Exam 3 Flashcards
What imbalance lessens the rate of secretion of parathyroid hormone (PTH)?
o Increased serum calcium levels
o Decreased levels of thyroid-stimulating hormone
o Increased levels of thyroid-stimulating hormone
o Decreased serum magnesium levels
Increased serum calcium levels
Regulation of the release of insulin is an example of which type of regulation?
o Negative feedback
o Neural
o Positive feedback
o Physiologic
Neural
A student asks the professor how a faulty negative-feedback mechanism results in a hormonal imbalance. What response by the professor is best?
o Decreased hormonal secretion is a response to rising hormone levels.
o Excessive hormone production results from a failure to turn off the system.
o Hormones are not synthesized in response to cellular and tissue activities.
o Too little hormone production is initiated.
Excessive hormone production results from a failure to turn off the system.
Which substance is a water-soluble protein hormone?
o Insulin
o Thyroxine
o Follicle-stimulating hormone
o Aldosterone
Insulin
Which of these is a lipid-soluble hormone?
o Epinephrine
o Growth hormone
o Oxytocin
o Cortisol
Cortisol
Most protein hormones are transported in the bloodstream and are what?
o Bound to a water soluble-binding protein
o Bound to a lipid-soluble carrier
o Free in an unbound, water-soluble form
o Free because of their lipid-soluble chemistry
Free in an unbound, water-soluble form
When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is an example of what type of effect by a hormone?
o Pharmacologic
o Synergistic
o Permissive
o Direct
Direct
Thyroid-stimulating hormone (TSH) is released to stimulate thyroid hormone (TH) and is inhibited when plasma levels of TH are adequate. What is this an example of?
o Neural regulation
o Positive feedback
o Negative feedback
o Physiologic regulation
Negative feedback
A person wants to know if eating only plant-based foods is advisable as a way to cut cholesterol to near-zero levels. What response by the health care professional is best?
o “No, you will become extremely malnourished.”
o “No, many hormones are made from cholesterol.”
o “Yes, that will increase the action of insulin.”
o “Yes, that is an effective way to eliminate cholesterol.”
“No, many hormones are made from cholesterol.”
Which second messenger is stimulated by epinephrine binding to a β-adrenergic receptor?
o Cyclic adenosine monophosphate (cAMP)
o Calcium
o Diacylglycerol (DAG)
o Inositol triphosphate (IP3)
Cyclic adenosine monophosphate (cAMP)
Why is the control of calcium in cells important?
o It acts as a second messenger.
o It is controlled by the calcium negative-feedback loop.
o It is continuously synthesized.
o It carries lipid-soluble hormones in the bloodstream.
It acts as a second messenger.
What is the portion of the pituitary that secretes oxytocin?
o Anterior
o Inferior
o Posterior
o Superior
Posterior
A patient is in severe shock and is receiving vasopressin. A student asks the health care professional to explain the rationale for this treatment. What response by the professional is most accurate?
o “Antidiuretic hormone conserves fluid when urine output is less than 20 mL/hr.”
o “Antidiuretic hormone leads to better insulin utilization.”
o “Antidiuretic hormone causes serum osmolality to be increased.”
o “Antidiuretic hormone causes vasoconstriction to help increase blood pressure.”
“Antidiuretic hormone causes vasoconstriction to help increase blood pressure.”
What is the target tissue for prolactin-releasing factor?
o Mammary glands
o Hypothalamus
o Posterior pituitary
o Anterior pituitary
Anterior pituitary
Where is antidiuretic hormone (ADH) synthesized, and where does it act?
o Anterior pituitary; posterior pituitary
o Hypothalamus; renal tubular cells
o Renal tubules; renal collecting ducts
o Posterior pituitary; loop of Henle
Hypothalamus; renal tubular cells
Where is oxytocin synthesized?
o Paraventricular nuclei
o Posterior pituitary
o Hypothalamus
o Anterior pituitary
Hypothalamus
How do the releasing hormones that are made in the hypothalamus travel to the anterior pituitary?
o Infundibular process
o Pituitary stalk
o Vessels of the zona fasciculata
o Portal hypophyseal blood vessels
Portal hypophyseal blood vessels
To ensure optimal thyroid health and function, which mineral does the health care professional advise a nutrition class to include in the daily diet?
o Iodide
o Iron
o Copper
o Zinc
Iodide
Which hormone triggers uterine contractions?
o Oxytocin
o Growth hormone
o Thyroxine
o Insulin
Oxytocin
What effect does hyperphosphatemia have on other electrolytes?
o Increases serum calcium
o Decreases serum calcium
o Increases serum magnesium
o Decreases serum magnesium
Decreases serum calcium
A diabetic patient has not taken insulin in several days and has an extremely high blood sugar. What electrolyte would the health care professional assess as the priority?
o Chloride
o Calcium
o Sodium
o Potassium
Potassium
A person who has experienced physiologic stresses will have increased levels of which hormone?
o Cortisol
o Thyroid hormone
o Somatostatin
o Alpha endorphin
Cortisol
What is the action of calcitonin?
o Decreases serum calcium
o Decreases metabolism
o Increases metabolism
o Increases serum calcium
Decreases serum calcium
Which hormone is involved in the regulation of serum calcium levels?
o Thyroxine (T4)
o Triiodothyronine (T3)
o Adrenocorticotropic hormone (ACTH)
o Parathyroid hormone (PTH)
Parathyroid hormone (PTH)
Which hormone inhibits the secretion of growth hormone (GH)?
o Somatostatin
o Thyroid-stimulating hormone
o Thyroxine
o Calcitonin
Somatostatin
Where are target cells for parathyroid hormone located?
o Smooth and skeletal muscles
o Thyroid gland
o Tubules of nephrons
o Glomeruli of nephrons
Tubules of nephrons
Which compound or hormone is secreted by the adrenal medulla?
o Aldosterone
o Cortisol
o Androgens
o Epinephrine
Epinephrine
What are the effects of aging on pancreatic cells?
o Pancreatic cells are replaced by fibrotic cells.
o No appreciable change occurs on pancreatic cells.
o Increased insulin production is typical.
o Beta cell function decreases.
Beta cell function decreases.
What does aldosterone directly increase the reabsorption of?
o Calcium
o Magnesium
o Water
o Sodium
Sodium
Which is an expected hormonal change in an older patient?
o Adrenocorticotropic hormone level above normal
o Cortisol level below normal
o Thyroid-stimulating hormone secretion below normal
o Triiodothyronine level below normal
Thyroid-stimulating hormone secretion below normal
What are actions of glucocorticoids? (Select all that apply.)
-Fat storage
-Liver gluconeogenesis
-Decreasing muscle cell reuptake of glucose
-Carbohydrate metabolism
-Decreased blood glucose
Liver gluconeogenesis
Decreasing muscle cell reuptake of glucose
Carbohydrate metabolism
The effects of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion include which solute?
o Sodium retention and water loss
o Sodium dilution and water loss
o Sodium dilution and water retention
o Sodium and water retention
Sodium dilution and water retention
Which patient would the healthcare professional assess for elevated levels of antidiuretic hormone (ADH) secretion?
o Taking high dose acetaminophen (Tylenol) for arthritis
o Has long-standing kidney disease from diabetes
o Being treated for small cell carcinoma of the stomach
o Had a hip replacement operation 14 days ago
Being treated for small cell carcinoma of the stomach
Which laboratory value would the nurse expect to find if a person is experiencing syndrome of inappropriate antidiuretic hormone (SIADH)?
o Serum potassium (K+) level of 5 mEq/L and urine hyperosmolality compared to serum
o Serum sodium (Na+) level of 120 mEq/L and serum osmolality 260 mOsm/kg
o Serum potassium (K+) of 2.8 mEq/L and serum hyperosmolality
o Hypernatremia and urine hypoosmolality
Serum sodium (Na+) level of 120 mEq/L and serum osmolality 260 mOsm/kg
What is diabetes insipidus a result of?
o Antidiuretic hormone hyposecretion
o Insulin hypersecretion
o Antidiuretic hormone hypersecretion
o Insulin hyposecretion
Antidiuretic hormone hyposecretion
A patient who is diagnosed with a closed head injury has a urine output of 6 to 8 L/day. Electrolytes are within normal limits, but the antidiuretic hormone (ADH) level is low. Although the patient has had no intake for 4 hours, no change in the polyuria level has occurred. What treatment or diagnostic testing does the healthcare professional prepare the patient for?
o Serum copeptin testing
o Renal angiogram
o Administration of desmopressin
o Insulin administration
Administration of desmopressin
A patient is having a water deprivation test. The patient’s initial weight was 220 pounds (100 kg). The next weight is 209 pounds (95 kg). What action by the healthcare professional is most appropriate?
o Continue with the test as planned.
o Administer salt tablets.
o Stop the water deprivation test.
o Take the patient’s blood glucose.
Stop the water deprivation test.
A healthcare professional is caring for four patients. Which patient does the professional assess for neurogenic diabetes insipidus (DI)?
o Renal tubule disease
o Anterior pituitary tumor
o Posterior pituitary trauma
o Thalamus hypofunction
Posterior pituitary trauma
Which form of diabetic insipidus (DI) will result if the target cells for antidiuretic hormone (ADH) in the renal collecting tubules demonstrate insensitivity?
o Psychogenic
o Ischemic
o Nephrogenic
o Neurogenic
Nephrogenic
Which laboratory value is consistent with diabetes insipidus (DI)?
o High serum total protein
o Low urine-specific gravity
o Low serum sodium
o Low urine protein
Low urine-specific gravity
A patient has nephrogenic diabetes insipidus (DI). What treatment does the healthcare professional anticipate for this patient?
o Exogenous ADH replacement
o Intranasal desmopressin
o Loop diuretic administration
o Water and sodium restriction
Exogenous ADH replacement
Visual disturbances are a result of a pituitary adenoma because of what?
o Liberation of anterior pituitary hormones into the optic chiasm
o Pressure of the tumor on the optic chiasm
o Pressure of the tumor on the optic and oculomotor cranial nerves
o Pituitary hormones clouding the lens of the eyes
Pressure of the tumor on the optic chiasm
A patient has an enlarged tongue, body odor, rough skin, and coarse hair. Which laboratory result does the healthcare professional associate with this presentation?
o Decreased ACTH
o Increased TSH
o Increased growth hormone
o Decreased blood glucose
Increased growth hormone
A patient has acromegaly. What assessment by the healthcare professional would be most important?
o Skin condition
o Bowel function
o Range of motion
o Sleep patterns
Sleep patterns
Why does giantism occur only in children and adolescents?
o Their epiphyseal plates have not yet closed.
o Their metabolic rates are higher than in adulthood.
o Their growth hormones are still diminished.
o Their skeletal muscles are not yet fully developed.
Their epiphyseal plates have not yet closed.
A patient chart notes the patient has amenorrhea, galactorrhea, hirsutism, and osteoporosis. What diagnostic test would the healthcare professional prepare the patient for?
o Water deprivation test
o Ovarian biopsy
o CT scan of the head
o Hemoglobin A1C
CT scan of the head
What does Graves’ disease develop from?
o An autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue
o A viral infection of the thyroid gland that causes overproduction of thyroid hormone
o A thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones
o An ingestion of goitrogens that inhibits the synthesis of the thyroid hormones, causing a goiter
A thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones
What does Graves’ disease develop from?
o An autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue
o A viral infection of the thyroid gland that causes overproduction of thyroid hormone
o A thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones
o An ingestion of goitrogens that inhibits the synthesis of the thyroid hormones, causing a goiter
A thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones
Which patient would the healthcare professional assess for other signs of thyrotoxic crisis?
o Bradycardia and bradypnea
o Constipation and lethargy
o Hyperthermia and tachycardia
o Constipation with gastric distention
Hyperthermia and tachycardia
Which pathologic changes are associated with Graves’ disease?
o High levels of thyroid-stimulating hormone
o High levels of circulating thyroid-stimulating immunoglobulins
o Diminished levels of thyroid-binding globulin
o Diminished levels of thyrotropin-releasing hormone
High levels of circulating thyroid-stimulating immunoglobulins
A healthcare professional is palpating the neck of a person diagnosed with Graves’ disease. What finding would the professional associate with this disorder?
o Thyroid diffusely enlarged
o Thyroid small with discrete nodules
o Parathyroids normal in size
o Parathyroids left of midline
Thyroid diffusely enlarged
A person has hypothyroidism. What chemical does the healthcare professional advise the person to include in the diet?
o Iodine
o Zinc
o Iron
o Magnesium
Iodine
A patient has a suspected thyroid carcinoma. What diagnostic test does the healthcare professional prepare the patient for?
o Measurement of serum thyroid levels
o Radioisotope scanning
o Fine-needle aspiration biopsy
o Ultrasonography
Fine-needle aspiration biopsy
Renal failure is the most common cause of which type of hyperparathyroidism?
o Inflammatory
o Secondary
o Primary
o Exogenous
Secondary
A patient had a thyroidectomy and now reports tingling around the mouth and has a positive Chvostek sign. What laboratory finding would be most helpful to the healthcare professional?
o TSH and T4
o Serum calcium
o Urine osmolality
o Serum sodium
Serum calcium
A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500 mg/dL; positive urine glucose and ketones; serum potassium (K+) 2 mEq/L; serum sodium (Na+) 130 mEq/L. The patient reports that he has been sick with the “flu” for 1 week. What relationship do these values have to his insulin deficiency?
o Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis.
o Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis.
o Increased glucose use causes the shift of fluid from the intravascular to the intracellular space.
o Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss.
Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis.
Why does polyuria occur with diabetes mellitus?
o Increase in antidiuretic hormone
o Chronic insulin resistance
o Elevation in serum glucose
o Formation of ketones
Elevation in serum glucose
A student asks the professor to differentiate Type 2 diabetes mellitus from Type 1. The professors’ response would be that Type 2 is best described as what?
o Need for lifelong insulin injections
o Resistance to insulin by insulin-sensitive tissues
o Presence of insulin autoantibodies that destroy beta cells in the pancreas
o Increase of glucagon secretion from beta cells of the pancreas
Resistance to insulin by insulin-sensitive tissues
A person diagnosed with type 1 diabetes experienced an episode of hunger, lightheadedness, tachycardia, pallor, headache, and confusion. The healthcare professional teaches the person that what is the most probable cause of these symptoms?
o Somogyi effect from insulin sensitivity
o Hyperglycemia caused by incorrect insulin administration
o Hypoglycemia caused by increased exercise
o Dawn phenomenon from eating a snack before bedtime
Hypoglycemia caused by increased exercise
Which serum glucose level would indicate hypoglycemia in a newborn?
o 28 mg/dL
o 80 mg/dL
o 40 mg/dL
o 60 mg/dL
28 mg/dL
When comparing the clinical manifestations of both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS), which condition is associated with only DKA?
o Weight loss
o Fluid loss
o Increased serum glucose
o Kussmaul respirations
Kussmaul respirations
Hypoglycemia, followed by rebound hyperglycemia, is observed in those with what?
o The Somogyi effect
o Hyperosmolar hyperglycemic nonketotic syndrome
o Diabetic ketoacidosis
o The dawn phenomenon
The Somogyi effect
A patient has diabetes mellitus. A recent urinalysis showed increased amounts of protein. What therapy does the healthcare provider educate the patient that is specific to this disorder?
o Treatment with an ACE inhibitor
o Moderate dietary sodium restriction
o Home blood pressure monitoring
o More frequent blood glucose monitoring
Treatment with an ACE inhibitor
Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake?
o Sulfonylureas (glyburide)
o Meglitinides (glinides)
o Biguanide (metformin)
o α-Glycosidase inhibitor (miglitol)
Biguanide (metformin)
Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake?
o Sulfonylureas (glyburide)
o Meglitinides (glinides)
o Biguanide (metformin)
o α-Glycosidase inhibitor (miglitol)
Biguanide (metformin)
What causes the microvascular complications in patients with diabetes mellitus?
o The capillary basement membranes thicken, and cell hyperplasia develops.
o The capillaries contain plaques of lipids that obstruct blood flow.
o Pressure in capillaries increases as a result of the elevated glucose attracting water.
o Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries.
The capillary basement membranes thicken, and cell hyperplasia develops.
A healthcare professional advises a person with diabetes mellitus to have an annual eye exam. When the person asks why this is necessary, the professional states that retinopathy develops in patients with diabetes mellitus because of what reason?
o Pressure in the retinal vessels increase as a result of increased osmotic pressure.
o Retinal ischemia and red blood cell aggregation occur.
o Ketones cause microaneurysms in the retinal vessels.
o Plaques of lipids develop in the retinal vessels.
Retinal ischemia and red blood cell aggregation occur.
A person has acne, easy bruising, thin extremities, and truncal obesity. The healthcare professional assesses the person for which of these?
o Serum electrolytes
o Urine osmolality
o Use of glucocorticoids
o Previous thyroid surgery
Use of glucocorticoids
A person may experience which complications as a result of a reduction in parathyroid hormone (PTH)? (Select all that apply.)
Asphyxiation
Laryngeal spasms
Muscle spasms
Hyporeflexia
Tonic-clonic seizures
Asphyxiation
Laryngeal spasms
Muscle spasms
Tonic-clonic seizures
A chronic complication of diabetes mellitus is likely to result in microvascular complications in which areas? (Select all that apply.)
Coronary arteries
Eyes
Peripheral vascular system
Nerves
Renal system
Eyes
Nerves
Renal system
What are clinical manifestations of hypothyroidism? (Select all that apply.)
Bradycardia
Constipation
Lethargy
Bradycardia
Constipation
Lethargy
Which type of adipose tissue contributes to obesity?
o MAT
o WAT
o bAT
o BAT
WAT