Deck 22: Alterations of Hormonal Regulation

Question 1

Diabetes insipidus is a result of:

A) Antidiuretic hormone hyposecretion
B) Antidiuretic hormone hypersecretion
C) Insulin hyposecretion
D) Insulin hypersecretion

Answer 1

Antidiuretic hormone hyposecretion

Question 2

Which disorder is considered a co-morbid condition of acromegaly?

A) Hypotension
B) Diabetes
C) Brain cancer
D) Thyroid cancer

Answer 2

Diabetes

Question 3

Which form of diabetes insipidus (DI)is treatable with exogenous antidiuretic hormone (ADH)?

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

Answer 3

Neurogenic

Question 4

Visual disturbances are a result of a pituitary adenoma because of the:

A) Liberation of anterior pituitary hormones into the optic chiasm
B) Pituitary hormones clouding the lens of the eyes
C) Pressure of the tumor on the optic chiasm
D) Pressure of the tumor on the optic and oculomotor cranial nerves

Question 5

Which laboratory value is consistently low in a patient with diabetes insipidus (DI)?

A) Urine-specific gravity
B) Serum sodium
C) Urine protein
D) Serum total protein

Question 6

Which laboratory value would the nurse expect to find if a person is experiencing syndrome of inappropriate antidiuretic hormone (SIADH)?

A) Hypernatremia and urine hypoosmolality
B) Serum potassium (K+) level of 5 mEq/L and urine hyperosmolality
C) Serum sodium (Na+) level of 120 mEq/L and serum hypoosmolality
D) Hypokalemia and serum hyperosmolality

Question 7

Which condition may result from pressure exerted by a pituitary tumor?

A) Hypothyroidism
B) Hypercortisolism
C) Diabetes insipidus
D) Insulin hyposecretion

Question 8

Giantism occurs only in children and adolescents because their:

A) Growth hormones are still diminished.
B) Epiphyseal plates have not yet closed.
C) Skeletal muscles are not yet fully developed.
D) Metabolic rates are higher than in adulthood.

Question 9

The cause of neurogenic diabetes insipidus (DI)is related to an organic lesion of the:

A) Anterior pituitary
B) Thalamus
C) Posterior pituitary
D) Renal tubules

Question 10

The common cause of elevated levels of antidiuretic hormone (ADH)secretion is:

A) Ectopically produced ADH
B) Inflammation of the hypothalamus
C) Posterior pituitary tumor
D) Inflammation of the nephrons

Question 11

The term used to describe a person who experiences a lack of all hormones associated with the anterior pituitary is:

A) Panhypopituitarism
B) Adrenocorticotropic hormone deficiency
C) Hypopituitarism
D) Anterior pituitary failure

Question 12

Which disorder is caused by hypersecretion of the growth hormone (GH)in adults?

A) Cushing syndrome
B) Acromegaly
C) Giantism
D) Myxedema

Question 13

Graves disease develops from a(n):

A) Viral infection of the thyroid gland that causes overproduction of thyroid hormone
B) Autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue
C) Thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones
D) Ingestion of goitrogens that inhibits the synthesis of the thyroid hormones, causing a goiter

Question 14

The effects of the syndrome of inappropriate antidiuretic hormone (SIADH)secretion include solute:

A) Retention and water retention
B) Retention and water loss
C) Dilution and water retention
D) Dilution and water loss

Question 15

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 his antidiuretic hormone (ADH)level is low.Although he has had no intake for 4 hours,no change in his polyuria level has occurred.These symptoms support a diagnosis of:

A) Neurogenic diabetes insipidus
B) Syndrome of inappropriate antidiuretic hormone
C) Psychogenic polydipsia
D) Osmotically induced diuresis

Question 16

Which form of diabetic insipidus (DI)will result if the target cells for antidiuretic hormone (ADH)in the renal collecting tubules demonstrate insensitivity?

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

Question 17

Diabetes insipidus,diabetes mellitus,and syndrome of inappropriate antidiuretic hormone all exhibit which symptom?

A) Polyuria
B) Edema
C) Vomiting
D) Thirst

Question 18

Pathologic changes associated with Graves disease include:

A) High levels of circulating thyroid-stimulating immunoglobulins
B) Diminished levels of thyrotropin-releasing hormone
C) High levels of thyroid-stimulating hormone
D) Diminished levels of thyroid-binding globulin

Question 19

The signs of thyrotoxic crisis include:

A) Constipation with gastric distention
B) Bradycardia and bradypnea
C) Hyperthermia and tachycardia
D) Constipation and lethargy

Question 20

Amenorrhea,galactorrhea,hirsutism,and osteoporosis are each caused by a:

A) Posterior pituitary adenoma
B) Thymoma
C) Prolactinoma
D) Growth hormone adenoma

Question 21

What causes the microvascular complications in patients with diabetes mellitus?

A) The capillaries contain plaques of lipids that obstruct blood flow.
B) Pressure in capillaries increase as a result of the elevated glucose attracting water.
C) The capillary basement membranes thicken, and cell hyperplasia develops.
D) Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries.

Question 22

Retinopathy develops in patients with diabetes mellitus because:

A) Plaques of lipids develop in the retinal vessels.
B) Pressure in the retinal vessels increase as a result of increased osmotic pressure.
C) Ketones cause microaneurysms in the retinal vessels.
D) Retinal ischemia and red blood cell aggregation occur.

Question 23

Renal failure is the most common cause of which type of hyperparathyroidism?

A) Primary
B) Secondary
C) Exogenous
D) Inflammatory

Question 24

Polyuria occurs with diabetes mellitus because of the:

A) Formation of ketones
B) Chronic insulin resistance
C) Elevation in serum glucose
D) Increase in antidiuretic hormone

Question 25

Hypoglycemia,followed by rebound hyperglycemia,is observed in those with:

A) The Somogyi effect
B) The dawn phenomenon
C) Diabetic ketoacidosis
D) Hyperosmolar hyperglycemic nonketotic syndrome

Question 26

Which serum glucose level would indicate hypoglycemia in a newborn?

A) 28 mg/dl
B) 40 mg/dl
C) 60 mg/dl
D) 80 mg/dl

Question 27

The most probable cause of low serum calcium after a thyroidectomy is:

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

Question 28

Palpation of the neck of a person diagnosed with Graves disease would detect a thyroid that is:

A) Left of midline
B) Small with discrete nodules
C) Normal in size
D) Diffusely enlarged

Question 29

Diagnosing a thyroid carcinoma is best performed with:

A) Measurement of serum thyroid levels
B) Radioisotope scanning
C) Ultrasonography
D) Fine-needle aspiration biopsy

Question 30

A deficiency of which chemical may result in hypothyroidism?

A) Iron
B) Iodine
C) Zinc
D) Magnesium

Question 31

What are clinical manifestations of hypothyroidism?

A) Intolerance to heat, tachycardia, and weight loss
B) Oligomenorrhea, fatigue, and warm skin
C) Restlessness, increased appetite, and metrorrhagia
D) Constipation, decreased heat rate, and lethargy

Question 32

The most common cause of hypoparathyroidism is:

A) Pituitary hyposecretion
B) Parathyroid adenoma
C) Parathyroid gland damage
D) Autoimmune parathyroid disease

Question 33

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?

A) Increased glucose use causes the shift of fluid from the intravascular to the intracellular space.
B) Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis.
C) Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis.
D) Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss.

Question 34

Type 2 diabetes mellitus is best described as a(an):

A) Resistance to insulin by insulin-sensitive tissues
B) Need for lispro instead of regular insulin
C) Increase of glucagon secretion from a cells of the pancreas
D) Presence of insulin autoantibodies that destroy b cells in the pancreas

Question 35

The first laboratory test that indicates type 1 diabetes is causing the development of diabetic nephropathy is:

A) Dipstick test for urine ketones
B) Increase in serum creatinine and blood urea nitrogen
C) Protein on urinalysis
D) Cloudy urine on the urinalysis

Question 36

A person diagnosed with type 1 diabetes experiences hunger,lightheadedness,tachycardia,pallor,headache,and confusion.The most probable cause of these symptoms is:

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

Question 37

The level of thyroid-stimulating hormone (TSH)in individuals with Graves disease is usually:

A) High
B) Low
C) Normal
D) In constant flux

Question 38

Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake?

A) Biguanide (metformin)
B) Sulfonylureas (glyburide)
C) Meglitinides (glinides)
D) a-Glycosidase inhibitor (miglitol)

Question 39

When comparing the clinical manifestations of both diabetic ketoacidosis (DKA)and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS),which condition is associated with only DKA?

A) Fluid loss
B) Weight loss
C) Increased serum glucose
D) Kussmaul respirations

Question 40

A person has acne,easy bruising,thin extremities,and truncal obesity.These clinical manifestations are indicative of which endocrine disorder?

A) Hyperthyroidism
B) Hypoaldosteronism
C) Diabetes insipidus
D) Cushing disease

Question 41

Match the phrases with the corresponding terms.
Hypersecretion of thyroid hormone (TH)

A)Acromegaly
B)Cushing disease
C)Addison disease
D)Graves disease
E)Myxedema
F)Pheochromocytoma

Question 42

Match the phrases with the corresponding terms.
Hyposecretion of thyroid hormone (TH)

A)Acromegaly
B)Cushing disease
C)Addison disease
D)Graves disease
E)Myxedema
F)Pheochromocytoma

Question 43

Match the phrases with the corresponding terms.
Hypersecretion of adrenal medulla hormones

A)Acromegaly
B)Cushing disease
C)Addison disease
D)Graves disease
E)Myxedema
F)Pheochromocytoma

Question 44

A chronic complication of diabetes mellitus is likely to result in microvascular complications in which areas? (Select all that apply.)

A) Eyes
B) Coronary arteries
C) Renal system
D) Peripheral vascular system
E) Nerves

Question 45

Match the phrases with the corresponding terms.
Hypersecretion of adrenocorticotropic hormone (ACTH)

A)Acromegaly
B)Cushing disease
C)Addison disease
D)Graves disease
E)Myxedema
F)Pheochromocytoma

Question 46

Match the phrases with the corresponding terms.
Hypersecretion of growth hormone (GH)

A)Acromegaly
B)Cushing disease
C)Addison disease
D)Graves disease
E)Myxedema
F)Pheochromocytoma

Question 47

A person may experience which complications as a result of a reduction in parathyroid hormone (PTH)? (Select all that apply.)

A) Muscle spasms
B) Tonic-clonic seizures
C) Laryngeal spasms
D) Hyporeflexia
E) Asphyxiation

Question 48

Match the phrases with the corresponding terms.
Hyposecretion of adrenal cortex hormones

A)Acromegaly
B)Cushing disease
C)Addison disease
D)Graves disease
E)Myxedema
F)Pheochromocytoma