General Endocrinology Flashcards
Which of the following hormones is responsible for "fight or flight?" A. Estrogen and testosterone B. FSH and LH C. Epinephrine and norepinephrine D. Calcitonin and parathyroid hormone
C. Epinephrine and norepinephrine
The hormones responsible for blood calcium levels are:
A. calcitonin and parathyroid hormone
B. estrogen and progesterone
C. melatonin and follicle-stimulating hormone (FSH)
D. thyroxine and parathyroid hormone
A. calcitonin and parathyroid hormone
Which of the following is the master gland of the body? A. Thyroid gland B. Adrenal gland C. Pineal gland D. Pituitary gland
D. Pituitary gland
What hormone is responsible for male secondary sex characteristics? A. Estrogen B. Progesterone C. Testosterone D. Adrenaline
C. Testosterone
The patient received 131-I yesterday in an attempt to slow the progression of her hyperthyroid condition. For which personnel would participating in her direct bedside care be dangerous?
A. A 19-year-old first-semester nursing student
B. A 34 year-old staff nurse who is new to the unit
C. A 22 year-old aide who is 6 weeks pregnant
D. A 49 year-old RN just returning from sick leave
C. A 22 year-old aide who is 6 weeks pregnant
A 35 year old patient had a total thyroidectomy. The first night she experienced signs and symptoms of postoperative tetany. The nurse should implement the physician's order and immediately administer: A. Sodium iodide PO B. Potassium chloride IV C. Magnesium sulfate IM D. Calcium gluconate IV
D. Calcium gluconate IV
A 47 year-old mother of three had cranial surgery to remove a pituitary tumor 3 days ago, leaving her with partial left hemiparesis and diabetes insipidus. Which nursing diagnosis is of the greatest priority postoperatively:
A. Risk for deficient fluid volume, related to excessive loss via the urinary system.
B. Hopelessness related to development of chronic illness (hemiparesis and diabetes insipidus)
C. Risk for impaired oral mucous membrane, related to dehydration.
D. Coping, ineffective family: compromised, risk for, related to chronic illness.
A. Risk for deficient fluid volume, related to excessive loss via the urinary system.
What are two conditions related to inappropriate amounts (either too high or too low) of ADH? A. Addison's B. Diabetes Insipidus C. Cushing's D. SIADH
B. Diabetes Insipidus (ADH is low)
D. SIADH (ADH is too high)
Which lab value is consistent with SIADH? A. Serum sodium of 125 mEq/L B. Serum osmolality of 310 mOsm/L C. Glucose in the urine D. Low urine osmolality
A. Serum sodium of 125 mEq/L
What is the treatment priority for diabetes insipidus? A. Fluid restriction of 1800 mL/Day B. Insulin 10 units IV push C. NS 1 liter IV D. Furosemide 40 mg PO
C. NS 1 liter IV
Rationale: pt is severely dehydrated D/T high urinary output.
A male patient, age 68, is admitted with a temperature of 101.1 degrees F, poor skin turgor and dry mucous membranes. He is lethargic and labs show glycosuria. What condition do you expect this patient to have?
A. Diabetes Insipidus
B. Diabetic Ketoacidosis
C. Hypoglycemic reaction
D. Hyperglycemic hyperosmolar nonketonic coma
D. Hyperglycemic hyperosmolar nonketonic coma
The nurse is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication? A. Tetany B. Hemorrhage C. Thyroid storm D. Hyperthroidism
A. Tetany
A female patient, age 35, complains that she has gained 15 pounds in the last 2 years. She has tried to exercise but tires easily. She also complains of heavy menstruation cycles and constipation. What condition would you suspect this woman to have? A. Cushing's B. Diabetes type II C. Hypothyroidism D. Hyperthyroidism
C. Hypothyroidism
When instructing a patient on proper diet for her hyperthyroid condition, the nurse stresses the importance of which of the following?
A. Low calorie, Low carbohydrate, High fiber, Increased fluid
B. High potassium, High protein, avoid stimulants (ie. coffee, tea, and cola)
C. High calorie, vitamin and mineral supplement and carbohydrates.
D. High carbohydrate, High fat, High proteins
C. High calorie, vitamin and mineral supplement and carbohydrates.
Which nursing diagnosis takes highest priority for a female client with hyperthyroidism?
A. Risk for imbalanced nutrition: More than body requirements related to thyroid hormone excess
B. Risk for impaired skin integrity related to edema, skin fragility, and poor wound healing
C. Body image disturbance related to weight gain and edema
D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
D. Imbalanced nutrition: Less than body requirements related to thyroid hormone excess
What are three possible post surgical complications of thyroidectomy? (Select all that apply) A. Hypercalcemia B. Thyroid storm C. Hypothyroidism D. Tetany E. Postural hypotension
B. Thyroid storm
C. Hypothyroidism
D. Tetany
Mrs. Thomas is 8 hours post-op from a thyroidectomy. She now has a HR of 110, Temp of 102 F and is vomiting. Which of the following are appropriate treatments: (select all)
A. IV Fluids, Sodium iodide and Oxygen
B. PTU, Methemazole, Antipyretics and corticosteroids
C. IV Fluids, Levothyroxine, Vitamin D
D. IV Fluids, and Radioactive iodine abalation therapy
E. A and B
E. A and B
IV fluids, Sodium iodide, Oxygen, PTU, Methemazole, Antipyretics and Corticosteroids
The nurse is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus? A. antidiuretic hormone (ADH). B. thyroid-stimulating hormone (TSH). C. follicle-stimulating hormone (FSH). D. luteinizing hormone (LH).
A. antidiuretic hormone (ADH).
A female male client with type 1 diabetes mellitus asks the nurse about getting a prescription for glucophage (Metformin). The nurse explains that this medications is only effective if the client:
A. has diabetes insipidus
B. has type 2 diabetes
C. has type 1 diabetes.
D. is pregnant and has gestational diabetes.
B. has type 2 diabetes
A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, nurse Julia formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which “related-to” phrase should the nurse add?
A. Related to bone demineralization resulting in pathologic fractures
B. Related to exhaustion secondary to an accelerated metabolic rate
C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces
D. Related to tetany secondary to a decreased serum calcium level
D. Related to tetany secondary to a decreased serum calcium level
Hypoparathyroidism occurs when there is decreased PTH resulting in decreased levels of serum calcium.
A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?
A. Infusing I.V. fluids rapidly as ordered
B. Encouraging increased oral intake
C. Restricting fluids
D. Administering glucose-containing I.V. fluids as ordered
C. Restricting fluids
A chemical messenger, which travels throughout the bloodstream to its target organ, is known as a(n): A. Exocrine gland B. Endocrine gland C. Hormone D. Negative feedback system
C. Hormone
The "master gland" which exerts control over the other glands is the: A. Pituitary gland B. Pancreas C. Thyroid gland D. Adrenal gland
A. Pituitary gland
The disorder caused by secretion of insufficient amounts of antidiuretic hormone (ADH) is called:
A. Hyperthyroidism
B. Diabetes Mellitus
C. Diabetes Insipidus
D. Syndrome of inappropriate ADH secretion (SIADH)
C. Diabetes Insipidus
You are caring for a patient who has undergone a thyroidectomy. Which of the following signs or symptoms should be reported immediately to the RN/MD for further evaluation? Select All That Apply.
A. Numbness in the fingers
B. Heart rate of 160
C. Blood pressure of 134/74
D. Noticeable arm twitching when you took the patient’s blood pressure
A. Numbness in the fingers
B. Heart rate of 160
D. Noticeable arm twitching when you took the patient’s blood pressure
Appropriate nursing care for the patient with hypothyroidism would include which of the following?
A. Keep the patient’s room at a cool temperature
B. Encourage a low-fiber diet
C. Encourage fluids
D. Encourage the patient to take her medications when she feels that her thyroid levels are low
C. Encourage fluids
Which of the following is a characteristic of hyperparathyroidism? A. Decreased parathormone levels B. Increased serum calcium C. Decreased alkaline phosphate levels D. Increased sodium phosphorous levels
B. Increased serum calcium
Which of the following is a feature of Cushing syndrome?
A. Adrenal hypofunction
B. Decreased secretion of glucocorticoids, mineralocorticoids, and sex hormones
C. Increased susceptibility to infection
D. Hyperkalemia
C. Increased susceptibility to infection
You are caring for a patient with Addison's disease. Which of the following signs and laboratory values would you expect? A. Hypertension B. Postural hypotension C. Increased serum sodium D. Decreased serum potassium
B. Postural hypotension
Select the following true statement(s) about diabetes mellitus, type 2.
A. It is thought to be an autoimmune disease.
B. The main problem in this disease seems to be abnormal resistance to insulin action.
C. It was formerly called “juvenile diabetes.”
D. The patients with this type of diabetes usually are required to take insulin injections from the moment of diagnosis.
B. The main problem in this disease seems to be abnormal resistance to insulin action.
In caring for a patient with diabetes mellitus who is experiencing an acute hyperglycemic reaction (diabetic ketoacidosis), which of the following interventions would be appropriate?
A. Blood glucose level checks every 4 hours
B. Intake and output measurement every shift
C. IV of 0.9% NaCl at KVO (keep vein open) rate
D. Insulin IV via infusion pump
D. Insulin IV via infusion pump
The nurse is assessing a client with Addison’s disease for signs if hyperkalemia. The nurse expects to note which of the following if hyperkalemia is present?
A. polyuria
B. cardiac dysrhythmias
C. dry mucous membranes
D. prolong bleeding time
B. cardiac dysrhythmias
A client is diagnosed with hypothyroidism and is scheduled to begin taking thyroid supplements. The nurse instructs the client about the medication. Which statement by the client would indicate the need for further instructions?
A. I need to take my daily dose every night at bedtime
B. I need to notify my physician if I develop any chest pain
C. I may experience some gastrointestinal problems, such as diarrhea
D. I need to speak to my physician when I begin to plan for parenthood
A. I need to take my daily dose every night at bedtime
These medications should be taken in the morning before meals.
The nurse provides home-care instructions to a client with Cushing’s syndrome. The nurse determines that the client understands the hospital discharge instructions if the client makes which statement?
A. I need to eat foods low in potassium
B. I need to monitor the color of my stools
C. I need to eat a high calorie, high carb diet
D. I need to take aspirin rather than Tylenol for a headache
B. I need to monitor the color of my stools
Cushing’s syndrome results in an increased secretion of cortisol. Cortisol stimulates the secretion of gastric acid, and this can result in the development of peptic ulcers and gastrointestinal bleeding.
Patient’s with Cushing’s need a diet w/ high K+ and reduced calorie and carb intake
A client is admitted to the hospital with Cushing’s syndrome. The nurse reviews the results of the client’s laboratory studies for which manifestation of this disorder?
A. hypokalemia
B. hyperglycemia
C. decreased plasma cortisol levels
D. low white blood cell (WBC) count
B. hyperglycemia
Which of the following is NOT an oral hypoglycemic medication? A. Exenatide (Byetta) B. Glipizide (Glucotrol) C. Metformin (Glucophage) D. Pioglitazone (Actos)
A. Exenatide (Byetta)
This insulin-enhancing drug can be used in type I and type II diabetics. It decreases gastric emptying, glucagon secretion, and glucose output from the liver. A. Arcabose (Precose) B. Glimeperide (Amaryl) C. Exenatide (Bayetta) D. Pramlintide (Symlin) E. Glargine (Lantus)
D. Pramlintide (Symlin)
Cortisol is responsible for what bodily function?
A. The regulation of sodium levels
B. The regulation of potassium levels
C. The provision of extra energy reserves during stress
D. The conservation of glucagon
C. The provision of extra energy reserves during stress
A patient asks what causes his unsightly goiter. Based on the nurse’s knowledge, the nurse responds that:
A. The elevated levels of T3 result in an inability of the body to respond to changing iodine levels.
B. High levels of serum iodine cause hyperplasia
C. The increasing formation of thyroglobulin accumulates in the thyroid follicles.
D. The body is attempting to compensate for reduced levels of T4.
C. The increasing formation of thyroglobulin accumulates in the thyroid follicles.
When reviewing the laboratory results for a patient diagnosed with hyperthyroidism, which of the following may be anticipated? (Select all that apply)
A. Decrease in thyroid-stimulating hormone (TSH) levels
B. Elevation in parathyroid hormone (PTH) levels
C. Radioactive iodine reuptake level of 30%
D. Radioactive iodine reuptake level of 60%
E. Increase in free thyroxine levels.
A. Decrease in thyroid-stimulating hormone (TSH) levels
D. Radioactive iodine reuptake level of 60%
E. Increase in free thyroxine levels.
When monitoring the postoperative patient for the onset of a thyroid crisis, the nurse must be aware that the greatest risk of onset is within: A. 4 hours B. 8 hours C. 12 hours D. 24 hours
c. 12 hours
