Pathopharm Endocrine NCLEX Practice
The effects of glucocorticoids includes: (select all that apply) a. Anti-inflammatory b. Tumor growth c. Hypertensive d. Metabolic e. Growth suppression
a. Anti-inflammatory d. Metabolic e. Growth suppression The hypertensive response and tumor growth are not results of glucocorticoids. The other three answers are all effects of glucocorticoids.
The healthcare provider orders hydrocortisone sodium succinate [Solu-Cortef] 500 mg IV now. The available medication is hydrocortisone sodium succinate [Solu-Cortef] 1000 mg/mL. How many mL will the nurse administer? a. 0.25 mL b. 0.5 mL c. 0.75 mL d. 2 mL
b. 0.5 mL Divide 500 mg by 1000 mg/mL, which equals 0.5 mL.
Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same syringe? a. "Draw up the clear regular insulin first, followed by the cloudy NPH insulin" b. "It is not necessary to rotate the NPH insulin vial when it is mixed with regular insulin." c. "The order of drawing up insulin does not matter as long as the insulin is refrigerated." d. "Rotate subcutaneous injection sites each day among the arm, thigh, and abdomen."
a. "Draw up the clear regular insulin first, followed by the cloudy NPH insulin" To ensure a consistent response, only NPH insulin is appropriate for mixing with a short-acting insulin. Unopened vials of insulin should be refrigerated; current vials can be kept at room temperature for up to 1 month. Drawing up the regular insulin into the syringe first prevents accidental mixture of NPH insulin into the vial of regular insulin, which could alter the pharmacokinetics of subsequent doses taken out of the regular insulin vial. NPH insulin is a cloudy solution, and it should always be rotated gently to disperse the particles evenly before loading the syringe. Subcutaneous injections should be made using one region of the body (eg, the abdomen or thigh) and rotated within that region for 1 month.
A patient has been given instructions about levothyroxine [Synthroid]. Which statement by the patient indicates understanding of these instructions? a. "I'll take this medication in the morning so as not to interfere with sleep." b. "I'll plan to double my dose if I gain more than 1 pound per day." c. "It is best to take the medication with food so I don't have any nausea." d. "I'll be glad when I don't have to take this medication in a few months."
a. "I'll take this medication in the morning so as not to interfere with sleep." Levothyroxine is used to treat hypothyroidism by increasing the basal metabolism and thus wakefulness. It is administered as a once daily dose and is a lifelong therapy. It is best taken on an empty stomach to enhance absorption.
A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse? a. "Inject this insulin with your first bite of food, because it is very fast acting." b. "The duration of action for this insulin is about 8 to 10 hours, so you'll need a snack." c. "This insulin needs to be mixed with regular insulin to enhance the effects." d. "To achieve tight glycemic control, this is the only type of insulin you'll need."
a. "Inject this insulin with your first bite of food, because it is very fast acting." Lispro is a rapid-acting insulin with an onset of 15 mins, and peak of 2 hrs., so it must be administered immediately before a meal or with meals to control postprandial rises in blood glucose. Lispro must be combined with an intermediate- or long-acting insulin, not regular insulin (which is also short-acting), for glucose control between meals and at night. To achieve tight glycemic control, pts must combine different types of insulin based on their duration of action.
A patient is receiving desmopressin [DDAVP] for the treatment of diabetes insipidus. Which instruction is the priority for a nurse to give the patient? a. "Reduce your water intake to prevent water intoxication." b. "Rotate the nostril you use daily to prevent irritation." c. "Weigh yourself several times each week." d. "You'll quickly see the results of a lower urine amount."
a. "Reduce your water intake to prevent water intoxication." Failure to reduce the fluid intake while using desmopressin results in water intoxication, leading to seizures and coma. It is administered intranasally, therefore rotating the nostril used is important to prevent irritation, but it is not priority. Monitoring weekly weights for volume status and understanding that rapid treatment response are also important, however, they are not as important as reducing the fluid intake to prevent water intoxication.
Which statement is the most important for a nurse to make to a patient who is taking methimazole? a. "You need to notify your doctor if you have a sore throat and fever." b. "Another medication can be given if you experience any nausea." c. "You may experience some muscle soreness with this medicine." d. "Headache and dizziness may occur but not very frequently."
a. "You need to notify your doctor if you have a sore throat and fever." Agranulocytosis (the absence of granulocytes to fight infection) is the most serious toxicity associated with methimazole. Sore throat and fever may be the earliest signs. Nausea, muscle soreness, and headache and dizziness are other adverse effects of methimazole that are not as serious as agranulocytosis.
The healthcare provider orders octreotide [Sandostatin LAR] 250 mcg IM now. The available medication is octreotide [Sandostatin LAR] 1000 mcg/mL. The nurse plans to administer how much? a. 0.25 mL b. 0.5 mL c. 1.25 mL d. 4 mL
a. 0.25 mL The ordered dose is 250 mcg, and the available medication is 1000 mcg/mL. Divide 250 mcg by 1000 mcg/mL, which equals 0.25 mL. The nurse will give one-fourth or 25% of 1 mL.
A nurse is developing a plan of care for a patient who has Addison's disease and is taking hydrocortisone [Cortef]. Which of these outcomes should receive priority in the plan? a. At times of stress, the patient increases the glucocorticoid dose. b. The patient wears a Medic Alert bracelet at all times. c. The patient carries an injectable form and an oral form of glucocorticoid. d. The patient divides the daily dose, taking two-thirds of it in the morning and one-third in the afternoon.
a. At times of stress, the patient increases the glucocorticoid dose. Patients with adrenal insufficiency require lifelong replacement doses of glucocorticoids. Failure to increase the dosage at times of stress and illness can be life-threatening. Wearing a Medic Alert bracelet, carrying injectable and oral forms of glucocorticoid, and dividing the daily glucocorticoid dose are important for a patient taking hydrocortisone, but they are not priorities over understanding the need to increase the dose during stress.
A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these outcomes related to the therapeutic effects of the medication? a. Blood glucose control for 24 hours b. Mealtime coverage of blood glucose c. Less frequent blood glucose monitoring d. Peak effect achieved in 2 to 4 hours
a. Blood glucose control for 24 hours Insulin glargine is administered as a once-daily subQ injection for pts with T1DM; it is used for basal insulin coverage, not mealtime coverage. It has a prolonged duration, up to 24 hrs. with no peaks. Blood glucose monitoring is still an essential component to achieve tight glycemic control.
Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value? a. Creatinine (Cr) level of 2.1 mg/dL b. Hemoglobin (Hgb) level of 9.5 gm/dL c. Sodium (Na) level of 131 mEq/dL d. Platelet count of 120,000/mm3
a. Creatinine (Cr) level of 2.1 mg/dL Metformin can reach toxic levels in individuals with renal impairment, which is indicated by a rise in serum Cr (NR 0.4-1.2 mg/dL).
Which statements about hydrocortisone are correct? (Select all that apply.) a. It is a synthetic steroid identical to cortisol. b. It is a preferred drug for adrenocortical insufficiency. c. It has glucocorticoid and mineralocorticoid actions. d. It is given IV for chronic replacement therapy. e. It should not be given during times of stress.
a. It is a synthetic steroid identical to cortisol. b. It is a preferred drug for adrenocortical insufficiency. c. It has glucocorticoid and mineralocorticoid actions. Hydrocortisone is a synthetic steroid with a structure identical to that of cortisol. Hydrocortisone is a preferred drug for all forms of adrenocortical insufficiency. Oral hydrocortisone is ideal for chronic replacement therapy. Parenteral administration is used for acute adrenal insufficiency and to supplement oral doses at times of stress. Despite being classified as a glucocorticoid, hydrocortisone also has mineralocorticoid actions.
When assessing a patient who has Cushing's syndrome, a nurse associates which clinical manifestations with this disorder? (Select all that apply.) a. Osteoporosis b. Moon face c. Glycosuria d. Ketonuria e. Mood swings
a. Osteoporosis b. Moon face c. Glycosuria e. Mood swings Cushing's syndrome results from excess secretion of ACTH, and is manifested by redistribution of fat to the face and abdomen, excess blood sugar, mood changes, and calcium loss from bone. Ketonuria does not occur.
A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which change to the nursing care plan? a. Refer the patient to a diabetes educator because the result reflects poor glycemic control b. Glycemic control is adequate; no changes are needed. c. Hypoglycemia is a risk; teach the patient the symptoms. d. Instruct the patient to limit activity and weekly exercise.
a. Refer the patient to a diabetes educator because the result reflects poor glycemic control HbA1c is a measure of plasma glucose levels on average over the previous 2-3 month period. The target value is 6.5% or lower; if it is greater than 6.5%, a diabetes educator is an additional resource who can facilitate lifestyle, exercise, and medication changes. Hypoglycemia is not a concern because elevated HcA1c indicate poor glycemic control. Exercise should be part of an overall management program because it counteracts insulin resistance
Which manifestations should a nurse investigate first when monitoring a patient who is taking levothyroxine [Synthroid]? a. Tachycardia b. Tremors c. Insomnia d. Irritability
a. Tachycardia High doses of levothyroxine may cause thyrotoxicosis, a condition of profound excessive thyroid activity. Tachycardia is the priority assessment because it can lead to severe cardiac dysfunction. Tremors, insomnia, and irritability are other symptoms of thyrotoxicosis and should be assessed after tachycardia.
The patient reports that she had to switch pharmacies to save money. She noticed that her "thyroid pill" looks different. The nurse anticipates that the healthcare provider will order what? a. Thyroid stimulating hormone (TSH) level b. Electrocardiogram (ECG) c. Beta human chorionic gonadotropin (hCG) test d. Creatinine level
a. Thyroid stimulating hormone (TSH) level If a switch is made between product manufacturers, TSH level will need to be retested in 6 weeks, and the levothyroxine dosage adjusted as indicated.
A nurse caring for a patient who has diabetic ketoacidosis recognizes which characteristics in the patient? (Select all that apply.) a. Type 2 Diabetes b. Altered fat metabolism leading to ketones c. Arterial blood pH of 7.35 to 7.45 d. Sudden onset, triggered by acute illness e. Plasma osmolality of 300 to 320 mOsm/L
b. Altered fat metabolism leading to ketones d. Sudden onset, triggered by acute illness e. Plasma osmolality of 300 to 320 mOsm/L Diabetic ketoacidosis is the most severe manifestation of insulin deficiency in pts with T1DM. It develops and worsens acutely over several hours to days. Alterations in fat metabolism lead to the production of ketones and ketoacids. Increased ketoacid levels lead to a fall in arterial blood pH below 7.35. Altered glucose metabolism leads to hyperglycemia, water loss, and an elevated plasma osmolality > 294 mOsm/L
Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are products of which structure? a. Hypothalamus b. Anterior pituitary gland c. Posterior pituitary gland d. Ovaries
b. Anterior pituitary gland FSH and LH are secreted by the anterior pituitary gland. They both act on the ovaries to promote either follicular growth and development or ovulation and the development of the corpus luteum. They act in a negative feedback loop with the anterior pituitary gland and hypothalamus to affect the ovaries.
A nurse administers dexamethasone [Decadron], 1 mg, at 11:00 PM to a patient who has suspected adrenal dysfunction. The nurse obtains blood for which of these laboratory tests at 8:00 AM the next morning? a. Potassium b. Cortisol c. Glucose d. Sodium
b. Cortisol The overnight dexamethasone suppression test is used to diagnose Cushing's syndrome. Normally dexamethasone acts to suppress the release of ACTH, thereby suppressing the release of cortisol. In a patient with Cushing's disease, no cortisol suppression occurs. Potassium, glucose, and sodium are not used as measures of adrenal function.
A patient who has Cushing's syndrome is taking ketoconazole [Nizoral] as an adjunct treatment to brain radiation. A nurse should expect the patient to have which of these therapeutic responses? a. Increased resistance to infection b. Enhanced radiation effect to the brain c. Suppressed glucose synthesis d. Increased ACTH production
b. Enhanced radiation effect to the brain Ketoconazole is an antifungal drug that inhibits glucocorticoid synthesis very effectively. It is used as an adjunct to radiation or surgery in pts with Cushing's syndrome. Increased ACTH production, resistance to infection, and suppressed glucose synthesis are not actions of ketoconazole.
Which finding in a patient taking levothyroxine [Synthroid] and warfarin [Coumadin] would require follow-up by a nurse? a. Cardiac dysrhythmias b. Excessive bruising c. Weight loss of 5 kg d. Shortness of breath
b. Excessive bruising Levothyroxine intensifies the effect of warfarin, an anticoagulant that increases the patient's risk for bleeding. The warfarin dose may need to be reduced. Dysrhythmias, weight loss, and SOB are not effects associated with interactions of levothyroxine and warfarin.
A nurse is caring for a patient with decreased triiodothyronine (T3) and thyroxine (T4) and elevated thyroid-stimulating hormone (TSH) levels. The nurse knows the patient is likely suffering from what? a. Thyrotoxicosis b. Hypothyroidism c. Hyperthyroidism d. Graves' disease
b. Hypothyroidism The anterior pituitary increases the production of TSH when thyroid hormone levels of T3 and T4 are reduced, reflecting primary hypothyroidism (Hashimoto's Thyroiditis). Patients may experience fatigue caused by a lowered basal metabolic rate. Thyrotoxicosis, hyperthyroidism, and Graves' disease are medical conditions indicative of excessive thyroid activity. T3 NR: 80-220 ng/dL; T4 NR: 4.5-12.5 mcg/dL; TSH NR: 0.3-6.0 microunits/mL
An adult patient who has GH deficiency is receiving somatropin [Nutropin]. An increase in which finding would indicate to the nurse that the patient is improving? a. Height (by 3 inches) b. Lean body mass c. Physical strength d. Joint range of motion
b. Lean body mass Somatropin is a form of GH. Nutropin is a form of GH. In adults with GH deficiency, replacement therapy does not cause long bone growth or an increase in height, because the epiphyses are already closed. It does increase lean body mass and reduces adipose tissue. Although it increases muscle mass, Somatropin does not increase strength. Joint ROM is unaffected.
Which statements about levothyroxine [Synthroid] are correct? (Select all that apply.) a. Levothyroxine should be taken with food. b. Levothyroxine can be given by IV but is usually taken orally. c. Levothyroxine brands should not be changed if possible. d. Levothyroxine should be taken at night to avoid adverse effects. e. Levothyroxine can affect the metabolism of other medications.
b. Levothyroxine can be given by IV but is usually taken orally. c. Levothyroxine brands should not be changed if possible. e. Levothyroxine can affect the metabolism of other medications. Levothyroxine is almost always administered by mouth, IV administration is reserved for use in the case of myxedema coma and for pts who can't take it PO. Oral doses should be taken once daily on an empty stomach to enhance absorption. Dosing is usually done in the morning at least 30-60 minutes before breakfast. Maintain patients on the same brand of levothyroxine. Levothyroxine affects the metabolism of other medications, including warfarin.
Which is a characteristic of the hypothalamus? It is: a. Divided into 2 nuclei b. Made up of neurosecretory neurons that secrete releasing hormones c. Connected to the anterior pituitary by a single membrane d. Connected to the posterior pituitary by blood vessels
b. Made up of neurosecretory neurons that secrete releasing hormones It is true that the hypothalamus comprises neurosecretory neurons that secrete releasing hormones. The hypothalamus is divided into numerous nuclei, while being connected to the anterior pituitary by blood vessels and to the posterior pituitary by a nerve tract.
A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect? a. Inhibition of carbohydrate digestion b. Promotion of insulin secretion c. Decreased insulin resistance d. Inhibition of ketone formation
b. Promotion of insulin secretion Nateglinide is a meglitinide medication that acts to increase pancreatic insulin release; it is used as an adjunct to calorie restriction and exercise to maintain glycemic control in pts with T2DM. It does not act to reduce insulin resistance or inhibit carbohydrate digestion. It should not be used to manage diabetic ketone formation, because its glucose-lowering effects are too slow to be of benefit.
Which outcome should a nurse establish for a patient who has acromegaly and is receiving octreotide [Sandostatin]? a. Normal urine volume b. Softening of facial features c. Increase in long-bone growth d. Stimulation of the milk reflex
b. Softening of facial features Excessive GH in acromegaly results in coarse facial features, splayed teeth, and large hands and feet. Treatment decreases these effects. he epiphyses have closed in adults, so height is not affected. Urine volume is affected by antidiuretic hormone. Prolactin stimulates the milk reflex.
A nurse assesses a patient who is taking pramlintide [Symlin] with mealtime insulin. Which finding requires immediate follow-up by the nurse? a. Skin rash b. Sweating c. Itching d. Pedal edema
b. Sweating Pramlintide is a new type of antidiabetic medication used as a supplement to mealtime insulin in patients with type 1 and 2 diabetes. Hypoglycemia, which is manifested by sweating, tremors, and tachycardia, is the adverse reaction of most concern. Skin rash, itching, and edema are not adverse effects of pramlintide.
Which manifestation would the nurse most clearly associate with a tumor of the hypothalamus? a. Mood swings b. Unstable body temperature c. Irregular respirations d. Increased heart rate
b. Unstable body temperature One function of the hypothalamus is the regulation of body temperature, and a tumor that compresses the hypothalamus would impair this function. Regulation of mood swings, respiratory rate, and heart rate are not functions of the hypothalamus.
A patient with Graves' disease is treated with iodine-131 therapy. Which statement by the patient would indicate understanding of the treatment's effects? a. "I'll have to isolate myself from my family so I don't expose them to radiation." b. "I'm looking forward to feeling better immediately after this treatment." c. "I'll tell my doctor if I have fatigue, hair loss, or cold intolerance." d. "I'll need to take this drug on a daily basis for at least 1 year."
c. "I'll tell my doctor if I have fatigue, hair loss, or cold intolerance." Iodine-131 is usually given as a single tx to produce remission of Graves' disease. Fatigue, hair loss, and cold intolerance are signs of hypothyroidism, a complication of the treatment. Iodine-131 has a quick radioactive decay and half-life, therefore isolation isn't needed, but it can take up to 2 months for the desired response to develop.
The patient states that when he takes hydrocortisone 24 mg in the morning, he is very tired by mid-afternoon. Which statement by the nurse is correct? a. "You can take 12 mg in the morning and 12 mg at night." b. "You can take 24 mg at night instead." c. "You can take 16 mg in the morning and 8 mg in the afternoon." d. "This is an adverse effect and you should stop taking the medication."
c. "You can take 16 mg in the morning and 8 mg in the afternoon." To mimic normal cortisol secretion, patients can take the entire daily dose in the morning, immediately after waking. If this schedule results in afternoon or evening fatigue, patients may split the dosage, taking two-thirds in the morning and one-third around 4:00 PM. Patients should not stop taking their medication unless advised by their healthcare provider.
The healthcare provider orders 150 mcg of levothyroxine [Synthroid] PO every morning. The medication available is levothyroxine [Synthroid] 75-mcg tablets. How many tablets will the nurse administer? a. 0.5 b. 1 c. 2 d. 4
c. 2 The ordered dose is 150 mcg. The available tablets are 75 mcg. 75 multiplied by 2 equals 150. Therefore, 2 tablets is the correct dose.
A nurse should consider which diagnostic test a priority to obtain before a patient receives iodine-131? a. White blood cell (WBC) count b. Electrocardiogram (ECG) c. Beta human chorionic gonadotropin (hCG) test d. Creatinine level
c. Beta human chorionic gonadotropin (hCG) test Beta hCG is the pregnancy hormone; any female of reproductive age requires a negative result before iodine-131 can be administered because it is a radioactive isotope used to treat hyperthyroidism and is contraindicated in pregnancy and lactation.
A patient in cardiac arrest receives vasopressin [Pitressin] during cardiopulmonary resuscitation (CPR). An increase in which finding would indicate a desired effect of the medication? a. Respiratory rate b. Blood pH c. Blood pressure d. Body temperature
c. Blood pressure Vasopressin is a potent vasoconstrictor. Benefits derive from increased blood flow to the heart and brain during CPR. The blood pH, body temp, and RR are unaffected by vasopressin.
A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse take? a. Take the patient's blood pressure. b. Give the patient's PRN dose of insulin. c. Check the patient's capillary blood sugar. d. Advise the patient to lie down with the legs elevated.
c. Check the patient's capillary blood sugar. The pt is showing symptoms of hypoglycemia at 5pm. NPH has a peak action of 8-10 hours. Based on the duration of action of NPH, the pt's hypoglycemic sx are from the 8am injection.
The nurse is planning care for a patient with signs of acute adrenal insufficiency. What is the priority nursing diagnosis? a. Altered comfort b. Altered nutrition c. Fluid volume deficit d. Activity intolerance
c. Fluid volume deficit Acute adrenal insufficiency (adrenal crisis) is characterized by hypotension, dehydration, weakness, lethargy, and GI sx of nausea/vomiting. Rapid replacement of fluid, salt, and glucocorticoids is essential to prevent shock and death. Comfort, nutrition, and activity are important to address once fluid balance has been restored.
Which nursing diagnosis should be the priority for a patient who is receiving desmopressin [DDAVP]? a. Activity intolerance b. Alteration in comfort c. Fluid volume imbalance d. Deficient knowledge
c. Fluid volume imbalance Desmopressin is a form of antidiuretic hormone that increases sodium and water retention, leading to an alteration in fluid volume. Monitoring of urine volumes and body weights is essential to prevent complications. Alteration in comfort, deficient knowledge of the condition, and activity intolerance are important nursing problems; however, they are not priorities according to the Maslow hierarchy of needs.
What clinical manifestation would the nurse expect in a patient with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH)? a. Serum hyperosmolality b. Urine hypoosmolality c. Hyponatremia from hemodilution d. Serum hypernatremia
c. Hyponatremia from hemodilution The cardinal features of SIADH are symptoms of water intoxication. These include hyponatremia (low serum sodium), serum hypoosmolality, and urine that is inappropriately concentrated (hyperosmolar) with respect to serum osmolality.
A patient is taking fludrocortisone [Florinef]. A nurse should recognize that the patient is at risk for developing an electrolyte imbalance if the patient reports which symptom? a. Syncope b. Weight loss c. Muscle weakness d. Numbness and tingling
c. Muscle weakness Muscle weakness is a sign of hypokalemia, which can occur because fludrocortisone has mineralocorticoid properties, resulting in sodium and fluid retention, and potassium excretion. Syncope and weight loss do not occur because of salt and water retention. Numbness and tingling may be associated with another problem, but are not related to fludrocortisone.
Which of the following characteristics of the parathyroid glands is accurate? a. Large and makes up the majority of the thyroid gland b. Made up of at least 6-10 pairs of glands c. Secretes the most importance factor in calcium regulation d. Influences the production of thyroid hormone
c. Secretes the most importance factor in calcium regulation Parathyroid hormone (PTH) is the most important regulator of calcium. While there are two pairs of parathyroid glands normally present, there may be 2 to 6. They are small and located behind the thyroid gland. Thyroid hormone is produced by the thyroid gland and is unaffected by the parathyroid gland.
A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is teaching hypoglycemia awareness and should warn the patient about the presence of which symptom? a. Vomiting b. Muscle cramps c. Tachycardia d. Chills
c. Tachycardia Glipizide is a sulfonylurea oral hypoglycemic that acts to promote insulin release from the pancreas. Beta-adrenergic blockers can mask early signs of sympathetic system responses to hypoglycemia; the most important of these is tachycardia. Vomiting, muscle cramps, and chills are symptoms that arise when glucose levels fall.
The nurse is teaching the patient about oral steroid therapy. Which statement by the patient indicates a need for further teaching? a. "I can take my full dose in the morning." b. "I can break up my dose and take some in the afternoon if I get tired." c. "I understand that I shouldn't experience many adverse effects." d. "When I am traveling for work I will take lower doses."
d. "When I am traveling for work I will take lower doses." To mimic normal cortisol secretion, patients can take the entire daily dose in the morning, immediately after waking. If this schedule results in afternoon or evening fatigue, the patients may split the dose taking 2/3 in the morning and 1/3 around 4pm. Stress, such as travel for work, may require an increase in medication.
A patient presents with nausea, vomiting, loss of body hair, fatigue, weakness, and hypoglycemia. Which lab value would the nurse expect to see a deficiency of? a. FSH (follicle-stimulating hormone) b. TSH (thyroid stimulating hormone) c. LH (luteinizing hormone) d. ACTH (adrenocorticotropic hormone)
d. ACTH (adrenocorticotropic hormone) Within 2 weeks of complete absence of ACTH, symptoms of nausea, vomiting, anorexia, fatigue, and weakness develop. With absence of TSH, there is cold intolerance, dry skin, mild myxedema, lethargy, and decreased metabolic rate. FSH and LH deficiencies are associated with amenorrhea, atrophic vagina, uterus, breasts, decrease in body hair, and diminished libido.
A pediatric patient has gigantism caused by excess growth hormone (GH). Which finding would indicate to the nurse that the patient has developed an additional complication related to this condition? a. Blood glucose below 70 mg/dL b. Elevation of liver function test results c. Atrophy of sweat glands d. Enlarged heart on chest x-ray
d. Enlarged heart on chest x-ray Gigantism caused by GH excess can cause children not only to grow very tall but also to develop complications such as headache, profuse sweating, cardiomegaly (enlarged heart), and diabetes. Because of its effect on carbohydrate metabolism, excess GH may cause an elevated blood glucose level, not hypoglycemia. It does not damage the liver; therefore, liver function tests are not affected. It also does not cause the sweat glands to atrophy.
A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse explains that normal insulin has which action in the body? a. It stimulates the pancreas to reabsorb glucose. b. It promotes the synthesis of amino acids into glucose. c. It stimulates the liver to convert glycogen to glucose. d. It promotes the passage of glucose into cells for energy
d. It promotes the passage of glucose into cells for energy The hormone insulin promotes the passage of glucose into cells, where it is metabolized for energy. It does not stimulate the pancreas to reabsorb glucose or synthesize amino acids into glucose. It does not stimulate the liver to convert glycogen into glucose.
Which hormones are secreted by the posterior pituitary? (Select all that apply) a. Parathyroid hormone (PTH) b. Calcitonin c. Thyroid-stimulating hormone (TSH) d. Oxytocin e. Thyrotropin-releasing hormone (TRH) f. Antidiuretic hormone (ADH)
d. Oxytocin f. Antidiuretic hormone (ADH) Oxytocin and ADH are secreted by the posterior pituitary hormone. PTH is secreted by the parathyroid glands. Calcitonin is secreted by the thyroid gland. TSH is secreted by the anterior pituitary. TRH is secreted by the hypothalamus.
A patient who has diabetes insipidus is receiving desmopressin [DDAVP]. Which laboratory test should a nurse obtain to evaluate the effectiveness of the medication? a. Urine ketones b. Blood urea nitrogen (BUN) c. Creatinine d. Urine specific gravity
d. Urine specific gravity Diabetes insipidus is characterized by a decrease in the urine specific gravity (NR: 1.001-1.035) because of the excretion of large volumes of dilute urine. Desmopressin acts to prevent fluid loss through the renal tubules and increase the urine specific gravity. BUN and Cr are indicators of renal function, but not of the effectiveness of treatment of hypothalamic diabetes insipidus.
