Deck 45: Nursing Assessment of the Patient Endocrine Disorders

Question 1

The nurse understands that an alteration in growth hormone can lead to changes in an individual's physical stature. Which finding would cause the nurse to assess for high levels of growth hormone?

A) Acromegaly
B) Dwarfism
C) Hirsutism
D) Gynecomastia

Answer 1

Acromegaly

Question 2

A patient has not eaten in 12 hours, and the blood sugar is low. The patient's endocrine system has suppressed the production of insulin. Which form of endocrine communication does this condition represent?

A) Positive feedback
B) Unregulated response
C) Free steroidal influence
D) Negative feedback

Answer 2

Negative feedback

Question 3

A patient is diagnosed with a disorder of autocrine regulation. Which explanation of this condition would the nurse provide to the patient and family?

A) "The cells that produce some of your body's hormones are not recognizing that sufficient hormone is present."
B) "Your blood is not circulating hormones well enough to get them to the places they need to be in your body."
C) "Some of your hormones are not able to travel to their neighboring cells to do their work."
D) "Your nervous system is not working with your endocrine system correctly."

Answer 3

"The cells that produce some of your body's hormones are not recognizing that sufficient hormone is present."

Question 4

The nurse is preparing to discuss the importance of neuroendrocrine regulation with a group of nurses who work in the endocrine clinic. The nurse will explain that this type of regulation facilitates which essential abilities?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Ability to think critically
B) Ability to reason
C) Ability to reproduce
D) Ability to adapt to external changes
E) Ability to grow physically

Question 5

During an assessment, the nurse notes that the patient's eyes are extremely wide open and bulging. The nurse would conduct additional assessment for which endocrine disorder?

A) Hyperthyroidism
B) Diabetes mellitus
C) Hypofunction of the adrenal glands
D) Hypofunction of the anterior pituitary gland

Question 6

A patient with hormone imbalance is demonstrating symptoms of dehydration and excessive urination. The nurse realizes that which hormone is most directly associated with these symptoms?

A) Antidiuretic hormone (ADH)
B) Adrenocorticotropic hormone (ACTH)
C) Follicle stimulating hormone (FSH)
D) Thyroid-stimulating hormone (TSH)

Question 7

Following thyroid surgery, a patient develops hypercalcemia. The nurse would suspect which etiology?

A) Damage to the part of the thyroid that produces T₃ hormone
B) Stimulation of the area of the thyroid that produces antidiuretic hormone
C) Damage to parathyroid tissues
D) Decrease in the amount of available thyroid-stimulating hormone

Question 8

A patient has had surgery to remove a tumor of the anterior pituitary. The nurse plans to assess for dysfunction associated with decreased levels of which hormones?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Adrenocorticotropic hormone (ACTH)
B) Thyroid-stimulating hormone (TSH)
C) Gonadotropic hormones
D) Antidiuretic hormone
E) Somatostatin

Question 9

A patient reports to the clinic with complaints of nervousness, weight changes, and a general feeling of ill health. History reveals that the patient recently took a demanding new job that requires frequent air travel across the country. The nurse recognizes which risk factors for endocrine disturbance?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Probable exposure to unfamiliar infection pathogens
B) Psychological stress from the new job
C) Physiological stress of travel
D) Disruption of circadian rhythms
E) Ingestion of unfamiliar foods and beverages

Question 10

A patient presents to the emergency department with reports of suddenly feeling exhausted. The patient reports loss of appetite, inability to sleep, and weight gain of 5 pounds over the last week. Which finding would the nurse evaluate as being least suggestive of an endocrine disorder?

A) Weight gain
B) Inability to sleep.
C) Sudden exhaustion
D) Loss of appetite

Question 11

An older adult female has been given instructions concerning an endocrine assessment the nurse will be conducting. Which statement by the patient would indicate that further instruction is necessary?

A) "Because I am already past menopause, there will be no need for a breast exam in this assessment."
B) "The nurse will look at my skin, nails, and hair."
C) "I'll be sure to let the nurse know that diabetes runs in my family."
D) "The nurse will palpate my throat in the front."

Question 12

The nurse is preparing to conduct physical assessment of a patient's endocrine system. The nurse will include palpation of which glands in this assessment?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Adrenal
B) Pancreas
C) Thyroid
D) Pituitary
E) Ovaries

Question 13

Which example would help the nurse explain hormone regulation directed by circadian rhythm?

A) The regulation of the female menstrual cycle
B) The release of cortisol to peak in the early morning
C) The stimulation of insulin production by an increased level of glucose
D) The increased production of luteinizing hormone (LH) during the menstrual cycle

Question 14

When caring for a patient diagnosed with Graves' disease, the nurse recognizes the importance of regular monitoring of which laboratory results?

A) Calcium level
B) Cortisol level
C) Thyroxine (T₄)
D) Urine-specific gravity

Question 15

During an endocrine assessment, the nurse asks specific questions about the patient's employment. What rationale would the nurse provide for this line of questioning?

A) Occupational exposure to some toxic chemicals may be implicated in the development of endocrine disorders.
B) People in occupations that require sitting for long periods are at higher risk for endocrine disorders.
C) People who are exposed to environmental tobacco smoke are at high risk for development of thyroid disorders.
D) People working in occupations requiring lifting are at higher risk for development of adrenal disorders.

Question 16

A patient with several adult-onset endocrine disorders is concerned that his children may develop similar problems as they grow older. Which information should the nurse provide?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Endocrine disorders are not known to be genetically transmitted."
B) "The tendency toward development of some endocrine disorders seems to cluster in families."
C) "It is too late to worry about that now, so we just need to be certain your children are well taken care of as adults."
D) "The current thinking is that it takes both a genetic tendency and environmental influences to cause some endocrine disorders."
E) "Some of these disorders seem to be autoimmune in nature, so genetics is not a factor."

Question 17

The nurse is conducting a health history interview with a female patient. To best assess the patient's endocrine system, the nurse asks which question?

A) "Is there a history of cancer in your family?"
B) "Is your menstrual cycle regular, every 28 days?"
C) "Have you ever experienced difficulty breathing?"
D) "Do you have problems with indigestion?"

Question 18

A patient is hospitalized following trauma to the neck that affected the thyroid gland. The nurse would monitor for changes in which hormone levels?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Androgens
B) Calcitonin
C) Triiodothyronine
D) Thyroxine
E) Thyomamine

Question 19

The nurse performing an assessment of a patient's endocrine system expects to address the structure and function of which glands?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Lacrimal glands
B) Gonads
C) Salivary glands
D) Hypothalamus
E) Thyroid gland

Question 20

The nurse is collecting patient history information as part of the initial clinic visit. Which patient statements would the nurse note as indicating a possible endocrine disorder?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "I am tired all the time, but I have trouble sleeping at night."
B) "I have gained 20 pounds since I retired."
C) "I haven't found very many gray hairs yet."
D) "My appetite has not been very good recently."
E) "I have burning when I urinate."

Question 21

Which information should the nurse provide for a patient scheduled for an MRI procedure as part of endocrine assessment?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "You will need to take out your earrings when you get in the MRI suite."
B) "I will remove your transdermal medication patch before you go to the MRI suite."
C) "Be certain to report any permanent cosmetic or other tattoos to the MRI technologist before you enter the MRI suite."
D) "I will help you remove your dentures before you go to the MRI suite."
E) "We will tape over the top of your wedding ring so that you can wear it during the procedure."

Question 22

A patient is scheduled for an ACTH stimulation test as part of endocrine evaluation. What information should the nurse provide as preparation for this test?

A) "At least two blood samples will be drawn."
B) "Wear comfortable clothing and supportive shoes for this exam."
C) "You will be asked to swallow some medication during X-ray examination."
D) "You should not drive for at least 12 hours after this exam."

Question 23

A patient is diagnosed with secondary hypothyroidism. The nurse would expect which laboratory test result?

A) Low triiodothyronine level
B) Low thyroid-stimulating hormone (TSH) level
C) Low thyroxine level
D) Low thyrotropin-releasing hormone level

Question 24

During an endocrine assessment, the nurse notes that the patient's heart rate is sustained at 160 beats per minute. The patient reports nervousness but has no loss of consciousness or reduced mentation. What nursing intervention is priority?

A) Ask how long the patient's heart has been beating so fast.
B) Note the findings in the patient's medical record.
C) Notify the health care provider immediately.
D) Have the patient ambulate around the room and reassess.

Question 25

A 70-year-old woman comes to the emergency department with a history of confusion and increasing depression over the last week. Auscultation of the heart and lungs reveals fine crackles and an S3 heart sound. Among other possible etiologies, the nurse considers which endocrine disorder?

A) Hypothyroidism
B) Graves' disease
C) Diabetes mellitus
D) Deficiency of luteinizing hormone

Question 26

A patient is scheduled for a thyroid scan. The nurse should specifically ask the patient about possible allergy to which substance?

A) Penicillin
B) Iodine
C) Citrus fruit
D) Sulfa drugs

Question 27

The patient is scheduled for an MRI using gadolinium contract medium. The nurse would teach the patient that which mild reactions are considered common and can be expected?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Headache
B) Nausea
C) Dizziness
D) Swelling of the lips
E) Dyspnea

Question 28

A patient with assessment findings suggesting acromegaly is scheduled for a growth hormone suppression test. The nurse would prepare the patient for this test with which information?.Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Several blood samples will be drawn for this test."
B) "You will be asked to drink a solution of glucose."
C) "You will be asked to assume several positions as X-rays are taken."
D) "Contrast media that includes iodine will be administered intravenously."
E) "Your urine will be collected for 24 hours."

Question 29

The nurse is conducting an endocrine assessment on a patient with cognitive impairment. Which nursing action is indicated?

A) Defer palpation of the thyroid.
B) Perform the palpation from in front of the patient.
C) Use standard palpation technique from behind the patient.
D) Have the caretaker hold the patient's head still during the exam.

Question 30

A patient is scheduled for MRI with gadolinium contrast. The nurse should review the medical record for which essential baseline test?

A) Kidney function
B) Chest X-ray
C) CBC with differential
D) Presence of pedal pulses