unit 12 patho: endocrine
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?
"A single hormone can act on not only one process or organ but often on several different locations or processes."
7. A 28-year-old male who is 611 tall has a diagnosis of acromegaly. The man is explaining to a curious but sympathetic coworker exactly what accounts for his extraordinary height. Which of the following explanations demonstrates a sound understanding of his health problem?
"A tumor in my brain threw off my hormone levels after I was finished adolescence."
The nurse is performing an assessment for a client who has hyperthyroidism that is untreated. When obtaining vital signs, what is the expected finding?
Heart rate 110 and bounding
The nurse is caring for a client with diabetes. Which of these findings is cause for concern, leading the nurse to initiate client education?
Hemoglobin A1C level is 8.7%.
Which maternal factor contributes to an infant having macrosomia, hypoglycemia, and hyperbilirubinemia?
maternal diabetes
Neurotransmitters like catecholamines (e.g., dopamine and epinephrine) have a reaction time of:
milliseconds
Which of the following best describes the half-life of a highly protein-bound drug such as thyroxine (99% protein bound)? The half-life would be:
much longer to reduce the concentration of the hormone by one half
Which structure controls the functions of the greatest number of target glands and cells?
pituitary gland
The nurse is teaching a client newly diagnosed with hypothyroidism. The nurse teaches that thyroid hormone is transported by which?
protein carriers
Several hormones, including growth hormone (GH) and thyrotropin-releasing hormone (TRH), are bound to and carried by which substance?
proteins
A client with diabetes mellitus is reporting burning pain of the feet and some numbness. These symptoms are likely due to which cause?
somatic neuropathy
While reviewing the major actions of follicle-stimulating hormone (FSH), the faculty points out that in males this hormone is responsible for the:
sperm production.
A client is scheduled for a suppression test as part of the diagnostic testing for his suspected endocrine disorder. The results of this test will help the care team determine:
whether the client is producing excessive hormone levels.
A patient exhibiting problems with his or her thyroid has been scheduled for a radioactive scan. From the following list of patients, what would the nurse question as to whether this would be a safe procedure for this patient?
young female patient who has been trying to get pregnant
The signs and symptoms of abrupt cessation of pharmacologic glucocorticoids closely resemble those of which disease process?
Addison disease
Following a meal, a woman's blood glucose level has increased. In addition, her pancreas has increased the amount of insulin produced and released. Which of the following phenomena has occurred?
Adjustment according to the level of the substance a hormone regulates
The critical care nurse has just admitted a client with diabetic ketoacidosis (DKA) whose blood glucose level is 877 mg/dL (48.67 mmol/L). The client's breath has a fruity odor and the client is confused. Which of these does the nurse set as the priority at this time?
Administration of intravenous fluids
Which of the following statements best captures an aspect of the role of hormones in the body?
Some chemical substances can function as hormones or be integrated with the central and peripheral nervous systems.
The nurse is performing an assessment for a client with Cushing syndrome and observes a "buffalo hump" on the back, a moon face, and a protruding abdomen. What does the nurse understand contributes to the distribution of fat in these areas?
Altered fat metabolism
After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?
A 70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and has an elevated temperature of 103.2°F
Select the category of hormones that include norepinephrine and epinephrine.
Amines and amino acids
Which of the following hormones are derivatives of cholesterol?
Aldosterone and testosterone
Hormones can be divided into three categories:
(1) amines and amino acids; (2) peptides, polypeptides, proteins, and glycoproteins; (3) steroids
A nurse examines the laboratory values of a client in heart failure. Which value indicates a compensatory hormone mechanism?
Elevated atrial natriuretic hormone
A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves disease. Which assessments should the nurse prioritize?
Eye health and visual acuity
The nurse is teaching a client how to collect a 24-hour urine sample for cortisol levels. The client asks why a blood sample cannot just be taken since collecting urine for 24-hours is inconvenient. How should the nurse respond?
"Because cortisol levels fluctuate, collecting a sample over time will be more accurate."
A client is diagnosed with Addison disease. What statement by the client indicates an understanding of the discharge instructions by the nurse?
"I will have to take my medication for the rest of my life."
A client is suspected to have increased growth hormone levels. When performing a health history, what assessment data would be important for the nurse to report to the physician? Select all that apply.
->The client has fainted due to low blood glucose levels on several occasions. ->The client has been experiencing a great deal of emotional stress due to family issues. ->The client is on a weight-loss diet and is exercising excessively.
Of the following patient conditions, which patients would be at risk for experiencing a thyroid problem due to a decrease in thyroxine-binding globulin (TBG)? Select all that apply.
-A 55-year-old male with cirrhosis due to alcohol abuse -A 75-year-old man receiving chronic glucocorticoid therapy to treat his severe chronic obstructive pulmonary disease (COPD) -A 18-year-old female anorexia nervosa patient weighing 78 lb and has consumed no protein for the past 3 years
Which hormones cross cell membranes to connect to nuclear receptors? Select all that apply
-Vitamin D -Thyroid hormones -Glucocorticoids
In which client would the nurse identify a primary endocrine disorder?
A client who has been diagnosed with Hashimoto thyroiditis
The mother of 6-year-old male and female fraternal twins has brought her son to see a pediatrician because he is nearly 4 inches shorter than his sister. Which of the following phenomena would the physician most likely suspect as contributing factor to the boy's short stature?
A shortage of hypothalamic GHRH production
A nurse who works in the office of an endocrinologist is orienting a new staff member. Which of the following teaching points is the nurse justified in including in the orientation? Select all that apply
A) "A bodily process can be the result of the combined effect of several different hormones from different sources." B) "A single hormone can act not only on one process or organ but often on several different locations or processes." C) "It's common for production of hormones to be far removed from the tissue where they ultimately exert their effect." D) "Sometimes hormones act locally on the area where they were produced, like in the case of paracrine and autocrine actions."
The health care provider is reviewing diurnal variation pattern in adrenocorticotropic (ACTH) levels. Select the typical diurnal variation pattern in adrenocorticotropic (ACTH) levels.
ACTH peaks in the morning and declines throughout the day.
Cyclic adenosine monophosphate (cAMP) performs which role in the functioning of the endocrine system?
Acting as a second messenger to mediate hormone action on target cells
The nurse is assessing a client with thyrotoxicosis and the nurse is explaining how the thyroid gland is stimulated to release thyroid hormones. The nurse should describe what process?
Action of releasing hormones from hypothalamus
When hormones act locally rather than being secreted into the bloodstream, their actions are termed:
Autocrine and paracrine
An adult client with growth-hormone deficiency related to hypopituitarism has been taking replacement therapy for several months. The client informs the nurse that she is having pain in the hand and wrist almost constantly. What does the nurse understand is a common side effect of this therapy that seems to have affected this client?
Carpal tunnel syndrome
A patient is admitted to the hospital in adrenal crisis 1 month after a diagnosis of Addison disease. The nurse knows which of the following clinical manifestations would support this diagnosis?
Change in the level of consciousness and profound hypotension
A client tells his health care provider that his body is changing. It used to be normal for his blood glucose to be higher during the latter part of the morning. However, now his fasting blood glucose level is elevated in the early AM (07:00). The health care provider recognizes the client may be experiencing:
Dawn phenomenon
A client experiences an increase in cortisol as a result of Cushing disease. Which hormonal responses demonstrate the negative feedback mechanism?
Decreased adrenocorticotropic hormone (ACTH)
Which type of imaging is preferred to evaluate the bone density of a client with hyperparathyroidism?
Dual energy x-ray absorptiometry (DXA) scan
Which of the following is an example of a positive feedback system?
Estradiol and follicle-stimulating hormone (FSH)
A 62-year-old man who is overweight has just been diagnosed with type 2 diabetes. The nurse educator is instructing him in the ways his diabetes can be controlled. The nurse should initially prioritize which action?
Helping the client make meaningful changes to his diet and activity level.
A nurse is assessing a client who is experiencing hypoglycemia caused by an insulin reaction. The client is conscious and can follow directions. Which intervention is most appropriate at this time?
Immediately administer a rapidly absorbed form of glucose (preferably via oral route if the client is alert enough to swallow).
Following the identification of low blood levels of cortisol and low 24-hour urinary free cortisol, a 51-year-old female client has been diagnosed with a primary adrenal cortical insufficiency. Which of the following health consequences would be attributable to her low levels of cortisol?
Impaired immunological and inflammatory response
A client develops hypocalcemia after thyroid surgery. Which hormonal imbalance caused this complication?
Lack of parathyroid hormone
Following a meal, a client's blood glucose level has increased. In addition, the client's pancreas has increased the amount of insulin produced and released. Which phenomenon has occurred?
Increased hormone level according to a negative feedback mechanism
A client diagnosed with metabolic syndrome and growth hormone (GH) deficiency will likely display which physical assessment finding?
Increased visceral fat
The diagnosis of type 1 diabetes would be confirmed by which principle?
Insulin is not available for use by the body. Explanation: Type 1 diabetes is a catabolic disorder characterized by an absolute lack of insulin. In type 2 diabetes, some insulin is produced.
Which metabolic abnormality can lead to the development of type 2 diabetes?
Insulin resistance
Which statement is accurate regarding how hormones are metabolized and excreted?
Peptides are degraded by enzymes in cells.
The newborn nursery nurse is preparing to perform a required neonatal screening for congenital hypothyroidism. What should the nurse do to obtain the necessary sample?
Perform a heel stick to obtain a drop of blood for a T4 and TSH.
Select the most common symptoms of diabetes. Select all that apply.
Polydipsia Polyuria Polyphagia
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?
Prescribing a tapering dose of the medication over weeks
As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated?
Prevent accumulation
A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?
Random blood glucose 85 mg/dL (4.72 mmol/L)
Which manifestation would a nurse expect when assessing a child with insufficient growth hormone (GH) secretion?
Rank below 10% on the growth chart
. A 21-year-old female is suspected of having inadequate function of her hypothalamic- pituitary-thyroid system. Her care provider is planning to inject thyrotropin-releasing hormone (TRH) and then measure her levels of TSH. Which of the following diagnostic tests is being performed?
Stimulation test
A 38-year-old male has presented to a clinic for the treatment of severe dermatitis after contact with poison ivy on a camping trip. The client has been prescribed prednisone, a corticosteroid, for the treatment of his skin condition. The client's care provider has emphasized that dosages of the drug will be gradually tapered off rather than stopped upon resolution of the symptoms. What is the most accurate rationale for this dosing protocol?
The client's hypothalamic-pituitary-adrenal (HPA) system will require recovery time before normal function is restored
Which of the following statements best captures the relationship between the hypothalamus and the pituitary gland as it relates to endocrine function?
The hypothalamus receives input from numerous sources throughout the body and directs the pituitary to then control many target glands and cells.
3. Following a long history of fatigue, weakness, and poor appetite, a 39-year-old male has been diagnosed with hypopituitarism. Which of the following clinical findings would most likely cause his care team to suspect that the man has an additional endocrine disorder from a different source?
The man has a chronic platelet deficiency and is occasionally anemic.
Which of the following statements best captures an aspect of the function of the hypothalamic-pituitary-adrenal (HPA) system?
The pituitary gland communicates with the adrenal cortex through the release of ACTH.
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.
An 8-year-old child has been diagnosed with gigantism. Which criteria would the nurse correlate with the diagnosis of gigantism?
There is increased growth hormone levels and the epiphyses of the long bones are not fused.
A client who has just undergone a thyroidectomy is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these findings as manifestations of which complication?
Thyroid storm
An obese adult has recently been diagnosed with type 2 diabetes. The nurse knows that the most likely treatment plan for this client will include which topics?
Weight loss, glucose monitoring, and oral antihyperglycemic medications
Paracrine action involves which characteristic?
act locally on cells other than those that produce the hormone
Hormones exert their action by interacting with which type of receptors?
affinity
Graves disease
an autoimmune disorder that is caused by hyperthyroidism and is characterized by goiter and/or exophthalmos
Hormones can be synthesized by both vesicle-mediated pathways and non-vesicle-mediated pathways. What hormones are synthesized by non-vesicle-mediated pathways?
androgens and estrogens
When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of:
anterior pituitary gland
A client with acromegaly comes to the clinic and informs the nurse that she is having a productive cough and a low grade fever. This is the client's fourth visit in 1 year for the same problem. What condition does the nurse understand results from this client's enlarged cartilaginous structures?
bronchitis
The nurse is caring for an adult client with growth hormone deficiency. When performing an assessment of this client, which system should the nurse be sure to assess for complications related to this disorder?
cardiovascular system
A client with type 1 diabetes has started a new exercise routine. Knowing there may be some increased risks associated with exercise, the health care provider should encourage the client to:
carry a snack with a rapidly absorbed form of glucose to prevent profound hypoglycemia.
Cushing's syndrome
caused by prolonged exposure to high levels of cortisol
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)
Which effect of thyroid hormone deficit alters the function of all major organs in the body?
decreases metabolism
An adult client presents to the emergency department after an episode of syncope. Blood pressure is low and the pulse is thready and rapid. The client frequently voids large amounts of pale, clear urine. Lung sounds are clear and skin turgor is inelastic. Which endocrine disorder is the likely cause of these manifestations?
diabetes insipidous
ophthalmopathy
disease of the eye
polyphagia
excessive hunger
When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response?
hormone stimulation
Addisonian crisis is related to:
hypoadrenalism
When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptom does the client report that the nurse would find associated with this disorder?
increase in appetite
Which physiologic process best exemplifies a positive feedback mechanism?
increase in prolactin secretion that occurs with more frequent breastfeeding
What is the most common mechanism of hormone control?
neg feedback
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?
neg feedback loop
Growth hormone (GH) secretion is inhibited by
obesity
Addison's disease
occurs when the adrenal glands do not produce enough of the hormones cortisol or aldosterone
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
A client's low serum T4 level has led to a diagnosis of hypothyroidism. When planning this client's care, the nurse should:
teach the client about the safe and effective use of synthetic thyroid hormones.
Which type of characteristic do thyroid and steroid hormones exert on target cells by way of nuclear receptors?
the ability to cross the cell membrane of target cells
macrosomia
large-bodied baby commonly seen in diabetic pregnancies
The mother of a 2-year-old newly diagnosed with type 1 diabetes asks why insulin has to be given by injection. The best response by the nurse is:
"Insulin is destroyed by the stomach contents and has to be administered by injection."
A child has been removed from a home in which she has experienced severe neglect and emotional abuse, and has been placed in foster care. The child has psychosocial dwarfism and the foster parents ask the nurse what this means for the future of the child. What is the best response by the nurse?
"The prognosis of the child depends on an improvement in behavior and catch-up growth."
A young child develops type 1A diabetes. The parents ask, "They tell us this is genetic. Does that mean our other children will get diabetes?" The best response by the health care provider would be:
"This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes."
A client's primary care provider has prescribed an oral glucose tolerance test (GTT) as a screening measure for diabetes. Which instruction should the client be given?
"You will drink a sugar solution and then your blood sugar will be measured at specified intervals."
A female patient presented to her primary care physician with classic signs and symptoms of Cushing syndrome. Upon testing, it was discovered that the patient had vaginal small cell carcinoma. How can the health care providers explain her Cushing syndrome signs and symptoms to this patient?
"Your tumor in your vagina is secreting a hormone called adrenocorticotropic hormone (ACTH), which is responsible for these signs and symptoms."
Of the following list of nursing interventions, which would be considered priority when managing a patient with life-threatening myxedematous coma? Select all that apply
-Administer 3% sodium IV solution to increase sodium levels. -Administer 50% dextrose to raise glucose levels. --Place on oxygen therapy to encourage deep breathing
A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of:
Antidiuretic hormone (ADH) and oxytocin
When educating a client about type 1 diabetes, the nurse will mention that this type is caused by which mechanism?
Autoimmune destruction of pancreatic beta cells
A nurse on a medical unit is providing care for a 37-year-old female patient who has a diagnosis of Graves disease. Which of the following treatments would the nurse most likely anticipate providing for the client?
B adrenergic-blocking med to reduce sympathetic nervous stimulation
A client with hypothyroidism has not taken medication for several months, informing the nurse that she lost her insurance and is unable to afford the medication. When assessing the client's temperature tolerance and skin, what does the nurse anticipate finding? Select all that apply.
Coarse and dry skin and hair Intolerance to cold Decreased sweating
A client with long-term diabetes mellitus reports a "pins and needles" feeling in the feet. What interventions can help reduce this symptom? Select all that apply.
Control blood glucose Gabapentin Lidocaine patch
. A 38-year-old woman takes clomiphene, an infertility drug that works by competing with, and thereby blocking, cellular receptors for estrogen. Which of the following statements is most likely to be true of this client?
Estrogen will continue to pass freely through the cellular membranes
Parents of a 7-year-old girl are concerned about their daughter because she has begun to develop secondary sexual characteristics. What etiologic factor is most likely to underlie the child's condition?
Early activation of the hypothalamic-pituitary-gonadal axis
Which pathophysiologic phenomenon may result in a diagnosis of Cushing disease?
Excess ACTH production by a pituitary tumor
A 23-year-old man is admitted to the hospital. He is experiencing polyphagia, polyuria, and polydipsia. He states that the condition has come on very suddenly. This client is likely to require what treatment?
Exogenous insulin injections
Which hormone is secreted based on a cyclic rather than a diurnal manner?
Follicle-stimulating hormone (FSH)
When the assessment of thyroid autoantibodies is performed, what is the suspected diagnosis?
Hashimoto thyroiditis
Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur?
Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen
A client with diabetes will be undergoing an evaluation of the fluctuation of blood glucose over the previous 120-day span. Which test will this client undergo?
Glycosylated hemoglobin -A1C
Following the identification of low levels of T3 and T4 coupled with the presence of a goiter, a 28-year-old female has been diagnosed with Hashimoto thyroiditis. In light of this diagnosis, which of the following assessment results would constitute an unexpected finding?
Increased white cell count and audible crackles on chest auscultation
A 51-year-old woman has been experiencing signs and symptoms of perimenopause and has sought help from her family physician. A deficiency in estrogen levels has been determined to be a contributing factor. Which of the following phenomena could potentially underlie the woman's health problem?
Insufficient estrogen production within the smooth endoplasmic reticulum of the relevant cells
The nurse knows that metabolic abnormalities that lead to type 2 diabetes include which physiologic problems? Select all that apply.
Insulin resistance Beta cell failure Hepatic glycogenolysis
Which factor contributes to an infant developing macrosomia (large body size)?
Maternal diabetes
A client admitted to the hospital with elevated blood glucose is diagnosed with type 1 diabetes mellitus. What characteristics commonly differentiate type 1 diabetes mellitus from type 2 diabetes mellitus? Select all that apply.
Onset before age 20 Autoimmune beta cell damage Abrupt onset of symptoms
A 51-year-old woman has been diagnosed with Cushing syndrome after a diagnostic workup that reveals cortisol hypersecretion. The nurse knows which of the following assessment findings would be inconsistent with her diagnosis?
Poor stress management and hyperpigmentation
An example of a single hormone that can exert effects in different tissues, erythropoietin, made in the kidney stimulates the bone marrow to produce:
RBCs
. Which of the following statements best captures the essence of a second messenger in the mechanisms of the endocrine system?
Second messengers act as the intracellular signal that responds to the presence of a hormone
A client with severe hypothyroidism is presently experiencing hypothermia. What nursing intervention is a priority in the care of this client?
Slow rewarming of the client to prevent vasodilation and vascular collapse
ACTH (adrenocorticotropic hormone)
Stimulates adrenal cortex to release glucocorticoids (cortisol)
The hallmark manifestations of Cushing syndrome are a moon face, a "buffalo hump" between the shoulder blades, and a protruding abdomen. What other manifestations of Cushing syndrome occur?
Thin extremities and muscle weakness
5. Which of the following statements best captures the role of the adrenal cortex in maintaining homeostasis?
The adrenal cortical hormones are primarily steroids and sex hormones.
The nurse is educating a newly diagnosed client with Hashimoto thyroiditis who is to be discharged from the acute care facility. What should the nurse be sure to include in the education to prevent complications?
The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.
The nurse is providing discharge instructions for a client with Graves disease who has ophthalmopathy. What should the nurse be sure to include in the instructions to decrease exacerbation of this clinical manifestation?
The client should be strongly urged not to smoke. Explanation: Ophthalmopathy can also be aggravated by smoking, which should be strongly discouraged
A client with long-standing type 2 diabetes is surprised to see high blood sugar readings while recovering from an emergency surgery. Which factor may have contributed to the client's inordinately elevated blood glucose levels?
The stress of the event caused the release of adrenal cortical hormones.
A client with a history of an endocrine exhibits signs and symptoms of hormone deficiency. Which of the following processes would the client's care team most likely rule out first as a contributing factor?
Up-regulation has increased the sensitivity of the body to particular hormone levels.
. A client with a new diagnosis of an endocrine disorder is unclear how the body can control the levels of different hormones over time. Which of the following statements most accurately underlies the dominant regulation process of hormone levels in the body?
With input from various sensors, hormone production and release are adjusted based on existing hormone levels.
The obstetrical nurse is caring for a client who has been treated for gestational diabetes. When teaching the client about the causes of gestational diabetes, the nurse should include which risk factor in the teaching?
Woman with a family history of diabetes
Thyroid storm
a relatively rare, life-threatening condition caused by exaggerated hyperthyroidism -fever -tachycardia -htn
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?
cortisol, a glucocorticoid
When caring for a client who is being screened for osteoporosis, the nurse plans to evaluate the results of which diagnostic test?
dual-energy x-ray absorptiometry (DXA)
The nurse is caring for a client with a hormonal disorder that is widely affecting many body systems. The nurse recognizes that which form of hormone signalling pathway is most likely involved in the client's disorder?
endocrine
The endocrine system is closely linked with the nervous system. Which neurotransmitter can also act as a hormone?
epinephrine
polydipsia
excessive thirst
polyuria
excessive urination
Diabetic ketoacidosis (DKA) in a client with type 1 diabetes occurs when the lack of insulin leads to the release of which physiologic product?
fatty acids
A client with hyperthyroidism is being treated with medication that blocks the activity of thyroid-stimulating hormone. Her care team has determined that she has been overproducing TSH. This client will have lost her ability to:
have negative feedback regulation.
A 30-year-old client who manages type 2 diabetes with glyburide presents at the emergency room reporting headache, confusion, and tachycardia. The client has come from a party at which the client drank two beers to celebrate running a half-marathon. Which is likely to be the cause of this client's?
hypogylcemia
A major manifestation of Cushing syndrome includes which of the following?
hypokalemia
Which manifestation indicates a client is at risk for developing diabetes mellitus?
2 hour oral GTT 175 mg/dL (9.7 mmol/L)
When explaining about structural classifications to a group of students, the instructor discusses the peptides and proteins. They talk about small hormones and hormones as large and complex as growth hormone (GH), which has approximately how many amino acids involved?
200 amino acids
Which diagnostic test will be performed for a client with a suspected pheochromocytoma?
24 hour urine
Steroid lifespans are longer, approximately ____ days, because they are protein bound
6
When educating a client with possible glucocorticoid dysfunction, the nurse will explain that the CRH controls the release of ACTH. The best time to perform the blood test to measure peak ACTH levels would be:
06:00 to 08:00 AM
An endocrinologist is providing care for a 30-year-old male who has lived with the effects of increased levels of growth hormone (GH). Which of the following teaching points about the client's future health risks is most accurate?
"When your pituitary gland is enlarged, there's a real risk that you'll develop some sight deficiencies."
A client with Graves disease has ophthalmopathy and asks the nurse if the eyes will stay like this forever. What is the best response by the nurse?
"With treatment of the hyperthyroid state, the ophthalmopathy usually tends to stabilize."
An infant born with congenital hypothyroidism and has not sought care from any health care provider is likely to develop which of the following complications? Select all that apply
-Impaired physical growth -Mental retardation
A woman in her 28th week of pregnancy develops gestational diabetes mellitus and has persistent elevated blood glucose when using the diet plan. What medications are appropriate?
-insulin -glyburide
Testing for short stature growth hormone (GH) problems can be done by pharmacologic means. Which of the following medications can be utilized to test for a rise in GH? Select all that apply.
-insulin -levodopa
Thyroid hormone is also degraded in _________ and metabolized in the _______.
-tissues -liver
Which client does the nurse recognize is at the most risk for the development of subacute thyroiditis?
A 32-year-old postpartum client
The nurse is providing education for a client diagnosed with hypothyroidism. What information about diet should the nurse be sure to include in this information?
The client should maintain a low cholesterol diet.
During the follicular stage of menstruation, increased estradiol production causes an increase in FSH production. This increase in FSH production by the anterior pituitary gland will have what effect on the follicle?
The follicle will die, which results in a fall of FSH
A middle-aged woman has acromegaly as a result of a pituitary adenoma that was found and removed when she was a teenager. The physician is suspecting that the tumor has returned and has ordered a diagnostic work-up. A glucose load is ordered. If the tumor has returned, the nurse would expect which result?
The growth hormone level will not be suppressed following glucose load.
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 hypothalamic-pituitary-target cell system
Which hormone is produced by the anterior pituitary gland?
growth hormone (GH)
The hypophysis is a unit formed by the pituitary and the hypothalamus. These two glands are connected by the blood flow in what system?
hypophyseal portal system
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?
hypothalamus
Release and synthesis of anterior pituitary hormones are mainly regulated by which part of the body?
hypothalamus
Which gland acts as a signal-relaying bridge between multiple body systems and the pituitary gland?
hypothalamus
An infant whose mother had myxedema during the pregnancy has failed to meet standards for growth and is developmentally delayed. Which hormonal imbalance is this child exhibiting?
hypothyroidism
The nurse is planning to collect a 24-hour urine sample for hormone assay. In which situation does the nurse collaborate with the health care provider to find an alternate type of testing?
pt has anuria
During a near-miss accident while cycling, a client marvels at how fast he was able to react. He attributes this to his "fight or flight" response but then wonders why it lasts for only a short period. The client had a short burst of catecholamine activity because catecholamines are:
rapidly degraded by enzymes in circulation and at the tissue.
Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to stimulate the adrenal glands, the adrenals' production of cortisol drops. This is an example of which type of endocrine disorder?
secondary
The nurse knows that the client with which complication of diabetes has the greatest risk for the development of foot ulcers?
sensory neuropathy
A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes. The best diagnostic indicator that would support the client's response would be:
Glycosylated hemoglobin, hemoglobin A1C (HbA1C)
A parent brings his child to the clinic, concerned about her short stature and asking the nurse if there is a problem with her height. What indication is the nurse aware of when performing the assessment that determines whether this child has short stature?
The child's height is well below the 3rd percentile on several clinic visits.
A client is managing diabetes with exercise and diet. The health care provider reviews the client's most recent laboratory results: fasting blood glucose level at 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (0.05). Select the response that best identifies the client.
The client is achieving normal glycemic control.
A middle-aged woman has acromegaly as a result of a pituitary adenoma that was found and removed when she was a teenager. The physician is suspecting that the tumor has returned and has ordered a diagnostic work-up. A glucose load is ordered. If the tumor has returned, the nurse would expect which of the following results?
The growth hormone level will not be suppressed following glucose load
Myxedema coma is related to:
hypothyroidism
Unbound adrenal and gonadal steroids are inactivated in the liver and then excreted:
in bile or urine
Which pregnant woman likely faces the greatest risk of developing gestational diabetes? A client who:
is morbidly obese (defined as greater than 100 pounds over ideal weight).
Since steroid hormones are bound to protein carriers for transport, this means:
they are inactive in the bound state
A client reports multiple nonspecific concerns, and the health care provider has ordered a positron emission tomography (PET). For which is the client being evaluated?
tumors located on the endocrine glands
A 48-year-old woman has been found to have nodules on her thyroid that must be biopsied to determine whether or not they are malignant. Which of the following imaging techniques will be most helpful to the surgeon in visualization of the nodes for fine needle aspiration?
ultrasound
When caring for the client with diabetes, the nurse emphasizes the risk of kidney disease. Which test does the nurse encourage the client to have performed annually for early detection of renal disease?
urine test for microalbuminuria