Deck 65: Review of the Endocrine System

Question 1

A nurse is assessing the therapeutic response of several patients to supplemental thyroid hormone.The nurse notes that each patient receives a different dose of the same drug.The nurse recognizes that this variation is mostly driven by:
1)The number and sensitivity of the individual patient's tissue receptors.
2)The patient's age and ethnicity.
3)The patient's height and weight.
4)The patient's psychological status and acceptance of hormone therapy.

Answer 1

1

Question 2

A nurse is caring for a patient with hyperglycemia.While choosing nursing interventions, the nurse is aware that a high serum blood sugar normally produces
Changes in the patient's pancreas that are consistent with a:
1)Humoral stimulus.
2)Neuronal stimulus.
3)Hormonal stimulus.
4)Exocrine gland stimulus.

Answer 2

1

Question 3

A nurse is assisting a new mother who is struggling to breastfeed.The nurse knows the production of breast milk is dependent up which hormonal mechanism?
1)Epinephrine binding to alpha receptors in the blood vessels of the chest wall
2)Prolactin binding to receptors in the breast secretory cells
3)Follicular-stimulating hormone binding to cells in the ovaries
4)Luteinizing hormone binding to cells in the ovaries

Answer 3

2

Question 4

A nurse is caring for a patient who had been receiving supplemental cortisone.The patient developed a bleeding ulcer, and the steroid was discontinued.The bleeding stopped yesterday, but the blood pressure remains unstable.The nurse recognizes that the unstable blood pressure is related to:
1)Down-regulation of corticosteroid receptors.
2)Up-regulation of corticosteroid receptors.
3)Down-regulation of epinephrine.
4)Up-regulation of epinephrine.

Question 5

A nurse is caring for a patient with hypocalcemia.In planning to meets the patient's needs, the nurse would expect what alteration in constituent of the patient's bloodstream?
1)A decreased level of parathyroid hormone
2)An increased level of parathyroid hormone
3)An increased level of serum calcium
4)A decreased level of T-3 and/or T-4

Question 6

A nurse is administering hormones to several patients.The nurse recognizes that which medication order is exaggerated response therapy?
1)Insulin to a patient with diabetes mellitus.
2)Vasopressin to a patient with diabetes insipidus.
3)Corticosteroid to a patient with lupus.
4)Thyroid hormone to a patient with a history of Graves' disease.

Question 7

The nurse is administering testosterone to a patient with breast cancer.The nurse recognizes that this therapy is part of the patient's treatment plan because:
1)Testosterone blocks the growth of estrogen-sensitive cancers.
2)Testosterone decreases the inflammation associated with rapid tumor growth.
3)Testosterone has a high affinity for rapidly dividing cancer cells.
4)Testosterone replicates the action of antineoplastic drugs without nausea.

Question 8

A nurse in an endocrinologist's office is planning to teach a mother whose small-for-age child is to receive supplemental injections of growth hormone.The mother asks the nurse, "Why does my child have to take these shots? I read in the paper that hormones are dangerous." Which response by the nurse is most appropriate?
1)"Your child's pituitary is not making enough of a hormone called GH.The injection is very safe."
2)"Your child's pituitary gland is not making enough growth hormone.This hormone makes bones and muscles grow to normal size.The shots can have some negative effects, but your child will be carefully monitored."
3)"There are some hormones that are dangerous, but the shot you child will receive is not one of them."
4)"Are you worried that your child will get hooked on drugs?"

Question 9

The nurse is caring for a patient with an infracted pituitary gland.The nurse knows that damage to the pituitary has the potential to limit production of all the pituitary hormones.
During assessment, the nurse notes that the patient's ACTH levels are low.The nurse knows this deficit will impact primarily on the patient's level of:
1)Thyroxine.
2)Corticosteroids.
3)Insulin.
4)Epinephrine.

Question 10

The nurse is caring for a patient who is acutely ill.The patient is unstable, and is struggling to regain homeostasis.The nurse is evaluating the patient's blood pressure.The nurse recognizes that when the patient's blood pressure drops, which hormonal mechanism takes action at once?
1)Epinephrine is released by the adrenal medulla, and triggers vasoconstriction.
2)Insulin is released by pancreas, and increases energy production.
3)Aldosterone is released by the adrenal cortex, and conserves water.
4)Cortisol is released by the adrenal cortex, and raises blood sugar.

Question 11

A nurse in an endocrinology practice is seeing a patient with low growth hormone levels. The patient's history reveals extensive pituitary damage secondary to a large adenoma.
The nurse recognizes that the patient's small stature results from:
1)An inability to respond to GnRH.
2)Lack of tissue receptors for GH.
3)Negative feedback from GH receptors.
4)High levels of ACTH.

Question 12

A patient is receiving steroid therapy because of an exacerbation of COPD.The dose is being tapered downward.The nurse recognizes that this approach is medically appropriate because it applies what principle of "up-regulation"?
1)Up-regulation requires time for re-growth of cell-wall hormone receptors.
2)Up-regulation changes the configuration of cell-wall hormone receptors to allow them to bind better.
3)Up-regulation decreases the number of receptors on the cell-wall surface.
4)Up-regulation decreases the sensitivity of the cell-wall hormone receptors.

Question 13

A patient with hyperthyroidism has been reading about PTU on the internet.The patient asks the nurse, "How do anti-hormones work to help my condition?" Which is the nurse's best response?
1)"Your body has been affected by too much thyroid hormone.PTU is a drug that can block your body's response to thyroid hormone."
2)"PTU regenerates your thyroid gland and causes normal tissue to regrow, so the effects of too much thyroid will go away."
3)"Anti-hormones oppose the action of estrogen, which allows thyroid to regain its effectiveness."
4)"PTU replaces your abnormal thyroid hormone with normal thyroid hormone."

Question 14

A patient with a pituitary defect is being treated for Addison's disease with supplemental corticosteroids.The patient begins to develop signs and symptoms of Cushing's syndrome.The nurse recognizes that this reaction is a result of failure of normal:
1)Receptor sensitivity.
2)Feedback mechanisms.
3)Chemical messengers.
4)ACTH formation.

Question 15

A nurse is caring for a patient newly diagnosed with hypothyroidism.The patient's doctor informed the patient about her thyroid-related lab work.Later, the patient says to the nurse, "I don't understand why my TSH is high.I thought I had low thyroid levels." The most appropriate response by the nurse is:
1)"TSH is a hormone released by the pituitary that signals your thyroid to make hormones.When the thyroid can't respond, the pituitary keeps trying to send its signal, and the TSH keeps going up."
2)"TSH is an incomplete thyroid hormone.Because it cannot bind to tissues, it builds up in the bloodstream."
3)"TSH is not thyroid hormone.When thyroid values are low, other lab tests are performed to see how you tolerate the low levels.
4)"You probably misunderstood the physician.Your TSH is low because your doctor spoke with you about hypothyroidism.

Question 16

The nurse is checking lab work on a patient's record.The patient's FSH and LH level are low.The nurse would suspect that this patient has concerns related to:
1)The reproductive system.
2)The renal system.
3)Nutrition and metabolism.
4)Growth and development.

Question 17

When a patient's blood sugar drops too low, the pancreas refrains from releasing insulin. The nurse caring for the patient recognizes that the drop in insulin production is a result of:
1)Negative feedback.
2)Positive feedback.
3)Up-regulation.
4)Down-regulation.

Question 18

The nurse is evaluating a patient who is receiving a thyroid hormone supplement.The patient's TSH level has gone down, and the T-3 and T-4 levels have increased.The nurse knows:
1)A decrease in the TSH is desirable.
2)A decrease in the TSH is undesirable.
3)An increase in the T-3 and T-4 is undesirable.
4)The TSH, T-3, and T-4 all should have increased.