porth essentials of pathophysiology Endocrine

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

25 minutes

When explaining about structural classifications to a group of students, the instructor discusses the peptides and proteins. They talk about small hormones and hormones as large and complex as growth hormone (GH) which has approximately how many amino acids involved?

200 amino acids.

In an adult with acromegaly, a growth hormone (GH)-secreting tumor is suspected. What diagnostic test would be used for this client?

A GH suppression test

A patient comes to a scheduled appointment in the endocrine clinic. Their primary care physician referred them suspecting the patient has develops acromegaly. Knowing the usual testing involved, the nurse should educate the patient about which of the following lab/diagnostic procedures?

A suppression test.

A patient exhibiting problems with their thyroid has been scheduled for a radioactive scan. From the following list of patients, which would the nurse question as to whether this would be a safe procedure for this patient?

A young female patient who has been trying to get pregnant.

Following a meal, a woman's blood glucose level has increased. In addition, her pancreas has increased the amount of insulin produced and released. Which of the following phenomena has occurred?

Adjustment according to the level of the substance a hormone regulates

Which of the following hormones are derivatives of cholesterol?

Aldosterone and testosterone

Hormones can be synthesized by both vesicle-mediated pathways and non-vesicle-mediated pathways. What hormones are synthesized by non-vesicle-mediated pathways?

Androgens and estrogens

When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of:

Anterior pituitary gland

The number of hormone receptors on a cell may be altered for any of several reasons. The most appropriate response would be:

Antibodies may destroy or block the receptor proteins.

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

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

Autocrine and paracrine

Select the hormone that requires protein as a transport carrier.

Cortisol

After having a very stressful day in pathophysiology class, the student knows that which hormone (secreted by the adrenal cortex) will help decrease the effects of stress?

Cortisol, a glucocorticoid

The nurse is caring for a client who has hyperthyroidism. When evaluating the laboratory test results, which of these alterations does the nurse anticipate will be present?

Decrease in TSH

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 patient experiences an increase in cortisol as a result of Cushing's disease. Which of the following hormonal responses demonstrates the negative feedback mechanism?

Decreased adrenocorticotropic hormone (ACTH)

A patient experiences an increase in thyroid hormone as a result of a thyroid tumor. Which of the following hormonal responses demonstrates the negative feedback mechanism?

Decreased thyroid-stimulating hormone (TSH)

A patient with osteoporosis is prescribed calcitonin (Miacalcin). Which of the following actions by the patient requires further instruction?

Drinks carbonated sodas daily

Which of the following types of imaging is preferred to evaluate the bone density of a patient with hyperparathyroidism?

Dual energy x-ray absorptiometry (DEXA) scan

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

Elevated atrial natriuretic hormone

Which of the following manifestations would the nurse observe when assessing a patient diagnosed with a pheochromocytoma of the adrenal medulla?

Elevated catecholamine levels and tachycardia

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

Epinephrine

When caring for a client with anemia and a decrease in red blood cells (RBCs), the nurse recognizes which of these hormones will stimulate the bone marrow to produce additional RBCs?

Erythropoietin

Which of the following is an example of a positive feedback system?

Estradiol and follicle-stimulating hormone (FSH)

Which hormone triggers the positive feedback mechanism that controls the secretion of luteinizing hormone (LH) levels?

Estrogen

A 38-year-old woman takes clomiphene, an infertility drug that works by competing with, and thereby blocking, cellular receptors for estrogen. Which of the following statements is most likely to be true of this client?

Estrogen will continue to pass freely through the cellular membranes.

Acne and rosacea are two types of viral skin disorders.

False

All hormones can cross the cell membrane.

False

The dermis is the outermost layer of the skin and covers the body.

False

Which of the following is the role of glucagon in initiating the breakdown of glycogen?

First messenger

Which hormone is secreted based on a cyclic rather than a diurnal manner?

Follicle-stimulating hormone (FSH)

While discussing the regulation of hormone levels, the instructor gives an example of hormones regulated by feedback mechanisms. Which example of this regulation is best?

Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.

A nurse assessing an 8-year-old child notes that the child is 6 feet tall. Which of the following diagnostic tests will be performed to evaluate the cause of the condition?

Glucose load

A diabetic client is controlled on Avandia (rosiglitazone), a thiazolidinedione medication that acts at the level of nuclear peroxisome proliferator-activated receptors (PPARs) to promote:

Glucose uptake

Select the statement that best explains the function of hormone receptors.

Hormone receptors recognize a specific hormone and translate the signal into a cellular response.

Select the most appropriate statement that describes the function of hormones.

Hormones function as modulators of cellular and systematic responses.

The physician is assessing a client with a preliminary diagnosis of endocrine disorder. Further assessment findings identify abnormalities with emotion, pain, body temperature, and neural input. The physician determines the need to further assess the:

Hypothalamus

Which gland acts as a signal relaying bridge between multiple body systems and the pituitary gland?

Hypothalamus

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

Increased GH secretion

An instructor is teaching the class about positive feedback mechanism. The best example would be:

Increased estradiol production causes increased gonadotropin (FSH) production.

A 51 year-old woman has been experiencing signs and symptoms of perimenopause and has sought help from her family physician. A deficiency in estrogen levels has been determined to be a contributing factor. Which of the following phenomena could potentially underlie the woman's health problem?

Insufficient estrogen production within the smooth endoplasmic reticulum of the relevant cells.

Which of the following is an advantage of assessing hormone levels through collection of a 24-hour urine?

It does not require serum collection for an accurate reading.

A patient develops hypocalcemia after thyroid surgery. Which of the following hormonal imbalances caused this complication?

Lack of parathyroid hormone

A nursing student who has a history of brain tumors that resulted in partial removal of her pituitary gland years ago is asking her OB/GYN doctor about her ability to breast-feed her infant. This is based on which physiological function of the pituitary gland that facilitates breast milk production?

Lactotrophs

Which type of hormone is released as soon as they are synthesized?

Lipid-soluble steroid hormones

Which of the following body functions is regulated by several hormones?

Lipolysis

Which of the following organ systems is matched with the preferred type of imaging?

Magnetic resonance imaging (MRI) of the pituitary gland

What neoplasm of the skin is associated with the poorest prognosis?

Malignant melanoma

Prior to running the marathon in the Olympics, an athelete is testing for the use of performance-enhancing agents. Which type of lab/diagnostic testing should the nurse review with this athelete?

Mass spectrometry with liquid chromatography.

A middle-aged female has been diagnosed with thyroid problems. While educating the patient about their new prescription and follow-up lab work to regulate dosage, the patient asks, "Why do I not return to the clinic for weeks, since I am starting the medication tomorrow morning?" The nurse bases their answer knowing that thyroid hormones:

Mechanism of action takes days for its full effect to occur.

Neurotransmitters like catecholamines (ex. dopamine and epinephrine) have a reaction time of:

Milliseconds.

What is the most common mechanism of hormone control?

Negative feedback

The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body?

Negative feedback loop

An adult patient with suspected hypothyroidism is scheduled for a thyrotropin-releasing hormone (TRH) stimulation test to evaluate pituitary response. Which of the following test results would confirm secondary hypothyroidism?

No increase in TSH

Which of the following hormones will elicit a more rapid response than the others?

Norepinephrine

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 of the following statements is accurate regarding how hormones are metabolized and excreted?

Peptides are degraded by enzymes in cells.

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

Pituitary

A patientreceives steroids for several months to treat an inflammatory condition. Which of the following actions by the primary healthcare provider indicates an understanding of the negative feedback mechanism when the patient no longer needs the medication?

Prescribing a tapering dose of the medication over weeks

While reviewing the concept of nuclear receptors with a group of pathophysiology students, the instructor uses the example of type 2 diabetes mellitus patients taking Pioglitazone (Actos), a thiazolidinedione medication. Because of the peroxisome proliferator-activated receptors (PPARs), the drug has which effect on the patients diabetes? Select the best answer.

Promote glucose uptake and increase the synthesis of certain proteins involved in fat metabolism, which reduces levels of certain types of lipids.

When trying to explain hypothyroidism to a newly diagnosed client, the nurse stresses the fact that the thyroid hormone is transported in blood by specific:

Proteins

Select the most accurate statement regarding measurements of urinary hormone:

Provide a better measure of hormone levels during a designated period.

Many hormones are measured for diagnostic reasons by using the plasma levels of the hormones. What is used today to measure plasma hormone levels?

Radioimmunoassay methods

Select the process that allows hormones to exert influence upon some cells and not others.

Receptor binding

How will cell receptors change in the absence of a particular hormone?

Receptors in each cell will increase.

An example of a single hormone that can exert effects in different tissues, erythropoietin, made in the kidney stimulates the bone marrow to produce:

Red blood cells.

The nurse is caring for a client who is receiving exogenous corticosteroids for rheumatoid arthritis. Recognizing that hormone levels are regulated by negative feedback, which of these laboratory test results does the nurse anticipate uncovering when reviewing the medical record?

Reduction in ACTH

Which of the following statements best captures the essence of a second messenger in the mechanisms of the endocrine system?

Second messengers act as the intracellular signal that responds to the presence of a hormone.

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 kidney produces 1,25-dihydroxyvitamin D. This form of vitamin D is responsible for which action in the body?

Stimulates calcium absorption from the intestine

A 21 year-old female is suspected of having inadequate function of her hypothalamic-pituitary-thyroid system. Her care provider is planning to inject thyrotropin-releasing hormone (TRH) and then measure her levels of TSH. Which of the following diagnostic tests is being performed?

Stimulation test

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 caring for a client who has been diagnosed with severe chronic obstructive pulmonary disease and has been taking oral steroids for several years. The nurse is aware that the client is at risk for:

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

Which of the following statements best captures the relationship between the hypothalamus and the pituitary gland as it relates to endocrine function?

The hypothalamus receives input from numerous sources throughout the body and directs the pituitary to then control many target glands and cells.

The nurse is caring for a client with decreased serum protein levels secondary to liver failure. When administering medications that are highly protein bound, the nurse anticipates the resulting drug level will respond in which of these ways?

The drug level will be elevated as lack of protein allows more free drug to circulate.

A homeless individual is brought to the emergency department (ED) after the police could not wake them up. Their breath is fruity and others state that the patient has been acting "different". Initial blood work identifies a blood glucose level of 642. The patient is admitted to the ICU in ketoacidosis. The patient is prescribed an insulin drip (IV infusion). The rationale for this is related to:

The fact that a lower pH of the body fluids (ketoacidosis) reduces insulin binding.

During the follicular stage of menstruation, increased estradiol production causes an increase in FSH production. This increase in FSH production by the anterior pituitary gland will have what effect on the follicle?

The follicle will die which results in a fall of FSH.

A client who is referred to the endocrinologist's office for an evaluation of his hormone levels asks what regulates the hormone levels. The best response would be that hormone levels in the body are primarily regulated by:

The hypothalamic-pituitary-target cell system

When describing to a newly diagnosed diabetic client 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 of these does the nurse explain to the client is the role of the thyroid gland?

The thyroid gland is responsible for increasing the metabolic rate.

Which of the following statements about immunoradiometric assay (IRMA) testing for measuring plasma hormone levels is most accurate?

These tests are very specific since they utilize two antibodies instead of one.

Which of the following describes how water-soluble peptides such as parathyroid hormone, or glucagon, exert their effect on cells?

They bind to receptors.

Malignant melanoma, which is a malignant tumor of melanocytes, is a rapidly progressive and metastatic form of skin cancer.

True

The dermis and epidermis play a role in immune function.

True

The endocrine system uses chemical substances called hormones as a means of regulating and integrating body functions.

True

A client with many nonspecific complaints has been ordered a positron emission tomography (PET) scanning for evaluation of:

Tumors located on the endocrine glands

A client with a history of an endocrine disorder exhibits signs and symptoms of hormone deficiency. Which of the following processes would the client's care team most likely rule out first as a contributing factor?

Up-regulation has increased the sensitivity of the body to particular hormone levels.

Sometimes the measurement of hormones is done through a urine sample. What is an advantage of measuring hormone levels through a urine sample rather than a blood sample?

Urine samples are easily obtaine

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 with a new diagnosis of an endocrine disorder is unclear how the body can control the levels of different hormones over time. Which of the following statements most accurately underlies the dominant regulation process of hormone levels in the body?

With input from various sensors, hormone production and release are adjusted based on existing hormone levels.

Most of the body's hair follicles are paired with:

a sebaceous gland.

A 44-year-old man has been brought to the emergency department by emergency medical services with severe electrical burns resulting from a workplace accident. The most immediate threat to this patient's survival at this time is:

hemodynamic instability.

Dry, itchy plaques on her elbows and knees have prompted a 23-year-old woman to seek care. The clinician has subsequently diagnosed the patient with psoriasis, a disorder that results from:

increased epidermal cell turnover.

Although both autocrine and paracrine hormonal actions occur without entering the blood stream, paracrine actions differ because they affect ______ cells.

local

Hormones are chemical messengers that:

regulate body functions.

The pilosebaceous unit of the skin consists of:

sebaceous glands.

Sebaceous glands secrete sebum, which is a:

skin lubricant.

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.

When hypofunction of an endocrine organ is suspected, a hormone ____________ test can be administered to measure and assess target gland response.

stimulation

For which of the following endocrine disorders would autoimmune antibody testing be appropriate? Select all that apply.

• Type 1 diabetes mellitus • Graves' disease • Hypoparathyroidism • Addison's disease

Which hormones illustrate non-vesicle-mediated synthesis? Select all that apply.

• Aldosterone • Cortisol • Androgens

The non-vesicle-mediated pathway has a role in synthesis and release of which of the following hormones? Select all that apply.

• Aldosterone • Testosterone

The vesicle-mediated pathway has a role in synthesis and release of which of the following hormones? Select all that apply.

• Dopamine • Follicle-stimulating hormone • Antidiuretic hormone

Which statements concerning endocrinology laboratory testing are true? Select all that apply.

• Endocrine tests are generally sensitive to storage requirements. • Patient education regarding endocrine testing must include specific test requirements.

Which of the following hormones are synthesized by non-vesicle-mediated pathways? Select all that apply.

• Estrogen • Aldosterone

Which of the following hormones exert paracrine action?

• Estrogen • Progesterone

A client has developed a tumor of the anterior pituitary gland. The nurse is aware that the client is at risk for alterations of: Select all that apply.

• Growth and metabolism • Function of the thyroid gland • Glucocorticoid hormone levels • Function of the gonads

Which of the following are examples of amines? Select all that apply.

• Norepinephrine • Epinephrine

While discussing the elimination of hormones from the body to prevent overaccumulation, which of the following hormones are eliminated in bile? Select all that apply.

• Unbound adrenal hormones • Gonadal steroid hormones • Thyroid hormones

Imaging has proven useful in both the diagnosis and follow-up of endocrine disorders. Two types of imaging studies are useful when dealing with endocrine disorders: Isotopic imaging and nonisotopic imaging. What is an example of isotopic imaging?

Thyroid scan

To prevent the accumulation of hormones in our bodies, the hormones are constantly being metabolized and excreted. Where are adrenal and gonadal steroid hormones excreted?

Bile and urine

The nurse administers a glucocorticoid medication to a client with pneumonia. Which of these does the nurse teach the client is the purpose of the medication?

To decrease airway inflammation

The nurse explains to a client in labor who has demonstrated ineffective contractions impeding progression of labor that the health care provider has added oxytocin infusion to the orders. Which of these does the nurse teach the client is the purpose of oxytocin?

To stimulate contraction of the uterus

A patient with hyperthyroidism took aspirin for a headache. Which of the following complications could develop? Select all that apply.

• Hyperthermia • Tachycardia • Diarrhea

A male patient has been diagnosed with a low sperm count. Which of the following endocrine imbalances could contribute to this condition? Select all that apply.

• Lack of follicle-stimulating hormone (FSH) • Insufficient androgens

When comparing the endocrine and nervous system functions, the nurse knows that the endocrine system: Select all that apply.

• Releases hormones into the blood that is transported throughout the body • Glands are widely scattered throughout the body • Takes longer to respond to innervations but has prolonged actions when they arrive

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 • Stimulation of sensors in the anterior pituitary gland • Decrease in secretion of thyroid stimulating hormone (TSH) • Increased levels of thyroid hormone

A nurse has just completed an explanation of how hormones are normally regulated by feedback mechanisms to a client. The client asks if anything can alter the regulation. The best response by the nurse would be: Select all that apply.

• Stress • Temperature • Nutritional status

When explaining factors that influence the number of receptors present on target cells, the instructor will likely mention: Select all that apply.

• The role antibodies may have on receptor proteins. • A decreased hormone level may produce increased receptor numbers. • A sustained excess hormone level brings about a decrease in receptor numbers.