Patho Week 9
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
A client with a suspected diagnosis of primary hypothyroidism would most likely demonstrate which serum laboratory value?
Elevated thyroid-stimulating hormone (TSH) and decreased thyroxine (T4)
Select the most appropriate intervention for the nurse to teach a client diagnosed with distal symmetric neuropathy related to diabetes.
Inspect the feet for blisters daily
A client diagnosed with type 2 diabetes has been instructed about managing his condition with diet. Which statements by the client indicate a need for additional education? Select all that apply.
"I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads." "I need to carefully limit my protein consumption."
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."
Which of the following are examples of amines? Select all that apply.
- Norepinephrine - Epinephrine
The nurse is working in a pediatric clinic. Which child would the nurse recognize as having isosexual precocious puberty?
A 5-year-old black female with developing breasts and pubic hair
A client comes to a scheduled appointment in the endocrine clinic. The primary care physician referred the client, suspecting acromegaly. Knowing the usual testing involved, the nurse should educate the client about which lab/diagnostic procedure?
A suppression test
A 25-year-old female client exhibits exophthalmos of both eyes. The health care provider recognizes this as a manifestation of:
Graves disease
What is the most common mechanism of hormone control?
Negative feedback
A nursing instructor is teaching a group of students about the action of hormones. The instructor determined that teaching was effective when the students recognize the local action of hormones as:
Paracrine
Which gland is often referred to as the master gland because it secretes many hormones?
Pituitary
A client is managing his type 2 diabetes with exercise and diet. He has a fasting blood sugar level (FBS) of 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (.05). Based on these findings, which of the following can the nurse assume?
The client is achieving normal glycemic control.
Which disorder is a result of excess cortisol?
Cushing syndrome
Which manifestation would the nurse observe when assessing a client diagnosed with a benign secreting tumor of the adrenal medulla?
Elevated catecholamine levels and tachycardia
Management of hyperthyroidism would include which interventions? Select all that apply.
- Eradication of the gland with radioactive iodine - Surgical removal of part of the gland or the entire gland - Drug therapy directed toward decreasing the gland's function
A client has developed a tumor of the anterior pituitary gland. The nurse is aware that the client is at risk for alterations in which body function? Select all that apply.
- Glucocorticoid hormone levels - Growth and metabolism - Function of the thyroid gland - Function of the gonads
Which interventions would be included in the plan of care for a client experiencing myxedema coma? Select all that apply.
- Initiation of thyroid replacement therapy - Reversal of hypoglycemia - Oxygen therapy to support ineffective respirations - Frequent monitoring of cardiac functions
A nurse is teaching a client with newly diagnosed type 1 diabetes about the importance of blood glucose control to decrease the risk of which potential chronic complications of diabetes? Select all that apply.
- Neuropathy - Retinopathy - Nephropathy - Gastroparesis
Which events are involved in the negative feedback mechanism that keeps the serum thyroid hormone level within appropriate range? Select all that apply.
- Stimulation of sensors in the hypothalamus - Decrease in secretion of thyroid stimulating hormone (TSH) - Stimulation of sensors in the anterior pituitary gland - Increased levels of thyroid hormone
A nurse has just completed client education on how hormones are normally regulated by feedback mechanisms. The client asks, "What, if anything, can alter the regulation of anterior pituitary hormones?" Which response by the nurse would be considered an appropriate reply? Select all that apply.
- Temperature - Nutritional status - Stress
Which manifestations regarding hypothyroidism are accurate? Select all that apply.
- Weight gain - Onset of symptoms is gradual - Anorexia
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.
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
A 48-year-old male client diagnosed with type 2 diabetes presents with the following: • Blood glucose level of 46 mg/dL (2.55 mmol/L) • Very lethargic • Has cool, clammy skin. Select the most appropriate intervention.
Administer injectable glucagon
The health care provider is teaching a client about the metabolic effect of cortisol. The most appropriate information to provide would be:
Breakdown of proteins and fats
Which complication of acromegaly can be life threatening?
Cardiac structures increase in size
If glucagon binds to surface receptors on liver cells to send an intracellular message for glycogen breakdown, this process is known as which mechanism of action?
Cell surface receptors
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
Which hormone is secreted based on a cyclic rather than a diurnal manner?
Follicle-stimulating hormone (FSH)
Select the most appropriate statement that describes the function of hormones.
Hormones function as modulators of cellular and systematic responses.
Which gland acts as a signal-relaying bridge between multiple body systems and the pituitary gland?
Hypothalamus
The diagnosis of type 1 diabetes would be confirmed by which principle?
Insulin is not available for use by the body.
The nurse is educating a client with a newly diagnosed thyroid cancer. Which testing procedure should be reviewed because it allows good examination of the tissue structure and provides information about the tissue function as well?
Positron emission tomography/CT (PET/CT)
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 asks the nurse what causes the secretion of growth hormone (GH) and adrenocorticotrophic hormone (ACTH) to fluctuate. The best response by the nurse would be:
Sleep-wake cycles
The nurse is assessing a female client with a diagnosis of primary adrenal cortical insufficiency. Which manifestation should the nurse anticipate?
Sparse axillary and pubic hair
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 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.
Which statement best describes a secondary disorder of endocrine function?
The disorder occurs when the target organ is normal, but stimulating hormones alter its function.
