Endocrine

An obese adult has recently been diagnosed with type 2 diabetes. The nurse knows that the most likely treatment plan for this client will include which topics?

Weight loss, glucose monitoring, and oral antihyperglycemic medications

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 risk factor in the teaching?

Woman with a family history of diabetes

Hormones that counteract insulin's storage function when regulating blood glucose during times when glucose intake is limited or glucose stores are depleted are called counterregulatory hormones. What are the counterregulatory hormones? Select all that apply.

Glucocorticoids Growth hormone Catecholamines Glucagon

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

Altered cerebral function and headache

Which manifestation indicates a client is at risk for developing diabetes mellitus?

2 hour oral GTT 175 mg/dL (9.7 mmol/L)

Which clinical manifestations would the nurse identify as indications of increased blood glucose levels? Select all that apply

Blurred vision Thirst Fatigue Skin infections

Which complication of acromegaly can be life threatening?

Cardiac structures increase in size

Which disorder is a result of excess cortisol?

Cushing syndrome

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 type of imaging is preferred to evaluate the bone density of a client with hyperparathyroidism?

Dual energy x-ray absorptiometry (DXA) scan

Which hormones exert paracrine action?

Estrogen Progesterone

The diagnosis of type 1 diabetes would be confirmed by which principle?

Insulin is not available for use by the body.

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 client with diabetes mellitus is reporting burning pain of the feet and some numbness. These symptoms are likely due to which cause?

Somatic neuropathy

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

Vomiting after eating

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 phenomenon would the physician most likely suspect as contributing factor to the boy's short stature?

A shortage of hypothalamic GHRH production

A nurse who works in the office of an endocrinologist is orienting a new staff member. Which teaching point should the nurse include in the orientation?

"A single hormone can act on not only one process or organ but often on several different locations or processes."

An adult 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 explanation demonstrates a sound understanding of his health problem?

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

An adolescent male with type 1 diabetes is exasperated by his regimen of blood sugar monitoring and insulin administration, and has told his mother that he wants to scale both back. Which response by his mother is most accurate?

"Even though it's hard to do, you need to continue so you don't go blind or need a kidney transplant down the road."

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."

A client is diagnosed with Addison 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 nurse educator is conducting a course for newly diagnosed diabetes clients. Which statement by a participant should the nurse follow up first?

"I've had a little sore on the sole of my foot for a few days, but I'm sure it will eventually heal."

The mother of a 2-year-old newly diagnosed with type 1 diabetes asks why insulin has to be given by injection. The best response by the nurse is:

"Insulin is destroyed by the stomach contents and has to be administered by injection."

The nurse has just completed teaching a client, newly diagnosed with type 1 diabetes, about the treatment options. Which response by the client leads the nurse to conclude that addidtional teaching is needed?

"So I can stop my insulin if I start an exercise program."

A 3-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 female client presented to her primary care physician with classic signs/symptoms of Cushing syndrome. Upon testing, it was discovered that the client had vaginal small cell carcinoma. How can the health care providers explain the Cushing syndrome signs/symptoms to this client?

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

Following an oral glucose tolerance, a 36-year-old mother of 4 has been diagnosed with gestational diabetes mellitus (GDM), a problem that was not present in any of her previous pregnancies. What should her primary care provider tell her about this new health problem?

"Your baby could become too large or have low blood sugars if we're not vigilant about controlling your sugars."

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 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 client is diagnosed with metabolic syndrome. Frequent concomitants of this syndrome include which of the following? Select all that apply. Body mass index (BMI) greater than 30 Elevated fasting plasma glucose (FPG) Coronary artery disease Hypertriglyceridemia

(BMI) greater than 30 Elevated fasting plasma glucose (FPG) Coronary artery disease Hypertriglyceridemia

When explaining about structural classifications to a group of students, the instructor discusses the peptides and proteins. The instructor talks 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 clients, which client 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 103.2°F (39.6°C)

The nurse educates a client newly diagnosed with diabetes regarding diet and energy requirements. The nurse knows that 1 gram of fat will provide _____ kcal of energy.

9

The nurse is reviewing assessment data and determines which client is at highest risk for developing type 2 diabetes?

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

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

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

Which pediatric assessment finding would the nurse recognize as an example of precocious puberty?

A 7-year-old female with early menarche

A client is admitted for ketoacidosis. The client's breath is fruity and others state that the client has been acting "different." Initial blood glucose level is 642 mg/dL (35.63 mmol/L). Which rationale for prescribing an insulin drip (IV infusion) is most accurate?

A lower pH of the body fluids (ketoacidosis) reduces insulin binding.

A nurse is evaluating clients for the risk of developing type 2 diabetes. Which client has the highest risk for developing this metabolic disorder?

A middle aged obese adult with a sedentary lifestyle

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

A young female client who has been trying to get pregnant

The health care provider is reviewing diurnal variation pattern in adrenocorticotropic (ACTH) levels. Select the typical diurnal variation pattern in adrenocorticotropic (ACTH) levels.

ACTH peaks in the morning and declines throughout the day.

The nurse is assessing a male client and finds abnormally large hands and feet, a bulbous nose, and a broad face with a protruding jaw. Based on these findings, which endocrine abnormality is most likely the cause for these physical changes?

Acromegaly

The nurse is assessing a client with thyrotoxicosis and the nurse is explaining how the thyroid gland is stimulated to release thyroid hormones. The nurse should describe what process?

Action of releasing hormones from hypothalamus

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

The critical care nurse has just admitted a client with diabetic ketoacidosis (DKA) whose blood glucose level is 877 mg/dL (48.67 mmol/L). 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

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:

Autocrine and paracrine

An adult with acromegaly presents with a very distinctive appearance. What is the distinctive feature in a person with acromegaly?

Broad, bulbous nose and a protruding lower jaw

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

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

Diabetic ketoacidosis (DKA) is a condition that mostly occurs in type 1 diabetics. What are the definitive diagnostic criteria for DKA?

Blood glucose level greater than 250 mg/dL (13.88 mmol/L); bicarbonate less than 15 mEq/L (15 mmol/L) and pH less than 7.3

The nurse and nursing student are caring for a client undergoing a severe stressor with release of epinephrine into the bloodstream. The nurse teaches the student that epinephrine will cause which effect on blood glucose levels?

Blood glucose will elevate.

Which clinical manifestations would the nurse identify as indications of increased blood glucose levels? Select all that apply.

Blurred vision Thirst Fatigue Skin infections

: 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 organ does the nurse recognize is reliant on glucose as the major energy source?

Brain

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 1 year for the same problem. What condition does the nurse understand results from this client's enlarged cartilaginous structures?

Bronchitis

A client with diabetes mellitus has sudden onset of slurred speech, incoordination, and cool, clammy skin. What will the nurse do first?

Check blood glucose

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

Choking Edema of the eyelids Syncope when coughing Neck vein distention

The parents of a child who is diagnosed with short stature ask what may have caused the abnormality. Which response by the nurse is most accurate? Select all that apply.

Chromosomal abnormalities GH deficiency Protein-calorie malnutrition Malabsorption syndromes

A male client is being evaluated for metabolic syndrome. Which are diagnostic criteria for this syndrome? Select all that apply.

Client's body mass index (BMI) is 31. Client's high-density lipoprotein (HDL) cholesterol is 25. Client's blood pressure (BP) is 150/90 mm Hg.

Which hormone requires a carrier protein for transport through the blood?

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

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

A woman with poorly controlled type 1 diabetes has been admitted to a hospital unit for the treatment of ketoacidosis. Place the following events in the pathophysiology of ketoacidosis in the correct chronological order. Use all the options.

Decrease in pH Breakdown of triglycerides Low serum insulin levels Ketone production by the liver Production of fatty acids and glycerol

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

Decreased thyroid-stimulating hormone (TSH)

Parents of a 7-year-old girl are concerned about their daughter because she has begun to develop secondary sexual characteristics. What etiologic factor is most likely to underlie the child's condition?

Early activation of the hypothalamic-pituitary-gonadal axis

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

Dry lips, excess urine output, and seizures.

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

Dual-energy x-ray absorptiometry (DXA)

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

Elevated atrial natriuretic hormone

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

A 23-year-old man is admitted to the hospital. He is experiencing polyphagia, polyuria, and polydipsia. He states that the condition has come on very suddenly. This client is likely to require what treatment?

Exogenous insulin injections

A 15-year-old child with type 1 diabetes asks nurse about the potential to "lose sight." Which response would be the most appropriate?

Explain that many people with diabetes experience some complications like retinopathy, but these are best prevented with tight control of glucose levels.

A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves disease. Which assessments should the nurse prioritize?

Eye health and visual acuity

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

Fine-needle aspiration biopsy

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)

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 40-year-old man who is morbidly obese and leads a sedentary lifestyle has recently been diagnosed with type 2 diabetes. Which aspects of the man's obesity likely contributed to his new health problem?

Free fatty acids contribute to problems such as beta cell dysfunction and insulin resistance.

Which interventions would be included in the plan of care for a client experiencing myxedema coma? Select all that apply.

Frequent monitoring of cardiac functions Initiation of thyroid replacement therapy Oxygen therapy to support ineffective respirations Reversal of hypoglycemia

A young adult has been experiencing some extreme fatigue, changes in vision, and unexpected weight loss, leading the health care provider to suspect hyperglycemia. Which clinical manifestations correlate with a diagnosis of diabetes? Select all that apply

Frequent thirst Excess urination Ravenous hunger

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.

The family of a client in the hospital with diabetes mellitus that is out of control asks the nurse to explain the client's recent weight loss while eating more than usual. How will the nurse respond?

Glucose is unused without insulin, so body fats are used for energy.

Which statement best describes an aspect of the normal process of glucose metabolism?

Glucose that exceeds metabolic needs is converted and stored by the liver.

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% (0.52)

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)

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

Graves disease

A client 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 clinical manifestations?

Headaches, dizziness, change in level of consciousness.

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

A 62-year-old man who is overweight has just been diagnosed with type 2 diabetes. The nurse educator is instructing him in the ways his diabetes can be controlled. The nurse should initially prioritize which action?

Helping the client make meaningful changes to his diet and activity level.

Which physiologic process allows hormones to exert influence upon some cells and not others?

Hormone receptors

Which statement best explains the function of hormone receptors?

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

The nurse is teaching a client diagnosed with Addison disease about the importance of lifetime oral replacement therapy. Which pharmacologic agent would be the drug of choice and included in this teaching plan?

Hydrocortisone

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

A health care provider is assessing a client for a potential endocrine disorder. Assessment findings identify abnormalities with emotion, pain, and body temperature. Which mechanism of endocrine control will require further laboratory/diagnostic assessment?

Hypothalamus

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

Hypothalamus

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

Hypothalamus

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

Increase in appetite

The nurse is discussing positive feedback mechanisms. Which example best explains this mechanism?

Increased estradiol production causes increased follicle-stimulating hormone (FSH) production.

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

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 phenomenon could potentially underlie the woman's health problem?

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

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

Insulin glargine

Diabetics are at higher risk than are the majority of the population for injury to organ systems in the body. Which organs are most at risk?

Kidneys and eyes

Which type of hormones are released as soon as they are synthesized?

Lipid-soluble steroid hormones

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

A male child, age 13, is brought to the clinic for a wellness checkup. He 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

The nurse screening for diabetes mellitus at a health fair does not have enough supplies for all of the clients attending. Which client should be given screening priority?

Male age 45, BMI 37

Neurotransmitters like catecholamines (e.g., dopamine and epinephrine) have a reaction time of:

Milliseconds

An overweight, 14-year-old boy feels tired all the time. He sleeps 12 to 14 hours a day and has a voracious appetite but no energy to burn off the calories. He has been diagnosed with hypothyroidism brought about by the accumulation of a nonpitting mucosus type of edema. For which life-threatening condition should his care team be prepared?

Myxedema coma

In which situation would an increase of glucagon be expected?

NPO before surgery

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

Which hormone will elicit a more rapid response than the others?

Norepinephrine

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

Orange juice orally

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

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.

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

Pituitary

The nurse knows that increased blood glucose levels will pull water out of cells and result in which fluid/electrolyte manifestations? Select all that apply.

Polydipsia Polyuria

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

Polydipsia Polyuria Polyphagia

What are the hallmark signs of diabetes mellitus?

Polyuria, polydipsia, and polyphagia

A client receives steroids for several months to treat an inflammatory condition. Which action by the primary health care provider indicates an understanding of the negative feedback mechanism when the client no longer needs the medication?

Prescribing a tapering dose of the medication over weeks

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?

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

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 health care provider for further evaluation?

Random blood glucose 195 mg/dL (10.82 mmol/L)

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 (4.72 mmol/L)

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

Secondary

A client with diabetes carries insulin with him at all times. At 11:35, he obtains a blood glucose reading of 218 mg/dL (12.1 mmol/L) and self-administers a dose of insulin in anticipation of eating lunch at noon. What type of insulin did he most likely inject?

Short acting

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

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

Somogyi effect

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 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 diagnostic test 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 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

The nurse cares for a client with severe chronic obstructive pulmonary disease who has been taking oral steroids for several years. Which response in the client's endocrine control will the nurse expect?

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

A client arrives in the clinic and states to the nurse, "I am tired all the time and have gained weight. My hair is so dry it is breaking." The nurse assesses that the client's face is puffy with edematous eyelids and the outer third of the eyebrows are thinning. What lab test will the nurse prepare the client for that is characteristic of this disorder?

T4 and TSH

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 woman with a diagnosis of type 2 diabetes has been ordered a hemoglobin A1C test for the first time by her primary care provider. The woman states, "I don't see why you want to test my blood cells when it's sugar that's the problem." What aspect of physiology will underlie the care provider's response to the client?

The amount of glucose attached to A1C cells reflects the average blood glucose levels over the life of the cell.

The nurse is teaching a client with diabetes about the signs and symptoms of hypoglycemia. The client asks, "Why will I get headache, disturbed behavior, coma, and seizures if it's my pancreas that's impaired?" Which response is the best explanation?

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

A client is managing diabetes with exercise and diet. The health care provider reviews the client's most recent laboratory results: fasting blood glucose level at 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (0.05). Select the response that best identifies the client.

The client is achieving normal glycemic control.

A client is managing his type 2 diabetes with exercise and diet. He has a fasting blood sugar level (FBS) of 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (.05). Based on these findings, which of the following can the nurse assume?

The client is achieving normal glycemic control.

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 disease who has been treated for hyponatremia and hypoglycemia related to the disease. The nurse inform the client that which action should be taken to ensure control of these conditions?

The client should eat and exercise on a regular schedule.

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 result?

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

A client undergoing an evaluation of hormone levels asks, "What regulates the hormone levels?" Which response by the nurse would be considered most accurate?

The hypothalamic-pituitary-target cell system

Which statement 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 child is born with dwarfism to normal-sized parents. The physician is explaining how growth hormone (GH) plays a central role in the increase in stature that characterizes childhood and adolescence. What is the first step in the growth hormone chain of events?

The hypothalamus secretes GHRH.

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

The infant will have dosage levels adjusted as he grows.

Which statement 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 statement about the role of the thyroid gland is most accurate?

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 is taking 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.

The nurse is teaching a client about a sulfonylurea medication. Which teaching points should be included in the discussion? Select all that apply.

These medications cause insulin to be released from the pancreas. Hypoglycemia may result from this type of medication.

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 who has just undergone a thyroidectomy is experiencing high fever, tachycardia, and extreme restlessness. The nurse would interpret these findings as manifestations of which complication?

Thyroid storm

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

When educating a client about glargine, the nurse should explain that this medication:

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

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 client's low serum T4 level has led to a diagnosis of hypothyroidism. When planning this client's care, the nurse should:

teach the client about the safe and effective use of synthetic thyroid hormones.

A client is scheduled for a suppression test as part of the diagnostic testing for his suspected endocrine disorder. The results of this test will help the care team determine:

whether the client is producing excessive hormone levels.