Chapter 29: Endocrine Function 5-8

Age and radiation history

A 40-year-old male client with a history of childhood non-Hodgkin lymphoma and radiation treatment is being admitted for thyroid cancer. The client is a commercial airline pilot, does not smoke, exercises regularly, and eats mostly take-out food. What risk factors are primarily associated with his diagnosis? Employment and smoking history Dietary choices and gender Age and radiation history Childhood cancer and physical activity

Bone density testing

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

Stimulate more hormones using the negative feedback system

A client has a decreased level of thyroid hormone being excreted. What will the feedback loop do to maintain the level of thyroid hormone required to maintain homeostatic stability? Be unable to perform in response to low levels of thyroid hormone. Produce a new hormone to try and regulate the thyroid function Stimulate more hormones using the negative feedback system Stimulate more hormones using the positive feedback system

Magnetic resonance imaging (MRI)

A client is suspected to have a pituitary tumor due to signs of diabetes insipidus. What initial test does the nurse help to prepare the client for? Radioactive iodine uptake test Radioimmunoassay Magnetic resonance imaging (MRI) A nuclear scan

"If treated successfully, the major physical changes will disappear with time."

A client with Cushing syndrome is admitted to the hospital. During the initial assessment, the client tells the nurse, "The worst thing about this disease is how awful I look. I want to cry every time I look in the mirror." Which statements by the nurse is the best response? "I can show you how to change your style of dress so that the changes are not so noticeable." "I can refer you to a support group. Talking to someone may help you feel better." "I do not think you look bad and I am sure your family loves you very much." "If treated successfully, the major physical changes will disappear with time."

Deficient production of vasopressin

A client with a traumatic brain injury is producing an abnormally large volume of dilute urine. Which alteration to a hormone secreted by the posterior pituitary would the nurse expect to find? Deficient production of vasopressin Increased oxytocin Increased antidiuretic hormone A deficient amount of somatostatin

moon face facial hair buffalo hump truncal obesity

A nurse assesses a female client and suspects that the client may be experiencing an excess in adrenocortical hormones. Which assessment finding would support the nurse's suspicion? Select all that apply. moon face facial hair buffalo hump truncal obesity exophthalmos

Kidneys

An instructor has just finished teaching a class about the endocrine system. The instructor determines that the students need additional instruction when they identify which of the following as an endocrine gland? Pancreas Adrenal gland Testes Kidneys

Oxytocin

An instructor is preparing a teaching plan for a class on the various pituitary hormones. Which hormone would the instructor include as being released by the posterior pituitary gland? Somatotropin Prolactin Oxytocin Adrenocorticotropic hormone

Detecting evidence of hormone hypersecretion

During physical examination of a client with a suspected endocrine disorder, the nurse assesses the body structures. The nurse gathers this data based on the understanding that it is an important aid in which of the following? Detecting evidence of hormone hypersecretion Detecting information about possible tumor growth Determining the presence or absence of testosterone levels Determining the size of the organs and location

Facilitating glucose transport into body cells

In response to a patient's elevated blood glucose level, the nurse has administered a dose of insulin as ordered. The nurse understands that insulin results in a lowered level of blood glucose by: Inhibiting the action of glucagon Facilitating glucose transport into body cells Stimulating thyroid hormone release and increasing metabolic needs Breaking the molecular bonds in glucose molecules

Pituitary

Vision and visual fields are altered in disorders of which of the following endocrine glands? Thyroid Pituitary Parathyroid Pancreas

Many endocrine glands respond to stimulation from the pituitary gland, which is connected by a stalk to the hypothalamus in the brain. Under the influence of the hypothalamus, the lobes of the pituitary gland secrete various hormones.

Which are correct statements about the relationship between the hypothalamus and the pituitary gland? Select all that apply. Many endocrine glands respond to stimulation from the pituitary gland, which is connected by a stalk to the hypothalamus in the brain. The pituitary gland is called the master gland because it regulates the function of the hypothalamus and other endocrine glands. Under the influence of the hypothalamus, the lobes of the pituitary gland secrete various hormones. The hypothalamus is called the master gland because it regulates the function of the pituitary gland.

Alpha

Which type of cell secretes glucagon and promotes gluconeogenesis? Alpha Beta Delta Omega

Hydrocortisone

A client with a history of Addison's disease and flu-like symptoms accompanied by nausea and vomiting over the past week is brought to the facility. His wife reports that he acted confused and was extremely weak when he awoke that morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. What should the nurse expect to administer by IV infusion? Insulin Hydrocortisone Potassium Hypotonic saline

Reassure the client that their emotional reactions are a result of the disorder and symptoms can be controlled with effective treatment.

A client with hyperthyroidism is concerned about changes in appearance. How can the nurse convey an understanding of the client's concern and promote effective coping strategies? Refer the client to professional counseling. Encourage the client to participate in outside activities to boost coping strategies. Suggest that the client wear cosmetics to cover any changes in appearance. Reassure the client that their emotional reactions are a result of the disorder and symptoms can be controlled with effective treatment.

"I'll stay here with you while the technician draws your blood."

A client with hypothyroidism is afraid of needles and doesn't want to have his blood drawn. What should the nurse say to help alleviate his concerns? "When your thyroid levels are stable, we won't have to draw your blood as often." "It's only a little stick. It'll be over before you know it." "The physician has ordered this test so you can get better sooner." "I'll stay here with you while the technician draws your blood."

Urine specific gravity of 1.001 to 1.005

A nurse caring for a patient with diabetes insipidus is reviewing the patient's laboratory results. What is an expected urinalysis finding? Glucose in the urine Albumin in the urine Urine specific gravity of 1.001 to 1.005 Leukocytes in the urine

An irregular apical pulse

A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately? Dry mucous membranes Frequent urination Pitting edema of the legs An irregular apical pulse

The client's thyroid rises.

A nurse is assessing a client's thyroid gland. The nurse asks the client to swallow. Which response would the nurse document as a normal finding? Thyroid slides to the left. The client's thyroid rises. Thyroid stays at the current position. Thyroid moves downward.

Atrophy of the gonads

A nurse is caring for a client suspected of having a pituitary tumor that is causing panhypopituitarism. During assessment of the client, which clinical manifestation would the nurse expect to find? Carpopedal spasm Hypertension Atrophy of the gonads Tachycardia

Tell the client she'll soon experience improvement in her looks as the medication corrects her hormone deficiency.

A nurse is caring for a female client with hypothyroidism. The client is extremely upset about her altered physical appearance. She doesn't want to take her medication because she doesn't believe it's doing any good. What should the nurse do? Tell the client that she looks fine and offer to help her with makeup. Tell the client she needs to learn to accept herself as she is and be compliant during treatment. Tell the client she'll feel better if she consistently takes the thyroid replacement medication. Tell the client she'll soon experience improvement in her looks as the medication corrects her hormone deficiency.

"Has your shoe size increased recently?"

A nurse is completing an assessment of a client with suspected acromegaly. To assist in making the diagnosis, which question should the nurse ask? "Have you had a recent head injury?" "Has your shoe size increased recently?" "Do you experience skin breakouts?" "Is there any family history of acromegaly?"

abnormal bulging or protrusion of the eyes

A nurse is performing an examination and notes that the client exhibits signs of exophthalmos. What has the nurse observed? excessive hair growth enlarged thyroid gland changes in pigmentation abnormal bulging or protrusion of the eyes

Encircle the client's neck with both hands, have the client slightly extend his neck, and ask him to swallow.

A nurse is preparing to palpate a client's thyroid gland. Which action by the nurse is appropriate? Place her hands around the client's neck, with the thumbs in the front of the neck, and gently massage the anterior neck. Have the client flex his neck onto his chest and cough while she palpates the anterior neck with her fingertips. Have the client hyperextend his neck and take slow, deep inhalations while she palpates his neck with her fingertips. Encircle the client's neck with both hands, have the client slightly extend his neck, and ask him to swallow.

The client is being tested for a thyroid disorder

A nurse is reviewing a laboratory order for a client who is scheduled to be tested for a suspected endocrine disorder. The client was recently seen in the office for bronchitis, and you note that he is still taking cough medication. The nurse explains to the client that he will not be able to get his lab testing done today. Why has the testing been postponed? The client is being tested for a pituitary disorder The client is being tested for a thyroid disorder The client is being tested for a parathyroid disorder The client is being tested for an adrenal disorder

Adequate vitamin D level

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

Intolerance to cold

A nurse who oversees the care that is provided in a long-term care facility is aware that there are numerous age-related changes to every body system. Which of the following phenomena may be a result of age-related changes to the endocrine system? Decreased auditory and visual acuity Increased response time to stimuli Intolerance to cold Decreased oil production by sebaceous glands

Fluid deprivation test

A patient comes to the clinic with complaints of severe thirst. The patient has been drinking up to 10 L of cold water a day, and the patient's urine looks like water. What diagnostic test does the nurse anticipate the physician will order for diagnosis? Complete blood count (CBC) Fluid deprivation test Urine specific gravity TSH test

Helps the body adjust to stress

A patient is diagnosed with Addison's disease, a condition that results in insufficient production of cortisol. Which of the following is the most important function of cortisol that the nurse needs to consider when caring for a patient with Addison's disease? Maintains blood pressure Helps the body adjust to stress Slows the body's response to inflammation Regulates metabolism

The stress of hospitalization and surgery may cause increased release of glucocorticoids.

A patient who is currently in the hospital recovering from orthopedic surgery has always considered herself to be a "borderline diabetic" who prides herself on maintaining acceptable blood glucose levels through diet and lifestyle modifications. Consequently, she is surprised that her primary care provider has ordered a sliding scale of insulin while she is in the hospital. Why might this patient require insulin at this particular time? Fluid and electrolyte changes surrounding surgery may increase her blood sugar levels. Immobility may cause decreased thyroid hormone levels, decreased metabolic demand, and consequent increased blood sugar. The stress of hospitalization and surgery may cause increased release of glucocorticoids. The action of anesthetic may temporarily blunt the normal release of endogenous insulin by the patient's pancreas.

"I do not know why my skin has gotten so dry lately." "I cannot stand to be in hot weather." "It seems like the fat on my legs moved to my stomach." "I do not have any energy to do what I normally do."

The nurse is assessing the endocrine system of a client. Which statement indicates to the nurse that the client is experiencing a condition that affects endocrine function? Select all that apply. "I get up in the middle of the night to void only occasionally." "I do not know why my skin has gotten so dry lately." "I cannot stand to be in hot weather." "It seems like the fat on my legs moved to my stomach." "I do not have any energy to do what I normally do."

The lower neck anterior to the trachea

The nurse is attempting to locate the thyroid gland in order to determine if it is enlarged. Where should the nurse palpate the thyroid gland? Mid trachea The upper neck posterior to the trachea Distal to the carotid arteries The lower neck anterior to the trachea

Hypocalcemia.

The nurse is aware that the clinical symptoms of a patient with hypoparathyroidism are the result of the initial physiologic response of: Decreased levels of vitamin D. Increased serum levels of phosphate. Hypocalcemia. Cardiac arrhythmias.

Bradycardia

The nurse is caring for a patient diagnosed with Hashimoto's thyroiditis. When assessing this patient what symptom would the nurse expect in a patient with hypothyroidism? Palpitations Bradycardia Flushed skin Bulging eyes

Risk for injury related to weakness

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? Fatigue related to sleep disturbances Disturbed body image related to changes in physical appearance Risk for injury related to weakness Risk for loneliness related to disturbed body image

A rise in serum calcium stimulates the release of calcitonin from the thyroid gland.

The nurse is reviewing a client's laboratory studies and determines that the client has an elevated calcium level. What does the nurse know will occur as a result of the rise in the serum calcium level? A rise in serum calcium stimulates the release of T lymphocytes. A rise in serum calcium stimulates the release of erythropoietin. A rise in serum calcium inhibits the release of calcitonin. A rise in serum calcium stimulates the release of calcitonin from the thyroid gland.

Vasopressin

Which hormone is secreted by the posterior pituitary? Calcitonin Corticosteroids Somatostatin Vasopressin

Have regular follow-up care.

Which instruction should be included in the discharge teaching plan for a client after thyroidectomy for Graves' disease? Keep an accurate record of intake and output. Use nasal desmopressin acetate (DDAVP). Have regular follow-up care. Exercise to improve cardiovascular fitness.

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

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