Patho Ch. 13 Questions
Which gland acts as a signal-relaying bridge between multiple body systems and the pituitary gland?
Hypothalamus
The nurse is teaching a client how to collect a 24-hour urine sample for cortisol levels. The client asks why a blood sample cannot just be taken since collecting urine for 24-hours is inconvenient. How should the nurse respond?
"Because cortisol levels fluctuate, collecting a sample over time will be more accurate."
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."
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
Select the category of hormones that includes norepinephrine and epinephrine.
Amines and amino acids
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
One of the earliest signs of Cushing syndrome is the loss of variable diurnal secretion of cortisol-releasing hormone (CRH) and:
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.
The nurse is caring for a client with impairment of the adrenal gland. The nurse notes abnormal sodium and potassium levels. Which hormone is the MOST likely to be impaired?
Aldosterone
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
The nurse is caring for a client being treated for diabetes insipidus after cranial surgery. The client has intravenous (IV) fluids infusing and has an indwelling urinary catheter. The nurse notes no urine output in the past hour. Which action is the nurse's PRIORITY?
Assess the urinary catheter and drainage system.
Which hormone is produced by the anterior pituitary gland?
Growth hormone (GH)
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 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 effect of thyroid hormone deficit alters the function of all major organs in the body?
Decreases metabolism
The nurse is caring for a client with acquired hypothyroidism. Which etiology of the client's condition does the nurse suspect? Select all that apply.
Deficient thyroid hormone synthesis Impaired thyroid stimulating hormone (TSH) secretion Impaired thyrotropin-releasing hormone (TRH) secretion Destruction of the thyroid gland
Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:
Graves disease
Which pathophysiologic phenomenon may result in a diagnosis of Cushing disease?
Excess ACTH production by a pituitary tumor
The nurse is caring for a client with adrenal hyperplasia. What is the nurse's understanding of the etiology of the condition?
Excessive hormonal stimulation
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
Release and synthesis of anterior pituitary hormones are mainly regulated by which part of the body?
Hypothalamus
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 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
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
A major manifestation of Cushing syndrome includes which of the following?
Hypokalemia
An infant whose mother had myxedema during pregnancy has failed to meet standards for growth and is developmentally delayed. Which hormonal imbalance is this child exhibiting?
Hypothyroidism
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 fine 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
A client diagnosed with metabolic syndrome and growth hormone (GH) deficiency will likely display which physical assessment finding?
Increased visceral fat
While teaching a science class, the instructor mentions that both autocrine and paracrine hormonal actions occur without entering the bloodstream. A student asks, "What cells do paracrine actions affect?" Which response is correct?
Local
What is the MOST common mechanism of hormone control?
Negative feedback
Which individual is experiencing the effects of a primary endocrine disorder?
Person who has low calcium levels because of the loss of the parathyroid gland
Which structure controls the functions of the greatest number of target glands and cells?
Pituitary gland
Several hormones, including growth hormone (GH) and thyrotropin-releasing hormone (TRH), are bound to and carried by which substance?
Proteins
Hormones are chemical messengers that provide which function in the body?
Regulate body functions
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
A client has developed the facial appearance that is characteristic of myxedema, along with an enlarged tongue, bradycardia, and voice changes. Which treatment modality is MOST likely to benefit this client?
Synthetic preparations of T3 or T4
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 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
When describing to a client newly diagnosed with diabetes how insulin is regulated, the nurse will draw upon her knowledge of which hormonal regulation mechanism?
The hypothalamic-pituitary-target cell system
The nurse is teaching a client who has been newly diagnosed with hypothyroidism about the function of the thyroid. Which statement about the role of the thyroid gland is MOST accurate?
The thyroid gland is responsible for increasing the metabolic rate
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
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. What does the nurse teach the client is the purpose of oxytocin?
To stimulate contraction of the uterus
Paracrine action involves which characteristic?
act locally on cells other than those that produce the hormone
The nurse is caring for a client with a hormonal disorder that is widely affecting many body systems. The nurse recognizes that which form of hormone signaling pathway is most likely involved in the client's disorder?
endocrine
Which clinical manifestations lead the health care worker to suspect the client is at the end-stage expression of hypothyroidism? A client: Select all that apply
who takes analgesics for chronic pain and goes into a coma brought to the emergency department with hypothermia who presents with low serum sodium levels
When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response?
Hormone stimulation
As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated?
Prevent accumulation
A client with a history of brain tumors that resulted in partial removal of the pituitary gland years ago expresses concern to the health care provider about whether she will be able to breast-feed her infant. Which physiologic function of the pituitary gland facilitates breast milk production?
Prolactin
Place the steps of the positive feedback mechanism involved in labor and delivery in the correct order.
Uterine contraction pushes head of baby into the cervix Nerve cells in cervix stimulate oxytocin Production of more forceful uterine contractions Resistant decent of baby Increased stretch of the cervix
The nurse is teaching a client newly diagnosed with hypothyroidism. The nurse teaches that thyroid hormone is transported by which?
protein carriers