Unit 9: Chapters 31-33

A 28-year-old male who is 6'11" tall has a diagnosis of acromegaly. The man is explaining to a curious but sympathetic coworker exactly what accounts for his extraordinary height. Which of the following explanations demonstrates a sound understanding of his health problem?

"A tumor in my brain threw off my hormone levels after I finished adolescence."

A client diagnosed with type 2 diabetes has been instructed about managing his condition with diet. The nurse determines further teaching is necessary when the client states:

"I must avoid all candies and cookies, but can eat unlimited amounts of pasta and breads."

An endocrinologist is providing care for a 30-year-old male who has lived with the effects of increased levels of growth hormone (GH). Which of the following teaching points about the client's future health risks is most accurate?

"When your pituitary gland is enlarged, there's a real risk that you'll develop some sight deficiencies."

A client with Graves' disease has opthalmopathy and asks the nurse if the eyes will stay like this forever. What is the best response by the nurse?

"With treatment of the hyperthyroid state, the opthalmopathy usually tends to stabilize."

A client with bipolar disorder has developed hypothyroidism with a goiter. When the nurse obtains a medication history, which medication taken by the client does the nurse understand may cause this disorder?

"With treatment of the hyperthyroid state, the opthalmopathy usually tends to stabilize."

A client is diagnosed with Addison's disease. What statement by the client indicates an understanding of the discharge instructions by the nurse?

"I will have to take my medication for the rest of my life."

A client with a pituitary adenoma has had a transsphenoidal removal, successfully. What statement made by the client after education by the nurse indicates the client understands pharmacological treatment?

"I will need to take my medication for about 6 to 12 months, or until my adrenal function returns."

The nurse is assessing a female client with a diagnosis of primary adrenal cortical insufficiency. The nurse anticipates the client will manifest:

Sparse axillary and pubic hair

A diabetic client presents to a clinic for routine visit. Blood work reveals a HbA1C of 11.0% (high)? Which response by the patient may account for this abnormal lab result?

"My meter broke so I have not been checking my blood glucose levels for a while."

The health care provider has prescribed Repaglinide 2 mg for a client diagnosed with type 2 diabetes. The most important information for the nurse to give the client would be:

"Take the medication 15 to 30 minutes before each meal."

A three year-old girl has just been diagnosed with type 1A diabetes. Her parents are currently receiving education from the diabetes education nurse. How can the nurse best explain to the parents the etiology (cause) of their daughter's diabetes?

"The problem that underlies her diabetes is that her own body has destroyed the cells in her pancreas that produce insulin."

A child has been removed from a home in which she has experienced severe neglect and emotional abuse, and has been placed in foster care. The child has psychosocial dwarfism and the foster parents ask the nurse what this means for the future of the child. What is the best response by the nurse?

"The prognosis of the child depends on an improvement in behavior and catch-up growth."

A young child develops type 1A diabetes. The parents ask, "They tell us this is genetic. Does that mean our other children will get diabetes?" The best response by the health care provider would be:

"This autoimmune disorder causes destruction of the beta cells, placing your children at high risk of developing diabetes."

A client with a new diagnosis of type 2 diabetes mellitus states, "I am really worried that I might need to take injections. Is there something I can do to avoid that?" What is the best response by the nurse?

"You could regulate your diet, exercise regularly, and lose weight."

A female patient presented to her primary care physician with classic signs/symptoms of Cushing syndrome. Upon testing, it was discovered that the patient had vaginal small cell carcinoma. How can the healthcare providers explain her Cushing syndrome signs/symptoms to this patient?

"Your tumor in your vagina is secreting a hormone called adenocorticotropic hormone (ACTH) which is responsible for these signs/symptoms."

When educating a client with possible glucocorticoid dysfunction, the nurse will explain that the CRH controls the release of ACTH. The best time to perform the blood test to measure peak ACTH levels would be:

06:00 to 08:00 AM

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.

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

25 minutes

After receiving change-of-shift report about the following four patients, which patient should the nurse assess first?

70-year-old returning from PACU following partial thyroidectomy who is extremely agitated, has an irregular pulse rate of 134, and an elevated temperature of 103.20 F

An adolescent boy asks the nurse what increases the secretion of growth hormone (GH). The best response would be:

Starvation

Which client does the nurse recognize is at the most risk for the development of subacute thyroiditis?

A 32-year-old postpartum client

A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to?

A hypermetabolic state

Which of the following clients would be considered to be exhibiting manifestations of "prediabetes"?

A middle-aged overweight adult with a fasting plasma glucose level of 122 with follow-up OGTT of 189 mg/dL.

A major manifestation of Cushing syndrome includes which of the following?

Hypokalemia

The mother of 6-year-old male and female fraternal twins has brought her son to see a pediatrician because he is nearly 4 inches shorter than his sister. Which of the following phenomena would the physician most likely suspect as contributing factor to the boy's short stature?

A shortage of hypothalamic GHRH production

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

When the nurse is performing a health history for a client who is being admitted for hyperthyroidism, what symptoms does the client report that the nurse would find associated with this disorder?

Increase in appetite

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

The nurse is caring for a 42-year-old male client who is admitted for treatment of heart failure. He has abnormally large hands and feet and a broad face with a protruding jaw. Based on these signs and symptoms, the nurse identifies which of the following endocrine disturbances as the most likely cause for these physical changes?

Acromegaly

At times, it is necessary to give medications that suppress the adrenal glands on a long-term basis. When the suppression of the adrenals becomes chronic, the adrenal glands atrophy. What does the abrupt withdrawal of these suppressive drugs cause?

Acute adrenal insufficiency

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

A 48-year-old male client diagnosed with type 2 diabetes presents with the following: • Blood glucose level of 46 mg/dL • Very lethargic • Has cool, clammy skin. Select the most appropriate intervention.

Administer injectable glucagon

The critical care nurse has just admitted a client with diabetic ketoacidosis (DKA) whose blood glucose level is 877 mg/dL. The client's breath has a fruity odor and the client is confused. Which of these does the nurse set as the priority at this time?

Administration of intravenous fluids

Which of the following hormones are derivatives of cholesterol?

Aldosterone and testosterone

Hypoglycemia has a sudden onset with a progression of symptoms. What are the signs and symptoms of hypoglycemia?

Altered cerebral function and headache

The nurse is performing an assessment for a client with Cushing syndrome and observes a "buffalo hump" on the back, a moon face, and a protruding abdomen. What does the nurse understand contributes to the distribution of fat in these areas?

Altered fat metabolism

Hormones are usually divided into categories according to their structure. The release of epinephrine would be classified as:

Amines and amino acids

Select the category of hormones that include norepinephrine and epinephrine.

Amines and amino acids

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

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

The pancreas is an endocrine organ that is composed of the acini and the islets of Langerhans. The islets of Langerhans have alpha, beta, and delta cells as well as the PP cell. Which cells secrete insulin?

Beta cells

Which classification of medication does the nurse prepare to administer to the client with hyperthyroidism that will block the effects of the hyperthyroid state on sympathetic nervous system function?

Beta-adrenergic blocking agent

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 and nursing student are caring for a client undergoing a severe stressor with release of epinephrine into the bloodstream. Which of these effects on blood glucose levels does the nurse teach the student epinephrine will cause?

Blood glucose will elevate.

When caring for the client with diabetic ketoacidosis, the nurse recognizes that fatty acids and ketones may be used for energy by most organs. Which of these organs does the nurse recognize is reliant on glucose as the major energy source?

Brain

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

Acromegaly is a disorder that is caused by the production of excessive GH in the adult. Because the person cannot grow taller, the soft tissues continue to grow, presenting a very distinctive appearance. What is it that is distinctive in a person with acromegaly?

Broad, bulbous nose and a protruding lower jaw

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 complication of acromegaly can be life threatening?

Cardiac structures increase in size

The nurse is caring for an adult client with growth hormone deficiency. When performing an assessment of this client, which system should the nurse be sure to assess for complications related to this disorder?

Cardiovascular system

An adult client with growth-hormone deficiency related to hypopituitarism has been taking replacement therapy for several months. The client informs the nurse that she is having pain in the hand and wrist almost constantly. What does the nurse understand is a common side effect of this therapy that seems to have affected this client?

Carpal tunnel syndrome

A patient is admitted to the hospital in Addisonian crisis one month after a diagnosis of Addison's disease. The nurse knows which of the following clinical manifestations would support this diagnosis?

Change in level of consciousness and profound hypotension

A client with diabetes mellitus reports morning hyperglycemia for several days. What action should taken?

Check blood glucose at 2 AM

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)

Peripheral neuropathies occur in people with diabetes mellitus. With the loss of sensation in the lower extremities, diabetics become predisposed to what?

Clawing of toes and denervation of the small muscles of the foot

Which of the following criteria about insulin would prompt a diagnosis of type 1 diabetes?

Complete failure of insulin secretion

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.

Select the hormone that requires protein as a transport carrier.

Cortisol

A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to begin replacement therapy. Regarding which type of replacement will the nurse educate the client?

Cortisol replacement therapy.

The nurse is preparing a client for a test that will measure negative feedback suppression of ACTH. Which medication will the nurse administer in conjunction for this test?

Dexamethasone

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

Drinks carbonated sodas daily

A pancreatitis patient is admitted with weight loss, nausea, and vomiting. To maintain nutrition, the physician orders parental nutrition to be started. Knowing that a major side effect of parenteral nutrition is a hyperosmolar hyperglycemic state, the nurse should assess the patient for which clinical manifestations (listed below)?

Dry lips, excess urine output, and seizures.

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

When caring for a client who is being screened for osteoporosis, the nurse plans to evaluate the results of which of theses diagnostic tests?

Dual-energy x-ray absorptiometry (DEXA)

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

Macrovascular disease includes coronary artery disease, cerebrovascular disease, and peripheral vascular disease. People with both type 1 and type 2 diabetes are at high risk for developing macrovascular disease. What are the risk factors for macrovascular disease in diabetics?

Elevated fibrinogen levels and hyperinsulinemia

Congenital adrenal hyperplasia is a congenital disorder in which a deficiency exists in any of the enzymes necessary for the synthesis of cortisol. Infants of both sexes are affected, although boys are not diagnosed at birth unless of enlarged genitalia. Female infants often have ambiguous genitalia because of the oversecretion of adrenal androgens. What are the manifestations of the ambiguous genitalia caused by congenital adrenal hyperplasia?

Enlarged clitoris, fused labia, and urogenital sinus

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.

Which test can the nurse prepare the client for to determine the differentiation between a benign and a malignant thyroid disease?

Fine-needle aspiration biopsy

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

First messenger

The nurse is caring for a child with congenital adrenal hyperplasia and has depletion of sodium levels. What pharmacological therapy does the nurse anticipate administering to this child?

Fludrocortisone acetate

Diabetics are hospitalized for a number of reasons. What is the most common complication of diabetes requiring hospitalization?

Foot problems

Advances in technology have made it possible to assess hypothalamic-pituitary function by newly developed imaging and radioimmunoassay methods. When baseline tests are not sufficient, what suppression test gives information about combined hypothalamic-pituitary function?

GH suppression test

Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur?

Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen

The nurse is caring for a client who received regular insulin at 7 am. Four hours later the nurse finds the client diaphoretic, cool, and clammy. Which of these interventions is the priority?

Give the client a concentrated carbohydrate.

A patient with diabetes asks the nurse for advice in controlling between-meal blood glucose levels. Which of the following might the nurse suggest as a long-acting insulin to provide a consistent basal level?

Glargine (Lantus)

A client is diagnosed with type 2 diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?

Glycosylated hemoglobin 5.2%

A client tells the health care provider that he has been very compliant over the last 2 months in the management of his diabetes .The best diagnostic indicator that would support the client's response would be:

Glycosylated hemoglobin, hemoglobin A1C (HbA1C)

The anatomy instructor is presenting a lecture on hormone synthesis. The instructor determines that instruction was effective when students identify the site of prohormone to hormone conversion as the:

Golgi complex

A 25-year-old female client exhibits exophthalmos of both eyes. The health care provider recognizes this as a manifestation of:

Graves disease

When educating a patient about glargine (Lantus), the nurse should explain that this medication:

Has a prolonged absorption rate and provides a relatively constant concentration for 12-24 hours.

When the assessment of thyroid autoantibodies is performed, what is the suspected diagnosis?

Hashimoto thyroiditis

A patient has been admitted with diabetic ketoacidosis. The Emergency Department starts an IV to improve circulatory volume. If there is a sudden change in extracellular fluid osmolality which results in a too rapid blood glucose lowering, the nurse will likely observe which of the following clinical manifestations?

Headaches, dizziness, change in level of consciousness.

During periods of fasting and starvation, the glucocorticoid and other corticosteroid hormones are critical for survival because of their stimulation of gluconeogenesis by the liver. When the glucocorticoid hormones remain elevated for extended periods of time, what can occur?

Hyperglycemia

A man is brought into the emergency department by paramedics who state that the client passed out on the street. The man smells of alcohol, and when roused says he has not eaten since yesterday. He is wearing a medic alert bracelet that says he is a diabetic. What would the nurse suspect as a diagnosis?

Hypoglycemia

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

A client has been taking long-term glucocorticoid therapy for the treatment of asthma. What condition is the nurse aware that this client may develop in relation to this pharmacological therapy?

Iatrogenic Cushing syndrome

While working on the med-surg floor, the nurse has a client who is experiencing an insulin reaction. The client is conscious and can follow directions. The most appropriate intervention would be:

Immediately administer 15 g of glucose (preferably via oral route if the client is alert enough to swallow) and wait for 15 minutes. Then repeat this if necessary.

A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing?

Increased levels of ACTH

A client has been diagnosed with metabolic syndrome and growth hormone (GH) deficiency. Physical assessment of the client would identify:

Increased visceral fat

Following the identification of low levels of T3 and T4 coupled with the presence of a goiter, a 28-year-old female has been diagnosed with Hashimoto's thyroiditis. In light of this diagnosis, which of the following assessment results would constitute an unexpected finding?

Increased white cell count and audible crackles on chest auscultation.

A newly diagnosed type 2 diabetic client has been prescribed metformin. When explaining the actions of this medication, the nurse should include which statement? This medication:

Inhibits hepatic glucose production and increases the sensitivity of peripheral tissues to the actions of insulin

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 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.

The diagnosis of type 1 diabetes would be confirmed by:

Insulin is not available for use by the body.

A patient with distal symmetric polyneuropathy usually begins by complaining of:

Loss of feeling or touch in the feet.

A client is admitted to the emergency department and diagnosed with diabetic ketoacidosis (DKA). The client would most likely manifest:

Ketosis

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

Lack of parathyroid hormone

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

Lipolysis

The nurse has just completed teaching a client newly diagnosed with type 1 diabetes about rapid-acting insulin. The nurse determines that teaching was effective when the client selects:

Lispro

A client with bipolar disorder has developed hypothyroidism with a goiter. When the nurse obtains a medication history, which medication taken by the client does the nurse understand may cause this disorder?

Lithium carbonate

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

Mass spectrometry with liquid chromatography

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

Milliseconds

Which of the following best describes the half-life of a highly protein bound drug such as thyroxine (99% protein bound)? The half-life would be:

Much longer to reduce the concentration of the hormone by one half.

An elderly woman is brought to the emergency department by her family. They relate to the nurse that the client has had mental status changes and cannot remember her grandchildren's names. They go on to say that she is intolerant of cold and is lethargic. On physical examination, the nurse notes that the client has a husky voice, her face is puffy around the eyes, and her tongue appears to be enlarged. What diagnosis would the nurse suspect?

Myxedema

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

Which of the following inhibits growth hormone (GH)?

Obesity

A 46 year-old man who is obese has received news that he has type 2 diabetes. He is in the process of determining a plan of care with an interdisciplinary team at a hospital-based diabetes clinic. The nurse knows that the most likely treatment plan for the man will include:

Oral antihyperglycemic medications and weight loss measures.

A client with severe hypoglycemia is unconscious. Which method of providing glucose should be avoided?

Orange juice orally

A client has a disorder that causes him to have a deficiency of all of the anterior pituitary hormones. What condition will the nurse education the client about for replacement therapy?

Panhypopituitarism

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.

The newborn-nursery nurse is preparing to perform a required neonatal screening for congenital hypothyroidism. What should the nurse do to obtain the necessary sample?

Perform a heel stick to obtain a drop of blood for a T4 and TSH.

A newborn is found to have transient hypothyroidism after having a cesarean birth. What nursing interventions provided to the mother in preparation of the surgical procedure may have induced this newborn's condition?

Performing a skin scrub on surgical site prior to incision with povidone-iodine solution

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

Pituitary

What are the hallmark signs of diabetes mellitus?

Polyuria, polydipsia, and polyphagia

A 51 year-old woman has been diagnosed with Cushing syndrome after a diagnostic workup that reveals cortisol hypersecretion. The nurse knows which of the following assessment findings would be inconsistent with her diagnosis?

Poor stress management and hyperpigmentation

A patient receives 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

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

A 33-year-old female client who presents to the doctor's office with pronounced enlargement of her hands and facial features is diagnosed with acromegaly. The acromegaly is most likely the result of:

Somatotrope adenoma

One of the first signs that indicates an infant may have congenital hypothyroidism is:

Prolonged period of physiologic jaundice

While reviewing the concept of nuclear receptors with a group of pathophysiology students, the instructor uses the example of clients with type 2 diabetes mellitus taking pioglitazone, a thiazolidinedione medication. Because of the peroxisome proliferator-activated receptors (PPARs), the drug has which effect on the clients' 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.

The nurse is caring for a client with hyperthyroidism and is preparing to administer the morning medications. Which medication will the nurse administer in order to block the conversion of T4 to T3 in the tissues?

Propylthiouracil (PTU)

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.

The nurse screening for diabetes mellitus at a health fair obtains these results. Which client should be referred to a primary healthcare provider for further evaluation?

Random blood glucose 195 mg/dl

A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?

Random blood glucose 85 mg/dl

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.

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

Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to stimulate the adrenal glands, the adrenals' production of cortisol drops. This is an example of which type of endocrine disorder?

Secondary

Precocious puberty is a disorder that occurs in both boys and girls. What does precocious puberty cause in adults?

Short stature in adults

A parent arrives in the endocrinology clinic with her 8-year-old son, concerned about his rapid development and tall stature. What significant assessment finding does the nurse recognize is important to report to the physician related to the development of precocious puberty?

Significant genital enlargement

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

A client with severe hypothyroidism is presently experiencing hypothermia. What nursing intervention is a priority in the care of this client?

Slow rewarming of the client to prevent vasodilation and vascular collapse

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 role of the adrenal cortex in maintaining homeostasis?

The adrenal cortical hormones are primarily steroids and sex hormones.

The nurse is teaching a client with diabetes and the family about the signs and symptoms of hypoglycemia. The client asks what produces signs and symptoms of headache, disturbed behavior, coma, and seizures. The best response would be:

The brain relies on blood glucose as its main energy source.

A very tall 8-year-old child is brought by a parent to the clinic for a follow-up visit after diagnostic testing reveals a diagnosis of gigantism. What objective assessment data gathered would the nurse recognize correlates with the child's condition?

The child has fusion of the epiphyses of the long bones and increased growth hormone levels.

A parent brings his child to the clinic, concerned about her short stature and asking the nurse if there is a problem with her height. What indication is the nurse aware of when performing the assessment that determines whether this child has short stature?

The child's height is well below the third percentile on several clinic visits.

A client is managing his diabetes with exercise and diet. The health care provider reviews the client's most recent lab results: fasting blood sugar level at 80 mg/dL and a hemoglobin A1C of 5%. Select the response that best identifies the client.

The client is achieving normal glycemic control.

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.

The nurse is providing discharge instructions for a client with Graves' disease who has ophthalmopathy. What should the nurse be sure to include in the instructions to decrease exacerbation of this clinical manifestation?

The client should be strongly urged not to smoke.

The nurse is providing education to a client with Addison's disease who has been treated for hyponatremia and hypoglycemia related to the disease. What should the nurse inform the client should be done to ensure control of these conditions?

The client should eat and exercise on a regular schedule.

Which of the following best describes a secondary disorder of endocrine function?

The disorder occurs when the target organ is normal, but stimulating hormones alter its function.

A patient is managing his type 2 diabetes with exercise and diet. He has a fasting blood sugar level (FBS) of 80 mg/dL and a hemoglobin A1C of 5%. Based on these findings, which of the following can the nurse assume?

The patient is achieving normal glycemic control.

Which of the following statements best captures an aspect of the function of the hypothalamic-pituitary-adrenal (HPA) system?

The pituitary gland communicates with the adrenal cortex through the release of ACTH.

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.

The nurse is caring for an older adult client who is being treated for primary hypothyroidism. The medication therapy includes a "go low and go slow" regimen. What is the importance of this medication regimen for this client?

There is a risk of inducing acute coronary syndromes in the older adult client if a more rapid correction of thyroid levels is used.

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

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 with type 1 diabetes mellitus wishes to stop taking insulin injections. What option is appropriate?

Using an insulin infusion pump

The nurse is caring for a client with diabetes who has developed gastroparesis. Which of these symptoms does the nurse expect the client to report?

Vomiting after eating

A middle-aged female client has been diagnosed with 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.

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 lung cancer client with small cell carcinoma may secrete an excess of which hormone causing an ectopic form of Cushing syndrome due to a nonpituitary tumor?

ACTH

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.

A client is seeking treatment for infertility. What decrease in hormone secretion from the anterior lobe of the pituitary gland that regulates fertility would the nurse recognize may cause this issue?

Follicle stimulating hormone (FSH)

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

Follicle-stimulating hormone (FSH)

A patient is evaluated for diabetes. Which of the following signs and symptoms would the nurse identify as indications of increased blood glucose levels? Select all that apply.

• Blurred vision • Thirst • Fatigue • Skin infections

The nurse is caring for several clients who are taking growth hormone replacement therapy. Which client does the nurse recognize is most at risk for side effects?

A 45-year-old obese client with an elevated serum IGF-1 concentration

The nurse is reviewing assessment data on four clients. Select the client at highest risk for developing type 2 diabetes.

A 45-year-old obese female with a sedentary lifestyle

A nurse is evaluating patients for the risk of developing type 2 diabetes. Which of the following patients has the highest risk?

A 45-year-old obese woman with a sedentary lifestyle

The nurse is working in a pediatric clinic. Which of the following children would the nurse recognize as having isosexual precocious puberty?

A 5-year-old African-American female with developing breasts and pubic hair

The nurse is reviewing the assessment data of four clients. Select the client who would be diagnosed with precocious puberty.

A 7-year-old female with early menarche

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 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.

The diabetes nurse educator is teaching a community education class for new diabetics. Which of these does the nurse include in the discussion of signs and symptoms of hyperglycemia? Select all that apply.

• Blurred vision • Weight loss • Thirst

The nurse is caring for a client who has a multinodular goiter. The nurse is aware that the client may be at risk for: Select all that apply.

• Choking • Edema of the eyelids • Syncope when coughing • Neck vein distention

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.

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.

The parents of a child who is diagnosed with short stature ask what may have caused the abnormality. The best response are: Select all that apply.

• Chromosomal abnormalities • GH deficiency • Protein-calorie malnutrition • Malabsorption syndromes

A client with acromegaly comes to the clinic and informs the nurse that she is having a productive cough and a low grade fever. This is the client's fourth visit in one year for the same problem. What condition does the nurse understand results from this client's enlarged cartilaginous structures?

Bronchitis

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

• Norepinephrine • Epinephrine

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 newborn-nursery nurse is obtaining a blood sample to determine if a newborn has congenital hypothyroidism. What long-term complication is the nurse aware can occur if this test is not performed and the infant has congenital hypothyroidism?

Cretinism

Which statements are true regarding hypothyroidism? Select all that apply.

• Onset of symptoms is gradual • Weight gain • Anorexia

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 client with Graves' disease has had radioiodine treatment with worsening of ophthalmopathy. What medication does the nurse prepare to administer that the client will use for several weeks to decrease these symptoms?

Glucocorticoids

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

The nurse is performing an assessment for a client who has hyperthyroidism that is untreated. When obtaining vital signs, what is the expected finding?

Heart rate 110 and bounding

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.

In Addison disease, the majority of the adrenal cortex has been destroyed. This causes a lack of mineralocorticoids and glucocorticoids. Therapy consists of oral replacement with what drug?

Hydrocortisone

The nurse is teaching a client diagnosed with Addison disease about the importance of lifetime oral replacement therapy. Select the pharmacologic agent that would be prescribed.

Hydrocortisone

The nurse is caring for an infant in the neonatal intensive care unit who has growth hormone deficiency. What critical issues should the nurse carefully monitor for in this infant?

Hypoglycemia and seizures

The hypophysis is a unit formed by the pituitary and the hypothalamus. These two glands are connected by the blood flow in what system?

Hypophyseal portal system

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

Increased estradiol production causes increased gonadotropin (FSH) production.

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.

Research has identified a cycle of insulin-induced posthypoglycemic episodes. What is this phenomenon called?

Somogyi effect

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 client who has just undergone a thyroidectomy is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these manifestations as:

Thyroid crisis

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

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.

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 middle-aged woman has acromegaly as a result of a pituitary adenoma that was found and removed when she was a teenager. The physician is suspecting that the tumor has returned and has ordered a diagnostic work-up. A glucose load is ordered. If the tumor has returned, the nurse would expect which of the following results?

The growth hormone level will not be suppressed following glucose load.

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

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.

A newborn is screened for congenital hypothyroidism and is found to have the disorder. When educating the mother about the importance of the infant's taking thyroid hormone supplement, what should be included in the education?

The infant will have dosage levels adjusted as he grows.

Following a long history of fatigue, weakness and poor appetite, a 39-year-old male has been diagnosed with hypopituitarism. Which of the following clinical findings would most likely cause his care team to suspect that the man has an additional endocrine disorder from a different source?

The man has a chronic platelet deficiency and is occasionally anemic.

The nurse is educating a parent of a child with short stature caused by growth hormone (GH) deficiency about the administration of GH. What should the nurse include when educating the parents about administration?

The medication will be given daily during the period of active growth and can be continued into adulthood.

The nurse is performing a health history from a client with acromegaly. The client informs the nurse that he is waking up several times a night and has been told he has sleep apnea. What does the nurse inform the client is the rationale for this syndrome?

There is an increase in pharyngeal soft tissue accumulation.

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.

The hallmark manifestations of Cushing syndrome are a moon face, a "buffalo hump" between the shoulder blades, and a protruding abdomen. What other manifestations of Cushing syndrome occur?

Thin extremities and muscle weakness

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

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.

The obstetrical nurse is caring for a client who has been treated for gestational diabetes. When teaching the client about the causes of gestational diabetes, the nurse should include which of these risk factors in the teaching?

Woman with a family history of diabetes

A client has just been diagnosed with Hashimoto thyroiditis and is asking the health care provider for information about the condition. The most appropriate information to provide would be: Select all that apply.

• Autoimmune disorder • Common in females • Prone to goiter development

A homeless individual is brought to the emergency department (ED) after the police could not wake the person. The client's breath is fruity and others state that the client has been acting "different." Initial blood work identifies a blood glucose level of 642. The client is admitted to the ICU in ketoacidosis. The client 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.

A nurse on a medical unit is providing care for a 37-year-old female patient who has a diagnosis of Graves' disease. Which of the following treatments would the nurse most likely anticipate providing for the client?

β-adrenergic-blocking medications to reduce sympathetic nervous stimulation

A nurse who works in the office of an endocrinologist is orientating a new staff member. Which of the following teaching points is the nurse justified in including in the orientation? Select all that apply.

• "A bodily process can be the result of the combined effect of several different hormones from different sources." • "A single hormone can act on not only one process or organ, but often on several different locations or processes." • "It's common for production of hormones to be far removed from the tissue where they ultimately exert their effect." • "Sometimes hormones act locally on the area where they were produced, like in the case of paracrine and autocrine actions."

The nurse is preparing a client for testing to determine if the client has Cushing syndrome. What tests are included in the screening process? Select all that apply.

• 24-hour urine secretion of cortisol • Dexamethasone suppression test • Plasma levels of ACTH

Which of the following clients are at risk for developing hypothyroidism? Select all that apply.

• A client who is prescribed amiodarone for frequent dysrhythmias • A client who has precancerous thyroid lesions who underwent ablation with radiation • A female experiencing an autoimmune disorder called thyroiditis • A bipolar client prescribed lithium carbonate

A client is exhibiting signs of Graves' disease. What clinical manifestations of this disorder would the nurse document that would indicate this disease state? Select all that apply.

• A goiter • Ophthalmolopathy (exophthalmos) • Tachycardia and rapid respiratory rate

Of the following list of nursing interventions, which would be considered priority when managing a patient with life-threatening myxedematous coma? Select all that apply.

• Administer 3% sodium IV solution to increase sodium levels. • Administer 50% dextrose to raise glucose levels. • Place on oxygen therapy to encourage deep breathing.

A client has been diagnosed with dysfunction of the anterior pituitary gland. The nurse is aware that which of the following hormones may be affected? Select all that apply.

• Adrenocorticotropic hormone (ACTH) • Thyroid-stimulating hormone (TSH) • Growth hormone (GH) • Luteinizing hormone (LH)

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 nurse is caring for a client with secondary adrenal insufficiency. What subjective assessment data obtained by the nurse would correlate with this client's condition?

• Client states, "I don't feel like eating anything." • Client states, "I feel as though I am going to vomit." • The client states that she feels weak

A client with hypothyroidism has not taken medication for several months, informing the nurse that she lost her insurance and is unable to afford the medication. When assessing the client's temperature tolerance and skin, what does the nurse anticipate finding? Select all that apply.

• Coarse and dry skin and hair • Intolerance to cold • Decreased sweating

A patient with diabetes is being evaluated for the disease's potential chronic complications. The nurse knows that a patient with distal symmetric neuropathy will have which of the following signs and symptoms? Select all that apply.

• Decreased pain perception • Risk for falling • Stocking-glove pattern function loss • Risk of foot injuries

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

The nurse is caring for a client with primary hypothyroidism who is being monitored for the complication of myxedema coma while thyroid level therapy is started. What does the nurse understand are the three major aspects of myxedema coma?

• Elevated carbon dioxide levels and decreased oxygen saturation • Fluid and electrolyte imbalance • Hypothermia

Growth hormone exerts its effects on the body in many ways. Which of these are effects of GH? (Select all that apply.)

• Enhances fatty acid mobilization • Increases insulin levels • Facilitates the rate of protein synthesis

Management of hyperthyroidism would include which interventions? Select all that apply.

• Eradication of the gland with radioactive iodine • Surgical removal of part or the entire gland • Drug therapy directed toward decreasing the gland's function

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

• Estrogen • Aldosterone

Which complications may be experienced by a client with diabetic neuropathies? Select all that apply.

• Foot ulcers • Gastroparesis • Erectile dysfunction • Urinary retention

A young adult has been experiencing some extreme fatigue, changes in vision and unexpected weight loss. At the health clinic, the healthcare provider is assessing for hyperglycemia. Which would be considered the most commonly identifiable signs/symptoms of diabetes? Select all that apply.

• Frequent thirst • Excess urination • Ravaging hunger

A nurse is teaching a patient with newly diagnosed type 1 diabetes about the importance of blood glucose control to decrease the risk of which of the following potential chronic complications of diabetes? Select all that apply.

• Gastroparesis • Nephropathy • Retinopathy • Neuropathy

A woman in her 28th week of pregnancy develops gestational diabetes mellitus and has persistent elevated blood glucose when using the diet plan. What medications are appropriate? Select all that apply.

• Glyburide • Insulin

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

Loss of pituitary function can result in deficiencies/loss of which of the following hormones' secretions? Select all that apply.

• Growth hormone • Luteinizing hormone • Follicle stimulating hormone • Prolactin

The nurse is caring for a client diagnosed with hyperthyroidism. Which of the following signs and symptoms are most likely to be seen in this client? Select all that apply.

• Hypertension • Diarrhea • Weight loss • Tremor

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

• Hyperthermia • Tachycardia • Diarrhea

A nurse is assessing an elderly woman diagnosed with chronic hypothyroidism who has developed myxedematous coma. The nurse is aware that the client may manifest: Select all that apply.

• Hypoventilation • Hyponatremia • Hypoglycemia • Lactic acidosis

An infant born with congenital hypothyroidism who does not receive care from any healthcare provider is likely to develop which of the following complications? Select all that apply.

• Impaired physical growth • Mental retardation

Testing for short statue growth hormone (GH) problems can be done by pharmacologic means. Which of the following medications can be utilized to test for a rise in GH? Select all that apply.

• Insulin • Levodopa

Which of the following options contain a pair of hormones that act to balance each other? Select all that apply.

• Insulin and glucagon • Calcitonin and parathyroid hormone (PTH)

Which of the following statements is correct about hormone transport? Select all that apply.

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

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

A male child, age 13, is brought to the clinic for a wellness checkup who has been diagnosed with constitutional short stature. What assessment data obtained by the nurse correlates with this diagnosis? Select all that apply.

• Moderate short stature • Thin build • Delayed sexual maturation

In an acute adrenal crisis, the onset of symptoms is sudden and, in the case of Addison disease, can be precipitated by exposure to a minor illness or stress. What are the manifestations of acute adrenal crisis? (Select all that apply.)

• Muscle weakness • Dehydration • Altered mental status • Vascular collapse

The nurse is receiving physician orders when admitting a client to the inpatient facility with cirrhosis of the liver. Which medications ordered by the physician should the nurse question since they may affect the binding of thyroid hormone to normal concentrations of binding proteins? Select all that apply.

• Phenytoin (Dilantin) • Aspirin • Diazepam (Valium)

A pregnant client asks the nurse if she is at risk for developing gestational diabetes. The nurse reviews the risk factors with the client. The most important information for the nurse to provide would be: Select all that apply.

• Polycystic ovary disease • Severe obesity • Glycosuria

Select the most common symptoms of diabetes. Select all that apply.

• Polydipsia • Polyuria • Polyphagia

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

A client has just undergone a diagnostic cardiac angiogram. As part of their ordered labs, the physician has ordered a thyroid panel. The physiological principle behind ordering this lab tests includes which of the following correlations? Hyperthyroidism can cause: Select all that apply.

• Rise in oxygen consumption • Increase in cardiac output

The nurse is caring for a client who is in a severely hypothyroid state. Which medications should be avoided related to the inability to metabolize these drugs? Select all that apply.

• Sedatives • Analgesics • Anesthetics

The nurse is educating a client with hyperthyroidism who has recovered from thyrotoxicosis (thyroid storm) and is preparing for discharge. What can the nurse inform the client that this hypermetabolic state can be caused by in order to decrease exacerbation? Select all that apply.

• Stress • Physical or emotional trauma • Manipulation of the thyroid gland

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

Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as a thyroid storm. What are the manifestations of a thyroid storm? (Select all that apply.)

• Tachycardia • Delirium • Very high fever

A client is suspected to have increased growth hormone levels. When performing a health history, what assessment data would be important for the nurse to report to the physician? Select all that apply.

• The client has fainted due to low blood glucose levels on several occasions. • The client has been experiencing a great deal of emotional stress due to family issues. • The client is on a weight loss diet and is exercising excessively.

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.

A client with type 2 diabetes has routine lab work, which reveals elevated free fatty acids (FFA). The client asks, "Why is this significant?" The most accurate response would be: Select all that apply.

• This may increase the amount of triglyceride (a form of fat) stored in your liver or around your heart. • Your pancreas is affected by increased fat (lipotoxicity), which causes beta cell dysfunction, leading to the need for insulin.

Which of the following hormones cross cell membranes to connect to nuclear receptors? Select all that apply.

• Vitamin D • Thyroid hormones • Glucocorticoids

A student nurse is taking a test on the endocrine system. From the following list of clinical manifestations, she needs to select the ones she would see in hypothyroidism. Which answers should she select? Select all that apply.

• Weight gain despite loss of appetite • Coarse brittle hair • Puffy face with swollen eyelids