Chapter 29: PrepU - Nursing Assessment: Endocrine Function
A 60-year-old woman has just been diagnosed with hypothyroidism after a diagnostic workup. What sign or symptom most likely motivated the woman to originally seek care? 1- Lethargy and apathy 2- Abnormal hair growth and excessive perspiration 3- Flushed skin and pruritus 4- Aggression and increased appetite
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A client has a decreased level of thyroid hormone being excreted. What will the feedback loop do to maintain the level of thyroid hormone required to maintain homeostatic stability? 1- Stimulate more hormones using the negative feedback system 2- Stimulate more hormones using the positive feedback system 3- Produce a new hormone to try and regulate the thyroid function 4- The feedback loop will be unable to perform in response to low levels of thyroid hormone.
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A client has been experiencing a decrease in serum calcium. After diagnostics, the physician proposes the calcium level fluctuation is due to altered parathyroid function. What is the typical number of parathyroid glands? 1- four 2- three 3- two 4- one
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A client is being screened for a thyroid disorder. The nurse would anticipate that the client would most likely undergo which test? 1- TSH (thyroid-stimulating hormone) 2- T4 3- T3 4- needle aspiration
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A client with hyperthyroidism is concerned about changes in appearance. How can the nurse convey an understanding of the client's concern and promote effective coping strategies? 1- Reassure the client that their emotional reactions are a result of the disorder and symptoms can be controlled with effective treatment. 2- Encourage the client to participate in outside activities to boost coping strategies. 3- Suggest that the client wear cosmetics to cover any changes in appearance. 4- Refer the client to professional counseling.
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A nurse educator is teaching a chapter on "The Function of the Endocrine System." Which hormone would not be included as one of the six hypothalamic hormones? 1- prolactin 2- corticotropin-releasing hormone 3- thyrotropin-releasing hormone 4- gonadotropin-releasing hormone
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A nurse is caring for a client suspected of having a pituitary tumor that is causing panhypopituitarism. During assessment of the client, which clinical manifestation would the nurse expect to find? 1- Atrophy of the gonads 2- Carpopedal spasm 3- Hypertension 4- Tachycardia
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A nurse is reviewing a laboratory order for a client who is scheduled to be tested for a suspected endocrine disorder. The client was recently seen in the office for bronchitis, and you note that he is still taking cough medication. The nurse explains to the client that he will not be able to get his lab testing done today. Why has the testing been postponed? 1- The client is being tested for a thyroid disorder 2- The client is being tested for a parathyroid disorder 3- The client is being tested for an adrenal disorder 4- The client is being tested for a parathyroid disorder 5- The client is being tested for a pituitary disorder
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A pheochromocytoma is a rare adrenal tumor that causes increased heart rate, blood pressure, and metabolism because of increased levels of circulating: 1- Catecholamines. 2- Cortisol. 3- Aldosterone. 4- Glucocorticoids.
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An adult patient is experiencing a temporary decrease in serum levels of T3 and T4. What physiological response is this state likely to result in? 1- Increased release of TSH 2- Increased resorption of T3 and T4 in the renal tubules 3- Release of sequestered T3 and T4 by the spleen 4- Compensatory release of T5 by the parathyroid
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During physical examination of a client with a suspected endocrine disorder, the nurse assesses the body structures. The nurse gathers this data based on the understanding that it is an important aid in which of the following? 1- Detecting evidence of hormone hypersecretion. 2- Detecting information about possible tumor growth. 3- Determining the presence or absence of testosterone levels. 4- Determining the size of the organs and location.
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Parathyroid hormone (PTH) has which effects on the kidney? 1- Stimulation of calcium reabsorption and phosphate excretion 2- Stimulation of phosphate reabsorption and calcium excretion 3- Increased absorption of vitamin D and excretion of vitamin E 4- Increased absorption of vitamin E and excretion of vitamin D
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The nurse knows to advise the patient with hyperparathyroidism that he or she should be aware of signs of the common complication of: 1- Kidney Stones 2- Heart palpitations 3- Bone fractures 4- Gastric esophageal reflex
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When describing the difference between endocrine and exocrine glands, which of the following would the instructor include as characteristic of endocrine glands? 1- The secretions are released directly into the blood stream. 2- The glands contain ducts that produce the hormones. 3- The secreted hormones act like target cells. 4- The glands play a minor role in maintaining homeostasis.
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Which of the following glands is considered the master gland? 1- Pituitary 2- Thyroid 3- Parathyroid 4- Adrenal
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Which diagnostic test is done to determine a suspected pituitary tumor? 1- Radiography of the abdomen 2- Computed tomography 3- Measuring blood hormone levels 4- Radioimmunoassay
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A client is admitted to the hospital and will be undergoing tests to determine if he has an abdominal mass. What should the nurse be sure to document when asking about allergies? 1- If the client is allergic to beef 2- If the client is allergic to pork 3- If the client is allergic to seafood 4- If the client is allergic to grapefruit
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A client is scheduled for a diagnostic test to measure blood hormone levels. The nurse expects that this test will determine which of the following? 1- The concentration of a substance in plasma 2- Details about the size of the organ and its location 3- The functioning of endocrine glands 4- The client's blood sugar level
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A client visits the clinic to seek treatment for disturbed sleep cycles and depressed mood. Which glands and hormones help to regulate sleep cycles and mood? 1- Thymus gland, thymosin 2- Parathyroid glands, parathormone 3- Pineal gland, melatonin 4- Adrenal cortex, corticosteroids
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A nurse caring for a patient with diabetes insipidus is reviewing the patient's laboratory results. What is an expected urinalysis finding? 1- Glucose in the urine 2- Albumin in the urine 3- Urine specific gravity of 1.001 to 1.005 4- Leukocytes in the urine
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A nurse is assigned to care for a patient with increased parathormone secretion. Which of the following serum levels should the nurse monitor for this patient? 1- Glucose 2- Sodium 3- Calcium 4- Potassium
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The nurse is assessing a patient diagnosed with Graves' disease. What physical characteristics of Graves' would the nurse expect to find? 1- Hair loss 2- Moon face 3- Bulging eyes 4- Fatigue
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The nursing educator is teaching a group of new graduates about Addison's disease. What symptom would the educator identify as being characteristic of Addison's disease? 1- Truncal obesity 2- Hypertension 3- Muscle weakness 4- "Moon" face
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Which instruction should be included in the discharge teaching plan for a client after thyroidectomy for Graves' disease? 1- Keep an accurate record of intake and output. 2- Use nasal desmopressin acetate (DDAVP). 3- Have regular follow-up care. 4- Exercise to improve cardiovascular fitness.
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A hospital patient's most recent blood work reveals a Ca2+ level of 14.2 mg/dL (normal 8.5 to 10.5 mg/dL) and a phosphorus level of 1.4 mg/dL (normal 3.0 to 4.5 mg/dL). What hormone has the potential to cause this alteration in the patient's electrolyte levels? 1- Calcitonin 2- Corticotropin-releasing hormone (CRH) 3- Thyroid hormone 4- Parathyroid hormone
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A patient with pheochromocytoma has been admitted for an adrenalectomy tomorrow. The patient is to start IV medication this evening to prevent adrenal insufficiency. What medication is the patient most likely to require? 1- Antibiotics 2- Antihypertensives 3- Parenteral nutrition 4- Corticosteroids
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A postpartum client is receiving intravenous oxytocin (Pitocin) after birth. Why will this medication be used for this client after the birth of her child? 1- Will prevent lactation for a woman who is bottle feeding her newborn 2- Decreases the postpartum cramping 3- Helps treat nausea 4- Stimulates the contraction of the uterus and prevents bleeding
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During a follow-up visit to the physician, a client with hyperparathyroidism asks the nurse to explain the physiology of the parathyroid glands. The nurse states that these glands produce parathyroid hormone (PTH). PTH maintains the balance between calcium and: 1- sodium. 2- potassium. 3- magnesium. 4- phosphorus.
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In response to a patient's elevated blood glucose level, the nurse has administered a dose of insulin as ordered. The nurse understands that insulin results in a lowered level of blood glucose by: 1- Breaking the molecular bonds in glucose molecules 2- Stimulating thyroid hormone release and increasing metabolic needs 3- Inhibiting the action of glucagon 4- Facilitating glucose transport into body cells
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The nurse is reviewing a client's laboratory studies and determines that the client has an elevated calcium level. What does the nurse know will occur as a result of the rise in the serum calcium level? 1- A rise in serum calcium stimulates the release of T lymphocytes. 2- A rise in serum calcium stimulates the release of erythropoietin. 3- A rise in serum calcium inhibits the release of calcitonin. 4- A rise in serum calcium stimulates the release of calcitonin from the thyroid gland.
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The nurse knows to assess a patient with hyperthyroidism for the primary indicator of: 1- Fatigue 2- Weight gain 3- Constipation 4- Intolerance to heat
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A nurse is developing a teaching plan for a client diagnosed with hyperparathyroidism that explains this condition. When describing the underlying problem, the nurse would most likely include a discussion about which mineral? 1- calcium 2- sodium 3- potassium 4- magnesium
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A patient's thyroid gland has secreted T3 and T4 into the bloodstream. This occurs in response to the stimulation of a hormone originating in the: 1- Anterior pituitary gland 2- Adrenal cortex 3- Parathyroid gland 4- Pancreas
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The nurse is aware that the clinical symptoms of a patient with hypoparathyroidism are the result of the initial physiologic response of: 1- Hypocalcemia. 2- Decreased levels of vitamin D. 3- Increased serum levels of phosphate. 4- Cardiac arrhythmias.
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The nurse is caring for a patient diagnosed with Hashimoto's thyroiditis. When assessing this patient what symptom would the nurse expect in a patient with hypothyroidism? 1- Bradycardia 2- Bulging eyes 3- Palpitations 4- Flushed skin
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The primary function of the thyroid gland includes which of the following? 1- Control of cellular metabolic activity 2- Facilitation of milk ejection 3- Reabsorption of water 4- Reduction of plasma level of calcium
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Which diagnostic test is done to determine suspected pituitary tumor? 1- computed tomography scan 2- measurement of blood hormone levels 3- radioimmunoassay 4- radiographs of the abdomen
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Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex? 1- Cushing syndrome 2- Addison disease 3- Graves disease 4- Hashimoto disease
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Which hormone is secreted by the posterior pituitary? 1- Vasopressin 2- Calcitonin 3- Corticosteroids 4- Somatostatin
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Which of the following hormones controls secretion of adrenal androgens? 1- Adrenocorticotropic hormone (ACTH) 2- Thyroid-stimulating hormone (TSH) 3- Parathormone 4- Calcitonin
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A client has a dysfunction in one of his glands that is causing a decrease in the level of calcium in the blood. What gland should be evaluated for dysfunction? 1- Thyroid gland 2- Parathyroid gland 3- Thymus gland 4- Adrenal gland
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A nurse is caring for a female client with hypothyroidism. The client is extremely upset about her altered physical appearance. She doesn't want to take her medication because she doesn't believe it's doing any good. What should the nurse do? 1- Tell the client she'll feel better if she consistently takes the thyroid replacement medication. 2- Tell the client she'll soon experience improvement in her looks as the medication corrects her hormone deficiency. 3- Tell the client she needs to learn to accept herself as she is and be compliant during treatment. 4- Tell the client that she looks fine and offer to help her with makeup.
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A nurse is providing care to a client who is experiencing low blood glucose levels. The nurse understands that the body attempts to raise the level by secreting which hormone? 1- insulin 2- glucagon 3- somatostatin 4- aldosterone
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A patient with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) is being cared for on a medical unit, and the nurse is writing an individualized care plan. The priority nursing diagnosis for a patient with this condition is what? 1- Deficient fluid volume 2- Excessive fluid volume 3- Hypothermia 4- Hyperthermia
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Vasopressin (antidiuretic hormone, ADH) has just been released into an individual's circulation. Which of the following changes in homeostasis most likely prompted the individual's posterior pituitary gland to release this hormone? 1- Psychological or physiological stress 2- Increased blood osmolality 3- Increased oxygen demand 4- Increased sodium intake
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Which hormones are secreted by the posterior lobe of the pituitary gland? Select all that apply. 1- Vasopressin 2- Oxytocin 3- Thyroid-stimulating hormone (TSH) 4- Follicle-stimulating hormone (FSH) 5- Luteinizing hormone (LH)
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A client is being seen in the clinic to receive the results of the lab work to determine thyroid levels. The nurse observes the client's eyes appear to be bulging, and there is swelling around the eyes. What does the nurse know that the correct documentation of this finding is? 1- Retinal detachment 2- Periorbital swelling 3- Bulging eyes 4- Exophthalmos
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Although not designated as endocrine glands, several organs within the body secrete hormones as part of their normal function. Which organ secretes hormones involved in increasing blood pressure and volume and maturation of red blood cells? 1- kidneys 2- cardiac atria 3- brain 4- liver
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A nurse is teaching a client with an endocrine disorder how the nervous system and endocrine system are linked. Which structure would the nurse identify as the link between the two systems. 1- hypothalamus 2- brain 3- medulla oblongata 4- pancreas
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During a client education session, the nurse describes the mechanism of hormone level maintenance. What causes most hormones to be secreted? 1- decrease in hormonal levels 2- increase in hormonal levels 3- hormonal overproduction 4- hormonal underproduction
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A nursing student asks the instructor why the pituitary gland is called the "master gland." What is the best response by the instructor? 1- "It regulates the function of other endocrine glands." 2- "It is the gland that is responsible for regulating the hypothalamus." 3- "The gland does not have any other function other than to cause secretion of the growth hormones." 4- "It regulates metabolism."
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