Deck 18: Assessing the Endocrine System

Question 1

A patient is demonstrating signs of exophthalmos. What additional finding should the nurse expect to assess in this patient?

A) enlarged thyroid gland
B) dry, thick nails
C) dry skin
D) decreased reflexes

Answer 1

enlarged thyroid gland

Question 2

A patient is having a 17-keosteroid test performed. What statement by the patient indicates that teaching about this test has been effective?

A) "I will store the specimen container in the refrigerator."
B) "I shouldn't eat or drink anything before this test."
C) "I know this test will be helpful in diagnosing my thyroid problem."
D) "I will arrive early to have my blood drawn."

Answer 2

"I will store the specimen container in the refrigerator."

Question 3

The nurse is assessing a patient with a pituitary disorder. Which finding does the nurse assess for in this patient?

A) enlargement of the hands and feet
B) thin, soft hair
C) excessive growth of facial hair
D) purple striae over the trunk

Answer 3

enlargement of the hands and feet

Question 4

The nurse is conducting a physical assessment with a patient. Using the diagram (see below), place an "X" over the location on the body where the nurse would assess for Chvostek sign.

Question 5

An older adult patient tells the nurse she is ingesting a fat-soluble vitamin every day to boost her endocrine system. For what age-related change does the nurse recognize the patient is addressing by taking this vitamin?

A) The ability to absorb fat-soluble vitamins declines with aging.
B) Lipase production is increased and results in fat intolerance.
C) Older patients have increased resistance to insulin.
D) Indigestion increases with aging due to decreased lipase production.

Question 6

When measuring the blood pressure of a patient with hypoparathyroidism, the nurse notes spasms of the patient's hand. How should the nurse document this finding?

A) Trousseau sign
B) Chvostek sign
C) Turner sign
D) Cullen sign

Question 7

The nurse is assessing an older patient with type 2 diabetes mellitus. What age-related endocrine change should the nurse expect in this patient?

A) decreased sensitivity to insulin
B) more rapid insulin release
C) intolerance of fatty foods
D) lower and prolonged blood glucose levels

Question 8

A patient is experiencing severe hypertension. The nurse realizes that this finding might indicate a disorder in which endocrine gland?

A) adrenal
B) thyroid
C) parathyroid
D) gonads

Question 9

A patient is scheduled for surgery to remove a tumor of the anterior pituitary. The nurse realizes that which hormones will be affected by this surgery?

A) adrenocorticotropic hormone (ACTH)
B) thyroid stimulating hormone (TSH)
C) gonadotropin hormones
D) prolactin
E) oxytocin

Question 10

The nurse is conducting a health assessment interview with a patient. What should the nurse include when assessing the patient's endocrine system?

A) occupation
B) use of alcohol, drugs, and tobacco
C) lifestyle
D) exercise and sleep patterns
E) alterations in bowel habits

Question 11

The nurse is conducting a physical assessment with a patient. Which assessment technique should the nurse use to assess the patient's thyroid gland?

A) Stand behind the patient and palpate the thyroid.
B) Stand in front of the patient and palpate the thyroid.
C) Place the patient supine and palpate one side of the neck at a time.
D) Have the patient flex the neck forward and palpate the thyroid.

Question 12

The nurse is beginning the assessment of a patient with an endocrine disorder. What should the nurse include in this assessment?

A) height and weight
B) skin, hair, and nails
C) deep tendon reflexes
D) musculoskeletal system
E) respiratory system

Question 13

The nurse is assessing a patient diagnosed with hypothyroidism. Which health assessment interview question should the nurse ask this patient?

A) "Is your skin feeling rough and dry?"
B) "Is your skin smooth or flushed?"
C) "Does your skin feel clammy?"
D) "Do you have brown, shiny patches on the lower extremities?"

Question 14

The nurse is caring for a patient with Graves disease. On which laboratory value should the nurse focus for this patient?

A) thyroxine
B) urine-specific gravity
C) cortisol
D) calcium

Question 15

During an endocrine assessment, the nurse asks a patient about changes in weight. For which organs is the nurse assessing function in the patient?

A) adrenal
B) thyroid
C) pituitary
D) parathyroid
E) gonads

Question 16

The nurse is conducting a health interview with a female patient. What should the nurse ask this patient that focuses on the endocrine system?

A) "Is your menstrual cycle regular?"
B) "Do you have children?"
C) "Are you able to provide for your children?"
D) "How old were you when your menses first began?"

Question 17

A patient has a positive Trousseau sign. For which problem should the nurse plan care for this patient?

A) pain
B) excessive fluid
C) difficulty breathing
D) reduced blood flow

Question 18

The nurse is assessing an older patient for genetic influences on the endocrine system. What should the nurse ask this patient during the assessment?

A) "Do you have any family members with diabetes mellitus?"
B) "Is there a pattern of obesity in your family?"
C) "Has anyone in your family been diagnosed with Hashimoto disease?"
D) "How do you cope with stress?"
E) "Have you noticed any changes in coloration of your skin?"

Question 19

The nurse is reviewing data collected during a patient's health history. What information would indicate a disorder of the pituitary gland?

A) dwarfism
B) carpal spasms
C) enlarged thyroid nodule
D) hyperpigmentation of the skin

Question 20

During a focused endocrine assessment, the patient states that her brother has fragile X syndrome. What should the nurse know about this health problem?

A) It is an endocrine disorder having a genetic basis.
B) It is not a relevant issue since the patient is female.
C) It is a health condition separate from the endocrine system.
D) It is a blood disorder.

Question 21

The nurse is planning to conduct a physical assessment of a patient's endocrine system. What should the nurse expect to perform on this patient?

A) palpation of the thyroid gland
B) palpation of the pancreas
C) percussion of the adrenal glands
D) palpation of the parathyroid glands

Question 22

A female patient comes into the clinic to be seen for fatigue and a cold that "won't go away," both of which began when she started a new job and her mother moved in with her family. The nurse realizes that this patient might be experiencing what reaction?

A) an increase in glucocorticoid secretion
B) an increase in epinephrine secretion
C) a drop in mineralocorticoid secretion
D) a reduction in norepinephrine secretion

Question 23

The nurse suspects that a patient is experiencing a response to stress. By which route should the nurse expect hormone transport to be conducted in this stress response?

A) neuroendocrine
B) paracrine
C) portal
D) nerve cell extension

Question 24

A patient who is scheduled to have a hemoglobin A1C level drawn asks the nurse about the purpose of the test. How should the nurse respond to this patient?

A) "It's to check for pancreas functioning."
B) "It's a blood test to check for kidney functioning."
C) "It's to check for thyroid functions."
D) "It's a blood test to check for menopausal symptoms."

Question 25

A middle-aged female patient is found to have a decrease in her cortisol level. The nurse realizes that this finding is consistent with what health problem?

A) Addison disease
B) hyperthyroidism
C) Cushing syndrome
D) nothing

Question 26

The nurse is assessing a patient for Trousseau sign. In which order should the nurse conduct this assessment?

A) Inflate the cuff.
B) Wait 2‒5 minutes.
C) Note a point greater than systolic blood pressure.
D) Place a blood pressure cuff above the antecubital space.
E) Observe for carpal spasms in the patient's hands and fingers.
F) non of the above.

Question 27

During an assessment the nurse notes that the patient's eyes are extremely wide open and bulging. The nurse realizes that this finding is consistent with what health problem?

A) hyperthyroidism
B) diabetes mellitus
C) hypofunction of the adrenal glands
D) hypofunction of the anterior pituitary gland

Question 28

The nurse is conducting an interview with an adult female patient. Which questions should the nurse ask that focus on genetic factors that influence the endocrine system?

A) Did you have any difficulties with your pregnancies?
B) What was the pattern and characteristics of your menstrual cycle?
C) Did you have any problems related to menopause?
D) Have you noticed any changes in your breasts?
E) Have you noticed any changes in the color of your urine or feces?

Question 29

A patient comes into the clinic demonstrating symptoms of hypocalcemic tetany. What assessment should the nurse conduct to determine the patient's condition?

A) Tap a finger in front of the patient's ear at the angle of the jaw.
B) Place a tuning fork over one of the patient's fingers.
C) Measure the patient's blood pressure.
D) Measure capillary blood.

Question 30

An older patient who is seen in the clinic has a palpable thyroid gland. What should the nurse realize this finding indicates?

A) normal finding in the older patient
B) onset of hypertension
C) onset of diabetes mellitus
D) explanation for a reduced urine output

Question 31

A patient is demonstrating symptoms of dehydration and excessive urination. The nurse realizes the patient might be experiencing an alteration in what hormone?

A) antidiuretic hormone (ADH)
B) adrenocorticotropic hormone (ACTH)
C) follicle-stimulating hormone (FSH)
D) thyroid-stimulating hormone (TSH)

Question 32

The results of a patient's oral glucose tolerance test are reviewed by the nurse. How should the nurse interpret these results? $$\begin{array} { | l | l | } \hline \text { Time } & \begin{array} { l } \text { Blood } \\\mathrm { mg } / \mathrm { mL }\end{array} \\\hline \text { Fasting } & 67 \\\hline 30 \text { minutes } & 128 \\\hline 1 \text { hour } & 151 \\\hline 2 \text { hours } & 102 \\\hline 3 \text { hours } & 70 \\\hline\end{array}$$

A) Results are within normal range.
B) The patient should be evaluated for diabetes mellitus.
C) The findings indicate hyperinsulinism.
D) The results are inconsistent; therefore, the test will need to be repeated.

Question 33

Place an "X" over the site of the site on the body where a nurse would assess stereognosis.

Question 34

The nurse is conducting a physical assessment on a patient. Place an "X" over the location on the body where the nurse should observe and/or palpate for a goiter.

Question 35

The nurse realizes an alteration in growth hormone can lead to changes in an individual's physical stature. What condition should the nurse suspect is being caused by abnormally high levels of growth hormone in a patient?

A) acromegaly
B) dwarfism
C) hirsutism
D) gynecomastia

Question 36

A patient being treated with medication for a seizure disorder is scheduled for a serum T3 and T4 level. What results should the nurse expect for these levels?

A) falsely reduced
B) falsely elevated
C) normal
D) indicative of pending parathyroid hormone disease

Question 37

When reviewing the patient's record, the nurse sees the results of a recent blood chemistry profile. These results indicate the patient is being evaluated for what health problem? $$\begin{array} { | l | l| } \hline \text { Calcium } & 10.2 \mathrm { mg } / \mathrm { dL } \\\hline \text { Phosphate } & 2.0 \mathrm { meq } / \mathrm { L } \\\hline \text { Vitamin D } & \begin{array} { l } \text { Within normal } \\\text { range }\end{array}\\\hline \end{array}$$

A) hyperparathyroidism
B) Cushing syndrome
C) thyroiditis
D) hypothyroidism

Question 38

The nurse is completing an endocrine-focused health assessment interview with an older adult. What finding should the nurse suspect is related to an age-related change in the patient's thyroid function?

A) inability to tolerate heat and cold
B) indigestion and intolerance of fatty foods
C) increased facial hair
D) enlarged nose, hands, and feet

Question 39

While instructing a patient on pain relief, the nurse uses the example of endorphins as endocrine hormones, which act locally at the site of injury. The nurse is explaining what route of hormone transport in the body?

A) paracrine method
B) direct release into the bloodstream
C) neuroendocrine route
D) nerve cell extension into the posterior pituitary

Question 40

The nurse is instructing a patient with low levels of circulating thyroid hormone. The nurse should encourage the patient to increase foods containing which nutrient?

A) iodine
B) calcium
C) phosphorus
D) vitamin D

Question 41

The nurse is reviewing the function of the pancreas with a patient who is newly diagnosed with diabetes mellitus. When discussing this organ's function, on which cell types should the nurse focus?

A) f cells
B) beta cells
C) delta cells
D) alpha cells
E) omega cells

Question 42

During a physical assessment the nurse suspects a patient is experiencing hypothyroidism. What skin assessment findings did the nurse use to make this assumption?

A) rough, dry skin
B) smooth, flushed skin
C) yellowish cast to the skin
D) areas of hyperpigmentation
E) purple striae over the abdomen

Question 43

After the most recent physician's office visit and blood work, the patient learns that an oral glucose tolerance test scheduled for the next week is not needed. The patient says to the nurse, "This is good news if I don't need additional testing." What should the nurse recognize that the cancellation of this test indicates?

A) consistently high fasting blood glucose levels
B) no evidence of type 1 diabetes mellitus
C) normal renal functioning
D) normal liver functioning

Question 44

The nurse suspects that a patient is experiencing a response caused by the hormones of the adrenal medulla. What did the nurse assess to come to this conclusion?

A) heart rate 112
B) cold extremities
C) respiratory rate 24
D) urine output 10 mL/hr
E) blood glucose level 142 mg/dL

Question 45

A patient is scheduled for a water deprivation test. What should the nurse instruct the patient to prepare for this test?

A) Expect this test to take 16 hours to complete.
B) Abstain from smoking as directed by the health care provider.
C) A sedative will be provided prior to the beginning of the test.
D) Do not eat or drink anything as directed by the health care provider.
E) Blood and urine samples will be collected every hour during the test.