Chapter 40: Mechanisms of Endocrine Control

What is the most common mechanism of hormone control? a. Negative feedback b. Hypothalamic-pituitary-adrenal axis c. Positive feedback d. Hypothalamic-pituitary-target cell feedback

a. Negative feedback

Which complications could occur when an adult client has a secreting tumor of the anterior pituitary gland that results in excess hormone production? Select all that apply. Acromegaly Hyperthyroidism Addison disease Diabetes mellitus Metrorrhagia

Acromegaly Diabetes mellitus Metrorrhagia

When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of: a. Anterior pituitary gland b. Pancreas c. Posterior adrenal cortex d. Thyroid gland

a. Anterior pituitary gland

The nurse is planning to collect a 24-hour urine sample for hormone assay. In which situation does the nurse collaborate with the health care provider to find an alternate type of testing? a. Client has anuria. b. Client has anemia. c. Client has diabetes. d. Client has hypothyroidism.

a. Client has anuria.

Which hormone is produced by the anterior pituitary gland? a. Growth hormone (GH) b. Norepinephrine c. Corticotropin-releasing hormone (CRH) d. Oxytocin

a. Growth hormone (GH)

When hormones act locally rather than being secreted into the bloodstream, their actions are termed: a. Autocratic and paracratic b. Autocrine and paracrine c. Preventers and inhibitors d. Localized and influential

b. Autocrine and paracrine

Which gland acts as a signal relaying bridge between multiple body systems and the pituitary gland? a. Thyroid b. Hypothalamus c. Posterior pituitary d. Parathyroid

b. Hypothalamus

Which statement best explains the function of hormone receptors? a. Hormone receptors are located within the red blood cells and carry hormones to the target cells. b. Hormone receptors respond to decreasing hormone levels by producing a decrease in receptor numbers. c. Hormone receptors recognize a specific hormone and translate the hormonal signal into a cellular response. d. Hormone receptors produce antibodies to block certain hormones from entering the cell.

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

Release and synthesis of anterior pituitary hormones are mainly regulated by which part of the body? a. Adrenal gland b. Cell receptors c. Thymus gland d. Hypothalamus

d. Hypothalamus

A client experiences an increase in cortisol as a result of Cushing disease. Which hormonal responses demonstrate the negative feedback mechanism? a. Decreased adrenocorticotropic hormone (ACTH) b. Increased follicle-stimulating hormone (FSH) c. Increased thyrotropin-releasing hormone (TRH) d. Decreased thyroid-stimulating hormone (TSH)

a. Decreased adrenocorticotropic hormone (ACTH)

A client with hyperthyroidism took aspirin for a headache. Which complications could develop? Select all that apply. a. Hyperthermia b. Edema c. Hyperlipidemia d. Tachycardia e. Agitation

a. Hyperthermia d. Tachycardia e. Agitation

Which gland acts as a signal relaying bridge between multiple body systems and the pituitary gland? a. Hypothalamus b. Posterior pituitary c. Thyroid d. Parathyroid

a. Hypothalamus

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? a. Prolactin b. Growth hormone (GH) c. Oxytocin d. Corticotropin-releasing hormone (CRH)

a. Prolactin

The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function. a. Stimulation tests b. Suppression tests c. Genetic testing d. Imaging studies

a. Stimulation tests

Which gland acts as a signal-relaying bridge between multiple body systems and the pituitary gland? a. Thyroid b. Hypothalamus c. Parathyroid d. Posterior pituitary

b. Hypothalamus

A client develops hypocalcemia after thyroid surgery. Which hormonal imbalance caused this complication? a. Lack of thyroid-stimulating hormone b. Lack of thyrotropic-releasing hormone c. Lack of thyroid hormone d. Lack of parathyroid hormone

d. Lack of parathyroid hormone

Several hormones, including growth hormone (GH) and thyrotropin-releasing hormone (TRH), are bound to and carried by which substance? a. Prohormones b. Cholesterol c. Target cells d. Proteins

d. Proteins

Paracrine action involves which characteristic? a. act locally on cells other than those that produce the hormone b. autoregulation c. act on a distant target cell d. act on the same cells which secreted the hormone

a. 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 signalling pathway is most likely involved in the client's disorder? a. endocrine b. local mediation c. autocrine d. paracrine

a. endocrine

The endocrine system is closely linked with the nervous system. Which neurotransmitter can also act as a hormone? a. epinephrine b. progesterone c. thyroid-stimulating hormone d. norepinephrine

a. epinephrine

Which physiologic process best exemplifies a positive feedback mechanism? a. increase in prolactin secretion that occurs with more frequent breastfeeding b. release of antidiuretic hormone when sodium levels are higher than normal c. release of parathyroid hormone in response to decreased serum calcium levels d. regulation of blood glucose levels by insulin

a. increase in prolactin secretion that occurs with more frequent breastfeeding

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? a. When a female is thinking about getting pregnant, the body knows to release female sex hormones in greater proportion than usual. b. Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas. c. When a person's body pH is decreasing, the stomach lining becomes more acidic to offset this. d. In children, the body knows to release growth hormones while they are sleeping instead of when they are awake and running around.

b. Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.

Which structure controls the functions of the greatest number of target glands and cells? a. Thyroid gland b. Pituitary gland c. Pancreas d. Adrenal cortex

b. Pituitary gland

A client experiences an increase in thyroid hormone as a result of a thyroid tumor. Which hormonal response demonstrates the negative feedback mechanism? a. increased thyrotropin-releasing hormone (TRH) b. decreased thyroid-stimulating hormone (TSH) c. decreased adrenocorticotropic hormone (ACTH) d. increased follicle-stimulating hormone (FSH)

b. decreased thyroid-stimulating hormone (TSH)

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? a. Dehydroepiandrosterone, an adrenal androgen b. Androstenedione, an adrenal androgen c. Cortisol, a glucocorticoid d. Aldosterone, a mineralocorticoid

c. Cortisol, a glucocorticoid

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: a. Increased TSH levels b. Increased TRH levels c. Decreased TSH levels d. Decreased TRH levels

c. Decreased TSH levels

As part of maintaining homeostasis, why are hormones, secreted by endocrine cells, continuously inactivated? a. Absorb metabolic waste b. Prevent accumulation c. Stimulate production d. Free receptor sites

b. Prevent accumulation

A middle-aged female client has been diagnosed with a thyroid condition. The nurse educates the client about the prescription and needed follow-up lab work, which will help regulate the dosage. The client asks, "Why do I not return to the clinic for weeks, since I am starting the medication tomorrow morning?" The nurse bases the answer on the knowledge that thyroid hormones: a. cause many side effects, and the clinic wants the client to be on the medication for several weeks so that all the effects can be reported. b. may take days for the full effect to occur, based on the mechanism of action. c. will begin working right away, and the clinic wants to see how the body is responding to the drug. d. can cause weight loss, so the clinic wants to see how much weight the client loses at the return visit.

b. may take days for the full effect to occur, based on the mechanism of action.

When caring for a client who is being screened for osteoporosis, the nurse plans to evaluate the results of which diagnostic test? a. Magnetic resonance imaging (MRI) b. Computed tomography (CT) c. Dual-energy x-ray absorptiometry (DXA) d. Positron emission tomography (PET)

c. 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? a. Decreased red blood cell count b. Elevated serum pH c. Elevated atrial natriuretic hormone d. Decreased hematocrit

c. Elevated atrial natriuretic hormone

Which hormone triggers the positive feedback mechanism that controls the secretion of luteinizing hormone (LH) levels? a. Prolactin b. Testosterone c. Estrogen d. Oxytocin

c. Estrogen

The nurse is discussing positive feedback mechanisms. Which example best explains this mechanism? a. Increased glucose levels in the blood decreases growth hormone (GH) levels. b. Decreased cortisone levels increase blood levels of adrenocorticotropic hormone (ACTH). c. Increased estradiol production causes increased follicle-stimulating hormone (FSH) production. d. Decreased thyroid hormone (TH) increases thyroid-stimulating hormone (TSH) levels.

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

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? a. Self b. Target c. Local d. Stored

c. Local

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? a. Scheduling a positron emission tomography scan a week after stopping the drug b. Measuring urine catecholamine levels before stopping the drug c. Prescribing a tapering dose of the medication over weeks d. Instructing the client to stop taking the medication

c. Prescribing a tapering dose of the medication over weeks

Which manifestation would a nurse expect when assessing a child with insufficient growth hormone (GH) secretion? a. Increased susceptibility to infection b. Mental sluggishness c. Rank below 10% on the growth chart d. Lower blood calcium levels

c. Rank below 10% on the growth chart

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? a. Steady-state continuous release b. Direct neural stimulation c. Homeostatic receptors on surface of gland d. Action of releasing hormones from hypothalamus

d. Action of releasing hormones from hypothalamus

A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of: a. Somatostatin and prolactin b. Adrenocorticotropic hormone (ACTH) and vasopressin c. Growth hormone-releasing hormone (GHRH) and dopamine d. Antidiuretic hormone (ADH) and oxytocin

d. Antidiuretic hormone (ADH) and oxytocin

A client undergoing an evaluation of hormone levels asks, "What regulates the hormone levels?" Which response by the nurse would be considered most accurate? a. The hypophysial portal system b. Exogenous forms of hormones c. The positive feedback loop d. The hypothalamic-pituitary-target cell system

d. The hypothalamic-pituitary-target cell system