Chapter 36: The Endocrine System My Nursing Test Banks

Chapter 36: The Endocrine System

MULTIPLE CHOICE

1. The nurse is aware that thyroid hormone production is dependent on the intake of:

a.

protein and iodine.

b.

fats and vitamins.

c.

carbohydrates and minerals.

d.

sodium and potassium.

ANS: A

The production of thyroid hormone is dependent on the intake of protein and iodine.

DIF: Cognitive Level: Comprehension REF: 819 OBJ: 2 (theory)

TOP: Thyroid Hormone Production KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

2. The nurse explains that the hormone that acts on bone to release calcium into the blood is:

a.

thyroxine (T4).

b.

thyrocalcitonin.

c.

triiodothyronine (T3).

d.

parathormone.

ANS: D

Parathormone, or parathyroid hormone, is produced and secreted by the parathyroid glands. Low calcium levels will stimulate release of parathormone, which increases the plasma level of calcium. Parathormone acts on the renal tubules to increase the excretion of phosphorus in the urine and to stimulate the reabsorption of calcium. Parathormone also acts on bone, causing the release of calcium from the bone into the bloodstream.

DIF: Cognitive Level: Comprehension REF: 821 OBJ: 2 (theory)

TOP: Parathormone: Function KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. The gland that secretes epinephrine and norepinephrine is:

a.

thyroid.

b.

pituitary.

c.

pancreas.

d.

adrenal medulla.

ANS: D

The adrenal medulla secretes epinephrine and norepinephrine.

DIF: Cognitive Level: Comprehension REF: 821 OBJ: 2 (theory)

TOP: Adrenal Medulla: Secretions KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. Mineralocorticoids and glucocorticoids are the products of the:

a.

adrenal cortex.

b.

adrenal medulla.

c.

pancreas.

d.

hypothalamus.

ANS: A

Mineralocorticoids and glucocorticoids are the products of the adrenal cortex.

DIF: Cognitive Level: Comprehension REF: 821 OBJ: 2 (theory)

TOP: Adrenal Cortex: Secretions KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. The androgenic hormones are secreted by the:

a.

adrenal cortex.

b.

adrenal medulla.

c.

pancreas.

d.

pituitary.

ANS: A

The adrenal cortex secretes the androgenic hormones.

DIF: Cognitive Level: Comprehension REF: 821 OBJ: 2 (theory)

TOP: Androgenic Hormones: Origin KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. The nurse explains that the function of aldosterone is to:

a.

conserve water.

b.

excrete sodium.

c.

constrict blood vessels.

d.

excrete phosphorus.

ANS: A

Aldosterone is classified as a mineralocorticoid. It promotes conservation of water by acting on the kidneys to retain sodium in exchange for potassium, which is excreted in the urine.

DIF: Cognitive Level: Comprehension REF: 821 OBJ: 2 (theory)

TOP: Aldosterone: Function KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. The corticoid that counteracts the inflammatory response is:

a.

thyroxine.

b.

cortisol.

c.

insulin.

d.

norepinephrine.

ANS: B

Cortisol is the corticoid that counteracts the inflammatory process. Thyroxine is secreted by the thyroid gland. Insulin is secreted by the beta cells of the pancreas. It is responsible for regulation of blood glucose levels. Norepinephrine is secreted by the adrenal medulla in response to stimulation from the sympathetic nervous system. It functions as a pressor (causing blood vessel constriction) hormone to maintain blood pressure.

DIF: Cognitive Level: Comprehension REF: 821 OBJ: 2 (theory)

TOP: Cortisol: Function KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

8. The only gland that is both an endocrine gland and an exocrine gland is the:

a.

thyroid.

b.

hypothalamus.

c.

pancreas.

d.

parathyroid.

ANS: C

The pancreas acts as an endocrine gland, secreting insulin directly into the bloodstream, and an exocrine gland, secreting digestive enzymes through ducts.

DIF: Cognitive Level: Comprehension REF: 821 OBJ: 2 (theory)

TOP: Pancreas KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

9. The nurse clarifies that endocrine glands, as opposed to exocrine glands:

a.

can put their secretions directly into the bloodstream.

b.

must use a duct to put their secretions into the bloodstream.

c.

must hold their secretions in a reservoir until they are needed by the body.

d.

can produce constantly for body needs.

ANS: A

Endocrine glands secrete directly into the bloodstream, whereas exocrine glands secrete via a duct.

DIF: Cognitive Level: Analysis REF: 821 OBJ: 2 (theory)

TOP: Endocrine vs. Exocrine KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

10. The nurse is caring for a patient who has been experiencing infertility. Inadequate levels of luteinizing hormone (LH) have been identified. The patient correctly verbalizes what outcome of the reduced hormone level?

a.

This hormone is responsible for maintaining my secondary sex characteristics.

b.

The swelling I experience during my menstrual cycle is the result of this hormone.

c.

This hormone is responsible for the irregularity of my menstrual cycle.

d.

Luteinizing hormone works to stimulate ovulation and the production of progesterone.

ANS: D

Luteinizing hormone (LH) is produced by the anterior pituitary gland. It targets the ovaries. LH stimulates ovulation and production of progesterone. LH does not affect fluid retention, menstrual cycle regularity, or the maintenance of secondary sex characteristics.

DIF: Cognitive Level: Analysis REF: 819 OBJ: 2 (theory)

TOP: Luteinizing Hormone: Function KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

11. An 80-year-old diabetic is to be tested with the fructosamine assay instead of the glycosylated hemoglobin (HbA1c) test because the fructosamine assay:

a.

can evaluate level of ketoacidosis.

b.

is less influenced by age.

c.

determines the amount of circulating glucose.

d.

is more accurate for type 2 diabetes.

ANS: B

The fructosamine assay is a diagnostic test used to assess the degree of diabetic control of blood sugar over the preceding 2- to 3-week period. The fructosamine assay is a better tool for the older adult as it is less influenced by age.

DIF: Cognitive Level: Comprehension REF: 827 OBJ: 4 (theory)

TOP: Fructosamine Assay KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

12. The patient who has a glucose tolerance test scheduled for next week is instructed not to take which medication because it will adversely affect the test result?

a.

Vitamin C

b.

Antihypertensive agent

c.

Birth control pills

d.

Calcium supplement

ANS: C

Birth control pills will affect the results of the glucose tolerance test. Vitamin C, antihypertensive agents, and calcium supplements do not affect the reliability of glucose screening tests.

DIF: Cognitive Level: Comprehension REF: 828 OBJ: 4 (theory)

TOP: Glucose Tolerance Test: Preprocedure Instructions

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

13. When caring for a patient who is having a 17-ketosteroid (17-KS) test done, the nurse will need to provide:

a.

a low-purine diet for the day of the test.

b.

a method to keep the urine container chilled for 24 hours.

c.

frequent high-calorie drinks during the test.

d.

antacids to reduce the acidity of the urine.

ANS: B

The 17-ketosteroid (17-KS) test is used to determine the amount of androgen metabolites in the urine. The urine collection container must be kept chilled for the 24 hours that the test is being conducted. Dietary changes are not needed to perform the test. Antacids will not alter the test results.

DIF: Cognitive Level: Comprehension REF: 826 OBJ: 4 (theory)

TOP: 17-Ketosteroid Test KEY: Nursing Process Step: Planning

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

14. The long-term diabetic has had a glycosylated hemoglobin (HbA1c) test done to evaluate the effectiveness of his glucose control. The nurse evaluates the laboratory report of 5% to indicate that the effectiveness of the glucose control is:

a.

excellent.

b.

good.

c.

fair.

d.

poor.

ANS: A

The hemoglobin A1c (A1C) test (formerly called the glycosylated hemoglobin test) measures blood glucose over a period of many weeks. Glucose in the bloodstream attaches itself to the hemoglobin A (red blood cell) molecule and remains there for the life span of the red blood cell. Physicians use A1C test results to prescribe adjustments to a patients treatment program for managing diabetes. Results of 4.9% to 6.7% are considered excellent results. Good results are between 7.6% and 8.5%. Fair results are between 9.4% and 10.0%. Poor control is considered 12.1% and 13.0%.

DIF: Cognitive Level: Comprehension REF: 829 OBJ: 4 (theory)

TOP: A1C Test Results KEY: Nursing Process Step: Evaluation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

15. The nurse clarifies that the actual structural unit that secretes insulin is the:

a.

pancreas.

b.

islets of Langerhans.

c.

beta cell.

d.

alpha cell.

ANS: C

The actual structural unit that secretes insulin is the beta cell. Beta cells are found on the islets of Langerhans, which are in the pancreas.

DIF: Cognitive Level: Knowledge REF: 818 OBJ: 1 (theory)

TOP: Insulin: Source KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. The nurse instructs the patient that, before having a thyroid panel done, the patient should omit taking ______ for two days before the test.

a.

aspirin

b.

antacids

c.

diuretics

d.

multivitamins

ANS: A

To ensure an accurate test result, aspirin should be avoided for two days before testing. Birth control pills also will alter the test results. Antacids, diuretics, and multivitamins do not affect the results of a thyroid panel.

DIF: Cognitive Level: Comprehension REF: 825 OBJ: 1 (clinical)

TOP: Thyroid Panel: Preprocedure Instructions

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

17. The nurse explains that, although thyroid hormone levels decrease with advancing age, the reduction in output of the gland is offset by the:

a.

decreased rate of thyroid hormone breakdown.

b.

increased level of calcium.

c.

increased level of phosphorus.

d.

decreased mineralocorticoids.

ANS: A

The production of thyroid hormones decreases with age, but the decrease is offset by a matching decrease in the bodys breakdown of the hormone. Changes in thyroid hormone levels are not affected by calcium, phosphorus, or mineralocorticoid levels.

DIF: Cognitive Level: Comprehension REF: 822 OBJ: 2 (theory)

TOP: Age-Related Changes: Thyroxine Level Decrease

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

18. The nurse is aware that because of the reduced levels of cortisol, the older adult finds it difficult to deal with:

a.

illness.

b.

stress.

c.

fatigue.

d.

heat.

ANS: B

Cortisol is a mineralocorticoid produced by the adrenal glands. Cortisol acts to increase glucose levels in the blood. Cortisol also helps counteract the inflammatory response. The reduced production of cortisol hinders the older adult in dealing with stress.

DIF: Cognitive Level: Comprehension REF: 821 OBJ: 2 (theory)

TOP: Cortisol: Function KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

19. The nurse explains that when an endocrine gland begins to hypersecrete, the usual cause is:

a.

hyperplasia.

b.

inflammatory process.

c.

allergic response.

d.

autoimmune response.

ANS: A

Hyperplasia (increased cellular growth) is the usual cause of hypersecretion of an endocrine gland.

DIF: Cognitive Level: Comprehension REF: 823-824 OBJ: 2 (theory)

TOP: Hypersecretion: Cause KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. The nurse is preparing a patient to undergo a test that will employ contrast media. Which finding in the patients health history should be reported to the physician before the examination?

a.

The patient was not NPO for at least 6 hours.

b.

The patient takes prescribed potassium supplements.

c.

The patients food allergies include shrimp.

d.

The patient did not take his morning dose of antihypertensive medication.

ANS: C

Before administering tests that involve contrast media, the nurse must ask about allergies to iodine or shellfish. An allergy to either of these may indicate that an individual is hypersensitive to contrast media.

DIF: Cognitive Level: Application REF: 827 OBJ: 4 (clinical)

TOP: Diagnostic Tests and Procedures KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

21. The physician has ordered cortisol level testing for a patient. When planning the test, what information should be provided to the patient?

a.

The patient will need to be NPO for 6 hours before the procedure.

b.

Increases in activity levels during the testing period will increase the reliability of results.

c.

Blood samples will be collected periodically during both the day and night.

d.

Sodium intake should be limited during the day before the test.

ANS: C

Cortisol levels are collected during both the day and night to take into account alterations associated with circadian rhythms. Stress should be kept at a minimum. Increases in activity levels may promote stress and alter the test results. Dietary intake will not affect the test results.

DIF: Cognitive Level: Application REF: 825 OBJ: 2 (clinical)

TOP: Diagnostic Tests and Procedures of the Endocrine System

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

22. The nurse is caring for a patient undergoing the fluid deprivation test. The nurse correctly recognizes that this test is used to assess for which condition?

a.

Diabetes insipidus

b.

Diabetes mellitus

c.

Hypothyroidism

d.

Hyperparathyroidism

ANS: A

The fluid deprivation test is used to assess for the presence of diabetes insipidus.

DIF: Cognitive Level: Comprehension REF: 827 OBJ: 4 (theory)

TOP: Diagnostic Tests and Procedures of the Endocrine System

KEY: Nursing Process Step: Assessment

MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

MULTIPLE RESPONSE

23. The nurse uses a visual aid to show the hormones the anterior pituitary secretes, including: (Select all that apply.)

a.

growth hormone (GH).

b.

thyroid-stimulating hormone (TSH).

c.

antidiuretic hormone (ADH).

d.

follicle-stimulating hormone (FSH).

e.

luteinizing hormone (LH).

ANS: A, B, D, E

All the hormones listed, except for ADH, are among those that the anterior pituitary gland secretes.

DIF: Cognitive Level: Comprehension REF: 819 OBJ: 2 (theory)

TOP: Anterior Pituitary: Secretions KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

24. The nurse lists the age-related changes to the endocrine function as: (Select all that apply.)

a.

the pituitary gland becoming larger.

b.

metabolism declining.

c.

blood glucose levels rising.

d.

decreasing level of epinephrine.

e.

decreasing level of thyroxine.

ANS: B, C, D, E

The pituitary gland becomes smaller.

DIF: Cognitive Level: Comprehension REF: 822 OBJ: 3 (theory)

TOP: Age-Related Changes in Endocrine Function

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

25. The nurse lists the various body processes in which the endocrine system is involved, which include: (Select all that apply.)

a.

regulation of metabolism.

b.

growth rate.

c.

physical development.

d.

sexual function.

e.

reproductive process.

ANS: A, B, C, D, E

All functions listed are affected or controlled by the pituitary gland.

DIF: Cognitive Level: Knowledge REF: 819 OBJ: 2 (theory)

TOP: Endocrine System: Functions KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

26. The nurse is aware that endocrine disorders are caused by: (Select all that apply.)

a.

overproduction of hormone.

b.

long periods of limited mobility.

c.

underproduction of hormone.

d.

severe viral infections.

e.

effects of certain drugs.

ANS: A, C, E

Overproduction or underproduction of hormones can lead to endocrine disorders. Effects of drugs such as steroids can cause endocrine disorders.

DIF: Cognitive Level: Comprehension REF: 823-824 OBJ: 2 (theory)

TOP: Endocrine Disorders: Etiology KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

COMPLETION

27. The nurse explains that, when the target tissue signals that the need for a specific hormone is satisfied, the endocrine gland inhibits the secretion. This process is called _____________.

ANS:

negative feedback

Negative feedback is the process by which the target tissue signals the endocrine gland that the hormone supply is adequate.

DIF: Cognitive Level: Comprehension REF: 823 OBJ: 2 (theory)

TOP: Negative Feedback: Process KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

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