Chapter 55Assessment of Endocrine Function My Nursing Test Banks

Chapter 55Assessment of Endocrine Function

MULTIPLE CHOICE

1.Blood work of a female client shows an increase in the production of estradiol. The nurse realizes that this hormone is controlled by:

1.

positive feedback.

2.

negative feedback.

3.

nervous feedback.

4.

reverse feedback.

ANS: 1

Even though most of the hormones in the endocrine system are under a negative feedback mechanism, estradiol is not one of those hormones. Estradiol is controlled by a positive feedback mechanism in that when it increases, there will be in an increase in the production of follicle-stimulating hormone by the anterior pituitary.

PTS: 1 DIF: Analyze REF: Positive Feedback Mechanisms

2.The nurse, instructing a client regarding hormones, would include which of the following in these instructions?

1.

Hormones are nonspecific.

2.

Hormone release triggers a rapid response.

3.

Hormones do not influence other hormones.

4.

The nervous system and hormones work together to maintain homeostasis.

ANS: 4

A close relationship between the endocrine and nervous systems is required to allow them to control homeostasis. The short-term rapid responses by the nervous system are balanced by the long-term responses from the endocrine system. Hormones are specific and can influence other hormones. This is what the nurse should instruct the client. The other choices are incorrect and should not be included in instructions to the client.

PTS: 1 DIF: Apply REF: Hormones

3.A client is experiencing a disorder to the anterior pituitary gland. The nurse realizes that all of the following hormones will be affected by this disorder EXCEPT:

1.

adrenocorticotropic hormone.

2.

antidiuretic hormone.

3.

melanocyte-stimulating hormone.

4.

luteinizing hormone.

ANS: 2

Antidiuretic hormone is stored by the posterior pituitary. The other choices are under the regulation of the anterior pituitary gland and would be affected by a disorder in this area.

PTS: 1 DIF: Analyze REF: Table 55-1 Endocrine Gland Hormones

4.A client has a central nervous system disorder. The nurse realizes that the client may be experiencing alterations in hormones regulated by which of the following organs?

1.

Hypothalamus

2.

Pineal gland

3.

Pituitary gland

4.

Thyroid

ANS: 1

The hypothalamus is considered the major regulating organ of the body because it is the connection between the nervous system and the endocrine system. The other organs take direction from the hypothalamus through the central nervous system.

PTS:1DIF:AnalyzeREF:Hypothalamus Gland

5.A client is diagnosed with a low serum calcium level. The nurse realizes that which hormone is released when serum calcium levels are low?

1.

Calcitonin

2.

Cortisol

3.

Parathyroid hormone

4.

Thyroxine

ANS: 3

Parathyroid hormone is secreted when serum calcium levels are low. Calcitonin is released when serum calcium levels are high. Cortisol and thyroxine are not related to calcium.

PTS: 1 DIF: Analyze REF: Thyroid Gland; Parathyroid Glands

6.A client is diagnosed with an increased level of glucagon. The nurse realizes that the production of glucagon occurs in which of the following cells within the pancreatic islets of Langerhans?

1.

Alpha

2.

Beta

3.

Delta

4.

F cells

ANS: 1

Alpha cells produce and secrete glucagon. Beta cells produce and secrete insulin. Delta and F cells are responsible for somatostatin and pancreatic polypeptide, respectively.

PTS:1DIF:AnalyzeREFancreas Gland

7.A client is diagnosed with a low level of triiodothyronine. The nurse realizes that this hormone affects which of the following body functions?

1.

Blood glucose regulation

2.

Bone growth

3.

Calcium regulation

4.

Metabolism

ANS: 4

Triiodothyronine (T3) affects the metabolic rate. Bone growth is affected by growth hormone. Calcium regulation is controlled by calcitonin and parathyroid hormone. Blood glucose regulation is controlled by insulin and glucagon.

PTS:1DIF:AnalyzeREF:Thyroid Gland

8.A client is diagnosed with benign cysts on the cortex of the adrenal glands. Which of the following hormones will be affected with this health problem?

1.

Aldosterone and cortisol

2.

Calcitonin and parathyroid hormone

3.

Epinephrine and norepinephrine

4.

Prolactin and luteinizing hormone

ANS: 1

Aldosterone and cortisol are released by the adrenal cortex. The adrenal medulla releases epinephrine and norepinephrine. Calcitonin and parathyroid hormone are released by the thyroid and parathyroid, respectively. Prolactin and luteinizing hormone are anterior pituitary hormones.

PTS: 1 DIF: Analyze REF: Adrenal Glands: Adrenal Cortex

9.The nurse realizes that an adequate amount of which vitamin must be present for parathyroid hormone to be fully effective?

1.

Vitamin A

2.

Vitamin C

3.

Vitamin D

4.

Vitamin E

ANS: 3

Adequate vitamin D is necessary for absorption of calcium into the bloodstream. Vitamins A, C, and E do not have a role in calcium regulation.

PTS:1DIF:AnalyzeREFarathyroid Glands

10.The nurse should suspect that a client has an endocrine disorder when which of the following findings is assessed regarding the integumentary status?

1.

Freckles

2.

Presence of moles

3.

Course hair

4.

Even skin tone

ANS: 3

Evidence of an endocrine disorder that can be assessed through the integumentary status would include hair loss, dry skin, course hair, brittle nails, or changes in pigmentation. Freckles, the presence of moles, or even skin tone are not evidence of an endocrine disorder.

PTS:1DIF:AnalyzeREF:Integumentary

11.A client is scheduled for x-rays of the long bones. The nurse realizes this diagnostic test is useful to help diagnose a disorder of the:

1.

pituitary gland.

2.

pancreas.

3.

thyroid gland.

4.

adrenal gland.

ANS: 1

X-rays of the long bones is used to help diagnose disorders of the pituitary gland. This test is not used to diagnose disorders of the pancreas, thyroid, or adrenal glands.

PTS:1DIF:Analyze

REF: Table 55-3 Common Diagnostic Tests for Endocrine System Disorders

12.The results of a clients thyroid scan showed black and gray areas. The nurse realizes this finding is consistent with:

1.

malignancies.

2.

elevated phosphorus levels.

3.

hyperactivity.

4.

renal disease.

ANS: 3

Hyperactive areas on the thyroid scan will appear as black or gray regions or hot spots. White areas or cold spots are indicative of malignancies. Black and gray areas on the thyroid scan are not indicative of elevated phosphorus levels or renal disease.

PTS:1DIF:AnalyzeREF:Thyroid Scan

13.A client is scheduled for a thyroid scan. Which of the following should the nurse instruct the client regarding this diagnostic test?

1.

Eliminate all salt in the diet.

2.

Take nothing by mouth after midnight if I-131 is being used during the test.

3.

Continue taking thyroid medication as prescribed.

4.

Take nothing by mouth for 45 minutes after receiving intravenous technetium for the test.

ANS: 2

Depending upon the medium being used, instructions to a client prior to having a thyroid scan may differ; however, if the client is having an oral dose of I-131 for the test, the client should be instructed to take nothing by mouth after midnight. Clients who are prescribed medications with iodine may be instructed to stop the medications for 2 weeks prior to the scan. If receiving intravenous technetium for the scan, the client does not need to be kept on a nothing by mouth order. The client should not be instructed to eliminate all salt from the diet. The client may be instructed to discontinue all thyroid medication for 4 to 6 weeks prior to the scan.

PTS: 1 DIF: Apply REF: Thyroid Scan: Nursing Management

14.Which of the following should the nurse instruct a client who is recovering from a thyroid biopsy as an outpatient?

1.

Notify the physician of any problems with breathing after the procedure.

2.

Go to the emergency room with any signs of a sore throat after the procedure.

3.

Expect to be admitted to the hospital if the surgeon decides to remove the thyroid after the biopsy.

4.

Perform no special preparations for the test.

ANS: 1

The possibility of hematoma formation and edema post-procedure are the major complications that may present as respiratory difficulty. The client should be instructed to notify the physician of any problems with breathing after the procedure. A sore throat after a thyroid biopsy is a common experience, and the client does not need to go to the emergency room. The surgeon will not remove the thyroid gland during the same time as the biopsy. There are special preparations for the test, depending upon the level of anesthesia the client will receive.

PTS:1DIF:ApplyREF:Thyroid Biopsy

MULTIPLE RESPONSE

1.The nurse is assessing the endocrine system of an elderly client. Which of the following are considered age-related changes of this system? (Select all that apply.)

1.

Increased estrogen in women

2.

Increased production of antidiuretic hormone

3.

Decreased testosterone in men

4.

Increased pancreatic secretion of insulin

5.

Smaller thyroid gland

6.

Risk for osteoporosis

ANS: 2, 3, 5, 6

Age-related changes include a decreasing basal metabolic rate as a result of a smaller thyroid gland. There is an increased production of antidiuretic hormone, resulting in more dilute urine and polyuria. Other changes are that the pancreas secretes less insulin, estrogen decreases in women, and testosterone decreases in men. Because estrogen function decreases in females, there is an increased risk for osteoporosis.

PTS: 1 DIF: Analyze REF: Effects of Aging on the Endocrine System

2.A client is diagnosed with a thyroid storm. Which of the following will the nurse most likely assess in this client? (Select all that apply.)

1.

Fever

2.

Tachycardia

3.

Hypotension

4.

Restlessness

5.

Cardiac arrhythmias

6.

Sweating

ANS: 1, 2, 4, 5, 6

Clinical manifestations of a thyroid storm include fever, tachycardia, restlessness, cardiac arrhythmias, and sweating. Hypotension is not a clinical manifestation of a thyroid storm.

PTS: 1 DIF: Analyze REF: Red Flag: Thyroid Crisis

3.Which of the following would indicate to the nurse that a client is experiencing an endocrine disorder that is affecting the neurological system? (Select all that apply.)

1.

Tremors

2.

Memory loss

3.

Jitteriness

4.

Nervousness

5.

Loss of sensation in the feet

6.

Nerve pain

ANS: 1, 2, 3, 4, 5

Common neurological findings with an endocrine disorder include tremors, memory loss, jitteriness, nervousness, and decreased sensation in the hands and feet. Nerve pain is not associated with an endocrine disorder affecting the neurological system.

PTS:1DIF:AnalyzeREF:Neurological

4.A client is scheduled for diagnostic tests to evaluate the adrenal glands. Which of the following will most likely be included in these tests? (Select all that apply.)

1.

Vasopressin level

2.

Urine specific gravity

3.

Cortisol level

4.

Dexamethasone suppression test

5.

Progesterone assay

6.

Aldosterone assay

ANS: 3, 4, 5, 6

Diagnostic tests used to evaluate the status of the adrenal glands include cortisol level, dexamethasone suppression test, progesterone assay, and aldosterone assay. Vasopressin level and urine specific gravity are used to assess the pituitary gland.

PTS:1DIF:Analyze

REF: Table 55-3 Common Diagnostic Tests for Endocrine System Disorders

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