Hormonal Regulation Practice Questions (ATI)

A nurse is caring for a client who has chronic hypothyroidism. For which of the following conditions should the nurse monitor? a. Lethargy b. Exophthalmos c. Goiter d. Photophobia

Answer: A- Lethargy is an early indication of myxedema coma, which can progress to stupor (a state of near-unconsciousness) and respiratory failure. Explanation: b. Exophthalmos is a manifestation of hyperthyroidism. c. Goiter is a manifestation of hyperthyroidism. d. Photophobia is a manifestation of hyperthyroidism.

A nurse is talking with a client whose thyroid-stimulating hormone (TSH) level will be measured. Which of the following statements by the nurse explains the purpose of this test? a. "This test measures the amount of thyroid hormone that attaches to a protein in your blood." b. "This test detects antithyroid antibodies in your blood." c. "This test measures the absorption of iodine and how it relates to the thyroid gland." d. "This test determines whether your thyroid gland is overactive, appropriately active, or underactive."

Answer: D- This describes the TSH test, which helps determine thyroid status and helps monitor the effectiveness and dosage of thyroid hormone replacement therapy. Explanation: a. This describes the T3 resin update test, which measures the amount of thyroid hormone bound to thyroxine binding globulin. b. This describes an antithyroid antibody titer. c. This describes the radioactive iodine uptake test.

A nurse is reviewing the laboratory values of a client who has primary hypothyroidism. The nurse should anticipate an elevation of which of the following laboratory values? a. Thyroid stimulating hormone (TSH) b. Free T4 c. Serum T4 d. Serum T3

Answer: A- The nurse should anticipate that TSH will be elevated. Explanation: b. The nurse should anticipate that the client's level of free T4 will be decreased. c. The nurse should anticipate that the client's serum T4 will be decreased. d. The nurse should anticipate that the client's level serum T3 will be decreased.

A nurse is teaching a client with a new diagnosis of hyperparathyroidism. The nurse should include in the teaching that which of the following is a complication? a. Impaired skin integrity b. Fluid retention c. Pathophysiologic fractures d. Dysphagia

Answer: C- Due to release of calcium and phosphate into the blood, which lower bone density and places client at risk for pathologic fractures Explanation: a. Hypercortisolism because of thinning skin and bruising b. Hypercortisolism because of fluid retention and dependent edema d. Stoke causes dysphagia

A nurse is assessing a client who has hyperthyroidism. The nurse should expect the client to report which of the following manifestations? a. Sensitivity to cold b. Constipation c. Frequent mood changes d. Weight gain of 4.5 kg (10 lb) in 3 weeks

Answer: C- Hyperthyroidism develops when the thyroid gland produces an excess of the thyroid hormones that regulate the metabolic rate. Clients experience emotional lability that fluctuates between emotional hyperexcitability and irritability. They often cannot sit quietly. Explanation: a. Hyperthyroidism causes an increased rate of body metabolism. The nurse should expect the client to report heat intolerance, rather than cold sensitivity. b. Hyperthyroidism causes increased peristalsis, which results in diarrhea. d. Hyperthyroidism causes an increased rate of body metabolism. The nurse should expect the client to report weight loss, rather than weight gain.

A nurse is assessing a client who has hypothyroidism. The nurse should expect which of the following findings? a. Exophthalmos b. Palpitations c. Weight gain d. Diaphoresis

Answer: C- The nurse should expect to find weight gain in clients who have hypothyroidism, even with no change in dietary intake. Explanation: a. Exophthalmos is an expected finding in clients who have Graves' disease, which is a form of hyperthyroidism. b. Palpitations are an expected finding in clients who have hyperthyroidism. d. Diaphoresis is an expected finding in clients who have hyperthyroidism.

A nurse is providing teaching to a client who has a new prescription for levothyroxine for hypothyroidism. The nurse should instruct the client to avoid which of the following herbal supplements? a. Saw palmetto b. Cranberry c. Soy d. Garlic

Answer: C- The nurse should instruct the client to avoid soy because soy can reduce the effectiveness of the levothyroxine. Explanation: a. Saw palmetto can increase the risk for bleeding in clients who take anticoagulants or antiplatelet medications. b. Cranberry juice can increase the risk for uric acid kidney stones and can also increase the risk of bleeding in clients who take warfarin. d. Garlic can increase the risk for bleeding in clients who take anticoagulants or antiplatelet medications.

A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose? a. Insomnia b. Constipation c. Drowsiness d. Hypoactive deep-tendon reflexes

Answer: A- Levothyroxine overdose will result in manifestations of hyperthyroidism, which include insomnia, tachycardia, and hyperthermia. Explanation: b. Constipation is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine. c. Drowsiness is a manifestation of hypothyroidism and indicates an inadequate dose of levothyroxine. d. Hypoactive deep-tendon reflexes are manifestations of hypothyroidism and indicate an inadequate dose of levothyroxine.

A nurse is caring for a child who has Addison's disease. Which of the following actions should the nurse take? a. Teach the parents about cortisol replacement therapy. b. Place the child on a low-sodium diet. c. Monitor the child for fluid volume excess. d. Discuss the manifestations of hyperglycemia with the parents.

Answer: A- The nurse should plan to teach the child's parents about cortisol replacement therapy. Administration of glucocorticoids and mineralocorticoids is necessary because inadequate supplies or a sudden cessation of the medications can cause acute adrenal crisis. Explanation: b. The nurse should ensure the child consumes salt liberally because Addison's disease causes sodium levels to decrease due to decreased aldosterone production. c. The nurse should monitor the child for fluid volume deficit due to the reduction or absence of cortisol and aldosterone. d. The nurse should discuss the manifestations of hypoglycemia with the child's parents because Addison's disease causes blood glucose levels to decrease as cortisol is no longer available to regulate it.

A nurse is assessing a client who is admitted with hyperthyroidism. The client reports weight loss of 5.4 kg (12 lbs) in the last 2 months, increased appetite, increase perspiration, fatigue, menstural irregularity, and restlessness. Which of the following should the nurse take to prevent thyroid crisis? a. Provide a quiet, low-stimulus environment b. Administer aspirin as prescribed for any sign of hyperthermia. c. Keep the client NPO. d. Observe the client carefully for signs of hypocalcemia.

Answer: A- Thyroid crisis can occur in response to a stressor, so the nurse should minimize stressful stimuli in the client's environment. Explanation: b. The nurse should plan to administer acetaminophen for fever because aspirin displaces the thyroid hormone from plasma proteins and results in active thyroid hormone in the blood, which may exacerbate a thyrotoxic crisis. c. The nurse should encourage the client to eat a high-protein, high-calorie diet to maintain weight and prevent negative nitrogen balance. The nurse should also promote fluid intake to replace loss through diaphoresis and diarrhea. d. The nurse should recognize hypocalcemia is a clinical finding in hypoparathyroidism, and calcium levels do not play a role in preventing thyrotoxic crisis.

A nurse is assessing a client who is admitted for elective surgery and has a history of Addison's disease. Which of the following findings should the nurse expect? a. Hyperpigmentation b. Intention tremors c. Hirsutism d. Purple striations

Answer: A-Addison's disease is an endocrine disorder that occurs when the adrenal glands do not produce enough of the hormone cortisol, and in some cases, the hormone aldosterone. The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and hyperpigmentation (darkening) of the skin in both exposed and non-exposed parts of the body. Explanation: b. Intention tremors may be seen in multiple sclerosis, a neuromuscular disorder that primarily affects the central nervous system. c. Addison's disease results in loss of body hair, called vitiligo. d. Purple striations on the skin of the abdomen, thighs, and breasts are a common manifestation in Cushing's syndrome. Hyperpigmentation can be seen as well.

A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take? a. Provide a low-carbohydrate diet. b. Weigh the client daily. c. Administer oral corticosteroids. d. Restrict fluid intake.

Answer: B- Addison's disease is an endocrine disorder that causes weight loss, muscle weakness, fatigue, low blood pressure, and hyperpigmentation (darkening) of the skin. Obtaining the client's daily weight will alert the nurse that dehydration is developing, which could indicate an impending crisis. Explanation: a. Clients who have Addison's disease are prone to hypoglycemia. They should follow a high-protein, high-carbohydrate diet to ensure adequate caloric intake and avoid weight loss, which is common with Addisonian crisis. c. The nurse should administer IV corticosteroids to manage Addisonian crisis until the client is no longer at risk for dehydration, hypotension, and shock. d. Due to the risk for dehydration, the nurse should not restrict the client's fluid intake.

A staff nurse is teaching a client who has Addison's disease about the disease process. The client asks the nurse what causes Addison's disease. Which of the following responses should the nurse make? a. "It is caused by the lack of production of insulin by the pancreas" b. "It is caused by the lack of production of aldosterone by the adrenal gland" c. "It is caused by the overproduction of growth hormone by the pituitary gland" d. "It is caused by the overproduction of parathormone by the parathyroid"

Answer: B-Addison's disease is caused by the lack of production of the adrenocorticotropic hormones (cortisol and aldosterone) by the adrenal gland Explanation: a. A client doesn't produce insulin has type 1 diabetes mellitus c. A client who has an overproduction of the growth hormone has acromegaly. d. A client who has hyperparathyroidism produces an excessive amount of parathormone

A nurse is assisting a client who has hypothyroidism with meal planning. Which of the following foods should the nurse recommend that the client add to her diet? a. Ripe bananas b. Poached eggs c. Whole grains d. Baked chicken

Answer: C- Constipation is a classic manifestation of hypothyroidism; therefore, this client should increase her fluid and fiber intake. Whole grains provide ample amounts of fiber. Explanation: a. Ripe bananas are an appropriate choice for clients who have diverticulitis or ulcerative colitis but not for hypothyroidism. b. Poached eggs are an appropriate choice for clients who have diverticulitis or ulcerative colitis but not for hypothyroidism. d. Animal based protein sources do not help with constipation, which is a classic manifestation of hypothyroidism.