course point unit 8

Question 1

When hypofunction of an endocrine organ is suspected, which type of diagnostic test can be administered to measure and assess target gland response?

Answer 1

Hormone stimulation

Question 2

Neurotransmitters like catecholamines (e.g., dopamine and epinephrine) have a reaction time of:

Answer 2

milliseconds

Question 3

Which manifestation would a nurse expect when assessing a child with insufficient growth hormone (GH) secretion?

Answer 3

Rank below 10% on the growth chart

Question 4

The nurse is teaching a client how to collect a 24-hour urine sample for cortisol levels. The client asks why a blood sample cannot just be taken since collecting urine for 24-hours is inconvenient. How should the nurse respond?

Answer 4

“Because cortisol levels fluctuate, collecting a sample over time will be more accurate.”

Question 5

A client experiences an increase in thyroid hormone as a result of a thyroid tumor. Which hormonal response demonstrates the negative feedback mechanism?

Answer 5

decreased thyroid-stimulating hormone (TSH)

Question 6

The nurse is assessing a client recovering from major surgery. As part of the stress response, the nurse monitors for the physiological effects of elevations in which hormones? Select all that apply.

Answer 6

Epinephrine,Cortisol, Growth hormone

Question 7

A health care provider is assessing a client for a potential endocrine disorder. Assessment findings identify abnormalities with emotion, pain, and body temperature. Which mechanism of endocrine control will require further laboratory/diagnostic assessment?

Answer 7

Hypothalamus

Question 8

A nurse examines the laboratory values of a client in heart failure. Which value indicates a compensatory hormone mechanism?

Answer 8

Elevated atrial natriuretic hormone

Question 9

A client has received an injection containing thyrotropin-releasing hormone (TRH) and is now being assessed for serum levels of thyroid-stimulating hormone (TSH). Which type of diagnostic testing is this client undergoing?

Answer 9

Stimulation testing

Question 10

Which hormones illustrate non-vesicle-mediated synthesis? Select all that apply.

Answer 10

Aldosterone, Androgens, Cortisol

Question 11

The nurse is discussing positive feedback mechanisms. Which example best explains this mechanism?

Answer 11

Increased estradiol production causes increased follicle-stimulating hormone (FSH) production.

Question 12

Which structure controls the functions of the greatest number of target glands and cells?

Answer 12

Pituitary gland

Question 13

An infant whose mother had myxedema during the pregnancy has failed to meet standards for growth and is developmentally delayed. Which hormonal imbalance is this child exhibiting?

Answer 13

Hypothyroidism

Question 14

Which gland is often referred to as the master gland because it secretes many hormones?

Answer 14

Pituitary

Question 15

The nurse is reviewing endocrine testing results. Which finding does the nurse identify as evidence the client is having an abnormal response to the expected hormonal feedback mechanisms?

Answer 15

Increased calcitonin levels in response to decreased blood calcium levels

Question 16

A client receives steroids for several months to treat an inflammatory condition. Which action by the primary health care provider indicates an understanding of the negative feedback mechanism when the client no longer needs the medication?

Answer 16

Prescribing a tapering dose of the medication over weeks

Question 17

The nurse is planning to collect a 24-hour urine sample for hormone assay. In which situation does the nurse collaborate with the health care provider to find an alternate type of testing?

Answer 17

Client has anuria.

Question 18

Which statement describes how water-soluble peptides, such as parathyroid hormone or glucagon, exert their effect on cells?

Answer 18

They bind to receptors.

Question 19

A middle-aged female client has been diagnosed with a thyroid condition. The nurse educates the client about the prescription and needed follow-up lab work, which will help regulate the dosage. The client asks, “Why do I not return to the clinic for weeks, since I am starting the medication tomorrow morning?” The nurse bases the answer on the knowledge that thyroid hormones:

Answer 19

may take days for the full effect to occur, based on the mechanism of action.

Question 20

The nurse is caring for a client who received an epinephrine injection for an allergic reaction. The client asks how long epinephrine lasts in the body. Which information will the nurse include when responding to the client? Select all that apply.

Answer 20

Epinephrine is water soluble and is excreted in the urine.
After binding to receptors, it is quickly broken down.

Question 21

A client reports multiple nonspecific concerns, and the health care provider has ordered a positron emission tomography (PET). For which is the client being evaluated?

Answer 21

tumors located on the endocrine glands

Question 22

Which hormone is produced by the anterior pituitary gland?

Answer 22

Growth hormone (GH)

Question 23

Which type of imaging is preferred to evaluate the bone density of a client with hyperparathyroidism?

Answer 23

Dual energy x-ray absorptiometry (DXA) scan

Question 24

A middle-aged client has acromegaly as a result of a pituitary adenoma that was found and removed when the client was an adolescent. The health care provider suspects that the tumor has returned and has ordered a diagnostic workup. A glucose load is ordered. If the tumor has returned, the nurse would expect which result?

Answer 24

The growth hormone level will not be suppressed following glucose load.

Question 25

Following a stroke that disrupts blood flow to the pituitary gland, a client develops signs of hypopituitarism. Which manifestations are unexpected findings?

Answer 25

Increased volume of dilute urine

Question 26

A client experiences an increase in cortisol as a result of Cushing disease. Which hormonal responses demonstrate the negative feedback mechanism?

Answer 26

Decreased adrenocorticotropic hormone (ACTH)

Question 27

The nurse is teaching a client how to collect a 24-hour urine sample for cortisol levels. The client asks why a blood sample cannot just be taken since collecting urine for 24-hours is inconvenient. How should the nurse respond?

Answer 27

“Because cortisol levels fluctuate, collecting a sample over time will be more accurate.”

Question 28

A hypernatremic client is researching his condition and learns that aldosterone binds to an intracellular receptor. What do intracellular receptors generally stimulate in a cell?

Answer 28

Gene expression

Question 29

A client with hyperthyroidism is being treated with medication that blocks the activity of thyroid-stimulating hormone. Her care team has determined that she has been overproducing TSH. This client will have lost her ability to:

Answer 29

have negative feedback regulation.

Question 30

The nurse is assessing a client with thyrotoxicosis and the nurse is explaining how the thyroid gland is stimulated to release thyroid hormones. The nurse should describe what process?

Answer 30

Action of releasing hormones from hypothalamus

Question 31

A client with diabetes is experiencing hyperglycemia. Which hormonal imbalance(s) will the nurse recognize as a possible contributor to hyperglycemia?

Answer 31

excess glucagon, decreased beta cell activity

Question 32

A teen with newly diagnosed pituitary dwarfism asks the nurse why growth hormone must be taken as an injection rather than a pill like the steroids used for arthritis. Which response best answers the client’s question?

Answer 32

Peptide proteins will be digested instead of entering the bloodstream.

Question 33

Which hormone is secreted based on a cyclic rather than a diurnal manner?

Answer 33

Follicle-stimulating hormone (FSH)

Question 34

The hypophysis is a unit formed by the pituitary and the hypothalamus. These two glands are connected by the blood flow in what system?

Answer 34

Hypophyseal portal system

Question 35

A client is scheduled for a suppression test as part of the diagnostic testing for his suspected endocrine disorder. The results of this test will help the care team determine:

Answer 35

whether the client is producing excessive hormone levels.

Question 36

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 mucosal edema. For which life-threatening condition should his care team be prepared?

Answer 36

Myxedema coma

Question 37

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 nurse inform him the test should be obtained?

Answer 37

Before 0800

Question 38

Which test can the nurse prepare the client for to determine the differentiation between a benign and malignant thyroid disease?

Answer 38

Fine-needle aspiration biopsy

Question 39

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?

Answer 39

Exogenous insulin injections

Question 40

Congenital adrenal hyperplasia is a congenital disorder in which a deficiency exists in any of the enzymes necessary for the synthesis of cortisol. Infants of both sexes are affected, although boys are not diagnosed at birth unless of enlarged genitalia. Female infants often have ambiguous genitalia because of the oversecretion of adrenal androgens. What are the manifestations of the ambiguous genitalia caused by congenital adrenal hyperplasia?

Answer 40

Enlarged clitoris, fused labia, and urogenital sinus

Question 41

A client with a new diagnosis of diabetes mellitus receives education about the diabetic diet plan. Which menu selection indicates the client understood the instruction?

Answer 41

Baked chicken breast, cole slaw, and milk

Question 42

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?

Answer 42

Significant genital enlargement

Question 43

During periods of fasting and starvation, the glucocorticoid and other corticosteroid hormones are critical for survival because of their stimulation of gluconeogenesis by the liver. When the glucocorticoid hormones remain elevated for extended periods of time, what can occur?

Answer 43

Hyperglycemia

Question 44

A client with severe hypothyroidism is presently experiencing hypothermia. What nursing intervention is a priority in the care of this client?

Answer 44

Slow rewarming of the client to prevent vasodilation and vascular collapse

Question 45

The nurse is caring for a client with diabetes. Which of these findings is cause for concern, leading the nurse to initiate client education?

Answer 45

Hemoglobin A1C level is 8.7%.

Question 46

Which factor contributes to an infant developing macrosomia (large body size)?

Answer 46

Maternal diabetes

Question 47

Which individual is experiencing the effects of a primary endocrine disorder?

Answer 47

Person who has low calcium levels because of the loss of the parathyroid gland

Question 48

The nurse screening for diabetes mellitus at a health fair obtains these results. Which client should be referred to a primary health care provider for further evaluation?

Answer 48

random blood glucose 195 mg/dl (10.8 mmol/l)

Question 49

Which treatment regimen is most likely to result in stable blood glucose levels for a client with a diagnosis of type 1 diabetes?

Answer 49

Monitor blood glucose levels throughout the day and administer exogenous insulin replacement as needed

Question 50

Abnormal stimulation of the thyroid gland by TSH-receptor antibodies is implicated in cases of:

Answer 50

Graves disease

Question 51

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:

Answer 51

06:00 to 08:00 AM

Question 52

A client with type 2 diabetes experiences unexplained elevations of fasting blood glucose in the early morning hours. Which conditions can account for this effect?

Answer 52

Dawn phenomenon

Question 53

A client is managing diabetes with exercise and diet. The health care provider reviews the client’s most recent laboratory results: fasting blood glucose level at 80 mg/dL (4.44 mmol/L) and a hemoglobin A1C of 5% (0.05). Select the response that best identifies the client.

Answer 53

The client is achieving normal glycemic control.

Question 54

When caring for the client with diabetes, the nurse emphasizes the risk of kidney disease. Which test does the nurse encourage the client to have performed annually for early detection of renal disease?

Answer 54

Urine test for microalbuminuria

Question 55

A woman in her 28th week of pregnancy tests positive for gestational diabetes mellitus and begins to follow a nutritional plan at home. What result at the follow-up visit indicates a successful outcome?

Answer 55

Random blood glucose 85 mg/dL (4.72 mmol/L)

Question 56

A child has been removed from a home in which she has experienced severe neglect and emotional abuse, and has been placed in foster care. The child has psychosocial dwarfism and the foster parents ask the nurse what this means for the future of the child. What is the best response by the nurse?

Answer 56

“The prognosis of the child depends on an improvement in behavior and catch-up growth.”

Question 57

A 30-year-old client who manages type 2 diabetes with glyburide presents at the emergency room reporting headache, confusion, and tachycardia. The client has come from a party at which the client drank two beers to celebrate running a half-marathon. Which is likely to be the cause of this client’s?

Answer 57

Hypoglycemia

Question 58

A nurse is assessing a client who is experiencing hypoglycemia caused by an insulin reaction. The client is conscious and can follow directions. Which intervention is most appropriate at this time?

Answer 58

Immediately administer a rapidly absorbed form of glucose (preferably via oral route if the client is alert enough to swallow).

Question 59

The mother of a 2-year-old newly diagnosed with type 1 diabetes asks why insulin has to be given by injection. The best response by the nurse is:

Answer 59

“Insulin is destroyed by the stomach contents and has to be administered by injection.”

Question 60

A client being treated for diabetes type 2 with insulin presents to a clinic for routine visit. Blood work reveals a HbA1C of 11.0% (high). Which response by the client may account for this abnormal laboratory result?

Answer 60

“My meter broke so I have not been checking my blood glucose levels for a while.”

Question 61

The newborn nursery nurse is obtaining a blood sample to determine if a newborn has congenital hypothyroidism. What long-term complication is the nurse aware can occur if this test is not performed and the infant has congenital hypothyroidism?

Answer 61

Cretinism

Question 62

A client with Graves disease has ophthalmopathy and asks the nurse if the eyes will stay like this forever. What is the best response by the nurse?

Answer 62

“With treatment of the hyperthyroid state, the ophthalmopathy usually tends to stabilize.”

Question 63

The nurse is providing education to a client with Addison disease who has been treated for hyponatremia and hypoglycemia related to the disease. The nurse inform the client that which action should be taken to ensure control of these conditions?

Answer 63

The client should eat and exercise on a regular schedule.

Question 64

Which characteristics in a pregnant woman increase the risk of gestational diabetes mellitus? Select all that apply.

Answer 64

BMI 35, Gravida 5, Sister with type 2 diabetes mellitus

Question 65

Diabetic ketoacidosis (DKA) in a client with type 1 diabetes occurs when the lack of insulin leads to the release of which physiologic product?

Answer 65

Fatty acids

Question 66

The health care provider is reviewing diurnal variation pattern in adrenocorticotropic (ACTH) levels. Which is the typical diurnal variation pattern in adrenocorticotropic (ACTH) levels?

Answer 66

ACTH peaks in the morning and declines throughout the day.

Question 67

A client with a history of diabetes presents to the emergency department following several days of polyuria and polydipsia with nausea/vomiting. On admission, the client labs show a blood glucose level of 480 mg/dL (26.64 mmol/L) and bicarbonate level of 7.8 mEq/L (7.8 mmol/L). The nurse suspects the client has diabetic ketoacidosis (DKA). The priority intervention should include:

Answer 67

Begin a loading dose of IV regular insulin followed by a continuous insulin infusion.

Question 68

The most common cause of thyrotoxicosis is Graves disease. When assessing this client, the nurse should put priority on which sign/symptom?

Answer 68

Ophthalmopathy

Question 69

The nurse is performing an assessment for a client with Cushing syndrome and observes a “buffalo hump” on the back, a moon face, and a protruding abdomen. What does the nurse understand contributes to the distribution of fat in these areas?

Answer 69

Altered fat metabolism

Question 70

A client is diagnosed with diabetic ketoacidosis (DKA) in the emergency department. Which clinical manifestations will the client likely exhibit?

Answer 70

Polyuria, polydipsia, vomiting, and fatigue

Question 71

Which pregnant woman likely faces the greatest risk of developing gestational diabetes? A client who:

Answer 71

is morbidly obese (defined as greater than 100 pounds over ideal weight).

Question 72

A client tells his health care provider that his body is changing. It used to be normal for his blood glucose to be higher during the latter part of the morning. However, now his fasting blood glucose level is elevated in the early AM (07:00). The health care provider recognizes the client may be experiencing:

Answer 72

Dawn phenomenon

Question 73

A client with diabetes mellitus is reporting burning pain of the feet and some numbness. These symptoms are likely due to which cause?

Answer 73

Somatic neuropathy

Question 74

A client’s primary care provider has prescribed an oral glucose tolerance test (GTT) as a screening measure for diabetes. Which instruction should the client be given?