Preview Extract
Chapter 51
1. The nurse performing an assessment of a client’s endocrine system expects to address the
structure and function of the:
Select all that apply.
1. Hypothalamus.
2. Thyroid gland.
3. Gonads.
4. Salivary glands.
5. Lacrimal glands.
Answer:
1. Hypothalamus.
2. Thyroid gland.
3. Gonads.
Rationale:
Hypothalamus. The assessment of the endocrine system (hormones are secreted into the
bloodstream in order to affect body functions) would include the hypothalamus. Thyroid
gland. The assessment of the endocrine system (hormones are secreted into the bloodstream
in order to affect body functions) would include the thyroid. Gonads. The assessment of the
endocrine system (hormones are secreted into the bloodstream in order to affect body
functions) would include the gonad glands. Salivary glands. Salivary glands are exocrine
glands (excrete their fluids to the outside of the body). Lacrimal glands. Lacrimal glands are
exocrine glands (excrete their fluids to the outside of the body).
2. When a client asks the nurse, “Why is the doctor concerned about my pituitary gland?” the
nurse’s response is based on an understanding that this gland influences:
Select all that apply.
1. Renal function.
2. Growth of body tissue.
3. Bone density.
4. Arterial blood flow.
5. Gender traits.
Answer:
1. Renal function.
2. Growth of body tissue.
3. Bone density.
4. Arterial blood flow.
5. Gender traits.
Rationale:
Renal function. The pituitary gland is often called the “master gland” because its hormones
regulate many body functions. The pituitary influences renal function. Growth of body tissue.
The pituitary gland is often called the “master gland” because its hormones regulate many
body functions. The pituitary influences tissue growth via the hormones that it releases. Bone
density. The pituitary gland is often called the “master gland” because its hormones regulate
many body functions. The pituitary influences bone density via the hormones that it releases.
Arterial blood flow. The pituitary gland is often called the “master gland” because its
hormones regulate many body functions. The pituitary influences arterial blood flow via the
hormones that it releases. Gender traits. Gonads produce the hormones that are important for
the progression into puberty, and they control other physical traits that differentiate men from
women.
3. A client recently diagnosed with type 1 diabetes mellitus asks the nurse to explain, “What’s
wrong with my pancreas?” The nurse’s response is based on the knowledge that there is a
malfunction of pancreas:
1. Beta cells.
2. Alpha cells.
3. Delta cells.
4. PP cells.
Answer: Beta cells.
Rationale:
Throughout the pancreas are clusters of cells called the islets of Langerhans. Islets are made
up of several types of cells, including beta cells that make insulin that facilitate the uptake
and use of glucose by the cells and prevent excessive breakdown of glycogen. Alpha cells are
responsible for the production of glucagon. Delta cells produce somatostatin, which inhibits
GH, TSH, and gastrointestinal hormones, such as glucagon and insulin, by the alpha and beta
cells of the pancreas. PP cells produce pancreatic polypeptides, or digestive enzymes, which
are responsible for the exocrine activity of the pancreas.
4. A nurse is preparing to discuss the importance of neuroendrocrine regulation with a group
of nurses who work in the endocrine clinic. The nurse plans to stress that this collaborative
effort facilitates the regulation of physiological function that includes a person’s ability to:
Select all that apply.
1. Grow physically.
2. Reproduce.
3. Adapt to external changes.
4. Critically think.
5. Reason.
Answer:
1. Grow physically.
2. Reproduce.
3. Adapt to external changes.
Rationale:
Grow physically. The endocrine system’s functioning is intimately connected to that of the
nervous system. This connection is referred to as neuroendrocrine regulation. The systems
work synergistically to regulate overall physiological functioning. Through the combined
efforts of the two systems, growth and development can occur. Reproduce. The endocrine
system’s functioning is intimately connected to that of the nervous system. This connection is
referred to as neuroendrocrine regulation. The systems work synergistically to regulate
overall physiological functioning. Through the combined efforts of the two systems,
reproduction can occur. Adapt to external changes. The endocrine system’s functioning is
intimately connected to that of the nervous system. This connection is referred to as
neuroendrocrine regulation. The systems work synergistically to regulate overall
physiological functioning. Through the combined efforts of the two systems, adaptability to
changes in the external environment can occur. Critically think. Critically thinking is a
cognitive function that is not regulated by neuroendrocrine collaboration. Reason. Reasoning
is a cognitive function that is not regulated by neuroendrocrine collaboration.
5. When asked to explain the hormone regulation process directed by circadian rhythms, the
nurse provides the example of:
1. The release of cortisol to peak in the early morning.
2. The regulation of the female menstrual cycle.
3. The stimulation of insulin production by an increased level of glucose.
4. The increased production of luteinizing hormone (LH) during the menstrual cycle.
Answer: The release of cortisol to peak in the early morning.
Rationale:
An example of circadian rhythms regulation is the release of cortisol, whose peaks and
troughs vary during a 24-hour period. Infradian rhythms are those that last for more than 24
hours. This is seen in the female menstrual cycle. The increased production of insulin as
stimulated by the brain’s perception of increased serum glucose is an example of the neural
regulatory process. Feedback systems can be positive or negative. An example of positive
feedback is the release of leuteinizing hormone in response to higher estrogen levels.
6. The lock-and-key method is the process by which the endocrine system brings about
specific responses within target organ tissue. The nurse best explains this process by stating:
1. “The process relies on the target organ to react to the appropriate hormone.”
2. “Each hormone is keyed to facilitate a specific response.”
3. “Hormones are transported to the target organs via the circulatory system.”
4. “The specific process is either turned on or turned off by the hormone.”
Answer: “The process relies on the target organ to react to the appropriate hormone.”
Rationale:
The receptors within the endocrine system are able to distinguish a specific hormone from all
other chemicals in circulation and bind to it in a lock-and-key type of manner. This binding
process then triggers the target tissues or organs to produce the desired response. While each
hormone facilitates a specific response, it cannot do so unless it is recognized by the target
organ. Hormones are transported via the circulatory system to the target organs, but this does
not adequately explain the lock-and-key process. A specific hormone is required to bring
about the response that may be either to cause or stop a response by the target organ, but this
does not adequately explain the lock-and-key process.
7. The nurse is providing care to a client with hypoparathyroidism. Which of the following
assessment findings would be consistent with this diagnosis?
Select all that apply.
1. Facial grimacing
2. Abdominal cramps
3. Hair loss
4. Arrhythmias
5. Exceptionally smooth, soft skin
Answer:
1. Facial grimacing
2. Abdominal cramps
3. Hair loss
4. Arrhythmias
Rationale:
Facial grimacing. Hypoparathyroidism affects the musculoskeletal, integumentary,
gastrointestinal, cardiovascular, and central nervous systems. Assessment findings would
include facial grimacing (musculoskeletal). Abdominal cramps. Hypoparathyroidism affects
the musculoskeletal, integumentary, gastrointestinal, cardiovascular, and central nervous
systems. Assessment findings would include abdominal cramps (gastrointestinal). Hair loss.
Hypoparathyroidism affects the musculoskeletal, integumentary, gastrointestinal,
cardiovascular, and central nervous systems. Assessment findings would include hair loss
(integumentary). Arrhythmias. Hypoparathyroidism affects the musculoskeletal,
integumentary, gastrointestinal, cardiovascular, and central nervous systems. Assessment
findings would include arrhythmias (cardiovascular). Exceptionally smooth, soft skin.
Exceptionally smooth, soft skin is not a common finding in the client with
hypoparathyroidism.
8. The nurse is caring for a client diagnosed with Cushing’s disease. Which of the following
nursing interventions would have highest priority for a client with increased levels of both
cortisol and aldosterone?
1. Monitor blood pressure frequently.
2. Plan for frequent rest periods.
3. Assess for signs of infection.
4. Review coping strategies.
Answer: Monitor blood pressure frequently.
Rationale:
Increased levels of cortisol and aldosterone may result in hypertension, so frequent
monitoring of BP is a nursing priority. Providing rest periods addresses the client’s fatigue
issues but does not have priority over BP concerns. Assessing for signs of infection is
appropriate but does not have priority over BP concerns. Reviewing coping strategies is
appropriate but does not have priority over BP concerns.
9. A client is admitted with dehydration and excessive urination. The nurse realizes that the
client might be experiencing an alteration in which of the following hormones?
1. Antidiuretic hormone (ADH)
2. Follicle-stimulating hormone (FSH)
3. Adrenocorticotropic hormone (ACTH)
4. Thyroid-stimulating hormone (TSH)
Answer: Antidiuretic hormone (ADH)
Rationale:
Antidiuretic hormone, or ADH, decreases urine production by causing the renal tubules to
reabsorb water form the urine and return it to the circulating blood. This client is
demonstrating excessive urination, which might indicate an alteration in this hormone. FSH
(follicle-stimulating hormone) functions in ovum and sperm formation. ACTH
(adrenocorticotropic hormone) stimulates the adrenal function. TSH (thyroid-stimulating
hormone) stimulates thyroid function. Alteration in these hormones does not have as direct of
a relationship to the client’s symptoms as ADH does.
10. When performing an endocrine assessment, a client shares with the nurse that she has
experienced a significant weight gain over the last 4 months “without even eating any
differently.” The nurse recognizes that unexplainable weight gains can indicate secretion
dysfunction of which of the following?
Select all that apply.
1. Adrenals
2. Thyroid
3. Pituitary
4. Parathyroids
5. Gonads
Answer:
1. Adrenals
2. Thyroid
3. Pituitary
Rationale:
Adrenals. In adrenal disease, the client’s weight changes might provide information as to the
endocrine disorder the client is experiencing. The client might gain weight with increased fat
deposits in the abdomen with an adrenal disorder such as Cushing’s disease. Thyroid. In
thyroid disease, the client’s weight changes might provide information as to the endocrine
disorder the client is experiencing. The client might experience general weight gain with a
thyroid disease such as hypothyroidism. Pituitary. In adrenal disease, the client’s weight
changes might provide information as to the endocrine disorder the client is experiencing.
The pituitary gland controls ADH, which influences the renal tubules to absorb water, which
can result in fluid retention leading to weight gain. Parathyroids. The parathyroid gland
regulates calcium and phosphorous. Gonads. The gonads influence estrogen and androgens.
11. An older adult client has been given instructions concerning an endocrine assessment the
nurse will be conducting. Which statement made by the client would indicate to the nurse that
further instruction is necessary?
1. “Because of my age, they’ll be checking for hyperthyroidism.”
2. “I’ll be sure to let the nurse know that diabetes runs in my family.”
3. “The nurse will look at my skin, nails, and hair.”
4. “I’ll be asked to swallow when my thyroid gland is being checked.”
Answer: “Because of my age, they’ll be checking for hyperthyroidism.”
Rationale:
Relative to the aging population, the most frequent sign of hormonal imbalance is
hypothyroidism. Diabetes mellitus is an endocrine disorder that appears to have some degree
of family connection, so the client is correct in providing this information. The endocrine
assessment does include inspection of the skin, nails, and hair, as well as palpation of the
thyroid while asking the client to swallow.
12. The nurse is conducting a health history interview on a female client. In order to best
assess the client’s endocrine system, the nurse asks:
1. “Is your menstrual cycle regularly every 28 days?”
2. “Do you have problems with indigestion?”
3. “Is there a history of cancer in your family?”
4. “Have you ever experienced difficulty breathing?”
Answer: “Is your menstrual cycle regularly every 28 days?”
Rationale:
The client who has an irregular menstrual cycle might be experiencing an endocrine disorder
such as increased androgen production or decreased estrogen levels. Gastrointestinal and
respiratory function is not directly related to endocrine system functioning, and there is no
known connection between a dysfunction of the endocrine system and cancer.
13. When caring for a client diagnosed with Graves’ disease, the nurse recognizes the
importance of regular monitoring of which of the following laboratory results?
1. Thyroxine (T4)
2. Urine-specific gravity
3. Cortisol level
4. Calcium level
Answer: Thyroxine (T4)
Rationale:
Graves’ disease is influenced by the secretions of the thyroid gland. Thyroxine (T4) is the
hormone secreted by the thyroid gland. Urine-specific gravity would be measured to provide
information about the posterior pituitary. The adrenal gland produces cortisol. The
parathyroid gland regulates calcium and phosphorous levels.
14. A client’s endocrine system is being evaluated for dysfunction as the possible origin of his
current symptomology. When it is learned that the results of the water deprivation test
showed no changes in urine osmolality, the nurse realizes that this finding is consistent with:
1. An absence of endocrine pathology.
2. Diabetes insipidus.
3. Diabetes mellitus.
4. Syndrome of inappropriate antidiuretic hormone.
Answer: An absence of endocrine pathology.
Rationale:
In clients without pathology, there is no change in urine and plasma osmolality. Diabetes
insipidus and syndrome of inappropriate antidiuretic hormone would result in changes in
urine osmolality. Water deprivation testing is not used to detect diabetes mellitus.
15. A client has had diagnostic laboratory testing that confirms the diagnosis of metastatic
bone cancer. The nurse prepares to explain the implications of:
1. A decrease in parathyroid hormone (PTH) levels.
2. An increase in thyroid-stimulating hormone (TSH).
3. An absence of testosterone.
4. The presence of cortisol.
Answer: A decrease in parathyroid hormone (PTH) levels.
Rationale:
A decrease in parathyroid hormone (PTH) levels is reflective of the presence of metastatic
bone cancer. The remaining hormones are not evaluated for diagnosis of metastatic bone
cancer.
Test Bank for Timby's Introductory Medical-Surgical Nursing
Loretta A Donnelly-Moreno, Brigitte Moseley
9781975172237, 9781975172268
