miles prep u metabolism

A client is undergoing diagnostics for an alteration in thyroid function. What physiologic function is affected by altered thyroid function?

metabolic rate Explanation: The thyroid concentrates iodine from food and uses it to synthesize thyroxine (T4) and triiodothyronine (T3). These two hormones regulate the body's metabolic rate.

Glycosylated hemoglobin reflects blood glucose concentrations over which period of time?

3 months Explanation: Glycosylated hemoglobin is a blood test that reflects average blood glucose concentrations over a period of 3 months.

A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which gland?

Adrenal cortex Explanation: Excessive secretion of aldosterone in the adrenal cortex is responsible for the client's hypertension. This hormone acts on the renal tubule, where it promotes reabsorption of sodium and excretion of potassium and hydrogen ions. The pancreas mainly secretes hormones involved in fuel metabolism. The adrenal medulla secretes the catecholamines — epinephrine and norepinephrine. The parathyroids secrete parathyroid hormone.

A client has been diagnosed with dysfunction of the anterior pituitary gland. The nurse is aware that which hormones will likely be affected? Select all that apply.

Adrenocorticotropic hormone (ACTH) Thyroid-stimulating hormone (TSH) Growth hormone (GH) Luteinizing hormone (LH) Explanation: The anterior lobe of the pituitary gland produces adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), growth hormone (GH), the gonadotropic hormones (follicle-stimulating hormone [FSH] and luteinizing hormone [LH]), and prolactin. ADH is produced in the posterior pituitary. Norepinephrine is produced in the adrenal medulla.

Ross Babcock, a 42-year-old firefighter, is being seen by an endocrinologist at the endocrinology group where you practice nursing. At this visit, he will receive results of previously ordered diagnostics. During your client education session, you describe the mechanism of hormone level maintenance. What causes most hormones to be secreted?

Decrease in hormonal levels Explanation: Most hormones are secreted in response to negative feedback, a decrease in levels stimulates the releasing gland; in positive feedback, the opposite occurs.

Management of hyperthyroidism would include which interventions? Select all that apply.

Eradication of the gland with radioactive iodine Surgical removal of part of the gland or the entire gland Drug therapy directed toward decreasing the gland's function Explanation: The treatment of hyperthyroidism is directed toward reducing the level of thyroid hormone. This can be accomplished with eradication of the thyroid gland with radioactive iodine, through surgical removal of part or all of the gland, or the use of drugs that decrease thyroid function and thereby the effect of thyroid hormone on the peripheral tissues. The pharmacologic agent that is used to manage adrenal insufficiencies (i.e., Addison disease) should have both glucocorticoid and mineralocorticoid activity. Cancer is not the cause of hyperthyroidism.

Which statement best explains the function of hormone receptors?

Hormone receptors recognize a specific hormone and translate the hormonal signal into a cellular response. Explanation: Hormone receptors are complex molecular structures that are located either on the surface of or inside target cells. The function of these receptors is to recognize a specific hormone and translate the hormonal signal into a cellular response.

The nurse is caring for a client with profound dehydration. The nurse recognizes the body should release antidiuretic hormone (ADH) in this situation based on which type of feedback from the body?

Increased serum osmolarity Explanation: ADH, which regulates the ability of the kidneys to concentrate urine, is synthesized by neurons in the hypothalamus, transported down their axons to the posterior pituitary gland, then released into the circulation. One of the main stimuli for synthesis and release of ADH is an increase in serum osmolarity.

Which options contain a pair of hormones that act to balance each other? Select all that apply.

Insulin and glucagon Calcitonin and parathyroid hormone (PTH) Explanation: Insulin lowers blood glucose, whereas glucagon raises blood glucose. Calcitonin stimulates calcium to enter the bones, whereas PTH removes calcium from the bones. Cortisol and aldosterone both come from the adrenal cortex, but they perform similar tasks. ADH and oxytocin both come from the pituitary gland but do not perform opposite tasks. Epinephrine and norepinephrine perform similar tasks as neurotransmitters.

The nurse recognizes that antidiuretic hormone (ADH) exerts its effects in which location?

Loop of Henle Explanation: The loop of Henle controls the concentration of the urine by establishing a high concentration of osmotically active particles in the interstitium surrounding the medullary collecting tubules, where the antidiuretic hormone (ADH) exerts its effects.

When preparing teaching plan for a client with an endocrine disorder, the nurse includes information about hormone regulation. Which of the following would the nurse include?

Most disorders result from over- or underproduction of the hormone. Explanation: Most endocrine disorders result from an overproduction or underproduction of specific hormones. A negative feedback loop controls hormone levels, such that a decrease in levels stimulates the releasing gland. Glandular enlargement is not involved with hormonal regulation.

Which of the following would the nurse need to be alert for in a client with severe hypothyroidism?

Myxedemic coma Explanation: Severe hypothyroidism is called myxedema and if untreated, it can progress to myxedemic coma, a life-threatening event. Thyroid storm is an acute, life-threatening form of hyperthyroidism. Addison's disease refers to primary adrenal insufficiency. Acromegaly refers to an oversecretion of growth hormone by the pituitary gland during adulthood.

What is the most common mechanism of hormone control?

Negative feedback Explanation: With negative feedback, the most common mechanism of hormone control, some feature of hormone action directly or indirectly inhibits further hormone secretion so that the hormone level returns to an ideal level or set point.

When thyroxine (T4) in the thyroid is low, it triggers the pituitary to increase thyroid stimulating hormone (TSH), which then increases T4 secretion. This is an example of which of the following?

Negative feedback mechanism Explanation In a negative feedback mechanism, when the monitored function or value decreases below the set point of the system, the feedback mechanism causes the function or value to increase. In a positive feedback mechanism, the initiating stimulus produces more of the same. Neuroendocrine control systems that influence behavior are called the stress response. The general adaptation syndrome is a manifestation of the body's attempt to adapt to stimuli.

During the admission assessment of a new client, the nurse is now preparing to inspect the client's thyroid gland. How should the nurse perform this assessment?

Observe the thyroid gland with the neck slightly hyperextended. Explanation: Assess the thyroid gland with the neck slightly hyperextended. Observe the lower portion of the neck overlying the thyroid gland. Assess for symmetry and visible masses. Percussion and auscultation are not central to assessment of the thyroid gland. Palpation of the thyroid is an advanced assessment skill and usually performed by advanced practitioners.

A nurse researching a diet for a patient with diabetes includes foods that supply energy to the body. Which of the following are classes of nutrients that supply this energy? Select all that apply.

Proteins Fats Carbohydrates Of the six classes of nutrients, three supply energy (carbohydrates, proteins, lipids [fats]) and three are needed to regulate body processes (vitamins, minerals, water).

Which events are involved in the negative feedback mechanism that keeps the serum thyroid hormone level within appropriate range? Select all that apply

Stimulation of sensors in the hypothalamus Stimulation of sensors in the anterior pituitary gland Decrease in secretion of thyroid stimulating hormone (TSH) Increased levels of thyroid hormone Explanation: The level of many of the hormones in the body is regulated by negative feedback mechanisms. In the endocrine system, sensors detect a change in the hormone level and adjust hormone secretion so that body levels are maintained within an appropriate range. For example, sensors in the hypothalamus or anterior pituitary gland detect an increase in thyroid hormone, and this causes a reduction in the secretion of TSH, with a subsequent decrease in the output of thyroid hormone from the thyroid gland. Gonadotropin (FSH) is not involved in thyroid level maintenance.

A nurse who provides care in a campus medical clinic is performing an assessment of a 21-year-old student who has presented for care. After assessment, the nurse determines that the patient has a BMI of 45. What does this indicate?

The patient is extremely obese. Explanation: Individuals who have a BMI between 25 and 29.9 are considered overweight. Obesity is defined as a BMI of greater than 30 (WHO, 2011). A BMI of 45 would indicate extreme obesity.

Which statement best captures an aspect of the function of the hypothalamic-pituitary-adrenal (HPA) system?

The pituitary gland communicates with the adrenal cortex through the release of ACTH. Explanation: ACTH mediates between the anterior pituitary gland and the adrenal cortex in the HPA system. ACTH is released by the pituitary, not the hypothalamus, and CRH acts on the pituitary, not the adrenal cortex. CRH flows from the hypothalamus to the pituitary, not vice versa.

A client with a new diagnosis of an endocrine disorder is unclear how the body can control the levels of different hormones over time. Which statement most accurately underlies the dominant regulation process of hormone levels in the body?

With input from various sensors, hormone production and release are adjusted based on existing hormone levels. Explanation: Most hormone levels are controlled by way of a negative feedback cycle, in which low levels stimulate production and/or release. A positive feedback cycle would not achieve this effect. While some hormones are released on a diurnal schedule, the dominant form of hormone regulation in the body is that of negative feedback. Hormone release is not predetermined by the pituitary gland.

A client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client's hypertension is caused by excessive hormone secretion from which gland?

adrenal cortex Explanation: Excessive secretion of aldosterone in the adrenal cortex is responsible for the client's hypertension. This hormone acts on the renal tubule, where it promotes reabsorption of sodium and excretion of potassium and hydrogen ions. The pancreas mainly secretes hormones involved in fuel metabolism. The adrenal medulla secretes the catecholamines — epinephrine and norepinephrine. The parathyroids secrete parathyroid hormone.

A nurse is explaining the action of insulin to a client with diabetes mellitus. During client teaching, the nurse reviews the process of insulin secretion in the body. The nurse is correct when she states that insulin is secreted from the:

beta cells of the pancreas. The beta cells of the pancreas secrete insulin. The adenohypophysis, or anterior pituitary gland, secretes many hormones, such as growth hormone, prolactin, thyroid-stimulating hormone, corticotropin, follicle-stimulating hormone, and luteinizing hormone, but not insulin. The alpha cells of the pancreas secrete glucagon, which raises the blood glucose level. The parafollicular cells of the thyroid secrete the hormone calcitonin, which plays a role in calcium metabolism.

A client is having a stress response related to a recent accident while boating. What does the nurse identify will be excreted from the adrenal cortex in response to this reaction?

cortisol Explanation: Cortisol is the main glucocorticoid hormone from the adrenal cortex. Cortisol affects glucose metabolism, which is necessary for increased energy expenditure.

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 Explanation: Most hormones are secreted in response to negative feedback; a decrease in levels stimulates the releasing gland. In positive feedback, the opposite occurs.

The nurse is reinforcing education with a client who has hypothyroidism about the thyroid gland. Which statement by the nurse would be most accurate about which gland controls the secretion of thyroid hormone?

pituitary gland Explanation: By secreting TSH, the pituitary gland controls the rate of thyroid hormone released. The adrenal gland isn't involved in the release of thyroid hormone. The parathyroid gland secretes parathyroid hormones, depending on the levels of calcium and phosphorus in the blood. The thyroid gland secretes thyroid hormone but doesn't control how much is released.

white blood

red blood

A nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

tetany Explanation: Tetany may result if the parathyroid glands are excised or damaged during thyroid surgery. Hemorrhage is a potential complication after thyroid surgery but is characterized by tachycardia, hypotension, frequent swallowing, feelings of fullness at the incision site, choking, and bleeding. Thyroid storm is another term for severe hyperthyroidism — not a complication of thyroidectomy. Laryngeal nerve damage may occur postoperatively, but its signs include a hoarse voice and, possibly, acute airway obstruction.

Early this morning, a client had a subtotal thyroidectomy. During evening rounds, the nurse assesses the client, who now has nausea, a temperature of 105° F (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?

thyroid crisis Explanation: Thyroid crisis usually occurs in the first 12 hours after thyroidectomy and causes exaggerated signs of hyperthyroidism, such as high fever, tachycardia, and extreme restlessness. Diabetic ketoacidosis is more likely to produce polyuria, polydipsia, and polyphagia. Hypoglycemia is likely to produce weakness, tremors, profuse perspiration, and hunger. Tetany typically causes uncontrollable muscle spasms, stridor, cyanosis, and possibly asphyxia.