Deck 20: Alterations of Hormonal Regulation

Question 1

While checking the lab 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.

Answer 1

high.

Question 2

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.

Answer 2

normal.

Question 3

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.

Answer 3

orbital edema and protrusion of the eyeball.

Question 4

When considering hypothyroidism, the basal metabolic rate is unusually:

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

Question 5

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 6

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 7

Which hypothyroid diagnosis is supported by low levels of TSH?

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

Question 8

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

Question 9

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

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

Question 10

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 11

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

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

Question 12

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 13

A patient presents with polyuria and extreme thirst and is 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

Question 14

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 15

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 16

Palpation of the neck of a patient diagnosed with Graves disease 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 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 18

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

Question 19

A 45 year old diagnosed with Graves disease underwent surgical removal of the thyroid gland.During the postoperative period, the patient's serum calcium is 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 20

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 21

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 22

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

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

Question 23

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 24

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 25

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 hyperreflexia
C) Abdominal pain and fever
D) Anorexia, nausea, and vomiting

Question 26

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 breathing
D) Weakness, vomiting, hypotension, and mental confusion

Question 27

What is the most common cause of hypoparathyroidism?

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

Question 28

Which physical feature supports the diagnosis of Cushing 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 29

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

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

Question 30

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

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

Question 31

What is the most common cause of Addison disease?

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

Question 32

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 33

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 34

What causes the chronic microvascular and macrovascular complications of DM?

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

Question 35

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

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

Question 36

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) Muscular atrophy
D) Height increases

Question 37

A patient presents reporting visual disturbances.When CT reveals a pituitary tumor and lab 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 38

A 19-year-old female with type 1 DM was admitted to the hospital with the following lab values: serum glucose 500 milligrams per deciliter (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 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 40

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

A) Renal 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 sign.
C) Trousseau sign.
D) oily skin.
E) hair loss.

Question 42

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

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

Question 43

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