Davis Advantage Ch. 24 Pituitary and Thyroid Disorders

Please place the following sequences in order to describe how iodine deficiency may lead to a goiter.

1. Decreased iodine in diet 2. Decreased thyroid hormone synthesis 3. Decreased negative feedback on anterior pituitary 4. Increased thyroid-stimulating hormone (TSH) secretion 5. Increased thyroid growth

A patient suffering for diabetes insipidus is given antidiuretic hormone (ADH). The result is increased fluid retention and decreased urine output. Which of the following conditions does the patient have? Nephrogenic diabetes insipidus Central diabetes insipidus Diabetes mellitus Syndrome of inappropriate diabetes insipidus (SIADH)

Central diabetes insipidus

The nurse finds decreased T3 and T4 hormone levels in the laboratory report of a patient diagnosed with an endocrine disorder. What specific characteristics does the nurse expect to find? Select all that apply. Fatigue Weight loss Feeling hot Decreased heart rate Weight gain

Fatigue Decreased heart rate Weight gain

The most common cause of thyroid hyperfunction is ______________. elevated TSH. Hashimoto's thyroiditis. Graves' disease. a tumor of the pituitary.

Graves' disease.

Based on your assessment, the physician decides to have several blood tests completed. All results are normal except the following: significantly elevated thyroid hormone levels (free T3 and free T4) and undetectable TSH and TRH. What endocrine disorder does Janelle most likely have? Primary thyroid hypofunction Secondary thyroid hyperfunction Tertiary thyroid hyperfunction Primary thyroid hyperfunction

Janelle's condition is hyperthyroidism as indicated by the elevated thyroid hormone levels. The condition is primary, a problem in the thyroid gland, because TSH levels (the signal from the anterior pituitary that stimulates the thyroid gland) are low.

A patient with Hashimoto's thyroiditis is being given levothyroxine. The patient wants to know how the medication works. Which of the following responses is correct for the nurse to make? Levothyroxine blocks excess thyroid hormones. Levothyroxine stimulates thyroid receptors. Levothyroxine blocks the antibodies that cause Hashimoto's thyroiditis. Levothyroxine replaces missing thyroid hormone.

Levothyroxine replaces missing thyroid hormone.

A patient presents with hyperthyroidism. Which of the following values enables the clinician to rule out secondary hyperthyroidism? Low thyroid-stimulating hormone (TSH) Elevated thyroxine Low thyrotropic releasing hormone (TRH) Elevated T3 levels

Low thyroid-stimulating hormone (TSH)

The physician informs Janelle that if her thyroid gland was removed, she would need to take medication to replace the hormones normally synthesized by this gland. Which medication will Janelle likely be prescribed? Naproxen Amantadine Herceptin Levothyroxine

Once the thyroid gland is removed, Janelle must take a replacement thyroid hormone such as levothyroxine for the rest of her life. She will work closely with her physician to determine the proper dosage to meet her metabolic needs.

Reviewing a patient's chart, a nurse notes the presence of acromegaly. Which of the following is likely to be present when the nurse assesses the patient? Increased stature Cold intolerance Overgrowth of jaw, hands Galactorrhea

Overgrowth of jaw, hands

The physician states that Janelle may need surgery to remove her thyroid gland. What other endocrine tissues are located near the thyroid glands? Adrenal glands Parathyroid glands Pituitary gland Pineal gland

The parathyroid glands are small glands, normally four in number, located on the posterior thyroid. Procedures on the thyroid gland may result in incidental parathyroid injury.

If the parathyroid gland is damaged during thyroid surgery, which condition will the physician be most concerned about Janelle developing? Hypernatremia Hypocalcemia Hypokalemia Diuresis

The parathyroid glands release parathyroid hormone in response to low serum calcium. If the parathyroid glands are damaged and cannot release parathyroid hormone, serum calcium levels may fall.

A nursing student notices elevated thyroid stimulating hormone (TSH) on laboratory values, along with low thyroxine levels. What is the proper interpretation of the results? The patient has secondary hypothyroidism. The patient has primary hypothyroidism. The patient has hyperfunctioning of the anterior pituitary. The patient has Grave's disease.

The patient has primary hypothyroidism.

Which signs or symptoms would result from syndrome of inappropriate antidiuretic hormone? Select all that apply. Concentrated plasma Thirst Fluid retention Hypervolemia Dehydration

Thirst Fluid retention Hypervolemia

You examine Janelle and notes her resting heart rate is 84 beats per minute and blood pressure is 144/88 mm Hg. Which hormone may increase resting heart rate and blood pressure? Oxytocin Growth hormone Thyroid hormone Antidiuretic hormone

Thyroid hormone

Hyperfunction of the ________________ that results in excess growth hormone may cause ___________. posterior pituitary; acromegaly anterior pituitary; acromegaly hypothalamus; acromegaly anterior pituitary; Graves' disease

anterior pituitary; acromegaly

Acromegaly is caused by __________________. excess growth hormone excess cortisol excess antidiuretic hormone excess thyroid hormone

excess growth hormone

Graves' disease ________________. Select all that apply. is an autoimmune condition of the posterior pituitary. is a form of hyperthyroidism. is a neurogenic disorder. causes weight gain, bradycardia, and fatigue. results in elevated thyroid hormones.

is a form of hyperthyroidism. results in elevated thyroid hormones.

Central diabetes insipidus _________________. Select all that apply. results in increased plasma osmolarity. results in excess water secretion. causes increased blood glucose. is another form of diabetes mellitus. is caused by oversecretion of ADH.

results in increased plasma osmolarity. results in excess water secretion.

A patient with central diabetes insipidus _________________. will drink less water than normal. will have a higher than normal metabolism. will likely have edema. will have increased urine output.

will have increased urine output.

A patient needs a screening of anterior pituitary hormone functioning. Which hormone should not be included in the evaluation? Antidiuretic hormone Thyroid stimulating hormone (TSH) Growth hormone Follicle-stimulating hormone

Antidiuretic hormone

Please indicate on the figure the step in which elevated T4 levels would decrease further stimulatory signals from the pituitary gland.

Between brain and hypothalamus, green highlight

A patient with a traumatic brain tumor suffered a pituitary apoplexy. Which of the following does the nurse expect to encounter? Patient with limited signs and symptoms Blood laboratory values revealing elevated growth hormone-releasing hormone (GHRH), thyrotropic releasing hormone (TRH) and corticotropin-releasing factor (CRF) Hyperfunctioning of thyroid and adrenal gland Increased adrenocorticotropic hormone (ACTH) and thyroid-stimulating hormone (TSH) blood levels

Blood laboratory values revealing elevated growth hormone-releasing hormone (GHRH), thyrotropic releasing hormone (TRH) and corticotropin-releasing factor (CRF)

Further screening reveals elevated thyroid-stimulating antibodies. What condition is Janelle experiencing? Hashimoto's thyroiditis Cushing's syndrome Graves' disease SIADH

Elevated thyroid hormone levels can occur for a variety of reasons. Determining the underlying etiology of the elevated hormones is key for treatment. In this case, Janelle is experiencing an autoimmune disease known as Graves' disease. In Graves' disease, there are excess levels of T3 and T4 because of thyroid-stimulating autoantibodies, which bind to and activate thyrotropin receptors within the thyroid gland, causing the gland to enlarge and continually synthesize thyroid hormones. Graves' disease is the most common cause of hyperthyroidism.

Which of the following is shown in this image? A. Exophthalmos B. Periorbital edema C. Bell's palsy D. Enophthalmos

Exophthalmos

Hypofunction of an endocrine gland is associated with which of the following? Select all that apply. Hashimoto's thyroiditis Graves' disease Central diabetes insipidus Syndrome of inappropriate antidiuretic hormone Acromegaly

Hashimoto's thyroiditis Central diabetes insipidus

A patient suffering from severe stress and anorexia has the following laboratory values, which are all low: gonadotropin-releasing hormone (GnRH), growth hormone-releasing hormone (GHRH), and corticotropin-releasing factor (CRF). Which tissue is likely dysfunctional? Adrenal cortex Hypothalamus Posterior pituitary Anterior pituitary

Hypothalamus

A patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following would support this diagnosis? Select all that apply. Increased plasma osmolarity Increased plasma ADH levels Increased urine concentration Dehydration and fluid volume deficit Dilutional hyponatremia

Increased plasma ADH levels Increased urine concentration Dilutional hyponatremia

Which of the following individuals would a nurse be most concerned about with respect to the development of Sheehan's syndrome? 15-year-old male Postpartum woman Young child with growth delay Postmenopausal woman

Postpartum woman

Hyperpituitarism is most commonly caused by which of the following? Prolactinoma Autoimmune disorder Congenital defect Sheehan syndrome

Prolactinoma

Excess antidiuretic hormone is associated with which of the following conditions? Central diabetes insipidus Graves' disease SIADH Hashimoto's thyroiditis

SIADH

Janelle, a 30-year-old woman, presents at her primary care office complaining of feeling nervous and anxious. She states that she even feels as if her heart is racing because she is "so stressed out." Janelle would like to be prescribed antianxiety medication.Janelle's height and weight measurements reveal she has lost 15 pounds in the last 6 months. She attributes her weight loss to stress.What hormone disorder may lead to weight loss? Thyroid hyperfunction Thyroid hypofunction Central diabetes insipidus Posterior pituitary hyperfunction

Thyroid hormone hyperfunction is commonly associated with weigh loss as thyroid hormones regulate body metabolism. Hyperthyroidism causes an elevation in the basal metabolic rate, which may result in significant weight loss.

A nursing student is reviewing signs and symptoms of hyperthyroidism. Which of the following should she include on her list? Select all that apply. Weight loss Tachycardia Lethargy Tremors Cold intolerance

Weight loss Tachycardia Tremors

You note slight tremors in Janelle's hands, and an area in her neck appears to be enlarged compared with its appearance in previous visits. Janelle lists further complaints, including hair loss, diarrhea, and "feeling hot all the time." Which of the following is true? Parathyroid gland enlargement normally appears in the anterior neck area. You should manually palpate Janelle's neck with moderate force to assess the size of the tissue. Enlargement of the thyroid gland can make the neck area appear "fuller" than normal. Any enlargement of the thyroid gland indicates the presence of thyroid cancer, which is likely Janelle's diagnosis.

When the thyroid gland enlarges, changes in the appearance of the neck may be noticeable. Janelle's neck should not be palpated with force as this can cause further damage to the thyroid gland. The parathyroid glands are located behind the thyroid, not on the anterior neck. An enlarged thyroid gland can occur for many reasons, not necessarily cancer.