Deck 18: Alterations of Hormonal Regulation

Question 1

A 22-year-old female has a low level of TSH.What condition does the nurse expect the patient is experiencing?

A) Primary hypothyroidism
B) Secondary hypothyroidism
C) Autoimmune hypothyroidism
D) Atypical hypothyroidism

Answer 1

Secondary hypothyroidism

Question 2

A 50-year-old male patient presents with polyuria and extreme thirst.He was given exogenous ADH.For which of the following conditions would this treatment be effective?

A) Neurogenic diabetes insipidus
B) Psychogenic diabetes insipidus
C) Nephrogenic diabetes insipidus
D) SIADH

Answer 2

Neurogenic diabetes insipidus

Question 3

A 54-year-old patient with pulmonary tuberculosis (lung infection)is evaluated for syndrome of inappropriate ADH secretion (SIADH).Which of the following electrolyte imbalances would be expected in this patient?

A) Hyponatremia
B) Hyperkalemia
C) Hypernatremia
D) Hypokalemia

Answer 3

Hyponatremia

Question 4

Diabetes insipidus,diabetes mellitus (DM),and SIADH share which of the following assessment manifestations?

A) Polyuria
B) Edema
C) Vomiting and abdominal cramping
D) Thirst

Question 5

What common neurologic disturbances should the nurse assess for in a patient with a pituitary adenoma?

A) Coma
B) Visual disturbances
C) Confused states
D) Breathing abnormalities

Question 6

A nurse is discussing endocrine system dysfunction with a patient.Which statement indicates the patient understood? Endocrine system dysfunction can result from hyposecretion,hypersecretion,or from:

A) Abnormal receptor activity
B) Abnormal hormone levels
C) Increased synthesis of second messengers
D) Extracellular electrolyte alterations

Question 7

A 15-year-old female presents with breast discharge,dysmenorrhea,and excessive excitability.Tests reveal that all her pituitary hormones are elevated.What does the nurse suspect as the most likely cause for these assessment findings?

A) A pituitary adenoma
B) Hypothalamic hyposecretion
C) Hypothalamic inflammation
D) Pheochromocytoma

Question 8

While planning care for a patient from general anesthesia,which principle should the nurse remember? A side effect of some general anesthetic agents is _____ diabetes insipidus.

A) Neurogenic
B) Nephrogenic
C) Psychogenic
D) Allogenic

Question 9

Visual disturbances are a common occurrence in patients with untreated Graves disease.The endocrinologist explains to the patient that the main cause of these complications is:

A) Decreased blood flow to the eye
B) Orbital edema and protrusion of the eyeball
C) TSH neurotoxicity to retinal cells
D) Local lactic acidosis

Question 10

An aide asks the nurse what is the most common cause of elevated levels of antidiuretic hormone (ADH)secretion.How should the nurse respond?

A) Autoimmune disease
B) Cancer
C) Pregnancy
D) Heart failure

Question 11

While planning care for a patient with hypothyroidism,which principle should the nurse remember? The basal metabolic rate is unusually _____ with hypothyroidism.

A) High
B) Low
C) Steady
D) Variable

Question 12

A 3-year-old male was diagnosed with congenital hypothyroidism.The parents ask the nurse if left untreated what will happen.What is the nurse's best response? If left untreated,the child would have:

A) Mental retardation and stunted growth
B) Increased risk of childhood thyroid cancer
C) Hyperactivity and attention deficit disorder
D) Liver, kidney, and pancreas failure

Question 13

A 22-year-old male is admitted to the intensive care unit with a closed head injury sustained in a motorcycle accident.The injury has caused severe damage to the posterior pituitary.Which of the following complications should the nurse anticipate?

A) Dilutional hyponatremia
B) Dehydration from polyuria
C) Cardiac arrest from hyperkalemia
D) Metabolic acidosis

Question 14

A 35-year-old female with Graves disease is admitted to a medical-surgical unit.Which of the following symptoms would the nurse expect to find before treatment?

A) Weight gain, cold intolerance
B) Slow heart rate, rash
C) Skin hot and moist, rapid heart rate
D) Constipation, confusion

Question 15

A 35-year-old female with Graves disease is admitted to a medical-surgical unit.While the nurse is reviewing the lab tests,which results would the nurse expect to find?

A) High levels of circulating thyroid-stimulating antibodies
B) Ectopic secretion of thyroid-stimulating hormone (TSH)
C) Low circulating levels of thyroid hormones
D) Increased circulation of iodine

Question 16

A 25-year-old female with Graves disease is admitted to a medical-surgical unit.Palpation of her neck would most likely reveal:

A) A normal-sized thyroid
B) A small discrete thyroid nodule
C) Multiple discrete thyroid nodules
D) Diffuse thyroid enlargement

Question 17

A 25-year-old male presents with fatigue,constipation,and sexual dysfunction.Tests reveal all pituitary hormones are normal and no masses are present.The nurse suspects the most likely cause of his symptoms is a dysfunction in the:

A) Anterior pituitary
B) Posterior pituitary
C) Pars intermedia
D) Pituitary stalk

Question 18

While checking the lab results for a patient with Graves disease,the nurse would check the T3 level to be abnormally:

A) Low
B) High
C) Variable
D) Absent

Question 19

A nurse is caring for a patient with SIADH.What severe complication should the nurse assess for?

A) Stroke
B) Diabetes insipidus
C) Neurologic damage
D) Renal failure

Question 20

A 44-year-old patient with pulmonary tuberculosis (lung infection)is evaluated for SIADH.Which of the following assessment findings would be expected in this patient?

A) Peripheral edema
B) Tachycardia
C) Low blood pressure
D) Concentrated urine

Question 21

When a staff member asks the nurse what causes the chronic complications of DM such as microvascular and macrovascular disease,how should the nurse respond? These complications are primarily related to:

A) Pancreatic changes
B) Hyperglycemia
C) Ketone toxicity
D) Hyperinsulinemia

Question 22

Which of the following alterations would the nurse expect to find in a patient with untreated Cushing disease or syndrome?

A) Bradycardia
B) Tachypnea
C) Hyperkalemia
D) Hypertension

Question 23

An 11-year-old male is newly diagnosed with type 1 DM.Which classic symptoms should the nurse assess the patient for?

A) Recurrent infections, visual changes, fatigue, and paresthesias
B) Polydipsia, polyuria, polyphagia, and weight loss
C) Vomiting; abdominal pain; sweet, fruity breath; dehydration; and Kussmaul breathing
D) Weakness, vomiting, hypotension, and mental confusion

Question 24

A nurse is reviewing lab results for glycosylated hemoglobin (hemoglobin A_1c)levels.A nurse recalls the purpose of this test is to:

A) Measure fasting glucose levels.
B) Monitor long-term serum glucose control.
C) Detect acute complications of diabetes.
D) Check for hyperlipidemia.

Question 25

A 30-year-old male was diagnosed with thyroid carcinoma.The lab tests the nurse would most likely find are _____ T₃ and T₄ levels.

A) High
B) Low
C) Normal
D) Variable

Question 26

When a patient asks what causes hyperglycemia in type 2 DM,how should the nurse respond? Hyperglycemia is a result of:

A) Insulin deficiency
B) Hyperinsulinemia
C) Glucagon deficiency
D) Liver dysfunction

Question 27

A 30-year-old female with Graves disease is admitted to a hospital unit for the surgical removal of her thyroid gland.During the postoperative period,the nurse notes that the patient's serum calcium is low.The nurse should observe the patient for which of the following signs/symptoms?

A) Muscle weakness and constipation
B) Laryngeal spasms and hyperreflexia
C) Abdominal pain and fever
D) Anorexia, nausea, and vomiting

Question 28

A 55-year-old female is admitted to the medical unit for complications of long-term,poorly controlled type 2 DM.Which of the following would the nurse expect to find in addition to elevated glucose?

A) Atherosclerosis
B) Metabolic alkalosis
C) Elevated liver enzymes
D) Anemia

Question 29

A 25-year-old male presents to his primary care provider reporting changes in facial features.CT scan reveals a mass on the anterior pituitary,and lab tests reveal severely elevated growth hormone (GH).Which of the following would the nurse also expect to find?

A) Decreased IGF-1
B) Hypotension
C) Sexual dysfunction
D) Height increases

Question 30

A 13-year-old male who uses insulin to control his type 1 diabetes experiences hunger,lightheadedness,tachycardia,pallor,headache,and confusion during gym class.The most probable cause of these symptoms is:

A) Hyperglycemia resulting from incorrect insulin administration
B) Dawn phenomenon caused by eating a snack before gym class
C) Hypoglycemia caused by increased exercise
D) Somogyi effect caused by insulin sensitivity

Question 31

A 12-year-old female is newly diagnosed with type 1 DM.When the parents ask what causes this,what is the nurse's best response?

A) A familial, autosomal dominant gene defect
B) Obesity and lack of exercise
C) Immune destruction of the pancreas
D) Hyperglycemia from eating too many sweets

Question 32

A 30-year-old male presents to his primary care provider reporting visual disturbances.CT reveals a pituitary tumor and lab tests reveal elevated prolactin.He is diagnosed with prolactinoma.Which of the following treatments would the nurse help implement? Administering:

A) Dopaminergic agonists
B) Calcium
C) Insulin
D) Radiation

Question 33

When a nurse is assessing the physical features of individuals with Cushing syndrome,these findings will include:

A) Weight loss and muscle wasting
B) Truncal obesity and moon face
C) Pallor and swollen tongue
D) Depigmented skin and eyelid lag

Question 34

A 12-year-old male is newly diagnosed with type 1 DM.Which of the following tests should the nurse prepare the patient to best confirm the diagnosis?

A) Fasting plasma glucose levels
B) Random serum glucose levels
C) Genetic testing
D) Glycosylated hemoglobin measurements

Question 35

A nurse checks lab results as both Cushing syndrome and Addison disease can manifest with elevated levels of:

A) ADH
B) Cortisol
C) Adrenocorticotropic hormone (ACTH)
D) Aldosterone

Question 36

When a patient wants to know what most commonly causes hypoparathyroidism,how should the nurse reply? It is most commonly caused by:

A) Pituitary hyposecretion
B) Parathyroid adenoma
C) Parathyroid gland injury
D) Hypothalamic inactivity

Question 37

What problem should the nurse assess for in a patient with chronic hyperparathyroidism?

A) Seizure disorders
B) Vitamin D malabsorption
C) Hyponatremia
D) Osteoporosis and pathologic fractures

Question 38

A 19-year-old female with type 1 DM was admitted to the hospital with the following lab values: serum glucose 500 mg/dl (high),urine glucose and ketones 4+ (high),and arterial pH 7.20 (low).Her parents state that she has been sick with the "flu" for a week.Which of the following statements best explains her acidotic state?

A) Increased insulin levels promote protein breakdown and ketone formation.
B) Her uncontrolled diabetes has led to renal failure.
C) Low serum insulin promotes lipid storage and a corresponding release of ketones.
D) Insulin deficiency promotes lipid metabolism and ketone formation.

Question 39

A 19-year-old female with type 1 DM was admitted to the hospital with altered consciousness and the following lab values: serum glucose 500 mg/dl (high)and serum K⁺ 2 (low).Her parents state that she has been sick with the "flu" for a week.The diagnosis is hyperosmolar hyperglycemia nonketotic syndrome (HHNKS).What relationship do these values have with her insulin deficiency?

A) Increased glucose utilization causes the shift of fluid from the intravascular to the intracellular space.
B) Decreased insulin causes hyperglycemia and osmotic diuresis.
C) Increased glucose and fatty acid metabolism stimulates renal diuresis and electrolyte loss.
D) Increased insulin use results in protein catabolism, tissue wasting, and electrolyte loss.

Question 40

A 45-year-old female with Graves disease underwent surgical removal of her thyroid gland.During the postoperative period,her serum calcium was low.The most probable reason for her low serum calcium is:

A) Hyperparathyroidism secondary to Graves disease
B) Myxedema secondary to surgery
C) Hypoparathyroidism caused by surgical injury to the parathyroid glands
D) Hypothyroidism resulting from lack of thyroid replacement

Question 41

A patient with Addison disease has weakness and easy fatigability.A nurse recalls this is due to:

A) Hyperkalemia
B) Hypoglycemia
C) Hypocortisolism
D) Metabolic acidosis

Question 42

What is the cause of the hyperpigmentation seen in people with Cushing syndrome?

A) Abnormal levels of cortisol
B) Permissive effects of aldosterone when cortisol levels are altered
C) Elevated levels of ACTH
D) Hypersensitivity of melanocytes with sun exposure

Question 43

A nurse is preparing to teach a patient about Addison disease.Which information should the nurse include? The most common cause of Addison disease is:

A) An autoimmune reaction
B) Dietary deficiency of sodium and potassium
C) Cancer
D) Viral infection of the pituitary gland

Question 44

A 50-year-old female presents with lightheadedness and overall abnormal feelings.Hyperaldosteronism is diagnosed.Which of the following symptoms would the nurse expect?

A) Hypovolemia
B) Hypotension
C) Hypokalemia
D) Hyponatremia

Question 45

A nurse wants to determine if there is kidney dysfunction in a patient with diabetes.Which of the following is the earliest manifestation?

A) Polyuria
B) Glycosuria
C) Microalbuminuria
D) Decreased glomerular filtration

Question 46

Which of the following diseases should the nurse teach the patient to prevent as it is the ultimate cause of death in the patient with diabetes?

A) Renal disease
B) Stroke
C) Cardiovascular disease
D) Cancer

Question 47

A 49-year-old female is diagnosed with hypercortisolism.Which of the following would the nurse expect?

A) Weight loss
B) Hypoglycemia
C) Decreased urination
D) Osteoporosis

Question 48

A 30-year-old female presents with hypertension,headache,tachycardia,impaired glucose tolerance,and weight loss.Which of the following diagnosis will the nurse see documented on the chart?

A) Addison disease
B) Conn disease
C) Cushing disease
D) Pheochromocytoma

Question 49

A 35-year-old female took corticosteroid therapy for several months.Which of the following would the nurse expect to find?

A) Renal toxicity
B) Episodes of hypoglycemia
C) Hypotension
D) Type 2 DM

Question 50

The body's inability to conserve water and sodium when affected by Addison disease is explained by which of the following conditions?

A) Elevated levels of cortisol
B) Decreased levels of ACTH
C) Hypersecretion of ADH
D) Aldosterone deficiency

Question 51

A nurse is assessing a patient with hypoparathyroidism.Clinical manifestations of hypoparathyroidism include (select all that apply):

A) Tetany
B) Chvostek sign
C) Trousseau sign
D) Oily skin
E) Hair loss