Chapter 40: Introduction to the Endocrine System
What hormone enters the cell and reacts with a receptor inside the cell to change messenger ribonucleic acid and affect the cells function? A) Estrogen B) Insulin C) Calcitonin D) Thyroid-stimulating hormone
Ans: A Feedback: Estrogen enters the cell and reacts with a receptor site inside of the cell to make changes and produce an action. This does not happen quickly, and it may take months to years to produce the changes. Estrogen, calcitonin, and thyroid-stimulating hormone react with specific receptor sites on the cell membrane to stimulate change and action within the cell.
The hypothalamicpituitary axis (HPA) functions through one of two processes to regulate hormone production. One of these processes is the negative feedback system. What is the other process? A) Direct use of inhibiting factors B) Indirect use of feedback loop C) Direct use of releasing factors D) Indirect use of stimulating factors
Ans: A Feedback: The HPA functions through negative feedback loops or the direct use of inhibiting factors to constantly keep particular hormones regulated. Other options are incorrect because hormones are not regulated by feedback loops, releasing factors, or stimulating factors.
The patients anterior pituitary hormone secretion is impacted by time of day and activity level, which the nurse assesses as what? A) Diurnal rhythm B) Physiological rhythm C) Circadian rhythm D) Biannual rhythm
Ans: A Feedback: The anterior pituitary hormones are released in a rhythmic manner into the bloodstream. Their secretion varies with time of day (often referred to as diurnal rhythm) or with physiological conditions, such as exercise or sleep. A biannual rhythm would be twice a year. Circadian rhythm is indicated by when the patient prefers to sleep or wake, such as those who describe themselves as morning people. There is no such thing as a physiological rhythm.
The hypothalamus fine-tunes and regulates the release of hormones using what process? A) Negative feedback systems B) Indirect feedback systems C) Direct local input D) Direct release of hormones into bloodstream
Ans: A Feedback: The fine-tuning and regulation of hormone release through the hypothalamus is often regulated by a series of negative feedback systems. Other options are incorrect answers as they are distracters for this question.
What organ should the nurse recognize as the coordinating center for the nervous and endocrine responses to internal and external stimuli? A) Hypothalamus B) Pituitary gland C) Thyroid gland D) Parathyroid gland
Ans: A Feedback: The hypothalamus is the coordinating center for the nervous and endocrine responses to internal and external stimuli. The pituitary, thyroid, and parathyroid glands all play an important role in maintaining homeostasis, but they do not connect the nervous and endocrine systems.
What is the connecting link between the nervous system and the endocrine system? A) Hypothalamus B) Thalamus C) Medulla oblongata D) Posterior pituitary
Ans: A Feedback: The main connecting link between the nervous system and the endocrine system is the hypothalamus, which responds to nervous system stimulation by producing hormones. The thalamus and medulla oblongata are part of the nervous system and the posterior pituitary is part of the endocrine system but none of these represents a link between the two systems.
The nurse is caring for a pregnant patient. What hormone must be secreted to cause uterine contractions? A) Oxytocin B) ADHD C) Estrogen D) Enkephalins
Ans: A Feedback: The pituitary is made up of three lobes: anterior, intermediate, and posterior. The posterior lobe stores two hormones produced by the hypothalamus, ADH and oxytocin. Oxytocin stimulates uterine smooth muscle contraction in late phases of pregnancy and also causes milk release or let down reflex in lactating women. The posterior lobe does not store estrogen or enkephalins. ADHD (i.e., attention deficit hyperactivity disorder is a disease process, not a hormone.
What hormones do not have a target organ to produce hormones and cannot be regulated by the same feedback as other hormones? A) Growth hormone and prolactin B) Estrogen and progesterone C) Erythropoietin and renin D) Insulin and glucagon
Ans: A Feedback: Two of the anterior pituitary hormones (i.e., growth hormone and prolactin) do not have a target organ to produce hormones and so cannot be regulated by the same type of feedback mechanism. Estrogen and progesterone have the uterus, ovaries, and breast, as their target organs. The target organs for erythropoietin is the bone marrow, for renin it is the arteries, and insulin and glucagon come from the pancreas to stimulate cells to metabolize glucose and regulate serum glucose levels
The nurse is preparing a class on the endocrine system for students. What benefit is served by the positioning of the hypothalamus in the brain? (Select all that apply.) A) Close to other important areas of the brain B) Able to influence and be influenced by emotions and thoughts C) Poorly protected by the bloodbrain barrier D) Floats within ventricles of the brain E) Protected from the limbic system
Ans: A, B, C Feedback: Situated at the base of the forebrain, the hypothalamus receives input from virtually all other areas of the brain, including the limbic system, cerebral cortex and the special senses that are controlled by the cranial nerves: smell, sight, touch, taste, hearing. Because of its positioning, the hypothalamus is able to influence, and be influenced by, emotions and thoughts. The hypothalamus also is located in an area of the brain that is poorly protected by the bloodbrain barrier, so it is able to act as a sensor to various electrolytes, chemicals, and hormones that are in circulation and do not affect other areas of the brain. It does not float within the ventricles of the brain, and it is located to allow input from the limbic system.
What hormones does the pancreas produce and release that aids in the bodys varying blood glucose levels? (Select all that apply.) A) Insulin B) Antidiuretic hormone (ADH) C) Glucagon D) Somatostatin E) Amylase
Ans: A, C, D Feedback: Hormones other than stimulating hormones are also released in response to stimuli. For example, the endocrine pancreas produces and releases insulin, glucagon, and somatostatin from different cells in response to varying blood glucose levels. ADH does not respond to blood glucose levels but controls sodium and potassium levels. Amylase is an enzyme released by the pancreas.
The nurse is discussing the endocrine system with a class of nursing students. What substance would the nurse label as a hormone? A) Acetylcholine B) Norepinephrine C) Nucleic acid D) Serotonin
Ans: B Feedback: A hormone is secreted directly into the bloodstream and travels from the site of production to react with specific receptor sites to cause an action. Norepinephrine, which is a neurotransmitter, is a hormone when it is produced in the adrenal medulla, secreted into circulation, and travels to norepinephrine receptor sites to cause an effect. Acetylcholine and serotonin are neurotransmitters, but are not hormones. Nucleic acid is used to build deoxyribonucleic acid and ribonucleic acid.
To better understand the negative feedback system, what might the nurse compare it with? A) The actions of use and disuse B) The law of supply and demand C) The concept of need and use D) The contract of give and take
Ans: B Feedback: A negative feedback system works much like the law of supply and demand in business. In business, when the supply of a product is adequate, production of that product will be cut back because demand is not there. Other options are distracters for this question.
The nurse is caring for a patient with abnormal calcium levels. What thyroid hormone does the nurse expect this will impact? A) Aldosterone B) Calcitonin C) Erythropoietin D) Insulin
Ans: B Feedback: Calcitonin is produced and secreted by the thyroid gland in direct response to serum calcium levels. Aldosterone is an adrenocorticoid hormone that is released in response to adrenocorticotropic hormone. Erythropoietin is released by the juxtaglomerular cells in the kidney in response to decreased pressure or decreased oxygenation of the blood flowing into the glomerulus. Insulin is produced by the pancreas in response to varying blood glucose levels.
The nurse is caring for a patient diagnosed with a condition resulting in inadequate production of cholecystokinin. What would the nurse expect to find when assessing this patient? A) Elevated serum sodium and reduced serum potassium levels B) Decreased bowel sounds C) Increased numbers of red blood cells D) Increased serum calcium levels
Ans: B Feedback: Cholecystokinin is secreted by the intestine and decreases gastric movement resulting in diminished bowel sounds as well as stimulation of bile and pancreatic juice secretion. Aldosterone causes sodium retention and potassium excretion. Erythropoietin increases red blood cell production. Parathyroid hormone causes an increase in serum calcium levels.
The patients body modulates pain perception as a result of the production of what in the intermediate lobe of the pituitary gland? A) Antidiuretic hormone (ADH) B) Endorphins C) Adrenocorticotropic hormone (ACTH) D) Oxytocin
Ans: B Feedback: Endorphins and enkephalins are produced by the intermediate lobe of the pituitary gland. Oxytocin and ADH are produced by the posterior pituitary gland, and ACTH is produced by the anterior pituitary gland.
What is a releasing hormone? A) Chemical that interacts with a hormone to activate it B) Chemical released by the body to stimulate the hypothalamus C) Chemical released by the body organs to stimulate the pituitary D) Chemical released by the hypothalamus into the anterior pituitary
Ans: B Feedback: Releasing hormones or factors are chemicals released by the hypothalamus into the anterior pituitary to stimulate the release of anterior pituitary hormones. The releasing hormone does not activate a hormone but stimulates its production. It does not stimulate the glands (hypothalamus or pituitary) but rather stimulates release of an anterior pituitary hormone.
The nurse overhears a physician talking about the master gland. What gland does the nurse recognize is being discussed? A) The pituitary gland B) The hypothalamus gland C) The thyroid gland D) The parathyroid gland
Ans: B Feedback: Scientists now designate the hypothalamus as the master gland because it has even greater direct regulatory effects over the neuroendocrine system, including stimulation of the pituitary gland to produce its hormones. The pituitary gland was formerly considered the master gland, but new research has helped scientists realize it is the hypothalamus that is the master gland.
Some hormones react with specific receptor sites on a cell membrane and stimulate what? A) Meiosis B) Cyclic adenosine monophosphate (cAMP) C) Increase in hormonal inactivity D) Decrease in hormonal activity
Ans: B Feedback: Some hormones react with specific receptor sites on a cell membrane to stimulate the nucleotide cAMP within the cell to elicit an effect. Hormones that react with specific receptor sites do not stimulate miosis, or a change in amount of hormonal activity, either an increase or decrease, which would be regulated by a negative feedback mechanism.
The nurse administers a thyroid hormone replacement pill to the patient. What effect will this action have on the patients production of thyroid hormones? A) Stimulates the gland that normally produces that hormone B) Stops production of releasing and stimulating hormones C) Initiates the negative feedback system D) Stimulates the hypothalamicpituitary axis
Ans: B Feedback: Supplying an exogenous hormone may increase the hormone levels in the body, but it then may affect the hypothalamicpituitary axis (HPA) to stop production of releasing and stimulating hormones, leading to a decrease in the bodys normal production of the hormone. It does not stimulate the gland or the HPA. It also does not trigger a negative feedback response.
What qualifies the hypothalamus to be called the master gland? A) It regulates the nervous and endocrine responses to stimuli. B) It stimulates the pituitary gland to control the endocrine system. C) It combines the nervous and endocrine system to work together. D) It produces all of the releasing hormones in the body.
Ans: B Feedback: The hypothalamus gland is called the master gland of the neuroendocrine system because it regulates both nervous and endocrine responses to internal and external stimuli. There is more to the hypothalamus than just its stimulation of the pituitary gland or its production of releasing hormones that leads it to be considered the master gland. The neuroendocrine system combines the nervous and endocrine systems to work closely together to maintain regulatory control and homeostasis in the body.
What receptors in the body stimulate the hypothalamus to release antidiuretic hormone (ADH)? A) Diuretic receptors B) Osmoreceptors C) Alpha receptors D) Nicotinic receptors
Ans: B Feedback: The osmoreceptors in the hypothalamus stimulate the release of ADH. There is no such thing as a diuretic receptor. Alpha receptors are associated with the sympathetic nervous system and nicotinic receptors are associated with the parasympathetic nervous system.
A group of nursing students are developing a presentation on hormones. What hormone will the students presentation identify as regulating the metabolic rate and influencing the growth and development of the body? A) Parathyroid hormone or parathormone B) Thyroid hormone C) Cortisol D) bInsulin
Ans: B Feedback: Thyroid hormone regulates the metabolic rate of the body and greatly influence growth and development. Parathormone, cortisol, and insulin do not regulate the metabolic rate or influence growth and development.
The nurse administers an exogenous hormone to the patient. How does the nurses action impact the endocrine system? (Select all that apply.) A) May decrease exogenous hormone levels B) May increase hormone levels in the body C) May stop production of releasing and stimulating hormones D) May lead to a decrease in the normal production of the hormone E) May increase the endogenous hormone levels
Ans: B, C, D Feedback: Supplying an exogenous hormone may increase the hormone levels in the body, but then might affect the hypothalamicpituitary axis (HPA) to stop production of releasing and stimulating hormones, leading to a decrease in the bodys normal production of the hormone. Supplying exogenous hormone will not cause a decrease in exogenous hormone levels nor will it cause an increase in endogenous hormone levels.
Estrogen enters the cell and reacts with a receptor site. What is the final result of this reaction? A) Deoxyribonucleic acid (DNA) is affected. B) Ribonucleic acid enters the cell nucleus. C) Alteration in cellular function D) Changes messenger RNA
Ans: C Feedback: Estrogen enters the cell and reacts with a receptor site inside the cell to change messenger RNA, which enters the cell nucleus to affect cellular DNA, and the final result is an alteration in the cells function.
What are the areas of the hypothalamus called that are specifically sensitive to certain stimuli to regulate body functions? A) Nodes B) Lobes C) Neurocenters D) Epicenters
Ans: C Feedback: The hypothalamus has various neurocentersareas specifically sensitive to certain stimulithat regulate various body functions, including body temperature, thirst, hunger, water retention, blood pressure, respiration, reproduction, and emotional reactions. Areas of special sensitivity in the hypothalamus are not called depots, lobes, or epicenters.
The nurse explains the end result of the hypothalamus in regulating the central nervous system (CNS), autonomic nervous system (ANS), and endocrine system is what? A) Regulation of the negative feedback system B) Creation of a diurnal rhythm C) Maintenance of homeostasis D) Production of prolactin-inhibiting factor (PIF)
Ans: C Feedback: The hypothalamus maintains internal homeostasis by sensing blood chemistries and by stimulating or suppressing endocrine, autonomic, and CNS activity. In essence, it can turn the ANS and its effects on or off. The negative feedback system is one way homeostasis is maintained. When the hypothalamus senses a need for a particular hormone, it secretes a releasing factor directly into an area such as the anterior pituitary. This causes the area to produce a hormone. When the hypothalamus senses a rising level of the hormone it stops secreting the releasing factor, which decreases the hormone production. When this occurs the hypothalamus senses the falling hormone level and the releasing factor is secreted again. This process is how the hormone level is maintained. Diurnal rhythm refers to the release of hormones at various times of the day. PIF, produced by the hypothalamus, acts as a regulator to shut off production of hormones when levels become too high.
The nurse explains the purpose of the negative feedback system used by the endocrine system is what? A) To change the environment of the pituitary gland B) To regulate hormone release C) To maintain hormone concentration at a certain level D) To control the action of hormones
Ans: C Feedback: The negative feedback system is a control system in which increasing levels of a hormone lead to decreased levels of releasing and stimulating hormones, leading to decreased hormone levels, which stimulates the release of releasing and stimulating hormones; it allows tight control of the endocrine system. It does not involve changing the environment or control the action of hormones.
The nursing instructor is talking with her clinical group about the hypothalamicpituitary axis (HPA) and what happens when a need arises to interact with the total system. The instructor explains that this can create what? A) A negative feedback system B) Homeostasis C) Complications D) Maximum efficiency
Ans: C Feedback: This system (i.e., the HPA) also can create complications, especially when a need exists to override or interact with the total system, as is the case with replacement therapy or treatment of endocrine disorders. Interactions with the total system cannot create a negative feedback system, homeostasis, or maximum efficiency. The other options are incorrect.
When the hypothalamus senses a need for thyroid hormone, where does it secrete the releasing factor thyrotropin-releasing hormone (TRH)? A) Directly into the posterior pituitary B) Directly into the bloodstream C) Directly into the anterior pituitary D) Directly into the thyroid gland
Ans: C Feedback: When the hypothalamus senses a need for a particular hormone, it secretes TRH directly into the anterior pituitary. Other options, therefore, are incorrect.
What criteria can the nurse use to describe all hormones? A) They are produced in very large amounts. B) They circulate until they are used by receptor cells. C) They are secreted directly into the tissue where they react. D) They travel in the blood to specific receptor sites.
Ans: D Feedback: Hormones are chemicals that are produced in the body and meet specific criteria. All hormones are produced in very small amounts and are secreted directly into the bloodstream. They travel in the blood to specific receptor sites throughout the body and are immediately broken down.
While caring for a diabetic patient, the nurse explains that normally insulin is produced by the pancreas and does what when reacting with the human cell? A) Metabolizes glucose B) Allows water to enter the cell C) Alters cellular messenger ribonucleic acid (RNA) D) Changes the cell permeability to glucose
Ans: D Feedback: Insulin reacts with specific receptor sites on the cell membrane to change the cells permeability to glucose to allow glucose to enter the cell. It does not affect water transport or messenger RNA. Insulin does not metabolize glucose but rather helps it move into the cell where it supplies energy for cellular activity.
Melanocyte-stimulating hormone (MSH) released from the anterior pituitary is important in humans because of its suspected ability to do what? A) Block the perception of pain B) Change the color of skin in some environments C) Stimulate fat mobilization D) Stimulate nerve growth and development
Ans: D Feedback: MSH might be important for nerve growth and development in humans. Animals use MSH to change skin color as part of protective camouflage, but it does not have this effect in humans. Lipotropins stimulate fat mobilization. Endorphins and enkephalins are hormones that block the perception of pain.
The hypothalamus receives input from virtually all other areas of the brain. Where is the hypothalamus located? A) Behind the frontal lobe B) In the substantia nigra C) At the base of the pons D) At the base of the forebrain
Ans: D Feedback: Situated at the base of the forebrain, the hypothalamus receives input from virtually all other areas of the brain, including the limbic system and the cerebral cortex. Therefore, the other options are incorrect.
When the student develops a poster of the endocrine system, what gland will be excluded because it is not classified as a major organ of the endocrine system? A) Hypothalamus B) Pituitary C) Thyroid D) Gallbladder
Ans: D Feedback: The gallbladder is not part of the endocrine system and does not secrete hormones. All other options are organs of the endocrine system.
A client is suspected to have a pituitary tumor due to signs of diabetes insipidus. What initial test does the nurse assist the client with preparing for? A) Magnetic resonance imaging (MRI) B) Radioactive iodine uptake test C) Radioimmunoassay D) A nuclear scan
Ans: A Feedback: A computed tomography (CT) or magnetic resonance imaging (MRI) scan is performed to detect a suspected pituitary tumor or to identify calcifications or tumors of the parathyroid glands. A radioactive iodine uptake test would be useful for a thyroid tumor. Radioimmunoassay determines the concentration of a substance in plasma.
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? A) Stimulate more hormones using the negative feedback system B) Stimulate more hormones using the positive feedback system C) Produce a new hormone to try and regulate the thyroid function D) The feedback loop will be unable to perform in response to low levels of thyroid hormone.
Ans: A Feedback: Feedback can be either negative or positive. Most hormones are secreted in response to negative feedback; a decrease in levels stimulates the releasing gland.
The nurse is preparing a client for a thyroid test. Which medications should the nurse document on the laboratory slip that the client is taking that may affect the thyroid test? A) Aspirin B) Metoclopramide (Reglan) C) Lisinopril (Prinivil) D) Furosemide (Lasix)
Ans: A Feedback: If a client has recently taken a drug that contains iodine or has had radiographic contrast studies that used iodine, thyroid test results may be inaccurate. Other drugs (e.g., salicylates, corticosteroids) also affect the results of thyroid tests. Be sure to enter on the laboratory request slip all drugs the client is taking or has taken within the past 3 months. The other drugs do not have relevance to the thyroid test.
A client is experiencing an increase in blood glucose levels. The nurse understands that which of the following hormones would be important in lowering the client's blood glucose level? A) Insulin B) Parathormone C) Melatonin D) Calcitonin
Ans: A Feedback: Insulin is a hormone released by the beta islet cells that lowers the level of blood glucose when it rises above normal limits. Parathormone increases the level of calcium in the blood when a decrease in serum calcium levels occurs. Melatonin aids in regulating sleep cycles and mood. Calcitonin is a thyroid hormone that inhibits the release of calcium from the bone into the extracellular fluid.
The nurse is caring for a client who has an excess amount of potassium being excreted and has a serum level of 6.2 mEq/L. What group of adrenal hormones is likely to be impacting the laboratory result? A) Mineralocorticoids B) Glucocorticoids C) Testosterone D) Estrogen
Ans: A Feedback: Mineralocorticoids, primarily aldosterone, maintain water and electrolyte balances. The androgenic hormones convert to testosterone and estrogens. Glucocorticoids, such as cortisol, affect body metabolism, suppress inflammation, and help the body withstand stress.
A client is scheduled to have a test to determine thyroid function. What should the nurse ask the client prior to scheduling the testing? A) If the client has had a diagnostic test that used dye within the last 3 months B) If the client is able to pay for the testing or have insurance coverage C) If the client is drinking adequate amounts of fluid daily D) If the client is taking birth control pills
Ans: A Feedback: The client should also report whether the client has had a diagnostic test that used iodine within the past 3 months. This information is essential before initiating a thyroid test. The nurse is not responsible for eliciting information regarding ability to pay. Fluid intake and taking birth control pills do not correlate with the thyroid tests and have no relevance.
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? A) Detecting evidence of hormone hypersecretion B) Detecting information about possible tumor growth C) Determining the presence or absence of testosterone levels D) Determining the size of the organs and location
Ans: A Feedback: The evaluation of body structures helps the nurse detect evidence of hypersecretion or hyposecretion of hormones. This helps in the assessment of findings that are unique to specific endocrine glands. Radiographs of the chest or abdomen are taken to detect tumors. Radiographs also determine the size of the organ and its location.
A client has a decreased secretion of erythropoietin from the kidneys due to end-stage kidney disease. What outcome will the decrease in erythropoietin have? A) Anemia from the decrease in maturation of red blood cells B) Decrease in blood sugar levels due to alteration in insulin levels C) Increase in blood sugar levels due to alteration in insulin levels D) Development of male sex characteristics
Ans: A Feedback: The kidneys secrete erythropoietin, which is a substance that promotes the maturation of red blood cells.
A client is having difficult with falling and staying asleep and has obtained over-the-counter melatonin to help with this issue. What gland would be responsible for the decreased secretion of melatonin? A) Pineal B) Adrenal C) Thyroid D) Thymus
Ans: A Feedback: The pineal gland is attached to the thalamus in the brain. It secretes melatonin, which aids in regulating sleep cycles and mood. Melatonin is believed to play a role in hypothalamic-pituitary interaction. The adrenal, thyroid, and thymus gland do not secrete melatonin.
A nursing student asks the instructor why the pituitary gland is called the "master gland." What is the best response by the instructor? A) "It regulates the function of other endocrine glands." B) "It is the gland that is responsible for regulating the hypothalamus." C) "The gland does not have any other function other than to cause secretion of the growth hormones." D) "It regulates metabolism."
Ans: A Feedback: The pituitary gland is called the master gland because it regulates the function of other endocrine glands. The term is somewhat misleading, however, because the hypothalamus influences the pituitary gland. The gland has many other hormones that it secretes.
A client with an immunodeficiency disorder does not have an adequate number of T lymphocytes in order to improve his immune function. Which gland should be investigated for dysfunction? A) Thymus B) Parathyroid C) Thyroid D) Adrenal
Ans: A Feedback: The thymus gland is located in the upper part of the chest above or near the heart. It secretes thymosin and thymopoietin, which aid in developing T lymphocytes, a type of white blood cell involved in immunity. The parathyroid, thyroid, and adrenal gland do not develop T lymphocyte production
A client has polycystic ovarian syndrome and has increased levels of testosterone. What symptoms does the nurse anticipate observing in this client? Select all that apply. A) Facial hair B) High voice C) Deep voice D) Acne E) Decrease in hair growth
Ans: A, C, D Feedback: Testosterone is involved with the development and maintenance of male secondary sex characteristics, such as facial hair and a deep voice. A high voice and decrease hair growth is the opposite of what will occur.
The nurse is reviewing the plan of care for a client with a disorder of the thyroid gland. Which diagnostic test would the nurse expect the physician to order to evaluate thyroid hormones? A) Magnetic resonance imaging B) Radioimmunoassay C) Computed tomography (CT) D) Cortisol level determination
Ans: B Feedback: A radioimmunoassay determines the concentration of a substance in plasma. A T3 determination by radioimmunoassay evaluates thyroid hormone function. A CT or magnetic resonance imaging scan is done to detect a suspected tumor and to determine organ size and placement. Cortisol levels determine adrenal hyperfunction.
The nurse is caring for a mother after the delivery of her newborn. The nurse is preparing to administer a dopamine antagonist to stimulate the mother's milk production. What medication will the nurse administer? A) Ondansetron (Zofran) B) Metoclopramide (Reglan) C) Meclizine (Antivert) D) Diphenhydramine (Benadryl)
Ans: B Feedback: Following delivery of a newborn, a dopamine antagonist such as metoclopramide (Reglan) may be prescribed to the mother to stimulate the production of breast milk. The other medications are used to assist in relieving nausea.
The nurse is caring for a client with diabetes who developed hypoglycemia. What can the nurse administer to the client to raise the blood sugar level? A) Insulin B) Glucagon C) Cortisone D) Estrogen
Ans: B Feedback: Glucagon, a hormone released by alpha islet cells, raises blood sugar levels by stimulating glycogenolysis, the breakdown of glycogen into glucose, in the liver. Insulin is released to lower the blood sugar levels. Cortisone and estrogen are not released from the pancreas.
The nurse is performing an assessment of the thyroid gland. In order to decrease the risk that the nurse will stimulate the release of large amounts of thyroid hormone, what should the nurse be sure to do? A) Palpate firmly in order to feel the thyroid gland. B) Palpate gently without repeated attempts. C) Continue to palpate the gland until it is felt for enlargement. D) Not palpate the thyroid and just listen for a bruit.
Ans: B Feedback: Repeated or forceful palpation of the thyroid in the case of thyroid hyperactivity can result in a sudden release of a large amount of thyroid hormones, which can have serious implications. Listening to the bruit can indicate a hyperactive thyroid and should be assessed in addition to palpation.
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? A) Thyroid gland B) Parathyroid gland C) Thymus gland D) Adrenal gland
Ans: B Feedback: The parathyroids secrete parathormone, which increases the level of calcium in the blood when there is a decrease in the serum level. The thyroid, thymus, and adrenal gland do not secrete calcium.
The nurse is interviewing a client being admitted for hypertension. The client states that he has been taking anabolic steroids, which the nurse knows are derivatives of adrenal androgens, daily. What use does the nurse suspect the client is taking the steroids for? A) Treatment of his hypertension B) Asthma C) Promote development of muscle mass D) Treatment of excess fluid accumulation
Ans: C Feedback: Anabolic steroids, derivatives of adrenal androgens, promote the development of muscle mass and other masculinizing characteristics. The use of the steroids may increase the blood pressure and make the hypertension worse. Corticosteroids would be beneficial for the treatment of asthma. Anabolic steroids do not decrease fluid accumulation.
A client is having chronic pain from arthritis. What type of hormone is released in response to the stress of this pain that suppresses inflammation and helps the body withstand stress? A) Testosterone B) Mineralocorticoids C) Glucocorticoids D) Estrogen
Ans: C Feedback: Glucocorticoids, such as cortisol, affect body metabolism, suppress inflammation, and help the body withstand stress. Mineralocorticoids, primarily aldosterone, maintain water and electrolyte balances. The androgenic hormones convert to testosterone and estrogens.
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? A) The concentration of a substance in plasma B) Details about the size of the organ and its location C) The functioning of endocrine glands D) The client's blood sugar level
Ans: C Feedback: Measuring blood hormone levels helps determine the functioning of endocrine glands. A radioimmunoassay determines the concentration of a substance in plasma. The measurement of blood hormone levels will not reveal a client's blood sugar level. Radiographs of the chest or abdomen determine the size of the organ and its location.
A group of students are reviewing for a test on hormones. The students demonstrate understanding of the material when they state which of the following as being secreted by the kidneys? A) Atrial natriuretic peptide B) Estrogen C) Renin D) Gastrin
Ans: C Feedback: The kidneys release renin and erythropoietin. Atrial natriuretic peptide is secreted by the atria of the heart. Estrogen is secreted by the placenta during pregnancy and the ovaries. Gastrin is secreted within the stomach to increase the production of hydrochloric acid.
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? A) If the client is allergic to beef B) If the client is allergic to pork C) If the client is allergic to seafood D) If the client is allergic to grapefruit
Ans: C Feedback: The nurse documents an allergy to iodine, a component of contrast dyes, or seafood, and informs the physician. Pork, beef, and grapefruit do not interact with the contrast dye that the client will receive during testing.
Which action would be most appropriate when evaluating a client's neck for thyroid enlargement? A) Inspect changes in pigmentation in the neck. B) Perform repeated palpation of the thyroid gland. C) Palpate the thyroid gland gently. D) Examine the skin of the neck for excessive oiliness.
Ans: C Feedback: The nurse should inspect the neck for thyroid enlargement and gently palpate the thyroid gland. Repeated palpation of the thyroid in case of thyroid hyperactivity can result in a sudden release of a large amount of thyroid hormones, which may have serious implications. Pigment changes in the neck and excessive oiliness of the skin are not related to assessment for thyroid enlargement.
An instructor is preparing a teaching plan for a class on the various pituitary hormones. Which hormone would the instructor include as being released by the posterior pituitary gland? A) Somatotropin B) Prolactin C) Oxytocin D) Adrenocorticotropic hormone
Ans: C Feedback: The posterior pituitary gland released oxytocin and antidiuretic hormone. Somatotropin, prolactin, and adrenocorticotropic hormone are released by the anterior pituitary gland.
A nurse is reading an article that describes the function of the neurohypophysis. The nurse identifies this as which of the following? A) Hypothalamus B) Pineal gland C) Posterior pituitary D) Thymus gland
Ans: C Feedback: The term neurohypophysis refers to the posterior lobe of the pituitary gland. The hypothalamus is a portion of the brain that projects down toward the pituitary gland. The pineal gland is attached to the thalamus in the brain. The thymus gland is involved in supporting the production of T lymphocytes.
The nurse is attempting to locate the thyroid gland in order to determine if it is enlarged. Where should the nurse palpate the thyroid gland? A) Mid trachea B) Distal to the carotid arteries C) The lower neck anterior to the trachea D) The upper neck posterior to the trachea
Ans: C Feedback: The thyroid gland is located in the lower neck anterior to the trachea. It is divided into two lateral lobes joined by a band of tissue called the isthmus.
After teaching a class about the endocrine system, the instructor determines that the students need additional instruction when they identify which of the following as an endocrine gland? A) Pancreas B) Adrenal gland C) Testes D) Kidneys
Ans: D Feedback: Although the kidneys secrete renin and erythropoietin, they are typically not considered endocrine glands. The pancreas, adrenal glands, and testes are considered endocrine glands.
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? A) A rise in serum calcium stimulates the release of T lymphocytes. B) A rise in serum calcium stimulates the release of erythropoietin. C) A rise in serum calcium inhibits the release of calcitonin. D) A rise in serum calcium stimulates the release of calcitonin from the thyroid gland.
Ans: D Feedback: Calcitonin, another thyroid hormone, inhibits the release of calcium from bone into the extracellular fluid. A rise in the serum calcium level stimulates the release of calcitonin from the thyroid gland.
When a client's gallbladder has decreased ability to release bile when he is having a high fat content meal, what hormone is not released to stimulate contractions of the gallbladder? A) Gastrin B) Erythropoietin C) Angiotensin D) Cholecystokinin
Ans: D Feedback: Cholecystokinin released from cells in the small intestine stimulates contraction of the gallbladder to release bile when dietary fat is ingested. Gastrin is released within the stomach to increase the production of hydrochloric acid. Erythropoietin is a substance that promotes the maturation of red blood cells. The kidneys release renin, a hormone that initiates the production of angiotensin and aldosterone to increase blood pressure and blood volume.
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? A) Retinal detachment B) Periorbital swelling C) Bulging eyes D) Exophthalmos
Ans: D Feedback: Exophthalmos is an abnormal bulging or protrusion of the eyes and periorbital swelling. These findings are not consistent with retinal detachment. Bulging eyes and periorbital swelling are only individual aspects of exophthalmos.
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? A) Will prevent lactation for a woman who is bottle feeding her newborn B) Decreases the postpartum cramping C) Helps treat nausea D) Stimulates the contraction of the uterus and prevents bleeding
Ans: D Feedback: Oxytocin (Pitocin) is released from the pituitary gland and stimulates contraction of pregnant uterus and release of breast milk after childbirth. It will not prevent lactation or help treat nausea. It will increase lactation.
A client is experiencing gastrointestinal (GI) bleeding from ruptured esophageal varices. What medication does the nurse prepare for administration that mimics the actions of somatostatin that will reduce the GI bleeding? A) Omeprazole (Prilosec) B) Epinephrine C) Vasopressin (Pitressin) D) Octreotide (Sandostatin)
Ans: D Feedback: Somatostatin and octreotide (Sandostatin), a drug that mimics the actions of somatostatin, have been used to reduce gastrointestinal bleeding. Clients treated with this form of drug therapy require fewer blood transfusions compared with those managed with other drugs affecting gastrointestinal function. The other choices are do not mimic the actions of somatostatin.
What does the nurse understand will be released to maintain a relatively constant level of blood sugar in a client with normal function of the pancreas? A) Cortisol B) Glucagon C) Insulin D) Somatostatin
Ans: D Feedback: Somatostatin, a hormone secreted by delta islet cells, helps maintain a relatively constant level of blood sugar by inhibiting the release of insulin and glucagon. Cortisol is a glucocorticoid release by the adrenal gland. Glucagon increases blood sugar levels and insulin reduces blood sugar levels.
A group of students are reviewing material about endocrine system function. The students demonstrate understanding of the information when they identify which of the following as secreted by the adrenal medulla? A) Glucocorticoids B) Mineralocorticoids C) Glucagon D) Epinephrine
Ans: D Feedback: The adrenal medulla secretes epinephrine and norepinephrine. The adrenal cortex manufactures and secretes glucocorticoids, mineralocorticoids, and small amounts of androgenic sex hormones. Glucagon is released by the pancreas.
A client who is frightened of needles has been told that he will have to have an intravenous (IV) line inserted. The patient's blood pressure and pulse rate increase, and the nurse observes the pupils dilating. What does the nurse recognize has occurred with this client? A) The client is developing an infection. B) The client is having a response to dehydration. C) The client is in a hypertensive crisis. D) The client is showing the fight-or-flight response.
Ans: D Feedback: The adrenal medulla secretes epinephrine and norepinephrine. These two hormones are released in response to stress or threat to life. They facilitate what is referred to as the physiologic stress response, also known as the fight-or-flight response. Many organs respond to the release of epinephrine and norepinephrine. Responses include increased blood pressure and pulse rate, dilation of the pupils, constriction of blood vessels, bronchodilation, and decreased peristalsis. The client does not demonstrate the signs of infection, dehydration, or hypertensive crisis.
