Chapter 40: Mechanisms of Endocrine

The nurse is caring for a client with a tentative diagnosis of Hashimoto thyroiditis. Which test result does the nurse anticipate will be present in autoimmune thyroiditis?

Positive anti-thyroid peroxidase antibodies

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

An adult client is scheduled for testing of a suspected growth hormone (GH)-secreting tumor. Which result from the glucose suppression test would confirm the condition?

Increased GH secretion

Which gland is often referred to as the master gland because it secretes many hormones?

Pituitary

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.

The nurse is teaching a client newly diagnosed with hypothyroidism. The nurse teaches that thyroid hormone is transported by which?

protein carriers

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.

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 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."

How long is the half-life of the hormone aldosterone, which is only 15% protein bound?

25 minutes

What is the most common mechanism of hormone control?

Negative feedback

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

Which hormone is produced by the anterior pituitary gland?

Growth hormone (GH)

As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated?

Prevent accumulation

The nurse is discussing positive feedback mechanisms. Which example best explains this mechanism?

Increased estradiol production causes increased follicle-stimulating hormone (FSH) production.

Which structure controls the functions of the greatest number of target glands and cells?

Pituitary gland

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

The nurse is caring for a client with a chronic endocrine disorder. The nurse identifies which factor(s) that influences the number or function of hormone receptors? Select all that apply. Antibodies can destroy or block the receptor proteins. A decreased hormone level may produce increased receptor numbers. A sustained excess hormone level brings about a decrease in receptor numbers. Hormones can change their affinity to receptors in response to current metabolic needs. Once in the blood stream, it may take days to weeks before a hormone reaches target cells.

Antibodies can destroy or block the receptor proteins. A decreased hormone level may produce increased receptor numbers. A sustained excess hormone level brings about a decrease in receptor numbers.

A student asks the faculty member, "I just do not get how a hormone can be produced within a neuron and then travel via the blood to affect target cells. Can you give me a couple of examples of this phenomenon?" Which faculty response(s) answers this student's question? Select all that apply. Antidiuretic hormone Parathyroid hormone Testosterone Insulin Epinephrine

Antidiuretic hormone Epinephrine

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

The nurse is reviewing the test results of a client who was given thyrotropin-releasing hormone (TRH) to evaluate the function of the pituitary gland. The nurse would recognize pituitary dysfunction as:

Decreased TSH levels

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)

A nurse examines the laboratory values of a client in heart failure. Which value indicates a compensatory hormone mechanism?

Elevated atrial natriuretic hormone

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 statements are correct about hormone transport? Select all that apply. Insulin is unbound. Thyroid hormone is unbound. Glucocorticoids are bound. Prolactin is unbound. Adrenocorticotropic hormone (ACTH) is bound.

Insulin is unbound. Glucocorticoids are bound. Prolactin is unbound.

A client develops hypocalcemia after thyroid surgery. Which hormonal imbalance caused this complication?

Lack of parathyroid hormone

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

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

Several hormones, including growth hormone (GH) and thyrotropin-releasing hormone (TRH), are bound to and carried by which substance?

Proteins

Which clinical manifestation in a client with suspected Cushing disease would confirm the medical diagnosis?

Red striae on trunk

Hormones are chemical messengers that provide which function in the body?

Regulate body functions

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

The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function.

Stimulation tests

The nurse cares for a client with severe chronic obstructive pulmonary disease who has been taking oral steroids for several years. Which response in the client's endocrine control will the nurse expect?

Suppression of the client's hypothalamic-pituitary-target cell system

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

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 hypothalamic-pituitary-target cell system

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.

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)

The endocrine system is closely linked with the nervous system. Which neurotransmitter can also act as a hormone?

epinephrine

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

In major athletic competition, athletes are required to submit to liquid chromatography testing looking for:

use of performance-enhancing agents to increase the chances of winning.

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.

When hormones act locally rather than being secreted into the bloodstream, their actions are termed:

Autocrine and paracrine