Chapter 49: Introduction to the Endocrine System
Following an addisonian crisis, a client's adrenal function has been gradually regained. The nurse should ensure that the client knows about the need for supplementary glucocorticoid therapy in which of the following circumstances? Episodes of high psychosocial stress Periods of dehydration Episodes of physical exertion Administration of a vaccine
Episodes of high psychosocial stress
The nurse providing care for a client with Cushing syndrome has identified the nursing diagnosis of risk for injury related to weakness. How should the nurse best reduce this risk? Establish falls-prevention measures. Encourage bed rest whenever possible. Encourage the use of assistive devices. Provide constant supervision.
Establish falls-prevention measures
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? Thymus gland, thymosin Parathyroid glands, parathormone Pineal gland, melatonin Adrenal cortex, corticosteroids
Pineal gland, melatonin
ADH is secreted by which gland? Anterior pituitary Posterior pituitary Adrenal Thyroid
Posterior pituitary
A client with symptoms of Cushing syndrome is admitted to the hospital for evaluation and treatment. The nurse is creating a plan of care for the client. Which is an appropriate nursing diagnosis? Self-care deficit related to weakness, fatigue, muscle wasting, and altered sleep patterns Insomnia related to increased nighttime voiding Impaired nutrition: more than body requirements related to polyphagia Activity intolerance related to muscle cramps, cardiac dysrhythmias, and weakness
Self-care deficit related to weakness, fatigue, muscle wasting, and altered sleep patterns
A nurse is reviewing the laboratory order for a client suspected of having an endocrine disorder. The lab slip includes obtaining cortisol levels. What is being tested? adrenal function thyroid function thymus function parathyroid function
adrenal function
A client has been experiencing a decrease in serum calcium. After diagnostics, the physician believes the calcium level fluctuation is due to altered parathyroid function. What is the role of parathormone? increase serum calcium level inhibit release of calcium into extracellular fluid decrease serum calcium level promote urinary secretion of calcium
increase serum calcium level
Which of the following can be performed to determine a client's general status and rule out disorders? A complete blood count A complete blood count and chemistry profile Chemistry profile Radiographs of the chest or abdomen
A complete blood count and chemistry profile
Which of the following hormones controls secretion of adrenal androgens? Adrenocorticotropic hormone (ACTH) Thyroid-stimulating hormone (TSH) Parathormone Calcitonin
Adrenocorticotropic hormone (ACTH)
When high levels of plasma calcium occur, the nurse is aware that the following hormone will be secreted: Thyroxine Phosphorus Parathyroid Calcitonin
Calcitonin
Which diagnostic test is done to determine a suspected pituitary tumor? Radiography of the abdomen Computed tomography Measuring blood hormone levels Radioimmunoassay
Computed tomography
Which disorder is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex? Cushing syndrome Addison disease Graves disease Hashimoto disease
Cushing syndrome
While palpating the neck of a client diagnosed with a thyroid disorder, the nurse takes special care to be very gentle. What is the rationale for the nurse's action? Deep palpation of the thyroid can result in excessive release of thyroid hormone. The nurse must be careful not to risk occluding neck vessels and disrupting circulation. Care must be taken to avoid causing a choking sensation and subsequent hormone release as a response. The thyroid is likely swollen, and pain must not be compounded by touch that is rough.
Deep palpation of the thyroid can result in excessive release of thyroid hormone.
A nurse is preparing to palpate a client's thyroid gland. Which action by the nurse is appropriate? Have the client flex his neck onto his chest and cough while she palpates the anterior neck with her fingertips. Place her hands around the client's neck, with the thumbs in the front of the neck, and gently massage the anterior neck. Encircle the client's neck with both hands, have the client slightly extend his neck, and ask him to swallow. Have the client hyperextend his neck and take slow, deep inhalations while she palpates his neck with her fingertips.
Encircle the client's neck with both hands, have the client slightly extend his neck, and ask him to swallow.
The nurse is educating a couple who has had difficulty with conception. The client asks about the hormone, which is responsible for the production of eggs. The nurse answers that this hormone is called: luteinizing hormone (LH) follicle-stimulating hormone (FSH) interstitial cell-stimulating hormone (ICSH) melanocyte-stimulating hormone
Follicle-stimulation hormone (FSH)
A client with Cushing syndrome has been hospitalized after a fall. The dietician consulted works with the client to improve the patient's nutritional intake. What foods should a client with Cushing syndrome eat to optimize health? Select all that apply. Foods high in vitamin D Foods high in calories Foods high in protein Foods high in calcium Foods high in sodium
Foods high in vitamin D Foods high in protein Foods high in calcium
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: sodium. potassium. magnesium. phosphorus.
Pth maintains the balance between calcium and Phosphorus
A nurse is caring for a client with a kidney disorder. What hormone released by the kidneys initiates the production of angiotensin and aldosterone to increase blood pressure and blood volume? renin erythropoietin cholecystokinin gastrin
Renin
A client is prescribed corticosteroid therapy. What would be priority information for the nurse to give the client who is prescribed long-term corticosteroid therapy? The client's diet should be low protein with ample fat. The client may experience short-term changes in cognition. The client is at an increased risk for developing infection. The client is at a decreased risk for development of thrombophlebitis and thromboembolism.
The client is at an increased risk for developing infection.
The physiology instructor is discussing negative feedback systems in endocrine activity. What would be the instructor's best explanation of the purpose of the negative feedback system in endocrine activity? To change the environment of the pituitary gland To regulate hormone release To maintain hormone concentration at a certain level To control the action of hormones
To maintain hormone concentration at a certain level
A client is having problems with parathyroid hormone. What vitamin would the nurse suspect as potentially contributing to the client's problem? Vitamin A Vitamin C Vitamin D Vitamin K
Vitamin D
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? four three two one
four
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? kidneys cardiac atria brain liver
kidneys
A client is undergoing diagnostics for an alteration in thyroid function. What physiologic function is affected by altered thyroid function? metabolic rate growth fluid/electrolyte balance sleep/wake cycles
metabolic rate
Hormones are chemicals produced in the body to perform specific functions. What is a characteristic of a hormone? They are produced in very large amounts They go through a very lengthy process to be broken down They are secreted indirectly into the blood stream They travel through the blood to specific receptor sites throughout the body
they travel through the blood to specific receptor sites throughout the body
A nurse is completing an assessment of a client with suspected acromegaly. To assist in making the diagnosis, which question should the nurse ask? "Have you had a recent head injury?" "Has your shoe size increased recently?" "Do you experience skin breakouts?" "Is there any family history of acromegaly?"
"Has your shoe size increased recently?"
The nurse is assessing mental and emotional status in a client about to begin therapy for an endocrine disorder. Which of the following would the nurse test to assess the client's mental and emotional status? Ability to respond to questions Motor function Sleep and awake cycles Facial expression
Ability to respond to questions
A nurse understands that for the parathyroid hormone to exert its effect, what must be present? Decreased phosphate level Adequate vitamin D level Functioning thyroid gland Increased calcium level
Adequate vitamin D level
The nurse is assessing a client diagnosed with Graves disease. What physical characteristics of Graves disease would the nurse expect to find? Hair loss Moon face Bulging eyes Fatigue
Bulging eyes
A client with hypofunction of the adrenal cortex has been admitted to the medical unit. What would the nurse most likely find when assessing this client? Increased body temperature Jaundice Copious urine output Decreased blood pressure
Decreased blood pressure
A client with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH) is being cared for on the critical care unit. The priority nursing diagnosis for a client with this condition is what? Risk for peripheral neurovascular dysfunction Excess fluid volume Hypothermia Ineffective airway clearance
Excess fluid volume
The nurse is caring for a client diagnosed with hypothyroidism secondary to Hashimoto thyroiditis. When assessing this client, what sign or symptom would the nurse expect? Fatigue Bulging eyes Palpitations Flushed skin
Fatigue
A nurse caring for a client with diabetes insipidus is reviewing laboratory results. What is an expected urinalysis finding? Glucose in the urine Albumin in the urine Highly dilute urine Leukocytes in the urine
Highly dilute urine
While assisting with the surgical removal of an adrenal tumor, the OR nurse is aware that the client's vital signs may change upon manipulation of the tumor. What vital sign changes would the nurse expect to see? Hyperthermia and tachypnea Hypertension and heart rate changes Hypotension and hypothermia Hyperthermia and bradycardia
Hypertension and heart rate changes
A client has returned to the floor after having a thyroidectomy for thyroid cancer. What laboratory finding may be an early indication of parathyroid gland injury or removal? Hyponatremia Hypophosphatemia Hypocalcemia Hypokalemia
Hypocalcemia
The typical triad of manifestations seen in a client diagnosed with pheochromocytoma does not include which of the following? Headache Hypotension Diaphoresis Palpitations
Hypotension
The pharmacology instructor is diagramming the nervous and endocrine systems. What organ would the instructor diagram as the connector between the nervous and endocrine systems? Hypothalamus Pituitary gland Thyroid gland Pineal gland
Hypothalamus
The nurse's assessment of a client with thyroidectomy suggests tetany and a review of the most recent blood work corroborates this finding. The nurse should prepare to administer what intervention? Oral calcium chloride and vitamin D IV calcium gluconate STAT levothyroxine Administration of parathyroid hormone (PTH)
IV calcium gluconate
A client newly diagnosed with diabetes is discussing the disease with the nurse. The client asks about the hormones that might affect diabetes. Which is considered client teaching information about somatostatin? It releases cortisol to help with stress. It stimulates the release of a hormone. It inhibits the release of insulin. It stimulates the breakdown of fats and proteins.
It inhibits the release of insulin
The negative feedback system along the HPA may include a secondary dimension. Current thought is that the anterior pituitary may be sensitive to TSH levels as well as thyroid hormone. What does this regulate in the body? The production of parathyroid hormone Its own production of TSH The conversion of parathyroid hormone into thyroid hormone Its own production of thyroid hormone
Its own production of TSH
The nurse is caring for a client with a diagnosis of Addison disease. What sign or symptom is most closely associated with this health problem? Truncal obesity Hypertension Muscle weakness Moon face
Muscle weakness
The hypothalamus fine tunes and regulates the release of hormones through what? Negative feedback systems Indirect feedback systems Direct local input Direct release of hormones into blood stream
Negative feedback systems
The pharmacology instructor is discussing the endocrine system with a class of pre-nursing students. What would the instructor tell the students is considered to be a hormone? Norepinephrine Acetylcholine Nucleic acid Serotonin
Norepinephrine
A nurse is attending a client in labor and is monitoring the duration and frequency of her uterine contractions. The client asks the nurse how the body knows how to give birth. Which hormone intensifies the contractions of the uterus and enables the uterus to push out the fetus? Prolactin Melanocyte Oxytocin Insulin
Oxytocin
Which glands regulate calcium and phosphorous metabolism? Parathyroid Thyroid Adrenal Pituitary
Parathyroid
A client reports difficulty falling asleep on a nightly basis. The physician suspects a lack of melatonin. What endocrine gland secretes melatonin? pineal gland thymus gland parathyroid gland thyroid gland
Pineal gland
Which gland was originally identified as the master gland? Pituitary Adrenal Hypothalamus Thyroid
Pituitary
A client has been taking prednisone for several weeks after experiencing a hypersensitivity reaction. To prevent adrenal insufficiency, the nurse should ensure that the client knows to do what action? Take the drug concurrent with levothyroxine. Take each dose of prednisone with a dose of calcium chloride. Gradually replace the prednisone with an over-the-counter (OTC) alternative. Slowly taper down the dose of prednisone, as prescribed.
Slowly taper down the dose of prednisone, as prescribed.
Parathyroid hormone (PTH) has which effects on the kidney? Stimulation of calcium reabsorption and phosphate excretion Stimulation of phosphate reabsorption and calcium excretion Increased absorption of vitamin D and excretion of vitamin E Increased absorption of vitamin E and excretion of vitamin D
Stimulation of calcium reabsorption and phosphate excretion
The nurse is caring for a client with Addison disease who is scheduled for discharge. When teaching the client about hormone replacement therapy, the nurse should address what topic? The possibility of precipitous weight gain The need for lifelong steroid replacement The need to match the daily steroid dose to immediate symptoms The importance of monitoring liver function
The need for lifelong steroid replacement
A group of nursing students are doing a presentation on hormones. What hormone would the presentation show regulates the metabolic rate and influences the growth and development of the body? PTH or parathormone Thyroid hormone Cortisol Insulin
Thyroid hormone
While preparing a client with mild cognitive impairment for upcoming diagnostics, the nurse includes the client's family during the information-gathering portion of the assessment. The nurse takes this action in order to: confirm the medications the client is using. reassure the family members that radioactive substances used for the tests are safe. reassure the client by including the family members in the process. determine the etiology of the client's symptoms.
confirm the medications the client is using.
During a client education session, the nurse describes the mechanism of hormone level maintenance. What causes most hormones to be secreted? decrease in hormonal levels increase in hormonal levels hormonal overproduction hormonal underproduction
decrease in hormonal levels
A nurse explains the role of the ovaries. Which hormones would be included in that discussion? estrogen and progesterone estrogen and progestin testosterone and progesterone estrogen and testosterone
estrogen and progesterone
Cardiac effects of hyperthyroidism include decreased pulse pressure. decreased systolic BP. bradycardia. palpitations.
palpitations
Which organ is both an exocrine and an endocrine gland? pancreas ovaries pineal gland thymus gland
pancreas
A client has had an alteration in the production of T lymphocytes and is undergoing diagnostics. What gland aids in the development of T lymphocytes? thymus pineal parathyroid thyroid
thymus t- for thymus