol and follicle-stimulating hormone(FSH) 4. Somatostatin and thyroid-stimulating hormone 5. Calcium and parathyroid hormone
Correct response: Insulin and glucagon Cortisol and adrenocorticotropic hormone Somatostatin and thyroid-stimulating hormone Calcium and parathyroid hormone Explanation: In negative feedback, sensors detect a change in hormone levels and adjust hormone secretion to maintain optimal levels. In positive feedback control, rising levels of a hormone cause another gland to release a hormone that stimulates the first. Release of the female hormone estradiol during the follicular stage of the menstrual cycle causes increased release of gonadotropin (FSH) which further increases release of estradiol until the follicle dies and ceases production.
A patient develops hypocalcemia after thyroid surgery. Which of the following hormonal imbalances caused this complication? 1. Lack of thyroid hormone 2. Lack of parathyroid hormone 3. Lack of thyroid-stimulating hormone 4. Lack of thyrotropic-releasing hormone
Correct response: Lack of parathyroid hormone Explanation: The parathyroid glands are located on the posterior side of the thyroid gland. If the parathyroid glands are removed at the same time as the thyroid the patient will experience a drop in serum calcium levels.
An adult patient with suspected hypothyroidism is scheduled for a thyrotropin-releasing hormone (TRH) stimulation test to evaluate pituitary response. Which of the following test results would confirm secondary hypothyroidism? 1. Increased thyroid-stimulating hormone (TSH) 2. No increase in TSH 3. Increased calcitonin 4. No increase in calcitonin
Correct response: No increase in TSH Explanation: A stimulation test is intended to determine if an organ that is undersecreting will produce an increased response. A normal response to the TRH stimulation test would be for the pituitary to produce an increased amount of TSH. If the pituitary gland responds with increased production, then hypothalamic undersecretion may be the cause of the condition. If the pituitary does not increase secretion, it can indicate secondary hypothyroidism. Calcitonin is not secreted by the pituitary.
An example of a single hormone that can exert effects in different tissues, erythropoietin, made in the kidney stimulates the bone marrow to produce: 1. Platelets. 2. Natural killer cells. 3. Red blood cells. 4. Mast cells.
Correct response: Red blood cells. Explanation: A characteristic of hormones is that a single hormone can exert various effects in different tissues. For example, erythropoietin, a traditional circulating hormone, is made in the kidney and stimulates erythropoesis in the bone marrow.
The nurse is caring for a client who is receiving exogenous corticosteroids for rheumatoid arthritis. Recognizing that hormone levels are regulated by negative feedback, which of these laboratory test results does the nurse anticipate uncovering when reviewing the medical record? 1. Reduction in ACTH 2. Increase in ACTH 3. Reduction in TSH 4. Increase in TSH
Correct response: Reduction in ACTH Explanation: The function of the negative feedback system is similar to that of the thermostat in a heating system. When the sensors detect a decrease in hormone levels, they initiate changes that cause an increase in hormone production. When hormone levels rise above the set point of the system, the sensors cause hormone production and release to decrease, driving the stimulating hormone down.
When comparing the endocrine and nervous system functions, the nurse knows that the endocrine system: Select all that apply. 1. Sends signals to neurons over a short distance to muscles 2. Responds to neurotransmitter molecules within milliseconds 3. Releases hormones into the blood that is transported throughout the body 4. Glands are widely scattered throughout the body 5.Takes longer to respond to innervations but has prolonged actions when they arrive
Correct response: Releases hormones into the blood that is transported throughout the body Glands are widely scattered throughout the body Takes longer to respond to innervations but has prolonged actions when they arrive Explanation: The endocrine system uses chemical messengers called hormones as a means of controlling the flow of information between the different tissues and organs of the body. It does not act alone, however, but interacts with the nervous system to coordinate and integrate the activity of body cells. Hormones regulate and integrate body functions. Hormones act on specific target cells, but they cause a variety of effects on tissues. Hormones do not transport other substances; hormones are transported and present in body fluids at all times. The endocrine system uses hormones released into the blood and transported throughout the body to influence the activity of body tissues. Tissue and organ responses to endocrine hormones tend to take much longer than the response to neurotransmitters, but once initiated, they tend to be much more prolonged than those induced by the nervous system. The glands of the endocrine system are widely scattered throughout the body.
When hypofunction of an endocrine organ is suspected, which hormone test can be administered to measure and assess target gland response? 1. Stimulation 2. 24-hour urine 3.Agglutination 4.Antibody binding
Correct response: Stimulation Explanation: Stimulating hormone can be given to identify (determine hypofunction) if the target gland is able to increase hormone response to increased stimulation. Agglutination with enzymes is a way of measuring hormone antigen levels. The 24-hour urine sample measures hormone metabolite excretion. Radioactive hormone-antibody binding levels are a method of measuring plasma levels.
The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function. 1.Stimulation tests 2. Suppression tests 3. Genetic testing 4. Imaging studies
Correct response: Stimulation tests Explanation: Stimulation tests are used when hypofunction of an endocrine organ is suspected. Suppression tests are used when hyperfunction of an endocrine organ is suspected. Genetic testing is used for DNA analysis, and imaging may be used as a follow-up after the diagnosis.
A nurse has just completed an explanation of how hormones are normally regulated by feedback mechanisms to a client. The client asks if anything can alter the regulation. The best response by the nurse would be: Select all that apply. 1.Stress 2.Temperature 3.Nutritional status 4.Genetics 5. Weight 6. Age
Correct response: Stress Temperature Nutritional status Explanation: In addition to positive and negative feedback mechanisms that monitor changes in hormone levels, some hormones are regulated by the level of the substance they regulate. For example, insulin levels normally are regulated in response to blood glucose levels, and those of aldosterone in response to blood levels of sodium and potassium. Other factors such as stress, environmental temperature, and nutritional status can alter feedback regulation of hormone. Genetics, weight, and age will not influence response.
The nurse is caring for a client who has been diagnosed with severe chronic obstructive pulmonary disease and has been taking oral steroids for several years. The nurse is aware that the client is at risk for: 1. Suppression of the client's hypothalamic-pituitary-target cell system 2. Experiencing increased levels of adrenocorticotropic hormone (ACTH) 3. Increased levels of epinephrine and norepinephrine 4. Suppression of the body's positive feedback mechanisms
Correct response: Suppression of the client's hypothalamic-pituitary-target cell system Explanation: Exogenous forms of hormones (given as drug preparations) can influence the normal feedback control of hormone production and release. One of the most common examples of this influence occurs with the administration of the corticosteroid hormones, which causes suppression of the hypothalamic-pituitary-target cell system that regulates the production of these hormones. Positive feedback control occurs when rising levels of a hormone cause another gland to release a hormone that is stimulating to the first. The steroid will not cause increase in the levels of the hormones.
The nurse administers a glucocorticoid medication to a client with pneumonia. Which of these does the nurse teach the client is the purpose of the medication? 1 To regulate glucose metabolism 2. To decrease appetite 3. To decrease airway inflammation 4. To decrease stress of illness
Correct response: To decrease airway inflammation Explanation: Glucocorticoids affect metabolism of all nutrients and have anti-inflammatory effects, which can assist with airway inflammation.
For which of the following endocrine disorders would autoimmune antibody testing be appropriate? Select all that apply. 1.Type 1 diabetes mellitus 2. Graves' disease 3. Hypoparathyroidism 4. Addison's disease 5. Acromegaly 6. Polycystic ovaries
Correct response: Type 1 diabetes mellitus Graves' disease Hypoparathyroidism Addison's disease Explanation: Autoantibody testing is most commonly used for autoimmune disorders such as type 1 diabetes mellitus, Graves' disease, hypoparathyroidism, and Addison's disease.