Deck 19: Alterations of Hormonal Regulation

Question 1

Which assessment result would the nurse expect to find associated with a patient diagnosed with Graves' disease?

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

Answer 1

High levels of circulating thyroid-stimulating autoantibodies

Question 2

What would palpation of the neck of a patient diagnosed with Graves' disease most likely reveal?

A) A normal-sized thyroid
B) A single, discrete thyroid nodule
C) A hard and painful thyroid
D) Diffuse thyroid enlargement

Answer 2

Diffuse thyroid enlargement

Question 3

A 44-year-old patient with pulmonary tuberculosis is evaluated for SIADH. Which assessment finding would support this diagnosis?

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

Answer 3

Concentrated urine

Question 4

Besides hyposecretion and hypersecretion, endocrine system dysfunction can result from:

A) abnormal receptor activity.
B) abnormal hormone levels.
C) increased synthesis of second messengers.
D) extracellular electrolyte alterations.

Question 5

A patient presents with polyuria and extreme thirst and is given ADH replacement therapy. 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

Question 6

While checking the laboratory results for a patient diagnosed with Graves' disease, the nurse would expect the T₃ level to be abnormally:

A) low.
B) high.
C) variable.
D) absent.

Question 7

What common neurological 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 8

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

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

Question 9

Which hypothyroid diagnosis is supported by low levels of TSH?

A) Primary
B) Central (secondary)
C) Autoimmune
D) Atypical

Question 10

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

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

Question 11

A patient diagnosed 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 12

A patient 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 13

When considering hypothyroidism, the basal metabolic rate is unusually:

A) high.
B) low.
C) steady.
D) variable.

Question 14

A patient presents with breast discharge, dysmenorrhea, and excessive excitability. Tests reveal that all 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 15

Visual disturbances are a common occurrence in patients with untreated Graves' disease. Why do these disturbances take place?

A) There is decreased blood flow to the eye.
B) Orbital edema and protrusion of the eyeball occurs.
C) TSH neurotoxicity to retinal cells takes place.
D) Local lactic acidosis develops.

Question 16

What type of diabetes insipidus may develop in a patient who had received a general anaesthetic?

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

Question 17

A patient diagnosed with thyroid carcinoma would be expected to have T₃ and T₄ levels that are:

A) high.
B) low.
C) normal.
D) variable.

Question 18

What is the most common cause of elevated levels of antidiuretic hormone (ADH) secretion?

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

Question 19

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

A) Stroke
B) Diabetes insipidus
C) Neurological damage
D) Kidney failure

Question 20

A 45-year-old diagnosed with thyroid carcinoma underwent surgical removal of the thyroid gland. During the postoperative period, the patient's serum calcium is low. What is the most probable reason for the hypocalcemia?

A) There is hyperparathyroidism secondary to Graves' disease.
B) Myxedema secondary to surgery develops.
C) Hypoparathyroidism develops caused by surgical injury to the parathyroid glands.
D) Hypothyroidism resulting from lack of thyroid replacement develops.

Question 21

The body's inability to conserve water and sodium when affected by Addison's 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 22

A 30-year-old diagnosed with Graves' disease is admitted to a hospital unit for the surgical removal of the 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 hyper-reflexia
C) Abdominal pain and fever
D) Anorexia, nausea, and vomiting

Question 23

A patient 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 24

A nurse checks laboratory results as both Cushing's disease and Addison's disease can manifest with elevated levels of:

A) ADH.
B) estrogen.
C) adrenocorticotropic hormone (ACTH).
D) aldosterone.

Question 25

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 laboratory 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) Muscular atrophy
D) Height increases

Question 26

A 19-year-old female with type 1 DM was admitted to the hospital with the following laboratory values: serum glucose 20 mmol/L (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 kidney failure.
C) Low serum insulin promotes lipid storage and a corresponding release of ketones.
D) Insulin deficiency promotes lipid metabolism and ketone formation.

Question 27

A patient diagnosed with Addison's disease reports weakness and is easily fatigued. What is the root of these symptoms?

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

Question 28

Which symptom would the nurse expect in a patient diagnosed with hyperaldosteronism?

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

Question 29

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 30

What is the earliest manifestation of diabetes-induced kidney dysfunction?

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

Question 31

What is the purpose of the glycosylated hemoglobin (hemoglobin A1c) test?

A) Measuring fasting glucose levels
B) Monitoring long-term serum glucose control
C) Detecting acute complications of diabetes
D) Checking for hyperlipidemia

Question 32

Which physical feature supports the diagnosis of Cushing's syndrome?

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

Question 33

What causes the chronic microvascular and macrovascular complications of DM?

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

Question 34

What is the most common cause of hypoparathyroidism?

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

Question 35

A patient presents reporting visual disturbances. When CT reveals a pituitary tumour and laboratory tests reveal elevated prolactin, the diagnosis of prolactinoma is made. Which intervention is the treatment of choice for this condition?

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

Question 36

What is the cause of type 1 diabetes mellitus (DM)?

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 37

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

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

Question 38

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

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

Question 39

What is the most common cause of Addison's disease?

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

Question 40

Which condition is considered the ultimate cause of death in the patient with diabetes?

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

Question 41

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

A) tetany.
B) Chvostek's sign.
C) Trousseau's sign.
D) oily skin.
E) hair loss.

Question 42

A 30-year-old presents with hypertension, headache, tachycardia, impaired glucose tolerance, diaphoresis, and weight loss. Which of the following diagnoses is supported by this symptomology?

A) Addison's disease
B) Conn's syndrome
C) Cushing's disease
D) Pheochromocytoma

Question 43

What is the cause of the hyperpigmentation seen in people with Cushing's 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