WEEK 2-48,49,50
The nurse is providing education for a client diagnosed with hypothyroidism. What information about diet should the nurse be sure to include in this information?
The client should maintain a low cholesterol diet.
While teaching a science class, the instructor mentions that both autocrine and paracrine hormonal actions occur without entering the blood stream. The instructor then asks the students, "What cells do paracrine actions affect?" The student with the correct answer is:
Local
The physician suspects a client may be experiencing hypofunction of an endocrine organ. Select the most appropriate test to determine organ function.
Stimulation tests
A nurse who works in the office of an endocrinologist is orienting a new staff member. Which teaching point should the nurse include in the orientation?
"A single hormone can act on not only one process or organ but often on several different locations or processes."
When providing nutrition education to the client with diabetes, the nurse should include which of these statements regarding fat intake?
"If you have diabetes, avoiding saturated fats is important."
When educating a client with possible glucocorticoid dysfunction, the nurse will explain that the CRH controls the release of ACTH. The best time to perform the blood test to measure peak ACTH levels would be:
06:00 to 08:00 AM
Which of the following diagnostic tests will be performed for a patient with a suspected pheochromocytoma?
24-Hour urine test for catecholamines
A nurse is evaluating patients for the risk of developing type 2 diabetes. Which of the following patients has the highest risk?
A 45-year-old obese woman with a sedentary lifestyle
The nurse is reviewing the assessment data of four clients. Select the client who would be diagnosed with precocious puberty.
A 7-year-old female with early menarche
A client is diagnosed with hyperthyroidism and is exhibiting weight loss, diarrhea, and tachycardia. What does the nurse understand that these clinical manifestations are related to?
A hypermetabolic state
The nurse is caring for a 42-year-old male client who is admitted for treatment of heart failure. He has abnormally large hands and feet and a broad face with a protruding jaw. Based on these signs and symptoms, the nurse identifies which of the following endocrine disturbances as the most likely cause for these physical changes?
Acromegaly
Cyclic adenosine monophosphate (cAMP) performs which of the following roles in the functioning of the endocrine system?
Acting as a second messenger to mediate hormone action on target cells
The nurse is teaching a client with diabetes and the family about the signs and symptoms of hypoglycemia. The client asks what produces signs and symptoms of headache, disturbed behavior, coma, and seizures. The best response would be:
The brain relies on blood glucose as its main energy source.
When discussing luteinizing hormone and follicle-stimulating hormone with students, the instructor will emphasize that these hormones are under the control of:
Anterior pituitary gland
A client has developed a tumor of the posterior pituitary gland. The client is at risk for problems with secretions of:
Antidiuretic hormone (ADH) and oxytocin
The release of insulin from the pancreatic beta cells can inhibit its further release from the same cells. This is an example of which type of hormone action?
Autocrine
The nurse knows that type 1 diabetes mellitus results from destruction of the pancreatic beta cells by two mechanisms. The mechanism for type 1A diabetes is _______ destruction.
Autoimmune
A client is to have a serum thyroxine and thyroid stimulating laboratory test performed to assess the baseline status of the hypothalamic-pituitary target cell hormones. When educating the client about the laboratory tests, when would the the nurse inform him the test should be obtained?
Before 0800
Which complication of acromegaly can be life threatening?
Cardiac structures increase in size
The nurse is planning to collect a 24-hour urine sample for hormone assay. In which of these situations does the nurse collaborate with the health care provider to find an alternate type of testing?
Client has anuria.
The nurse is providing discharge instructions for a client with Graves' disease who has ophthalmopathy. What should the nurse be sure to include in the instructions to decrease exacerbation of this clinical manifestation?
The client should be strongly urged not to smoke.
A client with diabetes who is being evaluated for distal symmetric neuropathy will display which signs and symptoms? Select all that apply.
Decreased pain perception Risk for falling Stocking-glove pattern function loss Risk of foot injuries
A patient experiences an increase in thyroid hormone as a result of a thyroid tumor. Which of the following hormonal responses demonstrates the negative feedback mechanism?
Decreased thyroid-stimulating hormone (TSH)
The nurse is educating a newly diagnosed client with Hashimoto thyroiditis who is to be discharged from the acute care facility. What should the nurse be sure to include in the education to prevent complications?
The client should be informed about the signs and symptoms of severe hypothyroidism and the need for early intervention.
Which of the following pathophysiologic phenomena may result in a diagnosis of Cushing disease?
Excess ACTH production by a pituitary tumor
A 23-year-old man is admitted to the hospital. He is experiencing polyphagia, polyuria, and polydipsia. He states that the condition has come on very suddenly. This client is likely to require what treatment?
Exogenous insulin injections
A nurse on a medical unit is providing care for a 37-year-old female client who has a diagnosis of Graves' disease. Which assessments should the nurse prioritize?
Eye health and visual acuity
Which of the following is the role of glucagon in initiating the breakdown of glycogen?
First messenger
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?
Following a meal that was high in carbohydrates, a person's blood glucose elevates, which stimulates the release of insulin from the pancreas.
Type 1A diabetes is now considered an autoimmune disorder. What factors are considered necessary for type 1A diabetes to occur?
Genetic predisposition, environmental triggering event, and a T-lymphocyte-mediated hypersensitivity reaction against some beta-cell antigen
The nurse is caring for a client who received regular insulin at 7 am. Four hours later the nurse finds the client diaphoretic, cool, and clammy. Which of these interventions is the priority?
Give the client a concentrated carbohydrate.
Which of the following hormones is produced by the anterior pituitary gland?
Growth hormone (GH)
An 11-year-old boy has poorly controlled type 1 diabetes. In addition to assessing for complications of hyperglycemia, the nurse should assess for which developmental abnormality?
Growth retardation.
When the assessment of thyroid autoantibodies is performed, what is the suspected diagnosi
Hashimoto thyroiditis
The nurse is performing an assessment for a client who has hyperthyroidism that is untreated. When obtaining vital signs, what is the expected finding?
Heart rate 110 and bounding
The nurse is caring for a client with diabetes. Which of these findings is cause for concern leading the nurse to initiate client education?
Hemoglobin A1 C level is 8.7.
Select the statement that best explains the function of hormone receptors.
Hormone receptors recognize a specific hormone and translate the signal into a cellular response.
A client is diagnosed with hyperglycemic hyperosmolar state (HHS). Which factors contribute to the severe hyperglycemia that precipitates HHS? Select all that apply
Hyperglucagonemia Glycosuria and dehydration Hepatic glycogenolysis Insulin deficiency
The physician is assessing a client with a preliminary diagnosis of endocrine disorder. Further assessment findings identify abnormalities with emotion, pain, body temperature, and neural input. The physician determines the need to further assess the:
Hypothalamus
Which gland acts as a signal relaying bridge between multiple body systems and the pituitary gland?
Hypothalamus
A client comes to the clinic with fatigue and muscle weakness. The client also states she has been having diarrhea. The nurse observes the skin of the client has a bronze tone and when asked, the client says she has not had any sun exposure. The mucous membranes of the gums are bluish-black. When reviewing laboratory results from this client, what does the nurse anticipate seeing?
Increased levels of ACTH
The diagnosis of type 1 diabetes would be confirmed by:
Insulin is not available for use by the body.
The metabolic abnormalities that lead to type 2 diabetes include which of the following
Insulin resistance
A client is admitted to the emergency department and diagnosed with diabetic ketoacidosis (DKA). The client would most likely manifest:
Ketosis
A patient develops hypocalcemia after thyroid surgery. Which of the following hormonal imbalances caused this complication?
Lack of parathyroid hormone
A client with diabetic retinopathy develops a retinal bleed and asks the nurse, "How can I prevent this from happening again?" What response provides the most effective information?
Maintain healthy blood pressure and blood sugar levels.
An overweight, 14-year-old boy feels tired all the time. He sleeps 12 to 14 hours a day and has a voracious appetite but no energy to burn off the calories. He has been diagnosed with hypothyroidism brought about by the accumulation of a nonpitting mucosus type of edema. For which life-threatening condition should his care team be prepared?
Myxedematous coma
The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body?
Negative feedback loop
The most common cause of thyrotoxicosis is Graves disease. When assessing this client, the nurse should put priority on which of the following signs/symptoms?
Ophthalmopathy
Which gland is often referred to as the master gland because it secretes many hormones?
Pituitary
Which of the following structures controls the functions of the greatest number of target glands and cells?
Pituitary gland
Select the most common symptoms of diabetes. Select all that apply.
Polydipsia Polyuria Polyphagia
A patient receives steroids for several months to treat an inflammatory condition. Which of the following actions by the primary healthcare provider indicates an understanding of the negative feedback mechanism when the patient no longer needs the medication?
Prescribing a tapering dose of the medication over weeks
A client arrives in the clinic and states to the nurse, "I am tired all the time and have gained weight. My hair is so dry it is breaking." The nurse assesses that the client's face is puffy with edematous eyelids and the outer third of the eyebrows are thinning. What lab test will the nurse prepare the client for that is characteristic of this disorder?
T4 and TSH
Hyperthyroidism that is inadequately treated can cause a life-threatening condition known as a thyroid storm. What are the manifestations of a thyroid storm? (Select all that apply.)
Tachycardia Delirium Very high fever
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 ehether she will be able to breastfeed her infant. Which physiological function of the pituitary gland facilitates breast milk production?
Prolactin
While reviewing the concept of nuclear receptors with a group of pathophysiology students, the instructor uses the example of clients with type 2 diabetes mellitus taking pioglitazone, a thiazolidinedione medication. Because of the peroxisome proliferator-activated receptors (PPARs), the drug has which effect on the clients' diabetes? Select the best answer.
Promote glucose uptake and increase the synthesis of certain proteins involved in fat metabolism, which reduces levels of certain types of lipids.
Select the most accurate statement regarding measurements of urinary hormone:
Provide a better measure of hormone levels during a designated period.
Infections are common in people with diabetes. Which infection is thought to be related to a neurogenic bladder?
Pyelonephritis
Select the process that allows hormones to exert influence upon some cells and not others.
Receptor binding
A parent arrives in the endocrinology clinic with her 8-year-old son, concerned about his rapid development and tall stature. What significant assessment finding does the nurse recognize is important to report to the physician related to the development of precocious puberty?
Significant genital enlargement
A client with severe hypothyroidism is presently experiencing hypothermia. What nursing intervention is a priority in the care of this client?
Slow rewarming of the client to prevent vasodilation and vascular collapse
When hypofunction of an endocrine organ is suspected, which hormone test can be administered to measure and assess target gland response?
Stimulation
The nurse is caring for a client with decreased serum protein levels secondary to liver failure. When administering medications that are highly protein bound, the nurse anticipates the resulting drug level will respond in which of these ways?
The drug level will be elevated as lack of protein allows more free drug to circulate.
A client who is referred to the endocrinologist's office for an evaluation of his hormone levels asks what regulates the hormone levels. The best response would be that hormone levels in the body are primarily regulated by:
The hypothalamic-pituitary-target cell system
A patient is managing his type 2 diabetes with exercise and diet. He has a fasting blood sugar level (FBS) of 80 mg/dL and a hemoglobin A1C of 5%. Based on these findings, which of the following can the nurse assume?
The patient is achieving normal glycemic control.
A client with many nonspecific complaints has been ordered a positron emission tomography (PET) scanning for evaluation of:
Tumors located on the endocrine glands
Which hormones cross cell membranes to connect to nuclear receptors?
Vitamin D Thyroid hormones Glucocorticoids
The obstetrical nurse is caring for a client who has been treated for gestational diabetes. When teaching the client about the causes of gestational diabetes, the nurse should include which of these risk factors in the teaching?
Woman with a family history of diabetes
What is the most common mechanism of hormone control?
negative feedback
Hormones are chemical messengers that:
regulate body functions
Hormones are usually divided into three categories according to their:
structure.