304 EAQ Hormonal Regulation
What are the signs and symptoms of syndrome of inappropriate antidiuretic hormone (SIADH)? Select all that apply. 1 Polyuria 2 Dyspnea 3 Anorexia 4 Coarse skin 5 Dulled sensorium
A patient with SIADH has dyspnea, anorexia, dulled sensorium, impaired taste, and fatigue. Polyuria is a symptom of diabetes insipidus. Coarse skin is a symptom of acromegaly.
A client has a dysfunctional gland that synthesizes and releases adrenocorticotropic hormone (ACTH). Which gland is affected? 1 Adrenal cortex 2 Adrenal medulla 3 Anterior pituitary 4 Posterior pituitary
ACTH is synthesized and released by the anterior pituitary gland in response to stimulation by corticotropin-releasing hormone (CRH) from the hypothalamus. ACTH is not synthesized and released by the adrenal cortex (aldosterone, glucocorticoids), adrenal medulla (catecholamines), or posterior pituitary (oxytocin, antidiuretic hormone).
A client is experiencing the fight-or-flight response. Which gland releases the catecholamines? 1 Pituitary 2 Adrenal cortex 3 Hypothalamus 4 Adrenal medulla
Catecholamines are released from the adrenal medulla. Catecholamine release and the body's response have been characterized as the fight-or-flight response. The adrenal cortex releases aldosterone and glucocorticoids. The hypothalamus releases various types of releasing hormones. The pituitary releases oxytocin and antidiuretic hormone.
A nurse is teaching the staff about steroid hormones. Which information should the nurse include? 1 They are water-soluble molecules. 2 They are relatively large hormones. 3 They are synthesized from cholesterol. 4 They are transported by high osmotic pressure
Steroids are synthesized from cholesterol and are lipid-soluble. They are relatively small molecules that can cross by simple diffusion.
Which hormone deficiency causes serum hyperosmolarity? 1 Prolactin 2 Antidiuretic hormone 3 Thyroid-stimulating hormone 4 Thyrotropin-releasing hormone
Deficiency in antidiuretic hormone levels leads to serum hyperosmolarity due to fluid and electrolyte imbalance. Inhibitory control of prolactin secretions prevents hyperprolactinemia. Deficiency of thyroid-stimulating hormone leads to hypothyroidism. Deficiency in thyrotropin-releasing hormone leads to hypothalamic hypothyroidism.
A client has syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Upon assessment, which findings would the nurse expect to observe? Select all that apply. 1 Thirst 2 Confusion 3 Muscle twitching 4 Peripheral edema 5 Dyspnea on exertion
Dyspnea on exertion, muscle twitching, confusion, and thirst are all typical with SIADH. Peripheral edema is absent.
Which pathophysiologic process should the nurse consider when caring for a client with the syndrome of inappropriate antidiuretic hormone (SIADH)? 1 Renal retention of sodium and water 2 Renal excretion of water and sodium 3 Renal retention of sodium without water 4 Renal retention of water without sodium
Excessive antidiuretic hormone (ADH) secretion in SIADH stimulates increased water reabsorption in the collecting tubules, without sodium reabsorption. ADH does not cause renal retention or excretion of both sodium and water, nor retention of sodium alone.
A nurse is talking about the hormone that has the opposite physiologic effects of insulin on the client's liver. Which hormone is the nurse describing? 1 Amylin 2 Glucagon 3 Aldosterone 4 Somatostatin
Glucagon increases blood glucose levels by stimulating glycogenolysis and gluconeogenesis by the liver, which is the opposite of the action of insulin on the liver. Amylin is co-secreted with insulin to suppress glucagon secretion after a meal. Aldosterone does not oppose the action of insulin on the liver but affects sodium. Although somatostatin can inhibit the secretion of insulin, the hormone that has the opposite effect of insulin on the liver is glucagon.
Which diseases cause primary hyperthyroidism? Select all that apply. 1 Meningitis 2 Cystic fibrosis 3 Graves disease 4 Solitary toxic adenoma 5 Toxic multinodular goiter
Graves disease, solitary toxic adenoma, and toxic multinodular goiter are the common diseases that impair the function of the thyroid gland. Meningitis and cystic fibrosis cause syndrome of inappropriate antidiuretic hormone (SIADH).
A nurse is teaching the staff about the cause of primary Addison disease. Which information should the nurse include in the teaching session? 1 A secreting adrenal cancer 2 Viral infection of the posterior pituitary 3 Autoimmune injury to the adrenal cortex 4 Bacterial infection of the adrenal medulla
In primary Addison disease, immune system attack on the adrenal cortex damages the gland. Secreting tumors cause hypersecretion of hormones; Addison disease causes a lack of secretions. Viral infection of the posterior pituitary would not cause Addison disease. Infection of the adrenal medulla primarily would affect the release of catecholamines.
A client with hypothyroidism has now run out of hormone replacement. What signs and symptoms will the client most likely experience in the next 2 or 3 days? 1 Hyperreflexia, diarrhea, and weight loss 2 Lethargy, cold intolerance, and bradycardia 3 Muscle wasting, hyperglycemia, and hypertension 4 Weight gain, development of goiter, and thyroid storm
Lethargy, cold intolerance, and bradycardia are signs and symptoms of hypothyroidism. Hyperreflexia, diarrhea, and weight gain are signs of hyperthyroidism. Muscle wasting, hyperglycemia, and hypertension are not clinical manifestations of hypothyroidism. A goiter would not develop in 2 to 3 days, and thyroid storm occurs with hyperthyroidism, not hypothyroidism.
A nurse is talking about the most potent naturally occurring glucocorticoid. Which glucocorticoid is the nurse describing? 1 Cortisol 2 Estrogen 3 Aldosterone 4 Adrenocorticotropic hormone
The most potent naturally occurring glucocorticoid is cortisol. Aldosterone is the most potent naturally occurring mineralocorticoid. Estrogen is not the most potent. The cells of the adrenal cortex are stimulated by adrenocorticotropic hormone to release cortisol.
A client has syndrome of inappropriate antidiuretic hormone (SIADH) secretion. Upon assessment of the laboratory results, which finding is typical? 1 Hypokalemia 2 Hyponatremia 3 Urine hyposmolarity 4 Serum hyperosmolality
SIADH leads to hyponatremia when free water is inappropriately retained and dilutes the serum to a sodium concentration below the normal range. Hypokalemia is not a defining assessment finding in SIADH. Serum hyposmolality, not hyperosmolality, and urine hyperosmolarity, not hyposmolarity, occur with SIADH.
A nurse is reviewing charts. Which client is most predisposed to an increase in antidiuretic hormone (ADH) secretion?
Specialized neurons called osmoreceptors, found in the hypothalamus, respond to changes in plasma osmolality. When body fluids become too concentrated (increased plasma osmolality), ADH is released and more water is reabsorbed from the kidneys. Body mass index is not a significant regulator of ADH release. Alcohol ingestion and an increased intravascular volume would decrease ADH secretion
A nurse is teaching the staff about the adrenal glands and their hormones. Which information should the nurse include for the hormones that are secreted by the adrenal cortex? Select all that apply. 1 Cortisol 2 Aldosterone 3 Epinephrine 4 Corticosterone 5 Norepinephrine
The adrenal cortex of the adrenal gland secretes mineralocorticoid (aldosterone), glucocorticoids (cortisol, cortisone, and corticosterone), adrenal androgens, and estrogen. The adrenal medulla of the adrenal gland secretes catecholamines (epinephrine and norepinephrine).
A nurse is teaching the staff about hormones that are secreted by the anterior pituitary. Which hormones should the nurse include? Select all that apply. 1 Oxytocin 2 Calcitonin 3 Parathyroid hormone (PTH) 4 Antidiuretic hormone (ADH) 5 Thyroid-stimulating hormone (TSH) 6 Adrenocorticotropic hormone (ACTH)
The anterior pituitary secretes TSH and ACTH. The posterior pituitary secretes oxytocin and ADH. The thyroid gland secretes calcitonin. The parathyroid glands secrete PTH.
A nurse is teaching about the posterior pituitary gland hormones. Which hormones should the nurse include? Select all that apply. 1 Oxytocin 2 Prolactin 3 Growth hormone 4 Antidiuretic hormone 5 Luteinizing hormone
The hormones produced by the posterior pituitary gland include antidiuretic hormone and oxytocin. Luteinizing hormone, growth hormone, and prolactin are hormones from the anterior pituitary gland.
A client has Addison disease. Which pathophysiologic process should the nurse remember when assessing the symptoms of this disease? 1 An insufficient amount of T4 and T3 2 Increased serum levels of aldosterone 3 An insufficient amount of circulating cortisol 4 Increased activity of the renin-angiotensin system
The symptoms of Addison disease are primarily a result of hypocortisolism and hypoaldosteronism. Addison disease is not related to amounts of T 4 and T 3 or to the renin-angiotensin system. Hypoaldosteronism, not increased serum levels of aldosterone, causes symptoms of Addison disease.
A nurse is teaching the staff about the regulation of the release of T3 and T4 from the thyroid gland. Which primary process should the nurse include? 1 Neural feedback 2 Positive feedback 3 Negative feedback 4 Dysregulated feedback
Thyroid hormones, like most other hormones, are regulated through negative feedback. Thyroid hormone levels are not regulated through neural feedback or positive feedback. Dysregulated feedback does not describe normal hormonal regulation.
A nurse is describing how thyroid hormone is made. In which correct order should the nurse present the steps? 1. Uniodinated thyroglobulin produced 2. Trapping of iodide into the thyroid follicular cells 3. Oxidation to iodine 4. Triiodothyronine and tetraiodothyronine produced 5. Stored in colloid
Uniodinated thyroglobulin is produced. Then follicular cells of the thyroid gland trap iodide, oxidize it to iodine, and couple it to molecules of the amino acid tyrosine. These iodotyrosines are then combined to form T4 and T3 and are stored in the colloid until they are released into the circulation.
A nurse is caring for a client with Addison disease and notices weakness. How should the nurse interpret this finding? 1 This is a result of hypocortisolism. 2 This is a result of encephalopathy. 3 This is a result of insulin resistance. 4 This is a result of central nervous system (CNS) ischemia
Weakness and fatigability in people with Addison disease are caused by low cortisol levels (hypocortisolism). CNS ischemia and encephalopathy are not associated with Addison disease, but hypocortisolism and hypoaldosteronism are associated with Addison disease. Insulin resistance is associated with type 2 diabetes.
A nurse is teaching about the hypothalamus. Which information should the nurse include? Select all that apply. 1 It is divided into two neurons. 2 It is located at the base of the brain. 3 It is connected to the posterior pituitary by blood vessels. 4 It is connected to the anterior pituitary by a single membrane. 5 It is made up of neurosecretory neurons that secrete releasing hormones
The hypothalamus is located at the base of the brain and comprises neurosecretory neurons that secrete releasing hormones. The hypothalamus is made of neurons; it is connected to the anterior pituitary by blood vessels and to the posterior pituitary by a nerve tract.
In an interdisciplinary team meeting, a nurse is describing diurnal patterns, pulsatile and cyclic patterns, and patterns that depend on levels of circulating substrates. Which topic is the nurse discussing? 1 Elimination patterns of hormones 2 Regulation patterns of hormones 3 Transport patterns of hormones 4 Secretion patterns of hormones
The three basic secretion patterns of hormones are diurnal patterns, pulsatile and cyclic patterns, and patterns that depend on levels of circulating substrates. Hormones are excreted by the kidneys or are deactivated by the liver or cellular mechanisms. Chemical factors, endocrine factors, and neural control regulate hormones. Hormones are transported in the blood unbound (free) or transported while bound to a carrier or transport protein.
Which information indicates a nurse has an accurate understanding of the thyroid-stimulating hormone (TSH)? 1 TSH secretion is controlled by positive feedback. 2 TSH secretion is regulated by thyrotropin-releasing hormone. 3 TSH is secreted by the hypothalamus when triiodothyronine (T3) is low. 4 TSH is secreted in excess when the pituitary is stimulated by thyroxine (T4)
Thyroid-stimulating hormone (TSH) secretion from the anterior pituitary is stimulated by thyrotropin-releasing hormone (TRH) from the hypothalamus and by decreased serum levels of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). Secretion of TSH stimulates the synthesis and secretion of thyroid hormones. Increasing levels of T4 and T3 then generate negative feedback on the pituitary and hypothalamus to inhibit TRH and TSH synthesis.
