1. A
22-year-old patient is being seen in the clinic with increased secretion of the
anterior pituitary hormones. The nurse would expect the laboratory results to
show
a. increased
urinary cortisol.
b. decreased
serum thyroxine.
c. elevated
serum aldosterone levels.
d. low
urinary catecholamines excretion.
ANS: A
Increased secretion of adrenocorticotropic hormone (ACTH) by
the anterior pituitary gland will lead to an increase in serum and urinary
cortisol levels. An increase, rather than a decrease, in thyroxine level would
be expected with increased secretion of thyroid stimulating hormone (TSH) by
the anterior pituitary. Aldosterone and catecholamine levels are not controlled
by the anterior pituitary.
2. Which
statement by a 50-year-old female patient indicates to the nurse that further
assessment of thyroid function may be necessary?
a. I notice
my breasts are tender lately.
b. I am so
thirsty that I drink all day long.
c. I get up
several times at night to urinate.
d. I feel a
lump in my throat when I swallow.
ANS: D
Difficulty in swallowing can occur with a goiter. Nocturia
is associated with diseases such as diabetes mellitus, diabetes insipidus, or
chronic kidney disease. Breast
tenderness would occur with excessive gonadal hormone
levels. Thirst is a sign of disease such as diabetes.
3. A
30-year-old patient seen in the emergency department for severe headache and
acute confusion is found to have a serum sodium level of 118 mEq/L. The nurse
will anticipate the need for which diagnostic test?
a. Urinary
17-ketosteroids
b. Antidiuretic
hormone level
c. Growth
hormone stimulation test
d. Adrenocorticotropic
hormone level
ANS: B
Elevated levels of antidiuretic hormone will cause water
retention and decrease serum sodium levels. The other tests would not be
helpful in determining possible causes of the patients hyponatremia.
4. Which
question will provide the most useful information to a nurse who is
interviewing a patient about a possible thyroid disorder?
a. What
methods do you use to help cope with stress?
b. Have you
experienced any blurring or double vision?
c. Have you
had a recent unplanned weight gain or loss?
d. Do you
have to get up at night to empty your bladder?
ANS: C
Because thyroid function affects metabolic rate, changes in
weight may indicate hyperfunction or hypofunction of the thyroid gland.
Nocturia, visual difficulty, and changes in stress level are associated with
other endocrine disorders.
5. A
29-year-old patient in the outpatient clinic will be scheduled for blood
cortisol testing. Which instruction will the nurse provide?
a. Avoid
adding any salt to your foods for 24 hours before the test.
b. You will
need to lie down for 30 minutes before the blood is drawn.
c. Come to
the laboratory to have the blood drawn early in the morning.
d. Do not
have anything to eat or drink before the blood test is obtained.
ANS: C
Cortisol levels are usually drawn in the morning, when
levels are highest. The other instructions would be given to patients who were
having other endocrine testing.
6. A
61-year-old female patient admitted with pneumonia has a total serum calcium
level of 13.3 mg/dL (3.3 mmol/L). The nurse will anticipate the need to teach
the patient about testing for levels.
a. calcitonin
b. catecholamine
c. thyroid
hormone
d. parathyroid
hormone
ANS: D
Parathyroid hormone is the major controller of blood calcium
levels. Although calcitonin secretion is a countermechanism to parathyroid
hormone, it does not play a major role in calcium balance. Catecholamine and
thyroid hormone levels do not affect serum calcium level.
7. During
the physical examination of a 36-year-old female, the nurse finds that the
patients thyroid gland cannot be palpated. The most appropriate action by the
nurse is to
a. palpate
the patients neck more deeply.
b. document
that the thyroid was nonpalpable.
c. notify
the health care provider immediately.
d. teach the
patient about thyroid hormone testing.
ANS: B
The thyroid is frequently nonpalpable. The nurse should
simply document the finding. There is no need to notify the health care
provider immediately about a normal finding. There is no indication for
thyroid-stimulating hormone (TSH) testing unless there is evidence of thyroid
dysfunction. Deep palpation of the neck is not appropriate.
8. Which
laboratory value should the nurse review to determine whether a patients
hypothyroidism is caused by a problem with the anterior pituitary gland or with
the thyroid gland?
a. Thyroxine
(T4) level
b. Triiodothyronine
(T3) level
c. Thyroid-stimulating
hormone (TSH) level
d. Thyrotropin-releasing
hormone (TRH) level
ANS: C
A low TSH level indicates that the patients hypothyroidism
is caused by decreased anterior pituitary secretion of TSH. Low T3 and T4
levels are not diagnostic of the primary cause of the hypothyroidism. TRH
levels indicate the function of the hypothalamus.
9. The nurse
reviews a patients glycosylated hemoglobin (Hb A1C) results to evaluate
a. fasting
preprandial glucose levels.
b. glucose
levels 2 hours after a meal.
c. glucose
control over the past 90 days.
d. hypoglycemic
episodes in the past 3 months.
ANS: C
Glycosylated hemoglobin testing measures glucose control
over the last 3 months. Glucose testing before/after a meal or random testing
may reveal impaired glucose tolerance and indicate prediabetes, but it is not
done on patients who already have a diagnosis of diabetes. There is no test to
evaluate for hypoglycemic episodes in the past.
Category | ATI |
Release date | 2021-09-14 |
Pages | 11 |
Comments | 0 |
Sales | 0 |
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