Deck 64: Review of the Endocrine System

Question 1

A client with hypothyroidism is told by the health care provider that the thyroid-stimulating hormone level is elevated.The client 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:

A)"You probably misunderstood your health care provider."
B)"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."
C)"TSH is not thyroid hormone.When thyroid values are low,other lab tests are performed to see how you tolerate the low levels."
D)"TSH is an incomplete thyroid hormone.Because it cannot bind to tissues,it builds up in the bloodstream."

Answer 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."

Question 2

A child who is small-for-age is to receive supplemental injections of growth hormone.The mother of the client asks,"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?

A)"There are some hormones that are dangerous,but the shot your child will receive is not one of them."
B)"Are you worried that your child will get hooked on drugs?"
C)"Your child's pituitary gland is not making enough growth hormone.This hormone makes bones and muscles grow to normal size.The shots are safe."
D)"Your child's parathyroid glands are not making enough of a hormone called GH.The injection is very safe."

Answer 2

"There are some hormones that are dangerous,but the shot your child will receive is not one of them."

Question 3

The nurse is evaluating a client who is receiving a thyroid hormone supplement.The client's TSH level has gone down,and the T3 and T4 levels have increased.The nurse knows that:

A)The TSH,T3,and T4 all should have increased.
B)A decrease in the TSH is undesirable.
C)An increase in the T3 and T4 is undesirable.
D)A decrease in the TSH is desirable.

Answer 3

A decrease in the TSH is desirable.

Question 4

When instructing an adolescent on the reproductive system,the nurse explains that which hormones interact to promote maturation of ovarian follicles and produce estrogen?
Select all that apply.

A)Follicle-stimulating hormone
B)Gonadotropin-releasing hormone
C)Adrenocorticotropic hormone
D)Antidiuretic hormone
E)Growth hormone

Question 5

The nurse notes that several clients prescribed supplemental thyroid hormone are all receiving different doses of the same drug.The nurse recognizes that this variation is mostly driven by:

A)the client's age and ethnicity.
B)the client's psychological status and acceptance of hormone therapy.
C)the number and sensitivity of the individual client's tissue receptors.
D)the client's height and weight.

Question 6

A client is diagnosed with a disorder of the pituitary gland.When reviewing this client's medical history,the nurse will identify which health problems as potential results of the pituitary disorder?
Select all that apply.

A)Diabetes insipidus
B)Acromegaly
C)Breast-feeding abnormalities
D)Graves disease
E)Addison disease

Question 7

The nurse in an endocrinology practice is seeing a client with low growth hormone levels.The client's history reveals extensive pituitary damage secondary to a large adenoma.The nurse recognizes that the client's small stature results from:

A)negative feedback from GH receptors.
B)an inability to respond to GH.
C)lack of tissue receptors for GH.
D)high levels of ACTH.

Question 8

When a client's blood sugar drops too low,the pancreas refrains from releasing insulin.The nurse caring for the client recognizes that the drop in insulin production is a result of:

A)positive feedback.
B)negative feedback.
C)up-regulation.
D)down-regulation.

Question 9

The nurse is caring for a client with hypocalcemia.In planning to meet the client's needs,the nurse would expect which alteration?

A)An increased level of parathyroid hormone
B)An increased level of serum calcium
C)A decreased level of parathyroid hormone
D)A decreased level of T3 and/or T4

Question 10

The nurse is checking lab work on a client's record.The client's FSH and LH levels are low.The nurse suspects this client may have health problems related to:

A)growth and development.
B)nutrition and metabolism.
C)the reproductive system.
D)the renal system.

Question 11

A client who is acutely ill is having difficulty maintaining a steady blood pressure.The nurse recognizes that when the client's blood pressure drops,the hormonal mechanism that immediately takes action is:

A)aldosterone,released by the adrenal cortex to conserve water.
B)cortisol,released by the adrenal cortex to raise blood sugar.
C)insulin,released by the pancreas to increase energy production.
D)epinephrine,released by the adrenal medulla to trigger vasoconstriction.

Question 12

The nurse is assisting a postpartum client who is new to breastfeeding.The nurse knows the production of breast milk is dependent on which hormonal mechanism?

A)Follicular-stimulating hormone binding to cells in the ovaries
B)Epinephrine binding to alpha receptors in the blood vessels of the chest wall
C)Luteinizing hormone binding to cells in the ovaries
D)Prolactin binding to receptors in the breast secretory cells

Question 13

A client with a pituitary defect is being treated for Addison disease with supplemental corticosteroids.The client develops signs and symptoms of Cushing syndrome.The nurse recognizes that this reaction is a result of the failure of normal:

A)chemical messengers.
B)feedback mechanisms.
C)receptor sensitivity.
D)ACTH formation.

Question 14

A client with an exacerbation of COPD is receiving steroid therapy in tapering doses.The nurse recognizes that this approach is medically appropriate because it applies what principle of up-regulation?

A)Up-regulation decreases the sensitivity of the cell-wall hormone receptors.
B)Up-regulation decreases the number of receptors on the cell-wall surface.
C)Up-regulation requires time for regrowth of cell-wall hormone receptors.
D)Up-regulation changes the configuration of cell-wall hormone receptors to allow them to bind better.

Question 15

A client with hyperthyroidism has been reading about PTU on the internet.The client asks the nurse,"How do antihormones work to help my condition?" Which is the nurse's best response?

A)"Your body has been affected by too much thyroid hormone.PTU is a drug that can block your body's response to thyroid hormone."
B)"Antihormones oppose the action of estrogen,which allows thyroid to regain its effectiveness."
C)"PTU regenerates your thyroid gland and causes normal tissue to regrow,so the effects of too much thyroid will disappear."
D)"PTU replaces your abnormal thyroid hormone with normal thyroid hormone."

Question 16

The nurse is caring for a client who had been receiving supplemental cortisone.The client developed a bleeding ulcer,and the steroid was discontinued.The bleeding has stopped but the blood pressure remains unstable.The nurse recognizes that the unstable blood pressure is related to:

A)down-regulation of corticosteroid receptors.
B)up-regulation of epinephrine.
C)up-regulation of corticosteroid receptors.
D)down-regulation of epinephrine.

Question 17

The nurse is administering testosterone to a client with breast cancer.The nurse recognizes that this therapy is part of the client's treatment plan because:

A)testosterone has a high affinity for rapidly dividing cancer cells.
B)testosterone decreases the inflammation associated with rapid tumor growth.
C)testosterone replicates the action of antineoplastic drugs without nausea.
D)testosterone blocks the growth of estrogen-sensitive cancers.

Question 18

The nurse is administering hormones to several clients.The nurse recognizes that which medication order represents exaggerated response therapy?

A)Insulin to a client with diabetes mellitus
B)Vasopressin to a client with diabetes insipidus
C)Thyroid hormone to a client with a history of Graves disease
D)Corticosteroid to a client with lupus

Question 19

The nurse is caring for a client with hyperglycemia.When choosing nursing interventions,the nurse is aware that a high serum blood sugar produces changes in the client's pancreas that are consistent with a:

A)hormonal stimulus.
B)humoral stimulus.
C)exocrine gland stimulus.
D)neuronal stimulus.

Question 20

While reviewing a medical record,the nurse notes that a client's ACTH levels are low.The nurse knows this deficit will primarily impact the client's level of:

A)thyroxine.
B)insulin.
C)corticosteroids.
D)epinephrine.

Question 21

A client receiving hormone replacement therapy tells the nurse that the medication is not working." How should the nurse respond to this client?
Select all that apply.

A)Hormones affect all body cells."
B)It may take several days or longer to achieve optimum results."
C)The medication should work immediately."
D)The medication will be changed to one that works faster."
E)The wrong hormone is being replaced."

Question 22

A client being treated for breast cancer is prescribed tamoxifen.What should the nurse instruct the client about this medication's mechanism of action?
Select all that apply.

A)This medication is an antihormone.
B)This medication blocks the action of estrogen.
C)This medication replaces a hormone in the body.
D)This medication will shrink the breast tumor.
E)This medication will cause the breast cancer to become more aggressive.

Question 23

The nurse is reviewing the pathophysiology of type 1 diabetes mellitus with a client newly diagnosed with the disorder.How will the nurse explain the control of pancreatic hormones in this disorder?
Select all that apply.

A)Cells in the pancreas sense the level of glucose in the blood.
B)Depending on the level of glucose in the blood,the pancreas will either secrete insulin or stop the secretion of insulin.
C)Nerve impulses to the pancreas stimulate the release of insulin.
D)The pancreas reacts to other hormone levels in the blood.
E)Insulin is secreted in response to hormone levels within other digestive system organs.

Question 24

A client's hormone replacement therapy for a health problem has been discontinued.The nurse should instruct the client about which effects because the therapy has been stopped?
Select all that apply.

A)Body cells will need time to adjust to the new hormone level.
B)Target cells are desensitized and are less responsive to the effects of the hormone.
C)Body cells will create more receptors on the plasma membrane to capture hormone molecules.
D)Body cells will send signals that hormone action is needed.
E)Body cells will secrete more hormone.

Question 25

A client tells the nurse that because a hormone replacement medication was not working," the client started taking double the prescribed dose.How should the nurse respond to this client?
Select all that apply.

A)The health care provider will need to be notified,because hormonal balance falls within a narrow range."
B)It may take several days or longer to produce the desired effect."
C)That was not a very wise thing to do."
D)The wrong hormone replacement was prescribed."
E)The health care provider would have probably made the same decision."

Question 26

The nurse is reviewing the process of ovulation with a young female desiring to become pregnant.During this teaching,the nurse will explain:
Select all that apply.

A)gonadotropin-releasing hormone stimulates the luteinizing hormone to stimulate ovulation.
B)gonadotropin-releasing hormone stimulates luteinizing hormone to produce estrogen.
C)the presence of estrogen stops gonadotropin-releasing hormone from secreting more hormone.
D)the presence of estrogen signals the ovaries to continue releasing gonadotropin-releasing hormone.
E)luteinizing hormone stimulates estrogen to release gonadotropin-releasing hormone for ovulation to occur.